open access

Vol 48, No 6 (2014)
Original research articles
Submitted: 2014-05-04
Get Citation

Falcotentorial and velum interpositum meningiomas: Two distinct entities of the pineal region

Arkadiusz Nowak1, Tomasz Dziedzic1, Tomasz Czernicki1, Przemysław Kunert1, Andrzej Marchel1
DOI: 10.1016/j.pjnns.2014.09.009
·
Neurol Neurochir Pol 2014;48(6):397-402.
Affiliations
  1. Department of Neurosurgery, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland

open access

Vol 48, No 6 (2014)
Original research articles
Submitted: 2014-05-04

Abstract

Objective

Among pineal region lesions meningiomas are extremely rare and include falcotentorial and velum interpositum meningiomas. It is very difficult to discriminate between these two lesions and description of the clinical presentation and the surgical technique in approaching these tumors is limited. We respectively analyzed a series of patients harboring pineal region meningiomas with regard to clinical features, neuroimaging studies, and results of surgical treatment.

Methods

Clinical data of 5 women and 1 man with pineal region meningiomas treated between January 1993 and December 2012 were retrospectively reviewed. All patients were assessed preoperatively with MRI and cerebral angiography. The only surgical approach we used was occipital transtentorial route.

Results

There were four falcotentorial and two velum interpositum meningiomas. The main presenting symptom was headache, dizziness and gait disturbance. The angiogram revealed that these tumors were fed by tentorial artery, posterior choroidal arteries, and branches of the posterior cerebral artery and in four cases additional evidence of occlusion of the galenic venous system was seen. Two patients had total resection (Simpson Grade I and Grade II) and in four patients small remnants of tumor were left (Simpson Grade III). No death occurred in this series. The most common complication after surgery was homonymous hemianopsia which fully recovered in all patients in the follow-up.

Conclusion

The falcotentorial and velum interpositum meningiomas can be safely managed with the use of occipital transtentorial approach. Homonymous hemianopsia is the most common although always transient complication of surgery.

Abstract

Objective

Among pineal region lesions meningiomas are extremely rare and include falcotentorial and velum interpositum meningiomas. It is very difficult to discriminate between these two lesions and description of the clinical presentation and the surgical technique in approaching these tumors is limited. We respectively analyzed a series of patients harboring pineal region meningiomas with regard to clinical features, neuroimaging studies, and results of surgical treatment.

Methods

Clinical data of 5 women and 1 man with pineal region meningiomas treated between January 1993 and December 2012 were retrospectively reviewed. All patients were assessed preoperatively with MRI and cerebral angiography. The only surgical approach we used was occipital transtentorial route.

Results

There were four falcotentorial and two velum interpositum meningiomas. The main presenting symptom was headache, dizziness and gait disturbance. The angiogram revealed that these tumors were fed by tentorial artery, posterior choroidal arteries, and branches of the posterior cerebral artery and in four cases additional evidence of occlusion of the galenic venous system was seen. Two patients had total resection (Simpson Grade I and Grade II) and in four patients small remnants of tumor were left (Simpson Grade III). No death occurred in this series. The most common complication after surgery was homonymous hemianopsia which fully recovered in all patients in the follow-up.

Conclusion

The falcotentorial and velum interpositum meningiomas can be safely managed with the use of occipital transtentorial approach. Homonymous hemianopsia is the most common although always transient complication of surgery.

Get Citation

Keywords

Meningioma, Falcotentorial junction, Velum interpositum, Surgical approach

About this article
Title

Falcotentorial and velum interpositum meningiomas: Two distinct entities of the pineal region

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 48, No 6 (2014)

Pages

397-402

Page views

305

Article views/downloads

557

DOI

10.1016/j.pjnns.2014.09.009

Bibliographic record

Neurol Neurochir Pol 2014;48(6):397-402.

Keywords

Meningioma
Falcotentorial junction
Velum interpositum
Surgical approach

Authors

Arkadiusz Nowak
Tomasz Dziedzic
Tomasz Czernicki
Przemysław Kunert
Andrzej Marchel

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl