A 50-Year-old diabetic patient presented with orbital pain, swelling and chemosis along with fever. Patient also gave history of orbital cellulitis 1 week back. O/E: - 3rd, 4th and 6th cranial nerves neuropathy Trigeminal neuropathy affecting V1 and V2 divisions The neuropathy was observed initially on left side but later right side was also affected. CT venogram of the patient Which of the following is not a tributary of the involved structure: -
This is a case of cavernous sinus thrombosis post orbital cellulitis meaning the septic thrombi came the superior ophthalmic vein. It is a life-threatening condition. Presents as orbital/facial pain Orbital swelling and chemosis is seen. 3rd, 4th, 5th and 6th cranial nerves are affected Occurs secondary to infection from orbital cellulitis and sinusitis CT venogram shows distended cavernous sinus with a non-fat density filling defect-likely thrombus. Pathways of spread of infection to cavernous sinus.
Superior ophthalmic vein
Superficial middle cerebral vein
Central vein of retina
Basilar plexus
Integrated QBank