No abstract available.
Arachnoid ; Superior Sagittal Sinus

A case of calvarial cavernous hemangioma is presented. The tumor was located in the postero-parietal bone, which was expanded extra and intracranially. The tumor and the attached dura were excised en bloc after ligation of superior sagittal sinus which had been completely obstructed on angiography. The preoperative X-ray and operative findings are presented. The authors reviewed the previously reported cases.
Angiography ; Hemangioma, Cavernous* ; Ligation ; Superior Sagittal Sinus

A rare case of mixd pial and dural arteriovenovs malformation in the left frontal convexity is reported. This arteriovenous malformation is supplied from the left middle meningeal artery and small pial vessels and drained into the superior sagittal sinus. This arteriovenous malformation was totally excised without artificial emoblization of the left middle meningeal artery.
Arteriovenous Malformations* ; Meningeal Arteries ; Superior Sagittal Sinus

The author has performed the experimental study to define the validity of the constant infusion technique used in determining the outflow resistance(Ro) of cerebrospinal fluid(CSF). The reduced formula of the constant infusion technique in clinical setting assume that the initial resing Ro and the post-infusion equilibrium Ro are equal, which means that the Ro value is constant regardless of CSF pressure or infusion rate. Although this assumption allows such measurement to be simply and readily applicable in clinical situation, these two Ro values are practically different. So the effect such assumption on calculated Ro data has been investigated. Using 2 different methods Ro was measured simultaneously on each of 20 adult cats;one method was clinically using reduced formula(RoFc) and the other derived from the data of CSF formation rate which was calculated by modified Masserman's method(RoFm). Constant infusion was performed with varying state of infusion(0.01 to 0.2 m/min). Mean values of resting CSF pressure and superior sagittal sinus pressure were 8.8+/-2.9 mmHg and 5.7+/-1.2 mmHg respectively. Mean calculated rate of CSF formation of integrative modifiying Massereman method was 0.0183+/-0.003 ml/min. The maximum Ro was achieved between the rate of infusion of 0.02 and 0.03 ml/min achieved between the range of CSF pressure of 14 and 18 mmHg. Either in level of low CSF pressure or in rate of low infusion, RoFc showed remarkable higher values than RoFm. But this difference did not distinguished in the higher range of CSF pressure or infusion rate. The minmum and maxmum value of RoFc differed the more and RoFm, the less. These findings suggest that in order to obtain more accurate Ro data with constant infusion technique, it must be corrected in low range of CSF pressure or the rate of infusion should be increased several times as that of CSF formation at the risk of possibility of induction of a pressure wave.
Adult ; Cerebrospinal Fluid* ; Humans ; Superior Sagittal Sinus

In surgical planning of the parasagittal meningioma, invasion and occlusion of the superior sagittal sinus are important factors. When tumor is located within anterior 1/3, or when angiographic finding shows total occlusion of superior sagittal sinus, it is regarded that the ligation of superior sagittal sinus is safe. We report a case of parasagittal meningioma in 59-year-old male patient with complete occlusion of superior sagittal sinus which was confirmed by preoperative angiography, who developed temporary neurologic deterioration after superior sagittal sinus ligation and resection.
Angiography ; Humans ; Ligation ; Male ; Meningioma ; Middle Aged ; Superior Sagittal Sinus

OBJECTS: Although plenty of articles about microsurgical anatomy of the cerebral arteries exist in literatures, there is a few articles which studied the microsurgical anatomy of the cerebral venous system. To get the more accurate knowledge about microsurgical anatomy of the cerebral venous system related to the commonly used surgical approach route for cerebovascular lesions, this study is performed. MATERIAL AND METHODS: The author reviewed several articles which described about the anatomy of cerebral venous system, and selected some articles which studied the microsurgical anatomy of cerebral veins related to the area of the surgical approach routes for cerebrovascular lesions. General venous anatomy of lateral surface of cerebral hemisphere and the venous system related to the surgical approach route are described. RESULTS: The superficial cortical veins of lateral surface of cerebral hemisphere are divided into an ascending group, which drain into superior sagittal sinus, and a descending group, which drain into superficial sylvian veins or transverse sinus. Three anastomotic veins, such as the vein of Labbe, Trolard and the superficial sylvian veins, connect between superior sagittal sinus, veins along the sylvian fissure and transverse sinus. The anatomical knowledge of the sylvian and frontal basal veins, venous sinus around the superior sagittal sinus and medial frontal veins, and temporal basal veins are required in pterional, interhemispheric, and subtemporal approach respectively. CONCLUSION: The author concludes that the advancement of anatomical knowledge about cerebral venous system will contribute the improvement of outcome of surgically treated patients with cerebrovascular disease.
Cerebral Arteries ; Cerebral Veins ; Cerebrum ; Humans ; Superior Sagittal Sinus ; Veins

The anatomical pattern of the dural venous sinuses in the vicinity of their confluence was examinaed in 54 cases of human fetus. The classification introduced here by author was based upon the presence or absence of bifurcation of the superior sagittal and straight sinuses without regard to their sizes or to those of the transverse sinuses. Four types of pattern occurred;common pool type, double bifurcation type, straight sinus bifurcation type and superior sagittal sinus bifurcation type. In a total of 54 anatomical dissections, 28 cases(51.8%) were of the first type(common pool), 5 cases(9.3%) of the second(double bifurcation), 6 cases(11.1%) of the third(straight sinus bifurcation) and 15 cases(27.8%) of the fourth(superior sagittal sinus bifurcation) .
Classification ; Fetus ; Humans ; Superior Sagittal Sinus ; Transverse Sinuses

We report superior sagittal sinus thrombosis as a central nervous system presentation of Behcet's disease in a patient with peripheral vascular and enteric involvement. The main symptoms were headache and horizontal diplopia due to intracranial hypertension. T1-weighted MRI with gadolinium enhancement revealed a similar pattern of the "empty delta sign" that is usually seen on brain CT. A magnetic resonance venogram revealed filling defects resulting from the thrombosis. These features are helpful for the noninvasive diagnosis of sagittal sinus thrombosis.
Brain ; Central Nervous System ; Diplopia ; Gadolinium ; Headache ; Humans ; Intracranial Hypertension ; Magnetic Resonance Spectroscopy ; Sagittal Sinus Thrombosis ; Superior Sagittal Sinus ; Thrombosis

Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences.
Adult ; Hemorrhage ; Humans ; Infarction ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus* ; Thrombectomy* ; Thrombosis*

OBJECTIVE: Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. METHODS: Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. RESULTS: All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed > or =2 times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. CONCLUSION: Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route.
Cavernous Sinus ; Central Nervous System Vascular Malformations* ; Fistula ; Humans ; Meningeal Arteries ; Punctures ; Superior Sagittal Sinus