Severe Edema and Venous Congestion Following Sphenoorbital Meningioma Resection in a Meningiomatosis Case: Importance of Predicting Venous Disturbances

Abstract

To achieve local disease control, radical removal is the best option for sphenoorbital meningiomas. Preservation of the venous system is crucial during the resection of skull base meningiomas. This vascular injury represents a major risk both for life and neurologic function. We present a case of a severe postoperative frontotemporal venous disturbance and cerebral edema following the radical removal of a giant sphenoorbital meningioma in a patient with meningiomatosis and occlusion of the superior sagittal sinus. The anatomical, radiologic, and surgical aspects are reviewed and discussed, with the aim of preventing such a serious complication.

Keywords

meningioma - cerebral veins - sphenoparietal sinus - dural venous sinus - sphenoorbital

• References

• 1 Tanaka M, Imhof HG, Schucknecht B, Kollias S, Yonekawa Y, Valavanis A. Correlation between the efferent venous drainage of the tumor and peritumoral edema in intracranial meningiomas: superselective angiographic analysis of 25 cases. J Neurosurg 2006; 104 (3) 382-388
• 2 da Silva CE, Peron CS, Nesi A, Nunes CAS, Santos SC, Silveira LC. Importance of the temporal venous drainage to the petrosal approaches to the skull base. JBNC 2009; 20 (1) 27-32 . Available at: www.abnc.org.br/ed_art_down.php?id=562
• 3 Rhoton Jr AL. The cerebral veins. Neurosurgery 2002; 51 (4, Suppl): S159-S205
• 4 Ide M, Jimbo M, Yamamoto M, Umebara Y, Hagiwara S, Kubo O. MIB-1 staining index and peritumoral brain edema of meningiomas. Cancer 1996; 78 (1) 133-143
• 5 Lobato RD, Alday R, Gómez PA , et al. Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema. Acta Neurochir (Wien) 1996; 138 (5) 485-493 ; discussion 493–494
• 6 Philippon J, Foncin JF, Grob R, Srour A, Poisson M, Pertuiset BF. Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurgery 1984; 14 (3) 295-301
• 7 Pistolesi S, Fontanini G, Camacci T , et al. Meningioma-associated brain oedema: the role of angiogenic factors and pial blood supply. J Neurooncol 2002; 60 (2) 159-164
• 8 Inamura T, Nishio S, Takeshita I, Fujiwara S, Fukui M. Peritumoral brain edema in meningiomas—influence of vascular supply on its development. Neurosurgery 1992; 31 (2) 179-185
• 9 Bikmaz K, Mrak R, Al-Mefty O. Management of bone-invasive, hyperostotic sphenoid wing meningiomas. J Neurosurg 2007; 107 (5) 905-912
• 10 Pieper DR, Al-Mefty O, Hanada Y, Buechner D. Hyperostosis associated with meningioma of the cranial base: secondary changes or tumor invasion. Neurosurgery 1999; 44 (4) 742-746 ; discussion 746–747
• 11 Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 1957; 20 (1) 22-39
• 12 Hasseleid BF, Meling TR, Rønning P, Scheie D, Helseth E. Surgery for convexity meningioma: Simpson grade I resection as the goal: clinical article. J Neurosurg 2012; 117 (6) 999-1006
• 13 Obeid F, Al-Mefty O. Recurrence of olfactory groove meningiomas. Neurosurgery 2003; 53 (3) 534-542 ; discussion 542–543
• 14 Oya S, Sade B, Lee JH. Sphenoorbital meningioma: surgical technique and outcome. J Neurosurg 2011; 114 (5) 1241-1249
• 15 da Silva CE, da Silva VD, da Silva JL. Sodium fluorescein in skull base meningiomas: a technical note. Clin Neurol Neurosurg 2014; 120: 32-35
• 16 da Silva CE, da Silva VD, da Silva JL. Convexity meningiomas enhanced by sodium fluorescein. Surg Neurol Int 2014; 5: 3
• 17 Sakata K, Al-Mefty O, Yamamoto I. Venous consideration in petrosal approach: microsurgical anatomy of the temporal bridging vein. Neurosurgery 2000; 47 (1) 153-160 ; discussion 160–161