The anatomical relation between the superior sagittal sinus and the sagittal suture with surgical considerations

Samadian, Mohammad; Nazparvar, Bashir; Haddadian, Karim; Rezaei, Omidvar; Khormaee, Fatemeh

doi:10.1016/j.clineuro.2010.09.006

Cited by 15 publications

(32 citation statements)

References 3 publications

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“…We found that the SSS was deviated to the right of the sagittal suture in 50% of cases at the bregma and in 46.7% of cases at the midpoint and lambda. Our findings are in agreement with the results from cadaveric studies [5,6], which showed displacement of the SSS to the right side in the majority of specimens, with the maximum deviation of 11 mm [5,6]. Together these results indicate that the 3D voxel-based neuronavigation with CT scans is comparable to cadaveric dissections in analyzing spatial relationships between anatomical structures.…”

Section: Discussionsupporting

confidence: 91%

“…The sagittal suture is regarded as an external landmark of the superior sagittal sinus (SSS) [1], although cadaveric studies show that the SSS is deviated to the right of the sagittal suture [5,6]. In this study, we used a neuronavigation system with 3D volumetric rendering of CT data to determine the spatial relationship between the sagittal suture and the SSS in patients with intracranial lesions.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and accuracy of a voxel-based neuronavigation system with 3D image rendering in preoperative planning and as a learning tool for young neurosurgeons, exemplified by the anatomical localization of the superior sagittal sinus

Feigl

Thaher

Danz

et al. 2019

Bosn J of Basic Med Sci

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It is essential for a neurosurgeon to know individual anatomy and the corresponding anatomical landmarks before starting a surgery. Continuous training, especially of young neurosurgeons, is crucial for understanding complex neuroanatomy. In this study, we used a neuronavigation system with 3D volumetric image rendering to determine the anatomical relationship between the sagittal suture and the superior sagittal sinus (SSS) in patients with intracranial lesions. Furthermore, we discussed the applicability of such system in preoperative planning, residency training, and research. The study included 30 adult patients (18 female/12 male) who underwent a cranial computed tomography (CT) scan combined with venous angiography, for preoperative planning. The position of the sagittal suture in relation to the SSS was assessed in 3D CT images using an image guidance system (IGS) with 3D volumetric image rendering. Measurements were performed along the course of the sagittal sinus at the bregma, lambda, and in the middle between these two points. The SSS deviated to the right side of the sagittal suture in 50% of cases at the bregma, and in 46.7% at the midpoint and lambda. The SSS was displaced to the left of the sagittal suture in 10% of cases at the bregma and lambda and in 13% at the midpoint. IGSs with 3D volumetric image rendering enable simultaneous visualization of bony surfaces, soft tissue and vascular structures and interactive modulation of tissue transparency. They can be used in preoperative planning and intraoperative guidance to validate external landmarks and to determine anatomical relationships. In addition, 3D IGSs can be utilized for training of surgical residents and for research in anatomy.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Feasibility and accuracy of a voxel-based neuronavigation system with 3D image rendering in preoperative planning and as a learning tool for young neurosurgeons, exemplified by the anatomical localization of the superior sagittal sinus

Feigl

Thaher

Danz

et al. 2019

Bosn J of Basic Med Sci

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“…This could be a limitation of the study. However, the distances found in control groups of other studies 8,16 were still less significant than the distances we found in the UCS group, making our results reliable.…”

Section: Discussioncontrasting

confidence: 55%

“…Samadian et al 16 found a maximum deviation of 10 mm, also to the right side. These studies were performed in cadaveric specimens without skull deformities or hyperostosis.…”

Section: Discussionmentioning

confidence: 99%

“…14 However, some authors have questioned this anatomical relationship, 6,16,19 and further studies are needed. The aim of the present study is 3-fold: 1) to study the position of the SSS in relation to the sagittal suture in 50 patients with UCS; 2) to compare this anatomical relationship between patients with UCS and 50 control children without craniosynostosis; and 3) to study the presence of extracerebral fluid collection and ventricular asymmetry in patients with UCS to see if there is a correlation with the degree of SSS displacement.…”

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confidence: 99%

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Unilateral coronal synostosis: can we trust the sagittal suture as a landmark for the underlying superior sagittal sinus?

