Case Notes
History
53 year old female who presented with confusion, depressed level of consciousnes, fever, and right ear pain. On admission patient had right coalescent otomastoiditis. Her lumbar puncture grew out strep pneumococcus.Exam
CTV of the neck
Prior Study
CT headThere is evidence of aggressive right otomastoiditis with sigmoid plate dehiscence (coalescent otomastoiditis) producing a small volume, epidural abscess, which partiall compresses the adjacent dural sinus. Focal deformity of the sigmoid sinus is evident at the site of epidural abscess, however, the remaining lumen of the right sigmoid sinus and the internal jugular vein are patent. Intraluminal thrombus is present in the torcular herophile, the left transverse/sigmoid sinuses, extending into the high cervical left IJ.
CT perfusion NO CT perfusion is available