“…As the occipital lobes and transverse sinuses are anatomically close to each other, Pettersson et al and Arsava et al suggested a possible relationship between occipital bending with transverse sinus dominance. 3,4 72% of their participants with rightwards occipital bending had a larger transverse sinus on the right side. Seventy percent of participants with leftwards occipital bending had a larger transverse sinus on the left side.…”
Section: Discussionmentioning
confidence: 96%
“…The morphology of the slope of the gSSS at the inner table of the calvarium which resembles the Mount Gibraltar on zoomed images was characterised as sloping to the right or left or no slope with respect to the reference line drawn through the posterior falx cerebri. 4 Next the anteroposterior diameters of jugular foramen on the right and left side were measured on T2-weighted MR images at the level of the carotid canal (Figure 1). Figure 1.(a) Axial T1 -weighted image of a patient shows occipital bending towards the left side (white arrow).…”
Section: Methodsmentioning
confidence: 99%
“…Occipital lobe bending, Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions have been used as parameters in assessing TS hypoplasia in different studies; but their role together has not been assessed in a single dataset. [2][3][4] The anatomic condition of occipital lobe bending and protruding towards the other cerebral hemisphere is called as occipital petalia. 5 Gibraltar sign represents the sloping of the superior sagittal sinus groove to the right or left side with respect to the midline.…”
Section: Introductionmentioning
confidence: 99%
“…5 Gibraltar sign represents the sloping of the superior sagittal sinus groove to the right or left side with respect to the midline. 4 We sought to analyse the degree of correlation between each of these parameters individually in diagnosing TS dominance.…”
Background Asymmetry between the transverse sinuses (TS) is quite common. We sought to test the possible hypothesis that certain anatomical features – namely, occipital lobe bending, Gibraltar sign of superior sagittal sinus groove (SSS) and jugular foramen (JF) dimensions – can predict dominance of the transverse sinuses on routine axial T1- and T2-weighted images. Materials and methods One hundred consecutively acquired combined MRI-MRV studies of brain were reviewed. On non-contrast axial T1WI, each reviewer assessed the occipital lobe bending, and Gibraltar sign of SSS groove; on axial T2-weighted images, JF dimensions were measured. TS cross-sectional area was measured on non-contrast sagittal 2-dimensional phase contrast MRV images and served as the reference standard. Results Of the 51 subjects with right-dominant TS, 37 had occipital bending to the right side and 35 showed sloping of the Gibraltar sign to right side. Of the 18 subjects with left dominant TS, 10 had occipital bending to left side and 13 showed left-sided sloping of the Gibraltar sign. Of the 31 subjects with co-dominant TS, 15 had no occipital bending and 20 showed no sloping of the Gibraltar sign. Mean right and left JF dimensions were higher in the right and left dominant TS respectively with no significant differences in patients with co-dominant sinus ( p < 0.02). Conclusion Right occipital bending had a good association with right TS dominance. The other two parameters- Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions – did not have a very good association with respect to TS dominance.
