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Arslan M. - One of the best experts on this subject based on the ideXlab platform.
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Emissary veins prevalence and evaluation of the relationship between Dural Venous sinus anatomic variations with posterior fossa emissary veins: MR study
'Springer Science and Business Media LLC', 2019Co-Authors: Gulmez Cakmak P., Ufuk F., Yagci A.b., Sagtas E., Arslan M.Abstract:Purpose: The aim of this study was to find the prevalence of emissary veins and to compare the visibility of these emissary veins with the anatomic variations of the Dural Venous Sinuses detected in magnetic resonance venography (MRV). Materials and methods: All MR images of two hundred twenty patients were evaluated retrospectively. Posterior cranial fossa emissary veins diameter measurements were performed in the axial plane. The anatomic variations of the Venous Sinuses in MRVs of all patients were recorded. Accordingly, the presence of the emissary veins was compared with the Dural Venous sinus anatomic variations. p < 0.05 was considered statistically significant. An inter-observer reliability analysis was performed. Results: The prevalence of emissary veins in MRI was found in the right mastoid emissary vein (MEV) 82.7% and left MEV 81.4%. Occipital emissary vein (OEV) was present in 63 patients (28.6%) for the first radiologist (R1), and it was present in 61 patients (27.7%) for the second radiologist (R2) (K = 0.978). A statistically significant correlation was detected between the diameter of the left MEV and gender (p < 0.05) for both radiologists. There was a statistically significant difference between the left MEV and OEV and transverse sinus anatomic variations. Conclusion: MR imaging is a noninvasive and irradiating imaging method for detecting posterior fossa major emissary veins, and we recommend using MR imaging for preoperative evaluation of posterior fossa major emissary veins and related Dural Venous Sinuses. © 2019, Italian Society of Medical Radiology
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Emissary veins prevalence and evaluation of the relationship between Dural Venous sinus anatomic variations with posterior fossa emissary veins: MR study.
'Springer Science and Business Media LLC', 2019Co-Authors: Gulmez Cakmak Pauid- Orcid: 0000-0003-4652-6748, Ufuk F., Sagtas E., Arslan M.Abstract:PURPOSE: The aim of this study was to find the prevalence of emissary veins and to compare the visibility of these emissary veins with the anatomic variations of the Dural Venous Sinuses detected in magnetic resonance venography (MRV). MATERIALS AND METHODS: All MR images of two hundred twenty patients were evaluated retrospectively. Posterior cranial fossa emissary veins diameter measurements were performed in the axial plane. The anatomic variations of the Venous Sinuses in MRVs of all patients were recorded. Accordingly, the presence of the emissary veins was compared with the Dural Venous sinus anatomic variations. p < 0.05 was considered statistically significant. An inter-observer reliability analysis was performed. RESULTS: The prevalence of emissary veins in MRI was found in the right mastoid emissary vein (MEV) 82.7% and left MEV 81.4%. Occipital emissary vein (OEV) was present in 63 patients (28.6%) for the first radiologist (R1), and it was present in 61 patients (27.7%) for the second radiologist (R2) (K = 0.978). A statistically significant correlation was detected between the diameter of the left MEV and gender (p < 0.05) for both radiologists. There was a statistically significant difference between the left MEV and OEV and transverse sinus anatomic variations. CONCLUSION: MR imaging is a noninvasive and irradiating imaging method for detecting posterior fossa major emissary veins, and we recommend using MR imaging for preoperative evaluation of posterior fossa major emissary veins and related Dural Venous Sinuses
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veins: MR study
'Springer Science and Business Media LLC', 2019Co-Authors: Pg Cakmak, Ufuk F., Sagtas E., Ab Yagci, Arslan M.Abstract:PurposeThe aim of this study was to find the prevalence of emissary veins and to compare the visibility of these emissary veins with the anatomic variations of the Dural Venous Sinuses detected in magnetic resonance venography (MRV).Materials and methodsAll MR images of two hundred twenty patients were evaluated retrospectively. Posterior cranial fossa emissary veins diameter measurements were performed in the axial plane. The anatomic variations of the Venous Sinuses in MRVs of all patients were recorded. Accordingly, the presence of the emissary veins was compared with the Dural Venous sinus anatomic variations. p
Bryan Pukenas - One of the best experts on this subject based on the ideXlab platform.
