Brain herniations into arachnoid granulations: about 68 cases in 38 patients and review of the literature

Neuroradiology
Sonaz MalekzadehlashkarianiDiego San Millán

Abstract

Brain herniations (BH) into arachnoid granulations (AG) in dural venous sinuses and calvarium have rarely been reported in the literature. MRIs of 38 patients with BH into AG (BHAG) were retrospectively analyzed. Locations of BHAG, gyrus/lobe of the herniated brain, parenchymal abnormalities of the BH, and clinical and radiological conditions with raised intracranial pressure were recorded. Sixty-eight BHAG were found, by order of frequency, in the occipital squama (OS), transverse sinus (TS), lateral lacuna of the superior sagittal sinus (LLSSS), and straight sinus (SS), with cerebellar tissue being the most frequently involved in BHAG (94.5 % of OS, 55 % of TS, 100 % SS BHAG). Multiple BHAG were found in 58 % of the patients (up to five per patient). Parenchymal signal and structural changes (SSCG) were observed in 46 % of BHAG (100 % were cerebellar). Three patients had pseudotumor cerebri (PTCS); one patient had only MRI signs of PTCS. Twenty-one percent of patients had intracranial conditions susceptible of increasing cerebrospinal fluid (CSF) pressure other than PTCS. BHAG occurred in the OS, TS, LLSSS, and the SS. SSCG of the herniated cerebellum were frequent and possibly result from tethering/strangulation in the AG. N...Continue Reading

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Citations

May 14, 2016·The Journal of Pediatrics·Luísa SampaioMiguel Leão
Nov 30, 2019·AJNR. American Journal of Neuroradiology·J C BensonK N Krecke
Sep 22, 2020·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Gerald T DroctonMatthew Amans
Apr 11, 2017·Case Reports in Radiology·Joana Ruivo Rodrigues, Gonçalo Roque Santos
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Jun 27, 2020·The Journal of International Medical Research·Bin LvSheng-Yuan Yu
Mar 30, 2021·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Barton WaserShivendra Lalloo

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