title: [Mono- or bilateral abducens paralysis as the initial symptom of sinus vein thrombosis].
abstract: 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.
authors.affiliation: Augenklinik und Poliklinik, Universität des Saarlandes, Homburg, Saar. aumlan@med-rz.uni-sb.de
authors.forename: M
authors.initials: M
authors.lastname: Lang
authors.forename: J
authors.initials: J
authors.lastname: Schmidbauer
authors.forename: M
authors.initials: M
authors.lastname: Voges
authors.forename: B
authors.initials: B
authors.lastname: Käsmann-Kellner
authors.forename: B
authors.initials: B
authors.lastname: Heinemann-Vernaleken
authors.forename: K W
authors.initials: KW
authors.lastname: Ruprecht
mesh_terms: 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*