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

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Abstract

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.

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Acknowledgements

We would like to thank the following anatomists and technician of Hokkaido University, Prof. Masahiko Watanabe, Prof. Kaoru Inoue, Prof. Emeritus George Kodama, and Mr. Hidemi Shimizu, for their encouragement with this research project and the helpful management of skull specimens. We are also grateful to Prof. Kazuo Miyasaka, Dr. Satoshi Terae, and Mr. Tsukasa Sasaki, Department of Radiology, Hokkaido University Medical Hospital, for their collaboration in the imaging procedures for the skull and dural sinuses of a normal volunteer by helical CT and MR venography. We finally thank two neurosurgeons: Dr. Tatsuya Ishikawa, Hokkaido University, for his valuable comments on the clinical considerations, and Prof. Masao Matsutani, Saitama Medical School, for his courtesy offering a clinical case of AVM, whose angiograms were reproduced in Fig. 4.

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Authors and Affiliations

  1. Department of Anatomy, Institute of Medical Sciences, Bananas Hindu University, 221-005, Vanarasi, India

    M. Singh

  2. Department of Anatomy, Saitama Medical School, 350-0495, Saitama, Japan

    M. Nagashima

  3. Department of Anatomy, Hokkaido University School of Medicine, 060-8638, Sapporo, Japan

    Y. Inoue

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  1. M. Singh
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  2. M. Nagashima
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  3. Y. Inoue
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Correspondence to M. Nagashima.

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Singh, M., Nagashima, M. & Inoue, Y. 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, 480–487 (2004). https://doi.org/10.1007/s00276-004-0269-4

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