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Sample records for da fossa craniana

  1. Tratamento cirúrgico da cisticircose da fossa craniana posterior

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    Pedro Garcia Lopes

    1971-03-01

    Full Text Available A cisticercose, um dos mais sérios problemas parasitológicos do sistema nervoso, apresenta, quando localizada na fossa posterior, um quadro clínico dramático, no qual predomina a hipertensão intracraniana. Foram estudados neste trabalho, 70 pacientes com cisticercose de fossa craniana posterior, atendidos no Serviço de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de 1945 a 1968. Considerando-se a grande diversidade existente em torno das técnicas de tratamento cirúrgico, foi objetivo deste trabalho o estudo dos resultados obtidos nestes pacientes, nos quais várias técnicas foram empregadas. As cirurgias paliativas que derivam o trânsito do líquido cefalorraqueano para regiões extracranianas, quando comparadas aos outros tipos de cirurgias utilizados, foram as que proporcionaram maior índice de recuperação, exigiram menos reoperações, além de terem sido acompanhadas de menor número de complicações, bem como de menor mortalidade pós-operatória. Por outro lado, a neurocisticercose geralmente é um processo difuso, encontrando-se parasitas em várias regiões do encéfalo e/ou aracnoidite, conforme comprovou-se, também, entre os casos ora reunidos e que vieram a falecer. Baseando-se nestes fatos, não se justificam as derivações intracranianas e, a não ser eventualmente, a abordagem direta do parasita. Os casos estudados permitem cone- tatar, portanto, que as derivações extracranianas, por sua simplicidade e eficácia, apresentam-se, atualmente, como a terapêutica cirúrgica mais propriada à cisticercose de fossa craniana posterior.

  2. Hematomas na fossa craniana posterior

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    Mário S. Cademartori

    1969-09-01

    Full Text Available São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural. Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada.

  3. Tratamento cirúrgico da cisticircose da fossa craniana posterior Surgical treatment of cysticercosis in posterior cranial fossa

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    Pedro Garcia Lopes

    1971-03-01

    Full Text Available A cisticercose, um dos mais sérios problemas parasitológicos do sistema nervoso, apresenta, quando localizada na fossa posterior, um quadro clínico dramático, no qual predomina a hipertensão intracraniana. Foram estudados neste trabalho, 70 pacientes com cisticercose de fossa craniana posterior, atendidos no Serviço de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de 1945 a 1968. Considerando-se a grande diversidade existente em torno das técnicas de tratamento cirúrgico, foi objetivo deste trabalho o estudo dos resultados obtidos nestes pacientes, nos quais várias técnicas foram empregadas. As cirurgias paliativas que derivam o trânsito do líquido cefalorraqueano para regiões extracranianas, quando comparadas aos outros tipos de cirurgias utilizados, foram as que proporcionaram maior índice de recuperação, exigiram menos reoperações, além de terem sido acompanhadas de menor número de complicações, bem como de menor mortalidade pós-operatória. Por outro lado, a neurocisticercose geralmente é um processo difuso, encontrando-se parasitas em várias regiões do encéfalo e/ou aracnoidite, conforme comprovou-se, também, entre os casos ora reunidos e que vieram a falecer. Baseando-se nestes fatos, não se justificam as derivações intracranianas e, a não ser eventualmente, a abordagem direta do parasita. Os casos estudados permitem cone- tatar, portanto, que as derivações extracranianas, por sua simplicidade e eficácia, apresentam-se, atualmente, como a terapêutica cirúrgica mais propriada à cisticercose de fossa craniana posterior.Cysticercosis is one of the most severe parasitic diseases of the nervous system. When located in the posterior fossa, it presents a dramatic picture of intracranial hypertension. Seventy patients of cysticercosis in posterior cranial fossa have been studied, all of them attended at the Neurosurgery Service of the University of São Paulo

  4. Hematomas na fossa craniana posterior Haematomata in the posterior fossa

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    Mário S. Cademartori

    1969-09-01

    Full Text Available São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural. Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada.Six cases of sub-tentorial haematomata (one chronic sub-dural, four intra-cerebellar, one extra-dural are reported. Emphasizing the relative rarity of haematomata in the posterior cranial fossa, the author claims the necessity of complementary examinations for proper diagnosis, indispensable for adequate surgical treatment.

  5. Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea

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    Aline Gomes Bittencourt

    2013-04-01

    Full Text Available A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nova abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada através de uma abordagem via fossa craniana média, na parte mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como pontos de reparo. A parede lateral do meato acústico interno foi dissecada após o broqueamento e esqueletização do ápice petroso. A parede dissecada do meato acústico interno foi acompanhada longitudinalmente até a cocleostomia. Design: Estudo anatômico de osso temporal. RESULTADOS: Em todos os ossos temporais, apenas a parte superficial do giro basal da cóclea foi aberta. A exposição do giro basal da cóclea permitiu que as escalas timpânica e vestibular fossem visualizadas. Assim, não houve dificuldade na inserção do feixe de eletrodos através da escala timpânica. CONCLUSÃO: A técnica proposta é simples e permite exposição suficiente do giro basal da cóclea.The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. OBJECTIVE: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa. METHOD: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and

  6. Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares

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    Manoel Antonio de Paiva-Neto

    2010-06-01

    Full Text Available The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%. All tumors were histologically benign. Two patients (8% experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%. One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months, with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações no tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%. Todos os tumores eram histologicamente benignos. Dois pacientes (8% apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%. Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (m

  7. Avaliação da simetria craniana através de imagens de TC cone beam = Cranial symmetry assessment through cone-beam CT images

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    Vilella, Oswaldo de Vasconcellos

    2014-01-01

    Full Text Available Objetivo: O objetivo do presente estudo foi comparar os lados direito e esquerdo de indivíduos que apresentavam simetria craniana através de 2 imagens geradas pela tomografia computadorizada cone beam (TCCB. Métodos: A amostra consistiu de 35 imagens obtidas pelo tomógrafo 3D-i-CAT (Imaging Sciences International Inc. , Hatfield, USA, sendo 13 de indivíduos do gênero masculino e 22 do gênero feminino, com idades variando de 8 a 64 anos, que apresentavam simetria facial aceitável. As imagens foram manipuladas com a ajuda do programa invivodental 5. 0 (Anatomage, San Jose, USA e posicionadas de forma análoga à postura da cabeça para a obtenção da radiografia cefalométrica de perfil. As distâncias lineares Go-Me, Go-Cd, S-Cd, Co-Gn e Co-A (mm; os ângulos mego. Cd, FMA e gogn. SN (graus, e cinco distâncias lineares côndilo-fossa glenóide foram as variáveis analisadas. Resultados: Uma diferença estatística significante entre os lados foi encontrada apenas para a variável S-Cd (mm. Conclusão: Portanto, não há necessidade de se obter valores bilaterais para essas variáveis (exceto S-Cd para avaliar o crânio de indivíduos sem assimetrias evidentes. Com relação à variável S-Cd, a dificuldade para se marcar o ponto S (sela nu

  8. Aspectos da tomografia computadorizada craniana na neurocisticercose na infância

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    Marilisa M. Guerreiro

    1989-06-01

    Full Text Available Os autores relatam aspectos tomográficos da neurocisticercose na infância a propósito da análise de 27 exames em 18 pacientes, que foram distribuídos em três grupos segundo o quadru clínico e os achados tomográficos. O grupo 1 foi caracterizado basicamente por epilepsias e calcificações. O grupo 2 caracterizou-se por hipertensão intracraniana e diversos aspectos tomográficos: edema, cistos e nódulos em três pacientes; hidrocefalia e calcificações em dois pacientes e normal em um paciente. O grupo 3 consistiu clinicamente de epilepsia e cefaléia, com vários padrões tomográficos. Os resultados são discutidos à luz da literatura disponível.

  9. Avaliação da simetria craniana através de imagens de TC cone beam = Cranial symmetry assessment through cone-beam CT images

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    Vilella, Oswaldo de Vasconcellos; Rothier, Eduardo Kant Colunga; Vilella, Beatriz de Souza

    2014-01-01

    Objetivo: O objetivo do presente estudo foi comparar os lados direito e esquerdo de indivíduos que apresentavam simetria craniana através de 2 imagens geradas pela tomografia computadorizada cone beam (TCCB). Métodos: A amostra consistiu de 35 imagens obtidas pelo tomógrafo 3D-i-CAT (Imaging Sciences International Inc. , Hatfield, USA), sendo 13 de indivíduos do gênero masculino e 22 do gênero feminino, com idades variando de 8 a 64 anos, que apresentavam simetria facial aceitável. As imagens...

  10. Epidermoid cyst of the posterior fossa: a case report Cisto epidermoide da fossa posterior: relato de caso

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    Eduardo Cambruzzi

    2011-02-01

    Full Text Available Epidermoid cysts of the central nervous system are uncommon conditions, which are frequently located in the cerebellopontine angle and around the pons. They are covered with keratinized squamous epithelium and keratin lamella, which give its contents a soft, white-pearly appearance. Epidermoid cysts are mostly originated from malformations, presumably associated with surface elements of the nervous system ectoderm during the closure of the neural groove or formation of secondary cerebral vesicles. The authors describe a case of epidermoid cyst in the posterior fossa causing hydrocephalus and review morphologic and diagnostic criteria of this lesion.Os cistos epidermoides do sistema nervoso central (SNC são condições incomuns, estando localizados mais frequentemente no ângulo pontocerebelar e ao redor da ponte. Eles são revestidos por epitélio escamoso queratinizado e lamelas de queratina, tornando seu conteúdo branco-perolado e pastoso. Os cistos epidermoides são, na maioria das vezes, originados de malformações, possivelmente associados ao entremeio de elementos superficiais do ectoderma do SNC durante o fechamento da placa neural, ou formação das vesículas cerebrais secundárias. Os autores descrevem um caso de cisto epidermoide da fossa posterior determinando hidrocefalia e revisam critérios morfológicos e diagnósticos dessa lesão.

  11. Aplicação clínica da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso Clinical application of transcranial Doppler ultrasonography in premature, very-low-birth-weight neonates

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    Marta Lúcia Gabriel

    2010-08-01

    Full Text Available OBJETIVO: Analisar o valor do diagnóstico precoce de alterações hemodinâmicas em hemorragias e eventos hipóxico-isquêmicos pela avaliação de imagens e mensuração do índice de resistência por meio da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso. MATERIAIS E MÉTODOS: Cinquenta neonatos prematuros de muito baixo peso foram submetidos a ultrassonografia craniana com Doppler com a técnica transfontanela anterior e transtemporal sequenciais. RESULTADOS: Foram detectadas alterações cerebrais em 32% dos prematuros, sendo 22% com hemorragia intracraniana, 8% com leucomalácia periventricular e 2% com toxoplasmose. Dentre os 34 casos (68%, do total de neonatos, nos quais não foram detectadas lesões cerebrais pela ultrassonografia craniana, 18 (53% apresentaram alterações no índice de resistência. O índice de resistência variou conforme a época do exame. CONCLUSÃO: Existe correlação entre a presença de alterações na hemodinâmica cerebral e subsequente desenvolvimento de hemorragias e lesões hipóxico-isquêmicas, pela mensuração do índice de resistência. Alterações do índice de resistência, embora não preditoras de morte, estão relacionadas com a gravidade do quadro clínico em neonatos prematuros de muito baixo peso.OBJECTIVE: The present study was aimed at analyzing the value of the early diagnosis of hemodynamic changes in hemorrhages and hypoxic-ischemic events in premature, very-low-birth-weight neonates through the evaluation of images and resistance index measurement by means of transcranial Doppler ultrasonography. MATERIALS AND METHODS: Fifty premature, very-low-birth-weight neonates were submitted to transcranial Doppler ultrasonography with sequential transfontanellar and transtemporal techniques. RESULTS: Cerebral abnormalities were detected in 32% of the neonates (22% with intracranial hemorrhage, 8% with periventricular leukomalacia, and 2% with toxoplasmosis

  12. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem

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    Nilton Alves

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.

  13. Estenose da fossa intercondilar após estabilização articular com retalho de fáscia lata em cães Intercondylar fossa stenosis after joint stabilization using a fascial strip in dogs

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    André Luis Selmi

    2012-01-01

    Full Text Available Determinaram-se os índices de largura da fossa intercondilar (FI, após transecção do ligamento cruzado cranial em nove cães adultos submetidos à estabilização articular com retalho de fáscia lata. Os joelhos foram alocados em dois grupos, sendo o joelho direito (GI submetido à incisuroplastia troclear (ITR e posterior estabilização articular, e o joelho esquerdo submetido somente à substituição ligamentar (GC. Cada grupo foi dividido em três subgrupos correspondentes aos momentos de eutanásia aos 30, 90 e 180 dias de pós-operatório. Os índices de largura da FI foram determinados, macroscópica e radiograficamente, pela mensuração da abertura cranial da FI nos terços cranial, médio e caudal, e indexados em relação à largura epicondilar. Observou-se aumento significativo dos índices macroscópicos e radiográficos nas articulações do GI, sendo estes estatisticamente diferentes daqueles das articulações de GC. Não foi observada estenose intercondilar nos joelhos de GC após a estabilização articular. Conclui-se que a estabilização articular com retalho de fáscia lata preveniu a estenose da fossa intercondilar, e que a ITR promoveu o alargamento permanente dessa estrutura.Intercondylar fossa width indexes (IFWI were determined in nine adult dogs submitted to intercondylar notchplasty (IN after transection of the cranial cruciate ligament (CCL followed by a fascial strip stabilization. The right stifle was submitted to IN followed by fascial strip reconstruction of the CCL (GI while in the left stifle IN was not performed (GC. Each group was then divided into three subgroups which corresponded to time of euthanasia at 30, 90 and 180 days after surgery. IFWI were determined, both macroscopically and radiographically, by measuring the cranial outlet of the intercondylar fossa in relation to the epicondylar width. A significant increase was observed in indexes of GI following IN, and these differed from indexes of

  14. Avaliação textural por ressonância magnética dos tumores da fossa posterior em crianças Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood

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    Joelson Alves dos Santos

    2004-08-01

    Full Text Available OBJETIVO: Possibilitar a distinção entre tecidos sãos e patológicos em pacientes da faixa etária pediátrica portadores de tumores da fossa posterior, por meio da análise de parâmetros texturais calculados a partir de imagens de ressonância magnética. MATERIAIS E MÉTODOS: Foram analisados 14 pacientes da faixa etária pediátrica, portadores de tumores da fossa posterior, através da definição dos valores texturais das regiões de interesse representando tecidos sãos e patológicos, com base em imagens de ressonância magnética pesadas em T2 pelo "software" MaZda. RESULTADOS: Houve diferença estatisticamente significativa entre os tecidos normal e tumoral, bem como entre os tecidos presumidamente normais adjacentes e distantes da lesão. Não foi possível a distinção entre edema e tumor. CONCLUSÃO: A avaliação textural por ressonância magnética é uma técnica útil para a determinação de diferenças entre diversos tipos de tecidos, inclusive entre áreas de tecidos presumidamente normais à análise visual.OBJECTIVE: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. MATERIALS AND METHODS: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. RESULTS: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. CONCLUSION: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis.

  15. Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs Achados da ultrassonografia e da ressonância magnética na esquistossomose mansônica: sinais da expansão da fossa da vesícula e do hilo gorduroso

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    Luciana Cristina dos Santos Silva

    2012-08-01

    Full Text Available INTRODUCTION: There is no study relating magnetic resonance imaging (MRI to ultrasound (US findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US. METHODS: Fifty-four patients (mean age 41.6±13.5years from an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma. RESULTS: Forty-seven (87% of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%, MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1% of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis. CONCLUSIONS: Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.INTRODUÇÃO: Não existem estudos que correlacionam os achados da ressonância magnética (RM aos da ultrassonografia (US em pacientes com esquistossomose mansônica. O objetivodeste estudo foi descrever os achados da imagem por RM em pacientes com doença hepática esquistossomótica identificada por US. MÉTODOS: Selecionaram-se 54 pacientes com idade média de 41,6±13,5 anos, provenientes de área endêmica para a

  16. Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood; Avaliacao textural por ressonancia magnetica dos tumores da fossa posterior em criancas

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    Santos, Joelson Alves dos; Costa, Maria Olivia Rodrigues da; Otaduy, Maria Concepcion Garcia; Lacerda, Maria Teresa Carvalho de; Leite, Claudia da Costa [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: joelson_alves@ig.com.br; Matsushita, Hamilton [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2004-08-01

    Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

  17. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem Formaciones venosas superficiales de la fosa cubital: aspectos de interés para la práctica de Enfermería Superficial venous formation of the cubital fossa: aspects of interest for nursing practice

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    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí reportado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA.The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we found that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV

  18. Posterior fossa epidural hematoma

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    Kushner, M.J.; Luken, M.G. III

    1983-01-01

    CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)

  19. Utilização da tração halo-craniana pré-operatória no tratamento de deformidades vertebrais de alto valor angular Uso de tracción halo gravitacional en el tratamiento quirúrgico de las deformidades graves de la columna vertebral Halo gravity preoperative traction in severe spine deformities treatment

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    Maximiliano Aguiar Porto

    2010-09-01

    Full Text Available OBJETIVOS: avaliar o resultado do tratamento cirúrgico das deformidades acentuadas da coluna vertebral por meio da utilização da tração halo-gravitacional. MÉTODOS: foram estudados 17 pacientes portadores de diferentes patologias (6 congênitas, 2 pós-neoplasia, 2 neurofibromatoses, 1 idiopática, 1 raquitismo e 5 neuromusculares submetidos a cirurgia para correção de deformidade de alto valor angular na coluna vertebral. A idade no momento da cirurgia variou de 6 a 26 anos (média de 13,75 anos±4,5. Os parâmetros clínicos avaliados foram o sexo, a idade, o tempo e o peso da tração. Os parâmetros radiográficos estudados foram: a medida da escoliose, da cifose e a altura da coluna vertebral. Os parâmetros radiográficos foram avaliados no período pré-operatório, durante a tração, e no pós-operatório. RESULTADOS: o tempo de tração variou de 14 a 106 dias (34,5±20,83 e a porcentagem de peso da tração em relação ao peso corporal variou de 12,5 a 50% (30%±9,36. A média inicial das escolioses foi de 98,6±25,7º(medida Cobb, reduzido para 83,5º±28,5º durante a tração e para 77º±29,4º no pós-operatório, com a média de correção de 27º, sendo 63% destes ocorridos no período do uso do halo. A média inicial da cifose foi de 86,3±32,08º (Cobb, reduzido para 62,2º±19,9º durante a tração e para 60º±20,9º no pós-operatório, com a média de correção de 26º, sendo 92% durante a tração. CONCLUSÃO: o tratamento cirúrgico das deformidades acentuadas da coluna vertebral, por meio da tração halo-gravitacional pré-operatória, é um método que melhora o ângulo de Cobb reduzindo a correção aguda intraoperatória assim como seus riscos de lesão neurológica.OBJETIVOS: evaluar el resultado del tratamiento quirúrgico en deformidades graves de la columna vertebral con el uso de tracción halo gravitacional. MÉTODOS: fueron estudiados 17 pacientes portadores de diferentes patologías (seis cong

  20. Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report

    Directory of Open Access Journals (Sweden)

    Yvens B. Fernandes

    1995-09-01

    Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17, estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning

  1. Medusae Fossae Formation

    Science.gov (United States)

    2002-01-01

    (Released 10 April 2002) The Science This THEMIS visible image was acquired near 7o S, 172o W (188o E) and shows a remarkable martian geologic deposit known as the Medusae Fossae Formation. This Formation, seen here as the raised plateau in the upper two-thirds of the image, is a soft, easily eroded deposit that extends for nearly 1,000 km along the equator of Mars. In this region the deposit has been heavily eroded by the wind to produce a series of linear ridges called yardangs. These parallel ridges point in direction of the prevailing winds that carved them, and demonstrate the power of martian winds to sculpt the dry landscape of Mars. The Medusae Fossae Formation has been completely stripped from the surface in the lower third of the image, revealing a harder layer below that is more resistant to wind erosion. The easily eroded nature of the Medusae Fossae Formation suggests that it is composed of weakly cemented particles, and was most likely formed by the deposition of wind-blown dust or volcanic ash. Several ancient craters that were once completely buried by this deposit are being exposed, or exhumed, as the overlying Medusae Formation is removed. Very few impact craters are visible on this Formation, indicating that the surface seen today is relatively young, and that the processes of erosion are likely to be actively occurring. The Story Medusa of Greek mythology fame, the name-giver to this region, had snaky locks of hair that could turn a person to stone. Wild and unruly, this monster of the underworld could certainly wreak havoc on the world of the human imagination. As scary as she was, Medusa would have no advantage over the fierce, masterful winds blowing across Mars, which once carved the streaky, terrain at the top of this image. Wild and whipping, these winds have slowly eroded away the 'topsoil,' revealing ancient craters and other surface features they once covered. The loosely cemented particles of this 'topsoil' are likely made up of dust

  2. Leptomeningite e tumor da região optoquiasmática Meningitis and tumor of the opto-chiasmatic region. Report of two cases

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    J. A. Gonçalves da Silva

    1967-03-01

    Full Text Available São registrados dois casos de tumores situados no assoalho da fossa craniana média (carcinoma sólido da hipófise e craniofaringeoma acompanhados de leptomeningite de etiologia não determinada. Especialmente no segundo caso esta se caracterizava pela ocorrência de repetidos surtos de exacerbação. Em ambos o diagnóstico inicial foi de leptomeningite, tendo sido o insucesso das medidas terapêuticas adotadas que levou a estudos radiológicos, na tentativa de evidenciar focos que pudessem estar mantendo a infecção. Em ambos os casos o exame radiológico forneceu dados que permitiram orientar o diagnóstico de tumor do assoalho da fossa craniana média. As condições clínicas, no entanto, impediram que fossem adotadas em tempo útil medidas terapêuticas que visassem diretamente o tumor, vindo os pacientes a falecer. A possibilidade da ocorrência de meningites em tumores dessa região é discutida, bem como a natureza séptica ou asséptica da reação inflamatória. Os casos apresentados permitem concluir que, em processos meningíticos de evolução longa, acompanhados de surtos de agudização, nos quais nem mesmo durante os surtos agudos é encontrado o agente etiológico no LCR, a possibilidade da ocorrência de tumores do assoalho da fossa média do crânio deve ser estudada. O estudo deve ser feito precocemente, para permitir a adoção de medidas terapêuticas adequadas, visando diretamente o tumor, em tempo hábil, na tentativa de evitar que os surtos meningíticos venham a comprometer a vida do paciente.A study was made of a patient with carcinoma of the hypophisis which invaded the sphenoid bone and made protrusion under the nasopharyngeal mucosa, and that of a patient with craniopharyngeoma. The patients had no symptoms proper to the tumors but presented several episodes of meningitis. The presence of the tumor, in both cases, was evidenced lately, when the failure of the antibiotic therapy became patent leading to the

  3. Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil - DOI: 10.4025/actascibiolsci.v29i4.887 Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil - DOI: 10.4025/actascibiolsci.v29i4.887

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    Maria de los Angeles Perez Lizama

    2008-02-01

    Full Text Available O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatro famílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais, variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher, 1988. Diferenças foram observadas nas medidas corporais dos parasitos e na quantidade de espécies de parasitos por espécie de peixe em relação aos copépodes encontrados em estudos anteriores na região amazônica. O presente estudo constitui um dos poucos trabalhos de identificação de copépodes parasitos de fossas nasais de peixes da região Sul do Brazil.The present work had the objective to study parasitic copepods in the nasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae, Schizodon borellii (Anostomidae, Prochilodus lineatus (Prochilodontidae, Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae. Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger

  4. Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images; Evolucao incomum de provavel histoplasmose de sistema nervoso central: de leptomeningite para granuloma da fossa posterior. Relato de caso com imagens por ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Carrilho, Paulo Eduardo Mestrinelli; Alves, Orival [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina. Disciplina de Neurologia e Neurocirurgia]. E-mail: carrilho@certto.com.br; Budant, Manfredo [UNITOM - Unidade de Diagnostico por Imagem, Cascavel, PR (Brazil). Centro de Tomografia; Bozo, Marlon K.; Meirelles, Noel [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina; Bueno, Alexandre Galvao [ANATOM - Instituto de Anatomia Patologica de Cascavel, PR (Brazil)

    2006-01-15

    We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

  5. Epidural hematomas of posterior fossa

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    Radulović Danilo

    2004-01-01

    Full Text Available Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery.

  6. Endoscopic approach to the infratemporal fossa

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    Ahmed Youssef

    2014-06-01

    Conclusions: Endoscopic endonasal transpterygoid approach is considered one of the most useful surgical solutions to manage selected tumors that involve the infratemporal fossa. A good understanding of the endoscopic anatomy of infratemporal fossa allows safe and complete resection of lesions arising or extending to infratemporal fossa.

  7. Tumors of the posterior cranial fossa; Tumoren der hinteren Schaedelgrube

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Politi, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

    2016-11-15

    Various types of brain tumor can occur in the region of the posterior fossa. Brain metastases in adults are the most common malignancies at this localization. Ependymomas, medulloblastomas and pilocytic astrocytomas occur mostly in children and only rarely in adults. Other tumors that occur in the posterior fossa are meningiomas, schwannomas, hemangioblastomas, brain stem gliomas and epidermoid tumors. Due to the fact that the various tumors of the posterior fossa have different treatment approaches and prognoses, an accurate and specific diagnosis is mandatory. This review discusses the imaging aspects by computed tomography (CT) and magnetic resonance imaging (MRI) of the most frequent tumors of the posterior fossa. (orig.) [German] Im Bereich der hinteren Schaedelgrube treten verschiedene Typen von Hirntumoren auf, wobei Hirnmetastasen bei Erwachsenen die haeufigsten Malignitaeten in dieser Region darstellen. Ependymome, Medulloblastome und pilozytische Astrozytome kommen meistens bei Kindern und nur selten bei Erwachsenen vor. Weitere Tumoren der hinteren Schaedelgrube sind Meningeome, Schwannome, Haemangioblastome, Hirnstammgliome und Epidermoide. Da die verschiedenen Tumoren der hinteren Schaedelgrube unterschiedliche Behandlungsansaetze sowie Prognosen haben, ist eine genaue und spezifische Diagnose obligatorisch. Dieser Review diskutiert die bildgebenden CT- und MRT-Aspekte der haeufigsten Tumoren der hinteren Schaedelgrube. (orig.)

  8. Diseases of the optic fossa

    International Nuclear Information System (INIS)

    Sakuma, S.; Banno, T.

    1983-01-01

    By using a whole body CT unit for coronal tomography, it is possible to observe the extraocular muscles at the same time. Diseases of the optic fossa that can be investigated by CT include muscular hypertrophy due to toxic goiter, calcification of the sclera in hyperparathyroidismus, foreign bodies, inflammatory pseudotumor, retrobulbar tumor, tumor of the retina, tumor of the choroidea, and tumor of the sclera

  9. Traumatic posterior fossa epidural hematoma

    International Nuclear Information System (INIS)

    Ikeda, Yukio; Nakazawa, Shozo; Yamakawa, Kazuomi; Kobayashi, Shiro; Tsuji, Yukihide

    1981-01-01

    In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

  10. Cisternography of the posterior fossa with metrizamide

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, N.; Saito, Y.; Miyashita, T.; Tajika, Y.

    1981-12-01

    Nine patients underwent metrizamide cisternography of the posterior fossa. Excellent opacification of the fourth ventricle resulted when the patient's head was suitably positioned and the contrast material was introduced via a C1-2 puncture. With this technique, a benign aqueductal stenosis can be readily identified and the posterior fossa and fourth ventricle can be studied easily.

  11. Treatment implications of posterior fossa ependymoma subgroups.

    Science.gov (United States)

    Ramaswamy, Vijay; Taylor, Michael D

    2016-11-15

    Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology. Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy, whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.

  12. Are Homo sapiens nonsupranuchal fossa and Neanderthal suprainiac fossa convergent traits?

    Science.gov (United States)

    Nowaczewska, Wioletta

    2011-04-01

    The autapomorphic status of the Neanderthal suprainiac fossa was recently confirmed. This was a result of a detailed analysis of the internal bone composition in the area of the suprainiac depression on Neanderthal and Homo sapiens specimens. However, while anatomical differences between Neanderthal suprainiac fossa and the depression in the inion region of the occipital bone of fossil and recent Homo sapiens have been discussed in detail, the etiology of these structures has not been resolved. In this article, the hypothesis that the Homo sapiens non-supranuchal fossa and the Neanderthal suprainiac fossa both formed to maintain the optimal shape of the occipital plane (to minimize strain on the posterior cranial vault) is tested. First, the variation in the expression of the fossa above inion in the crania of recent Homo sapiens from European, African, and Australian samples was examined, and the degree of structural similarity between these depressions and the Neanderthal suprainiac fossa was assessed. Next, the relationship between the shape of the occipital squama in the midsagittal plane and two particular features (the degree of the occipital torus development and the occurrence of a depression in the inion region that is not the supranuchal fossa) were analyzed. Based on the results, it is suggested that the Homo sapiens non-supranuchal fossa and Neanderthal suprainiac fossa are convergent traits. Copyright © 2010 Wiley-Liss, Inc.

  13. Congenital abnormalities of the posterior fossa.

    Science.gov (United States)

    Bosemani, Thangamadhan; Orman, Gunes; Boltshauser, Eugen; Tekes, Aylin; Huisman, Thierry A G M; Poretti, Andrea

    2015-01-01

    The frequency and importance of the evaluation of the posterior fossa have increased significantly over the past 20 years owing to advances in neuroimaging. Nowadays, conventional and advanced neuroimaging techniques allow detailed evaluation of the complex anatomic structures within the posterior fossa. A wide spectrum of congenital abnormalities has been demonstrated, including malformations (anomalies due to an alteration of the primary developmental program caused by a genetic defect) and disruptions (anomalies due to the breakdown of a structure that had a normal developmental potential). Familiarity with the spectrum of congenital posterior fossa anomalies and their well-defined diagnostic criteria is crucial for optimal therapy, an accurate prognosis, and correct genetic counseling. The authors discuss the spectrum of posterior fossa malformations and disruptions, with emphasis on neuroimaging findings (including diagnostic criteria), neurologic presentation, systemic involvement, prognosis, and risk of recurrence. RSNA, 2015

  14. Posterior Fossa Tumors and Intellectual Impairment

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    J Gordon Millichap

    2005-01-01

    Full Text Available The effect of cerebellar damage on intellectual function in 76 children treated surgically for malignant posterior fossa tumor was investigated at the Gustave Roussy Institute, Villejuif, and the Department of Pediatric Neurosurgery, Necker Hospital, Paris, France.

  15. Direct sagittal CT scanning in the diagnosis of pituitary fossa tumours and posterior fossa pathology

    International Nuclear Information System (INIS)

    Podlas, H.

    1981-01-01

    Two independent methods are presented for multidirectional CT scanning of the brain using the Philips Tomoscan 300. The advantages in scanning pituitary fossa tumours and pathology of the posterior fossa are discussed. No additional software or modifications are required. Direct sagittal scanning is particularly advantageous for accurate assessment of the size of pituitary tumours and intrasellar lesions requiring surgical intervention or radiation therapy. (Auth.)

  16. Radiographic imaging of the canine intercondylar fossa

    International Nuclear Information System (INIS)

    Montgomery, R.D.; Fitch, R.B.; Hathcock, J.T.; LaPrade, R.F.; Wilson, M.E.; Garrett, P.D.

    1996-01-01

    The intercondylar fossa is believed to play an important role in the pathology of cranial cruciate ligament rupture and therefore has received considerable attention in the last decade. Accurate radiographic imaging of the intercondylar fossa requires that the central x-ray beam pass through the center of the intercondylar “tunnel”. The anatomy of the canine intercondylar fossa is similar to humans, however, the orientations of the intercondylar fossa's differ. Consequently, the positioning techniques described for humans are not appropriate for the dog. To pass through the center of the dog, intercondylar fossa, the central x-ray beam should be 12° (S.D. 1.7°) caudal from the femoral diaphysis in the sagittal plane and obliqued caudolateral to craniomedial 7° (S.D. 0.60°) (caudo78°proximo7° lateralcraniodistomedial oblique). Cross table positioning was used with the hip flexed and the radiograph cassette placed on the cranial surface of the stifle. However, superimposition of the tuber ischii and soft tissues caudal to the femur made 15° to 20° the best angle obtainable. There was not a significant difference (p = 0.17) in the notch width index between a 12° versus 20° angle of the central x-ray beam caudal to the femoral diaphysis, both with 7° of external rotation of the stifle. The notch width index of 0.252 obtained from radiographic measurements was not significantly different from measurements obtained grossly of 0.254 (n = 26; p = 0.69). Failure to oblique the central x-ray beam caused a significant (p = 0.0008) decrease in the apparent fossa width radiographically

  17. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the temporomandibular...

  18. Herniographic appearance of the lateral inguinal fossa

    International Nuclear Information System (INIS)

    Ekberg, O.; Kesek, P.

    1987-01-01

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do. (orig.)

  19. Endoscopic Diagnosis of Pyriform Fossa Lymphoma

    Directory of Open Access Journals (Sweden)

    A Thomson

    1996-01-01

    Full Text Available Many endoscopists do not inspect the gastrointestinal tract superior to the cricopharyngeus, despite the fact that gastrointestinal symptoms (dysphagia, odynophagia and chest pain can be produced by glottic and supraglottic lesions. A case of incoordinate swallowing secondary to a right-sided pyriform fossa lymphoma diagnosed at gastroscopy is presented.

  20. Temporal fossa hemangiopericytoma: a case series.

    Science.gov (United States)

    Heiser, Marc A; Waldron, James S; Tihan, Tarik; Parsa, Andrew T; Cheung, Steven W

    2009-10-01

    Review clinical experience with temporal fossa hemangiopericytomas (HPCs). Retrospective case series review. Tertiary referral center. Intracranial HPCs within the temporal fossa. Craniotomy for either subtotal or gross total tumor excision. Determination of clinical outcome (alive with no evidence of disease, alive with disease, and died of disease). Five cases of HPC involving the temporal fossa were treated at our tertiary referral center for the period from 1995 to 2008. All but 1 patient were men. The age of presentation ranged from 31 to 62 years, and duration of follow-up ranged from 8 to 153 months. Clinical presentation was protean; headache was the most common symptom. Gross total tumor excision was achieved in 2 patients, whereas subtotal tumor excision was achieved in 3 patients. Reasons for subtotal resection included excessive intraoperative blood loss and inextricable tumor. Histologically, all tumors were composed of tightly packed, randomly oriented (jumbled-up) tumor cells with little intervening collagen. CD34 staining mostly highlighted the vascular background. One patient died of disease, 2 patients were alive with disease, and 2 patients had no evidence of disease. Management of temporal fossa HPC is challenging because clinical presentation is often late, and extent of tumor excision is constrained by vital structures in the cranial base and intracranial contents. A multidisciplinary approach with neurosurgery and neurotology undertaken to achieve the most complete tumor resection possible, whereas minimizing morbidity are likely to confer a longer period of symptom-free survival and improves curability of these difficult lesions.

  1. Extensive Supratentorial Hemorrhages Following Posterior Fossa ...

    African Journals Online (AJOL)

    Remote supratentorial hematoma soon after posterior fossa surgery for the removal of a space-occupying lesion is a rare but dramatic and dreaded complication, carrying significant morbidity and mortality. A 47-year-old woman presented with headache of 1-year duration that worsened over last 2 months, progressive ...

  2. Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM

    Directory of Open Access Journals (Sweden)

    Leodante B. Costa Jr

    2004-03-01

    Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paciente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar.

  3. Vermian agenesis without posterior fossa cyst

    International Nuclear Information System (INIS)

    Adamsbaum, C.; Moreau, V.; Bulteau, C.; Burstyn, J.; Lair Milan, F.; Kalifa, G.

    1994-01-01

    We report 11 cases of vermian partial agenesis without posterior fossa cyst or hemispheric abnormalities. Characteristic MR signs were: absence of the posterior lobe, hypoplasia of the anterior lobe, a narrow sagittal cleft separating the hemispheres (''buttocks sign'') and fourth ventricle deformity. The main clinical signs were complex oculomotor dysfunction and developmental delay. None of the patients had respiratory symptoms. Consideration is given to the relationship between Joubert syndrome and this entity as well as to embroyological data. (orig.)

  4. Mammary-type myofibroblastoma of popliteal fossa

    International Nuclear Information System (INIS)

    Scotti, C.; Camnasio, F.; Fontana, F.; Fraschini, G.; Rizzo, N.; De Cobelli, F.; Peretti, G.M.

    2008-01-01

    Mammary-type myofibroblastoma is a very rare, benign, spindle cell lesion, arising mainly in the inguinal region. This clinical entity strictly duplicates the features of its breast counterpart. To our knowledge, this is the first report of this particular lesion occurring in the popliteal fossa. We discuss the clinical, radiological and histopathological features of this case, emphasizing the role of incisional biopsy in such an unusual neoplasia. (orig.)

  5. [Cochlear implantation through the middle fossa approach].

    Science.gov (United States)

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

    2001-01-01

    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

  6. Computed tomography of lacrimal fossa tumors

    International Nuclear Information System (INIS)

    Park, Chan Sup; Kim, Young Goo; Chang, Kee Hyun

    1985-01-01

    The lacrimal fossa can be involved by a wide spectrum of orbital pathology. The correct diagnosis is important to avoid unnecessary procedure and to do appropriate management. 14 patients with mass lesions in the lacrimal fossa were evaluated with computed tomography (CT) and clinical findings. The results were as follows: 1. Final diagnosis of 14 cases with lacrimal fossa tumors was pleomorphic adenoma in 3 cases, adenoid cystic carcinoma in 1 case, pseudotumor in 5 cases, lymphoma in 2 cases, neurofibroma in 1 case, chloroma in 1 case and metastatic adenocarcinoma in 1 case. 2. The duration of symptoms of pleomorphic adenoma was more than 1 year and characteristic CT findings were globular masses with pressure erosion of the adjacent bone. Patient with adenoid cystic carcinoma had a short history of symptoms. CT showed a fusiform mass but intracranial extension with frank destruction of sphenoid bone. 3. Patients with pseudotumor and lymphoma had symptoms for less than 1 year. The CT findings were ill-defined infiltrative patterns with scleral thickening and the differential diagnosis of them was difficult. 4. The margins of neurofibroma and chloroma were well defined while that of the metastic adenocarcinoma was ill-defined. 5. The degree and the extent of the contrast enhancement gave no benefit in the differential diagnosis of each disease entities and even of the benign and malignant lesions

  7. Benign neurilemmoma in the infratemporal fossa involving maxillary sinus and pterygopalatine fossa

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo; Heo, Min Suk; Lee, Jin Koo; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Chang Hyeon [Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

    2004-12-15

    Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29- year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

  8. Pituitary fossa: a correlative anatomic and MR study

    International Nuclear Information System (INIS)

    Mark, L.; Pech, P.; Daniels, D.; Charles, C.; Williams, A.; Haughton, V.

    1984-01-01

    This study characterizes the normal appearance of the pituitary fossa in partial saturation magnetic resonance (MR) images. In sagittal images, the pituitary fossa appears inhomogeneous. Correlation of sagittal MR images in normal subjects with sagittal cryomicrotomic images in cadavers suggests that the highest intensity signal from the posterior-inferior pituitary fossa is due to a fat pad. This conclusion was supported by MR images and postmortem cryotome sections obtained in normal subhuman primates

  9. Correlação entre hipótese diagnóstica e laudo de tomografia axial computadorizada craniana Correlation between diagnostic hypothesis and result of cranial computed axial tomography

    Directory of Open Access Journals (Sweden)

    Edison Matos Nóvak

    2001-09-01

    Full Text Available Para avaliar a utilização da tomografia axial computadorizada craniana (TC em nosso meio, analisamos as solicitações de 367 exames consecutivos no período compreendido entre 07/1995 e 07/1996. Houve ampla variação da faixa etária, com média de 31,7 ± 22,9 anos. As especialidades que mais solicitaram o exame foram: Neurologia (36,2%, Pronto Atendimento (17,4%, Neuropediatria (16,9% e Clínica Médica (5,9%. As indicações mais frequentes para o exame foram: convulsão (30%, cefaléia (26,2%, déficit motor (20,2% e redução do nível de consciência (16,9%. As "hipóteses" aventadas com maior frequência foram: afastar lesão estrutural (9,0%, acidente vascular não discriminado (8,2% e neurocisticercose (8,2%. O laudo da TC foi normal em 50,4% dos exames. Os laudos anormais mais frequentes foram: hidrocefalia (5,4%, acidente vascular isquêmico (5,4% e neoplasia (3,5%. As maiores taxas de achados normais foram encontradas nas "hipóteses" de cefaléia (94,4%, convulsão (71,4% e afastar lesão estrutural (66,7%. Os maiores índices de acerto entre hipótese e laudo foram encontrados nas situações de "afastar lesões estruturais" (66,7%, hidrocefalia (50%, acidente vascular cerebral isquêmico (50% e hematoma (50%. Concluimos que a utilização de um recurso auxiliar de diagnóstico como a TC cumpre melhor ainda a sua função se o requisitante do exame preencher com clareza e detalhamento o pedido do exame.The use of computed axial tomography (CT in the investigation of neurologic disorders is attractive for his disponibility in the health services. However, the indications of the exam and the correlation with the clinical features has not been frequently studied. We study correlation between the requests of CT and the findings reported by the radiologist, in 367 exams performed from 07/1995 to 07/ 1996. The mean age was 31.7 ± 22.9 years. The CT were requested in decrescent order of frequency by the Services of Neurology (36

  10. Acute Spontaneous Posterior Fossa Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Osama Shukir Muhammed Amin

    2014-02-01

    Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient’s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

  11. MRI diagnosis of posterior fossa tumors

    International Nuclear Information System (INIS)

    Yamashita, Yasuyuki; Takahashi, Mutsumasa; Sakamoto, Yuuji; Kojima, Ryutarou; Bussaka, Hiromasa; Korogi, Yukunori

    1988-01-01

    Magnetic resonance images (MRI) of 58 patients with posterior fossa tumors were compared with computed tomography (CT). Spin echo (SE) technique and inversion recovery (IR) technique were obtained using 0.22 tesla resistive magnetic resonance unit. MRI was superior to CT in detecting the lesions and showing internal archtecture, hemorrhage, edema of the tumor and displacement of the normal brain. CT was superior to MRI in demonstrating calcification. MRI and CT were comparable in detecting erosions of the skull base, while MRI was superior to CT in showing erosions of the clivus. Most tumors showed hypointensity on T1 weighted images and hyperintensity on T2 weighted images. Meningioma showed equal or almost equal intensity to cerebral gray matter on both SE images. The boundary of intra-axial tumors was unclear in many cases without contrast enhancement using Gd-DTPA, while most extra-axial tumors showed clear margin surrounded by a thin band (rim). In 81.8 % of acoustic neurinomas, signal void rims were demonstrated on both SE images, and they were considered to be vessels around the tumor. The rims of meningioma, on the other hand, were hypointense on T1 weighted images and hyperintense on T2 weighted images. They were considered to be cerebrospinal fluid or capsule around the tumor. It has been concluded that MRI is the most important technique for diagnosis of posterior fossa tumors. (author)

  12. 3D CBCT anatomy of the pterygopalatine fossa.

    Science.gov (United States)

    Rusu, Mugurel Constantin; Didilescu, Andreea Cristiana; Jianu, Adelina Maria; Păduraru, Dumitru

    2013-03-01

    The anatomy of the pterygopalatine fossa keeps a traditional level and is viewed as constant, even though a series of structures neighboring the fossa are known to present individual variations. We aimed to evaluate on 3D volume renderizations the anatomical variables of the pterygopalatine fossa, as related to the variable pneumatization patterns of the bones surrounding the fossa. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 100 patients. The pterygopalatine fossa was divided into an upper (orbital) and a lower (pterygomaxillary) floor; the medial compartment of the orbital floor lodges the pterygopalatine ganglion. The pneumatization patterns of the pterygopalatine fossa orbital floor walls were variable: (a) the posterior wall pneumatization pattern was determined in 89.5 % by recesses of the sphenoidal sinus related to the maxillary nerve and pterygoid canals; (b) the upper continuation of the pterygopalatine fossa with the orbital apex was narrowed in 79.5 % by ethmoid air cells and/or a maxillary recess of the sphenoidal sinus; (c) according to its pneumatization pattern, the anterior wall of the pterygopalatine fossa was a maxillary (40.5 %), maxillo-ethmoidal (46.5 %), or maxillo-sphenoidal (13 %) wall. The logistic regression models showed that the maxillo-ethmoidal type of pterygopalatine fossa anterior wall was significantly associated with a sphenoidal sinus only expanded above the pterygoid canal and a spheno-ethmoidal upper wall. The pterygopalatine fossa viewed as an intersinus space is related to variable pneumatization patterns which can be accurately identified by CBCT and 3DVR studies, for anatomic and preoperatory purposes.

  13. Endoscopic third ventriculostomy and posterior fossa tumors.

    Science.gov (United States)

    Di Rocco, Federico; Jucá, Carlos Eduardo; Zerah, Michel; Sainte-Rose, Christian

    2013-02-01

    The management of hydrocephalus associated with a posterior fossa tumor is debated. Some authors emphasize the advantages of an immediate tumor removal that may normalize the cerebrospinal fluid (CSF) dynamics. However, in clinical practice, the mere excision of the lesion has been demonstrated to be accompanied by a persisting hydrocephalus in about one third of the cases. Preoperative endoscopic third ventriculostomy (ETV) offers several advantages. It may control the intracranial pressure (ICP), avoid the necessity of an emergency procedure, allow appropriate scheduling of the operation for tumor removal, and eliminate the risks related to the presence of an external drainage. The procedure also reduces the incidence of postoperative hydrocephalus. A final advantage, more difficult to weight, but obvious to the neurosurgeon, is the possibility to remove the lesion with a relaxed brain and normal ICP. In the postoperative phase, ETV can be used in case of persisting hydrocephalus, both in patients who underwent only the excision of the tumor and in those whose preoperative ETV failed as a consequence of intraventricular bleeding with secondary closure of the stoma (redoETV). The main advantage of postoperative ETV is that the procedure is carried out only in case of persisting hydrocephalus; its use is consequently more selective than preoperative ETV. The disadvantage consists in the common use of an external CSF drainage in the first few postoperative days, which is necessary to control the pressure and for ruling out those cases that reach a spontaneous cure of the hydrocephalus. The authors review the criteria for patient selection and the results of ETV performed in case of hydrocephalus secondary to a posterior fossa tumor. Preoperative ETV constitutes an effective procedure for controlling the hydrocephalus associated with posterior fossa tumors. It might lower the rate of persistent postoperative hydrocephalus and result in a short hospital stay. Low

  14. Is a 5 mm rat calvarium defect really critical? Um defeito de 5 mm em calota craniana de rato é realmente critico?

    Directory of Open Access Journals (Sweden)

    Gabriela Granja Porto

    2012-11-01

    Full Text Available PURPOSE: To evaluate bone regeneration in critical defects in the rats' calvarium. METHODS: Eighteen rats Wistar were divided into three groups of six animals each according to the time of evaluation (15, 30 and 60 days. One calvarium defect of 5mm was made in the parietal bone of each animal under general anesthesia. After the time of evaluation, the animals were killed, when the bone was histological studied and classified according to the type of tissue found: fibrosis or bone. RESULTS: The results showed that in the group of 15 days, in five animals there was only fibrosis. In the group of 30 days, the process of regeneration was growing and in four animals was found bone, in three with partial filling and in the other one with complete filling of the defect. In the group of 60 days, out of the three animals with bone, two had a complete filling of the defect. CONCLUSIONS: There was no bone regeneration in critical defects in 15 days. There was regeneration in the most part of the animals in 30 and 60 days.OBJETIVO: Avaliar a regeneração óssea de defeitos críticos em calota craniana de ratos. MÉTODOS: Foram utilizados 18 ratos Wistar que foram distribuídos em três grupos de acordo com o tempo de avaliação (15, 30 e 60 dias. Na calota craniana desses animais foi realizado defeito de 5mm, após anestesia geral prévia. Após o tempo de avaliação, os animais foram submetidos à eutanásia e a calota foi enviada para estudo histológico, quando foi classificada de acordo o tecido encontrado: fibroso ou ósseo. RESULTADOS: Diante dos achados deste estudo, pode-se observar que para o grupo de 15 dias na maioria dos animais, n=5, foi encontrado apenas fibrose. Com o passar do tempo de avaliação, no grupo de 30 dias, o processo de reparo foi evoluindo e em quatro animais já foi encontrado osso, sendo em três com preenchimento parcial e em um completo. No grupo de 60 dias, o processo praticamente permaneceu o mesmo, onde em tr

  15. Infratemporal and temporal fossa abscess complicating dental extraction.

    OpenAIRE

    Diacono, M S; Wass, A R

    1998-01-01

    Abscess formation in the infratemporal and temporal fossae is rare. Their presentation to accident and emergency departments is unusual and consequently may cause problems with diagnosis. Once diagnosed, treatment should be aggressive with intravenous antibiotics and surgical drainage.

  16. Extra-skeletal Ewing's sarcoma of the nasal fossa.

    Science.gov (United States)

    Lane, S; Ironside, J W

    1990-07-01

    Extraskeletal Ewing's sarcoma is rarely found arising in the head and neck region. An unusual case arising in the nasal fossa in a young child is reported and the differential diagnosis, pathology and treatment discussed.

  17. EVALUATION OF RIGHT ILIAC FOSSA MASS-A RETROSPECTIVE STUDY

    OpenAIRE

    Raja Billy Graham; Vijayabhasker

    2016-01-01

    Mass in right iliac fossa is one of the common clinical surgical entity with varied etiologies, involving intra peritoneal organs like vermiform appendix, caucus, ileum, retroperitoneal structures like kidneys, blood vessels etc., and abdominal wall masses like desmoids tumor. To know the etiology and the various pattern of presentation of right iliac fossa mass in our institution a retrospective study was designed including all adult patients diagnosed to have a mass in right ili...

  18. MRI of the fetal posterior fossa

    Energy Technology Data Exchange (ETDEWEB)

    Adamsbaum, Catherine; Andre, Christine; Merzoug, Valerie; Ferey, Solene [St Vincent de Paul Hospital, Department of Radiology, Paris Cedex 14 (France); Moutard, Marie Laure [St Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Quere, Marie Pierre [CHU, Department of Radiology, Nantes (France); Lewin, Fanny [St Vincent de Paul Hospital, Maternity Department, Paris (France); Fallet-Bianco, Catherine [Ste Anne Hospital, Department of Neuropathology, Paris (France)

    2005-02-01

    MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

  19. MRI of the fetal posterior fossa

    International Nuclear Information System (INIS)

    Adamsbaum, Catherine; Andre, Christine; Merzoug, Valerie; Ferey, Solene; Moutard, Marie Laure; Quere, Marie Pierre; Lewin, Fanny; Fallet-Bianco, Catherine

    2005-01-01

    MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

  20. CT findings of posterior fossa venous angiomas

    International Nuclear Information System (INIS)

    Satoh, Toru; Kinugasa, Kazushi; Nishimoto, Akira; Nishimoto, Ken.

    1986-01-01

    Three cases of posterior fossa venous angiomas were reported, with some comments on the CT findings. Case 1: A 53-year-old woman was admitted for the further examination of a viral meningitis which had appeared three months before. Neurological examination revealed no abnormality. Vertebral angiography, however, demonstrated numerous fine medullary veins, with an enlarged intraparenchymal draining vein, in the right cerebellum; they drained into the petrosal vein, which was characteristic of venous angioma. On the plain CT, part of the draining vein was identified as a slightly high-density node. A curvilinear draining vein was demonstrated by the enhanced CT. Case 2: A 29-year-old man was admitted complaining of headache, vomiting, and atxia. Neurological examination disclosed truncal ataxia. The enhanced CT demonstrated two distinct nodules on the anterior border of the hematoma in the deep median cerebellum, probably corresponding to the draining veins. On the angiogram, a venous angioma was found in the bilateral cerebellum; it drained into the precentral cerebellar veins and ultimately joined the straight sinus via the precentro-vermo-rectal vein. Case 3: A 4-year-old boy was admitted suffering from headache, vomiting, and ataxia. Neurological examination disclosed a co-ordination disturbance of the left side. The enhanced CT demonstrated a curvilinear structure inside the hematoma. Angiography showed a venous angioma in the left cerebellum which drained into the petrosal vein. Computerized angiotomography delineated the characteristic venous structure on the angiogram as many fine, high-density lines (medullary veins) converging to a large intraparenchymal linear structure (central medullary vein) and then to a superficial cortical vein. In all cases, large intraparenchymal draining veins were identified by the conventional CT. (J.P.N.)

  1. Fossa navicularis magna detection on cone-beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Syed, Ali Z. [Dept. of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland(United States); Mupparapu, Mel [Div. of Radiology, University of Pennsylvania School of Dental Medicine, Philadelphia (United States)

    2016-03-15

    Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed.

  2. Subarachnoid pouches of the posterior fossa with syringomyelia

    Energy Technology Data Exchange (ETDEWEB)

    Williams, B [Midland Centre for Neurosurgery and Neurology, Smethwick (UK)

    1979-01-01

    Three men are presented, all of whom were born with difficulty and later developed severe syringomyelia with collapsing cords on air myelography. Each had hydrocephalus and a sizable subarachnoid pouch in the posterior fossa. The clinical features and investigations are presented with a discussion of the aetiology and possible mechanisms concerned in pathogenesis and treatment. All three men had posterior fossa exploration over fifty years after birth, and the first two were also treated by valved ventriculo-atrial shunts. Each patient has improved a little since operation, but no certainly that this was due to surgery has been proved in any case; none has progressed since the last operation.

  3. Packing of Renal Fossa: Useful Technique for Intractable Bleeding ...

    African Journals Online (AJOL)

    There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours) to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone ...

  4. Gliosarcoma of the posterior cranial fossa: MRI findings

    International Nuclear Information System (INIS)

    Nitta, H.; Hayase, H.; Moriyama, Y.; Yamashima, T.; Yamashita, J.

    1993-01-01

    We report the MR findings of a biopsy-proven gliosarcoma of the posterior cranial fossa. Multiple homogeneously enhancing lesions had shaggy margins and broad-based dural attachments, which may reflect the gliomatous and sarcomatous element of this tumour. (orig.)

  5. Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

    Directory of Open Access Journals (Sweden)

    Jan Plzák

    Full Text Available OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.

  6. Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

    Science.gov (United States)

    Plzák, Jan; Kratochvil, Vít; Kešner, Adam; Šurda, Pavol; Vlasák, Aleš; Zvěřina, Eduard

    2017-01-01

    OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas) and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma) that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa. PMID:29069259

  7. Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa

    Directory of Open Access Journals (Sweden)

    Ordones, Alexandre Beraldo

    2014-01-01

    Full Text Available Objective To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and developed a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1 year postoperatively. Conclusion This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.

  8. Piezosurgery for the repair of middle cranial fossa meningoencephaloceles.

    Science.gov (United States)

    Acharya, Aanand N; Rajan, Gunesh P

    2015-03-01

    To describe the use of a piezosurgery medical device to perform a craniotomy and produce a split calvarial graft for the repair of middle cranial fossa meningoencephaloceles. Retrospective case review. Tertiary referral hospital. Ten consecutive patients undergoing middle cranial fossa approach for the repair of meningoencephaloceles. Therapeutic. Intraoperative and postoperative complications, success rate as defined by the ability to fashion a split calvarial graft that achieves complete closure of the tegmen defect. As a secondary outcome measure, evidence of integration of the split calvarial bone graft with the adjacent skull base was assessed. There were no intraoperative or postoperative complications. An appropriately sized calvarial bone graft was produced, and complete closure of the tegmen defect was achieved in all 10 cases. Computed tomography demonstrated evidence of integration of the bone graft in eight cases between 4 and 9 months after surgery. The piezosurgery medical device provides a safe and effective means by which the middle fossa craniotomy and split calvarial bone graft can be produced to repair defects of the middle fossa tegmen, with integration of the bone graft in the majority of cases.

  9. Posterior cranial fossa tumours in children at Kenyatta National ...

    African Journals Online (AJOL)

    Background: The management of children with posterior fossa tumours is a challenge to health care professionals worldwide. Difficulties in diagnosis especially in children less than three years is well documented. Limited diagnostic modalities and lack of awareness of the symptoms and signs as well as societal perception ...

  10. Quantitative imaging analysis of posterior fossa ependymoma location in children.

    Science.gov (United States)

    Sabin, Noah D; Merchant, Thomas E; Li, Xingyu; Li, Yimei; Klimo, Paul; Boop, Frederick A; Ellison, David W; Ogg, Robert J

    2016-08-01

    Imaging descriptions of posterior fossa ependymoma in children have focused on magnetic resonance imaging (MRI) signal and local anatomic relationships with imaging location only recently used to classify these neoplasms. We developed a quantitative method for analyzing the location of ependymoma in the posterior fossa, tested its effectiveness in distinguishing groups of tumors, and examined potential associations of distinct tumor groups with treatment and prognostic factors. Pre-operative MRI examinations of the brain for 38 children with histopathologically proven posterior fossa ependymoma were analyzed. Tumor margin contours and anatomic landmarks were manually marked and used to calculate the centroid of each tumor. Landmarks were used to calculate a transformation to align, scale, and rotate each patient's image coordinates to a common coordinate space. Hierarchical cluster analysis of the location and morphological variables was performed to detect multivariate patterns in tumor characteristics. The ependymomas were also characterized as "central" or "lateral" based on published radiological criteria. Therapeutic details and demographic, recurrence, and survival information were obtained from medical records and analyzed with the tumor location and morphology to identify prognostic tumor characteristics. Cluster analysis yielded two distinct tumor groups based on centroid location The cluster groups were associated with differences in PFS (p = .044), "central" vs. "lateral" radiological designation (p = .035), and marginally associated with multiple operative interventions (p = .064). Posterior fossa ependymoma can be objectively classified based on quantitative analysis of tumor location, and these classifications are associated with prognostic and treatment factors.

  11. STUDY OF POSTERIOR FOSSA TUMORS BY HIGH RESOLUTION MRI

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    Sree Hari

    2016-01-01

    Full Text Available INTRODUCTION Magnetic Resonance Imaging (MRI is the imaging modality used for the assessment of infratentorial neoplasms. Although Computed Tomography (CT provides better demonstration of small or subtle calcifications within tumors. OBJECTIVES Study is done to assess the potential of MRI in characterisation of different tumors in posterior fossa by evaluating various unenhanced and gadolinium enhanced sequences and to compare high resolution FSE MRI sequences with routine FSE MRI sequences in diagnosing posterior fossa brain tumors. Also correlate findings on Magnetic Resonance Imaging with Pathological diagnosis. MATERIALS AND METHODS A total of 52 patients were diagnosed by CT brain as having posterior fossa brain for a year of 2 years were included in the study. In all studies MR imaging was performed with a clinical 1.5 T system (General electrical medical systems. A dedicated phased-array coil was used. RESULTS The age group ranged from 1 year to 60 years, majority were between 1 to 20 years (39%. Slight male preponderance was seen (males 29, females 23. Commonest tumor encountered in our study was vestibular schwannoma. DWI alone can differentiate different pediatric posterior fossa brain tumors. One case of pilocytic astrocytoma showed solid lesion instead of typical cystic lesion with mural nodule. One case AT-RT showed 2 lesions one in cerebrum, one in CP angle. Common feature being intra-axial lesion involving cerebellum. MRI was able to predict diagnosis in 50 of the 52 tumors. CONCLUSION Magnetic Resonance Imaging was found to be a highly sensitive imaging procedure and method of choice for posterior fossa brain tumors.

  12. Malignant Transformation of Endometriosis in the Ischioanal Fossa

    Directory of Open Access Journals (Sweden)

    Jordan S. Klebanoff

    2018-01-01

    Full Text Available We present the case of a 28-year-old nulliparous female with malignant transformation of an ectopic focus of endometriosis in the right ischioanal fossa. A 28-year-old nulliparous patient with a past medical history of polycystic ovarian syndrome (PCOS was diagnosed with endometrioid adenocarcinoma in her right ischioanal fossa. Initially, patient presented to an emergency department and underwent a CT scan of the appendix to rule out appendicitis. A multiloculated cystic lesion adjacent to the right obturator internus muscle was found. She underwent surgical resection of the mass, which confirmed FIGO grade 2 endometrioid adenocarcinoma, followed by localized radiation therapy. Malignancy arising in endometriosis is rare, and the influence of PCOS on the rate of malignant transformation is not well established.

  13. Children's vomiting following posterior fossa surgery: A retrospective study

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    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  14. Venous anomalies and abnormalities of the posterior fossa

    International Nuclear Information System (INIS)

    Goulao, A.; Alvarez, H.; Garcia Monaco, R.; Pruvost, P.; Lasjaunias, P.

    1990-01-01

    The authors report a series of 16 patients with venous anomalies or abnormalities of the posterior fossa studied by angiography, CT and/or MRI. We believe that so-called 'venous angioma' are extreme anatomic variants that drain normal territories, and we prefer to call them developmental venous anomalies (DVA). Posterior fossa DVA, like the supra-tentorial ones are classified according to their drainage into deep and superficial type. They are exclusively located in the cerebellum or tectum. In 4 cases DVA was an incidental finding, in 3 an associated cerebral venous malformation (CVM) was found and felt to be the cause of the symptoms and only in one (Trigeminal pain) was a link between both suspected. Cavernous venous malformation (CVM) were found in frequent association with DVA (27%). 4 cases were single and 2 multiple. 5 CVM were located in the brain stem and 3 in the cerebellum. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all patients with CVM. In 2 cases venous dysplasia was found: 1 Sturge-Weber and 1 First branchial arch syndrome. Both posterior fossa venous abnormalities were incidental findings. (orig.)

  15. Antecubital Fossa Solitary Osteochondroma with Associated Bicipitoradial Bursitis

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    Colin Ng

    2015-01-01

    Full Text Available Antecubital fossa lesions are uncommon conditions that present to the orthopaedic clinic. Furthermore, the radius bone is an uncommonly reported location for an osteochondroma, especially when presenting with a concurrent reactive bicipitoradial bursitis. Osteochondromas are a type of developmental lesion rather than a true neoplasm. They constitute up to 15% of all bone tumours and up to 50% of benign bone tumours. They may occur as solitary or multiple lesions. Multiple lesions are usually associated with a syndrome known as hereditary multiple exostoses (HME. Malignant transformation is known to occur but is rare. Bicipitoradial bursitis is a condition which can occur as primary or secondary (reactive pathology. In our case, the radius bone osteochondroma caused reactive bicipitoradial bursitis. The differential diagnosis of such antecubital fossa masses is vast but may be narrowed down through a targeted history, stepwise radiological investigations, and histological confirmation. Our aim is to ensure that orthopaedic clinicians keep a wide differential in mind when dealing with antecubital fossa mass lesions.

  16. CT and MRI diagnosis of posterior fossa atypical ependymoma

    International Nuclear Information System (INIS)

    Yu Bolang; Zhang Ming; Luo Lin; Wang Shijie; Zhu Liping

    2000-01-01

    Objective: To analyse the CT and MRI features of posterior fossa atypical ependymoma. Methods: Sixteen cases of posterior fossa atypical ependymoma proved by surgery and pathology had CT and (or) MRI scanning. There were 11 males and 5 females. The age ranged from 17 to 46 (mean, 31.2). Twelve cases ranged from 20 to 40 years old. the main symptoms of all cases were dizziness, unsteady walking and vomiting. Results: The locations of all cases were cerebellum (12 cases), vermis (3 cases) and cerebellopontile angle (1 cases). Fifteen cases were solid with multiple cystic changes and 1 case in the cerebellopontile angle was cystic. The tumor was usually close to the surface of cerebellum with rather extensive connection with dura mater or tentorium. Calcifications were shown in 3 cases. The tumors revealed inhomogeneous density on CT scan and inhomogeneous intensity on MRI. Mild inhomogeneous enhancement was shown in most cases, while intense irregular enhancement in the others. Conclusions: The characteristic findings of the posterior fossa atypical ependymoma ependymoma were cerebellar intraparenchymatous multiple small cystic changes within solid tumor in most cases and inhomogeneous density and intensity on CT and MRI. The differential diagnosis is meningioma, metastasis and acoustic schwannoma

  17. Traumatic acute posterior fossa subdural hematoma – A case report and review of literature

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    Jaiswal Manish

    2014-12-01

    Full Text Available Traumatic subdural hematomas of the posterior fossa are rare but dangerous neurosurgical emergencies that require prompt diagnosis and management to avoid the uniformly poor outcome. We present a case of a teenager with severe TBI and acute subdural hematoma of the posterior fossa that deteriorated rapidly before surgery but eventually made a good recovery. We also the review the literature concerning traumatic posterior fossa subdural hematomas [PFSDH].

