A comprehensive overview of the contemporary management of skull base meningiomas Meningiomas, the second most frequent of intracranial tumors, are characterized by a protean range of possible locations and appearances, due to their origin from the extensive and intricately formed meninges. As such, a wide variety of differential diagnoses is typical, and the therapies chosen are necessarily highly variable. The introductory chapters of this book cover the pathology of these tumors, the evolution of special surgical methods, instrumentation, intraoperative monitoring, and the role of radiosurgery. Ten surgical chapters cover the individual regions of occurrence, including the sphenoid wing, olfactory groove, cerebellopontine angle, etc., all of which require a specialized approach and therapeutic strategy. Key Features: Discussion of pathology and therapy organized by anatomic location of the lesions with the goal of providing best patient outcomes New WHO meningioma classification system based on most recent research in growth patterns, gene sequencing, and molecular patterns of development Important updates on the newest developments in treatment modalities for meningioma, including the lesser invasive radiotherapy and radiosurgery for the smaller lesions and to avoid the necessity of performing radical surgery Meningiomas of the Skull Base: Treatment Nuances in Contemporary Neurosurgery is an essential reference guide for neurosurgeons and neurologists (in training and in practice) and will also be welcomed by skull base surgeons and otolaryngologists.

Although surgery of the skull base still represents a frontier involving different specialties, it is increasingly being accepted and recognized as a special area po sing both unique diagnostic and surgical challenges and specific requirements. This is the prime reason that colleagues involved in the management of skull base processes need special training stressing the different surgical approaches required either at different times or to reach the different areas of this intriguing anatomi cal landmark. Although the advent of microsurgical techniques and advanced diagnostic mo dalities - high-resolution computed tomography, magnetic resonance imaging (MRI) and MR-angiography, and supers elective endovascular protocols - in the last 25 years has brought significant improvements, such as the recent advances in endovascular treatment, a number of different kinds of limitations still persist. This is especially so in the case of skull base meningiomas, the pathological entity most frequently affecting this area which the neurosurgeon is confronted with in daily practice. Besides understanding the intrinsic characteristics of the different pathological entities which involve the skull base, it is the responsibility of physi cians to know and employ the expanded neurosurgical options in the most effecti ve and appropriate way.

This book is a practical guide on image-guided robotic (CyberKnife®) radiosurgery of the brain and the spine. The volume introduces the radiosurgical community to the potential of image-guidance in the treatment of neurosurgical diseases including neuro-oncological, vascular and functional disorders. Principles of image-guided radiosurgery, including physics and radiobiology are considered. Each chapter provides a critical review of the literature and analyses of several aspects to offer an assessment of single and hypofractionated treatments. Based on the authors’ experience, tables or summaries presenting the treatment approaches and associated risks are included as well. Providing a practical guide to define the selection of dose, fractionation schemes, isodose line, margins, imaging, constraints to the structures at risk will support safe practice of neuroradiosurgery. This book aims to shed new light on the treatment of neoplastic and non-neoplastic diseases of the central nervous system using the CyberKnife® image-guided robotic radiosurgery system. It will be adopted by neurosurgery residents and neurosurgery consultants as well as residents in radiation oncology and radiation oncologists; medical physicists involved in radiosurgery procedures may also benefit from this book.

In recent years, interest in the management of anterior skull base tumors has been fostered by the introduction and subsequent rapid expansion of indications of transnasal endoscopic techniques. In parallel, extraordinary progress has been made in all the other disciplines which are involved in the complex process of managing anterior skull base tumors, leading to substantial improvements in diagnosis and treatment. The anterior skull base can be involved in a large variety of tumors of a varying nature and histology, which in the majority of cases originate from adjacent anatomic sites. In fact, primary lesions of the anterior skull base mainly include osteoma and other tumors originating from bone and cartilage. Tumors involving the anterior skull base have their origin prevalently in the sinonasal tract, but lesions developing on the intracranial site, such as meningiomas, may also extend caudally to encroach upon this area. All these lesions are rare, which means that the pertinent literature does not include prospective studies or treatment guidelines based on a high level of evidence. In view of the extreme histological variability of lesions involving the anterior skull base, much emphasis has been placed on addressing the different nuances of treatment in relation to histology, especially for malignant tumors. The chapters focusing on surgery provide divergent views on selection criteria for a specific surgical technique, which is the aim of this publication.

Al-Mefty's Meningiomas, Second Edition is the definitive guide to meningioma diagnosis, treatment, and surgery, and reflects over a decade of major advances in the diagnosis and management of both intracranial and spinal meningiomas since the first edition was published.The text begins with important information on anatomy, pathology, and epidemiology, followed by clinical and preoperative considerations. The expert authors then provide detailed descriptions of state-of-the-art surgical approaches listed by anatomical site and special operative considerations for intracranial meningiomas. The book closes with incisive discussion of breakthroughs in radiosurgery, radiotherapy and chemotherapy.Features[li]New to this edition: information on molecular biology, natural history and growth rates, the rise of radiosurgery as a viable treatment option, and much more[/li][li]Over 500 high-quality radiographic images and full-color illustrations demonstrate anatomy and surgery[/li][li]In-depth coverage of intraoperative MRI and endoscopic resection[/li][li]Key topics often missing from other meningiomas texts including caseload management, and postoperative quality of life issues[/li]This landmark reference will enhance the precision and surgical skills of every clinician or resident in neurosurgery or neurology.

Although surgery of the skull base still represents a frontier involving different specialties, it is increasingly being accepted and recognized as a special area po sing both unique diagnostic and surgical challenges and specific requirements. This is the prime reason that colleagues involved in the management of skull base processes need special training stressing the different surgical approaches required either at different times or to reach the different areas of this intriguing anatomi cal landmark. Although the advent of microsurgical techniques and advanced diagnostic mo dalities - high-resolution computed tomography, magnetic resonance imaging (MRI) and MR-angiography, and supers elective endovascular protocols - in the last 25 years has brought significant improvements, such as the recent advances in endovascular treatment, a number of different kinds of limitations still persist. This is especially so in the case of skull base meningiomas, the pathological entity most frequently affecting this area which the neurosurgeon is confronted with in daily practice. Besides understanding the intrinsic characteristics of the different pathological entities which involve the skull base, it is the responsibility of physi cians to know and employ the expanded neurosurgical options in the most effecti ve and appropriate way.

The overall incidence of meningiomas, particularly in the developed countries, is rising due to a growing size of the aging population, with people living longer and enjoying healthier lives than ever before. Additionally, an increased utilization of imaging studies such as computer tomography (CT) and magnetic resonance (MR) for routine evaluation of closed head injuries, paranasal sinus problems and various non-specific neurological symptoms, ranging from headaches to dizziness, has contributed to enhanced detection of incidental meningiomas. The book contains the most up-to-date information in all matters related to meningiomas, and is written by multiple contributors - internationally recognized experts in their respective fields from Asia, USA and Europe. This is an essential reference guide to neurosurgeons and neurologists (in training and in practice), as well as medical libraries, throughout the world.