Materiały źródłowe

• #1 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  A variety of infectious organisms can cause cavernous sinus thrombosis although the majority are bacterial. Staphylococcus aureus may account for two-thirds of cases, and methicillin resistance should be considered. […] The biggest risk factors are facial infections, acute sinusitis, and periorbital infections. Thrombophilia is a significant risk factor for cavernous sinus thrombosis. […] The cavernous sinuses (one on each side of the sella turcica, above and lateral to the sphenoid sinuses, anteriorly superior orbital fissure and posteriorly petrous part of the temporal lobe) are trabeculated cavernous spaces created by the layers of dura mater and filled with venous blood. […] Septic cavernous sinus thrombosis occurs from the following: Local spread, often from valveless facial and ophthalmic veins; Adjacent infections, such as sinusitis (possibly the most common cause), especially sphenoiditis and ethmoiditis; Facial cellulitis or abscess (especially within the danger triangle of the face, formed by the corners of mouth and bridge of the nose); Periorbital and orbital cellulitis; Pharyngitis; Tonsillitis; Otitis media; Mastoiditis; Dental infections.

• #2 Cavernous Sinus Thrombosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/791704-overview

  Cavernous sinus thrombosis (CST) is usually a late complication of an infection of the central face or paranasal sinuses. […] CST is generally a fulminant process with high rates of morbidity and mortality. […] The cavernous sinuses are the most centrally located of the dural sinuses and lie on either side of the sella turcica. […] This intimate juxtaposition of veins, arteries, nerves, meninges, and paranasal sinuses accounts for the characteristic etiology and presentation of cavernous sinus thrombosis (CST). […] CST is more commonly seen with sphenoid and ethmoid and to a lesser degree with frontal sinusitis. […] Staphylococcus aureus accounts for approximately 70% of all infections.

• #3 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  Cavernous sinus thrombosis (CST) is a rare, life-threatening disorder that can complicate facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis or following traumatic injury or surgery, especially in the setting of a thrombophilic disorder. Early recognition of cavernous sinus thrombosis which, often presents with fever, headache, eye findings such as periorbital swelling, and ophthalmoplegia, is critical for a good outcome. Despite modern treatment with antibiotics and anticoagulation, the risk of long-term sequelae, such as vision, diplopia, and stroke, remains significant. […] Cavernous sinus thrombosis is usually septic, but can also be aseptic. Septic cases can follow central facial infections, especially within the danger triangle of the face (from the corners of the mouth to the bridge of the nose).

• #4 Cavernous sinus thrombosis – Wikipedia

  https://en.wikipedia.org/wiki/Cavernous_sinus_thrombosis

  Staphylococcus aureus is the most common infectious microbe, found in 70% of the cases. Streptococcus is the second leading cause. Gram-negative rods and anaerobes may also lead to cavernous sinus thrombosis. Rarely, Aspergillus fumigatus and mucormycosis cause CST. […] Aseptic cavernous sinus thrombosis is much less common and is usually associated with other disorders including trauma, circulatory problems, nasopharynx cancers and other tumors of the skull base, dehydration, and anemia. […] Recognizing the primary source of infection (i.e., facial cellulitis, middle ear, and sinus infections) and treating the primary source expeditiously is the best way to prevent cavernous sinus thrombosis.

• #5 Cavernous Sinus Thrombosis: Efficiently Recognizing and Treating a Life-Threatening Condition

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8451531/

  Cavernous sinus thrombosis (CST) can develop as a result of both infectious and noninfectious conditions. Infections in the middle part of the face caused by Staphylococcus aureus are the most common cause of septic thrombosis of the cavernous sinuses. […] CST is a rare, life-threatening condition that can occur as a result of a face infection, sinusitis, orbital cellulitis, pharyngitis, or otitis media. It can also result from a serious injury or surgery, especially in the presence of a thrombophilic disorder. […] The most prevalent causes of CST are sphenoid and ethmoid sinusitis, as well as frontal sinusitis. Over 70% of all infections are caused by the bacteria Staphylococcus aureus. […] CST had a near 100% fatality rate before the introduction of powerful antibiotic treatments. The most prevalent causes of death are sepsis or a CNS infection.

• #6 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Secondary treatment for cavernous sinus thrombosis may include corticosteroids (eg, dexamethasone 10 mg IV or orally every 6 hours) for cranial nerve dysfunction. Anticoagulation is controversial; unfractionated and low-molecular-weight heparin have been used in patients without contraindications. […] Mortality in the antibiotic era is up to approximately 15%. Approximately one-third more patients develop serious sequelae (eg, ophthalmoplegia, blindness); stroke and pituitary insufficiency are also possible, and deficits may be permanent.

• #7 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  A variety of infectious organisms can cause cavernous sinus thrombosis although the majority are bacterial. Staphylococcus aureus may account for two-thirds of cases, and methicillin resistance should be considered. […] The biggest risk factors are facial infections, acute sinusitis, and periorbital infections. Thrombophilia is a significant risk factor for cavernous sinus thrombosis. […] The cavernous sinuses (one on each side of the sella turcica, above and lateral to the sphenoid sinuses, anteriorly superior orbital fissure and posteriorly petrous part of the temporal lobe) are trabeculated cavernous spaces created by the layers of dura mater and filled with venous blood. […] Septic cavernous sinus thrombosis occurs from the following: Local spread, often from valveless facial and ophthalmic veins; Adjacent infections, such as sinusitis (possibly the most common cause), especially sphenoiditis and ethmoiditis; Facial cellulitis or abscess (especially within the danger triangle of the face, formed by the corners of mouth and bridge of the nose); Periorbital and orbital cellulitis; Pharyngitis; Tonsillitis; Otitis media; Mastoiditis; Dental infections.

• #8 Cavernous Sinus Thrombosis – emDocs

  https://www.emdocs.net/cavernous-sinus-thrombosis/

  Cavernous sinus thrombosis (CST) is a rare condition, defined as a septic thrombophlebitis of the cavernous sinus. It is caused by a bacterial infection that typically originates in the face, sinuses, ears, or orbits (1). […] The cavernous sinuses receive blood from the superior ophthalmic and cerebral veins, the sphenoparietal sinuses, and emissary veins. The cavernous sinuses also communicate with the deep facial and inferior ophthalmic veins. Many of these veins have no valves and blood can flow in either direction, depending on pressure gradients. It is hypothesized that this is the reason why infection spreads and thromboses form (2,6). In addition, the thrombus itself is a good growth medium for bacteria and the bacteria, in turn, stimulate thrombosis by releasing substances that cause tissue damage (1,9).

• #9 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  A variety of infectious organisms can cause cavernous sinus thrombosis although the majority are bacterial. Staphylococcus aureus may account for two-thirds of cases, and methicillin resistance should be considered. […] The biggest risk factors are facial infections, acute sinusitis, and periorbital infections. Thrombophilia is a significant risk factor for cavernous sinus thrombosis. […] The cavernous sinuses (one on each side of the sella turcica, above and lateral to the sphenoid sinuses, anteriorly superior orbital fissure and posteriorly petrous part of the temporal lobe) are trabeculated cavernous spaces created by the layers of dura mater and filled with venous blood. […] Septic cavernous sinus thrombosis occurs from the following: Local spread, often from valveless facial and ophthalmic veins; Adjacent infections, such as sinusitis (possibly the most common cause), especially sphenoiditis and ethmoiditis; Facial cellulitis or abscess (especially within the danger triangle of the face, formed by the corners of mouth and bridge of the nose); Periorbital and orbital cellulitis; Pharyngitis; Tonsillitis; Otitis media; Mastoiditis; Dental infections.

