Zakrzepica zatoki jamistej
Epidemiologia

Zakrzepica zatoki jamistej (ZZJ) stanowi około 1-4% wszystkich przypadków zakrzepicy zatok żylnych mózgu (CVST), z roczną zapadalnością szacowaną na 0,2-1,6 przypadków na 100 000 osób. W erze antybiotykowej śmiertelność spadła z niemal 100% do poniżej 30%, jednak pełne wyzdrowienie jest rzadkie – około 16% pacjentów doświadcza trwałych zaburzeń widzenia, a 50% deficytów nerwów czaszkowych. ZZJ dotyka głównie młodych dorosłych (średni wiek około 22 lata), a dane dotyczące przewagi płci są niejednoznaczne, z niektórymi badaniami wskazującymi na przewagę mężczyzn, a innymi na kobiet. Etiologia ZZJ dzieli się na septyczną, najczęściej związaną z zapaleniem zatok przynosowych i infekcją Staphylococcus aureus (do 70% przypadków), oraz aseptyczną, obejmującą urazy, zabiegi chirurgiczne, ciążę, stosowanie doustnych środków antykoncepcyjnych i nowotwory złośliwe (stanowiące około 7,4% przypadków CVST). Pandemia COVID-19 zwiększyła częstość występowania CVST, w tym ZZJ, a szczepionki wektorowe przeciw COVID-19 wiążą się z rzadkim, ale ciężkim powikłaniem immunologiczną małopłytkową zakrzepicą indukowaną szczepionką (VITT), o częstości 1:100 000 do 1:1 000 000 i śmiertelności 18,3-50%.

  1. Epidemiologia zakrzepicy zatoki jamistej
    1. Zmiany w częstliwości występowania
    2. Rozkład wiekowy i płciowy
  2. Czynniki ryzyka i etiologia
    1. Przyczyny septyczne
    2. Przyczyny aseptyczne
  3. Zakrzepica zatoki jamistej w kontekście COVID-19
    1. Zakrzepica związana ze szczepionkami przeciw COVID-19
  4. Nadzór i monitorowanie
    1. Znaczące badania i rejestry
    2. Wyzwania diagnostyczne
  5. Perspektywy i tendencje
    1. Poprawa rokowania
    2. Zmiana wzorca płci
    3. Wzrost częstliwości występowania
    4. Kolejne rozdziały

Epidemiologia zakrzepicy zatoki jamistej

Zakrzepica zatoki jamistej (ZZJ) jest niezwykle rzadkim schorzeniem, którego dokładne dane epidemiologiczne są trudne do oszacowania. Szacuje się, że stanowi ona około 1-4% wszystkich przypadków zakrzepicy zatok żylnych mózgu (CVST). Przy rocznej zapadalności na CVST wynoszącej od 2 do 4 przypadków na milion osób, można oszacować, że roczna zapadalność na zakrzepicę zatoki jamistej wynosi około 0,2-1,6 przypadku na 100 000 osób rocznie.123

Inne źródła podają podobną częstość występowania tej choroby – około 4,5 przypadku na 1 000 000 osób rocznie. Jest to najrzadziej występująca postać zakrzepicy zatok żylnych opony twardej, stanowiąca zaledwie 1,5% wszystkich przypadków.45

Zmiany w częstliwości występowania

Częstość występowania zakrzepicy zatoki jamistej oraz związana z nią śmiertelność uległy znacznemu zmniejszeniu w erze antybiotykowej. Przed wprowadzeniem antybiotyków śmiertelność w przebiegu ZZJ wynosiła praktycznie 100%. Obecnie, dzięki wczesnemu rozpoznaniu i agresywnemu leczeniu, wskaźnik ten spadł do poniżej 30%.678

Pomimo znacznej poprawy wskaźników przeżywalności, wskaźnik zachorowalności pozostaje wysoki, a pełne wyzdrowienie jest rzadkie. Około 1/6 pacjentów pozostaje z pewnym stopniem upośledzenia widzenia, a połowa z deficytami nerwów czaszkowych.9

Rozkład wiekowy i płciowy

Zakrzepica zatoki jamistej może wystąpić w każdym wieku, jednak średnia wieku pacjentów wynosi około 22 lata.10 W przeciwieństwie do ogólnej zakrzepicy zatok żylnych mózgu (CVST), w której obserwuje się wyraźną przewagę kobiet (stosunek 3:1), w przypadku zakrzepicy zatoki jamistej nie ma jednoznacznych danych dotyczących przewagi płci.1112

Niektóre badania wskazują nawet na nieznaczną przewagę mężczyzn. Weerasinghe odnotował stosunek mężczyzn do kobiet wynoszący 2:1 w 88 przypadkach septycznej ZZJ u dorosłych. Podobnie Thatai i wsp. oraz Smith i wsp. wskazują na niewielką przewagę płci męskiej odpowiednio w 35 i 12 przypadkach.13

Jednakże inne źródła sugerują, że ZZJ może częściej występować u kobiet niż u mężczyzn, ze stosunkiem kobiet do mężczyzn wynoszącym od 3,75 do 5,3:1.14 Ta rozbieżność w danych epidemiologicznych może być częściowo związana z różnymi metodologiami badań i niewielką liczbą analizowanych przypadków ze względu na rzadkość schorzenia.15

Czynniki ryzyka i etiologia

Zakrzepica zatoki jamistej może być pochodzenia septycznego lub aseptycznego. W erze przedantybiotykowej, infekcje środkowej części twarzy były odpowiedzialne za większość przypadków. Obecnie ostre zapalenie zatok przynosowych jest najczęstszym predysponującym stanem.16

Przyczyny septyczne

W przypadku septycznej zakrzepicy zatoki jamistej, najczęstszą przyczyną jest zapalenie zatok przynosowych, odpowiedzialne za około 50% wszystkich przypadków.17 Infekcja może rozprzestrzeniać się do zatoki jamistej jako przedłużenie zakrzepowego zapalenia żył lub przez septyczne zatory.18

W do 70% przypadków, przyczyną infekcji są bakterie Staphylococcus aureus.19 Inne przyczyny zakrzepicy zatoki jamistej obejmują:20

  • Bakteryjne zapalenie opon mózgowo-rdzeniowych
  • Zapalenie zatok przynosowych
  • Zapalenie ucha środkowego
  • Ropień zęba
  • Infekcje tkanek miękkich twarzy (np. czyrak środkowej części twarzy, trądzik twarzy, zapalenie tkanki łącznej twarzy)
  • Zapalenie tkanki oczodołowej

