Microsurgical management of suprasellar and intraventricular meningiomas.

A series of 78 intracranial meningiomas (68 suprasellar, 10 intraventricular) were operated on in our Institute after the advent of the operating microscope. In our review, we discuss the microsurgical technical problems related to the preservation of vascular and brain structures in the removal of intraventricular and parasellar meningiomas. Basic diagnostic criteria to plan correctly the surgical approach will be emphasized. Mortality and morbidity in parasellar meningiomas is, in our opinion, related to the experience of the surgeon in using the operating microscope rather then in using the laser and CUSA. We will also discuss the utility of preoperative embolization of the lesion as well as the indications for intraoperative EC/IC bypass. Finally, morbidity and mortality related to different approaches for intraventricular meningiomas will be discussed.