Italian Journal of Pediatrics (Sep 2020)

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

  • Massimo Luca Castellazzi,
  • Giada Maria di Pietro,
  • Michele Gaffuri,
  • Sara Torretta,
  • Giorgio Conte,
  • Francesco Folino,
  • Sebastiano Aleo,
  • Samantha Bosis,
  • Paola Marchisio

DOI
https://doi.org/10.1186/s13052-020-00882-9
Journal volume & issue
Vol. 46, no. 1
pp. 1 – 11

Abstract

Read online

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