Department of Neurosurgery, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Acta Neurochir (Wien). 2013 Nov;155(11):2183-9; discussion 2189. doi: 10.1007/s00701-013-1863-1. Epub 2013 Sep 14.
Only limited attention has been paid to the anatomy and clinical importance of the falcine venous plexus. The aim of this study was to evaluate the falcine venous plexus anatomically using scanning electron microscopy (SEM), and to provide guidance for neurosurgical approaches.
Latex or ink was injected into the superior and inferior sagittal sinus. The falcine venous plexus lying within the connective tissue of the falx cerebri was observed by dividing the falx into thirds (anterior, middle and posterior). Further, the SEM appearance of the falcine venous plexus was evaluated.
The anterior third of the falx cerebri consisted of small diameter falcine venous vessels. These vessels were localized close to either the superior or inferior sagittal sinus, and none extended as far as mid-falx cerebri levels in any of the 16 cases. They communicated with either superior or inferior sagittal sinuses, but not with both of these sinuses. In the middle third of the falx cerebri, the majority of the vessels of the falcine venous plexus had larger diameter compared to those of the anterior third. These vessels extended the length of the falx cerebri levels. They communicated with both superior and inferior sagittal sinuses. In the posterior third of the falx cerebri, the vessels of the falcine venous plexuses had the largest diameter and were located at the junction of the inferior sagittal sinus and the straight sinus. They were localized at the lower two-thirds of the falx cerebri. In all cases, the dense venous networks communicated with the inferior sagittal sinus but not with the superior sagittal sinus. The falcine venous plexus observed in the posterior third of the falx cerebri was denser than in the anterior and middle portions. The SEM revealed small vessels whose diameter ranged between 42 and 138 μm. The vessels of the falcine venous plexus in the anterior third had a mean diameter of 0.42 ± 0.1 mm, in the middle third a mean diameter of 0.87 ± 0.17 mm, and in the posterior third, 1.38 ± 0.21 mm.
The falcine venous plexus is a network of venous channels that exists within the connective tissue of the falx; the sizes and patterns of communication of these structures showed regional differences. Neurosurgeons should be aware of the regional differences when making an incision or puncturing the falx during a surgical approach.
目前仅有少量研究关注镰状窦静脉丛的解剖结构及其临床意义。本研究旨在通过扫描电子显微镜（SEM）评估镰状窦静脉丛的解剖结构，并为神经外科手术入路提供指导。
向矢状窦内注入乳胶或墨水。将镰状窦分为前、中、后三部分（1/3 处），观察位于镰状脑膜结缔组织内的镰状窦静脉丛。进一步评估镰状窦静脉丛的 SEM 外观。
镰状窦的前 1/3 由小直径的镰状窦静脉组成。这些血管靠近上矢状窦或下矢状窦，在 16 例中均未延伸至上矢状窦中部。它们与上矢状窦或下矢状窦相通，但与两者均不相通。在镰状窦的中 1/3 ，镰状窦静脉丛的大多数血管直径均大于前 1/3 的血管。这些血管延伸至整个镰状窦水平。它们与上、下矢状窦相通。在镰状窦的后 1/3 ，镰状窦静脉丛的血管直径最大，位于下矢状窦和直窦的交界处，位于镰状窦的中下 2/3 。所有情况下，密集的静脉网络与下矢状窦相通，但与上矢状窦不通。镰状窦后 1/3 的镰状窦静脉丛比前、中 1/3 更密集。SEM 显示直径为 42 至 138μm 的小血管。镰状窦静脉丛在前 1/3 的平均直径为 0.42±0.1mm，在中 1/3 的平均直径为 0.87±0.17mm，在后 1/3 的平均直径为 1.38±0.21mm。
镰状窦静脉丛是存在于镰状脑膜结缔组织内的静脉通道网络，这些结构的大小和沟通模式存在区域性差异。神经外科医生在手术入路时切开或穿刺镰状窦时应注意这些区域性差异。
