TY - JOUR
T1 - Occipital sinus pericranii superseding both jugular veins: description of two rare pediatric cases.
AU - Frassanito, Paolo
AU - Massimi, Luca
AU - Tamburrini, Gianpiero
AU - Caldarelli, Massimo
AU - Pedicelli, Alessandro
AU - Di Rocco, Concezio
PY - 2013
Y1 - 2013
N2 - BACKGROUND AND IMPORTANCE:
The extracranial venous drainage of the brain is provided mainly by the jugular veins with the variable participation of extrajugular pathways.
CLINICAL PRESENTATION:
Two cases of occipital sinus pericranii (SP) were observed. A 6-year-old girl presented with a progressively enlarging occipital lump; she was otherwise asymptomatic. An 8-year-old boy presented with mild nuchal headache. In the former case, neuroimaging examinations confirmed the diagnosis of SP; in the latter, SP was noticed on magnetic resonance imaging because it was neglected at physical examination. In both subjects, the radiological examination also showed bilateral occlusion of the jugular veins with ventricular dilation and herniation of cerebellar tonsils into the foramen magnum.
CONCLUSION:
Exceptionally, SP was noticed to represent the main venous drainage of the underlying brain, thereby compensating for the intracranial hypertension due to venous engorgement. Preservation of SP was advised, and any surgical or endovascular treatment was contraindicated.
AB - BACKGROUND AND IMPORTANCE:
The extracranial venous drainage of the brain is provided mainly by the jugular veins with the variable participation of extrajugular pathways.
CLINICAL PRESENTATION:
Two cases of occipital sinus pericranii (SP) were observed. A 6-year-old girl presented with a progressively enlarging occipital lump; she was otherwise asymptomatic. An 8-year-old boy presented with mild nuchal headache. In the former case, neuroimaging examinations confirmed the diagnosis of SP; in the latter, SP was noticed on magnetic resonance imaging because it was neglected at physical examination. In both subjects, the radiological examination also showed bilateral occlusion of the jugular veins with ventricular dilation and herniation of cerebellar tonsils into the foramen magnum.
CONCLUSION:
Exceptionally, SP was noticed to represent the main venous drainage of the underlying brain, thereby compensating for the intracranial hypertension due to venous engorgement. Preservation of SP was advised, and any surgical or endovascular treatment was contraindicated.
KW - sinus pericranii, children, neurosurgery
KW - sinus pericranii, children, neurosurgery
UR - http://hdl.handle.net/10807/124916
U2 - 10.1227/NEU.0b013e31828baab4
DO - 10.1227/NEU.0b013e31828baab4
M3 - Article
SN - 0148-396X
SP - 1054
EP - 1058
JO - Neurosurgery
JF - Neurosurgery
ER -