Cavernous sinus syndrome may result from mass effect of these tumors and cause ophthalmoplegia (from compression of the oculomotor nerve, trochlear nerve, and abducens nerve), ophthalmic sensory loss (from compression of the ophthalmic nerve), and maxillary sensory loss (from compression of the maxillary nerve). An abnormally growing pituitary adenoma, sitting on the bony sella turcica, will expand in the direction of least resistance and eventually invade the cavernous sinus. The pituitary gland lies between the two paired cavernous sinuses. Lesions affecting the cavernous sinus may affect isolated nerves or all the nerves traversing through it. If the internal carotid artery ruptures within the cavernous sinus, an arteriovenous fistula is created (more specifically, a carotid-cavernous fistula). It is the only anatomic location in the body in which an artery travels completely through a venous structure. The cavernous sinus drains by two larger channels, the superior and inferior petrosal sinuses, ultimately into the internal jugular vein via the sigmoid sinus, also draining with emissary vein to pterygoid plexus. The optic nerve lies just above and outside the cavernous sinus, superior and lateral to the pituitary gland on each side, and enters the orbital apex via the optic canal.įunction Venous drainage Īs a venous sinus, the cavernous sinus receives blood from the superior and inferior ophthalmic veins and from superficial cortical veins, and is connected to the basilar plexus of veins posteriorly. The maxillary branch passes external to, but immediately adjacent to, the lateral wall of the sinus. The maxillary nerve, division V 2 of the trigeminal nerve travels through the lower portion of the sinus and exits via the foramen rotundum. These nerves, with the exception of CN V 2, pass through the cavernous sinus to enter the orbital apex through the superior orbital fissure. Internal carotid artery accompanied by the internal carotid plexus.Structures passing through the midline (medial) wall: Ophthalmic and maxillary branches of the trigeminal nerve.Structures within the outer (lateral) wall of the compartment from superior to inferior: There are also connections with the pterygoid plexus of veins via inferior ophthalmic vein, deep facial vein and emissary veins.Īpart from the blood which passes through a venous sinus, several anatomical structures, including some cranial nerves and their branches, also pass through the sinus. Superior and inferior ophthalmic veins īlood leaves the sinus via superior and inferior petrosal sinuses as well as via the emissary veins through the foramina of the skull (mostly through foramen ovale).The cavernous sinus receives blood from: Posteriorly: apex of petrous temporal bone.Anteriorly: superior orbital fissure, and the apex of the orbit.Medially: pituitary gland (hypophysis cerebri), and sphenoidal air sinus.Inferiorly: foramen lacerum, and the junction of the body and greater wing of sphenoid bone.Above: optic tract, optic chiasma, internal carotid artery.The cavernous sinus lies in between the inner and outer layers of dura mater. Both sides of cavernous sinus is connected to each other via intercavernous sinuses. The carotid siphon of the internal carotid artery, and cranial nerves III, IV, V (branches V 1 and V 2) and VI all pass through this blood filled space. It sits on both sides of the sphenoidal bone and pituitary gland, approximately 1 × 2 cm in size in an adult. It is a network of veins that sit in a cavity. The cavernous sinus is one of the dural venous sinuses of the head. The cavernous sinus within the human head is one of the dural venous sinuses creating a cavity called the lateral sellar compartment bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica.
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