Superficial sylvian veins = orange. They will be as dense as venous sinuses. The same case, with arterial phase mask to show relationship with the carotid artery. This produces the characteristic gyral enhancement seen on MRI, and venous congestion that is better appreciated angiographically. Normal transmedullary veins can be seen exceptionally well in high-field MRI, especially 7T, where images are truly stunning: There appears to be deposition of paramagnetic substance (likely IRON) in the right head of the caudate and putamen (yellow and orange arrows) in this patient with a large DVA(dark blue) draining into the middle cerebral vein, a.k.a. MRI demonstrates a parietal hemorrhage (green, additional sequences confirm hemorrhagic nature). The longitudinal caudate veins are small veins on the lateral aspect of caudate body that collect tributaries from the deep white matter. The basal vein of Rosenthal, which is usually formed by the junction of the middle deep cerebral vein and the anterior cerebral vein, reveals a regular anatomy in 80% of cases. Notice absence of left basal vein, and most surface convexity veins. Somewhat later, as the choroid plexus grows (week 5 gestational age or so), a new system develops to drain the plexus. In the literature recent studies have suggested a possible contribution by primitive variants of Basal vein of Rosenthal … ), as many other small but vital veins drain there also. The basal vein of Rosenthal (BV) courses from the premesencephalic cistern, through the ambient cistern, and terminates in the quadrigeminal cistern. The surrounding brain is MRI-normal. Three segments are described in relation to the mesencephalon. Now you know where vertebrobasilar territory venous contributors enter the basal vein — right where it becomes diluted. are labeled yellow. The striate segment drains inferiorly via the anterior pontomesencephalic vein; the peduncular segment drains inferiorly through a prominent lateral mesencephalic vein; and the tributaries of the mesencephalic segment drain directly into the vein of Galen. Basal vein of Rosenthal are paried paramedian veins, closely related to the posterior cerebral artery. However, because of the dilated basal vein of Rosenthal and varix, indicating a potential risk of intracranial hemorrhage and the development of a visual deficit, radical treatment was required for the present patient. Privacy Policy | A case was presented of arteriovenous malformation in the region of the right basal vein of Rosenthal associated with an ipsilateral orbital varix. Thalamostriate vein = more posterior orange arrow. Red=PCA; Light blue=periatrial vein; Dark blue=internal cerebral vein; Orange=VOG; Yellow=Thalamostriate Vein; White=Straight Sinus. The second middle segment curves over the mesencephalon. As always, a bit of embryology: in the very early embryo the brain drains “centrifugally”, or from inside out to the surface, like the spinal cord. Late phase CT angiogram with anterior (purple) and middle cerebral (a.k.a. The striate veins come forth from the anterior perforated substance. Just looking at the deep venous structures on every angio (especially in stereo) will go a long way towards getting you comfortable with the anatomy, uncertain or not. The internal cerebral vein is missing. F, Inferior view of the right basal vein. The vein of Trolard is in yellow. Also seen are inferior sagittal sinus (green), the internal cerebral vein (red) with its anterior caudate (light blue), thalamostriate (pink) and posterior atrial (black) tributaries. The Vein of Galen — images of the classic Galen can be found elsewhere… no time for now. The AVM is supplied via the posterior lateral choroidal arteries (red). The basal vein ( of Rosenthal) begins on the orbital cortex as the anterior cerebral vein and in the sylvian fissure as the deep middle cerebral vein and proceeds around the medial edge of the temporal lobe to join the straight sinus. When the middle segment of the basal vein is hypoplastic bilaterally, curious drainage patterns are possible. Right light blue arrow is on an inferior temporal superficial tributary to the sinus. About 1/3 of patients only have the skin part, 1/3 have only brain, and 1/3 both — no rocket science here. This is a young patient with intractable seizures. There is also venous mass effect present on what is likely a medial septal vein (dark green). Variation is the rule. Classically its tributaries are divided into medial and lateral groups. Synonym(s): Rosenthal vein ; vena basalis Rosenthal aspiration needle It is closely related to the posterior cerebral artery (PCA). In order to find a potential venous source of bleeding, we compared the basal vein of Rosenthal (BVR) anatomy among the different groups. posterior communicating vein). Orange = VOG. Notice multiple venous channels draining the anterior frontal lobe over the left convexity. In a DVA situation, instead of small wispy veins collecting cerebral white matter blood towards the deep venous system, the DVA itself becomes a collector of neighboring venous territory and empties either into superficial or deep venous networks. This concept is useful as any of the three segments may be hypoplastic and drainage will be redirected accordingly. Mistakenly removing one will lead to venous infarction. Purple=straight sinus. Not ifrequently seen variant which illustrates the embryologic concept of a transcortical venous system which connects deep and superficial venous networks. The basal vein drains inferiorly through a prominent lateral mesencephalic vein. basal vein of Rosenthal - a large vein passing along the medial surface of the temporal lobe, from which it receives tributaries. Lateral anaglyphs looking from both lateral to medial and medial to lateral. The two basal veins are usually interconnected via a bridging vein located anterior to the midbrain, within the interpeduncular cistern, and therefore called interpeduncular vein (a.k.a. How amazing are things we can see now. Just like the SSS and straight sinus are dominant remnants of multiple previously existing channels, In this patient, a DVA (blue) was mistaken for an early draining vein of an AVM, An oblique view, projecting the apex of the parietal convexity (pink) above he superior sagittal sinus (black), shows the DVA (blue) draining into a falcine sinus (purple), — collaterals. In this patient, for some reason, basal vein drainage into the VOG did not develop. Venous Phase: Dark blue on top and green on bottom =basal vein; light blue=Labbe; red=superficial sylvian vein; yellow=parieto-occipital vein; white=posterior frontal vein; black=venous angle of the deep venous system; orange=trans-cerebral vein connecting the thalamostriate vein to the posterior frontal vein. Left and Right venous phase angiograms of the same patient demonsrate a hypoplastic middle basal vein segment with anterior portion of the basal vein draining into the deep sylvian (MCA) veins and posterior 1/3 portion emptying into the vein of Galen. Same DVA on MRI. The thalamostriate vein is also on the larger side (green) with a hypoplastic inferior sagittal sinus. MRI demonstrates a parietal hemorrhage (green, additional sequences confirm hemorrhagic nature). Basal vein drainage to Superior Petrosal Sinus — via the lateral mesencephaic vein and petrosal vein == same appearance. Both the anterior peduncular (anterior anastomotic vein) and the mesencephalic segment (posterior anastomotic veins; blue shaded areas) are absent, and the striate, peduncular, and mesencephalic segments of the basal vein are disconnected from each other. Here is the angiographic correlate to Dr. Huang’s vision, with a microcatheter injection of the distal pericalossal artery (left) and a specimen (different brain, right). It is formed at the anterior perforated substance by the union of. Basal Vein of Rosenthal. The middle and posterior portions of the basal vein can collect the inferior ventricular vein which drains the temporal choroid plexus, and portions of the temporal lobe as well as territory of the cerebral peduncles, hypothalamus, collicular plate, and sometimes receives veins of the cerebellum (which more commonly will drain into the Galen). The tentorial sinus is much more common than most realise. This system remains connected to brain surface veins by small trans-cerebral veins which run through the white matter and used to drain the entire deep brain. Noncontrast 2-D time of flight MRV can be a very sensitive screening tool, but beyond that I think they are of little value — contrast-based methods are required. On both sides, the superficial sylvain veins drain into the posteriorly draining basal vein, making it look pretty enormous. The larger the vein, the more likely it is to have a tentorial sinus component — part of embryology. For the most part, this is a straightforward excersize. Over the frontal lobe, where several surface veins (pink) have developed, the calcifications are less pronounced. The basal vein of Rosenthal originates on the medial surface of the temporal lobe and runs posteriorly and medially. DVAs are relatively common — their incidence is directly proportional to the quality of your MRI machine and thinness of your sequence slices. The Basal Vein of Rosenthal. Below I will be putting some examples soon…. The basal vein was first described in 1824 by Friederich-Christian Rosenthal, a German surgeon and anatomist. Its territory is drained by the basal vein. It is much more consistently seen in the venous phase of vertebrobasilar injections (see Veins of the Posterior Fossa). Each vein passes lateral to the midbrain through the ambient cistern to drain into the vein of Galen with the internal cerebral veins. Vein of Galen malformations and aneurysmal dilations, for example, both congenital anomalies, result in dilation of the internal cerebral veins and basal veins of Rosenthal due to reflux. The disease is not limited to anterior circulation.
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