Cavernous Sinus Thrombosis: Case Report

Discussion by Dr MGK Murthy, Dr GA Prasad      Cavernous sinus is extradural venous plexus surrounded by a dural fold in the middle cranial fossa containing internal carotid artery with its periarterial sympathetic plexus, abducens nerve lateral to the internal carotid artery, but medial to the oculomotor and trochlear nerves and the ophthalmic and maxillary divisions of the trigeminal nerve, which run superior to inferior within the lateral dural border of the cavernous sinus.     Thrombosis of the cavernous sinus is usually caused by bacterial or fungal invasion complicating sinusitis in patients with poorly controlled diabetes or immunosuppression.      Clinically characterized  by multiple cranial neuropathies with impairment of  ocular motor nerves, Horner ’s syndrome, and sensory loss of the first or second divisions  of the trigeminal nerve in various combinations. The pupil may or may not be involved.     CT and MR imaging direct signs are changes in signal intensity and in the size and contour of the cavernous sinus, and indirect signs are dilatation of the tributary veins, exophthalmos, and increased dural enhancement along the lateral border of the cavernous sinus.  Few infective agents are-Actinomycosis - mostly immunocompetent patients( men>women), bacteria generally gain access to the central nervous system by dire...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs