Middle and Posterior Third Parasagittal Meningiomas: A Preliminary Study of Twenty Cases

Background: Parasagittal meningiomas (PSMs) have always been a surgical challenge due to the fact that they are adherent/invading the superior sagittal sinus. Objectives: The aim of this study is to evaluate the surgical technique used to decrease the incidence of recurrence with the least postoperative morbidity. Patients and Methods: This is a retrospective study conducted on twenty consecutive patients between January 2009 and December 2012 presenting with parasagittal meningiomas. The follow up period ranged from twelve to forty-eight months with a mean of 30 months. Results: Total removal was achieved in all cases. Post operative morbidity occurred in four cases (20%). There was neither reported mortality nor recurrence till the end of the study. Complications were encountered in the form of deterioration of motor power in three cases, wound infection in one case. One non-surgical related morbidity in the form of drug allergy occurred in one patient. Three patients (15%) developed post operative hydrocephalus and ventriculo-peritoneal (V/P) shunt was inserted. Conclusion: Total surgical excision of the PSMs is possible obtaining a Simpson grade I-II in most cases without the need for venous bypass for the occluded or invaded sinus. This can be achieved without a great risk of postoperative morbidity and thus decreasing the incidence of recurrence of such tumors.