The Internal Cerebral Vein: New Classification of Branching Patterns Based on CTA

Area of Science:

• Neuroanatomy
• Vascular anatomy
• Medical imaging

Background:

• The internal cerebral vein is formed by the union of thalamostriate and anterior septal veins.
• Variations in internal cerebral vein branching patterns exist but lack classification.
• Accurate anatomical knowledge is vital for neurosurgical and neuroradiological procedures.

Purpose of the Study:

• To evaluate the anatomy of the internal cerebral vein and its main tributaries.
• To classify internal cerebral vein branching patterns based on their course using CTA.
• To provide a classification aiding in surgical planning.

Main Methods:

• Analysis of 250 head CTAs.
• Identification and assessment of anterior septal vein and lateral direct vein characteristics.
• Evaluation of internal cerebral vein-anterior septal vein junctions and their relation to the foramen of Monro.

Main Results:

• A four-type classification of internal cerebral vein branching patterns was established.
• Most commonly, the internal cerebral vein continued as one thalamostriate vein (77%).
• Lateral direct veins were present in 22% of hemispheres, typically draining into the middle third of the internal cerebral vein.

Conclusions:

• A classification system for internal cerebral vein branching patterns was developed.
• This classification can assist clinicians in planning surgical approaches to the ventricles.
• Detailed understanding of deep cerebral vein anatomy is critical for preventing iatrogenic injuries.