The occipital and marginal sinuses, when present, must be sacrificed in order to open the dura in most posterior fossa surgeries in the pediatric population, including posterior fossa decompression for Type I Chiari malformation (CM-I) with duraplasty. Apart from the immediate risk of hemorrhage, the voluntary occlusion of this structure is almost universally well tolerated. The authors report a case of intracranial hypertension following the sacrifice of occipital and marginal sinuses following posterior fossa decompression with duraplasty for CM-I. The specific draining pattern variant of the occipital and marginal sinuses leading to this complication as well as avoidance and management strategies of this condition are discussed.
KopuzCAydinMEKaleADemirMTÇorumluUKayaAH: The termination of superior sagittal sinus and drainage patterns of the lateral, occipital at confluens sinuum in newborns: clinical and embryological implications. Surg Radiol Anat32:827–8332010
SinghMNagashimaMInoueY: Anatomical variations of occipital bone impressions for dural venous sinuses around the torcular Herophili, with special reference to the consideration of clinical significance. Surg Radiol Anat26:480–4872004