Winner of CoW 25 September 2016
Sinus pericranii
Findings
Focal extracranial varicosities in left frontal scalp with underlying calvarial defect,communicating through prominent left diploic veins into the superior sagittal sinus TWIST angio shows superficial venous varicosities communicating with the superior sagittal sinus through an enlarged emissary vein.no arterial feeders demonstrated.
Discussion
Sinus pericranii is a large transcalvarial communication between the intra and extracranial venous drainage systems. Etiology-can be congenital or acquired,post traumatic or spontaneous.other possible etiologies include incomplete sutural fusion over prominent abundant diploic or emissary veins.scalp laceration and skull fracture that disrupts emissary veins at the outer table of the calvaria may result in development of an acquired SP. Dilated blood filled sac connects through an enlarged emissary vein with the intracranial circulation. Association –blue rubber bleb nevus syndrome Most SPs are isointense on T1WI and hyperintense to brain on T2WI.Puddling of contrast within the SP is typical.MRV is helpful in delineating both the intra and extracranial components. DD-hemangioma,cephalocoele,dermoid cyst and other scalp cysts.
Findings
Focal extracranial varicosities in left frontal scalp with underlying calvarial defect,communicating through prominent left diploic veins into the superior sagittal sinus TWIST angio shows superficial venous varicosities communicating with the superior sagittal sinus through an enlarged emissary vein.no arterial feeders demonstrated.
Discussion
Sinus pericranii is a large transcalvarial communication between the intra and extracranial venous drainage systems. Etiology-can be congenital or acquired,post traumatic or spontaneous.other possible etiologies include incomplete sutural fusion over prominent abundant diploic or emissary veins.scalp laceration and skull fracture that disrupts emissary veins at the outer table of the calvaria may result in development of an acquired SP. Dilated blood filled sac connects through an enlarged emissary vein with the intracranial circulation. Association –blue rubber bleb nevus syndrome Most SPs are isointense on T1WI and hyperintense to brain on T2WI.Puddling of contrast within the SP is typical.MRV is helpful in delineating both the intra and extracranial components. DD-hemangioma,cephalocoele,dermoid cyst and other scalp cysts.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!