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20-04-2024 | Hydrocephalus | Review

Jugular foramen stenosis in external hydrocephalus in infants

Authors: Giuseppe Cinalli, Giuliana Di Martino, Carmela Russo, Adriana Cristofano, Stefania Picariello, Maria Allegra Cinalli, Giuseppe Mirone, Federica Mazio, Mario Quarantelli, Pietro Spennato, Eugenio Covelli

Published in: Child's Nervous System

Abstract

Objective

To measure the size of jugular foramina in infants affected by external hydrocephalus (EH) and in a control group, to support the hypothesis that a jugular foramen (JF) stenosis may determine dural venous sinus alterations and increased venous outflow resistance as main pathophysiological factor.

Methods

Minimum, maximum, and mean values of JF areas were measured in a series of phase-contrast magnetic resonance venous angiography (angio MRV PCA3D) performed on 81 infants affected by EH. Results were compared with a group of 54 controls.

Results

Smaller JF area was significantly smaller in patients versus controls (43.1 ± 14.6 vs. 52.7 ± 17.8; p < 0.001) resulting in a significantly smaller mean JF areas in patients vs. controls (51.6 ± 15.8 vs. 57.0 ± 18.3; p = 0.043). In patients, smaller JF areas were significantly associated with higher venous obstruction grading score (VOGS) both on the right (p = 0.018) and on the left side (p = 0.005). Positional plagiocephaly (cranial vault asymmetry index > 3.5%) was more frequent among EH patients than controls (38/17) but the difference was not significant (p = 0.07). In the 38 plagiocephalic patients, JF area was smaller on the flattened side than the contralateral in a significant number of cases both in right (21/7) and left (9/1) plagiocephaly (p < 0.0005) as well as the mean area (48.2 + 16.4 mm² vs. 57.5 + 20.7 mm², p = 0.002) and VOGS was significantly higher on the plagiocephalic side than on the contralateral side (1.6 ± 1.1 vs. 1.1 ± 0.9, p = 0.019).

Conclusion

In this series of infants affected by EH, the mean size of the ostium of both JF resulted significantly smaller than controls. JF stenosis was significantly associated with higher degrees of venous obstruction on both sides, suggesting a direct extrinsic effect of JF size on dural sinus lumen and possible consequent effect on venous outflow resistance. Positional plagiocephaly, when present, was associated with a decreased JF area and increased VOGS on the flattened side.

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Title: Jugular foramen stenosis in external hydrocephalus in infants
Authors: Giuseppe Cinalli
Giuliana Di Martino
Carmela Russo
Adriana Cristofano
Stefania Picariello
Maria Allegra Cinalli
Giuseppe Mirone
Federica Mazio
Mario Quarantelli
Pietro Spennato
Eugenio Covelli
Publication date: 20-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Hydrocephalus
Hydrocephalus
Hydrocephalus
Published in: Child's Nervous System
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-024-06414-8

At a glance: The STEP trials

Springer Medicine

Jugular foramen stenosis in external hydrocephalus in infants

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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