Large Pontine Cavernoma Operated by Anterior Petrosal Approach-Two-Dimensional Operative Video.

Brainstem cavernoma is a challenging neurosurgical pathology and microsurgery remains the only treatment option. Although the decision-making between interventional and conservative approach to this disease may be complex, malformations presenting multiple bleedings are usually good candidates for surgery. 1 On the other hand, microsurgical resection of cavernomas can offer an effective resolution with acceptable morbidity.

Anterior Petrosal Approach to Petrous Apex Meningioma: Climbing the Rock-Two-Dimensional Operative Video.

A 47-year-old woman was referred to the neurological surgery department after a self-limiting episode of dizziness and headache. Magnetic resonance imaging showed an extra-axial mass in the right petrous apex, suggesting a meningioma. We chose the anterior petrosal approach (APA) because meningioma is a benign tumor with brainstem compression, and our goal was total removal for potential cure of the disease.

Clinoidal Meningioma with Cavernous Sinus Invasion.

We present a-49-year old female presenting headache and progressive right eye visual loss in the last 6 months. Magnetic resonance imaging showed a large clinoidal meningioma on the right side, invading the superior, lateral and medial aspects of the cavernous sinus, the optic canal, and the clinoidal segment of the internal carotid artery (ICA). A cranio-orbital approach was performed.

Spheno-Orbital Meningioma with Cavernous Sinus Extension.

We present a case of a 37-year-old female, with progressive left eye proptosis and an extensive ipsilateral en plaque spheno-orbital meningioma, with diffuse involvement of the lateral wall of the cavernous sinus and the orbit. A cranio-orbital zygomatic approach was performed to reach all extension of the lesion. We made an extradural clinoidectomy and an extensive bone removal of the orbit, exposition of the superior and lateral walls of the cavernous sinus, unroofing of the optic canal, superior orbital fissure, foramen rotundum, and foramen ovale.