Dural venous sinus [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Dural venous sinus ======

The dural [[venous sinus]]es (also called [[dural sinus]]es, [[cerebral venous sinus]]es, or cranial sinuses) are venous channels found between layers of dura mater in the brain.

They receive blood from internal and external veins of the brain, receive cerebrospinal fluid (CSF) from the subarachnoid space, and ultimately empty into the [[internal jugular vein]].


Traditionally, the dural venous sinuses have been described only in the cranium. However, anecdotally, during various neurosurgical intradural procedures in the lumbosacral spine, Iwanaga et al., noticed an intradural collection of blood. With no prior studies on this in the extant medical literature, the following anatomical investigation seemed warranted
((Iwanaga J, Alonso F, Akobo S, Turgut M, Yurttas C, Loukas M, Reina MA,
Oskouian RJ, Tubbs RS. The Lumbosacral Dural Venous Sinus: A New Discovery with
Potential Clinical Applications. World Neurosurg. 2017 Feb 8. pii:
S1878-8750(17)30142-0. doi: 10.1016/j.wneu.2017.01.116. [Epub ahead of print]
PubMed PMID: 28189870.
)).

see [[lumbosacral venous sinus]]
====Venous sinuses====
[[Cavernous sinus]]

[[Confluence of sinuses]]

[[Inferior petrosal sinus]]

[[Inferior sagittal sinus]]

[[Internal jugular vein]]

[[Occipital sinus]]

[[Sigmoid sinus]]

[[Sphenoparietal sinus]]

[[Straight sinus]]

[[Superior petrosal sinus]]	

[[Superior sagittal sinus]]	

[[Transverse sinus]].

====Structure====
The walls of the dural venous sinuses are composed of dura mater lined with endothelium, a specialized layer of flattened cells found in blood vessels. They differ from other blood vessels in that they lack a full set of vessel layers (e.g. tunica media) characteristic of arteries and veins. It also lacks valves as seen in veins.

====Clinical relevance====
The sinuses can be injured by trauma.

Damage to the dura mater, which may be caused by skull fracture, may result in blood clot formation (thrombosis) within the dural sinuses. While rare, dural sinus thrombosis may lead to hemorrhagic infarction with serious consequences including epilepsy, neurological deficits, or death.

see [[venous sinus diverticulum]]
The dural [[venous sinus]]es (also called dural sinuses, cerebral sinuses, or cranial sinuses) are venous channels found between layers of dura mater in the brain.

They receive blood from internal and external veins of the brain, receive cerebrospinal fluid (CSF) from the subarachnoid space, and ultimately empty into the internal jugular vein.

Many authors have reported the association of pulsatile [[tinnitus]] with anomalies of dural venous sinuses and the jugular bulb.
----
Profuse bleeding originating from an injured cerebral sinus can be a harrowing experience for any surgeon, particularly during an operation on a young child. Common surgical remedies include sinus ligation, primary repair, placement of a hemostatic plug, and patch or venous grafting that may require temporary stenting. 

In a paper the Tuite et al., describe the use of a contoured bioresorbable plate to hold a hemostatic plug in place along a tear in the inferomedial portion of a relatively inaccessible part of the posterior segment of the superior sagittal sinus in an 11-kg infant undergoing [[hemispherotomy]] for epilepsy. This variation on previously described hemostatic techniques proved to be easy, effective, and ultimately lifesaving. Surgeons may find this technique useful in similar dire circumstances when previously described techniques are ineffective or impractical
((Tuite GF, Carey CM, Nelson WW, Raffa SJ, Winesett SP. Use of a contoured
bioresorbable plate with a hemostatic plug to control life-threatening bleeding
from the superior sagittal sinus during hemispherotomy: technical note. J
Neurosurg Pediatr. 2016 Oct;18(4):487-492. PubMed PMID: 27391919.
)).
----
see [[Dural venous sinus thrombosis]].

====Imaging====
The evaluation of the [[cerebral venous system]], especially the [[dural venous sinus]]es, is most often performed using [[MR venography]] or CT [[venography]].

===== Dural sinus lesions =====

[[Dural sinus lesions]]