scholarly journals Management of Persistent Hypotension after Resection of Parasagittal Meningioma

2014 ◽  
Vol 2 (3) ◽  
pp. 483-487
Author(s):  
Salih Gulsen
Keyword(s):  
Frontal Sinus ◽  
Air Embolism ◽  
Sagittal Sinus ◽  
Large Size ◽  
Clinical Series ◽  
Emissary Veins ◽  
Cranial Mri ◽  
Persistent Hypotension ◽  
Normal Respiration ◽  
Parasagittal Meningioma

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.

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.

Ventriculosagittal Sinus Shunt Placement: Technical Case Report

Neurosurgery ◽  
2003 ◽  
Vol 53 (3) ◽  
pp. 778-780 ◽  
Author(s):  
Uzma Samadani ◽  
Julian A. Mattielo ◽  
Leslie N. Sutton
Keyword(s):  
Clinical Presentation ◽  
Air Embolism ◽  
Pneumatosis Intestinalis ◽  
Seldinger Technique ◽  
Ventricular Catheter ◽  
Shunt Valve ◽  
Distal Catheter ◽  
Shunt Placement ◽  
Sagittal Sinus ◽  
Theoretical Advantage

Abstract OBJECTIVE AND IMPORTANCE Determining an appropriate site for distal catheter placement for ventricular shunting for some hydrocephalic patients can be difficult. We describe a simplification of the technique for sagittal sinus shunt placement using a guidewire. CLINICAL PRESENTATION A 20-month-old infant with hydrocephalus secondary to Alexander's disease developed erosion of her parieto-occipital ventriculoperitoneal shunt reservoir through an occipital decubitus scalp ulceration. Her hydrocephalus was temporarily treated with a ventriculostomy; however, she developed pneumatosis intestinalis while in the hospital. TECHNIQUE The patient underwent placement of a ventriculosagittal sinus shunt. The ventricular catheter and shunt valve were placed through a burr hole at Kocher's point, and the distal end of the catheter was placed in the superior sagittal sinus by using the Seldinger technique. CONCLUSION Ventriculosagittal sinus shunting may be used as an alternative to traditional methods for patients for whom distal shunt placement is problematic. Our technique has the theoretical advantage of reducing the risks of blood loss or air embolism by not requiring a scalpel incision into the sinus.

scholarly journals Management of inadvertent injury to superior sagittal sinus in parasagittal meningioma: technical note

2015 ◽  
Vol 42 (S1) ◽  
pp. S43-S43
Author(s):  
AA Ahmed ◽  
B Yarascavitch ◽  
N Murty
Keyword(s):  
Surgical Resection ◽  
Superior Sagittal Sinus ◽  
Lateral Wall ◽  
Technical Note ◽  
Venous Sinus ◽  
Sagittal Sinus ◽  
Sinus Wall ◽  
Venous Wall ◽  
Parasagittal Meningioma ◽  
Tamponade Effect

Background: Parasagittal meningioma is a common type of intracranial meningiomas. Surgical resection of such lesions can result in injury to superior sagittal sinus. In rare occasions, extended craniotomy might be required for uncontrollable hemorrhage from a lacerated venous wall. Objective: In order to avoid extended craniotomy, we attempted a surgical technique that would provide more sustained control over the lacerated venous sinus. Method: A 56 year old lady underwent surgical resection for parasagittal meningioma. The lateral wall of the superior sagittal sinus was preached while scraping the tumor capsule from the sinus wall. Owing to difficulty in controlling the bleeding site, a tack up falx-assisted tension suture was attempted with a mass of Gelfoam and Surgicel over the laceration. Results: Adequate control for the venous sinus laceration. Conclusion: The falx-assisted suturing technique is quick, easy to perform and efficient in maintaining a constant tamponade effect over the lacerated site. We highly recommend such technique prior to extending the craniotomy over an injured venous sinus.

scholarly journals Bilateral Frontal Sinus Pericranii with an Intratabular Course

2010 ◽  
Vol 16 (2) ◽  
pp. 179-182 ◽  
Author(s):  
B. Schenk ◽  
P.A. Brouwer
Keyword(s):  
Frontal Sinus ◽  
Unusual Case ◽  
Superior Sagittal Sinus ◽  
Venous System ◽  
Venous Anomaly ◽  
Sinus Pericranii ◽  
Sagittal Sinus ◽  
Venous Circulation ◽  
Bridging Vein

Sinus pericranii is a rare venous anomaly, representing a transosseous connection between the intracranial venous system and the epicranial venous system. We present an unusual case of bilateral frontal sinus pericranii in a 12-year-old boy, with associated lacrimation. Instead of the usual short bridging vein between the intra- and extracranial venous circulation, in our case the veins connecting the superior sagittal sinus and the left superior ophthalmic/orbital vein coursed intratabularly over a distance of several centimeters. To our knowledge, such a course has not previously been reported in literature.

