Scalp veins as collateral pathway with parasagittal meningiomas occluding the superior sagittal sinus

In 3 cases with occlusion of the superior sagittal sinus (SSS) with parasagittal meningiomas, carotid angiography demonstrated scalp veins as an important collateral venous pathway. The authors believe that occlusion of the SSS is best seen in half axial oblique carotid phlebograms under contralateral carotid compression. Direct sinography is time consuming and troublesome. In the presence of scalp veins as important collaterals, strategic consideration for surgical treatment is discussed.