Asset Details
Do you wish to reserve the book?
The cuneus vein: initial anatomical description and preservation technique for posterior interhemispheric approaches
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
The cuneus vein: initial anatomical description and preservation technique for posterior interhemispheric approaches
Do you wish to request the book?
The cuneus vein: initial anatomical description and preservation technique for posterior interhemispheric approaches
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
The cuneus vein: initial anatomical description and preservation technique for posterior interhemispheric approaches
2026
Overview
Background and objective
The posterior interhemispheric approach provides optimal access to lesions located in a number of areas. A major advantage of this approach is that the parieto-occipital vein is typically the only venous structure encountered, which minimizes venous interference during exposure. In a surgical series of 12 patients, we identified a previously undescribed venous variant extending from the cuneus to the falx cerebri. Here, we characterize this venous structure and propose a microsurgical strategy to preserve it.
Methods
A total of 303 posterior interhemispheric approaches were performed from September 2005 to August 2025. We retrospectively reviewed clinical and radiological data collected from patients’ electronic medical records and searched the operative database to locate surgical videos.
Results
In 12 patients undergoing the posterior interhemispheric approach (12/303, 4%), we identified a previously unreported venous variation in which a cortical vein extended from the cuneus to the falx cerebri. We have termed this structure the
cuneus vein
. Among these 12, 2 were observed during a right-sided approach (2/157, 1.3%) and 10 during a left-sided approach (10/146, 6.8%). The vein-releasing technique was used in 7 patients, while the falx-cutting technique was done in 4. In all but one patient, the cuneus vein was successfully preserved. In one patient with hydrocephalus, excessive brain relaxation after CSF drainage limited mobilization and caused vein injury, without hemorrhagic or ischemic morbidity during follow-up.
Conclusions
The cuneus vein, a cortical vein extending from the cuneus to the falx cerebri, is an anatomical variation that has not been described previously but requires careful consideration during the posterior interhemispheric approach. The cuneus vein drains the visual cortex; thus, its sacrifice may lead to postoperative complications, including visual deficits secondary to venous infarction. In this study, we identified and characterized this venous variation and demonstrated its preservation using the vein-releasing technique and the falx-cutting technique.
