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Objective To explore the clinical significance of "Olive ⁃ Tipped" technique during cerebral venous sinus stenosis stenting. Methods A total of 79 patients (including 57 patients with intracranial hypertension and 22 patients with pulsatile tinnitus) who were diagnosed with cerebral venous sinus stenosis (VSS) and underwent stenting in Department of the First Medical Center of Chinese PLA General Hospital from January 2017 to May 2021 were retrospectively collected. The characteristics of Labbe vein in patients with "Olive⁃Tipped" technique, the changes of pressure difference at both ends of stenosis before and after surgery in patients with intracranial hypertension were analyzed. The improvement of postoperative stenosis and venous reflux, the improvement of postoperative intracranial hypertension and pulsatile tinnitus, the success rate of stenting and the utilization rate of "Olive ⁃ Tipped" technique were observed. Results All the stents were successfully placed (79/79). Immediate DSA after procedure showed no venous stasis in all patients, and residual stenosis was < 30%. "Olive⁃Tipped" technique was used in 23 patients (29.11%) to assist the stent in place due to the guiding catheter and stent could not reach the predetermined position smoothly. The diameter of the confluence of Labbe vein and venous sinus in the "Olive⁃Tipped" technique group was significantly larger than that in the conventional technique group (t = 7.041, P = 0.000). The pressure difference between the two ends of venous sinus stenosis in patients with intracranial hypertension was 15.00 (11.00, 21.50) mm Hg before surgery and 1 (0, 2) mm Hg immediately after surgery, the difference was statistically significant (Z = ⁃ 6.573, P = 0.000). The tinnitus sympoms of 22 patients with pulsatile tinnitus caused by cerebral venous sinus stenosis disappeared immediately or visibly lightened. Conclusions The diameter of the confluence of Labbe vein and venous sinus can be used as an index to evaluate whether the stent is easy to implant before the surgery. The dilated Labbe vein confluence is easy to cause the guiding catheter and stent to get stuck, and the stent is difficult to be in place. The use of "Olive⁃Tipped" technique can significantly improve the success rate of the surgery.

Background and Objectives: Allergic fungal rhinosinusitis (AFRS) is a relatively new and known disease with effective treatment, which belongs to the group of nasal polyposis diseases. According to high prevalence of AFRS in regions with warm and humid climate, the aim of this study was to detect the frequency of AFRS in patients with chronic rhinosinusitis (CRS) and nasal polyposis in Amir-al-momenin Hospital in Rasht city. Methods: During functional endoscopic sinus surgery, the samples were collected from 55 patients with CRS along with nasal polyposis and were examined in terms of histopathology, mycology, culture and total serum IgE level. Data were analyzed using chi-square and exact Fisher’s tests. Results: In this study, 17 (30.9%) female and 38 (69.1%) male patients with the mean age of 38.34±12.67 years, were participated. History of Atopia was seen in 54.5% of the patients, asthma in 25.5%, and blood eosinophilia (>6%) in 26.9%. Total serum IgE level was reported higher than natural value in 48.9% of the patients. Based on Kuhn and Benet criteria, the relative frequency of AFRS was 5.5% (3 patients) and nonfungal eosinophilic mucin rhinosinusitis (NF-EMRS) was 16.4% (9 patients). In AFRS patients, 3 cases had atopy, 3 were eosinophilic mucin positive, 2 cases had asthma, 1 direct smear-positive, 3 positive PAS staining, and 1 positive (Aspergillus fumigatus) culture. Conclusion: In sinus samples of the studied patients, the frequency of eosinophilic mucin was much higher compared to other reports. Although, the frequency of positive smear and fungal culture is lower than other similar studies.

Cerebral venous thrombosis (CVT) is an uncommon but fatal type of stroke with a wide spectrum of signs and symptoms. We report a 40-year-old woman who presented with acute intractable neck pain and lateral cervical bending. Investigations with neuroimaging revealed evidence of thrombosis in her right transverse and sigmoid sinuses. The precipitating factors for the thrombosis were consumption of oral contraceptive pills during the month of Ramadan, and dehydration due to fasting. The patient immediately was treated with the therapeutic dose of anticoagulant. We concluded that in patients with severe cervical pain, especially those who are predisposed to thrombotic complications, CVT should be considered in the differential diagnosis.

The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

Si bien la trombosis venosa intracraneal es una patología relativamente poco frecuente, es una entidad que debe ser diagnosticada a tiempo y con certeza en los servicios de urgencia, dada la necesidad de pronto tratamiento para evitar complicaciones graves que incluyen déficit neurológicos e incluso muerte. Existen varios signos imaginológicos que nos permiten hacer este diagnóstico, tanto en tomografía computarizada como en resonancia magnética. Por otra parte, es necesario considerar algunos diagnósticos diferenciales para no cometer errores, confundiendo esta patología con otras entidades.Although intracranial venous thrombosis is a relatively rare disease, it constitutes an entity that must be timely and accurately diagnosed in emergency services, given the need for prompt treatment to avoid serious complications, including neurological deficits or even death. There are several imaging signs provided by both CT and magnetic resonance imaging scans that allow this early diagnosis. On the other hand, some differential diagnoses need to be performed to prevent the error of mistaking intracranial venous thrombosis for any other entity.

ABSTRACT We report an analysis of the cranial venous sinuses circulation, emphasizing morphological and angiographic characteristics. Methods Data of 100 cerebral angiographies were retrospectively analyzed (p = 0.05). Results Mean age was 56.3 years, 62% female and 38% male. Measurements and dominance are shown in the Tables. There was no association between age or gender and dominance. Right parasagittal division of the superior sagittal sinus was associated with right dominance of the transverse sinus, sigmoid sinus and internal jugular vein; and left parasagittal division of the superior sagittal sinus was associated with left dominance of the transverse sinus, sigmoid sinus and internal jugular vein. Conclusion A dominance pattern of cranial venous sinuses was found. Age and gender did not influence this pattern. Angiographic findings, such as division of the superior sagittal sinus, were associated with a pattern of cranial venous dominance. We hope this article can add information and assist in preoperative venous analysis for neurosurgeons and neuroradiologists.