The use of antibiotics in the treatment of acute otitis media is reported to have reduced intracranial complications (ICs) from 2.3% to 0.24%.1 However, in cases of acute mastoiditis, the risk of ICs is reported to be as high as 6% to 16%.1-6 The epidemiological and clinical causes of ICs are probably multifactorial. For example, when antibiotic treatment fails in children with acute otitis media,1,4 ICs may be caused by inappropriate treatment, low compliance with drug therapy, insufficient drug dosages, and bacterial resistance. The most common ICs in cases of acute mastoiditis are meningitis, brain abscess, lateral sinus thrombosis, and epidural empyema.