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Sample records for left middle occipital

  1. Leptomeningeal angiomatosis of the left occipital surface detected by CT scan

    International Nuclear Information System (INIS)

    Niiro, Masaki; Mihara, Tadahiro; Maeda, Yoshiki; Awa, Hiroshi; Kadota, Koki; Asakura, Tetsuhiko

    1982-01-01

    A case of left occipital leptomeningeal angiomatosis was reported. The patient was a 12-year-old boy who had episodes of severe vascular type headache accompanied by transient right homonymous hemianopsia. CT scan showed localized superficial high density area in the left occipital pole. Remarkable enhancement of the lower and inner surface of the left occipital lobe was demonstrated. Angiography showed poor filling of the distal portion of the left posterior cerebral artery. Skull tomograms showed linear calcifications in the left occipital region. Brain scan showed increased RI uptake in the left occipital region. During operation, the surface of the left occipital lobe was covered by excessive, fine, vascular networks which extended over the arachnoid membrane. The abnormal vessels were cauterized by a CO 2 laser as throughly as possible. The occipital pole, felt gritty. Histologically, the abnormal vessels had spread into the subarachnoid space and were predominantly veins with thin and enlarged walls. The abnormal vessels followed the leptomeninges in the sulci of the cerebral cortex. Underneath the abnormal vessels, in the external layers of the cerebral cortex, calcium deposits were scattered and gliosis and degeneration of the ganglion cells were observed. The lesion was comparable with leptomeningeal angiomatosis. Though the pathological findings of the specimen, CT findings, and brain scan findings were extremely similar to those of Sturge-Weber disease, in this case, the typical clinical and roentgenographic findings of Sturge-Weber disease were all absent. (author)

  2. Inattention Predicts Increased Thickness of Left Occipital Cortex in Men with Attention-Deficit/Hyperactivity Disorder

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    Peter Sörös

    2017-09-01

    Full Text Available BackgroundAttention-deficit/hyperactivity disorder (ADHD in adulthood is a serious and frequent psychiatric disorder with the core symptoms inattention, impulsivity, and hyperactivity. The principal aim of this study was to investigate associations between brain morphology, i.e., cortical thickness and volumes of subcortical gray matter, and individual symptom severity in adult ADHD.MethodsSurface-based brain morphometry was performed in 35 women and 29 men with ADHD using FreeSurfer. Linear regressions were calculated between cortical thickness and the volumes of subcortical gray matter and the inattention, hyperactivity, and impulsivity subscales of the Conners Adult ADHD Rating Scales (CAARS. Two separate analyses were performed. For the first analysis, age was included as additional regressor. For the second analysis, both age and severity of depression were included as additional regressors. Study participants were recruited between June 2012 and January 2014.ResultsLinear regression identified an area in the left occipital cortex of men, covering parts of the middle occipital sulcus and gyrus, in which the score on the CAARS inattention subscale predicted increased mean cortical thickness [F(1,27 = 26.27, p < 0.001, adjusted R2 = 0.4744]. No significant associations were found between cortical thickness and the scores on CAARS subscales in women. No significant associations were found between the volumes of subcortical gray matter and the scores on CAARS subscales, neither in men nor in women. These results remained stable when severity of depression was included as additional regressor, together with age.ConclusionIncreased cortical thickness in the left occipital cortex may represent a mechanism to compensate for dysfunctional attentional networks in male adult ADHD patients.

  3. [Total dream loss secondary to left temporo-occipital brain injury].

    Science.gov (United States)

    Poza, J J; Martí Massó, J F

    2006-04-01

    Recently the case of a woman who reported cessation of dreaming after a bilateral PCA stroke but without REM sleep loss has been reported, suggesting that deep bilateral occipital lobe damage including the right inferior lingual gyrus may represent the "minimal lesion extension" necessary for dream loss. We report the case of a 24-year-old man who ceased dreaming after a unilateral left temporo- occipital hematoma. The polysomnographic characteristics in rapid eyes movements (REM) sleep were otherwise normal. Our patient demonstrates that a unilateral left temporo-occipital injury could be sufficient for losing dreams.

  4. Inattention Predicts Increased Thickness of Left Occipital Cortex in Men with Attention-Deficit/Hyperactivity Disorder.

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    Sörös, Peter; Bachmann, Katharina; Lam, Alexandra P; Kanat, Manuela; Hoxhaj, Eliza; Matthies, Swantje; Feige, Bernd; Müller, Helge H O; Thiel, Christiane; Philipsen, Alexandra

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) in adulthood is a serious and frequent psychiatric disorder with the core symptoms inattention, impulsivity, and hyperactivity. The principal aim of this study was to investigate associations between brain morphology, i.e., cortical thickness and volumes of subcortical gray matter, and individual symptom severity in adult ADHD. Surface-based brain morphometry was performed in 35 women and 29 men with ADHD using FreeSurfer. Linear regressions were calculated between cortical thickness and the volumes of subcortical gray matter and the inattention, hyperactivity, and impulsivity subscales of the Conners Adult ADHD Rating Scales (CAARS). Two separate analyses were performed. For the first analysis, age was included as additional regressor. For the second analysis, both age and severity of depression were included as additional regressors. Study participants were recruited between June 2012 and January 2014. Linear regression identified an area in the left occipital cortex of men, covering parts of the middle occipital sulcus and gyrus, in which the score on the CAARS inattention subscale predicted increased mean cortical thickness [ F (1,27) = 26.27, p  attentional networks in male adult ADHD patients.

  5. [A patient with prosopagnosia which developed after an infarction in the left occipital lobe in addition to an old infarction in the right occipital lobe].

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    Iwanaga, Keisuke; Satoh, Akira; Satoh, Hideyo; Seto, Makiko; Ochi, Makoto; Tsujihata, Mitsuhiro

    2011-05-01

    A 66-year-old, right-handed male, was admitted to our hospital with difficulty in recognizing faces and colors. He had suffered a stroke in the right occipital region three years earlier that had induced left homonymous hemianopsia, but not prosopagnosia. A neurological examination revealed prosopagnosia, color agnosia, constructional apraxia, and topographical disorientation, but not either hemineglect or dressing apraxia. The patient was unable to distinguish faces of familiar persons such as his family and friends, as well as those of unfamiliar persons such as doctors and nurses. Brain MRI demonstrated an old infarction in the right medial occipital lobe and a new hemorrhagic infarction in the left medial occipital lobe, including the fusiform and lingual gyrus. It is unclear whether a purely right medial occipital lesion can be responsible for prosopagnosia, or whether bilateral medial occipital lesions are necessary for this occurrence. The current case indicated that bilateral medial occipital lesions play an important role in inducing porsopagnosia.

  6. Cystic solitary fibrous tumor arising from the left occipital meninges: a case report

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    Oh, Bae Geun; Hwang, Yoon Joon; Cha, Soon Joo; Hur, Gham; Kim, Yong Hoon; Kim, Su Young; Seo, Jung Wook; Lee, Ji Young; Kim, Han Seung [Ilsan Paik Hospital, Inje University, School of Medicine, Goyang (Korea, Republic of)

    2007-02-15

    Solitary fibrous tumor (SFT) is a benign mesenchymal neoplasm of a spindle-cell origin, and it usually involves the pleura. It's occurrence in various organs of the body has recently been described. Meningeal SFT is very rare. Radiologically, it is a strongly enhancing solid mass and is undistinguishable from fibrous meningioma and hemangiopericytoma. Yet we report here on a case of SFT with massive cystic degeneration that arose from the meninges of the left occipital region.

  7. Dissociative Disturbance in Hangul-Hanja Reading after a Left Posterior Occipital Lesion

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    Key-Chung Park

    2008-01-01

    Full Text Available Since the Korean language has two distinct writing systems, phonogram (Hangul and ideogram (Hanja: Chinese characters, alexia can present with dissociative disturbances in reading between the two systems. A 74-year-old right-handed man presented with a prominent reading impairment in Hangul with agraphia of both Hangul and Hanja after a left posterior occipital- parietal lesion. He could not recognize single syllable words and nonwords in Hangul, and visual errors were predominant in both Hanja reading and the Korean Boston Naming Test. In addition, he had difficulties in visuoperceptual tests including Judgment of Line Orientation, Hierarchical Navon figures, and complex picture scanning. These findings are consistent with the hypothesis that Hangul reading impairment results from a general visual perceptual deficit. However, this assumption cannot explain why performance on visually complex Hanja was better than performance on visually simple Hanja in our patient. In addition, the patient did not demonstrate higher accuracy on Hanja characters with fewer strokes than on words with more strokes. Thus, we speculate that the left posterior occipital area may be specialized for Hangul letter identification in this patient. This case demonstrates that Hangul-Hanja reading dissociation impairment can occur after occipital-parietal lesions.

  8. The Visual Word Form Area remains in the dominant hemisphere for language in late-onset left occipital lobe epilepsies: A postsurgery analysis of two cases.

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    Lopes, Ricardo; Nunes, Rita Gouveia; Simões, Mário Rodrigues; Secca, Mário Forjaz; Leal, Alberto

    2015-05-01

    Automatic recognition of words from letter strings is a critical processing step in reading that is lateralized to the left-hemisphere middle fusiform gyrus in the so-called Visual Word Form Area (VWFA). Surgical lesions in this location can lead to irreversible alexia. Very early left hemispheric lesions can lead to transfer of the VWFA to the nondominant hemisphere, but it is currently unknown if this capability is preserved in epilepsies developing after reading acquisition. In this study, we aimed to determine the lateralization of the VWFA in late-onset left inferior occipital lobe epilepsies and also the effect of surgical disconnection from the adjacent secondary visual areas. Two patients with focal epilepsies with onset near the VWFA underwent to surgery for epilepsy, with sparing of this area. Neuropsychology evaluations were performed before and after surgery, as well as quantitative evaluation of the speed of word reading. Comparison of the surgical localization of the lesion, with the BOLD activation associated with the contrast of words-strings, was performed, as well as a study of the associated main white fiber pathways using diffusion-weighted imaging. Neither of the patients developed alexia after surgery (similar word reading speed before and after surgery) despite the fact that the inferior occipital surgical lesions reached the neighborhood (less than 1cm) of the VWFA. Surgeries partly disconnected the VWFA from left secondary visual areas, suggesting that pathways connecting to the posterior visual ventral stream were severely affected but did not induce alexia. The anterior and superior limits of the resection suggest that the critical connection between the VWFA and the Wernicke's Angular Gyrus cortex was not affected, which is supported by the detection of this tract with probabilistic tractography. Left occipital lobe epilepsies developing after reading acquisition did not produce atypical localizations of the VWFA, even with foci in the

  9. The cognitive profile of occipital lobe epilepsy and the selective association of left temporal lobe hypometabolism with verbal memory impairment.

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    Knopman, Alex A; Wong, Chong H; Stevenson, Richard J; Homewood, Judi; Mohamed, Armin; Somerville, Ernest; Eberl, Stefan; Wen, Lingfeng; Fulham, Michael; Bleasel, Andrew F

    2014-08-01

    We investigated the cognitive profile of structural occipital lobe epilepsy (OLE) and whether verbal memory impairment is selectively associated with left temporal lobe hypometabolism on [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Nine patients with OLE, ages 8-29 years, completed presurgical neuropsychological assessment. Composite measures were calculated for intelligence quotient (IQ), speed, attention, verbal memory, nonverbal memory, and executive functioning. In addition, the Wisconsin Card Sorting Test (WCST) was used as a specific measure of frontal lobe functioning. Presurgical FDG-PET was analyzed with statistical parametric mapping in 8 patients relative to 16 healthy volunteers. Mild impairments were evident for IQ, speed, attention, and executive functioning. Four patients demonstrated moderate or severe verbal memory impairment. Temporal lobe hypometabolism was found in seven of eight patients. Poorer verbal memory was associated with left temporal lobe hypometabolism (p = 0.002), which was stronger (p = 0.03 and p = 0.005, respectively) than the association of left temporal lobe hypometabolism with executive functioning or with performance on the WCST. OLE is associated with widespread cognitive comorbidity, suggesting cortical dysfunction beyond the occipital lobe. Verbal memory impairment is selectively associated with left temporal lobe hypometabolism in OLE, supporting a link between neuropsychological dysfunction and remote hypometabolism in focal epilepsy. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  10. Differential contribution of right and left temporo-occipital and anterior temporal lesions to face recognition disorders

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    Guido eGainotti

    2011-06-01

    Full Text Available In the study of prosopagnosia, several issues (such as the specific or non-specific manifestations of prosopagnosia, the unitary or non-unitary nature of this syndrome and the mechanisms underlying face recognition disorders are still controversial. Two main sources of variance partially accounting for these controversies could be the qualitative differences between the face recognition disorders observed in patients with prevalent lesions of the right or left hemisphere and in those with lesions encroaching upon the temporo-occipital or the (right anterior temporal cortex.Results of our review seem to confirm these suggestions. Indeed, they show that (a the most specific forms of prosopagnosia are due to lesions of a right posterior network including the OFA and the FFA, whereas (b the face identification defects observed in patients with left temporo-occipital lesions seem due to a semantic defect impeding access to person-specific semantic information from the visual modality. Furthermore, face recognition defects resulting from right anterior temporal lesions can usually be considered as part of a multimodal people recognition disorder.The implications of our review are, therefore, the following: (1 to consider the components of visual agnosia often observed in prosopagnosic patients with bilateral temporo-occipital lesions as part of a semantic defect, resulting from left-sided lesions (and not from prosopagnosia proper; (2 to systematically investigate voice recognition disorders in patients with right anterior temporal lesions to determine whether the face recognition defect should be considered a form of ‘associative prosopagnosia’ or a form of the ‘multimodal people recognition disorder’.

  11. Category-selective attention modulates unconscious processes in the middle occipital gyrus.

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    Tu, Shen; Qiu, Jiang; Martens, Ulla; Zhang, Qinglin

    2013-06-01

    Many studies have revealed the top-down modulation (spatial attention, attentional load, etc.) on unconscious processing. However, there is little research about how category-selective attention could modulate the unconscious processing. In the present study, using functional magnetic resonance imaging (fMRI), the results showed that category-selective attention modulated unconscious face/tool processing in the middle occipital gyrus (MOG). Interestingly, MOG effects were of opposed direction for face and tool processes. During unconscious face processing, activation in MOG decreased under the face-selective attention compared with tool-selective attention. This result was in line with the predictive coding theory. During unconscious tool processing, however, activation in MOG increased under the tool-selective attention compared with face-selective attention. The different effects might be ascribed to an interaction between top-down category-selective processes and bottom-up processes in the partial awareness level as proposed by Kouider, De Gardelle, Sackur, and Dupoux (2010). Specifically, we suppose an "excessive activation" hypothesis. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Hyperfamiliarity for unknown faces after left lateral temporo-occipital venous infarction: a double dissociation with prosopagnosia.

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    Vuilleumier, Patrik; Mohr, Christine; Valenza, Nathalie; Wetzel, Corinne; Landis, Theodor

    2003-04-01

    Right hemisphere dominance in face processing is well established and unilateral right inferior temporo-occipital damage can result in prosopagnosia. Here, we describe a 21-year-old right-handed woman with acute impairment in face recognition that selectively concerned unfamiliar faces, following a focal left lateral temporo-occipital venous infarct. She was severely impaired in discerning that unknown people seen in everyday life were unfamiliar, although she had no difficulty recognizing familiar people. Thus, she had no prosopagnosia, but abnormal 'hyperfamiliarity' for unknown faces. Her difficulty was not accompanied by delusions or deficits in discrimination, identification or memory for faces. Standard neuropsychological testing showed that her recognition of familiar faces was entirely normal. By contrast, her sense of personally knowing faces was severely impaired when unknown faces evoked weak signals of familiarity based on spurious cues, to the extent that she would misattribute fame to faces that were unknown but to which she had been incidentally exposed on a prior occasion. Priming experiments also revealed that, unlike normal subjects, she made familiarity judgements without accessing semantic identity representations. Moreover, in face recognition tests, she generally showed bias in that she relied more on right-hemisphere strategies to identify global traits and less on left-hemisphere processes compared with healthy subjects. This case provides novel evidence for a differential contribution of the two hemispheres to face recognition. Hyperfamiliarity for unknown faces might arise from an imbalance between reciprocal hemispheric functions in face recognition, with relative hypoactivation of left hemisphere processes but hyperactivation of right-hemisphere processes for retrieving stored associations about people, linking seen faces to representations of affective and personal relevance. Hence, abnormal bias in attributing some personal meaning to

  13. Subcomponents and connectivity of the inferior fronto-occipital fasciculus revealed by diffusion spectrum imaging fiber tracking

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    Yupeng Wu

    2016-09-01

    Full Text Available The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF are still controversial. In this study, we aimed to investigate the connectivity, asymmetry and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI analysis was performed on ten healthy adults and a 90-subject DSI template (NTU-90 Atlas. In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous standard definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient

  14. Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking.

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    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

    2016-01-01

    The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous "standard" definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity to

  15. Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking

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    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

    2016-01-01

    The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the fiber reconstructions. More widespread anterior-posterior connections than previous “standard” definition of the IFOF were found. This distinct pathway demonstrated a greater inter-subjects connective variability with a maximum of 40% overlap in its central part. The statistical results revealed no asymmetry between the left and right hemispheres and no significant differences existed in distributions of the IFOF according to sex. In addition, five subcomponents within the IFOF were identified according to the frontal areas of originations. As the subcomponents passed through the anterior floor of the external capsule, the fibers radiated to the posterior terminations. The most common connection patterns of the subcomponents were as follows: IFOF-I, from frontal polar cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-II, from orbito-frontal cortex to occipital pole, inferior occipital lobe, middle occipital lobe, superior occipital lobe, and pericalcarine; IFOF-III, from inferior frontal gyrus to inferior occipital lobe, middle occipital lobe, superior occipital lobe, occipital pole, and pericalcarine; IFOF-IV, from middle frontal gyrus to occipital pole, and inferior occipital lobe; IFOF-V, from superior frontal gyrus to occipital pole, inferior occipital lobe, and middle occipital lobe. Our work demonstrates the feasibility of high resolution diffusion tensor tractography with sufficient sensitivity

  16. Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

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    Son, Byung-chul; Choi, Jin-gyu

    2017-01-01

    Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although re...

  17. Focal epileptic seizures with secondary generalization in cortical atrophy and gliosis dysplasia in the left temporal lobe and hemimegalencephaly in the left occipital lobe

    International Nuclear Information System (INIS)

    Manchev, I.; Mancheva-Ganeva, V.; Manolova, T.; Manchev, L.

    2016-01-01

    It is a case of an eight-year-old patient with cortical dysplasia and gliosis in the left temporal lobe clinically manifested with focal epileptic seizures with secondary generalization. Signs of mental retardation and a number of somatic complications - diabetes, etc., were found. The complex therapy with anticonvulsant medications, immunovenin, plasmaphoresis and anti-diabetic drugs was partially effective

  18. Origin of human motor readiness field linked to left middle frontal gyrus by MEG and PET

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    Pedersen, Jane Rygaard; Johannsen, P; Bak, Christen Kjeldahl

    1998-01-01

    Combined magnetoencephalography and positron emission tomography identified a prior source of activity in the left middle frontal gyrus duping uncued movements of the right index finger Voluntary movements gave rise to a change in the cortical electrical potential known as the Bereitschaftspotent......Combined magnetoencephalography and positron emission tomography identified a prior source of activity in the left middle frontal gyrus duping uncued movements of the right index finger Voluntary movements gave rise to a change in the cortical electrical potential known...... sources subsequently to be active were mapped to the supplementary motor area, premotor cortex, and motor cortex (M1), all in the left hemisphere. (C) 1998 Academic Press....

  19. BOLD Response to Motion Verbs in Left Posterior Middle Temporal Gyrus during Story Comprehension

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    Wallentin, Mikkel; Nielsen, Andreas Hojlund; Vuust, Peter; Dohn, Anders; Roepstorff, Andreas; Lund, Torben Ellegaard

    2011-01-01

    A primary focus within neuroimaging research on language comprehension is on the distribution of semantic knowledge in the brain. Studies have shown that the left posterior middle temporal gyrus (LPMT), a region just anterior to area MT/V5, is important for the processing of complex action knowledge. It has also been found that motion verbs cause…

  20. Multiple-slice spiral CT evaluation of occipital condyle fractures

    International Nuclear Information System (INIS)

    Wang Xifu; Zhang Guixiang; Li Kang'an; Zhao Jinglong; Wang Han; Feng Yan; Zheng Linfeng

    2011-01-01

    Objective: To explore the MSCT findings of occipital condyle fracture (OCF) and improve its diagnostic accuracy. Methods: Nineteen patients with OCF, selected from 110 patients suffering high energy injuries at the craniocervical junction, were enrolled into the study. The MSCT appearances of OCFs were retrospectively analyzed by two experienced radiologists. OCF had four types: type Ⅰ was a comminuted fracture, type Ⅱ was a extension of basilar skull fracture, type Ⅲ was an avulsion fracture at the attachment site of alar ligament on occipital condyle, type Ⅳ was a fracture of mixed pattern consisting of two or more above fracture types. Results: In 19 patients, the left, right and bilateral OCFs were seen in 7, 11 cases, and 1 case, respectively. Type Ⅰ was found in one case, which was a comminution of the left occipital condyle. Type Ⅱ was found in 5 cases, which involved the middle and posterior parts of occipital condyles with 2 on the left and 3 on the right, Type Ⅲ was found in 12 cases which showed various degree of fragment displacement with 3 occurring on the left, 8 on the right, 1 involving bilateral sides, 6 involving articular surfaces and 7 accompanying by enlargement of alar ligaments. Type Ⅳ was found in one case, with coexistence of Type Ⅱ and type Ⅲ In addition, OCFs were accompanied by head and (or) cervical spine injuries in 14 cases, which included cranial fracture in 8 cases, epidural hematoma in 4 cases, subarachnoid hemorrhage in one case, cerebral contusion and laceration in one case, subfalcial hernia in one case, cervical spine fracture and dislocation in 9 cases, and so on. Conclusion: OCFs can be accurately diagnosed by MSCT, which is important for selection of treatment protocols. (authors)

  1. The left middle temporal gyrus in the middle of an impaired social-affective communication network in social anxiety disorder.

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    Yun, Je-Yeon; Kim, Jae-Chang; Ku, Jeonghun; Shin, Jung-Eun; Kim, Jae-Jin; Choi, Soo-Hee

    2017-05-01

    Previous studies on patients diagnosed with social anxiety disorder (SAD) reported changed patterns of the resting-state functional connectivity network (rs-FCN) between the prefrontal cortices and other prefrontal, amygdalar or striatal regions. Using a graph theory approach, this study explored the modularity-based community profile and patterns of inter-/intra-modular communication for the rs-FCN in SAD. In total, for 28 SAD patients and 27 healthy controls (HC), functional magnetic resonance imaging (fMRI) data were acquired in resting-state and subjected to a graph theory analysis. The within-module degree z-score for a hub region [out of a total of 10 hub regions ranked using the participation coefficient] named left middle temporal gyrus was impaired in SAD compared to HC, proportional to the severity of clinician-scored and patient-reported functional impairment in SAD. Most of participants included in this study were undergraduate students in their early-to-mid 20's. This study showed the importance of functional communication from the left middle temporal gyrus with other opercular-insular-subcortical regions for better objective functioning and lesser subjective disability in SAD. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Occipital neuralgia: anatomic considerations.

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    Cesmebasi, Alper; Muhleman, Mitchel A; Hulsberg, Paul; Gielecki, Jerzy; Matusz, Petru; Tubbs, R Shane; Loukas, Marios

    2015-01-01

    Occipital neuralgia is a debilitating disorder first described in 1821 as recurrent headaches localized in the occipital region. Other symptoms that have been associated with this condition include paroxysmal burning and aching pain in the distribution of the greater, lesser, or third occipital nerves. Several etiologies have been identified in the cause of occipital neuralgia and include, but are not limited to, trauma, fibrositis, myositis, fracture of the atlas, and compression of the C-2 nerve root, C1-2 arthrosis syndrome, atlantoaxial lateral mass osteoarthritis, hypertrophic cervical pachymeningitis, cervical cord tumor, Chiari malformation, and neurosyphilis. The management of occipital neuralgia can include conservative approaches and/or surgical interventions. Occipital neuralgia is a multifactorial problem where multiple anatomic areas/structures may be involved with this pathology. A review of these etiologies may provide guidance in better understanding occipital neuralgia. © 2014 Wiley Periodicals, Inc.

  3. Spontaneous neural activity in the right superior temporal gyrus and left middle temporal gyrus is associated with insight level in obsessive-compulsive disorder.

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    Fan, Jie; Zhong, Mingtian; Gan, Jun; Liu, Wanting; Niu, Chaoyang; Liao, Haiyan; Zhang, Hongchun; Tan, Changlian; Yi, Jinyao; Zhu, Xiongzhao

    2017-01-01

    Insight into illness is an important issue for psychiatry disorder. Although the existence of a poor insight subtype of obsessive-compulsive disorder (OCD) was recognized in the DSM-IV, and the insight level in OCD was specified further in DSM-V, the neural underpinnings of insight in OCD have been rarely explored. The present study was designed to bridge this research gap by using resting-state functional magnetic resonance imaging (fMRI). Spontaneous neural activity were examined in 19 OCD patients with good insight (OCD-GI), 18 OCD patients with poor insight (OCD-PI), and 25 healthy controls (HC) by analyzing the amplitude of low-frequency fluctuation (ALFF) in the resting state. Pearson correlation analysis was performed between regional ALFFs and insight levels among OCD patients. OCD-GI and OCD-PI demonstrated overlapping and distinct brain alterations. Notably, compared with OCD-GI, tOCD-PI had reduced ALFF in left middle temporal gyrus (MTG) and right superior temporal gyrus (STG), as well as increased ALFF in right middle occipital gyrus. Further analysis revealed that ALFF values for the left MTG and right STG were correlated negatively with insight level in patients with OCD. Relatively small sample size and not all patients were un-medicated are our major limitations. Spontaneous brain activity in left MTG and right STG may be neural underpinnings of insight in OCD. Our results suggest the great role of human temporal brain regions in understanding insight, and further underscore the importance of considering insight presentation in understanding the clinical heterogeneity of OCD. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Mirror focus in a patient with intractable occipital lobe epilepsy.

    Science.gov (United States)

    Kim, Jiyoung; Shin, Hae Kyung; Hwang, Kyoung Jin; Choi, Su Jung; Joo, Eun Yeon; Hong, Seung Bong; Hong, Seung Chul; Seo, Dae-Won

    2014-06-01

    Mirror focus is one of the evidence of progression in epilepsy, and also has practical points for curative resective epilepsy surgery. The mirror foci are related to the kindling phenomena that occur through interhemispheric callosal or commissural connections. A mirror focus means the secondary epileptogenic foci develop in the contralateral hemispheric homotopic area. Thus mirror foci are mostly reported in patients with temporal or frontal lobe epilepsy, but not in occipital lobe epilepsy. We have observed occipital lobe epilepsy with mirror focus. Before epilepsy surgery, the subject's seizure onset zone was observed in the left occipital area by ictal studies. Her seizures abated for 10 months after the resection of left occipital epileptogenic focus, but recurred then. The recurred seizures were originated from the right occipital area which was in the homotopic contralateral area. This case can be an evidence that occipital lobe epilepsy may have mirror foci, even though each occipital lobe has any direct interhemispheric callosal connections between them.

  5. Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve.

    Science.gov (United States)

    Son, Byung-Chul; Choi, Jin-Gyu

    2017-01-01

    Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although referral of pain from the stimulation of occipital and cervical structures innervated by upper cervical nerves to the frontal head of V1 trigeminal distribution has been reported, the development of hemifacial sensory change associated with referred trigeminal pain from chronic occipital neuralgia is extremely rare. Chronic continuous and strong afferent input of occipital neuralgia caused by pathological vascular contact with the greater occipital nerve seemed to be associated with sensitization and hypersensitivity of the second-order neurons in the trigeminocervical complex, a population of neurons in the C2 dorsal horn characterized by receiving convergent input from dural and cervical structures.

  6. Occipital bending in schizophrenia.

    Science.gov (United States)

    Maller, Jerome J; Anderson, Rodney J; Thomson, Richard H; Daskalakis, Zafiris J; Rosenfeld, Jeffrey V; Fitzgerald, Paul B

    2017-01-01

    To investigate the prevalence of occipital bending (an occipital lobe crossing or twisting across the midline) in subjects with schizophrenia and matched healthy controls. Occipital bending prevalence was investigated in 37 patients with schizophrenia and 44 healthy controls. Ratings showed that prevalence was nearly three times higher among schizophrenia patients (13/37 [35.1%]) than in control subjects (6/44 [13.6%]). Furthermore, those with schizophrenia had greater normalized gray matter volume but less white matter volume and had larger brain-to-cranial ratio. The results suggest that occipital bending is more prevalent among schizophrenia patients than healthy subjects and that schizophrenia patients have different gray matter-white matter proportions. Although the cause and clinical ramifications of occipital bending are unclear, the results infer that occipital bending may be a marker of psychiatric illness.

  7. OCCIPITAL LOBE SYNDROME

    OpenAIRE

    Shahdevi Nandar Kurniawan

    2016-01-01

    The ability to recognize objects and words is not just depend on the integrity of visual pathway and primary vision area on cerebral cortex (Brodmann area 17), but also secondary vision area 18 and tertiary vision area 19 on occipital lobe. Lesion in occipital lobe could disturb of human visual function such as visual field defects, inability to recognize colors, inability to recognize words, visual hallucinations and illusions, occipital lobe epilepsy, and Anton’s syndrome. Some causes of oc...

  8. Occipital bending (Yakovlevian torque) in bipolar depression.

    Science.gov (United States)

    Maller, Jerome J; Anderson, Rodney; Thomson, Richard H; Rosenfeld, Jeffrey V; Daskalakis, Zafiris J; Fitzgerald, Paul B

    2015-01-30

    Differing levels of occipital lobe asymmetry and enlarged lateral ventricles have been reported within patients with bipolar disorder (BD) compared with healthy controls, suggesting different rates of occipital bending (OB). This may exert pressure on subcortical structures, such as the hippocampus, reduced among psychiatric patients. We investigated OB prevalence in 35 patients with BD and 36 healthy controls, and ventricular and occipital volumes. Prevalence was four times higher among BD patients (12/35 [34.3%]) than in control subjects (3/36 [8.3%]), as well as larger lateral ventricular volumes (LVVs). Furthermore, we found OB to relate to left-to-right ventricular and occipital lobe volume (OLV) ratios. Those with OB also had reduced left-to-right hippocampal volume ratios. The results suggest that OB is more common among BD patients than healthy subjects, and prevalent in both BD Type I and Type II patients. We posit that anomalies in neural pruning or ventricular enlargement may precipitate OB, consequently resulting in one occipital lobe twisting around the other. Although the clinical implications of these results are unclear, the study suggests that asymmetrical ventricular volume matched with a pattern of oppositely asymmetrical occipital volume is related to OB and may be a marker of psychiatric illness. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Giant high occipital encephalocele

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2016-03-01

    Full Text Available Encephaloceles are rare embryological mesenchymal developmental anomalies resulting from inappropriate ossification in skull through with herniation of intracranial contents of the sac. Encephaloceles are classified based on location of the osseous defect and contents of sac. Convexity encephalocele with osseous defect in occipital bone is called occipital encephalocele. Giant occipital encephaloceles can be sometimes larger than the size of baby skull itself and they pose a great surgical challenge. Occipital encephaloceles (OE are further classified as high OE when defect is only in occipital bone above the foramen magnum, low OE when involving occipital bone and foramen magnum and occipito-cervical when there involvement of occipital bone, foramen magnum and posterior upper neural arches. Chiari III malformation can be associated with high or low occipital encephaloceles. Pre-operatively, it is essential to know the size of the sac, contents of the sac, relation to the adjacent structures, presence or absence of venous sinuses/vascular structures and osseous defect size. Sometimes it becomes imperative to perform both CT and MRI for the necessary information. Volume rendered CT images can depict the relation of osseous defect to foramen magnum and provide information about upper neural arches which is necessary in classifying these lesions.

  10. Occipital bending in depression.

    Science.gov (United States)

    Maller, Jerome J; Thomson, Richard H S; Rosenfeld, Jeffrey V; Anderson, Rodney; Daskalakis, Zafiris J; Fitzgerald, Paul B

    2014-06-01

    There are reports of differences in occipital lobe asymmetry within psychiatric populations when compared with healthy control subjects. Anecdotal evidence and enlarged lateral ventricles suggests that there may also be a different pattern of curvature whereby one occipital lobe wraps around the other, termed 'occipital bending'. We investigated the prevalence of occipital bending in 51 patients with major depressive disorder (males mean age = 41.96 ± 14.00 years, females mean age = 40.71 ± 12.41 years) and 48 age- and sex-matched healthy control subjects (males mean age = 40.29 ± 10.23 years, females mean age = 42.47 ± 14.25 years) and found the prevalence to be three times higher among patients with major depressive disorder (18/51, 35.3%) when compared with control subjects (6/48, 12.5%). The results suggest that occipital bending is more common among patients with major depressive disorder than healthy subjects, and that occipital asymmetry and occipital bending are separate phenomena. Incomplete neural pruning may lead to the cranial space available for brain growth being restricted, or ventricular enlargement may exacerbate the natural occipital curvature patterns, subsequently causing the brain to become squashed and forced to 'wrap' around the other occipital lobe. Although the clinical implications of these results are unclear, they provide an impetus for further research into the relevance of occipital bending in major depression disorder. © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. BOLD response to motion verbs in left posterior middle temporal gyrus during story comprehension

    DEFF Research Database (Denmark)

    Wallentin, Mikkel; Nielsen, Andreas Højlund; Vuust, Peter

    2011-01-01

    A primary focus within neuroimaging research on language comprehension is on the distribution of semantic knowledge in the brain. Studies have shown that the left posterior middle temporal gyrus (LPMT), a region just anterior to area MT/V5, is important for the processing of complex action...... knowledge. It has also been found that motion verbs cause activation in LPMT. In this experiment we investigated whether this effect could be replicated in a setting resembling real life language comprehension, i.e. without any overt behavioral task during passive listening to a story. During f......, clauses containing motion verbs were accompanied by a robust activation of LPMT with no other significant effects, consistent with the hypothesis that this brain region is important for processing motion knowledge, even during naturalistic language comprehension conditions....

  12. Occipital lobe infarction and positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Koichi; Nagata, Ken; Shishido, Fumio (Research Inst. of Brain and Blood Vessels, Akita (Japan))

    1990-08-01

    Even though the PET study revealed a total infarct in the territory of the left PCA in our 3 cases of pure alesia, it is still obscure which part of the left occipital lobe is most closely associated with the occurrence of the pure alexia. In order to elucidate the intralobar localization of the pure alexia, it is needed to have an ideal case who shows an pure alexia due to the localized lesion within the left occipital lobe. Furthermore, high-resolution PET scanner will circumvent the problem in detecting the metabolism and blood flow in the corpus callosum which plays an important role in the pathogenesis. We have shown that the occlusion of the right PCA also produced a left unilateral agnosia which is one of the common neurological signs in the right MCA infarction. To tell whether the responsible lesion for the unilateral spatial agnosia differs between the PCA occlusion and the MCA occlusion, the correlation study should be carried out in a greater number of the subjects. Two distinctive neuropsychological manifestations, cerebral color blidness and prosopagnosia, have been considered to be produced by the bilateral occipital lesion. The PET studies disclosed reduction of blood flow and oxygen metabolism in both occipital lobes in our particular patient who exibited cerebral color blindness and posopagnosia. (author).

  13. Occipital lobe infarction and positron emission tomography

    International Nuclear Information System (INIS)

    Tagawa, Koichi; Nagata, Ken; Shishido, Fumio

    1990-01-01

    Even though the PET study revealed a total infarct in the territory of the left PCA in our 3 cases of pure alesia, it is still obscure which part of the left occipital lobe is most closely associated with the occurrence of the pure alexia. In order to elucidate the intralobar localization of the pure alexia, it is needed to have an ideal case who shows an pure alexia due to the localized lesion within the left occipital lobe. Furthermore, high-resolution PET scanner will circumvent the problem in detecting the metabolism and blood flow in the corpus callosum which plays an important role in the pathogenesis. We have shown that the occlusion of the right PCA also produced a left unilateral agnosia which is one of the common neurological signs in the right MCA infarction. To tell whether the responsible lesion for the unilateral spatial agnosia differs between the PCA occlusion and the MCA occlusion, the correlation study should be carried out in a greater number of the subjects. Two distinctive neuropsychological manifestations, cerebral color blidness and prosopagnosia, have been considered to be produced by the bilateral occipital lesion. The PET studies disclosed reduction of blood flow and oxygen metabolism in both occipital lobes in our particular patient who exibited cerebral color blindness and posopagnosia. (author)

  14. Rudhe syndrome: reversible right middle lobe emphysema in infants with left-to-right shunts - an historical review

    International Nuclear Information System (INIS)

    Collins, Lee K.; Levin, Terry L.; Berdon, Walter E.; Cowles, Robert A.; Newman, Beverley

    2010-01-01

    In 1971, the Swedish radiologist Ulf Rudhe wrote a provocative paper on right middle lobe emphysema in infants with left-to-right shunts in which he suggested cardiac surgery rather than lung resection. At the time, this was counter to accepted medical practice. Earlier diagnosis and better medical management of ventricular septal defect in infants has proved Rudhe correct. However, two current cases of large left-to-right shunts in infants with emphysema of the right middle lobe prompt this historical review of what seemed a closed-episode in pediatric cardiac surgery. (orig.)

  15. Brain Herniation in Neurofibromatosis with Dysplasia of Occipital Bone and Posterior Skull Base

    Directory of Open Access Journals (Sweden)

    Vithal Rangarajan

    2015-01-01

    Full Text Available A 22-year-old female, a known case of neurofibromatosis 1 (NF1, presented with a congenital swelling in the left occipital region. She had developed recent onset dysphagia and localized occipital headache. Neuroradiology revealed a left occipital meningoencephalocele and a left parapharyngeal meningocele. This was associated with ventriculomegaly. She was advised on cranioplasty along with duraplasty which she denied. She agreed to a lumbar-peritoneal shunt. She described a dramatic improvement in her symptoms following the lumbar-peritoneal shunt. Occipital dysplasias, though uncommon, have been reported in the literature. We review this case and its management and discuss relevant literature on occipital dysplasias in NF1.

  16. Auditory middle latency responses differ in right- and left-handed subjects: an evaluation through topographic brain mapping.

    Science.gov (United States)

    Mohebbi, Mehrnaz; Mahmoudian, Saeid; Alborzi, Marzieh Sharifian; Najafi-Koopaie, Mojtaba; Farahani, Ehsan Darestani; Farhadi, Mohammad

    2014-09-01

    To investigate the association of handedness with auditory middle latency responses (AMLRs) using topographic brain mapping by comparing amplitudes and latencies in frontocentral and hemispheric regions of interest (ROIs). The study included 44 healthy subjects with normal hearing (22 left handed and 22 right handed). AMLRs were recorded from 29 scalp electrodes in response to binaural 4-kHz tone bursts. Frontocentral ROI comparisons revealed that Pa and Pb amplitudes were significantly larger in the left-handed than the right-handed group. Topographic brain maps showed different distributions in AMLR components between the two groups. In hemispheric comparisons, Pa amplitude differed significantly across groups. A left-hemisphere emphasis of Pa was found in the right-handed group but not in the left-handed group. This study provides evidence that handedness is associated with AMLR components in frontocentral and hemispheric ROI. Handedness should be considered an essential factor in the clinical or experimental use of AMLRs.

  17. Absence of Middle Hepatic Vein Combined with Retro-Aortic Left Renal Vein: a Very Rare Case Report

    Directory of Open Access Journals (Sweden)

    Sezer Akçer

    2012-06-01

    Full Text Available The hepatic and renal veins drain into the inferior vena cava. The upper group of hepatic veins consists of three veins which extend to the posterior face of the liver to join the inferior cava. The left renal vein passes anterior to the aorta just below the origin of the superior mesenteric artery. We detected a variation in the hepatic and renal veins in a multislice CT angiogram of a nine-year-old male patient in the Radiology Department of Afyon Kocatepe University Medical School. The upper group hepatic veins normally drains into the inferior vena cava as three separate trunks, namely the right, left and middle. In our case, we found that only the right and left hepatic veins existed and the middle hepatic vein was absent. Furthermore, the left renal vein, which normally passes anterior to the abdominal aorta, was retro-aortic. Left renal vein variations are of great importance in planning retroperitoneal surgery and vascular interventions. Knowledge of a patient’s hepatic vein and renovascular anatomy and determining their variations and anomalies are of critical importance to abdominal operations, transplantations and preoperative evaluation of endovascular interventions.

  18. Occipital bone lacunae

    International Nuclear Information System (INIS)

    Pavlica, P.; Sciascia, R.

    1988-01-01

    Sixteen patients with lacunar alterations of the squamous occipital bone were studied in various radiographic projections; in many cases studies were also performed. In 7 cases lacunae in the cerebral fossa were observed, with an average diameter of 3 cm. These defects were due to a thinning of the inner table of the theca. In 9 cases smaller lacunae were demonstrated bilaterally, which were more radiolucent, isolated or confluent, located in the area corresponding to the internal occipital protuberance at the ridges of cruciform eminence. The latter were representative of diploic venous lakes, as the best demonstrated in lateral projection. This kind of lacunae are considered as anatomic variants, because no bone destruction is demonstrable, as confirmed by technetium scintigraphy

  19. Auditory verbal hallucinations are related to cortical thinning in the left middle temporal gyrus of patients with schizophrenia.

    Science.gov (United States)

    Cui, Y; Liu, B; Song, M; Lipnicki, D M; Li, J; Xie, S; Chen, Y; Li, P; Lu, L; Lv, L; Wang, H; Yan, H; Yan, J; Zhang, H; Zhang, D; Jiang, T

    2018-01-01

    Auditory verbal hallucinations (AVHs) are one of the most common and severe symptoms of schizophrenia, but the neuroanatomical abnormalities underlying AVHs are not well understood. The present study aims to investigate whether AVHs are associated with cortical thinning. Participants were schizophrenia patients from four centers across China, 115 with AVHs and 93 without AVHs, as well as 261 healthy controls. All received 3 T T1-weighted brain scans, and whole brain vertex-wise cortical thickness was compared across groups. Correlations between AVH severity and cortical thickness were also determined. The left middle part of the middle temporal gyrus (MTG) was significantly thinner in schizophrenia patients with AVHs than in patients without AVHs and healthy controls. Inferences were made using a false discovery rate approach with a threshold at p < 0.05. Left MTG thickness did not differ between patients without AVHs and controls. These results were replicated by a meta-analysis showing them to be consistent across the four centers. Cortical thickness of the left MTG was also found to be inversely correlated with hallucination severity across all schizophrenia patients. The results of this multi-center study suggest that an abnormally thin left MTG could be involved in the pathogenesis of AVHs in schizophrenia.

  20. Occipital lobe seizures and epilepsies.

    Science.gov (United States)

    Adcock, Jane E; Panayiotopoulos, Chrysostomos P

    2012-10-01

    Occipital lobe epilepsies (OLEs) manifest with occipital seizures from an epileptic focus within the occipital lobes. Ictal clinical symptoms are mainly visual and oculomotor. Elementary visual hallucinations are common and characteristic. Postictal headache occurs in more than half of patients (epilepsy-migraine sequence). Electroencephalography (EEG) is of significant diagnostic value, but certain limitations should be recognized. Occipital spikes and/or occipital paroxysms either spontaneous or photically induced are the main interictal EEG abnormalities in idiopathic OLE. However, occipital epileptiform abnormalities may also occur without clinical relationship to seizures particularly in children. In cryptogenic/symptomatic OLE, unilateral posterior EEG slowing is more common than occipital spikes. In neurosurgical series of symptomatic OLE, interictal EEG abnormalities are rarely strictly occipital. The most common localization is in the posterior temporal regions and less than one-fifth show occipital spikes. In photosensitive OLE, intermittent photic stimulation elicits (1) spikes/polyspikes confined in the occipital regions or (2) generalized spikes/polyspikes with posterior emphasis. In ictal EEG, a well-localized unifocal rhythmic ictal discharge during occipital seizures is infrequent. A bioccipital field spread to the temporal regions is common. Frequency, severity, and response to treatment vary considerably from good to intractable and progressive mainly depending on underlying causes.

  1. Intramuscular Lipoma-Induced Occipital Neuralgia on the Lesser Occipital Nerve.

    Science.gov (United States)

    Han, Hyun Ho; Kim, Hak Soo; Rhie, Jong Won; Moon, Suk Ho

    2016-06-01

    Occipital neuralgia (ON) is commonly characterized by a neuralgiform headache accompanied by a paroxysmal burning sensation in the dermatome area of the greater, lesser, or third occipital nerve. The authors report a rare case of ON caused by an intramuscular lipoma originating from the lesser occipital nerve.A 52-year-old man presented with sharp pain in the left postauricular area with a 3 × 2-cm palpable mass. Computed tomography revealed a mass suspiciously resembling an intramuscular lipoma within splenius muscle. In the operation field, a protruding mass causing stretching of the lesser occipital nerve was found. After complete resection, the neuralgiform headache symptom had resolved and the intramuscular lipoma was confirmed through histopathology.Previous studies on the causes of ON have reported that variation in normal anatomic structures results in nerve compression. Occipital neuralgia, however, caused by intramuscular lipomas in splenius muscles have not been previously reported, and the dramatic resolution following surgery makes it an interesting case worth reporting.

  2. Solitary Langerhans cell histiocytosis of the occipital condyle: a case report and review of the literature.

    Science.gov (United States)

    Teranishi, Yu; Shin, Masahiro; Yoshino, Masanori; Saito, Nobuhito

    2016-02-01

    Despite the recent advent of various radiographic imaging techniques, it is still very difficult to correctly distinguish a pediatric osteolytic lesion in the occipital condyle, which makes it further complicated to decide on the necessity of and the adequate timing for radical resection and craniocervical fusions. To establish a legitimate therapeutic strategy for this deep-seated lesion, surgical biopsy is a reasonable choice for first-line intervention. The choice of surgical approach becomes very important because a sufficient amount of histological specimen must be obtained to confirm the diagnosis but, ideally, the residual bony structures and the muscular structures should be preserved so as not to increase craniocervical instability. In this report, we present our experience with a case of solitary Langerhans cell histiocytosis (LCH) involving the occipital condyle that was successfully treated with minimally invasive surgical biopsy with a far lateral condylar approach supported by preoperative 3D computer graphic simulation. An 8-year-old girl presented with neck pain. Magnetic resonance imaging and computed tomography (CT) revealed an osteolytic lesion of the left occipital condyle. At surgery, the patient was placed in the prone position. A 3-cm skin incision was made in the posterior auricular region, and the sternocleidomastoid and splenius capitis muscles were dissected in the middle of the muscle bundle along the direction of the muscle fiber. Under a navigation system, we approached the occipital condyle through the space between the longissimus capitis muscle and the posterior belly of the digastric muscle and lateral to the superior oblique muscle, verifying each muscle at each depth of the surgical field and, finally, obtained sufficient surgical specimen. After the biopsy, her craniocervical instability had not worsened, and chemotherapy was performed. Twelve weeks after chemotherapy, her neck pain had gradually disappeared along with her

  3. Pure agraphia after infarction in the superior and middle portions of the left precentral gyrus: Dissociation between Kanji and Kana.

