Determination of sinus pericranii resectability by external compression during angiography: technical note

Area of Science:

• Vascular Malformations
• Pediatric Neurosurgery
• Diagnostic Imaging

Background:

• Sinus pericranii is a rare congenital cranial venous malformation affecting the pediatric population.
• Distinguishing between dominant and accessory sinus pericranii is crucial for treatment decisions, based on intracranial venous drainage.
• Current methods for assessing dominance via angiography lack definitive safety assurance for obliteration procedures.

Purpose of the Study:

• To introduce a novel, safe method for evaluating the impact of sinus pericranii treatment on intracranial venous outflow.
• To enhance the appraisal of surgical intervention safety for sinus pericranii.

Main Methods:

• A technique involving temporary external compression of the sinus pericranii lesion during catheter angiography was employed.
• Intracranial venous outflow was analyzed under temporary occlusion to predict changes from permanent obliteration.
• This method allows for visualization of potential compromise before definitive treatment.

Main Results:

• The described method provides a direct assessment of intracranial venous outflow dynamics during temporary sinus pericranii occlusion.
• Angiographic changes observed during temporary compression accurately predict the effects of permanent obliteration.
• This technique offers a more reliable means to appraise the safety of surgical intervention.

Conclusions:

• The described angiography technique offers a safe and effective means to evaluate the risk of compromising intracranial venous outflow during sinus pericranii treatment.
• This method aids in better surgical planning and decision-making for pediatric patients with sinus pericranii.
• It enhances the ability to determine the safety of obliterating accessory sinus pericranii.