Search tips
Search criteria 


Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
Skull base surgery. 1998; 8(3): 153–161.
PMCID: PMC1656674

Asterion Meningiomas


Asterion meningiomas arise from the posterior petrous ridge at the junction of the transverse and sigmoid sinuses (sinodural angle). The authors retrospectively reviewed the charts of seven patients with asterion meningiomas who underwent a Simpson I tumor resection by either the petrosal or suboccipital approach. Patients presented with headaches, dizziness, ataxia, or seizures. Preoperative angiograms and intraoperative observations confirmed occlusion of the transverse and sigmoid sinuses by tumor, thrombus, or both in four of the patients. In all cases, tumor infiltrated the sinuses and the sinuses were ligated without adverse sequelae. Temporal bone invasion was seen in one patient who had the only tumor recurrence. Postoperatively, there were two transient CSF leaks. Asterion meningiomas can be completely resected with a low incidence of major morbidity. In this small series, a patent transverse/sigmoid sinus was resected in three patients without sequelae. We believe that in young patients with asterion meningiomas a nondominant transverse/sigmoid sinus should be resected if the torcula is patent. More research is needed to determine the safety of resecting a patent dominant transverse/sigmoid sinus.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (3.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Day JD, Kellogg JX, Tschabitscher M, Fukushima T. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery. 1996 Jun;38(6):1079–1084. [PubMed]
  • CASTELLANO F, RUGGIERO G. Meningiomas of the posterior fossa. Acta Radiol Suppl. 1953;104:1–177. [PubMed]
  • Sekhar LN, Jannetta PJ, Maroon JC. Tentorial meningiomas: surgical management and results. Neurosurgery. 1984 Mar;14(3):268–275. [PubMed]
  • Gökalp HZ, Arasil E, Erdogan A, Egemen N, Deda H, Cerçi A. Tentorial meningiomas. Neurosurgery. 1995 Jan;36(1):46–51. [PubMed]
  • Guidetti B, Ciappetta P, Domenicucci M. Tentorial meningiomas: surgical experience with 61 cases and long-term results. J Neurosurg. 1988 Aug;69(2):183–187. [PubMed]
  • Martínez R, Vaquero J, Areitio E, Bravo G. Meningiomas of the posterior fossa. Surg Neurol. 1983 Mar;19(3):237–243. [PubMed]
  • Schmidek HH, Auer LM, Kapp JP. The cerebral venous system. Neurosurgery. 1985 Oct;17(4):663–678. [PubMed]
  • Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg. 1985 Jan;62(1):18–24. [PubMed]
  • SIMPSON D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957 Feb;20(1):22–39. [PMC free article] [PubMed]
  • BROWNING H. The confluence of dural venous sinuses. Am J Anat. 1953 Nov;93(3):307–329. [PubMed]
  • Bisaria KK. Anatomic variations of venous sinuses in the region of the torcular Herophili. J Neurosurg. 1985 Jan;62(1):90–95. [PubMed]
  • Durgun B, Ilglt ET, Cizmeli MO, Atasever A. Evaluation by angiography of the lateral dominance of the drainage of the dural venous sinuses. Surg Radiol Anat. 1993;15(2):125–130. [PubMed]
  • Al-Mefty O, Fox JL, Smith RR. Petrosal approach for petroclival meningiomas. Neurosurgery. 1988 Mar;22(3):510–517. [PubMed]
  • Gardner G, Robertson JH, Clark WC. Transtemporal approaches to the cranial cavity. Am J Otol. 1985 Nov;Suppl:114–120. [PubMed]
  • Pensak ML, Van Loveren H, Tew JM, Jr, Keith RW. Transpetrosal access to meningiomas juxtaposing the temporal bone. Laryngoscope. 1994 Jul;104(7):814–820. [PubMed]
  • Rosenberg SI, Flamm ES, Hoffer ME, Schwartz DM. The retrolabyrinthine transsigmoid approach to midbasilar artery aneurysms. Laryngoscope. 1992 Jan;102(1):100–104. [PubMed]
  • Samii M, Ammirati M, Mahran A, Bini W, Sepehrnia A. Surgery of petroclival meningiomas: report of 24 cases. Neurosurgery. 1989 Jan;24(1):12–17. [PubMed]
  • Malis LI. The petrosal approach. Clin Neurosurg. 1991;37:528–540. [PubMed]
  • Origitano TC, al-Mefty O, Leonetti JP, DeMonte F, Reichman OH. Vascular considerations and complications in cranial base surgery. Neurosurgery. 1994 Sep;35(3):351–363. [PubMed]
  • Jackson CG, Cueva RA, Thedinger BA, Glasscock ME., 3rd Conservation surgery for glomus jugulare tumors: the value of early diagnosis. Laryngoscope. 1990 Oct;100(10 Pt 1):1031–1036. [PubMed]
  • Brown JS. Glomus jugulare tumors revisited: a ten-year statistical follow-up of 231 cases. Laryngoscope. 1985 Mar;95(3):284–288. [PubMed]
  • Sekhar LN, Tzortzidis FN, Bejjani GK, Schessel DA. Saphenous vein graft bypass of the sigmoid sinus and jugular bulb during the removal of glomus jugulare tumors. Report of two cases. J Neurosurg. 1997 Jun;86(6):1036–1041. [PubMed]
  • Sakaki T, Morimoto T, Nakase H, Kakizaki T, Nagata K. Dural arteriovenous fistula of the posterior fossa developing after surgical occlusion of the sigmoid sinus. Report of five cases. J Neurosurg. 1996 Jan;84(1):113–118. [PubMed]
  • SUGARBAKER ED, WILEY HM. Intracranial-pressure studies incident to resection of the internal jugular veins. Cancer. 1951 Mar;4(2):242–250. [PubMed]
  • Lanzieri CF, Sacher M, Duchesneau PM, Rosenbloom SA, Weinstein MA. The preoperative venogram in planning extended craniectomies. Neuroradiology. 1987;29(4):360–365. [PubMed]
  • Watson GH. Effect of head rotation on jugular vein blood flow. Arch Dis Child. 1974 Mar;49(3):237–239. [PMC free article] [PubMed]
  • Sekhar LN, Pomeranz S, Janecka IP, Hirsch B, Ramasastry S. Temporal bone neoplasms: a report on 20 surgically treated cases. J Neurosurg. 1992 Apr;76(4):578–587. [PubMed]
  • Lewin JS, Masaryk TJ, Smith AS, Ruggieri PM, Ross JS. Time-of-flight intracranial MR venography: evaluation of the sequential oblique section technique. AJNR Am J Neuroradiol. 1994 Oct;15(9):1657–1664. [PubMed]
  • Nadel L, Braun IF, Muizelaar JP, Laine FJ. Tumoral thrombosis of cerebral venous sinuses: preoperative diagnosis using magnetic resonance phase imaging. Surg Neurol. 1991 Mar;35(3):189–195. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers