Canio Pietro Picciano
Background: We report a case of acute hydrocephalus in a 29-year-old woman following otitis media and bilateral stenosis of the transverse sinuses.
Observation: A 29-year-old woman presented to the Emergency Department of Parma Hospital with fever, headache, photophobia, nausea and altered sensorium. The blood tests, along with the concurrent fever, raised suspicion of an ongoing inflammatory process. Brain CT revealed acute hydrocephalus, requiring urgent external ventricular drainage. Given the suspicion of meningitis, a Cerebrospinal Fluid (CSF) sample was obtained in the operating room, yielding negative results both in terms of culture, cytology and biochemistry. Brain MRI conducted the following day showed progressive reduction of hydrocephalus. However, signs of intracranial hypertension persisted in the posterior fossa, with dilation of the fourth ventricle and bilateral stenosis of the transverse sinuses confirmed on cerebral angiography. Third ventriculocisternostomy was performed, followed by stenting of the dominant transverse sinus, resulting in resolution of the condition.
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