Dural entrance of the bridging vein in the middle cranial fossa: a novel classification of the cerebral veins for preoperative planning

Abstract

Background and importance: Understanding of the intracranial venous anatomy is essential for preoperative planning.

Objective: To identify anatomic features of the dural entrance of the bridging veins (BVs) into the dural sinuses in the middle cranial fossa on the cadaver and to correlate such features with those of digital subtraction venogram, computed tomographic venogram, and magnetic resonance venogram.

Clinical presentation: A total of 30 adult cadavers and 86 patients were examined with anatomic dissection or neuroimages. The number, diameter, and location of the BVs entering the dural sinuses in the middle cranial fossa were recorded and compared between the cadavers and neuroimages. The dural entrances of the BVs were identifiable on neuroimages and distributed mainly at the anteromedial area of the fossa. Morphological features of the dural sinuses and meningeal veins in the fossa indicated that the techniques of lengthening the BV by dissecting it away from the dura mater or cutting a small area of the dura along the sides of the BV may not be applicable for the management of BVs in the anteromedial middle cranial fossa.

Conclusion: Unique anatomic features of the dural entrance of BVs entering the dural sinuses in the cadaver are correlated to those on neuroimages. Identification of the dural entrance of BVs with neuroimaging modalities provides a reliable measure for preoperative planning.