Sinus pericranii

Diagnosis:

Clinical:

  • Scalp mass that increases with valsalva or lying down & reduces with standing

CT:

  • Focal bone defect may be present
  • Extracranial venous malformation that enhances heterogenously
  • Cortical varix that strongly enhances

CTV shows this well
MRI:

  • T1, T2: signal based on flow
  • Contrast: Cortical Varix enhances well. Extracranial Venous malformation enhances heterogeneously

MRV shows this well
Catheter Angiogram/angiography:

  • Normal arterial phase
  • No early draining vein
  • Allows classification

Percutanseous venography:

  • Shows extracranial venous component & draining scalp veins

Classification:

  • Closed: blood originates from & drains into dural venous sinus
  • Open: blood comes from dural venous sinus & drains into scalp veins

Treatment:

No treatment is necessary, this is a normal variant