Imaging of the Cavernous Sinus and Skull Base

For those born in the imaging era it is hard to conceive of a time when we could not look non-invasively into the cranium or orbit. This is particularly true for those areas of the skull base. This was no man's land where surgery was off limits. The first advance in imaging, of course, came with Roentgen's description of x-rays in 1895. This permitted analysis of bony lesions with plain films and subsequent fluoroscopy. Lesions such as meningiomas that cause hyperostosis and pituitary lesions that enlarge the sella could be visualized on plain films. Contrast; however, was poor and soft tissue pathology could not be truly appreciated.