Blindness associated with enlarging mycotic aneurysm after cavernous sinus thrombosis.
OBJECTIVE
We report a patient with an enlarging internal carotid mycotic aneurysm secondary to septic cavernous sinus thrombosis presenting with acute visual loss.


METHODS
Single observational case report.


METHODS
Retrospective review of the medical record and review of the literature.


RESULTS
A 19-year-old man with residual left sixth nerve palsy and decreased vision in his left eye caused by left cavernous sinus thrombosis secondary to pansinusitis was seen 2 weeks after discharge with acute decreased visual acuity in the right eye. A workup revealed an enlarging left carotid/ophthalmic aneurysm that compressed the optic chiasm and right optic nerve. The patient was taken to the interventional angiography suite, where his left internal carotid artery was occluded endovascularly. The patient's vision improved on discharge.


CONCLUSIONS
Visual loss caused by a mycotic carotid aneurysm is an infrequent sequelae after cavernous sinus thrombosis and is not well described in the literature. To our knowledge, this is the first reported case of acute visual loss associated with a mycotic ophthalmic aneurysm. The result of treatment was good in this case, with the patient's visual acuity returning to pretreatment status.
Quisling
Susannah V
SV
Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
Mawn
Louise A
LA
Larson
Theodore C
TC
D000328:Adult; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology*; D001766:Blindness / Q000209:etiology* / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000473:pathology* / Q000601:surgery; D020226:Cavernous Sinus Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002533:Cerebral Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009408:Nerve Compression Syndromes / Q000209:etiology; D009897:Optic Chiasm / Q000473:pathology; D009901:Optic Nerve Diseases / Q000209:etiology; D012189:Retrospective Studies; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields