Clinical Case Report of Cavernous Sinus Thrombosis with an Atypical Presentation

Cavernous sinus thrombosis represents a form of cerebral venous thrombosis, constituting a rare and life-threatening condition that lacks pathognomonic features. An acute, severe headache is a non-specific symptom frequently associated with this pathology and may, in some instances, be its sole manifestation. The diagnostic challenges, extensive differential diagnoses, and the imperative for immediate therapeutic intervention underscore the clinical significance of this entity. This article details a clinical case of atypical cavernous sinus thrombosis in a 48-year-old male with no apparent predisposing risk factors. The clinical presentation was characterised by a combination of headache and fever, in the absence of focal neurological deficits or ophthalmological manifestations. Computed tomography of the brain revealed radiological evidence of right cavernous sinus thrombosis. Therapeutic-dose direct anticoagulation with heparin was initiated to achieve sinus recanalisation. Upon resolution of the acute phase, the patient was transitioned to a regimen of oral rivaroxaban. Follow-up neurovascular imaging at one month demonstrated no residual signs of thrombosis.