• #10 Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

  https://openophthalmologyjournal.com/VOLUME/15/PAGE/70/

  Initial clinical presentation often involves fever, malaise accompanied by unilateral chemosis, palpebral swelling and peri-orbital oedema, all of which are signs stemming from concomitant venous congestion secondary to infective inflammation within the CS and related sinuses and tributaries. […] The most implicated pathogen in CST appears to be Staphylococcus aureus, identified in approximately 60%-70% of patients. […] Empirical antibiotic therapy is aimed at broad-spectrum coverage, targeting the commonly associated pathogens in CST and frequently involves the intravenous use of nafcillin sodium/flucloxacillin, metronidazole, and ceftriaxone sodium. […] Early use of anti-coagulant therapy (within 7 days of hospitalisation for CST) may reduce mortality and morbidity rates, particularly in patients with unilateral disease and patients without cortical venous infarction.

• #11 Cavernous Sinus Thrombosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/791704-overview

  Cavernous sinus thrombosis (CST) is usually a late complication of an infection of the central face or paranasal sinuses. […] CST is generally a fulminant process with high rates of morbidity and mortality. […] The cavernous sinuses are the most centrally located of the dural sinuses and lie on either side of the sella turcica. […] This intimate juxtaposition of veins, arteries, nerves, meninges, and paranasal sinuses accounts for the characteristic etiology and presentation of cavernous sinus thrombosis (CST). […] CST is more commonly seen with sphenoid and ethmoid and to a lesser degree with frontal sinusitis. […] Staphylococcus aureus accounts for approximately 70% of all infections.

• #12 Cavernous sinus thrombosis – Wikipedia

  https://en.wikipedia.org/wiki/Cavernous_sinus_thrombosis

  Staphylococcus aureus is the most common infectious microbe, found in 70% of the cases. Streptococcus is the second leading cause. Gram-negative rods and anaerobes may also lead to cavernous sinus thrombosis. Rarely, Aspergillus fumigatus and mucormycosis cause CST. […] Aseptic cavernous sinus thrombosis is much less common and is usually associated with other disorders including trauma, circulatory problems, nasopharynx cancers and other tumors of the skull base, dehydration, and anemia. […] Recognizing the primary source of infection (i.e., facial cellulitis, middle ear, and sinus infections) and treating the primary source expeditiously is the best way to prevent cavernous sinus thrombosis.

• #13 Cavernous Sinus Thrombosis – MD Searchlight

  https://mdsearchlight.com/blood-disorders/cavernous-sinus-thrombosis/

  Fungal infections are less common but can happen, especially in people with weak immune systems. […] The main risk factors are facial infections, acute sinusitis, and infections around the eyes. A condition called thrombophilia, where your blood clots more easily than normal, can also be a significant risk factor. […] Cavernous sinus thrombosis is a rare condition, making it hard to estimate how many new cases occur each year. […] Its not clear whether this condition affects more men or women. […] The number of new cases and deaths from cavernous sinus thrombosis might be decreasing, likely due to the use of antibiotics. […] Cavernous sinus thrombosis is a serious condition that typically manifests with a range of symptoms. […] Dysfunction of the sixth cranial nerve is common, causing partial paralysis of the eye muscles and limiting the eyes ability to move to the side.

• #14 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Local compression and inflammation of cranial nerves can lead to several partial or complete cranial neuropathies including: Diplopia from partial or complete external ophthalmoplegia due to compression of the sixth (abducens), third (oculomotor) and fourth (trochlear) nerves. […] Septic cavernous venous thrombosis can result in the central nervous system or infectious pulmonary complications. […] Stroke can occur following carotid artery narrowing, vasculitis, or hemorrhagic infarction following progression to cortical vein thrombosis. […] Hypopituitarism can occur due to ischemia or the direct spread of infection.

• #15 Cavernous Sinus Thrombosis – emDocs

  https://www.emdocs.net/cavernous-sinus-thrombosis/

  Cavernous sinus thrombosis (CST) is a rare condition, defined as a septic thrombophlebitis of the cavernous sinus. It is caused by a bacterial infection that typically originates in the face, sinuses, ears, or orbits (1). […] The cavernous sinuses receive blood from the superior ophthalmic and cerebral veins, the sphenoparietal sinuses, and emissary veins. The cavernous sinuses also communicate with the deep facial and inferior ophthalmic veins. Many of these veins have no valves and blood can flow in either direction, depending on pressure gradients. It is hypothesized that this is the reason why infection spreads and thromboses form (2,6). In addition, the thrombus itself is a good growth medium for bacteria and the bacteria, in turn, stimulate thrombosis by releasing substances that cause tissue damage (1,9).

• #16 Cavernous Sinus Thrombosis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23520-cavernous-sinus-thrombosis

  Cavernous sinus thrombosis is a rare, potentially life-threatening blood clot in your cavernous sinuses. Your cavernous sinuses are located behind your eyes, beneath your brain. Multiple veins, including a major one called the jugular vein, run through your cavernous sinuses. They help drain the blood from your brain and face. If a blood clot forms in one of these veins (often in response to an infection), the clot can restrict blood flow from your brain. […] Cavernous sinus thrombosis is most often a complication of a bacterial infection in your face or skull. The blood in your cavernous sinus veins clots to prevent the infection from spreading. Instead of stopping the spread, however, the clot traps the infection. It prevents blood from flowing away from your brain. The blood creates pressure in your cavernous sinuses, causing common symptoms like headache and eye pain.

• #17 Cavernous Sinus Syndrome – EyeWiki

  https://eyewiki.org/Cavernous_Sinus_Syndrome

  Cavernous sinus thrombosis (CST) is an important infectious etiology of CSS, which may present initially to an ophthalmologist and requires urgent management due to its life-threatening prognosis. […] Septic CST is typically seen as a complication of a facial infection, such as sinusitis or cellulitis. […] Due to the valveless nature of the facial veins, the sinuses are vulnerable to stagnation and poor drainage in the setting of severe infection, causing the formation of a thrombus. […] The thrombus can then cause damage locally or travel to the brain, causing stroke-like symptoms or encephalitis and meningitis. […] The pathomechanism of CSS is characterized by the compression and dysfunction of the structures within the cavernous sinus. […] The cavernous sinus is a fixed space limited by bony structures, so any pathology within the sinus has the ability to compress internal structures, causing ophthalmoplegia and facial sensory changes.

• #18 Cavernous Sinus Thrombosis – emDocs

  https://www.emdocs.net/cavernous-sinus-thrombosis/

  Cavernous sinus thrombosis (CST) is a rare condition, defined as a septic thrombophlebitis of the cavernous sinus. It is caused by a bacterial infection that typically originates in the face, sinuses, ears, or orbits (1). […] The cavernous sinuses receive blood from the superior ophthalmic and cerebral veins, the sphenoparietal sinuses, and emissary veins. The cavernous sinuses also communicate with the deep facial and inferior ophthalmic veins. Many of these veins have no valves and blood can flow in either direction, depending on pressure gradients. It is hypothesized that this is the reason why infection spreads and thromboses form (2,6). In addition, the thrombus itself is a good growth medium for bacteria and the bacteria, in turn, stimulate thrombosis by releasing substances that cause tissue damage (1,9).

• #19 Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

  https://openophthalmologyjournal.com/VOLUME/15/PAGE/70/

  CST primarily results from the spread of bacterial or fungal infections in the face, oral cavity, paranasal sinuses, and orbits via superficial venous channels such as the facial veins and pterygoid plexus, which drain into the CS via the superior ophthalmic vein and emissary’s veins, respectively. […] It has also been postulated that the trabeculated set-up of sinuses within the CS aids in trapping septic emboli and bacteria from the anteriorly infected sites. […] The extensive input and output venous channels of the CS which include the dural sinuses and cerebral veins, are non-valvular in nature. As such, the direction of blood flow within the CS venous system is highly susceptible to change in pressure gradients due to infective thrombi, potentially allowing for extensive spread of infections from and into the CS.

