Cavernous Sinus Thrombophlebitis: Case Report and Literature Review.
- Author:
Min Hyuk LEE
1
;
Yoon Soo LEE
;
Jeong Ho LEE
;
Kee Young RYU
;
Dong Gee KANG
Author Information
1. Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea. myiki@msn.com
- Publication Type:Case Report
- Keywords:
Cavernous sinus;
Cavernous sinus thrombophlebitis;
Cavernous sinus thrombosis;
Exophthalmos
- MeSH:
Abducens Nerve Diseases;
Aged;
Anti-Bacterial Agents;
Brain;
Cavernous Sinus;
Cavernous Sinus Thrombosis;
Caves;
Conjunctiva;
Cranial Nerve Diseases;
Cranial Nerves;
Early Diagnosis;
Ecchymosis;
Edema;
Exophthalmos;
Eyelids;
Female;
Headache;
Humans;
Magnetic Resonance Imaging;
Paralysis;
Steroids;
Tolosa-Hunt Syndrome
- From:Korean Journal of Cerebrovascular Surgery
2010;12(3):131-135
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cavernous sinus thrombophlebitis is characterized by edema of the eyelids and the conjunctivae, and paralysis of the cranial nerves. It is rare, often misdiagnosed or underestimated by neurosurgeons, and is generally related with high rates of mortality and morbidity. High rate of suspicion is required for early diagnosis, and aggressive managements can lead to better outcomes. With recent advancements in antibiotic therapies, the mortality rate has been decreased to less than 30%. However, the morbidity remains high and complete recovery is rare. A 69-year-old woman presented with headache and right ocular pain with sixth cranial nerve palsy for one week. Under the suspicion of Tolosa-Hunt syndrome, steroid treatment was done. On discharge, there was improvement in right ocular pain, but the cranial nerve palsy remained. Subsequently, the patient returned with left ocular pain, lid swelling, redness, ecchymosis of conjunctiva, and ptosis. Enhanced brain magnetic resonance imaging revealed an asymmetrically enlarged left cavernous sinus with heterogeneously enhancing contour. Intravenous antibiotics and oral steroids along with anticoagulant medications were administered.
