A Case of Bilateral Cavernous Sinus Thrombosis Secondary to Right Sphenoid Sinusitis.

Kang, Min Ho; Lee, Yoon Jung; Shin, Sun Young

Case Report

Journal of the Korean Ophthalmological Society 2004;45(7):1194-1199.
Published online July 1, 2004.

A Case of Bilateral Cavernous Sinus Thrombosis Secondary to Right Sphenoid Sinusitis.

Min Ho Kang, Yoon Jung Lee, Sun Young Shin

Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea. sunyoung1022@hanmail.net

우측 접형동염에 의한 양측 해면정맥동 혈전증 1예

강민호 ( Min Ho Kang ) , 이윤정 ( Yoon Jung Lee ) , 신선영 ( Sun Young Shin )

Abstract

PURPOSE
Cavernous sinus thrombosis (CST) is rare and fatal. We report a case of a 46-year-old female who had bilateral CST which spread from a right sphenoid sinusitis. METHODS: A 46-year-old female was medicated by high dose oral prednisolone for the right facial palsy. The next day she showed left eyelid ptosis, swelling and left oculomotor nerve palsy signs. 2 days later, the signs and symptoms were rapidly progressed to total ophthalmoplegia of both eyes. We evaluated the magnetic resonance image (MRI), cerebrospinal fluid (CSF), and blood culture findings. RESULTS: Brain MRI showed the right dominant both sphenoid sinusitis and bilateral CST. In the blood and CSF cultures, and the gram stains we found Staphylococcus aureus. Surgical drainage and antibiotic therapy were applied but the symptoms were not improved and she died of complications of subarachnoid hemorrhage. CONCLUSIONS: After high-dose oral steroid medication, CST occurred secondary to sphenoid sinusitis. We must be vigilant for CST as it is a rapidly progressing and fatal disease. and rule out other infection before using immunosuppressants.

Key Words: Cavernous sinus thrombosis;Immunosuppressants;Sphenoid sinusitis;Staphylococcus aureus