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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Subarachnoid haemorrhage associated with septic cavernous sinus thrombosis secondary to odontogenic maxillary
Yoshiyuki Nagamine1,2, Takuro Endo3, Masayuki Iwashita3
1Department of Emergency and Critical Care Medicine, Teikyo University Hospital, Itabashi, Japan nagamine.yoshiyuki.ku@teikyo-u.ac.jp.
Abstract:
This case report describes a man in his 50 s who developed septic cavernous sinus thrombosis secondary to odontogenic maxillary sinusitis complicated by a non-aneurysmal subarachnoid haemorrhage (SAH). He presented with visual loss, altered consciousness and shock. CT revealed SAH near the left Sylvian fissure; right maxillary sinusitis and thrombosis of the cavernous sinuses, superior ophthalmic veins and internal jugular veins without an aneurysm. Despite intensive treatment, including broad-spectrum antibiotics, anticoagulants, tooth extraction and endoscopic sinus drainage, he developed a haemorrhagic venous infarction and subsequently died from cerebral herniation due to progressive brain swelling. Streptococcus dysgalactiae subsp. equisimilis (Group C Streptococcus) was isolated from both blood cultures and purulent material was aspirated during tooth extraction. This case highlights the pathogenic potential of Group C Streptococcus and the importance of recognising septic cerebral venous thrombosis as a cause of SAH.
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