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Intracranial Angiography

I. The Diagnosis of Vascular Lesions

Carl F. List and Fred J. Hodges

—internal jugular vein. (6) Cavernous sinus—basal vein of Rosenthal—straight sinus—transverse sinus—jugular vein. Any one of the above-mentioned venous channels may be well demonstrated at the arterial phase of the angiogram, but it is our impression that usually the superior ophthalmic vein is the most important venous outlet. Since the blood rushes into the cavernous sinus under arterial pressure, all veins and sinuses connected with the cavernous sinus are tremendously dilated. Angiographic demonstration of the main venous return is helpful in planning the

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The Importance of the Deep Cerebral Veins in Cerebral Angiography

With Special Emphasis on the Orientation of the Foramen of Monro through the Visualization of the “Venous Angle” of the Brain

Paul M. Lin, John F. Mokrohisky, Herbert M. Stauffer and Michael Scott

” of the brain, in various types of cerebral space-taking lesions. ANATOMY OF THE DEEP CEREBRAL VEINS The deep cerebral veins are the choroid veins, the striothalamic veins, the internal cerebral veins, the great cerebral vein of Galen and the basal vein of Rosenthal 1, 3, 11 ( Figs. 1, 2, 3, 4 and 5 ). Embryologically, 11 the deep veins take origin from the anterior plexus and the middle plexus of the primary head vein. When the cerebral hemispheres increase in size the dura mater is compressed between them in the form of the fold that later forms

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William H. Mosberg Jr. and Richard Lindenberg

corpus Luysi and of the substantia nigra, the choroid plexus of the lower ventricular horn, and eventually the rostrolateral portion of the lateral geniculate body. It is the pallidal branches that are involved in the lesion here described. The veins of the pallidum and striate body usually drain into the basal vein of Rosenthal, which, after encircling the midbrain, empties into the great vein of Galen. They anastomose, however, also with the terminal vein and the longitudinal communicating veins which pass along the lateral angle of the lateral ventricle. Both the

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D. M. Perese

Sylvian fissure, communicated with the basal vein of Rosenthal and with deep veins draining the insula, and emptied into the cavernous, sphenoparietal and middle meningeal sinuses ( Figs. 8 and 9 ). Careful dissection of the veins running in the Sylvian fissure disclosed that they were made up of 2 or 3 branches. In addition, in 91 per cent of the brains, another vein ran below the fissure and parallel to it. This vein emptied into the middle meningeal vein after rolling over the tip of the temporal lobe ( Fig. 10 ). No bridging veins were found along the inferior

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William M. Hammon, Ludwig G. Kempe and George J. Hayes

the lateral ventricle in man, observing the major arterial supply to be the anterior choroid artery, particularly to the area of the glomus. Fig. 3. Fig. 4. ( left ). Left carotid angiogram, arterial phase, lateral projection. Note contribution of anterior and posterior choroid arteries. ( right ). Diagram of Fig. 3 . Abbreviations in Figs. 4 and 8 : A.C. Anterior cerebral artery B.V. Basal vein of Rosenthal d.v. A deep vein I.C. Internal carotid artery I.C.V. Internal cerebral vein M.C. Middle

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Sanford J. Larson and Leonard W. Worman

superior petrosal sinus, the superior ophthalmic vein, the Sylvian vein, and the basal vein of Rosenthal. A right carotid arteriogram with compression of the left carotid artery demonstrated the anterior and middle cerebral arteries bilaterally and the fistula. Fig. 1. Case 1. Left carotid arteriogram shows the contrast medium leaving the cavernous sinus via the superior ophthalmic vein, the Sylvian veins, the basal vein of Rosenthal, and the superior petrosal sinus. There is sparse and partial filling of the middle cerebral artery. Operation A left

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Glenn W. Kindt and Trygve O. Gabrielsen

) and septal vein ( arrows ). Other subependymal veins are barely visible but also drain into the well-opacified internal cerebral vein ( double crossed arrows ). The straight sinus and basal vein of Rosenthal are shown well. Fig. 3. Case 1. Left vertebral angiograms (subtraction films), lateral views, taken during arterial phase. Left: No abnormality is seen. Right: Film 1.5 sec later shows marked contrast “staining” in the occipitotemporal region just above the tentorium cerebelli. Fig. 4. Case 1. Left vertebral angiograms during

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Kenneth G. Jamieson

basal vein of Rosenthal can be treated as expendable. Once the right-sided tributaries of the vein of Galen have been identified, tumor removal can be undertaken from beneath them while they remain in full vision. The texture of the tumors in this area will vary widely. Some (Case 2) can be rolled out in toto, others (Case 3) are friable and may be sucked away, while others (Case 4) may require tedious and piecemeal removal by dissection. Once tumor removal has been completed, hemostasis is not difficult, nor is identification of the tributaries of the vein of

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Enrique Palacios and Edwin E. Macgee

spinosum. These anastomosing branches usually run deep to the Gasserian ganglion. They may be displaced medially by a trigeminal neurinoma. The middle cerebral and anterior choroidal arteries as well as the basal vein of Rosenthal may be displaced upward, suggesting a middle fossa mass. Posterior displacement of the upper portion of the basilar artery indicate subtentorial tumor extension ( Fig. 5 ). Fig. 4. Case 1. Left: Anteroposterior projection of the carotid arteriogram showing medial displacement of the ganglial portion of the carotid siphon by the

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Harry A. Kaplan and Jefferson Browder

veins from the upper convexity of this lobe joined the superficial Sylvian vein or veins. Those of the rostral tip of the lobe joined the superficial Sylvian vein as it coursed to the sphenoparietal or cavernous sinus. Those of the medial inferior surface coursed to the basal vein of Rosenthal. Those of the inferolateral convexity and the lateral base, ran posteriorly, some joining the vein of Labbé as it crossed the posterior temporal lobe, while most continued as a series of subdural veins that joined the transverse sinus just short of the junction of the veins of