DOCSLIB.ORG

Radiographic Evaluation and Clinical Implications of Venous Connections Between Dural Arteriovenous Fistula of the Cavernous

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Radiographic Evaluation and Clinical Implications of Venous Connections Between Dural Arteriovenous Fistula of the Cavernous Original Article Radiographic Evaluation and Clinical Implications of Venous Connections Between Dural Arteriovenous Fistula of the Cavernous Sinus and Cerebellum and the Pontomedullary Venous System Chai Kobkitsuksakul, Pakorn Jiarakongmun, Ekachat Chanthanaphak, Sirintara Pongpech - OBJECTIVE: The types of cortical venous reflux chan- - CONCLUSIONS: Connections of CS are not limited to nels, posterior fossa and pontomesencephalic venous intercavernous, ophthalmic veins, sphenoparietal sinuses, reflux or their connections with the cavernous sinus (CS) and inferior and superior petrosal sinuses. They also occur are inadequately described in the literature. This study with complex venous drainages at the base of the fronto- uses angiography, magnetic resonance imaging, and X-ray temporal lobes, insula, brainstem, and cerebellum. computed tomography to clarify the possible route of Knowledge of the venous connection of CS is key to un- cavernous dural arteriovenous fistulae (CVDAVF) that derstanding the possible locations of venous congestion/ causes posterior fossa and pontomedullary venous reflux hemorrhage and the clinical presentation of patients with and documents the clinical presentations associated with CSDAVF. the reflux. - METHODS: Eighty-six patients with CSDAVF treated at Ramathibodi Hospital, Bangkok, Thailand, during 2009 to 2013 were studied retrospectively. Sixteen cases with INTRODUCTION posterior fossa and pontomedullary venous reflux were included for analysis. extbooks state that the cavernous sinus (CS) receives venous blood from the tributaries of the superior and - RESULTS: Bridging veins serve as an important pathway T inferior ophthalmic veins, the sphenoparietal sinuses, and for venous reflux from CS to the posterior fossa and the superficial middle cerebral veins. Cavernous venous blood brainstem. The uncal vein directly terminates at the CS and exits through the superior and inferior petrosal sinuses, as well as has several connecting routes, ranging from the inferior by the skull base emissary veins, mostly the veins of the foramen frontal lobes and insula to the posterior fossa through the ovale that connect with the pterygoid venous plexus. In a high- gradient pressure environment, specifically the arteriovenous basal vein of Rosenthal. The petrosal vein was most shunt, the arterialized veins are able to reverse direction of their frequently and easily detected angiographically. It plays a normal inlet and are potentially able to reflux into the existing major role in the cerebellar hemispheric venous reflux. venous channels. This reversal of direction is difficult to recognize Only 1 patient developed brainstem and cerebellar venous in most angiographic or imaging studies. congestion, which returned to normal after endovascular The term bridging vein refers to the vein that links the sub- treatment. arachnoid vein with the dural venous sinus. In the CS, bridging Key words Division of Interventional Neuroradiology, Department of Radiology, Ramathibodi Hospital, - Cavernous dural arteriovenous fistulae Bangkok, Thailand - Endovascular To whom correspondence should be addressed: Chai Kobkitsuksakul, M.D. - Hemorrhagic venous infarction [E-mail: [email protected]] Citation: World Neurosurg. (2015) 84, 4:1112-1126. Abbreviations and Acronyms http://dx.doi.org/10.1016/j.wneu.2015.05.074 BVR: Basal vein of Rosenthal Journal homepage: www.WORLDNEUROSURGERY.org CS: Cavernous sinus CSDAVF: Cavernous sinus dural arteriovenous fistulae Available online: www.sciencedirect.com CT: Computed tomography ª 