    Science.gov (United States)

    Kurosaki, Yoshiko; Hashimoto, Ryusaku; Tatsumi, Hiroshi; Hadano, Kazuo

    2016-04-01

    The present study describes a Japanese patient with pure agraphia displaying differential disturbances in processing Kanji (morphogram) and Kana (syllabogram) letters after an infarction in the middle and superior portions of the left precentral gyrus. Kana errors reflected the patient's difficulty with retrieving both motor and visual letter images, whereas Kanji errors included partial letter stroke omissions or additions. This present case suggests that differences in writing disturbances between Kana and Kanji letters are caused by a differential dependency on letter motor images. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Correlations between measures of executive attention and cortical thickness of left posterior middle frontal gyrus - a dichotic listening study

    Directory of Open Access Journals (Sweden)

    Lundervold Arvid

    2009-10-01

    Full Text Available Abstract Background The frontal lobe has been associated to a wide range of cognitive control functions and is also vulnerable to degeneration in old age. A recent study by Thomsen and colleagues showed a difference between a young and old sample in grey matter density and activation in the left middle frontal cortex (MFC and performance on a dichotic listening task. The present study investigated this brain behaviour association within a sample of healthy older individuals, and predicted a positive correlation between performance in a condition requiring executive attention and measures of grey matter structure of the posterior left MFC. Methods A dichotic listening forced attention paradigm was used to measure attention control functions. Subjects were instructed to report only the left or the right ear syllable of a dichotically presented consonant-vowel syllable pair. A conflict situation appears when subjects are instructed to report the left ear stimulus, caused by the conflict with the bottom-up, stimulus-driven right ear advantage. Overcoming this processing conflict was used as a measure of executive attention. Thickness and volumes of frontal lobe regions were derived from automated segmentation of 3D magnetic resonance image acquisitions. Results The results revealed a statistically significant positive correlation between the thickness measure of the left posterior MFC and performance on the dichotic listening measures of executive attention. Follow-up analyses showed that this correlation was only statistically significant in the subgroup that showed the typical bottom-up, stimulus-driven right ear advantage. Conclusion The results suggest that the left MFC is a part of an executive attention network, and that the dichotic listening forced attention paradigm may be a feasible tool for assessing subtle attentional dysfunctions in older adults.

  5. Hostile Attribution Bias Mediates the Relationship Between Structural Variations in the Left Middle Frontal Gyrus and Trait Angry Rumination

    Directory of Open Access Journals (Sweden)

    Yueyue Wang

    2018-04-01

    Full Text Available Angry rumination is a common mental phenomenon which may lead to negative social behaviors such as aggression. Although numerous neuroimaging studies have focused on brain area activation during angry rumination, to our knowledge no study has examined the neuroanatomical and cognitive mechanisms of this process. In this study, we conducted a voxel-based morphometry analysis, using a region of interest analysis to identify the structural and cognitive mechanisms underlying individual differences in trait angry rumination (as measured by the Angry Rumination Scale in a sample of 82 undergraduate students. We found that angry rumination was positively correlated with gray matter density in the left middle frontal gyrus (left-MFG, which is implicated in inhibition control, working memory, and emotional regulation. The mediation analysis further revealed that hostile attribution bias (as measured by the Social Information Processing–Attribution Bias Questionnaire acted as a cognitive mechanism underlying the positive association between the left-MFG gray matter density and trait angry rumination. These findings suggest that hostile attribution bias may contribute to trait angry rumination, while the left-MFG may play an important role in the development of hostile attribution bias and trait angry rumination. The study reveals the brain mechanisms of trait angry rumination and plays a role in revealing the cognitive mechanisms of the development of trait angry rumination.

  6. The regional neuronal activity in left posterior middle temporal gyrus is correlated with the severity of chronic aphasia.

    Science.gov (United States)

    Li, Jianlin; Du, Dunren; Gao, Wei; Sun, Xichun; Xie, Haizhu; Zhang, Gang; Li, Jian; Li, Honglun; Li, Kefeng

    2017-01-01

    Aphasia is one of the most disabling cognitive deficits affecting >2 million people in the USA. The neuroimaging characteristics of chronic aphasic patients (>6 months post onset) remain largely unknown. The objective of this study was to investigate the regional signal changes of spontaneous neuronal activity of brain and the inter-regional connectivity in chronic aphasia. Resting-state blood oxygenation level-dependent functional magnetic resonance imaging (fMRI) was used to obtain fMRI data from 17 chronic aphasic patients and 20 healthy control subjects in a Siemens Verio 3.0T MR Scanner. The amplitude of low-frequency fluctuation (ALFF) was determined, which directly reflects the regional neuronal activity. The functional connectivity (FC) of fMRI was assessed using a seed voxel linear correlation approach. The severity of aphasia was evaluated by aphasia quotient (AQ) scores obtained from Western Aphasia Battery test. Compared with normal subjects, aphasic patients showed decreased ALFF values in the regions of left posterior middle temporal gyrus (PMTG), left medial prefrontal gyrus, and right cerebellum. The ALFF values in left PMTG showed strong positive correlation with the AQ score (coefficient r =0.79, P temporal gyrus (BA20), fusiform gyrus (BA37), and inferior frontal gyrus (BA47\\45\\44). Left PMTG might play an important role in language dysfunction of chronic aphasia, and ALFF value might be a promising indicator to evaluate the severity of aphasia.

  7. Complications of occipital bone pneumatization

    International Nuclear Information System (INIS)

    Moss, Mary; Roche, Jim; Biggs, Michael; Forer, Martin; Fagan, Paul; Davis, Martin

    2004-01-01

    Four cases of occipital bone pneumatization and subsequent complications are described, which include a pathological fracture of C 1 and the occipital bone, spontaneous subcutaneous emphysema and pneumatocele formation. Reviews of the published literature and possible aetiological factors have been discussed Copyright (2004) Blackwell Publishing Asia Pty Ltd

  8. Fracture of the occipital condyle

    International Nuclear Information System (INIS)

    Wessels, L.S.

    1990-01-01

    The term fracture of the occipital condyle is a misnomer and and usually represents an extensive fracture of the posterior fossa skull base extending onto the squamous portion of the occipital bone and even further forward. These fractures should be suspected when the lower cranial nerves are affected after severe cranial trauma. Conservative management appears to be indicated. 2 figs., 5 refs

  9. Effects of post-traumatic stress disorder on occipital lobe function and structure.

    Science.gov (United States)

    Chao, Linda L; Lenoci, Maryann; Neylan, Thomas C

    2012-05-09

    Although there is evidence for strong connectivity between the amygdala and the visual cortex and some evidence for reduced occipital lobe gray matter volume in patients with post-traumatic stress disorder (PTSD), few studies have directly examined the effects of PTSD on occipital function. The current study used functional and structural MRI to examine occipital cortex function and structure in male combat veterans with and without PTSD. Left occipital gray matter volume was reduced in PTSD patients relative to the controls and correlated negatively with the severity of PTSD symptoms. Functional activity in the lateral occipital complex to aversive and nonaversive pictures presented in novel and repeated presentations was not altered by PTSD. These findings suggest that PTSD adversely affects occipital lobe volume but not the reactivity of the lateral occipital complex to generally aversive, trauma nonspecific stimuli.

  10. Giant Occipital Intradiploic Epidermoid Cyst.

    Science.gov (United States)

    Oommen, Arun; Govindan, Jayasree; Peroor, Devan Surendran; Azeez, C Roshan; Rashmi, R; Abdul Jalal, Muhammed Jasim

    2018-01-01

    Intraparenchymal or intradiploic epidermoid cysts are very rare. Most of these cysts, when present, tend to involve the frontal and temporal lobes, and occasionally, the pineal gland or the brain stem. Here, we report a 45-year-old female, who presented with localized occipital headache and a tender occipital swelling, gradually increasing in size. She was hemodynamically and neurologically stable and did not have any focal neurological deficits. Whole skull and brain imaging revealed a well-demarcated expansile lytic lesion in the right occipital bone, which was hypointense on T1-weighted and hyperintense on both T2-weighted imaging and diffusion-weighted imaging without any contrast enhancement. The patient underwent a right occipital craniotomy and total excision of the intradiploic space occupying lesion. Histopathological examination confirmed the lytic bone lesion over occipital bone as intradiploic epidermoid cyst.

  11. Experience of Surgical Treatment for Occipital Migraine in Taiwan.

    Science.gov (United States)

    Lin, Shang-Hsi; Lin, Huwang-Chi; Jeng, Chu-Hsu; Hsieh, Cheng-Han; Lin, Yu-Hsien; Chen, Cha-Chun

    2016-03-01

    Refractory migraine surgery developed since 2003 has excellent results over the past 10 years. According to the pioneer of migraine surgery, Dr. Bahman Guyuron, 5 major surgical classifications of migraines are described in the field of plastic surgery, namely, frontal migraine, temporal migraine, rhinogenic migraine, occipital migraine, and auriculotemporal migraine. In this study, we present the preliminary surgical results of the occipital migraine surgery. A total of 22 patients with simple occipital migraines came to our outpatient clinic for help from June 2014 to February 2015. Thirteen cases were excluded owing to ineligibility for operation or other reasons. The patients who concurrently experienced other types of migraines were precluded even if they received combined migraine surgery. Therefore, 9 simple occipital migraine cases were enrolled in this study. Migraine severity was evaluated by uniform questionnaires to identify the source of migraine. Neurolysis was performed under general anesthesia, with the patient in a prone position. Postoperative conditions were evaluated at the second, fourth, sixth, and eighth weeks by posttreatment questionnaires. Of all the 9 patients, 5 experienced single-sided migraines of greater occipital nerve origin (2 left-sided and 3 right-sided cases). Two patients had bilateral migraines of greater occipital nerve origin, and unilateral right lesser occipital nerve origin was noted in one patient. The last patient had right-sided migraines of greater and lesser occipital nerve origin. As a result in the follow-up, a response rate greater than 90% was documented, and complete resolution was observed in 2 patients. Drug doses were reduced more than 50% in the remaining patients. The overall efficacy of occipital migraine surgery in this study was 88.8% (8/9 cases). Some patients with migraine are good candidates for surgical resolution with appropriate and meticulous selection. Similar to what is observed in Western

  12. Dyke-Davidoff-Masson syndrome: case report of fetal unilateral ventriculomegaly and hypoplastic left middle cerebral artery.

    Science.gov (United States)

    Piro, Ettore; Piccione, Maria; Marrone, Gianluca; Giuffrè, Mario; Corsello, Giovanni

    2013-05-14

    Prenatal ultrasonographic detection of unilateral cerebral ventriculomegaly arises suspicion of pathological condition related to cerebrospinal fluid flow obstruction or cerebral parenchimal pathology. Dyke-Davidoff-Masson syndrome is a rare condition characterized by cerebral hemiatrophy, calvarial thickening, skull and facial asymmetry, contralateral hemiparesis, cognitive impairment and seizures. Congenital and acquired types are recognized and have been described, mainly in late childhood, adolescence and adult ages. We describe a female infant with prenatal diagnosis of unilateral left ventriculomegaly in which early brain MRI and contrast enhanced-MRI angiography, showed cerebral left hemiatrophy associated with reduced caliber of the left middle cerebral artery revealing the characteristic findings of the Dyke-Davidoff-Masson syndrome. Prenatal imaging, cerebral vascular anomaly responsible for the cerebral hemiatrophy and the early clinical evolution have never been described before in such a young child and complete the acquired clinical descriptions in older children. Differential diagnosis, genetic investigations, neurophysiologic assessments, short term clinical and developmental follow up are described. Dyke-Davidoff-Masson syndrome must be ruled out in differential diagnosis of fetal unilateral ventriculomegaly. Early clinical assessment, differential diagnosis and cerebral imaging including cerebral MRI angiography allow the clinicians to diagnose also in early infancy this rare condition.

  13. Plenty of action left in northern Europe's middle-aged offshore

    International Nuclear Information System (INIS)

    Knott, D.J.

    1994-01-01

    Northern Europe's offshore oil industry this year has begun to reveal several symptoms generally associated with middle age. Though in its prime in terms of oil production, North Sea industry has begun a dramatic slimming program. It has started a search for fresh experiences, and it has begun to revisit the big successes of its youth. The paper cites examples demonstrating these trends. The paper then discusses production, outlook for exploration, trends in the United Kingdom, development advances in the natural gas industry, exploration activities, and redevelopment projects

  14. [Influences of life event and coping style on left-behind middle school student mental health in a three-gorge area county].

    Science.gov (United States)

    Wu, Rui; Li, Jianqiao; Liu, Qin; Wang, Hong

    2014-07-01

    To study the effects of life event and coping style on left-behind middle school student mental health. 1405 left-behind middle school students were selected by multi-stage cluster random sampling method and investigated with Middle School Student Mental Health Scale (MSSMHS), Multidimensional Life Events Rating Questionnaire for Middle School Students (MLERQ) and Trait Coping Style Questionnaire (TCSQ). The mental health detection rate of left-behind middle school students was 26.33%. Life event have significant influence on mental health (F = 447.624, P = 0.000). The main effect for negative coping style on mental health was significant (F = 263.669, P = 0.000). Positive coping style have effect on mental health but the main effect was not significant (F = 2.436, P = 0.119). The interaction effect of life event and negative coping style was significant (F = 23.173, P = 0.000). Life event and coping style has a certain effect on left-behind middle school student mental health, but its mechanism is complicated and still uncertain.

  15. Posterior reversible encephalopathy syndrome mimicking a left middle cerebral artery stroke.

    Science.gov (United States)

    Terranova, Santo; Kumar, Jai Dev; Libman, Richard B

    2012-01-01

    Certain Acute Clinical presentations are highly suggestive of stroke caused by specific mechanisms. One example of this would be the sudden onset of aphasia without hemiparesis often reflecting cerebral embolism, frequently from a cardiac source. Posterior reversible encephalopathy syndrome (PRES) describes a usually reversible neurologic syndrome with a variety of presenting symptoms from headache, altered mental status, seizures, vomiting, diminished spontaneity and speech, abnormalities of visual perception and visual loss. We report a patient presenting with elevated blood pressure, CT characteristics of PRES but a highly circumscribed neurologic syndrome (Wernicke's Aphasia without hemiparesis) suggestive of a cardioembolic stroke affecting the left MCA territory. That is, PRES mimicked a focal stroke syndrome. The importance of recognizing this possibility is that his deficits resolved with blood pressure control, while other treatments, such as intensifying his anticoagulation would have been inappropriate. In addition, allowing his blood pressure to remain elevated as is often done in the setting of an acute stroke might have perpetuated the underlying pathophysiology of PRES leading to a worse clinical outcome. For this reason PRES needs to be recognized quickly and treated appropriately.

  16. A case of viral encephalitis localized in the occipital lobe

    International Nuclear Information System (INIS)

    Izawa, Masahiro; Okino, Teruhiko; Kagawa, Mizuo; Kitamura, Koichi.

    1987-01-01

    A case is reported of a 63-year-old female admitted to our hospital in Oct., 1986, with complaints of headache and visual field disturbance. A plain CT scan showed no abnormal low-density focal area. A contrast-enhancement CT scan, however, showed a localized linear abnormal enhancement in the right occipital lobe, without any mass-effect. A dynamic CT scan demonstrated a hyperemic perfusion pattern of the right occipital lobe. A visual-field examination showed left homonymous hemianopsia with concentric narrowing. These abnormal findings on CT, EEG, and ophthalmological examination disappeared within 3 weeks. (author)

  17. The occipital cortex in detection and categorisation abilities: an fMRI study in hemianopia

    International Nuclear Information System (INIS)

    Perez, C.; Coubard, O.; Cavezian, C.; Gout, O.; Chokron, S.; Peyrin, C.; Andersson, F.; Doucet, G.

    2011-01-01

    Complete text of publication follows: Previous studies have shown that the right and left hemispheres are predominant for detection and categorization tasks, respectively. This asymmetry appears to be instantiated at a processing stage as early as the occipital cortex. The present study was intended to assess the cerebral network responsible for natural scenes perception in hemianopic patients suffering from an occipital cortex lesion. One Left and one Right hemianopic patient (LH or RH; respectively right and left occipital damage) were compared with 14 healthy controls in detection and categorisation tasks of natural scenes. Both tasks were performed in a 1.5 T scanner to collect anatomical and functional data. In healthy controls, occipital activation was observed in the extra-striate areas of both hemispheres in the detection task but only of the left hemisphere in the categorization task. The LH (patient showed a bilateral occipital activation in both tasks. while, the RH patient showed unilateral right (intact) occipital activation in both tasks. These results highlight the importance of the perceptual task (detection vs. categorization) on the hemispheric asymmetry. They also suggest that different cortical reorganisations take place depending on the occipital lesion side

  18. [Intracranial remote epidural haematoma as a complication after resection of an occipital lobe metastatic tumour from a testicular embryonal carcinoma – a case report].

    Science.gov (United States)

    Andrusewicz, Wojciech; Limanówka, Bartosz; Sagan, Leszek; Kojder, Ireneusz

    We present the case of a patient who suffered from intracranial epidural haematoma in the left fronto -temporo -parietal region as a complication after left parieto -occipital craniotomy and a resection of a metastatic lesion from a testicular embryonal carcinoma to the left occipital lobe. We also discuss possible causes of this complication.

  19. Middle ear effusion

    African Journals Online (AJOL)

    NJSR

    Bone scan showed a hot spot in the right mastoid. Magnetic resonance imaging of the petrous ridges showed an irregular enhancing mass eroding and occupying the middle and inferior aspects of the right petrous temporal bone. This extended into the adjacent occipital bone, occipital condyle and the posterior cranial ...

  20. A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion.

    Science.gov (United States)

    King, Nicolas K K; Rajendra, Tiruchelvarayan; Ng, Ivan; Ng, Wai Hoe

    2014-01-01

    Occipital-cervical fusion (OCF) has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrumentation. The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT) to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in a South East Asian population. Thirty patients undergoing cranio-cervical junction instrumentation during the period 2008-2010 were included. The thickness of the occipital bone and the length and diameter of the C2 pedicle were measured based on CT. The thickest point on the occipital bone was in the midline with a maximum thickness below the external occipital protuberance of 16.2 mm (±3.0 mm), which was thicker than in the Western population. The average C2 pedicle diameter was 5.3 mm (±2.0 mm). This was smaller than Western population pedicle diameters. The average length of the both pedicles to the midpoint of the C2 vertebral body was 23.5 mm (±3.3 mm on the left and ±2.3 mm on the right). The results of this first study in the South East Asian population should help guide and improve the safety in occipito-cervical region instrumentation. Thus reducing the risk of technical failures and neuro-vascular injury.

  1. Cervical myelitis presenting as occipital neuralgia.

    Science.gov (United States)

    Noh, Sang-Mi; Kang, Hyun Goo

    2018-07-01

    Occipital neuralgia is a common form of headache that is characterized by paroxysmal severe lancinating pain in the occipital nerve distribution. The exact pathophysiology is still not fully understood and occipital neuralgia often develops spontaneously. There are no specific guidelines for evaluation of patients with occipital neuralgia. Cervical spine, spinal cord and posterior neck muscle lesions can induce occipital neuralgia. Brain and spine imaging may be necessary in some cases, according to the nature of the headache or response to treatment. We report a case of cervical myelitis presenting as occipital neuralgia.

  2. Occipital Encephalocele: A Case Report

    OpenAIRE

    Aslanova, Rakhshanda; Dolgun, Zehra Nihal; Turhan, Emrah; Ökten, Sabri Berkem

    2015-01-01

    Encephalocele is a neural tube defect characterized by sac-like protrusions of the brain and the covering membranes through an opening in the skull. In this case we presented a 21-year old 20 weeks pregnant woman with fetal occipital encephalocele accompanying lemon sign, normal posterior fossa imaging and normal level of maternal serum alpha-fetoprotein (MSAFP).

  3. Childhood Falls With Occipital Impacts

    NARCIS (Netherlands)

    Atkinson, Norrell; van Rijn, Rick R.; Starling, Suzanne P.

    2017-01-01

    Falls are commonly reported in children who present with both accidental and inflicted brain injuries. Short falls rarely result in serious or life-threatening injuries. Our purpose is to describe a series of cases of short falls with occipital impact leading to subdural hemorrhage (SDH). We present

  4. Intractable Occipital Neuralgia Caused by an Entrapment in the Semispinalis Capitis

    Science.gov (United States)

    Kim, Deok-ryeong; Lee, Sang-won

    2013-01-01

    Occipital neuralgia is a rare pain syndrome characterized by periodic lancinating pain involving the occipital nerve complex. We present a unique case of entrapment of the greater occipital nerve (GON) within the semispinalis capitis, which was thought to be the cause of occipital neuralgia. A 66-year-old woman with refractory left occipital neuralgia revealed an abnormally low-loop of the left posterior inferior cerebellar artery on the magnetic resonance imaging, suggesting possible vascular compression of the upper cervical roots. During exploration, however, the GON was found to be entrapped at the perforation site of the semispinalis capitis. There was no other compression of the GON or of C1 and C2 dorsal roots in their intracranial course. Postoperatively, the patient experienced almost complete relief of typical neuralgic pain. Although occipital neuralgia has been reported to occur by stretching of the GON by inferior oblique muscle or C1-C2 arthrosis, peripheral compression in the transmuscular course of the GON in the semispinalis capitis as a cause of refractory occipital neuralgia has not been reported and this should be considered when assessing surgical options for refractory occipital neuralgia. PMID:24278663

  5. Early (N170/M170 face-sensitivity despite right lateral occipital brain damage in acquired prosopagnosia

    Directory of Open Access Journals (Sweden)

    Esther eAlonso Prieto

    2011-12-01

    Full Text Available Compared to objects, pictures of faces elicit a larger early electromagnetic response at occipito-temporal sites on the human scalp, with an onset of 130 ms and a peak at about 170 ms. This N170 face effect is larger in the right than the left hemisphere and has been associated with the early categorization of the stimulus as a face. Here we tested whether this effect can be observed in the absence of some of the visual areas showing a preferential response to faces as typically identified in neuroimaging. Event related potentials were recorded in response to faces, cars and their phase-scrambled versions in a well-known brain-damaged case of prosopagnosia (PS. Despite the patient’s right inferior occipital gyrus lesion encompassing the most posterior cortical area showing preferential response to faces (occipital face area, OFA, we identified an early face-sensitive component over the right occipito-temporal hemisphere of the patient that was identified as the N170. A second experiment supported this conclusion, showing the typical N170 increase of latency and amplitude in response to inverted faces. In contrast, there was no N170 in the left hemisphere, where PS has a lesion to the middle fusiform gyrus and shows no evidence of face-preferential response in neuroimaging (no left fusiform face area, or lFFA. These results were replicated by a magneto-encephalographic (MEG investigation of the patient, disclosing a M170 component only in the right hemisphere. These observations indicate that face preferential activation in the inferior occipital cortex is not necessary to elicit early visual responses associated with face perception (N170/M170 on the human scalp. These results further suggest that when the right inferior occipital cortex is damaged, the integrity of the middle fusiform gyrus and/or the superior temporal sulcus – two areas showing face preferential responses in the patient’s right hemisphere - might be necessary to generate

  6. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

    1984-01-01

    We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

  7. Progressive microstructural changes of the occipital cortex in Huntington's disease.

    Science.gov (United States)

    Odish, Omar F F; Reijntjes, Robert H A M; van den Bogaard, Simon J A; Roos, Raymund A C; Leemans, Alexander

    2018-02-28

    In this study we longitudinally investigated the rate of microstructural alterations in the occipital cortex in different stages of Huntington's disease (HD) by applying an automated atlas-based approach to diffusion MRI data. Twenty-two premanifest (preHD), 10 early manifest HD (early HD) and 24 healthy control subjects completed baseline and two year follow-up scans. The preHD group was stratified based on the predicted years to disease onset into a far (preHD-A) and near (preHD-B) to disease onset group. Clinical and behavioral measures were collected per assessment time point. An automated atlas-based DTI analysis approach was used to obtain the mean, axial and radial diffusivities of the occipital cortex. We found that the longitudinal rate of diffusivity change in the superior occipital gyrus (SOG), middle occipital gyrus (MOG), and inferior occipital gyrus (IOG) was significantly higher in early HD compared to both preHD and controls (all p's ≤ 0.005), which can be interpreted as an increased rate of microstructural degeneration. Furthermore, the change rate in the diffusivity of the MOG could significantly discriminate between preHD-B compared to preHD-A and the other groups (all p's ≤ 0.04). Finally, we found an inverse correlation between the Stroop Word Reading task and diffusivities in the SOG and MOG (all p's ≤ 0.01). These findings suggest that measures obtained from the occipital cortex can serve as sensitive longitudinal biomarkers for disease progression in preHD-B and early HD. These could in turn be used to assess potential effects of proposed disease modifying therapies.

  8. Occipital lobe infarctions are different

    OpenAIRE

    Naess, Halvor; Waje-Andreassen, Ulrikke; Thomassen, Lars

    2007-01-01

    Halvor Naess, Ulrikke Waje-Andreassen, Lars ThomassenDepartment of Neurology, Haukeland University Hospital, University of Bergen, N-5021 Bergen, NorwayObjectives: We hypothesized that occipital lobe infarctions differ from infarctions in other locations as to etiology, risk factors and prognosis among young adults.Methods: Location, etiology, risk factors and long-term outcome were evaluated among all young adults 15–49 years suffering from cerebral infarction in Hordaland County, Norw...

  9. CT diagnosis of occipital bone pacchionian depression

    International Nuclear Information System (INIS)

    Zhu Jianguo; Xu Xiaolin

    2004-01-01

    Objective: To improve the recognition of the CT findings of occipital bone pacchionian depression, in order to avoid misdiagnosis. Methods: occipital bone pacchionian depression underwent CT with plain scan and intravenous contrast enhancement in 11 cases, and then the CT findings were analyzed. Results: Occipital bone pacchionian depression situated beside the torcular herophilia in 11 cases. The depression or bone defect were found at occipital bone inner plate, they can reach diploe or outer plate and had no enhancement after contrast injection. Conclusions: CT scans play an important role in diagnosis and differential diagnosis of occipital bone pacchionian depression

  10. The occipital lobe convexity sulci and gyri.

    Science.gov (United States)

    Alves, Raphael V; Ribas, Guilherme C; Párraga, Richard G; de Oliveira, Evandro

    2012-05-01

    The anatomy of the occipital lobe convexity is so intricate and variable that its precise description is not found in the classic anatomy textbooks, and the occipital sulci and gyri are described with different nomenclatures according to different authors. The aim of this study was to investigate and describe the anatomy of the occipital lobe convexity and clarify its nomenclature. The configurations of sulci and gyri on the lateral surface of the occipital lobe of 20 cerebral hemispheres were examined in order to identify the most characteristic and consistent patterns. The most characteristic and consistent occipital sulci identified in this study were the intraoccipital, transverse occipital, and lateral occipital sulci. The morphology of the transverse occipital sulcus and the intraoccipital sulcus connection was identified as the most important aspect to define the gyral pattern of the occipital lobe convexity. Knowledge of the main features of the occipital sulci and gyri permits the recognition of a basic configuration of the occipital lobe and the identification of its sulcal and gyral variations.

  11. Occipital headaches and neuroimaging in children.

    Science.gov (United States)

    Bear, Joshua J; Gelfand, Amy A; Goadsby, Peter J; Bass, Nancy

    2017-08-01

    To investigate the common thinking, as reinforced by the International Classification of Headache Disorders, 3rd edition (beta), that occipital headaches in children are rare and suggestive of serious intracranial pathology. We performed a retrospective chart review cohort study of all patients ≤18 years of age referred to a university child neurology clinic for headache in 2009. Patients were stratified by headache location: solely occipital, occipital plus other area(s) of head pain, or no occipital involvement. Children with abnormal neurologic examinations were excluded. We assessed location as a predictor of whether neuroimaging was ordered and whether intracranial pathology was found. Analyses were performed with cohort study tools in Stata/SE 13.0 (StataCorp, College Station, TX). A total of 308 patients were included. Median age was 12 years (32 months-18 years), and 57% were female. Headaches were solely occipital in 7% and occipital-plus in 14%. Patients with occipital head pain were more likely to undergo neuroimaging than those without occipital involvement (solely occipital: 95%, relative risk [RR] 10.5, 95% confidence interval [CI] 1.4-77.3; occipital-plus: 88%, RR 3.7, 95% CI 1.5-9.2; no occipital pain: 63%, referent). Occipital pain alone or with other locations was not significantly associated with radiographic evidence of clinically significant intracranial pathology. Children with occipital headache are more likely to undergo neuroimaging. In the absence of concerning features on the history and in the setting of a normal neurologic examination, neuroimaging can be deferred in most pediatric patients when occipital pain is present. © 2017 American Academy of Neurology.

  12. Occipital GABA correlates with cognitive failures in daily life.

    Science.gov (United States)

    Sandberg, Kristian; Blicher, Jakob Udby; Dong, Mia Yuan; Rees, Geraint; Near, Jamie; Kanai, Ryota

    2014-02-15

    The brain has limited capacity, and so selective attention enhances relevant incoming information while suppressing irrelevant information. This process is not always successful, and the frequency of such cognitive failures varies to a large extent between individuals. Here we hypothesised that individual differences in cognitive failures might be reflected in inhibitory processing in the sensory cortex. To test this hypothesis, we measured GABA in human visual cortex using MR spectroscopy and found a negative correlation between occipital GABA (GABA+/Cr ratio) and cognitive failures as measured by an established cognitive failures questionnaire (CFQ). For a second site in parietal cortex, no correlation between CFQ score and GABA+/Cr ratio was found, thus establishing the regional specificity of the link between occipital GABA and cognitive failures. We further found that grey matter volume in the left superior parietal lobule (SPL) correlated with cognitive failures independently from the impact of occipital GABA and together, occipital GABA and SPL grey matter volume statistically explained around 50% of the individual variability in daily cognitive failures. We speculate that the amount of GABA in sensory areas may reflect the potential capacity to selectively suppress irrelevant information already at the sensory level, or alternatively that GABA influences the specificity of neural representations in visual cortex thus improving the effectiveness of successful attentional modulation. © 2013. Published by Elsevier Inc. All rights reserved.

  13. Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury.

    LENUS (Irish Health Repository)

    Aquilina, K

    2012-02-03

    Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.

  14. Transient facial nerve palsy after occipital nerve block: a case report.

    Science.gov (United States)

    Strauss, Lauren; Loder, Elizabeth; Rizzoli, Paul

    2014-01-01

    Occipital nerve blocks are commonly performed to treat a variety of headache syndromes and are generally believed to be safe and well tolerated. We report the case of an otherwise healthy 24-year-old woman with left side-locked occipital, parietal, and temporal pain who was diagnosed with probable occipital neuralgia. She developed complete left facial nerve palsy within minutes of blockade of the left greater and lesser occipital nerves with a solution of bupivicaine and triamcinolone. Magnetic resonance imaging of the brain with gadolinium contrast showed no abnormalities, and symptoms had completely resolved 4-5 hours later. Unintended spread of the anesthetic solution along tissue planes seems the most likely explanation for this adverse event. An aberrant course of the facial nerve or connections between the facial and occipital nerves also might have played a role, along with the patient's prone position and the use of a relatively large injection volume of a potent anesthetic. Clinicians should be aware that temporary facial nerve palsy is a possible complication of occipital nerve block. © 2014 American Headache Society.

  15. Primary Occipital Ewing’s Sarcoma with Subsequent Spinal Seeding

    Directory of Open Access Journals (Sweden)

    Ali Alqahtani

    2017-01-01

    Full Text Available Ewing’s sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing’s sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI showed cerebrospinal fluid (CSF seeding from the L5 to the S4 vertebrae. Primary cranial Ewing’s sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing’s sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing’s sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

  16. Primary Occipital Ewing's Sarcoma with Subsequent Spinal Seeding.

    Science.gov (United States)

    Alqahtani, Ali; Amer, Roaa; Bakhsh, Eman

    2017-01-01

    Ewing's sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing's sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT) imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) seeding from the L5 to the S4 vertebrae. Primary cranial Ewing's sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing's sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing's sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

  17. Morphologic Analysis of Occipital Sinuses for Occipital Screw Fixation Using Digital Subtraction Angiography.

    Science.gov (United States)

    Lee, Dong Hoon; Hong, Jae Taek; Sung, Jae Hoon; Jain, Ashish; Huh, Joon; Kim, Sang Uk; Kim, Joon Young; Kwon, Jae Yoel; Cho, Chul Bum; Kim, Il Sup; Lee, Sang Won

    2016-07-01

    Numerous methods to achieve occipitocervical stabilization have been described, including the use of occipital plate/screw constructs. Bicortical screws may increase the pullout strength, but intracranial injuries to venous sinuses have been reported. This study was performed to analyze the variations in occipital sinuses to prevent sinus injury caused by the bicortical screw. Occipital sinuses of 1720 patients were examined using digital subtraction angiography. The data collected included patient age and sex, occipital sinus type, distance between occipital sinus and midline, depth from inion to occipital sinus, and distance between occipital sinus and midline occiput at different levels. The mean age of patients was 57 years ± 13. There were 807 (46.9%) men and 913 (53.1%) women. The most common occipital sinus type was single occipital sinus off-midline (type B2). The least common occipital sinus type was absent occipital sinuses (type A; 8.7% of patients). There was no significant difference between age and occipital sinus type (P = 0.310). Also, the difference between sexes was not significant in regard to occipital sinus type in general. However, in subgroup analysis of type B1 and B2, there was a significant difference between sexes (P occipital sinus was 19.913 mm ± 7.437. The occipital sinus shows several variations, and many morphologic differences can be seen. Preoperative detailed examination by magnetic resonance venography or vertebral angiography may be required for cases in which bicortical occipital screw fixation is necessary to avoid occipital sinus-related complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Occipital projections in the skeletal dysplasias

    International Nuclear Information System (INIS)

    Takamine, Yuji; Field, Fiona M.; Lachman, Ralph S.; Rimoin, David L.

    2004-01-01

    Occipital projections of the cranium have been reported in a number of skeletal dysplasias and syndromes. We observed two cases of atelosteogenesis type I with a bony occipital projection. This finding has neither been noted nor reported in any form of atelosteogenesis. This led us to search the International Skeletal Dysplasia Registry for occipital projections, and we found them in four other syndromes in which they had not been reported. Thus occipital spurs are a non-diagnostic feature that can be found in at least ten distinct disorders as well as a normal variant. (orig.)

  19. Occipital bone thickness: Implications on occipital-cervical fusion. A cadaveric study

    Directory of Open Access Journals (Sweden)

    Kourosh Zarghooni

    2016-12-01

    Conclusion: The measurements demonstrated a great individual variability of bone thickness of the occipital bone. The results emphasize the role of preoperative planning for the feasibility of placement of an occipital screw.

  20. Occipital alopecia following cardiopulmonary bypass.

    Science.gov (United States)

    Lwason, N W; Mills, N L; Ochsner, J L

    1976-03-01

    Postoperative alopecia is a minor complication of surgery but a cosmetic disaster to the patient. Over a 3 year period, 60 cases of occipital alopecia were discovered in patients following open-heart surgery and 5 cases on other surgical services. In contrast to previous reports, 29 patients had alopecia one year later, presumed to be permanent. Extensive operations, with prolonged recovery and elective overnight mechanical ventilation, were common to all. Retrospective analysis and prospective studies clearly demonstrated that localized scalp pressure was the cause of the alopecia and that the duration of pressure determined the extent of the damage. Moving the patient's head at regular intervals during operation and recovery eliminated the alopecia. The type of head rest used did not modify the development of alopecia. Electrical injury and the use of heparin, hypothermia, electrocautery, or hypotension were eliminated as possible causes. Conclusive evidence correlating periperative events with the formation of pressure sores in man has not been previously reported.

  1. [The occipital sinus: a radioanatomic study].

    Science.gov (United States)

    Gaumont-Darcissac, M; Viart, L; Foulon, P; Le Gars, D; Havet, E; Peltier, J

    2015-03-01

    The aim of this study was to assess the presence of an occipital sinus in both children and adults, and to detail its main associated anatomical characteristics. One hundred of patients' MRI (3D T1 EG) between 0 and 86 years old were studied, in sagittal and axial sections, with the software DxMM. Occipital sinus length, perimeter, and cerebellar falx length measurements were performed with the software's tools. Forty-three percent of patients had an occipital sinus (average perimeter was 3.02 mm, average length was 19.85 mm), and 23.26% of these patients had a cerebellar falx, 30.23% of these patients had one vein or more draining into the occipital sinus. Sixty-two percent of children had an occipital sinus (average perimeter was 2.87 mm, average length was 21.63 mm), and 29.03% of them had a cerebellar falx. Twenty-four percent of adults had an occipital sinus (average perimeter was 3.4mm, average length was 15.28 mm), and 8.33% of them had a cerebellar falx. This work highlights a link between the age and the occipital sinus existence. The perimeter of this sinus seems to be superior for adults, but its length seems to be superior for children. A cerebellar falx with the occipital sinus was found more frequently for children. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Charles Bonnet Syndrome in a Patient With Right Medial Occipital Lobe Infarction: Epileptic or Deafferentation Phenomenon?

    Science.gov (United States)

    Kumral, Emre; Uluakay, Arzu; Dönmez, İlknur

    2015-07-01

    Charles Bonnet syndrome (CBS) is an uncommon disorder characterized by complex and recurrent visual hallucinations in patients with visual pathway pathologic defects. To describe a patient who experienced complex visual hallucinations following infarction in the right occipital lobe and epileptic seizure who was diagnosed as having CBS. A 65-year-old man presented acute ischemic stroke caused by artery to artery embolism involving the right occipital lobe. Following ischemic stroke, complex visual hallucinations in the left visual field not associated with loss of consciousness or delusion developed in the patient. Hallucinations persisted for >1 month and during hallucination, no electrographic seizures were recorded through 24 hours of videoelectroencephalographic monitoring. CBS may develop in a patient with occipital lobe infarction following an embolic event. CBS associated with medial occipital lobe infarction and epilepsy may coexist and reflects the abnormal functioning of an integrated neuronal network.

  3. Severe reversible dilated cardiomyopathy associated with a large left ventricular thrombus in a young child with middle aortic syndrome

    OpenAIRE

    Ponniah, U; Overholt, E

    2014-01-01

    this article reports a case of a seven-year girl who presented with severe dilated cardiomyopathy (DCM) associated with a large thrombus in the left ventricle (LV). She had a long segment stenosis of the lower thoracic descending aorta, possibly due to non-specific aortitis and underwent successful stent angioplasty. The LV thrombus resolved after heparin without sequelae.

  4. Alterations of the occipital lobe in schizophrenia.

    Science.gov (United States)

    Tohid, Hassaan; Faizan, Muhammad; Faizan, Uzma

    2015-07-01

    The relationship of the occipital lobe of the brain with schizophrenia is not commonly studied; however, this topic is considered an essential subject matter among clinicians and scientists. We conducted this systematic review to elaborate the relationship in depth. We found that most schizophrenic patients show normal occipital anatomy and physiology, a minority showed dwindled values, and some demonstrated augmented function and structure. The findings are laborious to incorporate within single disease models that present the involvement of the occipital lobe in schizophrenia. Schizophrenia progresses clinically in the mid-twenties and thirties and its prognosis is inadequate. Changes in the volume, the gray matter, and the white matter in the occipital lobe are quite evident; however, the mechanism behind this involvement is not yet fully understood. Therefore, we recommend further research to explore the occipital lobe functions and volumes across the different stages of schizophrenia.

  5. Alterations of the occipital lobe in schizophrenia

    Science.gov (United States)

    Tohid, Hassaan; Faizan, Muhammad; Faizan, Uzma

    2015-01-01

    The relationship of the occipital lobe of the brain with schizophrenia is not commonly studied; however, this topic is considered an essential subject matter among clinicians and scientists. We conducted this systematic review to elaborate the relationship in depth. We found that most schizophrenic patients show normal occipital anatomy and physiology, a minority showed dwindled values, and some demonstrated augmented function and structure. The findings are laborious to incorporate within single disease models that present the involvement of the occipital lobe in schizophrenia. Schizophrenia progresses clinically in the mid-twenties and thirties and its prognosis is inadequate. Changes in the volume, the gray matter, and the white matter in the occipital lobe are quite evident; however, the mechanism behind this involvement is not yet fully understood. Therefore, we recommend further research to explore the occipital lobe functions and volumes across the different stages of schizophrenia. PMID:26166588

  6. Presentation of moyamoya disease with occipital hemorrhage: a case report

    Directory of Open Access Journals (Sweden)

    Serkan Demir

    2012-12-01

    Full Text Available Moyamoya disease is a cerebrovascular disease which is characterized with stenosis and occlusions at the distal part of internal carotid artery and at the proximal part of anterior and middle cerebral arteries. It rarely causes temporary or recurrent hemiparesis due to intracranial hemorrhage while symptoms like headache, convulsion, nystagmus, aphasia and ataxia may also occur. In this paper, we present a case of Moyamoya disease which was diagnosed with a 23 year old female patient who was admitted to our emergency department with headache, nausea and vomiting complaints and whose radiological findings showed occipital lobe hemorrhage.

  7. A Qualitative Exploration of the School Experiences of Middle-School Students in the Era of No Child Left Behind

    OpenAIRE

    Hamilton, Charles H

    2009-01-01

    Since the inception of the most recent iteration of the Elementary and Secondary Education Act of 1965, No Child Left Behind (NCLB) has drawn widespread study and discussion. The majority of the research concerning NCLB has reported the perspective of teachers and administrative staff in public schools. The purpose of this research study was to add to the literature the voices of students. Participants in this qualitative research study were six students at Galaxy Junior High. These six stude...

  8. Dandy-Walker syndrome together with occipital encephalocele.

    Science.gov (United States)

    Cakmak, A; Zeyrek, D; Cekin, A; Karazeybek, H

    2008-08-01

    Dandy-Walker malformation is an anomaly characterized by dysgenesis of the foramina of Magendie and Lushka in the upper 4(th) ventricle, hypoplasia of the cerebellar vermis and agenesis of the corpus callosum. Encephalocele is diagnosed from the calvarium defect, cerebrospinal fluid (CSF) and herniation of the meninges. It is the rarest neural tube defect. A 7 x 9 cm encephalocele was found on physical examination of a 6-day old baby boy patient. From cranial magnetic resonance, it was seen that the posterior fossa was enlarged with cysts and there was agenesis of the vermis. A connection was established between the ventricle and the development of cysts on the posterior fossa. These findings were evaluated as significant from the aspect of Dandy-Walker malformation. The extension of the bone defect in the left occipital area towards the posterior, and the cranio-caudal diameter reaching 9 cm was seen to be in accordance with encephalocele. It is rare for Dandy-Walker syndrome to occur together with occipital encephalocele. The authors present a case of Dandy-Walker syndrome together with occipital encephalocele.

  9. Neurosurgical Interventions for Occipital Encephalocele

    Science.gov (United States)

    Rehman, Lal; Farooq, Ghulam; Bukhari, Irum

    2018-01-01

    Aims and Objectives: The aim of this study is to find the outcome of repair and resection of the occipital encephalocele. Study Design: Case series. Materials and Methods: The clinical data of fifty consecutive occipital encephalocele patients were retrieved from medical records including operative notes, postoperative follow-up visits, and postsurgical complications were noted for analysis from November 2009 to November 2013 at the Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan. All patients were assessed by computed tomography scan, magnetic resonance imaging brain, and ultrasound when needed. Physician's assessment, physical examination, and his/her questions to the family at follow-up were used as a tool to determine if there was a developmental delay rather than quantitative analysis like hydrocephalus questionnaires. Patients who developed complications and delayed milestone were regarded as no improvement and those who did not develop complications and achieved appropriate milestone were regarded as improved at 18 months follow-up. Results: Of 50 patients, 17 were males and 33 were females. The average age at presentation was 2.4 months. 16 (32%) patients had increased head circumference and hydrocephalus, 2 (4%) had associated Dandy–Walker cyst, 3 (6%) developed developmental delays, and 8 (15%) had a seizure disorder. None of our patients had neurological deficits. The size of the sac ranged from 2 cm × 3 cm to 27 cm × 15 cm. 9 (18%) patients were admitted with the complication of sac rupture and 2 (4%) patients sac ruptured after admission. Only one patient (2%) had a cerebrospinal fluid leak postoperatively that was repaired primarily without patch graft or dura seal while 4 (8%) developed hydrocephalus after repair of the sac which was treated with placement of ventriculoperitoneal shunt. One (2%) patient did not recover from anesthesia and expired. Conclusion: Encephalocele is commonly seen in the practice of

  10. Delayed recovery of adipsic diabetes insipidus (ADI) caused by elective clipping of anterior communicating artery and left middle cerebral artery aneurysms.

    Science.gov (United States)

    Tan, Jeffrey; Ndoro, Samuel; Okafo, Uchenna; Garrahy, Aoife; Agha, Amar; Rawluk, Danny

    2016-12-16

    Adipsic diabetes insipidus (ADI) is an extremely rare complication following microsurgical clipping of anterior communicating artery aneurysm (ACoA) and left middle cerebral artery (MCA) aneurysm. It poses a significant challenge to manage due to an absent thirst response and the co-existence of cognitive impairment in our patient. Recovery from adipsic DI has hitherto been reported only once. A 52-year-old man with previous history of clipping of left posterior communicating artery aneurysm 20 years prior underwent microsurgical clipping of ACoA and left MCA aneurysms without any intraoperative complications. Shortly after surgery, he developed clear features of ADI with adipsic severe hypernatraemia and hypotonic polyuria, which was associated with cognitive impairment that was confirmed with biochemical investigations and cognitive assessments. He was treated with DDAVP along with a strict intake of oral fluids at scheduled times to maintain eunatremia. Repeat assessment at six months showed recovery of thirst and a normal water deprivation test. Management of ADI with cognitive impairment is complex and requires a multidisciplinary approach. Recovery from ADI is very rare, and this is only the second report of recovery in this particular clinical setting.

  11. How does occipitalization influence the dimensions of the cranium?

    DEFF Research Database (Denmark)

    Caspersen, L M; Kjaer, I; Sonnesen, L

    2010-01-01

    To describe occipitalization on human dry skulls and to compare craniofacial morphology including the posterior cranial fossa in skulls with occipitalization and in skulls without occipitalization and with normal craniofacial morphology (controls).......To describe occipitalization on human dry skulls and to compare craniofacial morphology including the posterior cranial fossa in skulls with occipitalization and in skulls without occipitalization and with normal craniofacial morphology (controls)....

  12. Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

    Science.gov (United States)

    Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

    2016-01-01

    Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the

  13. A simplified CT-guided approach for greater occipital nerve infiltration in the management of occipital neuralgia.

    Science.gov (United States)

    Kastler, Adrian; Onana, Yannick; Comte, Alexandre; Attyé, Arnaud; Lajoie, Jean-Louis; Kastler, Bruno

    2015-08-01

    To evaluate the efficacy of a simplified CT-guided greater occipital nerve (GON) infiltration approach in the management of occipital neuralgia (ON). Local IRB approval was obtained and written informed consent was waived. Thirty three patients suffering from severe refractory ON who underwent a total of 37 CT-guided GON infiltrations were included between 2012 and 2014. GON infiltration was performed at the first bend of the GON, between the inferior obliqus capitis and semispinalis capitis muscles with local anaesthetics and cortivazol. Pain was evaluated via VAS scores. Clinical success was defined by pain relief greater than or equal to 50 % lasting for at least 3 months. The pre-procedure mean pain score was 8/10. Patients suffered from left GON neuralgia in 13 cases, right GON neuralgia in 16 cases and bilateral GON neuralgia in 4 cases. The clinical success rate was 86 %. In case of clinical success, the mean pain relief duration following the procedure was 9.16 months. Simplified CT-guided infiltration appears to be effective in managing refractory ON. With this technique, infiltration of the GON appears to be faster, technically easier and, therefore, safer compared with other previously described techniques. • Occipital neuralgia is a very painful and debilitating condition • GON infiltrations have been successful in the treatment of occipital neuralgia • This simplified technique presents a high efficacy rate with long-lasting pain relief • This infiltration technique does not require contrast media injection for pre-planning • GON infiltration at the first bend appears easier and safer.

