Cavernous Sinus: A Focus on “Laterocavernous Sinus”

Abstract

Cavernous sinus (CS) is a dural sinus located at the bilateral sides of the pituitary fossa, in which arteriovenous shunt and/or other neoplastic disease may occur. CS plays a role of the cross-road receiving the orbital, meningeal and neuronal venous drainage, and the venous drainage may show some anatomical variations. The knowledge about the venous drainage patterns is important for the treatment of the vascular and neoplastic lesions involving the CS and surrounding venous structures.

The major neuronal venous systems, including the superficial middle cerebral vein (SMCV) and uncal vein (UV), may be a route of the cortical venous reflux from the CS in case with the dural arteriovenous fistula (DAVF) or direct carotid-cavernous fistula. SMCV and UV often terminate directly at lateral wall of CS or at the anterolateral aspect of CS through the sphenoparietal sinus. However, they sometimes terminates at the laterocavernous sinus (LCS). LCS itself may show the anatomical variation of the drainage pattern and may be involved in the CSDAVF. It is important to know about the angioarchitectures of CSDAVF and the surrounding venous drainage patterns. In this paper, the anatomy of CS and variations will be described with focusing on the anatomy of LCS and CSDAVFs.