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Microsurgical Anatomy of the Carotid Cave.
MedLine Citation:
PMID:  22113241     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The carotid cave was first described more than 20 years ago, but itsrelationships to the dural rings defining theclinoid segment of the internal carotid artery (ICA), the carotid collar, and the adjacent osseous structures need further definition. OBJECTIVE: To further define the microanatomy of the carotid cave and its relationships to the adjacent structures. METHODS: The cave and its relationshipswere examined in cadaveric specimens using 3 to 40X magnification. RESULTS: The cave is anintradural pouch, found in 19 of 20 paraclinoid areas, that extends below thelevel of the distal dural ring between the wall of the ICA and the dural collar surrounding the ICA. The distal dural ring is tightly adherent to the anterior and lateral walls of the ICAadjacent the anterior clinoid process and optic strut but not on the medial and posterior sides of the artery facing the upper part of the carotid sulcus where the carotid cave is located. The superior hypophyseal artery frequently arisesin the cave. The depth and circumferential length of the cave averaged 2.4 mm (range, 1.5-5 mm) and 9.9 mm (range, 4.5-12 mm), respectively. Aneurysms arising at the level of the cave, although appearing on radiologic studies to extend below the level of theupper edge of the anterior clinoid,may extend into and may be a source of subarachnoid space. CONCLUSION: The surgical treatment of aneurysms arising in the cave requiresan accurate understanding of the relationships of the cave to theICA, dural rings, and carotid collar.
Authors:
Wonil Joo; Takeshi Funaki; Fumitaka Yoshioka; Albert L Rhoton
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-22
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Neurosurgery, University of Florida, Gainesville, Florida, U.S.A. 2Department of Neurosurgery, Catholic University of Korea, Seoul, South Korea.
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