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Marano M, Barbieri FR, Sucapane P, Pagano S, Marruzzo D, DI Lazzaro V, Ricciuti R. Screw bubbling with air embolism, an unusual complication of a frameless deep brain stimulation. J Neurosurg Sci 2024; 68:501-502. [PMID: 38757971 DOI: 10.23736/s0390-5616.24.06241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Affiliation(s)
- Massimo Marano
- Neurology, Neurobiology, Neurophysiology and Psychiatry, Campus Bio-Medico University, Rome, Italy -
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy -
| | | | | | - Serena Pagano
- Neurosurgery Unit, Belcolle Hospital, ASL of Viterbo, Viterbo Italy
| | - Daniele Marruzzo
- Neurosurgery Unit, Belcolle Hospital, ASL of Viterbo, Viterbo Italy
| | - Vincenzo DI Lazzaro
- Neurology, Neurobiology, Neurophysiology and Psychiatry, Campus Bio-Medico University, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Watkins T, Milne N, Ong BB. Suicide by an Electric Power Drill and Spade Drill Bit: An Unusual Mechanism of Death. Am J Forensic Med Pathol 2024:00000433-990000000-00203. [PMID: 39018454 DOI: 10.1097/paf.0000000000000970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
ABSTRACT Self-inflicted penetrating brain injuries with drills have been reported but are uncommon and typically involve the use of conventional drill bits. We report an unusual case of a 56-year-old man with a history of psychiatric illness who completed suicide using an electric drill and spade-type drill bit. Multiple superficial scalp and deeper bony injuries were sustained, although without breach of the dura, and death was not from brain injury, but secondary to venous air embolism related to entrainment of air into diploic vessels.
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Hui J, Balzeau A. Investigating the relationship between cranial bone thickness and diploic channels: A first comparison between fossil Homo sapiens and Homo neanderthalensis. Anat Rec (Hoboken) 2024; 307:2036-2046. [PMID: 38059273 DOI: 10.1002/ar.25360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/13/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023]
Abstract
Diploic veins are part of the circulatory system of the head. They transport venous blood and cerebrospinal fluid and are housed in diploic channels (DCs). DCs are highly variable in terms of their position, extension, and size. These parameters were hypothesized to be related to the variations in cranial vault thickness (CVT). For the first time, we analyzed the spatial relationship between CVT and DCs in a sample of eight H. neanderthalensis and H. sapiens cranial fossils. Using micro-CT scanning data, we constructed color maps of the CVT and visually inspected whether the regional thickness variation was associated with the morphology and distribution of the DC branches. The results showed that when regional bone thickness was below a certain threshold, no DCs or scattered small DC branches were present. Larger DC branches appeared only when the thickness exceeded the threshold. However, once the threshold was reached, further increases in thickness no longer resulted in more or larger DCs. This study also found that our sample of H. neanderthalensis and H. sapiens have different distribution patterns in thin areas, which may affect how their DCs connect with different branches of the middle meningeal vessels. This preliminary study provides evidence for the discussion on the interaction between the cranium, brain, and blood vessels. Future research should include more hominin fossils to better document the variation within each species and possible evolutionary trends among hominin lineages.
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Affiliation(s)
- Jiaming Hui
- PaleoFED Team, UMR 7194 Histoire Naturelle de l'Homme Préhistorique, CNRS, Département Homme et Environnement, Muséum national d'Histoire naturelle, Paris, France
- Ecole Doctorale 227 Sciences de la nature et de l'Homme: évolution et écologie, Sorbonne Université, Paris, France
| | - Antoine Balzeau
- PaleoFED Team, UMR 7194 Histoire Naturelle de l'Homme Préhistorique, CNRS, Département Homme et Environnement, Muséum national d'Histoire naturelle, Paris, France
- Department of African Zoology, Royal Museum for Central Africa, Tervuren, Belgium
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Morales-Roccuzzo D, Sabahi M, Obrzut M, Najera E, Monterroso-Cohen D, Bsat S, Adada B, Borghei-Razavi H. A primer to vascular anatomy of the brain: an overview on anterior compartment. Surg Radiol Anat 2024; 46:829-842. [PMID: 38630270 PMCID: PMC11161539 DOI: 10.1007/s00276-024-03359-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/30/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE Knowledge of neurovascular anatomy is vital for neurosurgeons, neurologists, neuro-radiologists and anatomy students, amongst others, to fully comprehend the brain's anatomy with utmost depth. This paper aims to enhance the foundational knowledge of novice physicians in this area. METHOD A comprehensive literature review was carried out by searching the PubMed and Google Scholar databases using primary keywords related to brain vasculature, without date restrictions. The identified literature was meticulously examined and scrutinized. In the process of screening pertinent papers, further articles and book chapters were obtained through analysis and additional assessing of the reference lists. Additionally, four formalin-fixed, color latex-injected cadaveric specimens preserved in 70% ethanol solution were dissected under surgical microscope (Leica Microsystems Inc, 1700 Leider Ln, Buffalo Grove, IL 60089 USA). Using microneurosurgical as well as standard instruments, and a high-speed surgical drill (Stryker Instruments 1941 Stryker Way Portage, MI 49002 USA). Ulterior anatomical dissection was documented in microscopic images. RESULTS Encephalic circulation functions as a complex network of intertwined vessels. The Internal Carotid Arteries (ICAs) and the Vertebral Arteries (VAs), form the anterior and posterior arterial circulations, respectively. This work provides a detailed exploration of the neurovascular anatomy of the anterior circulation and its key structures, such as the Anterior Cerebral Artery (ACA) and the Middle Cerebral Artery (MCA). Embryology is also briefly covered, offering insights into the early development of the vascular structures of the central nervous system. Cerebral venous system was detailed, highlighting the major veins and tributaries involved in the drainage of blood from the intracranial compartment, with a focus on the role of the Internal Jugular Veins (IJVs) as the primary, although not exclusive, deoxygenated blood outflow pathway. CONCLUSION This work serves as initial guide, providing essential knowledge on neurovascular anatomy, hoping to reduce the initial impact when tackling the subject, albeit the intricate vasculature of the brain will necessitate further efforts to be conquered, that being crucial for neurosurgical and neurology related practice and clinical decision-making.
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Affiliation(s)
- Diego Morales-Roccuzzo
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
| | - Mohammadmahdi Sabahi
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Michal Obrzut
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Edinson Najera
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - David Monterroso-Cohen
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Shadi Bsat
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Badih Adada
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Hamid Borghei-Razavi
- Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
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Mizutani K, Miyauchi T, Yamada Y, Yamada M, Yokoyama Y, Kosugi K, Yoshida K, Akiyama T, Toda M, Jinzaki M. Exploration of postural effects on the external jugular and diploic venous system using upright computed tomography scanning. Neuroradiology 2024; 66:963-971. [PMID: 38613702 DOI: 10.1007/s00234-024-03357-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE Few studies have investigated the influence of posture on the external jugular and diploic venous systems in the head and cranial region. In this study, we aimed to investigate the effects of posture on these systems using upright computed tomography (CT) scanning. METHODS This study retrospectively analysed an upright CT dataset from a previous prospective study. In each patient, the diameters of the vessels in three external jugular tributaries and four diploic veins were measured using CT digital subtraction venography in both supine and sitting positions. RESULTS Amongst the 20 cases in the original dataset, we eventually investigated 19 cases due to motion artifacts in 1 case. Compared with the supine position, most of the external jugular tributaries collapsed, and the average size significantly decreased in the sitting position (decreased by 22-49% on average). In contrast, most of the diploic veins, except the occipital diploic veins, tended to increase or remain unchanged (increased by 12-101% on average) in size in the sitting position compared with the supine position. However, the changes in the veins associated with this positional shift were not uniform; in approximately 5-30% of the cases, depending on each vein, an opposite trend was observed. CONCLUSION Compared to the supine position, the contribution of external jugular tributaries to head venous drainage decreased in the sitting position, whilst most diploic veins maintained their contribution. These results could enhance our understanding of the physiology and pathophysiology of the head region in upright and sitting positions.
