ABSTRACT
PURPOSE: Knowledge of variations in the cerebral dural venous sinus anatomy seen on magnetic resonance (MR) venography is essential to avoid over-diagnosis of cerebral venous sinus thrombosis (CVST). Very limited data is available on gender difference of the cerebral dural venous sinus anatomy variations. MATERIALS AND METHODS: A retrospective study was conducted to study the normal anatomy of the intracranial venous system and its normal variation, as depicted by 3D MR venography, in normal adults and any gender-related differences. RESULTS: A total of 1654 patients (582 men, 1072 women, age range 19 to 86 years, mean age: 37.98±13.83 years) were included in the study. Most common indication for MR venography was headache (75.4%). Hypoplastic left transverse sinus was the most common anatomical variation in 352 (21.3%) patients. Left transverse sinus was hypoplastic in more commonly in male in comparison to female (24.9% versus 19.3%, p = 0.009). Most common variation of superior sagittal sinus (SSS) was atresia of anterior one third SSS (15, 0.9%). Except hypoplastic left transverse sinus, rest of anatomical variations of the transverse and other sinuses were not significantly differ among both genders. CONCLUSION: Hypoplastic left transverse sinus is the most common anatomical variation and more common in male compared to female in the present study. Other anatomical variations of dural venous sinuses are not significantly differ among both genders.
Subject(s)
Adult , Female , Humans , Male , Headache , Phlebography , Retrospective Studies , Sinus Thrombosis, Intracranial , Superior Sagittal SinusABSTRACT
Radiation induced carotid stenosis (RICS) is known but challenging complication of head and neck irradiation. Endovascular revascularization is preferred treatment modality than surgical revascularization. Sometimes endovascular treatment may be difficult in view of long segment of stenosis and associated pseudoaneurysm. We report a unique technique of carotid stenting named as "conjoined stent technique" in a challenging case of RICS with long segment of stenosis and pseudoaneurysm. In this technique we overlapped distal end of one stent with proximal end of second stent to occlude pseudoaneurysm. "Conjoined stent technique" may be viable option in case of long segment of RICS with associated pseudoaneurysm and alternative to flow diverters in extracranial carotid pseudoaneurysm.