FUNDAMENTALS OF THE ETIOPATHOGENESIS, CLINICAL FEATURES AND PATHOMORPHOLOGY OF CAVERNOUS SINUS THROMBOSIS

Abstract

Cavernous sinus thrombosis (CST) is a rare and potentially dangerous disorder that may complicate facial infections, sinusitis, orbital cellulitis, pharyngitis, or otitis, and may also develop after traumatic injury or surgery, especially in the presence of a thrombophilic disorder. Early recognition of CST, which is often accompanied by fever, headache, visual disturbances such as periorbital swelling, and ophthalmoplegia, is critical for a favorable outcome. Despite modern treatment with antibiotics and anticoagulants, the risk of long-term complications such as vision loss, diplopia, and stroke remains significant. Cavernous sinus thrombosis is usually infectious in origin, but may also be aseptic. Septic cases may follow central facial infections, particularly in the dangerous triangular facial area (from the corners of the mouth to the bridge of the nose). These include abscess or cellulitis, sinusitis (especially posterior sphenoiditis and ephemoiditis), dental infections, dental extractions or procedures (including posterior periosteal blocks penetrating the pterygoid plexus), upper facial surgery, otitis media, and mastoiditis. Aseptic causes are less common than septic causes and include trauma, surgery, or pregnancy.