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Review
. 2020 Sep 3;46(1):122.
doi: 10.1186/s13052-020-00882-9.

Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review

Massimo Luca Castellazzi  1 , Giada Maria di Pietro  2 , Michele Gaffuri  3 , Sara Torretta  3 , Giorgio Conte  4 , Francesco Folino  2 , Sebastiano Aleo  5 , Samantha Bosis  6 , Paola Marchisio  5   7
Affiliations
Review

Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review

Massimo Luca Castellazzi et al. Ital J Pediatr. .

Abstract

Background: Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011.

Case presentation: The child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient's full recovery.

Conclusion: Cerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.

Keywords: Acute mastoiditis; Acute otitis media; Cerebral venous sinus thrombosis; Children; Fusobacterium necrophorum.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a On bone window of the pre-contrast CT showed complete obliteration of the tympanic cavity (arrow), the mastoid (asterisk) and the external auditory canal (arrowhead), compatible with an otomastoiditis. b Contrast-enhanced CT showed multiple abscesses in the right peri-auricular soft-tissue (arrow) and the thrombosis of the right sigmoid sinus (arrowhead)
Fig. 2
Fig. 2
a Magnetic Resonance Venography showed the absence of the flow-related signal in the right sigmoid sinus (arrow). b The contrast-enhanced T1-weighted sequence showed the thrombosis and the wall-thickening of the right sigmoid sinus (arrowhead), as well as (c) the inflammatory thickening and the contrast-enhancement of dura mater (arrow) in the right temporal region
See this image and copyright information in PMC

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