Cavernous sinus thrombosis natural history, complications and prognosis: Difference between revisions
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===Natural History=== | ===Natural History=== | ||
The symptoms of cavernous sinus thrombosis may vary | 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: | * The most common symptoms of cavernous sinus thrombosis include: | ||
** Severe holocranial and bifrontal headache whit increasing severity | ** 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> | ** 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> | ||
** 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> | ** 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> | ||
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** 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> | ** 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> | ||
** 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> | ** 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=== | ===Complications=== | ||
*Common complications of cavernous sinus thrombosis include: | *Common complications of cavernous sinus thrombosis include: | ||
**[Complication 1] | **[Complication 1] | ||
** | **Bilateral blindness | ||
** 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> | ** 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> | ||
Revision as of 14:00, 29 June 2018
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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
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:
Complications
- Common complications of cavernous sinus thrombosis include:
- [Complication 1]
- Bilateral blindness
- Seizures[4]
Prognosis
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.
Natural History
In reality, most patients with cavernous sinus thrombosis do not present with such serious illness, and if they survive tend to have a better prognosis than patients with arterial thrombosis. The real trick is suspecting and making the diagnosis.
Complications
Progressive coma and death with hemorrhagic infarction pathologically.
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