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儿童单侧全鼻窦炎后早期海绵窦血栓形成

Early cavernous sinus thrombosis following unilateral pansinusitis in a child.

作者信息

Mallick Ajay, Pathak Som Dutt, Shankar Sandeep, Sati Alok

机构信息

Department of ENT, Command Hospital, Kolkata, West Bengal, India.

Department of Ophthalmology, Command Hospital, Kolkata, West Bengal, India.

出版信息

BMJ Case Rep. 2015 Apr 26;2015:bcr2014208441. doi: 10.1136/bcr-2014-208441.

Abstract

Cavernous sinus thrombosis (CST) is a life-threatening entity with a high rate of mortality and lifelong morbidity. A strong clinical suspicion of the complication, early radiological detection and institution of timely, aggressive treatment are required to prevent permanent neurological disability. We present a 12-year-old girl with bilateral CST following unilateral pansinusitis. Clinical symptoms of headache and retro-orbital pain out of proportion to clinical signs on presentation prompted a suspicion of something beyond sinusitis and raised the clinical suspicion of cavernous sinus involvement. In spite of institution of an early medical treatment, she progressed to develop bilateral cranial nerve paresis. However, with the persistence of antibiotics and anticoagulation therapy, she was successfully managed with no residual neurological sequelae. The aim of this presentation is to highlight the grave consequences of cavernous sinus involvement following infections of paranasal sinus and the rare complete recovery from disability in this case.

摘要

海绵窦血栓形成(CST)是一种危及生命的疾病,死亡率高且会导致终身残疾。要预防永久性神经功能障碍,就需要对该并发症有高度的临床怀疑、进行早期影像学检测并及时采取积极治疗。我们报告一名12岁女孩,单侧全鼻窦炎后发生双侧CST。就诊时头痛和眶后疼痛等临床症状与体征不符,这提示病情可能不止是鼻窦炎,从而增加了海绵窦受累的临床怀疑。尽管早期进行了药物治疗,但她仍进展为双侧颅神经麻痹。然而,通过持续使用抗生素和抗凝治疗,她成功康复,没有留下神经后遗症。本病例报告的目的是强调鼻窦感染后海绵窦受累的严重后果,以及该病例罕见的完全康复情况。

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