title: Surgical treatment of parasagittal and falcine meningiomas invading the superior sagittal sinus.
abstract: OBJECTIVE
  We present our experience with surgery of parasagittal and falcine meningiomas invading the superior sagittal sinus with special consideration of the surgical complications and the incidence of tumour recurrence.
  
  
  METHODS
  The analysis included 37 patients with parasagittal and falcine meningiomas invading the superior sagittal sinus. In 13 cases, the sinus was ligated and resected with tumour. In 14 cases, the sinus was entered with the goal of tumour resection and the sinus was reconstructed, while in 10 patients the sinus was not entered and the remaining residual tumour was observed for growth.
  
  
  RESULTS
  Out of 13 patients after radical resection of the tumour and invaded part of sinus, 9 revealed haemodynamic complications: venous infarction (4), significant brain oedema (3) and hypoperfusion syndrome (2). 2 out of 14 patients after resection of the tumour from the lumen of the superior sagittal sinus with subsequent sinus repair developed venous infarction after surgery. Among 27 patients after radical tumour excision the remote follow-up revealed recurrence in 2 patients. There were no significant haemodynamic complications in none of 10 cases, in which the residual tumour was left after surgery in the superior sagittal sinus. In this group, 3 cases were subjected to early post-operative radiotherapy and local recurrence was observed in 4 patients.
  
  
  CONCLUSIONS
  The aggressive surgical treatment of meningiomas infiltrating the superior sagittal sinus is associated with a high surgical risk. The incidence of recurrence of these tumours increases significantly in the case of non-radical excision of the tumour.
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland. Electronic address: arkady.n@wp.pl.
authors: Arkadiusz
authors: A
authors: Nowak
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Tomasz
authors: T
authors: Dziedzic
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Tomasz
authors: T
authors: Czernicki
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Przemysław
authors: P
authors: Kunert
authors: Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
authors: Andrzej
authors: A
authors: Marchel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D054063:Superior Sagittal Sinus / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: Microsurgical resection; Parasagittal meningioma; Superior sagittal sinus; Tumour recurrence