CEREBRAL VEINS SEEN IN CT ANGIOGRAPHY

Parizad Hooshi MD, Noriko Salamon MD, William Chou, Alexander Juncosa, Georges Salamon M.D.
Department of Radiological Sciences at UCLA David Geffen School of Medicine

Part I Normal Anatomy 1. Superficial Cerebral Veins 2. Deep Cerebral Veins 3. Posterior Fossa Veins

Superficial veins

Deep veins

from G.Salamon. Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Classification of cerebral veins byPosterior fossa veins Y.P.Huang

Cerebral veins
Superficial veins

There are three main divisions in the venous drainage of the brain:
1:Superficial supratentorial veins. 2:Deep cerebral veins. 3:Posterior fossa veins. All these systems drain toward a large venous sinus and to a jugular vein.
Transverse sinus

Cerebellar.v. Jugular v.

from D.L.Bassett. Stereoscopic Atlas of Human Anatomy. Sawyers inc 1952

Part I Normal Anatomy 1. Superficial Cerebral Veins 2. Deep Cerebral Veins 3. Posterior Fossa Veins

Superficial cerebral veins

Vein of Trolard Superior Sagittal Sinus

Lateral sinus

Vein of Labbe

Superficial veins are more superficial than cortical arteries

from D.L.Bassett. Stereoscopic Atlas of Human Anatomy .Sawyers inc 1952

Superficial cerebral veins

Superior Sagittal Sinus

Superior sagittal sinus Inferior sagittal sinus

Straight sinus

Vein of Labbe

(Leon Labbe, 18321916, French surgeon)

Large superficial vein running from the Sylvian fissure to the transverse sinus. An inconstant vein that passes from the superficial middle cerebral vein posteriorly over the lateral aspect of the temporal lobe to enter the transverse sinus. Inferior anastomotic vein

Vein of Trolard

(Paulin Trolard, 18421910, French anatomist)

Large superficial vein running from the Sylvian fissure to the superior sagittal sinus. Superior anastomotic vein.

Superior sagittal sinus

Vein of Trolard

Transverse sinus

Vein of Labbe

Transverse sinus

Sinus Spehnoparietalis

Basal Vein of Rosenthal

Sphenobasal Vein

Sphenopetrosal Vein

Part I Normal Anatomy 1. Superficial Cerebral Veins 2. Deep Cerebral Veins 3. Posterior Fossa Veins

Deep middle cerebral vein

Basal vein of Rosenthal

Internal cerebral vein

Deep middle cerebral vein

Basal vein of Rosenthal

Internal cerebral vein

Vein of Galen

Straight sinus

Basal vein of Rosenthal

Lateral view

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Basal vein of Rosenthal

Axial view

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Deep middle cerebral vein

1 2

Basal vein of Rosenthal

Inferior ventricular vein

Deep middle cerebral V

Olfactory V
Anterior cerebral V Inferior striate V Peduncular V Inf. Thalamic V Inf. Ventricular V Lateral mesencephalic V Temporal V Occipital V hippocampal V

Segment 1

Segment 2

Segment 3

Basal vein of Rosenthal

Thalamostriate vein (TSV) :

Drain from the striatum, no drainage from the thalamus.

15% asymmetric. When hypoplastic, there is direct lateral vein (DLV).

Symmetric TSV (arrow)

Hypoplastic TSV with DLV (arrowhead)

Thalamic venous drainage

Internal cerebral vein

Superior thalamic vein

Inferior thalamic vein

Posterior thalamic vein

Basilar vein
From G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Internal cerebral vein (lateral group)

Y.P.Huang

From G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Internal cerebral vein (medial group)

Y.P.Huang

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Septal vein Caudate vein Thalamostriate vein Superior choroidal Vein Atrial vein

