Cavernous Sinus Syndrome

Cavernous sinus syndrome is a syndrome characterized by neuropathies of the cranial nerves passing through the cavernous sinus

The nerves passing through the cavernous sinus are:
  • Occulomotor (III) 
  • Trochlear (IV) 
  • Ophthalmic (V1)
  • Maxillary (V2) 
  • Abducens (VI) 

The optic nerve (II) runs just above the cavernous sinus. 

A diagram illustrating the anatomy of the cavernous sinus is shown below: 

Presentation of cavernous sinus syndrome is with palsies of whichever cranial nerve is affected, such as impairment of eye movement or Horner’s syndrome. 

Causes of cavernous sinus syndrome include: 
  • Infection 
    • Bacterial – staph, strep, tuberculosis 
    • Fungal 
    • Viral 
  • Vascular 
    • Aneurysm of internal carotid artery 
    • Thrombosis 
  • Inflammation 
  • Neoplasia 
    • Pituitary adenoma
    • meningioma 
    • mets – especially nasopharangeal carcinoma, lymphoma, meningioma, lung and breast metastases 

Treatment depends on the cause. 

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