The Ophthalmology Unit, Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, SarawakGeneralHospital,
Kuching, Sarawak, East Malaysia.
a
a
Cavernous sinus
thrombosis
Photo by Dr. Tan Aik Kah
A 15 year-old girl was
bitten by an unknown insect to her right forehead. The site became infected
and she pinched and tried to express the small abscess. Two days later she
developed a sudden right complete ptosis. Examination revealed poor ocular
motility involving mainly the muscles supplied by the oculomotor nerve. An
urgent MRI scan with contrast revealed filling defect in the right cavernous
sinus which was hyperintense on T1 view and hypointense on T2 view
suggestive of subacute thrombosis which displaced the internal carotid
artery laterally. The area was enhanced heterogeneously following
intravenous gadolinium. She was started on intravenous antibiotics and
heparin.
Right ptosis and inflammed right
upper eyelid.
Limitation of the right ocular
movement especially on adduction, up and downgaze.
Filling defect in the right
cavernous sinus.
Heterogenous enhancement of the
right cavernous sinus following gadolinium injection.
