Black turbinate sign: a potential predictor of mucormycosis in cavernous sinus thrombophlebitis

Sinal da concha preta: um potencial preditor de mucormicose nas tromboflebites do seio cavernoso

IMAGES IN NEUROLOGY

"Black turbinate sign": a potential predictor of mucormycosis in cavernous sinus thrombophlebitis

"Sinal da concha preta": um potencial preditor de mucormicose nas tromboflebites do seio cavernoso

Douglas Mendes Nunes^I; Antônio José da Rocha^II; Marcos Rosa Júnior^I; Carlos Jorge da Silva^II

^IFellow in Neuroradiology, Santa Casa de Misericórdia de São Paulo, São Paulo SP, Brazil

^IISection of Neuroradiology, Santa Casa de Misericórdia de São Paulo, São Paulo SP, Brazil

^{Correspondence}

Rhinosinusitis has the potential to result in catastrophic intracranial extension in the presence of predisposing conditions, such as diabetes, immunosuppression (fungus) or the incomplete treatment of bacterial infection. It is assumed that cavernous sinus thrombophlebitis (CST) is secondary to retrograde extension due to a valveless system of the vein that communicates paranasal cavities to the cavernous sinus¹. The "black turbinate sign" results from dry gangrene in affected tissues, which presents in early stages paranasal mucormycosis. Conversely, bacterial sinusitis does not promote local necrosis and, therefore, it affects neither mucosal enhancement nor its T2 signal intensity².

A poor prognosis of CST highlights the relevance of correct diagnosis for early treatment. The "black turbinate sign" could represent a potential discriminating feature to distinguish mucormycosis in CST etiology (Figure).

Conflict of interest:

There is no conflict to interest to declare.

Received 24 August 2011

Received in final form 15 September 2011

Accepted 23 September 2011

• 1. Hoxworth JM, Glastonbury CM. Orbital and intracranial complications of acute sinusitis. Neuroimaging Clin North America 2010;20:511-526.
• 2. Safder S, Carpenter JS, Roberts TD, Bailey N. The "black turbinate" sign: an early MR imaging finding of nasal mucormycosis. AJNR. Amer J Neuroradiol 2010;31:771-774.

Correspondence:

Antônio José da Rocha

Rua Cincinato Braga 232

01333-910 São Paulo SP - Brasil

Publication Dates

• Publication in this collection
  05 Jan 2012
• Date of issue
  Jan 2012