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Affiliation(s)
- Katsuhiro Mizutani
- Department of Neurosurgery, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Tsubasa Miyauchi
- Department of Neurosurgery, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Yoshitake Yamada
- Department of Radiology, School of Medicine, Keio University, Shinjuku, Tokyo, Japan.
| | - Minoru Yamada
- Department of Radiology, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Yoichi Yokoyama
- Department of Radiology, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Kenzo Kosugi
- Department of Neurosurgery, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Keisuke Yoshida
- Department of Neurosurgery, Mihara Memorial Hospital, Isezaki, Gumma, Japan
| | - Takenori Akiyama
- Department of Neurosurgery, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Masahiro Toda
- Department of Neurosurgery, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
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Mazzitelli JA, Pulous FE, Smyth LCD, Kaya Z, Rustenhoven J, Moskowitz MA, Kipnis J, Nahrendorf M. Skull bone marrow channels as immune gateways to the central nervous system. Nat Neurosci 2023; 26:2052-2062. [PMID: 37996526 PMCID: PMC10894464 DOI: 10.1038/s41593-023-01487-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Abstract
Decades of research have characterized diverse immune cells surveilling the CNS. More recently, the discovery of osseous channels (so-called 'skull channels') connecting the meninges with the skull and vertebral bone marrow has revealed a new layer of complexity in our understanding of neuroimmune interactions. Here we discuss our current understanding of skull and vertebral bone marrow anatomy, its contribution of leukocytes to the meninges, and its surveillance of the CNS. We explore the role of this hematopoietic output on CNS health, focusing on the supply of immune cells during health and disease.
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Affiliation(s)
- Jose A Mazzitelli
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Center for Brain Immunology and Glia (BIG), Washington University School of Medicine, St. Louis, MO, USA
- Medical Scientist Training Program, Washington University School of Medicine, St. Louis, MO, USA
- Neuroscience Graduate Program, Washington University School of Medicine, St. Louis, MO, USA
| | - Fadi E Pulous
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Leon C D Smyth
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Center for Brain Immunology and Glia (BIG), Washington University School of Medicine, St. Louis, MO, USA
| | - Zeynep Kaya
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Justin Rustenhoven
- Department of Pharmacology and Clinical Pharmacology, The University of Auckland, Auckland, New Zealand
| | - Michael A Moskowitz
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jonathan Kipnis
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
- Center for Brain Immunology and Glia (BIG), Washington University School of Medicine, St. Louis, MO, USA.
- Medical Scientist Training Program, Washington University School of Medicine, St. Louis, MO, USA.
- Neuroscience Graduate Program, Washington University School of Medicine, St. Louis, MO, USA.
| | - Matthias Nahrendorf
- Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Internal Medicine I, University Hospital Wuerzburg, Wuerzburg, Germany.
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Noufal M, Liang C, Chhabra V. Percutaneous transosseous embolization of a diploic vein arteriovenous fistula with intracranial and extracranial shunting. Interv Neuroradiol 2023; 29:773-777. [PMID: 35505599 PMCID: PMC10680960 DOI: 10.1177/15910199221096009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/26/2022] [Indexed: 11/15/2022] Open
Abstract
EDUCATIONAL MESSAGE Transosseous embolization of diploic vein arteriovenous fistula is feasible when necessary in select cases.
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Affiliation(s)
- Mazen Noufal
- Department of Neurosurgery, Kaiser Permanente, Southern California, Fontana, CA, USA
| | - Conrad Liang
- Department of Neurosurgery, Kaiser Permanente, Southern California, Fontana, CA, USA
| | - Vaninder Chhabra
- Department of Neurosurgery, Kaiser Permanente, Southern California, Fontana, CA, USA
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Hui J, Balzeau A. The diploic venous system in Homo neanderthalensis and fossil Homo sapiens: A study using high-resolution computed tomography. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:412-427. [PMID: 37747127 DOI: 10.1002/ajpa.24843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/22/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES The diploic venous system has been hypothesized to be related to human brain evolution, though its evolutionary trajectory and physiological functions remain largely unclear. This study examines the characteristics of the diploic venous channels (DCs) in a selection of well-preserved Homo neanderthalensis and Upper Paleolithic Homo sapiens crania, searching for the differences between the two taxa and exploring the associations between brain anatomy and DCs. MATERIALS AND METHODS Five H. neanderthalensis and four H. sapiens fossil specimens from Western Europe were analyzed. Based on Micro-CT scanning and 3D reconstruction, the distribution pattern and draining orifices of the DCs were inspected qualitatively. The size of the DCs was quantified by volume calculation, and the degree of complexity was quantified by fractal analyses. RESULTS High-resolution data show the details of the DC structures not documented in previous studies. H. neanderthalensis and H. sapiens specimens share substantial similarities in the DCs. The noticeable differences between the two samples manifest in the connecting points surrounding the frontal sinuses, parietal foramina, and asterional area. DISCUSSION This study provides a better understanding of the anatomy of the DCs in H. neanderthalensis and H. sapiens. The connection patterns of the DCs have potential utility in distinguishing between the two taxa and in the phylogenetic and taxonomic discussion of the Neandertal-like specimens with controversial taxonomic status.
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Affiliation(s)
- Jiaming Hui
- PaleoFED team, UMR 7194 Histoire Naturelle de l'Homme Préhistorique, CNRS, Département Homme et Environnement, Muséum national d'Histoire naturelle, Paris, France
- Ecole Doctorale 227 Sciences de la nature et de l'Homme : évolution et écologie, Sorbonne Université, Paris, France
| | - Antoine Balzeau
- PaleoFED team, UMR 7194 Histoire Naturelle de l'Homme Préhistorique, CNRS, Département Homme et Environnement, Muséum national d'Histoire naturelle, Paris, France
- Department of African Zoology, Royal Museum for Central Africa, Tervuren, Belgium
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Goertz JE, Garcia-Bonilla L, Iadecola C, Anrather J. Immune compartments at the brain's borders in health and neurovascular diseases. Semin Immunopathol 2023:10.1007/s00281-023-00992-6. [PMID: 37138042 DOI: 10.1007/s00281-023-00992-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/14/2023] [Indexed: 05/05/2023]
Abstract
Recent evidence implicates cranial border immune compartments in the meninges, choroid plexus, circumventricular organs, and skull bone marrow in several neuroinflammatory and neoplastic diseases. Their pathogenic importance has also been described for cardiovascular diseases such as hypertension and stroke. In this review, we will examine the cellular composition of these cranial border immune niches, the potential pathways through which they might interact, and the evidence linking them to cardiovascular disease.
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Affiliation(s)
- Jennifer E Goertz
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61St Street; RR-405, New York, NY, 10065, USA
| | - Lidia Garcia-Bonilla
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61St Street; RR-405, New York, NY, 10065, USA
| | - Costantino Iadecola
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61St Street; RR-405, New York, NY, 10065, USA
| | - Josef Anrather
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, 407 East 61St Street; RR-405, New York, NY, 10065, USA.
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Evaluating diploic vein blood flow using time-resolved whole-head computed tomography angiography and determining the positional relationship between typical craniotomy approaches and diploic veins in patients with meningioma. Acta Neurochir (Wien) 2022; 164:2999-3010. [PMID: 36006508 DOI: 10.1007/s00701-022-05349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/18/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Diploic veins may act as collateral venous pathways in cases of meningioma with venous sinus invasion. Diploic vein blood flow should be preoperatively evaluated to consider preserving the veins. In this study, we evaluated the use of time-resolved whole-head computed tomography angiography (4D-CTA)-which is less patient-intensive than digital subtraction angiography (DSA)-for assessing diploic vein blood flow and the positional relationship between typical craniotomy approaches and diploic veins. METHODS We retrospectively examined 231 patients who underwent surgery for intracranial meningioma. We performed contrast-enhanced magnetic resonance imaging (MRI) to evaluate diploic vein pathways and compared the visualization rates of diploic vein blood flow assessed using 4D-CTA and DSA. Subsequently, we evaluated the rates of the diploic veins transected during craniotomy by comparing the pre- and postoperative contrast-enhanced MRI. RESULTS The diagnostic performance of 4D-CTA was assessed in 45 patients. Of the 320 diploic veins identified in these patients, blood flow in 70 (21.9%) diploic veins was identified by 4D-CTA and DSA, and both results were consistent. To assess the transection rates of the diploic veins, 150 patients were included. A trend towards a high transection rate of the diploic vein in the basal interhemispheric, frontotemporal, orbitozygomatic, combined transpetrosal, and convexity craniotomy approaches was observed. CONCLUSIONS In patients with meningiomas, both 4D-CTA and DSA are useful in evaluating diploic vein blood flow. In meningiomas with venous sinus invasion, determining the extent of craniotomy after understanding the pathways and blood flow of diploic veins is recommended.
