ANTERIOR CLINOID MENINGIOMA
Benign brain tumor. Colored computed tomography (CT) scan of the brain of a 48-year-old patient with a meningioma (purple). This is a benign (non-cancerous) tumor that arises from the meninges, the membranes that surround the brain.
Anterior Clinoid Meningioma
Anterior Clinoid Meningioma is a tumor that arises from the dura covering the small bone process named anterior clinoid. The anterior clinoid is next to the optic nerve in the skull base. The tumor grows deep under the brain between the frontal and temporal lobes from the anterior clinoid. It can cause pressure and displacement of the optic nerve. Often, it encases the internal carotid artery and its main branches. In some cases, the tumor can grow to a formidable size before diagnosis.
Symptoms of Clinoid Meningioma
Anterior clinoid Meningioma can cause unilateral vision loss and headaches. The progression of the tumor will compress the frontal lobe and temporal lobe of the brain. This compression causes disabling seizures and cognitive dysfunction. Also, speech difficulties can occur when the tumor is on the dominant side of the brain.
Treatment
Treatment of anterior clinoid Meningioma requires surgery when the patient has vision loss, cognitive dysfunction, or seizures. Elderly patients with small tumors and minimal symptoms can be treated conservatively with surveillance MRIs. Radiation is generally not recommended in these tumors as primary treatment because they are close to the optic nerve. Because these tumors are so close to the optic nerve they do not want to risk damage with radiation.
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Surgical Treatment at the Meningioma Center
At the Meningioma Center, we use the focal orbital approach which can be used for the removal of anterior clinoid Meningiomas. This approach associated with the extradural navigation concept allows access to this tumor without hazardous exposure and only minimal direct manipulation or retraction of the brain. In selected cases, the focal orbital approach can be done through a small eyebrow incision. The approach allows for early and full decompression of the involved optic nerve and early identification for safe control of the carotid artery. Finally, the approach offers maximal potential for complete resection or removal of the tumor including its meningeal roots
Patient Prognosis after surgery
In conclusion, by utilizing the focal orbital approach patients can have a full or partial recovery. A recovery of full or partial recovery of visual difficulties, cognitive dysfunction, and speech difficulties are possible. The patients have the potential for returning to their lifestyle and their previous employment. Moreover, maximal removal of the tumor and its meningeal root maximizes the chances of a cure without tumor recurrence.