2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY- MRI: Magnetic resonance imaging NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). NBCA: N-butyl cyanoacrylate PV: Petrosal vein SPS: Superior petrosal sinus UV: Uncal vein 1112 www.SCIENCEDIRECT.com WORLD NEUROSURGERY, http://dx.doi.org/10.1016/j.wneu.2015.05.074 CHAI KOBKITSUKSAKUL ET AL. VENOUS CONNECTIONS BETWEEN CAVERNOUS DURAL AVF AND CEREBELLUM AND THE BRAINSTEM WORLD NEUROSURGERY Table 1. Clinical Presentation of Patients With CSDAVF With Pontomedullary and Cerebellar Venous Reflux 84 [4]: 1112-1126, O CN Patient Red Eye & CN III CN IV CN VI CN VII Subjective Cerebellar Number Proptosis Palsy Palsy Palsy V1 V2 V3 Palsy Bruit Hemiparesis Signs 1 þ þÀÀÀÀ þ À À 2 þ þþþþþÀþ þ þ þ CTOBER 3 þ ÀÀÀÀÀÀÀ À À À 4 þ þÀÀÀÀ þ À À 2015 5 À ÀÀÀÀÀÀÀ þ À À 6 þ ÀÀÀÀÀÀÀ þ À À 7 þ ÀÀÀÀÀÀÀ þ À À 8 þ ÀÀÀÀÀÀÀ À À À 9 þ þþÀÀÀÀ þ À À 10 þ ÀÀÀÀÀÀÀ þ À À 11 þ þþþÀÀÀÀ þ À À 12 þ þÀÀÀÀ À þ À www.WORLDNEUROSURGERY.org 13 na na na na na na na na na na na 14 þ þÀÀÀÀ À À À 15 þ ÀÀÀÀÀÀÀ À À À 16 þ þþþÀÀÀÀ þ À À þ, presence; À, absence; na, not available (the data were lost at the admission to hospital); CN, cranial nerve. O RIGINAL 1113 A RTICLE CHAI KOBKITSUKSAKUL ET AL. VENOUS CONNECTIONS BETWEEN CAVERNOUS DURAL AVF AND CEREBELLUM AND THE BRAINSTEM 1114 Table 2. Demographic Data, Computed Tomographic Scan, and Magnetic Resonance Imaging (Treatment Methods and Venous Connection) Evidence of VI or www.SCIENCEDIRECT.com PatientNumber Sex Age ICH Access Route Treatment Primary Venous Connection Secondary Venous Connection 1 M 59 Not Inferior petrosal Transvenous coil Uncal vein, superficial sylvian vein Basal vein of Rosenthal present sinus Bridging vein Transverse pontine vein 2 F 53 VI Inferior petrosal Transvenous NBCA Superior petrosal sinus-petrosal vein Cerebellar vein sinus Bridging vein Anterior medullary vein, spinal vein 3 F 68 Not Inferior petrosal Transvenous coil Uncal vein, superficial sylvian vein, Basal vein of Rosenthal present sinus paracavernous sinus 4 F 61 Not Ophthalmic vein Transvenous NBCA Uncal vein Basal vein of Rosenthal present 5 F 68 Not Inferior petrosal Transvenous coil Superior petrosal sinus Lateral pontomesencephalic vein, basal vein of Rosenthal present sinus 6 F 52 Not Inferior petrosal Transvenous coil Superior petrosal sinus -petrosal vein Cerebellar vein WORLD NEUROSURGERY present sinus 7 F 81 Not Artery Transarterial NBCA Superior petrosal sinus -petrosal vein Cerebellar vein present Bridging vein Anterior pontomesencephalic vein, basal vein of Rosenthal 8 F 67 Not Inferior petrosal Transvenous coil Superior petrosal sinus -petrosal vein Cerebellar vein present sinus 9 F 45 Not Inferior petrosal Transvenous coil Uncal vein, superficial sylvian vein Basal vein of Rosenthal, lateral and anterior pontomesencephalic veins, Anterior present sinus medullary vein, spinal vein Superior petrosal sinus -petrosal vein Cerebellar vein & , 10 F 42 Not Inferior petrosal Transvenous coil Uncal vein, superficial sylvian vein Peduncular vein http://dx.doi.org/10.1016/j.wneu.2015.05.074 present sinus NBCA Bridging vein Anterior pontomesencephalic vein, anterior medullary vein, basal vein of Rosenthal 11 M 62 Not Inferior petrosal Transvenous NBCA Uncal vein Basal vein of Rosenthal present sinus 12 F 62 ICH Inferior petrosal Transvenous coil Superior petrosal sinus-petrosal vein Left cerebellar vein sinus 13 M 52 Not Inferior petrosal Transvenous coil Bridging vein, superior petrosal sinus- Transverse pontine & lateral pontomesencephalic veins, basal vein of Rosenthal, present sinus petrosal vein cerebellar vein 14 F 61 Not Inferior petrosal Transvenous coil Uncal vein Basal vein of Rosenthal present sinus 15 M 51 VI Inferior petrosal Transvenous coil Uncal vein Basal vein of Rosenthal O sinus RIGINAL 16 M 51 ICH Inferior petrosal Transvenous coil & Bridging vein Transverse pontine and pontomesencephalic veins, basal vein of