Dural relationships of Meckel cave and lateral wall of the cavernous sinus

Abstract

OBJECT: The purpose of this study was to elucidate the anatomy of the trigeminal nerve (cranial nerve [CN] V), Meckel cave (MC), and lateral wall of the cavernous sinus (CS). METHODS: Ten fresh cadaver heads (20 sides) and 2 middle fossa embalmed specimens were removed, decalcified, sectioned, stained, and studied microscopically. RESULTS: In the MC, the posterior fossa meningeal dura extended into the middle fossa surrounding CN V. The average medial length of the MC was 16.7 mm and the lateral length was 13.5 mm. The dural roof of MC was thicker than its floor and was covered by a paw-shaped fibrous tissue extending from the tentorium to the ganglion (in 100% of specimens). Between the dural sleeve of the MC and venous space of the CS, a separate fibrous wall could be identified in 45% (9 of 20) extending between the tentorium and the floor of the CS. The mean length of CN V in the MC proximal to the posterior margin of the Gasserian ganglion was 11.8 mm. The mean length of CN V1 was 19.4 mm; V2, 12.3 mm; and V3, 7.4 mm distal to the anterior margin of the ganglion. The periosteal dura followed the bone of the middle fossa and was continuous with the extracranial periosteum. The lateral dural wall of the CS consisted of a medial (membranous) and a lateral wall. The latter was separated into a thin outer layer and a thicker fibrous inner layer that became thinner as it extended posterolaterally. CONCLUSIONS: The MC is an extension of the posterior fossa dura with intricate relationships with the surrounding dural layers.