| Autor: |
Li CR; Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung 40201, Taiwan., Chen PH; Department of Neurosurgery, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 40201, Taiwan., Chen SY; Department of Neurosurgery, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 40201, Taiwan., Yang TH; Department of Neurosurgery, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 40201, Taiwan., Chang CS; Department of Neurosurgery, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 40201, Taiwan., Shen CY; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung 40201, Taiwan., Chan FH; Department of Neurosurgery, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 40201, Taiwan. |
| Abstrakt: |
We describe a rare and complex case of septic cavernous sinus thrombosis (SCST) in a 70-year-old patient who initially presented with ocular symptoms that rapidly progressed to severe intracranial vascular complications, including subarachnoid hemorrhage (SAH). Despite the use of broad-spectrum antibiotics and anticoagulants, the patient's condition deteriorated. SCST, often caused by sinus infections, presents a significant diagnostic and therapeutic dilemma, with mortality rates exceeding 20%. This report underscores the diversity of clinical presentations, ranging from mild headaches to severe cranial nerve deficits, that complicate diagnosis and treatment. The inability to detect any aneurysms in our patient using magnetic resonance imaging (MRI) and computed tomography angiography (CTA) may indicate an alternative pathogenesis. This could involve venous hypertension and endothelial hyperpermeability. This case illustrates the need for personalized treatment approaches, as recommended by the European Federation of Neurological Societies, and the importance of a multidisciplinary perspective when managing such intricate neurological conditions. Our findings contribute to the understanding of SCST coexisting with SAH. |
