Sinus pericranii diagnosis [Neurosurgery Wiki]

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====== Sinus pericranii diagnosis ======


===== Ultrasound =====

Color Doppler may show communication with superficial veins and dural venous sinuses 
((Luker GD, Siegel MJ. Sinus pericranii: sonographic findings. AJR Am J
Roentgenol. 1995 Jul;165(1):175-6. PubMed PMID: 7785580.
))

===== CT =====

Non contrast

slightly increased attenuation compared with brain parenchyma
        
may show an associated cranial vault defect

Post contrast
        
unless thrombosed, the abnormal communication between dural sinuses and the cranial vault will tend to enhance to the same degree as cerebral venous structures

===== MRI =====

Signal may vary due to slow flow. An abnormal communication between dural sinuses and the cranial vault is usually seen.

===== DSA =====

DSA can be helpful for definitive diagnosis and deciding treatment option, through analyzing venous flow dynamics and discovering the vascular nature.

Some authors recommend direct percutaneous [[venography]] as a confirmatory tool, however, it is associated with a high risk of bleeding and infarction
((Akram H, Prezerakos G, Haliasos N, O'Donovan D, Low H. Sinus pericranii: an
overview and literature review of a rare cranial venous anomaly (a review of the 
existing literature with case examples). Neurosurg Rev. 2012 Jan;35(1):15-26;
discussion 26. doi: 10.1007/s10143-011-0325-6. Epub 2011 Jun 9. Review. PubMed
PMID: 21656130.
)).