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Visualization of the Torcular Herophili by MV-Flow™ and LumiFlow™ Doppler Technology: A Step Forward in the Prenatal Assessment of the Cerebral Tentor

  • #Ultrasound System>Womens Health
  • writerAndrea Dall’Asta, MD PhD , Gianpaolo Grisolia, MD PhD, Nicola Volpe, MD PhD, Tullio Ghi, MD PhD
  • date2019.09.30
The torcular herophili (TH), also known as “confluence of sinuses”, is a venous structure draining the major vessels of the intracerebral venous system, which includes the superior sagittal sinus and the straight, transverse, sigmoid, cavernous and occipital sinuses. Under normal circumstances the TH is located inferior to the occipital bones and posterior to the cerebellum, just inside the cranial vault, at the junction of the falxcerebri with the tentorium cerebelli. This latter anatomic structure has been acknowledged by radiologists and fetal medicine specialists among those involved in the differential diagnosis of posterior fossa abnormalities. Inparticular, the upwards displacement of the tentorium cerebelli in respect to its normal insertion on the occipital clivus(defined as the part of the skull base, which forms a gradual sloping process at the most anterior portion of the basilar occipital bone, where the neck muscles are inserted) is among the diagnostic criteria of classic Dandy-Walker Malformation (DWM) in fetuses with or without hypoplastic and supraelevated cerebellar vermis, and abnormal communication between the fourth ventricle and the cisterna magna.