Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage
Background/Object: The ligation and transection of anterior third of superior sagittal sinus (AT-SSS) is an important step to approach anterior skull base lesions. Some clinical studies have shown frontal lobe venous infarct following such surgical procedures questioning the safety of its ligation....
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doaj-85db3d90c746486ca2af3dea8645c70b2021-02-02T05:23:00ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neurosciences in Rural Practice0976-31470976-31552016-04-01070225726110.4103/0976-3147.176201Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainageSushanta K. Sahoo0Mandeep S. Ghuman1Pravin Salunke2Sameer Vyas3Rahat Bhar4N. K. Khandelwal5Department of Neurosurgery, PGIMER, Chandigarh, Punjab, IndiaDepartment of Radiodiagnosis, PGIMER, Chandigarh, Punjab, IndiaDepartment of Neurosurgery, PGIMER, Chandigarh, Punjab, IndiaDepartment of Radiodiagnosis, PGIMER, Chandigarh, Punjab, IndiaDepartment of Radiology, Fortis Hospital, Mohali, Punjab, IndiaDepartment of Radiodiagnosis, PGIMER, Chandigarh, Punjab, IndiaBackground/Object: The ligation and transection of anterior third of superior sagittal sinus (AT-SSS) is an important step to approach anterior skull base lesions. Some clinical studies have shown frontal lobe venous infarct following such surgical procedures questioning the safety of its ligation. We have studied the variations in venous drainage patterns to AT-SSS in the normal population using postcontrast magnetic resonance venogram (MRV). A novel scoring system to recognize the subgroup with dominant venous drainage from frontal lobes has been described. Materials and Methods: In this study, 60 three-dimensional contrast-enhanced (CE) MRVs were obtained from those cases being evaluated for a headache not harboring any intracranial mass lesion. The AT-SSS with all its draining veins was studied in detail. Morphology of individual veins such as length, caliber, tributaries, and angulation with AT-SSS was studied, and a numerical value of 0 or 1 was assigned for each of the above parameters. Summing up these scores derived from the individual cortical veins quantified the drainage of AT-SSS. Results: There are 3–4 veins on either side draining to AT-SSS. Barely, 3% of the veins had > 3 tributaries. Only 6.6% of veins had a caliber >3 mm, and 16.5% drained at acute angles to AT-SSS. About 26% of the veins did cross at least half of the lateral frontal lobe. We found in 26 individuals the AT-SSS score was 0–2, in 22 it was 3–5 and, in only in 12 (20%) the score was 6 or more (dominant drainage). Conclusion: There are anatomical variations in venous drainage of frontal lobes into AT-SSS. Those with dominant drainage are likely to develop venous congestion and complications if sacrificed. It is possible to identify these individuals on the basis of venous drainage pattern as shown in CE-MRV.http://www.thieme-connect.de/DOI/DOI?10.4103/0976-3147.176201anterior third superior sagittal sinushigh riskligationnormal populationscoring systemthree-dimensional contrast-enhanced magnetic resonance venogramvariations |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sushanta K. Sahoo Mandeep S. Ghuman Pravin Salunke Sameer Vyas Rahat Bhar N. K. Khandelwal |
spellingShingle |
Sushanta K. Sahoo Mandeep S. Ghuman Pravin Salunke Sameer Vyas Rahat Bhar N. K. Khandelwal Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage Journal of Neurosciences in Rural Practice anterior third superior sagittal sinus high risk ligation normal population scoring system three-dimensional contrast-enhanced magnetic resonance venogram variations |
author_facet |
Sushanta K. Sahoo Mandeep S. Ghuman Pravin Salunke Sameer Vyas Rahat Bhar N. K. Khandelwal |
author_sort |
Sushanta K. Sahoo |
title |
Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage |
title_short |
Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage |
title_full |
Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage |
title_fullStr |
Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage |
title_full_unstemmed |
Evaluation of anterior third of superior sagittal sinus in normal population: Identifying the subgroup with dominant drainage |
title_sort |
evaluation of anterior third of superior sagittal sinus in normal population: identifying the subgroup with dominant drainage |
publisher |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
series |
Journal of Neurosciences in Rural Practice |
issn |
0976-3147 0976-3155 |
publishDate |
2016-04-01 |
description |
Background/Object: The ligation and transection of anterior third of superior sagittal sinus (AT-SSS) is an important step to approach anterior skull base lesions. Some clinical studies have shown frontal lobe venous infarct following such surgical procedures questioning the safety of its ligation. We have studied the variations in venous drainage patterns to AT-SSS in the normal population using postcontrast magnetic resonance venogram (MRV). A novel scoring system to recognize the subgroup with dominant venous drainage from frontal lobes has been described. Materials and Methods: In this study, 60 three-dimensional contrast-enhanced (CE) MRVs were obtained from those cases being evaluated for a headache not harboring any intracranial mass lesion. The AT-SSS with all its draining veins was studied in detail. Morphology of individual veins such as length, caliber, tributaries, and angulation with AT-SSS was studied, and a numerical value of 0 or 1 was assigned for each of the above parameters. Summing up these scores derived from the individual cortical veins quantified the drainage of AT-SSS. Results: There are 3–4 veins on either side draining to AT-SSS. Barely, 3% of the veins had > 3 tributaries. Only 6.6% of veins had a caliber >3 mm, and 16.5% drained at acute angles to AT-SSS. About 26% of the veins did cross at least half of the lateral frontal lobe. We found in 26 individuals the AT-SSS score was 0–2, in 22 it was 3–5 and, in only in 12 (20%) the score was 6 or more (dominant drainage). Conclusion: There are anatomical variations in venous drainage of frontal lobes into AT-SSS. Those with dominant drainage are likely to develop venous congestion and complications if sacrificed. It is possible to identify these individuals on the basis of venous drainage pattern as shown in CE-MRV. |
topic |
anterior third superior sagittal sinus high risk ligation normal population scoring system three-dimensional contrast-enhanced magnetic resonance venogram variations |
url |
http://www.thieme-connect.de/DOI/DOI?10.4103/0976-3147.176201 |
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