Cerebellar veins

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General

  • The vertebral venous plexus anastomoses with the internal jugular vein. Bridging veins pass from the surface of the cerebellum and brainstem to the dural sinuses.

Superficial Veins

  • Drain the cortical surfaces of the cerebellum

Tentorial surface

  1. Superior vermian veins
  1. Superior hemispheric veins

Suboccipital surface

  1. Inferior vermian veins
  1. Inferior hemispheric veins
  1. Retrotonsillar veins
  1. Medial and lateral tonsillar veins

Petrosal surface

  1. Anterior hemispheric veins

Deep Veins

  • Course in the three deep fissures between the cerebellum and brainstem near the roof and walls of the fourth ventricle and on the three cerebellar peduncles that course within these fissures

Cerebellomesencephalic fissure: related to the superior half of the roof

  1. Vein of superior cerebellar peduncle
  1. Vein of cerebellomesencephalic fissure
  1. Pontotrigeminal vein
  1. Tectal veins

Cerebellopontine fissure: related to the lateral recess and lateral walls of the 4th ventricle

  1. Vein of cerebellopontine fissure
  1. Vein of middle cerebellar peduncle

Cerebellomedullary fissure: related to the inferior half of the roof

  1. Vein of cerebellomedullary fissure
  1. Vein of inferior cerebellar peduncle
  1. Supratonsillar veins
  1. Choroidal veins

Veins of the Brainstem

Named on the basis of three characteristics:

  • The subdivision of the brainstem drained (mesencephalon, pons, or medulla)
  • The surface of the brainstem drained (median anterior, lateral anterior, etc.)
  • The direction in which they course (transverse or longitudinal).

Longitudinal veins

  1. Midline
    1. Median anterior pontomesencephalic vein
    2. Median anterior medullary vein
  1. Anterolateral
    1. Lateral anterior pontomesencephalic vein
    2. Lateral anterior medullary vein
  1. Lateral
    1. Lateral mesencephalic vein
    2. Lateral medullary and retro-olivary veins

Transverse Veins

  1. Peduncular vein
  1. Posterior communicating vein
  1. Vein of pontomesencephalic sulcus
  1. Transverse pontine veins
  1. Vein of pontomedullary sulcus
  1. Transverse medullary vein

Bridging Veins (Major Draining Groups)

  • Terminal ends of veins draining the brainstem and cerebellum form bridging veins that cross the subarachnoid and subdural spaces to reach the venous sinuses in the dura
  1. Galenic group (to vein of Galen)
  1. Tentorial group (to torcula and tentorial sinuses)
  1. Petrosal group (to petrosal sinuses)
  1. Other bridging veins

Drainage patterns of the cerebellar surfaces

  • The tentorial surface is drained by the superior hemispheric and superior vermian veins, which are divided into an anterior and a posterior group.
    • Anterior group and the veins from the cerebellomesencephalic fissure empty predominantly into the vein of Galen and its tributaries.
    • Posterior group drains the posterior part of the tentorial surface and empties into the tentorial sinuses, which are tributaries of the straight, transverse, or superior petrosal sinus, or the torcula.
  • Some of the inferior hemispheric veins from the suboccipital surface pass forward under the transverse sinus and cross the posterior part of the tentorial surface to empty into the tentorial sinuses.
Tentorial surface.
Tentorial surface.
  • The suboccipital surface is drained by the inferior hemispheric and inferior vermian veins, which ascend toward the transverse sinus, but then turn forward below the sinus and commonly empty into the tentorial sinuses.
  • Some of the inferior hemispheric veins from the suboccipital surface empty into the inferior vermian veins, which in turn empty into the tentorial sinuses.
Suboccipital surface
Suboccipital surface
  • The anterior hemispheric veins, which drain the petrosal surface, and the veins from the brainstem commonly unite to form the superior petrosal veins that empty into the superior petrosal sinus.
 