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Tsutsumi S, Sugiyama N, Ueno H, Ishii H. Does diploic venous flow drain extracranially in the pterional area? A magnetic resonance imaging study. Surg Neurol Int 2022; 13:425. [PMID: 36324908 PMCID: PMC9609885 DOI: 10.25259/sni_760_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
Abstract
Background: To the best of our knowledge, no study using neuroimaging modalities has documented calvarial diploic veins (DVs) connected to the extracranial sites. This study aimed to characterize them using magnetic resonance imaging (MRI). Methods: A total of 88 patients underwent thin-sliced contrast MRI. In addition, the DVs coursing through the pterional area were observed on three injected cadaver heads. Results: On postcontrast MRI, the DVs of the pterional area directly drained into the temporalis muscle or supplied branches coursing into the muscle in 43% on the right side and 40% on the left. The DVs and their branches were highly variable in diameter and number. In 9% of cases, the DV of the pterional area was found to drain into an extracranial site and connected to large venous channels distributed in the temporalis muscle. Furthermore, in 17% of cases, the DVs drained into the extracranial sites in the frontal skull region, followed by 9% in the parietal, 2% in the occipital, and 1% in the temporal regions. The DVs coursed superficially in the pterional area on both sides of all three cadaver heads. On one side, the DV in the area was open to an extracranial site. Conclusion: Part of the diploic venous flow drains extracranially in the pterional area. This area may provide an important interface between the calvarial DVs and the extracranial venous system.
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Morosanu CO, Nita AR, Florian IS. Intra-osseous cerebrospinal fluid shunts-Overview of past and present clinical and experimental evidence. Neurochirurgie 2022; 68:e84-e96. [PMID: 36087694 DOI: 10.1016/j.neuchi.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/08/2022] [Accepted: 08/21/2022] [Indexed: 10/14/2022]
Abstract
In the history of hydrocephalus treatment, a variety of diversion sites have been explored to ensure an adequate alternative when the peritoneum was not a feasible option. An interesting choice was the elimination of excessive cerebrospinal fluid (CSF) in the skeletal system. The purpose of this review was to evaluate all shunting systems that have been implemented in bone structures and to determine their therapeutic potential. All articles pertaining to bone derivations were selected from PubMed, Medline, EBSCO and Scopus, using relevant search terms. The search revealed 6 types of osseous shunts that have been used throughout history: vertebral, diploic, ventriculomastoid, ventriculoiliac, ventriculosternal and ventriculohumeral. Some of them are purely of historical significance, but data from more recent clinical and experimental studies have rendered this type of receptacle a potential site for diverting CSF. Having knowledge of all the alternatives used in cases of refractory hydrocephalus is vital for choosing the appropriate surgical intervention.
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Affiliation(s)
- C O Morosanu
- Department of Neurosurgery, Royal Preston Hospital, Preston, UK; Human Anatomy Resource Centre, Faculty of Life and Health Sciences, University of Liverpool, Liverpool, UK.
| | - A R Nita
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - I S Florian
- Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
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Eisová S, Velemínský P, Velemínská J, Bruner E. Diploic vein morphology in normal and craniosynostotic adult human skulls. J Morphol 2022; 283:1318-1336. [PMID: 36059180 DOI: 10.1002/jmor.21505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
Diploic veins (DV) run within the cranial diploe, where they leave channels that can be studied in osteological samples. This study investigates overall DV variability in human adults and the effects of sex, age, cranial dimensions, and dysmorphogenesis associated with craniosynostosis (CS). The morphology of macroscopic diploic channels was analyzed in a set of the qualitative and quantitative variables in computed tomography-images of crania of anatomically normal and craniosynostotic adult individuals. Macroscopic diploic channels occur most frequently in the frontal and parietal bones, often with a bilaterally symmetrical pattern. DV-features (especially DV-pattern) are characterized by high individual diversity. On average, there are 5.4 ± 3.5 large macroscopic channels (with diameters >1 mm) per individual, with a mean diameter of 1.7 ± 0.4 mm. Age and sex have minor effects on DV, and cranial proportions significantly influence DV only in CS skulls. CS is associated with changes in the DV numbers, distributions, and diameters. Craniosynostotic skulls, especially brachycephalic skulls, generally present smaller DV diameters, and dolichocephalic skulls display increased number of frontal DV. CS, associated with altered cranial dimensions, suture imbalance, increased intracranial pressure, and with changes of the endocranial craniovascular system, significantly also affects the macroscopic morphology of DV in adults, in terms of both structural (topological redistribution) and functional factors. The research on craniovascular morphology and CS may be of interest in biological anthropology, paleopathology, medicine (e.g., surgical planning), but also in zoology and paleontology.
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Affiliation(s)
- Stanislava Eisová
- Antropologické oddělení, Přírodovědecké muzeum, Národní muzeum, Prague, Czech Republic.,Katedra antropologie a genetiky člověka, Přírodovědecká fakulta, Univerzita Karlova, Prague, Czech Republic
| | - Petr Velemínský
- Antropologické oddělení, Přírodovědecké muzeum, Národní muzeum, Prague, Czech Republic
| | - Jana Velemínská
- Katedra antropologie a genetiky člověka, Přírodovědecká fakulta, Univerzita Karlova, Prague, Czech Republic
| | - Emiliano Bruner
- Programa de Paleobiología, Centro Nacional de Investigación sobre la Evolución Humana, Burgos, Spain
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Abstract
The cerebral venous system is complex and sophisticated and serves various major functions toward maintaining brain homeostasis. Cerebral veins contain about 70% of cerebral blood volume, have thin walls, are valveless, and cross seamlessly white matter, ependymal, cisternal, arachnoid, and dural boundaries to eventually drain cerebral blood either into dural sinuses or deep cerebral veins. Although numerous variations in the cerebral venous anatomic arrangement may be encountered, the overall configuration is relatively predictable and landmarks relatively well defined. A reasonable understanding of cerebral vascular embryology is helpful to appreciate normal anatomy and variations that have clinical relevance. Increasing interest in transvascular therapy, particularly transvenous endovascular intervention provides justification for practitioners in the neurosciences to acquire at least a basic understanding of the cerebral venous system.
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Canine Intracranial Venous System: A Review. FOLIA VETERINARIA 2022. [DOI: 10.2478/fv-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The intracranial venous system (ICVS) represents in mammals a complex three-dimensional structure, which provides not only for adequate brain perfusion, but has also a significant impact on: cerebrospinal fluid (CSF) resorption, maintaining of the intracranial pressure (ICP), and brain thermoregulation. An intimate understanding of the anatomy and physiology of ICVS is fundamental for neurological diagnostics, selection of therapeutic options, and success of neurosurgical procedures in human and veterinary medicine. Since the intracranial interventions in dogs are recently performed more frequently than twenty or thirty years ago, the authors decided to review and report on the basic knowledge regarding the complex topic of morphology and function of the canine ICVS. The research strategy involved an NCBI/NLM, PubMed/MED-LINE, and Clarivate Analytics Web of Science search from January 1, 1960, to December 31, 2021, using the terms “canine dural venous sinuses” and “intracranial venous system in dogs” in the English language literature; also references from selected papers were scanned and relevant articles included.
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Jo JI, Ryu CW, Ko HC, Shin HS. Direct Cannulation of a Calvarial Diploic Vein for Embolization of a Symptomatic Intraosseous Arteriovenous Fistula: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:712-718. [PMID: 36238517 PMCID: PMC9514518 DOI: 10.3348/jksr.2021.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
Diploic arteriovenous fistulas (AVFs) or intraosseous dural AVFs are rare arteriovenous shunts. A diploic AVF is formed between a meningeal artery and an intraosseous diploic vein or the transosseous emissary vein, and the nidus is located exclusively within the bone. Currently, endovascular embolization with a transvenous approach is considered the treatment of choice for most dural AVFs. However, in the absence of an accessible venous channel, an alternate treatment approach should be considered. Herein, we report a case of a diploic AVF that was treated using embolization with transosseous direct cannulation.
