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Microsurgical resection of anterior clinoidal meningiomas with arterial engulfment: lessons from 2 contrasting cases. 伴有动脉吞噬的斜前脑膜瘤的显微外科切除：2例对比分析的经验教训。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25169
Umid Sulaimanov, Ufuk Erginoglu, Abdullah Keles, Yerkebulan Serikkanov, Franco Vera Figueroa, Umut Tan Sevgi, Oyku Ozturk, Mustafa K Baskaya
{"title":"Microsurgical resection of anterior clinoidal meningiomas with arterial engulfment: lessons from 2 contrasting cases.","authors":"Umid Sulaimanov, Ufuk Erginoglu, Abdullah Keles, Yerkebulan Serikkanov, Franco Vera Figueroa, Umut Tan Sevgi, Oyku Ozturk, Mustafa K Baskaya","doi":"10.3171/2025.10.FOCVID25169","DOIUrl":"10.3171/2025.10.FOCVID25169","url":null,"abstract":"<p><p>Anterior clinoidal meningiomas are among the most complex skull base tumors because of their proximity to the optic apparatus, internal carotid artery (ICA), and its branches. When vessels are engulfed or encased, the difficulty of resection and the risk to the vasculature increase significantly. Surgical management requires balancing maximal resection with neurovascular preservation. The authors present 2 cases with ICA engulfment. The first involved anterior choroidal artery injury managed using collateral assessment, neurophysiological monitoring, and indocyanine green angiography as a surrogate intraoperative balloon test occlusion. The second emphasizes meticulous dissection and progressive debulking to achieve gross-total resection while preserving neurological function. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25169.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V3"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic endonasal approach for a tuberculum sellae meningioma with optic canal involvement. 经鼻内镜入路治疗累及视神经管的鞍结节脑膜瘤。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25151
Shunsuke Shibao, Yusuke Morinaga, Takeshi Hongo, Sotaro Oshida, Takashi Kashiwagi, Yasuhiro Tsunemi, Ryu Kurokawa, Tsuguhisa Nakayama, Hiroyoshi Akutsu
{"title":"Endoscopic endonasal approach for a tuberculum sellae meningioma with optic canal involvement.","authors":"Shunsuke Shibao, Yusuke Morinaga, Takeshi Hongo, Sotaro Oshida, Takashi Kashiwagi, Yasuhiro Tsunemi, Ryu Kurokawa, Tsuguhisa Nakayama, Hiroyoshi Akutsu","doi":"10.3171/2025.10.FOCVID25151","DOIUrl":"10.3171/2025.10.FOCVID25151","url":null,"abstract":"<p><p>The endoscopic endonasal approach has emerged as an effective and minimally invasive technique for the management of tuberculum sellae meningiomas. A 53-year-old woman with progressive visual deterioration due to a tuberculum sellae meningioma extending into the optic canal underwent endoscopic endonasal resection with optic canal decompression. Gross-total removal was achieved using a \"French-door\" dural opening and angled dissection, resulting in Simpson grade II resection with the preservation of neurovascular structures. Optic canal opening enabled safe tumor removal and significant visual improvement. Reconstruction employed sutured fascia lata grafts and a sphenoid sinus mucosal flap resulted in no postoperative cerebrospinal fluid leakage. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25151.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V13"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two-stage approach for olfactory groove meningioma. 两阶段入路治疗嗅沟脑膜瘤。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25185
Matthieu D Weber, James Mamaril-Davis, Mark A Damante, Daniel M Prevedello
{"title":"Two-stage approach for olfactory groove meningioma.","authors":"Matthieu D Weber, James Mamaril-Davis, Mark A Damante, Daniel M Prevedello","doi":"10.3171/2025.10.FOCVID25185","DOIUrl":"10.3171/2025.10.FOCVID25185","url":null,"abstract":"<p><p>A 51-year-old female presented with an olfactory groove meningioma causing seizures, confusion, and anosmia. Large tumor size and frontal lobe edema can complicate resection in a single-stage craniotomy and lead to brain injury secondary to intraoperative retraction. Moreover, complete resection by the endoscopic endonasal approach (EEA) alone is not feasible given the lateral extent of the tumor. A two-stage resection with a transcribriform transplanum EEA, followed by a fronto-temporo-parietal craniotomy 4.5 months later, was performed. The EEA allows for initial decompression, devascularization, and reduction of edema, which may decrease the morbidity of craniotomy by reducing the significance of frontal lobe retraction. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25185.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lateral supraorbital approach for large olfactory groove meningioma and unruptured large anterior communicating artery aneurysm: operative video and technical considerations. 外侧眶上入路治疗大嗅沟脑膜瘤和未破裂的大前交通动脉瘤：手术录像和技术考虑。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25165
Nobuyuki Watanabe, Verónica de Los Santos, Tingting Jiang, Arianna Fava, Mamoune El Mostarchid, Sébastien Froelich
