John N Fink1, David L McAuley. 1. Department of Neurology, Christchurch Hospital, (New Zealand). john.fink@cdhb.govt.nz
Abstract
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. SUMMARY OF REPORT: 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.
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. SUMMARY OF REPORT: 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.
Authors: Dani C Inglesby; Michael U Antonucci; Maria Vittoria Spampinato; Heather R Collins; Ted A Meyer; Rodney J Schlosser; Kazuhito Shimada; Donna R Roberts Journal: JAMA Otolaryngol Head Neck Surg Date: 2020-06-01 Impact factor: 6.223