  18. Posterior Fossa Decompression with Duraplasty in Chiari-1 Malformations

    International Nuclear Information System (INIS)

    Rehman, L.; Akbar, H.; Bokhari, I.; Babar, A. K.; Hahim, A. S. M.; Arain, S. H.

    2015-01-01

    Objective: To evaluate the symptomatic outcome after PFD (Posterior Fossa Decompression) with duraplasty in Chiari-1 malformations. Study Design: Case series. Place and Duration of Study: Department of Neurosurgery, JPMC, Karachi, from July 2008 to September 2012. Methodology: This included 21 patients of Chiari 1 malformations admitted in department through OPD with clinical features of headache, neck pain, numbness, neurological deficit, and syringomyelia. Diagnosis was confirmed by MRI. PFD followed by C1 laminectomy with duraplasty was done in all cases and symptomatic outcome was assessed in follow-up clinic. Results: Among 21 patients, 13 were females and 8 were males. Age ranged from 18 to 40 years. All the patients had neck pain and numbness in hands. Only 3 patients had weakness of all four limbs and 12 with weakness of hands. Symptoms evolved over a mean of 12 months. Syringomyelia was present in all cases. All patients underwent posterior fossa decompression with duraplasty with an additional C1 laminectomy and in 2 cases C2 laminectomy was done. Syringo-subarachnoid shunt was placed in one patient and ventriculo-peritoneal shunt was placed in 2 patients. Pain was relieved in all cases. Weakness was improved in all cases and numbness was improved in 19 cases. Syringomyelia was improved in all cases. Postoperative complications included CSF leak in 2 patients and wound infection in one patient. However, there was no mortality. Conclusion: Posterior fossa decompression with duraplasty is the best treatment option for Chiari-1 malformations because of symptomatic improvement and less chances of complications. (author)

  19. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Liu, H M; Shih, H C; Huang, Y C; Wang, Y H [Dept. of Medical Imaging, National Taiwan University Hospital, Taipei (Taiwan)

    2001-05-01

    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  20. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    International Nuclear Information System (INIS)

    Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H.

    2001-01-01

    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  1. Large intradiploic growing skull fracture of the posterior fossa

    International Nuclear Information System (INIS)

    Hamamcioglu, M. Kemal; Hicdonmez, Tufan; Kilincer, Cumhur; Cobanoglu, Sebahattin

    2006-01-01

    Growing skull fractures (GSFs) are rare complications of head injury and mostly occur in infancy and early childhood. Location in the posterior fossa and intradiploic development of a GSF is very uncommon. We report a 7-year-old boy with a large, 9 x 7 x 4-cm, occipital intradiploic GSF. The lesion developed progressively over a period of 5 years following a documented occipital linear fracture. This case of a GSF developing from a known occipital linear fracture demonstrates that a GSF may reach a considerable size and, although uncommon, intradiploic development and occipital localization of a GSF is possible. (orig.)

  2. Incidence of Clavicular Rhomboid Fossa in Northeastern Thais: An Anthropological Study

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    Ailadda Kaewma

    2016-01-01

    Full Text Available The rhomboid fossa of clavicle is used to determine the age and sex in anthropology and forensic sciences. The variant types of rhomboid fossa on inferior surface have been reported in many races except in Thais. This study therefore was aimed at classifying the types of the rhomboid fossa in Northeastern Thais. The identified 476 Northeastern Thais dried clavicles (270 males and 206 females were observed and recorded for the types of rhomboid fossa. The results showed that Thai-rhomboid fossa could be classified into 4 types: Type 1: smooth; Type 2: flat; Type 3: elevated; and Type 4: depressed, respectively. The incidences of rhomboid fossa were as follows: Type 1: 0.21%; Type 2: 19.75%; Type 3: 76.26%; and Type 4: 3.78%, respectively. Additionally, it was found that the percentage of Type 4 (11.84% was much greater than that of female (1.94% compared to other types. This incidence of rhomboid fossa types especially Type 4 may be a basic knowledge to be used in sex identification. The high incidence of rhomboid fossa in both sexes of Northeastern Thai clavicles was Type 3 (elevated type.

  3. Cerebellar Mutism Syndrome and Other Complications After Surgery in the Posterior Fossa in Adults

    DEFF Research Database (Denmark)

    Wibroe, Morten; Rochat, Per; Juhler, Marianne

    2018-01-01

    BACKGROUND: Cerebellar mutism syndrome (CMS) is rarely described in adults; however, data on self-assessed linguistic complications after posterior fossa surgery do not exist. METHODS: Through a prospective single-center study, data on 59 tumor operations in the posterior fossa were collected pre...

  4. Schwannoma of the facial nerve involving the middle cranial fossa:case report

    Institute of Scientific and Technical Information of China (English)

    SAI Ke; CHEN Zhong-ping

    2007-01-01

    @@ Facial nerve schwannoma involving the middle cranial fossa is quite rare,and its accurate diagnosis is very difficult before SUrgery.Here we present a case of schwannoma of the facial nerve at the middle cranial fossa that was misdiagnosed previously at a local hospital and then cured in our hospital.

  5. Preauricular infratemporal fossa approach for advanced malignant parotid tumors.

    Science.gov (United States)

    Leonetti, John P; Benscoter, Brent J; Marzo, Sam J; Borrowdale, Richard W; Pontikis, George C

    2012-09-01

    The aims of this study were to demonstrate the surgical technique involved in the preauricular infratemporal fossa (ITF) approach, outline the clinical indications for use of this technique, and present the results in using this approach in 159 patients with malignant parotid tumors. At the conclusion of this article, the reader should be able to understand the utility of the preauricular infratemporal fossa approach in the management of patients with advanced malignant parotid tumors. This was a retrospective chart review of 159 patients treated at a tertiary care academic medical center following institutional review board approval. A comprehensive medical records review was performed for all patients with malignant parotid tumors who underwent a preauricular ITF approach between July 1988 and July 2010. The most common presenting symptoms were pain and trismus, whereas the presence of a parotid mass and facial paralysis were the most common clinical signs. Mucoepidermoid and adenoid cystic carcinoma accounted for 63% of the tumors, and perineural invasion was found in nearly 71% of the patients. Despite negative surgical margins in 92% of the patients, local or regional tumor recurrence was found in 17% of the cases. The mean follow-up time was 12.8 years. The preauricular ITF approach should be used in the surgical extirpation of advanced malignant parotid neoplasms. This technique provides proximal facial nerve identification, internal carotid artery protection, and negative tumor margins at the skull base. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  6. Ependymomas of the posterior cranial fossa: CT and MRI findings

    International Nuclear Information System (INIS)

    Tortori-Donati, P.; Fondelli, M.P.; Cama, A.; Garre, M.L.; Rossi, A.; Andreussi, L.

    1995-01-01

    We studied nine children with posterior cranial fossa ependymomas to identify specific neuroradiological features. Patients were studied preoperatively with CT and MRI; T1-, T2- and proton-density (PD)-weighted images were obtained. All children underwent surgery and a definite histopathological diagnosis was made. All the tumours grew into the fourth ventricle and caused dilatation of its upper part, which resembled a cap. All but one were separated from the vermis by a cleavage plane. In eight cases there was desmoplastic development through the foramina of the fourth ventricle, and five were heterogeneous due to necrosis and cystic change; one had a haemorrhagic area. In most cases the solid portion was isointense with grey matter on T1-weighted images, hyperintense on PD weighting, and isointense on T2-weighted images. On CT the tumour was isodense in six cases and calcification was detected in four. The presence of both desmoplastic development and a tumour/vermis cleavage plane in a posterior cranial fossa tumour isodense on CT is highly suggestive of ependymoma. (orig.)

  7. [A pediatric case of hydatid cyst in the infratemporal fossa].

    Science.gov (United States)

    Hiroual, A; Elbouihi, M; Fawzi, S; Lahmiti, S; Aimmadeddine, S; Mansouri-Hattab, N

    2014-06-01

    Hydatid cyst or disease is an anthropozoonosis due to the development of the larval form of the taenia Echinococcus granulosus in humans. It is endemic in Morocco. The location of a hydatid cyst in the infratemporal fossa (ITF) is extremely rare. The authors report a pediatric case. An 11 year old child was admitted to hospital with a history of left latero-facial swelling gradually increasing in volume for 2 months, CT scan of the face revealed a cystic formation of 7 cm diameter sitting at the left ITF, hydatid serology was negative. A transzygomatic approach allowed the excision of the cyst. The histopathological examination of the resected specimen confirmed the diagnosis of hydatid cyst. The location at the infratemporal fossa of an expansive process such as hydatid cyst in children may have a particular impact on adjacent structures and a more meaningful clinical expression. The rate of growth of hydatid cysts is highly variable and ranges from 1 to 5 cm a year. Hydatid serology is often negative. CT examination is the gold-standard radiological examination. Surgical removal of the hydatid cyst is the most effective treatment. The transzygomatic approach allowed a sufficient access to the cyst and a good quality of excision. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Diagnosis and treatment of trigeminal schwannomas extending into both the middle and posterior cranial fossa

    Institute of Scientific and Technical Information of China (English)

    徐启武; 车晓明; 胡杰; 杨伯捷

    2004-01-01

    @@ Trigeminal schwannomas (TSs) account for 0.1%-0.4% of all intracranial tumors and 1%-8% of intracranial schwannomas.1,2 Yoshida and Kawase3 classified TSs into 6 types according to their locations: M (TS involving the middle cranial fossa), P (TS involving the posterior cranial fossa), E (TS located at extracranial space), MP (TS involving both the middle and the posterior cranial fossa), ME (TS involving the middle cranial fossa and the extracranial space), and MPE (TS involving the the middle and the posterior cranial fossa and the extracranial space). Of these types, MP is the commonest, but is difficult to be totally removed. Between January 1984 and June 2003, we surgically treated 28 patients with TSs of type MP and obtained satisfactory results. To make a correct diagnosis of TS, to select appropriate surgical approach, and to improve surgical outcome of TS of type MP, we analysed the related clinical data and experiences.

  9. Nasoangiofibroma juvenil: concordância interobservadores no estadiamento por tomografia computadorizada Juvenile nasopharyngeal angiofibroma: interobserver agreement in cancer staging using computed tomography

    Directory of Open Access Journals (Sweden)

    Jefferson Luiz Gusso

    2001-08-01

    Full Text Available Com o advento da tomografia computadorizada, a avaliação dos locais de acometimento e extensão do nasoangiofibroma juvenil tornou-se mais precisa, o que facilitou o correto estadiamento pré-operatório. O objetivo deste trabalho é avaliar a concordância interobservadores, por meio da análise por tomografia computadorizada, de 15 casos de nasoangiofibroma juvenil em relação à extensão para locais relacionados com altos índices de recidivas. Todos os pacientes eram do sexo masculino, com idade média de 15,8 anos. A análise da concordância entre os observadores quanto à extensão e envolvimento da fossa infratemporal, seios esfenóide e cavernoso e fossa craniana média foi excelente, em relação à fissura orbitária superior foi boa e em relação à base do processo pterigóide e fossa craniana anterior foi ruim. Concluiu-se que a análise apresenta alta concordância entre os observadores para os locais estabelecidos, com exceção da base do processo pterigóide e da fossa craniana anterior.The advent of computed tomography permitted a much more precise evaluation of tumor localization, thus facilitating presurgical staging. The objective of this study was to evaluate the interobserver agreement on the analysis of computed tomography scans of 15 patients with juvenile nasopharyngeal angiofibroma, regarding assessment of tumor extension to sites of high recurrence rate. All patients were male and had a mean age of 15.8 years. The results of the interobserver agreement analysis regarding tumor invasion and extension to the infratemporal fossa, cavernous sinus, sphenoid sinus and medium cranial fossa were excellent. Identification of involvement of the superior orbital fissure was considered good. Interobserver agreement regarding tumor extension to the base of pterigoid process and anterior cranial fossa was considered poor. We concluded that there is a very good interobserver agreement on the evaluation of the established

  10. Posterior fossa malformations: main features and limits in prenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Garel, Catherine [Hopital d' Enfants Armand-Trousseau, Department of Radiology, Paris (France)

    2010-06-15

    Posterior fossa (PF) malformations are commonly observed during prenatal screening. Their understanding requires knowledge of the main steps of PF development and knowledge of normal patterns in US and MR imaging. The vast majority of PF malformations can be strongly suspected by acquiring a midline sagittal slice and a transverse slice and by systematically scrutinizing the elements of the PF: cerebellar vermis, hemispheres, brainstem, fourth ventricle, PF fluid spaces and tentorium. Analysis of cerebellar echogenicity and biometry is also useful. This review explains how to approach the diagnosis of the main PF malformations by performing these two slices and answering six key questions about the elements of the PF. The main imaging characteristics of PF malformations are also reviewed. (orig.)

  11. The topographic relations of the high jugular fossa to the inner ear

    International Nuclear Information System (INIS)

    Wadin, K.; Wilbrand, H.

    1986-01-01

    The radioanatomy of high jugular fossae and their topographic relations to the inner ear structures were investigated in 245 unselected temporal bones. One hundred and fifty specimens were submitted to multidirectional and 10 to computed tomography. After careful chemical and fermentative maceration plastic casts were made, using polyester resin and silicone rubber. With the use of vacuum, even minute structures became filled with the casting material. The specimens offered a three-dimensional view of the jugular fossae and surrounding structures. Fifty-eight (24%) of the total 245 specimens had high jugular fossae at a level above the lower border of the round window. Five casts showed a dehiscence of the peripheral portion of the vestibular aqueduct caused by the high jugular fossa. In 2 casts the proximal portion of the cochlear aqueduct was affected. In some casts the posterior semicircular canal, the facial canal, the stapedial muscle and the round window lay so close to the fossa that a dehiscence could not be excluded. In a clinical material of 102 high fossae the radiographic findings were in accordance with the experimental results. High jugular fossae were predominantly found in pyramids with low-grade mastoid bone pneumatization and sparse or no perilabyrinthine air cells. (orig.)

  12. The role of ovarian fossa evaluation in patients with ovarian endometriosis.

    Science.gov (United States)

    De Cicco Nardone, Carlo; Terranova, Corrado; Plotti, Francesco; Ricciardi, Roberto; Capriglione, Stella; Luvero, Daniela; Caserta, Donatella; Moscarini, Massimo; Benedetti Panici, Pierluigi; Angioli, Roberto

    2015-10-01

    The aim of this study is to evaluate prospectively the presence of endometriosis in the peritoneum of the ovarian fossa of patients affected by endometriomas and its correlation with the adhesion between this peritoneum and endometrioma. Patients presenting ovarian endometriomas and candidate to laparoscopy were considered for inclusion in the study. Patients underwent laparoscopic excision of endometriomas. The presence of adherence of the ovarian fossa to endometrioma was investigated. In all patients, the removal of a peritoneum fragment from the ovarian fossa of the affected ovary was carried out. 68 patients were enrolled in the study. 48 patients presented adhesions to the ovarian fossa. Histopathologic examination of the peritoneum of the ovarian fossa revealed the presence of endometriosis in 87 % of patients presenting adhesions of the endometriomas with ovarian fossa; surprisingly it was present only in 15 % of patients not presenting this condition (p endometriosis on the peritoneal surface of the fossa. This condition significantly correlates with pain symptoms and may predict endometrioma recurrence. The removal of this peritoneum in case of adherent endometrioma may potentially reduce the incidence of recurrence.

  13. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear

    International Nuclear Information System (INIS)

    Wadin, K.; Thomander, L.; Wilbrand, H.; Uppsala Univ.

    1986-01-01

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value. (orig.)

  14. Assessment of growth dynamics of human cranium middle fossa in foetal period.

    Science.gov (United States)

    Skomra, Andrzej; Kędzia, Alicja; Dudek, Krzysztof; Bogacz, Wiesław

    2014-01-01

    Available literature analysis demonstrated smallness of studies of cranial base. The goal of the study was to analyse the medial fossa of the human cranium in the foetal period against other fossae. Survey material consisted of 110 human foetuses at a morphological age of 16-28 weeks of foetal life, CRL 98-220 mm. Anthropological, preparation method, reverse method and statistical analysis were utilized. The survey incorporated the following computer programmes: Renishaw, TraceSurf, AutoCAD, CATIA. The reverse method seems especially interesting (impression with polysiloxane (silicone elastomer of high adhesive power used in dentistry) with 18 D 4823 activator. Elicited impression accurately reflected complex shape of cranium base. On assessing the relative rate of cranium medial fossa, the rate was found to be stable (linear model) for the whole of the analysed period and is 0.19%/week, which stands for the gradual and steady growth of the middle fossa in relation to the whole of the cranium base. At the same time, from the 16th till 28th week of foetal life, relative volume of the cranium middle fossa increases more intensively than cranium anterior fossa, whereas the cranium middle fossa volume as compared with the cranium posterior fossa is definitely slower. In the analysed period, the growth rate of the cranium base middle fossa was bigger in the 4th and 5th weeks than in the 6th and 7th weeks of foetal life. The investigations revealed cranium base asymmetry of the left side. Furthermore, the anterior fossae volume on the left side is significantly bigger than the one of the fossae on the right side. Volume growth rate is more intensive in the 4th and 5th than in the 6th and 7th weeks of foetal life. In the examined period, the relative growth rate of cranium base middle fossa is 0.19%/week and it is stable - linear model. The study revealed correlations in the form of mathematical models, which enabled foetuses age assessment.

  15. Decreased Sudomotor Function is Involved in the Formation of Atopic Eczema in the Cubital Fossa

    Directory of Open Access Journals (Sweden)

    Aya Takahashi

    2013-01-01

    Conclusions: These results suggest that decreased sweating is a major source of water in the stratum corneum, and decreased sudomotor function may be involved in both the cause and aggravation of representative atopic eczema in the cubital fossa.

  16. Factors affecting outcome in posterior fossa EDH: an analytical study at tertiary referral hospital

    Directory of Open Access Journals (Sweden)

    Anurag Pateriya

    2016-06-01

    Full Text Available Introduction. Posterior fossa extradural hematomas (PFEDHs are uncommon as compared to supratentorial EDH and these patients can deteriorate very rapidly due to compression over brainstem. Thus early identification and intervention can save the lives of these patients.

  17. Posterior cranial fossa dimensions in the Chiari I malformation: relation to pathogenesis and clinical presentation

    International Nuclear Information System (INIS)

    Stovner, L.J.; Bergan, U.; Nilsen, G.; Sjaastad, O.

    1993-01-01

    Skull dimensions were measured on lateral skull radiographs in 33 adult patients with MRI-verified Chiari I malformations and in 40 controls. The posterior cranial fossa was significantly smaller and shallower in patients than in controls. In the patients, there was a positive correlation between posterior fossa size and the degree of the cerebellar ectopia, which might indicate that a posterior cranial fossa which was originally too small had been expanded by the herniation of hindbrain structures at an early stage. No special clinical presentation was associated with a very small posterior cranial fossa, which may indicate that a small posterior cranial per se has little or no clinical significance, although it may be the primary developmental anomaly. (orig./GD)

  18. Effect of Rapid Maxillary Expansion on Glenoid Fossa and Condyle-Fossa Relationship in Growing Patients (MEGP): Study Protocol for a Controlled Clinical Trial

    Science.gov (United States)

    Ghoussoub, Mona Sayegh; Rifai, Khaldoun; Garcia, Robert; Sleilaty, Ghassan

    2018-01-01

    Aims and Objectives: Rapid maxillary expansion (RME) is an orthodontic nonsurgical procedure aiming at increasing the width of the maxilla by opening mainly the intermaxillary suture in patients presenting a transverse maxillary skeletal deficiency. The objectives of the current prospective controlled clinical and radiographic study are to evaluate the hypothesis that RME in growing patients will result in radiographic changes at the level of interglenoid fossa distance, condyle-fossa relationship, and nasal cavity widths compared to the group who received no treatment initially and served as untreated control. Materials and Methods: In this prospective controlled clinical and radiographic study, forty healthy growing patients selected from a school-based population following a large screening campaign, ranging in age between 8 and 13 years, presenting a maxillary constriction with bilateral crossbite, and candidates for RME are being recruited. The first group will include participants willing to undergo treatment (n = 25) and the other group will include those inclined to postpone (n = 15). Results: The primary outcome is to compare radiologically the interglenoid fossa distance and the condyle-fossa relationship; nasal cavity width will be a secondary outcome. A multivariable analysis of Covariance model will be used, with the assessment of the time by group interaction, using age as covariate. The project protocol was reviewed and approved by the Ethics Committee of the Lebanese University, National Institute in Lebanon (CUEMB process number 31/04/2015). The study is funded by the Lebanese University and Centre National de Recherche Scientifique, Lebanon (Number: 652 on 14/04/2016). Conclusion: This prospective controlled clinical trial will give information about the effect of RME on the glenoid fossa and condyle-fossa relationship and its impact on the nasal cavity width. Trial Registration: Retrospectively registered in BioMed Central (DOI10.1186/ISRCTN

  19. Dislocation of a mandibular condyle in the middle cranial fossa, diagnosed 54 years after trauma

    OpenAIRE

    De Mol, Antoni; Nicolielo, Laura; Ghekiere, Olivier; Jacobs, Reinhilde; Politis, Constantinus

    2017-01-01

    Abstract Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma. We report the remarkable case of a 63-year-old patient in whom trauma 54 years prior to consultation resulted in intrusion of the right mandibular condyle into the middle cranial fossa. The diagnosis was missed because of insufficient data provided by conventional radiographies. Failure of timely diagnosis and lack of appropriate treatment resulted in temporomandibular joi...

  20. Radiological imaging detection of tumors localized in fossa cranii posterior.

    Science.gov (United States)

    Kabashi, Serbeze; Muçaj, Sefedin; Ahmetgjekaj, Ilir; Gashi, Sanije; Fazliu, Ilir; Dreshaj, Shemsedin; Shala, Nexhmedin

    2008-01-01

    Intracranial tumors are characterized by a variety imaging aspects and their detection is always a challenge. Clinical application of Magnetic Resonance Imaging (MRI) and Computerized Tomography has provided an earlier detection and treatment of many CNS pathologies. The aim of this study is to estimate the role of CT and MRI in the determination of posterior fossa tumors. During period 2000-2005 in UCCK-Prishtina, 368 patients were diagnosed with intracranial tumors. Fifty-nine of them were found to have tumor localized in fossa crani posterior (FCP) without any significant difference between genders (50.8% female vs. 49.2% male, chi2 test=0.02 p=0.896). The average age of patients with FCP tumors was 33.1 (SD +/- 22.5, rank 1-70). The most of these patients were registered in 2003 (20.3%) whereas the least in 2000 (11.9%). The most affected age-group was 0-9 (25.4%) and 50-59 (23.7%) whereas the incidences was between 30-39 years of age (3.4%). Tumor types that more often were found in young's individuals were: Astrocytomas with a peak incidence in teenagers (average age was 12-year-old SD +/- 7.5, rank 3-23), next was Medulloblastomas (average age was 11-years-old, SD +/- 2.9, rank 6-16 years) and ependymomas (average age was 6.8-years-old, SD +/- 4.6, rank 1-12). Patients with osseous tumors are characterized by older age than median (61.0, SD +/- 4.2, rank 58-64), then metastases (53.0, SD +/- 5.3, rank 45-60) and meningiomas (50.8, SD +/- 7.7, rank 38-63). The overall average mortality was 0.41 cases per 100,000 inhabitants with variations through years from 0.30-0.50/100,000 inhabitants. Comparing with other countries, for some types of FCP tumors, lower morbidity is shown in Kosova, with mean incidence 0.41/100,000. The most frequent tumors in children were medulloblastomas, brainstem gliomas, astrocytomas and ependymomas whereas meningiomas and metastasis were most often found in adults. For FCP tumors detection, MRI had 100% sensitivity, specificity and

  1. Endoscopic transnasal resection of anterior cranial fossa meningiomas.

    Science.gov (United States)

    de Divitiis, Enrico; Esposito, Felice; Cappabianca, Paolo; Cavallo, Luigi M; de Divitiis, Oreste; Esposito, Isabella

    2008-01-01

    The extended transnasal approach, a recent surgical advancements for the ventral skull base, allows excellent midline access to and visibility of the anterior cranial fossa, which was previously thought to be approachable only via a transcranial route. The extended transnasal approach allows early decompression of the optic canals, obviates the need for brain retraction, and reduces neurovascular manipulation. Between 2004 and 2007, 11 consecutive patients underwent transnasal resection of anterior cranial fossa meningiomas--4 olfactory groove (OGM) and 7 tuberculum sellae (TSM) meningiomas. Age at surgery, sex, symptoms, and imaging studies were reviewed. Tumor size and tumor extension were estimated, and the anteroposterior, vertical, and horizontal diameters were measred on MR images. Medical records, surgical complications, and outcomes of the patients were collected. A gross-total removal of the lesion was achieved in 10 patients (91%), and in 1 patient with a TSM only a near-total (> 90%) resection was possible. Four patients with preoperative visual function defect had a complete recovery, whereas 3 patients experienced a transient worsening of vision, fully recovered within few days. In 3 patients (2 with TSMs and 1 with an OGM), a postoperative CSF leak occurred, requiring a endoscopic surgery for skull base defect repair. Another patient (a case involving a TSM) developed transient diabetes insipidus. The operative time ranged from 6 to 10 hours in the OGM group and from 4.5 to 9 hours in the TSM group. The mean duration of the hospital stay was 13.5 and 10 days in the OGM and TSM groups, respectively. Six patients (3 with OGMs and 3 with TSMs) required a blood transfusion. Surgery-related death occurred in 1 patient with TSM, in whom the tumor was successfully removed. The technique offers a minimally invasive route to the midline anterior skull base, allowing the surgeon to avoid using brain retraction and reducing manipulation of the large vessels and

  2. Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Rueckriegel, Stefan M., E-mail: rueckriegel.s@nch.uni-wuerzburg.de [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Driever, Pablo Hernaiz [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Bruhn, Harald [Department of Radiology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Department of Radiology, Klinikum der Friedrich-Schiller-Universitaet, Erlanger (Germany)

    2012-03-01

    Purpose: Therapy and tumor-related effects such as hypoperfusion, internal hydrocephalus, chemotherapy, and irradiation lead to significant motor and cognitive sequelae in pediatric posterior fossa tumor survivors. A distinct proportion of those factors related to the resulting late effects is hitherto poorly understood. This study aimed at separating the effects of neurotoxic factors on central nervous system metabolism by using H-1 MR spectroscopy to quantify cerebral metabolite concentrations in these patients in comparison to those in age-matched healthy peers. Methods and Materials: Fifteen patients with World Health Organization (WHO) I pilocytic astrocytoma (PA) treated by resection only, 24 patients with WHO IV medulloblastoma (MB), who additionally received chemotherapy and craniospinal irradiation, and 43 healthy peers were investigated using single-volume H-1 MR spectroscopy of parietal white matter and gray matter. Results: Concentrations of N-acetylaspartate (NAA) were significantly decreased in white matter (p < 0.0001) and gray matter (p < 0.0001) of MB patients and in gray matter (p = 0.005) of PA patients, compared to healthy peers. Decreased creatine concentrations in parietal gray matter correlated significantly with older age at diagnosis in both patient groups (MB patients, p = 0.009, r = 0.52; PA patients, p = 0.006, r = 0.7). Longer time periods since diagnosis were associated with lower NAA levels in white matter of PA patients (p = 0.008, r = 0.66). Conclusions: Differently decreased NAA concentrations were observed in both PA and MB groups of posterior fossa tumor patients. We conclude that this reflects a disturbance of the neurometabolic steady state of normal-appearing brain tissue due to the tumor itself and to the impact of surgery in both patient groups. Further incremental decreases of metabolite concentrations in MB patients may point to additional harm caused by irradiation and chemotherapy. The stronger decrease of NAA in MB

  3. MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation

    Energy Technology Data Exchange (ETDEWEB)

    Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan); Shakudo, Miyuki [Osaka City General Hospital, Department of Radiology, Osaka (Japan); Tanaka, Hiroyuki [Hyogo College of Medicine, Department of Gynecology, Nishinomiya (Japan); Minagawa, Kyoko [Hyogo College of Medicine, Department of Pediatrics, Nishinomiya (Japan)

    2007-12-15

    Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

  4. MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation

    International Nuclear Information System (INIS)

    Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo; Shakudo, Miyuki; Tanaka, Hiroyuki; Minagawa, Kyoko

    2007-01-01

    Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

  5. Glenoid fossa position in Class III malocclusion associated with mandibular protrusion.

    Science.gov (United States)

    Innocenti, Cristina; Giuntini, Veronica; Defraia, Efisio; Baccetti, Tiziano

    2009-04-01

    Our aim in this study was to investigate the position of the glenoid fossa in subjects with Class III malocclusion associated with mandibular protrusion to better clarify the role of this craniofacial component in Class III skeletal disharmony. A sample of 30 subjects, aged 8 years +/- 6 months, with skeletal and dental Class III malocclusion associated with mandibular protrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a control group of 33 subjects with skeletal and dental Class I relationships. The comparisons between the Class III group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed with the Mann-Whitney U test at P <0.05. Subjects with Class III malocclusion had a significantly more mesial position of the glenoid fossa, when compared with the control group as measured with 3 parameters. An anterior position of the glenoid fossa is a possible diagnostic anatomic feature of Class III malocclusion associated with mandibular protrusion. An effective measurement to evaluate glenoid fossa position in craniofacial relationships is the cephalometric distance from the glenoid fossa to the frontomaxillary-nasal suture.

  6. Glenoid fossa position in Class II malocclusion associated with mandibular retrusion.

    Science.gov (United States)

    Giuntini, Veronica; De Toffol, Laura; Franchi, Lorenzo; Baccetti, Tiziano

    2008-09-01

    To assess the position of the glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion and normal mandibular size in the mixed dentition. A sample of 30 subjects (16 male, 14 female), age 9 years +/- 6 months, with skeletal and dental Class II malocclusion associated with mandibular retrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a matched group of 37 subjects (18 male, 19 female) with skeletal and dental Class I relationships. The comparisons between the Class II group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed by means of a nonparametric test for independent samples (Mann-Whitney U-test, P < .05). Subjects with Class II malocclusion presented with a significantly more distal position of the glenoid fossa, when compared with the control group as measured by means of three parameters (GF-S on FH, GF-Ptm on FH, and GF-FMN). A posteriorly displaced glenoid fossa is a possible diagnostic feature of Class II malocclusion associated with mandibular retrusion. An effective cephalometric measurement to evaluate glenoid fossa position is the distance from the glenoid fossa to the frontomaxillonasal suture (GF-FMN).

  7. Quality of life in children survivors of posterior fossa tumors

    International Nuclear Information System (INIS)

    Martinez-Climent, J.A.; Castel Sanchez, V.; Esquembre Menor, C.; Ferris Tortajada, J.; Verdeguer Miralles, A.

    1994-01-01

    We have created a numerical scale in order to measure the Quality of Life in children survivors of posterior fossa tumors. We evaluated the long-term sequelae in 39 patients seen during a 20 year period, with a medium follow-up of 9 years. They were 25 Cerebelar Astrocytoma (CA), 6 Medulloblastoma (MDB), 5 Brain-Stem Glioma (BSG) and 3 Ependymoma of IV ventricle (EPD). Sixty-six per cent of children showed neurologic and/or visual sequelae (Bloom's levels I-II in 66%). Psychointellectual dysfunctions were identified in 44%, with an IQ<90 in 39%. Endocrine disorders were found in 26%. Quality of Life (QL) was measured with our Scale, finding that 19 patients (49%) have a good or acceptable QL, eight (20%) a moderate QL that can be acceptable with adequate rehabilitation, and the remaining 12 (36%) a bad QL that can be improved slightly. Unfavorable outcomes were related to age less than 4 years at diagnosis, type of tumor (MDB, EPD, BSG), incomplete tumoral resection, and use of radiotherapy and/or chemotherapy. We consider that our scale is complete and adequate to measure the QL of children survivors of CNS tumors. (Author) 55 refs

  8. Comparison of posterior fossa and tumor bed boost in medulloblastoma.

    Science.gov (United States)

    Paulino, A C; Saw, C B; Wen, B C

    2000-10-01

    To quantify the difference between the area of brain irradiated using the posterior fossa boost (PFB) and tumor bed boost (TBB) in medulloblastoma, we studied 15 simulation radiographs of patients treated in our institution from 1990 and 1999. The PFB was compared with the TBB, which was defined as the tumor bed plus 2-cm margin as demonstrated by postoperative magnetic resonance imaging. The PFB field treated a mean area of 9.43 cm2 more brain than the TBB. In 3 patients (20%), the area of the brain in the TBB was larger than the PFB. In 11 patients (73.3%), the PFB field had more than 10% more brain than the TBB. The cochlea was in the PFB and TBB field in all patients. In more than two thirds of patients, the area of brain irradiated with the PFB was at least 10% greater than the TBB. Future studies are needed to determine whether the TBB can replace the PFB in patients with medulloblastoma.

  9. The management of right iliac fossa pain - is timing everything?

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-01-31

    BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.

  10. Metrics and textural features of MRI diffusion to improve classification of pediatric posterior fossa tumors.

    Science.gov (United States)

    Rodriguez Gutierrez, D; Awwad, A; Meijer, L; Manita, M; Jaspan, T; Dineen, R A; Grundy, R G; Auer, D P

    2014-05-01

    Qualitative radiologic MR imaging review affords limited differentiation among types of pediatric posterior fossa brain tumors and cannot detect histologic or molecular subtypes, which could help to stratify treatment. This study aimed to improve current posterior fossa discrimination of histologic tumor type by using support vector machine classifiers on quantitative MR imaging features. This retrospective study included preoperative MRI in 40 children with posterior fossa tumors (17 medulloblastomas, 16 pilocytic astrocytomas, and 7 ependymomas). Shape, histogram, and textural features were computed from contrast-enhanced T2WI and T1WI and diffusivity (ADC) maps. Combinations of features were used to train tumor-type-specific classifiers for medulloblastoma, pilocytic astrocytoma, and ependymoma types in separation and as a joint posterior fossa classifier. A tumor-subtype classifier was also produced for classic medulloblastoma. The performance of different classifiers was assessed and compared by using randomly selected subsets of training and test data. ADC histogram features (25th and 75th percentiles and skewness) yielded the best classification of tumor type (on average >95.8% of medulloblastomas, >96.9% of pilocytic astrocytomas, and >94.3% of ependymomas by using 8 training samples). The resulting joint posterior fossa classifier correctly assigned >91.4% of the posterior fossa tumors. For subtype classification, 89.4% of classic medulloblastomas were correctly classified on the basis of ADC texture features extracted from the Gray-Level Co-Occurence Matrix. Support vector machine-based classifiers using ADC histogram features yielded very good discrimination among pediatric posterior fossa tumor types, and ADC textural features show promise for further subtype discrimination. These findings suggest an added diagnostic value of quantitative feature analysis of diffusion MR imaging in pediatric neuro-oncology. © 2014 by American Journal of Neuroradiology.

  11. The enlargement of geniculate fossa of facial nerve canal: a new CT finding of facial nerve canal fracture

    International Nuclear Information System (INIS)

    Gong Ruozhen; Li Yuhua; Gong Wuxian; Wu Lebin

    2006-01-01

    Objective: To discuss the value of enlargement of geniculate fossa of facial nerve canal in the diagnosis of facial nerve canal fracture. Methods: Thirty patients with facial nerve canal fracture underwent axial and coronal CT scan. The correlation between the fracture and the enlargement of geniculate fossa of facial nerve canal was analyzed. The ability of showing the fracture and enlargement of geniculate fossa of facial nerve canal in axial and coronal imaging were compared. Results: Fracture of geniculate fossa of facial nerve canal was found in the operation in 30 patients, while the fracture was detected in CT in 18 patients. Enlargement of geniculate ganglion of facial nerve was detected in 30 patients in the operation, while the enlargement of fossa was found in CT in 28 cases. Enlargement and fracture of geniculate fossa of facial nerve canal were both detected in CT images in 18 patients. Only the enlargement of geniculate fossa of facial nerve canal was shown in 12 patients in CT. Conclusion: Enlargement of geniculate fossa of facial nerve canal was a useful finding in the diagnosis of fracture of geniculate fossa in patients with facial paralysis, even no fracture line was shown on CT images. (authors)

  12. A Percutaneous Transtubular Middle Fossa Approach for Intracanalicular Tumors.

    Science.gov (United States)

    Bernardo, Antonio; Evins, Alexander I; Tsiouris, Apostolos J; Stieg, Philip E

    2015-07-01

    In cases of small intracanalicular tumors (≤ 1.5 cm), the middle fossa approach (MFA) provides the ability for adequate tumor removal with preservation of existing auditory function. Application of a minimally invasive tubular retractor in this approach may help mitigate the risk of postoperative seizures, aphasia, and venous complications by minimizing intraoperative retraction of the temporal lobe. We propose a minimally invasive microscopic and/or endoscopic percutaneous transtubular MFA for the management of intracanalicular tumors. Subtemporal keyhole craniectomies were performed on 5 preserved cadaveric heads (10 sides), with 6 sides previously injected with a synthetic tumor model. A ViewSite Brain Access System tubular retractor (Vycor Medical, Inc., Boca Raton, Florida, USA) was used to provide minimal temporal retraction and protection of the surrounding anatomy. An extradural dissection of the internal auditory canal was performed under microscopic and endoscopic visualization with a minimally invasive surgical drill and tube shaft instruments, the intracanalicular tumors were removed, and degree of resection was assessed. All 10 approaches were completed successfully through the tubular retractor with minimal retraction of the temporal lobe. Excellent visualization of the structures within the internal auditory canal was achieved with both the microscope and 3-dimensional endoscope. On the 6 synthetic intracanalicular tumors resected, 5 gross total (Grade I) and 1 near total (Grade II) resections were achieved. A percutaneous transtubular MFA is a feasible minimally invasive option for resection of small intracanalicular tumors with potential preservation of auditory function, reduced temporal retraction, and enhanced protection of surrounding structures. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery

    Directory of Open Access Journals (Sweden)

    Verena Heymanns

    2016-07-01

    Full Text Available Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8% in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark, Gelfoam® (Pfizer Inc., New York, NY, USA and polymethylmethacrylate (osteoclastic craniotomy. The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.

  14. 3D printing the pterygopalatine fossa: a negative space model of a complex structure.

    Science.gov (United States)

    Bannon, Ross; Parihar, Shivani; Skarparis, Yiannis; Varsou, Ourania; Cezayirli, Enis

    2018-02-01

    The pterygopalatine fossa is one of the most complex anatomical regions to understand. It is poorly visualized in cadaveric dissection and most textbooks rely on schematic depictions. We describe our approach to creating a low-cost, 3D model of the pterygopalatine fossa, including its associated canals and foramina, using an affordable "desktop" 3D printer. We used open source software to create a volume render of the pterygopalatine fossa from axial slices of a head computerised tomography scan. These data were then exported to a 3D printer to produce an anatomically accurate model. The resulting 'negative space' model of the pterygopalatine fossa provides a useful and innovative aid for understanding the complex anatomical relationships of the pterygopalatine fossa. This model was designed primarily for medical students; however, it will also be of interest to postgraduates in ENT, ophthalmology, neurosurgery, and radiology. The technical process described may be replicated by other departments wishing to develop their own anatomical models whilst incurring minimal costs.

  15. Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report

    Directory of Open Access Journals (Sweden)

    Abdel-Aziz Mosaad

    2012-06-01

    Full Text Available Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Conclusions Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

  16. Clinical analysis of surgical treatment of traumatic hematomas of the posterior cranial fossa

    International Nuclear Information System (INIS)

    Wang Wenhua; Zhou Youxin; Zhu Fengqing; Zhou Dai

    2000-01-01

    Objective: To discuss the clinical features and surgical outcome of the traumatic hematomas posterior cranial fossa. Methods: Fifteen patients with traumatic hematomas posterior cranial fossa in authors' hospital during the period from 1995 to 1998 were reviewed. Results: Thirteen patients had an occipital skull fracture, 11 pure epidural hematomas among whom 4 had cerebellar contusion and hematomas 4 posterior cranial fossa hematoma with associated cerebral hematoma or contusion, and 5 acute hydrocephalus. Fifteen patients were treated by emergency surgery, 9 had good recovery and 1 had severe disability in GCS between 9 and 15 marking, 1 had good recovery, 1 had severe disability and 3 died in GCS between 3 and 8. Nine patients had good recovery in 11 patient having pure epidural hematoma of posterior cranial fossa. Conclusions: The clinical course of the traumatic hematomas posterior cranial fossa was acute and severe. The GCS value below 9 predicts the poor out-come for patients. Early diagnosis and appropriately and promptly treatment are crucial for achieving good results

  17. Radiographic and computed tomographic evaluation of the canine intercondylar fossa in normal stifles and after notchplasty in stable and unstable stifles

    International Nuclear Information System (INIS)

    Fitch, R.B.; Hathcock, J.T.; Montgomery, R.D.

    1996-01-01

    The role of the intercondylar fossa in cranial cruciate ligament injury has gained notable attention in humans and it's role is now being questioned in animals. Controversy exists regarding the accuracy of radiographs and computed tomography (CT) in evaluating the intercondylar fossa. This study compared radiographic and CT evaluation with gross evaluation of the intercondylar fossa. Six greyhounds were evaluated before notchplasty, immediately after notchplasty and 6 months after notchplasty in stable and unstable stifles. A fossa width index was used for comparison because it negates the effects of patient size and radiographic magnification. The fossa width index is calculated by dividing the width of the intercondylar fossa by the total condylar width. The fossa width indices of dogs determined from radiographs and CT were not significantly different before notchplasty except for the cranial fossa width indices which were more inconsistent and tended to underestimate the size when compared to gross measurements. At six months, both stable and unstable stifles had refilling of the notchplasty, but the unstable stifles had significantly greater refilling resulting in no significant enlargement in intercondylar fossa size as compared to the prenotchplasty size. Osteophytes that occurred within the intercondylar fossa were less radiopaque and more easily visualized by computed tomography. Computed tomography provided several advantages, including clearer visualization of the intercondylar fossa, avoiding superimposition of the intercondylar fossa by caudal thigh muscles or tuber ischii and the ability to analyze the cranial and caudal components of the intercondylar fossa separately

  18. Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa

    International Nuclear Information System (INIS)

    Brainin, M.; Samec, P.

    1983-01-01

    The etiology of arteriovenous meningeal fistulas (AVMFs) of the posterior fossa often remains unclear. Analyses of three personal cases, however, suggest a change in venous hemodynamics due to a primary lesion, the cases being of sinus thrombosis, intracerebral abcess with oedema and arteriovenous malformation. It is suggested that increase of venous pressure in the posterior fossa leads to increased drainage and, consequently, to dilatation of infratentorial veins and of meningeal branches of the external carotid and vertebral artery. Clinical findings and anatomical facts underlying AVMF lesions tend to confirm the view that the concept of a congenital malformation decompensating with age cannot be upheld for all AVMFs, especially when located in the posterior fossa and when clinical symptoms arise in middle age. It is proposed that a pressure activated mechanism of growth results in widening of normally insignificantly small dural vessels. (orig.)

  19. Clival osteomyelitis resulting from spread of infection through the fossa navicularis magna in a child

    International Nuclear Information System (INIS)

    Prabhu, Sanjay P.; Zinkus, Timothy; Cheng, Alan G.; Rahbar, Reza

    2009-01-01

    The fossa navicularis is a notch-like bone defect in the basiocciput that has been hitherto considered as an anatomical variant of the clivus and not previously described as a potential source of clival or skull base pathology. We report the imaging findings in a 5-year-old child who presented acutely with a retropharyngeal abscess and osteomyelitis of the clivus. Imaging after treatment revealed a ''notch-like'' defect in the anterior clivus consistent with a fossa navicularis. Based on these appearances, we postulate that the lymphoid tissue of the pharyngeal tonsil residing in the fossa navicularis served as a route through which infection spread and subsequently developed into clival osteomyelitis, which is a rare diagnosis. This case is unique, and we believe that the presence of this variant in young children may be important and is not merely an anatomical curiosity. (orig.)

  20. Ependymoma of the pituitary fossa. Case report and review of the literature.

    Science.gov (United States)

    Mukhida, Karim; Asa, Sylvia; Gentili, Fred; Shannon, Patrick

    2006-10-01

    The authors describe a case of pituitary fossa ependymoma and discuss its immunohistochemical and ultrastructural characteristics. A 43-year-old man presented with decreased libido and panhypopituitarism. Magnetic resonance imaging demonstrated a well-demarcated enhancing lesion of the pituitary fossa that was completely resected via a transsphenoidal approach. Ependymomas rarely occur in the pituitary fossa, and have been reported in this location only three times in humans and once in a horse. This is the first study in which investigators examined the appearance of a pituitary ependymoma by using electron microscopy. Theories of the origin and treatment of these rare tumors are discussed as they relate to other articles on intracranial ependymomas.

  1. Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa

    International Nuclear Information System (INIS)

    Gwozdz, John T.; Morrison, William H.; Garden, Adam S.; Weber, Randal S.; Peters, Lester J.; Ang, K. Kian

    1997-01-01

    Purpose: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating patients with squamous carcinoma of the tonsillar fossa. Patients and Methods: Between December 1983 and November 1992, 83 patients with squamous carcinoma of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on Cancer T stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The tumor dose was 69-72 Gy, given over 6 weeks. Twenty-one patients, who all had N2 or N3 regional disease, underwent neck dissections, either before (13 patients) or 6 weeks after radiotherapy (8 patients); the other patients were treated with radiotherapy alone. Results: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. Patients with T2 and T3 primary tumors had 5-year actuarial local control rates of 96 and 78%, respectively. Patients with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 patients who had neck dissections all had their disease regionally controlled. Patients presenting with nodal disease or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five patients had confluent Grade 4 mucositis during treatment. Severe late complications attributable to radiation included mandibular necrosis, in-field osteosarcoma, and chronic dysphagia for solid foods. Conclusions: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late

  2. The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai [Catholic University College of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a nonenhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. Clinically, the lesions of the lacrimal gland and fossa are found as palpable masses in the superior lateral aspect of the orbit, and these lesions constitute about 5-13% of all of the orbital masses confirmed by biopsy. Many different pathological entities arise from the lacrimal gland and fossa, and as each of them requires a different therapeutic approach, the radiological characterization of each lesion is important. Approximately, half of the lacrimal gland masses are tumors of epithelial origin and the rest are lesions that arise from lymphoid or inflammatory diseases. Pseudotumors, metastatic masses and developmental cysts may also occur in the lacrimal fossa. This paper aims to discuss the radiologic findings of the lesions that are found in

  3. The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa

    International Nuclear Information System (INIS)

    Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai

    2007-01-01

    CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a nonenhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. Clinically, the lesions of the lacrimal gland and fossa are found as palpable masses in the superior lateral aspect of the orbit, and these lesions constitute about 5-13% of all of the orbital masses confirmed by biopsy. Many different pathological entities arise from the lacrimal gland and fossa, and as each of them requires a different therapeutic approach, the radiological characterization of each lesion is important. Approximately, half of the lacrimal gland masses are tumors of epithelial origin and the rest are lesions that arise from lymphoid or inflammatory diseases. Pseudotumors, metastatic masses and developmental cysts may also occur in the lacrimal fossa. This paper aims to discuss the radiologic findings of the lesions that are found in

  4. Remote Supratentorial Hemorrhage After Posterior Fossa Surgery: A Brief Case Report

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2014-10-01

    Full Text Available The supratentorial hemorrhage after posterior fossa surgery is an unusual but delicate complication that carries high mortality and morbidity. A 50 year old woman presented vertigo 6 months of evolution, which worsened in the last 2 months accompanied by ataxia. She showed left cerebellar signs, had no focal motor or sensory deficits. A brain MRI identified cerebellopontine angle lesion with mass effect. The patient was treated on suboccipital craniectomy and resection of right posterior fossa tumor, the histopathological diagnosis was consistent with typical meningioma. (WHO Class I.

  5. [Morphometric evaluation of the lateral fossa during the pre-gyrus period].

    Science.gov (United States)

    Varlam, H; Macovei, G N; Antohe, D St

    2002-09-01

    During edification of neocortex, the lateral fossa is involved in the process of development of cerebral hemispheres. It changes its shape and, from a shallow depression at the end of the 3rd month, it becomes a triangular surface with marked borders. Finally, in the same time with the appearance of circumvolutions the opercles that limit it come closer and give rise to the lateral sulcus. The evolution of the lateral fossa can be analysed by linear and surface parameters. Morphometric and statistic analyse of these parameters, compared with those of the cerebral hemisphere, allowed us to establish some original criteria for appreciating the growth of the foetal brain.

  6. Chololesterol granuloma in the middle cranial fossa: report of two cases

    International Nuclear Information System (INIS)

    Morioka, T.; Fujii, K.; Nishio, S.; Hasuo, K.; Hisashi, K.; Miyagi, Y.; Nagata, S.; Fukui, M.

    1995-01-01

    We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed. (orig.)

  7. Unilateral abducens and bilateral facial nerve palsies associated with posterior fossa exploration surgery.

    Science.gov (United States)

    Khalil, Ayman; Clerkin, James; Mandiwanza, Tafadzwa; Green, Sandra; Javadpour, Mohsen

    2016-03-06

    Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are different theories to explain this presentation, but the exact mechanism remains unclear. We propose that this patient cranial nerve palsies developed following cerebrospinal fluid (CSF) leak, potentially as a consequence of rapid change in CSF dynamics. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

  8. Relationship between external and histologic features of progressive stages of caries in the occlusal fossa

    DEFF Research Database (Denmark)

    Ekstrand, K R; Kuzmina, I; Bjørndal, L

    1995-01-01

    highly correlated (rs = 0.90). Dentinal changes were also highly correlated with enamel changes (rs = 0.85). The histologic classifications in conjunction with the macroscopical observations made it possible to demonstrate a clear relationship between the external degree of caries progression......) and 8 (M) classification criteria, ranging from 'sound' to 'cavitation with dentine involvement'. Six radiographic scores were used in the classification. Sections 250 microns in thickness were cut in buccolingual direction through the central fossa, and the fossa section with the most extensive...

  9. Teratoma of the posterior fossa CT and MR aspects A case

    International Nuclear Information System (INIS)

    Pina, J.I.; Feijoo, R.; Lasierra, R.; Medrano, J.; Benito, J.L. de

    1994-01-01

    The CT and MR findings are reported for a patient diagnosed as having teratoma of the posterior fossa with onset in the form of intracranial hypertension. The objective of this article is to report the detection of the lesion, as well as its origin in the closure defect of the cranial cavity with the formation of a cutaneous fistula, and review the recent literature

  10. Posterior fossa syndrome in a patient with an ornithine transcarbamylase deficiency

    NARCIS (Netherlands)

    Nedermeijer, S. C M; Van Den Hout, J.; Geleijns, C.; De Klerk, H.; Catsman-Berrevoets, C. E.

    2015-01-01

    The posterior fossa syndrome (PFS) is a well-known clinical entity and mainly occurs in children. Ornithine transcarbamylase deficiency (OTC) is the most common urea cycle disorder, which occurs in an estimated 1 per 50.000 live births in Japan. Symptoms are mostly due to hyperammonemia and include

  11. 3DCRT for posterior fossa: Sparing of surrounding organs at risk ...

    African Journals Online (AJOL)

    Introduction: Radiotherapy of the posterior fossa is routinely delivered using 3DCRT parallel-opposed lateral fields. However high incidence of sensorineural hearing loss, hypothalamic– pituitary dysfunction, thyroid and gonadal dysfunction during radiotherapy makes the need for treatment plan which provides adequate ...

  12. Cysts of the fossa of Rosenmüller: report of two cases.

    Science.gov (United States)

    Lloyd, Simon K W; Di Cuffa, Riccardo A; Seymour, Felicity K; Savy, Lloyd E; Grant, Henry R

    2010-08-01

    Cystic lesions of the nasopharynx are rare. Two cases of mucous retention cysts originating from the fossa of Rosenmüller are described, together with their characteristic radiologic appearance, which allows differentiation from other types of lesions in this region. The differential diagnosis and treatment options are discussed.

  13. Is bacterial colonisation of the tonsillar fossa a factor in post-tonsillectomy haemorrhage?

    NARCIS (Netherlands)

    Stephens, J. C.; Georgalas, C.; Kyi, M.; Ghufoor, K.

    2008-01-01

    OBJECTIVES: To identify if there is a link between bacterial colonisation of the tonsillar fossa and post-tonsillectomy haemorrhage. STUDY DESIGN AND SETTING: Prospective non-interventional study of 105 patients who underwent tonsillectomy during a seven-month period. The study took place in a

  14. Traumatic acute subdural haematomas of the posterior fossa: clinicoradiological analysis of 24 patients

    International Nuclear Information System (INIS)

    Avella, D. d'; Conti, A.; Cardali, S.; Tomasello, F.; Servadei, F.; Scerrati, M.; Tomei, G.; Brambilla, G.; Massaro, F.; Stefini, R.; Cristofori, L.

    2003-01-01

    We report 24 patients with a traumatic acute subdural haematoma of the posterior fossa managed between 1997 and 1999 at 8 Italian neurosurgical centres. Each centre provided data about patients clinico-radiological findings, management, and outcomes, which were retrospectively reviewed. A poor result occurred in 14 patients (58.3 %). Ten patients (41.7 %) had favourable results. Patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (12/24 cases; GCS score, 8), the outcome was favourable in 75 % of cases. In Group 2 (12/12 cases; GCS score, <8), the outcome was poor in 91.6 % of cases. Nineteen patients underwent posterior fossa surgery. Factors correlating to outcome were GCS score, status of the basal cisterns and the fourth ventricle, and the presence of supratentorial hydrocephalus. Multivariate analysis showed significant independent prognostic effect only for GCS score (P < 0.05). Acute posterior fossa subdural haematomas can be divided into two distinct groups: those patients admitted in a comatose state and those with a moderate/mild head injury on admission. Comatose patients present usually with signs of posterior fossa mass effect and have a high percentage of bad outcomes. On the contrary, patients admitted with a GCS of 8 or higher are expected to recover. In these patients the thickness of the haematoma (< 1 cm) seems to be a guide to indicate surgical evacuation of the haematoma. (author)

  15. Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma.

    Science.gov (United States)

    Struewer, Johannes; Kiriazidis, Ilias; Figiel, Jens; Dukatz, Thomas; Frangen, Thomas; Ziring, Ewgeni

    2012-07-01

    Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Owing to the proximity of the temporal glenoid fossa to the middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 36-year-old male patient, who was beaten up in a family dispute and presented with complex mandibular and maxillofacial fractures, including mandibular condyle intrusion into the middle cranial fossa causing extensive meningeal bleeding. The patient underwent immediate surgery, with evacuation of the epidural haematoma via a temporal approach. In addition open reduction and reconstruction of the temporal glenoid fossa via anatomic reduction of the fragments was performed. A functional occlusion was re-established via miniplate reconstruction of the complex mandibular body and ramus fractures. Prompt diagnosis and a multidisciplinary approach are essential to minimize the complications. Advanced imaging modalities of computed tomography are indicated. Treatment options should be individualized in particular in case of suspected neurological injury. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Temporalis myofascial repair of traumatic defects of the anterior fossa. Technical note.

    Science.gov (United States)

    Gillespie, R P; Shagets, F W; de los Reyes, R A

    1986-06-01

    Bilateral temporalis myofascial flaps in continuity with frontal periosteum can be used in repairing extensive dural and bone defects of the anterior cranial fossa floor. The technique of preserving and using this flap is described and offers an alternative to the use of frontal pericranial tissue for repair of anterior dural defects.

  17. Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia

    Directory of Open Access Journals (Sweden)

    S Rai

    2012-01-01

    Full Text Available Idiopathic CD4 lymphocytopenia (ICL is a rare disorder which is often diagnosed as HIV-negative AIDS in the light of poor immunity and AIDS-defining illnesses. We present a case of a 50-year-old male who presented with a midline posterior fossa tumour with ICL diagnosed as cerebellar cryptococcoma.

  18. The intercondylar fossa of the normal canine stifle: an anatomic and radiographic study

    International Nuclear Information System (INIS)

    Fitch, Randall B.; Montgomery, Ronald D.; Milton, James L.; Garrett, Phillip D.; Kincaid, Steven A.; Wright, James C.; Terry, Glenn C.

    1995-01-01

    The intercondylar fossa (ICF) in dogs consists of a cranial outlet, intercondylar shelf, caudal arch, caudal outlet, a medial wall, and a lateral wall. The normal cranial outlet is bell-shape and, in mixed-breed dogs (mean body weight 19.2 kg, N = 21), measured 5.8 mm cranially, 8.1 mm centrally, and 10.3 mm caudally. The ICF is oriented 12 degree from the dorsal plane of the femoral diaphysis and obliqued 7 degree , proximolateral to distomedial, in the sagittal plane. To adjust for dog size, a fossa width index (FWI) was calculated by dividing the cranial outlet width by the distance between epicondyles. The normal FWI as determined in this study was 0.18 cranially, 0.25 centrally, and 0.32 caudally. The fossa height index was 0.31. Contact between the ICF and the cranial cruciate ligament began at about 115 degree of extension. The contact area moved cranially in the intercondylar fossa as the stifle was extended. Evaluation of the ICF can be performed radiographically but positioning is critical

  19. Infraorbital Foramen and Pterygopalatine Fossa Location in Dry Skulls: Anatomical Guidelines for Local Anesthesia

    Directory of Open Access Journals (Sweden)

    Omar Masabni

    2017-01-01

    Full Text Available Purpose. The aim of the study was to locate the infraorbital foramen (IOF in relation to the infraorbital margin (IOM for proper injections of local anesthetics in skull specimens. Another aim was to determine the depth of needle penetration into pterygopalatine fossa through the greater palatine canal (GPC. Materials and Methods. 102 skull halves were used to measure the distances between (1 IOF and IOM and (2 IOF and alveolar ridge of maxilla at second premolar. Needles were inserted and bent at a 45° angle, passing through the GPC at the level of hard palate. The depth of the tip of needle emerging out of GPC into pterygopalatine fossa was measured. Results. The mean distance between IOF and IOM was 6.46±1.57 mm on the right side and 6.74±1.72 mm on the left. The mean distance between IOF and alveolar bone process of the maxilla at second premolar was 29.07±3.58 mm on the right side and 29.39±3.78 mm on the left. The mean depth of penetration of the needle into the pterygopalatine fossa was similar on both sides. Conclusions. Proper identification of IOF and pterygopalatine fossa is of great significance during local anesthesia injections, due to their close proximity to vital anatomic structures.

  20. 3DCRT for posterior fossa: Sparing of surrounding organs at risk

    African Journals Online (AJOL)

    Azza Helal

    2013-06-25

    Jun 25, 2013 ... including non-posterior fossa brain, pituitary, cochlea, eyes, optic nerves, optic chiasm, ... grams; Rt.C, right cochlea; Lt. C, left cochlea; Non P.F, non posterior ... child's cognitive function and quality of life.6 Although the.

  1. Infratemporal fossa extension of primary parotid squamous cell carcinoma: a rare entity with diagnosis dilemma

    International Nuclear Information System (INIS)

    Karaf, J.H.; Gendeh, B.S.; Yunus, M.R.M.

    2015-01-01

    Primary squamous cell carcinoma of parotid gland is rare but it is an aggressive neoplasm that can have extension into the infratemporal fossa. We report a 60-year-old female presenting with toothache over left lower molar causing a diagnostic dilemma. (author)

  2. Arterial relationships to the nerves and some rigid structures in the posterior cranial fossa.

    Science.gov (United States)

    Surchev, N

    2008-09-01

    The close relationships between the cranial nerves and the arterial vessels in the posterior cranial fossa are one of the predisposing factors for artery-nerve compression. The aim of this study was to examine the relationships of the vertebral and basilar arteries to some skull and dural structures and the nerves in the posterior cranial fossa. For this purpose, the skull bases and brains of 70 cadavers were studied. The topographic relationships of the vertebral and basilar arteries to the cranial nerves in the posterior cranial fossa were studied and the distances between the arteries and some osseous formations were measured. The most significant variations in arterial position were registered in the lower half of the basilar artery. Direct contact with an artery was established for the hypoglossal canal, jugular tubercle, and jugular foramen. The results reveal additional information about the relationships of the nerves and arteries to the skull and dural formations in the posterior cranial fossa. New quantitative information is given to illustrate them. The conditions for possible artery-nerve compression due to arterial dislocation are discussed and two groups (lines) of compression points are suggested. The medial line comprises of the brain stem points, usually the nerve root entry/exit zone. The lateral line includes the skull eminences, on which the nerves lie, or skull and dural foramina through which they exit the cranial cavity. (c) 2008 Wiley-Liss, Inc.

  3. [Acute epidural hematoma of the posterior fossa caused by forehead impact].

    Science.gov (United States)

    Abe, S; Furukawa, K; Endo, S; Hoshi, S; Kanaya, H

    1988-03-01

    A rare case of acute epidural hematoma of the posterior fossa caused by forehead impact is reported. This 36-year-old man fell from a truck and hit his face. He was conscious and was brought to our center 30 minutes after the injury. On admission, a contused wound of the right forehead was noticed. He was restless and had severe pain in the neck and upper extremities. Skull X-ray showed a linear fracture of the frontal bone and computed tomography (CT) scan was normal. He continued to be restless and sudden respiratory arrest and pupillary dilation occurred 10 hours after the admission. A CT scan revealed a lenticular high density area in the left posterior fossa which extended to the supratentorial region. The 4th ventricle was compressed and displaced to the right and also the quadrigeminal and ambient cisterns were not visualized at all. Immediate surgery disclosed a 30 g epidural hematoma of the left posterior fossa and the supratentorium and the clot was completely evacuated. The source of bleeding could not be identified. Opening of the dura revealed contusion in the occipital lobe. He died on the 17th postoperative day. The possible mechanism in the production of the posterior fossa hematoma in this case is discussed.

  4. PAEDIATRIC POSTERIOR FOSSA TUMORS: A CLIN ICO - PATHOLOGICAL STUDY I N A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Raja Sekhar Kennedy

    2015-09-01

    Full Text Available INTRODUCTION: Tumors of the Central Nervous S ystem , are the second commonest childhood tumors and are the most common solid paediatric tumors comprising 40% - 50% of all tumors . 1 2 Posterior fossa brain tumors are one of the most devastating forms of human illnesses wh ich are more common in children. AIMS AND OBJECTIVES : To study the incidence, clinicopathological features and management of paediatric posterior fossa tumors. MATERIALS AND METHOD S : This is a prospective study done in the Department of Neurosurgery, Ranga raya Medical College, Government General Hospital, Kakinada from 2012 to 2015. It is a Tertiary Care Hospital. A total of 25 paediatric patients ranging from infants to 15 years were included in the study. DISCUSSION AND CONCL USION: Posterior fossa tumors are the commonest solid brain tumors of children with a rate of 2.4 per lakh of children at risk per year. The predominant symptoms are headache and vomiting followed by cerebellar symptoms (gait disturbances. Posterior fossa tumors are predominantly seen in children with peak incidence in first decade. Commonest presenting symptoms are due to raised intracranial pressure with headache and vomiting followed by cerebellar symptoms. Meticulous microsurgical techniques are to be followed in removing these tum ors. The incidence of recurrence is very less after gross total excision. Prognosis is good in patients with total excision

  5. Pontine encephalocele and abnormalities of the posterior fossa following transclival endoscopic endonasal surgery.

    Science.gov (United States)

    Koutourousiou, Maria; Filho, Francisco Vaz Guimaraes; Costacou, Tina; Fernandez-Miranda, Juan C; Wang, Eric W; Snyderman, Carl H; Rothfus, William E; Gardner, Paul A

    2014-08-01

    Transclival endoscopic endonasal surgery (EES) has recently been used for the treatment of posterior fossa tumors. The optimal method of reconstruction of large clival defects following EES has not been established. A morphometric analysis of the posterior fossa was performed in patients who underwent transclival EES to compare those with observed postoperative anatomical changes (study group) to 50 normal individuals (anatomical control group) and 41 matched transclival cases with preserved posterior fossa anatomy (case-control group) using the same parameters. Given the absence of clival bone following transclival EES, the authors used the line between the anterior commissure and the basion as an equivalent to the clival plane to evaluate the location of the pons. Four parameters were studied and compared in the two populations: the pontine location/displacement, the maximum anteroposterior (AP) diameter of the pons, the maximum AP diameter of the fourth ventricle, and the cervicomedullary angle (CMA). All measurements were performed on midsagittal 3-month postoperative MR images in the study group. Among 103 posterior fossa tumors treated with transclival EES, 14 cases (13.6%) with postoperative posterior fossa anatomy changes were identified. The most significant change was anterior displacement of the pons (transclival pontine encephalocele) compared with the normal location in the anatomical control group (p 50% of the clivus) and dura. Nine (64.3%) of the 14 patients were overweight (body mass index [BMI] > 25 kg/m(2)). An association between BMI and the degree of pontine encephalocele was observed, but did not reach statistical significance. The use of a fat graft as part of the reconstruction technique following transclival EES with dural opening was the single significant factor that prevented pontine displacement (p = 0.02), associated with 91% lower odds of pontine encephalocele (OR = 0.09, 95% CI 0.01-0.77). The effect of fat graft reconstruction was

  6. Appendicular endometriosis as a cause of chronic abdominal pain alone in the right iliac fossa: case report and literature review

    Directory of Open Access Journals (Sweden)

    Marcelo Pandolfi Basso

    2012-03-01

    Full Text Available Endometriosis is a disease characterized by the presence of ectopic endometrial glands and stroma. Although its etiology is undefined, it is suggested to be a result of coelomic metaplasia, retrograde menstruation, to provide a genetic component, or to be one that occurs due to blood or lymphatic spread. The involvement of the gastrointestinal tract is common. However, appendicular endometriosis is a rare condition. It is usually asymptomatic. Recurrent pain in the right iliac fossa is an unusual clinical manifestation. There are no non-invasive complementary tests to confirm the diagnosis. Laparoscopy is the main option for research, due to its diagnostic and therapeutic features. A histopathological examination is necessary for the diagnosis. Although surgical and drug therapies have special indications, the combination therapy showed lower symptom recurrence. This study reports a case of appendicular endometriosis that was diagnosed and treated in the service of Coloproctology of the Base Hospital at Faculdade de Medicina of São Jose do Rio Preto. There is also a literature review about this situation.Endometriose é uma doença caracterizada pela presença de estroma e glândulas endometriais ectópicas. Apesar de sua etiologia não definida, sugere-se que seja decorrente de metaplasia celômica, menstruação retrógada, apresente componente genético, ou ocorra devido à disseminação linfática ou sanguínea. O acometimento do trato gastrointestinal é comum; no entanto, a endometriose apendicular é condição rara e se apresenta com maior frequência de forma assintomática. Dor recorrente em fossa ilíaca direita é uma manifestação clínica incomum. Não há exames complementares não invasivos que confirmem o diagnóstico. A laparoscopia é a principal opção durante a investigação, por sua característica diagnóstica e terapêutica. O diagnóstico pode ser feito apenas após um exame histopatológico. Embora as terapias

  7. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation

    Energy Technology Data Exchange (ETDEWEB)

    Wadin, K.; Thomander, L.; Wilbrand, H.

