Otitic hydrocephalus

  • Otitic hydrocephalus is a condition in which there is increased intracranial tension secondary to acute or chronic middle ear infection.
  • The CSF shows shows normal levels of protein, glucose and is sterile


  • Middle ear infection can predispose to lateral sinus (transverse sinus) thrombosis
  • The thrombus can extend into the superior sagittal sinus and impede the drainage of CSF
  • This results in increased intracranial tension

Clinical features

Features of increased intracranial tension are present:

  • Headache, nausea, vomiting
  • Diploplia due to lateral rectus palsy (abducent nerve is usually the first nerve to be affected in increased intracranial tension)
  • Blurred vision – due to papilloedema / optic atrophy


  • Papilloedema
  • Nystagmus
  • Lumbar puncture – shows increased CSF pressure, but normal levels of cells, protein and glucose. It is sterile


  • Measures to decrease the intracranial tension
    • Medical
      • high dose steroids
      • acetazolamide
      • mannitol
    • Surgical
      • repeated lumbar puncture
      • lumbar drain
      • lumboperitoneal shunt
  • Treating the ear infection
    • antibiotics – topical and intravenous
    • mastoid surgery

Add a Comment

Your email address will not be published. Comments will be displayed only after moderation.

Read previous post:
Mansonia egg

Mansonia egg - microscopic view Click on image for an enlarged view Mansonia mosquitoes are vectors of malayan (brugian) filariasis...