Cavernous sinus and abducens nerve in human fetuses near. The technique of choice for study is mri, although ct can help recognize and identify some anomalies, such as bone destruction. The external structure of each cavernous sinus cs is made of four dural walls. Sepsis dangerous area of face, paranasal sinuses, nasal cavities neurological severe pain eye anf forehead ophthalmic n. The anterior clinoid process was removed, exposing the clinoidal triangle 1. This cavity contains the internal carotid artery and several important nerves including the oculomotor nerve, the trochlear nerve, the ophthalmic nerve, the maxillary nerve, and the abducens nerve. Cavernous sinus thrombosis is a potentially lifethreatening condition that can happen after an infection in your head. Jan 01, 2005 the anatomy of the cavernous sinus is complex because of the high density of critically important neural and vascular structures. Suboccipital cavernous sinus definitions ofabbreviationsforfigure legends a muscular artery ofv3h acv anterior condylar vein ar anterior ramus av anastomotic vein c condyle c1n col nerve c2n c2nerve c3n c3nerve d posterior fossa dura dm digastric muscle dr distal ring ill inferior lateral loop iml inferior medial loop ist inferior suboccipital triangle jb jugular bulb.
The cavernous sinus contents structures within the sinus proper and also in its lateral wall and their relative positions can be recalled with the following mnemonic. Discrepancies between anatomic and ct appearance are discussed. It follows the groove of the bone and drains into the cavernous sinus after receiving a tributary on either side from the superficial middle cerebral vein. In addition, the ophthalmic and dorsal meningeal arteries arose from the carotid artery within the cavernous sinus in 8% and 6%, respectively. They exit the cavernous sinus and terminate in the sigmoid sinus. The lateral aspects of the petroclival region have been of interest to a few pioneering ent surgeons and neurosurgeons but the cavernous sinus in most respects has remained the final unconquered summit. Microsurgical anatomy and approaches to the cavernous sinus. Inside the cavernous sinus, there are venous and a rich supply of arterial branches and venules. As such, infections of the face particularly those involving the danger triangle orbits, nasal sinuses, and superior part of the face can cause a cavernous sinus thrombosis. The clinical anatomy of the cavernous sinus article pdf available in forensic medicine and anatomy research 0302. The surgical anatomy, safeentry zones, and corresponding surgical routes to the cs have been studied by several authors. In the human body, the abn might be a limited example showing a drastic postnatal change in course. Winslow in 1732 gave name cs due to presence of fibrous trabeculae. May 11, 2020 the sphenoparietal sinus courses along the free border of the lesser wing of the sphenoid bone.
The cavernous sinus receives blood from several sources, including the superior orbital vein, a major vein from the orbit that connects the cavernous sinus to veins in the upper part of the face. The superficial middle cerebral vein communicates with the superior cerebral veins via the. Anatomy of the cavernous sinus and related structures. Inferior petrosal sinus to the internal jugular veins. Cavernous sinus contents mnemonic radiology reference. Cavernous sinus thrombosis the veins of the face drain blood into the cavernous sinus via the superior ophthalmic vein. Microsurgical anatomy, cavernous sinus, microsurgery, carotid.
The coronal projection provided imaging of cranial nerves within the cavernous sinus. Epub ahead of print cavernous sinus and abducens nerve in human fetuses near term. Anatomy and clinical relevance of the cavernous sinus. The cavernous sinus is located on either side of the pituitary fossa and body of the sphenoid bone between the endosteal and meningeal layers of the dura. This video covers the anatomy of the cavernous sinus lateral sellar compartment, its location, drainage and function.
Increasing surgical experience within the cavernous sinus region has generated increased interest in the regions anatomy. Cavernous sinus definition of cavernous sinus by medical. Each cavernous sinus has a close anatomical relationship with several key structures in the head, and is arguably the most clinically important venous sinus. In this case, the internal carotid artery moves blood from the brain and face back to the heart to be oxygenated. Apr 30, 2020 the anatomy of the cavernous sinus is unique because it is the only place in the human body where an artery moves entirely through a venous structure. The margins of this compartment are limited by the. Anatomy anatomy and clinical relevance of the cavernous sinus see online here the cavernous sinus is one of the most important dural venous sinuses located between the endosteal dura and meninges. To move the model in 3d space, use your mouses left click and drag.
The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica. Emissary veins passing through various foramina in the skull base, e. Cavernous sinus and abducens nerve in human fetuses near term. Mar 12, 2020 cerebral images used for this module on human anatomy. Unlike other dural venous sinuses, it is divided by numerous fibrous septa into a series of. Request pdf cavernous sinus and abducens nerve in human fetuses near term a long tortuous course of the abducens nerve abn crossing a highly curved siphon of the internal carotid artery is. The cavernous sinuses are paired dural venous sinuses gross anatomy.
Please use the full screen function for optimal visualization by clicking on the arrows on the right lower corner of the model. May 11, 2020 the cavernous sinus is an unconventional venous system in the sense that it does not have a unidirectional flow of blood. Anatomical study of the cavernous sinus emphasizing. The cavernous sinus is a vascular channel of great importance not only in ophthal mology but in. We studied 42 adult cadaveric heads, fixed with formalin and injected with coloured silicon. Cavernous sinus anatomy and clinical relevance lecturio. The cavernous sinuses are one of several drainage pathways for the brain that sits in the middle. Visualization of cns iii, iv, v 1, v 2, and vi in the cavernous sinus has been reported with both mr imaging and ct 18. Relevant dural, arterial, venous and cranial nerve anatomy is presented. In addition to receiving venous drainage from the brain, it also. What better way to show all available cavernous sinus connections than a highpressure cavernous sinus state, exemplified by the various complex and challenging fistulas which afflict it. Nothing demonstrates the limits of anatomical plasticity quite like pathology. However, precise evaluation of these cns in the cavernous sinus is difficult.
A long tortuous course of the abducens nerve abn crossing a highly curved siphon of the internal carotid artery is of interest to neurosurgeons for cavernous sinus surgery. The cavernous sinus cs is closely related to the osseous. The cavernous sinus is a unique component of the cranial vascular system, having direct or indirect connections with the cerebrum, cerebellum, brainstem. Given the inclusion of these major vessels and nerves, the cavernous sinus is a clinically important structure. As a result, the intracavernous anatomy of the nerves iii through vi, the internal carotid artery ica with its branches, and the related osseous structures and adjacent dural folds are well described 3, 12, 21, 23, 25, 3337, 41, 42, 47, 51. Controversy still persists regarding whether cs is a venous channel or a true venous plexus. Medially, the cavernous sinus is related to the pituitary gland and the sphenoid sinus. Cavernous sinus human head and neck human anatomy free. Pdf the clinical anatomy of the cavernous sinus researchgate.
It is divided by septa into small caves from which it gets its name. Interior is divided into a number of spaces or caverns by trabeculae cavernous sinus anatomy boundaries anterior extends into medial end of. The macroscopic and microscopic anatomy of the parasellar skull base region has been increasingly investigated in recent years. The histological examination of medial wall mw and lateral wall lw was performed in 15 normal human fetuses. Large venous space situated in the middle cranial fossa, on either side of body of the sphenoid bone. Anatomy of cavernous sinus earliest description of cs by ridley in 1695. Gross anatomy the cavernous sinus is located on either side of the pituitary fossa and body of the sphenoid bone between the endosteal and meningeal layers of the dura. It spans from the apex of the orbit to the apex of the petrous temporal bone.
