Surgical and Radiologic Anatomy

, Volume 26, Issue 6, pp 480–487

Anatomical variations of occipital bone impressions for dural venous sinuses around the torcular Herophili, with special reference to the consideration of clinical significance

Original Article


Venous blood flow through the cerebral dural sinus is variable and clinically significant. It has been investigated by cadaver dissection or radiology; however, we thought that osteology might be informative. A total of 160 dried skulls were macroscopically examined for impressions on the inner surface of the occipital bone in order to interpret the sinus flow around the torcular Herophili. The continuity between the grooves for the superior sagittal sinus (SSS) and the transverse sinuses was categorized into four types. Confluence type was noted in 56 specimens (35%), in which SSS drained into a common pool of venous sinuses. Bifurcation type was noted in 22 cases (14%), in which SSS was divided to drain into the bilateral transverse sinuses. Right dominant type was the most frequent one with 66 cases (41%), in which SSS drained only into the right transverse sinus. Left dominant type was the least frequent one with 16 cases (10%), in which SSS drained to the left, in a mirror image to the right dominant type. Clinical significance is discussed with our preliminary trial for the optimization of the inner skull surface and venous flow using computed tomography and magnetic resonance imaging, and demonstration of cerebrovascular disease.


Confluence Superior sagittal sinus Transverse sinus Helical computed tomography Magnetic resonance venography 


