Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Child's Nervous System
Published in: Child's Nervous System 2/2013

01-02-2013 | Review Paper

The safety of the intraoperative sacrifice of the deep cerebral veins

Authors: Laurence Davidson, J. Gordon McComb

Published in: Child's Nervous System | Issue 2/2013

Login to get access

Abstract

Background

The effect of surgically ligating the deep cerebral veins is often thought to be of significant risk. That concern and the paucity of information on surgery of the deep venous system confound surgical decision making when operations involve manipulation of the deep cerebral veins.

Discussion

The authors review the human and animal literature on the selective sacrifice of the deep cerebral veins. Robust experimental studies and limited clinical experience indicate that occlusion of one or several deep cerebral veins is generally safe.
Literature
1.
McComb JG (1987) Is there risk to occlusion of the deep cerebral veins when removing pineal location tumors. Concepts in Pediatr Neurosurg 7:72–80
2.
Bailey P (1934) Peculiarities of the intracranial venous system and their clinical significance. Arch Neurol Psychiatr 32:1105
3.
Rhoton AL Jr (2003) In: Apuzzo MLJ (ed) Cranial anatomy and surgical approaches. Lippincott Williams & Wilkins, Schaumburg, p 230
4.
Stein BM (1979) Surgical treatment of pineal tumors. Clin Neurosurg 26:490–510PubMed
5.
Bassiouni H, Asgari S, Konig HJ, Stolke D (2008) Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type. Surg Neurol 69:339–349, discussion 349PubMed
6.
Davidson L, Krieger MD, McComb JG (2011) Posterior interhemispheric retrocallosal approach to pineal region and posterior fossa lesions in a pediatric population. J Neurosurg Pediatr 7:527–533PubMed
7.
Moshel YA, Parker EC, Kelly PJ (2009) Occipital transtentorial approach to the precentral cerebellar fissure and posterior incisural space. Neurosurgery 65:554–564, discussion 564PubMed
8.
Suzuki J, Iwabuchi T (1965) Surgical removal of pineal tumors (pinealomas and teratomas). Experience in a series of 19 cases. J Neurosurg 23:565–571PubMed
9.
Krause F (1926) Operative freilegung der vierhugel nebst Beobachtungen uber hirndruck und dekompression. Zbl Chir 53:2812–2819
10.
Stein BM (1971) The infratentorial supracerebellar approach to pineal lesions. J Neurosurg 35:197–202PubMed
11.
Kaplan HA (1984) Results of obliteration of specific cerebral veins and dural venous sinuses: animal and human studies. In: Kapp J, Schmidek H (eds) The cerebral venous system and its disorders. Grune & Stratton, Inc, Orlando, pp 275–282
12.
Smith RS, Sanford RA (1984) Disorders of the deep cerebral veins. In: Kapp JP, Schmidek HH (eds) The cerebral venous system and its disorders. Grune & Stratton, Inc., Orlando, pp 547–555
13.
Hassler O (1966) Deep cerebral venous system in man. A microangiographic study on its areas of drainage and its anastomoses with the superficial cerebral veins. Neurology 16:505–511PubMed
14.
Braun JP, Tournade A, Ammerich H (1976) Transverse anastomoses of the veins at the base of the brain. Neuroradiology 12:165–169PubMed
15.
Schlesinger B (1939) The venous drainage of the brain, with special reference to the Galenic system. Brain 62:274–291
16.
Dandy W (1936) Operative experience in cases of pineal tumor. Arch Surg 33:19–46
17.
Youssef AS, Downes AE, Agazzi S, Van Loveren HR (2011) Life without the vein of Galen: clinical and radiographic sequelae. Clin Anat 24(6):776–785PubMed
18.
Konovalov AN, Spallone A, Pitzkhelauri DI (1996) Meningioma of the pineal region: a surgical series of 10 cases. J Neurosurg 85:586–590PubMed
19.
Odake G (1992) Meningioma of the falcotentorial region: report of two cases and literature review of occlusion of the galenic system. Neurosurgery 30:788–793, discussion 793–784PubMed
20.
Sakaki S, Shiraishi T, Takeda S, Matsuoka K, Sadamoto K (1984) Occlusion of the great vein of Galen associated with a huge meningioma in the pineal region. Case report. J Neurosurg 61:1136–1140PubMed
21.
Browder J, Kaplan HA, Krieger AJ (1976) Anatomical features of the straight sinus and its tributaries. J Neurosurg 44:55–61PubMed
22.
Hammock MK, Milhorat TH, Earle K, Di Chiro G (1971) Vein of Galen ligation in the primate. Angiographic, gross, and light microscopic evaluation. J Neurosurg 34:77–83PubMed
23.
Dandy W, Blackfan K (1914) Internal hydrocephalus: an experimental, clinical and pathologic study. Am J Dis Child 8:406–482
24.
25.
26.
