Last Updated: April 25, 2020
Torcular meningiomas arise from the wall of the torcular Herophili, the site of confluence of the superior sagittal, straight, occipital, and both transverse sinuses. On the other hand, peritorcular meningiomas originate from the neighboring dural structures and secondarily grow into the torcular region, sparing the patency of he torcula.
Meningiomas associated with the torcular herophili present considerable surgical challenges because of their relationships to structures involved in the principal venous drainage systems of the bilateral hemispheres. Hyperostosis in the region of the internal occipital protuberance and en plaque extension of tumor along the venous sinuses is not unlikely.
These tumors are fortunately very rare and account for less than 1% of all intracranial meningiomas. With careful patient selection and detailed preoperative assessment, surgical risks can be minimized.
Meticulous surgical technique is mandatory when working in the vicinity of the dural venous sinuses and central venous structures, given the requirement for patency of venous outflow and the risk of...