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CEREBRAL VENOUS ANATOMY

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The veins of the brain contain no valves, and the vessel wall is slim because of the absence of the muscular layer. The veins penetrate the dura mater and drain into the cranial venous sinuses.1,2,3 The cerebral veins are divided into two main groups—cerebral and cerebellar. The cerebral veins drain the external and internal surfaces of the hemispheres. The cerebral veins that drain the external surfaces of the cerebral hemispheres are the superior, middle, and inferior superficial cerebral veins. The cerebral veins that drain the internal cerebral structures are mainly the internal cerebral vein and the basal vein of Rosenthal, which drain in the great vein of Galen. There are two pairs of cerebellar veins, the superior and the inferior cerebellar veins (Figure 15-1).

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The cerebral venous sinuses are also devoid of valves. They drain cerebral blood mainly into the internal jugular vein. They are divided into the anterior-inferior and posterior-superior group. The posterior-superior group includes the superior sagittal sinus (SSS), two transverse sinuses (TS), straight sinus (STS), and inferior sagittal sinus (ISS). The anterior-inferior groups are all a pair of sinuses, and include the cavernous, superior petrosal, inferior petrosal, and intracavernous sinuses (Figure 15-2).

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The Cerebral Veins

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The superficial superior cerebral veins drain blood from the superior, upper lateral, and upper medial surfaces of the cerebral hemispheres. They drain into the SSS. The superficial middle cerebral vein runs along the lateral cerebral fissure of Sylvius and drain blood from the lateral surface of the cerebral hemispheres. The vein of Trolard is an anastomotic vein that connects the superficial middle cerebral veins with the SSS. The vein of Labbé is another anastomotic vein that connects the superficial middle cerebral vein with the TS (Figure 15-3). The superficial middle cerebral veins drains mainly into the cavernous and sphenopalatine sinuses. The superficial inferior cerebral veins drain the inferior surface of the cerebral hemispheres. The vessel on the orbital surface connects with the superior cerebral vein, and the vessels on the temporal surface connect with the middle cerebral veins.

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FIGURE 15-3.

Left lateral view magnetic resonance venography imaging of the cerebral venous circulation. Venous structures are labeled. Note the vein of Labbé branching from the left transverse sinus.

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The deep cerebral veins mainly drain into the great vein of Galen, which is formed by the union of the basal vein of Rosenthal and the internal cerebral veins. The basal vein of Rosenthal is formed by the junction of the ...

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