Cavernous sinus thrombosis
Presentation:
23 year old girl with 2 hour history of blurred vision.
Case Discussion:
Non-contrast CT demonstrates dense, distended bilateral superior ophthalmic veins. While there is some periorbital swelling, much more prominent swelling is seen within the left masticator space.
CT venogram demonstrates non-enhancement of the cavernous sinuses, left transverse sinus and left internal jugular vein.
Arterial phase CT of the neck demontrates marked oedema within the deep tissues of the left side of the face and neck, with displacement and narrowing of the upper airway.
Findings are chiefly those of cavernous sinus thrombosis secondary to ascending deep facial infection. Staph aureus was isolated as the causative organism.
Extra clinical information
This patient had squeezed a pimple near her left nasolabial fold 3 days prior. Within an hour of presenting to the emergency department the patient had progressed from having slightly blurred vision to complete blindness and upper airway compromise. Unfortunately she died due complications of her infection.
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