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Demelo-Rodriguez, PabloAuthor

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June 2, 2021
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Torcular herophili and lateral sinus thrombosis: An atypical presentation of Lemierre's syndrome

Publicated to:Intractable Rare Dis Res. 8 (3): 206-209 - 2019-08-01 8(3), DOI: 10.5582/irdr.2019.01071

Authors: Baltasar-Corral, Jesus; Maria Martin-Rojas, Reyes; Parra-Virto, Alejandro; Galeano-Valle, Francisco; Del-Valle-Dieguez, Mariano; Del-Toro-Cervera, Jorge; Demelo-Rodriguez, Pablo

Affiliations

Gregorio Maranon Hlth Res Inst, Madrid, Spain - Author
Univ Gen Hosp Gregorio Maranon, Dept Hematol, Madrid, Spain - Author
Univ Gen Hosp Gregorio Maranon, Dept Internal Med, Venous Thromboembolism Unit, Madrid, Spain - Author
Univ Gen Hosp Gregorio Maranon, Dept Radiol, Madrid, Spain - Author

Abstract

Lemierre's syndrome (LS) is an uncommon disease characterized by septic thrombophlebitis of the jugular vein in the context of otorhinolaryngologic infections. These patients are often young and the pharyngotonsillar infection is the most frequent primary focus, but other foci like acute otitis media or otomastoiditis have been described. Although the internal jugular vein is the most commonly affected site, a few case reports have been published with thrombosis of other veins, such as the facial vein or transverse sinus. We report the case of a 93-year-old woman with an atypical presentation of LS presenting with thrombophlebitis of the internal jugular vein, transverse sinuses and Herophili torcula after an acute otitis media complicated with acute otomastoiditis. Infectious cerebral venous thrombosis (CVT) is rare and accounts for 6-12% of the total in large adult series and is usually associated to otorhinolaryngologic infections. CVT is an atypical presentation of LS that can be potentially lethal, especially during the acute phase. For this reason, clinical suspicion and early treatment are vital to improve the prognosis of these patients. Although surgical treatment is recommended in cases of LS complicated with CVT, conservative management with antibiotics and anticoagulation lead to ad integrum restitutio without neurological sequelae in our case, suggesting that surgical treatment may not be necessary in all cases of LS complicated with CVT.

Keywords

Cerebral venous thrombosisLemierre's syndromeOtomastoiditisTorcula herophili

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Intractable Rare Dis Res due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2019, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Medicine (Miscellaneous).

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.71, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Aug 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-08-02, the following number of citations:

  • WoS: 3
  • Scopus: 4

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-02:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 14 (PlumX).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (DEMELO RODRIGUEZ, PABLO).