Abstract
Skull base approach is a neurosurgical challenge requiring dexterity of the operating
surgeon for good postoperative outcome. In addition to the experience of the operating
surgeon, adequate preoperative information of the tumor is necessary to ensure better
outcome. In clinoid meningioma, it is sometimes difficult to determine its relationship
with the surrounding structure and the feeding artery. Previously, preoperative simulation
has been utilized to determine the intracranial course of the compressed nerves in
relation to the petroclival meningioma. We report a case of clinoid meningioma where
preoperative fusion of three dimensional computed tomography angiography (3D-CTA)
and 3T-fast imaging employing steady-state acquisition (FIESTA) images was useful
in determining the exact location of the feeding artery to devascularize the tumor
and aid in surgery. Preoperative simulation with three-dimensional digital subtraction
angiography (3D-DSA) and 3T-FIESTA fusion images can be a useful adjunct tool to supplement
surgery and to train neurosurgical trainees.
Keywords
preoperative simulation - skull base - 3D-CTA - FIESTA - clinoid meningioma - feeding
artery
