Septic cst is a rapidly evolving thrombophlebitic process with an infectious origin typically from the middle third of the face, sinuses, ears, teeth, or mouth, affecting the cavernous sinus and its structures. Cavernous sinus anatomy large venous space situated in the middle cranial fossa, on either side of body of the sphenoid bone. He was diagnosed to have cavernous sinus thrombosis secondary to pansinusitis. Varshney s, malhotra m, gupta p, gairola p, kaur n. It is caused by a bacterial infection that typically originates in the face, sinuses, ears, or orbits 1. It is caused by a bacterial infection that typically originates in. Cavernous sinus thrombosis in a 14year old boy the turkish. Cavernous sinus thrombosis cst is an ocular emergency because of its devastating effect and it is prone to cause serious complications. Severe infection involving complications of paranasal sinus and facial. Pyrrolidinomethyl tetracycline in cavernous sinus thrombosis.
Efforts to promptly diagnose and initiate treatment require a high index of suspicion and a deep understanding of the disease. Jul 16, 2018 cavernous sinus thrombosis cst was initially described by bright in 1831 as a complication of epidural and subdural infections. There are no randomised, controlled trials of management of this condition and existing. This condition is uncommon but a serious one and affects both children and adults. Cavernous sinus thrombosis eye disorders merck manuals. Although s aureus is the usual cause, broadspectrum coverage for gram positive, gramnegative, and anaerobic organisms should be instituted pending the outcome of cultures. Tributary venosinus occlusion and septic cavernous sinus thrombosis. Cavernous sinus thrombosis complications bmj best practice.
Septic thrombosis of the cavernous sinuses cardiology. Cavernous sinus thrombosis cst is a rare condition, most commonly infectious in nature, and the diagnosis on imaging is not always straightforward. Aug 16, 20 treatment of cavernous sinus thrombosis septic cavernous sinus thrombosis the mainstay of therapy is early and aggressive antibiotic administration. Cavernous sinus thrombosis cst is a rare and lifethreatening complication of infection involving the paranasal sinuses, facial, and oral cavities. This patient had squeezed a pimple near her left nasolabial fol. Early recognition of cavernous sinus thrombosis which, often presents with fever, headache, eye findings such as periorbital swelling. Findings are chiefly those of cavernous sinus thrombosis secondary to ascending deep facial infection. It is very often unrecognised at initial presentation. Cavernous sinus thrombosis cst is the formation of thrombus clot within the cavernous sinus, which can either be septic or aseptic. Cavernous sinus thrombosis symptoms, diagnosis and. Cavernous sinus thrombosis in ent practice juniper publishers. Cavernous sinus thrombosis msd manual consumer version.
See that article for a discussion of the larger clinical entity. Septic thrombosis of the cavernous sinuses or cavernous sinus thrombophlebitis cst is a dramatic and potentially lethal illness, which is still occasionally seen by clinicians. Although the advent of antibiotics has decreased the incidence of the condition, a clinician should be able to recognize its signs and immediately refer the patient to the proper specialists. Before the availability of antimicrobial agents, mortality from cst was near 100%, but it markedly decreased to.
Cavernous sinus thrombosis cavernous sinus thrombosis is a specialised form of cerebral venous sinus thrombosis, where there is thrombosis of the cavernous sinus of the basal skull dura, due to the retrograde spread of infection and endothelial damage from the danger triangle of the face. Diagnosis and management of cerebral venous thrombosis stroke. Mar 22, 2018 cavernous sinus thrombosis is a potentially lifethreatening condition that can happen after an infection in your head. The course of his illness was complicated by a stroke despite prompt treatment. Cavernous sinus thrombosis is a very rare disorder in which a blood clot thrombosis forms in the cavernous sinus a large vein at the base of the skull. Symptoms and signs include pain, proptosis, ophthalmoplegia, vision loss, papilledema, and fever. Cavernous sinus thrombosis cst is a rare, lifethreatening disorder that can complicate facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis or following traumatic injury or surgery, especially in the setting of a thrombophilic disorder. Cavernous sinus thrombosis statpearls ncbi bookshelf. Cavernous sinus thrombosis is typically caused by an infection that has spread beyond the face, sinuses, or teeth. Cavernous sinus thrombosis cst is the formation of a blood clot within the cavernous sinus, a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart. Septic cavernous sinus thrombosisneurology and neurosciences. Intravenous heparin maintaining the partial thromboplastin time or thrombin clot time at 1.
Cavernous sinus thrombosis cst is a rare condition, defined as a septic thrombophlebitis of the cavernous sinus. Despite treatment of cst is directed to the causal situation, being shown that. It is the least common dural venous sinus thrombosis, accounting for cavernous sinus thrombosis is a lifethreatening complication that may rarely result from infection spreading back through the emissary veins from the maxillary or nasal region, or upper teeth, or from infected thrombi in the anterior facial vein or less commonly the pterygoid plexus. Ppt cavernous sinus thrombosis human head and neck human. Its marked by a blood clot behind your eyes or at the base of your skull. Cavernous sinus thrombosis cst was initially described by bright in 1831 as a complication of epidural and subdural infections. Cavernous sinus thrombosis cst is a rare condition, usually results from a late. Cavernous sinus thrombosis of nasal origin in children. Clinical data and radiographic studies on 12 cases from our institution were analyzed retrospectively. Cavernous sinus thrombosis an overview sciencedirect. The dural sinuses are grouped into the sagittal, lateral including the transverse, sigmoid, and petrosal sinuses, and cavernous sinuses. Cvst indicates cerebral venous and sinus thrombosis. Pdf cavernous sinus thrombosis cst is a rare condition, usually results from. Septic cavernous sinus thrombosis is a rare but serious complication of infection of the cavernous sinuses.
