12 2
Fig. 9.5 Case 4. Preoperative axial (a) and coronal (b)
T1-weighted magnetic resonance images with gadolinium
showing the large right incisural type of tentorial menin-
gioma. Postoperative axial (c) and coronal (d) T1-weighted
magnetic resonance images with gadolinium showing
near-total resection of the tumor via a right combined
transpetrosal approach. After cutting of the superior
petrosal sinus (e) and opening of Meckel’s cave, internal
debulking of the tumor is performed (f, g). The proximal
portion of the right SCA is exposed (h). The distal portion
of the right SCA and brain stem are peeled from the tumor
(i). Near-total resection of the tumor is achieved with a
small residual tumor along the right oculomotor nerve (j).
SPS superior petrosal sinus, SCA superior cerebellar
artery, * residual tumorH. Morisako et al.