• #20 Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

  https://openophthalmologyjournal.com/VOLUME/15/PAGE/70/

  CST primarily results from the spread of bacterial or fungal infections in the face, oral cavity, paranasal sinuses, and orbits via superficial venous channels such as the facial veins and pterygoid plexus, which drain into the CS via the superior ophthalmic vein and emissary’s veins, respectively. […] It has also been postulated that the trabeculated set-up of sinuses within the CS aids in trapping septic emboli and bacteria from the anteriorly infected sites. […] The extensive input and output venous channels of the CS which include the dural sinuses and cerebral veins, are non-valvular in nature. As such, the direction of blood flow within the CS venous system is highly susceptible to change in pressure gradients due to infective thrombi, potentially allowing for extensive spread of infections from and into the CS.

• #21 Cavernous Sinus Thrombosis – emDocs

  https://www.emdocs.net/cavernous-sinus-thrombosis/

  Cavernous sinus thrombosis (CST) is a rare condition, defined as a septic thrombophlebitis of the cavernous sinus. It is caused by a bacterial infection that typically originates in the face, sinuses, ears, or orbits (1). […] The cavernous sinuses receive blood from the superior ophthalmic and cerebral veins, the sphenoparietal sinuses, and emissary veins. The cavernous sinuses also communicate with the deep facial and inferior ophthalmic veins. Many of these veins have no valves and blood can flow in either direction, depending on pressure gradients. It is hypothesized that this is the reason why infection spreads and thromboses form (2,6). In addition, the thrombus itself is a good growth medium for bacteria and the bacteria, in turn, stimulate thrombosis by releasing substances that cause tissue damage (1,9).

• #22 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Local compression and inflammation of cranial nerves can lead to several partial or complete cranial neuropathies including: Diplopia from partial or complete external ophthalmoplegia due to compression of the sixth (abducens), third (oculomotor) and fourth (trochlear) nerves. […] Septic cavernous venous thrombosis can result in the central nervous system or infectious pulmonary complications. […] Stroke can occur following carotid artery narrowing, vasculitis, or hemorrhagic infarction following progression to cortical vein thrombosis. […] Hypopituitarism can occur due to ischemia or the direct spread of infection.

• #23 Cavernous sinus thrombosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cavernous-sinus-thrombosis?lang=us

  Cavernous sinus thrombosis (CST), the presence of thrombus in the cavernous sinus, is a rare condition, most commonly infectious in nature, and the diagnosis on imaging is not always straightforward. It has high mortality and morbidity rates. […] Cavernous sinus thrombosis from a septic etiology occurs due to embolization of bacteria which trigger thrombosis that becomes trapped within the cavernous sinus. The subsequent reduction in venous drainage results in facial and periorbital edema, ptosis, proptosis, chemosis, painful eye movements, papilledema, retinal venous distension and loss of vision. […] Thrombus can propagate into the dural system as the lack of valves in the dural sinus allow flow through emissary veins into and out of the cavernous sinus.

• #24 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Local compression and inflammation of cranial nerves can lead to several partial or complete cranial neuropathies including: Diplopia from partial or complete external ophthalmoplegia due to compression of the sixth (abducens), third (oculomotor) and fourth (trochlear) nerves. […] Septic cavernous venous thrombosis can result in the central nervous system or infectious pulmonary complications. […] Stroke can occur following carotid artery narrowing, vasculitis, or hemorrhagic infarction following progression to cortical vein thrombosis. […] Hypopituitarism can occur due to ischemia or the direct spread of infection.

• #25 Cavernous sinus thrombosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cavernous-sinus-thrombosis?lang=us

  Cavernous sinus thrombosis (CST), the presence of thrombus in the cavernous sinus, is a rare condition, most commonly infectious in nature, and the diagnosis on imaging is not always straightforward. It has high mortality and morbidity rates. […] Cavernous sinus thrombosis from a septic etiology occurs due to embolization of bacteria which trigger thrombosis that becomes trapped within the cavernous sinus. The subsequent reduction in venous drainage results in facial and periorbital edema, ptosis, proptosis, chemosis, painful eye movements, papilledema, retinal venous distension and loss of vision. […] Thrombus can propagate into the dural system as the lack of valves in the dural sinus allow flow through emissary veins into and out of the cavernous sinus.

• #26 Cavernous Sinus Syndrome – EyeWiki

  https://eyewiki.org/Cavernous_Sinus_Syndrome

  Cavernous sinus thrombosis (CST) is an important infectious etiology of CSS, which may present initially to an ophthalmologist and requires urgent management due to its life-threatening prognosis. […] Septic CST is typically seen as a complication of a facial infection, such as sinusitis or cellulitis. […] Due to the valveless nature of the facial veins, the sinuses are vulnerable to stagnation and poor drainage in the setting of severe infection, causing the formation of a thrombus. […] The thrombus can then cause damage locally or travel to the brain, causing stroke-like symptoms or encephalitis and meningitis. […] The pathomechanism of CSS is characterized by the compression and dysfunction of the structures within the cavernous sinus. […] The cavernous sinus is a fixed space limited by bony structures, so any pathology within the sinus has the ability to compress internal structures, causing ophthalmoplegia and facial sensory changes.

• #27 Cavernous Sinus Thrombosis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/19035

  Cavernous sinus thrombosis is usually septic, but can also be aseptic. […] Septic cavernous sinus thrombosis occurs from the following: Local spread, often from valveless facial and ophthalmic veins. […] The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Lack of valves in the dural sinus system allows flow through the emissary veins into and out of the cavernous sinus and thrombus can propagate into the dural system.

• #28 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Local compression and inflammation of cranial nerves can lead to several partial or complete cranial neuropathies including: Diplopia from partial or complete external ophthalmoplegia due to compression of the sixth (abducens), third (oculomotor) and fourth (trochlear) nerves. […] Septic cavernous venous thrombosis can result in the central nervous system or infectious pulmonary complications. […] Stroke can occur following carotid artery narrowing, vasculitis, or hemorrhagic infarction following progression to cortical vein thrombosis. […] Hypopituitarism can occur due to ischemia or the direct spread of infection.

• #29 Cavernous sinus thrombosis: Treatment, causes, and more

  https://www.medicalnewstoday.com/articles/cavernous-sinus-thrombosis

  Cavernous sinus thrombosis (CST) is a rare but serious condition where blood clots form within the cavernous sinuses. These are a pair of small, thin-walled venous spaces behind each eye at the base of the skull. […] CST typically occurs due to the spread of infection from nearby structures, such as the face, sinuses, or teeth. […] Bacteria or fungi can enter the bloodstream and reach the cavernous sinuses, causing inflammation and blood clot formation. […] Without treatment, CST can lead to potentially life threatening complications. […] The blood clot and infection within the cavernous sinuses can spread to adjacent structures, forming abscesses. […] Additionally, the infection can extend to the meninges, which are the protective membranes covering the brain and spinal cord, leading to meningitis, a potentially serious condition.

• #30 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Local compression and inflammation of cranial nerves can lead to several partial or complete cranial neuropathies including: Diplopia from partial or complete external ophthalmoplegia due to compression of the sixth (abducens), third (oculomotor) and fourth (trochlear) nerves. […] Septic cavernous venous thrombosis can result in the central nervous system or infectious pulmonary complications. […] Stroke can occur following carotid artery narrowing, vasculitis, or hemorrhagic infarction following progression to cortical vein thrombosis. […] Hypopituitarism can occur due to ischemia or the direct spread of infection.

