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Cavernous sinus thrombosis (CST) is the formation of a blood clot within the cavernous sinus, a cavity at the base of the brain which drains deoxygenated blood from the brain back to the heart. This is a rare disorder and can be of two types–septic cavernous thrombosis and aseptic cavernous thrombosis. [1]
As a venous sinus, the cavernous sinus receives blood from the superior and inferior ophthalmic veins and from superficial cortical veins, and is connected to the basilar plexus of veins posteriorly. The cavernous sinus drains by two larger channels, the superior and inferior petrosal sinuses, ultimately into the internal jugular vein via the ...
Treatment based on the idea of CCSVI is considered experimental. [6] Balloon dilatation of stenosed jugular vein in a MS patient. Stenosis prevents the balloon from inflating (in the middle) while pressure is low. Further trials are required to determine if the benefits, if any, of the procedure outweigh its risks. [22]
Dural venous sinuses bordered by hard meninges (shown in blue) direct blood outflow from cerebral veins to the internal jugular vein at the base of skull. The veins of the brain, both the superficial veins and the deep venous system, empty into the dural venous sinuses, which carry blood back to the jugular vein and thence to the heart. In ...
The walls of the dural venous sinuses are composed of dura mater lined with endothelium, a specialized layer of flattened cells found in blood and lymph vessels.They differ from other blood vessels in that they lack a full set of vessel layers (e.g. tunica media) characteristic of arteries and veins.
The superficial middle cerebral vein (superficial Sylvian vein) begins on the lateral surface of the hemisphere. It runs along the lateral sulcus [1] to empty into either the cavernous sinus, [1] [2] or sphenoparietal sinus. [1] It is adherent to the deep surface of the arachnoid mater bridging the lateral sulcus. It drains the adjacent cortex. [2]
Patients are seen with a cyanotic discoloration of the shoulder skin and neck and face, jugular distention, bulging of the eyeballs, and swelling of the tongue and lips. The latter two are resultants of edema, caused by excessive blood accumulating in the veins of the head and neck and venous stasis.
The traditional treatment for thrombosis is the same as for a lower extremity DVT, and involves systemic anticoagulation to prevent a pulmonary embolus. [10] Some have also recommended thrombolysis with catheter directed alteplase or mechanical thrombectomy with a large bore catheter and manual aspiration providing definitive intervention with an endovascular approach. [11]
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