Cavernous sinus thrombosis

2,084 views

Assessments
Cavernous sinus thrombosis

Flashcards

0 / 9 complete

Questions

0 / 1 complete

High Yield Notes

13 pages

$TREATMENT MEDICATIONS ▪ Targeted antibiotic therapy ▫ Penetration through abscess wall poor, typically accompanies surgical management ▪ Hyperbaric oxygen therapy ▫ Reduces intracranial pressure, bacteriostatic, enhances oxidative immune function ▪ Corticosteroids in complicated cases with pituitary insufﬁciency SURGERY ▪ Drainage ▪ Removal of any foreign material Figure 65.1 A CT scan of the head in the axial plane demonstrating a abscess in the left frontal lobe. This example developed ﬁve weeks following a repair of a depressed skull fracture. CAVERNOUS SINUS THROMBOSIS osms.it/cavernous-sinus-thrombosis PATHOLOGY & CAUSES Cavernous sinuses ▪ Irregularly shaped, trabeculated, blood ﬁlled cavities, acts as venous channel between endosteum, dura mater at base of skull ▪ Numerous important structures pass through cavernous sinuses ▫ Internal carotid artery ▫ Cranial nerves III, IV, V (branches V1, V2), VI ▪ Drain into internal jugular vein Infection ▪ Infection → formation of blood clot within cavernous sinus ▪ Infection often arises via contiguous spread from nearby infection (e.g. nasal furuncle, sphenoidal/ethmoidal sinusitis/dental infection) ▫ Commonly associated organisms: Staphylococcus aureus, Streptococcus 502 OSMOSIS.ORG RISK FACTORS ▪ Immunosuppression (e.g. uncontrolled diabetes, corticosteroid use, cancer, chemotherapy) ▪ Thrombophilia ▪ Obesity ▪ Severe dehydration COMPLICATIONS ▪ Dural venous, cavernous system valveless → communication with dural sinuses, cerebral, emissary veins → meningitis, dural empyema, brain abscess ▪ Spread via jugular vein to pulmonary vasculature → septic emboli, pulmonary abscesses, pneumonia ▪ Carotid artery narrowing → stroke ▪ Ischemia/direct infectious spread → hypopituitarism$

Flashcards

Cavernous sinus thrombosis

9 flashcards

Questions

USMLE® Step 2 style questions USMLE

1 questions

Preview

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?

Memory Anchors and Partner Content