title: Venous organization in the transverse foramen: dissection, histology, and magnetic resonance imaging.
abstract: OBJECTIVE
  The anatomical arrangement of the venous system within the transverse foramen is controversial; there is disagreement whether the anatomy consists of a single vertebral vein or a confluence of venous plexus. Precise knowledge of this arrangement is necessary in imaging when vertebral artery dissection is suspected, as well as in surgical approaches for the cervical spine. This study aimed to better explain anatomical organization of the venous system within the transverse foramen according to the Trolard hypothesis of a transverse vertebral sinus.
  
  
  METHODS
  This was an anatomical and radiological study. For the anatomical study, 10 specimens were analyzed after vascular injection. After dissection, histological cuts were prepared. For the radiological study, a high-resolution MRI study with 2D time-of-flight segment MR venography sequences was performed on 10 healthy volunteers.
  
  
  RESULTS
  Vertebral veins are arranged in a plexiform manner within the transverse canal. This arrangement begins at the upper part of the transverse canal before the vertebral vein turns into a single vein along with the vertebral artery running from the transverse foramen of the C-6. This venous system runs somewhat ventrolaterally to the vertebral artery. In most cases, this arrangement is symmetrical and facilitates radiological readings. The anastomoses between vertebral veins and ventral longitudinal veins are uniform and arranged segmentally at each vertebra.
  
  
  CONCLUSIONS
  These findings confirm recent or previous anatomical descriptions and invalidate others. It is hard to come up with a common description of the arrangement of vertebral veins. The authors suggest providing clinicians as well as anatomists with a well-detailed description of components essential to the understanding of this organization.
authors.affiliation: Department of Neurosurgery, CHU de la Cavale Blanche;|Anatomical Laboratory, Medical Faculty;|INSERM, UMR 1101 LaTIM; and.
authors.forename: Elsa
authors.initials: E
authors.lastname: Magro
authors.affiliation: Department of Radiology, CHU de la Cavale Blanche;
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gentric
authors.affiliation: Department of Pathological Anatomy and Cytology, CHU Morvan;|INSERM, EA 4685, Brest, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Talagas
authors.affiliation: INSERM, CIC 1412, CHU de la Cavale Blanche;
authors.forename: Zarrin
authors.initials: Z
authors.lastname: Alavi
authors.affiliation: Department of Radiology, CHU de la Cavale Blanche;
authors.forename: Michel
authors.initials: M
authors.lastname: Nonent
authors.affiliation: Department of Neurosurgery, CHU de la Cavale Blanche;|INSERM, EA 4685, Brest, France.
authors.forename: Phong
authors.initials: P
authors.lastname: Dam-Hieu
authors.affiliation: Department of Neurosurgery, CHU de la Cavale Blanche;|Anatomical Laboratory, Medical Faculty;|INSERM, UMR 1101 LaTIM; and.
authors.forename: Romuald
authors.initials: R
authors.lastname: Seizeur
mesh_terms: D002102:Cadaver; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D002574:Cervical Vertebrae / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D004210:Dissection; D005260:Female; D006653:Histology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010690:Phlebography; D009626:Terminology as Topic
keywords: DLL = dorsal longitudinal ligament; MRA = MR angiography; MRV = MR venography; TOF = time of flight; anatomy; histology; magnetic resonance imaging; transverse foramen; vascular disorders; vertebral veins