  14. Occipital cortex of blind individuals is functionally coupled with executive control areas of frontal cortex.

    Science.gov (United States)

    Deen, Ben; Saxe, Rebecca; Bedny, Marina

    2015-08-01

    In congenital blindness, the occipital cortex responds to a range of nonvisual inputs, including tactile, auditory, and linguistic stimuli. Are these changes in functional responses to stimuli accompanied by altered interactions with nonvisual functional networks? To answer this question, we introduce a data-driven method that searches across cortex for functional connectivity differences across groups. Replicating prior work, we find increased fronto-occipital functional connectivity in congenitally blind relative to blindfolded sighted participants. We demonstrate that this heightened connectivity extends over most of occipital cortex but is specific to a subset of regions in the inferior, dorsal, and medial frontal lobe. To assess the functional profile of these frontal areas, we used an n-back working memory task and a sentence comprehension task. We find that, among prefrontal areas with overconnectivity to occipital cortex, one left inferior frontal region responds to language over music. By contrast, the majority of these regions responded to working memory load but not language. These results suggest that in blindness occipital cortex interacts more with working memory systems and raise new questions about the function and mechanism of occipital plasticity.

  15. prenatal ultrasound diagnosis of discordant occipital encephalocele

    African Journals Online (AJOL)

    drclement

    PRENATAL ULTRASOUND DIAGNOSIS OF DISCORDANT OCCIPITAL. ENCEPHALOCELE IN MULTIPLE PREGNANCY - A CASE REPORT. *O.U Ogbeide (MBBS, FMCR), *EJ IKUBOR (MBBS). *Department of Radiology University of Benin Teaching Hospital, Benin-City, Nigeria. Correspondence: Dr Ogbeide Osesogie ...

  16. Right Occipital Cortex Activation Correlates with Superior Odor Processing Performance in the Early Blind

    Science.gov (United States)

    Grandin, Cécile B.; Dricot, Laurence; Plaza, Paula; Lerens, Elodie; Rombaux, Philippe; De Volder, Anne G.

    2013-01-01

    Using functional magnetic resonance imaging (fMRI) in ten early blind humans, we found robust occipital activation during two odor-processing tasks (discrimination or categorization of fruit and flower odors), as well as during control auditory-verbal conditions (discrimination or categorization of fruit and flower names). We also found evidence for reorganization and specialization of the ventral part of the occipital cortex, with dissociation according to stimulus modality: the right fusiform gyrus was most activated during olfactory conditions while part of the left ventral lateral occipital complex showed a preference for auditory-verbal processing. Only little occipital activation was found in sighted subjects, but the same right-olfactory/left-auditory-verbal hemispheric lateralization was found overall in their brain. This difference between the groups was mirrored by superior performance of the blind in various odor-processing tasks. Moreover, the level of right fusiform gyrus activation during the olfactory conditions was highly correlated with individual scores in a variety of odor recognition tests, indicating that the additional occipital activation may play a functional role in odor processing. PMID:23967263

  17. Association of clearance of middle- and large-molecular-weight substance with arterial stiffness and left ventricular mass in children receiving renal replacement therapy.

    Science.gov (United States)

    Özdemir, Kadriye; Yilmaz, Ebru; Dincel, Nida; Bozabali, Sibel; Apaydin, Sukriye; Gun, Zubeyr H; Sozeri, Betul; Mir, Sevgi

    2017-12-01

    The prominent cause of mortality in children receiving dialysis treatment is cardiovascular diseases. Risk factors related to chronic renal disease, are effective in the development of cardiovascular diseases. The aim of study was to investigate cardiovascular system (CVS) involvement for functional and structural alterations in children receiving dialysis, and display any association between cardiovascular morbidity and uremic toxins. 20 dialysis patients and 20 healthy controls were included to the study. Clearance of small, middle and large molecular-weight uremic toxins was evaluated in blood samples collected 30 minutes before (D0) and 2 hour after dialysis (D2), and change value was calculated as D0-D2/D0. Cardiovascular involvement was determined by comparing arterial stiffness, carotid intima-media thickness (CIMT) and Left Ventricular Mass Index (LVMI) with the control group. Four patients receiving hemodialysis and two patients in continuous ambulatory peritoneal dialysis (CAPD) group who have significant differences in all functional and structural parameters were detected. Four dialysis patients with detected cardiovascular disease have distinctively lower beta-2 microglobulin and homocysteine clearances compared to the patients with no CVS involvement. The clearance of middle and large molecular-weight substances should be closely monitored in children receiving dialysis.

  18. Decreased left middle temporal gyrus volume in antipsychotic drug-naive, first-episode schizophrenia patients and their healthy unaffected siblings.

    Science.gov (United States)

    Hu, Maorong; Li, Jun; Eyler, Lisa; Guo, Xiaofeng; Wei, Qingling; Tang, Jingsong; Liu, Feng; He, Zhong; Li, Lihua; Jin, Hua; Liu, Zhening; Wang, Juan; Liu, Fang; Chen, Huafu; Zhao, Jingping

    2013-03-01

    The shared neuropathological characteristics of patients with schizophrenia and their siblings might represent intermediate phenotypes that could be used to investigate genetic susceptibility to the illness. We sought to discover gray matter volume differences in patients with schizophrenia and their unaffected siblings with voxel-based morphometry (VBM). We recruited antipsychotic drug-naive, first-episode schizophrenia (FES) patients, their unaffected siblings and age-, sex- and handedness-matched healthy controls. We used VBM to investigate differences in gray matter volume among the 3 groups. There were significant gray matter volumetric differences among the 3 groups in bilateral hippocampal and parahippocampal gyri, bilateral middle temporal gyri, and superior temporal gyri (FDR ptemporal gyrus, and volume of this region was not different between siblings and patients. Our findings confirm and extend previous VBM analyses in schizophrenia and it indicate that schizophrenia may be characterized by an abnormal development of cerebral lateralization. Furthermore, these data argue that patients and their unaffected siblings might share decreases in the gray matter volume of the left middle temporal gyrus, and this regional reduction might be a potential endophenotype for schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults).

    Science.gov (United States)

    Kishi, Satoru; Armstrong, Anderson C; Gidding, Samuel S; Colangelo, Laura A; Venkatesh, Bharath A; Jacobs, David R; Carr, J Jeffery; Terry, James G; Liu, Kiang; Goff, David C; Lima, João A C

    2014-10-01

    The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year change to left ventricular (LV) structure and function. Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low: obesity from young adulthood to middle age is associated with impaired LV systolic and diastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age 43 to 55 years. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Nocturnal Intermittent Hypoxia Is Associated With Left Ventricular Hypertrophy in Middle-Aged Men With Hypertension and Obstructive Sleep Apnea.

    Science.gov (United States)

    Yamaguchi, Tasuku; Takata, Yoshifumi; Usui, Yasuhiro; Asanuma, Ryoko; Nishihata, Yosuke; Kato, Kota; Shiina, Kazuki; Yamashina, Akira

    2016-03-01

    Obstructive sleep apnea (OSA) and left ventricular (LV) hypertrophy are considered to be closely associated. However, the relationship has not yet been fully demonstrated and is hence still controversial. The purpose of this study was to assess in hypertensive male patients the relationship between OSA and cardiac structure using a new index, namely, integrated area of desaturation (IAD), in addition to the apnea-hypopnea index (AHI) that is currently the most frequently used index of sleep-disordered breathing. In our cross-sectional study, 223 hypertensive men younger than 65 years with sleep apnea and normal cardiac function were enrolled. All subjects were evaluated by fully attended polysomnography. Cardiac structure and function were evaluated by echocardiography. LV mass index significantly correlated with IAD (r = 0.203, P intermittent hypoxia defined by IAD may be associated with LV hypertrophy in men with well-controlled hypertension and obstructive sleep apnea. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Using inquiry-based instruction to meet the standards of No Child Left Behind for middle school earth science

    Science.gov (United States)

    Harris, Michael W.

    This study examined the effectiveness of a specific instructional strategy employed to improve performance on the end-of-the-year Criterion-Referenced Competency Test (CRCT) as mandated by the No Child Left Behind (NCLB) Act of 2001. A growing body of evidence suggests that the perceived pressure to produce adequate aggregated scores on the CRCT causes teachers to neglect other relevant aspects of teaching and attend less to individualized instruction. Rooted in constructivist theory, inquiry-based programs provide a o developmental plan of instruction that affords the opportunity for each student to understand their academic needs and strengths. However, the utility of inquiry-based instruction is largely unknown due to the lack of evaluation studies. To address this problem, this quantitative evaluation measured the impact of the Audet and Jordan inquiry-based instructional model on CRCT test scores of 102 students in a sixth-grade science classroom in one north Georgia school. A series of binomial tests of proportions tested differences between CRCT scores of the program participants and those of a matched control sample selected from other district schools that did not adopt the program. The study found no significant differences on CRCT test scores between the treatment and control groups. The study also found no significant performance differences among genders in the sample using inquiry instruction. This implies that the utility of inquiry education might exist outside the domain of test scores. This study can contribute to social change by informing a reevaluation of the instructional strategies that ideally will serve NCLB high-stakes assessment mandates, while also affording students the individual-level skills needed to become productive members of society.

  2. Benign occipital unicameral bone cyst causing lower cranial nerve palsies complicated by iophendylate arachnoiditis

    Science.gov (United States)

    Bradley, W. G.; Kalbag, R. M.; Ramani, P. S.; Tomlinson, B. E.

    1974-01-01

    A 20 year old girl presented with a history of neck and occipital pain for six weeks, which was found to be due to a unicameral bone cyst of the left occipital condylar region. The differential diagnosis of bone cysts in the skull is discussed. Six months after the operation, the patient again presented with backache due to adhesive arachnoiditis. The latter was believed to have arisen as a result of a combination of spinal infective meningitis and intrathecal ethyl iodophenyl undecylate (iophendylate, Myodil, Pantopaque). The nature of meningeal reactions to iophendylate and the part played by intrathecal corticosteroids in relieving the arachnoiditis in the present case are discussed. Images

  3. Occipital Nerve Stimulation for the Treatment of Refractory Occipital Neuralgia: A Case Series.

    Science.gov (United States)

    Keifer, Orion P; Diaz, Ashley; Campbell, Melissa; Bezchlibnyk, Yarema B; Boulis, Nicholas M

    2017-09-01

    Occipital neuralgia is a chronic pain syndrome characterized by sharp, shooting pains in the distribution of the occipital nerves. Although relatively rare, it associated with extremely debilitating symptoms that drastically affect a patient's quality of life. Furthermore, it is extremely difficult to treat as the symptoms are refractory to traditional treatments, including pharmacologic and procedural interventions. A few previous case studies have established the use of a neurostimulation of the occipital nerves to treat occipital neuralgia. The following expands on that literature by retrospectively reviewing the results of occipital nerve stimulation in a relatively large patient cohort (29 patients). A retrospective review of 29 patients undergoing occipital nerve stimulation for occipital neuralgia from 2012 to 2017 at a single institution with a single neurosurgeon. Of those 29 patients, 5 were repair or replacement of previous systems, 4 did not have benefit from trial stimulation, and 20 saw benefit to their trial stage of stimulation and went on to full implantation. Of those 20 patients, even with a history of failed procedures and pharmacological therapies, there was an overall success rate of 85%. The average preoperative 10-point pain score dropped from 7.4 ± 1.7 to a postoperative score of 2.9 ± 1.7. However, as with any peripheral nerve stimulation procedure, there were complications (4 patients), including infection, hardware erosion, loss of effect, and lead migration, which required revision or system removal. Despite complications, the results suggest, overall, that occipital nerve stimulation is a safe and effective procedure for refractory occipital neuralgia and should be in the neurosurgical repertoire for occipital neuralgia treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Ultrasound-Guided Greater Occipital Nerve Blocks and Pulsed Radiofrequency Ablation for Diagnosis and Treatment of Occipital Neuralgia

    OpenAIRE

    VanderHoek, Matthew David; Hoang, Hieu T; Goff, Brandon

    2013-01-01

    Occipital neuralgia is a condition manifested by chronic occipital headaches and is thought to be caused by irritation or trauma to the greater occipital nerve (GON). Treatment for occipital neuralgia includes medications, nerve blocks, and pulsed radiofrequency ablation (PRFA). Landmark-guided GON blocks are the mainstay in both the diagnosis and treatment of occipital neuralgia. Ultrasound is being utilized more and more in the chronic pain clinic to guide needle advancement when performing...

  5. The Effects of No Child Left Behind on the Prevalence of Evidence-Based Drug Prevention Curricula in the Nation’s Middle Schools*

    Science.gov (United States)

    Ringwalt, Chris; Hanley, Sean; Ennett, Susan T.; Vincus, Amy A.; Bowling, J. Michael; Haws, Susan W.; Rohrbach, Louise A.

    2014-01-01

    BACKGROUND Concerns have been expressed that No Child Left Behind (NCLB) may be reducing the amount of classroom time devoted to subjects other than those for which students are tested. The purpose of this article is to explore whether NCLB legislation has affected the provision of evidence-based drug prevention curricula (EBC) in the nation’s middle schools, a subject area that is not assessed by standardized tests. METHODS Data were collected in spring 2005 and spring 2008 from a nationally representative sample of middle schools. Respondents completed a survey regarding their provision of EBC (2005 response rate: 78.1%). We also collected data on schools’ adequate yearly progress (AYP) status as of 2005 as a measure of their compliance with NCLB targets. We restricted our sample to schools that responded to our survey in both waves (n = 1324, or 76.9% of those schools responding in 2005) and conducted logistic regression analyses to determine whether those schools not making AYP in 2005 were less likely to be using an EBC in 2008. RESULTS Our results revealed no relationship between AYP status in 2005 and EBC use in 2008. Analyses of demographic characteristics showed that schools making AYP were more likely to be small and rural, and to serve majority White student populations whose families were characterized by lower levels of poverty. CONCLUSIONS Our failure to find any relationship between AYP status and the provision of EBC suggests that concerns about the potential adverse effects of NCLB on drug use prevention have yet to be validated. Implications of our results are discussed. PMID:21517866

  6. Pure alexia after right temporo-occipital hemorrhage in a right-handed female

    Directory of Open Access Journals (Sweden)

    Buse Rahime Hasırcı

    2016-12-01

    Full Text Available Alexia without agraphia is a rare clinical disorder which is characterized by impairment of reading in spite of protection of writing ability. It usually results from infarction within the vascular territory of the posterior cerebral artery. The lesions of left occipital lobe or splenium of corpus callosum can cause alexia without agraphia by the deterioration of connection between the right occipital lobe and left parietal lobe. We describe the case of a 70-year-old right-handed woman who was presented with moderate headache and blurred vision and affected by alexia without agraphia and aphasia. Our case indicates that pure alexia may arise as a consequence of damage to the right hemisphere in right-handed patients and may lead to a severe reading disorder, as in individuals with left-hemisphere dominance for language.

  7. Association Between Sedentary Lifestyle and Diastolic Dysfunction Among Outpatients With Normal Left Ventricular Systolic Function Presenting to a Tertiary Referral Center in the Middle East.

    Science.gov (United States)

    Matta, Stephanie; Chammas, Elie; Alraies, Chadi; Abchee, Antoine; AlJaroudi, Wael

    2016-05-01

    Sedentary lifestyle has become prevalent in our community. Recent data showed controversy on the effect of regular exercise on left ventricular compliance and myocardial relaxation. We sought to assess whether physical inactivity is an independent predictor of diastolic dysfunction in or community, after adjustment for several covariates. Consecutive outpatients presenting to the echocardiography laboratory between July 2013 and June 2014 were prospectively enrolled. Clinical variables were collected prospectively at enrollment. Patients were considered physically active if they exercised regularly ≥3× a week, ≥30 minutes each time. The primary endpoint was presence of diastolic dysfunction. The final cohort included 1356 patients (mean age [SD] 52.9 [17.4] years, 51.3% female). Compared with physically active patients, the 1009 (74.4%) physically inactive patients were older, more often female, and had more comorbidities and worse diastolic function (51.3% vs 38.3%; P < 0.001). On univariate analysis, physical inactivity was associated with 70% increased odds of having diastolic dysfunction (odds ratio: 1.70, 95% confidence interval: 1.32-2.18, P < 0.001). There was significant interaction between physical activity and left ventricular mass index (LVMI; P = 0.026). On multivariate analysis, patients who were physically inactive and had LVMI ≥ median had significantly higher odds of having diastolic dysfunction (odds ratio: 2.82, 95% confidence interval: 1.58-5.05, P < 0.001). In a large, prospectively enrolled cohort from a single tertiary center in the Middle East, physically inactive patients with increased LVMI had 2- to 3-fold increased odds of having diastolic dysfunction after multivariate adjustment. © 2016 Wiley Periodicals, Inc.

  8. Riluzole Effect on Occipital Cortex: A Structural and Spectroscopy Pilot Study

    Science.gov (United States)

    Abdallah, Chadi G.; Coplan, Jeremy D.; Jackowski, Andrea; Sato, João R.; Mao, Xiangling; Shungu, Dikoma C.; Mathew, Sanjay J.

    2012-01-01

    Background To investigate the mechanism underlying the anxiolytic properties of riluzole, a glutamate-modulating agent, we previously studied the effect of this drug on hippocampal N-Acetylaspartate (NAA) and volume in patients with Generalized Anxiety Disorder (GAD). In the same cohort, we now extend our investigation to the occipital cortex, a brain region that was recently implicated in the antidepressant effect of riluzole. Methods Fourteen medication-free adult patients with GAD received 8-week of open-label riluzole. Ten healthy subjects served as a comparison group. The healthy group did not receive riluzole treatment. Both groups underwent magnetic resonance imaging and spectroscopy at baseline and at the end of Week 8. Hamilton Anxiety Rating Scale (HAM-A) and Penn State Worry Questionnaire (PSWQ) were used as the primary and secondary outcome measures, respectively. Results At baseline, we found clusters of increased cortical thickness in the occipital region in GAD compared to healthy subjects. In the right hemisphere, eight weeks of treatment reduced occipital cortical thickness in the GAD group (t = 3.67, p = 0.004). In addition, the improvement in HAM-A scores was negatively correlated with post-treatment right occipital NAA (r = − 0.68, p = 0.008), and with changes in NAA levels (r = − 0.53, p = 0.051). In the left hemisphere, we found positive associations between changes in occipital cortical thickness and improvement in HAM-A (r = 0.60, p = 0.04) and PSWQ (r = 0.62, p = 0.03). Conclusion These pilot findings implicate the occipital cortex as a brain region associated with pathology and clinical improvement in GAD. In addition, the region specific effect of riluzole implies a distinct pathophysiology in the occipital cortex – compared to other, previously studied, frontolimbic brain structures. PMID:23043888

  9. Primary Occipital Encephalocele in an Elderly Patient.

    Science.gov (United States)

    Barros, Fernanda Carvalho; Barros, Henrique Almeida; Júnior, Helvécio Marangon; Taitson, Paulo Franco

    2016-05-01

    The encephalocele is a condition characterized by the protrusion of the intracranial contents through a bone defect of the skull. The authors report a clinical case of an 80-year-old woman with primary occipital encephalocele on the right side and that was affected by trauma and presented liquor fistula and infection. Tomographic sections were obtained by injection intravenous of contrast. The images showed bone thickness thinning on the right occipital region and solution of continuity (encephalocele) with regular contours, reduction in brain volume, and hypodensity of the periventricular white substance were observed. The patient was successfully operated.

  10. Headache Following Occipital Brain Lesion: A Case of Migraine Triggered by Occipital Spikes?

    Science.gov (United States)

    Vollono, Catello; Mariotti, Paolo; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazzucchi, Edoardo; Valentini, Piero; De Rose, Paola; Della Marca, Giacomo

    2015-10-01

    This study describes the case of an 8-year-old boy who developed a genuine migraine after the surgical excision, from the right occipital lobe, of brain abscesses due to selective infestation of the cerebrum by Entamoeba histolytica. After the surgical treatment, the boy presented daily headaches with typical migraine features, including right-side parieto-temporal pain, nausea, vomiting, and photophobia. Electroencephalography (EEG) showed epileptiform discharges in the right occipital lobe, although he never presented seizures. Clinical and neurophysiological observations were performed, including video-EEG and polygraphic recordings. EEG showed "interictal" epileptiform discharges in the right occipital lobe. A prolonged video-EEG recording performed before, during, and after an acute attack ruled out ictal or postictal migraine. In this boy, an occipital lesion caused occipital epileptiform EEG discharges without seizures, probably prevented by the treatment. We speculate that occipital spikes, in turn, could have caused a chronic headache with features of migraine without aura. Occipital epileptiform discharges, even in absence of seizures, may trigger a genuine migraine, probably by means of either the trigeminovascular or brainstem system. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  11. Occipital and occipital "plus" epilepsies: A study of involved epileptogenic networks through SEEG quantification.

    Science.gov (United States)

    Marchi, Angela; Bonini, Francesca; Lagarde, Stanislas; McGonigal, Aileen; Gavaret, Martine; Scavarda, Didier; Carron, Romain; Aubert, Sandrine; Villeneuve, Nathalie; Médina Villalon, Samuel; Bénar, Christian; Trebuchon, Agnes; Bartolomei, Fabrice

    2016-09-01

    Compared with temporal or frontal lobe epilepsies, the occipital lobe epilepsies (OLE) remain poorly characterized. In this study, we aimed at classifying the ictal networks involving OLE and investigated clinical features of the OLE network subtypes. We studied 194 seizures from 29 consecutive patients presenting with OLE and investigated by stereoelectroencephalography (SEEG). Epileptogenicity of occipital and extraoccipital regions was quantified according to the 'epileptogenicity index' (EI) method. We found that 79% of patients showed widespread epileptogenic zone organization, involving parietal or temporal regions in addition to the occipital lobe. Two main groups of epileptogenic zone organization within occipital lobe seizures were identified: a pure occipital group and an occipital "plus" group, the latter including two further subgroups, occipitotemporal and occipitoparietal. In 29% of patients, the epileptogenic zone was found to have a bilateral organization. The most epileptogenic structure was the fusiform gyrus (mean EI: 0.53). Surgery was proposed in 18/29 patients, leading to seizure freedom in 55% (Engel Class I). Results suggest that, in patient candidates for surgery, the majority of cases are characterized by complex organization of the EZ, corresponding to the occipital plus group. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Assessment of arcuate fasciculus with diffusion-tensor tractography may predict the prognosis of aphasia in patients with left middle cerebral artery infarcts

    International Nuclear Information System (INIS)

    Hosomi, Akiko; Nagakane, Yoshinari; Kuriyama, Nagato; Mizuno, Toshiki; Nakagawa, Masanori; Yamada, Kei; Nishimura, Tsunehiko

    2009-01-01

    It is often clinically difficult to assess the severity of aphasia in the earliest stage of cerebral infarction. A method enabling objective assessment of verbal function is needed for this purpose. We examined whether diffusion tensor (DT) tractography is of clinical value in assessing aphasia. Thirteen right-handed patients with left middle cerebral artery infarcts who were scanned within 2 days after stroke onset were enrolled in this study. Magnetic resonance data of ten control subjects were also examined by DT tractography. Based on the severity of aphasia at discharge, patients were divided into two groups: six patients in the aphasic group and seven in the nonaphasic group. Fractional anisotropy (FA) and number of arcuate fasciculus fibers were evaluated. Asymmetry index was calculated for both FA and number of fibers. FA values for the arcuate fasciculus fibers did not differ between hemispheres in either the patient groups or the controls. Number of arcuate fasciculus fibers exhibited a significant leftward asymmetry in the controls and the nonaphasic group but not in the aphasic group. Asymmetry index of number of fibers was significantly lower (rightward) in the aphasic group than in the nonaphasic (P = 0.015) and control (P = 0.005) groups. Loss of leftward asymmetry in number of AF fibers predicted aphasia at discharge with a sensitivity of 0.83 and specificity of 0.86. Asymmetry of arcuate fasciculus fibers by DT tractography may deserve to be assessed in acute infarction for predicting the fate of vascular aphasia. (orig.)

  13. Context-dependent lexical ambiguity resolution: MEG evidence for the time-course of activity in left inferior frontal gyrus and posterior middle temporal gyrus.

    Science.gov (United States)

    Mollo, Giovanna; Jefferies, Elizabeth; Cornelissen, Piers; Gennari, Silvia P

    An MEG study investigated the role of context in semantic interpretation by examining the comprehension of ambiguous words in contexts leading to different interpretations. We compared high-ambiguity words in minimally different contexts (to bowl, the bowl) to low-ambiguity counterparts (the tray, to flog). Whole brain beamforming revealed the engagement of left inferior frontal gyrus (LIFG) and posterior middle temporal gyrus (LPMTG). Points of interest analyses showed that both these sites showed a stronger response to verb-contexts by 200 ms post-stimulus and displayed overlapping ambiguity effects that were sustained from 300 ms onwards. The effect of context was stronger for high-ambiguity words than for low-ambiguity words at several different time points, including within the first 100 ms post-stimulus. Unlike LIFG, LPMTG also showed stronger responses to verb than noun contexts in low-ambiguity trials. We argue that different functional roles previously attributed to LIFG and LPMTG are in fact played out at different periods during processing. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  14. Assessment of arcuate fasciculus with diffusion-tensor tractography may predict the prognosis of aphasia in patients with left middle cerebral artery infarcts

    Energy Technology Data Exchange (ETDEWEB)

    Hosomi, Akiko; Nagakane, Yoshinari; Kuriyama, Nagato; Mizuno, Toshiki; Nakagawa, Masanori [Kyoto Prefectural University of Medicine, Department of Neurology, Graduate School of Medical Science, Kyoto (Japan); Yamada, Kei; Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2009-09-15

    It is often clinically difficult to assess the severity of aphasia in the earliest stage of cerebral infarction. A method enabling objective assessment of verbal function is needed for this purpose. We examined whether diffusion tensor (DT) tractography is of clinical value in assessing aphasia. Thirteen right-handed patients with left middle cerebral artery infarcts who were scanned within 2 days after stroke onset were enrolled in this study. Magnetic resonance data of ten control subjects were also examined by DT tractography. Based on the severity of aphasia at discharge, patients were divided into two groups: six patients in the aphasic group and seven in the nonaphasic group. Fractional anisotropy (FA) and number of arcuate fasciculus fibers were evaluated. Asymmetry index was calculated for both FA and number of fibers. FA values for the arcuate fasciculus fibers did not differ between hemispheres in either the patient groups or the controls. Number of arcuate fasciculus fibers exhibited a significant leftward asymmetry in the controls and the nonaphasic group but not in the aphasic group. Asymmetry index of number of fibers was significantly lower (rightward) in the aphasic group than in the nonaphasic (P = 0.015) and control (P = 0.005) groups. Loss of leftward asymmetry in number of AF fibers predicted aphasia at discharge with a sensitivity of 0.83 and specificity of 0.86. Asymmetry of arcuate fasciculus fibers by DT tractography may deserve to be assessed in acute infarction for predicting the fate of vascular aphasia. (orig.)

  15. TMS interferes with lexical-semantic retrieval in left inferior frontal gyrus and posterior middle temporal gyrus: Evidence from cyclical picture naming.

    Science.gov (United States)

    Krieger-Redwood, Katya; Jefferies, Elizabeth

    2014-11-01

    We used TMS to investigate the contribution of left inferior frontal gyrus (LIFG) and posterior middle temporal gyrus (pMTG) to lexical/semantic selection and retrieval processes using a cyclical naming paradigm. Participants named pictures that were presented repeatedly across six cycles, either in semantically related or unrelated sets. Previous research has suggested that selection demands are higher for related sets, especially after repetition, since participants experience competition from the activation of semantic neighbours. In contrast, retrieval demands are greater for unrelated sets in the absence of semantic priming, particularly on the first cycle when the target names have not been previously activated. Therefore, this paradigm can reveal independent effects of (i) retrieval demands (i.e., the ease of accessing picture names from visual input) and (ii) selection/competition. We found that rTMS to LIFG and pMTG produced similar behavioural effects: stimulation of both sites disrupted picture naming performance on early cycles (when participants were less practised at producing the picture names) and for semantically-related sets (when there was the potential for increased competition and yet also facilitation from semantic neighbours). There were no effects of TMS when either retrieval or selection requirements were maximal on their own. The data therefore support the view that both LIFG and pMTG contribute to picture name retrieval, with both sites playing a critical role in mediating the semantic facilitation of naming when retrieval demands are high. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Gastaut type idiopathic childhood occipital epilepsy.

    Science.gov (United States)

    Ferrari-Marinho, Taissa; Macedo, Eugenia Fialho; Costa Neves, Rafael Scarpa; Costa, Lívia Vianez; Tudesco, Ivanda S S; Carvalho, Kelly C; Carrete, Henrique; Caboclo, Luis Otavio; Yacubian, Elza Marcia; Hamad, Ana Paula

    2013-03-01

    Gastaut type idiopathic childhood occipital epilepsy is an uncommon epileptic syndrome characterised by frequent seizures, most commonly presenting as elementary visual hallucinations or blindness. Other occipital (non-visual) symptoms may also occur. Interictal EEG typically shows occipital paroxysms, often with fixation-off sensitivity. Ictal EEG is usually characterised by interruption by paroxysms and sudden appearance of low-voltage, occipital, fast rhythm and/or spikes. Despite well described clinical and EEG patterns, to our knowledge, there are very few reports in the literature with video-EEG recording of either seizure semiology or fixation-off phenomena. We present a video-EEG recording of a 12-year-old girl with Gastaut type epilepsy, illustrating the interictal and ictal aspects of this syndrome. Our aim was to demonstrate the clinical and neurophysiological pattern of a typical seizure of Gastaut type epilepsy, as well as the fixation-off phenomena, in order to further clarify the typical presentation of this syndrome. [Published with video sequences].

  17. Prognostic factors in patients with occipital encephalocele.

    Science.gov (United States)

    Kiymaz, Nejmi; Yilmaz, Nebi; Demir, Ismail; Keskin, Siddik

    2010-01-01

    An encephalocele is a herniation of the brain and the meninges through a skull defect protruding towards the exterior. The condition is not rare when compared to spinal dysraphisms, but the worldwide incidence is not precisely known. The cases involving occipital encephaloceles which we have diagnosed in our clinic and the surgical approaches for this rare condition are presented herein. Thirty patients who were diagnosed with occipital encephaloceles and referred to our Neurosurgery Clinic at the Yuzuncu Yil University, Faculty of Medicine Research Hospital between 2000 and 2009 were enrolled in this study. The age of the patient, size of the sac, pathologies that accompanied the condition, and treatments applied were assessed. In the present study, 30 patients (22 girls and 8 boys), whose ages varied between newborn and 14 months, were evaluated. The encephalocele sac was located in the occipital region in 27 patients (90%) and in the occipitocervical region in 3 patients (3%). Nine (30%) of the 30 patients died; 2 in the preoperative period, 2 in the postoperative early period (0-7 days) and 5 in the late postoperative period (first week to 3 months). With the exception of the 2 patients who died preoperatively, surgery was performed on all of the patients. The mortality rate in our study was 29%. Our study demonstrated that factors which determine the prognosis of patients diagnosed with occipital encephaloceles include the size of the sac, the contents of the neural tissue, hydrocephaly, infections, and pathologies that accompany the condition. An occipital encephalocele is a congenital neurologic condition with an extremely high morbidity and mortality in spite of the treatments rendered pre- and postoperatively. Copyright 2010 S. Karger AG, Basel.

  18. Neuralgias of the Head: Occipital Neuralgia.

    Science.gov (United States)

    Choi, Il; Jeon, Sang Ryong

    2016-04-01

    Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up. There also remains a substantial group of intractable patients that do not benefit from local injections and conventional procedures. Moreover, treatment of occipital neuralgia is sometimes challenging. More invasive procedures, such as C2 gangliotomy, C2 ganglionectomy, C2 to C3 rhizotomy, C2 to C3 root decompression, neurectomy, and neurolysis with or without sectioning of the inferior oblique muscle, are now rarely performed for medically refractory patients. Recently, a few reports have described positive results following peripheral nerve stimulation of the greater or lesser occipital nerve. Although this procedure is less invasive, the significance of the results is hampered by the small sample size and the lack of long-term data. Clinicians should always remember that destructive procedures carry grave risks: once an anatomic structure is destroyed, it cannot be easily recovered, if at all, and with any destructive procedure there is always the risk of the development of painful neuroma or causalgia, conditions that may be even harder to control than the original complaint.

  19. Condroblastoma benigno do osso occipital: Relato do caso Benign chondroblastoma of the occipital bone: case report

    Directory of Open Access Journals (Sweden)

    João Flávio Mattos Araújo

    1995-12-01

    Full Text Available Condroblastoma benigno é tumor ósseo raro, tendo como origem células cartilagíneas. Classicamente este tumor acomete regiões epifisárias de ossos longos, sendo incomum o envolvimento de ossos do crânio, principalmente o osso occipital. Relatamos o caso de uma paciente com 16 anos de idade, com o diagnóstico de condroblastoma benigno do osso occipital e discutimos os principais aspectos deste tumor.Benign chondroblastoma is a rare bone tumor of immature cartilage cell derivation. This lesion classically occur at the ends of long bones in young persons. Chondroblastoma arising from the occipital bone is extremely rare. We report the case of a 16 year old girl with a benign condroblastoma in the occipital bone, and discuss the clinical, radiological and treatment aspects of this tumor.

  20. Occipital bone thickness: Implications on occipital-cervical fusion. A cadaveric study.

    Science.gov (United States)

    Zarghooni, Kourosh; Boese, Chrisoph K; Siewe, Jan; Röllinghoff, Marc; Eysel, Peer; Scheyerer, Max J

    2016-12-01

    The aim of this study was to create a map of the occipital bone using a cadaveric morphometric analysis. Twelve heads, from seven male and five female cadavers, were studied. The thickness of the occipital bone was measured with a digital vernier caliper within a coordinate system. The maximum thickness of the occipital bone could be measured at the external occipital protuberance (mean 15.4 mm; range 9-29.3 mm). All male individuals had higher bone thickness around this point. Further lateral a steady decrease of bone thickness could be observed. Same could be observed in craniocaudal direction. However, values above the superior nuchal line were on average thicker than below. The measurements demonstrated a great individual variability of bone thickness of the occipital bone. The results emphasize the role of preoperative planning for the feasibility of placement of an occipital screw. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  1. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

  2. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Nancy Mohamed El Sekily

    2014-08-19

    Aug 19, 2014 ... Abstract Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to ...

  3. More than blindsight: Case report of a child with extraordinary visual capacity following perinatal bilateral occipital lobe injury.

    Science.gov (United States)

    Mundinano, Inaki-Carril; Chen, Juan; de Souza, Mitchell; Sarossy, Marc G; Joanisse, Marc F; Goodale, Melvyn A; Bourne, James A

    2017-11-13

    Injury to the primary visual cortex (V1, striate cortex) and the geniculostriate pathway in adults results in cortical blindness, abolishing conscious visual perception. Early studies by Larry Weiskrantz and colleagues demonstrated that some patients with an occipital-lobe injury exhibited a degree of unconscious vision and visually-guided behaviour within the blind field. A more recent focus has been the observed phenomenon whereby early-life injury to V1 often results in the preservation of visual perception in both monkeys and humans. These findings initiated a concerted effort on multiple fronts, including nonhuman primate studies, to uncover the neural substrate/s of the spared conscious vision. In both adult and early-life cases of V1 injury, evidence suggests the involvement of the Middle Temporal area (MT) of the extrastriate visual cortex, which is an integral component area of the dorsal stream and is also associated with visually-guided behaviors. Because of the limited number of early-life V1 injury cases for humans, the outstanding question in the field is what secondary visual pathways are responsible for this extraordinary capacity? Here we report for the first time a case of a child (B.I.) who suffered a bilateral occipital-lobe injury in the first two weeks postnatally due to medium-chain acyl-Co-A dehydrogenase deficiency. At 6 years of age, B.I. underwent a battery of neurophysiological tests, as well as structural and diffusion MRI and ophthalmic examination at 7 years. Despite the extensive bilateral occipital cortical damage, B.I. has extensive conscious visual abilities, is not blind, and can use vision to navigate his environment. Furthermore, unlike blindsight patients, he can readily and consciously identify happy and neutral faces and colors, tasks associated with ventral stream processing. These findings suggest significant re-routing of visual information. To identify the putative visual pathway/s responsible for this ability, MRI

  4. The radiologic spectrum of occipital condyle fractures

    International Nuclear Information System (INIS)

    Hanson, J.A.; Deliganis, A.V.; Baxter, A.B.; Cohen, W.A.; Wilson, A.J.; Mann, F.A.

    2002-01-01

    Full text: Occipital condyle fractures (OCFs) are increasingly diagnosed in survivors of high energy blunt trauma, and may be associated with craniocervical junction disruption.We aimed to describe and classify the imaging appearances of occipital condyle fractures in a large series of trauma patients. We reviewed conventional radiographs, computed tomography (CT), and magnetic resonance (MR) imaging in 95 patients with 107 OCFs, who were treated at a level 1 trauma centre (1992-1999). We described fracture patterns according to two current classification systems (Anderson and Montesano, and Tuli), and correlated imaging appearances with clinical findings, neurosurgical management and patient outcome. Fracture morphology and craniocervical junction integrity were best assessed by 1-1.5mm collimation CT. Inferomedial occipital condyle avulsion fractures (Anderson and Montesano type III) were the commonest OCF category, comprising 80/107 (75%). Unilateral OCFs were found in 73/95 (77%) patients, 58 of whom were managed by cervical orthotic brace or collar. Bilateral OCFs or occipito-atlanto-axial joint injuries were seen in the remaining 22/95 (23%) patients. Occipitocervical fusion or craniocervical halo traction were required in 12 patients, all of whom had CT evidence of bilateral occipito-atlanto-axial joint disruption. Associated cervical spine injuries were present in 29/95 (31%) patients. Ten (10/95, 10.5%) patients died in hospital, and 30/95 (32%) showed continuing disability. The remaining 55/95 (57.5%) patients showed good outcome and functional independence at 1 month. Occipital condyle fractures are rare injuries with a wide range of morphology, stability and clinical significance. Thorough radiological evaluation of all components of the occipito-atlanto-axial joint complex must be performed in order to determine the full extent of injury. In this series, most unilateral OCFs were managed by non-operative immobilisation, whereas bilateral occipito

  5. Occipital pressure sores in two neonates.

    Science.gov (United States)

    Liu, Yi; Xiao, Bin; Zhang, Cheng; Su, Zhihong

    2015-01-01

    The preference for a specific head shape can be influenced by people's culture, religious beliefs and race. Modern Chinese people prefer a "talented" head shape, which is rounded and has a long profile. To obtain their preferred head shape, some parents try to change their neonates' sleeping position. Due to these forced sleeping positions, positional skull deformities, such as plagiocephaly, may be present during the first few months of life. In this article, we report two neonatal cases, of Hui nationality and Dongxiang nationality, with occipital pressure sores that were caused by using hard objects as pillows with the intention of obtaining a flattened occiput. The pressure sores were deep to the occipital bone and needed surgical management. These pressure sores caused wounds that were repaired by local skin flaps, after debridement, and the use of external constraints from a dense sponge-made head frame for approximately two weeks. One case recovered with primary healing after surgical operation. The other case suffered from a disruption of the sutured wound, and a secondary operation was performed to cover the wound. These occipital pressure sores are avoidable by providing guidance to the parents in ethnic minorities' area regarding the prevention, diagnosis and management of positional skull deformity.

  6. Bilateral optical nerve atrophy secondary to lateral occipital lobe infarction.

    Science.gov (United States)

    Mao, Junfeng; Wei, Shihui

    2013-06-01

    To report a phenomenon of optical nerve atrophy secondary to lateral occipital lobe infarction. Two successive patients with unilateral occipital lobe infarction who experienced bilateral optical nerve atrophy during the follow-up underwent cranial imaging, fundus photography, and campimetry. Each patient was diagnosed with occipital lobe infarction by cranial MRI. During the follow-up, a bilateral optic atrophy was revealed, and campimetry showed a right homonymous hemianopia of both eyes with concomitant macular division. Bilateral optic atrophy was related to occipital lobe infarction, and a possible explanation for the atrophy was transneuronal degeneration caused by occipital lobe infarction.

  7. Hypoplasia of the basi-occipital bone and persistance of the spheno-occipital synchondrosis in a patient with transitory supplementary fissure of the basi-occipital

    International Nuclear Information System (INIS)

    Wackenheim, A.

    1985-01-01

    The author had the opportunity to observe the progressive development of a special form of basilar impression characterized by transitory supplementary fissure of the basi-occipital bone, persistance of the spheno-occipital synchondrosis and hypoplasia of the basi-occipital. He proposes to dissociate the general concept of basilar impression and to consider anatomo-clinical entities such as the example described in this paper. (orig.)

  8. Occipital Headaches in Children: Are They a Red Flag?

    Science.gov (United States)

    Genizi, Jacob; Khourieh-Matar, Amal; Assaf, Nurit; Chistyakov, Irena; Srugo, Isaac

    2017-10-01

    Occipital headache is considered a risk factor for serious secondary headache pathology. The purpose of our study was to assess the etiology of occipital headaches among children visiting the emergency department. Subjects were children aged 5 to 18 years who were referred to the emergency department due to headaches during the years 2013 to 2014. A total of 314 patients with headaches were seen at our emergency department. Thirty-nine patients had occipital headaches. Viral infections were the most prevalent final diagnosis (97; 31%), followed by migraine (37; 11.8%). None of our patients had a brain tumor. There was no difference in final diagnosis between the occipital and nonoccipital groups. The most common causes of occipital headaches are viral infections and primary headaches. Serious intracranial disorders presenting solely as occipital headaches and not accompanied by other neurologic signs are uncommon. Thus, occipital headaches should be evaluated in the same manner as other headache locations.

  9. Ruptured Aneurysms of the Occipital Artery Associated with Congenital Occipital Bone Defect.

    Science.gov (United States)

    Kawasaki, Toshinari; Yoshida, Kazumichi; Kikuchi, Takayuki; Ishii, Akira; Takagi, Yasushi; Miyamoto, Susumu

    2017-01-01

    Traumatic aneurysms of the superficial temporal artery have been frequently reported in the literature, whereas traumatic aneurysms of the occipital artery (OA) are extremely rare. A 30-year-old man had been followed at another hospital for meningoencephalocele associated with his congenital occipital bone defect. He was admitted to our hospital with a chief complaint of neck swelling and pain during a football game. Computed tomography and magnetic resonance imaging showed a hematoma in his right neck along with the meningoencephalocele. In addition, it showed an atrophic cerebellum with a cyst protruding from his occipital bone defect. Digital subtraction angiography of the right OA showed 3 aneurysms responsible for the large hematoma in his neck. Endovascular embolization with 20% N-butyl-2-cyanoacrylate was performed for treatment of the ruptured aneurysms followed by emergent surgical evacuation of the hematoma. An occipital cranioplasty with titanium mesh was performed 10 months after the emergent intervention. In this patient, the congenital occipital bone defect with meningoencephalocele might have been the remote source of risk for traumatic pseudoaneurysms along the muscle branches of the OA. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. MRI study on the cortical thickness of occipital lobe in children with ametropic amblyopia

    International Nuclear Information System (INIS)

    Du Hanjian; Wang Jian; Li Chuan; Zhang Jiuquan; Chen Li; Liu Bo

    2008-01-01

    Objective: To study cortical thickness of the occipital lobe in children with ametropic amblyopia by using MRI technique and the FreeSurfer software. Methods: Nine children with ametropic amblyopia were included in the amblyopic group and 8 normal children were included in the control group. All the children underwent brain MRI on the Siemens Avanto 1.5 T scanner. For the cortical thickness analysis, 3-demensional MPRAGE images were collected and analyzed with FreeSurfer software package. Cortical thickness of related regions in the occipital lobe (including the cuneus, later occipital, lingual, and pericalcarine gyri) were recorded and compared. Results: The cortical thickness of the lingual, pericalcarine gyri on the left hemisphere and the cuneus, lateraloccipital, lingual gyri on the right hemisphere in amblyopic group were lower than the control group (P<0.05). Conclusion: Morphological changes existed in the occipital lobe in ametropic amblyopic children. The analysis technique with the FreeSurfer package has a potential value in the clinical application. (authors)

  11. Improvement of visual field defects after focal resection for occipital lobe epilepsy: case report.

    Science.gov (United States)

    Yamamoto, Takahiro; Hamasaki, Tadashi; Nakamura, Hideo; Yamada, Kazumichi

    2018-03-01

    Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion. Perimetry revealed left-sided incomplete hemianopia, and MRI showed an old contusion in the right occipital lobe. After evaluation with ictal video-electroencephalography, electrocorticography, and mapping of the visual cortex with subdural electrodes, the patient underwent resection of the scarred tissue, including the epileptic focus at the occipital lobe. After surgery, he became seizure free and his visual field defect improved gradually. In addition, postoperative 123 I-iomazenil (IMZ) SPECT showed partly normalized IMZ uptake in the visual cortex. This case is a practical example suggesting that neurological deficits attributable to the functional deficit zone can be remedied by successful focal resection.

  12. A Technique for Resecting Occipital Pole Gliomas Using a Keyhole Lobectomy.

    Science.gov (United States)

    Conner, Andrew K; Baker, Cordell M; Briggs, Robert G; Burks, Joshua D; Glenn, Chad A; Smitherman, Adam D; Morgan, Jake P; Pittman, Nathan A; Sughrue, Michael E

    2017-10-01

    Our purpose is to describe a method of resecting occipital pole gliomas through a keyhole lobectomy and share the patient outcomes of this technique. We performed a retrospective review of data obtained on all patients who underwent resection of occipital pole gliomas by the senior author between 2012 and 2016. We describe our technique for resecting these tumors using a keyhole lobectomy and share the patient outcomes of this operation. Eight patients were included in this study. Four patients (50%) had not received previous surgery. One patient (13%) was diagnosed with a World Health Organization grade II tumor, and 7 patients (88%) were diagnosed with glioblastoma. Two tumors (25%) were left sided and 6 (75%) right sided. The median size of resection was 28 cm 3 . The median extent of resection was 96%, and at least 90% of the tumor was resected in all cases. None of the patients experienced permanent postoperative complications. Temporary neurologic complications included 3 patients (38%) with encephalopathy and 1 patient (13%) with aphasia. There were no neurosurgical complications. Our study provides details on the technical aspects of occipital keyhole lobectomies and gives the outcomes of patients who have received an operation for tumors in this uncommon location. Taking white matter tract anatomy into consideration, we show that the keyhole method can be applied to gliomas of the occipital lobe. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. A RARE CASE OF ATYPICAL PRIMARY EWING’S SARCOMA OF OCCIPITAL BONE

    Directory of Open Access Journals (Sweden)

    K. Srihari

    2016-07-01

    Full Text Available BACKGROUND Ewing’s Sarcoma is an aggressive malignant neoplasm most frequently manifesting in the second decade of life and accounting for 4% of childhood and adolescent malignancies. These tumours were first described by James Ewing in 1921 as tumours that arise from bone. These osseous lesions have since become infamous for their highly aggressive course with 20% to 30% of patients having evidence of metastasis at the time of diagnosis and an estimated 10-year survival rate of 50%. Metastases to the CNS have most recently been estimated to occur in less than 5% of cases and are usually due to direct extension of an osseous lesion into the extradural space or more rarely through haematogenous spread. CASE REPORT In this article, we report a case of 17-year-old boy who presented to the radiology department with complaints of recurrent episodes of headache and vomiting for the past 3 days. On radiological investigation, there was a large well-defined, lobulated, extra-axial mass lesion measuring 3.6 X 5.7 X 5.9 cm noted in the supratentorial left occipital region which was fairly enhancing after contrast administration. The mass was causing permeative type of destruction of the left occipital bone and extending into extracranial soft tissue. Final diagnosis was done by biopsy and histopathology which showed “Atypical Ewing’s Sarcoma” of the left occipital bone. Considering its unusual site and soft tissue extension, we report this case of Primary Atypical Ewing’s sarcoma of occipital bone. CONCLUSION Primary cranial Ewing's sarcoma is to be considered in the differential diagnosis in children with a tumour involving the skull with destruction of the bone and presence of extra-axial soft tissue swelling. CT is the excellent modality for demonstration of bone destruction while MRI depicts soft tissue extension and metastasis if any.

