Cavernous Sinus Anatomy: Where CN VI Lies Relative to the ICA

The abducens nerve (CN VI) runs within the cavernous sinus, closely related to the cavernous internal carotid artery, unlike other nerves that lie in the lateral wall. This proximity makes CN VI especially vulnerable to cavernous sinus and ICA pathology.

• The oculomotor (CN III), trochlear (CN IV), and ophthalmic division of the trigeminal nerve (V1) travel in the lateral dural wall of the cavernous sinus.
• This intrasinus course of CN VI explains why abducens palsy is an early sign of cavernous sinus masses or ICA aneurysms.

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