CT brain angiogram demonstrates abnormal early enhancement in both cavernous sinuses, similar to arterial enhancement in the internal carotid arteries and exceeding enhancement in the transverse sinuses.
Enhancement extends into the superior and inferior ophthalmic veins bilaterally, which are mildly engorged. In the right superior ophthalmic vein, there is an abrupt cut-off of enhancement in the posterior orbit with the corresponding vessel being hyperdense on the non-contrast series, suggesting a thrombus.
Non-contrast CT brain is otherwise normal. No intracranial hemorrhage, retrobulbar fat stranding or enlargement of the extraocular muscles.