Septic cavernous sinus thrombosis secondary to halo vest pin site infection

N Am Spine Soc J. 2020 Nov 26:4:100036. doi: 10.1016/j.xnsj.2020.100036. eCollection 2020 Dec.

Abstract

Background: Pin site infection is one of the frequent complications of the halo crown application which can be easily handled if addressed early. However, if this issue is neglected then serious infectious events may quickly transpire. Among all of the medical literature that the previously described scenarios have illuminated; we did not encounter a case involving infectious cavernous sinus thrombosis.

Case description: The authors present a middle age man who arrived at our clinic with an acute left peri-orbital swelling, proptosis, and ophthalmoplegia which had occurred subsequent to an untreated halo pine site infection. With a diagnosis of septic cavernous sinus thrombosis (CST), appropriate antibiotics and anticoagulant therapies were administered.

Outcome: With the continuation of this conservative treatment regimen, he was successfully managed with no residual neurological consequences.

Conclusion: Halo vest orthosis is an appropriately tolerated upper cervical spinal stabilizing device that is a commonly used worldwide. Septic CST that is secondary to a halo vest pin site infection has not been previously described within medical literature. In the case of a neglected pin site infection, with demonstration of ipsilateral eyelid edema and proptosis, septic CST should be immediately considered and treated vigorously with antibiotics and anticoagulant therapies.

Keywords: Anticoagulants; Cavernous sinus thrombosis; Halo vest orthosis; Upper cervical spine.

Publication types

  • Case Reports