Neuroimages of persistent falcine sinus in children
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Neuroimages of persistent falcine sinus in children Chun-Quan Cai, Qing-Jiang Zhang, Wei-Dong Yang, Chun-Xiang Wang, Chang-Hong Shen Tianjin, China
the right hemisphere. The straight sinus was patent with terminal stenosis (Fig. 2B-F). The neonate died 36 hours after birth due to the high-output congestive heart failure.
Summary
Case 1 A 14-year-old girl with a known diagnosis of systemic lupus erythematosus came to our department with the initial complaint of headache. Brain MRI revealed a normal brain parenchyma in all sequences. In addition, an incidental falcine sinus was observed in its entire length in sagittal images (Fig. 1A). The sinus connected the junction of the middle and posterior thirds of the superior sagittal sinus with the origin of the straight sinus. The straight sinus was also seen (Fig. 1B, 1C). MR venography confirmed the presence of the persistent falcine sinus with the straight sinus (Fig. 1D).
The falcine sinus is a normal intrauterine venous structure located between the dural leaves of the falx cerebri, normally involutes before birth.[1-3] It develops from the mesenchyme in the mesencephalic flexure, the same area that gives rise to the straight sinus.[2] There are a few known conditions associated with a persistent falcine sinus, including malformation of the vein of Galen, arteriovenous malformation, corpus callosum agenesis, bifid cranium, osteogenesis imperfecta, acrocephalosyndactyly (Apert syndrome), Chiari II malformations, absent tentorium, and occipital
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Case 2 A full-term male neonate was admitted to our department because of respiratory distress and mild cyanosis for 4 hours (20 hours after birth). Head CT revealed a markedly dilated vein of Galen and dilated vessels in the right Sylvian fissure (Fig. 2A). Brain MRI and MR angiography (MRA) revealed aneurysmal dilatation of the vein of Galen with a persistent falcine sinus reaching the superior sagittal sinus in its posterior third and arteriovenous malformation in
A
B
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D
Author Affiliations: Department of Pediatric Neurosurgery, General Hospital of Tianjin Medical University, Tianjin 300052, China (Cai CQ, Yang WD, Shen CH); Department of Neurosurgery, Tianjin Children's Hospital, Tianjin 300074, China (Cai CQ, Zhang QJ); Department of Radiology, Tianjin Children's Hospital, Tianjin 300074, China (Wang CX) Corresponding Author: Prof. Chang-Hong Shen, MD, Department of Pediatric Neurosurgery, General Hospital of Tianjin Medical University, No. 54 Anshan Road, Heping District, Tianjin 300052, China (Tel: +86-22-23519459-86403; Email: [email protected]) doi:10.1007/s12519-009-0012-7 ©2009, World J Pediatr. All rights reserved.
Clinical images
T
he falcine sinus is a normal anatomic structure located in the falx cerebri and it closes usually before birth. In this paper, we report two patients with persistent falcine sinus with emphasis on the neuroimages.
Fig. 1. Persistent falcine sinus without associated anomalies. Precontrast sagittal (A), postcontrast sagittal (B) and postcontrast coronal (C) T1 weighted images
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