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Published on: January 17, 2018
Diagnostic and therapeutic considerations for sinus pericranii
Takanobu Kaido1, Yang Keun Kim, Katsuhiro Ueda
1Department of Neurosurgery, Oyodo Town General Hospital, Oyodo, Nara, Japan. kaido@nmu-gw.naramed-u.ac.jp
Summary
Sinus pericranii, a rare scalp vascular anomaly, can present after head trauma. Surgical disconnection of diploic veins successfully treated a case, preventing complications.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Radiology
Background:
- Sinus pericranii is a rare vascular anomaly involving abnormal venous drainage between intracranial and extracranial systems.
- It presents as a subcutaneous soft scalp mass and is a crucial differential diagnosis.
- Early and accurate diagnosis is essential for appropriate management and to prevent complications.
Observation:
- A 16-year-old female presented with a scalp mass following minor head trauma.
- Imaging revealed heterogeneous enhancement, a crater-like skull depression, and diploic holes.
- Percutaneous sinusography confirmed a connection between the lesion and the superior sagittal sinus.
Findings:
- CT and MRI demonstrated the vascular nature and intracranial connection of the sinus pericranii.
- Three-dimensional CT precisely visualized the skull defect and associated diploic venous network.
- Sinusography confirmed the abnormal communication with the superior sagittal sinus, differentiating it from other vascular malformations.
Implications:
- Surgical intervention to disconnect the diploic veins from the lesion is an effective treatment.
- Proper diagnosis and surgical planning are vital to avoid complications like profuse bleeding and air emboli.
- Successful surgical management can also address cosmetic concerns associated with sinus pericranii.
