Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 9/2019

16.07.2019 | Original Article

Possible cerebrospinal fluid pathways in the middle fossa floor and pterional diploe: a magnetic resonance imaging study

verfasst von: Satoshi Tsutsumi, Hideo Ono, Yukimasa Yasumoto, Hisato Ishii

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

There has not been a study documenting the distribution of cerebrospinal fluid (CSF) pathways in the anterolateral base of the middle fossa (ALB) and diploe of the pterional region (Pt). The present study aimed to delineate these pathways using magnetic resonance imaging.

Methods

Thin-sliced, axial, and coronal T2-weighted sequences were performed for a total of 358 outpatients, including 20 pediatric patients.

Results

Adult population: CSF-filled channels were identified on axial images in the ALB in 57% and in the diploe of the Pt in 65% of 338 patients. These pathways showed variable morphology and number bilaterally. CSF-filled channels were identified on coronal images in the ALB in 14% and in the diploe of the Pt in 100% of 59 patients. These were delineated as linear structures of variable number and thickness. Eleven percent of the pathways identified in the ALB was connected with extracranial channels. Pediatric population: CSF-filled channels were identified on axial images in the ALB in 75% and in the diploe of the Pt in 80% of 20 patients.

Conclusions

The ALB and diploe of the Pt may function as CSF pathways in children and adults. The pathways in the ALB can be a CSF-drainage route connecting to the extracranial sites.
Literatur
1.
Zurück zum Zitat Aksu F, Akyer SP, Kale A, Geylan S, Gayretli O (2014) The localization and morphology of pterion in adult West Anatolian skulls. J Craniofac Surg 25:1488–1491CrossRefPubMed Aksu F, Akyer SP, Kale A, Geylan S, Gayretli O (2014) The localization and morphology of pterion in adult West Anatolian skulls. J Craniofac Surg 25:1488–1491CrossRefPubMed
2.
Zurück zum Zitat Apostolopoulos K, Ferekidis E (2003) Extensive primary Ewings’ sarcoma in the greater wing of the sphenoid bone. ORL J Otorhinolaryngol Relat Spec 65:235–237CrossRefPubMed Apostolopoulos K, Ferekidis E (2003) Extensive primary Ewings’ sarcoma in the greater wing of the sphenoid bone. ORL J Otorhinolaryngol Relat Spec 65:235–237CrossRefPubMed
3.
Zurück zum Zitat Aspelund A, Antila S, Proulx ST, Karlsen TV, Karaman S, Detmar M, Wiig H, Alitalo K (2015) A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med 212:991–999CrossRefPubMedPubMedCentral Aspelund A, Antila S, Proulx ST, Karlsen TV, Karaman S, Detmar M, Wiig H, Alitalo K (2015) A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med 212:991–999CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Aydin ME, Kopuz C, Demir MT, Corumlu U, Kaya AH (2010) Localization of pterion in neonatal cadavers: a morphometric study. Surg Radiol Anat 32:545–550CrossRefPubMed Aydin ME, Kopuz C, Demir MT, Corumlu U, Kaya AH (2010) Localization of pterion in neonatal cadavers: a morphometric study. Surg Radiol Anat 32:545–550CrossRefPubMed
5.
Zurück zum Zitat Battal B, Hamcan S, Akgun V, Sari S, Oz O, Tasar M, Castillo M (2016) Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance. Eur Radiol 26:1723–1731CrossRefPubMed Battal B, Hamcan S, Akgun V, Sari S, Oz O, Tasar M, Castillo M (2016) Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance. Eur Radiol 26:1723–1731CrossRefPubMed
6.
