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Papilloedema secondary to venous sinus thrombosis following glomus jugulare tumour surgery

  • S Izadi (a1), P D Karkos (a2), R Krishnan (a1), J Hsuan (a1) and T H J Lesser (a2)...

Abstract

Objective:

We present a case of a patient who had undergone embolisation and resection of a left glomus jugulare tumour, who presented three weeks post-operatively with magnetic resonance venography confirmed symptomatic cerebral venous sinus thrombosis.

Method:

We present a case report and a review of the world literature concerning glomus jugulare tumours and cerebral venous sinus thrombosis.

Case report:

A 42-year-old man presented with blurred vision and reduced Snellen visual acuity just three weeks after glomus jugulare tumour surgery. Fundoscopy revealed bilateral haemorrhagic optic disc oedema. Urgent magnetic resonance venography confirmed a left lateral venous sinus thrombosis. It was felt that this was responsible for inadequate cerebrospinal fluid drainage, resulting in raised intracranial pressure and papilloedema.

Conclusion:

To the authors' knowledge, this is the first account of a magnetic resonance venography confirmed venous sinus thrombosis and secondary papilloedema following glomus jugulare tumour surgery. Patients undergoing surgery involving resection or manipulation of the internal jugular vein may be at higher risk of developing thrombosis superior to the level of resection, and magnetic resonance venography ought to be considered an important diagnostic adjunct.

Copyright

Corresponding author

Address for correspondence: Miss S Izadi, Department of Ophthalmology, University Hospitals Aintree, Rice Lane, Liverpool L9 1AE, UK. Fax: 0151 525 6086 E-mail: shahrni@hotmail.com

References

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1Beck, DW, Kassell, NF, Drake, CG. Glomus jugulare tumor presenting with increased intracranial pressure. Case report. J Neurosurg 1979;50:823–5
2Angeli, SI, Sato, Y, Gantz, BJ. Glomus jugulare tumors masquerading as benign intracranial hypertension. Arch Otolaryngol Head Neck Surg 1994;120:1277–80
3Bousser, MG. Cerebral venous thrombosis: diagnosis and management. J Neurol 2000;247:252–8
4Brookes, GB, Graham, MD. Benign intracranial hypertension complicating glomus jugulare tumor surgery. Am J Otol 1984;5:350–4
5Lin, A, Foroozan, R, Danesh-Meyer, HV, De Salvo, G, Savino, PJ, Sergott, RC. Occurrence of cerebral venous sinus thrombosis in patients with presumed idiopathic intracranial hypertension. Ophthalmology 2006;113:2281–4
6Wustenberg, EG, Offergeld, C, Zahnert, T, Huttenbrink, KB, Kittner, T. Extension of intracranial thrombosis after unilateral dissection of the internal jugular vein. Arch Otolaryngol Head Neck Surg 2005;131:430–3

Keywords

Papilloedema secondary to venous sinus thrombosis following glomus jugulare tumour surgery

  • S Izadi (a1), P D Karkos (a2), R Krishnan (a1), J Hsuan (a1) and T H J Lesser (a2)...

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