scholarly journals Cranial venous sinus dominance: what to expect? Analysis of 100 cerebral angiographies

2017 ◽  
Vol 75 (5) ◽  
pp. 295-300 ◽  
Author(s):  
Matheus Augusto Pinto Kitamura ◽  
Leonardo Ferraz Costa ◽  
Danilo Otávio de Araújo Silva ◽  
Laécio Leitão Batista ◽  
Maurus Marques de Almeida Holanda ◽  
...  

ABSTRACT We report an analysis of the cranial venous sinuses circulation, emphasizing morphological and angiographic characteristics. Methods Data of 100 cerebral angiographies were retrospectively analyzed (p = 0.05). Results Mean age was 56.3 years, 62% female and 38% male. Measurements and dominance are shown in the Tables. There was no association between age or gender and dominance. Right parasagittal division of the superior sagittal sinus was associated with right dominance of the transverse sinus, sigmoid sinus and internal jugular vein; and left parasagittal division of the superior sagittal sinus was associated with left dominance of the transverse sinus, sigmoid sinus and internal jugular vein. Conclusion A dominance pattern of cranial venous sinuses was found. Age and gender did not influence this pattern. Angiographic findings, such as division of the superior sagittal sinus, were associated with a pattern of cranial venous dominance. We hope this article can add information and assist in preoperative venous analysis for neurosurgeons and neuroradiologists.

2016 ◽  
Vol 33 (02) ◽  
pp. 083-089
Author(s):  
S. Thamke ◽  
S. Kalra ◽  
A. Khandelwal

Abstract Introduction: Knowledge of the normal anatomical variations of venous sinuses is important for clinicians and radiologist for investigations and diagnosing various pathologies of dural venous sinuses like thrombosis, embolism and fistula etc. The detailed morphometric study of dural venous sinuses is missing in academic literature. Although few radiological studies have been done in the past but direct anatomical proof in the form of cadaveric study of dural venous sinuses is not available in the literature. Methods: The present study involved the examination of superior sagittal sinus, sigmoid sinus, transverse sinus, straight sinus and occipital sinus in 12 dura maters of formaldehyde fixed cadavers. The length and width (at midpoint and near confluences) of these sinuses and width of confluences were measured with venire callipers. Results: Some remarkable findings were observed in this study. It was established that the width of torcular herophilus is directly proportional to length of superior sagittal sinus and is also directly proportional to length of right sigmoid sinus. Torcular herophilus is situated away from right sigmoid sinus with intervening right transverse sinus and still its width is directly proportional to length of right sigmoid sinus. Also it was observed that the length of straight sinus was directly proportional to length of right transverse sinus. Right sigmoid sinus is a continuation of right transverse sinus but its width increases with increase in width of left transverse sinus. Length of left sigmoid sinus was directly proportional to length of right but width of left sigmoid sinus and vice a versa. Width of left sigmoid sinus is directly proportional to the length of right and left sigmoid sinus. Conclusion: It is extrapolated that this study will be valuable to neurosurgeons for preoperative planning and clinicians and radiologist to prevent misdiagnosis.


2010 ◽  
Vol 124 (10) ◽  
pp. 1126-1128
Author(s):  
D J Howe ◽  
M J Henderson ◽  
I Ahmad

AbstractObjective:To report a superior sagittal sinus thrombosis occurring as a rare complication of neck dissection, and to present a review of published literature.Case report:A 42-year-old man underwent an elective neck dissection for a tumour stage 2, node stage 2b, tonsillar squamous cell carcinoma, prior to chemoradiotherapy. During surgery, the right internal jugular vein was sacrificed as part of the resection, as tumour was adherent to it. Two weeks after surgery, the patient was readmitted with seizures. Subsequent computed tomography and magnetic resonance venography confirmed a superior sagittal sinus thrombosis. The patient was subsequently anticoagulated and underwent radiotherapy without further complication. A review of pre-operative imaging indicated a dominant internal jugular vein, ligation of which may have been a factor in the subsequent sagittal sinus thrombosis.Conclusion:Superior sagittal sinus thrombosis following neck dissection is a rare occurrence, with little reported in the literature. Dominant internal jugular vein anatomy may be evident on pre-operative imaging. An awareness of this complication may be helpful to surgeons contemplating sacrifice of the internal jugular vein.


Author(s):  
Gitanjali Khorwal ◽  
Sunita Kalra

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.


2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONSE91-ONSE92
Author(s):  
Wataro Tsuruta ◽  
Yuji Matsumaru ◽  
Kensuke Suzuki ◽  
Tomoji Takigawa ◽  
Akira Matsumura

Abstract Objective: To report the usefulness of a side-hole on a guiding catheter for transvenous embolization of transverse-sigmoid sinus (TSS) dural arteriovenous fistulae (DAVF) by a contralateral approach with a reversed Y-shaped confluence. Clinical Presentation: A 66-year-old woman presented after an epileptic seizure. Magnetic resonance imaging revealed venous infarctions of the left temporal area. Angiography showed a DAVF in the left TSS with retrograde drainage toward the superior sagittal sinus and remarkable cortical reflux. Intervention: A transvenous approach through the right jugular vein was attempted after failure of the approach through the angiographically invisible left jugular vein. Catheterization beyond the confluence failed because the shape of the confluence was a reversed Y. A 5-French catheter with a side-hole was then placed in the superior sagittal sinus from the right TSS, and the microcatheter was successfully navigated into the left TSS through the side-hole. Subsequently, the DAVF was completely occluded by transvenous embolization without any adverse events. Conclusion: A side-hole on a guiding catheter was found to be useful for the navigation of a microcatheter to override a reversed Y-shaped confluence in transvenous embolization of TSS DAVF. This technique could be applicable to difficult configurations for transvenous catheterization, although attention should be paid to disruption of the catheter.


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