scholarly journals Parasagittal Meningioma (Posterior Third) Occluding the Superior Sagittal Sinus: Complete Resection and Venous Repair: 3-Dimensional Operative Video

2017 ◽  
Vol 13 (5) ◽  
pp. 650-650
2019 ◽  
Vol 17 (4) ◽  
pp. E162-E163
Author(s):  
Marcos Dellaretti ◽  
Daniel Espindola Ronconi

Abstract Intraoperative ultrasound navigation was initially introduced in the neurosurgical field for brain tumor surgery and was then extended to arteriovenous malformation surgery with good success. This tool provides real-time intraoperative images.1 Moreover, Doppler ultrasound permits early identification of feeding arteries and supplies the surgeon with a global impression of the flow dynamics.2 A further use of doppler is to check for residual nidus. Other advantages are the capacity to identify intracerebral hemorrhage.2 In this video, we demonstrate the case of a 15-yr-old patient who presented intracranial hemorrhage. Magnetic resonance imaging revealed the presence of left frontoparietal hematoma associated with an image suggestive of cerebral arteriovenous malformation (AVM). Arteriography confirmed the diagnosis of AVM fed by branches of the anterior cerebral and superficial drainage for the superior sagittal sinus. The patient was placed in dorsal decubitus with his head turned to the right and a left parietal-frontal craniotomy was performed. After the dura mater was opened, cortical mapping was performed to locate the motor and sensory cortex. After the mapping, ultrasound with doppler was performed to locate the AVM and the hematoma and determine its relation to the motor and sensory cortex. At the end of the surgery, doppler ultrasound was used again to ensure complete resection of the AVM. Intraoperative Ultrasound navigation with doppler is an inexpensive technology that can be used in the treatment of AVMs, especially in the subcortex, as it assists in locating the nidus and confirms its complete resection.


2019 ◽  
Vol 10 (1) ◽  
pp. 79-83
Author(s):  
Yury G. Yakovlenko ◽  
Vladimir A. Moldovanov ◽  
Larisa V. Araslanova ◽  
Igor M. Blinov ◽  
Olga P. Suhanova

Clinical observation of the patient with parasagittal meningioma at the level of the middle third of the superior sagittal sinus and falx is presented. When such tumors are removed, the main task is to prevent damage to the parasagittal veins, the injury of which can cause a persistent neurological defi cit in the postoperative period. A feature of this case is the complex use of advanced minimally invasive methods of angiographic diagnosis when planning surgical treatment, which signifi cantly increases the chances of a successful outcome of the operation.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Masataka Nakano ◽  
Toshihide Tanaka ◽  
Aya Nakamura ◽  
Mitsuyoshi Watanabe ◽  
Naoki Kato ◽  
...  

Pulmonary metastases of benign meningiomas are extremely rare. The case of a 34-year-old man with bilateral parasagittal meningioma who developed pulmonary metastases is described. The meningioma was an enormous hypervascular tumor with invasion of the superior sagittal sinus. The tumor was resected completely and histologically diagnosed as transitional meningioma. The Ki-67 labeling index was 5%. Four months after operation, the patient subsequently developed bilateral multiple lung lesions later identified as metastases. The lung lesions were partially removed surgically and histologically diagnosed as meningothelial meningioma WHO grade I. The Ki-67 labeling index was 2%. The histological findings demonstrated that the tumor occupied the arterial lumen and the perivascular space, suggesting that pulmonary tumors might metastasize via the vascular route. The histopathological features and mechanisms of metastasizing meningiomas are reviewed and discussed.


Author(s):  
AA Ahmed ◽  
B Yarascavitch ◽  
N Murty

Background: Parasagittal meningioma is a common type of intracranial meningiomas. Surgical resection of such lesions can result in injury to superior sagittal sinus. In rare occasions, extended craniotomy might be required for uncontrollable hemorrhage from a lacerated venous wall. Objective: In order to avoid extended craniotomy, we attempted a surgical technique that would provide more sustained control over the lacerated venous sinus. Method: A 56 year old lady underwent surgical resection for parasagittal meningioma. The lateral wall of the superior sagittal sinus was preached while scraping the tumor capsule from the sinus wall. Owing to difficulty in controlling the bleeding site, a tack up falx-assisted tension suture was attempted with a mass of Gelfoam and Surgicel over the laceration. Results: Adequate control for the venous sinus laceration. Conclusion: The falx-assisted suturing technique is quick, easy to perform and efficient in maintaining a constant tamponade effect over the lacerated site. We highly recommend such technique prior to extending the craniotomy over an injured venous sinus.


1994 ◽  
Vol 81 (4) ◽  
pp. 520-524 ◽  
Author(s):  
Kazunari Oka ◽  
Yoshinori Go ◽  
Hideo Kimura ◽  
Masamichi Tomonaga

✓ The authors present studies of eight patients who had obstruction of the superior sagittal sinus caused by parasagittal meningioma. The results indicate that meningeal veins and end-to-end anastomoses of the superficial veins of the cerebrum play important roles as collateral venous pathways. This assessment suggests that, in patients with obstruction of the superior sagittal sinus, venous phase angiography should be carefully interpreted before surgery is attempted for parasagittal meningiomas.


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