Síndrome do seio cavernoso: estudo de 70 casos

Cavernous sinus syndrome: study of 70 cases

RESUMO

Objetivo:

Caracterizar as manifestações clínicas e determinar a distribuição epidemiológica e etiológica da síndrome do seio cavernoso (SSC) pela primeira vez no Brasil.

Métodos:

Os casos de SSC vistos num período de 15 anos foram analisados. Os pacientes foram submetidos a completo exame neurológico e oftalmológico, a extensa propedéutica laboratorial e a exames de imagem do encéfalo para determinação da etiología. Em alguns pacientes foí realizada biópsia cerebral.

Resultados:

70 casos foram encontrados com idades entre 4 e 74 anos (mediana de 41). Ambos sexos foram igualmente afetados. Cefaléia ocorreu em 80% dos pacientes, envolvimento do III nervo em 76%, do IV em 43%, do VI em 59%, e do nervo óptico em 46% dos casos. A síndrome de Tolosa-Hunt foí encontrada em 18 pacientes, a paquimeningite hipertrófica em 17, os tumores em 12, os aneurismas em 11, as fístulas carótido-cavernosas em 10, tuberculoma em um, e tromboflebite em uma paciente.

Conclusões:

XSSC ocorre em ambos os sexos e em todos os grupos etários, se manifestando por graves déficits neuro-oftalmológícos. Neuropatía óptica é comum. Inflamação foi a causa mais freqüentemente encontrada da SSC nesta série.

Palavras-chave:
Síndrome do seio cavernoso; Cefaléia; Oftalmoplegia; Neuropatia óptica

SUMMARY

Purpose:

To determine the epidemiological and clinical features of the cavernous sinus syndrome as well as its most common etiologies in a series of patients in Brazil.

Methods:

The medical records of patients with cavernous sinus syndrome were analyzed. They had undergone an extensive laboratory workup including biopsy in selected cases.

Results:

70 cases were found with ages ranging from 4 to?4 years (median 41). Both sexes were equally involved. Headache occurred in 80% of the patients; the III nerve was involved in 76%, the IV in 43%, the VI in 59%. Optic neuropathy was seen in 46%) of the cases. The main etiologies were: Tolosa-Hunt syndrome in 18 patients, hypertrophic pachymeningitis in 17, tumors in 12, aneurysms in 11; tuberculoma in 1 and thrombophlebitis in 1.

Conclusions:

Our series shows that cavernous sinus syndrome occurs at any age and equally in both sexes. Optic neuropathy is common. Inflammatory diseases were found to be the most frequent cause of the syndrome in this series.

Keywords:
Cavernous sinus syndrome; Headache; Ophthalmoplegia; Optic neuropathy

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Datas de Publicação

• Publicação nesta coleção
  Dez 1998