Abstract
Introduction
Torcular dural sinus malformations (tDSMs) are rare vascular pathologies with various anatomoclinical pictures and prognosis. We analyzed our case series and corroborated the complexity of this rare unit by a review of literature.
Case series
From 2003 to 2018, we treated four tDSMs patients. The evolution of three postnatally diagnosed cases of similar angioarchitecture contrasted with a fourth antenatally diagnosed case with significant torcular thrombosis. All patients were examined by computed tomography, magnetic resonance imaging, CT angiography, and MRI angiography. Three patients underwent digital subtraction angiography with embolization of feeders. Unusual pathological images were depicted.
Conclusions
Early diagnosis along with embolization of feeders and lake could improve the outcome for tDSM patients with dural arteriovenous shunts. Ventriculoperitoneal shunt implantation before endovascular treatment led to significant worsening of both clinical presentation and MRI picture. For patients who persist with hydrocephalus despite the endovascular approach, we suggest endoscopic third ventriculostomy as a first-line treatment option. Antenatally diagnosed patients with thrombosed lakes constitute a prognostically better group of patients. Spontaneous thrombosis and remodelation of the lake can, however, still leave neurological sequelae, as observed in our patient.
Similar content being viewed by others
References
Lasjaunias P, Magufis G, Goulao A, Piske R, Suthipongchai S, Rodesch R, Alvarez H (1996) Anatomoclinical aspects of dural arteriovenous shunts in children. Interv Neuroradiol 2(3):179–191
Merzoug V, Flunker S, Drissi C, Eurin D, Grangé G, Garel C, Richter B, Geissler F, Couture A, Adamsbaum C (2007) Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up. Eur Radiol 18(4):692–699
Barbosa M, Mahadevan J, Weon YC, Yoshida Y, Ozanne A, Rodesch G, Alvarez H, Lasjaunias P (2003) Dural sinus malformations (DSM) with giant lakes, in neonates and infants. Review of 30 consecutive cases. Interv Neuroradiol 9(4):407–424
Streeter GL (1918) The development of alterations in the vascular system of the brain of the human embryo. Contrib Embryol 24:7–38
Padget DH (1956) Cranial venous system in man in reference to development of adult configuration and relation to arteries. Am J Anat 98:307–355
Padget DH (1957) The development of the cranial venous system in man: from the viewpoint of comparative anatomy. Contrib Embryol 247:81–138
Tubbs RS, Iwanaga J, Oskouian R, et al (2020) Anatomy, imaging and surgery of the intracranial dural venous sinuses. Elsevier, St. Louis, MO
Kobayashi K, Matsui O, Suzuki M, Ueda F (2006) Anatomical study of the confluence of the sinuses with contrast-enhanced magnetic resonance venography. Neuroradiology. 48(5):307–311
Mortazavi MM, Griessenauer CJ, Foreman P, Bavarsad Shahripour R, Shoja MM, Rozzelle CJ, Tubbs RS, Fisher WS 3rd, Fukushima T (2013) Vein of Galen aneurysmal malformations: critical analysis of the literature with proposal of a new classification system. J Neurosurg Pediatr 12(3):293–306. https://doi.org/10.3171/2013.5.PEDS12587
Kassem MW, Choi PJ, Iwanaga J, Mortazavi MM, Tubbs RS (2018) Imaging characteristics of dural arteriovenous fistulas involving the vein of Galen: a comprehensive review. Cureus 10(2):e2180
Okudera T, Huang YP, Ohta T, Yokota A, Nakamura Y, Maehara F, Utsunomiya H, Uemura K, Fukasawa H (1994) Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol 15(10):1871–1883
Singh M, Nagashima M, Inoue Y (2004) Anatomical variations of occipital bone impressions for dural venous sinuses around the torcular Herophili, with special reference to the consideration of clinical significance. Surg Radiol Anat 26(6):480–487
Liby P, Lomachinsky V, Petrák B (2019) Jugular bulb dysmaturation in torcular dural sinus malformation, clinical images and a review of literature. World Neurosurg 127:434–435
Yang E, Storey A, Olson HE, Soul J, Estroff JA, Trenor CC, Cooper BK, Smith ER, Orbach DB (2018) Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part I: review of experience at Boston Children’s Hospital. J NeuroIntervent Surg 10:470–473
Herman JM, Spetzler RF, Bederson JB, Kurbat JM, Zabramski JM (1995) Genesis of a dural arteriovenous malformation in a rat model. J Neurosurg 83(3):539–545
Morita A, Meyer FB, Nichols DA, Patterson MC (1995) Childhood dural arteriovenous fistulae of the posterior dural sinuses: three case reports and literature review. Neurosurgery 37(6):1193–1199; discussion 1199-200
Jagadeesan BD, Grande AW, Guillaume DJ, Nascene DR, Tummala RP (2015) The role of percutaneous embolization techniques in the management of dural sinus malformations with atypical angioarchitecture in neonates: report of 2 cases. J Neurosurgery Pediatr 16(1):74–79
Folkerth RD, McLaughlin ME, Levine D (2001) Organizing posterior fossa hematomas simulating developmental cysts on prenatal imaging: report of 3 cases. J Ultrasound Med 20(11):1233–1240
Ichord R (2017) Cerebral sinovenous thrombosis. Front Pediatr 5:163. https://doi.org/10.3389/fped.2017.00163
Quisling RG, Mickle JP (1989) Venous pressure measurements in vein of Galen aneurysms. AJNR Am J Neuroradiol 10(2):411–417
Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R (2006) The management of vein of Galen aneurysmal malformations. Neurosurgery 59(5 Suppl 3):S184–S194; discussion S3-13
d’Avella D, Causin F (2016) Hydrocephalus in vein of Galen malformation. Another paradigm shift in neurosurgery. Acta Neurochir 158(7):1285–1288
Feletti A, Denaro L, Marton E, d’Avella D, Longatti P (2007) Endoscopic treatment of hydrocephalus due to aneurysm of the vein of Galen: case report and literature review. Minim Invasive Neurosurg 50(5):285–291
Meila D, Grieb D, Melber K, Jacobs C, Maslehaty H, Petridis A, El Habony R, Lanfermann H, Scholz M, Brassel F (2016) Hydrocephalus in vein of Galen malformation: etiologies and therapeutic management implications. Acta Neurochir 158(7):1279–1284
Acknowledgments
We thank Mr. Richard Bruna for the excellent 3D CT and MRI reconstructions.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Informed consent
Informed consent was obtained from the next of kin.
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Liby, P., Lomachinsky, V., Petrak, B. et al. Torcular dural sinus malformations: a single-center case series and a review of literature. Childs Nerv Syst 36, 333–341 (2020). https://doi.org/10.1007/s00381-019-04280-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-019-04280-3