The Experts below are selected from a list of 243 Experts worldwide ranked by ideXlab platform

R. Shane Tubbs - One of the best experts on this subject based on the ideXlab platform.

  • The Torcular Herophili (Confluence of Sinuses)
    Anatomy Imaging and Surgery of the Intracranial Dural Venous Sinuses, 2020
    Co-Authors: Andre Granger, R. Shane Tubbs
    Abstract:

    Abstract The torcular Herophili (Confluence of Sinuses) is a highly variable structure that constitutes a vital part of the network of dural venous Sinuses. The torcular Herophili is defined historically as the intersection of the superior sagittal sinus, the straight sinus, the occipital sinus, and the two transverse Sinuses. Its size varies and it is located inferior to the occipital lobes and posterosuperiomedially to the cerebellum. This chapter outlines the anatomy and clinical implications of this sinus.

  • Drainage of the basal vein of Rosenthal into the Confluence of Sinuses.
    Anatomy & cell biology, 2019
    Co-Authors: Stephen J. Bordes, Marios Loukas, Skyler Jenkins, Joe Iwanaga, Joel K. Curé, R. Shane Tubbs
    Abstract:

    An adult female was found to have a variation of the left basal vein of Rosenthal after presenting with complaints of headache. The vein, in this case, drained directly into the Confluence of Sinuses instead of the great vein of Galen. Variation of the basal vein is likely due to the embryonic development of the deep cerebral venous system as primitive structures either differentiate further or regress with age. Such changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case reported of the basal vein draining into the Confluence of Sinuses.

Mikhail Chernov - One of the best experts on this subject based on the ideXlab platform.

  • Meningiomas of the superior sagittal sinus.
    Journal of neurosurgery, 2007
    Co-Authors: Mikhail Chernov
    Abstract:

    Object. Radical removal of meningiomas involving the major dural Sinuses remains controversial. In particular, whether the fragment invading the sinus must be resected and whether the venous system must be reconstructed continue to be issues of debate. In this paper the authors studied the effects, in terms of tumor recurrence rate as well as morbidity and mortality rates, of complete lesion removal including the invaded portion of the sinus and the consequences of restoring or not restoring the venous circulation. Methods. The study consisted of 100 consecutive patients who had undergone surgery for meningiomas originating at the superior sagittal sinus in 92, the transverse sinus in five, and the Confluence of Sinuses in three. A simplified classification scheme based on the degree of sinus involvement was applied: Type I, lesion attachment to the outer surface of the sinus wall; Type II, tumor fragment inside the lateral recess; Type III, invasion of the ipsilateral wall; Type IV, invasion of the later...

Alan Waters - One of the best experts on this subject based on the ideXlab platform.

  • Severe brain edema caused by a meningioma obstructing cerebral venous outflow and treated with venous sinus stenting. Case report.
    Journal of neurosurgery, 2008
    Co-Authors: J. Nicholas P. Higgins, Neil G. Burnet, Christian F. Schwindack, Alan Waters
    Abstract:

    ✓ Peritumoral edema is a common feature of cerebral meningiomas, but venous outflow obstruction is not normally considered as a cause even when a tumor involves the venous Sinuses. The authors describe a patient with a ventricu-loperitoneal shunt in situ, who had undergone several debulking operations and conventional radiotherapy and in whom had developed progressive life-threatening edema from a tentorial meningioma. Radiological studies showed occlusion of the straight sinus and stenosis of the sagittal sinus at the Confluence of Sinuses. The sagittal sinus was stented, and thereafter the patient made an almost complete symptomatic recovery and returned to work. This case shows that progressive edema in patients with meningioma is not necessarily caused by radiotherapy or tumor enlargement into the brain and that in venous outflow obstruction, addressing the obstructive lesion directly can improve the palliation afforded by a shunt.

Fabio L. A. Gattuta - One of the best experts on this subject based on the ideXlab platform.

