![]() The remaining cranial nerves 9, 11, and 12 all pierce the carotid sheath anteriorly. ![]() The 10th cranial nerve lies in the posterior groove between these two vessels. The carotid artery is the center of the carotid space, and the jugular vein lies posterolateral to the carotid artery. Knowledge of the location of particular structures within the carotid space can lead to the correct diagnosis, if not narrow, the differential to a few lesions. The internal jugular vein and the common carotid artery are also contained within the infrahyoid carotid space. Below the level of the hyoid, the ansa cervicalis (a loop of the first 3 cervical nerves) and cranial nerves 9, 11, and 12 have exited, thus leaving only cranial nerve 10. The infrahyoid carotid space is surrounded anteriorly by the anterior cervical space, medially by the visceral and retropharyngeal spaces, and posteriorly by the perivertebral and posterior cervical spaces. The suprahyoid portion of the carotid space contains the internal carotid artery, the internal jugular vein, cranial nerves 9 through 12, the ansa cervicalis, the sympathetic plexus, and deep cervical lymph nodes. A mass centered within the carotid space will displace the parapharyngeal fat/space anteromedially. The suprahyoid carotid space is surrounded anteriorly by the masticator and parapharyngeal spaces, laterally by the parotid space, medially by the retropharyngeal space, and posteriorly by the perivertebral space. Extending from the jugular foramen at the skull base to the aortic arch at the thoracic inlet, the carotid space is divided craniocaudally into the supra- and infrahyoid regions. The carotid space is a paired space defined by the carotid sheath, a connective tissue boundary in the neck, that is made by the superficial, middle, and deep layers of the deep cervical fascia. As the name implies, the carotid artery and jugular vein may also be involved as part of the pathology. Masses within this space include paragangliomas, nerve sheath tumors, lipomas, and pathology involving the deep cervical chain lymph nodes. This article will review the anatomy of the carotid space, as well as the various types of pathology that may occur within this confined region. ![]() The complex anatomy of the carotid space within a small confined space in the neck allows for a vast array of pathology. Understanding the complex and unique anatomy of the carotid space, as well as the nuances of navigating a broad differential, will empower the reader to make an accurate diagnosis. Entities discussed include paragangliomas, nerve sheath tumors, meningioma, fibromuscular dysplasia, carotidynia, thrombus, dissection, pseudoaneurysm, and pathology of the deep cervical chain lymph nodes. The discussion will include anatomic considerations in differential diagnoses, imaging features, and lesion characteristics across multiple imaging modalities including CT, MRI, ultrasound, and conventional angiography. The paper will also describe the myriad of mass lesions and vascular pathologies that may occur within the carotid space. This paper will review the anatomy of the carotid space from the skull base to the thorax, defining its borders at multiple levels, as well as its contents. The complex anatomy of the carotid space within a small confined area is unique to the head and neck and allows for a vast array of pathology.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |