Subtle imaging signs of sigmoid sinus thrombosis in otitis media ("otitic hydrocephalus").

A 3-year-old boy developed otitis media, mastoiditis, papilledema, sixth nerve palsy, and increased intracranial pressure. The initial diagnosis was idiopathic intracranial hypertension, but doubt about that diagnosis at such a young age led to imaging reevaluation. When the abnormalities from multiple pulse sequences were aggregated with this clinical input, the correct diagnosis of otitic hydrocephalus emerged, allowing prompt implementation of appropriate treatment to avoid the risk of venous stroke.