Wackenheim. Braun The Veins of the Posterior Fossa

Transcription

1 Wackenheim. Braun The Veins of the Posterior Fossa

2 A.Wackenheim J. P. Braun The Veins of the Posterior Fossa Normal and Pathologic Findings With a Foreword by 1. Bull With 1 Figures Springer-Verlag Berlin Heidelberg New York 1978

3 Auguste Wackenheim Professeur agrege Head of the Department of Neuroradiology, University Hospital F Strasbourg Jean Paul Braun Docteur de medecine Head of the Department of Neuroradiology, Pasteur Hospital F Colmar The cover picture is an x-ray of meningioma of right cerebellopontine angle which is shown in more detail in Figure 2 on page 7. lsbn-: e-lsbn-: DOl: / Library of Congress Cataloging in Publication Data. Wackenheim Auguste. The veins of the posterior fossa. Bibliography: p. Includes index. I. Brain - Blood-vessels - Abnormalities. 2. Cranial fossa, Posterior-Blood-vessels. 3. Veins. 1. Braun, Jean Paul, joint author. II. Title. [DNLM: 1. Skull Bloody supply. 2. Cerebral angiography. WL141 W115v]. RC388.5.w32 6.8' This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machine or similar means, and storage in data banks. Under 54 of the German Copyright Law where copies are made for other than private use, a fee is payable to the publisher, the amount of the fee to be determined by agreement with the publisher. by Springer-Verlag Berlin Heidelberg 1978 Softcover reprint of the hardcover 1 st edition 1978 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

4 Foreword It is a privilege and pleasure to write a foreword to this work. Who, twenty years ago, would have thought that a whole book could be devoted to the veins of the posterior fossa? Even today the standard text-books of anatomy only give a paragraph to the subject. Thanks to the dedicated work of rather a few neuroradiologists our knowledge has now reached a very sophisticated level. The careful correlation of anatomical dissection with the angiographic image has achieved this, but without the aid of subtraction (discovered by a world figure in neuroradiology - Professor ZIEDSES DES PLANTES) the subject would not be as advanced as it is. The authors are to be congratulated not only for presenting the most up to date anatomical information but also for showing how wide the applications are in the clinical field by the careful analysis of displacements of veins, many of which were quite unrecognised only a very few years ago. Drs W ACKENHEIM and BRAUN are in the forefront of this discipline to which they and the French school have contributed so much. Also it was their great enthusiasm and drive which led to the birth of the European Society of Neuroradiology, the first meeting of which was held in Colmar in September The Society has flourished under their guidance and very successful annual meetings have been held for nearly a decade. The schools of neuroradiology at Strasbourg and Colmar have attracted dedicated assistants who have contributed in no small way to the teaching and research which is so active. It is pleasant to see that the authors pay tribute to these men and women who have assisted in the production of this book. All those involved in the neurological sciences will benefit by carefully studying the text and excellent illustrations. January 1978 JAMES BULL v

5 Acknowledgments This book is the fruit of a regular collaboration between the medical staffs of the Neuroradiology Departments in Strasbourg and Colmar. This collaboration was made possible by the understanding and support of the authors' families, especially their wives, who bore their necessary absences in loving stride. We owe them our devoted thanks. We thank Dr. Y.P. HUANG, pioneer in the field of posterior fossa veins, for his valuable suggestions. We are grateful to our medical collaborators, Dr. ELISABETH BABIN and Dr. ALAIN TOURNADE, for their efficient participation in our work, and to our technical staffs, especially Mrs. ELEONORE BROMHORST and Miss MARIE-PAULE HEITZ, whose radiographic documents illustrate this book. Our special thanks go to Mr. AUGUSTE FREY for his competent work in subtraction and photography, and to Mrs. ROSEMARIE KIPPER and Miss FRANCINE BURGY, our secretaries, for their capable work. This book could not have been written without the kindness and friendship of our colleague, Dr. NICOLE HELDT, neuropathologist, who prepared specimens with our study in mind. To her we express our sincere gratitude. To our many other colleagues who remain unnamed, we express our thanks. To our translator, Mrs. LILLIAN BRAUN, our last, but not least, thanks. A. W ACKENHEIM J.P. BRAUN VII