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Affiliation(s)
- Jung In Jo
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang-Woo Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hak Cheol Ko
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hee Sup Shin
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
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Eisová S, Naňka O, Velemínský P, Bruner E. Craniovascular traits and braincase morphology in craniosynostotic human skulls. J Anat 2021; 239:1050-1065. [PMID: 34240418 PMCID: PMC8546506 DOI: 10.1111/joa.13506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022] Open
Abstract
Middle meningeal vessels, dural venous sinuses, and emissary veins leave imprints and canals in the endocranium, and thus provide evidence of vascular patterns in osteological samples. This paper investigates whether craniovascular morphology undergoes changes in craniosynostotic human skulls, and if specific alterations may reflect structural and functional relationships in the cranium. The analyzed osteological sample consists of adult individuals with craniosynostoses generally associated with dolichocephalic or brachycephalic proportions, and a control sample of anatomically normal adult skulls. The pattern and dominance of the middle meningeal artery, the morphology of the confluence of the sinuses, and the size and number of the emissary foramina were evaluated. Craniovascular morphology was more diverse in craniosynostotic skulls than in anatomically normal skulls. The craniosynostotic skulls often displayed enlarged occipito-marginal sinuses and more numerous emissary foramina. The craniosynostotic skulls associated with more brachycephalic morphology often presented enlarged emissary foramina, while the craniosynostotic skulls associated with dolichocephalic effects frequently displayed more developed posterior branches of the middle meningeal artery. The course and morphology of the middle meningeal vessels, dural venous sinuses, and emissary veins in craniosynostotic skulls can be related to the redistribution of growth forces, higher intracranial pressure, venous hypertension, or thermal constraints. These functional and structural changes are of interest in both anthropology and medicine, involving epigenetic traits that concern the functional and ontogenetic balance between soft and hard tissues.
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Affiliation(s)
- Stanislava Eisová
- Katedra antropologie a genetiky člověkaPřírodovědecká fakultaUniverzita KarlovaPragueCzech Republic
- Antropologické odděleníPřírodovědecké muzeum, Národní muzeumPragueCzech Republic
| | - Ondřej Naňka
- Anatomický ústav1. lékařská fakultaUniverzita KarlovaPragueCzech Republic
| | - Petr Velemínský
- Antropologické odděleníPřírodovědecké muzeum, Národní muzeumPragueCzech Republic
| | - Emiliano Bruner
- Programa de PaleobiologíaCentro Nacional de Investigación sobre la Evolución HumanaBurgosSpain
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Yamashiro K, Muto J, Wakako A, Murayama K, Kojima D, Omi T, Adachi K, Hasegawa M, Hirose Y. Diploic veins as collateral venous pathways in patients with dural venous sinus invasion by meningiomas. Acta Neurochir (Wien) 2021; 163:1687-1696. [PMID: 33629122 DOI: 10.1007/s00701-021-04777-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although it is known that diploic veins frequently communicate with the dural venous sinuses, the role of diploic veins in patients with venous sinus invasion from meningiomas remains unknown. METHODS We retrospectively examined the medical records of 159 patients who underwent their first craniotomies for intracranial meningiomas. Contrast-enhanced magnetic resonance imaging was used to evaluate diploic vein routes, and digital subtraction angiography (DSA) was used to evaluate diploic vein blood flow. When high blood flow was visualized concurrently with the venous sinuses, the veins were classified as of the "early type." Diploic vein routes were classified into five routes. RESULTS DSA was performed in 110 patients, with 14 showing superior sagittal sinus (SSS) invasion (SSS group) and 23 showing non-SSS venous sinus invasion (non-SSS group). The proportion of early type diploic veins was significantly higher in the SSS group (27.1%) than in other patients (patients without venous sinus invasion, 2.1%; non-SSS, 4.3%) (p < 0.01). In patients not in the SSS group, diploic veins were sacrificed during craniotomy in 76 patients, including four patients with veins of the early type. No patients demonstrated new neurological deficits postoperatively. In the SSS group, diploic veins were sacrificed in all patients, and early type diploic veins were cut in five patients. Two of these five patients showed postoperative neurological deficits. CONCLUSIONS In the SSS group, diploic veins may function as collateral venous pathways, and attention is recommended for their interruption. In patients without SSS invasion, diploic veins, even of the early type, can be sacrificed.
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Ogura R, Oishi M, Hiraishi T, Takahashi H, Shibuya K, Suzuki T, Natsumeda M, Okamoto K, Fujii Y. Four-dimensional multifusion imaging for assessment of meningioma hemodynamics. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Eponyms in Vascular Neurosurgery: Comprehensive Review of 18 Veins. World Neurosurg 2021; 151:190-200. [PMID: 34033951 DOI: 10.1016/j.wneu.2021.05.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 11/20/2022]
Abstract
This review is the first comprehensive anatomic report of all venous eponyms used in vascular neurosurgery and provides the historical context of their authors as well as the surgical relevance of every structure. A PubMed literature review identified 13 individuals for whom 18 eponymous venous structures of the brain were named. These structures are the Batson plexus, veins of Breschet, Breschet sinus, vein of Dandy, vein of Galen, prosencephalic vein of Markowski, torcular Herophili, vein of Labbé, venous plexus of Rektorzik, vein of Rolando, basal vein of Rosenthal, sylvian veins, lateral lakes of Trolard, vein of Trolard, hypoglossal plexus of Trolard, petro-occipital vein of Trolard, venous circle of Trolard, and the vein of Vesalius. Eponyms provide a valuable shorthand that encompasses anatomic nuances, variabilities, and surgical relevance. In addition, they elucidate the historical context in which these structures were described and are an academic honor to our predecessors.
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21
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Tsutsumi S, Ono H, Ishii H. Calvarial diploic venous channels: delineation with maximal intensity projection technique. Surg Radiol Anat 2021; 43:1319-1325. [PMID: 33677684 DOI: 10.1007/s00276-021-02729-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/25/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To date, very few studies have explored the three-dimensional architecture of calvarial diploic venous channels (CDVCs). This study aimed to characterize the three-dimensional architecture of CDVCs using maximum intensity projection (MIP) images based on contrast-enhanced magnetic resonance imaging (MRI). METHODS A total of 77 patients with intact calvarial hemispheres and underlying dura mater and dural sinuses underwent contrast-enhanced MRI. Among them, we extracted the data of 49 with at least a part of the major CDVC pathways identified on the MIP images for analysis. RESULTS On serial contrast-enhanced MRI images, the CDVCs were commonly detected as curvilinear structures with inhomogeneous diameters and tributaries, while the MIP images delineated the three-dimensional architecture of the developed CDVC pathways. More than such CDVC pathway was entirely delineated on the right in 67.3% and on the left in 71.4%, most frequently in the frontal and temporal regions, with their connecting sites to the sphenoparietal and superior sagittal sinuses. The morphology, distribution, and course of the identified CDVCs were highly variable. In 55.1%, the CDVCs formed fenestrations that were variable in size, shape, and number. CONCLUSIONS The developed CDVC pathways may be characterized by morphological variability and fenestrations. Thin-sliced, contrast-enhanced MRI is useful to depict diploic veins, while MIP images allow for better appreciation of the entire course of the developed CDVC pathways. Traumatic and intraoperative disconnection between the dura mater overlying the dural sinuses and the adjacent inner table of the skull can cause epidural venous bleeding.
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Affiliation(s)
- Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Hideo Ono
- Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
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22
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Intraosseous Dural Arteriovenous Fistula Causing Contralateral Intracerebral Hemorrhage. Can J Neurol Sci 2021; 48:886-888. [PMID: 33557992 DOI: 10.1017/cjn.2021.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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23
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Cruz AAV, Equiterio BSN, Cunha BSA, Caetano FB, Souza RL. Deep lateral orbital decompression for Graves orbitopathy: a systematic review. Int Ophthalmol 2021; 41:1929-1947. [PMID: 33517506 DOI: 10.1007/s10792-021-01722-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To systematically review the literature on the deep lateral orbital decompression (DLD). METHODS The authors searched the MEDLINE, Lilac, Scopus, and EMBASE databases for all articles in English, Spanish, and French that used as keywords the terms orbital decompression and lateral wall. Two articles in German were also included. Data retrieved included the number of patients and orbits operated, types of the approach employed, exophthalmometric and horizontal eye position changes, and complications. The 95% confidence intervals (CI) of the mean Hertel changes induced by the surgery were calculated from series with 15 or more data. RESULTS Of the 204 publications initially retrieved, 131 were included. Detailed surgical techniques were analyzed from 59 articles representing 4559 procedures of 2705 patients. In 45.8% of the reports, the orbits were decompressed ab-interno. Ab-externo and rim-off techniques were used in 25.4% and 28.8% of the orbits, respectively. Mean and 95% CI intervals of Hertel changes, pooled from 15 articles, indicate that the effect of the surgery is not related to the technique and ranges from 2.5 to 4.5 mm. The rate of new onset of diplopia varied from zero to 8.6%. Several complications have been reported including dry eye, oscillopsia, temporal howling, lateral rectus damage, and bleeding. Unilateral amaurosis and subdural hematoma have been described in only one patients each. CONCLUSIONS The low rate of new-onset diplopia is the main benefit of DLD. Prospective studies are needed to compare the rate of complications induced by the 3 main surgical techniques used.
