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Superior vein of vermis

The superior vein of vermis is a small but significant midline venous structure located on the dorsal aspect of the cerebellar vermis. It serves as a critical draining vein for the superior part of the cerebellar vermis, collecting blood from adjacent cerebellar tissue and channeling it superiorly into the vein of Galen (great cerebral vein). Recognizing its imaging appearance is vital in neuroimaging to distinguish it from pathologic vascular structures and to assess cerebellar venous drainage, especially in cases of posterior fossa disease or malformations.

Synonyms

  • Superior vermian vein

  • Superior cerebellar vermian vein

  • Vein of the superior vermis

  • Superior median cerebellar vein

Function

  • Drains the superior (dorsal) aspect of the cerebellar vermis

  • Empties into the vein of Galen (great cerebral vein)

  • Participates in venous drainage of the midline cerebellum

  • Helps regulate venous outflow and pressure in the posterior fossa

MRI Appearance

  • T2-Weighted MRI

    • Appears as a flow void (hypointense/black signal) in the midline above the cerebellar vermis

    • Thin linear or curvilinear structure

    • Occasionally, may appear as a serpiginous hypointense line paralleling the dorsal vermis

  • T1-Weighted MRI

    • Appears as a hypointense (dark) linear structure in the midline above the cerebellar vermis

    • Flow-related signal loss is typical

    • Difficult to visualize unless dilated or thrombosed

  • 3D Phase Contrast (PC 3D) MRI / MR Venography

    • Superior vein of vermis is more conspicuous

    • Visualized as a small, linear venous channel draining into the vein of Galen

    • Enhances the anatomy of posterior fossa veins

    • Aids in mapping cerebellar venous drainage

  • Post-Contrast T1 MRI

    • Shows linear or curvilinear enhancement in the midline above the cerebellar vermis

    • Enhancement is usually subtle due to the small caliber of the vein

    • More apparent in cases of venous engorgement, thrombosis, or adjacent pathology

CT & CTV Appearance

  • Non-Contrast CT

    • Usually not visualized due to small size and isodensity with adjacent brain tissue

    • May appear as a faint linear hypodensity if dilated or calcified (rare)

  • CT Venography (CTV)

    • Demonstrated as a thin, linear, midline enhancing vessel above the cerebellar vermis

    • Best appreciated on reformatted venous phase images

    • Seen draining into the vein of Galen

MRI images

Superior vein of vermis axial mri 3t image1

MRI images

Superior vein of vermis MRI 3T coronal image

MRI images

Superior vein of vermis MRI 3T sagittal image