21

Przyczyny aseptyczne

Aseptyczna zakrzepica zatoki jamistej może być spowodowana przez:22

  • Uraz
  • Zabieg chirurgiczny
  • Ciążę
  • Stosowanie doustnych środków antykoncepcyjnych
  • Nowotwory złośliwe

23

Nowotwory złośliwe stanowią niezwykle rzadką przyczynę ZZJ, odpowiadając za około 7,4% wszystkich przypadków zakrzepicy zatok żylnych mózgu. Ryzyko ZZJ w przypadku nowotworów złośliwych wzrasta 5-krotnie.24

Zakrzepica zatoki jamistej w kontekście COVID-19

Pandemia COVID-19 przyniosła zwiększoną liczbę przypadków zakrzepicy zatok żylnych mózgu (CVST), w tym zakrzepicy zatoki jamistej. Badanie retrospektywne wieloośrodkowe wykazało częstość występowania CVST wynoszącą 8,8 na 10 000 przypadków COVID-19, w porównaniu do 3-4 na milion w publikacjach sprzed pandemii.25

Zakrzepica związana ze szczepionkami przeciw COVID-19

Zarówno infekcja COVID-19, jak i szczepionki przeciw COVID-19 były związane z epizodami zakrzepowo-zatorowymi w wielu raportach i przeglądach. Jednym z najpoważniejszych działań niepożądanych przypisywanych szczepionkom wektorowym przeciw COVID-19 jest immunologiczna małopłytkowa zakrzepica indukowana szczepionką (VITT).26

Częstość występowania VITT po szczepionce:27

  • 1 na 1 000 000 dla Ad26.COV2.S (marki Johnson & Johnson i Janssen)
  • 1 na 100 000 dla ChAdOx1 nCoV-19 (marka AstraZeneca)

28

Śmiertelność VITT jest wysoka, wahająca się od 18,3% do 50%.29

Nadzór i monitorowanie

Ze względu na rzadkość występowania zakrzepicy zatoki jamistej, nie istnieją specjalne programy nadzoru epidemiologicznego poświęcone wyłącznie temu schorzeniu. Jednak dane na temat zakrzepicy zatoki jamistej są zbierane w ramach szerszych badań nad zakrzepicą zatok żylnych mózgu (CVST).30

Znaczące badania i rejestry

Jednym z największych badań dotyczących CVST jest Międzynarodowe Badanie Zakrzepicy Żył Mózgowych i Zatok Opony Twardej (International Study on Cerebral Vein and Dural Sinus Thrombosis – ISCVDST), które obejmowało 624 pacjentów z CVST. W tym badaniu zatoka jamista została zidentyfikowana jako najczęściej dotknięta zatoka (1,3%).31

Inne istotne badanie to włoskie wieloośrodkowe badanie obejmujące 706 pacjentów z CVST.32 Te duże badania przyczyniają się do lepszego zrozumienia epidemiologii i czynników ryzyka zakrzepicy zatoki jamistej, pomimo jej rzadkości.

Wyzwania diagnostyczne

Rozpoznanie zakrzepicy zatoki jamistej jest często trudne ze względu na jej rzadkość i niespecyficzne objawy początkowe. Wymaga ono głębokiego zrozumienia procesu chorobowego i wysokiego wskaźnika klinicznego podejrzenia, ponieważ pacjenci nie zawsze prezentują klasyczne objawy.33

Diagnostyka opiera się na obrazowych badaniach neuroradiologicznych, takich jak rezonans magnetyczny (MRI) lub tomografia komputerowa (CT), przy czym preferencyjnie stosuje się wzmocnioną kontrastem angiografię rezonansu magnetycznego (MR venogram) lub angiografię tomografii komputerowej (CT venogram), jeśli są dostępne.34

Zakrzepica zatoki jamistej może być trudna do wykrycia za pomocą CT lub MRI we wczesnej fazie choroby.35 Należy dokładnie ocenić także zatoki żylne opony twardej i żyły mózgowe w przypadkach zakrzepicy zatoki jamistej, ponieważ do 90% pacjentów będzie miało wiele zakrzepic.36

Perspektywy i tendencje

W ostatnich dekadach obserwuje się pewne istotne zmiany w epidemiologii zakrzepicy zatoki jamistej i szerszej kategorii zakrzepicy zatok żylnych mózgu (CVST).

Poprawa rokowania

Rokowanie w zakrzepicy zatoki jamistej uległo znacznej poprawie w porównaniu z doniesieniami historycznymi. Starsze artykuły opisują wyższe wskaźniki śmiertelności (14-80%), ale nowsze artykuły raportują wskaźniki śmiertelności i zachorowalności podobne do współczesnych wyników.37

W jednym z niedawnych badań, na 12 pacjentów z ZZJ, 11 przeżyło, a 9 wyzdrowiało bez żadnych trwałych deficytów.38 Ten trend jest prawdopodobnie wynikiem lepszej diagnostyki i wcześniejszego rozpoznania, a także skuteczniejszych metod leczenia.

Zmiana wzorca płci

Chociaż tradycyjnie uważano, że CVST częściej występuje u kobiet (ze stosunkiem 3:1), niektóre nowsze badania sugerują zmianę tego wzorca w przypadku zakrzepicy zatoki jamistej, przy czym niektóre dane wskazują na przewagę mężczyzn.39

Te zmiany mogą być częściowo związane ze stałym spadkiem proporcji CVST związanej z ciążą, co przypisuje się lepszej opiece zdrowotnej.40 Jednak dokładne przyczyny tej zmiany wzorca płci w ZZJ wymagają dalszych badań.

