Cavernous sinus thrombosis

Question 1

describe the presentation of a cavernous sinus thrombosis.

Answer 1

periorbital oedema, chemosis, exophthalmos
horner’s syndrome (post ganglionic)
hyperaesthesia of upper face and eye pain (trigeminal nerve involvement)
central retinal vein thrombosis = unilateral loss of vision

Question 2

describe the presentation of a lateral sinus thrombosis.

Answer 2

CN VI and VII palsies

trochlear and facial

Question 3

describe the presentation of a sagittal sinus thrombosis.

Answer 3

may present with seizures and hemiplegia

Question 4

what is a sign of venous sinus thrombosis on CT venogram ?

Answer 4

filling defect - empty delta sign

Question 5

what investigations would you carry out to identify a venous sinus thrombosis ?

Answer 5

contrast enhanced head CT

CT venogram

Question 6

what is the management for a venous sinus thrombosis ?

Answer 6

manage risk factors

LMWH i.e. dalteparin