TY - JOUR
T1 - Challenging presentations of cavernous sinus thrombophlebitis
AU - Kraus, Courtney L.
AU - Culican, Susan M.
PY - 2012/9
Y1 - 2012/9
N2 - Aim: The purpose of this study was to describe two challenging cases of septic cavernous sinus thrombosis (CST), which presented with vastly different clinical signs and symptoms. Methods: We present two cases of CST with markedly differing clinical presentations, medical comorbidities, and degree of impairment. Initial imaging of each patient failed to show thromboembolic disease. Results: Both patients required multiple imaging procedures to arrive at the correct diagnosis. Each child did respond to treatment once the correct diagnosis was made. Conclusion: CST can have a highly variable clinical presentation, from a subtle sixth nerve palsy to complete ophthalmoplegia and loss of periorbital sensation and corneal reflex. Onset of symptoms may be acute and fulminant or indolent and delayed. The diagnosis is challenging, requiring clinical suspicion and confirmation by imaging. These cases illustrate the importance of retaining clinical suspicion when cranial nerve palsies persist and how valuable rescanning a patient can be.
AB - Aim: The purpose of this study was to describe two challenging cases of septic cavernous sinus thrombosis (CST), which presented with vastly different clinical signs and symptoms. Methods: We present two cases of CST with markedly differing clinical presentations, medical comorbidities, and degree of impairment. Initial imaging of each patient failed to show thromboembolic disease. Results: Both patients required multiple imaging procedures to arrive at the correct diagnosis. Each child did respond to treatment once the correct diagnosis was made. Conclusion: CST can have a highly variable clinical presentation, from a subtle sixth nerve palsy to complete ophthalmoplegia and loss of periorbital sensation and corneal reflex. Onset of symptoms may be acute and fulminant or indolent and delayed. The diagnosis is challenging, requiring clinical suspicion and confirmation by imaging. These cases illustrate the importance of retaining clinical suspicion when cranial nerve palsies persist and how valuable rescanning a patient can be.
KW - Cavernous sinus thrombosis
KW - Cranial nerve palsies
KW - Imaging
KW - Septic thrombophlebitis
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U2 - 10.1007/s12348-011-0053-7
DO - 10.1007/s12348-011-0053-7
M3 - Article
C2 - 22139823
AN - SCOPUS:84879707721
SN - 1869-5760
VL - 2
SP - 133
EP - 136
JO - Journal of Ophthalmic Inflammation and Infection
JF - Journal of Ophthalmic Inflammation and Infection
IS - 3
ER -