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Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage.

Sahoo SK, Ghuman MS, Salunke P, Vyas S, Bhar R, Khandelwal NK - J Neurosci Rural Pract (2016 Apr-Jun)

Bottom Line: We found in 26 individuals the AT-SSS score was 0-2, in 22 it was 3-5 and, in only in 12 (20%) the score was 6 or more (dominant drainage).Those with dominant drainage are likely to develop venous congestion and complications if sacrificed.It is possible to identify these individuals on the basis of venous drainage pattern as shown in CE-MRV.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.

ABSTRACT

Background/object: The ligation and transection of anterior third of superior sagittal sinus (AT-SSS) is an important step to approach anterior skull base lesions. Some clinical studies have shown frontal lobe venous infarct following such surgical procedures questioning the safety of its ligation. We have studied the variations in venous drainage patterns to AT-SSS in the normal population using postcontrast magnetic resonance venogram (MRV). A novel scoring system to recognize the subgroup with dominant venous drainage from frontal lobes has been described.

Materials and methods: In this study, 60 three-dimensional contrast-enhanced (CE) MRVs were obtained from those cases being evaluated for a headache not harboring any intracranial mass lesion. The AT-SSS with all its draining veins was studied in detail. Morphology of individual veins such as length, caliber, tributaries, and angulation with AT-SSS was studied, and a numerical value of 0 or 1 was assigned for each of the above parameters. Summing up these scores derived from the individual cortical veins quantified the drainage of AT-SSS.

Results: There are 3-4 veins on either side draining to AT-SSS. Barely, 3% of the veins had > 3 tributaries. Only 6.6% of veins had a caliber >3 mm, and 16.5% drained at acute angles to AT-SSS. About 26% of the veins did cross at least half of the lateral frontal lobe. We found in 26 individuals the AT-SSS score was 0-2, in 22 it was 3-5 and, in only in 12 (20%) the score was 6 or more (dominant drainage).

Conclusion: There are anatomical variations in venous drainage of frontal lobes into AT-SSS. Those with dominant drainage are likely to develop venous congestion and complications if sacrificed. It is possible to identify these individuals on the basis of venous drainage pattern as shown in CE-MRV.

No MeSH data available.


Related in: MedlinePlus

Methodology to mark anterior third superior sagittal sinus. (a) Point at the level of coronal suture on superior sagittal sinus was marked (red arrow) in midsagittal three-dimensional contrast-enhanced magnetic resonance venogram. 1 cm anterior to it marks the posterior limit of anterior third superior sagittal sinus (intersection of green and blue lines). (b) Corresponding superior view showing anterior third of superior sagittal sinus
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Figure 1: Methodology to mark anterior third superior sagittal sinus. (a) Point at the level of coronal suture on superior sagittal sinus was marked (red arrow) in midsagittal three-dimensional contrast-enhanced magnetic resonance venogram. 1 cm anterior to it marks the posterior limit of anterior third superior sagittal sinus (intersection of green and blue lines). (b) Corresponding superior view showing anterior third of superior sagittal sinus

Mentions: Coronal suture was identified on sagittal MPR images, and the corresponding point was marked on axial MPR images by placing cross references lines [Figure 1]. The AT-SSS, approximately 1 cm anterior to the marked point (corresponding to the coronal suture) and its draining veins were analyzed.


Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage.

Sahoo SK, Ghuman MS, Salunke P, Vyas S, Bhar R, Khandelwal NK - J Neurosci Rural Pract (2016 Apr-Jun)

Methodology to mark anterior third superior sagittal sinus. (a) Point at the level of coronal suture on superior sagittal sinus was marked (red arrow) in midsagittal three-dimensional contrast-enhanced magnetic resonance venogram. 1 cm anterior to it marks the posterior limit of anterior third superior sagittal sinus (intersection of green and blue lines). (b) Corresponding superior view showing anterior third of superior sagittal sinus
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4821935&req=5

Figure 1: Methodology to mark anterior third superior sagittal sinus. (a) Point at the level of coronal suture on superior sagittal sinus was marked (red arrow) in midsagittal three-dimensional contrast-enhanced magnetic resonance venogram. 1 cm anterior to it marks the posterior limit of anterior third superior sagittal sinus (intersection of green and blue lines). (b) Corresponding superior view showing anterior third of superior sagittal sinus
Mentions: Coronal suture was identified on sagittal MPR images, and the corresponding point was marked on axial MPR images by placing cross references lines [Figure 1]. The AT-SSS, approximately 1 cm anterior to the marked point (corresponding to the coronal suture) and its draining veins were analyzed.

Bottom Line: We found in 26 individuals the AT-SSS score was 0-2, in 22 it was 3-5 and, in only in 12 (20%) the score was 6 or more (dominant drainage).Those with dominant drainage are likely to develop venous congestion and complications if sacrificed.It is possible to identify these individuals on the basis of venous drainage pattern as shown in CE-MRV.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.

ABSTRACT

Background/object: The ligation and transection of anterior third of superior sagittal sinus (AT-SSS) is an important step to approach anterior skull base lesions. Some clinical studies have shown frontal lobe venous infarct following such surgical procedures questioning the safety of its ligation. We have studied the variations in venous drainage patterns to AT-SSS in the normal population using postcontrast magnetic resonance venogram (MRV). A novel scoring system to recognize the subgroup with dominant venous drainage from frontal lobes has been described.

Materials and methods: In this study, 60 three-dimensional contrast-enhanced (CE) MRVs were obtained from those cases being evaluated for a headache not harboring any intracranial mass lesion. The AT-SSS with all its draining veins was studied in detail. Morphology of individual veins such as length, caliber, tributaries, and angulation with AT-SSS was studied, and a numerical value of 0 or 1 was assigned for each of the above parameters. Summing up these scores derived from the individual cortical veins quantified the drainage of AT-SSS.

Results: There are 3-4 veins on either side draining to AT-SSS. Barely, 3% of the veins had > 3 tributaries. Only 6.6% of veins had a caliber >3 mm, and 16.5% drained at acute angles to AT-SSS. About 26% of the veins did cross at least half of the lateral frontal lobe. We found in 26 individuals the AT-SSS score was 0-2, in 22 it was 3-5 and, in only in 12 (20%) the score was 6 or more (dominant drainage).

Conclusion: There are anatomical variations in venous drainage of frontal lobes into AT-SSS. Those with dominant drainage are likely to develop venous congestion and complications if sacrificed. It is possible to identify these individuals on the basis of venous drainage pattern as shown in CE-MRV.

No MeSH data available.


Related in: MedlinePlus