Atresia of the rostral superior sagittal sinus: Associated cerebral venous patterns

Abstract

Summary. It has been accepted generally that the superior sagittal sinus takes origin at the foramen caecum. While this obtains in a few, 58 per cent of the cadaver specimens examined have a one-to-three centimeter atresia of the most rostral end of the sinus. In these the veins of the frontal poles of the brain were directed medially and caudally to join in the midline, thus establishing the lumen of the sinus. In instances of more extensive atresia, the anterior superior cerebral veins, as well as those from the infero-mesial poles, all course medially and caudally to form the sinus. In other words, the longer the atretie segment, the more striking the change in venous patterns oi the superior and mesial frontal lobes of the brain. Atresie du sinus rostral sagittal superieur avec signes veneux cerebraux associesRgsumd. On admet g@ndralement que le sinus sagittal supdrieur nait dans le foramen caecum. Mais 58% des cadavres examinds pr@sentaient une atrdsie de 1~ 3 cm de l'extrdmit@ la plus rostrale du sinus. Dans ees eas, les veines des p61es frontaux du cerveau se dirigeaient vers le milieu et le bas pour se joindre sur la ligne mddiane, formant lc lument du sinus. En eas d'atr6sie plus dtendue, les veines c6rgbrales antdro-sup6rieures et les veines des p61es inf@ro-mddians sent mddianes et se dirigent vers l'arrigre pour former le sinus. En d'autres termes, plus l'atrgsie est @tendue, plus les modifications des veines sent importantes sur les parties sup@rieures et m@dio-frontales du cerveau. Atresie des rostralen Abschnitts des Sinus sagittalis superior: die dabei bestehenden Venen.MusterZusammenfassung. Bei einer Atresie des rostralen Sinus-Abschnitts, die mehr oder weniger ausgepr~gt sein kann, kommt es zu einer bestimmten Ver~nderung des ven6sen Abitusses im Bereich der Frontallappen.Neuroradiologists have made significant advances by angiography in the demonstration and interpretation of vascular anomalies of the central nervous system and its meningeal coverings. In cooperation with neurologists and neurosurgeons, clinical syndromes resulting from these malformations have been delineated. Less attention has been accorded some of the variations in venous patterns of the frontal brain and its overlying meninges associated with failure of development of the rostral superior sagittal sinus. This may stem, in part, from the incompleteness of filling of the venous system during angiography or, more likely, from the lack of awareness of these anatomical variabilities.

Unilateral Hypoplasia of the Rostral End of the Superior Sagittal Sinus

“…12 The most frequently reported variation of the SSS after preferential damage to 1 of the transverse sinuses, is hypoplasia of its rostral third. 2,3 In the most extensive form of rostral hypoplasia, the SSS takes its origin in the vicinity of or at the coronal suture. 2 In such instances, a rudimentary rostral segment may occasionally be documented by DSA, CTV, or MR venography, though no cortical or meningeal tributaries of this hypoplastic segment can usually be demonstrated by radiologic means.…”

“…2,3 In the most extensive form of rostral hypoplasia, the SSS takes its origin in the vicinity of or at the coronal suture. 2 In such instances, a rudimentary rostral segment may occasionally be documented by DSA, CTV, or MR venography, though no cortical or meningeal tributaries of this hypoplastic segment can usually be demonstrated by radiologic means. The distinction between hypoplastic rostral SSS and thrombosis of the anterior third of the SSS relies on the demonstration of prominent bilateral superior frontal veins that follow a parasagittal course running from the pole of the frontal lobes to the origin of the SSS at the coronal suture.…”

“…In cases of complete hypoplastic rostral SSS, the absent rostral portion of the SSS is replaced by a pair of large parasagittal superior frontal cortical veins that run dorsally to join the origin of the SSS close to the coronal suture. 2,3 The purpose of the present study was to report the existence of a unilateral hypoplastic rostral SSS, which, to the best of our knowledge, has not been previously documented. The potential clinical implications of the variant and its embryologic origin are discussed.…”

“…Dural sinus anomalies most frequently involve the transverse sinuses, 1 though other venous sinuses, such as the SSS, are commonly involved as well. Hypoplasia of the rostral third of the SSS is a frequent variation, 2 second only to preferential drainage of the SSS into either of the transverse sinuses. In cases of complete hypoplastic rostral SSS, the absent rostral portion of the SSS is replaced by a pair of large parasagittal superior frontal cortical veins that run dorsally to join the origin of the SSS close to the coronal suture.…”

Microsurgery of tumours of the frontal white matter

“…2 B and C show a hypoplastic anterior cerebral artery on the left side; in this case the bilateral territory of the anterior cerebral artery is supplied by the right anterior cerebral artery, the latter being located in the median fissure above the corpus callosum and supplying several branches to both sides of the frontal lobes. One has to reckon, upon this relatively common variation in operative procedures 4.18, a7.4s, 49, 69 There are also numerous variations of the branching of the calloso-marginal artery 39 The beginning of the anterior cerebral artery in the medio-basal section of the frontal lobe has anatomical correlations with the rostrum corporis callosi, the Septum pellucidum and cranial nerves I and II (Fig, 2 C). The operative procedure has to be adapted to the branching of the perforating arteries to the diencephalon and to the optic nerve region 6, 26, 38 The section placed through the anterior third of the corpus callosum, marked by point S in Fig.…”