Cavernous Sinus Meningioma Classification

Hirsh et al. categorized cavernous sinus meningioma into three groups based on their relationship to the cavernous carotid to predict the difficulty of resection ¹⁾.

Sekhar’s Classification

Grade I— tumors involve 1 region of the sinus & do not invoke the ICA

Grade II—tumors occupy multiple regions of the sinus & displace but do not encase the ICA

Grade III—tumors encase the ICA w/o narrowing

Grade IV—tumors encase & narrow the ICA

Grade V—tumors involve both CSs & encase the ICA

Sphenocavernous, clinoidocavernous, and sphenoclinoidocavernous meningiomas ²⁾.

DeMonte’s grading of tumour resection

Grade Definition

I Complete removal of tumour and dural attachment with any abnormal bone

II Complete removal of tumour and coagulation of its dural attachment

IIIa Complete removal of intra- and extradural tumour without resection or coagulation of its dural attachment

IIIb Complete removal of intradural tumour without resection or coagulation of its dural attachment or any extradural tumour extensions

IVa Intentional subtotal removal to preserve cranial nerve or blood vessels with complete removal of its dural attachment

IVb Subtotal removal leaving <10% tumour volume V Subtotal removal leaving >10% tumour volume or decompression with or without biopsy ³⁾.