![Page 1: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/1.jpg)
Circle of Willisand
Cavernous Sinus
Clinical Anatomy
Dr. Ankit M. PunjabiDept of Ophthalmology,
KIMS Hospital,Bangalore
Karnataka, INDIA
![Page 2: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/2.jpg)
CIRCLE OF
WILLIS
![Page 3: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/3.jpg)
![Page 4: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/4.jpg)
![Page 5: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/5.jpg)
![Page 6: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/6.jpg)
![Page 7: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/7.jpg)
![Page 8: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/8.jpg)
![Page 9: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/9.jpg)
![Page 10: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/10.jpg)
![Page 11: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/11.jpg)
![Page 12: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/12.jpg)
![Page 13: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/13.jpg)
![Page 14: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/14.jpg)
TERRITORIES OF MAJOR ARTERIES OF BRAIN
![Page 15: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/15.jpg)
TERRITORIES OF MAJOR ARTERIES OF BRAIN
![Page 16: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/16.jpg)
TERRITORIES OF MAJOR ARTERIES OF BRAIN
![Page 17: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/17.jpg)
![Page 18: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/18.jpg)
![Page 19: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/19.jpg)
Representationto show
major arterial supplyin the Circle of Willis
![Page 20: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/20.jpg)
![Page 21: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/21.jpg)
![Page 22: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/22.jpg)
• Cerebral Infarction • Transient Ischemic Attacks• Vascular Malformations (Aneurysm, etc)• Intracranial Hemorrhage• Tumors of adjacent structures• Inflammatory Diseases of Arteries
![Page 23: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/23.jpg)
![Page 24: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/24.jpg)
Common Sites for Plaque Formation
• Internal Carotid– Ipsilateral blindness– Contralateral hemiparesis– Contralateral hemianesthesia– Hemianopia– Aphasia, hemineglect
• Middle Cerebral – Main trunk : Hemiplegia, hemianesthesia,
hemianopia, Aphasia– Upper division : Hemiparesis & sensory loss ( arm/face > leg)– Lower division : Wernicke Aphasia– Penetrating Artery : pure motor hemiparesis
![Page 25: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/25.jpg)
Common Sites for Plaque Formation
• Anterior Cerebral– Hemiparesis & sensory loss (leg>arm)– Impaired responsiveness
• Posterior Cerebral– Cortical (U/L) : isolated hemianopia
(or quadrantic defect), color anomia
– Cortical (B/L) : cerebral blindness (+/- macular sparing)
– Thalamic : Pure sensory stroke– Subthalamic : Hemiballism– B/L inf temporal lobe : Amnesia– Midbrain : Oculomotor &
other Cr. N. palsy
![Page 26: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/26.jpg)
30-35%
30-35%
20%
5%
5%
![Page 27: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/27.jpg)
![Page 28: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/28.jpg)
![Page 29: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/29.jpg)
• Macular area is watershed area
![Page 30: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/30.jpg)
CAVERNOUS SINUS
![Page 31: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/31.jpg)
CAVERNOUS SINUS
![Page 32: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/32.jpg)
![Page 33: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/33.jpg)
![Page 34: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/34.jpg)
![Page 35: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/35.jpg)
![Page 36: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/36.jpg)
Structures in lateral wall
• Oculomotor nerve• Trochlear nerve• Ophthalmic nerve
• Lacrimal• Frontal• Nasociliary
• Maxillary nerve• Trigeminal ganglion
Structures in centre of sinus
• Internal carotid artery• Men.Hypo. A• Capsular A• A. to Cav sinus
• Sympathetic plexuses• Abducent nerve
![Page 37: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/37.jpg)
![Page 38: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/38.jpg)
![Page 39: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/39.jpg)
VENOUSVASCULATUREOF BASE OF SKULL
1.Sup. Oph. Vein2.Ant. Int. Cav. Sinus3.Inf. Oph. Vein4.Pterygoid Plexus5.Mid. Menng. Vein6.Sup. Petr. Sinus7.Inf. Petr. Sinus8.Basilar plexus9.Transverse Sinus10.Post. Int. Cav. Sinus11.Cavernous Sinus12.Sphenoparietal Sinus
![Page 40: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/40.jpg)
CAVERNOUS SINUS SYNDROMES• Multiple cranial neuropathies:
– Unilateral & isolated 3rd ,4th,5th, 6th nerve palsy– Conbimation patterns of ophthalmoplegia– Painful ophthalmoplegia– Proptosis– Ocular & cranial bruits– Conjunctival congestion, arterialization of conjunctival veins– Ocular hypertension– Optic disc edema/pallor– Retinal hemorrhage– Anaesthesia in ophthalmic division of trigeminal– Horner’s syndrome
![Page 41: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/41.jpg)
CAVERNOUS SINUS SYNDROMES
![Page 42: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/42.jpg)
![Page 43: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/43.jpg)
Carotico-Cavernous Fistula
![Page 44: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/44.jpg)
Cavernous Hemangioma
![Page 45: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/45.jpg)
Intra-Cavernous Carotid Aneurysm
![Page 46: Clinical Anatomy Circle Of Willis & Cavernous Sinus](https://reader035.vdocuments.pub/reader035/viewer/2022062418/554b33d5b4c905ce088b513f/html5/thumbnails/46.jpg)
Thank You