Diffusion restriction in thrombosed superior ophthalmic veins: Two cases of diverse etiology and literature review

Restricted Diffusion of the Superior and Inferior Ophthalmic Veins in Cavernous Sinus Thrombosis

“…A subsequent publication documented restricted diffusion in the SOVs bilaterally in a 64-year-old woman with a dental abscess (2). This is the first report of CST with MRI evidence of restricted diffusion, not only in a thrombosed SOV but also in a thrombosed IOV.…”

Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children

“…9 Findings on MR include expansion of the cavernous sinus and change in contour of the lateral wall from the normal concave appearance to a flat or convex shape can be observed on CT or MR (Figure 2). 10 Other findings include filling defects and heterogeneous enhancement of the cavernous sinus when contrast is administered (Figure 3) 3,10 Two of our patients had enlargement of the cavernous sinus that was thrombosed. The use of diffusion-weighted MRI in demonstrating hyperintensity within the cavernous sinus has also been shown to be useful in diagnosis (Figure 4).…”

“…The use of diffusion-weighted MRI in demonstrating hyperintensity within the cavernous sinus has also been shown to be useful in diagnosis (Figure 4). 10 Two of our patients (22%) demonstrated this phenomenon and likely represents cytotoxic edema. Other commonly associated findings on imaging are dilation or thrombosis of the superior ophthalmic vein, enlarged extraocular muscles, proptosis, and extensive soft-tissue edema.…”

“…There are 2 well-documented cases of death from intracerebral hemorrhage in patients receiving heparin for CST. 10 Six of our patients were treated with anticoagulation, with 1 suffering a hemorrhagic stroke due to a dosing error. Duration of anticoagulation therapy in CST is not well defined, but 3 months has been suggested based on data from patients with dural venous sinus thrombosis.…”

Simultaneous Isolated Bilateral Superior Orbital Vein Thrombosis as a Presenting Feature of Antiphospholipid Syndrome

“…3 Bilateral SOVT has been reported in association thrombosis of the cavernous sinus and carotico-cavernous fistula. 4,5 Bilateral isolated SOVT is very rare, although has previously been reported in association with oral contraceptive use. 6 This represents the first report of bilateral isolated SOVT related to APS.…”