Kei Yamashiro1,2, Jun Muto3, Akira Wakako3,4, Kazuhiro Murayama5, Daijiro Kojima3, Tatsuo Omi3,4, Kazuhide Adachi3, Mitsuhiro Hasegawa3, Yuichi Hirose3. 1. Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 4701192, Japan. keiyamashiro1577@gmail.com. 2. Department of Neurosurgery, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, 4440827, Japan. keiyamashiro1577@gmail.com. 3. Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 4701192, Japan. 4. Department of Neurosurgery, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, 4440827, Japan. 5. Department of Radiology, Fujita Health University, Toyoake, Aichi, 4701192, Japan.
Abstract
BACKGROUND: Although it is known that diploic veins frequently communicate with the dural venous sinuses, the role of diploic veins in patients with venous sinus invasion from meningiomas remains unknown. METHODS: We retrospectively examined the medical records of 159 patients who underwent their first craniotomies for intracranial meningiomas. Contrast-enhanced magnetic resonance imaging was used to evaluate diploic vein routes, and digital subtraction angiography (DSA) was used to evaluate diploic vein blood flow. When high blood flow was visualized concurrently with the venous sinuses, the veins were classified as of the "early type." Diploic vein routes were classified into five routes. RESULTS: DSA was performed in 110 patients, with 14 showing superior sagittal sinus (SSS) invasion (SSS group) and 23 showing non-SSS venous sinus invasion (non-SSS group). The proportion of early type diploic veins was significantly higher in the SSS group (27.1%) than in other patients (patients without venous sinus invasion, 2.1%; non-SSS, 4.3%) (p < 0.01). In patients not in the SSS group, diploic veins were sacrificed during craniotomy in 76 patients, including four patients with veins of the early type. No patients demonstrated new neurological deficits postoperatively. In the SSS group, diploic veins were sacrificed in all patients, and early type diploic veins were cut in five patients. Two of these five patients showed postoperative neurological deficits. CONCLUSIONS: In the SSS group, diploic veins may function as collateral venous pathways, and attention is recommended for their interruption. In patients without SSS invasion, diploic veins, even of the early type, can be sacrificed.
BACKGROUND: Although it is known that diploic veins frequently communicate with the dural venous sinuses, the role of diploic veins in patients with venous sinus invasion from meningiomas remains unknown. METHODS: We retrospectively examined the medical records of 159 patients who underwent their first craniotomies for intracranial meningiomas. Contrast-enhanced magnetic resonance imaging was used to evaluate diploic vein routes, and digital subtraction angiography (DSA) was used to evaluate diploic vein blood flow. When high blood flow was visualized concurrently with the venous sinuses, the veins were classified as of the "early type." Diploic vein routes were classified into five routes. RESULTS: DSA was performed in 110 patients, with 14 showing superior sagittal sinus (SSS) invasion (SSS group) and 23 showing non-SSS venous sinus invasion (non-SSS group). The proportion of early type diploic veins was significantly higher in the SSS group (27.1%) than in other patients (patients without venous sinus invasion, 2.1%; non-SSS, 4.3%) (p < 0.01). In patients not in the SSS group, diploic veins were sacrificed during craniotomy in 76 patients, including four patients with veins of the early type. No patients demonstrated new neurological deficits postoperatively. In the SSS group, diploic veins were sacrificed in all patients, and early type diploic veins were cut in five patients. Two of these five patients showed postoperative neurological deficits. CONCLUSIONS: In the SSS group, diploic veins may function as collateral venous pathways, and attention is recommended for their interruption. In patients without SSS invasion, diploic veins, even of the early type, can be sacrificed.
Authors: Ulises García-González; Daniel D Cavalcanti; Abhishek Agrawal; L Fernando Gonzalez; Robert C Wallace; Robert F Spetzler; Mark C Preul Journal: Neurosurg Focus Date: 2009-11 Impact factor: 4.047
Authors: I Hershkovitz; C Greenwald; B M Rothschild; B Latimer; O Dutour; L M Jellema; S Wish-Baratz; I Pap; G Leonetti Journal: Am J Phys Anthropol Date: 1999-03 Impact factor: 2.868
Authors: Victoria Leung; Ari Aharon Shemesh; Laila Al Shafai; Timo Krings; Taufik Valiante; Edward Margolin Journal: Neuroophthalmology Date: 2018-10-25