Incidence of venous infarction after sacrificing middle-third superior sagittal sinus cortical bridging veins in a pediatric population

2011 ◽  
Vol 2011 ◽  
pp. 269-270
Author(s):  
P. Klimo
Keyword(s):  
Superior Sagittal Sinus ◽  
Pediatric Population ◽  
Venous Infarction ◽  
Sagittal Sinus ◽  
Bridging Veins

Incidence of venous infarction after sacrificing middle-third superior sagittal sinus cortical bridging veins in a pediatric population

2011 ◽  
Vol 7 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Sean A. McNatt ◽  
Ivan J. Sosa ◽  
Mark D. Krieger ◽  
J. Gordon McComb
Keyword(s):  
Los Angeles ◽  
Mr Imaging ◽  
Superior Sagittal Sinus ◽  
Pediatric Population ◽  
Operative Procedure ◽  
Neurological Injury ◽  
Venous Infarction ◽  
Transcallosal Approach ◽  
Sagittal Sinus ◽  
Bridging Veins

Object The interhemispheric transcallosal approach offers an excellent surgical corridor for the treatment of deep-seated midline lesions. The approach typically requires the sacrifice of one or more middle-third superior sagittal sinus (SSS) cortical bridging veins, which introduces the risk of venous infarction and associated neurological injury. The authors studied the incidence of venous infarcts following this operative approach in a pediatric population. Methods The authors performed a retrospective review of surgical cases involving pediatric patients treated at the Children's Hospital Los Angeles between 1990 and 2007, in which an interhemispheric transcallosal operative procedure was performed and one or more middle-third SSS cortical bridging veins were occluded. Postoperative MR imaging studies done 1–3 days following the procedure were analyzed and compared with preoperative studies. Results Sixty-three patients met the inclusion criteria. No patient developed MR imaging evidence of venous infarction. Conclusions The occlusion of one or more middle-third SSS cortical bridging veins related to the interhemispheric transcallosal approach resulted in no incidence of cerebral venous infarction in this pediatric population.

Pterional Approach for Surgical Treatment of Olfactory Groove Meningiomas

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 942-947 ◽  
Author(s):  
W. Hassler ◽  
J. Zentner
Keyword(s):  
Surgical Treatment ◽  
Superior Sagittal Sinus ◽  
Cerebrospinal Fluid Fistula ◽  
Pterional Approach ◽  
Olfactory Groove ◽  
Sagittal Sinus ◽  
Frontal Brain ◽  
Bridging Veins ◽  
Frontal Sinuses ◽  
Fluid Fistula

Abstract We present our experience with the surgical treatment of olfactory groove meningiomas using a pterional approach. This approach provides the advantages of previous techniques, such as preserving the frontal brain and superior sagittal sinus, early devascularization of the tumor, and late dissection of tumor borders. Moreover, it also compensates for the shortcomings of other techniques, e.g., compression of frontal bridging veins, late dissection of dorsal tumor aspects involving vessels and optic nerves as well as facultative infection and cerebrospinal fluid fistula-related complications caused by opening of frontal sinuses. To date, 11 patients were treated in this way. As we encountered no surgical complications in our series we are encouraged to present our procedure.

Posterior interhemispheric retrocallosal approach to pineal region and posterior fossa lesions in a pediatric population

2011 ◽  
Vol 7 (5) ◽  
pp. 527-533 ◽  
Author(s):  
Laurence Davidson ◽  
Mark D. Krieger ◽  
J. Gordon McComb
Keyword(s):  
Posterior Fossa ◽  
Postoperative Morbidity ◽  
Pediatric Population ◽  
Pineal Region ◽  
Cerebral Vein ◽  
Radiographic Evidence ◽  
Venous Infarction ◽  
Safety And Efficacy ◽  
Bridging Veins ◽  
Bridging Vein

Object The purpose of this study was to evaluate the posterior interhemispheric retrocallosal approach (PIRA) for its safety and efficacy in the resection of pineal region and posterior fossa lesions in children. Methods Twenty-nine PIRAs were performed in 26 children between March 1997 and March 2009, and these cases were retrospectively reviewed. There were 15 girls and 11 boys in the series. The median age at the time of surgery was 7 years (range 7 months–17 years). Twenty-seven cases were treated for tumor, 1 for loculated hydrocephalus, and 1 for an aneurysm. Results Of the 27 cases treated for tumor, there were 20 (74%) gross-total resections, 5 (19%) subtotal resections, and 2 (7%) biopsies. One bridging vein was sacrificed in 6 cases and 2 bridging veins were divided in 1 case, whereas in 3 cases there was sacrifice of a single deep cerebral vein. No patient developed radiographic evidence of venous infarction. Approach-related complications were low, and included 2 cases of transient homonymous hemianopia. There were no surgery-related deaths. Conclusions This approach allows for ample access to pineal region and posterior fossa lesions, with low postoperative morbidity.

