Cavernous sinus thrombosis natural history, complications and prognosis: Difference between revisions
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{{Cavernous sinus thrombosis}} | {{Cavernous sinus thrombosis}} | ||
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==Overview== | ==Overview== | ||
==Natural History== | The symptoms of cavernous sinus thrombosis may vary depend on the anatomical structures involved. The most common symptoms of cavernous sinus thrombosis include: Severe holocranial and bifrontal [[headache]] whit increasing severity, [[Fever|fever,]] [[Proptosis]], [[Chemosis]], [[Ophthalmoplegia|external ophthalmoplegia]], periorbital swelling and redness in one or both eyes. Other symptoms of cavernous sinus thrombosis include: [[Ptosis|Drooping eyelids]], [[Decreased visual acuity]], [[Vision loss]] or [[double vision|double vision,]] Inability to move the eye, periorbital sensory loss, pain or numbness around the face or eyes, fatigue, [[Seizure]]<nowiki/>s and <nowiki/>[[Lethargy]]. Common complications of cavernous sinus thrombosis include: Death, bilateral [[blindness]], [[Seizures]], total [[ophthalmoplegia]], [[Anisocoria]], [[Meningitis]], [[Intracerebral hemorrhage]], [[Facial palsy]], [[Hemiparesis]], venous infarction, [[Ptosis]] and [[Hypopituitarism]]. Prognosis better as diagnosis is increasing made with imaging instead of [[autopsy]], with mortality rates down from 100% to 6.5% in a recent review of 76 patients. Poor prognostic features include: Rapid progression, [[Coma]], extremes of age, focal signs and symptoms, [[Hemorrhagic]] [[infarct]] and serious underlying cause. | ||
==Natural History, Complications, and Prognosis== | |||
== | ===Natural History=== | ||
The symptoms of cavernous sinus thrombosis may vary depend on the anatomical structures involved.<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
* The most common symptoms of cavernous sinus thrombosis include: | |||
** Severe holocranial and bifrontal [[headache]] whit increasing severity<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref><ref name="pmid28936075">{{cite journal| author=Botta R, Donirpathi S, Yadav R, Kulkarni GB, Kumar MV, Nagaraja D| title=Headache Patterns in Cerebral Venous Sinus Thrombosis. | journal=J Neurosci Rural Pract | year= 2017 | volume= 8 | issue= Suppl 1 | pages= S72-S77 | pmid=28936075 | doi=10.4103/jnrp.jnrp_339_16 | pmc=5602266 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28936075 }} </ref><ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
**[[Fever]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref><ref name="pmid28936075" /><ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
**[[Proptosis]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
** [[Chemosis]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
** [[Ophthalmoplegia|External ophthalmoplegia]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref><ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
** Periorbital swelling and redness in one or both eyes<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref><ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
==Prognosis== | * Other symptoms of cavernous sinus thrombosis include: | ||
* Prognosis better as diagnosis is increasing made with imaging instead of autopsy, with mortality rates down from 100% to 6.5% in a recent review of 76 patients. | ** [[Ptosis|Drooping eyelids]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref><ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | ||
** [[Decreased visual acuity]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref><ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
** [[Vision loss]] or [[double vision]]<ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
** Inability to move the eye<ref name="pmid25917067">{{cite journal| author=Mallick A, Pathak SD, Shankar S, Sati A| title=Early cavernous sinus thrombosis following unilateral pansinusitis in a child. | journal=BMJ Case Rep | year= 2015 | volume= 2015 | issue= | pages= | pmid=25917067 | doi=10.1136/bcr-2014-208441 | pmc=4422932 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25917067 }} </ref> | |||
** Periorbital sensory loss<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
** Pain or numbness around the face or eyes<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
** Fatigue<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
** [[Seizure]]<nowiki/>s<ref name="pmid29039017">{{cite journal| author=Sha DJ, Qian J, Gu SS, Wang LN, Wang F, Xu Y| title=Cerebral venous sinus thrombosis complicated by seizures: a retrospective analysis of 69 cases. | journal=J Thromb Thrombolysis | year= 2018 | volume= 45 | issue= 1 | pages= 186-191 | pmid=29039017 | doi=10.1007/s11239-017-1570-5 | pmc=5756278 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29039017 }} </ref> | |||
** [[Lethargy]]<ref name="pmid25247150">{{cite journal| author=Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS et al.