Volume: 10 Issue: 2
Year: 2022, Page: 13-20, Doi: https://doi.org/10.47799/pimr.1002.04
Received: Dec. 2, 2021 Accepted: Feb. 26, 2022 Published: Feb. 26, 2022
The intracranial dural venous sinuses can be injured leading to thrombosis with in the dural sinuses causing headache, abnormal vision, weakness of the face and limbs on one side of the body, and seizures.Magnetic Resonance Venography (MRV) is one of the preferred methods of evaluation of the cerebral venous sinus anatomy, variations and pathology, particularly in the diagnosis of venous sinus thrombosis.
The purpose of this study is to evaluate the use of MRV to depict the normal intracranial venous anatomy and its variants in North Indian population which can help to avoid potential pitfalls in the diagnosis of dural venous sinus thrombosis, venous infarcts and venous hemorrhage.
Aim:The purpose of this study is to evaluate the use of MRV to depict the normal intracranial venous anatomy and its variants in North Indian population, which can help to avoid potential pitfalls in the diagnosis of dural venous sinus thrombosis, venous infarcts and venous hemorrhage.
Materials:The present study was undertaken in the Departments of Anatomy and Radiodiagnosis at a North Indian tertiary care teaching hospital over a period of two years. Magnetic Resonance Venograms (MRV) of patients attending the radiology department were used to study the normal anatomy and variations in the dural venous sinuses. 50 MRV scans of which 26 were of females and 24 of male, were included in the study. Anatomical variations and variations in drainage of the dural venous sinuses were assessed and statistical analysis was done.
Results:For both superior sagittal sinus drainage and straight sinus drainage, the proportion of veins draining in right and left transverse sinuses and confluence of sinuses was significantly different in the two age groups (p<0.001) in both males and females. Partial splitting of superior sagittal sinus in anterior one third or posterior one third was also seen. Statistically significant findings were observed regarding the laterality for vein of Labbe & vein of Trolard.
Conclusion:MR venography is an excellent diagnostic technique to visualise anatomy and anatomic variations of venous sinuses as observed in our study. The partial splitting of superior sagittal sinus in either anterior one third or posterior one third as seen in our study, can cause misdiagnosis of thrombosis. Hence, knowledge of normal anatomy and anatomic variations in the intracranial venous sinuses is very important to diagnose cerebral venous sinus thrombosis accurately.
Keywords: Anatomical Variations, Cerebral Venous Thrombosis, Dural Venous Sinus, Headache, Magnetic Resonance Venography
Adeeb, N, Mortazavi, M M, Tubbs, R S & Cohen-Gadol, A A . The cranial dura mater: a review of its history, embryology, and anatomy. Childs Nerv Syst 28:827–837.
Mancall, L M & Brock, D G . The Anatomical Basis for Clinical Neuroscience. In: Gray’s Clinical Neuroanatomy. Philadelphia: Elsevier Saunders
Widjaja, E & Griffiths, P D . 2004. Intracranial MR Venography in Children: Normal Anatomy and Variations. American Journal of Neuroradiology 25:1557–1562.
Bousser, M G, Chiras, J, Bories, J & Castaigne, P . 1985. Cerebral venous thrombosis - a review of 38 cases. Stroke; A journal of cerebral circulation 16:199–213.
Casey, S O, Alberico, R A, Patel, M, Jimenez, J M, Ozsvath, R R, Maguire, W M & Taylor, M L . 1996. Cerebral CT venography. Journal of Radiology 198:163–170.
Heiserman, J E, Dean, B L, Hodak, J A, Flom, R A, Bird, C R, Drayer, B P & Fram, E K . 2000. Neurologic complications of cerebral angiography. American Journal of Neuroradiology 15:1401–1407.
Mattle, H P, Wentz, K U, Edelman, R R, Wallner, B, Finn, J P, Barnes, P, Atkinson, D J, Kleefield, J & Hooguewood, H M . 1991. Cerebral Venography with MR. Journal of Radiology 178:453–458.
Padayachee, T S, Bingham, J B, Graves, M J, Colchester, A C & Cox, T C . 1991. Dural sinus thrombosis: diagnosis and follow-up by magnetic resonance angiography and imaging. Neuroradiology 33:165–167.
Liauw, L, Van Buchem, M A, Spilt, A, De Bruine, F T, Van Den Berg, R & Hermans, J . 2000. MR angiography of the intracranial venous system. Radiology 214:678–82.
Surendrababu, N, Subathira, & Livingstone, R S . 2006. Variations in the cerebral venous anatomy and pitfalls in the diagnosis of cerebral venous sinus thrombosis: Low field MR experience. Indian Journal of Medical Sciences 60:135–142.
Saloner, D . 1995. The AAPM/RSNA physics tutorial for residents. An introduction to MR angiography. Radiographics 15(2):453–465.
Ayanzen, R H, Bird, C R, Keller, P J, Mccully, F J, Theobald, M R & Heiserman, J E . 2000. Cerebral MR Venography: Normal Anatomy and Potential Diagnostic Pitfalls. American Journal of Neuroradiology 21:74–78.
Huang, Y P, Okudera, T, Ohta, T & Robbins, A . 1984. Anatomic variations of the dural venous sinuses. The Cerebral Venous System and Its Disorders 109–67.
Ruiz, Dsm, Gailloud, P, Rufenacht, D A, Delaville, J, Henry, F & Fasel, J . 2002. The craniocervical venous system in relation to cerebral venous drainage. American Journal of Neuroradiology 23:1500–1508.
Rollins, N, Ison, C, Reyes, T & Chia, J . 2005. Cerebral MR Venography in children. American Journal of Neuroradiology 26:50–55.
Dora, F & Zileli, T . 1980. Common variations of the lateral and occipital sinuses at the confluens sinuum. Journal of Neuroradiology 20(1):23–27.
Okudera, T, Huang, Y P & Ohta, T . 1994. Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. American Journal of Neuroradiology 15:1871–1883.
Agarwal N, Pakhiddey R, Dhissa NC. Intracranial Magnetic Resonance Venography of Superior Sagittal Sinus, Straight Sinus and Cerebral Venous Channels: Normal Anatomy and Variations in North Indian Population. Perspectives in Medical Research. 2022;10(2):13-20 DOI: 10.47799/pimr.1002.04