Dural venous sinuses

Last revised by Craig Hacking on 6 Feb 2024

Dural venous sinuses are venous channels located intracranially between the two layers of the dura mater (endosteal layer and meningeal layer) and can be conceptualised as trapped epidural veins. Unlike other veins in the body, they run alone and not parallel to arteries. Furthermore, they are valveless, allowing for bidirectional blood flow from and into intracranial veins. 

Together the dural venous sinuses form the major drainage pathways from the brain, predominantly to the internal jugular veins.

It is important to note that the draining territories of intracranial veins are different from those of arterial territories of the major cerebral arteries. 

The main dural venous sinuses can be classified as midline unpaired sinuses and bilateral sinuses that often drain to midline vessels:

During early embryonic development, the dural venous system evolves from a primary brain plexus via the union of the anterior cardinal vein and sprouts from the dorsal aorta. By week 4 to 5, a primitive capillary network forms, leading to the development of three venous plexuses (anterior, middle, and posterior) that shape the future dural layer. These plexuses link to the primary head sinus, which undergoes lateral migration, transforming into the internal jugular vein. Over time, the primary head sinus diminishes, and bridging veins emerge as primary anastomoses decrease. By the end of the embryonic stage, embryonic sinuses such as the pro-otic and primitive tentorial sinuses appear, laying the groundwork for the mature cranial venous system. In the foetal stages (40-80 mm crown-rump length), the pro-otic sinus matures through chondrocranium and membranous skull formation, with tributaries giving rise to structures like the middle meningeal sinuses, cavernous sinus, and inferior petrosal sinus. Other transformations include the formation of the sphenoid emissary, connections between various veins, and the elongation of sinuses due to cerebral expansion 6.

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Cases and figures

  • Figure 1: venous sinuses
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  • Figure 2: venous sinuses
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  • Figure 3: meningeal layers
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  • Case 1: normal CT venogram
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  • Figure 4: venous vascular territories (illustration)
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  • Figure 5: dural venous development (Gray's illustrations)
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  • Figure 6: dural venous sinuses (Gray's illustrations)
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  • Figure 7: dural venous sinuses (Gray's illustrations)
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  • Figure 8: dural venous sinuses (Gray's illustrations)
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