• #31 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Cavernous sinus thrombosis is a very rare, typically septic thrombosis of the cavernous sinus, usually caused by nasal furuncles or bacterial sinusitis. […] Cavernous sinus thrombosis is an extremely rare complication of common facial infections, most notably nasal furuncles, sphenoidal or ethmoidal sinusitis (greater than 50%), and dental infections. […] The 3rd, 4th, and 6th cranial nerves and the ophthalmic and maxillary branches of the 5th cranial nerve are adjacent to the cavernous sinus and are commonly affected in cavernous sinus thrombosis. […] Complications of cavernous sinus thrombosis include meningoencephalitis, brain abscess, stroke, blindness, and pituitary insufficiency. […] Initial antibiotics for patients with cavernous sinus thrombosis include, eg, nafcillin or oxacillin 1 to 2 g every 4 hours combined with a third-generation cephalosporin (eg, ceftriaxone 1 g every 12 hours).

• #32 Cavernous sinus thrombosis: Treatment, causes, and more

  https://www.medicalnewstoday.com/articles/cavernous-sinus-thrombosis

  Cavernous sinus thrombosis (CST) is a rare but serious condition where blood clots form within the cavernous sinuses. These are a pair of small, thin-walled venous spaces behind each eye at the base of the skull. […] CST typically occurs due to the spread of infection from nearby structures, such as the face, sinuses, or teeth. […] Bacteria or fungi can enter the bloodstream and reach the cavernous sinuses, causing inflammation and blood clot formation. […] Without treatment, CST can lead to potentially life threatening complications. […] The blood clot and infection within the cavernous sinuses can spread to adjacent structures, forming abscesses. […] Additionally, the infection can extend to the meninges, which are the protective membranes covering the brain and spinal cord, leading to meningitis, a potentially serious condition.

• #33 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  A variety of infectious organisms can cause cavernous sinus thrombosis although the majority are bacterial. Staphylococcus aureus may account for two-thirds of cases, and methicillin resistance should be considered. […] The biggest risk factors are facial infections, acute sinusitis, and periorbital infections. Thrombophilia is a significant risk factor for cavernous sinus thrombosis. […] The cavernous sinuses (one on each side of the sella turcica, above and lateral to the sphenoid sinuses, anteriorly superior orbital fissure and posteriorly petrous part of the temporal lobe) are trabeculated cavernous spaces created by the layers of dura mater and filled with venous blood. […] Septic cavernous sinus thrombosis occurs from the following: Local spread, often from valveless facial and ophthalmic veins; Adjacent infections, such as sinusitis (possibly the most common cause), especially sphenoiditis and ethmoiditis; Facial cellulitis or abscess (especially within the danger triangle of the face, formed by the corners of mouth and bridge of the nose); Periorbital and orbital cellulitis; Pharyngitis; Tonsillitis; Otitis media; Mastoiditis; Dental infections.

• #34 Cavernous Sinus Thrombosis – MD Searchlight

  https://mdsearchlight.com/blood-disorders/cavernous-sinus-thrombosis/

  Fungal infections are less common but can happen, especially in people with weak immune systems. […] The main risk factors are facial infections, acute sinusitis, and infections around the eyes. A condition called thrombophilia, where your blood clots more easily than normal, can also be a significant risk factor. […] Cavernous sinus thrombosis is a rare condition, making it hard to estimate how many new cases occur each year. […] Its not clear whether this condition affects more men or women. […] The number of new cases and deaths from cavernous sinus thrombosis might be decreasing, likely due to the use of antibiotics. […] Cavernous sinus thrombosis is a serious condition that typically manifests with a range of symptoms. […] Dysfunction of the sixth cranial nerve is common, causing partial paralysis of the eye muscles and limiting the eyes ability to move to the side.

• #35 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  A variety of infectious organisms can cause cavernous sinus thrombosis although the majority are bacterial. Staphylococcus aureus may account for two-thirds of cases, and methicillin resistance should be considered. […] The biggest risk factors are facial infections, acute sinusitis, and periorbital infections. Thrombophilia is a significant risk factor for cavernous sinus thrombosis. […] The cavernous sinuses (one on each side of the sella turcica, above and lateral to the sphenoid sinuses, anteriorly superior orbital fissure and posteriorly petrous part of the temporal lobe) are trabeculated cavernous spaces created by the layers of dura mater and filled with venous blood. […] Septic cavernous sinus thrombosis occurs from the following: Local spread, often from valveless facial and ophthalmic veins; Adjacent infections, such as sinusitis (possibly the most common cause), especially sphenoiditis and ethmoiditis; Facial cellulitis or abscess (especially within the danger triangle of the face, formed by the corners of mouth and bridge of the nose); Periorbital and orbital cellulitis; Pharyngitis; Tonsillitis; Otitis media; Mastoiditis; Dental infections.

• #36 Cavernous Sinus Thrombosis – MD Searchlight

  https://mdsearchlight.com/blood-disorders/cavernous-sinus-thrombosis/

  Fungal infections are less common but can happen, especially in people with weak immune systems. […] The main risk factors are facial infections, acute sinusitis, and infections around the eyes. A condition called thrombophilia, where your blood clots more easily than normal, can also be a significant risk factor. […] Cavernous sinus thrombosis is a rare condition, making it hard to estimate how many new cases occur each year. […] Its not clear whether this condition affects more men or women. […] The number of new cases and deaths from cavernous sinus thrombosis might be decreasing, likely due to the use of antibiotics. […] Cavernous sinus thrombosis is a serious condition that typically manifests with a range of symptoms. […] Dysfunction of the sixth cranial nerve is common, causing partial paralysis of the eye muscles and limiting the eyes ability to move to the side.

• #37 Cavernous Sinus-Orbital Vein Thrombosis due to Infection and Thrombophilia | Jaffry | Journal of Clinical Gynecology and Obstetrics

  https://jcgo.org/index.php/jcgo/article/view/33/42

  The aseptic cases of CST can be seen in debilitated patients (marasmic phlebothrombosis) at the extremes of age, with the etiologic factors being anemia, hypercoagulability, dehydration, hypotension allowing stagnation of blood, carotid aneurysms, surgical treatment of trigeminal neuralgia. […] The increase in incidence of thromboembolism is also supported by studies that have shown that patients taking estrogens or combined oral contraceptives have increased platelet aggregation, accelerated blood clotting, altered blood concentrations of some clotting factors, and altered fibrinolytic activity related to decrease in antithrombin III. […] The inherited thrombophilias are the leading cause of maternal thromboembolism and are associated with an increased risk of certain adverse pregnancy outcomes including second- and third-trimester fetal loss.

• #38 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. […] 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. […] 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.

• #39 Cavernous Sinus Thrombosis: Causes, Symptoms, and Treatment

  https://www.webmd.com/brain/cavernous-sinus-thrombosis

  Cavernous sinus thrombosis is a very rare, life-threatening condition that can affect adults and children. […] In cavernous sinus thrombosis, a blood clot blocks a vein that runs through a hollow space underneath the brain and behind the eye sockets. These veins carry blood from the face and head back to the heart. […] The cause of cavernous sinus thrombosis is usually an infection. But other factors may play a role. […] To contain the infection, the body’s immune system creates a clot to prevent bacteria or other pathogens from spreading. The clot increases pressure inside the brain. This pressure can damage the brain and may ultimately cause death. […] Cavernous sinus thrombosis is more common in people who take certain medications such as oral contraceptives or who have underlying health conditions such as uncontrolled diabetes or cancer that may increase their risk for blood clots.

