Cavernous Sinus Thrombosis: Current Therapy

Desa, V.; Green, Ryan

doi:10.1016/j.joms.2011.09.048

Cited by 109 publications

(119 citation statements)

References 31 publications

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“…As previously established, prompt recognition of the condition and definitive treatment is the key to limiting the complications of CST. 18 In our singlecenter cohort study, the very high frequency of positive outcomes may be related to several factors, including early recognition and aggressive therapy with surgery, antibiotics, and anticoagulation. No guidelines exist directing management of CST, but these outcomes suggest that an aggressive approach should be considered for all patients and deserves further evaluation.…”

Section: Figure 1 Contrast Vs Noncontrast Head Ctmentioning

confidence: 90%

Pediatric cavernous sinus thrombosis

et al. 2015

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Objective: To describe clinical characteristics, imaging findings, morbidity, and mortality in a single-center cohort of 12 pediatric cavernous sinus thrombosis cases and to review all cases available in recent English literature.Methods: Clinical data and radiographic studies on 12 cases from our institution were analyzed retrospectively. A literature search and review was conducted, with additional cases pooled with the new cohort for an aggregate analysis.Results: Twelve cases of cavernous sinus thrombosis in children from the Children's Hospital of Philadelphia between January 1, 2000, and December 31, 2013, were reviewed. All patients survived to discharge; 3 of 12 (25%) experienced neurologic morbidity. Contrast-enhanced MRI and contrast-enhanced head CT were 100% sensitive for detecting cavernous sinus thrombosis, while noncontrast time-of-flight magnetic resonance venography (TOF MRV) and noncontrast head CT were 0% sensitive. Literature review produced an additional 40 cases, and the aggregate mortality rate was 4 of 52 (8%) and morbidity rate was 10 of 40 (25%). Outcomes did not vary by treatment or with unilateral vs bilateral cavernous sinus involvement. There was a trend toward worse outcomes with fungal infections. Conclusion:Our case series demonstrates low morbidity and mortality with early, aggressive surgical, antimicrobial, and anticoagulation therapies. Although anticoagulation and surgery were not associated with significantly different outcomes, more study is needed. Neurology ® 2015;85:763-769 GLOSSARY CST 5 cavernous sinus thrombosis; ICA 5 internal carotid artery; MRA 5 magnetic resonance angiography; MRV 5 magnetic resonance venography; TOF MRV 5 time-of-flight magnetic resonance venography without contrast.

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Section: Figure 1 Contrast Vs Noncontrast Head Ctmentioning

confidence: 90%

Pediatric cavernous sinus thrombosis

et al. 2015

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“…CST caused by otitis media, facial cellulitis, and odontogenic infections are frequently polymicrobial. 5 No patient in our series had a polymicrobial infection. Invasive Zygomycetes, which include Rhizopus, Absidia, and Mucor, is perhaps the most catastrophic cause of CST.…”

Section: Discussionmentioning

confidence: 71%

“…4 Overall, the most common organisms implicated in CST in the literature are Staphylococcus aureus and Streptococcus species. 5 Five (56%) of our patients had documented grampositive bacilli infections, including MRSA, MSSA, and Peptostreptoccus infections. Gram-negative bacilli, anaerobes and fungi have been reported but are less common.…”

Section: Discussionmentioning

confidence: 79%

“…This leads to a spreading phlebitis of the valveless veins draining the midface into the cavernous sinus. [2][3][4][5][6] Each sinus conducts the third, fourth, and sixth cranial nerves, as well as the first and second division of the trigeminal nerve. CST is characterized by dysfunction of some or all of these nerves, usually preceding acutely over days after the onset of the precipitating infection.…”

Section: Discussionmentioning

confidence: 99%

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Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children

Frank

Smith

Davies

et al. 2015

Journal of American Association for Pediatric Ophthalmology and

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“…Aseptic CST is managed with primary attention to coagulation status and any underlying disease. However, initial antibiotics treatment is recommended, until a septic etiology is ruled out [21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Neuro-ophthalmological emergency disorders: A general view

Turgut¹

2017

Int J Clin Exp Ophthalmol

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Neuro-ophthalmological emergency disorders usually occur with symptoms of visual loss, diplopia, ocular motility impairment and anisocoria. In this mini-review, we aim to take look the common neuro-ophthalmological emergency disorders. The delayed diagnosis of the neuro-ophthalmological emergencies puts the patient at risk of death or blindness. If these are well-known, the discrimination and management of these emergency conditions will be easier.

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Cavernous Sinus Thrombosis: Current Therapy

Cited by 109 publications

References 31 publications

Pediatric cavernous sinus thrombosis

Pediatric cavernous sinus thrombosis

Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children

Neuro-ophthalmological emergency disorders: A general view

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