Recurrent cavernous sinus thrombosis: a rare complication of Cushing disease

2021 ◽  
Vol 14 (6) ◽  
pp. e243786
Author(s):  
Chin Voon Tong ◽  
Chee Kit Tee
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Pituitary Tumour ◽  
Somatostatin Analogue ◽  
Pituitary Macroadenoma ◽  
Cavernous Sinus Thrombosis ◽  
Pituitary Mass ◽  
Cushing Disease

A 14-year-old girl who presented in 2017 with headache, unilateral right eye ptosis and secondary amenorrhoea had an initial workup consistent with non-functioning pituitary macroadenoma. She underwent debulking of pituitary tumour in October 2017. Postoperatively, she developed recurrent cavernous sinus thrombosis. In view of recurrent thrombosis, she was reinvestigated and was found to have adrenocorticotropic hormone-dependent Cushing. Follow-up MRI 1 year after initial presentation showed that there was structural recurrence of pituitary macroadenoma. She subsequently underwent a petrosal craniotomy for debulking of tumour. Postsurgery she remained biochemically Cushingnoid. MRI 5 months after second surgery showed an enlarging pituitary mass which was deemed inoperable. A multidisciplinary meeting discussion consensus for treatment included radiotherapy and somatostatin analogue, pasireotide. She completed 30 cycles of radiotherapy and MRI post radiotherapy showed reduction in the size of the macroadenoma. Currently, she is waiting for pasereotide initiation.

scholarly journals Case Report: Petrous Apicitis and Otogenic Thrombosis of the Cavernous Sinus in a 10-Year-Old Boy

2021 ◽  
Vol 8 ◽  
Author(s):  
Patrick Bergsma ◽  
Seraina Kunz ◽  
Anna-Lena Kienle ◽  
Yves Brand
Keyword(s):  
Otitis Media ◽  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Acute Otitis Media ◽  
Petrous Apex ◽  
Cavernous Sinus Thrombosis ◽  
Petrous Apicitis ◽  
Air Cells ◽  
Ct And Mri

Background: Petrous apicitis and cavernous sinus thrombosis are exceedingly rare complications of acute otitis media with only few reported cases in the post-antibiotic era. Especially in children, the appropriate management is a subject of controversy.Case Presentation: We report the case of a 10-year-old boy who presented to the emergency department with left-sided otalgia, otorrhea, and hearing loss, accompanied by somnolence and high spiking fevers. CT and MRI revealed partially obstructed mastoid air cells including a pneumatized petrous apex. Furthermore, thrombosis of the cavernous sinus and vasculitis of the internal carotid artery on the left side were present. The patient was treated with antibiotics for 6 weeks and anticoagulant therapy for 3 months. Follow-up carried out 3 months post-admission showed complete recanalization of the cavernous sinus on MRI and fatigue as the only remaining symptom.Conclusion: A complicated otitis media with petrous apicitis and cavernous sinus thrombosis in a child can in some cases be managed without a surgical intervention.

Diagnostic difficulties in a patient with multiple sclerosis who presents with cranial nerve palsies: an unusual complication of dental work

2020 ◽  
Vol 13 (10) ◽  
pp. e232903
Author(s):  
Jennifer Cathcart ◽  
Rebecca Caitlin Johnson ◽  
Nicholas Hughes ◽  
Manish Patel
Keyword(s):  
Multiple Sclerosis ◽  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Unusual Complication ◽  
Cavernous Sinus Thrombosis ◽  
Dental Abscess ◽  
First Case ◽  
Cranial Nerve Palsies ◽  
Diagnostic Difficulties

A woman in her 60s with multiple sclerosis (MS) presented with right-sided ptosis, right sixth nerve palsy, right facial paraesthesia and signs of sepsis. She had a recent diagnosis of a dental abscess. Investigations revealed a right submasseter abscess leading to bacterial meningitis (Streptococcus intermedius) and a cavernous sinus thrombosis. She was managed in intensive care and underwent surgical drainage of the abscess. Anticoagulation for 6 months was planned. Cavernous sinus thrombosis is a very rare complication of a dental abscess, and even less frequently associated with submasseter abscesses. The case was complicated by a history of MS, to which the patient’s symptoms and signs were initially attributed to. This case highlights the diagnostic pitfalls, and aims to enhance learning around similar cases. To the best of our knowledge, this is the first case report of a masseter/submasseter abscess leading to cavernous sinus thrombosis.

scholarly journals Post-traumatic carotid-cavernous fistula with bilateral proptosis simulating cavernous sinus thrombosis

2019 ◽  
Vol 12 (3) ◽  
pp. e227757 ◽  
Author(s):  
Nirupama Kasturi ◽  
Pooja Kumari ◽  
Gayatri Nagarajan ◽  
Nagarajan Krishnan
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Cavernous Sinus Thrombosis ◽  
Coil Embolisation ◽  
Carotid Cavernous Fistula ◽  
Orbital Trauma ◽  
Cavernous Fistula ◽  
Intravenous Antibiotics ◽  
Post Traumatic

A 48-year-old woman presented with bilateral non-pulsatile proptosis and ophthalmoplegia after 3 days following blunt orbital trauma. It was associated with fever, malaise and loss of vision in right eye. She was provisionally diagnosed with cavernous sinus thrombosis and was treated with intravenous antibiotics with no improvement. A subtle bruit was present on examination, and digital subtraction angiography revealed a right direct (type A) carotid-cavernous fistula (CCF). The patient underwent right coil embolisation of direct CCF. On follow-up at 4 months, her proptosis resolved completely and extraocular movements improved.

scholarly journals Horner Syndrome as Complication of Acute Sphenoid Sinusitis

2019 ◽  
Vol 11 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Christoph Käcker ◽  
Franca Wagner ◽  
Marco Caversaccio ◽  
Lukas Anschuetz
Keyword(s):  
Case Report ◽  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Cavernous Sinus Thrombosis ◽  
Horner Syndrome ◽  
Sphenoid Sinusitis

Horner syndrome is described in this case report as a rare complication of bacterial sphenoid sinusitis. A patient presented with miosis, ptosis, and ophthalmic nerve palsy with acute sphenoid sinusistis and cavernous sinus thrombosis on MRI. The impairment of sympathetic fiberscan can be explained through the direct septic effects of the sphenoid sinusitis and indirectly through thrombosis of the cavernous sinus at the level of the carotid plexus.

scholarly journals Transient pituitary enlargement with central hypogonadism secondary to bilateral cavernous sinus thrombosis: pituitary oedema?

2009 ◽  
Vol 160 (5) ◽  
pp. 873-875 ◽  
Author(s):  
Michael Joubert ◽  
Renaud Verdon ◽  
Yves Reznik
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Imaging Features ◽  
Cavernous Sinus Thrombosis ◽  
Resonance Imaging ◽  
Pituitary Mass ◽  
Pituitary Enlargement ◽  
Pituitary Lesion

DesignWe report the case of an incidental pituitary mass discovered in the context of bilateral cavernous sinus thrombosis due to a bacterial pansinusitis.ConclusionsMagnetic resonance imaging features of the pituitary lesion, together with transient central hypogonadism and total regression of the mass after anticoagulation and antimicrobial therapy, suggest that this lesion is a pituitary oedema of vascular mechanism. Other possible causes of pituitary mass in such a situation are also discussed.

scholarly journals Cavernous sinus thrombosis after follow-up cerebral angiography

2020 ◽  
Vol 5 (6) ◽  
pp. e097
Author(s):  
Isabel Taveira ◽  
Daniela Ferro ◽  
João Tavares Ferreira ◽  
João Pedro Filipe ◽  
Rita Figueiredo ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Cerebral Angiography ◽  
Sinus Thrombosis ◽  
Cavernous Sinus Thrombosis
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