scholarly journals Malignant Subdural Hematoma Associated with High-Grade Meningioma

2018 ◽  
Vol 04 (02) ◽  
pp. e91-e95
Author(s):  
Shinichiro Teramoto ◽  
Akira Tsunoda ◽  
Kaito Kawamura ◽  
Natsuki Sugiyama ◽  
Rikizo Saito ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Superior Sagittal Sinus ◽  
Chronic Subdural Hematoma ◽  
Acute Subdural Hematoma ◽  
Tumor Removal ◽  
Sagittal Sinus ◽  
Simpson Grade ◽  
Grade Ii ◽  
Bilateral Chronic Subdural Hematoma ◽  
Parasagittal Meningioma

AbstractA 70-year-old man, who had previously undergone surgical resection of left parasagittal meningioma involving the middle third of the superior sagittal sinus (SSS) two times, presented with recurrence of the tumor. We performed removal of the tumor combined with SSS resection as Simpson grade II. After tumor removal, since a left dominant bilateral chronic subdural hematoma (CSDH) appeared, it was treated by burr hole surgery. However, because the CSDH rapidly and repeatedly recurred and eventually changed to acute subdural hematoma, elimination of the hematoma with craniotomy was accomplished. The patient unfortunately died of worsening of general condition despite aggressive treatment. Histopathology of brain autopsy showed invasion of anaplastic meningioma cells spreading to the whole outer membrane of the subdural hematoma. Subdural hematoma is less commonly associated with meningioma. Our case indicates the possibility that subdural hematoma associated with meningioma is formed by a different mechanism from those reported previously.

scholarly journals Severe Infantile Chronic Subdural Hematoma Treated by the Lowering of the Superior Sagittal Sinus

1982 ◽  
Vol 22 (3) ◽  
pp. 227-234 ◽  
Author(s):  
Tadashi TSUCHIDA ◽  
Mitsunori FUKUDA ◽  
Ryuichi TANAKA ◽  
Motoharu YOKOYAMA ◽  
Isamu KURITA ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Superior Sagittal Sinus ◽  
Chronic Subdural Hematoma ◽  
Sagittal Sinus

scholarly journals Resection of Giant Invasive Parasagittal Atypical Meningioma With a Venous Graft Reconstruction of the Sagittal Sinus: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Emad Aboud ◽  
Wardan Almir Tamer ◽  
Walid Ibn Essayed ◽  
Ossama Al-Mefty
Keyword(s):  
Saphenous Vein Graft ◽  
Venous Drainage ◽  
Radical Resection ◽  
Surgical Removal ◽  
Sagittal Sinus ◽  
Simpson Grade ◽  
Grade Ii ◽  
Graft Reconstruction ◽  
Venous Complication ◽  
Parasagittal Meningioma

Abstract Parasagittal meningioma becomes challenging when it involves the sagittal sinus and frequently invades the skull1; hence, resection of the invasive bone and management of the involved sinus are the two crucial issues in these tumors; notwithstanding the practice of conservative surgical resection coupled with irradiation (radiosurgery or stereotactic radiotherapy),2 radical surgical removal, including the invaded bone and sinus (Simpson grade I), alleviates recurrences. It is more valuable and particularly recommended in grade II meningiomas,3 since radical surgery is the principal factor in a long control of grade II meningioma4 and radiation effectiveness is directly related to gross total removal.5 On the other hand, removal of tumor involving the sinus and sinus reconstruction has been recommended and practiced for years.6-10 When the sinus is occluded, preservation of the collateral venous drainage becomes paramount.11 If the collateral venous drainage included cutaneous and dural channels, as in this patient, reconstructing of the sinus would become preventative of a major venous complication. Sindou et al8 even advocate the routine reconstruction of occluded sinus to minimize morbidity.  The patient is 39 yr old with a giant parasagittal meningioma that invaded the skull, occluded the sinus at the mid-third, and had venous collateral through the dura and cutaneous veins. He underwent radical resection with reconstruction of the sinus by saphenous vein graft. Patient consented for the operation and publication of images.  Illustrations at 1:51 and 2:15 from Al-Mefty O, Operative Atlas of Meningiomas, © LWW, 1997, with permission.

scholarly journals Preoperative evaluation of the venous system during the surgery of parasagittal meningioma

2019 ◽  
Vol 10 (1) ◽  
pp. 79-83
Author(s):  
Yury G. Yakovlenko ◽  
Vladimir A. Moldovanov ◽  
Larisa V. Araslanova ◽  
Igor M. Blinov ◽  
Olga P. Suhanova
Keyword(s):  
Surgical Treatment ◽  
Clinical Observation ◽  
Superior Sagittal Sinus ◽  
Preoperative Evaluation ◽  
Successful Outcome ◽  
Main Task ◽  
Sagittal Sinus ◽  
Minimally Invasive Methods ◽  
Parasagittal Meningioma ◽  
Angiographic Diagnosis

