The blood supply of the cranial nerves in the lateral wall of the cavernous sinus

  • E. Knosp
  • G. Müller
  • A. Perneczky


Cranial nerves III, IV, V, and VI are embedded in the deep layer of the lateral wall of the cavernous sinus, and are supplied by arteries which approach the nerves from medially. The arteries arise from two main stems of the internal carotid artery (ICA): the meningohypophyseal trunk (TMH), and the inferior lateral trunk (ILT). The ILT points towards the lateral wall of the cavernous sinus, where it supplies the cranial nerves which converge to the superior orbital fissure. The TMH points dorsally and supplies cranial nerve VI within Dorello’s canal, the Gasserian ganglion, and the dural entrance area around cranial nerve IV. Branches and anastomoses from and to the middle meningeal and ophthalmic artery system, as well as from and to the internal maxillary artery system, may in part replace the arterial supply pattern of the TMH and the ILT. In the sella and clivus area there exist anastomoses with the contralateral intracavernous branches of the ICA. Many of the anastomotic vessels observed in this study can be explained as developmental remnants of ancestral arterial patterns of the skull base.


Cranial Nerve Cavernous Sinus Ophthalmic Artery Oculomotor Nerve Middle Meningeal Artery 
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  1. 1.
    Bernasconi Y, Cassinari V (1956) Un segno carotidografico tipico di meningioma del tentorio. Chirurgia 11: 586–588Google Scholar
  2. 2.
    De la Torre E, Netsky MG (1960) Study of persistant primitive maxillary artery in human fetus. Am J Anat 106: 185–195CrossRefGoogle Scholar
  3. 3.
    Debrun G, Lacour P, Vinuela F et al (1981) Treatment of 54 carotid cavernous fistulas. J Neurosurg 55: 678PubMedCrossRefGoogle Scholar
  4. 4.
    Dolenc V (1983) Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 58: 824PubMedCrossRefGoogle Scholar
  5. 5.
    Derome P (1984) 2nd “Skull-base Study Group” meeting. (Oral presentation) MainzGoogle Scholar
  6. 6.
    Lang J, Schäfer K (1976) Über Ursprung und Versorgungsgebiete der intracavernösen Strecke der A. Carotis interna. Gegenbaurs Morphol Jahrb 122: 182–202PubMedGoogle Scholar
  7. 7.
    Lang J (1981) Klinische Anatomie des Kopfes. Springer, Berlin Heidelberg New York, p 200Google Scholar
  8. 8.
    Lang J, Reiter U (1984) Über den Verlauf der Hirnnerven in der Seitenwand des Sinus cavernosus. Neurochirurgia (Stuttg) 27: 93–97Google Scholar
  9. 9.
    Lanz T, Wachsmuth W [Lang J, Wachsmuth W (Hrsg)] (1979) Praktische Anatomie, Bd 1, Teil 1. Springer, Berlin Heidelberg New York, pp 63–90Google Scholar
  10. 10.
    Lasjaunias P, Merland J, Theron J, Moret J (1977) Dural vascularization of the middle cranial fossa. J Neuroradiol 4: 361PubMedGoogle Scholar
  11. 11.
    Lasjaunias P, Moret J, Mink J (1977) The anatomy of the inferior lateral trunk of the internal carotid artery. Neuroradiology 13: 215PubMedCrossRefGoogle Scholar
  12. 12.
    Lasjaunias P, Brismar J, Moret J, Theron J (1978) Recurrent cavernous branches of the ophthalmic artery. Acta Radiol 194: 553Google Scholar
  13. 13.
    Lasjaunias P (1981) Craniofacial and upper cervical arteries. Williams and Wilkins, Baltimore, pp 13–78Google Scholar
  14. 14.
    Harris FS, Rhoton AL Jr (1976) Anatomy of the cavernous sinus. J Neurosurg 45: 169PubMedCrossRefGoogle Scholar
  15. 15.
    McConnell EM (1953) The arterial blood supply of the human hypophysis cerebri. Anat Rec 115: 175PubMedCrossRefGoogle Scholar
  16. 16.
    Krayenbühl H, Yasargil M, Huber P (1979) Zerebrale Angiographie für Klinik und Praxis. Thieme, Stuttgart, pp 68–71Google Scholar
  17. 17.
    Padget DH (1948) The development of cranial arteries in the human embryo. Contrib Embryol 32: 205Google Scholar
  18. 18.
    Parkinson D (1973) Carotid cavernous fistula: direct repair with preservation of the carotid artery. J Neurosurg 38: 99PubMedCrossRefGoogle Scholar
  19. 19.
    Parkinson D (1964) Collateral circulation of the cavernous carotid artery: anatomy. Can J Surg 7: 251PubMedGoogle Scholar
  20. 20.
    Parkinson D (1965) A surgical approach to the cavernous portion of the carotid artery: Anatomical studies and case report. J Neurosurg 23: 474PubMedCrossRefGoogle Scholar
  21. 21.
    Perneczky A, Knosp E, Vorkapic P, Czech TH (1985) Direct surgical approach to infraclinoidal aneurysms. Acta Neurochir (Wien) 76: 36CrossRefGoogle Scholar
  22. 22.
    Perneczky A, Knosp E (1986) The intracavernous connective tissue cover of internal carotid artery: anatomy and surgery. In: Scheunemann H (ed) 2nd “Skullbase Study Group”. W de Gruyter, Berlin, pp 171–175Google Scholar
  23. 23.
    Rhoton AL, Hardy DG, Chambers SM (1979) Microsurgical anatomy and dissection of the sphenoid bone cavernous sinus and sella area. Surg Neurol 12: 63PubMedGoogle Scholar
  24. 24.
    Umansky F, Nathan H (1982) The lateral wall of the cavernous sinus with special reference to the nerves related to it. J Neurosurgery 56: 228CrossRefGoogle Scholar
  25. 25.
    Schniirer LB, Stattin S (1963) Vascular supply of the intracranial dura from the internal carotid artery with special reference to its arteriographic significance. Acta Radiol [Diagn] (Stockh) 1: 441–450Google Scholar
  26. 26.
    Siegfried J (1981) Percutaneous controlled thermocoagulation of Gasserian ganglion in trigeminal neuralgia: experience with 1000 cases. In: Samii M, Jannetta P (eds) The cranial nerves. Springer, Berlin Heidelberg New York, pp 323–331Google Scholar
  27. 27.
    Yasargil G, Mortara RW, Curcic M (1980) Meningiomas of the basal posterior cranial fossa. In: Krayenbühl H et al (eds) Adavances and technical standards in neurosurgery, vol 7. Springer, Wein New York, pp 3–115Google Scholar
  28. 28.
    Yasargil G (1984) Microneurosurgery, vol 1. Thieme, Stuttgart New York, pp 54–60Google Scholar
  29. 29.
    Xuerub GB, Prichard ML, Daniel PM (1954) The arterial supply and venous drainage of the human hypophysis cerebri. QJ Exp Physiol 39: 199–217Google Scholar

Copyright information

© Springer-Verlag/Wien 1987

Authors and Affiliations

  • E. Knosp
    • 1
  • G. Müller
    • 2
  • A. Perneczky
    • 1
  1. 1.Department of NeurosurgeryUniversity of ViennaViennaAustria
  2. 2.Institute of AnatomyUniversity of ViennaViennaAustria

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