Cranial venous sinus dominance: what to expect? Analysis of 100 cerebral angiographies

Abstract

We report an analysis of the cranial venous sinuses circulation, emphasizing morphological and angiographic characteristics. Methods: Data of 100 cerebral angiographies were retrospectively analyzed (p = 0.05). Results: Mean age was 56.3 years, 62% female and 38% male. Measurements and dominance are shown in the Tables. There was no association between age or gender and dominance. Right parasagittal division of the superior sagittal sinus was associated with right dominance of the transverse sinus, sigmoid sinus and internal jugular vein; and left parasagittal division of the superior sagittal sinus was associated with left dominance of the transverse sinus, sigmoid sinus and internal jugular vein. Conclusion: A dominance pattern of cranial venous sinuses was found. Age and gender did not influence this pattern. Angiographic findings, such as division of the superior sagittal sinus, were associated with a pattern of cranial venous dominance. We hope this article can add information and assist in preoperative venous analysis for neurosurgeons and neuroradiologists.Keywords: cranial sinuses; cerebral angiography; anatomy. RESUMORelatamos uma análise da circulação dos seios venoso cranianos, enfatizando características morfológicas e angiográficas. Métodos: Dados de 100 angiografias cerebrais foram retrospectivamente analisados (p = 0,05). Resultados: Média de idade 56,3 anos, 62% feminino e 38% masculino. Medições e dominância expostos em tabelas. Sem associação entre idade ou sexo e dominância. Divisão parassagittal direita do Seio Sagital Superior (SSS) foi associada com dominância direita do Seio Transverso (ST), Seio Sigmóide (SS) e Veia Jugular Interna (VJI), e divisão parassagittal esquerda do SSS foi associada com dominância esquerda do ST, SS e VJI. Conclusão: Um padrão de dominância dos seios venosos do crânio foi encontrado. Idade e sexo não influenciaram esse padrão. Achados angiográficos, como divisão do SSS, foram associados com o padrão de dominância venoso cerebral. Esperamos que este artigo acrescente informações e auxilie na análise venosa pré-operatória para neurocirurgiões e neuroradiologistas.Palavras-chave: seios cranianos; angiografia cerebral; anatomia.The cranial venous sinuses are channels lined by endothelial layers located between the periosteal (outer) and meningeal (internal) dura mater 1 . They collect blood from the superficial and deep cerebral veins, meninges and calvarium, and form the main drainage route of the cranial cavity 2 . The understanding of the cranial venous sinus anatomy is fundamental in neurosurgery and radiology, especially in surgical planning and treatment of neurological diseases, and to avoid complications 3,4,5,6,7,8,9 . The cerebral venous drainage dominance analysis should be considered before operations on patients for a large variety of neurosurgical diseases, especially if possible coagulation of venous structures is needed 5 . Analysis of cranial venous dominance is of great importance in many neurosurgeries, as well in neck surgeries 5 . Venous ...

Morphological analysis of sigmoid sinus anatomy: clinical applications to neurotological surgery

“…Seventy-four percent of the paired specimens revealed SS dominance on the right side. These results coincide with findings in the literature that the SS is frequently larger on the right side [19, 21, 22, 24]. The specific distances analyzed in this study were chosen based on those most applicable to neurotologic surgical approaches.…”

“…There have been many cadaveric [18–20, 23–30] and radiologic [21, 22, 26, 31–36] studies investigating the variability of the SS, as well as its anatomic relationships to other structures within the temporal bone. However, the intricacies of temporal bone anatomy can make morphological analysis in two-dimensions (2D) challenging.…”

Anatomy imaging and hemodynamics research on the cerebral vein and venous sinus among individuals without cranial sinus and jugular vein diseases

“…The goal is to provide possible measurement parameters for the clinical treatment of suspected thrombosis or the identification of anatomical variations. The average diameters of TS obtained by Manara et al were 6.5 mm ± 1.84 on the right side and 5.1 mm ± 1.72 on the left side (P < 0.0001) (Manara et al, 2010), which were the same as the values of TS measured by Kitamura et al using DSA (right,6.4 mm vs. left, 5.4 mm) (Kitamura et al, 2017), but both were larger than those obtained by Baikov et al The average diameters observed by them were 5.34 mm on the right side and 4.73 mm on the left (Baikov et al, 2007). All studies confirmed that the right TS had a larger diameter than the left TS, and no study in the cohort of Manara et al had a right-left mean diameter <3 mm.…”

“…Interestingly, the presence of the parasagittal right division of the SSS was correlated with the right dominance of the transverse sinus (TS), straight sinus (SS), and IJV, while the presence of the parasagittal left division of the SSS was correlated with the left dominance of the TS, SS, and IJV, both of which were statistically significant. Epidemiological factors such as age and sex did not affect venous sinus drainage patterns in this cohort ( Kitamura et al, 2017 ). Angiographic results in the venous phase in a study by Zouaoui et al confirmed that the absence of the entire lateral sinus (transverse or sigmoid) is not equivalent to lateral sinus thrombosis, which may be due to embryonic hypoplasia and creates venous drainage dominance on the non-deleted side ( Zouaoui and Hidden, 1988 ).…”

Influence of pneumatization on morphology of temporal bone-related vasculatures and their morphometric relationship with ear regions: a computed tomography study

“…The location, as well as the size and shape of these vasculatures, such as sigmoid sinus (SS) and jugular bulb (JB) (a connection between the SS and the internal jugular vein), is highly variable, including a significant difference in laterality 2 , 4 – 6 . The pneumatization of the TB has been reported to be responsible for these variabilities 7 , 8 .…”