Venous complications following petrosal vein sectioning in surgery of petrous apex meningiomas

Koerbel, Andrei; Gharabaghi, Alireza; Safavi–Abbasi, Sam; Samii, Amir; Ebner, Florian; Samii, M.; Tatagiba, Marcos

doi:10.1016/j.ejso.2008.02.015

Cited by 61 publications

(53 citation statements)

References 17 publications

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“…Some previous clinical series of CPA meningiomas focusing on the superior petrosal vein introduced cases of the vein not being observed, which was considered to be encased and/or occluded by tumors. [182540] However, this anomaly has not been reported in any previous studies of the normal anatomy of the superior petrosal vein, which includes studies involving as many as 50 sides. [414222335]…”

Section: Discussionmentioning

confidence: 99%

“…[2] Complications have followed sacrifice of the superior petrosal veins. [11218192122272930323336394042] Anatomic studies have focused on preventing such complications. [142335] This report calls attention to a unique variant in which the superior petrosal veins and sinus are absent, and the petrosal group of veins is drained by tributaries of the galenic and the tentorial groups.…”

Section: Introductionmentioning

confidence: 99%

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Absence of the superior petrosal veins and sinus: Surgical considerations

Matsushima¹,

Ribas²,

Kiyosue³

et al. 2015

Surg Neurol Int

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Background:The superior petrosal vein, one of the most constant and largest drainage pathways in the posterior fossa, may result in complications if occluded. This study calls attention to a unique variant in which the superior petrosal veins and sinus were absent unilaterally, and the venous drainage was through the galenic and tentorial drainage groups.Methods:This study examines one venogram and another anatomic specimen in which the superior petrosal vein and sinus were absent.Results:The superior petrosal veins, described as 1–3 bridging veins, emptying into the superior petrosal sinus, are the major drainage pathways of the petrosal group of posterior fossa veins. In the cases presented, the superior petrosal vein and sinus were absent and venous drainage was through the galenic and tentorial groups, including the lateral mesencephalic or bridging vein on the tentorial cerebellar surface.Conclusions:In cases in which the superior petrosal sinus and veins are absent, care should be directed to preserving the collateral drainage through the galenic and tentorial tributaries. Although surgical strategies for intraoperative management and preservation of venous structures are still controversial, knowledge of the possible anatomical variations is considered to be essential to improve surgical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Absence of the superior petrosal veins and sinus: Surgical considerations

Matsushima¹,

Ribas²,

Kiyosue³

et al. 2015

Surg Neurol Int

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“…One such meningioma saddled from the middle to posterior cranial fossa is PCM. A transpetrosal approach is appropriate for PCM; 46–57) however, some authors have reported postoperative venous complications 28,48,51,58) secondary to the impairment of venous drainage routes and modified the transpetrosal approach to prevent these complications. 7,59–61) Shibao et al reported the idea of an epidural and/or subdural modification to the anterior transpetrosal approach for PCM based on the SMCV drainage pattern.…”

Section: Falcine Groupmentioning

confidence: 99%

“…For the retrosigmoid approach, the rate of petrosal vein sacrifice is 42.1–47% and that of postoperative venous complication is 30–37.5%. 23,28) In contrast, for the anterior transpetrosal approach, the rate of petrosal vein sacrifice is 25–35.7% and that of postoperative venous complication is 0%. 25,64) According to these results, Mizutani et al suggested that sacrifice of the petrosal vein during the retrosigmoid approach may cause further venous congestion and increase intracerebellar pressure, leading to venous complications.…”

Section: Falcine Groupmentioning

confidence: 99%

Evaluation of Venous Drainage Patterns for Skull Base Meningioma Surgery

Adachi

Hasegawa

Hirose

2017

Neurol. Med. Chir.(Tokyo)

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The evaluation of venous drainage patterns prior to surgery for skull base meningioma is important owing to their deep location and the vulnerability of surrounding vascular structures. In recent years, the microsurgical skull base approach has matured as a surgical technique, making it an important option for reducing complications related to skull base meningioma surgery. In addition, knowledge of the venous anatomy can prevent venous drainage route disturbance and potentially life-threatening complications. Hence, this topic review aimed to provide an overview of normal venous anatomy as it relates to the microsurgical skull base approach, discuss known changes in venous drainage routes that are associated with the progression of skull base meningioma and the selection of an appropriate operative approach with the highest likelihood of preserving venous drainage structures.

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“…Moreover, postoperative venous complications are known to occur, such as cerebellar edema, cerebellar hemorrhage, or cerebellar infarction after sectioning the petrosal vein. 8,11,12,17,19,28) The venous drainage system of the petrosal vein has received increasing attention in the surgical treatment of pathologies involving the petroclival region. 4,18,22,24) Although most petroclival meningiomas are located against the dural surface of the posterior medial petrous bone, preservation of the petrosal venous complex, especially of the large petrosal vein, should be attempted whenever possible to reduce the risk of surgical complications.…”

Section: Introductionmentioning

confidence: 99%