Septic cavernous sinus thrombophlebitis with formation of pseudoaneurysm in a 7-year-old child
DOI:
https://doi.org/10.33448/rsd-v10i3.13443Keywords:
Cavernoussinus; Intracranial sinus thrombosis; Orbital cellulitis; Meningitis.Abstract
Septic cavernous sinus thrombosis is a rare complication of infections involving paranasal sinuses and can lead to carotid cavernous aneurysm formation. Thus, the objective of this study was to describe the clinical case of a patient with internal carotid artery mycotic pseudoaneurysm secondary to a case of sphenoid sinusitis that evolved into a cavernous sinus syndrome. A seven-year-old female patient with a recent history of sphenoid sinusitis, showed signs of meningeal irritation, mental confusion and severe fever. Brain magnetic resonance imaging showed areas suggestive of acute infarctions secondary to vasculitis due to meningitis and thrombophlebitis of the left cavernous sinus, with the formation of an internal carotid artery pseudoaneurysm. The patient evolved with ptosis and complete paralysis of the left eye, associated with unilateral periorbital edema on the left, with visual turbidity. After antibiotic therapy for approximately five weeks, an endovascular procedure was performed, with a good clinical outcome. Therefore, this study highlights the importance of a high diagnostic suspicion to institute early treatment and increase survival, avoiding infant morbidity and mortality.
References
Allen, L. M., Fowler, A. M., Walker, C., Derdeyn, C. P., Nguyen, B. V., Hasso, A. N., et al. (2013). Retrospective review of cerebral mycotic aneurysms in 26 patients: focus on treatment in strongly immunocompromised patients with a brief literature review. AJNR Am J Neuroradiol, 34, .823-827. https://doi.org/10.3174/ajnr.A3302
Cantón,-De-Seoane, J., et al. (2020). Síndrome de Tolosa-Hunt: una causa infrecuente de oftalmoplejía. Rev Esp Casos Clin Med Intern (RECCMI). 5(3), .120-122. https://doi.org/10.32818/reccmi.a5n3a7
Costa, A. I., Lima, A., Azevedo, C., Quintas-Neves, M., Rodrigues, B., & Dias, L. (2019). Pseudotumor inflamatório do seio cavernoso, síndrome de Tolosa-Hunt e paralisia facial: Qual é a relação? Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, 57(2), 63-68. https://doi.org/10.34631/sporl.784
Dutta, M., & Ghatak, S. (2013). Acute exacerbation of chronic rhinosinusitis (AECRS) with orbital complications in an atrophic rhinitis patient: a mere co-incidence? J ClinDiagn Res, 7(12), .2973. https://doi.org/10.7860/JCDR/2013/6461.3814
Geng, B., et al. (2020). Septic cavernous sinus thrombosis—Case series and review of the literature. Clinical Neurology And Neurosurgery, 197, .106092. http://dx.doi.org/10.1016/j.clineuro.2020.106092.
Henderson, A. D., & Miller, N. R. (2017). Carotid-cavernous fistula: current concepts in aetiology, investigation, and management. Eye, 32(2), .164-172. http://dx.doi.org/10.1038/eye.2017.240.
Idiculla, P. S, et al. (2020). Cerebral Venous Thrombosis: a comprehensive review. European Neurology. 83 (4), .369-379. https://doi.org/10.1159/000509802
Komatsu, H. et al. (2013). Cavernous sinus thrombosis caused by contralateral sphenoid sinusitis: a case report. Head & Face Medicine, 9(1), .1-5. http://dx.doi.org/10.1186/1746-160x-9-9.
Kuybu, O., & Dossani, R. H. (2020). CavernousSinusSyndromes. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK532976/
Maia, L. P., et al. (2018). Trombose de seio cavernoso e aneurisma micótico como complicações de rinossinusite aguda. Arquivos de Asma, Alergia e Imunologia, 2(2), .290-294. http://aaai-asbai.org.br/detalhe_artigo.asp?id=882
Martel, A. (2017). Septic thrombosis of cavernous sinus extended to the ipsilateral internal jugular vein and transversal sinus with favorable outcome: clinical and radiological features of a lemierre syndrome. Orbit, 37(2), .94-96. https://doi.org/10.1080/01676830.2017.1383458
Morita, K., Sorimachi, T., Ito, Y., Nishino, K., Jimbo, Y., Kumagai, T., & Fujii, Y. (2011). Intra-aneurysmal coil embolization for large or giant carotid artery aneurysms in the cavernous sinus. Neurol Med Chir (Tokyo), 51(11) .762-766. http://dx.doi.org/10.2176/nmc.51.762.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. UFSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.
Pierot, L., Portefaix, C., Rodriguez-Régent, C., Gallas, S., Meder, J. F., & Oenheim, C. (2013). Role of MRA in the detection of intracranial aneurysm in the acute phase of subarachnoid hemorrhage. J Neuroradiol, 40(3) 204-10. http://dx.doi.org/10.1016/j.neurad.2013.03.004.
Plewa, M. C., et al. (2020). Cavernous Sinus Thrombosis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK448177/
Ponte, F., et al. (2006). Aneurisma gigante do segmento intracavernoso da carótida interna associado a doença renal policística autossômica dominante: relato de caso. Arquivos de Neuro-Psiquiatria, 64 (3), 881-884. http://dx.doi.org/10.1590/S0004-282X2006000500034
Teixeira, A. B., et al. (2018). Bacterialmeningitis: anupdate. Revista Brasileira de Análises Clínicas, 50(4), 327-9. http://dx.doi.org/10.21877/2448-3877.201800725.
Van Rooij, W. J. (2012). Endovascular treatment of cavernous sinus aneurysms. AJNR Am J Neuroradiol, 33(2), 323-326. http://dx.doi.org/10.3174/ajnr.a2759.
Weerasinghe, D., & Lueck, C. J. (2016). Septic Cavernous Sinus Thrombosis: case report and review of the literature. Neuro-Ophthalmology, 40(6), .263-276. http://dx.doi.org/10.1080/01658107.2016.1230138.
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Copyright (c) 2021 Júlia Vieira Ferreira Côrtes; Larissa Terra Freire; Sabrina Silva Rodrigues de Oliveira; Gérsika Bitencourt Santos; Débora Mônica Costa Vieira; Renato Ortolani Marcondes de Castro
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