The anatomical variations of the confluence of sinuses were examined, focusing on the continuity of the superior sagittal sinus (SSS) and the transverse sinuses (TSs). In the 142 specimens studied, there were 72 symmetric cases (50.7%) and 70 asymmetric cases (49.3%). The symmetric group (no dominant type) was categorized into 34 cases of bifurcation (23.9%) and 38 cases of confluence (26.8%). The asymmetric group was categorized into 54 cases of the right-dominant type (38.0%) and 16 cases of the left-dominant type (11.3%). The right-dominant type was further categorized into 38 partially-communicating (26.8%) and 16 non-communicating types (11.3%). The left-dominant type was categorized into 11 partially-communicating (7.7%) and 5 non-communicating types (3.5%). In summary, the SSS asymmetrically drained into one TS in about half of the cases studied. The right-dominant type was about three to four times as common as the left-dominant type. The draining pattern shown by the asymmetric group could provoke intracranial hypertension due to unilateral jugular vein obstruction. In order to avoid this risk in cases of neck dissection, jugular vein catheterization, or hypercoagulopathy, preoperative evaluations of the dural sinus variations via MR venography, three-dimensional CT, or plain X-ray of the skull are recommended.
Confluence of sinuses Dural sinus Superior sagittal sinus Transverse sinus Torcular Herophili
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This work was supported by Grants-in-Aid for Scientific Research (C) 15K10360 and (C) 17K01481, Grants-in-Aid from The Ministry of Education, Culture, Sports, Science, and Technology (MEXT) for Scientific Research (25282247 and 15K12770), and a Grant-in-Aid for Scientific Research on Innovative Areas (“Adaptive Circuit Shift;” 26112001). We would like to express our thanks to R. Tsujishima, Y. Banno, and H. Kito for their dedicated technical support in relation to this study.
Compliance with ethical standards
Conflict of interest
The authors hereby declare that there are no conflicts of interest relating to this study.
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