The basilar venous plexus

Abstract

The basilar venous plexus is the anteromedian venous channel of the posterior cranial fossa that has many conflicting and brief descriptions in the extant literature. To our knowledge, no single study has been performed that analyzed this venous structure in detail. The aim of the current study was to elucidate further the anatomy of this structure of the posterior cranial fossa. The authors examined twenty adult cadaveric specimens following injection of the internal jugular veins or cavernous sinus to observe the morphology of the basilar plexus. All specimens were found to have a basilar plexus which was always plexiform and very variable in nature. This structure was dorsal to the clivus superiorly and dorsal clivus and overlying tectorial membrane inferiorly. The mean diameter of the channels making up this plexus was 1.1 mm. Communication was always found between the basilar plexus and the inferior petrosal sinuses and this was the primary route used to drain the basilar sinus out of the cranium. In fact, these two venous structures were more or less contiguous across the midline at multiple levels. In seven specimens (35%), the basilar plexus communicated with veins draining into the hypoglossal canal. The basilar plexus communicated with the marginal sinus in 12 specimens (60%). This plexus became much less concentrated as it descended inferior to a plane between the jugular tubercles. No specimen was found to have connections with veins of the anterior brain stem or ventral surface of the clivus. The basilar plexus is a highly variable posterior fossa venous structure. Clinicians and radiologists should take into account this variability when managing cerebral venous disorders or interpreting imaging studies of the skull base.

Visualization of the Abducens Nerve in its Petroclival Segment Using Contrast-Enhanced FIESTA MRI: The Size of the Petroclival Venous Confluence Affects Detectability

“…A few into the jugular bulb via the PVC and the inferior petrosal sinus [5,22]. These communicating sinuses may show individual variations in size, a feature that explains why we found varying diameters for the PVC [9,23]. In addition, as these interconnecting dural spaces are filled by the venous blood homogeneously, their dimensions are relatively uniform without major changes at different levels.…”

Regarding “Retroclival Epidural Hematomas: A Clinical Series”

“…19 Tubb et al have also written 2 excellent articles on the tectorial membrane and the basilar venous plexus. 20,21 REDH could be associated with retroclival subdural hematomas (RSDHs), particularly in violent injuries, as in our second patient. 6 Isolated RSDHs are rarer than REDHs: only 7 cases have been reported, [22][23][24][25][26][27][28] but the context, clinical presentation, and mechanisms of formation are different.…”

“…20 Noting similarities between blast and ballistic waves, a recent paper estimated mild traumatic brain injury (TBI) thresholds for the thoracic mechanism of blastinduced TBI by analyzing data from ballistic pressure wave and behind armor blunt trauma studies. 21 A myth is an assertion that has either been disproved by careful experiment or for which there is no historical or scientific evidence in cases where it is reasonably expected. Belief in the remote effects of penetrating projectiles may have originated with hunters and soldiers, but their reality is now well established in a broad body of scientific literature, even though the clinical significance for the practicing neurosurgeon might be debatable.…”

Endovascular Treatment and Computed Imaging Follow-up of 14 Anterior Condylar Dural Arteriovenous Fistulas

“…in this particular type of shunt, the lesion involves mainly the epidural space and is in direct contact with the adjacent osseous structures that may invade or recruit the blood supply from the spongy bone structures and has no primary role in the drainage of the central nervous system. Tubbs et al reported that a communication was always found between the basilar venous plexus and the inferior petrosal sinuses in a cadaver study 19 . A cadaver study reported by kunicki et al showed 96% (47/50) of the basilar venous plexus drained into the inferior petrosal sinus 20 .…”