Surgical Anatomy of the Internal Carotid Artery by Paolo Castelnuovo Iacopo Dallan & Manfred Tschabitscher

Author:Paolo Castelnuovo, Iacopo Dallan & Manfred Tschabitscher
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

3.2.2.6 Sympathetic Plexus

The sympathetic plexus fibres diverge from the ICAc to adhere to the abducens nerve while crossing to join the ophthalmic nerve (V1). The main target exit is V1 on the lateral wall of the CS (Jittapiromsak et al. 2010).

3.2.3 Vascular Branches (Isolan et al. 2005; Yasuda et al. 2005; Tubbs et al. 2007)

3.2.3.1 Meningohypophyseal Trunk

Also called the dorsal main stem artery (Jinkins 2000), the meningohypophyseal trunk (MHT) typically arises from the posterior bend of the ICA. This trunk originates a mean of 10.2 mm distal to the foramen lacerum (Inoue et al. 1990). Two types of the vessel are described: complete and incomplete. In the complete version, there are three branches: the tentorial artery (also called the Bernasconi-Cassinari artery), the dorsal meningeal artery (also called the dorsal clival artery) (Conti et al. 2008), and the inferior hypophyseal artery (IHA). The incomplete type demonstrates one or more of these three vessels arising directly from the cavernous ICA. More often, it is the dorsal meningeal artery. Rarely, all three vessels arise directly from the ICA. The other two tentorial branches are described by Jinkins (Jinkins 2000) as the basal meningeal and the marginal tentorial arteries that travel along the attached and free borders of the tentorium cerebelli, respectively. The IHA travels superior and medially toward the pituitary gland and primarily to its posterior lobe. In some cases, the vessel supplies the anterior lobe, mainly on its periphery (Jinkins 2000). The vessel, when approaching the pituitary gland, bifurcates and sometimes trifurcates (Parkinson 1964). The IHA and the dorsal meningeal arteries anastomose with one another on both sides, thus forming a circulus arteriosus around the root of the dorsum sellae. The dorsal meningeal artery, or dorsal clival artery, passes posterior toward Dorello’s canal and supplies the dura of the upper clivus and the proximal aspect of the abducens nerve. During its travelling, it contributes, with the artery of Bernasconi-Cassinari, to the blood supply of the proximal part of the cranial nerves inside the CS. The outer circumference of the MHT is 0.75–1 mm (Lang 1995).

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