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

  8. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  9. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    International Nuclear Information System (INIS)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M.

    2016-01-01

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  10. Temporal bone encephalocele and cerebrospinal fluid fistula repair utilizing the middle cranial fossa or combined mastoid-middle cranial fossa approach.

    Science.gov (United States)

    Carlson, Matthew L; Copeland, William R; Driscoll, Colin L; Link, Michael J; Haynes, David S; Thompson, Reid C; Weaver, Kyle D; Wanna, George B

    2013-11-01

    The goals of this study were to report the clinical presentation, radiographic findings, operative strategy, and outcomes among patients with temporal bone encephaloceles and cerebrospinal fluid fistulas (CSFFs) and to identify clinical variables associated with surgical outcome. A retrospective case series including all patients who underwent a middle fossa craniotomy or combined mastoid-middle cranial fossa repair of encephalocele and/or CSFF between 2000 and 2012 was accrued from 2 tertiary academic referral centers. Eighty-nine consecutive surgeries (86 patients, 59.3% women) were included. The mean age at time of surgery was 52.3 years, and the left side was affected in 53.9% of cases. The mean delay between symptom onset and diagnosis was 35.4 months, and the most common presenting symptoms were hearing loss (92.1%) and persistent ipsilateral otorrhea (73.0%). Few reported a history of intracranial infection (6.7%) or seizures (2.2%). Thirteen (14.6%) of 89 cases had a history of major head trauma, 23 (25.8%) were associated with chronic ear disease without prior operation, 17 (19.1%) occurred following tympanomastoidectomy, and 1 (1.1%) developed in a patient with a cerebral aqueduct cyst resulting in obstructive hydrocephalus. The remaining 35 cases (39.3%) were considered spontaneous. Among all patients, the mean body mass index (BMI) was 35.3 kg/m(2), and 46.4% exhibited empty sella syndrome. Patients with spontaneous lesions were statistically significantly older (p = 0.007) and were more commonly female (p = 0.048) compared with those with nonspontaneous pathology. Additionally, those with spontaneous lesions had a greater BMI than those with nonspontaneous disease (p = 0.102), although this difference did not achieve statistical significance. Thirty-two surgeries (36.0%) involved a middle fossa craniotomy alone, whereas 57 (64.0%) involved a combined mastoid-middle fossa repair. There were 7 recurrences (7.9%); 2 patients with recurrence developed

  11. Is there a dural wall between the cavernous sinus and the pituitary fossa? Anatomical and MRI findings

    International Nuclear Information System (INIS)

    Dietemann, J.L.; Diniz, R.; Reis, M. Jr.; Neugroschl, C.; Vinclair, L.; Maillot, C.

    1998-01-01

    We compared MRI studies of the sellar area and embryological and adult histological studies of the cavernous sinuses and pituitary fossa. MRI studies were performed in 50 normal subjects with coronal sections using a fast inversion-recovery sequence to demonstrate the dural walls of the cavernous sinus and pituitary fossa. With this sequence, dura mater appears as a high-signal linear structure. The lateral and superior walls of the cavernous sinus was easily identified on all studies, but demonstration of a dural wall separating the cavernous sinus from the pituitary fossa was not possible. These results correlated well with embryological and adult histological studies obtained from 14 specimens. The absence of a strong separation between the pituitary fossa and the cavernous sinus explains the high incidence of extension of pituitary tumours to the cavernous sinuses and vice versa. (orig.) (orig.)

  12. Facial Nerve Schwannoma Involving Middle Cranial Fossa: When the Unilateral Sensorineural Hearing Loss Guide to the Correct Diagnosis

    OpenAIRE

    De Stefano, Alessandro; Dispenza, Francesco; Kulamarva, Gautham

    2011-01-01

    The Facial Nerve Schwannoma is a rare tumor and it seldom involved the middle cranial fossa. Facial nerve schwannoma has various manifestations, including facial palsy but unfortunately facial nerve is very resistant to compression and often facial nerve paralysis or a facial weakness are not present. We present a case of giant facial nerve schwannoma involved the middle cranial fossa without facial nerve paralysis. In these cases the unilateral hearing loss (if present) guide to a correct di...

  13. Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood

    International Nuclear Information System (INIS)

    Santos, Joelson Alves dos; Costa, Maria Olivia Rodrigues da; Otaduy, Maria Concepcion Garcia; Lacerda, Maria Teresa Carvalho de; Leite, Claudia da Costa; Matsushita, Hamilton

    2004-01-01

    Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

  14. Influence of occlusal splints on TMJ condyle-fossa relationship and disc shape

    OpenAIRE

    Braun, Barbara Victoria

    2012-01-01

    Background. Occlusal splints are nowadays commonly used in dentistry to treat symptoms of myoarthropathies of the masticatory system, but also to treat simple occlusal parafunctions. Still, the exact mechanism by which the treatment works is unknown. The aim of this study was to find out the answers to following questions: 1. is there an immediate change of the minimum condyle-fossa distance and accompanying disc thickness by inserting a Michigan splint and 2. is it possible to displace the m...

  15. A nomenclature for vertebral fossae in sauropods and other saurischian dinosaurs.

    Directory of Open Access Journals (Sweden)

    Jeffrey A Wilson

    Full Text Available BACKGROUND: The axial skeleton of extinct saurischian dinosaurs (i.e., theropods, sauropodomorphs, like living birds, was pneumatized by epithelial outpocketings of the respiratory system. Pneumatic signatures in the vertebral column of fossil saurischians include complex branching chambers within the bone (internal pneumaticity and large chambers visible externally that are bounded by neural arch laminae (external pneumaticity. Although general aspects of internal pneumaticity are synapomorphic for saurischian subgroups, the individual internal pneumatic spaces cannot be homologized across species or even along the vertebral column, due to their variability and absence of topographical landmarks. External pneumatic structures, in contrast, are defined by ready topological landmarks (vertebral laminae, but no consistent nomenclatural system exists. This deficiency has fostered confusion and limited their use as character data in phylogenetic analysis. METHODOLOGY/PRINCIPAL FINDINGS: We present a simple system for naming external neural arch fossae that parallels the one developed for the vertebral laminae that bound them. The nomenclatural system identifies fossae by pointing to reference landmarks (e.g., neural spine, centrum, costal articulations, zygapophyses. We standardize the naming process by creating tripartite names from "primary landmarks," which form the zygodiapophyseal table, "secondary landmarks," which orient with respect to that table, and "tertiary landmarks," which further delineate a given fossa. CONCLUSIONS/SIGNIFICANCE: The proposed nomenclatural system for lamina-bounded fossae adds clarity to descriptions of complex vertebrae and allows these structures to be sourced as character data for phylogenetic analyses. These anatomical terms denote potentially homologous pneumatic structures within Saurischia, but they could be applied to any vertebrate with vertebral laminae that enclose spaces, regardless of their developmental

  16. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

    2011-11-15

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  17. Branchial fistula arising from pyriform fossa: CT diagnosis of a case and discussion of radiological features.

    Science.gov (United States)

    Chauhan, Narvir Singh; Sharma, Yash Paul; Bhagra, Tilak; Sud, Bindu

    2012-01-01

    Anomalies of third or fourth branchial apparatus origin are very uncommon and present as recurrent neck infections or thyroiditis with a predominant left-sided involvement. Radiological diagnosis requires a high index of suspicion and is critical for initiation of proper treatment. We describe a case of branchial sinus of pyriform fossa with external fistulization that presented in adulthood and was diagnosed on computed tomographic scan. The radiological features of this rare anomaly are revisited. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Primary hydatid disease of the infratemporal fossa and the parotid gland

    International Nuclear Information System (INIS)

    Kalovidouris, A.; Gouliamos, A.; Andreou, I.; Levett, J.; Vlahos, I.; Papavasiliou, C.; Ioannovits, I.

    1985-01-01

    Hydatid disease should be considered in the differential diagnosis of lesions causing swelling of the parotid area or exophthalmos in patients originating from countries where the incidence of the disease is high. An unusual case of hydatid disease located in the infratemporal fossa and the anterior parotid region is presented. Computed Tomography is a valuable tool for establishment of the diagnosis, before any surgical approach to the lesion is initiated and for postoperative follow-up and evaluation. (orig.) [de

  19. Primary hydatid disease of the infratemporal fossa and the parotid gland

    Energy Technology Data Exchange (ETDEWEB)

    Kalovidouris, A.; Gouliamos, A.; Andreou, I.; Levett, J.; Vlahos, I.; Papavasiliou, C.; Ioannovits, I.

    1985-05-01

    Hydatid disease should be considered in the differential diagnosis of lesions causing swelling of the parotid area or exophthalmos in patients originating from countries where the incidence of the disease is high. An unusual case of hydatid disease located in the infratemporal fossa and the anterior parotid region is presented. Computed Tomography is a valuable tool for establishment of the diagnosis, before any surgical approach to the lesion is initiated and for postoperative follow-up and evaluation.

  20. Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI

    International Nuclear Information System (INIS)

    Pollo, C.; Porchet, F.; Meuli, R.

    2003-01-01

    A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

  1. Imaging techniques in evaluation of juvenile angiofibroma with lateral extension in the pterygopalatine and infratemporal fossa

    International Nuclear Information System (INIS)

    Szymanska, A.; Pietura, R.; Drelich-Zbroja, A.; Trojanowski, P.

    2004-01-01

    Juvenile angiofibroma is a benign tumour arising in the nasopharynx and penetrating laterally into the pterygopalatine fossa, infratemporal fossa and orbit. Precise preoperative evaluation of the presence and extension of its lateral spread is crucial for choosing the best surgical approach and performing radical operation. The aim of the study was to assess usefulness of imaging methods in diagnosis and evaluation of lateral extension of juvenile angiofibroma. In a group of 39 patients operated on from 1973 to 2002 due to juvenile angiofibroma in 21 (54%) cases a lateral extension of the tumor was diagnosed. All patients underwent carotid angiography (CA) and lateral plain skull X-ray. Computed tomography (CT) was performed in 18,and magnetic resonance imaging (MRI) in 4 patients. In all cases the extension of the tumor and its lateral spread was verified during surgery. A widening of the pterygopalatine fossa on lateral plain X-ray was present in 13 (62%) patients. CT and MRI demonstrated the presence of lateral extension in all patients diagnosed with these methods. In 9 cases, lateral CA revealed dislodgement of the internal maxillary artery by the tumor in the pterygopalatine fossa. The presence of big lateral extension of the juvenile angiofibroma is demonstrated on lateral plain X-ray as anterior bowing of the posterior wall of the maxillary sinus (Holman-Miller sign). MRI shows better than CT the extent and margins of the tumor in soft tissues. Lateral CA shows dislodgement of the internal maxillary artery and its course in relation to the lateral extension of the tumor, which is important for surgical planning. (author)

  2. A systematic review of neuropsychological outcomes following posterior fossa tumor surgery in children.

    Science.gov (United States)

    Hanzlik, Emily; Woodrome, Stacey E; Abdel-Baki, Mohamed; Geller, Thomas J; Elbabaa, Samer K

    2015-10-01

    Central nervous system tumors are the most common solid tumors in the pediatric population. As children with central nervous system (CNS) tumors are surviving into adolescence and adulthood, more research is being focused on the long-term cognitive outcomes of the survivors. This review examines the literature on different cognitive outcomes of survivors of different childhood posterior fossa CNS tumor types. The authors reviewed the literature for articles published from 2000 to 2012 about long-term neuropsychological outcomes of children diagnosed with posterior fossa brain tumors before the age of 18, which distinguished between histological tumor types, and had a minimum follow-up of 3 years. The literature search returned 13 articles, and a descriptive analysis was performed comparing intelligence quotient (IQ), attention/executive function, and memory components of 456 survivors of childhood posterior fossa tumors. Four articles directly compared astrocytoma and medulloblastoma survivors and showed medulloblastoma survivors fared worse in IQ, attention/executive function, and memory measurements. Five articles reporting medulloblastomas found IQ, attention, and memory scores to be significantly below the standardized means. Articles examining astrocytoma survivors found IQ scores within the normal range for the population. Survivors of ependymomas reported 2/23 survivors impaired on IQ scores, while a second study reported a significant number of ependymoma survivors lower than the expected population norm. Tumor histopathology and the type of postoperative adjuvant therapy seem to have a significant impact on the long-term neuropsychological complications of pediatric posterior fossa CNS tumor survivors. Age at diagnosis and treatment factors are important variables that affect the outcomes of the survivors.

  3. Lateral posterior fossa encephalocele with associated migrational disorder of the cerebellum in an infant.

    Science.gov (United States)

    Hamilton, Kimberly M; Wiens, Andrea L; Fulkerson, Daniel H

    2011-11-01

    Encephaloceles are acquired or congenital defects in which intracranial contents protrude through a defect in the calvaria. The embryogenesis of these lesions is incompletely understood. The vast majority of lesions occur at or near the anatomical midline. The authors present an extremely rare case of a laterally oriented, pathologically proven encephalocele associated with a posterior fossa cyst and cerebellar migrational defect in an infant. The authors review past and current theories of encephalocele formation as it relates to this case.

  4. Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours

    Energy Technology Data Exchange (ETDEWEB)

    Warmuth-Metz, M.; Solymosi, L. [Abteilung fuer Neuroradiologie, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Kuehl, J. [Paediatric Oncology, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Krauss, J. [Paediatric Neurosurgery, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany)

    2004-03-01

    In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

  5. Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Pollo, C.; Porchet, F. [Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland); Meuli, R. [Department of Radiology, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland)

    2003-08-01

    A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

  6. Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O'Donovan, Raquel

    2011-01-01

    Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

  7. Cerebellar mutism syndrome in children with brain tumours of the posterior fossa

    DEFF Research Database (Denmark)

    Wibroe, Morten; Cappelen, Johan; Castor, Charlotte

    2017-01-01

    , the clinical course and strategies for prevention and treatment are yet to be determined.Methods: This observational, prospective, multicentre study will include 500 children with posterior fossa tumours. It opened late 2014 with participation from 20 Nordic and Baltic centres. From 2016, five British centres...... for and the clinical course of CMS - with the ultimate goal of defining strategies for prevention and treatment of this severely disabling condition....

  8. The Lost City Hydrothermal Field: A Spectroscopic and Astrobiological Analogue for Nili Fossae, Mars.

    Science.gov (United States)

    Amador, Elena S; Bandfield, Joshua L; Brazelton, William J; Kelley, Deborah

    2017-11-01

    Low-temperature serpentinization is a critical process with respect to Earth's habitability and the Solar System. Exothermic serpentinization reactions commonly produce hydrogen as a direct by-product and typically produce short-chained organic compounds indirectly. Here, we present the spectral and mineralogical variability in rocks from the serpentine-driven Lost City Hydrothermal Field on Earth and the olivine-rich region of Nili Fossae on Mars. Near- and thermal-infrared spectral measurements were made from a suite of Lost City rocks at wavelengths similar to those for instruments collecting measurements of the martian surface. Results from Lost City show a spectrally distinguishable suite of Mg-rich serpentine, Ca carbonates, talc, and amphibole minerals. Aggregated detections of low-grade metamorphic minerals in rocks from Nili Fossae were mapped and yielded a previously undetected serpentine exposure in the region. Direct comparison of the two spectral suites indicates similar mineralogy at both Lost City and in the Noachian (4-3.7 Ga) bedrock of Nili Fossae, Mars. Based on mapping of these spectral phases, the implied mineralogical suite appears to be extensive across the region. These results suggest that serpentinization was once an active process, indicating that water and energy sources were available, as well as a means for prebiotic chemistry during a time period when life was first emerging on Earth. Although the mineralogical assemblages identified on Mars are unlikely to be directly analogous to rocks that underlie the Lost City Hydrothermal Field, related geochemical processes (and associated sources of biologically accessible energy) were once present in the subsurface, making Nili Fossae a compelling candidate for a once-habitable environment on Mars. Key Words: Mars-Habitability-Serpentinization-Analogue. Astrobiology 17, 1138-1160.

  9. Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours

    International Nuclear Information System (INIS)

    Warmuth-Metz, M.; Solymosi, L.; Kuehl, J.; Krauss, J.

    2004-01-01

    In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

  10. Mortality Rates After Emergent Posterior Fossa Decompression for Ischemic or Hemorrhagic Stroke in Older Patients.

    Science.gov (United States)

    Puffer, Ross C; Graffeo, Christopher; Rabinstein, Alejandro; Van Gompel, Jamie J

    2016-08-01

    Cerebellar stroke causes major morbidity in the aging population. Guidelines from the American Stroke Association recommend emergent decompression in patients who have brainstem compression, hydrocephalus, or clinical deterioration. The objective of this study was to determine 30-day and 1-year mortality rates in patients >60 years old undergoing emergent posterior fossa decompression. Surgical records identified all patients >60 years old who underwent emergent posterior fossa decompression. Mortality rates were calculated at 30 days and 1 year postoperatively, and these rates were compared with patient and procedure characteristics. During 2000-2014, 34 emergent posterior fossa decompressions were performed in patients >60 years old. Mortality rates at 30 days were 0%, 33%, and 25% for age deciles 60-69 years, 70-79 years, and ≥80 years. Increasing age (alive at 30 days 75.2 years ± 1.7 vs. deceased 81.1 years ± 1.7, P = 0.01) and smaller craniectomy dimensions were associated with 30-day mortality. Mortality rates at 1 year were 0%, 50%, and 67% for age deciles 60-69 years, 70-79 years, and ≥80 years. Increasing age was significantly associated with mortality at 1 year (alive at 1 year 72.3 years ± 2.0 vs. deceased 81.1 years ± 1.2, P mortality. Age was independent of admission Glasgow Coma Scale score as a predictor of mortality at 30 days, 90 days, and 1 year postoperatively. Increasing age and smaller craniectomy size were significantly associated with mortality in patients undergoing emergent posterior fossa decompression. Among patients ≥80 years old, one-quarter were dead within 1 month of the operation, and more than two-thirds were dead within 1 year. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Interactive web-based programs to teach functional anatomy: the pterygopalatine fossa.

    Science.gov (United States)

    Sinav, Ahmet; Ambron, Richard

    2004-07-01

    Certain areas of the body contain structures that are difficult to envision in their proper spatial orientations and whose functions are complex and difficult to grasp. This is especially true in the head, where many structures are relatively small and inaccessible. To address this problem, we are designing Web-based programs that consist of high-resolution interactive bitmap illustrations, prepared using Adobe Photoshop, and vector-based animations, prepared via Macromedia Flash. Flash action script language is used for the animations. We have used this approach to prepare a program on the pterygopalatine fossa, an important neurovascular junction in the deep face that is especially difficult to approach by dissection and to depict in static images in an atlas. The program can be viewed online at http://cds.osr.columbia.edu/anatomy/ppfossa/. A table of contents simplifies navigation through the program and a menu enables the user to identify each of the vascular and neuronal components and either to insert or to remove each from its position in the fossa. The functional anatomy of the nerves in the fossa is animated. For example, users can activate and subsequently follow action potentials as they course along axons to their targets. This high degree of interactivity helps promote learning.

  12. Pattern of recurrence in children with midline posterior fossa malignant neoplasms

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    Wootton-Gorges, S.L.; Foreman, N.K.; Albano, E.A.; Dertina, D.M.; Nein, P.K.; Shukert, B.; Cesario, K.B.; Gage, S.; Rumack, C.M.; Strain, J.D. [Children' s Hospital, Department of Radiology, Denver, CO (United States)

    2000-02-01

    Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

  13. Pattern of recurrence in children with midline posterior fossa malignant neoplasms

    International Nuclear Information System (INIS)

    Wootton-Gorges, S.L.; Foreman, N.K.; Albano, E.A.; Dertina, D.M.; Nein, P.K.; Shukert, B.; Cesario, K.B.; Gage, S.; Rumack, C.M.; Strain, J.D.

    2000-01-01

    Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

  14. Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

    Directory of Open Access Journals (Sweden)

    Kamal Kataria

    2012-05-01

    Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

  15. Effect of Incremental Endoscopic Maxillectomy on Surgical Exposure of the Pterygopalatine and Infratemporal Fossae.

    Science.gov (United States)

    Upadhyay, Smita; Dolci, Ricardo L L; Buohliqah, Lamia; Fiore, Mariano E; Ditzel Filho, Leo F S; Prevedello, Daniel M; Otto, Bradley A; Carrau, Ricardo L

    2016-02-01

    Objective Access to the pterygopalatine and infratemporal fossae presents a significant surgical challenge, owing to their deep-seated location and complex neurovascular anatomy. This study elucidates the benefits of incremental medial maxillectomies to access this region. We compared access to the medial aspect of the infratemporal fossa provided by medial maxillectomy, anteriorly extended medial maxillectomy, endoscopic Denker approach (i.e., Sturmann-Canfield approach), contralateral transseptal approach, and the sublabial anterior maxillotomy (SAM). Methods We studied 10 cadaveric specimens (20 sides) dissecting the pterygopalatine and infratemporal fossae bilaterally. Radius of access was calculated using a navigation probe aligned with the endoscopic line of sight. Area of exposure was calculated as the area removed from the posterior wall of maxillary sinus. Surgical freedom was calculated by computing the working area at the proximal end of the instrument with the distal end fixed at a target. Results The endoscopic Denker approach offered a superior area of exposure (8.46 ± 1.56 cm(2)) and superior surgical freedom. Degree of lateral access with the SAM approach was similar to that of the Denker. Conclusion Our study suggests that an anterior extension of the medial maxillectomy or a cross-court approach increases both the area of exposure and surgical freedom. Further increases can be seen upon progression to a Denker approach.

  16. Temporal fossa defects: techniques for injecting hyaluronic acid filler and complications after hyaluronic acid filler injection.

    Science.gov (United States)

    Juhász, Margit Lai Wun; Marmur, Ellen S

    2015-09-01

    Facial changes with aging include thinning of the epidermis, loss of skin elasticity, atrophy of muscle, and subcutaneous fat and bony changes, all which result in a loss of volume. As temporal bones become more concave, and the temporalis atrophies and the temporal fat pad decreases, volume loss leads to an undesirable, gaunt appearance. By altering the temporal fossa and upper face with hyaluronic acid filler, those whose specialty is injecting filler can achieve a balanced and more youthful facial structure. Many techniques have been described to inject filler into the fossa including a "fanned" pattern of injections, highly diluted filler injection, and the method we describe using a three-injection approach. Complications of filler in the temporal fossa include bruising, tenderness, swelling, Tyndall effect, overcorrection, and chewing discomfort. Although rare, more serious complications include infection, foreign body granuloma, intravascular necrosis, and blindness due to embolization into the ophthalmic artery. Using reversible hyaluronic acid fillers, hyaluronidase can be used to relieve any discomfort felt by the patient. Injectors must be aware of the complications that may occur and provide treatment readily to avoid morbidities associated with filler injection into this sensitive area. © 2015 Wiley Periodicals, Inc.

  17. Management of the stricture of fossa navicularis and pendulous urethral strictures

    Directory of Open Access Journals (Sweden)

    Shrawan K Singh

    2011-01-01

    Full Text Available Objective : Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods : The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results : Etiology of stricture is shifting from infective to inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions : Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising.

  18. Management of the stricture of fossa navicularis and pendulous urethral strictures

    Science.gov (United States)

    Singh, Shrawan K.; Agrawal, Santosh K.; Mavuduru, Ravimohan S.

    2011-01-01

    Objective: Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods: The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results: Etiology of stricture is shifting from infective to inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions: Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising. PMID:22022062

  19. Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

    Science.gov (United States)

    Kataria, Kamal; Sagar, Sushma; Singhal, Manish; Yadav, Rajni

    2012-01-01

    Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature. PMID:29181131

  20. Packing of renal fossa: Useful technique for intractable bleeding after open pyelolithotomy surgery

    Directory of Open Access Journals (Sweden)

    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone surgery in peripheral hospitals. Several studies have shown the usefulness of temporary packing to control bleeding in liver injuries and following open heart operations. Packing of the renal fossa with laparotomy pads in unstable patients, and transferring the patient to the surgical intensive care unit (ICU is also described in trauma but not in controlling bleeding after open pyelolithotomy .This study comprises of three such patients whose kidneys were salvaged by a simple procedure of temporary packing of renal fossa for period of 24-48 hours who had developed life threatening haemorrhage after open pyelolithotomy. This technique is simple and worth trying especially for surgeons who are contemplating nephrectomy as prolonged packing has not lead to any compromise in renal functions. The aim of this manuscript is very limited and clear. Packing is not a licence to carry out open pyelolithotomy without proper expertise and local backup or resources. Principles of safe and ethical surgical practice should never be violated as it can lead to medico legal complications.

  1. Delayed effect of radiation therapy on extracerebral cavernous angioma in the middle fossa

    International Nuclear Information System (INIS)

    Shibata, Shobu; Mori, Kazuo

    1988-01-01

    This is a report of a case with extracerebral cavernous angioma in the middle fossa which had received radiation therapy. Follow-up study with serial computed tomography during and after irradiation were presented. A 62-year-old housewife complained of vertigo. CT scan revealed a slightly high density area in the left middle cranial fossa which was markedly enhanced with contrast media. Left carotid angiography demonstrated a large avascular mass in the left middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. Irradiation with a total dose of 50 Gy was delivered. At the end of radiation, CT scan revealed a slight decrease in size and CT number of the tumor. Follow-up CT scans 5 months later showed 50 % regression of the tumor and 19 months later were negative for tumor. It is concluded that in case of an extracerebral cavernous angioma with massive hemorrhage, radiation of up to 30 - 50 Gy was a method of choice. The treatment results in the possibility of eliminating surgery and the benefit of irradiation may not become evident until the first year. (author)

  2. 3D Super-Resolution Motion-Corrected MRI: Validation of Fetal Posterior Fossa Measurements.

    Science.gov (United States)

    Pier, Danielle B; Gholipour, Ali; Afacan, Onur; Velasco-Annis, Clemente; Clancy, Sean; Kapur, Kush; Estroff, Judy A; Warfield, Simon K

    2016-09-01

    Current diagnosis of fetal posterior fossa anomalies by sonography and conventional MRI is limited by fetal position, motion, and by two-dimensional (2D), rather than three-dimensional (3D), representation. In this study, we aimed to validate the use of a novel magnetic resonance imaging (MRI) technique, 3D super-resolution motion-corrected MRI, to image the fetal posterior fossa. From a database of pregnant women who received fetal MRIs at our institution, images of 49 normal fetal brains were reconstructed. Six measurements of the cerebellum, vermis, and pons were obtained for all cases on 2D conventional and 3D reconstructed MRI, and the agreement between the two methods was determined using concordance correlation coefficients. Concordance of axial and coronal measurements of the transcerebellar diameter was also assessed within each method. Between the two methods, the concordance of measurements was high for all six structures (P fetal motion and orthogonal slice acquisition. This technique will facilitate further study of fetal abnormalities of the posterior fossa. Copyright © 2016 by the American Society of Neuroimaging.

  3. The use of wavelet filters for reducing noise in posterior fossa Computed Tomography images

    International Nuclear Information System (INIS)

    Pita-Machado, Reinado; Perez-Diaz, Marlen; Lorenzo-Ginori, Juan V.; Bravo-Pino, Rolando

    2014-01-01

    Wavelet transform based de-noising like wavelet shrinkage, gives the good results in CT. This procedure affects very little the spatial resolution. Some applications are reconstruction methods, while others are a posteriori de-noising methods. De-noising after reconstruction is very difficult because the noise is non-stationary and has unknown distribution. Therefore, methods which work on the sinogram-space don’t have this problem, because they always work over a known noise distribution at this point. On the other hand, the posterior fossa in a head CT is a very complex region for physicians, because it is commonly affected by artifacts and noise which are not eliminated during the reconstruction procedure. This can leads to some false positive evaluations. The purpose of our present work is to compare different wavelet shrinkage de-noising filters to reduce noise, particularly in images of the posterior fossa within CT scans in the sinogram-space. This work describes an experimental search for the best wavelets, to reduce Poisson noise in Computed Tomography (CT) scans. Results showed that de-noising with wavelet filters improved the quality of posterior fossa region in terms of an increased CNR, without noticeable structural distortions

  4. Bare spot of the glenoid fossa in children: incidence and MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee Kyung; Emery, Kathleen H. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Salisbury, Shelia R. [Cincinnati Children' s Hospital Medical Center, Centers for Epidemiology and Biostatistics, Cincinnati, OH (United States)

    2010-07-15

    The bare spot of the glenoid fossa is a normal cartilage defect seen frequently in adults. It has been used on arthroscopy as a landmark for the center of the glenoid fossa. There are no reports of this variant in children, but we have noted it on some pediatric clinical shoulder MRI studies. Our main purpose is to evaluate the incidence of the bare spot in children and define location and MRI features. Shoulder MRI studies (total 570) from 2004 to 2008 were reviewed. Children were divided into two age groups: group 1, 0-10 years (n=200), group 2, 11-20 years (n=370). A total of 12 bare spots (2.1%) were identified; all were seen in group 2. Eight (67%) were central and four were eccentric in the glenoid fossa. All showed a well-marginated focal cartilage defect containing hyperintense joint fluid or contrast agent. Three also had air. The bare spot is seen in children. The absence in children younger than 10 years and the low incidence in the second decade support the proposed acquired nature. Familiarity with this finding is important so as not to misinterpret it as a pathologic condition. (orig.)

  5. Chronic Expanding Hematoma in the Popliteal Fossa after Pseudoaneurysm Surgery because of Nail Puncture

    Directory of Open Access Journals (Sweden)

    Serdar Yilmaz

    2014-01-01

    Full Text Available Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH. Magnetic resonance imaging (MRI is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115 × 107 × 196 cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery.

  6. Neurinomas of the facial nerve extending to the middle cranial fossa

    International Nuclear Information System (INIS)

    Ichikawa, Akimichi; Tanaka, Ryuichi; Matsumura, Kenichiro; Takeda, Norio; Ishii, Ryoji; Ito, Jusuke.

    1986-01-01

    Three cases with neurinomas of the facial nerve are reported, especially with regard to the computerized tomographic (CT) findings. All of them had a long history of facial-nerve dysfunction, associated with hearing loss over periods from several to twenty-five years. Intraoperative findings demonstrated that these tumors arose from the intrapetrous portion, the horizontal portion, or the geniculate portion of the facial nerve and that they were located in the middle cranial fossa. The histological diagnoses were neurinomas. CT scans of three cases demonstrated round and low-density masses with marginal high-density areas in the middle cranial fossa, in one associated with diffuse low-density areas in the left temporal and parietal lobes. The low-density areas on CT were thought to be cysts; this was confirmed by surgery. Enhanced CT scans showed irregular enhancement in one case and ring-like enhancement in two cases. High-resolution CT scans of the temporal bone in two cases revealed a soft tissue mass in the middle ear, a well-circumscribed irregular destruction of the anterior aspect of the petrous bone, and calcifications. These findings seemed to be significant features of the neurinomas of the facial nerve extending to the middle cranial fossa. We emphasize that bone-window CT of the temporal bone is most useful in detecting a neurinoma of the facial nerve in its early stage in order to preserve the facial- and acoustic-nerve functions. (author)

  7. Mandibular fossa morphology during therapy with a fixed functional orthodontic appliance : A magnetic resonance imaging study.

    Science.gov (United States)

    Kinzinger, Gero Stefan Michael; Hourfar, Jan; Kober, Cornelia; Lisson, Jörg Alexander

    2018-03-01

    During therapy of distoclusion entailing a rigid, fixed orthodontic appliance, the mandibular fossa and condyle are ideally remodeled, while dentoalveolar effects occur through adaptive mechanisms. Adaptive processes, especially in the fossa region, have not been adequately investigated. Our magnetic resonance imaging (MRI) investigation aimed to assess the effects of therapy with a functional mandibular advancer (FMA) on mandibular fossa morphology. We monitored via MRI the therapeutic course of 25 patients at three time points. Visual findings and metric assessments were carried out in the sagittal plane. Three-dimensional (3D) reconstructions of the joint structure of two exemplary patients were also made. Visual examinations of the MRI slices at the three time points revealed no changes in fossa shape in any of the 50 temporomandibular joints. Lateral comparisons showed that the morphology of the fossae of all 25 patients was identical. Metric analysis demonstrated no significant alterations in width, depth, or in their ratio, not even laterally. Nine measurements of the distances between the porion, mandibular fossa, and articular eminence revealed no significant changes in total or on the left and right sides, or intralaterally. The visual findings and metric analyses of parasagittal MRI slices did not indicate any morphological changes in the mandibular fossa or articular eminence in patients with distoclusion treated via a rigid, fixed orthodontic appliance. However, special reworking of the MRI data facilitated reconstruction of the surfaces of joint structures in 3D. This new method makes it possible to depict more accurately and noninvasively the adaptive mechanisms not ascertainable via metric methods and to assess them as 3D structures.

  8. Presentation and management of lateral sinus thrombosis following posterior fossa surgery.

    Science.gov (United States)

    Apra, Caroline; Kotbi, Owais; Turc, Guillaume; Corns, Robert; Pagès, Mélanie; Souillard-Scémama, Raphaëlle; Dezamis, Edouard; Parraga, Eduardo; Meder, Jean-François; Sauvageon, Xavier; Devaux, Bertrand; Oppenheim, Catherine; Pallud, Johan

    2017-01-01

    OBJECTIVE There are no guidelines for the management of postoperative lateral sinus thrombosis following posterior fossa surgery. Introducing treatment-dose anticoagulant therapy during the immediate postoperative period increases the risk of intracranial bleeding. This study assessed the incidence of and risk factors associated with postoperative lateral sinus thrombosis and the complications related to thrombosis and/or anticoagulation. METHODS This study was a retrospective monocentric analysis of adult patients who underwent surgical removal of a posterior fossa space-occupying lesion with available postoperative imaging. Postoperative lateral sinus thrombosis was defined as a T2 * hypointensity within the venous sinus and/or a filling defect on postcontrast MRI or CT scan. RESULTS Among 180 patients, 12 (6.7%; 95% CI 3.0-10.4) were found to have lateral sinus thrombosis on postoperative imaging, none of whom were symptomatic. Unadjusted risk factors for postoperative lateral sinus thrombosis were a history of deep venous thrombosis (p = 0.016), oral contraceptive pill (p = 0.004), midline surgical approach (p = 0.035), and surgical exposure of the sinus (p < 0.001). Seven of the patients (58.3%) with a postoperative lateral sinus thrombosis received immediate treatment-dose anticoagulant therapy. Lateral sinus recanalization occurred radiologically at a mean time of 272 ± 23 days in 85.7% of patients (6 of 7) undergoing treatment-dose anticoagulant therapy and in 20% of patients (1 of 5) not receiving treatment-dose anticoagulant therapy. Postoperative complications occurred in 56.2% of patients (9 of 16) who received treatment-dose curative anticoagulant therapy and in 27% of patients (45 of 164) who did not. CONCLUSIONS Incidental radiological lateral sinus thrombosis following posterior fossa surgery has an incidence of 6.7%. To further define the benefit-to-risk ratio of a treatment-dose anticoagulant therapy, a prospective trial should be considered.

  9. Condyle-fossa modifications and muscle interactions during herbst treatment, part 1. New technological methods.

    Science.gov (United States)

    Voudouris, John C; Woodside, Donald G; Altuna, Gurkan; Kuftinec, Mladen M; Angelopoulos, Gerassimos; Bourque, Paul J

    2003-06-01

    Changes in the condyle, the glenoid fossa, and the muscles of mastication were investigated in subjects undergoing continuous orthopedic advancement of the mandible with a Herbst-block appliance. The total sample consisted of 56 subjects and included 15 nonhuman primates (in the middle mixed, early permanent, and permanent dentitions), 17 human Herbst patients in the early permanent dentition, and 24 human controls from the Burlington Growth Center. The 8 nonhuman primates in the middle mixed dentition were the focus of this study. Mandibular advancement was obtained progressively in 5 animals by adding stops to the telescopic arms of fixed functional Herbst appliances with occlusal coverage; activations of 5.0 mm, 7.0 mm, and 8.0 mm were achieved. Two primates served as controls, and the third was a sham control. Two experimental animals and the 2 controls also wore surgically implanted electromyographic electrodes in the superior and inferior heads of the lateral pterygoid muscles and in the superficial masseter and anterior digastric muscles. Changes in condylar growth direction and amount were assessed with the Björk method from measurements made on serial cephalometric tracings superimposed on metallic implants. Undecalcified sections, treated with intravenous tetracycline vital staining, were viewed with fluorescence microscopy to examine histologic changes in the condyle and the glenoid fossa. New bone formation in the fossa associated with continuous mandibular protrusion was quantified by using computerized histomorphometric analysis of decalcified histological sections and polarized light. The unique combination of permanently implanted electromyographic electrodes, tetracycline vital staining, and histomorphometry represents a significant technological advancement in methods and materials. Together, they demonstrated different muscle-bone interaction results for functional appliances than those reported in previous studies. In Part 1 of this study, we

  10. Postoperative intraspinal subdural collections after pediatric posterior fossa tumor resection: incidence, imaging, and clinical features.

    Science.gov (United States)

    Harreld, J H; Mohammed, N; Goldsberry, G; Li, X; Li, Y; Boop, F; Patay, Z

    2015-05-01

    Postoperative intraspinal subdural collections in children after posterior fossa tumor resection may temporarily hinder metastasis detection by MR imaging or CSF analysis, potentially impacting therapy. We investigated the incidence, imaging and clinical features, predisposing factors, and time course of these collections after posterior fossa tumor resection. Retrospective review of postoperative spine MRI in 243 children (5.5 ± 4.6 years of age) from our clinical data base postresection of posterior fossa tumors from October 1994 to August 2010 yielded 37 (6.0 ± 4.8 years of age) subjects positive for postoperative intraspinal subdural collections. Their extent and signal properties were recorded for postoperative (37/37), preoperative (15/37), and follow-up spine (35/37) MRI. Risk factors were compared with age-matched internal controls (n = 37, 5.9 ± 4.5 years of age). Associations of histology, hydrocephalus and cerebellar tonsillar herniation, and postoperative intracranial subdural collections with postoperative intraspinal subdural collections were assessed by the Fisher exact test or χ(2) test. The association between preoperative tumor volume and postoperative intraspinal subdural collections was assessed by the Wilcoxon rank sum test. The overall incidence of postoperative intraspinal subdural collections was 37/243 (15.2%), greatest ≤7 days postoperatively (36%); 97% were seen 0-41 days postoperatively (12.9 ± 11.0 days). They were T2 hyperintense and isointense to CSF on T1WI, homogeneously enhanced, and resolved on follow-up MR imaging (35/35). None were symptomatic. They were associated with intracranial subdural collections (P = .0011) and preoperative tonsillar herniation (P = .0228). Postoperative intraspinal subdural collections are infrequent and clinically silent, resolve spontaneously, and have a distinctive appearance. Preoperative tonsillar herniation appears to be a predisposing factor. In this series, repeat MR imaging by 4 weeks

  11. Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa

    International Nuclear Information System (INIS)

    Shibata, Shobu; Kurihara, Masaki; Mori, Kazuo; Amamoto, Yuhei.

    1981-01-01

    This is a report of case with the extracerebral cavernous hemangioma in the middle fossa in which total removal was carried out after radiotherapy. Follow-up study with computed tomography during and after irradiation are presented. A 44-year-old house-wife complained of a decreased vision of the both eyes and paresis of the left upper and lower limbs. CT scan revealed a slightly high density area in the right middle cranial fossa which was markedly enhanced with contrast media. Right carotid angio-graphy demonstrated a large avascular mass in the right middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. An attempt to total removal of the tumor had failed to success because of extensive hemorrhage from the tumor. Histological examination revealed a cavernous hemangioma. Irradiation with a total dose of 5000 rads was delivered. After irradiation. CT scan revealed a marked decrease of size and EMI number of the tumor. At this stage, hypervascular mass lesion with feeding arteries was noted in conventional angiography. Tumor stain in prolonged injection angiography was also visualized. In the second operation, removal of the tumor was performed without any difficulty and hemorrhage was controlled easily by electrocoagulation. Histology revealed a marked narrowing of vessels with an increase in the connective tissues. In the central part of specimen, there noted findings of coagulation necrosis, intraluminal thrombus formations and so on, which were attributed to the influence of radiation. It is concluded that in case of a extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3000 - 5000 rads was a method of choice. The treatment results in an increase of probability of total removal of the tumor. (author)

  12. ModFossa: A library for modeling ion channels using Python.

    Science.gov (United States)

    Ferneyhough, Gareth B; Thibealut, Corey M; Dascalu, Sergiu M; Harris, Frederick C

    2016-06-01

    The creation and simulation of ion channel models using continuous-time Markov processes is a powerful and well-used tool in the field of electrophysiology and ion channel research. While several software packages exist for the purpose of ion channel modeling, most are GUI based, and none are available as a Python library. In an attempt to provide an easy-to-use, yet powerful Markov model-based ion channel simulator, we have developed ModFossa, a Python library supporting easy model creation and stimulus definition, complete with a fast numerical solver, and attractive vector graphics plotting.

  13. Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant

    International Nuclear Information System (INIS)

    Bloom, David A.; Adler, Brent H.; Forsythe, Robert C.; Mutabagani, Khaled; Teich, Steven

    2003-01-01

    A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

  14. Visible and Near-Infrared Spectroscopy of Hephaestus Fossae Cratered Cones, Mars

    Science.gov (United States)

    Dapremont, A.; Wray, J. J.

    2017-12-01

    Hephaestus Fossae are a system of sub-parallel fractures on Mars (> 500 km long) interpreted as near-surface tensional cracks [1]. Images of the Martian surface from the High Resolution Imaging Science Experiment have revealed cratered cones within the Hephaestus Fossae region. A volcanic origin (cinder/tuff cones) has been proposed for these features based on morphometric measurements and fine-scale surface characteristics [2]. In an effort to further constrain the origin of these cones as the products of igneous or sedimentary volcanism, we use data from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM). We take advantage of CRISM's S (0.4 - 1.0 microns) and L (1.0 - 3.9 microns) detector wavelength ranges to investigate the presence or absence of spectral signatures consistent with previous identifications of igneous and mud volcanism products on Mars [3,4]. Hephaestus Fossae cratered cone rims exhibit a consistent nanophase ferric oxide signature. We also identify ferrous phases and 3-micron absorptions (attributed to fundamental vibrational stretch frequencies in H2O) on the crater rims of several cones. Mafic signatures on cratered cone rims support an igneous provenance for these features. The 3-micron absorptions are consistent with the presence of structurally bound or adsorbed water. Our CRISM observations are similar to those of small edifice features in Chryse Planitia, which were interpreted as mud volcanism products based on their enrichment of nanophase ferric minerals and 3-micron absorptions on summit crater rims [3]. Hydrothermal activity was invoked for a Coprates Chasma pitted cone (scoria/tuff cone) based on CRISM identification of partially dehydrated opaline silica, which we do not observe in Hephaestus Fossae [4]. Our spectral observations are more consistent with mud volcanism, but we do not definitively rule out an igneous volcanic origin for the cones in our study region. We demonstrate that VNIR spectroscopy is a valuable

  15. Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review.

    Science.gov (United States)

    Sharma, Divashree; Khasgiwala, Ankit; Maheshwari, Bharat; Singh, Charanpreet; Shakya, Neelam

    2017-02-01

    Temporomandibular joint dislocation refers to the dislodgement of mandibular condyle from the glenoid fossa. Anterior and anteromedial dislocations of the mandibular condyle are frequently reported in the literature, but superolateral dislocation is a rare presentation. This report outlines a case of superolateral dislocation of an intact mandibular condyle that occurred in conjunction with an ipsilateral mandibular parasymphysis fracture. A review of the clinical features of superolateral dislocation of the mandibular condyle and the possible techniques of its reduction ranging from the most conservative means to extensive surgical interventions is presented. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Surgery for juvenile nasopharyngeal angiofibroma with lateral extension to the infratemporal fossa.

    Science.gov (United States)

    Yamada, Masato; Tsunoda, Atsunobu; Tokumaru, Takao; Aoyagi, Masaru; Kawano, Yoshihisa; Yano, Tomoyuki; Kishimoto, Seiji

    2014-08-01

    The study aimed to assess the usefulness of skull base surgery for large juvenile nasopharyngeal angiofibroma (JNA) with lateral extension to the infratemporal fossa. Eleven cases were enrolled for this study, and the mean age was 17.7 years old (range: 8-32). Six out of 11 cases underwent surgery as an initial treatment, and the other five underwent secondary surgery after initial surgery or radiotherapy in other institutions. The range of extension of tumor, feeding arteries, surgical approach, and treatment outcome were estimated. All tumors originated from the sphenopalatine foramen. Based on the imaging study, there was extension to the cavernous sinus observed in eight cases, as well as to the middle cranial fossa (8), orbit (4), and anterior cranial fossa (1). These tumors were diagnosed as Andrews' Stage IVa (3) and IVb (8). However, infiltration into the cavernous sinus was observed in one case only during surgery. Ten tumors were separated carefully from the cavernous sinus or dura and were accurately diagnosed as Stage IIIb. In all cases, the main arterial feeders of the JNAs were branches of the external carotid artery, which were embolized prior to surgery. However, 10 cases were also fed by branches of the internal carotid artery (branches of the ophthalmic artery), in which these arteries could not be embolized. Coronal skin incision (1) and a facial dismasking flap (9) were used, and in one case, wide lateral skin incision with temporary incision of the facial nerve was applied. The orbito-zygomatic approach and its modification was applied to all the cases. Fronto-lateral craniotomy was applied in four cases and lateral craniotomy in seven cases. Total resection was achieved in 10 cases and subtotal resection in one case. No mortality was noted in this series. Temporal trismus was observed in all cases which subsided gradually. Cheek numbness and facial palsy were observed in three and two cases, respectively. Coupled with craniotomy, tumor removal

  17. Posterior fossa reconstruction using titanium plate for the treatment of cerebellar ptosis after decompression for Chiari malformation.

    Science.gov (United States)

    Udani, Vikram; Holly, Langston T; Chow, Daniel; Batzdorf, Ulrich

    2014-01-01

    We describe our use of a perforated titanium plate to perform a partial posterior fossa cranioplasty in the treatment of cerebellar ptosis and dural ectasia after posterior fossa decompression (PFD). Twelve patients who had undergone PFD underwent posterior fossa reconstruction using a titanium plate. Symptoms were related to either descent of the cerebellum into the decompression or to dural ectasia into the craniectomy defect. Twelve patients who had undergone large suboccipital craniectomies and who presented with persistent headaches and some with neurological symptoms related to syringomyelia, underwent reoperation with placement of a small titanium plate. Ten of 12 patients showed symptomatic improvement after reoperation. Placement of a titanium plate appears to be an effective method of treatment of cerebellar ptosis and dural ectasia after PFD for Chiari malformation. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip : a randomized controlled study with in-depth functional outcome results

    NARCIS (Netherlands)

    Moein, C. M. Ansari; ten Duis, H. J.; Oey, P. L.; de Kort, G. A. P.; van der Meulen, W.; van der Werken, Chr

    2011-01-01

    In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients

  19. Fetal MRI for characterising a variety of posterior fossa anomalies suspected on 3rd trimester ultrasound examination – a short series of four cases

    Directory of Open Access Journals (Sweden)

    Amaresh Indravadan Ranchod

    2012-02-01

    Full Text Available Fetal MRI is increasingly being used to more accurately assess abnormalities detected on screening ultrasound. This procedure is more pertinent when the initial ultrasound is done late in the third trimester and when the abnormality involves the posterior fossa of the brain. Four cases with a variety of unusual posterior fossa anomalies are presented.

  20. Long-term outcomes of gamma knife surgery for posterior fossa arteriovenous malformations

    International Nuclear Information System (INIS)

    Matsunaga, Shigeo; Shuto, Takashi

    2014-01-01

    The long-term outcomes of gamma knife surgery (GKS) in patients with posterior fossa arteriovenous malformations (AVMs) were retrospectively analyzed in 82 patients followed up for more than 5 years to evaluate the efficacy and safety. The median AVM volume at GKS was 0.95 cm 3 . The prescribed dose to the AVM margin was median 18 Gy with 1-18 isocenters. The actual complete AVM obliteration rate was 58.5% at 3 years and 78.0% at 5 years. The significant factors for higher complete obliteration rate were younger patient age and smaller maximum/minimum nidus diameter ratio. Two patients experienced hemorrhage caused by residual AVM rupture at 4 and 49 months. Twenty patients developed peri-nidal edema as an adverse radiation-induced reaction at median 13 months. One patient developed radiation-induced necrosis at 6.8 years. Neurological complication was observed in 12 patients and 6 patients remained with neurological dysfunction permanently. Larger nidus volume and location adjacent to an eloquent area significantly increased the risk of neurological complication. Pittsburgh radiosurgery-based AVM grading scale was significantly correlated with the outcome of neurological symptoms after GKS. GKS achieved acceptable and complete obliteration rate for posterior fossa AVM with relatively low risk of morbidity on neuroimaging and neurological symptoms for the long-term period after treatment. We recommend conformable and selective treatment planning to achieve both obliteration of the AVM nidus and preservation of neurological function. (author)

  1. Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies.

    Science.gov (United States)

    James, Adrian; Stewart, Craig; Warrick, Paul; Tzifa, Constance; Forte, Vito

    2007-11-01

    The objective of this study was to review clinical and embryologic aspects of third and fourth branchial anomalies. Retrospective study. We reviewed the institutional and departmental databases at our institution to identify all cases of third and fourth branchial anomalies encountered from 1992 to 2006. All patient records were examined with respect to demographics, clinical history, and radiologic and pathologic reports. We identified 17 cases of third and fourth branchial anomalies, the largest series of its kind reported to date. The lesions were predominantly left sided, all presenting with neck infection. Fistula formation was iatrogenic, secondary to incision and drainage. Preoperative direct laryngoscopy always revealed a pit within the apex of the piriform fossa. Surgical excision involved ipsilateral thyroidectomy as the lesion passed through the thyroid gland. No lesions following the classical course of a either a third or fourth branchial anomaly were identified. The clinical presentation of branchial sinuses arising from the piriform fossa is more in keeping with derivation from the thymopharyngeal duct (of the third pouch) than the hypothetical course of third and fourth branchial fistulae.

  2. Pathology, treatment and management of posterior fossa brain tumors in childhood

    International Nuclear Information System (INIS)

    Bonner, K.; Siegel, K.R.

    1988-01-01

    Brain tumors are the second most common childhood malignancy. Between 1975 and 1985, 462 newly diagnosed patients were treated at the Children's Hospital of Philadelphia; 207 (45%) tumors arose in the posterior fossa and 255 (55%) appeared supratentorially. A wide variety of histological subtypes were seen, each requiring tumor-specific treatment approaches. These included primitive neuroectodermal tumor (n = 86, 19%), astrocytoma (n = 135, 30%), brainstem glioma (n = 47, 10%), anaplastic astrocytoma (n = 32, 7%), and ependymoma (n = 30, 6%). Because of advances in diagnostic abilities, surgery, radiotherapy, and chemotherapy, between 60% and 70% of these patients are alive today. Diagnostic tools such as computed tomography and magnetic resonance imaging allow for better perioperative management and follow-up, while the operating microscope, CO 2 laser, cavitron ultrasonic aspirator and neurosurgical microinstrumentation allow for more extensive and safer surgery. Disease specific treatment protocols, utilizing radiotherapy and adjuvant chemotherapy, have made survival common in tumors such as medulloblastoma. As survival rates increase, cognitive, endocrinologic and psychologic sequelae become increasingly important. The optimal management of children with brain tumors demands a multidisciplinary approach, best facilitated by a neuro-oncology team composed of multiple subspecialists. This article addresses incidence, classification and histology, clinical presentation, diagnosis, pre-, intra- and postoperative management, long-term effects and the team approach in posterior fossa tumors in childhood. Management of specific tumor types is included as well. 57 references

  3. Expansion of Chiari I-associated syringomyelia after posterior-fossa decompression.

    Science.gov (United States)

    Gil, Z; Rao, S; Constantini, S

    2000-09-01

    Chiari I malformation (CMI) is an abnormality that involves caudal herniation of the cerebellar tonsils into the foramen magnum. CMI has been shown to be closely associated with the development of syringomyelia (SM). Several theories have emerged to explain the apparent correlation between the existence of CMI with subsequent development of SM. However, the exact mechanism of the evolution of SM is still subject to controversy. We report here the case of a 12-year-old girl admitted to hospital with headache, vomiting, ataxia, and moderate pyramidal signs. Radiological evaluation revealed the presence of CMI, accompanied by a small SM. The patient underwent posterior fossa decompression and improved significantly. She was re-admitted 6 months later with clinical evidence of progressive spinal cord dysfunction. MR revealed gross expansion of the syrinx. This case raises questions regarding the pathophysiology of CMI and its association with SM. The case indicates the need for neurological and radiological follow-up for patients undergoing posterior fossa decompression due to CMI, even for those without an initial syrinx. This is the first report known to us of expansion of a syrinx following decompression of an associated CMI.

  4. Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs

    Directory of Open Access Journals (Sweden)

    Luciana Cristina dos Santos Silva

    2012-08-01

    Full Text Available INTRODUCTION: There is no study relating magnetic resonance imaging (MRI to ultrasound (US findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US. METHODS: Fifty-four patients (mean age 41.6±13.5years from an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma. RESULTS: Forty-seven (87% of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%, MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1% of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis. CONCLUSIONS: Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.

  5. Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Steggerda, S.J.; Smits-Wintjens, V.E.H.J.; Verbon, P.; Walther, F.J. [Leiden University Medical Centre, Department of Neonatology, Leiden (Netherlands); Bruine, F.T. de [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Wezel-Meijler, G. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Isala Hospital, Department of Neonatology, Zwolle (Netherlands)

    2015-09-15

    We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

  6. Transzygomatic approach with intraoperative neuromonitoring for resection of middle cranial fossa tumors.

    Science.gov (United States)

    Son, Byung Chul; Lee, Sang Won; Kim, Sup; Hong, Jae Taek; Sung, Jae Hoon; Yang, Seung-Ho

    2012-02-01

    The authors reviewed the surgical experience and operative technique in a series of 11 patients with middle fossa tumors who underwent surgery using the transzygomatic approach and intraoperative neuromonitoring (IOM) at a single institution. This approach was applied to trigeminal schwannomas (n = 3), cavernous angiomas (n = 3), sphenoid wing meningiomas (n = 3), a petroclival meningioma (n = 1), and a hemangiopericytoma (n = 1). An osteotomy of the zygoma, a low-positioned frontotemporal craniotomy, removal of the remaining squamous temporal bone, and extradural drilling of the sphenoid wing made a flat trajectory to the skull base. Total resection was achieved in 9 of 11 patients. Significant motor pathway damage can be avoided using a change in motor-evoked potentials as an early warning sign. Four patients experienced cranial nerve palsies postoperatively, even though free-running electromyography of cranial nerves showed normal responses during the surgical procedure. A simple transzygomatic approach provides a wide surgical corridor for accessing the cavernous sinus, petrous apex, and subtemporal regions. Knowledge of the middle fossa structures is essential for anatomic orientation and avoiding injuries to neurovascular structures, although a neuronavigation system and IOM helps orient neurosurgeons.

  7. Posterior fossa abnormalities in high-risk term infants: comparison of ultrasound and MRI

    International Nuclear Information System (INIS)

    Steggerda, S.J.; Smits-Wintjens, V.E.H.J.; Verbon, P.; Walther, F.J.; Bruine, F.T. de; Wezel-Meijler, G. van

    2015-01-01

    We aimed to assess the characteristics of posterior fossa (PF) abnormalities in a cohort of high-risk term neonates, as well as the diagnostic performance of cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views for the detection of these abnormalities, with magnetic resonance imaging (MRI) being the reference standard. In this retrospective study, 113 term neonates with CUS and subsequent MRI were included. Sensitivity, specificity, and predictive values of routine CUS and CUS with MF views were calculated. Posterior fossa abnormalities were diagnosed on CUS in 46 of 113 infants. MRI confirmed these findings in 43 and showed additional abnormalities in 32 infants. The sensitivity and specificity of anterior fontanelle views for major PF abnormalities as seen on MRI were 16 % and 99 %. Adding MF views increased the sensitivity of US to 82 %. The sensitivity and specificity of MF views for the detection of any (major or minor) PF abnormality were 57 % and 95 %. Especially acute hypoxic-ischemic injury and small subdural and punctate cerebellar haemorrhage remained undetected by CUS. PF abnormalities are frequent in high-risk term infants. MF-CUS enables early diagnosis of major PF abnormalities. We therefore advocate to perform MF-CUS in high-risk term neonates. (orig.)

  8. A morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia

    International Nuclear Information System (INIS)

    Ieshima, A.; Yoshino, K.; Takashima, S.; Takeshita, K.; Kisa, T.

    1984-01-01

    We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls. (orig.)

  9. Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

    International Nuclear Information System (INIS)

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Shimia, Mohammad; Mazaheri-Khamene, Ramin; Daghighi, Shadi

    2012-01-01

    A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran

  10. Muscular Variation In The Neck Region With Narrowing Of The Minor And Major Supraclavicular Fossa

    Directory of Open Access Journals (Sweden)

    Humberto Ferreira Arquez

    2017-06-01

    Full Text Available Background: The sternocleidomastoideus muscle is the most prominent landmarks of the surface anatomy of the neck, separates the anterior part of the neck (anterior triangle from the posterior part of the neck (posterior triangle. An accessory head of sternocleidomastoideus muscle may cause complications while trying to access vital neurovascular structures that are located in the minor and major supraclavicular fossa. The purpose of this study is to describe an anatomical variation of the sternocleidomastoideus muscle and clinical impact. Methods and Findings: The anatomical variations described were found during routine dissection conducted in the laboratory of Morphology of the University of Pamplona in two male cadavers of 47 and 75 years respectively. Measurements were taken using a Vernier caliper. Topographic details of the variations were examined, recorded and photographed. The morphological variations in the number of heads (three and four of origin of sternocleidomastoideus muscle was found in two male subjects in right and left neck, bilaterally.  The posterior cervical triangle was diminished. The bilateral narrowing of the minor and major supraclavicular fossa minimizing space needed for potential surgical access. The branching patterns of the spinal accessory nerve and arterial patterns were normal. Conclusions: The Knowledge of the presence of additional heads of sternocleidomastoideus muscle it might cause difficulties in subclavian or external jugular vein catheterization, and in surgical interventions involving structures lying under the sternocleidomastoideus muscle. These variations must be kept in mind while approaching the region to avoid complications as the classical anatomical landmarks might be misinterpreted and confuse.

  11. Late effects of treatment on the intelligence of children with posterior fossa tumors

    International Nuclear Information System (INIS)

    Duffner, P.K.; Cohen, M.E.; Thomas, P.

    1983-01-01

    This retrospective pilot study was undertaken to evaluate the late effects of treatment on intelligence in a population of children with posterior fossa tumors. Ten children with posterior fossa tumors treated with radiation and chemotherapy received intellectual evaluations at least one year following diagnosis. Six children had medulloblastomas, one child had a fourth ventricular ependymoma, two children had brainstem gliomas, and one child had a recurrent cerebellar astrocytoma. Children with supratentorial tumors were specifically excluded from the study in order to eliminate the possible influence of the tumor on intellectual functioning. Four children had had intelligence testing in school prior to treatment of their tumor. In each case results following treatment revealed a deterioration of full scale IQ of at least 25 points. Six children did not have prior testing; of these, two had IQ's less than 20. Overall, 50% of the patients had IQ's of less than 80 and 20% had IQ's of greater than 100. Furthermore, four children with normal intelligence (IQ greater than 80) have learning problems requiring special classes. Thus, of the ten children evaluated, all have either dementia, learning disabilities, or evidence of intellectual retardation. This study suggests that aggressive treatment of children with brain tumors may improve survivals but may be associated with significant long-term disabilities

  12. High precision locations of long-period events at La Fossa Crater (Vulcano Island, Italy

    Directory of Open Access Journals (Sweden)

    Salvatore Rapisarda

    2009-06-01

    Full Text Available Since the last eruption in 1888-90, the volcanic activity on Vulcano Island (Aeolian Archipelago, Italy has been limited to fumarolic degassing. Fumaroles are mainly concentred at the active cone of La Fossa in the northern sector of the island and are periodically characterized by increases in temperature as well as in the amount of both CO2 and He. Seismic background activity at Vulcano is dominated by micro-seismicity originating at shallow depth (<1-1.5 km under La Fossa cone. This seismicity is related to geothermal system processes and comprises long period (LP events. LPs are generally considered as the resonance of a fluid-filled volume in response to a trigger. We analyzed LP events recorded during an anomalous degassing period (August-October 2006 applying a high precision technique to define the shape of the trigger source. Absolute and high precision locations suggest that LP events recorded at Vulcano during 2006 were produced by a shallow focal zone ca. 200 m long, 40 m wide and N30-40E oriented. Their occurrence is linked to magmatic fluid inputs that by modifying the hydrothermal system cause excitation of a fluid-filled cavity.

  13. Comparação entre imagens ultrassonográficas do cérebro do cão com e sem a calota craniana e sua correlação com a anatomia real

    Directory of Open Access Journals (Sweden)

    Carla Aparecida Batista Lorigados

    2013-04-01

    Full Text Available Os ossos são tidos como uma barreira intransponível para obtenção de imagens sonográficas, pois a grande diferença entre as impedâncias acústicas das superfícies de tecidos moles e ósseos gera importantes artefatos de reflexão, contudo, a transmissão do feixe ultrassônico depende da espessura e da estrutura óssea e neste caso o osso temporal tem sido usado como uma janela acústica para o acesso, por ultrassonografia, do encéfalo de pacientes adultos. O presente trabalho examinou o encéfalo de cães adultos com o emprego da ultrassonografia com e sem a interposição do crânio, comparou as imagens obtidas e as correlacionou com a anatomia encefálica. Foram examinados dez cães adultos, mesaticefálicos. O exame ultrassonográfico foi realizado através do orifício magno e dos ossos temporal, parietal (porção lateral e frontal. No exame sem a interposição óssea foi realizada uma pequena craniotomia no osso frontal. As imagens do encéfalo com a interposição óssea apresentaram resolução inferior às obtidas por craniotomia. Importantes estruturas anatômicas foram identificadas. Devido à correlação e a sua ampla disponibilidade, concluiu-se que o aparelho de ultrassom pode ser usado para o acompanhamento de lesões intracranianas expansivas, bem como em procedimentos intraoperatórios.

