Inferior anastomotic vein
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At the time the article was created Frank Gaillard had no recorded disclosures.View Frank Gaillard's current disclosures
At the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
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The inferior anastomotic vein, also known as the vein of Labbé, is part of the superficial venous system of the brain.
The vein of Labbé is the largest venous channel on the lateral surface of the brain that crosses the temporal lobe between the Sylvian fissure and the transverse sinus. It courses posteroinferiorly from the mid-Sylvian fissure connecting the superficial middle cerebral vein (Sylvian vein) to the anterolateral portion of the transverse sinus.1
The frequency with which the vein of Labbé is identified varies across publications and modalities and is anywhere between 25-97% of cases. Its location is also highly variable 1:
mid-temporal region: 60%
posterior temporal: 30%
anterior temporal: 10%
The anatomy of the vein itself is also variable, with a dominant single channel, multiple branching channels and even venous lakes having been described. It may drain directly into the transverse sinus or indirectly via the tentorium and its presence is less variable than the superior anastomotic vein of Trolard 3.
Along with draining the brain immediately adjacent to it, the vein of Labbé also gathers draining tributaries from medial, anteroinferior, and posteroinferior temporal lobe in 80% of cadaveric dissection.
As can be surmised by first principles, there is an inverse relationship between the size of the terminal Sylvian vein, the vein of Trolard, and the vein of Labbé, as all three share a similar drainage territory 3, 4. Usually either the vein of Labbé or Trolard are dominant, both are small with the Sylvian vein being dominant or both are co-dominant with a small Sylvian vein. Occasionally the veins of Labbé and Trolard anastomose with themselves and bypass the Sylvain vein 3.
Surgically it is of importance in planning temporal lobectomy for refractory temporal epilepsy, as the vein should be preserved, often requiring some cortical tissue to be left behind. This is especially the case in the 10% of cases where the vein is located anteriorly.
History and etymology
It is eponymously named after French surgeon Charles Labbé (1851-1889) who described it in his 3rd year of medical school in 1879.1 He published an article on the venous circulation of the brain when supervised by the prominent surgeon Paul Jules Tillaux, describing the inferior anastomotic vein and its relationship with the superior anastomotic vein, which had earlier been decsribed by the French doctor and anatomist Jean Baptiste Paulin Trolard 5.
- 1. Sood S, Asano E, Chugani HT. Significance of preserving the vein of Labbé in epilepsy surgery involving temporal lobe resection. J. Neurosurg. 2006;105 (3): 210-3. doi:10.3171/ped.2006.105.3.210 - Pubmed citation
- 2. Susan Stranding DSc SSP. Gray's Anatomy. Churchill Livingstone. (2011) ISBN:0443066841. Read it at Google Books - Find it at Amazon
- 3. Tomasi S, Umana G, Scalia G et al. The Superficial Anastomosing Veins of the Human Brain Cortex: A Microneurosurgical Anatomical Study. Front Surg. 2022;8:817002. doi:10.3389/fsurg.2021.817002 - Pubmed
- 4. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. Cambridge University Press. (2012) ISBN:0521766664. Read it at Google Books - Find it at Amazon
- 5. Benner D, Hendricks B, Benet A, Lawton M. Eponyms in Vascular Neurosurgery: Comprehensive Review of 18 Veins. World Neurosurg. 2021;151:190-200. doi:10.1016/j.wneu.2021.05.053 - Pubmed