Abstract
A 40-year-old man presented with severe headache and pain and swelling of right eye for four days and consulted with an eye specialist who prescribed him analgesic and steroid, but he did not get any relief. The patient was hospitalized and treated at a medical college hospital for COVID-19 moderate illness, which was identified clinically and confirmed by RT-PCR positive and HRCT of the chest. He improved immensely without complications and was discharged from the hospital on 28/4/2021 following a 14-day hospital stay on rivaroxamine 10 mg daily, vitamin D, vitamin C, and zinc. The cavernous sinus (CS) is a pair of cerebral dural venous sinuses found in the middle cranial fossa on each side of the sellaturcica. The cavernous sinus contains the third, fourth, and sixth cranial nerves, as well as the ophthalmic and maxillary divisions of the fifth cranial nerve and the internal carotid artery with its surrounding sympathetic plexus. CST related with COVID-19 is becoming more common, however therapy is problematic since the appropriate anticoagulant and length of therapy are unknown. We are now treating the patient with subcutaneous low molecular heparin.
References
- WHO/ Pneumonia of unknown cause – China. 2020 [cited 2021 Apr 24]; Available from: https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/ de
- Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8):523–34.
- Aghagoli G, Gallo Marin B ,Soliman LB, Sellke FW. Cardiac involvement in COVID-19 patients: risk factors, predictors, and complications: a review. J Card Surg 2020;35(6):1302–5 .
- Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologicmanifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020.
- Fan S, XiaoM, Han F, Xia P, Bai X, Chen H, et al. Neurological manifestations in Critically Ill patients with COVID-19:a retrospective study. Front Neurol 2020; 11:806.
- Carneiro T DJ, Leung LY, Nobleza COS, Marulanda-Londono E, Hathidara M, et al. Intravenous tPA for acuteischemic stroke in patients with COVID-19. J Stroke Cerebrovasc Dis 2020;2020(105201).
- Lodigiani C, Iapichino G, Ferrazzi P, Sebastian T ,Kucher N ,Studt J-D ,et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res 2020;191:9–14 .
- Tempea V, Gorun G (1959) Cavernous sinus thrombosis. AMAArch Otolaryngol 69:220–223
- Pavlovich P, Looi A, Rootman J (2006) Septic thrombosis of thecavernous sinus: two different mechanisms. Orbit 25:39–43
- Iba T, Levy JH, Levi M, Connors JM, Thachil J. Coagulopathy of coronavirus disease 2019. Crit Care Med 2020; 48:1358-64.
- Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020;135:2033-40.
- Uthman IW, Gharavi AE (2002) Viral infections and antiphospholipid antibodies. Semin Arthritis Rheum 31:256–63 (Cross-Ref Medline)
- Gupta N, Zhao YY, Evans CE (2019) The stimulation of thrombosis by hypoxia. Thromb Res 181:77–83 (Cross-Ref Medline)
- Costa A, Weinstein ES, Sahoo DR, Thompson SC, Faccincani R, Ragazzoni L. How to build the plane while flying: VTE/PE thromboprophylaxis clinical guidelines for COVID-19 patients. Disaster Med Public Health Prep 2020;55:1–15.
Corresponding Author
HN Sarker
Professor (Ex), Medicine, Sher E Bangla Medical College, Barishal, Bangladseh
DOI: https://dx.doi.org/10.18535/jmscr/v9i8.05