Wzrost częstliwości występowania

Pomimo spadku hospitalizacji związanych z ZZJ u kobiet, w ciągu ostatnich kilku dekad nastąpił ogólny wzrost częstości występowania CVST.41 W jednym z badań odnotowano wzrost częstości występowania z 0,05% do 0,1% wszystkich przyjęć w okresie badania.42

Ten wzrost może być częściowo związany z lepszą diagnostyką i większą świadomością kliniczną, a także z szerszym zastosowaniem obrazowania metodą rezonansu magnetycznego.43

W podsumowaniu, zakrzepica zatoki jamistej pozostaje rzadkim, ale potencjalnie zagrażającym życiu schorzeniem, którego epidemiologia ulega stopniowym zmianom w czasie. Wczesne rozpoznanie i agresywne leczenie są kluczowe dla poprawy wyników pacjentów z tym schorzeniem.44

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK448177/
    Cavernous sinus thrombosis is so rare that incidence data is difficult to estimate. Since cavernous sinus thrombosis comprises approximately 1% to 4% of cerebral venous and sinus thrombosis (CVST), which has an annual incidence of approximately two to four per million people per year, with a higher incidence in children, one can estimate that the annual incidence of cavernous sinus thrombosis might be approximately 0.2 to 1.6 per 100,000 per year. […] A male or female predominance in cavernous sinus thrombosis is uncertain. Despite a 3:1 female predominance in cerebral venous thrombosis, this may not be the case for cavernous sinus thrombosis. Weerasinghe reported a 2:1 male to female ratio in 88 septic adult cases. Similarly, Thatai et al. and Smith et al. report a slight male preponderance in 35 and 12 cases, respectively. […] The incidence and mortality may be decreasing likely due to the availability and use of antibiotics.
  • #2 Cavernous Sinus Thrombosis | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19035
    Cavernous sinus thrombosis is so rare that incidence data is difficult to estimate. […] Since cavernous sinus thrombosis comprises approximately 1% to 4% of cerebral venous and sinus thrombosis (CVST), which has an annual incidence of approximately two to four per million people per year, with a higher incidence in children, one can estimate that the annual incidence of cavernous sinus thrombosis might be approximately 0.2 to 1.6 per 100,000 per year. […] A male or female predominance in cavernous sinus thrombosis is uncertain. […] Despite a 3:1 female predominance in cerebral venous thrombosis, this may not be the case for cavernous sinus thrombosis. […] The incidence and mortality may be decreasing likely due to the availability and use of antibiotics.
  • #3 A Case Report of Cavernous Sinus Thrombosis in a 40-year-old pati
    https://www.iomcworld.org/open-access/a-case-report-of-cavernous-sinus-thrombosis-in-a-40yearold-patient-with-adenocarcinoma-of-unknown-primary-origin-93505.html
    We herein report a case of bilateral Cavernous Sinus Thrombosis in a 40-yearold male in the setting of nasopharyngeal adenocarcinoma of unknown primary origin. […] Cavernous Sinus Thrombosis (CST) is a very rare condition with an incidence of 0.2-1.6 cases per 100,000 per annum. […] Out of all cases of cerebral and dural venous sinus thrombosis, malignancy as a cause accounts for 7.4% which shows that the risk of CST in malignancy is increased by 5-fold. […] Even with the use of antibiotics and other modern methods of medical management, the mortality rate is still high at 30% with up to 50% having residual cranial neuropathies. […] Diagnosis of Cavernous Sinus Thrombosis is quite challenging and requires a deeper understanding of the disease process and a high index of clinical suspicion, as these patients do not always present with classical symptoms, making it more challenging.
  • #4 Cavernous sinus thrombosis | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/cavernous-sinus-thrombosis?lang=us
    Cavernous sinus thrombosis is rare, with ~4.5 cases per 1,000,000 per year. […] It is the least common dural venous sinus thrombosis, accounting for 1.5% of cases.
  • #5 Cavernous sinus thrombosis | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/cavernous-sinus-thrombosis?embed_domain=hackmd.io%25252F%252540yIPUAFeCSL2JsU8smR5nJQ%25252Fbnjhjgjghjghjgh&lang=us
    Cavernous sinus thrombosis is rare, with ~4.5 cases per 1,000,000 per year. […] It is the least common dural venous sinus thrombosis, accounting for 1.5% of cases. […] The dural venous sinuses and cerebral veins should also be carefully evaluated in cases of cavernous sinus thrombosis as up to 90% of patients will have multiple thromboses.
  • #6 Cavernous Sinus Thrombosis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/791704-overview
    Occurrence of cavernous sinus thrombosis (CST) has always been low, with only a few hundred case reports in the medical literature. The majority of these date from before the modern antibiotic era. One review of the English-language literature found only 88 cases from 1940-1988. […] Prior to the advent of effective antimicrobial agents, the mortality rate from CST was effectively 100%. Typically, death is due to sepsis or central nervous system (CNS) infection. With aggressive management, the mortality rate is now less than 30%. Morbidity, however, remains high, and complete recovery is rare. Roughly one sixth of patients are left with some degree of visual impairment, and one half have cranial nerve deficits. These mortality and morbidity rates may be due to delayed diagnosis without prompt surgical drainage and antibiotic administration. […] All ages are affected, with a mean of 22 years.
  • #7 Cavernous Sinus Thrombosis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/23520-cavernous-sinus-thrombosis
    Cavernous sinus thrombosis is so rare that its difficult to predict how many cases happen yearly. […] Cases have declined substantially in the modern era, thanks to the widespread availability of antibiotics. […] In up to 70% of cases, Staphylococcus aureus bacteria cause the infection. […] Before antibiotics, cavernous sinus thrombosis nearly always resulted in death. Now, more than 70% of people with cavernous sinus thrombosis survive.
  • #8
    https://step2.medbullets.com/neurology/121848/cavernous-sinus-thrombosis
    Mortality 30% with antibiotic administration. […] Complete recovery is rate. […] Can affect all ages.
  • #9 Cavernous Sinus Thrombosis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/791704-overview
    Occurrence of cavernous sinus thrombosis (CST) has always been low, with only a few hundred case reports in the medical literature. The majority of these date from before the modern antibiotic era. One review of the English-language literature found only 88 cases from 1940-1988. […] Prior to the advent of effective antimicrobial agents, the mortality rate from CST was effectively 100%. Typically, death is due to sepsis or central nervous system (CNS) infection. With aggressive management, the mortality rate is now less than 30%. Morbidity, however, remains high, and complete recovery is rare. Roughly one sixth of patients are left with some degree of visual impairment, and one half have cranial nerve deficits. These mortality and morbidity rates may be due to delayed diagnosis without prompt surgical drainage and antibiotic administration. […] All ages are affected, with a mean of 22 years.
