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 next to the optic nerve in the skull base. From the anterior clinoid, the tumor grows deep under the brain between the frontal lobe and temporal lobe. It can cause pressure and displacement of the optic nerve and 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
Anterior clinoid Meningioma can cause unilateral vision loss and headache. The progression of the tumor will compress the frontal lobe and temporal lobe of the brain causing disabling seizures and cognitive dysfunction. 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 of the proximity to the optic nerve.
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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. The approach offers maximal potential for complete resection of the tumor including its meningeal roots
Prognosis
Full or partial recovery of visual difficulties, cognitive dysfunction, and speech difficulties are possible by using the focal orbital. Moreover, the patients have the potential for returning to their lifestyle and job occupation. Maximal removal of the tumor and its meningeal root maximizes the chances of a cure without tumor recurrence.