Anatomic variations of the deep cerebral veins: a susceptibility-weighted imaging study in a population of Côte d’Ivoire and surgical implications

Purpose A precise understanding of the anatomic variations of the deep cerebral veins is a prerequisite for safe neurosurgical intervention in the third ventricular region. This study aimed to delineate the anatomy and prevalence of variations of the deep cerebral veins using Susceptibility-Weighted Imaging (SWI) in a population of Côte d’Ivoire. Methods In this retrospective study, 303 normal brain magnetic resonance imaging (MRI) examinations (606 cerebral hemispheres) performed on a 3 Tesla system were analyzed. SWI sequences were evaluated to determine the visualization rates of eight deep cerebral veins, assess inter-hemispheric symmetry, and classify anatomic variants of the thalamostriate (TSV), anterior septal (ASV), and anterior caudate (ACNV) veins. Results The lateral direct thalamic vein demonstrated the highest visualization rate (99.33%), while the superior choroidal vein demonstrated the lowest (41.66%). The deep venous network was asymmetric in 76.57% of subjects. The TSV-ASV junction was most frequently Type IA (57.5%). A statistically significant lateralization was observed, with Type IIA being more prevalent in the right hemisphere (p = 0.015). The ACNV drained predominantly into the TSV (78.7%), with significant inter-hemispheric differences in its drainage pattern (p < 0.001). Conclusion SWI provides excellent visualization of the deep cerebral venous system. The high prevalence of anatomic variations and inter-hemispheric asymmetries documented herein, including the significant lateralization of the Type IIA TSV-ASV junction, provides crucial anatomic data for preoperative planning, potentially minimizing vascular risk during transcallosal-transforaminal approaches to the third ventricle.