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The cavernous sinus in cluster headache - a quantitative structural magnetic resonance imaging study.

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Summary

Individuals with cluster headache or chronic paroxysmal hemicrania have wider skulls, but cavernous sinus dimensions are similar to controls. This study investigated potential links between skull base anatomy and these headache types.

Keywords:
Cluster headachecavernous sinuschronic paroxysmal hemicrania

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Area of Science:

  • Neurology
  • Radiology
  • Anatomy

Background:

  • A narrow cavernous sinus has been hypothesized to predispose individuals to cluster headache.
  • Cavernous sinus dimensions have not been previously assessed in relation to cluster headache or chronic paroxysmal hemicrania.

Purpose of the Study:

  • To investigate the relationship between cavernous sinus dimensions and cluster headache (CH) and chronic paroxysmal hemicrania (CPH).
  • To compare the anatomical dimensions of the cavernous sinus and surrounding structures in patients with CH and CPH versus headache-free controls.

Main Methods:

  • High-resolution T2-weighted magnetic resonance imaging (MRI) was used to measure cavernous sinus, skull base, internal carotid artery, and pituitary gland dimensions.
  • Measurements were taken in patients with episodic cluster headache (n=25), chronic cluster headache (n=24), probable cluster headache (n=13), chronic paroxysmal hemicrania (n=8), and headache-free controls (n=22).
  • Statistical analysis involved comparing dimensions between groups, with corrections for age, sex, and transcranial diameter.

Main Results:

  • No significant pathologies or anatomical variants were observed in the cavernous sinus or paracavernous structures.
  • Headache groups exhibited a significantly larger left-to-right transcranial diameter compared to controls.
  • After adjusting for transcranial diameter and multiple comparisons, no significant differences in cavernous sinus or surrounding structure dimensions were found between patients and controls.

Conclusions:

  • Patients with cluster headache or chronic paroxysmal hemicrania possess wider skulls than headache-free individuals.
  • The proportional dimensions of the cavernous sinus are similar across cluster headache, chronic paroxysmal hemicrania, and control groups.
  • Cranial width, not cavernous sinus size, differentiates these headache patient groups from controls.