Outgoing and incoming channels of cavernous sinus
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Cavernous Sinus - Incoming and Outgoing Channels
Fig. 8.46 - Veins, Meninges, and Dural Venous Sinuses (Gray's Anatomy for Students)
Incoming Channels (Tributaries)
These channels bring blood into the cavernous sinus:
| Channel | Source/Notes |
|---|---|
| Superior ophthalmic vein | Begins in the anterior orbit from the supra-orbital and angular veins; passes through the superior orbital fissure to enter the cavernous sinus. Principal orbital tributary. |
| Inferior ophthalmic vein | Smaller; may drain into the cavernous sinus directly through the superior orbital fissure, or join the superior ophthalmic vein first, or drain into the pterygoid plexus via the inferior orbital fissure. |
| Superficial middle cerebral vein | Drains the temporal lobe cortex along the lateral fissure; a fairly constant superficial cerebral vein. |
| Sphenoparietal sinuses | Small paired sinuses along the inferior surface of the lesser wings of the sphenoid; drain into the anterior ends of each cavernous sinus; receive diploic and meningeal veins. |
| Emissary veins from the pterygoid plexus | Pass through the foramen ovale (or foramen of Vesalius when present) to connect the pterygoid plexus with the cavernous sinus. This route allows facial infection to spread intracranially. |
| Intercavernous sinuses | Connect the right and left cavernous sinuses to each other, anteriorly and posteriorly around the pituitary stalk (forming the "circular sinus"). Allow infection to spread rapidly (within 24-48 hours) to the contralateral sinus. |
| Hypophyseal veins (pituitary) | Short portal and hypophyseal veins drain the posterior pituitary into the cavernous sinus. |
Outgoing Channels (Drainage)
These channels carry blood out of the cavernous sinus:
| Channel | Drains Into | Course |
|---|---|---|
| Superior petrosal sinus | Transverse sinus | Begins at the posterior end of the cavernous sinus; runs posterolaterally along the superior margin of the petrous temporal bone to join the transverse sinus. |
| Inferior petrosal sinus | Internal jugular vein | Also begins at the posterior end of the cavernous sinus; runs posteroinferiorly in a groove between the petrous temporal and the occipital bone, ending in the internal jugular vein. Also drains cerebellar veins and veins from the internal ear and brainstem. |
| Basilar plexus/sinus | Connects bilateral inferior petrosal sinuses; communicates with the vertebral plexus of veins | Lies on the clivus, just posterior to the sella turcica. |
| Emissary veins | Pterygoid plexus (extracranially) | Run through foramina ovale/Vesalius in reverse direction - bidirectional flow. |
Summary Diagram (Coronal Section)
Coronal section of the cavernous sinus showing the ICA, pituitary gland, and cranial nerve relations (Gray's Anatomy for Students)
Memory Mnemonics
Incoming ("ESOME"):
- Superficial middle cerebral vein
- Emissary veins (pterygoid plexus)
- Sphenoparietal sinus
- Ophthalmic veins (superior + inferior)
- Meningeal veins (via sphenoparietal)
- Each other (via intercavernous sinuses)
Outgoing: The cavernous sinus drains posteriorly - superior petrosal sinus → transverse sinus → sigmoid sinus → internal jugular vein; and inferior petrosal sinus → directly to internal jugular vein.
Sources:
- Gray's Anatomy for Students, Table 8.3 and Cavernous Sinuses section (pp. 1025-1027)
- Gray's Anatomy for Students, Veins of the Orbit section (p. 1082)
- Scott-Brown's Otorhinolaryngology, Cavernous Sinus section (p. 1247)
- Neuroanatomy through Clinical Cases, 3rd ed., Venous Drainage of the Cerebral Hemispheres
- Goldman-Cecil Medicine, Anatomy and Pathophysiology section
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