How to understand an enlarged Meckel's cave? An anatomical study.
Arachnoid
Foramen ovale
Meckel’s cave
Journal
Surgical and radiologic anatomy : SRA
ISSN: 1279-8517
Titre abrégé: Surg Radiol Anat
Pays: Germany
ID NLM: 8608029
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
28
12
2022
accepted:
27
05
2023
medline:
24
7
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
ppublish
Résumé
Dilatation of the trigeminal cavum, or Meckel's cave (MC), is usually considered a radiological sign of idiopathic intracranial hypertension. However, the normal size of the trigeminal cavum is poorly characterized. In this study, we describe the anatomy of this meningeal structure. We dissected 18 MCs and measured the length and width of the arachnoid web and its extension along the trigeminal nerve. Arachnoid cysts were clearly attached to the ophthalmic (V1) and maxillary (V2) branches until they entered the cavernous sinus and foramen rotundum, respectively, without extension to the skull base. Arachnoid cysts were close to the mandibular branch toward the foramen ovale, with a median anteromedial extension of 2.5 [2.0-3.0] mm, lateral extension of 4.5 [3.0-6.0] mm, and posterior extension of 4.0 [3.2-6.0] mm. The trigeminal cavum arachnoid had a total width of 20.0 [17.5-25.0] mm and length of 24.5 [22.5-29.0] mm. Our anatomical study revealed variable arachnoid extension, which may explain the variability in size of the trigeminal cavum in images and calls into question the value of this structure as a sign of idiopathic intracranial hypertension. The arachnoid web extends beyond the limits described previously, reaching almost double the radiological size of the cavum, particularly at the level of V3 afference of the trigeminal nerve. It is possible that strong adhesion of the arachnoid to the nerve elements prevents the formation of a true subarachnoid space that can be visualized by magnetic resonance imaging.
Identifiants
pubmed: 37318563
doi: 10.1007/s00276-023-03177-w
pii: 10.1007/s00276-023-03177-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
933-937Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Aaron GP, Illing E, Lambertsen Z et al (2017) Enlargement of Meckel’s cave in patients with spontaneous cerebrospinal fluid leaks. Int Forum Allergy Rhinol 7:421–424. https://doi.org/10.1002/alr.21891
doi: 10.1002/alr.21891
pubmed: 27918153
Bond JD, Xu Z, Zhang H, Zhang M (2021) Meckel’s cave and somatotopy of the trigeminal ganglion. World Neurosurg 148:178–187. https://doi.org/10.1016/j.wneu.2021.01.081
doi: 10.1016/j.wneu.2021.01.081
pubmed: 33516868
Burkett JG, Ailani J (2018) An up to date review of pseudotumor cerebri syndrome. Curr Neurol Neurosci Rep 18:33. https://doi.org/10.1007/s11910-018-0839-1
doi: 10.1007/s11910-018-0839-1
pubmed: 29721718
Chavez-Herrera VR, Campero Á, Ballesteros-Herrera D et al (2023) Microsurgical and illustrative anatomy of the cavernous sinus, middle fossa, and Paraclival triangles: a straightforward, comprehensive review. Surg Radiol Anat 45:389–400. https://doi.org/10.1007/s00276-023-03105-y
doi: 10.1007/s00276-023-03105-y
pubmed: 36853414
pmcid: 10039822
Chen BS, Meyer BI, Saindane AM et al (2021) Prevalence of incidentally detected signs of intracranial hypertension on magnetic resonance imaging and their association with Papilledema. JAMA Neurol 78:718–725. https://doi.org/10.1001/jamaneurol.2021.0710
doi: 10.1001/jamaneurol.2021.0710
pubmed: 33871552
Degnan AJ, Levy LM (2011) Narrowing of Meckel’s cave and cavernous sinus and enlargement of the optic nerve sheath in Pseudotumor Cerebri. J Comput Assist Tomogr 35:308–312. https://doi.org/10.1097/RCT.0b013e31820d7a70
doi: 10.1097/RCT.0b013e31820d7a70
pubmed: 21412109
Janjua RM, Al-Mefty O, Densler DW, Shields CB (2008) Dural relationships of meckel cave and lateral wall of the cavernous sinus. Neurosurg Focus 25:E2. https://doi.org/10.3171/FOC.2008.25.12.E2
doi: 10.3171/FOC.2008.25.12.E2
pubmed: 19035700
Joo W, Yoshioka F, Funaki T et al (2014) Microsurgical anatomy of the trigeminal nerve. Clin Anat 27:61–88. https://doi.org/10.1002/ca.22330
doi: 10.1002/ca.22330
pubmed: 24323792
Joukal M, Klusáková I, Dubový P (2016) Direct communication of the spinal subarachnoid space with the rat dorsal root ganglia. Ann Anat 205:9–15. https://doi.org/10.1016/j.aanat.2016.01.004
doi: 10.1016/j.aanat.2016.01.004
pubmed: 26844624
Kamali A, Sullivan KC, Rahmani F et al (2020) Indentation and transverse diameter of the meckel cave: imaging markers to diagnose idiopathic intracranial hypertension. AJNR Am J Neuroradiol 41:1487–1494. https://doi.org/10.3174/ajnr.A6682
doi: 10.3174/ajnr.A6682
pubmed: 32763895
pmcid: 7658889
Kehrli P, Ali MM, Maillot C et al (1997) Comparative microanatomy of the lateral wall of the „cavernous sinus“ in humans and the olive baboon. Neurol Res 19:571–576. https://doi.org/10.1080/01616412.1997.11740862
doi: 10.1080/01616412.1997.11740862
pubmed: 9427955
Kehrli P, Maillot C, Wolff MJ (1997) Anatomy and embryology of the trigeminal nerve and its branches in the parasellar area. Neurol Res 19:57–65. https://doi.org/10.1080/01616412.1997.11740773
doi: 10.1080/01616412.1997.11740773
pubmed: 9090638
Marashdeh WM, Al Qaralleh MA, Hdeeb AH (2021) Quantitative parameters for diagnosis of idiopathic intracranial hypertension on brain MRI. Eur J Radiol Open 8:100371. https://doi.org/10.1016/j.ejro.2021.100371
doi: 10.1016/j.ejro.2021.100371
pubmed: 34485627
pmcid: 8403732
Sabancı PA, Batay F, Civelek E et al (2011) Meckel’s cave. World Neurosurg 76:335–341. https://doi.org/10.1016/j.wneu.2011.03.037
doi: 10.1016/j.wneu.2011.03.037
pubmed: 21986433
Wang BC, Bogart B, Hillman DE, Turndorf H (1989) Subarachnoid injection–a potential complication of retrobulbar block. Anesthesiology 71:845–847. https://doi.org/10.1097/00000542-198912000-00006
doi: 10.1097/00000542-198912000-00006
pubmed: 2589673
Youssef S, Kim E-Y, Aziz KMA et al (2006) The subtemporal interdural approach to dumbbell-shaped trigeminal schwannomas: cadaveric prosection. Neurosurgery. https://doi.org/10.1227/01.NEU.0000227590.70254.02
doi: 10.1227/01.NEU.0000227590.70254.02
pubmed: 17041497