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

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.

Cerebral Venous Thrombosis in Pediatric Age: Risk Factors and Prognosis

“…Regarding risk factors, acute head and neck infections in previously health children were the dominant predisposing factor for CVT, as seen in previous studies. (28)(29)(30) The most frequent permanent risk factor in our cohort was a history of malignancy. This may be justified by the fact the our hospital is a reference center for oncology pediatric patients.…”