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Meningiomas are the most frequently reported neuro-oncologic condition, accounting for 12% to 30% of all primary intracranial tumors. The first case of intracranial meningioma treated with stereotactic radiosurgery was reported by Backlund E-O in 1971. Since then, more than 200,000 meningiomas have been treated with stereotactic radiosurgery worldwide to date. The large number of patients treated using this method is due to the fact that meningiomas are frequently located in critical areas and microsurgery is often associated with severe and permanent neurological complications.This book discusses the advantages, risks and limits of stereotactic radiosurgery relating to all regions of interest for a neuroradiosurgical approach for the treatment of central nervous system meningiomas. Firstly, it presents an introduction focusing on the “state of the art”. It then discusses the physics, imaging, neurological and neuro-oncological issues in multidisciplinary management. Lastly,it features a summary of results, including the most recent published papers regarding all the locations involved in the stereotactic radiosurgery treatment as well as new approaches to meningiomas, with particular reference to the hypofrationated treatments. Intended for anyone involved in the neuroradiosurgical treatment of brain diseases, the book provides an up-to-date overview of the latest stereotactic radiosurgery treatment of central nervous system meningiomas.

This book provides a comprehensive overview of the multidisciplinary management of meningiomas, followed by evaluation and management considerations along a spectrum of benign to more malignant behavior. It outlines the management of presumed Grade 1 tumors and how to identify features of tumors radiographically and clinically that may support a benign course rather than aggressive and vice versa. Following a stepwise progression from simple to complex, chapters introduce and tackle more aggressive meningiomas and tumor recurrence (of all Grades), with paradigms for evaluation and treatment. Tumor biology and genomics are fundamental and largely focused in the book. More recent findings which have directed personalized medicine and clinical trials are also addressed. Meningiomas: Comprehensive Strategies for Management addresses all aspects of the evaluation and care of patients with all WHO grades of meningiomas. It is highly informative and provides clarity for a wide audience of neurosurgeons, reconstructive surgeons, oncologists, neurologists, radiation oncologists, pathologists, radiologists, residents and students who treat these patients and those who are training for a career in managing patients with these potentially challenging tumors.

A comprehensive overview of the contemporary management of skull base meningiomasMeningiomas, the second most frequent of intracranial tumors, are characterized by a protean range of possible locations and appearances, due to their origin from the extensive and intricately formed meninges. As such, a wide variety of differential diagnoses is typical, and the therapies chosen are necessarily highly variable.The introductory chapters of this book cover the pathology of these tumors, the evolution of special surgical methods, instrumentation, intraoperative monitoring, and the role of radiosurgery. Ten surgical chapters cover the individual regions of occurrence, including the sphenoid wing, olfactory groove, cerebellopontine angle, etc., all of which require a specialized approach and therapeutic strategy.Key Features:Discussion of pathology and therapy organized by anatomic location of the lesions with the goal of providing best patient outcomesNew WHO meningioma classification system based on most recent research in growth patterns, gene sequencing, and molecular patterns of developmentImportant updates on the newest developments in treatment modalities for meningioma, including the lesser invasive radiotherapy and radiosurgery for the smaller lesions and to avoid the necessity of performing radical surgeryMeningiomas of the Skull Base: Treatment Nuances in Contemporary Neurosurgery is an essential reference guide for neurosurgeons and neurologists (in training and in practice) and will also be welcomed by skull base surgeons and otolaryngologists.

Although surgery of the skull base still represents a frontier involving different specialties, it is increasingly being accepted and recognized as a special area po­ sing both unique diagnostic and surgical challenges and specific requirements. This is the prime reason that colleagues involved in the management of skull base processes need special training stressing the different surgical approaches required either at different times or to reach the different areas of this intriguing anatomi­ cal landmark. Although the advent of microsurgical techniques and advanced diagnostic mo­ dalities - high-resolution computed tomography, magnetic resonance imaging (MRI) and MR-angiography, and supers elective endovascular protocols - in the last 25 years has brought significant improvements, such as the recent advances in endovascular treatment, a number of different kinds of limitations still persist. This is especially so in the case of skull base meningiomas, the pathological entity most frequently affecting this area which the neurosurgeon is confronted with in daily practice. Besides understanding the intrinsic characteristics of the different pathological entities which involve the skull base, it is the responsibility of physi­ cians to know and employ the expanded neurosurgical options in the most effecti­ ve and appropriate way.

'Modem Neurosurgery of Meningiomas and Pituitary Adenomas'presents the state-of-the-art of neurosurgery for these two types of tumors. Following a classification of the pituitary adenomas according to pathology, molecular biological factors are presented and their effects evaluated as these aspects deepen our understanding of the growth and further expansion of these tumors. The diagnosis is made not only by a study of the hormonal status, but also by neuroradiology. A number of authors have devoted their efforts to the special problem groups such as the elderly patients and those with huge pituitary adenomas. Particular emphasis is of course placed on the surgical treatment, including transcranial and transphenoidal neurosurgery, but the use of medical treatment and irradiation must be discussed as well. The treatment of meningiomas has also been influenced by the molecular biology of hormone and growth factors. Therefore it is accorded extensive space in this volume. The prognostic significance of nuclear DNA content is discussed. Recent research with new diagnostic methods such as somatostatin scintigraphy, PET studies end progesterone receptor in tumor fragment spheroids is presented here. The treatment of these tumors, however, depends largely on their localization. For the neurosurgeon, the surgical treatment of meningiomas involving the cavernous sinus, meningiomas of the ventral Foramen of Monroe, meningiomas of the cerebello­ pontine angle and of the optic sheath is presented by prominent experienced leaders in this field.