Rosenthal sinus NBCA A RTICLE Patient 2, venous congestion at the pons and cerebellum; Patient 12, intracranial hemorrhage at the insula; Patient 15, venous congestion at the left temporopolar; Patient 16, unexplainable hemosiderin deposition at the left high parietal area. VI, venous congestion or infarction; ICH, intracranial hemorrhage; NBCA, N-butyl cyanoacrylate. ORIGINAL ARTICLE CHAI KOBKITSUKSAKUL ET AL. VENOUS CONNECTIONS BETWEEN CAVERNOUS DURAL AVF AND CEREBELLUM AND THE BRAINSTEM Figure 1. Venous phase of the vertebral artery angiogram shows tortuous computed tomography angiogram (CTA) shows bridging vein (dashed anterior and lateral pontomesencephalic veins (arrow) connecting with the arrow) from the posterior CS to the anterior pontomesencephalic vein (C). basal vein of Rosenthal (double arrows)(A). The same veins as seen in (A) Tortuous anterior pontomesencephalic veins in the CTA sagittal view can are visualized by superselective ascending pharyngeal angiogram, showing also be observed (D). venous reflux from the posterior portion of cavernous sinus (CS) (B). Axial veins mostly refer to veins that traverse the prepontine cistern, arteriovenous shunt. The UV can also be categorized as a which connects the veins on the anterior surface of the mesen- bridging vein and is recognized as the venous anastomotic cephalon with the posterior portion of the CS (9).Theyare channel between the CS and the basal vein of Rosenthal (BVR), responsible for the brainstem and cerebellum venous reflux the anastomotic venous circle of the base of the brain (4, 5). channel in patients presenting with a cavernous dural The petrosal vein (PV) is the bridging vein in which the WORLD NEUROSURGERY 84 [4]: 1112-1126, OCTOBER 2015 www.WORLDNEUROSURGERY.org 1115 ORIGINAL ARTICLE CHAI KOBKITSUKSAKUL ET AL. VENOUS CONNECTIONS BETWEEN CAVERNOUS DURAL AVF AND CEREBELLUM AND THE BRAINSTEM Figure 2. Normal venous phase of the vertebral angiogram shows flow-related enhancement of the peduncular veins (arrow) connecting
Load more

Recommended publications
  • Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations
    ORIGINAL RESEARCH INTERVENTIONAL Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations Z.-S. Shi, J. Ziegler, L. Feng, N.R. Gonzalez, S. Tateshima, R. Jahan, N.A. Martin, F. Vin˜uela, and G.R. Duckwiler ABSTRACT BACKGROUND AND PURPOSE: DAVFs rarely involve the sphenoid wings and middle cranial fossa. We characterize the angiographic findings, treatment, and outcome of DAVFs within the sphenoid wings. MATERIALS AND METHODS: We reviewed the clinical and radiologic data of 11 patients with DAVFs within the sphenoid wing that were treated with an endovascular or with a combined endovascular and surgical approach. RESULTS: Nine patients presented with ocular symptoms and 1 patient had a temporal parenchymal hematoma. Angiograms showed that 5 DAVFs were located on the lesser wing of sphenoid bone, whereas the other 6 were on the greater wing of the sphenoid bone. Multiple branches of the ICA and ECA supplied the lesions in 7 patients. Four patients had cortical venous reflux and 7 patients had varices. Eight patients were treated with transarterial embolization using liquid embolic agents, while 3 patients were treated with transvenous embo- lization with coils or in combination with Onyx. Surgical disconnection of the cortical veins was performed in 2 patients with incompletely occluded DAVFs. Anatomic cure was achieved in all patients. Eight patients had angiographic and clinical follow-up and none had recurrence of their lesions. CONCLUSIONS: DAVFs may occur within the dura of the sphenoid wings and may often have a presentation similar to cavernous sinus DAVFs, but because of potential associations with the cerebral venous system, may pose a risk for intracranial hemorrhage.
    [Show full text]
  • Why Do Bridging Veins Rupture Into the Virtual Subdural Space?
