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What Is Cavernous Sinus Thrombosis?

In cavernous sinus thrombosis, also known as sinus thrombosis, a blood clot (thrombus) forms in the cavernous sinus. The cavernous sinus is a cavity at the bottom of the brain, in the skull. It helps drain blood from the brain and the middle part of the face back to the heart. Cranial nerves surround the sinus. These nerves are needed for eye movement and feeling at the top and middle parts of the head and face. People of any age, sex, or race can have this condition.

What Causes Cavernous Sinus Thrombosis?

The cause of this rare condition is usually an infection starting in the face (skin), eyes, eyelids, sphenoid sinus, or ears. Most often, infection of the sphenoid sinus, just below the cavernous sinus, lets bacteria spread easily. Infections caused by the bacteria Streptococcus and Staphylococcus are the most common.

What Are the Symptoms of Cavernous Sinus Thrombosis?

Symptoms include reduced vision or loss of vision, drooping eyelid, bulging eyeballs, and suddenly being unable to move the eye in a certain direction. Fever, headaches, rapid heart rate, and stiff neck can occur.

How Is Cavernous Sinus Thrombosis Diagnosed?

The health care provider makes a preliminary diagnosis from the medical history, physical examination, and blood tests for infection. To best way to find cavernous sinus thrombosis is magnetic resonance imaging (MRI) of the brain. Sometimes, lumbar puncture will be done to rule out meningitis. In lumbar puncture, the doctor puts a needle in the lower back to get fluid from around the spinal cord to be analyzed for signs of infection.

How Is Cavernous Sinus Thrombosis Treated?

Treatment involves high-dose intravenous antibiotics. The blood thinner called heparin may be used, but its use is controversial. The use of corticosteroids (anti-inflammatory steroids) is also controversial. In severe cases, a neurosurgeon will drain an infected sphenoid sinus during an operation, when this is the cause.

DOs and DON’Ts in Managing Cavernous Sinus Thrombosis:

  • DO understand that the best treatment is prevention. The main cause of the disorder is infection of the face, middle ear, or sinus. Therefore, treating these infections promptly is the best prevention method.
  • DO understand that cavernous sinus thrombosis can be a life-threatening, rapidly progressive infection. It can be fatal even after antibiotic treatment.
  • DO call your health care provider if you have eye pain, vision loss, or problems seeing.
  • DO call your health care provider if you have fever, headache, nausea, vomiting, and a stiff neck.
  • DO call your health care provider if you have ear pain, hearing loss, or drainage from your ear.
  • DO call your health care provider if yellow, green, or blood-tinged mucus drains from the sinus.
  • DO call your health care provider if you see bulging of the eye or droopy eyelids.
  • DO call your health care provider if you cannot move the eye in a certain direction.
  • DON’T forget that this disorder is a medical emergency.
  • DON’T ignore symptoms that suggest infections of the face, eye, ears, and sinuses.
FOR MORE INFORMATION

Contact the following sources:

  • U.S. National Library of Medicine
    Web: http://www.nlm.nih.gov/nlmhome.html
  • American Academy of Ophthalmology
    Phone:415-561-8500
    Web:www.aao.org
  • National Institute of Neurological Disorders and Stroke
    Tel: (800) 787-6537
    Website:www.ninds.nih.gov

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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