6 Contents A. Introduction B. Historical Background. 2 C. Practical Methodology The Basal Veins and Their Tributaries The Superior and Inferior Vermian Veins 5 3. The Precentral Vein The Peduncular and Pontine Veins The Superior Petrosal Veins and Their Tributaries 6 D. Normal Findings I. The Venous Sinuses II. The Emissary Veins The Occipital Emissary Veins The Anterior and Posterior Condylar Veins The Mastoid Emissary Vein III. The Great Vein of Galen and Its Tributaries 7 1. The Internal Cerebral Vein a) The Pellucidal Vein b) The Vein of the Caudate Nucleus. 7 c) The Superior Choroidal Vein... 8 d) The Ventricular or Subependymal Veins. 8 e) The Anterior Thalamic Vein 8 f) The Striothalamic Vein The Basal Vein a) Origin of the Basal Vein. 9 b) Trunk of the Basal Vein. 9 c) Tributaries of the Basal Vein. 9 d) Veins of the Cerebral Peduncles 9 e) Variations in the Drainage of the Basal Vein The Posterior Mesencephalic Vein The Precentral, Paracentral and Postcentral Veins. 10 a) The Precentral Vein. 10 b) The Paracentral Vein c) The Postcentral Vein The Anterosuperior Cerebellar Hemispheric Vein The Internal Occipital Veins The Posterior Pericallosal Vein (Posterior Cerebral Vein) The Superior Thalamic Veins IX

7 x 9. The Superior Vermian Vein The Veins of the Quadrigeminal Plate 11. The Veins of the Pineal Gland IV. The Petrosal Veins The Superior Petrous Vein.. 2. The Inferior Petrous Vein.. V. The Superficial Veins of the Pons 1. The Transversal Pontine Veins 2. The Longitudinal Pontine Veins. VI. VII. The Lateral Mesencephalic Veins The Cerebellar Hemispheric Veins 1. The Anterior Group. 2. The Posterior Group The Medial Group..... VIII. The Veins of the Medulla Oblongata and of the Fourth Ventricle Anatomical Study a) The Anterior Bulbar Veins. b) The Lateral Bulbar Veins. c) The Posterior Bulbar Veins 2. Radiographic Study..... a) The Lateral Medullopontine Veins b) The Medial Bulbar Vein..... c) The Transversal Medullopontine Vein. d) The Marginal Veins of the Fourth Ventricle IX. The Vein of the Lateral Recess of the Fourth Ventricle 1. Anatomical Study Phlebographic Study a) Morphologic and Topographic Study of the Vein of the Lateral Recess of the Fourth Ventricle in a Frontal Projection b) Morphologic and Topographic Study of the Vein of the Lateral Recess of the Fourth Ventricle in Lateral Projection... X. The Lateral Medullopontine Vein XI. The Inferior Vermian Vein... XII. The Vein of the Tentorial Margin XIII. Venous Drainage of the Craniocervical Junction 1. The Internal Jugular Vein 2. The Posterior Jugular Vein 3. The Vertebral Vein.. '. 4. Anastomoses XIV. Venous Landmarks as Observed in Normal Vertebral Angiography The Copular Point of Huang The Anteroinferior Cerebellar Vermis 3. The Isthmus of the Mesencephalon. 4. The Lateral Groove of the Medulla Oblongata

8 5. The Cerebral Peduncle.. 6. The Pons The Quadrigeminal Plate. 8. The Cerebellopontine Angle 9. The Anteroposterior Localization Figures 1 to 81 E. Pathologic Findings I. Pathology of the Venous Sinuses. 1. Thromboses of the Lateral Sinus 2. Extracerebral Tumors Touching the Sinuses. a) Cranial Tumors.... b) Meningiomas c) Jugular Glomus Tumors II. Venous Signs of Hydrocephalus in Children Noncommunicating Hydrocephalus a) Venous Signs of Congenital Stenosis of the Aqueduct of Sylvius b) Venous Signs of a Tumor Responsible for Compression of the Aqueduct of Sylvius c) Direct Venous Signs of Vascular Malformation Localized in the Aqueduct of Sylvius Communicating Hydrocephalus Hydranencephaly Hydroma III. Intracranial Hypertension and Herniations Herniations a) Cerebellar or Transtentorial Herniation 79 b) Hernia of the Superior Vermis or Hernia of the Superior Vermis in the Subdural Supravermian Space 79 c) Tonsillar Herniation. 80 d) Temporal Herniation.. 80 e) Associated Herniations. 80 IV. Tumors of the Fourth Ventricle 80 V. Tumors of the Brain Stem Tumors of the Cerebral Peduncles Tumors of the Pons Tumors of the Medulla Oblongata. 83 VI. Tumors of the Mesencephalon and the Thalamus 83 VII. Tumors of the Cerebellar Hemispheres VIII. Tumors of the Cerebellopontine Angle IX. Hemangioblastomas and Vascular Malformations 86 X. Congenital Malformations 86 Figures 82 to Bibliography Subject Index XI