• #40 Cavernous sinus thrombosis – Wikipedia

  https://en.wikipedia.org/wiki/Cavernous_sinus_thrombosis

  Staphylococcus aureus is the most common infectious microbe, found in 70% of the cases. Streptococcus is the second leading cause. Gram-negative rods and anaerobes may also lead to cavernous sinus thrombosis. Rarely, Aspergillus fumigatus and mucormycosis cause CST. […] Aseptic cavernous sinus thrombosis is much less common and is usually associated with other disorders including trauma, circulatory problems, nasopharynx cancers and other tumors of the skull base, dehydration, and anemia. […] Recognizing the primary source of infection (i.e., facial cellulitis, middle ear, and sinus infections) and treating the primary source expeditiously is the best way to prevent cavernous sinus thrombosis.

• #41 Cavernous Sinus Syndrome | Select 5-Minute Pediatrics Topics

  https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14022/all/Cavernous_Sinus_Syndrome

  Cavernous sinus syndrome is typically caused by septic or aseptic sinus thrombosis, neoplasm, or trauma. Acute obstruction by mass or thrombosis may progress rapidly if not diagnosed and treated quickly. […] Aseptic venous thrombosis has been associated with sickle cell anemia, trauma, dehydration, vasculitis, pregnancy, oral contraceptive use, congenital heart disease, inflammatory bowel disease, and hypercoagulable states.

• #42 Cavernous sinus thrombosis – Wikipedia

  https://en.wikipedia.org/wiki/Cavernous_sinus_thrombosis

  Staphylococcus aureus is the most common infectious microbe, found in 70% of the cases. Streptococcus is the second leading cause. Gram-negative rods and anaerobes may also lead to cavernous sinus thrombosis. Rarely, Aspergillus fumigatus and mucormycosis cause CST. […] Aseptic cavernous sinus thrombosis is much less common and is usually associated with other disorders including trauma, circulatory problems, nasopharynx cancers and other tumors of the skull base, dehydration, and anemia. […] Recognizing the primary source of infection (i.e., facial cellulitis, middle ear, and sinus infections) and treating the primary source expeditiously is the best way to prevent cavernous sinus thrombosis.

• #43 Cavernous Sinus Syndrome | Select 5-Minute Pediatrics Topics

  https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14022/all/Cavernous_Sinus_Syndrome

  Cavernous sinus syndrome is typically caused by septic or aseptic sinus thrombosis, neoplasm, or trauma. Acute obstruction by mass or thrombosis may progress rapidly if not diagnosed and treated quickly. […] Aseptic venous thrombosis has been associated with sickle cell anemia, trauma, dehydration, vasculitis, pregnancy, oral contraceptive use, congenital heart disease, inflammatory bowel disease, and hypercoagulable states.

• #44 Cavernous Sinus-Orbital Vein Thrombosis due to Infection and Thrombophilia | Jaffry | Journal of Clinical Gynecology and Obstetrics

  https://jcgo.org/index.php/jcgo/article/view/33/42

  The aseptic cases of CST can be seen in debilitated patients (marasmic phlebothrombosis) at the extremes of age, with the etiologic factors being anemia, hypercoagulability, dehydration, hypotension allowing stagnation of blood, carotid aneurysms, surgical treatment of trigeminal neuralgia. […] The increase in incidence of thromboembolism is also supported by studies that have shown that patients taking estrogens or combined oral contraceptives have increased platelet aggregation, accelerated blood clotting, altered blood concentrations of some clotting factors, and altered fibrinolytic activity related to decrease in antithrombin III. […] The inherited thrombophilias are the leading cause of maternal thromboembolism and are associated with an increased risk of certain adverse pregnancy outcomes including second- and third-trimester fetal loss.

• #45 Cavernous Sinus Thrombosis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23520-cavernous-sinus-thrombosis

  In up to 70% of cases, Staphylococcus aureus bacteria cause the infection. Other types of bacteria and some fungi may also cause infections that lead to cavernous thrombosis. There are also a few documented cases of cavernous sinus thrombosis related to COVID-19 infection. […] Cavernous sinus thrombosis requires immediate treatment. You’ll likely be admitted into an intensive care unit (ICU) so your provider can monitor you closely. Treatments include antibiotics, anticoagulants, corticosteroids, and sinus surgery.

• #46

  https://journals.lww.com/tjop/fulltext/2022/12030/a_case_of_aseptic_bilateral_cavernous_sinus.13.aspx

  This case report aims to describe the first report of bilateral aseptic cavernous sinus thrombosis (CST) with a recent history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. […] Despite its tolerability and safety, several cases of coagulopathy leading to venous thrombosis, including cerebral venous sinus thrombosis (CVST), following COVID-19 vaccinations, have been reported, particularly due to the viral vector vaccines. […] To date, there is no current report of severe coagulopathy that leads to aseptic bilateral CST following inactivated SARS-CoV-2 vaccination. […] The underlying process of aseptic CST in our case is not easy to be elucidated. However, the possible link between SARS-CoV-2 and coagulopathy has been tried to be explained elsewhere. […] Although extrapolation from the hypothesized pathophysiology of coagulopathy COVID-19 is still not even close in our case, which only had a recent inactivated vaccine, several mechanisms might be of concern.

• #47

  https://journals.lww.com/tjop/fulltext/2022/12030/a_case_of_aseptic_bilateral_cavernous_sinus.13.aspx

  This case report aims to describe the first report of bilateral aseptic cavernous sinus thrombosis (CST) with a recent history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. […] Despite its tolerability and safety, several cases of coagulopathy leading to venous thrombosis, including cerebral venous sinus thrombosis (CVST), following COVID-19 vaccinations, have been reported, particularly due to the viral vector vaccines. […] To date, there is no current report of severe coagulopathy that leads to aseptic bilateral CST following inactivated SARS-CoV-2 vaccination. […] The underlying process of aseptic CST in our case is not easy to be elucidated. However, the possible link between SARS-CoV-2 and coagulopathy has been tried to be explained elsewhere. […] Although extrapolation from the hypothesized pathophysiology of coagulopathy COVID-19 is still not even close in our case, which only had a recent inactivated vaccine, several mechanisms might be of concern.

• #48 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

  Aseptic causes of CST include trauma, surgery, pregnancy, oral contraceptive pill usage, and malignancy. […] Coagulopathy in cancer is speculated to be an adverse effect of radiation causing vessel injury or chemotherapy itself, compression, or infiltrating the vasculature. […] Long Term anticoagulation with Vitamin K agonists or Dabigatran is proved to be efficient in a random control trial. […] CST in the setting of malignancy is very rare and there are very few cases reported in the literature.

• #49 Cerebral Venous Sinus Thrombosis (CVST) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/cerebra-venous-sinus-thrombosis-cvst

  The blood clotting condition experienced by these women who received the Johnson Johnson vaccine is known as thrombosis with thrombocytopenia syndrome (TTS) or vaccine-induced immune thrombotic thrombocytopenia (VITT). TTS can cause blood clotting in common sites, such as deep vein thromboses or pulmonary embolisms, but it can also lead to clotting in atypical sites, including the cerebral venous sinuses. […] The main treatment for CVST is the anticoagulation drug heparin. Heparin and other anticoagulantsor blood thinnersare used to treat CVST because they help to prevent new blood clots from forming in blood vessels throughout the body, including the venous sinuses of the brain, and can keep existing clots from getting larger. Blood thinners, however, cannot dissolve existing clots. […] Treatment for people who experience CVST following Johnson Johnson vaccination differs from the usual treatment protocols. These patients should not take heparin, as it may be unsafe for the particular type of clot associated with this vaccine.

