Cavernous sinus thrombosis



Cavernous sinus thrombosis

Nervous system

Autonomic nervous system disorders

Horner syndrome

Orthostatic hypotension


Cavernous sinus thrombosis


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USMLE® Step 2 questions

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High Yield Notes

13 pages


Cavernous sinus thrombosis

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USMLE® Step 2 style questions USMLE

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A 41-year-old man comes to the office because of a 1-day history of fever, headache, and bilateral periorbital and mid-facial swelling. The day prior to the onset of the symptoms, the patient had attempted to burst a furuncle in the inner margin of his right nostril. His past medical history is noncontributory, and he does not take any medications. He had last traveled to India 4 months ago. Temperature is 38.1°C (100.5°F), pulse is 66/min, respirations are 12/min, and blood pressure is 124/72 mmHg. Physical examination shows marked facial and periorbital swelling with bilateral blepharoptosis, chemosis, and proptosis. On fundoscopy, there is no evidence of optic disc swelling. The patient has a full range of eye movements but complains of pain with eye movement. A high-resolution orbital CT with contrast demonstrates bilateral septic cavernous sinus thrombosis. Occlusion of which of the following veins is the most likely underlying cause of this patient’s condition? 

External References

First Aid



A cavernous sinus thrombosis is a rare, life-threatening condition that occurs when a blood clot blocks the cavernous sinus, which is one of the veins that drain blood from your head and brain. It is usually caused by a bacterial infection that has spread from the sinuses, ear, or nose. Symptoms may include headache, eye pain and swelling, red eye, fever, nausea, vomiting, and loss of balance. A cavernous sinus thrombosis can lead to permanent vision loss, coma, or death if left untreated.


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