Cavernous sinus
3182604
218969435
2008-06-13T00:04:34Z
Zeix01
7299944
/* Clinical significance */
{{Infobox Vein |
Name = Cavernous sinus |
Latin = sinus cavernosus |
GraySubject = 171 |
GrayPage = 658 |
Image = Gray488_blue.gif |
Caption = Cavernous sinus (center, labeled "SIN. CAVERN.") |
Image2 = Cavernous sinus.png |
Caption2 = The sinuses at the base of the skull. Cavernous sinus labeled in red |
DrainsFrom = |
Source = [[middle cerebral vein]], [[sphenoparietal sinus]], [[superior ophthalmic vein|superior ophthalmic vein]]|
DrainsTo = [[inferior petrosal sinus]], [[superior petrosal sinus]]|
MeshName = Cranial+Sinuses |
MeshNumber = A07.231.908.224 |
DorlandsPre = s_12 |
DorlandsSuf = 12738628 |
}}
The '''cavernous sinus''' (or '''lateral sellar compartment'''), within the human head, is a large collection of thin-walled [[vein]]s creating a cavity bordered by the [[sphenoid bone]], lateral to the sella turcia, and the [[temporal bone]] of the [[skull]].
==Contents==
The sinus may be joined by several anastomoses across the midline. The cavernous sinus receives the ophthalmic vein through the superior orbital fissure and is connected to the basilar plexus of veins posteriorly. The internal carotid artery, and cranial nerve III, IV, V, and VI all pass through this blood filled space. Infection from the face may reach the cavernous sinus through its many anastomotic connections, with severe consequences. The cavernous sinus drains by two channels, the superior and inferior petrosal sinuses.
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 V<sub>1</sub> branch of the [[trigeminal nerve]] (CN V)
** [[maxillary nerve]], the V<sub>2</sub> 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"<ref> {{MedicalMnemonics|1094|||}}</ref>
==Venous connections==
It receives tributaries from:
*[[Superior ophthalmic vein|Superior]] and [[inferior ophthalmic vein]]s
*[[Sphenoparietal sinus]]
*[[Superficial middle cerebral vein]]s
The veins of exit are to the superior and [[inferior petrosal sinus]]es as well as via the [[emissary veins]] through the [[foramina]] of the skull (mostly through foramen ovale).
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 between the two paired cavernous sinuses. An abnormally growing [[pituitary adenoma]], sitting on the bony [[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 [[Ophthalmoparesis|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).
Because of its connections with the [[facial vein]] via the [[superior ophthalmic vein]], it is possible to get infections in the cavernous sinus from an external facial injury. This is especially likely as the [[facial vein]] has no valves, allowing blood to pass in both directions. In patients with [[thrombophlebitis]] of the facial vein, pieces of the clot may break off and enter the cavernous sinus, and from there the infection may spread to the [[dural venous sinuses]]. Infections may also be introduced by facial lacerations and by bursting pimples in the areas drained by the facial vein.<ref>Kumar, P. & Clark, M. Clinical Medicine, 6th ed. Londonn: W.B. Saunders; 2005.</ref>
==Additional images==
<gallery>
Image:Gray571.png|Oblique section through the cavernous sinus.
Image:Gray572.png|Veins of orbit.
Image:Ciliary ganglion pathways.png|Pathways in the Ciliary Ganglion.
Image:Human brain dura mater (reflections) description.JPG|Human brain dura mater (reflections)
</gallery>
==See also==
* [[Dural venous sinuses]]
==References==
<references/>
==External links==
* {{LoyolaMedEd|grossanatomy/h_n/cn/dvs/dvs3.htm}}
* {{SUNYAnatomyFigs|28|03|06}} - "Venous dural sinuses."
* {{MeshName|Cavernous+Sinus}}
* {{NormanAnatomy|lesson2}}
* {{UMichAtlas|n3a8p1}}
* {{eMedicineDictionary|Cavernous+sinus}}
{{VeinsHeadNeck}}
{{circulatory-stub}}
[[Category:Head and neck]]
[[ar:جيب كهفي]]
[[de:Sinus cavernosus]]