Disease relevance of Cavernous Sinus

• Shrinkage of inoperable adenomas in cavernous sinus with high-dose octreotide [1].
• We treated a 60-year-old diabetic woman with rhinocerebral mucormycosis involving the cavernous sinus whose infection responded to medical therapy with amphotericin B lipid complex [2].
• Retrospective analysis suggests that treatment with heparin may reduce mortality in carefully selected cases of septic cavernous-sinus thrombosis [3].
• DESIGN: We retrospectively reviewed CVS data in patients with ACTH-dependent Cushing's syndrome, in whom cavernous sinus sampling (CSS), inferior petrosal sinus sampling (IPSS) and IPSS after administration of ovine corticotrophin releasing hormone (oCRH) were performed [4].
• CONCLUSIONS: This small series suggests that cavernous sinus sampling with CRH is as accurate as inferior petrosal sinus sampling in detecting Cushing disease and perhaps more accurate in lateralizing the abnormality within the pituitary gland [5].

High impact information on Cavernous Sinus

• In these studies we noted a bilateral activation in midline structures over several planes that, based on its anatomy, is likely to arise from bilateral large intracranial arteries in the region of the cavernous sinus [6].
• Magnetic resonance imaging revealed a large sellar mass compressing the optic chiasm and invading the left cavernous sinus, whereas a prolactin elevation at 438.6 ng/ml (19.73 nmol/liter) was noted [7].
• This report describes a patient with pituitary-dependent Cushing's disease who had a preoperative ACTH gradient to the left at the level of the cavernous sinus [8].
• H1 and H2 isoform expression of nm23 was investigated using a ribonuclease protection assay. nm23 H2 messenger ribonucleic acid expression was significantly reduced in invasive tumors and correlated highly (P = 0.0016) with cavernous sinus invasion [9].
• Clinically, there was no correlation between expression of the PDGF subunits or receptors and tumor size or with invasion into adjacent structures (cavernous sinus, sphenoid sinus, or clivus) [10].

Chemical compound and disease context of Cavernous Sinus

• Normal cavernous sinus enhancement by gadolinium made identification of cavernous sinus extension of adenoma difficult [11].
• A complex case of carotid-cavernous fistula was treated transvenously by injection of ethyl vinyl alcohol co-polymer into the cavernous sinus after an unsuccessful embolization attempt with detachable coils and liquid adhesive agents [12].
• A repeat CT performed 48 hours after admission, on the same day as gallium imaging, demonstrated findings consistent with cavernous sinus thrombosis [13].
• The patient initially presented with proptosis and conjunctival congestion believed to be caused by a cavernous sinus hemangioma and was prescribed oral prednisone [14].
• RESULTS: NMDA acid infusion or acute hypoxia caused an increase of oxytocin concentration in the blood dialysate outflowing from the vicinity of the cavernous sinus of the sella turcica and from the femoral vein [15].

Biological context of Cavernous Sinus

• After neurosurgery (at immunocytochemistry mixed ACTH-PRL adenoma was shown) hypercortisolism remitted, whereas pathological hyperprolactinemia with tumor remnant in cavernous sinus persisted and hypopituitarism developed [16].
• The present case illustrates the development of acute bilateral cavernous sinus syndrome with loss of eye movement bilaterally during octreotide therapy [17].
• CONCLUSION: This is a case of cavernous sinus pPNET in a 48-year-old woman, in whom the diagnosis is supported by the presence of EWS-FLI1 fusion gene [18].

Anatomical context of Cavernous Sinus

• The c/p gradients of PRL were smaller than those of ACTH in the cavernous sinus, inferior petrosal sinus, and jugular vein [19].
• The coronal projection and reformatted views provided imaging of the cranial nerves within the cavernous sinus [20].
• In normal patients, the pituitary gland, cavernous sinus, and infundibulum enhanced by T1 shortening after gadolinium [11].
• Magnetic resonance imaging studies revealed an isointense lesion, with enhancement after gadolinium administration, located inferomedial to the internal carotid artery within the left cavernous sinus [21].
• The artery is surrounded by a loose connective tissue layer that allows blunt preparation along the C3 segment, without compromising the cranial nerves and without damaging venous compartments of the cavernous sinus [22].

Associations of Cavernous Sinus with chemical compounds

• All four had manifestations of a cavernous sinus syndrome, normal radiologic and medical investigations, and response to steroid therapy [23].
• Cavernous sinus: correlation between anatomic and dynamic gadolinium-enhanced MR imaging findings [24].
• Optimal visualization of the cavernous sinus was obtained with continuous contrast enhancement of both axial and coronal tomograms [20].
• Detachable latex balloons were used as the embolic material in five patients, and in one patient the cavernous sinus was packed transarterially with coils [25].
• Six patients were treated with transvenous n-BCA infusion alone in the cavernous sinus, 7 with a combination of transvenous n-BCA and coil embolization, and one with transvenous n-BCA combined with transarterial polyvinyl alcohol (PVA)-particle embolization of the feeding arteries [26].

Gene context of Cavernous Sinus

• Matrix metalloproteinase 2 and 9 expression correlated with cavernous sinus invasion of pituitary adenomas [27].
• The aim of this study is to evaluate the relationship between the expression of MMP-2, MMP-9, MIB-1 LI and cavernous sinus invasion in pituitary adenomas [27].
• However, no significant difference was found in the frequency of PCNA- or MIB1-positive cells between adenomas with and without cavernous sinus invasion [28].
• In Cushing's disease the central/peripheral (c/p) gradients of ACTH in the cavernous sinus (11.9-111.1; mean, 49.6) were much greater than those in the inferior petrosal sinus (1.0-52.0; mean, 14.0) [19].
• The diagnostic value of super-selective bilateral cavernous sinus sampling with the administration of corticotropin-releasing hormone (CRH) was assessed in patients with functioning ACTH-producing pituitary adenoma [29].

Analytical, diagnostic and therapeutic context of Cavernous Sinus

• Using superselective catheterization technique, venous sampling directly from the cavernous sinus was performed in seven patients with Cushing's disease and one patient with ectopic ACTH secreting tumor [19].
• Under the guidance of intraoperative digital subtraction angiography, isobutyl-2-cyanoacrylate was injected directly into the surgically exposed cavernous sinus [30].
• OBJECTIVE: We present a quantitative comparison of radiosurgery treatments for cavernous sinus tumors using the Leksell gamma knife Model U versus the Model C with automatic positioning system (APS) (Elekta Instruments, Norcross, GA) [31].
• A woman with a large ball-shaped meningioma of the right sphenoid wing invading the cavernous sinus exhibited a 74% decrease of the initial tumor volume in 10 months of treatment with oral hydroxyurea [32].
• Sephadex G-75 gel filtration of plasma ACTH immunoreactivity in plasma obtained by cavernous sinus sampling showed mainly high molecular forms of ACTH, probably proopiomelanocortin and ACTH-beta-lipotropin [33].

References