The large size of these lesions at the time of diagnosis, as well as their close relation with important neurovascular structures, often makes their resection challenging. This group of tumors represents an exemplar of the evolution of craniotomy for surgical approaches to the skull base.
The first surgical procedures to treat these tumors were performed in the late 19th century and were carried out by prominent and pioneering neurosurgeons. Subsequent technical advances have allowed better surgical outcomes, and presently these tumors can be treated safely using a plethora of surgical approaches. Furthermore, adjuvant therapies not available at the outset of surgical treatment of anterior fossa meningiomas, such as stereotactic radiation and intensity modulated radiation therapies, have provided options for treating surgeons 1).