The Internal Cerebral Vein: New Classification of Branching Patterns Based on CTA

Abstract

BACKGROUND AND PURPOSE: The internal cerebral vein begins at the foramen of Monro by the union of the thalamostriate and the anterior septal veins. The lateral direct vein is its other major tributary. Numerous researchers have reported differences in internal cerebral vein branching patterns but did not classify them. Hence, the objectives of this study were to evaluate the anatomy of the internal cerebral vein and its primary tributaries and classify them depending on their course patterns using CTA.MATERIALS AND METHODS: Head CTAs of 250 patients were evaluated in this study, in which we identified the number and termination of the anterior septal vein and the lateral direct vein. The course of the lateral direct vein and its influence on the number of thalamostriate veins and their diameters and courses were assessed. The anterior septal vein-internal cerebral vein junctions and their locations in relation to the foramen of Monro also were evaluated. RESULTS:We classified internal cerebral vein branching patterns into 4 types depending on the presence of an extra vessel draining the striatum. Most commonly, the internal cerebral vein continued further as 1 thalamostriate vein (77%). The lateral direct veins were identified in 22% of the hemispheres, and usually they terminated at the middle third of the internal cerebral vein (65.45%). The most common location of the anterior septal vein-internal cerebral vein junction was anterior (57.20%), with the anterior septal vein terminating at the venous angle.CONCLUSIONS: Detailed knowledge of the anatomy of the deep cerebral veins is of great importance in neuroradiology and neurosurgery because iatrogenic injury to the veins may result in basal nuclei infarcts. A classification of internal cerebral vein branching patterns may aid clinicians in planning approaches to the third and lateral ventricles.

Unusual vascular anatomical variant leads to spontaneous hemorrhage in a cavum septum pellucidum in an adolescent: A case report and literature review

“…who classified variations of the ASV-ICV junction and its relation to the foramen of Monro into five types. [ 1 ] We have not encountered previously reported description of an ASV drain into a contralateral ICV like our case. This variation in the venous drainage caused distension and engorgement of the unilateral ICV and ASV that predisposed to bleeding.…”

The black rim susceptibility sign in the MRI evaluation of intracranial colloid cysts

“…The anterior septal and internal cerebral veins run along the sides of the foramen of Monro and appreciated as thin dark signal along the lateral aspects of the colloid cysts that arise here 21,22 . This could confound the use or presence of the black rim susceptibility sign, although our observation of these veins in relation to the black rim sign shows that the anterior and posterior surface of the cysts are black rimmed in all 19 cases of colloid cyst, whereas the veins were only visualized along the sides of the cyst.…”

CT angiographic study of the cerebral deep veins around the vein of Galen

“…Sometimes, the ICV gives rise to the LDV, which is also known as the thalamocaudate vein and is located on the floor of the body of the lateral ventricle and enters the ICV at various levels 6 . In Brzegowy et al's (2019) study, the LDV was identified in 22% of the hemispheres evaluated and usually terminated at the middle third of the ICV (65.45%) 7 . In our study, the incidence of an LDV was 19.0%, which was similar to that of Brzegowy et al's study 7 .…”

“…In Brzegowy et al's (2019) study, the LDV was identified in 22% of the hemispheres evaluated and usually terminated at the middle third of the ICV (65.45%) 7 . In our study, the incidence of an LDV was 19.0%, which was similar to that of Brzegowy et al's study 7 . To prevent unintentional injury to the LDV during endoscopic surgery involving the lateral ventricle, different kinds of classifications of the LDV were proposed.…”