scholarly journals The suboccipital cavernous sinus

1996 ◽  
Vol 1 (6) ◽  
pp. E2
Author(s):  
Kenan I. Arnautovic ◽  
Ossama Al-Mefty ◽  
T. Glenn Pait ◽  
Ali F. Krisht ◽  
Muhammad M. Husain
Keyword(s):  
Cavernous Sinus ◽  
Internal Carotid ◽  
Microsurgical Anatomy ◽  
Review Of The Literature ◽  
Transverse Foramen ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Arterial Walls ◽  
The Third ◽  
Pathological Conditions

The authors studied the microsurgical anatomy of the suboccipital region, concentrating on the third segment (V3) of the vertebral artery (VA), which extends from the transverse foramen of the axis to the dural penetration of the VA, paying particular attention to its loops, branches, supporting fibrous rings, adjacent nerves, and surrounding venous structures. Ten cadaver heads (20 sides) were fixed in formalin, their blood vessels were perfused with colored silicone rubber, and they were dissected under magnification. The authors subdivided the V3 into two parts, the horizontal (V3h) and the vertical (V3v), and studied the anatomical structures topographically, from the superficial to the deep tissues. In two additional specimens, serial histological sections were acquired through the V3 and its encircling elements to elucidate their cross-sectional anatomy. Measurements of surgically and clinically important features were obtained with the aid of an operating microscope. This study reveals an astonishing anatomical resemblance between the suboccipital complex and the cavernous sinus, as follows: venous cushioning; anatomical properties of the V3 and those of the petrous-cavernous internal carotid artery (ICA), namely their loops, branches, supporting fibrous rings, and periarterial autonomic neural plexus; adjacent nerves; and skull base locations. Likewise, a review of the literature showed a related embryological development and functional and pathological features, as well as similar transitional patterns in the arterial walls of the V3 and the petrous-cavernous ICA. Hence, due to its similarity to the cavernous sinus, this suboccipital complex is here named the "suboccipital cavernous sinus." Its role in physiological and pathological conditions as they pertain to various clinical and surgical implications is also discussed.

The suboccipital cavernous sinus

1997 ◽  
Vol 86 (2) ◽  
pp. 252-262 ◽  
Author(s):  
Kenan I. Arnautović ◽  
Ossama Al-Mefty ◽  
T. Glenn Pait ◽  
Ali F. Krisht ◽  
Muhammad M. Husain
Keyword(s):  
Cavernous Sinus ◽  
Internal Carotid ◽  
Microsurgical Anatomy ◽  
Transverse Foramen ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Content Type ◽  
Arterial Walls ◽  
Pathological Conditions ◽  
Fine Print

✓ The authors studied the microsurgical anatomy of the suboccipital region, concentrating on the third segment (V3) of the vertebral artery (VA), which extends from the transverse foramen of the axis to the dural penetration of the VA, paying particular attention to its loops, branches, supporting fibrous rings, adjacent nerves, and surrounding venous structures. Ten cadaver heads (20 sides) were fixed in formalin, their blood vessels were perfused with colored silicone rubber, and they were dissected under magnification. The authors subdivided the V3 into two parts, the horizontal (V3h) and the vertical (V3v), and studied the anatomical structures topographically, from the superficial to the deep tissues. In two additional specimens, serial histological sections were acquired through the V3 and its encircling elements to elucidate their cross-sectional anatomy. Measurements of surgically and clinically important features were obtained with the aid of an operating microscope. This study reveals an astonishing anatomical resemblance between the suboccipital complex and the cavernous sinus, as follows: venous cushioning; anatomical properties of the V3 and those of the petrous—cavernous internal carotid artery (ICA), namely their loops, branches, supporting fibrous rings, and periarterial autonomic neural plexus; adjacent nerves; and skull base locations. Likewise, a review of the literature showed a related embryological development and functional and pathological features, as well as similar transitional patterns in the arterial walls of the V3 and the petrous-cavernous ICA. Hence, due to its similarity to the cavernous sinus, this suboccipital complex is here named the “suboccipital cavernous sinus.” Its role in physiological and pathological conditions as they pertain to various clinical and surgical implications is also discussed.