  14. MR-Guided Laser-Induced Thermotherapy of the Infratemporal Fossa and Orbit in Malignant Chondrosarcoma via a Modified Technique

    International Nuclear Information System (INIS)

    Vogl, Thomas J.; Mack, Martin G.; Straub, Ralf; Eichler, Katrin; Zangos, Stephan

    2001-01-01

    A 76-year-old patient presented with a recurrent mass of a malignant chondrosarcoma in the right infratemporal fossa and in the left maxillary sinus with orbital invasion. The patient was treated with a palliative intention with MR-guided laser-induced thermotherapy using a modified applicator technique. Following treatment clinical symptoms improved and MRI revealed complete laser-induced tumor necrosis

  15. Bone changes in the condylar head and mandibular fossa in patients with temporomandibular disorders. Helical CT observation

    International Nuclear Information System (INIS)

    Shimahara, Satoru; Ariyoshi, Yasunori; Kimura, Yoshihiro; Shimahara, Masashi

    2011-01-01

    In the present study, we investigated whether bone changes are present in sites impossible to observe by panoramic X-ray and Schuller's X-ray examination, namely the medial of the condylar head and mandibular fossa, in patients with type IV temporomandibular joint disorders. We observed the articular fossa using computed tomography, which is able to obtain detailed 3-dimensional information, in patients with type IV temporomandibular disorders. We examined 120 joints of 60 patiens who visited the Department of Oral Surgery, Osaka Medical College Hospital. Each condylar head was clearly visualized in panoramic X-ray and Schuller's X-ray examination findings, and shown to have possible changes unilaterally. Each joint was diagnosed as type IV, according to the diagnostic guidelines set by Japanese Society for Temporomandibular Joint, and further examined using helical CT. Changes in condylar head; We concluded that bone changes were present with considerable probability in the medial of condylar head in a manner similar to those found in the lateral and center of joints with type IV temporomandibular disorders. Changes in mandibular fossa; The bone changes occurred in various locations of the mandibular fossa, while they appeared significantly more frequently in the condylar head. We think that our finding will contribute to development of treatment strategies for temporomandibular disorders, as they clarify bone changes in sites previously unreported. (author)

  16. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    Science.gov (United States)

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  17. A method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus: the "mosquito" method.

    Science.gov (United States)

    Lee, Hee Chang; Lee, Ji Yeoun; Ryu, Seul Ki; Lim, Jang Mi; Chong, Sangjoon; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang

    2016-12-01

    The posterior fossa dural opening requires the ligation of the occipital sinus to gain successful exposure. However, there could be a prominent occipital sinus which is functioning as the main drainage route and is harboring the risk of unpredictable massive hemorrhage during the dural opening. We introduce a safe method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus using four curved hemostat clamps. For the dural incision at the midline part of the posterior cranial fossa, we used four curved hemostat clamps to occlude the prominent occipital sinus: one pair of clamps at the proximal part and the other pair at the distal part to occlude the occipital sinus. Dural incision was made between the two pairs of the curved hemostat clamps. By clamping of the sinus, it allows observation of possible brain swelling after occlusion of the occipital sinus as well as minimizes hemorrhage during incision of the midline dura of the posterior fossa. This method allows observation of brain swelling after occipital sinus occlusion and is an easy and safe incision of the midline dura minimizing hemorrhage in selected cases with a prominent occipital sinus.

  18. Contribution of sup(99m)Tc pertechnetate brain scintigraphy in the diagnosis of tumours of posterior fossa

    International Nuclear Information System (INIS)

    Sergent, Aline.

    1976-01-01

    The present work concerns 38 posterior cranial fossa tumour cases subjected to sup(99m)Tc pertechnetate brain scintigraphy between May 1974 and June 1976. 33 of these patients have undergone an anatomical check while for the remaining 5, the existence of a posterior fossa tumour is established from the conjunction of clinical signs and other paraclinical examinations. The procedure was the same for all these 38 patients: after a 300 μC/kg injection of tracer, an immediate angioscintigraphic period, an early set of pictures (half an hour after the tracer injection) then delayed set (4 to 5 hours later) taken from 4 angles: front, back and two profiles. The examination was performed with an OHIO NUCLEAR SIEMENS gamma camera and sometimes a conventional scanner as well (the latter giving no better a diagnosis than the former). In 75% of the cases a hyperfixation of the injected tracer was observed and its site located quite accurately in the posterior fossa tumour. The etiology of the lesion could be diagnosed in 'most probable' or 'least probable' terms. Examination of work by other authors, who obtained similar results, leads to the conclusion that this method is very helpful in the diagnosis of posterior fossa tumours when used as a means of early detection, before the undertaking of more complex neuroradiological explorations [fr

  19. Correlation of Acute and Late Brainstem Toxicities With Dose-Volume Data for Pediatric Patients With Posterior Fossa Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Nanda, Ronica H., E-mail: rhazari@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University College of Medicine, Atlanta, Georgia (United States); Ganju, Rohit G.; Schreibmann, Edward [Department of Radiation Oncology, Winship Cancer Institute, Emory University College of Medicine, Atlanta, Georgia (United States); Chen, Zhengjia; Zhang, Chao [Department of Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University Rollins School of Public Health, Atlanta, Georgia (United States); Jegadeesh, Naresh; Cassidy, Richard; Deng, Claudia; Eaton, Bree R.; Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University College of Medicine, Atlanta, Georgia (United States)

    2017-06-01

    Purpose: Radiation-induced brainstem toxicity after treatment of pediatric posterior fossa malignancies is incompletely understood, especially in the era of intensity modulated radiation therapy (IMRT). The rates of, and predictive factors for, brainstem toxicity after photon RT for posterior fossa tumors were examined. Methods and Materials: After institutional review board approval, 60 pediatric patients treated at our institution for nonmetastatic infratentorial ependymoma and medulloblastoma with IMRT were included in the present analysis. Dosimetric variables, including the mean and maximum dose to the brainstem, the dose to 10% to 90% of the brainstem (in 10% increments), and the volume of the brainstem receiving 40, 45, 50, and 55 Gy were recorded for each patient. Acute (onset within 3 months) and late (>3 months of RT completion) RT-induced brainstem toxicities with clinical and radiographic correlates were scored using Common Terminology Criteria for Adverse Events, version 4.0. Results: Patients aged 1.4 to 21.8 years underwent IMRT or volumetric arc therapy postoperatively to the posterior fossa or tumor bed. At a median clinical follow-up period of 2.8 years, 14 patients had developed symptomatic brainstem toxicity (crude incidence 23.3%). No correlation was found between the dosimetric variables examined and brainstem toxicity. Vascular injury or ischemia showed a strong trend toward predicting brainstem toxicity (P=.054). Patients with grade 3 to 5 brainstem toxicity had undergone treatment to significant volumes of the posterior fossa. Conclusion: The results of the present series demonstrate a low, but not negligible, risk of brainstem radiation necrosis for pediatric patients with posterior fossa malignancies treated with IMRT. No specific dose-volume correlations were identified; however, modern treatment volumes might help limit the incidence of severe toxicity. Additional work investigating inherent biologic sensitivity might also provide

  20. Silent internal sinus of the pyriform fossa: a rare adult manifestation of a branchial anomaly.

    Science.gov (United States)

    Lin, Chao-Jung; Lin, Yaoh-Shiang; Kang, Bor-Hwang; Lee, Jin-Chin

    2003-03-01

    Branchial anomalies present with a wide range of pathologic characteristics, including cysts, fistulas, and sinuses of the head and neck region. Branchial cysts are most commonly diagnosed during the second through fourth decades of life, while branchial sinuses and fistulas are diagnosed almost exclusively in children with infection episodes. Only rarely has an internal sinus of a third or fourth branchial anomaly manifested in adults as a noninfectious swelling in the neck during swallowing. In this report, we describe our experience treating a 21-year-old man with a left-sided swallowing-induced neck protrusion of 10 years' duration. Findings of physical examination, videolaryngoscopy, and a pharyngoesophagogram confirmed the diagnosis of internal sinus of the pyriform fossa, with uncertain origin of a third or fourth branchial anomaly. The patient underwent regular follow-up as an outpatient and experienced no further infectious episodes.

  1. A branchial cyst of the pyriform fossa transoral laser resection: a case report.

    Science.gov (United States)

    Abdelfattah, Hesham Mostafa; Ahmed, Mohammed Elrabie; Ahmed, Mona El-Rabie; Ahmed, Mohamed Abd El-Kader; Moussa, Abd-Elmateen

    2016-02-01

    Pyriform sinus malformations represent rare third and fourth branchial anomalies. Fistulae at the latter site were initially described and make up less than 1 % of all brachial anomalies. They may be discovered incidentally, or may present as a neck mass with recurrent infection, dysphagia, or airway compromise, and can be an unusual cause of dysphonia in infant and children. Here, we present a case of third branchial cyst located in pharyngeal wall of the left pyriform sinus which presented with dysphonia since birth in a 6-year-old girl. Transoral CO2 laser excision was carried out successfully with no communicating tract. The patient's dysphonia showed progressive regression at 1-year follow-up. Third branchial cyst in the left pyriform sinus (Bailey's type IV) is an unusual cause of dysphonia in pediatric. Our present case report is the first brachial cyst to be reported in the pyriform fossa and the second branchial anomalies to be excised transorally with CO2 laser.

  2. Acoustic neurinoma and posterior fossa meningioma - clinical and CT radiologic findings

    International Nuclear Information System (INIS)

    Catz, A.; Reider-Groswasser, I.; Ichilov Hospital, Tel Aviv; Tel Aviv Univ.

    1986-01-01

    Clinical and computed tomography (CT) findings of twenty-three patients with acoustig neurinoma (AN) and eleven patients with posterior fossa meningioma (PFM) are described. AN frequently (94%) presents with the complaint of hearing loss, while PFM often (60%) presents with non-specific pains in the head or neck. The CT characteristics of AN and PFM in this series were similar to those found in most previous publications. The maximal measured mean diamter of PFM (40.2 mm) was significantly larger than that of AN (26.4 mm). Hydrocephalus was apparently influenced by tumor location rather than by its size. It is concluded that diagnostic ability has been improved in cases of CPA tumors, but not in those of non-CPA PFM, probably because of the earlier clinical presentation of the former. Clinical efforts are still necessary to detect the smaller tumors. (orig.)

  3. Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia

    Directory of Open Access Journals (Sweden)

    Vijay P Joshi

    2013-01-01

    Full Text Available Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia.

  4. Infraorbital nerve block within the Pterygopalatine fossa of the horse: anatomical landmarks defined by computed tomography

    International Nuclear Information System (INIS)

    Carsten, S.; Hagen, G.

    2008-01-01

    In order to provide anaesthesia of the equine maxillary cheek teeth, a local nerve block of the infraorbital nerve in the pterygopalatine fossa had been proposed, which is referred to as the 'Palatine Bone Insertion' (PBI). As several complications with this method were reported, our study was designed to recommend a modified injection technique which avoids the risk of puncturing of relevant anatomical structures. Five cadaver heads and two living horses were examined by contrast medium injections and subsequent computed tomography (CT). Spinal needles were inserted using two different insertion techniques: The above mentioned (PBI), and a modification called 'Extraperiorbital Fat Body Insertion' (EFBI). Both techniques (PBI and EFBI) provide a consistent distribution of contrast medium around the infraorbital nerve. However, only the EFBI technique is appropriate to minimize the risk of complications. This study is an example for the permanent challenge of anatomists to supply a basis for clinical and surgical procedures

  5. Posterior fossa decompression with duraplasty in Chiari surgery: A technical note

    Directory of Open Access Journals (Sweden)

    Marcelo Ferreira Sabba

    Full Text Available Summary Chiari malformation (CM is the most common and prevalent symptomatic congenital craniocervical malformation. Radiological diagnosis is established when the cerebellar tonsils are located 5 mm or more below the level of the foramen magnum on magnetic resonance imaging (MRI. Surgical treatment is indicated whenever there is symptomatic tonsillar herniation or syringomyelia/hydrocephalus. The main surgical treatment for CM without craniocervical instability (such as atlantoaxial luxation is posterior fossa decompression, with or without duraplasty. The authors describe in details and in a stepwise fashion the surgical approach of patients with CM as performed at the State University of Campinas, emphasizing technical nuances for minimizing the risks of the procedure and potentially improving patient outcome.

  6. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Tewari, Sanjit O., E-mail: tewaris@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Petre, Elena N., E-mail: petree@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Osborne, Joseph, E-mail: osbornej@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Sofocleous, Constantinos T., E-mail: sofoclec@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

    2013-12-15

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

  7. Life-threatening macroglossia after posterior fossa surgery: a surgical positioning problem?

    Science.gov (United States)

    Vermeersch, G; Menovsky, T; De Ridder, D; De Bodt, M; Saldien, V; Van de Heyning, P

    2014-01-01

    A 55-year-old woman was operated in the lateral park bench position with significant neck flexion and oral packing. Macroglossia was noticed immediately postoperatively after endotracheal extubation. The patient was reintubated for 13 days and subsequently required a tracheostoma. After the placement of the tracheostoma and the removal of the endotracheal tube, the congestion of the tongue decreased markedly within 24 hours. Macroglossia is a rare complication following posterior fossa procedures with few cases reported so far. It can cause airway obstruction, which could be a life-threatening complication, and it therefore requires prompt treatment. The aetiology of postoperative macroglossia remains uncertain and has been attributed to arterial, venous and lymphatic compression, mechanical compression, or neurogenic causes. This article describes new insights into aetiology and also describes preventive measures and possible treatment.

  8. Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns

    International Nuclear Information System (INIS)

    Eguchi, Takahiko; Nikaido, Yuji; Shiomi, Kazuaki; Fujimoto, Takatoshi; Otsuka, Hiroyuki; Takeuchi, Hiroshi; Taoka, Toshiaki.

    1996-01-01

    Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre-and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space. (author)

  9. Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kamikawa, Shuji; Kuwamura, Keiichi [Hyogo Prefectural Awaji Hospital, Sumoto (Japan); Tamaki, Norihiko

    1998-07-01

    The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients` ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

  10. Topographical anatomy of superficial veins, cutaneous nerves, and arteries at venipuncture sites in the cubital fossa.

    Science.gov (United States)

    Mikuni, Yuko; Chiba, Shoji; Tonosaki, Yoshikazu

    2013-01-01

    We investigated correlations among the superficial veins, cutaneous nerves, arteries, and venous valves in 128 cadaveric arms in order to choose safe venipuncture sites in the cubital fossa. The running patterns of the superficial veins were classified into four types (I-IV) and two subtypes (a and b). In types I and II, the median cubital vein (MCV) was connected obliquely between the cephalic and basilic veins in an N-shape, while the median antebrachial vein (MAV) opened into the MCV in type I and into the basilic vein in type II. In type III, the MCV did not exist. In type IV, additional superficial veins above the cephalic and basilic veins were developed around the cubital fossa. In types Ib-IVb, the accessory cephalic vein was developed under the same conditions as seen in types Ia-IVa, respectively. The lateral cutaneous nerve of the forearm descended deeply along the cephalic vein in 124 cases (97 %), while the medial cutaneous nerve of the forearm descended superficially along the basilic vein in 94 (73 %). A superficial brachial artery was found in 27 cases (21 %) and passed deeply under the ulnar side of the MCV. A median superficial antebrachial artery was found in 1 case (1 %), which passed deeply under the ulnar side of the MCV and ran along the MAV. Venous valves were found at 239 points in 28 cases with superficial veins, with a single valve seen at 79 points (33 %) and double valves at 160 points (67 %). At the time of intravenous injection, caution is needed regarding the locations of cutaneous nerves, brachial and superficial brachial arteries, and venous valves. The area ranging from the middle segment of the MCV to the confluence between the MCV and cephalic vein appears to be a relatively safe venipuncture site.

  11. Fluorodeoxyglucose positron emission tomography/computed tomography findings in a patient with cerebellar mutism after operation in posterior fossa

    Directory of Open Access Journals (Sweden)

    Gonca Kara Gedik

    2017-03-01

    Full Text Available Cerebellar mutism is a transient period of speechlessness that evolves after posterior fossa surgery in children. Although direct cerebellar and brain stem injury and supratentorial dysfunction have been implicated in the mediation of mutism, the pathophysiological mechanisms involved in the evolution of this kind of mutism remain unclear. Magnetic resonance imaging revealed dentatothalamocortical tract injuries and single photon emission computed tomography showed cerebellar and cerebral hypoperfusion in patients with cerebellar mutism. However, findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT in this group of patients have not been documented previously. In this clinical case, we report a patient who experienced cerebellar mutism after undergoing a posterior fossa surgery. Right cerebellar and left frontal lobe hypometabolism was shown using FDG PET/CT. The FDG metabolism of both the cerebellum and the frontal lobe returned to normal levels after the resolution of the mutism symptoms.

  12. Curative analysis of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa

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    Yu-xiang MA

    2015-07-01

    Full Text Available Objective  The article analyzed the curative effect of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa to explore reasonable operation method.  Methods  Clinical data of 61 patients with non-solid hemangioblastoma who underwent surgeries in Tianjin Huanhu Hospital during July 2007 and June 2014 were retrospectively analyzed. According to surgical approaches and the situation of foramen magnum and atlas, these patients were divided into 5 groups: midline approach opening foramen magnum and atlas (Group A, midline approach without opening foramen magnum and atlas (Group B, paramedian approach opening foramen magnum and atlas (Group C, paramedian approach without opening foramen magnum and atlas (Group D, retrosigmoid approach (Group E. By collecting clinical symptoms, imaging findings, surgical records and postoperative complications, the surgical results and occurrence of postoperative complications were summarized and reasonable operation method was discussed.  Results  Among 61 patients, total resection was achieved in 56 cases (91.80%, and partial resection was achieved in 5 cases (8.20% . The postoperative remission rate of 43 cases with hydrocephalus was 79.07% (34/43. Intracranial infection was the most common postoperative complication, accounting for 22.95% (14/61. There was significant difference in occurrence rate of intracranial infection among 4 subgroups: opening or not opening the foramen magnum and atlas with or without restoring bone flap (Z = 16.269, P = 0.001. In the subgroup of not opening foramen magnum and atlas with restoring bone flap, the infection rate, which accounted for 6.90% (2/29, was the lowest.  Conclusions  The surgical treatment options for non-solid hemangioblastoma in posterior fossa should be done according to patients' condition, and performed by a professional group. If conditions allow, not to open the foramen magnum and atlas, as well as intraoperative

  13. [Efficacies of arthroscopic debridement and olecranon fossa plasty in the treatment of osteoarthritis and posterior elbow impingement].

    Science.gov (United States)

    Liu, Yu-jie; Wang, Jun-liang; Li, Hai-feng; Qi, Wei; Wang, Ning

    2012-07-17

    To evaluate the efficacies of arthroscopic debridement and removal of osteophyma for olecroanon and olecranon fossa plasty for posterior impingement of elbow joint. Between 1999 and 2008, a total of 21 cases were diagnosed with osteoarthritis and posterior elbow impingement. There were 15 males and 6 females. And there were 16 right and 15 left cases. They included volleyball players (n = 7), tennis players (n = 7), golf enthusiasts (n = 4) and fencers (n = 3). The average duration of onset-operation was 3.5 years (range: 2.5 - 8). Arthroscopic exploration revealed synovial hyperplasia hypertrophy, cartilage degeneration and olecranon fossa hyperplasia with deformed olecranon fossa. Debridement and plasty were performed. Loose bodies were removed from elbow joint in 6 patients. Partial resection of posterior olecranon tip was performed and osteophytes or fibrous tissue removed in this area. Dynamic observation showed no posterior elbow impingement. Postoperative follow-up was conducted in 19 cases and 2 cases became lost to follow-up. The average follow-up period was 25.3 months (range: 18 - 42). All patients were evaluated preoperatively and postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. The outcomes were excellent (n = 12), good (n = 7) and fair (n = 2). Postoperative patients elbow swelling and pain relieve, sports and life function returns to normal, elbow flexion and rotating mobility obviously improved. With the elbow radiological films to measure the range of motion, the average range of motion was 90.5° preoperatively and improved to 130° postoperatively. There was significant improvement in all cases. Posterior elbow impingement is caused by hyperextension trauma and elbow overuse during specific sporting activities. Arthroscopic debridement and olecroanon or olecranon fossa plasty demonstrates excellent results for posterior impingement of elbow joint.

  14. Longitudinal MRI assessment: the identification of relevant features in the development of Posterior Fossa Syndrome in children

    Science.gov (United States)

    Spiteri, M.; Lewis, E.; Windridge, D.; Avula, S.

    2015-03-01

    Up to 25% of children who undergo brain tumour resection surgery in the posterior fossa develop posterior fossa syndrome (PFS). This syndrome is characterised by mutism and disturbance in speech. Our hypothesis is that there is a correlation between PFS and the occurrence of hypertrophic olivary degeneration (HOD) in lobes within the posterior fossa, known as the inferior olivary nuclei (ION). HOD is exhibited as an increase in size and intensity of the ION on an MR image. Intra-operative MRI (IoMRI) is used during surgical procedures at the Alder Hey Children's Hospital, Liver- pool, England, in the treatment of Posterior Fossa tumours and allows visualisation of the brain during surgery. The final MR scan on the IoMRI allows early assessment of the ION immediately after the surgical procedure. The longitudinal MRI data of 28 patients was analysed in a collaborative study with Alder Hey Children's Hospital, in order to identify the most relevant imaging features that relate to the development of PFS, specifically related to HOD. A semi-automated segmentation process was carried out to delineate the ION on each MRI. Feature selection techniques were used to identify the most relevant features amongst the MRI data, demographics and clinical data provided by the hospital. A support vector machine (SVM) was used to analyse the discriminative ability of the selected features. The results indicate the presence of HOD as the most efficient feature that correlates with the development of PFS, followed by the change in intensity and size of the ION and whether HOD occurred bilaterally or unilaterally.

  15. Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis.

    Science.gov (United States)

    Ramaswamy, Vijay; Hielscher, Thomas; Mack, Stephen C; Lassaletta, Alvaro; Lin, Tong; Pajtler, Kristian W; Jones, David T W; Luu, Betty; Cavalli, Florence M G; Aldape, Kenneth; Remke, Marc; Mynarek, Martin; Rutkowski, Stefan; Gururangan, Sridharan; McLendon, Roger E; Lipp, Eric S; Dunham, Christopher; Hukin, Juliette; Eisenstat, David D; Fulton, Dorcas; van Landeghem, Frank K H; Santi, Mariarita; van Veelen, Marie-Lise C; Van Meir, Erwin G; Osuka, Satoru; Fan, Xing; Muraszko, Karin M; Tirapelli, Daniela P C; Oba-Shinjo, Sueli M; Marie, Suely K N; Carlotti, Carlos G; Lee, Ji Yeoun; Rao, Amulya A Nageswara; Giannini, Caterina; Faria, Claudia C; Nunes, Sofia; Mora, Jaume; Hamilton, Ronald L; Hauser, Peter; Jabado, Nada; Petrecca, Kevin; Jung, Shin; Massimi, Luca; Zollo, Massimo; Cinalli, Giuseppe; Bognár, László; Klekner, Almos; Hortobágyi, Tibor; Leary, Sarah; Ermoian, Ralph P; Olson, James M; Leonard, Jeffrey R; Gardner, Corrine; Grajkowska, Wieslawa A; Chambless, Lola B; Cain, Jason; Eberhart, Charles G; Ahsan, Sama; Massimino, Maura; Giangaspero, Felice; Buttarelli, Francesca R; Packer, Roger J; Emery, Lyndsey; Yong, William H; Soto, Horacio; Liau, Linda M; Everson, Richard; Grossbach, Andrew; Shalaby, Tarek; Grotzer, Michael; Karajannis, Matthias A; Zagzag, David; Wheeler, Helen; von Hoff, Katja; Alonso, Marta M; Tuñon, Teresa; Schüller, Ulrich; Zitterbart, Karel; Sterba, Jaroslav; Chan, Jennifer A; Guzman, Miguel; Elbabaa, Samer K; Colman, Howard; Dhall, Girish; Fisher, Paul G; Fouladi, Maryam; Gajjar, Amar; Goldman, Stewart; Hwang, Eugene; Kool, Marcel; Ladha, Harshad; Vera-Bolanos, Elizabeth; Wani, Khalida; Lieberman, Frank; Mikkelsen, Tom; Omuro, Antonio M; Pollack, Ian F; Prados, Michael; Robins, H Ian; Soffietti, Riccardo; Wu, Jing; Metellus, Phillipe; Tabori, Uri; Bartels, Ute; Bouffet, Eric; Hawkins, Cynthia E; Rutka, James T; Dirks, Peter; Pfister, Stefan M; Merchant, Thomas E; Gilbert, Mark R; Armstrong, Terri S; Korshunov, Andrey; Ellison, David W; Taylor, Michael D

    2016-07-20

    Posterior fossa ependymoma comprises two distinct molecular variants termed EPN_PFA and EPN_PFB that have a distinct biology and natural history. The therapeutic value of cytoreductive surgery and radiation therapy for posterior fossa ependymoma after accounting for molecular subgroup is not known. Four independent nonoverlapping retrospective cohorts of posterior fossa ependymomas (n = 820) were profiled using genome-wide methylation arrays. Risk stratification models were designed based on known clinical and newly described molecular biomarkers identified by multivariable Cox proportional hazards analyses. Molecular subgroup is a powerful independent predictor of outcome even when accounting for age or treatment regimen. Incompletely resected EPN_PFA ependymomas have a dismal prognosis, with a 5-year progression-free survival ranging from 26.1% to 56.8% across all four cohorts. Although first-line (adjuvant) radiation is clearly beneficial for completely resected EPN_PFA, a substantial proportion of patients with EPN_PFB can be cured with surgery alone, and patients with relapsed EPN_PFB can often be treated successfully with delayed external-beam irradiation. The most impactful biomarker for posterior fossa ependymoma is molecular subgroup affiliation, independent of other demographic or treatment variables. However, both EPN_PFA and EPN_PFB still benefit from increased extent of resection, with the survival rates being particularly poor for subtotally resected EPN_PFA, even with adjuvant radiation therapy. Patients with EPN_PFB who undergo gross total resection are at lower risk for relapse and should be considered for inclusion in a randomized clinical trial of observation alone with radiation reserved for those who experience recurrence. © 2016 by American Society of Clinical Oncology.

  16. Cranial CT with 64-, 16-, 4- and single-slice CT systems-comparison of image quality and posterior fossa artifacts in routine brain imaging with standard protocols

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    Ertl-Wagner, Birgit; Eftimov, Lara; Becker, Christoph; Reiser, Maximilian [University of Munich, Grosshadern (Germany). Institute of Clinical Radiology; Blume, Jeffrey; Cormack, Jean [Brown University, Center for Statistical Sciences, Providence, RI (United States); Bruening, Roland; Brueckmann, Hartmut [University of Munich, Grosshadern (Germany). Department of Neuroradiology

    2008-08-15

    Posterior fossa artifacts constitute a characteristic limitation of cranial CT. To identify practical benefits and drawbacks of newer CT systems with reduced collimation in routine cranial imaging, we aimed to investigate image quality, posterior fossa artifacts and parenchymal delineation in non-enhanced CT (NECT) with 1-, 4-, 16- and 64-slice scanners using standard scan protocols. We prospectively enrolled 25 consecutive patients undergoing NECT on a 64-slice CT. Three groups with 25 patients having undergone NECT on 1-, 4- and 16-slice CT machines were matched regarding age and sex. Standard routine CT parameters were used on each CT system with helical acquisition in the posterior fossa; the parameters varied regarding collimation and radiation dose. Three blinded readers independently assessed the cases regarding image quality, infra- and supratentorial artifacts and delineation of brain parenchymal structures on a five-point ordinal scale. Reading orders were randomized. A proportional odds model that accounted for the correlated nature of the data was fit using generalized estimating equations. Posterior fossa artifacts were significantly reduced, and the delineation of infratentorial brain structures was significantly improved with the thinner collimation used for the newer CT systems (p<0.001). No significant differences were observed for midbrain structures (p>0.5). The thinner collimation available on modern CT systems leads to reduced posterior fossa artifacts and to a better delineation of brain parenchyma in the posterior fossa. (orig.)

  17. Diffusion tensor imaging in evaluation of posterior fossa tumors in children on a 3T MRI scanner

    International Nuclear Information System (INIS)

    Assis, Zarina Abdul; Saini, Jitender; Ranjan, Manish; Gupta, Arun Kumar; Sabharwal, Paramveer; Naidu, Purushotham R

    2015-01-01

    Primary intracranial tumors in children are commonly located in the posterior fossa. Conventional MRI offers limited information regarding the histopathological type of tumor which is essential for better patient management. The purpose of the study was to evaluate the usefulness of advanced MR imaging techniques like diffusion tensor imaging (DTI) in distinguishing the various histopathological types of posterior fossa tumors in children. DTI was performed on a 3T MRI scanner in 34 untreated children found to have posterior fossa lesions. Using third party software, various DTI parameters [apparent diffusion coefficient (ADC), fractional anisotropy (FA), radial diffusivity, planar index, spherical index, and linear index] were calculated for the lesion. Data were subjected to statistical analysis [analysis of variance (ANOVA)] using SPSS 15.0 software. We observed significant correlation (P < 0.01) between ADC mean and maximum, followed by radial diffusivity (RD) with the histopathological types of the lesions. Rest of the DTI parameters did not show any significant correlation in our study. The results of our study support the hypothesis that most cellular tumors and those with greater nuclear area like medulloblastoma would have the lowest ADC values, as compared to less cellular tumors like pilocytic astrocytoma

  18. [CLINICAL STUDIES ON EFFECT OF ARTHROSCOPIC INTERCONDYLAR FOSSA ANGIOPLASTY ON ABILITY OF NEUROMUSCULAR CONTROL IN ELDERLY PATIENTS WITH KNEE OSTEOARTHRITIS].

    Science.gov (United States)

    Huang, Jingmin; Wang, Haijiao; Wu, Jiang; Li, Dongchao; Li, Yuhong

    2015-08-01

    To study the effect of arthroscopic intercondylar fossa angioplasty on the ability of neuromuscular control of the knee joint in elderly patients with knee osteoarthritis (KOA). Between June 2012 and March 2013, 20 elderly patients with KOA and in accordance with inclusion and exclusion criteria underwent arthroscopic intercondylar fossa angioplasty (operation group), and 20 healthy elderly people served as control group. There was no significant difference in age, height, weight, and body mass index between 2 groups (P > 0.05). The proprioception capability (using passive regeneration test at measurement angles of 15, 30, and 60°) and quadriceps mobilization [including maximum voluntary contraction (MVC), central activation ratio (CAR), and activation deficit (AD)] were measured to avaluate the neuromuscular control of the knee; the Lysholm score was used to evaluate knee function. The above indexes were measured to assess the knee neuromuscular control and recovery of joint function in patients of operation group at 3, 6, and 9 months after operation. Compared with the control group, MVC, CAR, and Lysholm scores were significantly decreased, and the AD and passive knee angle difference were significantly increased in operation group (P 0.05). Arthroscopic intercondylar fossa angioplasty can relieve ACL pressure, abrasion, and impact, which will recover the ability of neuromuscular control, increase proprioception and quadriceps mobilization capacity, and improve the joint function.

  19. Evolution of posterior fossa and brain morphology after in utero repair of open neural tube defects assessed by MRI

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    Rethmann, Christin; Scheer, Ianina; Kellenberger, Christian Johannes [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University of Zurich, The Zurich Center for Fetal Diagnosis and Therapy, Zurich (Switzerland); Children' s Research Center (CRC), Zurich (Switzerland); Meuli, Martin; Mazzone, Luca; Moehrlen, Ueli [University of Zurich, The Zurich Center for Fetal Diagnosis and Therapy, Zurich (Switzerland); Children' s Research Center (CRC), Zurich (Switzerland); University Children' s Hospital Zurich, Department of Pediatric Surgery, Zurich (Switzerland)

    2017-11-15

    To describe characteristics of foetuses undergoing in utero repair of open neural tube defects (ONTD) and assess postoperative evolution of posterior fossa and brain morphology. Analysis of pre- and postoperative foetal as well as neonatal MRI of 27 foetuses who underwent in utero repair of ONTD. Type and level of ONTD, hindbrain configuration, posterior fossa and liquor space dimensions, and detection of associated findings were compared between MRI studies and to age-matched controls. Level of bony spinal defect was defined with exactness of ± one vertebral body. Of surgically confirmed 18 myelomeningoceles (MMC) and 9 myeloschisis (MS), 3 MMC were misdiagnosed as MS due to non-visualisation of a flat membrane on MRI. Hindbrain herniation was more severe in MS than MMC (p < 0.001). After repair, hindbrain herniation resolved in 25/27 cases at 4 weeks and liquor spaces increased. While posterior fossa remained small (p < 0.001), its configuration normalised. Lateral ventricle diameter indexed to cerebral width decreased in 48% and increased in 12% of cases, implying a low rate of progressive obstructive hydrocephalus. Neonatally evident subependymal heterotopias were detected in 33% at preoperative and 50% at postoperative foetal MRI. MRI demonstrates change of Chiari malformation type II (CM-II) features. (orig.)

  20. I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery

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    Chaoliang Tang

    2015-01-01

    patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients. Methods. Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT or I-gel facilitated endotracheal tube intubation (Group TI. Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared. Results. Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P<0.05 versus Group TT. Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasma β-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI. Conclusion. Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery.

  1. Evolution of posterior fossa and brain morphology after in utero repair of open neural tube defects assessed by MRI

    International Nuclear Information System (INIS)

    Rethmann, Christin; Scheer, Ianina; Kellenberger, Christian Johannes; Meuli, Martin; Mazzone, Luca; Moehrlen, Ueli

    2017-01-01

    To describe characteristics of foetuses undergoing in utero repair of open neural tube defects (ONTD) and assess postoperative evolution of posterior fossa and brain morphology. Analysis of pre- and postoperative foetal as well as neonatal MRI of 27 foetuses who underwent in utero repair of ONTD. Type and level of ONTD, hindbrain configuration, posterior fossa and liquor space dimensions, and detection of associated findings were compared between MRI studies and to age-matched controls. Level of bony spinal defect was defined with exactness of ± one vertebral body. Of surgically confirmed 18 myelomeningoceles (MMC) and 9 myeloschisis (MS), 3 MMC were misdiagnosed as MS due to non-visualisation of a flat membrane on MRI. Hindbrain herniation was more severe in MS than MMC (p < 0.001). After repair, hindbrain herniation resolved in 25/27 cases at 4 weeks and liquor spaces increased. While posterior fossa remained small (p < 0.001), its configuration normalised. Lateral ventricle diameter indexed to cerebral width decreased in 48% and increased in 12% of cases, implying a low rate of progressive obstructive hydrocephalus. Neonatally evident subependymal heterotopias were detected in 33% at preoperative and 50% at postoperative foetal MRI. MRI demonstrates change of Chiari malformation type II (CM-II) features. (orig.)

  2. Lumbar meningeal enhancement after surgery in the posterior cranial fossa: a normal finding in children?

    International Nuclear Information System (INIS)

    Krampla, W.; Urban, M.; Newrkla, S.; Hruby, W.; Schatzer, R.; Knosp, E.

    2002-01-01

    Purpose: Spinal meningeal Gd-DTPA enhancement after cranial surgery is a known observation of a not well understood underlying mechanism. This paper demonstrates that this MRI finding is a normal meningeal reaction to subarachnoid hemorrhage, which should not be mistaken for metastatic spread. Material and methods: Three pediatric patients were examined by MRI for metastatic spread of malignant infratentorial tumors along the spinal canal two to nine days after the removal of the primary cerebral lesion. The findings were compared with a control group that underwent cranial surgery (cyst resection or fenestration of the posterior cranial fossa) without major bleeding into the subarachnoid space. Unenhanced and enhanced sequences were obtained to prove that the high singal within the CSF is caused by an abnormal Gd-DTPA uptake and not by methemoglobin. Results: Meningeal enhancement was observed in all patients with intraoperative bleeding resembling subarachnoid masses on enhanced T 1 -weighted images. This was not present in any patient of the control group. This finding lasts for approximately two weeks. Conclusion: The meningeal enhancement renders immediate postoperative studies inconclusive for the detection of metastatic spread. Consequently, the obligatory tumor staging along the spinal canal should ideally be done prior to the resection of a cerebral tumor. (orig.) [de

  3. The value of metrizamide CT cisternography in the diagnosis of suprasellar and posterior fossa tumors

    International Nuclear Information System (INIS)

    Takahara, Nobuhiko; Mizuno, Makoto; Suwa, Jun; Yamanouchi, Yasuo; Matsumura, Hiroshi

    1982-01-01

    We have studied the diagnostic value of metrizamide CT cisternography (MCTC) in 22 patients. Six patients received metrizamide for the delineation of suprasellar tumors, 8 for posterior fossa tumors, and 8 for miscellaneous lesions, such as congenital cystic lesions and subdural fluid collections. Metrizamide with a concentration of 170 mgI/ml was used; 10 ml of it was introduced through the lumbar intrathecal route in every case. The patients were kept in a 15-degree Trendelenburg position, and Computed Tomography with an ACTA scanner (ACTA 200FS) was performed in principle one hour after the intrathecal injection and, if necessary, serially thereafter. The morphology of the subarachnoid space was well visualized in detail by CSF enhancement with metrizamide in all cases. The contours of the tumors in and around the basal cisterns were clearly shown; their relationship to the adjacent structures became more evident upon direct coronal section or upon coronal and sagittal reconstruction. It is suggested that the differential diagnosis in the suprasellar tumors and the C-P angle tumors can be made by means of the exact representation of the contours and extension of these tumors. MCTC can delineate the brain-stem glioma more accurately than the conventional CT scan: thus, it offers a definite advantage for the diagnosis and evaluation of those tumors which show isodensity on precontrast and no enhancement on postcontrast conventional CT scan. An arachnoid cyst or a porencephalic cyst can be diagnosed by the evaluation of the CSF-flow pattern. (author)

  4. Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy

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    Brian O’Sullivan

    2012-01-01

    Full Text Available Tumefactive fibroinflammatory lesion (TFIL is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in tumor size was noted over the course of years and she is free of disease after more than 11 years of follow-up. The major longterm side effect this patient developed was an expected unilateral radiation-induced retinopathy, due to the close proximity of the lesion to the orbit. The dilemma of treatment of benign disease with radiation with potential long-term complications is discussed and a review of the literature on TFIL is presented.

  5. Posterior Cranial Fossa Crowdedness Is Related to Age and Sex: an Magnetic Resonance Volumetric Study

    International Nuclear Information System (INIS)

    Lirng, J.F.; Fuh, J.L.; Chen, Y.Y.; Wang, S.J.

    2005-01-01

    Purpose: To measure 3-dimensional (3D) posterior cranial fossa (PCF) crowdedness and to evaluate the effect of age, sex, and body height on PCF. Material and Methods: Fifty-two healthy volunteers (24 M and 28 F; mean age 55.4±17.2 years; range 24-82 years) were recruited. Using a semi-automated magnetic resonance technique, we calculated a PCF crowdedness index (CI) as the ratio of hindbrain (HB) volume to PCF volume x100% and correlated this index with age, sex, body height, and other crowdedness parameters. Results: The mean PCF CI was 93.7±2.7%. Women had a more crowded PCF than men (95.0±1.7% versus 92.1±2.7%; P <0.001). PCF CI declined with age for both men ( r = -0.61; P = 0.002) and women ( r = -0.68; P <0.001). The association with age - but not HB volume - was maintained after we controlled for sex and body height. On multiple regression, both age and sex accounted for 57.5% of the PCF CI variance. Conclusion: Our study shows that PCF CI is associated with age and sex, and can therefore be used as a surrogate to assess hindbrain atrophy in a cross-sectional sample. Moreover, sex- and age-specific normal ranges may be needed to evaluate the PCF CI in clinical practice

  6. Indirect computerized tomography sign of chronic subdural hematoma demonstrated in the posterior fossa

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    Machi, Takao; Fukui, Masashi; Maeyama, Ryutaro; Takaki, Tosuke; Yoshiura, Shogo; Kamoi, Itsuma

    1985-03-01

    In cases of chronic subdural hematoma (CSH), brain computerized tomography (CT) scans frequently disclose a low density band in the posterior fossa (LDBP) between the lateral margin of the cerebellum and the adjacent petrous bone/tentorium cerebelli. Out of 121 cases of CSH, 56 (46%) showed the LDBP. The LDBP was mostly ipsilateral to the side of the CSH or bilateral. The frequency of the LDBP had no correlation with the severity of the cerebral midline shift or the thickness of the hematoma. As normal controls, CT scans of 257 cases in which no organic lesions were detected were used. Also 30 cases with dementing diseases, 2 cases with spinocerebellar degeneration and 428 cases of other neurological diseases such as head trauma other than CSH, brain tumor, cerebrovascular disease etc. were studied as disease controls. The incidence of the LDBP in both controls was significantly lower than in CSH. Therefore, the LDBP in cases of CSH was considered to be a significant associated finding of CT scans. The mechanism of the LDBP is discussed.

  7. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    Science.gov (United States)

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.

  8. Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus.

    Science.gov (United States)

    Verit, Ayhan; Savas, Murat; Ciftci, Halil; Unal, Dogan; Yeni, Ercan; Kaya, Mete

    2006-02-01

    Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.

  9. A report of the anesthesia in posterior fossa operations in the sitting position in 55 patients

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    Jahanguiri B

    1994-04-01

    Full Text Available In this survey, 55 patients were studied in a period of six years for having the anesthesia in the sitting position. In this position, the surgeon will had a better access to the location, whose damages have been sustained, so less damages would be given to the healthy tissues. For the patients, due to their critical general conditions, one week prior to giving anesthesia to the posterior fossa, operation in the sitting position the right ventriculoatiral shunt was placed. For preventing the fall of blood pressure, a bandage was placed in the lower limbs after inducing anesthesia and changing supine position to sitting position. Before the induction, central venous pressure was measured for treating the air embolism. The head of catheter was placed inside the right atrial. Premedications such as atropine, pethidine, and inductive agents like thiopenton, and muscle relaxants, maintained with halothane and nitrous oxide. All of the patients endured this condition without the fall of blood pressure and air embolism

  10. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo

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    Emin Mehmet Ceylan

    2016-01-01

    Full Text Available Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient’s vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient.

  11. Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa

    International Nuclear Information System (INIS)

    Shibata, Shobu; Fukushima, Masaaki; Mori, Kazuo; Tsujimura, Masaki; Yokoyama, Hiroaki.

    1987-01-01

    We report three cases of extracerebral cavernous hemangiomas in the middle fossa all of which had received radiotherapy. Follow-up study with serial computed tomography during and after irradiation were presented. In Case 1, radiotherapy after partial removal of the tumor reduced the tumor's size and CT number, and facilitated total removal. In Case 2 as well, irradiation was started before the operation. The tumor responded very well to irradiation and showed significant reduction in the size and CT number of the tumor with a dose of about 3,000 rads. Subtotal romoval was possible. In Case 3, the tumor responded very well clinically to irradiation, and vertigo were much improved with a dose of about 3,000 rads, and CT scan at that time showed significant reduction in the size and CT number of the tumor, therefore she only received radiation therapy, no surgical intervention. It is concluded that in cases of extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3,000 rads was a method of choice. The treatment results in an increased probability of total removal of the tumor, and moreover the possibility of eliminating surgery. (author)

  12. Posterior Cranial Fossa Crowdedness Is Related to Age and Sex: an Magnetic Resonance Volumetric Study

    Energy Technology Data Exchange (ETDEWEB)

    Lirng, J.F.; Fuh, J.L.; Chen, Y.Y.; Wang, S.J. [Taipei Veterans General Hospital, Taiwan (China). Dept. of Radiology and Neurological Inst.

    2005-11-01

    Purpose: To measure 3-dimensional (3D) posterior cranial fossa (PCF) crowdedness and to evaluate the effect of age, sex, and body height on PCF. Material and Methods: Fifty-two healthy volunteers (24 M and 28 F; mean age 55.4{+-}17.2 years; range 24-82 years) were recruited. Using a semi-automated magnetic resonance technique, we calculated a PCF crowdedness index (CI) as the ratio of hindbrain (HB) volume to PCF volume x100% and correlated this index with age, sex, body height, and other crowdedness parameters. Results: The mean PCF CI was 93.7{+-}2.7%. Women had a more crowded PCF than men (95.0{+-}1.7% versus 92.1{+-}2.7%; P <0.001). PCF CI declined with age for both men ( r = -0.61; P = 0.002) and women ( r = -0.68; P <0.001). The association with age - but not HB volume - was maintained after we controlled for sex and body height. On multiple regression, both age and sex accounted for 57.5% of the PCF CI variance. Conclusion: Our study shows that PCF CI is associated with age and sex, and can therefore be used as a surrogate to assess hindbrain atrophy in a cross-sectional sample. Moreover, sex- and age-specific normal ranges may be needed to evaluate the PCF CI in clinical practice.

  13. Excision versus trichloroacetic acid (TCA) chemocauterization for branchial sinus of the pyriform fossa.

    Science.gov (United States)

    Hwang, Jihee; Kim, Seong Chul; Kim, Dae Yeon; Namgoong, Jung-Man; Nam, Soon Yuhl; Roh, Jong-Lyel

    2015-11-01

    We analyzed the outcomes of open surgical excision and endoscopic trichloroacetic acid (TCA) chemocauterization for the treatment of branchial sinus of the pyriform fossa (BSPF). We retrospectively reviewed the records of 27 patients (16 males and 11 females) who were treated for BSPF at the Asan Medical Center between 1996 and 2013. The median age of the 27 patients was 4.5years (range, 0 to 15years). Before definitive surgery, 19 (70.3%) of the patients had histories of neck infection, and 16 (59.2%) patients had neck abscesses that were drained. The lesions were predominantly located on the left side (26 of 27; 96.2%). Excisions were performed for 14 (48.1%) patients. TCA chemocauterizations were performed for 13 patients. After a median follow-up period of 5.5years, 11 patients developed recurrence. The recurrence rates were not significantly different between the excision and chemocauterization groups (35.7% vs 46.1%, respectively, p=0.704). All of the recurred patients were successfully treated with repeated chemocauterization or reexcision. Analyses of the risk factors for recurrence revealed that a previous infection history tended to increase the rate of recurrence (90.9% vs 56.2%, p=0.090). Our experience suggests that the outcomes of excision and TCA chemocauterization are not significantly different. Additional studies are needed to reach a consensus regarding the best treatment strategy for BSPF. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. "CEPHALIC VEIN ANATOMY IN ANTECUBITAL FOSSA DURING THE CONSTRUCTION OF ARTERIOVENOUS FISTULA"

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    S. M. Alamshah

    2004-08-01

    Full Text Available In order to create an effective arteriovenous fistula (AVF in patients with sustained chronic renal failure (CRF, surgeons need to become familiar with various anatomical variations of venous structures in the operating field. Because of variety and different types of cubital venous anatomies, there is more than a 90% possibility of creating suitable AVFs in the cubital fossa , but in the wrist and forearm, due to old injections and thrombophlebitis, there is less chance to do so. Since cephalic vein is the main venous conduit for constructing an AVF in the antecubital region, this study focuses on the various anatomical variations of cephalic vein and its communicating branches. We studied the cubital cephalic anatomy of 103 patients with CRF during construction of an AVF from July 1999 to June 2001. Five types of cephalic vein anatomy were seen: type A (44.66%, type B (30.1%, type C (18.44%, type D (3.88% and type E (2.29% in 39 right and 64 left arms. Seventy-six anastomoses were performed to brachial trunk, 25 to the radial and 2 to the ulnar artery. Eleven cases with progressive swelling after AVF were uneventfully cured by hand elevation. No infection, false aneurysm, venous hypertension or steal syndrome was detected. In order to obtain the best results and select appropriate operative technique for reliable vascular access in CRF, it is necessary to understand the anatomical variety of cephalic vein.

  15. Endoscopic Endonasal Transturbinate Approach to the Pterygopalatine Fossa in the Management of Juvenile Nasopharyngeal Angiofibromas

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    Satoru Kodama

    2012-01-01

    Full Text Available Pterygopalatine fossa (PPF is a difficult-to-access anatomic area located behind the posterior wall of the maxillary sinus. Juvenile nasopharyngeal angiofibroma (JNA often affects this area, and the management of feeding artery to the tumor is important in the surgery. Endoscopic endonasal approach to the PPF without endangering all other nasal structures is useful in the management of JNA. We describe a new approach to the PPF, endoscopic transturbinate approach, which is effective in the management of JNA. Submucous inferior turbinoplasty was performed, and sphenopalatine artery, the feeder to the tumor, was identified at the sphenopalatine foramen. The posterior wall of maxillary sinus was removed. Internal maxillary artery was identified in the PPF and was ligated with a hemoclip. The tumor in the PPF was pushed into the nasal cavity. These procedures were all performed via submucous turbinate tunnel. Then, the tumor was successfully removed in en bloc from the nasal cavity by transnasal approach without ethmoidectomy. This approach improves accessibility and visualization in the PPF and potential to reduce intraoperative bleeding due to ligation of the feeder safely without touching the tumor. Endoscopic transturbinate approach is effective in the management of early stage of JNA.

  16. Declarative and procedural learning in children and adolescents with posterior fossa tumours

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    Casares Encarnación

    2006-03-01

    Full Text Available Abstract Background This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma, given that memory has an important impact on the child's academic achievement and personal development. Methods We had three groups: two clinical (eighteen subjects and one control (twelve subjects. The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version 1 of the California Verbal Learning Test-Children's Version- CVLT- 2 to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available Results The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups. Conclusion The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning.

  17. Imaging of lesions in the posterior cranial fossa using single photon emission computed tomography

    International Nuclear Information System (INIS)

    Kawakami, Michiro; Uesugi, Yasuo; Higashikawa, Masahiko; Ochi, Mari; Makimoto, Kazuo; Takahashi, Hiroaki; Shin, Akinori; Utsunomiya, Keita; Akagi, Hiroaki

    1988-01-01

    Lesions in the posterior cranial fossa were visualized by single photon emission computed tomography (SPECT) with 123 I-IMP (N-isopropyl-p- 123 I-iodoamphetamine) and 99m Tc-HM-PAO ( 99m Tc-hexametylpropyleneamine oxime). It is generally held that these radiopharmaceuticals penetrate the walls of cerebral blood vessels and that their accumulations in the brain tissue may reflect the cerebral blood flow. Six patients with lesions in the central nervous system all showed wider areas of abnormality in SPECT than in X-ray CT, indicating a larger lesion of blood flow disturbance. In the next series of 11 patients with vertigo or dizziness of unknown etiology, eight had abnormal findings in the scan with 123 I-IMP as did four of the nine in the scan with 99m Tc-HM-PAO. Thus, most patients with dizziness of unknown etiology may have some vertebral blood flow disorder, which in some cases is not clearly diagnosed by conventional vestibular examinations or even by X-ray CT scan. The accuracy of the diagnostic measures for otoneurological problems awaits further studies of their sensitivity and specificity. (author)

  18. Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases

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    MR Etemadifar

    2005-05-01

    Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

  19. Chromosomal aneuploidies and copy number variations in posterior fossa abnormalities diagnosed by prenatal ultrasonography.

    Science.gov (United States)

    Lei, Ting; Feng, Jie-Ling; Xie, Ying-Jun; Xie, Hong-Ning; Zheng, Ju; Lin, Mei-Fang

    2017-11-01

    To explore the genetic aetiology of fetal posterior fossa abnormalities (PFAs). This study involved cases of PFAs that were identified by prenatal ultrasonographic screening and confirmed postnatally between January 2012 and January 2016. Conventional cytogenetic analyses and chromosomal microarray analysis were performed, and chromosomal aneuploidies and copy number variations (CNVs) were identified. Among 74 cases included in this study, 8 were of Blake's pouch cyst; 7, Dandy-Walker malformation; 11, vermian hypoplasia; 32, enlarged cisterna magna; and 16, cerebellar hypoplasia. The rates of nonbenign chromosomal aberrations (including chromosomal aneuploidies, pathogenic CNVs, and variants of unknown significance) were 2/8 (25.0%), 2/7 (28.5%), 8/11 (72.7%), 7/32 (21.9%), and 6/16 (37.5%), respectively. Cases were also classified as isolated PFAs (30/74), PFAs with other central nervous system (CNS) abnormalities (13/74), or PFAs with extra-CNS structural abnormalities (31/74). No fetuses with isolated PFAs or PFAs accompanied by other CNS abnormalities exhibited chromosomal aneuploidies or pathogenic CNVs. The rate of pathogenic chromosomal aberrations in the remaining fetuses was 17/31 (22.9%). The combined use of chromosomal microarray analysis and karyotype analysis might assist the prenatal diagnosis and management of PFAs, with extra-CNS structural abnormalities being detected by ultrasonography. © 2017 John Wiley & Sons, Ltd.

  20. High-resolution MRI of cranial nerves in posterior fossa at 3.0 T.

    Science.gov (United States)

    Guo, Zi-Yi; Chen, Jing; Liang, Qi-Zhou; Liao, Hai-Yan; Cheng, Qiong-Yue; Fu, Shui-Xi; Chen, Cai-Xiang; Yu, Dan

    2013-02-01

    To evaluate the influence of high-resolution imaging obtainable with the higher field strength of 3.0 T on the visualization of the brain nerves in the posterior fossa. In total, 20 nerves were investigated on MRI of 12 volunteers each and selected for comparison, respectively, with the FSE sequences with 5 mm and 2 mm section thicknesses and gradient recalled echo (GRE) sequences acquired with a 3.0-T scanner. The MR images were evaluated by three independent readers who rated image quality according to depiction of anatomic detail and contrast with use of a rating scale. In general, decrease of the slice thickness showed a significant increase in the detection of nerves as well as in the image quality characteristics. Comparing FSE and GRE imaging, the course of brain nerves and brainstem vessels was visualized best with use of the three-dimensional (3D) pulse sequence. The comparison revealed the clear advantage of a thin section. The increased resolution enabled immediate identification of all brainstem nerves. GRE sequence most distinctly and confidently depicted pertinent structures and enables 3D reconstruction to illustrate complex relations of the brainstem. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  1. Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid leaks to the middle ear.

    Science.gov (United States)

    Altuna, Xabier; Navarro, Juan José; García, Leire; Ugarte, Ane; Thomas, Izaskun

    Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach. We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). Thirteen patients with spontaneous CSF leak to the middle ear were treated with this approach. The primary and first symptom in all of them was conductive hearing loss. In all cases, the defect or defects were closed in a multilayer manner using muscle, temporalis fascia and cortical bone. Minimum follow-up in this series was 14 months, with successful closure in all but one patient (who required reintervention). We found no intra- or postoperative complications due to the craniotomy, and the audiometry improved and normalised in all cases except for the failed case. The MCF approach with a multilayer closure of the defect is an effective technique for repairing spontaneous CSF leaks to the middle ear and for restoring hearing in these patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  2. Volcanic emissions from soils at the base of La Fossa volcano, Vulcano island, Italy

    Science.gov (United States)

    Obenholzner, J. H.; Parks, J. L.

    2006-12-01

    A top-sealed plastic tube with a diameter of ca. 15 cm had been buried vertically at the base of La Fossa volcano, Volcano island, Italy, next to the front of the obsidian flow. The tube had been filled with quartz wool to condense vapors emanating from the soil. At ca. 75 cm below the surface the sample had been exposed to vapors from Sept. 2005 to April 2006. The leached sample had not been in touch with the ground. Another glass wool cushion (ca. 3 cm thick) had been underneath to minimize capillary effects. Leaching of the quartz wool and ICP-MS analysis documented positive values for: Mg, Al, Si, P, K, Ca, Cr, Mn, Ni, Cu, Zn, Cd, Sn, Pb. Leaching with nitric acid documented also V and Fe. Acid leaching produced higher values for all elements, except K and Sn, than leaching with deionized water. Negative values had been obtained for As, Se, Mo. Influence from soil breathing can be excluded as the active fumaroles contain As and Se. This experiment documents for the first time an unknown element transport by vapors/gases through a volcanic edifice interacting with hydrothermal and magmatic gases. It remains unknown if elements detected are entering the atmosphere or are getting adsorbed onto the volcanic ash soil particles derived from reworked surge beds. This question is very important as soils might be an unknown filter medium to filter volcanically polluted air in case of major volcanic crises. Data can be obtained from the authors.

  3. High-resolution MRI of cranial nerves in posterior fossa at 3.0 T

    Institute of Scientific and Technical Information of China (English)

    Zi-Yi Guo; Jing Chen; Qi-Zhou Liang; Hai-Yan Liao; Qiong-Yue Cheng; Shui-Xi Fu; Cai-Xiang Chen; Dan Yu

    2013-01-01

    Objective:To evaluate the influence of high-resolution imaging obtainable with the higher field strength of3.0T on the visualization of the brain nerves in the posterior fossa.Methods:In total,20 nerves were investigated onMRI of12 volunteers each and selected for comparison, respectively, with theFSE sequences with5 mm and2 mm section thicknesses and gradient recalled echo(GRE) sequences acquired with a3.0-T scanner.TheMR images were evaluated by three independent readers who rated image quality according to depiction of anatomic detail and contrast with use of a rating scale.Results:In general, decrease of the slice thickness showed a significant increase in the detection of nerves as well as in the image quality characteristics. ComparingFSE andGRE imaging, the course of brain nerves and brainstem vessels was visualized best with use of the three-dimensional(3D) pulse sequence.Conclusions:The comparison revealed the clear advantage of a thin section.The increased resolution enabled immediate identification of all brainstem nerves.GRE sequence most distinctly and confidently depicted pertinent structures and enables3D reconstruction to illustrate complex relations of the brainstem.

  4. Metástases intrarraquidianas de glioblastoma multiforme supratentorial da infância: relato de caso Spinal cord metastatic glioblastoma multiforme of childhood: case report

    Directory of Open Access Journals (Sweden)

    Patricia Imperatriz Porto Rondinelli

    2002-09-01

    Full Text Available Relatamos o caso de uma menina de onze anos de idade com glioblastoma multiforme na região têmporo-parietal direita, completamente ressecado cirurgicamente, submetida a radioterapia craniana pós-operatória. Houve recaída três meses após, em topografia distante do sítio primário, na porção caudal do canal raquidiano. Após, ocorreu evolução rápida para o óbito. A propósito desse caso, discutimos nossa experiência quanto à conduta nesses tumores e a literatura sobre o assunto.We report the case of an eleven years-old girl with a right temporo-parietal glioblastoma multiforme. The tumor was totally resected on neurossurgery, and cranial radioteraphy was applied at next. The tumor recurred three months later, far from primary site, in the caudal portion of the spinal canal. Death occurred in less than one month later. Taking into account the data of this case, we discuss our experience in the management of such tumors and the literature on the subject.

  5. Método para registro continuo da pressão intracraniana A method for continuous monitoring of the intracranial pressure

    Directory of Open Access Journals (Sweden)

    Henrique S. Ivamoto

    1975-06-01

    Full Text Available Pacientes com hipertensão intracraniana aguda podem ser melhor manipulados se a pressão intracraniana for constantemente medida. Uma série de 91 pacientes com traumatismos cranio-encefálicos agudos, hemorragia subaracnóidea, encefalite, hemorragia intracerebral, ou intoxicação por monóxido de carbono foi acompanhada usando o interruptor a pressão de Numoto por um método aqui descrito. O principal benefício tem sido o conhecimento do valor da pressão intracraniana a todo momento e a detecção rápida de elevações da pressão. Complicações se limitaram a 3 casos de infecção. Dois deles foram pequenas coleções purulentas no ponto de saída do tubo no couro cabeludo. Um paciente com uma fratura craniana exposta, laceração cerebral e hematoma intracerebral desenvolveu uma infecção da ferida operatoria e abscesso cerebral que requereu drenagem.Patients suffering acute intracranial pressure increases can be more advantageously handled if the intracranial pressure is constantly monitored. 91 patients with acute head injuries, hydrocephalus, cerebral infarction, subarachnoid hemorrhage, encephalitis, intracerebral hemorrhage, or carbon monoxide intoxication have been so monitored by using the Numoto pressure switch by a method herein described. The main advantage has been the knowledge of the level of intracranial pressure at any given time and the early detection of a rising pressure when this phenomenon occurred. There were no complications except for 3 cases of infection. Two of these cases were minor purulent collections only at the site of exit of the tube in the scalp. One patient with a compound wound, cerebral laceration, and intracerebral hematoma developed a wound infection and brain abscess which required drainage.

  6. Quantitative approach to the posterior cranial fossa and craniocervical junction in asymptomatic children with achondroplasia

    International Nuclear Information System (INIS)

    Calandrelli, Rosalinda; Panfili, Marco; D'Apolito, Gabriella; Pedicelli, Alessandro; Colosimo, Cesare; Zampino, Giuseppe; Pilato, Fabio

    2017-01-01

    We propose an magnetic resonance imaging (MRI)-based quantitative morphovolumetric approach to the posterior cranial fossa (PCF) and craniocervical junction (CCJ) changes in achondroplastic patients investigating possible associations with ventriculomegaly and medullary compression. We analyzed MRI of 13 achondroplastic children not treated by surgery. 3D FSPGR T1-weighted images were used to analyze (1) PCF synchondroses; (2) PCF volume (PCFV), PCF brain volume (PCFBV), PCFV/PCFBV ratio, cerebellar volume, cerebrospinal fluid (CSF) spaces volume, and IV ventricle volume; (3) PCF (clivus, supraocciput, exocciput lengths, tentorial angle) and CCJ (AP and LL diameters of foramen magnum (FM)) morphometry; (4) measurements of FM and jugular foramina (JF) areas; and (5) supratentorial ventricular volume. All patients showed synostosis of spheno-occipital synchondroses, eight showed synostosis of intra-occipital synchondroses, nine showed CCJ impingement on the cervical cord but only three had cervical myelopathy. Compared to controls, clivus and exocciput lengths, LL and AP diameters of FM, FM area and JF area were significantly reduced, supraocciput length, tentorial angle, PCFV, PCFBV, cerebellar volume, supratentorial ventricular system volume were significantly increased. A correlation was found between clivus length and supratentorial ventricular volume, premature closure of intra-occipital synchondroses and FM area while a trend was found between FM area and supraocciput length. Our analysis demonstrates a relationship between the shortening of the clivus and the ventriculomegaly. On the other hand the premature closure of PCF synchondroses, the shape, and the growth direction of supraocciput bone contribute to reduce the FM area, causing in some patients medullary compression. (orig.)

  7. Quantitative approach to the posterior cranial fossa and craniocervical junction in asymptomatic children with achondroplasia

    Energy Technology Data Exchange (ETDEWEB)

    Calandrelli, Rosalinda; Panfili, Marco; D' Apolito, Gabriella; Pedicelli, Alessandro; Colosimo, Cesare [Fondazione Policlinico Universitario Agostino Gemelli, Univ. Cattolica del Sacro Cuore, Area Diagnostica per Immagini, Roma (Italy); Zampino, Giuseppe [Fondazione Policlinico Universitario Agostino Gemelli, Univ. Cattolica del Sacro Cuore, Area Salute del Bambino, Roma (Italy); Pilato, Fabio [Fondazione Policlinico Universitario Agostino Gemelli, Univ. Cattolica del Sacro Cuore, Area Neuroscienze, Roma (Italy)

    2017-10-15

    We propose an magnetic resonance imaging (MRI)-based quantitative morphovolumetric approach to the posterior cranial fossa (PCF) and craniocervical junction (CCJ) changes in achondroplastic patients investigating possible associations with ventriculomegaly and medullary compression. We analyzed MRI of 13 achondroplastic children not treated by surgery. 3D FSPGR T1-weighted images were used to analyze (1) PCF synchondroses; (2) PCF volume (PCFV), PCF brain volume (PCFBV), PCFV/PCFBV ratio, cerebellar volume, cerebrospinal fluid (CSF) spaces volume, and IV ventricle volume; (3) PCF (clivus, supraocciput, exocciput lengths, tentorial angle) and CCJ (AP and LL diameters of foramen magnum (FM)) morphometry; (4) measurements of FM and jugular foramina (JF) areas; and (5) supratentorial ventricular volume. All patients showed synostosis of spheno-occipital synchondroses, eight showed synostosis of intra-occipital synchondroses, nine showed CCJ impingement on the cervical cord but only three had cervical myelopathy. Compared to controls, clivus and exocciput lengths, LL and AP diameters of FM, FM area and JF area were significantly reduced, supraocciput length, tentorial angle, PCFV, PCFBV, cerebellar volume, supratentorial ventricular system volume were significantly increased. A correlation was found between clivus length and supratentorial ventricular volume, premature closure of intra-occipital synchondroses and FM area while a trend was found between FM area and supraocciput length. Our analysis demonstrates a relationship between the shortening of the clivus and the ventriculomegaly. On the other hand the premature closure of PCF synchondroses, the shape, and the growth direction of supraocciput bone contribute to reduce the FM area, causing in some patients medullary compression. (orig.)

