Two-stage approach for olfactory groove meningioma

A 51-year-old female presented with an olfactory groove meningioma causing seizures, confusion, and anosmia. Large tumor size and frontal lobe edema can complicate resection in a single-stage craniotomy and lead to brain injury secondary to intraoperative retraction. Moreover, complete resection by the endoscopic endonasal approach (EEA) alone is not feasible given the lateral extent of the tumor. A two-stage resection with a transcribriform transplanum EEA, followed by a fronto-temporo-parietal craniotomy 4.5 months later, was performed. The EEA allows for initial decompression, devascularization, and reduction of edema, which may decrease the morbidity of craniotomy by reducing the significance of frontal lobe retraction. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25185.