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CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0043-1777276
Original Article

Morphometry of Superior Sagittal Sinus and Its Clinical Significance

Grace Suganya 
1   Department of Anatomy, All India Institute of Medical Sciences (AIIMS) Kalyani, Nadia, West Bengal, India
,
Ariharan Krishnaraj 
2   Department of Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
,
Raveendranath Veeramani 
3   Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)], Puducherry, India
,
Dinesh Kumar 
3   Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)], Puducherry, India
,
Nagarajan Krishnan 
2   Department of Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Abstract

The position of the superior sagittal sinus (SSS) in the midline along the sagittal suture is still a debate among neurosurgeons. The aim of the study is to evaluate the diameter and deviation of the SSS at various landmarks in the midline. We evaluated 100 computed tomography venography images. The mean diameter of SSS between nasion and bregma was 2.6 ± 0.7 mm and it was 3.7 ± 0.9 at bregma. Between bregma and lambda and at lambda, the mean diameters were 5.1 ± 1.2 and 5.7 ± 1.04, respectively. Deviation of SSS toward the right side was seen in approximately 77% of cases, while left deviation and no deviation were seen in 11 and 12%, respectively, between nasion and bregma. At bregma, 62, 10, and 28% deviation was seen toward the right side, left side, and in midline, respectively. In other three segments between bregma and lambda, at lambda and beyond lambda the right and left deviation of SSS were found in 68, 70, 71% and 11, 9, 11% respectively. While in these three segments there was no deviation in SSS in 21(between bregma and lambda), 21(at lambda) and 18% (beyond lambda). Further, we compared our data between genders and age groups. A statistically significant difference in diameter of SSS between genders was noted at the level of bregma and a significant difference in deviation of SSS between genders was noted in the segment between nasion and bregma. Thus, the findings of this study would serve as the crucial surgical data for the neurosurgeons in placing the burr holes in craniotomies and in the interhemispheric approach for midline tumors.

Keywords

superior sagittal sinus - sagittal suture - bregma - lambda - burr holes

Authors' Contribution

R.V. and D.K.V. conceptualized the study. G.S.S., A.K., and N.K. helped in data acquisition. G.S.S. was involved in data analysis and interpretation. G.S.S., R.V., and D.K.V. drafted the manuscript. G.S.S., R.V., D.K.V., and N.K. critically revised the manuscript. All authors provided approval for this study.




Publication History

Article published online:
22 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Gleeson M. Head and neck. In: Gray's Anatomy - The Anatomic Basis of Clinical Practice, Standring S, ed. 41st ed.. New York: Elsevier Limited; 2016: 434-435
    Google Scholar
  • 2 Oberman DZ, Rabelo NN, Correa JLA, Ajler P. Relationship of superior sagittal sinus with sagittal midline: a surgical application. Surg Neurol Int 2020; 11: 309
    CrossrefPubMedGoogle Scholar
  • 3 Reis CV, Gusmao SN, Elhadi AM. et al. Midline as a landmark for the position of the superior sagittal sinus on the cranial vault: an anatomical and imaging study. Surg Neurol Int 2015; •••: 6
    PubMedGoogle Scholar
  • 4 Samadian M, Nazparvar B, Haddadian K, Rezaei O, Khormaee F. The anatomical relation between the superior sagittal sinus and the sagittal suture with surgical considerations. Clin Neurol Neurosurg 2011; 113 (02) 89-91
    CrossrefPubMedGoogle Scholar
  • 5 Sayhan S, Guvencer M, Ozer E, Arda MN. Morphometric evaluation of parasagittal venous anatomy for intracranial approaches: a cadaveric study. Turk Neurosurg 2012; 22 (05) 540-546
    PubMedGoogle Scholar
  • 6 Tubbs RS, Salter G, Elton S, Grabb PA, Oakes WJ. Sagittal suture as an external landmark for the superior sagittal sinus. J Neurosurg 2001; 94 (06) 985-987
    CrossrefPubMedGoogle Scholar
  • 7 Thamke S, Kalra S, Khandelwal A. Morphometric evaluation of dural venous sinuses: anatomical study with its implications in surgical interventions. J Morphol Sci 2016; 33 (02) 83-89
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Eichberg DG, Casabella AM, Menaker SA, Shah AH, Komotar RJ. Parasagittal and parafalcine meningiomas: integral strategy for optimizing safety and retrospective review of a single surgeon series. Br J Neurosurg 2020; 34 (05) 559-564
    CrossrefPubMedGoogle Scholar
  • 9 DiMeco F, Li KW, Casali C. et al. Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases. Neurosurgery 2004; 55 (06) 1263-1272 , discussion 1272–1274
    CrossrefPubMedGoogle Scholar
  • 10 Ricci A, Di Vitantonio H, De Paulis D. et al. Parasagittal meningiomas: our surgical experience and the reconstruction technique of the superior sagittal sinus. Surg Neurol Int 2017; 8: 1
    CrossrefPubMedGoogle Scholar