Diploic Veins as Collateral Venous Pathway in Patients with Superior Sagittal Sinus Obstruction caused by Large Size Meningioma

Abstract

  Diploic veins sometime develops into collateral venous pathways in patients with superior sagittal sinus (SSS) thrombosis due to a large parasagittal meningioma. Preserving the diploic venous system is essential for preventing bleeding and venous infarcts. However, few reports have described methods for avoiding damage to the diploic venous system. Herein, we report successful tumor resection while preserving the diploic venous system. Three-dimensional multislice computed tomographic angiography was used for preoperatively determining the positional relations between the tumor, SSS, and diploic venous system. Catheter angiography helped in understanding the detailed perfusion dynamics of the veins. Based on this preoperative information, it is important to design a craniotomy to preserve veins during surgery.