Meningiomas

Meningiomas

Diagnosis, Treatment, and Outcome

Edited by

Joung H. LeeBrain Tumor & Neuro-Oncology Center/Department of Neurosurgery, Neurological Institute, The Cleveland Clinic Foundation, Cleveland, OH, USA

EditorJoung H. Lee, MDBrain Tumor & Neuro-Oncology CenterDepartment of Neurosurgery, Neurological InstituteCleveland Clinic Foundation, Cleveland, OH, USA

DOI: 10.1007/978-1-84628-784-8

Library of Congress Control Number: 2007940436

Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers.The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use.The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made.Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature.

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e-ISBN 978-1-84628-784-8

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ISBN 978-1-84628-526-4 (HB)ISBN 978-1-84882-910-7 (PB)

To all my patients,Who inspire me to do my very best in their care

vii

Foreword

Joung H. Lee has assembled a masterful volume on the diagnosis, treatment, and outcome of meningiomas. It is complete in that it covers all aspects of this tumor; every location is discussed by acknowledged experts and every technique is described in detail. Basic biology forms an important and up-to-date part of the text. This book will serve as a reference for many years; in particular, Dr. Lee feels surgeons and future patients will benefit. There is little question that these aims will be fulfilled in this important tour de force.

John A. Jane, Sr., MD, PhDCharlottesville, VA, USA

ix

Preface

In planning this book, I had three major goals. The first was to compile and disseminate all the advances and new information relating to meningiomas which became available in the last 15-20 years. In this time frame, there has been a significant increase in our understanding in regards to the meningioma pathologic classification, the natural history and basic science. Dramatic technological advancements have also been made in diagnostic and interventional radiology as well as in surgical and radiation treatments for meningiomas, such as incorporation of the following in the treatment armamentaria: endoscopy, various skull base techniques, computer-assisted surgery and radiosurgery. Additionally, new information regarding surgical outcome and patient selection for surgery are becoming available, all of which are resulting in a significant change in how neurosurgeons treat patients with meningiomas.

The second goal for this book was to teach and stimulate the next generation of neurosurgeons. Because meningiomas can occur anywhere within the intracranial space or along the spine, for an individual neu-rosurgeon, mastering the surgery of meningiomas allows one to become a master surgeon. In other words, to learn the basics of meningioma surgery – i.e. surgical decision making, positioning, anatomy, approach, exposure and microdissection, tumor removal, hemostasis, closure- is to learn the basics of neurosurgery. Moreover, meningioma surgery is arguably the most rewarding, challenging and, at times, daunting task for neurosurgeons: rewarding, because of the benign nature of most meningiomas, leading to a possible cure follow-ing total removal, challenging because of the tumors’ common sites of involvement in proximity to critical neurovascular structures especially when involving the central skull base, and daunting due to the tumor’s tendency to recur in higher grades of histologic subtypes and to its frequent involvement of the surround-ing skull base bone, dura and neurovascular structures making complete removal often risky or impossible. Although meningioma surgery can be enjoyable and rewarding, I wanted young readers to appreciate and respect the challenging and daunting aspects, which will undoubtedly serve as the stimulus for continued learning, refinement and progress in this field in the future.

The third goal, but the most important one, was to give back to our patients. As neurosurgeons or physi-cians, we are nothing without our patients. Our patients are truly the backbone of our professional livelihood. It is a great privilege to be able to provide care for other human beings. I firmly believe that the best way to show sincere gratitude to our patients is to not only provide the best care possible, but also to learn from each, so that treatment for the subsequent patients is better and improved.

Editing this book was a much greater task than initially anticipated, with 64 chapters contributed by over 110 distinguished authors from 5 different continents. I am truly honored to be given the opportunity to complete this project which could not have been possible without the support of all the contributors and the publisher, Springer-Verlag. My only regret is that I could not possibly include all of the international experts to join me in this project.

I intentionally solicited differing views and approaches when there are multiple reasonable ways of deal-ing with the same problem. I thought presentation of multiple ways is superior to pre-selected (and, hence biased) single presentation. Moreover, I wanted very much for young readers to appreciate the fact that there is no single best way of treating certain meningiomas. Hopefully, they will appreciate that whatever technique or approach that results in the best long-term patient outcome in their local setting is what really matters, whether it is surgery vs. radiosurgery for cavernous sinus meningiomas, endoscopic surgery vs. microsurgery in anterior skull base meningiomas, total vs. subtotal resection followed by radiosurgery in parasagittal or skull base meningiomas, anterior vs. posterior transpetrosal approach in petroclival meningiomas, aggressive surgery vs. radiation in optic nerve sheath meningiomas, etc.

