Flow replacement cerebrovascular bypass in the management of skull base meningiomas

Meningiomas are common skull base lesions that are often in the vicinity of the internal carotid artery and its major branches. Their growth compresses, occludes or invades these vessels. Although most of the lesions can be carefully dissected from the vessels, a vascular bypass and sacrifice of the vessel may be necessary to achieve complete excision or prevent ischaemic complications from vessel manipulation. These procedures require considerable planning and skill and their use is quickly waning in the face of improving modalities for managing small residual meningiomas in inaccessible locations.