Surgical and Radiologic Anatomy

, Volume 41, Issue 9, pp 1045–1051 | Cite as

Possible cerebrospinal fluid pathways in the middle fossa floor and pterional diploe: a magnetic resonance imaging study

  • Satoshi TsutsumiEmail author
  • Hideo Ono
  • Yukimasa Yasumoto
  • Hisato Ishii
Original Article



There has not been a study documenting the distribution of cerebrospinal fluid (CSF) pathways in the anterolateral base of the middle fossa (ALB) and diploe of the pterional region (Pt). The present study aimed to delineate these pathways using magnetic resonance imaging.


Thin-sliced, axial, and coronal T2-weighted sequences were performed for a total of 358 outpatients, including 20 pediatric patients.


Adult population: CSF-filled channels were identified on axial images in the ALB in 57% and in the diploe of the Pt in 65% of 338 patients. These pathways showed variable morphology and number bilaterally. CSF-filled channels were identified on coronal images in the ALB in 14% and in the diploe of the Pt in 100% of 59 patients. These were delineated as linear structures of variable number and thickness. Eleven percent of the pathways identified in the ALB was connected with extracranial channels. Pediatric population: CSF-filled channels were identified on axial images in the ALB in 75% and in the diploe of the Pt in 80% of 20 patients.


The ALB and diploe of the Pt may function as CSF pathways in children and adults. The pathways in the ALB can be a CSF-drainage route connecting to the extracranial sites.


Cerebrospinal fluid Middle fossa Diploe Glymphatic 



This work was not supported by grant funding.

Author contributions

All the authors contributed equally to the study. ST conceived the study design. HI and YY collected the imaging data. HO and HI analyzed the imaging data. ST wrote the manuscript.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest concerning the materials or methods used in this study, or the findings presented in this paper.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • Satoshi Tsutsumi
    • 1
    Email author
  • Hideo Ono
    • 2
  • Yukimasa Yasumoto
    • 1
  • Hisato Ishii
    • 1
  1. 1.Department of Neurological SurgeryJuntendo University Urayasu HospitalUrayasuJapan
  2. 2.Division of Radiological TechnologyMedical Satellite Yaesu ClinicTokyoJapan

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