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.47.2.121 on 1 February 1984. Downloaded from Journal of Neurology, Neurosurgery, and Psychiatry 1984;47:121-127 Why do bridging veins rupture into the virtual subdural space? T YAMASHIMA, RL FRIEDE From the Department ofNeuropathology, University of Gottingen, Gottingen, Federal Republic of Germany SUMMARY Electron microscopic data on human bridging veins show thin walls of variable thick- ness, circumferential arrangement of collagen fibres and a lack of outer reinforcement by arach- noid trabecules, all contributory to the subdural portion of the vein being more fragile than its subarachnoid portion. These features explain the laceration of veins and the subdural location of resultant haematomas. Most subdural haematomas due to venous bleeding walls are delicate, lacking muscle fibres, with only a have been attributed to lacerations in bridging veins. thin fibrous wall and a thin elastic lamina adjacent to These veins form short trunks passing directly from the endothelial layer. The conclusions of these two the brain to the dura mater, almost at right angles to authors, have gained wide acceptance, although guest. Protected by copyright. both. Between these two points, bridging veins take there was little evidence concerning the fragility of a straight course with no tortuosity to allow for the the vein walls. possible displacement of brain.' Trotter2 speculated The purpose of the present communication is to that subdural haematomas are invariably due to provide electron microscopic data on tissue fixed in trauma tearing large veins, an interpretation situ, which might throw some light on to the lacera- elaborated by Krauland.3 According to Leary,4 the tion mechanism of bridging veins and its relationship common sources of subdural haematomas are rup- to the development of subdural haematoma.
    [Show full text]
  • Gross Anatomy Assignment Name: Olorunfemi Peace Toluwalase Matric No: 17/Mhs01/257 Dept: Mbbs Course: Gross Anatomy of Head and Neck
    GROSS ANATOMY ASSIGNMENT NAME: OLORUNFEMI PEACE TOLUWALASE MATRIC NO: 17/MHS01/257 DEPT: MBBS COURSE: GROSS ANATOMY OF HEAD AND NECK QUESTION 1 Write an essay on the carvernous sinus. The cavernous sinuses are one of several drainage pathways for the brain that sits in the middle. In addition to receiving venous drainage from the brain, it also receives tributaries from parts of the face. STRUCTURE ➢ The cavernous sinuses are 1 cm wide cavities that extend a distance of 2 cm from the most posterior aspect of the orbit to the petrous part of the temporal bone. ➢ They are bilaterally paired collections of venous plexuses that sit on either side of the sphenoid bone. ➢ Although they are not truly trabeculated cavities like the corpora cavernosa of the penis, the numerous plexuses, however, give the cavities their characteristic sponge-like appearance. ➢ The cavernous sinus is roofed by an inner layer of dura matter that continues with the diaphragma sellae that covers the superior part of the pituitary gland. The roof of the sinus also has several other attachments. ➢ Anteriorly, it attaches to the anterior and middle clinoid processes, posteriorly it attaches to the tentorium (at its attachment to the posterior clinoid process). Part of the periosteum of the greater wing of the sphenoid bone forms the floor of the sinus. ➢ The body of the sphenoid acts as the medial wall of the sinus while the lateral wall is formed from the visceral part of the dura mater. CONTENTS The cavernous sinus contains the internal carotid artery and several cranial nerves. Abducens nerve (CN VI) traverses the sinus lateral to the internal carotid artery.
    [Show full text]
  • Gross Anatomy
    www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY www.BookOfLinks.com Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the infor- mation contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY David A. Morton, PhD Associate Professor Anatomy Director Department of Neurobiology and Anatomy University of Utah School of Medicine Salt Lake City, Utah K. Bo Foreman, PhD, PT Assistant Professor Anatomy Director University of Utah College of Health Salt Lake City, Utah Kurt H.
