Aseptic lateral sinus thrombosis.

Abstract

Introduction: Aseptic lateral sinus thrombosis is not associated with infections of the ears or the paranasal sinuses. Due to the widespread use of antibiotics, is currently the most frequent form of manifestation of this process that, due to the clinical and radiological findings, supposes that the otorhinolaryngologist is frequently consulted to rule out a possible mastoid origin, reason why we consider it necessary to know this pathology.Clinical case: It is a 53-year-old male with a history of high blood pressure, who goes to his regional hospital with fever of 5 days of evolution without apparent focus. After the study by nuclear magnetic resonance it is derived urgently to our otorhinolaryngology service, with the diagnosis of left mastoiditis and thrombosis of the lateral and transverse sinuses of the same side, with extension to the internal jugular vein. In the computed tomography it is observed that the left mastoid cells are partially occupied, with preservation of their structure. The otorhinolaryngological study rules out the presence of mastoiditis and / or middle ear involvement, so the patient was referred to the Neurology Service who prescribe anticoagulant treatment. In the control by nuclear magnetic resonance, 3 months later, the persistence of the thrombosis was observed.Results and Discussion: Cerebral venous sinus thrombosis is an infrequent pathological entity, difficult to diagnose and complex, given the variability of presentation forms and the lack of therapeutic consensus. Aseptic lateral sinus thrombosis may be secondary to coagulation disorders, chronic and debilitating diseases, but between 10 and 15% of cases, the cause is not identified. Retention of venous drainage caused by thrombosis produces edema of the mastoid mucosa that raises suspicion at the radiological level the existence of an inflammatory process of the mastoid, causing, as in the case presented, diagnostic confusion. The evaluation of these patients should be done within the clinical context and the findings of the physical examination, considering the antecedents of otitis media.
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Ramírez-Salas, J. E., Benito-Orejas, J. I., Bauer, M., Santos-Pérez, J., Viveros-Díez, P., & Morais-Pérez, D. (2019). Aseptic lateral sinus thrombosis. Revista ORL, 10(5), 2.25. https://doi.org/10.14201/orl.20644

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Author Biography

Jesus Eduardo Ramírez-Salas

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Universidad Central de Venezuela
MIR Otorrinolaringologia Hospital Clinico Universitario de Valladolid
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