Septic cavernous sinus thrombosis: A review

Surv Ophthalmol. 2021 Nov-Dec;66(6):1021-1030. doi: 10.1016/j.survophthal.2021.03.009. Epub 2021 Apr 5.

Abstract

Septic cavernous sinus thrombosis (SCST) is a rare, yet severe, process typically arising from infections of the paranasal sinuses (predominately ethmoid and/or sphenoid sinusitis) and less commonly, otogenic, odontogenic, and pharyngeal sources. Clinical symptoms of SCST arise from obstruction of venous drainage from the orbit and compression of the cranial nerves within the cavernous sinus. In the preantibiotic era SCST was considered universally fatal (80-100%); however, with the introduction of antibiotics the overall incidence, morbidity, and mortality of SCST have greatly declined. In spite of dramatic improvements, morbidity and mortality remain high, with the majority of patients experiencing neurological sequalae, highlighting the severity of the disease and the need for prompt recognition, diagnosis, and treatment. Here we review of the literature on SCST with a focus on the current recommendations and recent evidence for diagnostic and medical management of this condition.

Keywords: Anticoagulation; Cavernous Sinus Thrombosis; Cerebral Venous Thrombosis; Sinusitis; Superior Ophthalmic Vein Thrombosis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cavernous Sinus Thrombosis* / diagnosis
  • Cavernous Sinus Thrombosis* / etiology
  • Cavernous Sinus Thrombosis* / therapy
  • Cavernous Sinus*
  • Humans
  • Sinus Thrombosis, Intracranial* / complications
  • Sinus Thrombosis, Intracranial* / diagnosis
  • Sinus Thrombosis, Intracranial* / therapy

Substances

  • Anti-Bacterial Agents