The parasellar region of human infants: cavernous sinus topography and surgical approaches

Abstract

The anatomy of the infant PSR differs distinctly from that of the adult. The parasellar portion of the internal carotid artery (ICA) does not form a siphon, but takes a straight course, and the venous pathways as well as the cranial and sympathetic nerves have different topographical relationships. Analyses of surgical approaches demonstrate that, in young children, the anterolateral approach can be used to reach the pterygopalatine compartment, the superior ophthalmic vein, and those pathological processes that extend from the orbit into the PSR. The approach via Parkinson's triangle can be used in 45% of cases to access the pathological processes that occur in the voluminous space above and behind the posterior flexure of the parasellar ICA. Taking this route, sympathetic nerve fibers passing through the PSR are not at risk, but some arterial branches that run within the lateral wall of the sinus can complicate this approach. This study presents a guideline that can assist radiologists and neurosurgeons in the planning and performance of interventions within the PSR of neonates and young children.

Duplication of the Abducens Nerve at the Petroclival Region: An Anatomic Study

“…Once the abducens nerve has passed through the dural opening, the cerebral layer of the petroclival dura envelops the nerve and separates the nerve from the venous blood (3,15,20,24). We found both of the branches to be enveloped by a dural sheath; this is in agreement with the literature (3,(14)(15)(16).…”

The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study

“…Petroclival dura encircles abducens nerve at the site of dural entry point by reflecting outwards just from that point [19]. Meanwhile, arachnoid membrane surrounds the nerve within its dural sleeve.…”

The venous system of E14.5 mouse embryos—reference data and examples for diagnosing malformations in embryos with gene deletions

“…At stage 22+ and later, it appears to drain into the junction of transverse and sigmoid sinus, passing basically without notable morphological alteration through the very locations where the cavernous and superior petrosal sinus form. This is rather surprising and suggests that the venous plexus of the parasellar region (Weninger & Müller, 1999 ; Weninger & Pramhas, 2000 ) does not form around an existing vein, but connects to it in later developmental stages. This is only hypothetical and has to be verified in future studies.…”