• #50 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Cavernous sinus thrombosis is a very rare, typically septic thrombosis of the cavernous sinus, usually caused by nasal furuncles or bacterial sinusitis. […] Cavernous sinus thrombosis is an extremely rare complication of common facial infections, most notably nasal furuncles, sphenoidal or ethmoidal sinusitis (greater than 50%), and dental infections. […] The 3rd, 4th, and 6th cranial nerves and the ophthalmic and maxillary branches of the 5th cranial nerve are adjacent to the cavernous sinus and are commonly affected in cavernous sinus thrombosis. […] Complications of cavernous sinus thrombosis include meningoencephalitis, brain abscess, stroke, blindness, and pituitary insufficiency. […] Initial antibiotics for patients with cavernous sinus thrombosis include, eg, nafcillin or oxacillin 1 to 2 g every 4 hours combined with a third-generation cephalosporin (eg, ceftriaxone 1 g every 12 hours).

• #51 Cavernous Sinus Thrombosis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23520-cavernous-sinus-thrombosis

  In up to 70% of cases, Staphylococcus aureus bacteria cause the infection. Other types of bacteria and some fungi may also cause infections that lead to cavernous thrombosis. There are also a few documented cases of cavernous sinus thrombosis related to COVID-19 infection. […] Cavernous sinus thrombosis requires immediate treatment. You’ll likely be admitted into an intensive care unit (ICU) so your provider can monitor you closely. Treatments include antibiotics, anticoagulants, corticosteroids, and sinus surgery.

• #52 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Cavernous sinus thrombosis is a very rare, typically septic thrombosis of the cavernous sinus, usually caused by nasal furuncles or bacterial sinusitis. […] Cavernous sinus thrombosis is an extremely rare complication of common facial infections, most notably nasal furuncles, sphenoidal or ethmoidal sinusitis (greater than 50%), and dental infections. […] The 3rd, 4th, and 6th cranial nerves and the ophthalmic and maxillary branches of the 5th cranial nerve are adjacent to the cavernous sinus and are commonly affected in cavernous sinus thrombosis. […] Complications of cavernous sinus thrombosis include meningoencephalitis, brain abscess, stroke, blindness, and pituitary insufficiency. […] Initial antibiotics for patients with cavernous sinus thrombosis include, eg, nafcillin or oxacillin 1 to 2 g every 4 hours combined with a third-generation cephalosporin (eg, ceftriaxone 1 g every 12 hours).

• #53 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Secondary treatment for cavernous sinus thrombosis may include corticosteroids (eg, dexamethasone 10 mg IV or orally every 6 hours) for cranial nerve dysfunction. Anticoagulation is controversial; unfractionated and low-molecular-weight heparin have been used in patients without contraindications. […] Mortality in the antibiotic era is up to approximately 15%. Approximately one-third more patients develop serious sequelae (eg, ophthalmoplegia, blindness); stroke and pituitary insufficiency are also possible, and deficits may be permanent.

• #54 Cavernous Sinus Thrombosis – emDocs

  https://www.emdocs.net/cavernous-sinus-thrombosis/

  The use of anticoagulation and corticosteroids remains controversial (1,4). Some studies have found improved cranial nerve function with steroid use, but there is currently no data to support its routine use (1,4,6). […] It is theorized that anticoagulation may prevent the spread of the thrombus to other sinuses (1,5) as well as help dissolve the clot, allowing the antibiotic to reach the infected thrombus more readily (13,17).

• #55 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/eye-disorders/eye-socket-disorders/cavernous-sinus-thrombosis

  High doses of antibiotics given by vein (intravenously) are started immediately in people with cavernous sinus thrombosis. […] It is not clear whether some people benefit from treatment with anticoagulants (medications that prevent new blood clots from forming and established blood clots from growing).

• #56 Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

  https://openophthalmologyjournal.com/VOLUME/15/PAGE/70/

  Initial clinical presentation often involves fever, malaise accompanied by unilateral chemosis, palpebral swelling and peri-orbital oedema, all of which are signs stemming from concomitant venous congestion secondary to infective inflammation within the CS and related sinuses and tributaries. […] The most implicated pathogen in CST appears to be Staphylococcus aureus, identified in approximately 60%-70% of patients. […] Empirical antibiotic therapy is aimed at broad-spectrum coverage, targeting the commonly associated pathogens in CST and frequently involves the intravenous use of nafcillin sodium/flucloxacillin, metronidazole, and ceftriaxone sodium. […] Early use of anti-coagulant therapy (within 7 days of hospitalisation for CST) may reduce mortality and morbidity rates, particularly in patients with unilateral disease and patients without cortical venous infarction.

• #57 Cerebral Venous Sinus Thrombosis (CVST) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/cerebra-venous-sinus-thrombosis-cvst

  The blood clotting condition experienced by these women who received the Johnson Johnson vaccine is known as thrombosis with thrombocytopenia syndrome (TTS) or vaccine-induced immune thrombotic thrombocytopenia (VITT). TTS can cause blood clotting in common sites, such as deep vein thromboses or pulmonary embolisms, but it can also lead to clotting in atypical sites, including the cerebral venous sinuses. […] The main treatment for CVST is the anticoagulation drug heparin. Heparin and other anticoagulantsor blood thinnersare used to treat CVST because they help to prevent new blood clots from forming in blood vessels throughout the body, including the venous sinuses of the brain, and can keep existing clots from getting larger. Blood thinners, however, cannot dissolve existing clots. […] Treatment for people who experience CVST following Johnson Johnson vaccination differs from the usual treatment protocols. These patients should not take heparin, as it may be unsafe for the particular type of clot associated with this vaccine.

• #58 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Secondary treatment for cavernous sinus thrombosis may include corticosteroids (eg, dexamethasone 10 mg IV or orally every 6 hours) for cranial nerve dysfunction. Anticoagulation is controversial; unfractionated and low-molecular-weight heparin have been used in patients without contraindications. […] Mortality in the antibiotic era is up to approximately 15%. Approximately one-third more patients develop serious sequelae (eg, ophthalmoplegia, blindness); stroke and pituitary insufficiency are also possible, and deficits may be permanent.

• #59 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1091793

  The clinical symptoms of CST vary depending upon the anatomical structures involved. […] CT and MRI are the diagnostic modalities of choice for CST. […] Optimal therapy for CST includes the concomitant administration of nafcillin, metronidazole, and ceftriaxone/cefotaxime. […] CST treatment must include proper management of the primary infection site and empiric antibiotics considering the possible pathogens. […] CST can be fatal when a thrombus forms in the cavernous sinus. […] The development of antibiotics has decreased the mortality of CST. However, the mortality rate is still relatively high at 14%-30%. […] Even after treatment, cranial nerve dysfunction may remain and intra-cavernous aneurysm may also occur. Therefore, long-term patient follow-up is imperative.

• #60 Cavernous Sinus Thrombosis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/cavernous-sinus-thrombosis

  Secondary treatment for cavernous sinus thrombosis may include corticosteroids (eg, dexamethasone 10 mg IV or orally every 6 hours) for cranial nerve dysfunction. Anticoagulation is controversial; unfractionated and low-molecular-weight heparin have been used in patients without contraindications. […] Mortality in the antibiotic era is up to approximately 15%. Approximately one-third more patients develop serious sequelae (eg, ophthalmoplegia, blindness); stroke and pituitary insufficiency are also possible, and deficits may be permanent.

• #61 Cavernous Sinus Thrombosis: Efficiently Recognizing and Treating a Life-Threatening Condition

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8451531/

  Anticoagulation is the cornerstone of treatment, as it is required to stop clot propagation and achieve re-canalization. Anticoagulation is not contraindicated in the presence of intracranial hemorrhage. […] Patients with CST have a range of outcomes, from complete healing to chronic neurological damage. Approximately 10% had persistent neurological damage by the 12th month of follow-up.

