INTRODUCTION: Torcular dural sinus malformations (tDSMs) are rare vascular pathologies with various anatomoclinical pictures and prognosis. We analyzed our case series and corroborated the complexity of this rare unit by a review of literature. CASE SERIES: From 2003 to 2018, we treated four tDSMs patients. The evolution of three postnatally diagnosed cases of similar angioarchitecture contrasted with a fourth antenatally diagnosed case with significant torcular thrombosis. All patients were examined by computed tomography, magnetic resonance imaging, CT angiography, and MRI angiography. Three patients underwent digital subtraction angiography with embolization of feeders. Unusual pathological images were depicted. CONCLUSIONS: Early diagnosis along with embolization of feeders and lake could improve the outcome for tDSM patients with dural arteriovenous shunts. Ventriculoperitoneal shunt implantation before endovascular treatment led to significant worsening of both clinical presentation and MRI picture. For patients who persist with hydrocephalus despite the endovascular approach, we suggest endoscopic third ventriculostomy as a first-line treatment option. Antenatally diagnosed patients with thrombosed lakes constitute a prognostically better group of patients. Spontaneous thrombosis and remodelation of the lake can, however, still leave neurological sequelae, as observed in our patient.

• MeSH
• cévní malformace centrálního nervového systému * diagnostické zobrazování   chirurgie   MeSH
• dítě MeSH
• dura mater MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mozková angiografie MeSH
• novorozenec MeSH
• sinus cavernosus * MeSH
• sinus durae matris * abnormality   diagnostické zobrazování   MeSH
• těhotenství MeSH
• terapeutická embolizace * MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

We present unique clinical images of jugular bulb dysmaturation (JBD) in an infant with torcular dural sinus malformation (tDSM). Lasjaunias et al hypothesized that the former possess a pivoting role for development of the latter. However, reports about tDSM are extremely rare and lack focus on JBD presence. In this paper we focused on JBD depiction. The combination of magnetic resonance imaging angiography, computed tomography angiography, and digital subtraction angiography imaging of JBD is unique. Moreover, we reviewed current tDSM literature and showed that the presence of JBD in tDSMs correlates significantly with a higher mortality.

• MeSH
• cévní malformace centrálního nervového systému diagnóza   MeSH
• kojenec MeSH
• lidé MeSH
• magnetická rezonanční angiografie MeSH
• sinus durae matris abnormality   MeSH
• trombóza nitrolebních žilních splavů diagnóza   MeSH
• venae jugulares abnormality   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

BACKGROUND: We explore the role of dural sinus morphology, leptomeningeal collaterals, and clot localization in the development of malignant brain edema in acute ischemic stroke in anterior circulation. METHODS: This is a single-center retrospective study of consecutive stroke patients with acute occlusion (middle cerebral artery M1 ± intracranial internal carotid artery) treated with intravenous thrombolysis (from November 2009 to November 2014). Admission computed tomography angiography data were evaluated for hypoplasia of dural sinuses, leptomeningeal collaterals, and clot location. Primary outcome was midline shift (<5 mm versus ≥5 mm) on follow-up computed tomography. Secondary outcomes were infarct volume and modified Rankin Scale score of 2 or lower at 90 days. Multivariate logistic regression was used. RESULTS: Of 86 patients (49 females), 36 (42%) had poor collaterals, 26 (30%) had ipsilesional sinus hypoplasia, and 38 (44%) had proximal clots. A midline shift of 5 mm or higher was diagnosed in 14 patients (16%). Infarct volume was larger in the group with midline shift (median: 318 mL [interquartile range {IQR} = 260-350]) than in the group without midline shift (median: 44 mL [IQR = 28-60]) (P = .007). In multivariate analysis, poor leptomeningeal collaterals (odds ratio [OR] = .11, 95% confidence interval [CI] = .03-.44, P = .002 for good collaterals) and ipsilesional sinus hypoplasia (OR = 6.43, 95% CI = 1.5-46.1, P = .008) were independently associated with a midline shift of 5 mm or higher. CONCLUSION: Patients with poor leptomeningeal collaterals and ipsilesional hypoplasia of dural sinuses are more likely to develop midline shift.

• MeSH
• cévní malformace centrálního nervového systému komplikace   diagnostické zobrazování   patofyziologie   MeSH
• CT angiografie MeSH
• edém mozku diagnostické zobrazování   etiologie   patofyziologie   MeSH
• infarkt arteria cerebri media diagnostické zobrazování   farmakoterapie   etiologie   patofyziologie   MeSH
• intrakraniální trombóza komplikace   diagnostické zobrazování   farmakoterapie   patofyziologie   MeSH
• ischemie mozku diagnostické zobrazování   farmakoterapie   etiologie   patofyziologie   MeSH
• kolaterální oběh * MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• meningy krevní zásobení   MeSH
• mozková angiografie metody   MeSH
• mozkový krevní oběh * MeSH
• multivariační analýza MeSH
• odds ratio MeSH
• prognóza MeSH
• registrace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sinus durae matris abnormality   diagnostické zobrazování   patofyziologie   MeSH
• trombolytická terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH