It is a short trunk formed by the union of the two internal cerebral veins and basal vein of Rosenthal. It lies in the quadrigeminal cistern. It curves backward and upward around the posterior border of the splenium of the corpus callosum to drain into the confluence of the inferior sagittal sinus and the anterior extremity of the straight sinus.
It receives numerous tributaries:
precentral cerebellar vein
superior cerebellar veins
inferior cerebral veins (draining medial inferior temporal lobe)
Quiñones-Hinojosa, et al. 1) described a bilateral occipital transtentorial/transfalcine approach for large falcotentorial meningiomas. They ligated and cut the transverse sinus after checking the patency of the occluded sinus, and used permanent aneurysmal clips to ligate the vein of Galen when the straight sinus was occluded. The area above and below the tentorium can provide wide exposure and reduce occipital lobe retraction during prolonged operation times. Moreover, this approach may allow surgeons some form of intraoperative flexibility in terms of their surgical plan.