Microsurgery of Meningiomas Involving the Superior Sagittal Sinus

• Published in: World neurosurgery Vol. 170; p. 174
• Main Authors: Zanaty, Mario, Choutka, Ondrej
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2023
• Subjects: Adult; Convexity meningioma; Humans; Male; Meningeal Neoplasms - diagnostic imaging; Meningeal Neoplasms - pathology; Meningeal Neoplasms - surgery; Meningioma; Meningioma - diagnostic imaging; Meningioma - pathology; Meningioma - surgery; Microsurgery; Microsurgical resection; Neurosurgery; Operative technique; Sagittal sinus reconstruction; Superior sagittal sinus; Superior Sagittal Sinus - diagnostic imaging; Superior Sagittal Sinus - pathology; Superior Sagittal Sinus - surgery; Treatment Outcome; Young Adult; Operative technique; Superior sagittal sinus; SSS; Microsurgical resection; Sagittal sinus reconstruction; Convexity meningioma; Neurosurgery; Meningioma
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2022.11.026

Meningiomas involving major dural sinuses can be difficult to resect without proper handling of the sinus. In young patients, a gross total resection should be attempted when feasible. A 24-year-old man presented with headaches, progressive left-sided weakness, and partial motor seizures. He was found to have a parasagittal meningioma in front of the motor cortex that invaded the superior sagittal sinus (SSS). The sinus was still patent, and the walls were preserved. Thus a gross total resection was achieved with primary suturing of the sinus, followed by reinforcement with an AnastoClip GC. Videos 1–3 details the separation of the tumor from the convexity veins and the cortex, removal of the tumor from the SSS, and reconstruction of the SSS. Gross total resection of meningiomas involving the SSS is achievable without sacrificing the sinus when planned correctly and methodically. The patient consented for the procedure and to the publication of these images.