2/When I look at the skullbase veins, I see an angry Santa yelling at me. His eyebrows are raised, his mouth is open, & he has a mustache w/a big beard hanging down.
Each I look at the skullbase, I look for this Santa—bc each part of him is an important venous structure.
3/So let’s start w/Santa’s eyes. The eyes are actually not a venous structure, but an important landmark—foramen ovale, where the V3 trigeminal nerve exit.
I remember ovale is Santa's eyes bc eyes are OVAL, so his eyes are OVALE
4/Next are Santa’s angry raised eyebrows. These are the sphenoparietal sinuses.
I remember these are the eyebrows bc I call them “seen”-oparietal sinuses & you see w/your eyes.
These have this “eyebrow” shape bc they are following the curve of the greater sphenoid wing
5/Sphenoparietal sinuses meet in the middle at the cavernous sinus—like your eyebrows meet in the middle at your nose.
I remember the cavernous sinus & intracavernous sinuses are Santa’s nose bc you dig in a cavern. And where do all kids like to go digging? Their nose! 🤢
6/Right below Santa’s nose is his mustache & this is the basilar plexus, right below the cavernous sinus.
You can remember this bc mustaches are made of a base & handlebars—and the BASE of Santa’s mustache is the BASilar plexus
7/Extending from Santa’s mustache is his beard. These are the petrosal sinuses (inferior & superior), important in many neurosurgical approaches.
You can remember that the PETROsal sinuses make up sides of the beard bc you use PETROleum to smooth the sides of your beard
8/Finally, Santa’s mouth is the marginal sinus. I remember this bc the word marginal sounds like “Aaaargh”—the sound pirates make from their mouth. I call it the Maaaargh—inal sinus
So hopefully this thread has given you some ELF-confidence when it comes to skullbase anatomy!
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@TheAJNR 2/Since the prehistoric days of medicine (1979!), we knew that some brain tumor patients treated w/radiation (XRT) initially declined, but then get better.
Today, we see this on imaging, where it looks worse early, but then gets better.
Now we call this pseudoprogression.
@TheAJNR 3/Why does this happen?
XRT induces a lot of inflammatory changes—from initiating the complement cascade to opening the blood brain barrier (BBB)
It’s these inflammatory changes that make the imaging look worse.