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Topic

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Superior vermian vein

The superior vermian vein is a midline superficial cerebellar vein that drains blood from the superior aspect of the cerebellar vermis. It courses posteriorly along the superior surface of the cerebellum, typically joining the vein of Galen (great cerebral vein) either directly or through the internal cerebral veins. This vein plays an essential role in draining the superior cerebellar vermis and adjacent cerebellar hemispheres, contributing to the deep venous system of the brain.

Synonyms

  • Vein of the superior vermis

  • Midline superior cerebellar vermian vein

  • Superior cerebellar vermian vein

Function

  • Drains venous blood from the superior vermis of the cerebellum

  • Contributes to the deep venous system, connecting to the vein of Galen

  • Maintains cerebellar venous outflow and pressure balance

  • Provides collateral venous pathways in case of venous obstruction

MRI Appearance

T1-weighted images (non-contrast):

  • Appears as a linear or curvilinear hypointense structure (flow void) along the superior vermis

  • Best seen in sagittal or coronal sections

T2-weighted images:

  • Demonstrates a flow void (dark signal) due to fast venous blood flow

  • Surrounding cerebellar parenchyma appears intermediate to high signal intensity

MRA / MR Venography:

  • TOF (time-of-flight) MR venography or contrast-enhanced MRV shows the superior vermian vein as a bright enhancing venous channel draining into the vein of Galen

  • Useful for detecting venous anomalies, thrombosis, or collateral venous patterns

T1 Post-Contrast (Gadolinium-enhanced MRI):

  • Enhances strongly and homogeneously, allowing precise delineation of its origin, course, and termination

  • Contrast-enhanced MRV is often combined for best evaluation

CT Appearance

Non-contrast CT:

  • Normally not visible unless thrombosed, in which case it may appear hyperdense (cord sign) in the midline posterior fossa

CT Venography (CTV):

  • Clearly shows the course along the superior vermis, draining into the vein of Galen

  • Enhances brightly with contrast, allowing detection of thrombosis, compression, or venous anomalies

  • Valuable for preoperative mapping and venous outflow assessment

MRI images

Superior Vermian Vein mri sagittal image -img-00000-00000

MRI images

Superior vermian vein