Microsurgical anatomy of the tentorial sinuses

Abstract

Variations of the tentorial sinus of cadaver cerebellar tentoria were examined under a surgical microscope. The tentorial sinuses were classified into four groups: Group I, in which the sinus received venous blood from the cerebral hemisphere; Group II, in which the sinus drains the cerebellum; Groups III, in which the sinus originates in the tentorium itself; and Group IV, in which the sinus originates from a vein bridging to the tentorial free edge. The tentorial sinuses of Groups I and II were frequently located in the posterior portion of the tentorium. The sinuses of Group I were short and most frequently present in the lateral portion of the tentorium. The tentorial sinuses of Group II, which were usually large and drained into the dural sinuses near the torcular, were separated into five subtypes according to the draining veins and direction of termination. The tentorial sinuses of Groups III and IV were located near the tentorial free edge or the straight sinus. The draining patterns of the tentorial sinuses and their draining veins (so-called "bridging veins") were present in most cases. Knowledge of this anatomy can benefit the neurosurgeon carrying out repair near or on the cerebellar tentorium.

Neurosurgical venous considerations for tumors of the pineal region resected using the infratentorial supracerebellar approach

“…When surgeons approach the pineal region using the ITSC route, they find several bridging veins between the cerebellar surface and the tentorium ( Figure 3A, 4A). These bridging veins are divided into two groups (17,25,26). Those belonging to the vermian group receive venous blood from the inferior vermian veins and other superficial veins and drain to the torcular Herophili.…”

“…As bridging veins and superficial veins of the cerebellum have frequent communications with one another, some of them can be divided without any adverse effects (21,26). On the other hand, Page reported that severe cerebellar swelling occurred after the division of all vermian bridging veins and one hemispheric bridging vein.…”

Straight sinus: ultrastructural analysis aimed at surgical tumor resection

“…1,4,7,29,32,33 Additionally, histological divergence has been found among these structures. 11,15,25,26 Some studies have described spongy tissue embedded with collagen fibers, whereas others have not found that structure, but have found many elastic and few collagen fibers.…”

Transverse Sinus-Tentorium Splitting Approuch for Pineal Region Tumors. Case Report.

“…The venous channels around the torcular herophili show wide variation and complexity, so caution is essential in sectioning the transverse sinus. [1][2][3][4]8,11,14) Sectioning the hypoplastic transverse sinus after uneventful test occlusion seems to be a safe procedure. The patient position and the type of anesthesia influence the venous pressure, but the change rather than the absolute value during the test occlusion is critical.…”