Search Our Scientific Publications & Authors

Front Oncol 2021 4;11:672228. Epub 2021 Jun 4.

Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany.

Objective: Spheno-orbital meningiomas (SOM) are rare intracranial tumors that arise at the sphenoid wing. These tumors can invade important neurovascular structures making radical resection difficult, while residual tumors often lead to recurrence. The purpose of this study was to evaluate prognostic factors influencing the recurrence and progression-free survival (PFS) rates of spheno-orbital meningiomas, with a particular focus on the role of surgery and postoperative radiotherapy. Read More

Neurochirurgie 2021 May 26. Epub 2021 May 26.

Department of Neurosurgery, USA. Electronic address:

Background: Sphenoid wing meningiomas are a challenging surgical disease with relatively high perioperative morbidity. Most studies to date have focused on resection strategies as it relates to disease recurrence. Few have examined the optimal strategy as it relates to overall patient survival. Read More

Oper Neurosurg (Hagerstown) 2021 Apr 30. Epub 2021 Apr 30.

Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.

The optic canal (OC) is a bony channel that transmits the optic nerve (ON) and ophthalmic artery (OphA) as they course through the lesser wing of the sphenoid bone to the orbital apex. The OC is involved in a variety of intracranial and extracranial pathologies,1 and opening of the canal may be necessary in order to achieve adequate exposure, better disease control, and vision preservation.2 Depending on the location of the pathology and its relationship with the optic nerve, the OC may be decompressed through an open transcranial approach or an endoscopic endonasal approach. Read More

World Neurosurg 2021 Apr 22;151:44-51. Epub 2021 Apr 22.

Department of Neurosurgery, Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil.

Background: Single-stage surgical treatment of cranial intraosseous meningiomas includes complete tumor resection followed by aesthetic reconstruction. Tailored tumor resection with a computer-aided design/computer-aided manufacturing custom-made implant for the defect has been advocated in recent years to achieve a satisfactory cosmetic result with reduced operative time and fewer complications. However, several technical nuances related to the area of osseous removal may compromise cranioplasty. Read More

Ocul Oncol Pathol 2021 Mar 30;7(1):54-61. Epub 2020 Nov 30.

Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom.

Purpose: To describe our experience in performing biopsy of post-septal orbital masses with core needle under computerized tomography guidance (CT-CNB).

Methods: The medical records of all patients who underwent this procedure were reviewed. The procedure was performed under local anesthesia on a day case basis under a peribulbar block. Read More

Ophthalmic Plast Reconstr Surg 2021 Mar 24. Epub 2021 Mar 24.

Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital Centre for Eye Research Australia, University of Melbourne Department of Radiology, St Vincent's Hospital, Melbourne, Victoria, Australia Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.

Purpose: To review the imaging features of the broad range of nonmeningioma lesions of the greater wing of the sphenoid (GWS) bone and adjacent orbit to assist clinicians in differentiating these lesions from each other and from the most common lesion of the GWS and adjacent orbit, meningioma.

Methods: We reviewed 32 cases of spheno-orbital lesions involving the GWS from our own practice, as well as 109 published cases (total 141), with emphasis on available imaging features on computerized tomography (CT) and MRI. Features that might assist in differentiating meningioma from its mimics were analyzed for each lesion, including the presence of an osteoblastic or hyperostotic response, bone erosion or osteolysis, homogeneous hypo- or hyperintensity on T2-weighted MRI, leptomeningeal involvement, and the absence of a "dural tail" on contrast-enhanced MRI. Read More

J Radiol Case Rep 2021 Jan 31;15(1):1-10. Epub 2021 Jan 31.

Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Malaysia.

A 46-year-old male presented with painless, recurrent bilateral ear discharge and an enlarging right temporal swelling. There were no neurological deficits. Imaging revealed an enhancing, soft tissue mass at the right infratemporal region involving the right temporalis muscle with a small, enhancing intradural component and associated hyperostosis of the greater wing of the right sphenoid bone. Read More

Asian J Neurosurg 2020 Oct-Dec;15(4):1031-1033. Epub 2020 Oct 19.

Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh, India.

Atrial fibrillation (AF) has been associated with cancer. However, the literature regarding the occurrence of AF in patients with brain tumors is limited. Neuroanatomic connections between the brain and the heart may affect heart rate and rhythm. Read More

J Community Hosp Intern Med Perspect 2021 Jan 26;11(1):156-157. Epub 2021 Jan 26.

Department of Internal Medicine, Reading Hospital and Medical Center, Reading, PA, USA.

Cerebral venous sinus thrombosis may present with transient aphasia and focal seizure-likeactivity mimicking a TIA or stroke. In this case, the patient's presentation was further complicated by non-diagnostic CT findings, which can be common in up to 27% of cases [1]. An 86-year-old right-handed male with a history of colon adenocarcinoma status post resection and recent surgery for right sphenoid wing meningioma presented to the ED with transient episodes of fluent aphasia lasting approximately 10 minutes and one episode of involuntary right-hand clenching, both of which resolved spontaneously and were concerning for possible TIA. Read More

Cancers (Basel) 2021 Jan 25;13(3). Epub 2021 Jan 25.

