Article Figures & Data
Figures
- fig 1.
Classification of the superficial sylvian venous drainage pathways. 1, Sphenoparietal type: the SMCV enters the sphenoparietal sinus and runs along the lesser wing of the sphenoid bone to enter the cavernous sinus. 2, Cavernous type: the SMCV directly enters the anterior end of the cavernous sinus. 3, Emissary type: the SMCV courses along the lesser wing, turns inferiorly to reach the floor of the middle cranial fossa, joins the sphenoidal emissary veins, and passes through the floor to reach the pterygoid plexus. 4, Superior petrosal type: the SMCV runs along the lesser wing and just before reaching the cavernous sinus, turns downward along the anterior inner wall of the middle cranial fossa, then runs along its floor medially to the foramen ovale to join the superior petrosal sinus. 5, Basal type: the SMCV runs along the lesser wing, turns downward along the anterior wall of the middle cranial fossa, then runs along its floor laterally to the foramen ovale over the petrous pyramid, presumably to join the transverse sinus through the lateral tentorial sinus or superior petrosal sinus. 6, Squamosal type: the SMCV fails to turn medially to join the sinus along the lesser wing, and instead turns directly backward along the inner aspect of the temporal squama and runs posteriorly to join the transverse sinus or lateral tentorial sinus. 7, Undeveloped type: the SMCV is absent, and the superficial sylvian drainage is through a large channel that extends forward, upward, upward and backward, or downward and backward into the superior sagittal sinus or transverse sinus
- fig 2.
Variations of the superficial sylvian venous drainage pathway revealed by 3D CT angiography.
A, Axial view. The SMCV enters the sphenoparietal sinus (arrow).
B, Axial view. The SMCV directly enters the anterior end of the cavernous sinus (arrows).
C–F, Axial stereo and oblique views. The right SMCV courses along the lesser wing, turns inferiorly to reach the floor of the middle cranial fossa, and enters the foramen ovale (open arrows). This vein anastomoses with the cavernous sinus through the paracavernous sinus (arrowhead). The left SMCV turns downward along the anterior wall of the middle cranial fossa, then runs along its base laterally to the foramen ovale over the petrous pyramid, presumably to join the transverse sinus at the sigmoidal angle (closed arrows).
G–J, Axial stereo and oblique views. The SMCV turns medially into the sinus of the lesser wing, and before reaching the cavernous sinus turns downward along the anterior inner wall of the middle cranial fossa and runs posteriorly to join the superior petrosal sinus (arrows).
K and L, Axial stereo views. The SMCV turns downward along the anterior wall of the middle cranial fossa at the lesser wing and then runs along its floor laterally to the foramen ovale to drain into the transverse sinus (arrows).
M, Axial view. The SMCV turns directly backward along the inner aspect of the temporal squama and runs posteriorly to join the transverse sinus (arrows).
N, Axial view. The SMCV is absent, and the sylvian drainage area is taken over by a superficial temporal vein, which extends downward and backward into the lateral tentorial sinus (arrows).
O, Axial view. The remnant of the tentorial sinus originates from the cavernous sinus, runs beyond the petrous pyramid, and enters the lateral tentorial sinus. Note the anastomosis between the anterior end of the cavernous sinus and the basal vein of Rosenthal (arrowheads).
L, left; R, right; A, anterior; P, posterior.
- fig 2.
Continued
- fig 3.
Developmental stages of the basal cranial veins (after Padget).
A, 60-mm stage of embryologic development. The transverse sinus has swung backward on the sigmoid sinus and receives the elongated tentorial sinus. A lateral tributary of the prootic sinus, which primarily receives the middle meningeal sinus, is continuous with the definitive petrosquamosal sinus. The tentorial sinus becomes plexiform caudally as it is shifted toward the sigmoid sinus. The ophthalmic veins primarily drain laterally through the prootic sinus, and secondarily drain medially through the cavernous sinus and inferior petrosal sinus.
B, Typical infant stage. The SMCV still drains through the tentorial sinus, which has a variable position. The superior petrosal sinus has not yet joined the cavernous sinus.
C, Typical adult stage. Note the secondary anastomoses between the cavernous sinus and sphenoparietal sinus, derived from the prootic sinus (arrow), and between the cavernous sinus and superior petrosal sinus (arrowhead). The typical lateral wing of the cavernous sinus, just below the mandibular nerve root, is a remnant of the prootic sinus and extends to the foramen ovale and emissary veins. The petrosquamosal sinus and remnant of the prootic sinus draining the dura and bone become diploic in the adult, when the middle meningeal sinuses drain through the foramen ovale and sigmoid sinus.
1, SMCV; 2, superior orbital vein; 3, transverse sinus; 4, embryonic tentorial sinus; 5, prootic sinus; 6, sigmoid sinus; 7, superior sagittal sinus; 8, cavernous sinus and inferior petrosal sinus; 9, superior petrosal sinus; 10, petrosquamosal sinus; 11, sphenoparietal sinus; 12, emissary venous drainage; 13, middle meningeal sinus.
Tables
Table 1:Distribution of drainage veins from the superficial sylvian area by 3D CT angiography
- Table 2:
Comparison of classification systems for variants of the superficial middle cerebral vein
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