{"title":"Lateral supraorbital approach for large olfactory groove meningioma and unruptured large anterior communicating artery aneurysm: operative video and technical considerations.","authors":"Nobuyuki Watanabe, Verónica de Los Santos, Tingting Jiang, Arianna Fava, Mamoune El Mostarchid, Sébastien Froelich","doi":"10.3171/2025.10.FOCVID25165","DOIUrl":"10.3171/2025.10.FOCVID25165","url":null,"abstract":"<p><p>Anterior skull base meningiomas can be approached via frontotemporal, interhemispheric, lateral supraorbital (LSO), transeyebrow supraorbital, or endonasal transsphenoidal approaches. The LSO approach, with extensive orbital roof drilling, provides a sufficient corridor to reach tumors located most anteriorly while achieving a favorable cosmetic outcome. This video demonstrates the utility of the LSO approach for resection of a large olfactory groove meningioma infiltrating the pia mater and clipping of a large anterior communicating artery (Acom) aneurysm. Even for a superiorly projecting Acom aneurysm, the space created after tumor resection allowed wide interhemispheric dissection and adequate exposure of the aneurysm. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25165.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combined lateral and ventral approach for 360° decompression of an intraosseous suprasellar meningioma encasing the optic nerve. 外侧腹侧联合入路360°减压包膜视神经的骨内鞍上脑膜瘤。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25187
Adway Gopakumar, Shovan Bhatia, Eric W Wang, Georgios A Zenonos
{"title":"Combined lateral and ventral approach for 360° decompression of an intraosseous suprasellar meningioma encasing the optic nerve.","authors":"Adway Gopakumar, Shovan Bhatia, Eric W Wang, Georgios A Zenonos","doi":"10.3171/2025.10.FOCVID25187","DOIUrl":"10.3171/2025.10.FOCVID25187","url":null,"abstract":"<p><p>Suprasellar meningiomas present operative challenges because of their involvement with cranial nerves and neurovascular structures. The optimal approach for suprasellar meningiomas encasing the optic nerve remains debated. This video presents a patient with profound vision loss limited to hand motion, arising from a calcified suprasellar meningioma with 360° optic nerve encasement, which was resected via an anterolateral approach with extradural anterior clinoidectomy followed by an endoscopic endonasal approach. Postoperatively, vision improved to 20/30 at 2 months with no recurrence at 2 years. This case highlights the complementary roles of transcranial and endonasal strategies in safely resecting an intraosseous suprasellar meningioma encasing the optic nerve. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25187.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V20"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic endonasal resection of a large recurrent tuberculum sellae meningioma with vascular adherence. 经鼻内窥镜切除复发性大鞍结节脑膜瘤伴血管粘连。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25148
Ashutosh Carpenter, Jaskaran S Gosal, Akhilesh Gowda G Basappa, Syed Yasin S S Emanee, Pooja Choudhary, Easwer H Venkat, Krishnakumar Kesavapisharady, Gowtham Matham, Prakash Nair
{"title":"Endoscopic endonasal resection of a large recurrent tuberculum sellae meningioma with vascular adherence.","authors":"Ashutosh Carpenter, Jaskaran S Gosal, Akhilesh Gowda G Basappa, Syed Yasin S S Emanee, Pooja Choudhary, Easwer H Venkat, Krishnakumar Kesavapisharady, Gowtham Matham, Prakash Nair","doi":"10.3171/2025.10.FOCVID25148","DOIUrl":"10.3171/2025.10.FOCVID25148","url":null,"abstract":"<p><p>Tuberculum sellae meningiomas often compress the optic apparatus and encase the ACA-ACom complex, making approach selection challenging. This video demonstrates endoscopic endonasal resection of a large, recurrent, tuberculum sellae meningioma with severe adherence to the ACA-ACom complex. A transplanum-transtuberculum corridor provided direct access to the dural base, enabling early tumor devascularization and meticulous dissection of microvasculature to the optic nerves, pituitary stalk, and hypothalamus. Unroofing the optic canal facilitated early optic nerve decompression, reducing the risk of neural injury during tumor manipulation. Multilayer skull base reconstruction achieved watertight closure. Gross-total resection was achieved without ischemic sequelae, and postoperative visual function improved significantly. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25148.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V15"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Giant planum sphenoidale meningioma: rationale for Dolenc's step in the pterional approach. 巨大蝶形平面脑膜瘤：翼点入路Dolenc步骤的基本原理。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25172
Akshohini Garg, Kuntal Kanti Das, Sudarsana Gogoi, Arun Srivastava
