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How to understand an enlarged Meckel’s cave? An anatomical study

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Abstract

Purpose

Dilatation of the trigeminal cavum, or Meckel’s cave (MC), is usually considered a radiological sign of idiopathic intracranial hypertension. However, the normal size of the trigeminal cavum is poorly characterized. In this study, we describe the anatomy of this meningeal structure.

Methods

We dissected 18 MCs and measured the length and width of the arachnoid web and its extension along the trigeminal nerve.

Results

Arachnoid cysts were clearly attached to the ophthalmic (V1) and maxillary (V2) branches until they entered the cavernous sinus and foramen rotundum, respectively, without extension to the skull base. Arachnoid cysts were close to the mandibular branch toward the foramen ovale, with a median anteromedial extension of 2.5 [2.0–3.0] mm, lateral extension of 4.5 [3.0–6.0] mm, and posterior extension of 4.0 [3.2–6.0] mm. The trigeminal cavum arachnoid had a total width of 20.0 [17.5–25.0] mm and length of 24.5 [22.5–29.0] mm.

Conclusion

Our anatomical study revealed variable arachnoid extension, which may explain the variability in size of the trigeminal cavum in images and calls into question the value of this structure as a sign of idiopathic intracranial hypertension. The arachnoid web extends beyond the limits described previously, reaching almost double the radiological size of the cavum, particularly at the level of V3 afference of the trigeminal nerve. It is possible that strong adhesion of the arachnoid to the nerve elements prevents the formation of a true subarachnoid space that can be visualized by magnetic resonance imaging.

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Data availability

Dr. Le Petit had full access to all of the data used in this study and takes responsibility for the integrity and accuracy of the data analysis. Data are available upon request to the corresponding author.

Code availability

None.

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Authors and Affiliations

  1. Department of Neurosurgery A, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France

    Laetitia Le Petit, Paul Roblot, Gaëlle Kerdiles, Dominique Liguoro & Vincent Jecko

  2. Laboratory of Anatomy, University of Bordeaux, 33000, Bordeaux, France

    Laetitia Le Petit, Paul Roblot, Gaëlle Kerdiles, Dominique Liguoro & Vincent Jecko

  3. Department of Neurosurgery B, University Hospital of Bordeaux, Bordeaux, France

    Arthur Durouchoux

Authors
  1. Laetitia Le Petit
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  2. Paul Roblot
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  3. Arthur Durouchoux
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  4. Gaëlle Kerdiles
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  5. Dominique Liguoro
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  6. Vincent Jecko
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Contributions

Dominique Liguoro, Vincent Jecko and Laetitia Le Petit developed the study design. Arthur Durouchoux and Laetitia Le Petit performed anatomical dissections and prepared figures. Paul Roblot and Laetitia Le Petit wrote the main manuscript text. Gaelle Kerdiles made critical revisions. All authors reviewed the manuscript.

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Correspondence to Laetitia Le Petit.

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All authors declare that they received no support from any organization for this study and have no financial relationships with any organizations that could have an interest in the submitted work.

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Le Petit, L., Roblot, P., Durouchoux, A. et al. How to understand an enlarged Meckel’s cave? An anatomical study. Surg Radiol Anat 45, 933–937 (2023). https://doi.org/10.1007/s00276-023-03177-w

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  • DOI: https://doi.org/10.1007/s00276-023-03177-w

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