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Warning-sign checks

Cavernous sinus thrombosis: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    New vision loss, confusion, seizure, fainting, weakness, severe breathing difficulty, or uncontrolled bleeding requires emergency care.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact the treating team promptly for a returning headache, fever, increasing eye swelling, new double vision, or medication concerns.

  3. 3

    Does any of this apply?

    Book an appointment

    After discharge, follow-up is usually arranged with the teams involved in treatment.

    Appointments may assess vision, eye movement, facial sensation, headaches, neurological recovery, and whether the original infection has cleared.

    People taking an anticoagulant need instructions about missed doses, interactions, planned dental or surgical procedures, and signs of abnormal bleeding.

    Some anticoagulants require blood tests, while others do not.

    They should not be stopped or changed without advice from the prescribing clinician.

The article also says

Repeat MRI, MRV, or CT venography may be used to check the clot and nearby structures.

The timing depends on the clinical course and will not be the same for everyone.

Testing for an underlying clotting disorder may be considered, especially when there was no clear infection or temporary trigger.

Some tests are affected by an active clot, pregnancy, severe illness, or anticoagulant treatment, so clinicians may delay them until results are more reliable.

Double vision or reduced eye movement may require continuing care from an eye specialist.

Temporary prisms, patching, rehabilitation, or later procedures may be considered depending on recovery.

Ongoing dental, sinus, or ear care may help address the original source.

Every sign above is quoted from the sofidex article on Cavernous sinus thrombosis. If you are not sure, err upward — it is always reasonable to be checked.