Vascular engineering of the vertebral venous drainage system

Abstract The recent distribution infra‐cranial distribution of malignant cerebral neoplasms has prompted a search for possible routes to explain such spread. The intimate connections of the intracerebral veins with the vertebral venous system, the close proximity of cerebral neoplasms to the ventricular system, and the postural hemodynamics of a largely valveless drainage system have all added another dimension to the vertebral venous circulation described by Batson. This flow pattern ascended from the sacrum to the skull. An inferior “reverse” flow is now proposed by which neoplastic cells may extend into the cervical and mediastinal lymph nodes, breast, liver, or lung.