Anatomy of the cavernous sinus. A microsurgical study

Area of Science:

• Anatomy
• Neurosurgery
• Vascular Surgery

Background:

• The cavernous sinus is a complex venous structure at the base of the skull.
• Understanding its intricate anatomy is vital for neurosurgical procedures and managing vascular pathologies like arteriovenous fistulas.

Purpose of the Study:

• To provide a detailed anatomical description of the intracavernous carotid artery and its surrounding structures.
• To elucidate arterial contributions to cavernous sinus arteriovenous fistulas.
• To identify key anatomical landmarks for surgical navigation.

Main Methods:

• Detailed dissection of 50 human cadaver cavernous sinuses using magnification.
• Systematic examination of the intracavernous carotid artery, its branches, and adjacent cranial nerves and venous spaces.

Main Results:

• The meningohypopyseal artery was consistently present (100%), with other branches like the artery of the inferior cavernous sinus (84%) also identified.
• The carotid artery's proximity to the trigeminal nerve and pituitary gland was documented, with variations noted.
• The sixth cranial nerve exhibited variable rootlet formation.
• Key venous spaces within the sinus were mapped relative to the intracavernous carotid artery.

Conclusions:

• The study provides a comprehensive anatomical map of the cavernous sinus, highlighting critical relationships for surgical planning.
• Variations in arterial branching and nerve relationships underscore the need for meticulous surgical technique.
• This detailed anatomical knowledge aids in the diagnosis and treatment of cavernous sinus arteriovenous fistulas.