Sinus pericranii: from gross and neuroimaging findings to different pathophysiological changes.
METHODS
We report two girls with a typical presentation of sinus pericranii. Both patients received total excision of the subgaleal masses with complete obliteration of the communications to the intracranial portion. However, different gross appearances, neuroimaging findings and intraoperative findings were found. It took more time and attention to control the bleeding due to the large communication between the extracranial and intracranial components in the second case.


CONCLUSIONS
Sinus pericranii is composed of abnormal extracranial vascular tissues that communicate directly with intracranial dural sinuses or veins. A review of the literature showed that 13 out of 31 patients with sinus pericranii had a high-flow pattern. Detailed physical examination and imaging studies to detect dilated scalp veins and a large bony defect should remind surgeons of the presence of large venous communications. Meticulous treatment of the large communication during surgery can avoid massive bleeding.
Wen
Chung-Shi
CS
Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan, Republic of China. mfk@ha.mc.ntu.edu.tw
Chang
Yih-Leong
YL
Wang
Huei-Shyong
HS
Kuo
Meng-Fai
MF
Tu
Yong-Kwang
YK
D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D042783:Endothelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D012196:Review Literature as Topic; D020779:Sinus Pericranii / Q000473:pathology* / Q000503:physiopathology*