Human skull anatomy poster shows anterior and lateral aspects of the skull for patient and classroom education. The three main branches of the meningohypophyseal trunk were the tentorial artery, present in 100%, the dorsal meningeal 90%, and the inferior hypophyseal 80%. This operation was at least 50% more difficult than the average complex joint skull base chondrosarcoma in that it extended from the level of the cavernous sinus down the foramen magnum via the petroclival region. Its marked by a blood clot behind your eyes or at the base of your skull. The surgical anatomy of the nose and paranasal sinuses is published with great detail in most standard textbooks, but it is the purpose of this chapter to describe those structures in a very clear and systematic presentation focused for the endoscopic sinus surgeon. Revisit the cavernous sinus from fetus to adultnew and old data. Evaluation of over 255 patients with sellar and parasellar lesions allowed study of the computed tomographic ct appearance of the cavernous sinus. Venous plexus around the ica to the basilar venous plexus. B d chaurasia apos s human anatomy head and neck brain volume 3 9788123920993. Anatomy and embryology of the lateral sellar compartment. It is located at the sella turcica of the sphenoid, surrounding the pituitary gland, within the diaphragma sella dural fold. View of the right cavernous sinus with triangle identification. Aug 03, 2016 this video covers the anatomy of the cavernous sinus lateral sellar compartment, its location, drainage and function. The veins that communicate with the cavernous sinus are.
The article states that the abducens nerve is in the lateral wall. According to grays anatomy for students 2nd edition and clinically oriented anatomy moore and dalley both state that the abducens nerve cranial nerve vi is not in the lateral wall of the sinus but in the cavernous sinus proper. Cavernous sinus compartments from the endoscopic endonasal approach. Although previously described as a tetrahedron 6 or a pentahedron, 16 in our dissections the cavernous sinus appeared as a hexahedronshaped space on either side of the sella turcica at the convergence of the floors of the anterior and middle cranial fossae, the sphenoid wing, and petroclival ridge fig. It is located in the middle cranial fossa, on either side of the sella turcica or pituitary fossa and the body of the sphenoid at the base of the skull. The outer layer of the dura has been peeled away, exposing the supratrochlear 2, infratrochlear 4, anteromedial middle fossa 5, and anterolateral middle fossa 6 triangles. Disorder of dopamine retrograde transfer in the cavernous sinus and thus of the dopamine metabolites supply to the glial cells may be. The cavernous sinus contents structures within the sinus proper and also in its lateral wall and their relative positions can be recalled with the following mnemonic o tom cat. Two types of sinus, the bloodfilled and the airfilled sinuses, are discussed in this article. The cranial venous sinuses are spaces between the layers of dura mater, which covers the brain, and are lined with endothelium similar to.
Usually, the paired cavernous sinuses are situated superolateral to the sphenoid or the posterior ethmoid sinuses and posterior to the optic chiasma the sinuses have an irregular shape, and each sinus is. Sinus, in anatomy, a hollow, cavity, recess, or pocket. Cavernous and petrosal sinuses aclands video atlas of. Therefore, it is important that a pathway exists to return blood that enters the cranium to systemic circulation. Although a straight intracavernous carotid artery in fetuses can change into an adultlike siphon in infants, there is no information on when or how the unique course of abn is established. Fernandezmiranda jc1, zwagerman nt1, abhinav k1, lieber s1, wang ew2, snyderman ch2, gardner pa1. P ituitary and skull base tumors with cavernous sinus cs invasion represent a neurosurgical challenge. Anatomy and surgery of the cavernous sinus vinko v. Anatomy mnemonics the best anatomy mnemonics for medical student finals, osces and mrcp anatomical layers of the scalp scalp mnemonic skin connective tissue aponeurosis galea loose connective tissue periosteum bones in the medial wall of the orbit my little eye sits in the orbit mnemonic maxilla frontal process lacrimal ethmoid sphenoid body bones. Drains the cavernous sinus internal jugular vein directly. The cavernous sinus is a centrally located cavity situated at the base of the brain next to the temporal bone and sphenoid bone. Cavernous sinus free download as powerpoint presentation. Fifty cavernous sinuses from cadavers were studied in detail using magnification, with special attention to the relationships important in surgical approaches on the intracavernous structures, and to understanding arterial contributions to arteriovenous fistulas involving the.
