China
Africa
Explore chapters and articles related to this topic
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The history and CT findings are suggestive of venous sinus thrombosis. This most commonly affects the superior sagittal sinus, leading to bilateral parasagittal infarcts. Thrombus in the straight sinus or vein of Galen may lead to basal ganglia infarcts. Infarct affecting the temporal lobe could be secondary to a transverse or sigmoid sinus thrombus or thrombus in the vein of Labbe. CT or MR venogram is the next best investigation, depending on availability. MRI will show loss of normal flow venous voids in the area of thrombosis. MRV sequences (either time-of-flight or post gadolinium) will show filling defects in the affected vein. Asymmetrical hypoplastic transverse and sigmoid sinuses can be misleading. Remember to look at the jugular foramen; if it is also small it can help to distinguish between the two.
Anatomy of veins and lymphatics
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
The superficial system of superior, superficial middle and inferior cerebral veins drains the cerebral cortex to the midline superior sagittal sinus. The deep system drains to the midline great cerebral vein of Galen which joins the inferior sagittal sinus to form the straight sinus. The cavernous sinus drains the ophthalmic veins and lies on either side of the sella turcica, and from here blood returns to the internal jugular vein through the superior and inferior petrosal sinuses, then the transverse sinus.
Head, neck and vertebral column
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Venous sinuses - veins within the skull formed by a double layer of dura mater normally located where dural folds meet the bones of the skull (Figs.3.1, 3.3, 3.4). The superior sagittal sinus (in the superior edge of the falx cerebri) runs posteriorly below the midline of the cranial vault to the confluence of sinuses. Most of the blood normally flows to the right, becoming the right transverse sinus, which in turn runs down as the right sigmoid sinus to pass through the jugular foramen on the right and emerging inferior to the skull as the right internal jugular vein. The straight sinus receives the inferior sagittal sinus (lying in the lower edge of the falx cerebri) and the great cerebral vein and runs posteriorly to the confluence of sinuses at the junction of the falx cerebri and tentorium cerebelli. Most of this blood normally flows to the left as the left transverse sinus, which continues as the left sigmoid sinus and, via the left jugular foramen, becomes the left internal jugular vein. The paired cavernous sinuses lie on either side of the pituitary gland and body of the sphenoid bone.
Malignant cerebral edema after cranioplasty: a case report and literature review
Published in Brain Injury, 2023
Shaoxiong Wang, Yongxin Luan, Tao Peng, Guangming Wang, Lixiang Zhou, Wei Wu
Cerebral venous pressure after cranioplasty was less affected by atmospheric pressure, which was beneficial to the recovery of cerebrospinal fluid circulation and the absorption of intracranial fluid (22). But the patient died 24 hours after cranioplasty in the present case. The possible reason is that the position of the patient’s skull defect is close to the parieto-occipital. The size of the skull defect is about 121.2 mm*82.9 mm, and it was past the superior sagittal sinus. Before cranioplasty, there was a subdural hydrogen in the parieto-occipital on the right side. Cranioplasty relieved the compression of subdural hydrogen on the brain tissue, and eliminated the long-term atmospheric pressure exerted on the patient’s damaged and atrophied brains, and the negative pressure suction of the epidural was performed to make the epidural a negative pressure environment at the end of the cranioplasty, resulting in the intracranial production from the left. The pressure gradient from the lateral cerebral hemisphere to the surgery area promoted the displacement of the brain tissue to the surgery area. The draining veins of brain tissue might be blocked due to the exposure of the superior sagittal sinus to negative pressure, and the intracranial venous pressure difference might be reduced due to transient negative pressure in the brain, which affected the centripetal return of cerebral venous blood. Intracranial blood flow regulation was disordered, which in turn led to malignant cerebral edema and enhanced intracranial pressure.
Surgical outcomes and prognostic factors of parasagittal meningioma: a single-center experience 165 consecutive cases
Published in British Journal of Neurosurgery, 2022
Bo Wang, Gui-Jun Zhang, Zhen Wu, Jun-Ting Zhang, Pi-Nan Liu
Reconstruction of the superior sagittal sinus is one of the critical steps in successful operation. Many techniques and materials for repair and vein grafting of the sagittal sinus have been proposed. In our cases, autologous tissue was acceptable as repair material at the preferred source, such as adjacent autologous periosteum, autologous temporalis fascia, and autologous cerebral falx. Additionally, adequate resources were more readily available, lower economic burden, and better histocompatibility compared with artificial materials.11 If a relatively small area wall of the sinus was invaded (type III), repair with a patch of adjacent free autologous periosteum was recommended. If a relatively large area wall of the sinus was invasive (type IV), repair with a patch of reversal cerebral falx was proposed. The latter was more concise and facilitated to a short operation period. Temporary haemostasis of the sinus was easily achieved by temporarily plugging wet cotton strips, temporary vascular clamps, and aneurysm clips were avoided because of their propensity to crush the sinus walls. After the reconstruction of the superior sagittal sinus, verifying the patency of the superior sagittal sinus was an indispensable step. Although indocyanine green video angiography has been used for identification,11 patients are still at risk of delayed cerebral venous infarction during the week following surgery. Intermediate MRI examination of patients was helpful in the timely discovery of infarct.
Postoperative Focal Lower Extremity Supplementary Motor Area Syndrome: Case Report and Review of the Literature
Published in The Neurodiagnostic Journal, 2021
Nicholas B. Dadario, Joanna K. Tabor, Justin Silverstein, Xiaonan R. Sun, Randy S. DAmico
Surgical resection during stage II proceeded without complication. The entirety of the left frontal region as well as a portion of the involved superior sagittal sinus was resected. Again, the lateral and inferior and posterior margins of the tumor were noted to have infiltrated the pia arachnoid of the underlying brain. These regions were carefully resected. The patient awoke with mild language deficits including persistent repetition, paraphasic errors and word finding difficulty which resolved prior to discharge. Post-operative brain MRI demonstrated resection of the bifrontal disease with known residual within the posterior superior sagittal sinus. The diffusion-weighted images demonstrated multiple punctate areas of diffusion abnormality within the high frontal and parietal lobes with corresponding ADC drop-off compatible with mild ischemic changes or devitalized tissue along the regions of brain invasion. Post-operative MRI of the lumbar spine confirmed no spinal pathology capable of producing an isolated foot drop. Post-operative EEG again demonstrated no focal seizure activity although the patient did suffer post-operative epileptiform events involving speech arrest ultimately controlled on anticonvulsants. His left foot began functioning on approximately post-operative day 7 with initial extensor hallucis longus movement progressing to dorsiflexion and plantarflexion abilities prior to discharge on post-operative day 11.