Anatomical Variations in the Location of Veins Draining Into the Anterior Superior Sagittal Sinus: Implications for the Transbasal Approach

2019 ◽  
Author(s):  
Hamid Borghei-Razavi ◽  
Alankrita Raghavan ◽  
Aldo Eguiluz-Melendez ◽  
Krishna Joshi ◽  
Juan C Fernandez-Miranda ◽  
...  
Keyword(s):  
Superior Sagittal Sinus ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
Sagittal Sinus ◽  
Skull Base Approach ◽  
Anterior Fossa ◽  
Cranial Fossa ◽  
The Mean ◽  
Level 1 ◽  
Subfrontal Approach

Abstract BACKGROUND Many approaches are used for midline anterior cranial fossa meningioma resection. In the subfrontal approach, the anterior superior sagittal sinus (SSS) is commonly ligated to release the anterior falx. The transbasal approach allows access to the origin of the anterior SSS, allowing for maximum venous preservation. OBJECTIVE To investigate variations in the first and second veins draining into the SSS. METHODS We performed stepwise dissections for a transbasal level 1 approach on 8 anatomic specimens. We visualized the first and second veins draining into the sinus and measured the distance from the foramen cecum to these veins. We also measured the orbital bar height to determine the length of sagittal sinus that could be preserved with orbital bar removal. RESULTS The distance between the foramen cecum and the first vein ranged from 4 to 36 mm while the distance to the second vein ranged from 6 to 48 mm. The mean orbital bar height was 26.4 mm. Based on these measurements, with a traditional bicoronal craniotomy without orbital bar removal, 81% of first veins and 58% of second veins would be sacrificed. CONCLUSION A supraorbital bar or nasofrontal osteotomy, part of the transbasal skull base approach, is helpful to preserve the first and second veins when ligating the anterior SSS. Based on this study, it may be difficult to preserve these veins without orbital bar removal. Preservation of these veins may be of clinical importance when approaching midline anterior fossa pathologies.

scholarly journals Incidence, Clinicopathological Profile and Location - Based Outcome of Intracranial Meningiomas: 10-Year Institutional Study with Review of Literature

2021 ◽  
Vol 10 (01) ◽  
pp. 042-048
Author(s):  
Feroze Ganai ◽  
Humam Nisar Tanki ◽  
Afaq Sherwani ◽  
Kirmani Altaf ◽  
Nazish Chisti ◽  
...  
Keyword(s):  
Middle Cranial Fossa ◽  
Review Of Literature ◽  
Young Females ◽  
Intracranial Meningiomas ◽  
Significant Incidence ◽  
Clinicopathological Profile ◽  
Anterior Fossa ◽  
Cranial Fossa ◽  
The Mean ◽  
Sphenoid Ridge

Abstract Intracranial meningiomas are the most common extra-axial tumors, representing 15% of all brain tumors. Arising from the arachnoid cells, and common in middle-aged women, 90% meningiomas are benign. We conducted a 10-year study on 183 cases of intracranial meningiomas and observed a lower and decreasing trend; the mean age was 43.3 years but there was also a significant incidence in young females. Parasagittal/falx (29%), sphenoid ridge, convexity meningiomas and middle cranial fossa locations were more common. Histopathologically, meningothelial meningioma was the most common. Benign (WHO I) tumors were found in above 90%, atypical (WHO II) in 5% cases, and malignant (WHO III) in < 4% patients. Most patients underwent Simpsons Grade I excision (35.6%) with dural reconstruction because of late presentations. Posterior fossa meningiomas were mostly benign, while intraventricular ones were mostly malignant with highest postoperation mortality. Mortality in operated patients was 9.8% but was highest in anterior fossa tumors (12.5%).

scholarly journals Study of Dural Arteriovenous Fistula Drains into Leptomeningeal Vein without Sinus Interposition

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 127-134 ◽  
Author(s):  
T. Kawaguchi ◽  
M. Nakatani ◽  
T. Kawano
Keyword(s):  
Emergency Treatment ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Venous Ischemia

We evaluated dural arteriovenous fistulas (DAVF) drains into leptomeningeal vein (LMV) without the venous sinus interposition. This type of DAVF contained the extra-sinusal type DAVF and the DAVF with so-called pure leptomeningeal venous drainage (PLMVD). We studied 15 patients with DAVF that flows into LMVD without passing into the sinus. The subjects were 5 patients with DAVF in the anterior cranial fossa, 2 with DAVF in the tentorium cerebelli, and 3 with DAVF in the craniocervical junction as extra-sinusal type DAVF and 3 with DAVF in the transverse sigmoid sinus and 2 with DAVF in the superior sagittal sinus as DAVF with PLMVD. This type appears to take a very aggressive course. The arterial pressure of the shunt is directly applied to LMV, which causes bending and winding of the vein, eventually varices, inducing intracranial haemorrhage or venous ischemia in the LMV reflux area. Emergency treatment should be performed as soon as possible. Although it is recognized that interruption of the draining vein is very effective, treatment methods such as TAE, direct surgery, and g knife treatment, or their combinations should be carefully chosen for each case.

