The vertebral vein is a paired blood vessel that is found on either side of the neck. As a single vessel, it is formed at the level of the sixth cervical vertebra (C6). Its initial part is a venous plexus that goes through the transverse foramina of the cervical vertebrae.

The beginning of the plexus, which later forms a single vertebral vein, is found within the suboccipital triangle at the level of the atlas (C1). Numerous small tributaries arising from the internal vertebral plexuses leave the vertebral canal above the posterior atlantal arch and join with small veins coming from the suboccipital plexus.

Additionally, the mentioned veins are joined by the branches of the occipital vein. All these mentioned vessels anastomose and form a venous plexus that accompanies and surrounds the vertebral artery.

The venous plexus enters the transverse foramen of the atlas (C1) and passes downward through the transverse foramina of the cervical vertebrae until it reaches the transverse foramen of the sixth cervical vertebra (C6). Here, these veins unite to form a single trunk - the vertebral vein.

After the vertebral vein emerges from the transverse foramen of the sixth cervical vertebra (C6), it descends anterior to the vertebral artery. The vertebral vein crosses the first part of the subclavian artery anteriorly, going posterior to the internal jugular vein. And finally, it ends by draining into the posterior aspect of the brachiocephalic vein (Read more!).

The vertebral vein and its precursor venous plexus receive several tributaries, including the following:

Branches from the occipital vein
Muscular veins coming from the suboccipital and prevertebral muscles
Branches from the internal vertebral plexus
Branches from the external vertebral plexus
Anterior vertebral vein
Deep cervical vein
First intercostal vein (occasionally)

Overall, the vertebral vein collects deoxygenated blood from the cervical part of the spine and deep upper neck muscles, including the prevertebral and suboccipital muscles.

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Vertebral vein