Management of parasagittal meningiomas invading superior sagittal sinus

Abstract

Introduction Meningioma in parasagittal location represents between 20 and 30% of meningioma cases in the cranial cavity. The close relation of it with superior sagittal sinus makes its surgical resection a great challenge to the surgeon to get a good result. Aim A retrospective and prospective study of management of 15 cases of parasagittal meningiomas invading superior sagittal sinus was conducted, including clinical assessment, diagnosis, and surgical management done in Al Azhar University Hospitals. Patients and methods The authors recruited 15 patients with parasagittal meningioma who were admitted to the Neurosurgery Department, Al Azhar University Hospitals. These cases had been assessed according to clinical picture, radiological evaluation, operative details, and postoperative complications. Surgical resection was achieved for these cases in the period between October 2015 and February 2019. Results The patients’ age varied between 20 and 60 years. Patients comprised eight males and seven females. The presenting symptoms were headache (15 patients), seizures (10 patients), motor weakness (12 cases), papilledema (four patients), and frontal manifestation (four cases). A total of 11 cases had gross total tumor excision, whereas four cases showed partial tumor removal. Moreover, there were two mortality cases. Conclusion Several factors contribute to the success of parasagittal meningioma surgery. The authors consider the preservation of the cortical veins to be important, and when possible should be done. The experience has led to believe that until now, surgery is a winning choice if practiced by expert hands.