Cavernous Sinus thrombosis

both CT scan are 2 different cuts in the same person who is suffering from left sided cavernous sinus thrombosis as demonstrated by the thick arrow at slide (B) and as a result there's markedly congested and thrombosed left ophthalmic vein as demonstated in slide (A), notice also the proptosis in the left eye and subsequently expected associated papilledema

- Usually cavernous sinus thrombosis is a SEPTIC thrombosis that occurs due hematogenous spread of severe infections of nearby head structures that drain into the cavernous sinus, as in severe chronic bacterial sinusitis, or in meningitis.

- Cavernous sinus thrombosis is associated with increased intracranial pressure, cerebral edema, manifested by papilledema, sometimes proptosis, bradycardia and hypertension. (Cushing's triad)

-The best INITIAL step is to perform a head CT scan, although corticosteroids administration is mandatory and highly beneficial in that conditions, CT scan should be performed first to establish the diagnosis.

- Other causes of increased intracranial pressure include subdural hematoma, or extradural hematoma, but you have to consider Cavernous sinus thrombosis if there's no history of recent trauma or a positive history of sinusitis  or head infection,

- never perform a lumbar puncture even if meningitis is suspected.