Occipital Sinus Pericranii Associated With Giant Cervical Hemangioma

Blanco Cabañero, Ana Gema; Seguí Moya, Pedro; Abad Ortiz, Lorenzo

doi:10.1016/j.otoeng.2010.03.002

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On exploration it had a soft consistency and was superficial but adhered to deep planes.An MRI confirmed the presence of a large hyperintense cervical mass on T1, T2 and STIR, compatible with haemangioma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> – coronal STIR with contrast), which affected the subcutaneous tissue and cervical and deep paravertebral musculature, extending to several cervical spaces and compromising the air lumen (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> – axial STIR). Through the use of contrast, it was possible to observe dilated diploic veins that drained into the transverse sinus (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> – multi-planar reconstruction). A CT with bone window verified dipole erosion.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>It turned out to be an occipital sinus pericranii associated with a giant cervical haemangioma, consisting of a vascular anomaly with communication between the extracranial and intracranial venous circulation. Its aetiology can be traumatic, spontaneous or congenital as in our case, and it can be associated with other vascular malformations. The most common location is in the superior sagittal sinus, affecting the frontal bone and less often the transverse sinus and the occipital bone. The differential diagnosis must be carried out with other vascular malformations, such as subepicranial varix (not connected with the intracranial circulation), venous cavernoma (receiving arterial blood) and arteriovenous fistula (communication with the external carotid artery), as well as with other, non-vascular lesions (leptomeningeal cyst, cephalohaematoma, dermoid cyst or epidermoid cyst). Regarding treatment options, asymptomatic patients are not treated except for cosmetic purposes. When it is associated with vascular malformations, embolization is performed prior to surgery.Conflict of InterestsThe authors have no conflicts of interest to declare." 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Acta Otorrinolaringol Esp. 2011;62:404–5." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1048 "Ancho" => 950 "Tamanyo" => 116197 ] ] "descripcion" => array:1 [ "en" => "Coronal STIR with contrast." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 858 "Ancho" => 950 "Tamanyo" => 97353 ] ] "descripcion" => array:1 [ "en" => "Axial STIR." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 857 "Ancho" => 950 "Tamanyo" => 104772 ] ] "descripcion" => array:1 [ "en" => "Multi-planar reconstruction." ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735735/0000006200000005/v1_201304231502/S2173573511000470/v1_201304231502/en/main.assets" "Apartado" => array:4 [ "identificador" => "5869" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in otorhinolaryngology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735735/0000006200000005/v1_201304231502/S2173573511000470/v1_201304231502/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573511000470?idApp=UINPBA00004N"]

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Acta Otorrinolaringológica Española, the official publication of the Spanish Society of Otolaryngology and Head and Neck Surgery and the Ibero-American Society of Otorhinolaryngology, is the most important journal in Spanish dedicated to Otorhinolaryngology, which reflects the continuous scientific and technical progress of the specialty. It has become an important tool to be kept up to date. The Journal publishes Original Articles (articles on basic research and clinical investigation), reviews, brief communications, case studies and images, which are subjected to a rigorous peer review process.

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