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Straight Sinus

sinus rectus

The straight sinus runs in the junction of the falx cerebri and the tentorium cerebelli from the great cerebral vein of Galen anteriorly to the confluence of sinuses posteriorly. It drains the deep venous system of the brain, receiving the great cerebral vein (which drains both internal cerebral veins and the basal veins of Rosenthal) along with the inferior sagittal sinus from the inferior falx margin.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The straight sinus drains the deep white matter and basal ganglia via the great cerebral vein, making it critical for deep cerebral venous drainage. Thrombosis of the straight sinus produces bilateral thalamic and basal ganglia infarction, causing altered consciousness, vertical gaze palsy, and coma. Vein of Galen malformations in neonates can produce high-output cardiac failure from large arteriovenous shunting into the straight sinus system. The straight sinus is a landmark in the tentorial notch and in approaches to the pineal region.

Pathology

Common Injuries & Conditions

Deep Cerebral Venous Thrombosis

Thrombosis of the straight sinus and internal cerebral veins produces bilateral thalamic oedema and infarction with abrupt impairment of consciousness, vertical gaze palsy, and decerebrate posturing; a catastrophic CVST variant with high mortality requiring urgent anticoagulation.