Combined treatment of surgery and sclerotherapy for sinus pericranii

Ryu, Jeong Yeop; Lee, Jong Ho; Lee, Joon Seok; Lee, Jeong Woo; Lee, Seok Jong; Lee, Jong Min; Lee, Sang Yub; Huh, Seung; Kim, Ji Yoon; Hwang, Seung-Hyun; Chung, Ho Yun

doi:10.7181/acfs.2019.00521

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…The whole brain angiography venous phase shows extracranial veins connected to the intracranial dural sinuses by dilated platysmal veins. [5][6][7] There are still no clear diagnostic criteria for the diagnosis of sinus pericranii. The diagnosis is usually clear based on typical clinical symptoms, signs and ancillary examinations, but it should be differentiated from the meningeal bulge, dermatomal cyst and epidermoid cyst.…”

Section: Discussionmentioning

confidence: 99%

Rapidly growing sinus pericranii within a short period: a case report

Sun

Wang

2023

Childs Nerv Syst

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Sinus pericranii (SP) is a rare vascular malformation characterized by an abnormal communication between the intracranial and extracranial venous systems. [1] Sinus pericranii are most commonly seen in the distribution areas of the superior sagittal and transverse sinuses. [2] There are no uniform criteria for the etiology, pathogenesis, diagnostic criteria, treatment options, or prognosis of Sinus pericranii. [3] In this paper, we present the diagnosis and treatment of a child admitted to our neurosurgery department in 2019 with rapidly growing frontal Sinus pericranii, as well as the 3-year postoperative follow-up. Authors summarize the clinical presentation characteristics, diagnosis and treatment methods, and prognosis of this disease using relevant domestic and international literature to improve clinicians' understanding of this disease. Case PresentationClinical Course We describe a case of SP in a 10-year-old girl who was noted to have a frontal scalp swelling at birth and signi cantly increased within six months. After the child was born, her parents noticed that the forehead swelling appeared when the child cried. The mass was peanut-sized, soft, with normal skin on its surface. When the child was quiet, it vanished on its own. In the past six months, the swelling was found to be rapidly growing, occasionally accompanied by headache and local tenderness, so the child came to our hospital for consultation. The child's parents denied any history of head trauma within the last decade.

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Section: Discussionmentioning

confidence: 99%

Rapidly growing sinus pericranii within a short period: a case report

Sun

Wang

2023

Childs Nerv Syst

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“…However, complications such as thromboembolic events, craniofacial pain, swelling and paralysis, and nasopharyngeal ulcers may occur due to intraoperative rupture of the pseudoaneurysm wall [ 12 ]. Also, the development of a new venous malformation region near the site of embolization can occur [ 13 ]. So, persistent follow-up through imaging is required.…”

Section: Discussionmentioning

confidence: 99%

Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report

Hwang

Kim

Choi

et al. 2021

Arch Craniofac Surg

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Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

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“…The management indications of SP are prevention of fatal thrombosis, traumatic air embolism, and spontaneous hemorrhage, in addition to a negative cosmetic appearance [10]. Direct surgery, endovascular surgery, and sclerotherapy have been used for the treatment of SP [3, 8, 15]. Endovascular surgery is performed via direct subcutaneous puncture or a transvenous approach [3].…”

Section: Discussionmentioning

confidence: 99%

“…The preoperative diagnosis of SP is based on color Doppler ultrasound (CDU), MRI, CT, and digital subtraction angiography (DSA) [1,3,[5][6][7]. Based on preoperative radiological findings, SP without normal venous circulation is called accessory type SP and can be managed with surgical treatment, endovascular treatment, or sclerotherapy [3,8]. Meanwhile, dominant type SP contributes to the major intracranial venous circulation.…”

Section: Introductionmentioning

confidence: 99%

A Simple Surgical Technique for Pediatric Sinus Pericranii: Intraoperative Manual Compression of a Major Shunting Point

et al. 2021

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Introduction: Sinus pericranii is a vascular anomaly with extra- and intracranial venous connections. Sinus pericranii is categorized into 2 groups according to its contribution to the normal venous circulation. The accessory type sinus pericranii, which does not contribute to the normal major venous circulation, can be managed. Despite several proposed operative maneuvers, a standardized technique is yet to be established to control intraoperative bleeding. Case Presentation: A 2-week-old neonate underwent examination of a subcutaneous mass in the parieto-occipital region. The subcutaneous mass had a major venous connection to the superior sagittal sinus on ultrasonography. The subcutaneous mass was partially thrombolized on magnetic resonance imaging and was minimally enhanced on computed tomography venography. The subcutaneous mass seemed not to contribute to the normal venous circulation. Surgical removal of the subcutaneous mass was performed due to its increased size at the age of 1 year and 3 months. While subcutaneous mass was detached from the scalp, the major venous connection was manually compressed, and minor venous connections were easily detected. The intraoperative bleeding was controllable. The pathological diagnosis was sinus pericranii. The patient is now followed up in the outpatient clinic. No recurrence was seen 18 months after the surgery. Discussion/Conclusion: Intraoperative hemostasis is essential while sinus pericranii is detached from the cranium. Hemostatic agents such as bone wax or absorbable gelatin and heat coagulation seem to be useful. However, complicative hemorrhage concerning to the preceded technique has been also reported. As seen in our case, to detect minor shunting points between the sinus pericranii and the intracranial veins, the major venous connection was manually compressed. Intraoperative manual compression of a major venous connection of sinus pericranii can be an option to manage intraoperative bleeding.

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Combined treatment of surgery and sclerotherapy for sinus pericranii

Cited by 8 publications

References 16 publications

Rapidly growing sinus pericranii within a short period: a case report

Rapidly growing sinus pericranii within a short period: a case report

Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report

A Simple Surgical Technique for Pediatric Sinus Pericranii: Intraoperative Manual Compression of a Major Shunting Point

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