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capillaries, which in turn would tend to produce cerebral edema and perivascular transudation of fluid.As a matter of fact, bilateral papilledema occurs frequently in thrombosis of the lateral sinuses.5 Ordinarily the lateral sinus of the opposite side can take care of the extra volume of blood when one lateral sinus is thrombosed. However, anatomic variations of the venous sinuses are common, and if there is not adequate cross circulation at the torcular herophili or if the unobstructed lateral sinus is small there is resultant back pressure and consequently an increased intracranial pressure." Woodhall and Seeds 7 have shown that the markings on the inner table of the occipital bone, as revealed in the anteroposterior roentgenogram of the skull, correspond to differences in volume and distribution of the lateral sinuses. This roentgenogram of our patient clearly reveals that the left lateral sinus has at least twice the diameter of the right. Therefore the major venous drainage of the brain had to be carried by a relatively tiny vessel after the left lateral sinus was thrombosed. We surmise on the other hand that, if the right lateral sinus of this patient had been occluded, the left one, being much larger, could easily have carried the excess venous blood and the patient would have had no sequelae.In this case, therefore, there was originally normal pressure in the cerebrospinal fluid. During mastoidectomy the left lateral sinus was opened and packed. Subsequently a state of persistently increased intracranial tension ensued. This intracranial hypertension responded neither to rigorous dehydrating measures nor to ventricular punctures. It did, however, disappear promptly (and the choked disks subsequently) when the patient's head was maintained higher than the rest of her body, which aided venous drainage through the remaining and collateral channels.It is suggested that sterile thrombosis of the cerebral venous sinuses may underlie this syndrome in many cases and that the patient's posture should be considered in its management. SUMMARY A case of intracranial hypertension followed a mastoidectomy with opening and packing of a lateral sinus. This syndrome, otherwise known as serous meningitis or otitic hydrocephalus, is perhaps a matter of obstruction to venous outflow from the cranial cavity. Maintenance of the patient's head higher than the rest of the body was followed by prompt relief of the symptoms and increase in spinal fluid pressure as well as by early subsidence of the choked disks. Lately I was consulted by a group of department store employees, all of whom showed bites and dermatitis from scratching.Four women and a man showed wheals and papules. Many of the papules and a few wheals showed a central punctum. The bites varied from five to forty in number on the women and numerous on the man. In the women the sites of predilection were the arms and forearms, while the man had an extensive eruption of the hands, ankles, legs, belt line, upper part of the shoulders and the neck. The itching varied acco...

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