Microvascular repair of an injured cortical draining vein

Cortical venous injury can occur during any intracranial procedure with potentially severe consequences. We describe a simple technique that allowed for successful repair of a large cortical draining vein.

A 43-year-old, right-handed woman presented with 6 months of headaches and progressive difficulty with right-sided hemiparesis. She had significant loss of hand coordination and writing ability. Computed tomography and MR imaging revealed a parasagittal meningioma in the left, posterior frontal region. The patient underwent craniotomy with resection of the lesion.

When a cortical vein is injured, collateral drainage pathways may prevent the development of a clinical problem. Because of the unpredictability of these collateral channels, venous reconstruction may be feasible and even straightforward in some cases.