Great cerebral vein

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Vein: Vein of Galen
Gray565.png
Velum interpositum. (Great cerebral vein labeled at bottom center.)
Gray567.png
Dura mater and its processes exposed by removing part of the right half of the skull, and the brain. (Great cerebral vein labeled at bottom left.)
Latin vena magna cerebri
Gray's p.653
Drains from cerebrum
Source internal cerebral veins
Drains to straight sinus
Artery cerebral arteries

The great cerebral vein is one of the large blood vessels in the skull draining the cerebrum (brain). It is also known as the "vein of Galen" (VG), named for its discoverer, the Greek physician Galen. However, it is not the only vein with this eponym.

Structure[edit]

The great cerebral vein of Galen is considered a deep/internal cerebral vein. The internal cerebral veins are formed by the union of the thalamostriate vein and the choroid vein at the interventricular foramen. The deep/internal group of cerebral veins can be seen on the superior surfaces of the caudate nuclei and thalami just under the corpus callosum.[1] The veins at the anterior poles of the thalami merge posterior to the pineal gland to form the Great Cerebral Vein of Galen.[1] Most of the blood in the deep cerebral veins collects into the great cerebral vein.[2] This comes from the inferior side of the posterior end of the corpus callosum and empties into the straight sinus located in the midline of the tentorium.[2] Unlike the arteries, the cerebral veins have anastomoses.[2] With extensive anastomoses, a slow occlusion of a venous channel rarely produces more than transitory effects.[2]

There are both superficial/external and deep/internal cerebral veins, the great cerebral vein being a deep/internal vein as mentioned above) in the brain. As there are similarities, there are also differences between these two types of veins in the brain. The superficial veins at the dorsal parts of the hemispheres run upward and medially and empty into the large superior sagittal sinus in the upper margin of the falx cerebri. The superior sagittal sinus divides into two parts called the transverse sinuses where the falx cerebri meets the tentorium cerebelli.[3] The sigmoid sinus, which continues the transverse sinus, empties into the jugular vein at the jugular foramen. The internal jugular vein leaves the skull and travels downward to the neck.[3]

The veins of the brain have very thin walls and contain no valves. They emerge in the brain and lie in the subarachnoid space. They pierce the arachnoid matter and the meningeal layer in the dura and drain into the cranial venous sinuses.[3]

Clinical relevance[edit]

Malformations[edit]

Most conditions associated with the great cerebral vein are due to congenital defects. Vein of Galen aneurysmal malformations (VGAM) are the most common form of symptomatic cerebrovascular malformation in neonates and infants.[4] The presence and locations of angiomas are very variable and do not follow any predictable pattern.[5] The congenital malformation develops during weeks 6-11 of fetal development as a persistent embryonic prosencephalic vein of Markowski; thus, VGAM is actually a misnomer. The vein of Markowski actually drains into the vein of Galen.

Absence[edit]

Absence of the great cerebral vein is a type of malformation. The veins of the deep structures of the brain normally drain through the Galenic system. In the absence of the great cerebral vein, the veins from the diencephalon and the basal ganglia drain laterally into the transverse sinus instead of conjoining in the midline through the Galenic drainage system.[6] Absence of the great cerebral vein is quite rare. It is detected in infancy. Most patients die in the neonatal period or in early infancy.

Thrombosis[edit]

Thrombosis of the great cerebral vein is a form of stroke due to a blood clot in the vein. It affects just 3 to 8% of patients, predominantly women.[7] Patients may present with consciousness problems, headaches, nausea, visual defects, fatigue, disturbance of eye movements and pupillary reflexes, or coma.[7] Thrombosis of the cerebral vein is often deadly but can be survived. Risk factors include oral contraceptives, pregnancy, and the puerperium.[7]

History[edit]

See also[edit]

This article uses anatomical terminology; for an overview, see anatomical terminology.

References[edit]

  1. ^ a b Diamond, Marian C.; Elson, Lawrence M.; Scheibel, Arnold B. (1985). "Venous Drainage of the Cerebral Hemispheres". The Human Brain Coloring Book. HarperCollins. ISBN 978-0-06-460306-5. 
  2. ^ a b c d Brodal, Per (2004) [1992]. The central nervous system: structure and function (3rd (rev) ed.). Oxford University Press. pp. 100–102. ISBN 978-0-19-516560-9. 
  3. ^ a b c Snell, Richard S. (August 1997) [1980]. Clinical Neuroanatomy: A Review with Questions and Explanations (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. pp. 217–219. ISBN 978-0-316-80315-1. 
  4. ^ Johnston IH; Whittle IR; Besser M; Morgan MK (May 1987). "Vein of Galen malformation: diagnosis and management.". Neurosurgery 20 (5): 747–758. doi:10.1227/00006123-198705000-00013. ISSN 0148-396X. PMID 3601022. 
  5. ^ Vidyasagar C (April 2005). "Persistent embryonic veins in the arteriovenous malformation of the diencephalon.". Acta Neurochirurgica 47 (1): 63–82. doi:10.1007/BF01404664. ISSN 0942-0940. PMID 474205. 
  6. ^ Lasjaunias P; Garcia-Monaco R; Rodesch G; Terbrugge K (May 1991). "Deep venous drainage in great cerebral vein (vein of Galen) absence and malformations.". Neuroradiology 33 (3): 234–238. doi:10.1007/BF00588224. ISSN 1432-1920. PMID 1881541. 
  7. ^ a b c van den Bergh WM; van der Schaaf I; van Gijn J (July 2005). "The spectrum of presentations of venous infarction caused by deep cerebral vein thrombosis.". Neurology 65 (2): 192–196. doi:10.1212/01.wnl.0000179677.84785.63. ISSN 1526-632X. PMID 16043785. 

External links[edit]