Introduction

Cavernous sinus thrombosis is a blood clot in the cavernous sinuses. It can belife-threatening .

The cavernous sinuses are hollow spaces located under the brain, behind each eye socket. A major blood vessel called the jugular vein carries blood through the cavernous sinuses awayfrom the brain.

A blood clot can develop when an infection in the face or skull spreads to the cavernous sinuses. The blood clot develops to prevent the infection spreading further, but it can restrict the blood flow from the brain, which can damage the brain, eyes andnerves running between them. Sometimes, clots can develop without infection.

Treatment will be started as soon as possible, even before tests have confirmed if a bacterial infection is responsible.

If tests later show that a bacterial infection didn't cause the condition, antibiotic treatment may be stopped.

Most people will require at least a three- to four-week course of antibiotics to ensure the infection has been fully cleared from their body. The antibiotics will be given through an intravenous drip directly connected to one of your veins.

Around 1 in 10 people will experience side effects when taking antibiotics. These are generally mild and can include diarrhoea, nausea and a skin rash.

Anticoagulants

In some cases, you may also be given a medication called heparin to help dissolve the clot and prevent further clots. Heparin is an Anticoagulant medicines , which means it makes the blood less sticky.

There are some uncertainties about using anticoagulants to treat cavernous sinus thrombosis, such as when they should be used and for how long. There's also a risk of provoking serious problems, such as excessive bleeding (haemorrhaging).

As cavernous sinus thrombosis is so rare, it's difficult to study, which means there's a lack of evidence regarding the use of anticoagulants to treat it. However, the small amount of research that does exist seems to suggest that anticoagulants can be an effective treatment for some people, and most doctors agree it should be used where appropriate.

Corticosteroids

You may also be given steroid medication ( corticosteroids ). Corticosteroids can reduce inflammation and swelling in your body.

As with anticoagulant therapy, there's little evidence concerning the effectiveness of corticosteroids in treating cavernous sinus thrombosis. Nonetheless, corticosteroids are thought to be beneficial for some people.

Surgical drainage

If the symptoms of cavernous sinus thrombosis were caused by an infection spreading from a boil or sinusitis, it may be necessary to drain away pus from that site. This can be done either using a needle or during surgery.

How long does treatment last?

Several weeks of antibiotic treatment are usually necessary to ensure the infection has cleared. However, it can take a long time to recover fully, and it may be several months before you're well enough to leave hospital.

Complications of cavernous sinus thrombosis

Cavernous sinus thrombosis is a very serious condition. Even with prompt treatment, as many asone inthree people with the condition may die.

Around 1 in10 people who survive will develop long-term health problems due to damage to their brain, such as persistent headaches and fits, orsome degree of vision loss .

This may be because pregnancy and taking the oral contraceptive pill can make women more vulnerable to blood clots.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 28 Nov 2016