Cavernous sinus lesions

Clin Imaging. 2020 Dec:68:71-89. doi: 10.1016/j.clinimag.2020.06.029. Epub 2020 Jun 18.


The cavernous sinus is a complex structure susceptible to a wide variety of vascular, neoplastic and inflammatory pathologies. Vascular pathologies include ICA aneurysms, carotid-cavernous fistulas, cavernous sinus thrombosis, and cavernous hemangioma. Neoplasms that involve the cavernous sinus include pituitary adenoma, meningioma, schwannoma, lymphoma, perineural tumor spread, metastases, and direct tumor invasion. Infectious and inflammatory diseases include Tolosa-Hunt syndrome, sarcoidosis, granulomatosis with polyangiitis, IgG-4 related disease and invasive fungal infections. In this article, we review the clinical and imaging findings of a number of pathologies involving the cavernous sinus, focusing on key features that can narrow the differential diagnosis and, in some cases, support a particular diagnosis.

Keywords: Carotid-cavernous fistula; Cavernous sinus; Head and neck; Meningioma; Neuroradiology; Tolosa-Hunt syndrome.

Publication types

  • Review

MeSH terms

  • Cavernous Sinus* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms*
  • Meningioma*
  • Tolosa-Hunt Syndrome*