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Medica Jadertina, Vol. 55 No. Suplement 1, 2025.

Meeting abstract

Quadruple thrombosis originating from the sphenoid sinus

Ema Ahel Ledić orcid id orcid.org/0009-0009-4404-0454 ; KBC Rijeka, Krešimirova 42, 51000 Rijeka, Hrvatska
Dubravko Manestar orcid id orcid.org/0000-0001-8908-1617 ; KBC Rijeka, Krešimirova 42, 51000 Rijeka, Hrvatska

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Abstract

Aim: Superior ophthalmic vein thrombosis (SOVT) is a rare, serious ophthalmic emergency with high
mortality and significant complications if not promptly diagnosed and treated. It is often an early indicator of
cavernous sinus thrombosis (CST), which may lead to complications like pituitary insufficiency, hemiparesis
and death. Less than 100 cases have been reported and just few cases describe simultaneous CST and bilateral
ophthalmic vein thrombosis. This case report presents an 86-year-old female patient with SOVT and bilateral
CST. Materials and methods: The patient was admitted with severe, persistent headaches and blurred vision in
the left eye. Ophthalmological examination showed ptosis (more pronounced on the left eye), restricted ocular
motility and no diplopia. Pupillary reactions were slightly delayed but symmetrical. In clinical examination
hyperemia and mild oedema of the skin was detected. Nasal endoscopy revealed no abnormalities, except for
a small septal spur. Neuroradiological workup confirmed bilateral SOVT and CST with right sphenoid sinus
inflammation. Results: Treatment for SOVT varies depending on the underlying cause, and early diagnosis is
crucial. The patient was treated with anticoagulants, antibiotics and surgery (right-sided sphenoidotomy with
purulent material drained from the right sphenoid sinus). She showed improvement and was discharged with
ongoing anticoagulation therapy. Conclusion: SOVT is a rare and severe condition that can lead to lifethreatening complications if orbital cellulitis progresses to cavernous sinus involvement. This study adds the
importance of a multidisciplinary approach and timely intervention to improve patient outcomes

Keywords

cavernous sinus thrombosis; inflammation; sphenoid sinus; venous thrombosis

Hrčak ID:

336371

URI

https://hrcak.srce.hr/336371

Publication date:

10.11.2025.

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