Cavernous Sinus Thrombosis; a rare complication of acute sinusitis

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Cavernous Sinus Thrombosis; A rare complication of acute sinusitis

Cashman EC, Fennessy B, Kinsella J.

Dept Otolaryngology H&N Surgery, Tallaght Hospital


Cavernous sinus thrombosis has a high mortality. With the advent of antibiotics it is a rare complication of acute sinusitis. Sturge Weber syndrome (SWS) is thought to predispose to CST.


A 28 year old presented with acute sinusitis associated with retro-orbital pain, chemosis and VI palsy. His medical history included SWS. CT & MRV demonstrated opacification of maxillary and ethmoid sinuses with thrombosis of the superior and inferior veins. He underwent sinus surgery and commenced on warfarin. He developed recurrent epistaxis, was changed to LMWH and epistaxis resolved.


Sinusitis in the setting of SWS may predispose to CST. Urgent imaging is indicated if orbital symptoms are present. Changing warfarin to LMWH may resolve epistaxis.

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