69 yo man with known diagnosis of meningioma and two previous attempts at removal of the tumor at a different institution. The tumor was not removed due its vascularity and its proximity to optic nerve, middle cerebral artery, and carotid artery.
On examination he had no focal neurological deficits.
Imaging
MRI scan of brain shows a left sphenoid wing meningioma arising from the dura (covering of brain) with intimate relationship with optic nerve, middle cerebral artery, carotid artery. It is causing mass effect on brainstem.
Cerebral Angiography Vascular anatomy of the tumor was studies utilizing cerebral angiography. Tumor is outlined in red.
Computer Navigation
Computer navigation and stereotaxy was utilized to map out and localize the tumor (yellow) and critical vessels (red) intra-operatively.
Post op course
Before Operation After Operation
Post op MRI shows complete resection of the tumor with no injury to surrounding neuro-vascular structures.
