The anastomotic venous circle of the base of the brain

Abstract

Adjacent to the arterial circle of Willis at the base of the brain, there is an anastomotic circle of veins linking the right and left halves of the cerebral deep venous system. This venous circle is formed by anterior and posterior transverse anastomotic channels (the anterior and posterior communicating veins), and paramedian longitudinal vessels (the basal veins of Rosenthal). This collateral venous network has received considerably less attention than its arterial counterpart, but is its functional homologue. Although inconstant, it can be seen readily with current neuroimaging techniques including three-dimensional digital subtraction venographic phase 3D arteriography (3D-DSV) and CT venography (CTV). The venous circle represents a route of contralateral venous drainage that may become important, particularly when segments of the basal vein are absent (with or without complex DVA), or in high flow states including arteriovenous shunts that access the deep venous system.We review the gross anatomy and provide examples of the radiologic imaging of this venous circle.

Figure 1

The venous circle (reprinted from 6). 1, anterior cerebral vein;2, anterior communicating vein; 3, olfactory vein;4, inferior frontal vein;5, deep middle cerebral vein;6, inferior striate vein;7, vein of the optic tract;8, hypothalamic vein;9, peduncular vein;10, peduncular perforating vein; 11, transmesencephalic vein; 12, posterior communicating vein; 13, tegmental perforating vein; 14, tectal perforating vein; 15, hippocampal and medial temporal veins;16, uncal vein;17, infratemporal vein.

Figure 2

Anterior communicating vein (arrows) - gross specimen.

Figure 3

Posterior communicating vein (arrows) - gross specimen.

Figure 4

Axial (A) and coronal (B) 3D-DSV MR fusion image of anterior communicating vein (arrows) draining an arteriovenous malformation.

Figure 5

Axial (A) and coronal (B) CT venographam (CTV) images of anterior communicating vein (arrows).

Figure 6

Anteroposterior (A) and lateral (B) late phase of an internal carotid angiogram showing a large posterior communicating vein, with controlateral venous drainage (arrows).

Figure 7

Lateral view 3D DSV of posterior communicating vein, showing "notch" of interpeduncular fossa (arrows).

Figure 8

CTV axial (A) and coronal (B) images of posterior communicating vein (arrows).

Figure 9

Lateral views of 3D DSV showing agenesis of vein of Galen with complex developmental venous anomaly (DVA) with controlateral venous drainage via a large anterior communicating vein. Septal vein (single arrow). Epsilon-shaped drainage (double arrow).

Figure 10

Anteroposterior views of 3D DSV showing agenesis of vein of Galen with complex developmental venous anomaly (DVA) with controlateral venous drainage via a large anterior communicating vein. Septal vein (single small arrow). Left cavernous plexus drainage (single large arrow).

Figure 11

Two-dimensional (A) and 3D angiographic images (B,C) of arteriovenous malformation with controlateral venous drainage via the posterior communicating vein (arrows).

Figure 12

Late phase of an internal carotid angiogram showing large posterior communicating vein with wash-in from tentorial sinus (arrows).