Radio-anatomy of the internal occipital veins

Three underdogs among galenic veins: anatomical analysis and literature review of surgical relevant veins in the quadrigeminal cistern

Recent studies (Alaou-Ismaili et al. 2020; Kilic et al. Eur J Radiol 56:212-219, 2005) among experienced sub-specialized neurosurgeons described divergent perceptions of surgical risk for venous sacrifice in posterior fossa surgery. Three galenic veins stood out as controversial in venous risk assessment and underexplored in the literature: the internal occipital vein (IOV), the precentral cerebellar vein (PCV), and the superior vermian vein (SVV). We have conducted a narrative review based on a systematic literature search to analyze terminology and anatomic descriptions and to suggest a coherent synthesis of published data on these veins. A systematic PubMed literature search was carried out using the keywords: "posterior fossa," "venous anatomy," and "radiology." Relevant radiological, microsurgical, and anatomical articles were selected if they described the anatomy of the three veins. Anatomical descriptions were analyzed with hermeneutic methodology alongside the articles' radiological and anatomical dissection pictures. New illustrations were created to depict the synthesized image of the venous anatomy. A total of 13 articles described the anatomy and terminology of the relevant veins. The descriptions of the IOV included smaller non-occipital vessels that confused the identification of the vessel. IOV is analyzed to be the vein draining the primary visual cortex, which drains into the vein of Galen (VG). The PCV and SVV enter the VG from below and are fused in almost half of all studied patients, creating a third vessel by the name of the superior cerebellar vein. A conscientious narrative review and hermeneutic analysis produced a synthesized, uniform picture of terminology and anatomy. Consensus on anatomical descriptions and definitions are indispensable for validation of anatomy, research into anatomical variation, for surgical planning and documentation.

Negative BOLD-fMRI signals in large cerebral veins

Reductions in blood oxygenation level dependent (BOLD)-functional magnetic resonance imaging (fMRI) signals below baseline levels have been observed under several conditions as negative activation in task-activation studies or anticorrelation in resting-state experiments. Converging evidence suggests that negative BOLD signals (NBSs) can generally be explained by local reductions in neural activity. Here, we report on NBSs that accompany hemodynamic changes in regions devoid of neural tissue. The NBSs were investigated with high-resolution studies of the visual cortex (VC) at 7 T. Task-activation studies were performed to localize a task-positive area in the VC. During rest, robust negative correlation with the task-positive region was observed in focal regions near the ventricles and dispersed throughout the VC. Both positive and NBSs were dependent on behavioral condition. Comparison with high-resolution structural images showed that negatively correlated regions overlapped with larger pial and ependymal veins near sulcal and ventricular cerebrospinal fluid (CSF). Results from multiecho fMRI showed that NBSs were consistent with increases in local blood volume. These findings confirm theoretical predictions that tie neural activity to blood volume increases, which tend to counteract positive fMRI signal changes associated with increased blood oxygenation. This effect may be more salient in high-resolution studies, in which positive and NBS may be more often spatially distinct.