Images - Gradenigo's Syndrome: Findings on Computed Tomography and Magnetic Resonance Imaging

A 25-year old man presented with history of right-sided otorrhoea for 3 weeks. It was accompanied with headache, vomiting and diplopia. On examination, this afebrile patient was noted to have ipsilateral sixth nerve palsy and a pinpoint perforation in the tympanic membrane of the right ear. The right mastoid was tender. However, there was no evidence of papilloedema or neck stiffness. The leucocyte count was 11000/ mm³ [polymorphs 73%, lymphocytes 19% and monocytes 6%] while the ESR was 87 mm at the end of 1 hour.