Murata J, Sawamura Y, Saito H, Abe H
Sapporo Azabu Neurosurgical Hospital, Japan.
Surg Neurol. 1997 Dec;48(6):592-5; discussion 595-7. doi: 10.1016/s0090-3019(97)00303-0.
Simpson Grade I resection of parasagittal meningiomas is not always feasible because of the involvement of the sagittal sinus and cortical veins. Complete resection requires reconstruction of the sagittal sinus and cortical veins. This report describes a surgical technique to preserve patency of the cortical veins.
A recurrent parasagittal meningioma completely occupied the superior sagittal sinus and encased several large cortical veins. The tumor in the sagittal sinus was totally resected and the roof of the sinus was sutured. To avoid thrombotic cortical vein occlusion, two cortical veins encased by the meningioma were anastomosed end-to-end, regardless of their flow directions. The postsurgical course was uneventful and patency of the anastomosed veins was confirmed by postoperative angiography.
End-to-end anastomosis of cortical veins was a useful surgical technique for radical resection of a parasagittal meningioma.
矢状窦旁脑膜瘤的辛普森一级切除并不总是可行的,因为矢状窦和皮质静脉受累。完整切除需要重建矢状窦和皮质静脉。本报告描述了一种保留皮质静脉通畅的手术技术。
一例复发性矢状窦旁脑膜瘤完全占据上矢状窦并包绕数条大的皮质静脉。矢状窦内的肿瘤被完全切除,窦顶予以缝合。为避免血栓形成导致皮质静脉闭塞,将被脑膜瘤包绕的两条皮质静脉进行端端吻合,而不考虑其血流方向。术后过程顺利,术后血管造影证实吻合静脉通畅。
皮质静脉端端吻合是矢状窦旁脑膜瘤根治性切除的一种有用的手术技术。