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Review paper

Spontaneous brain and arachnoid herniation into the dural venous sinuses: a rare anatomic variation or clinical entity?

By
Hakija Bečulić Orcid logo ,
Hakija Bečulić
Contact Hakija Bečulić

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Department of Anatomy, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Rasim Skomorac ,
Rasim Skomorac

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Aldin Jusić ,
Aldin Jusić

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Melica Imamović ,
Melica Imamović

Department of Emergency Medicine, Cantonal Hospital, Zenica, Zenica, Bosnia and Herzegovina

Fahrudin Alić ,
Fahrudin Alić

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Anes Mašović ,
Anes Mašović

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Alma Mekić Abazović ,
Alma Mekić Abazović

Department of Oncology and Radiotherapy, Cantonal Hospital, Zenica, Zenica, Bosnia and Herzegovina

Alma Efendić ,
Alma Efendić

Department of Radiology, Cantonal Hospital, Zenica, Zenica, Bosnia and Herzegovina

Eldin Burazerović ,
Eldin Burazerović

Clinic of Neurosurgery, University Clinical Centre University of Sarajevo,, Sarajevo, Bosnia and Herzegovina

Benjamin Halilović
Benjamin Halilović

Thermal Power Plant, Tuzla, Tuzla, Bosnia and Herzegovina

Abstract

Aim
To investigate the presence, type and distribution of spontaneous brain and arachnoid herniation into the dural venous sinuses as well as a clinical significance of these herniations.
Methods
This retrospective-prospective, non-randomised anatomical and clinical study included 990 patients who were referred to Magnetic Resonance Imaging at the Department of Radiology of the Cantonal Hospital in Zenica in the period from January to December 2016. The T1 and T2 sequences in axial, sagittal, and coronary section were used for brain or arachnoid herniation analysis. In all patients with intra-sinusal herniation health records were analysed and symptoms and reasons to refer for MRI examination were evaluated.
Results
In 26 (2.6%) patients (19 females; 73.08%) the arachnoid or brain herniation was found. Average age of patients was 40.269±16.496 years. Arachnoid herniation was presented in 15 (57.69%) and brain herniation in 11 (42.31%) patients. Statistical significance in relation to type of herniation was not found (p=11.070). Statistical significance between the symptoms and localisation of herniation (except for nausea and vomiting and posterior fossa herniations) (p=0.05) as well us between symptoms and type of herniation was not found (p>0.05).
Conclusion
The results suggest that there is a possibility of interconnection between arachnoid or/and brain herniations and some clinical symptoms such as nausea and vomiting.

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