J Neurol Surg B Skull Base 2020; 81(S 01): S1-S272
DOI: 10.1055/s-0040-1702557
Poster Presentations
Georg Thieme Verlag KG Stuttgart · New York

Microsurgical Anatomy of the Inferior Petroclival Vein: An Anatomic and Radiologic Study

Satoshi Matsuo
1   Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
,
Noritaka Komune
2   Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Sojiro Yamashita
1   Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
,
Yuichiro Miyamatsu
1   Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
,
Toshiyuki Amano
1   Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
,
Akira Nakamizo
1   Department of Neurosurgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2020 (online)

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    Objective: The inferior petroclival vein courses along the extracranial surface of the petroclival fissure. It is occasionally involved in vascular diseases and has recently been used for vascular access to the cavernous sinus. However, detailed descriptions of its anatomy are currently lacking. This study aimed to define the anatomic relationship between the inferior petroclival vein and its surrounding structures based on cadaveric dissection and radiologic analysis.

    Methods: A cadaver was dissected step-by-step to reveal the relationships between the inferior petroclival vein and the surrounding structures. The existence of the inferior petroclival vein and its relationships with other venous structures were also examined retrospectively by contrast-enhanced, fat-suppressed T1-weighted magnetic resonance imaging (MRI) in 26 adult Japanese patients (51 sides).

    Results: Stepwise cadaveric dissection defined the three-dimensional network of venous structures around the craniocervical junction comprising the jugular bulb, sigmoid sinus, inferior petrosal sinus, suboccipital cavernous sinus, petrosal confluence (also known as the anterior condylar confluence), and inferior petroclival vein, and the posterior, lateral, and anterior condylar veins. The inferior petroclival vein was identified on all sides and was shown to originate from the venous plexus around the carotid artery in all cases. The vein coursed along the petroclival fissure and drained into the petrosal confluence in most cases (39/51, 76.5%), or into the end of the inferior petrosal sinus (10/51, 19.6%), or anterior condylar vein (2/51, 3.9%).

    Conclusion: Contrast-enhanced, fat-suppressed T1-weighted MRI allows profound visualization of the venous network at the craniocervical junction, including the inferior petroclival vein. This examination, combined with stepwise cadaver dissection, will aid our understanding of the three-dimensional anatomy in terms of both the venous relationships and the relationships between the vein and surrounding structures. A precise understanding of this anatomy will enable endovascular and skull base surgeons to gain safe access to lesions involving the inferior petroclival vein.


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    No conflict of interest has been declared by the author(s).