This book could not be completed without the valuable assistance of Ms. Christine Moore, an editorial assistant in the Department of Neurosurgery, Cleveland Clinic, and Dr. Burak Sade, my former fellow and present colleague. I cannot thank them enough! I am also greatly indebted to all my mentors: as stated above, they include all my patients, in addition to Professors Eve Marder (neurophysiology professor in college), Alain B. Rossier (college senior thesis preceptor) and John A. Jane, Sr. Lastly, I thank my lovely wife, Heey-ang, and my dearest sons, Terry, Nick and Ryan, for their constant support, love and inspiration.

As stated earlier, one of the goals of this book was to teach. However, in completing this book, I became the biggest beneficiary, having learned so much. Just like meningioma surgery, editing this book was immensely enjoyable, rewarding and challenging. If through this book, I have stimulated even a small number of young neurosurgeons to learn and make continued progress in the area of meningiomas, so that they in turn can provide better and improved care for their future patients, I have fulfilled my goals.

Joung H. LeeCleveland, Ohio, USA

x Preface

xi

Contents

Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

Preface.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

I. General Information

1. Meningiomas: Historical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3David O. Okonkwo and Edward R. Laws, Jr.

2. Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Bong Jin Park, Han Kyu Kim, Burak Sade, and Joung H. Lee

3. Human Meninges: Anatomy and Its Role in Meningioma Pathogenesis . . . . . . . . . . . . . . . . . . . 15Tetsumori Yamashima

4. Meninges: Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25M. Beatriz S. Lopes

5. Pathology of Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Richard A. Prayson

6. Natural History, Growth Rates, and Recurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Kyung Gi Cho

II. Diagnostic Considerations

7. Diagnostic Neuroradiology: CT, MRI, fMRI, MRS, PET, and Octreotide SPECT . . . . . . . . . . . 55Albert S. Chang and Jeffrey S. Ross

8. Meningiomas: Imaging Mimics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Manzoor Ahmed, Joung H. Lee, and Thomas J. Masaryk

9. Preoperative Embolization of Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89David J. Fiorella, Vivek R. Deshmukh, Cameron G. McDougall, Robert F. Spetzler, and Felipe C. Albuquerque

10. Neuro-ophthalmic Evaluations in Patients with Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . 101Steven A. Newman

III. Basic Science

11. Meningioma Tumorigenesis: An Overview of Etiologic Factors . . . . . . . . . . . . . . . . . . . . . . . . . 137Michael J. Link and Arie Perry

12. Molecular Basis of Meningioma Tumorigenesis and Progression . . . . . . . . . . . . . . . . . . . . . . . . 147Lilyana Angelov and Mladen Golubic

13. Meningiomas of the Central Neuraxis: Unique Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157Joung H. Lee and Burak Sade

14. Radiation-Induced Meningiomas: Historical Perspective, Presentation, Management, and Genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163Yigal Shoshan, Sergey Spektor, Guy Rosenthal, Shifra Fraifeld, and Felix Umansky

15. Emerging Treatment Modalities I: Cyclooxygenase-2 as a Therapeutic Target for Meningioma Tumor Growth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177Brian T. Ragel and William T. Couldwell

16. Emerging Treatment Modalities II: Gene Therapy for Meningiomas . . . . . . . . . . . . . . . . . . . . . . 185Nader Pouratian, Charles A. Sansur, John A. Jane, Jr., and Gregory A. Helm

IV. Management and Outcome

17. Management Options and Surgical Principles: An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203Joung H. Lee and Burak Sade

18. Operative Outcome Following Meningioma Surgery: A Personal Experience of 600 Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209Joung H. Lee and Burak Sade

19. Factors Influencing Outcome in Meningioma Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213Burak Sade and Joung H. Lee

20. The Novel “CLASS” Algorithmic Scale for Patient Selection in Meningioma Surgery . . . . . . . 217Joung H. Lee and Burak Sade

