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PubMed1976

Circumflex coronary artery bypass grafting via transverse sinus.

Grafting the circumflex coronary artery has been more difficult technically than the right or anterior descending because of its posterior location and the angles of its marginal branches. However, grafting this artery has been substantially simplified by a method wherein the graft is passed directly through the transverse sinus and anastomosed to the back of the ascending aorta. This follows the most direct course to the ascending aorta and the graft is much shorter than one brought anterior to the heart. There is little chance of kinking the graft, since its angle of attachment is ideal, and due to the anatomical configuration of the transverse sinus, there is more room for the graft and compression is unlikely. This allows more room on the anterior surface of the aorta for grafts to other coronary arteries. This method has been used in 50 cases and blood flows have been excellent. Twelve of these cases have been restudied postoperatively and the grafts are patent.

Coronary Artery Bypass↗
PubMed1988

Transverse sinus thrombosis in newborns: clinical and magnetic resonance imaging findings.

Neonatal transverse sinus thrombosis (TST) is considered a rare and severe sequela of birth injury. Clinical descriptions of this entity are few since most published series are postmortem studies. The advent of magnetic resonance imaging (MRI) allows recognition of TST ante mortem. We describe 4 full-term infants with distinct clinical and neuroradiological features indicative of TST, which we suggest may be relatively common, with a wide spectrum of severity, including favorable outcome.

Brain↗
PubMed2005

Comparison of different MR venography techniques for detecting transverse sinus stenosis in idiopathic intracranial hypertension.

Cerebral venous outflow abnormalities, as transverse sinuses (TSs) stenosis,may underlie a picture of idiopathic intracranial hypertension (IIH). To identify the best non-invasive MR venography (MRV) technique for exploring the disturbance of flow of TSs in IIH patients, we compared three dimensional phase contrast (3-DPC) MRV images, acquired with different velocity encodings (15 and 40 cm/s) with two-dimensional time-of-flight (2D-TOF) MR images in 6 subjects with IIH and 12 age-matched normal controls. In both groups, we also measured flow velocity in TSs by using single slice 2D-CINE PC acquisitions. In all subjects with IIH, 3D-PC showed marked flow disturbance in the mid-lateral portion of both TSs when velocity encoding (VENC) was set to 15 cm/s while only a slightly irregular flow in TSs was detected when VENC was set to 40 cm/s or when 2D-TOF was used. By contrast, 3D-PC (VENC 15 and 40) and 2D-TOF techniques were comparable in detecting TS signal flow in normal controls. Measures of flow velocity, by using 2D-CINE PC, revealed a three-fold increase of velocity at the level of the flow disturbance in IIH patients compared to normal controls (p<0.0001), suggesting a marked stenosis of mid-lateral portion of TSs in these patients. Setting the VENC to 15 cm/s on 3D-PC MRV may represent the best technical approach for visualizing disturbances of flow in TSs in subjects with symptoms suggestive of IIH.

Adult↗
PubMed1999

[Congenital arteriovenous malformation of the scalp with a drainage to the transverse sinus: a case report].

Arteriovenous malformation (AVM) of the scalp is uncommon, and a subtype which has connection with the intracranial dural sinus is extremely rare. Only 3 cases have been reported. We present a case of congenital AVM of the scalp which was connected with the intracranial venous sinus. A 27-year-old woman had been noted as having a pulsatile soft mass in the midline of the occipital region since her birth. She visited our hospital because of pain and enlargement of the mass. The patient had had no history of trauma. Physical examination revealed a pulsatile scalp mass in the midline of the occipital region, measuring 3.5 x 3.5 x 1 cm. A loud bruit was ausculated. Tenderness was noted. The skin over the mass was slightly reddish. No focal neurological deficits were noted. Plain skull films demonstrated a round defect in the midline of the occipital bone. Magnetic resonance imaging (MRI) demonstrated a subcutaneous mass with low signal intensity and an infratentorial mass with flow void. 3D CT angiograms demonstrated a subcutaneous vascular mass with a single large vein draining into the right transverse sinus. External carotid angiograms revealed a vascular lesion within the scalp with supply from the branches of the bilateral occipital arteries and the meningeal arteries. The nidus penetrated the skull and connected to a dilated varix, which had a draining vein shunting into the right transverse sinus. After embolization of the right meningeal feeding arteries, surgery was performed. The vascular lesion penetrated the skull and the dura. The infratentorial mass was in the epiarachnoid space and was fed by a small pial artery. The mass was excised completely after interruption of the pial artery and the draining vein. Postoperative course was uneventful. Histologically, the subcutaneous mass and infratentorial vascular mass were shown to be AVM and varix, respectively.

