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Morphometric evaluation of great vein of Galen and its clinical implications

  • Grace Suganya. S (Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research) ;
  • Ariharan. K (Department of Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research) ;
  • Raveendranath Veeramani (Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research) ;
  • Dinesh Kumar. V (Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research) ;
  • Nagarajan Krishnan (Department of Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research)
  • Received : 2022.03.07
  • Accepted : 2022.08.25
  • Published : 2023.03.31

Abstract

The Galenic venous system plays a vital role in the drainage of blood from deeper parts of the brain. This venous system is contributed by many major veins. These veins are located closer to the pineal gland making the surgical approach in this region difficult. Any accidental injury or occlusion of the vein of Galen could lead to devasting results. Thus, studying the dimensions of the vein of Galen is more important. Hence, we aimed to evaluate the morphometry and trajectory to the vein of Galen. About 100 computed tomographic venography records were evaluated and the length, diameter of vein of Galen, angle between straight sinus and vein of Galen and distance from internal occipital protuberance and roof of fourth ventricle to vein of Galen were studied. The mean length and diameter of vein of Galen were 9.8±2.7 and 4.08±1.04 respectively. The mean angle between straight sinus and vein of Galen was 64.2°. The mean distance between external occipital protuberance and roof of fourth ventricle to vein of Galen were 52±6.9 and 33.3±4.5 respectively. No significant morphometric differences were observed between the age groups as well as between the sexs. The results obtained from this study may be helpful for the neurosurgeons in better understanding of the anatomy of the Galenic venous system and to adopt a safe surgical approach to improve the efficacy of the surgeries of the pineal gland and also in the region of vein of Galen.

Keywords

References

  1. Ono M, Rhoton AL Jr, Peace D, Rodriguez RJ. Microsurgical anatomy of the deep venous system of the brain. Neurosurgery 1984;15:621-57.  https://doi.org/10.1227/00006123-198411000-00002
  2. Standring S. Gray's anatomy: the anatomical basis of clinical practice. 41st ed. Philadelphia (PA): Elsevier; 2016. 289 p. 
  3. Youssef AS, Downes AE, Agazzi S, Van Loveren HR. Life without the vein of Galen: clinical and radiographic sequelae. Clin Anat 2011;24:776-85.  https://doi.org/10.1002/ca.21176
  4. Chaynes P. Microsurgical anatomy of the great cerebral vein of Galen and its tributaries. J Neurosurg 2003;99:1028-38.  https://doi.org/10.3171/jns.2003.99.6.1028
  5. Berenstein A, Paramasivam S, Sorscher M, Molofsky W, Meila D, Ghatan S. Vein of Galen aneurysmal malformation: advances in management and endovascular treatment. Neurosurgery 2019;84:469-78. Erratum in: Neurosurgery 2018;83:593. 
  6. D'Amico A, Tinari S, D'Antonio F, Rizzo G, Liberati M, Vasciaveo L, Buca D. Outcome of fetal vein Galen aneurysmal malformations: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2021 Jan 28 [Epub]. https://doi.org/10.1080/14767058.2021.1878494. 
  7. Browder J, Kaplan HA, Krieger AJ. Anatomical features of the straight sinus and its tributaries. J Neurosurg 1976;44:55-61.  https://doi.org/10.3171/jns.1976.44.1.0055
  8. Yamamoto I, Kageyama N. Microsurgical anatomy of the pineal region. J Neurosurg 1980;53:205-21.  https://doi.org/10.3171/jns.1980.53.2.0205
  9. Deniz C, Gokce E, Acu B, Kuyucu YE. Comparative evaluation of dural venous sinuses and cerebral veins using contrast-enhanced spoiled gradient recalled echo and time-of-flight magnetic resonance venography. J Contemp Med 2019;9:214-21.  https://doi.org/10.16899/jcm.556044
  10. Ghali WM, Rafla MF, Ekladious EY, Ibrahim KA. A study of the junction between the straight sinus and the great cerebral vein. J Anat 1989;164:49-54. 
  11. Hernesniemi J, Romani R, Albayrak BS, Lehto H, Dashti R, Ramsey C 3rd, Karatas A, Cardia A, Navratil O, Piippo A, Fujiki M, Toninelli S, Niemela M. Microsurgical management of pineal region lesions: personal experience with 119 patients. Surg Neurol 2008;70:576-83.  https://doi.org/10.1016/j.surneu.2008.07.019
  12. Gutierrez S, Iwanaga J, Dumont AS, Tubbs RS. Direct drainage of the basal vein of Rosenthal into the superior petrosal sinus: a literature review. Anat Cell Biol 2020;53:379-84.  https://doi.org/10.5115/acb.20.199
  13. Widjaja E, Griffiths PD. Intracranial MR venography in children: normal anatomy and variations. AJNR Am J Neuroradiol 2004;25:1557-62. 
  14. Hoang S, Choudhri O, Edwards M, Guzman R. Vein of Galen malformation. Neurosurg Focus 2009;27:E8. 
  15. Sasidharan CK, Anoop P, Vijayakumar M, Jayakrishnan MP, Reetha G, Sindhu TG. Spectrum of clinical presentations of vein of Galen aneurysm. Indian J Pediatr 2004;71:459-63. https://doi.org/10.1007/BF02725643