Anat Cell Biol.  2019 Sep;52(3):250-254. 10.5115/acb.19.006.

Persistent fetal superficial middle cerebral vein: an anatomical study

Affiliations
  • 1Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India. sushma.rk@manipal.edu

Abstract

The superficial middle cerebral vein (SMCV) drains the venous blood from most of the superolateral surface of the brain and drains typically into the cavernous sinus as mentioned in standard textbooks. But the drainage of the SMCV is variable as indicated by various radiological studies. Although variations in the drainage of the SMCV exist, there is a shortage in the literature providing cadaveric evidence for the same. The present study was designed to identify the variations in the drainage pattern of the SMCV in fetal cadavers. During the dissection of formalin-fixed full-term fetuses, deviation in the drainage of the SMCV was observed in five out of 30 cases. In three out of 30 specimens (10%), SMCV was observed draining into superior petrosal sinus; and in two specimens (6.6%) into the transverse sinus. In the remaining specimens, the SMCV drained directly into the cavernous sinus. Knowledge of the variations noted in the present study is essential, not only for diagnosing several diseases involving the cavernous sinus or paracavernous sinuses but also in surgeries of paracavernous sinus lesions and endovascular treatment of arteriovenous fistulas. The SMCV and superior petrosal sinus can be a venous refluxing route in patients with arteriovenous fistulas.

Keyword

Superficial middle cerebral vein; Tentorial sinus; Cavernous sinus; Superior petrosal sinus; Transverse sinus

MeSH Terms

Arteriovenous Fistula
Brain
Cadaver
Cavernous Sinus
Cerebral Veins*
Drainage
Fetus
Humans

Figure

  • Fig. 1 Drainage pattern of superficial middle cerebral vein (SMCV)-sphenoparietal type. (A) The SMCV draining into the cavernous sinus on the left side. Symbol ** represent the location of the right cavernous sinus. (B) Schematic representation of the drainage pattern of SMCV-sphenoparietal type. The Interrupted lines represent the regression of the tentorial sinus (TS). LWS, lesser wing of sphenoid; SPS, superior petrosal sinus.

  • Fig. 2 Drainage pattern of superficial middle cerebral vein (SMCV)-superior petrosal type. (A) The SMCV draining into the superior petrosal sinus (SPS) on the left side. This pattern of drainage of SMCV was observed in three cases (10%). Symbol ** represent the location of the right cavernous sinus. (B) Schematic representation of the drainage pattern of SMCV-superior petrosal type. The Interrupted lines represent the regression of the tentorial sinus.

  • Fig. 3 Drainage pattern of superficial middle cerebral vein (SMCV)-basal type. (A) The SMCV draining into transverse sinus (TS). This pattern of drainage of SMCV was present in 2 (6.6%) of the cases. Symbol * represents the junction of the drainage of the SMCV into TS. (B) Schematic representation of the drainage pattern of SMCV-basal type. SPS, superior petrosal sinus.


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