21. Endoscopy in Meningioma Surgery: Basic Principles, Applications, and Indications . . . . . . . . . 223Paolo Cappabianca, Luigi M. Cavallo, Felice Esposito, and Enrico de Divitiis

22. Image-Guided Surgery for Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231Tina Thomas and Gene H. Barnett

23. Meningiomas and Epilepsy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243Jorge A. González-Martínez and Imad M. Najm

24. Surgical Correction of Postoperative Strabismus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247Gregory Kosmorsky

V. Adjunct Treatment Modalities

25. Recent Advances in Therapeutic Radiation: An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253Simon S. Lo, Eric L. Chang, and John H. Suh

xii Contents

26. Conventional Radiation for Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259Simon S. Lo, Brent A. Tinnel, and John H. Suh

27. Gamma Knife Surgery for Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267Jason Sheehan, Nader Pouratian, Charles A. Sansur, and Ladislau Steiner

28. Linear Accelerator Radiosurgery for Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277William A. Friedman

29. Brachytherapy for Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283P. Pradeep Kumar and Burak Sade

30. Medical Therapy for Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293Glen H.J. Stevens and David M. Peereboom

VI. Meningiomas by Location: Special Considerations, Surgical Technique, Outcome, Complication Avoidance

31. Convexity Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301Noojan J. Kazemi and Andrew H. Kaye

32. Parasagittal Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309Jorge E. Alvernia and Marc P. Sindou

33. Falcine Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319Chae-Yong Kim and Hee Won Jung

34. Olfactory Groove/Planum Sphenoidale Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327Douglas Fox, Vini G. Khurana, and Robert F. Spetzler

35. Tuberculum Sellae Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333Chang Jin Kim and Seok Ho Hong

36. Anterior Clinoidal Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347Joung H. Lee and Burak Sade

37. Optic Nerve Sheath Meningiomas I: Aggressive Surgical Management. . . . . . . . . . . . . . . . . . . . 355Werner Hassler and Uta Schick

38. Optic Nerve Sheath Meningiomas II: Conservative Management with Fractionated Stereotactic Radiotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363David W. Andrews and James J. Evans

39. Lateral and Middle Sphenoid Wing Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371Benoit J.M. Pirotte and Jacques Brotchi

40. Orbitosphenoid Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379Eric H. Sincoff and Johnny B. Delashaw, Jr.

41. Cavernous Sinus Meningiomas: Conservative Surgical Management. . . . . . . . . . . . . . . . . . . . . . 389Burak Sade and Joung H. Lee

42. Temporal Bone Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393Mario Sanna, Maurizio Falcioni, Abdelkader Taibah, and Sean Flanagan

Contents xiii

43. Posterior Clinoidal Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399Takeo Goto and Kenji Ohata

44. Petroclival and Upper Clival Meningiomas I: An Overview of Surgical Approaches . . . . . . . . . 403Marcus L. Ware, Svetlana Pravdenkova, Kadir Erkmen, and Ossama Al-Mefty

45. Petroclival and Upper Clival Meningiomas II: Anterior Transpetrosal Approach . . . . . . . . . . . . 415Takeshi Kawase, Kazunari Yoshida, and Koichi Uchida

46. Petroclival and Upper Clival Meningiomas III: Combined Anterior and Posterior Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425Samuel L. Barnett, Anthony L. D’Ambrosio, Siviero Agazzi, and Harry R. van Loveren

47. Petrous Meningiomas I: An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433H. Maximilian Mehdorn and Ralf M. Buhl

48. Petrous Meningiomas II: Ventral, Posterior and Superior Subtypes . . . . . . . . . . . . . . . . . . . . . . . 443Burak Sade and Joung H. Lee

49. Foramen Magnum Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449Luis A.B. Borba and Benedicto O. Colli

50. Cerebellar Convexity Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457Roberto Delfini, Antonio Santoro, and Angelo Pichierri

51. Tentorial Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465Khaled A. Aziz, Sebastien C. Froelich, Philip Theodosopoulos, and John M. Tew, Jr.

