Diodrast Studies of the Vertebral and Cranial Venous Systems to Show Their Probable Role in Cerebral Metastases

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Abstract
Cerebral metastases secondary to pathology in the pelvis, or of the genito-urinary tract, in the absence of metastases to the lung and without a patent foramen ovale or other congenital cardiac defect, point to other modes of hematogenic spread. It is known that venous emboli frequently move in a direction opposite to that of their usual flow. This is particularly true in the vertebral veins where there is an absence of valves and frequent reversals of blood flow as a result of postural changes and variations in intrathoracic and intra-abdominal pressures. To determine the extent of connections between various venous plexuses, the vertebral system and cranial venous sinuses, diodrast studies were made in 12 cadavers and by 22 injns. in living humans. The close relationship of intravertebral and intracranial venous systems with veins of prostate, kidneys, lungs, breast and thyroid was readily demonstrated in cadavers. The shunting of blood from the systemic circulation into the vertebral venous system was demonstrated in living subjects. The observations are supporting evidence of routes for spread of metastases via the vertebral venous system from distant primary foci to the cerebrum.