Abstract
Falcine sinus is a normal midline embryonic venous sinus present in the fetal brain and usually disappears by birth. Persistent falcine sinus (PFS) has been reported as a normal variant or along with vein of Galen (VOG) malformation, encephalocele, and other abnormalities. Schizencephaly, either closed or open type, has been reported with other associated vascular anomalies. We report a 22-month-old child, who presented with delayed milestones and referred for magnetic resonance (MR) imaging, and the child was found to have PFS with associated bilateral temporo-occipital closed-lip schizencephaly, hippocampal abnormalities, falco-tentorial dehiscence, and white matter abnormalities. The vein of Galen and straight sinus were absent, and the internal cerebral veins were seen draining into superior sagittal sinus via the falcine sinus. These set of abnormalities are unique from abnormalities reported previously in association with the falcine sinus.
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References
Barkovich AJ (1988) Abnormal vascular drainage in anomalies of neuronal migration. AJNR Am J Neuroradiol 9:939–942
Barkovich AJ, Kjos BO (1992) Schizencephaly: correlation of clinical findings with MR characteristics. AJNR Am J Neuroradiol 13:85–94
Bartels RH, Merx JL, van Overbeeke JJ (1998) Falcine sinus and occipital encephalocele: a magnetic resonance venography study. J Neurosurg 89:738–741
Griffith PD (2018) Schizencephaly revisited. Neuroradiology 60:945–960
Hayashi N, Tsutsumi Y, Barkovich AJ (2002) Morphological features and associated anomalies of schizencephaly in the clinical population: detailed analysis of MR images. Neuroradiology 44:418–427. https://doi.org/10.1007/s00234-001-0719-1
Hung PC, Wang HS, Yeh YS, Lui TN, Lee ST (1996) Coexistence of schizencephaly and intracranial arteriovenous malformation in an infant. AJNR Am J Neuroradiol 17:1921–1922
Kim MS, Lee GJ (2010) Two cases with persistent falcine sinus as congenital variation. J Korean Neurosurg Soc 48:82–84
Lasjaunias P, Garcia-Monaco R, Rodesch G, Terbrugge K (1991) Deep venous drainage in great cerebral vein (vein of Galen) absence and malformations. Neuroradiology 33(3):234–238
Lin L, Lin JH, Guan J, Zhang XL, Chu JP, Yang ZY (2018) Falcine sinus: incidence and imaging characteristics of three-dimensional contrast-enhanced thin-section magnetic resonance imaging. Korean J Radiol 9(3):463–469
Manjila S, Bazil T, Thoma M, Mani S, Kay M, Udayasankar U (2018) A review of extraaxial developmental venous anomalies of the brain involving dural venous flow or sinuses: persistent embryonic sinuses, sinus pericranii, venous varices or aneurysmal malformations, and enlarged emissary veins. Neurosurg Focus 45(1):E9
Manoj KS, Krishnamoorthy T, Thomas B, Kapilamoorthy TR (2006) An incidental persistent falcine sinus with dominant straight sinus and hypoplastic distal superior sagittal sinus. Pediatr Radiol 36:65–67
Mizutani K, Miwa T, Akiyama T, Sakamoto Y, Fujiwara H, Yoshida K (2018) Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus. Neuroradiology 60(3):325–333. https://doi.org/10.1007/s00234-018-1980-x
Reddy AT, Hedlund GL, Percy AK (2000) Enlarged parietal foramina: association with cerebral venous and cortical anomalies. Neurology 54:1175–1178
Ryu CW (2010) Persistent falcine sinus: is it really rare? AJNR Am J Neuroradiol 31:367–369
Sato Y, Shibasaki J, Aida N, e al (2018) Novel COL4A1 mutation in a fetus with early prenatal onset of schizencephaly. Hum Genome Var 5: 4. https://doi.org/10.1038/s41439-018-0005-y
Sener RN (2000) Association of persistent falcine sinus with different clinico-radiologic conditions: MR imaging and MR angiography. Comput Med Imaging Graph 24:343–348
Smith A, Choudhary AK (2014) Prevalence of persistent falcine sinus as an incidental finding in the pediatric population. AJR Am J Roentgenol 203:424–425
Vahedi K, Alamowitch S (2011) Clinical spectrum of type IV collagen (COL4A1) mutations: a novel genetic multisystem disease. Curr Opin Neurol 24(1):63–68. https://doi.org/10.1097/WCO.0b013e32834232c6
Van der Knaap MS, Valk J (1988) Classification of congenital abnormalities of the CNS. AJNR Am J Neuroradiol 9:315–326
Yoneda Y, Haginoya K, Kato M, Osaka H, Yokochi K, Arai H, Kakita A, Yamamoto T, Otsuki Y, Shimizu SI, Wada T, Koyama N, Mino Y, Kondo N, Takahashi S, Hirabayashi S, Takanashi JI, Okumura A, Kumagai T, Hirai S, Nabetani M, Saitoh S, Hattori A, Yamasaki M, Kumakura A, Sugo Y, Nishiyama K, Miyatake S, Tsurusaki Y, Doi H, Miyake N, Matsumoto N, Saitsu H (2013) Phenotypic spectrum of COL4A1 mutations: porencephaly to schizencephaly. Ann Neurol 73:48–57
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Sunilkumar, D., Nagarajan, K., Kiran, M. et al. Persistent falcine sinus with temporo-occipital schizencephaly: case report with a review of literature in relation to the undeveloped vein of Galen and/or straight sinus. Childs Nerv Syst 36, 417–421 (2020). https://doi.org/10.1007/s00381-019-04234-9
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DOI: https://doi.org/10.1007/s00381-019-04234-9