Neurosurgery notes/Anatomy/Cortex/Temporal lobe/Veins temporal lobe

Veins temporal lobe

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Temporal lobe

The deep venous system of the brain is divided into

  • Ventricular group
    • The ventricular group is represented by the veins located in the temporal horn that ultimately drain into the second or peduncular segment of the basal vein of Rosenthal, usually via the inferior ventricular vein.
      • Inferior ventricular vein.
        • The inferior ventricular vein arises in the posterolateral part of the roof of the temporal horn and runs anteromedially to exit the temporal horn just behind the inferior choroidal point to join the basal vein at the most lateral point of the course of the basal vein around the crus cerebri near the lateral geniculate body
      • Amygdalar vein
        • Runs medially across the anterior wall on or near the ventricular surface of the amygdala and ends in the inferior ventricular, basal, or anterior longitudinal hippocampal veins near the inferior choroidal point, either before or after it has passed through the choroidal fissure to enter the crural cistern.
      • Transverse hippocampal veins
        • A group of very fine veins that run medially across the hippocampus and the collateral eminence.
        • Divided into
          • Anterior group, which crosses the floor of the temporal horn,
          • Posterior group, which crosses the floor of the atrium.
        • They penetrate the attachment of the fimbria to the hippocampus to enter the ambient cistern through the fimbriodentate sulcus to drain into the anterior and posterior hippocampal veins.
      • Inferior choroidal vein,
        • The inferior choroidal vein runs anteriorly in the temporal horn along the inferior end of the choroid plexus and ends by joining the inferior ventricular and amygdalar vein or by passing through the choroidal fissure near the inferior choroidal point to reach the basal vein or its tributaries.
  • Cisternal group
    • Drains
      • The walls of the basal cisterns.
    • Composed of
      • Basal vein of Rosenthal
        • Main venous channel that drains the mesial temporal region.
        • Originates below the anterior perforated substance by the union of the deep middle cerebral, inferior striate, olfactory, fronto-orbital, and anterior cerebral veins, and it usually drains into the vein of Galen after passing around the midbrain
        • Divided into 3 segments:
          • Anterior or striate segment
            • Course
              • Originates
                • Junction of the anterior cerebral, inferior striate, olfactory, fronto-orbital, and deep middle cerebral veins under the anterior perforated substance
              • Runs posteriorly under the optic tract, medially and inferiorly to the anterior portion of the crus cerebri.
                • This point corresponds to the most medial part in the course of the basal vein (before its termination into the vein of Galen), and it usually also corresponds to the most inferior part in its course.
                • This point also denotes laterally the location of the apex of the uncus.
            • Main tributaries of the first or striate segment of the basal vein are:
              • Fronto-orbital
              • Olfactory
              • Inferior striate
              • Anterior cerebral
              • Deep middle cerebral
              • Anterior pericallosal veins
          • Middle or peduncular segment,
            • Course
              • starts from this most medial point in the course of the basal vein, which usually corresponds to the site where the peduncular vein joins the basal vein.
              • Runs laterally between the upper part of the posteromedial surface of the uncus and the upper part of the crus cerebri, under the optic tract, to reach the most lateral part of the crus cerebri, which corresponds to the most lateral point of the vein as it turns around the crus cerebri, and it is usually where the inferior ventricular vein joins the basal vein.
                • This is called the anterior peduncular segment by Huang and Wolf;
              • it then turns medially, superiorly, and posteriorly to the plane of the lateral mesencephalic sulcus, behind the crus cerebri, to constitute the posterior peduncular segment.
            • Main tributaries
              • Peduncular or interpeduncular vein,
              • Inferior ventricular,
              • Inferior choroidal,
              • Hippocampal,
              • Anterior hippocampal veins.
          • Posterior or posterior mesencephalic segment,
            • Course
              • runs medially, superiorly, and posteriorly from the lateral mesencephalic sulcus, under the pulvinar of the thalamus, to penetrate the quadrigeminal cistern and generally to drain into the vein of Galen.
            • Main tributaries
              • Lateral mesencephalic vein,
              • Posterior thalamic,
              • Posterior longitudinal hippocampal,
              • Medial temporal veins,
                • In the mesial temporal region, both ventricular and cisternal groups drain into the basal vein of the Rosenthal.
              • Medial occipital veins (Figs. 60 and 61).
              • Occasional
                • Precentral cerebellar,
                • Superior vermian,
                • Internal occipital,
                • Splenial,
                • Medial atrial,
                • Direct lateral and lateral atrial subependymal veins