  1. 1.
    Ayanzen RH, Bird CR, Keller PJ, McCully FJ, Theobald MR, Heiserman JE (2000) Cerebral MR venography: normal anatomy and potential diagnostic pitfalls. Am J Neuroradiol 21:74–78PubMedGoogle Scholar
  2. 2.
    Bisaria KK (1985) Anatomic variations of venous sinuses in the region of the torcular Herophili. J Neurosurg 62:90–95PubMedGoogle Scholar
  3. 3.
    Browning H (1953) The confluence of dural venous sinuses. Am J Anat 93:307–329PubMedGoogle Scholar
  4. 4.
    Casey SO, Alberico RA, Patel M, Jimenez JM, Ozsvath RR, Maguire WM et al (1996) Cerebral CT venography. Radiology 198:163–170PubMedGoogle Scholar
  5. 5.
    Daikokuya H, Inoue Y, Yamada R (2001) Three-dimensional gadolinium-enhanced MR angiography of the intracranial venous system. Osaka City Med J 47:165–175PubMedGoogle Scholar
  6. 6.
    Dora F, Zileli T (1980) Common variations of the lateral and occipital sinuses at the confluens sinuum. Neuroradiology 20:23–27PubMedGoogle Scholar
  7. 7.
    Edwards EA (1931) Anatomic variations of the cranial venous sinuses. Their relation to the effect of jugular compression in lumbar manometric tests. Arch Neurol Psychiat 26:801–814Google Scholar
  8. 8.
    Gibbs EL, Gibbs FA (1934) The correlation areas of the vessels that form the torcular, and the manner in which flow is distributed to the right and left lateral sinus. Anat Rec 59:419–426Google Scholar
  9. 9.
    Goto N, Koda M (2000) Blood vessels in the central nervous system [in Japanese]. In: Sato T, Akita K (eds) Anatomical variations in Japanese. University of Tokyo Press, Tokyo, pp 401–429Google Scholar
  10. 10.
    Hacker H (1974) Dural venous sinus. In: Newton TH, Potts DG (eds) Radiology of the skull and brain: angiography. Mosby, St. Louis, pp 1862–1870Google Scholar
  11. 11.
    Hirata K (2000) Cranium [in Japanese]. In: Sato T, Akita K (eds) Anatomical variations in Japanese. University of Tokyo Press, Tokyo, pp 11–39Google Scholar
  12. 12.
    Hollinshead WH, Rosse C (1985) Textbook of anatomy, 4th edition. Harper & Row, Philadelphia, pp 867–872, 922–926Google Scholar
  13. 13.
    Ikawa F, Sumida M, Uozumi T, Kiya K, Kurisu K, Arita K et al (1995) Demonstration of the venous systems with gadolinium-enhanced three-dimensional phase-contrast MR venography. Neurosurg Rev 18:101–107PubMedGoogle Scholar
  14. 14.
    Ishizaka H (1985) Anatomical study of the torcular Herophili [in Japanese with English abstract]. Neurol Med Chir (Tokyo) 25:873–880Google Scholar
  15. 15.
    Kaplan HA, Browder J, Knightly JJ, Rush BF Jr, Browder A (1972) Variations of the cerebral dural sinuses at the torcular Herophili. Importance in radical neck dissection. Am J Surg 124:456-461CrossRefPubMedGoogle Scholar
  16. 16.
    Knott JF (1881) On the cerebral sinuses and their variations. J Anat Physiol 16:27–42Google Scholar
  17. 17.
    Koos WT, Spetzler RF, Pendle G, Perneczky A, Lang J (1985) Color atlas of microneurosurgery. Thieme, StuttgartGoogle Scholar
  18. 18.
    Liang L, Korogi Y, Sugahara T, Onomichi M, Shigematsu Y, Yang D et al (2001) Evaluation of the intracranial dural sinuses with a 3D contrast-enhanced MP-RAGE sequence: prospective comparison with 2D-TOF MR venography and digital subtraction angiography. Am J Neuroradiol 22:481–492PubMedGoogle Scholar
  19. 19.
    Matsushima T, Rhoton AL Jr, Oliveira E de, Peace D (1983) Microsurgical anatomy of the veins of the posterior fossa. J Neurosurg 59:63–105PubMedGoogle Scholar
  20. 20.
    Mattle HP, Wentz KU, Edelman RR (1991) Cerebral venography with MR. Radiology 178:453–458PubMedGoogle Scholar
  21. 21.
    Mehta NR, Jones L, Kraut MA, Melhem ER (2000) Physiologic variations in dural venous sinus flow on phase-contrast MR imaging. Am J Roentgenol 175:221–225Google Scholar
  22. 22.
    Nagashima M, Inoue K, Sasaki T, Miyasaka K, Matsumura G, Kodama G (1998) Three-dimensional imaging and osteometry of adult human skulls using helical computed tomography. Surg Radiol Anat 20:291–297PubMedGoogle Scholar
  23. 23.
    Oka K, Rhoton AL Jr, Barry M, Rodriguez R (1985) Microsurgical anatomy of the superficial veins of the cerebrum. Neurosurgery 17:711–748PubMedGoogle Scholar
  24. 24.
    Okudera T, Huang YP, Ohta T, Yokota A, Nakamura Y, Maehara F et al (1994) Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. Am J Neuroradiol 15:1871–1883PubMedGoogle Scholar
  25. 25.
    Ozsvath RR, Casey SO, Lustrin ES, Alberico RA, Hassankhani A, Patel M (1997) Cerebral venography: comparison of CT and MR projection venography. Am J Roentgenol 169:1699–1707Google Scholar
  26. 26.
    Seeger W (1978) Atlas of topographic anatomy of the brain and surrounding structures. Springer, Berlin Heidelberg New YorkGoogle Scholar
  27. 27.
    Williams PL (1995) Gray’s anatomy, 38th edn. Churchill Livingstone, New York, pp 572–574, 582–585, 1582–1589Google Scholar
  28. 28.
    Woodhall B (1936) Variations of the cranial venous sinuses in the region of the torcular Herophili. Arch Surg (Chicago) 33:297–314Google Scholar
  29. 29.
    Yasargil MG, Damur M (1974) Thrombosis of the cerebral veins and dural sinuses. In: Newton TH, Potts DG (eds) Radiology of the skull and brain: angiography. Mosby, St Louis, pp 2375-2400Google Scholar
  30. 30.
    Yasui N, Kamiyama H (1985) Microsurgery of cerebral aneurysms. Elsevier, Amsterdam and Nishimura, NiigataGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Anatomy, Institute of Medical SciencesBananas Hindu UniversityVanarasiIndia
  2. 2.Department of AnatomySaitama Medical SchoolSaitamaJapan
  3. 3.Department of AnatomyHokkaido University School of MedicineSapporoJapan

Personalised recommendations