• #62 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1091793

  The clinical symptoms of CST vary depending upon the anatomical structures involved. […] CT and MRI are the diagnostic modalities of choice for CST. […] Optimal therapy for CST includes the concomitant administration of nafcillin, metronidazole, and ceftriaxone/cefotaxime. […] CST treatment must include proper management of the primary infection site and empiric antibiotics considering the possible pathogens. […] CST can be fatal when a thrombus forms in the cavernous sinus. […] The development of antibiotics has decreased the mortality of CST. However, the mortality rate is still relatively high at 14%-30%. […] Even after treatment, cranial nerve dysfunction may remain and intra-cavernous aneurysm may also occur. Therefore, long-term patient follow-up is imperative.

• #63 Cavernous Sinus Thrombosis – MD Searchlight

  https://mdsearchlight.com/blood-disorders/cavernous-sinus-thrombosis/

  The best way to diagnose cavernous sinus thrombosis is by using imaging techniques, such as a CT (Computed Tomography) scan with contrast, or an MRI (Magnetic Resonance Imaging). […] Because of how uncommon this condition is, no set treatment trials have been conducted. Therefore, treatment decisions are guided by expert opinions. […] Many experts suggest the use of blood-thinning medications known as anticoagulants, provided there are no strong reasons not to, such as risk of severe bleeding. […] Even after antibiotic therapy is discontinued, its crucial to continue monitoring the patient. […] The prognosis for Cavernous Sinus Thrombosis (CST) can vary depending on the individual case, but it is a serious condition that can be life-threatening. Even with modern treatments using antibiotics and medicines to prevent blood clotting, there is still a considerable risk of long-term effects such as vision problems, double vision, and stroke.

• #64 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1091793

  The clinical symptoms of CST vary depending upon the anatomical structures involved. […] CT and MRI are the diagnostic modalities of choice for CST. […] Optimal therapy for CST includes the concomitant administration of nafcillin, metronidazole, and ceftriaxone/cefotaxime. […] CST treatment must include proper management of the primary infection site and empiric antibiotics considering the possible pathogens. […] CST can be fatal when a thrombus forms in the cavernous sinus. […] The development of antibiotics has decreased the mortality of CST. However, the mortality rate is still relatively high at 14%-30%. […] Even after treatment, cranial nerve dysfunction may remain and intra-cavernous aneurysm may also occur. Therefore, long-term patient follow-up is imperative.

• #65 Traversing the cavern: radiological manifestations of cavernous sinus pathologies | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-024-01364-2

  Cavernous sinus thrombosis is one of the most frequently encountered vascular pathologies of the cavernous sinus and can be life-threatening if not managed in time. […] Bacterial and fungal infections of the paranasal sinuses, orbit, face, and skull base predispose the cavernous sinuses to septic involvement. This occurs due to lack of valves within the tributaries of cavernous sinuses resulting in the bidirectional flow of blood from adjacent areas to the sinuses and vice versa. The most common manifestation is in the form of cavernous sinus thrombosis. […] In recent years, cavernous sinus thrombosis has been very frequently seen with invasive fungal infections of mucormycosis in the wake of COVID-19 pandemic. […] In suspected cases of cavernous sinus thrombosis, a delayed scan at about 45-50 seconds post-contrast injection should be performed.

• #66 Traversing the cavern: radiological manifestations of cavernous sinus pathologies | Egyptian Journal of Radiology and Nuclear Medicine | Full Text

  https://ejrnm.springeropen.com/articles/10.1186/s43055-024-01364-2

  On MRI, a bulky sinus with loss of normal flow void of sinus and signal characteristics depending upon the age of the thrombus are seen. Early stages of sinus thrombosis can demonstrate diffusion restriction within the sinus. Other ancillary findings of cavernous sinus thrombosis include engorged and /or thrombosed superior ophthalmic vein, bulky and heterogenous appearing ipsilateral extraocular muscles with surrounding periorbital/ retro-orbital fat stranding. Thrombosis of intracavernous ICA may also be seen.

• #67 Cavernous sinus thrombosis – Knowledge and References – Taylor & Francis

  https://taylorandfrancis.com/knowledge/Medicine_and_healthcare/Hematology/Cavernous_sinus_thrombosis/

  Cavernous sinus thrombosis is a medical condition characterized by the presence of a blood clot within the cavernous sinus. It is most commonly caused by sphenoid sinusitis, although ethmoid or maxillary sinusitis can also be potential causes. […] Cavernous sinus thrombosis is a type of cerebral venous thrombosis, in which the blood clot is located in the cavernous sinus. The most common precipitating factor is infection of the nose, sinuses, teeth or eyes that spreads directly to the cavernous sinus. […] Many studies have shown that cavernous sinus thrombosis and vascular complications of the disease can be detected by MRI. Cavernous sinus involvement appears hypointense on T1 and T2 with intense inhomogeneous postcontrast enhancement. […] Differential diagnosis includes cavernous sinus lesions as cavernous sinus thrombosis, carotico-cavernous fistula, and intracranial neoplasms.

• #68 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. […] 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. […] 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.

• #69 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

  The angioinvasive nature of Mucor leads to vasculitis and thrombosis that progress to tissue infarction and necrosis. […] Cavernous sinus thrombosis may be difficult to detect by CT or MR imaging in the early phase of the disease, Therefore, astute clinical examination with a high index of suspicion for cavernous sinus thrombosis, supported by known risk factors of diabetes, malignancy and immunosuppression, can lead to a diagnosis.

• #70 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  Cavernous sinus thrombosis (CST) is a rare, life-threatening disorder that can complicate facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis or following traumatic injury or surgery, especially in the setting of a thrombophilic disorder. Early recognition of cavernous sinus thrombosis which, often presents with fever, headache, eye findings such as periorbital swelling, and ophthalmoplegia, is critical for a good outcome. Despite modern treatment with antibiotics and anticoagulation, the risk of long-term sequelae, such as vision, diplopia, and stroke, remains significant. […] Cavernous sinus thrombosis is usually septic, but can also be aseptic. Septic cases can follow central facial infections, especially within the danger triangle of the face (from the corners of the mouth to the bridge of the nose).

• #71 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1091793

  Cavernous sinus thrombosis not only presents with constitutional symptoms including fever, pain and swelling but also with specific findings such as proptosis, chemosis, periorbital swelling, and cranial nerve palsies. […] CST is an infectious disease that is potentially fatal if it is not treated in its early stage. […] Dental infections are not common sources of CST. […] CST is a rare condition in which blood clots form within the cavernous sinus, a large collection of thin-walled veins. […] Septic CST may be caused by sinusitis, otitis, odontogenic infection, or facial cellulitis. […] The most frequent cause of septic CST is sinusitis in the sphenoid or ethmoidal sinuses. […] Venous flow is bidirectional in the cerebral vein, emissary vein, and dural sinus because these vessels do not have valves. Therefore, bacteria or thrombi from another facial region can spread to the cavernous sinus via the facial vein or pterygoid plexus.

• #72 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  Cavernous sinus thrombosis (CST) is a rare, life-threatening disorder that can complicate facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis or following traumatic injury or surgery, especially in the setting of a thrombophilic disorder. Early recognition of cavernous sinus thrombosis which, often presents with fever, headache, eye findings such as periorbital swelling, and ophthalmoplegia, is critical for a good outcome. Despite modern treatment with antibiotics and anticoagulation, the risk of long-term sequelae, such as vision, diplopia, and stroke, remains significant. […] Cavernous sinus thrombosis is usually septic, but can also be aseptic. Septic cases can follow central facial infections, especially within the danger triangle of the face (from the corners of the mouth to the bridge of the nose).

