Normal anatomy and variations in the confluence of sinuses using digital subtraction angiography

AbstractObjectives: The configuration of the confluence of sinuses differs not only between individuals, but also between the two brain hemispheres, making the anatomical classification of this region difficult. In this study, we evaluated the anatomy of the confluence of sinuses and ascertained the accuracy and usefulness of digital subtraction angiography (DSA) in the evaluation of cerebral veins.Methods: Bilateral carotid and vertebral artery angiographies were performed in 500 adult patients to evaluate the anatomy of the confluence of sinuses and contributory venous sinuses. We appraised the anatomy of the sinuses adjacent to the confluence, the lateralization of venous draining into the transverse sinuses (TSs), the communications between the TSs, and the presentation of the occipital sinus (OS).Results: Based on the anatomical descriptions of Osborn’s Brain (Diagnostic Cerebral Angiography, 2nd edition), we delineated 10 different configurations of the confluence of sinuses that showed connections ...