ABSTRACT NUMBER: ESOC2026A2183 CEREBRAL VENOUS SINUS THROMBOSIS IN THE CONTEXT OF SUPERIOR OPHTHALMIC VEIN THROMBOSIS: A CASE REPORT

Abstract Background and aims Superior ophthalmic vein thrombosis (SOVT) is a rare but serious condition that can extend to the cavernous sinus and other cerebral venous sinuses. This case highlights the severity and potentially treatable nature of this condition, emphasizing the importance of early recognition and timely intervention. Methods Descriptive presentation of a clinical case. Results A 46-year-old man with no relevant medical history presented multiple times to the emergency department with headache, neck pain, and blepharitis, treated symptomatically. His condition deteriorated, with altered level of consciousness and right-sided exophthalmos. Cranial CT revealed thrombophlebitis of the superior ophthalmic vein, which was managed with canthotomy and empirical antibiotic therapy. Due to further clinical deterioration with meningeal signs and a Glasgow Coma Scale of 9, the patient was admitted to the ICU. Lumbar puncture was compatible with bacterial meningitis. Subsequent CT angiography demonstrated thrombosis of the cavernous sinus, superior sagittal sinus, transverse sinus, and left sigmoid sinus, as well as tetraventricular obstructive hydrocephalus. Antibiotic therapy was escalated, and anticoagulation with low molecular weight heparin and corticosteroids was initiated, resulting in significant clinical improvement. The patient was later discharged asymptomatic, continuing oral anticoagulation as chronic therapy. Conclusions In patients with superior ophthalmic vein thrombosis and clinical deterioration due to ocular infections, cerebral venous sinus thrombosis should be considered as a possible complication. Early recognition of this condition is critical for timely management, as it can be potentially fatal, both for vision and systemic health. Conflict of interest Daniel Antonio Ginarte Milanés: Nothing to disclose Figure 1 - belongs to Results