Internal cerebral vein

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag

Straight sinus

Choroid plexus

Septal vein

Caudate vein

Internal cerebral vein

Atrial vein

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag

Septal vein

Thalamostriate vein

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag

Septal vein

Thalamostriate vein Caudate vein

Internal cerebral vein

Thalamostriate vein

Atrial vein

Part I Normal Anatomy 1. Superficial Cerebral Veins 2. Deep Cerebral Veins 3. Posterior Fossa Veins

Veins of posterior fossa

Precentral cerebellar vein Superior vermian vein Mesencephalic vein

Anterior ponto mesencephalic vein

Ponto medullary vein

from D.L.Bassett. Stereoscopic Atlas of Human Anatomy. Sawyers inc 1952

Inferior vermian vein

Tonsillar vein

Veins of posterior fossa

from G.Salamon.Y.P. Huang . Radiologic Anatomy of the brain. Springer verlag 1976

Veins of posterior fossa

Midsagittal view

from G.Salamon.Y.P. Huang Radiologic Anatomy of the brain. Springer verlag 1976

Veins of posterior fossa

They are subdivided by their drainage (Y.P. Huang).

The first group drains superiorly to the vein of Galen. Tributaries are mesencephalic (anterior, lateral, posterior) and cerebellar. The most important cerebellar vein of this group is the precentral vein. The second group drains anteriorly to the petrosal vein with afferents from brain stem and cerebellum. The third group drains posteriorly to the straight or lateral sinus.

Injected specimen . by courtesy of H.Duvernoy

Veins of posterior fossa

Precentral cerebellar vein

Superior vermian vein

Anterior pontomesencephalic vein

Vein of primary fissure

Medial tonsilar vein

Inferior vermian vein

Veins of posterior fossa

Superior hemispheric vein

Inferior hemispheric veins

Transverse sinus

Part II Pathology 1.Hypoplasia (Normal Variant) 2.Venous sinus Thrombosis 3.Developmental Venous anomaly

Case 1 History: 9 year old boy with cerebral aneurysms

Dilated superficail coritcal veins

Large abnormal venous structure

No straight sinus

Dilated superficail coritcal veins

No straight sinus

Diagnosis: Hypoplastic superior sagittal sinus and absence of straight sinus

Case 2 History: 67 year old female with multiple intracranial aneurysms.

Superior sagittal sinus Inferior sagittal sinus

Aneurysmal dilatation of superior cerebelalr vein

Partial hypoplasia of straight sinus

Diagnosis: Partial hypoplasia of straight sinus

Case 3 History: 33 year-old woman incidental venous asymmetry

Small left jugular foramen

Small left sigmoid sinus and jugular vein

Diagnosis: Asymmetric venous system

Case 4 History: 45 year-old man with basilar tip aneurysm.

Falcine vein

Diagnosis: Persistent falcine vein.

Falcine vein

Median prosencephalic vein

Basilar tip aneurysm

At 7-12 weeks, embryonic vascular channel; median prosencephalic vein drains into a primitive accessory sinus called the falcine sinus.

Part II Pathology 1.Hypoplasia (Normal Variant) 2.Venous sinus Thrombosis 3.Developmental Venous anomaly

Case 5 History: 36 year old man with vomiting.

No enhancement in the superior sagittal sinus

Enlarged superficial veins

Normal

No enhancement in the sinus

No enhancement in the superior sagittal sinus

Normal Normal Superior Sagittal Sinus

Diagnosis: Superior sagittal sinus thrombosis

Case 6: History: 9 day old male status post repair of transpostion of great arteries.

Vein of Galen and straight sinus is enlarged.

Superior sagittal sinus is normal

No enhancement of the bilateral transverse sinus

Diagnosis: Transverse sinus thrombosis

Part II Pathology 1.Hypoplasia (Normal Variant) 2.Venous sinus Thrombosis 3.Developmental Venous anomaly

Case 7 History: 86 year old man.

Diagnosis: Developmental Venous anomaly

Case 8 History: 34 year-old woman.

Diagnosis: Developmental Venous anomaly

The End.