Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study.

BACKGROUND: Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. METHODS: Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. RESULTS: The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34 ± 9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38 ± 9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). CONCLUSION: The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

Olfactory Bulb Volume Changes in Patients With Nasal Septal Deviation.

OBJECTIVES: The olfactory bulb (OB) plays a pivotal role in the processing of olfactory information. The aim of this study was to investigate the OB volume changes and its possible associations with nasal septal deviation. STUDY DESIGN: Cross-sectional study. SETTING: Otolaryngology Department of Bozok University School of Medicine and Neurology Department of Yozgat State Hospital. SUBJECTS AND METHODS: Ninety patient's cranial magnetic resonance imaging (MRI) studies (46 males and 44 females, mean age 36 ±â€Š13.4 years; range 18-56 years) with isolated nasal septal deviations were recruited for the study. Olfactory bulb volumes in all study subjects were evaluated in T2-weighted coronal MRI images by planimetric manual contouring. RESULTS: Nasal septal deviation angles were found to range between 5° and 23.21° (mean 13.6°â€Š±â€Š3.58°). The right-sided deviations included 17 mild (<9°, Group I), 20 moderate (9°-15°, Group II), and 16 severe (15° and up, Group III) patients. The left-sided deviations included 14 mild (<9°, Group I), 13 moderate (9°-15°, Group II), and 10 severe (15° and up, Group III) subjects. Olfactory bulb volumes were calculated in both right- and left-sided deviation groups. In the patients with left-sided septal deviations of Groups I, II, and III, the left OB volumes of Groups I, II, and III were 46.49 ±â€Š3.87, 47.46 ±â€Š3.36, and 60.68 ±â€Š5.65 mm and the right OB volumes were 53.37 ±â€Š3.76, 56.47 ±â€Š4.43, and 76.69 ±â€Š6.84 mm, respectively. The statistical evaluation of the right OB volumes did not produce significant difference between Groups I and II (P = 0.73). The authors demonstrated statistically significant differences in comparison of Groups I to III and Groups II to III (P = 0.002 and P = 0.016, respectively). In the right septal deviation group for Groups I, II, and III, mean volumes of right OB volumes were 45.59 ±â€Š4.46, 48.63 ±â€Š3.78, and 61.35 ±â€Š5.84 mm, respectively, and the left OB volumes were 54.67 ±â€Š4.73, 57.65 ±â€Š4.53, and 75.84 ±â€Š7.67 mm, respectively. There was no statistically significant difference between Groups I and II (P = 0.95) left OB volumes in the right-sided deviation group, but statistically significant difference was demonstrated in Groups I to III and Groups II to III compartments (P = 0.002 and P = 0.003). CONCLUSION: In our study, while mild and moderate septal deviations lacked any significant affect on OB volumes, severe deviations were found to have significant impact on these parameter. Additionally the contralateral OB volumes in the severe septum deviation group were significantly bigger when compared to the ipsilateral OB volumes. Further multidisciplinary studies are required to evaluate the clinical significance of OB volume changes in diagnosis and follow-up of several otolaryngologic or nonotolaryngologic diseases.

Traumatic internal carotid artery dissection associated with playing soccer: a case report.

Soccer, one of the most popular sports worldwide among young men, can result in a wide range of orthopedic injuries. Although vascular injuries such as dissection occur rarely, they can cause significant mortality if left undiagnosed. We report herein a 31-year-old male who suffered a large middle cerebral artery infarction due to traumatic internal carotid artery dissection after a ball struck his head and neck. He recovered with mild neurologic deficit after decompressive surgery.