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Affiliation(s)
- Antonio Augusto V Cruz
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.
| | - Bruna S N Equiterio
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Barbara S A Cunha
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Fabiana Batista Caetano
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - Roque Lima Souza
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
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Arachnoid cyst with bony erosion of the posterior frontal sinus wall as cause of a subdural empyema after pansinusitis. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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25
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Rangel‐de Lázaro G, Neubauer S, Gunz P, Bruner E. Ontogenetic changes of diploic channels in modern humans. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 173:96-111. [DOI: 10.1002/ajpa.24085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/26/2020] [Accepted: 05/10/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Gizéh Rangel‐de Lázaro
- Department of Earth SciencesNatural History Museum London UK
- Institut Català de Paleoecologia Humana i Evolució Social Tarragona Spain
- Departament d'Història i Història de l'ArtUniversitat Rovira i Virgili Tarragona Spain
| | - Simon Neubauer
- Department of Human EvolutionMax Planck Institute for Evolutionary Anthropology Leipzig Germany
| | - Philipp Gunz
- Department of Human EvolutionMax Planck Institute for Evolutionary Anthropology Leipzig Germany
| | - Emiliano Bruner
- Centro Nacional de Investigación sobre la Evolución Humana Burgos Spain
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26
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Tao L, Wu Q, Wang J, Xu K, Yu G, Wan F, Qian H, Tang J. A patient with cerebral venous sinus thrombosis induced by facial hyaluronic acid injection. Ann Hematol 2020; 100:2403-2405. [PMID: 32388609 DOI: 10.1007/s00277-020-04038-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Liyuan Tao
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Qian Wu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Jun Wang
- Key Lab of Modern Toxicology (NJMU), Ministry of Education; Department of Toxicology, School of Public Health, Nanjing Medical University, 818 Tianyuan East Road, Nanjing, 211166, Jiangsu, China
| | - Kangjing Xu
- Department of General Surgical, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Guoqin Yu
- Department of Neurology, Nanjing Jiangbei People's Hospital, 552 Geguan Road, Jiangbei New District, Nanjing, 210000, Jiangsu, China
| | - Fen Wan
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Huiming Qian
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Jinrong Tang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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Tokuyama K, Kiyosue H, Hori Y, Nagatomi H. Diploic arteriovenous fistulas with marked cortical venous reflux. Interv Neuroradiol 2019; 26:254-259. [PMID: 31856646 DOI: 10.1177/1591019919894496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diploic arteriovenous fistulas are rare arteriovenous shunts involving the skull, which often drain antegradely into the internal or external jugular veins. Diploic arteriovenous fistulas with marked cortical venous reflux are extremely rare. Here, we present the case of a patient with diploic arteriovenous fistulas with marked cortical venous reflux and a literature review. A 73-year-old woman presented with headache. Magnetic resonance angiography revealed abnormal signal intensity in the diploic layer of the left frontal bone. Digital subtraction angiography demonstrated a diploic arteriovenous fistulas located in the left frontal bone. The arteriovenous fistulas were fed by multiple branches of the left external carotid artery, mainly from the middle meningeal artery, branches of the ophthalmic artery, and the inferolateral trunk. The fistulas drained into the cerebral cortical veins surrounding the frontal lobe via an emissary vein of the frontal bone. With the femoral arterial approach, transarterial catheterization into the shunted diploic vein was performed with a small tapered microcatheter, and the arteriovenous fistulas were completely embolized with N-butyl-2-cyanoacrylate. The patient was discharged without complications. No recurrent arteriovenous fistulas were observed during the 12-month follow-up period. Endovascular treatment is an effective technique for the curative treatment of diploic arteriovenous fistulas.
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Affiliation(s)
- Kohei Tokuyama
- Department of Radiology, Nagatomi Neurosurgical Hospital, Oita City, Japan
| | - Hiro Kiyosue
- Department of Radiology, Oita University Faculty of Medicine, Yufu City, Japan
| | - Yuzo Hori
- Department of Radiology, Nagatomi Neurosurgical Hospital, Oita City, Japan
| | - Hirofumi Nagatomi
- Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita City, Japan
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28
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Iida T, Enomoto Y, Egashira Y, Yamauchi K, Iwama T. A case of cranial vault intraosseous arteriovenous fistula treated with transarterial embolization. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2019.100520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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29
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Eisová S, Píšová H, Velemínský P, Bruner E. Normal craniovascular variation in two modern European adult populations. J Anat 2019; 235:765-782. [PMID: 31236921 PMCID: PMC6742892 DOI: 10.1111/joa.13019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 01/06/2023] Open
Abstract
The vascular networks running into the meningeal layers, between the brain and braincase, leave imprints on the endocranial surface. These traces are visible in osteological specimens and skeletal collections, providing indirect evidence of vascular patterns in those cases in which bone remains are the only source of anatomical information, such as in forensic science, bioarchaeology and paleontology. The main vascular elements are associated with the middle meningeal artery, the venous sinuses of the dura mater, and the emissary veins. Most of these vascular systems have been hypothesized to be involved in endocranial thermal regulation. Although these traits deal with macroanatomical features, much information on their variation is still lacking. In this survey, we analyze a set of craniovascular imprints in two European dry skull samples with different neurocranial proportions: a brachycephalic Czech sample (n = 103) and a mesocephalic Italian sample (n = 152). We analyzed variation and distribution, correlation with cranial metrics, and sex differences in the dominance of the branches of the middle meningeal artery, the patterns of confluence of the sinuses, and the size of the emissary foramina. The descriptive statistics provide a reference to compare specimens and samples from different case studies. When compared with the Italian skulls, the Czech skulls display a greater dominance of the anterior branch of the middle meningeal artery and more asymmetric right-dominance of the confluence of the venous sinuses. There is no sex difference in the middle meningeal vessels, but males show a greater prevalence of the occipito-marginal draining system. Differences in the middle meningeal vessels or venous sinuses are apparently not influenced by cranial dimensions or proportions. The mastoid foramina are larger in larger and more brachycephalic skulls, which increases the emissary potential flow in the Czech sample and males, when compared with the Italian samples and females, respectively. The number of mastoid foramina increases in wider skulls. This anatomic information is necessary to develop further morphological and functional inferences on the relationships between neurocranial bones and vessels at the genetic, ontogenetic, and phylogenetic levels.
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Affiliation(s)
- Stanislava Eisová
- Department of Anthropology and Human GeneticsCharles UniversityPragueCzech Republic
- Department of AnthropologyNational MuseumPragueCzech Republic
| | - Hana Píšová
- Department of Anthropology and Human GeneticsCharles UniversityPragueCzech Republic
| | - Petr Velemínský
- Department of AnthropologyNational MuseumPragueCzech Republic
| | - Emiliano Bruner
- Centro Nacional de Investigación sobre la Evolución HumanaBurgosSpain
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Kassem MW, Ishak B, Mehta K, Iwanaga J, Loukas M, Tubbs RS. Ventriculo-humeral shunt: a cadaveric feasibility study with application to treating hydrocephalus. Childs Nerv Syst 2019; 35:1561-1564. [PMID: 31055619 DOI: 10.1007/s00381-019-04175-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 04/25/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Intraosseous vascular access is often used when vascular access is difficult. However, the use of this space for a receptacle for cerebrospinal fluid (CSF) diversion has been scantly considered. MATERIALS AND METHODS Six upper limbs of fresh frozen cadavers were used for this study. In the supine position, a small hole was drilled through the outer cortex of the proximal humerus and into the medullary cavity. A 16-gauge needle was placed into the hole in the humerus and 150 cc of saline infused. Next, the adjacent axillary vein and tributaries were dissected to observe dilation or the presence of the blue-colored saline. For part two of the study, shunt tubing was passed subcutaneously from a supraclavicular incision to the hole made in the humerus. Range of motion of the shoulder was then performed. RESULTS On all sides, all 150 cc of fluid was easily infused into the humerus. No specimen was found to have leakage from the drill hole site or into the extravascular soft tissues. With dissection of the axillary vein and its tributaries, all sides were found to have engorgement of these vessels. No tension was placed on the distal shunt tubing with full range of motion of the shoulder. CONCLUSION Based on our study, the humerus is another option available to the neurosurgeon for CSF diversion.
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Affiliation(s)
- Mohammad W Kassem
- Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
- Mercy Health Neuroscience Institute, Toledo, OH, USA
| | - Basem Ishak
- Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA
| | - Karishma Mehta
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
| | - Joe Iwanaga
- Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada
| | - R Shane Tubbs
- Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA.
