Radiological study of the adipose tissue at the para-cavernous region of middle cranial fossa

Introduction: The cavernous sinus (CS) lesions are difficult to identify on computed tomogram (CT) film, and the subtle changes may help in the diagnosis. The objective of the present study was to examine the para-cavernous adipose tissue in the CT scan in the Indian population. Material and Methods: The study included 100 patients of all age groups, who were examined using a 16 slice multidetector CT. The axial images were analyzed for the presence of adipose tissue on either side of the CS. The intracranial pathology and atrophic changes, if any, were noted. Results: The present study observed that 17% of the patients had intracranial pathologies. Among the 83% of patients with no pathology, paracavernous adipose tissue was observed in 85.5% and 89.2% over the right and left sides, respectively. It was observed that the paracavernous fat was visualized in higher frequency in elderly adults. It was visualized in all the patients (100%) of over 60 years. In some patients, with mass effect, the paracavernous fat was obliterated over the ipsilateral side, but it was visualized on the contralateral side. Discussion and Conclusion: The present study suggests that the CS lesions are difficult to identify on the CT scan, and the subtle signs may help in making a diagnosis. The para-CS adipose deposit is one among these subtle changes; if there is the presence of adipose tissue on one side and its absence on the other side, then pathology should be suspected.