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Six cases of sinus pericranii are reported and new classifications are proposed. The age of onset varied from neonate to 22 years. Two patients were male and four were female. In all cases, diagnostic radiography obtained by direct injection of contrast medium at the site of epicranial blood cyst revealed communication between the intracranial dural sinus and sinus pericranii. Total removal of the tumor was performed in four patients, and ventriculo-peritoneal shunt alone was carried out in two cases associated with hydrocephalus. Sinus pericranii is a symptom-complex, and not an independent clinical entity. Therefore, its definition and classification are matters of controversy. The authors describe a new classification from the pathological aspects, based on their own cases and previous reports. The new classification is the following. Type 1: multilocular blood cyst consisting of fibrous connective tissue similar to the architecture of cavernous hemangioma. (This type is defined as the only type of sinus pericranii by some authors.) Type 2: true hemangiomas (such as capillary hemangioma and cavernous hemangioma) as neoplastic entities. Type 3: varicose vein represented by enlarged emissary vein. Type 4: herniated dural sinus through the defect of calvarium. Type 5: miscellaneous.

Histological Classification and Therapeutic Problems of Sinus Pericranii