  8. Shallow radar (SHARAD) sounding observations of the Medusae Fossae Formation, Mars

    Science.gov (United States)

    Carter, L.M.; Campbell, B.A.; Watters, T.R.; Phillips, R.J.; Putzig, N.E.; Safaeinili, A.; Plaut, J.J.; Okubo, C.H.; Egan, A.F.; Seu, R.; Biccari, D.; Orosei, R.

    2009-01-01

    The SHARAD (shallow radar) sounding radar on the Mars Reconnaissance Orbiter detects subsurface reflections in the eastern and western parts of the Medusae Fossae Formation (MFF). The radar waves penetrate up to 580 m of the MFF and detect clear subsurface interfaces in two locations: west MFF between 150 and 155?? E and east MFF between 209 and 213?? E. Analysis of SHARAD radargrams suggests that the real part of the permittivity is ???3.0, which falls within the range of permittivity values inferred from MARSIS data for thicker parts of the MFF. The SHARAD data cannot uniquely determine the composition of the MFF material, but the low permittivity implies that the upper few hundred meters of the MFF material has a high porosity. One possibility is that the MFF is comprised of low-density welded or interlocked pyroclastic deposits that are capable of sustaining the steep-sided yardangs and ridges seen in imagery. The SHARAD surface echo power across the MFF is low relative to typical martian plains, and completely disappears in parts of the east MFF that correspond to the radar-dark Stealth region. These areas are extremely rough at centimeter to meter scales, and the lack of echo power is most likely due to a combination of surface roughness and a low near-surface permittivity that reduces the echo strength from any locally flat regions. There is also no radar evidence for internal layering in any of the SHARAD data for the MFF, despite the fact that tens-of-meters scale layering is apparent in infrared and visible wavelength images of nearby areas. These interfaces may not be detected in SHARAD data if their permittivity contrasts are low, or if the layers are discontinuous. The lack of closely spaced internal radar reflectors suggests that the MFF is not an equatorial analog to the current martian polar deposits, which show clear evidence of multiple internal layers in SHARAD data. ?? 2008 Elsevier Inc.

  9. Retrospective comparison of three-dimensional imaging sequences in the visualization of posterior fossa cranial nerves.

    Science.gov (United States)

    Ors, Suna; Inci, Ercan; Turkay, Rustu; Kokurcan, Atilla; Hocaoglu, Elif

    2017-12-01

    To compare efficancy of three-dimentional SPACE (sampling perfection with application-optimized contrasts using different flip-angle evolutions) and CISS (constructive interference in steady state) sequences in the imaging of the cisternal segments of cranial nerves V-XII. Temporal MRI scans from 50 patients (F:M ratio, 27:23; mean age, 44.5±15.9 years) admitted to our hospital with vertigo, tinnitus, and hearing loss were retrospectively analyzed. All patients had both CISS and SPACE sequences. Quantitative analysis of SPACE and CISS sequences was performed by measuring the ventricle-to-parenchyma contrast-to-noise ratio (CNR). Qualitative analysis of differences in visualization capability, image quality, and severity of artifacts was also conducted. A score ranging 'no artefact' to 'severe artefacts and unreadable' was used for the assessment of artifacts and from 'not visualized' to 'completely visualized' for the assesment of image quality, respectively. The distribution of variables was controlled by the Kolmogorov-Smirnov test. Samples t-test and McNemar's test were used to determine statistical significance. Rates of visualization of posterior fossa cranial nerves in cases of complete visualization were as follows: nerve V (100% for both sequences), nerve VI (94% in SPACE, 86% in CISS sequences), nerves VII-VIII (100% for both sequences), IX-XI nerve complex (96%, 88%); nerve XII (58%, 46%) (p<0.05). SPACE sequences showed fewer artifacts than CISS sequences (p<0.002). Copyright © 2017 Elsevier B.V. All rights reserved.

  10. [Teratoma of the rhinopharynx and the infratemporal fossa in neonates: report of 3 cases].

    Science.gov (United States)

    Benlyazid, A; Lescanne, E; Marque, A; Robier, A; Beutter, P; Ployet, M J

    2001-02-01

    Teratomas are tumors which develop in childhood or early adulthood, generally in the gonads. More rarely these tumors may be found in an axial localization, notably in cervicofacial forms. We report three cases of teratomas observed in rhinopharynx of three neonates operated at the Clocheville General Hospital. We present the main anatomoclinical features of these tumors, focusing on the cervicofacial forms in neonates. All three cases occurred in female neonates presenting acute dyspnea within the first hours of life, requiring intubation in two cases. The first two tumors invaded the infratemoral region and the third was a pediculated tumor of the velum exteriorized via the mouth. In one case antenatal ultrasound had suggested the diagnosis of a right temporomaxillary tumor. Rapid excision of the rhinopharngyeal component allow extubation for the two intubated infants and pathology diagnosis. In the first infant operated at 2 months, the lateral route was adapted to age, with mandibulotomy with section of the coronoid process but preserving the mandibular condyle. The second infant was operated at the age of 3 weeks using a wide frontotemporoperitonial approach then at the age of 3.5 months for recurrence extending to the floor of the temporal fossa and the middle ear. A type C infratemporal approach was used with lost-bone temporal craniectomy. Per-buccal excision was possible in the third infant with resection at the base of implantation. No recurrence has been observed in the first two cases at 3.5 and 2.5 months follow-up in the first two cases. The third infant was lost to follow-up.

  11. The acetabular fossa hot spot on {sup 18}F-FDG PET/CT: epidemiology, natural history, and proposed etiology

    Energy Technology Data Exchange (ETDEWEB)

    Kubicki, Shelby L. [Trinity University, San Antonio, TX (United States); Richardson, Michael L. [University of Washington, Department of Radiology, Seattle, WA (United States); Martin, Thomas [X-Ray Associates of New Mexico, Department of Radiology, Albuquerque, NM (United States); Rohren, Eric [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Nuclear Medicine, Houston, TX (United States); Wei, Wei [The University of Texas M.D. Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States); Amini, Behrang [The University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, Houston, TX (United States)

    2015-01-15

    To describe a benign focus of increased activity in the acetabular fossa (the acetabular fossa hot spot, AFHS) on {sup 18}F-FDG PET/CT that can mimic a neoplasm. {sup 18}F-FDG PET/CT images from four patient populations were examined. Group 1 (n = 13) was collected from a search of radiology reports and used to define the AFHS and for hypothesis generation. Group 2 (n = 1,150) was used for prevalence of AFHS. Group 3 (n = 1,213) had PET/CT and MRI pelvis within a week of each other and was used to correlate metabolic and anatomic findings. Group 4 (n = 100) was used to generate the control group. Data were collected on demographics, common comorbidities, underlying cancer diagnosis and status, and hip symptoms. Prevalence of AFHS was 0.36 % (95 % CI 0.10-0.91 %). None progressed to malignancy or was associated with cancer status. The majority (71 %) were on the left, and 6 % were bilateral. Mean SUV{sub max} of the AFHS was 4.8 (range, 2.7-7.8). Male patients were more likely to have the AFHS (OR = 8.69, 95 % CI 1.88-40.13). There was no difference with respect to other collected data, including hip symptoms. Average minimum duration of AFHS was 346 days (range, 50-1,010 days). Readers did not detect corresponding hip abnormalities on MRIs. AFHS is a benign finding that may be caused by subclinical ligamentum teres injury, focal synovitis, or degeneration of acetabular fossa fat. Despite uncertainty regarding its etiology, recognition of AFHS as a benign finding can prevent morbidity associated with unnecessary biopsy or initiation of therapy. (orig.)

  12. Middle cranial fossa approach to repair tegmen defects assisted by three-dimensionally printed temporal bone models.

    Science.gov (United States)

    Ahmed, Sameer; VanKoevering, Kyle K; Kline, Stephanie; Green, Glenn E; Arts, H Alexander

    2017-10-01

    To explore the perioperative utility of three-dimensionally (3D)-printed temporal bone models of patients undergoing repair of lateral skull base defects and spontaneous cerebrospinal fluid leaks with the middle cranial fossa approach. Case series. 3D-printed temporal bone models-based on patient-specific, high-resolution computed tomographic imaging-were constructed using inexpensive polymer materials. Preoperatively, the models demonstrated the extent of temporal lobe retraction necessary to visualize the proposed defects in the lateral skull base. Also preoperatively, Silastic sheeting was arranged across the modeled tegmen, marked, and cut to cover all of the proposed defect sites. The Silastic sheeting was then sterilized and subsequently served as a precise intraoperative template for a synthetic dural replacement graft. Of note, these grafts were customized without needing to retract the temporal lobe. Five patients underwent the middle cranial fossa approach assisted by 3D-printed temporal bone models to repair tegmen defects and spontaneous cerebrospinal fluid leaks. No complications were encountered. The prefabricated dural repair grafts were easily placed and fit precisely onto the middle fossa floor without any additional modifications. All defects were covered as predicted by the 3D temporal bone models. At their postoperative visits, all five patients maintained resolution of their spontaneous cerebrospinal fluid leaks. Inexpensive 3D-printed temporal bone models of tegmen defects can serve as beneficial adjuncts during lateral skull base repair. The models provide a panoramic preoperative view of all tegmen defects and allow for custom templating of dural grafts without temporal lobe retraction. 4 Laryngoscope, 127:2347-2351, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa. Follow-up study with computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, S; Kurihara, M; Mori, K [Nagasaki Univ. (Japan). School of Medicine; Amamoto, Y

    1981-02-01

    This is a report of case with the extracerebral cavernous hemangioma in the middle fossa in which total removal was carried out after radiotherapy. Follow-up study with computed tomography during and after irradiation are presented. A 44-year-old house-wife complained of a decreased vision of the both eyes and paresis of the left upper and lower limbs. CT scan revealed a slightly high density area in the right middle cranial fossa which was markedly enhanced with contrast media. Right carotid angio-graphy demonstrated a large avascular mass in the right middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. An attempt to total removal of the tumor had failed to succeed because of extensive hemorrhage from the tumor. Histological examination revealed a cavernous hemangioma. Irradiation with a total dose of 5000 rads was delivered. After irradiation CT scan revealed a marked decrease of size and EMI number of the tumor. At this stage, hypervascular mass lesion with feeding arteries was noted in conventional angiography. Tumor stain in prolonged injection angiography was also visualized. In the second operation, removal of the tumor was performed without any difficulty and hemorrhage was controlled easily by electrocoagulation. Histology revealed a marked narrowing of vessels with an increase in the connective tissues. In the central part of specimen, there noted findings of coagulation necrosis, intraluminal thrombus formations and so on, which were attributed to the influence of radiation. It is concluded that in case of an extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3000 - 5000 rads was a method of choice. The treatment results in an increase of probability of total removal of the tumor.

  14. Appearance of the fetal posterior fossa at 11 + 3 to 13 + 6 gestational weeks on transabdominal ultrasound examination.

    Science.gov (United States)

    Egle, D; Strobl, I; Weiskopf-Schwendinger, V; Grubinger, E; Kraxner, F; Mutz-Dehbalaie, I S; Strasak, A; Scheier, M

    2011-12-01

    To describe the sonographic appearance of the structures of the posterior cranial fossa in fetuses at 11 + 3 to 13 + 6 weeks of pregnancy and to determine whether abnormal findings of the brain and spine can be detected by sonography at this time. This was a prospective study including 692 fetuses whose mothers attended Innsbruck Medical University Hospital for first-trimester sonography. In 3% (n = 21) of cases, measurement was prevented by fetal position. Of the remaining 671 cases, in 604 there was either a normal anomaly scan at 20 weeks or delivery of a healthy child and in these cases the transcerebellar diameter (TCD) and the anteroposterior diameter of the cisterna magna (CM), measured at 11 + 3 to 13 + 6 weeks, were analyzed. In 502 fetuses, the anteroposterior diameter of the fourth ventricle (4V) was also measured. In 25 fetuses, intra- and interobserver repeatability was calculated. We observed a linear correlation between crown-rump length (CRL) and CM (CM = 0.0536 × CRL - 1.4701; R2 = 0.688), TCD (TCD = 0.1482 × CRL - 1.2083; R2 = 0.701) and 4V (4V = 0.0181 × CRL + 0.9186; R2 = 0.118). In three patients with posterior fossa cysts, measurements significantly exceeded the reference values. One fetus with spina bifida had an obliterated CM and the posterior border of the 4V could not be visualized. Transabdominal sonographic assessment of the posterior fossa is feasible in the first trimester. Measurements of the 4V, the CM and the TCD performed at this time are reliable. The established reference values assist in detecting fetal anomalies. However, findings must be interpreted carefully, as some supposed malformations might be merely delayed development of brain structures. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

  15. Survival of very young children with medulloblastoma (primitive neuroectodermal tumor of the posterior fossa) treated with craniospinal irradiation

    International Nuclear Information System (INIS)

    Saran, Frank H.; Driever, Pablo Herniz; Thilmann, Christoph; Mose, Stephan; Wilson, Paula; Sharpe, Geoff; Adamietz, Irenaeus A.; Boettcher, Heinz D.

    1998-01-01

    Purpose: Very young children with medulloblastoma are considered to have a worse prognosis than older children. As radiotherapy remains an important part of the treatment, the adverse prognosis could be due to inadequate radiation treatment rather than biological factors. We analyzed the published literature to examine the impact of radiotherapy on survival in this group. Methods and Materials: A Medline search was performed and we reviewed studies of treatment of medulloblastoma where radiotherapy was delivered using megavoltage equipment and the minimum follow-up allowed the calculation of 5-year survival rates. Results: Thirty-nine studies were published between 1979 and 1996 with a treatment including craniospinal irradiation and boost to the posterior fossa. Eleven studies comprising 1366 patients analyzed survival by age at diagnosis. Eight of 11 studies showed a worse 5-year survival for the younger patient group which reached statistical significance in two. There is also a suggestion of a higher proportion of children with metastatic disease at presentation in the very young age group. The usual policy in younger children was to give a lower dose of radiotherapy to the craniospinal axis (CSA) and posterior fossa (PF) with reduction of dose in the range of 15 to 25% compared to standard treatment. As dose reduction to the posterior fossa is associated with worse survival and local recurrence is the predominant site of failure, the major determinant of worse survival in very young children with medulloblastoma may be suboptimal radiotherapy. Protocols including postoperative chemotherapy with delayed, omitted, or only local tumor irradiation do not reach survival rates of protocols with standard radiotherapy, also suggesting a continued importance for irradiation. Conclusion: Very young children with medulloblastoma have a worse prognosis than older children. Inadequate radiation dose and technique to the primary tumor region may be a major contributing

  16. Comparative Morphology and Histology of the Nasal Fossa in Four Mammals: Gray Squirrel, Bobcat, Coyote, and White-Tailed Deer.

    Science.gov (United States)

    Yee, Karen K; Craven, Brent A; Wysocki, Charles J; Van Valkenburgh, Blaire

    2016-07-01

    Although the anatomy of the nasal fossa is broadly similar among terrestrial mammals, differences are evident in the intricacies of nasal turbinal architecture, which varies from simple scroll-like to complex branching forms, and in the extent of nonsensory and olfactory epithelium covering the turbinals. In this study, detailed morphological and immunohistochemical examinations and quantitative measurements of the turbinals and epithelial lining of the nasal fossa were conducted in an array of species that include the gray squirrel, bobcat, coyote, and white-tailed deer. Results show that much more of the nose is lined with olfactory epithelium in the smallest species (gray squirrel) than in the larger species. In two species with similar body masses, bobcat and coyote, the foreshortened felid snout influences turbinal size and results in a decrease of olfactory epithelium on the ethmoturbinals relative to the longer canine snout. Ethmoturbinal surface area exceeds that of the maxilloturbinals in all four sampled animals, except the white-tailed deer, in which the two are similar in size. Combining our results with published data from a broader array of mammalian noses, it is apparent that olfactory epithelial surface area is influenced by body mass, but is also affected by aspects of life history, such as diet and habitat, as well as skull morphology, itself a product of multiple compromises between various functions, such as feeding, vision, and cognition. The results of this study warrant further examination of other mammalian noses to broaden our evolutionary understanding of nasal fossa anatomy. Anat Rec, 299:840-852, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  17. Spinal level of myelomeningocele lesion as a contributing factor in posterior fossa volume, intracranial cerebellar volume, and cerebellar ectopia.

    LENUS (Irish Health Repository)

    Sweeney, Kieron J

    2013-02-01

    McLone and Knepper\\'s unified theory of Chiari malformation Type II (CM-II) describes how the loss of CSF via the open posterior neuropore fails to create adequate distending pressure for the developing rhomboencephalic vesicle. The authors of the present article describe the relationship between the posterior fossa volume and intracranial cerebellar volume as being related to the distance from the obex of the fourth ventricle to the myelomeningocele lesion using a common mathematical model, the Hagen-Poiseuille law.

  18. Extradural haematoma of the posterior fossa: a report of eight cases and a review of the literature

    International Nuclear Information System (INIS)

    Brambilla, G.; Rainoldi, F.; Gipponi, D.; Paoletti, P.

    1986-01-01

    The authors review the literature and present 8 cases of extradural haematoma of the posterior fossa operated from 1979 to 1985 at the Neurosurgical Clinic of the University of Pavia. Emphasis is placed on the importance of an early diagnosis of the symptoms which are often ignored due to the absence of specific clinical signs. The authors recognize a substantial improvement in results because of the recent introduction of CT scanning facilities which permit an early and precise diagnosis of this traumatic pathology. (Author)

  19. [Ultrasound measurement of fetal posterior fossa at 11 to 13⁺⁶ gestational weeks for screening open spina bifida].

    Science.gov (United States)

    Qin, Feng-Zhen; Li, Sheng-Li; Wen, Hua-Xuan; Ouyang, Yu-Rong; Zheng, Qiong; Bi, Jing-Ru

    2014-06-01

    To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13⁺⁶ gestational weeks and explore their clinical value in screening open spina bifida (OSB). Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13⁺⁶ weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges. In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL; the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1. The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to fourth ventrical

  20. Cisto dermóide cerebelar

    Directory of Open Access Journals (Sweden)

    Walter Pereira

    1964-06-01

    Full Text Available Os autores relatam um caso de cisto dermóide cerebelar, único encontrado entre 513 tumores intracranianos operados de janeiro de 1945 a março de 1963, confirmando sua raridade. Tratava-se de criança que apresentava síndrome de hipertensão intracraniana e quadro cerebelar instalados dois meses antes da internação. Os exames complementares levaram ao diagnóstico provável de meduloblastoma cerebelar. Foi feita a abertura da lâmina terminal para aliviar a hipertensão intracraniana e, ulteriormente, cobaltoterapia visando a fossa poterior. Com estas medidas houve apenas discreta melhora do quadro de hipertensão intracraniana, não se alterando o quadro cerebelar. Cogitava-se da intervenção direta na fossa craniana posterior quando ocorreu osteomielite do retalho da craniotomia frontal. O osso contaminado foi retirado, seguindo-se a esta intervenção hipertermia acentuada e convulsões generalizadas, vindo a paciente a falecer. A necropsia mostrou, além de meningite purulenta, a existência de cisto dermóide cerebelar direito, contendo grande quantidade de substância sebácea e alguns pêlos. O exame histopatológico confirmou o diagnóstico microscópico, mostrando tratar-se de tecidos derivados do ectoderma e do mesoderma.

  1. Naso-ethmoid schwannoma with intracranial extension: case report Schwannoma naso-etmoidal com extensão intracraniana: relato de caso

    Directory of Open Access Journals (Sweden)

    Mario G. Siqueira

    2001-06-01

    Full Text Available Intranasal schwannomas are rare lesions, specially when they present with an intracranial extension. The fifth case in the medical literature of a naso-ethmoid schwannoma with extension into the anterior cranial fossa is presented. The magnetic resonance findings and the details of the combined intracranial / transfacial operative approach used are described. The possible origin and the clinical characteristics of this rare lesion are reviewed.Schwannomas intranasais são lesões raras, principalmente quando apresentam um extensão intracraniana. Estamos apresentando o quinto caso da literatura médica de um schwannoma naso-etmoidal com extensão para o interior da fossa craniana anterior. São descritos os achados da ressonância magnética e os detalhes da via de acesso cirúrgico combinada intracraniana/transfacial. A possível origem e as características clínicas dessa lesaõ rara são revistas.

  2. Long-term quality of life in children treated for posterior fossa brain tumors.

    Science.gov (United States)

    Kulkarni, Abhaya V; Piscione, Janine; Shams, Iffat; Bouffet, Eric

    2013-09-01

    In the face of increasing survival, quality of life (QOL) has become an important indicator of treatment success in children with posterior fossa brain tumors (PFBTs). The authors' objective was to assess the long-term QOL in survivors of PFBT. The authors conducted a cross-sectional study of children who, between birth and age 18 years at diagnosis, had previously been treated at their institution for a PFBT. At the time of assessment for this study, children were between 5 and 19 years old and had received standard treatment for PFBT ending at least 6 months before the assessment. The QOL was measured with the Pediatric Quality of Life Inventory (PedsQL) generic score scales and the Health Utilities Index Mark 3 (HUI3). Multivariate analyses were used to assess several variables (patient related, treatment related, and socioeconomic) for association with QOL. A total of 62 children participated in the study (median age at assessment 11.9 years, interquartile range [IQR] 7.8-14.8, and median age at tumor diagnosis of 4.9 years, IQR 2.5-6.9). Median time since active treatment for their PFBT was 5.2 years (IQR 2.4-10.1). Tumor types included cerebellar pilocytic astrocytoma (45.2%), medulloblastoma (30.6%), ependymoma (11.3%), and brainstem astrocytoma (11.3%). Adjuvant therapy included chemotherapy (40.3%) or radiotherapy (14.5% focal and 21.0% craniospinal radiotherapy). Permanent treatment for hydrocephalus was required in 38.7% of the patients. Tumors recurred in 11.3%, requiring repeat treatment in these patients. The median HUI3 utility score was 0.91 (IQR 0.71-1.00) and the median PedsQL total score was 78.3 (IQR 64.1-92.4). Only the following variables were significantly associated with decreased QOL in multivariable model testing (all p size, decreased family functioning, and lower family income. As a group, long-term survivors of pediatric PFBT appear to have QOL indicators that are similar to those of the general population, although a reasonable

  3. Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

    Science.gov (United States)

    Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

    2009-08-01

    Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

  4. Síndrome de gerstmann de desenvolvimento associada a neoplasia cerebelar: relato de um caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Lineu César Werneck

    1975-03-01

    Full Text Available É relatado um caso de síndrome de Gerstmann de Desenvolvimento, que apresentava acalculia, agrafía, confusão direita-esquerda, agnosia de dedos e apraxia construcional, em um menino de 7 anos. O tratamento inicial com metilfenidato determinou bons resultados no que concerne à hiperatividade, à atenção e à apraxia construcional. Durante o curso clínico, o paciente apresentou sintomatologia cerebelar, hipertensão intracraniana, tendo sido feita intervenção cirúrgica na fossa posterior, sendo excisado um meduloblastoma de cerebelo. O autor acredita que é esta a primeira descrição na literatura da concomitância da síndrome de Gerstmann de Desenvolvimento e neoplasia de fossa posterior. São feitos comentários focalizando cada um dos aspectos clínicos, fatores etiológicos e topográficos.

  5. Diagnosis of small posterior fossa stroke on brain CT: effect of iterative reconstruction designed for brain CT on detection performance

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Taihei; Yoshida, Morikatsu; Yokoyama, Koichi [Amakusa Medical Center, Department of Radiology, Amakusa, Kumamoto (Japan); Nakaura, Takeshi; Hirata, Kenichiro; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto (Japan); Harada, Kazunori [Amakusa Medical Center, Department of Surgery, Kumamoto (Japan)

    2017-09-15

    In this study, we aimed to determine whether iterative model reconstruction designed for brain CT (IMR-neuro) would improve the accuracy of posterior fossa stroke diagnosis on brain CT. We enrolled 37 patients with ischaemic stroke in the posterior fossa and 37 patients without stroke (controls). Using axial images reconstructed using filtered back-projection (FBP) and IMR-neuro, we compared the CT numbers in infarcted areas, image noise in the pons, and contrast-to-noise ratios (CNRs) of infarcted and non-infarcted areas on scans subjected to IMR-neuro and FBP. To analyse the performance of hypo-attenuation detection, we used receiver-operating characteristic (ROC) curve techniques. The image noise was significantly lower (2.2 ± 0.5 vs. 5.1 ± 0.9 Hounsfield units, p < 0.01) and the difference in CNR between the infarcted and non-infarcted areas was significantly higher with IMR-neuro than with FBP (2.2 ± 1.7 vs. 4.0 ± 3.6, p < 0.01). Furthermore, the average area under the ROC curve was significantly higher with IMR-neuro (0.90 vs. 0.86 for FBP, p = 0.04). IMR-neuro yielded better image quality and improved hypo-attenuation detection in patients with ischaemic stroke. (orig.)

  6. Fluvio geomorphic set-up of Noctis Fossae in Noctis Labyrinthus of Syria-Planum Provenance, Mars

    Science.gov (United States)

    Chavan, A. A.; Bhandari, S.

    2017-12-01

    The modern era of planetary exploration has revealed fluvial or fluvial like landforms on the extraterrestrial surfaces of planets and moons of our solar system. This has posed as interesting challenges for advancing our fundamental understanding of fluvial processes and their associated landforms on the planetary surfaces especially on Mars. It has been recognized through earlier studies that the channels and valleys are extensively dissected on Mars. The Valleys are low lying, elongate troughs surrounded by elevated topography. Moreover, valley networks on Mars are the most noticeable features attesting that different geological processes and possibly climatic conditions prevailed in the past and played a vital role in formulating the Martian topography. Channel incisions which are a domino effect both tectonic and surface runoff and groundwater sapping. The components of surface runoff have been deciphered with the help of morphometric exercises. Further, the geomorphological studies of these landforms are critical in understanding the regional tectonics. The present work is an assessment of Fluvio geomorphic set-up of Noctis Fossae in Noctis Labyrinthus of Syria-Planum Provenance, Mars. This study focuses on the fluvio geomorphology of the southern highlands (00 to 400S to 850-1200W) to determine how these features were formed, which process formed these valleys and includes the probable causes resulting into the development of the topography. Keywords: Noctis Fossae; Noctis Labyrinthus; Syria Planum; Mars

  7. Anterolateral corridor approach to the infratemporal fossa and central skull base in maxillectomy: rationale and technical aspects.

    Science.gov (United States)

    McMahon, Jeremy D; Crowther, John; Taylor, William M; Wong, Ling Siew; Paterson, Tom; Devine, John; Wales, Craig; MacIver, Colin

    2015-11-01

    We describe the technical aspects and report our clinical experience of a surgical approach to the infratemporal fossa that aims to reduce local recurrence after operations for cancer of the posterior maxilla. We tested the technique by operating on 3 cadavers and then used the approach in 16 patients who had posterolateral maxillectomy for disease that arose on the maxillary alveolus or junction of the hard and soft palate (maxillary group), and in 19 who had resection of the masticatory compartment and central skull base for advanced sinonasal cancer (sinonasal group). Early proximal ligation of the maxillary artery was achieved in all but one of the 35 patients. Access to the infratemporal fossa enabled division of the pterygoid muscles and pterygoid processes under direct vision in all cases. No patient in the maxillary group had local recurrence at median follow up of 36 months. Four patients (21%) in the sinonasal group had local recurrence at median follow up of 27 months. Secondary haemorrhage from the cavernous segment of the internal carotid artery resulted in the only perioperative death. The anterolateral corridor approach enables controlled resection of tumours that extend into the masticatory compartment. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Woo; Cho, Jae Ho; Jang, Han Won; Kim, Dong Sug; Moon, Gi Hak [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

    2004-08-01

    Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed.

  9. Diagnosis of small posterior fossa stroke on brain CT: effect of iterative reconstruction designed for brain CT on detection performance

    International Nuclear Information System (INIS)

    Inoue, Taihei; Yoshida, Morikatsu; Yokoyama, Koichi; Nakaura, Takeshi; Hirata, Kenichiro; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Yamashita, Yasuyuki; Harada, Kazunori

    2017-01-01

    In this study, we aimed to determine whether iterative model reconstruction designed for brain CT (IMR-neuro) would improve the accuracy of posterior fossa stroke diagnosis on brain CT. We enrolled 37 patients with ischaemic stroke in the posterior fossa and 37 patients without stroke (controls). Using axial images reconstructed using filtered back-projection (FBP) and IMR-neuro, we compared the CT numbers in infarcted areas, image noise in the pons, and contrast-to-noise ratios (CNRs) of infarcted and non-infarcted areas on scans subjected to IMR-neuro and FBP. To analyse the performance of hypo-attenuation detection, we used receiver-operating characteristic (ROC) curve techniques. The image noise was significantly lower (2.2 ± 0.5 vs. 5.1 ± 0.9 Hounsfield units, p < 0.01) and the difference in CNR between the infarcted and non-infarcted areas was significantly higher with IMR-neuro than with FBP (2.2 ± 1.7 vs. 4.0 ± 3.6, p < 0.01). Furthermore, the average area under the ROC curve was significantly higher with IMR-neuro (0.90 vs. 0.86 for FBP, p = 0.04). IMR-neuro yielded better image quality and improved hypo-attenuation detection in patients with ischaemic stroke. (orig.)

  10. Evaluation of Pneumatization in the Articular Eminence and Roof of the Glenoid Fossa with Cone-Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Mehmet İlgüy

    2015-03-01

    Full Text Available Background: Detection of air cavities, so called pneumatizations, nearby to the temporomandibular joint (TMJ area is important, as they represent sites of minimal resistance and facilitate the spread of various pathologies into the joint as inflammation, tumor or fractures and serve as a possible complicating factor in TMJ surgery. Aims: To determine the prevalence of pneumatization of the articular eminence (PAT and roof of the glenoid fossa (PRGF using cone-beam computed tomography (CBCT. Study Design: Cross-sectional study. Methods: Acquired images of 111 patients (222 TMJs were evaluated. The presence of pneumatization was recorded at the articular eminence and roof of the glenoid fossa. Age and gender were recorded for all patients and type (unilocular or multilocular and laterality were noted for the cases of pneumatization. Results: The mean age of the study group was 48.86±18.31 years. Among all the patients, 73 (65.8% had PAT, while 13 (11.7% had PRGF. Forty-two (37.8% of the patients had PAT bilaterally; whereas 3 of them (2.7% presented PRGF bilaterally. The percentage of PAT was higher for females (73.6% than males (51.3% (p<0.05. Conclusion: CBCT images are an accurate and reliable means of detection of the exact size and type of pneumatization and the relationship of pneumatization to the adjacent tissues. This is especially significant before a surgical intervention is planned in this region, in order to make a sound diagnosis.

  11. Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report

    International Nuclear Information System (INIS)

    Lee, Seung Woo; Cho, Jae Ho; Jang, Han Won; Kim, Dong Sug; Moon, Gi Hak

    2004-01-01

    Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed

  12. Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?

    International Nuclear Information System (INIS)

    Fukunaga-Johnson, Nina; Lee, Jason H.; Robertson, Patricia; Sandler, Howard M.; McNeil, Elizabeth; Goldwein, Joel W.

    1997-01-01

    Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard post-operative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed, or outside the tumor bed but still within the PF. With improved diagnostic imaging, better definition of tumor volumes, and the use of 3D conformal therapy, we may be able to restrict the boost volume to the tumor bed plus a margin without compromising local control. This retrospective study analyzes the patterns of failure within the PF of a series of patients treated with radiation therapy (RT). Methods: From (7(86)) through (2(96)), 27 of 114 (24%) patients > 18 mo and < 18 yr with medulloblastoma, who were treated at the University of Michigan and Children's Hospital of Philadelphia, with RT following surgical resection were found to have a recurrence. RT consisted of CSRT followed by a boost to the entire posterior fossa. Patient's preoperative MRI and/or CT studies were used to compare the original tumor volume with the specific region of local relapse. Failure was defined as MRI or CT evidence of recurrence or positive cerebrospinal fluid cytology. Relapse was scored as local, if it was within the original tumor bed and regional, if it was outside of the tumor bed but still within the PF. Results: The median age of the patients was 8.6 years. Three patients were < 3 years old. (21(27)) had disease localized to the PF. (19(21)) patients received chemotherapy during their treatment regimen; 6 patients did not have information on systemic treatment. The median dose of RT to the craniospinal axis was 32.5 Gy and to the PF was 55.2 Gy. The median time to recurrence was 19.5 months. Local failure within the tumor bed as any component of first failure occurred in 52% ((14(27))) of all failures but

  13. Uma proposta de utilização de material manipulativo no aprendizado da função exponencial.

    OpenAIRE

    Ricardo Antonio Faustino da Silva Braz

    2006-01-01

    Neste trabalho temos como objetivo geral investigar o uso de material manipulativo no aprendizado da função exponencial, como proposta. Como orientação teórica, temos as pesquisas da professora Josinalva Estacio Menezes, os trabalhos do professor John Andrew Fossa e ainda as contribuições dos trabalhos de Brousseau e Lima, que serviram como apoio ao indicarem suas propostas metodológicas para possíveis superações de uso do referido recurso na sala de aula, como também apontaram literaturas...

  14. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations

    International Nuclear Information System (INIS)

    Guzinski, Maciej; Waszczuk, Lukasz; Sasiadek, Marek J.

    2016-01-01

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. (orig.)

  15. Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images

    International Nuclear Information System (INIS)

    Carrilho, Paulo Eduardo Mestrinelli; Alves, Orival

    2006-01-01

    We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

  16. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations

    Energy Technology Data Exchange (ETDEWEB)

    Guzinski, Maciej; Waszczuk, Lukasz; Sasiadek, Marek J. [Wroclaw Medical University, Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw (Poland)

    2016-10-15

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. (orig.)

  17. Head CT: Image quality improvement of posterior fossa and radiation dose reduction with ASiR - comparative studies of CT head examinations.

    Science.gov (United States)

    Guziński, Maciej; Waszczuk, Łukasz; Sąsiadek, Marek J

    2016-10-01

    To evaluate head CT protocol developed to improve visibility of the brainstem and cerebellum, lower bone-related artefacts in the posterior fossa and maintain patient radioprotection. A paired comparison of head CT performed without Adaptive Statistical Iterative Reconstruction (ASiR) and a clinically indicated follow-up with 40 % ASiR was acquired in one group of 55 patients. Patients were scanned in the axial mode with different scanner settings for the brain and the posterior fossa. Objective image quality analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality analysis was based on brain structure visibility and evaluation of the artefacts. We achieved 19 % reduction of total DLP and significantly better image quality of posterior fossa structures. SNR for white and grey matter in the cerebellum were 34 % to 36 % higher, respectively, CNR was improved by 142 % and subjective analyses were better for images with ASiR. When imaging parameters are set independently for the brain and the posterior fossa imaging, ASiR has a great potential to improve CT performance: image quality of the brainstem and cerebellum is improved, and radiation dose for the brain as well as total radiation dose are reduced. •With ASiR it is possible to lower radiation dose or improve image quality •Sequentional imaging allows setting scan parameters for brain and posterior-fossa independently •We improved visibility of brainstem structures and decreased radiation dose •Total radiation dose (DLP) was decreased by 19.

  18. Deep Venous Reflux Associated with a Dilated Popliteal Fossa Vein Reversed with Endovenous Laser Ablation and Sclerotherapy

    Directory of Open Access Journals (Sweden)

    Daniel P. Link

    2013-01-01

    Full Text Available Objective. To report an incidence of reflux in the deep venous system reversed by ablation of a popliteal fossa vein (PFV. Method. A 40-year-old man with pain and swelling in the medial upper calf was found to have an incompetent PFV. Results. Reflux in the femoral and popliteal veins was reversed utilizing endovenous laser ablation and foam sclerotherapy, documented on Duplex studies before and after the intervention. There was also resolution of symptoms. Conclusion. A PFV can be associated with deep venous reflux. Correction of this reflux with ablation of the PFV suggests that his type of reflux is secondary to volume effects of the incompetent popliteal vein.

  19. Retrospective analysis of the use of amniotic membranes and xenografts in spinal surgery and anterior cranial fossa operations

    International Nuclear Information System (INIS)

    Jafri Malim Abdullah

    1999-01-01

    To determine the suitability of amniotic membrane an bovine bone xenografts for the use in spinal surgery and anterior cranial for a generations. Fifteen patients with anterior cranial fossa defects and spinal bone fractures received bovine bone xenografts and 10 patients with meningomyeloceles received amniotic membranes (produced by the Malaysian National Tissue Bank) were analysed retrospectively. Clinical criterias like fever, signs of inflammation, breakdown of graft implant, non specific reaction to the nervous tissue were analysed haematological and radiologically. All patients who received the bovine grafts and amniotic membranes did not show any evidence of inflammation or fever. There were no graft implant breakdowns. There was no radiological or clinical evidence of specific or non specific reaction to the nervous tissue after 12-36 months followup Amniotic membranes and bovine xenografts may be used in the healing and reconstruction of spinal and cranial defects. Despite no evidence of rejection and infection after 36 months, a long term followup is still needed

  20. Standard deviation analysis of the mastoid fossa temperature differential reading: a potential model for objective chiropractic assessment.

    Science.gov (United States)

    Hart, John

    2011-03-01

    This study describes a model for statistically analyzing follow-up numeric-based chiropractic spinal assessments for an individual patient based on his or her own baseline. Ten mastoid fossa temperature differential readings (MFTD) obtained from a chiropractic patient were used in the study. The first eight readings served as baseline and were compared to post-adjustment readings. One of the two post-adjustment MFTD readings fell outside two standard deviations of the baseline mean and therefore theoretically represents improvement according to pattern analysis theory. This study showed how standard deviation analysis may be used to identify future outliers for an individual patient based on his or her own baseline data. Copyright © 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  1. Analysis on the diagnosis and treatment of the fractures of the anterior cranial fossa in the 26 cases

    International Nuclear Information System (INIS)

    Zhou Jianjun; Xia Xiwei; Shi Yimin; Yang Yilin

    2000-01-01

    Objective: To study the diagnosis and treatment of anterior cranial fossa fracture. Methods: The medical records of 26 patients treated were reviewed retrospectively. All cases were examined by CT imaging scans preoperatively. The total cases were divided into three types. The types of operation such as acute decompress, skull base reconstruction, dural repairement, optical canaldompress were performed. Results: Only one case developed postoperative cerebrospinal fluid leakage in the chronic period. After using repair operation, the patient recovered. Three cases visual impairement did not recover postoperativaly. Two patients died. Conclusion: Verification of the fracture types and initial necerological systemic impairments by means of CT scanning is important preoperatively. It is very effective to prevent cerebrospinal fluid leakage if the dura is repaired and the skull base recons-tructed in primury operation

  2. Pedicled Gastrocnemius Flap: Clinical Application in Limb Sparing Surgical Resection of Sarcoma Around the Knee Region and Popliteal Fossa

    International Nuclear Information System (INIS)

    EL-SHERBINY, M.

    2008-01-01

    To highlight on the versatility of superiorly based pedicled gastrocnemius muscle flap in the limb-sparing surgery for bone or soft tissue sarcoma around the knee and popliteal fossa. Patients and Methods: A total of 30 patients with localized bone or soft tissue sarcoma around the knee and popliteal fossa were treated with limb-salvage procedure. The study included 5 cases with bone sarcoma of the distal femur, 15 cases having bone sarcoma of proximal tibia and 10 cases having soft tissue sarcoma around the knee region and popliteal fossa. Routine preoperative staging studies were done for every patient and included local plain radiography, local MRI, isotopic bone scan and CT chest. Local MRA or angiography was done in selected cases. According to the Enneking staging system, 19 patients had stage IIB and 11 had stage IIA. Patients having bone sarcoma of the proximal tibia were subjected to wide resection, endo prosthetic reconstruction and reconstruction of the extensor mechanism by the medial gastrocnemius muscle flap. Patients having bone sarcoma of the distal femur were subjected to wide resection, endo prosthetic reconstruction and coverage of the prosthesis and re balance of the patellar tendon by the medial gas-trocnemius flap. Patients having soft tissue sarcoma were subjected to wide resection and soft tissue coverage with either medial or lateral myocutaneous gastrocnemius flap or muscle flap with grafting. Limb function was evaluated according to MSTS functional scores. Adjuvant chemotherapy or radiotherapy was given according to nationally agreed protocols. Results: There were 18 males and 12 females with a mean age of 29 years at the time of surgery (range 11-44 years). The mean follow-up period was 52 months (range 25-72 months). Resection with a negative bony and soft tissue margins could be achieved in all cases. A total of 30 flaps were used and included medial gastrocnemius muscle flaps in 21 cases (15 cases had proximal tibia endoprothesis, 5

  3. Sagittal reconstruction computed tomography in metrizamide cisternography. Useful diagnostic procedure for malformations in craniovertebral junction and posterior fossa

    Energy Technology Data Exchange (ETDEWEB)

    Mochizuki, H.; Okita, N.; Fujii, T.; Yoshioka, M.; Saito, H. (Tohoku Univ., Sendai (Japan). School of Medicine)

    1982-08-01

    We studied the sagittal reconstruction technique in computed tomography with metrizamide. Ten ml of metrizamide, 170 mg iodine/ml in concentration, were injected by lumbar puncture. After diffusion of the injected metrizamide, axial computed tomograms were taken by thin slice width (5 mm) with overlapped technique. Then electrical sagittal reconstruction was carried out by optioned software. Injection of metrizamide, non-ionic water soluble contrast media, made clear contrasts among bone, brain parenchyma and cerebrospinal fluid with computed tomography. Sagittal reconstruction technique could reveal more precise details and accurate anatomical relations than ordinary axial computed tomography. This technique was applied on 3 cases (Arnold-Chiari malformation, large cisterna magna and partial agenesis cerebellar vermis), which demonstrated a useful diagnostic procedure for abnormalities of craniovertebral junction and posterior fossa. The adverse reactions of metrizamide were negligible in our series.

  4. Internal Occipital Crest Misalignment with Internal Occipital Protuberance: A Case Report of Posterior Cranial Fossa Anatomic Variations

    Science.gov (United States)

    Kim, Jae Ha

    2016-01-01

    During gross anatomy head and neck laboratory session, one dissection group observed an abnormal anatomic variation in the posterior cranial fossa of a 94-year-old male cadaver. The internal occipital crest was not aligned with internal occipital protuberance and groove for superior sagittal sinus. It seemed that the internal occipital protuberance was shifted significantly to the right side. As a result the skull was overly stretched in order to connect with the internal occipital ridge. These internal skull variations of occipital bone landmarks can influence the location of adjacent dural venous sinuses and possibly influence cerebrospinal fluid flow. Similar anatomical anomalies have been attributed to presence of hydrocephalus and abnormalities in cisterna magna. PMID:27648322

  5. Thermal analysis of fractures at Cerberus Fossae, Mars: Detection of air convection in the porous debris apron

    Science.gov (United States)

    Antoine, R.; Lopez, T.; Baratoux, D.; Rabinowicz, M.; Kurita, K.

    2011-08-01

    This study investigates the cause of high nighttime temperatures within Cerberus Fossae, a system of fractures affecting the Central Elysium Planitia. The inner parts (walls and floor) of the fractures are up to 40 K warmer than the surrounding plains. However, several temperature profiles exhibit a local temperature minima occurring in the central part of the fractures. We examined first the influence of cooling efficiency at night in the case of a strong reduction of the sky proportion induced by the fracture's geometry. However, the lack of correlation between temperature and sky proportion, calculated from extracted Mars Orbiter Laser Altimeter (MOLA) profiles argues against this hypothesis. Albedo variations were considered but appear to be limited within the fractures, and are generally not correlated with the temperatures. Variations of the thermal properties of bedrocks exposures, debris aprons and sand dunes inferred from high-resolution images do not either correlate with temperature variations within the fractures. As none of these factors taken alone, or combined, can satisfactorily explain the temperature variations within and near the fracture, we suggest that geothermal heat transported by air convection within the porous debris aprons may contribute to explain high temperatures at night and the local minima on the fracture floor. The conditions for the occurrence of the suggested phenomenon and the consequences on the surface temperature are numerically explored. A conservative geothermal gradient of 20 mW/m 2 was used in the simulations, this value being consistent with either inferred lithosphere elastic thicknesses below the shield volcanoes of the Tharsis dome or values predicted from numerical simulations of the thermal evolution of Mars. The model results indicate that temperature differences of 10-20 K between the central and upper parts of the fracture are explained in the case of high Darcy velocities which require high permeability values

  6. Comparison of Porcine and Bovine Collagen Dural Substitutes in Posterior Fossa Decompression for Chiari I Malformation in Adults.

    Science.gov (United States)

    Lee, Christine K; Mokhtari, Tara; Connolly, Ian D; Li, Gordon; Shuer, Lawrence M; Chang, Steven D; Steinberg, Gary K; Hayden Gephart, Melanie

    2017-12-01

    Posterior fossa decompression surgeries for Chiari malformations are susceptible to postoperative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been used to improve surgical outcomes. This study examined whether the collagen matrix dural substitute type correlated with the incidence of postoperative complications after posterior fossa decompression in adult patients with Chiari I malformations. A retrospective cohort study was conducted of 81 adult patients who underwent an elective decompressive surgery for treatment of symptomatic Chiari I malformations, with duraplasty involving a dural substitute derived from either bovine or porcine collagen matrix. Demographics and treatment characteristics were correlated with surgical outcomes. A total of 81 patients were included in the study. Compared with bovine dural substitute, porcine dural substitute was associated with a significantly higher risk of pseudomeningocele occurrence (odds ratio, 5.78; 95% confidence interval, 1.65-27.15; P = 0.01) and a higher overall complication rate (odds ratio, 3.70; 95% confidence interval, 1.23-12.71; P = 0.03) by univariate analysis. There was no significant difference in the rate of meningitis, repeat operations, or overall complication rate between the 2 dural substitutes. In addition, estimated blood loss was a significant risk factor for meningitis (P = 0.03). Multivariate analyses again showed that porcine dural substitute was associated with pseudomeningocele occurrence, although the association with higher overall complication rate did not reach significance. Dural substitutes generated from porcine collagen, compared with those from bovine collagen, were associated with a higher likelihood of pseudomeningocele development in adult patients undergoing Chiari I malformation decompression and duraplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Effects of uterine cervix constriction on Wistar rats Efeitos da constrição do cérvix uterino em ratos Wistar

    Directory of Open Access Journals (Sweden)

    Cassio Eduardo Raposo-Amaral

    2010-12-01

    ratos sobreviveram ao parto (grupo A com restrição. Dois ratos nascidos de outra mãe e com a mesma idade foram utilizados como controle (grupo B sem restrição controle durante o seu crescimento. Os oito animais foram sacrificados após 1,2 ano. Medidas lineares, histologia e tomografia computadorizada foram utilizadas para a aferição de assimetrias cranianas através da mensuração de pontos anatômicos do esqueleto craniofacial dos ratos dos dois grupos. RESULTADOS: Não foi observada diferença estatisticamente significante entre as medidas obtidas nos ratos dos dois grupos (p>0,05 obtidas através de métodos morfológicos e radiológicos. As análises histológicas não revelaram sinais de fusão prematura da suturas do crânio. Diminuição do segmento corpóreo, bem como do tamanho dos membros foi evidenciado em todos os animais do grupo A. CONCLUSÃO: A restrição do cérvix uterino levou ao sofrimento fetal, morte de alguns animais e diminuição do tamanho do corpo de todos os animais, mas não craniossinostose.

  8. Posterior fossa scintiangiography: documentation of genetic penetrance of von Hippel--Lindau syndrome in a clinically unaffected girl and her father

    International Nuclear Information System (INIS)

    Hattner, R.S.

    1975-01-01

    The syndrome of von Hippel and Lindau is a rare hereditary disorder constituted by retinal angiomata, posterior fossa and spinal cord hemangioblastomata, cystic and adenomatous dysplasia of major organs, and occasionally renal cell carcinomata. Although the syndrome is transmitted by an autosomal dominant gene, the penetrance is variable and affected persons may have any or all of the elements of the disease. The 16-year-old clinically normal daughter of a patient with the von Hippel--Lindau syndrome demonstrated a vascular posterior fossa lesion on /sup 99m/Tc-DTPA scintiangiography that failed detection in delayed images. Contrast arteriography corroborated the presence of a hemangioblastoma. Noninvasive demonstration of the genetic penetrance of this disorder offers its victims an opportunity for low morbidity early surgical cure of the associated brain lesions. (auth)

  9. Late Noachian/Early Hesperian Ridge Network in Nili Fossae: Evidence for Water-Saturated Near-Surface Crust

    Science.gov (United States)

    Mustard, J. F.; Pascuzzo, A.

    2017-12-01

    The region north of the contact between Syrtis Major and the Isidis Basin is populated by thousands of ridges 100s of meters in length, up to a few 10s of meters high and 15-50 meters wide. The resistant ridges are being exhumed from weak early Noachian smectite-bearing host rocks. Hypotheses for the formation include igneous intrusion or fill, impact-induced breccia dikes and chemical alteration of pre-existing fracture planes or mineralized fracture planes through groundwater circulation (our preferred mode of formation). Mineralogic interpretations of visible-near infrared reflectance spectra from the CRISM instrument on MRO may be critical in interpreting the formation process. While most of the ridges are at the limit of CRISM's spatial resolution of 18 m/pixel, CRISM has a special observing mode which can increase the resolution in the along track observing (ATO) direction by a factor of 2-3 (e.g. 6 m). Using a combination of full resolution and one ATO observation, we have analyzed well-exposed ridges in the Nili Fossae region. Ridges are commonly exposed from beneath a distinctive mafic capping rock rich in olivine and variably altered to magnesite. Many of the ridges exhibit weaker smectite absorptions near 1.9 and 2.3 µm compared to the host rock but no additional spectral features are observed. One cause for weaker absorptions is grain size (i.e. solid rock shows weaker absorptions than its powdered equivalent). Alternatively the presence of a spectrally neutral cementing compound or mineral like quartz could lead to weaker features. Timing of ridge formation is constrained by two key stratigraphic makers. First the ridges were likely formed after the Isidis basin-forming event, 3.9 Ga, because many are observed between the 1st and 2nd rings of the basin structure and would not have survived the impact event otherwise. Second the ridges are exhumed from beneath a distinctive olivine-rich mafic cap unit with its emplacement dated to between the Isidis

  10. Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note

    OpenAIRE

    Felbaum, Daniel R; Mueller, Kyle; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

    2016-01-01

    Introduction:?Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa?but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk. Methods:?A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboc...

  11. Earth's crust and heat flow in the Fossa Brandanica, Southern Italy. [0. 4 to 2. 2. mu. cal/cm/sup 2//sec

    Energy Technology Data Exchange (ETDEWEB)

    Mongelli, F; Ricchetti, G

    1970-01-01

    A detailed study has been made of the Fossa Bradanica by means of seven shallow boreholes drilled in the clays. The observed gradients together with the results of in-situ thermal conductivity measurements indicate the heat flow as being between 0.4 and 2.2 ..mu..cal/cm/sup 2/ . sec. The influence of geographic and geological factors is discussed. The results obtained are not incompatible with crustal structures indicated by other geophysical methods.

  12. Trans aqueductal, third ventricle - Cervical subarachnoid stenting: An adjuvant cerebro spinal fluid diversion procedure in midline posterior fossa tumors with hydrocephalus: The technical note and case series.

    Science.gov (United States)

    Teegala, Ramesh

    2016-01-01

    Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle - Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012. Fifteen clinicoradiological diagnosed cases of midline posterior fossa tumors with hydrocephalus were included in this study. All the tumors were approached through the cerebello medullary (telo velo tonsilar) fissure technique. Following the excision of the posterior fossa tumor, a sizable stent was placed across the aqueduct from the third ventricle to the cervical subarachnoid space. There were nine male and six female patients with an average age of 23 years. Complete tumor excision could be achieved in 12 patients and subtotal excision with clearance of aqueduct in remaining three patients. Hydrocephalus was controlled effectively in all the patients. There were no stent-related complications. This study showed the reliability of single-stage tumor excision followed by placement of aqueductal stent. The success rate of this technique is comparable to those of conventional CSF diversion procedures. This is a simple, safe, and effective procedure for the management of persistent and or progressive hydrocephalus. This technique may be very useful in situations where the patient's follow-up is compromised and the patients who are from a poor economic background. Long-term results need further evaluation to assess the overall functioning of this stent technique.

  13. Combined Endoscopic Transorbital and Endonasal Repair of High Flow Orbital Apex/Middle Fossa Cerebrospinal Fluid Leak with a Nasoseptal Flap.

    Science.gov (United States)

    Lucke-Wold, Brandon; Mendez, Gustavo; Cua, David; Akins, Paul; Gillham, Haley; Ciporen, Jeremy

    2018-01-01

    High flow orbital apex or middle fossa cerebrospinal fluid (CSF) leaks can be life threatening and complex to repair. These leaks associated with large dural defects are most commonly repaired with an open temporalis muscle patch or free flaps, but these flaps do not always stop the leak. A 65-year-old patient presented two years after orbital exenteration and radiation for squamous cell carcinoma. He developed multi-organism meningitis and pneumocephalus secondary to a large high-flow orbital apex/middle fossa CSF leak. To repair the leak, a combined endoscopic transorbital/endonasal approach with pedicled nasospetal flap and dermis fat graft was used. We describe the unique endoscopic technique that was used to treat the life threatening high flow orbital apex/middle fossa CSF leak. The technique allowed the use of the transposed pedicled flap, which is an alternative to the free flap in controlling CSF leak. Cisternogram post-operatively and clinical exam confirmed resolution of CSF leak. Although a critically ill patient at admission with a modified Rankin scale (MRS) of 5, he was discharged home on continued IV antibiotic therapy with a MRS of 3. Endoscopic evaluation at three months after treatment showed the effectiveness of the flap and he continued to improve clinically. This is the first case to describe a combined endoscopic transorbital and endonasal repair of high flow orbital apex/middle fossa CSF leak with a pedicled nasoseptal flap. These techniques can be utilized during initial reconstruction after orbital exenteration or as a salvage flap.

  14. RADIATION THERAPY QUALITY IN CCG/POG INTERGROUP 9961: IMPLICATIONS FOR CRANIOSPINAL IRRADIATION AND THE POSTERIOR FOSSA BOOST IN FUTURE MEDULLOBLASTOMA TRIALS

    Directory of Open Access Journals (Sweden)

    Bernadine eDonahue

    2012-12-01

    Full Text Available Purpose: Associations of RT deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose CSI and chemotherapy. The aim of this study is to evaluate the quality of RT on CCG/POG 9961 and analyze associations of RT deviations with outcome.Methods and Materials: Major volume deviations were assessed based on the distance from specified anatomical region to field edge. We investigated associations of RT deviations with progression-free survival (PFS, overall survival (OS, and explored associations with demographics and clinical variables.Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33% did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa; posterior fossa deviations resulted from treating less than whole posterior fossa. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of radiation therapy delivered in COG institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of posterior fossa volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome.

  15. The correlation between hematoma volume and outcome in ruptured posterior fossa arteriovenous malformations indicates the importance of surgical evacuation of hematomas.

    Science.gov (United States)

    Yilmaz, Adem; Musluman, Ahmet Murat; Kanat, Ayhan; Cavusoglu, Halit; Terzi, Yuksel; Aydin, Yunus

    2011-01-01

    The correlation between hematoma volume and outcome in ruptured arteriovenous malformations (AVM) with accompanying posterior fossa hematoma was retrospectively evaluated. Microsurgery operations were performed on 127 patients with intracranial AVM between January 1998 and January 2009 at our clinic. Fifteen (11.8%) patients were identified as suffering from posterior fossa AVM, and twelve of these patients presented with a cerebellar hematoma. All patients were clinically evaluated according to the following criteria: modified Rankin Scale (mRS) prior to surgery, Spetzler-Martin grade (SMG) of the AVMs, hematoma volume prior to surgery, and mRS following surgery. Postoperative mRS scores were significantly lower than preoperative scores (p=0.0001). Postoperative outcomes were concordant with the SMG of the AVMs (r=0.67, p=0.033), hematoma volume (r=0.537, p=0.072) and preoperative mRS scores (r=0.764, p=0.004). These analyses show that the postoperative mRS score is strongly correlated with a preoperative mRS score, hematoma volume and SMG. Posterior fossa AVMs present an increased risk for hemorrhage and for increased morbidity and mortality. Cases with hematoma should be operated on an urgent basis. We conclude that hematoma volume is a factor that impacts postoperative results and prognosis. SMG and preoperative mRS scores were also correlated with outcome.

  16. Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma.

    Science.gov (United States)

    Chua, Felicia H Z; Thien, Ady; Ng, Lee Ping; Seow, Wan Tew; Low, David C Y; Chang, Kenneth T E; Lian, Derrick W Q; Loh, Eva; Low, Sharon Y Y

    2017-03-01

    Posterior fossa syndrome (PFS) is a serious complication faced by neurosurgeons and their patients, especially in paediatric medulloblastoma patients. The uncertain aetiology of PFS, myriad of cited risk factors and therapeutic challenges make this phenomenon an elusive entity. The primary objective of this study was to identify associative factors related to the development of PFS in medulloblastoma patient post-tumour resection. This is a retrospective study based at a single institution. Patient data and all related information were collected from the hospital records, in accordance to a list of possible risk factors associated with PFS. These included pre-operative tumour volume, hydrocephalus, age, gender, extent of resection, metastasis, ventriculoperitoneal shunt insertion, post-operative meningitis and radiological changes in MRI. Additional variables included molecular and histological subtypes of each patient's medulloblastoma tumour. Statistical analysis was employed to determine evidence of each variable's significance in PFS permanence. A total of 19 patients with appropriately complete data was identified. Initial univariate analysis did not show any statistical significance. However, multivariate analysis for MRI-specific changes reported bilateral DWI restricted diffusion changes involving both right and left sides of the surgical cavity was of statistical significance for PFS permanence. The authors performed a clinical study that evaluated possible risk factors for permanent PFS in paediatric medulloblastoma patients. Analysis of collated results found that post-operative DWI restriction in bilateral regions within the surgical cavity demonstrated statistical significance as a predictor of PFS permanence-a novel finding in the current literature.

  17. Partial maxillectomy for ameloblastoma of the maxilla with infratemporal fossa involvement: A combined endoscopic endonasal and transoral approach.

    Science.gov (United States)

    Guha, A; Hart, L; Polachova, H; Chovanec, M; Schalek, P

    2018-02-21

    Ameloblastoma represents the most common epithelial odontogenic tumor. Because of the proximity of the maxillary tumors to the orbit and skull base, it should be managed as radically as possible. Maxillectomy, mainly via the transfacial or transoral approach, represents the most common type of surgical procedure. Drawback of these approaches is limited control of the superiomedial extent of the tumour in the paranasal area. We report the use of a combined endoscopic endonasal and transoral approach to manage maxillary plexiform ameloblastoma in a 48-year-old male patient. A combined endoscopic endonasal and transoral approach enabled the radical removal of tumour with a 1.5cm margin of radiographically intact bone with good control from both intrasinusal and intraoral aspects. Adequate visualization of the extent of the lesion (e.g. orbit, infratemporal fossa, anterior cranial base) had been achieved. Non-complicated healing was achieved. This technique of partial maxillectomy led to very good aesthetic and functional results. No recurrence had been noted during review appointments. The combination of endoscopic endonasal and transoral approach for a partial maxillectomy allows sufficient reduction of the defect, thus eliminating the necessity for reconstruction and reducing the morbidity associated with it. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  18. The relation of catastrophic flooding of Mangala Valles, Mars, to faulting of Memnonia Fossae and Tharsis volcanism

    International Nuclear Information System (INIS)

    Tanaka, K.L.; Chapman, M.G.

    1990-01-01

    Detailed stratigraphic relations indicate two coeval periods of catastrophic flooding and Tharsis-centered faulting (producing Memnonia Fossae) in the Mangala Valles region of Mars. Major sequences of lava flows of the Tharsis Montes Formation and local, lobate plains flows were erupted during and between these channeling and faulting episodes. First, Late Hesperian channel development overlapped in time the Tharsis-centered faulting that trends north 75 degree to 90 degree E. Next, Late Hesperian/Early Amazonian flooding was coeval with faulting that trends north 55 degree to 70 degree E. In some reaches, resistant lava flows filled the early channels, resulting in inverted channel topography after the later flooding swept through. Both floods likely originated from the same graben, which probably was activated during each episode of faulting. Faulting broke through groundwater barriers and tapped confined aquifers in higher regions west and east of the point of discharge. The minimum volume of water required to erode Mangala Valles (about 5 x 10 12 m 3 ) may have been released through two floods that drained a few percent pore volume from a relatively permeable aquifer. The peak discharges of the floods may have lasted from days to weeks. The perched water discharged from the aquifer may have been produced by hydrothermal groundwater circulation induced by Tharsis magmatism, tectonic uplift centered at Tharsis Montes, and compacting of saturated crater ejecta due to loading by lava flows

  19. Middle infratemporal fossa less invasive approach for radical resection of parapharyngeal tumors: surgical microanatomy and clinical application.

    Science.gov (United States)

    Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Sakai, Jun; Friedman, Allan H; Zomorodi, Ali R

    2016-01-01

    Surgery of the infratemporal fossa (ITF) and parapharyngeal area presents a formidable challenge to the surgeon due to its anatomical complexity and limited access. Conventional surgical approaches to these regions were often too invasive and necessitate sacrifice of normal function and anatomy. To describe a less invasive transcranial extradural approach to ITF parapharyngeal lesions and to determine its advantages, 17 patients with ITF parapharyngeal neoplasms who underwent tumor resection via this approach were enrolled in the study. All lesions located in the ITF precarotid parapharyngeal space were resected through a small operative corridor between the trigeminal nerve third branch (V3) and the temporomandibular joint (TMJ). Surgical outcomes and postoperative complications were evaluated. Pathological diagnosis included schwannoma in eight cases, paraganglioma in two cases, gangliocytoma in two cases, carcinosarcoma in one case, giant cell tumor in one case, pleomorphic adenoma in one case, chondroblastoma in one case, and juvenile angiofibroma in one case. Gross total resection was achieved in 12 cases, near-total and subtotal resection were in 3 and 2 cases, respectively. The most common postoperative complication was dysphagia. Surgical exposure can be customized from minimal (drilling of retrotrigeminal area) to maximal (full skeletonization of V3, removal of all structures lying lateral to the petrous segment of internal carotid artery) according to tumor size and location. Since the space between the V3 and TMJ is the main corridor of this approach, the key maneuver is the anterior translocation of V3 to obtain an acceptable surgical field.

  20. Macroscopic Innervation of the Dura Mater Covering the Middle Cranial Fossa in Humans Correlated to Neurovascular Headache.

    Science.gov (United States)

    Lee, Shin-Hyo; Hwang, Seung-Jun; Koh, Ki-Seok; Song, Wu-Chul; Han, Sang-Don

    2017-01-01

    The trigeminovascular system within the cranial dura mater is a possible cause of headaches. The aim of this study is to investigate macroscopically dural innervation around the middle meningeal artery (MMA) in the middle cranial fossa. Forty-four sides of the cranial dura overlying the skull base obtained from 24 human cadavers were stained using Sihler's method. Overall, the nervus spinosus (NS) from either the maxillary or mandibular trigeminal divisions ran along the lateral wall of the middle meningeal vein rather than that of the MMA. Distinct bundles of the NS running along the course of the frontal branches of the MMA were present in 81.8% of cases ( N = 36). Others did not form dominant nerve bundles, instead giving off free nerve endings along the course of the MMA or dural connective tissue. The distribution of these nerve endings was similar to that of the course of the frontal, parietal and petrosal branches of the MMA (11.4%). The others were not restricted to a perivascular plexus, crossing the dural connective tissues far from the MMA (6.8%). These findings indicate that the NS generally travels alongside the course of the frontal branches of the MMA and terminates in the vicinity of the pterion.

  1. Macroscopic Innervation of the Dura Mater Covering the Middle Cranial Fossa in Humans Correlated to Neurovascular Headache

    Directory of Open Access Journals (Sweden)

    Shin-Hyo Lee

    2017-12-01

    Full Text Available The trigeminovascular system within the cranial dura mater is a possible cause of headaches. The aim of this study is to investigate macroscopically dural innervation around the middle meningeal artery (MMA in the middle cranial fossa. Forty-four sides of the cranial dura overlying the skull base obtained from 24 human cadavers were stained using Sihler’s method. Overall, the nervus spinosus (NS from either the maxillary or mandibular trigeminal divisions ran along the lateral wall of the middle meningeal vein rather than that of the MMA. Distinct bundles of the NS running along the course of the frontal branches of the MMA were present in 81.8% of cases (N = 36. Others did not form dominant nerve bundles, instead giving off free nerve endings along the course of the MMA or dural connective tissue. The distribution of these nerve endings was similar to that of the course of the frontal, parietal and petrosal branches of the MMA (11.4%. The others were not restricted to a perivascular plexus, crossing the dural connective tissues far from the MMA (6.8%. These findings indicate that the NS generally travels alongside the course of the frontal branches of the MMA and terminates in the vicinity of the pterion.

