A Month in Cross Section: A Case Series of Eleven Sphenoid Wing Meningiomas: A Single Center Experience

Abstract

Objective:  The objective of this work was to present our experience of SWM in a single-center case series of eleven patients in one month.

Materials & Methods:  11 cases of joint global sphenoid wing meningiomas were operated on in September 2022. Patient demographic, clinical, radiology, and perioperative salient features were noted. Post-operative clinical outcome included improvement in visual acuity, neural deficit, and headache. The extent of resection on radiology plus survival was noted as an outcome measure.

Results:  Patients aged 28 to 65 years, with 9 females and 2 males, had giant sphenoid wing meningioma. Complete medial sphenoid wing involvement along with neurovascular structures, post operatively, they had visual deterioration; hence, the extent of resection was limited to prevent greater post-operative morbidity. 3/7 undergoing GTR had complete carotid artery encasement, in which full full-thickness MCA infarct was noted in 6 6-hour post-operative scan; they were later converted to a full 16 cm decompressive craniotomy. One survived with hemiparesis and aphasia while two died – male (49y), female (65), both had left craniectomies. STR was done in four patients, with cavernous sinus invasion and internal carotid encasement.

Conclusion:  Giant sphenoid meningioma involving the medial sphenoid wing and associated neurovascular structures is surgically challenging and must be treated with STR. If GTR is to be attempted, early CT Brain postoperatively to prevent mortality.