Adult↗
PubMed1999

Tentorial meningioma encroaching the transverse sinuses and sigmoid sinus junction area associated with dural arteriovenous fistulous malformation: a case report.

A 62-year-old woman was evaluated for tinnitis and headache. Magnetic resonance imaging and angiography revealed the coexistence of a tentorial tumor encroaching the junction of the right transverse-sigmoid sinuses, and dural arteriovenous fistulous malformation (AVFM) of the right transverse sinus. AVFM was not manipulated at all during the surgery. The pathology was fibroblastic meningioma. Postoperatively, the dural AVFM completely disappeared on follow-up angiography. The fistulas were occluded also after surgery, even though there was no manipulation of the AVFM. It is suggested that the right dominant transverse-sigmoid sinuses are partially occluded by tentorial meningioma, developing the dural arteriovenous fistula of the right transverse sinus. An acquired origin of the dural AVFM was suggested in this case.

Arteriovenous Malformations↗
PubMedDate not supplied

Extradural epidermoid cyst occluding the transverse sinus: a case report.

A case of an epidermoid cyst obstructing the transverse sinus is presented. The preoperative radiologic evaluation comprised CT, MR Imaging, and cerebral angiogram. The discussion includes the relative value of each test as part of the preoperative evaluation and the differential diagnosis of lateral sinus occlusion.

Bone Diseases↗
PubMed2000

Longitudinal changes in the ductus venosus, cerebral transverse sinus and cardiotocogram in fetal growth restriction.

OBJECTIVE: To evaluate the changes in flow velocity waveforms in the transverse cerebral sinus in growth-restricted fetuses and to correlate these changes with (1) flow velocity waveforms in the ductus venosus and (2) changes in computerized analysis of the fetal cardiotocogram. DESIGN: Fetuses between 22 and 37 weeks' gestation with an estimated fetal weight below the fifth centile were included in this prospective longitudinal study. Doppler measurements of the umbilical artery, descending aorta, middle cerebral artery, transverse cerebral sinus and ductus venosus were recorded. Fetal heart rate was analyzed by a computer system according to the Dawes-Redman criteria. RESULTS: We measured a significant correlation between pulsatility index in the cerebral transverse sinus and in the ductus venosus over the study period and at delivery. There was a negative correlation between these indices and short- and long-term variability of the fetal heart rate. There was a parallel increase in pulsatility in the ductus venosus and the transverse cerebral sinus. These changes were inversely correlated with fetal heart rate variability and preceded fetal distress. CONCLUSION: Cerebral venous blood flow in IUGR fetuses may be a useful additional investigation to discriminate between fetal adaptation and fetal decompensation in chronic hypoxemia.

Aorta↗
PubMed1976

Acute intravenous infusion in freely moving rats through the sagittal and transverse sinuses.

A technique is described which allows drugs to be injected intravenously using the junction of the sagittal and transverse sinuses as the point of entry into the venous system. The procedure is rapid and uses conventional stereotaxic techniques. Subsequent restraint of movement during drug infusion is minimal. Using this method, 15 mug/kg d-lysergic acid diethylamide produced an increase in acoustic startle amplitide within about 1-2 min which lasted for about 25 min.

Acoustic Stimulation↗
PubMedDate not supplied

Increased intracranial pressure as a complication of unilateral radical neck dissection in a patient with congenital absence of the transverse sinus.

We report a patient with increased intracranial pressure occurring after unilateral neck dissection. Subsequent vascular studies reveal a hypoplastic contralateral transverse sinus drainage and occlusion of the ipsilateral jugular bulb. We review the literature on the etiology of this vascular malformation and conclude that vascular anomalies of the venous drainage of the head be considered whenever postoperative signs of increased intracranial pressure occur after unilateral radical neck dissection.

Carcinoma, Squamous Cell↗
PubMed1993

Penetrating injury of the transverse sinus by a nail-gun--case report.

A 46-year-old male presented with a penetrating injury of the transverse sinus caused by a nail-gun. Open craniotomy reflected a doughnut-shaped bone flap and the 45 mm long nail, which was fortunately only touching the edge of the sinus, successfully removed. A wide surgical exposure and careful manipulation of the embedded nail are important to avoid inadvertent injury to the venous sinus and the surrounding brain tissues during the surgical procedure.

