The Diploic Veins: A Comprehensive Review with Clinical Applications

Lachkar, Stefan; Dols, Mary-Margaret; Ishak, Basem; Iwanaga, Joe; Tubbs, R. Shane

doi:10.7759/cureus.4422

Cited by 17 publications

(14 citation statements)

References 18 publications

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“…Moreover, these findings are similar to existing pediatric ARS studies finding that males are at increased risk for developing complications 10,28‐30 . Although the exact mechanism for this sex disparity is not understood, one possibility is that the increased vascularity of the diploic system in males vs females contributes to the increased rates of orbital and intracranial sequelae 10,36 . These findings are in stark contrast to results from studies investigating the impact of sex in CRS, where females had more severe disease with increased complications and decreased responses to medical treatment 20‐27 …”

Section: Discussionsupporting

confidence: 77%

Sex Disparities in Pediatric Acute Rhinosinusitis: A National Perspective

Shah

Haimowitz

Desai

et al. 2022

Otolaryngol.--head neck surg.

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Objective This study aims to provide an age-stratified analysis of associations with patient sex in pediatric inpatients with acute rhinosinusitis (ARS). Study Design Retrospective cohort study. Setting National administrative database. Methods The 2016 Kids’ Inpatient Database was queried for pediatric inpatients (<21 years old) with ARS ( ICD-10 J01). Orbital and intracranial sequelae were selected via ICD-10 codes. Statistical associations by sex were determined via univariate and multivariable analyses. Weighted measures are reported to provide national estimates. Results Of the 5882 patients identified with ARS, 2404 (40.9%) were female and 3478 (59.1%) were male. Male patients were younger than female patients (mean, 9.3 vs 9.9 years; P < .001). Multivariable analysis indicated that males and females had similar total charges ($71,094 vs $66,892, P = .464) and length of stay (5.8 vs 6.1 days, P = .263). However, male patients underwent more procedures (1.8 vs 1.5, P < .001). Mortality was similar between male and female patients (odds ratio [OR], 0.91; P = .664). Male patients also had increased odds for having orbital (OR, 1.58; P < .001) and intracranial (OR, 1.99; P < .001) complications. Differences in sex-dependent sequela risk were starkest in patients aged 14 to 20 years, with male patients being more likely to have orbital (OR, 2.91; P < .001) and intracranial (OR, 3.86; P < .001) complications. Conclusion In a cohort of pediatric inpatients with ARS, males have increased odds for orbital and intracranial sequelae and undergo more procedures than females. However, males and females have similar charges and length of stay. Our study highlights age-stratified differences in ARS across patient sex.

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Section: Discussionsupporting

confidence: 77%

Sex Disparities in Pediatric Acute Rhinosinusitis: A National Perspective

Shah

Haimowitz

Desai

et al. 2022

Otolaryngol.--head neck surg.

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“…The hemodynamics in the transverse sinus and sigmoid sinus are closely related to the occurrence of venous PT[ 5 , 6 ]. The occipitoparietal DV connects to the junction of the transverse-sigmoid sinus and inevitably influences the flow pattern[ 3 ]; however, to the best of our knowledge, the relationship between the DV and PT has not been previously reported.…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiological roles of DVs have not yet been well recognized. Several conditions, including reabsorption of cerebrospinal fluid, acute subdural hematoma, thrombosis, arteriovenous fistulas, intracranial and external communicating infections and cancer metastases, have been reported to be related to DV[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Diploic vein as a newly treatable cause of pulsatile tinnitus: A case report

Zhao¹,

Zeng²,

Qiu³

et al. 2021

WJCC

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BACKGROUND Pulsatile tinnitus (PT) is an annoying sound that can be eliminated with targeted treatment of the cause. However, the causes of PT have not been fully elucidated. CASE SUMMARY A 38-year-old woman with right-sided objective PT underwent preoperative computed tomography arteriography and venography (CTA/V). A 3.8 mm vine diploic vein (DV), which passed through the mastoid air cells posteriorly in a dehiscent canal and was continuous with the transverse-sigmoid sinus, was thought to be the causative finding. Four-dimensional flow magnetic resonance (4D flow MR) imaging showed that the blood in the DV flowed toward the transverse-sigmoid sinus. The closer the blood was to the transverse-sigmoid sinus, the higher the velocity. No vortex or turbulence was found in the DV or adjacent transverse sinus. The sound was eliminated immediately after ligation of the DV with no recurrence during a three-month follow-up. No flow signal of the DV was noted on postoperative 4D flow MR. CONCLUSION A DV may be a treatable cause of PT. CTA/V and 4D flow MR could be utilized to determine the morphological and hemodynamic characteristics of the DV.

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“…DV presence has been documented from the 7th–9th month of fetal development, and a fully established diploic pattern seems to appear by the age of 5 years (Hershkovitz et al, 1999). The complexity of DV (e.g., the number, length and size of the branches) then continues to develop during ontogeny until adulthood (Alarfaj et al, 2021; Lachkar et al, 2019; Rangel de Lázaro et al, 2020; Tsutsumi et al, 2013). DV pattern is unique in every individual, and in that aspect could be used analogously to fingerprints (Hershkovitz et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

“…DV may function as collateral venous pathways in patients with dural venous sinus invasion by meningiomas (Yamashiro et al, 2021). Rarely, diploic arteriovenous fistulas may also occur, usually due to trauma (Lachkar et al, 2019; Rivera‐Lara et al, 2015; Tsutsumi, 2020).…”

Section: Introductionmentioning

confidence: 99%

Diploic vein morphology in normal and craniosynostotic adult human skulls

Eisová

Velemínský

Velemínská

et al. 2022

Journal of Morphology

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Diploic veins (DV) run within the cranial diploe, where they leave channels that can be studied in osteological samples. This study investigates overall DV variability in human adults and the effects of sex, age, cranial dimensions, and dysmorphogenesis associated with craniosynostosis (CS). The morphology of macroscopic diploic channels was analyzed in a set of the qualitative and quantitative variables in computed tomography-images of crania of anatomically normal and craniosynostotic adult individuals. Macroscopic diploic channels occur most frequently in the frontal and parietal bones, often with a bilaterally symmetrical pattern. DV-features (especially DV-pattern) are characterized by high individual diversity. On average, there are 5.4 ± 3.5 large macroscopic channels (with diameters >1 mm) per individual, with a mean diameter of 1.7 ± 0.4 mm. Age and sex have minor effects on DV, and cranial proportions significantly influence DV only in CS skulls. CS is associated with changes in the DV numbers, distributions, and diameters.Craniosynostotic skulls, especially brachycephalic skulls, generally present smaller DV diameters, and dolichocephalic skulls display increased number of frontal DV. CS, associated with altered cranial dimensions, suture imbalance, increased intracranial pressure, and with changes of the endocranial craniovascular system, significantly also affects the macroscopic morphology of DV in adults, in terms of both structural (topological redistribution) and functional factors. The research on craniovascular morphology and CS may be of interest in biological anthropology, paleopathology, medicine (e.g., surgical planning), but also in zoology and paleontology.

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The Diploic Veins: A Comprehensive Review with Clinical Applications

Cited by 17 publications

References 18 publications

Sex Disparities in Pediatric Acute Rhinosinusitis: A National Perspective

Sex Disparities in Pediatric Acute Rhinosinusitis: A National Perspective

Diploic vein as a newly treatable cause of pulsatile tinnitus: A case report

Diploic vein morphology in normal and craniosynostotic adult human skulls

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