Bilateral frontal sinus pericranii with an intratabular course. A case report

Abstract

Sinus pericranii is a rare venous anomaly, representing a transosseous connection between the intracranial venous system and the epicranial venous system. We present an unusual case of bilateral frontal sinus pericranii in a 12-year-old boy, with associated lacrimation. Instead of the usual short bridging vein between the intra- and extracranial venous circulation, in our case the veins connecting the superior sagittal sinus and the left superior ophthalmic/orbital vein coursed intratabularly over a distance of several centimeters. To our knowledge, such a course has not previously been reported in literature.

Figure 1

DSA+DA images, LICA+RICA injection. On both sides, the intratabular intra-osseous channels are clearly visible. Also, venous drainage through the sinus pericranii on both sides is depicted.

Figure 2

3d reconstruction of the superficial venous drainage through the angular-and facial veins on both sides. The vein on the right is slightly dilated. The vein on the left shows marked dilatation, consistent with the more prominent sinus pericranii on the left.

Figure 3

Axial and sagittal CE CT images. Sequence of images depicting the intratabular course of both sinus pericranii. The entry-point through the tabula interna is clearly seen, as well as the exit through the orbital roof into the orbit.

Figure 4

DSA + DA image, LICA injection. Full view of the venous drainage from the left side, depicting the connection of both sinus pericranii to the superior sagittal sinus, the intratabular course and the connection to the angular and facial veins on both sides.