  • #10 Cavernous Sinus Thrombosis: Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/791704-overview
    Occurrence of cavernous sinus thrombosis (CST) has always been low, with only a few hundred case reports in the medical literature. The majority of these date from before the modern antibiotic era. One review of the English-language literature found only 88 cases from 1940-1988. […] Prior to the advent of effective antimicrobial agents, the mortality rate from CST was effectively 100%. Typically, death is due to sepsis or central nervous system (CNS) infection. With aggressive management, the mortality rate is now less than 30%. Morbidity, however, remains high, and complete recovery is rare. Roughly one sixth of patients are left with some degree of visual impairment, and one half have cranial nerve deficits. These mortality and morbidity rates may be due to delayed diagnosis without prompt surgical drainage and antibiotic administration. […] All ages are affected, with a mean of 22 years.
  • #11 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK448177/
    Cavernous sinus thrombosis is so rare that incidence data is difficult to estimate. Since cavernous sinus thrombosis comprises approximately 1% to 4% of cerebral venous and sinus thrombosis (CVST), which has an annual incidence of approximately two to four per million people per year, with a higher incidence in children, one can estimate that the annual incidence of cavernous sinus thrombosis might be approximately 0.2 to 1.6 per 100,000 per year. […] A male or female predominance in cavernous sinus thrombosis is uncertain. Despite a 3:1 female predominance in cerebral venous thrombosis, this may not be the case for cavernous sinus thrombosis. Weerasinghe reported a 2:1 male to female ratio in 88 septic adult cases. Similarly, Thatai et al. and Smith et al. report a slight male preponderance in 35 and 12 cases, respectively. […] The incidence and mortality may be decreasing likely due to the availability and use of antibiotics.
  • #12 Cavernous Sinus Thrombosis | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19035
    Cavernous sinus thrombosis is so rare that incidence data is difficult to estimate. […] Since cavernous sinus thrombosis comprises approximately 1% to 4% of cerebral venous and sinus thrombosis (CVST), which has an annual incidence of approximately two to four per million people per year, with a higher incidence in children, one can estimate that the annual incidence of cavernous sinus thrombosis might be approximately 0.2 to 1.6 per 100,000 per year. […] A male or female predominance in cavernous sinus thrombosis is uncertain. […] Despite a 3:1 female predominance in cerebral venous thrombosis, this may not be the case for cavernous sinus thrombosis. […] The incidence and mortality may be decreasing likely due to the availability and use of antibiotics.
  • #13 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK448177/
    Cavernous sinus thrombosis is so rare that incidence data is difficult to estimate. Since cavernous sinus thrombosis comprises approximately 1% to 4% of cerebral venous and sinus thrombosis (CVST), which has an annual incidence of approximately two to four per million people per year, with a higher incidence in children, one can estimate that the annual incidence of cavernous sinus thrombosis might be approximately 0.2 to 1.6 per 100,000 per year. […] A male or female predominance in cavernous sinus thrombosis is uncertain. Despite a 3:1 female predominance in cerebral venous thrombosis, this may not be the case for cavernous sinus thrombosis. Weerasinghe reported a 2:1 male to female ratio in 88 septic adult cases. Similarly, Thatai et al. and Smith et al. report a slight male preponderance in 35 and 12 cases, respectively. […] The incidence and mortality may be decreasing likely due to the availability and use of antibiotics.
  • #14 Cavernous sinus thrombosis epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Cavernous_sinus_thrombosis_epidemiology_and_demographics
    The prevalence of cavernous sinus thrombosis is approximately 1.321.57 per 100,000 individuals worldwide. The mortality rate of cavernous sinus thrombosis is approximately 20%. […] The combination of anticoagulants with antibiotics in treatment of cavernous sinus thrombosis has significantly decreased the mortality rate of it. […] Patients of all age groups may develop cavernous sinus thrombosis. The incidence of cavernous sinus thrombosis significantly increases with age. […] Women are more commonly affected by cavernous sinus thrombosis than men. The women to men ratio is approximately 3.75.3 to 1.
  • #15
    https://www.nhs.uk/conditions/cavernous-sinus-thrombosis/
    Cavernous sinus thrombosis is a blood clot in the cavernous sinuses. It can be life-threatening. […] It’s difficult to say exactly how many people are affected by cavernous sinus thrombosis, but it’s thought to be very rare. […] The condition affects people of all ages and tends to be more common in women than men. This may be because pregnancy and taking the oral contraceptive pill can make women more vulnerable to blood clots.
  • #16 Cavernous sinus thrombosis – Symptoms, diagnosis and treatment | BMJ Best Practice US
    https://bestpractice.bmj.com/topics/en-us/956
    Cavernous sinus thrombosis (CST) is a thrombus formation within the cavernous sinus, which may be either septic or aseptic in origin. Infection can spread to the cavernous sinus either as an extension of thrombophlebitis or by septic emboli. The origin of aseptic cavernous sinus thrombosis is usually through trauma or a prothrombotic condition. […] In the pre-antibiotic era, infections of the middle third of the face were responsible for the majority of cases. Currently, acute sinusitis is the most common predisposing condition.
  • #17
    https://link.springer.com/article/10.1007/s00405-018-5062-9
    Septic cavernous sinus thrombosis (CST) is a rare complication of infections in the head and neck area. CST is notorious for its bad prognosis, with high mortality and morbidity rates described in literature. […] The primary purpose of this study is to assess the mortality and morbidity of CST. […] We found 12 patients with CST in the study period. Of the 12 patients, 11 survived and 9 recovered without any permanent deficits. […] In literature, older articles describe higher mortality rates (14-80%), but more recent articles report mortality and morbidity rates similar to our results. […] The prognosis of CST nowadays is more favorable than previously described. […] CST is a rare disorder, although the exact incidence is unclear. […] In our series, sinusitis is the most common cause of CST (50% of the cases). […] In our series, 33% of cases were due to infections of the head and neck area. […] CST has always been notorious for its bad prognosis. […] Our series and other recent series in literature demonstrate that the prognosis of CST is not as devastating as it previously had been described.
  • #18 Cavernous sinus thrombosis – Symptoms, diagnosis and treatment | BMJ Best Practice US
