Abstract
ObjectiveThe drainage portion of the vein of Labbé varies, and it is difficult to predict whether the operation is likely to damage this vein. The aim of this study was to correlate the microanatomy of the vein of Labbé with digital subtraction angiography (DSA) and computed tomographic venography (CTV), in order to provide a basis for the preservation of the vein of Labbé during a supratentorial surgical approach.MethodsA total of 30 human cadavers (60 sides) and 61 living patients (110 sides) were examined in this study. Each cadaver head was injected with blue latex via the superior sagittal sinus and the internal jugular veins. The venograms of each patient were obtained from the venous phases of DSA (60 sides for 36 patients) or CTV (50 sides for 25 patients).ResultsThe patients were divided into four subgroups based on the location where a vein entered the dural sinus: the transverse sinus group, the tentorial group, the petrosal group, and the upper-transverse sinus group. The veins of Labbé in transverse sinus group and petrosal group directly entered dural sinus. The veins of Labbé in tentorial group and upper-transverse sinus group indirectly entered transverse sinus via the tentorium sinus or the upper-transverse sinus. These sinuses were meningeal veins running through two layers of the cerebral dura mater. The length of meningeal veins in these groups was 10.0 ± 7.2 mm. The veins of Labbé were mainly localized around the STP junction, which was the confluence of sigmoid sinus, transverse sinus, and superior petrosal sinus. The distance between the dural entrance of veins and the STP junction was 16.8 ± 10.2 mm. There was no significant difference in the results of the DSA and CTV examinations when compared to the observations in cadavers.ConclusionsPreoperative venograms are useful to design an individualized surgical approach for the preservation of the vein of Labbé. In general, the supratentorial median approach has the least chance to damage this vein. However, when preoperative venograms show that the vein of Labbé is too close to the confluence of sinuses or the meningeal veins are too long, an alternative approach should be chosen.
Highlights
Anatomic and histological observation has shown that the cerebral venous wall is thin and the course is flat [1]
The aim of this study was to correlate the microanatomy of the vein of Labbé with venograms as obtained by digital subtraction angiography (DSA) and computed tomographic venography (CTV), in order to provide a basis for the preservation of the vein of Labbé during supratentorial surgical approaches
In DSA and CTV images, the superficial middle cerebral veins intersected with the transverse sinus through the veins of Labbé (Figs. 3, 4, 5, 6), except for no vein of Labbé was present in one case
Summary
Anatomic and histological observation has shown that the cerebral venous wall is thin and the course is flat [1]. The vein of Labbé is a type of bridging vein that is first discovered and should be protected during the operation It was originally defined as one of a group of anastomosis veins that connect the superficial middle cerebral vein around the lateral sulcus and the lateral sinus. It was called the inferior anastomotic vein [12] which drained the blood from lateral temporal lobe and the gyrus around lateral sulcus. In the clinical supratentorial surgical approaches, the separation of blood vessels, cerebral traction, expansion of the operation space and other risks, may injure the vein of Labbé and result in aphasia, logagraphia, encephaledema, and other complications. Neurosurgeons should protect the vein of Labbé as much as possible [13, 14]
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