Basicranial venous anomalies associated with complex nonsyndromic craniosynostosis in a child.
We report the radiological findings of severe bilateral jugular foraminal stenosis along with anomalous basicranial venous drainage in a child with a history of complex nonsyndromic craniosynostosis. CT with 3D reconstructions and MR venography revealed that the lateral sinuses were draining transosseously through several markedly enlarged emissary veins. The main route of transverse and sigmoid sinus drainage was through large mastoid emissaries to the deep cervical veins. There was additional drainage of these mastoid emissaries into the vertebral and paravertebral plexuses as well as into venous collaterals which subsequently reconstituted the internal jugular veins. Basicranial venous anomalies are common among children with complex craniosynostosis, and although they may not resemble intracranial vascular outflow deficiencies, they can pose significant surgical risks. This case emphasizes the need for proper clinical assessment and documentation of anomalous basicranial venous anatomy to facilitate management of complex craniosynostosis patients.
From the *School of Medicine, Louisiana State University Health Sciences Center; †Department of Pediatric Radiology, Children's Hospital; ‡Department of Surgery, Division of Plastic & Reconstructive Surgery, Louisiana State University Health Sciences Center; and §Department of Cell Biology and Anatomy, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
Ruston
R
Sanchez
Kenneth
K
Ward
Hugo
H
St Hilaire
Jason
J
Mussell
D002550:Cerebral Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D002675:Child, Preschool; D003392:Cranial Sinuses / Q000002:abnormalities / Q000000981:diagnostic imaging; D003398:Craniosynostoses / Q000150:complications / Q000000981:diagnostic imaging*; D005539:Foramen Magnum / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D007601:Jugular Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D010690:Phlebography / Q000379:methods; D012039:Regional Blood Flow; D019291:Skull Base / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed