Surprising

Nervous System & Special Senses


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This 22-year-old woman has presented with a left lateral gaze palsy of sudden onset, in association with a headache and fever. She also has chemosis and proptosis of both eyes and hypoesthesia over the left frontal region. Examination additionally reveals cranial nerves V1 and VI to be affected. These nerves are in close proximity at only two sites: the pons (their origin) and the cavernous sinus.\n\nA pontine lesion would not explain the chemosis and proptosis. On the other hand, the above findings are eminently compatible with cavernous sinus thrombosis (CST). In particular, the facial furuncle raises suspicion of septic CST secondary to bacterial invasion via the facial venous plexuses. \n\nThe possibility of orbital cellulitis should also b"}]}

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