  14. The prognosis of impaired left ventricular systolic function and heart failure in a middle-aged and elderly population in an urban population segment of Copenhagen

    DEFF Research Database (Denmark)

    Raymond, Ilan; Mehlsen, Jesper; Pedersen, Frants

    2004-01-01

    To determine the prognosis, total mortality and cardiac morbidity, of patients with left ventricular systolic dysfunction and heart failure (HF) in a general population sample.......To determine the prognosis, total mortality and cardiac morbidity, of patients with left ventricular systolic dysfunction and heart failure (HF) in a general population sample....

  15. Application of Normative Occipital Condyle-C1 Interval Measurements to Detect Atlanto-Occipital Injury in Children.

    Science.gov (United States)

    Corcoran, B; Linscott, L L; Leach, J L; Vadivelu, S

    2016-05-01

    Prior studies have found that widening or asymmetry of the occipital condyle-C1 interval on CT is a sensitive and specific marker for atlanto-occipital dislocation. Previously reported abnormal occipital condyle-C1 interval values are not age-specific, possibly leading to false-positive findings in younger children, in whom this joint space is normally larger than that in adults. This study assesses the utility of applying age-specific normative occipital condyle-C1 interval ranges to documented cases of atlanto-occipital injury compared with previously reported abnormal cutoff values. Retrospective review of CT and MR imaging of 14 subjects with atlanto-occipital injury was performed, and occipital condyle-C1 interval measurements were made for each subject. Sensitivities and specificities of proposed occipital condyle-C1 interval cutoffs of 2 and 3 SDs above the mean and previously published occipital condyle-C1 interval cutoffs for atlanto-occipital injury were then calculated on the basis of occipital condyle-C1 interval measurements for each subject. An occipital condyle-C1 interval 2 SDs above the age-specific mean has a sensitivity of 50% and specificity of 89%-100%, depending on the age group. An occipital condyle-C1 interval 3 SDs above the age-specific mean has a sensitivity of 50% and a specificity of 95%-100%. A 4.0-mm occipital condyle-C1 interval has a sensitivity of 36% and a specificity of 100% in all age groups. A 2.5-mm occipital condyle-C1 interval has a sensitivity of 93% and a specificity of 18%-100%. Occipital condyle-C1 interval widening cutoffs used to establish atlanto-occipital injury lack both sensitivity and specificity in children and young teenagers. MR imaging is necessary to establish a diagnosis of atlanto-occipital injury in children and young teenagers when the appropriate mechanism of injury is present. © 2016 by American Journal of Neuroradiology.

  16. Unilateral Eye Blinking Arising From the Ictal Ipsilateral Occipital Area.

    Science.gov (United States)

    Falsaperla, Raffaele; Perciavalle, Valentina; Pavone, Piero; Praticò, Andrea Domenico; Elia, Maurizio; Ruggieri, Martino; Caraballo, Roberto; Striano, Pasquale

    2016-07-01

    We report on an 18-month-old boy with unilateral left eye blinking as a single ictal manifestation without facial twitching. The clinical onset of this phenomenon was first recorded (as an occasional event) at age 3 months, and it was overlooked. By age 6 months, the child's blinking increased to almost daily occurrence in clusters: during blinking the infant showed intact awareness and occasional jerks in the upper limbs and right leg. A video-electroencephalography (video-EEG) documented clinical correlation with a focal pattern arising from the left occipital region, and brain magnetic resonance imaging (MRI) revealed severe brain damage, consisting in poroencephalic hollows and increased spaces in the convexities involving a large area of the left cerebral hemisphere. The boy was prescribed sodium valproate (30 mg/kg/d), resulting in drastic reduction of his clinical seizures. Follow-up to his current age documented good general status, with persistent partial right hemilateral seizures. The blinking progressively disappeared, and is no longer recorded. The pathogenic hypotheses of the unilateral ictal blinking include involvement of the ipsilateral cerebral hemisphere and/or the cerebellar pathways. Review of previous reports of unilateral eye blinking, arising from the ictal ipsilateral brain, revealed that different damaged regions may give rise to blinking ictal phenomena, likely via the trigeminal fibres innervating the subdural intracranial structures and the pial vessels in the ipsilateral affected brain. The eye blinking in the present child represents a further example of an ictal phenomenon, which is predictive of the damaged brain region. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  17. Reorganization of retinotopic maps after occipital lobe infarction.

    Science.gov (United States)

    Vaina, Lucia M; Soloviev, Sergei; Calabro, Finnegan J; Buonanno, Ferdinando; Passingham, Richard; Cowey, Alan

    2014-06-01

    We studied patient JS, who had a right occipital infarct that encroached on visual areas V1, V2v, and VP. When tested psychophysically, he was very impaired at detecting the direction of motion in random dot displays where a variable proportion of dots moving in one direction (signal) were embedded in masking motion noise (noise dots). The impairment on this motion coherence task was especially marked when the display was presented to the upper left (affected) visual quadrant, contralateral to his lesion. However, with extensive training, by 11 months his threshold fell to the level of healthy participants. Training on the motion coherence task generalized to another motion task, the motion discontinuity task, on which he had to detect the presence of an edge that was defined by the difference in the direction of the coherently moving dots (signal) within the display. He was much better at this task at 8 than 3 months, and this improvement was associated with an increase in the activation of the human MT complex (hMT(+)) and in the kinetic occipital region as shown by repeated fMRI scans. We also used fMRI to perform retinotopic mapping at 3, 8, and 11 months after the infarct. We quantified the retinotopy and areal shifts by measuring the distances between the center of mass of functionally defined areas, computed in spherical surface-based coordinates. The functionally defined retinotopic areas V1, V2v, V2d, and VP were initially smaller in the lesioned right hemisphere, but they increased in size between 3 and 11 months. This change was not found in the normal, left hemisphere of the patient or in either hemispheres of the healthy control participants. We were interested in whether practice on the motion coherence task promoted the changes in the retinotopic maps. We compared the results for patient JS with those from another patient (PF) who had a comparable lesion but had not been given such practice. We found similar changes in the maps in the lesioned

  18. True aneurysm of the proximal occipital artery: Case report

    Directory of Open Access Journals (Sweden)

    Giulio Illuminati

    Full Text Available Introduction: True aneurysms of the proximal occipital artery are rare, may cause neurological symptoms due to compression of the hypoglossal nerve and their resection may be technically demanding. Presentation of case: The case of an aneurysm of the proximal occipital artery causing discomfort and tongue deviation by compression on the hypoglossal nerve is reported. Postoperative course after resection was followed by complete regression of symptoms. Conclusion: Surgical resection, as standard treatment of aneurysms of the occipital artery, with the eventual technical adjunct of intubation by the nose is effective in durably relieving symptoms and preventing aneurysm-related complication. Keywords: Arterial aneurysm, Occipital artery, Case report

  19. Sex Prediction using Foramen Magnum and Occipital Condyles Computed Tomography Measurements in Sudanese Population

    Directory of Open Access Journals (Sweden)

    Usama Mohamed El-Barrany

    2016-12-01

    Full Text Available Sex determination is important in establishing the identity of an individual. The foramen magnum is an important landmark of the skull base. The present research aimed to study the value of foramen magnum measurements to determine sex using computed tomography (CT among Sudanese individuals. Foramen magnum CT scans of 400 Sudanese individuals (200 males and 200 females aged 18 - 83 years were included in this study. Foramen magnum (length and width, right occipital condyle (length and width, left occipital condyle (length and width, minimum intercondylar distance, maximum bicondylar distance and maximum medial intercondylar distance were measured. All data were subjected to discriminant functions analysis. All nine measurements were significantly higher in males than females. Among these measurements, the right condyle length, minimum intercondylar distance, and foramen magnum width were able to determine sex in Sudanese individuals with an accuracy rate of 83 %.

  20. Reduced frontal and occipital lobe asymmetry on the CT-scans of schizophrenic patients. Its specificity and clinical significance

    International Nuclear Information System (INIS)

    Falkai, P.; Schneider, T.; Greve, B.; Klieser, E.; Bogerts, B.

    1995-01-01

    Frontal and occipital lobe widths were determined in the computed tomographic (CT) scans of 135 schizophrenic patients, 158 neuro psychiatrically healthy and 102 psychiatric control subjects, including patients with affective psychosis, neurosis and schizoaffective psychosis. Most healthy right-handed subjects demonstrate a relative enlargement of the right frontal as well as left occipital lobe compared to the opposite hemisphere. These normal frontal and occipital lobe asymmetries were selectively reduced in schizophrenics (f.: 5%, p < .0005; o.: 3%, p < .05), irrespective of the pathophysiological subgroup. Schizophrenic neuroleptic non-responders revealed a significant reduction of frontal lobe asymmetry (3%, p < .05), while no correlation between BPRS-sub scores and disturbed cerebral laterality could be detected. In sum the present study demonstrates the disturbed cerebral lateralisation in schizophrenic patients supporting the hypothesis of interrupted early brain development in schizophrenia. (author)

  1. Occipital lobe seizures and subcortical T2 and T2* hypointensity associated with nonketotic hyperglycemia: a case report.

    Science.gov (United States)

    Sasaki, Fuyuko; Kawajiri, Sumihiro; Nakajima, Sho; Yamaguchi, Ai; Tomizawa, Yuji; Noda, Kazuyuki; Hattori, Nobutaka; Okuma, Yasuyuki

    2016-08-12

    Nonketotic hyperglycemia often causes seizures. Recently, seizures associated with nonketotic hyperglycemia have been found to be associated with subcortical T2 hypointensity on magnetic resonance imaging, especially in the occipital lobes. However, the mechanism remains unclear, although iron accumulation is suggested. We present a case of occipital lobe seizures associated with nonketotic hyperglycemia supporting the hypothesis that the mechanism of subcortical T2 hypointensity is iron accumulation using gradient-echo T2*-weighted magnetic resonance imaging. A 65-year-old Japanese man complained of intermittent pastel-colored flashing lights. On neurological examination, he also had lower right-side quadrant hemianopia. No other abnormal neurological findings were found. On laboratory analysis, his blood glucose level was 370 mg/dL, HbA1c was 11.4 %, and serum osmolarity was 326 mOsm/L. No ketones were detected in urine. A magnetic resonance imaging scan of his head showed subcortical T2 and T2* hypointensity in his left occipital lobe. Single-photon emission computed tomography with I123-N-isopropyl-iodoamphetamine revealed hyperperfusion in the left dominant occipital lobe. These magnetic resonance imaging abnormalities resolved during clinical recovery and treatment to control his blood sugar level. Therefore, a diagnosis of occipital lobe seizures associated with nonketotic hyperglycemia was made. To the best of our knowledge, this is the first case of occipital lobe seizures associated with nonketotic hyperglycemia supporting the role of iron accumulation as a mechanism for subcortical T2 hypointensity using T2*-magnetic resonance imaging.

  2. Remnants of occipital vertebrae: proatlas segmentation abnormalities.

    Science.gov (United States)

    Menezes, Arnold H; Fenoy, Kathleen A

    2009-05-01

    Developmental remnants around the foramen magnum, or proatlas segmentation abnormalities, have been recorded in postmortem studies but very rarely in a clinical setting. Because of their rarity, the pathological anatomy has been misunderstood, and treatment has been fraught with failures. The objectives of this prospective study were to understand the correlative anatomy, pathology, and embryology and to recognize the clinical presentation and gain insights on the treatment and management. Our craniovertebral junction (CVJ) database started in 1977 and comprises 5200 cases. This prospective study has retrieval capabilities. Neurodiagnostic studies changed with the evolution of imaging. Seventy-two patients were recognized as having symptomatic proatlas segmentation abnormalities. Ventral bony masses from the clivus or medial occipital condyle occurred in 66% (44/72), lateral or anterolateral compressive masses in 37% (27 of 72 patients), and dorsal bony compression in 17% (12 of 72 patients). Hindbrain herniation was associated in 33%. The age at presentation was 3 to 23 years. Motor symptoms occurred in 72% (52 of 72 patients); palsies in Cranial Nerves IX, X, and XII in 33% (24 of 72 patients); and vertebrobasilar symptoms in 25% (18 of 72 patients). Trauma precipitated symptoms in 55% (40 of 72 patients). The best definition of the abnormality was demonstrated by 3-dimensional computed tomography combined with magnetic resonance imaging. Treatment was aimed at decompression of the pathology and stabilization. Remnants of the occipital vertebrae around the foramen magnum were recognized in 72 of 5200 CVJ cases (7.2%). Magnetic resonance imaging with 3-dimensional computed tomography of the CVJ provides the best definition and understanding of the lesions. Brainstem myelopathy and lower cranial nerve deficits are common clinical presentations in the first and second decades of life. Treatment is aimed at decompression of the pathology and CVJ stabilization.

  3. Modality-specific involvement of occipital cortex in Early Blind?

    NARCIS (Netherlands)

    van der Lubbe, Robert Henricus Johannes; van Mierlo, C.M.; Postma, A.

    2008-01-01

    What happens in occipital cortex when neuronal activity is no longer evoked by regular visual stimulation? Studying brain activity induced by tactile and auditory stimuli in the blind may provide an answer. Several studies indicate that occipital cortex in the blind is recruited in simple tasks,

  4. Delayed Occipital Artery Pseudoaneurysm Following Blunt Force Trauma.

    Science.gov (United States)

    Changa, Abhinav R; Meleis, Ahmed M; Bassani, Luigi

    2016-05-01

    Occipital artery pseudoaneurysms are extremely rare pathologies that manifest after traumatic injury; only 11 cases have been reported in the literature. Because of their low incidence and vague symptoms, the initial diagnosis can be difficult. However, for correctly diagnosed occipital artery pseudoaneurysms, many successful treatment modalities exist. We review the pathology of occipital pseudoaneurysms, elucidate the reasons for their rarity, discuss effective diagnostic measures, and discuss the currently available treatment options. We also present a case of a 16-year-old boy who sustained blunt force trauma in May 2014 and presented 6 months later with a painful, pulsatile mass in the occipital region. The patient underwent surgical resection to alleviate the pain and the potential risk of hemorrhage. He experienced complete resolution of pain and associated symptoms. Our case highlights the fact that occipital swelling, a significant initial sign of pseudoaneurysm development, can be delayed. Therefore, occipital artery pseudoaneurysms cannot be ruled out of the differential diagnosis based on time course alone. Surgical resection is a quick and effective method for relief of severe pain resulting from occipital artery pseudoaneurysms. Although they are rare entities, occipital artery pseudoaneurysms must be considered in the differential diagnosis of cases of pulsatile mass lesions in the posterior scalp. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Explicit memory and implicit memory in occipital lobe stroke patients.

    Science.gov (United States)

    Gong, Liang; Wang, JiHua; Feng, Lei; Wang, MeiHong; Li, Xiu; Hu, JiaYun; Wang, Kai

    2015-03-01

    Occipital stroke patients mainly showed cortical blindness and unilateral vision loss; memory is generally reserved. Recent reports from neuroimaging show the occipital lobe may be involved in the processing of implicit memory (IM), especially the perception type of IM processing. In this study, we explored the explicit memory (EM) and IM damage in occipital lobe stroke patients. A total of 25 occipital strokes and 29 years of age, educational level equivalent healthy controls (HCs), evaluated by using immediate recall, delayed recall, recognition for EM tasks, picture identification, and category exemplar generation for IM tasks. There was no significant difference between occipital stroke patients and HCs in EM tasks and category exemplar generation task. In the picture identification task, occipital lobe stroke group score was poorer than HC group, the results were statistically significant, but in the pictures identify rate, occipital stroke patients and normal control group had no significant difference. The occipital stroke patients may have IM damage, primarily damage the perception type of IM priming effects, which was unrelated with their cortical blindness. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Epileptiform transients of the occipital lobe in pediatrics.

    Science.gov (United States)

    Campbell, Stefan

    2013-09-01

    Differentiating between benign occipital transients and epileptic discharges from the occipital lobes is imperative. Focal occipital spikes and sharp waves are not always associated with benign disorders. The occurrence of occipital spikes and spike and wave complexes depends on the child's age, the maturation of the occipital cortex, and the cortex's connection with other structures (Beaumanoir et al. 1993). Clinical manifestations also evolve as the patient ages. Seizure semiology is due to the maturation of the visual system and its connections. An infant from birth to twelve months of age could experience autonomic symptoms such as pallor and vomiting with possible minor motor movements. Visual symptoms and/or headaches are usually not noticed until between five and seven years of age. These visual phenomena can continue into adulthood.

  7. Peripheral neurostimulation for control of intractable occipital neuralgia.

    Science.gov (United States)

    Weiner, R L; Reed, K L

    1999-07-01

    Objective. To present a novel approach for treatment of intractable occipital neuralgia using percutaneous peripheral nerve electrostimulation techniques. Methods. Thirteen patients underwent 17 implant procedures for medically refractory occipital neuralgia. A subcutaneous electrode placed transversely at the level of C1 across the base of the occipital nerve trunk produced paresthesias and pain relief covering the regions of occipital nerve pain Results. With follow-up ranging from 1-½ to 6 years, 12 patients continue to report good to excellent response with greater than 50% pain control and requiring little or no additional medications. The 13th patient (first in the series) was subsequently explanted following symptom resolution. Conclusions. In patients with medically intractable occipital neuralgia, peripheral nerve electrostimulation subcutaneously at the level of C1 appears to be a reasonable alternative to more invasive surgical procedures following failure of more conservative therapies.

  8. The Effects of No Child Left Behind on the Prevalence of Evidence-Based Drug Prevention Curricula in the Nation's Middle Schools

    Science.gov (United States)

    Ringwalt, Chris; Hanley, Sean; Ennett, Susan T.; Vincus, Amy A.; Bowling, J. Michael; Haws, Susan W.; Rohrbach, Louise A.

    2011-01-01

    Background: Concerns have been expressed that No Child Left Behind (NCLB) may be reducing the amount of classroom time devoted to subjects other than those for which students are tested. The purpose of this article is to explore whether NCLB legislation has affected the provision of evidence-based drug prevention curricula (EBC) in the nation's…

  9. Activation of the left inferior frontal gyrus in the first 200 ms of reading: evidence from magnetoencephalography (MEG).

    Science.gov (United States)

    Cornelissen, Piers L; Kringelbach, Morten L; Ellis, Andrew W; Whitney, Carol; Holliday, Ian E; Hansen, Peter C

    2009-01-01

    It is well established that the left inferior frontal gyrus plays a key role in the cerebral cortical network that supports reading and visual word recognition. Less clear is when in time this contribution begins. We used magnetoencephalography (MEG), which has both good spatial and excellent temporal resolution, to address this question. MEG data were recorded during a passive viewing paradigm, chosen to emphasize the stimulus-driven component of the cortical response, in which right-handed participants were presented words, consonant strings, and unfamiliar faces to central vision. Time-frequency analyses showed a left-lateralized inferior frontal gyrus (pars opercularis) response to words between 100-250 ms in the beta frequency band that was significantly stronger than the response to consonant strings or faces. The left inferior frontal gyrus response to words peaked at approximately 130 ms. This response was significantly later in time than the left middle occipital gyrus, which peaked at approximately 115 ms, but not significantly different from the peak response in the left mid fusiform gyrus, which peaked at approximately 140 ms, at a location coincident with the fMRI-defined visual word form area (VWFA). Significant responses were also detected to words in other parts of the reading network, including the anterior middle temporal gyrus, the left posterior middle temporal gyrus, the angular and supramarginal gyri, and the left superior temporal gyrus. These findings suggest very early interactions between the vision and language domains during visual word recognition, with speech motor areas being activated at the same time as the orthographic word-form is being resolved within the fusiform gyrus. This challenges the conventional view of a temporally serial processing sequence for visual word recognition in which letter forms are initially decoded, interact with their phonological and semantic representations, and only then gain access to a speech code.

  10. 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

  11. Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage.

    Science.gov (United States)

    Tubbs, R Shane; Fries, Fabian N; Kulwin, Charles; Mortazavi, Martin M; Loukas, Marios; Cohen-Gadol, Aaron A

    2016-10-01

    Chronic postoperative neuralgias and headache following retrosigmoid craniotomy can be uncomfortable for the patient. We aimed to better elucidate the regional nerve anatomy in an effort to minimize this postoperative complication. Ten adult cadaveric heads (20 sides) were dissected to observe the relationship between the lesser occipital nerve and a traditional linear versus modified U incision during retrosigmoid craniotomy. Additionally, the relationship between these incisions and the occipital artery were observed. The lesser occipital nerve was found to have two types of course. Type I nerves (60%) remained close to the posterior border of the sternocleidomastoid muscle and some crossed anteriorly over the sternocleidomastoid muscle near the mastoid process. Type II nerves (40%) left the posterior border of the sternocleidomastoid muscle and swung medially (up to 4.5cm posterior to the posterior border of the sternocleidomastoid muscle) as they ascended over the occiput. The lesser occipital nerve was near a midpoint of a line between the external occipital protuberance and mastoid process in all specimens with the type II nerve configuration. Based on our findings, the inverted U incision would be less likely to injure the type II nerves but would necessarily cross over type I nerves, especially more cranially on the nerve at the apex of the incision. As the more traditional linear incision would most likely transect the type I nerves and more so near their trunk, the U incision may be the overall better choice in avoiding neural and occipital artery injury during retrosigmoid approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Morphometric analysis of hypoglossal canal of the occipital bone in Iranian dry skulls

    Directory of Open Access Journals (Sweden)

    Bayat Parvindokht

    2015-01-01

    Full Text Available Background: The hypoglossal canal (HC is in basal part of cranium that transmits the nerve that supplies the motor innervations to the muscles of tongue. Study on morphometry of (HC and its variations has been a considerable interest field to neurosurgeons and research workers especially because of their racial and regional. Material and Methods: In this retrospective study, 26 adult dry human crania of no sex known were studied for (HC and its variants. Thirty five skulls were observed for any damage of post cranial fossa and those in good condition (26 skullswere selected. Sliding Vernier caliper was used for morphometric analysis. Results: There were significant difference between distances of: a-(HC till anterior tip of condyles (right and left, b-(HC till posterior tip of condyles (right and left, c-(HCtill lower border of occipital condyles (right and left, d-(HC till external border of foramen jugular (right and left, e-(HC till opisthion(right and left, f-(HC till carotid canal (right and left, g-(HC till jugular tubercle (right and left. There wasn′t significant difference in other parameters. Conclusion: Detailed morphometric analysis of (HC will help in planning of surgical intervention of skull base in safer and easier ways.

  13. Intractable occipital lobe epilepsy: clinical characteristics and surgical treatment.

    Science.gov (United States)

    Jobst, Barbara C; Williamson, Peter D; Thadani, Vijay M; Gilbert, Karen L; Holmes, Gregory L; Morse, Richard P; Darcey, Terrance M; Duhaime, Ann-Christine; Bujarski, Krysztof A; Roberts, David W

    2010-11-01

    Intractable occipital lobe epilepsy remains a surgical challenge. Clinical characteristics of 14 patients were analyzed. Twelve patients had surgery, seven patients had visual auras (50%) and only eight patients (57%) had posterior scalp EEG changes. Ictal single-proton emission computed tomography (SPECT) incorrectly localized in 7 of 10 patients. Six patients (50%) had Engel's class I outcome. Patients with inferior occipital seizure onset appeared to fare better (three of four class I) than patients with lateral or medial occipital seizure onset (three of eight class I). Patients who had all three occipital surfaces covered with electrodes had a better outcome (four of five class I) than patients who had limited electroencephalography (EEG) coverage (two of seven class I). Magnetic resonance imaging (MRI) lesions did not guarantee a seizure free outcome. In conclusion, visual auras, scalp EEG, and imaging findings are not reliable for correct identification of occipital onset. Occipital seizure onset can be easily missed in nonlesional epilepsy. Comprehensive intracranial EEG coverage of all three occipital surfaces leads to better outcomes.

  14. Helmet-Induced Occipital Neuralgia in a Military Aviator.

    Science.gov (United States)

    Chalela, Julio A

    2018-04-01

    Headaches among military personnel are very common and headgear wear is a frequently identified culprit. Helmet wear may cause migrainous headaches, external compression headache, other primary cranial neuralgias, and occipital neuralgia. The clinical features and the response to treatment allow distinction between the different types of headaches. Headaches among aviators are particularly concerning as they may act as distractors while flying and the treatment options are often incompatible with flying status. A 24-yr-old door gunner presented with suboccipital pain associated with the wear of his helmet. He described the pain as a paroxysmal stabbing sensation coming in waves. The physical exam and history supported the diagnosis of primary occipital neuralgia. Systemic pharmacological options were discussed with the soldier, but rejected due to his need to remain in flying status. An occipital nerve block was performed with good clinical results, supporting the diagnosis of occipital neuralgia and allowing him to continue as mission qualified. Occipital neuralgia can be induced by helmet wear in military personnel. Occipital nerve block can be performed in the deployed setting, allowing the service member to remain mission capable and sparing him/her from systemic side effects.Chalela JA. Helmet-induced occipital neuralgia in a military aviator. Aerosp Med Hum Perform. 2018; 89(4):409-410.

  15. Occipital Neuralgia Diagnosis and Treatment: The Role of Ultrasound.

    Science.gov (United States)

    Narouze, Samer

    2016-04-01

    Occipital neuralgia is a form of neuropathic type of pain in the distribution of the greater, lesser, or third occipital nerves. Patients with intractable occipital neuralgia do not respond well to conservative treatment modalities. This group of patients represents a significant therapeutic challenge and may require interventional or invasive therapeutic approaches. Occipital neuralgia frequently occurs as a result of nerve entrapment or irritation by a tight muscle or vascular structure, or nerve trauma during whiplash injury. Although the entrapment theory is most commonly accepted, it lacks strong clinical evidence to support it. Accordingly, the available interventional approaches have been targeting the accessible part of the occipital nerve rather than the entrapped part. Bedside sonography is an excellent imaging modality for soft tissue structures. Ultrasound not only allows distinguishing normal from abnormal entrapped occipital nerves, it can identify the level and the cause of entrapment as well. Ultrasound guidance allows precise occipital nerve blocks and interventions at the level of the "specific" entrapment location rather than into the site of "presumed" entrapment. © 2016 American Headache Society.

  16. Q-Ball of Inferior Fronto-Occipital Fasciculus and Beyond

    Science.gov (United States)

    Amirbekian, Bagrat; Berger, Mitchel S.; Henry, Roland G.

    2014-01-01

    The inferior fronto-occipital fasciculus (IFOF) is historically described as the longest associative bundle in the human brain and it connects various parts of the occipital cortex, temporo-basal area and the superior parietal lobule to the frontal lobe through the external/extreme capsule complex. The exact functional role and the detailed anatomical definition of the IFOF are still under debate within the scientific community. In this study we present a fiber tracking dissection of the right and left IFOF by using a q-ball residual-bootstrap reconstruction of High-Angular Resolution Diffusion Imaging (HARDI) data sets in 20 healthy subjects. By defining a single seed region of interest on the coronal fractional anisotropy (FA) color map of each subject, we investigated all the pathways connecting the parietal, occipital and posterior temporal cortices to the frontal lobe through the external/extreme capsule. In line with recent post-mortem dissection studies we found more extended anterior-posterior association connections than the “classical” fronto-occipital representation of the IFOF. In particular the pathways we evidenced showed: a) diffuse projections in the frontal lobe, b) fronto-parietal lobes connections trough the external capsule in almost all the subjects and c) widespread connections in the posterior regions. Our study represents the first consistent in vivo demonstration across a large group of individuals of these novel anterior and posterior terminations of the IFOF detailed described only by post-mortem anatomical dissection. Furthermore our work establishes the feasibility of consistent in vivo mapping of this architecture with independent in vivo methodologies. In conclusion q-ball tractography dissection supports a more complex definition of IFOF, which includes several subcomponents likely underlying specific function. PMID:24945305

  17. Q-ball of inferior fronto-occipital fasciculus and beyond.

    Directory of Open Access Journals (Sweden)

    Eduardo Caverzasi

    Full Text Available The inferior fronto-occipital fasciculus (IFOF is historically described as the longest associative bundle in the human brain and it connects various parts of the occipital cortex, temporo-basal area and the superior parietal lobule to the frontal lobe through the external/extreme capsule complex. The exact functional role and the detailed anatomical definition of the IFOF are still under debate within the scientific community. In this study we present a fiber tracking dissection of the right and left IFOF by using a q-ball residual-bootstrap reconstruction of High-Angular Resolution Diffusion Imaging (HARDI data sets in 20 healthy subjects. By defining a single seed region of interest on the coronal fractional anisotropy (FA color map of each subject, we investigated all the pathways connecting the parietal, occipital and posterior temporal cortices to the frontal lobe through the external/extreme capsule. In line with recent post-mortem dissection studies we found more extended anterior-posterior association connections than the "classical" fronto-occipital representation of the IFOF. In particular the pathways we evidenced showed: a diffuse projections in the frontal lobe, b fronto-parietal lobes connections trough the external capsule in almost all the subjects and c widespread connections in the posterior regions. Our study represents the first consistent in vivo demonstration across a large group of individuals of these novel anterior and posterior terminations of the IFOF detailed described only by post-mortem anatomical dissection. Furthermore our work establishes the feasibility of consistent in vivo mapping of this architecture with independent in vivo methodologies. In conclusion q-ball tractography dissection supports a more complex definition of IFOF, which includes several subcomponents likely underlying specific function.

  18. True aneurysm of the proximal occipital artery: Case report.

    Science.gov (United States)

    Illuminati, Giulio; Cannistrà, Marco; Pizzardi, Giulia; Pasqua, Rocco; Frezzotti, Francesca; Calio', Francesco G

    2018-01-01

    True aneurysms of the proximal occipital artery are rare, may cause neurological symptoms due to compression of the hypoglossal nerve and their resection may be technically demanding. The case of an aneurysm of the proximal occipital artery causing discomfort and tongue deviation by compression on the hypoglossal nerve is reported. Postoperative course after resection was followed by complete regression of symptoms. Surgical resection, as standard treatment of aneurysms of the occipital artery, with the eventual technical adjunct of intubation by the nose is effective in durably relieving symptoms and preventing aneurysm-related complication. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Anton's Syndrome due to Bilateral Ischemic Occipital Lobe Strokes.

    Science.gov (United States)

    Zukić, Sanela; Sinanović, Osman; Zonić, Lejla; Hodžić, Renata; Mujagić, Svjetlana; Smajlović, Edina

    2014-01-01

    We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

  20. C1-C2 instability with severe occipital headache in the setting of vertebral artery facet complex erosion.

    Science.gov (United States)

    Taher, Fadi; Bokums, Kristaps; Aichmair, Alexander; Hughes, Alexander P

    2014-05-01

    An exact understanding of patient vertebral artery anatomy is essential to safely place screws at the atlanto-axial level in posterior arthrodesis. We aim to report a case of erosion of the left vertebral artery into the C1-C2 facet complex with resultant rotatory and lateral listhesis presenting with severe occipital headache. This represents a novel etiology for this diagnosis and our report illustrates technical considerations when instrumenting the C1-C2 segment. We report a case of severe occipital headache due to C1-C2 instability with resultant left C2 nerve compression in the setting of erosion of the vertebral artery into the C1-C2 facet complex. A 68-year-old woman presented with a 12-month history of progressively debilitating headache and neck pain with atlanto-axial instability. Computed tomography (CT) angiography demonstrated erosion of the left vertebral artery into the left C1-C2 facet complex. In addition, the tortuous vertebral arteries had eroded into the C2 pedicles, eliminating the possibility for posterior pedicle screw placement. The patient underwent posterior arthrodesis of C1-C2 utilizing bilateral lateral mass fixation into C1 and bilateral trans-laminar fixation into C2 with resolution of all preoperative complaints. This study constitutes the first report of a tortuous vertebral artery causing the partial destruction of a C1-C2 facet complex, as well as instability, with the clinical presentation of severe occipital headache. It hereby presents a novel etiology for both the development of C1-C2 segment instability as well as the development of occipital headache. Careful evaluation of such lesions utilizing CT angiography is important when formulating a surgical plan.

  1. Quantitative Magnetic Resonance Imaging of Brainstem Volumes, Plaques, and Surface Area in the Occipital Regions of Patients with Multiple Sclerosis

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    Alper, F.; Kantarci, M.; Altunkaynak, E.; Varoglu, A. O.; Karaman, A.; Oral, E.; Okur, A. [Ataturk Univ., Erzurum (Turkey). Depts. of Radiology, Histology, Neurology and Embryology, Psychiatry

    2006-07-15

    Purpose: To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes. Material and Methods: Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated. Results: Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm{sup 3} , 3515 mm{sup 3} , and 4517 mm{sup 3} , respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7-3.4 in RR-MS and 5.2-2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52-88.24 mm{sup 2} in RR MS and 124.3-64.82 mm{sup 2} in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls ( P <0.01). Conclusion: Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency.

  2. Quantitative Magnetic Resonance Imaging of Brainstem Volumes, Plaques, and Surface Area in the Occipital Regions of Patients with Multiple Sclerosis

    International Nuclear Information System (INIS)

    Alper, F.; Kantarci, M.; Altunkaynak, E.; Varoglu, A. O.; Karaman, A.; Oral, E.; Okur, A.

    2006-01-01

    Purpose: To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes. Material and Methods: Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated. Results: Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm 3 , 3515 mm 3 , and 4517 mm 3 , respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7-3.4 in RR-MS and 5.2-2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52-88.24 mm 2 in RR MS and 124.3-64.82 mm 2 in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls ( P <0.01). Conclusion: Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency

  3. Occipital transtentorial/falcine approach, a "cross-court" trajectory to accessing contralateral posterior thalamic lesions: case report.

    Science.gov (United States)

    Iwami, Kenichiro; Fujii, Masazumi; Saito, Kiyoshi

    2017-07-01

    Surgical treatment of lesions in the posterior thalamus, especially those extending laterally, is technically challenging because of a deep surgical field, narrow operative corridor, and the surrounding critical neurovascular structures. The authors describe an occipital transtentorial/falcine approach (OTFA) that was successfully used in the treatment of a cavernous malformation (CM) extending laterally from thalamus to midbrain. A 40-year-old man complained of progressive right hemiparesis and numbness. Radiological evaluation revealed a large CM in the left thalamus, surfacing on the pulvinar thalami, and extending 4 cm laterally from the midline. In addition to the usual procedures of a right-sided occipital transtentorial approach, the authors incised the falx cerebri to expand the operative corridor to the left thalamus. They achieved generous exposure of the left thalamus through a "cross-court" oblique trajectory while avoiding excessive retraction on the occipital lobe. The CM was completely removed, and no newly developed or worsening deficits were detected postoperatively. To better understand the OTFA and its application, the authors performed a cadaveric dissection. The OTFA provides increased exposure of the posterior thalamus without cortical incision and facilitates lateral access to this area through the "cross-court" operative corridor. This approach adds to the armamentarium for neurosurgeons treating thalamic lesions.

  4. Computed Tomography-Based Occipital Condyle Morphometry in an Indian Population to Assess the Feasibility of Condylar Screws for Occipitocervical Fusion.

    Science.gov (United States)

    Srivastava, Abhishek; Nanda, Geetanjali; Mahajan, Rajat; Nanda, Ankur; Mishra, Nirajana; Karmaran, Srinivasa; Batra, Sahil; Chhabra, Harvinder Singh

    2017-12-01

    A retrospective computed tomography (CT)-based morphometric study of 82 occipital condyles in the Indian population, focusing on critical morphometric dimensions with relation to placing condylar screws. This study focused on determining the feasibility of placing occipital condylar screws in an Indian population using CT anatomical morphometric data. The occipital condylar screw is a novel technique being explored as one of the options in occipitocervical stabilization. Sex and ethnic variations in anatomical structures may restrict the feasibility of this technique in some populations. To the best of our knowledge, there are no CT-based data on an Indian population that assess the feasibility of occipital condylar screws. We measured the dimensions of 82 occipital condyles in 41 adults on coronal, sagittal, and axial reconstructed CT images. The differences were noted between the right and left sides and also between males and females. Statistical analysis was performed using the t -test, with a p -value of occipital condyle shows that condylar screws are anatomically feasible in a large portion of the Indian population. However, because a small number of population may not be suitable for this technique, meticulous study of preoperative anatomy using detailed CT data is advised.

  5. Memory for shape reactivates the lateral occipital complex.

    Science.gov (United States)

    Karanian, Jessica M; Slotnick, Scott D

    2015-04-07

    Memory is thought to be a constructive process in which the cortical regions associated with processing event features are reactivated during retrieval. Although there is evidence for non-detailed cortical reactivation during retrieval (e.g., memory for visual or auditory information reactivates the visual or auditory processing regions, respectively), there is limited evidence that memory can reactivate cortical regions associated with processing detailed, feature-specific information. Such evidence is critical to our understanding of the mechanisms of episodic retrieval. The present functional magnetic resonance imaging (fMRI) study assessed whether the lateral occipital complex (LOC), a region that preferentially processes shape, is associated with retrieval of shape information. During encoding, participants were presented with colored abstract shapes that were either intact or scrambled. During retrieval, colored disks were presented and participants indicated whether the corresponding shape was previously "intact" or "scrambled". To assess whether conscious retrieval of intact shapes reactivated LOC, we conducted a conjunction of shape perception/encoding and accurate versus inaccurate retrieval of intact shapes, which produced many activations in LOC. To determine whether activity in LOC was specific to intact shapes, we conducted a conjunction of shape perception/encoding and intact versus scrambled shapes, which also produced many activations in LOC. Furthermore, memory for intact shapes in each hemifield produced contralateral activity in LOC (e.g., memory for left visual field intact shapes activated right LOC), which reflects the specific reinstatement of perception/encoding activity. The present results extend previous feature-specific memory reactivation evidence and support the view that memory is a constructive process. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Visual interhemispheric communication and callosal connections of the occipital lobes.

    Science.gov (United States)

    Berlucchi, Giovanni

    2014-07-01

    Callosal connections of the occipital lobes, coursing in the splenium of the corpus callosum, have long been thought to be crucial for interactions between the cerebral hemispheres in vision in both experimental animals and humans. Yet the callosal connections of the temporal and parietal lobes appear to have more important roles than those of the occipital callosal connections in at least some high-order interhemispheric visual functions. The partial intermixing and overlap of temporal, parietal and occipital callosal connections within the splenium has made it difficult to attribute the effects of splenial pathological lesions or experimental sections to splenial components specifically related to select cortical areas. The present review describes some current contributions from the modern techniques for the tracking of commissural fibers within the living human brain to the tentative assignation of specific visual functions to specific callosal tracts, either occipital or extraoccipital. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Malignant melanotic neuroectodermal tumour of infancy affecting the occipital squama.

    Directory of Open Access Journals (Sweden)

    Patankar T

    1998-07-01

    Full Text Available An unusual case of a melanotic neuroectodermal tumour of the occipital squama, which underwent malignant transformation in a nine-month-old infant is reported and pertinent literature reviewed.

  8. Dorsal and ventral changes of the occipital vertebrae

    International Nuclear Information System (INIS)

    Banki, Z.

    1981-01-01

    Based on his own observation and on the literature, the author discusses various types of calcification in the occipital-cervical region, beginning with those situated dorsally and followed by ventral forms. An attempt is made to classify these changes, depending on their morphology and situation, from an embryological point of view. The pro-atlantal and ante pro-atlanto origin of the occipital vertebrae is discussed. Differentiation depends on appearances. (orig.) [de

  9. Decreased occipital lobe metabolism by FDG-PET/CT

    Science.gov (United States)

    Solnes, Lilja; Nalluri, Abhinav; Cohen, Jesse; Jones, Krystyna M.; Zan, Elcin; Javadi, Mehrbod S.; Venkatesan, Arun

    2017-01-01

    Objective: To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti–NMDA receptor and other definite autoimmune encephalitis (AE) and to assess how these patterns differ between anti–NMDA receptor neurologic disability groups. Methods: Retrospective review of clinical data and initial dedicated brain FDG-PET/CT studies for neurology inpatients with definite AE, per published consensus criteria, treated at a single academic medical center over a 10-year period. Z-score maps of FDG-PET/CT were made using 3-dimensional stereotactic surface projections in comparison to age group–matched controls. Brain region mean Z scores with magnitudes ≥2.00 were interpreted as significant. Comparisons were made between anti–NMDA receptor and other definite AE patients as well as among patients with anti–NMDA receptor based on modified Rankin Scale (mRS) scores at the time of FDG-PET/CT. Results: The medial occipital lobes were markedly hypometabolic in 6 of 8 patients with anti–NMDA receptor encephalitis and as a group (Z = −4.02, interquartile range [IQR] 2.14) relative to those with definite AE (Z = −2.32, 1.46; p = 0.004). Among patients with anti–NMDA receptor encephalitis, the lateral and medial occipital lobes were markedly hypometabolic for patients with mRS 4–5 (lateral occipital lobe Z = −3.69, IQR 1; medial occipital lobe Z = −4.08, 1) compared with those with mRS 0–3 (lateral occipital lobe Z = −0.83, 2; p occipital lobe Z = −1.07, 2; p = 0.001). Conclusions: Marked medial occipital lobe hypometabolism by dedicated brain FDG-PET/CT may serve as an early biomarker for discriminating anti–NMDA receptor encephalitis from other AE. Resolution of lateral and medial occipital hypometabolism may correlate with improved neurologic status in anti–NMDA receptor encephalitis. PMID:29159205

  10. An Anatomic Morphological Study of Occipital Spurs in Human Skulls.

    Science.gov (United States)

    Srivastava, Monika; Asghar, Adil; Srivastava, Nitya Nand; Gupta, Nandkishore; Jain, Anuj; Verma, Jayant

    2018-01-01

    Occipital spurs are quite common; however, they are also the source of frequent discomfort to the patients. Their role has been implicated in causation of pain at the base of skull, which may extend to shoulder limiting the movement of the shoulder and neck. The present was carried out to find out the prevalence of occipital spur in human skull and to find out the anatomic morphological characteristics of occipital spur. A total of 30 cadaveric skulls were examined in the Department of Anatomy, Uttar Pradesh University of Medical Sciences, for the presence of occipital spur. These skulls were the part of boneset obtained as a part of undergraduate training in the department. All the measurements were taken using a digital Vernier Caliper after taking all necessary precaution to avoid any damage to these spurs. The prevalence of occipital spur in the present study was 10%. The mean width recorded in the present study was 13.40 mm (±6.7) and the mean length recorded was 13.45 mm (±1.05). Similarly, mean thickness noted was 2.43 mm (±0.43). Thus, the present study concludes that occipital spurs are the frequent source of discomfort to patients. The knowledge of this tubercle is of paramount importance to neurosurgeons, sports physicians, and radiologists for the diagnosis of such discomfort.

  11. Giant Atretic Occipital Lipoencephalocele in an Adult with Bony Outgrowth.

    Science.gov (United States)

    Nimkar, Kshama; Sood, Dinesh; Soni, Pawan; Chauhan, Narvir; Surya, Mukesh

    2016-01-01

    We present unique case of a giant extracranial atretic occipital lipoencephalocele in an adult patient with new bone formation within it which was not associated with any developmental malformation of brain. Resection of the lipoencephalocele was performed for esthetic reasons. 18 year old female patient presented to the surgery OPD with complains of a large mass in the occipital region present since birth. It was of size of a betel nut at the time of birth and gradually increased in size over a long period of time. It was painless and not associated with any other constitutional symptoms. On examination the rounded fluctuant mass was present in the midline in occipital region covered with alopecic skin with dimpling in the overlying skin. On MRI there was mass showing both T1 and T2 hyperintense signal area suggestive of fat component. Herniation of meninges and atretic brain parenchyma was also seen through a defect in the occipital bone in the midline. There was a Y shaped bony outgrowth seen arising from occipital bone into the mass which was quite unusual in association with an atretic lipoencephalocele. A large lipoencephalocele with bony outgrowth in an adult patient is a rare presentation of atreic occipital encephalocele.

  12. Headache and Central Positioning Vertigo in a Middle Aged Female-a Case of Solitary Cerebellar Tuberculoma Involving Left Cerebellar Hemisphere

    Directory of Open Access Journals (Sweden)

    Shakya Bhattacharjee

    2012-03-01

    Full Text Available A 48 year old female presented with headache and an illusory sensation of spinning of head in respect to environment for last 8 weeks. Her head spinning or vertigo had no particular direction or not precipitated by any specific head posture. Headache is non- specific in nature and intensified in last few days.Her neurological examination revealed a central positional vertigo with horizontal gaze evoked nystagmus and ataxia. Her MRI scan brain showed the presence of a large solitary ring enhancing lesion in the left cerebellar hemisphere. The lesion was surgically excised and was examined histopathologicaliy that revealed a chronic inflammatory granuloma with caseation necrosis and multinucleated giant cells suggestive of tuberculosis

  13. Type III occipital condylar fracture presenting with hydrocephalus, vertebral artery injury and vasospasm: case report

    International Nuclear Information System (INIS)

    Menendez, J.A.; Baskaya, M.K.; Day, M.A.; Nanda, A.

    2001-01-01

    Occipital condylar fractures (OCF) are rare and have a high mortality rate. We report a patient with OCF who presented with acute hydrocephalus and died from diffuse vasospasm secondary to vertebral artery injury. A 45-year-old man fell 20 feet from a deer stand and landed on his head. CT showed a type III OCF continuing to the anterior rim of the foramen magnum on the left, with a bone fragment pushing into the medulla, causing hydrocephalus. The patient was stabilized, and a four-vessel arteriogram showed diffuse vasospasm with complete occlusion of the left vertebral artery at the level of the OCF. To our knowledge, this is the first documented case of the conjunction of OCF, hydrocephalus, and vasospasm. (orig.)

  14. Sub-occipital craniectomy in a lion (Panthera leo) with occipital bone malformation and hypovitaminosis A.

    Science.gov (United States)

    Shamir, Merav H; Shilo, Yael; Fridman, Alon; Chai, Orit; Reifen, Ram; Miara, Limor

    2008-09-01

    Neurologic dysfunction accompanied by malformation of both the skull and the cervical vertebrae has been previously described in lions kept in captivity worldwide, and this dysfunction and malformation were most often related to vitamin A deficiency. Diagnosis of the bone malformation and its effects on the neural tissue was until recently limited to postmortem examination, with characteristic thickening of the bones of the cranial vault, cerebellar herniation, compression of the foramen magnum, and enlargement of the lateral ventricles. For some mildly affected lion cubs with neurologic signs, improvement was reported with excessive vitamin A supplementation. However, definitive diagnosis was only available for those that eventually died or were euthanized. This case documents the antemortem diagnosis of the disease using computed tomographic imaging and liver biopsy. While conservative treatment failed, suboccipital craniectomy removed the thickened occipital bone and was demonstrated to be a successful surgical intervention that can be used to treat more severely affected lions.

  15. Left ventricular vascular and metabolic adaptations to high-intensity interval and moderate intensity continuous training: a randomized trial in healthy middle-aged men.