scholarly journals Commentary: Anatomical Variations in the Location of Veins Draining Into the Anterior Superior Sagittal Sinus: Implications for the Transbasal Approach

2019 ◽  
Vol 18 (6) ◽  
pp. E207-E208
Author(s):  
Daniel M Heiferman ◽  
Vikram C Prabhu ◽  
Anand V Germanwala ◽  
Douglas E Anderson
Keyword(s):  
Superior Sagittal Sinus ◽  
Anatomical Variations ◽  
Sagittal Sinus

scholarly journals A peculiar case of dural venous sinuses with resulting atypical bony markings in posterior cranial fossa

2017 ◽  
Vol 5 (6) ◽  
pp. 2830
Author(s):  
Gitanjali Khorwal ◽  
Sunita Kalra
Keyword(s):  
Right Hemisphere ◽  
Superior Sagittal Sinus ◽  
Transverse Sinus ◽  
Posterior Cranial Fossa ◽  
Undergraduate Medical Students ◽  
Venous Sinuses ◽  
Sagittal Sinus ◽  
Cranial Fossa ◽  
The Right ◽  
Dural Venous Sinuses

A paramedian or midline suboccipital approach for craniotomies and craniectomies is commonly employed for decompression or tumour resections from posterior cranial fossa. The reference for midline is taken as the line joining the nasion and inion on the surface of the skull which is the estimated position of superior sagittal sinus. In the interior, the internal occipital protuberance is the site of confluence of sinuses which presents a spectrum of variations. An unusual pattern of drainage of dural venous sinuses was observed at the site of customary confluence during routine dissection of head region for undergraduate medical students in a sixty-year-old female cadaver. The superior sagittal sinus continued as right transverse sinus as usual but it was connected to the left transverse sinus through a venous channel. There was no appreciable confluence of sinuses at this site. A prominent and atypical cerebellar process emerged from right hemisphere of cerebellum and projected between right transverse sinus and the venous channel connecting right and left transverse sinuses. In the posterior cranial fossa, the internal occipital crest was present on the left of midline separated from internal occipital protuberance. Another small ridge was present to the right of midline. A triangular fossa thus formed on the right side of internal occipital crest was occupied by the unusual prominent process emerging from the right hemisphere of cerebellum.Pre-operative assessment of dural venous sinuses is imperative before any surgical intervention especially around the confluence of the sinuses.

Doppler ultrasound measurements of superior sagittal sinus blood velocity

1972 ◽  
Vol 37 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Ronald Brisman ◽  
Sadek K. Hilal ◽  
Michael Tenner
Keyword(s):  
Intracranial Pressure ◽  
Superior Sagittal Sinus ◽  
Mass Effect ◽  
Blood Velocity ◽  
Doppler Measurement ◽  
Content Type ◽  
Sagittal Sinus ◽  
The Mean ◽  
Sagittal Sinus Occlusion ◽  
The Relationship

✓ Transcutaneous Doppler recordings from the patent anterior fontanel were used to measure superior sagittal sinus blood velocity (SSSV). In 15 cases it ranged from 4.5 to 18.1 cm/sec. In five of these patients with no mass effect and normal intracranial pressure, the mean SSSV was 13.6 cm/sec. An independent arteriographic measurement of SSSV was 4.5 cm/sec in a hydrocephalic patient with elevated intracranial pressure whose Doppler measurement of SSSV was 6.6 cm/ sec. The Doppler technique may be used to diagnose sagittal sinus occlusion. SSSV tended to be low when CSF pressure was elevated, but the relationship was not constant.

Atresia of the rostral superior sagittal sinus: substitute parasagittal venous channels

1973 ◽  
Vol 38 (5) ◽  
pp. 602-607 ◽  
Author(s):  
Harry A. Kaplan ◽  
Jefferson Browder
Keyword(s):  
Superior Sagittal Sinus ◽  
Clinical Importance ◽  
Content Type ◽  
Sagittal Sinus ◽  
Developmental Variants ◽  
Fine Print

✓ Failure of development of a rostral superior sagittal sinus results in concomitant embryonal establishment of substitute dural and cerebral venous pathways. The longer the segment of atresia of this sinus, the more extensive the compensatory venous channels. These developmental variants assume clinical importance in the interpretation of cerebral angiograms.

Anatomical Variations of the First Vein Draining into the Anterior Superior Sagittal Sinus: Implications for the Transbasal Approach

2019 ◽  
Author(s):  
Hamid Borghei-Razavi ◽  
Aldo Eguiluz ◽  
Huy Truong ◽  
Juan Fernandez-Miranda ◽  
Varun Kshettry ◽  
...  
Keyword(s):  
Superior Sagittal Sinus ◽  
Anatomical Variations ◽  
Sagittal Sinus
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