DR. DHRUV GOYAL

Dr. Bhagyajyothi B. K., DR. UMESH HARAKUNI, DR. EESHITA JAIN, DR. MITALI MANGOLI

Abstract

The cavernous sinus is an important drainage structure which houses a number of important structures, the superior and inferior ophthalmic vein, internal carotid artery (ICA), cranial nerves 3,4,5 and 6. Any pathology arising in the cavernous sinus would lead to an array of symptoms depending on the exact location of the lesion.

A 52-year-old was referred to the ophthalmology OPD for complaints of acute onset headache and diplopia. Visual acuity was 6/6 in both eyes. Anterior segment examination showed OD- mild proptosis OS-normal. Extra ocular movements(EOM) OD -restriction of movement (4,6 and partial 3 nerve involvement) with sparing 2nd and 5th nerve. OU- restriction of movements and OS- normal. Posterior segment examination was unremarkable. MRI Brain showed enhancing soft tissue lesion in right cavernous sinus, suggestive of inflammatory lesion extending to the right orbital apex and inferior orbital fissure not involving 2nd nerve. It presented with Waxing and Waning course.