Cavernous sinus thrombosis natural history, complications and prognosis: Difference between revisions
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===Complications=== | ===Complications=== | ||
*Common complications of cavernous sinus thrombosis include: | *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 | **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> | ** 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 ophtalmoplegia<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=== |
Revision as of 14:24, 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:
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.
- ↑ 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.
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