Cavernous Sinus Meningioma Causing Bilateral Cavernous Sinus Syndrome and Profound Visual Impairment: A Case Report
Keywords:
Cavernous sinus syndrome, cavernous sinus meningioma, cranial nerve palsy, toxoplasmic chorioretinitis, high myopia.Abstract
Background: Cavernous sinus syndrome (CSS) is an uncommon but potentially life- and sight-threatening neurological condition, most often presenting as a combination of multiple cranial nerve palsies. One of its primary neoplastic causes, cavernous sinus meningioma (CSM), can lead to compressive optic neuropathy and profound visual loss.
Case Report: A 46-year-old female presented with a gradual bilateral decline in visual acuity, accompanied by intense headaches and left facial asymmetry. Clinical evaluation showed ophthalmoplegia, ptosis, decreased facial sensation in the V1–V2 regions, abnormal fundus findings, and significant color vision loss. MRI revealed bilateral cavernous sinus lesions encasing the internal carotid arteries, consistent with meningioma. The patient underwent subtotal surgical excision, with residual tumor remaining within the cavernous sinus. Postoperatively, visual function remained markedly reduced. The case was further complicated by high myopia with degenerative changes and multifocal toxoplasmic chorioretinitis.
Conclusion: This report highlights the complexity of diagnosing and managing CSS caused by bilateral CSM, particularly when coexisting with other ocular pathologies. Early recognition, detailed neuroimaging, and multidisciplinary management focused on preserving neurological and visual function are crucial to achieving optimal outcomes in such rare cases.
