Microsurgery of Meningiomas Involving the Superior Sagittal Sinus

Meningiomas involving major dural sinuses can be difficult to resect without proper handling of the sinus. In young patients, a gross total resection should be attempted when feasible. A 24-year-old man presented with headaches, progressive left-sided weakness, and partial motor seizures. He was found to have a parasagittal meningioma in front of the motor cortex that invaded the superior sagittal sinus (SSS). The sinus was still patent, and the walls were preserved. Thus a gross total resection was achieved with primary suturing of the sinus, followed by reinforcement with an AnastoClip GC. Videos 1-3 details the separation of the tumor from the convexity veins and the cortex, removal of the tumor from the SSS, and reconstruction of the SSS. Gross total resection of meningiomas involving the SSS is achievable without sacrificing the sinus when planned correctly and methodically. The patient consented for the procedure and to the publication of these images.