Comprehensive microsurgical anatomy of the middle cranial fossa: Part II—neurovascular anatomy

Meybodi, Ali Tayebi; Mignucci-Jiménez, Giancarlo; Lawton, Michael T.; Liu, James K.; Preul, Mark C.; Sun, Hai

doi:10.3389/fsurg.2023.1132784

Cited by 3 publications

(4 citation statements)

References 49 publications

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“…It then divides into two main branches: anterior and posterior. The anterior branch courses over the pterion, running forward and medially on the sphenoid ridge ( 19 , 20 ). By beveling the prominence of the sphenoid ridge, a surgeon can enhance visibility and access to the skull base.…”

Section: Discussionmentioning

confidence: 99%

Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Kim

2024

Front. Neurol.

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BackgroundAlthough microsurgical clipping for unruptured aneurysms has become safer and more efficient with modern neurosurgical advances, postoperative chronic subdural hematoma (CSDH) persists as an underrecognized complication. This study investigated the association between preservation of the anterior branch of the middle meningeal artery (MMA) during surgery and CSDH development.MethodsWe retrospectively reviewed 120 patients who underwent clipping for unruptured aneurysms at Kyungpook National University Chilgok Hospital between May 2020 and July 2023. We evaluated the patients on the basis of surgical approach—lateral supraorbital (LSO) or standard pterional craniotomy—and the status of the MMA postoperatively. We employed pre-and post-operative MR angiography to assess MMA preservation and used follow-up computed tomography scans to monitor CSDH development.ResultsOf the 120 patients, 22 (18.3%) developed CSDH. Univariate analysis revealed that male sex, advanced age, and MMA preservation are risk factors for postoperative CSDH. Multivariate analysis supported these findings, indicating a significant association with the development of CSDH. MMA preservation was reported in 65 patients, of whom 60 and 5 underwent LSO and pterional craniotomy, respectively.ConclusionPreservation of the anterior branch of the MMA during unruptured aneurysm surgery is a risk factor for postoperative CSDH development. Advanced age and male sex also contribute to the increased risk. These findings highlight the need for further investigation into surgical techniques that could mitigate postoperative CSDH development.

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Section: Discussionmentioning

confidence: 99%

Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Kim

2024

Front. Neurol.

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“…The sphenoparietal sinus is another major draining venous structure located within the anterior temporal dura that courses along the anterior branch of the middle meningeal artery. 5 This sinus receives flow from the superficial middle cerebral vein (also known as the “Sylvian vein”) and often drains into the cavernous sinus. However, it has been reported that the superficial middle cerebral vein drains directly into the LTVS via the sphenoparietal sinus in up to 18% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…The EVFO then goes on to communicate with the LTVS in this subset of patients. Such cases of anatomical variation are termed the “sphenobasal sinus.” 4 , 5 …”

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confidence: 99%

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Arteriovenous malformation with unique drainage through the emissary vein of the foramen ovale: illustrative case

Zhao,

Evans,

Tayebi Meybodi

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND As part of the laterotrigeminal venous system (LTVS), the emissary vein of the foramen ovale (EVFO) is an underrecognized venous structure communicating between the cavernous sinus and pterygoid plexus. The sphenobasal sinus is an anatomical variation of the sphenoparietal sinus that drains directly into the EVFO. The authors present the case of a ruptured arteriovenous malformation (AVM) with a unique drainage pattern through the sphenobasal sinus and EVFO. OBSERVATIONS A 9-year-old female initially presented with loss of consciousness and was subsequently found to have a ruptured AVM in the left basal frontal area. She underwent an immediate decompressive hemicraniectomy, with a computed tomography angiogram demonstrating a unique anatomical variation in which the sphenobasal sinus communicated with the EVFO and LTVS. The final venous drainage returned to the pterygoid plexus and external jugular vein. Postoperatively, the patient made a substantial recovery, with generalized right-sided weakness remaining as the sole deficit. LESSONS The authors present the case of a ruptured AVM with unique venous drainage into the sphenobasal sinus and EVFO, for which the current literature remains limited. As exemplified by this illustrative case, technique modification may be warranted in the setting of this unique anatomical variation to avoid venous sinus injury.

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Anterior Petrosal Approach

Froelich,

Grouls,

Charitos

2024

Neuroanatomy Guidance to Successful Neurosurgical Interventions

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Comprehensive microsurgical anatomy of the middle cranial fossa: Part II—neurovascular anatomy

Cited by 3 publications

References 49 publications

Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Preservation of the middle meningeal artery during unruptured aneurysm surgery: an independent risk factor for postoperative chronic subdural hematoma

Arteriovenous malformation with unique drainage through the emissary vein of the foramen ovale: illustrative case

Anterior Petrosal Approach

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