Zurück zum Zitat Boulton M, Flessner M, Armstrong D, Hay J, Johnston M (1998) Determination of volumetric cerebrospinal fluid absorption into extracranial lymphatics in sheep. Am J Physiol 274:R88–R96CrossRefPubMed Boulton M, Flessner M, Armstrong D, Hay J, Johnston M (1998) Determination of volumetric cerebrospinal fluid absorption into extracranial lymphatics in sheep. Am J Physiol 274:R88–R96CrossRefPubMed
7.
Zurück zum Zitat Boulton M, Armstrong D, Flessner M, Hay J, Szalai JP, Johnston M (1998) Raised intracranial pressure increases CSF drainage through arachnoid villi and extracranial lymphatics. Am J Physiol 275:R889–R896PubMed Boulton M, Armstrong D, Flessner M, Hay J, Szalai JP, Johnston M (1998) Raised intracranial pressure increases CSF drainage through arachnoid villi and extracranial lymphatics. Am J Physiol 275:R889–R896PubMed
8.
Zurück zum Zitat Cohen JE, Gomori JM, Grigoriadis S, Spektor S, Rajz G (2008) Dural arteriovenous fistula of the greater sphenoid wing region in neurofibromatosis type 1. Pediatr Neurosurg 44:172–175CrossRefPubMed Cohen JE, Gomori JM, Grigoriadis S, Spektor S, Rajz G (2008) Dural arteriovenous fistula of the greater sphenoid wing region in neurofibromatosis type 1. Pediatr Neurosurg 44:172–175CrossRefPubMed
9.
Zurück zum Zitat Crisi G, Calo M, Mauri C (1986) Case report 358: desmoid tumor of the greater wing of the right sphenoid bone. Skeletal Radiol 15:247–250CrossRefPubMed Crisi G, Calo M, Mauri C (1986) Case report 358: desmoid tumor of the greater wing of the right sphenoid bone. Skeletal Radiol 15:247–250CrossRefPubMed
10.
Zurück zum Zitat De Foer B, Hermans R, Morlion J, Baert AL (1993) Solitary plasmacytoma of the greater wing with secondary submandibular soft tissue metastasis. J Belge Radiol 76:169–170PubMed De Foer B, Hermans R, Morlion J, Baert AL (1993) Solitary plasmacytoma of the greater wing with secondary submandibular soft tissue metastasis. J Belge Radiol 76:169–170PubMed
11.
Zurück zum Zitat Eide PK, Vatnehol SAS, Emblem KE, Ringstad G (2018) Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes. Sci Rep 8:7194CrossRefPubMedPubMedCentral Eide PK, Vatnehol SAS, Emblem KE, Ringstad G (2018) Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes. Sci Rep 8:7194CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Gupta PK, Mital M, Dwivedi A, Gupta K (2011) Metastasis of greater wing of sphenoid bone in bronchogenic carcinoma: a unusual case report. J Cancer Res Ther 7:195–197CrossRefPubMed Gupta PK, Mital M, Dwivedi A, Gupta K (2011) Metastasis of greater wing of sphenoid bone in bronchogenic carcinoma: a unusual case report. J Cancer Res Ther 7:195–197CrossRefPubMed
13.
Zurück zum Zitat Johnston M (2003) The importance of lymphatics in cerebrospinal fluid transport. Lymphat Res Biol 1:41–44CrossRefPubMed Johnston M (2003) The importance of lymphatics in cerebrospinal fluid transport. Lymphat Res Biol 1:41–44CrossRefPubMed
15.
Zurück zum Zitat Ma S, Baillie LJ, Stringer MD (2012) Reappraising the surface anatomy of the pterion and its relationship to the middle meningeal artery. Clin Anat 25:330–339CrossRefPubMed Ma S, Baillie LJ, Stringer MD (2012) Reappraising the surface anatomy of the pterion and its relationship to the middle meningeal artery. Clin Anat 25:330–339CrossRefPubMed
16.
Zurück zum Zitat Meel R, Thulkar S, Sharma MC, Jagadesan P, Mohanti BK, Sharma SC, Bakhshi S (2012) Childhood osteosarcoma of greater wing of sphenoid: case report and review of literature. J Pediatr Hematol Oncol 34:e59–e62CrossRefPubMed Meel R, Thulkar S, Sharma MC, Jagadesan P, Mohanti BK, Sharma SC, Bakhshi S (2012) Childhood osteosarcoma of greater wing of sphenoid: case report and review of literature. J Pediatr Hematol Oncol 34:e59–e62CrossRefPubMed
