Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Oct;37(10):3177-3187.
doi: 10.1007/s00381-021-05315-4. Epub 2021 Aug 18.

Venous anomalies in hypoplastic posterior fossa: unsolved questions

T Protzenko  1 , A Bellas  2 , C Maria Cunha Ribeiro  3 , S Maria de Carvalho Gonzalez  4 , D Dain Gandelman Horovitz  5
Affiliations
Review

Venous anomalies in hypoplastic posterior fossa: unsolved questions

T Protzenko et al. Childs Nerv Syst. 2021 Oct.

Abstract

Introduction: Anomalous intracranial venous anatomy is described in patients with syndromic craniosynostosis and is of significant importance when it comes to surgical morbidity. However, it is still controversial its origin, type of circulation in each syndrome, how it behaves over time, when it can be interrupted and wether it needs to be studied. The purpose of this paper is to discuss these issues by reviewing the literature.

Methods: A literature search was performed using the PubMed database with a focus on papers including detailed descriptions of the venous outflow in complex and syndromic craniosynostosis. Search details used were the following: ("veins"[MeSH Terms] OR "veins"[All Fields] OR "venous"[All Fields]) AND ("abnormalities"[Subheading] OR "abnormalities"[All Fields] OR "anomalies"[All Fields]) AND syndromic[All Fields] AND ("craniosynostoses" [MeSH Terms] OR "craniosynostoses"[All Fields] OR "craniosynostosis"[All Fields]). Studies that exposed details of venous anomalies found in syndromic or complex craniosynostosis were selected.

Results: Of a total of 211 articles found, 11 were selected for this review. Of these, 5 were case reports, 5 retrospective studies, and only 1 prospective study. From the 6 series of cases presented, 5 discussed the relationship between jugular foramen stenosis (JFS) and collateral venous drainage. The authors discuss data from the literature for each leading question presented: 1-collateral circulation: is it an intrinsic trouble, a consequence of stenosis of the cranial base foramina or related to raised intracranial pressure (ICP)?; 2-what venous anomalies should we search for, and what is the best exam to study them?; 3-collateral circulation changes with time?; 4-can neurosurgeons interrupt the collateral circulation?; 5-should we study all complex types of craniosynostosis?

Conclusion: The importance of the study of the venous outflow in patients with complex craniosynostosis is evident in the literature. The real relationship between intracranial hypertension, hypoplastic skull base foramen, Chiari I malformation, hydrocephalus, and venous collateral circulation remains unknown. Prospective studies focusing on molecular biology analysis will possibly solve all of these leading questions.

Keywords: Complex craniosynostosis; Jugular foramen stenosis; Syndromic craniosynostosis; Venous outflow.

PubMed Disclaimer

References

    1. Copeland AE, Hoffman CE, Tsitouras V et al (2018) Clinical significance of venous anomalies in syndromic craniosynostosis: plastic and reconstructive surgery - Global Open 6:e1613. https://doi.org/10.1097/GOX.0000000000001613 - DOI - PubMed - PMC
    1. Jeevan DS, Anlsow P, Jayamohan J (2008) Abnormal venous drainage in syndromic craniosynostosis and the role of CT venography. Child’s Nervous System 24:1413–1420. https://doi.org/10.1007/s00381-008-0667-8 - DOI - PubMed
    1. Florisson JMG, Barmpalios G, Lequin M et al (2015) Venous hypertension in syndromic and complex craniosynostosis: the abnormal anatomy of the jugular foramen and collaterals. J Craniomaxillofac Surg 43:312–318. https://doi.org/10.1016/j.jcms.2014.11.023 - DOI - PubMed
    1. Wang JC, Nagy L, Demke JC (2016) Syndromic craniosynostosis. Facial Plast Surg Clin North Am 24:531–543. https://doi.org/10.1016/j.fsc.2016.06.008 - DOI - PubMed
    1. Coll G, Sakka L, Botella C et al (2018) Pattern of closure of skull base synchondroses in crouzon syndrome. World Neurosurg 109:e460–e467. https://doi.org/10.1016/j.wneu.2017.09.208 - DOI - PubMed

LinkOut - more resources