Clinical observation of the patient with parasagittal meningioma at the level of the middle third of the superior sagittal sinus and falx is presented. When such tumors are removed, the main task is to prevent damage to the parasagittal veins, the injury of which can cause a persistent neurological defi cit in the postoperative period. A feature of this case is the complex use of advanced minimally invasive methods of angiographic diagnosis when planning surgical treatment, which signifi cantly increases the chances of a successful outcome of the operation.

scholarly journals Multiple Pulmonary Metastases following Total Removal of a Bilateral Parasagittal Meningioma with Complete Occlusion of the Superior Sagittal Sinus: Report of a Case

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Masataka Nakano ◽  
Toshihide Tanaka ◽  
Aya Nakamura ◽  
Mitsuyoshi Watanabe ◽  
Naoki Kato ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Superior Sagittal Sinus ◽  
Labeling Index ◽  
Ki 67 ◽  
Who Grade ◽  
Lung Lesions ◽  
Sagittal Sinus ◽  
Arterial Lumen ◽  
Hypervascular Tumor ◽  
Parasagittal Meningioma

Pulmonary metastases of benign meningiomas are extremely rare. The case of a 34-year-old man with bilateral parasagittal meningioma who developed pulmonary metastases is described. The meningioma was an enormous hypervascular tumor with invasion of the superior sagittal sinus. The tumor was resected completely and histologically diagnosed as transitional meningioma. The Ki-67 labeling index was 5%. Four months after operation, the patient subsequently developed bilateral multiple lung lesions later identified as metastases. The lung lesions were partially removed surgically and histologically diagnosed as meningothelial meningioma WHO grade I. The Ki-67 labeling index was 2%. The histological findings demonstrated that the tumor occupied the arterial lumen and the perivascular space, suggesting that pulmonary tumors might metastasize via the vascular route. The histopathological features and mechanisms of metastasizing meningiomas are reviewed and discussed.

Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses

2006 ◽  
Vol 105 (4) ◽  
pp. 514-525 ◽  
Author(s):  
Marc P. Sindou ◽  
Jorge E. Alvernia
Keyword(s):  
Recurrence Rate ◽  
Superior Sagittal Sinus ◽  
Lateral Wall ◽  
Type I ◽  
Tumor Removal ◽  
En Bloc ◽  
Venous Flow ◽  
Dural Sinuses ◽  
Sagittal Sinus ◽  
Sinus Wall

Object Radical removal of meningiomas involving the major dural sinuses remains controversial. In particular, whether the fragment invading the sinus must be resected and whether the venous system must be reconstructed continue to be issues of debate. In this paper the authors studied the effects, in terms of tumor recurrence rate as well as morbidity and mortality rates, of complete lesion removal including the invaded portion of the sinus and the consequences of restoring or not restoring the venous circulation. Methods The study consisted of 100 consecutive patients who had undergone surgery for meningiomas originating at the superior sagittal sinus in 92, the transverse sinus in five, and the confluence of sinuses in three. A simplified classification scheme based on the degree of sinus involvement was applied: Type I, lesion attachment to the outer surface of the sinus wall; Type II, tumor fragment inside the lateral recess; Type III, invasion of the ipsilateral wall; Type IV, invasion of the lateral wall and roof; and Types V and VI, complete sinus occlusion with or without one wall free, respectively. Lesions with Type I invasion were treated by peeling the outer layer of the sinus wall. In cases of sinus invasion Types II to VI, two strategies were used: a nonreconstructive (coagulation of the residual fragment or global resection) and a reconstructive one (suture, patch, or bypass). Gross-total tumor removal was achieved in 93% of cases, and sinus reconstruction was attempted in 45 (65%) of the 69 cases with wall and lumen invasion. The recurrence rate in the study overall was 4%, with a follow-up period from 3 to 23 years (mean 8 years). The mortality rate was 3%, all cases due to brain swelling after en bloc resection of a Type VI meningioma without venous restoration. Eight patients—seven of whom harbored a lesion in the middle third portion of the superior sagittal sinus—had permanent neurological aggravation, likely due to local venous infarction. Six of these patients had not undergone a venous repair procedure. Conclusions The relatively low recurrence rate in the present study (4%) favors attempts at complete tumor removal, including the portion invading the sinus. The subgroup of patients without venous reconstruction displayed statistically significant clinical deterioration after surgery compared with the other subgroups (p = 0.02). According to this result, venous flow restoration seems justified when not too risky.

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