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Objective: Several studies in the literature have used contrast-enhanced magnetic resonance imaging to investigate arachnoid granulations protruding into the cranial dural sinuses. The current study aimed to investigate the protrusion of arachnoid granulations into the superior sagittal sinus, transverse sinus, straight sinus, and confluence of sinuses and determine the frequency of brain herniation into giant arachnoid granulations using contrast-enhanced 3-dimensional T1-weighted magnetic resonance imaging. Materials and Methods: Images of 550 patients with intra-sinus arachnoid granulations who underwent contrast-enhanced 3-dimensional T1-weighted thin-slice magnetic resonance imaging were retrospectively re-evaluated. Only 300 patients with at least 1 intra-sinus arachnoid granulation were included in the study. The protrusion of arachnoid granulations into superior sagittal sinus, transverse sinus, straight sinus, and confluence of sinuses was investigated. In addition, large arachnoid granulations and brain herniations into arachnoid granulations were also noted. Results: A total of 889 focal filling defects of arachnoid granulations, at least 1 in the dural sinus, were detected. Of the filling defects of arachnoid granulations, 183 were in the right transverse sinus, 222 in the left transverse sinus, 265 in superior sagittal sinus, 185 in straight sinus, and 34 in confluence of sinuses. Brain herniation into arachnoid granulations was detected in 8 (2.7%) of the patients included in the study. All the filling defects detected in the dural sinuses on post-contrast 3-dimensional T1-weighted images were isointense with cerebrospinal fluid and had round, oval, or lobulated contours. A positive weak correlation was found between patient age and the size and number of arachnoid granulations (r = 0.181, P < .01 and r = 0.207, P < .001, respectively). It was observed that the size and number of arachnoid granulations increased as the age of the patients increased. Conclusions: The distribution, shape, number, and size of intra-sinus arachnoid granulations can vary considerably. Brain herniation into arachnoid granulation can also be seen. Three-dimensional cranial magnetic resonance imaging sequences can be safely used in the evaluation of arachnoid granulations. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to examine the role of the contrast-enhanced gadolinium-enhanced three-dimensional magnetic resonance venography (GE 3D MRV) technique in the detection of dural sinus pathologies by comparing the two-dimensional (2D TOF MRV). Methods: One hundred and eighty patients who underwent MRV due to dural sinus pathology in the radiology department of Haydarpaşa Numune Training and Research Hospital between January 2019 and July 2019 were included in the study. Images of 21 patients in the study group who had both 2D TOF MRV or GE 3D MRV were evaluated retrospectively. Results: About 33.3% of cases were male and 66.7% (n=14) were female. The mean age of the patients was 29.7±4.64 years (18-64 years). In 2D TOF MRV series, complete signal loss was observed in the unilateral transverse sinus (TS) of four patients (2.2%/180-1.6%) and in the sinus rectus of 1 patient (1/180-0.55%). Of these, 2 (1.1%) located in the TS and GE (2.1%) located in the sinus rectus were confirmed in the 3D MRV. Two patients' imaging showed a jugular vein and ipsilateral sigmoid sinus flow defect on 2D TOF MRV, but no findings on GE 3D MRV. There were four arachnoid granulations observed in the transverse sinuses in 4% of cases on two-dimensional venography, all of them confirmed on contrast-enhanced examinations. Six of the flow gaps observed in the transverse sinuses of 12 patients in 2D TOF MRV, disappeared completely in GE 3D MRV. When the diameters of the transverse sinuses were determined using the two techniques, the ratio of inconsistencies in Grade 0 and Grade 3 was higher than the others. Discussion and Conclusion: GE 3D MRV, a contrast imaging method, can be used effectively when there is a diagnostic challenge to exclude sinus thrombosis on 2D TOF imaging. [ABSTRACT FROM AUTHOR]

