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Child's Nervous System
Published in: Child's Nervous System 11/2020

01-11-2020 | Cerebral Sinus Venous Thrombosis | Original Article

Torcular dural sinus malformations: a grading system proposal

Authors: P. Liby, V. Lomachinsky, B. Petrak, M. Kyncl, U.R. Montarroyos, M. Tichy

Published in: Child's Nervous System | Issue 11/2020

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Abstract

Background

Torcular dural sinus malformations (tDSMs) are congenital complex vascular anomalies often referred as a single unit. Nevertheless, they possess distinct anatomical features, clinical diversity, and markedly different outcomes.

Objective

On the basis of our institutional experience and analysis of published data, we propose a grading system.

Methods

We have identified 44 papers to which we added our four institutional cases for a total of 126 patients. Eight predictor variables were studied. In order to assess their individual impact on mortality and possible correlations, a logistic regression model was constructed through a stepwise forward process.

Results

Overall mortality was 22.1%. Mortality was higher in tDSM patients diagnosed postnatally, 40.7% versus a 15.6% in prenatally found cases (p = 0.007). We divided the patients into four grades. Grade I comprised patients with no feeder evidence and possessed the best outcomes (mortality of 7.55%). Mortality rose for grades II and III defined respectively by scarce and multiple feeders. Brain damage was the defining feature of grade IV. A mortality of 75% could be observed within this grade. Grade IV was further divided into grades IVa (antenatal) and IVb (postnatal cases). Furthermore, our logistic regression model found that brain damage (OR 11.3, p < 0.001, 95% CI 2.97–42.91) and patent feeders (OR 4, p = 0.03, 95% CI 1.15–13.86) were major determinants of poor outcome (area under ROC curve of 81.44%).

Conclusion

The grading system (tDSM-GS) streamlines classification into four different grades facilitating both diagnosis, clinical decision-making, and proper prognostication.
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Literature
1.
Lasjaunias P, Magufis G, Goulao A, Piske R, Suthipongchai S, Rodesch R, Alvarez H (1996) Anatomoclinical aspects of dural arteriovenous shunts in children. Interv Neuroradiol 2(3):179–191CrossRef
2.
Yang E, Storey A, Olson HE, Soul J, Estroff JA, Trenor CC, Cooper BK, Smith ER, Orbach DB (2018) Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part I: review of experience at Boston Children’s Hospital. J NeuroIntervent Surg 10:470–473
3.
Yang E, Storey A, Olson HE, Soul J, Estroff JA, Trenor CC, Cooper BK, Smith ER, Orbach DB (2018) Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part II: synthesis of the literature and patient management. J Neurointervent Surg 10(5):471–475CrossRef
4.
Merzoug V, Flunker S, Drissi C, Eurin D, Grangé G, Garel C, Richter B, Geissler F, Couture A, Adamsbaum C (2007) Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up. Eur Radiol 18(4):692–699CrossRef
5.
Rayssiguier R, Dumont C, Flunker S, Couture A, Boulot P, Prodhomme O (2014) Thrombosis of torcular herophili: diagnosis, prenatal management, and outcome. Prenat Diagn 34:1168–1175CrossRef
6.
Barbosa M, Mahadevan J, Weon YC, Yoshida Y, Ozanne A, Rodesch G, Alvarez H, Lasjaunias P (2003) Dural sinus malformations (DSM) with giant lakes, in neonates and infants. Review of 30 consecutive cases. Interv Neuroradiol 9(4):407–424CrossRef
7.
Morita A, Meyer FB, Nichols DA, Patterson MC (1995) Childhood dural arteriovenous fistulae of the posterior dural sinuses: three case reports and literature review. Neurosurgery 37(6):1193–1199 discussion 1199-200CrossRef
8.
9.
Liby P, Lomachinsky V, Petrak B (2019) Jugular bulb dysmaturation in torcular dural sinus malformation: clinical images and review of literature. World Neurosurg 127:434–435CrossRef
10.
Collins GS, Reitsma JB, Altman DG, Moons KGM (2015) Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. BMJ (Clinical research ed) 350:g7594
11.
Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R (2006) The management of vein of Galen aneurysmal malformations. Neurosurgery 59(5 Suppl 3):S184–S194 discussion S3-13PubMed
12.
Fanou EM, Reeves MJ, Howe DT, Joy H, Morris S, Russell S, Griffiths PD (2013) In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus. Pediatr Radiol 43(12):1591–1598CrossRef
13.
Delmas HL, Winer N, Gallot D, Lopes K, Perrotin F, Fluncker S, Geissler F, Beaufrere AM, Vendittelli F, Couture C, Lemery D (2008) Prenatal diagnosis of thrombosis of the dural sinuses: report of six cases, review of the literature and suggested management. Ultrasound Obstet Gynecol 32(2):188–198CrossRef
14.
Corral E, Stecher X, Malinger G, Ochoa JH, de Catte L, Sepulveda W (2014) Thrombosis of the torcular herophili in the fetus: a series of eight cases. Prenat Diagn 34(12):1176–1181CrossRef
15.
Sato Y, Fujita Y, Anami A, Yumoto Y, Fukushima K, Wake N (2013) Doppler sonographic evaluation of arteriovenous shunt flow in a fetus with dural sinus malformation. J Obstet Gynaecol Res 39:1081–1084CrossRef
16.
Albright LA, Latchaw RE, Price RA (1983) Posterior dural arteriovenous malformations in infancy. Neurosurgery 13(2):129–135CrossRef
17.
Jagadeesan BD, Grande AW, Guillaume DJ, Nascene DR, Tummala RP (2015) The role of percutaneous embolization techniques in the management of dural sinus malformations with atypical angioarchitecture in neonates: report of 2 cases. J Neurosurg Pediatr 16(1):74–79CrossRef
18.
Johnson JN, Hartman TK, Barbaresi W, Raffel C, Colby CE (2009) Developmental outcomes for neonatal dural arteriovenous fistulas. J Neurosurg Pediatr 3(2):105–109CrossRef
19.
Geibprasert S, Pongpech S, Jiarakongmun P, Shroff MM, Armstrong DC, Krings T (2010) Radiologic assessment of brain arteriovenous malformations: what clinicians need to know. RadioGraphics 30(2):483–501CrossRef
20.
21.
d’Avella D, Causin F (2016) Hydrocephalus in vein of Galen malformation. Another paradigm shift in neurosurgery. Acta Neurochir 158(7):1285–1288CrossRef
22.
Feletti A, Denaro L, Marton E, d’Avella D, Longatti P (2007) Endoscopic treatment of hydrocephalus due to aneurysm of the vein of Galen: case report and literature review. Minim Invasive Neurosurg 50(5):285–291CrossRef
23.
Meila D, Grieb D, Melber K, Jacobs C, Maslehaty H, Petridis A, El Habony R, Lanfermann H, Scholz M, Brassel F (2016) Hydrocephalus in vein of Galen malformation: etiologies and therapeutic management implications. Acta Neurochir 158(7):1279–1284CrossRef
24.
Folkerth RD, McLaughlin ME, Levine D (2001) Organizing posterior fossa hematomas simulating developmental cysts on prenatal imaging: report of 3 cases. J Ultrasound Med 20(11):1233–1240CrossRef
Metadata
Title
Torcular dural sinus malformations: a grading system proposal
Authors
P. Liby
V. Lomachinsky
B. Petrak
M. Kyncl
U.R. Montarroyos
M. Tichy
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 11/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-020-04569-8

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