Complete Resection of a Torcular Herophili Hemangiopericytoma without Sinus Reconstruction

We describe the gross total resection (GTR) of a torcular Hero- phili hemangiopericytoma with venous sinus resection instead of reconstruction. Hemangiopericytomas (HPCs) are a rare mesenchymal tumor. They represent approximately 1% of all intracranial tumors are thought to originate from Zimmerman’s pericytes. A 78-year-old woman presented to the emergency department with mild headaches and a sudden onset of blurred vision. Computerized tomography scan and magnetic resonance imaging showed what was described at first as a meningioma invading and occluding the torcular Herophili, the posterior third of the superior sagittal sinus and the proximal part of the right transverse sinus. Gross total resection of the tumor was performed without reconstructing dural sinuses. The patient was discharged home without new neurological deficit. Histopathology was in favor of a hemangiopericytoma Grade II World Health Organization (WHO). Total body positron emission tomography [18F]fluorodeoxyglucose found no secondary location. Radiotherapy was planned post-operatively. Preoperative embolization can be of good use in reducing preoperative bleeding and cases that could benefit from it should be carefully selected. Finally, GTR should always be the first intention when pos- sible and radiotherapy should be administered to reduce as much as possible the local recurrence.