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Superior anastomotic vein

The Superior Anastomotic Vein, commonly known as the Vein of Trolard, is a major superficial cerebral vein that plays a critical role in draining the lateral surface of the cerebral hemispheres. It serves as a vital anastomotic channel between the superficial middle cerebral vein (Sylvian vein) and the superior sagittal sinus. Due to its strategic anatomical position, the vein of Trolard is important in maintaining effective venous outflow from the cerebral cortex, and is often visible in advanced neuroimaging studies.

Synonyms:

  • Superior Anastomotic Vein

  • Vein of Trolard

  • Vena anastomotica superior

Function:

  • Connects the superficial middle cerebral vein (Sylvian vein) with the superior sagittal sinus.

  • Drains blood from the cortical surfaces, especially the parietal and posterior frontal regions.

  • Serves as an important collateral pathway for venous drainage if primary routes are compromised.

MRI Appearance:

  • T2-weighted Images:

    • Appears as a flow void (signal loss) due to fast-flowing blood within the vein.

    • Typically seen as a linear or tubular hypointense structure in the high parietal convexity.

  • T1-weighted Images:

    • Visualized as a flow void, similar to T2, due to the presence of rapidly moving blood.

    • May be difficult to distinguish from other cortical veins unless thrombosed or in specific planes.

  • Phase-Contrast 3D (PC 3D):

    • High sensitivity for venous structures.

    • The vein of Trolard is clearly delineated as a high-signal channel connecting the Sylvian vein to the superior sagittal sinus.

    • Used for mapping cerebral venous anatomy and detecting flow abnormalities.

  • Post-Contrast T1-weighted Images:

    • Enhances strongly, becoming hyperintense relative to brain parenchyma.

    • Provides excellent delineation of the vein’s course and connections.

    • Helpful for identifying anomalies, stenosis, or thrombosis.

CT and CTV Appearance:

  • CT (Non-contrast):

    • The vein is usually not well seen on standard non-contrast CT.

    • May appear as a subtle linear density if calcified or if thrombosed (hyperdense).

  • CT Venography (CTV):

    • Clearly visualized as an enhancing linear/tubular structure on the cortical surface.

    • Easily traced from the superficial middle cerebral vein to the superior sagittal sinus.

    • Useful for assessing patency, thrombosis, or anatomical variations.

MRI images

Superior anastomotic vein (Trolard) MRI 3T axial image

MRI images

Superior anastomotic vein (Trolard) MRI 3T coronal image

MRI images

Superior anastomotic vein MRI 3T mip sagittal image