    [Show full text]
  • Dynamic Assessment of Venous Anatomy and Function in Neurosurgery with Real-Time Intraoperative Multimodal Ultrasound: Technical Note
    NEUROSURGICAL FOCUS Neurosurg Focus 45 (1):E6, 2018 Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: technical note Francesco Prada, MD,1,2 Massimiliano Del Bene, MD,1,3 Giovanni Mauri, MD,4 Massimo Lamperti, MD,5 Davide Vailati, MD,6 Carla Richetta, MD,7 Marco Saini, MD,1 Davide Santuari, MD,8 M. Yashar S. Kalani, MD, PhD,2 and Francesco DiMeco, MD1,9 1Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy; 2Department of Neurological Surgery, University of Virginia Health Science Center, Charlottesville, Virginia; Departments of 3Experimental Oncology and 4Radiology, European Institute of Oncology, Milan, Italy; 5Anesthesiology Unit, Cleveland Clinic, Abu Dhabi, United Arab Emirates; 6Anesthesiology Unit, Ospedale di Circolo di Melegnano, Presidio di Vizzolo Predabissi, Milan, Italy; 7Department of Neurosurgery, Sourasky Medical Center, Tel Aviv, Israel; 8Department of Vascular Surgery, Ospedale S. Carlo, Milan, Italy; and 9Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, Maryland The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics.
    [Show full text]
  • CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit
    228 CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit MUSCLES OF FACIAL EXPRESSION Dural Venous Sinuses Not in the Subendocranial Occipitofrontalis Space More About the Epicranial Aponeurosis and the Cerebral Veins Subcutaneous Layer of the Scalp Emissary Veins Orbicularis Oculi CLINICAL SIGNIFICANCE OF EMISSARY VEINS Zygomaticus Major CAVERNOUS SINUS THROMBOSIS Orbicularis Oris Cranial Arachnoid and Pia Mentalis Vertebral Artery Within the Cranial Cavity Buccinator Internal Carotid Artery Within the Cranial Cavity Platysma Circle of Willis The Absence of Veins Accompanying the PAROTID GLAND Intracranial Parts of the Vertebral and Internal Carotid Arteries FACIAL ARTERY THE INTRACRANIAL PORTION OF THE TRANSVERSE FACIAL ARTERY TRIGEMINAL NERVE ( C.N. V) AND FACIAL VEIN MECKEL’S CAVE (CAVUM TRIGEMINALE) FACIAL NERVE ORBITAL CAVITY AND EYE EYELIDS Bony Orbit Conjunctival Sac Extraocular Fat and Fascia Eyelashes Anulus Tendineus and Compartmentalization of The Fibrous "Skeleton" of an Eyelid -- Composed the Superior Orbital Fissure of a Tarsus and an Orbital Septum Periorbita THE SKULL Muscles of the Oculomotor, Trochlear, and Development of the Neurocranium Abducens Somitomeres Cartilaginous Portion of the Neurocranium--the The Lateral, Superior, Inferior, and Medial Recti Cranial Base of the Eye Membranous Portion of the Neurocranium--Sides Superior Oblique and Top of the Braincase Levator Palpebrae Superioris SUTURAL FUSION, BOTH NORMAL AND OTHERWISE Inferior Oblique Development of the Face Actions and Functions of Extraocular Muscles Growth of Two Special Skull Structures--the Levator Palpebrae Superioris Mastoid Process and the Tympanic Bone Movements of the Eyeball Functions of the Recti and Obliques TEETH Ophthalmic Artery Ophthalmic Veins CRANIAL CAVITY Oculomotor Nerve – C.N. III Posterior Cranial Fossa CLINICAL CONSIDERATIONS Middle Cranial Fossa Trochlear Nerve – C.N.
    [Show full text]
  • Vessels and Circulation
    CARDIOVASCULAR SYSTEM OUTLINE 23.1 Anatomy of Blood Vessels 684 23.1a Blood Vessel Tunics 684 23.1b Arteries 685 23.1c Capillaries 688 23 23.1d Veins 689 23.2 Blood Pressure 691 23.3 Systemic Circulation 692 Vessels and 23.3a General Arterial Flow Out of the Heart 693 23.3b General Venous Return to the Heart 693 23.3c Blood Flow Through the Head and Neck 693 23.3d Blood Flow Through the Thoracic and Abdominal Walls 697 23.3e Blood Flow Through the Thoracic Organs 700 Circulation 23.3f Blood Flow Through the Gastrointestinal Tract 701 23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 705 23.3h Blood Flow Through the Upper Limb 705 23.3i Blood Flow Through the Lower Limb 709 23.4 Pulmonary Circulation 712 23.5 Review of Heart, Systemic, and Pulmonary Circulation 714 23.6 Aging and the Cardiovascular System 715 23.7 Blood Vessel Development 716 23.7a Artery Development 716 23.7b Vein Development 717 23.7c Comparison of Fetal and Postnatal Circulation 718 MODULE 9: CARDIOVASCULAR SYSTEM mck78097_ch23_683-723.indd 683 2/14/11 4:31 PM 684 Chapter Twenty-Three Vessels and Circulation lood vessels are analogous to highways—they are an efficient larger as they merge and come closer to the heart. The site where B mode of transport for oxygen, carbon dioxide, nutrients, hor- two or more arteries (or two or more veins) converge to supply the mones, and waste products to and from body tissues. The heart is same body region is called an anastomosis (ă-nas ′tō -mō′ sis; pl., the mechanical pump that propels the blood through the vessels.
