Reconstruction of vein of Labb, in temporo-occipital meningioma invading transverse sinus: technical report

Meningiomas invading major venous sinuses and veins are not uncommon. However, meningiomas involving both the transverse sinus and vein of Labb, 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 Labb, 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 Labb,. After removal of all the tumors except the piece attached to the transverse sinus and vein of Labb, with standard neurosurgical techniques, the left transverse sinus lumen and vein of Labb, lumen were explored. The tumor tissue inside the transverse sinus and vein of Labb, were removed along with tumor-invaded venous wall. Venous reconstruction of the transverse sinus and vein of Labb, 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 Labb, was reconstructed in the surgery of temporo-occipital meningioma invading the vein of Labb, and transverse sinus together.