One of the most unusual and grave conditions is cavernous sinus thrombosis (CST). It arises from a complication due to facial infections. This involves a blood clot developing in the cavernous sinuses of the skull which are hollow spaces beneath the base of the brain found at the back of the eye sockets. CST can result to severe medical conditions such as stroke, blindness, brain abscess and death according to medical experts.
Diagnosis of CST can be done through a computed tomography (CT) scan on the head so that the characteristic effects would be shown. In this scan, X-rays are taken via a computer that shall give precise imaging of the area scanned. Another diagnosis is through magnetic resonance imaging or MRI which gives better and helpful results. There are also doctors who perform blood cultures and lumbar punctures to diagnose CST. Diagnosis of mortality is thirty percent while mortality of those with sphenoid sinus infection is at fifty percent. In the past, the absence of potent antibiotics led to a 100% mortality rate. Many doctors usually have a misdiagnosis because CST resembles another ailment termed as orbital cellulitis.
CST emerges from sinusitis infection which starts from the facial skin, nose, ears, eyes or teeth according to doctors. A sufferer of sinus infection who also has other medical conditions which elevate blood risks may also have CST. The latter happens when a bacterial or viral infection goes to an area of the skull and then goes to the cavernous sinuses. To defend the body from infection and to avoid spreading of the infection, the immune system shall produce a blood clot in these sinuses. Because the clot can produce pressure, the brain would be affected. If treatment is not sought, the brain would get damaged which can then produce fatal effects.
The initial symptom of cavernous sinus thrombosis is a worsening headache felt at an area of the face which is at the back of the eye’s orbit or near the eye. A high fever then follows. A seizure may also occur in fifty percent of the sufferers. One limb may convulse which is known as focal seizure, or the whole body feels a series of convulsion and loss of consciousness which is a generalized seizure. These symptoms develops slowly (over a few hours or weeks) than an arterial stroke.
The initial symptoms would later on affect both eyes after one part of the face has become infected. Aside from pain, the eyelids and optic never would swell and the eyeballs would bulge. Paralysis and conjunctiva redness will also occur. The eyes would not be able to move and the vision becomes blurry. This would later on result to total loss of vision. The other eye would then have the said symptoms later on.
Loss of consciousness and confusion would help spread the symptoms of CST. A sufferer would become disorientated and unaware and would not even know his name, location and the time.
He would not experience sensation or feelings on his face. The patient will eventually fall into a coma. According to a medical study, fifteen percent of sufferers became comatose while forty percent experienced a lower level of consciousness.
In CST, the pituitary gland might become compressed thus this will result to hypopituitarism. The hormones would not emerge from the pituitary gland. If this were not treated, shock and death may happen to the sufferer. Fifty percent of the survivors would develop complications such as blindness, eye movement paralysis and hypopituitarism.
Other possible symptoms of CST are drowsiness, a stiff and painful neck, quick heart rate, numb face and a coma. Complications include meningitis, sepsis, central nervous system infection and cranial nerve palsy. Those with chronic sinusitis or diabetes mellitus have a high chance of having these complications as well. It is therefore vital to treat CST immediately once a person is diagnosed.
It is necessary to contact a doctor when one experiences severe and progressive headaches that were not felt before. Although a headache does not signify cavernous sinus thrombosis, it should be investigated further by an expert. If there is extreme eye pain and swelling on the area surrounding the eyes, it is best to go to the doctor. Once CST is diagnosed or suspected, the patient needs to stay in the hospital, particularly in the intensive care unit.
Because CST is a life-threatening disease, it is necessary to undergo treatments advised by the doctor and not mind about the expenses. The bacterial infection must be drained out while the blood clots in the vein found at the bottom of the brain must be taken out. This can be done through intravenous antibiotics in the intensive care unit of the hospital. There are times when surgery is really necessary so as to avoid death.
Different antibiotics shall be given via a drip connected to any of the veins. This shall be given from three to four weeks so as to make sure the infection is eliminated from the body. There are times when a patient needs to be given heparin, a medicine that will dissolve a blood clot, prevent further occurrences and thin the blood. Patients may also be given corticosteroids, a certain kind of steroid so as to minimize inflammation and swelling.
If sinusitis or a boil causes the symptoms of CST, the pus must be drained away from its area. Surgery is then essential for this procedure. To avoid surgery, it is therefore necessary to see a doctor immediately so that antibiotics would be enough to cure the infection. Patients who have responded effectively to treatments will still have to stay for months in the hospital for further evaluation and thorough recuperation.
CST is a rare condition and a study says that in England, only one in two and half million people suffer from it at anytime. This is usually experienced by more women than men. The reason for this is the vulnerability of women to blood clots from pregnancy and consumption of oral contraceptive birth control pills. Studies also say that CST can occur more in children and young adults than in older adults.
These are the essential things to know about cavernous sinus thrombosis.