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Right Cerebral Hemispheres, Showing the Venous Drainage of the Opercular and Insular Areas

Surgical Correlation

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Right Cerebral Hemispheres, Showing the Venous Drainage of the Opercular and Insular Areas. A, Lateral view. The portion of the SSV posterior to the central sulcus is small, and the anterior portion is large. The SSV receives drainage from the frontosylvian and temporosylvian veins and empties into the sphenoparietal sinus along the sphenoid ridge. The frontosylvian veins drain the inferior frontal gyrus and descend along the anterior horizontal and anterior ascending rami of the sylvian fissure to join the SSV. The temporosylvian veins extend along the superior temporal gyrus. The more posterior temporosylvian veins join into the vein of Labbé. B, Enlarged lateral view of the sylvian fissure. The frontosylvian veins drain the inferior frontal gyrus and descend along the anterior horizontal and anterior ascending rami to join the SSV. The temporosylvian veins cross the superior temporal gyrus to join the SSV. C, Lateral view. The sylvian fissure has been opened to expose the relationship between the SSV and the insular drainage. Frontosylvian tributaries of the SSV drain a portion of the middle and posterior short insular gyri. The frontoorbital ramus, the least frequently occurring of the four rami of the sylvian fissure, is located inferior to the anterior horizontal ramus and is crossed by the frontoorbital vein. D, Enlarged lateral view of C. Drainage of the insular apex and middle short gyrus occurs predominantly through the frontosylvian tributaries of the SSV. Photographs obtained during stepwise dissections of right cerebral hemisphere to display the relationship between the SSV and insular veins (E and F). E, Lateral view. The frontosylvian and parietosylvian veins empty into the SSV. The temporosylvian veins cross the superior temporal gyrus to empty predominantly into the vein of Labbé. F, The frontal and temporal opercula have been retracted to expose the connections between the SSV and insular veins. The precentral insular vein drains the posterior short gyrus and empties into the SSV. The frontosylvian tributaries of the SSV drain the middle short gyrus and insular apex. The anterior insular vein drains the anterior short gyrus and descends to terminate into the deep MCV near the limen area. (Images courtesy of AL Rhoton, Jr.)

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