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October 1986

High-Field Magnetic Resonance Imaging in the Diagnosis of Cavernous Sinus Thrombosis

Author Affiliations

From the Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson University (Drs Savino, Schatz, Sergott, and Bosley), and the Department of Radiology, Hospital of the University of Pennsylvania (Dr Grossman), Philadelphia.

Arch Neurol. 1986;43(10):1081-1082. doi:10.1001/archneur.1986.00520100085020

Cavernous sinus thrombosis is an important but difficult clinical diagnosis to confirm by most imaging modalities.1,2 Until the advent of highfield magnetic resonance imaging (MRI), the imaging method of choice for evaluating thrombus formation in the cavernous sinus was transarterial or intravenous digital subtraction angiography. This article discusses the MRI findings in the diagnosis of cavernous sinus thrombosis.

REPORT OF A CASE  A 73-year-old woman noticed pain around her left eye ten days before examination. Over the next four days, her left upper eyelid drooped, and she experienced double vision. She was hospitalized elsewhere, and computed tomography (CT) showed a mass in the left anterior cavernous sinus. A cerebral arteriogram was normal. The patient was treated with systemic corticosteroids (prednisone, 80 mg/d), with no resolution of the pain or ocular motility disturbance.Five years prior to admission, the patient had an episode of painful ophthalmoplegia that was described

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