fig1

Figure 1. Algorithm for approaching tuberculum sella meningiomas with 4 possible scenarios. In A the endonasal route is preferred; in B the supraorbital is favored, and in C either approach may be reasonable based on tumor location, parasellar anatomy and presence or absence of optic canal invasion. Overall, a slight majority of these tumors are now approached by the endonasal given a high propensity of tuberculum meningiomas to invade one or both medial optic canals. ICAs: Internal carotid arteries.