Transclival Venous Circulation: Anatomic Study.

Document Type


Publication Date


Publication Title

World Neurosurg


Anatomy; Clival diploic veins; Clivus; Emissary veins; Transclival veins; Aged; Aged, 80 and over; Cadaver; Cerebral Veins/physiology; Cranial Fossa, Posterior/blood supply; Female; Humans; Male; Middle Aged


INTRODUCTION: The clivus is a small, central area of the basal cranium with limited surgical access and high morbidity associated with pathologies of its surrounding structures. Therefore thorough knowledge and understanding of the anatomy in this region are crucial for the success of treatments and interpretation of imaging. As to our knowledge, there is no extant cadaveric examination of the transclival veins, so the present study was performed.

METHODS: Fifteen lightly embalmed adult heads underwent blue latex injection of the left and right internal jugular veins. Special attention was given to the presence or absence of transclival vessels. When transclival veins were identified, their intracranial source, point of penetration of the clivus and anterior connections were documented.

RESULTS: Ten (66.7%) specimens were found to have transclival veins. These connected the basilar venous plexus to the retropharyngeal venous plexus on all specimens. Eight of the 10 specimens had multiple transclival veins, and 2 had only 1 vessel. The majority of the transclival veins were found penetrating the clivus at its lower one third. However, 2 specimens also had transclival veins that pierced the clivus at its upper one third.

CONCLUSIONS: An improved understanding of the skull base and its venous drainage can assist clinicians and surgeons in better understanding normal, pathologic, and variant anatomy in this region.

Clinical Institute

Neurosciences (Brain & Spine)