Intracranial Venous System Overview

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Intracranial Venous System Overview

Main Text

TERMINOLOGY

Abbreviations

• Superior sagittal sinus (SSS)
• Inferior sagittal sinus (ISS)
• Internal cerebral vein (ICV)
• Straight sinus (SS)
• Great cerebral vein [vein of Galen (VofG)]
• Transverse sinus (TS)
• Superior/inferior petrosal sinuses (SPS/IPS)
• Cavernous sinus (CS)
• Internal jugular vein (IJV)
• Basal vein of Rosenthal (BVR)
• Superficial, deep middle cerebral veins (SMCV; DMCV)

Definitions

• Dural sinuses are large, endothelial-lined trabeculated venous channels encased within folds/reflections of dura that define, form their walls
• Cerebral veins are thin-walled, valveless structures that cross SAS, pierce arachnoid/inner dura to enter dural venous sinus

GROSS ANATOMY

Overview

• Dural venous sinuses (divided into 2 groups)

Anteroinferior group (CS, SPS/IPS, clival, sphenoparietal)

Posterosuperior group (SSS, ISS, SS, TS, sigmoid, occipital)
• Cerebral veins (divided into 3 groups)

Superficial (“external”) veins (3 subgroups)

– Superior: 8-12 smaller cortical veins over hemispheres, vein of Trolard

– Middle: SMCV, vein of Labbé

– Inferior: DMCV, BVR

Deep (“internal”) veins

– Subependymal veins

– ICVs (formed by thalamostriate, septal veins)

– Great cerebral vein (VofG)

Brainstem/posterior fossa veins (3 subgroups)

– Superior (galenic) group

– Anterior (petrosal) group

– Posterior (tentorial) group

Vascular Territories

• Venous vascular territories

More variable, less well known than arterial territories

General concepts

– Venous drainage generally radial, centrifugal (exception = deep cerebral structures)

– Much of middle/superior brain surfaces (cortex, subcortical white matter) drained by cortical veins to SSS

– Posterior/inferior temporal lobe, adjacent parietal lobe drained by vein of Labbé to TS

– Insular cortex, parenchyma around sylvian (middle cerebral) fissure drained by sphenoparietal sinus to CS

– Deep cerebral structures (central/deep white matter, basal ganglia) drained by medullary/subependymal veins to ICVs, VofG, SS; medial temporal lobe via DMCV/BVR to VofG

Anatomy Relationships

• Dural venous sinuses

Communicate with extracranial veins directly (via diploic veins in calvarium, emissary veins through basilar foramina)

Receive venous blood from superficial (cortical) veins, deep (subependymal) veins
• Cerebral veins

Superficial (cortical) veins lie in SAS, mainly follow sulci

Subependymal veins outline ventricles

IMAGING ANATOMY

Overview

• Dural venous sinuses

Visualization at DSA varies widely

– Almost always: SSS, SS, TS, sigmoid sinus, IJVs

– Sometimes: ISS, SPS/IPS

– Rare/inconstant: CS, sphenoparietal sinus, occipital sinus, clival (basal) venous plexus

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Tags: Imaging Anatomy Brain and Spine

Mar 13, 2021 | Posted by admin in NUCLEAR MEDICINE | Comments Off

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