Turbulent Flow in a Cavernous Sinus Lesion: Does It Suggest Something?. (3rd September 2021)

• Record Type: Journal Article
• Authors: Jain, Vaibhav Kumar; Singh, Vivek; Charlotte, Akshata; Kanaujia, Vikas; Sharma, Kumudini
• Is Part Of: Neuro-ophthalmology. Volume 45:Number 5(2021)
• Page Start: 324
• Page End: 328
• Publication Date: 2021-09-03
• Subjects: Mycotic aneurysm -- intracavernous internal carotid artery aneurysm -- turbulent flow -- internal carotid artery; Neuroophthalmology -- Periodicals; 617.7
• DOI: 10.1080/01658107.2020.1779314
• Languages: English
• ISSNs: 0165-8107

Abstract

ABSTRACT: A 14-year-old boy who had been complaining of double vision for the previous month was referred for neuro-ophthalmological evaluation. He was carrying a diagnosis of a cavernous sinus haemangioma causing a right VIth nerve palsy, based on imaging elsewhere. He reported having a boil at the angle of his mouth, which was associated with left-sided facial cellulitis, two weeks before the onset of the diplopia. His blood investigations showed a leukocytosis with elevated inflammatory markers. Re-evaluation of the magnetic resonance imaging suggested a sac-like out-pouching in the intracavernous part of the right internal carotid artery with differential intensity suggestive of turbulent flow. On the basis of the clinico-radiological findings, a diagnosis of mycotic aneurysm of the cavernous sinus part of internal carotid artery was made. A high index of suspicion is required to detect this rare clinical entity, which is associated with a potentially catastrophic clinical course.