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Query: UMLS:C0033377 (
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11,717
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Superior orbital fissure syndrome
is a rare condition that presents itself as gross and persistent edema of the periorbital tissues, proptosis, subconjunctival ecchymosis,
ptosis
, ophthalmoplegia, dilation of the pupil, absence of direct light reflex and presence of consensual light reflex. The corneal reflex is lost, sensation is diminished over the forehead, and it is possible that the dimensions of the superior orbital fissure are reduced. Infection, however, is not often reported as the etiology. The case presented here describes an unusual occurrence of superior orbital fissure syndrome secondary to an infected dentigerous cyst of the maxillary sinus and its management.
...
PMID:Superior orbital fissure syndrome. Secondary to infected dentigerous cyst of the maxillary sinus. 780 20
Cavernous sinus syndrome
(CSS) is characterized by deficits in more than one of the cranial nerves (CN) that traverse the cavernous sinus at the base of the cranial vault: CN III (oculomotor), IV (trochlear), VI (abducens), and the first two branches of CN V (trigeminal). Records from 4 dogs and 8 cats with CSS diagnosed over a 14-year period were reviewed. The most common clinical signs were ophthalmoparesis or ophthalmoplegia, mydriasis with no direct or consensual pupillary light reflexes,
ptosis
, decreased corneal sensation, and decreased retractor oculi reflex. All cats had initial signs referable to a left CSS lesion (one had bilateral CSS), whereas in all dogs the lesions were localized to the right cavernous sinus. Median ages at diagnosis were 9 and 10 years of age for dogs and cats, respectively. Cerebel lomedullary cisternae cerebrospinal fluid analysis in 6 animals was useful as a sensitivebut nonspecific diagnostic test of an intracranial inflammatory or neoplastic lesion. Magnetic resonance imaging scans provided a more definitive diagnostic test in all dogs, revealing a contrast-enhancing mass on T1 weighted scans in the region of the cavernous sinus. A definitive pathological diagnosis was obtained in 2 dogs: a primary intracranial neoplasm and a metastatic intracranial neoplasm. A definitive diagnosis was obtained in 6 cats: metastatic neoplasm (n = 1), primary intracranial neoplasm (n = 1), primary intracranial infectious disease (n = 2), and associated systemic infectious disease (n = 2). The prognosis associated with CSS in dogs and cats was considered guarded to poor.
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PMID:A retrospective study of cavernous sinus syndrome in 4 dogs and 8 cats. 868 82
Cavernous sinus syndrome
(CSS) may be caused by a wide range of pathological process among we include metastatic disease. A case of a woman whose breast neoplasm was initially expressed by a CSS is discussed in this article. We describe a 64-year-old woman with several weeks progressive course of pain and numbness in her left-side facies and occasional diplopia. Neurological examination showed left
ptosis
, limitation of elevation of left eye and abducens nerve palsy as well as hypoesthesia in the frontal and maxillary regions of her left-side facies. Brain magnetic resonance imaging (MRI) scan revealed the presence of a mass in the orbit and left cavernous sinus. General examination disclosed a sclerotic and retractile lesion in her left breast which involved the nipple suggesting breast carcinoma metastases. The patient underwent a breast fine-needle aspiration biopsy which established the presence of an infiltrating breast carcinoma. This case shows the importance role of the general physical examination to determine the etiology of the CSS. It is necessary and fundamental to perform it on each patient not only to orientate further investigations but also to avoid more invasive diagnostic procedures.
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PMID:[Cavernous sinus syndrome: an initial expression of a breast carcinoma]. 1581 52
A 40-year-old male with left-sided headaches,
ptosis
, proptosis and extra-ocular muscle paralysis developed right-sided headaches, proptosis, chemosis, diplopia, extra-ocular muscle paralysis and trigeminal sensory loss. An enhancing left orbital, intrasellar and parasellar cavernous nodule on magnetic resonance imaging progressed into a right cavernous sinus and orbital apex soft tissue mass.
Cavernous sinus syndrome
from sphenoid sinusitis resolved after endoscopic transnasal sphenoidotomy. This diagnostic complexity and its treatment options are discussed according to current literature.
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PMID:Alternating orbital symptoms in cavernous sinus syndrome due to isolated sphenoid sinusitis. 2046 40
Cavernous sinus syndrome
(CSS) is a rare condition characterised by ophthalmoplegia, proptosis, ocular and conjunctival congestion, trigeminal sensory loss and Horner's syndrome. These signs and symptoms result from the involvement of the cranial nerves passing through the cavernous sinus. We report the case of a 53-year-old man with a history of daily stabbing headache associated with dizziness, progressive blurred vision, right ocular pain,
ptosis
and ophthalmoplegia. After working up the patient, a meningioma was identified as the cause of the CSS. Despite advances in neuroimaging techniques, in some cases, the aetiology of CSS remains difficult to determine. We highlight the clinical and radiological features of a meningioma, one of the causes of CSS. Early diagnosis and treatment of CSS play a key role in a better prognosis.
