Microsurgical Resection of a Diaphragma Sellae Meningioma via Extradural Clinoidectomy with Preservation of Superior Hypophyseal Arteries

Diaphragma sellae meningiomas are rare suprasellar tumors often misidentified as tuberculum sellae meningiomas. Their association with the optic nerve, chiasm, pituitary stalk, internal carotid, and superior hypophyseal arteries presents unique surgical challenges. These tumors are classified into three types based on dural attachment with precise subtype identification. We present a Type A diaphragma sella meningioma, located anterior to the pituitary stalk, managed via a pterional craniotomy with extradural anterior clinoidectomy and optic unroofing. Posterior attachment with ICA adhesion and multiple SHA involvement favored a transcranial route, with clinoidectomy and optic unroofing widening the optico-carotid triangle for safe resection.

anterior clinoidectomy - diaphragma sellae meningioma - microsurgical resection - optic nerve decompression - pterional approach - skull base surgery

The patient in this study has provided consent for their procedures and for the use and publication of their anonymous medical images. No IRB is required for case reports.

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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