Pediatric Otogenic Sigmoid Sinus Thrombosis: Case Report and Literature Reappraisal

Area of Science:

• Pediatric Neurology
• Otolaryngology
• Infectious Diseases

Background:

• Mastoiditis, an infection of the mastoid bone, can lead to serious intracranial complications.
• Sigmoid sinus thrombosis (SST) is a rare but severe complication, often associated with acute otitis media.
• Increased intracranial pressure (ICP) can occur secondary to dural sinus thrombosis.

Purpose of the Study:

• To review a case of mastoiditis with sigmoid sinus thrombosis and increased intracranial pressure.
• To synthesize findings from existing literature on similar pediatric cases.
• To evaluate treatment outcomes and neurosurgical approaches.

Main Methods:

• Case report of a 6-year-old boy with acute otitis media, mastoiditis, and complex dural sinus thrombosis.
• Comprehensive literature review of pediatric mastoiditis complicated by sigmoid sinus thrombosis and increased ICP.
• Analysis of treatment strategies and neurological outcomes.

Main Results:

• The case involved a child with ipsilateral sigmoid sinus and contralateral distal transverse sinus thrombosis.
• Literature suggests a generally favorable neurological outcome in children treated conservatively.
• Conservative management, including antibiotics and anticoagulation, is often effective.

Conclusions:

• Most children with dural sinus thrombosis secondary to mastoiditis and increased ICP achieve good neurological outcomes with conservative neurosurgical management.
• Appropriate antibiotic therapy and anticoagulation form the cornerstone of treatment.
• Surgical interventions (e.g., external ventricular drain, endovascular thrombectomy) are reserved for refractory cases with neurological deterioration.