Department of Neurosurgery, University Hospital, Goethe University Frankfurt, 60528 Frankfurt am Main, Germany.

Seizures are among the most common symptoms of meningioma. This retrospective study sought to identify risk factors for early and late seizures in meningioma patients and to evaluate a modified STAMPE2 score. In 556 patients who underwent meningioma surgery, we correlated different risk factors with the occurrence of postoperative seizures. Read More

Chin Neurosurg J 2020 Nov 2;6(1):35. Epub 2020 Nov 2.

Department of Neurosurgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China.

Background: Three-dimensional (3D) fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively.

Methods: We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors' location, volume, cavernous sinus involvement, vascular encasement, and bone invasion by 3D multimodality fusion imaging. Read More

Neurochirurgie 2021 Jul 3;67(4):391-395. Epub 2020 Dec 3.

Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, 410W. 10th Ave., N-1049 Doan Hall, Columbus, OH 43210, United States; Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Wexner Medical Center, Columbus, OH, United States. Electronic address:

Introduction: Extradural anterior clinoidectomy (eAC) is key to expose the paraclinoid region. Several authors have pointed limitations of performing an eAC through a supraorbital craniotomy. In this article, we aim to provide educational material and discuss the technical nuances to successfully perform an eAC throughout a modification of the supraorbital approach, the extradural extended eyebrow approach (xEBA+eAC). Read More

Surg Neurol Int 2020 2;11:314. Epub 2020 Oct 2.

Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The origin of meningioma tumors is known as the meningothelial or arachnoid cap cells. The arachnoid granulations or villi are concentrated along with the dural venous sinuses in the cerebral convexity, parasagittally, and sphenoid wing regions. The majority of meningiomas are found in these locations with dural attachment. Read More

J Neurol Surg B Skull Base 2020 Aug 20;81(4):357-368. Epub 2020 Aug 20.

Division of Otolaryngology, Groote Schuur Hospital, Faculty of Health Science, University of Cape Town, Cape Town, South Africa.

Sphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Read More

Oper Neurosurg (Hagerstown) 2020 12;20(1):E55-E56

Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.

Medial sphenoid wing meningiomas constitute up to 10% of all intracranial meningiomas.1 These meningiomas have a tendency to engulf the internal carotid artery (ICA), its termination, and the middle cerebral artery. These arteries and the optic apparatus are at a particularly high risk of injury during the microsurgical resection of these tumors. Read More

World Neurosurg 2021 01 25;145:340-347. Epub 2020 Sep 25.

Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, USA. Electronic address:

Background: A collision tumor is a rare entity consisting of 2 histologically distinct tumor types (benign or malignant) in the same anatomic location. This can occur from a tumor-to-tumor metastasis or as a result of 2 adjacent intracranial tumors colliding and growing together. To our knowledge, this is the first reported case of collision tumor with confirmed meningioma and uterine adenocarcinoma. Read More

Front Oncol 2020 21;10:1412. Epub 2020 Aug 21.

Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Meningiomas presented preferred intracranial distribution, which may reflect potential biological natures. This study aimed to analyze the preferred locations of meningioma according to different biological characteristics. A total of 1,107 patients pathologically diagnosed with meningiomas between January 2012 and December 2016 were retrospectively analyzed. Read More

World Neurosurg 2020 12 8;144:e576-e581. Epub 2020 Sep 8.

Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: Sphenoorbital en plaque meningioma is located in a sensitive and complex cranial region. Therefore the therapeutic approach for this type of tumor is of great importance. We aimed to examine the clinical and radiologic outcomes of patients diagnosed with sphenoid wing en plaque meningioma undergoing surgery. Read More

Orbit 2020 Sep 7:1-6. Epub 2020 Sep 7.

South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia.

Purpose: Surgical resection is the mainstay of treatment for spheno-orbital meningiomas. The Sonopet® is an ultrasonic aspirator device that provides several advantages over the traditional standard suction techniques and bone drill, including decreased collateral soft tissue damage, more precise bone removal and a clearer operative field. The purpose of the study was to examine the treatment outcomes of Sonopet®-assisted resection of spheno-orbital meningiomas. Read More

Oper Neurosurg (Hagerstown) 2020 Jul 28. Epub 2020 Jul 28.

Department of Neurological Surgery, George Washington University, Washington, District of Columbia.

A "keyhole" approach to a deep-lying skull base lesion, as such a clinoid meningioma, can be a daunting challenge.1-3 The minimally invasive exposure must be precisely placed and adequately wide to accomplish the surgical goal. Surgical rehearsal in virtual reality (VR) can not only increase the confidence of the surgeon through practice on patient-specific anatomy,4 but it can also generate navigation-integrated templates to ensure precise placement and adequate bone openings. Read More

Asian J Neurosurg 2020 Apr-Jun;15(2):349-353. Epub 2020 Apr 7.

Department of Microbiology, UPUMS, Etawah, Uttar Pradesh, India.

