Symptoms of Cavernous Sinus Thrombosis
Symptoms of cavernous sinus thrombosis often appear suddenly and progress rapidly, making it essential to act quickly. The classic presentation of CST includes symptoms related to eye function, facial swelling, and systemic infection. However, the exact symptoms can vary depending on the speed and severity of the clot development.
1. Eye-Related Symptoms
One of the first and most striking symptoms is swelling around one or both eyes, known as periorbital oedema. As the condition progresses, the eyes may become bulging (proptosis) due to pressure behind the eye socket. Patients may also develop painful or restricted eye movements, blurred or double vision, and in severe cases, vision loss.
2. Cranial Nerve Involvement | Symptoms of Cavernous Sinus Thrombosis
The cavernous sinus is home to several cranial nerves — including the third (oculomotor), fourth (trochlear), and sixth (abducens) nerves — that control eye movement. If these nerves are affected, patients may develop:
- Double vision (diplopia)
- Drooping eyelids (ptosis)
- Inability to move the eyes properly
The fifth cranial nerve (trigeminal) may also be involved, causing facial numbness or pain, particularly around the cheeks and forehead.
3. Headache and Fever
A sudden, severe headache is a hallmark symptom. This is typically constant and located behind the eyes or forehead. The headache may be accompanied by high fever, chills, and general signs of infection, including malaise and fatigue.
4. Neurological Symptoms
As the condition worsens, patients may become confused, drowsy, or even unconscious due to brain swelling, increased intracranial pressure, or complications like meningitis or brain abscesses.
5. Bilateral Progression | Symptoms of Cavernous Sinus Thrombosis
Although symptoms may begin on one side of the face or head, they frequently become bilateral due to the interconnected nature of the cavernous sinuses. This is a key distinguishing feature from other conditions like orbital cellulitis, which typically remains one-sided.
Recognising the symptoms of cavernous sinus thrombosis early can save lives. Anyone experiencing eye pain, swelling, fever, and difficulty moving their eyes — particularly after a recent facial or sinus infection — should seek emergency medical care without delay.
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