52. Torcular, Transverse, and Sigmoid Sinus Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473Jorge E. Alvernia and Marc P. Sindou

53. Falcotentorial and Pineal Region Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 485Ivan Radovanovic and Nicolas de Tribolet

54. Intraventricular Meningiomas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495Peter A. Winkler, Ralf M. Buhl, and Jörg-Christian Tonn

55. Jugular Foramen Meningiomas I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515Tomio Sasaki and Nobutaka Kawahara

56. Jugular Foramen Meningiomas II: An Otologist’s Approach, Perspective, and Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521Mario Sanna, Sean Flanagan, G. DeDonato, A. Bacciu, and Maurizio Falcioni

57. Spinal Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529Eve C. Tsai, John Butler, and Edward C. Benzel

VII. Miscellaneous

58. Pediatric Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543Amro Al-Habib and James T. Rutka

59. NF2/Multiple Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555Ralf M. Buhl, H. Maximilian Mehdorn, and Peter A. Winkler

xiv Contents

60. Peritumoral Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565Han Soo Chang

61. Primary Ectopic Meningiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573Sarah E. Gibson and Richard A. Prayson

62. Management of Arterial Encasement by Intracranial Meningiomas . . . . . . . . . . . . . . . . . . . . . . . 585Laligam N. Sekhar and Sabareesh Kumar Natarajan

63. Venous Reconstruction in the Management of Intracranial Meningiomas . . . . . . . . . . . . . . . . . . 603Sabareesh Kumar Natarajan and Laligam N. Sekhar

64. Dural Reconstruction in Meningioma Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619Joung H. Lee and Burak Sade

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 625

Contents xv

Contributors List

Siviero Agazzi, MDDepartment of Neurosurgery, University of South Florida, Tampa, FL, USA

Manzoor Ahmed, MDDepartment of Radiology, Cleveland Clinic, Cleveland, OH, USA

Felipe C. Albuquerque, MDDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

Amro Al-Habib, MDHopsita l for Sick Children, Toronto, Ontario, Canada

Ossama Al-Mefty, MDUniversity of Arkansas, Little Rock, AR, USA

Jorge E. Alvernia, MDDepartment of Neurosurgery, Tulane University, New Orleans, LA, USA

David W. Andrews, MDThomas Jefferson University Hospital, Philadelphia, PA, USA

Lilyana Angelov, MD, FRCSBrain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Khaled A. Aziz, MD, PhDDepartment of Neurosurgery, University of Cincinnati College of Medicine. Cincinnati, OH, USA

A. Bacciu, MD, ENTDepartment of Neurosurgery, University of Parma, Parma, Italy

Gene H. Barnett, MDBrain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Samuel L. Barnett, MDDepartment of Neurosurgery, University of Mississippi Medical Center, Jackson, MS, USA

Edward C. Benzel, MDCenter for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Luis A.B. Borba, MDDepartment of Neurosurgery, Evangelic University Medical School, Curitiba, Parana, Brazil

Jacques Brotchi, MD, PhDDepartment of Neurosurgery, Universite Libre de Bruxelles, Bruxelles, Belgium

xvii

xviii Contributors List

Ralf M. Buhl, MD, PhDDepartment of Neurosrugery, Clemens Hospital, Munster, Germany

John Butler, MDCenter for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Paolo Cappabianca, MDDepartment of Neurological Sciences, Universita degli Studi di Napoli Federico II, Napoli, Italy

Luigi M. Cavallo, MD, PhDDepartment of Neurological Sciences, Universita degli Studi di Napoli Federico II, Napoli, Italy

Albert S. Chang, MDDepartment of Radiology and Neuro-Radiology, Cleveland Clinic, Cleveland, OH, USA

Eric L. Chang, MDDepartment of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA

Han Soo Chang, MDDepartment of Neurosurgery, Saitama Medical Center, Saitama, Japan

Kyung Gi Cho, MD, PhDDepartment of Neurosurgery, Ajou University School of Medicine, Suwon, South Korea

Benedicto O. Colli, MDDepartment of Neurosurgery, University of São Paulo, Ribeirao Preto, São Paulo, Brazil

William T. Couldwell, MD, PhDDepartment of Neurosurgery, University of Utah, Salt Lake City, UT, USA

Anthony L. D’Ambrosio, MDDepartment of Neurosurgery, University of South Florida, Tampa, FL, USA

Enrcio de Divitiis, MDDepartment of Neurological Sciences, Universita degli Studi di Napoli Federico II, Napoli, Italy

