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Cranial burr hole
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
The flat calvarial cranium bone formed by membranous ossification has three layers: the inner table and outer table with a diploic space interposed between the two tables. First, both tables are made up of compact cancellous bone, whereas the diploic space is made up of spongy bone. Second, the diploic space is aerated at places forming air sinuses and at places it is absent like in suture lines. It contains diploic veins, which communicate with the extracalvarial emissary veins. Bleeding from diploic vessels may arise at the time of traversing the skull bone during burr hole surgery. And, opening of diploic veins communicating to the major venous sinuses may lead to air embolism.2
Extradural Haematoma
Published in Sunjay Parmar, Pamela Shaw, Neurology, 2017
Pathophysiology (seen in 85% of cases): pterion fracture → rupture of MMA → rapid expansion under systemic arterial pressure within the dural space (between the periosteal dural layer and the meningeal dural layer). If large enough → risk of herniation (usually uncal). Remainder of cases are due to bleeding from middle meningeal veins, dural sinus or bone/diploic veins
Head
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
Between the inner and outer tables of the bones of the skull vault lie trabecular bone, termed diploe, which contains red bone marrow. This is highly vascular and a common site for blood-borne metastatic tumour deposits and multiple myeloma. Diploic veins (see (8) on page 20) occupy channels in this trabecular bone. These are absent at birth but begin to appear at about 2 years of age. They are large and thin-walled, being merely endothelium supported by elastic tissue, and they communicate with meningeal veins, dural sinuses and the pericranial veins. Radiographically they may appear as relatively transparent bands 3–4 mm in diameter.
Acute subperiosteal orbital haematoma following general anaesthesia in the setting of recent trauma
Published in Orbit, 2022
Daniel T. Hogarty, Elad Ben Artsi, Brandon Thia, Robin Meusemann, Brent Gaskin
The pathophysiology of SOH involves bleeding within the potential space between the periosteum and orbital bone. This periosteum is normally loosely attached except around the orbital fissures, optic canal, arcus marginalis, suture lines, and foramina.2 A loose attachment has been postulated to be more prominent in younger patients.3,4 The potential space between the periosteum and orbital bone is traversed by a number of small diploic vessels that are part of the valveless orbital venous system that has the potential to transmit transient elevations in central venous pressure or intracranial pressure.2,5 Rupture of these diploic veins is the likely source of bleeding. SOH most commonly occurs in the superior orbit, as this area has the largest section of periosteum without firm adhesions.2
Posttraumatic subgaleal herniation of an intracranial cerebral arterial segment
Published in Baylor University Medical Center Proceedings, 2019
Manav Bhalla, John L. Ulmer, Andrew P. Klein, Kieran E. McAvoy, Namrata M. Bhalla
Arteries in the subgaleal space are, however, beyond the current spatial resolution of CTA. Diploic veins are thin-walled venous channels located between the inner and outer tables of the skull, which communicate with dural sinuses and pericranial veins through the meningeal and emissary veins, respectively. Unless developmentally large, diploic veins are often not delineated on CTA or DSA.2 The scalp veins communicate with the diploic veins and superior sagittal sinus through the posterior parietal emissary veins and the transverse sinus through the mastoid veins. There should be no CTA-identifiable venous channel seen in the subgaleal space.
Severe Intraoperative Orbital Venous Congestion during Resection of a Frontal Meningioma Presenting with Post-operative Vision Loss and Ophthalmoplegia: A Case Report
Published in Neuro-Ophthalmology, 2019
Victoria Leung, Ari Aharon Shemesh, Laila Al Shafai, Timo Krings, Taufik Valiante, Edward Margolin
We propose that all convexity meningiomas associated with dilated diploic veins on routine pre-operative imaging should be further evaluated with pre-operative computed tomography angiography and venography in order to evaluate the tumour’s vascular supply and outflow. In cases where vascular communication between the tumour and surrounding structures is demonstrated, pre-operative embolisation should be considered in order to reduce the pressure flow within the tumour. This may assist in preventing tissue damage caused by unanticipated redirection of high flow venous drainage from the tumour into adjacent structures.