PMC10499534_01
Representative images of intracranial hemangiopericytoma invading the CoS, the SSS, and RTS. (a) CT scan images shows the bony invasion. (b) MRI shows heterogeneously enhancing mass inside the confluent of sinuses. (c) Brainlab  3D reconstruction of the tumor (red) in relation with dural sinuses (blue).
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Magnetic resonance imaging (MRI) imaging showed an invasion of the posterior third of the superior sagittal sinus (SSS), the confluence of sinuses (CoS), and the proximal third of the right transverse sinus (RTS) with bone invasion (Figure 1).
(a and b) Pre-operative carotid angiogram revealing the occlusion of the posterior third of the SSS (red arrow) by the tumor. (c) Right external carotid angiogram, moderate tumor stain feeding from the occipital artery (yellow arrow) was observed. The strait sinus directly connects to the left transverse sinus (black arrow).
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The tumor was supplied by both occipital arteries, dural and adjacent parenchymal arteries (Figure 2).
Illustration of the surgical steps. After exposing the CoS, bilateral TSs, and distal SSS. (a) 4 silk knots were closed at the edges of the tumor. (b) Complete removal of the dural sinuses after partial debulking of the tumor was performed.
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The sinuses were occluded with silk knots before resecting the invaded part of the SSS and RTS (Figure 3).
Post-operative MRI confirming the GTR of the tumor with no signs of recurrence at (a) 24 hours, (b) 3 months, (c) 6 months, and (d) 12 months. No signs of cerebral venous infarction after complete removal of the tumor.
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Post-operative MRI showed complete resection and no recurrence at 3, 6, and 12 months (Figure 4).