Anatomical Variations of Cerebral MR Venography: Is Gender Matter? / 신경중재치료의학

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.

Two Cases with Persistent Falcine Sinus as Congenital Variation

The falcine sinus is an abnormal anatomic structure located in the falx cerebri that is closed after birth and is rarely observed. We describe two cases of persistent falcine sinus. A 60-year-old woman presented with headache. An 11-year-old girl presented with intermittent headache and a palpable scalp mass in the middle of the high parietal area. The straight sinuses were absent in both patients. In both patients, drainage of the galenic system took place through a sinus within the falx, also known as a falcine sinus. Suspicious dysplastic tentorium cerebelli was observed in one patient. It can be concluded that a mesenchymal disorder can be the primary cause for a persistent falcine sinus.

The Normal Variation of Tentorial Sinuses Draining into the Straight Sinus

One hundred human cerebral hemispheres from 50 cadevers were dissected for evaluation on the variation of the tentorial sinus. Tentorial sinuses were found in 43 hemispheres which revealed a total of 63 branches. Tentorial sinuses were observed bilaterally in 14 cadevers and unilaterally in 15, but were absent in 21 cadevers. We divided the draining site of the tentorial sinuses at the straight sinus into 3 zones : Zone 1, anterior one third of the straight sinus, into which 15 out of 63 tentorial sinuses were found to be drained, zone 2 which is the most prevalent site, middle one third of the straight sinus draining 27 out of 63 tentorial sinuses and zone 3, posterior one third of the straight sinus draining 21 out of 63 tentorial sinuses.