Pediatric Lateral Sinus Thrombosis: Retrospective Case Series and Literature Review

Wong, Ian Chi Kei; Kozak, Frederick K.; Poskitt, Ken; Ludemann, Jeffrey P.; Harriman, Maureen

doi:10.2310/7070.2005.00079

Cited by 32 publications

(19 citation statements)

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“…Finally, the role and extent of surgery is not fully characterized. More recent reports cite fewer internal jugular vein ligations [8,13,14]. Many advocate incision of the sinus with removal of the clot, while other simply unroof the sinus and confirm the presence of thrombus with needle aspiration.…”

Section: Discussionmentioning

confidence: 97%

“…The nature of the surgical procedure for treatment of lateral sinus thrombosis remains controversial, with advocates voicing support for procedures that range from simple ventilation tube placement to simple mastoidectomy to canal wall down or radical mastoidectomy [7][8][9]. The type of surgical procedure advocated recommended depends on the extent of the patient's disease.…”

Section: Discussionmentioning

confidence: 98%

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Lateral sinus thrombosis: A review of seven cases and proposal of a management algorithm

Christensen

Wayman

Spencer

2009

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

Lateral sinus thrombosis: A review of seven cases and proposal of a management algorithm

Christensen

Wayman

Spencer

2009

International Journal of Pediatric Otorhinolaryngology

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“…Although masteidectomy, myringotomy and/or placement of tympanostomy tube have not been proven to contribute to treatment, these interventions are preferred by otolaryngologists (31). In our study, all patients who had cerebral thrombosis related with mastoiditis received antibiotic treatment and mastoidectomy was also performed in these patients.…”

Section: Discussionmentioning

confidence: 91%

Evaluation of cases with cerebral thrombosis in children

et al. 2016

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Aim: We aimed to evaluate the patients who were followed up in our clinic with a diagnosis of cerebral sinovenous thrombosis in terms of age, sex, clinical findings, etiology, thrombophilic factors, imaging findings, treatment and prognosis. Material and Methods:The files of 11 patients who were followed up in our pediatric neurology clinic with a diagnosis of cerebral thrombosis between 1 December 2010 and 31 December 2014 were retrospectively analyzed. Results:Seven of 11 patients were male (63.6%). The median age was 14 years (2-17 years). Six (54%) of the patients presented with a complaint of headache. Other complaints at presentation included diplopia (n:3), weakness and difficulty in speaking (n:1) and seizure (n:1). A diagnosis of pseudotumor cerebri was made in eight of the patients (72.7%). In the etiology, mastoiditis was found in three patients, mastoiditis and meningitis were found in combination in one patient, Behçet's disease was found in three patients and head trauma was found in one patient. In 3 patients, only prothrombotic genetic risk factors were present; one patient had deficiency of protein C and S, one patient had deficiency of antithrombin III and one patient had hyperhomosisteinemia in association with vitamin B12 deficiency. 1A homozygous MTFHR A1298C mutation was detected in the patient who had mastoiditis and meningitis and protein S deficiency and lupus anticoagulant were found in another patient who had mastoiditis. All patients received anticoagulant treatment and all patients recovered without neurological sequelae except one.Conclusions: Cerebral sinovenous thrombosis should be considered in patients who present with headache and focal neurological deficits. Appropriate utilization of imaging studies is necessary for the diagnosis. Detailed ear, nose and throat examination should be performed to detect mastoiditis. It is recommended that genetic risk factors should be investigated, because hereditary thrombophilis factors may have a role in children. Behçet's disease which is relatively common in our country should be considered in differential diagnosis. (Turk Pediatri Ars 2016; 51: 87-93)

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“…Mastoidectomy with incision of the lateral sinus and removal of the clot is also considered LST's standard care [12][13][14]. Recently, conservative management of LST has been suggested in selected cases, although surgical debridement is unavoidable for those patients unresponsive to intravenous antibiotics or patients with resistant organisms and abscess formation [5, 15,16]. Intravenous antibiotics are recommended for at least 2-3 weeks, but osteomyelitis may require up to 6 weeks of treatment.…”

Section: Discussionmentioning

confidence: 99%

Gradenigo's syndrome with lateral venous sinus thrombosis: successful conservative treatment

et al. 2009

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Gradenigo's syndrome (GS) is a rare disease characterised by the triad otitis media, pain in the region innervated by the first and the second division of trigeminal nerve and abducens nerve palsy. Septic sinus thrombosis is one of the most frequent and relevant complication of GS; it is often due to persistent damage and late diagnosis. Computed tomography (CT) scan and magnetic resonance imaging (MRI) allow the correct diagnosis in most cases. Surgical therapy may be necessary for a better and more rapid resolution of the disease. We report the case of a 4-year-old child that was admitted for facial nerve palsy and abducens nerve palsy subsequent to a 2-week persistent pain in the right ear. MRI showed infective acute process of the right mastoid and partial ipsilateral sinus thrombophlebitis. The child was treated with high-dose intravenous antibiotics and with oral anticoagulants. A complete resolution of symptoms and radiological alterations were observed within 7 weeks. In conclusion, lateral sinus thrombosis and Gradenigo's syndrome are rare but potential fatal complications of otitis media and mastoiditis. High-dose intravenous antibiotics and a low dose of anticoagulant can achieve a complete recovery without surgery.

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Pediatric Lateral Sinus Thrombosis: Retrospective Case Series and Literature Review

Cited by 32 publications

References 0 publications

Lateral sinus thrombosis: A review of seven cases and proposal of a management algorithm

Lateral sinus thrombosis: A review of seven cases and proposal of a management algorithm

Evaluation of cases with cerebral thrombosis in children

Gradenigo's syndrome with lateral venous sinus thrombosis: successful conservative treatment

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