Vols. Videos

Parasagittal Craniotomy

Last Updated: September 27, 2018

Parasagittal Craniotomy: Nuances of Technique

General Considerations

The parasagittal craniotomy exposes lesions along the paramedian hemispheres and superior sagittal sinus. This basic cranial exposure provides access to the superior sagittal sinus itself and can be extended across the midline for complete control over the sinus. Because of numerous bridging veins and the inconsistent location and size of parasagittal venous lakes, operating in this region can be difficult. The risks of profuse blood loss and life-threatening venous air embolism are significant and therefore appropriate precautions are necessary.

Contrary to common knowledge, the sagittal suture does not define the exact location of the superior sagittal sinus. If fact, the sinus is typically deviated to the right of the sagittal suture; the maximum deviation is usually no more than 11 mm.

The interhemispheric modification of the parasagittal approach is very flexible...