Percorsi clinici
Trombosi venosa cerebrale associata a otomastoidite con segni di ipertensione endocranica
Cerebral venous thrombosis associated with otomastoiditis and endocranial hypertension
Angela Troisi1, Elisa Pasquali1,2, Alessandra Iacono1, Carlotta Farneti1, Enrico Cocchi1,3, Ignacio Javier Fernandez3,4, Chiara Romeo5, Federico Marchetti1,3
1UOC di Pediatria e Neonatologica, Ospedale di Ravenna, AUSL della Romagna
2Scuola di Specializzazione in Pediatria, Università di Bologna
3Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna
4UOC di Otorinolaringoiatria, 5SSD di Neuroradiologia, Ospedale di Ravenna, AUSL della Romagna
Gennaio 2025 - pagg. 25 -31 | DOI: 10.53126/MEB44025
Abstract
Venous thrombosis of the cerebral sinuses can complicate acute otitis media (AOM) due to the close anatomical relationship between these structures. This condition presents a diagnostic challenge for clinicians, as it often manifests with nonspecific symptoms like headaches and carries the risk of quickly developing into intracranial hypertension. The paper presents the case of a 10-year-old child with a history of AOM who developed headache, later diagnosed as otomastoiditis complicated by thrombosis of the sigmoid sinus and jugular-sigmoid junction. The patient required surgical intervention, along with antibiotic and anticoagulant therapy, leading to a full resolution of the thrombosis.
Riassunto
La trombosi venosa dei seni cerebrali è una possibile complicanza dell’otite media acuta (OMA), derivante dalla prossimità anatomica delle strutture coinvolte. Questa rappresenta un’insidia per il clinico vista la presentazione sfumata con una generica cefalea, associata al rischio di rapida degenerazione in ipertensione endocranica. Riportiamo il caso di un bambino di dieci anni giunto alla nostra attenzione per cefalea e pregressa otite come presentazione di una otomastoidite complicata da trombosi seno sigmoide e del passaggio giugulare-sigmoideo, che ha richiesto trattamento chirurgico, oltre alla terapia farmacologica antibiotica e anticoagulante, con completa risoluzione della trombosi.
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Corrispondenza: angela.troisi@auslromagna.it