Angiographic anteroposterior view

notion image
notion image
The overall shape of both basal veins resembles the legs of a frog lying on back with its toes directed anterolaterally:
  1. Foot:
    1. Correspond to: Striate segment of basal vein
    2. Relation
      1. Superiorly to the anterior perforated substance
      2. Laterally to the anterior segment of the uncus,
      3. Medially to the optic tract
      4. Inferiorly to the contents of the carotid cistern
  1. Ankle:
    1. Corresponds to
      1. Transition of Striate segment of basal vein to anterior peduncular segment
    2. Relation
      1. Posteriorly to the anterior aspect of the crus cerebri,
      2. Laterally to the vertex of the uncus
      3. Superiorly to the optic tract
  1. Leg
    1. Corresponds to
      1. Anterior peduncular segment
    2. Relation
      1. Superiorly to the optic tract
      2. Laterally to the upper portion of the posteromedial surface of the uncus,
      3. Medially to the upper portion of the crus cerebri
  1. Knee
    1. Corresponds to
      1. Transition between anterior and posterior peduncular segment
      2. the most lateral aspect of the crus cerebri and to the posterior edge of the posterior segment of the uncus, and to the site where the inferior ventricular vein joins the basal vein
    2. Relation
      1. Laterally to the inferior choroidal point,
      2. Superiorly to the optic tract just before this reaches the lateral geniculate body
      3. Inferiorly to the contents of the ambient cistern.
        1. The uncus therefore is located ahead of the knee of the basal vein on the angiographic anteroposterior view.
  1. Thigh
    1. Correspond to:
      1. Posterior peduncular segments and
      2. Posterior mesencephalic segments,
    2. Relations
      1. Medially to the tegmentum of the midbrain,
      2. Laterally to the parahippocampal gyrus,
      3. Superiorly to the medial aspect of the pulvinar of the thalamus, which is the roof of the wing of the ambient cistern
      4. Inferiorly to the contents of the wing of the ambient cistern

Images

notion image
1, Olfactory vein;
2, Fronto-orbital vein;
3, Deep middle cerebral vein;
4, Inferior striate vein;
5, Anterior cerebral vein;
6, optic tract;
7, striate segment of basal vein;
8, apex of the uncus;
9, peduncular vein;
10, anterior peduncular segment of basal vein;
11, inferior surface of the posterior segment of the uncus;
12, oculomotor nerve;
13, inferior ventricular vein;
14, dentate gyrus and fimbria;
15, lateral mesencephalic vein;
16, lateral geniculate body;
17, pulvinar of the thalamus;
18, posterior mesencephalic segment of basal vein;
19, Tectal area of the midbrain;
20, posterior longitudinal hippocampal vein;
21, vein of Galen;
22, internal occipital vein;
*, lateral mesencephalic sulcus.
notion image
1, Deep middle cerebral veins and limen insuale
2, olfactory veins
3, anterior pericallosal veins
4, fronto-orbital vein
5, Semilunar gyrus
6, Striate segment of basal vein
7, CN3
8, optic chiasm
9, uncus apex
10, peduncular vein in peduncular cistern
11, peduncular segment of basal vein
12, uncal vein
13, inferior ventricular vein
14, cerebral crux
*, anterior cerebral vein
notion image
1, anterior border of uncus
2, apex uncus
3, inferior surface of the posterior segment of the uncus;
4, Anterior peduncular segment of basal vein
5, cerebral crux
6, anterior longitudinal hippocampal vein
7, posterior peduncular segment of the basal vein
8, lateral mesencephalic vein and lateral mesencephalic sulcus
9, medial geniculate body and posterior mesencephalic segment of basal vein
10, pulvinar of thalamus
11, internal occipital vein
12, internal cerebral vein
13, basal vein of rosenthal
14, great vein of galen
*, posterior longitudinal hippocampal vein.