Petrosal surface and anterior surface of the brainstem
Petrosal surface and anterior surface of the brainstem

Tentorial surface and cerebellomesencephalic fissure

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The left half of the tentorium has been removed while preserving a laterally placed tentorial sinus. A large sinus is seen through the right tentorial surface.
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The right half of the tentorium has been removed to expose a large inferior hemispheric vein from the suboccipital surface and a smaller superior hemispheric vein from the tentorial surface emptying into the large tentorial sinus.
The superior hemispheric veins, which drain the tentorial surface, are divided into an
  • Anterior group, which empties into the Galenic system,
  • Posterior group, like the vein shown, which empties into the tentorial sinuses.
Smaller veins from both the left tentorial and suboccipital surfaces join the laterally placed tentorial sinus near the junction of the left transverse and superior petrosal sinuses.
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The straight and tentorial sinuses have been removed. The anterior group drains toward the cerebellomesencephalic fissure and the vein of Galen, and the posterior group passes backward to empty into the tentorial sinuses.
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The posterior lip of the cerebellomesencephalic fissure has been removed to expose the veins of the superior cerebellar peduncle, which ascend to unite and form the vein of the cerebellomesencephalic fissure that empties into the vein of Galen. A transverse pontine vein and the vein of the cerebellopontine fissure join to form a superior petrosal vein that empties into the superior petrosal sinus.
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The posterior lip of the cerebellomesencephalic fissure has been removed to expose the tributaries of the vein of the cerebellomesencephalic fissure and the branches of the SCA.
The paired veins of the superior cerebellar peduncle unite to form the vein of the cerebellomesencephalic fissure that empties into the vein of Galen.
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The branches of the SCA within the cerebellomesencephalic fissure have been removed. The paired veins of the superior cerebellar peduncle ascend on the superior cerebellar peduncles and join to form the vein of the cerebellomesencephalic fissure. The veins on the surface of the middle cerebellar peduncle course laterally to join the veins emptying into the superior petrosal sinus.
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The left half of the tentorium has been removed while preserving the tentorial sinuses. The anterior group of superior vermian and superior hemispheric veins arise on the upper part of the tentorial surface and ascend to reach the veins exiting the cerebellomesencephalic fissure, which empty into the vein of Galen. The posterior group of superior vermian and superior hemispheric veins arise on the posterior part of the tentorial surface and descend to empty into tentorial sinuses. The inferior hemispheric veins, which arise on the suboccipital surface, also empty into the tentorial sinuses.
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Both halves of the tentorium have been removed while preserving the large tentorial sinuses. The superior hemispheric veins from the posterior part of the tentorial surface and the inferior hemispheric veins from the suboccipital surface drain into the paired large tentorial sinus that join the torcula. The veins draining the anterior part of the tentorial surface empty into the tributaries of the vein of Galen.
Lateral view of the cerebellomesencephalic fissure
Lateral view of the cerebellomesencephalic fissure
The largest vein in the fissure is the vein of the cerebellomesencephalic fissure. The internal cerebral veins pass above the pineal to join the vein of Galen.
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The veins draining the walls of the cerebellomesencephalic fissure join the vein of Galen, as do the internal cerebral and basal veins.

Suboccipital surface

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The falx cerebelli, which fits into the posterior cerebellar incisura in which the vermis is partially buried, has been preserved. The inferior hemispheric veins drain the hemispheric portion of the suboccipital surface. A large left inferior hemispheric vein ascends toward a tentorial sinus. A large right inferior hemispheric vein descends medially to join an inferior vermian vein, which ascends to empty into the sinuses in the tentorium. The occipital sinus courses within the falx cerebelli and joins the torcula above and the sigmoid sinus below.
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The falx cerebelli has been removed to expose the inferior vermian veins, which ascend and pass below the transverse sinus to empty into the tentorial sinuses.
The retrotonsillar veins and other veins around the superior pole of the tonsils ascend to join the inferior vermian veins.
Another cerebellum
Another cerebellum
The branches of the PICA supplying the left hemisphere have been removed, but those on the right have been preserved. The inferior vermian and hemispheric veins on both halves of the suboccipital surface ascend and pass below the transverse sinus to empty into the sinuses in the tentorium.
Another cerebellum
Another cerebellum
Enlarged view of the inferior vermian veins that ascend to empty into sinuses in the tentorium.
Another cerebellum
Another cerebellum
A large right inferior hemispheric vein joins an inferior vermian vein that crosses the upper edge of the suboccipital surface and courses for a short distance on the tentorial surface before emptying into a tentorial sinus.
Enlarged view of another cerebellum
Enlarged view of another cerebellum
The large right inferior vermian vein passes forward to join the sinuses in the tentorium. A superior hemispheric vein from the tentorial surface descends to join a tentorial sinus. In the midline, a superior and inferior vermian join to empty into a tentorial sinus
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The veins from the region of the tonsil empty into the inferior vermian veins that ascend toward the sinuses in the tentorium.
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Gentle retraction of the cerebellar tonsils exposes the veins of the cerebellomedullary fissure crossing the inferior medullary velum.
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The cerebellar tonsils have been removed. The tela on the left side has been removed. The veins of the cerebellomesencephalic fissure cross the inferior medullary velum to join the veins in the cerebellopontine angles, which empty into the superior petrosal veins. The medial end of the veins of the cerebellomedullary fissure anastomose with the veins around the tonsil.
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A portion of the left half of the cerebellum has been removed. The inferior hemispheric veins from the suboccipital surface ascend and cross the junction of the suboccipital and tentorial surfaces to course on the posterior part of the tentorial surface, where they often form common stems with the superior hemispheric veins from the posterior part of the tentorial surface before emptying into the tentorial sinuses.
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The retrotonsillar veins pass upward in the fissure between the tonsil and biventral lobule and empty into the inferior vermian veins.
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The tonsils have been removed to expose the veins of the cerebellomedullary fissure, which pass laterally on the inferior medullary velum and across the lateral recesses to join the veins in the cerebellopontine angles. The medial end of the veins of the cerebellomedullary fissure anastomose with the veins around the tonsil.
Another specimen
Another specimen
The tonsils and part of the biventral lobules have been removed to expose the paired veins of the cerebellomedullary fissure, which cross the inferior medullary velum to empty into the veins in the cerebellopontine angles.
notion image
The cerebellar hemispheres, except for the right tonsil, have been removed. The right retrotonsillar vein courses along the posterior surface of the tonsil and empties into an inferior vermian vein. The left vein of the cerebellomedullary fissure passes through the lateral recess to join the vein of the middle cerebellar peduncle, which ascends to empty into a superior petrosal vein. The paired veins of the superior cerebellar peduncle ascend on the peduncle and join to form the vein of the cerebellomesencephalic fissure. An interpeduncular vein courses between the superior and middle cerebellar peduncles.

Brainstem and petrosal surface

notion image
The vertebral and basilar arteries and their branches course superficial to the veins. The veins on the anterior surface of the pons and medulla and the petrosal surface drain predominantly into the superior petrosal veins, which empty into the superior petrosal sinuses.
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The arteries have been removed. The median anterior pontomesencephalic and median anterior medullary veins ascend on the front of the brainstem. The transverse pontine and transverse medullary veins run transversely across the pons and medulla surfaces. The anterior hemispheric veins drain the petrosal surface and commonly empty into the vein of the cerebellopontine fissure, which ascends to join the superior petrosal veins. The vein of the pontomedullary sulcus passes across the pontomedullary junction.
Enlarged view of the right petrosal surface
Enlarged view of the right petrosal surface
The anterior hemispheric veins drain the petrosal surface and pass forward to empty into the vein of the cerebellopontine fissure or a superior petrosal vein. The vein of the cerebellopontine fissure arises at the lateral apex of the cerebellopontine fissure and crosses the middle cerebellar peduncle, where it is joined by a large transverse pontine vein.
Enlarged view of the left petrosal surface
Enlarged view of the left petrosal surface
The vein of the cerebellopontine fissure arises from the union of the anterior hemispheric veins at the apex of the cerebellopontine fissure and ascends to be joined by a superior hemispheric vein from the lateral part of the tentorial surface before emptying into the superior petrosal sinus.
 
Pon. Trig: . up. pet. Pon. V. V. Mid. cer.ped. v. cei. .æ.' V. cur. . Cer.
The cerebellum has been removed to expose the veins of the superior, inferior, and middle cerebellar peduncles. The vein of the superior cerebellar peduncle ascends to join the vein of the cerebellomesencephalic fissure. The vein of the inferior cerebellar peduncle crosses the peduncle at the inferolateral margin of the fourth ventricle and passes around the lateral recess to join the veins in the cerebellopontine angle. The veins of the cerebellopontine fissure and middle cerebellar peduncle and a transverse pontine vein join to form a superior petrosal vein. The vein of the cerebellomedullary fissure empties into the vein of the middle cerebellar peduncle.
 
X 'XI NO •paw •A— IIIA N RNO •dns
Posterior view of the right cerebellopontine angle
The vein of the cerebellomedullary fissure passes laterally across the lateral recess and empties into the vein of the middle cerebellar peduncle. The latter vein and the vein of the cerebellopontine fissure join to form a large superior petrosal vein. A large anterior hemispheric vein ascends along the petrosal surface.
 

Upper brainstem veins

Trans. P ed Fiss.
The veins on the anterior surface of the pons and medulla and the veins of the cerebellopontine fissure and their tributaries empty into the superior petrosal veins.
The median anterior medullary vein and median anterior pontomesencephalic veins course in the midline, but often do not extend along the full length of the pons and medulla.
The vein of the pontomesencephalic sulcus and the transverse pontine veins are transversely oriented.
The veins of the cerebellomedullary fissure join the veins of the middle cerebellar peduncle, which ascends to join the veins of the cerebellopontine fissure.
rural s Cis V alem
The veins in the crural and ambient cistern join the basal vein, which empties into the vein of Galen in the quadrigeminal cistern. The basal vein also drains the walls of the temporal horn, which has been opened on the right. An internal occipital vein passes from the calcarine sulcus and occipital lobe to the vein of Galen.
InfÅ}e Crural is Basal V mbi is , Cist
Enlarged view of the basal cisterns
The inferior ventricular vein from the temporal horn and the lateral atrial vein join the basal vein, which also drains the walls of the crural and ambient cisterns. The cerebellomesencephalic fissure, an inferior extension of the quadrigeminal cistern, is drained by tributaries of the vein of Galen.
V. Cer. Mes. cer. Mes. Fi ,•Hem. V, . Cer.+on. Fiss. Trans. on. V.
Lateral view of the cerebellomesencephalic fissure
The veins in the medial portion of the cerebellomesencephalic fissure empty into the vein of Galen and those from the lateral part may join the superior petrosal veins. In this case, the vein of the cerebellomesencephalic fissure is small, resulting in most of the fissure’s drainage being directed laterally through a pontotrigeminal vein, which passes above the trigeminal nerve to empty into a superior petrosal vein formed by a superior hemispheric and transverse pontine vein and the vein of the cerebellopontine fissure.

Abbreviation

Abbreviation
Full Form
Abbreviation
Full Form
Abbreviation
Full Form
A.
Artery
Int.
Internal
Quad.
Quadrigeminal
A.I.C.A.
Anteroinferior cerebellar artery
Interped.
Interpeduncular
Retrot.
Retrotonsillar
Ant.
Anterior
Jug.
Jugular
Sag.
Sagittal
Atr.
Atrial
Lat.
Lateral
S.C.A.
Superior cerebellar artery
Bas.
Basilar
Lig.
Ligament
Seg.
Segment
Bivent.
Biventral
Marg.
Marginal
Sig.
Sigmoid
Br.
Bridging
Med.
Medial, medullary
Str.
Straight
Carotid
Carotid
Mes.
Mesencephalic
Sulc.
Sulcus
Cav.
Cavernous
Mid.
Middle
Sup.
Superior
Cer.
Cerebellar, cerebellum
N.
Nerve
Supracol.
Supracolliculate
Cer. Med
Cerebellomedullary
Occip.
Occipital
Supraton.
Supratonsillar
Cer. Mes.
Cerebellomesencephalic
Olf.
Olfactory
Temp.
Temporal
Cer. Pon.
Cerebellopontine
P.C.A.
Posterior cerebral artery
Tent.
Tentorial
Ch.
Choroidal
Ped.
Peduncle
Ton.
Tonsillar
Cist.
Cistern
Pet.
Petrosal
Trans.
Transverse
CN
Cranial nerve
P.I.C.A.
Posteroinferior cerebellar artery
Trig.
Trigeminal
Comm.
Communicating
Pon.
Pontine, ponto
V.
Vein
Condylar
Condylar
Pon. Med.
Pontomedullary
Ve.
Vermian
Em.
Emissary
Pon. Mes.
Pontomesencephalic
Vel.
Velum
Fiss.
Fissure
Pon. Trig.
Pontotrigeminal
Vent.
Ventricle
Hem.
Hemispheric
Post.
Posterior
Vert.
Vertebral
Inf.
Inferior