{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:30:46Z","timestamp":1767349846536,"version":"3.48.0"},"reference-count":42,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Giant skull base meningiomas are rare and surgically demanding due to proximity to critical neurovascular structures, prolonged operative time, and reduced resection rates. Reports encompassing multiple skull base regions remain limited. This case-based series includes anterior, middle, and posterior fossa tumors, emphasizing anatomical diversity and surgical strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>Eleven patients with giant skull base meningiomas were retrospectively reviewed, including tumors \u22655 cm and surgically complex lesions. The mean age was 47.7 years (range 32\u201362), with a female predominance (8 females, 3 males). Presenting symptoms included visual loss, headache, anosmia, hemiparesis, and cranial nerve deficits. Approaches were tailored to tumor location, most commonly pterional and retrosigmoid, followed by bifrontal and combined skull base craniotomies. Gross total resection was achieved in 8 of 11 patients (72.7%). Near-total or subtotal resection (3\/11) was performed when tumors encased critical neurovascular structures. Visual outcomes were favorable, with recovery or preservation in most anterior and middle fossa cases. Transient cranial nerve palsies occurred in two patients and resolved on follow-up. No postoperative mortality occurred. During follow-up ranging from 4 months to 5 years, no recurrences were observed, and residual disease remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This series illustrates the anatomical spectrum and surgical complexity of giant skull base meningiomas. Favorable outcomes were achieved with individualized approaches and multidisciplinary planning. These cases contribute practical insights to the limited literature and reinforce the need for tailored management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_783_2025","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:10:17Z","timestamp":1766146217000},"page":"542","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Giant skull base meningiomas: Definitions, case reports, and surgical approaches"],"prefix":"10.25259","volume":"16","author":[{"given":"Breno","family":"Nery","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Benefic\u00eancia Portuguesa Hospital, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00edvson","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Medicine UNIFACISA, University Center, Para\u00edba, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alencar Neto","family":"Joaquim Fechine de","sequence":"additional","affiliation":[{"name":"Department of Medicine UNIFACISA, University Center, Para\u00edba, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuella Arruda do Rego","family":"N\u00f3brega","sequence":"additional","affiliation":[{"name":"Department of Medicine UNIFACISA, University Center, Para\u00edba, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilly Beatriz Aleixo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Medicine UNIFACISA, University Center, Para\u00edba, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Quaggio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Benefic\u00eancia Portuguesa Hospital, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Campero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Padilla, Tucuman, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"10.25259\/SNI_783_2025\/ref-1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.otc.2015.08.002","article-title":"An overview of anterior skull base meningiomas and the endoscopic endonasal approach","volume":"49","author":"Abbassy","year":"2016","journal-title":"Otolaryngol Clin North Am"},{"key":"10.25259\/SNI_783_2025\/ref-2","first-page":"74","article-title":"Meningiomas of the tuberculum and diaphragma sellae","volume":"76","author":"Ajlan","year":"2015","journal-title":"J Neurol Surg B Skull Base"},{"key":"10.25259\/SNI_783_2025\/ref-3","first-page":"124","article-title":"Endoscopic-assisted approaches for complex posterior fossa meningioma: Techniques and outcomes","volume":"26","author":"Al-Mefty","year":"2024","journal-title":"Oper Neurosurg"},{"key":"10.25259\/SNI_783_2025\/ref-4","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.wneu.2017.03.009","article-title":"Clinical outcome, tumor recurrence, and causes of death: A long-term follow-up of surgically treated meningiomas","volume":"102","author":"Almeida","year":"2017","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_783_2025\/ref-5","first-page":"65","article-title":"Hydrocephalus as a prognostic marker in giant posterior fossa meningiomas: Clinical implications for management","volume":"139","author":"Almeida","year":"2023","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_783_2025\/ref-6","doi-asserted-by":"crossref","first-page":"e228454","DOI":"10.1136\/bcr-2018-228454","article-title":"Giant posterior fossa meningioma: The importance of early diagnosis and challenges concerning treatment","volume":"12","author":"Antunes","year":"2019","journal-title":"BMJ Case Rep"},{"key":"10.25259\/SNI_783_2025\/ref-7","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.3171\/2009.3.17685","article-title":"Anterior clinoidal meningiomas: Functional outcome after microsurgical resection in a consecutive series of 106 patients. 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