Anatomical implications of posterior cephaloceles in the dural venous sinuses
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CASE REPORT
Anatomical implications of posterior cephaloceles in the dural venous sinuses Anderson Alexsander Rodrigues Teixeira 1 & Fernando Furtado de Melo Neto 1 & Nina Maia Pinheiro de Abreu 2 & Daniel Aguiar Dias 3 & Moyses Loiola Ponte Souza 1 Received: 23 October 2019 / Accepted: 25 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective To analyze the venous anatomy of the dural sinuses of patients with posterior encephaloceles, in order to formulate anatomical patterns which can ensure safer surgery. Methods This is a retrospective study, analyzing eight patients diagnosed with posterior encephalocele throughout 1 year. Results Eight patients with cephaloceles were evaluated in our study from January 2017 to January 2018. The most common alteration was dysgenesis of the straight sinus (n = 7), followed by venous anomalies in the encephalocele and alterations in the SSS (superior sagittal sinus) (n = 4), and the occurrence of a falcine sinus (FC) in 3 patients. Conclusion Anatomical variations are frequent in patients with cephaloceles. Therefore, an understanding of them is necessary for safe and effective treatment. Keywords Encephalocele . Nervous system malformations . Dural venous sinuses . Anomalous venous system
Introduction A cephalocele is the herniation of one or more intracranial structures through a congenital cranial bone defect or, more rarely, through normal foramen or fissures in the skull. It can also be called cranial dysraphism [9, 10]. One hypothesis is that both encephalocele and meningocele develop due to a failure of fusion of the paraxial mesoderm of the dura mater and the cranium along the midline, secondary to an adhesion between the neural and cutaneous ectoderm, before their disjunction. The classification of encephaloceles is based on the anatomical location of the skull defect, and the two main groups are anterior and posterior: anterior encephaloceles are divided * Anderson Alexsander Rodrigues Teixeira [email protected] 1
Department of Neurosurgery, Federal University of Ceará - UFC, Fortaleza, CE, Brazil
2
Department of Diagnostic Imaging, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
3
Department of Diagnostic Imaging, Federal University of Ceará UFC, Fortaleza, CE, Brazil
into sincipital (sinciput or forehead) and basal, while posterior encephaloceles are divided into occipital, occipitocervical, and parietal [28]. The prevalence of encephaloceles may range from 0.08 to 0.5/1000 live births [1, 11, 24, 27]. Occipital encephaloceles are more common in the west, while in Asia, frontal or sincipital variations are more prevalent [5, 24]. Only 50% of fetuses with encephalocele survive until birth, with occipital encephaloceles being almost exclusively associated with the highest mortality rates [11, 13]. Children with meningocele (a defect that does not contain nervous tissue, but only the leptomeninges) tend to be neurologically normal [24], unlike with encephaloceles, which present a higher incidenc
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