{"title":"Giant planum sphenoidale meningioma: rationale for Dolenc's step in the pterional approach.","authors":"Akshohini Garg, Kuntal Kanti Das, Sudarsana Gogoi, Arun Srivastava","doi":"10.3171/2025.10.FOCVID25172","DOIUrl":"10.3171/2025.10.FOCVID25172","url":null,"abstract":"<p><p>Large meningiomas of the midline anterior skull base do not respect anatomical boundaries. Therefore, a giant planum sphenoidale meningioma has the unique risk of simultaneously endangering the olfactory and visual functions. A pterional approach to such cases has several advantages, and the Dolenc's modification allows a complete extradural anterior clinoidectomy, early release of compressed optic nerve, and exposure of basal portions of the internal carotid artery with a possible operative corridor expansion. This enhances tumor resection ergonomics with a more basal angle of attack while visualizing the anterior-to-posterior expanse of the entire anterior skull base. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25172.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V5"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contralateral orbitopterional approach for anterior skull base meningioma resection. 前颅底脑膜瘤切除术的对侧眶眼入路。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25189
Serdar Rahmanov, Mohammadmahdi Sabahi, Qais Alrashidi, Hamid Borghei-Razavi, Badih A Adada
{"title":"Contralateral orbitopterional approach for anterior skull base meningioma resection.","authors":"Serdar Rahmanov, Mohammadmahdi Sabahi, Qais Alrashidi, Hamid Borghei-Razavi, Badih A Adada","doi":"10.3171/2025.10.FOCVID25189","DOIUrl":"10.3171/2025.10.FOCVID25189","url":null,"abstract":"<p><p>The authors present the resection of an anterior skull base parasellar meningioma causing vasogenic edema due to compression of the frontopolar vein. A contralateral orbitopterional craniotomy was chosen to provide a minimally invasive approach while avoiding morbidity from a bifrontal approach. Extradural removal of the orbital roof minimized frontal lobe retraction. The infrafrontal corridor enabled identification and preservation of the olfactory and optic nerves, the carotid artery, and the frontopolar vein. Circumferential microsurgical dissection with low-power bipolar coagulation enabled en bloc tumor removal. Postoperative MRI confirmed gross-total resection, resolution of the edema, and preservation of the vein. The patient had an uneventful recovery and intact neurological function at the 5-week follow-up. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25189.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V6"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic transnasal "microsurgery" for suprasellar meningioma involving the anterior communicating artery complex. 经鼻内窥镜“显微手术”治疗鞍上脑膜瘤累及前交通动脉复合体。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25131
Hirotaka Hasegawa, Shunya Hanakita, Masahiro Shin, Yuki Shinya, Motoyuki Umekawa, Taichi Kin, Nobuhito Saito
{"title":"Endoscopic transnasal \"microsurgery\" for suprasellar meningioma involving the anterior communicating artery complex.","authors":"Hirotaka Hasegawa, Shunya Hanakita, Masahiro Shin, Yuki Shinya, Motoyuki Umekawa, Taichi Kin, Nobuhito Saito","doi":"10.3171/2025.10.FOCVID25131","DOIUrl":"10.3171/2025.10.FOCVID25131","url":null,"abstract":"<p><p>This video demonstrates endoscopic transnasal \"microsurgery\" for a suprasellar meningioma involving the anterior communicating artery complex. A 44-year-old woman presented with visual loss due to a suprasellar tumor. Preoperative three-dimensional simulation aided in planning the expanded skull base exposure. Using bimanual dissection and meticulous vascular handling, the tumor was resected while preserving critical structures. Skull base reconstruction employed multilayered techniques with dural suturing. This case illustrates how endoscopic microsurgical strategies enable safe resection of anatomically challenging tumors, combining the benefits of endoscopic visualization and microsurgical precision for optimal outcomes. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25131.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V11"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microsurgical management of anterior clinoidal meningioma with internal carotid artery compression following pregnancy-associated tumor growth. 妊娠相关肿瘤生长后颈动脉压迫的颈内动脉前脑膜瘤显微外科治疗。
Neurosurgical focus: Video Pub Date : 2026-01-01 DOI: 10.3171/2025.10.FOCVID25130
Toshikazu Kimura, Shunsuke Ichi
{"title":"Microsurgical management of anterior clinoidal meningioma with internal carotid artery compression following pregnancy-associated tumor growth.","authors":"Toshikazu Kimura, Shunsuke Ichi","doi":"10.3171/2025.10.FOCVID25130","DOIUrl":"10.3171/2025.10.FOCVID25130","url":null,"abstract":"<p><p>Meningiomas may enlarge during pregnancy. This video presents a case of an anterior clinoidal meningioma that showed rapid growth during a patient's second trimester of pregnancy, leading to marked stenosis of the internal carotid artery (ICA). In clinoidal meningiomas, early identification of the proximal ICA and middle cerebral artery is essential for safe orientation and efficient resection. However, a narrowed ICA increases the risk of dissection and, in young patients with large tumors, securing distal control can be challenging. This video highlights technical nuances for safe dissection in such cases. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25130.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 1","pages":"V7"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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