RT Journal Article
SR Electronic
T1 Restricted Diffusion in Bilateral Optic Nerves and Retinas as an Indicator of Venous Ischemia Caused by Cavernous Sinus Thrombophlebitis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1815
OP 1816
VO 27
IS 9
A1 J.S. Chen
A1 P. Mukherjee
A1 W.P. Dillon
A1 M. Wintermark
YR 2006
UL http://www.ajnr.org/content/27/9/1815.abstract
AB SUMMARY: A 44-year-old man developed bilateral blindness following severe periorbital cellulitis and pansinusitis. CT and MR imaging demonstrated bilateral cavernous sinus thrombosis. Diffusion-weighted imaging revealed reduced apparent diffusion coefficient in bilateral optic nerves, suggesting optic nerve ischemia caused by the cavernous sinus thrombophlebitis (CST). Following surgical debridement of pansinusitis, antimicrobial therapy, and anticoagulation, the patient recovered from the infectious episode but sustained permanent bilateral blindness. This case shows that both retinal and optic nerve ischemia can be the cause of blindness after CST. Arguments supporting an arterial-versus-venous origin for the ischemia are discussed.