CEREBELLAR VENOUS INFARCTION IN CHRONIC SUPPURATIVE OTITIS-MEDIA - A CASE-REPORT WITH REVIEW OF 4 OTHER CASES

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.