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ReplyLETTER

Reply:

A.S. Larson and W. Brinjikji
American Journal of Neuroradiology April 2021, 42 (4) E28; DOI: https://doi.org/10.3174/ajnr.A6986
A.S. Larson
aDepartment of Radiology
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W. Brinjikji
bDepartment of RadiologyDepartment of NeurosurgeryMayo ClinicRochester, Minnesota
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We read with interest the letter by Balak regarding our study. We appreciate the interest in our study. We agree that perhaps the right terminology is not to say that the occipital sinus regresses, because it is likely always persistent, but that it no longer plays a dominant role in the dural venous sinus drainage pathway. There have been numerous examples in the literature of embryonic sinuses (of which we consider the occipital sinus to be one) recanalizing or playing a dominant role in cerebral venous drainage due to the presence of arteriovenous shunting lesions or venous sinus thrombosis.1⇓-3 In this regard, the author is correct; in all likelihood, the occipital sinus is present but just does not have enough flow to be opacified on the MRV study.

References

  1. 1.↵
    1. Varma D,
    2. Reddy B,
    3. Rao R
    . Recanalization and obliteration of falcine sinus in cerebral venous sinus thrombosis. Neurology 2008;70:79–80 doi:10.1212/01.wnl.0000277449.59456.cf pmid:18166710
    FREE Full Text
  2. 2.↵
    1. Kawauchi T,
    2. Ikeda H,
    3. Miyakoshi A, et al
    . Occipital sinus dural arteriovenous fistula presenting with cerebellar hemorrhage. World Neurosurg 2019;131:116–19 doi:10.1016/j.wneu.2019.07.231 pmid:31398518
    CrossRefPubMed
  3. 3.↵
    1. Tanaka J,
    2. Fujita A,
    3. Maeyama M, et al
    . Cognard type V dural arteriovenous fistula involving the occipital sinus. J Stroke Cerebrovasc Dis 2017;26:e62–63 doi:10.1016/j.jstrokecerebrovasdis.2017.01.004 pmid:28161148
    CrossRefPubMed
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American Journal of Neuroradiology: 42 (4)
American Journal of Neuroradiology
Vol. 42, Issue 4
1 Apr 2021
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A.S. Larson, W. Brinjikji
American Journal of Neuroradiology Apr 2021, 42 (4) E28; DOI: 10.3174/ajnr.A6986

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A.S. Larson, W. Brinjikji
American Journal of Neuroradiology Apr 2021, 42 (4) E28; DOI: 10.3174/ajnr.A6986
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