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Vein of Trolard

vena anastomotica superior Trolardi

The vein of Trolard (superior anastomotic vein) connects the middle cerebral vein system in the Sylvian fissure to the superior sagittal sinus across the parietal convexity. It drains the parietal and superior temporal cortex and is the largest cortical bridging vein in many individuals. When dominant, it must be protected during parasagittal and parietal craniotomy approaches.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The vein of Trolard is the superior counterpart of the vein of Labbe, and the two form the dominant cortical venous drainage of the temporal and parietal lobes. Either may be dominant; when Trolard is large, injury during parietal craniotomy causes superior parietal and sensorimotor cortex venous infarction. Subdural haematoma from bridging vein rupture most commonly involves the bridging veins including the Trolard in their course from cortex to the superior sagittal sinus. Preoperative MR venography maps these veins before all parasagittal procedures.

Pathology

Common Injuries & Conditions

Bridging Vein Rupture Causing Subdural Haematoma

The vein of Trolard and similar large cortical bridging veins crossing from the parietal cortex to the superior sagittal sinus are ruptured by head acceleration-deceleration in trauma, producing acute or chronic subdural haematoma that compresses the underlying cortex and requires surgical evacuation.