Krishnan M, Walijee H, Jesurasa A, et al. - Researchers conducted this retrospective case note review to assess the recent experience with acute mastoiditis [most common intra-temporal complication of acute otitis media] secondary to acute otitis media and its related intracranial complications at a tertiary paediatric centre. This investigation was performed for patients admitted to Alder Hey Children’s Hospital between January 2006 and December 2016 with a diagnosis of acute mastoiditis. Using ICD-10 codes H700, H701, H702, H708 and H709, patients were identified. They identified 30 patients (18 males and 12 females) with intracranial complications of acute otitis media and mastoiditis. Otalgia and vomiting were the most common presenting complaint, with only 27% of patients presenting with mastoid swelling. The authors concluded that acute mastoiditis intracranial complications stay a major challenge. Most patients tend to have no mastoid swelling, requiring a high index of suspicion in patients with picket fence fever, vomiting, drowsiness, headaches, seizures or involvement of the cranial nerve. In addition to adjuvant medical treatment with full recovery of the majority of patients, most cases treated at the institution required acute surgical intervention.