Surgical Treatment of Olfactory Groove Meningioma

Background: Olfactory groove meningiomas represent a surgically challenging problem. They invariably involve the arteries of the anterior circulation, and sometimes invade the anterior visual pathways, if they are in large sizes. Objective: To present our patients with olfactory groove meningiomas concerning presenting symptoms, neurological deficits, radiological appearance, surgical approach and outcomes as well as clinical and radiological follow-up findings. Methods: During February 2006 to July 2012 we prospectively followed a cohort of 21 patients with olfactory groove meningiomas. Information on the patients clinical history and signs, surgical approach, pathology and outcomes were recorded. The extent of tumor resection was classified according to the Simpson classification. Results: There were 17 women and four men ranging in age from 31 to 64 years with mean age of 42. The leading symptom was Dementia in 12 patients. The bifrontal approach was the surgical approach in all cases. Simpson grade I or II was achieved in 16 patients, and grade III or IV was attained in 5 cases. In 19 patients there was a good result. Two patients had a postoperative intracerebral hemorrhage after surgery; one of them has a permanent dysphasia. Conclusion: The meningiomas of the olfactory groove are a frequent tumor encountered. Its main treatment is surgical resection with good results and liability to complications. The knowledge of the microsurgical anatomy of the region is essential for the good outcome.