title: Occipital sinus pericranii superseding both jugular veins: description of two rare pediatric cases.
abstract: BACKGROUND
  The extracranial venous drainage of the brain is provided mainly by the jugular veins with the variable participation of extrajugular pathways.
  
  
  METHODS
  Two cases of occipital sinus pericranii (SP) were observed. A 6-year-old girl presented with a progressively enlarging occipital lump; she was otherwise asymptomatic. An 8-year-old boy presented with mild nuchal headache. In the former case, neuroimaging examinations confirmed the diagnosis of SP; in the latter, SP was noticed on magnetic resonance imaging because it was neglected at physical examination. In both subjects, the radiological examination also showed bilateral occlusion of the jugular veins with ventricular dilation and herniation of cerebellar tonsils into the foramen magnum.
  
  
  CONCLUSIONS
  Exceptionally, SP was noticed to represent the main venous drainage of the underlying brain, thereby compensating for the intracranial hypertension due to venous engorgement. Preservation of SP was advised, and any surgical or endovascular treatment was contraindicated.
authors: Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy. paolo.frassanito@gmail.com
authors: Paolo
authors: P
authors: Frassanito
authors: Luca
authors: L
authors: Massimi
authors: Gianpiero
authors: G
authors: Tamburrini
authors: Massimo
authors: M
authors: Caldarelli
authors: Alessandro
authors: A
authors: Pedicelli
authors: Concezio
authors: C
authors: Di Rocco
mesh_terms: D001139:Arnold-Chiari Malformation / Q000150:complications; D002561:Cerebrovascular Disorders / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D007601:Jugular Veins / Q000473:pathology*; D007714:Klippel-Feil Syndrome / Q000150:complications; D008297:Male; D020779:Sinus Pericranii / Q000150:complications / Q000209:etiology