Sinus pericranii: an overview and literature review of a rare cranial venous anomaly (A review of the existing literature with case examples)

Abstract

Sinus pericranii is a rare vascular abnormality characterised by abnormal connections between the intra- and extracranial venous systems and is usually found in children. In most instances, a sinus pericranii presents as a soft scalp swelling that appears with the patient in the recumbent position and disappears in the erect position. We review two cases of sinus pericranii presented in adulthood and treated surgically with good outcomes. We have performed a search of the English literature using the PubMed database and reviewed the published cases to date to present an overview of this pathological entity.

Sinus Pericranii: A Scalp Mass in a 6-Month-Old Boy

“…Usually, the lesion stabilizes in size after puberty. However, spontaneous involution and thrombosis have also been described [1]. …”

“…Patients with SP present with a soft, nonpulsatile mass adherent to the scalp and situated near an intracranial sinus increasing in size with intracranial pressure (crying or Valsalva maneuvers) and disappearing on compression [1,2,5,7]. The lesion is usually located in the frontal region (40%), followed by parietal (34%), occipital (23%) and temporal (4%) locations [8].…”

“…Other authors have suggested that transient venous hypertension due to venous outlet obstruction in the late embryonic period could result in the development of SP. Finally, SP related to craniosynostosis may result from the development of collateral vessels due to impaired venous drainage at the cranial base [1]. …”

“…It is an abnormal communication between extracranial veins and dural venous sinuses (usually the superior sagittal and the transverse sinuses) [1]. It is defined as a collection of nonmuscular venous blood vessels adhering tightly to the outer surface of the skull and directly communicating with an intracranial venous sinus through multiple diploic veins of various sizes [2].…”

Determination of sinus pericranii resectability by external compression during angiography: technical note

“…Of this curiosity Stromeyer wrote that it "…consists of a blood bag on the skull, which stands in connection with the veins of the diploe and through these with the sinuses of the brain…." 2,57,58 Due to the rarity of sinus pericranii, its pathogenesis and natural history remain unclear. Thus, the optimal management strategy for this lesion is also unknown.…”