Pankaj R Nepal and Suman Rijal
B & C Teaching Hospital and Research Center Pvt.Ltd., Nepal
Scientific Tracks Abstracts: J Neurol Neurophysiol
Aim: The aim of the study is to analyze the morphological variation of the confluences of sinuses and propose a classification
system.
Method: The study was based on the cross sectional analytical study. Data collection and analysis was done from all the cases
of CT Venogram were evaluated in the CT console using the inbuilt software. This Venogram was evaluated using the VRT
view of the sinuses and the part of the arterial phage of the angiogram were punched out. Evaluation of the sinuses was done
by carefully rotating the venous sinus in all the direction. Evaluation of typical form of the confluence of sinus was identified
and variations of the sinuses were evaluated for the rest atypical type.
Result: Total 70 cases were enrolled in the study. Overall the confluence of sinus of Torcula was identified as typical and
atypical type. The typical types were further seen as solid or a fenestrated type. The atypical confluences of sinus were seen as
(1) Aplastic/hypoplastic transverse sinus, (2) Transverse sinus connecting only with superior sagittal sinus, straight sinus or
occipital sinus and (3) Various patterns of occipital sinus either unilateral branching, bilateral branching or no branching. The
typical form of the confluences were present in only few cases, however rest were the atypical type. The aplastic or hypoplastic
trasverse sinuses were more common in the left side. The presence of occipital sinus in the typical morphology gave the
confluence a diamond shaped, however the shape were angled to one side when one of the draining sinus was not connected
at Torcula.
Conclusion: Keeping the classification of confluence of sinus in mind could aid in the surgical planning and prevent an
advertent injury to the anomalous sinus type.
Pankaj Raj Nepal is currently the Head of Department of Neurosurgery at BNC Medical College and Teaching Hospital in Birtamode, Nepal. He completed his Residency (FCPS Neurosurgery) under the supervision of Professor Upendra P Devkota.
E-mail: drprnepal@yahoo.com
