PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
 
Skull base surgery. 1992 July; 2(3): 129–133.
PMCID: PMC1656371

Rate of Progression and Severity of Neuro-Ophthalmologic Manifestations of Cavernous Sinus Meningiomas

Abstract

The progression of neuro-ophthalmologic signs and symptoms caused by cavernous sinus meningiomas (CSMs) was evaluated in 24 patients. Ten patients had primary involvement of the cavernous sinus by meningioma, and 14 patients had extension of a sphenoid ridge meningioma into the cavernous sinus. Eighteen patients were followed after intradural meningioma debulking. Two of these patients underwent conventional radiation therapy after surgery. The other six patients were followed without treatment. Optic neuropathy caused by extension of the CSM was the most frequently (67%) seen manifestation at the beginning of the follow-up period. Proptosis (50%), ocular motor nerve palsies (46%), and trigeminal neuropathy (33%) were also common. During a mean follow-up period of 57 months, 14 patients (58%) had no change in neurologic status, four patients (17%) had improvement in one or more parameters and six patients (25%) worsened. The patients who worsened had progression of preexisting cranial nerve palsies (two patients), developed new cranial neuropathies (three patients), or both (one patient). Patients who worsened had a significantly longer mean follow-up (76 months) than patients who remained stable or improved (47 months) (p = 0.01). Although the signs and symptoms of CSMs may worsen with time, the rate is slow and the degree is mild. These factors are important when considering treatment options.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • van Effenterre R, Bataïni JP, Cabanis EA, Iba-Zizen MT. High energy radiotherapy in the treatment of meningiomas of the cavernous sinus. Acta Neurochir Suppl (Wien) 1979;28(2):464–467. [PubMed]
  • Sekhar LN, Sen CN, Jho HD, Janecka IP. Surgical treatment of intracavernous neoplasms: a four-year experience. Neurosurgery. 1989 Jan;24(1):18–30. [PubMed]
  • Sekhar LN, Møller AR. Operative management of tumors involving the cavernous sinus. J Neurosurg. 1986 Jun;64(6):879–889. [PubMed]
  • Trobe JD, Acosta PC, Krischer JP, Trick GL. Confrontation visual field techniques in the detection of anterior visual pathway lesions. Ann Neurol. 1981 Jul;10(1):28–34. [PubMed]
  • Schatz NJ, Savino PJ, Corbett JJ. Primary aberrant aculomotor regeneration. A sign of intracavernous meningioma. Arch Neurol. 1977 Jan;34(1):29–32. [PubMed]
  • Trobe JD, Glaser JS, Post JD. Meningiomas and aneurysms of the cavernous sinus. Neuro-ophthalmologic features. Arch Ophthalmol. 1978 Mar;96(3):457–467. [PubMed]
  • Boghen D, Chartrand JP, Laflamme P, Kirkham T, Hardy J, Aube M. Primary aberrant third nerve regeneration. Ann Neurol. 1979 Nov;6(5):415–418. [PubMed]
  • Johnston JA, Parkinson D. Intracranial sympathetic pathways associated with the sixth cranial nerve. J Neurosurg. 1974 Feb;40(2):236–243. [PubMed]
  • Lesoin F, Jomin M, Bouchez B, Duret MH, Clarisse J, Arnott G, Pellerin P, Francois P. Management of cavernous sinus meningiomas. Neurochirurgia (Stuttg) 1985 Sep;28(5):195–198. [PubMed]
  • Kennerdell JS, Maroon JC, Malton M, Warren FA. The management of optic nerve sheath meningiomas. Am J Ophthalmol. 1988 Oct 15;106(4):450–457. [PubMed]
  • Kupersmith MJ, Warren FA, Newall J, Ransohoff J. Irradiation of meningiomas of the intracranial anterior visual pathway. Ann Neurol. 1987 Feb;21(2):131–137. [PubMed]
  • Fukui M, Kitamura K, Nakagaki H, Yamakawa Y, Kinoshita K, Hayabuchi N, Jingu K, Numaguchi Y, Matsuura K, Watanabe K. Irradiated meningiomas: a clinical evaluation. Acta Neurochir (Wien) 1980;54(1-2):33–43. [PubMed]
  • Carella RJ, Ransohoff J, Newall J. Role of radiation therapy in the management of meningioma. Neurosurgery. 1982 Mar;10(3):332–339. [PubMed]
  • Wara WM, Sheline GE, Newman H, Townsend JJ, Boldrey EB. Radiation therapy of meningiomas. Am J Roentgenol Radium Ther Nucl Med. 1975 Mar;123(3):453–458. [PubMed]
  • Petty AM, Kun LE, Meyer GA. Radiation therapy for incompletely resected meningiomas. J Neurosurg. 1985 Apr;62(4):502–507. [PubMed]
  • Barbaro NM, Gutin PH, Wilson CB, Sheline GE, Boldrey EB, Wara WM. Radiation therapy in the treatment of partially resected meningiomas. Neurosurgery. 1987 Apr;20(4):525–528. [PubMed]
  • Kondziolka D, Lunsford LD, Coffey RJ, Flickinger JC. Stereotactic radiosurgery of meningiomas. J Neurosurg. 1991 Apr;74(4):552–559. [PubMed]
  • Slavin ML. Isolated trochlear nerve palsy secondary to cavernous sinus meningioma. Am J Ophthalmol. 1987 Oct 15;104(4):433–434. [PubMed]
  • Sakalas R, Harbison JW, Vines FS, Becker DP. Chronic sixth nerve palsy. An initial sign of basisphenoid tumors. Arch Ophthalmol. 1975 Mar;93(3):186–190. [PubMed]
  • Gurinsky JS, Quencer RM, Post MJ. Sixth nerve ophthalmoplegia secondary to a cavernous sinus lesion. J Clin Neuroophthalmol. 1983 Dec;3(4):277–281. [PubMed]
  • Firsching RP, Fischer A, Peters R, Thun F, Klug N. Growth rate of incidental meningiomas. J Neurosurg. 1990 Oct;73(4):545–547. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers