Satoshi Tsutsumi1, Hideo Ono2, Hisato Ishii3. 1. Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan. shotaro@juntendo-urayasu.jp. 2. Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan. 3. Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
Abstract
PURPOSE: To date, no study has explored the external occipital protuberance (EOP) using neuroimaging modalities. This study aims to characterize them using magnetic resonance imaging (MRI). METHODS: A total of 96 patients underwent thin-sliced, post-contrast MRI. The sagittal images were analyzed. RESULTS: In 97%, the EOPs were delineated as a focal external protrusion of the midline region of the occiput with varying morphologies. In 89% of 93 patients with identifiable EOPs, parts of the intracranial dural sinuses were found to lie just below the inion, the most prominent point of the EOP. The most frequently targeted dural sinus was the confluence of sinuses that was found in 57%, followed by the superior sagittal sinus. In 16%, a bony foramen and transmitting vessel were detected in the EOP, connecting between the diploic channels and the subcutaneous veins. Furthermore, in 33%, bony foramina and transmitting venous structures were identified in the region just below the EOPs, connecting between the diploic channels and the subcutaneous veins. CONCLUSIONS: The intracranial dural venous sinus is located just below the EOP with a high probability. Most bony foramina in the EOP and midline suboccipital region may transmit veinous structures connecting to the diploic channel.
PURPOSE: To date, no study has explored the external occipital protuberance (EOP) using neuroimaging modalities. This study aims to characterize them using magnetic resonance imaging (MRI). METHODS: A total of 96 patients underwent thin-sliced, post-contrast MRI. The sagittal images were analyzed. RESULTS: In 97%, the EOPs were delineated as a focal external protrusion of the midline region of the occiput with varying morphologies. In 89% of 93 patients with identifiable EOPs, parts of the intracranial dural sinuses were found to lie just below the inion, the most prominent point of the EOP. The most frequently targeted dural sinus was the confluence of sinuses that was found in 57%, followed by the superior sagittal sinus. In 16%, a bony foramen and transmitting vessel were detected in the EOP, connecting between the diploic channels and the subcutaneous veins. Furthermore, in 33%, bony foramina and transmitting venous structures were identified in the region just below the EOPs, connecting between the diploic channels and the subcutaneous veins. CONCLUSIONS: The intracranial dural venous sinus is located just below the EOP with a high probability. Most bony foramina in the EOP and midline suboccipital region may transmit veinous structures connecting to the diploic channel.