The EM Educator Series: Cavernous Sinus Thrombosis

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case 1:

A 35-year-old female with a recent diagnosis of sinusitis presents with worsening headache, eye pain, nausea, and double vision for 3 days. Her symptoms started with facial pain and nasal congestion approximately 1 week ago. She has a history of diabetes type II on metformin. Exam reveals BP 118/55, HR 108, RR 17, T 37.2 C. Exam reveals difficulty looking laterally with the left eye. Her visual acuity is normal, and her strength and sensation are also normal.



  • What are the pertinent features of the cavernous sinus anatomy?
  • What are risk factors for cavernous sinus thrombosis?
  • What are the various ways cavernous sinus thrombosis can present?
  • What is the ED work-up for cavernous sinus thrombosis?
  • What is the ED management of cavernous sinus thrombosis?


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