Presentación bilateral de trombosis del seno cavernoso:  reporte de un caso

Clara Baserga; Sheila Diment; Caterina Marcoccia; Macarena Clementi; Santiago Vivante

doi:10.70313/2718.7446.v15.n04.196

Authors

Clara Baserga Servicio de Oftalmología, Hospital Central de San Isidro, Buenos Aires, Argentina
Sheila Diment Servicio de Oftalmología, Hospital Central de San Isidro, Buenos Aires, Argentina
Caterina Marcoccia Servicio de Clínica Médica, Hospital Central de San Isidro, Buenos Aires, Argentina
Macarena Clementi Servicio de Oftalmología, Hospital Central de San Isidro, Buenos Aires, Argentina
Santiago Vivante Servicio de Oftalmología, Hospital Central de San Isidro, Buenos Aires, Argentina

DOI:

https://doi.org/10.70313/2718.7446.v15.n04.196

Keywords:

cavernous sinus thrombosis, diplopia, neuro-ophthalmology, neuroimaging

Abstract

Purpose: To present a case of cavernous sinus thrombosis with bilateral manifestation, highlighting the role of ophthalmologists in a multidisciplinary team.

Case presentation: A 91-year-old female patient with a history of high blood pressure and non-anticoagulated atrial fibrillation consulted to the ER due to acute diplopia 20 days prior, which had abruptly evolved in the last two days to bilateral proptosis, chemosis and decreased visual acuity. In the clinical evaluation, the patient presented unreactive mydriasis and ophthalmoplegia in both eyes. A thrombosis of the left cavernous sinus was diagnosed through neuroimaging, so combined treatment with antibiotics (vancomycin and ceftazidime), anticoagulation, and intravenous corticosteroids was started. Finally, the patient evolved favorably, but with a great loss of visual acuity as a complication of the disease.

Conclusion: As has been observed in the present case, cavernous sinus thrombosis is a rare entity with a high risk of mortality, so the diagnosis must be made urgently to establish the necessary therapeutic measures, which require teamwork between ophthalmology, neurology, internal medicine, hematology and diagnostic imaging services.

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