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Jugular Foramen Lesions and their Management
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
The transverse sinus is an important structure in the venous drainage system of the brain, which opens into the sigmoid sinus. Venous flow proceeds via the jugular foramen through the skull base towards the IJV in the neck. Several venous pathways drain into the sigmoid–jugular complex: the superior and inferior petrosal sinuses, the occipital sinus and the mastoid and condylar emissary veins. The most important is the inferior petrosal sinus that contains the effluence of the cavernous sinus and the basilar plexus. The dome of the jugular bulb is in close contact with the floor of the hypotympanum, the vestibule, the posterior semicircular canal, the vestibular aqueduct and the internal auditory canal. The lateral side of the jugular bulb is close to the mastoid (vertical) segment of the facial nerve. The jugular foramen lies in close proximity to the internal carotid artery: only a small osseous spine separates the vertical part of the carotid canal from the jugular foramen (Figures 107.2 and 107.3).
Selective Sampling of Petrosal Veins
Published in Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner, Endocrine Surgery, 2017
Justin R. Mascitelli, Aman B. Patel
Venous sampling must be obtained from a source that represents the venous drainage of the pituitary gland. The venous drainage of the pituitary gland is via the cavernous sinus. The cavernous sinus then usually drains into the IPSs, superior petrosal sinuses (SPSs), and basilar venous plexus. These all have variable drainage courses into the internal jugular vein (IJV) and paraspinal venous plexus. There are as many as four intercavernous venous connections (the largest of which is the basilar plexus located along the dorsum sellae). Despite these connections, pituitary venous drainage is unilateral under normal circumstances [14, 15]. Therefore, bilateral simultaneous sampling is required to evaluate the side of possible pituitary microadenoma. The IPSs are usually the best sites to obtain venous samples from, since they usually capture a large portion of the cavernous sinus drainage from their respective side.
Turbulent Flow in a Cavernous Sinus Lesion: Does It Suggest Something?
Published in Neuro-Ophthalmology, 2021
Vaibhav Kumar Jain, Vivek Singh, Akshata Charlotte, Vikas Kanaujia, Kumudini Sharma
A possible mechanism of mycotic aneurysm formation of the intracavernous part of the internal carotid artery after facial infection could be retrograde spread and extension into the cavernous sinus through the facial vein which communicates with the pterygoid plexus through the deep facial vein. The pterygoid plexus of veins is connected to the cavernous sinus through emissary veins and both cavernous sinuses communicate with each other through the anterior and posterior intercavernous sinuses and basilar plexus of veins.3 All of these communications are valveless and blood can flow through them in either direction. In our case, the cellulitis was in a dangerous area of face which led to the cavernous sinus thrombophlebitis via above mentioned pathway leading to the focal angiitis of the intracavernous part of internal carotid artery that could have caused vessel wall weakness with subsequent aneurysm formation.4 Similar to our case, other cases of mycotic intracavernous internal carotid artery aneurysm following facial infection have been reported.5–7
Endovascular treatment of carotid–cavernous sinus fistulas: ophthalmic and visual outcomes
Published in Orbit, 2019
Lee J. Holland, Ken Mitchell Ranzcr, John D. Harrison, Damien Brauchli, Yun Wong, Timothy J. Sullivan
Carotid cavernous fistulas (CCF) are abnormal communications inducing shunting of blood between the carotid arterial system and the cavernous sinus (CS), resulting in flow reversal in the veins draining through the CS. Flow may be directed anteriorly (ophthalmic venous system), posteriorly (inferior petrosal sinus (IPS), superior petrosal sinus, or the basilar plexus), laterally (sphenoparietal sinus), contralaterally (inter-CS), or inferiorly via the pterygoid plexus through the vein of the foramen rotundum and the vein of the foramen ovale. Commonly, a multidirectional revision of drainage occurs.1 Serious neuro-ophthalmic morbidity and mortality may result.
Subarachnoid hemorrhage caused by spontaneous intracranial hypotension: two rare cases report
Published in International Journal of Neuroscience, 2023
Ya Cao, Weinan Na, Hui Su, Xiaolin Wang, Zhao Dong, Shengyuan Yu
Some articles [10, 11] speculated that as the CSF volume decreases, the intracranial venous structures dilate and the venous blood flow velocity slows down, resulting in venous thrombosis being limited to a single cortical vein. Thus, SAH was induced by damage to the vessel wall due to blood and pressure accumulating backwards in the subarachnoid segment of the cortical vein. Even though venous thrombosis was not found in our two cases, we speculate that SIH might mechanically lead to congestive intracranial veins, which in turn rupture the cortical veins, basilar plexus or bridging veins, finally resulting in SAH [10].