Abstract
The aim of the study was to discuss our management strategy and results of patients affected by meningiomas infiltrating the superior sagittal sinus. We describe 328 patients with meningiomas that were infiltrating the superior sagittal sinus. All the patients were surgically treated. Patients with meningioma involving the anterior segment of the sinus underwent total sinus resection. Patients with meningioma that was infiltrating the middle and posterior third of the sinus had a complete sinus removal if the dural sinus was completely obliterated by meningioma and incomplete removal if the sinus was not occluded. The tumour removal was grade I according to Simpson’s grading system in 193 cases and grade II or III in the remainder. The superior longitudinal sinus was totally resected in 215 patients and marginally resected in 113. The tumour reappeared in 38 patients. The number of re-interventions did not affect clinical outcome. The extent of removal significantly influenced the regrowth or recurrence rate. Our results suggest that the risks of aggressive surgery, with sinus reconstruction, may be avoided, and conservative surgery for meningiomas that are infiltrating but not obliterating the superior sagittal sinus may be a reasonable choice.
Similar content being viewed by others
References
Al-Mefty O, Yamamoto Y (1993) Neurovascular reconstruction during and after skull base surgery. Contemp Neurosurg 15:1–6
Bederson JB, Eisenberg MB (1995) Resection and replacement of the superior sagittal sinus for treatment of a parasagittal meningioma: technical case report. Neurosurgery 37:1015–1018
Black PM (1993) Meningiomas. Neurosurgery 32:643–657
Bonnal J, Buduba C (1974) Surgery of the central third of the superior sagittal sinus. Acta Neurochir (Wien) 30:207–215
Borovich B, Doron Y (1986) Recurrence of intracranial meningiomas: the role played by regional multicentricity. J Neurosurg 64:58–63
Borovich B, Doron Y, Brown J, Guilburd JN, Zaaroor N, Goldsher D, Lemberger A, Gruszkiewicz, Feinsod M (1986) Recurrence of intracranial meningiomas: the role played by regional multicentricity. 2: Clinical and radiological aspects. J Neurosurg 65:168–171
Buster WP, Rodas RA, Fenstermaker RA, Kattner KA (2004) Major venous sinus resection in the surgical treatment of recurrent aggressive dural based tumors. Surg Neurol 62:522–530
Crompton MF, Gautier-Smith PC (1970) The prediction of recurrence in meningiomas. J Neurol Neurosurg Psychiatry 33:80–87
Donaghy RM, Wallman LJ, Flanagan MJ, Numato M (1973) Sagittal sinus repair: technical note. J Neurosurg 38:244–248
Giombini S, Solero CL, Lasio G, Morello G (1984) Immediate and late outcome of operations for parasagittal and falx meningiomas. Surg Neurol 21:427–435
Hakuba A (1991) Reconstruction of dural sinus involved in meningiomas. In: Al Mefty O (ed) Meningiomas. Raven Press, New York, pp 371–382
Kapp JP, Gielchinsky I (1972) Management of combat wounds of the dural venous sinuses. Surgery 71:913–917
Kapp JP, Gielchinsky I, Deardourff S (1977) Operative techniques for management of lesions involving the dural venous sinuses. Surg Neurol 7:339–342
Meier U, Gartner F, Knopf W, Klotzer R, Wolf O (1992) The traumatic dural sinus injury: a clinical study. Acta Neurochir (Wien) 119:91–93
Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann R, Martuza R (1985) Meningioma: analysis of recurrence ad progression following neurosurgical resection. J Neurosurg 62:18–24
Oka K, Go Y, Kimura H, Tomonaga M (1994) Obstruction of the superior sagittal simus caused by parasagittal meningiomas: the role of collateral venous pathways. J Neurosurg 81:520–524
Quest DO (1978) Meningiomas: an update. Neurosurgery 3:219–225
Rish BL (1971) The repair of dural venous sinus wounds by autogenous venorrhaphy. J Neurosurg 35:392–395
Schmid-Elsaesser R, Steiger HJ, Yousry T, Seelos KC, Reulen HJ (1997) Radical resection of meningiomas and arteriovenous fistulas involving critical dual sinus segments: experience with intraoperative sinus pressure monitoring and elective sinus reconstruction in 10 patients. Neurosurgery 41:1005–10016
Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39
Sindou M (1994) Reconstructive procedures of the intracranial venous system. Presented at the first international workshop on surgery of the intracranial venous system, Osuka, Japan, 12–14 September
Steiger HJ, Reulen HJ, Huber P, Boll J (1989) Radical resection of superior sagittal sinus meningioma with venous interposition graft and reimplantation of rolandic veins. Acta Neurochir (Wien) 100:108–111
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Caroli, E., Orlando, E.R., Mastronardi, L. et al. Meningiomas infiltrating the superior sagittal sinus: surgical considerations of 328 cases. Neurosurg Rev 29, 236–241 (2006). https://doi.org/10.1007/s10143-006-0020-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10143-006-0020-1