Shahid M Nimjee, Honey Jones, Sankalp Gohkale, Carmen Graffagnino, Ali R Zomorodi and Tony P Smith
Cavernous sinus thrombosis (CST) is a rare disease that can have devastating morbidity. Despite medical
therapy, in rare circumstances, patients will continue to decline. We present a patient who complained of headache,
left eye pain and vision loss. Magnetic resonance imaging revealed bilateral superior ophthalmic vein and cavernous
sinus thrombosis. She was treated with antibiotics and intravenous heparin. Despite a therapeutic activated partial
thromboplastic time, she progressed to bilateral blindness. Microcatheter transvenous pharmacological thrombolysis
with recombinant tissue plasminogen activator (rTPA) was performed including overnight continuous infusion. She
recovered light perception the following morning and left the hospital neurologically intact. This case demonstrates
that in patients with cerebral deep venous thrombosis that decline despite medical therapy, endovascular
intervention is a viable option