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Dural venous sinus thrombosis: an overview and case report
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Abstract
Torcular herophili is the site of the confluence of superior sagittal sinus, tranverse sinus, straight sinus and
occipital sinus [1]. Anatomy of torcular herophili is highly variable. Dilatation of torcular herophili is presented as an
anechoic triangular structure, with venous flow communicated with other sinuses and cerebral veins.
Torcular herphili thrombosis is a rare cerebrovascular disorder[9, 11, 13, 15], and the prenatal diagnosis of
this condition is difficult. This condition can be caused by the abnormalities that produce prothrombotic states, such
as acute fetal distress, and congenital deficiency of anticoagulants such as antithrombin III, protein C, and protein
S[8]. Prenatal ultrasound is the firs-line modality for diagnosing and monitoring thrombosis of the torcular herophili.
In addition, color-Doppler ultrasound helps to differentiate this disorder from other cerebrovascular malformations
such as vein of Galen aneurysmal dilatation[5] and identify the presence of collateral vessels and its relationship
with other dural sinuses[6, 7]. As a complementary technique, MRI can provide additional information to rule out
secondary cerebral damages and associated brain malformations. Prognosis of this disorder is highly variable,
ranging from spontaneous resolution with a normal neurologic outcome to severe neurologic deficits and death.
We present 1 case of thrombosis of ectatic torcular herophili with serial sonographic and magnetic resonance
imaging (MRI) examinations, along with review of literature of this condition. Besides, we have a routine follow-up of
the new-born mental development until now.
Article Details
Keywords
thrombosis, torcular herophili, ultrasound, magnetic resonance imaging (MRI)
References
2. Segal, S. and H. Rosenberg, Sonographic appearance of the torcular Herophili. American journal of roentgenology, 1986. 146(1): p. 109-112.
3. Pandey, V., K. Dummula, and P. Parimi, Antenatal thrombosis of torcular herophili presenting with anemia, consumption coagulopathy and highoutput cardiac failure in a preterm infant. Journal of Perinatology, 2012. 32(9): p. 728.
4. Jenny, B., et al., Giant dural venous sinus ectasia in neonates: Report of 4 cases. Journal of Neurosurgery: Pediatrics, 2010. 5(5): p. 523-528.
5. Sepulveda, W., C. Platt, and N. Fisk, Prenatal diagnosis of cerebral arteriovenous malformation using color Doppler ultrasonography: case report and review of the literature. Ultrasound in Obstetrics & Gynecology, 1995. 6(4): p. 282-286.
6. Visentin, A., et al., Prenatal diagnosis of thrombosis of the dural sinuses with real‐time and color Doppler ultrasound. Ultrasound in obstetrics &
gynecology, 2001. 17(4): p. 322-325. 104 ÑIEÄN QUANG VIEÄT NAM Số 29 - 1/2018
7. Schwartz, N., et al., Thrombosis of an ectatic torcular herophili: anatomic localization using fetal neurosonography. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine, 2008. 27(6): p. 989-991.
8. Byrd, S.E., et al., Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes. Pediatric radiology, 2012. 42(5): p. 536-543.
9. Clode, N., R. Gouveia, and L. Graca, Prenatal diagnosis of thrombosis of the dural sinuses. International Journal of Gynecology and Obstetrics,
2005. 91(2): p. 172-174.
10. Marc Gicquel, J., et al., Normal outcome after prenatal diagnosis of thrombosis of the torcular Herophili. Prenatal diagnosis, 2000. 20(10): p. 824-827.
11. Laurichesse Delmas, H., et al., Prenatal diagnosis of thrombosis of the dural sinuses: report of six cases, review of the literature and suggested
management. Ultrasound in Obstetrics & Gynecology, 2008. 32(2): p. 188-198.
12. Komiyama, M., et al., Transumbilical embolization of a congenital dural arteriovenous fistula at the torcular herophili in a neonate: case report.
Journal of neurosurgery, 1999. 90(5): p. 964-969.
13. Merzoug, V., et al., Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up. European radiology, 2008. 18(4): p. 692-699.
14. Fanou, E.M., et al., In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus. Pediatric radiology, 2013. 43(12): p. 1591-1598.
15. Has, R., et al., Prenatal Diagnosis of Torcular Herophili Thrombosis. Journal of Ultrasound in Medicine, 2013. 32(12): p. 2205-2211.
16. Grangé, G., et al., Prenatal demonstration of afferent vessels and progressive thrombosis in a torcular malformation. Prenatal diagnosis, 2007. 27(7): p. 670-673.
17. Rossi, A., et al., Prenatal MR imaging of dural sinus malformation: a case report. Prenatal diagnosis, 2006. 26(1): p. 11-16.
18. Legendre, G., et al., Prenatal diagnosis of a spontaneous dural sinus thrombosis. Prenatal diagnosis, 2009. 29(8): p. 808-813.
19. Breysem, L., et al., Fetal magnetic resonance imaging of an intracranial venous thrombosis. Fetal diagnosis and therapy, 2006. 21(1): p. 13-17.
20. Spampinato, M.V., et al., Thrombosed fetal dural sinus malformation diagnosed with magnetic resonance imaging. Obstetrics & Gynecology, 2008. 111(2, Part 2): p. 569-572.
21. Sheerin, F. The imaging of the cerebral venous sinuses. in Seminars in Ultrasound, CT and MRI. 2009. Elsevier.