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Torcular Herophili classification and evaluation of dural venous sinus variations using digital subtraction angiography and magnetic resonance venographies

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Abstract

Purpose

The configurations of cerebral veins and dural venous sinuses differ not only between individuals, but also between the two brain hemispheres of an individual, making the anatomical classification of the cerebral veins difficult. We evaluated the superior dural venous sinuses and classified their types and variations using magnetic resonance venography (MRV) and digital substraction angiography (DSA).

Methods

A total of 394 patients were studied retrospectively. Superior dural venous sinuses were evaluated and the confluence of the sinuses was classified on 2-dimensional time-of-flight MRV, contrast-enhanced 3-dimensional spoiled gradient recalled echo magnetic resonance imaging, and/or cerebral DSA. Confluens sinuum was divided into three types: true confluence, partial confluence, and non-confluence.

Results

Of the three types, partial confluence (type II) was most frequently seen. Co-dominance of the transverse sinuses was most frequently observed. An occipital sinus was observed in 15 % of the patients. There were statistically significant differences between the left transverse sinus agenesis and the presence of the occipital sinus (p < 0.001), between the co-presence of the partial confluence type torcular and the occipital sinus (p = 0.040), and between the co-presence of the fenestrated straight sinus and the occipital sinus (p = 0.010).

Conclusions

Although anatomical variations of dural venous sinuses are seen frequently, classification of venous sinuses helps surgeons in preoperative evaluation and management, and prevention of possible complications. In this study, we think that a comprehensive evaluation and classification of dural venous sinuses is a significant contribution to the literature.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the Medical Ethics Committee of Gaziosmanpasa University School of Medicine. This study complied with current Turkey laws.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Gaziosmanpaşa University, 60200, Tokat, Turkey

    Erkan Gökçe, Tansu Pınarbaşılı, Berat Acu & M. Murat Fırat

  2. Departmant of Biostatistics, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey

    Ünal Erkorkmaz

Authors
  1. Erkan Gökçe
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  2. Tansu Pınarbaşılı
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  3. Berat Acu
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  4. M. Murat Fırat
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  5. Ünal Erkorkmaz
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Correspondence to Erkan Gökçe.

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Gökçe, E., Pınarbaşılı, T., Acu, B. et al. Torcular Herophili classification and evaluation of dural venous sinus variations using digital subtraction angiography and magnetic resonance venographies. Surg Radiol Anat 36, 527–536 (2014). https://doi.org/10.1007/s00276-013-1223-0

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  • DOI: https://doi.org/10.1007/s00276-013-1223-0

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