BACKGROUND AND PURPOSE: The laterocavernous sinus (LCS) has recently been r
ecognized as one of the major drainage pathways of the superficial middle c
erebral vein (SMCV), Our purpose was to investigate the drainage pattern of
the SMCV, with special emphasis on the angiographic anatomy of the LCS,
METHODS: The drainage pathways of the SMCV were evaluated prospectively on
100 selective carotid angiograms obtained in 65 consecutive patients,
RESULTS: The SMCV was absent in 19% of cases. A classic termination into th
e cavernous sinus (CS) was found in 20%, a paracavernous sinus in 39%, and
an LCS in 22%, The LCS drained toward the pterygoid plexus (27%), the super
ior petrosal sinus (18%), the posterior aspect of the CS (32%), or a combin
ation of these pathways (23%), A complete absence of connection between the
LCS and CS was observed in 63.5% of the patients.
CONCLUSION: The LCS is a laterosellar venous space that is anatomically and
angiographically distinct from the CS, Secondary small anastomoses between
the LCS and CS may make it difficult to differentiate the two structures,
Appreciation of the course and connection pattern of the LCS is important,
particularly when planning an endovascular approach to treatment of lesions
in the region of the CS.