Cerebello-pontine angel meningiomas: Surgical results and complications

Background: Cerebellopontine angle (CPA) meningiomas present various surgical difficulties determined by tumor size, dural attachment, and proximity to adjacent neurovascular bundles. Objective: This study aimed to report the results of our experience in management of patients undergoing surgical excision for their CP angel meningioma in Sohag University Hospitals. Patients and methods: Analysis was performed on a series of 12 consecutive patients between June 2019 and May 2024 diagnosed with cerebellopontine angle meningiomas who received microscopic transcranial excision. The study documented various parameters, including patient clinical results, the extent of neoplastic resection, and postoperative adverse events. Results: There were 9 females and 3 males. Age varied from 30 to 65 years old. Headache was the most predominating symptom in 41 % of patients. According to radiological data, 7 cases (59%) had left sided CP angel meningioma, while 5 patients (41%) had their lesions on right side. Associated hydrocephalus was present in 3 patients. Gross total resection was achieved in 9 patients (75%). Subtotal resection was achieved in 2 cases (16%), and debulking was done in one case (8.3%). Post-operative bulbar palsy occurred in 2 patients (16%). Postoperative subcutaneous CSF leak occurred in one patient (8.3%). One patient developed postoperative hydrocephalus and ventriculoperitoneal (VP) shunt was inserted. Conclusion: Microscopic transcranial approach for CPA meningioma was a safe and effective surgical strategy for the management of CPA meningiomas. When performed with modern microsurgical techniques and careful patient selection, this approach allows adequate tumor exposure, and high rates of resection, while preserving critical neurovascular structures.