title: Anatomical variations in termination of the uncal vein and its clinical implications in cavernous sinus dural arteriovenous fistulas.
abstract: BACKGROUND
  The aim of the study was to investigate the variations in the uncal vein (UV) termination and its clinical implication in cavernous sinus dural arteriovenous fistulas (CSDAVFs).
  
  
  METHODS
  Biplane cerebral angiography in 80 patients (160 sides) with normal cerebral venous return (normal group) was reviewed with special interest in the termination of the UV. Frequency and types of uncal venous drainage from CSDAVFs in consecutive 26 patients were also analyzed.
  
  
  RESULTS
  In the normal group, the UV was identified in 118 sides (74 %). The UV terminated into cavernous sinus (CS) in 41 sides (34 %), the superficial middle cerebral vein (SMCV) in 58 sides (48 %), the laterocavernous sinus (LCS) in 15 sides (13 %), and the paracavernous sinus (PCS) in 4 sides (3 %). Cerebral venous blood via the UV draining into the CS directly (n=41) or through the SMCV and/or the LCS (n=45) was observed in 86 sides (54 %). Uncal venous drainage from CSDAVFs was found in 13 patients (50 %). The CSDAVFs drained directly into the UV in two patients, drained via LCS into the UV in two patients, and drained through the SMCV into the UV in the remaining nine patients. All cases were successfully treated by transvenous embolization with special attention given to uncal venous drainage.
  
  
  CONCLUSIONS
  There are several variations in UV termination according to the embryological development of the primitive tentorial sinus and the deep telencephalic vein. Careful attention should be paid to uncal venous drainage for the treatment of CSDAVFs.
authors.affiliation: Department of Radiology, Oita University Hospital, 1-1 Idaigaoka, Hasama, Yufu City, Oita, 879-5593, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Ide
authors.forename: Hiro
authors.initials: H
authors.lastname: Kiyosue
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tanoue
authors.forename: Mika
authors.initials: M
authors.lastname: Okahara
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Sagara
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Hori
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002426:Cavernous Sinus / Q000033:anatomy & histology*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000033:anatomy & histology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult