THROMBOSIS SINUS

CAVERNOSUS
OLEH:
HERI HERLIANA
ANGEI LAURA DANIEL
HARFINDO NISMAL
GATOT SUBROTO
CONNY DIANAWATI
 definition
CAVERNOUS SINUS THROMBOSIS

a blood clot that forms

in a blood vessel
in the cavernous sinus.
Anatomy of Cavernous
Sinus
The cavernous sinuses receive
venous blood from the facial veins
(via the superior and inferior
ophthalmic veins) as well as the
sphenoid and middle cerebral
veins.

They, in turn, empty into the

inferior sinuses, then into the
internal jugular veins and the
sigmoid sinuses via the superior
sinuses.

This complex web of veins

contains no valves; blood can flow
in any direction depending on the
prevailing pressure gradients.
Since the cavernous sinuses
receive blood via this distribution,
infections of the face including the
nose, tonsils, and orbits can
spread easily by this route.
 Cavernous Sinus
Thrombosis
Causes
Most commonly sphenoid and ethmoid sinus
infections
Face danger area
Nose
Teeth (Maxillary teeth)
Ears

Most common pathogen S. Aureus

S. Pneumoniae, Gram-negatives, anaerobes,
Aspergillus, Rhizopus
 Cavernous Sinus
Thrombosis
Signs
Fever, ptosis, proptosis(bulging eye), chemosis
(swelling of the conjunctiva),.
Neuropathies
Papilledema
Visual impairment
Spread of signs to opposite side is ominous
Pituitary necrosis
Global neurologic compromise
 Studies
CT

MRI

Angiography
 Mortality
80-100% prior to antibiotic era
Now 20-30%
Sequelae
Up to 77% can have long term sequelae
Occulomotor neuropathy
Visual impairment
Pituitary insufficiency
Hematogenous spread of infection.
 TREATMENT
BROAD SPECTRUM ANTIBIOTIC (IV)
CORTICOSTEROID
ANTICOAGULANT
 The end

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