Cavernous sinusdevelopmentvariationDevelopment and variation of cavernous sinus

Shuichi Tanoue, Hiro KiyosueDepartment of Radiology, Oita University Faculty of Medicine

Key words Cavernous sinus, development, variation, superficial middle cerebral vein

Cavernous sinusdural sinussuperficial drainagemeningeal drainageneuronal drain-agecross roadcavernous sinusvariationvariationCavernous sinusvariationspacecavernous sinussuperficial middle cerebral veinvariation

Cavernous sinusconnection Pagetanatomy(1) primary head sinusanteriormiddleposterior primitive dural plexi(2,3)venous plexusdural sinusprimitive tentorial sinusprootic sinuscavernous sinus(4,5)8prootic sinusopthalmic veinprimitive maxillary veinprimitive tentorial sinuscortical veintransverse sinus (Fig.1 a,b)

!

Tanoue

(a) (b)Fig.1 cavernous sinus(a)8(b) SSS, superior sagittal sinus; PTS, primitive tentorial sinus; PS, prootic sinus; PMS, primitive maxillary sinus; TS, transverse sinus

primitive tentorial sinuscortical veinsuperficial middle cerebral vein12prootic sinus cavernous sinusvenous plexus venous plexussuperficial middle cerebral veinprimitive tentorial sinus transverse sinus

Knospcavernous sinussinusveincavernous venous plexus5cavernous sinusPlexus

!

Tanoue

(c) (d) (e)

Fig.1 cavernous sinus(c) 12(d) (e)

Fig.2 Knosp (5)cavernous sinusdura Cavernous sinus SOV

Fig.3 cavernous venous plexus schemaICAvenous plexus SOV, foramen ovale plexus foramen lacerum plexus, SPS, IPS

Cavernous sinusvariation- Superficial middle cerebral vein- Cavernous sinussuperficial middle cerebral vein (SMCV)variationSMCVsphenoparietal sinusvariation6SMCVsphenoparietal sinuscavernous sinus type(type A, 39%)cavernous sinustype (type B, 30%)cavernous sinusforamen ovalepterygoid plexustype (type C, 11%)superior petrosal sinustransverse sinus type (type D, 8%)variationprimitive tentorial sinus variation

!

Tanoue

Type A type B type C type D

Fig.4 SMCVschemaSOV, superior ophthalmic vein; CS, cavernos sinus; SPS, sphenoparietal sinus; PP, pterygoid plexus; SuPS, superior petrosal sinus, SS, sigmoid sinus; SS, sigmoid sinus

Fig.5 type Avariation. SMCVlesser sphenoid wing()spheno-parietal sinus

- Laterocavernous sinus - Laterocavernous sinusLCScavernous sinus lateral compartmentcavernous sinus inner dural layer GailloudSMCV22%LCStypeSMCV(7)LCSdefectinner dura l layer cavernous s inus cavernous sinusmiddle fossa pterygoid plexus transverse sinus LCSlateral cavernous sinus type D

LCS

!

Tanoue

Fig.6 type Dvariation. SMCV()transverse sinussuperior petrosal sinus

Fig.7 Laterocavernous sinusschema ()Cavernous sinuslateral compartment inner dural layer ()

!

Tanoue

Fig.8 43. Rt direct CCF. MRISMCVcavernous sinus pterygoid plexus MRItype CCavernous sinustransvenous packing DSAcoil masssinus()LCStypeSMCVLCSpterygoid plexus type

coils

- Cavernous sinusprootic sinusprimitive tentorial sinus

- Cavernous sinuslaterocavernous sinussuperficial middle cerebral veinvariationprimitive tentorial sinuscavernous sinus

- variationmodality

1. Paget DH. The cranial venous system in man in reference to development, adult configuration, and relation to the arteries. Am J Anat 1956; 98: 307-55.

2. Truwit CL, et al. Embryology of the cerebral vasculature. Neuroimaging Clin N Am1994; 4: 663-89.3. The cerebral veins. In Osborn AG, Jacobs JM. 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999:217-37.4. Suzuki Y, matsumoto K. Variations of the superficial middle cerebral vein: classification using three-dimentional CT angiography. AJNR Am J Neuroradiol 2000; 21: 932-38.5. Knosp E, Muller G, Perneczky A, et al. Anatomical remarks on the fetal cavernous sinus and on the veins of the middle cranial fossa. In: Dolenc VV, ed. The Cavernous sinus: A multidisciplinary Appproach to Vascular and Tumorous Lesions. New York: Springer-Verlag; 1987: 104-116.6. Tanoue S, Kiyosue H, et al. Para-cavernous sinus venous structures: Anatomical variations and pathologic conditions evaluated on fat-suppressed 3D fast gradient-echo MR images. AJNR Am J Neuroradiol 2006; 27: 108.3-89.7. Gailloud P, San Millan Ruiz D, et al. Angiographic anatomy of the laterocavernous sinus. AJNR Am J Neuroradiol 2000; 21: 1923-29.

!

Tanoue

Fig.9 71. Rt cavernous sinus dural AVF3D-DSA source imagert SMCVlesser sphenoid wing cavernous sinusSMCVLCStypeLCScavernous sinustype.SMCVrefluxmicrocathetercavernous sinus LCSSMCVcoil