Microsurgical ressection for parasagittal meningiomas with preservation of the parasagittal sinus and excelent neurovascular control

Lynch, José Carlos; Schiavini, Hugo; Bomfim, Cleber; Fonseca, Joelton; Pereira, Celestino

doi:10.1590/0004-282x20130025

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…Parasagittal bölge meningiomların primer ve nüks olarak en sık görüldüğü lokalizasyonlardan biridir [39][40][41][42]. Bonnal ve Brotchi [38] 21 hastalık serisinde total rezeksiyon %81, nüks %14, mortalite %5 olarak bildirilmektedir.…”

Section: Discussionunclassified

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Dev Meninjiomalar: Bir Üniversite Hastanesinin 5 Yıllık Deneyimi

Ocal¹,

Kurt²

2021

Pamukkale Medical Journal

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Çapı 6 santimetreden (cm) büyük meningiomlar dev meningiomlar olarak isimlendirilir. Bu çalışmada cerrahi uyguladığımız 40 dev meningiom olgusunun klinik, patolojik ve radyolojik özellikleri ile tedavi yaklaşımlarını tartıştık. Gereç ve yöntem: 2015-2019 yılları arasında çapı 6 cm'den büyük olan ve patolojik tanısı meningiom olarak rapor edilen hastalar yaş, cinsiyet, lokalizasyon, semptom ve bulgular, tedavi, takip süresi, nüks, morbidite ve mortalite açısından incelenmiştir. Bulgular: Çalışmada toplam 40 vaka olup, vakaların 30 tanesi (%75) kadın, 10 tanesi ise (%25) erkek cinsiyette idi. Ortalama yaş 55,77,33 (ortalama  Standart Sapma-SS) (min:39, maks:72) olarak saptandı. En sık konveksite yerleşimliydi (13 hasta, %32). En sık semptom %42,5 ile baş ağrısıydı. Hastaların 7'sinde (%17,5) Simpson Evre I, 16 hastada (%40) Evre II, 2 hastada (%5) Evre III ve 15 hastada ise (%37,5) Evre IV cerrahi rezeksiyon uygulandı. Patolojik tanı 32 olguda (%80) Evre I, 6 olguda (%15) Evre II ve 2 olguda ise (%5) Evre III meningiom olarak raporlandı. Hastaların ortalama takip süresi 225,24 (min:12, maks:44), nüks oranı %7,5 oranında görüldü. Serimizde morbidite %30, mortalite %0 olarak saptandı. Sonuç: Tümörün mevcut lokalizasyonu ve boyutu total rezeksiyon oranını, mortalite ve morbiditeyi önemli oranda etkilemektedir. Dev meningiomların yönetiminde cerrahi tedavi esas olup, dikkat ve deneyim gerektiren özellikli bir tedavi şeklidir.

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Section: Discussionunclassified

“…Lynch ve ark. [39] 58 hastalık serisinde ise gross total rezeksiyon %77,7, nüks %12, mortalite %1,7 olarak bildirilmiştir. Colli ve ark.…”

Section: Discussionunclassified

Dev Meninjiomalar: Bir Üniversite Hastanesinin 5 Yıllık Deneyimi

Ocal¹,

Kurt²

2021

Pamukkale Medical Journal

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“…Parasagittal tumors arise from the dura mater on the hemisphere's convexity involving the walls and the superior sagittal sinus (3). Cushing and Eisenhardt first described parasagittal meningioma coming from a parasagittal angle without brain tissue between the superior sagittal sinus and tumor in 1938 (4).…”

Section: Introductionmentioning

confidence: 99%

Giant Parasagittal Meningioma with Complete Visual Loss in Young Female: A Case Report

Sinaga

Irsyad

Dharmajaya

2021

JKB

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<p>Parasagittal meningioma is a benign extra-axial tumor from the arachnoid cap cell that fills the parasagittal angle. This case report presents a case of a 21-years old young female with a history of complete visual loss, left side paresthesia, and progressive blunt headache. Brain MRI and MRV revealed a giant enhancing tumor measuring 9.2 cm x 8.41 cm x 7.5 cm on the right parietooccipital lobe with obstruction of the posterior third of the superior sagittal sinus. Gross total removal was achieved. The pathology reports confirmed a WHO grade I meningioma. The paresthesia and headache were improved, but the loss of visions did not change. Giant parasagittal meningioma may invade the superior sagittal sinus leading to intracranial hypertension. The surgical strategy should target the survival and postoperative quality of life. Occlusion of posterior third superior sagittal sinus affects deficiency venous return resulting in visual loss.</p>

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“…(2)(3)(4)(5) They comprise approximately 19.5 to 45% of all intracranial meningiomas. (6) Parasagittal meningiomas are classified according to which third of the sinus they involve; as anterior third (from the crista galli to the coronal suture), middle third (from the coronal to the lambdoid suture), or posterior third (from the lambdoid suture to the torcular) (1,5,7) . .…”

Section: Introductionmentioning

confidence: 99%

“…(18,19) The advantages of a radical resection should be weighed against the potential additional risks related to the opening of the sinus and its wall resection. (1,(20)(21) Some neurosurgeons consider the invasion of the middle and posterior third parts of the sinus as a contraindication for a complete resection (19)(20) and have proposed alternately more or less aggressive treatment modalities to manage this dilemma by resecting the tumor mass outside the sinus wall(s) and coagulate the remnant (5)(6)14) . Other neurosurgeons consider important to perform tumor excision when the SSS is completely occluded and sufficient collateral venous pathways have been established, (1,14,16,(22)(23)…”

Section: Introductionmentioning

confidence: 99%

Attempted Radical Removal of Parasagittal Meningioma: Risks and Benefits

Nofal

Samir

El-Shazly

et al. 2019

Ain Shams Medical Journal

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Background: Parasagittal meningiomas involving the superior sagittal sinus (SSS) pose formidable obstacles to surgical management. Invasion is often considered a contraindication to surgery because of associated morbidity, such as cerebral venous thrombosis.Aim of the work: was to evaluate the risk/benefit ratio in attempting radical excision of parasagittal meningiomas involving the superior sagittal sinus. Patients and methods:The study consisted of 25 patients who had undergone surgery for parasagittal meningioma. Patients with meningioma involving the anterior third of the sinus underwent radical removal. Patients with meningioma that was involving the middle and posterior third of the sinus had a radical removal if the sinus was completely obliterated, and subtotal removal of tumors that are infiltrating but not obliterating the SSS. Results: 23 patients (92%) had radical tumor resection achieving Simpson GI and 2 patients (8%) had subtotal tumor resection achieving Simpson GIV. There were 3 postoperative transient neurological deterioration (12%) and 2 postoperative deaths (8%).The recurrence rate in the study was 5%, with a follow-up for 24 months. Conclusion:The benefits must be carefully weighed against the risks deciding between more aggressive, radical, or less aggressive subtotal resections. The less aggressive subtotal resections if the sinus ispartially occluded may be a reasonable choice.

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Microsurgical ressection for parasagittal meningiomas with preservation of the parasagittal sinus and excelent neurovascular control

Cited by 6 publications

References 17 publications

Dev Meninjiomalar: Bir Üniversite Hastanesinin 5 Yıllık Deneyimi

Dev Meninjiomalar: Bir Üniversite Hastanesinin 5 Yıllık Deneyimi

Giant Parasagittal Meningioma with Complete Visual Loss in Young Female: A Case Report

Attempted Radical Removal of Parasagittal Meningioma: Risks and Benefits

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