[Mono- or bilateral abducens paralysis as the initial symptom of sinus vein thrombosis].
BACKGROUND
Sinus vein thrombosis is a rare intracerebral complication of mastoiditis. We report on the clinical ophthalmologic symptomatology of this secondary illness.


METHODS



METHODS
two young female patients, aged 14 and 3.5 years, presented at our pediatric ophthalmology section due to diplopia. Both girls had suffered 1-2 weeks earlier from otitis media, which had been treated with antibiotics. Other neurological symptoms were not reported.


METHODS
Best corrected visual acuity was 20/20 OD/OS in both patients. Ocular alignment revealed a bilateral abduction deficit in the 14-year-old girl and a monolateral abduction deficit of the right eye in the younger patient. Ophthalmoscopic examination evidenced bilateral papilledema in both patients. Magnetic resonance tomography and magnetic resonance angiography showed mastoiditis and thrombosis of the sigmoid and transverse sinuses.


METHODS
Following mastoidectomy, high-dose antibiotic therapy, and full-dose heparin therapy, rapid improvement occurred.


CONCLUSIONS
Thrombosis of the sigmoid sinus following mastoiditis is a rare but severe complication of middle ear inflammation. Immediate surgical and antibiotic therapy is necessary. Symptoms can possibly occur even when the primary focus seems to resolve.
Lang
M
M
Augenklinik und Poliklinik, Universität des Saarlandes, Homburg, Saar. aumlan@med-rz.uni-sb.de
Schmidbauer
J
J
Voges
M
M
Käsmann-Kellner
B
B
Heinemann-Vernaleken
B
B
Ruprecht
K W
KW
D020434:Abducens Nerve Diseases / Q000209:etiology*; D000293:Adolescent; D002675:Child, Preschool; D003392:Cranial Sinuses / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008417:Mastoiditis / Q000150:complications / Q000175:diagnosis; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis; D010211:Papilledema / Q000209:etiology; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis*