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At least 19 recordsLinked to original sources
PubMed1977

Cavernous sinus syndrome produced by communication between the external carotid artery and cavernous sinus.

The authors present two cases of cavernous sinus syndrome with spontaneous onset secondary to arteriovenous malformations and review the cases reported previously. These malformations enlarge slowly and produce symptoms only in adult life. Diagnosis may be difficult when there is no associated bruit. Adequate evaluation necessitates selective angiography of both the internal and external carotid artery circulation and the vertebral circulation. Conservative treatment is recommended unless symptoms worsen or there is progressive loss of vision.

Adult↗
PubMed1976

Anatomy of the cavernous sinus. A microsurgical study.

Fifty cavernous sinuses from cadavers were studied in detail using magnification, with special attention to the relationships important in surgical approaches on the intracavernous structures, and to understanding arterial contributions to arteriovenous fistulas involving the cavernous sinus. Significant findings were: 1) The three main branches of the intracavernous portion of the carotid artery were the meningohypopyseal artery, present in 100% of the specimens, the artery of the inferior cavernous sinus (84%), and McConnell's capsular arteries (28%). In addition, the ophthalmic and dorsal meningeal arteries arose from the carotid artery within the cavernous sinus in 8% and 6%, respectively. The three main branches of the meningohypopyseal trunk were the tentorial artery, present in 100%, the dorsal meningeal (90%), and the inferior hypophyseal (80%). 2) The carotid artery was separated from the trigeminal nerve just proximal to the sinus by only dura in 84% of the specimens, and the artery was exposed in the floor of the middle fossa lateral to the trigeminal nerve in 38%. 3) The intracavernous portion of the carotid artery indented the lateral side of the pituitary gland in 28% of dissections but could be as far as 7 mm from it. 4) A triangular area, described by Parkinson, through which the intracavernous portion of the carotid artery could be exposed surgically was found in all specimens. 5) The sixth cranial nerve may split into as many as five rootlets as it passes lateral to the intracavernous portion of the carotid artery. 6) The three major venous spaces within the sinus were posterosuperior, anteroinferior, and medial to the intracavernous portion of the carotid artery.

Abducens Nerve↗
PubMed1977

The cavernous sinus: an anatomical survey.

An anatomical survey of the cavernous sinus in 16 adult cadavera has been made, based on serial sections cut at 15 micron in the coronal and sagittal planes. Certain aspects of the survey are of particular interest: (1) the oculomotor, trochlear, and ophthalmic nerves do not run in the lateral dural wall of the cavernous sinus; (2) venous sinuses of the cavernous sinus flow freely in a medial direction both anterior and posterior to the dorsum sellae; (3) trabeculae in the form of collections of fine areolar tissue extend between the vascular and neural elements. The amount present is variable; (4) the horizontal section of the internal carotid artery within the cavernous sinus runs a variable course in relation to the hypophysis and the lateral dural wall; (5) the oculomotor nerve lies within a meningeal envelope as far anteriorly as the tip of the anterior clinoid process; (6) the ophthalmic nerve communicates with the oculomotor, trochlear, and abducent nerves in the anterior part of the cavernous sinus; (7) the abducent nerve may lie within a meningeal envelope in the posterior part of the cavernous sinus; (8) the greater part of the sympathetic nerve plexus around the vertical part of the internal carotid artery passes into the abducent and ophthalmic nerves. Sympathetic fibres pass into the sheaths surrounding the oculomotor and trochlear nerves. Sympathetic ganglia are suspended from the ophthalmic nerve.

Abducens Nerve↗
PubMed1979

Dural and direct cavernous sinus fistulas.

Fistulas between the cavernous sinus and the carotid artery occur either after trauma or spontaneously. Unilateral exophthalmos is invariably the most conspicuous symptom. Until recently, treatment consisted of some method of occluding the carotid artery involved. Interventional catheter techniques have since been developed that use either Gelfoam embolization or released balloons. The results seem very promising, but long-term results of these new techniques are not yet available. Carotid-cavernous sinus fistulas may be dural or direct, each requiring a different interventional technique. Theredore, it is essential to determine the type involved by selective internal and external carotid angiography. This paper discusses 19 patients with carotid-cavernous fistulas, four of whom were successfully treated by catheter techniques. Gelfoam embolization was used in one case, and in three cases the fistula was closed with the aid of a balloon.

