Fulminant intracranial hypertension as a result of otological surgery: case report and discussion of management

2021 ◽  
pp. 1-4
Author(s):  
A Morris ◽  
J N Higgins ◽  
P R Axon
Keyword(s):  
Case Report ◽  
Intracranial Hypertension ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
Surgical Reconstruction ◽  
Lateral Sinus ◽  
Life Threatening ◽  
Venous Outflow Obstruction

Abstract Background Dural venous sinus injury is a rare complication of otological surgery that can lead to life-threatening sequelae, the management of which is complex and poorly described. Case report This paper describes the case of a 40-year-old female who underwent routine right myringoplasty complicated by sigmoid sinus laceration. The patient subsequently developed right-sided lateral sinus thrombosis leading to fulminant intracranial hypertension. The patient underwent successful emergency management by surgical reconstruction of the sigmoid sinus, followed by endovascular thrombolysis, catheter balloon angioplasty and endovascular stenting. Conclusion Torrential haemorrhage following otological procedures is uncommon and rarely requires packing of a bleeding venous sinus. This case highlights that injury to a highly dominant venous sinus can lead to venous outflow obstruction and life-threatening intracranial hypertension. To our knowledge, the development of this complication following otological surgery and its management has not been reported previously.

Lateral sinus thrombosis following myringoplasty: a rare complication

2012 ◽  
Vol 127 (S1) ◽  
pp. S39-S41 ◽  
Author(s):  
G Sim ◽  
F Lannigan
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Otitis Media ◽  
High Mortality ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Lateral Sinus ◽  
Lateral Sinus Thrombosis ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractObjective:We report lateral sinus thrombosis occurring as a rare complication following a routine and uneventful otological procedure.Case report:Lateral sinus thrombosis is a rare but known complication of otitis media. It has not been documented as a complication of routine otological surgery. We present a case of this rare complication following a myringoplasty. We also discuss the presentation, investigation and treatment of lateral sinus thrombosis. It is essential to be able to recognise and treat this rare complication early, due to its high mortality rate.Conclusion:Lateral sinus thrombosis is a rare but potentially life-threatening complication. It is therefore essential for clinicians to be able to recognise and treat this condition early.

scholarly journals Successful treatment of cerebral venous sinus thrombosis by balloon venoplasty: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110632
Author(s):  
Wei Chen ◽  
Wen-Jing Gu ◽  
Ming-Chao Shi ◽  
De-Rui Kong ◽  
Ke-Xin Zhao ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Sinus Thrombosis ◽  
Clinical Manifestations ◽  
Cerebral Venous Sinus Thrombosis ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Aged People ◽  
The Right

Cerebral venous sinus thrombosis is a special cerebrovascular disease affecting young adult and middle-aged people. The clinical manifestations of cerebral venous sinus thrombosis are diverse and nonspecific; thus, imaging plays an important role in early diagnosis. Anticoagulation with heparin is the preferred treatment for cerebral venous sinus thrombosis. Endovascular treatment is also being increasingly used to achieve recanalization of the cerebral venous sinus. We herein describe a woman in her early 50s who was diagnosed with cerebral venous sinus thrombosis for which anticoagulation with heparin was ineffective. To improve her symptoms and prognosis, we selected balloon venoplasty to treat the right sigmoid sinus thrombosis. Her condition subsequently improved, and no recurrence was observed after several follow-ups.

Surgical corridors for congenital aural atresia with otogenic cerebellar abscess and lateral sinus thrombosis

2021 ◽  
Vol 14 (5) ◽  
pp. e239403
Author(s):  
Saranya Thangavel ◽  
Lokesh Kumar Penubarthi ◽  
Arun Alexander ◽  
Sunil Kumar Saxena
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Multidisciplinary Approach ◽  
Sinus Thrombosis ◽  
Lateral Sinus ◽  
Aural Atresia ◽  
Lateral Sinus Thrombosis ◽  
Cerebellar Abscess ◽  
Intracranial Complications ◽  
Congenital Aural Atresia

The following is a case report of an adolescent with mental retardation who had congenital aural atresia with contralateral congenital facial palsy. She developed multiple intracranial complications (cerebellar abscess and lateral sinus thrombosis) due to cholesteatoma. We managed her in a multidisciplinary approach. This report discusses case management, emphasising the meticulous intraoperative steps taken in identifying the landmarks and precautions adopted to avoid postoperative facial palsy and other complications.