| title=Cavernous sinus thrombosis caused by a dental infection: a case report. | journal=J Korean Assoc Oral Maxillofac Surg | year= 2014 | volume= 40 | issue= 4 | pages= 195-8 | pmid=25247150 | doi=10.5125/jkaoms.2014.40.4.195 | pmc=4170663 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25247150 }} </ref> | |||
===Complications=== | |||
*Common complications of cavernous sinus thrombosis include: | |||
**Death<ref name="pmid7161604">{{cite journal| author=Clifford-Jones RE, Ellis CJ, Stevens JM, Turner A| title=Cavernous sinus thrombosis. | journal=J Neurol Neurosurg Psychiatry | year= 1982 | volume= 45 | issue= 12 | pages= 1092-7 | pmid=7161604 | doi= | pmc=491689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7161604 }} </ref> | |||
**Bilateral [[blindness]]<ref name="pmid2050471">{{cite journal| author=Coutteel C, Leys A, Fossion E, Missotten L| title=Bilateral blindness in cavernous sinus thrombosis. | journal=Int Ophthalmol | year= 1991 | volume= 15 | issue= 3 | pages= 163-71 | pmid=2050471 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2050471 }} </ref> | |||
** [[Seizures]]<ref name="pmid29039017">{{cite journal| author=Sha DJ, Qian J, Gu SS, Wang LN, Wang F, Xu Y| title=Cerebral venous sinus thrombosis complicated by seizures: a retrospective analysis of 69 cases. | journal=J Thromb Thrombolysis | year= 2018 | volume= 45 | issue= 1 | pages= 186-191 | pmid=29039017 | doi=10.1007/s11239-017-1570-5 | pmc=5756278 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29039017 }} </ref> | |||
**Total [[ophthalmoplegia]]<ref name="pmid27532532">{{cite journal| author=Bouraoui R, Bouladi M, Ben Romdhane B, Limaiem R, Mghaieth F, El Matri L| title=Ophthalmic artery occlusion with total ophtalmoplegia and anisocoria revealing cavernous sinus thrombosis. | journal=Tunis Med | year= 2016 | volume= 94 | issue= 2 | pages= 145-7 | pmid=27532532 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27532532 }} </ref> | |||
**[[Anisocoria]]<ref name="pmid27532532">{{cite journal| author=Bouraoui R, Bouladi M, Ben Romdhane B, Limaiem R, Mghaieth F, El Matri L| title=Ophthalmic artery occlusion with total ophtalmoplegia and anisocoria revealing cavernous sinus thrombosis. | journal=Tunis Med | year= 2016 | volume= 94 | issue= 2 | pages= 145-7 | pmid=27532532 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27532532 }} </ref> | |||
**[[Meningitis]]<ref name="pmid18380704">{{cite journal| author=Munckhof WJ, Krishnan A, Kruger P, Looke D| title=Cavernous sinus thrombosis and meningitis from community-acquired methicillin-resistant Staphylococcus aureus infection. | journal=Intern Med J | year= 2008 | volume= 38 | issue= 4 | pages= 283-7 | pmid=18380704 | doi=10.1111/j.1445-5994.2008.01650.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18380704 }} </ref> | |||
**[[Intracerebral hemorrhage]]<ref name="pmid22664979">{{cite journal| author=Pongmoragot J, Saposnik G| title=Intracerebral hemorrhage from cerebral venous thrombosis. | journal=Curr Atheroscler Rep | year= 2012 | volume= 14 | issue= 4 | pages= 382-9 | pmid=22664979 | doi=10.1007/s11883-012-0260-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22664979 }} </ref> | |||
**[[Facial palsy]]<ref name="pmid24665189">{{cite journal| author=Verma R, Junewar V, Singh RK, Ram H, Pal US| title=Bilateral cavernous sinus thrombosis and facial palsy as complications of dental abscess. | journal=Natl J Maxillofac Surg | year= 2013 | volume= 4 | issue= 2 | pages= 252-5 | pmid=24665189 | doi=10.4103/0975-5950.127664 | pmc=3961908 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24665189 }} </ref> | |||
**[[Hemiparesis]]<ref name="pmid16467601">{{cite journal| author=Kamouchi M, Wakugawa Y, Okada Y, Kishikawa K, Matsuo R, Toyoda K et al.