- Department of Anatomical Sciences, St. George's University, True Blue, Grenada.
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31
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Tsutsumi S, Ono H, Ishii H, Yasumoto Y. Diploic veins of the cranial base: an anatomical study using magnetic resonance imaging. Surg Radiol Anat 2019; 41:1029-1036. [PMID: 31286202 DOI: 10.1007/s00276-019-02283-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE The anatomy and distribution of the diploic veins (DVs) of the cranial base have not been fully documented. The aim of this study was to characterize these veins using contrast magnetic resonance imaging (MRI). METHODS In total, 95 patients underwent thin-sliced, contrast MRI. Coronal and sagittal images were used for the analysis. The cranial base was divided into the anterior, middle, and posterior bases. Then, each base was further subdivided into three equal parts in the anteroposterior and lateromedial directions. The anteroposterior parts were evaluated on coronal images, while the lateromedial parts were evaluated on sagittal images. RESULTS The DVs were identified over the entire cranial base. However, they were more frequent in the posterior-third of the lateral-third region of the anterior, middle-third of the lateral and middle-third regions of the middle, and middle-third region of the posterior cranial base, and sparse in the posterior and medial-third regions of the middle cranial base. The DVs showed marked morphological variability. For instance, the DVs of the pterional area were generally well defined, as pivotal channels connecting the lateral parts of the anterior and middle cranial base, but were highly varied in appearance. CONCLUSIONS The DVs of the cranial base are distinct structures characterized by morphological variability and topographical predilection. Contrast MRI is useful for delineating these veins.
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Affiliation(s)
- Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Hideo Ono
- Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Yukimasa Yasumoto
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
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Epidermoid Cyst with Torcular Herophili Obstruction and Unusual Venous Drainage. World Neurosurg 2019; 128:14-17. [PMID: 31054339 DOI: 10.1016/j.wneu.2019.04.223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND An epidermoid cyst arising from diploic space in the skull can cause an intracranial mass effect with compression of the underlying venous sinuses. CASE DESCRIPTION A 66-year-old woman came to us with a persistent headache and unsteadiness. Computed tomography demonstrated an occipital bone cystic lesion with an intracranial mass effect overlying the torcular herophili, with high-intensity findings in diffusion-weighted magnetic resonance imaging. Cerebral angiogram demonstrated obstruction of the torcular herophili with development of diploic venous drainage. The patient underwent removal of the lesion and a cranioplasty procedure. The diagnosis was torcular epidermoid cyst. The postoperative course was uneventful, and the symptoms were resolved. CONCLUSIONS Development of diploic venous drainage contributed to avoidance of critical intracranial hypertension during slow growth of a torcular epidermoid cyst.
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Lachkar S, Dols MM, Ishak B, Iwanaga J, Tubbs RS. The Diploic Veins: A Comprehensive Review with Clinical Applications. Cureus 2019; 11:e4422. [PMID: 31245209 PMCID: PMC6559436 DOI: 10.7759/cureus.4422] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/09/2019] [Indexed: 01/15/2023] Open
Abstract
The diploic veins serve as an important connection between the extracranial and intracranial venous systems. They change in size during growth from adolescence to adulthood. The diploic space has been identified as an additional site of reabsorption of cerebrospinal fluid (CSF). Herein, the anatomy and physiology of the diploic veins are reviewed.
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Affiliation(s)
| | | | - Basem Ishak
- Neurosurgery, Seattle Science Foundation, Seattle, USA
| | - Joe Iwanaga
- Medical Education and Simulation, Seattle Science Foundation, Seattle, USA
| | - R Shane Tubbs
- Neurosurgery, Seattle Science Foundation, Seattle, USA
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Bhalla M, Ulmer JL, Klein AP, McAvoy KE, Bhalla NM. Posttraumatic subgaleal herniation of an intracranial cerebral arterial segment. Proc (Bayl Univ Med Cent) 2019; 32:271-273. [DOI: 10.1080/08998280.2018.1560782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/09/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- Manav Bhalla
- Department of Radiology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John L. Ulmer
- Department of Radiology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew P. Klein
- Department of Radiology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Namrata M. Bhalla
- Department of Radiology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin
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Tsutsumi S, Ono H, Ishii H, Yasumoto Y. Visualization of the supraorbital notch/foramen using magnetic resonance imaging. J Clin Neurosci 2019; 62:212-215. [DOI: 10.1016/j.jocn.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/10/2018] [Accepted: 01/04/2019] [Indexed: 10/27/2022]
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Anomalous Sphenoid Diploe Vein: Case Report Highlighting the Value of Careful CT Evaluation Prior to Decompression Surgery. Ophthalmic Plast Reconstr Surg 2018; 34:e74-e75. [PMID: 29319638 DOI: 10.1097/iop.0000000000001046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Lateral bony decompression may offer several biomechanical advantages and has become a commonly used surgical approach. Preoperative imaging plays a key role in surgical planning by providing information about the locoregional anatomy. The marrow space of the greater wing of the sphenoid is a focal point of the decompression surgery based on the volume that it occupies. Several vessels pass through the sphenoid bone, but most are small caliber vessels. The authors describe a case of an uncommon anatomical variant of the cranial diploic venous system in which the anterior transverse diploic vessel traverses the marrow space of the sphenoid. The vessel was identified on preoperative CT evaluation. Despite anticipation of potential bleeding, lateral decompression was abandoned due to difficulties in maintaining hemostasis which compromised the view for safe surgical progress.
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Intramedullary placement of ventricular shunts: a review of using bone as a distal cerebrospinal absorption site in treating hydrocephalus. Childs Nerv Syst 2017; 33:2095-2098. [PMID: 28836037 DOI: 10.1007/s00381-017-3575-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Intraosseous (IO) vascular access has been used since the Second World War and is warranted when there is an emergency and/or urgent need to replenish the vascular pool. Despite long-term and satisfactory results from delivering large quantities of intravenous fluid via the medullary space of bone, use of this space for a distant receptacle for cerebrospinal fluid (CSF) diversion has seldom been considered. METHODS The current paper reviews the literature regarding the bony medullary space as a receptacle for intravenous fluid and CSF. RESULTS Previous authors have demonstrated the potential of the diploic space of the calvaria for CSF shunting. Pugh and colleagues tested the ability of the cranium to receive and absorb a small amount of tracer fluid. CONCLUSION The literature suggests that intraosseous placement of ventricular diversionary shunts is an alternative to more traditional sites such as the pleural cavity and peritoneum. When these latter locations are not available or are contraindicated, placement in the medullary space of bone is another option available to the surgeon.
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He SK, Guo JH, Wang ZL, Zhang Y, Tu YH, Wu SZ, Huang FG, Xie HQ. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 73:267-274. [DOI: 10.1016/j.msec.2016.12.077] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/07/2016] [Accepted: 12/15/2016] [Indexed: 10/20/2022]
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Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography. Neuroradiology 2017; 59:213-219. [DOI: 10.1007/s00234-017-1784-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/05/2017] [Indexed: 11/27/2022]
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Wolkow N, Jakobiec FA, Stagner AM, Cunnane ME, Piantadosi AL, Basgoz N, Lefebvre D. Chronic orbital and calvarial fungal infection with Apophysomyces variabilis in an immunocompetent patient. Surv Ophthalmol 2017; 62:70-82. [PMID: 27256687 DOI: 10.1016/j.survophthal.2016.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 02/07/2023]
Abstract
Apophysomyces is a rare fungal organism causing rhino-orbito-cerebral mycotic infections with high morbidity and mortality, typically in immunocompetent individuals. Several cases of Apophysomyces elegans orbital disease have been reported. Herein, we report a case of Apophysomyces variabilis infection involving the orbit, sinuses, and calvarium in an immunocompetent 74-year-old woman, with a review of the literature. Unlike prior cases of A. elegans classic rhino-orbito-cerebral infection, our case included diffuse calvarial lytic lesions and overlying soft tissue nodules, but without parenchymal intracranial involvement. There was radiographic and clinical evidence of infarction of the orbital contents and cavernous sinus thrombosis. Anastomoses between the superior orbital (ophthalmic) vein and diploic veins of the calvarium are believed to be primarily responsible for the unusual mode of spread on the extradural surface of the brain. Although the patient stabilized without definitive surgical intervention, her disease slowly and intermittently progressed for over a year after presentation, requiring multiple courses of antifungal treatment.
