Cavernous Sinus - Contents

Contents

The sinus may be joined by several anastomoses across the midline. The cavernous sinus receives blood via the superior and inferior ophthalmic veins through the superior orbital fissure and from superficial cortical veins, and is connected to the basilar plexus of veins posteriorly. The internal carotid artery (carotid siphon), and cranial nerves III, IV, V (branches V1 and V2) 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, ultimately into the internal jugular vein via the sigmoid sinus.

Each cavernous sinus (one for each hemisphere of the brain) contains the following:

  • vertically, from superior to inferior (within the lateral wall of the sinus)
    • oculomotor nerve (CN III)
    • trochlear nerve (CN IV)
    • ophthalmic nerve, the V1 branch of the trigeminal nerve (CN V)
    • maxillary nerve, the V2 branch of CN V

Unlike the nerves listed above, the abducens nerve (CN VI) does not run within the lateral wall of the cavernous sinus; rather, it runs through the middle of the sinus alongside the internal carotid artery.

These nerves, with the exception of CN V2, pass through the cavernous sinus to enter the orbital apex through the superior orbital fissure. The maxillary nerve, division V2 of the trigeminal nerve travels through the lower portion of the sinus and exits via the foramen rotundum.

  • horizontally, from medial to lateral
    • internal carotid artery (and sympathetic plexus). See also cavernous part of internal carotid artery.

The optic nerve lies just above and outside the cavernous sinus, superior and lateral to the pituitary gland on each side, and enters the orbital apex via the optic canal.

One mnemonic for remembering the contents is "OTOM CAT"

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