WordNet

commit a sin; violate a law of God or a moral law (同)transgress, trespass
violent and excited activity; "they began to fight like sin" (同)hell
estrangement from god (同)sinfulness, wickedness
an act that is regarded by theologians as a transgression of Gods will (同)sinning
the 21st letter of the Hebrew alphabet
being or suggesting a cavern; "vast cavernous chambers hollowed out of limestone"
any of various air-filled cavities especially in the bones of the skull

PrepTutorEJDIC

〈U〉(宗教・道徳上の)『罪』 / 〈C〉(宗教・道徳上の)『罪の行為』,罪悪 / 〈C〉《特におどけて》違反(過失)の行為 / (宗教・道徳上の)おきてを破る,罪を犯す / (…に)違反(過失)をする,背く《+『against』+『名』》
sine
ほら穴の多い / ほら穴のような
洞(どう)(骨や組織の中の穴・くぼみなど);静脈洞

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/12 07:38:31」(JST)

wiki en

The cavernous sinus (or lateral sellar compartment), within the human head, is a large collection of thin-walled veins ^[1] creating a cavity bordered by the temporal bone of the skull and the sphenoid bone, lateral to the sella turcica.

Contents[edit]

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"^[2]

Venous connections[edit]

It receives tributaries from:

Superior and inferior ophthalmic veins
Sphenoparietal sinus
Superficial middle cerebral veins

The veins of exit are to the superior and inferior petrosal sinuses as well as via the emissary veins through the foramina of the skull (mostly through foramen ovale). There are also connections with the pterygoid plexus of veins via inferior ophthalmic vein, deep facial vein and emissary veins.

Clinical significance[edit]

It is the only anatomic location in the body in which an artery travels completely through a venous structure. If the internal carotid artery ruptures within the cavernous sinus, an arteriovenous fistula is created (more specifically, a carotid-cavernous fistula). Lesions affecting the cavernous sinus may affect isolated nerves or all the nerves traversing through it.

The pituitary gland lies between the two paired cavernous sinuses. An abnormally growing pituitary adenoma, sitting on the bony sella turcica, will expand in the direction of least resistance and eventually compress the cavernous sinus. Cavernous sinus syndrome may result from mass effect of these tumors and cause ophthalmoplegia (from compression of the oculomotor nerve, trochlear nerve, and abducens nerve), ophthalmic sensory loss (from compression of the ophthalmic nerve), and maxillary sensory loss (from compression of the maxillary nerve). A complete lesion of the cavernous sinus disrupts CN III, IV, and VI, causing total ophthalmoplegia, usually accompanied by a fixed, dilated pupil. Involvement of CN V (V₁ and variable involvement of V₂) causes sensory loss in these divisions of the trigeminal nerve. Horner's syndrome can also occur due to involvement of the carotid ocular sympathetics, but may be difficult to appreciate in the setting of a complete third nerve injury.^[3]

Because of its connections with the facial vein via the superior ophthalmic vein, it is possible to get infections in the cavernous sinus from an external facial injury within the Danger area of the face. In patients with thrombophlebitis of the facial vein, pieces of the clot may break off and enter the cavernous sinus, forming a cavernous sinus thrombosis. From there the infection may spread to the dural venous sinuses. Infections may also be introduced by facial lacerations and by bursting pimples in the areas drained by the facial vein.^[4]

Potential causes of cavernous sinus syndrome include metastatic tumors, direct extension of nasopharyngeal tumors, meningioma, pituitary tumors or pituitary apoplexy, aneurysms of the intracavernous carotid artery, cavernous-carotid arteriovenous fistula, bacterial infection causing cavernous sinus thrombosis, aseptic thrombosis, idiopathic granulomatous disease (Tolosa-Hunt syndrome), and fungal infections. Cavernous sinus syndrome is a medical emergency, requiring prompt medical attention, diagnosis, and treatment.^[5]

Additional images[edit]

Oblique section through the cavernous sinus.
Veins of orbit.
Pathways in the Ciliary Ganglion.
Cavernous sinus
Human brain dura mater (reflections)

References[edit]

^ Jonathan Dutton. Atlas of Clinical and Surgical Orbital Anatomy, 2011.ch1
^ Mnemonic at medicalmnemonics.com 1094
^ Blumenfeld, H, Neuroanatomy through clinical cases. Sinauer Associates, Inc., 2002.
^ Kumar, P. & Clark, M. Clinical Medicine, 6th ed. Londonn: W.B. Saunders; 2005.
^ Blumenfeld, H, Neuroanatomy through clinical cases. Sinauer Associates, Inc., 2002.