The human brain is a highly vascular organ responsible for coordinating a myriad of processes throughout the body. Owing to the fact that there are no valves in the sinus and its connected veins, the direction of blood flow is dependent on venous pressure. Selective cases demonstrate how a detailed knowledge of cavernous sinus anatomy can provide for safer surgery with low morbidity. Ppt cavernous sinus thrombosis human head and neck human. Each cavernous sinus has a close anatomical relationship with several key structures in the head, and is arguably the most clinically important venous sinus in this article, we shall look at the anatomy of the cavernous sinus. The roof of the sinus is formed by the inner layer of the meningeal dura, which is continuous with the diaphragma sellae covering the pituitary gland. The cavernous sinus shares part of its wide posterior wall with the lateral border of the basilar sinus. The dangers of uncontrollable hemorrhage from the basal sinuses and postoperative csf rhinorrhea appeared unsurmountable.
Although the anatomy of the cavernous sinus is complex, detailed knowledge of this area is essential for safe surgical approaches to the region. Pdf endoscopic anatomy and approaches of the cavernous. The book has received numerous updates since it was first launched, creating a new volume every time it is updated. Anatomical remarks on the fetal cavernous sinus and on the. The aim of this study was to describe the anatomy of the dural walls of the cs. The cavernous sinus is a paired dural venous sinus located within the cranial cavity. Ppt cavernous sinus thrombosis human head and neck. Despite many attempts to understand the morphological complexity of the cavernous sinus, its description and interpretation are still controversial.
Endoscopic anatomy and approaches of the cavernous sinus. Taptas in 1982 argued in favour of cs an irregular network of veins a part of ed venous network at skull base. Anatomy and embryology of the lateral sellar compartment cavernous sinus medial wall. This 20x26 inch human anatomy poster with illustrations by peter bachin shows anterior and lateral aspects of the skull for patient and classroom education. Optimal visualization of the cavernous sinus was obtained with continuous contrast enhancement of both axial and coronal tomograms.
Cavernous sinus compartments from the endoscopic endonasal. A note on the relationship of the human max illary nerve. They are of irregular form, larger behind than in front, and are placed one on either side of the body of the sphenoid bone, extending from the superior orbital fissure to the apex of the petrous portion of the. O tom are the first letters of components of the lateral wall of cavernous sinus considered vertically, from the top to the bottom. Surgical anatomy of the dural walls of the cavernous sinus. The cavernous sinus drains into the two petrosal sinuses, superior and. Jul 10, 2019 this article covers the anatomy and location of the cavernous sinus and helps you to understand the clinical relevance. Anatomy cavernous sinus dura mater microsurgery abstract the external structure of each cavernous sinus cs is made of four dural walls. As the name suggests, cst involves the cavernous sinus source transcavernous repair of carotid cavernous fistula.
Situated on either side of the sella turcica of the sphenoid bone of the skull. Test yourself on the dural venous sinuses with our quiz at. The cavernous sinuses are paired dural venous sinuses. Cavernous sinus anatomy the neurosurgical atlas, by. Fifty cavernous sinuses from cadavers were studied in detail using magnification, with special attention to the relationships important in surgical approaches on the intracavernous structures, and to understanding arterial contributions to arteriovenous fistulas involving the cavernous sinus. Anatomic variations of these veins have been previously reported. They run along the petrous part of the temporal bone in the base of the tentorium cerebelli, terminating in the sigmoid sinus. Cavernous sinus connections demonstrated by cavernous sinus dural fistula. Since the present observations strongly suggested morphologies at birth and in infants, major angulations of the abn as well as the wellknown course independent of the other nerves in the cavernous sinus seemed to be established during childhood.