Cavernous sinus thrombosis natural history, complications and prognosis

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

Natural History, Complications, and Prognosis

Natural History

• The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
• The symptoms of (disease name) typically develop ___ years after exposure to ___.
• If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

• Common symptoms of cavernous sinus thrombosis include:
  • Severe holocranial and bifrontal headache whit increasing severity
  • Swelling, redness, or irritation around one or both eyes
  • Drooping eyelids
  • Inability to move the eye
  • High fever
  • Pain or numbness around the face or eyes
  • Fatigue
  • Vision loss or double vision
  • Seizures
  • Altered mental status that can range from confusion to coma

Complications

• Common complications of cavernous sinus thrombosis include:
  • [Complication 1]
  • [Complication 2]
  • [Complication 3]

References

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Natural History

In reality, most patients with cavernous sinus thrombosis do not present with such serious illness, and if they survive tend to have a better prognosis than patients with arterial thrombosis. The real trick is suspecting and making the diagnosis.

Complications

Progressive coma and death with hemorrhagic infarction pathologically.

Prognosis

• Prognosis better as diagnosis is increasing made with imaging instead of autopsy, with mortality rates down from 100% to 6.5% in a recent review of 76 patients.
• Poor prognostic features:

  • Rapid progression
  • Coma
  • Extremes of age
  • Focal signs and symptoms
  • Hemorrhagic infarct
  • Serious underlying cause

• Of note, if patient survives, outcome is better than for arterial infarct

References

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