Abstract
The interpretation of cerebral venous pathologies in paediatric practice is challenging as there are several normal anatomical variants, and the pathologies are diverse, involving the venous system through direct and indirect mechanisms. This paper aims to provide a comprehensive review of these entities, as their awareness can avoid potential diagnostic pitfalls. We also propose a practical classification system of paediatric cerebral venous pathologies, which will enable more accurate reporting of the neuroimaging findings, as relevant to the underlying pathogenesis of these conditions. The proposed classification system comprises of the following main groups: arterio-venous shunting–related disorders, primary venous malformations and veno-occlusive disorders. A multimodal imaging approach has been included in the relevant subsections, with a brief overview of the modality-specific pitfalls that can also limit interpretation of the neuroimaging. The article also summarises the current literature and international practices in terms of management options and outcomes in specific disease entities.
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Change history
18 May 2020
The original version of this article unfortunately contained a referencing omission. Figure 11 is reused from the original publication of Figure 10 of Gunny and Lin [1].
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Key points
1. Myriad pathologies involve the intracranial venous system in foetuses and children through direct and indirect mechanisms.
2. These disorders may be practically classified into arterio-venous shunting–related disorders, primary venous malformations and veno-occlusive disorders.
3. There are several anatomical and physiological variants in the venous anatomy in children that create potential diagnostic pitfalls. Furthermore, there are imaging-based pitfalls that one needs to be aware of.
4. A multimodal imaging approach is essential in making a confident diagnosis of the primary venous disorder and its secondary effects on the brain.
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Mankad, K., Biswas, A., Espagnet, M.C.R. et al. Venous pathologies in paediatric neuroradiology: from foetal to adolescent life. Neuroradiology 62, 15–37 (2020). https://doi.org/10.1007/s00234-019-02294-x
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DOI: https://doi.org/10.1007/s00234-019-02294-x