CAVERNOUS SINUS SYNDROME - ANALYSIS OF 151 CASES

Objective: To characterize lesions causing cavernous sinus syndrome. D esign: Review of 26 years of personal experience in a large city hospi tal. Results: Among 151 patients, tumors (45 patients, 30%) were the m ost frequent cause of cavernous sinus syndrome. However, when surgical causes (17 patients, 11%) were included, trauma (36 patients, 24%) be came most common; Self-limited inflammation was the third frequent cau se (34 patients, 23%), while carotid aneurysms and fistulas, infection , and other causes composed the remaining 12%. The age at onset varied with the cause, and patients with aneurysms (average age, 52 years) a nd patients with tumors (average age, 47 years) were older than those with self-limited inflammation (average age, 35 years) and trauma (ave rage age, 29 years). Spontaneous remissions defined ''self-limited inf lammation'' but were also seen following an acute onset of symptoms du e to aneurysms and pituitary apoplexy. Conclusions: In an unselected s eries from a city hospital, tumor, trauma, and self-limited inflammati on were the predominant causes of cavernous sinus syndrome, and classi c causes such as aneurysm, meningioma, and bacterial infection were un common. Contrast-enhanced magnetic resonance imaging and watchful wait ing proved the most effective diagnostic procedures.