Diagnosis

Abstract

A noncontrast head computed tomography (CT) scan showed slight narrowing of the ventricles and mild left-sided edema. A magnetic resonance imaging scan revealed a cavernous sinus thrombosis (Figure 2). The patient was admitted and treated with intravenous antibiotics and heparin. Magnetic resonance imaging with gadolinium is the diagnostic test of choice for detection of cerebral venous thrombosis because thrombi can be visualized. CT scans are often abnormal but nonspecific. The most common CT findings are small ventricles and edema; results of CT scans are abnormal but nonspecific in up to 80% of patients. Images in emergency medicineAnnals of Emergency MedicineVol. 44Issue 5PreviewA 42-year-old, previously healthy man presented to the emergency department complaining of a progressive headache behind his left eye for 3 days. He was well until 3 weeks earlier when he developed a persistent nasal discharge and low-grade fever. The day of presentation, he developed double vision, became nauseated, and vomited twice. At presentation, he had a temperature of 100.4°F (38.0°C) and tenderness over the maxillary and frontal sinuses. Ophthalmologic examination revealed marked chemosis of his left eye, a fixed and dilated left pupil, a left abducens nerve palsy, and bilateral papilledema (Figure 1). Full-Text PDF