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Dominant Occipital Sinus: A Rare Anatomical Variant With Potentially Catastrophic Consequences if Unrecognized Preoperatively.
Cureus
December 2024
Department of Neurosurgery, Southmead Hospital, North Bristol NHS Trust, Bristol, GBR.
The occipital sinus is often thought of as a redundant vestigial structure in adults. However, in rare cases, it can form the dominant route of intracerebral venous drainage, with a risk of significant surgical morbidity if unrecognised. We present an illustrative case describing this anatomical variant and tailoring of a midline suboccipital craniotomy to allow resection of a fourth ventricular epidermoid tumour with preservation of a dominant occipital sinus, and a review of the published literature.
View Article and Find Full Text PDFA Complex, Convexity, Anterior Superior Sagittal Sinus Dural Arteriovenous Fistula Secondary to Venous Sinus Thrombosis.
Cureus
December 2024
Neurosurgery, Queens Hospital Center, Romford, GBR.
We report the management of a convexity dural arteriovenous fistula (dAVF) in an uncommon anterior superior sagittal sinus (SSS) location. This was a high-risk Cognard IIa+b dAVF, which is notoriously complex to treat. Endoscopic management alone for complex SSS dAVFs is challenging due to the often bilateral arterial supply to the fistula, as demonstrated in this case.
View Article and Find Full Text PDFIntra-arterial lidocaine administration of lidocaine in middle meningeal artery for short-term treatment of subarachnoid hemorrhage-related headaches.
Interv Neuroradiol
January 2025
Neuroradiology, The Royal London Hospital, Barts NHS Trust, London, UK.
Background And Purpose: We report short- and intermediate-term effects on headaches with intra-arterial injection of lidocaine in the middle meningeal artery in patients with severe headaches associated with subarachnoid hemorrhage.
Methods: We treated seven patients with intra-arterial lidocaine in doses up to 50 mg in each middle meningeal artery via a microcatheter bilaterally (except in one patient). We recorded the maximum intensity of headache (graded by 11-point numeric rating scale) prior to procedure and every day for the next 10 days or discharge, whichever came first.
Pneumocephalus and Pneumorrhachis Following Titanium Rib Implant: A Case Report and Literature Review.
Curr Med Imaging
January 2025
Consultant in Emergency Medicine, WIC Clinic, Primary Health Care Corporation, Doha, Qatar.
Introduction: Pneumocephalus and pneumorrhachis are rare postoperative complications, commonly occurring within a few days to months after spinal surgery. They are very rarely reported after thoracic surgeries. This case highlights a unique presentation in the emergency department involving headache and vomiting caused by late complications following thoracic surgery with a titanium rib implant.
View Article and Find Full Text PDFArtificial dural regeneration matrix as a substitute for autologous tissue in indirect bypass in Moyamoya disease: Investigation of a rat model of chronic cerebral hypoperfusion.
Neurosurg Rev
January 2025
Department of Neurosurgery, Kumamoto University Hospital, 1-1-1 Honjo, 860-8556, Chuo-ku Kumamoto, Japan.
Indirect bypass using autologous tissue is effective in Moyamoya disease, especially among pediatric patients. This study aimed to evaluate the effectiveness of indirect bypass using DuraGen (absorbable artificial dura mater composed of collagen matrix), as a substitute for autologous tissue in a rat model of chronic cerebral hypoperfusion. Male Wistar rats were subjected to bilateral internal carotid artery occlusion and divided into three groups: a control group without bypass surgery, a group wherein indirect bypass was performed using the temporalis muscle (encephalo-myo-synangiosis [EMS] group), and a group wherein DuraGen was used (Dura group).
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