4.4 Review

Cerebral venous anatomy: implications for the neurointerventionalist

Journal

JOURNAL OF NEUROINTERVENTIONAL SURGERY
Volume 15, Issue 5, Pages 452-+

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/neurintsurg-2022-018917

Keywords

Angiography; Brain; Fistula; Vein; Intracranial Pressure

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Meaningful contributions to neurointerventional practice can be made by considering the dynamic aspects of angiography in addition to fixed morphologic information. This review emphasizes the importance of balance between alternative venous networks and their redundancy, as well as the problems that may arise when these systems are lacking. The role of veins in major neurovascular diseases is highlighted, with deficiencies in knowledge emphasized.
Meaningful contributions to neurointerventional practice may be possible by considering the dynamic aspects of angiography in addition to fixed morphologic information. The functional approach to venous anatomy requires integration of the traditional static anatomic features of the system-deep, superficial, posterior fossa, medullary veins, venous sinuses, and outflow routes into an overall appreciation of how a classic model of drainage is altered, embryologically, or pathologically, depending on patterns of flow-visualization made possible by angiography. In this review, emphasis is placed on balance between alternative venous networks and their redundancy, and the problems which arise when these systems are lacking. The role of veins in major neurovascular diseases, such as dural arteriovenous fistulae, arteriovenous malformations, pulsatile tinnitus, and intracranial hypertension, is highlighted, and deficiencies in knowledge emphasized.

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