    https://bestpractice.bmj.com/topics/en-us/956
    Cavernous sinus thrombosis (CST) is a thrombus formation within the cavernous sinus, which may be either septic or aseptic in origin. Infection can spread to the cavernous sinus either as an extension of thrombophlebitis or by septic emboli. The origin of aseptic cavernous sinus thrombosis is usually through trauma or a prothrombotic condition. […] In the pre-antibiotic era, infections of the middle third of the face were responsible for the majority of cases. Currently, acute sinusitis is the most common predisposing condition.
  • #19 Cavernous Sinus Thrombosis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/23520-cavernous-sinus-thrombosis
    Cavernous sinus thrombosis is so rare that its difficult to predict how many cases happen yearly. […] Cases have declined substantially in the modern era, thanks to the widespread availability of antibiotics. […] In up to 70% of cases, Staphylococcus aureus bacteria cause the infection. […] Before antibiotics, cavernous sinus thrombosis nearly always resulted in death. Now, more than 70% of people with cavernous sinus thrombosis survive.
  • #20 Cavernous Sinus Thrombosis — Pediatric EM Morsels
    https://pedemmorsels.com/cavernous-sinus-thrombosis-in-children/
    Cavernous Sinus Thrombosis is rare, but life-threatening. [Smith, 2015; Frank, 2015] […] Frequency has been reduced since high utilization of antibiotics. […] Mortality has been also reduced, but still exists and morbidity can be significant. […] Usually a late complication of an infection of the central face. [Varshney, 2015] […] Cavernous Sinus Thrombosis is an associated complication of: Bacterial Meningitis, Sinusitis, Otitis Media, Dental Abscess, Facial Soft-tissue Infections (ie, mid-face furnuncle, facial acne, facial cellulitis), Orbital Cellulitis. […] Prompt recognition is key to limiting complications! [Smith, 2015; Frank, 2015] […] There is no current consensus guidelines for management of Cavernous Sinus Thrombosis. [Smith, 2015] […] Cavernous sinus thrombosis is a rare presentation. Early diagnosis and aggressive treatment are required to prevent morbidity and mortality.
  • #21 Cavernous Sinus Thrombosis — Pediatric EM Morsels
    https://pedemmorsels.com/cavernous-sinus-thrombosis-in-children/
    Cavernous Sinus Thrombosis is rare, but life-threatening. [Smith, 2015; Frank, 2015] […] Frequency has been reduced since high utilization of antibiotics. […] Mortality has been also reduced, but still exists and morbidity can be significant. […] Usually a late complication of an infection of the central face. [Varshney, 2015] […] Cavernous Sinus Thrombosis is an associated complication of: Bacterial Meningitis, Sinusitis, Otitis Media, Dental Abscess, Facial Soft-tissue Infections (ie, mid-face furnuncle, facial acne, facial cellulitis), Orbital Cellulitis. […] Prompt recognition is key to limiting complications! [Smith, 2015; Frank, 2015] […] There is no current consensus guidelines for management of Cavernous Sinus Thrombosis. [Smith, 2015] […] Cavernous sinus thrombosis is a rare presentation. Early diagnosis and aggressive treatment are required to prevent morbidity and mortality.
  • #22 A Case Report of Cavernous Sinus Thrombosis in a 40-year-old pati
    https://www.iomcworld.org/open-access/a-case-report-of-cavernous-sinus-thrombosis-in-a-40yearold-patient-with-adenocarcinoma-of-unknown-primary-origin-93505.html
    Malignancy is an extremely rare cause of CST and here we present a unique case of left-sided CST that eventually progressed to the right side in a 40-year-old male with extensive metastasis of adenocarcinoma of unknown primary origin. […] Cavernous Sinus Thrombosis in and itself is a very rare condition and malignancy as a cause of CST is indeed very rare. […] To date, only a few such cases have been reported in the scientific literature. […] Aseptic causes of CST include trauma, surgery, pregnancy, oral contraceptive pill usage, and malignancy. […] CST in the setting of malignancy is very rare and there are very few cases reported in the literature. Risks and benefits should be carefully assessed individually while considering anticoagulation as a treatment avenue in patients with malignancy.
  • #23 A Case Report of Cavernous Sinus Thrombosis in a 40-year-old pati
    https://www.iomcworld.org/open-access/a-case-report-of-cavernous-sinus-thrombosis-in-a-40yearold-patient-with-adenocarcinoma-of-unknown-primary-origin-93505.html
    Malignancy is an extremely rare cause of CST and here we present a unique case of left-sided CST that eventually progressed to the right side in a 40-year-old male with extensive metastasis of adenocarcinoma of unknown primary origin. […] Cavernous Sinus Thrombosis in and itself is a very rare condition and malignancy as a cause of CST is indeed very rare. […] To date, only a few such cases have been reported in the scientific literature. […] Aseptic causes of CST include trauma, surgery, pregnancy, oral contraceptive pill usage, and malignancy. […] CST in the setting of malignancy is very rare and there are very few cases reported in the literature. Risks and benefits should be carefully assessed individually while considering anticoagulation as a treatment avenue in patients with malignancy.
  • #24 A Case Report of Cavernous Sinus Thrombosis in a 40-year-old pati
    https://www.iomcworld.org/open-access/a-case-report-of-cavernous-sinus-thrombosis-in-a-40yearold-patient-with-adenocarcinoma-of-unknown-primary-origin-93505.html
    We herein report a case of bilateral Cavernous Sinus Thrombosis in a 40-yearold male in the setting of nasopharyngeal adenocarcinoma of unknown primary origin. […] Cavernous Sinus Thrombosis (CST) is a very rare condition with an incidence of 0.2-1.6 cases per 100,000 per annum. […] Out of all cases of cerebral and dural venous sinus thrombosis, malignancy as a cause accounts for 7.4% which shows that the risk of CST in malignancy is increased by 5-fold. […] Even with the use of antibiotics and other modern methods of medical management, the mortality rate is still high at 30% with up to 50% having residual cranial neuropathies. […] Diagnosis of Cavernous Sinus Thrombosis is quite challenging and requires a deeper understanding of the disease process and a high index of clinical suspicion, as these patients do not always present with classical symptoms, making it more challenging.
  • #25 Epidemiology and Management of Cerebral Venous Thrombosis during the COVID-19 Pandemic
    https://www.mdpi.com/2075-1729/12/8/1105
    Cerebral venous thrombosis (CVT) is an uncommon type of stroke with an incidence around 3–4 cases per million adults, with a predominance in Caucasian females. […] By May 2022, COVID-19 had infected 513 million people worldwide and had caused over 6.2 million deaths. Part of its morbidity and mortality has been related to the potential increase in thromboembolic events, such as CVT, described in several case reports. A retrospective multicenter cohort study reported an incidence of 8.8 per 10,000, versus 3–4 per million in previous publications before the pandemics. Thus, its prevalence is higher in COVID-19-positive patients than in the general population, with a predominance of males (66%) and a mean age of 48 years. […] The clinical presentation of CVT related to COVID-19 does not seem to be different from CVT which is not COVID-19-related: cephalalgia, seizures, encephalopathy, abducent palsies, papilledema and focal deficits such as hemiparesis or aphasia.
