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Intracranial Complications of Otitis Media

On admission, she was febrile (39°C) and had a right-sided facial palsy with spontaneous nystagmus, papilledema, severe cerebellar ataxia, fluctuating retroauricular swelling, and a right-sided purulent, malodorous otorrhea. She also showed signs of meningeal irritation. Computed tomography (CT) of the brain and temporal bones revealed a right posterior temporal abscess and a posterior parafalcial subdural empyema. There was also a right cerebellar abscess and thrombosis of the right sigmoid sinus. The right mastoid was opacified, with an associated durai enhancement and granulation tissue (Figs 1 and 2). She was started on gentamicin sulfate (60 mg every 12 hours), metronidazole hydrochloride (500 mg every