Why we
have not discussed the cerebral veins
Infarction or hemorrhage caused by problems in the venous rather than the arterial
system is fairly rare. Often the cause of venous thrombosis is one of the hypercoagulability
states or blood volume depletion, and it is usually large veins and sinuses that
are most affected.
To put it simply, what happens is that blockage of a large vein can 'back up'
the circulation in a region, causing decreased arterial flow which in turn produces
ischemia and infarction. Clinical findings in these patients usually do
not reflect the typical arterial territory syndromes that you have been learning
about. One of the reasons for this may be that there are far more functional anastomoses
in the venous than in the arterial system. For all these reasons, problems secondary
to occlusion of cerebral veins are not particularly helpful in learning about
the territories supplied by the cerebral arteries.