    [Show full text]
  • Non-Pathological Opacification of the Cavernous Sinus on Brain CT
    healthcare Article Non-Pathological Opacification of the Cavernous Sinus on Brain CT Angiography: Comparison with Flow-Related Signal Intensity on Time-of-Flight MR Angiography Sun Ah Heo 1, Eun Soo Kim 1,* , Yul Lee 1, Sang Min Lee 1, Kwanseop Lee 1 , Dae Young Yoon 2, Young-Su Ju 3 and Mi Jung Kwon 4 1 Department of Radiology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 14068, Korea; [email protected] (S.A.H.); [email protected] (Y.L.); [email protected] (S.M.L.); [email protected] (K.L.) 2 Department of Radiology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 14068, Korea; [email protected] 3 National Medical Center, Seoul 04564, Korea; [email protected] 4 Department of Pathology, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 14068, Korea; [email protected] * Correspondence: [email protected] Abstract: Purpose: To investigate the non-pathological opacification of the cavernous sinus (CS) on brain computed tomography angiography (CTA) and compare it with flow-related signal intensity (FRSI) on time-of-flight magnetic resonance angiography (TOF-MRA). Methods: Opacification of the CS was observed in 355 participants who underwent CTA and an additional 77 participants who underwent examination with three diagnostic modalities: CTA, TOF-MRA, and digital subtraction angiography (DSA). Opacification of the CS, superior petrosal sinus (SPS), inferior petrosal sinus Citation: Heo, S.A.; Kim, E.S.; Lee, Y.; Lee, S.M.; Lee, K.; Yoon, D.Y.; Ju, Y.-S.; (IPS), and pterygoid plexus (PP) were also analyzed using a five-point scale.
    [Show full text]
  • Carotid-Cavernous Sinus Fistulas and Venous Thrombosis
    141 Carotid-Cavernous Sinus Fistulas and Venous Thrombosis Joachim F. Seeger1 Radiographic signs of cavernous sinus thrombosis were found in eight consecutive Trygve 0. Gabrielsen 1 patients with an angiographic diagnosis of carotid-cavernous sinus fistula; six were of 1 2 the dural type and the ninth case was of a shunt from a cerebral hemisphere vascular Steven L. Giannotta · Preston R. Lotz ,_ 3 malformation. Diagnostic features consisted of filling defects within the cavernous sinus and its tributaries, an abnormal shape of the cavernous sinus, an atypical pattern of venous drainage, and venous stasis. Progression of thrombosis was demonstrated in five patients who underwent follow-up angiography. Because of a high incidence of spontaneous resolution, patients with dural- cavernous sinus fistulas who show signs of venous thrombosis at angiography should be followed conservatively. Spontaneous closure of dural arteriovenous fistulas involving branches of the internal and/ or external carotid arteries and the cavernous sinus has been reported by several investigators (1-4). The cause of such closure has been speculative, although venous thrombosis recently has been suggested as a possible mechanism (3]. This report demonstrates the high incidence of progres­ sive thrombosis of the cavernous sinus associated with dural carotid- cavernous shunts, proposes a possible mechanism of the thrombosis, and emphasizes certain characteristic angiographic features which are clues to thrombosis in evolution, with an associated high incidence of spontaneous " cure. " Materials and Methods We reviewed the radiographic and medical records of eight consecutive patients studied at our hospital in 1977 who had an angiographic diagnosis of carotid- cavernous sinus Received September 24, 1979; accepted after fistula.
