The vulnerability of the vein of Labbe during combined craniotomies of themiddle and posterior fossae

During combined middle and: posterior cranial fossae ("petrosal") approache s to the skull base, the anastamotic vein of Labbe, which, bridges between the inferior surface of the temporal lobe and the transverse sinus is place d at risk. Occlusion of this vein, which map drain a large section of the t emporal and parietal lobes, may lead to speech, memory, and/or other cognit ive disorders. Labbe may be injured along its course on the inferior aspect of the temporal lobe where it may be lacerated during dural-incision or th rombosed due to prolonged or overly vigorous retraction. The anastamotic se gment of the vein, which bridges between the temporal lobe and transverse s inus, may be avulsed during elevation of the temporal lobe or injured durin g tentorial division, Labbe may course in close proximity to the upper surf ace of the tentorium or even travel within it for a short segment of its co urse en route to the transverse sinus. This article reviews the anatomy of the vein of Labbe, discusses its clinical significance, and highlights the technical points relevant to the preservation of this important structure.