Diagnosis and treatment of cavernous sinus thrombosis

1 Causes of

Cavernous sinus thrombosis can be infectious and non-infectious. The latter most often prevails at the present time. Calling sinus thrombosis of the brain can for a variety of reasons, even the common cold, frolic in sinusitis. The main ones are:

• tumor or brain trauma;
• heart failure;
• hereditary thrombophilia;
• various infectious diseases of the nose, ears, eyes or teeth;
• autoimmune pathologies;
• poor blood clotting;
• unsuccessful surgery;
• diabetes;
• heart failure;
• fungal and parasitic diseases;
• abortion.

2 Symptoms of the disease

Symptoms of pathology are very diverse, and depend on the age of the patient, the prevalence of thrombosis and the causes that caused it. Among the main ones, the following can be distinguished:

• Pains in the head region of pulsating, pressing or bursting nature.
• Nausea and vomiting reflexes.
• General weakness and fatigue.
• Sore and aching muscles and joints.
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• Elevated body temperature.
• Stiffness of the neck muscles.
• Development of exophthalmos( protrusion of the eyeball).
• Significant decrease in vision. In some cases, there is turbidity and doubling in the eyes.
• Painful sensation and swelling in the forehead, nose and eyes.

If the pathology begins to progress, the patient may experience impairment of consciousness and convulsions. In the most severe cases, a coma develops. If you have the slightest suspicion of thrombosis of the cavernous sinus, you should immediately contact a specialist. This will significantly increase the chances of recovery.

3 Detecting the ailment

Recognizing thrombosis of the cavernous sinus is difficult, because its symptoms are similar to a number of other diseases. To fully diagnose this disease, a visual inspection and a number of laboratory and instrumental examinations are necessary.

On visual inspection, attention is paid to the difference in eye size of the patient( in case of disease they will differ significantly).Also, signs of the pathological process are puffiness of the eyelids and face. In the horizontal position and under physical exertion, the patient is greatly aggravated with headaches, which can not be stopped with anesthetics.

Laboratory tests include:

• a common blood test, which allows to determine the level of leukocytes and accelerated ESR;
• blood culture for sterility;
• coagulogram;
• determination of the D-diameter value;
• sampling of cerebrospinal fluid to detect the presence of bacteria or viruses in it.

The most accurate diagnosis allows an instrumental examination. In this case, the patient is assigned a computer tomography and MRI, which makes it possible to get a complete picture of the condition of the inner part of the head. It should be noted that this method of investigation allows to identify the disease at the earliest stage.

4 General principles of therapeutic tactics

Therapy of thrombosis of the cavernous sinus can be conservative( with the help of medicines) and surgical( with neglected state of the disease).It is important to remember that timely treatment starts reduces the risk of recurrence of this disease. Therapy of this pathology deals with an infectious disease doctor or a neurologist.

5 Conservative therapy

Conservative treatment is aimed at the following tasks:

• elimination of organism intoxication;
• fight against the formed clots;
• elimination of cerebral edema;
• stop infectious processes;
• slowing down the destruction of tissues in the brain.

In cases where the cause of the formation of thrombi was an infection, detoxification with antibiotics is carried out. This makes it possible to eliminate toxins and remove them from the body. To do this, use drugs Hemodez, Reopoliglyukin, etc. After identifying the pathogen, antibiotics of a wide spectrum of action, such as Oxacillin or Ceftriaxone, are prescribed. The infection is prevented by Metronidazole and its derivatives.

To eliminate the formed thrombus and restore normal blood circulation, anticoagulants of direct action( Heparin), and after - indirect action( Warfarin) are appointed. To prevent further formation of blood clots will help anti-Aggraganty, such as Clopidogrel, Dipiridamol and others. During the recovery period, vasodilators and neurometabolic agents are taken.

If the disease has taken a particularly severe form, osmotic diuretics will help to stop the swelling of the brain.

6 Surgical treatment

If medications do not bring the expected results or an extensive degree of thrombus damage has been established, surgery is prescribed. Because of the peculiarities of the anatomical location of the cavernous sinus, the operation is reduced to the opening of the paranasal sinuses and the sanation of the infected site. Because the operation is very difficult, after it requires a long rehabilitation. During this period, it is necessary to take blood thinners and prevent the formation of new blood clots. Also, in order to reduce the risk of inflammation, antibiotic therapy is mandatory.

7 Possible complications of

This disease can lead to serious complications. Timely diagnostics and quality therapy can significantly reduce the risk of their development.

There is a classification of complications that divides them into immediate and remote ones. The first include partial seizures, edema and cerebral infarction.

Of the remote, the following should be noted:

• decreased visual acuity;
• curvature of the pupil;
• abnormally low position of the upper eyelid;
• limited movement of the eyeball;
• autoimmune inflammatory lesion of the arachnoid of the brain;
• disturbance of the anterior lobe of the pituitary gland.

There are often cases when the illness led the patient to complete loss of vision, stroke, as well as violation of sexual development and behavior.

8 Conclusion

For the prophylaxis of cavernous sinus thrombosis, it is necessary to treat infectious diseases in due time and to carry out therapeutic and preventive measures to improve the body. In the case of chronic diseases that are characterized by changes in the vascular wall and blood viscosity, it is necessary to observe the specialist, as well as strict adherence to all of his recommendations.