DR. RASNA BHANUMAN

Dr.VIRNA SHAH

Abstract

We report a rare case of 62 year old diabetic patient who presented with binocular diplopia of sudden onset . Ophthalmological examination revealed an esotropia of the left eye in primary position, with marked abduction deficit. Visual acuity was 6/9 on both eyes with age appropriate lens changes.MRI brain showed Skull based osteomyelitis with sinusitis and mastoiditis showing involvement of basisphenoid and left posterior skull base with irregular bony destruction and adjacent soft tissue inflammation ,dysplastic left ICA extending from distal cervical segment with secondary mycotic pseudoaneurysms most prominent at left petrocavernous junction. She was subsequently transferred to neurologist for higher level of care. Pseudoaneurysm of ICA caused by skull base osteomyelitis is a very rare complication, which can be life threatening ,if not identified and managed immediately. Involvement of cranial nerves is a common complication and is considered a poor prognostic factor.