    [Show full text]
  • Dural Venous Channels: Hidden in Plain Sight–Reassessment of an Under-Recognized Entity
    Published July 16, 2020 as 10.3174/ajnr.A6647 ORIGINAL RESEARCH INTERVENTIONAL Dural Venous Channels: Hidden in Plain Sight–Reassessment of an Under-Recognized Entity M. Shapiro, K. Srivatanakul, E. Raz, M. Litao, E. Nossek, and P.K. Nelson ABSTRACT BACKGROUND AND PURPOSE: Tentorial sinus venous channels within the tentorium cerebelli connecting various cerebellar and su- pratentorial veins, as well as the basal vein, to adjacent venous sinuses are a well-recognized entity. Also well-known are “dural lakes” at the vertex. However, the presence of similar channels in the supratentorial dura, serving as recipients of the Labbe, super- ficial temporal, and lateral and medial parieto-occipital veins, among others, appears to be underappreciated. Also under-recog- nized is the possible role of these channels in the angioarchitecture of certain high-grade dural fistulas. MATERIALS AND METHODS: A retrospective review of 100 consecutive angiographic studies was performed following identification of index cases to gather data on the angiographic and cross-sectional appearance, location, length, and other features. A review of 100 consecutive dural fistulas was also performed to identify those not directly involving a venous sinus. RESULTS: Supratentorial dural venous channels were found in 26% of angiograms. They have the same appearance as those in the tentorium cerebelli, a flattened, ovalized morphology owing to their course between 2 layers of the dura, in contradistinction to a rounded cross-section of cortical and bridging veins. They are best appreciated on angiography and volumetric postcontrast T1- weighted images. Ten dural fistulas not directly involving a venous sinus were identified, 6 tentorium cerebelli and 4 supratentorial.
    [Show full text]
  • Cerebellar Disease in the Dog and Cat
    CEREBELLAR DISEASE IN THE DOG AND CAT: A LITERATURE REVIEW AND CLINICAL CASE STUDY (1996-1998) b y Diane Dali-An Lu BVetMed A thesis submitted for the degree of Master of Veterinary Medicine (M.V.M.) In the Faculty of Veterinary Medicine University of Glasgow Department of Veterinary Clinical Studies Division of Small Animal Clinical Studies University of Glasgow Veterinary School A p ril 1 9 9 9 © Diane Dali-An Lu 1999 ProQuest Number: 13815577 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a com plete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest ProQuest 13815577 Published by ProQuest LLC(2018). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode Microform Edition © ProQuest LLC. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 GLASGOW UNIVERSITY lib ra ry ll5X C C ^ Summary SUMMARY________________________________ The aim of this thesis is to detail the history, clinical findings, ancillary investigations and, in some cases, pathological findings in 25 cases of cerebellar disease in dogs and cats which were presented to Glasgow University Veterinary School and Hospital during the period October 1996 to June 1998. Clinical findings were usually characteristic, although the signs could range from mild tremor and ataxia to severe generalised ataxia causing frequent falling over and difficulty in locomotion.
    [Show full text]
  • Safety Profile of Superior Petrosal Vein (The Vein of Dandy) Sacrifice in Neurosurgical Procedures: a Systematic Review
    NEUROSURGICAL FOCUS Neurosurg Focus 45 (1):E3, 2018 Safety profile of superior petrosal vein (the vein of Dandy) sacrifice in neurosurgical procedures: a systematic review *Vinayak Narayan, MD, MCh, Amey R. Savardekar, MD, MCh, Devi Prasad Patra, MD, MCh, Nasser Mohammed, MD, MCh, Jai D. Thakur, MD, Muhammad Riaz, MD, FCPS, and Anil Nanda, MD, MPH Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana OBJECTIVE Walter E. Dandy described for the first time the anatomical course of the superior petrosal vein (SPV) and its significance during surgery for trigeminal neuralgia. The patient’s safety after sacrifice of this vein is a challenging question, with conflicting views in current literature. The aim of this systematic review was to analyze the current surgical considerations regarding Dandy’s vein, as well as provide a concise review of the complications after its obliteration. METHODS A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A thorough literature search was conducted on PubMed, Web of Science, and the Cochrane database; articles were selected systematically based on the PRISMA protocol and reviewed completely, and then relevant data were summarized and discussed. RESULTS A total of 35 publications pertaining to the SPV were included and reviewed. Although certain studies report almost negligible complications of SPV sectioning, there are reports demonstrating the deleterious effects of SPV oblit- eration when achieving adequate exposure in surgical pathologies like trigeminal neuralgia, vestibular schwannoma, and petroclival meningioma. The incidence of complications after SPV sacrifice (32/50 cases in the authors’ series) is 2/32 (6.2%), and that reported in various case series varies from 0.01% to 31%.
    [Show full text]