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Pterygoid Venous Plexus Asymmetry
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Pterygoid venous plexus (PVP) asymmetry
            • Synonyms

              • Pterygoid plexus
            • Definitions

              • Unilateral prominence of deep facial venous network draining cavernous sinus
                • Usually incidental finding on brain or neck imaging
                  • May be secondary to underlying carotid cavernous fistula (CCF) or arteriovenous malformation
                  • Angiography indicated in symptomatic patients

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Golub B, Bordoni B. Neuroanatomy, pterygoid plexus. StatPearls, 2020
                                      2. Fabre C et al: Maxillary sinusitis complicated by stroke. Eur Ann Otorhinolaryngol Head Neck Dis. 135(6):449-51, 2018
                                      3. Bernal-Mañas CM et al: New anatomo-radiological findings of the lateral pterygoid muscle. Surg Radiol Anat. 38(9):1033-43, 2016
                                      4. Qureshi AI et al: Patterns and rates of supplementary venous drainage to the internal jugular veins. J Neuroimaging. 26(4):445-9, 2016
                                      5. Kim E et al: MRI and MR angiography findings to differentiate jugular venous reflux from cavernous dural arteriovenous fistula. AJR Am J Roentgenol. 202(4):839-46, 2014
                                      6. Watanabe K et al: Normal flow signal of the pterygoid plexus on 3T MRA in patients without DAVF of the cavernous sinus. AJNR Am J Neuroradiol. 34(6):1232-6, 2013
                                      7. Oshima T et al: Involvement of pterygoid venous plexus in patulous eustachian tube symptoms. Acta Otolaryngol. 127(7):693-9, 2007
                                      8. Tanoue S et al: Para-cavernous sinus venous structures: anatomic variations and pathologic conditions evaluated on fat-suppressed 3D fast gradient-echo MR images. AJNR Am J Neuroradiol. 27(5):1083-9, 2006
                                      9. Schievink WI et al: Spontaneous carotid-jugular fistula and carotid dissection in a patient with multiple intracranial arachnoid cysts and hemifacial atrophy: a generalized connective tissue disorder? Case report. J Neurosurg. 83(3):546-9, 1995
                                      10. Lanzieri CF et al: The significance of asymmetry of the foramen of Vesalius. AJNR Am J Neuroradiol. 9(6):1201-4, 1988
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Pterygoid venous plexus (PVP) asymmetry
                                                • Synonyms

                                                  • Pterygoid plexus
                                                • Definitions

                                                  • Unilateral prominence of deep facial venous network draining cavernous sinus
                                                    • Usually incidental finding on brain or neck imaging
                                                      • May be secondary to underlying carotid cavernous fistula (CCF) or arteriovenous malformation
                                                      • Angiography indicated in symptomatic patients

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Angiographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Golub B, Bordoni B. Neuroanatomy, pterygoid plexus. StatPearls, 2020
                                                                          2. Fabre C et al: Maxillary sinusitis complicated by stroke. Eur Ann Otorhinolaryngol Head Neck Dis. 135(6):449-51, 2018
                                                                          3. Bernal-Mañas CM et al: New anatomo-radiological findings of the lateral pterygoid muscle. Surg Radiol Anat. 38(9):1033-43, 2016
                                                                          4. Qureshi AI et al: Patterns and rates of supplementary venous drainage to the internal jugular veins. J Neuroimaging. 26(4):445-9, 2016
                                                                          5. Kim E et al: MRI and MR angiography findings to differentiate jugular venous reflux from cavernous dural arteriovenous fistula. AJR Am J Roentgenol. 202(4):839-46, 2014
                                                                          6. Watanabe K et al: Normal flow signal of the pterygoid plexus on 3T MRA in patients without DAVF of the cavernous sinus. AJNR Am J Neuroradiol. 34(6):1232-6, 2013
                                                                          7. Oshima T et al: Involvement of pterygoid venous plexus in patulous eustachian tube symptoms. Acta Otolaryngol. 127(7):693-9, 2007
                                                                          8. Tanoue S et al: Para-cavernous sinus venous structures: anatomic variations and pathologic conditions evaluated on fat-suppressed 3D fast gradient-echo MR images. AJNR Am J Neuroradiol. 27(5):1083-9, 2006
                                                                          9. Schievink WI et al: Spontaneous carotid-jugular fistula and carotid dissection in a patient with multiple intracranial arachnoid cysts and hemifacial atrophy: a generalized connective tissue disorder? Case report. J Neurosurg. 83(3):546-9, 1995
                                                                          10. Lanzieri CF et al: The significance of asymmetry of the foramen of Vesalius. AJNR Am J Neuroradiol. 9(6):1201-4, 1988