scholarly journals Optimizing Burr Hole Placement for Craniotomy: A Technical Note

2019 ◽  
Vol 10 (03) ◽  
pp. 413-416 ◽  
Author(s):  
Survendra Kumar Rajdeo Rai ◽  
Saswat Kumar Dandpat ◽  
Dikpal Jadhav ◽  
Shashi Ranjan ◽  
Abhidha Shah ◽  
...  
Keyword(s):  
Superior Sagittal Sinus ◽  
Technical Note ◽  
Burr Hole ◽  
Bone Flap ◽  
Sagittal Sinus ◽  
Large Size ◽  
Good Cosmesis ◽  
Burr Holes ◽  
Minimum Numbers ◽  
Smooth Margin

Abstract Objective Usually, burr holes are placed along the line of a craniotomy. We describe a novel technique of burr hole placement to obtain smooth and beveled bony margin without any troughs and crests. Dural separation is obtained by minimizing the number of burr holes required. Methods Fifty craniotomies of diameter ranging from 3.5 to 11.5 cm were accomplished by placing burr hole in the center of bone flap rather than along the craniotomy line permitting 360 degrees of dura separation dependent on the length of dura separator. Craniotomy < 9  cm in diameter was performed by placing a single burr hole and a larger size craniotomy was performed with two burr holes. Parasagittal craniotomy was performedby placing burr hole not > 2.5  cm away from expected craniotomy site, namely superior sagittal sinus area enabling separation of adhered dura and venous sinuses. The bone cutter was used in a particular fashion to create smooth margin and beveled edges. Results Craniotomy < 9  cm in diameter was possible with single burr hole in 34 cases. Craniotomy larger than 9  cm in size was performed in 16 cases with double burr hole by strategically placing burr in the center of the desired bone flap. The craniotomy was achieved in all cases without damaging dura and venous structures. Conclusions An optimally placed single burr hole is sufficient for small to moderately large size craniotomy. Larger size craniotomy is possible with minimum numbers of burr holes. This achieves good cosmesis and avoids sinking of the bone flap.

scholarly journals Cerebral Venous Air Embolism due to a Hidden Skull Fracture Secondary to Head Trauma

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Ai Hosaka ◽  
Tetsuto Yamaguchi ◽  
Fumiko Yamamoto ◽  
Yasuro Shibagaki
Keyword(s):  
Head Trauma ◽  
Superior Sagittal Sinus ◽  
Skull Fracture ◽  
Air Embolism ◽  
Skull Fractures ◽  
Venous Air Embolism ◽  
Sagittal Sinus ◽  
The Right ◽  
Head Computed Tomography

Cerebral venous air embolism is sometimes caused by head trauma. One of the paths of air entry is considered a skull fracture. We report a case of cerebral venous air embolism following head trauma. The patient was a 55-year-old man who fell and hit his head. A head computed tomography (CT) scan showed the air in the superior sagittal sinus; however, no skull fractures were detected. Follow-up CT revealed a fracture line in the right temporal bone. Cerebral venous air embolism following head trauma might have occult skull fractures even if CT could not show the skull fractures.

scholarly journals Fronto-ethmoidal Mucocele with Frontal Sinus Destruction

2019 ◽  
Vol VOLUME 7 (VOLUME 7 NUMBER 2 NOV 2018) ◽  
pp. 35-39
Author(s):  
Mudit Gupta
Keyword(s):  
Ct Scan ◽  
General Anaesthesia ◽  
Frontal Sinus ◽  
Ethmoid Sinus ◽  
Frontal Bone ◽  
Rare Presentation ◽  
Puncture Wound ◽  
Large Size ◽  
Csf Rhinorrhoea ◽  
Orbital Region

Fronto ethmoidal mucocele is a benign but expansive pseudo cyst due to mucous secreting nature of fronto-ethmoid sinus. A rare presentation of frontoethmoidal mucocele was reported. Our subject a 61 years old female presented with frontoethmoidal mucocele of unusually large size and two in number which developed over 2 years. Two masses one above left supra-orbital region and next on forehead was noted along with diplopia and non-axial proptosis in left eye due to swelling. Similar findings were found on CT scan and diagnosis was confirmed during surgery. Endoscopic marsupialisation of fronto-ethmoid pyocele with incision & drainage of isolated pyocele in the frontal bone was performed under general anaesthesia. A puncture wound in the posterior table of frontal sinus which might have resulted in CSF rhinorrhoea was dealt at the same setting. Keywords: Fronto-ethmoidal mucocele, diplopia, two mucocele, CSF rhinorrhoea

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