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4 Folia Morphologica

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A rare variation of the posterior cranial fossa: duplicated falx cerebelli, occipital venous sinus, and internal occipital crest

100%

Shoja M. M. , Tubbs R. S. , Khaki A. A. , Shokouhi G.

nr 2

171-174

Folds of the meningeal layer of the dura mater, the falx cerebri and tentorium cerebelli, traverse the vertebrate intracranial cavity and thus compartmentalise the brain. The falx cerebelli, another dural fold, is found in the posterior cranial fossa and attaches to the inferior aspect of the tentorium cerebelli and to the internal occipital crest. We present a case of a duplicated falx cerebelli, occipital venous sinus and internal occipital crest that was detected upon routine dissection of a male cadaver. Since haemorrhage of a dural venous sinus can be a fatal complication of posterior cranial fossa surgery, knowledge of venous sinus variations in this region may prevent unpredictable complications during intracranial procedures.

Type I split cord malformation with an unusual bony morphology

100%

Shokouhi G. , Tubbs R. S. , Shoja M. M.

tom 66

nr 1

Variations in the configuration of the bony septum found in patients with split cord malformations are rare. We report the seemingly rare occurrence of a midline bony septum that ended posteriorly as a fully formed bony spinous process. We speculate that this variation is due to misplaced mesodermal cells associated with the primitive endomesenchymal tract during approximately the third week of foetal life. The clinician that manages these patients may wish to consider this rare morphology and avoid excessive manipulation of such a process, which could potentially injure an underlying hemicord.

A rare variation of the inferior alveolar artery with potential clinical consequences

88%

Khaki A. A. , Tubbs R. S. , Shoja M. M. , Shokouhi G. , Farahani R. M.

nr 4

345-346

Variations of the inferior alveolar artery are seemingly quite rare, especially with regard to its origin from the maxillary artery. We present an unusual case of an inferior alveolar artery that originated from the external carotid artery. To the best of our knowledge, our case is one of only two reports of the inferior alveolar artery arising from the external carotid artery. The clinician who deals with the mandibular region should be aware of such a variation in the arterial architecture.

A complex dural-venous variation in the posterior cranial fossa: a triplicate falx cerebelli and an aberrant venous sinus

88%

Shoja M. M. , Tubbs R. S. , Loukas M. , Shokouhi G. , Oakes W. J.

nr 2

Variations of the dural folds and the dural venous sinuses are seldom reported in the extant medical literature. Such variations in the posterior cranial fossa may be problematic in various diagnostic and operative procedures of this region. We report our observation of an extremely rare variation of the falx cerebelli and posterior cranial fossa venous sinuses encountered upon dissection of a young male cadaver. In this specimen the falx cerebelli was duplicated with dimensions of 45.3 × 5.1 mm and 49.8 × 5.3 mm for the right and left falces respectively. The distance between the two falces was 3.2, 4.5 and 7.8 mm at their proximal, middle and distal thirds. An accessory small falx (31.8 × 2 mm) was also found approximately 3.4 mm lateral to the right falx cerebelli and blended with the lateral surface of the right falx cerebelli. There was only one occipital venous sinus (diameter, 2.5 mm) and no marginal sinus was detected. At the right floor of the posterior cranial fossa (posterolateral to the foramen magnum) an additional dural venous sinus was found, which connected the terminal portion of the right sigmoid sinus to the occipital and right transverse sinuses via one medial and two lateral branches respectively. We believe that such a complex dural-venous variation in the posterior cranial fossa has not previously been reported. Neurosurgeons and neuroradiologists should be aware of such variations, as these could be potential sources of haemorrhage during suboccipital approaches or may lead to erroneous interpretations of imaging of the posterior cranial fossa.