“…As the occipital lobes and transverse sinuses are anatomically close to each other, Pettersson et al and Arsava et al suggested a possible relationship between occipital bending with transverse sinus dominance. 3,4 72% of their participants with rightwards occipital bending had a larger transverse sinus on the right side. Seventy percent of participants with leftwards occipital bending had a larger transverse sinus on the left side.…”
Section: Discussionmentioning
confidence: 96%
“…The morphology of the slope of the gSSS at the inner table of the calvarium which resembles the Mount Gibraltar on zoomed images was characterised as sloping to the right or left or no slope with respect to the reference line drawn through the posterior falx cerebri. 4 Next the anteroposterior diameters of jugular foramen on the right and left side were measured on T2-weighted MR images at the level of the carotid canal (Figure 1). Figure 1.(a) Axial T1 -weighted image of a patient shows occipital bending towards the left side (white arrow).…”
Section: Methodsmentioning
confidence: 99%
“…Occipital lobe bending, Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions have been used as parameters in assessing TS hypoplasia in different studies; but their role together has not been assessed in a single dataset. [2][3][4] The anatomic condition of occipital lobe bending and protruding towards the other cerebral hemisphere is called as occipital petalia. 5 Gibraltar sign represents the sloping of the superior sagittal sinus groove to the right or left side with respect to the midline.…”
Section: Introductionmentioning
confidence: 99%
“…5 Gibraltar sign represents the sloping of the superior sagittal sinus groove to the right or left side with respect to the midline. 4 We sought to analyse the degree of correlation between each of these parameters individually in diagnosing TS dominance.…”
Background Asymmetry between the transverse sinuses (TS) is quite common. We sought to test the possible hypothesis that certain anatomical features – namely, occipital lobe bending, Gibraltar sign of superior sagittal sinus groove (SSS) and jugular foramen (JF) dimensions – can predict dominance of the transverse sinuses on routine axial T1- and T2-weighted images. Materials and methods One hundred consecutively acquired combined MRI-MRV studies of brain were reviewed. On non-contrast axial T1WI, each reviewer assessed the occipital lobe bending, and Gibraltar sign of SSS groove; on axial T2-weighted images, JF dimensions were measured. TS cross-sectional area was measured on non-contrast sagittal 2-dimensional phase contrast MRV images and served as the reference standard. Results Of the 51 subjects with right-dominant TS, 37 had occipital bending to the right side and 35 showed sloping of the Gibraltar sign to right side. Of the 18 subjects with left dominant TS, 10 had occipital bending to left side and 13 showed left-sided sloping of the Gibraltar sign. Of the 31 subjects with co-dominant TS, 15 had no occipital bending and 20 showed no sloping of the Gibraltar sign. Mean right and left JF dimensions were higher in the right and left dominant TS respectively with no significant differences in patients with co-dominant sinus ( p < 0.02). Conclusion Right occipital bending had a good association with right TS dominance. The other two parameters- Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions – did not have a very good association with respect to TS dominance.
“…Compared to HR-MRBTI, conventional CE-MRV screening only detected CCVT in 66.7% of patients with positive indirect symptoms (i.e., asymmetrically dilated cortical veins and/or abnormal collateral cortical vein formation). When using CE-MRV, it is difficult to distinguish anatomic variations from the abnormal compensatory cortical veins in CCVT ( 23 – 26 ). Furthermore, DSA detection of CCVT is also based on indirect signs—including focal narrowing and slow blood flow in the CVS, and had a diagnostic rate of only 14.3% in this cohort.…”
Cerebral cortical vein thrombosis (CCVT) is often misdiagnosed because of its non-specific diagnostic symptoms. Here, we analyzed a cohort of patients with CCVT in hopes of improving understandings and treatments of the disease. A total of 23 patients with CCVT (confirmed with high-resolution imaging), who had been diagnosed between 2017 and 2019, were enrolled in this cohort study. Baseline demographics, clinical manifestations, laboratory data, radiological findings, treatment, and outcomes were collected and analyzed. Fourteen females and nine males were enrolled (mean age: 32.7 ± 11.9 years), presenting in the acute (within 7 days, n = 9), subacute (8–30 days, n = 7), and chronic (over 1 month, n = 7) stages. Headaches (65.2%) and seizures (39.1%) were the most common symptoms. Abnormally elevated plasma D-dimers were observed in the majority of acute stage patients (87.5%). The diagnostic accuracy of contrast-enhanced magnetic resonance venography (CE-MRV) and high-resolution magnetic resonance black-blood thrombus imaging (HR-MRBTI) in detecting CCVT were 57.1 and 100.0%, respectively. All patients had good functional outcomes after 6-month of standard anticoagulation (mRS 0–1) treatment. However, four CCVT patients that had cases involving multiple veins showed symptom relief after batroxobin therapy (p = 0.030). HR-MRBTI may be a fast and accurate tool for non-invasive CCVT diagnosis. HR-MRBTI combined with D-dimer can also precisely identify the pathological stage of CCVT. Batroxobin may safely accelerate cortical venous recanalization in combination with anticoagulation. Follow-up studies with larger sample sizes are suggested to evaluate the safety and efficacy of batroxobin for treating CCVT.
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