The imaging of conditions affecting the cavernous sinus

Cavernous Sinus Syndrome as the Presentation of Systemic Non-Hodgkin’s Lymphoma

“…On MRI the lymphoma enlarges the CS without compressing the intracavernous ICA. It is usually isohypointense on both T1 and T2-weighted images and enhances homogeneously [6]. Bilateral CS involvements by NHL constitute a diagnostic challenge, particularly when appearing at the presentation of the disease.…”

“…On MRI, the CS is usually iso or hypointense on T1-weighted imaging and enhances homogeneously. Hypointensity on T2-weighted imaging may be seen with chronic inflammation representing fibrous tissue [6].…”

“…In rare cases, involvement of the CS can be the inaugural sign of lymphoma and neurologic signs may appear rapidly as in our patient. Presentation of lymphoma with CS involvement are no specific and may present with painful ophthalmoplegia, chemosis, proptosis, Horner's syndrome and sensory deficits in the first or second division of the trigeminal nerve [6].…”

“…In fact, a wide range of disorders can affect the CS including neoplastic, vascular, infectious, and inflammatory lesions. Imaging can often provide a diagnosis, which helps determine the need and approach for treatment [6].…”

Imaging of skull base tumours

“…Pituitary adenomas invade the cavernous sinus in 6-10% of cases, often unilaterally, thereby limiting surgical resectability. 24 Unlike meningiomas, pituitary adenomas rarely narrow the cavernous carotid artery. 25 Occasionally, pituitary adenomas can grow inferiorly eroding the sella floor or arising in an exclusively intraosseous location in which case an empty sella appearance maybe the relevant imaging clue.…”