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PMID:Cavernous sinus syndrome: need for early diagnosis. 2581 16
Orbital apex syndrome is an uncommon disorder characterized by ophthalmoplegia, proptosis,
ptosis
, hypoesthesia of the forehead, and vision loss. It may be classified as part of a group of orbital apex disorders that includes superior orbital fissure syndrome and cavernous sinus syndrome.
Superior orbital fissure syndrome
presents similarly to orbital apex syndrome without optic nerve impairment.
Cavernous sinus syndrome
includes hypoesthesia of the cheek and lower eyelid in addition to the signs seen in orbital apex syndrome. While historically described separately, these three disorders share similar causes, diagnostic course, and management strategies. The purpose of this study was to report three cases of orbital apex disorders treated recently and to review the literature related to these conditions. Inflammatory and vascular disorders, neoplasm, infection, and trauma are potential causes of orbital apex disorders. Management is directed at the causative process. The cases described represent a rare but important group of conditions seen by the maxillofacial surgeon. A review of the clinical presentation, etiology, and management of these conditions may prompt timely recognition and treatment.
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PMID:Orbital apex disorders: a case series. 2672 7
Cavernous sinus syndrome
(CSS) is a condition characterized by multiple cranial nerve palsies manifesting with ophthalmoplegia,
ptosis
, and facial sensory loss due to involvement of adjacent cranial nerves. Tumors, trauma, and vascular, infectious, and noninfectious inflammatory disorders have all been described as causes. Lymphomas have been reported to involve the cavernous sinus, both as primary cavernous sinus lymphomas or as secondary lesions. Here, we describe the case of a 63-year-old-man with untreated chronic lymphocytic leukemia (CLL), diagnosed 4 years earlier, who presented with CSS. Our patient underwent standard chemotherapy, but he succumbed to infection during the neutropenic period.
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PMID:Cavernous sinus syndrome. 2896 64
The cavernous sinus (CS) is a paired venous sinus that runs along either side of the pituitary gland on the floor of the calvarium.
Cavernous sinus syndrome
(CSS) refers to deficits in more than one of the cranial nerves III, IV, V, and VI, as they are in close association in this region. The purpose of this study was to identify the presenting complaints, neurologic findings, diagnosis, and outcomes in dogs and cats with confirmed cavernous sinus syndrome (CSS). Medical records between 2002 and 2015 were reviewed. Inclusion criteria were neurologic signs consistent with CSS and advanced imaging and/or post-mortem examination. Thirteen dogs and 2 cats were included. Twelve dogs received advanced imaging. Post-mortem examination was performed on 2 cats and 3 dogs. Dogs were 6 -13 years (mean= 10.8 years) of age and comprised of several different breeds. Both cats were male neutered domestic shorthair, ages 3 and 14 years. Presenting complaints included mydriasis (N=4), behavior changes (N=3), hyporexia (N=3),
ptosis
(N=2), ataxia (N=2), pain (N=2), weakness (N=2), lethargy (N=2), and one each of epiphora, ocular swelling, polydipsia, seizures, facial muscle atrophy, dysphagia, and head tilt. Neurologic signs included ophthalmoparesis/plegia (N=13), reduced/absent pupillary light response (N= 11), mydriasis (N= 10), reduced/absent corneal sensation (N= 7),
ptosis
(N= 6), reduced facial sensation (N= 2), and enophthalmos (N=1). Thirteen patients had a mass lesion within the cavernous sinus, 6 of which were confirmed neoplastic via histopathology. Median survival time for the 4 patients treated with radiation therapy was 1035 days (range 150-2280). Median survival for the 4 patients that received medical treatment was 360 days (range 7-1260 days), and for the 5 non-treated patients 14 days (range 0-90 days). In conclusion mydriasis and ophthalmoplegia are common signs of CSS. A mass lesion within the CS is the most common cause. Survival time may be improved with radiation therapy.
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PMID:Cavernous sinus syndrome in dogs and cats: case series (2002-2015). 2991 Oct 23
Allergic fungal sinusitis (AFS), a noninvasive form of fungal sinusitis, is rarely seen in immunocompetent patients. Involvement of sphenoid sinus can result in proptosis and loss of vision. We report AFS masquerading as posterior cavernous sinus syndrome. A 59-year-old African-American man presented with right complete
ptosis
with ophthalmoplegia. After an initial work-up and imaging studies, patient underwent endonasal sphenoid surgery, which revealed characteristic 'allergic fungal mucin'.
Cavernous sinus syndrome
is a rare presenting clinical feature of allergic fungal sinusitis. Ophthalmologists should be aware of this rare presentation of relatively common otorhinological disease for timely referral and appropriate management.
...
PMID:Allergic fungal sinusitis masquerading as cavernous sinus thrombosis. 3285 97