Successful Treatment of a Nail Gun Injury in Right Parietal Region and Superior Sagittal Sinus

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
An Shuo Wang ◽  
Ming Hui Zeng ◽  
Fei Wang
Keyword(s):  
Successful Treatment ◽  
Superior Sagittal Sinus ◽  
Parietal Region ◽  
Sagittal Sinus ◽  
Nail Gun Injury

scholarly journals Successful treatment of superior sagittal sinus thrombosis after translabyrinthine resection of metastatic neuroendocrine tumor: A case report and review of literature

2020 ◽  
Vol 11 ◽  
pp. 410
Author(s):  
Andrew K. Wong ◽  
Ricky H. Wong
Keyword(s):  
Neuroendocrine Tumor ◽  
Posterior Fossa ◽  
Successful Treatment ◽  
Cerebellopontine Angle ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Posterior Fossa Tumor ◽  
Venous Sinuses ◽  
Sagittal Sinus ◽  
Metastatic Neuroendocrine Tumor

Background: Postoperative cerebral venous sinus thrombosis (pCVST) after resection of cerebellopontine angle and posterior fossa tumor resections occur almost exclusively in the lateral venous sinuses and are generally asymptomatic. Thrombus extension and involvement of the superior sagittal sinus (SSS) – a serious and potentially devastating complication – are rarely described and, as such, successful treatment for which is still poorly understood. We report a case of pCVST involving the SSS after translabyrinthine approach for resection of a metastatic neuroendocrine tumor (NET), and the first that was successfully treated with anticoagulation therapy. Case Description: A 40-year-old man presented with headaches, diminished right-sided hearing, and ataxia was found to have a large right-sided cerebellopontine angle (CPA) lesion with extra-axial and possible intraparenchymal invasion. A retrosigmoid craniotomy for debulking and diagnosis was undertaken. Postoperative imaging revealed patent venous sinuses. Pathology confirmed NET. Further imaging revealed a likely pancreatic primary lesion. The patient then underwent subsequent translabyrinthine approach for definitive surgical resection. Postoperative imaging again revealed patent venous sinuses. The patient subsequently developed headaches on postoperative day 10 and was found to have pCVST involving the ipsilateral internal jugular to the SSS. The patient was started on therapeutic heparin with significant improvement in pCVST and symptoms. Conclusion: Extensive pCVST involving the SSS after CPA and posterior fossa tumor resections is extremely rare. Initial management with anticoagulation can yield promising results and should be initiated early in the clinical course unless otherwise contraindicated.

scholarly journals Parietal Foramen as A Landmark to Locate Intracranial Vascular and Parenchymal Structures

2020 ◽  
Author(s):  
Pedro Brainer-Lima ◽  
Alessandra Brainer-Lima ◽  
Maria Rosana Ferreira ◽  
Paulo Brainer-Lima ◽  
Marcelo Valença
Keyword(s):  
Parietal Lobe ◽  
Superior Sagittal Sinus ◽  
Average Distance ◽  
Air Embolism ◽  
Neurosurgical Procedures ◽  
Parietal Region ◽  
Sagittal Suture ◽  
Emissary Vein ◽  
Sagittal Sinus ◽  
The Right

Abstract The aim of this study was to define the location of the parietal foramina (PF) with reference to skull landmarks and correlate the PF with cerebral and vascular structures to optimize neurosurgical procedures in the intracranial compartment. Two hundred and thirty-eight parietal bones studied by magnetic resonance imaging (MRI) of 119 patients were reviewed. The cephalometric points, inion, bregma, sagittal suture and lambda were used as anatomical references to locate the PF and define its anatomical relationships to parenchymal cerebral structures, especially some eloquent areas. The PF was identified in the MRI in 83 of the 119 individuals (69.7%) and was located at an average distance of 9.5 ± 0.8 cm (mean ± SD) posteriorly and 0.9 ± 0.3cm laterally to the Bregma. In over 90% of cases, the PF was located within a 2 cm radius of the bregma-PF distance’s mean value. Surgeons operating in the parietal region should be aware of the frequency of PF (69.7%), its location (superolateral to lambda) and its stable relationship with underlying anatomical structures. 88% of the 62 left PF’s were situated within 1cm, laterally to the left margin of the superior sagittal sinus (SSS). 60% of the right PF were situated within 1.3 cm laterally from the right margin of the SSS, while 40% were directly above the SSS. We propose that the PF should be used as the reference for the superior sagittal sinus during its course through the parietal lobe, as its constancy overtakes other commonly used landmarks (sagittal suture and midline). In conclusion, clinicians should be aware of the PF to both avoid iatrogenic injury to an emissary vein that courses through it that can lead to air embolism and as a guide to maneuvering through the parietal region.

Successful Treatment of Superior Sagittal Sinus Thrombosis

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 198-200
Author(s):  
J. Niwa ◽  
H. Ohyama ◽  
S. Mastumura ◽  
T. Sasaki
Keyword(s):  
Pregnant Women ◽  
Successful Treatment ◽  
Clinical Condition ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Neurological Deficits ◽  
Dramatic Improvement ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

A 22-year-old pregnant women showed a rapid deterioration in her clinical condition. Superior sagittal sinus thrombosis was diagnosed, and direct transvenous infusion of t-PA into the superior sagittal sinus was performed. This treatment resulted in recanalization of the occluded superior sagittal sinus and in a dramatic improvement of neurological deficits.

