Bilateral superior ophthalmic vein thrombosis in a case of viral meningo-encephalitis: A case report and review of literature

Superior ophthalmic vein thrombosis may be unilateral or bilateral and may or may not be associated with cavernous sinus thrombosis. Thirty-year old male presented with headache, altered sensorium and mild neck stiffness. He had conjunctival congestion and mild restriction of ocular movements on examination without any orbital bruit. No visual impairment or field defects were noted. CT and contrast MRI of the brain were normal. MRI sections from orbits showed bilateral superior ophthalmic vein thrombosis. CSF showed mild pleocytosis (mostly lymphocytes) confirming diagnosis of viral meningo-encephalitis. CSF gram stain and culture were negative. He recovered after 2 weeks and conjunctival congestion resolved completely. This case illustrates the need for awareness of this rare entity.