Purpose: Cerebral sinus vein thrombosis (CSVT) associated with acute mastoiditis is a rare complication of acute otitis media. Elevated intracranial pressure (ICP) frequently occurs secondary to CSVT. The study aims to review the 5 years of experience of four medical centres to treat sigmoid sinus thrombosis and elevated intracranial pressure in children. Methods: Patients with CSVT that developed secondary mastoiditis from 2016 through 2021 were evaluated in four centres from Turkey. Patients diagnosed with a preceding or synchronous mastoiditis and intracranial sinus thrombosis were included in the study. Magnetic resonance imaging (MRI), magnetic resonance venography (MRV), ICP measurements, ophthalmological examinations, thrombophilia studies and treatments for increased ICP have also been recorded. Results: The study group comprises 18 children. Twelve patients were diagnosed with right-sided, six patients with left-sided sinus vein thrombosis. All of the patients had ipsilateral mastoiditis. The most common presenting symptoms were fever, ear pain, headache, visual disorders and vomiting. The most encountered neurologic findings were papilledema, strabismus and sixth cranial nerve palsy. ICP was over 20 cm H2O in eleven patients. Anticoagulant treatment, antibiotics, pressure-lowering lumbar puncture and lumboperitoneal shunt were among the treatment modalities. Conclusion: Elevated ICP can damage the brain and optic nerve irreversibly, without treatment. For treating elevation of ICP associated with cerebral sinus thrombosis, pressure-lowering lumbar puncture (LP), acetazolamide therapy, optic nerve sheath fenestration (ONSF) and cerebrospinal fluid (CSF)-shunting procedures are suggested in case of deteriorated vision. [ABSTRACT FROM AUTHOR]

Background: Pseudotumor cerebri is a common disease in reproductive-age women characterized by increased intracranial pressure. The aim of our study was to investigate the clinical and demographic characteristics of pseudotumor cerebri patients from Erzurum and nearby provinces living in eastern Turkey. Methods: In our study, the records of 27 patients from Erzurum and nearby provinces, followed-up with the diagnosis of pseudotumor cerebri at the Ataturk University, Neurology Outpatient Clinic between January 2015 and December 2018, were retrospectively reviewed. The diagnosis of the patients was made with modified Dandy criteria. Results: Of the patients, 23 (85.18%) were female and 4 (14.81%) were male. The mean age was 38.75 in females and 48.25 in males. Of the patients, 17 (62.96%) had headache, 14 (51.85%) had blurred vision, 4 (14.81%) had double vision, 5 (18.51%) had nausea and vomiting, 3 (11.11%) had tinnitus. Fundus examination revealed unilateral papilledema in 3 (11.11%) patients and bilateral papilledema in 24 (88.88%) patients. The mean CSF pressure measurement was 348.33 mmH2O. Magnetic resonance venography showed unilateral hypoplasia of the transverse sinus in 5 (18.51%) patients. Distention of the perioptic subarachnoid space was the most common finding on Magnetic resonance Imaging examinations with 62.96% (n=17). Obesity and history of drug use were found to be the etiological causes in 8 and 3 patients, respectively, while the etiology could not be determined in 16 patients. Conclusion: The most common symptom is headache and findings is papillary edema in patients. Neuroimaging does not show parenchymal or meningeal pathology, but findings that support the diagnosis are observed. Since the most important complication of the disease is loss of vision, early diagnosis is important to maintain visual functions. [ABSTRACT FROM AUTHOR]

Objective: Parietal foramen is an important anatomical structure located on both sides of the sagittal sutura through which parietal emissary vein passes. We aimed to determine the parietal foramen' prevalence, number, and localization compared to sagittal sutura. Methods: Thirty skulls of unknown age and sex characteristics belonging to Çukurova University were used. Morphometric measurements were performed by digital caliper. Presence, number, localization and distance from sagittal sutura of parietal foramen were evaluated. SPSS Statistics 22 for statistical analysis (SPSS IBM, Turkey) programs was utilized in evaluation. Significance was evaluated at p<0.05. Results: 1, 2 and 3 parietal foraminawere found in 58.8%, 35.3% and 5.9% of 58 skulls with parietal foramen, respectively. Furthermore, unilateral and bilateral were observed in 58.8% and 41.2%. Of these skulls with parietal foramen respectively. 50% and 41.2% of the unilateral parietal foramen were found on the right and left side. There was no statistically significant difference between the unilateral and bilateral parietal foramina regarding their distance from sagittal sutura (p>0.05). There was no statistically significant difference in distance between bilateral parietal foramina and sagittal sutura as regards being the right and left (p>0.05). Conclusion: Knowing parietal foramen location, number and relationship with sagittal sutura helps to understand the relationship between dural venous sinuses and scalp veins. Knowledge of variations may be helpful in detecting congenital anomalies. We think that results of our study will constitute an important morphometric data for anatomists and clinicians. [ABSTRACT FROM AUTHOR]