Cardona JJ, Iwanaga J, Chaiyamoon A, Wang AR, Nickele CM, Amans MR, Heiferman DM, Johnson KD, Dumont AS, Tubbs RS
Abstract
Cerebral vein and dural venous sinus thromboses (CVST) account for 0.5%-1% of all strokes. Some structural factors associated with a potentially higher risk for developing CVST have been described. However, angulation of the dural venous sinuses (DVS) has yet to be studied as a structural factor. The current study was performed because this variable could be related to alterations in venous flow, thus predisposing to a greater risk of CVST development. Additionally, such information could help shed light on venous sinus stenosis (VSS) at or near the transverse-sigmoid junction. The angulations formed in the different segments of the grooves of the transverse (TS), sigmoid (SS), and superior sagittal sinuses (SSS) were measured in 52 skulls (104 sides). The overall angulation of the TS groove was measured using two reference points. Other variables were examined, such as the communication pattern at the sinuses' confluence and the sinus grooves' lengths and widths. The patterns of communication between sides were compared statistically. The most typical communication pattern at the sinuses' confluence was a right-dominant TS groove (82.98%). The mean angulations of the entire left TS groove at two different points (A and B) were 46 degrees and 43 degrees. Those of the right TS groove were 44 degrees and 45 degrees. The median angulations of the left and right SSS-transverse sinus junction grooves were 127 degrees and 124 degrees. The mean angulations of the left and right TS-SSJsv grooves were 111 degrees (range 82 degrees-152 degrees) and 103 degrees (range 79 degrees-130 degrees). Differentiating normal and abnormal angulations of the DVSs of the posterior cranial fossa can help to explain why some patients are more susceptible to pathologies affecting the DVSs, such as CVST and VSS. Future application of these findings to patients with such pathologies is now necessary to extrapolate our results.
