Depiction of small veins draining into the vein of galen using preoperative 3-dimensional navigation in living patients.
OBJECTIVE
The purpose of this study was to delineate the anatomy of the precentral cerebellar vein, superior vermian vein, and internal occipital vein using reconstructions of computed tomographic and magnetic resonance imaging scans with navigation software. These data were compared with previous anatomic and angiographic findings to show the resolution and accuracy of the system.


METHODS
We retrospectively reviewed 100 patients with intracranial pathologies (50 computed tomographic scans with contrast and 50 magnetic resonance imaging scans with gadolinium) using a neuronavigation workstation for 3-dimensional reconstruction. Particular attention was paid to depiction of the precentral cerebellar vein, superior vermian vein, and internal occipital vein. The data were reviewed and analyzed.


RESULTS
The precentral cerebellar vein, superior vermian vein, and its tributary, the supraculminate vein, were depicted in 52 (52%) patients. The internal occipital vein was delineated on 99 (49.5%) sides and joined the basal vein and vein of Galen in 39 (39.4%) and 60 (60.6%) hemispheres, respectively. Comparing these results with previous angiographic studies, the ability of the neuronavigation system for depicting these vessels is similar to that of digital subtraction angiography.


CONCLUSIONS
This study illustrates the possibility of depicting the small vessels draining into the pineal region venous complex using 3-dimensional neuronavigation with an accuracy comparable to that of digital subtraction angiography. This tool provides important information for both surgical planning and intraoperative orientation.
Giordano
Mario
M
Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany.
Wrede
Karsten H
KH
Stieglitz
Lennart H
LH
Columbano
Laura
L
Samii
Madjid
M
Luedemann
Wolf O
WO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000592:standards; D001921:Brain / Q000098:blood supply / Q000601:surgery; D002550:Cerebral Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D010870:Pineal Gland / Q000033:anatomy & histology / Q000098:blood supply / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011300:Preoperative Care / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012984:Software; D012986:Software Validation; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult