Treatment

• Prior to the advent of antibiotics and antimicrobials, the mortality rate for cavernous sinus syndrome was 100 percent. With these treatments available, this relatively rare condition's mortality rate is approximately 30 percent. The primary treatment is aggressive antibiotic treatment. Until cultures come back confirming the bacteria, broad spectrum antibiotics for gram positive, gram negative and anaerobic organisms (especially if a dental infection is suspected) should be implemented. This should include penicillinase-resistant penicillin as well as cephalosporin (third or fourth generation). For three to four weeks, IV antibiotics should be administered. Anticoagulation therapy in order to reduce clot incidence as well as septic emboli have retrospectively been shown to decrease mortality. However, since incidence of the syndrome is rare, there is controversy as there are few trial results. After antibiotic therapy, the administration of corticosteroids will reduce inflammation and edema. In the event that the syndrome has led to pituitary insufficiency, corticosteroids are necessary to prevent adrenal crisis. Surgery in general is not effective, however, draining the sinuses of the initial infection may prove helpful.