Cavernous sinus syndrome. Analysis of 151 cases

Arch Neurol. 1996 Oct;53(10):967-71. doi: 10.1001/archneur.1996.00550100033012.


Objective: To characterize lesions causing cavernous sinus syndrome.

Design: Review of 26 years of personal experience in a large city hospital.

Results: Among 151 patients, tumors (45 patients, 30%) were the most frequent cause of cavernous sinus syndrome. However, when surgical causes (17 patients, 11%) were included, trauma (36 patients, 24%) became most common. Self-limited inflammation was the third frequent cause (34 patients, 23%), while carotid aneurysms and fistulas, infection, and other causes composed the remaining 12%. The age at onset varied with the cause, and patients with aneurysms (average age, 52 years) and patients with tumors (average age, 47 years) were older than those with self-limited inflammation (average age, 35 years) and trauma (average age, 29 years). Spontaneous remissions defined "self-limited inflammation" but were also seen following an acute onset of symptoms due to aneurysms and pituitary apoplexy.

Conclusions: In an unselected series from a city hospital, tumor, trauma, and self-limited inflammation were the predominant causes of cavernous sinus syndrome, and classic causes such as aneurysm, meningioma, and bacterial infection were uncommon. Contrast-enhanced magnetic resonance imaging and watchful waiting proved the most effective diagnostic procedures.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / complications
  • Carotid Artery Diseases / complications
  • Cavernous Sinus*
  • Cerebrovascular Disorders* / complications
  • Cerebrovascular Disorders* / etiology
  • Cranial Nerve Diseases / etiology
  • Female
  • Humans
  • Infections / complications
  • Inflammation / microbiology
  • Male
  • Middle Aged
  • Syndrome
  • Wounds, Nonpenetrating / complications