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Cavernous sinus thrombosis

Definition

Cavernous sinus thrombosis is a blood clot in the cavernous sinus. The cavernous sinus is a cavity at the base of the brain that contains a vein, several nerves, and other structures. The vein carries deoxygenated blood from the brain and face back to the heart.

The vein and cavity run between the large bone at the base of the skull (sphenoid bone) and temporal bone (near the temple).

Causes, incidence, and risk factors

The cause of cavernous sinus thrombosis is usually a bacterial infection that has spread from the sinuses, teeth, ears, eyes, nose, or skin of the face. Persons with conditions that cause an increased risk of blood clots may also develop cavernous sinus thrombosis.

Symptoms

  • Bulging eyeballs
  • Cannot move the eye in a particular direction
  • Drooping eyelids
  • Headaches
  • Vision loss

Signs and tests

Tests that may be ordered include:

  • CT scan of the head
  • Magnetic resonance imaging (MRI) of the brain
  • Sinus x-ray

Treatment

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

Expectations (prognosis)

Cavernous sinus thrombosis can be fatal. However, the death rate of this condition has improved tremendously since the introduction of antibiotics.

Calling your health care provider

Call your doctor right away if you have:

  • Bulging of your eyes
  • Drooping eyelids
  • Eye pain
  • Inability to move your eye in any particular direction
  • Vision loss

References

Nath A. Brain abscess and parameningeal infection. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 438.


Review Date: 2/5/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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