Subepicranial Varix Mimicking Sinus Pericranii : Usefulness of Three-Dimensional Computed Tomography Angiography and Bone Window Computed Tomography

概要

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A 16-year-old female presented with a rare case of subepicranial varix in the left temporal area manifesting as a soft mass in the left temporal area when she laid down in the left lateral position. Bulging of the mass was observed when intracranial venous pressure was raised by the Valsalva maneuver, the left lateral position, or the prone position. Bone window computed tomography(CT)revealed a tiny hole, 1 mm in diameter, in the outer bone table. Three-dimensional CT(3D-CT)angiography clearly visualized a mass with a diameter of approximately 10 mm connected to the diploic vein. The mass was totally resected by operation. Venous bleeding was observed from the tiny hole. Histological examination revealed a venous lesion mimicking sinus pericranii and containing endothelial cells. No communication with the intracranial venous sinuses was identified, so the diag-nosis was subepicranial varix. Radiological examination by direct injection of contrast medium is usually performed to identify subepicranial varix, but 3D-CT angiography is a non-invasive preoper-ative examination that can visualize this small venous lesion. Adjustment of the CT acquisition con-ditions may allow 3D-CT angiography to identify sinus pericranii in the future.
日本脳神経外科学会の論文
2000-09-15