A technical approach to dissecting and assessing cadaveric veins pertinent to chronic cerebrospinal venous insufficiency in multiple sclerosis
Open Access
- 1 October 2012
- journal article
- Published by Informa UK Limited in Neurological Research
- Vol. 34 (8), 810-818
- https://doi.org/10.1179/1743132812y.0000000071
Abstract
To establish a detailed technical procedure for studying the anatomical correlates of chronic cerebrospinal venous insufficiency in cadavers of multiple sclerosis and control subjects, and to present our findings of the normal anatomic venous structures, with reference to previous descriptions from the literature. This study examined the internal jugular veins (IJVs), the brachiocephalic veins, and the azygos vein from 20 cadavers (10 control and 10 multiple sclerosis). These veins were exposed, isolated by clamps from the rest of the venous system, flushed with water, and then injected with fluid silicone from the superior ends of both IJVs. After the silicone cured to its solid state, the venous tree was removed en bloc and dissected longitudinally to expose the luminal surface. All vein segments were analyzed for anatomic variation. Anatomical analysis for this manuscript focused on normal vein architecture and its variants. Thirty-seven of 40 IJVs contained valves: 29 bicuspid, 6 tricuspid, and 2 unicuspid. The average circumferences of the right and left IJVs were 2·2 and 1·8 cm, respectively. Thirteen of 20 azygos veins contained a valve, located on average 3·6 cm away from the superior vena cava junction. Nine of the 13 azygos valves were bicuspid; four were tricuspid. Only one of the 40 brachiocephalic veins contained a valve. We detailed a technical approach for harvesting cadaveric neck and thoracic veins with relevance to chronic cerebrospinal venous insufficiency. The anatomy of the venous system has significant variability, including differing number of valves in different regions and variable characteristics of the valves. Average vein circumference was less than that typically reported in imaging studies of live patients.Keywords
This publication has 24 references indexed in Scilit:
- Intra- and Extraluminal Structural and Functional Venous Anomalies in Multiple Sclerosis, as Evidenced by 2 Noninvasive Imaging TechniquesAmerican Journal Of Neuroradiology, 2011
- Review of Venous Anatomy for Venographic Interpretation in Chronic Cerebrospinal Venous InsufficiencyJournal of Vascular and Interventional Radiology, 2011
- A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiencyJournal of Vascular Surgery, 2009
- Azygos Arch Valves at Computed Tomography Angiography and Pitfalls Related to its Variety in Appearance and FunctionJournal of Computer Assisted Tomography, 2009
- Estimation of the diameter and cross-sectional area of the internal jugular veins in adult patientsCritical Care, 2009
- Anatomical variations of the internal jugular veins and their relationship to the carotid arteries: A CT evaluationAustralasian Radiology, 2006
- The Origin of the Azygos Venous System, as Deduced from an Anatomical and Radiological Study Employing a Corrosion TechniqueEuropean Journal of Morphology, 2001
- The Origin of the Azygos Venous System, as Deduced from an Anatomical and Radiological Study Employing a Corrosion TechniqueEuropean Journal of Morphology, 2001
- Anatomic and pathophysiologic studies of the human internal jugular valveThe American Journal of Surgery, 1987
- Venenklappen in den grossen Wurzelstämmen der Vena cava superiorCells Tissues Organs, 1984