  • #26 Epidemiology and Management of Cerebral Venous Thrombosis during the COVID-19 Pandemic
    https://www.mdpi.com/2075-1729/12/8/1105
    Not only COVID-19 infection but also COVID-19 vaccines were associated with thromboembolic episodes in many reports and reviews. To this date, 11.5 billion doses of COVID-19 vaccines have been administered worldwide, which has dramatically decreased morbidity and mortality related to the disease. […] The rapid development of the vaccines was due, partially, to previous research on the technology of adenoviral vectors, which, along with m-RNA technology, accounts for the majority of vaccines that were administered during the pandemic period. […] One of the most severe adverse effects attributed to the adenovirus-vector COVID-19 vaccine is immune thrombotic thrombocytopenia (VITT), which has already been associated with other adenoviral vector vaccines. […] The fact that VITT occurs mainly after vaccination with ChAdOx1 suggests that VITT-induced antibodies against PF-4 do not react to the COVID-19 spike protein but probably react to the adenoviral vector.
  • #27 Cerebral venous thrombosis – WikEM
    https://wikem.org/wiki/Cerebral_venous_thrombosis
    No precise prevalence or incidence established due to rarity of condition. However the disease is more prevalent in patients with thrombophilia, oral contraceptive use, and during pregnancy.[2] […] Median Age ~ 37 years[2] […] Female:Male ratio 3:1[2] […] COVID-19 vaccines (rare)[3] […] 1 per 1,000,000 for the Ad26.COV2.S (Johnson Johnson And Janssen brands) […] 1 per 100,000 for the ChAdOx1 nCoV-19 (AstraZeneca brand) […] Suspect in patients with headache, signs of increased ICP, or focal neurologic deficits, especially if any of above predisposing factors are present […] D-Dimer is not a reliable test to rule out a cerebral venous thrombosis[13][14] […] Kristoffersen ES, Harper CE, Vetvik KG, Faiz KW. Cerebral venous thrombosis epidemiology, diagnosis and treatment. Cerebral venetrombose forekomst, diagnostikk og behandling. Tidsskr Nor Laegeforen. 2018;138(12):10.4045/tidsskr.17.1047. Published 2018 Aug 20. doi:10.4045/tidsskr.17.1047
  • #28 Cerebral venous thrombosis – WikEM
    https://wikem.org/wiki/Cerebral_venous_thrombosis
    No precise prevalence or incidence established due to rarity of condition. However the disease is more prevalent in patients with thrombophilia, oral contraceptive use, and during pregnancy.[2] […] Median Age ~ 37 years[2] […] Female:Male ratio 3:1[2] […] COVID-19 vaccines (rare)[3] […] 1 per 1,000,000 for the Ad26.COV2.S (Johnson Johnson And Janssen brands) […] 1 per 100,000 for the ChAdOx1 nCoV-19 (AstraZeneca brand) […] Suspect in patients with headache, signs of increased ICP, or focal neurologic deficits, especially if any of above predisposing factors are present […] D-Dimer is not a reliable test to rule out a cerebral venous thrombosis[13][14] […] Kristoffersen ES, Harper CE, Vetvik KG, Faiz KW. Cerebral venous thrombosis epidemiology, diagnosis and treatment. Cerebral venetrombose forekomst, diagnostikk og behandling. Tidsskr Nor Laegeforen. 2018;138(12):10.4045/tidsskr.17.1047. Published 2018 Aug 20. doi:10.4045/tidsskr.17.1047
  • #29 Epidemiology and Management of Cerebral Venous Thrombosis during the COVID-19 Pandemic
    https://www.mdpi.com/2075-1729/12/8/1105
    A VITT risk score was developed, adapted from the HIT 4Ts scoring system which considers the number of thrombocytes, the timing post-vaccine, the presence of thrombosis or elevated D-dimers and the presence of other possible causes for thrombosis or thrombocytopenia. […] The mortality of VITT is high, varying from 18.3% to 50%.
  • #30 Cerebral Venous and Dural Sinus Thrombosis – EyeWiki
    https://eyewiki.org/Cerebral_Venous_and_Dural_Sinus_Thrombosis
    CVST is an uncommon type of stroke. It accounts for 0.5-3% of all strokes and affects approximately 5 per one million people annually. A patient presenting with CVST-stroke is more likely to be younger (less than 50 years old) and more likely to be female when compared to typical ischemic strokes. […] Currently the largest studies exploring CVST are an Italian multicenter study of 706 patients with CVST, and the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVDST) which included 624 patients with CVST. […] All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). It is difficult to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations (different from conventional stroke, and often mimicking other acute neurological conditions), and because it is often challenging to obtain and interpret optimal and timely brain imaging. Although CVT can result in death or permanent disability, it generally has a favourable prognosis if diagnosed and treated early. Neurologists involved in stroke care therefore also need to be aware of the treatments for CVT (with varying degrees of supporting evidence): the mainstay is prompt anticoagulation but patients who deteriorate despite treatment can be considered for endovascular procedures (endovascular thrombolysis or thrombectomy) or neurosurgery (decompressive craniotomy). This review summarises current knowledge on the risk factors, diagnosis, treatment and prognosis of CVT in adults, and highlights some areas for future research.
  • #31 Cerebral venous sinus thrombosis: review of the demographics, pathophysiology, current diagnosis, and treatment in: Neurosurgical Focus Volume 27 Issue 5 (2009) Journals
    https://thejns.org/focus/view/journals/neurosurg-focus/27/5/article-pE3.xml
    Cerebral venous sinus thrombosis (CVST) is a rare clinicopathological entity. The incidence of CVST in children and neonates has been reported to be as high as 7 cases per million people, whereas in adults the incidence is 34 cases per million. […] The estimated incidence of CVST differs significantly between adult and pediatric populations. In adults, the incidence of CVST has been estimated to be as high as 34 cases per million people, while the respective incidence in children and neonates is higher and has been estimated to be as many as 7 cases per million. […] Recent clinical series and review studies have confirmed the female predominance among patients suffering CVST, contrary to older reports postulating that males and females were equally affected. […] The largest CVST multicenter clinical study (the ISCVT, including 624 patients) revealed valuable information regarding the anatomical location of the most commonly involved cerebral sinuses. The cavernous sinus was identified as the most commonly affected sinus (1.3%).
  • #32 Cerebral Venous and Dural Sinus Thrombosis – EyeWiki
    https://eyewiki.org/Cerebral_Venous_and_Dural_Sinus_Thrombosis
