A 75-year-old male with a past history of chronic renal failure (under maintenance hemodialysis), bronchial asthma, old myocardial ifarction and angina pectoris was complaining of pain and hearing loss in the left ear. Cranial nurve palsies (IX X XI XII) and Horner syndrome were noted on the affected side. Mastoidectomy was performed because CT and MRI suggested a diagnosis of acute mastoiditis. Although his symptoms temporarily improved after surgery, he died of complicated pneumonia with recurrence of multiple cranial nerve palusies.
Villaret syndrome caused by acute mastoiditis has rarely been reported in the literature. We reported the first case of Villare syndrome caused by acute mastoiditis and hypertrophic pachymeningitis that was confirmed at autopsy.