120
Fig. 9.4 Case 3. 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 total
removal of the tumor via an anterior transpetrosal
approach. After opening of Meckel’s cave (e), internal
debulking of the tumor is performed. The tumor is care-
fully peeled from the trochlear nerve (f), and the tento-
rium is detached from the tumor (g). The tumor located
around the trigeminal nerve and brain stem is removed
(h). Residual tentorium, which was the origin of the
tumor, is resected completely (i), and the tumor is totally
removed (j)H. Morisako et al.