IN THE prechemotherapeutic era thrombosis of a cavernous sinus was a condition with an extremely grave prognosis. Whether septic or aseptic, thrombosis of a cavernous sinus carried with it a high mortality. Therapy was mainly expectant and palliative. The clinical course of the disease has been well described by Lyle1:
Early symptoms on the part of the eye are caused by interference with the venous drainage from the eye and orbit. There is discoloration and swelling of the lids with exophthalmos. The conjunctiva is congested. The orbit shows increasing edema with gradual immobilization of the eyes, both from orbital swelling and involvement of the third, fourth and sixth nerves in the sinus. Ophthalmoscopic examination shows an initial edema of the retina with dilated veins. Papilledema is not uncommon. Retinal hemorrhages are occasionally present. As the condition progresses, the media becomes hazy so that the fundus cannot be seen. Pain
GANS ME, GANS JA. UNILATERAL THROMBOSIS OF A CAVERNOUS SINUS TREATED WITH PENICILLIN AND SULFADIAZINE: Report of a Case with Follow-Up Study. Arch Ophthalmol. 1949;42(6):801–807. doi:10.1001/archopht.1949.00900050812008
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