Relationship of superior sagittal sinus with sagittal midline: A surgical application.

Content Provider	Europe PMC
Author	Oberman, Dan Zimelewicz Rabelo, Nícollas Nunes Correa, Jorge Luiz Amorim Ajler, Pablo
Copyright Year	2020
Abstract	Background: Interhemispheric approach is widely used to surgical management of midline tumors and vascular lesion in and around the third ventricle. Complete exposure of the superior sagittal sinus to obtain adequate working space of midline lesion is difficult, because of the risk to inadvertent injury to the sinus and bridging veins, which may cause several neurological deficits. Understanding the SSS neuroanatomy and its relationships with external surgical landmarks avoid such complications. The objective of this study is to accurately describe the position of SSS and its displacement in relation with sagittal midline by magnetic resonance imaging.Methods: A retrospective cross-sectional, observational study was performed. Magnetic resonance image of 76 adult patients with no pathological imaging was analyzed. The position of the halfway between nasion and bregma, bregma, halfway between bregma and lambda, and lambda was performed. The width and the displacement of the superior sagittal sinus accordingly to the sagittal midline were assessed in those landmarks.Results: The mean width of superior sagittal sinus at halfway between nasion and bregma, bregma, halfway between bregma and lambda, and lambda was 5.62 ± 2.5, 6.5 ± 2.8, 7.4 ± 3.2, and 8.5 ± 2.1 mm, respectively, without gender discrepancy. The mean displacement according to the midline at those landmarks showed a statistically significant difference to the right side among sexes.Conclusion: In this study, we demonstrate that sagittal midline may approximate external location of the superior sagittal sinus. Our data showed that in the majority of the cases, the superior sagittal sinus is displaced to the right side of sagittal midline as far as 16.3 mm. The data we obtained provide useful information that suggest that neurosurgeons should use safety margin to perform burr holes and drillings at the sagittal midline.
ISSN	22295097
Volume Number	11
PubMed Central reference number	PMC7568091
PubMed reference number	33093986
Journal	Surgical Neurology International [Surg Neurol Int]
e-ISSN	21527806
DOI	10.25259/SNI_509_2020
Language	English
Publisher	Scientific Scholar
Publisher Date	2020-09-25
Publisher Place	USA
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Copyright: © 2020 Surgical Neurology International
Subject Keyword	Anatomical study Bregma Coronal suture Dural sinus Superior sagittal sinus
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery