Sinus pericranii

Case contributed by Dr Sahra Emamzadehfard

Presentation

Frequent migraine headaches. Past medical history: significant right temporal scalp cauterization at age 15.

Patient Data

Age: 45
Gender: Female
CT

 

Calvarium and skull base: Mild bony dehiscence in the base of the  skull involving greater wing sphenoid and adjacent squamous portion of the right temporal bone. No fracture.

MRI

Cerebral parenchyma/extra-axial spaces:  No intracranial mass lesion, hemorrhage, or infarction.

FLAIR/T2 hyperintensities in the right temporal bone, likely postsurgical. Scattered hypointense SWI regions. There is vascular collection in the extracranial infratemporal fossa. There is filling of the multiple vascular channels within the soft tissues overlying the temporal bone on the right side. There is extension into the diploic space of the cranial vault. There is some communication with superficial intracranial venous structure just above the right temporal bone.
 
MRV: Superficial and deep cerebral venous structures are essentially symmetric bilaterally. Nonvisualization of the transverse sinus with small sigmoid sinus and internal jugular vein on the left side. Right transverse and sigmoid sinuses and right internal jugular vein are unremarkable.

 

Case Discussion

Sinus pericranii is a rare congenital (or occasionally, acquired) epicranial venous malformation of the scalp, which is secondary to abnormal communication between the intracranial and extracranial venous drainages. Treatment of this condition is recommended to prevention of hemorrhage.

Surgical treatment is focused on the resection of the extracranial venous system with ligation of the emissary communicating vein.

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Case information

rID: 58665
Published: 3rd Mar 2018
Last edited: 4th Mar 2018
System: Head & Neck
Inclusion in quiz mode: Included
Institution: University of Texas health Science Center at San Antonio

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