Cavernous Sinus Thrombosis Secondary to Pansinusitis in a Healthy Young Male: A Rare and Vision-Threatening Orbital Complication
Author: Jia Xuan Tan
Base Hospital / Institution: Diana Princess of Wales Hospital
ePoster presentation
Abstract ID: 25-189
Purpose
To highlight the diagnostic and therapeutic challenges of cavernous sinus thrombosis (CST) presenting with orbital signs in a healthy young male, secondary to pansinusitis
Methods
We present a case of a 20-year-old male who presented with acute headache, neck stiffness, photophobia, and right periorbital swelling. Initial CT and CSF findings were inconclusive. Progressive orbital signs prompted urgent MRI, which confirmed CST and superior ophthalmic vein thrombosis. A multidisciplinary team involving ophthalmology, ENT, neurology, and microbiology was involved early.
Results
MRI revealed right cavernous sinus and superior ophthalmic vein thrombosis with extensive pansinusitis. Urgent functional endoscopic sinus surgery (FESS) was performed. The patient was commenced on broad-spectrum intravenous antibiotics and anticoagulation. His clinical condition improved gradually with full resolution of orbital symptoms.
Conclusion
CST is a rare but potentially fatal condition requiring a high index of suspicion, especially when early imaging is non-diagnostic. Orbital signs may be the first clinical indicator of underlying intracranial pathology. Early multidisciplinary intervention and timely surgical and medical treatment were crucial to this patient’s favourable outcome.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Naw Eh Ler Pwe | Diana Princess of Wales Hospital |
