Septic Thrombophelebitis of intracranial venous sinuses following submandibular abscess, a case report

Background: Septic intracranial venous thrombosis is a rare vascular disease of the brain with no specific sign or symptom. While urgent treatment will result in complete recovery, delays may cause permanent complications or even death.

Case Report: The patient was a 23-year-old woman who had suffered visual loss, hallucination, and confusion two weeks after undergoing submandibular abscess removal surgery. In neurological examinations, she had difficulty speaking, was febrile (T: 38.5) and showed signs of meningeal irritations. Bilateral pupil edema and sixth nerve palsy were also observed. MRI and MRV showed cerebral venous thrombosis with right occipital lobe infarction. The patient went under treatment with antibiotics. The symptoms improved gradually.

Conclusion: Septic intracranial thrombosis may lead to death, when diagnosis and treatment is delayed. Therefore detection of predisposing factors that cause development of infection to cerebral venous sinuses such as facial infection and cervical abscesses is considered vital. It is important that appropriate antibiotic is administered before removal of such abscesses.