PT  - JOURNAL ARTICLE
AU  - Rosenblum, J.S.
AU  - Tunacao, J.M.
AU  - Chandrashekhar, V.
AU  - Jha, A.
AU  - Neto, M.
AU  - Weiss, C.
AU  - Smirniotopoulos, J.
AU  - Rosenblum, B.R.
AU  - Heiss, J.D.
TI  - Tentorial Venous Anatomy: Variation in the Healthy Population
AID  - 10.3174/ajnr.A6775
DP  - 2020 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1825--1832
VI  - 41
IP  - 10
4099  - http://www.ajnr.org/content/41/10/1825.short
4100  - http://www.ajnr.org/content/41/10/1825.full
SO  - Am. J. Neuroradiol.2020 Oct 01; 41
AB  - BACKGROUND AND PURPOSE: A new transtentorial venous system consisting of medial, intermediate, and lateral tentorial veins, connecting infra- and supratentorial compartments, was recently shown in 2 cadaver dissections and 2 patient scans. We sought to characterize the venous patterns within the tentorium and their relation to measures of skull development in a cohort of healthy adults.MATERIALS AND METHODS: We retrospectively reviewed tentorial venous anatomy of the head using CTA/CTV performed for routine care or research purposes in 238 patients. Included studies had adequate contrast opacification of venous structures and a section thickness of ≤2 mm; we excluded cases with space-occupying lesions and vascular pathologies. Tentorial angle, dural sinus configurations, and measures of skull base development were assessed as predictors of tentorial venous anatomy variation via Cramér V association, the binary encoded Pearson correlation, and nearest-point algorithm with the Euclidean distance metric for clustering.RESULTS: Tentorial vein development was related to the ringed configuration of the tentorial sinuses (P < .005). There were 3 configurations. Groups 1A and 1B (n = 50/238) had ringed configuration, while group 2 did not (n = 188/238). Group 1A (n = 38/50) had a medialized ringed configuration, and group 1B had a lateralized ringed configuration (n = 12/50). Measurements of skull base development were predictive of these groups. The ringed configuration of group 1 was related to the presence of a split confluens, which correlated with a decreased internal auditory canal–petroclival fissure angle. Configuration 1A was related to the degree of petrous apex pneumatization (P value = .010).CONCLUSIONS: Variations in the transtentorial venous system directly correlate with cranial development.CC-JBcarotid canal–jugular bulbIAC-PCFinternal auditory canal–petroclival fissureITVintermediate tentorial veinLTSlateral tentorial sinusLTVlateral tentorial veinMTSmedial tentorial sinusMTVmedial tentorial veinRCringed configuration