External links[edit]

MedEd at Loyola grossanatomy/h_n/cn/dvs/dvs3.htm
SUNY Figs 28:03-06 - "Venous dural sinuses."
Cavernous Sinus at the US National Library of Medicine Medical Subject Headings (MeSH)
lesson2 at The Anatomy Lesson by Wesley Norman (Georgetown University)
Atlas of anatomy at UMich n3a8p1
Cavernous+sinus at eMedicine Dictionary

UpToDate Contents

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1. 敗血症性硬膜静脈洞血栓症 septic dural sinus thrombosis
2. 脳静脈血栓症の病因、臨床的特徴、および診断 etiology clinical features and diagnosis of cerebral venous thrombosis
3. トロサハント症候群 tolosa hunt syndrome
4. 頚動脈海綿静脈洞瘻 carotid cavernous fistulas
5. 成人における第三脳神経（動眼神経）麻痺 third cranial nerve oculomotor nerve palsy in adults

English Journal

Does wet hair in cold weather cause sinus headache and posterior eye pain? A possible mechanism through selective brain cooling system.

Kaya A, Calışkan H.SourceGATA Haydarpasa Training Hospital, Department of Ophthalmology, Istanbul, Turkey. Electronic address: abdullahkayamd@gmail.com.
Medical hypotheses.Med Hypotheses.2012 Dec;79(6):744-5. doi: 10.1016/j.mehy.2012.08.017. Epub 2012 Sep 10.
As a general observation, wet hair in cold weather seems to be a predisposing factor for sinus headache and posterior eye pain. We offer a mechanism through selective brain cooling system for this observation. Selective brain cooling (SBC) is a mechanism to protect brain from hyperthermia. Component
PMID 22975448

T-cell lymphoblastic lymphoma/leukemia presenting as a pituitary mass lesion: A case report and review of the literature.

Wiens AL, Hagen MC, Bonnin JM, Rizzo KA.SourceDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine/Professional Pathology Services, Columbia, South Carolina, USA.
Neuropathology : official journal of the Japanese Society of Neuropathology.Neuropathology.2012 Dec;32(6):668-74. doi: 10.1111/j.1440-1789.2012.01314.x. Epub 2012 Mar 21.
We present a rare case of primary T-cell lymphoblastic lymphoma of the pituitary gland. A 58-year-old woman presented with headaches, right-sided ptosis and cranial nerve III palsy. She subsequently developed polyuria, polydipsia, and hyperglycemia and was found to have hypopituitarism. MRI revealed
PMID 22432597

Japanese Journal

経上眼窩裂硬膜外前床突起切除術 : 3次元立体頭蓋底モデルを用いた解説を中心に(手術手技・周術期管理)

森健太郎,山本拓史,中尾保秋,江崎孝徳
脳神経外科ジャーナル 20(12), 914-921, 2011-12-20
経上眼窩裂硬膜外前床突起切除術(Trans-SOF法)は,meningo-orbital bandの切除,上眼窩裂から固有硬膜の剥離,前床突起全体の露出とその削除からなる.さらに,テント切痕内側端部の切除を加えると,extradural temporopolar approachに移行できる.われわれは,この方法を3次元立体頭蓋底モデルと実際の手術写真を用いて解説するとともに,21例の手術結果につ …
NAID 110008799378

脳静脈の機能解剖(手術合併症を防ぐために,II 手術訓練としての外科解剖実習-第23回微小脳神経外科解剖セミナーより-,微小脳神経外科解剖)

小宮山雅樹
脳神経外科ジャーナル 20(Supplement_2), 140-148, 2011-10-20
… (dural sinus)や脳静脈(pial vein)が形成される.神経管の閉鎖により脈絡叢からの導出は1本のmedial vein of prosencephalonが担うようになり,これは一対の内大脳静脈の形成により,こちらに移行され,さらにgreat vein of Galenに導出される.大きく発達する大脳の表在性静脈(Sylvian,Trolard,and Labbe veins)の間には,互いに十分な吻合が形成される.大脳の重さを支えるべく発達するtentorium cerebelli内にあるprimitive tentorial sinusの導 …
NAID 110008790790

Related Pictures

★リンクテーブル★

リンク元	「海綿静脈洞」
拡張検索	「carotid-cavernous sinus fistula」「carotid cavernous sinus」「carotid-cavernous sinus」
関連記事	「cavernous」

「海綿静脈洞」

Vein: Cavernous sinus
	Cavernous sinus (center, labeled "SIN. CAVERN.")
	The sinuses at the base of the skull. Cavernous sinus labeled in red
Latin	sinus cavernosus
Gray's	subject #171 658
Source	middle cerebral vein, sphenoparietal sinus, superior ophthalmic vein
Drains to	inferior petrosal sinus, superior petrosal sinus
MeSH	Cranial+Sinuses

　　[★]

英: cavernous sinus (KH)
ラ: sinus cavernosus
関: 硬膜静脈洞、小脳の静脈

図：N.98