• Partha S Ghosh, Debabrata Ghosh, Johanna Goldfarb, and Camille Sabella.
• Pediatric Neurology Center, Children's Hospital, Cleveland Clinic, Cleveland, Ohio 44195, USA. ghoshd2@ccf.org
• J. Child Neurol. 2011 Aug 1; 26 (8): 1000-4.

AbstractThe authors describe the clinical features and management of lateral sinus thrombosis associated with mastoiditis and otitis media in children. Of 475 patients with mastoiditis and otitis media, 13 (2.7%) had lateral sinus thrombosis identified by magnetic resonance imaging/magnetic resonance venography (n = 11) and angiography (n = 2). Clinical features included headache, vomiting, fever, diplopia, papilledema, sixth nerve palsy, seventh nerve palsy, and unilateral cerebellar ataxia. All patients received antibiotics for 1 to 8 weeks. Four patients underwent mastoidectomy alone, 5 mastoidectomy with concurrent myringotomy and ventilation tube, and 1 myringotomy with tube without mastoidectomy. Three underwent anticoagulation for 6 months (1 had heterozygous factor V Leiden mutation). All survived; deafness occurred in 5 patients (4 transient, 1 persistent). Magnetic resonance imaging/magnetic resonance venography should be obtained in any child with otitis media having features of raised intracranial pressure and/or focal neurodeficits to rule out lateral sinus thrombosis. Antibiotics and mastoidectomy are essential in management. A hypercoagulable state may predispose to lateral sinus thrombosis.

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