Skull Base Surgery of the Posterior Fossa

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collectively as “tumors of the cerebellar cham-
ber,” there are distinct clinical syndromes associ-
ated with location and size. Previously, we
reported an early experience with 24 patients and
now have accumulated over 50 such patients [ 9 ].
The senior author has divided these now into
three distinct locations with four clinical syn-
dromes, similar to the classification of Peyre
et al. and the modified Desgeorges and Sterkers
classification [ 6 , 13 ]. The trends in presentation

size and symptomatology by location described

in this chapter were also seen by Schaller et al.

[ 16 ] Rather than dividing into three regions, they

simply categorized the CPA meningiomas as pre-

or retromeatal and found that smaller tumors

were symptomatic anteriorly, while retromeatal

tumors tended to grow much larger before caus-

ing symptoms. The importance of the tumor

origin and dural attachment were emphasized in

Robertson’s series, where they demonstrated that

Fig. 8.4 Intraoperative photos from case example 2, small
MPFM. (a) Intraoperative photo showing residual tumor
superior and anterior to the IAC that extends into canal

after drilling of superior and posterior wall of IAC. (b)

Final result with gross tumor resection

8 Meningiomas of the Cerebellopontine Angle