Abstract
The cavernous sinus is a large venous cavity that lies on both sides of the sella turcica of the sphenoid bone. It extends from the petrous apex posteriorly to the superior orbital fissure anteriorly, and the sphenoidal sinus and the hypophyseal fossa are medial to it. In the inferoposterior part of its lateral wall lies Meckel’s cave and the trigeminal ganglion. Among the major contents of the sinus are the cavernous segment of the internal carotid artery and carotid sympathetic nervous plexus, and several cranial nerves.
The oculomotor nerve lies most superior in the lateral wall of the sinus, followed by the trochlear nerve. Having exited Meckel’s cave, the ophthalmic (V1) and maxillary (V2) divisions of the trigeminal nerve pass in the lateral wall in this order, inferior to the trochlear nerve. The abducens nerve begins its cavernous segment after having passed through Dorello’s canal under the petrosphenoidal ligament of Grüber. In this segment, the abduces nerve passes lateral to the artery within the sinus’ cavity.
The cavernous sinus is richly connected to other venous systems. It receives tributaries from the superior and inferior ophthalmic veins, from the sphenoparietal sinus that follows the edge of the sphenoid lesser wing, and from several cerebral veins. The sinus communicates with the transverse sinus and the internal jugular vein via the superior and inferior petrosal sinuses, respectively, and also with the laterally situated pterygoid venous plexus.
MRI is the imaging of choice to evaluate most pathologies although most cranial nerves may not be readily demonstrated in the normal cavernous sinus. CT angiography and DSA are essential in vascular anomalies (e.g., carotid aneurysm and CC fistula).
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Rootman, J. et al. (2021). Cavernous Sinus. In: Ben Simon, G., Greenberg, G., Prat, D. (eds) Atlas of Orbital Imaging . Springer, Cham. https://doi.org/10.1007/978-3-030-41927-1_6-1
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DOI: https://doi.org/10.1007/978-3-030-41927-1_6-1
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