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Miyake S, Nakai Y, Suenaga J, Akimoto T, Uemura K, Funakoshi K, Yamamoto T. Characteristic of Non–Sinus-Type Parasagittal Dural Arteriovenous Fistulas: Clinical and Cadaveric Experiences. NEUROSURGERY OPEN 2022. [DOI: 10.1227/neuopn.0000000000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ye Y, Ding J, Liu S, Wen G, Huang S, Wang Q. A Transvenous Endovascular Approach in Straight Sinus has Minor Impacts on Chordae Willisii. Neurol India 2022; 70:1506-1511. [PMID: 36076651 DOI: 10.4103/0028-3886.355179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The transvenous endovascular approach has become an optimal method for the treatment of cerebrovascular diseases. This procedure might cause iatrogenic damage to the chordae willisii (CW) in the straight sinus. However, little literature has been found to support this hypothesis. Objective To investigate the possible damage of CW in the straight sinus during a transvenous endovascular procedure. Materials and Methods The features of the CW from 38 cadaveric heads were observed via an endoscope mimicking a mechanical thrombectomy procedure in the straight sinus. Endoscopic observation and light microscopy examination were used to assess the damage of the CW throughout the procedure. Results Valve-like lamellae and longitudinal lamellae were found predominantly in the posterior portion of the straight sinus. Trabeculae were present in both the anterior and posterior portions of the straight sinus. Samples treated with a stent had a significantly higher rate of Grade 1 damage during the eight procedures compared with samples treated with a balloon (P = 0.02). The incidence of damage to the CW surface was higher in the stent group than in the balloon group (P = 0.00). The use of stent or balloon did not increase the rate of CW damage during repeated experiments. Conclusions The stent or balloon navigation through the straight sinus can cause minor damage to the CW. Frequent uses of retrograde navigation through the straight sinus do not seem to increase the possibility of damage to CW.
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Affiliation(s)
- Yuanliang Ye
- Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, Guangxi Autonomous Region; Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiuyang Ding
- Department of Forensic Medicine, Guizhou Medical University, Guiyang, Guizhou, China
| | - Shoutang Liu
- Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, Guangxi Autonomous Region, China
| | - Ge Wen
- Department of Research, The Bioillus Institute of Technology, Guangzhou, Guangdong Province, China
| | - Shaoming Huang
- Department of Anatomy, Guangxi Medical University, Nanning, Guangxi Autonomous Region, China
| | - Qiujing Wang
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
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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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Ye Y, Ding J, Liu S, Lan T, Chen L, Wang Y, Xia B, Yang J. A Transvenous Endovascular Approach in Straight Sinus Has Minor Impacts on Chordae Willisii. Front Neurol 2022; 13:725703. [PMID: 35222237 PMCID: PMC8874329 DOI: 10.3389/fneur.2022.725703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebral dural sinuses contain different types of chordae willisii (CW). The transvenous endovascular approach, which has become an optimal method for the treatment of cerebrovascular diseases, such as malformation, fistula, and chronic intracranial hypertension, due to sinus thromboses, frequently uses retrograde navigation through dural sinuses. Whether or how much the endoscopic procedure damages the chordae willisii is often not well-assessed. In our study, an overall number of 38 cadaveric heads were analyzed for the distribution and features of the chordae willisii in the straight sinus. We used an endoscope on these samples mimicking a mechanical thrombectomy procedure performed in the straight sinus. Both endoscopic gross observation and light microscopic histological examination were used to assess the damages to the chordae willisii by the procedure. We found that the valve-like lamellae and longitudinal lamellae structures were mainly found in the posterior part of straight sinus whereas trabeculae were present in both anterior and posterior portions. We treated a group of samples with a stent and another with a balloon. The stent-treated group had a significantly higher rate of Grade 1 damage comparing with the balloon-treated group (p = 0.02). The incidence of damage to the surface of chordae willisii was also higher in the stent-treated group (p = 0.00). Neither the use of stent nor of balloon increased the rate of damage to chordae willisii during repeated experiments. These findings indicated that stent or balloon navigation through the straight sinus can cause minor damages to the chordae willisii and frequent uses of retrograde navigation through the straight sinus do not appear to increase the rates of damage to chordae willisii.
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Affiliation(s)
- Yuanliang Ye
- Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, China
| | - Jiuyang Ding
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Shoutang Liu
- Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, China
| | - Tiancai Lan
- Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, China
| | - Long Chen
- Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, China
| | - Yingxue Wang
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Bing Xia
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
- Bing Xia
| | - Jianqing Yang
- Department of General Surgery, Liuzhou People's Hospital, Liuzhou, China
- *Correspondence: Jianqing Yang
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Walsh DR, Lynch JJ, O' Connor DT, Newport DT, Mulvihill JJE. Mechanical and structural characterisation of the dural venous sinuses. Sci Rep 2020; 10:21763. [PMID: 33303894 PMCID: PMC7729903 DOI: 10.1038/s41598-020-78694-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/26/2020] [Indexed: 12/27/2022] Open
Abstract
The dural venous sinuses play an integral role in draining venous blood from the cranial cavity. As a result of the sinuses anatomical location, they are of significant importance when evaluating the mechanopathology of traumatic brain injury (TBI). Despite the importance of the dural venous sinuses in normal neurophysiology, no mechanical analyses have been conducted on the tissues. In this study, we conduct mechanical and structural analysis on porcine dural venous sinus tissue to help elucidate the tissues’ function in healthy and diseased conditions. With longitudinal elastic moduli values ranging from 33 to 58 MPa, we demonstrate that the sinuses exhibit higher mechanical stiffness than that of native dural tissue, which may be of interest to the field of TBI modelling. Furthermore, by employing histological staining and a colour deconvolution protocol, we show that the sinuses have a collagen-dominant extracellular matrix, with collagen area fractions ranging from 84 to 94%, which likely explains the tissue’s large mechanical stiffness. In summary, we provide the first investigation of the dural venous sinus mechanical behaviour with accompanying structural analysis, which may aid in understanding TBI mechanopathology.
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Affiliation(s)
- Darragh R Walsh
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland
| | - James J Lynch
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland
| | - David T O' Connor
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - David T Newport
- Bernal Institute, University of Limerick, Limerick, Ireland.,School of Engineering, University of Limerick, Limerick, Ireland
| | - John J E Mulvihill
- Bernal Institute, University of Limerick, Limerick, Ireland. .,School of Engineering, University of Limerick, Limerick, Ireland. .,Health Research Institute, University of Limerick, Limerick, Ireland.
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Ye Y, Ding J, Huang S, Wang Q. Related Structures in the Straight Sinus: An Endoscopic Anatomy and Histological Study. Front Neuroanat 2020; 14:573217. [PMID: 33192341 PMCID: PMC7658480 DOI: 10.3389/fnana.2020.573217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/14/2020] [Indexed: 12/03/2022] Open
Abstract
Some structure might be encountered with endovascular procedures within the straight sinus and is not now readily seen on digital subtraction angiography (DSA). We investigated the morphological and histological characteristics of the straight sinus, chordae willisii (CW), and junction between the great cerebral vein (GCV) and straight sinus. A total of 22 cadaveric heads and 135 patients were analyzed with either anatomic dissection or neuroimaging. The morphological features of the CW and the junction between the GCV and straight sinus were analyzed by endoscope. The histology of the junction between the GCV and straight sinus was evaluated under the microscope with staining for elastic fiber, Masson’s, and immunohistochemistry. We found that fold, elevation, small bugle, or nodule and CW were detected by endoscope in the straight sinus. The most common type of CW was valve-like lamellae, which comprised 40.46% of all CW. Three different types of junctions between the GCV and straight sinus were identified: type 1 has folds in the GCV and elevation on the floor of the straight sinus; type 2 has folds and a small bugle; and type 3 presents with an intraluminal nodule located at the opening of the GCV. Compared with arachnoid granulation, the nodule consists of smooth muscle fibers and higher rate of elastic fibers. Understanding the detailed anatomy of the straight sinus may help surgeons to avoid procedural difficulties and to achieve higher success rate.
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Affiliation(s)
- Yuanliang Ye
- The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Engineering Technology Research Center of Education Ministry of China, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Department of Neurosurgery, Liuzhou General Hospital, Liuzhou, China
| | - Jiuyang Ding
- School of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Shaoming Huang
- Department of Anatomy, Guangxi Medical University, Nanning, China
| | - Qiujing Wang
- The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Engineering Technology Research Center of Education Ministry of China, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Department of Cerebrovascular Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Balik V, Uberall I, Sulla I, Ehrmann J, Kato Y, Sulla IJ, Takizawa K. Variability in Wall Thickness and Related Structures of Major Dural Sinuses in Posterior Cranial Fossa: A Microscopic Anatomical Study and Clinical Implications. Oper Neurosurg (Hagerstown) 2020; 17:88-96. [PMID: 30395343 DOI: 10.1093/ons/opy287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/12/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Regional variability in dural sinus (DS) wall thickness in posterior cranial fossa (PCF) have not been studied in detail yet. OBJECTIVE To clarify the possible regional variability in DS wall thickness and determine the occurrence and localization of the chordae Willisii (CW) in PCF. METHODS Fifty-nine human cadaveric DSs of PCF were investigated. A measurement of the DS walls/dura mater/CW thickness of parafin-embedded/hematoxylin-eosin stained axial sections was performed by using Cell Sens Science Imaging Software (Olympus Corporation, Tokyo, Japan). RESULTS The osseus wall (OW) was the thickest one in the confluens sinuum (CS) and the thinnest one in the jugular bulb (JB) and sigmoid sinus (P < .05). The biggest differences between individual walls were observed in the JB where the superior wall was almost twice as thick as the OW. At the transverse-sigmoid junction, the thickness of the walls was comparable. In the CS and transverse sinuses, the OW was even thicker than the surrounding dura mater. The occurrence and thickness of the CW increased from the JB towards CS and prevailed on the right side. An overall number of the CW in PCF was comparable to that observed in the superior sagittal sinus. CONCLUSION The present study displayed for the first time the regional variability in the DS walls thickness and occurrence of the CW in PCF. Application of these findings may afford greater freedom in exposure of the DSs or neoplasms adhering to the DSs.
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Affiliation(s)
- Vladimir Balik
- Department of Neurosurgery and Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and Faculty Hospital Olomouc, Olomouc, Czech Republic
| | - Ivo Uberall
- Department of Clinical and Molecular Pathology and Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and Faculty Hospital Olomouc, Olomouc, Czech Republic
| | - Igor Sulla
- Department of Anatomy, Histology and Physiology, University of Veterinary Medicine and Pharmacy in Kosice, Kosice, Slovak Republic
| | - Jiri Ehrmann
- Department of Clinical and Molecular Pathology and Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University and Faculty Hospital Olomouc, Olomouc, Czech Republic
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Aichi, Japan
| | - Igor J Sulla
- Department of Surgery, World of Health, Hospital of Slovak Railways, Kosice, Slovak Republic
| | - Katsumi Takizawa
- Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Hokkaido, Japan
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The Anatomy of the Sigmoid-Transverse Junction According to the Tentorial Angle. J Craniofac Surg 2019; 30:2280-2284. [PMID: 31369515 DOI: 10.1097/scs.0000000000005793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Dural sinuses have critical importance during intracranial approaches. Detailed anatomical knowledge of the dural sinuses is crucial for surgeons to reduce unexpected venous bleeding. The aim of this study was to investigate anatomical relation of sigmoid sinus and tentorium cerebelli according to clinically palpable landmarks and cranial morphometry. The authors evaluated 222 individuals' (94 women, 128 men) 3-dimensional computed tomography angiograms, retrospectively. The authors also studied on 12 mid-sagittal cut dried hemiskulls and 8 formalin fixed cadaver heads hemisected midsagitally. All measurements were completed using Osirix-Lite version 9 software. Craniometrical values were measured to define cranium morphology. Furthermore, level of the sigmoid sinus according to asterion and tentorial angle were evaluated in detail. Our results demonstrated that there were significant differences between parameters and genders, except vertical angle of the tentorium cerebelli. Distance between asterion and sigmoid sinus was statistically different between right and left sides in favor of the left side. This also varied depending on the position of the sigmoid sinus, as well. Only transverse angle between the upper point of external acoustic meatus and asterion demonstrated a significant correlation with age. This study evaluated the detailed 3D anatomy of sigmoid sinus and tentorium cerebelli related with the cranium morphology. Determining to sigmoid sinus anatomy according to clinically palpable landmarks has advantages for setting surgical protocols and reducing to unexpected injuries while surgery to these structures.
