Zentralblatt für Neurochirurgie
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Zentralbl. Neurochir. · May 2007
Efficacy of gamma-knife surgery for treating meningiomas that involve the superior sagittal sinus.
Meningiomas involving the superior sagittal sinus (SSS) are among the most challenging tumors to treat. Authors of some recent series have advocated total removal with SSS reconstruction. However gamma-knife surgery is a reasonable choice for these tumors. ⋯ When a small meningioma involves the SSS and the sinus is patent, the first-line treatment should be radiosurgery. If the tumor is large and the sinus is patent, we recommend gross total resection with no removal of SSS. If postoperative or follow-up MR imaging demonstrates residual tumor or recurrence, gamma-knife surgery should be performed. If a large meningioma has completely obliterated the SSS, our policy is to remove the tumor and all sinus tissue without reconstructing the SSS.