{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:11:36Z","timestamp":1779253896630,"version":"3.51.4"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Cavernous sinus thrombosis (CST) is a rare and life-threatening neuro-ophthalmologic emergency. The role of adjunctive anticoagulation in infection-driven CST\u2014especially when patients respond rapidly to antibiotics\u2014remains a clinically significant dilemma. We report the case of a 50-year-old male presenting with acute right periorbital swelling, proptosis, ocular pain, and headache. Magnetic resonance imaging (MRI) confirmed right cavernous sinus thrombosis secondary to bilateral sinusitis. After multidisciplinary review, anticoagulation was withheld due to the patient\u2019s prompt clinical improvement on targeted intravenous antibiotics (meropenem\/ertapenem) and concerns regarding bleeding risk. Complete symptomatic and radiological recovery was achieved, as evidenced by serial MRI follow-up over eight months. This case demonstrates that in selected patients with septic CST and a treatable infectious source, aggressive antibiotic therapy alone may lead to full resolution. It highlights the value of individualized management and contributes to the ongoing discussion on the timing and necessity of anticoagulation in this complex condition.<\/jats:p>","DOI":"10.3389\/fneur.2026.1788368","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:48:09Z","timestamp":1779252489000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful management of cavernous sinus thrombosis without anticoagulation: a neuro-ophthalmologic case report"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiao-ou","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Geriatric, The First Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cui-zhu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Geriatric, The First Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-meng","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Geriatric, The First Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Geriatric, The First Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.nec.2024.02.002","article-title":"Cavernous sinus thrombosis","volume":"35","author":"Housley","year":"2024","journal-title":"Neurosurg Clin N Am"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e17339","DOI":"10.7759\/cureus.17339","article-title":"Cavernous sinus thrombosis: efficiently recognizing and treating a life-threatening condition","volume":"13","author":"Ali","year":"2021","journal-title":"Cureus"},{"key":"ref3","volume-title":"StatPearls","author":"Plewa","year":"2025"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.ajem.2024.06.024","article-title":"High risk and low prevalence diseases: cavernous sinus thrombosis","volume":"83","author":"Long","year":"2024","journal-title":"Am J Emerg Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.1007\/s00405-018-5062-9","article-title":"Prognosis of septic cavernous sinus thrombosis remarkably improved: a case series of 12 patients and literature review","volume":"275","author":"van der Poel","year":"2018","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1177\/2396987317719364","article-title":"European stroke organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European academy of neurology","volume":"2","author":"Ferro","year":"2017","journal-title":"Eur Stroke J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e77","DOI":"10.1161\/STR.0000000000000456","article-title":"Diagnosis and management of cerebral venous thrombosis: a scientific statement from the American Heart Association","volume":"55","author":"Saposnik","year":"2024","journal-title":"Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1007\/s11910-019-0988-x","article-title":"Cerebral venous thrombosis: an update","volume":"19","author":"Ferro","year":"2019","journal-title":"Curr Neurol Neurosci Rep"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.emc.2025.08.014","article-title":"Cerebral venous thrombosis","volume":"44","author":"Darby","year":"2026","journal-title":"Emerg Med Clin North Am"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"CD002005","DOI":"10.1002\/14651858.CD002005.pub2","article-title":"Anticoagulation for cerebral venous sinus thrombosis","volume":"2011","author":"Coutinho","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2671","DOI":"10.1001\/archinte.161.22.2671","article-title":"Septic thrombosis of the cavernous sinuses","volume":"161","author":"Ebright","year":"2001","journal-title":"Arch Intern Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/00005792-198603000-00002","article-title":"Septic thrombosis of the dural venous sinuses","volume":"65","author":"Southwick","year":"1986","journal-title":"Medicine Baltimore"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1212\/WNL.0000000000001886","article-title":"Pediatric cavernous sinus thrombosis: a case series and review of the literature","volume":"85","author":"Smith","year":"2015","journal-title":"Neurology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1016\/j.survophthal.2021.03.009","article-title":"Septic cavernous sinus thrombosis: a review","volume":"66","author":"Caranfa","year":"2021","journal-title":"Surv Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1161\/STR.0b013e31820a8364","article-title":"Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"42","author":"Saposnik","year":"2011","journal-title":"Stroke"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1161\/01.STR.0000062344.87396.72","article-title":"Anticoagulation for cerebral sinus thrombosis","volume":"34","author":"Stam","year":"2003","journal-title":"Stroke"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1111\/jth.14210","article-title":"Cerebral venous sinus thrombosis","volume":"16","author":"Capecchi","year":"2018","journal-title":"J Thromb Haemost"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1007\/s00405-024-08992-4","article-title":"Anticoagulation for cavernous sinus thrombosis: a systematic review and individual patient data meta-analysis","volume":"282","author":"Akarapas","year":"2025","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1080\/01658107.2016.1230138","article-title":"Septic cavernous sinus thrombosis: case report and review of the literature","volume":"40","author":"Weerasinghe","year":"2016","journal-title":"Neuroophthalmology"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1788368\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:48:20Z","timestamp":1779252500000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1788368\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":19,"alternative-id":["10.3389\/fneur.2026.1788368"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1788368","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"article-number":"1788368"}}