    Science.gov (United States)

    Eskelinen, Jari-Joonas; Heinonen, Ilkka; Löyttyniemi, Eliisa; Hakala, Juuso; Heiskanen, Marja A; Motiani, Kumail K; Virtanen, Kirsi; Pärkkä, Jussi P; Knuuti, Juhani; Hannukainen, Jarna C; Kalliokoski, Kari K

    2016-12-01

    High-intensity interval training (HIIT) has become popular, time-sparing alternative to moderate intensity continuous training (MICT), although the cardiac vascular and metabolic effects of HIIT are incompletely known. We compared the effects of 2-week interventions with HIIT and MICT on myocardial perfusion and free fatty acid and glucose uptake. Insulin-stimulated myocardial glucose uptake was decreased by training without any significantly different response between the groups, whereas free fatty acid uptake remained unchanged. Adenosine-stimulated myocardial perfusion responded differently to the training modes (change in mean HIIT: -19%; MICT: +9%; P = 0.03 for interaction) and was correlated with myocardial glucose uptake for the entire dataset and especially after HIIT training. HIIT and MICT induce similar metabolic and functional changes in the heart, although myocardial vascular hyperaemic reactivity is impaired after HIIT, and this should be considered when prescribing very intense HIIT for previously untrained subjects. High-intensity interval training (HIIT) is a time-efficient way of obtaining the health benefits of exercise, although the cardiac effects of this training mode are incompletely known. We compared the effects of short-term HIIT and moderate intensity continuous training (MICT) interventions on myocardial perfusion and metabolism and cardiac function in healthy, sedentary, middle-aged men. Twenty-eight healthy, middle-aged men were randomized to either HIIT or MICT groups (n = 14 in both) and underwent six cycle ergometer training sessions within 2 weeks (HIIT session: 4-6 × 30 s all-out cycling/4 min recovery, MICT session 40-60 min at 60% V̇O2 peak ). Cardiac magnetic resonance imaging (CMRI) was performed to measure cardiac structure and function and positron emission tomography was used to measure myocardial perfusion at baseline and during adenosine stimulation, insulin-stimulated glucose uptake (MGU) and fasting free

  16. Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus.

    Science.gov (United States)

    Mizutani, Katsuhiro; Miwa, Tomoru; Akiyama, Takenori; Sakamoto, Yoshiaki; Fujiwara, Hirokazu; Yoshida, Kazunari

    2018-03-01

    The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus. The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults. The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

  17. Benign occipital lobe seizures: Natural progression and atypical evolution

    Directory of Open Access Journals (Sweden)

    Prithika Chary

    2013-01-01

    Full Text Available Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and it is also not very easy to elicit visual hallucinations during history taking. These seizures have a good response to treatment; however, there could be atypical evolution and refractoriness to treatment especially with ICOE-G. We describe three children who presented with visual and non-visual symptoms and the electroencephalography (EEG in all the three cases showed occipital paroxysms. We have emphasized the clues in the clinical history and EEG leading to the diagnosis of these distinct epilepsy syndromes. We have also discussed the natural course of these epilepsy syndromes with some atypical evolution, which clinicians need to be aware of during treatment of these children.

  18. Benign occipital lobe seizures: Natural progression and atypical evolution.

    Science.gov (United States)

    Chary, Prithika; Rajendran, Bhuvaneshwari

    2013-10-01

    Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G) including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and it is also not very easy to elicit visual hallucinations during history taking. These seizures have a good response to treatment; however, there could be atypical evolution and refractoriness to treatment especially with ICOE-G. We describe three children who presented with visual and non-visual symptoms and the electroencephalography (EEG) in all the three cases showed occipital paroxysms. We have emphasized the clues in the clinical history and EEG leading to the diagnosis of these distinct epilepsy syndromes. We have also discussed the natural course of these epilepsy syndromes with some atypical evolution, which clinicians need to be aware of during treatment of these children.

  19. Versive seizures in occipital lobe epilepsy: lateralizing value and pathophysiology.

    Science.gov (United States)

    Usui, Naotaka; Mihara, Tadahiro; Baba, Koichi; Matsuda, Kazumi; Tottori, Takayasu; Umeoka, Shuichi; Kondo, Akihiko; Nakamura, Fumihiro; Terada, Kiyohito; Usui, Keiko; Inoue, Yushi

    2011-11-01

    To clarify the value of versive seizures in lateralizing and localizing the epileptogenic zone in patients with occipital lobe epilepsy, we studied 13 occipital lobe epilepsy patients with at least one versive seizure recorded during preoperative noninvasive video-EEG monitoring, who underwent occipital lobe resection, and were followed postoperatively for more than 2 years with Engel's class I outcome. The videotaped versive seizures were analyzed to compare the direction of version and the side of surgical resection in each patient. Moreover, we examined other motor symptoms (partial somatomotor manifestations such as tonic and/or clonic movements of face and/or limbs, automatisms, and eyelid blinking) associated with version. Forty-nine versive seizures were analyzed. The direction of version was always contralateral to the side of resection except in one patient. Among accompanying motor symptoms, partial somatomotor manifestations were observed in only five patients. In conclusion, versive seizure is a reliable lateralizing sign indicating contralateral epileptogenic zone in occipital lobe epilepsy. Since versive seizures were accompanied by partial somatomotor manifestations in less than half of the patients, it is suggested that the mechanism of version in occipital lobe epilepsy is different from that in frontal lobe epilepsy. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Supra- and infra-torcular double occipital encephalocele.

    Science.gov (United States)

    Canaz, Hüseyin; Ayçiçek, Ezgi; Akçetin, Mustafa Ali; Akdemir, Osman; Alataş, Ibrahim; Özdemir, Bülent

    2015-01-01

    An encephalocele is a protrusion of the brain and/or meninges through a defect in the skull that is closed or covered with skin. Occipital encephaloceles are the most frequent type in North America and Western Europe, where about 85% of encephaloceles take this form. To the best of our knowledge, there are only three other reported cases of double occipital encephaloceles in the literature. The current study reports a double and both supra- and infra-torcular occipital encephalocele in a neonate and discusses the importance of preoperative neuroimaging studies to optimize the outcome. The patient was a 1-day-old male child who was identified by prenatal ultrasound to have two occipital encephaloceles. The patient underwent a closure of the occipital encephalocele on the second postnatal day. The infant tolerated the procedure well and was extubated on the first postoperative day. The child continues to do well during follow-up. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  1. [Treatment of Occipital Neuralgia by Electroacupuncture Combined with Neural Mobilization].

    Science.gov (United States)

    Wang, Yan; Guo, Zi-Nan; Yang, Zhen; Wang, Shun

    2018-03-25

    To observe the effect of electroacupuncture (EA) combined with neural mobilization (NM) in the treatment of occipital neuralgia. A total of 62 occipital neuralgia patients were randomized into EA group (19 cases), NM group (22 cases) and EA+NM group (21 cases). EA was applied at acupoint-pairs as Yuzhen (BL 9)- Tianzhu (BL 10), Fengchi (GB 20)- Wangu (GB 12), etc. NM intervention consisted of occipital muscle group mobilization, C 2 spinous process mobilization, cervical joint passive movement management mobilization, etc., was performed at the impaired cervical spine segment. The two methods were used in combination for patients in the EA+NM group. All the treatment was given once a day for 2 weeks. Before and after treatment, the visual analogue scale (VAS) and the 6-point (1-6 points) behavioral rating scale (BRS-6) of headache were used to assess the severity of pain. The therapeutic effect was evaluated according to the "Criteria for Diagnosis and Cure-Improvement of Clinical Conditions" formulated by State Administration of Traditional Chinese Medicine of the People's Republic of China in 1994. After treatment, both VAS and BRS-6 scores were significantly lower than those before treatment in each of the three groups ( P occipital neuralgia, and EA+NM has a synergic analgesic effect for occipital neuralgia.

  2. Occipital lobe epilepsy with fear as leading ictal symptom.

    Science.gov (United States)

    Oehl, Bernhard; Schulze-Bonhage, Andreas; Lanz, Michael; Brandt, Armin; Altenmüller, Dirk-Matthias

    2012-03-01

    Ictal fear is a semiological feature which is commonly associated with mesial temporal lobe epilepsy. Here, we describe fear as a leading symptom in cryptogenic occipital lobe epilepsy. In a patient with negative MRI findings, intracranial EEG recordings documented a strict correlation between habitual ictal anxiety attacks and both spontaneous and stimulation-induced epileptic activity in a right occipital epileptogenic area with subsequent spreading to the symptomatogenic zone in the amygdala. Circumscribed occipital topectomy led to seizure freedom. Episodes of non-epileptic fear ceased shortly afterwards. This report provides insight into pathways of propagation of epileptic activity, illustrates different etiologies of pathologic fear and underlines the importance of ictal EEG recordings. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Human V4 and ventral occipital retinotopic maps

    Science.gov (United States)

    Winawer, Jonathan; Witthoft, Nathan

    2016-01-01

    The ventral surface of the human occipital lobe contains multiple retinotopic maps. The most posterior of these maps is considered a potential homolog of macaque V4, and referred to as human V4 (‘hV4’). The location of the hV4 map, its retinotopic organization, its role in visual encoding, and the cortical areas it borders have been the subject of considerable investigation and debate over the last 25 years. We review the history of this map and adjacent maps in ventral occipital cortex, and consider the different hypotheses for how these ventral occipital maps are organized. Advances in neuroimaging, computational modeling, and characterization of the nearby anatomical landmarks and functional brain areas have improved our understanding of where human V4 is and what kind of visual representations it contains. PMID:26241699

  4. Pathways of the inferior frontal occipital fasciculus in overt speech and reading.

    Science.gov (United States)

    Rollans, Claire; Cheema, Kulpreet; Georgiou, George K; Cummine, Jacqueline

    2017-11-19

    In this study, we examined the relationship between tractography-based measures of white matter integrity (ex. fractional anisotropy [FA]) from diffusion tensor imaging (DTI) and five reading-related tasks, including rapid automatized naming (RAN) of letters, digits, and objects, and reading of real words and nonwords. Twenty university students with no reported history of reading difficulties were tested on all five tasks and their performance was correlated with diffusion measures extracted through DTI tractography. A secondary analysis using whole-brain Tract-Based Spatial Statistics (TBSS) was also used to find clusters showing significant negative correlations between reaction time and FA. Results showed a significant relationship between the left inferior fronto-occipital fasciculus FA and performance on the RAN of objects task, as well as a strong relationship to nonword reading, which suggests a role for this tract in slower, non-automatic and/or resource-demanding speech tasks. There were no significant relationships between FA and the faster, more automatic speech tasks (RAN of letters and digits, and real word reading). These findings provide evidence for the role of the inferior fronto-occipital fasciculus in tasks that are highly demanding of orthography-phonology translation (e.g., nonword reading) and semantic processing (e.g., RAN object). This demonstrates the importance of the inferior fronto-occipital fasciculus in basic naming and suggests that this tract may be a sensitive predictor of rapid naming performance within the typical population. We discuss the findings in the context of current models of reading and speech production to further characterize the white matter pathways associated with basic reading processes. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Cytoarchitecture of the human lateral occipital cortex: mapping of two extrastriate areas hOc4la and hOc4lp.

    Science.gov (United States)

    Malikovic, Aleksandar; Amunts, Katrin; Schleicher, Axel; Mohlberg, Hartmut; Kujovic, Milenko; Palomero-Gallagher, Nicola; Eickhoff, Simon B; Zilles, Karl

    2016-05-01

    The microstructural correlates of the functional segregation of the human lateral occipital cortex are largely unknown. Therefore, we analyzed the cytoarchitecture of this region in ten human post-mortem brains using an observer-independent and statistically testable parcellation method to define the position and extent of areas in the lateral occipital cortex. Two new cytoarchitectonic areas were found: an anterior area hOc4la and a posterior area hOc4lp. hOc4la was located behind the anterior occipital sulcus in rostral and ventral portions of this region where it occupies the anterior third of the middle and inferior lateral occipital gyri. hOc4lp was found in caudal and dorsal portions of this region where it extends along the superior and middle lateral occipital gyri. The cytoarchitectonic areas were registered to 3D reconstructions of the corresponding brains, which were subsequently spatially normalized to the Montreal Neurological Institute reference space. Continuous probabilistic maps of both areas based on the analysis of ten brains were generated to characterize their inter-subject variability in location and size. The maps of hOc4la and hOc4lp were then used as seeds for meta-analytic connectivity modeling and quantitative functional decoding to identify their co-activation patterns and assignment to functional domains. Convergent evidence from their location, topography, size, functional domains and connectivity indicates that hOc4la and hOc4lp are the potential anatomical correlates of the functionally defined lateral occipital areas LO-1 and LO-2.

  6. DCDC2 polymorphism is associated with left temporoparietal gray and white matter structures during development.

    Science.gov (United States)

    Darki, Fahimeh; Peyrard-Janvid, Myriam; Matsson, Hans; Kere, Juha; Klingberg, Torkel

    2014-10-22

    Three genes, DYX1C1, DCDC2, and KIAA0319, have been previously associated with dyslexia, neuronal migration, and ciliary function. Three polymorphisms within these genes, rs3743204 (DYX1C1), rs793842 (DCDC2), and rs6935076 (KIAA0319) have also been linked to normal variability of left temporoparietal white matter volume connecting the middle temporal cortex to the angular and supramarginal gyri. Here, we assessed whether these polymorphisms are also related to the cortical thickness of the associated regions during childhood development using a longitudinal dataset of 76 randomly selected children and young adults who were scanned up to three times each, 2 years apart. rs793842 in DCDC2 was significantly associated with the thickness of left angular and supramarginal gyri as well as the left lateral occipital cortex. The cortex was significantly thicker for T-allele carriers, who also had lower white matter volume and lower reading comprehension scores. There was a negative correlation between white matter volume and cortical thickness, but only white matter volume predicted reading comprehension 2 years after scanning. These results show how normal variability in reading comprehension is related to gene, white matter volume, and cortical thickness in the inferior parietal lobe. Possibly, the variability of gray and white matter structures could both be related to the role of DCDC2 in ciliary function, which affects both neuronal migration and axonal outgrowth. Copyright © 2014 the authors 0270-6474/14/3414455-08$15.00/0.

  7. Facilitation of speech repetition accuracy by theta burst stimulation of the left posterior inferior frontal gyrus.

    Science.gov (United States)

    Restle, Julia; Murakami, Takenobu; Ziemann, Ulf

    2012-07-01

    The posterior part of the inferior frontal gyrus (pIFG) in the left hemisphere is thought to form part of the putative human mirror neuron system and is assigned a key role in mapping sensory perception onto motor action. Accordingly, the pIFG is involved in motor imitation of the observed actions of others but it is not known to what extent speech repetition of auditory-presented sentences is also a function of the pIFG. Here we applied fMRI-guided facilitating intermittent theta burst transcranial magnetic stimulation (iTBS), or depressant continuous TBS (cTBS), or intermediate TBS (imTBS) over the left pIFG of healthy subjects and compared speech repetition accuracy of foreign Japanese sentences before and after TBS. We found that repetition accuracy improved after iTBS and, to a lesser extent, after imTBS, but remained unchanged after cTBS. In a control experiment, iTBS was applied over the left middle occipital gyrus (MOG), a region not involved in sensorimotor processing of auditory-presented speech. Repetition accuracy remained unchanged after iTBS of MOG. We argue that the stimulation type and stimulation site specific facilitating effect of iTBS over left pIFG on speech repetition accuracy indicates a causal role of the human left-hemispheric pIFG in the translation of phonological perception to motor articulatory output for repetition of speech. This effect may prove useful in rehabilitation strategies that combine repetitive speech training with iTBS of the left pIFG in speech disorders, such as aphasia after cerebral stroke. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Two members of the CERN HPD team present their babies. André Braem (left) holds in his hands a 5-inch glass HPD, while a ceramic HPD for medical applications is shown by Christian Joram. The large detector in the middle is a 10-inch HPD developed for an astrophysics experiment.

    CERN Multimedia

    Maximilien Brice

    2004-01-01

    Two members of the CERN HPD team present their babies. André Braem (left) holds in his hands a 5-inch glass HPD, while a ceramic HPD for medical applications is shown by Christian Joram. The large detector in the middle is a 10-inch HPD developed for an astrophysics experiment.

  9. Amount of lifetime video gaming is positively associated with entorhinal, hippocampal and occipital volume.

    Science.gov (United States)

    Kühn, S; Gallinat, J

    2014-07-01

    Playing video games is a popular leisure activity among children and adults, and may therefore potentially influence brain structure. We have previously shown a positive association between probability of gray matter (GM) volume in the ventral striatum and frequent video gaming in adolescence. Here we set out to investigate structural correlates of video gaming in adulthood, as the effects observed in adolescents may reflect only a fraction of the potential neural long-term effects seen in adults. On magnetic resonance imaging (MRI) scans of 62 male adults, we computed voxel-based morphometry to explore the correlation of GM with the lifetime amount of video gaming (termed joystick years). We found a significant positive association between GM in bilateral parahippocamal region (entorhinal cortex) and left occipital cortex/inferior parietal lobe and joystick years (Pvideo game genres played, such as logic/puzzle games and platform games contributing positively, and action-based role-playing games contributing negatively. Furthermore, joystick years were positively correlated with hippocampus volume. The association of lifetime amount of video game playing with bilateral entorhinal cortex, hippocampal and occipital GM volume could reflect adaptive neural plasticity related to navigation and visual attention.

  10. Tracing short connections of the temporo-parieto-occipital region in the human brain using diffusion spectrum imaging and fiber dissection.

    Science.gov (United States)

    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yunjie; Wang, Yibao

    2016-09-01

    The temporo-parieto-occipital (TPO) junction plays a unique role in human high-level neurological functions. Long-range fibers from and to this area have been described in detail but little is known about short TPO tracts mediating local connectivity. In this study, we performed high angular diffusion spectrum imaging (DSI) analyses to visualize the short TPO connections in the human brain. Fiber tracking was conducted on a subject-specific approach (10 subjects) and a template of 90 subjects (NTU-90 Atlas). Three tracts were identified: posterior segment of the superior longitudinal fasciculus (SLF-V), connecting the posterior part of the middle and inferior temporal gyri with the angular gyrus and supramarginal gyrus, vertical occipital fasciculus (VOF), connecting the inferior parietal with the lower temporal and occipital lobe, and a novel temporo-parietal (TP) connection, interconnecting the inferior temporal gyrus, middle temporal gyrus and fusiform gyrus, and inferior occipital lobe with the superior parietal lobe. These studies were complemented by fiber dissection techniques. It is the first study that demonstrated the trajectory and connectivity of the VOF using fiber dissection, as well as displayed the spatial relationship of the SLF-V with the cortex and the adjacent fiber bundles on one dissecting hemisphere. By providing a more accurate and detailed description of the local connectivity of the TPO junction, our findings help to develop new insights into its functional role in the human brain. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. False Memories for Shape Activate the Lateral Occipital Complex

    Science.gov (United States)

    Karanian, Jessica M.; Slotnick, Scott D.

    2017-01-01

    Previous functional magnetic resonance imaging evidence has shown that false memories arise from higher-level conscious processing regions rather than lower-level sensory processing regions. In the present study, we assessed whether the lateral occipital complex (LOC)--a lower-level conscious shape processing region--was associated with false…

  12. Grooves on the occipital lobe of Indian brains.

    Science.gov (United States)

    Bisaria, K K

    1984-01-01

    The existence of a groove on the occipital lobe formed by the dural venous sinus or ridge has only rarely been described in the past. As observed in this study such grooves are either unilateral or bilateral and their incidence is very high in Indian brains. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6490537

  13. Grooves on the occipital lobe of Indian brains.

    OpenAIRE

    Bisaria, K K

    1984-01-01

    The existence of a groove on the occipital lobe formed by the dural venous sinus or ridge has only rarely been described in the past. As observed in this study such grooves are either unilateral or bilateral and their incidence is very high in Indian brains.

  14. Occipital condyle fracture and ligament injury: imaging by CT

    International Nuclear Information System (INIS)

    Bloom, A.I.; Neeman, Z.; Floman, Y.; Gomori, J.; Bar-Ziv, J.

    1996-01-01

    The true incidence of fracture of the occipital condyles is unknown. It may be associated with instability at the craniocervical joint. CT is the modality of choice for the demonstration of these fractures, but its use for imaging of the associated ligament injury has not been reported. In order to demonstrate normal anatomy, occipital condyle fracture and ligament injury, and to estimate the incidence of this lesion, 21 children and young adults with high-energy blunt craniocervical injury were examined prospectively. Thin-slice, axial, contiguous, CT was performed from the base of C2 to above the foramen magnum. Bone and soft tissue windows and coronal, sagittal, and curvilinear 2D reconstructions were performed. Five occipital condyle fractures were identified in four patients (19 %), with demonstration of alar ligament injury in two cases and local hematoma in one. In four, artifacts or rotation precluded assessment of ligaments. In all remaining cases normal bone and ligament anatomy was demonstrated. Fracture of the occipital condyles following craniocervical injury is not uncommon in children and young adults. Normal bone and ligament anatomy and pathology can be safely and clearly demonstrated in seriously injured patients and others using this CT technique. Increased awareness of this entity and a low threshold for performing CT should avoid the potentially serious consequences of a missed diagnosis. (orig.). With 8 figs., 2 tabs

  15. Occipital White Matter Tracts in Human and Macaque.

    Science.gov (United States)

    Takemura, Hiromasa; Pestilli, Franco; Weiner, Kevin S; Keliris, Georgios A; Landi, Sofia M; Sliwa, Julia; Ye, Frank Q; Barnett, Michael A; Leopold, David A; Freiwald, Winrich A; Logothetis, Nikos K; Wandell, Brian A

    2017-06-01

    We compare several major white-matter tracts in human and macaque occipital lobe using diffusion magnetic resonance imaging. The comparison suggests similarities but also significant differences in the tracts. There are several apparently homologous tracts in the 2 species, including the vertical occipital fasciculus (VOF), optic radiation, forceps major, and inferior longitudinal fasciculus (ILF). There is one large human tract, the inferior fronto-occipital fasciculus, with no corresponding fasciculus in macaque. We could identify the macaque VOF (mVOF), which has been little studied. Its position is consistent with classical invasive anatomical studies by Wernicke. VOF homology is supported by similarity of the endpoints in V3A and ventral V4 across species. The mVOF fibers intertwine with the dorsal segment of the ILF, but the human VOF appears to be lateral to the ILF. These similarities and differences between the occipital lobe tracts will be useful in establishing which circuitry in the macaque can serve as an accurate model for human visual cortex. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Post-mortem CT evaluation of atlanto-occipital dissociation.

    Science.gov (United States)

    Madadin, Mohammed; Samaranayake, Ravindra Priyalal; O'Donnell, Chris; Cordner, Stephen

    2017-02-01

    Atlanto-occipital dissociation injury is an important injury in forensic pathology practice. Radiological diagnosis of atlanto-occipital dissociation clinically is assessed by direct measurement of occipito-vertebral skeletal relationships. Different measurements may be used to diagnose atlanto-occipital dissociation, including the basion-dens interval (BDI) and basion-axial interval (BAI). It is not known whether the normal ante-mortem measurements of BDI and BAI described in the literature are applicable to post-mortem CT images of the occipito-cervical junction (OCJ) or whether these measurements could be affected by early post-mortem changes. This study aims to compare post-mortem BDI and BAI measurements with ante-mortem values. Post-mortem CT scans of the cervical spines of 100 deceased adults were reviewed, and the BDI and BAI were measured. Different parameters were recorded in each case. The results from this study suggest that there are no effects of post-mortem changes on the measurement of BAI as relied upon clinically. There appear to be some effects of fully established rigor mortis on BDI measurement, shortening it. This may have consequences for the post mortem diagnosis of atlanto-occipital dissociation. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  17. A case study of occipital outgrowth: a rare suboccipital abnormality.

    Science.gov (United States)

    Mushkin, A Y; Gubin, A V; Ulrich, E V; Snischuk, V P

    2016-05-01

    To describe the clinical and radiological characteristics of uncommon upper cervical spine abnormality in children. Clinical and diagnostic characteristics of three patients aged 6-12 years with a similar uncommon type of occipital anomaly are described. The patients were admitted in 2007, 2009, and 2014, respectively. All patients were clinically and radiologically examined. In each case the massive, additional unilateral outgrowth of the occipital bone (os occipitale) was visualized. The signs and symptoms included torticollis, acute brain ischemia, and limited head motion. Two of the three patients underwent surgical treatment: an occipital-cervical fusion was performed in the first patient, and the outgrowth was removed in the second patient. After 1 year of follow-up the results were estimated as good for both patients, with better functional outcome for the second patient. The parents of the third patient did not consent for the surgical treatment. The unique features of this abnormality distinguish it from previous descriptions of the manifestation of pro-atlas, atlas, or atlanto-occipital synostosis. The presented abnormality had different manifestation of various severity in each case, from torticollis to acute vascular disorder. Clinical case series. IV.

  18. Etiology and Treatment Modalities of Occipital Artery Aneurysms.

    Science.gov (United States)

    Chaudhry, Nauman S; Gaynor, Brandon G; Hussain, Shahrose; Dernbach, Paul D; Aziz-Sultan, Mohammad A

    2017-06-01

    Aneurysms of the external carotid artery represent approximately 2% of cervical carotid aneurysms, with the majority being traumatic pseudoaneurysms. Given the paucity of literature available for guidance, the diagnosis, treatment, and follow-up of such lesions are completely individualized. We report an 83-year-old woman with an 8-week history of headache in the occipital region, transient episode of gait disturbance, and pulsatile tinnitus on the right. She had no history of trauma, surgery, autoimmune disease, or infection. Physical examination revealed a pulsatile mass tender to palpation in the right occipital scalp. The mass was surgically excised, and histopathological diagnosis of a true aneurysm was made. Postoperatively, the patient's symptoms resolved; however, 1 month after the procedure, she developed occipital neuralgia, which was successfully treated with a percutaneous nerve block. To the best of our knowledge, this is the second reported case of a true aneurysm of the occipital artery in a patient with no history of trauma. The clinical examination, diagnosis, and treatment are discussed and the literature is reviewed for previously reported cases. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. A comparison of occipital and temporal lobe epilepsies.

    Science.gov (United States)

    Appel, S; Sharan, A D; Tracy, J I; Evans, J; Sperling, M R

    2015-10-01

    Differentiating between occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE) is often challenging. This retrospective case-control study compares OLE to TLE and explores markers that suggest the diagnosis of OLE. We queried the Jefferson Epilepsy Center surgery database for patients who underwent a resection that involved the occipital lobe. For each patient with OLE, three sequential case-control patients with TLE were matched. Demographic characteristics, symptoms, electrophysiological findings, imaging findings, and surgical outcome were compared. Nineteen patients with OLE and 57 patients with TLE were included in the study. Visual symptoms were unique to patients with OLE (8/19) and were not reported by patients with TLE (P Occipital interictal spikes (IIS) were found only in one-third of the patients with OLE (6/19) and in no patients with TLE (P lobe were found in five of 19 patients with OLE vs one of 57 patients with TLE (P = 0.003). IIS involved more than one lobe of the brain in most patients with OLE (11/19) but only in nine of 57 the TLE group. (P = 0.0003) Multilobar resection was needed in most patients with OLE (15/19), typically including the temporal lobe, but in only one of the patients with TLE (P Occipital lobe epilepsy is difficult to identify and may masquerade as temporal lobe epilepsy. Visual symptoms and occipital findings in the EEG suggest the diagnosis of OLE, but absence of these features, does not exclude the diagnosis. When posterior temporal EEG findings or multilobar involvement occurs, the diagnosis of OLE should be considered. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. CT-based morphometric analysis of the occipital condyle: focus on occipital condyle screw insertion.

    Science.gov (United States)

    Zhou, Jinsong; Espinoza Orías, Alejandro A; Kang, Xia; He, Jade; Zhang, Zhihai; Inoue, Nozomu; An, Howard S

    2016-11-01

    OBJECTIVE The segmental occipital condyle screw (OCS) is an alternative fixation technique in occipitocervical fusion. A thorough morphological study of the occipital condyle (OC) is critical for OCS placement. The authors set out to introduce a more precise CT-based method for morphometric analysis of the OC as it pertains to the placement of the segmental OCS, and they describe a novel preoperative simulation method for screw placement. Two new clinically relevant parameters, the height available for the OCS and the warning depth, are proposed. METHODS CT data sets from 27 fresh-frozen human cadaveric occipitocervical spines were used. All measurements were performed using a commercially available 3D reconstruction software package. The length, width, and sagittal angle of the condyle were measured in the axial plane at the base of the OC. The height of the OC and the height available for the segmental OCS were measured in the reconstructed oblique sagittal plane, fitting the ideal trajectory of the OCS recommended in the literature. The placement of a 3.5-mm-diameter screw that had the longest length of bicortical purchase was simulated into the OC in the oblique sagittal plane, with the screw path not being blocked by the occiput and not violating the hypoglossal canal cranially or the atlantooccipital joint caudally. The length of the simulated screw was recorded. The warning depth was measured as the shortest distance from the entry point of the screw to the posterior border of the hypoglossal canal. RESULTS The mean length and width of the OC were found to be larger in males: 22.2 ± 1.7 mm and 12.1 ± 1.0 mm, respectively, overall (p < 0.0001 for both). The mean sagittal angle was 28.0° ± 4.9°. The height available for the OCS was significantly less than the height of the OC (6.2 ± 1.3 mm vs 9.4 ± 1.5 mm, p < 0.0001). The mean screw length (19.3 ± 1.9 mm) also presented significant sex-related differences: male greater than female (p = 0.0002). The

  1. Examining Brain-Cognition Effects of Ginkgo Biloba Extract: Brain Activation in the Left Temporal and Left Prefrontal Cortex in an Object Working Memory Task

    Directory of Open Access Journals (Sweden)

    R. B. Silberstein

    2011-01-01

    Full Text Available Ginkgo Biloba extract (GBE is increasingly used to alleviate symptoms of age related cognitive impairment, with preclinical evidence pointing to a pro-cholinergic effect. While a number of behavioral studies have reported improvements to working memory (WM associated with GBE, electrophysiological studies of GBE have typically been limited to recordings during a resting state. The current study investigated the chronic effects of GBE on steady state visually evoked potential (SSVEP topography in nineteen healthy middle-aged (50-61 year old male participants whilst completing an object WM task. A randomized double-blind crossover design was employed in which participants were allocated to receive 14 days GBE and 14 days placebo in random order. For both groups, SSVEP was recorded from 64 scalp electrode sites during the completion of an object WM task both pre- and 14 days post-treatment. GBE was found to improve behavioural performance on the WM task. GBE was also found to increase the SSVEP amplitude at occipital and frontal sites and increase SSVEP latency at left temporal and left frontal sites during the hold component of the WM task. These SSVEP changes associated with GBE may represent more efficient processing during WM task completion.

  2. Occipital epilepsy versus progressive myoclonic epilepsy in a patient with continuous occipital spikes and photosensitivity in electroencephalogram: A case report.

    Science.gov (United States)

    Lv, Yudan; Zhang, Nan; Liu, Chang; Shi, Mingchao; Sun, Li

    2018-04-01

    Progressive myoclonic epilepsy (PME) is rare epilepsy syndrome. Although EEG is a useful neurophysiological technique in the evaluation of epilepsy, few EEG abnormalities have been described in PME. So, how to use EEG hints to establish the suspected diagnosis of PME as soon as possible should be addressed. We presented a case with refractory myoclonic seizures, and progressive neurological deterioration, diagnosed as PME and neuronal ceroid lipofuscinosis disease by gene testing. The patient manifested with a significant regression in her speech ability and motor balance. The mini-mental state examination showed poor scores of 15/30. The magnetic resonance imaging showed diffused atrophy. Her EEG showed slow background with continuous occipital small spikes and photosensitivity. The following genetic testing with mutation in CLN6 confirmed the diagnosis and excluded the occipital epilepsy. Our case showed rare manifestations and special EEG features of PME, which may be confused with occipital epilepsy or photosensitive epilepsy. Thus, if the continuous occipital spikes and photosensitivity were presented in a patient with refractory seizures and developmental regression, PME should be considered.

  3. Activation of the occipital cortex and deactivation of the default mode network during working memory in the early blind.

    Science.gov (United States)

    Park, Hae-Jeong; Chun, Ji-Won; Park, Bumhee; Park, Haeil; Kim, Joong Il; Lee, Jong Doo; Kim, Jae-Jin

    2011-05-01

    Although blind people heavily depend on working memory to manage daily life without visual information, it is not clear yet whether their working memory processing involves functional reorganization of the memory-related cortical network. To explore functional reorganization of the cortical network that supports various types of working memory processes in the early blind, we investigated activation differences between 2-back tasks and 0-back tasks using fMRI in 10 congenitally blind subjects and 10 sighted subjects. We used three types of stimulus sequences: words for a verbal task, pitches for a non-verbal task, and sound locations for a spatial task. When compared to the sighted, the blind showed additional activations in the occipital lobe for all types of stimulus sequences for working memory and more significant deactivation in the posterior cingulate cortex of the default mode network. The blind had increased effective connectivity from the default mode network to the left parieto-frontal network and from the occipital cortex to the right parieto-frontal network during the 2-back tasks than the 0-back tasks. These findings suggest not only cortical plasticity of the occipital cortex but also reorganization of the cortical network for the executive control of working memory.

  4. Estimated GFR and Subsequent Higher Left Ventricular Mass in Young and Middle-Aged Adults With Normal Kidney Function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    Science.gov (United States)

    Bansal, Nisha; Lin, Feng; Vittinghoff, Eric; Peralta, Carmen; Lima, Joao; Kramer, Holly; Shlipak, Michael; Bibbins-Domingo, Kirsten

    2016-02-01

    Left ventricular hypertrophy is common and is associated with cardiovascular events and death among patients with known chronic kidney disease. However, the link between reduced glomerular filtration rate (GFR) and left ventricular mass index (LVMI) remains poorly explored among young and middle-aged adults with preserved kidney function. In this study, we examined the association of cystatin C-based estimated GFR (eGFRcys) and rapid decline in eGFR with subsequent LVMI. Observational study. We included 2,410 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort with eGFRcys > 60mL/min/1.73m(2) at year 15 and who had an echocardiogram obtained at year 25. eGFRcys at year 15 and rapid decline in eGFRcys (defined as >3% per year over 5 years from years 15 to 20). LVMI measured at year 25. We adjusted for age, sex, race, diabetes, body mass index, low- and high-density lipoprotein cholesterol levels, cumulative systolic blood pressure, and albuminuria. Mean age was 40±4 (SD) years, 58% were women, and 43% were black. After 10 years of follow-up, mean LVMI was 39.6±13.4g/m(2.7). Compared with eGFRcys > 90mL/min/1.73m(2) (n = 2,228), eGFRcys of 60 to 75mL/min/1.73m(2) (n = 29) was associated with 5.63 (95% CI, 0.90-10.36) g/m(2.7) greater LVMI (P = 0.02), but there was no association of eGFRcys of 76 to 90mL/min/1.73m(2) (n = 153) with LVMI after adjustment for confounders. Rapid decline in eGFRcys was associated with higher LVMI compared with participants without a rapid eGFRcys decline (β coefficient, 1.48; 95% CI, 0.11-2.83; P = 0.03) after adjustment for confounders. There were a limited number of participants with eGFRcys of 60 to 90mL/min/1.73m(2). Among young and middle-aged adults with preserved kidney function, eGFRcys of 60 to 75mL/min/1.73m(2) and rapid decline in eGFRcys were significantly associated with subsequently higher LVMI. Further studies are needed to understand the mechanisms that contribute to elevated

  5. Occipital deep white matter hyperintensity as seen by MRI, 1

    International Nuclear Information System (INIS)

    Miyazaki, Masahito; Hashimoto, Toshiaki; Tayama, Masanobu; Kuroda, Yasuhiro

    1992-01-01

    Magnetic resonance imaging was performed in 270 patients with various neurologic complaints (1-15Y) with a 0.5 tesla superconducting imaging system using a field echo T1-weighted sequence and spin echo T2-weighted and PD-weighted sequences. Twenty-seven of them had deep white matter hyperintensity (DWMH) in the occipital lobe on T2-weighted images. The frequency of mild DWMH differed in different age groups, suggesting that mild DWMH may result from delayed myelination in the central nervous system. However, the frequency of severe DWMH, which was revealed as isointense relative to cerebrospinal fluid, did not differ in different age groups and it was significantly more common in severely retarded patients. Classification of DWMH based on the signal intensity is valuable to distinguish white matter abnormalities in the occipital lobe from delayed myelination in the same site. (author)

  6. Giant cell reparative granuloma of the occipital bone

    International Nuclear Information System (INIS)

    Santos-Briz, A.; Ricoy, J.R.; Martinez-Tello, F.J.; Lobato, R.D.; Ramos, A.; Millan, J.M.

    2003-01-01

    Giant cell reparative granuloma (GCRG) is a non-neoplastic fibrous lesion with unevenly distributed multinucleated giant cells, areas of osseous metaplasia and hemorrhage. The small bones of the hands and feet are the most common sites, followed by the vertebral bodies and craniofacial bones. In the craniofacial bones GCRG has been reported in the temporal bone, in the frontal bone and paranasal sinus. However, to the best of our knowledge no case has been reported in the occipital bone. We report on the imaging findings and pathological features of a GCRG of the occipital bone and discuss the differential diagnosis of this entity in this particular location, especially with giant cell tumor because of the therapeutic and prognostic implications. (orig.)

  7. Occipital MEG Activity in the Early Time Range (

    DEFF Research Database (Denmark)

    Andersen, Lau M; Pedersen, Michael N; Sandberg, Kristian

    2015-01-01

    . Recent studies have suggested that the late component may not be uniquely related to perceptual consciousness, but also to sensory expectations, task associations, and selective attention. We conducted a magnetoencephalographic study; using multivariate analysis, we compared classification accuracies....... These results are the first of its kind where the predictive values of the 2 components are quantitatively compared, and they provide further evidence for the primary importance of occipital sources in realizing perceptual consciousness. The results have important consequences for current theories of perceptual...

  8. Mirror Focus in a Patient with Intractable Occipital Lobe Epilepsy

    OpenAIRE

    Kim, Jiyoung; Shin, Hae kyung; Hwang, Kyoung Jin; Choi, Su Jung; Joo, Eun Yeon; Hong, Seung Bong; Hong, Seung Chul; Seo, Dae-Won

    2014-01-01

    Mirror focus is one of the evidence of progression in epilepsy, and also has practical points for curative resective epilepsy surgery. The mirror foci are related to the kindling phenomena that occur through interhemispheric callosal or commissural connections. A mirror focus means the secondary epileptogenic foci develop in the contralateral hemispheric homotopic area. Thus mirror foci are mostly reported in patients with temporal or frontal lobe epilepsy, but not in occipital lobe epilepsy....

  9. Prenatal Diagnosis of Tectocerebellar Dysraphia with Occipital Encephalocele

    Science.gov (United States)

    Sanhal, Cem Y; Tokmak, Aytekin; Müftüoglu, Kamil H; Danisman, Nuri

    2015-01-01

    Tectocerebellar dysraphia (TCD) is an extremely rare disorder and comprises the congenital abnormalities including occipital encephalocele, aplasia and/or hypoplasia of cerebellar vermis and deformity of tectum. Only few reported cases of this entity are there in the literature. However, the diagnosis in each of the previous cases had been made after birth. We herein describe the first reported case of prenatal diagnosis for TCD in a Turkish woman. PMID:26816952

  10. Metabolic changes in occipital lobe epilepsy with automatisms

    Directory of Open Access Journals (Sweden)

    Chong H Wong

    2014-07-01

    Full Text Available Purpose: Some studies suggest that the pattern of glucose hypometabolism relates not only to the ictal-onset zone, but also reflects seizure propagation. We investigated metabolic changes in patients with occipital lobe epilepsy (OLE that may reflect propagation of ictal discharge during seizures with automatisms.Methods: Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET between 1994 and 2004 were divided into two groups (with and without automatisms during seizure. Significant regions of hypometabolism were identified by comparing 18F-FDG-PET results from each group with 16 healthy controls by using Statistical Parametric Mapping (SPM 2.Key Findings: Significant hypometabolism was confined largely to the epileptogenic occipital lobe in the patient group without automatisms. In patients with automatisms, glucose hypometabolism extended from the epileptogenic occipital lobe into the ipsilateral temporal lobe.Significance: We identified a distinctive hypometabolic pattern that was specific for OLE patients with automatisms during a seizure. This finding supports the postulate that seizure propagation is a cause of glucose hypometabolism beyond the region of seizure onset.

  11. Metabolic changes in occipital lobe epilepsy with automatisms.

    Science.gov (United States)

    Wong, Chong H; Mohamed, Armin; Wen, Lingfeng; Eberl, Stefan; Somerville, Ernest; Fulham, Michael; Bleasel, Andrew F

    2014-01-01

    Some studies suggest that the pattern of glucose hypometabolism relates not only to the ictal-onset zone but also reflects seizure propagation. We investigated metabolic changes in patients with occipital lobe epilepsy (OLE) that may reflect propagation of ictal discharge during seizures with automatisms. Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG-PET) between 1994 and 2004 were divided into two groups (with and without automatisms during seizure). Significant regions of hypometabolism were identified by comparing (18)F-FDG-PET results from each group with 16 healthy controls by using statistical parametric mapping. Significant hypometabolism was confined largely to the epileptogenic occipital lobe in the patient group without automatisms. In patients with automatisms, glucose hypometabolism extended from the epileptogenic occipital lobe into the ipsilateral temporal lobe. We identified a distinctive hypometabolic pattern that was specific for OLE patients with automatisms during a seizure. This finding supports the postulate that seizure propagation is a cause of glucose hypometabolism beyond the region of seizure onset.

  12. Androgen receptor immunoreactivity in rat occipital cortex after callosotomy

    Directory of Open Access Journals (Sweden)

    G Lepore

    2009-08-01

    Full Text Available Gonadal steroidogenesis can be influenced by direct neural links between the central nervous system and the gonads. It is known that androgen receptor (AR is expressed in many areas of the rat brain involved in neuroendocrine control of reproduction, such as the cerebral cortex. It has been recently shown that the occipital cortex exerts an inhibitory effect on testicular stereoidogenesis by a pituitary-independent neural mechanism. Moreover, the complete transection of the corpus callosum leads to an increase in testosterone (T secretion of hemigonadectomized rats. The present study was undertaken to analyze the possible corticocortical influences regulating male reproductive activities. Adult male Wistar rats were divided into 4 groups: 1 intact animals as control; 2 rats undergoing sham callosotomy; 3 posterior callosotomy; 4 gonadectomy and posterior callosotomy. Western blot analysis showed no remarkable variations in cortical AR expression in any of the groups except in group I where a significant decrease in AR levels was found. Similarly, both immunocytochemical study and cell count estimation showed a lower AR immunoreactivity in occipital cortex of callosotomized rats than in other groups. In addition, there was no difference in serum T and LH concentration between sham-callosotomized and callosotomized rats. In conclusion, our results show that posterior callosotomy led to a reduction in AR in the right occipital cortex suggesting a putative inhibiting effect of the contralateral cortical area.

  13. Progressive skin necrosis of a huge occipital encephalocele

    Science.gov (United States)

    Andarabi, Yasir; Nejat, Farideh; El-Khashab, Mostafa

    2008-01-01

    Objects: Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life. Methods: A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems. Conclusion: Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested. PMID:19753210

  14. Progressive skin necrosis of a huge occipital encephalocele

    Directory of Open Access Journals (Sweden)

    Andarabi Yasir

    2008-01-01

    Full Text Available Objects: Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life. Methods: A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems. Conclusion: Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested.

  15. Use of occipital nerve block in emergency department treatment of status migrainosus: A case report.

    Science.gov (United States)

    Yanuck, Justin; Nelson, Ariana; Jen, Maxwell

    2018-03-21

    Migraine headaches make up a significant proportion of emergency department visits. There are multiple pharmacologic treatment modalities for migraine abortive therapy; however, these treatments are rarely targeted to the precise area of pain and thus elicit multiple systemic effects. It has been well established in the anesthesia pain literature that occipital nerve blocks can provide not only immediate pain relief from occipital migraines, but can also result in a long-term resolution of occipital migraines. In this case report, we present how an occipital nerve block in the emergency department resulted in immediate and long-lasting resolution of a patient's occipital migraine. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Traumatic atlanto-occipital dissociation presenting as locked-in syndrome.

    Science.gov (United States)

    Desai, Rupen; Kinon, Merritt D; Loriaux, Daniel B; Bagley, Carlos A

    2015-12-01

    We present an unusual presentation of unstable atlanto-occipital dissociation as locked-in syndrome. Traumatic atlanto-occipital dissociation is a severe injury that accounts for 15-20% of all fatal cervical spinal injuries. A disruption occurs between the tectorial ligaments connecting the occipital condyle to the superior articulating facets of the atlas, resulting in anterior, longitudinal, or posterior translation, and it may be associated with Type III odontoid fractures. Furthermore, the dissociation may be complete (atlanto-occipital dislocation) or incomplete (atlanto-occipital subluxation), with neurologic findings ranging from normal to complete quadriplegia with respiratory compromise. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Effect of Donepezil on Wernicke Aphasia After Bilateral Middle Cerebral Artery Infarction: Subtraction Analysis of Brain F-18 Fluorodeoxyglucose Positron Emission Tomographic Images.

    Science.gov (United States)

    Yoon, Seo Yeon; Kim, Je-Kyung; An, Young-Sil; Kim, Yong Wook

    2015-01-01

    Aphasia is one of the most common neurologic deficits occurring after stroke. Although the speech-language therapy is a mainstream option for poststroke aphasia, pharmacotherapy is recently being tried to modulate different neurotransmitter systems. However, the efficacy of those treatments is still controversial. We present a case of a 53-year-old female patient with Wernicke aphasia, after the old infarction in the territory of left middle cerebral artery for 8 years and the recent infarction in the right middle cerebral artery for 4 months. On the initial evaluation, the Aphasia Quotient in Korean version of the Western Aphasia Battery was 25.6 of 100. Baseline brain F-18 fluorodeoxyglucose positron emission tomographic images demonstrated a decreased cerebral metabolism in the left temporoparietal area and right temporal lobe. Donepezil hydrochloride, a reversible acetylcholinesterase inhibitor, was orally administered 5 mg/d for 6 weeks after the initial evaluation and was increased to 10 mg/d for the following 6 weeks. After the donepezil treatment, the patient showed improvement in language function, scoring 51.0 of 100 on Aphasia Quotient. A subtraction analysis of the brain F-18 fluorodeoxyglucose positron emission tomographic images after donepezil medication demonstrated increased uptake in both middle temporal gyri, extended to the occipital area and the left cerebellum. Thus, we suggest that donepezil can be an effective therapeutic choice for the treatment of Wernicke aphasia.

  18. Pathways of seizure propagation from the temporal to the occipital lobe.

    Science.gov (United States)

    Jacobs, Julia; Dubeau, François; Olivier, André; Andermann, Frederick

    2008-12-01

    Propagation of ictal epileptic discharges influences the clinical appearance of seizures. Fast propagation from the occipital to temporal lobe has been well described, but until now the reverse direction of spread has not been emphasized. We describe two patients who experienced ictal propagation from temporal to occipital regions. One case presented with amaurosis during a seizure with temporal onset and temporal-occipital spread. In the second, temporal-occipital spread was documented during a seizure, which continued in the occipital lobe for six minutes. Depth electrode studies suggested the temporal ictal onset of seizures in both patients. Propagation from temporal to occipital lobe structures must be considered in the assessment of patients who have seizures with both temporal and occipital features. The propagation may have predictive value for their surgical outcome. The underlying anatomical structure might be the inferior longitudinal fasciculus.

  19. Clinico-anatomical correlations of left posterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Isono, Osamu; Shiota, Junichi; Kawamura, Mitsuru; Hirayama, Keizou; Maki, Toshiyuki.