  • Resection of the transverse Sinuses and Confluence of Sinuses for treatment of multiple dural arteriovenous fistulas. Case report.
    Journal of neurosurgery, 2004
    Co-Authors: Ettore Fiumara, Silvana Tumbiolo, Maria Luisa Bellomonte, Paolino Savatteri, Francesca Finazzo, Fabio L. A. Gattuta
    Abstract:

    Dural arteriovenous fistulas (DAVFs) occurring simultaneously at two or more separate locations are not frequent. In fact, the incidence of multiple DAVFs is 7 to 8% of all DAVFs. Patients harboring multiple DAVFs have a higher incidence of hemorrhage, venous infarction, and neurological deficits due to a greater frequency of leptomeningeal venous drainage. To the authors' knowledge only a few cases of DAVFs involving both transverse Sinuses (TSs) have been reported. These patients underwent various combined treatments (transarterial embolization, transvenous obliteration, surgical isolation, resection, and radiosurgery). Treatments performed that do not include resection of the involved Sinuses do not always guarantee a cure. The authors present a patient who harbored multiple DAVFs of the TSs, both distally occluded with secondary reflux into the superior sagittal sinus (SSS), the straight sinus, the deep venous system, and the leptomeningeal veins of both hemispheres. An en bloc removal of the portions including the fistulas of the TSs, the Confluence of Sinuses, and the distal parts of the SSS, and straight sinus allowed for the patient to be cured. The fact is emphasized that despite the progress of endovascular treatment and radiosurgery this kind of DAVF must be surgically treated. The operation may be complex and dangerous.

Benedicto Oscar Colli - One of the best experts on this subject based on the ideXlab platform.

  • Straight sinus: ultrastructural analysis aimed at surgical tumor resection
    Journal of neurosurgery, 2016
    Co-Authors: Marcelo Campos Moraes Amato, Luis Fernando Tirapelli, Carlos Gilberto Carlotti, Benedicto Oscar Colli
    Abstract:

    OBJECTIVE Accurate knowledge of the anatomy of the straight sinus (SS) is relevant for surgical purposes. During one surgical procedure involving the removal of part of the SS wall, the authors observed that the venous blood flow was maintained in the SS, possibly through a vein-like structure within the dural sinus or dural multiple layers. This observation and its divergence from descriptions of the histological features of the SS walls motivated the present study. The authors aimed to investigate whether it is possible to dissect the SS walls while keeping the lumen intact, and to describe the histological and ultrastructural composition of the SS wall. METHODS A total of 22 cadaveric specimens were used. The SS was divided into three portions: anterior, middle, and posterior. The characteristics of the SS walls were analyzed, and the feasibility of dissecting them while keeping the SS lumen intact was assessed. The thickness and the number of collagen fibers and other tissues in the SS walls were compared with the same variables in other venous Sinuses. Masson's trichrome and Verhoeff's stains were used to assess collagen and elastic fibers, respectively. The data were analyzed using Zeiss image analysis software (KS400). RESULTS A vein-like structure independent of the SS walls was found in at least one of the portions of the SS in 8 of 22 samples (36.36%). The inferior wall could be delaminated in at least one portion in 21 of 22 samples (95.45%), whereas the lateral walls could seldom be delaminated. The inferior wall of the SS was thicker (p < 0.05) and exhibited less collagen and greater amounts of other tissues-including elastic fibers, connective tissue, blood vessels, and nerve fibers (p < 0.05)-compared with the lateral walls. Transmission electron microscopy revealed the presence of muscle fibers at a level deeper than that of the subendothelial connective tissue in the inferior wall of the SS, extending from its junction with the great cerebral vein to the Confluence of Sinuses. CONCLUSIONS The presence of a structure within the SS that can maintain the venous blood flow despite the dural wall might be considered an anatomical variation. The greater thickness of the inferior wall of the SS compared with the lateral walls is mainly due to the presence of larger amounts of tissues other than collagen. Delamination of the inferior wall of the SS was mostly possible in its inferior wall, but an attempt to delaminate the lateral walls is not recommended. Ultrastructural assessment corroborated a recent report of the presence of muscle fibers in the inferior wall of the SS.