G. DeDonato, MDGruppo Otologico, Piacenza, Rome, Italy

Johnny B. Delashaw, Jr., MDDepartment of Neurosurgery, Oregon Health Sciences University, Portland, OR, USA

Roberto Delfini, MD, PhDDepartment of Neurosurgery, University of Roma, Roma, Italy

Vivek R. Deshmukh, MDDepartment of Neurosugery, Barrow Neurological Institute, Phoenix, AZ, USA

Nicholas de Tribolet, MDDepartment of Neurosurgery, Geneva University Hospital, Geneva, Switzerland

Kadir Erkmen, MDDepartment of Neurosurgery, Darthmoth-Hitchcock Medical Center, Lebanon, NH, USA

Felice Esposito, MD, PhDDepartment of Neurological Sciences, Universita degli Studi di Napoli Federico II, Napoli, Italy

James J. Evans, MDDepartment of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA

Maurizio Falcioni, MDGruppo Otologico, Piacenza, Rome, Italy

David J. Fiorella, MD, PhDDepartment of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Sean Flanagan, MDGruppo Otologico, Piacenza, Rome, Italy

Douglas Fox, MDDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

Shifra Fraifeld, MBADepartment of Neurosurgery, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

William A. Friedman, MDDepartment of Neurosugery, University of Florida, Gainesville, FL, USA

Sebastein C. Froelich, MDDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Sarah E. Gibson, MDDepartment of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA

Mladen Golubic, MD, PhDBrain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Jorge A. González-Martínez, MD, PhDDepartment of Neurosurgery & Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Takeo Goto, MDDepartment of Neurosurgery, Osaka City University, Osaka, Japan

Werner Hassler, MD, PhDNeurosurgical Clinic, Duisburg, Germany

Gregory A. Helm, MD, PhDDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA

Seok Ho Hong, MD, PhDDepartment of Neurosugery, Asan Medical Center, University of Ulsan, Seoul, South Korea

John A. Jane, Jr. , MDDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA

Hee Won Jung, MD, PhDDepartment of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea

Nobutaka Kawahara, MDDepartment of Neurosurgery, University of Tokyo, Tokyo, Japan

Takeshi Kawase, MD, PhDDepartment of Neurosurgery, Keio University School of Medicine, Tokyo, Japan

Contributors List xix

xx Contributors List

Andrew H. Kaye, MBBS, MD, FRACSDepartment of Neurosurgery, Royal Melbourne Hospital, Melbourne, Australia

Noojan J. Kazemi, MBBSDepartment of Neurosurgery, Royal Melbourne Hospital, Melbourne, Australia

Vini G. Khurana, MD, PhDDepartment of Neuroscience, Barrow Neurological Institute, Phoenix, AZ, USA

Chae-Yong Kim, MD, PhDDepartment of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea

Chang Jin Kim, MD, PhDDepartment of Neurosurgery, Asan Medical Center, University of Ulsan, Seoul, South Korea

Han Kyu Kim, MD, PhDDepartment of Neurosurgery, Eulji University, Dae Jeon, South Korea

Gregory Kosmorsky, DODepartment of Neuro-Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA

P. Pradeep Kumar, MDDepartment of Radiation-Oncology, James H. Quillen VA Medical Center, Mountain Home, TN, USA

Edward R. Laws, Jr. , MDDepartment of Neurosurgery, Brigham &Women’s Hospital, Boston, MA, USA

Joung H. Lee, MDBrain Tumor & Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

Michael J. Link, MDDepartment of Neurological Surgery, Mayo Clinic, Rochester, MN, USA

Simon S. Lo, MDDepartment of Neuro-Radiation Oncology and Radiosurgery, Ohio State University Medical Center, Columbus, OH, USA

M. Beatriz S. Lopes, MDDepartment of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA

Thomas J. Masaryk, MD, FACRDepartment of Neuroradiology, Cleveland Clinic, Cleveland, OH, USA

Cameron G. McDougall, MDDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

H. Maximilian Mehdorn, MD, PhDDepartment of Neurosurgery, University Hospitals of Schleswig-Holstein, Kiel, Germany

Imad M. Najm, MDEpilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH USA

Sabareesh Kumar Natarajan, MD, MSDepartment of Neurosurgery, University of Washington Medical Center, Seattle, WA, USA

