Everyone Healthy Library
Cavernous Sinus Thrombosis
Also Known As: Venous Sinus Thrombosis
Condition / disease reference page from the Everyone Healthy database.
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Connected health information
Explore this condition in a clear order
Linked signs and symptoms
12Each sign/symptom opens its own page and links back to related conditions.
Linked drugs / medications
1Medication information is educational only. A doctor or pharmacist should advise whether any medicine is appropriate.
Treatments, therapies and supportive options
2Grouped by treatment type. These are educational database links, not personal treatment recommendations. Evidence labels are shown only where stored in the EH database.
Medical emergencies
1Linked diagnostic tests and investigations
21These are pulled from both EH diagnostic-test link tables, including the older large test-link table.
- Activated Coagulation Time (ACT)
- Antithrombin 111 (AT-111) Activity Test
- Blood Culture
- Breast-Specific Gamma Imaging
- Cerebral Angiography
- Coagulation Factor Assay (Blood Clotting Factors)
- complete Blood Count (CBC)
- Computerized Tomography (CT) Scan
- D-Dimer Blood Test
- erythrocyte Sedimentation Rate (ESR)
- Fibrin Degradation Products (FDPs, Fibrin Split Products, FSPs, Fibrin Breakdown Products, Fbps)
- Fibrin Monomers Test
- Fibrinopeptide A (FPA) Action Assay
- Intracranial Prassure Monitoring (CSF Pressure)
- magnetic Resonance Angiogram (MRA)
- Ophthalmoscopy
- Plasminogen Activity
- Protein C (PC ANtigen)
- Protein S Concentration
- sigmoidoscopy
- Spinal Tap (lumbar Puncture)
Biological markers/agents
11This visual map shows biological markers/agents reported as increased or decreased with this condition. These are educational relationships only; test results must be interpreted by a qualified clinician because ranges vary by lab, method, age, sex and clinical context.
Often increased
6- D-DimerReference range exampleAdult ( > 16y): 0–240 µg/LLinked diagnostic testsD-Dimer Blood Test
- Factor VIII (Antihemophilic Globulin, Percentage of Normal Value)Reference range exampleAdult ( > 16y): 55–145 %Linked diagnostic testsCoagulation Factor Assay (Blood Clotting Factors)
- Fibrin MonomersReference range example0–10,000 µg/LLinked diagnostic testsFibrin Monomers Test
- Fibrin Split ProductsReference range exampleAll: 0–1 mg/dLLinked diagnostic testsFibrin Degradation Products (FDPs, Fibrin Split Products
- Fibrinopeptide A (FPA)Reference range exampleAdult ( > 16y), Female: 0.7–3.1 mg/mL; Adult ( > 16y), Male: 0.35–2.5 mg/mLLinked diagnostic testsFibrinopeptide A (FPA) Action Assay
- Intracranial Pressure (Cerebrospinal Fluid Pressure, CSF Pressure)Linked diagnostic testsIntracranial Prassure Monitoring (CSF Pressure)
Often decreased
5- Antithrombin 111 (AT-111)Reference range exampleAdult ( > 16y): 90–110 %Linked diagnostic testsAntithrombin 111 (AT-111) Activity Test
- Coagulation Bleeding TimeReference range exampleAdult ( > 16y): 65–110 secondsLinked diagnostic testsActivated Coagulation Time (ACT)
- PlasminogenReference range exampleAdult ( > 16y), Female: 65–153 %; Adult ( > 16y), Male: 70–120 %Linked diagnostic testsPlasminogen Activity
- Protein CReference range exampleAdult ( > 16y): 70–150 %Linked diagnostic testsProtein C (PC ANtigen)
- Protein SReference range exampleAdult ( > 16y), Female: 50–120 %; Adult ( > 16y), Male: 55–120 %Linked diagnostic testsProtein S Concentration
Introduction / full article
Cavernous Sinus Thrombosis
Cavernous sinus thrombosis
Cavernous sinus thrombosis (CST) is a serious medical condition that involves a blood clot in an anatomical area called cavernous sinus situated at the bottom of the brain. [1] With the available medications, mortality was lowered down to 30% however complete healing is uncommon. [2] CST can lead to complications such as stroke and blindness. Prompt medical attention is required. [1]
Epidemiology
The condition is rare. There are no reported race and gender predilection. Everyone can be affected. Average age of affected individuals is 22 years old. [2]
Causes
The typical cause is an infection by a bacteria seeding from other adjacent parts such as the teeth, sinuses and ears. [3] In order to contain the infection, the body undergoes adaptive mechanisms, one of which leads to clot formation. However, clot raises pressure inside the brain leading to brain injury. [4]
Trauma also has been suggested to cause CST. [1] Conditions like chronic sinusitis and diabetes are risk factors. [2]
Signs and Symptoms
Headache is very common. The symptoms depend on the structures involved. A patient may manifest with swelling in the areas around the eye accompanied by changes in vision or drooping eyelids. It may occur initially on one eye then later involve the other eye in a span of one to two days. This is due to spreading within the intercavernous sinuses.
A patient may also manifest with neck rigidity and decreased sensation. If there is sepsis, the person may have fever and chills. Since the brain is involved, the individual may develop confusion and fall into coma. [2]
Diagnosis
History often points out to a recent infection. Diagnosis is based on laboratory imaging results such as MRI and CT scan. Lumbar puncture tests and blood cultures are also valuable. [5]
Treatment
Central to treatment of CST is prompt high-dose antibiotic administration through intravenous line usually given in a minimum period of three to four weeks. Corticosteroids and blood thinners are at times prescribed. Surgery is infrequently done as it is technically hard although drainage is sometimes indicated. [2]
References:
- http://www.wisegeek.com/what-is-cavernous-sinus-thrombosis.htm
- http://emedicine.medscape.com/article/791704-overview#a0199
- http://www.nlm.nih.gov/medlineplus/ency/article/001628.htm
- http://www.webmd.com/a-to-z-guides/cavernous-sinus-thrombosis
- http://www.merckmanuals.com/professional/eye_disorders/orbital_diseases/cavernous_sinus_thrombosis.html