Cavernous sinus thrombosis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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History and Symptoms

• Presentation may be acute (<48h) in a third, subacute (48h – 30 days) in a third, or chronic (>30 days) in a third.
• Patterns

  • Isolated intracranial hypertension:

    • HA (headache)
    • Papilledema
    • Sixth nerve palsy

  • Mimicks pseudotumor cerebri, is most homogeneous presentation, and accounts for almost half of all presentations
  • HA is nonspecific, sometimes with vomiting
  • Focal cerebral signs:

    • Quite heterogeneous, often reflecting focal areas of stroke, or seizure activity

  • Cavernous sinus syndrome:

    • Chemosis
    • Proptosis
    • Painful ophthalmoplegia
    • CN III, IV, and VI findings

  • Unilateral or bilateral
  • Other:

    • HA alone
    • Seizure
    • Psychiatric disturbance

References

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