Spencer PS, Cardona JJ, Reina F, Carrera A, Iwanaga J, Dumont AS, Donofrio CA, Badaloni F, Fioravanti A, Tubbs RS
Abstract
-INTRODUCTION: Neurosurgeons must master micro-anatomy and its variants that occur at the skull base. To the best of our knowledge, we describe a previously unre-ported dural venous sinus (DVS) within the anterior pet-roclinoid fold and discuss its potential surgical relevance.-METHODS: Fifteen latex-injected human cadaveric heads (30 sides) underwent skull base dissection using a surgical microscope. The anterior petroclinoid fold was opened in search of evidence of an embedded DVS. When identified, this sinus was documented, photographed, and measured with microcalipers.-RESULTS: An anterior petroclinoid sinus (APCS) was identified in 67% of sides. These DVSs had a mean diam-eter of 0.65 mm and a length ranging from 8 to 15 mm (mean: 12.5 mm). The APCS ran from the anterior aspect of the cavernous sinus, arising just lateral (60%), posterior (20%), or medial (20%) to the anterior clinoid process, to the su-perior petrosal sinus (65%) or the posterior aspect of the cavernous sinus (35%), at the level of the posterior clinoid process. Along the course of the APCS, the oculomotor nerve was located medially at the oculomotor porus. Although slightly more common and larger on the right side, there was no statistically significant side difference.-CONCLUSIONS: An improved knowledge of variant DVSs can lower the risk of intraoperative complications and increase our understanding of the venous outflow from the cavernous sinus. Future neuroimaging techniques might also seek to identify the APCS. This is the first description of a DVS contained within the anterior petroclinoid fold.
