TL;DR: The microsurgical anatomy of the deep venous system of the brain was examined in 20 cerebral hemispheres and the operative approaches to the major trunks in this system are reviewed.
Abstract: The microsurgical anatomy of the deep venous system of the brain was examined in 20 cerebral hemispheres. The deep venous system is composed of the internal cerebral, basal, and great veins and their tributaries. This system drains the deep white and gray matter surrounding the lateral and 3rd ventricles and the basal cisterns. The deep veins are divided into a ventricular group composed of the veins converging on the walls of the lateral ventricles and a cisternal group that includes the veins draining the walls of the basal cisterns. The internal cerebral vein is included in the ventricular group because it is predominantly related to the ventricles, and the basal and great veins are reviewed with the cisternal group because they course through the basal cisterns. The choroidal veins are included with the ventricle veins because they arise on the choroid plexus in the ventricles. The thalamic veins appear in both the ventricular and the cisternal groups because some course on the ventricular surfaces and others course in the basal cisterns. The operative approaches to the major trunks in this system are reviewed.
TL;DR: Angiograms obtained prior to treatment in 53 cases of deep-seated cerebral arteriovenous malformations were retrospectively analyzed with particular attention to the topography of the AVM nidus and the venous drainage to suggest a relationship between an increased incidence of intracranial bleeding and impaired venous outlets.
Abstract: ✓ Angiograms obtained prior to treatment in 53 cases of deep-seated cerebral arteriovenous malformations (AVM's) were retrospectively analyzed with particular attention to the topography of the AVM nidus and the venous drainage. The location of the lesion was determined by a combination of angiography and computerized tomography. Twenty-seven AVM's involved the basal ganglia and thalamus, 12 were located in the corpus callosum, six were intraventricular, and eight involved the mesencephalon and brain stem. Forty-one patients (77.3%) presented with intracranial hemorrhage. Vessel wall irregularities and/or stenosis of the system of the vein of Galen were observed in 14 cases, and occlusion of the deep venous system was present in seven cases. These AVM's showed numerous collateral venous pathways through enlarged medullary and cortical regional veins. There was dominant participation of the basal vein of Rosenthal in all cases. Unique local hemodynamic factors produced by the convergence of the draining ve...
TL;DR: Although transversely directed arteries and veins may suggest a hippocampal lamellar neuronal organization, microvascular fields must be mapped before claims are made for a totally segmental vascular architecture in the hippocampus.
TL;DR: Transcranial Doppler methods can be used for evaluation of the basal cerebral veins in both sexes, in differing age groups, and without major difficulty and could be identified on the basis of their anatomic relation to specific arteries.
Abstract: Background and Purpose Transcranial Doppler ultrasound has not yet been applied systematically to the analysis of the venous system and cerebrovenous disorders. Assessment of the intracranial venous system, however, would contribute to the understanding of cerebral hemodynamics and thus allow new possibilities for clinical application of the Doppler technique. Therefore, we demonstrated the validity of the transcranial Doppler technique in analyzing the basal cerebral veins. Methods Venous transcranial Doppler ultrasound was performed with a range-gated 2-MHz transducer in 60 healthy volunteers and patients without central nervous disorders ranging in age from 10 to 71 years (mean±SD, 41.9±15 years). Results A venous signal away from the probe and adjacent to the posterior cerebral artery, considered to correspond to the basal vein of Rosenthal, was found in all subjects on at least one side. Mean blood flow velocity ranged from 4 to 17 cm/s (mean±SD, 10.1±2.3 cm/s). Analysis for age dependency revealed a...
TL;DR: In this article, anatomic variability of the arterial supply and venous drainage of each segment of the medial temporal region (MTR) was investigated and discussed and illustrate the implications of the findings for surgery of arteriovenous malformations (AVM) of the MTR.
Abstract: Background The medial temporal region (also called the temporomesial or mediobasal temporal region) is the site of the most complex cortical anatomy. Objective To investigate the anatomic variability of the arterial supply and venous drainage of each segment of the medial temporal region (MTR), and to discuss and illustrate the implications of the findings for surgery of arteriovenous malformations (AVM) of the MTR. Methods Forty-seven cerebral hemispheres and 10 silicon-injected cadaveric heads were examined using x3 to x40 magnification. Illustrative surgical cases of MTR AVMs were selected. Results The anterior choroidal artery (AChA) gave rise to an anterior uncal artery in 83% of hemispheres and a posterior uncal or unco-hippocampal artery in 98%. The plexal segment of the AChA gave off neural branches in 38%. The MCA was the site of origin of anterior uncal, unco-parahippocampal, or anterior parahippocampal arteries in 94% of hemispheres. An anterior uncal artery arose from the internal carotid artery (ICA) in 45% of hemispheres. The posterior cerebral artery (PCA) irrigated the entorhinal area through its anterior parahippocampal or hippocampo-parahippocampal branches in every case. A PCA bifurcation was identified in 89% of hemispheres, typically at the middle segment of the MTR. The most common pattern of bifurcation was by division into posteroinferior temporal and parieto-occipital arterial trunks. The anterior segment of the basal vein had a predominant anterior drainage in 35% of hemispheres, and the middle segment had a predominant inferior drainage in 16%. Conclusion An understanding of the vascular variability of the MTR is essential for accurate microsurgical resection of MTR AVMs.