TECHNICAL NOTE Reconstruction of vein of Labbé in temporo-occipital meningioma invading transverse sinus: technical report Bulent Guclu & Marc Sindou Received: 11 September 2009 / Accepted: 24 November 2009 / Published online: 15 December 2009 # Springer-Verlag 2009 Abstract Objective and importance 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. Clinical presentation 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 ve- nography 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. Technique 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. Conclusion 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. Keywords Cerebral veins . Dural sinuses . Meningioma . Vascular microsurgery . Vein of Labbé . Venous occlusion . Venous reconstruction Introduction The vein of Labbé is the main stream of the inferior cerebral venous system [2]. Also known as the inferior anastomotic vein, it creates an anastomosis between the superficial sylvian vein and the transverse sinus where it makes a junction with the sigmoid sinus. Vein of Labbé is predominant in the dominant hemisphere [8]. Sacrificing this vein may produce serious consequences such as temporal lobe hemorrhagic infarction and/or significant edema. When the vein of Labbé is large and is the only vein in the lateral temporal lobe surface, sacrificing this vessel may be even more dangerous when there are no sufficient connections with other venous systems [4]. Reconstruction of the vein of Labbè can be most useful when tumor tissue invades this vein. In this paper, we report a case in which the vein of Labbé was reconstructed in the surgery of temporo-occipital meningioma invading both this vein and the transverse sinus. B. Guclu : M. Sindou Department of Neurosurgery, Hopital Neurologique Pierre Wertheimer, Université Claude-Bernard de Lyon, Lyon, France B. Guclu (*) Department of Neurosurgery, Yeditepe University Hospital, Devlet Yolu Ankara Caddesi, No: 102/104, Kozyatagi, 34752 Istanbul, Turkey e-mail: guclubulent@hotmail.com Acta Neurochir (2010) 152:941–945 DOI 10.1007/s00701-009-0572-2