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Tromboflebitis del seno cavernoso. A prop?sito de un caso

Authors: Fernández Rodríguez, Ana; Morais Pérez, Darío; Santos Pérez, Jaime; Blanco Mateos, Gonzalo; Millás Gómez, Teresa; Landinez Cepeda, Guillermo Arturo;

Tromboflebitis del seno cavernoso. A prop?sito de un caso

Abstract

[ES] NTRODUCI?N: La trombosis del seno cavernoso (TSC) es una entidad rara pero grave. Puede estar causada por procesos infecciosos o no infecciosos. En la trombosis s?ptica, el foco infeccioso primario frecuentemente es la sinusitis, superando a las infecciones faciales. CASO CL?NICO: Mujer de 23 a?os, en tratamiento con anticonceptivos orales. Remitida por presentar cefalea, fiebre, congesti?n conjuntival, diplop?a, edema palpebral bilateral y disminuci?n del nivel de conciencia. Exploraci?n neurol?gica: parexia del VI par derecho. Punci?n lumbar normal. TAC: rotura e hipodensidad en primer molar superior derecho, ocupaci?n de senos paranasales, con disrupci?n de la pared posterior del seno esfenoidal derecho. Angio-RNM: ocupaci?n de senos derechos y alteraci?n de la se?al del clivus con hipointensidad en T1, aumento de se?al y mala definici?n de senos cavernosos. Estudio hematol?gico: Hipercoagulabilidad. Hemocultivo: Fusobacterium nucleatum. Tratamiento: anticoagulaci?n, cefalosporinas de tercera generaci?n, metronidazol y penicilinas antiestafilococicas. Revisi?n: m?nima limitaci?n de abducci?n ojo derecho. DISCUSI?N: La incidencia de trombosis venosas cerebrales s?pticas ha disminuido notablemente, puede presentarse en infecciones en cara y cuello y t?picamente afectan el seno cavernoso. Entre las causas no infecciosas, las trombofilias cong?nitas suelen ser las m?s comunes, pero en mujeres j?venes el embarazo, puerperio o los anticonceptivos orales desempe?an un papel determinante. Se recomienda tratamiento antitromb?tico y antibi?tico prolongado. El tratamiento quir?rgico est? indicado para el drenaje de los focos primarios. La mortalidad es del 30% con morbilidad residual en el 50%. CONCLUSION: El diagn?stico de TSC implica una alta sospecha cl?nica. El pron?stico depender? del tiempo de demora en el tratamiento.

[EN] The cavernous sinus thrombosis (CST) is a rare but serious condition. It can be caused by infectious or noninfectious processes. In septic thrombosis, the primary infection is often the sinusitis or facial beating infections. CASE REPORT: A 23 year old woman, treated with oral contraceptives, is submitted by presenting headache, fever, right conjunctival congestion, diplopia, bilateral eyelid edema and decreased level of consciousness. Neurologic examination: parexia right sixth cranial nerve. Lumbar puncture normal. TAC: breakage and hypodensity in the right upper first molar, occupation sinus, with disruption of the posterior wall of the right sphenoid sinus. Angio-MRI: Breast occupation rights and alteration of the clivus with hypointense signal in T1, signal gain and poor definition of cavernous sinuses. Hematological: Hypercoagulability. Blood culture: Fusobacterium nucleatum. Treatment: anticoagulation, third-generation cephalosporins, metronidazole and antistaphylococcal penicillins. Review: minimum limitation of right eye abduction.

Country
Spain
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Keywords

Tromboflebitis, Thromboflebitis, Sinusitis, 32 Ciencias m?dicas, Otorrinolaringolog?a, 32 Ciencias médicas, Otorrinolaringología

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green