What Is Sinus Thrombosis?

Cavernous sinus thrombosis, or CST, is a severe sinus condition which can arise from complications attendant upon some kinds of facial infection, often leading to the development of a blood clot in the cavernous sinuses of the skull, where there are hollow areas behind both eye sockets. Severe medical conditions can result from CST, including blindness, brain abscesses, stroke, blood poisoning, and even death. Infections which originate in the nose, ears, eyes, teeth, or skin around the facial area can all lead to the development of cavernous sinus thrombosis. For this reason, all infections originating from the facial area should be regarded with extreme caution.

Diagnosis of Cavernous Sinus Thrombosis

Cavernous sinus thrombosis can be diagnosed in some cases via a computed tomography (CT) scan performed on the head, in which x-rays are taken by a computer to provide precise imaging of the affected area. Magnetic resonance imaging (MRI) can also be used to diagnose the condition, and this can be even more precise. In addition to using these types of advanced technology, doctors will sometimes diagnose CST by taking blood cultures and lumbar punctures, and then analyze the results for accuracy. In the past when antibiotics were not available, a diagnosis of CST meant that death was relatively certain, for the victim but with modern medical treatments, mortality rates are much lower.

Causes of CST

The jugular vein, the major blood vessel responsible for the transport of blood away from cavernous sinuses in the brain, is where CST can cause dangerous blood clots. Any infection which develops in the facial area or the skull, can spread to the cavernous sinuses and cause a blood clot to take shape.
Blood clots often develop as the immune system works to fight the spread of infection, but in this case, that works against the body, because the blood clot can restrict the flow of blood from the brain – sometimes right in the critical jugular vein. This, in turn, can cause significant brain and eye damage, as well as nerve damage between the eyes.

In unusual cases, blood clots can develop independently of any other infection, and cause any or all of these same symptoms.
Not only is the blood clot unable to halt the proliferation of infection, but that infection can then permeate the entire bloodstream, and lead to blood poisoning. Although infections are by far the most common cause of CST, the condition can also be caused by a severe head injury, a fungal infection, some kinds of medication, medical conditions which make you susceptible to blood clots, and even some conditions which trigger inflammation inside the body, such as lupus.

Red blood cells flowing through a vein, representing the blood clots that can occur as a symptom of sinus thrombosis.

Sinus thrombosis can result in dangerous or even fatal blood clots, which is why it’s important to treat the infection as early on as possible.

Symptoms of CST

Some of the most common symptoms of cavernous sinus thrombosis are as follows: experiencing double vision, having severe, concentrated pain around the eyes, swelling around the eyes, and sharp, intense headaches which frequently occur in the area around the eyes. Of these, the most common symptom is an acute headache centered around the eyes, which steadily worsens.

Bacterially-induced CST develops within a week of that infection, and soon after that, the characteristic headaches start to occur. However, after the appearance of headaches, no other symptoms appear for up to several weeks.

This is one of the reasons that CST is commonly misdiagnosed, because as far as can be observed, the only real problem is headaches, although these are more or less relentless. When other symptoms do develop, later on, you might see a body temperature greater than 100°, frequent vomiting, seizures, and unusual changes in the victim’s mental status, as evidenced by confusion or disorientation.

When these symptoms are left untreated, very severe health issues may follow. Fairly often, people suffering from cavernous sinus thrombosis will become more and more drowsy, eventually slipping into a reduced level of consciousness. In approximately 15% of such cases, that will even deteriorate into a coma-like state. Because of the extreme danger of overlooking treatment, the appearance of any of the symptoms described above should be a red flag to you, and you should consult your doctor about whichever of the symptoms are being evidenced.

Persistent severe headaches which you have never had in your past medical history should be treated with extreme vigilance, and so should any of the symptoms related to the eyes, e.g., swelling, sharp pain, and headaches centered around the eyes.

Treatment of CST

Antibiotics are usually administered to treat the infection which led to the development of CST, and this is often one of the first steps in treatment. If any of the head scans have indicated the presence of a blood clot, that must be removed before it can cause any of the extreme conditions mentioned above. Heparin is a medication that can dissolve blood clots, since it thins the blood, and corticosteroids are sometimes also used to reduce swelling and inflammation. The main thing about any treatment program is that it must be addressed as early as possible after diagnosis, to avoid any of the potential health issues we’ve discussed.

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