Obstruction of the superior sagittal sinus caused by parasagittal meningiomas: the role of collateral venous pathways

Oka, Kazunari; Go, Yoshinori; Kimura, Hideo; Tomonaga, Masamichi

doi:10.3171/jns.1994.81.4.0520

Cited by 54 publications

(24 citation statements)

References 6 publications

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“…These complications include postoperative hematoma, venous air embolism, subgaleal fluid collection, new onset of seizures, deep venous thrombosis, brain edema and transient or permanent neurological worsening in the immediate postoperative period [2,3,4,8,9]. Operative mortality varies between 1.8% and 7.3%, but has been reduced with new imaging systems and improved microsurgical technique [2,3,4,9].…”

Section: Discussionmentioning

confidence: 99%

“…Grade VIII represents bilateral complete invasion of the sagittal sinus. As these grade increases, the surgical resection and dissection from the sagittal sinus may be more difficult and there is an increased complication risk depending on whether collateral venous drainage has developed or not [2,4,9]. Moreover, Merrem Krause and Bonnal Brotchi also classified meningiomas regarding their invasion to the dural venous sinus in six different grades [11].…”

Section: Discussionmentioning

confidence: 99%

“…A meningioma located at the anterior third of the sagittal sinus can be removed without significant morbidity risk. The middle and posterior third of the sagittal sinus is the problematic location for meningioma that invades the sagittal sinus, because the major cortical drainage veins and the vein of Trolard are located around these parts [2,3,4,9].…”

Section: Discussionmentioning

confidence: 99%

“…But we prefered to ligate instead of making bypass because totally occluded part located anterior one third of superior sagittal sinus and sacrificing of this part would not cause any complication such as edema or hemorrhagic infarct [2,3,4,9,12]. However, while sacrificing the totally occluded part of the superior sagittal sinus does not create any major clinical problem, sacrificing or inadvertent injury to the veins around the occluded part of the superior sagittal sinus can cause significant morbidity and even mortality [2,3,4,9,12]. A meningioma located at the anterior third of the sagittal sinus can be removed without significant morbidity risk.…”

Section: Discussionmentioning

confidence: 99%

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Management of Persistent Hypotension after Resection of Parasagittal Meningioma

Gülşen

2014

Open Access Maced J Med Sci

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Various complications including air embolism have been discussed in large clinical series regarding the parasagittal meningioma. We presented and discussed the patient suffering from persistent hypotension after excision of parasagittal meningioma. A 47-year-old man was admitted to our hospital with complaints of headache and frontal region swelling. His cranial MRI showed a bilaterally located parasagittal meningioma at the anterior one third of the sagittal sinus. Conspicuously, he had large frontal sinus and its length was about totally 7 cm in sagittal and transverse part.During cranitomy, we had to open frontal sinus because of its large size and open the sagittal sinus while removing of the tumor. So coincidental opening of the superior sagittal sinus and/or emissary veins located within diploe of the cranium and frontal sinus may cause hypotension after extubation due to normal respiration led to air escaping from the frontal sinus to the emissary veins placed next to the frontal sinus. Bilateral application of the tamponade embedded with vaseline inside to the nose prevents air escaping from the frontal sinus to the emissary veins

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Management of Persistent Hypotension after Resection of Parasagittal Meningioma

Gülşen

2014

Open Access Maced J Med Sci

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“…However, intracranial hypertension was caused by meningioma involving the dural sinuses in only a few cases. 1,10,11) In patients with meningioma, the occlusive procedure of the dural sinuses may be gradual so allow adequate development of collateral pathways. In contrast, rapid occlusion of the dural sinuses, such as by cerebral venous thrombosis, may not allow sufficient time to complete alternative pathways and thus result in increased intracranial pressure.…”

Section: Discussionmentioning

confidence: 99%

Reversible Non-thrombotic Occlusion of the Superior Sagittal Sinus Caused by Metastatic Malignant Lymphoma-Case Report-

Matsumoto

Ohta

Takeshita

2003

Neurol. Med. Chir.(Tokyo)

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A 57-year-old female presented with intracranial hypertension secondary to non-thrombotic superior sagittal sinus occlusion manifesting as acute onset of headache, vomiting, and disorientation. She had a history of intrapelvic malignant lymphoma. Neuroimaging and tumor biopsy revealed that both the superior sagittal sinus and the straight sinus were occluded by metastatic deposits of malignant lymphoma. Her clinical symptoms were remarkably improved by irradiation and chemotherapy, and the affected sinuses were angiographically recanalized.

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Morphological study of sinus flow in the confluence of sinuses

et al. 2008

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The confluence of sinuses (CS; torcular herophili) is represented by the junction of the superior sagittal (SSS), straight (SS), occipital (OS), and two transverse sinuses (TS). The objective of this study was to interpret sinus flow around the CS by morphological investigation of the sinuses. This study is based on visual examination of dural venous sinuses in the region of the CS in 31 adult cadavers. In the inflow zone, we examined the direction of SSS and SS flow. In the communication zone, we examined the extent to which outflow sinuses communicate with other sinuses. In the outflow zone, we used the diameters of outflow sinuses to determine anatomical dominance. The SSS entered the CS via the right TS in 16 cases (51.6%) and via the center of the CS in 14 cases (45.2%). The SS entered via the center of the CS in 18 cases (58.1%) and via the left TS in 11 cases (35.5%). Outflow sinuses communicated freely in 26 cases (83.8%) and communicated partially in five cases (16.2%). Partial communication was the result of a septate CS. In terms of outflow, the right TS was dominant in 11 cases (35.5%), and in 18 cases (58.1%), outflow was symmetrical. The direction of SSS inflow was different from that of SS inflow, and partial communication was observed in five cases (16.1%). Therefore, the presence of a septum may be considered an anatomical factor, with implications in diagnosis or in the sacrifice of the outflow sinus of the CS.

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Obstruction of the superior sagittal sinus caused by parasagittal meningiomas: the role of collateral venous pathways

Cited by 54 publications

References 6 publications

Management of Persistent Hypotension after Resection of Parasagittal Meningioma

Management of Persistent Hypotension after Resection of Parasagittal Meningioma

Reversible Non-thrombotic Occlusion of the Superior Sagittal Sinus Caused by Metastatic Malignant Lymphoma-Case Report-

Morphological study of sinus flow in the confluence of sinuses

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