Thrombosis of cavernous sinus syndrome

Face | Neurology | Thrombosis of cavernous sinus syndrome (Disease)


Cavernous sinus thrombosis actually consists in the appearance of a clot (thrombus) in the cavernous sinus. Signs and symptoms of cavernous sinus thrombosis are often nonspecific and because of this, the correct diagnosis may be delayed (because thrombosis is rare, it is less suspected initial diagnosis). Patients have a wide range of signs and symptoms. Therefore, any person complaining of persistent headache, refractory to common analgesic treatment and has the objective neurological signs of cranial nerve damage, must be investigated properly and cavernous sinus thrombosis.

Patients symptoms are related to anatomical structures affected by the infectious process, as follows: (1) sinusitis or infection localized dermatological segment of the facial median (the middle) - most commonly a boil (over 50% of cases) - the evolution of 5-10 days. Most often, in more than 25% of cases furuncle precipitating factor is infection, especially if it was drained in any way (personal patient or surgical procedures); (2) headache is the most common accusation: it precedes fever, per orbital edema and signs of involvement of cranial nerves. The pain is usually acute, gradually increases in intensity and is located in regions innervated by ophthalmic nerve and the maxillary branch of trigeminal nerve. If the infection spreads, the patient may have a permanent feeling of tension, accompanied by per orbital edema and visual disturbances. In the absence of effective treatment, signs appear and infection spreads via communicating veins to the contralateral cavernous sinus.

Causes and Risk factors

Cavernous sinus thrombosis occurs most often in late complications of frontal and para-nasal sinus infections. Other causes for its occurrence are: bacteremia, trauma, ear infections (otitis) or maxillary teeth. It is an infectious process with fulminant evolution and morbidity and mortality rates high enough.

However, the prompt and efficient use of antimicrobial agents, the incidence of thrombosis was significantly reduced lately.

Diagnosis and Treatment

Cavernous sinus thrombosis is treated with high-dose intravenous (through a vein) antibiotics. Sometimes surgery is needed to drain the infection. ...