Dural Venöz Sinüsler ya da Kalvarum İçerisine Beyin Herniasyonlarının Tespitinde Yüksek Rezolüsyonlu 3T MRG Yararı

Abstract

Objective: Brain parenchyma herniation into the dural venous sinus or calvarium is considered a rare anatomical variation. The aim of this study is to evaluate the frequency, localization, and clinical and radiological findings of brain herniation into dural venous sinus and/or calvarium with high resolution 3 Tesla magnetic resonance imaging in a large group of patients.Material and Methods: A total of 6825 cranial magnetic resonance images containing pre-contrast and post-contrast 3D T1-weighted sequences as well as conventional sequences were retrospectively evaluated. The presence of brain herniation into dural sinuses or calvarium, location and size of herniation, signal intensity of the adjacent brain parenchyma, presence of arachnoid granulation adjacent to the herniation were noted.Results: Brain herniation into DVS/ calvarium was determined in 50 patients (0.73%). The detected brain herniations were most frequently associated with the temporal lobe parenchyma (n=37, 68.5%), and 91% (n=49) extended into the transverse sinuses. All brain herniations were detected both by 3D T1-weighted and 3D T2-weighted sequences; however, 29 (53.7%) of the 54 herniations were not detected by conventional sequences.Conclusion: High resolution MRI sequences are superior to conventional sequences in detecting brain herniation into DVS/ calvarium. Patients with brain herniation into DVS/ calvarium may present with heterogeneous symptomatology, and the relationship between brain herniation and symptoms is controversial.