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Superior ophthalmic vein thrombosis

Case contributed by Craig Hacking
Diagnosis certain

Presentation

2-day history of fall with a long lie. Possible head strike, left-sided weakness. Exclude intracranial hemorrhage.

Patient Data

Age: 70 years
Gender: Male

No intra or extra-axial hemorrhage. No space occupying lesion, mass effect or midline shift evident. Prominence of the ventricles and CSF spaces indicating a degree of cerebral involution. Grey-white matter differentiation is maintained.

The left superior ophthalmic vein is dilated and hyperdense. The cavernous sinus is not hyperdense. Otherwise unremarkable appearance of the globes and orbits.

The imaged paranasal sinuses and mastoid air cells are clear. Mild soft tissue swelling within the left periorbital region and frontal scalp. No skull fracture.

Case Discussion

The presumed cause for this incidental finding of SOV thrombosis was due to dehydration from the 48 hours of lying on the floor. Follow up neuroimaging (following more falls) showed resolution of the thrombosis.

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