SEPTIC CAVERNOUS SINUS THROMBOSIS FOLLOWING TRANSSPHENOIDAL CRANIOTOMY - CASE-REPORT

The authors present a case of late-onset cavernous sinus thrombosis in a 74-year-old man who had undergone transsphenoidal craniotomy for a pituitary macroadenoma 9 weeks previously. The patient developed heada che, rapidly progressive ophthalmoplegia, and signs of orbital congest ion. After 2 days of ineffective broad spectrum antibiotic therapy he underwent a second transsphenoidal craniotomy for abscess drainage. In traoperative cultures grew 4+ non-hemolytic Streptococcus, 4+ Staphylo coccus coagulase negative, and 4+ Haemophilus influenzae. The patient was maintained on intravenous antibiotic therapy for the following 6 w eeks, resulting in a complete clinical recovery. To the authors' knowl edge, this is the first report of a septic cavernous sinus thrombosis following a transsphenoidal craniotomy.