  2. Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches.

    Science.gov (United States)

    Noudel, R; Gomis, P; Duntze, J; Marnet, D; Bazin, A; Roche, P H

    2009-08-01

    Therapeutic options for vestibular schwannomas (VS) include microsurgery, stereotactic radiosurgery and conservative management. Early treatment of intracanalicular vestibular schwannomas (IVS) may be advisable because their spontaneous course will show hearing loss in most cases. Advanced microsurgical techniques and continuous intraoperative monitoring of cranial nerves may allow hearing preservation (HP) without facial nerve damage. However, there are still controversies about the definition of hearing preservation, and the best surgical approach that should be used. In this study, we reviewed the main data from the recent literature on IVS surgery and compared hearing, facial function and complication rates after the retrosigmoid (RS) and middle fossa (MF) approaches, respectively. The results showed that the average HP rate after IVS surgery ranged from 58% (RS) to 62% (MF). HP varied widely depending on the audiometric criteria that were used for definition of serviceable hearing. There was a trend to show that the MF approach offered a better quality of postoperative hearing (not statistically significant), whereas the RS approach offered a better facial nerve preservation and fewer complications (not statistically significant). We believe that the timing of treatment in the course of the disease and selection between radiosurgical versus microsurgical procedure are key issues in the management of IVS. Preservation of hearing and good facial nerve function in surgery for VS is a reasonable goal for many patients with intracanalicular tumors and serviceable hearing. Once open surgery has been decided, selection of the approach mainly depends on individual anatomical considerations and experience of the surgeon.

  3. Immediate and Long-term Hearing Outcomes With the Middle Cranial Fossa Approach for Vestibular Schwannoma Resection.

    Science.gov (United States)

    Ahmed, Sameer; Arts, H Alexander; El-Kashlan, Hussam; Basura, Gregory J; Thompson, B Gregory; Telian, Steven A

    2018-01-01

    To analyze the immediate postoperative and long-term hearing outcome data in patients who have undergone hearing preservation attempts with the middle cranial fossa (MCF) approach for the resection of sporadic vestibular schwannoma. Retrospective review of a surgical patient cohort. Tertiary academic referral center. Adult patients with unilateral sporadic vestibular schwannoma. Surgical treatment with a MCF approach. Comparison of pre- and postoperative audiometric data in accordance with the 1995 and 2012 American Academy of Otolaryngology/Head and Neck Surgery guidelines on reporting hearing outcomes and with a word recognition score only scale. Long-term hearing outcome data were analyzed in the following postoperative groups: 3 to 5, 6 to 8, 9 to 11, and 12+ years after surgery. From 1999 to 2016, 174 patients underwent the MCF approach and 155 of them met inclusion criteria for analysis of hearing outcome data. Class A or B hearing was preserved in 70% of the entire cohort after recovery. Seventy-one patients with measurable hearing met criteria for long-term data analysis. The rate of American Academy of Otolaryngology/Head and Neck Surgery class A or B hearing preservation was 82% at 3 to 5 years and declined thereafter. The rate of word recognition score class I or II hearing preservation was 98% at 3 to 5 years and declined less rapidly thereafter. Patients with preoperative Class A hearing had significantly higher rates of successful hearing preservation at all postoperative intervals. Delayed hearing loss occurs in a progressively increasing fashion but speech understanding remains durable for a majority of patients whose hearing is initially preserved with the MCF approach.

  4. DTI fiber tractography of cerebro-cerebellar pathways and clinical evaluation of ataxia in childhood posterior fossa tumor survivors.

    Science.gov (United States)

    Oh, Myung Eun; Driever, Pablo Hernáiz; Khajuria, Rajiv K; Rueckriegel, Stefan Mark; Koustenis, Elisabeth; Bruhn, Harald; Thomale, Ulrich-Wilhelm

    2017-01-01

    Pediatric posterior fossa (PF) tumor survivors experience long-term motor deficits. Specific cerebrocerebellar connections may be involved in incidence and severity of motor dysfunction. We examined the relationship between long-term ataxia as well as fine motor function and alteration of differential cerebellar efferent and afferent pathways using diffusion tensor imaging (DTI) and tractography. DTI-based tractography was performed in 19 patients (10 pilocytic astrocytoma (PA) and 9 medulloblastoma patients (MB)) and 20 healthy peers. Efferent Cerebello-Thalamo-Cerebral (CTC) and afferent Cerebro-Ponto-Cerebellar (CPC) tracts were reconstructed and analyzed concerning fractional anisotropy (FA) and volumetric measurements. Clinical outcome was assessed with the International Cooperative Ataxia Rating Scale (ICARS). Kinematic parameters of fine motor function (speed, automation, variability, and pressure) were obtained by employing a digitizing graphic tablet. ICARS scores were significantly higher in MB patients than in PA patients. Poorer ICARS scores and impaired fine motor function correlated significantly with volume loss of CTC pathway in MB patients, but not in PA patients. Patients with pediatric post-operative cerebellar mutism syndrome showed higher loss of CTC pathway volume and were more atactic. CPC pathway volume was significantly reduced in PA patients, but not in MB patients. Neither relationship was observed between the CPC pathway and ICARS or fine motor function. There was no group difference of FA values between the patients and healthy peers. Reduced CTC pathway volumes in our cohorts were associated with severity of long-term ataxia and impaired fine motor function in survivors of MBs. We suggest that the CTC pathway seems to play a role in extent of ataxia and fine motor dysfunction after childhood cerebellar tumor treatment. DTI may be a useful tool to identify relevant structures of the CTC pathway and possibly avoid surgically induced long

  5. Automated segmentation of the atrial region and fossa ovalis towards computer-aided planning of inter-atrial wall interventions.

    Science.gov (United States)

    Morais, Pedro; Vilaça, João L; Queirós, Sandro; Marchi, Alberto; Bourier, Felix; Deisenhofer, Isabel; D'hooge, Jan; Tavares, João Manuel R S

    2018-07-01

    Image-fusion strategies have been applied to improve inter-atrial septal (IAS) wall minimally-invasive interventions. Hereto, several landmarks are initially identified on richly-detailed datasets throughout the planning stage and then combined with intra-operative images, enhancing the relevant structures and easing the procedure. Nevertheless, such planning is still performed manually, which is time-consuming and not necessarily reproducible, hampering its regular application. In this article, we present a novel automatic strategy to segment the atrial region (left/right atrium and aortic tract) and the fossa ovalis (FO). The method starts by initializing multiple 3D contours based on an atlas-based approach with global transforms only and refining them to the desired anatomy using a competitive segmentation strategy. The obtained contours are then applied to estimate the FO by evaluating both IAS wall thickness and the expected FO spatial location. The proposed method was evaluated in 41 computed tomography datasets, by comparing the atrial region segmentation and FO estimation results against manually delineated contours. The automatic segmentation method presented a performance similar to the state-of-the-art techniques and a high feasibility, failing only in the segmentation of one aortic tract and of one right atrium. The FO estimation method presented an acceptable result in all the patients with a performance comparable to the inter-observer variability. Moreover, it was faster and fully user-interaction free. Hence, the proposed method proved to be feasible to automatically segment the anatomical models for the planning of IAS wall interventions, making it exceptionally attractive for use in the clinical practice. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Síndrome de Fraser: relato de caso nas vias lacrimais

    Directory of Open Access Journals (Sweden)

    Silvia Helena Tavares Lorena

    2014-04-01

    Full Text Available A síndrome de Fraser é uma condição sistêmica caracterizada por criptoftalmo, sindactilia e anomalia da genitália, podendo se associar com alterações dos rins, do ouvido, do nariz, da laringe e do esqueleto. O criptoftalmo pode representar um achado isolado, representado por herança autossômica dominante, associado a outras anomalias congênitas, relatado como herança autossômica recessiva. Criança do sexo feminino, 9 meses, avaliada no ambulatório de vias lacrimais da Universidade Federal de São Paulo. Filha de pais consanguíneos. Ao exame, foram observados criptoftalmo total à esquerda, epífora em olho direito associada à secreção mucopurulenta, nariz em sela, implantação baixa das orelhas, malformação de conduto auditivo, aumento de grandes lábios e sindactilia de mãos e pés. A tomografia de crânio evidenciou braquicefalia ausência de septo pelúcido, proeminência dos ventrículos laterais, importante falha óssea na calota craniana, presença de afilamento do manto tecidual cerebral, fossa posterior pequena, desorganização do segmento anterior, afacia e descolamento total da retina.

  7. Emergency department CT screening of patients with nontraumatic neurological symptoms referred to the posterior fossa: comparison of thin versus thick slice images.

    Science.gov (United States)

    Kamalian, Shervin; Atkinson, Wendy L; Florin, Lauren A; Pomerantz, Stuart R; Lev, Michael H; Romero, Javier M

    2014-06-01

    Evaluation of the posterior fossa (PF) on 5-mm-thick helical CT images (current default) has improved diagnostic accuracy compared to 5-mm sequential CT images; however, 5-mm-thick images may not be ideal for PF pathology due to volume averaging of rapid changes in anatomy in the Z-direction. Therefore, we sought to determine if routine review of 1.25-mm-thin helical CT images has superior accuracy in screening for nontraumatic PF pathology. MRI proof of diagnosis was obtained within 6 h of helical CT acquisition for 90 consecutive ED patients with, and 88 without, posterior fossa lesions. Helical CT images were post-processed at 1.25 and 5-mm-axial slice thickness. Two neuroradiologists blinded to the clinical/MRI findings reviewed both image sets. Interobserver agreement and accuracy were rated using Kappa statistics and ROC analysis, respectively. Of the 90/178 (51 %) who were MR positive, 60/90 (66 %) had stroke and 30/90 (33 %) had other etiologies. There was excellent interobserver agreement (κ > 0.97) for both thick and thin slice assessments. The accuracy, sensitivity, and specificity for 1.25-mm images were 65, 44, and 84 %, respectively, and for 5-mm images were 67, 45, and 85 %, respectively. The diagnostic accuracy was not significantly different (p > 0.5). In this cohort of patients with nontraumatic neurological symptoms referred to the posterior fossa, 1.25-mm-thin slice CT reformatted images do not have superior accuracy compared to 5-mm-thick images. This information has implications on optimizing resource utilizations and efficiency in a busy emergency room. Review of 1.25-mm-thin images may help diagnostic accuracy only when review of 5-mm-thick images as current default is inconclusive.

  8. Fast imaging employing steady-state acquisition (FIESTA) MRI to investigate cerebrospinal fluid (CSF) within dural reflections of posterior fossa cranial nerves.

    Science.gov (United States)

    Noble, David J; Scoffings, Daniel; Ajithkumar, Thankamma; Williams, Michael V; Jefferies, Sarah J

    2016-11-01

    There is no consensus approach to covering skull base meningeal reflections-and cerebrospinal fluid (CSF) therein-of the posterior fossa cranial nerves (CNs VII-XII) when planning radiotherapy (RT) for medulloblastoma and ependymoma. We sought to determine whether MRI and specifically fast imaging employing steady-state acquisition (FIESTA) sequences can answer this anatomical question and guide RT planning. 96 posterior fossa FIESTA sequences were reviewed. Following exclusions, measurements were made on the following scans for each foramen respectively (left, right); internal acoustic meatus (IAM) (86, 84), jugular foramen (JF) (83, 85) and hypoglossal canal (HC) (42, 45). A protocol describes measurement procedure. Two observers measured distances for five cases and agreement was assessed. One observer measured all the remaining cases. IAM and JF measurement interobserver variability was compared. Mean measurement difference between observers was -0.275 mm (standard deviation 0.557). IAM and JF measurements were normally distributed. Mean IAM distance was 12.2 mm [95% confidence interval (CI) 8.8-15.6]; JF was 7.3 mm (95% CI 4.0-10.6). The HC was difficult to visualize on many images and data followed a bimodal distribution. Dural reflections of posterior fossa CNs are well demonstrated by FIESTA MRI. Measuring CSF extension into these structures is feasible and robust; mean CSF extension into IAM and JF was measured. We plan further work to assess coverage of these structures with photon and proton RT plans. Advances in knowledge: We have described CSF extension beyond the internal table of the skull into the IAM, JF and HC. Oncologists planning RT for patients with medulloblastoma and ependymoma may use these data to guide contouring.

  9. High-resolution STIR for 3-T MRI of the posterior fossa: visualization of the lower cranial nerves and arteriovenous structures related to neurovascular compression.

    Science.gov (United States)

    Hiwatashi, Akio; Yoshiura, Takashi; Yamashita, Koji; Kamano, Hironori; Honda, Hiroshi

    2012-09-01

    Preoperative evaluation of small vessels without contrast material is sometimes difficult in patients with neurovascular compression disease. The purpose of this retrospective study was to evaluate whether 3D STIR MRI could simultaneously depict the lower cranial nerves--fifth through twelfth--and the blood vessels in the posterior fossa. The posterior fossae of 47 adults (26 women, 21 men) without gross pathologic changes were imaged with 3D STIR and turbo spin-echo heavily T2-weighted MRI sequences and with contrast-enhanced turbo field-echo MR angiography (MRA). Visualization of the cranial nerves on STIR images was graded on a 4-point scale and compared with visualization on T2-weighted images. Visualization of the arteries on STIR images was evaluated according to the segments in each artery and compared with that on MRA images. Visualization of the veins on STIR images was also compared with that on MRA images. Statistical analysis was performed with the Mann-Whitney U test. There were no significant differences between STIR and T2-weighted images with respect to visualization of the cranial nerves (p > 0.05). Identified on STIR and MRA images were 94 superior cerebellar arteries, 81 anteroinferior cerebellar arteries, and 79 posteroinferior cerebellar arteries. All veins evaluated were seen on STIR and MRA images. There were no significant differences between STIR and MRA images with respect to visualization of arteries and veins (p > 0.05). High-resolution STIR is a feasible method for simultaneous evaluation of the lower cranial nerves and the vessels in the posterior fossa without the use of contrast material.

  10. Behandling af defaekationsblokade som følge af dyb fossa recto-genitalis med total baekkenbundsrekonstruktion med Prolene-net

    DEFF Research Database (Denmark)

    Møller, P; Monrad, H; Kehlet, H

    1992-01-01

    of the patients. The condition had not been diagnosed despite previous hospital contact for many years in two of the patients. Complete reconstruction of the pelvic floor with prolene net was performed. Subsequent defaecography showed normalization of defaecation without rectal compression and with relief...... of the abdominal pain and dependence on morphine in two of the patients. Rectal compression resulting from an abnormally deep recto-genital fossa should be included in the differential diagnostic deliberations in patients with severe constipation and defaecation blockage. Complete reconstruction of the pelvic...

  11. Discordant K-Ar ages between hornblende and biotite from the Tanzawa tonalitic pluton in the southern Fossa Magna, central Japan

    International Nuclear Information System (INIS)

    Sato, Kohei; Shibata, Ken; Uchiumi, Shigeru

    1986-01-01

    K-Ar ages were determined for hornblende and biotite in three tonalites from the Tanzawa pluton in the southern Fossa Magna, central Japan. The two minerals show discordant ages of 10.1 and 10.7 Ma for hornblende and 4.6 - 5.1 Ma for biotite. The age data and field evidence indicate that the pluton was emplaced in the Tanzawa Group in Middle Miocene time and its slow cooling (ca. 50 deg C/Ma in average) resulted in younger ages of boitites than hornblendes due to lower closure temperature for biotite. (author)

  12. Mapping Variability in the Medusae Fossae Formation: Yardang Morphologies, Fluvial Reworking, and Crater Depth to Diameter Ratios

    Science.gov (United States)

    Khuller, A. R.; Kerber, L.

    2017-12-01

    The Medusae Fossae Formation (MFF) is a voluminous, fine-grained deposit thought to be of pyroclastic origin. While it contains widespread, well-preserved inverted fluvial features, its pervasive cover of dust means that little is known about its composition, and indirect means must be used to characterize its material properties. This project aims to correlate fluvial features in the Western MFF with other indicators of material strength: yardang morphology and crater depth-to-diameter ratios. For this work, Context Camera (CTX) images were used to map features of fluvial origin (inverted channels, sinuous ridges, alluvial fans). The presence of rounded, meso-yardangs in close proximity to fluvial features was also mapped. Crater depth-diameter (d/D) ratios (for craters 1-512km) were analyzed using a global Mars crater database (Robbins and Hynek, 2012) as a proxy for material strength. Approximately 1400 fluvial segments were mapped, with the most populous cluster located in Aeolis and Zephyria Plana. Rounded meso-yardangs were found to be common in areas that also have fluvial features. In agreement with previous work (Barlow, 1993), MFF craters were found to have a greater d/D ratio (0.0523) than the global mean (0.0511). Ratios between MFF lobes differ significantly, providing insight into the heterogeneity of induration within the formation. The deepest craters are found in Eumenides Dorsum and the shallowest in Aeolis Planum, consistent with a greater degree of induration and reworking in the western part of the formation where the fluvial features and "salt-playa" meso-yardangs are found. It also suggests that Eumenides, which is the tallest MFF outcrop, could also be the least compacted. The presence of long, complex, and sometimes overlapping branching networks imply multiple relative episodes of channel formation. Rounded meso-yardangs, which are associated with salt playa surfaces on Earth, provide additional evidence for the presence of liquid water

  13. Skull-base foramina of the middle cranial fossa : assessment of normal variation with high-resolution CT

    International Nuclear Information System (INIS)

    Kim, Hyae Young; Chung, Eun Chul; Suh, Jeong Soo; Choi, Hye Young; Ko, Eun Joo; Lee, Myung Sook

    1997-01-01

    To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4-73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5mm collimation at 1.5mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. In 45 cases (27.6%) the foramen ovale was 5-10mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1%). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8%) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1%). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22%). The foramen spinosum was asymmetrical in 42 cases (25.8%). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7%). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5%). In 74 cases (45.4%), the foramen of Vesalius was absent; it was present unilaterally and bilaterally in 55 (33.7%) and 34 cases (20.9%), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9%) and was present bilaterally in three (1.8%). HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images

  14. Ankle Block vs Single-Shot Popliteal Fossa Block as Primary Anesthesia for Forefoot Operative Procedures: Prospective, Randomized Comparison.

    Science.gov (United States)

    Schipper, Oliver N; Hunt, Kenneth J; Anderson, Robert B; Davis, W Hodges; Jones, Carroll P; Cohen, Bruce E

    2017-11-01

    Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures. All patients having elective outpatient orthopedic forefoot procedures were invited to participate in the study. Patients were prospectively randomized to receive either an ultrasound-guided AB or PFB by a board-certified anesthesiologist prior to their procedure. Intraoperative conversion to general anesthesia and postanesthesia care unit (PACU) opioid requirements were recorded. Postoperative pain was assessed using the visual analog scale (VAS) at regular time intervals until 8 am on postoperative day (POD) 2. Patients rated the effectiveness of the block on a 1 to 5 scale, with 5 being very effective. A total of 167 patients participated in the study with 88 patients (53%) receiving an AB and 79 (47%) receiving a single-shot PFB. There was no significant difference in the rate of conversion to general anesthesia between the 2 groups (13.6% [12/88] AB vs 12.7% [10/79] PFB). PACU morphine requirements and doses were significantly reduced in the PFB group ( P = .004) when compared to the AB group. The VAS was also significantly lower for the PFB patients at 10 pm on POD 0 (4.6 vs 1.6, P block site pain and/or erythema (AB 6.9% [6/88] vs PFB 5.1% [4/79], P = .44). The analgesic effect of the PFB lasted significantly longer when compared to the ankle block (AB 14.5 hours vs PFB 20.9 hours, P block between the 2 groups, with both blocks being highly effective (AB 4.79/5 vs PFB 4.82/5, P = .68). Regional anesthesia was a safe and reliable adjunct to perioperative pain management and highly

  15. Balancing the shortcomings of microscope and endoscope: endoscope-assisted technique in microsurgical removal of recurrent epidermoid cysts in the posterior fossa.

    Science.gov (United States)

    Ebner, F H; Roser, F; Thaher, F; Schittenhelm, J; Tatagiba, M

    2010-10-01

    We report about endoscope-assisted surgery of epidermoid cysts in the posterior fossa focusing on the application of neuro-endoscopy and the clinical outcome in cases of recurrent epidermoid cysts. 25 consecutively operated patients with an epidermoid cyst in the posterior fossa were retrospectively analysed. Surgeries were performed both with an operating microscope (OPMI Pentero or NC 4, Zeiss Company, Oberkochen, Germany) and endoscopic equipment (4 mm rigid endoscopes with 30° and 70° optics; Karl Storz Company, Tuttlingen, Germany) under continuous intraoperative monitoring. Surgical reports and DVD-recordings were evaluated for identification of adhesion areas and surgical details. 7 (28%) of the 25 patients were recurrences of previously operated epidermoid cysts. Mean time to recurrence was 17 years (8-22 years). In 5 cases the endoscope was used as an adjunctive tool for inspection/endoscope-assisted removal of remnants. The effective time of use of the endoscope was limited to the end stage of the procedure, but was very effective. In a modern operative setting and with the necessary surgical experience recurrent epidermoid cysts may be removed with excellent clinical results. The combined use of microscope and endoscope offers relevant advantages in demanding anatomic situations. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

    International Nuclear Information System (INIS)

    Hoff, Katja von; Kieffer, Virginie; Habrand, Jean-Louis; Kalifa, Chantal; Dellatolas, Georges; Grill, Jacques

    2008-01-01

    To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. 23 patients (age 0.3 – 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT. Mean last full scale IQ (FSIQ), verbal IQ (VIQ) and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores ≤ 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p < 0,001). The absence of hydrocephalus was an indicator of better neuropsychologic outcome (mean FSIQ of 102.6 vs 83.9, p = 0.025). Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome

  17. An unusual and spectacular case of spindle cell lipoma of the posterior neck invading the spinal cervical canal and posterior cranial fossa.

    Science.gov (United States)

    Petit, Damien; Menei, Philippe; Fournier, Henri-Dominique

    2011-11-01

    The authors describe the first case of spindle cell lipoma of the posterior neck invading the upper cervical spinal canal and the posterior cranial fossa. Spindle cell lipoma is an extremely rare variant of benign lipoma. It usually occurs as a solitary subcutaneous well-circumscribed lesion in the posterior neck or shoulders of adult men. Local aggressiveness is unusual. This 61-year-old man presented with an increased left cerebellar syndrome and headaches. He also had a posterior neck tumefaction, which had been known about for a long time. Computed tomography and MR imaging studies revealed a voluminous mass extending to the upper cervical canal and posterior cranial fossa and eroding the neighboring bones. The lesion was well delimited, and contrast enhancement was intense and heterogeneous. The tumor, which had initially developed under the muscles of the posterior neck, was totally resected. Histological assessment revealed numerous fat cells with spindle cells secreting collagen. The large size of the tumor and the submuscular location, bone erosion, and compression of the CNS were unusual in this rare subtype of benign adipose tumor. Its presentation could simulate a sarcoma.

  18. Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications

    Directory of Open Access Journals (Sweden)

    Kalifa Chantal

    2008-01-01

    Full Text Available Abstract Background To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. Methods 23 patients (age 0.3 – 14 years at diagnosis who were treated with local posterior fossa irradiation (54 Gy underwent one (4 patients or sequential (19 patients neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5 years after RT. Results Mean last full scale IQ (FSIQ, verbal IQ (VIQ and PIQ were 89.1, 94.0, and 86.2 respectively. All patients had difficulties with reading, and individual patients showed deficits in visuospatial, memory and attentional tasks. There was no trend for deterioration of intellectual outcome over time. All 5 children with IQ scores ≤ 75 were under the age of four at diagnosis. There was a significant association between the presence of cerebellar deficits and impaired IQ (72.0 vs 95.2, p Conclusion Within the evaluated cohort, intellectual functions were moderately impaired. Markedly reduced IQ scores were only seen with early disease manifestation and treatment, and postoperative neurological deficits had a strong impact on intellectual outcome.

  19. Ulysses Fossae in Tharsis

    Science.gov (United States)

    2002-01-01

    [figure removed for brevity, see original site] Extensional forces in the volcanic province of Tharsis have produced a fractured terrain that resembles wrinkled skin.Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  20. Uso da fáscia temporal na suspensão frontal: descrição da técnica cirúrgica - Relato de caso Use of temporal fascia in frontalis suspension: description of the surgical technique - Case report

    Directory of Open Access Journals (Sweden)

    Tânia Pereira Nunes

    2004-04-01

    Full Text Available OBJETIVOS: Familiarizar o oftalmologista com a anatomia da região temporal, descrever a técnica cirúrgica da retirada da fáscia temporal e da suspensão frontal e analisar as vantagens e desvantagens da fáscia temporal na suspensão frontal. MÉTODOS: Revisão do prontuário de uma paciente com blefaroptose grave que foi submetida à suspensão frontal com fáscia temporal. Revisão da anatomia da fossa temporal e das técnicas cirúrgicas. RESULTADOS: Bom resultado estético e funcional foi conseguido no caso descrito. CONCLUSÃO: A fáscia temporal é boa opção na suspensão frontal com algumas vantagens: é um tecido autógeno, de fácil obtenção e mínima morbidade no pós-operatório.PURPOSE: To familiarize the ophthalmologist with the anatomy of the temporal region, to describe the surgical technique of temporal fascia harvest and frontalis suspension and to demonstrate advantages and disadvantages of temporal fascia in frontalis suspension. METHODS: Review of the clinical and surgical data of one case with severe blepharoptosis who underwent frontalis suspension using temporal fascia. Review of the anatomy of the temporal fossa and the surgical techniques. RESULTS: Good esthetic and functional results were obtained in this case. CONCLUSION: Temporal fascia is a good choice for frontalis suspension with some advantages: it is autogenous, it is easily harvested and it yields minimal post-operative morbidity.

  1. Filosofia da análise da estabilidade da liquidez

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    Rodrigo Antônio Chaves da Silva

    2005-07-01

    Full Text Available A informação foi considerada finalidade de nosso conhecimento, até o período em os pensadores e pesquisadores da contabilidade passaram a raciocinar sobre o conteúdo e o significado dos informes. Nesta busca da razão sobre os estados patrimoniais, surgiu a análise contábil que procura por meio de relações e identidades, o significado da dinâmica expressa da estaticamente na informação. O primeiro aspecto que surgiu no objeto de análise foi o estudo da liquidez, que é um dos principais exercícios do patrimônio. A estabilidade também é outro exercício básico e imprescindível, pois este é que promove o equilíbrio do organismo administrativo. A ciência contábil após a sua dignidade científica passou a trilhar caminhos esplendorosos, amparados em doutrina que permite alcançar os píncaros filosóficos. Os estudos concernentes aos aspectos de interação da estabilidade na liquidez são, complexos e somente com os recursos filosóficos da contabilidade se pode estudá-los com o panorama holístico e sublime. A filosofia da contabilidade não é alheia às suas práticas tecnológicas, podendo buscar pontos sublimes de panoramas abrangentes, para o estudo analítico da liquidez e estabilidade, observando todas as dimensionalidades e essencialidades de acontecimentos, na comprovação e orientação dos estados de ineficácia e eficácia patrimonial.

  2. Doenças da cavidade nasal em ruminantes no Brasil Diseases of the nasal cavity of ruminants in Brazil

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    Roseane de A Portela

    2010-10-01

    Full Text Available Este trabalho descreve as doenças das fossas nasais diagnosticadas em ruminantes no Hospital Veterinário da Universidade Federal de Campina Grande, em Patos, Paraíba, nos anos de 2003-2009. No período foram registrados três diagnósticos de doenças das fossas nasais de bovinos, três em caprinos e nove em ovinos (de um total de 404 diagnósticos em bovinos, 330 em caprinos e 338 em ovinos. Descrevem-se um caso de rinite atópica em bovinos, sete surtos de conidiobolomicose e dois de pitiose rinofacial em ovinos, dois casos de prototecose e um de aspergilose nasal em caprinos e um mixoma e um fibrossarcoma em bovinos. Adicionalmente, é realizada uma revisão de outras doenças das fossas nasais de ruminantes descritas em outras regiões do Brasil, incluindo oestrose, rinosporidiose, carcinoma epidermóide e tumor etmoidal enzoótico.This paper reports diseases of the nasal cavity diagnosed in ruminants in the Veterinary Hospital of the Federal University of Campina Grande, in Patos, state of Paraiba, northeastern Brazil, from 2003 to 2009. During that period three cases or outbreaks of diseases of the nasal cavity were reported in cattle, three in goats and nine in sheep (out of 404 diseases diagnosed in cattle, 330 in goats, and 338 in sheep. At all are reported one case of atopic rhinitis in cattle, seven outbreaks of conidiobolomycosis and two outbreaks of rhinofacial pythiosis in sheep, two cases of protothecosis and one of nasal aspergillosis in goats, and a myxoma and a fibrosarcoma in cattle. Additionally, other diseases of the nasal cavity reported in Brazil are reviewed, including oestrosis, rhinosporidiosis, squamous cell carcinoma, and enzootic ethmoidal tumor.

  3. Georeferenced cartography dataset of the La Fossa crater fumarolic field at Vulcano Island (Aeolian Archipelago, Italy: conversion and comparison of data from local to global positioning methods

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    Carmelo Sammarco

    2011-07-01

    Full Text Available The present study illustrates the procedures applied for the coordinate system conversion of the historical fumarole positions at La Fossa crater, to allow their comparison with newly acquired global positioning system (GPS data. Due to the absence of ground control points in the field and on both the old Gauss Boaga and the new UTM WGS 1984 maps, we had to model the transformation errors between the two systems using differential GPS techniques. Once corrected, the maps show a residual Easting shifting, due to erroneous georeferencing of the original base maps; this is corrected by morphological comparative methods. The good correspondence between the corrected positions of the historical data and the results of the new GPS survey that was carried out in 2009 highlights the good quality of the old surveys, although they were carried out without the use of accurate topographical instruments.

  4. Temporal lobe sulcal pattern and the bony impressions in the middle cranial fossa: the case of the el Sidrón (Spain) neandertal sample.

    Science.gov (United States)

    Rosas, Antonio; Peña-Melián, Angel; García-Tabernero, Antonio; Bastir, Markus; De La Rasilla, Marco

    2014-12-01

    Correspondence between temporal lobe sulcal pattern and bony impressions on the middle cranial fossae (MCF) was analyzed. MCF bone remains (SD-359, SD-315, and SD-1219) from the El Sidrón (Spain) neandertal site are analyzed in this context. Direct comparison of the soft and hard tissues from the same individual was studied by means of: 1) dissection of two human heads; 2) optic (white light) surface scans; 3) computed tomography and magnetic resonance of the same head. The inferior temporal sulcus and gyrus are the features most strongly influencing MCF bone surface. The Superior temporal sulcus and middle temporal and fusiform gyri also leave imprints. Temporal lobe form differs between Homo sapiens and neandertals. A wider and larger post-arcuate fossa (posterior limit of Brodmann area 20 and the anterior portion of area 37) is present in modern humans as compared to neandertals. However other traits of the MCF surface are similar in these two large-brained human groups. A conspicuous variation is appreciated in the more vertical location of the inferior temporal gyrus in H. sapiens. In parallel, structures of the lower surface of the temporal lobe are more sagittally orientated. Grooves accommodating the fusiform and the lower temporal sulci become grossly parallel to the temporal squama. These differences can be understood within the context of a supero-lateral deployment of the lobe in H. sapiens, a pattern previously identified (Bastir et al., Nat Commun 2 (2011) 588-595). Regarding dural sinus pattern, a higher incidence of petrosquamous sinus is detected in neandertal samples. © 2014 Wiley Periodicals, Inc.

  5. Quantitative analysis of the Kawase versus the modified Dolenc-Kawase approach for middle cranial fossa lesions with variable anteroposterior extension.

    Science.gov (United States)

    Tripathi, Manjul; Deo, Rama Chandra; Suri, Ashish; Srivastav, Vinkle; Baby, Britty; Kumar, Subodh; Kalra, Prem; Banerjee, Subhashis; Prasad, Sanjiva; Paul, Kolin; Roy, Tara Sankar; Lalwani, Sanjeev

    2015-07-01

    The surgical corridor to the upper third of the clivus and ventral brainstem is hindered by critical neurovascular structures, such as the cavernous sinus, petrous apex, and tentorium. The traditional Kawase approach provides a 10 × 5-mm fenestration at the petrous apex of the temporal bone between the 5th cranial nerve and internal auditory canal. Due to interindividual variability, sometimes this area proves to be insufficient as a corridor to the posterior cranial fossa. The authors describe a modification to the technique of the extradural anterior petrosectomy consisting of additional transcavernous exploration and medial mobilization of the cisternal component of the trigeminal nerve. This approach is termed the modified Dolenc-Kawase (MDK) approach. The authors describe a volumetric analysis of temporal bones with 3D laser scanning of dry and drilled bones for respective triangles and rhomboid areas, and they compare the difference of exposure with traditional versus modified approaches on cadaver dissection. Twelve dry temporal bones were laser scanned, and mesh-based volumetric analysis was done followed by drilling of the Kawase triangle and MDK rhomboid. Five cadaveric heads were drilled on alternate sides with both approaches for evaluation of the area exposed, surgical freedom, and angle of approach. The MDK approach provides an approximately 1.5 times larger area and 2.0 times greater volume of bone at the anterior petrous apex compared with the Kawase's approach. Cadaver dissection objectified the technical feasibility of the MDK approach, providing nearly 1.5-2 times larger fenestration with improved view and angulation to the posterior cranial fossa. Practical application in 6 patients with different lesions proves clinical applicability of the MDK approach. The larger fenestration at the petrous apex achieved with the MDK approach provides greater surgical freedom at the Dorello canal, gasserian ganglion, and prepontine area and better

  6. Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note.

    Science.gov (United States)

    Felbaum, Daniel R; Mueller, Kyle; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

    2016-12-28

     Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk.  A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy. Patient data was reviewed for craniotomy or craniectomy, dural graft, and/or sealant use as well as CSF complications. A pseudomeningocele was defined as a subcutaneous collection of cerebrospinal fluid palpable clinically and confirmed on imaging. A CSF leak was defined as a CSF-cutaneous fistula manifested by CSF leaking through the wound. All patients underwent regular postoperative visits of two weeks, one month, and three months.  Our retrospective review identified 33 patients matching the inclusion criteria. Overall, our cohort had a 21% (7/33) rate of clinical and radiographic pseudomeningocele formation with 9% (3/33) requiring surgical revision or a separate procedure. The rate of clinical and radiographic pseudomeningocele formation in the myofascial cuff preservation technique was less than standard techniques (12% and 31%, respectively). Revision or further surgical procedures were also reduced in the myofascial cuff preservation technique vs. the standard technique (6% vs 13%).  Preservation of the myofascial cuff during posterior fossa surgery is a simple and adoptable technique that reduces the rate of pseudomeningocele formation and CSF leak as compared with standard techniques.

  7. Microanatomical and immunohistochemical study of the human lateral antebrachial cutaneous nerve of forearm at the antecubital fossa and its clinical implications.

    Science.gov (United States)

    Marx, S Chakravarthy; Kumar, Pramod; Dhalapathy, S; Prasad, Keerthana; Marx, C Anitha

    2010-09-01

    Changes in the intraneural anatomy with age can cause poor prognosis of nerve repair in patients after nerve injury. The occurrence of Complex Regional Pain Syndrome-Type II, secondary to peripheral nerve injury, is common. The purpose of this study is to asses changes in cross-sectional anatomy of the lateral antebrachial cutaneous nerve of forearm (LCNF) at the antecubital fossa in the fascicular, nonfascicular components (adipose and nonadipose tissue), and sympathetic fibers area with respect to age. For the purpose of the study, 32 human (37-88 years) fresh cadaveric LCNF were collected from left-antecubital fossae and processed for histological, morphometric analysis [total cross-sectional (Asc), fascicular (Af), and nonfascicular area (Anonf)], and immunohistochemical method (tyrosine hydroxylase) for sympathetic fibers. The LCNF's average total cross-sectional area was 3.024 mm(2), and fascicular area was 0.582 mm(2). The average number of fascicles per mm(2) was 3.09. The cross-sectional area in the nerve was mainly occupied by nonfascicular connective tissue (80.75%). There was increased adipose tissue deposition (48.48% of Asc) and decreased collagen fibers (32.24% of Asc) in interfascicular domains without any definite relationship with age. The average sympathetic fiber area was 0.026 mm(2) within the nerve fascicular area without any correlation with age. In LCNF, there was more adipose tissue and less collagen fibers deposition in the interfascicular domains of all age cases, and this may act as an obstacle for nerve fiber regeneration on using LCNF as an interpositional nerve graft.

  8. Immunohistochemical analysis of H3K27me3 demonstrates global reduction in group-A childhood posterior fossa ependymoma and is a powerful predictor of outcome.

    Science.gov (United States)

    Panwalkar, Pooja; Clark, Jonathan; Ramaswamy, Vijay; Hawes, Debra; Yang, Fusheng; Dunham, Christopher; Yip, Stephen; Hukin, Juliette; Sun, Yilun; Schipper, Matthew J; Chavez, Lukas; Margol, Ashley; Pekmezci, Melike; Chung, Chan; Banda, Adam; Bayliss, Jill M; Curry, Sarah J; Santi, Mariarita; Rodriguez, Fausto J; Snuderl, Matija; Karajannis, Matthias A; Saratsis, Amanda M; Horbinski, Craig M; Carret, Anne-Sophie; Wilson, Beverly; Johnston, Donna; Lafay-Cousin, Lucie; Zelcer, Shayna; Eisenstat, David; Silva, Marianna; Scheinemann, Katrin; Jabado, Nada; McNeely, P Daniel; Kool, Marcel; Pfister, Stefan M; Taylor, Michael D; Hawkins, Cynthia; Korshunov, Andrey; Judkins, Alexander R; Venneti, Sriram

    2017-11-01

    Posterior fossa ependymomas (EPN_PF) in children comprise two morphologically identical, but biologically distinct tumor entities. Group-A (EPN_PFA) tumors have a poor prognosis and require intensive therapy. In contrast, group-B tumors (EPN_PFB) exhibit excellent prognosis and the current consensus opinion recommends future clinical trials to test the possibility of treatment de-escalation in these patients. Therefore, distinguishing these two tumor subtypes is critical. EPN_PFA and EPN_PFB can be distinguished based on DNA methylation signatures, but these assays are not routinely available. We have previously shown that a subset of poorly prognostic childhood EPN_PF exhibits global reduction in H3K27me3. Therefore, we set out to determine whether a simple immunohistochemical assay for H3K27me3 could be used to segregate EPN_PFA from EPN_PFB tumors. We assembled a cohort of 230 childhood ependymomas and H3K27me3 immunohistochemistry was assessed as positive or negative in a blinded manner. H3K27me3 staining results were compared with DNA methylation-based subgroup information available in 112 samples [EPN_PFA (n = 72) and EPN_PFB tumors (n = 40)]. H3K27me3 staining was globally reduced in EPN_PFA tumors and immunohistochemistry showed 99% sensitivity and 100% specificity in segregating EPN_PFA from EPN_PFB tumors. Moreover, H3K27me3 immunostaining was sufficient to delineate patients with worse prognosis in two independent, non-overlapping cohorts (n = 133 and n = 97). In conclusion, immunohistochemical evaluation of H3K27me3 global reduction is an economic, easily available and readily adaptable method for defining high-risk EPN_PFA from low-risk posterior fossa EPN_PFB tumors to inform prognosis and to enable the design of future clinical trials.

  9. A Peek into a Cul-De-Sac and a Mews of Martian Dust Storm Activity: Western Hellas and Syria-Claritas Fossae During Mars Year 29

    Science.gov (United States)

    Heavens, N. G.

    2016-12-01

    Western Hellas Planitia (WHP) and the region encompassed by Syria Planum and Claritas Fossae are the main centers of textured dust storm activity in Mars's southern low to mid-latitudes. (Texture in this context refers to distinct fine structure at the cloud tops indicative of active lifting.) WHP is a well-known initiation zone for regional and global dust storm activity and often the end point of the Utopia "flushing storm" track. Syria-Claritas Fossae (SCF), too, can be a lifting center in global dust storm activity. Indeed, SCF and the area to its west was the region most denuded of dust by the Mars Year (MY) 25 global dust storm, perhaps suggesting that SCF contained the principal lifting center of the storm. Thus, if the Acidalia and Utopia storm tracks are Mars's dust storm alleys, through which dust storms pass quickly again and again; WHP might be a cul-de-sac and SCF something like a mews, where dust storm activity can enter more or less easily but may not as easily leave. In this presentation, I will focus on dust storm activity in these areas in a typical non-global dust storm year, MY 29. Synthesizing visible imagery by the Mars Color Imager (MARCI) on board Mars Reconnaissance Orbiter (MRO) and Mars Climate Sounder (MCS) also on board MRO, I will consider the climatology, morphology, texture, and vertical structure of dust storm activity in these areas in order to infer their governing dynamics. This investigation has two aims: (1) to understand why these areas are centers of textured dust storm activity; and (2) to connect the characteristics of smaller-scale dust storm activity in these regions to the underlying dynamics in order to understand the role of WHP and SCF in the dynamics of global dust storms. This work is supported by NASA's Mars Data Analysis Program (NNX14AM32G).

  10. Disorders Incidence and Analysis of a Flat Stabilization Splint as Its Therapy Levantamento de Incidência de DTMS e Análise da Efetividade da Placa de Mordida Plana Como Terapia TMJ

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    João Ricardo T. Milam

    2004-10-01

    ético utilizou-se do Critério de Classificação e Diagnóstico para Cefaléias, Neuralgias Cranianas e Dor Facial da Sociedade Internacional de Dores de Cabeça / IHS, associado ao Critério Diagnóstico para Pesquisa em DTMs. Os sinais e sintomas diagnosticados em ambos os Grupos, fundamentados nos dois critérios acima especificados, foram: dor nas ATMs e na musculatura que auxilia a mastigação, limitação de movimentos de abertura e fechamento da boca, dores faciais, bruxismo, dor relacionada a problemas de oclusão dentária, estalido ao abrir a boca, cansaço mandibular, efeito de apertamento dos dentes . Ainda, e somente no Grupo I, foi analisada a efetividade da placa de mordida plana como terapia aplicada a esses casos, sendo que esta se demonstrou eficaz em todos os tratamentos realizados.  

  11. Proteínas morfogenéticas ósseas associadas a osso esponjoso autógeno na reparação de falhas experimentais na calota craniana de coelhos (Oryctolagus cuniculus Bone morphogenetic proteins associated with autogenous bone graft in the reparation of calvarial experimental defects of rabbits (Oryctolagus cuniculus

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    B.S. Monteiro

    2007-12-01

    Full Text Available Foi avaliada a reparação óssea após implantação de proteínas morfogenéticas ósseas (BMP em diferentes concentrações e períodos de observação, carreadas por auto-enxerto ósseo esponjoso (EOE, em falhas ósseas, produzidas na região fronto-parietal do crânio de 20 coelhas. A falha I não foi preenchida, a II foi completamente preenchida com 3mg de EOE e as falhas III, IV, V e VI foram preenchidas com EOE associado a 0,5; 1; 2 e 5mg de BMP, respectivamente. Nas avaliações mesoscópicas, post mortem, verificou-se que, independentemente do período de tratamento, o preenchimento ósseo iniciou-se a partir das bordas para o centro e do fundo para a superfície das falhas. Na falha I manifestou-se o menor preenchimento ósseo quando comparada com as demais falhas, em todos os períodos, e nas que receberam 2mg de BMP exibiu-se a melhor cobertura óssea. Microscopicamente, verificou-se que, aos sete dias, o preenchimento ósseo iniciou-se a partir das bordas e do fundo da lesão, com mobilização e diferenciação de células provenientes do periósteo e das meninges, respectivamente e, nas avaliações subseqüentes, a atividade osteoblástica originou-se, também, de "ilhas de ossificação" semelhantes a centros de ossificação, localizadas no centro da falha. A formação trabecular aumentou, proporcionalmente, com a concentração utilizada de BMP, e a aposição e organização óssea aumentaram com o tempo de observação. Verificou-se também a presença de tecido cartilaginoso. A BMP associada ao EOE contribuiu para a formação de novo tecido ósseo, promovendo maior mobilização, diferenciação e organização celular, e abreviou o tempo de formação óssea, sugerindo processo de ossificação endocondral. Os melhores resultados foram observados com a associação de 2mg de BMP a 3mg de enxerto, e a adição de BMP, mesmo em menor quantidade, determinou precocidade de formação óssea. A maior quantidade de BMP n

  12. A Sintaxe da Janela

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    Luís Antônio Jorge

    1993-12-01

    Full Text Available A preocupação fundamenta! do trabalho é de caráter ontológico: esboçar o problema das significações apriorísticas e autônomas dos elementos que compõem a sintaxe arquitetônica. O trabalho elege um desses elementos: a janela. Este artigo parte da aproximação histórica entre a janela e a secção da pirâmide visual, construção imaginária da teoria da perspectiva renascentista. A consideração da janela na linguagem arquitetônica implica reconhecer uma ambigüidade essencial: a janela deve inserir-se ordenadamente no plano da parede - raciocínio típico da modenatura - mas também relacionar-se com a imagem vista através dela, que extrapola o plano, ressaltando a tridimensionalidade - herança da perspectiva renascentista, fundamentada no espaço euclidiano. Ver janela ou ver através da janela são alternativas que se colocam tanto ao observador interno ao edifício, quanto ao externo. Texto de duplaface, a sintaxe da janela versa sobre o relacionamento desses dois lados

  13. Avaliação radiografica de duas tecnicas, para o registro da relação centrica em pacientes classe I de Angle

    OpenAIRE

    Guilherme da Gama Ramos

    2007-01-01

    Resumo: Este estudo teve como objetivo comparar, por meio de radiografias transcranianas (técnica Accurad), duas técnicas descritas na literatura para a obtenção da relação cêntrica e posição das cabeças da mandíbula nas fossas mandibulares. Uma delas, a manipulação bilateral descrita por DAWSON em 1974. A outra, um traçado gráfico dos movimentos mandibulares no plano horizontal, denominado por GYSI, em 1910, de arco gótico, obtido por meio de um dispositivo, chamado de registro intra-oral. F...

  14. Avaliação da concordância interobservadores na análise da polipose nasossinusal por meio da tomografia computadorizada Evaluation of the concordance between observers in sinunasal polyposis through computed tomographic analysis

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    Elaine A. Mendes

    2004-08-01

    Full Text Available Polipose nasossinusal (PNS é uma entidade de etiologia controversa, caracterizada por uma condição inflamatória da superfície mucosa das fossas nasais e seios paranasais, bilateralmente. A queixa principal do paciente consiste na obstrução nasal e, ao exame físico, observam-se freqüentemente massas polipóides ocupando as cavidades nasais em extensões variáveis. Além da rinoscopia anterior e da endoscopia nasal, o uso da tomografia computadorizada (TC torna-se necessário para avaliação das fossas nasais e da presença ou não do acometimento dos seios paranasais por essas massas, bem como a sua extensão. Este trabalho tem como objetivo avaliar a concordância interobservadores, por meio da análise da tomografia computadorizada, de 32 casos de PNS. FORMA DE ESTUDO: Clínico prospectivo. CASUÍSTICA E MÉTODOS: Foram avaliadas 32 TC de pacientes portadores PNS por dois observadores experientes, separadamente, em relação à presença ou não de 3 sinais tomográficos sugestivos dessa doença: (1 alargamento infundibular do complexo ostiomeatal, (2 abaulamento lateral da lâmina papirácea e (3 apagamento do trabeculado ósseo etmoidal. RESULTADOS: Observou-se Qui-quadrado não significante para o primeiro e segundo sinais (p=0,7055 e p=0,2057 e significante para o terceiro (p=0,0040. Contudo, o coeficiente de correlação de Kendall entre os dois observadores foi significante para os três sinais tomográficos acima citados (pSinonasal polyposis (SNP is a condition with a controversial aethiology, known by bilaterally inflammatory mucous membranes of nasal and paranasal sinuses. The major patient's complaint is nasal obstruction, and polypoid masses in different sizes can be found during nasal cavity examination. Beyond anterior rhinoscophy and nasal endoscopy, screening sinus computed tomography (SSCT is necessary to measure the size and the extent of the polyps into nasal cavities and paranasal sinuses. The purpose of this

  15. Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.

    Science.gov (United States)

    Coll, Guillaume; Lemaire, Jean-Jacques; Di Rocco, Federico; Barthélémy, Isabelle; Garcier, Jean-Marc; De Schlichting, Emmanuel; Sakka, Laurent

    2016-11-01

    To date, no study has compared the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification. To illustrate these features in healthy children. The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan. The mean FMA of 6.49 cm in girls was significantly inferior to the FMA of 7.67 cm in boys (P < .001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P < .001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously. The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P ≤ .02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P = .01). AIOS, anterior interoccipital synchondrosesFMA, foramen magnum areaLS, lambdoid suturesOMS, occipitomastoidal synchondrosesPCFV, posterior cranial fossa volumePIOS, posterior interoccipital synchondrosesPOS, petro-occipital synchondrosesSOS, spheno-occipital synchondrosisyo, years old.

  16. Inner structure of La Fossa di Vulcano (Vulcano Island, southern Tyrrhenian Sea, Italy) revealed by high-resolution electric resistivity tomography coupled with self-potential, temperature, and CO2 diffuse degassing measurements

    OpenAIRE

    Revil , A.; Finizola , Anthony; Piscitelli , A.; Rizzo , E.; Ricci , T.; Crespy , A.; Angeletti , B.; Balasco , M.; Barde-Cabusson , Stéphanie; Bennati , L.; Boleve , A.; Byrdina , S.; Carzaniga , N.; Di Gangi , F.; Morin , Julie

    2008-01-01

    International audience; La Fossa cone is an active stratovolcano located on Vulcano Island in the Aeolian Archipelago (southern Italy). Its activity is characterized by explosive phreatic and phreatomagmatic eruptions producing wet and dry pyroclastic surges, pumice fall deposits, and highly viscous lava flows. Nine 2-D electrical resistivity tomograms (ERTs; electrode spacing 20 m, with a depth of investigation >200 m) were obtained to image the edifice. In addition, we also measured the sel...

  17. Tópicos da teoria da relatividade

    OpenAIRE

    Fragata, Paulo Renato Ferreira

    2013-01-01

    Dissertação de Mestrado, Matemática para Professores, 25 de Outubro 2013, Universidade dos Açores. Qualquer descrição física da natureza tem por base a especificação da posição e do instante em que decorre determinado acontecimento. Para tal, é necessário recorrer a um sistema de coordenadas, escolhido por cada observador, do modo que ele achar mais pertinente. Dada a generalidade na escolha do sistema de coordenadas, é útil conhecer as regras que nos permitem comparar cálculos feitos em d...

  18. [A Case of Ruptured Internal Carotid-Posterior Communicating Artery Aneurysm Associated with Acute Subdural Hematoma, Extending from the Interhemispheric Space to the Posterior Fossa].

    Science.gov (United States)

    Otsuka, Hiroaki; Fukuda, Yuhtaka; Yoshimura, Shouta; Somagawa, Chika; Hiu, Takeshi; Ono, Tomonori; Ushijima, Ryujirou; Toda, Keisuke; Tsutsumi, Keisuke

    2016-06-01

    A 69-year-old woman was admitted to our hospital because of a sudden severe headache without a history of head trauma. CT and MRI revealed an acute subdural hematoma (ASDH) extending from the right interhemispheric space to the posterior fossa bilaterally, with a small amount of subarachnoid hemorrhage that was predominantly localized to the left side of the basal cistern. CT angiogram demonstrated a long protruding ruptured aneurysm at the junction of the right internal carotid and posterior communicating arteries (IC/PC AN) with a posteroinferior projection, associated with a small bleb located near the tentorial edge close to the ipsilateral posterior clinoid process, for which she received clipping surgery. Though rare, IC/PC AN could cause pure or nearly pure ASDH in the above-mentioned distribution. Therefore, in patients with such ASDH, especially without a history of head injury or precise information regarding the situation at the time of onset, urgent imaging evaluation and early intervention are essential to prevent devastating re-rupture events.

  19. Revision muduloblastoma and treatment of posterior fossa ependinoma analysis of new therapeutic strategies; Revision de tratamiento de meduloblastoma y ependinoma de fosa posterior analisis de nuevas estrategias terapeuticas

    Energy Technology Data Exchange (ETDEWEB)

    Mara, C.; Rodríguez, R.; Torres, M.; Roldán, G.; Ferreira, V. [Depto. de Oncologia del Hospital de Clínicas, Facultad de Medicina, Universidad de la Republica, Montevideo (Uruguay); Instituto Nacional de Oncología, Ministerio de Salud Pública, Montevideo (Uruguay)

    2010-12-15

    Fulltext: In general the primary tumors of S.n.c. required at some stage in their treatment, use of radiotherapy, usually as postoperative treatment or exclusively in the case that the surgery is not possible, in turn for treatment of some of these tumors association with chemotherapy has shown to be beneficial. In the case of medulloblastomas, ependymomas of the posterior fossa tumors of the choroid plexus and the pineal gland, irradiation technique that used for their particular spread is the total craniospinal irradiation. In this paper a review of the treatment techniques are performed, the overall survival and disease-free survival and complications treatments, in patients with medulloblastoma and ependymomas treated in the Department. Oncology Hospital and Clinics in INDO period of approximately 30 years. Results were compared with the international literature and analysis was performed new perspectives on the therapeutic radiation treatment (radiotherapy 3D shaped for example) and its association with chemotherapy. The results will be analyzed in Congress.

  20. Remote Sensing and Geodetic Measurements for Volcanic Slope Monitoring: Surface Variations Measured at Northern Flank of La Fossa Cone (Vulcano Island, Italy

    Directory of Open Access Journals (Sweden)

    Alessandro Bonforte

    2013-05-01

    Full Text Available Results of recent monitoring activities on potentially unstable areas of the NW volcano flank of La Fossa cone (Vulcano Island, Italy are shown here. They are obtained by integration of data by aerial photogrammetry, terrestrial laser scanning (TLS and GPS taken in the 1996–2011 time span. A comparison between multi-temporal models built from remote sensing data (photogrammetry and TLS highlights areas characterized by ~7–10 cm/y positive differences (i.e., elevation increase in the upper crown of the slope. The GPS measurements confirm these results. Areas characterized by negative differences, related to both mass collapses or small surface lowering, also exist. The higher differences, positive and negative, are always observed in zones affected by higher fumarolic activity. In the 2010–2012 time span, ground motions in the northern part of the crater rim, immediately above the upper part of observed area, are also observed. The results show different trends for both vertical and horizontal displacements of points distributed along the rim, with a magnitude of some centimeters, thus revealing a complex kinematics. A slope stability analysis shows that the safety factors estimated from these data do not indicate evidence of possible imminent failures. Nevertheless, new time series are needed to detect possible changes with the time of the stability conditions, and the monitoring has to go on.

  1. MACIEZ DA CARNE BOVINA

    Directory of Open Access Journals (Sweden)

    Antonio Bento Mancio

    2006-10-01

    Full Text Available Dentre as características de qualidade da carne bovina, a maciez assume posição de destaque, sendo considerada a característica organoléptica de maior influência na aceitação da carne por parte dos consumidores. A dureza da carne pode ser dividida em dureza residual, causada pelo tecido conjuntivo e outras proteínas do estroma, e dureza de actomiosina, causada pelas proteínas miofibrilares. Dentre os fatores que influenciam a maciez da carne, podem ser destacados a genética, a raça, a idade ao abate, o sexo, a alimentação, o uso de agentes hormonais (?-adrenérgicos e os tratamentos post-mortem. A qualidade final da carne é resultante de tudo o que aconteceu com o animal durante toda a cadeia produtiva. Devem-se assegurar procedimentos adequados de transporte, armazenamento, manipulação, exposição e preparo da carne, a fim de se obter um produto de melhor qualidade. PALAVRAS-CHAVE: Calpaínas, calpastatina, qualidade da carne, rigor mortis, tecido muscular.

  2. GERONTOLOGIA: ESTADO DA ARTE

    Directory of Open Access Journals (Sweden)

    Vera M.A.Tordino Brandão

    2010-02-01

    Full Text Available O Programa de Gerontologia da PUC desenvolve pesquisas focando o ser na perspectiva do envelhecimento. As atividades são interdisciplinares e reúnem docentes, alunos e ex-alunos. Nesta mesa redonda apresentamos um panorama sobre estes estudos. Na área da educação e comunicação o foco está centrado na longevidade e na preparação e representação social da velhice. São ressaltadas como temáticas: a formação continuada de profissionais e pesquisadores; o significado da religiosidade/espiritualidade ao longo da trajetória, e sua repercussão na qualidade de vida do idoso; os programas sócio-educacionais para idosos e concepções sobre educação; o monitoramento da mídia na cobertura da crescente longevidade e seus impactos. Em identidade e modos de morar reflete-se sobre soluções planejadas e sua adequação para a inclusão do envelhecimento populacional como questão fundamental, que implica a elaboração de novas políticas, investigações e, especialmente, apresenta-se como questão a ser analisada, refletida e vivenciada pela sociedade em geral. Quanto à saúde, o Programa desenvolve várias pesquisas numa abordagem interdisciplinar tendo como objetos de estudo: a terapia assistida com animais direcionada a idosos com diagnóstico de Alzheimer; o acompanhamento terapêutico e o atendimento psicoterapêutico em grupo, a aplicação da técnica de Calatonia em idosos moradores de ILPI, além da investigação sobre impasses clínicos no idoso frágil. Palavras-chave: gerontologia, longevidade, envelhecimento

  3. Conjecturas da Epistemológia Jurídica e Aspectos da Teoria da Linguagem

    OpenAIRE

    Oliveira, Rita de Cássia Cartelli de; Cesumar; Motta, Ivan Dias; Cesumar

    2008-01-01

    Apresentar-se-ão reflexões em torno da epistemologia jurídica e alguns aspectos da teoria da linguagem; a necessidade de acompanhamento e aprimoramento da linguagem jurídica, para que o direito não se distancie da realidade, mantendo-se apenas como um sistema do status quo; uma breve análise de algumas teorias da ciência do direito e da linguagem; as especificidades dos termos lingüísticos para a análise da ciência do direito, pautada na contemporaneidade sob a perspectiva humanista, buscando...

  4. CONDICIONANTES DA COMPETITIVIDADE EMPRESARIAL

    Directory of Open Access Journals (Sweden)

    José Luiz Contador

    2010-03-01

    Full Text Available Este trabalho examina teoricamente os fatores determinantes da competitividade do produto e do negócio, imprescindíveis à elaboração de estratégias competitivas que visam à obtenção e sustentação de vantagens competitivas. Esse tema é objeto tanto da área de marketing estratégico quanto da de estratégia empresarial. Nas duas áreas, há um ponto de consenso que afirma que a empresa deve diferenciar sua oferta para conquistar e manter vantagem competitiva. Mas, os estudos conduzidos por meio do modelo de Campos e Armas da Competição revelaram que a empresa pode diferenciar seu produto e/ou serviço de modo mais amplo, levando em consideração, na formulação da sua estratégia competitiva, também o campo da competição, quer do produto, quer dela própria. Assim, o objetivo deste artigo é evidenciar que, para a empresa ser competitiva, além de diferenciar seu produto e/ou seu serviço no sentido tradicional, ela precisa: 1 diferenciar seu produto incluindo a definição em quais campos vai competir em cada segmento; e 2 escolher as armas da competição que irá utilizar e definir a intensidade de cada arma. Para atingir tal objetivo, foram necessários vários conceitos do modelo de Campos e Armas da Competição: campo da competição, arma da competição, tese do modelo, configuração dos campos da competição, campo coadjuvante, produto coadjuvante e par produto-mercado. Como uma proposta inovadora sempre desperta dúvida, é mostrado o processo de validação do modelo de Campos e Armas da Competição e são discutidas sua universalidade, consistência e completude.

  5. Efeitos da fratura do arco zigomático no crescimento facial em ratos jovens Effect of zygomatic arch fracture on facial growth in young rats

    Directory of Open Access Journals (Sweden)

    Elza Maria Villanova Fernandes ROCHA

    1999-01-01

    Full Text Available Os efeitos da fratura unilateral do arco zigomático no crescimento facial foram avaliados através de mensurações cefalométricas. Fratura com desvio medial no lado direito foi realizada em ratos com um mês de idade. Os animais foram sacrificados com três meses de idade e sua mandíbula foi desarticulada. O crânio foi submetido à tomada radiográfica axial e as hemimandíbulas à norma lateral. As mensurações foram realizadas através de um sistema de computador. Foi verificada diferença significante a menor para a altura do corpo e do ramo da mandíbula. Não houve diferença significante para a profundidade da fossa infratemporal, bem como para as diversas mensurações na maxila e para o comprimento mandibular. A tendência de retorno do arco zigomático com desvio à sua posição original foi confirmada.The effect of unilateral zygomatic arch fracture on facial growth was analysed by means of cephalometric measurements. Medially displaced fracture of the right side was achieved in one month old rats. Reaching three months the animals were sacrified, and their mandibles disarticulated. The skull was submitted to axial radiographic incidence and the hemimandibles to a lateral radiographic incidence. The measurements were made through a computer system. Significant differences were verified with a decrease in body height and ramus of the mandible. There was no significant difference in infratemporal fossae depth, as well as in diverse measurements in maxilla and in mandibular lenght. The tendency of the fractured arch to return to its original position was confirmed.

  6. Efeito da eutonia no tratamento da fibromialgia

    OpenAIRE

    Maeda,Cecília; Martinez,José Eduardo; Neder,Matilde

    2006-01-01

    OBJETIVO: avaliar a eutonia como método terapêutico auxiliar no tratamento da fibromialgia (FM). MÉTODOS: estudou-se um grupo de 20 mulheres, segundo os critérios do American College of Rheumatology (ACR), com duração mínima de seis meses, sem alterações no tratamento medicamentoso ou prescrição de exercícios nesse período. As pacientes foram avaliadas através do questionário de dados sociodemográficos; Escala Visual Analógica (EVA) para dor e questionário genérico de avaliação da qualidade d...

  7. Het Italiaanse voorzetsel da

    NARCIS (Netherlands)

    Boer, M.G. de

    2010-01-01

    SAMENVATTING In een voorzetselstudie in het kader van Jackendoffs semantische theorie wordt het sterk polyseme Italiaanse voorzetsel da geanalyseerd als een verzameling deelbetekenissen waarbij de meeste door een of meer semantische regels afgeleid kunnen worden van de basisbetekenis ruimtelijke

  8. ESPECTROS INFRAVERMELHOS DA CREATINA

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    Kumiko K. Sakane

    2011-08-01

    Full Text Available São apresentados espectros infravermelhos da creatina, na faixa de 4000 a 400 cm−1. Os resultados são comparados com espectros observados e calculados, publicados na literatura.

  9. Significados Ocultos da Enfermagem

    Directory of Open Access Journals (Sweden)

    Wiliam César alves Machado

    2011-04-01

    Full Text Available Sabe-se que as ações de cuidar em enfermagem foram sendo moldadas através da história da humanidade e deram-se, majoritariamente, na esfera do subjetivo que permeia as interações existenciais do ser humano que cuida e daquele que recebe cuidados. Campo fecundo para intercâmbios eletromagnéticos. Suas origens remontam ao cuidado prestado por mães, pais, avós, irmãos e demais familiares incumbidos da responsabilidade de ajudar entes recém-natos, crianças, doentes e idosos em suas necessidades de cuidados para preservação da vida.

  10. ORIGEM DA ANGTIA MODERNA

    Directory of Open Access Journals (Sweden)

    Edvino Rabuske

    1971-01-01

    Full Text Available O tema que me foi proposto "origem da angtia moderna". Por certo, um tema extremamente complexo. Trata-se de surpreender as modalidades modernas de um fenomeno, antigo como o prrio homem. Visando contribuir numa semana de reflexo sobre a esperan crist em, que esta abordada a partir, de diversos gulos, parece indicado que esta exposio n se atenha a um ico aspeto da angtia.

  11. Transurethral ventral buccal mucosa graft inlay urethroplasty for reconstruction of fossa navicularis and distal urethral strictures: surgical technique and preliminary results.

    Science.gov (United States)

    Nikolavsky, Dmitriy; Abouelleil, Mourad; Daneshvar, Michael

    2016-11-01

    To introduce a novel surgical technique for the reconstruction of distal urethral strictures using buccal mucosal graft (BMG) through a transurethral approach. A retrospective institution chart review was conducted of all the patients who underwent a transurethral ventral BMG inlay urethroplasty from March 2014 to March 2016. Patients with greater than one-year follow-up were included. Steps of the procedure: transurethral ventral wedge resection of the stenosed segment and transurethral delivery and spread fixation of appropriate BMG inlay into the resultant urethrotomy. The patients were followed for post-operative complications and stricture recurrence with uroflow, PVR, cystoscopy and outcome questionnaires. Three patients with a minimum of 12-month follow-up are included in this case series. The mean age of the patients was 42 years (35-53); mean stricture length was 2.1 cm (1-4). All patients had at least 2 previous failed procedures. Mean follow-up was 18 months (12-24). There were no stricture recurrences or fistula. Mean pre- and post-operative uroflow values were 4.3 (0-8) and 19 (16-26), respectively. Neither penile chordee nor changes in sexual function were noted in patients on follow-up. Transurethral ventral BMG inlay urethroplasty is a feasible option for treatment of fossa navicularis strictures. This single-stage technique allows for avoiding skin incision or urethral mobilization. It helps to prevent glans dehiscence, fistula formation and avoids the use of genital skin flaps in all patients, especially those affected with LS. This novel surgical technique is an effective treatment alternative for men with distal urethral strictures.