| title=Venous infarction secondary to septic cavernous sinus thrombosis. | journal=Intern Med | year= 2006 | volume= 45 | issue= 1 | pages= 25-7 | pmid=16467601 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16467601 }} </ref><ref name="pmid6671735">{{cite journal| author=Rodrigues R, Merchant R, Parekh S| title=Cavernous sinus thrombosis with retrobulbar mass and hemiplegia. | journal=Indian J Pediatr | year= 1983 | volume= 50 | issue= 405 | pages= 457-9 | pmid=6671735 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6671735 }} </ref> | |||
**Venous infarction<ref name="pmid16467601">{{cite journal| author=Kamouchi M, Wakugawa Y, Okada Y, Kishikawa K, Matsuo R, Toyoda K et al.| title=Venous infarction secondary to septic cavernous sinus thrombosis. | journal=Intern Med | year= 2006 | volume= 45 | issue= 1 | pages= 25-7 | pmid=16467601 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16467601 }} </ref> | |||
**[[Ptosis]]<ref name="pmid22139823">{{cite journal| author=Kraus CL, Culican SM| title=Challenging presentations of cavernous sinus thrombophlebitis. | journal=J Ophthalmic Inflamm Infect | year= 2012 | volume= 2 | issue= 3 | pages= 133-6 | pmid=22139823 | doi=10.1007/s12348-011-0053-7 | pmc=3438306 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22139823 }} </ref> | |||
**[[Hypopituitarism]]<ref name="pmid6302919">{{cite journal| author=Silver HS, Morris LR| title=Hypopituitarism secondary to cavernous sinus thrombosis. | journal=South Med J | year= 1983 | volume= 76 | issue= 5 | pages= 642-6 | pmid=6302919 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6302919 }} </ref> | |||
===Prognosis=== | |||
* Prognosis better as diagnosis is increasing made with imaging instead of [[autopsy]], with mortality rates down from 100% to 6.5% in a recent review of 76 patients. | |||
* Poor prognostic features: | * Poor prognostic features: | ||
*:* Rapid progression | *:* Rapid progression | ||
*:* Coma | *:* [[Coma]] | ||
*:* Extremes of age | *:* Extremes of age | ||
*:* Focal signs and symptoms | *:* Focal signs and symptoms | ||
*:* Hemorrhagic infarct | *:* [[Hemorrhagic]] [[infarct]] | ||
*:* Serious underlying cause | *:* Serious underlying cause | ||
* Of note, if patient survives, outcome is better than for arterial infarct | * Of note, if patient survives, outcome is better than for arterial infarct | ||
== References == | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{ | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: | [[Category: (name of the system)]] | ||
Latest revision as of 14:46, 29 June 2018
Cavernous sinus thrombosis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
The symptoms of cavernous sinus thrombosis may vary depend on the anatomical structures involved. The most common symptoms of cavernous sinus thrombosis include: Severe holocranial and bifrontal headache whit increasing severity, fever, Proptosis, Chemosis, external ophthalmoplegia, periorbital swelling and redness in one or both eyes. Other symptoms of cavernous sinus thrombosis include: Drooping eyelids, Decreased visual acuity, Vision loss or double vision, Inability to move the eye, periorbital sensory loss, pain or numbness around the face or eyes, fatigue, Seizures and Lethargy. Common complications of cavernous sinus thrombosis include: Death, bilateral blindness, Seizures, total ophthalmoplegia, Anisocoria, Meningitis, Intracerebral hemorrhage, Facial palsy, Hemiparesis, venous infarction, Ptosis and Hypopituitarism. Prognosis better as diagnosis is increasing made with imaging instead of autopsy, with mortality rates down from 100% to 6.5% in a recent review of 76 patients. Poor prognostic features include: Rapid progression, Coma, extremes of age, focal signs and symptoms, Hemorrhagic infarct and serious underlying cause.
Natural History, Complications, and Prognosis
Natural History
The symptoms of cavernous sinus thrombosis may vary depend on the anatomical structures involved.[1]
- The most common symptoms of cavernous sinus thrombosis include:
- Other symptoms of cavernous sinus thrombosis include:
- Drooping eyelids[1][3]
- Decreased visual acuity[1][3]
- Vision loss or double vision[3]
- Inability to move the eye[3]
- Periorbital sensory loss[1]
- Pain or numbness around the face or eyes[1]
- Fatigue[1]
- Seizures[4]
- Lethargy[1]
Complications
- Common complications of cavernous sinus thrombosis include:
- Death[5]
- Bilateral blindness[6]
- Seizures[4]
- Total ophthalmoplegia[7]
- Anisocoria[7]
- Meningitis[8]
- Intracerebral hemorrhage[9]
- Facial palsy[10]
- Hemiparesis[11][12]
- Venous infarction[11]
- Ptosis[13]
- Hypopituitarism[14]
Prognosis
- Prognosis better as diagnosis is increasing made with imaging instead of autopsy, with mortality rates down from 100% to 6.5% in a recent review of 76 patients.
