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December 2005

Otitic Hydrocephalus

Arch Neurol. 2005;62(12):1940. doi:10.1001/archneur.62.12.1940-a

With great interest we read the article by Bari et al1 on otitic hydrocephalus (OH) complications resulting from mastoiditis in a 10-year-old child. The authors described a study analyzing the clinical data and radiological approach to this case. We would like to present some comments on this problem based on our experience and the literature review.

Otitic hydrocephalus is a rare complication of acute mastoiditis, which is accompanied by lateral sinus thrombosis. Commonly applied antibiotics in upper respiratory tract infections and acute otitis reduced the incidence of intracranial complications. Development of these complications may result from improper antibiotic therapy. The pathophysiologic features of OH itself remain unclear. Diagnosing OH is relatively easy with computed tomography scans and magnetic resonance angiography. Magnetic resonance imaging is useful for diagnosing OH and enables physicians to diagnose vascular malformations and control treatment results. The treatment of OH is still controversial. In our opinion, reducing intracranial pressure is essential for protecting the central nervous system and especially the optic nerve.2