Fig. 1

Meningioma in plaque situated in the parasagittal region. Preoperative image, MRI with contrast. a Axial view verified an enhanced occipital mass. b Sagittal view showed that tumor attached to the bone and involved the sagittal sinus. c Coronal view demonstrated mass lesion was crossing the midline bilateral in the parieto-occipital region more on the left side. The tumor was surrounded by mild edema. d It implicated the posterior aspect of the superior sagittal sinus and left transverse sinus in venography. Two year’s postoperative MRI with contrast. e Axial view revealed complete removal with nearly no mass lesion and decompressed occipital horn. f Sagittal view showed small residual mass parafalcine encasing superior sagittal sinus; the bony defect was closed by titanium mesh. g In coronal view, we discovered no mass lesion in the parieto-occipital region. h The posterior aspect of the superior sagittal sinus was opened. Geriatric Scoring System (GSS) score = 18. i It showed gross bony invasion of the tumor. j Slide represented syncytial meningioma with scatted psammoma bodies, WHO grade I