The purpose of a recent study published in the Journal of Stroke and Cerebrovascular Diseases was to describe otogenic lateral sinovenous thrombosis (OLST), a rare, potentially life-threatening complication of otomastoiditis.

In this study, 7 children diagnosed with OLST in a tertiary-care Hospital from 2014-2019 were retrospectively selected. Clinical and radiological features, timing of diagnosis, treatment and outcome are reported.

The findings suggested that fever and neurological symptoms—headache, lethargy, diplopia, dizziness and papilledema—were always present. Otalgia and/or otorrhea were found in 6 children; none had signs of mastoiditis. Brain CT-scan was performed in five children, and was diagnostic for three. While venography-MRI detected OLST and mastoiditis in all cases without parenchymal lesions. Treatment was based on intravenous rehydration, antibiotic and low-molecular weight heparin – acetazolamide was added in 3 children. Mastoidectomy and ventriculoperitoneal-shunting were selectively performed. Patients were discharged after 26 days (median). Follow-up neuroimaging showed sinus recanalization after a median of 6 months.

In inference, it was stated that a multidisciplinary approach is needed to optimize diagnostic-therapeutic protocols of pediatric OLST.

Source: Journal of Stroke and Cerebrovascular Diseases. 2020 Oct;29(10):105184. doi:10.1016/j.jstrokecerebrovasdis.2020.105184.