Background. Otitis media is a prevalent paediatric condition. While complications are infrequent, intracranial complications, such as lateral or transverse sinus thrombosis (LST), can be serious. LST, which is often challenging to diagnose, remains a subject of debate regarding optimal management.
Case Report. The paper reports the case of a 6-year-old boy presenting with headache, intermittent esotropia and right-sided hemiparesis. Fundoscopic examination revealed bilateral blurred optic disc margins. Following a recent course of antibiotics for bilateral otitis media, imaging studies confirmed bilateral transverse-sigmoid sinus thrombosis. The patient received triple antibiotic therapy and anticoagulants; surgical intervention included bilateral mastoidectomy with trans tympanic drainage tube placement.
Discussion. The diagnosis and management of this rare condition in paediatric age remain complex. While MRI is the gold standard for diagnosis, the optimal therapeutic approach is debated. Antibiotic therapy is universally accepted, but the role of anticoagulants is controversial. Recent guidelines support the use of heparin for at least two months, with direct oral anticoagulants as an alternative. Surgical intervention, such as mastoidectomy, may be considered in specific cases.