Anatomical relationships of intracavernous internal carotid artery to intracavernous neural structures

Pakrit Jittapiromsak, Hakan Sabuncuoglu, Pushpa Deshmukh, Cameron G. McDougall, Robert F. Spetzler, Mark C. Preul

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


The objective is to correlate the intracavernous internal carotid artery (ICA) with the position of the intracavernous neural structures. The cavernous sinuses of nine injected cadaveric heads were dissected bilaterally. As measured on computed tomographic angiograms from 100 adults, anatomical relationships and measurements of intracavernous ICA and neural structures were studied and correlated to the intracavernous ICA curvature. Intracavernous ICAs were classified as normal and redundant. The meningohypophyseal trunk (MHT) of normal ICAs appeared to be closely related to the abducens nerve compared with redundant ICAs (5.5±2.1 mm versus 10.0±2.5 mm, respectively; p=0.001). The position of the inferolateral trunk (ILT) varied along the horizontal segment of the intracavernous ICA. On imaging studies the ICA curvature correlated with the kyphotic degree of the skull and similarity of the ICA curvature between sides. The safety margin for preventing iatrogenic intracavernous nerve injury during surgical exploration or transarterial embolization of vascular lesions around the MHT is high with redundant ICAs. In contrast, a transvenous endovascular approach via the inferior petrosal sinus may be too distant to reach the MHT when ICAs are redundant. Approaching lesions of the inferolateral trunk may be the same regardless of ICA type.

Original languageEnglish (US)
Pages (from-to)327-336
Number of pages10
JournalSkull Base
Issue number5
StatePublished - 2010
Externally publishedYes


  • Abducens nerve
  • carotid-cavernous fistula
  • cavernous sinus anatomy
  • internal carotid artery
  • sympathetic nerve

ASJC Scopus subject areas

  • Clinical Neurology


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