Cavernous sinus thrombosis following manipulation of fractured nasal bones

Ahmmed, Afsara; Camilleri, A. E.; Small, M.

doi:10.1017/s002221510013275x

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…In all, 95% of CST cases (ours included) develop visible signs of chemosis, periorbital oedema and proptosis 9. In addition, the advancement from unilateral to bilateral proptosis is pathognomonic of CST 1 , 10. Compression of one or more of cranial nerves III, IV, VI, V 1 and V 2 results in impedance of extraocular movement as projections of these nerves lie within or against the CS (in this case, cranial nerve VI).…”

Section: Discussionmentioning

confidence: 98%

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Sudden onset proptosis secondary to cavernous sinus thrombosis from underlying mandibular dental infection

Jones¹,

Arnold

2009

Case Reports

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The present report concerns a patient who presented with a 4-day history of left-sided facial pain arising from a pre-existing dental infection and progressive shortness of breath. The patient had a previous diagnosis of rheumatoid arthritis and was being treated with methotrexate. The rapid development of a right eye proptosis necessitated urgent decompression with a lateral canthotomy and cantholysis. Imaging revealed a left facial abscess, cavernous sinus thrombosis (CST), bilateral internal jugular thrombosis and multiple lung abscesses. Blood cultures yielded Streptococcus constellatus, a member of the Peptostreptococcus family. The patient was admitted to the intensive care unit (ICU) with respiratory failure and septic shock. She was treated with intravenous meropenem and clindamycin, and anticoagulated. Despite early intervention, the patient developed a middle cerebral artery infarct. Over a 3-week period she was gradually weaned from vasopressor and ventilatory support.

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Section: Discussionmentioning

confidence: 98%

“…Staphylococcus aureus is the causative agent in more than half of septic CST cases,4 , 12 , 13 most of which arise from sphenoidal and ethmoidal sinus infections 10 , 13. Mixed organisms are usually found in odontogenic sources and these include streptococci (notably of the β haemolytic variety) and anaerobes 8 , 14.…”

Section: Discussionmentioning

confidence: 99%

Sudden onset proptosis secondary to cavernous sinus thrombosis from underlying mandibular dental infection

Jones¹,

Arnold

2009

Case Reports

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“…Paranasal sinusitis, principally sphenoid sinusitis, is rarely reported to generate CVST (14). On the other hand, septic CVST may occur following medical processes especially dental processes, nasal bone fractures, and nasal sinus surgeries (15)(16)(17).…”

Section: Cvst and Infectionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis Risk Factors

Saadatnia

Fatehi

Basiri

et al. 2009

International Journal of Stroke

109

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Cerebral venous sinus thrombosis is an uncommon disease marked by clotting of blood in cerebral venous, or dural sinuses, and, in rare cases, cortical veins. It is a rare but potentially fatal cause of acute neurological deterioration previously related to otomastoid, orbit, and central face cutaneous infections. After the advent of antibiotics, it is more often related to neoplasm, pregnancy, puerperium, systemic diseases, dehydration, intracranial tumors, oral contraceptives, and coagulopathies are the most common causes, but in 30% of cases no underlying etiology can be identified. It has been found in association with fibrous thyroiditis, jugular thrombosis after catheterization, or idiopathic jugular vein stenosis. Other factors include surgery, head trauma, arterio-venous malformations, infection, paraneoplastic, and autoimmune disease. This article presents a comprehensive review of cerebral venous sinus thrombosis etiologies.

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“…The most common cause of cavernous sinus thrombosis is infection of the sphenoid and ethmoid sinuses; otitis media is the second most common cause, with maxillary dental infection accounting for only 10% of the dural infections 4 . This case was unique in that not only was the nidus of infection from an unusual location, the parapharyngeal space via the mandibular tooth, but the patient regained complete function without deficit after treatment and rehabilitation.…”

Section: Discussionmentioning

confidence: 90%

“…The patient presented to our hospital with the classical signs of a cavernous sinus thrombosis: bilateral proptosis, chemosis, sluggish pupils, palsy of cranial nerves III, IV, and VI, and a lack of a corneal reflex. Literature 4 has stated that the advancement of unilateral to bilateral proptosis of the eyes is pathognomonic to the above diagnosis. The lack of extraocular movements is to be expected since cranial nerves III, IV, VI, V 1 , and V 2 run either within or against the cavernous sinus; inflammation of this area would compress the nerves, creating the above physical symptoms.…”

Section: Discussionmentioning

confidence: 99%