Abstract
Some structure might be encountered with endovascular procedures within the straight sinus and is not now readily seen on digital subtraction angiography (DSA). We investigated the morphological and histological characteristics of the straight sinus, chordae willisii (CW), and junction between the great cerebral vein (GCV) and straight sinus. A total of 22 cadaveric heads and 135 patients were analyzed with either anatomic dissection or neuroimaging. The morphological features of the CW and the junction between the GCV and straight sinus were analyzed by endoscope. The histology of the junction between the GCV and straight sinus was evaluated under the microscope with staining for elastic fiber, Masson’s, and immunohistochemistry. We found that fold, elevation, small bugle, or nodule and CW were detected by endoscope in the straight sinus. The most common type of CW was valve-like lamellae, which comprised 40.46% of all CW. Three different types of junctions between the GCV and straight sinus were identified: type 1 has folds in the GCV and elevation on the floor of the straight sinus; type 2 has folds and a small bugle; and type 3 presents with an intraluminal nodule located at the opening of the GCV. Compared with arachnoid granulation, the nodule consists of smooth muscle fibers and higher rate of elastic fibers. Understanding the detailed anatomy of the straight sinus may help surgeons to avoid procedural difficulties and to achieve higher success rate.
Highlights
The straight sinus, which receives the venous blood from the cerebellar, thalamus, and basal ganglia and terminates into the confluence of the sinuses, is the most important venous drainage in the deep venous systems of the cranium
We investigated the morphological and histological characteristics of the straight sinus, chordae willisii (CW), and junction between the great cerebral vein (GCV) and straight sinus
Eighty-seven valve-like lamellae were found in our study, contributing to 33.85% of the CW in the examined sinuses
Summary
The straight sinus, which receives the venous blood from the cerebellar, thalamus, and basal ganglia and terminates into the confluence of the sinuses, is the most important venous drainage in the deep venous systems of the cranium. The transvenous approach is the first-line therapeutic strategy in treating the deep brain vascular diseases involving the straight sinus (Gomez et al, 2000; Stam et al, 2008; De Beritto et al, 2015; Pu et al, 2017), there is much more to know about its histology, morphology, and intraluminal structures. Imaging and standard anatomical methods have already been used to describe the anatomical structure of the straight sinus (Saxena et al, 1974; Browder et al, 1976; Shin et al, 2000; Tsutsumi et al, 2018; Kim et al, 2019). Some literatures have well described the anatomy of this junction by macroscopic methods (Dagain et al, 2008). The nodule at the junction was recognized as arachnoid granulations, and its histological structure has not been described
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