Intracranial Magnetic Resonance Venography of Superior Sagittal Sinus, Straight Sinus and Cerebral Venous Channels: Normal Anatomy and Variations in North Indian Population

Abstract

Abstract The intracranial dural venous sinuses can be injured leading to thrombosis with in the dural sinuses causing headache, abnormal vision, weakness of the face and limbs on one side of the body, and seizures.Magnetic Resonance Venography (MRV) is one of the preferred methods of evaluation of the cerebral venous sinus anatomy, variations and pathology, particularly in the diagnosis of venous sinus thrombosis. The purpose of this study is to evaluate the use of MRV to depict the normal intracranial venous anatomy and its variants in North Indian population which can help to avoid potential pitfalls in the diagnosis of dural venous sinus thrombosis, venous infarcts and venous hemorrhage. Aim:The purpose of this study is to evaluate the use of MRV to depict the normal intracranial venous anatomy and its variants in North Indian population, which can help to avoid potential pitfalls in the diagnosis of dural venous sinus thrombosis, venous infarcts and venous hemorrhage. Materials:The present study was undertaken in the Departments of Anatomy and Radiodiagnosis at a North Indian tertiary care teaching hospital over a period of two years. Magnetic Resonance Venograms (MRV) of patients attending the radiology department were used to study the normal anatomy and variations in the dural venous sinuses. 50 MRV scans of which 26 were of females and 24 of male, were included in the study. Anatomical variations and variations in drainage of the dural venous sinuses were assessed and statistical analysis was done. Results:For both superior sagittal sinus drainage and straight sinus drainage, the proportion of veins draining in right and left transverse sinuses and confluence of sinuses was significantly different in the two age groups (p<0.001) in both males and females. Partial splitting of superior sagittal sinus in anterior one third or posterior one third was also seen. Statistically significant findings were observed regarding the laterality for vein of Labbe & vein of Trolard. Conclusion:MR venography is an excellent diagnostic technique to visualise anatomy and anatomic variations of venous sinuses as observed in our study. The partial splitting of superior sagittal sinus in either anterior one third or posterior one third as seen in our study, can cause misdiagnosis of thrombosis. Hence, knowledge of normal anatomy and anatomic variations in the intracranial venous sinuses is very important to diagnose cerebral venous sinus thrombosis accurately.