Abstract
The cerebral venous outflow consists of the superficial system and the deep draining system. The deep one drains the areas of the great vein of Galen, the two basal veins of Rosenthal, and their tributaries. Simultaneous obstruction of these veins can effect great harm. In the case of obstruction of the vein of Galen, the basal vein can ensure the venous outflow. Therefore, attention should be paid to anastomoses between the basal vein and the infratentorial venous system. The lateral mesencephalic vein (LMV) is the most important anastomosis between the supra- and infratentorial system linking the basal vein to the superior petrosal sinus. Since microanatomical studies concerning this vein have received less attention the aim of the present study was to visualize the course of this vein, its junction with the basal vein, its tributaries and its relationship with neural structures. Fifty-two cadaveric hemispheres were examined under the operating microscope. The LMV could be identified in all cases, with a mean diameter of 1.07 mm. Thorough understanding of the microanatomy of the LMV is crucial to avoid brain damage due to venous infarction during surgery, and its preservation could ensure deep venous outflow in the case of obstruction of the vein of Galen.
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References
Andeweg J (1999) Consequences of the anatomy of deep venous outflow from the brain. Neuroradiology 41:233–241
Babin E, Megret M (1973) Variations in the drainage of the basal vein. Neuroradiology 6:154–161
Billewicz O (1973) Radiologic pattern of the lateral mesencephalic vein and its ramifications under normal and pathological conditions (in Polish). Neurol Neurochir Pol 7:799–806
Bradac GB, Holdorff B, Simon RS (1971) Aspects of the venous drainage of the pons and the mesencephalon. Neuroradiology 3:102–108
Cannon BW (1951) Acute vascular lesions of the brain stem—a complication of supratentorial space-occupying lesions. Arch Neurol Psychiatry 66:678–696
Duvernoy HM (1975) The superficial veins of the human brain. Veins of the brain stem and of the base of the brain. Springer, Berlin Heidelberg New York
Duvernoy HM (1978) Human brainstem vessels. Springer, Berlin Heidelberg New York
Hochstetter F (1938) Über eine Varität Vena ceebralis basalis des Menschen nebst Bemerkungen über die Entwicklung bestimmter Hirnnerven. Z Anat Entwicklungsgesch 108:311–336
Huang YP, Wolf BS (1965) The veins of the posterior fossa—superior or galenic draining group. Am J Roentgenol Radium Ther Nucl Med 95:808–821
Huang YP, Wolf BS, Antin SP, Okudera T (1968) The veins of the posterior fossa—anterior or petrosal draining group. Am J Roentgenol Radium Ther Nucl Med 104:36–56
Lang J, Köth R, Reiss G (1981) Über die bildung, die zuflüsse und den verlauf der V. basalis und V. cerebri interna. Ann Anat 150:385–423
Lang J, Schaffrath H, Fischer G (1987) Weitere befunde zu den Vv. mesencephalicae. Neurochirurgia 30:69–71
Mayer ET (1969) Zur pathologie des traumatischen mittelhirn- und apallischen syndroms. Radiologe 9:16–22
Matsushima T, Rhoton AL Jr, de Oliveira E, Peace D (1983) Microsurgical anatomy of the veins of the posterior fossa. J Neurosurg 59:63–105
Ono M, Ono M, Rhoton AL Jr, Barry M (1984) Microsurgical anatomy of the region of the tentorial incisura. J Neurosurg 60:365–399
Ono M, Rhoton AL Jr, Barry M (1984) Microsurgical anatomy of the superficial veins of the cerebrum. Neurosurgery 15:621–657
Padget DH (1956) The cranial venous system in man in reference to development, adult configuration, and relation to the arteries. Am J Anat 98:307–355
Padget DH (1957) The development of the cranial venous system in man, from the viewpoint of comparative anatomy. Contrib Embryol 247:79–140
Stephens RB, Stilwell DL (1969) Arteries and veins of the human brain. Charles C Thomas, Springfield
Suzuki Y, Ikeda H, Shimado M, Ikeda Y, Matsumoto K (2001) Variations of the basal vein: identification using three-dimensional CT angiography. AJNR Am J Neuroradiol 22:670–676
Wackenheim A, Braun JP (1970) Angiography of the mesencephalon. Springer, Berlin Heidelberg New York
Wackenheim A, Heldt N, Amor MB (1971) Variations in the drainage of the lateral mesencephalic vein. Neuroradiology 2:154–161
Wolf BS, Huang YP, Newman CM (1963) The lateral anastomotic mesencephalic vein and other variations in drainage of the basal cerebral vein. Am J Roentgenol Radium Ther Nucl Med 89:411–422
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We thank Florian Stingl for help in preparing the manuscript.
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Helder Tedeschi, Evandro de Oliveira, São Paulo, Brasil
Dr. Ardeshiri and his colleagues have conducted a very interesting study of the anatomical variations of the lateral mesencephalic vein. The study discusses the potential role of the lateral mesencephalic vein as an anastomotic alternative pathway to venous flow between the supra- and infratentorial venous system in the case of venous obstruction and thoroughly describes the anatomical variations of the vein in relation to the cerebral peduncle, the basal vein of Rosenthal, and to the superior petrosal sinus.
Pre-operative studies of the venous system are becoming an important tool in a variety of neurosurgical procedures. The authors study’ on the lateral mesencephalic vein will certainly add to the knowledge of the vein as a useful anatomic landmark in surgery of deep areas of the brain. In our practice the vein is usually used as a reference for the position of the lateral mesencephalic sulcus in the posterolateral aspect of the midbrain during surgery dedicated to cavernomas or certain tumours of the upper brain stem. It is also used as a guide for evaluating the intraoperative extent of resection of medial temporal lobe structures during intraventricular surgery in the temporal lobe in which the choroidal fissure is opened, as is the case with trans-sylvian selective amygdalohippocampectomy for the treatment of refractory mesial temporal lobe epilepsy.
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Ardeshiri, A., Ardeshiri, A., Tonn, JC. et al. Microsurgical anatomy of the lateral mesencephalic vein and its meaning for the deep venous outflow of the brain. Neurosurg Rev 29, 154–158 (2006). https://doi.org/10.1007/s10143-005-0016-2
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DOI: https://doi.org/10.1007/s10143-005-0016-2