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Affiliation(s)
- Natalie Wolkow
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA
| | - Frederick A Jakobiec
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA; Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA.
| | - Anna M Stagner
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA; Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA
| | - Mary E Cunnane
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Department of Radiology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Anne L Piantadosi
- Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nesli Basgoz
- Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel Lefebvre
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Division of Ophthalmic Plastic Surgery, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, USA
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Bożek P, Kluczewska E, Misiołek M, Ścierski W, Lisowska G. The Prevalence of Persistent Petrosquamosal Sinus and Other Temporal Bone Anatomical Variations on High-Resolution Temporal Bone Computed Tomography. Med Sci Monit 2016; 22:4177-4185. [PMID: 27811834 PMCID: PMC5108369 DOI: 10.12659/msm.898546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of the study was to determine the prevalence of petrosquamosal sinus (PSS) and other temporal bone (TB) anatomical variations in various patients using high-resolution computed tomography (CT). MATERIAL AND METHODS We reviewed clinical and consecutively obtained CT data for 276 TBs of 138 patients. The incidence of TB anatomical variations was compared among patients with radiological markers of chronic otitis media (RCOM) and non-RCOM. RESULTS The PSS incidence in our sample was 6.9%, and it was significantly higher in TBs with RCOM (14.6%). Selected anatomical variations of RCOM TBs were observed: lateral sigmoid sinus (14.5%), prominent sigmoid sinus (23.6%), PSS (14.6%), and high jugular bulb (17.3%). Lateral sigmoid sinus and prominent sigmoid sinus (p<0.01), high jugular bulb (p<0.05), and PSS (p<0.01) were observed more often in RCOM than in non-RCOM TBs. CONCLUSIONS The TB vascular and anatomical variations, including PSS, a high jugular bulb, and a laterally and prominent placed sigmoid sinus, were more often observed in TBs with RCOM. Presurgical imaging and CT-based navigation techniques for TB surgery can offer remarkable value for understanding the altered anatomy of this complex structure and can localize rare anatomical variations.
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Affiliation(s)
- Paweł Bożek
- Department of Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Ewa Kluczewska
- Department of Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Maciej Misiołek
- Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Wojciech Ścierski
- Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Grażyna Lisowska
- Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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MITSUHASHI Y, HAYASAKI K, KAWAKAMI T, NAGATA T, KANESHIRO Y, UMABA R, OHATA K. Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations. Neurol Med Chir (Tokyo) 2016; 56:326-39. [PMID: 27063146 PMCID: PMC4908076 DOI: 10.2176/nmc.ra.2015-0346] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/09/2016] [Indexed: 11/22/2022] Open
Abstract
The cavernous sinus (CS) is one of the cranial dural venous sinuses. It differs from other dural sinuses due to its many afferent and efferent venous connections with adjacent structures. It is important to know well about its complex venous anatomy to conduct safe and effective endovascular interventions for the CS. Thus, we reviewed previous literatures concerning the morphological and functional venous anatomy and the embryology of the CS. The CS is a complex of venous channels from embryologically different origins. These venous channels have more or less retained their distinct original roles of venous drainage, even after alterations through the embryological developmental process, and can be categorized into three longitudinal venous axes based on their topological and functional features. Venous channels medial to the internal carotid artery "medial venous axis" carry venous drainage from the skull base, chondrocranium and the hypophysis, with no direct participation in cerebral drainage. Venous channels lateral to the cranial nerves "lateral venous axis" are exclusively for cerebral venous drainage. Venous channels between the internal carotid artery and cranial nerves "intermediate venous axis" contribute to all the venous drainage from adjacent structures, directly from the orbit and membranous skull, indirectly through medial and lateral venous axes from the chondrocranium, the hypophysis, and the brain. This concept of longitudinal venous axes in the CS may be useful during endovascular interventions for the CS considering our better understandings of its functions in venous drainage.
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Affiliation(s)
- Yutaka MITSUHASHI
- Department of Neurosurgery, Ishikiri-Seiki Hospital, Higashiosaka, Osaka
| | - Koji HAYASAKI
- Department of Neurosurgery, Japan Community Health Care Organization, Hoshigaoka Medical Center, Hirakata, Osaka
| | - Taichiro KAWAKAMI
- Department of Neurosurgery, Osaka City University, Graduate School of Medicine, Osaka, Osaka
| | - Takashi NAGATA
- Department of Neurosurgery, Ishikiri-Seiki Hospital, Higashiosaka, Osaka
| | - Yuta KANESHIRO
- Department of Neurosurgery, Japan Community Health Care Organization, Hoshigaoka Medical Center, Hirakata, Osaka
| | - Ryoko UMABA
- Department of Neurosurgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Osaka
| | - Kenji OHATA
- Department of Neurosurgery, Osaka City University, Graduate School of Medicine, Osaka, Osaka
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Eisová S, Rangel de Lázaro G, Píšová H, Pereira-Pedro S, Bruner E. Parietal Bone Thickness and Vascular Diameters in Adult Modern Humans: A Survey on Cranial Remains. Anat Rec (Hoboken) 2016; 299:888-96. [DOI: 10.1002/ar.23348] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 09/25/2015] [Accepted: 02/23/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Stanislava Eisová
- Grupo de Paleobiología, Centro Nacional de Investigación sobre la Evolución Humana; Burgos Spain
| | - Gizéh Rangel de Lázaro
- Area de Prehistoria, Universitat Rovira i Virgili; Tarragona Spain
- Institut Català De Paleoecologia Humana i Evolució Social (IPHES); Tarragona Spain
| | - Hana Píšová
- Katedra antropologie a genetiky člověka, Univerzita Karlova; Czech Republic
- Antropologické oddělení Přírodovědeckého muzea; Narodnı Muzeum Prague Czech Republic
| | - Sofia Pereira-Pedro
- Grupo de Paleobiología, Centro Nacional de Investigación sobre la Evolución Humana; Burgos Spain
| | - Emiliano Bruner
- Grupo de Paleobiología, Centro Nacional de Investigación sobre la Evolución Humana; Burgos Spain
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Low-pressure headaches following foramen magnum decompression secondary to absorption of cerebrospinal fluid into the venous system of the diploic space. Childs Nerv Syst 2016; 32:897-9. [PMID: 26445976 DOI: 10.1007/s00381-015-2928-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/29/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION We describe a case of a patient who suffered low-pressure headaches secondary to absorption of cerebrospinal fluid into the venous system of the diploic space following a foramen magnum decompression. This case is important as it describes a physiologically plausible but previously undescribed complication of a common surgical intervention. CASE A nine-year-old boy underwent a foramen magnum decompression for a Chiari malformation (Type I). Five years after his initial decompression, his original symptoms returned and he underwent further decompression with short-term relief of symptoms. He then began to describe low-pressure headaches. Comprehensive investigations revealed a small posterior pseudomeningocoele that had extended into the diploic space at the site of the previous surgery to the occipital bone. It was postulated that the diploic space may be acting as an additional site for reabsorption of his CSF, and as a result of this, he was experiencing consistently low-pressure symptoms. His symptoms have completely resolved following surgical intervention to seal the site of communication with the diploic space. DISCUSSION We review recent literature that supports this theory through an understanding of the anatomy of the diploic venous system and also its physiological behaviour as demonstrated in recent cadaveric and porcine studies.
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Yako R, Masuo O, Kubo K, Nishimura Y, Nakao N. A case of dural arteriovenous fistula draining to the diploic vein presenting with intracerebral hemorrhage. J Neurosurg 2016; 124:726-9. [DOI: 10.3171/2015.2.jns142227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report an unusual case of a dural arteriovenous fistula (dAVF) draining only to the diploic vein and causing intracerebral hemorrhage. A 62-year-old woman presented with disturbance of consciousness and left hemiparesis. Brain CT scanning on admission showed a right frontal subcortical hemorrhage. Digital subtraction angiography revealed an arteriovenous shunt located in the region around the pterion, which connected the frontal branch of the right middle meningeal artery with the anterior temporal diploic vein and drained into cortical veins in a retrograde manner through the falcine vein. The dAVF was successfully obliterated by percutaneous transarterial embolization with N-butyl-2-cyanoacrylate. The mechanism of retrograde cortical venous reflux causing intracerebral hemorrhage is discussed.
