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Extracranial prevertebral venous network of the craniocervical junction: CT-digital subtraction venography analysis

  • Diagnostic Neuroradiology
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Abstract

Purpose

Although the craniocervical junction has a complex anatomical structure associated with clinical diseases, its ventral venous network has not been well studied. This study aimed to clarify the extracranial ventral venous structure at the craniocervical junction.

Methods

Head computed tomography digital subtraction venography (CT-DSV) images of 273 patients (age 6 months to 93 years) taken at our department were retrospectively analyzed. We analyzed the frequency and anatomical features of the venous channels, as well as their upstream and downstream connections with the surrounding channels at the ventral craniocervical junction, from the level of the hypoglossal canal to the second cervical vertebra.

Results

In 54% of the cases, the vein descended from the anterior condylar confluence, running medially along the basioccipital and fusing with its counterpart in the midline at the level of the atlanto-occipital membrane. Furthermore, 24% of this vein was connected caudally to the anterior external vertebral venous plexus. We also identified venous channels, either as a sole vein or venous plexus, on the tip of the odontoid process (10%), which has not been well described previously. The vein around the odontoid process was connected to several veins, including the aforementioned vein anterior to the condyle and the anterior internal vertebral venous plexus.

Conclusions

CT-DSV analysis revealed a detailed venous architecture ventral to the craniocervical junction. Venous structures identified in this study may be involved in diseases in this area.

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Abbreviations

ACC:

Anterior condylar confluence

AEVVP:

Anterior external vertebral venous plexus

AIVVP:

Anterior internal vertebral venous plexus

CT-DSV:

Computed tomography digital subtraction venography

CCJ:

Craniocervical junction

DAVF:

Dural arteriovenous fistula

Pre-VVP:

Prevertebral venous plexus

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hiroki Yamada, Katsuhiro Mizutani, Takenori Akiyama & Masahiro Toda

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  1. Hiroki Yamada
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  2. Katsuhiro Mizutani
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  3. Takenori Akiyama
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  4. Masahiro Toda
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Corresponding author

Correspondence to Katsuhiro Mizutani.

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Ethics approval

This study was approved by the ethics committee of Keio University School of Medicine.

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This study waived the need for informed consent (given the study design) under the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

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This study waived the need for informed consent (given the study design) under the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

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The authors declare no competing interests.

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Presentation in meeting: The contents of this study were presented at the 37th Annual Meeting of the Japanese Society of Neuroendovascular Therapy.

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Yamada, H., Mizutani, K., Akiyama, T. et al. Extracranial prevertebral venous network of the craniocervical junction: CT-digital subtraction venography analysis. Neuroradiology 64, 2227–2233 (2022). https://doi.org/10.1007/s00234-022-02980-3

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  • DOI: https://doi.org/10.1007/s00234-022-02980-3

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