Taming the Cavernous Sinus: Technique of Hemostasis Using Fibrin Glue

2007 ◽  
Vol 61 (suppl_3) ◽  
pp. ONS-E52-ONS-E52 ◽  
Author(s):  
Niklaus Krayenbühl ◽  
Ahmad Hafez ◽  
Juha A. Hernesniemi ◽  
Ali F. Krisht
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Fibrin Glue ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cranial Base ◽  
Sinus Surgery ◽  
Microsurgical Anatomy ◽  
Glue Injection

Abstract Objective: Improved understanding of the microsurgical anatomy of the cranial base region has made surgery in and through the cavernous sinus safer. However, continuous venous oozing that occurs during cavernous sinus surgery can cause significant blood loss and poor visualization. We describe a technique that will help minimize cavernous sinus bleeding and improve the safety of the surgical steps. Methods: The lateral wall of the cavernous sinus is exposed. Cavernous sinus access windows between the V1 and V2 branches of the trigeminal nerve and posterior to the clinoidal internal carotid artery are used to inject fibrin glue into the different cavernous sinus compartments. Postoperative follow-up cerebral angiography in basilar apex aneurysms clipped using the transcavernous approach were evaluated for cavernous sinus patency during the venous phase. Results: Fibrin glue injection between V1 and V2 obliterated the lateral cavernous sinus compartment. Fibrin glue injection posterior to the clinoidal segment of the internal carotid artery obliterated the medial compartment of the cavernous sinus. These steps were used in 217 surgical procedures (95 benign and 9 malignant neoplastic lesions; 113 aneurysms). There were no significant clinical side effects. Follow-up angiographic controls of basilar aneurysms operated on via the transcavernous approach consistently showed the reestablishment of flow within the cavernous sinus as early as 2 to 3 months postoperatively. Conclusion: Presently, the use of hemostatic agents and the better understanding of the microsurgical anatomy of the cranial base and cavernous sinus enable us to tame the cavernous sinus and operate in and around it with a high degree of safety.

scholarly journals Microsurgical anatomy of the arterial compartment of the cavernous sinus: analysis of 24 cavernous sinus

2005 ◽  
Vol 63 (2a) ◽  
pp. 259-264 ◽  
Author(s):  
Gustavo Isolan ◽  
Evandro de Oliveira ◽  
João Paulo Mattos
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Sella Turcica ◽  
Microsurgical Anatomy ◽  
Isolated Artery ◽  
Anatomy Knowledge ◽  
Tentorial Artery ◽  
Meningohypophyseal Trunk

The cavernous sinus is a complex compartment situated in both sides of the sella turcica, being its microsurgical anatomy knowledge of fundamental importance when consider to approach surgically. We studied the arterial microanatomy of 24 cavernous sinus at the microsurgical laboratory, considering that in all the internal carotid artery were filled with colored latex. The meningohypophyseal trunk was present in 18 cases (75%) with its origin in intracavernous portion of the internal carotid artery. In relation to the 18 presented cases with meningohypophyseal trunk, 14 (77.7%) had a trifurcate and 4 (23.3%) had a bifurcate pattern. The tentorial artery was present in all. Its origin was observed, arising from the meningohypophyseal trunk in 17 (70.8%) and as an isolated artery in some extension of the intracavernous portion in 7 (29.1%). An accessory tentorial artery was found in one specimen. The dorsal meningeal artery was present in 22 cases (91.6%). Its origin was in the meningohypophyseal trunk in 17 cases (77.2%), arising from internal carotid artery in 4 cases (18.1%) and from inferior hypophyseal artery in one case (4.1%).The inferior hypophyseal artery was present in all cases, having its origin at the meningohypophyseal trunk in 16 cases (66.6%). In the remaining 8 cases (33.3%) the artery was found arising alone from the intracavernous portion also. The artery of the inferior cavernous sinus or inferolateral trunk was present in all cases and had its origin from internal carotid artery in its intracavernous segment. The McConnell's artery was not found in any cavernous sinus.

scholarly journals Incidence of Carotico-clinoid Foramen and Interclinoid Osseous Bridge in Dry Human Skulls in Sudan_ Neurosurgical Interest

2020 ◽  
Author(s):  
yasser seddeg ◽  
Kamalelden Elbadawi
Keyword(s):  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cross Sectional Study ◽  
Type I ◽  
Type Ii ◽  
Success Rates ◽  
Anterior Clinoid Process ◽  
Cross Sectional ◽  
Type Iv ◽  
Human Skulls