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thrombosis of posterior condylar vein with extension to internal jugular vein a rare radiological finding in traumatic brain injury
Surgical Neurology International, 2015Co-Authors: Seyed Ali Nabavizadeh, Ashkan Mowla, Aaron Bress, Bryan PukenasAbstract:Dear Editor, The posterior condylar canal is located posterior to the occipital condyle and transmits the posterior condylar vein, one of the largest emissary veins in the retromastoid region.[1,6] This vein usually origins from superior bulb of the internal jugular vein or less frequently from the medial side of the distal portion of the sigmoid sinus and connect to the suboccipital Venous plexus.[5,9] We report a patient with occipital bone fracture coursing through the posterior condylar canal causing thrombosis of posterior condylar vein with extension to internal jugular vein. To the best of our knowledge, thrombosis of posterior condylar vein with subsequent extension to major Venous Sinuses due to trauma has not been reported yet. A 50-year-old patient was brought to the emergency department following a fall from 15 steps. Initial head computed tomography (CT) scan demonstrated bilateral inferior frontal hemorrhagic contusions, traumatic subarachnoid hemorrhage in bilateral frontal and right temporal lobe, and linear occipital bone fracture extending to the posterior condylar vein on the right side. There was no extension of fracture line to the major Dural Venous Sinuses. Subsequent CT venography (CTV) demonstrated thrombosis of right posterior condylar vein with extension to upper aspect of right internal jugular vein causing nonocclusive thrombosis [Figure 1]. Given the presence of hemorrhagic brain contusions and nonocclusive nature of thrombosis in the internal jugular vein, patient was not considered an appropriate candidate for anticoagulation and was managed conservatively. Follow-up CTV in 48 h demonstrated stable thrombosis with no extension. Figure 1 Axial CT scan demonstrates linear occipital bone fracture with extension to the right posterior condylar canal (a white arrow). Axial and sagittal oblique CT Venogram (b and c) demonstrate right condylar vein thrombosis (white arrow) with extension to ... Emissary veins connect the extracranial Venous system with the intracranial Venous Sinuses. Although they are usually small in healthy people, they may enlarge in patients with increased intracranial pressure, in patients with high-flow vascular malformations or severe hypoplasia/aplasia or obstruction of the jugular veins. They may also serve as a conduit for retrograde spread of infection or tumors. Familiarity with major posterior fossa emissary veins is important to avoid misdiagnosis as abnormal findings and also to prevent surgical complications, which can result in intracranial hemorrhage, air embolism, and fatal increases in intracranial pressure.[7] The role of traumatic close head injuries as an important etiology of cerebral Venous sinus thrombosis has been demonstrated in multiple studies.[2] Extension of skull fractures to Venous Sinuses had been reported in 10.4% and 13% of patients in two recent large studies.[3,8] Delgado Almandoz et al. demonstrated traumatic Dural sinus thrombosis in 40.7% of patients with blunt head trauma with skull fractures extending to Dural Venous Sinuses or jugular bulb, and more than half of those were occlusive.[3] In a more recent study, Rivkin et al. found thrombosis of at least one Venous sinus or jugular bulb in 34.9% of patients (20.6% nonocclusive, 14.3% occlusive).[8] Fujii et al. also evaluated 97 patients with skull fractures crossing Venous Sinuses and found 22.4% of them to have thrombosis.[4] The indication for performing CTV in all of these studies was extension of skull fracture line to the major Dural Sinuses including superior sagittal sinus, transverse sinus, sigmoid sinus, or jugular bulb, and, to the best of our knowledge, traumatic thrombosis of posterior condylar vein with subsequent extension to major Venous Sinuses has not been reported yet. Development of Venous sinus thrombosis in the setting of blunt trauma can result in poor clinical outcome resulting from multiple neurological complications including increased intracranial pressure, hemorrhagic Venous infarctions, and increase in seizure frequency, with mortality rates as high as 50% for occlusive Venous thrombosis.[3,4,8] Treatment of Dural Venous sinus thrombosis in the setting of trauma might be very challenging and only a small minority of patients with occlusive Venous sinus thrombosis has been reported in prior studies.[3] In conclusion, in the setting of blunt head trauma, extension of the fracture lines to the posterior condylar canal can cause condylar vein thrombosis with secondary extension to major Dural Venous Sinuses. Increase in awareness of this anatomical structure and routine CTV when there is extension of skull fracture line to the major Dural Sinuses is important for appropriate diagnosis.
