Cavernous sinus

Vein: Cavernous sinus
Oblique section through the cavernous sinus. (Cavernous sinus labeled at upper right.)
The sinuses at the base of the skull. Cavernous sinus labeled in red
Latin	sinus cavernosus
Gray's	subject #171 658
Source	middle cerebral vein, sphenoparietal sinus, superior ophthalmic vein
Dorlands / Elsevier	s_12/12738628

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The cavernous sinus (or lateral sellar compartment) is a large collection of thin-walled veins creating a cavity bordered by the sphenoid bone and the temporal bone of the skull.

Contents

Each cavernous sinus (one for each hemisphere of the brain) contains the following:

• vertically, from superior to inferior
  • oculomotor nerve (CN III)
  • trochlear nerve (CN IV)
  • ophthalmic nerve, the V₁ branch of the trigeminal nerve (CN V)
  • maxillary nerve, the V₂ branch of CN V

• horizontally
  • internal carotid artery (and sympathetic plexus). See also cavernous part of internal carotid artery.
  • abducens nerve (CN VI)

One mnemonic for remembering the contents is "OTOM CAT"

Venous connections

It receives tributaries from:

• Superior and inferior ophthalmic veins
• Superior parietal sinus
• Superior and middle cerebral veins

The veins of exit are to the superior and inferior petrosal sinuses as well as via the emissary veins through the foramina of the skull. There are also connections with the pterygoid plexus of veins via inferior ophthalmic vein, deep facial vein and emissary veins.

Clinical significance

It is the only anatomic location in the body in which an artery travels completely through a venous structure. If the internal carotid artery ruptures within the cavernous sinus, an arteriovenous fistula is created (more specifically, a carotid-cavernous fistula).

The pituitary gland lies directly below the cavernous sinus. An abnormally growing pituitary adenoma, surrounded on all other sides by the bony walls of the sella turcica, will expand in the direction of least resistance and eventually compress the cavernous sinus. 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).

Additional images

• 

  Veins of orbit.

• 

  Pathways in the Ciliary Ganglion.

See also

• Dural venous sinuses

External links

• MedEd at Loyola grossanatomy/h_n/cn/dvs/dvs3.htm
• SUNY Figs 28:03-06 - "Venous dural sinuses."
• MeSH Cavernous+Sinus
• Norman/Georgetown lesson2
• UMichAtlas|n3a8p1
• Cavernous+sinus at eMedicine Dictionary

de:Sinus cavernosus