Steven A. Newman, MDDepartment of Ophthalmology, University of Virginia HSC, Charlottesville, VA, USA

Kenji Ohata, MDDepartment of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan

David O. Okonkwo, MD, PhDDepartment of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, USA

Bong Jin Park, MD, PhDDepartment of Neurosurgery, Kyung Hee University, Seoul, South Korea

David M. Peereboom, MDDepartment of Medical Oncology, Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

Arie Perry, MDDepartment of Neuropathology, Washington University School of Medicine, St. Louis, MO, USA

Angelo Pichierri, MDDepartment of Neuroscience, University of Rome, Rome, Italy

Benoit J.M. Pirotte, MD, PhDDepartment of Neurosurgery, Universite Libre de Bruxelles, Bruxelles, Belgium

Nader Pouratian, MD, PhDDepartment of Neurosurgery, University of Virginia HSC, Charlottesville, VA, USA

Svetlana Pravdenkova, MD, PhDDepartment of Neurosurgery, University of Arkansas, Little Rock, AR, USA

Richard A. Prayson, MDDepartment of Neuropathology, Cleveland Clinic, Cleveland, OH, USA

Ivan Radovanovic, MDDepartment of Neurosurgery, Geneva University Hospital, Geneva, Switzerland

Brian T. Ragel, MDDepartment of Neurosurgery, University of Utah, Salt Lake City, UT, USA

Guy Rosenthal, MDDepartment of Neurosurgery, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

Jeffrey S. Ross, MDDepartment of Neuro-Radiology, Barrow Neurological Institute, Phoenix, AZ, USA

James T. Rutka, MDDepartment of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada

Burak Sade, MDBrain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Mario Sanna, MDGruppo Otologico, Piacenza, Rome, Italy

Charles A. Sansur, MDDepartment of Neurosurgery, University of Virginia HSC, Charlottesville, VA, USA

Contributors List xxi

Antonio Santoro, MDDepartment of Neuroscience, University of Rome, Rome, Italy

Tomio Sasaki, MDDepartment of Neurosurgery, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

Uta Schick, MD, PhDNeurosurgical Clinic, Duisburg, Germany

Laligam N. Sekhar, MD, FACSDepartment of Neurosurgery, University of Washington Medical Center, Seattle, WA, USA

Jason Sheehan, MD, PhDDepartment of Neurosurgery, University of Virginia HSC, Charlottesville, VA, USA

Yigal Shoshan, MDDepartment of Neurosurgery, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

Eric H. Sincoff, MDDeaprtment of Neurosurgery, Oregon Health Sciences University, Portland, OR, USA

Marc P. Sindou, MD, DScDepartment of Neurosurgery, Hospital Neurologique, Lyon, France

Sergey Specktor, MDDepartment of Neurosurgery, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

Robert F. Spetzler, MDDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

Ladislau Steiner, MD, PhDDepartment of Neurosurgery and Radiology, University of Virginia HSC, Charlottesville, VA, USA

Glen H.J. Stevens, MD, PhDBrain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

John H. Suh, MDDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA

Abdelkader Taibah, MDGruppo Otologico, Piacenza, Rome, Italy

John M. Tew, Jr., MDDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Philip Theodosopoulos, MDDepartment of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Tina Thomas, MDBrain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Brent A. Tinnel, MDDepartment of Radiation Oncology, Walter Reed Army Medical Center, Washington, DC, USA

Jörg-Christian Tonn, MDDepartment of Neurosurgery, University of Munich, Munich, Germany

xxii Contributors List

Eve C. Tsai, MD, PhDCenter for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

Koichi Uchida, MDDepartment of Neurosurgery, Keio University School of Medicine, Tokyo, Japan

Felix Umansky, MDDepartment of Neurosurgery, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

Harry R. van Loveren, MDDepartment of Neurosurgery, University of South Florida, Tampa, FL, USA

Marcus L. Ware, MD, PhDDepartment of Neurosurgery, University of Arkansas, Little Rock, AR, USA

Peter A. Winkler, MD, PhDDepartment of Neurosurgery, University of Munich, Munich, Germany

Tetsumori Yamashima, MD, PhDDepartment of Restorative Neurosurgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

Kazunari Yoshida, MDDepartment of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.

Contributors List xxiii