Donato Pacione - One of the best experts on this subject based on the ideXlab platform.
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postoperative cerebral Venous sinus thrombosis in the setting of surgery adjacent to the major Dural Venous Sinuses
Journal of Neurosurgery, 2019Co-Authors: Carolina Benjamin, Sean O Mcmenomey, Rajeev Sen, John G Golfinos, Chandra N Sen, Thomas J Roland, Donato PacioneAbstract:OBJECTIVECerebral Venous sinus thrombosis (CVST) is a known complication of surgeries near the major Dural Venous Sinuses. While the majority of CVSTs are asymptomatic, severe sinus thromboses can have devastating consequences. The objective of this study was to prospectively evaluate the true incidence and risk factors associated with postoperative CVST and comment on management strategies.METHODSA prospective study of 74 patients who underwent a retrosigmoid, translabyrinthine, or suboccipital approach for posterior fossa tumors, or a supratentorial craniotomy for parasagittal/falcine tumors, was performed. All patients underwent pre- and postoperative imaging to evaluate sinus patency. Demographic, clinical, and operative data were collected. Statistical analysis was performed to identify incidence and risk factors.RESULTSTwenty-four (32.4%) of 74 patients had postoperative MR venograms confirming CVST, and all were asymptomatic. No risk factors, including age (p = 0.352), BMI (p = 0.454), sex (p = 0.955), surgical approach (p = 0.909), length of surgery (p = 0.785), fluid balance (p = 0.943), mannitol use (p = 0.136), tumor type (p = 0.46, p = 0.321), or extent of resection (p = 0.253), were statistically correlated with thrombosis. All patients were treated conservatively, with only 1 patient receiving intraVenous fluids. There were no instances of Venous infarctions, hemorrhages, or neurological deficits. The rate of CSF leakage was significantly higher in the thrombosis group than in the nonthrombosis group (p = 0.01).CONCLUSIONSThis prospective study shows that the radiographic incidence of postoperative CVST is higher than that previously reported in retrospective studies. In the absence of symptoms, these thromboses can be treated conservatively. While no risk factors were identified, there may be an association between postoperative CVST and CSF leak.
Sean O Mcmenomey - One of the best experts on this subject based on the ideXlab platform.
