Abstract
Asterion meningiomas arise from the posterior petrous ridge at the junction of the
transverse and sigmoid sinuses (sinodural angle). The authors retrospectively reviewed
the charts of seven patients with asterion meningiomas who underwent a Simpson I tumor
resection by either the petrosal or suboccipital approach. Patients presented with
headaches, dizziness, ataxia, or seizures. Preoperative angiograms and intraoperative
observations confirmed occlusion of the transverse and sigmoid sinuses by tumor, thrombus,
or both in four of the patients. In all cases, tumor infiltrated the sinuses and the
sinuses were ligated without adverse sequelae. Temporal bone invasion was seen in
one patient who had the only tumor recurrence. Postoperatively, there were two transient
CSF leaks. Asterion meningiomas can be completely resected with a low incidence of
major morbidity. In this small series, a patent transverse/sigmoid sinus was resected
in three patients without sequelae. We believe that in young patients with asterion
meningiomas a nondominant transverse/sigmoid sinus should be resected if the torcula
is patent. More research is needed to determine the safety of resecting a patent dominant
transverse/sigmoid sinus.
