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, the most common cause is as a complication of acute sinusitis.
Diagnosis is usually made through clinical evaluation together with imaging (CT or MRI).
In the acute presentation, one eye is typically affected first, followed by the second eye within 48 hours of symptom onset.
Must be differentiated from meningitis. Common early clinical features of both conditions include fever, headache, vomiting, and nuchal rigidity.
Antibiotics should be started immediately because they have the greatest effect on prognosis.
Cavernous sinus thrombosis (CST) is the formation of thrombus (clot) within the cavernous sinus, which can either be septic or aseptic. Septic CST is a rapidly evolving thrombophlebitic process with an infectious origin (typically from the middle third of the face, sinuses, ears, teeth, or mouth), affecting the cavernous sinus and its structures. Aseptic CST is usually a thrombotic process that is a result of trauma, iatrogenic injuries, or prothrombotic conditions.
Assistant Professor of Surgery
Section of Otolaryngology-Head and Neck Surgery
University of Chicago
JP declares that he has no competing interests.
School of Medicine
University of Alabama at Birmingham
MC declares that he has no competing interests.
Division of Neurosurgery
University of Toronto
DR declares that he has no competing interests.
Lecturer in Neurology
Beth Israel Deaconess Medical Center
Division of Cerebrovascular/Stroke
LRC declares that he has no competing interests.
Clinical Associate Professor of Emergency Medicine
Ohio State University
SK declares that he has no competing interests.
Use of this content is subject to our disclaimer