Superior Sagittal Sinus Bifurcation Variation

Abstract

It is important to define the dural sinuses during assessment of the clinical presentations in neurosurgery and neurology and especially before performing surgical interventions involving the brain. Variations of dural sinuses are frequently seen in confluence of the sinuses. In our case, cranial venous MRI angiography of a 49-year-old male patient demonstrated that the superior sagittal sinus bifurcated near sutura lambdoidea of the cranium. These coursed as two separate branches and drained into the transverse sinus without forming the confluence of the sinuses. Sinus rectus joined to the left transverse sinus. We think that this unusual variation which was not reported before will contribute to the assessment of the neurologic presentations and also to the surgical interventions

Keywords

• Variation, MR angiography, superior sagittal sinus, straight sinus

Superior Sagittal Sinus Bifurcation Variation

Öz

Nöroşirürji ve nöroloji ve özellikle beyin ile ilgili cerrahi müdahaleler öncesindeki klinik değerlendirmede, dural sinüsleri tanımlamak önemlidir. Dural sinüs varyasyonları, confluens sinuum içinde sık olarak görülür. Olgumuzda, 49 yaşındaki erkek hastanın çekilen kraniyal venöz MR anjiyografisinde süperior sagittal sinüs, kafatasındaki sutura lambdoidea hizasında çatallaştığı gösterilmektedir. Bunlar, iki ayrı dal şeklinde ve confluens sinuum’u oluşturmadan transvers sinüs’e drene olmaktadır. Sinüs rektus, sol transvers sinüs’e katılmaktadır. Biz, daha önce bildirilmemiş bu sıradışı varyasyonun, nörolojik prezentasyonlar ve de cerrahi müdahaleleri değerlendirmede katkı sağlayacağı düşüncesindeyiz

Anahtar Kelimeler

• varyasyon, MR anjiografi, superiyor sagital sinüs, düz sinüs

References

1. 1. Widjaja E, Griffiths PD. Intracranial MR venography in children: normal anatomy and variations. AJNR Am J Neuroradiol 2004; 25: 1557-62.
2. 2. Padget DH. The cranial venous system in man in reference to development, adult configuration and relation to the arteres. Am J Anat 1956; 98:307-6
3. 3. Kobayashi K, Matsui O, Suzuki M, Ueda F. Anatomical study of the confluence of the sinuses with contrast-enhanced magnetic resonance venography. Neuroradiology 2006; 48(5): 307-11.
4. 4. Singh M, Nagashima M, Inoue Y. Anatomical variations of occipital bone impressions for dural venous sinuses around the torcular Herophili, with special reference to the consideration of clinical significance. Surg Radiol Anat 2004; 26(6): 480-7.
5. 5. Surendrababu NR, Subathira, Livingstone RS. Variations in the cerebral venous anatomy and pitfalls in the diagnosis of cerebral venous sinus thrombosis: low field MR experience. Indian J Med Sci 2006; 60(4): 135-42.
6. 6. Hwang SK, Gwak HS, Paek SH, Kim DG, Jung HW. The experience of ligation of transverse or sigmoid sinus in surgery of large petroclival meningiomas. J Korean Med Sci 2002; 17(4): 544-8.
7. 7. Fiumara E, Tumbiolo S, Bellomonte ML, Savatteri P, Finazzo F, La Gattuta F. Resection of the transverse sinuses and confluence of sinuses for treatment of multiple dural arteriovenous fistulas. Case report. J Neurosurg 2004;100(2): 348-52.
8. 8. Zouaoui A, Hidden G. Cerebral Venous Sinuses: Anatomical Variants or Thrombosis? Acta Anatomica 1988;133:318-24.