Aim: The aim of this article is to describe the microsurgical anatomy of the cavernous sinus, the triangles, and the osseous relationships in the region with special attention to the relationships important in surgical approaches on the intracavernous structures.
Material And Methods: Fifty cavernous sinuses obtained from twenty-five cadaver heads were studied in detail using magnification. Stepwise dissections of the cavernous sinuses performed to demonstrate the intradural and extradural routes, anatomy of the triangles and osseous relationships in the region.
Results: The main branches of the intracavernous portion of the carotid artery were the meningohypophyseal, the inferior cavernous sinus, and McConnell;s capsular artery . The main branches of the meningohypophyseal trunk were the tentorial, the dorsal meningeal, and the inferior hypophyseal artery. There were variations of the main branches of the meningohypophyseal trunk. The sixth cranial may splite into rootlets as it passes lateral to the carotid artery. There were size and shape variation of the triangles.
Conclusion: Aprecise understanding of the bony relationships, the anatomy of the triangels and neurovascular content of the cavernous sinus, together with the use of cranial base and microsurgical techniques are necessary for safer surgery. Asingle approach is not capable of providing exposure of all parts of the sinus.
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http://dx.doi.org/10.5137/1019-5149.JTN.2343-09.1 | DOI Listing |
J Clin Neurosci
January 2025
Department of Neurological Surgery and Rosa Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Electronic address:
Background And Objective: Radiosurgery can serve as a primary, adjuvant, or salvage treatment modality for cavernous sinus tumors (CST), providing high tumor control. However, particularly with cavernous sinus expansion, there may be insufficient distance from the optic apparatus to perform radiosurgery safely. The internal carotid artery adjacent to the distal dural ring (ICAddr), when enhancing similarly to the CST, can be difficult to delineate, and can lead to over-contouring of target volume near the optic nerve and therefore increasing the risk of radiation-induced optic toxicity.
View Article and Find Full Text PDFJ Pak Med Assoc
January 2025
Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan.
Tolosa-Hunt Syndrome (THS) is an exceptionally rare disorder characterised by recurrent episodes of excruciating ophthalmoplegia, commonly affecting one side of the face and involving the third, fourth, sixth, and fifth cranial nerves. This syndrome results from non-specific inflammation affecting the cavernous sinus, superior orbital fissure (SOF), and/or orbital apex. In this case report, we present the clinical features, diagnostic evaluation, and management of a 46-year-old female with THS.
View Article and Find Full Text PDFWorld Neurosurg
January 2025
Faculdade de Medicina da Universidade de São Paulo, University of São Paulo, São Paulo, Brazil.
Oper Neurosurg (Hagerstown)
February 2025
Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester , Minnesota , USA.
Background And Objectives: The coexistence of complete carotico-clinoid bridge (CCB), an ossification between the anterior (ACP) and the middle clinoid (MCP), and an interclinoidal osseous bridge (ICB), between the ACP and the posterior clinoid (PCP), represents an uncommonly reported anatomic variant. If not adequately recognized, osseous bridges may complicate open or endoscopic surgery, along with the pneumatization of the ACP, especially when performing anterior or middle clinoidectomies.
Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, a systematic scoping review was conducted up to June 5, 2023.
Climate change has caused heat stress (HS) to become an increasingly severe problem for high-producing dairy herds. Although cooling systems allow milk production to remain nearly constant throughout the year, fertility decreases during summer. Physiological counter-current heat transfer mechanisms maintaining brain/hypothalamic and reproductive functions in cattle are vulnerable to HS.
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