Anatomy of the falcine venous plexus

Restricted access

Object

The superior and inferior sagittal sinuses have been well studied. Interestingly, other venous structures within the falx cerebri have received scant attention in the medical literature. The present study was performed to elucidate the presence and anatomy of these midline structures.

Methods

The authors examined 27 adult latex- or ink-injected cadaveric specimens to observe the morphological features of the sinuses within the falx cerebri (excluding the inferior and superior sagittal sinuses).

Results

All specimens were found to have an extensive network of small tributaries within the falx cerebri that were primarily concentrated in its posterior one third. In this posterior segment, these structures were usually more pronounced in the inferior two thirds. The portion of the falx cerebri not containing significant falcine venous sinus was termed a “safe area.” These vascular channels ranged in size from 0.5 mm to 1.1 cm (mean 0.6 mm); 100% of these vessels communicated with the inferior sagittal sinus. Classification of the structures was then performed based on communication of the falcine venous sinus with the superior sagittal sinus. Type I falcine sinuses had no communication with the superior sagittal sinus, Type II falcine sinuses had limited communication with the superior sagittal sinus, and Type III falcine sinuses had significant communication with the superior sagittal sinus. Seventeen (63%) of 27 specimens communicated with the superior sagittal sinus (Types II and III). Further subdivision revealed 10 Type I, seven Type II, and 10 Type III falcine venous plexuses.

Conclusions

There are other venous sinuses in the falx cerebri in addition to the superior and inferior sagittal sinuses. Neurosurgical procedures that necessitate incising or puncturing the falx cerebri can be done more safely via a described safe area. Given that the majority of specimens in the authors' study were found to have a plexiform venous morphology within the falx cerebri, they propose that these channels be referred to as the falcine venous plexus and not sinus. The falcine venous plexus should be taken into consideration by the neurosurgeon.

Article Information

Address reprint requests to: R. Shane Tubbs, Ph.D., Pediatric Neurosurgery, Children's Hospital, 1600 Seventh Avenue South ACC 400, Birmingham, Alabama 35233. email: rstubbs@uab.edu.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    A: Schematic depiction of the falcine venous plexus. Note the relative “safe area” in which the falcine venous plexus is not concentrated. B and C: Photographs. In situ observation of the falcine venous plexus (B; closer view in C).

  • View in gallery

    Photographs showing the different types of falcine venous plexuses. A: Type I. Note the absence of communication between the inferior sagittal sinus and superior sagittal sinus via the falcine venous plexus. B: Type II. Note the limited communication between the superior sagittal and inferior sagittal sinuses via the falcine venous plexus. C: A variation of Type II. Again note the limited communication between the superior sagittal and inferior sagittal sinuses via the falcine venous plexus. D: Type III. Note the significant communication between the superior and inferior sagittal sinuses via the falcine venous plexus.

References

  • 1

    Bartels RHMerx JLvan Overbeeke JJ: Falcine sinus and occipital encephalocele: a magnetic resonance venography study. J Neurosurg 89:7387411998

    • Search Google Scholar
    • Export Citation
  • 2

    Browder J: Cerebral Dural Sinuses and Their Tributaries Springfield, ILCharles C Thomas1976. 29

  • 3

    Crosby ECHumphrey TLauer EW: Correlative Anatomy of the Nervous System New YorkThe Macmillan Company1962. 568

  • 4

    Kaplan HABrowder JKrieger AJ: Venous channels within the intracranial dural partitions. Radiology 115:6416451975

  • 5

    Kesava PP: Recanalization of the falcine sinus after venous sinus thrombosis. AJNR Am J Neuroradiol 17:164616481996

  • 6

    Manoj KSKrishnamoorthy TThomas BKapilamoorthy TR: An incidental persistent falcine sinus with dominant straight sinus and hypoplastic distal superior sagittal sinus. Pediatr Radiol 36:65672006

    • Search Google Scholar
    • Export Citation
  • 7

    Reddy ATHedlund GLPercy AK: Enlarged parietal foramina association with cerebral venous and cortical anomalies. Neurology 54:117511782000

    • Search Google Scholar
    • Export Citation
  • 8

    Rhoton AL: Rhoton Cranial Anatomy and Surgical Approaches Schaumburg, ILCongress of Neurological Surgeons2003. 187233

  • 9

    Sener RN: Association of persistent falcine sinus with different clinicoradiologic conditions: MR imaging and MR angiography. Comput Med Imaging Graph 24:3433482000

    • Search Google Scholar
    • Export Citation
  • 10

    Streeter GL: The development of the venous sinuses of the dura mater in the human embryo. Am J Anat 18:1451781915

  • 11

    Strub WMLeach JLTomsick TA: Persistent falcine sinus in an adult: demonstration by MR venography. AJNR Am J Neuroradiol 26:7507512005

    • Search Google Scholar
    • Export Citation

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 166 166 12
Full Text Views 178 178 4
PDF Downloads 70 70 4
EPUB Downloads 0 0 0

PubMed

Google Scholar