Reis Cassius V C, Deshmukh Vivek, Zabramski Joseph M, Crusius Marcelo, Desmukh Pushpa, Spetzler Robert F, Preul Mark C
Neurosurgery Research Laboratory, Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Neurosurgery. 2007 Nov;61(5 Suppl 2):193-200; discussion 200-1. doi: 10.1227/01.neu.0000303217.53607.d9.
The superficial venous system of the posterior neck (suboccipital venous plexus) is a potential source of complications from bleeding and air embolism. Because there is little information available about this in the literature, an anatomic study of the superficial posterior neck venous system and a morphometric analysis of the mastoid emissary vein (MEV) complex were undertaken. Both surgical and endovascular implications were considered.
The posterior craniocervical regions of 15 silicon-injected human cadaveric specimens were dissected. The patterns and variances of venous anatomy were observed. Distances between fixed bony landmarks were measured with a caliper.
The suboccipital venous plexus, which forms a complex venous network located between the posterior muscular layers of the neck, drains to the anterior vertebral vein and deep cervical vein. The MEV connects this plexus to the sigmoid sinus. Its average diameter was 2.15 mm, and it was located a mean of 21.14 mm from the asterion and a mean of 33.65 mm from the mastoid tip. However, the size of the MEV complex varied considerably.
The suboccipital venous plexus in the posterior neck region may be very large. The size of the veins in the plexus varies, but the drainage pattern remains consistent. The plexus is a potential source of intense bleeding and air embolism during posterior fossa approaches. The risks are greatest for lateral surgical approaches, as a result of the anatomic position of the venous system. The described measurements can be used to approach the MEV in endovascular procedures that involve the sigmoid sinus.
后颈部浅静脉系统（枕下静脉丛）是出血和空气栓塞并发症的潜在来源。由于文献中关于此的信息很少，因此对后颈部浅静脉系统进行了解剖学研究，并对乳突导静脉（MEV）复合体进行了形态计量分析。同时考虑了手术和血管内介入的影响。
解剖了15例注入硅的人体尸体标本的后颅颈区域。观察静脉解剖的模式和变异情况。用卡尺测量固定骨性标志之间的距离。
枕下静脉丛形成一个位于颈部后肌层之间的复杂静脉网络，引流至椎前静脉和颈深静脉。MEV将该静脉丛与乙状窦相连。其平均直径为2.15mm，距星点平均距离为21.14mm，距乳突尖平均距离为33.65mm。然而，MEV复合体的大小差异很大。
后颈部区域的枕下静脉丛可能非常大。丛内静脉大小各异，但引流模式保持一致。在后颅窝手术入路过程中，该静脉丛是严重出血和空气栓塞的潜在来源。由于静脉系统的解剖位置，外侧手术入路的风险最大。所描述的测量方法可用于涉及乙状窦的血管内手术中接近MEV。
