Ak. Nayak et al., CEREBELLAR VENOUS INFARCTION IN CHRONIC SUPPURATIVE OTITIS-MEDIA - A CASE-REPORT WITH REVIEW OF 4 OTHER CASES, Stroke, 25(5), 1994, pp. 1058-1060
Background Cerebellar venous infarction is a rare condition. Thus far
only four cases have been reported in the literature. We recently enco
untered a patient with chronic suppurative otitis media complicated by
cerebellar venous infarction. The features of cerebellar venous infar
ction in the other four cases are also reviewed. Case Description A 20
-year-old man presented with clinical features suggestive of chronic s
uppurative otitis media. Computed tomographic scan of the brain reveal
ed left mastoiditis with cholesteatoma and moderate communicating hydr
ocephalus. The patient was subjected to left radical mastoidectomy, an
d an attice-antral cholesteatoma was removed. Subsequently the patient
developed clinical features suggestive of cerebellar abscess. A repea
t computed tomographic scan revealed normal posterior fossa. Four-vess
el angiography revealed left sigmoid and lateral sinus thrombosis and
nonopacification of the left-sided cerebellar veins. Magnetic resonanc
e imaging showed a venous infarct in the left cerebellar hemisphere. T
he patient was treated with cerebral dehydration measures. The patient
subsequently improved and had no neurological deficit 3 months after
surgery. Conclusions Although cerebellar venous infarction is rare, it
can occur in chronic suppurative otitis media, pregnancy, antithrombi
n III deficiency, and diabetic osmolar coma. Sometimes no cause is fou
nd. Treatment includes correction of the underlying cause. The presenc
e of a hemorrhagic lesion on computed tomographic scan and deep coma a
t presentation indicate poor prognosis.