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Occipital sinus pericranii superseding both jugular veins: description of two rare pediatric cases

Paolo Frassanito1, Luca Massimi, Gianpiero Tamburrini

  • 1Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy. paolo.frassanito@gmail.com

Neurosurgery
|February 15, 2013
PubMed

Insights

Sinus pericranii (SP) can be a critical pathway for brain venous drainage, especially when jugular veins are occluded. Preservation of SP is recommended in cases of intracranial hypertension due to venous engorgement.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Extracranial venous drainage of the brain primarily relies on jugular veins.
  • Extrajugular pathways play a variable role in cerebral venous outflow.

Observation:

  • Two cases of occipital sinus pericranii (SP) were identified in pediatric patients.
  • One patient presented with an enlarging occipital mass; the other with mild nuchal headache.
  • Neuroimaging revealed bilateral jugular vein occlusion, ventricular dilation, and cerebellar tonsil herniation in both cases.

Findings:

  • Sinus pericranii (SP) exceptionally served as the main venous drainage pathway for the brain.
  • SP compensated for intracranial hypertension caused by venous engorgement.

Implications:

  • Preservation of sinus pericranii (SP) is advised in such cases.
  • Surgical or endovascular intervention for SP is contraindicated when it provides essential venous drainage.
Abstract

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