Classification of Peritumoral Veins in Convexity and Parasagittal Meningiomas and Its Significance in Preventing Cerebral Venous Infarction

Cai, Qing; Wang, Shoujie; Wang, Julei; Tian, Qilong; Huang, Tao; Qin, Huaizhou; Feng, Dayun

doi:10.1016/j.wneu.2021.02.041

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Destruction of veins during the procedure may lead to several adverse consequences, such as cerebral infarction or hemorrhage, seizures or neurological deficits, and even death in severe cases. Therefore, protecting the peritumoral veins is critical to the success of the procedure ( 16 , 17 ). Intraoperatively, it is necessary to open the dura mater from above the tumor to avoid damaging the cortical veins at the tumor margins and to fully decompress the tumor.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Duan,

Zhou,

Yan

et al. 2024

Front. Neurol.

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BackgroundNo standardized criteria for surgical resection of parasagittal sinus meningiomas (PSM) have been established, and different surgical strategies have been proposed. The aim of the present study was to investigate the efficacy and safety of a “radical” surgical strategy in the treatment of PSM.MethodsThe clinical histories, radiological findings, pathologic features, and surgical records of 53 patients with PSM admitted by the same surgical team using the “radical” surgical strategy were retrospectively analyzed between 2018 and 2023.ResultsAmong the 53 PSM cases, 16 (30.2%) had a patent sinus proper, 28 (52.8%) had partial obstruction of the sinus proper, and 9 (17.0%) had complete obstruction of the sinus proper before the operation. During operation, Simpson grade I resection was performed in 34 (64.2%) cases and Simpson grade II in 19 (35.8%) cases. Postoperative pathologic examination suggested tumors of WHO grade I in 47 (88.7%) cases, WHO grade II in 4 (7.5%) cases, and WHO grade III in 2 (3.8%) cases. Postoperative complications primarily included a small amount of delayed intracerebral hemorrhage in 3 (5.7%) cases, exacerbation of cerebral edema in 3 (5.7%) cases, exacerbation of motor and sensory deficits in 4 (7.5%) cases, and intracranial infection in 2 (3.8%) cases. There were no cases of death or new-onset neurological dysfunction. Dizziness and headache symptoms improved to varying degrees, and a seizure-free status was achieved postoperatively. Excluding one case lost to follow-up, the average follow-up period was 33 months, and there were no cases of recurrence.ConclusionA “radical” strategy for the surgical management of PSM is effective, safe, and simple to perform, provided that the sagittal sinus is properly managed and its associated veins are protected.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Duan,

Zhou,

Yan

et al. 2024

Front. Neurol.

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“…To better expose the focus, the venous vessels that can be electrocoagulated or the venous sinuses that can be ligated in the surgical approach are sacrificed, such as the frontal drainage vein and the corresponding anterior 1/3 of the sagittal sinus ( 13 ), the corresponding drainage vein in the posterior 1/3 sagittal sinus ( 14 ), and the superior petrosal vein in the cerebellopontine angle ( 15 , 16 ). However, according to case reports ( 17 ), series reports ( 18 ) and systematic analyses of CVI ( 19 – 21 ), hemorrhagic CVI has the characteristics of short onset time, serious clinical manifestations and poor prognosis, which should be acted upon urgently ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic cerebral venous infarction after vein injury during intraoperative lesion resection: incidence, hemorrhagic stages, risk factors and prognosis

Wu,

Tian,

Wang

et al. 2024

Front. Neurol.

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ObjectiveCerebral venous infarction (CVI) after vein injury during intraoperative lesion resection is associated with intracranial hemorrhage. We conducted this study to identify the incidence, clinical and imaging features, and prognosis of hemorrhage CVI.MethodsWe performed a retrospective analysis of patients with confirmed CVI after vein injury who underwent craniotomy in our hospital. Postoperative clinical symptoms were observed, and imaging features were compared between patients with and without intracranial hemorrhages through CT examination. Variables were analyzed using univariate and multivariate regression analyses.ResultsAmong 2,767 patients who underwent craniotomy, 93 cases of injured veins were identified intraoperatively. Hemorrhagic CVI was found in 38% (35/93). Multivariate analysis revealed that midline approach, meningioma, postoperative seizures, disorders of consciousness and interval in hours < 72 h were identified as predictors of hemorrhagic CVI. After 3 months of follow-up, the prognosis was poor in 15 cases (16%, 15/93), including death (two cases), vegetative survival (four cases), and severe disability (nine cases).ConclusionsHemorrhagic CVI, as a critical complication after venous injury, can have disastrous consequences. Do not injure known veins intraoperatively. In case of injury, requisite remedial measures should be adopted during and after surgery.

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“…Detailed identification of CVI, arterial cerebral infarction, and glioma is shown in Table 1 . CVI is most common in patients with CVT or venous sinus thrombosis (Coutinho et al, 2014 ) but can also be secondary to trauma (Harris et al, 2021 ) or iatrogenic cortical venous injury (Cai et al, 2021 ). Pregnant or postpartum women and young women taking contraceptives are considered high-risk groups and account for 75% of CVT cases (Farooqui et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: An illusive cortical venous infarction mimicking glioma hemorrhage

et al. 2022

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Cortical vein thrombosis (CVT) is a rare subtype of cerebral venous thrombosis. Because CVT is rare and its clinical and imaging findings are atypical, the misdiagnosis of CVT may be extremely high. We report a case of cortical venous infarction (CVI) secondary to CVT. Due to the atypical symptoms, we were perplexed about confirming the diagnosis between CVI and glioma hemorrhage. Eventually, CVT was confirmed by pathology combined with imaging.

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Classification of Peritumoral Veins in Convexity and Parasagittal Meningiomas and Its Significance in Preventing Cerebral Venous Infarction

Cited by 4 publications

References 17 publications

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Hemorrhagic cerebral venous infarction after vein injury during intraoperative lesion resection: incidence, hemorrhagic stages, risk factors and prognosis

Case report: An illusive cortical venous infarction mimicking glioma hemorrhage

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