Surgical management of suprasellar meningioma. Part 1: The influence of tumor size, duration of symptoms, and microsurgery on surgical outcome in 101 consecutive cases.

A consecutive series of 101 cases of suprasellar meningioma has been reviewed. Most of the patients were between 40 and 60 years of age, and women predominated in all age groups. Visual impairment was the most common admitting complaint and visual field defect the most common finding. Symmetrical visual field defects were noted in 22 cases, while the remaining 79 cases had either asymmetrical binocular involvement or only monocular defects. All patients underwent craniotomy with the operating microscope being used in 33 cases. Mortality and partial resection rates were lower and overall outcome was better in patients with tumors 3 cm or less in size and a duration of symptoms of 2 years or less. Use of the operating microscope also appeared to lower the mortality rate and improve the overall outcome; however, no effect on postoperative visual improvement was noted.