Endoscopic anatomy of the chordae willisii in the superior sagittal sinus

2004 ◽  
Vol 101 (5) ◽  
pp. 832-835 ◽  
Author(s):  
Mansoor Sharifi ◽  
Jacek Kunicki ◽  
Pawel Krajewski ◽  
Bogdan Ciszek
Keyword(s):  
Superior Sagittal Sinus ◽  
Tap Water ◽  
Digital Camera ◽  
Content Type ◽  
Sagittal Sinus ◽  
Structural Relationships ◽  
Human Cadavers ◽  
Bridging Veins ◽  
Different Diameters ◽  
Fine Print

Object. Chordae willisii are structures located in the lumen of the superior sagittal sinus (SSS). It is thought that they act as flow-improving structures within the sinuses. There are few anatomical descriptions of chordae willisii, and all previous observations were performed through standard anatomical dissections. The purpose of this study was to visualize and describe structural and topographical features of the chordae willisii with the aid of rigid endoscopy. Methods. Twenty-five SSSs obtained from fresh human cadavers during autopsies were the material for this study. Specimens were flushed with tap water to remove clots. Bridging veins emptying into the sinus were ligated, and continuous flow of a saline solution through the sinus in a physiological direction was achieved by connecting the sinus to an irrigating system. Rigid endoscopes of different diameters (2.7–4.5 mm) and optic (0 and 30°) were inserted into the lumen of the sinus. The endoscope was connected to a digital camera and a video system to allow for recording of the observed structures. Finally, the sinuses were opened and the chordae willisii were dissected using standard anatomical methods. The chordae willisii were observed in all examined specimens. Three different types of the cords were found: lamellar, trabecular, and valvelike types. The most common type was the valvelike (mixed) one, which comprised 45.1% of all cords. The chordae willisii were most commonly observed in the parietooccipital region of the SSS. Conclusions. Witout disturbing any structural relationships, the use of endoscopy allowed visualization and description of intraluminal structures as they behaved physiologically.

Variations of the superior sagittal sinus and bridging veins in human dissections and computed tomography venography

2012 ◽  
Vol 36 (2) ◽  
pp. 85-89 ◽  
Author(s):  
Carolin Brockmann ◽  
Sandra C. Kunze ◽  
Peter Schmiedek ◽  
Christoph Groden ◽  
Johann Scharf
Keyword(s):  
Computed Tomography ◽  
Superior Sagittal Sinus ◽  
Sagittal Sinus ◽  
Bridging Veins ◽  
Computed Tomography Venography

A hypothesis of cerebral venous system regulation based on a study of the junction between the cortical bridging veins and the superior sagittal sinus

2007 ◽  
Vol 107 (6) ◽  
pp. 1205-1210 ◽  
Author(s):  
Jean-Rodolphe Vignes ◽  
Arnaud Dagain ◽  
Jean Guérin ◽  
Dominique Liguoro
Keyword(s):  
Smooth Muscle ◽  
Superior Sagittal Sinus ◽  
Anatomical Study ◽  
Venous System ◽  
Luminal Diameter ◽  
Cortical Vein ◽  
Sagittal Sinus ◽  
Pathological Conditions ◽  
Bridging Veins ◽  
Formalin Fixed

Object The cerebral venous regulation involved in various physiological and pathological processes has received little attention. Here the authors describe the anatomy of the junction between the cortical vein and the superior sagittal sinus (SSS) and propose a new theory of cerebral venous regulation. Methods Ten adult human cadaveric heads (20 sides), including five specimens into which stained latex had been injected, were used for anatomical study. Formalin-fixed cadaver heads were dissected to demonstrate the cortical veins along the SSS. The characteristics of the cortical bridging veins and their openings into the SSS were established by anatomical, histological, immunohistochemical, and ultrastructural study of the junction. Results After their subarachnoid course, the cortical bridging veins penetrated the SSS at different points in the dura mater depending on their rostrocaudal position. The venous endothelium stretched beyond the sinus endothelium. The orientation of the collagen fibers changed at the level of the venous openings, with the luminal diameter becoming narrow and oval-shaped. The major finding was the organization of the smooth-muscle cells at the end of each cortical vein. At this site and particularly in the frontoparietal region, the vessel resembled a myoendothelial “sphincter.” The authors hypothesize that this organization is involved in cerebral venous system regulation. Conclusions The point of convergence between the cortical veins and the SSS is a key area. The authors also hypothesize that the myoendothelial junction acts as a smooth sphincter and that it plays a role in cerebral venous hemodynamics and pathological conditions.

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