Cavernous sinus syndrome

Last revised by Henry Knipe on 26 Mar 2019

Cavernous sinus syndromes refer to constellations of clinical signs and symptoms referable to pathology within or adjacent to the cavernous sinus.

Patients present with multiple unilateral cranial neuropathies involving any combination of the following:

  • ophthalmoplegia (cranial nerves III, IV, or VI), most commonly presenting as diplopia
  • facial sensory loss (cranial nerves V1 and V2)
  • Horner syndrome (oculosympathetic fibers)

Pain can occur, especially with inflammatory processes.

Additional symptoms may be vascular in origin:

  • chemosis
  • proptosis

Causes are diverse 1-4 and may be organized by surgical sieve:

Cases and figures

  • Case 1: nasopharyngeal cancer
  • Case 2: pituitary macroadenoma
  • Case 3: chondrosarcoma
  • Case 4: plasmacytoma
  • Case 5: meningioma
  • Case 6: Tolosa-Hunt syndrome
  • Case 7: septic thrombophlebitis
  • Case 8: cavernous malformation/hemangioma
  • Case 9: caroticocavernous fistula
  • Case 10: epidermoid cyst
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