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postoperative cerebral Venous sinus thrombosis in the setting of surgery adjacent to the major Dural Venous Sinuses
Journal of Neurosurgery, 2019Co-Authors: Carolina Benjamin, Sean O Mcmenomey, Rajeev Sen, John G Golfinos, Chandra N Sen, Thomas J Roland, Donato PacioneAbstract:OBJECTIVECerebral Venous sinus thrombosis (CVST) is a known complication of surgeries near the major Dural Venous Sinuses. While the majority of CVSTs are asymptomatic, severe sinus thromboses can have devastating consequences. The objective of this study was to prospectively evaluate the true incidence and risk factors associated with postoperative CVST and comment on management strategies.METHODSA prospective study of 74 patients who underwent a retrosigmoid, translabyrinthine, or suboccipital approach for posterior fossa tumors, or a supratentorial craniotomy for parasagittal/falcine tumors, was performed. All patients underwent pre- and postoperative imaging to evaluate sinus patency. Demographic, clinical, and operative data were collected. Statistical analysis was performed to identify incidence and risk factors.RESULTSTwenty-four (32.4%) of 74 patients had postoperative MR venograms confirming CVST, and all were asymptomatic. No risk factors, including age (p = 0.352), BMI (p = 0.454), sex (p = 0.955), surgical approach (p = 0.909), length of surgery (p = 0.785), fluid balance (p = 0.943), mannitol use (p = 0.136), tumor type (p = 0.46, p = 0.321), or extent of resection (p = 0.253), were statistically correlated with thrombosis. All patients were treated conservatively, with only 1 patient receiving intraVenous fluids. There were no instances of Venous infarctions, hemorrhages, or neurological deficits. The rate of CSF leakage was significantly higher in the thrombosis group than in the nonthrombosis group (p = 0.01).CONCLUSIONSThis prospective study shows that the radiographic incidence of postoperative CVST is higher than that previously reported in retrospective studies. In the absence of symptoms, these thromboses can be treated conservatively. While no risk factors were identified, there may be an association between postoperative CVST and CSF leak.
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Dural arterioVenous fistula of the anterior condylar confluence and hypoglossal canal mimicking a jugular foramen tumor case report
Journal of Neurosurgery, 2008Co-Authors: Sean O Mcmenomey, James K Liu, Kelly B Mahaney, Stanley L Barnwell, Johnny B DelashawAbstract:The anterior condylar confluence (ACC) is located on the external orifice of the canal of the hypoglossal nerve and provides multiple connections with the Dural Venous Sinuses of the posterior fossa, internal jugular vein, and the vertebral Venous plexus. Dural arterioVenous fistulas (DAVFs) of the ACC and hypoglossal canal (anterior condylar vein) are extremely rare. The authors present a case involving an ACC DAVF and hypoglossal canal that mimicked a hypervascular jugular bulb tumor. This 53-year-old man presented with right hypoglossal nerve palsy. A right pulsatile tinnitus had resolved several months previously. Magnetic resonance imaging demonstrated an enhancing right-sided jugular foramen lesion involving the hypoglossal canal. Cerebral angiography revealed a hypervascular lesion at the jugular bulb, with early Venous drainage into the extracranial vertebral Venous plexus. This was thought to represent either a glomus jugulare tumor or a DAVF. The patient underwent preoperative transarterial embolization followed by surgical exploration via a far-lateral transcondylar approach. At surgery, a DAVF was identified draining into the ACC and hypoglossal canal. The fistula was surgically obliterated, and this was confirmed on postoperative angiography. The patient's hypoglossal nerve palsy resolved. Dural arterioVenous fistulas of the ACC and hypoglossal canal are rare lesions that can present with isolated hypoglossal nerve palsies. They should be included in the differential diagnosis of hypervascular jugular bulb lesions. The authors review the anatomy of the ACC and discuss the literature on DAVFs involving the hypoglossal canal.
Seyed Ali Nabavizadeh - One of the best experts on this subject based on the ideXlab platform.
