The superficial middle cerebral vein (SMCV) commonly drains in the cavernous sinus. Its different drainage variants include preserved segments of the primitive tentorial sinus. In any of these variants, the terminal venous segment of SMCV passes on the base of the skull. The archived computed tomography angiograms of a 58-year-old female case were documented anatomically. On the left side was found the sinus of the lesser sphenoidal wing converging with the middle meningeal vein to form a venous channel located within the Sylvian fissure at 4 mm laterally to the cavernous sinus and trigeminal cavum. That venous channel was thus termed the 'laterocavernous vein'. It drained posteriorly within the superior petrosal sinus. This aberrant vein could interfere unpleasantly with pterional neurosurgical approaches for the Sylvian fissure, cavernous sinus or trigeminal ganglion.
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http://dx.doi.org/10.1007/s00276-022-03038-y | DOI Listing |
BMJ Case Rep
January 2025
Department of Ophthalmology and Visual Sciences, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
A paediatric patient presented with periorbital oedema and fever. Initially, there was low suspicion for cavernous sinus thrombosis and orbital cellulitis due to the presence of full extraocular movements. However, given worsening bilateral periorbital oedema, lethargy and sepsis, neuroimaging was performed demonstrating inflammation and enhancement of the leptomeninges and left cavernous sinus, and raising concern for cavernous sinus thrombosis in the setting of orbital cellulitis.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
The Trauma and Neuroscience Institutes, St. John's Hospital and Medical Center, Tulsa, Oklahoma.
Background: Direct carotid-cavernous fistulas (CCFs) are relatively rare but dangerous complications of penetrating traumatic brain injury or maxillofacial trauma. A variety of clinical signs have been described, including ophthalmological and neurological ones. In some cases, severely altered cerebral blood flow can present as massive life-threatening bleeding through the nose, subarachnoid hemorrhage, and/or intraparenchymal hemorrhage.
View Article and Find Full Text PDFPituitary
January 2025
Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Purpose: Pituitary adenomas, despite their histologically benign nature, can severely impact patients' quality of life due to hormone hypersecretion. Invasion of the medial wall of the cavernous sinus (MWCS) by these tumors complicates surgical outcomes, lowering biochemical remission rates and increasing recurrence. This study aims to share our institutional experience with the selective resection of the MWCS in endoscopic pituitary surgery.
View Article and Find Full Text PDFPurpose: Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid artery and cavernous sinus, often causing ocular symptoms like chemosis, proptosis, and diplopia. Endovascular embolization is the preferred treatment, typically performed via the transfemoral transvenous route through the inferior petrosal sinus (IPS). However, we present a case and a systematic review of indirect CCF treated through deep orbital puncture of the superior ophthalmic vein (SOV) for embolization.
View Article and Find Full Text PDFCancers (Basel)
January 2025
Department of Neurosurgery, Institute of Science Tokyo Hospital, Tokyo 1130034, Japan.
: Resection of tumors invading the cavernous sinus (CS) carries a risk of injury to the cranial nerves and internal carotid artery. Therefore, radical surgery involving lesions around the CS remains challenging, especially for lesions invading the CS, optic sheath, and oculomotor cave. Here, we describe a surgical strategy for meningiomas invading these structures and report on the clinical outcomes.
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