title: Parasagittal meningiomas: Our surgical experience and the reconstruction technique of the superior sagittal sinus.
abstract: BACKGROUND
  The radical resection of parasagittal meningiomas without complications and recurrences is the goal of the neurosurgeon. Nowadays, different managements are proposed. This study describes our surgical technique during the lesional excision and the reconstruction of the superior sagittal sinus (SSS).
  
  
  METHODS
  The total removal (Simpson I and II) of parasagittal meningiomas (WHO grade I and II) was obtained in 75 patients from September 2000 to January 2010. The indocyanine green videoangiography was used before the dural opening and, when necessary, to identify and preserve the cortical veins. The surgery of the SSS was performed in accordance with Sindou's classification, and its reconstruction was achieved through the use of a patch of galea capitis.
  
  
  RESULTS
  We had no cases of recurrence and thrombotic occlusion of the SSS in 5 years after the reconstruction. No complications were observed in 65 patients, and no cases of mortality were reported. Neurological focal deficits were observed in 5 patients. A brain swelling and a venous infarction were observed in 1 patient. Only one case of thrombotic occlusion was observed. A cerebrospinal fluid leak was observed in 2 patients, and a systemic complication was found in 1 patient.
  
  
  CONCLUSIONS
  Several factors contribute to the success of the parasagittal meningioma surgery. We consider the preservation of the cortical veins to be important, and, when possible, we recommend the reconstruction of the anterior third of the SSS. Our experience has led us to believe that until now surgery is a winning choice if practiced by expert hands.
authors.affiliation: Department of Neurosurgery, San Salvatore City Hospital L'Aquila, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ricci
authors.affiliation: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors.forename: Hambra
authors.initials: H
authors.lastname: Di Vitantonio
authors.affiliation: Department of Neurosurgery, San Salvatore City Hospital L'Aquila, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: De Paulis
authors.affiliation: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Del Maestro
authors.affiliation: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Gallieni
authors.affiliation: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors.forename: Soheila Raysi
authors.initials: SR
authors.lastname: Dechcordi
authors.affiliation: Department of Neurosurgery, San Salvatore City Hospital L'Aquila, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Marzi
authors.affiliation: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors.forename: Renato Juan
authors.initials: RJ
authors.lastname: Galzio
keywords: Collateral and cortical veins; galea capitis; parasagittal meningioma; superior sagittal sinus