Management of Persistent Hypotension after Resection of Parasagittal Meningioma


  • Salih Gulsen Baskent University Medical Faculty Hospital - Neurosurgery, Maresal Fevzi Cakmak cad.10, sok. No: 45, Ankara 06540



Various complications including air embolism have been discussed in large clinical series regarding the parasagittal meningioma. We presented and discussed the patient suffering from persistent hypotension after excision of parasagittal meningioma.

A 47-year-old man was admitted to our hospital with complaints of headache and frontal region swelling. His cranial MRI showed a bilaterally located parasagittal meningioma at the anterior one third of the sagittal sinus. Conspicuously, he had large frontal sinus and its length was about totally 7 cm in sagittal and transverse part.

During cranitomy, we had to open frontal sinus because of its large size and open the sagittal sinus while removing of the tumor. So coincidental opening of the superior sagittal sinus and/or emissary veins located within diploe of the cranium and frontal sinus may cause hypotension after extubation due to normal respiration led to air escaping from the frontal sinus to the emissary veins placed next to the frontal sinus. Bilateral application of the tamponade embedded with vaseline inside to the nose prevents air escaping from the frontal sinus to the emissary veins.


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Palmon SC, Moore LE, Lundberg J, Toung T. Venous air embolism: a review. J Clin Anesth. 1997; 9(3): 9:251-7.

Bonnal J, Brotchi J. Surgery of the superior sagittal sinus in parasagittal meningiomas. J Neurosurg. 1978; 48(6):935-45.

Colli BO, Carlotti CG Jr, Assirati JA Jr, Dos Santos MB, Neder L, Dos Santos AC. Parasagittal meningiomas: follow-up review. 2006;66 (Suppl 3):20-8.

DiMeco F, Li KW, Casali C, Ciceri E, Giombini S, Filippini G, Broggi G, Solero CL. Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases. Neurosurgery. 2004; 55(6):1263-74.

Ohigashi Y, Tanabe A. A huge frontal meningioma associated with intraoperative massive bleeding and severe brain swelling-case report. J Clin Neurosci. 2001;(1):54-8.

Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957; (20):22-39.

Ayerbe J, Lobato RD, De La Cruz J, Alday R, Rivas JJ, Gómez PA, Cabrera A. Risk factors predicting recurrence in patients operated on for intracranial meningioma. A multivariate analysis. Acta Neurochir (Wien). 1999;(141):921-32.

Jääskeläinen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol. 1986;(25):233-42.

Oka K, Go Y, Kimura H, Tomonaga M. Obstruction of the superior sagittal sinus caused by parasagittal meningiomas: the role of collateral venous pathways. J Neurosurg. 1994; (81):520-24.

Sindou M, Hallacq P. Venous reconstruction in surgery of meningiomas invading the sagittal and transverse sinuses. Skull Base Surg. 1998;8(2):57-64.

Merrem G. Die parasagittalen meningeome. Fedor KRAUSEGedachtnivorlesung. Acta Neurochir. 1970;(23):203-216.

Peter L. Williams: Gray's Anatomy, Ed. 38 New York: ELBS with Churchill Livingstone, 1995: 1882-1883.

Hattori K, Miyachi S, Kobayashi N, Kojima T, Hattori K, Negoro M, Yoshida J, Nagasaka T. Contralateral meningeal artery supply of paramedian meningiomas. Surg Neurol. 2005;(64) :242-48.




How to Cite

Gulsen S. Management of Persistent Hypotension after Resection of Parasagittal Meningioma. Open Access Maced J Med Sci [Internet]. 2014 Sep. 15 [cited 2021 Oct. 19];2(3):483-7. Available from:



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