PURPOSE: Little attention has been paid to the superficial anastomotic veins but severe post-operative complications can be related to iatrogenic venous damage. The importance of the position of VL (vein of Labbé) relates with the lateral accesses to skull base and medial tentorial lesions by posterior temporal approaches. The aim of this study was to characterize and deepen knowledge on the VL anatomy. METHODS: We reviewed retrospectively 101 hemispheres from cerebral angiographic studies in 59 patients (42 patients with bilateral angiography). RESULTS: VL duplication was found in 13 patients (31 %) and it was predominant on the left side. The absence of VL was rare (3 of 101 hemispheres). The mean location of the VL entry point in the transverse sinus was almost the middle of the distance between the inion and external acoustic meatus. The mean angle for this entry point was 69°. The mean VL caliber for the patients studied was 3.2 mm. Regarding the relation between VL and vein of Trolard, we found VL dominance in 31 % of the cases. About left-right intrapersonal variability we found a tendency for left VL dominance. CONCLUSIONS: We emphasized not only the interindividual differences but also the great intrapersonal variability of VL anatomy. The adequate study of the cerebral venous system particularities is of crucial importance for pre-operative planning to avoid severe complications.
PURPOSE: Little attention has been paid to the superficial anastomotic veins but severe post-operative complications can be related to iatrogenic venous damage. The importance of the position of VL (vein of Labbé) relates with the lateral accesses to skull base and medial tentorial lesions by posterior temporal approaches. The aim of this study was to characterize and deepen knowledge on the VL anatomy. METHODS: We reviewed retrospectively 101 hemispheres from cerebral angiographic studies in 59 patients (42 patients with bilateral angiography). RESULTS: VL duplication was found in 13 patients (31 %) and it was predominant on the left side. The absence of VL was rare (3 of 101 hemispheres). The mean location of the VL entry point in the transverse sinus was almost the middle of the distance between the inion and external acoustic meatus. The mean angle for this entry point was 69°. The mean VL caliber for the patients studied was 3.2 mm. Regarding the relation between VL and vein of Trolard, we found VL dominance in 31 % of the cases. About left-right intrapersonal variability we found a tendency for left VL dominance. CONCLUSIONS: We emphasized not only the interindividual differences but also the great intrapersonal variability of VL anatomy. The adequate study of the cerebral venous system particularities is of crucial importance for pre-operative planning to avoid severe complications.
Authors: Cassius Vinicius C Reis; Kaan Yagmurlu; Ali M Elhadi; Alexander Dru; Ting Lei; Sebastião N S Gusmão; Uédson Tazinaffo; Joseph M Zabramski; Robert F Spetzler; Mark C Preul Journal: J Neurol Surg B Skull Base Date: 2016-05-27