What is cavernous sinus meningioma?

Cavernous sinus meningioma (CSM) gradually compresses the above nerves and artery causing varied degrees of unilateral ophthalmoplegia. It may also cause compression of the chiasma over a long period of time. Histologically, the tumor is often benign and slow growing.

Can a meningioma cause sinus problems?

Skull base meningiomas include: Cavernous sinus meningiomas are rare tumors that affect the cavernous sinus, an area that controls eye movement and allows your face to feel sensations. Cavernous sinus meningiomas can cause double vision, dizziness and facial pain.

What nerves go through the cavernous sinus?

The nerves of the cavernous sinus are the oculomotor nerve (CN III), trochlear nerve (CN IV), ophthalmic nerve (V1), maxillary nerve (V2), abducens nerve (CN VI), and the sympathetic plexus around the internal carotid artery.

Why is the cavernous sinus clinically important?

The cavernous sinus is a true dural venous sinus and not a venous plexus. It is clinically important because of its location, its close relationship to several cranial nerves and the internal carotid artery, and the complex of veins without valves that drain from and to the paired cavernous sinuses.

Can you shrink a meningioma?

Since the vast majority of meningiomas are benign (noncancerous), they are most commonly treated with surgery. Total removal of a meningioma is preferred since it lessens the chances of the tumor returning. Sometimes radiation can help reduce the size of a meningioma.

How many cavernous sinuses are in the brain?

The two cavernous sinuses are connected to each other by anterior and posterior cavernous sinuses lying in front and behind the pituitary. See Clinical box 7.9.

Is the cavernous sinus in the brain?

The cavernous sinuses are located within the middle cranial fossa, on either side of the sella turcica of the sphenoid bone (which contains the pituitary gland). They are enclosed by the endosteal and meningeal layers of the dura mater.

Can a meningioma be malignant?

Grade III anaplastic meningiomas are malignant (cancerous). This means they are fast-growing tumors.

What size is considered a large meningioma?

Meningiomas in the diameter range of 0.5 to 2.7 cm (“small” meningiomas) were significantly associated with extraneural malignancies and chronic renal failure as opposed to those in the diameter range of 2.8 to 10.5 cm (“large” meningiomas).

What does a cavernous sinus meningioma look like?

A cavernous sinus meningioma is a benign tumor arising from the cells that form the internal lining membrane of the brain, called the pia mater, which expands to fill the cavernous sinus. The cavernous sinus has many vital structures passing through it, including the carotid artery and the third, fourth, fifth, and sixth cranial nerves.

Can a cavernous sinus meningioma cause ICA?

As previously described, cavernous sinus meningiomas carry a high risk of ICA and intracavernous cranial nerve injury secondary to tumor infiltration of the ICA adventitia and CN perineurium. To prevent injury to these structures, some tumor should be left behind.

How does radiosurgery help with cavernous sinus meningiomas?

Radiosurgery provided improved rates of tumor control compared with surgery alone, regardless of the subjective extent of resection 14). One hundred and seventeen patients with cavernous sinus meningiomas had LINAC radiosurgery in the period 1993-2007. Six cases were lost and 9 had less than 1 year follow up.

Are there nontumorous lesions in the cavernous sinus?

Nontumorous lesions can readily mimic meningiomas in the cavernous sinus, and their consideration in the differential diagnoses list can have a significant impact on the preoperative workup and ultimately the surgical decision-making process. Physical and neurologic exams are performed with particular attention to CNs II-VI.