Presentation
Right ear pain, vomiting and headache.
Patient Data
Age: 30 years
Gender: Female
From the case:
Complicated coalescent mastoiditis
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Axial FLAIR
- Right mastoiditis with complete opacification of the mastoid air cells by secretions showing abnormal signal and patchy post contrast enhancement. It also shows small cortical defects.
- Intracranial extension showing:
- Meningeal thickening and enhancement along the tentorial leaflets, the temporal lobe and right cerebellar hemisphere.
- Loss of normal signal void of the right transverse, sigmoid and examined portion of the right internal jugular vein which post contrast enhancement.
- Associated right temporal and cerebellar swelling and edema signal.
- Similar opacification of the left mastoid air cells by abnormal signal and enhancement.
From the case:
Complicated coalescent mastoiditis
MRV
Right transverse, sigmoid and internal jugular venous thrombosis evident by loss of their bright signal.
Case Discussion
The case illustrates multiple intra-cranial complications of the acute mastoiditis:
- meningitis
- dural sinus occlusive disease (DSOD)
- cerebral and cerebellar parenchymal edema (cerebritis)
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