PMC6739703_01
a Preoperative ptosis. b Preoperative palsy looking upwards. c Preoperative palsy of adduction. d-f Postoperative status with normal eye movements.
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F1
Ptosis and miosis of the right eye (Fig. 1a) were found, consistent with Horner syndrome. Signs of paralysis of the oculomotor nerve included palsy of right eye movement when looking upwards (Fig. 1b), during adduction (Fig. 1c), and looking downwards. Four weeks after surgery, the patient was symptom free apart from a mild headache (Fig. 1d-f).
MRI multiplanar reconstruction post-contrast. a Thrombosed sigmoid sinus. b Thrombosed ophthalmic vein. c Thrombosed sphenoparietal sinus. d CT with osseous erosion of the right sphenoid sinus.
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F2
Furthermore, thrombosis of the cavernous sinus, ophthalmic vein, superior petrosal sinus, sigmoid sinus, internal jugular vein, and sphenoparietal sinus on the right side (Fig. 2) was seen in post-contrast acquired images. The additional computed tomography scan showed a permeative osseous erosion of the posterior and lateral walls of the right sphenoid sinus, while the carotid artery remained covered by bone (Fig. 2d).