Introduction: Giant meningiomas represent very uncommon and challenging tumors. Surgical morbidity is high due to the difficult and complex approaches to devascularize these hypervascular lesions. In the present series, we demonstrate a two-staged approach for surgical resection of giant hypervascular meningiomas. Read More

J Pathol Transl Med 2020 Nov 1;54(6):508-512. Epub 2020 Jul 1.

Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Meningiomas in bone are rarely subjected to fine-needle aspiration diagnosis, and those arising in the skull bone with a cystic presentation are rare. A 24-year-old woman presented with subdural hemorrhage, and subsequent radiology depicted an osteolytic mass-like lesion in the sphenoid bone. Intraoperatively, a solid and cystic hemorrhagic lesion mimicking an aneurysmal bone cyst was observed in the sphenoid bone with dural tearing. Read More

Handb Clin Neurol 2020 ;170:65-67

Miami Neuroscience Institute, Baptist Health of South Florida, Miami, FL, United States; Division of Neuroscience, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States. Electronic address:

The middle cranial fossa is bounded anteriorly by the sphenoid ridge, medially by the lateral wall of the cavernous sinus and Meckel's cave, posteriorly by the sphenoid wing and petrous bone, and laterally by the greater wing of sphenoid and squamous temporal bone. In normal individuals, unnamed venous channels within the dura and arachnoid granulations can be seen on the floor of this fossa by the operating surgeon. Meningiomas arising mainly from the dura of the floor are uncommon, and middle fossa meningiomas have been arbitrarily named so based on an attachment of more than 75% to this location. Read More

Handb Clin Neurol 2020 ;170:45-63

Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, United Kingdom. Electronic address:

Some sphenoid wing meningiomas are associated with a significant hyperostotic reaction of the adjacent sphenoid ridge that may even exceed the size of the intradural mass. The decision-making process and surgical planning based on neuroanatomic knowledge are the mainstays of management of this group of lesions. Given their natural history and biologic behavior, many hyperostosing meningiomas at this location require long-term management analogous to a chronic disease. Read More

Handb Clin Neurol 2020 ;170:37-43

Miami Neuroscience Institute, Baptist Health of South Florida, Miami, FL, United States; Division of Neuroscience, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States.

Meningiomas that arise from the dura along the sphenoid wing can occur in globoid or en plaque forms. Radiographically they can be defined as occurring in the medial, middle, or lateral portions of the sphenoid wing. The medial group carries the highest neurologic risk for surgical treatment, while the hyperostosing en plaque type is the most difficult to remove completely because of orbital and bone involvement. Read More

Clin Neurol Neurosurg 2020 08 12;195:105905. Epub 2020 May 12.

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

Objective: Despite contemporary diagnostic and therapeutic techniques intracranial emergencies in the obstetric setting pose still a major challenge for the clinicians. There are limited guidelines and differing ethical views. Multidisciplinary teams are needed to support the pregnant woman in a way that she can deliver a viable and healthy child. Read More

World Neurosurg 2020 08 8;140:192. Epub 2020 May 8.

Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, New York, USA.

A 79-year-old woman presented to the emergency department following multiple falls in the previous week. Her past medical history was unremarkable except for chronic obstructive pulmonary disease. She was neurologically intact on arrival with normal laboratory data. Read More

World Neurosurg 2020 07 6;139:343. Epub 2020 Apr 6.

Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA; Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, USA; Department of Radiology, Mayo Clinic, Phoenix, Arizona, USA; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona. Electronic address:

Fluorescence-guided resection of brain tumors using 5-aminolevulinic acid (5-ALA) has been established for high-grade gliomas. Recently, its application for the resection of low grade tumors and benign lesions including meningioma has been suggested in the literature. Achieving a Simpson grade I resection in meningioma surgery is associated with a lower rate of recurrence. Read More

J Neurol Surg Rep 2020 Jan 31;81(1):e28-e32. Epub 2020 Mar 31.

Department of Neurological Surgery, Carolinas Medical Center, Charlotte, North Carolina, United States.

 We present a case of a patient with a residual intraosseous sphenoid wing meningioma presenting with proptosis, orbital pain, and monocular vision loss for 8 months who underwent decompression of the optic canal, orbital contents, and orbital reconstruction resulting in significant improvement in her vision loss with full resolution of proptosis and orbital pain.  A 43-year-old female presented with a 1 year history of headache, peri-orbital pain, proptosis, and severe vision loss. She had previously undergone subtotal resection of a large Simpson Grade 1 spheno-orbital meningioma 3 years prior at an outside institution. Read More

Ophthalmic Plast Reconstr Surg 2020 Sep/Oct;36(5):e128-e131

Department of Ophthalmology, University of Washington, Seattle, Washington, U.S.A.

A 47-year-old man who presented with subacute binocular diplopia and a left head turn was found to have a right sixth nerve palsy and right optic disc edema. Radiologic imaging revealed a non-lytic right greater sphenoid wing mass with a dural tail, suggestive of a sphenoid wing meningioma. The patient underwent an orbitotomy with lesion biopsy; histopathologic analysis and subsequent imaging revealed the diagnosis of metastatic clear cell renal cell carcinoma. Read More