Microsurgical Anatomy of the Venous Drainage into the Superior Sagittal Sinus

Neurosurgery ◽  
1989 ◽  
Vol 24 (4) ◽  
pp. 514-520 ◽  
Author(s):  
Brian T. Andrews ◽  
Manuel Dujovny ◽  
Haresh G. Mirchandani ◽  
James I. Ausman
Keyword(s):  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Frontal Region ◽  
Microsurgical Anatomy ◽  
Parietal Region ◽  
Sagittal Sinus ◽  
Mean Width ◽  
The Mean ◽  
Human Brains ◽  
Cortical Venous Thrombosis

ABSTRACT Ten unfixed human brains were examined under an operating microscope to evaluate the feasibility of reimplanting the parasagittal veins into the superior sagittal sinus. On average, there were 6.5 veins draining the surface of each hemisphere in the anterior frontal region, 3 veins draining each posterior frontal region, 4 veins draining each parietal region, and 1 vein draining each occipital region. The veins were most frequently 0.1 to 1.0 mm in diameter, but were as large as 3.0 mm in the anterior frontal and occipital regions, 3.5 mm in the parietal region, and 5.0 mm in the posterior frontal region. The mean vein length between the superior sagittal sinus and the first lateral attachment was 3.0 to 7.4 mm; individual veins were as long as 30.0 mm. The 20 hemispheres contained a total of 5 veins in the anterior frontal region. 7 veins in the posterior frontal region, and 8 veins in the parietal region that appeared to have an adequate diameter and length for microsurgical reimplantation into the superior sagittal sinus. The superior sagittal sinus had a mean width of 4.3 mm and depth of 3.6 mm in the midanterior frontal region and enlarged to a mean width of 9.9 mm and depth of 6.8 mm in the midoccipital region. In all sites, the sinus appeared to be structurally compatible with vein reimplantation. In 3 cases, veins 2.8 to 4.6 mm in diameter were reimplanted microsurgically into the sinus; in each case, the anastomosis was technically satisfactory and patent. These results support the feasibility of reimplanting parasaggital veins into the superior sagittal sinus for such problems as trauma, tumors, and cortical venous thrombosis. Veins suitable for reimplantation are located primarily in the posterior frontal and parietal regions.

Superior sagittal sinus thrombosis induced by thyrotoxicosis

2001 ◽  
Vol 94 (1) ◽  
pp. 130-132 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Chun-Chung Lui ◽  
Cheng-Loong Liang ◽  
Han-Jung Chen ◽  
Yeh-Lin Kuo ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Venous Blood ◽  
Fibrinogen Concentration ◽  
Venous Blood Flow ◽  
Content Type ◽  
Sagittal Sinus ◽  
Low Protein ◽  
Diffuse Goiter

✓ There is a wide variety of disorders associated with thrombosis of the superior sagittal sinus (SSS), including infectious disease, noninfectious conditions such as vasculitis and hypercoagulable states, and complications arising from pregnancy or use of oral contraceptive medications. Despite these well-defined associations, approximately 25% of the cases remain idiopathic. In this article the authors describe a patient who was found to have SSS thrombosis while experiencing a thyrotoxic phase of Graves disease. The patient presented with intracerebral hemorrhage, subarachnoid hemorrhage, seizure, coma, a raised fibrinogen concentration, low protein C activity, and atrial fibrillations. Thrombolysis was successfully performed despite the coexistence of thrombosis and intracranial hemorrhage. Patients with thyrotoxicosis and a diffuse goiter may be predisposed to the development of SSS thrombosis, as a result of hypercoagulation and stasis of local venous blood flow. In the present case, a patient in whom thrombosis coexisted with intracranial hemorrhage was successfully treated using thrombolytic therapy.

scholarly journals Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

2021 ◽  
Author(s):  
Rajendra Chavan ◽  
Shreya Sethi ◽  
Harsha Sahu ◽  
Neeraj Rao ◽  
Shivani Agarwal
Keyword(s):  
Literature Review ◽  
Treatment Option ◽  
Systematic Literature Review ◽  
Superior Sagittal Sinus ◽  
English Literature ◽  
Venous Drainage ◽  
Sagittal Sinus ◽  
Complete Obliteration ◽  
Cortical Venous Drainage ◽  
Special Subgroup

AbstractDural arteriovenous fistulas (DAVFs) located within superior sagittal sinus (SSS) wall with direct cortical venous drainage are rare. They are also known as variant DAVF (vDAVF) and form a special subgroup of DAVFs. Their chance of presenting with aggressive features is high compared with transverse sigmoid sinus fistula. They drain directly into cortical veins (Borden type 3, Cognard type III and IV). A systematic English literature review of SSS vDAVF was made. Systematic literature review revealed a total of 31 published cases. These were commonly seen in male population, (24 males, 77.41%, 24/31). Average age of patients was 54 years. A total of 24 patients (77.41%, 24/31) had aggressive clinical presentations with 13 patients (41.93%, 13/31) having intracranial hemorrhages (ICH). Two patients had rebleeding (15.38%, 2/13). Middle portion of SSS was commonly involved (15 cases, 75%). A total of 25 (96.15%, 25/26) cases had patent SSS. Most of the fistulas were idiopathic (65.38%, 17/26), with trauma being a frequent etiological factor (26.92%, 7/26). Venous ectasia was seen in 19 patients (59.37%, 19/32). Middle meningeal arterial (MMA) supply was seen in all patients (100%, 26/26), with bilateral MMA supply in 21 cases (80.76%), and unilateral in 5 cases (19.23%). Twenty patients (62.50%, 20/32) received only endovascular treatment (EVT), while four patients had EVT followed by surgery (12.5%, 4/32). Transarterial route via MMA was the preferred treatment option (79.16%). Complete obliteration of fistulas was noted in all cases (100%, 30/30). No immediate complication was noted after EVT. As much as 92.30% patients showed good recovery. Thus, SSS vDAVF forms a special subgroup of DAVF, with aggressive presentation, and warrants urgent treatment. EVT is effective treatment option and can produce complete obliteration.

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