    CVST is an uncommon type of stroke. It accounts for 0.5-3% of all strokes and affects approximately 5 per one million people annually. A patient presenting with CVST-stroke is more likely to be younger (less than 50 years old) and more likely to be female when compared to typical ischemic strokes. […] Currently the largest studies exploring CVST are an Italian multicenter study of 706 patients with CVST, and the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVDST) which included 624 patients with CVST. […] All neurologists need to be able to recognise and treat cerebral venous thrombosis (CVT). It is difficult to diagnose, partly due to its relative rarity, its multiple and various clinical manifestations (different from conventional stroke, and often mimicking other acute neurological conditions), and because it is often challenging to obtain and interpret optimal and timely brain imaging. Although CVT can result in death or permanent disability, it generally has a favourable prognosis if diagnosed and treated early. Neurologists involved in stroke care therefore also need to be aware of the treatments for CVT (with varying degrees of supporting evidence): the mainstay is prompt anticoagulation but patients who deteriorate despite treatment can be considered for endovascular procedures (endovascular thrombolysis or thrombectomy) or neurosurgery (decompressive craniotomy). This review summarises current knowledge on the risk factors, diagnosis, treatment and prognosis of CVT in adults, and highlights some areas for future research.
  • #33 A Case Report of Cavernous Sinus Thrombosis in a 40-year-old pati
    https://www.iomcworld.org/open-access/a-case-report-of-cavernous-sinus-thrombosis-in-a-40yearold-patient-with-adenocarcinoma-of-unknown-primary-origin-93505.html
    We herein report a case of bilateral Cavernous Sinus Thrombosis in a 40-yearold male in the setting of nasopharyngeal adenocarcinoma of unknown primary origin. […] Cavernous Sinus Thrombosis (CST) is a very rare condition with an incidence of 0.2-1.6 cases per 100,000 per annum. […] Out of all cases of cerebral and dural venous sinus thrombosis, malignancy as a cause accounts for 7.4% which shows that the risk of CST in malignancy is increased by 5-fold. […] Even with the use of antibiotics and other modern methods of medical management, the mortality rate is still high at 30% with up to 50% having residual cranial neuropathies. […] Diagnosis of Cavernous Sinus Thrombosis is quite challenging and requires a deeper understanding of the disease process and a high index of clinical suspicion, as these patients do not always present with classical symptoms, making it more challenging.
  • #34 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis
    Consider the diagnosis in patients at risk who have facial pain and fever, particularly with mental status changes, ophthalmoplegia (eg, with the 6th cranial nerve), Horner syndrome, proptosis, and/or eyelid edema. […] Obtain immediate neuroimaging with MRI or CT (or contrast-enhanced MR venogram or CT venogram if immediately available).
  • #35 Cavernous Sinus Thrombosis as a Complication of Cerebro-Rhino Orbital Mucormycosis Associated With Covid-19: A Case Report
    https://www.clinmedjournals.org/articles/ijodh/international-journal-of-oral-and-dental-health-ijodh-8-147.php?jid=ijodh
    Cavernous sinus thrombosis is a life-threatening infection with a mortality rate of 30% to 40% caused by retrograde spread infection from the upper dentition or paranasal sinuses through the valveless ophthalmic venous system to the cavernous sinus. […] The ongoing COVID-19 pandemic has caused a sudden increase in cases of mucormycosis associated with COVID19, mainly in developing countries. […] Cavernous sinus thrombosis, secondary to fungal involvement, is rarely found and there are few reported cases. […] Cavernous sinus thrombosis can affect individuals of all ages, but occurs more frequently in young adults. […] The diagnosis of cavernous sinus thrombosis is made on clinical grounds, with appropriate radiological imaging to confirm the diagnosis. […] Cavernous sinus thrombosis may be difficult to detect by CT or MR imaging in the early phase of the disease.
  • #36 Cavernous sinus thrombosis | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/cavernous-sinus-thrombosis?embed_domain=hackmd.io%25252F%252540yIPUAFeCSL2JsU8smR5nJQ%25252Fbnjhjgjghjghjgh&lang=us
    Cavernous sinus thrombosis is rare, with ~4.5 cases per 1,000,000 per year. […] It is the least common dural venous sinus thrombosis, accounting for 1.5% of cases. […] The dural venous sinuses and cerebral veins should also be carefully evaluated in cases of cavernous sinus thrombosis as up to 90% of patients will have multiple thromboses.
  • #37
    https://link.springer.com/article/10.1007/s00405-018-5062-9
    Septic cavernous sinus thrombosis (CST) is a rare complication of infections in the head and neck area. CST is notorious for its bad prognosis, with high mortality and morbidity rates described in literature. […] The primary purpose of this study is to assess the mortality and morbidity of CST. […] We found 12 patients with CST in the study period. Of the 12 patients, 11 survived and 9 recovered without any permanent deficits. […] In literature, older articles describe higher mortality rates (14-80%), but more recent articles report mortality and morbidity rates similar to our results. […] The prognosis of CST nowadays is more favorable than previously described. […] CST is a rare disorder, although the exact incidence is unclear. […] In our series, sinusitis is the most common cause of CST (50% of the cases). […] In our series, 33% of cases were due to infections of the head and neck area. […] CST has always been notorious for its bad prognosis. […] Our series and other recent series in literature demonstrate that the prognosis of CST is not as devastating as it previously had been described.
  • #38
    https://link.springer.com/article/10.1007/s00405-018-5062-9
    Septic cavernous sinus thrombosis (CST) is a rare complication of infections in the head and neck area. CST is notorious for its bad prognosis, with high mortality and morbidity rates described in literature. […] The primary purpose of this study is to assess the mortality and morbidity of CST. […] We found 12 patients with CST in the study period. Of the 12 patients, 11 survived and 9 recovered without any permanent deficits. […] In literature, older articles describe higher mortality rates (14-80%), but more recent articles report mortality and morbidity rates similar to our results. […] The prognosis of CST nowadays is more favorable than previously described. […] CST is a rare disorder, although the exact incidence is unclear. […] In our series, sinusitis is the most common cause of CST (50% of the cases). […] In our series, 33% of cases were due to infections of the head and neck area. […] CST has always been notorious for its bad prognosis. […] Our series and other recent series in literature demonstrate that the prognosis of CST is not as devastating as it previously had been described.
  • #39 Cerebral venous sinus thrombosis: changing trends in the incidence, age and gender (findings from the CMC Vellore CVT registry) | Stroke and Vascular Neurology
    https://svn.bmj.com/content/9/3/252
    Among 1701 patients treated during the study period, 908 (53%) were women and 793 (47%) were men. […] The mean incidence of CVT was 49 per 100000 admissions before 2010, which increased to 96 per 100000 after 2010. […] There was a clear change in the gender pattern from being a condition with female preponderance, to one where equal or more men are being affected. […] We report a high incidence of CVT at about 96 per 100000 cases, which has doubled over the last decade. […] This study should prompt more research into the changing gender trends across the globe and identify factors predisposing men to develop this condition. […] The epidemiology of Cortical Venous Sinus Thrombosis (CVT) is constantly changing. […] We aimed to describe the age and gender-specific incidence of CVT in South India.
  • #40 Cerebral venous sinus thrombosis: changing trends in the incidence, age and gender (findings from the CMC Vellore CVT registry) | Stroke and Vascular Neurology
    https://svn.bmj.com/content/9/3/252
    The overall incidence of CVT was less than 0.05% of all in-patient admissions under Neurology, indicating that it is a relatively rare neurological condition. […] The incidence of CVT before 2010 was 4.9 per 10000 cases, which increased to 9.6 per 10000 cases after 2010; the change in incidence was statistically significant (p=0.001). […] The observed gender ratio reversal seemed partly related to the steady decline in the proportion of pregnancy-related CVT, which has shown a significant reduction with the impact of better public health. […] Despite the decline in female CVT-related hospitalisations, over the last few decades, there has been an overall increase in the incidence of CVT. […] Our study reflects this change in trend, where there was an increase in the incidence from 0.05% to 0.1% of all admissions during the study period. […] We report an increasing incidence of CVT, with a reversal in gender predilection, with men being at two times the risk of developing CVT compared with women over the last decade.
  • #41 Cerebral venous sinus thrombosis: changing trends in the incidence, age and gender (findings from the CMC Vellore CVT registry) | Stroke and Vascular Neurology
    https://svn.bmj.com/content/9/3/252
    The overall incidence of CVT was less than 0.05% of all in-patient admissions under Neurology, indicating that it is a relatively rare neurological condition. […] The incidence of CVT before 2010 was 4.9 per 10000 cases, which increased to 9.6 per 10000 cases after 2010; the change in incidence was statistically significant (p=0.001). […] The observed gender ratio reversal seemed partly related to the steady decline in the proportion of pregnancy-related CVT, which has shown a significant reduction with the impact of better public health. […] Despite the decline in female CVT-related hospitalisations, over the last few decades, there has been an overall increase in the incidence of CVT. […] Our study reflects this change in trend, where there was an increase in the incidence from 0.05% to 0.1% of all admissions during the study period. […] We report an increasing incidence of CVT, with a reversal in gender predilection, with men being at two times the risk of developing CVT compared with women over the last decade.
  • #42 Cerebral venous sinus thrombosis: changing trends in the incidence, age and gender (findings from the CMC Vellore CVT registry) | Stroke and Vascular Neurology
    https://svn.bmj.com/content/9/3/252
    The overall incidence of CVT was less than 0.05% of all in-patient admissions under Neurology, indicating that it is a relatively rare neurological condition. […] The incidence of CVT before 2010 was 4.9 per 10000 cases, which increased to 9.6 per 10000 cases after 2010; the change in incidence was statistically significant (p=0.001). […] The observed gender ratio reversal seemed partly related to the steady decline in the proportion of pregnancy-related CVT, which has shown a significant reduction with the impact of better public health. […] Despite the decline in female CVT-related hospitalisations, over the last few decades, there has been an overall increase in the incidence of CVT. […] Our study reflects this change in trend, where there was an increase in the incidence from 0.05% to 0.1% of all admissions during the study period. […] We report an increasing incidence of CVT, with a reversal in gender predilection, with men being at two times the risk of developing CVT compared with women over the last decade.
  • #43 Cerebral venous thrombosis: Etiology, clinical features, and diagnosis – UpToDate
    https://www.uptodate.com/contents/cerebral-venous-thrombosis-etiology-clinical-features-and-diagnosis
    Cerebral vein and dural sinus thrombosis (CVT) is less common than most other types of stroke but can be more challenging to diagnose. Due to the widespread use of magnetic resonance imaging (MRI) and rising clinical awareness, CVT is recognized with increasing frequency. In addition, it is now known to have a more varied clinical spectrum than previously realized. Because of its myriad causes and presentations, CVT is a disease that may be encountered not only by neurologists and neurosurgeons but also by emergency clinicians, internists, oncologists, hematologists, obstetricians, pediatricians, and family practitioners. […] The available data suggest that CVT is uncommon. The annual incidence ranges from 1.16 to 2.02 per 100,000 and is more common in females than males, with a female-to-male ratio of 3:1. The imbalance may be due to the increased risk of CVT associated with pregnancy and puerperium and with oral contraceptives.
  • #44 Cavernous Sinus Thrombosis — Pediatric EM Morsels
    https://pedemmorsels.com/cavernous-sinus-thrombosis-in-children/
    Cavernous Sinus Thrombosis is rare, but life-threatening. [Smith, 2015; Frank, 2015] […] Frequency has been reduced since high utilization of antibiotics. […] Mortality has been also reduced, but still exists and morbidity can be significant. […] Usually a late complication of an infection of the central face. [Varshney, 2015] […] Cavernous Sinus Thrombosis is an associated complication of: Bacterial Meningitis, Sinusitis, Otitis Media, Dental Abscess, Facial Soft-tissue Infections (ie, mid-face furnuncle, facial acne, facial cellulitis), Orbital Cellulitis. […] Prompt recognition is key to limiting complications! [Smith, 2015; Frank, 2015] […] There is no current consensus guidelines for management of Cavernous Sinus Thrombosis. [Smith, 2015] […] Cavernous sinus thrombosis is a rare presentation. Early diagnosis and aggressive treatment are required to prevent morbidity and mortality.

Zobacz więcej

angiografia tomografii komputerowej upośledzenie widzenia zakrzepowe zapalenie żył zakrzepica zatok żylnych mózgu ropień zęba septyczna zakrzepica zatoki jamistej aseptyczna zakrzepica zatoki jamistej zapalenie zatok przynosowych zapalenie tkanki oczodołowej bakteryjne zapalenie opon mózgowo-rdzeniowych zakrzepica zatoki jamistej zapalenie tkanki łącznej twarzy tomografia komputerowa angiografia rezonansu magnetycznego zakrzepica zatok żylnych opony twardej deficyt nerwów czaszkowych rezonans magnetyczny zapalenie ucha środkowego Staphylococcus aureus