Management of meningiomas involving the transverse or sigmoid sinus

Abstract

<jats:p>Meningiomas that invade the transverse or sigmoid sinuses are uncommon tumors that are challenging to treat surgically. Although the risk of recurrence is associated with the extent of resection, complete removal of meningiomas in these locations must be balanced with avoidance of venous outflow obstruction, which could cause venous infarction and significant neurological consequences. When a meningioma occludes a venous sinus completely, gross-total resection of the intravascular portion is commonly performed. When the tumor invades but does not completely obliterate a major venous sinus, however, opinions differ on whether to accept a subtotal resection or to open the sinus, perform a complete resection, and reconstruct the venous outflow tract. In this paper, the authors review the different strategies used to treat these lesions and provide illustrative case examples.</jats:p>

Predictors of postoperative motor function in rolandic meningiomas

“…Several studies presenting the results of surgery for parasagittal meningioma with significant venous involvement or invasion of the sagittal sinus highlight the surgical challenge. 4,21 While some authors favor a more balanced approach, 13 others favor radical resection to avoid recurrence. Neurological outcome in these series is not presented in detail, but complication rates are higher than those in convexity meningiomas without venous involvement.…”

Review of controversies in management of non-benign meningioma

“…In some of these, notably the venous sinuses and around the optic pathways, it has become common to attempt STR and consider radiation treatment after resection [10,[43][44][45]. However, the decision whether to treat these tumor remnants upfront, or to follow them and treat with radiation when the remnant increases, remains a controversial topic.…”

Percutaneous endovascular biopsy in the diagnosis of venous sinus lesions: technical note

“…Specimens from patients with hypertrophic pachymeningitis or meningioma can be obtained by standard meningeal biopsy or resection. 13,16,22 However, this procedure may cause relatively severe surgical trauma. Thrombus specimens from patients with cerebral venous sinus thrombosis can be obtained by mechanical thrombectomy.…”