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Dominant Occipital Sinus: A Rare Anatomical Variant With Potentially Catastrophic Consequences if Unrecognized
Arman Khan1, Richard Moon2, Matias Costa3
1Medical School, University of Adelaide, Adelaide, AUS.
Cureus
|January 24, 2025
Summary
The occipital sinus, typically minor, can be a critical venous drainage route. Recognizing this anatomical variant is vital for neurosurgery to prevent complications during tumor resection.
Area of Science:
- Neurosurgery
- Anatomy
- Vascular Neurology
Background:
- The occipital sinus is often considered a vestigial structure in adult anatomy.
- However, it can rarely serve as the primary pathway for venous drainage within the brain.
Observation:
- A case study details a 48-year-old female with a large fourth ventricular epidermoid tumor.
- Preoperative imaging revealed hypoplastic transverse sinuses and a dominant occipital sinus draining major cerebral veins.
Findings:
- Surgical resection of the tumor was achieved by tailoring a midline suboccipital craniotomy.
- The dominant occipital sinus and right marginal sinus were preserved, avoiding significant surgical morbidity.
Implications:
- This case underscores the importance of identifying dominant occipital sinuses preoperatively.
- Recognizing such dural venous sinus anatomical variants allows for modified surgical approaches, minimizing potential complications.
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