Otitic hydrocephalus is a rare complication of acute suppurative otitis media. The main symptoms are nausea, vomiting , headache, blurred vision and diplopia.
Pathogenetically it is thought to be a complication of acute mastoiditis with lateral (sigmoid) sinus thrombosis causing intracranial hypertension. Diagnosis is suspected upon CT and MRI images, lumbar puncture should be done for confirmation.
Treatment includes methods to lower intracranial pressure, surgical treatment of middle ear infection, systemic antibiotic and anticoagulation therapy. We present a 4-year-old boy with otitic hydrocephalus that primarily came for lesion of abducens and oculomotor nerve and headache after treatment of otogenic meningitis.
Antromastoidectomy was performed, followed by intravenous antibiotic and anticoagulation therapy. The patient made a fast and complete recovery, the palsy of the eye movement involved nerves recovered completely as well.