Int. Adv. Otol. 2009; 6(1); 102-104

Disseminated lateral sinus thrombosis, Case report
Huseyin Dere, Gokce Saygi, Ozgur Akdogan, Adin Selcuk, Gokhan Gokturk
Ankara Numune Education  and Research Hospital 4th ENT Clinic, Samanpazari, Ankara. sadin27@yahoo.com

Lateral sinus thrombosis is a rare condition that can be caused by an otogenic disease with cholesteatoma or can be itself a
primary condition. It can be associated with acute and chronic otitis media, hyperhomocysteinemia, pregnancy, malignancy or
vasculitic syndromes.
We present a case with a primary complaint of headache. A 24-years old male suffering of chronic headache for 4 months was
admitted to our clinic. He had also 2-weeks history of insensitivity of legs. Physical examination revealed hyperemia of right
tympanic membrane and sensitivity on right mastoid apex. The MRI and MR-Angiography of the brain indicated cerebral sinus
thrombosis (right sigmoid, transverse and superior sagittal sinuses) and right acute mastoiditis. Laboratory test values were
almost normal, except high blood homocysteine value. Intravenous Meroperem was initiated as the medical therapy. We
operated the patient on 8th days of his admission. Right simple mastoidectomy was performed. The mastoid air cells were
infected. Anticoagulant therapy was initiated postoperatively. Following mastoidectomy and broad spectrum intravenous
antibiotics the patient had a full recovery.
The exact etiology of the patient remained controversial whether the infected mastoid cells were the cause or the effect. The
most probable etiology was assumed as the complication of acute otitis media, hyperhomocysteinemia or aseptic cerebral sinus
thrombosis.