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Vein of lateral recess of fourth ventricle

The vein of the lateral recess of the fourth ventricle is a small but significant venous structure located in the posterior fossa of the brain. It courses along the lateral recess of the fourth ventricle and is responsible for draining venous blood from this region into the adjacent cerebellar veins or the petrosal veins. Although rarely visualized in standard neuroimaging due to its size, it is important in neurovascular anatomy and pathology, especially in the context of posterior fossa surgery or vascular malformations.

Synonyms

  • Lateral recess vein of fourth ventricle

  • Vein of lateral recess

  • Vein of Luschka (less commonly, can cause confusion with the foramen)

  • Lateral pontine vein (occasionally, if draining pattern overlaps)

Function

  • Drains venous blood from the lateral recess region of the fourth ventricle

  • Contributes to venous drainage of adjacent cerebellar tissue

  • May connect with petrosal veins or superior petrosal sinus

  • Plays a role in maintaining cerebrospinal fluid (CSF) dynamics by draining venous blood away from the fourth ventricle area

MRI Appearance

  • T2-weighted imaging:

    • Appears as a flow void (signal loss) due to rapid blood flow

    • Difficult to visualize unless dilated or in high-resolution images

    • Sometimes seen as a thin hypointense linear structure along the lateral recess

  • T1-weighted imaging:

    • Generally not visualized due to small size and rapid blood flow

    • If visualized, appears as a hypointense (dark) line

  • 3D Phase Contrast MR Venography (PC 3D MRV):

    • Best sequence for visualization if the vein is of sufficient caliber

    • Seen as a thin, enhancing venous structure extending from the lateral recess

    • Useful for mapping venous anatomy in pre-surgical planning

  • Post-Contrast T1-weighted imaging:

    • May show faint linear enhancement if the vein is large enough

    • Small veins often not visualized unless there is pathological dilation or venous congestion

CT and CTV Appearance

  • CT (Non-contrast):

    • Typically not visualized due to small caliber and lack of contrast

    • May be indirectly inferred if there is abnormal density or hemorrhage in the region

  • CT Venography (CTV):

    • May show as a thin enhancing vein if of sufficient size and high-resolution imaging is used

    • Best seen in cases of venous malformation or dilation

    • Otherwise, often below the threshold of detection for routine CTV

MRI images

Vein of lateral recess of fourth ventricle Axial MRI 3T image

MRI images

Vein of lateral recess of fourth ventricle coronal MRI 3T image