Meningiomas of meckel's cave: experience with 22 cases and review of surgical strategy

Meningiomas of Meckel's cave are rare (0.5 to 3.3% ofintracranial meningiomas) and their nosographic definition difficult. Differential diagnosis with petroclival meningiomas is often only theorical: this probably explains why less than 100 cases have been reported. Presenting symptoms frequently consist of cranial nerve deficits due to the close anatomical relationship with the cavernous sinus and the vasculo-nervous structures of the p.c.f. Despite advances in microsurgical technique and improved anatomical knowledge of this region, there is still a significant risk of cranial nerve deficits, especially when radical removal is attempted. We treated 22 patients between 1951 and 1997 and found that it is sometimes possible to adopt a less aggressive surgical strategy which is beneficial for the quality of life and survival of the patient: this finding is supported by increasingly significant published data. We believe that the role of RT in the surgical outcome of this pathology should no longer be underestimated.