faithferro.blogg.se - Porus 5 april 2018

Trigeminal nerve (CN 5) branches V1 and V2, oculomotor nerve (CN 3) and trochlear nerve (CN 4) course within a dural sheath that comprises cavernous sinus lateral wall itself. Anteriorly, lies the cavernous sinus, with its lateral wall superomedial to the cave. The internal carotid artery precavernous segment courses inferomedial to the cave. The cuff of the glove or the entrance of the cave, the porus trigeminus, is between the superior and inferior petrosal sinuses and contains the trigeminal nerve with an arachnoid sheath. The fingers of the glove, superior to inferior, contain the three postganglionic rootlets that comprise the “tri-” of the trigeminal nerve-ophthalmic (V1), maxillary (V2) and mandibular (V3), which provides sensory innervation to the face and motor function for mastication. The palm of the glove rests within a bony indentation of the petrous apex (impressio trigemini) and contains the semilunar-shaped Gasserian ganglion of the trigeminal nerve. The cave is shaped like an open-ended three-fingered glove pointing anterosuperomedially (Fig. Meckel’s cave is an aperture within petrous apex’s meningeal dura propria and periosteal layers measuring 4 × 9 mm wide at its opening and 15 mm in length.

Key imaging: neural enhancement, enlargement, perineural fat/CSF effacement, skull base foraminal changes.

Assessment is essential for perineural spread of disease and trigeminal neuralgia.

Meckel’s cave contains the trigeminal nerve between prepontine cistern and cavernous sinus.

The purpose of this pictorial review is threefold: (1) to review the normal anatomy of Meckel’s cave (2) to describe imaging findings that identify disease involving Meckel’s cave (3) to present case examples of trigeminal and non-trigeminal processes affecting Meckel’s cave. It serves as a major pathway in perineural spread of pathologies such as head and neck neoplasms, automatically upstaging tumours, and is a key structure to assess in cases of trigeminal neuralgia. Meckel’s cave is a dural recess in the posteromedial portion of the middle cranial fossa that acts as a conduit for the trigeminal nerve between the prepontine cistern and the cavernous sinus, and houses the Gasserian ganglion and proximal rootlets of the trigeminal nerve.