Supratentorial veins

The superficial system

Made up of numerous and variable superficial cortical veins, which typically accompany arteries travelling within the cerebral sulci.

Drain into a number of larger named veins, which subsequently drain into the venous sinuses:

Superficial middle cerebral vein

drains into the cavernous (or sphenoparietal) sinus

Great anastomotic vein (of Trolard)

Drains the superficial middle cerebral vein into the superior sagittal sinus

Is the largest superficial vein on the lateral surface of the parietal or frontal lobe

Connects the superior sagittal sinus and the superficial middle cerebral vein (of Sylvius).

Usually runs in the post-central sulcus draining the adjacent cortex.

Posterior anastomotic vein (of Labbé)

drains superficial middle cerebral vein into the transverse sinus.
There is often a reciprocal arrangement between the two anastomotic veins with Labbé larger in the dominant hemisphere and Trolard in the non- dominant.
Clinical

Slight difficulty with naming and had agraphia and acalculia
Thrombosis can cause temporal lobe hemorrhagic infarction, hemorrhage, or edema.

Dural venous sinus

Dural sinuses are valveless, venous channels formed from dural folds.

The principal dural sinuses are the

Superior sagittal

Start

Crista galli

Ends

Torcular Herophili
It can also divide prior to the torcula, where it usually meets the transverse sinuses, leading clinically to misdiagnosis of superior sagittal sinus thrombosis.

Inferior sagittal sinus

lies in the free margin of the falx cerebri
drains tributaries from the corpus callosum and cingulate gyrus,
itself drains into the straight sinus at the venous confluence.
It is typically not visible radiologically

Transverse sinus

Are commonly asymmetric
Usually with a dominant right side which receives the majority of the blood from the superior sagittal sinus at the torcula.
Become the sigmoid sinuses at the posterior petrous edge, which then continue to the jugular bulb.

Sigmoid sinus

Can vary in size compared to the transverse sinus, particularly when receiving large flow from the posterior anastomotic vein (of Labbé) into its proximal part.

Straight sinus
Superior and inferior petrosal sinus
Cavernous sinus

Receives flow from the

Superficial middle cerebral (Sylvian) veins,
Ophthalmic veins
Sphenoparietal sinus (itself sometimes draining the Sylvian veins).

Outflow from the cavernous sinus is through the

Superior petrosal sinuses

connecting to sigmoid sinus

Inferior petrosal sinuses

Connecting to jugular foramen

Contralateral cavernous sinus
Pterygoid and clival venous plexuses.

Sphenoparietal sinus
Occipital sinus

Varyingly present
More common in children,

may run from the torcula in the midline to the foramen magnum and can be the source of significant bleeding in an otherwise straightforward midline posterior fossa approach.

The dural venous sinuses also communicate with the extracranial venous system through valveless emissary veins, which can serve as a route for the introduction of intracranial infection

The deep system

The deep venous system drains the deep white and grey matter surrounding the lateral and third ventricle and basal cisterns.

The great cerebral vein (of Galen)

found below the splenium of the corpus callosum

a short, single midline vessel.

formed by

joining of the two internal cerebral veins,
two basal veins (of Rosenthal)
occipital veins draining the medial and inferior occipital lobes.

Drains into the venous confluence where it is joined by the inferior sagittal sinus to form the straight sinus.

The basal veins (of Rosenthal)

Originates on the surface of the anterior perforated substance

arise at the anterior perforated substance on the medial aspect of the temporal lobe

run posteriorly and medially.

They travel laterally around the midbrain through the ambient cistern

Drain the hypothalamus, midbrain, and medial and inferior portions of the frontal and temporal lobes, including the insula and operculum.

The internal cerebral veins,

situated in the velum interpositum (roof of the third ventricle),
formed by the union of the choroidal and thalamostriate veins.

The choroidal vein

drains the choroid plexus of the lateral ventricle.

Tributaries draining into the thalamostriate vein include the

transverse caudate veins,
anterior terminal vein (draining the ventricular surface of the caudate nucleus)
septal vein (draining the corpus callosum and deep frontal white matter).

The posterior cerebral artery and its branches have been removed to display the vascular and neural structures underneath.

1, pons;
2, pontomesencephalic sulcus and vein;
3, lateral mesencephalic vein;
4, tegmentum of the mesencephalon;
5, crus cerebri;
6, anterior choroidal artery (cisternal segment);
7, anterior peduncular segment of the basal vein;
8, posterior peduncular segment of the basal vein;
9, posterior mesencephalic segment of the basal vein;
10, inferior ventricular vein and plexal segment of the anterior choroidal artery;
11, pulvinar of the thalamus;
12, tail of the hippocampus;
*, vein of Galen.

Images

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	ㅤ	ㅤ	ㅤ	ㅤ