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Julian L. Robinson and Carol B. Sedzimir

posterior auricular artery was demonstrated running through the skull defect to a 5 × 4 cm “aneurysmal sac” draining into an enormously dilated transverse sinus ( Fig. 1 ). Fig. 1. Left external carotid angiograms, arterial ( left ) and venous ( right ) phases, showing the large posterior auricular artery running through the skull defect to the aneurysmal sac. Operation On September 22, 1954, the common carotid artery was dissected at its bifurcation. It was confirmed by auscultation that occlusion of the external carotid abolished the bruit, and the

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Frederic P. Collignon, Aaron A. Cohen-Gadol and David G. Piepgras

Neurosurg 35 : 392 – 395 , 1971 Rish BL: The repair of dural venous sinus wounds by autogenous venorrhaphy. J Neurosurg 35: 392–395, 1971 21. Sindou M : Meningiomas invading the sagittal or transverse sinuses, resection with venous reconstruction. J Clin Neurosci 8 (Suppl 1) : 8 – 11 , 2001 Sindou M: Meningiomas invading the sagittal or transverse sinuses, resection with venous reconstruction. J Clin Neurosci 8 (Suppl 1): 8–11, 2001 22. Sindou M , Mazoyer JF , Fischer G , et al

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Ettore Fiumara, Silvana Tumbiolo, Maria Luisa Bellomonte, Paolino Savatteri, Francesca Finazzo and Fabio La Gattuta

–185, 1988 8. Gobin YP , Houdart E , Rogopoulos A , et al : Percutaneous transvenous embolization through the thrombosed sinus in transverse sinus dural fistula. AJNR 14 : 1102 – 1105 , 1993 Gobin YP, Houdart E, Rogopoulos A, et al: Percutaneous transvenous embolization through the thrombosed sinus in transverse sinus dural fistula. AJNR 14: 1102–1105, 1993 9. Goto K , Sidipratomo P , Ogata N , et al : Combining endovascular and neurosurgical treatments of high-risk dural arteriovenous

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Mustafa Nadi, Navid Khezri, Tahani Ahmad, Michael Ellis, Eric Bouffet, James T. Rutka and Michael D. Taylor

worse prognosis. Despite its well-known propensity to metastasize along CSF pathways, local invasion of posterior fossa structures, such as the dura mater and dural venous sinuses, is extremely rare and has yet to be reported in children with medulloblastoma. Here, we report the rare case of a child with medulloblastoma with focal invasion of the transverse sinus. The cellular mechanisms underlying this finding as well as the implications for disease prognosis and management are discussed. Case Report History and Examination A 15-year-old girl

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R. Shane Tubbs, George Salter and W. Jerry Oakes

Object. The purpose of this anatomical study is to identify reliable external landmarks that can be used to determine accurately the lower border of the proximal segment of the transverse sinus (TS).

Methods. The authors used 15 formalin-fixed cadaveric specimens for this project. Various anatomical structures were dissected and measurements of the distance between these structures and the proximal TS were obtained.

The data collected in this study demonstrate that the inion is not always a reliable external landmark to use when determining the internal location of the very proximal TS and its drainage into the area of the torcular herophili. In addition, the authors found that the most accurate external landmark to use in reliably estimating the internal placement of the proximal TS is the point of insertion of the musculus semispinalis capitus and not the superior nuchal line. In the present study, this muscle never covered more than 5 mm of the inferior edge of the TS and was found to be a reliable anatomical structure for avoiding the medial segment of the TS.

Conclusions. These findings could aid the surgeon in localizing the TS with various midline approaches to the posterior fossa and the craniocervical junction.

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Neurosurgical Forum: Letters to the Editor To The Editor Ibrahim M. Ziyal , M.D. Tunçalp Özgen , M.D. Hacettepe University Ankara, Turkey 686 687 Abstract Object. The purpose of this anatomical study is to identify reliable external landmarks that can be used to determine accurate ly the lower border of the proximal segment of the transverse sinus (TS). Methods. The authors used 15 formalin-fixed cadaveric specimens for this project. Various anatomical structures were dissected and

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Shigeki Takada, Fumiaki Isaka, Takuya Nakakuki, Yuto Mitsuno and Takaaki Kaneko

the DAVF from the posterior cerebral arteries. Antegrade venous drainage was directed toward the right transverse sinus, and retrograde venous drainage was directed toward the deep venous system through the straight sinus. Markedly dilated cortical and deep veins and right transverse sinus stenosis were observed ( Fig. 3 ). FIG. 3. Bilateral ECA, bilateral ICA, and right VA angiograms demonstrating a torcular DAVF. Right ECA angiograms demonstrated the DAVF feeding of the right superficial temporal artery and right occipital artery in the anteroposterior

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Samuel C. Ohaegbulam

P lexiform neurofibromas have been reported to occur at different sites in the body, 1, 2 including the limbs, face, trunk, stomach, urinary bladder, and the scalp. The case reported here is of a congenital plexiform neurofibroma of the occipital scalp that was adherent to the dura of the transverse sinus through a skull defect. Case Report This 13-year-old girl presented with a swelling on the right side of the back of the head. The mother had noticed a small lump in the right occipital scalp during the first month of life. The lump did not upset the

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Krishna Kumar Bisaria

V ariations of the dural venous sinuses in the region of the torcular Herophili have been described by various authors. 2, 3, 5, 6, 8, 9 Das and Hasan, 3 Furstenberg, 4 and Williams and Hallberg 10 reported cases in which a lateral sinus was absent. Waltner 9 reported a case where the transverse sinus was narrow and the sigmoid sinus was absent. In the present study some hitherto unreported anomalies are described along with some common variations. Materials and Methods This study is based on examination with the naked eye of the cranial dural

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Justin M. Cappuzzo, Ryan M. Hess, John F. Morrison, Jason M. Davies, Kenneth V. Snyder, Elad I. Levy and Adnan H. Siddiqui

procedure and the most recent clinic visit. This was defined as our follow-up period. The effectiveness of the procedure was analyzed by examining each patient’s initial presenting signs and symptoms and noting if they had improved, worsened, or remained unchanged during the follow-up period. Additionally, the need for postoperative shunt placement, optic nerve sheath fenestration, or LP was recorded to determine if remaining symptoms were severe enough to warrant further intervention. Of note, all patients who received transverse sinus stents were placed on dual