title: Decisions regarding intracranial complications from acute mastoiditis in children.
abstract: OBJECTIVE
  To review the clinical findings and treatment algorithms for intracranial complications of acute mastoiditis, such as sigmoid sinus thrombosis, otitic hydrocephalus, intracranial abscess, and otitic meningitis. We also briefly discuss the clinical sequelae of these complications.
  
  
  RESULTS
  Recent changes in the microbiology and treatment paradigms of otitis media have the potential to influence the rates of intracranial complications of mastoiditis; however, evidence supporting a resultant increase in the rates of these complications is lacking.
  
  
  CONCLUSIONS
  Antibiotic therapy and myringotomy with ventilation tube placement, with or without mastoidectomy, are the mainstays of treatment for intracranial complications of acute mastoiditis. Adjunct treatment, such as anticoagulation for sigmoid sinus thrombosis, is often used; however, the rarity of these complications makes establishing appropriate levels of evidence to support their use difficult.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. alex.osborn@sickkids.ca
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Osborn
authors.forename: Susan
authors.initials: S
authors.lastname: Blaser
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D001922:Brain Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003657:Decision Making; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D008417:Mastoiditis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D008581:Meningitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy*