Unique Case Series of Occipital Sinus and Its Thrombosis- A Radiological Marvel
Unique Case Series of Occipital Sinus and Its Thrombosis
Background: Variations of the dural venous sinuses may result in inaccurate imaging interpretation or complications during surgical approaches. One of these variations reported infrequently is the occipital sinus with an overall incidence of under 10%.When present, it may get thrombosed or become source of intracranial bleeds or pose difficulty during occipital craniotomies. Our review suggests that the thrombosis of this unique venous sinus variant is a rare condition as there are very few case reports of the same. Herein, we present a case series of persistent occipital sinus and the unusual combination of a persistent occipital sinus and its thrombosis. Subjects and Methods: The study included 4 paediatric cases that presented with neonatal seizuressecondary to different underlying aetiologies and in retrospect had either persistent andpatent occipital sinus or a thrombosed occipital sinus. A descriptive study of the aforementioned cases was carried out. MRI scanner PHILIPS Achieva 1.5 Tesla was used for diagnosis. Results: One case had thrombosis of bilateral persistent occipital sinuses and superficial cortical veins with minimal intraventricular haemorrhage in bilateral lateral ventricles.Second case had persistent and thrombosed right occipital sinus; while two other cases had persistent but patent occipital sinuses. Conclusion: A comprehensive knowledge of cerebral venous anatomy and meticulous recognition of venous variations essentially helps when dealing with a pathology, which presents along with a particular venous variation, no matter how rare this combination is.
Beyrouti R, Mansour M, Kacem A, Zaouali J, Mrissa R. Occipital Sinus Thrombosis: An Exceptional Case Report. J Stroke Cerebrovasc Dis. 2016;25(6):71–73. Available from: https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.02.006.
Rollins N, Ison C, Booth T. MR venography in the pediatric patient. Am J Neuroradiol. 2005;26:50–55.
Ayanzen RH, Bird CR, Keller PJ. Cerebral MR venography: normal anatomy and potential diagnostic pitfalls. Am J Neuroradiol. 2000;21(1):74–78.
Guillaume D, Menezes AH. Retroclival hematoma in the pediatric population. Report of two. cases and review of the literature. J Neurosurg. 2006;105((4 Suppl)):321–325. Available from: https://dx.doi.org/10.3171/ped.2006.105.4.321.
Tubbs RS, Bosmia AN, Shoja MM, Mariosloukas JK, Curé AA, Cohen-Gadol. The oblique occipital sinus: A review of anatomy and imaging characteristics. Surg Radiol Anat. 2009;33(9):747–749. Available from: https://dx.doi.org/10.1007/s00276-011-0831-9.
Patel N. Venous anatomy and imaging of the first centimeter. Semin Ultrasound CT MR. 2009;30(6):513–524. Available from: https://dx.doi.org/10.1053/j.sult.2009.08.003.
Lang J. Clinical anatomy of the posterior cranial fossa and its foramina. New York: Thieme; 1991.
Kobayashi K, Suzuki M, Ueda F, Matsui O. Anatomical study of the occipital sinus using contrast-enhanced magnetic resonance venography. Neuroradiology. 2006;48(6):373–379. Available from: https://dx.doi.org/10.1007/s00234-006-0087-y.
Srijit D, Lativ AA, Suhaimi FH, Othman FB, Yahaya MF, Ahmad F. An anatomico-radiological study of the grooves for occipital sinus in the posterior cranial fossa. Bratisl Lek Listy. 2008;109(11):520–524.
Tubbs RS, Shojamm, Loukas M. An unusual finding of the posterior cranial fossa: one case report. Ital J Anat Embryol. 2008;113:83–86.
Lang J. Clinical anatomy of the posterior cranial fossa and its foramina. In: The floor of the posterior cranial fossa. New York: Thieme; 1991. p. 6–9.
Costa D, Krishnamurthy S, Nayak A, Madhyasta SR, Prabhu S, Jiji LV, et al. Duplication of falxcerebelli, occipital sinus, and internal occipital crest. Rom J Morphol Embryol. 2009;50:107– 110.
Dora F, Zileli T. Common variations of the lateral and occipital sinuses at the confluens sinuum. Neuroradiology. 1980;20(1):23–27. Available from: https://dx.doi.org/10.1007/bf00346857.
Bisaria KK. Anatomic variations of venous sinuses in the region of the torcular Herophili. J Neurosurg. 1985;62(1):90–95. Available from: https://doi.org/10.3171/jns.1985.62.1.0090.
Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F, Massaro A. Delay in the diagnosis of cerebral vein and dural sinus thrombosis: influence on outcome. Stroke. 2009;40(9):3133–3138. Available from: https://doi.org/10.1161/strokeaha.109.553891.