Ophthalmic artery occlusion combined with superior sagittal sinus thrombosis caused by hyaluronic acid injection for facial soft tissue augmentation: A case report

RATIONALE: Cosmetic hyaluronic acid injections for facial soft tissue augmentation are gaining popularity because of their convenience and favorable outcomes. Several associated complications have been described; however, ophthalmic artery occlusion (OAO) combined with superior sagittal sinus thrombosis (SSST) has been rarely reported. PATIENT CONCERNS: A 21-year-old woman presented with sudden loss of vision and severe pain in the left eye, right upper limb weakness, and headache immediately after hyaluronic acid injection on the left side of her forehead. DIAGNOSIS: Clinical manifestations and multimodal imaging, including spectral-domain optical coherence tomography, fundus fluorescein angiography, and digital subtraction angiography, indicated OAO and SSST. INTERVENTIONS: Various clinical examinations were performed, and the patient was treated by thrombolysis, corticosteroids, oxygen therapy, a formula for the nourishment of the optic nerve, and measures for improving the microcirculation. OUTCOMES: The treatment response was closely observed. The intracerebral hemorrhages were absorbed after 2 weeks of treatment, while the clinical manifestations, including ocular pain, headache, and limb dysfunction, were gradually alleviated. However, the visual acuity in the left eye remained at no light perception. LESSONS: Cosmetic hyaluronic acid injection can result in emergent and catastrophic complications that require immediate treatment. Thus, the development of appropriate prevention and management protocols for such scenarios is considered crucial.