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Skull base tumors arising from the middle cranial fossa and invading of the infratemporal fossa (ITF) and middle cranial fossa are challenging for neurosurgeons, because of complex anatomy and critical neurovascular structure involvement. The first pioneering ITF approaches resulted in invasive procedures and carried a high rate of surgical morbidity. However, the acquisition of deep anatomical knowledge, and the development operative skills and reconstruction techniques allowed surgeons to achieve total or near total resection of many ITF lesions with a low morbidity rate. In Video 1 we illustrate our technique for the anterior ITF approach for the surgical treatment of a middle cranial fossa meningioma invading the ITF. This surgical video describes the anterior ITF approach in 2 steps. First, a standard extradural middle fossa approach subtemporal approach is performed on a cadaveric specimen, illustrating the anterior extension to the cavernous sinus. Second, the anterior ITF approach is performed for the surgical treatment of a temporal lobe meningioma with extension to the anterior ITF. This technique provides a minimally invasive approach for treating middle fossa lesions with anterior ITF extension., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Object: High-dose radiation-induced meningiomas in children are a rare occurrence. We discuss the clinical data and the differences of these rare tumors from those of spontaneous counterpart and radiation-induced meningiomas of the adult population., Case Report: We report a case of meningothelial meningioma, which occurred in a 9-year-old boy who underwent radiotherapy for a parieto-occipital cutaneous angioma. In addition, we collected 18 cases of high-dose radiation-induced meningiomas in children from a literature review with Medline., Results: Radiation-induced meningiomas in children show a female predominance, a short latency period that seems to be related to the age at irradiation, and an aggressive behaviour., Conclusion: Exposure to the potentially carcinogenic effects of radiotherapy should be reserved only for tumors that demonstrate subsequent progression. A meticulous follow-up of patients treated with radiation therapy is mandatory.

Objective: Spinal en plaque meningiomas are rare and challenging lesions because of their tendency to induce spinal arachnoiditis. The surgical treatment of this type of meningioma is more complex than that of classic meningioma., Methods: We report seven cases of spinal en plaque meningiomas and review all the cases reported in the literature accessible to us by a MEDLINE search., Results: All patients underwent microsurgery. Complete tumor removal was achieved in three patients. Subtotal removal was performed in four patients. A permanent neurological worsening was observed in one patient., Conclusion: Spinal meningiomas en plaque bear a prognosis poorer than that of classic meningiomas with regard to the possibility of a definitive surgical cure because recurrence or postoperative arachnoiditis occurs frequently. Total surgical removal should be attempted only when a clear plane of cleavage between tumor and arachnoid exists.