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Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis
  1. Travis R Ladner1,
  2. Brandon J Davis1,
  3. Lucy He1,
  4. Louise A Mawn2,
  5. J Mocco1
  1. 1Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA
  2. 2Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, Tennessee, USA
  1. Correspondence to Travis Ryan Ladner, Department of Neurosurgery, Vanderbilt University, T 4224 Medical Center North, 1161 21st Ave, Nashville, TN 37232-2380, USA; travis.r.ladner{at}


Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.

  • Orbit
  • Vein
  • Blood Flow
  • Coil
  • Intervention

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