The Blood Supply of the Intracavernous Cranial Nerves

Krisht, Ali F.; Barnett, David W.; Barrow, Daniel L.; Bonner, Gary D.

doi:10.1227/00006123-199402000-00011

Cited by 98 publications

(48 citation statements)

References 7 publications

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“…7,[42][43][44][45] The most important ECA supplies to the cranial nerves are the supplies to CN VII (facial nerve) and the lower cranial nerves (IXϪXII). Supply of the geniculate ganglion of the facial nerve is through the facial arcade, which, in most of the cases, consists of the petrous branch of the MMA and the stylomastoid branch of the posterior auricular artery (Fig 15).…”

Section: Cranial Nerve Supplymentioning

confidence: 99%

Dangerous Extracranial–Intracranial Anastomoses and Supply to the Cranial Nerves: Vessels the Neurointerventionalist Needs to Know

Geibprasert

Pongpech²,

Armstrong³

et al. 2009

AJNR Am J Neuroradiol

303

188

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SUMMARY:Transarterial embolization in the external carotid artery (ECA) territory has a major role in the endovascular management of epistaxis, skull base tumors, and dural arteriovenous fistulas. Knowledge of the potential anastomotic routes, identification of the cranial nerve supply from the ECA, and the proper choice of embolic material are crucial to help the interventionalist avoid neurologic complications during the procedure. Three regions along the skull base constitute potential anastomotic routes between the extracranial and intracranial arteries: the orbital, the petrocavernous, and the upper cervical regions. Branches of the internal maxillary artery have anastomoses with the ophthalmic artery and petrocavernous internal carotid artery (ICA), whereas the branches of the ascending pharyngeal artery are connected to the petrocavernous ICA. Branches of both the ascending pharyngeal artery and the occipital artery have anastomoses with the vertebral artery. To avoid cranial nerve palsy, one must have knowledge of the supply to the lower cranial nerves: The petrous branch of the middle meningeal artery and the stylomastoid branch of the posterior auricular artery form the facial arcade as the major supply to the facial nerve, and the neuromeningeal trunk of the ascending pharyngeal artery supplies the lower cranial nerves (CN IXϪXII).

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Section: Cranial Nerve Supplymentioning

confidence: 99%

Dangerous Extracranial–Intracranial Anastomoses and Supply to the Cranial Nerves: Vessels the Neurointerventionalist Needs to Know

Geibprasert

Pongpech²,

Armstrong³

et al. 2009

AJNR Am J Neuroradiol

303

188

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“…An anatomical study of the extraneural blood supply to the intracranial oculomotor nerve showed that its proximal part receives nutrient arterioles mainly from thalamoperforating arteries arising from the posterior cerebral artery 13 . Small arteries arising from the basilar artery and posterior comunicating artery may also contribute 14 . The distal (intracavernous) portion of the oculomotor nerve is supplied mainly by arterioles originating from the inferior cavernous sinus artery and, to a lesser degree, by the meningohypophyseal trunk, both derived from the intracavernous internal carotid artery, which may be prone to embolic, hemodynamic or both mechanisms of ischemia 13 .…”

Section: Discussionmentioning

confidence: 99%

Isolated oculomotor nerve palsy inspontaneous internal carotid artery dissection: case report

Campos

Massaro

Scaff

2003

Arq. Neuro-Psiquiatr.

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-Partial oculosympathetic palsy followed by ischemic manifestations in brain or retina are the main symptoms of extracranial internal carotid artery (ICA) dissection. Unusually, cranial nerves may be affected. Isolated oculomotor nerve palsy is found only rarely. Case: We present a 50-year-old nondiabetic man who experienced acute onset of right occipital headache which spread to the right retro-orbital region. Five days later he noticed diplopia and right blurred vision sensation. Neurologic examination disclosed only impaired adduction and upward gaze of right eye, slight ipsilateral pupillary dilatation, without ptosis. Brain MRI was normal. Angiography showed right internal carotid artery dissection with forward occlusion to the base of the skull. Intravenous heparin followed by warfarin was prescribed. The headache and the oculomotor nerve deficit gradually resolved in the next three weeks. Discussion: Isolated oculomotor nerve palsy is underrecognized as a clinical presentation of extracranial ICA dissection. If the angiographic evaluation is incomplete without careful study of extracranial arteries, misdiagnosis may lead to failure to initiate early treatment to prevent thromboembolic complications. For this reason we draw attention to the need for careful evaluation of cervical arteries in patients with oculomotor nerve palsy. Mechanical compression or stretching of the third nerve are possible mechanisms, but the direct impairment of the blood supply to the third nerve seems to be the most plausible explanation.KEY WORDS: third nerve; oculomotor palsy; carotid artery; dissection; angiography. Paralisia isolada do nervo oculomotor na dissecção de artéria carótida interna: relato de casoRESUMO -A paralisia oculosimpática parcial (síndrome de Horner) seguida por manifestações isquêmicas cerebrais ou retinianas são os principais sintomas da dissecção da artéria carótida interna (ACI) extracraniana. O acometimento de nervos cranianos é incomum. Apenas raramente a paralisia isolada do nervo oculomotor pode ser encontrada. Caso: homem de 50 anos, sem diabetes, apresentou cefaléia occipital de início súbito irradiada a seguir para a região retro-orbitária direita. Após 5 dias começou a notar diplopia e visão embassada no olho direito, quando procurou o hospital. O exame neurológico evidenciou apenas prejuízo da adução e do olhar vertical para cima no olho direito, com discreta dilatação pupilar ipsilateral, sem ptose. RNM foi normal. A angiografia digital revelou dissecção da ACI direita com oclusão a montante até a base do crânio. A anticoagulação foi iniciada. A cefaléia e a movimentação ocular melhoraram em 3 semanas. Discussão: A paralisia isolada do nervo oculomotor dificilmente é reconhecida como um possível sinal clínico de dissecção da ACI. Se o estudo angiográfico for incompleto, sem a avaliação cuidadosa das artérias extracranianas, esse diagnóstico deixa de ser feito, impedindo assim o início precoce da anticoagulação para a prevenção dos eventos tromboembólicos. Por isso, reforçamos a impor...

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“…It sends branches to the proximal portion of the third and fourth cranial nerve as well as medial portion of the gasserian ganglion, 1,12 and anastomoses with the branches of the tentorial artery from the opposite side. Similar findings were observed in our study.…”

Section: Anatomymentioning

confidence: 99%

The Artery of Bernasconi and Cassinari: A Morphometric Study for Superselective Catheterization

Banerjee¹,

Ezer²,

Nanda³

2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The artery of Bernasconi and Cassinari is an important infraclinoid branch of the internal cerebral artery. It is of neuroendovascular relevance in view of its supply to complex lesions such as meningiomas and arteriovenous malformations in the tentorial and falcotentorial regions. The present microanatomic study attempts a morphometric elucidation of this slender but important branch of the meningohypophyseal trunk.

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The Blood Supply of the Intracavernous Cranial Nerves

Cited by 98 publications

References 7 publications

Dangerous Extracranial–Intracranial Anastomoses and Supply to the Cranial Nerves: Vessels the Neurointerventionalist Needs to Know

Dangerous Extracranial–Intracranial Anastomoses and Supply to the Cranial Nerves: Vessels the Neurointerventionalist Needs to Know

Isolated oculomotor nerve palsy inspontaneous internal carotid artery dissection: case report

The Artery of Bernasconi and Cassinari: A Morphometric Study for Superselective Catheterization

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