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Vertebral vein !

The vertebral vein is a vein network running with the vertebral artery through the neck vertebrae; it drains blood from the neck.

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What it is

A vein network running with the vertebral artery through the transverse holes of the neck vertebrae.

What it does

Drains blood from the neck and the vertebral venous plexus.

Key facts

Drains
Suboccipital venous plexus, internal vertebral venous plexus, deep neck muscles; descends through the transverse foramina (usually C1–C6)
Into
Brachiocephalic vein at the root of the neck

Relations

Course
From the suboccipital venous plexus it descends with the vertebral artery through the transverse foramina, leaves through C6 (sometimes C7) and runs down in front of the artery to the back of the brachiocephalic vein
In front
Internal jugular vein at the root of the neck
Behind
Vertebral artery (first part) and, lower, the subclavian artery

How to find it

It cannot be felt. After leaving the C6 foramen it descends anterior to the first part of the subclavian artery, ending in the back of the brachiocephalic vein, near where that vein forms.

On imaging

Rarely assessed on its own. On contrast CT or MR angiography of the neck it is the enhancing venous plexus round the vertebral artery in the transverse foramina, leaving through the C6 foramen; the C7 foramen often holds only a vein. Knowing it avoids mistaking it for a dissection or a mass and helps plan foraminal surgery. Doppler ultrasound shows it beside the artery.

Clinical notes

  • The venous plexus in the transverse foramen and around the C2 nerve root bleeds readily in foraminotomy, uncinate resection and C1–C2 exposure; it is controlled with packing and haemostatic material
  • Its valveless links with the epidural venous plexus are a route for infection and tumour spread
  • When standing, more blood from the brain drains through the vertebral venous system and less through the internal jugular veins

Anatomical variants

  • It may run as a single vein or a plexus, leave through C7 rather than C6, or end in the subclavian vein; the spinal venous system as a whole varies widely

Test yourself

Think of the answer, then tap the question to see it.

Into which vein does the vertebral vein end?

The brachiocephalic vein at the root of the neck, after descending through the transverse foramina.

What usually passes through the C7 transverse foramen?

Only veins (an accessory vertebral vein), not the vertebral artery.

Why can the vertebral vein spread infection and tumour?

It is part of the valveless vertebral venous system (Batson), linked to the epidural venous plexus.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)
vena vertebralis TA2 4780
Official Spanish (DeCS)
Vena vertebral
English (TA2)
Vertebral vein

Sources: Terminologia Anatomica (TA2); Neuroanatomy, Spinal Cord Veins; 20.5 Circulatory Pathways (OpenStax (Rice University), 2022) · adapted, CC BY 4.0.

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Representative model, for educational purposes only.

Vertebral vein highlighted on the Durgical 3D model