Posterior condylar canal: Anatomy and medical insights
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https://doi.org/10.37085/nsa.2025.1Keywords:
Cranial venous system, Neuroanatomy, Neurosurgery, Posterior cranial fossaAbstract
Introduction
The importance of the posterior condylar canal lies in its role as a pathway for venous drainage of the brain and its relevance for surgical approaches in the region.
Objective
To describe the posterior condylar canal in the context of the skull’s emissary foramina, its development, frequency, morphological/morphometric aspects of clinical/ surgical importance.
Methods
A human anatomical specimen displaying significant morphological variations of the posterior condylar canal is presented. A review is undertaken and further illustrated using anatomical dissections of injected cadaveric heads and dry skulls.
Results
The posterior condylar canal and its emissary vein form a connection between jugular and vertebral plexus venous systems. They can be activated during positional changes and reversible/permanent blocks in drainage through the jugular system - therefore its neurosurgical importance. These structures should be dealt with during lateral approaches to the posterior cranial fossa, requiring understanding of its path, size and variations. Considered a developmental selection induced by bipedalism and a characteristic of the human species, this anatomical feature should be understood within the context of emissary foramina and other structures involved in venous drainage of the head.
Conclusion
Awareness of role and variations of the posterior condylar canal are important when analysing the pattern of venous drainage to plan postero-lateral approaches to the posterior fossa. This knowledge is required to safely customize surgical approaches to a patient’s specific needs. Lack of uniform methodology may explain differences in frequency/morphology of PCC in the literature and justify gathering new data into this subject.
References
Ginsberg LE. The posterior condylar canal. AJNR Am J Neuroradiol 1994;15:969–72.
Boyd GI. The Emissary Foramina of the Cranium in Man and the Anthropoids. J Anat 1930;65:108–21.
Alghamdi MA, Honnegowda TM, Nautiyal A, Deepanjan M. Radiological and Morphometric Study of the Emissary Foramens and Canal in the Posterior Cranial Fossa of the Human Skull with Its Neurosurgical Significance. Asian J Neurosurg 2022;17:588–94. Doi:10.1055/s-0042-1757429.
Haas LL. The Posterior Condylar Fossa, Foramen and Canal, and the Jugular Foramen. Radiology 1957;69:546–52. Doi:10.1148/69.4.546.
Ferreira MR de S, Magalhães CP, Lima MCM de, Valença MM. Historical skull illustrations: Parietal foramen. Neurological Surgery and Anatomy 2024;1:72–6. Doi:10.37085/nsa.2024.16.
Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL. Microsurgical Anatomy for Lateral Approaches to the Foramen Magnum with Special Reference to Transcondylar Fossa (Supracondylar Transjugular Tubercle) Approach. Skull Base 1998;8:119–25. Doi:10.1055/s-2008-1058570.
Martins C, Yasuda A, Campero A, Ulm AJ, Tanriover N, Rhoton A. Microsurgical Anatomy of the Dural Arteries. Operative Neurosurgery 2005;56:ONS-211-ONS-251. Doi:10.1227/01.NEU.0000144823.94402.3D.
San Millán Ruíz D, Gailloud P, Rüfenacht DA, Delavelle J, Henry F, Fasel JHD. The craniocervical venous system in relation to cerebral venous drainage. AJNR Am J Neuroradiol 2002;23:1500–8.
Berge JK, Bergman RA. Variations in size and in symmetry of foramina of the human skull. Clinical Anatomy 2001;14:406–13. Doi:10.1002/ca.1075.
Forte V, Turner A, Liu P. Objective tinnitus associated with abnormal mastoid emissary vein. J Otolaryngol 1989;18:232–5.
Kapakin S. An Unusual Anatomic Variation of the Jugular Foramen with Doubled Posterior Condylar Canal. International Journal of Morphology 2011;29:1186–8. Doi:10.4067/S0717-95022011000400019.
Falk D. Evolution of cranial blood drainage in hominids: Enlarged occipital/marginal sinuses and emissary foramina. Am J Phys Anthropol 1986;70:311–24. Doi:10.1002/ajpa.1330700306.