Screening for thrombophilia may give false results during anticoagulation therapy and should be delayed until after. Large venous space situated in the middle cranial fossa, on either side of body of the sphenoid bone. Cavernous sinus thrombosis is a very rare but extremely dangerous major complication of head and neck infections. Treatment of cavernous sinus thrombosis request pdf. Oct 27, 2017 cerebral venous thrombosis cvt is a blood clot of a cerebral vein in the brain. Cavernous sinus trombosis dr munish kumar g b pant delhi 2. The cavernous sinus and dural sinuses are more vulnerable to septic thrombosis, because they lack valves. Cavernous sinus thrombosis stellenbosch university. Cavernous sinus thrombosis is usually caused by the spread of bacteria from infections of the face and orbit including the skin of the nose, orbit, or sinus. Other causes include prothrombotic disorders, anemia and. Early administration of heparin may serve to prevent spread of thrombosis to the other cavernous sinus as well as to the inferior and superior petrosal sinuses. If blood collects in this vein, it will begin to leak.
The cavernous sinus is one of the several cerebral veins and cavernous sinus thrombosis is a specific type of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a challenging condition because of its variability of clinical symptoms and signs. Dec 07, 2014 summary cavernous sinus contains cn 3,4,5,6 and internal carotid artery cavernous sinus thrombosis is divided into septic and aseptic cst is mainly due to bacterial infections thrombus is formed to prevent further spread of bacteria patient with diabetes mellitus or women who take contraceptive pills are at higher risk. Cerebral venous sinus thrombosis postgraduate medical journal. Cerebral venous thrombosis cvt is a blood clot of a cerebral vein in the brain. Cavernous sinus thrombosis is a very serious condition. This vein is responsible for draining blood from the brain. Thrombosis of the cavernous, lateral, or sagittal sinus can later induce a dural. The mortality rate of septic cavernous sinus thrombosis is approximately 2030%, even after the introduction of antibiotics. Cavernous sinus thrombosis is a condition where a blood clot forms in the region under your brain and at the back of the eye socket. Cavernous sinus thrombosis is a very rare, typically septic thrombosis of the cavernous sinus, usually caused by nasal furuncles or bacterial sinusitis.
Infection can reach the cavernous sinus via either the. Some people who survive will develop longterm health problems due to damage to their brain, such as persistent headaches and fits, or some degree of vision loss. Less commonly, infections of the ears or eyes may cause cavernous sinus thrombosis. Diagnosis and management of cerebral venous thrombosis. This is a rare disorder and can be of two typesseptic cavernous thrombosis and aseptic cavernous thrombosis. Cavernous sinus thrombosis radiology reference article. Cavernous sinus thrombosis cst was first described by bright in 18311.
The presentation of intracranial abscesses have been reported to occur up to 8 months after cavernous sinus thrombosis cst. Extensive collateral circulation within the cerebral venous system allows for a significant degree of. Cavernous sinus thrombosis symptoms, treatment, causes. The mainstay of therapy for cavernous sinus thrombosis is early and aggressive antibiotic administration. Thrombosis of the dural sinus andor cerebral veins cvt is an uncommon form. Diagnosis of cavernous sinus thrombosis is a challenging task despite medical advancement. Highest recanalization rates in deep cerebral veins and cavernous sinus thrombosis, lowest in lateral sinus thrombosis in adults, recanalization of the occluded sinus is not related to outcome saposnik et al. Most commonly the form is of septic cavernous sinus thrombosis.
Cavernous sinus thrombosis eye disorders msd manual. These clots obstruct the vein in the aforementioned area of your body. Cavernous sinus thrombosis cst is a rare condition, usually results from a late complication of an infection of the paranasal sinuses. Large sinuses such as the superior sagittal sinus are most frequently involved. Despite treatment of cst is directed to the causal situation, being shown. Cavernous sinus thrombosis is a potentially lifethreatening condition that can happen after an infection in your head. Treatment and management of venous sinus thrombosis. Such infections develop from peritonsillar abscess, operations on the tonsil, surgery or osteomyelitis. Backgroundthe purpose of this statement is to provide an overview of cerebral venous sinus thrombosis and to provide recommendations for its diagnosis, management, and treatment. Nov 05, 2017 cavernous sinus thrombosis is a condition where a blood clot forms in the region under your brain and at the back of the eye socket. Cavernous sinus thrombosis an overview sciencedirect topics.
1465 469 1173 967 714 537 1519 800 1140 909 760 1270 579 795 79 47 871 937 934 956 699 1404 762 127 751 5 70 1293 455 691