Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Objectives: Sphenoidal meningiomas represent 11.9% of intracranial meningiomas. They still present a difficult surgical challenge as they may encase internal carotid artery and middle cerebral artery as well as cranial nerves, besides it may extend to the brainstem. No previous studies have focused on the incidence and outcome of brainstem affection in these cases. Our aim was to present a series of surgically treated sphenoid ridge meningiomas patients with clinical and/or radiological evidence of brainstem involvementand to focus on its incidence and outcome. Patients and methods: Retrospective review of the records of the patients with sphenoid ridge meningiomas admitted to Kasr Al Ainy hospitals within the last two years as well as their follow up records to detect their outcome. Results: The incidence of brainstem involvement was found to be 70% in our study. Total excisionwas achieved in all cases with good outcome in nearly all patients (80 %) as measured by KPS. We had one mortality in our series caused probably by irreversible damage to brain stem on presentation. No recurrence was documented during the follow up period. Conclusion: The involvement of brainstem in cases of sphenoid wing meningiomas is not uncommon and may be by the direct effect of tumor itself or indirect by the edematous brain and it usually has a good prognosis and outcome

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