후두부 양측 천막경유 접근법/대뇌 겸상막경유 접근법을 통한 겸천막수막종 수술 후 발생한 일시적 양측 전맹 -증 례 보 고

Falcotentorial meningiomas are rare. The infratentorial supracerebellar and the occipital transtentorial approaches are frequently used to reach the tumor. A 56-year-old female was admitted to the hospital because of headache. Magnetic resonance imaging (MRI) of her brain showed a 35×38×20 mm-sized tumor, suspected as a meningioma, with heterogeneous signal intensity in the pineal region. The patient was operated using the occipital bi-transtentorial/transfalcine approach. The observed tumor was a fibrotic mass with calcification and was not pulled to one side after internal decompression. It was totally removed through the bilateral approach. Immediately after surgery, however, the patient complained of total blindness. Following steroid therapy, the patient showed remarkable improvement. The occipital bi-transtentorial/transfalcine approach provides a well-exposed operation field and an optimized visibility of anatomical structures. However, the potential visual cortex injury should be considered due to undue, prolonged retraction.