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(2): 57–64.
PMCID: PMC1656689

Venous Reconstruction in Surgery of Meningiomas Invading the Sagittal and Transverse Sinuses


Surgery of meningiomas involving major dural sinuses leaves the surgeon confronted with a difficult dilemma: leave the fragment invading the sinus in place and have a higher risk of recurrence, or attempt a total removal with or without venous reconstruction and expose the patient to a potentially greater operative danger. The authors report a series of 47 meningiomas (41 of the sagittal sinus, 4 of the transverse sinus and 2 of the torcular) in whom gross total removal was achieved in all cases, and venous reconstruction (of various types) attempted in a majority. Thirty-nine patients had a good outcome and resumed their previous activities. There was a permanent neurological deficit in five due to infarction secondary to injury of central veins (all in the sagittal sinus midthird). Three patients died from brain swelling; all with meningioma totally occluding the sinus and in whom resection was achieved without sinus reconstruction. There were two recurrences in this series which has a mean follow-up of 7.5 years.

The authors' surgical experience led them to favor whenever possible, total removal with sinus reconstruction, using a patch for meningiomas with partial sinus invasion and a venous bypass for those with total sinus occlusion.

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.
  • Bonnal J, Brotchi J. Surgery of the superior sagittal sinus in parasagittal meningiomas. J Neurosurg. 1978 Jun;48(6):935–945. [PubMed]
  • Bonnal J. La chirurgie conservatrice et réparatrice du sinus longitudinal supérieur (S.L.S.). Neurochirurgie. 1982;28(3):147–172. [PubMed]
  • Hakuba A, Huh CW, Tsujikawa S, Nishimura S. Total removal of a parasagittal meningioma of the posterior third of the sagittal sinus and its repair by autogenous vein graft. Case report. J Neurosurg. 1979 Sep;51(3):379–382. [PubMed]
  • Merrem G. Die parasagittalen Meningeome. Fedor Krause-Gedächtnisvorlesung. Acta Neurochir (Wien) 1970;23(2):203–216. [PubMed]
  • Sindou M, Mazoyer JF, Fischer G, Pialat J, Fourcade C. Experimental bypass for sagittal sinus repair. Preliminary report. J Neurosurg. 1976 Mar;44(3):325–330. [PubMed]
  • Sindou M, Mercier P, Bokor J, Brunon J. Bilateral thrombosis of the transverse sinuses: microsurgical revascularization with venous bypass. Surg Neurol. 1980 Mar;13(3):215–220. [PubMed]
  • Steiger HJ, Reulen HJ, Huber P, Boll J. Radical resection of superior sagittal sinus meningioma with venous interposition graft and reimplantation of the rolandic veins. Case report. Acta Neurochir (Wien) 1989;100(3-4):108–111. [PubMed]

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