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The Governor Vessel (GV)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Emissary veins: Emissary veins connect the dural venous sinuses to extracranial veins. Emissary veins lack valves, and blood may flow in either direction, though usually its flow is from the brain outward. Emissary veins vary in size and number. Children have a frontal emissary vein that may persist in some adults. The frontal emissary vein connects the superior sagittal sinus with the frontal sinus and nasal cavities. Parietal emissary veins may occur in pairs, passing through the parietal foramina in the calvaria and allowing flow between the superior sagittal sinus and the veins of the scalp. Occipital or posterior auricular veins connect with the sigmoid sinus via the mastoid emissary veins, which course through the mastoid foramina.
Utility of right adrenal signature veins in venous sampling for primary aldosteronism
Published in Annals of Medicine, 2023
Zhenglin Shen, Shaoyong Xu, Siyu Guan, Bo Chen, Qingan Li, Ming Yu, Zhao Gao
Previous studies have not given much attention to the course and distribution of adrenal veins, resulting in confusion among clinicians regarding adrenal venography [16,17]. To better understand the characteristics of adrenal vein distribution, it is necessary to reconstruct the 3D anatomical structure of the adrenal gland [18]. Through fusion images of adrenal venography and 3D structure, we made some important discoveries, as follows: (1) When adrenal venography was performed at a right anterior oblique angle of 30 degrees, 93% of venous morphology was of the trunk branch type. (2) The ‘uvula vein’ that we discovered, along with the central vein, was the primary branch of the RAV. The central vein was accompanied by a combination cord, while the ‘uvula vein’ was distributed in the uvula. (3) Adrenal internal signature veins included the central vein, brush vein, and uvula vein. (4) Adrenal external signature veins were the renal capsular veins [19]. A previous study reported that the inferior emissary vein, which belongs to the renal capsular veins, could serve as a reliable landmark in AVS [20].
Intravenous sinus meningioma with intraluminal extension to the internal jugular vein: case report and review of the literature
Published in British Journal of Neurosurgery, 2023
Kei Yamashiro, Mitsuhiro Hasegawa, Saeko Higashiguchi, Hisayuki Kato, Yuichi Hirose
An arc-shaped initial skin incision surrounding the auricle was used, the caudal side incision extended to the neck. A skin incision along the front edge of the sternocleidomastoid muscle was added to make a T-shaped cut (Figure 5, left). Small lateral suboccipital craniotomy and splitting mastoidectomy were performed to expose the transverse sinus to the sigmoid sinus. The fallopian canal was not opened. The superior oblique muscle and the rectus capitis lateralis muscle were detached from the bone, and the jugular process was removed. The right transverse sinus, sigmoid sinus, jugular bulb, and internal jugular vein were exposed (Figure 5, right), being aware not to remove the lateral process of atlas due to the reaction of the vagus nerve by the NIM response. To reduce the postoperative risk of lower cranial nerve damage, the cranial and the cranio-cervical junction of the intraluminal tumour was removed via incision of the venous sinus wall and internal jugular vein wall (Figure 6(A)). The tumour invaded the mastoid emissary vein, posterior condylar emissary vein, superior petrosal sinus, and the inferior petrosal sinus in a branched manner. It was removed as thoroughly as possible (Figure 6(B–D)). The distal side of the tumour was removed to the transverse-sigmoid junction as the distal end of the tumour was well controlled by radiation therapy.
Application of retrosigmoid sinus approach in Bonebridge implantation
Published in Acta Oto-Laryngologica, 2021
Danni Wang, Ran Ren, Peiwei Chen, Jinsong Yang, Mengdie Gao, Yujie Liu, Shouqin Zhao
RS approach can be applied for above cases. A skin incision of 4–5 cm in length is made 2 cm posterior and parallel to auricle. Then, posterior auricle myo-periosteum flap is elevated to expose skull bone cortex. Emissary veins of mastoid process and occipital bone are frequently encountered and handled with bipolar cautery or bone wax. Guided by CT 3D images, implant bed for BC-FMT is marked on skull surface. Implant coil is then placed beneath the periosteum, with an angle of 45° superior–posterior to the auricle. Accordingly, BC-FMT is bent inferior-posteriorly. 3D CT images of temporal bone have been proved helpful in RS approach cases, to locate implant bed precisely [14]. Some studies reported various methods, topographic bone thickness maps [15] or surface template-assisted marker positioning method [16] for example, to help the preoperative planning and precise locating during the surgery, especially for those with limited surgical space.