Cavernous sinus thrombophlebitis: case report.

Abstract

Cavernous sinus thrombophlebitis is a rare, dangerous, and historically difficult condition to diagnose and treat. Knowledge of the imaging findings and the importance of early diagnosis and treatment are emphasized. We present a case of cavernous sinus thrombo-phlebitis caused by sphenoid sinusitis. Previously undescribed magnetic resonance imaging findings of cavernous sinus thrombophlebitis include enlargement of the cavernous sinus, abnormal enhancement and increased T2 signal of the petrous apex and clivus, and marked narrowing of the cavernous portion of the internal carotid artery. Resolution of cavernous sinus thrombophlebitis is also documented by magnetic resonance imaging. The anatomy of the cavernous sinus dictates the natural history and diagnosis of cavernous sinus thrombophlebitis. We review the literature regarding the clinical diagnosis, differential diagnosis, and treatment of cavernous sinus thrombophlebitis. We emphasize the importance of a high index of suspicion, the potentially rapid and fatal course of the disease process, and the subsequent need for antibiotic therapy and selective surgery.