Anatomical Location of the Cavernous Sinus
The cavernous sinus is located in the floor of the middle cranial fossa on either side of the sella turcica and sphenoid sinus. 1
Detailed Anatomical Position
The cavernous sinuses are paired interconnected venous plexuses that occupy a critical position in the skull base. Their specific anatomical characteristics include:
- Located lateral to the sella turcica and sphenoid sinus 1
- Situated in the middle cranial fossa floor 1
- Lined by dura mater and containing multiple venous channels 1
- Connected to the opposite cavernous sinus via a venous sinus within the dorsum sellae 2
Important Anatomical Relationships
The cavernous sinus has several critical neurovascular structures running through or adjacent to it:
- Internal carotid artery and its sympathetic plexus 1
- Cranial nerves:
In the cavernous sinus, the sixth nerve (abducens) is in close proximity to the intracavernous carotid artery, ocular sympathetics, and other cranial nerves (III, IV, and V1). 3
Anatomical Connections
The cavernous sinus connects to several important regions:
- Orbit
- Pterygopalatine fossa
- Infratemporal fossa
- Nasopharynx
- Posterior cranial fossa 1
These connections occur through various foramina, fissures, and canals in the skull base, making the cavernous sinus a critical junction for various pathological processes.
Clinical Significance
The anatomical position of the cavernous sinus makes it vulnerable to various pathological processes:
- Pituitary adenomas can invade the cavernous sinus through its medial wall 3, 4
- Infections from the paranasal sinuses (particularly ethmoid and sphenoid) can spread to the cavernous sinus causing septic thrombosis 3, 5
- Carotid artery aneurysms, inflammatory processes, or other structural lesions in the cavernous sinus may cause multiple cranial neuropathies 3
Imaging Considerations
When evaluating the cavernous sinus:
- MRI is the modality of choice for visualizing the cavernous sinus 1
- CT and digital subtraction angiography play supplementary roles in specific situations 1
- MRI with MRV (magnetic resonance venography) is preferred for diagnosing sinus thrombosis 6
The cavernous sinus's complex anatomy and critical neurovascular relationships make it an important structure to understand in the context of various neurological, ophthalmological, and otorhinolaryngological conditions.