Abstract
Purpose
Anterior cranial fossa dural arteriovenous shunts (ACFdAVS) are a subtype of dural arteriovenous shunts that affect the anterior cranial fossa. However, the venous structures around the anterior skull base that may predispose patients to ACFdAVS have been poorly characterized. This study investigated the midline and paramedian venous channels of the anterior cranial fossa and their association with ACFdAVS.Methods
We retrospectively analyzed computed tomography-digital subtraction venography data from 285 consecutive patients to identify venous channels crossing the anterior cranial fossa floor. Additionally, venous drainage in nine ACFdAVS cases were analyzed using cone beam computed tomography.Results
We identified two veins piercing the anterior cranial fossa floor: the vein of the foramen caecum (VFC) running through the midline foramen caecum in six cases (2.1%) and the veins piercing the paramedian cribriform plate, here termed the veins of the cribriform plate (VCP), in 19 cases (6.7%). The VFC typically drains directly into the superior sagittal sinus and infrequently into the frontal pial veins, whereas the VCP connected to the frontal pial veins, and drained into the superior sagittal sinus or olfactory veins. Both drained the nasal cavity and were occasionally connected to the facial veins. In all ACFdAVSs, the venous drainage arose from the paramedian region of the cribriform plate, corresponding to the intracranial segment of the VCPs, while the nasal segment was absent.Conclusion
The VCPs may play a key role in the pathogenesis of ACFdAVS, and thrombosis or occlusion in their extracranial segment may trigger the development of ACFdAVS.