C, Superior view. The anterior perforating arteries are stretched across the upper surface of a sphenoid ridge meningioma. D, Pterional exposure. The incision is shown in the inset. The frontal and temporal lobes have been retracted to expose the carotid artery, which is encased by tumor. The anterior perforating arteries are stretched across the upper surface of the tumor. It is best to debulk a tumor of this type before separating the tumor capsule from the perforating arteries by using careful microtechnique. (Images courtesy of AL Rhoton, Jr.)