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Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography

  • Diagnostic Neuroradiology
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Abstract

Purpose

Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus.

Methods

Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively.

Results

Eighteen emissary veins were identified in 14 (28.0%) cases. A half of the emissary veins connected the inferior petrosal sinus with the inferior petro-occipital vein (IPOV) in the middle clivus. The clival diploic vein (CDV) was identified in 14.0% of cases, 42.9% of which had the clivus of the presellar type. The CDV was connected to the posterior intercavernous sinus or the rostral end of the basilar plexus superiorly, and was connected to the IPOV, anterior condylar vein, marginal sinus, or the anterior condylar confluence.

Conclusion

The CDV provides collateral channels between the cavernous sinus and the internal jugular vein and the inferior petrosal sinus and the IPOV. Understanding of the emissary veins in the clivus and the CDV is valuable for skull base surgery, especially for endonasal endoscopic skull base procedures.

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Acknowledgments

The authors thank Dr. Masaki Komiyama and Dr. Hiro Kiyosue for their advice on neurovascular anatomy and embryology.

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Authors and Affiliations

  1. Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku City, Tokyo, 160-0016, Japan

    Katsuhiro Mizutani, Masahiro Toda, Takenori Akiyama & Kazunari Yoshida

  2. Department of Radiology, Keio University School of Medicine, Tokyo, Japan

    Jun Kurasawa, Hirokazu Fujiwara & Masahiro Jinzaki

Authors
  1. Katsuhiro Mizutani
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  2. Masahiro Toda
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  3. Jun Kurasawa
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  4. Takenori Akiyama
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  5. Hirokazu Fujiwara
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  6. Masahiro Jinzaki
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  7. Kazunari Yoshida
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Corresponding author

Correspondence to Katsuhiro Mizutani.

Ethics declarations

We declare that all human and animal studies have been approved by the ethics committee of Keio University School of Medicine and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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We declare that we have no conflict of interest.

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Mizutani, K., Toda, M., Kurasawa, J. et al. Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography. Neuroradiology 59, 213–219 (2017). https://doi.org/10.1007/s00234-017-1784-4

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  • DOI: https://doi.org/10.1007/s00234-017-1784-4

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