Background: Anterior clinoid process is usually drilled in order to approach cavernous sinus and related structures in neurosurgical operations. The presence of carotico-clinoid foramen and interclinoid osseous bridge create difficulties while approaching anterior clinoid process and increases the risks of injury to the internal carotid artery and nearby structures. Aim: To observe incidence, anatomy of carotico-clinoid foramen and interclinoid osseous bridge in the Sudanese dry skulls. Methods: This was a cross sectional study, conducted in the departments of anatomy in different medical schools in Sudan between the period from June 2019 to January 2020. Total 30 dry adult human skulls were examined to observe incidence of carotico-clinoid foramen and of interclinoid osseous bridge. Result: The incidence of carotico-clinoid foramen was 13.3% (4 skulls out of 30). The foramen was bilaterally present in one skull (n=1/30, 3.3%) and unilateral in 3 skulls (n=3/30, 10%). Type I bridge is the carotico-clinoid foramen itself, the Type II interclinoid osseous bridge was found in one skull (n=1/30, 3.3%) , no Type III and Type IV bridges were observed in the present study. Conclusion: the presence of this foramen and interclinoid osseous bridge can complicate neurosurgical operations in cavernous sinus, sellar and para-sellar regions. Therefore, the detailed anatomical knowledge is very important to decrease complications and to increase success rates of neurosurgical operations in this area.

Endoscopic anatomy of the fourth ventricle

2008 ◽  
Vol 109 (3) ◽  
pp. 530-535 ◽  
Author(s):  
Pierluigi Longatti ◽  
Alessandro Fiorindi ◽  
Alberto Feletti ◽  
Domenico D'Avella ◽  
Andrea Martinuzzi
Keyword(s):  
Fourth Ventricle ◽  
Area Postrema ◽  
Point Of View ◽  
Microsurgical Anatomy ◽  
Anatomical Structures ◽  
Endoscopic Anatomy ◽  
Video Recordings ◽  
Pathological Conditions ◽  
Anatomical Point ◽  
Inside View

Object Microsurgical anatomy of the fourth ventricle has been comprehensively addressed by masterly reports providing classic descriptions of this complex region. Neuroendoscopy could offer a new, somewhat different perspective of the “inside” view of the fourth ventricle. The purpose of this study was to examine from the anatomical point of view the access to the fourth ventricle achieved by the endoscopic transaqueductal approach, to enumerate and describe the anatomically identifiable landmarks, and to compare them with those described during microsurgery. Methods The video recordings of 52 of 75 endoscopic explorations of the fourth ventricle performed at the authors' institution for different pathological conditions were reviewed and evaluated to identify and describe every anatomical landmark. According to the microsurgical anatomy, at least 23 superficial structures are clearly identifiable in the fourth ventricle, and they represent the comparative basis of parallel endoscopic anatomy of the structures found during the fourth ventricle navigation. Results The following anatomical structures were identified in all cases: median sulcus, superior and inferior vela medullare, choroid plexus, inferior fovea, hypoglossal and vagal triangles, area postrema, obex, canalis medullaris, lateral recess, and the foramina of Luschka and Magendie. The median eminence, facial colliculus, striae medullaris, auditory tubercle, and inferior fovea were seen in the majority of cases. The locus caevruleus could never be seen. Conclusions On the whole, 20 anatomical structures could consistently be identified by exploring the fourth ventricle with a fiberscope. Neuroendoscopy offers a quite different outlook on the anatomy of the fourth ventricle, and compared with the microsurgical descriptions it seems to provide a superior and detailed visualization, particularly of the structures located in the inferior triangle.

scholarly journals Microsurgical and Endoscopic Anatomy of the Cavernous Sinus

2020 ◽  
Vol 39 (02) ◽  
pp. 083-094
Author(s):  
Gustavo Rassier Isolan ◽  
Francisco Luiz Souza Braga ◽  
Alvaro Campero ◽  
José Alberto Landeiro ◽  
Ricardo Marques Lopes de Araújo ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Cavernous Sinus ◽  
Carotid Arteries ◽  
Lateral Wall ◽  
Endoscopic Approach ◽  
Microsurgical Anatomy ◽  
Endoscopic Findings ◽  
Endoscopic Anatomy ◽  
Pathological Conditions ◽  
Formalin Fixed

Abstract Objective To describe the endoscopic and microsurgical anatomy of the cavernous sinus (CS) with focus on the surgical landmarks in microsurgical anatomy. Materials and methods Ten formalin-fixed central skull base specimens (20 CSs) with silicone-injected carotid arteries were examined through an extended endoscopic transsphenoidal approach. Fifteen formalin-fixed heads were dissected to simulate the surgical position in CS approaches. Results Endoscopic access enables identification of the anterior and posterior surgical corridors. Structures within the CS and on its lateral wall could be visualized and studied, but none of the triangular areas relevant to the transcranial microsurgical anatomy were fully visible through the endoscopic approach. Conclusion The endoscopic approach to the CS is an important surgical technique for the treatment of pathological conditions that affect this region. Correlating endoscopic findings with the conventional (transcranial) microsurgical anatomy is a useful way of applying the established knowledge into a more recent operative technique. Endoscope can provide access to the CS and to the structures it harbors.

