Intracranial Venous Sinuses

Basilar Plexus. The basilar plexus consists of interlacing venous channels over the basilar occipital bone; it connects the inferior petrosal sinuses while also draining the anterior vertebral venous plexus.

CEREBRAL VENOUS SYSTEM

The cerebral veins are best considered as being related to either superficial or deep brain structures.

Superficial Group

These veins drain the cerebral cortex and subcortical white matter to drain into the superior sagittal, straight, transverse, and cavernous sinuses. These include the following: (1) the great anastomotic vein of Trolard, connecting the middle cerebral veins to the superior sagittal sinus; (2) the vein of Labbé, connecting the middle cerebral veins with the transverse sinuses; (3) the middle cerebral veins, receiving communicating branches from the veins of Trolard and Labbé and draining into cavernous sinuses.

Veins of the posterior fossa, draining the cerebellum and brainstem, are divided into (1) the superior (Galenic) vein, including precentral, superior cerebellar, superior vermian, posterior mesencephalic, lateral mesencephalic, quadrigeminal, and anterior pontomesencephalic veins that drain the superior portion of the cerebellum and upper brainstem into the vein of Galen; (2) the anterior (petrosal) vein, including petrosal, anterior medullary, cerebellar hemispheric, and lateral medullary veins, each draining into the petrosal sinuses; and (3) the posterior (tentorial) vein, including the inferior vermian and some cerebellar bihemispheric veins, these draining into the confluence of the sinuses and neighboring transverse sinuses.

Deep Group

These veins drain the deep central white matter and basal ganglia to empty into the subependymal veins of the lateral ventricles. The major subependymal veins include (1) septal veins draining frontal horns of the lateral ventricles near the septum pellucidum, the corpus callosum, and deep frontal white matter; uniting with (2) the thalamostriate veins formed by the anterior caudate and terminal veins. These run in the floor of the lateral ventricle and drain into (3) the internal cerebral veins; each receiving blood from the thalamostriate, choroidal, septal, epithalamic, and lateral ventricular veins and situated within the roof of the third ventricle. Both internal cerebral veins unite beneath the splenium of the corpus callosum to merge with (4) the basal veins of Rosenthal arising within the sylvian fissure. These receive blood from the anterior cerebral, deep middle cerebral, and inferior striate veins and then course around the cerebral peduncles and midbrain tectum to form the great cerebral vein of Galen. This curves around the splenium in the quadrigeminal cistern, terminating near the tentorial apex, where it joins the inferior sagittal sinus to form the straight sinus.

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