Cavernous sinus

 

Cavernous Sinus: Critical Contents

The cavernous sinus is a paired dural venous sinus located on either side of the sella turcica. It is a frequent site of clinical concern due to the high density of vital structures passing through it.

Location Structures
Within the sinus (Medial) Internal Carotid Artery (with sympathetic plexus) and CN VI (Abducens).
Within the lateral wall CN III (Oculomotor), CN IV (Trochlear), CN V1 (Ophthalmic), and CN V2 (Maxillary).
High-Yield Clinical Notes:

  • Cavernous Sinus Thrombosis: Often secondary to infections in the “danger triangle” of the face (drained by facial vein → superior ophthalmic vein → cavernous sinus).
  • Clinical Presentation: Presents with ophthalmoplegia (CN III, IV, VI palsies) and sensory loss in the V1/V2 distribution.
  • Key Differentiator: CN VI is the only cranial nerve that runs inside the sinus with the internal carotid artery, making it the first nerve typically affected by mass effect or internal carotid pathology.