Trauma, mass in anterior cranial fossa (meningioma, glioma, osteoma, abscess)

Medial sphenoid wing4

Ipsilateral anosmia and optic nerve atrophy, contralateral papilledema


Medial sphenoid wing mening-ioma, mass in anterior cranial fossa

Medial/lateral sphenoid wing4

Pain in ipsilateral eye, forehead, temple; exophthalmos, diplopia

V/1, III, IV

Medial (eye pain) or lateral (temporal pain) sphenoid wing meningioma

Orbital apex, superior orbital fissure5

Ipsilateral: incomplete or complete external ophthal-moplegia, sensory deficit on forehead; papilledema, visual disturbances, optic atrophy

II, III, IV, V/1, VI

Tumor (pituitary adenoma, meningioma, metastasis, naso-pharyngeal tumor, lymphoma), granuloma (TB, fungal infection, Tolosa-Hunt syndrome, arteritis), trauma, infraclinoid ICA aneurysm

Cavernous sinus6

Ipsilateral symptoms and signs appear earlier than in orbital apex syndrome; exophthalmos7, Horner syndrome

III, IV, V/1, VI

Same as in orbital apex syndrome + cavernous sinus thrombosis, carotid-cavernous fistula

Optic chiasm8

Visual field defects

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