Jugular Foramen Meningioma with Transverse and Sigmoid Sinuses Invasion and Jugular Vein Extension

Abstract

We present the case of a jugular foramen meningioma with predominantly intraluminal invasion of the transverse, sigmoid sinuses, jugular bulb, and internal jugular vein with venous occlusion in a 45-year-old woman. Magnetic resonance imaging (MRI) of the brain and conventional angiography were performed preoperatively and revealed a right-sided extra-axial dural-based mass in the jugular foramen. The surgical approach was a high cervical approach with exposure of the internal carotid artery, jugular vein, and cranial nerves IX to XII as well as a combined posterior temporo-basal and retrosigmoid craniotomy with mastoidectomy and posterior retrolabyrinthine petrosectomy. The transverse, sigmoid sinuses, jugular bulb, and superior internal jugular vein were removed en bloc, and the exophytic intradural tumor extension around cranial nerves IX, X, XI, and XII was resected subtotally. Postoperatively, the patient presented a transient right facial weakness (House-Brackmann II). MRI showed partial resection. This is the first case report of a jugular foramen meningioma with transverse and sigmoid sinuses invasion and jugular vein extension in the adult population.