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Cavernous sinus thrombosis is a blood clot in the cavernous sinus. Cavernous sinus thrombosis is usually a late complication of an infection of the central face or paranasal sinuses. Cavernous sinus thrombosis is generally a fulminant process with high rates of morbidity and mortality. The cavernous sinuses are situated within the skull, immediately behind each eye socket (orbit) and on either side of the pituitary gland. They are large veins and their purpose is to drain blood from the brain and face back to the heart. Other causes include bacteremia, trauma, and infections of the ear or maxillary teeth. It is an uncommon complication following infection of face,paranasal sinuses resulting in thrombosis of cavernous sinus and its surrounding anatomic structures including cranial nerves 3,4,5[maxillary and ophthalmic division],6 and the internal carotid artery. The most common signs of Cavernous sinus thrombosis are related to anatomical structures affected within the cavernous sinus, notably cranial nerves III-VI, as well as symptoms resulting from impaired venous drainage from the orbit and eye. Classic presentations are abrupt onset of unilateral periorbital edema, headache, photophobia, and proptosis.

Cavernous sinus thrombosis is often misdiagnosed because it is so uncommon. It may be confused with orbital cellulitis. Features that distinguish Cavernous sinus thrombosis from orbital cellulitis include cranial nerve dysfunction, bilateral eye involvement, and mental status changes. Without effective therapy, signs appear in the contralateral eye by spreading through the communicating veins to the contralateral cavernous sinus. Eye swelling begins as a unilateral process and spreads to the other eye within 24-48 hours via the intercavernous sinuses. This is pathognomonic for Cavernous sinus thrombosis. The condition can affect any one at any age but is not contagious or inherited. Bacterial infections caused by Streptococcus and Staphylococcus are the most common organisms found in patients with cavernous sinus thrombosis. Before antibiotics were discovered, the mortality from cavernous sinus thrombosis was 80% to 100%. Since the discovery of antibiotics, the mortality ranges between 20% and 30%. The condition can be easily treated with high doses of intravenous antibiotic drugs which are given immediately after diagnosis. If the condition does not improve, the sinus may be drained surgically.

Causes of Cavernous Sinus Thrombosis

The main causes of Cavernous Sinus Thrombosis:

• Due to the spread of bacteria from an infection in the sinus, eye, ears, and nose or on the face.
• Chronic sinusitis or diabetes mellitus.
• Streptococci, pneumococci, and fungi.

Signs and symptoms of Cavernous Sinus Thrombosis

Signs and symptoms often experienced with Cavernous Sinus Thrombosis are:

• High fever.
• Severe pain behind and around the eye.
• Rapid heart rate.
• Muscle weakness.
• Numbness in the face.
• Hearing loss or fluid from the ear.
• Swelling of the eye lids and of the membrane covering the white of the eye.
• Loss of vision.

Treatment of Cavernous Sinus Thrombosis

Some most common treatmet of Cavernous Sinus Thrombosis:

• The condition can be easily treated with high doses of intravenous antibiotic drugs which are given immediately after diagnosis.
• Oral antibiotics are given for mild cases; intravenous antibiotics are given for severe cases.
• Sometimes surgery is needed to drain a collection of pus or an infected sinus.
• You may also be placed on a blood thinner called heparin, but this remains controversial and the decision is made between you and your physician.