Publish in this journal
Journal Information
Vol. 25. Num. 3.May - June 2014
Pages 99-148
Share
Share
Download PDF
More article options
ePub
Visits
1174
Vol. 25. Num. 3.May - June 2014
Pages 99-148
Case report
DOI: 10.1016/j.neucir.2013.10.003
Full endoscopic endonasal transclival approach: Meningioma attached to the ventral surface of the brainstem
Abordaje endonasal transclival: Meningioma implantado en la superficie ventral del tronco cerebral
Visits
1174
Juan Antonio Simal Julian??
Corresponding author
juanantonio.simal@gmail.com

Corresponding author.
, Pablo Sanromán Álvarez, Pablo Miranda Lloret, Estela Plaza Ramirez, Pedro Pérez Borreda, Carlos Botella Asunción
Neurosurgical Department, HUyP La Fe de Valencia, Valencia, Spain
This item has received
1174
Visits
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (1)
Table 1. Published infratentorial meningiomas without dural attachment.
Abstract
Background

Intracranial meningiomas without dural attachment (MWODA) are rare entities. We present the first case published, to the best of our knowledge, regarding a MWODA attached to the ventral surface of the brainstem. This location makes the patient subsidiary to treatment through an expanded endonasal transclival approach.

Clinical presentation

A 16-year-old female with suspected diagnosis of recurrence of a clear cell meningioma (CCM) at a distance from the initial lesion, located on the premedullary cistern. The patient underwent a pure endoscopic low transclival approach. The attachment to the ventral surface of the brainstem was confirmed intraoperatively. Postoperative MRI confirmed gross total resection and treatment was complemented with adjuvant fractionated stereotactic radiotherapy. No complications related to the procedure were observed.

Conclusion

MWODA may appear attached to the ventral brainstem. The expanded endonasal approach to the clivus provides a critical anatomical advantage in the treatment of medial lesions, even ventral meningiomas, to the lower cranial nerves. Reconstruction principles must be strictly respected to reduce complications.

Keywords:
Transclival approach
Dural attachment
Endonasal
Endoscope
Meningioma
Resumen
Introducción

Los meningiomas sin implantación dural MSID son una rara entidad. Presentamos el primer caso publicado en nuestro conocimiento, de MSID implantado en la superficie ventral del tronco cerebral. Dicha localización permite la realización de un abordaje quirúrgico endonasal expandido transclival para su tratamiento.

Caso clínico

Paciente mujer de 16 años con la sospecha de presentar una recurrencia de meningioma de células claras localizada en la cisterna prebulbar a distancia de la lesión inicialmente tratada. Se llevó a cabo un abordaje endonasal expandido transclival. El hallazgo de implantación en la cara ventral del tronco cerebral fue claramente evidenciado en el acto quirúrgico. La RM cerebral postoperatoria confirmó la resección completa y el tratamiento fue completado con radioterapia estereotáctica fraccionada. No se presentaron complicaciones relacionadas con los procedimientos.

Conclusión

Los MSID pueden presentarse en íntima relación con la cara ventral del tronco cerebral. El abordaje endonasal expandido transclival otorga ventajas anatómicas importantes a la hora de tratar lesiones de localización medial, incluso meningiomas ventrales a los pares craneales bajos. Las técnicas reconstructivas deben ser estrictamente respetadas para minimizar complicaciones.

Palabras clave:
Abordaje transclival
Endonasal
Endoscopio
Implantación dural
Meningioma

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Contact
Telephone
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
902 88 87 40
Calls from outside Spain
+34 932 418 800
E-mail
Idiomas
Neurocirugía (English edition)

Subscribe to our Newsletter

Article options
Tools
Supplemental materials
es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.