Cerebral Venous System and Implications in Neurosurgery

  • Yongxin Zhang
  • Wanling Wen
  • Qinghai Huang
Part of the Springer Series in Translational Stroke Research book series (SSTSR)


The cerebral venous system is a vital component of cerebral circulation. However, the anatomy and physiological function has not been thoroughly understood. We reviewed the anatomic features and physiological function of certain cerebral venous structures based on experimental and surgical experiences, and trying to provide some notes for neurosurgeons on evaluating and managing cerebral venous structures during open cranial surgery and some clues for function study as well.


Cerebral veins Anatomy Physiology Neurosurgery 


  1. 1.
    Kaplan HA, Browder A, Browder J. Naasal venous drainage and the foramen caecum. Laryngoscope. 1973;83(3):327–9.CrossRefGoogle Scholar
  2. 2.
    Matsushima T, Rhoton AJ, de Oliveira E, et al. Microsurgical anatomy of the veins of the posterior fossa. J Neurosurg. 1983;59(1):63–105.CrossRefGoogle Scholar
  3. 3.
    Durgun B, Ilglt ET, Cizmeli MO, et al. Evaluation by angiography of the lateral dominance of the drainage of the dural venous sinuses. Surg Radiol Anat. 1993;15(2):125–30.CrossRefGoogle Scholar
  4. 4.
    Bono F, Lupo MR, Lavano A, et al. Cerebral MR venography of transverse sinuses in subjects with normal CSF pressure. Neurology. 2003;61(9):1267–70.CrossRefGoogle Scholar
  5. 5.
    Parkinson D. Surgical anatomy of the lateral sellar compartment (cavernous sinus). Clin Neurosurg. 1990;36:219–39.PubMedGoogle Scholar
  6. 6.
    Day JD, Kellogg JX, Tschabitscher M, et al. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery. 1996;38(6):1079–83; discussion 1083-1084.PubMedGoogle Scholar
  7. 7.
    Rhoton AJ. The cerebral veins. Neurosurgery. 2002;51(4 Suppl):S159–205.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Schaller B. Physiology of cerebral venous blood flow: from experimental data in animals to normal function in humans. Brain Res Brain Res Rev. 2004;46(3):243–60.CrossRefGoogle Scholar
  9. 9.
    Sampei T, Yasui N, Okudera T, et al. Anatomic study of anterior frontal cortical bridging veins with special reference to the frontopolar vein. Neurosurgery. 1996;38(5):971–5.CrossRefGoogle Scholar
  10. 10.
    Sakata K, Al-Mefty O, Yamamoto I. Venous consideration in petrosal approach: microsurgical anatomy of the temporal bridging vein. Neurosurgery. 2000;47(1):153–60; discussion 160-161.PubMedGoogle Scholar
  11. 11.
    Blumenthal I. Shaken baby syndrome. Postgrad Med J. 2002;78(926):732–5.CrossRefGoogle Scholar
  12. 12.
    Delye H, Goffin J, Verschueren P, et al. Biomechanical properties of the superior sagittal sinus-bridging vein complex. Stapp Car Crash J. 2006;50:625–36.PubMedGoogle Scholar
  13. 13.
    Ehrlich E, Maxeiner H, Lange J. Postmortem radiological investigation of bridging vein ruptures. Leg Med (Tokyo). 2003;5(Suppl 1):S225–7.CrossRefGoogle Scholar
  14. 14.
    Aryan HE, Ozgur BM, Jandial R, et al. Complications of interhemispheric transcallosal approach in children: review of 15 years experience. Clin Neurol Neurosurg. 2006;108(8):790–3.CrossRefGoogle Scholar
  15. 15.
    Chaynes P. Microsurgical anatomy of the great cerebral vein of Galen and its tributaries. J Neurosurg. 2003;99(6):1028–38.CrossRefGoogle Scholar
  16. 16.
    Browder J, Kaplan HA, Krieger AJ. Anatomical features of the straight sinus and its tributaries. J Neurosurg. 1976;44(1):55–61.CrossRefGoogle Scholar
  17. 17.
    Carmel PW. Tumours of the third ventricle. Acta Neurochir. 1985;75(1-4):136–46.CrossRefGoogle Scholar
  18. 18.
    Elhammady MS, Heros RC. Cerebral veins: to sacrifice or not to sacrifice, that is the question. World Neurosurg. 2015;83(3):320–4.CrossRefGoogle Scholar
  19. 19.
    Nakase H, Shin Y, Nakagawa I, et al. Clinical features of postoperative cerebral venous infarction. Acta Neurochir. 2005;147(6):621–6; discussion 626.CrossRefGoogle Scholar
  20. 20.
    Mclaughlin MR, Jannetta PJ, Clyde BL, et al. Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg. 1999;90(1):1–8.CrossRefGoogle Scholar
  21. 21.
    Barker FN, Jannetta PJ, Bissonette DJ, et al. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334(17):1077–83.CrossRefGoogle Scholar
  22. 22.
    Distelmaier P. [Complications of the operative neurosurgical treatment of trigeminal neuralgia]. Zentralbl Neurochir. 1976;37(2):119–25.Google Scholar
  23. 23.
    Ryu H, Yamamoto S, Sugiyama K, et al. Neurovascular decompression for trigeminal neuralgia in elderly patients. Neurol Med Chir (Tokyo). 1999;39(3):226–9. discussion 229–30.CrossRefGoogle Scholar
  24. 24.
    Singh D, Jagetia A, Sinha S. Brain stem infarction: a complication of microvascular decompression for trigeminal neuralgia. Neurol India. 2006;54(3):325–6.CrossRefGoogle Scholar
  25. 25.
