Cavernous sinus syndrome. Analysis of 151 cases

Area of Science:

• Neurology
• Ophthalmology
• Neurosurgery

Background:

• Cavernous sinus syndrome (CSS) presents with diverse etiologies.
• Understanding the spectrum of causes is crucial for timely diagnosis and management.
• Previous studies have focused on specific etiologies or smaller patient cohorts.

Purpose of the Study:

• To characterize the spectrum of lesions causing cavernous sinus syndrome.
• To identify the relative frequencies and demographic characteristics of different CSS etiologies.
• To evaluate the effectiveness of diagnostic procedures for CSS.

Main Methods:

• Retrospective review of 151 patients diagnosed with cavernous sinus syndrome over 26 years.
• Analysis of patient demographics, clinical presentation, etiology, and diagnostic methods.
• Correlation of age at onset with specific causative lesions.

Main Results:

• Tumors (30%), trauma (24%), and self-limited inflammation (23%) were the most frequent causes of CSS.
• Surgical causes and trauma collectively represented the most common etiology.
• Classic causes like aneurysms, meningiomas, and bacterial infections were less frequent.
• Age at onset varied significantly with etiology, with aneurysms and tumors occurring in older patients.

Conclusions:

• Tumor, trauma, and self-limited inflammation are the predominant causes of cavernous sinus syndrome in an unselected urban hospital population.
• Contrast-enhanced magnetic resonance imaging (CE-MRI) and a strategy of watchful waiting were found to be the most effective diagnostic approaches.
• The findings highlight the importance of considering a broad differential diagnosis for CSS.