Sinus pericranii: neuroradiologic findings and clinical management

We report an 11-year-old boy with a sinus pericranii. Magnetic resonance images demonstrated a small hole in the cranium underneath the subcutaneous mass. Magnetic resonance angiography (MRA) with sequential two-dimensional time-of-flight (2D-TOF) method demonstrated that the venous flow via the sinus pericranii was directed from the intra- to the extracranial venous system (the drainer type). This was confirmed by a combination of conventional cerebral angiography and percutaneous sinography. We advocate that both the correct diagnosis and classification of sinus pericranii can be established with a combination of current noninvasive neuroradiologic studies, especially for the pediatric age group. MRA with the 2D-TOF method is useful in the assessment of this venous anomaly.