Suprasellar Meningioma

When her vision didn’t return after an ophthalmology exam, Josephine Dambuleff, 62, saw several doctors before a neurologist ordered an MRI. That’s when she found out that the impaired vision she experienced turned out not to be caused by eye drops, but to a ping-pong ball-sized grade 1 meningioma. Learn more about Josephine's treatment and recovery.

Mount Sinai Health System and its team of fellowship-trained skull base surgeons, led by Joshua Bederson, MD, specializes in diagnosis and treatment of suprasellar meningiomas, a tumor that develops between the two optic nerves. We are a major referral center in the tri-state area and home to the Pituitary Care and Research Center.

Suprasellar meningiomas tend to affect middle-aged men and women, account for about 10 percent of all meningiomas, and occur near the pituitary gland and optic nerves at the skull base. These slow-growing tumors can cause severe visual impairment in one or both eyes if they press directly on the optic nerves. You can lose your vision altogether as the tumor grows. These tumors grow over months or years and can cause pituitary hormone dysfunction. Other symptoms include changes in behavior, facial numbness, headaches, loss of sense of smell, memory loss, and seizures.

To confirm diagnosis, we typically use magnetic resonance imaging or a computed tomography scan.

Treatment Options

Our experienced skull base surgeons develop individualized treatment plans, based on the size and location of the tumor, your specific needs, and information from the imaging scans. If you are experiencing symptoms, we typically remove the tumor completely (surgical resection). Depending on your individual situation, we will either use an open craniotomy or a more minimally invasive endoscopic procedure, where we perform the procedure through your nose. If you have a tumor near or in your pituitary region, we will consult with your neuroendocrinologist to ensure proper pituitary care and management.

You may spend a night or two in our neurocritical care unit and leave the hospital within two to five days after the procedure. We encourage physical activity, working with our physical therapists, as early as the day after surgery.

If the surgery was performed transnasally, through your nose, it is important to avoid blowing your nose after the procedure. You should expect to have nasal packing in place for approximately a week.

If your neurosurgeon clears you to do so, we encourage you to get up and walk as soon as possible after the procedure. You should avoid heavy lifting. Most patients who have surgery for a suprasellar meningioma do not require acute rehabilitation therapy after surgery. We usually schedule a follow-up appointment for a week or two after you leave the hospital.