The Jewel Box

Different proposals have been made to denominate the cavernous sinus which is in fact rarely a true sinus, for instance laterosellar extradural space or “the jewel box” to remember that this space contains numerous essential arteries, veins, and nerves. The meningioma of the cavernous sinus can mimic tumoral invasion from pituitary adenoma. Internal carotid aneurysms display a well-defined signal loss or more frequently various signal intensities when partially thrombosed. Carotid-cavernous fistulas are responsible for chemosis and display dilated veins. The picture of cavernous sinus thrombosis is that of an enlarged cavernous sinus with delayed enhancement. Cavernous sinus hemangiomas can mimic PitNET and can lead to hemorrhagic complications if not recognized. A unique slow centripetal post-gadolinium enhancement is pathognomonic.