Meningeal Architecture of the Jugular Foramen: An Anatomic Study Using Plastinated Histologic Sections.

World neurosurgery(2019)

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摘要
OBJECTIVE:This 3-dimensional histologic study aimed to provide a precise description of the meningeal structures in the jugular foramen. METHODS:22 posterior skull base tissue blocks containing the jugular foramen region were obtained from 11 human cadaveric heads. These blocks were plastinated and cut into serial sections. After staining, these sections were examined under an optical microscope and used to reconstruct a 3-dimensional visualization model. RESULTS:At the intracranial orifice of the jugular foramen, the meningeal dura formed 2 separate dural perforations: the glossopharyngeal meatus and the vagal meatus. The arachnoid extended into 2 dural meatuses and terminated at the inferior ganglion of the glossopharyngeal nerve in the glossopharyngeal meatus and the superior ganglion of the vagus nerve in the vagal meatus. At the intraforaminal part of the jugular foramen, the meningeal dura encased the glossopharyngeal nerve to form a dural sheath while encasing the vagus and accessory nerves to form a dural network. At the extracranial orifice of the jugular foramen, the dural wall of the jugular bulb extended downward to form a dense connective tissue sheath. The initial end of the internal jugular vein invaginated into this sheath and fused with the jugular bulb. CONCLUSIONS:Knowledge of the anatomy of the meningeal architecture of the jugular foramen can be helpful in avoiding surgical complications of the lower cranial nerves when this complex area is approached.
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