    1988-01-01

    The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of occlusion of the left posterior cerebral artery. All the patients were righthanded. Right homonimous hemianopia was noted in 8 cases, right upper quadrantanopia in 2 cases, and right lower quadrantanopia in 1 case. Of the 11 cases, alexia without agraphia was noted in 9 cases, all 9 of which showed lesions of inferior occipital cortex (lingual and fusiform gyri) and subjacent white matter. Lesions of splenium were found in only 5 of the cases of alexia without agraphia. In 2 cases with neither alexia nor agraphia, lesions were seen in the medial occipital cortex and the subjacent white matter but not in the inferior occipital lobe. Three patients had color anomia which was accompanied by memory disturbances and alexia without agraphia. In 2 of these 3, lesions were widespread in the region of the left posterior cerebral artery. Memory disturbances were observed in 6 cases, all of which also showed alexia without agraphia. The lesions extended not only of the inferior surface of the occipital lobe and along the interhemispheric fissure, but also of hippocampal and parahippocampal gyri. In 3 cases of alexia without agraphia in which no memory distrubance was found, the symptoms of alexia were slight and disappeared at an early stage. (J.P.N.)

  20. Biomechanical and morphometric evaluation of occipital condyle for occipitocervical segmental fixation

    International Nuclear Information System (INIS)

    Hong, Jae-Taek; Takigaya, Tomoyuki; Sugisaki, Keizo; Orias, A.A.E.; Inoue, Nozomu; An, H.S.

    2011-01-01

    Two recent novel techniques of occipital fixation are the occipitoatlantal (C0-C1) transarticular screw technique and the direct occipital condyle screw technique. The present study evaluated and compared the biomechanical stability of the direct occipital condyle screw and C0-C1 transarticular screw with the established method for craniocervical spine fixation using the midline occipital keel screw and C1 lateral mass screw. Morphometric evaluation of the occipital condyle and the hypoglossal canal was performed to avoid hypoglossal nerve injury during the screw placement. Thirteen recently frozen cadaveric specimens were used. The occipital condyle anatomy and the hypoglossal canal dimension were measured using reconstructed computed tomography images. Insertion torque and pullout strength were evaluated to compare the midline occipital keel screw, C0-C1 transarticular screw, C1 lateral mass screw, and direct occipital condyle screw. The dimensions of the occipital condyle allow use of a 3.5 or 4.0-mm diameter screw. Mean pullout strength was 1619.6 N for the midline occipital keel screw, 870.7 N for the C0-C1 transarticular screw, 707.0 N for the C1 lateral mass screw, and 431.7 N for the direct occipital condyle screw. Mean insertion torque was 0.55 Nm for the midline occipital keel screw, 0.32 Nm for the C0-C1 transarticular screw, 0.14 Nm for the C1 lateral mass screw, and 0.11 Nm for the direct occipital condyle screw. The condylar anatomy allows direct insertion of the occipital condyle screw and C0-C1 transarticular screw. These techniques are suitable options for the treatment of craniovertebral junction instabilities in selected patients. (author)

  1. Occipital plagiocephaly: deformation or lambdoid synostosis? I. morphometric analysis and results of unilateral lambdoid craniectomy

    International Nuclear Information System (INIS)

    Dias, M.S.; Klein, D.M.; Backstrom, J.W.

    1997-01-01

    Between 1987 and 1992, 30 infants aged 1.4-13 months (mean 7.3 months) underwent unilateral lambdoid strip craniectomy at the Children's Hospital of Buffalo for occipital plagiocephaly. Males outnumbered females (22:8) and right-sided occipital flattening was significantly more common than left-sided flattening (25:5). The deformity was noticed at an average age of 3.2 months; 16% of the infants had an asymmetry at birth. Positional preferences (a distinct tendency to lie preferentially on the back, in most cases with the head turned to the ipsilateral side) were described in 79% of infants for whom this information was available, and torticollis was present in 10%. Pre-and post-operative CT scans were analyzed using several morphometric measurements. Asymmetries were measured between the flattened and contralateral sides, both posteriorly and anteriorly, using a translucent grid placed over the CT slice showing maximum asymmetry. The average maximum asymmetry between the flattened and contralateral sides was 24% posteriorly and 16% anteriorly. Significant improvements were seen postoperatively, with both anterior and posterior asymmetries improving by an average of one third (p < 0.05). However, when compared with CT scans from a control group of infants without synostosis, the operated group showed persistent and significant asymmetries postoperatively. The morphometric measurements described allow an objective and reproducible means of assessing the results of various treatments for this disorders. The improvements following unilateral lambdoid craniectomy are difficult to interpret in isolation; we suggest that future efforts be directed toward similarly assessing the results of both nonoperative treatments such as positional changes and molding helmets, and more aggressive surgical treatments that have been advocated for this disorders. (authors)

  2. Rapid recurrence and bilateral lungs, multiple bone metastasis of malignant solitary fibrous tumor of the right occipital lobe: report of a case and review.

    Science.gov (United States)

    Wu, Zhengrong; Yang, Hongjun; Weng, Desheng; Ding, Yanqing

    2015-07-09

    Intracranial malignant solitary fibrous tumor (MSFT) is extremely rare. The authors report a case of MSFT of the right occipital lobe with a rapid recurrence and bilateral lung, multiple bone metastasis. The patient was a 25-year-old male presenting with headache, nausea and visual disturbances without obvious cause. Three times right-side occipital craniotomies were performed and two times postoperative conformal radiotherapy were administered within one year. 4 months after the third time of right-side occipital craniotomy, the patient felt right chest pain and neck pain. Positron emission tomography/computed tomography (PET/CT) showed tumor recurrence of the right occipital lobe and bilateral lung metastasis, multiple bone metastasis including: vertebrae, libs, the left iliac wing, sacrum, the right ischium and upper parts of both femurs. Ultrasound guided puncture biopsy of left-side back of the neck and CT guided puncture biopsy of the third lumbar vertebra were performed. General sample showed grayish white or grayish red with irregular shape. Histopathologically, the tumor was composed of areas of alternating hypercellularity and hypocellularity with spindle-shaped cells, which arranged as fascicular, storiform pattern or patternless pattern, with intervening irregular eosinophilic collagen bundles. Some areas showed hemangiopericytoma-like perivascular pattern and perivascular hyalinization. Tumor cells were pleomorphic with mitotic counts of more than 4 per 10 high power fields and showed coagulative necrosis. Immunohistochemically, tumor cells were diffusely positive for vimentin and CD99, focal positive for CD34, bcl-2 and Actin. Ki-67 labelling index was more than 40%. The final pathological diagnosis was MSFT of the right occipital lobe, metastatic MSFT of left-side back of the neck and the third lumbar vertebra. The MSFT of the right occipital lobe with recurrence and bilateral lung, multiple bone metastasis is extremely rare. Although intracranial

  3. Benign childhood epilepsy with occipital paroxysms: neuropsychological findings.

    Science.gov (United States)

    Germanò, Eva; Gagliano, Antonella; Magazù, Angela; Sferro, Caterina; Calarese, Tiziana; Mannarino, Erminia; Calamoneri, Filippo

    2005-05-01

    Benign childhood epilepsy with occipital paroxysms is classified among childhood benign partial epilepsies. The absence of neurological and neuropsychological deficits has long been considered as a prerequisite for a diagnosis of benign childhood partial epilepsy. Much evidence has been reported in literature in the latest years suggesting a neuropsychological impairment in this type of epilepsy, particularly in the type with Rolandic paroxysms. The present work examines the neuropsychological profiles of a sample of subjects affected by the early-onset benign childhood occipital seizures (EBOS) described by Panayotopulos. The patient group included 22 children (14 males and 8 females; mean age 10.1+/-3.3 years) diagnosed as having EBOS. The patients were examined with a set of tests investigating neuropsychological functions: memory, attention, perceptive, motor, linguistic and academic (reading, writing, arithmetic) abilities. The same instruments have been given to a homogeneous control group as regards sex, age, level of education and socio-economic background. None of the subjects affected by EBOS showed intellectual deficit (mean IQ in Wechsler Full Scale 91.7; S.D. 8.9). Results show a widespread cognitive dysfunction in the context of a focal epileptogenic process in EBOS. In particular, children with EBOS show a significant occurrence of specific learning disabilities (SLD) and other subtle neuropsychological deficits. We found selective dysfunctions relating to perceptive-visual attentional ability (pmemory abilities (psupports the hypothesis that epilepsy itself plays a role in the development of neuropsychological impairment. Supported by other studies that have documented subtle neuropsychological deficits in benign partial epilepsy, we stress the importance of reconsidering its supposed "cognitive benignity", particularly in occipital types.

  4. Epilepsy classification and additional definitions in occipital lobe epilepsy.

    Science.gov (United States)

    Yilmaz, Kutluhan; Karatoprak, Elif Yüksel

    2015-09-01

    To evaluate epileptic children with occipital lobe epilepsy (OLE) in the light of the characteristics of Panayiotopoulos syndrome and late-onset occipital lobe epilepsy of Gastaut (OLE-G). Patients were categorized into six groups: primary OLE with autonomic symptoms (Panayiotopoulos syndrome), primary OLE with visual symptoms (OLE-G), secondary OLE with autonomic symptoms (P-type sOLE), secondary OLE with visual symptoms (G-type sOLE), and non-categorized primary OLE and non-categorized secondary OLE according to characteristic ictal symptoms of both Panayiotopoulos syndrome and OLE-G, as well as aetiology (primary or secondary). Patients were compared with regards to seizure symptoms, aetiology, cranial imaging, EEG, treatment and outcome. Of 108 patients with OLE (6.4±3.9 years of age), 60 patients constituted primary groups (32 with Panayiotopoulos syndrome, 11 with OLE-G, and 17 with non-categorized primary OLE); the other 48 patients constituted secondary groups (eight with P-type sOLE, three with G-type sOLE, and 37 with non-categorized sOLE). Epileptiform activity was restricted to the occipital area in half of the patients. Generalized epileptiform activity was observed in three patients, including a patient with Panayiotopoulos syndrome (PS). Only one patient had refractory epilepsy in the primary groups while such patients made up 29% in the secondary groups. In OLE, typical autonomic or visual ictal symptoms of Panayiotopoulos syndrome and OLE-G do not necessarily indicate primary (i.e. genetic or idiopathic) aetiology. Moreover, primary OLE may not present with these symptoms. Since there are many patients with OLE who do not exhibit the characteristics of Panayiotopoulos syndrome or OLE-G, additional definitions and terminology appear to be necessary to differentiate between such patients in both clinical practice and studies.

  5. Imagery of a moving object: the role of occipital cortex and human MT/V5+.

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    Kaas, Amanda; Weigelt, Sarah; Roebroeck, Alard; Kohler, Axel; Muckli, Lars

    2010-01-01

    Visual imagery--similar to visual perception--activates feature-specific and category-specific visual areas. This is frequently observed in experiments where the instruction is to imagine stimuli that have been shown immediately before the imagery task. Hence, feature-specific activation could be related to the short-term memory retrieval of previously presented sensory information. Here, we investigated mental imagery of stimuli that subjects had not seen before, eliminating the effects of short-term memory. We recorded brain activation using fMRI while subjects performed a behaviourally controlled guided imagery task in predefined retinotopic coordinates to optimize sensitivity in early visual areas. Whole brain analyses revealed activation in a parieto-frontal network and lateral-occipital cortex. Region of interest (ROI) based analyses showed activation in left hMT/V5+. Granger causality mapping taking left hMT/V5+ as source revealed an imagery-specific directed influence from the left inferior parietal lobule (IPL). Interestingly, we observed a negative BOLD response in V1-3 during imagery, modulated by the retinotopic location of the imagined motion trace. Our results indicate that rule-based motion imagery can activate higher-order visual areas involved in motion perception, with a role for top-down directed influences originating in IPL. Lower-order visual areas (V1, V2 and V3) were down-regulated during this type of imagery, possibly reflecting inhibition to avoid visual input from interfering with the imagery construction. This suggests that the activation in early visual areas observed in previous studies might be related to short- or long-term memory retrieval of specific sensory experiences.

  6. Conceito anátomo-fisiológico do lobo occipital Functional anatomy of the occipital lobe

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    M. Caetano de Barros

    1972-03-01

    Full Text Available Apenas do ponto de vista estritamente anatômico o lobo occipital pode ser delimitado com relativa facilidade. Aparentemente constitui uma unidade morfológica, séde de estruturas basicamente relacionados com a percepção visual, aí entendidos também certos mecanismos integrativos óculo-motores que, em última análise, não são senão componentes dêste complexo fenômeno perceptivo. Depois de revistos alguns detalhes da anatomia convencional do lobo occipital (limites, área cortical estriada, peri-estriada e para-estriada é feita uma tentativa, à base de estudo da literatura, no sentido de indicar as principais conexões destas áreas (radiações ópticas, feixes de associação, fibras de projeção e fibras comissurais com diferentes estruturas do sistema nervoso central. A vascularização do lobo occipital é revisada com o auxílio de preparações anátomo-radiológicas seriadas e seletivas de diferentes troncos arteriais, nas quais se constatam intercomunicações entre os setores "terminais" dos sistemas das artérias cerebral posterior, média e anterior. Algumas variações morfológicas dos cornos occipitais são também postas em evidência com recursos de técnicas anátomo-radiológicas. Todavia, dados puramente anatômicos não são suficientes para compreensão das funções psico-fisiológicas do lobo occipital que pode ser conceituado como parte de um sistema perceptivo — o sistema óptico — altamente complexo, funcionando integradamente com múltiplos sectores do sistema nervoso e envolvendo diferentes mecanismos. Muito provàvelmente êste sistema, à maneira de muitos outros sistemas biológicos, está composto de vários circuitos mutuamente conjugados agindo sob o princípio de servo-mecanismos, devendo sua ação ser encaixada dentro do conceito das "totalidades" (Gestalten, cuja funcionalidade não deriva da soma dos seus componentes, mas da relação funcional que estes mantém entre sí para a atua

  7. Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation.

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    María José Fernández-Pérez

    Full Text Available The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM in growing and young adult subjects using cone beam computed tomography (CBCT. CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method. Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89 that essential was similar for females (r = 0.88 and males (r = 0.89. CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.

  8. Segregation and persistence of form in the lateral occipital complex.

    Science.gov (United States)

    Ferber, Susanne; Humphrey, G Keith; Vilis, Tutis

    2005-01-01

    While the lateral occipital complex (LOC) has been shown to be implicated in object recognition, it is unclear whether this brain area is responsive to low-level stimulus-driven features or high-level representational processes. We used scrambled shape-from-motion displays to disambiguate the presence of contours from figure-ground segregation and to measure the strength of the binding process for shapes without contours. We found persisting brain activation in the LOC for scrambled displays after the motion stopped indicating that this brain area subserves and maintains figure-ground segregation processes, a low-level function in the object processing hierarchy. In our second experiment, we found that the figure-ground segregation process has some form of spatial constancy indicating top-down influences. The persisting activation after the motion stops suggests an intermediate role in object recognition processes for this brain area and might provide further evidence for the idea that the lateral occipital complex subserves mnemonic functions mediating between iconic and short-term memory.

  9. Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation.

    Science.gov (United States)

    Fernández-Pérez, María José; Alarcón, José Antonio; McNamara, James A; Velasco-Torres, Miguel; Benavides, Erika; Galindo-Moreno, Pablo; Catena, Andrés

    2016-01-01

    The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.

  10. [A painful occipital mass revealing a posterior encephalocele].

    Science.gov (United States)

    Meunier, Sarah; Michalak, Sophie; Chaigneau, Julien; Mercier, Philippe; Rousseau, Audrey

    2014-08-01

    Encephalocele is a congenital malformation caused by a neural tube defect during embryonic development. We report a case of posterior encephalocele in a 7-month-old infant with a painful occipital mass known since birth. Pathological examination of the mass showed different mature tissues derived from the brain and its coverings (e.g., neuroglia, ependymal canals and clusters of meningothelial cells). A diagnosis of encephalocele was made. The different forms of neural tube defect will be briefly discussed, especially the "aborted" forms (e.g., non-specific midline mass lesion or angioma) that the pathologist may encounter in his/her daily practice. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Occipital Alpha and Gamma Oscillations Support Complementary Mechanisms for Processing Stimulus Value Associations.

    Science.gov (United States)

    Marshall, Tom R; den Boer, Sebastiaan; Cools, Roshan; Jensen, Ole; Fallon, Sean James; Zumer, Johanna M

    2018-01-01

    Selective attention is reflected neurally in changes in the power of posterior neural oscillations in the alpha (8-12 Hz) and gamma (40-100 Hz) bands. Although a neural mechanism that allows relevant information to be selectively processed has its advantages, it may lead to lucrative or dangerous information going unnoticed. Neural systems are also in place for processing rewarding and punishing information. Here, we examine the interaction between selective attention (left vs. right) and stimulus's learned value associations (neutral, punished, or rewarded) and how they compete for control of posterior neural oscillations. We found that both attention and stimulus-value associations influenced neural oscillations. Whereas selective attention had comparable effects on alpha and gamma oscillations, value associations had dissociable effects on these neural markers of attention. Salient targets (associated with positive and negative outcomes) hijacked changes in alpha power-increasing hemispheric alpha lateralization when salient targets were attended, decreasing it when they were being ignored. In contrast, hemispheric gamma-band lateralization was specifically abolished by negative distractors. Source analysis indicated occipital generators of both attentional and value effects. Thus, posterior cortical oscillations support both the ability to selectively attend while at the same time retaining the ability to remain sensitive to valuable features in the environment. Moreover, the versatility of our attentional system to respond separately to salient from merely positively valued stimuli appears to be carried out by separate neural processes reflected in different frequency bands.

  12. Overlooked metastatic lesions of the occipital condyle: a missed case treasure trove.

    Science.gov (United States)

    Loevner, L A; Yousem, D M

    1997-01-01

    Radiologic images obtained in nine patients with known primary cancer and occipital or head and neck pain were retrospectively reviewed after having been initially interpreted as normal. Imaging studies included head computed tomography (CT) in five cases, brain magnetic resonance (MR) imaging in six cases, cervical spine CT and MR imaging in five cases, radiography in two cases, and scintigraphy in two cases. This reevaluation demonstrated lesions of the occipital condyles in all patients. Seven patients had unilateral occipital condyle masses, and two patients had bilateral condyle lesions. Lesions were found to either involve only the occipital condyle (n = 4), extend to the adjacent occipital bone (n = 3), or extend to the ipsilateral clivus (n = 2). Misinterpretation of radiologic examinations resulted in an average delay in diagnosis of 10 weeks from the onset of symptoms to definitive therapy (irradiation). It is important to evaluate the occipital condyles in all patients with occipital pain, especially those with cancer. Neoplastic disease involving the occipital condyles is not common; however, it is frequently missed at imaging. Careful review of unenhanced sagittal and axial T1-weighted MR images and of the inferior sections from axial head CT studies will make it possible to avoid this potential pitfall.

  13. Brain mapping of epileptic activity in a case of idiopathic occipital lobe epilepsy (Panayiotopoulos syndrome).

    Science.gov (United States)

    Leal, Alberto J R; Nunes, Sofia; Martins, António; Secca, Mário Forjaz; Jordão, Constança

    2007-06-01

    The Panayiotopoulos type of occipital lobe epilepsy has generated great interest, but the particular brain areas involved in the peculiar seizure manifestations have not been established. We studied a patient with the syndrome, using high-resolution EEG and simultaneous EEG and functional magnetic resonance imaging (fMRI). Resolution of the scalp EEG was improved using a realistic spline Laplacian algorithm, and produced a complex distribution of current sinks and sources over the occipital lobe. The spike-related blood oxygen level dependent (BOLD) effect was multifocal, with clusters in lateral and inferior occipital lobe and lateral and anterior temporal lobe. We also performed regional dipole seeding in BOLD clusters to determine their relative contribution to generation of scalp spikes. The integrated model of the neurophysiologic and vascular data strongly suggests that the epileptic activity originates in the lateral occipital area, spreading to the occipital pole and lateral temporal lobe.

  14. Transsynaptic neuronal degeneration of optic nerves associated with bilateral occipital lesions

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    Sachdev Mahipal

    1990-01-01

    Full Text Available A case is reported of a 9-year old male who presented with abnormal behaviour and progressive diminution of vision. Pupils were middilated in both eyes but the pupillary reflexes were preserved. Fundus examination revealed a bilateral optic atrophy and radiological investigations showed a bilateral occipital calcification. We hereby document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions. Transsynapptic neuronal degeneration of optic nerves consequent to occipital lobe lesions is a rare phenomenon. Experimentally occipital lobe ablation in non-human primates has been shown to result in optic atrophy. Herein, we document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions.

  15. Neuronal populations in the occipital cortex of the blind synchronize to the temporal dynamics of speech

    Science.gov (United States)

    Van Ackeren, Markus Johannes; Barbero, Francesca M; Mattioni, Stefania; Bottini, Roberto

    2018-01-01

    The occipital cortex of early blind individuals (EB) activates during speech processing, challenging the notion of a hard-wired neurobiology of language. But, at what stage of speech processing do occipital regions participate in EB? Here we demonstrate that parieto-occipital regions in EB enhance their synchronization to acoustic fluctuations in human speech in the theta-range (corresponding to syllabic rate), irrespective of speech intelligibility. Crucially, enhanced synchronization to the intelligibility of speech was selectively observed in primary visual cortex in EB, suggesting that this region is at the interface between speech perception and comprehension. Moreover, EB showed overall enhanced functional connectivity between temporal and occipital cortices that are sensitive to speech intelligibility and altered directionality when compared to the sighted group. These findings suggest that the occipital cortex of the blind adopts an architecture that allows the tracking of speech material, and therefore does not fully abstract from the reorganized sensory inputs it receives. PMID:29338838

  16. The oblique occipital sinus: anatomical study using bone subtraction 3D CT venography.

    Science.gov (United States)

    Shin, Hwa Seon; Choi, Dae Seob; Baek, Hye Jin; Choi, Ho Cheol; Choi, Hye Young; Park, Mi Jung; Kim, Ji Eun; Han, Jeong Yeol; Park, SungEun

    2017-06-01

    An occipital sinus draining into the sigmoid sinus has been termed the oblique occipital sinus (OOS). The frequency, anatomical features, patterns, and relationship with the transverse sinus of the oblique occipital sinus were analyzed in this study. The study included 1805 patients who underwent brain CT angiography during a 3-year period from 2013 to 2015. CT examinations were performed using a 64-slice MDCT system. The OOS was identified in 41 patients (2.3%). There were many anatomical variations in the oblique occipital sinuses. A hypoplastic or aplastic TS was seen in 31 (75.6%) of the 41 patients with OOS. Many anatomical variations in the oblique occipital sinus can be seen on CT venography. Some OOSs function as the main drainage route of the intracranial veins instead of the TS. Thus, careful examination is essential for preoperative evaluation in posterior fossa lesions.

  17. The Occipital Face Area Is Causally Involved in Facial Viewpoint Perception.

    Science.gov (United States)

    Kietzmann, Tim C; Poltoratski, Sonia; König, Peter; Blake, Randolph; Tong, Frank; Ling, Sam

    2015-12-16

    Humans reliably recognize faces across a range of viewpoints, but the neural substrates supporting this ability remain unclear. Recent work suggests that neural selectivity to mirror-symmetric viewpoints of faces, found across a large network of visual areas, may constitute a key computational step in achieving full viewpoint invariance. In this study, we used repetitive transcranial magnetic stimulation (rTMS) to test the hypothesis that the occipital face area (OFA), putatively a key node in the face network, plays a causal role in face viewpoint symmetry perception. Each participant underwent both offline rTMS to the right OFA and sham stimulation, preceding blocks of behavioral trials. After each stimulation period, the participant performed one of two behavioral tasks involving presentation of faces in the peripheral visual field: (1) judging the viewpoint symmetry; or (2) judging the angular rotation. rTMS applied to the right OFA significantly impaired performance in both tasks when stimuli were presented in the contralateral, left visual field. Interestingly, however, rTMS had a differential effect on the two tasks performed ipsilaterally. Although viewpoint symmetry judgments were significantly disrupted, we observed no effect on the angle judgment task. This interaction, caused by ipsilateral rTMS, provides support for models emphasizing the role of interhemispheric crosstalk in the formation of viewpoint-invariant face perception. Faces are among the most salient objects we encounter during our everyday activities. Moreover, we are remarkably adept at identifying people at a glance, despite the diversity of viewpoints during our social encounters. Here, we investigate the cortical mechanisms underlying this ability by focusing on effects of viewpoint symmetry, i.e., the invariance of neural responses to mirror-symmetric facial viewpoints. We did this by temporarily disrupting neural processing in the occipital face area (OFA) using transcranial magnetic

  18. Functional organization of the face-sensitive areas in human occipital-temporal cortex.

    Science.gov (United States)

    Shao, Hanyu; Weng, Xuchu; He, Sheng

    2017-08-15

    face-selective response similarity with r-pFFA and r-OFA, indicating it was specifically involved in processing face information. Results also reveal two properties of these face sensitive regions across the two hemispheres: (1) the averaged left intra-hemispheric response similarity for the images was lower than the averaged right intra-hemispheric and the inter-hemispheric response similarity, implying convergence of face processing towards the right hemisphere, and (2) the response similarities between homologous regions in the two hemispheres decreased as information processing proceeded from the early, more posterior, processing stage (OFA), indicating an increasing degree of hemispheric specialization and right hemisphere bias for face information processing. This study contributes to an emerging picture of how faces are processed within the occipital and temporal cortex. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Analysis of occipital lobe activation during functional MRI in patients with open-angle glaucoma and correlation with clinical results

    International Nuclear Information System (INIS)

    Dai Hui; Liu Yunlian; Hu Chunhong; Li Yonggang; Guo Liang; Qi Jianpin; Xia Liming

    2013-01-01

    Objective: To evaluate the activation of the visual cortex in patients with primary open angle glaucoma (POAG) and to explore whether the neuronal activity corresponds with retinal nerve fiber layer (RNFL) and cup-to-disc (C/D) values. Methods: Twenty-five patients and 25 gender-and age matched healthy volunteers were studied. Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and three-dimensional brain volume imaging (3D BRAVO) sequences were obtained using 3 T MR imaging system. A full-screen black-white shift checkerboard was used for visual stimulus during the fMRI experiment and was performed on each eye of all subjects using a visual-acoustical system. All acquired data were postprocessed and analyzed by statistical parametric mapping (SPM). After analysis, individual activated mapping, intra-group mean activated mapping, and inter-group variant mapping were observed. The voxel number, intensity, and Montreal Neurological Institute (MNI) coordinate of the activated clusters were recorded. The Xjviewer software was utilized to obtain activated voxel numbers in occipital lobe. A Pearson correlated test was performed to test the correlation between the number of activated voxels and RNFL, C/D and Hodapp-Anderson-Parrish (HAP) clinical stage. Results: Intra-group mean activated mappings of both patients and volunteers showed obvious activation in bilateral occipital lobes. As compared with healthy volunteers, the POAG patients exhibited statistically significantly decreased activation in bilateral occipital lobes, left hippocampus, and left cerebellum, along with lower mean RNFL [(71.56 ± 21.54) μm versus (111.88 ± 9.96) μm] and higher C/D values (0.71 ± 0.18 versus 0.36 ± 0.08 ; t value was respectively -10.901 and 11.643, P 0.05). Conclusions: fMRI demonstrated differences in visual cortex activation in POAG patients relative to healthy volunteers, suggesting it might be a promising complementary method for diagnosing

  20. The transperiosteal "inside-out" occipital artery harvesting technique.

    Science.gov (United States)

    Benet, Arnau; Tabani, Halima; Ding, Xinmin; Burkhardt, Jan-Karl; Rodriguez Rubio, Roberto; Tayebi Meybodi, Ali; Nisson, Peyton; Kola, Olivia; Gandhi, Sirin; Yousef, Sonia; Lawton, Michael T

    2018-01-26

    OBJECTIVE The occipital artery (OA) is a frequently used donor vessel for posterior circulation bypass procedures due to its proximity to the recipient vessels and its optimal caliber, length, and flow rate. However, its tortuous course through multiple layers of suboccipital muscles necessitates layer-by-layer dissection. The authors of this cadaveric study aimed to describe a landmark-based novel anterograde approach to harvest OA in a proximal-to-distal "inside-out" fashion, which avoids multilayer dissection. METHODS Sixteen cadaveric specimens were prepared for surgical simulation, and the OA was harvested using the classic (n = 2) and novel (n = 14) techniques. The specimens were positioned three-quarters prone, with 45° contralateral head rotation. An inverted hockey-stick incision was made from the spinous process of C-2 to the mastoid tip, and the distal part of the OA was divided to lift up a myocutaneous flap, including the nuchal muscles. The OA was identified using the occipital groove (OG), the digastric muscle (DM) and its groove (DG), and the superior oblique muscle (SOM) as key landmarks. The OA was harvested anterogradely from the OG and within the flap until the skin incision was reached (proximal-to-distal technique). In addition, 35 dry skulls were assessed bilaterally (n = 70) to study additional craniometric landmarks to infer the course of the OA in the OG. RESULTS The OA was consistently found running in the OG, which was found between the posterior belly of the DM and the SOM. The mean total length of the mobilized OA was 12.8 ± 1.2 cm, with a diameter of 1.3 ± 0.1 mm at the suboccipital segment and 1.1 ± 0.1 mm at the skin incision. On dry skulls, the occipitomastoid suture (OMS) was found to be medial to the OG in the majority of the cases (68.6%), making it a useful landmark to locate the OG and thus the proximal OA. CONCLUSIONS The anterograde transperiosteal inside-out approach for harvesting the OA is a fast and easy technique

  1. Activation on occipital lobe in children with abacus mental calculation training: an fMRI study

    International Nuclear Information System (INIS)

    Shen Xiaojun; Long Jinfeng; Zhao Kunyuan; Li Lixin; Sun Jining; Wang Bin

    2011-01-01

    Objective: By exploring the activation on occipital lobe in children with and without abacus mental calculation training when they engaged in different calculation tasks with functional magnetic resonance imaging (fMRI), to identify the possible mechanism of occipital lobe in abacus mental calculation. Methods: fMRI was performed in children trained with and without (sixteen in each group) abacus mental calculation when they engaged in addition, subtraction. multiplication, division, and number-object control judging tasks. The data processing and statistical analysis were performed on SPM 2.0 (statistical parametric mapping 2.0) and the related-brain functional areas were identified. The activation on occipital lobe was observed carefully. The difference in activated areas of occipital lobe was statistically significant between two groups engaged in different tasks of calculations (P<0.01). Result: Bilateral occipital lobe, especially in the cuneus and lingual gyrus, were activated in children trained with abacus mental calculation. The main activated area was lingual gyrus in children without abacus mental calculation. Conclusion: The occipital lobe participates visuospatial processing in the abacus mental calculations. The neuromechanism maybe account for the specific activation in occipital lobe. (authors)

  2. Early seizure propagation from the occipital lobe to medial temporal structures and its surgical implication.

    Science.gov (United States)

    Usui, Naotaka; Mihara, Tadahiro; Baba, Koichi; Matsuda, Kazumi; Tottori, Takayasu; Umeoka, Shuichi; Nakamura, Fumihiro; Terada, Kiyohito; Usui, Keiko; Inoue, Yushi

    2008-12-01

    Intracranial EEG documentation of seizure propagation from the occipital lobe to medial temporal structures is relatively rare. We retrospectively analyzed intracranial EEG recorded with electrodes implanted in the medial temporal lobe in patients who underwent occipital lobe surgery. Four patients with occipital lesions, who underwent intracranial EEG monitoring with intracerebral electrodes implanted in the medial temporal lobe prior to occipital lobe surgery, were studied. Subdural electrodes were placed over the occipital lobe and adjacent areas. Intracerebral electrodes were implanted into bilateral hippocampi and the amygdala in three patients, and in the hippocampus and amygdala ipsilateral to the lesion in one. In light of the intracranial EEG findings, the occipital lobe was resected but the medial temporal lobe was spared in all patients. The follow-up period ranged from six to 16 years, and seizure outcome was Engel Class I in all patients. Sixty six seizures were analyzed. The majority of the seizures originated from the occipital lobe. In complex partial seizures, ictal discharges propagated to the medial temporal lobe. No seizures originating from the temporal lobe were documented. In some seizures, the ictal-onset zone could not be identified. In these seizures, very early propagation to the medial temporal lobe was observed. Interictal spikes were recorded in the medial temporal lobe in all cases. Intracranial EEG revealed very early involvement of the medial temporal lobe in some seizures. Seizure control was achieved without resection of the medial temporal structures.

  3. Prevalence of resistant occipital lobe epilepsy associated with celiac disease in children.

    Science.gov (United States)

    Dai, Alper I; Akcali, Aylin; Varan, Celal; Demiryürek, Abdullah T

    2014-06-01

    Celiac disease (CD) is a chronic, inflammatory autoimmune disorder caused by intolerance to ingested gluten. Increased frequency of CD has been reported in occipital lobe epilepsy. The aim of the present study is to investigate the frequency of CD among children followed up due to epilepsy and diagnosed with epileptic activity in the occipital lobe in at least one electroencephalography (EEG) test. For this research, 90 pediatric epilepsy patients with epileptic activity in the occipital lobe were enrolled in the study group, while the control group comprised of 100 healthy children. In addition to the EEG examination, tissue transglutaminase (tTG) antibody was determined on duodenal biopsy. None of the healthy children in the control group was positive in terms of the tTG antibody test used to scan CD. In the group with epileptic activity in the occipital lobe, two patients out of 90 were tTG antibody positive. The seroprevalence was 1/45 (2.22 %) in this group. These two patients were diagnosed with CD based on the endoscopic duodenal biopsy. In these patients, the seizures were uncontrollable through monotherapy. Our results showed that the prevalence of CD is observed to be higher than the normal population among the patients with occipital lobe epilepsy. This type of seizure disorder seems to be more resistant to monotherapy, compared with other types of occipital epilepsy. Therefore, screening for CD is recommended in children with resistant epileptic activity in the occipital lobe.

  4. Atlanto-Occipital Rotatory Dislocation: A Case Report and Systematic Review.

    Science.gov (United States)

    Robles, Luis A; Mundis, Greg M; Cuevas-Solórzano, Abel

    2018-02-01

    Atlanto-occipital rotatory dislocation (AORD) has rarely been reported in the literature; for this reason, the clinicoradiologic characteristics of this injury are not well described. We describe the case of a 67-year-old man who sustained a cervical spine trauma. He reported only neck pain and was neurologically intact. A computed tomography scan showed a rotatory displacement of the atlanto-occipital joints associated with a widened condylar-C1 interval; in addition, magnetic resonance imaging showed injuries to the stabilizing ligaments of this area. A systematic literature review was also performed to identify previous cases of patients with AORD. The patient was treated with craniocervical fixation from occipital to C1, achieving a good outcome. The literature review yielded 9 cases of patients with AORD. Compared with patients with atlanto-occipital dislocation, patients with rotatory dislocations have a less severe degree of displacement of the atlanto-occipital joints and better clinical outcome. Compared with previously classified atlanto-occipital dislocations, AORD is an independent and unique variation. AORD presents with different biomechanical, clinicoradiologic, and prognostic characteristics and represents an important addition to the spectrum of atlanto-occipital dislocation injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Ultrasonography of occipital arteries to diagnose giant cell arteritis: a case series and literature review.

    Science.gov (United States)

    Pinnell, Jonathan; Tiivas, Carl; Perkins, Phillip; Blake, Tim; Saravana, Shanmugam; Dubey, Shirish

    2018-02-01

    We describe four cases of giant cell arteritis (GCA) that presented with occipital headache in the last 6 months. Typical ultrasound features of GCA were found in the occipital arteries which helped to confirm the diagnosis. One patient had already suffered significant visual loss by the time the diagnosis was made, reflecting the similarity in prognosis to the more typical GCA patients. These cases prompted a review of the literature to evaluate the evidence regarding the use of occipital artery ultrasonography in the investigation of GCA. We searched PubMed, Google Scholar and Web of Science and identified 17 papers but only four of these were relevant studies. The studies available show that typical features of GCA can be detected in the occipital arteries using ultrasonography. They also suggest that ultrasonography can detect changes in the occipital arteries when temporal arteries are not involved. However, occipital artery abnormalities were less common than temporal artery abnormalities in GCA. We advocate maintaining a high index of suspicion for GCA in patients presenting with atypical features, such as occipital headache. Ultrasonography has a vital role to play in the diagnosis of these patients. We recommend priority imaging of the affected area to facilitate prompt and accurate diagnosis of GCA, especially when atypical vessels are involved.

  6. Widespread temporo-occipital lobe dysfunction in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Loewe, Kristian; Machts, Judith; Kaufmann, Jörn; Petri, Susanne; Heinze, Hans-Jochen; Borgelt, Christian; Harris, Joseph Allen; Vielhaber, Stefan; Schoenfeld, Mircea Ariel

    2017-01-09

    Recent studies suggest that amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) lie on a single clinical continuum. However, previous neuroimaging studies have found only limited involvement of temporal lobe regions in ALS. To better delineate possible temporal lobe involvement in ALS, the present study aimed to examine changes in functional connectivity across the whole brain, particularly with regard to extra-motor regions, in a group of 64 non-demented ALS patients and 38 healthy controls. To assess between-group differences in connectivity, we computed edge-level statistics across subject-specific graphs derived from resting-state functional MRI data. In addition to expected ALS-related decreases in functional connectivity in motor-related areas, we observed extensive changes in connectivity across the temporo-occipital cortex. Although ALS patients with comorbid FTD were deliberately excluded from this study, the pattern of connectivity alterations closely resembles patterns of cerebral degeneration typically seen in FTD. This evidence for subclinical temporal dysfunction supports the idea of a common pathology in ALS and FTD.

  7. The occipital place area represents the local elements of scenes.

    Science.gov (United States)

    Kamps, Frederik S; Julian, Joshua B; Kubilius, Jonas; Kanwisher, Nancy; Dilks, Daniel D

    2016-05-15

    Neuroimaging studies have identified three scene-selective regions in human cortex: parahippocampal place area (PPA), retrosplenial complex (RSC), and occipital place area (OPA). However, precisely what scene information each region represents is not clear, especially for the least studied, more posterior OPA. Here we hypothesized that OPA represents local elements of scenes within two independent, yet complementary scene descriptors: spatial boundary (i.e., the layout of external surfaces) and scene content (e.g., internal objects). If OPA processes the local elements of spatial boundary information, then it should respond to these local elements (e.g., walls) themselves, regardless of their spatial arrangement. Indeed, we found that OPA, but not PPA or RSC, responded similarly to images of intact rooms and these same rooms in which the surfaces were fractured and rearranged, disrupting the spatial boundary. Next, if OPA represents the local elements of scene content information, then it should respond more when more such local elements (e.g., furniture) are present. Indeed, we found that OPA, but not PPA or RSC, responded more to multiple than single pieces of furniture. Taken together, these findings reveal that OPA analyzes local scene elements - both in spatial boundary and scene content representation - while PPA and RSC represent global scene properties. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Frontal and occipital perfusion changes in dissociative identity disorder.

    Science.gov (United States)

    Sar, Vedat; Unal, Seher N; Ozturk, Erdinc

    2007-12-15

    The aim of the study was to investigate if there were any characteristics of regional cerebral blood flow (rCBF) in dissociative identity disorder. Twenty-one drug-free patients with dissociative identity disorder and nine healthy volunteers participated in the study. In addition to a clinical evaluation, dissociative psychopathology was assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders, the Dissociative Experiences Scale and the Clinician-Administered Dissociative States Scale. A semi-structured interview for borderline personality disorder, the Hamilton Depression Rating Scale, and the Childhood Trauma Questionnaire were also administered to all patients. Normal controls had to be without a history of childhood trauma and without any depressive or dissociative disorder. Regional cerebral blood flow (rCBF) was studied with single photon emission computed tomography (SPECT) with Tc99m-hexamethylpropylenamine (HMPAO) as a tracer. Compared with findings in the control group, the rCBF ratio was decreased among patients with dissociative identity disorder in the orbitofrontal region bilaterally. It was increased in median and superior frontal regions and occipital regions bilaterally. There was no significant correlation between rCBF ratios of the regions of interest and any of the psychopathology scale scores. An explanation for the neurophysiology of dissociative psychopathology has to invoke a comprehensive model of interaction between anterior and posterior brain regions.

  9. Stereoscopic vision in the absence of the lateral occipital cortex.

    Directory of Open Access Journals (Sweden)

    Jenny C A Read

    2010-09-01

    Full Text Available Both dorsal and ventral cortical visual streams contain neurons sensitive to binocular disparities, but the two streams may underlie different aspects of stereoscopic vision. Here we investigate stereopsis in the neurological patient D.F., whose ventral stream, specifically lateral occipital cortex, has been damaged bilaterally, causing profound visual form agnosia. Despite her severe damage to cortical visual areas, we report that DF's stereo vision is strikingly unimpaired. She is better than many control observers at using binocular disparity to judge whether an isolated object appears near or far, and to resolve ambiguous structure-from-motion. DF is, however, poor at using relative disparity between features at different locations across the visual field. This may stem from a difficulty in identifying the surface boundaries where relative disparity is available. We suggest that the ventral processing stream may play a critical role in enabling healthy observers to extract fine depth information from relative disparities within one surface or between surfaces located in different parts of the visual field.

  10. Diagnosis of occipital condyle fractures; Diagnostik von Frakturen der Okzipitalkondylen

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    Hefele-Roedel, B. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany); Vogl, T.J. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany); Lochbuehler, H. [Dr. v. Haunersches Kinderspital, Kinderchirurgische Klinik, Univ. Muenchen (Germany); Lissner, J. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany)

    1995-01-01

    Following the conventional X-ray diagnosis of the skull and upper cervical spine, CT proved to be the primary diagnostic method after a skull and brain injury: For all 4 cases we succeeded in detecting the occipital condyle fracture and in determing its size and location by reconstructions (coronal, sagittal, 3-D). In the case of complex occompanying injuries like soft tissue hematomas (cerebral, in the spinal cord, and the soft tissue of the neck) or for the detection of brain stem contusion, MRT had significant advantages. MRT can offer a higher image quality in soft tissue, especially in the spinal cord and the brain. (orig.) [Deutsch] Im Anschluss an die konventionelle Roentgendiagnostik des Schaedels und der Halswirbelsaeule, erwies sich die Computertomographie als primaer einzusetzendes diagnostisches Verfahren, nach erlittenem Schaedel-Hirn-Trauma. In allen Faellen gelang der exakte Frakturnachweis an den Okzipitalkondylen, die Bestimmung des Frakturausmasses und die genaue Frakturlokalisation in Rekonstruktionen (koronar, sagittal, 3-D). Bei komplexen Begleitverletzungen, wie Blutungen (zerebral, spinal und in den Halsweichteilen) oder zum Nachweis einer Hirnstammkontusion, erwies sich der Einsatz der MRT als vorteilhaft. Mit der MRT laesst sich ein deutlich hoeherer Weichteilkontrast, insbesondere spinal und zerebral, erzielen. (orig.)

  11. MRI diagnosis of suspected atlanto-occipital dissociation in childhood

    International Nuclear Information System (INIS)

    Grabb, B.C.; Frye, T.A.; Hedlund, G.L.; Vaid, Y.N.; Royal, S.A.; Grabb, P.A.

    1999-01-01

    Objective. To demonstrate the utility of magnetic resonance (MR) imaging in the diagnosis of complete and partial ligamentous injuries in patients with suspected atlanto-occipital dissociation (AOD). Materials and methods. Five patients with suspected AOD had MR imaging performed within an average of 4 days after injury. MR scans were reviewed with specific analysis of craniocervical ligamentous structures. Charts were reviewed to obtain clinical information regarding presentation, treatment, hospital course, and outcome. Results. Two patients demonstrated MR evidence of complete AOD. One had disruption of all visualized major ligamentous structures at the craniocervical junction with anterolisthesis and evidence of cord damage. The second had injuries to the tectorial membrane, superior band of the cruciform ligament, apical ligament, and interspinous ligament at C 1-2. The remaining three patients sustained incomplete severance of the ligamentous structures at the craniocervical junction. All patients demonstrated subtle radiographic findings suggestive of AOD, including soft tissue swelling at the craniocervical junction without fracture. The two patients with complete AOD died. The three patients with partial AOD were treated with stabilization. On follow-up, these three children were asymptomatic following their craniocervical injury. Conclusion. MR imaging of acute AOD provides accurate identification of the craniocervical ligaments injured, classification of full versus partial ligamentous disruption, and analysis of accompanying spinal cord injury. This information is important for early appropriate neurosurgical management and preservation of neurologic function in survivors. (orig.)

  12. Prevention of postoperative visual field defect after the occipital transtentorial approach: anatomical study.

    Science.gov (United States)

    Matsuo, Satoshi; Baydin, Serhat; Güngör, Abuzer; Middlebrooks, Erik H; Komune, Noritaka; Iihara, Koji; Rhoton, Albert L

    2017-10-20

    OBJECTIVE A postoperative visual field defect resulting from damage to the occipital lobe during surgery is a unique complication of the occipital transtentorial approach. Though the association between patient position and this complication is well investigated, preventing the complication remains a challenge. To define the area of the occipital lobe in which retraction is least harmful, the surface anatomy of the brain, course of the optic radiations, and microsurgical anatomy of the occipital transtentorial approach were examined. METHODS Twelve formalin-fixed cadaveric adult heads were examined with the aid of a surgical microscope and 0° and 45° endoscopes. The optic radiations were examined by fiber dissection and MR tractography techniques. RESULTS The arterial and venous relationships of the lateral, medial, and inferior surfaces of the occipital lobe were defined anatomically. The full course of the optic radiations was displayed via both fiber dissection and MR tractography. Although the stems of the optic radiations as exposed by both techniques are similar, the terminations of the fibers are slightly different. The occipital transtentorial approach provides access for the removal of lesions involving the splenium, pineal gland, collicular plate, cerebellomesencephalic fissure, and anterosuperior part of the cerebellum. An angled endoscope can aid in exposing the superior medullary velum and superior cerebellar peduncles. CONCLUSIONS Anatomical findings suggest that retracting the inferior surface of the occipital lobe may avoid direct damage and perfusion deficiency around the calcarine cortex and optic radiations near their termination. An accurate understanding of the course of the optic radiations and vascular relationships around the occipital lobe and careful retraction of the inferior surface of the occipital lobe may reduce the incidence of postoperative visual field defect.

  13. The impact of occipital lobe cortical thickness on cognitive task performance: An investigation in Huntington's Disease.

    Science.gov (United States)

    Johnson, Eileanoir B; Rees, Elin M; Labuschagne, Izelle; Durr, Alexandra; Leavitt, Blair R; Roos, Raymund A C; Reilmann, Ralf; Johnson, Hans; Hobbs, Nicola Z; Langbehn, Douglas R; Stout, Julie C; Tabrizi, Sarah J; Scahill, Rachael I

    2015-12-01

    The occipital lobe is an important visual processing region of the brain. Following consistent findings of early neural changes in the occipital lobe in Huntington's Disease (HD), we examined cortical thickness across four occipital regions in premanifest (preHD) and early HD groups compared with controls. Associations between cortical thickness in gene positive individuals and performance on six cognitive tasks, each with a visual component, were examined. In addition, the association between cortical thickness in gene positive participants and one non-visual motor task was also examined for comparison. Cortical thickness was determined using FreeSurfer on T1-weighted 3T MR datasets from controls (N=97), preHD (N=109) and HD (N=69) from the TRACK-HD study. Regression models were fitted to assess between-group differences in cortical thickness, and relationships between performance on the cognitive tasks, the motor task and occipital thickness were examined in a subset of gene-positive participants (N=141). Thickness of the occipital cortex in preHD and early HD participants was reduced compared with controls. Regionally-specific associations between reduced cortical thickness and poorer performance were found for five of the six cognitive tasks, with the strongest associations in lateral occipital and lingual regions. No associations were found with the cuneus. The non-visual motor task was not associated with thickness of any region. The heterogeneous pattern of associations found in the present study suggests that occipital thickness negatively impacts cognition, but only in regions that are linked to relatively advanced visual processing (e.g., lateral occipital, lingual regions), rather than in basic visual processing regions such as the cuneus. Our results show, for the first time, the functional implications of occipital atrophy highlighted in recent studies in HD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Parieto-occipital encephalomalacia in children; clinical and electrophysiological features of twenty-seven cases.

