Prison Attack Resulting in Ophthalmoplegia: Case of Cavernous Sinus Thrombosis and Superior Orbital Fissure Syndrome

Pathology in the cavernous sinus may produce a syndrome identical to superior orbital fissure syndrome (SOFS). Lesion localization may be challenging since cranial nerves III, IV, VI, and V1 traverse both the cavernous sinus and superior orbital fissure (SOF). Deficits of the V2 nerve, if present with palsies of the former nerves, localize the lesion to the cavernous sinus since V2 does not enter the SOF. Cavernous sinus thrombosis (CST) is a rare condition, with incidence of ~1.6 per 100,000 per year. SOFS is also uncommon with incidence of ~0.3% of maxillofacial fracture cases. To our knowledge, this is the first reported patient with both SOFS and CST.