A 35-year-old man with a furuncle in the nasal area develops high fever, headache, and bilateral ophthalmoplegia. Imaging confirms cavernous sinus thrombosis. Which venous channel most likely transmitted the infection to the cavernous sinus?
- A Superficial middle cerebral vein
- B Superior ophthalmic vein ✓
- C Inferior petrosal sinus
- D Superior sagittal sinus
Correct answer: B. Superior ophthalmic vein
Explanation
The danger triangle of the face drains via the angular vein, which communicates with the superior ophthalmic vein. This vein passes posteriorly through the superior orbital fissure to drain directly into the cavernous sinus. Because these veins lack valves, infections from the central face spread intracranially through this pathway. The superficial middle cerebral vein drains cerebral cortex, and the superior sagittal sinus drains the cortical convexity, neither connecting to facial veins.
Reference: Gray's Anatomy for Students, 4th ed.
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Written and medically reviewed by the StethoPrep medical team.