Cavernous sinus thrombosis physical examination

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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.

Vital Signs

  • High-grade fever
  • Tachycardia with regular pulse
  • Tachypnea
  • Low blood pressure with normal pulse pressure

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

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