Management of vascular encasement in parasellar meningiomas-How I Do It.

Abstract

Tumours of the parasellar area may engulf the internal carotid artery(ICA) and its branches which may preclude complete resection and may be a risk factor for ischemic complications. We present a surgical technique based on a stepwise identification of the arterial branches which may enable a complete resection in selected cases even when complete encasement of the ICA is present on preoperative images. Resection of tumours encasing the major vascular structures should be systematically attempted while continuously weighing the delicate balance between the risk of vascular injury and the extent of resection.