  12. Primary extraparenchymal hemorrhage of the posterior cranal fossa as a premonitory symptom of atlanto-axial instability; Traumatische extraparenchymale Blutung der hinteren Schaedelgrube als Warnsymptom einer atlantoaxialen Instabilitaet

    Energy Technology Data Exchange (ETDEWEB)

    Holl, K.; Rolli, K.; Olschowski, A.; Wurm, G. [Neurochirurgische Abt., Landesnervenklinik Linz (Austria); Nussbaumer, K. [Neuroradiologische Abt., Landesnervenklinik Linz (Austria)

    2001-07-01

    The contribution discusses the cases of five patients with cranio-cerebral trauma, (four children and one adult patient), where CT examination revealed extraparenchymal hemorrhage of the posterior cranal fossa, which did not fit into their pattern of intracranial trauma and therefore gave reason to suspect a lesion of the upper cervical spine. The various types of hemorrhage found are explained, as well as the underlying cervical spine lesions, and the choice of respective therapies which proved to be successful. (orig./CB) [German] Wir berichten ueber fuenf Patienten nach Schaedel-Hirn-Trauma, deren gemeinsamer Befund in der kraniellen Computertomographie eine extraparenchymale Blutung der hinteren Schaedelgrube (HSG) ohne Zusammenhang mit dem uebrigen intrakraniellen Verletzungsmuster bzw. ohne sonstige intrakranielle Verletzung war. Es handelte sich um vier Kinder und einen Erwachsenen mit einem Durchschnittsalter von 8,8 (4-22) Jahren. Drei dieser Patienten wiesen eine epidurale Blutung am Clivus bzw. am Foramen magnum auf, bei einem Patienten handelte es sich um eine Subarachnoidalblutung um das Cerebellum, bei einem weiteren Patienten lag eine Blutung im IV. Ventrikel vor. Diese infratentoriellen Blutungen waren der erste Hinweis, dass eine Verletzung in der oberen Halswirbelsaeule (HWS) vorliegen koennte. Es wurde bei den vier Kindern als zugrundeliegende Ursache der Blutung eine ligamentaere Verletzung C1/C2 diagnostiziert, nur bei dem erwachsenen Patienten lag eine knoecherne Verletzung C1/C2 vor. Die Therapie erfolgte in den vier Faellen mit Instabilitaet chirurgisch, bei dem Patienten ohne Instabilitaet konservativ. Nach einem mittleren Nachbeobachtungszeitraum von 5,2 Jahren waren alle operierten Patienten klinisch gebessert bzw. weiterhin neurologisch unauffaellig. Es konnte bei allen Patienten eine stabile Situation C1/C2 bei guter Funktionalitaet der HWS nachgewiesen werden. (orig.)

  13. Radio-anatomical Study of the Greater Palatine Canal and the Pterygopalatine Fossa in a Lebanese Population: A Consideration for Maxillary Nerve Block

    Directory of Open Access Journals (Sweden)

    Georges Aoun

    2016-01-01

    Full Text Available Aim: The aim of this study was to describe the morphology of the component, greater palatine canal-pterygopalatine fossa (GPC-PPF, in a Lebanese population using cone-beam computed tomography (CBCT technology. Materials and Methods: CBCT images of 79 Lebanese adult patients (38 females and 41 males were included in this study, and a total of 158 cases were evaluated bilaterally. The length and path of the GPCs-PPFs were determined, and the data obtained analyzed statistically. Results: In the sagittal plane, of all the GPCs-PPFs assessed, the average length was 35.02 mm on the right and 35.01 mm on the left. The most common anatomic path consisted in the presence of a curvature resulting in an internal narrowing whose average diameter was 2.4 mm on the right and 2.45 mm on the left. The mean diameter of the upper opening was 5.85 mm on the right and 5.82 mm on the left. As for the lower opening corresponding to the greater palatine foramen, the right and left average diameters were 6.39 mm and 6.42 mm, respectively. Conclusion: Within the limits of this study, we concluded that throughout the Lebanese population, the GPC-PPF path is variable with a predominance of curved one (77.21% [122/158] in both the right and left sides; however, the GPC-PPF length does not significantly vary according to gender and side.

  14. A prospective study on fetal posterior cranial fossa assessment for early detection of open spina bifida at 11-13 weeks.

    Science.gov (United States)

    Kose, Semir; Altunyurt, Sabahattin; Keskinoglu, Pembe

    2018-01-01

    The objective of this study was to test three measurements: brain stem (BS), intracranial translucency (IT) and brain stem to occipital bone distance (BSOB), as well as one landmark: cisterna magna (CM) visibility, for early diagnosis of open spina bifida (OSB) in a low risk population. A prospective observational study was undertaken in a university hospital. A sample of 1479 women consented to participate between 20 September 2013 and 30 June 2015. Measurements were performed from the mid-sagittal view, as is routinely used for nuchal thickness assessment. CM visibility was assessed qualitatively as the third anechoic band in the posterior cranial fossa (PCF). All pregnancies were screened with a combination of maternal serum alpha-fetoprotein and second trimester anomaly scan and followed until delivery. Predictive values were calculated for each marker. We were able to diagnose two OSB cases and highly suspect one Dandy-Walker malformation case at the first trimester scan by the observation of PCF. PCF characteristics of OSB cases were increased BS diameter, increased BS-BSOB ratio and non-visualization of the CM. All the markers demonstrated high sensitivity and specificity but CM visibility reached the highest positive predictive value. Due to relatively high false positive rates, PCF measurements could not reach a satisfactory performance to validate their clinical use as a single marker. CM visibility has the advantage of being a qualitative marker and reduces the need for sophisticated and time-consuming measurements. Intracranial translucency and BS-BSOB ratio measurements should be used when the CM visibility is absent or in doubt. © 2017 Japanese Teratology Society.

  15. Long-term results of middle fossa plugging of superior semicircular canal dehiscences: clinically and instrumentally demonstrated efficiency in a retrospective series of 16 ears.

    Science.gov (United States)

    Thomeer, Hans; Bonnard, Damien; Castetbon, Vincent; Franco-Vidal, Valérie; Darrouzet, Patricia; Darrouzet, Vincent

    2016-07-01

    The objective of this study is to report the surgical outcome after middle fossa approach (MFA) plugging in patients suffering from a superior semi-circular canal dehiscence (SCD) syndrome. This is a retrospective case review. Tertiary referral center. Sixteen ears in 13 patients with a SCD syndrome suffering from severe and disabling vestibular symptoms with a bony dehiscence on CT scan >3 mm and decreased threshold of cervical vestibular evoked potentials (cVEMPs). We assessed preoperatively: clinical symptoms, hearing, cVEMPs threshold, size of dehiscence and videonystagmography (VNG) with caloric and 100 Hz vibratory tests. Postoperatively, we noted occurrences of neurosurgical complication, evolution of audiological and vestibular symptoms, and evaluation of cVEMP data. Tullio's phenomenon was observed in 13 cases (81.3 %) and subjectively reported hearing loss in seven (43.7 %). All patients were so disabled that they had to stop working. No neurosurgical complications were observed in the postoperative course. In three cases (16.6 %), an ipsilateral and transitory immediate postoperative vestibular deficit associated with a sensorineural hearing loss (SNHL) was noted, which totally resolved with steroids and bed rest. All patients were relieved of audiological and vestibular symptoms and could return to normal activity with a mean follow-up of 31.1 months (range 3-95). No patient had residual SNHL. cVEMPs were performed in 14 ears postoperatively and were normalized in 12 (85.7 %). Two of the three patients operated on both sides kept some degree of unsteadiness and oscillopsia. MFA plugging of the superior semi-circular canal is an efficient and non-hearing deteriorating procedure.

  16. Chemical compositions and Sr, Nd isotope ratios of gabbroic xenoliths in calc-alkali andesites of Naeba and Torikabuto volcanoes, North Fossa Magna, central Japan

    International Nuclear Information System (INIS)

    Shimazu, Mitsuo; Kawano, Yoshinobu; Kaji, Kiyoshi; Igarashi, Satoshi.

    1991-01-01

    Gabbroic, doleritic and basaltic xenoliths found in calc-alkali andesites of Naeba and Torikabuto volcanoes are geochemically divided into three groups. Gabbro A of the group 1 from Naeba is rich in MgO and Ni, poor in alkalis, and shows depleted REE pattern resembling those of Ichinomegata (Sp. No.2232) and Hakone (HKG1, HKG2) volcanoes. On the basis the REE pattern and high Al IV contents in clinopyroxenes, gabbro A is interpreted to have been cumulate from a primary magma generated by partial melting of upper mantle. From REE pattern, gabbros of the group 2 from Ichinomegata (Sp. No.2218) may have derived from low alkali tholeiite magma which have been formed by removal of material such as the group 1 gabbro at shallow depth. Doleritic and basaltic xenoliths of the group 3 from Naeba, gabbroic xenoliths from Torikabuto and Umikawa are poorer in MgO and richer in alkalis than those of the group 1 and show enriched pattern in REE resembling that of high alkali tholeiite and contain clinopyroxenes having low Al IV . Therefore, these rocks are considered to be differentiates of high alkali tholeiite magma at shallow depth. On εNd- 87 Sr/ 86 Sr diagram, isotope data of gabbro A of the group 1 plot near those of andesites from Asama and Myoko volcanoes of the North Fossa Magna. It is interpreted that these rocks have derived from the same mantle source as the Asama and Myoko volcanoes which are richer in incompatible elements than those of MORB. (author)

  17. As dobras da imagem

    Directory of Open Access Journals (Sweden)

    Profª. Drª. Fátima Antunes da Silva (Yaska Antunes

    2009-05-01

    Full Text Available O presente trabalho tem por objetivo tentar compreender a produção da imagem visual no teatro. Para isso se vale da apropriação livre do conceito de “dobra? de Gilles Deleuze para se referir à multiplicidade de imagens criadas pelas diversas modalidades artísticas. Como no teatro há o entrelaçamento de imagens verbais – palavras enunciadas pelo texto dramático ou teatral – com imagens visuais – a visualidade advinda da composição cênica concreta que organiza no espaço ator e objeto –, a ênfase só podia recair sobre estas duas formas imagéticas. No caso do teatro, surge ainda a percepção de que para além da materialidade da cena, outras imagens emergem do confronto entre palco e platéia. Nesse sentido, imagem teatral seria então aquilo que surge da interação entre ator e espectador. A contribuição desse trabalho pode estar no fato de atualizar certos conceitos sobre a criação da imagem poética na poesia e no cinema para aplicá-los ao teatro. Ao recuperar o pensa-mento de Otávio Paz, Alfredo Bosi, Sergei Eisenstein, entre outros, bus-ca-se promover uma reflexão mais aprofundada sobre a construção visual no teatro.

  18. Trauma da Veia Porta

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    Gustavo Pereira Fraga

    Full Text Available OBJETIVO: O trauma da veia porta é raro e freqüentemente fatal por causa de exsanguinação e alta incidência de lesões de estruturas adjacentes. Devido às pecualiaridades desta lesão e diferentes condutas propostas na literatura, o objetivo dos autores é relatar a experiência neste tipo de lesão. MÉTODO: Estudo retrospectivo, de janeiro de 1994 e dezembro de 2001, de 1370 pacientes submetidos à laparotomia devido trauma abdominal. Entre esses, 15 pacientes apresentavam lesão da veia porta. As lesões foram classificadas conforme a sua extensão e localização. RESULTADOS: O mecanismo de trauma predominante foi o penetrante. O diagnóstico da lesão foi realizado no intraoperatório. Os procedimentos executados foram: sutura, anastomose término-terminal e ligadura da veia porta. A mortalidade foi de 53,3%. CONCLUSÃO: A lesão da veia porta possui alta taxa de mortalidade e o atendimento adequado está diretamente relacionado à sobrevida.

  19. Da Vinci Linjen

    DEFF Research Database (Denmark)

    Nissen, Poul

    Afsluttende evalueringsrapport fra følgeforskningen gennem tre år i forbindelse med dety pædagogiske arbejde på Blåbjerggårdskolens Da Vinci Linje for skolemotiverede og underpræsterende elever på 7. til 9. klassetrin.......Afsluttende evalueringsrapport fra følgeforskningen gennem tre år i forbindelse med dety pædagogiske arbejde på Blåbjerggårdskolens Da Vinci Linje for skolemotiverede og underpræsterende elever på 7. til 9. klassetrin....

  20. A new species of Dermopristis Kearn, Whittington & Evans-Gowing, 2010 (Monogenea: Microbothriidae), with observations on associations between the gut diverticula and reproductive system and on the presence of denticles in the nasal fossae of the host Glaucostegus typus (Bennett) (Elasmobranchii: Rhinobatidae).

    Science.gov (United States)

    Whittington, Ian D; Kearn, Graham C

    2011-09-01

    Dermopristis cairae n. sp. (Monogenea: Microbothriidae) is described from the skin and possibly from the nasal fossae of the giant shovel-nosed ray Glaucostegus typus (Bennett). The new species is distinguished from D. paradoxus Kearn, Whittington & Evans-Gowing, 2010 by its larger size, body shape, lack of transverse ridges on the ventral surface and absence of a seminal receptacle. Extensive short gut branches lie dorsal to the testes and adjacent to the coiled region of the vas deferens and the oötype, possibly reflecting high metabolic demand in these areas. Denticles are present in the lining of the nasal fossae of G. typus, providing a firm substrate for the cement-based attachment of a microbothriid. However, confirmation that D. cairae inhabits the nasal fossae of G. typus is required.

  1. SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room

    International Nuclear Information System (INIS)

    Ju, N; Chen, C; Gans, S; Hug, E; Cahlon, O; Chon, B; Tsai, H; Sine, K; Mah, D; Wolden, S; Yeh, B

    2016-01-01

    Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm"3 of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.

  2. SU-F-T-208: An Efficient Planning Approach to Posterior Fossa Tumor Bed Boosts Using Proton Pencil Beam Scanning in Fixed-Beam Room

    Energy Technology Data Exchange (ETDEWEB)

    Ju, N; Chen, C; Gans, S; Hug, E; Cahlon, O; Chon, B; Tsai, H; Sine, K; Mah, D [Procure Treatment Center, Somerset, New Jersey (United States); Wolden, S [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Yeh, B [Mount Sinai Hospital, New York, NY (United States)

    2016-06-15

    Purpose: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. Methods: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4–7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty. Results: A concave 54-Gy(RBE) isodose line surrounding the brainstem could be achieved using all three techniques. The mean V95% of the PTV was 99.7% (range: 97.6% to 100%) while the V100% of the PTV ranged from 56.3% to 93.1% depending on the involvement of the brainstem with the PTV. The mean doses received by 0.05 cm{sup 3} of the brainstem were effectively identical: 54.0 Gy(RBE), 53.4 Gy(RBE) and 53.3 Gy(RBE) for US, PBS optimized with PRV, and PBS optimized with robustness plans respectively. The cochlea mean dose increased by 23% of the prescribed boost dose in average from the bi-lateral fields used in the PBS plan. Planning time for the PBS plan with PRV was 5–10 times less than the US plan and the robustly optimized PBS plan. Conclusion: We have demonstrated that a fixed-beam with PBS can deliver a dose distribution comparable to a gantry plan using uniform scanning. Planning time can be reduced substantially using a PRV around the brainstem instead of robust optimization.

  3. Profilaxia da peste

    Directory of Open Access Journals (Sweden)

    Renato dos Santos Araújo

    1967-12-01

    Full Text Available O autor parte da premissa de que a profilaxia da doença infecciosa decorre do encadeamento epidemiológico: fonte de infecção-veículo transmissor - receptivel, para explicar a da peste, baseada no mesmo princípio. Depois de citar os 4 principais complexos epidemiológicos da peste e afirmar que tôda a profilaxia da doença consiste em atingir os dois primeiros elos dessas cadeias e proteger o último, passa a classificar os vários métodos profiláticos empregados em 2 grandes grupos: o das medidas destrutivas ou provisórias e o das medidas supressivas ou definitivas. Entre as primeiras arrola a desratização e a despulização, às quais acrescenta o tratamento e isolamento do doente e do portaãor, e entre as segundas inclui a anti-ratização e a imunização. A seguir, passa a explicar em que consistem essas várias medidas profiláticas e quais os agentes de que se tem lançado mão para executá-las, expendendo ao curso dessa exposição o conceito que formula a respeito de cada uma delas, à guisa de apreciação do seu valor relativo. Enaltece sobretudo as medidas supressivas ou definitivas, às quais empresta a maior significação na luta antipestosa, chamando a atenção, em especial, para a necessidade de estudos imunológicos para aperfeiçoamento do poder imunitário das vacinas de germes vivos avirulentos, que considera um grande recurso para a profilaxia da doença, sobretudo para a proteção do rurícola, cujo labor e modo de vida o expõem inevitavelmente a se infectar, por ocasião da ocorrência de epizootias de origem silvestre. Concluída essa primeira parte, passa a fazer o histórico de como se desenvolveu a campanha contra a peste, no Brasil, desde a época da sua invasão em 1899 pelo pôrto de Santos até os nossos dias. Nesse histórico, detem-se um pouco para expôr a atuação do extinto Serviço Nacional de Peste, o qual, criado em 1941, após a reorganização do Departamento Nacional de Saúde, passou

  4. Posterior fossa meningioma (surgical experiences)

    African Journals Online (AJOL)

    Wael M. Moussa

    2012-08-27

    Aug 27, 2012 ... of the CNS, representing about a third of brain tumors. They arise from the ... subtypes based on cell structure.1–4 In 1979, the World Health. Organization .... anterior or posterior to the internal auditory meatus), petrocli-.

  5. da Zehirlenmeleri

    Directory of Open Access Journals (Sweden)

    Necati Akbulut

    2015-02-01

    Full Text Available Gıda Teknolojisinin gelişmesi ile, gıda maddesinin tüketici için daha alımlı olmasını sağlamak, kısa zamanda bozulmasını engellemek ve pazara yeni çeşitler sunmak için bazı kimyasal maddeler kullanılmaya başlanılmıştır. Bunun yanında tarımda kullanılan kimyasal maddeler artmış, ambalaj sanayi gelişmiş, bu dada maddelerine bulaşan maddelerin türlerini arttırmıştır. Ayrıca gıda maddelerine belirli amacı olmadan katılan maddelerde vardır. Diğer taraftan tüketiciyi aldatmak, hile yapmak, çok kar sağlamak veya kötü kaliteyi gizlemek amacı ile de kullanılan maddeler bulunmaktadır. İster teknik zorunluk, ister hile amacıyla olsun bu tür yabancı maddeler öncelikle insan sağlığını ilgilendirmektedir. Bazı maddelerin vücuda alınması sakıncasız olduğu halde, bazıları sakıncalıdır. Sakıncasız olanlarında belirli bir sınırın üzerinde uzun süre alınmaları zararlı olabilmektedir. Bu toplum sağlığı sorunu birçok ülkeyi gıda sanayiinde kullanılan kimyasal maddelerin hoşgörü sınırlarının hesaplanması noktasına götürmüştür.

  6. A REFORMA DA IGREJA

    Directory of Open Access Journals (Sweden)

    Vítor Galdino Feller

    2014-01-01

    Full Text Available O pontificado do papa Francisco trouxe à tona o tema da reforma da Igreja. Retoma-se essa causa que acompanha a história da Igreja desde os seus primórdios e que interessa a todos os membros do povo santo de Deus. O texto divide-se em quatro partes. Primeiro, faz-se um apanhado histórico dos anseios de reforma da Igreja, mostrando que, muitas vezes em instâncias subterrâneas, sempre houve o desejo e também ações concretas de renovação. Em seguida, apresenta-se como razão para a reforma da Igreja o anúncio e a realização do Reino de Deus, pelo qual é preciso que a Igreja se volte à concretude humana e histórica de Jesus de Nazaré, pela superação do apego ao poder e às estruturas religiosas. Num terceiro momento, trata-se do critério pelo qual se mede a realização e a veracidade da reforma da Igreja: a santidade de cada fiel e do povo cristão no meio do mundo. Por fim, conclui-se que o caminho para a reforma da Igreja está na escuta dos clamores do Espírito Santo, que fala na própria Igreja e no mundo através do sensus fidei dos fiéis, das Igrejas particulares, dos pobres, das mulheres e das realidades terrestres. ABSTRACT: The pontificate of Pope Francis brought to the surface the theme of reform of the Church. This essay takes up this cause that accompanies the history of the Church from its beginnings and concerns all the members of the holy people of God. The text is divided into four parts. First, it gives a historical summary of the yearnings for reform of the Church, showing that, in many instances subterranean, there has always been the desire and also the concrete actions of renewal. Following from this, the essay presents as the reason for the reform of the Church the proclamation and the realization of the Kingdom of God, whereby it is necessary that the Church return to the concrete human and historical Jesus of Nazareth, in order to overcome the addiction to power and to religious structures. In the

  7. A cultura da internet

    OpenAIRE

    Cádima, Francisco Rui

    2017-01-01

    O novo ambiente digital é cada vez mais perturbante na sua dimensão ‘visível’ e está, em boa parte, incontrolável nessa área ainda algo desconhecida da Internet negra, conhecida por deep web ou dark net, convoca-nos para uma reflexão profunda de largo espectro, que não se pode vincular apenas às questões de mercado, tecnológicas e de redes, mas que nos vem alertar sobretudo para a ordem do político e da cidadania, do ‘desconhecido’ e do conhecimento e, enfim, do acesso à rede, quer no que is...

  8. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  9. A utilização da teoria da aprendizagem significativa no ensino da Enfermagem

    OpenAIRE

    Alana Tamar Oliveira de Sousa; Nilton Soares Formiga; Simone Helena dos Santos Oliveira; Marta Miriam Lopes Costa; Maria Júlia Guimarães Oliveira Soares

    2015-01-01

    RESUMO Objetivo: sintetizar a produção científica acerca da Teoria da Aprendizagem Significativa no processo de ensino-aprendizagem em Enfermagem. Método: revisão integrativa realizada nas bases de dados MEDLINE, LILACS, SciELO, BDENF e CINAHL, com artigos que abordaram a temática ou aspectos da teoria da aprendizagem significativa de David Ausubel. Fizeram parte da amostra dez artigos, sendo seis escritos no idioma português e quatro no inglês, publicados de 1998 a 2013. Resultados: cinco...

  10. Os (descaminhos da identidade

    Directory of Open Access Journals (Sweden)

    Oliveira Roberto Cardoso de

    2000-01-01

    Full Text Available A conferência procurou apresentar uma interpretação das vicissitudes da identidade étnica e/ou nacional quando observada em situações de ambigüidade. É quando o processo identitário expressa crises reais ou virtuais, como as que têm lugar entre imigrantes latino-americanos nos Estados Unidos, entre povos de diferentes regiões da Espanha emigrados para Barcelona, entre catalães espanhóis, franceses e andorranos residentes em Andorra, e entre povos indígenas em regiões de fronteira do Brasil com países vizinhos. O exame do processo identitário que tem lugar em diferentes latitudes, nas Américas e na Europa, sugere que os fenômenos socioculturais de etnicidade e de nacionalidade possuem em comum características tais como a busca de reconhecimento da pessoa moral, o respeito à diferença e, como corolário ético, a elevação do que se pode definir como "taxa de consideração".

  11. Hepatotoxicidade da cianotoxina microcistina

    Directory of Open Access Journals (Sweden)

    Andréa de Castro Leal

    2004-01-01

    Full Text Available Constitui interesse emergente em saúde pública avaliar a possibilidade de intoxicação humana por biotoxinas de algas cianofíceas, principalmente as hepatotoxinas do grupo das microcistinas. A microcistina, um heptapeptídeo monocíclico, é produzida principalmente pela cianobactéria Microcistis aeruginosa. São caracterizadas por alguns aminoácidos variáveis, dois deles com uma estrutura não usual que possuem importante papel na hepatotoxidade da microcistina. Apesar do acometimento humano atribuído as microcistinas incluírem gastroenterite, reações alérgicas ou irritativas, neurotoxicidade, o principal alvo da toxina é o fígado. Nos hepatócitos as microcistinas são carreadas pelo sistema transportador do ácido biliar, inibindo a atividade da proteína fosfatase no citoplasma. A inibição leva a mudanças morfológicas na membrana plasmática pela hiperfosforilação de citoqueratinas, e à atividade de promoção tumoral pelas proteínas hiperfosforiladas. Os métodos de detecção e quantificação de microcistinas no ambiente incluem a cromatografia líquida, o bioensaio em camundongos e os testes imunoenzimáticos. O último vem ganhando destaque pela praticidade e alta sensibilidade.

  12. 经中颅底硬膜间入路切除中后颅窝哑铃型三叉神经鞘瘤%Middle cranial fossa interdural approach for dumbbell-shaped trigeminal schwannomas

    Institute of Scientific and Technical Information of China (English)

    何升学; 刘宏毅; 邹元杰; 马骏; 张岩松; 黄庆玖; 陈永严; 章文斌; 刘永

    2016-01-01

    目的 探讨经中颅底硬膜间入路切除中后颅窝哑铃型三叉神经鞘瘤的手术适应症及治疗效果.方法 回顾性分析2009年10月至2014年11月间南京医科大学附属脑科医院神经外科采用经中颅底硬膜间入路切除中后颅窝哑铃型三叉神经鞘瘤7例患者的临床及影像资料、手术疗效和术后并发症情况. 结果 7例患者中Mp型5例、MP型2例. 7例患者术后第1 d复查MRI显示肿瘤均全切,无手术死亡者;术后脑神经功能障碍较术前改善4例,无明显变化3例,无加重和出现新的脑神经麻痹;1例患者出现皮下积液和颅内感染,经腰穿置管脑脊液引流和抗生素治疗痊愈;1例出现颞肌萎缩. 术后7例患者均长期随访,随访时间12~60个月,无1例患者复发. 结论 中颅底硬膜间入路手术是切除Mp型和部分MP型三叉神经鞘瘤的一种有效治疗方法,主要在硬膜间进行手术操作,有利于脑组织、脑神经及血管的保护,手术损伤小、反应小、并发症少.%Objective To investigate the effect and indication of the middle cranial fossa interdural approach for dumbbell-shaped trigeminal schwannomas .Methods The clinical data of 7 patients with dumbbell-shaped trigeminal schwannomas underwent through middle cranial fossa interdural approach from October , 2009 to November , 2014 were analyzed retrospectively .Tumors were classified into three types based on their distribution over the petrous ridge ( Mp type,MP type and mP type ) .The middle cranial fossa interdural approach was selected for type Mp and MP .The extent of tumor resection , cranial nerve outcome , approach-related morbidities , and recurrence of the tumors were documented .Results Of 7 patients,5 were Mp and 2 MP.MRI of postoperative one day showed that total resection was achieved in all patients .There was no operative mortality or new permanent neurological deficits .Improvement of the preoperative cranial nerve dysfunction was observed

  13. Hepatotoxicidade da cianotoxina microcistina

    OpenAIRE

    Leal,Andréa de Castro; Soares,Manoel do Carmo Pereira

    2004-01-01

    Constitui interesse emergente em saúde pública avaliar a possibilidade de intoxicação humana por biotoxinas de algas cianofíceas, principalmente as hepatotoxinas do grupo das microcistinas. A microcistina, um heptapeptídeo monocíclico, é produzida principalmente pela cianobactéria Microcistis aeruginosa. São caracterizadas por alguns aminoácidos variáveis, dois deles com uma estrutura não usual que possuem importante papel na hepatotoxidade da microcistina. Apesar do acometimento humano atrib...

  14. Aspectos moleculares da anemia falciforme

    Directory of Open Access Journals (Sweden)

    Galiza Neto Gentil Claudino de

    2003-01-01

    Full Text Available No presente artigo abordaram-se vários aspectos relacionados à natureza molecular da anemia falciforme, desordem hematológica de caráter hereditário que acomete expressivo número de indivíduos em várias regiões do mundo. As pesquisas realizadas em torno desta patologia da hemácia, ao longo de quase um século, a partir de 1910, cooperaram para a criação de um novo e importante segmento da ciência, denominado biologia molecular. A descoberta dos polimorfismos da mutação (GAT->GTG no gene que codifica a cadeia beta da hemoglobina, originando diferentes haplótipos da doença, permitiu um melhor e mais amplo conhecimento em torno da heterogeneidade clínica nos pacientes falcêmicos. Analisando a hemoglobina na sua estrutura normal e mutante, sua produção e evolução, pode-se ter um entendimento mais completo da fisiopatologia desta doença e da sua complexidade clínica.

  15. Merging field mapping and numerical simulation to interpret the lithofacies variations from unsteady pyroclastic density currents on uneven terrain: The case of La Fossa di Vulcano (Aeolian Islands, Italy)

    Science.gov (United States)

    Doronzo, Domenico M.; Dellino, Pierfrancesco; Sulpizio, Roberto; Lucchi, Federico

    2017-01-01

    In order to obtain results from computer simulations of explosive volcanic eruptions, one either needs a statistical approach to test a wide range of initial and boundary conditions, or needs using a well-constrained field case study via stratigraphy. Here we followed the second approach, using data obtained from field mapping of the Grotta dei Palizzi 2 pyroclastic deposits (Vulcano Island, Italy) as input for numerical modeling. This case study deals with impulsive phreatomagmatic explosions of La Fossa Cone that generated ash-rich pyroclastic density currents, interacting with the topographic high of the La Fossa Caldera rim. One of the simplifications in dealing with well-sorted ash (one particle size in the model) is to highlight the topographic effects on the same pyroclastic material in an unsteady current. We demonstrate that by merging field data with 3D numerical simulation results it is possible to see key details of the dynamical current-terrain interaction, and to interpret the lithofacies variations of the associated deposits as a function of topography-induced sedimentation (settling) rate. Results suggest that a value of the sedimentation rate lower than 5 kg/m2 s at the bed load can still be sheared by the overlying current, producing tractional structures (laminae) in the deposits. Instead, a sedimentation rate higher than that threshold can preclude the formation of tractional structures, producing thicker massive deposits. We think that the approach used in this study could be applied to other case studies (both for active and ancient volcanoes) to confirm or refine such threshold value of the sedimentation rate, which is to be considered as an upper value as for the limitations of the numerical model.

  16. Magnetic resonance imaging of the cranial nerves in the posterior fossa: a comparative study of t2-weighted spin-echo sequences at 1.5 and 3.0 tesla.

    Science.gov (United States)

    Fischbach, F; Müller, M; Bruhn, H

    2008-04-01

    High-field magnetic resonance imaging (MRI) at 3.0 Tesla (T) is rapidly gaining clinical acceptance. Whether doubling of the field strength of 1.5T and the subsequent increase in signal-to-noise ratio (SNR) leads to a significant improvement of image quality is not automatically given. To evaluate the depiction of fine anatomic detail in the posterior fossa, focusing on brain nerves, on T2-weighted imaging, and to define the potential advantage of imaging at 3.0T versus 1.5T. In total, 10 brainstem nerve pairs of 12 volunteers were identified on T2-weighted MR images of 2- and 5-mm section thickness acquired at 1.5T and 3.0T. The MR images were compared for each subject at both field strengths by three independent readers who rated image quality according to depiction of anatomic detail and contrast by using a rating scale. In general, MR images at 3.0T were considered more conspicuous and less noisy than images at 1.5T. The SNR value measured was almost doubled. With respect to structural identification and contrast according to the rating scale, observer scores were significantly improved both for standard imaging with 5-mm sections and high-resolution imaging with 2-mm sections at 3.0T. Direct comparison revealed a significant increase for evaluated image quality criteria and the number of nerves detected. The comparison revealed a clear advantage in favor of T2-weighted MRI at 3.0T vs. 1.5T in depicting the roots and course of brain nerves in the posterior fossa.

  17. REFLETINDO SOBRE AS ESPECIFICIDADES DA GEOGRAFIA NA CRISE DA MODERNIDADE

    Directory of Open Access Journals (Sweden)

    Patrício A. S. Carneiro Carneiro

    2010-08-01

    Full Text Available O presente artigo discute a evolução da ciência moderna, bem como a crise desse paradigma dominante e seus efeitos sobre a geografia. Destaca ainda a necessidade da construção de um novo pensamento científico para além das fronteiras disciplinares e do método absoluto.

  18. A dignidade da pessoa humana na doutrina social da igreja

    Directory of Open Access Journals (Sweden)

    Manzone, Gianni

    2010-01-01

    Full Text Available O texto faz uma análise panorâmica sobre a compreensão da dignidade humana nos diversos textos da Doutrina Social da Igreja, mostrando o entendimento da mesma nos diversos documentos dos Papas, notadamente Leão XII, Pio XI, Pio XII e João Paulo II, além de apontar aspectos históricos e culturais que influenciaram cada pronunciamento, o que foi determinante para a evolução do pensamento do Magistério na questão social. O ponto de partida é a visão antropológica da Doutrina Social da Igreja, resumida em termos de “homem criado por Deus a sua imagem e resgatado pelo sangue de Jesus Cristo” (Sollicitudo Rei Socialis 29. A partir daí, há a defesa do primado do ser humano sobre o social e reivindicações totalitaristas que perpassaram a história recente da humanidade, embora a pessoa seja sempre um ser-em-relação e situado em uma sociedade determinada

  19. Os usos da diversidade

    Directory of Open Access Journals (Sweden)

    Clifford Geertz

    1999-05-01

    Full Text Available Resumo Ao discorrer sobre o “Futuro do Etnocentrismo”, este artigo parte da premissa de que a globalização, apesar de ter – em muitos casos – diminuído as diferenças entre povos, não tem amenizado os preconceitos e as formas de discriminação que ocorrem em nome dessas diferenças. Ele resgata a importância do antropólogo neste cenário lembrando que a diversidade cultural faz parte da sociedade complexa, remetendo-se não apenas a grupos étnicos ou nacionais bem delimitados, mas também a diferenças de geração, gênero, sexo e classe, entre outros. Neste contexto, a tolerância passiva de modos distantes de vida assim como a aceitação pragmática de nosso próprio paroquialismo são atitudes não somente intelectualmente desonestas mas também moralmente repreensíveis. É no encontro incômodo de subjetividades variantes na sua própria sociedade que o antropólogo define seu lugar.

  20. Progresso Interdisciplinar da Medicina

    Directory of Open Access Journals (Sweden)

    Jorge Correia-Pinto

    2018-02-01

    Full Text Available Portugal é muitas vezes citado como um bom exemplo na prestação de cuidados de saúde. Para tal concorreram a investigação (engenharia biomédica, a evolução técnica e a diferenciação clínica de diferentes especialidades. Para que esta evolução se transfira para o paciente com o seu máximo potencial, o diálogo e a interdisciplinaridade são imprescindíveis. Nesta Edição da Gazeta Médica, vários artigos trazem até ao leitor alguns exemplos desta evolução e interdisciplinaridade, que continua todos os dias nos nossos hospitais. Assim não podemos deixar de salientar o enorme progresso que houve no desenvolvimento de antimicrobianos e logicamente, o desafio que agora enfrentamos, o da resistência aos antibióticos. Por outro lado, a biologia molecular ao permitir-nos conhecer melhor a origem e fisiopatologia de inúmeras doenças, abriu um janela de oportunidade para individualizar o algoritmo clínico de orientação e tratamento clínicos. É com naturalidade, portanto, que a seguir encontramos vários artigos que relatam estratégias de individualização terapêutica, aumentando o efeito terapêutico, e minimizando os efeitos laterais. Sendo o relator deste editorial, um cirurgião, não posso deixar de dar enfoque à forma como a cirurgia minimamente invasiva tem revolucionado a intervenção cirúrgica. A história reporta-nos que foram os urologistas e os ginecologistas os pioneiros em muitos dos passos determinantes para chegarmos à cirurgia laparoscópica. Aqueles e os cirurgiões digestivos documentaram clinicamente que o desenvolvimento da cirurgia minimamente invasiva trouxe consigo várias vantagens que, resumidamente, resultam numa convalescença pós-operatória mais suave e mais curta. Inspirado pelos benefícios bem documentados de cirurgia minimamente invasiva em adultos e crianças, o século XXI começou com as primeiras tentativas de transportar as vantagens desta abordagem para recém-nascidos, tal

  1. Os limites da competitividade

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    Henrique Rattner

    2009-08-01

    Full Text Available

    Costuma-se destacar os aspectos aparentemente positivos e as vantagens hipotéticas da concorrência e da competitividade entre empresas e também entre nações. Não se pode negar que a concorrência nos mercados tenha exercido uma função central e fundamental na gênese e na expansão do sistema de produção capitalista. Ela contribuiu para a geração e acumulação de riquezas materiais. Também estimulou e fortaleceu as aspirações de seus principais atores sociais, os empreendedores, de exigir uma organização política mais democrática em oposição ao regime feudal ou absolutista, em determinado período da história do mundo ocidental.

  2. Engenharia da mente

    OpenAIRE

    Bueno, Tânia Cristina D'Agostini

    2005-01-01

    Tese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção. Na era da informação digitalizada, pesquisadores de diferentes áreas do conhecimento enfrentam uma nova questão: a organização semântica dos dados. A matéria tornou-se importante pelo fato das informações digitalmente disponíveis estarem dispostas, em sua maioria, como dados não-estruturados. Todavia, sabe-se que a estruturação de dados é um problema complexo ...

  3. Em favor da talassografia

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    Jean-Louis Boudou

    2001-01-01

    Full Text Available A Talassografia (“descrição do mar” interessa-sepelos impactos físicos, biológicos, ecológicos... culturais da violenta antropização dos ambientes costeiros (oceânicos e continentais, caracterizados pelaexigüidade, vulnerabilidade, fragilidade e plasticidade. Como o Brasil é um “país marítimo”, os geó-grafos (os talassógrafos brasileiros são convidadosa intensificar suas pesquisas nas áreas costeiras e acriar novas estruturas para divulgá-las: Revista, Encontros, Associação, Pós-Graduação... tudo em prolda talassografia.

  4. ANÁLISE PRELIMINAR DA CONTROLADORIA DA CIDADE DE SALVADOR

    Directory of Open Access Journals (Sweden)

    João Marcelo Pitiá Barreto

    2012-06-01

    Full Text Available A Controladoria tem sido alvo de estudos e destaque de análises e reflexões dos estudiosos das ciências que têm como foco o campo gerencial das organizações como a da Administração e Contabilidade. É importante observar a contribuição da Controladoria à governança pública, fundamento de uma gestão democrática e participativa. Nesse contexto, insere-se o objetivo deste estudo, refletir sobre atuação da controladoria pública da cidade de Salvador, observando a contribuição efetiva na governança nesse município. Os estudos foram desenvolvidos na Secretaria da Fazenda (SEFAZ do município a quem Controladoria vincula-se. Com caráter exploratório, essa investigação descritiva envolveu pesquisa de campo, análise de documentos e relatórios emitidos pela SEFAZ e pelo Tribunal de Contas do Município (TCM. Verificou-se o organograma da SEFAZ, seu orçamento e os pareceres do TCM. Os resultados expressam a importância da Controladoria e denotam a impressão de que, na instituição estudada, essa área não esteja cumprindo bem seu papel. 

  5. Ocorrência da ferrugem da videira em Minas Gerais

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    Adelica Aparecida Xavier

    2012-03-01

    Full Text Available A ferrugem da videira causada por Phakopsora euvitis Ono constitui-se numa ameaça às regiões produtoras de uva em função do potencial destrutivo da planta. A doença foi detectada no Brasil, pela primeira vez, em 2001. Atualmente, ela ocorre no Paraná, Mato Grosso do Sul, São Paulo, Rio Grande do Sul, Mato Grosso, Roraima, Espírito Santo e Santa Catarina. Em abril de 2010, observaram-se na estação experimental da Unimontes, Janaúba, Minas Gerais, plantas da cv. Niágara rosada com sintomas típicos da doença. A análise dos sintomas e a caracterização dos urediniósporos sésseis, levemente equinulados, com formato oval, ou elipsoide formado em urédias subepidérmicas na origem, inrompentes e com paráfises circundantes dorsalmente, levaram à diagnose de Phakopsora euvitis como o agente causal da doença. Este é o primeiro relato da doença no Estado de Minas Gerais.

  6. Historicidade da filosofia em Hegel e Heidegger

    OpenAIRE

    Christian Iber

    2017-01-01

    Gostaria de discutir, em forma de teses, a temática da historicidade da filosofia em contraste e na sua divergência em Hegel e Heidegger. Diferente do historicismo, que não soluciona o problema da historicidade da filosofia, porque ele dissolve tendencialmente a filosofia na história da filosofia e não coloca em especial a questão da verdade, Hegel e Heidegger desenvolvem uma teoria genuinamente filosófica da história da filosofia do interesse filosófico pela verdade. Esse interesse genuiname...

  7. Síndrome de gerstmann de desenvolvimento associada a neoplasia cerebelar: relato de um caso e revisão da literatura Developmental Gerstmann syndrome associated with cerebellar neoplasm: a case report with review of litterature

    Directory of Open Access Journals (Sweden)

    Lineu César Werneck

    1975-03-01

    Full Text Available É relatado um caso de síndrome de Gerstmann de Desenvolvimento, que apresentava acalculia, agrafía, confusão direita-esquerda, agnosia de dedos e apraxia construcional, em um menino de 7 anos. O tratamento inicial com metilfenidato determinou bons resultados no que concerne à hiperatividade, à atenção e à apraxia construcional. Durante o curso clínico, o paciente apresentou sintomatologia cerebelar, hipertensão intracraniana, tendo sido feita intervenção cirúrgica na fossa posterior, sendo excisado um meduloblastoma de cerebelo. O autor acredita que é esta a primeira descrição na literatura da concomitância da síndrome de Gerstmann de Desenvolvimento e neoplasia de fossa posterior. São feitos comentários focalizando cada um dos aspectos clínicos, fatores etiológicos e topográficos.A Developmental Gerstmann syndrome in a 7 years-old-boy with hyperactivity, short attention span, acalculia, agraphia, right-left confusion, finger agnosia and constructional apraxia is reported. An initial trial with methylphenidate was done with good improvement regarding hyperactivity, attention span and constructional apraxia. In the clinical course developed a cerebellar syndrome and intracranial hypertension. Surgical exploration of the cerebellum discovered a medulloblastoma. The author believes that this is the first described association of Developmental Gerstmann syndrome and cerebellar neoplasia. The clinical findings, the etiology and the topography of the Gerstmann syndrome are discussed.

  8. Modelo para sistemas da qualidade como base da estrategia competitiva

    OpenAIRE

    Marco Antonio Silveira

    1999-01-01

    Resumo: Vários autores propõem a empresa como um sistema em transformação, sendo que esse enfoque sistêmico parece oferecer um meio efetivo de prover as capacidades estratégicas que são valorizadas pelos mercados atuais. Por outro lado, vem crescendo a consciência para o enfoque da qualidade como base da estratégia competitiva, onde esta é associada à lucratividade e incluída no processo de planejamento estratégico, tornando-se um instrumento eficaz de concorrência que, para fazer frente à di...

  9. Dimensão da maturidade à luz da logoterapia

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    Libardi, Tadeu Antonio

    2008-01-01

    Full Text Available O artigo aborda o tema da maturidade humana à luz da logoterapia, fundada por Viktor Emil Frankl. Nos dias de hoje, existe a frustração existencial, não mais a sexual, como analisada por Freud. Cada ser humano, como pessoa livre e responsável e tendo como meta a busca da maturidade, vai percorrendo seu próprio caminho, que o leva à ceitação de si, de seus limites e potencialidades e ao relacionamento social e religioso, capacitando-o ao confronto com o sofrimento humano

  10. O carnaval da turba futurista

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    Ana Paula Freitas de Andrade

    2017-11-01

    Full Text Available O artigo trata da repercussão do futurismo italiano no Brasil, a partir da análise de crônicas de Menotti Del Picchia publicadas no Correio Paulistano, entre 1920 e 1922. Nessa época o escritor participou da polêmica sobre a vanguarda italiana veiculada na imprensa paulistana, publicando uma série de crônicas que, ao promover ideias futuristas e criticar a literatura passadista, estabelecem a formulação de um futurismo compósito, adaptado à realidade brasileira; e esboçam as principais teses do movimento modernista.

  11. Evapotranspiração da cultura da cebola

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    G. M. Oliveira

    2015-10-01

    Full Text Available A determinação da quantidade de água necessária para as culturas é um dos principais fatores para o correto planejamento, dimensionamento e manejo de qualquer sistema de irrigação. O presente trabalho teve como objetivo, comparar medida da evapotranspiração da cultura (ETc da cebola com estimativa obtida a partir da evapotranspiração de referência (ETo determinada por diferentes métodos e Kc proposto na literatura. O experimento foi conduzido no campo experimental do Departamento de Tecnologia e Ciências Sociais da Universidade do Estado da Bahia - UNEB, em Juazeiro, no período de junho a setembro de 2011. As medidas da ETc foram obtidas em evapotranspirômetros e as estimativas, a partir de ETo determinada pelos métodos: Penman-Monteith (padrão FAO, Penman-Monteith modificado por Villa Nova et al. (2004, Hargreaves & Samani, Makkink e Jensen & Haise e Kc proposto por Marouelli et al. (2005, para a cultura da cebola. É fundamental a avaliação de métodos de estimativa da evapotranspiração de referência antes de sua aplicação, pois erros consideráveis podem ser cometidos na determinação da quantidade de água a ser aplicada a uma cultura, o que repercutirá certamente, na produtividade.Evapotranspiration crop onionAbstract: The determination of the amount of water needed for crops is a major factor for the correct planning, sizing and management of any irrigation system. This study aimed to compare measure of crop evapotranspiration (ETc onion with estimates obtained from the reference evapotranspiration (ETo determined by different methods and Kc proposed in the literature. The experiment was conducted in the experimental field of the Department of Technology and Social Sciences, University of the State of Bahia, in Juazeiro, from June to September 2011. The ETc measurements were obtained in evapotranspirometers and estimates, from ETo determined by the methods: Penman-Monteith (FAO standard, Penman-Monteith modified

  12. Dos Males da Medida

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    Lilia Moritz Schwarcz

    1997-01-01

    Full Text Available Esse artigo tem como objeto a difícil percepção da "diferença". Tema polêmico, o debate sobre as variedades culturais foi transformado, em meados do século XIX, em uma questão racial e, nesse sentido, vinculado às regularidades da biologia. Tecendo comparações entre os teóricos raciais brasileiros e os impasses mais contemporâneos, sobre a aferição de inteligência e capacidade, esse ensaio pretende provocar. Em pauta estarão as contradições que têm se destacado, mais recentemente, quando se opõem de um lado as etnicidades locais, de outro a tão propalada globalização. Tal qual dois lados de uma mesma moeda, a afirmação de identidades tem se mostrado tão evidente como o próprio estreitamento das relações internacionais. Mudam os termos do debate - de raça, para etnia -, mas, de alguma maneira, continuamos presos a uma lógica positiva de estabelecimento de hierarquias ontológicas.This article has as its objective the difficult perception of "difference". A controversial theme, in the nineteenth century, this debate on cultural varieties, became a racial issue and in this sense, bonded to the regularities of biology. In such a context, this essay intends to provoke comparisons about the standard measure of intelligence and capacity, between Brazilian racial theorists and the impasse of more contemporary times. Appointed here will be the contradictions which have, more recently grown in importance, and have opposed through one aspect, local ethnic groups and through another the greatly publicized globalization. As are the two sides of a coin, the affirmation of identities has shown itself as evident as the tightening of international relations. The terms of the debate change from race to ethnicism, but in some way, we are still tied to a positivist logic which establishes ontologic hierarchies.

  13. SOBRE OS FUNDAMENTOS DA ARQUITETURA DA INFORMAÇÃO

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    Alfram Roberto Rodrigues de Albuquerque

    2011-10-01

    Full Text Available Expõe-se o estado atual da disciplina Arquitetura da Informação quanto a problemática terminológica da definição do campo de estudo, apresentando-se argumentos para uma definição de Arquitetura da Informação de uma forma ampla na qual os usos correntes dessa expressão sejam vistos como especializações. Defende-se uma definição com a utilização de um conjunto de propriedades mínimas cujas interações levam a uma terminologia formal e cuja abstração leva a uma definição formal do conceito que emprega a linguagem de morfismos da Teoria das Categorias. Trata-se de um recorte de alguns dos resultados obtidos na tese de doutoramento de um dos autores, defendida em setembro de 2010. O contexto da pesquisa é exposto e alguns dos resultados obtidos são delineados.

  14. O sentido da espiritualidade na transitoriedade da vida

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    Isabel Cristina de Oliveira Arrieira

    Full Text Available Resumo Objetivo: Compreender o sentido da espiritualidade para a pessoa em cuidados paliativos. Métodos: Abordagem qualitativa, fundamentada na fenomenologia existencialista e referencial de Viktor Frankl. Os participantes foram nove pessoas em cuidados paliativos atendidas no domicílio. Informações coletadas por meio da observação e de entrevista realizadas no período de junho a outubro de 2014, gravadas, transcritas e transformadas em texto interpretado com a abordagem fenomenológica hermenêutica. Resultados: Surgiram as seguintes categorias: sentido de continuidade da vida; sentido de alívio do sofrimento; sentido de naturalidade da morte e sentido de valorização do viver. Conclusão: Para a integralidade da atenção faz-se necessário a inclusão da espiritualidade na prática do cuidado em saúde. A espiritualidade proporciona o encontro existencial entre a pessoa em cuidados paliativos e os profissionais que a cuidam em sua integralidade.

  15. O uso da aromaterapia na melhora da autoestima

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    Juliana Rizzo Gnatta

    2011-10-01

    Full Text Available Os objetivos deste estudo foram verificar se a inalação dos óleos essenciais de rosa e de ylang-ylang alteram a percepção da autoestima e comparar a eficácia dos mesmos. O projeto foi aprovado pelo Comitê de Ética em Pesquisa do Hospital da Universidade de São Paulo. Participaram 43 funcionários dos setores de Higienização e da Central de Materiais e Esterilização durante os meses de maio a julho de 2009. Os sujeitos foram randomizados em três grupos: dois que receberem os óleos essenciais e outro que recebeu placebo (essência de rosa. A avaliação da autoestima foi feita através de uma escala já validada no Brasil, sendo aplicada antes do uso dos aromas, depois de 30 dias de uso e ao completar 60 dias. Dentre os resultados, verificou-se que a amostra era constituída por 88,6% de indivíduos com média e alta autoestima e que os óleos essenciais em questão não alteraram de forma significativa a percepção da autoestima.

  16. A utilização da teoria da aprendizagem significativa no ensino da Enfermagem

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    Alana Tamar Oliveira de Sousa

    2015-08-01

    Full Text Available RESUMOObjetivo:sintetizar a produção científica acerca da Teoria da Aprendizagem Significativa no processo de ensino-aprendizagem em Enfermagem.Método:revisão integrativa realizada nas bases de dados MEDLINE, LILACS, SciELO, BDENF e CINAHL, com artigos que abordaram a temática ou aspectos da teoria da aprendizagem significativa de David Ausubel. Fizeram parte da amostra dez artigos, sendo seis escritos no idioma português e quatro no inglês, publicados de 1998 a 2013.Resultados:cinco artigos fizeram alusão à Teoria da Aprendizagem Significativa, quatro citaram Ausubel como autor dessa teoria e apenas dois seguiram a estrutura para a aplicação da teoria completamente. Há escassez de estudos sobre o tema e os que o abordam não o correlacionam com a teoria de Ausubel.Conclusão:faz-se necessário romper com a dicotomia entre teoria e prática e promover a articulação dos conteúdos com a ação, introduzindo o aluno como autor de seu próprio conhecimento.

  17. Long-term monitoring on a closed-conduit volcano: A 25 year long time-series of temperatures recorded at La Fossa cone (Vulcano Island, Italy), ranging from 250 °C to 520 °C

    Science.gov (United States)

    Diliberto, Iole Serena

    2017-10-01

    The longest record of temperature data from an active volcano in southern Italy is presented. The dataset comes from continuous monitoring of fumarole temperatures from the La Fossa cone of Vulcano (Aeolian Islands) running from 1991 to 2016. The discussion includes an empirical approach, based on a large number of direct measurements. At Vulcano Island, geochemical monitoring of the uprising fluids allows detection of the surface effects of perturbation in the state variables of the buried hydrothermal and magmatic systems. The presented datasets show that fumaroles' changing temperatures, which are related to surface heat flow, are useful indicators. Over the past 25 years, the combined effects of runoff and chemo-physical alterations were negligible on the output temperature of the earliest monitored fumaroles. The maximum recorded variation was 298 °C (measured in the ground very close to the steaming vents, at a depth of 0.5 m). Repetition of output temperature values occurred after 19 years in the same position; the time variations suggest a cyclic characteristic, although more years are needed to register the complete cyclic modulation. A combination of minor cyclical variations has also been registered in the fumarole output. The minor cycles appeared in this long series of data after 1995, and they can be interpreted as one of the surface effects of temporary departures from a stationary state assumed for the system feeding the La Fossa area. In this sector of the Mediterranean area, the steady state pressure field, as well as the steady state temperature gradients, can be perturbed either by magmatism or by seismo-tectonic processes related to regional dynamics. This long-term monitoring allowed comparisons of many temperature subsets with other validated geochemical and geophysical data series and highlighted common source mechanisms accounting for endogenous processes. Changes in the magma source and/or seismo-tectonic activity have been the primary

  18. Da janela do meu quarto

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    Esther Hamburger

    2008-12-01

    Full Text Available O texto aborda o curta Da Janela do Meu Quarto de Cao Guimarães como contraponto a filmes brasileiros recentes que lidam com a desigualdade social brasileira na chave da violência. O texto contrasta o distanciamento imposto pelo posicionamento de câmera e efeitos de montagem e som nesse filme, com o uso de estratégias de pertencimento e apropriação presentes em filmes "de resultado".

  19. Da janela do meu quarto

    OpenAIRE

    Hamburger, Esther

    2008-01-01

    O texto aborda o curta Da Janela do Meu Quarto de Cao Guimarães como contraponto a filmes brasileiros recentes que lidam com a desigualdade social brasileira na chave da violência. O texto contrasta o distanciamento imposto pelo posicionamento de câmera e efeitos de montagem e som nesse filme, com o uso de estratégias de pertencimento e apropriação presentes em filmes "de resultado".

  20. GRAU DA PRÁXIS DA GESTÃO DA RESPONSABILIDADE AMBIENTAL PRATICADA POR USINAS SUCROALCOOLEIRAS

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    Renata Longo

    2014-12-01

    gerencial (PCDA foi o Action que apresentou maior grau de aderência. Há uma concordância acentuada às características fundamentais do ciclo gerencial na Gestão da Responsabilidade Socioambiental.

  1. Papel da vitamina B12 na patogenia da mielose funicular

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    Horacio M. Canelas

    1965-12-01

    Full Text Available Foi estudada a absorção da vitamina B12 radioativa em 29 casos de mielose funicular. O diagnóstico baseou-se na clássica sintomatologia neu- rológica e na presença de acloridria gástrica e eventuais alterações hemato-lógicas. As manifestações neurológicas foram avaliadas de modo semiquan-titativo e correlacionadas com os resultados do teste de excreção urinária da vitamina B12. Não foi verificada correlação significante da absorção da vitamina B12, quer com a sintomatologia nuerológica total, quer com as síndromes periférica e funicular dorsal. Contudo, foi encontrada significante correlação negativa entre a síndrome piramidal e a absorção da vitamina B12. Os resultados são confrontados com o papel desempenhado pela vitamina B12 na síntese das bainhas de mielina e do ácido ribonuclêico, sendo salientada a importância dêste último para a vida das células nervosas e dos longos axônios.

  2. Maturação das vértebras cervicais e sua correlação com a idade óssea da mão e punho como indicadores no tratamento ortodôntico Cervical vertebral maturation and the correlation between the skeletal age of the hand-wrist as orthodontic treatment indicators

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    Vitoria Aparecida Muglia Moscatiello

    2008-08-01

    Full Text Available OBJETIVOS: a proposta deste estudo prospectivo, transversal e multicêntrico foi correlacionar as alterações morfológicas das vértebras cervicais C2, C3 e C4, com a idade cronológica e comparar com a idade esqueletal dos ossos da mão e punho; e verificar se existem diferenças no padrão de crescimento ósseo entre os gêneros masculino e feminino. METODOLOGIA: a amostra foi constituída por 140 pacientes, 74 do gênero feminino e 66 do masculino. A avaliação das alterações das vértebras cervicais foi feita pelo método de Hassel e Farman modificado por Baccetti, Franchi e McNamara para 5 estágios que se correlacionam com o crescimento puberal em telerradiografias cranianas em norma lateral. As radiografias da mão e punho avaliaram os eventos de ossificação por meio do método de Greulich e Pyle. RESULTADOS: os resultados demonstraram correlação dos estágios de maturação das vértebras cervicais com a idade cronológica; e correlação positiva e moderada, estatisticamente significante entre os dois métodos com r = 0,6326 (IC = 95% e p AIM: The aim of this prospective, transversal, multicentric study was to determine the correlation between the morphologic changes of the second, third and fourth cervical vertebral bodies and the chronological age; to compare with the skeletal age of the hand and wrist bones; and to verify the differences in the bone growth pattern between male and female. METHODS: The sample was constituted by 140 subjects, 74 girls and 66 boys. The morphologic alterations of the cervical vertebrae was analyzed by the Hassel and Farman method modified by Baccetti, Franchi and McNamara to 5 stages that correlate to the puberal growth in lateral cephalometric radiographs. The hand-wrist radiographs evaluated the events of ossification by the method of Greulich and Pyle. RESULTS: The results demonstrated: correlation of the stages of cervical vertebral maturation with the chronological age; positive and

  3. Resultados de los primeros casos de craneoplastia con tela de titanio y colgajo galeal bipediculado postraumatismo craneano Resultados dos primeiros casos da cranioplastia com tela de titânio e retalho galeal bipediculado pós-trauma crânio-encefálico Results of first cases of craneoplasty with titanium mesh and galeal bipediculated flap after craneal trauma

    Directory of Open Access Journals (Sweden)

    L. Dos Santos Fonseca

    2010-03-01

    Full Text Available La causa más frecuente de una solución de continuidad de los huesos de la calota craneana es un traumatismo craneoencefálico grave. La reparación de la misma es lo que conocemos como craneoplastia. El objetivo de nuestro artículo es presentar nuestros primeros resultados de craneoplastia con tela de titanio y colgajo galeal bipediculado. A través de un estudio retrospectivo, descriptivo, tipo serie de casos, relatamos los resultados de nuestra experiencia en craneoplastia con tela de titanio y colgajo sobre 10 pacientes operados entre Enero y Octubre de 2007, tras valoración con Tomografía Computerizada, de los cuales el 90% fueron de sexo masculino y con una edad media de 29,9 años. El tiempo medio de internamiento hospitalario fue de 10,3 días. Tuvimos un caso de complicación y una reintervención por desplazamiento de la tela de titanio a los 4 meses. Todos los pacientes quedaron satisfechos con los resultados. Como conclusión, la craneoplastia con tela de titanio asociada a colgajo galeal bipediculado es un procedimiento eficaz y viable dentro de la red pública hospitalaria.A falta de continuidade entre ossos da calota craniana é mais frequentemente causada por trauma crânio-encefálico grave. A reparação dessas deformidades é conhecida como cranioplastia. Objetivo: Avaliar os resultados dos primeiros casos da cranioplastia com tela de titânio e retalho galeal bipediculado. Por meio de estudo retrospectivo, descritivo, tipo série de casos, relatam-se os resultados de cranioplastia com tela de titânio e retalho a que 10 pacientes foram submetidos, entre Janeiro a Outubro de 2007, após avaliação por tomografia computadorizada, sendo 90% do sexo masculino, com média de idade de 29,9 anos. O tempo médio de internamento foi de 10,3 dias. Houve uma complicação e uma reoperação por deslocamento da tela após quatro meses. Todos os pacientes ficaram satisfeitos com os resultados. Conclusão: A cranioplastia com tela de

  4. Publicidade e ética: um estudo da construção da imagem da mulher

    Directory of Open Access Journals (Sweden)

    Elizabeth Moraes Gonçalves

    2010-02-01

    Full Text Available O texto propõe uma reflexão sobre a ética da responsabilidade na publicidade veiculada nas revistas Claudia e Nova. Trata-se de uma pesquisa descritiva, resultante da leitura dos anúncios selecionados, subsidiada por teóricos da Análise do Discurso da linha francesa, que busca averiguar como a mulher é representada. Constatou-se que no contexto da sociedade contemporânea o retrato da mulher como sedutora ainda está presente, mesmo que em vários momentos ela apareça como protagonista de sua própria vida.

  5. Variedades da Democracia no Brasil

    Directory of Open Access Journals (Sweden)

    Fernando Bizzarro

    Full Text Available Resumo Neste artigo apresentamos resultados coletados pelo projeto Variedades da Democracia para o Brasil. Descrevemos a evolução histórica da democracia brasileira entre 1900 e 2015 enfocando seus cinco principais componentes (eleitoral, liberal, participativo, deliberativo e igualitário e duas dimensões adjacentes ao regime (corrupção e partidos políticos. Por fim, nós comparamos os dados para o Brasil com resultados obtidos para outros países da América do Sul. A análise dos dados aponta: a. a existência de uma trajetória “em espiral” dos regimes políticos no Brasil, na qual novas experiências democráticas tendem a superar experiências anteriores em todos os quesitos; b. os avanços e limites da experiência democrática contemporânea em que se combinam bons resultados nos indicadores eleitoral, liberal e deliberativo da democracia, e resultados menos elevados nos componentes igualitário e participativo do regime, bem como em suas dimensões adjacentes.

  6. 76 FR 12627 - Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG...

    Science.gov (United States)

    2011-03-08

    ... Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG Airplanes AGENCY: Federal Aviation Administration (FAA... on Diamond aeroplanes, the majority of which were DA 40. In additional, at least 18 doors have been... conditions) while the aeroplane was parked. All DA 40 and DA 42 aeroplanes have a system installed that...

  7. 76 FR 27861 - Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG...

    Science.gov (United States)

    2011-05-13

    ... Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 42, DA 42 NG, and DA 42 M-NG Airplanes... on Diamond aeroplanes, the majority of which were DA 40. In additional, at least 18 doors have been... conditions) while the aeroplane was parked. All DA 40 and DA 42 aeroplanes have a system installed that...

  8. Ensino da música

    OpenAIRE

    Vieira, Maria Helena

    2017-01-01

    O papel da Igreja Católica no desenvolvimento do ensino da música em Portugal é inquestionável. Neste texto descreve-se como a música e o seu ensino antecederam a própria fundação da nacionalidade no território que é hoje Portugal, e como a Igreja Católica teve um papel preponderante, até aos nossos dias, no desenvolvimento desse ensino e na criação de estruturas pedagógicas que permitiram a aprendizagem musical ao longo dos séculos. Primeiro nas escolas monacais, depois nas sés catedrais, e ...

  9. O LUGAR DA MORADIA SOCIAL

    OpenAIRE

    Daniela das Neves Alvarenga; Paulo Romano Reschilian

    2017-01-01

    Objetivou-se com este artigo analisar o processo de segregação socioespacial nas cidades industriais europeias, com olhar na localização da moradia operária no espaço urbano. A partir desta análise, parte-se para a construção do cenário no Brasil, apontando as origens da habitação social nas cidades industriais, com enfoque na inserção urbana da moradia produzida pela iniciativa privada e pelo Estado até os dias atuais, culminando na produção de interesse social vinculada ao programa habitaci...

  10. Terapia cognitivo-comportamental da fobia social

    OpenAIRE

    Ito,Lígia M; Roso,Miréia C; Tiwari,Shilpee; Kendall,Philip C; Asbahr,Fernando R

    2008-01-01

    OBJETIVO: Este artigo revisa aspectos relevantes da fobia social e os estágios de tratamento através da terapia cognitivo-comportamental em crianças, adolescentes e adultos. MÉTODO: A partir do banco de dados Medline, realizou-se revisão da literatura publicada a respeito do tratamento da fobia social por meio da terapia cognitivo-comportamental. RESULTADOS: Revisão da literatura sugere que a fobia social é uma condição prevalente e crônica, caracterizada por inibição social e timidez excessi...