Bedford THB (1934) The great vein of Galen and the syndrome of increased intracranial pressure. Brain 57:1–24
27.
Levinson A (1929) The cerebrospinal fluid. London
28.
Bedford THB (1934) The venous system of the velum interpositum of the rhesus monkey and the effects of experimental occlusion of the great vein of Galen. Brain 57:255–265
29.
Ono M, Rhoton AL Jr, Peace D, Rodriguez RJ (1984) Microsurgical anatomy of the deep venous system of the brain. Neurosurgery 15:621–657PubMed
30.
Horrax G (1937) Extirpation of a huge pinealoma from a patient with pubertas praecox: a new operative approach. Arch Neurol Psychiatr 37:385–395
31.
Stern WE, Batzdorf U, Rich JR (1971) Challenges of surgical excision of tumors in the pineal region. Bull Los Angel Neurol Soc 36:105–118
32.
Kunicki A (1960) Operative experiences in 8 cases of pineal tumor. J Neurosurg 17:815–823PubMed
33.
Dandy W (1921) An operation for the removal of pineal tumors. Surg Gynec Obstet 33:113–119
34.
Caron JP, Nick J, Contamin F, Singer B, Comoy J, Keravel Y (1977) Tolerance of ligation and of aseptic thrombosis of deep cerebral veins in man. Apropos of 4 cases. Ann Med Interne (Paris) 128:899–906
35.
Rhoton AL Jr (2002) The cerebral veins. Neurosurgery 51:S159–S205PubMed
36.
Hirsch JF, Zouaoui A, Renier D, Pierre-Kahn A (1979) A new surgical approach to the third ventricle with interruption of the striothalamic vein. Acta Neurochir (Wien) 47:135–147
37.
Goetzen B (1964) Veins internes du cerveau humain: morphologie et topographie des anastomosis veineuses centro-peripheriques du cerveau. Arch Anat Path 12:126–133
38.
Rhoton AL Jr (2000) The posterior fossa veins. Neurosurgery 47:S69–S92PubMed
39.
Chaynes P (2004) Microsurgical anatomy of the venous drainage of the mesencephalodiencephalic junction. Neurosurgery 54:678–685, discussion 685–676PubMed
40.
Page LK (1977) The infratentorial-supracerebellar exposure of tumors in the pineal area. Neurosurgery 1:36–40PubMed
41.
Reid WS, Clark WK (1978) Comparison of the infratentorial and transtentorial approaches to the pineal region. Neurosurgery 3:1–8PubMed
42.
Andrews RJ, Bringas JR (1993) A review of brain retraction and recommendations for minimizing intraoperative brain injury. Neurosurgery 33:1052–1063, discussion 1063–1054PubMed
43.
Chi JH, Lawton MT (2006) Posterior interhemispheric approach: surgical technique, application to vascular lesions, and benefits of gravity retraction. Neurosurgery 59: ONS41-49; discussion ONS41-49
44.
McNatt SA, Sosa IJ, Krieger MD, McComb JG (2011) Incidence of venous infarction after sacrificing middle-third superior sagittal sinus cortical bridging veins in a pediatric population. J Neurosurg Pediatr 7:224–228PubMed
45.
Nazzaro JM, Shults WT, Neuwelt EA (1992) Neuro-ophthalmological function of patients with pineal region tumors approached transtentorially in the semisitting position. J Neurosurg 76:746–751PubMed
46.
Xu W, Mellergard P, Ungerstedt U, Nordstrom CH (2002) Local changes in cerebral energy metabolism due to brain retraction during routine neurosurgical procedures. Acta Neurochir (Wien) 144:679–683
47.
Kilic T, Ozduman K, Cavdar S, Ozek MM, Pamir MN (2005) The galenic venous system: surgical anatomy and its angiographic and magnetic resonance venographic correlations. Eur J Radiol 56:212–219PubMed
Metadata
Title
The safety of the intraoperative sacrifice of the deep cerebral veins
Authors
Laurence Davidson
J. Gordon McComb
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 2/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-1958-7

Other articles of this Issue 2/2013

Child's Nervous System 2/2013 Go to the issue

Letter to the Editor

Pediatric focal intracranial suppuration: a UK single-center experience

Letter to the Editor – Reply

Paediatric focal intracranial suppuration: a UK single-centre experience

Case Report

Multifocal arteriovenous malformations and facial nevus without leptomeningeal angioma: a variant form of Sturge–Weber syndrome? A case report and review of the literatures

Case Report

Obstructive hydrocephalus following aqueductal stenosis caused by supra- and infratentorial developmental venous anomaly: case report

Letter to the Editor

Re: Schweitzer T, Bohm H, Meyer-Marcotty P, Collmann H, Ernestus RI, Krauss J (2012) Avoiding CT scans in children with single-suture craniosynostosis. Childs Nerv Syst 28: 1077–1082

Original Paper

A systematic review of the results of surgery and radiotherapy on tumor control for pediatric craniopharyngioma