Skull Base Surgery of the Posterior Fossa

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Fig. 9.3 Case 2. Preoperative axial (a) and coronal (b)
T1-weighted magnetic resonance images with gadolinium
showing the left incisural type of tentorial meningioma.
Postoperative axial (c) and coronal (d) T1-weighted mag-
netic resonance images with gadolinium showing near-
total resection of the tumor via a retrosigmoid approach
with drilling of the petrous bone. After internal debulking

of the tumor (e), the left SCA is exposed (f). The tumor is

peeled from the brain stem (g), and the petrous apex is

drilled out (h). The tumor in Meckel’s cave is removed (i),

and most of the tumor is resected, except for just around

the porous part of the trochlear nerve (j). SCA superior

cerebellar artery

H. Morisako et al.