    Science.gov (United States)

    Karaoğlu, Pakize; Polat, Ayşe İpek; Yiş, Uluç; Hız, Semra

    2015-01-01

    Brain injuries occurring at a particular time may cause damages in well-defined regions of brain. Perinatal hypoxic ischemic encephalopathy and hypoglycemia are some of the most common types of brain injuries. Neonatal hypoglycemia can cause abnormal myelination in parietal and occipital lobes resulting in parieto-occipital encephalomalacia. There is a small number of studies about clinical and electroencephalographic (EEG) features of children with parieto-occipital encephalomalacia. They might have important neurologic sequelae such as cortical visual loss, seizures, and psychomotor retardation. We aimed to evaluate the causes of parieto-occipital encephalomalacia and evaluate the clinical and electrophysiological features of children with parieto-occipital encephalomalacia. We evaluated clinical features and EEGs of 27 children with parieto-occipital encephalomalacia. Descriptive statistics were used. Hospitalization during the neonatal period was the most common cause (88.9%) of parieto-occipital brain injury. Eleven patients (40.7%) had a history of neonatal hypoglycemia. Twenty-three patients (85.2%) had epilepsy and nine of the epileptic patients (39%) had refractory seizures. Most of the patients had bilateral (50%) epileptic discharges originating from temporal, parietal, and occipital lobes (56.2%). However, some patients had frontal sharp waves and some had continuous spike and wave discharges during sleep. Visual abnormalities were evident in 15 (55.6%) patients. Twenty-two (81.5%) had psychomotor retardation. Fine motor skills, social contact and language development were impaired more than gross motor skills. In our study, most of the patients with parieto-occipital encephalomalacia had an eventful perinatal history. Epilepsy, psychomotor retardation, and visual problems were common neurologic complications.

  15. Occipital neuralgia associates with high cervical spinal cord lesions in idiopathic inflammatory demyelinating disease.

    Science.gov (United States)

    Kissoon, Narayan R; Watson, James C; Boes, Christopher J; Kantarci, Orhun H

    2018-01-01

    Background The association of trigeminal neuralgia with pontine lesions has been well documented in multiple sclerosis, and we tested the hypothesis that occipital neuralgia in multiple sclerosis is associated with high cervical spinal cord lesions. Methods We retrospectively reviewed the records of 29 patients diagnosed with both occipital neuralgia and demyelinating disease by a neurologist from January 2001 to December 2014. We collected data on demographics, clinical findings, presence of C2-3 demyelinating lesions, and treatment responses. Results The patients with both occipital neuralgia and multiple sclerosis were typically female (76%) and had a later onset (age > 40) of occipital neuralgia (72%). Eighteen patients (64%) had the presence of C2-3 lesions and the majority had unilateral symptoms (83%) or episodic pain (78%). All patients with documented sensory loss (3/3) had C2-3 lesions. Most patients with progressive multiple sclerosis (6/8) had C2-3 lesions. Of the eight patients with C2-3 lesions and imaging at onset of occipital neuralgia, five (62.5%) had evidence of active demyelination. None of the patients with progressive multiple sclerosis (3/3) responded to occipital nerve blocks or high dose intravenous steroids, whereas all of the other phenotypes with long term follow-up (eight patients) had good responses. Conclusions A cervical spine MRI should be considered in all patients presenting with occipital neuralgia. In patients with multiple sclerosis, clinical features in occipital neuralgia that were predictive of the presence of a C2-3 lesion were unilateral episodic symptoms, sensory loss, later onset of occipital neuralgia, and progressive multiple sclerosis phenotype. Clinical phenotype predicted response to treatment.

  16. Balint′s Syndrome As a Manifestation of Solitary Right Occipital Lobe Metastasis

    Directory of Open Access Journals (Sweden)

    Sarat Chandra P

    1998-01-01

    Full Text Available Balint′s syndrome is a rare clinical condition characterized by a triad of occulomotor apraxia (psychic paralysis of gaze, optic ataxia and visual inattention and usually follows bilateral parieto-occipital lesions. We report this syndrome occurring in a patient with a solitary metastasis in right occipital lobe. To the best of our knowledge it has not been previously described in English literature. Pressure over the opposite occipital lobe due to mass effect, diaschisis and extension of edema along the corpus callosum involvement may contribute to this exceptional phenomenon.

  17. A Giant Occipital Encephalocele in Neonate with Spontaneous Hemorrhage into the Encephalocele Sac: Surgical Management

    Science.gov (United States)

    Satyarthee, Guru Dutta; Moscote-Salazar, Luis Rafael; Escobar-Hernandez, Nidia; Aquino-Matus, Jose; Puac-Polanco, Paulo Cesar; Hoz, Samer S; Calderon-Miranda, Willem Guillermo

    2017-01-01

    The presence of giant occipital encephalocele represents a surgical challenge. However, preoperative magnetic resonance imaging with venography can help in delineating relation of venous sinus, content of the sac and help classify occipital encephalocele into infra-torcular and torcular depending on the relation with position of torcula. However, the presence of old hemorrhage into encephalocele sac is extremely rare and in the detailed PubMed search, the authors could find one such case, reported by Nath et al. The author reports a case of giant occipital encephalocele; during surgery, evidence of old bleed was noted. Pertinent literature and management are reviewed briefly. PMID:29204205

  18. Occipital condyle metastasis: an unusual clinical presentation in carcinoma of the lung

    International Nuclear Information System (INIS)

    Pasricha, R.; Mohanty, P.P.; Madan, R.C.; Datta, N.R.

    2005-01-01

    Metastases to the base of the skull and occipital condyle metastases are uncommon as a presenting feature of malignancy. Lung cancers are known for their metastatic potential to various sites, some of which could be the only presenting feature of the underlying malignancy. However, occipital condyle metastases are very rare and to the best of our knowledge, metastases to this site from carcinoma of the lung, as a presenting feature, have never been reported in the literature. The present case report describes the clinical, radiological and the therapeutic interventions that were undertaken in a patient presenting with lung cancer who had solely the features of occipital condyle metastasis

  19. Human left ventral premotor cortex mediates matching of hand posture to object use.

    Directory of Open Access Journals (Sweden)

    Guy Vingerhoets

    Full Text Available Visuomotor transformations for grasping have been associated with a fronto-parietal network in the monkey brain. The human homologue of the parietal monkey region (AIP has been identified as the anterior part of the intraparietal sulcus (aIPS, whereas the putative human equivalent of the monkey frontal region (F5 is located in the ventral part of the premotor cortex (vPMC. Results from animal studies suggest that monkey F5 is involved in the selection of appropriate hand postures relative to the constraints of the task. In humans, the functional roles of aIPS and vPMC appear to be more complex and the relative contribution of each region to grasp selection remains uncertain. The present study aimed to identify modulation in brain areas sensitive to the difficulty level of tool object - hand posture matching. Seventeen healthy right handed participants underwent fMRI while observing pictures of familiar tool objects followed by pictures of hand postures. The task was to decide whether the hand posture matched the functional use of the previously shown object. Conditions were manipulated for level of difficulty. Compared to a picture matching control task, the tool object - hand posture matching conditions conjointly showed increased modulation in several left hemispheric regions of the superior and inferior parietal lobules (including aIPS, the middle occipital gyrus, and the inferior temporal gyrus. Comparison of hard versus easy conditions selectively modulated the left inferior frontal gyrus with peak activity located in its opercular part (Brodmann area (BA 44. We suggest that in the human brain, vPMC/BA44 is involved in the matching of hand posture configurations in accordance with visual and functional demands.

  20. Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness.

    Science.gov (United States)

    Cohen, Steven P; Peterlin, B Lee; Fulton, Larry; Neely, Edward T; Kurihara, Connie; Gupta, Anita; Mali, Jimmy; Fu, Diana C; Jacobs, Michael B; Plunkett, Anthony R; Verdun, Aubrey J; Stojanovic, Milan P; Hanling, Steven; Constantinescu, Octav; White, Ronald L; McLean, Brian C; Pasquina, Paul F; Zhao, Zirong

    2015-12-01

    Occipital neuralgia (ON) is characterized by lancinating pain and tenderness overlying the occipital nerves. Both steroid injections and pulsed radiofrequency (PRF) are used to treat ON, but few clinical trials have evaluated efficacy, and no study has compared treatments. We performed a multicenter, randomized, double-blind, comparative-effectiveness study in 81 participants with ON or migraine with occipital nerve tenderness whose aim was to determine which treatment is superior. Forty-two participants were randomized to receive local anesthetic and saline, and three 120 second cycles of PRF per targeted nerve, and 39 were randomized to receive local anesthetic mixed with deposteroid and 3 rounds of sham PRF. Patients, treating physicians, and evaluators were blinded to interventions. The PRF group experienced a greater reduction in the primary outcome measure, average occipital pain at 6 weeks (mean change from baseline -2.743 ± 2.487 vs -1.377 ± 1.970; P occipital pain through 3 months (mean change from baseline -1.925 ± 3.204 vs -0.541 ± 2.644; P = 0.043), and average overall headache pain through 6 weeks (mean change from baseline -2.738 ± 2.753 vs -1.120 ± 2.1; P = 0.037). Adverse events were similar between groups, and few significant differences were noted for nonpain outcomes. We conclude that although PRF can provide greater pain relief for ON and migraine with occipital nerve tenderness than steroid injections, the superior analgesia may not be accompanied by comparable improvement on other outcome measures.

  1. Occipital lobe lesions result in a displacement of magnetoencephalography visual evoked field dipoles.

    Science.gov (United States)

    Pang, Elizabeth W; Chu, Bill H W; Otsubo, Hiroshi

    2014-10-01

    The pattern-reversal visual evoked potential measured electrically from scalp electrodes is known to be decreased, or absent, in patients with occipital lobe lesions. We questioned whether the measurement and source analysis of the neuromagnetic visual evoked field (VEF) might offer additional information regarding visual cortex relative to the occipital lesion. We retrospectively examined 12 children (6-18 years) with occipital lesions on MRI, who underwent magnetoencephalography and ophthalmology as part of their presurgical assessment. Binocular half-field pattern-reversal VEFs were obtained in a 151-channel whole-head magnetoencephalography. Data were averaged and dipole source analyses were performed for each half-field stimulation. A significant lateral shift (P occipital lesions. Magnetoencephalography may be useful as a screening test of visual function in young patients. We discuss potential explanations for this lateral shift and emphasize the utility of adding the magnetoencephalography pattern-reversal visual evoked field protocol to the neurologic work-up.

  2. Study of transpedicular occipital-cervical fusion (report of 17 cases)

    International Nuclear Information System (INIS)

    Zhang Zhiming; Yang Huilin; Yuan Feng; Tang Tiansi

    2004-01-01

    Objective: To introduce a new method for occipital-cervical fusion. Method: Seventeen patients, among them C1, C2 tumor patient 16, all were fixed by transpedicular occipital-cervical fusion before cutting off tumor. Another case was odontoid process fracture. Results: Seventeen patients were visited for 2 years and 3 months on average, and all were fixed good. The patient whose tumor was transferred from the cancer of breast died after half a year for the cancer was extensively transferred, not caused by the surgical operation method. Conclusion: Stability of unstable patients or patients with tumor at occipital-cervical area can be re-constructed by transpedicular occipital-cervical fusion. Before and during operation the precise position must be decided and operation should be carried out carefully. Then good clinical treatment results can be obtained

  3. Posterior atlanto-occipital and atlanto-axial area and its surgical interest

    Directory of Open Access Journals (Sweden)

    Newton José Godoy Pimenta

    2014-10-01

    Full Text Available Classic anatomical studies describe two membranes – atlanto-occipital and atlanto-axial in the posterior aspect of the craniocervical region. During many surgical procedures in this area, however, we have not found such membranes. Objective To clarify the anatomical aspects and structures taking part of the posterior atlanto-occipital and atlanto-axial area. Method Analysis of histological cuts of three human fetuses and anatomical studies of 8 adult human cadavers. Results In both atlanto-occipital and atlanto-axial areas, we have observed attachment between suboccipital deep muscles and the spinal cervical dura. However, anatomical description of such attachments could not be found in textbooks of anatomy. Conclusion Our study shows the absence of the classical atlanto-occipital and atlanto-axial membranes; the occipito-C1 and C1-C2 posterior intervals are an open area, allowing aponeurotic attachment among cervical dura mater and posterior cervical muscles.

  4. Occipital dysplasia and associated cranial spinal cord abnormalities in two dogs

    International Nuclear Information System (INIS)

    Bagley, R.S.; Harrington, M.L.; Tucker, R.L.; Sande, R.D.; Root, C.R.; Kramer, R.W.

    1996-01-01

    Occipital dysplasia was found in association with cervical spinal cord abnormalities in two dogs. One dog presented for tetraparesis and cervical hyperesthesia, the other for historical cervical hyperesthesia and mild paraparesis. In dog 1, a midline cervical spinal cord defect consistent with a communicating syrinx was found. In the other dog, a presumptive syringo/hydromyelia of the cervical spinal cord was found on magnetic resonance imaging. While occipital dysplasia alone is not thought to cause any clinical abnormalities, the dogs of this report suggest that intramedullary central nervous system abnormalities may be present concurrently with occipital dysplasia and should be considered as a possible cause of the clinical signs. The relationship between occipital dysplasia and syringo/hydromyelia in these dogs remains unclear, however, similar associated abnormalities are occasionally found in humans with Chiari malformation

  5. [Complex visual hallucinations following occipital infarct and perception of optical illusions].

    Science.gov (United States)

    Renou, P; Deltour, S; Samson, Y

    2008-05-01

    The physiopathology of visual hallucinations in the hemianopic field secondary to occipital infarct is uncertain. We report the case of a patient with a history of occipital infarct who presented nonstereotyped complex hallucinations in the quadranopic field resulting from a second controlateral occipital infarct. Based on an experience with motion optical illusions, we suggested that the association of these two occipital lesions, involving the V5 motion area on the one side and the V1 area on the other side, could have produced the complex hallucinations due to a release phenomenon. The patient experienced simultaneously a double visual consciousness, with both hallucinations and real visual perceptions. The study of perceptual illusions in patients with visual hallucinations could illustrate the innovative theory of visual consciousness as being not unified but constituted of multiple microconsciousnesses.

  6. Three Cases with Visual Hallucinations following Combined Ocular and Occipital Damage

    Directory of Open Access Journals (Sweden)

    Bogusław Paradowski

    2013-01-01

    Full Text Available Charles Bonnet syndrome is an underrecognized disease that involves visual hallucinations in visually impaired patients. We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms. In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis. Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

  7. Perimetric demonstration of spontaneous visual field recovery following occipital lobe haemorrhage.

    Science.gov (United States)

    Lin, Siying; George, Badie Z; Wilson-Holt, Nicholas J

    2013-08-29

    A 45-year-old patient on lifelong warfarin therapy after a metal aortic valve replacement developed a homonymous visual field defect following an occipital lobe haemorrhage. The patient received only conservative management and yet described continued improvement in her visual field defect for up to 20 months following the initial cerebral insult. We present the first conclusive illustrative documentation of visual recovery in a patient with an occipital lobe haemorrhage with sequential automated perimetric assessments over an extended period of time.

  8. Elevated occipital β-amyloid deposition is associated with widespread cognitive impairment in logopenic progressive aphasia.

    Science.gov (United States)

    Whitwell, Jennifer L; Lowe, Val J; Duffy, Joseph R; Strand, Edythe A; Machulda, Mary M; Kantarci, Kejal; Wille, Samantha M; Senjem, Matthew L; Murphy, Matthew C; Gunter, Jeffrey L; Jack, Clifford R; Josephs, Keith A

    2013-12-01

    Most subjects with logopenic variant of primary progressive aphasia (lvPPA) have β-amyloid (Aβ) deposition on Pittsburgh Compound B positron emission tomography (PiB-PET), usually affecting prefrontal and temporoparietal cortices, with less occipital involvement. To assess clinical and imaging features in lvPPA subjects with unusual topographic patterns of Aβ deposition with highest uptake in occipital lobe. Thirty-three lvPPA subjects with Aβ deposition on PiB-PET were included in this case-control study. Line plots of regional PiB uptake were created, including frontal, temporal, parietal and occipital regions, for each subject. Subjects in which the line sloped downwards in occipital lobe (lvPPA-low), representing low uptake, were separated from those where the line sloped upwards in occipital lobe (lvPPA-high), representing unusually high occipital uptake compared to other regions. Clinical variables, atrophy on MRI, hypometabolism on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and presence and distribution of microbleeds and white matter hyperintensities (WMHs) were assessed. Seventeen subjects (52%) were classified as lvPPA-high. Mean occipital PiB uptake in lvPPA-high was higher than all other regions and higher than all regions in lvPPA-low. The lvPPA-high subjects performed more poorly on cognitive testing, including executive and visuospatial testing, but the two groups did not differ in aphasia severity. Proportion of microbleeds and WMH was higher in lvPPA-high than lvPPA-low. Parietal hypometabolism was greater in lvPPA-high than lvPPA-low. Unusually high occipital Aβ deposition is associated with widespread cognitive impairment and different imaging findings in lvPPA. These findings help explain clinical heterogeneity in lvPPA and suggest that Aβ influences severity of overall cognitive impairment but not aphasia.

  9. A Giant Occipital Encephalocele in Neonate with Spontaneous Hemorrhage into the Encephalocele Sac: Surgical Management

    OpenAIRE

    Satyarthee, Guru Dutta; Moscote-Salazar, Luis Rafael; Escobar-Hernandez, Nidia; Aquino-Matus, Jose; Puac-Polanco, Paulo Cesar; Hoz, Samer S; Calderon-Miranda, Willem Guillermo

    2017-01-01

    The presence of giant occipital encephalocele represents a surgical challenge. However, preoperative magnetic resonance imaging with venography can help in delineating relation of venous sinus, content of the sac and help classify occipital encephalocele into infra-torcular and torcular depending on the relation with position of torcula. However, the presence of old hemorrhage into encephalocele sac is extremely rare and in the detailed PubMed search, the authors could find one such case, rep...

  10. A novel technique in airway management of neonates with occipital encephalocele.

    Science.gov (United States)

    Rangaswamy, N; Pramanik, A K

    2014-11-01

    Airway stabilization in neonates with occipital encephalocele (OE) is critical during surgery or if they develop hypoxic-respiratory failure. Endotracheal intubation can be challenging due to difficulty in positioning the head in a patient with large occipital mass. We describe a novel technique for positioning neonates with large OE using a commonly used hospital apparatus which facilitated appropriate positioning of the baby and successful endotracheal intubation with ease and no additional staff.

  11. Missed Total Occlusion Due to the Occipital Artery Arising from the Internal Carotid Artery

    International Nuclear Information System (INIS)

    Ustunsoz, Bahri; Gumus, Burcak; Koksal, Ali; Koroglu, Mert; Akhan, Okan

    2007-01-01

    A 56-year-old man was referred for digital subtraction angiography (DSA) with an ultrasound diagnosis of right proximal internal carotid artery (ICA) stenosis for possible carotid artery stenting. DSA revealed total occlusion of the ICA and an occipital artery arising from the stump and simulating continuation of the ICA. An ascending pharyngeal artery also arose from the same occipital artery. This case is of interest because this is a rare variation besides being a cause of misdiagnosis at carotid ultrasound

  12. In-Depth Review of Symptoms, Triggers, and Treatment of Occipital Migraine Headaches (Site IV).

    Science.gov (United States)

    Ascha, Mona; Kurlander, David E; Sattar, Abdus; Gatherwright, James; Guyuron, Bahman

    2017-06-01

    This study reports the surgical technique and efficacy of deactivation of occipital-triggered migraine headaches. In addition, it reports the effect of surgical deactivation of occipital-triggered migraine headaches on migraine triggers and associated symptoms other than pain. One hundred ninety-five patients undergoing surgery for occipital-triggered migraine headaches performed by a single surgeon, and followed for at least 1 year, were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine postoperative reduction in occipital-specific Migraine Headache Index, which is the product of migraine duration, frequency, and severity. Reduction in migraine-days was also measured. The association between symptom or trigger resolution and occipital-specific Migraine Headache Index reduction was studied by logistic regression. Details of surgical treatment are discussed and complication rates reported. Eighty-two percent of patients (n = 160) reported successful surgery at least 12 months postoperatively (mean follow-up, 3.67 years). Eighty-six percent (n = 168) had successful surgery as measured by migraine-days. Fifty-two percent reported complete occipital-triggered migraine headaches elimination. Symptoms resolving with successful surgery beyond headache include being bothered by light and noise, feeling lightheaded, difficulty concentrating, vomiting, blurred/double vision, diarrhea, visual aura, numbness and tingling, speech difficulty, and limb weakness (p occipital-triggered migraine headaches provides long-lasting migraine relief. Successful site IV surgery is associated with changes in specific symptoms and triggers. This can assist in trigger avoidance and aid occipital-triggered migraine headache trigger-site identification. Therapeutic, IV.

  13. Decreased occipital lobe metabolism by FDG-PET/CT: An anti-NMDA receptor encephalitis biomarker.

    Science.gov (United States)

    Probasco, John C; Solnes, Lilja; Nalluri, Abhinav; Cohen, Jesse; Jones, Krystyna M; Zan, Elcin; Javadi, Mehrbod S; Venkatesan, Arun

    2018-01-01

    To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti-NMDA receptor and other definite autoimmune encephalitis (AE) and to assess how these patterns differ between anti-NMDA receptor neurologic disability groups. Retrospective review of clinical data and initial dedicated brain FDG-PET/CT studies for neurology inpatients with definite AE, per published consensus criteria, treated at a single academic medical center over a 10-year period. Z-score maps of FDG-PET/CT were made using 3-dimensional stereotactic surface projections in comparison to age group-matched controls. Brain region mean Z scores with magnitudes ≥2.00 were interpreted as significant. Comparisons were made between anti-NMDA receptor and other definite AE patients as well as among patients with anti-NMDA receptor based on modified Rankin Scale (mRS) scores at the time of FDG-PET/CT. The medial occipital lobes were markedly hypometabolic in 6 of 8 patients with anti-NMDA receptor encephalitis and as a group (Z = -4.02, interquartile range [IQR] 2.14) relative to those with definite AE (Z = -2.32, 1.46; p = 0.004). Among patients with anti-NMDA receptor encephalitis, the lateral and medial occipital lobes were markedly hypometabolic for patients with mRS 4-5 (lateral occipital lobe Z = -3.69, IQR 1; medial occipital lobe Z = -4.08, 1) compared with those with mRS 0-3 (lateral occipital lobe Z = -0.83, 2; p occipital lobe Z = -1.07, 2; p = 0.001). Marked medial occipital lobe hypometabolism by dedicated brain FDG-PET/CT may serve as an early biomarker for discriminating anti-NMDA receptor encephalitis from other AE. Resolution of lateral and medial occipital hypometabolism may correlate with improved neurologic status in anti-NMDA receptor encephalitis.

  14. Predictors of response to occipital nerve stimulation in refractory chronic headache.

    Science.gov (United States)

    Miller, Sarah; Watkins, Laurence; Matharu, Manjit

    2017-01-01

    Background Occipital nerve stimulation is a promising treatment for refractory chronic headache disorders, but is invasive and costly. Identifying predictors of response would be useful in selecting patients. We present the results of an open-label prospective cohort study of 100 patients (35 chronic migraine, 33 chronic cluster headache, 20 short-lasting unilateral neuralgiform headache attacks and 12 hemicrania continua) undergoing occipital nerve stimulation, using a multivariate binary regression analysis to identify predictors of response. Results Response rate of the cohort was 48%. Multivariate analysis showed short lasting unilateral neuralgiform headache attacks (OR 6.71; 95% CI 1.49-30.05; p = 0.013) and prior response to greater occipital nerve block (OR 4.22; 95% CI 1.35-13.21; p = 0.013) were associated with increased likelihood of response. Presence of occipital pain (OR 0.27; 95% CI 0.09-0.76; p = 0.014) and the presence of severe anxiety and/or depression (as measured on hospital anxiety and depression score) at time of implantation (OR 0.32; 95% CI 0.11-0.91; p = 0.032) were associated with reduced likelihood of response. Conclusion Possible clinical predictors of response to occipital nerve stimulation for refractory chronic headaches have been identified. Our data shows that those with short-lasting unilateral neuralgiform headache attacks respond better than those with chronic migraine, and that a prior response to greater occipital nerve block is associated with positive outcomes. This study suggests that the presence of occipital pain and severe mood disorder at time of implant are both associated with poor outcomes to occipital nerve stimulation.

  15. Origin of frontal lobe spikes in the early onset benign occipital lobe epilepsy (Panayiotopoulos syndrome).

    Science.gov (United States)

    Leal, Alberto J R; Ferreira, José C; Dias, Ana I; Calado, Eulália

    2008-09-01

    Early onset benign occipital lobe epilepsy (Panayiotopoulos syndrome [PS]) is a common and easily recognizable epilepsy. Interictal EEG spike activity is often multifocal but most frequently localized in the occipital lobes. The origin and clinical significance of the extra-occipital spikes remain poorly understood. Three patients with the PS and interictal EEG spikes with frontal lobe topography were studied using high-resolution EEG. Independent component analysis (ICA) was used to decompose the spikes in components with distinct temporal dynamics. The components were mapped in the scalp with a spline-laplacian algorithm. The change in scalp potential topography from spike onset to peak, suggests the contribution of several intracranial generators, with different kinetics of activation and significant overlap. ICA was able to separate the major contributors to frontal spikes and consistently revealed an early activating group of components over the occipital areas in all the patients. The local origin of these early potentials was established by the spline-laplacian montage. Frontal spikes in PS are consistently associated with early and unilateral occipital lobe activation, suggesting a postero-anterior spike propagation. Frontal spikes in the PS represent a secondary activation triggered by occipital interictal discharges and do not represent an independent focus.

  16. Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report.

    Science.gov (United States)

    Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed

    2017-06-01

    Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.

  17. Normal left ventricular wall motion measured with two-dimensional myocardial tagging

    DEFF Research Database (Denmark)

    Qi, P; Thomsen, C; Ståhlberg, F

    1993-01-01

    contraction towards the center of the left ventricle, a motion of the base of the heart towards the apex, and a rotation of the left ventricle around its long axis. The direction of left ventricular rotation changed from early systole to late systole. The base and middle levels of the left ventricle rotated...

  18. Activity in the lateral occipital cortex between 200 and 300 ms distinguishes between physically identical seen and unseen stimuli

    Directory of Open Access Journals (Sweden)

    Ying eLiu

    2012-07-01

    Full Text Available There is converging evidence that electrophysiological responses over posterior cortical regions in the 200-300 ms range distinguish between physically identical stimuli that reach consciousness or remain unseen. Here, we attempt at determining the sources of this awareness-related activity using MEG. Fourteen subjects were presented with faint colored gratings at threshold for contrast and reported on each trial whether the grating was seen or unseen. Subjects were primed with a color cue that could be congruent or incongruent with the color of the grating, to probe to what extent two co-localized features (color and orientation would be bound in consciousness. The contrast between neural responses to seen and unseen physically identical gratings revealed a sustained posterior difference between 190 and 350 ms, thereby replicating prior studies. We further show that the main sources of the awareness-related activity were localized bilaterally on the lateral convexity of the occipito-temporal region, in the lateral occipital (LO complex, as well as in the right posterior infero-temporal region. No activity differentiating seen and unseen trials could be observed in frontal or parietal regions in this latency range, even at lower threshold. Color congruency did not improve gratings' detection, and the awareness-related activity was independent from color congruency. However, at the neural level, color congruency was processed differently in grating-present and grating-absent trials. The pattern of results suggests the existence of a neural process of color congruency engaging left parietal regions that is affected by the mere presence of another feature, whether this feature reaches consciousness or not. Altogether, our results reveal an occipital source of visual awareness insensitive to color congruency, and a simultaneous parietal source not engaged in visual awareness, but sensitive to the manipulation of co-localized features.

  19. Visual object agnosia is associated with a breakdown of object-selective responses in the lateral occipital cortex.

    Science.gov (United States)

    Ptak, Radek; Lazeyras, François; Di Pietro, Marie; Schnider, Armin; Simon, Stéphane R

    2014-07-01

    Patients with visual object agnosia fail to recognize the identity of visually presented objects despite preserved semantic knowledge. Object agnosia may result from damage to visual cortex lying close to or overlapping with the lateral occipital complex (LOC), a brain region that exhibits selectivity to the shape of visually presented objects. Despite this anatomical overlap the relationship between shape processing in the LOC and shape representations in object agnosia is unknown. We studied a patient with object agnosia following isolated damage to the left occipito-temporal cortex overlapping with the LOC. The patient showed intact processing of object structure, yet often made identification errors that were mainly based on the global visual similarity between objects. Using functional Magnetic Resonance Imaging (fMRI) we found that the damaged as well as the contralateral, structurally intact right LOC failed to show any object-selective fMRI activity, though the latter retained selectivity for faces. Thus, unilateral damage to the left LOC led to a bilateral breakdown of neural responses to a specific stimulus class (objects and artefacts) while preserving the response to a different stimulus class (faces). These findings indicate that representations of structure necessary for the identification of objects crucially rely on bilateral, distributed coding of shape features. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Characterizing occipital condyle loads under high-speed head rotation.

    Science.gov (United States)

    Pintar, Frank A; Yoganandan, Narayan; Baisden, Jamie

    2005-11-01

    Because of the need to evaluate anthropomorphic test device (ATD) biofidelity under high-head angular accelerations, the purpose of the present investigation was to develop appropriate instrumentation for intact post mortem human subject (PMHS) testing, validate the instrumentation, and obtain information to characterize the response of the head-neck complex under this loading scenario. A series of rigid-arm pendulum, inertially loaded ATD tests was conducted. Head and neck ATD hydraulic piston chin pull tests were conducted. Subsequently, a series of PMHS tests was conducted to derive the response of the human head-neck under high-rate chin loading. Finally, Hybrid III and THOR-NT ATD head-neck systems were evaluated under the same scenario as the PMHS. A parametric analysis for center of gravity (CG) location and accelerometer orientation determined that even small errors (+/- 3 mm or 2 degrees), produced errors in the force and moment calculations by as much as 17 %. If the moment of inertia (MOI) term was varied by 5 %, resulting moment calculations were affected by as much as 8 %. If the 5 % error in MOI was used to compute occipital condyle moments, and results compared to upper load cell derived moments, peaks differed by as much as 24 %. The head CG and mass MOI should be directly measured for each preparation to obtain accurate results. The injury run on each specimen resulted in predominantly C1-C2 separations or partial separations. The 50(th) percentile probability of AIS=2+ neck injury using tensile force was about 2400 N; for AIS=3+ neck injury the 50(th) percentile risk was about 3180 N. When inserting extension moment as the criteria, the 50(th) percentile probability of an AIS=2+ injury was 51 Nm. The AIS=3+ extension moment at the 50(th) percentile probability was 75 Nm. The new THOR-NT ATD head-neck produced more biofidelic responses with an alternate head-neck junction design compared to the Hybrid III ATD.

  1. Clinical study of the visual field defects caused by occipital lobe lesions.

    Science.gov (United States)

    Ogawa, Katsuhiko; Ishikawa, Hiroshi; Suzuki, Yutaka; Oishi, Minoru; Kamei, Satoshi

    2014-01-01

    The central visual field is projected to the region from the occipital tip to the posterior portion of the medial area in the striate cortex. However, central visual field disturbances have not been compared with the location of the lesions in the striate cortex. Thirteen patients with visual field defects caused by partial involvement of the striate cortex were enrolled. The lesions were classified according to their location into the anterior portion, the posterior portion of the medial area, and the occipital tip. Visual field defects were examined by the Goldmann perimetry, the Humphrey perimetry and the auto-plot tangent screen. We defined a defect within the central 10° of vision as a central visual field disturbance. The visual field defects in 13 patients were compared with the location of their lesions in the striate cortex. The medial area was involved in 7 patients with no involvement of the occipital tip. In 2 of them, peripheral homonymous hemianopia without central visual field disturbance was shown, and their lesions were located only in the anterior portion. One patient with a lesion in the posterior portion alone showed incomplete central homonymous hemianopia. Three of 4 patients with lesions located in both the anterior and posterior portions of the medial area showed incomplete central homonymous hemianopia and peripheral homonymous hemianopia. The occipital tip was involved in 6 patients. Five of them had small lesions in the occipital tip alone and showed complete central homonymous hemianopia or quadrantanopia. The other patient with a lesion in the lateral posterior portion and bilateral occipital tip lesions showed bilateral slight peripheral visual field disturbance in addition to complete central homonymous hemianopia on both sides. Lesions in the posterior portion of the medial area as well as the occipital tip caused central visual field disturbance in our study, as indicated in previous reports. Central homonymous hemianopia tended to

  2. The anatomy of fronto-occipital connections from early blunt dissections to contemporary tractography.

    Science.gov (United States)

    Forkel, Stephanie J; Thiebaut de Schotten, Michel; Kawadler, Jamie M; Dell'Acqua, Flavio; Danek, Adrian; Catani, Marco

    2014-07-01

    The occipital and frontal lobes are anatomically distant yet functionally highly integrated to generate some of the most complex behaviour. A series of long associative fibres, such as the fronto-occipital networks, mediate this integration via rapid feed-forward propagation of visual input to anterior frontal regions and direct top-down modulation of early visual processing. Despite the vast number of anatomical investigations a general consensus on the anatomy of fronto-occipital connections is not forthcoming. For example, in the monkey the existence of a human equivalent of the 'inferior fronto-occipital fasciculus' (iFOF) has not been demonstrated. Conversely, a 'superior fronto-occipital fasciculus' (sFOF), also referred to as 'subcallosal bundle' by some authors, is reported in monkey axonal tracing studies but not in human dissections. In this study our aim is twofold. First, we use diffusion tractography to delineate the in vivo anatomy of the sFOF and the iFOF in 30 healthy subjects and three acallosal brains. Second, we provide a comprehensive review of the post-mortem and neuroimaging studies of the fronto-occipital connections published over the last two centuries, together with the first integral translation of Onufrowicz's original description of a human fronto-occipital fasciculus (1887) and Muratoff's report of the 'subcallosal bundle' in animals (1893). Our tractography dissections suggest that in the human brain (i) the iFOF is a bilateral association pathway connecting ventro-medial occipital cortex to orbital and polar frontal cortex, (ii) the sFOF overlaps with branches of the superior longitudinal fasciculus (SLF) and probably represents an 'occipital extension' of the SLF, (iii) the subcallosal bundle of Muratoff is probably a complex tract encompassing ascending thalamo-frontal and descending fronto-caudate connections and is therefore a projection rather than an associative tract. In conclusion, our experimental findings and review of the

  3. Paleoneurology of two new neandertal occipitals from El Sidrón (asturias, Spain) in the context of homo endocranial evolution.

    Science.gov (United States)

    Peña-Melián, Angel; Rosas, Antonio; García-Tabernero, Antonio; Bastir, Markus; De La Rasilla, Marco

    2011-08-01

    The endocranial surface description and comparative analyses of two new neandertal occipital fragments (labelled SD-1149 and SD-370a) from the El Sidrón site (Asturias, Spain) reveal new aspects of neandertal brain morphological asymmetries. The dural sinus drainage pattern, as observed on the sagittal-transverse system, as well as the cerebral occipito-petalias, point out a slightly differential configuration of the neandertal brain when compared to other Homo species, especially H. sapiens. The neandertal dural sinus drainage pattern is organized in a more asymmetric mode, in such a way that the superior sagittal sinus (SSS) drains either to the right or to the left transverse sinuses, but in no case in a confluent mode (i.e. simultaneous continuation of SSS with both right (RTS) and left (LTS) transverse sinuses). Besides, the superior sagittal sinus shows an accentuated deviation from of the mid-sagittal plane in its way to the RTS in 35% of neandertals. This condition, which increases the asymmetry of the system, is almost nonexistent neither in the analyzed Homo fossil species sample nor in that of anatomically modern humans. Regarding the cerebral occipito-petalias, neandertals manifest one of the lowest percentages of left petalia of the Homo sample (including modern H. sapiens). As left occipito-petalia is the predominant pattern in hominins, it seems as if neandertals would have developed a different pattern of brain hemispheres asymmetry. Finally, the relief and position of the the cerebral sulci and gyri impressions observed in the El Sidrón occipital specimens look similar to those observed in modern H. sapiens. Copyright © 2011 Wiley-Liss, Inc.

  4. MR Neurography of Greater Occipital Nerve Neuropathy: Initial Experience in Patients with Migraine.

    Science.gov (United States)

    Hwang, L; Dessouky, R; Xi, Y; Amirlak, B; Chhabra, A

    2017-11-01

    MR imaging of peripheral nerves (MR neurography) allows improved assessment of nerve anatomy and pathology. The objective of this study was to evaluate patients with unilateral occipital neuralgia using MR neurography and to assess the differences in greater occipital nerve signal and size between the symptomatic and asymptomatic sides. In this case-control evaluation using MR neurography, bilateral greater occipital nerve caliber, signal intensity, signal-to-noise ratios, and contrast-to-noise ratios were determined by 2 observers. Among 18 subjects with unilateral occipital migraines, the average greater occipital nerve diameter for the symptomatic side was significantly greater at 1.77 ± 0.4 mm than for the asymptomatic side at 1.29 ± 0.25 mm ( P = .001). The difference in nerve signal intensity between the symptomatic and asymptomatic sides was statistically significant at 269.06 ± 170.93 and 222.44 ± 170.46, respectively ( P = .043). The signal-to-noise ratios on the symptomatic side were higher at 15.79 ± 4.59 compared with the asymptomatic nerve at 14.02 ± 5.23 ( P = .009). Contrast-to-noise ratios were significantly higher on the symptomatic side than on the asymptomatic side at 2.57 ± 4.89 and -1.26 ± 5.02, respectively ( P = .004). Intraobserver performance was good to excellent (intraclass coefficient correlation, 0.68-0.93), and interobserver performance was fair to excellent (intraclass coefficient correlation, 0.54-0.81). MR neurography can be reliably used for the diagnosis of greater occipital nerve neuropathy in patients with unilateral occipital migraines with a good correlation of imaging findings to the clinical presentation. © 2017 by American Journal of Neuroradiology.

  5. Recovery of visual-field defects after occipital lobe infarction: a perimetric study.

    Science.gov (United States)

    Çelebisoy, Mehmet; Çelebisoy, Neşe; Bayam, Ece; Köse, Timur

    2011-06-01

    To assess the temporal course of homonymous visual-field defects due to occipital lobe infarction, by using automated perimetry. 32 patients with ischaemic infarction of the occipital lobe were studied prospectively, using a Humphrey Visual Field Analyser II. The visual field of each eye was divided into central, paracentral and peripheral zones. The mean visual sensitivity of each zone was calculated and used for the statistical analysis. The results of the initial examination, performed within 2 weeks of stroke, were compared with the results of the sixth-month control. The lesions were assigned to the localisations, optic radiation, striate cortex, occipital pole and occipital convexity, by MRI. A statistically significant improvement was noted, especially for the lower quadrants. Lesions of the occipital pole and convexity were not significantly associated with visual-field recovery. However, involvement of the striate cortex and extensive lesions involving all the areas studied was significantly associated with poor prognosis. Homonymous visual-field defects in our patients improved within 6 months. Restoration of the lower quadrants and especially the peripheral zones was noted. Incomplete damage to the striate cortex, which has a varying pattern of vascular supply, could explain this finding. Magnification factor theory, which is the increment of the receptive-field size of striate cortex cells with visual-field eccentricity, may explain the more significant improvement in the peripheral zones.

  6. Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia.

    Science.gov (United States)

    Montassir, Hesham; Maegaki, Yoshihiro; Ohno, Kousaku; Ogura, Kaeko

    2010-02-01

    To report on long-term clinical course in patients with symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia. Six patients with neonatal hypoglycemia and symptomatic occipital lobe epilepsy were studied in our hospital through reviewing their medical records retrospectively. The median onset age of epilepsy was 2 years 8 months and median follow-up period was 12 years and 4 months. Initial seizure types were generalized convulsions in 4 patients, hemiconvulsion in 1, and infantile spasms in 1. Ictal manifestations of main seizures were identical to occipital lobe seizures, such as eye deviation, eye blinking, ictal vomiting, and visual hallucination. Seizure frequency was maximum during infancy and early childhood and decreased thereafter with no seizure in 2 patients, a few seizures a year in 3, and once a month in 1. All patients had status epilepticus in the early course of epilepsy. EEGs showed parieto-occipital spikes in all patients. MRI revealed cortical atrophy and T2 prolongation parieto-occipitally in 4 patients, hippocampal atrophy in 1, and unremarkable in 1. This study indicates that epilepsy secondary to neonatal hypoglycemia is intractable during infancy and early childhood with frequent status epilepticus but tends to decrease in older age.

  7. Phosphene-guided transcranial magnetic stimulation of occipital but not parietal cortex suppresses stimulus visibility

    Science.gov (United States)

    Tapia, Evelina; Mazzi, Chiara; Savazzi, Silvia; Beck, Diane M.

    2014-01-01

    Transcranial magnetic stimulation (TMS) applied over the occipital lobe approximately 100 ms after the onset of a stimulus decreases its visibility if it appears in the location of the phosphene. Because phosphenes can also be elicited by stimulation of the parietal regions, we asked if the same procedure that is used to reduce visibility of stimuli with occipital TMS will lead to decreased stimulus visibility when TMS is applied to parietal regions. TMS was randomly applied at 0 to 130 ms after the onset of the stimulus (SOA) in steps of 10 ms in occipital and parietal regions. Participants responded to the orientation of the line stimulus and rated its visibility. We replicate previous reports of phosphenes from both occipital and parietal TMS. As previously reported, we also observed visual suppression around the classical 100 ms window both in the objective line orientation and subjective visibility responses with occipital TMS. Parietal stimulation, on the other hand, did not consistently reduce stimulus visibility in any time window. PMID:24584900

  8. Respiratory arrest at the onset of idiopathic childhood occipital epilepsy of Gastaut.

    Science.gov (United States)

    Funata, Keiko; Shike, Tatsuhiko; Takenouchi, Toshiki; Yamashita, Yukio; Takahashi, Takao

    2018-01-01

    Occipital lobe epilepsy of childhood includes two entities: Panayiotopoulos syndrome in pre-school children, and idiopathic childhood occipital epilepsy of Gastaut (ICOEG) in school-age children. The typical initial manifestation of the former is vomiting, and that of the latter is visual hallucinations. Ictal cardiopulmonary arrest at initial presentation has been reported for Panayiotopoulos syndrome, but not for ICOEG. We document a 7-year-old previously healthy girl who experienced an acute elemental visual hallucination of seeing insects, followed by a new-onset generalized seizure. Upon arrival at the local hospital, she was unconscious and soon thereafter, developed respiratory arrest. She was resuscitated and initiated on mechanical ventilation. An electroencephalogram taken three days after seizure cessation showed frequent occipital spikes, consistent with the diagnosis of ICOEG. The sequence of acute elementary visual hallucination followed by a motor seizure, and then witnessed respiratory arrest illustrated occurrence of life-threatening autonomic involvement at initial onset in ICOEG. We speculate that the epileptic propagation from the occipital lobes eventually compromised the respiratory center in the brainstem. The possibility of occipital lobe epilepsy should be considered in school-age children presenting with acute visual hallucination followed by respiratory arrest. Such a presentation should prompt an urgent electroencephalogram and initiation of antiepileptic treatment if indicated. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  9. An anatomical study of the transversus nuchae muscle: Application to better understanding occipital neuralgia.

    Science.gov (United States)

    Watanabe, Koichi; Saga, Tsuyoshi; Iwanaga, Joe; Tabira, Yoko; Yamaki, Koh-Ichi

    2017-01-01

    The transversus nuchae muscle appears inconsistently in the occipital region. It has gained attention as one of the muscles composing the superficial musculoaponeurotic system (SMAS). The purpose of this study was to clarify its detailed anatomical features. We examined 124 sides of 62 cadavers. The transversus nuchae muscle was identified when present and examined after it had been completely exposed. We also examined its relationship to the occipital cutaneous nerves.The transversus nuchae muscle was detected in 40 sides (40/124, 32.2%) of 26 cadavers; it was present bilaterally in 14 and unilaterally in 12. It originated from the external occipital protuberance; 43% of the observed muscles inserted around the mastoid process, and 58% curved upward around the mastoid process and became the uppermost bundle of the platysma. In one case, an additional bundle originated from the lower posterior border of the sternocleidomastoid muscle and coursed obliquely upward along with platysma. Ninety percent of the muscles ran below the sling through which the greater occipital nerve passed; 65% of the lesser occipital nerves ran deep to the muscle, and 55% of the great auricular nerves ran superficial to it. Our observations clarify the unique anatomical features of the transversus nuchae muscle. We found that it occurs at a rate similar to that described in previous reports, but its arrangement is variable. Further investigations will be performed to clarify its innervation and other anatomical features. Clin. Anat. 30:32-38, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Zygomatic arch-atlas wing stabilization in 5 dogs with atlanto-occipital dislocation.

    Science.gov (United States)

    Dolera, Mario; Malfassi, Luca; Bianchi, Cristina; Carrara, Nancy; Corbetta, Laura; Finesso, Sara; Marcarini, Silvia; Mazza, Giovanni; Pavesi, Simone; Sala, Massimo

    2016-07-01

    The aim of this work was to present a novel minimally invasive surgical stabilization technique for canine atlanto-occipital dislocation and to report the associated magnetic resonance imaging (MRI) findings. All 5 dogs in this case series underwent 1.5 T MRI of the head and neck and 3 underwent both MRI and computed tomography (CT). Atlanto-occipital dislocations were diagnosed based on the increased joint space between the occipital condyles and the atlas on MRI. Surgery was performed immediately with a never previously described fixation technique based on an external ligature. The stabilization was performed via 4 holes drilled in the zygomatic processes and in the atlas wings on each side. A nylon monofilament of 1 mm diameter was inserted in the 4 holes, and an O-shaped ligature was carried out externally to the skin through the ipsilateral zygomatic arch. Ligatures were removed within 2 months. At the postsurgical follow-up examination, 14 days after surgery, all dogs were found to be ambulatory. Atlanto-occipital stability was assessed by clinical examination with an average of 24 months of follow-up. The positive outcomes in this case series suggest that atlanto-occipital dislocation may be surgically treated with this novel technique, irrespective of the severity of the clinical presentation and associated lesions observed on MRI.

  11. Colgajo prefabricado occipital para cobertura de exposición ósea craneal Prefabricated occipital flap to cover craneal bone exposition

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    B. Rivas León

    2010-03-01

    Full Text Available La exposición del cráneo tras un tratamiento quirúrgico oncológico agresivo es un desafió reconstructivo para el cirujano plástico; los defectos pueden variar en dimensiones y complejidad, desde pequeños defectos, que pueden ser cubiertos con injertos dérmicos o colgajos locales, a defectos más extensos que requerirán de un colgajo libre para su cobertura. Presentamos el caso de un varón de 39 años de edad que presentó un defecto biparietal posterior a radioterapia y resección por carcinoma. El defecto fue cubierto con un colgajo prefabricado axial, tomado del área antebraquial e implantado bajo la piel cabelluda occipital, para posteriormente ser llevado al sitio del defecto. El colgajo axial occipital evolucionó satisfactoriamente y logramos cubrir el defecto en su totalidad, sin complicaciones. En conclusión, el colgajo prefabricado occipital aporta suficiente piel cabelluda con patrón vascular axial para cubrir hueso craneal expuesto, cuando no hay una mejor opción cosmética.Cranial bone exposition after an aggressive oncological treatment is a challenge for plastic surgeon; defects can range in size and complexity, from small defects which can be covered only with skin graft or local flaps, to extensive defects that will require a free flap cover. We report a case of a 39 years-old man, who presented soft tissue defect of biparietal area following to radiotherapy and carcinoma resection. This defect was covered by prefabricated axial flap, which was harvest of forearm area and implanted under occipital hair skin and subsequently transported to the defect. The axial occipital flap healed uneventfully with a good outcome; we managed to cover the scalp defect completely without complications. As a conclusion, prefabricated occipital flap provides enough hair skin, with axial vascularity pattern to cover cranial bone exposed, when there is not a better cosmetical option.