    Koerbel A, Gharabaghi A, Safavi-Abbasi S, et al. Venous complications following petrosal vein sectioning in surgery of petrous apex meningiomas. Eur J Surg Oncol. 2009;35(7):773–9.CrossRefGoogle Scholar
  26. 26.
    Matsushima K, Matsushima T, Kuga Y, et al. Classification of the superior petrosal veins and sinus based on drainage pattern. Neurosurgery. 2014;10(Suppl 2):357–367, 367.CrossRefGoogle Scholar
  27. 27.
    Oakes WJ. Venous infarction. J Neurosurg Pediatr. 2011;7(3):223; discussion 223.CrossRefGoogle Scholar
  28. 28.
    Mccomb JG. What is the risk of venous infarction to intra-operative sacrifice of either the superficial or deep cerebral bridging veins? Childs Nerv Syst. 2014;30(5):811–3.CrossRefGoogle Scholar
  29. 29.
    Mcnatt SA, Sosa IJ, Krieger MD, et al. Incidence of venous infarction after sacrificing middle-third superior sagittal sinus cortical bridging veins in a pediatric population. J Neurosurg Pediatr. 2011;7(3):224–8.CrossRefGoogle Scholar
  30. 30.
    Davidson L, Krieger MD, Mccomb JG. Posterior interhemispheric retrocallosal approach to pineal region and posterior fossa lesions in a pediatric population. J Neurosurg Pediatr. 2011;7(5):527–33.CrossRefGoogle Scholar
  31. 31.
    Davidson L, Mccomb JG. The safety of the intraoperative sacrifice of the deep cerebral veins. Childs Nerv Syst. 2013;29(2):199–207.CrossRefGoogle Scholar
  32. 32.
    Sindou M, Hallacq P. Venous reconstruction in surgery of meningiomas invading the sagittal and transverse sinuses. Skull Base Surg. 1998;8(2):57–64.CrossRefGoogle Scholar
  33. 33.
    Sindou M. Meningiomas invading the sagittal or transverse sinuses, resection with venous reconstruction. J Clin Neurosci. 2001;8(Suppl 1):8–11.CrossRefGoogle Scholar
  34. 34.
    Sindou M, Auque J. The intracranial venous system as a neurosurgeon’s perspective. Adv Tech Stand Neurosurg. 2000;26:131–216.CrossRefGoogle Scholar
  35. 35.
    Kanno T, Kasama A, Shoda M, et al. A pitfall in the interhemispheric translamina terminalis approach for the removal of a craniopharyngioma. Significance of preserving draining veins. Part I. Clinical study. Surg Neurol. 1989;32(2):111–5.CrossRefGoogle Scholar
  36. 36.
    Kasama A, Kanno T. A pitfall in the interhemispheric translamina terminalis approach for the removal of a craniopharyngioma. Significance of preserving draining veins. Part II. Experimental study. Surg Neurol. 1989;32(2):116–20.CrossRefGoogle Scholar
  37. 37.
    Takao T, Kouguchi M, Nakahara Y, et al. [Three-dimensional images of petrosal veins for preoperative evaluation: four case reports]. No Shinkei Geka. 2011;39(12):1175–81.Google Scholar
  38. 38.
    Kaku S, Miyahara K, Fujitsu K, et al. Drainage pathway of the superior petrosal vein evaluated by CT venography in petroclival meningioma surgery. J Neurol Surg B Skull Base. 2012;73(5):316–20.CrossRefGoogle Scholar
  39. 39.
    Koerbel A, Wolf SA, Kiss A. Peduncular hallucinosis after sacrifice of veins of the petrosal venous complex for trigeminal neuralgia. Acta Neurochir. 2007;149(8):831–2; discussion 832-833.CrossRefGoogle Scholar
  40. 40.
    Chen HJ, Lui CC. Peduncular hallucinosis following microvascular decompression for trigeminal neuralgia: report of a case. J Formos Med Assoc. 1995;94(8):503–5.PubMedGoogle Scholar
  41. 41.
    Tsukamoto H, Matsushima T, Fujiwara S, et al. Peduncular hallucinosis following microvascular decompression for trigeminal neuralgia: case report. Surg Neurol. 1993;40(1):31–4.CrossRefGoogle Scholar
  42. 42.
    Gharabaghi A, Koerbel A, Lowenheim H, et al. The impact of petrosal vein preservation on postoperative auditory function in surgery of petrous apex meningiomas. Neurosurgery. 2006;59(1 Suppl 1):S68–74; discussion S68-S74.Google Scholar
  43. 43.
    Xi J, Ding X, Peng Z, et al. [Protection of the superior petrosal vein in microneurosurgery for acoustic neuroma]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013;38(7):695–8.Google Scholar
  44. 44.
    Sugita K, Kobayashi S, Yokoo A. Preservation of large bridging veins during brain retraction. Technical note. J Neurosurg. 1982;57(6):856–8.CrossRefGoogle Scholar
  45. 45.
    Morita A, Sekhar LN. Reconstruction of the vein of Labbe by using a short saphenous vein bypass graft. Technical note. J Neurosurg. 1998;89(4):671–5.CrossRefGoogle Scholar
  46. 46.
    Sekhar LN, Tzortzidis FN, Bejjani GK, et al. Saphenous vein graft bypass of the sigmoid sinus and jugular bulb during the removal of glomus jugulare tumors. Report of two cases. J Neurosurg. 1997;86(6):1036–41.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Yongxin Zhang
    • 1
  • Wanling Wen
    • 2
  • Qinghai Huang
    • 1
  1. 1.Department of NeurosurgeryChanghai HospitalShanghaiChina
  2. 2.Department of NeurologyThe 306 Hospital of PLABeijingChina

Personalised recommendations