Dural venous sinuses

Krings T, Hans FJ (2004) New developments in MRA time-resolved MRA. Neuroradiology 46 [Suppl 2] 214-222 Kudo K, Terae S, Ishii A, Omatsu T, Asano T, Tha KK, Miyasaka K (2004) Physiologic change in flow velocity and direction of dural venous sinuses with respiration MR venography and flow analysis. AJNR 25 551-557 Kiiker W, Mull M, Mayfrank L, Weis J, Schiefer J, Thron A (1997) A cystic lesion within the dural sinuses a rare cause of increased intracranial pressure. Neuroradiology 39 132-135... 

The venous anatomy is very variable. Venous blood flows centrally via the deep cerebral veins and peripherally via the superficial cerebral veins into the dural venous sinuses, which lie between the outer and meningeal inner layer of the dura and drain into the internal jugular veins (Stam 2005) (Fig. 4.4). The cerebral veins do not have valves and are thin walled, and the blood flow is often in the same direction as in neighboring arteries. There are numerous venous connections between the cerebral veins and the dural sinuses, the venous system of the meninges, skull, scalp, and nasal sinuses, allowing infection or thrombus to propagate between these vessels. 

Saadatnia M, Tajmirriahi M (2007). Hormonal contraceptives as a risk factor for cerebral venous and sinus thrombosis. Acta Neurology Scandinavica 115 295-300 Southwick FS, Richardson EP, Swartz MN (1986). Septic thrombosis of the dural venous sinuses. Medicine (Baltimore) 65 82-106 Stam J (2005). Thrombosis of the cerebral veins and sinuses. New England Journal of Medicine 352 1791-1798... 

Schick RM, Jolesz F, Barnes PD, Mackhs JD. MR diagnosis of dural venous sinus thrombosis comphcating L-asparaginase therapy. Comput Med Imaging Graph 1989 13(4) 319-27. 

Gazzeri, R., Galarza, M., Fiore, C., CaUovini, G., Alfieri, A., 2015. Use of tissue-glue-coated collagen sponge (TachoSil) to repair minor cerebral dural venous sinus lacerations technical note. Neurosurgery 11 (Suppl. 2), 32-36 discussion 36. 

Beers GJ, Carter AP, Ordia Jl, Shapiro M (1984) Sinus peri-cranii with dural venous lakes. AJNR Am J Neuroradiol... 

Dural arteriovenous malformations (DAVM) are abnormal shunts between the arterial and the venous side of the vascular tree that are located within the dura, most frequently within the wall of or immediately around the venous sinuses. 

The venous sinuses are spaces within dural layers that convey venous blood from veins within the cranium to the systemic venous circulation (Fig. 103-4). Venous sinuses are devoid of the elastic and muscle tissue found in all other veins and therefore have no elasticity and muscular contraction to enhance drainage. Circulation is dependent on motion. During the inhalation phase, the sinuses change from "V"-shaped to ovoid, with a resultant Increase In capacity. During this phase, the tributary veins increase drainage into the sinuses. 

Tsai FY, Wang AM, Matovich VB, Lavin M, Berberian B, Simonson TM, Yuh W. MR staging of acute dural sinus thrombosis correlation with venous pressure measurements and implications for treatment and prognosis. Am J Neuroradiol 1995 16 1021-1029. 

Vogel TJ, Bergman C, Villringer A, Einhaupl K, Lissner J, Felix R (1994) Dural sinus thrombosis value of venous MR angiography for diagnosis and follow-up. Am J Roentgenol 162 1191-1198... 

Thrombosis in the dural sinuses or cerebral veins is much less common than cerebral arterial thromboembolism. It causes a variety of clinical syndromes, which often do not resemble stroke (Bousser and Ross Russell 1997). While ischemic arterial stroke and cerebral venous thrombosis share some causes (Southwick et al. 1986), others are specific to cerebral venous thrombosis (Table 29.1). A particularly high index of suspicion is required in women on the oral contraceptive pill (Saadatnia and Tajmirriahi 2007) and in the puerperium. In the past, cerebral venous thrombosis was strongly associated with otitis media and mastoiditis, lateral sinus thrombosis or otitic hydrocephalus, but the most common causes are now pregnancy and the puerperium, which cause 5-20% of the cerebral venous thrombosis in the developed world, the oral contraceptive pill, malignancy, dehydration, inflammatory disorders and hereditary coagulation disorders. No cause is found in around 20% of cases. 

The posterior cerebral artery supplies the occipital lobe and portions of the medial and inferior temporal lobe. The arterial supply of the spinal cord is derived from the vertebral arteries and the radicular arteries. The brain is supplied by the internal carotid arteries (the anterior circulation) and the vertebral arteries, which join at the pon tomedullary junction to form the basilar artery (collectively termed the posterior circulation). The brainstem is supplied by the posterior system. The medulla receives blood from branches of the vertebral arteries as well as from the spinal arteries and the posterior inferior cerebellar artery (PICA). The pons is supplied by paramedian and short circumferential branches of the basilar artery. Two major long circumferential branches are the anterior inferior cerebellar artery (AICA) and the superior cerebellar artery. The midbrain receives its arterial supply primarily from the posterior cerebral artery as well as from the basilar artery. The venous drainage of the spinal cord drains directly to the systemic circulation. By contrast, veins draining the cerebral hemispheres and brain stem drain into the dural sinuses. Cerebrospinal fluid also drains into the dural sinuses through unidirectional valves termed arachnoid villi. 

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