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Abstract：
We describe a rare and complex case of septic cavernous sinus thrombosis (SCST) in a 70-year-old patient who initially presented with ocular symptoms that rapidly progressed to severe intracranial vascular complications, including subarachnoid hemorrhage (SAH). Despite the use of broad-spectrum antibiotics and anticoagulants, the patient\'s condition deteriorated. SCST, often caused by sinus infections, presents a significant diagnostic and therapeutic dilemma, with mortality rates exceeding 20%. This report underscores the diversity of clinical presentations, ranging from mild headaches to severe cranial nerve deficits, that complicate diagnosis and treatment. The inability to detect any aneurysms in our patient using magnetic resonance imaging (MRI) and computed tomography angiography (CTA) may indicate an alternative pathogenesis. This could involve venous hypertension and endothelial hyperpermeability. This case illustrates the need for personalized treatment approaches, as recommended by the European Federation of Neurological Societies, and the importance of a multidisciplinary perspective when managing such intricate neurological conditions. Our findings contribute to the understanding of SCST coexisting with SAH.
摘要：
我们描述了一个罕见且复杂的化脓性海绵窦血栓形成（SCST）的70岁患者，该患者最初表现为眼部症状，并迅速发展为严重的颅内血管并发症。包括蛛网膜下腔出血(SAH)。尽管使用了广谱抗生素和抗凝剂，病人的病情恶化。SCST,通常由鼻窦感染引起，提出了一个重大的诊断和治疗难题，死亡率超过20%。这份报告强调了临床表现的多样性，从轻度头痛到严重的颅神经缺陷，复杂的诊断和治疗。无法使用磁共振成像（MRI）和计算机断层扫描血管造影（CTA）检测患者的任何动脉瘤可能表明另一种发病机制。这可能涉及静脉高压和内皮通透性过高。这个案例说明了个性化治疗方法的必要性，根据欧洲神经学会联合会的建议，以及在管理这种复杂的神经系统疾病时，多学科观点的重要性。我们的发现有助于理解SCST与SAH共存。
