title: Meningiomas infiltrating the superior sagittal sinus: surgical considerations of 328 cases.
abstract: The aim of the study was to discuss our management strategy and results of patients affected by meningiomas infiltrating the superior sagittal sinus. We describe 328 patients with meningiomas that were infiltrating the superior sagittal sinus. All the patients were surgically treated. Patients with meningioma involving the anterior segment of the sinus underwent total sinus resection. Patients with meningioma that was infiltrating the middle and posterior third of the sinus had a complete sinus removal if the dural sinus was completely obliterated by meningioma and incomplete removal if the sinus was not occluded. The tumour removal was grade I according to Simpson's grading system in 193 cases and grade II or III in the remainder. The superior longitudinal sinus was totally resected in 215 patients and marginally resected in 113. The tumour reappeared in 38 patients. The number of re-interventions did not affect clinical outcome. The extent of removal significantly influenced the regrowth or recurrence rate. Our results suggest that the risks of aggressive surgery, with sinus reconstruction, may be avoided, and conservative surgery for meningiomas that are infiltrating but not obliterating the superior sagittal sinus may be a reasonable choice.
authors.affiliation: Division of Neurosurgery, Department of Neurological Sciences, St. Andrea Hospital, Second Faculty of Medicine, La Sapienza University Medical School, Rome, Italy. manucarol2000@yahoo.it
authors.forename: Emanuela
authors.initials: E
authors.lastname: Caroli
authors.forename: Epimenio Ramundo
authors.initials: ER
authors.lastname: Orlando
authors.forename: Luciano
authors.initials: L
authors.lastname: Mastronardi
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrante
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D003392:Cranial Sinuses / Q000473:pathology / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008579:Meningioma / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome