Cavernous sinus thrombosis physical examination: Difference between revisions

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===Appearance of the Patient===
===Appearance of the Patient===
*Patients with cavernous sinus thrombosis usually appear very ill and toxic.  
*Patients with cavernous sinus thrombosis usually appear very ill and toxic.<ref name="pmid28239275">{{cite journal| author=Goh KG, Shanthi V| title=The Importance of Early Recognition of Cerebral Venous Sinus Thrombosis: A Case Report. | journal=Malays J Med Sci | year= 2015 | volume= 22 | issue= 5 | pages= 98-102 | pmid=28239275 | doi= | pmc=5295744 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28239275  }} </ref><ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>


===Vital Signs===
===Vital Signs===


*High-grade fever
*High-grade fever<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
*[[Tachycardia]] with regular pulse
*[[Tachycardia]] with regular pulse<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
*[[Tachypnea]]
*[[Tachypnea]]<ref name="pmid27594955">{{cite journal| author=Sacchetti F, Stagni S, Spinardi L, Raumer L, Dentale N, Cirillo L| title=A singular case of cavernous internal carotid artery aneurysm in patient with cavernous sinus syndrome and bacterial meningitis. | journal=Radiol Case Rep | year= 2016 | volume= 11 | issue= 3 | pages= 227-33 | pmid=27594955 | doi=10.1016/j.radcr.2016.05.005 | pmc=4996927 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27594955  }} </ref>
*Low blood pressure with normal pulse pressure
*Low blood pressure with normal pulse pressure


=== Skin ===
=== Skin ===
* [[Pallor]] may be present
* [[Pallor]] may be present<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>


===HEENT===
===HEENT===
* [[Periorbital edema]] (initially unilateral but typically bilateral)
* [[Periorbital edema]] (initially unilateral but typically bilateral)<ref name="pmid22802153">{{cite journal| author=Visvanathan V, Uppal S, Prowse S| title=Ocular manifestations of cavernous sinus thrombosis. | journal=BMJ Case Rep | year= 2010 | volume= 2010 | issue=  | pages=  | pmid=22802153 | doi=10.1136/bcr.08.2009.2225 | pmc=3028264 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22802153  }} </ref><ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref><ref name="pmid20009315">{{cite journal| author=Senthilkumaran S, Balamurgan N, Arthanari K, Thirumalaikolundusubramanian P| title=Periorbital swelling in emergency room: Get your eyes in. | journal=J Emerg Trauma Shock | year= 2009 | volume= 2 | issue= 3 | pages= 209-10 | pmid=20009315 | doi=10.4103/0974-2700.55349 | pmc=2776373 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20009315  }} </ref>
* Unilateral or bilateral [[exophthalmos]]
* Unilateral or bilateral [[exophthalmos]]<ref name="pmid27401467">{{cite journal| author=Kamawal A, Schmidt MA, Rompel O, Gusek-Schneider GC, Mardin CY, Trollmann R| title=[Cavernous sinus thrombosis as a rare cause of exophthalmos in childhood : A case report]. | journal=Ophthalmologe | year= 2017 | volume= 114 | issue= 5 | pages= 457-461 | pmid=27401467 | doi=10.1007/s00347-016-0317-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27401467  }} </ref><ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
* Extra-ocular movements may be abnormal from [[Oculomotor nerve palsy|third]], [[Fourth (trochlear) nerve palsy|fourth]] and [[Sixth nerve palsy|sixth]] cranial neuropathy
* Extra-ocular movements may be abnormal from [[Oculomotor nerve palsy|third]], [[Fourth (trochlear) nerve palsy|fourth]] and [[Sixth nerve palsy|sixth]] cranial neuropathy<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
** [[Sixth nerve palsy|Sixth cranial nerve neuropathy]] is the most common [[neuropathy]] (resulting in partial [[ophthalmoplegia]] with limited eye abduction).
** [[Sixth nerve palsy|Sixth cranial nerve neuropathy]] is the most common [[neuropathy]] (resulting in partial [[ophthalmoplegia]] with limited eye abduction).<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
*[[Pupil|Pupils]] non-reactive to neither light nor accommodation (from [[paralysis]] of the iris and [[ciliary body]])
*[[Pupil|Pupils]] non-reactive to neither light nor accommodation (from [[paralysis]] of the iris and [[ciliary body]])
*Lid [[erythema]]
*Lid [[erythema]]
*[[Horner's syndrome|Horner syndrome]] ([[ptosis]], [[miosis]], and [[anhidrosis]])
*[[Horner's syndrome|Horner syndrome]] ([[ptosis]], [[miosis]], and [[anhidrosis]])
*[[Chemosis]]
*[[Chemosis]]<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>
*[[Ptosis]]
*[[Ptosis]]
*[[Proptosis]] (due to impaired venous drainage of [[orbit]])
*[[Proptosis]] (due to impaired venous drainage of [[orbit]])<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>
*Painful eye movement
*Painful eye movement<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>
*[[Papilledema]]
*[[Papilledema]]
*[[Retinal haemorrhage|Retinal hemorrhages]]
*[[Retinal haemorrhage|Retinal hemorrhages]]
*Decreased [[visual acuity]]
*Decreased [[visual acuity]]
*[[Photophobia]]
*[[Photophobia]]<ref name="pmid28239275">{{cite journal| author=Goh KG, Shanthi V| title=The Importance of Early Recognition of Cerebral Venous Sinus Thrombosis: A Case Report. | journal=Malays J Med Sci | year= 2015 | volume= 22 | issue= 5 | pages= 98-102 | pmid=28239275 | doi= | pmc=5295744 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28239275  }} </ref>
*Pulsating [[conjunctiva]]
*Pulsating [[conjunctiva]]<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>
* Facial tenderness
* Facial tenderness<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
* Impaired [[corneal reflex]]
* Impaired [[corneal reflex]]
* [[Blindness]]
* [[Blindness]]


===Neck===
===Neck===
*[[Neck stiffness|Stiff neck]] may be present.
*[[Neck stiffness|Stiff neck]] may be present.<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>


===Lungs===
===Lungs===
Line 57: Line 57:
* Genitourinary examination of patients with cavernous sinus thrombosis is usually normal.
* Genitourinary examination of patients with cavernous sinus thrombosis is usually normal.
===Neuromuscular===
===Neuromuscular===
* [[Altered mental status]]
* [[Altered mental status]]<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
* Extra-ocular movements may be abnormal from [[Oculomotor nerve palsy|third]], [[Fourth (trochlear) nerve palsy|fourth]] and [[Sixth nerve palsy|sixth]] cranial neuropathy
* Extra-ocular movements may be abnormal from [[Oculomotor nerve palsy|third]], [[Fourth (trochlear) nerve palsy|fourth]] and [[Sixth nerve palsy|sixth]] cranial neuropathy<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref><ref name="pmid25425249">{{cite journal| author=Xia P, Jiao Y| title=Septic cavernous sinus thrombosis caused by tuberculosis infection. | journal=BMJ Case Rep | year= 2014 | volume= 2014 | issue=  | pages=  | pmid=25425249 | doi=10.1136/bcr-2014-206209 | pmc=4248139 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25425249  }} </ref>
** [[Sixth nerve palsy|Sixth cranial nerve neuropathy]] is the most common [[neuropathy]] (resulting in partial [[ophthalmoplegia]] with limited eye abduction).
** [[Sixth nerve palsy|Sixth cranial nerve neuropathy]] is the most common [[neuropathy]] (resulting in partial [[ophthalmoplegia]] with limited eye abduction).<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>
* [[Photophobia]]
* [[Photophobia]]
* [[Horner's syndrome|Horner syndrome]] ([[ptosis]], [[miosis]], and [[anhidrosis]])
* [[Horner's syndrome|Horner syndrome]] ([[ptosis]], [[miosis]], and [[anhidrosis]])<ref name="pmid27781123">{{cite journal| author=Arian M, Kamali A, Tabatabaeichehr M, Arashnia P| title=Septic Cavernous Sinus Thrombosis: A Case Report. | journal=Iran Red Crescent Med J | year= 2016 | volume= 18 | issue= 8 | pages= e34961 | pmid=27781123 | doi=10.5812/ircmj.34961 | pmc=5068248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27781123  }} </ref>
* [[Hyperreflexia]]
* [[Hyperreflexia]]
* [[Weakness|Generalised weakness]]
* [[Weakness|Generalised weakness]]<ref name="pmid28239275">{{cite journal| author=Goh KG, Shanthi V| title=The Importance of Early Recognition of Cerebral Venous Sinus Thrombosis: A Case Report. | journal=Malays J Med Sci | year= 2015 | volume= 22 | issue= 5 | pages= 98-102 | pmid=28239275 | doi= | pmc=5295744 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28239275  }} </ref>
*Abnormal [[gait]]
*Abnormal [[gait]]
*Decreased [[visual acuity]]
*Decreased [[visual acuity]]

Revision as of 15:27, 5 July 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Physical examination of patients with cavernous sinus thrombosis is usually remarkable for high grade fever, Tachycardia with regular pulse, Tachypnea, low blood pressure with normal pulse pressure, Pallor of skin, Altered mental status, Periorbital edema (initially unilateral but typically bilateral), unilateral or bilateral exophthalmos, abnormal extra-ocular movements from third, fourth and sixth cranial neuropathy, non-reactive pupils to neither light nor accommodation (from paralysis of the iris and ciliary body), lid erythema, horner syndrome (ptosis, miosis, and anhidrosis), Chemosis, Ptosis, Proptosis (due to impaired venous drainage of orbit, painful eye movement, Papilledema, retinal hemorrhages, decreased visual acuity, Photophobia, pulsating conjunctiva, facial tenderness, impaired corneal reflex, blindness, stiff neck, Photophobia, Hyperreflexia, generalised weakness, downgoing plantar reflex, Ptosis and Hemiparesis.

Physical Examination

Appearance of the Patient

  • Patients with cavernous sinus thrombosis usually appear very ill and toxic.[1][2][3]

Vital Signs

Skin

HEENT

Neck

Lungs

  • Pulmonary examination of patients with cavernous sinus thrombosis is usually normal.

Heart

  • Cardiovascular examination of patients with cavernous sinus thrombosis is usually normal.

Abdomen

  • Abdominal examination of patients with cavernous sinus thrombosis is usually normal.

Back

  • Back examination of patients with cavernous sinus thrombosis is usually normal.

Genitourinary

  • Genitourinary examination of patients with cavernous sinus thrombosis is usually normal.

Neuromuscular

Extremities

  • Extremities examination of patients with cavernous sinus thrombosis is usually normal.

References

  1. ↑ 1.0 1.1 1.2 Goh KG, Shanthi V (2015). "The Importance of Early Recognition of Cerebral Venous Sinus Thrombosis: A Case Report". Malays J Med Sci. 22 (5): 98–102. PMC 5295744. PMID 28239275.
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 Arian M, Kamali A, Tabatabaeichehr M, Arashnia P (2016). "Septic Cavernous Sinus Thrombosis: A Case Report". Iran Red Crescent Med J. 18 (8): e34961. doi:10.5812/ircmj.34961. PMC 5068248. PMID 27781123.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 Xia P, Jiao Y (2014). "Septic cavernous sinus thrombosis caused by tuberculosis infection". BMJ Case Rep. 2014. doi:10.1136/bcr-2014-206209. PMC 4248139. PMID 25425249.
  4. ↑ Sacchetti F, Stagni S, Spinardi L, Raumer L, Dentale N, Cirillo L (2016). "A singular case of cavernous internal carotid artery aneurysm in patient with cavernous sinus syndrome and bacterial meningitis". Radiol Case Rep. 11 (3): 227–33. doi:10.1016/j.radcr.2016.05.005. PMC 4996927. PMID 27594955.
  5. ↑ Visvanathan V, Uppal S, Prowse S (2010). "Ocular manifestations of cavernous sinus thrombosis". BMJ Case Rep. 2010. doi:10.1136/bcr.08.2009.2225. PMC 3028264. PMID 22802153.
  6. ↑ Senthilkumaran S, Balamurgan N, Arthanari K, Thirumalaikolundusubramanian P (2009). "Periorbital swelling in emergency room: Get your eyes in". J Emerg Trauma Shock. 2 (3): 209–10. doi:10.4103/0974-2700.55349. PMC 2776373. PMID 20009315.
  7. ↑ Kamawal A, Schmidt MA, Rompel O, Gusek-Schneider GC, Mardin CY, Trollmann R (2017). "[Cavernous sinus thrombosis as a rare cause of exophthalmos in childhood : A case report]". Ophthalmologe. 114 (5): 457–461. doi:10.1007/s00347-016-0317-6. PMID 27401467.

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