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Affiliation(s)
- Rie Yako
- 1Department of Neurological Surgery, Wakayama Medical University; and
| | - Osamu Masuo
- 1Department of Neurological Surgery, Wakayama Medical University; and
| | - Kenji Kubo
- 2Department of Neurological Surgery, Koyo Hospital, Wakayama, Japan
| | | | - Naoyuki Nakao
- 1Department of Neurological Surgery, Wakayama Medical University; and
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Rangel de Lázaro G, de la Cuétara JM, Píšová H, Lorenzo C, Bruner E. Diploic vessels and computed tomography: Segmentation and comparison in modern humans and fossil hominids. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:313-24. [DOI: 10.1002/ajpa.22878] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/10/2015] [Accepted: 09/21/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Gizéh Rangel de Lázaro
- Área de Prehistoria; Universitat Rovira I Virgili; Tarragona Spain
- Institut Català De Paleoecologia Humana I Evolució Social (IPHES); Tarragona Spain
| | | | - Hana Píšová
- Antropologické Oddělení; Univerzita Karlova and Národní Muzeum; Prague Czech Republic
| | - Carlos Lorenzo
- Área de Prehistoria; Universitat Rovira I Virgili; Tarragona Spain
- Institut Català De Paleoecologia Humana I Evolució Social (IPHES); Tarragona Spain
| | - Emiliano Bruner
- Grupo de Paleobiología; Centro Nacional De Investigación Sobre La Evolución Humana (CENIEH); Burgos Spain
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Carreira LM, Ferreira A. Morphological Variations in the Transverse Venous Sinus Anatomy of Dogs and its Relationship to Skull Landmarks. Anat Histol Embryol 2015; 45:308-18. [PMID: 26315333 DOI: 10.1111/ahe.12199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 07/13/2015] [Indexed: 11/29/2022]
Abstract
We characterized the anatomical morphology of the transverse venous sinus (TVS) of 69 canine adult cadavers belonging to three groups: brachycephalic (B), dolichocephalic (D) and mesaticephalic (M). In addition, we outlined its path over the skull using five classic human craniometric points (CPs): the asterion (ast), the bregma (b), the glabella (g), the stephanion (st) and the pterion (pt). The study aimed to establish anatomical differences in the TVS between groups and in the relationship between the TVS and skull. We found that TVS anatomy and its relationships to skull landmarks vary markedly between the groups, with similar anatomical arrangements in B and M. The TVS length can be ranked as M < B < D (with D being the biggest), whereas the width can be ranked as M < D < B (with B being the widest) with the right side being smaller than the left. In the B and M groups, the TVS assumes a craniocaudal trajectory that is closer to the lateral skull wall than in D, where the TVS presents a caudocranial direction. By documenting the morphological characteristics of the TVS, we can create a set of anatomical references allowing construction of a basic framework to greatly decrease the probability of TVS injury during neuronavigation procedures when supported by a good knowledge of the skull, brain anatomies and their relationships.
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Affiliation(s)
- L Miguel Carreira
- Faculty of Veterinary Medicine, Department of Clinic - Surgery, University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica de Lisboa, Polo Universitário Alto da Ajuda, 1300-477, Lisbon, Portugal.,Interdisciplinary Centre of Research in Animal Health (CIISA), FMV/ULisboa, Av. da Universidade Técnica de Lisboa, Polo Universitário Alto da Ajuda, 1300-477, Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre (CMVAA), Rua Dª. Francisca da Azambuja N° 9 - 9A, 2830-077, Barreiro, Portugal
| | - A Ferreira
- Faculty of Veterinary Medicine, Department of Clinic - Surgery, University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica de Lisboa, Polo Universitário Alto da Ajuda, 1300-477, Lisbon, Portugal.,Interdisciplinary Centre of Research in Animal Health (CIISA), FMV/ULisboa, Av. da Universidade Técnica de Lisboa, Polo Universitário Alto da Ajuda, 1300-477, Lisbon, Portugal
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Tsutsumi S, Ogino I, Miyajima M, Nakamura M, Yasumoto Y, Arai H, Ito M. Cranial arachnoid protrusions and contiguous diploic veins in CSF drainage. AJNR Am J Neuroradiol 2014; 35:1735-9. [PMID: 24948506 DOI: 10.3174/ajnr.a4007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Studies have suggested that arachnoid villi or granulations found in the walls of the cranial dural sinuses, olfactory mucosa, and cranial nerve sheaths function as outlets for intracranial CSF. However, their role as CSF outlets has not yet been verified. Here we show that arachnoid protrusions and contiguous diploic veins provide an alternative drainage route for intracranial CSF. MATERIALS AND METHODS Four hundred patients with intact skull, dura mater, and dural sinuses underwent MR imaging to explore arachnoids protruding into the skull and diploic veins. Patients with symptoms of increased intracranial pressure or intracranial hypotension were excluded. For 15 patients undergoing craniotomy, both peripheral and diploic venous blood was collected. Albumin and the CSF-specific biomarkers were measured by enzyme-linked immunosorbent assay. RESULTS With MR imaging, arachnoid protrusions into the skull and contiguous diploic veins were consistently identified throughout the cranium with their characteristic appearance depending on the cranial region. In addition, elevated amounts of prostaglandin D synthase and cystatin C were confirmed in diploic veins compared with peripheral venous blood. CONCLUSIONS Diploic veins are distributed ubiquitously throughout the cranium. A portion of the intracranial CSF may be drained through arachnoid protrusions and contiguous diploic veins.
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Affiliation(s)
- S Tsutsumi
- From the Department of Neurological Surgery (S.T., Y.Y., M.I.), Juntendo University Urayasu Hospital, Chiba, Japan
| | - I Ogino
- Department of Neurological Surgery (I.O., M.M., H.A.), Juntendo University School of Medicine, Tokyo, Japan
| | - M Miyajima
- Department of Neurological Surgery (I.O., M.M., H.A.), Juntendo University School of Medicine, Tokyo, Japan
| | - M Nakamura
- Division of Radiological Technology (M.N.), Medical Satellite Yaesu Clinic, Tokyo, Japan
| | - Y Yasumoto
- From the Department of Neurological Surgery (S.T., Y.Y., M.I.), Juntendo University Urayasu Hospital, Chiba, Japan
| | - H Arai
- Department of Neurological Surgery (I.O., M.M., H.A.), Juntendo University School of Medicine, Tokyo, Japan
| | - M Ito
- From the Department of Neurological Surgery (S.T., Y.Y., M.I.), Juntendo University Urayasu Hospital, Chiba, Japan
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Calvarial diploic venous channels: an anatomic study using high-resolution magnetic resonance imaging. Surg Radiol Anat 2013; 35:935-41. [PMID: 23625040 DOI: 10.1007/s00276-013-1123-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 04/18/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The calvarial diploic venous channels (CDVCs) are well-known intraosseous structures, but their distribution and anatomofunctional implications are not fully understood. OBJECTIVE To investigate the architecture of CDVCs using high-resolution magnetic resonance (MR) imaging. METHOD This prospective study enrolled 43 male and 37 female outpatients who underwent a 3.0-T MR imaging equipped by a 32-channel head coil. T1-weighted imaging covering the whole cranial vault was performed after gadolinium injection. In addition, one-piece orbitozygomatic craniotomy was performed in three cadaveric heads to observe the interruption of the CDVCs. RESULTS The CDVCs showed irregular contours and peculiar branching patterns with four common major pathways: the pteriofrontparietal (PFP), frontoorbital (FO), occipitoparietal (OP), and occipitocervical (OC) routes. The proximal PFP coursed as a single trunk and divided into several branches at the level of the frontal eminence. The orbital part of the FO continued to the subcutaneous vein via the supraorbital rim. The PFP and the pterional part of the FO fused proximally with the sphenoparietal sinus and descended as the middle meningeal vein. The OP coursed in the superoinferior direction and connected the junction part of the transverse-sigmoid sinus to the parietal superior sagittal sinus. The OC occurred as a single trunk in the median occipital bone, drained extracranially, and joined the suboccipital venous channels. CONCLUSIONS The CDVCs seem to be a relatively consistent network functioning not only as conduits connecting the intracranial dural sinuses but also as pathways to the extracranial venous systems. High-resolution MR imaging is useful for investigating the CDVCs.
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Balzeau A, Rougier H. New information on the modifications of the neandertal suprainiac fossa during growth and development and on its etiology. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 151:38-48. [DOI: 10.1002/ajpa.22249] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 01/25/2013] [Indexed: 11/05/2022]
Affiliation(s)
- Antoine Balzeau
- Département de Préhistoire, Équipe de Paléontologie Humaine; UMR 7194 du CNRS, Muséum National d'Histoire Naturelle; Paris; France
| | - Hélène Rougier
- Department of Anthropology; California State University Northridge; 18111 Nordhoff St.; Northridge; CA; 91330-8244
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