Trabeculae in the basilar venous plexus: anatomical and histological study with application to intravascular procedures

Viktoriya S. Grayson,Mitchell Couldwell,Arada Chaiyamoon,Juan J. Cardona,Francisco Reina,Ana Carrera,Erin P. McCormack,Kendrick Johnson,Sassan Keshavarzi,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2023 Anatomy & Cell Biology Vol.56 No.4

Few studies have examined the basilar venous plexus (BVP) and to our knowledge, no previous study has describedits histology. The present anatomical study was performed to better elucidate these structures. In ten cadavers, the BVP wasdissected. The anatomical and histological evaluation of the intraluminal trabeculae within this sinus were evaluated. Onceall gross measurements were made, the clivus and overlying BVP were harvested and submitted for histological analysis. A BVP was identified in all specimens and in each of these, intraluminal trabeculae were identified. The mean number oftrabeculae per plexus was five. These were most concentrated in the upper half of the clivus and were more often centrallylocated. These septations traveled in a posterior to anterior direction and usually, from inferiorly to superiorly however somewere noted to travel horizontally. In a few specimens the trabeculae had wider bases, especially on the posterior attachmentto the meningeal layer of dura mater. More commonly, the trabeculae ended in a denticulate form at their two terminalends. The trabeculae were on average were 0.85 mm in length. The mean width of the trabeculae was 0.35 mm. Theseseptations were consistent with the cords of Willis as are found in the lumen of some of the other intradural venous sinuses. An understanding of the internal anatomy of the BVP can aid in our understanding of venous pathology. Furthermore, thisknowledge will benefit patients undergoing interventional treatments that involve the BVP.

Case report of a vertical straight sinus with hydrocephalus and Chiari I malformation

Dany Hage,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.4

The straight sinus is a division of the dural venous sinuses, found beneath the splenium of the corpus callosum. At the internal occipital protuberance, it comes together with the superior sagittal sinus and transverse sinus to form the torcular Herophili. It functions as a major site of venous drainage for the cerebellum, inferior sagittal sinus, and vein of Galen. Many morphological variations have been reported involving the angulation, positioning, and number of straight sinuses present. Patients with Chiari II and III malformations have been observed to have a high incidence of anatomical variation with their dural venous sinuses, including vertically oriented straight sinuses. Additionally, there is a high rate of hydrocephalus in this patient population. Herein, we report a vertically oriented straight sinus in a child.

Caudal regression syndrome and a pelvic kidney: case report

Dany Hage,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.4

Caudal regression syndrome (CRS) is a rare congenital variation. A high incidence of renal and genitourinary malformations has been observed in patients with CRS, with the most common being neurogenic bladder and renal agenesis. We report a rare case report documenting both CRS and a pelvic kidney found during a diagnostic magnetic resonance imaging. Although renal anatomy variants are found in patients with CRS, a pelvic kidney is normally not part of the constellation of findings in this malformation. As seen in our patient, a pelvic kidney should be considered in patients suspected of having CRS.

Giant dural arteriovenous fistula in an infant

Charles Peper,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2021 Anatomy & Cell Biology Vol.54 No.4

Dural arteriovenous fistulas (dAVFs) are commonly encountered by the neurosurgeon. Herein, we present a case illustration of an infant presenting with an extremely large fistula that took up a significant part of the intracranial volume. A one-month-old female presented with irritability and failure to thrive. She was the product of a 35-week pregnancy and was delivered vaginally without complications or a difficult labor. Based on the findings of magnetic resonance imaging, the diagnosis of a giant dAVF involving the transerve-sigmoid sinuses was made. The patient was scheduled for an arteriogram but died before the procedure could be performed. Such a case illustrates how large some dAVF can become and at a very early age. As in the present case, the patient was minimally symptomatic. Therefore, the time to intervention after diagnosis is thus, sometimes, critical.

A giant foramen of Vesalius: case report

Charles Peper,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2022 Anatomy & Cell Biology Vol.55 No.3

Anatomical variations identified at the skull base can result in challenges to the clinician. For example, the anatomy of the foramen ovale and its neighboring structures is critical knowledge for the surgeon who performs transcutaneous approaches to the foramen ovale for treating patients with trigeminal neuralgia. One nearby structure that can compound invasive procedures and potentially result in complications is the foramen of Vesalius. Although usually small, we report a giant foramen of Vesalius found in an adult female skull. The anatomy and clinical aspects of such a finding are discussed and related to other reports in the literature.