- Poor prognostic features:
- Rapid progression
- Coma
- Extremes of age
- Focal signs and symptoms
- Hemorrhagic infarct
- Serious underlying cause
- Of note, if patient survives, outcome is better than for arterial infarct
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 Yeo GS, Kim HY, Kim H, Kwak EJ, Jung YS, Park HS; et al. (2014). "Cavernous sinus thrombosis caused by a dental infection: a case report". J Korean Assoc Oral Maxillofac Surg. 40 (4): 195–8. doi:10.5125/jkaoms.2014.40.4.195. PMC 4170663. PMID 25247150.
- ↑ 2.0 2.1 Botta R, Donirpathi S, Yadav R, Kulkarni GB, Kumar MV, Nagaraja D (2017). "Headache Patterns in Cerebral Venous Sinus Thrombosis". J Neurosci Rural Pract. 8 (Suppl 1): S72–S77. doi:10.4103/jnrp.jnrp_339_16. PMC 5602266. PMID 28936075.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Mallick A, Pathak SD, Shankar S, Sati A (2015). "Early cavernous sinus thrombosis following unilateral pansinusitis in a child". BMJ Case Rep. 2015. doi:10.1136/bcr-2014-208441. PMC 4422932. PMID 25917067.
- ↑ 4.0 4.1 Sha DJ, Qian J, Gu SS, Wang LN, Wang F, Xu Y (2018). "Cerebral venous sinus thrombosis complicated by seizures: a retrospective analysis of 69 cases". J Thromb Thrombolysis. 45 (1): 186–191. doi:10.1007/s11239-017-1570-5. PMC 5756278. PMID 29039017.
- ↑ Clifford-Jones RE, Ellis CJ, Stevens JM, Turner A (1982). "Cavernous sinus thrombosis". J Neurol Neurosurg Psychiatry. 45 (12): 1092–7. PMC 491689. PMID 7161604.
- ↑ Coutteel C, Leys A, Fossion E, Missotten L (1991). "Bilateral blindness in cavernous sinus thrombosis". Int Ophthalmol. 15 (3): 163–71. PMID 2050471.
- ↑ 7.0 7.1 Bouraoui R, Bouladi M, Ben Romdhane B, Limaiem R, Mghaieth F, El Matri L (2016). "Ophthalmic artery occlusion with total ophtalmoplegia and anisocoria revealing cavernous sinus thrombosis". Tunis Med. 94 (2): 145–7. PMID 27532532.
- ↑ Munckhof WJ, Krishnan A, Kruger P, Looke D (2008). "Cavernous sinus thrombosis and meningitis from community-acquired methicillin-resistant Staphylococcus aureus infection". Intern Med J. 38 (4): 283–7. doi:10.1111/j.1445-5994.2008.01650.x. PMID 18380704.
- ↑ Pongmoragot J, Saposnik G (2012). "Intracerebral hemorrhage from cerebral venous thrombosis". Curr Atheroscler Rep. 14 (4): 382–9. doi:10.1007/s11883-012-0260-1. PMID 22664979.
- ↑ Verma R, Junewar V, Singh RK, Ram H, Pal US (2013). "Bilateral cavernous sinus thrombosis and facial palsy as complications of dental abscess". Natl J Maxillofac Surg. 4 (2): 252–5. doi:10.4103/0975-5950.127664. PMC 3961908. PMID 24665189.
- ↑ 11.0 11.1 Kamouchi M, Wakugawa Y, Okada Y, Kishikawa K, Matsuo R, Toyoda K; et al. (2006). "Venous infarction secondary to septic cavernous sinus thrombosis". Intern Med. 45 (1): 25–7. PMID 16467601.
- ↑ Rodrigues R, Merchant R, Parekh S (1983). "Cavernous sinus thrombosis with retrobulbar mass and hemiplegia". Indian J Pediatr. 50 (405): 457–9. PMID 6671735.
- ↑ Kraus CL, Culican SM (2012). "Challenging presentations of cavernous sinus thrombophlebitis". J Ophthalmic Inflamm Infect. 2 (3): 133–6. doi:10.1007/s12348-011-0053-7. PMC 3438306. PMID 22139823.
- ↑ Silver HS, Morris LR (1983). "Hypopituitarism secondary to cavernous sinus thrombosis". South Med J. 76 (5): 642–6. PMID 6302919.