Louis RG, Loukas M, Wartmann CT, Tubbs RS, Apaydin N, Gupta AA, et al. Clinical anatomy of the mastoid and occipital emissary veins in a large series. Surgical and Radiologic Anatomy 2009;31:139. Doi:10.1007/s00276-008-0423-5.
Ferreira MR de S, Galvão APO, Lima PTMB de Q, Lima AMB de Q, Magalhães CP, Valença MM. The parietal foramen anatomy: studies using dry skulls, cadaver and in vivo MRI. Surgical and Radiologic Anatomy 2021;43:1159–68. Doi:10.1007/s00276-020-02650-0.
Matsushima K, Kawashima M, Matsushima T, Hiraishi T, Noguchi T, Kuraoka A. Posterior condylar canals and posterior condylar emissary veins—a microsurgical and CT anatomical study. Neurosurg Rev 2014;37:115–26. Doi:10.1007/s10143-013-0493-7.
Verma R, Kumar S, Rai A, Mansoor I, Mehra R. The anatomical perspective of human occipital condyle in relation to the hypoglossal canal, condylar canal, and jugular foramen and its surgical significance. J Craniovertebr Junction Spine 2016;7:243. Doi:10.4103/0974-8237.193258.
Okudera T, Huang YP, Ohta T, Yokota A, Nakamura Y, Maehara F, et al. Development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol 1994;15:1871–83.
Pekcevik Y, Pekcevik R. Why should we report posterior fossa emissary veins? Diagnostic and Interventional Radiology 2013. Doi:10.5152/dir.2013.13203.
O’Connor WJ, Cook AW, Bedo AW. Varix of the sigmoid sinus; persistent emissary veins. Pediatrics 1955;15:768–70.
Murlimanju B v, Chettiar G, Krishnamurthy A, Pai M, Saralaya V, Prabhu L, et al. The paracondylar skull base: anatomical variants and their clinical implications. Turk Neurosurg 2014. Doi:10.5137/1019-5149.JTN.11850-14.1.
Ohta T, Waga S, Handa H, Nishimura S, Mitani T. Sinus pericranii. J Neurosurg 1975;42:704–12. Doi:10.3171/jns.1975.42.6.0704.
Lambert PR, Cantrell RW. Objective tinnitus in association with an abnormal posterior condylar emissary vein. Am J Otol 1986;7:204–7.
Epstein HM, Linde HW, Crompton AR, Cine IS, Eckenholf JJE. The Vertebral Venous Plexus as a Major Cerebral Venous Outflow Tract. Anesthesiology 1970;32:332–40. Doi:10.1097/00000542-197004000-00007.
Pearce JMS. Queckenstedt’s manoeuvre. J Neurol Neurosurg Psychiatry 2006;77:728–728. Doi:10.1136/jnnp.2005.083618.
Mueller SM, Reinertson JE. Reversal of emissary vein blood flow in achondroplastic dwarfs. Neurology 1980;30:769–769. Doi:10.1212/WNL.30.7.769.
Cabanac M, Brinnel H. Blood flow in the emissary veins of the human head during hyperthermia. Eur J Appl Physiol Occup Physiol 1985;54:172–6. Doi:10.1007/BF02335925.
Marsot-Dupuch K, Gayet-Delacroix M, Elmaleh-Bergès M, Bonneville F, Lasjaunias P. The Petrosquamosal Sinus: CT and MR Findings of a Rare Emissary Vein. AJNR Am J Neuroradiol 2001;22:1186–93.
Rivet DJ, Goddard JK, Rich KM, Derdeyn CP. Percutaneous transvenous embolization of a dural arteriovenous fistula through a mastoid emissary vein. J Neurosurg 2006;105:636–9. Doi:10.3171/jns.2006.105.4.636.
Reis CVC, Deshmukh V, Zabramski JM, Crusius M, Desmukh P, Spetzler RF, et al. Anatomy of the mastoid emissary vein and venous system of the posterior neck region: neurosurgical implications. Operative Neurosurgery 2007;61:193–201. Doi:10.1227/01.neu.0000303217.53607.d9.
Wen HT, Rhoton AL, Katsuta T, Oliveira E de. Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg 1997;87:555–85. Doi:10.3171/jns.1997.87.4.0555.
