Extensive dural sinus thrombosis and bilateral lateral rectus palsy as an uncommon complication of chronic suppurative otitis media.
Dural venous sinus thrombosis, especially of the sigmoid sinus, is a known but uncommon intracranial extradural complication of chronic suppurative otitis media. Even rarer is the simultaneous occurrence of bilateral abducens palsy in the same patient. We report the case of an adolescent male who presented with signs of raised intracranial pressure, diplopia and bilateral lateral rectus palsy associated with a history of left ear discharge and neck swelling. Extensive dural sinus thrombosis extending right up to the left internal jugular vein was confirmed on CT imaging. The patient was successfully treated with thrombolytic agents and antibiotic therapy. The pathophysiology of the concurrent complications is discussed.
Department of Otorhinolaryngology-Head and Neck Surgery, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia. aansangel@yahoo.com
Anusha
A
Balasubramanian
Irfan
I
Mohamad
Dinsuhaimi
D
Sidek
D020434:Abducens Nerve Diseases / Q000209:etiology*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002908:Chronic Disease; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015242:Ofloxacin / Q000627:therapeutic use; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000175:diagnosis*; D012851:Sinus Thrombosis, Intracranial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D002443:Ceftriaxone; D006493:Heparin; D015242:Ofloxacin