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Título

Arterial Sinus Pericranii. A case report

Descrição sucinta do(s) objetivo(s)

The aim of this presentation is to elaborate on the imaging findings using Doppler Ultrasound and Magnetic Resonance Imaging (MRI) in cases of Arterial Sinus Pericranii.

História clínica

A 5-year-old child, with no history of previous head trauma, presents with a soft, palpable, and painless nodule in the left parietal region. The nodule increases in size during Valsalva maneuvers and has been progressively growing since its onset. Initial evaluation suggested midline capillary malformation of the parietal bone, leading to Doppler ultrasound and MRI, which confirmed the suspected diagnosis of Sinus Pericranii.

Discussão e diagnóstico

Sinus pericranii is a rare vascular anomaly characterized by an abnormal intradiploic communication between the extracranial venous system and intracranial venous sinuses. Typically, it manifests as an asymptomatic congenital soft mass in the cranial midline with progressive growth, significantly enlarging with Valsalva maneuver. In this specific case, the vascular anomaly involves both intra and extra cranial arterial systems, a particularly rare and benign congenital condition. In this patient, a conclusive Doppler ultrasound indicating a high-flow malformation was performed and confirmed the arterial nature of the vascular communication, and it was complemented with a cerebral MRI angiography that displayed imaging findings supporting the diagnosis made through Doppler ultrasound.

Conclusões

Arterial sinus pericranii is a rare and typically asymptomatic vascular anomaly that presents a diagnostic challenge, often being underdiagnosed or misdiagnosed. Therapeutic options are diverse, ranging from observing the lesion to embolizing the intracerebral component or completely excising both the extra and intracranial components. In all these scenarios, potentially life-threatening complications may arise, including cerebral thrombosis and hemorrhage.
It is crucial to recognize this anomaly to differentiate it from other cranial malformations, as the long-term outcome depends on accurate management and initial follow-up.

Palavras Chave

Arterial Sinus Pericranii

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