A rare case report of dominant paediatric sinus pericranii: food for thought!

Abstract

Abstract Background Sinus pericranii (SP) is a rare venous anomaly abnormally connecting the intracranial dural sinuses with the epicranial venous channels. Various authors have attempted to classify this entity to decide management for this potentially life-threatening condition. With approximately 200 cases reported in world literature till date, no definitive guidelines for management have emerged. Case presentation A female child aged 7 years presented to us with complaints of occipital swelling since birth. This swelling was gradually increasing in size as reported by the parents. On examination, the swelling was located in the right parieto-occipital region, size 10 cm diameter in lying position, soft, non-tender, fluid-like diffuse swelling with underlying areas of palpable bony defects, partially reducible in sitting up position, and cough impulse was present. On evaluation, a case of dominant SP was established. Conclusion Traditionally, SP has been reported mostly in paediatric population and managed surgically or endovascularly for selected cases, while the remaining cases have been observed. Profuse haemorrhage has been a major deterrent to manage these lesions surgically. Long-term complications like trauma, haemorrhage, infection and thrombosis have been reported in conservatively managed cases. The neurosurgical community has thus been left searching for the optimal management of SP. The authors report this case attempting to classify this case according to the available classification systems and hence decide the best possible management.