17.
Zurück zum Zitat Nevrekar D, Abdu E, Selden NR (2009) Craniectomy for a bilobed dermoid cyst in the temporal fossa and greater wing of the sphenoid bone. Pediatr Neurosurg 45:46–48CrossRefPubMed Nevrekar D, Abdu E, Selden NR (2009) Craniectomy for a bilobed dermoid cyst in the temporal fossa and greater wing of the sphenoid bone. Pediatr Neurosurg 45:46–48CrossRefPubMed
18.
Zurück zum Zitat Oguz O, Sanli SG, Bozkir MG, Soames RW (2004) The pterion in Turkish male skulls. Surg Radiol Anat 26:220–224CrossRefPubMed Oguz O, Sanli SG, Bozkir MG, Soames RW (2004) The pterion in Turkish male skulls. Surg Radiol Anat 26:220–224CrossRefPubMed
19.
Zurück zum Zitat Pelaz AC, Llorente Pendás JL, Rodrigo Tapia JP, Suárez Nieto C (2008) Giant cell tumor of the greater wing of the sphenoid: an unusual presentation. J Craniofac Surg 19:822–826CrossRefPubMed Pelaz AC, Llorente Pendás JL, Rodrigo Tapia JP, Suárez Nieto C (2008) Giant cell tumor of the greater wing of the sphenoid: an unusual presentation. J Craniofac Surg 19:822–826CrossRefPubMed
20.
Zurück zum Zitat Pinna A, Demontis S, Maltese G, Dore S, Carta F (2005) Absence of the greater sphenoid wing in neurofibromatosis 1. Arch Ophthalmol 123:1454CrossRefPubMed Pinna A, Demontis S, Maltese G, Dore S, Carta F (2005) Absence of the greater sphenoid wing in neurofibromatosis 1. Arch Ophthalmol 123:1454CrossRefPubMed
21.
Zurück zum Zitat Pun A, King JA, Phal PM, Iseli TA (2018) Giant pseudomeningocele of the greater wing of sphenoid. ANZ J Surg 88:E89–E90CrossRefPubMed Pun A, King JA, Phal PM, Iseli TA (2018) Giant pseudomeningocele of the greater wing of sphenoid. ANZ J Surg 88:E89–E90CrossRefPubMed
22.
Zurück zum Zitat Reymond J, Charuta A, Wysocki J (2005) The morphology and morphometry of the foramina of the greater wing of the human sphenoid bone. Folia Morphol (Warsz) 64:188–193 Reymond J, Charuta A, Wysocki J (2005) The morphology and morphometry of the foramina of the greater wing of the human sphenoid bone. Folia Morphol (Warsz) 64:188–193
23.
Zurück zum Zitat Rhoton AL Jr (2002) The anterior and middle cranial base. Neurosurgery 51:S273–S302PubMed Rhoton AL Jr (2002) The anterior and middle cranial base. Neurosurgery 51:S273–S302PubMed
24.
Zurück zum Zitat Sharma RR, Netalkar A, Lad SD (2000) Primary Ewing’s sarcoma of the greater wing of the sphenoid bone. Br J Neurosurg 14:53–56CrossRefPubMed Sharma RR, Netalkar A, Lad SD (2000) Primary Ewing’s sarcoma of the greater wing of the sphenoid bone. Br J Neurosurg 14:53–56CrossRefPubMed
25.
Zurück zum Zitat Urbach H, Jamneala G, Mader I, Egger K, Yang S, Altenmüller D (2018) Temporal lobe epilepsy due to meningoencephaloceles into the greater sphenoid wing: a consequence of idiopathic intracranial hypertension? Neuroradiology 60:51–60CrossRefPubMed Urbach H, Jamneala G, Mader I, Egger K, Yang S, Altenmüller D (2018) Temporal lobe epilepsy due to meningoencephaloceles into the greater sphenoid wing: a consequence of idiopathic intracranial hypertension? Neuroradiology 60:51–60CrossRefPubMed
Metadaten
Titel
Possible cerebrospinal fluid pathways in the middle fossa floor and pterional diploe: a magnetic resonance imaging study
verfasst von
Satoshi Tsutsumi
Hideo Ono
Yukimasa Yasumoto
Hisato Ishii
Publikationsdatum
16.07.2019
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 9/2019
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-019-02290-z

Weitere Artikel der Ausgabe 9/2019

Surgical and Radiologic Anatomy 9/2019 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.