Adolescent↗
PubMed1977

Cavernous sinus thrombosis revisited.

In summary, cavernous sinus thrombosis is still with us. Patients now survive the disease more often than not, and therapy and diagnosis are reasonably clear cut. An increasing array of antibiotic-resistant bacteria have been balanced by an increasing army of antibiotics. The controversy over anticoagulation has not changed since reviewed by Parsons (1967). Ancillary measures remain more of value in diagnosis than in therapy. It is a disease primarily diagnosed by physical signs and symptoms, which requires prompt treatment. In our modern age of computerization and laboratory-based medical care, cavernous sinus thrombosis demands the diagnostic skill of the clinician, whose prompt ministrations should usually yield a favourable result.

Cavernous Sinus↗
PubMed1978

The radiographic recognition of two clinically elusive mass lesions of the cavernous sinus: meningiomas and aneurysms.

Cavernous sinus syndromes secondary to chronic mass lesions, although a relatively rare cause of ophthalmoplegia, represent a distinct challenge in neuroradiologic diagnosis. Puzzling neuro-ophthalmologic signs and often subtle radiologic changes consistently lead to erroneous and delayed diagnoses as exemplified by a review of 20 patients; a correct clinical or radiographic diagnosis was initially not made in any individual.

Aged↗
PubMed1979

Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region.

The topographic and internal anatomy of the sphenoid bone is reviewed with an emphasis on the relationships important to the transcranial and subcranial surgical approaches to the sphenoid sinus, sella turcica and cavernous sinus. A stepwise method of study and dissection is outlined. The equipment and materials needed for sphenoid bone dissection in the laboratory are reviewed.

Cavernous Sinus↗
PubMed1977

[Interesting radiological and pathological findings of the internal carotid artery observed in a case of cavernous sinusitis (author's transl)].

A 47-year-old man was admitted to the neurosurgical department of Nagasaki University Hospital with complaints of high fever, deteriorated conciousness and nonpulsating exophthalmus on the left side. The first carotid angiography which had been done 2 days prior to admission, showed only an irregular narrowing in the cavernous portion of the left carotid artery. The right carotid angiogram did not show any recognizable abnormality. The second angiography which was performed 4 days after the admission, revealed an cylindrical aneurysmal opacification about 0.8 cm in diameter in the left intracavernous portion. The right angiography could not be done at that time. On the 47th hospital day, the third angiogram was performed. There noted again, the aneurysmal opacification in the left carotid artery and furthermore, the right carotid artery was occluded completely at its entrance into the cavernous sinus. On post-mortem examination, the cavernous sinus was filled with coagulated blood which drived from the ruptured left internal carotid artery. Microscopic examination revealed marked invasion of leucocytes to the wall of the internal carotid artery at the cavernous portion in both sides. These findings suggested that a mycotic aneurysm which resulted from the cavernous sinusitis ruptured into the left cavernous sinus and spelled blood compressed the opposite (right) carotid artery within the carvernous sinus which resulted in occlusion of the artery.

Carotid Artery, Internal↗
PubMed1977

[Blood supply of intracranial meningiomas involving the cavernous sinus].

The normal topographic-anatomic interrelationships of the cavernous sinus and its structures were studied in 12 preparations of pathology-free brains removed from the skull en bloc with the meninges and the skull base bones. In 14 cases of fatal sphenoidal wings meningiomas of the medial and total variants the microsurgical anatomy of these tumorus was studied by polychromatic injection of cerebral and tumourous vessels with a subsequent macro-micro preparation. The peculiarites of the interrelationship between the tumour and the cavernous sinus with its structures and the major vesels, and the blood supply sources to the tumour were revealed. Contraindications for total exirpation of the tumours were precised, and the necessity of microsurgical technique was substantiated.

Brain Neoplasms↗
PubMed1978

Ischemic optic neuropathy in cavernous sinus thrombosis.

Visual loss is uncommon in thrombosis of the cavernous sinus. A patient observed closely in the acute stages developed high introcular and intraorbital pressures. Although the retinal vasculature remained patent, total unilateral blindness occurred within 48 hours. To our knowledge this is the first documented case in which ischemic optic neuropathy caused blindness in a patient suffering from cavernous sinus thrombosis.

Adult↗
PubMed1975

Effect of intracranial pressure on cavernous sinus flow: a cadaver model.

Through an artificially created carotid-cavernous fistula, the cavernous sinus of four suitable cadavers was perfused at a constant input pressure of 50 cm H20 at various levels of intracranial pressure. The flow rate fell 25% at an intracranial pressure of 50 mm Hg but could not be totally arrested even at the extremes of intracranial hypertension. The authors conclude that the cavernous sinus in man is not collapsible.

Blood Flow Velocity↗
PubMed1977

Thrombosis of the intraorbital veins and cavernous sinus.

Eight cases with phlebographic appearances consistent with aseptic thrombosis of the cavernous sinus or of the posterior part of the superior ophthalmic vein are presented. The clinical course is briefly described and the phlebographic findings and possible differential diagnoses discussed. Even if recent methods may obviate the need for phlebography in the demonstration of orbital tumors in certain cases, the possibility of intraorbital or cavernous sinus thrombosis constitutes an important indication for phlebography.

Adult↗
PubMedDate not supplied

[Extension of pituitary adenomas into the cavernous sinuses (clinico-anatomic study)].

The article deals with the study of 288 verified cases with adenomas of the pituitary gland. Growth of the tumor into the cavernous sinus was revealed in 102 cases (35.4%). The possible routes of penetration of pituitary tumours into the cavernous sinus and the relationship of the new growths with the intracavernous structures are described in detail. The findings of purposeful radio-diagnostic examination revealing the characteristic combinations of the symptoms of intracavernous expansion of the tumor are of paramount importance in recognizing growth of pituitary adenomas into the cavernous sinuses. It is emphasized that the possibility of such growth must be borne in mind when the operation is planned.

Adenoma↗
PubMed1979

Scanning electron microscopy of the parimarginal cavernous sinus plexus of the human spleen.

The perifolicular region of the human spleen was studied under the scanning electron microscope. The marginal zone 10 to 50 micron in width was located around the white pulp, and was composed of concentrically arranged reticulum cell networks and intervening lymphocytes, red blood cells and macrophages. The cavernous sinuses 10-150 micron in width were situated between the marginal zone and the red pulp, and were lined by thin, flat endothelia. The perimarginal cavernous sinuses communicated with one another through narrow canals and formed a plexus. Transmural passages of lymphocytes were noted on the side of the white pulp. The perimarginal cavernous sinus plexus was also in communication with the interspaces between reticulum cells in the marginal zone. The human perimarginal cavernous sinus plexus appears to correspond to the marginal sinus in rat and rabbit spleens.

Aged↗
PubMed1977

Aseptic thrombosis of orbital veins and cavernous sinus. Clinical symptomatology.

Occlusion or thrombosis of the superior ophthalmic vein or of the cavernous sinus is an unspecific finding that may be secondary to different disorders such as tumours of the skull base or nasopharynx. Sometimes, however, no underlying disorder is found in spite of an extensive clinical and radiological evaluation. Eight such cases are here presented. Similar cases have previously been described, both as examples of the Tolosa-Hunt syndrome and as aseptic cavernous sinus thrombosis. The literature on these two disorders is reviewed and different diagnostic criteria discussed.

Aged↗
PubMed1978

Bilateral dural arteriovenous fistula in the region of the cavernous sinus.

The case of a patient with a fistula between the left internal carotid artery and the cavernous sinus, and another fistula between the right external carotid artery and the cavernous sinus, is reported. The clinical symptomatology, which was of spontaneous onset, was unilateral and consisted of exophthalmos and injection of the conjunctiva on the left side. Almost complete remission occurred after angiography.

Aged↗