Ocular tilt reaction and internuclear ophthalmoplegia associated with venous sinus thrombosis: an unusual case

Case report A 11-year-old previously healthy girl presented to the emergency department with an acute history of vomiting, neck and back pain, diplopia and photophobia after a 14-day unsuccessful treatment for bilateral otitis media. The presence of RNFL attenuation, ischaemic spots (cotton wool spots) and the emergence of an RAPD indicate progressive damage to the anterior visual system by the continued raised ICP/papilledema and probable increased susceptibility to continued elevated pressure.