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(Stroke. 2002;33:290.)
© 2002 American Heart Association, Inc.

Short Communications

Mastoid Air Sinus Abnormalities Associated With Lateral Venous Sinus Thrombosis

Cause or Consequence?

John N. Fink, MB ChB, FRACP David L. McAuley, MB ChB, FRACP

From the Department of Neurology, Christchurch Hospital (J.N.F.), and Department of Neurology, Auckland Hospital (D.L.M.) (New Zealand).

Correspondence to John N. Fink, MB ChB, FRACP, Department of Neurology, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. E-mail john.fink{at}cdhb.govt.nz

Abstract

Background— Mastoiditis is a known cause of lateral venous sinus thrombosis (LST). We have encountered patients with LST associated with mastoid abnormality on MRI without any clinical signs of infection; the significance of these abnormalities is uncertain. This study examines the relationship of LST and mastoid air sinus abnormalities systematically.

Summary of Report— We performed a retrospective clinical and radiological review of a series of 26 patients with cerebral venous thrombosis. Mastoid abnormalities were detected ipsilateral to 9 of 23 thrombosed lateral sinuses (39%) and 0 of 29 unaffected lateral sinuses (P<0.001). No patient had clinical evidence of mastoiditis. Eight of 9 patients with mastoid abnormalities were treated without antibiotics; all made uneventful clinical recoveries. Repeated MRI in 1 patient revealed reversal of the mastoid changes.

Conclusions— The mastoid changes observed are likely to be due to venous congestion as a consequence of LST, not mastoiditis.

Key Words: lateral sinus thrombosis • magnetic resonance imaging • mastoiditis • sinus thrombosis, intracranial

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