Cavernous sinus thrombosis (CST) is a rare complication of facial infections. A blood clot forms in the cavernous sinus, stopping blood flow. The cavernous sinus is located in the skull and drains deoxygenated blood from the brain and face back to the heart. The cavity contains nerves, veins and other tissue. The area is surrounded by cranial nerves 3, 4 and 6 which affect eye movement, as well as cranial nerve 5 which detects sensation on the top and middle portion of the face. The condition is serious and can cause major medical conditions, including brain abscess, stroke, blindness and even death, according to The Merk Manual, an online medical guide. Diagnosis is made by MRI or CT scans; lumbar punctures and blood cultures may also be taken. Prognosis of mortality is 30 percent, and 50 percent in patients with sphenoid sinusitis.
Initial Symptoms
A progressively worsening headache is an initial symptom of CST. Pain is usually on one side of the face, near the eye, or behind the orbit of the eye. A high-grade fever of 103 or higher is common.
Symptoms Affecting the Eye
Though one side of the face is initially affected, symptoms later develop affecting both eyes. Symptoms include paralysis, bulging of the eyeballs and swelling of the eyelids. Pupils may be different sizes, known as anisocoria. The optic nerve may begin to swell; this is not visually present without using an ophthalmoscope to see the edema. A person may be unable to move eyes. Vision becomes blurry and eventually, total vision loss can occur.
Spreading of CST
Signs and symptoms the disease is spreading include confusion and loss of consciousness. A person may not be alert and oriented and know there name, where they are at or the time. A person may lapse into seizures. Facial feeling and sensation may be limited or absent.
