Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mitsuhashi, Y. Articles by Hara, M. Search for Related Content PubMed Articles by Mitsuhashi, Y. Articles by Hara, M.

American Journal of Neuroradiology 28:1179-1184, June-July 2007
DOI 10.3174/ajnr.A0489
© 2007 American Society of Neuroradiology

INTERVENTIONAL

Morphologic Evaluation of the Caudal End of the Inferior Petrosal Sinus Using 3D Rotational Venography

Y. Mitsuhashi^a, A. Nishio^b, S. Kawahara^a, T. Ichinose^a, S. Yamauchi^a, H. Naruse^a, Y. Matsuoka^a, K. Ohata^b and M. Hara^b

^a Department of Neurosurgery, Izumi Municipal Hospital, Osaka, Japan
^b Department of Neurosurgery, Osaka City University, Graduate School of Medicine, Osaka, Japan

Please address correspondence to Y. Mitsuhashi, MD, 4-10-10 Fuchu. cho, Izumi, Osaka Japan 594-0071; e-mail: y-mitsuhashi{at}mtf.biglobe.ne.jp

BACKGROUND AND PURPOSE: The inferior petrosal sinus (IPS) is the main transvenous access route used to examine or treat lesions involving the cavernous sinus. To carry out these procedures successfully, one must have a detailed knowledge of the anatomy of the venous system around the junction of the IPS and the internal jugular vein (IJV).

MATERIALS AND METHODS: Eighty-three sides in 63 patients (26 men, 37 women; mean, 56.5 years of age) were examined by using 3D rotational venography (3DRV).

RESULT: The drainage patterns of the IPS could be classified into the following 6 types, with emphasis on the level of IPS-IJV junction: type A, the IPS drains into the jugular bulb in 1/83 sides (1.2%); type B, the IPS drains into the IJV at the level of the extracranial opening of the hypoglossal canal in 29/83 sides (34.9%); type C, the IPS drains into the lower extracranial IJV in 31/83 sides (37.3%); type D, the IPS forms a plexus and has multiple junctions to the IJV near the jugular foramen in 5/83 sides (6.0%); type E, the IPS drains directly into the vertebral venous plexus (VVP) with no connection to the IJV in 3/83 sides (3.6%); and type F, the IPS is absent in 14/83 sides (16.9%). Each type is also characterized by the way of anastomosis with the VVP.

CONCLUSION: This classification seemed to be rational from the embryologic viewpoint, and it may be useful in establishing treatment strategies that involve endovascular manipulation via the IPS.