Mastoid air sinus abnormalities associated with lateral venous sinus thrombosis: cause or consequence?
BACKGROUND
Mastoiditis is a known cause of lateral venous sinus thrombosis (LST). We have encountered patients with LST associated with mastoid abnormality on MRI without any clinical signs of infection; the significance of these abnormalities is uncertain. This study examines the relationship of LST and mastoid air sinus abnormalities systematically.


METHODS
We performed a retrospective clinical and radiological review of a series of 26 patients with cerebral venous thrombosis. Mastoid abnormalities were detected ipsilateral to 9 of 23 thrombosed lateral sinuses (39%) and 0 of 29 unaffected lateral sinuses (P<0.001). No patient had clinical evidence of mastoiditis. Eight of 9 patients with mastoid abnormalities were treated without antibiotics; all made uneventful clinical recoveries. Repeated MRI in 1 patient revealed reversal of the mastoid changes.


CONCLUSIONS
The mastoid changes observed are likely to be due to venous congestion as a consequence of LST, not mastoiditis.
Fink
John N
JN
Department of Neurology, Christchurch Hospital, (New Zealand). john.fink@cdhb.govt.nz
McAuley
David L
DL
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000473:pathology*; D008417:Mastoiditis / Q000175:diagnosis; D008875:Middle Aged; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000175:diagnosis / Q000473:pathology