  11. O panorama das Drogas no México: da margem da sociedade ao centro da cultura

    Directory of Open Access Journals (Sweden)

    Diana Palaversich

    2013-12-01

    Full Text Available O artigo destaca o percurso das manifestações culturais ligadas ao tráfico de drogas no México, de um lugar marginal, de subcultura, na sociedade mexicana das décadas de 1970 e 1980, expressas principalmente através dos narcocorridos e do narcocine, para um lugar no mainstream cultural mexicano, desde o início do século 21, com destaque especial para a narcoliteratura. O aumento da violência, provocado pela guerra ao narcotráfico, produz uma proliferação da temática nos meios de comunicação e se reflete em áreas da cultura como as artes plásticas e a literatura, produzindo um novo tipo de expressão artística ou narrativa, que tanto pode ser oportunista e contribuir para a banalização da violência do narcotráfico como ser crítica e narrar o impacto individual e coletivo do tráfico de drogas, narrar a desenfreada e violenta realidade mexicana sem cair no estilo da imprensa marrom, do folclore ou dos lugares comuns dos romances de ação.

  12. Cinco discursos da digitalidade audiovisual

    Directory of Open Access Journals (Sweden)

    Gerbase, Carlos

    2001-01-01

    Full Text Available Michel Foucault ensina que toda fala sistemática - inclusive aquela que se afirma “neutra” ou “uma desinteressada visão objetiva do que acontece” - é, na verdade, mecanismo de articulação do saber e, na seqüência, de formação de poder. O aparecimento de novas tecnologias, especialmente as digitais, no campo da produção audiovisual, provoca uma avalanche de declarações de cineastas, ensaios de acadêmicos e previsões de demiurgos da mídia.

  13. CILADAS DA DIFERENÇA

    Directory of Open Access Journals (Sweden)

    Antônio Flávio Pierucci

    1990-12-01

    Full Text Available Este artigo procura analisar os efeitos perversos da apropriação pela esquerda de um tema definidor das tradições de direita, a saber, a diferença. Com base no caso Sears (EUA e no caso Le Pen (França, o autor aponta para as armadilhas racistas e sexistas presentes nos discursos que focalizam e enfatizam a diferença, sobretudo num período histórico de reemergência dos conservadorismos que, por sua vez, se apropriam do argumento da diferença, dirigindo-o contra os próprios movimentos de esquerda.

  14. Cultura da Convergência

    Directory of Open Access Journals (Sweden)

    Rogério Christofoletti

    2008-12-01

    Full Text Available Três idéias já seriam suficientes para que a leitura de “Cultura da Convergência”, de Henry Jenkins, interessasse a jornalistas e pesquisadores da área: a convergência midiática como um processo cultural; o fortalecimento de uma economia afetiva que orienta consumidores de bens simbólicos e criadores midiáticos; a expansão de formas narrativas transmidiáticas.

  15. da Vinci decoded: does da Vinci stereopsis rely on disparity?

    Science.gov (United States)

    Tsirlin, Inna; Wilcox, Laurie M; Allison, Robert S

    2012-11-01

    In conventional stereopsis, the depth between two objects is computed based on the retinal disparity in the position of matching points in the two eyes. When an object is occluded by another object in the scene, so that it is visible only in one eye, its retinal disparity cannot be computed. Nakayama and Shimojo (1990) found that a precept of quantitative depth between the two objects could still be established for such stimuli and proposed that this precept is based on the constraints imposed by occlusion geometry. They named this and other occlusion-based depth phenomena "da Vinci stereopsis." Subsequent research found quantitative depth based on occlusion geometry in several other classes of stimuli grouped under the term da Vinci stereopsis. However, Nakayama and Shimojo's findings were later brought into question by Gillam, Cook, and Blackburn (2003), who suggested that quantitative depth in their stimuli was perceived based on conventional disparity. In order to understand whether da Vinci stereopsis relies on one type of mechanism or whether its function is stimulus dependent we examine the nature and source of depth in the class of stimuli used by Nakayama and Shimojo (1990). We use three different psychophysical and computational methods to show that the most likely source for depth in these stimuli is occlusion geometry. Based on these experiments and previous data we discuss the potential mechanisms responsible for processing depth from monocular features in da Vinci stereopsis.

  16. Efeito da urina de vaca no estado nutricional da alface

    Directory of Open Access Journals (Sweden)

    Nelson Licínio C. de Oliveira

    2010-08-01

    Full Text Available Existem diversos relatos da utilização da urina de vaca em hortaliças, todavia sua eficácia carece de comprovação. Objetivou-se avaliar o efeito da urina de vaca no estado nutricional da alface. O experimento foi constituído de 12 tratamentos, esquema de parcelas subdivididas, em blocos ao acaso, com quatro repetições. Nas parcelas foram alocadas as vias de aplicação (solo ou foliar e nas subparcelas as concentrações das soluções (0,00; 0,25; 0,50; 0,75; 1,00 e 1,25% v/v. Aplicou-se 60 mL de solução/planta, divididos em cinco aplicações de 5; 5; 10; 20 e 20 mL/planta, aos 7, 14, 21, 28 e 35 após o transplante, respectivamente. Durante o ciclo avaliou-se o índice SPAD e na colheita a massa da matéria seca de cabeça (MSCA e os teores de N, P, K, Ca, Mg, S, Na, Zn, Fe, Mn, Cu e B na matéria seca das folhas (MSF, caule (MSC e raízes (MSR. Em ambas as vias de aplicação o índice SPAD apresentou incremento linear às concentrações e resposta quadrática ao longo do tempo. A MSCA teve comportamento linear às concentrações, com aumento de 25,9 e 35,4% nas aplicações via foliar e solo, respectivamente. Não houve efeito de concentrações sobre teores de nutrientes na MSF e MSC. Na MSR, via solo, os teores de P e K apresentaram pontos de máximo enquanto Fe e Mn de mínimo; o Na apresentou incremento linear às concentrações via foliar. Os efeitos da urina sobre o crescimento da alface provavelmente são devidos a fatores outros que não somente a quantidade de nutrientes veiculados nas soluções.

  17. A identidade à flor da pele: etnografia da prática da tatuagem na contemporaneidade

    Directory of Open Access Journals (Sweden)

    Andrea Lissett Pérez

    2006-04-01

    Full Text Available No presente artigo, realiza-se uma descrição etnográfica da prática da tatuagem na contemporaneidade, a partir de uma perspectiva que prioriza as noções da prática, das interações e das experiências vividas durante o processo de ser tatuado. A reflexão tenta reconstruir uma visão total da prática da tatuagem que abrange o mundo subjetivo e as dinâmicas sociais como partes constitutivas desse ato. Entre as idéias conclusivas estão, de um lado, o surgimento de uma nova normalidade estética e vivencial no seio da sociedade ocidental e, de outro, a configuração de uma nova subjetividade, a dos "tatuados", como um processo interativo, inovador, emotivo e reflexivo, em que o corpo se converte em uma forma de expressão e construção do sujeito.This article provides a descriptive account of contemporary tattooing, based on a perspective that prioritizes the notion of practice, as well as the interactions and experiences involved in the process of being tattooed. The analysis attempts to rebuild a holistic view of tattooing, combining subjective processes and social dynamics as equally constitutive parts of this activity. Among the conclusions reached are: (a the emergence of tattooing as a new aesthetic norm and a lived experience at the heart of the western society; and (b the configuration of a new subjectivity, the ‘tattooed,’ as an interactive, innovative, emotional and reflexive process in which the body is converted into a form of expressing and constructing the subject.

  18. Leonardo da Vinci and the Downburst.

    Science.gov (United States)

    Gedzelman, Stanley David

    1990-05-01

    Evidence from the drawings, experiments, and writings of Leonardo da Vinci are presented to demonstrate that da Vinci recognized and, possibly, discovered the downburst and understood its associated airflow. Other early references to vortex flows resembling downbursts are mentioned.

  19. Tratamento da dor em queimados

    Directory of Open Access Journals (Sweden)

    Rodrigo José Alencar de Castro

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Apesar dos avanços, ainda é observado manejo analgésico inadequado dos pacientes com queimaduras. O objetivo desta revisão foi coletar dados sobre tratamento da dor em queimados. CONTEÚDO: Foi feita revisão sobre os mecanismos de dor, avaliação do paciente com queimadura e o tratamento farmacológico e não farmacológico. CONCLUSÕES: O manejo da dor em pacientes vítimas de queimaduras ainda é um desafio por parte da equipe multiprofissional. A avaliação frequente e contínua da resposta apresentada pelo paciente é muito importante, tendo em vista os vários momentos por que passa o paciente internado em decorrência de uma queimadura, além de uma terapêutica combinada com medicações analgésicas e medidas não farmacológicas. Entender a complexidade de alterações fisiopatológicas, psicológicas e bioquímicas apresentadas por um paciente em tratamento de queimadura é o primeiro passo para alcançar o sucesso no seu manejo analgésico.

  20. Šmakuláda

    Czech Academy of Sciences Publication Activity Database

    Ireinová, Martina

    2017-01-01

    Roč. 100, č. 3 (2017), s. 189-191 ISSN 0027-8203 R&D Projects: GA ČR(CZ) GA16-04648S Keywords : šmakuláda * šmak * Czech National Corpus * database Neomat * etymology Subject RIV: AI - Linguistics OBOR OECD: Linguistics

  1. Smart AD and DA Converters

    NARCIS (Netherlands)

    Roermund, van A.H.M.; Hegt, J.A.; Harpe, P.J.A.; Radulov, G.I.; Zanikopoulos, A.; Doris, K.; Quinn, P.J.

    2005-01-01

    In this paper, a concept is proposed to solve the problems related to the embedding of AD and DA converters in system-on-chips, FPGAs or other VLSI solutions. Problems like embedded testing, yield, reliability and reduced design space become crucial bottlenecks in the integration of high-performance

  2. O LUGAR DA MORADIA SOCIAL

    Directory of Open Access Journals (Sweden)

    Daniela das Neves Alvarenga

    2017-01-01

    Full Text Available Objetivou-se com este artigo analisar o processo de segregação socioespacial nas cidades industriais europeias, com olhar na localização da moradia operária no espaço urbano. A partir desta análise, parte-se para a construção do cenário no Brasil, apontando as origens da habitação social nas cidades industriais, com enfoque na inserção urbana da moradia produzida pela iniciativa privada e pelo Estado até os dias atuais, culminando na produção de interesse social vinculada ao programa habitacional Minha Casa, Minha Vida (MCMV. Por fim, será feita uma análise comparativa da localização das vilas operárias em São José dos Campos, com a inserção urbana dos empreendimentos produzidos pelo Estado.

  3. Cultura da Convergência

    Directory of Open Access Journals (Sweden)

    Rogério Christofoletti

    2008-12-01

    Full Text Available Three ideas would suffice for the reading of “Cultura da Convergência” (Culture of Convergence by Henry Jenkins to be of interest to journalists and researchers in the area: media convergence as a cultural process; the strengthening of an emotional economy which guides consumers of symbolic goods and media creators; the expansion of trans-media narrative forms.

  4. Cultura da Convergência

    Directory of Open Access Journals (Sweden)

    Rogério Christofoletti

    2011-02-01

    Full Text Available Three ideas would suffice for the reading of “Cultura da Convergência” (Culture of Convergence by Henry Jenkins to be of interest to journalists and researchers in the area: media convergence as a cultural process; the strengthening of an emotional economy which guides consumers of symbolic goods and media creators; the expansion of trans-media narrative forms.

  5. Encefalocele basal esfenoetmoidal associada a fissura labiopalatina mediana: relato de caso

    Directory of Open Access Journals (Sweden)

    Maurus Marques de Almeida Holanda

    2011-12-01

    Full Text Available Associação de encefalocele basal esfenoetmoidal com fissura labiopalatina é extremamente rara. Relatamos um caso de uma criança de nove anos de idade apresentando uma fissura facial mediana com meningocele, que era evidente através da falha do palato como uma massa mediana intranasal pulsátil. Uma análise dos aspectos clínicos e radiológicos deste caso de disrafia craniana foi realizada.

  6. Tratamento dos abscessos intracranianos por trepanopunção

    Directory of Open Access Journals (Sweden)

    J. Jorge Facure

    1972-12-01

    Full Text Available São relatados os casos de 9 pacientes com abscessos intracranianos submetidos à aspiração. Apenas um paciente faleceu. Dois apresentaram seqüelas: um com hemiparesia e outro com convulsões focais. Em 5 casos foi feita cirurgia de urgência com alívio imediato da hipertensão intra-craniana.

  7. Multi-Institution Prospective Trial of Reduced-Dose Craniospinal Irradiation (23.4 Gy) Followed by Conformal Posterior Fossa (36 Gy) and Primary Site Irradiation (55.8 Gy) and Dose-Intensive Chemotherapy for Average-Risk Medulloblastoma

    International Nuclear Information System (INIS)

    Merchant, Thomas E.; Kun, Larry E.; Krasin, Matthew J.; Wallace, Dana; Chintagumpala, Murali M.; Woo, Shiao Y.; Ashley, David M.; Sexton, Maree; Kellie, Stewart J.; Ahern, Verity M.B.B.S.; Gajjar, Amar

    2008-01-01

    Purpose: Limiting the neurocognitive sequelae of radiotherapy (RT) has been an objective in the treatment of medulloblastoma. Conformal RT to less than the entire posterior fossa (PF) after craniospinal irradiation might reduce neurocognitive sequelae and requires evaluation. Methods and Materials: Between October 1996 and August 2003, 86 patients, 3-21 years of age, with newly diagnosed, average-risk medulloblastoma were treated in a prospective, institutional review board-approved, multi-institution trial of risk-adapted RT and dose-intensive chemotherapy. RT began within 28 days of definitive surgery and consisted of craniospinal irradiation (23.4 Gy), conformal PF RT (36.0 Gy), and primary site RT (55.8 Gy). The planning target volume for the primary site included the postoperative tumor bed surrounded by an anatomically confined margin of 2 cm that was then expanded with a geometric margin of 0.3-0.5 cm. Chemotherapy was initiated 6 weeks after RT and included four cycles of high-dose cyclophosphamide, cisplatin, and vincristine. Results: At a median follow-up of 61.2 months (range, 5.2-115.0 months), the estimated 5-year event-free survival and cumulative incidence of PF failure rate was 83.0% ± 5.3% and 4.9% ± 2.4% (± standard error), respectively. The targeting guidelines used in this study resulted in a mean reduction of 13% in the volume of the PF receiving doses >55 Gy compared with conventionally planned RT. The reductions in the dose to the temporal lobes, cochleae, and hypothalamus were statistically significant. Conclusion: This prospective trial has demonstrated that irradiation of less than the entire PF after 23.4 Gy craniospinal irradiation for average-risk medulloblastoma results in disease control comparable to that after treatment of the entire PF

  8. Hanna Krall e os caminhos tortos da memória e da identidade

    OpenAIRE

    Piotr Kilanowski

    2013-01-01

    Neste artigo apresentamos a escritora polonesa de origem judaica Hanna Krall por meio da análise literária do seu romance Sublokatorka (A sublocatária).  O romance, com elementos autobiográficos, apresenta a personalidade cindida de uma menina sobrevivente do Holocausto e discute o tema da identidade polonesa, judaica e judaico-polonesa. Através da observação da memória e do processo de criação da memória, a autora mostra a construção da identidade falsa e a repressão da verdadeira, o comport...

  9. A PROBLEMÁTICA DA BIOPIRATARIA: REFLEXÕES A PARTIR DA GEOPOLÍTICA E DOS DIREITOS DA SOCIOBIODIVERSIDADE

    OpenAIRE

    Nunes, Denise Silva; UFSM; Tybusch, Jerônimo Siqueira; UFSM

    2013-01-01

    O bioimperialismo configura-se como uma característica da geopolítica da atualidade, com alicerces nas estruturas da globalização e do capitalismo. Nesse contexto, a problemática da pesquisa consiste na violação dos direitos dos povos locais e a exploração do meio ambiente, em que o atual sistema internacional de propriedade intelectual contribui para a biopirataria dos recursos naturais, por meio da infiltração, em áreas ricas em diversidade biológica, das grandes corporações, multinacionais...

  10. SANEAMENTO BÁSICO E SEU REFLEXO NAS CONDIÇÕES SOCIOAMBIENTAIS DA ZONA RURAL DO BAIXO MUNIM (MARANHÃO

    Directory of Open Access Journals (Sweden)

    João José Pessoa Mota

    2015-07-01

    Full Text Available O saneamento básico contribui para o equilíbrio da humanidade, através dos serviços de abastecimento de água, disposição dos esgotos sanitários, acondicionamento do lixo e provimento da drenagem. No Brasil 38,4% dos domicílios não estão ligados a uma rede coletora de esgoto, sendo que no Maranhão apenas 19,9% dos domicílios tem esgotamento sanitário adequado, ficando bem abaixo da média da região nordeste que chega a 35,6%. Os serviços de saneamento básico são externalidades positivas de responsabilidade pública e sua provisão é um entrave enfrentado pelos gestores, que devem considerar aspectos da economia, meio ambiente, saúde e educação, prevendo a elevação na utilização dos recursos naturais e a quantidade de resíduos a serem tratados. Objetivou-se analisar os serviços de saneamento básico e suas influencias nas condições socioambientais da zona rural do Baixo Munim – MA. A metodologia utilizada foi a análise quantitativa e qualitativa, envolvendo visitas a campo, registros fotográficos, aplicação de questionários e entrevistas, comparando os valores encontrados. Foram realizados comparativos do PIB e das disposições dos serviços de saneamento entre as regiões do país, apontando diferenças entre a zona rural e urbana, mas também entre as cidades sedes das comunidades objeto de estudo. A região estudada representa uma participação insignificante na composição do PIB do estado, com baixo indicadores de desenvolvimento e com uma evolução insuficiente nos serviços de saneamento. O atendimento por rede de esgoto praticamente não existe na região, sendo baseado no uso de fossas rudimentares, influenciando negativamente a bela paisagem local, comprometendo a qualidade de vida.

  11. Euclides da Cunha nas vascas da modernidade // Euclides da Cunha in the throes of modernity

    Directory of Open Access Journals (Sweden)

    Walnice Nogueira Galvão

    2017-06-01

    Full Text Available Euclides da Cunha embraced the role of posthumous champion of the backlanders slaughtered by the Brazilian army during the Canudos War. He claimed to have written an “avenging book”. Coming of age at the turn of the century, his work would bear witness to a Modernity that was both historical and aesthetic.

  12. Da ordem. Da cidade. Da literatura: personagens à beira do "ruim do mundo"

    Directory of Open Access Journals (Sweden)

    Eliana Kuster

    2007-12-01

    Full Text Available As grandes cidades estão doentes. Seus sintomas: a quebra da sociabilidade e a irrupção rotineira da violência. Diante disso, ecoa na sociedade um clamor por ordem. No mesmo momento em que a polícia põe a tropa na rua, os literatos criam personagens que dão voz à sensação crescente de que a cidade está deixando de ser uma referência à constituição das identidades urbanas. É a partir da literatura, em especial da obra do escritor Rubem Fonseca, que iremos perscrutar as possibilidades apresentadas pela cidade para o convívio humano.The great cities are sick. Its indications: the sociability in addition and the routine irruption of the violence. Ahead of this, a outcry for order echoes in the society. At the same moment where the policy goes to the street, the writers create personages who give voice to the increasing sensation of that the city is leaving of being a reference to the constitution of the urban identities. It is from literature, in special of the writer Rubem Fonseca, that we will go to investigate the possibilities presented for the city for the human conviviality.

  13. Uso da fluoxetina no tratamento da tricotilomania felina

    OpenAIRE

    Sousa,Marlos Gonçalves; Ferreira,Lilian Stefanoni; Gerardi,Daniel Guimarães; Costa,Mirela Tinucci

    2004-01-01

    A tricotilomania ou alopecia psicogênica felina é uma dermatopatia de origem psicogênica, decorrente da lambedura compulsiva do pelame, realizada pelo gato em situações de estresse. Tal distúrbio decorre de alterações neuro-hormonais e pode associar-se à introdução de novos animais e/ou crianças no ambiente. Além de mudanças de manejo e atitude para com o animal, sugere-se o emprego de ansiolíticos no tratamento da doença. A fluoxetina foi utilizada no tratamento de cinco gatos domésticos com...

  14. Teoria da adequação econômica da conduta: significado econômico da conduta em face da tutela penal antitruste

    OpenAIRE

    Luiz da Silva, Ivan

    2009-01-01

    Essa tese tem por objetivo o desenvolvimento da teoria da adequação econômica da conduta no direito penal econômico. Vale-se de uma abordagem interdisciplinar abrangendo a Economia, o direito econômico e o direito penal. Para alcançar o desiderato a investigação analisou a intervenção do direito penal em face da atividade econômica e, em especial, os fundamentos da tutela penal antitruste, para fins de estabelecer os contornos teóricos necessários à aplicação das premissas fund...

  15. Newton da Costa e a Filosofia da Quase-Verdade

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    Décio Krause

    2009-08-01

    Full Text Available This paper intends to introduce the three issues of Principia which will appear in a sequel honoring Newton da Costa’s 80th birthday. Instead of presenting the papers one by one, as it is common in presentations such as this one, we have left the papers speak by themselves, and instead we have preferred to present to the Brazilian readers, specialty to our students, some aspects of Newton da Costa’s conception of science and of the scientific activity, grounded on the concept of quasi-truth, which he contributed to develop in a rigorous way. Da Costa is known as one of the founding fathers of paraconsistent logic, but his contributions go also to the foundations of physics, theoretical computation, model theory, algebraic logic, lattice theory, applications of non-classical logics to law and technology, etc. But perhaps his main contribution was to provide a basis for the birth of a school of logic in our country (Brazil, serving as teacher and inspiring new researchers for generations. It is a pleasure to have had so enthusiastic acceptation from the editors of Principia to organize these volumes. I would like to thank the contributors and the editors of Principia, specially Prof. Cezar Mortari for his help in organizing the issue.

  16. 75 FR 52292 - Airworthiness Directives; Diamond Aircraft Industries GmbH Models DA 40 and DA 40F Airplanes

    Science.gov (United States)

    2010-08-25

    ... Industries GmbH Models DA 40 and DA 40F Airplanes AGENCY: Federal Aviation Administration (FAA), Department... new airworthiness directive (AD) for all Diamond Aircraft Industries GmbH Models DA 40 and DA 40F... received information from Diamond Aircraft Industries GmbH that the Models DA 40 and DA 40F airplanes have...

  17. Aspectos incomuns da paracoccidioidomicose infantil

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    Achiléa Lisboa Bittencourt

    1987-12-01

    Full Text Available São relatados dois casos de paracoccidioidomicose (PCM infantil. Em um deles, a principal manifestação da doença foi tumoração abdominal, simulando linfoma maligno não Hodgkin. O outro apresentou acentuado envolvimento articular, com ruptura da cápsula. Representam o segundo e terceiro casos de PCM infantil observados na Bahia, ambos procedentes de áreas urbanas.The authors present two cases of infantil para-coccidioidomycosis. In one case the main presentation was an abdominal mass that mimicked non- Hodgkin lymphoma. In the other case the child had a joint swelling with rupture of the capsule and the clinical diagnosis was piogenic arthritis. They represent the second and third cases of infantile paracoccidioidomycosis observed in the state of Bahia, all coming from urban areas.

  18. 1992: a redescoberta da Natureza

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    Milton Santos

    1992-04-01

    Full Text Available Com a presença do homem sobre a Terra, a natureza está, sempre, sendo redescoberta, com a criação da natureza social. É a história de uma rutura progressiva entre o homem e o entorno, acelerada pela mecanização. Mediante a tecnociência, a natureza artificializada alcança seu estágio supremo, onde a natureza e o homem tornam-se reciprocramente hostis. Com a globalização da economia, da política e da cultura, não há mais relações totalizantes entre a sociedade e o meio. A natureza tecnicizada se impõe como algo abstrato, exigindo um discurso. A questão do meio ambiente é um aspecto dessa evolução e reclama um estudo abrangente, para permitir uma correta interpretação. Para alcançar essa interpretação, a universidade deve fugir dos raciocínios técnicos e conformistas e enfrentar o entendimento do mundo como um todo.With man on Earth, Nature is being permanently rediscovered through the creation of social nature. The progressive rupture between man and his surrounding is quickened by mechanization. More recently, with globalization of economy, politics and culture, there are no longer totalizing relations between society and environment. Through technoscience, nature and man become reciprocally hostile. Tecnicized nature emerges as an abstraction that demands a discourse. Environmental problems are only an aspect of this evolution, and ask for a comprehensive approach, in order to reach its correct interpretation. University must fly away from technical and conformicist reasonning and face the understanding of the world as a whole.

  19. A travessia da escrita machadiana

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    Ruth Silviano Brandão

    2000-03-01

    Full Text Available A narração machadiana constrói-se de uma maneira tal que se pode falar de determinadas posições do sujeito da enunciação em relação a seus fantasmas. Assim, é possível pensar num trajeto que se pode chamar de travessia exatamente pelas modificações ocorridas na escritade Machado de Assis até o Memorial de Aires.

  20. Cultura da Convergência

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    Rogério Christofoletti

    2008-12-01

    Full Text Available Três idéias já seriam suficientes para que a leitura de “Culturada Convergência”, de Henry Jenkins, interessasse a jornalistas epesquisadores da área: a convergência midiática como um processo cultural; o fortalecimento de uma economia afetiva que orienta consumidores de bens simbólicos e criadores midiáticos; a expansão de formas narrativas transmidiáticas.

  1. Malformação da transição crânio-vertebral como causa de síndrome do ângulo ponto-cerebelar: relato de dois casos

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    Amauri Batista da Silva

    1972-03-01

    Full Text Available Os autores relatam dois casos de síndrome do ângulo ponto-cerebelar nos quais não havia neoplasia nessa região. Ambos os pacientes apresentavam uma associação de impressão basilar com síndrome de Arnold-Chiari. Após cirurgia descompressiva de fossa posterior os casos evoluiram favoravelmente com a diminuição progressiva dos sintomas neurológicos, restando apenas, no segundo paciente, certo grau de paralisia e de espasmo facial, à direita. São feitas considerações em tôrno das causas mais freqüentes da síndrome do ângulo ponto-cerebelar, bem como acêrca dos quadros clínicos mais usualmente encontrados em doentes que apresentam malformações da transição crânio-vertebral. Finalmente, os autores tecem breves considerações a respeito do possível mecanismo lesionai do VIII, do V e do VII nervos cranianos nos dois casos relatados.

  2. The major histocompatibility complex genes impact pain response in DA and DA.1U rats.

    Science.gov (United States)

    Guo, Yuan; Yao, Fan-Rong; Cao, Dong-Yuan; Li, Li; Wang, Hui-Sheng; Xie, Wen; Zhao, Yan

    2015-08-01

    Our recent studies have shown that the difference in basal pain sensitivity to mechanical and thermal stimulation between Dark-Agouti (DA) rats and a novel congenic DA.1U rats is major histocompatibility complex (MHC) genes dependent. In the present study, we further used DA and DA.1U rats to investigate the role of MHC genes in formalin-induced pain model by behavioral, electrophysiological and immunohistochemical methods. Behavioral results showed biphasic nociceptive behaviors increased significantly following the intraplantar injection of formalin in the hindpaw of DA and DA.1U rats. The main nociceptive behaviors were lifting and licking, especially in DA rats (PDA rats were significantly higher than those in DA.1U rats in both phases of the formalin test (PDA rats was significantly higher than that of DA.1U rats (PDA was greater than that in DA.1U rats (PDA rats was significantly higher than that in DA.1U rats in the respective experimental group (PDA and DA.1U rats exhibited nociceptive responses in formalin-induced pain model and DA rats were more sensitive to noxious chemical stimulus than DA.1U rats, indicating that MHC genes might contribute to the difference in pain sensitivity. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Da onda da gestão da qualidade a uma filosofia da qualidade da gestão: Balanced Scorecard promovendo mudanças

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    Andréa Cavalcanti Correia Lima

    2004-06-01

    Full Text Available No final da década de 80 a Gestão da Qualidade Total (GQT era apresentada como capaz de resolver todos os problemas e atender a todas as necessidades da gestão das organizações. Buscando solucionar problemas de gestão não equacionados pela GQT, muitas organizações começam a adotar o Balanced Scorecard (BSC. Uma questão ainda não discutida com profundidade no mundo acadêmico é a viabilidade de integração desses dois modelos. O presente artigo discute a possibilidade de integração dessas duas ferramentas, verificando as melhorias que podem alcançar, principalmente no gerenciamento da estratégia da organização. Assim sendo, realizou-se estudo de caso no Caesar Park Hotel Fortaleza (CPHF, empresa que vêm adotando com sucesso os dois modelos. A pesquisa revela que é possível integrar os princípios da GQT com os do BSC, à medida que os fundamentos de ambos se complementam, sendo assim a utilização conjunta das ferramentas propicia melhor gerenciamento da estratégia da organização.In recent years, many organizations have been managed according to the principles of Total Quality Management (TQM, which became known around the globe in the 1980's, when looking for explanations for the so-called "Japanese miracle". TQM was presented as being capable of solving all problems and attending to all company management needs, a stage that seems outdated now. In the search for a model that would allow them to analyze and follow up the implementation of organizational strategies, without remaining limited to Quality indicators, many companies started to adopt the Balanced Scorecard (BSC. Companies using TQM question whether it is viable together with the BSC. In order to contribute to a solution to this question, this article discusses the possibility of aligning these two tools. Therefore, a case study was carried out at the Caesar Park Hotel Fortaleza, a company that implanted TQM in 1997 and started to adopt the BSC in 2000. The

  4. EM TORNO DA GUERRA E DO PACIFISMO

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    Betty Bernardo Fuks

    2013-02-01

    Full Text Available O artigo apresenta algumas das principais reflexões de Freud sobre os temas da guerra e do pacifismo.  Partindo do texto “Da guerra e morte. Temas da atualidade”, escrito  durante a Primeira Guerra Mundial,  a autora mostra de que modo  Freud estabeleceu a incursão da psicanálise no campo da política e de que modo esta conexão exige do analista  manter sua escuta voltada  para a singularidade contemporânea.  Conclui que  em relação a dimensão catastrófica do psiquismo, que podemos observar hoje, por exemplo, na passagem ao ato violento; na delinqüência; na toxicomania; no totalitarismo que se coloca acima da lei e no fundamentalismo como  instrumento da lei divina etc,  importa salientar que a existência desses  novos modos de expressão dos sintomas, põe à prova o devir da psicanálise.  Lança, por fim, a aposta: o futuro da psicanálise depende da responsabilidade do analista em manter seu trabalho voltado à dinâmica psíquica do sujeito, individual ou coletivo, sem abrir mão do rigor dos conceitos freudianos.

  5. A metodologia de projecto na aprendizagem da biodiversidade e geodiversidade na praia da concha

    OpenAIRE

    Rosa, Marina Maria Filipe

    2012-01-01

    Dissertação de mestrado em Biologia e de Geologia, apresentada ao Departamento de Ciências da Terra e ao Departamento de Ciências da Vida Este trabalho consistiu na implementação e avaliação da metodologia de projeto no estudo da Biodiversidade e Geodiversidade na Praia da Concha, Portugal Central, dando ênfase ao trabalho prático, através de uma aula de campo e de aulas laboratoriais. O trabalho foi realizado numa escola da Marinha Grande, com 11 alunos do 10º ano de escolaridade. Sendo a...

  6. Vulnerabilidades sociais e juvenil nos mananciais da zona sul da cidade de São Paulo

    OpenAIRE

    Borelli,Elizabeth

    2012-01-01

    http://dx.doi.org/10.1590/S1414-49802012000100006 Este artigo é um produto parcial da pesquisa “Reflexos da Vulnerabilidade Socioambiental nas Manifestações Musicais dos Jovens Paulistanos da Periferia”, identificando como recorte geográfico a periferia da Zona Sul da cidade de São Paulo. Trata-se de uma região que começou a se formar devido à ocupação populacional desordenada em áreas de manancial, onde a vulnerabilidade social é agravada por situações de risco e degradação ambiental, da...

  7. Fresnel: O formulador matemático da teoria ondulatória da luz

    OpenAIRE

    Bassalo, José Maria Filardo

    1988-01-01

    Neste artigo, apresentamos alguns aspectos da vida de Fresnel, engenheiro e físico francês que se notabilizou pela formulação matemática da teoria ondulatória da luz, e cujo bicentenário de nascimento transcorre neste ano de 1988. Realçamos, neste trabalho, suas principais pesquisas relacionadas com o estudo da difração, dupla-refração e reflexão da luz, nas quais utilizou a idéia revolucionária de transversalidade da onda luminosa para deduzir equações, as quais explicaram alg...

  8. A escrita da dor : testemunhos da ditadura militar

    OpenAIRE

    Fabricio Flores Fernandes

    2008-01-01

    Resumo: Esta pesquisa tem como objeto de estudo as obras testemunhais de Luiz Roberto Salinas Fortes, Retrato calado (1988), e de Flávio Tavares, Memórias do esquecimento (1999), em que os autores narram acontecimentos vividos durante os anos da ditadura militar no Brasil (1964-1985), entre os quais suas passagens por sessões de tortura. Exploram-se, neste trabalho, os motivos por que os relatos apresentam determinadas características estruturais, tais como a cisão do narrador ante a descriçã...

  9. Simultaneous whole-body {sup 18}F-PSMA-1007-PET/MRI with integrated high-resolution multiparametric imaging of the prostatic fossa for comprehensive oncological staging of patients with prostate cancer. A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Freitag, Martin T.; Bonekamp, David; Schlemmer, Heinz-Peter [German Cancer Research Center, Department of Radiology, Heidelberg (Germany); Kesch, Claudia; Radtke, Jan P.; Hohenfellner, Markus [University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Cardinale, Jens; Kopka, Klaus [German Cancer Research Center, Division of Radiopharmaceutical Chemistry, Heidelberg (Germany); Flechsig, Paul; Kratochwil, Clemens; Giesel, Frederik [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); Floca, Ralf [German Cancer Research Center, Medical Image Computing Group, Heidelberg (Germany); Eiber, Matthias [Technical University Hospital Munich, Department of Nuclear Medicine, Munich (Germany); Stenzinger, Albrecht [University Hospital Heidelberg, Institute of Pathology, Heidelberg (Germany); Haberkorn, Uwe [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany)

    2018-03-15

    The aim of the present study was to explore the clinical feasibility and reproducibility of a comprehensive whole-body {sup 18}F-PSMA-1007-PET/MRI protocol for imaging prostate cancer (PC) patients. Eight patients with high-risk biopsy-proven PC underwent a whole-body PET/MRI (3 h p.i.) including a multi-parametric prostate MRI after {sup 18}F-PSMA-1007-PET/CT (1 h p.i.) which served as reference. Seven patients presented with non-treated PC, whereas one patient presented with biochemical recurrence. SUV{sub mean}-quantification was performed using a 3D-isocontour volume-of-interest. Imaging data was consulted for TNM-staging and compared with histopathology. PC was confirmed in 4/7 patients additionally by histopathology after surgery. PET-artifacts, co-registration of pelvic PET/MRI and MRI-data were assessed (PI-RADS 2.0). The examinations were well accepted by patients and comprised 1 h. SUV{sub mean}-values between PET/CT (1 h p.i.) and PET/MRI (3 h p.i.) were significantly correlated (p < 0.0001, respectively) and similar to literature of {sup 18}F-PSMA-1007-PET/CT 1 h vs 3 h p.i. The dominant intraprostatic lesion could be detected in all seven patients in both PET and MRI. T2c, T3a, T3b and T4 features were detected complimentarily by PET and MRI in five patients. PET/MRI demonstrated moderate photopenic PET-artifacts surrounding liver and kidneys representing high-contrast areas, no PET-artifacts were observed for PET/CT. Simultaneous PET-readout during prostate MRI achieved optimal co-registration results. The presented {sup 18}F-PSMA-1007-PET/MRI protocol combines efficient whole-body assessment with high-resolution co-registered PET/MRI of the prostatic fossa for comprehensive oncological staging of patients with PC. (orig.)

  10. EFEITOS DA LARGURA DA FAIXA DE CAPINA NA CULTURA DA MAMONA

    Directory of Open Access Journals (Sweden)

    EDISON MARTINS PAULO

    1997-01-01

    Full Text Available Estudou-se a influência de diferentes larguras de faixas de controle de plantas daninhas sobre a altura, o número de racemos e a produção de grãos da mamoneira (Ricinus communis L. var. IAC-80, objetivando-se determinar a área vegetada entre as linhas de plantio. Os experimentos foram desenvolvidos em Adamantina, na Estação Experimental de Agronomia da Alta Paulista do Instituto Agronômico (IAC, nos anos agrícolas 1989/90, 1990/91 e 1991/92. O delineamento estatístico adotado foi o de blocos ao acaso com quatro repetições e oito tratamentos. Os tratamentos consistiram em faixas com 0,0; 0,5; 1,0; 1,5; 2,0; 2,5 e 3,0 m de largura capinadas ao longo da linha de plantio e mantidas sempre livres de plantas daninhas; além dessas, mateve-se uma faixa de 1,0 m de largura e mesmo procedimento, na qual a comunidade infestante das entrelinhas era roçada manual- mente sempre que a altura média de 0,3 m era atingida. Concluiu-se que faixas de capina menores do que 1,0 m aplicadas sobre a linha de plantio da cultura diminuíram a produção de grãos, o número de racemos e a altura da mamoneira.Three experiments were carried out in Adamantina at the Experimental Station of Agronomy of Alta Paulista, Instituto Agronômico (IAC, State of São Paulo, Brazil, on a Dark Red Latosol during 1989-1992, in order to study the effects of different row widths covered by weeds on the yield, height and number of racemes of IAC-80 castor bean cultivar. Hoed rows of 0.0, 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 m wide were studied. An extra treatment had the entire plot covered with weeds mantained at 0.3 m height. The row space used was 3.0 x 1.0 m and the plots were 9.0 x 5.0 m. The experiment was set in a randomized complete block design with four replications. Hoeing row width of 1.0 m or less reduced raceme emission, plant height and seed yields.

  11. O uso da quimioterapia no tratamento do retinoblastoma: avaliação retrospectiva The use of chemotherapy in the treatment of retinoblastoma: retrospective analysis

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    Fernando Leite Kronbauer

    2000-12-01

    de enucleações com margens livres neste grupo foi 50%, metade dos casos. 3 - A quimioterapia com protocolo utilizando VEC associado ou não a radioterapia ou enucleação demostrou redução tumoral satisfatória e melhora da sobrevida dos pacientes com doença avançada, embora não altere o desfecho letal da doença quando existe metástase craniana e/ou invasão de nervo óptico. Estudos randomizados serão necessários para determinar a eficácia e complicações dos novos protocolos quimioterápicos. Abreviatura: VEC- vincristina 1,5 mg/m², etoposida 100mg/m ² , carboplatina 360 mg/m 2.Purpose: Retrospective uncontrolled series of consecutive patients with retinoblastoma considering: 1-tumor features on computed tomography, 2-proportion of patients with optic nerve invasion in pathology studies of enucleated eyes and 3-results after chemotherapy. Methods: The authors revised the charts of 11 consecutive patients diagnosed with retinoblastoma betweenFebuary/98 and September/99, treated at the Departments of Pediatric Oncology and Ophthalmology. Seven cases who received chemotherapy with vincristine sulfate, etoposide and carboplatin (VEC were selected for this study to evaluate tumor presentation (response to chemotherapy and patient survival. Results: The seven studied patients were diagnosed between the ages of 15 and 38 months (mean =25.7 months, 3 being unilateral, 3 bilateral and 1 trilateral (with pinealo- blastoma. All patients were treated with VEC protocol administered in 2 to 5 cycles, and divided in to 2 groups: Group1- Patients treated with primary chemotherapy to obtain tumor reduction and preservation of one of the eyes (5 patients; Group2- Patients treated with aggressive chemotherapy for extraocular disease (2 patients. Of the 5 patients treated with primary chemotherapy (4 subsequently enucleated due to eye filling tumor, 4 achieved some tumor reduction, however 2 of them had only an initial tumor response and died on average 10 months later

  12. O potencial da imagem televisiva na sociedade da cultura audiovisual

    Directory of Open Access Journals (Sweden)

    Juliana L. M. F. Sabino

    Full Text Available Resumo A cultura audiovisual vem cada vez mais ganhando espaço, e os avanços tecnológicos contribuem, vertiginosamente, para o seu desenvolvimento e sua abrangência. Assim, este estudo tem como temática a cultura audiovisual, e como objetivo de pesquisa, discutir a importância das imagens na televisão. Para tanto, selecionamos um exemplo de propaganda televisiva observada no ano de 2006, que inspirou uma reflexão crítica sobre a importância das linguagens híbridas na televisão, ilustrando a interferência dessas na produção do sentido na mensagem televisiva. Como referencial teórico e metodológico, utilizamos as concepções de imagem e linguagens híbridas de Lúcia Santaella. A partir da análise da propaganda ora proposta concluímos que sua constituição é mais icônica do que de verbal, mas que se insere numa concepção dialógica, constituindo-se, portanto, por meio de um processo criativo de produção de significados.

  13. Cultura digital: odisseia da tecnologia e da ciência

    Directory of Open Access Journals (Sweden)

    Joana Coeli Ribeiro Garcia

    2011-12-01

    Full Text Available Rememora a história da tecnologia, culminando na moderna cultura digital, associando-a a uma odisseia. Contextualiza a necessidade do homem de registrar seus conhecimentos para compartilhá-los com outras gerações, o que começou com o verbo, logo, a pedra, depois, a argila, a madeira, peles, papel e, enfim, o ciberespaço. Discorre sobre vantagens da tecnologia na cultura digital e contradições na aceitação do meio eletrônico, tais como as limitações digitais e a facilidade com que se realiza plágio e se burla o direito autoral. Apresenta o letramento digital como elemento para utilização das novas tecnologias e considera que as metáforas biblioteca, ciberespaço, cibercultura, cultura digital e hipertexto serviram de inspiração para o texto, assim como, a Odisseia de Homero, que conta a viagem de Ulisses, que percorre e conhece vários costumes e tormentas. A coexistência com as mudanças serve de vivência para os desafios ou o que ainda há por ser feito.

  14. O PAPEL DA ÁFRICA NA NOVA ROTA DA SEDA MARÍTIMA

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    Diego Pautasso

    2017-01-01

    Full Text Available O objetivo do presente artigo é analisar o lugar da África na construção da Nova Rota da Seda Marítima. Este é justamente um dos vetores do ambicioso projeto chinês de integração da Ásia, Europa e África, lançada em 2013 sob título de Iniciativa OBOR (One Belt, One Road. Na medida que os desafios da reconstrução nacional são superados, a China torna-se mais assertiva e dá forma à sua estratégia de inserção mundial. Nesse sentido, a Nova Rota da Seda agrega os objetivos centrais da diplomacia da China para o século XXI, reservando à África a condição de trampolim para que o projeto se torne global.

  15. Fisiopatologia da enxaqueca Migraine pathophysiology

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    MAURICE B. VINCENT

    1998-12-01

    Full Text Available A fisiopatologia da enxaqueca ainda não foi completamente elucidada. As principais estruturas envolvidas parecem ser o sistema nervoso central (córtex e tronco cerebral, o sistema trigeminovascular e os vasos correspondentes, outras fibras autonômicas que inervam estes vasos, e os vários agentes vasoativos locais, como a SP, CGRP, NO, VIP, NPY, ACh, NA, NKA, entre outros. A depressão alastrante é o fenômeno neurológico que provavelmente justifica achados experimenais e clínicos na enxaqueca. Ela tem velocidade de propagação semelhante à aura, ativa o núcleo espinhal do trigêmeo e está relacionada à liberação de CGRP e NO. Alterações circulatórias detectadas por métodos complementares reforçam o papel da depressão alastrante. A identificação de anormalidades em pelo menos três loci (cromossomas 19 e 1 na enxaqueca hemiplégica familiar ocorreu recentemente. Elas estão relacionadas a anormalidades nos canais de cálcio voltagem dependentes tipo P/Q, específicos do sistema nervoso central, que regulam a liberação de vários neurotransmissores, incluindo possivelmente a serotonina. A exemplo de outras anormalidades neurológicas paroxísticas que resultam da hiperexcitabilidade da membrana plasmática, é possível que a enxaqueca ocorra devido a uma desordem de canais iônicos.The pathophysiology of migraine is not yet fully understood. The most important structures involved seem to be the central nervous system (cortex and brain stem, the trigeminovascular system and related cranial arteries, other autonomic fibres innervating such vessels, and various local vasoactive agents, including SP, CGRP, NO, VIP, NPY, ACh, NA, NKA, among others. The spreading depression phenomenon may explain clinical as well experimental findings in migraine. Its propagation velocity mirrors what is found in clinical aura, it may activate the spinal trigeminal nucleus and may induce CGRP and NO release. Circulatory changes detected with

  16. Efeito da enxertia em mandioca

    OpenAIRE

    Bomfim, Nayra Nascimento

    2011-01-01

    Enxertos de duas espécies silvestres (M. glaziovii e M. fortalezensis) sobre M. esculenta, mandioca, foram estudados morfologicamente, anatomicamente e citogeneticamente e a fim de se avaliar possíveis efeitos devido à interação entre enxerto e porta-enxerto. Foram feitas análises anatômicas das raízes dos porta-enxertos UnB 201 e UnB 122 (variedades de M. esculenta), em comparação com as variedades não enxertadas. Analisou-se a meiose em enxerto da espécie M. glaziovii que apresentava morfol...

  17. Da apoteose à Damnatio Memoriae

    OpenAIRE

    Corrêa, Luciano Prado

    2011-01-01

    Resumo: O sistema política romano transitou de um governo aristocrático, a república, para um governo monárquico, o principado. Otávio inaugurou o principado e a dinastia julio-claudiana. Gradativamente foram estabelecidos princípios que visavam promover a legitimação da figura central, o prínceps. Um dos mecanismos de fortalecimento imperial tinha cunho religioso, a divinização dos imperadores. O alvo de um imperador ao divinizar seu antecessor era tornar-se sucessor ou até filho de um deus....

  18. Por uma arte no mundo da vida

    Directory of Open Access Journals (Sweden)

    Rachel Costa

    2016-12-01

    Full Text Available O artigo visa debater a análise colocada por Jacinto Lageira no texto “As razões do agir, contribuição a uma poética da ação”. O debate se estabelece no que concerne ao problema da autonomia da arte e suas consequências, tendo em vista a necessidade de pensar possibilidades contemporâneas para a experiência estética que pressuponham o mundo material. Isso é realizado a partir da teoria dos gestos do filósofo Vilém Flusser.

  19. Aspectos jurídicos da publicidade

    Directory of Open Access Journals (Sweden)

    André Luiz Cavalcanti Cabral

    2003-01-01

    Full Text Available O presente artigo aborda a publicidade comoobjeto do direito. Trata da regulamentação da publicidade noordenamento jurídico brasileiro, iniciando o estudo pelaconceituação da publicidade, bem como de outros institutosinerentes ao cotidiano do ambiente publicitário, para assimdelimitar a abrangência de seu campo de atuação. Analisa asespécies de publicidade ilícitas, apresentando conclusõesacerca da abordagem realizada. Espera contribuir para odebate de tema pouco explorado pelos juristas.

  20. A RELAÇÃO DA TELEVISÃO E DA INTERNET COM O CONSUMO: ANÁLISES DA IDEOLOGIA E DA CULTURA NAS PROPAGANDAS

    Directory of Open Access Journals (Sweden)

    Fábio Carlos Rodrigues Alves

    2016-10-01

    Full Text Available Mais que um meio de comunicação, as tecnologias da comunicação, em especial a TV, transmitem valores, ideias e atitudes, ou seja, todo um conteúdo atitudinal e procedimental. O presente texto discute o papel da mídia televisiva e da internet na transmissão de valores culturais, atendo-se principalmente na questão do consumo. Analisamos propagandas oriundas do ambiente televisivo e também a veiculada pela internet a partir da qual objetivamos, à luz do conceito de Cultura e Ideologia investigar e assinalar o condicionamento dos consumidores ao ato de consumo.

  1. A aplicação dos recursos da seguridade social, a partir da perspectiva da teoria dos sistemas, da teoria comunicacional e do caos

    OpenAIRE

    Júnior, Dávio Antonio Prado Zarzana

    2011-01-01

    Este trabalho, focalizando o custeio da Seguridade Social, pretende realizar três verificações: a primeira, a existência ou não de desvios na aplicação dos recursos arrecadados para este financiamento, inclusive a partir da formulação de um conceito de desvio. A segunda, examinar os desequilíbrios que esses possíveis desvios produziriam, sob a ótica da Teoria dos Sistemas, utilizando-se, em adição, terminologia própria da Teoria Comunicacional. E a terceira, perscrutar a pos...

  2. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2011-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  3. Temporal fossa intra-extracranial dumbbell schwannoma.

    LENUS (Irish Health Repository)

    Wong, Limy

    2012-02-01

    Intra-extracranial schwannomas arising unrelated to major cranial nerves are exceedingly rare neoplasms. We report the case of a 23-year-old male who presented with a 9 month history of progressive temporal swelling which was excised and found histologically to be a schwannoma. A succinct review of the relevant literature is presented.

  4. Posterior fossa meningioma (surgical experiences) | Moussa ...

    African Journals Online (AJOL)

    Symptoms included headache (75%), cerebellar manifestations (60%), cranial nerve affection (40%) and hearing disturbances (15%). Most of the cases (50%) were cerebellopontine angle meningioma while the least (5%) were foramen magnum meningioma. Surgical approaches used included retrosigmoid approach ...

  5. Isolated posterior fossa involvement of progressive multifocal ...

    African Journals Online (AJOL)

    2017-11-14

    Nov 14, 2017 ... and the HIV pandemic has resulted in an increased prevalence of PML, affecting 3% – 7% of HIV- infected ... majority of HIV-infected patients with PML have CD4 lymphocyte counts < 200 cells/mm3. JC ... infrequent contrast enhancement.3 There is no involvement of the optic nerves or spinal cord. Isolated ...

  6. Disruption of the 37-kDa/67-kDa laminin receptor gene in bovine ...

    African Journals Online (AJOL)

    ... gene encoding for the prion binding site in bovine fetal fibroblasts. The heterozygous BFF are ready to be used in producing homozygous cattle, which will be applied to study the interaction between prion and the 37-kDa/67-kDa LRP/LR. Key words: Prion, PrPC, PrPSc, 37-kDa/67-kDa laminin receptor, gene targeting.

  7. Autocorrelation descriptor improvements for QSAR: 2DA_Sign and 3DA_Sign

    Science.gov (United States)

    Sliwoski, Gregory; Mendenhall, Jeffrey; Meiler, Jens

    2016-03-01

    Quantitative structure-activity relationship (QSAR) is a branch of computer aided drug discovery that relates chemical structures to biological activity. Two well established and related QSAR descriptors are two- and three-dimensional autocorrelation (2DA and 3DA). These descriptors encode the relative position of atoms or atom properties by calculating the separation between atom pairs in terms of number of bonds (2DA) or Euclidean distance (3DA). The sums of all values computed for a given small molecule are collected in a histogram. Atom properties can be added with a coefficient that is the product of atom properties for each pair. This procedure can lead to information loss when signed atom properties are considered such as partial charge. For example, the product of two positive charges is indistinguishable from the product of two equivalent negative charges. In this paper, we present variations of 2DA and 3DA called 2DA_Sign and 3DA_Sign that avoid information loss by splitting unique sign pairs into individual histograms. We evaluate these variations with models trained on nine datasets spanning a range of drug target classes. Both 2DA_Sign and 3DA_Sign significantly increase model performance across all datasets when compared with traditional 2DA and 3DA. Lastly, we find that limiting 3DA_Sign to maximum atom pair distances of 6 Å instead of 12 Å further increases model performance, suggesting that conformational flexibility may hinder performance with longer 3DA descriptors. Consistent with this finding, limiting the number of bonds in 2DA_Sign from 11 to 5 fails to improve performance.

  8. Direito à palavra: interrogações acerca da proposta da justiça restaurativa

    Directory of Open Access Journals (Sweden)

    Edson Luiz André de Sousa

    Full Text Available Partindo da constatação da necessidade de alternativas ao sistema de Justiça atual, o presente artigo objetiva dar voz a uma das propostas que vem ganhando força no cenário jurídico mundial: a Justiça Restaurativa. Para tanto, este artigo explora essa proposta, promovendo uma análise crítica amparada em autores da psicanálise (freudo-lacaniana e da Filosofia (com F. Ost e J. Derrida. Através da Justiça Restaurativa, é possível questionar a potência da circulação da palavra, característica que promove o tensionamento entre psicanálise e Direito. Além disso, a questão da Lei e das leis, da performatividade dos atos da fala, da posição do Juiz, da experiência do encontro restaurativo e da função das utopias são os principais vieses que compõem esta análise. Mais voltado para a possibilidade de anunciar questionamentos sobre essa proposta tão nova no contexto brasileiro do que de encontrar respostas satisfatórias, este artigo mantém em suspenso várias conclusões, embora assuma a constatação da importante função utópica da Justiça Restaurativa.

  9. ESTUDO DA SECAGEM DA FIBRA RESIDUAL DO ABACAXI

    Directory of Open Access Journals (Sweden)

    T. G. M. WAUGHON

    2009-01-01

    Full Text Available

    O objetivo deste trabalho foi caracterizar o resíduo fibroso gerado na industrialização do suco de abacaxi (Ananas comosus L. e estudar seu beneficiamento, através da secagem, visando obter um produto rico em fibras dietéticas. O resíduo caracterizado apresentou um elevado teor de fibras (32,95% b.s.. A secagem foi realizada em secador de leito fixo, em camada delgada, utilizando planejamento fatorial completo a três níveis, com triplicata no ponto central. As variáveis de entrada foram: temperatura (50 ºC, 60 ºC e 70ºC e velocidade de circulação do ar (2,0 m/s; 2,5 m/s e 3,0 m/s. As variáveis de resposta avaliadas foram: umidade de equilíbrio, tempo de secagem, taxa de secagem à velocidade constante e coloração do produto. Os resultados obtidos através da análise de variância mostraram que a temperatura foi a variável de entrada que apresentou maior influência sobre as variáveis de resposta analisadas, não exercendo influência significativa apenas sobre a cor do produto.

  10. Avaliação da inibição recíproca em humanos durante contrações isométricas dos músculos tibial anterior e sóleo Assessment of reciprocal inhibition in humans during isometric contractions of the tibialis anterior and soleus muscles

    Directory of Open Access Journals (Sweden)

    José Eduardo Pompeu

    2009-09-01

    Full Text Available Os objetivos do presente trabalho foram: (1 desenvolver um método para estimar o grau de inibição recíproca (IR entre músculos antagonistas em humanos (sóleo e tibial anterior e (2 comparar os níveis de IR no repouso, na dorsiflexão (DF e na flexão plantar (FP. Participaram nove sujeitos saudáveis com idade entre 20 e 30 anos, quatro homens e cinco mulheres. Os sujeitos permaneceram sentados numa cadeira com o pé direito apoiado e fixo num pedal acoplado a um torquímetro; as medições foram feitas no repouso e durante contração isométrica dos músculos dorsiflexores e flexores plantares do tornozelo. A onda H do músculo sóleo foi captada por eletrodos de superfície. O reflexo H (RH "teste" do músculo sóleo foi medido aplicando-se um estímulo na fossa poplítea (nervo tibial. O reflexo H "condicionado" foi obtido pelo pareamento de dois estímulos: o primeiro aplicado sobre a cabeça da fíbula e o segundo, na fossa poplítea, após 1 a 3 ms.. As amplitudes pico-a-pico dos RH teste e condicionado foram utilizadas para o cálculo da IR. Os valores de IR foram: 16,41%±8,68 no repouso; 21,94%±5,39 na DF e 3,12%±11,84 na FP. Foi constatada menor inibição recíproca na FP quando comparada às demais condições (pThe purposes of the present study were (1 to develop a method to estimate the level of reciprocal inhibition (RI between antagonist (soleus and anterior tibial muscles in humans, and (2 to compare RI levels during rest, dorsiflexion (DF and plantar flexion (PF. Nine healthy subjects (four men, five women aged between 20 and 30 years were assessed. Each subject remained seated with his/her right foot strapped to a rigid foot plate coupled to a torquemeter; measurements were taken at rest and during isometric contraction of the ankle dorsiflexor and plantar flexor muscles. The soleus muscle H-wave was captured by surface electrodes. A "test" H- reflex was elicited by a stimulus (electrical pulse to the popliteal fossa

  11. Estatuto da cidade e juridificação da reforma urbana no Brasil

    OpenAIRE

    Ana Paula Soares Carvalho

    2012-01-01

    O início da década passada foi marcado por um importante evento relacionado ao tratamento das questões urbanas no Brasil. Em dez de julho de 2001, foi promulgada a Lei Federal n 10.257, conhecida como Estatuto da Cidade, que regulamenta o capítulo da política urbana da Constituição de 1988. O Estatuto da Cidade provê suporte legal consistente para aquelas municipalidades comprometidas com o enfrentamento dos problemas sociais e urbanos que afetam diariamente as condições de vida dos habitante...

  12. Imagens e contra imagens da favela

    Directory of Open Access Journals (Sweden)

    Mário Hélio Trindade de Lima

    2008-01-01

    Full Text Available O presente artigo aborda as representações sociais da pobreza urbana no Brasil. O objeto de estudo é, por um lado, o conjunto de discursos e imagens sobre a favela na imprensa e, por outro lado, as auto-representações visuais de favelas e periferias da cidade do Rio de Janeiro, na virada do século XXI. O objetivo é analisar o uso da categoria favela na formação do imaginário social da cidade e, ao mesmo tempo, investigar como se constrói o olhar periférico nas representações fotográficas dos moradores de favelas. O método empregado baseia-se nas contribuições de Pierre Bourdieu e de Roland Barthes para a análise do discurso e nas contribuições da antropologia visual e da história cultural para a análise da fotografia enquanto campo documental na etnografia. Os resultados revelam um movimento de constituição de novas subjetividades no cenário das grandes cidades dos anos 90, por meio da ação de ONG’s nas favelas, criando um espaço de reflexão sobre si e sobre o outro e de afirmação de novas identidades.

  13. Flaskehalsen peger på DA

    DEFF Research Database (Denmark)

    Post, Bettina

    2015-01-01

    Nu har vi i årevis stillet krav til de arbejdsløse. Flaskehalsen peger nu på DA. Kom ind i kampen!......Nu har vi i årevis stillet krav til de arbejdsløse. Flaskehalsen peger nu på DA. Kom ind i kampen!...

  14. Arquitetura da paisagem da cidade e a importância da sistematização da análise do problema projetual

    Directory of Open Access Journals (Sweden)

    Rodrigo Gonçalves dos Santos

    2007-12-01

    Full Text Available Com este artigo pretende-se levantar os conceitos próprios da atividade da Arquitetura Paisagística encarando-a como disciplina projetual e associando-a ao Design Ambiental, necessitando, assim, de linhas metodológicas específicas para apresentação de soluções coerentes aos problemas paisagísticos. Sob esta ótica, reflexões sobre o uso da vegetação no projeto dos espaços exteriores são apresentadas apontando-se uma etapa de sistematização da análise do problema de projeto, dentro da abordagem da concepção de uma metodologia projetual em arquitetura paisagística. Também foram analisadas oito vias de circulação da área central de Florianópolis, Santa Catarina, Brasil, exemplificando uma etapa de sistematização da análise do problema de projeto.

  15. Avaliação da Sustentabilidade da Madeira por Meio da Ferramenta ISMAS

    Directory of Open Access Journals (Sweden)

    Márcia Bissoli-Dalvi

    2017-10-01

    Full Text Available RESUMO Esta pesquisa objetivou avaliar o índice de sustentabilidade da madeira usada na construção civil a partir dos critérios previamente estabelecidos na ferramenta ISMAS – Instrumento para Seleção de Materiais Mais Sustentáveis, cuja metodologia considera especificamente os aspectos relacionados à “economia de matérias-primas” e “geração e gestão de resíduos” nos procedimentos de avaliação. A ferramenta apresenta a seguinte escala de graduação para os possíveis resultados: muito baixo, baixo, médio, alto e elevado. A metodologia adotada para a obtenção dos resultados foi estabelecida a partir de testes com o instrumento, envolvendo arquitetos sediados no Estado do Espírito Santo, Brasil. O resultado demonstrou que a madeira obteve o índice “alto” de sustentabilidade, contrariando a hipótese inicial de que o material alcançaria o nível “elevado”. Esse resultado sugere o amadurecimento do conceito sustentável da madeira, que atualmente relaciona-se somente com o critério renovável. A avaliação pelo ISMAS demonstrou a necessidade do uso de outros critérios.

  16. A ferrovia e o desenho da cidade

    OpenAIRE

    Atilio Comin; Antonio Soukef Júnior

    2017-01-01

    A pesquisa pretende analisar a concepção do bairro da Água Branca a partir da introdução da ferrovia São Paulo Railway Company.  Esmiuçando o contexto da cidade de São Paulo no final do século XIX e início do século XX, época em que surge o bairro Água Branca. Com a presença dos trilhos e o forte crescimento da economia cafeeira, os imigrantes vieram para São Paulo em busca de empregos, dentre eles, se destacou Francisco Matarazzo, um jovem audacioso que teve um papel fundamental na compo...

  17. Da Vinci-assisted abdominal cerclage.

    Science.gov (United States)

    Barmat, Larry; Glaser, Gretchen; Davis, George; Craparo, Frank

    2007-11-01

    To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot. Case report. Tertiary-care hospital. A 39-year-old female with a history of cervical insufficiency who required a cerclage and was not a candidate for transvaginal cerclage placement. Abdominal cervicoisthmic cerclage placement using the da Vinci robot. Ability to safely and successfully place an abdominal cerclage using the da Vinci robot. Abdominal cerclage was successfully placed using the da Vinci robot. The patient had minimal blood loss and was discharged to home on the same day as surgery. Da Vinci robot-assisted abdominal cerclage placement is an innovative application of robotic surgery and may alter the standard of care for women who require this surgery.

  18. A Lei Maria da Penha sob a perspectiva da ética da vingança / Maria da Penha law unde the ethics of revenge approach

    OpenAIRE

    Nunes, Thaísa Silva de Oliveira; Faculdade de Direito de Vitória

    2011-01-01

    RESUMO: Analisa-se a lei 11.340/2006, conhecida como Lei Maria da Penha, sob a perspectiva da ética da vingança, considerando-se a situação de seu uso de forma equivocada. Nesse sentido, argui-se que o judiciário deve tomar um cuidado maior ao julgar casos de violência doméstica. Aborda-se também a possibilidade de uma mulher abandonada ou ultrajada pelo seu companheiro reagir de forma a resgatar a confiança em si, ao invés de se utilizar da prática da vingança permitida pelos mecanismos jurí...

  19. ARTIMANHAS DA HEGEMONIA: OBSTÁCULOS À RADICALIZAÇÃO DA DEMOCRACIA NO BRASIL

    Directory of Open Access Journals (Sweden)

    Frederico Alves Costa

    Full Text Available Resumo Este artigo apresenta como foco o debate sobre dificuldades na construção da luta política na contemporaneidade brasileira, mais especificamente nos últimos anos do governo do Presidente da República Luiz Inácio Lula da Silva. Objetiva-se, a partir do diálogo entre a Teoria Democrática Radical e Plural - desenvolvida por Ernesto Laclau e Chantal Mouffe - e posicionamentos de representantes de diferentes grupos de movimentos sociais brasileiros, discutir dois modos de resistência da hegemonia a alternativas de democratização da sociedade. Esses modos, concebidos como artimanhas da hegemonia, são denominados expansão hegemônica e expurgo à diferença. O debate contribui para a análise sobre estratégias políticas no campo da psicologia social.

  20. Endocardite acuta da Staphylococcus haemolyticus meticillino sensibile, con recidiva dopo trattamento da ceppo meticillino resistente

    Directory of Open Access Journals (Sweden)

    Giacomo Magnani

    2005-03-01

    Full Text Available Le endocarditi su valvole native (NVE da Stafilococchi coagulasi negativi (CoNS presentano un andamento aggressivo simile a quello da Staphylococcus aureus e sono difficili da trattare per l’alta incidenza da parte dei CoNS di resistenza a oxacillina.Viene riportato un caso di NVE da Staphylococcus haemolyticus meticillino sensibile, con risposta iniziale favorevole al trattamento con oxacillina, ma con successiva recidiva a distanza di tre mesi legata comparsa di ceppo oxacillino-resistente. L’ipotesi è che l’infezione sia stata sostenuta da una popolazione batterica con fenotipo eteroresistente, che in seguito al trattamento antibiotico ha sviluppato resistenza omogenea a oxacillina. Nell’impostare un trattamento per infezioni gravi da Stafilococchi sensibili in vitro ad oxacillina è necessario considerare sempre la presenza di un eteroresistenza.