POTT’S PUFFY TUMOR: A CASE REPORT

2020 ◽  
Vol 18 (Suppl.1) ◽  
pp. 93-96
Author(s):  
V. Stoyanov ◽  
D. Petkov ◽  
P. Bozdukova
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Rare Complication ◽  
Frontal Bone ◽  
Frontal Sinusitis ◽  
Subperiosteal Abscess ◽  
Prompt Treatment ◽  
Pott’S Puffy Tumor ◽  
Intracranial Complications ◽  
Life Threatening

Pott’s puffy tumor (PPT) is a rare complication of sinusitis characterized by osteomyelitis of the frontal bone with subperiosteal abscess presenting as frontal swelling. It was first described by Sir Percival Pott in 1768 in relation to frontal head trauma. Later, it was established that this entity is more common in relation to frontal sinusitis (1). In this article we report a case of PPT in a 17-year-old boy. CT scan confirmed subperiosteal abscess. At surgery, the subperiosteal abscess was drained and sequestrectomy of the affected frontal bone was done. Broad-spectrum antibiotics were given for 4 weeks. The patient recovered without residual problems and has remained well. PPT is now relatively uncommon and early diagnosis and prompt treatment is necessary to avoid further intracranial complications, which can be life-threatening.

Abstract 1122‐000232: The Importance of Performing Venous Pressure Measurements Following Venous Sinus Stenting for Idiopathic Intracranial Hypertension

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Yazan Radaideh
Keyword(s):  
Pressure Gradient ◽  
Intracranial Hypertension ◽  
Stent Placement ◽  
Idiopathic Intracranial Hypertension ◽  
Venous Pressure ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
Pressure Measurements ◽  
Sinus Stenosis ◽  
The Right

Introduction : Although venous sinus stenting is an established treatment for medically refractory idiopathic intracranial hypertension, a subset of patients shows little or no improvement of symptoms after stenting. While this could be related to a number of factors, failure to sufficiently address the pressure gradient is one that can be recognized during the treatment procedure. We describe two patients who had a persistent venous pressure gradient after stent placement. Once identified, a second stent was placed with subsequent resolution of the pressure gradient. Methods : This retrospective chart review identified patients at a single institution who underwent venous sinus stenting and required immediate placement of a second venous sinus stent for a persistent pressure gradient. Results : Two patients with refractory idiopathic intracranial hypertension underwent cerebral angiography with venous manometry. In the first patient, unilateral venous sinus stenosis was present with a maximum pressure of 50 mmHg, which only decreased to 30 mmHg after placement of a right transverse‐sigmoid sinus stent. Subsequent manometry revealed a persistent gradient between the superior sagittal sinus and the right transverse sinus, which resolved after placement of a second stent in this location. In the second patient, bilateral stenosis was observed at the transverse‐sigmoid sinus junction; the maximum venous pressure was 40 mmHg, and a gradient of 30 mmHg was measured at the right transverse‐sigmoid junction, where a venous sinus stent was placed. Venous sinus pressure measurements performed immediately after the stent placement demonstrated a persistent pressure gradient of 20 mmHg in the contralateral transverse‐sigmoid sinus junction, which resolved after contralateral stent placement. Both patients showed sustained improvement in their symptoms at 1 year follow up. Conclusions : In some patients with idiopathic intracranial hypertension and venous sinus stenosis, a single stent may not sufficiently reduce the pressure gradient. A second stent may be required; however, this is only detectable with post‐stent pressure measurements. Performing manometry after stent placement should be routinely performed in order to detect persistent venous pressure gradient.

scholarly journals Catatonia, beyond a psychiatric syndrome

2017 ◽  
Vol 11 (2) ◽  
pp. 209-212
Author(s):  
Nathália Stela Visoná de Figueiredo ◽  
Débora Bartzen Moraes Angst ◽  
Antônio de Matos Lima Neto ◽  
Michel Ferreira Machado ◽  
Maria Sheila Guimarães Rocha ◽  
...  
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Clinical Manifestation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Nonconvulsive Status Epilepticus ◽  
Diagnostic Investigation ◽  
Venous Sinus Thrombosis ◽  
Psychiatric Syndrome

ABSTRACT Although catatonia is a well-known psychiatric syndrome, there are many possible systemic and neurological etiologies. The aim of this case report was to present a case of a patient with cerebral venous sinus thrombosis and infarction in which catatonia was the clinical manifestation of a possible nonconvulsive status epilepticus. To our knowledge, only one such case has been reported in the literature, which had a simplified diagnostic investigation. It is important to correctly recognize the organic cause underlying catatonia in order to treat the patient as soon as possible thereby improving outcome. Therefore, physicians need to update their knowledge on catatonia, recognizing that it can be part of a psychiatric or neurologic condition.

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