• #73 Cavernous Sinus Thrombosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448177/

  The mechanism is due to embolization of bacteria and other infectious organisms which trigger thrombosis which then can trap infection within the cavernous sinus. […] Cavernous sinus thrombosis leads to decreased drainage from the facial vein and superior and inferior ophthalmic veins resulting in facial and periorbital edema, ptosis, proptosis, chemosis, discomfort and pain with eye muscle movement, papilledema, retinal venous distention, and loss of vision. […] Local compression and inflammation of cranial nerves can lead to several partial or complete cranial neuropathies including: Diplopia from partial or complete external ophthalmoplegia due to compression of the sixth (abducens), third (oculomotor) and fourth (trochlear) nerves. […] Septic cavernous venous thrombosis can result in the central nervous system or infectious pulmonary complications. […] Stroke can occur following carotid artery narrowing, vasculitis, or hemorrhagic infarction following progression to cortical vein thrombosis. […] Hypopituitarism can occur due to ischemia or the direct spread of infection.

• #74 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1091793

  Cavernous sinus thrombosis not only presents with constitutional symptoms including fever, pain and swelling but also with specific findings such as proptosis, chemosis, periorbital swelling, and cranial nerve palsies. […] CST is an infectious disease that is potentially fatal if it is not treated in its early stage. […] Dental infections are not common sources of CST. […] CST is a rare condition in which blood clots form within the cavernous sinus, a large collection of thin-walled veins. […] Septic CST may be caused by sinusitis, otitis, odontogenic infection, or facial cellulitis. […] The most frequent cause of septic CST is sinusitis in the sphenoid or ethmoidal sinuses. […] Venous flow is bidirectional in the cerebral vein, emissary vein, and dural sinus because these vessels do not have valves. Therefore, bacteria or thrombi from another facial region can spread to the cavernous sinus via the facial vein or pterygoid plexus.

• #75 Cavernous Sinus Thrombosis – MD Searchlight

  https://mdsearchlight.com/blood-disorders/cavernous-sinus-thrombosis/

  Fungal infections are less common but can happen, especially in people with weak immune systems. […] The main risk factors are facial infections, acute sinusitis, and infections around the eyes. A condition called thrombophilia, where your blood clots more easily than normal, can also be a significant risk factor. […] Cavernous sinus thrombosis is a rare condition, making it hard to estimate how many new cases occur each year. […] Its not clear whether this condition affects more men or women. […] The number of new cases and deaths from cavernous sinus thrombosis might be decreasing, likely due to the use of antibiotics. […] Cavernous sinus thrombosis is a serious condition that typically manifests with a range of symptoms. […] Dysfunction of the sixth cranial nerve is common, causing partial paralysis of the eye muscles and limiting the eyes ability to move to the side.

• #76

  https://journals.lww.com/md-journal/fulltext/2023/12010/pathophysiology,_diagnosis_and_management_of.69.aspx

  The entire pathophysiology has not been experimentally proven, but CVT may present as either of the following 4 distinct clinical syndromes: Intracranial hypertension; Focal neurological syndrome; Diffuse encephalopathy, and; Cavernous sinus syndrome. […] Cerebral vein thrombosis increases venous pressure and reduces capillary perfusion pressure, leading to a rise in cerebral blood volume; ultimately, patients develop intracranial hypertension. […] However, cortical collateral circulation is engaged, but intracranial hypertension subsequently leads to disruption of the blood-brain barrier and the development of vasogenic edema. This pathophysiology causes failure of the sodium-potassium ATPase dependent pump, an indirect regulator of intracellular water volume results in cytotoxic edema development.

• #77 Cerebral venous thrombosis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cerebral-venous-thrombosis/

  Cavernous sinus thrombosis is a rare subtype of CVT, typically septic in origin, that is associated with cavernous sinus syndrome. […] Thrombogenesis occurs in the cerebral venous system, including the dural sinuses cerebral drainage intracranial pressure clinical features; […] Additionally, thrombus formation congestion within the venous system of the brain blood stasis oxygenated blood in brain tissue cerebral edema and/or infarcts/stroke.

• #78

  https://journals.lww.com/md-journal/fulltext/2023/12010/pathophysiology,_diagnosis_and_management_of.69.aspx

  The entire pathophysiology has not been experimentally proven, but CVT may present as either of the following 4 distinct clinical syndromes: Intracranial hypertension; Focal neurological syndrome; Diffuse encephalopathy, and; Cavernous sinus syndrome. […] Cerebral vein thrombosis increases venous pressure and reduces capillary perfusion pressure, leading to a rise in cerebral blood volume; ultimately, patients develop intracranial hypertension. […] However, cortical collateral circulation is engaged, but intracranial hypertension subsequently leads to disruption of the blood-brain barrier and the development of vasogenic edema. This pathophysiology causes failure of the sodium-potassium ATPase dependent pump, an indirect regulator of intracellular water volume results in cytotoxic edema development.

• #79 Cerebral venous thrombosis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cerebral-venous-thrombosis/

  Cavernous sinus thrombosis is a rare subtype of CVT, typically septic in origin, that is associated with cavernous sinus syndrome. […] Thrombogenesis occurs in the cerebral venous system, including the dural sinuses cerebral drainage intracranial pressure clinical features; […] Additionally, thrombus formation congestion within the venous system of the brain blood stasis oxygenated blood in brain tissue cerebral edema and/or infarcts/stroke.

• #80 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 predisposing factors to this condition are mainly genetic and acquired prothrombotic states and infection. […] Two distinct pathophysiological theories have been developed for explaining the development of CVST. The first theory postulates that the thrombosis of the cerebral veins along with the subsequent blood-brain barrier disruption and the thrombosis of the major venous sinuses result in intracranial hypertension. The second pathophysiological mechanism theory relies on the direct thrombosis of major cerebral venous sinuses. The resulting higher pressure of the thrombosed sinuses (especially the SSS) impedes the absorption and the smooth circulation of the CSF from the subarachnoid space to the cerebral venous circulation via the arachnoid villi structures. […] Prothrombotic states, either genetically imposed or acquired, represent a large component of the etiology and play an important role in the development of CVST.

• #81

  https://journals.lww.com/md-journal/fulltext/2023/12010/pathophysiology,_diagnosis_and_management_of.69.aspx

  Superficial cortical veins drain into the SSS against the blood flow within the sinus, resulting in blood turbulence which is further aggravated by the existing fibrous septa at the inferior angle of the sinus. This is the most acceptable explanation of the higher prevalence of thrombosis in SSS. […] Furthermore, in addition to draining the cerebral hemisphere, the SSS and other dural venous sinuses also drain blood from diploic, meningeal and emissary veins. This explains the relationship between the occurrence of CVT following infective pathologies in their draining areas, For example, cavernous sinus thrombosis in facial infections, lateral sinus thrombosis in chronic otitis media and sagittal sinus thrombosis in scalp infections. […] The dural venous sinuses contain most of the arachnoid villi and granulations, especially in the SSS, responsible for cerebrospinal fluid absorption. So, thrombosis of the dural venous sinus causes blockage of villi and granulations and prevention of cerebrospinal fluid absorption, which eventually leads to intracranial hypertension and papilloedema provoked coma and mortality.

• #82 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

  The angioinvasive nature of Mucor leads to vasculitis and thrombosis that progress to tissue infarction and necrosis. […] Cavernous sinus thrombosis may be difficult to detect by CT or MR imaging in the early phase of the disease, Therefore, astute clinical examination with a high index of suspicion for cavernous sinus thrombosis, supported by known risk factors of diabetes, malignancy and immunosuppression, can lead to a diagnosis.

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