Reconstruction of vein of Labbé in temporo-occipital meningioma invading transverse sinus: technical report.

Abstract

Meningiomas invading major venous sinuses and veins are not uncommon. However, meningiomas involving both the transverse sinus and vein of Labbé are exceedingly rare. Venous reconstruction can be challenging after radical removal of the meningioma which invades major venous sinuses and veins. In this report, we present reconstruction of vein of Labbé in the surgery of temporo-occipital meningioma invading the transverse sinus. A 55-year-old woman was admitted to our institution with a 13-year history of focal epilepsy in the form of transient aphasia with vertigo. Cranial magnetic resonance imaging revealed a homogeneously contrast enhancing lesion measuring 40 mm in diameter in the left temporo-occipital area. Cerebral magnetic resonance venography and venous phase of cerebral digital subtraction angiography revealed invasion of the upper wall of left transverse sinus and total occlusion of the lumen of the vein of Labbé. After removal of all the tumors except the piece attached to the transverse sinus and vein of Labbé with standard neurosurgical techniques, the left transverse sinus lumen and vein of Labbé lumen were explored. The tumor tissue inside the transverse sinus and vein of Labbé were removed along with tumor-invaded venous wall. Venous reconstruction of the transverse sinus and vein of Labbé was performed using autologous dura mater as a patch for the defect. This is the first report in the literature in which the vein of Labbé was reconstructed in the surgery of temporo-occipital meningioma invading the vein of Labbé and transverse sinus together.