Single-session percutaneous embolization with onyx and coils of sinus pericranii

Abstract

Background:Sinus pericranii (SP) is a rare vascular malformation consisting of an abnormal communication between the extra- and the intracranial venous system. It occurs due to the adhesion of vessels without a muscular layer or a hemangioma on the outer surface of the skull through diploic vessels, communicating with an intracranial venous sinus.Case Description:A 10-month-old female presented with a pulsatile mass on the posterior parietal region. Investigation with brain vascular examinations showed a venous malformation communicating with the superior sagittal sinus under the scalp, without arterial feeder or nidus. An endovascular embolization with coils and a percutaneous embolization with Onyx ® were performed. The final venography showed complete exclusion of the lesion, which was gradually being absorbed.Conclusion:This is the first case of an SP successfully treated in a single session by embolization with coils and onyx.

Pulsating lid: a rare presentation of sinus pericranii

“…There have been only 4 cases reported in the literature of the SP involving the eyelid, 2À4,13 and few cases in adults 10,14 and pulsatile. 15 The case reported herein is both exceptionally rare and atypical in a number of ways: (i) it involved the upper eyelid; (ii) there was subtle (transmitted) pulsatility and no enlargement with Valsalva manoeuvre; (iii) the patient presented in the fifth decade of life. Although rare, physicians should consider SP in the differential diagnosis of a vascular lid anomaly.…”

Treatment of an Elusive Symptomatic Sinus Pericranii: Case Report and Review of the Literature

“…1 Histology can reveal fibrosis, suggesting a traumatic origin. 7,12 The potential complications and cosmetic disturbances are indications for treatment of accessory SP in appropriately selected patients. 3,7,12 We reviewed the literature for pediatric SP not associated with congenital syndromes and found 32 such cases (►Table 1).…”

“…7,12 The potential complications and cosmetic disturbances are indications for treatment of accessory SP in appropriately selected patients. 3,7,12 We reviewed the literature for pediatric SP not associated with congenital syndromes and found 32 such cases (►Table 1). 1,[9][10][11][12][13][14][15][16] Clinical presentations included scalp masses, headaches, dizziness, and tinnitus.…”

“…1,[3][4][5][6] Venous drainage pattern is dominant when it serves as a major intracranial venous outflow pathway, and accessory when only a small or trivial amount of outflow is dependent on the SP. 1,3,4,7 Treating a dominant SP may result in venous congestion and hemorrhage, and typically only accessory SP are amenable to treatment. 8,9 If an SP is deemed symptomatic and amenable to treatment, both endovascular and open surgical techniques can be used.…”