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Dural Sinus and Aberrant Arachnoid Granulations
H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Arachnoid granulation (AG)
            • Aberrant arachnoid granulation (AbAG)
          • Synonyms

            • Pacchionian depressions, granulations, or bodies
            • When large → "giant" arachnoid granulation
            • When in sphenoid bone and temporal bone (T-bone) → AbAG
          • Definitions

            • Arachnoid villi: Term used to describe smaller AG
            • AG: Enlarged arachnoid villi projecting into major dural venous sinus lumen
            • AbAG: AG that penetrated dura, but fails to reach venous sinus, typically in sphenoid or T-bone
              • Also referred to as arachnoid pits or osteodural defects

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Battal B et al: Brain herniations into the dural venous sinuses or calvarium: MRI of a recently recognized entity. Neuroradiol J. 27(1):55-62, 2014
                                      2. De Keyzer B et al: Giant arachnoid granulations mimicking pathology. A report of three cases. Neuroradiol J. 27(3):316-21, 2014
                                      3. Settecase F et al: Spontaneous lateral sphenoid cephaloceles: anatomic factors contributing to pathogenesis and proposed classification. AJNR Am J Neuroradiol. 35(4):784-9, 2014
                                      4. La Fata V et al: CSF leaks: correlation of high-resolution CT and multiplanar reformations with intraoperative endoscopic findings. AJNR Am J Neuroradiol. 29(3):536-41, 2008
                                      5. Lloyd KM et al: Imaging of skull base cerebrospinal fluid leaks in adults. Radiology. 248(3):725-36, 2008
                                      6. Schuknecht B et al: Nontraumatic skull base defects with spontaneous CSF rhinorrhea and arachnoid herniation: imaging findings and correlation with endoscopic sinus surgery in 27 patients. AJNR Am J Neuroradiol. 29(3):542-9, 2008
                                      7. Haroun AA et al: Arachnoid granulations in the cerebral dural sinuses as demonstrated by contrast-enhanced 3D magnetic resonance venography. Surg Radiol Anat. 29(4):323-8, 2007
                                      8. Amlashi SF et al: Intracranial hypertension and giant arachnoid granulations. J Neurol Neurosurg Psychiatry. 75(1):172, 2004
                                      9. Liang L et al: Normal structures in the intracranial dural sinuses: delineation with 3D contrast-enhanced magnetization prepared rapid acquisition gradient-echo imaging sequence. AJNR Am J Neuroradiol. 23(10):1739-46, 2002
                                      10. Casey SO et al: Prevalence of arachnoid granulations as detected with CT venography of the dural sinuses. AJNR Am J Neuroradiol. 18(5):993-4, 1997
                                      11. Leach JL et al: Normal appearance of arachnoid granulations on contrast-enhanced CT and MR of the brain: differentiation from dural sinus disease. AJNR Am J Neuroradiol. 17(8):1523-32, 1996
                                      12. Roche J et al: Arachnoid granulations in the transverse and sigmoid sinuses: CT, MR, and MR angiographic appearance of a normal anatomic variation. AJNR Am J Neuroradiol. 17(4):677-83, 1996
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Arachnoid granulation (AG)
                                                • Aberrant arachnoid granulation (AbAG)
                                              • Synonyms

                                                • Pacchionian depressions, granulations, or bodies
                                                • When large → "giant" arachnoid granulation
                                                • When in sphenoid bone and temporal bone (T-bone) → AbAG
                                              • Definitions

                                                • Arachnoid villi: Term used to describe smaller AG
                                                • AG: Enlarged arachnoid villi projecting into major dural venous sinus lumen
                                                • AbAG: AG that penetrated dura, but fails to reach venous sinus, typically in sphenoid or T-bone
                                                  • Also referred to as arachnoid pits or osteodural defects

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Battal B et al: Brain herniations into the dural venous sinuses or calvarium: MRI of a recently recognized entity. Neuroradiol J. 27(1):55-62, 2014
                                                                          2. De Keyzer B et al: Giant arachnoid granulations mimicking pathology. A report of three cases. Neuroradiol J. 27(3):316-21, 2014
                                                                          3. Settecase F et al: Spontaneous lateral sphenoid cephaloceles: anatomic factors contributing to pathogenesis and proposed classification. AJNR Am J Neuroradiol. 35(4):784-9, 2014
                                                                          4. La Fata V et al: CSF leaks: correlation of high-resolution CT and multiplanar reformations with intraoperative endoscopic findings. AJNR Am J Neuroradiol. 29(3):536-41, 2008
                                                                          5. Lloyd KM et al: Imaging of skull base cerebrospinal fluid leaks in adults. Radiology. 248(3):725-36, 2008
                                                                          6. Schuknecht B et al: Nontraumatic skull base defects with spontaneous CSF rhinorrhea and arachnoid herniation: imaging findings and correlation with endoscopic sinus surgery in 27 patients. AJNR Am J Neuroradiol. 29(3):542-9, 2008
                                                                          7. Haroun AA et al: Arachnoid granulations in the cerebral dural sinuses as demonstrated by contrast-enhanced 3D magnetic resonance venography. Surg Radiol Anat. 29(4):323-8, 2007
                                                                          8. Amlashi SF et al: Intracranial hypertension and giant arachnoid granulations. J Neurol Neurosurg Psychiatry. 75(1):172, 2004
                                                                          9. Liang L et al: Normal structures in the intracranial dural sinuses: delineation with 3D contrast-enhanced magnetization prepared rapid acquisition gradient-echo imaging sequence. AJNR Am J Neuroradiol. 23(10):1739-46, 2002
                                                                          10. Casey SO et al: Prevalence of arachnoid granulations as detected with CT venography of the dural sinuses. AJNR Am J Neuroradiol. 18(5):993-4, 1997
                                                                          11. Leach JL et al: Normal appearance of arachnoid granulations on contrast-enhanced CT and MR of the brain: differentiation from dural sinus disease. AJNR Am J Neuroradiol. 17(8):1523-32, 1996
                                                                          12. Roche J et al: Arachnoid granulations in the transverse and sigmoid sinuses: CT, MR, and MR angiographic appearance of a normal anatomic variation. AJNR Am J Neuroradiol. 17(4):677-83, 1996