Operative Anatomy and Classification of the Sylvian Veins for the Distal Transsylvian Approach

Kazumata, Ken; Kamiyama, Hiroyasu; Ishikawa, Tatsuya; Takizawa, Kazuyasu; Maeda, Takahiro; Makino, Kennichi; Gotoh, Satoshi

doi:10.2176/nmc.43.427

Cited by 62 publications

(34 citation statements)

References 11 publications

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“…The superolateral drainage type involves draining routes from the cavernous sinus through the SMCV and deep middle cerebral vein and/or uncal vein to the basal cerebral vein, and was found in 10% of CSDAVFs. A study involving the surgical observation of the SMCV demonstrated communication between the SMCV and the deep middle cerebral vein in 39 (45%) of 82 hemispheres [14]. Although the superolateral type is relatively well known as a typical basal cerebral venous drainage, it was less frequently observed than the other types, in our present study.…”

Section: Discussioncontrasting

confidence: 51%

Basal cerebral venous drainage from cavernous sinus dural arteriovenous fistulas

et al. 2008

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Introduction This study aimed to define the patterns of basal cerebral venous drainage (BCVD) from cavernous sinus dural arteriovenous fistulas (CSDAVFs). Materials and methods Forty sets of selective angiographic data from 36 patients with spontaneous CSDAVFs (age range, 53-79 years) were retrospectively analyzed for their drainage patterns. Three types of BCVD were observed, i.e., superolateral type, BCVD via the deep middle cerebral vein or uncal vein; posterolateral type, BCVD via the superior petrosal sinus and petrosal vein; and posteromedial type, BCVD via the bridging vein and the anterior pontomesencephalic vein. MR images and/or 3D-DSA images were also reviewed when available. Results BCVD from CSDAVF was found in 12 patients (30%), and the other drainage routes included the superior ophthalmic vein in 25 (63%), the inferior petrosal sinus in 17 (43%), the superficial middle cerebral vein in 17 (43%), intercavernous sinus in 15 (38%), the superior petrosal sinus in seven (18%), and pterygoid plexus in two (5%), respectively. In 12 patients with BCVD, superolateral type was found in four (33%), posterolateral type in five (42%), and posteromedial type in seven (58%). Four cases of posteromedial type were associated with other types of BCVD. Conclusion CSDAVFs are often associated with BCVD via three different pathways. The posteromedial type via the bridging vein is the most frequent type of BCVD.

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Section: Discussioncontrasting

confidence: 51%

Basal cerebral venous drainage from cavernous sinus dural arteriovenous fistulas

et al. 2008

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“…15) In 53% of cases, the deep middle cerebral vein and SMCV are connected, 16) and this connection serves as an important collateral route when the proximal position of the SMCV is occluded by a tumor. The drainage pattern of the SMCV influences the selection of a microsurgical skull base approach with middle cranial fossa dura incision.…”

Section: Sphenoidal Groupmentioning

confidence: 99%

Evaluation of Venous Drainage Patterns for Skull Base Meningioma Surgery

Adachi

Hasegawa

Hirose

2017

Neurol. Med. Chir.(Tokyo)

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The evaluation of venous drainage patterns prior to surgery for skull base meningioma is important owing to their deep location and the vulnerability of surrounding vascular structures. In recent years, the microsurgical skull base approach has matured as a surgical technique, making it an important option for reducing complications related to skull base meningioma surgery. In addition, knowledge of the venous anatomy can prevent venous drainage route disturbance and potentially life-threatening complications. Hence, this topic review aimed to provide an overview of normal venous anatomy as it relates to the microsurgical skull base approach, discuss known changes in venous drainage routes that are associated with the progression of skull base meningioma and the selection of an appropriate operative approach with the highest likelihood of preserving venous drainage structures.

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“…The draining pathway and termination of the SMCV vary greatly, and many studies have been conducted to describe this anatomic complexity ( Fig 5) (32)(33)(34)(35). Most commonly, the SMCV drains into the sphenoparietal sinus (Fig 6) or courses separately along the lesser sphenoid wing parallel to the sphenoparietal sinus and drains into the anterior cavernous sinus (Fig 7).…”

Section: Smcv and Sphenoparietal Sinusmentioning

confidence: 99%

Contrast-enhanced Reformatted MR Images for Preoperative Assessment of the Bridging Veins of the Skull Base

Wangaryattawanich¹,

Chavali²,

Shah³

et al. 2016

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Magnetic resonance (MR) venography and computed tomographic (CT) venography are suited for displaying the convexity veins that drain the medial and lateral surfaces of the brain hemispheres. However, such is not the case for the bridging veins of the skull base. Technical factors prevent contrast material-enhanced MR or CT images obtained in standard axial, coronal, and sagittal planes from fully displaying the curved pathways of these clinically important venous structures. This limitation can be overcome by using a reconstruction technique that depicts these venous structures and their interconnections. Curved and multiplanar reformatted images that distill the important venous features often require knowledgeable manipulation of source images by an operator who is familiar with numerous venous variants and their surgical implications. The normal anatomy of the draining veins is detailed-anatomy that radiologists must master before they can show the surgeon the important venous anatomy that is often missing at standard imaging; this information will foster better communication between radiologists and their surgical colleagues. As a practical matter, the skull base veins are arbitrarily subdivided into those that are at greatest risk with the pterional approach and the subtemporal approach, respectively. These approaches can be expanded to define connections between the superficial venous system and the other valveless venous networks that drain the deep portions of the cerebral hemisphere, the scalp, face, muscles of the neck, diploë of the skull, and meninges. As radiologists gain experience, their image interpretations should mature beyond simple analysis of the primary hemodynamic changes induced by intraoperative sacrifice or injury.

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Operative Anatomy and Classification of the Sylvian Veins for the Distal Transsylvian Approach

Cited by 62 publications

References 11 publications

Basal cerebral venous drainage from cavernous sinus dural arteriovenous fistulas

Basal cerebral venous drainage from cavernous sinus dural arteriovenous fistulas

Evaluation of Venous Drainage Patterns for Skull Base Meningioma Surgery

Contrast-enhanced Reformatted MR Images for Preoperative Assessment of the Bridging Veins of the Skull Base

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