Total resection of torcular herophili hemangiopericytoma with radial artery graft: case report.

Abstract

A case of recurrent hemangiopericytoma involving the torcular herophili is reported, with special reference to the reconstruction of the straight sinus with a radial artery graft. In preoperative investigations, the tumor was found invading the straight and transverse sinuses. The involved occipital superior sagittal sinus had been removed in the previous surgery. A collateral bypass was observed from the superior sagittal sinus to the straight sinus, and the veins of Rosenthal were not opacified, suggesting poor venous drainage from the deep venous system to the cavernous sinus. We considered it necessary to reconstruct the straight and right transverse sinuses to achieve total removal of the tumor. The affected sinuses were removed and were successfully reconstructed with a radial artery interposition graft between the straight and right transverse sinus. The postoperative course was good, and the bypass was patent on the postoperative angiogram. The details of the operative technique are described.