Parasagittal meningiomas – literature review and a case report

Journal of Clinical and Investigative Surgery. 2017;2(1):39-44 DOI 10.25083/2559.5555.21.3944

 

Journal Homepage

Journal Title: Journal of Clinical and Investigative Surgery

ISSN: 2559-5555 (Online)

Publisher: Digital ProScholar Media

Society/Institution: Digital ProScolar media

LCC Subject Category: Medicine

Country of publisher: Romania

Language of fulltext: English

Full-text formats available: PDF

 

AUTHORS

Toma Papacocea (Carol Davila University, Department of Neurosurgery, Bucharest, Romania)
Andrei Mladin (St. Pantelimon Emergency Clinical Hospital, Department of Neurosurgery, Bucharest, Romania)
Alexandru Papacocea (Ploiești County Emergency Hospital, Department of Neurosurgery, Ploiești, Romania)

EDITORIAL INFORMATION

Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 12 weeks

 

Abstract | Full Text

Meningiomas are tumors that can develop anywhere along the neuraxis, but with increased concentration in some specific areas. Parasagittal meningiomas have the dural attachment on the external layer of the superior sagittal sinus (SSS) and invade the parasagittal angle displacing brain away from its normal position. Among meningiomas, the parasagittal location is the most common (22%). Taking into account their anatomic insertion along SSS, parasagittal meningiomas can have their dural attachment in the anterior, the middle or the posterior third of the SSS. Most frequently parasagittal meningiomas are located in the middle third of the superior sagittal sinus (between coronal suture and lambdoid suture). The clinical picture of parasagittal meningiomas depends on the tumor location along the SSS and so is the attitude towards ligation and reconstruction of the sinus. Controversial issues regarding surgical management of parasagittal meningiomas concerning leaving a tumor remnant that invades the SSS instead attempting total resection, or the attitude in the case of totally occluded segment of a sinus are summarized in this paper. The special care for the venous system is emphasized. The recurrence matter is also approached underlining the importance of adjuvant radiosurgery for the management of residual tumors. Results described in the main papers of the literature are reviewed. Conclusions are referring to the historical evolution regarding the surgical management of parasagittal meningiomas: aggressiveness of resection, sinus reconstruction, importance of adjuvant techniques: radiosurgery, endovascular surgery and to the importance of microsurgery and careful and meticulous planning of the approach in order to avoid interference with venous collaterals. A suggestive clinical case from the authors experience is presented.