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thrombosis of posterior condylar vein with extension to internal jugular vein a rare radiological finding in traumatic brain injury
Surgical Neurology International, 2015Co-Authors: Seyed Ali Nabavizadeh, Ashkan Mowla, Aaron Bress, Bryan PukenasAbstract:Dear Editor, The posterior condylar canal is located posterior to the occipital condyle and transmits the posterior condylar vein, one of the largest emissary veins in the retromastoid region.[1,6] This vein usually origins from superior bulb of the internal jugular vein or less frequently from the medial side of the distal portion of the sigmoid sinus and connect to the suboccipital Venous plexus.[5,9] We report a patient with occipital bone fracture coursing through the posterior condylar canal causing thrombosis of posterior condylar vein with extension to internal jugular vein. To the best of our knowledge, thrombosis of posterior condylar vein with subsequent extension to major Venous Sinuses due to trauma has not been reported yet. A 50-year-old patient was brought to the emergency department following a fall from 15 steps. Initial head computed tomography (CT) scan demonstrated bilateral inferior frontal hemorrhagic contusions, traumatic subarachnoid hemorrhage in bilateral frontal and right temporal lobe, and linear occipital bone fracture extending to the posterior condylar vein on the right side. There was no extension of fracture line to the major Dural Venous Sinuses. Subsequent CT venography (CTV) demonstrated thrombosis of right posterior condylar vein with extension to upper aspect of right internal jugular vein causing nonocclusive thrombosis [Figure 1]. Given the presence of hemorrhagic brain contusions and nonocclusive nature of thrombosis in the internal jugular vein, patient was not considered an appropriate candidate for anticoagulation and was managed conservatively. Follow-up CTV in 48 h demonstrated stable thrombosis with no extension. Figure 1 Axial CT scan demonstrates linear occipital bone fracture with extension to the right posterior condylar canal (a white arrow). Axial and sagittal oblique CT Venogram (b and c) demonstrate right condylar vein thrombosis (white arrow) with extension to ... Emissary veins connect the extracranial Venous system with the intracranial Venous Sinuses. Although they are usually small in healthy people, they may enlarge in patients with increased intracranial pressure, in patients with high-flow vascular malformations or severe hypoplasia/aplasia or obstruction of the jugular veins. They may also serve as a conduit for retrograde spread of infection or tumors. Familiarity with major posterior fossa emissary veins is important to avoid misdiagnosis as abnormal findings and also to prevent surgical complications, which can result in intracranial hemorrhage, air embolism, and fatal increases in intracranial pressure.[7] The role of traumatic close head injuries as an important etiology of cerebral Venous sinus thrombosis has been demonstrated in multiple studies.[2] Extension of skull fractures to Venous Sinuses had been reported in 10.4% and 13% of patients in two recent large studies.[3,8] Delgado Almandoz et al. demonstrated traumatic Dural sinus thrombosis in 40.7% of patients with blunt head trauma with skull fractures extending to Dural Venous Sinuses or jugular bulb, and more than half of those were occlusive.[3] In a more recent study, Rivkin et al. found thrombosis of at least one Venous sinus or jugular bulb in 34.9% of patients (20.6% nonocclusive, 14.3% occlusive).[8] Fujii et al. also evaluated 97 patients with skull fractures crossing Venous Sinuses and found 22.4% of them to have thrombosis.[4] The indication for performing CTV in all of these studies was extension of skull fracture line to the major Dural Sinuses including superior sagittal sinus, transverse sinus, sigmoid sinus, or jugular bulb, and, to the best of our knowledge, traumatic thrombosis of posterior condylar vein with subsequent extension to major Venous Sinuses has not been reported yet. Development of Venous sinus thrombosis in the setting of blunt trauma can result in poor clinical outcome resulting from multiple neurological complications including increased intracranial pressure, hemorrhagic Venous infarctions, and increase in seizure frequency, with mortality rates as high as 50% for occlusive Venous thrombosis.[3,4,8] Treatment of Dural Venous sinus thrombosis in the setting of trauma might be very challenging and only a small minority of patients with occlusive Venous sinus thrombosis has been reported in prior studies.[3] In conclusion, in the setting of blunt head trauma, extension of the fracture lines to the posterior condylar canal can cause condylar vein thrombosis with secondary extension to major Dural Venous Sinuses. Increase in awareness of this anatomical structure and routine CTV when there is extension of skull fracture line to the major Dural Sinuses is important for appropriate diagnosis.
