A 55-year-old male patient presented with a giant olfactory groove meningioma supplied
by both ophthalmic arteries. The tumor was debulked through a bifrontal craniotomy,
but the surgery was discontinued because of extensive blood loss. During a second
operation, the dura of the frontal base was dissected extradurally before the tumor
was removed. The meningeal blood supply was occluded with bipolar coagulation of the
epidural meningeal vessels around the crista galli. The highly vascular tumor then
was totally removed with considerably less blood loss. The patient's postoperative
course was uneventful. Because the ophthalmic artery cannot be embolized preoperatively,
the direct extradural approach to the skull base to devascularize the blood supply
around the olfactory groove may reduce blood loss and facilitate resection.
Giant olfactory groove meningioma - ophthalmic artery - orbitofrontal craniotomy -
extradural devascularization
