Implication of the inferolateral trunk of the cavernous internal CAROTID artery in cranial nerve blood supply: Anatomical study and review of the literature

Abstract The inferolateral trunk (ILT) of the internal carotid artery (ICA) is a branch that arises inferiorly from the C4 segment of the cavernous ICA. It provides blood supply to the 3rd, 4th, and 6th cranial nerves, as well as to the gasserian ganglion. The ILT anastomoses to branches of the internal maxillary artery, providing collateral circulation between the external carotid artery and the ICA systems. Retinal and cerebral emboli can arise from the external carotid artery system and travel via the ILT to the ICA. Cranial nerve palsies may result after occlusion of the ILT. We present the cases of four patients who had iatrogenic neurological dysfunction subsequent to intravascular procedures that involved the ILT. These cases provide further clinical confirmation of the importance of this blood vessel. A 5th case involving iatrogenic occlusion of the ILT and no neurological deficit is also presented, demonstrating that the ILT is not the sole blood supply of the cranial nerves in the cavernous sinus.

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Intracavernous branches of the internal carotid artery through an endoscopic endonasal approach: anatomical study and review of the literature

World Neurosurgery ◽

10.1016/j.wneu.2021.04.046 ◽

2021 ◽

Author(s):

Juan Ángel Aibar-Durán ◽

Fernando Muñoz-Hernández ◽

Carlos Asencio-Cortés ◽

Joan Montserrat-Gili ◽

Juan Ramón Gras-Cabrerizo ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Anatomical Study ◽

Endoscopic Endonasal Approach ◽

Endonasal Approach ◽

Review Of The Literature ◽

Endoscopic Endonasal

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Septic Necrosis of the Internal Carotid Artery: A Complication of Peritonsillar Abscess

Otolaryngology ◽

10.1177/019459988309100202 ◽

1983 ◽

Vol 91 (2) ◽

pp. 114-118 ◽

Cited By ~ 22

Author(s):

Daniel J. Blum ◽

Thomas V. McCaffrey

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Cranial Nerve ◽

Internal Carotid ◽

False Aneurysm ◽

Major Complication ◽

Peritonsillar Abscess ◽

Common Complication ◽

Review Of The Literature ◽

Cranial Nerve Palsies

Septic necrosis of the internal carotid artery is a major complication of peritonsillar abscess. Although once a common complication, its occurrence is rare since the introduction of antibiotics. A 12-year-old girl was referred to our institution after a false aneurysm of the internal carotid artery had been entered during routine tonsillectomy for a peritonsillar abscess. Review of the literature and features of the present case demonstrate the following findings suggestive of erosion of the internal carotid artery as a result of peritonsillar abscess: (1) spontaneous hemorrhage from a peritonsillar abscess, (2) persistent peritonsillar swelling after resolution of symptoms of peritonsillar abscess, (3) ipsilateral Horner's syndrome, and (4) otherwise unexplained cranial nerve palsies (nerves IX, X, XI, and XII).

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Shotgun pellet embolization to the intracranial internal carotid artery: Report of a case and review of the literature

Emergency Radiology ◽

10.1007/bf02614925 ◽

1994 ◽

Vol 1 (4) ◽

pp. 200-205 ◽

Cited By ~ 5

Author(s):

Allen B. Oser ◽

Christopher J. Moran ◽

DeWitte T. Cross ◽

Robert W. Thompson

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Review Of The Literature

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Surgical considerations about the anterior syphon knee of the internal carotid artery

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1995000100006 ◽

1995 ◽

Vol 53 (1) ◽

pp. 34-37 ◽

Cited By ~ 2

Author(s):

Murilo S. Meneses ◽

Danielle Molinari ◽

Marcia Fortes ◽

Patricia Rangel ◽

Tatiana Neves ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Anatomical Study ◽

Vascular Lesions ◽

Intracavernous Carotid Artery ◽

Microsurgical Approach ◽

Microsurgical Techniques ◽

Anatomical Finding ◽

Anterior Knee

An anatomical study about the anterior knee of the intracavernous carotid artery is presented. Twenty cavernous sinuses (CS) were dissected in cadavers using microsurgical techniques. A fibrous ring around the internal carotid artery (ICA) at the CS roof was found in all specimens. This fibrous attachment could be dissected from the surrounding dura and a loose connective tissue could be demonstrated around the ICA. This anatomical finding makes possible the microsurgical approach to vascular lesions of this portion of the ICA, without opening the cavernous sinus.

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Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.3.45266 ◽

2020 ◽

Vol 4 (3) ◽

pp. 362-365

Author(s):

Austin Brown ◽

Health Jolliff ◽

Douglas Poe ◽

Michael Weinstock

Keyword(s):

Case Report ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Cranial Nerve ◽

Nerve Palsy ◽

Internal Carotid ◽

Artery Aneurysm ◽

Carotid Artery Aneurysm ◽

Internal Carotid Artery Aneurysm ◽

Sixth Nerve

Introduction: Diplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process. Case Report: A 69-year-old female presented to the ED with two days of diplopia and dizziness. The physical exam revealed a sixth cranial nerve palsy isolated to the left eye. Imaging demonstrated an intracavernous internal carotid artery aneurysm. The patient was treated with embolization by neurointerventional radiology. Discussion: The evaluation of diplopia is initially divided into monocular, usually from a lens problem, or binocular, indicating an extraocular process. Microangiopathic disease is the most common cause of sixth nerve palsy; however, more serious etiologies may be present, such as an intracavernous internal carotid artery aneurysm, as in the patient described. Imaging modalities may include computed tomography or magnetic resonance imaging. Conclusion: Some causes of sixth nerve palsy are benign, while others will require more urgent attention, such as consideration of an intracavernous internal carotid artery aneurysm.

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Internal Carotid Artery dissection presenting as Isolated Hypoglossal nerve palsy

Acute Medicine Journal ◽

10.52964/amja.0226 ◽

2009 ◽

Vol 8 (1) ◽

pp. 22-25

Author(s):

Amir Ahmad ◽

◽

Amir Ahmad ◽

Philip Travis ◽

Mark Doran ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Cranial Nerve ◽

Nerve Palsy ◽

Internal Carotid ◽

Cranial Nerves ◽

Carotid Artery Dissection ◽

Artery Dissection ◽

Internal Carotid Artery Dissection ◽

Cranial Nerve Palsies

Internal carotid dissection most commonly presents as headache, focal neurological deficits or stroke. Rarely it can manifest itself by causing a palsy of the lower cranial nerves (IX, X, XI, XII). The reported incidence of isolated cranial nerve palsies is rare. We report a case of an internal carotid artery dissection manifesting as isolated XII (hypoglossal) cranial nerve palsy.

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