emDOCs.net Emergency Medicine (EM) Podcast Episode 117: Cavernous Sinus Thrombosis
Apr 1, 2025
Discover the critical insights into cavernous sinus thrombosis, a serious condition stemming from facial infections. The discussion highlights risk factors and complications, emphasizing the urgency of accurate diagnosis and treatment. Learn about the pivotal role of anticoagulation in improving outcomes, the use of steroids, and the essential diagnostic imaging required in emergencies. This engaging conversation covers everything you need to understand about managing this life-threatening condition.
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CST Basics and Severity
- Cavernous sinus thrombosis (CST) is a rare but serious thrombophlebitic disease mostly caused by local infections like sinusitis.
- Its complex anatomy and proximity to critical nerves explain the severe neurological complications and mortality risks.
CST Causes and Infectious Agents
- Up to 80% of cavernous sinus thrombosis cases are septic, usually from sinus infections mainly in ethmoid or sphenoid sinuses.
- Bacteria like Staphylococcus aureus cause the majority, while fungi and viruses are rarer causes in immunocompromised patients.
Pathophysiology of CST
- The cavernous sinuses lack valves allowing bidirectional spread for infection and thrombi, worsening disease progression.
- Thrombus formation leads to impaired venous drainage causing increased pressure, inflammation, and cranial nerve complications.