cavernous sinus thrombosis

This work was done by 2nd year student in faculty of medicine,Menoufia University,Egypt and under supervision of staff of anatomy and embryology department

1. Cavernous Sinus Thrombosis
(CST)
2nd year (group 1 ) ----2017……-anatomy department
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2. Team Work
Mona Adel
SamiaAdel
Mona Abd
Elwahab
NourElhoda
Nada Gamal
HebaAllam
Hala
Elshafey
Nermeen
Zidan
Nesma
Omara
Marwa
Helmy
2nd year (group1)---2017.....-anatomy department
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Supervisor
Professor Dr. HanaaNooh
DrLubnaTaher
Dr. EngyAbdEl Azeem

3. Component
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4. A series of hollow spaces
located under the bottom of
the brain , behind each eye
socket
Each forms a major vein that is a part
of a network of sinuses that eventually
drain into jugular veins , which carry
blood away from the brain .
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5. Sup-optic tract ,optic
chisma,internal carotid A
Inf-greater wing of
sphenoid bone
Med-sellaturcica,
sphenoidalair sinus
Lat-temporal lobe with
uncus
Ant –superior orbital
fissure
Post-apex of petrous
temporal bone
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7. S
A
p
I
L
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9. Cavernous sinus thrombosis
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10. Serious condition consisting in the
formation of a thrombus in cavernous
sinus or its communicating branches
.Infections of the head , face and
intraoral structures above the maxilla
are particularly prone to produce this
disease
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11. dental abscess
2.Blood clot
Contraceptive pills
pregnancy
sever head injury
Systemic lupus1.infection;
face ,sinuses or
teeth y , ears or
eyes
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12. Frequency
CST is rare with ~4.5 cases per 1,000,000 per year .
It is least common duralvenous sinus thrombosis , accounting for<1.5% of cases . One
review of the English –language literature found only 88 cases from 1940-1988.
Age
All ages are affected , with a mean 22 years.
Mortility&Morbidity
The mortilityrate from CST was effectively 100% in the past
Now the rate is less than 30% however ,remain high and complete recovery is rare.
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14. CST is more common in people who take certain medication or who have
underlying health condition that may increase their risk for blood clot .
Personal history
Age :-24 years
Sex:-female
House wife , married with one spring has 6 months
Complication:-acute onset headache and blurring of vision
past history :-
She took( contraceptive pills )
Family history :-
Hypertension is common in her family
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15. headache
initial(most
common)
the eyes are
affected,
swelling of
the eyes ,red
eyes ,double
vision ,
drooping
eyelids
The most
common
symptom
vomiting
seizures
high temperature above 38
Other symptomsusually
a sharp
pain
located
behind or
around the
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16. investigation
Radiographic
feature
•CST is a clinical diagnosis , however , MRI with
contrast is the modality of choice to confirm
its presence and to differentiate it from
alternatives such as orbital cellulitis.
Laboratory
test
•CBC, ESR , blood cultures , and sinus culture help
establish and identify an infectious primary source.
Imaging
studies
•*CT scan
•*MRI and MR venogram
•*cerebral angiography
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17. Vision
problem
-Blood
clot
Lung , pulmonary
embolism
Brain , this
triggers a stroke
and affect in 1 in
330 people
About 1 in 6
people
experience
some degree of
permanent
visual
impairment
Complication
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18. *primary treatment
-Antibiotics:-& anaerobes drugs (sinusitis or dental infection).
-Secondary treatment
-Corticosteroids (cranial nerves dysfunction & reduce swelling)
-Anticoagulant medication :-(to dissolve and prevent blood clot )
It is controversial because most patients respond to antibiotics ,
and adverse effects may exceed benefits.
Medical
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19. If the symptoms of CST were caused
by sphenoid sinusitis or boil , it may
be necessary to drain the pus away
from that site
Especially if there is no clinical
response to antibiotics within 24 hours
This can be done either using a
needle or during surgery
Surgical
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20. Treatment of vision :-
The drugs may include Beta-blockers
carbonic anhydrase inhibitors and
sympathomimetic
Treatment of deep vein thrombosis:-
These drugs are called anticoagulants
like, heparin
Treatment of the complication
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21. *100% Mortality prior to effective antimicrobials
*Typically , death is due to sepsis or central nervous
system (CNS) infection
*With aggressive management , the mortality rate is
now less than 30%
*Morbidity , however , remains high , and complete
recovery is rare .
*Roughly one sixth of patients are left with some
degree of visual impairment , and one half (50%)
have cranial nerves deficits
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