Cavernous sinusitis

Cavernous sinus embolism refers to cavernous sinus embolism. Cavernous sinus embolism is often more serious than we think, and corresponding treatment measures need to be taken in time. It is often accompanied by dizziness and vomiting. Don't underestimate these symptoms. If you don't take them seriously and don't deal with them in time, it may be a phenomenon of death. Let's talk about acute cavernous sinus embolism.

Acute cavernous sinus thrombotic phlebitis is a severe suppurative inflammation of the cavernous sinus. If not treated in time, the mortality rate is very high. The main route of infection is that purulent emboli from purulent infection in adjacent parts are drained into the cavernous sinus through the blood flow, such as facial eyelid swelling, blepharitis, goiter, erysipelas, cellulitis, sinusitis, tonsillitis, etc., which mainly enter the cavernous sinus through the facial vein, superior ophthalmic vein, and inferior ophthalmic vein; throat infection enters the cavernous sinus through the pterygoid vein cluster; purulent inflammation of the middle ear mastoid enters the cavernous sinus through the petrous sinus; another route of infection is direct spread from adjacent parts to the cavernous sinus, such as sphenoid sinusitis. Spread from distant purulent lesions to the cavernous sinus is rare.

Department: Otorhinolaryngology and Head and Neck Surgery

Common causes: Staphylococcus aureus, hemolytic streptococci, pneumococcal infections, etc.

Common symptoms: acute onset, sudden high fever, headache, vomiting, drowsiness and even coma

Cause: This disease is caused by purulent bacterial infection. The most common pathogens are Staphylococcus aureus, hemolytic Streptococcus, Streptococcus pneumoniae, etc.

Clinical manifestations

Patients often have a history of acute infection. The disease is acute, with sudden high fever, headache, vomiting, drowsiness and even coma. Mild pain and edema in the pharynx and the upper part of the orbit may touch the dilated and solid superior ophthalmic vein. The blood vessels on the surface of the eyeball are spirally dilated, and the blood vessels are arranged radially with the cornea as the center. Most of them start from the edge of the cornea and disappear in the dome, similar to the carotid artery-cavernous sinus fistula. Eye movement is slightly restricted, vision may be reduced, and the fundus veins are dilated, which is caused by reflux obstruction.

Check

1. Routine blood test

Check for infectious diseases.

2. Ultrasound examination

B-mode ultrasound exploration shows tubular dilation of the superior ophthalmic vein, with little or no internal echo, no pulsation, and compression of the eyeball. This tubular echo-free band cannot be closed. D-mode ultrasound exploration shows no colored blood flow filling the lumen, and no vascular spectrum appears except for organized blood clots in the lumen. These are also different from carotid artery-cavernous sinus fistula.

3. CT examination

CT scans show dilation, curvature, increased density of the superior ocular vein, and slight widening of the extraocular muscles. CT scans show enlargement of the spongiosum sinus on one or both sides, high density of the soft tissue in the orbit, hypertrophy of the extraocular muscles, and protrusion of the eyeball.

Diagnosis

The clinical diagnosis of this disease is relatively difficult, but B-ultrasound and CT examinations can provide a clear diagnosis.