Definition: Inflammation of cavernous venous sinus. It is highly dangerous with mortality rate of 30% away from its serious complications.
Etiology: spread of infection from:
- Skin of face, nose, forehead (via anterior facial vein).
- Sinusitis (via pterygoid venous plexus)
- Orbital cellulites (via ophthalmic veins).
- Pharyngeal suppuration e.g. quinsy (via pterygoid venous plexus).
- Chronic Suppurative Otitis Media → lateral sinus thrombosis.
Symptoms:
- Fever, rigor, toxic facies, anorexia, nausea.
- Severe headache and diplopia.
Signs:
- Swelling & edema of upper eyelid.
- Proptosis (may be pulsating).
- Chemosis
- Ophthalmoplegia: affection of 3rd, 4th and 6th cranial nerves.
- Fundus examination: papilledema.
Investigations:
- CBC: leukocytosis, high ESR.
- CT brain with contrast.
- MRV brain: diagnostic.
Complications:
- Affection of the other eye through intercavernous connections
- Meningitis, cerebral thrombophlebitis
- Mortality 30%
Treatment:
- Massive antibiotics.
- Anti coagulants.
- Care of comatosed (if needed).
- After control, treat sinus infection.