Learning objectives
To review the normal anatomy and clinical manifestations of the cavernous sinus (CS) pathology.
To illustrate the diverse pathologic conditions which commonly affects the CS and elucidate their characteristic radiologic findings.
Background
The cavernous sinuses are extradural venous spaces located on each side of the sella turcica, containing within neurovascular structures that may be affected by different infectious, inflammatory, neoplastic, infiltrative and vascular pathologies. An adequate knowledge of the local anatomy helps to recognize different lesions that may occur in this area.
1-Normal anatomy
CS is a septated venous plexus surrounded by a dural fold. It is hexahedronal in shape, with a 5-7 mm transverse diameter, 5-8 mm vertical diameter and 10-15 mm anteroposterior diameter. Both cavernous...
Findings and procedure details
There are a variety ofpathologic conditionsthat can affect CS. These conditions include neoplasms, inflammatory and infectious diseases and vascular pathologies. Tumor involvement of the cavernous sinuses may be due to direct invasion of nearby lesions, being the most common pituitary macroadenomas and meningiomas. The lesions of vascular etiology, being the most common cause aneurysms, are another entity to be considered in front of a CS syndrome of uncertain etiology.
The technique of choice for study is MRI that can identify primary tumors and can evaluate...
Conclusion
The cavernous sinus contains vital neurovascular structures that may be affected by various disease entities. Knowledge of the anatomy, clinical and imaging findings of the lesions on this complex structure are essential for the evaluation of the tumors and non-neoplasic processes affecting the cavernous sinus. MRI is the key modality allowing a multiplanar analysis and direct visualization of the diseases and adjacent structures involvement. 3D heavily T2-weighted, thin T1-weighted contrast-enhanced sequences and MR-angiography are needed to make a proper diagnosis in most cases.
Personal information and conflict of interest
N. E. Marzouki; Tunis/TN - nothing to disclose T. E. B. M'rad; Ksar Said. Mannouba/TN - nothing to disclose N. Achour; Tunis/TN - nothing to disclose O. Ghdes; Tunis/TN - nothing to disclose N. Mnif; Tunis/TN - nothing to disclose
References
[1] Tang Y, Booth T, Steward M, Solbach T, Wilhelm T. The imag-ing of conditions affecting the cavernous sinus. Clin Radiol2010;65:937—45.
[2] Razek AA, Castillo M. Imaging lesions of the cavernous sinus.AJNR Am J Neuroradiol 2009;30:444—52.
[3] Nadarajah J, et al. MR imaging of cavernous sinus lesions: Pictorial review. J Neuroradiol (2015).
[4] Korchi AM, et al. Imaging of the cavernous sinus lesions. Diagnostic and Interventional Imaging (2013).
[5] Rousset P, Cattin F, Chiras J, Bonneville JF, Bonneville F. Diagnostic significance of T2W hypointensity of...