scholarly journals Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

2021 ◽  
Vol 15 (1) ◽  
pp. 70-78
Author(s):  
Palaniraj Rama Raj ◽  
Vinayak Smith
Keyword(s):  
Cavernous Sinus ◽  
Surgical Intervention ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Narrative Review ◽  
Review Of The Literature ◽  
Anatomical Structures ◽  
Medical Practitioners ◽  
Cavernous Sinus Syndrome ◽  
Anatomical Basis

Pathology involving the Cavernous Sinus (CS), generally referred to as Cavernous Sinus Syndrome (CSS), can arise from vascular disorders, neoplasms, infections, and non-infectious inflammatory disorders. An acute understanding of the CS and its regional anatomical structures is therefore pertinent in expounding the highly variable clinical manifestations seen in CSS as well as laying the groundwork for surgical intervention. Though the neuroanatomy of the cavernous sinus has been substantially chronicled in literature, their correlation to clinical signs has only been minimally described. This narrative review serves to address this knowledge gap and aims to comprehensively correlate the clinical manifestations of CSS with the relevant neuroanatomy, thereby allowing medical practitioners to better navigate the diagnostic quandary. We conducted a scoping review of the literature concerning CS anatomy and CSS, complied through MEDLINE/OVID and cross-referencing of articles on PubMed and Google Scholar with the keywords cavernous sinus, cavernous sinus syndrome, clinical signs/manifestations, neuroanatomy, CS pathology, Cavernous Sinus Thrombus (CST) and cavernous sinus neoplasms/tumours.

Microsurgical anatomy of the supraclinoid portion of the internal carotid artery

1981 ◽  
Vol 55 (4) ◽  
pp. 560-574 ◽  
Author(s):  
Hirohiko Gibo ◽  
Carla Lenkey ◽  
Albert L. Rhoton
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Third Ventricle ◽  
Optic Tract ◽  
Microsurgical Anatomy ◽  
Content Type ◽  
The Third ◽  
Cervical Portion ◽  
Anterior Choroidal

✓ The microsurgical anatomy of the supraclinoid portion of the internal carotid artery (ICA) was studied in 50 adult cadaver cerebral hemispheres using × 3 to × 40 magnification. The ICA was divided into four parts: the C1 or cervical portion; the C2 or petrous portion; the C3 or cavernous portion; and the C4 or supraclinoid portion. The C4 portion was divided into three segments based on the origin of its major branches: the ophthalmic segment extended from the origin of the ophthalmic artery to the origin of the posterior communicating artery (PCoA); the communicating segment extended from the origin of the PCoA to the origin of the anterior choroidal artery (AChA); and the choroidal segment extended from the origin of the AChA to the bifurcation of the carotid artery. Each segment gave off a series of perforating branches with a relatively constant site of termination. The perforating branches arising from the ophthalmic segment passed to the optic nerve and chiasm, infundibulum, and the floor of the third ventricle. The perforating branches arising from the communicating segment passed to the optic tract and the floor of the third ventricle. The perforating branches arising from the choroidal segment passed upward and entered the brain through the anterior perforated substance. The anatomy of the ophthalmic, posterior communicating, anterior choroidal, and superior hypophyseal branches of the C4 portion was also examined.

Experience of prenatal diagnosis of true knots of the umbilical cord during ultrasound examination in the third trimester of gestation

2019 ◽  
Author(s):  
M.Y. Morozova, V.V. Zotov, M.S. Kovalenko et all
Keyword(s):  
Prenatal Diagnosis ◽  
Umbilical Cord ◽  
Ultrasound Examination ◽  
Technological Advance ◽  
Prenatal Ultrasound ◽  
Ultrasound Diagnosis ◽  
Review Of The Literature ◽  
Third Trimester ◽  
The Third

Despite the rapid technological advance, the expansion of prenatal ultrasound diagnosis, as well as the accumulation of experience by both domestic and foreign experts, prenatal recognition of true knots of the umbilical cord causes significant difficulties. Three cases of successful ultrasound diagnosis of true knots of the umbilical cord and brief review of the literature are presented.

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