Morphometry of Superior Sagittal Sinus and Its Clinical Significance

The position of the superior sagittal sinus (SSS) in the midline along the sagittal suture is still a debate among neurosurgeons. The aim of the study is to evaluate the diameter and deviation of the SSS at various landmarks in the midline. We evaluated 100 computed tomography venography images. The mean diameter of SSS between nasion and bregma was 2.6 +/- 0.7 mm and it was 3.7 +/- 0.9 at bregma. Between bregma and lambda and at lambda, the mean diameters were 5.1 +/- 1.2 and 5.7 +/- 1.04, respectively. Deviation of SSS toward the right side was seen in approximately 77% of cases, while left deviation and no deviation were seen in 11 and 12%, respectively, between nasion and bregma. At bregma, 62, 10, and 28% deviation was seen toward the right side, left side, and in midline, respectively. In other three segments between bregma and lambda, at lambda and beyond lambda the right and left deviation of SSS were found in 68, 70, 71% and 11, 9, 11% respectively. While in these three segments there was no deviation in SSS in 21(between bregma and lambda), 21(at lambda) and 18% (beyond lambda). Further, we compared our data between genders and age groups. A statistically significant difference in diameter of SSS between genders was noted at the level of bregma and a significant difference in deviation of SSS between genders was noted in the segment between nasion and bregma. Thus, the findings of this study would serve as the crucial surgical data for the neurosurgeons in placing the burr holes in craniotomies and in the interhemispheric approach for midline tumors.