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Tentorial Venous Anatomy: Cadaveric and Radiographic Study with Discussion of Origin and Surgical Significance. World Neurosurg 2019; 131:e38-e45. [PMID: 31295599 DOI: 10.1016/j.wneu.2019.06.232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/28/2019] [Accepted: 06/29/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Described variations of tentorial venous anatomy impact surgical sectioning of the tentorium in skull base approaches; however, described configurations do not consistently explain postoperative complications. To understand the outcomes of 2 clinical cases we studied the tentorial venous anatomy of 2 cadavers. METHODS The venous anatomy of the tentorium isolated in 2 uninjected fresh cadaver head specimens with preserved bridging veins was observed by transillumination before and after methylene blue injection of the dural sinuses and tentorial veins. Our findings in cadavers were applied to explain the clinical and radiologic (magnetic resonance imaging and computed tomographic venography) findings in the 2 cases presented. RESULTS A consistent transtentorial venous system, arising from transverse and straight sinuses, communicating with supra- and infratentorial bridging veins was seen in the cadaver and patient radiography (magnetic resonance imaging and computed tomographic venography). Our first patient had a cerebellar venous infarct from compromise of the venous drainage from the adjacent brain after ligation of a temporal lobe bridging vein to the tentorium. Our second patient suffered no clinical effects from bilateral transverse sinus occlusion due to drainage through the accessory venous system within the tentorium. CONCLUSIONS Herein, we elaborate on transtentorial venous anatomy. These veins, previously reported to obliterate in completed development of the tentorium, remain patent with consistent observed configuration. The same transtentorial venous system was observed in both cases and provided insight to their outcomes. These findings emphasize the importance of the transtentorial venous system physiologically and in surgical approaches.
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Lee SH, Shin KJ, Koh KS, Song WC. Visualization of the tentorial innervation of human dura mater. J Anat 2017; 231:683-689. [PMID: 28695607 DOI: 10.1111/joa.12659] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 01/24/2023] Open
Abstract
Posterior projections of the ophthalmic division of the trigeminal nerve (the ophthalmic nerve) are distributed in the tentorium cerebelli as recurrent meningeal branches. We investigated the morphological tentorial distribution of the ophthalmic nerve. Fifty-two sides of the tentorium cerebelli and adjacent dura mater obtained from 29 human specimens were stained using Sihler's method to examine the nerve fibres in the dural sheets. The innervation patterns of the tentorium cerebelli were classified into the following four types according to their distributions: Type 1, where nerve fibres projected to both the straight and transverse sinuses; Type 2, where nerve fibres projected only to the transverse sinus and lateral convexity; Type 3, where nerve fibres projected medially only to the straight sinus and the posterior part of the falx cerebri; and Type 4, where the nerve fibres terminated within the tentorium cerebelli. Images of the tentorium cerebelli were superimposed to identify areas of dense innervation. The incidence rates of Types 1-4 were 71.2% (n = 37), 21.2% (n = 11), 3.8% (n = 2) and 3.8% (n = 2), respectively. More branches of nerve fibres traversed towards the transverse sinus posterolaterally than towards the straight sinus medially. The space between the anterior half of the straight sinus and the medial tentorial notch can be considered a safe surgical area where innervation is scarce. The posterior part of the falx cerebri was innervated by the ophthalmic nerve that traversed to the straight sinus. The parietal branches of the middle meningeal artery in the lateral convexity that were projected orthogonally by the ophthalmic nerve traversed the transverse sinus, implicating their vulnerability and possible sensitivity under physiological or neurosurgical conditions. This study has revealed the macroscopic tentorial innervation of the dura mater in humans, which could be useful information for both neurosurgeons and neurologists.
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Affiliation(s)
- Shin-Hyo Lee
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Kang-Jae Shin
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Ki-Seok Koh
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Wu-Chul Song
- Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
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