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Anatomical variations in termination of the uncal vein and its clinical implications in cavernous sinus dural arteriovenous fistulas.

Ide S, Kiyosue H, Tanoue S, Okahara M, Sagara Y, Hori Y, Mori H - Neuroradiology (2014)

Bottom Line: The CSDAVFs drained directly into the UV in two patients, drained via LCS into the UV in two patients, and drained through the SMCV into the UV in the remaining nine patients.All cases were successfully treated by transvenous embolization with special attention given to uncal venous drainage.There are several variations in UV termination according to the embryological development of the primitive tentorial sinus and the deep telencephalic vein.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Oita University Hospital, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan.

ABSTRACT

Introduction: The aim of the study was to investigate the variations in the uncal vein (UV) termination and its clinical implication in cavernous sinus dural arteriovenous fistulas (CSDAVFs).

Methods: Biplane cerebral angiography in 80 patients (160 sides) with normal cerebral venous return (normal group) was reviewed with special interest in the termination of the UV. Frequency and types of uncal venous drainage from CSDAVFs in consecutive 26 patients were also analyzed.

Results: In the normal group, the UV was identified in 118 sides (74 %). The UV terminated into cavernous sinus (CS) in 41 sides (34 %), the superficial middle cerebral vein (SMCV) in 58 sides (48 %), the laterocavernous sinus (LCS) in 15 sides (13 %), and the paracavernous sinus (PCS) in 4 sides (3 %). Cerebral venous blood via the UV draining into the CS directly (n=41) or through the SMCV and/or the LCS (n=45) was observed in 86 sides (54 %). Uncal venous drainage from CSDAVFs was found in 13 patients (50 %). The CSDAVFs drained directly into the UV in two patients, drained via LCS into the UV in two patients, and drained through the SMCV into the UV in the remaining nine patients. All cases were successfully treated by transvenous embolization with special attention given to uncal venous drainage.

Conclusion: There are several variations in UV termination according to the embryological development of the primitive tentorial sinus and the deep telencephalic vein. Careful attention should be paid to uncal venous drainage for the treatment of CSDAVFs.

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Types of termination of the uncal vein. Type A: The uncal vein terminated directly into the cavernous sinus (41 sides, 34 %). Type B: The uncal vein terminated into the superficial middle cerebral vein (58 sides, 48 %). Type C: The uncal vein terminated into the laterocavernous sinus (15 sides, 13 %). Type D: The uncal vein terminated into the paracavernous sinus (4 sides, 3 %). Arrows indicate the uncal vein, and arrowheads indicate the superficial middle cerebral vein
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Fig2: Types of termination of the uncal vein. Type A: The uncal vein terminated directly into the cavernous sinus (41 sides, 34 %). Type B: The uncal vein terminated into the superficial middle cerebral vein (58 sides, 48 %). Type C: The uncal vein terminated into the laterocavernous sinus (15 sides, 13 %). Type D: The uncal vein terminated into the paracavernous sinus (4 sides, 3 %). Arrows indicate the uncal vein, and arrowheads indicate the superficial middle cerebral vein

Mentions: In the normal group, the UV was identified in 118 sides (74 %) of 160 sides. The UV terminated into the CS in 41 sides (type A, 35 %), the superficial middle cerebral vein (SMCV) in 58 sides (type B, 49 %), the laterocavernous sinus (LCS) in 15 sides (type C, 13 %), and the paracavernous sinus (PCS) in 4 sides (type D, 3 %) (Table 1; Figs. 1 and 2).Table 1


Anatomical variations in termination of the uncal vein and its clinical implications in cavernous sinus dural arteriovenous fistulas.

Ide S, Kiyosue H, Tanoue S, Okahara M, Sagara Y, Hori Y, Mori H - Neuroradiology (2014)

Types of termination of the uncal vein. Type A: The uncal vein terminated directly into the cavernous sinus (41 sides, 34 %). Type B: The uncal vein terminated into the superficial middle cerebral vein (58 sides, 48 %). Type C: The uncal vein terminated into the laterocavernous sinus (15 sides, 13 %). Type D: The uncal vein terminated into the paracavernous sinus (4 sides, 3 %). Arrows indicate the uncal vein, and arrowheads indicate the superficial middle cerebral vein
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4125747&req=5

Fig2: Types of termination of the uncal vein. Type A: The uncal vein terminated directly into the cavernous sinus (41 sides, 34 %). Type B: The uncal vein terminated into the superficial middle cerebral vein (58 sides, 48 %). Type C: The uncal vein terminated into the laterocavernous sinus (15 sides, 13 %). Type D: The uncal vein terminated into the paracavernous sinus (4 sides, 3 %). Arrows indicate the uncal vein, and arrowheads indicate the superficial middle cerebral vein
Mentions: In the normal group, the UV was identified in 118 sides (74 %) of 160 sides. The UV terminated into the CS in 41 sides (type A, 35 %), the superficial middle cerebral vein (SMCV) in 58 sides (type B, 49 %), the laterocavernous sinus (LCS) in 15 sides (type C, 13 %), and the paracavernous sinus (PCS) in 4 sides (type D, 3 %) (Table 1; Figs. 1 and 2).Table 1

Bottom Line: The CSDAVFs drained directly into the UV in two patients, drained via LCS into the UV in two patients, and drained through the SMCV into the UV in the remaining nine patients.All cases were successfully treated by transvenous embolization with special attention given to uncal venous drainage.There are several variations in UV termination according to the embryological development of the primitive tentorial sinus and the deep telencephalic vein.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Oita University Hospital, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan.

ABSTRACT

Introduction: The aim of the study was to investigate the variations in the uncal vein (UV) termination and its clinical implication in cavernous sinus dural arteriovenous fistulas (CSDAVFs).

Methods: Biplane cerebral angiography in 80 patients (160 sides) with normal cerebral venous return (normal group) was reviewed with special interest in the termination of the UV. Frequency and types of uncal venous drainage from CSDAVFs in consecutive 26 patients were also analyzed.

Results: In the normal group, the UV was identified in 118 sides (74 %). The UV terminated into cavernous sinus (CS) in 41 sides (34 %), the superficial middle cerebral vein (SMCV) in 58 sides (48 %), the laterocavernous sinus (LCS) in 15 sides (13 %), and the paracavernous sinus (PCS) in 4 sides (3 %). Cerebral venous blood via the UV draining into the CS directly (n=41) or through the SMCV and/or the LCS (n=45) was observed in 86 sides (54 %). Uncal venous drainage from CSDAVFs was found in 13 patients (50 %). The CSDAVFs drained directly into the UV in two patients, drained via LCS into the UV in two patients, and drained through the SMCV into the UV in the remaining nine patients. All cases were successfully treated by transvenous embolization with special attention given to uncal venous drainage.

Conclusion: There are several variations in UV termination according to the embryological development of the primitive tentorial sinus and the deep telencephalic vein. Careful attention should be paid to uncal venous drainage for the treatment of CSDAVFs.

Show MeSH
Related in: MedlinePlus