eMedicine Specialties > Emergency Medicine > Neurology

Cavernous Sinus Thrombosis: Follow-up

Author: Rahul Sharma, MD, MBA, Instructor in Medicine, Weill Medical College of Cornell University; Consulting Staff, Department of Emergency Medicine, New York Presbyterian Hospital-Weill Cornell Medical Center
Coauthor(s): Edward Bessman, MD, Chairman, Department of Emergency Medicine, John Hopkins Bayview Medical Center; Assistant Professor, Department of Emergency Medicine, Johns Hopkins University
Contributor Information and Disclosures

Updated: Jul 18, 2008

Follow-up

Further Inpatient Care

  • Admission to intensive care unit is indicated.

Deterrence/Prevention

  • Patients should be educated that furuncles or abscesses (pimples) in the central portion of the face should not be manipulated without prior antibiotic coverage.

Complications

  • Meningitis
  • Septic emboli
  • Blindness
  • Cranial nerve palsies
  • Sepsis and shock

Prognosis

  • Mortality rate is as high as 30%; the majority of survivors suffer permanent sequelae.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider CST in the differential diagnosis of sinusitis, facial, or periorbital cellulitis
 


More on Cavernous Sinus Thrombosis

Overview: Cavernous Sinus Thrombosis
Differential Diagnoses & Workup: Cavernous Sinus Thrombosis
Treatment & Medication: Cavernous Sinus Thrombosis
Follow-up: Cavernous Sinus Thrombosis
Multimedia: Cavernous Sinus Thrombosis
References

References

  1. Bhatia K, Jones NS. Septic cavernous sinus thrombosis secondary to sinusitis: are anticoagulants indicated? A review of the literature. J Laryngol Otol. Sep 2002;116(9):667-76. [Medline].

  2. Canhao P, Ferro JM, Lindgren AG. Causes and predictors of death in cerebral venous thrombosis. Stroke. Aug 2005;36(8):1720-5. [Medline].

  3. Cannon ML, Antonio BL, McCloskey JJ, et al. Cavernous sinus thrombosis complicating sinusitis. Pediatr Crit Care Med. Jan 2004;5(1):86-8. [Medline].

  4. DiNubile MJ. Septic thrombosis of the cavernous sinuses. Arch Neurol. May 1988;45(5):567-72. [Medline].

  5. Duong DK, Leo MM, Mitchell EL. Neuro-ophthalmology. Emerg Med Clin North Am. Feb 2008;26(1):137-80, vii. [Medline].

  6. Ferro JM, Canhao P, Bousser MG. Cerebral vein and dural sinus thrombosis in elderly patients. Stroke. Sep 2005;36(9):1927-32. [Medline].

  7. Goodwin WJ. Orbital complications of ethmoiditis. Otolaryngol Clin North Am. Feb 1985;18(1):139-47. [Medline].

  8. Heckmann JG, Tomandl B. Cavernous sinus thrombosis. Lancet. Dec 13 2003;362(9400):1958. [Medline].

  9. Karlin RJ, Robinson WA. Septic cavernous sinus thrombosis. Ann Emerg Med. Jun 1984;13(6):449-55. [Medline].

  10. Lessner A, Stern GA. Preseptal and orbital cellulitis. Infect Dis Clin North Am. Dec 1992;6(4):933-52. [Medline].

  11. Levine SR, Twyman RE, Gilman S. The role of anticoagulation in cavernous sinus thrombosis. Neurology. Apr 1988;38(4):517-22. [Medline].

  12. Peters KS. Secondary headache and head pain emergencies. Prim Care. Jun 2004;31(2):381-93, vii. [Medline].

  13. Schnipper D, Spiegel JH. Management of intracranial complications of sinus surgery. Otolaryngol Clin North Am. Apr 2004;37(2):453-72, ix. [Medline].

  14. Southwick FS, Richardson EP, Swartz MN. Septic thrombosis of the dural venous sinuses. Medicine (Baltimore). Mar 1986;65(2):82-106. [Medline].

  15. Watkins LM, Pasternack MS, Banks M. Bilateral cavernous sinus thromboses and intraorbital abscesses secondary to Streptococcus milleri. Ophthalmology. Mar 2003;110(3):569-74. [Medline].

  16. Yanofsky NN. The acute painful eye. Emerg Med Clin North Am. Feb 1988;6(1):21-42. [Medline].

  17. Zimmer J, Bhatt J, et al. Is it all in his head?. The Internet Journal of Pediatrics and Neonatology. 2006;6.

Further Reading

Keywords

cavernous sinus thrombosis, CST, thrombosis of the cavernous intracranial sinus, cavernous sinus syndrome, cavernous sinus, cavernous sinuses, parasellar lesions, tumors, carotid artery aneurysms, carotid-cavernous fistulas, C-C fistulas, cavernous sinus thrombosis

Contributor Information and Disclosures

Author

Rahul Sharma, MD, MBA, Instructor in Medicine, Weill Medical College of Cornell University; Consulting Staff, Department of Emergency Medicine, New York Presbyterian Hospital-Weill Cornell Medical Center
Rahul Sharma, MD, MBA is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Edward Bessman, MD, Chairman, Department of Emergency Medicine, John Hopkins Bayview Medical Center; Assistant Professor, Department of Emergency Medicine, Johns Hopkins University
Edward Bessman, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

David FM Brown, MD, Assistant Professor, Department of Medicine, Division of Emergency Medicine, Harvard Medical School; Associate-Chief, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital
David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

J Stephen Huff, MD, Associate Professor of Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia Health Sciences Center
J Stephen Huff, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP, Program Director, Professor, Department of Emergency Medicine, Professor, Internal Medicine, University Hospitals, Case Western Reserve School of Medicine
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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