Suppurative intracranial thrombophlebitis

Suppurative intracranial thrombophlebitis

    * Introduction
    * Clinical
    * Diagnostic Laboratory
    * Treatment
Suppurative intracranial thrombophlebitis is characterized by the presence of venous thrombosis and suppurations inside the skull. This condition is the result of localized infection in sinuses or middle ear or mastoid level, oropharynx or facial skin. These infections can spread by direct or marrow and cause a suppurative thrombophlebitis within the vein or the intracranial venous sinuses. Other infectious processes can lead to intracranial vessels are trombozarea bacterial meningitis, subdural empyema or abscess epiduraln. It should be noted that this disease is quite rare and serious complication of these infectious processes, and it occurs in patients who imunotarati or congenital defects of the bones of the skull bone and allowing relatively direct communication with the interior skull skull sinuses. And rarely intracranial thrombophlebitis may occur after hematogenous dissemination of an infectious outbreak located away from the cephalic extremity, such as a chronic pulmonary infection or a kidney suppurative process.
Risk factors associated with suppurative intracranial thrombophlebitis: dehydration, pregnancy, oral contraceptive use, sickle cell anemia, polycythemia, cancer, trauma and generally states that increase blood viscosity and coagulability. Diseases that cause a high propensity for intracranial thrombophlebitis and cavernous sinus are particularly trombozarea maxillary sinusitis, frontal sinusitis, ethmoid or sphenoid, infections of the skin of the face or mouth. The most common is the maxillary sinus, it appeared as a result of an infectious process upper dental arch, following a respiratory illness, flu, or from medical maneuvers that the introduction of naso-gastric probe incompletely sterilized. Also, maxillary sinusitis and may develop after a septal deviation that obscure all or part of a nasal cavity. Because the maxillary sinus communicates through a small hole on the same side of the nasal cavity, filling it through an inflammatory process or lead to reduction or blockage of congenital sinus ventilation, with the possibility of developing germ sinus cavity. Maxillary sinus drainage hole in the nasal cavity is located higher floor away from the sinus secretions such as sinus drainage is incomplete. Because of proximity, frontal sinus and ethmoid cells quite rapidly become inflamed after maxillary sinusitis.
Etiologic agents most frequently involved in suppurative intracranial thrombosis are staphylococci, streptococci, aerobic or anaerobic, Gram-negative bacilli and anaerobic bacilli. Staphyloccusus aureus is the most common pathogen in patients with cavernous sinus thrombosis, and is found in most patients with this disorder. Less cavernous sinus thrombosis is caused by pneumococcus, streptococcus, Gram-negative bacteria or strains of Bacteroides. Usually, if after a trial sinusitis following dental infections, sinusitis germs are responsible for developing anaerobic. From here they can spread to the frontal sinus, sphenoidal and cavernous sinus to. Staphyloccusus aureus skin infections is met in the face. From the face Staphylococcus aureus can spread quite slowly, at about intracranial marrow or lymphatic, a situation more common in those cases imunotarate. Otitis media and otomastoidita can complicate the production of lateral sinus thrombosis in or sinus infections can cause upper and lower stony. Superior sagittal sinus thrombosis may occur from the release of the outbreaks of infectious germs located in the skin of the face, scalp, subdural space, epidural space. And bacterial meningitis can sometimes complicate the sagittal sinus thrombosis. At admission and initiation of empirical therapy must consider infectious outbreak that has caused intracranial thrombophlebitis, because the most likely infecting organism depends on the infectious process associated.