The cavernous sinus in cluster headache – a quantitative structural magnetic resonance imaging study. (March 2017)

• Record Type: Journal Article
• Authors: Arkink, Enrico B; Schoonman, Guus G; van Vliet, Jorine A; Bakels, Hannah S; Sneeboer, Marjolein AM; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C
• Is Part Of: Cephalalgia. Volume 37:Number 3(2017)
• Page Start: 208
• Page End: 213
• Publication Date: 2017-03
• Subjects: Cluster headache -- chronic paroxysmal hemicrania -- cavernous sinus; Headache -- Periodicals; 616.8491
• DOI: 10.1177/0333102416640513
• Languages: English
• ISSNs: 0333-1024

Abstract

Background: It has been hypothesized that a constitutionally narrow cavernous sinus might predispose individuals to cluster headache. Cavernous sinus dimensions, however, have never been assessed. Methods: In this case–control study, we measured the dimensions of the cavernous sinus, skull base, internal carotid and pituitary gland with high-resolution T2-weighted magnetic resonance imaging in 25 episodic, 24 chronic and 13 probable cluster headache patients, 8 chronic paroxysmal hemicrania patients and 22 headache-free controls. Dimensions were compared between groups, correcting for age, sex and transcranial diameter. Results: On qualitative inspection, no relevant pathology or anatomic variants that were previously associated with cluster headache or chronic paroxysmal hemicranias were observed in the cavernous sinus or paracavernous structures. The left-to-right transcranial diameter at the temporal fossa level (mean ± SD) was larger in the headache groups (episodic cluster headache: 147.5 ± 7.3 mm, p = 0.044; chronic cluster headache: 150.2 ± 7.3 mm, p < 0.001; probable cluster headache: 146.0 ± 5.3 mm, p = 0.012; and chronic paroxysmal hemicrania: 145.2 ± 9.4 mm, p = 0.044) compared with controls (140.2 ± 8.0 mm). After adjusting for transcranial diameter and correcting for multiple comparisons, there were no differences in the dimensions of the cavernous sinus and surrounding structures between headache patients and controls. Conclusion: Patients with cluster headache or chronic paroxysmal hemicrania had wider skulls than headache-free controls, but the proportional dimensions of the cavernous sinus were similar.