Direct drainage of the basal vein of Rosenthal into the superior petrosal sinus: a literature review

Santiago Gutierrez,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.4

An adult male was found to have a variation of the left basal vein of Rosenthal after presenting with complaints of headache and balance issues. In this case, the vein drained directly into the left superior petrosal sinus (SPS) instead of the great vein of Galen. Anatomical variation of the basal vein is likely due to embryonic development of the deep cerebral venous system as primitive structures either differentiate regress or further with age. These changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case that shows the basal vein drains into the SPS. The normal and variant anatomy of this vessel are discussed.

A rare cadaveric case of a duplicated internal thoracic artery

Harry Nanthakumar,Joe Iwanaga,Aaron S,Dumont,R,Shane Tubbs 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.3

The internal thoracic artery (ITA) arises from the subclavian artery and terminates as the musculophrenic and inferior epigastric arteries. During routine cadaveric dissection, an aberrant left ITA was discovered. A medial and a lateral branch of the ITA branched directly off the subclavian artery as opposed to bifurcating at the 6th or 7th intercostal space. To our knowledge, this is the first reported case of this particular ITA variation arising from the third part of the subclavian artery. Additionally, such a variant might also be considered a high bifurcation of the ITA. Our report examines this variation and its potential implications for coronary artery bypass grafts where the ITA is commonly used.

Cadaveric findings of a duplicated superior petrosal sinus

Tina K. Reddy,Łukasz Olewnik,Joe Iwanaga,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2022 Anatomy & Cell Biology Vol.55 No.3

Knowledge of the intracranial dural venous sinuses and their variations is important in the diagnosis and management of many cranial pathologies. We report a unique duplication of the right-sided superior petrosal sinus identified during routine dissection of the skull base.. Lateral to this sinus, a separate and more curvilinear superior petrosal sinus left the normally positioned superior petrosal sinus and traveled posteriorly near the foramen spinosum and then turned medially to drain into the normally positioned superior petrosal sinus. Anteriorly, the two sinuses joined together and drained into the cavernous sinus. Posteriorly, the laterally positioned sinus drained into the normally positioned sinus which then traveled in normal fashion along the petrous ridge to end in the transverse sinus. To our knowledge, such a duplication has not been previously reported in the extant medical literature.

Duplication of the odontoid process with other congenital defects of the craniocervical Junction: case report and review of the literature

Tyler Zeoli,Joe Iwanaga,CJ Bui,Aaron S. Dumont,R. Shane Tubbs 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.4

Duplication of the odontoid process remains a rare developmental pathology that is underrepresented in the current literature. As the pivot point for the craniovertebral junction, the odontoid process is vital for the integrity of the atlanto-axial joint and the ability of the head and cervical spine to rotate correctly. The pathogenesis being incompletely understood, it has been proposed that odontoid process duplication involves faulty sclerotome migration and disruption of the axis ossification center. Patients presenting with this pathology usually have associated structural abnormalities. A detailed anatomical and embryological understanding of the odontoid process is necessary for successful management and treatment of patients presenting with odontoid process duplication. We present a rare case of a patient with a duplicated odontoid process in association with C2-C3 fusion, incomplete anterior arch of C1, variant inferior bony process of the transverse process of C1, and enlarged right jugular foramen.

Bilateral venous sinuses of Kelch

Mitchell Couldwell,Aimee Aysenne,Joe Iwanaga,Aaron S,Dumont,R,Shane Tubbs 대한해부학회 2021 Anatomy & Cell Biology Vol.54 No.3

Knowledge of the variant anatomy of the intradural venous sinuses is important to anatomists and clinicians alike. Herein, we report a cadaveric case of the rare venous sinus of Kelch, which some have believed is a remnant of the cranioorbital sinuses. To our knowledge, only one other cadaveric case has been reported in the extant medical literature. Clinically, knowledge of such a variant venous sinus can minimize misdiagnoses such as when anatomical variations are noted on imaging. Surgically, such an understanding can avoid intraoperative complications such as iatrogenic hemorrhage.