The Anatomy of the Convergence of Major Deep Cerebral Veins in the Pineal Region: A Computed Tomography Angiography Study

Brzegowy, Karolina; Solewski, Bernard; Zarzecki, Michał; Musiał, Agata; Kasprzycki, Tomasz; Popiela, T; Walocha, Jerzy

doi:10.1016/j.wneu.2020.12.057

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…In agreement with reports, 11,12 radiation plus CSF diversion is often advocated for the treatment of pediatric pineal region lesions in our center, especially for germinomas and lymphomas, because some pineal region lesions are sensitive to radiation and difficult to resect 13 . Moreover, we found radiotherapy is easier to perform and has fewer complications in the short term when compared with lesion resection (Supplementary Table7, Supplemental Digital Content 7, http://links.lww.com/SCS/F657): compared with lesion resection, the radiotherapy cases had better postoperative KPS and mRS scores, shorter hospital stays, a lower reoperation rate, and higher hydrocephalus remission rate.…”

Section: Discussionsupporting

confidence: 89%

Treatment of Pineal Region Lesions in Children

Huang,

Zhou,

Tong

2023

Journal of Craniofacial Surgery

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Background: Pineal region lesions are more common in children than adults; however, therapeutic strategies for pineal region lesions in children are controversial. Methods: A retrospective study involving 54 pediatric with pineal region lesions was conducted. The therapeutic strategies for lesions and hydrocephalus were classified and analyzed. Results: Radiotherapy of pineal region lesions was shown to result in better postoperative recovery and fewer complications in the short-term compared with lesion resection. Total resection was related to smaller lesion size, endoscopic procedures, and a better prognosis. Cerebrospinal fluid (CSF) diversion before the resection reduced hydrocephalus recurrences, whereas further lesion resection had a negative short-term influence on CSF diversion. Among the 4 therapeutic strategies to manage hydrocephalus, a third ventriculostomy (ETV) was reasonable and further resection did not have a negative impact on the ETV. The relief of hydrocephalus was also related to better postoperative recovery, a higher total resection rate, fewer complications, and a better prognosis. Logistical regression analysis indicated that lesion size and intracranial complications were predictors of outcome. Conclusions: For lesion treatment, total resection and radiotherapy are essential components in children. Total resection and CSF diversion before resection were beneficial, whereas further lesion resection had a negative impact on CSF diversion. For hydrocephalus treatment, ETV was shown to be the best therapeutic strategy for management of pediatric hydrocephalus. Total resection and better preoperative health status were associated with greater hydrocephalus relief. For the overall prognosis, a lack of hydrocephalus relief was associated with poor outcomes. Lesion size and intracranial complications may be the best predictors of outcome.

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Section: Discussionsupporting

confidence: 89%

Treatment of Pineal Region Lesions in Children

Huang,

Zhou,

Tong

2023

Journal of Craniofacial Surgery

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“…Therefore, evaluation of the anatomy of the cerebral small veins is critical for choosing an optimal surgical strategy (Table 2). Brzegowy et al used CT angiography to retrospectively analyze the anatomy of internal cerebral veins (ICVs), Galen veins GV, basal veins BV, and other deep cerebral veins and their branches in 250 subjects, excluding cerebral parenchymal and vascular diseases, and attempted to establish a new classification for these veins (Brzegowy et al, 2019(Brzegowy et al, , 2021. The results showed that in 77% of the cerebral hemispheres, the thalamostriate vein was the only main tributary of the ICV, and this type was considered normal anatomy (Brzegowy et al, 2019).…”

Section: Imaging Anatomy Of Cerebral Small Veinsmentioning

confidence: 99%

“…Computed tomography venography is widely used in daily life and has better clinical applicability. However, for small veins that end at venous convergence, the resolution of this imaging method is often insufficient to observe them all ( Brzegowy et al, 2021 ). CTV cannot be widely used in certain populations, such as children, patients with metallic vascular clips, or in the presence of highly enhanced tumors, due to high radiation doses ( Rollins et al, 2005 ; Manara et al, 2010 ).…”

Section: Imaging Techniques Of Cerebral Veinsmentioning

confidence: 99%

“…After classifying the BV according to the continuity of its trunk, they found that 66% of patients did not have the absence of the three segments of the BV trunk. The most common pattern was seen as a normal anatomical structure, while for the termination pattern of BV in the pineal region, they suggested that tributaries of the ICV and GV should be taken into account, as different BV termination patterns may imply different surgical approaches ( Brzegowy et al, 2021 ).…”

Section: Imaging Anatomy Of the Cerebral Venous Systemmentioning

confidence: 99%

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

Liu

Zhang

et al. 2022

Front. Neurosci.

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In recent years, imaging technology has allowed the visualization of intracranial and extracranial vascular systems. However, compared with the cerebral arterial system, the relative lack of image information, individual differences in the anatomy of the cerebral veins and venous sinuses, and several unique structures often cause neurologists and radiologists to miss or over-diagnose. This increases the difficulty of the clinical diagnosis and treatment of cerebral venous system diseases. This review focuses on applying different imaging methods to the normal anatomical morphology of the cerebral venous system and special structural and physiological parameters, such as hemodynamics, in people without cranial sinus and jugular vein diseases and explores its clinical significance. We hope this study will reinforce the importance of studying the cerebral venous system anatomy and imaging data and will help diagnose and treat systemic diseases.

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