Accidents, Occupational↗
PubMed1991

[A case of Behçet disease with transverse sinus thrombosis and successful treatment with colchicine].

A 64-year-old man was admitted to our hospital because of headache and fever. Four months before admission, he had suffered from thrombophlebitis of the legs, erythema, oral aphtha and genital ulcers, and was diagnosed as having Behçet disease. Several days prior to admission he developed fever and was treated with enoxacine, which caused disorientation and abnormal behavior. These psychiatric symptoms disappeared after enoxacine was discontinued. On admission he was neurologically normal. Fever and headache disappeared spontaneously. However, he complained again of headache, and was suspected to have cerebral sinus thrombosis. Brain CT scan showed no abnormality, but brain MRI and cerebral angiography demonstrated right transverse sinus thrombosis and stasis. He was treated with colchicine, isosorbide, and ticlopidine. Because he had a gastric ulcer, corticosteroids were not indicated. Two months later, brain MRI demonstrated reduction of the size of the sinus thrombosis, and the clinical outcome was favorable. We would like to emphasize the usefulness of MRI and colchicine in the patient with Behçet disease complicated by sinus thromboses.

Behcet Syndrome↗
PubMed1977

[Benign intracranial hypertension due to thrombosis of a transverse sinus. Diagnosis by scintigraphy using bleomycin labelled with cobalt 57 (author's transl)].

In a case of benign intracranial hypertension with no apparent aetiology, cerebral scintigraphy demonstrated abnormal uptake in the left transverse sinus 24 hours after injection of the isotope. This sinus was seen to be thrombosed by cerebral angiography. On the basis of this case, the role of cerebral venous thrombosis in cases of "pseudo-tumor cerebri" is discussed.

Adult↗
PubMed2000

Superficial surgical landmarks for the transverse sinus and torcular herophili.

OBJECT: The purpose of this anatomical study is to identify reliable external landmarks that can be used to determine accurately the lower border of the proximal segment of the transverse sinus (TS). METHODS: The authors used 15 formalin-fixed cadaveric specimens for this project. Various anatomical structures were dissected and measurements of the distance between these structures and the proximal TS were obtained. The data collected in this study demonstrate that the inion is not always a reliable external landmark to use when determining the internal location of the very proximal TS and its drainage into the area of the torcular herophili. In addition, the authors found that the most accurate external landmark to use in reliably estimating the internal placement of the proximal TS is the point of insertion of the musculus semispinalis capitus and not the superior nuchal line. In the present study, this muscle never covered more than 5 mm of the inferior edge of the TS and was found to be a reliable anatomical structure for avoiding the medial segment of the TS. CONCLUSIONS: These findings could aid the surgeon in localizing the TS with various midline approaches to the posterior fossa and the craniocervical junction.

Aged↗
PubMed2000

Endovascular treatment of a grade IV transverse sinus dural arteriovenous fistula by sinus recanalization, angioplasty, and stent placement: technical case report.

OBJECTIVE AND IMPORTANCE: The frequent association of dural arteriovenous fistulae (DAVFs) and dural sinus thrombosis may render the treatment of these complex lesions difficult. We report a case of DAVF eradicated by recanalization of the chronically thrombosed transverse sinus (TS) and sigmoid sinus followed by balloon angioplasty and stent deployment at the site of the fistula. CLINICAL PRESENTATION: A 52-year-old man presented with a Type IV DAVF of the left TS with widespread white matter changes secondary to venous hypertension. Arterial feeders arose from the left internal carotid, external carotid, and vertebral arteries. The distal segment of the left TS, the left sigmoid sinus, and the proximal segment of the right TS were occluded. Reverse flow was observed in the deep venous system and in the superior sagittal sinus. INTERVENTION: Endovascular access was gained through the left internal jugular vein. Mechanical recanalization of the thrombosed left TS and sigmoid sinus was followed by balloon angioplasty and placement of six overlapping stents extending from the TS to the proximal internal jugular vein. Angiograms performed after surgery showed resaturation of antegrade venous drainage as well as complete eradication of the fistulous connections. The patient was discharged with an improving clinical CONCLUSION: Recanalization of a chronically occluded dural venous sinus through a jugular approach is feasible. In addition to eradicating cerebral venous hypertension by reestablishing antegrade venous drainage, balloon angioplasty and stent deployment at the DAVF site produced complete closure of the fistula. This may prove to be a new therapeutic strategy for management of DAVF.

Angiography, Digital Subtraction↗