Protzenko¹,

Arnaud²,

Brunelle³

et al. 2016

PED

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OBJECTIVE The sagittal suture is usually considered an external anatomical landmark, indicating the location of the superior sagittal sinus (SSS) for surgical approaches. Children with unilateral coronal synostosis (UCS) often present with an important deviation of the sagittal suture. Because these patients usually undergo frontal reconstruction or even endoscope-assisted minimally invasive procedures, it is imperative to know the location of the SSS. The aim of this investigation was to study the anatomical relationship between the SSS and the sagittal suture in children with anterior plagiocephaly. METHODS The authors retrospectively studied the relationship between the sagittal sinus and the sagittal suture at 5 points: nasion, midpoint nasion-bregma, bregma, midpoint bregma-lambda, and lambda. The study analyzed CT scans of 50 children with UCS admitted to the craniofacial unit of Necker Enfants Malades Hospital between March 2006 and March 2013 and compared them with 50 control children with no evidence of craniosynostosis, bone disease, or genetic syndromes. The authors also analyzed the presence of extracerebral fluid collection and ventricular asymmetry in children with UCS. RESULTS Fifty-six percent of patients had anterior right UCS and 44% had left-sided UCS. Type I UCS was seen in 1 patient, Type IIA in 20 patients, Type IIB in 20 patients, and Type III in 9 patients. The authors found that the nasion is usually deviated to the ipsilateral side of the synostosis, the bregma contralaterally, and the lambda ipsilaterally. The gap distances between the reference point and the SSS were 0–7.3 mm (mean 1.4 mm) at the nasion; 0–16.7 mm (mean 3.8 mm) at the midpoint nasion-bregma; 0–12 mm (mean 5.8 mm) at the bregma; 0–9.5 mm (mean 3 mm) at the midpoint bregma-lambda; and 0–11.6 mm (mean 5.5 mm) at the lambda. Conversely, a discrepancy of more than 1 mm between the SSS and the position of the suture was found only in 7 control cases (14%). Of patients with UCS, 38% presented with an extracerebral fluid collection contralateral to the fused coronal suture. Fifty-two percent had a ventricular asymmetry, which was characterized by reduced ventricular volume ipsilateral to the synostosis in all but 1 patient. CONCLUSIONS In this study, the SSS was usually deviated contralaterally to the closed coronal suture. It tended to be in the midline of the cranial vault and could be projected virtually along an imaginary line passing through the midline of the cranial base. The authors recommend a distance of 37 mm from the sagittal suture as a safety margin during surgery.

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Microsurgical Anatomy of the Interhemispheric Fissure Complex: An Anatomical-Functional Model in Brain Tumors

Monroy-Sosa

Chakravarthi

Epping

et al. 2020

Principles of Neuro-Oncology

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The anatomical relation between the superior sagittal sinus and the sagittal suture with surgical considerations

Cited by 15 publications

References 3 publications

Feasibility and accuracy of a voxel-based neuronavigation system with 3D image rendering in preoperative planning and as a learning tool for young neurosurgeons, exemplified by the anatomical localization of the superior sagittal sinus

Feasibility and accuracy of a voxel-based neuronavigation system with 3D image rendering in preoperative planning and as a learning tool for young neurosurgeons, exemplified by the anatomical localization of the superior sagittal sinus

Unilateral coronal synostosis: can we trust the sagittal suture as a landmark for the underlying superior sagittal sinus?

Microsurgical Anatomy of the Interhemispheric Fissure Complex: An Anatomical-Functional Model in Brain Tumors

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