  12. Paroxysmal occipital discharges suppressed by eye opening: Spectrum of clinical and imaging features at a tertiary care center in India

    OpenAIRE

    Bhavna Kaul; Garima Shukla; Vinay Goyal; Achal Srivastava; Madhuri Behari

    2012-01-01

    Background: Paroxysmal occipital discharges (PODs) demonstrating the phenomena of fixation-off sensitivity have classically been described in childhood epilepsies with occipital paroxysms. Aim: We attempted to delineate the demographic, clinical and imaging characteristics of patients whose interictal electroencephalograms (EEGs) showed occipital discharges with fixation-off sensitivity at our center. Materials and Methods: During the period between 2003 and 2005, patients whose interictal EE...

  13. Carcinoid tumour of the middle ear

    LENUS (Irish Health Repository)

    Baig, Salman

    2012-09-01

    A case of middle ear mass in a young female from Ireland is described, who presented with left ear hearing loss and intermittent bloody discharge from the same ear. Examination under microscope revealed occlusive polyp in the left ear and a biopsy had been taken under general anaesthesia. Histopathology report described an adenoma \\/ carcinoid tumour of the middle ear confirmed by positive immunohistochemical staining. CT temporal bones revealed the extension of the disease. The patient underwent left tympanotomy and excision of the tumour. In general, these tumours are regarded as benign but may be mistaken for adenocarcinomas because of their histological heterogenecity.

  14. Decoding the content of visual short-term memory under distraction in occipital and parietal areas.

    Science.gov (United States)

    Bettencourt, Katherine C; Xu, Yaoda

    2016-01-01

    Recent studies have provided conflicting accounts regarding where in the human brain visual short-term memory (VSTM) content is stored, with strong univariate fMRI responses being reported in superior intraparietal sulcus (IPS), but robust multivariate decoding being reported in occipital cortex. Given the continuous influx of information in everyday vision, VSTM storage under distraction is often required. We found that neither distractor presence nor predictability during the memory delay affected behavioral performance. Similarly, superior IPS exhibited consistent decoding of VSTM content across all distractor manipulations and had multivariate responses that closely tracked behavioral VSTM performance. However, occipital decoding of VSTM content was substantially modulated by distractor presence and predictability. Furthermore, we found no effect of target-distractor similarity on VSTM behavioral performance, further challenging the role of sensory regions in VSTM storage. Overall, consistent with previous univariate findings, our results indicate that superior IPS, but not occipital cortex, has a central role in VSTM storage.

  15. Sulcal and gyral anatomy of the basal occipital-temporal lobe.

    Science.gov (United States)

    Chau, Anthony Minh Tien; Stewart, Fiona; Gragnaniello, Cristian

    2014-12-01

    The sulcal and gyral anatomy of the basal occipital-temporal lobe is highly variable and detailed descriptions of this region are limited and often inconsistent. The aim of this study was to describe the salient features of the sulcal and gyral anatomy of the basal occipital-temporal lobe. We studied the sulcal and gyral patterns of 30 formalin-fixed cerebral hemispheres. The major landmarks are the collateral sulcus (separated into the rhinal, proper, and caudal segments) and occipitotemporal sulcus (often interrupted), which were always present in this study. The bifurcation of the caudal collateral sulcus is a useful landmark. In relation to these sulci, we have described the surface anatomy and nominated landmarks of the medial (parahippocampal and lingual) and lateral (fusiform) occipitotemporal gyri. Understanding of the sulcal and gyral patterns of the basal occipital-temporal lobe may provide valuable information in its radiological and intraoperative interpretation.

  16. Airway management for occipital encephalocele in neonatal patients: A review of 17 cases

    Directory of Open Access Journals (Sweden)

    Zeynep Baysal Yildirim

    2011-01-01

    Full Text Available Introduction: Encephalocele, midline defect of cranial bone fusion, occurs most frequently in the occipital region. Airway management in pediatric patients with craniofacial disorders poses many challenges to the anesthesiologist. The purpose of this study is to describe the airway problems encountered for such cases, and describe how these problems were managed. Materials and Methods: We reviewed the charts of occipital encephalocele newborn that were treated by surgical correction in Harran University Hospital during 2006-2008. The collected data were categorized into preoperative, intraoperative, and postoperative data. Results: The mean age of the patients was 5.17 days. Of these 17 patients, eight patients (47.1% had hydrocephaly, one patient (5.8% with Dandy Walker syndrome. Micrognathia, macroglossia, restriction in neck movements were recorded as the reasons in six cases each. No major anesthetic complication was found. Conclusions: We reported perioperative management in 17 occipital encephalocele infant. Comprehensive care during peroperative period is essential for successful outcome.

  17. Antecedent occipital alpha band activity predicts the impact of oculomotor events in perceptual switching

    Directory of Open Access Journals (Sweden)

    Hironori eNakatani

    2013-05-01

    Full Text Available Oculomotor events such as blinks and saccades transiently interrupt the visual input and, even though this mostly goes undetected, these brief interruptions could still influence the percept. In particular, both blinking and saccades facilitate switching in ambiguous figures such as the Necker cube. To investigate the neural state antecedent to these oculomotor events during the perception of an ambiguous figure, we measured the human scalp electroencephalogram (EEG. When blinking led to perceptual switching, antecedent occipital alpha band activity exhibited a transient increase in amplitude. When a saccade led to switching, a series of transient increases and decreases in amplitude was observed in the antecedent occipital alpha band activity. Our results suggest that the state of occipital alpha band activity predicts the impact of oculomotor events on the percept.

  18. Anton’s Syndrome due to Bilateral Ischemic Occipital Lobe Strokes

    Directory of Open Access Journals (Sweden)

    Sanela Zukić

    2014-01-01

    Full Text Available We present a case of a patient with Anton’s syndrome (i.e., visual anosognosia with confabulations, who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton’s syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

  19. Decoding the content of visual short-term memory under distraction in occipital and parietal areas

    Science.gov (United States)

    Bettencourt, Katherine C.; Xu, Yaoda

    2015-01-01

    Recent studies have provided conflicting accounts regarding where in the human brain visual short-term memory (VSTM) content is stored, with strong univariate fMRI responses reported in superior intraparietal sulcus (IPS) but robust multivariate decoding reported in occipital cortex. Given the continuous influx of information in everyday vision, VSTM storage under distraction is often required. We found that neither distractor presence nor predictability during the memory delay affected behavioral performance. Similarly, superior IPS exhibited consistent decoding of VSTM content across all distractor manipulations and had multivariate responses that closely tracked behavioral VSTM performance. However, occipital decoding of VSTM content was significantly modulated by distractor presence and predictability. Furthermore, we found no effect of target-distractor similarity on VSTM behavioral performance, further challenging the role of sensory regions in VSTM storage. Overall, consistent with previous univariate findings, these results show that superior IPS, not occipital cortex, plays a central role in VSTM storage. PMID:26595654

  20. Anatomo-functional study of the temporo-parieto-occipital region: dissection, tractographic and brain mapping evidence from a neurosurgical perspective

    Science.gov (United States)

    De Benedictis, Alessandro; Duffau, Hugues; Paradiso, Beatrice; Grandi, Enrico; Balbi, Sergio; Granieri, Enrico; Colarusso, Enzo; Chioffi, Franco; Marras, Carlo Efisio; Sarubbo, Silvio

    2014-01-01

    The temporo-parieto-occipital (TPO) junction is a complex brain territory heavily involved in several high-level neurological functions, such as language, visuo-spatial recognition, writing, reading, symbol processing, calculation, self-processing, working memory, musical memory, and face and object recognition. Recent studies indicate that this area is covered by a thick network of white matter (WM) connections, which provide efficient and multimodal integration of information between both local and distant cortical nodes. It is important for neurosurgeons to have good knowledge of the three-dimensional subcortical organisation of this highly connected region to minimise post-operative permanent deficits. The aim of this dissection study was to highlight the subcortical functional anatomy from a topographical surgical perspective. Eight human hemispheres (four left, four right) obtained from four human cadavers were dissected according to Klingler's technique. Proceeding latero-medially, the authors describe the anatomical courses of and the relationships between the main pathways crossing the TPO. The results obtained from dissection were first integrated with diffusion tensor imaging reconstructions and subsequently with functional data obtained from three surgical cases, all resection of infiltrating glial tumours using direct electrical mapping in awake patients. The subcortical limits for performing safe lesionectomies within the TPO region are as follows: within the parietal region, the anterior horizontal part of the superior longitudinal fasciculus and, more deeply, the arcuate fasciculus; dorsally, the vertical projective thalamo-cortical fibres. For lesions located within the temporal and occipital lobes, the resection should be tailored according to the orientation of the horizontal associative pathways (the inferior fronto-occipital fascicle, inferior longitudinal fascicle and optic radiation). The relationships between the WM tracts and the ventricle

  1. Relevance of Spectral Cues for Auditory Spatial Processing in the Occipital Cortex of the Blind

    Science.gov (United States)

    Voss, Patrice; Lepore, Franco; Gougoux, Frédéric; Zatorre, Robert J.

    2011-01-01

    We have previously shown that some blind individuals can localize sounds more accurately than their sighted counterparts when one ear is obstructed, and that this ability is strongly associated with occipital cortex activity. Given that spectral cues are important for monaurally localizing sounds when one ear is obstructed, and that blind individuals are more sensitive to small spectral differences, we hypothesized that enhanced use of spectral cues via occipital cortex mechanisms could explain the better performance of blind individuals in monaural localization. Using positron-emission tomography (PET), we scanned blind and sighted persons as they discriminated between sounds originating from a single spatial position, but with different spectral profiles that simulated different spatial positions based on head-related transfer functions. We show here that a sub-group of early blind individuals showing superior monaural sound localization abilities performed significantly better than any other group on this spectral discrimination task. For all groups, performance was best for stimuli simulating peripheral positions, consistent with the notion that spectral cues are more helpful for discriminating peripheral sources. PET results showed that all blind groups showed cerebral blood flow increases in the occipital cortex; but this was also the case in the sighted group. A voxel-wise covariation analysis showed that more occipital recruitment was associated with better performance across all blind subjects but not the sighted. An inter-regional covariation analysis showed that the occipital activity in the blind covaried with that of several frontal and parietal regions known for their role in auditory spatial processing. Overall, these results support the notion that the superior ability of a sub-group of early-blind individuals to localize sounds is mediated by their superior ability to use spectral cues, and that this ability is subserved by cortical processing in

  2. Mapping occipital bone thickness using computed tomography for safe screw placement.

    Science.gov (United States)

    Morita, Tomonori; Takebayashi, Tsuneo; Takashima, Hiroyuki; Yoshimoto, Mitsunori; Ida, Kazunori; Tanimoto, Katsumasa; Ohnishi, Hirofumi; Fujiwara, Hiroyoshi; Nagae, Masateru; Yamashita, Toshihiko

    2015-08-01

    OBJECT Safe and effective insertion of occipital bone screws requires morphological analysis of the occipital bone, which is poorly documented in the literature. The authors of this study present morphological data for determining the area of screw placement for optimal internal fixation. METHODS The subjects of this institutional review board-approved retrospective study were 105 individuals without head and neck disease who underwent CT imaging at the authors' hospital. There were 55 males and 50 females, with a mean age of 57.1 years (range 20-91 years). Measurements using CT were taken according to a matrix of 55 points following a grid with 1-cm spacing based on the external occipital protuberance (EOP). RESULTS The maximum thickness of the occipital bone was at the level of the EOP at 16.4 mm. Areas with thicknesses > 8 mm were more frequent at the EOP and up to 2 cm in all directions, as well as up to 1 cm in all directions at a height of 1 cm inferiorly, and up to 3 cm from the EOP inferiorly. The male group tended to have a thicker occipital bone than the female group, and the differences were significant around the EOP. The ratio of the trabecular bone to the occipital bone thickness was > 30% in the central region. At positions more than 2 cm laterally, the ratio was < 15%, and the ratio gradually decreased further laterally. CONCLUSIONS Screws that are 8 mm long can be placed in the area extending 2 cm laterally from the EOP at the level of the superior nuchal line and approximately 3 cm inferior to the center. These results suggest that it may be possible to effectively insert a screw over a wider area than the conventional reference range.

  3. Human occipital cortices differentially exert saccadic suppression: intracranial recording in children

    Science.gov (United States)

    Uematsu, Mitsugu; Matsuzaki, Naoyuki; Brown, Erik C.; Kojima, Katsuaki; Asano, Eishi

    2013-01-01

    By repeating saccades unconsciously, humans explore the surrounding world every day. Saccades inevitably move external visual images across the retina at high velocity; nonetheless, healthy humans don’t perceive transient blurring of the visual scene during saccades. This perceptual stability is referred to as saccadic suppression. Functional suppression is believed to take place transiently in the visual systems, but it remains unknown how commonly or differentially the human occipital lobe activities are suppressed at the large-scale cortical network level. We determined the spatial-temporal dynamics of intracranially-recorded gamma activity at 80–150 Hz around spontaneous saccades under no-task conditions during wakefulness and those in darkness during REM sleep. Regardless of wakefulness or REM sleep, a small degree of attenuation of gamma activity was noted in the occipital regions during saccades, most extensively in the polar and least in the medial portions. Longer saccades were associated with more intense gamma-attenuation. Gamma-attenuation was subsequently followed by gamma-augmentation most extensively involving the medial and least involving the polar occipital region. Such gamma-augmentation was more intense during wakefulness and temporally locked to the offset of saccades. The polarities of initial peaks of perisaccadic event-related potentials (ERPs) were frequently positive in the medial and negative in the polar occipital regions. The present study, for the first time, provided the electrophysiological evidence that human occipital cortices differentially exert peri-saccadic modulation. Transiently suppressed sensitivity of the primary visual cortex in the polar region may be an important neural basis for saccadic suppression. Presence of occipital gamma-attenuation even during REM sleep suggests that saccadic suppression might be exerted even without external visual inputs. The primary visual cortex in the medial region, compared to the

  4. Shape of the feline cerebellum and occipital bone related to breed on MRI of 200 cats.

    Science.gov (United States)

    Huizing, Xander; Sparkes, Andy; Dennis, Ruth

    2017-10-01

    Objectives The MRI features of the feline cerebellum and occipital bone have not previously been described in the literature. The aims of this study were three-fold. Firstly, to document variations in cerebellar shape on MRI in neurologically normal cats to support our hypothesis that crowding of the contents of the caudal fossa or herniation of the cerebellar vermis through the foramen magnum occurs frequently as an anatomical variant. Secondly, to document variations in the morphology of the occipital bone. Thirdly, to see whether these variations in shape of the feline cerebellum and occipital bone could be associated with head conformation, such as brachycephaly. Methods The imaging records of the small animal clinic at the Animal Health Trust between 2000 and 2013 were searched retrospectively to identify adult cats that had undergone high-field (1.5 T) MRI investigation which included the brain. Exclusion criteria included evidence of intracranial disease or the presence of cervical syringomyelia. Midline sagittal T2-weighted and transverse images were used to assess the occipital bone morphology and cerebellar shape, and to measure the width to length ratio of the cranial cavity. Results Fourteen different breeds were represented. A cerebellar shape consistent with crowding of the contents of the caudal fossa, or herniation through the foramen magnum was present in 40% of the entire population. Persians (recognised as a brachycephalic breed) had a higher proportion of cerebellar crowding or herniation than all other breeds. There was no significant difference in the distribution of occipital bone morphology between these breed groups. Conclusions and relevance It is important to recognise morphological variations of the feline cerebellum and occipital bone in order to avoid false-positive diagnoses of raised intracranial pressure and pathological herniation on MRI.

  5. Alexia for Braille following bilateral occipital stroke in an early blind woman.

    Science.gov (United States)

    Hamilton, R; Keenan, J P; Catala, M; Pascual-Leone, A

    2000-02-07

    Recent functional imaging and neurophysiologic studies indicate that the occipital cortex may play a role in Braille reading in congenitally and early blind subjects. We report on a woman blind from birth who sustained bilateral occipital damage following an ischemic stroke. Prior to the stroke, the patient was a proficient Braille reader. Following the stroke, she was no longer able to read Braille yet her somatosensory perception appeared otherwise to be unchanged. This case supports the emerging evidence for the recruitment of striate and prestriate cortex for Braille reading in early blind subjects.

  6. Os sulcos e giros na face súpero-lateral do lobo occipital

    OpenAIRE

    Raphael Vicente Alves

    2014-01-01

    INTRODUÇÃO: A anatomia da face súpero-lateral do lobo occipital é tão complexa e variável que a sua descrição precisa não é encontrada nos livros clássicos de anatomia. Os sulcos e giros occipitais da convexidade cerebral encontram-se descritos com nomenclaturas diferentes de acordo com os diversos autores. O objetivo deste estudo foi investigar e descrever a anatomia da face súpero-lateral lobo occipital e esclarecer a sua nomenclatura. MÉTODOS: As configurações anatômicas dos sulcos e giros...

  7. MEGALENCEPHALY, POLYMICROGYRIA, POLYDACTYLY AND HYDROCEPHALUS (MPPH) SYNDROME: A NEW CASE WITH OCCIPITAL ENCEPHALOCELE AND CLEFT PALATE.

    Science.gov (United States)

    Demir, N; Peker, E; Gülşen I; Kaba, S; Tuncer, O

    2015-01-01

    The megalencephaly, polymicrogyria, polydactyly, and hydrocephalus (MPPH) syndrome is quite rarely seen. The four main findings in this syndrome may be accompanied by severe psychomotor retardation, blindness, hypotonia, convulsions, and facial dysmorphism. In this paper, we present a female newborn at 39 weeks gestational age born to parents who are first degree cousins. Beside the facial dysmorphism and four main features of the MPPH syndrome, the findings on the physical examination of the patient were, hypertonicity, occipital encephalocele, cleft palate, and multiple polyps in the tongue. The presence of occipital encephalocele, cleft palate, and polyps in the tongue in this patient was not reported previously in the literature.

  8. Brain metabolite changes in alcoholism: Localized proton magnetic resonance spectroscopy study of the occipital lobe

    Energy Technology Data Exchange (ETDEWEB)

    Modi, Shilpi; Bhattacharya, Manisha; Kumar, Pawan [NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (DRDO), Lucknow Road, Timarpur, Delhi 110054 (India); Deshpande, Smita N. [Department of Psychiatry, Dr. Ram Manohar Lohia Hospital, New Delhi (India); Tripathi, Rajendra Prasad [NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (DRDO), Lucknow Road, Timarpur, Delhi 110054 (India); Khushu, Subash, E-mail: skhushu@yahoo.com [NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (DRDO), Lucknow Road, Timarpur, Delhi 110054 (India)

    2011-07-15

    Chronic alcoholism is associated with altered brain metabolism, morphology and cognitive abilities. Besides deficits in higher order cognitive functions, alcoholics also show a deficit in the processing of basic sensory information viz. visual stimulation. To assess the metabolic changes associated with this deficit, {sup 1}H MRS was carried out in the occipital lobe of alcohol dependents. A significant increase in Cho/Cr ratio (p < 0.015) was observed in occipital lobe in the alcoholic group indicating altered cell membrane metabolism, which may probably be associated with the alterations in the cognitive abilities associated with vision.

  9. Brain metabolite changes in alcoholism: Localized proton magnetic resonance spectroscopy study of the occipital lobe

    International Nuclear Information System (INIS)

    Modi, Shilpi; Bhattacharya, Manisha; Kumar, Pawan; Deshpande, Smita N.; Tripathi, Rajendra Prasad; Khushu, Subash

    2011-01-01

    Chronic alcoholism is associated with altered brain metabolism, morphology and cognitive abilities. Besides deficits in higher order cognitive functions, alcoholics also show a deficit in the processing of basic sensory information viz. visual stimulation. To assess the metabolic changes associated with this deficit, 1 H MRS was carried out in the occipital lobe of alcohol dependents. A significant increase in Cho/Cr ratio (p < 0.015) was observed in occipital lobe in the alcoholic group indicating altered cell membrane metabolism, which may probably be associated with the alterations in the cognitive abilities associated with vision.

  10. The Superior Fronto-Occipital Fasciculus in the Human Brain Revealed by Diffusion Spectrum Imaging Tractography: An Anatomical Reality or a Methodological Artifact?

    Science.gov (United States)

    Bao, Yue; Wang, Yong; Wang, Wei; Wang, Yibao

    2017-01-01

    The existence of the superior fronto-occipital fasciculus (SFOF) in the human brain remains controversial. The aim of the present study was to clarify the existence, course, and terminations of the SFOF. High angular diffusion spectrum imaging (DSI) analysis was performed on six healthy adults and on a template of 842 subjects from the Human Connectome Project. To verify tractography results, we performed fiber microdissections of four post-mortem human brains. Based on DSI tractography, we reconstructed the SFOF in the subjects and the template from the Human Connectome Project that originated from the rostral and medial parts of the superior and middle frontal gyri. By tractography, we found that the fibers formed a compact fascicle at the level of the anterior horn of the lateral ventricle coursing above the head of caudate nucleus, medial to the corona radiate and under the corpus callosum (CC), and terminated at the parietal region via the lower part of the caudate nucleus. We consider that this fiber bundle observed by tractography is the SFOF, although it terminates mainly at the parietal region, rather than occipital lobe. By contrast, we were unable to identify a fiber bundle corresponding to the SFOF in our fiber dissection study. Although we did not provide definite evidence of the SFOF in the human brain, these findings may be useful for future studies in this field. PMID:29321729

  11. The Superior Fronto-Occipital Fasciculus in the Human Brain Revealed by Diffusion Spectrum Imaging Tractography: An Anatomical Reality or a Methodological Artifact?

    Directory of Open Access Journals (Sweden)

    Yue Bao

    2017-12-01

    Full Text Available The existence of the superior fronto-occipital fasciculus (SFOF in the human brain remains controversial. The aim of the present study was to clarify the existence, course, and terminations of the SFOF. High angular diffusion spectrum imaging (DSI analysis was performed on six healthy adults and on a template of 842 subjects from the Human Connectome Project. To verify tractography results, we performed fiber microdissections of four post-mortem human brains. Based on DSI tractography, we reconstructed the SFOF in the subjects and the template from the Human Connectome Project that originated from the rostral and medial parts of the superior and middle frontal gyri. By tractography, we found that the fibers formed a compact fascicle at the level of the anterior horn of the lateral ventricle coursing above the head of caudate nucleus, medial to the corona radiate and under the corpus callosum (CC, and terminated at the parietal region via the lower part of the caudate nucleus. We consider that this fiber bundle observed by tractography is the SFOF, although it terminates mainly at the parietal region, rather than occipital lobe. By contrast, we were unable to identify a fiber bundle corresponding to the SFOF in our fiber dissection study. Although we did not provide definite evidence of the SFOF in the human brain, these findings may be useful for future studies in this field.

  12. Evaluating the Influence of Chromatic and Luminance Stimuli on SSVEPs from Behind-the-Ears and Occipital Areas

    Directory of Open Access Journals (Sweden)

    Alan Floriano

    2018-02-01

    Full Text Available This work presents a study of chromatic and luminance stimuli in low-, medium-, and high-frequency stimulation to evoke steady-state visual evoked potential (SSVEP in the behind-the-ears area. Twelve healthy subjects participated in this study. The electroencephalogram (EEG was measured on occipital (Oz and left and right temporal (TP9 and TP10 areas. The SSVEP was evaluated in terms of amplitude, signal-to-noise ratio (SNR, and detection accuracy using power spectral density analysis (PSDA, canonical correlation analysis (CCA, and temporally local multivariate synchronization index (TMSI methods. It was found that stimuli based on suitable color and luminance elicited stronger SSVEP in the behind-the-ears area, and that the response of the SSVEP was related to the flickering frequency and the color of the stimuli. Thus, green-red stimulus elicited the highest SSVEP in medium-frequency range, and green-blue stimulus elicited the highest SSVEP in high-frequency range, reaching detection accuracy rates higher than 80%. These findings will aid in the development of more comfortable, accurate and stable BCIs with electrodes positioned on the behind-the-ears (hairless areas.

  13. Cerebellar dermoid tumor and occipital meningocele in a monozygotic twin : clues to the embryogenesis of craniospinal dysraphism

    NARCIS (Netherlands)

    Groen, R J; van Ouwerkerk, W J

    A case of monochorionic/monoamnionic twin with discordant occipital developmental malformations is presented. One female twin appeared to have an occipital meningocele with cerebellar aplasia and died immediately after birth. The other twin presented with signs and symptoms of raised intracranial

  14. 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.

  15. TMS of the occipital cortex induces tactile sensations in the fingers of blind Braille readers.

    Science.gov (United States)

    Ptito, M; Fumal, A; de Noordhout, A Martens; Schoenen, J; Gjedde, A; Kupers, R

    2008-01-01

    Various non-visual inputs produce cross-modal responses in the visual cortex of early blind subjects. In order to determine the qualitative experience associated with these occipital activations, we systematically stimulated the entire occipital cortex using single pulse transcranial magnetic stimulation (TMS) in early blind subjects and in blindfolded seeing controls. Whereas blindfolded seeing controls reported only phosphenes following occipital cortex stimulation, some of the blind subjects reported tactile sensations in the fingers that were somatotopically organized onto the visual cortex. The number of cortical sites inducing tactile sensations appeared to be related to the number of hours of Braille reading per day, Braille reading speed and dexterity. These data, taken in conjunction with previous anatomical, behavioural and functional imaging results, suggest the presence of a polysynaptic cortical pathway between the somatosensory cortex and the visual cortex in early blind subjects. These results also add new evidence that the activity of the occipital lobe in the blind takes its qualitative expression from the character of its new input source, therefore supporting the cortical deference hypothesis.

  16. Hypoxic-Ischemic Encephalopathy With Clinical and Imaging Abnormalities Limited to Occipital Lobe.

    Science.gov (United States)

    Parmar, Hemant A; Trobe, Jonathan D

    2016-09-01

    The vulnerable brain areas in hypoxic-ischemic encephalopathy (HIE) following systemic hypotension are typically the neocortex, deep cerebral gray nuclei, hippocampus, cerebellum, and the parieto-occipital arterial border zone region. The visual cortex is not commonly recognized as a target in this setting. Single-institution review from 2007 to 2015 of patients who suffered cortical visual loss as an isolated clinical manifestation following systemic hypotension and whose brain imaging showed abnormalities limited to the occipital lobe. Nine patients met inclusion criteria. Visual loss at outset ranged from hand movements to 20/20, but all patients had homonymous field loss at best. In 1 patient, imaging was initially normal but 4 months later showed encephalomalacia. In 2 patients, imaging was initially subtle enough to be recognized as abnormal only when radiologists were advised that cortical visual loss was present. The occipital lobe may be an isolated target in HIE with cortical visual loss as the only clinical manifestation. Imaging performed in the acute period may appear normal or disclose abnormalities subtle enough to be overlooked. Radiologists informed of the clinical manifestations may be more attune to these abnormalities, which will become more apparent months later when occipital volume loss develops.

  17. Occipital lobe seizures related to marked elevation of hemoglobin A1C: report of two cases.

    Science.gov (United States)

    Hung, Wan-Ling; Hsieh, Peiyuan F; Lee, Yi-Chung; Chang, Ming-Hong

    2010-07-01

    Occipital lobe seizures caused by nonketotic hyperglycemia (NKH) have been reported in only a few cases and are not fully characterized. We report two cases of NKH-related occipital lobe seizures with high hemoglobin A1C (HbA1C), epileptiform electroencephalograph (EEG) and MRI abnormalities. Both patients had moderate hyperglycemia (310-372 mg/dl) and mildly elevated serum osmolarity (295-304 mOsm/kg) but markedly elevated HbA1C (13.8-14.4%). One patient had a clinico-EEG seizure originating from the right occipital region during sleep. The other patient had an interictal epileptiform discharge consisting of unilateral occipital beta activity in sleep. None of the previously reported cases fulfilled the criteria of a nonketotic hyperglycemic hyperosmolar (NKHH) state, or showed any interictal beta paroxysms, spikes, sharp waves, or spike/sharp-slow wave complexes. We suggest that prolonged exposure to uncontrolled hyperglycemia, as indicated by HbA1C, rather than an acute NKHH state is crucial in the development of this peculiar seizure. We also suggest clinicians look for the presence of interictal focal beta paroxysms in addition to the usual epileptiform discharges while reading the EEG of these patients. 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. The white matter of the human cerebrum: part I The occipital lobe by Heinrich Sachs.

    Science.gov (United States)

    Forkel, Stephanie J; Mahmood, Sajedha; Vergani, Francesco; Catani, Marco

    2015-01-01

    This is the first complete translation of Heinrich Sachs' outstanding white matter atlas dedicated to the occipital lobe. This work is accompanied by a prologue by Prof Carl Wernicke who for many years was Sachs' mentor in Breslau and enthusiastically supported his work. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Perinatal occipital lobe injury in children: analysis of twenty-one cases.

    Science.gov (United States)

    Wang, San-Mei; Yang, Chang-Shuan; Hou, Yu; Ma, Xiu-Wei; Feng, Zhi-Chun; Liao, Yu-Zhen

    2012-12-01

    This study used magnetic resonance imaging to analyze causes and clinical courses of pediatric occipital lobe injury. Patients undergoing magnetic resonance imaging for suspected bilateral occipital lobe injury at our Neurodevelopmental Department between July 2007 and June 2011 were included. We evaluated magnetic resonance imaging characteristics, clinical courses, electroencephalogram monitoring, and Denver Development Screen Test scores. Twenty-one infants were examined. Of these, 10 had been born preterm. Thirteen patients demonstrated hypoglycemia. Perinatal period hypoglycemia comprised the most common cause (71.4%) of occipital brain injury. Visual abnormalities were evident in 18 patients. Seventeen (80.9%) patients manifested epilepsy. Infantile spasms were observed in 13 cases (76.5%). According to Denver Development Screen Test assessment, 17 patients demonstrated delayed motor development. Motor function and language improved in 10 patients after effective control of their seizures. Hypoglycemia constitutes the most common cause of occipital injury in infants. Visual impairment, startle episodes, infantile spasms, and motor developmental delay comprise the most common complications, whereas language function is usually spared. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Lateralized occipital degeneration in posterior cortical atrophy predicts visual field deficits

    Directory of Open Access Journals (Sweden)

    Rebecca S Millington

    2017-01-01

    Conclusions: Detailed brain imaging shows that the asymmetric visual field deficits in patients with PCA reflect the pattern of degeneration of both white and gray matter in the occipital lobe. Understanding the nature of both visual field deficits and the neurodegenerative brain changes in PCA may improve diagnosis and understanding of this disease.

  1. A giant occipital encephalocele with spontaneous hemorrhage into the sac: A rare case report

    Science.gov (United States)

    Nath, H. D.; Mahapatra, A. K.; Borkar, S. A.

    2014-01-01

    In giant encephalocele, head size is smaller than the encelphalocele. Occipital encephalocele is the commonest of all encephalocele. In our case, there was rare association with giant encephalocele with old hemorrhage in the sac. This was a unique presentation. In world literature, there was rare association with giant encephalocele with hemorrhage. PMID:25685207

  2. A giant occipital encephalocele with spontaneous hemorrhage into the sac: A rare case report

    OpenAIRE

    Nath, H. D.; Mahapatra, A. K.; Borkar, S. A.

    2014-01-01

    In giant encephalocele, head size is smaller than the encelphalocele. Occipital encephalocele is the commonest of all encephalocele. In our case, there was rare association with giant encephalocele with old hemorrhage in the sac. This was a unique presentation. In world literature, there was rare association with giant encephalocele with hemorrhage.

  3. The anatomic basis for localized occipital thinning: A normal anatomic variant

    International Nuclear Information System (INIS)

    Haden, M.A.; Keats, T.E.

    1982-01-01

    The radiographic evidence presented in this case confirms that the asymptomatic, incidentally found occipital radiolucencies previously described by Keats are not a problem in differential diagnosis of inner table erosion. The entity appears to be a developmental variant with typical features and occurring in a characteristic location. (orig.)

  4. Opsoclonus-induced occipital deactivation with a region-specific distribution

    NARCIS (Netherlands)

    de Jong, BM; van Weerden, TW; Haaxma, R

    The cerebral distribution of 2-[18F]fluoro 2-deoxy-D-glucose (FDG) uptake in a patient with opsoclonus was measured by positron emission tomography (PET) and subsequently compared with the distribution in ten normal subjects. Statistical parametric mapping (SPM) revealed a decreased occipital FDG

  5. The white matter of the human cerebrum: Part I The occipital lobe by Heinrich Sachs

    Science.gov (United States)

    Forkel, Stephanie J.; Mahmood, Sajedha; Vergani, Francesco; Catani, Marco

    2015-01-01

    This is the first complete translation of Heinrich Sachs' outstanding white matter atlas dedicated to the occipital lobe. This work is accompanied by a prologue by Prof Carl Wernicke who for many years was Sachs' mentor in Breslau and enthusiastically supported his work. PMID:25527430

  6. Dorsal surgical stabilisation using tension bands for treatment of traumatic atlanto-occipital instability in a cat.

    Science.gov (United States)

    Vedrine, B; Maurin, M P

    2017-12-01

    An atlanto-occipital instability secondary to a dog bite was diagnosed in a 4-year-old Persian cat. Dorsal stabilisation of the instability was made with two OrthoFiber prostheses (Securos), which were used as tension bands between the nuchal crests of the occipital bone and the spinous process of the axis. Total recovery was achieved 4 days after surgery. Normal alignment of the atlanto-occipital joint was observed on survey radiographs taken 6 weeks post-surgery. Although the right loop had failed, the alignment was still normal and no neurological after-effects could be identified. Dorsal divergent tension bands between the nuchal crests of the occipital bone and the spinous process of the axis can be used to stabilise traumatic atlanto-occipital instability. © 2017 Australian Veterinary Association.

  7. Panayiotopoulos syndrome and symptomatic occipital lobe epilepsy of childhood: a clinical and EEG study.

    Science.gov (United States)

    Tata, Gulten; Guveli, Betul Tekin; Dortcan, Nimet; Cokar, Ozlem; Kurucu, Hatice; Demirbilek, Veysi; Dervent, Aysin

    2014-06-01

    Panayiotopoulos syndrome (PS) is an age-related seizure susceptibility syndrome that affects the central autonomic system. Although the majority of the few ictal recordings obtained so far suggest an occipital origin, semiological and interictal EEG data appear to favour more extensive involvement. In this study, the characteristics (including those based on semiology and EEG) of children with Panayiotopoulos syndrome (n=24) and those with lesion-related, symptomatic occipital lobe epilepsy (SOLE) (n=23) were compared. Detailed semiological information and EEG parameters including the localisation, distribution, density (n/sec), reactivity, and morphological characteristics of spike-wave foci and their relationship with different states of vigilance were compared between the two groups. The age at seizure onset was significantly younger in patients with symptomatic occipital lobe epilepsy than in those with PS (mean age at onset: 3.4 versus 5.6 years, respectively; p=0.044). Autonomic seizures (p=0.001) and ictal syncope (p=0.055) were more frequent in PS than in symptomatic occipital lobe epilepsy (87.5% and 37.5% versus 43.5% and 13%, respectively). The interictal spike-wave activity increased significantly during non-rapid eye movement (non-REM) sleep in both groups. The spike waves in non-REM seen in PS tended to spread mainly to central and centro-temporal regions. The results indicate that although common features do exist, Panayiotopoulos syndrome differs from symptomatic occipital lobe epilepsy and has a unique low epileptogenic threshold related to particular brain circuits.

  8. Intralobar fibres of the occipital lobe: a post mortem dissection study.

    Science.gov (United States)

    Vergani, Francesco; Mahmood, Sajedha; Morris, Cristopher M; Mitchell, Patrick; Forkel, Stephanie J

    2014-07-01

    The atlas by Heinrich Sachs (1892) provided an accurate description of the intralobar fibres of the occipital lobe, with a detailed representation of the short associative tracts connecting different parts of the lobe. Little attention has been paid to the work of Sachs since its publication. In this study, we present the results of the dissection of three hemispheres, performed according to the Klingler technique (1935). Our anatomical findings are then compared to the original description of the occipital fibres anatomy as detailed by Sachs. Three hemispheres were dissected according to Klingler's technique (1935). Specimens were fixed in 10% formalin and frozen at -15 °C for two weeks. After defreezing, dissection of the white matter fibres was performed with blunt dissectors. Coronal sections were obtained according to the cuts originally described by Sachs. In addition, medial to lateral and lateral to medial dissection of the white matter of the occipital lobe was also performed. A network of short association fibres was demonstrated in the occipital lobe, comprising intralobar association fibres and U-shaped fibres, which are connecting neighbouring gyri. Lateral to the ventricles, longitudinal fibres of the stratum sagittale were also identified that are arranged as external and internal layers. Fibres of the forceps major were also found to be in direct contact with the ventricular walls. We were able to replicate all tracts originally described by Sachs. In addition, a previously unrecognised tract, connecting the cuneus to the lingual gyrus, was identified. This tract corresponds to the "sledge runner", described in tractography studies. The occipital lobe shows a rich network of intralobar fibres, arranged around the ventricular wall. Good concordance was observed between the Klingler dissection technique and the histological preparations of Sachs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Three-dimensional CT features of occipital squama normal anatomy, anatomic variations and fractures

    International Nuclear Information System (INIS)

    Liu Jungang; Li Xin; Wang Chunxiang; Zhang Lin; Guo Wanhua

    2013-01-01

    Objective: To evaluate 3D CT features of normal anatomy, anatomic variations and fractures of occipital squama. Methods: The 3D CT features on MIP, VR images were analyzed retrospectively in 589 pediatric cases. The normal anatomy, anatomic variations and fractures of occipital squama were observed respectively, and the differential diagnostic features including the individual location, appearance and extension were analyzed. Results: Four hundred and thirty-three patients (75.2%) showed normal anatomy, including 154 patients with adult occipital anatomical features, 279 patients with posterior intraoccipital synchondrosis, and 37 patients with Kerckring-supraoccipital synchondrosis. When cases with recent trauma history were excluded, 113 patients (19.1%) showed anatomic variants, including unpenetrating sutures and penetrating sutures. The former could be subdivided to Mendosal sutures in 23 cases, superior median fissures in 19 cases, and midline supraoccipital fissures in 4 cases, while the latter could be subdivided to the interparietal bone variations in 54 cases, wormian bones in 23 cases, and accessory bones in 7 cases. Two or more variations coexisted in 33 cases. The occipital squama fractures were shown in 34 cases (5.6%), including linear fractures in 27 cases, comminuted fractures in 3 cases, with depression fracture in one case, separation of cranial sutures in 3 cases, and other fractures associated with variants in 3 cases. The fractures were sharp, or jagged, without limitation of the occification. Conclusion: There are different 3D CT features of normal anatomy, anatomic variations and fractures of occipital squama in children, which are important for making the accurate diagnosis. (authors)

  10. Brief communication: timing of spheno-occipital closure in modern Western Australians.

    Science.gov (United States)

    Franklin, Daniel; Flavel, Ambika

    2014-01-01

    The spheno-occipital synchondrosis is a craniofacial growth centre between the occipital and sphenoid bones-its ossification persists into adolescence, which for the skeletal biologist, means it has potential application for estimating subadult age. Based on previous research the timing of spheno-occipital fusion is widely variable between and within populations, with reports of complete fusion in individuals as young as 11 years of age and nonfusion in adults. The aim of this study is, therefore, to examine this structure in a mixed sex sample of Western Australian individuals that developmentally span late childhood to adulthood. The objective is to develop statistically quantified age estimation standards based on scoring the degree of spheno-occipital fusion. The sample comprises multidetector computed tomography (MDCT) scans of 312 individuals (169 male; 143 female) between 5 and 25 years of age. Each MDCT scan is visualized in a standardized sagittal plane using three-dimensional oblique multiplanar reformatting. Fusion status is scored according to a four-stage system. Transition analysis is used to calculate age ranges for each defined stage and determine the mean age for transition between an unfused, fusing and fused status. The maximum likelihood estimates for the transition from open to fusing in the endocranial half is 14.44 years (male) and 11.42 years (female); transition from fusion in the ectocranial half to complete fusion is 16.16 years (male) and 13.62 years (female). This study affirms the potential value of assessing the degree of fusion in the spheno-occipital synchondrosis as an indicator of skeletal age. Copyright © 2013 Wiley Periodicals, Inc.

  11. Relationship between cortical resection and visual function after occipital lobe epilepsy surgery.

    Science.gov (United States)

    Heo, Won; Kim, June Sic; Chung, Chun Kee; Lee, Sang Kun

    2017-10-27

    OBJECTIVE In this study, the authors investigated long-term clinical and visual outcomes of patients after occipital lobe epilepsy (OLE) surgery and analyzed the relationship between visual cortical resection and visual function after OLE surgery. METHODS A total of 42 consecutive patients who were diagnosed with OLE and underwent occipital lobe resection between June 1995 and November 2013 were included. Clinical, radiological, and histopathological data were reviewed retrospectively. Seizure outcomes were categorized according to the Engel classification. Visual function after surgery was assessed using the National Eye Institute Visual Functioning Questionnaire 25. The relationship between the resected area of the visual cortex and visual function was demonstrated by multivariate linear regression models. RESULTS After a mean follow-up period of 102.2 months, 27 (64.3%) patients were seizure free, and 6 (14.3%) patients had an Engel Class II outcome. Nineteen (57.6%) of 33 patients had a normal visual field or quadrantanopia after surgery (normal and quadrantanopia groups). Patients in the normal and quadrantanopia groups had better vision-related quality of life than those in the hemianopsia group. The resection of lateral occipital areas 1 and 2 of the occipital lobe was significantly associated with difficulties in general vision, peripheral vision, and vision-specific roles. In addition, the resection of intraparietal sulcus 3 or 4 was significantly associated with decreased social functioning. CONCLUSIONS The authors found a favorable seizure control rate (Engel Class I or II) of 78.6%, and 57.6% of the subjects had good visual function (normal vision or quadrantanopia) after OLE surgery. Lateral occipital cortical resection had a significant effect on visual function despite preservation of the visual field.

  12. Adult-onset photosensitivity: clinical significance and epilepsy syndromes including idiopathic (possibly genetic) photosensitive occipital epilepsy.

    Science.gov (United States)

    Koutroumanidis, Michalis; Tsirka, Vasiliki; Panayiotopoulos, Chrysostomos

    2015-09-01

    To evaluate the clinical associations of adult-onset photosensitivity, we studied the clinical and EEG data of patients who were referred due to a possible first seizure and who had a photoparoxysmal response on their EEG. Patients with clinical evidence of photosensitivity before the age of 20 were excluded. Of a total of 30 patients, four had acute symptomatic seizures, two had vasovagal syncope, and 24 were diagnosed with epilepsy. Nine of the 24 patients had idiopathic (genetic) generalized epilepsies and predominantly generalized photoparoxysmal response, but also rare photically-induced seizures, while 15 had exclusively, or almost exclusively, reflex photically-induced occipital seizures with frequent secondary generalization and posterior photoparoxysmal response. Other important differences included a significantly older age at seizure onset and paucity of spontaneous interictal epileptic discharges in patients with photically-induced occipital seizures; only a quarter of these had occasional occipital spikes, in contrast to the idiopathic (genetic) generalized epilepsy patients with typically generalized epileptic discharges. On the other hand, both groups shared a positive family history of epilepsy, common seizure threshold modulators (such as tiredness and sleep deprivation), normal neurological examination and MRI, a generally benign course, and good response to valproic acid. We demonstrated that photosensitivity can first occur in adult life and manifest, either as idiopathic (possibly genetic) photosensitive occipital epilepsy with secondary generalization or as an EEG, and less often, a clinical/EEG feature of idiopathic (genetic) generalized epilepsies. Identification of idiopathic photosensitive occipital epilepsy fills a diagnostic gap in adult first-seizure epileptology and is clinically important because of its good response to antiepileptic drug treatment and fair prognosis.

  13. Temporary occipital fixation in young children with severe cervical-thoracic spinal deformity.

    Science.gov (United States)

    Kelley, Brian J; Minkara, Anas A; Angevine, Peter D; Vitale, Michael G; Lenke, Lawrence G; Anderson, Richard C E

    2017-10-01

    OBJECTIVE The long-term effects of instrumentation and fusion of the occipital-cervical-thoracic spine on spinal growth in young children are poorly understood. To mitigate the effects of this surgery on the growing pediatric spine, the authors report a novel technique used in 4 children with severe cervical-thoracic instability. These patients underwent instrumentation from the occiput to the upper thoracic region for stabilization, but without bone graft at the craniovertebral junction (CVJ). Subsequent surgery was then performed to remove the occipital instrumentation, thereby allowing further growth and increased motion across the CVJ. METHODS Three very young children (15, 30, and 30 months old) underwent occipital to thoracic posterior segmental instrumentation due to cervical or upper thoracic dislocation, progressive kyphosis, and myelopathy. The fourth child (10 years old) underwent similar instrumentation for progressive cervical-thoracic scoliosis. Bone graft was placed at and distal to C-2 only. After follow-up CT scans demonstrated posterior arthrodesis without unintended fusion from the occiput to C-2, 3 patients underwent removal of the occipital instrumentation. RESULTS Follow-up cervical spine flexion/extension radiographs demonstrated partial restoration of motion at the CVJ. One patient has not had the occipital instrumentation removed yet, because only 4 months have elapsed since her operation. CONCLUSIONS Temporary fixation to the occiput provides increased biomechanical stability for spinal stabilization in young children, without permanently eliminating motion and growth at the CVJ. This technique can be considered in children who require longer instrumentation constructs for temporary stabilization, but who only need fusion in more limited areas where spinal instability exists.

  14. Age estimation by an analysis of spheno-occipital synchondrosis using cone-beam computed tomography.

    Science.gov (United States)

    Sinanoglu, Alper; Kocasarac, Husniye Demirturk; Noujeim, Marcel

    2016-01-01

    The spheno-occipital synchondrosis has a relatively late ossification in comparison with other cranial base synchondroses, which makes it a point of interest for forensic age determination studies. The purpose of the present study was to evaluate the reliability of spheno-occipital synchondrosis development in age determination in a Turkish population and to evaluate the reproducibility and reliability of cone beam computed tomography (CBCT) in an evaluation of the fusion stages of spheno-occipital synchondrosis. CBCT mid-sagittal images of 238 (90 males and 148 females) patients between the ages of 7 and 25, with a mean age of 15.45±0.26 and 16.43±0.37, respectively, were examined by three Oral and Maxillofacial Radiologists who evaluated the degree of synchondrosis fusion using a four-stage system. A reevaluation of 50 cases was conducted for intraobserver assessment. Multiple statistical analyses were used to assess the correlation between age and the fusion stage, to compare gender and age according to stages, and to evaluate the inter- and intraobserver agreement. The mean ages for complete fusion (Stage 3) were 18 and 20 for females and males, respectively. The interobserver agreement ranged between substantial and perfect, while the intraobserver agreement was substantial for all three observers. Based on these results, CBCT, when available, might be the method of choice for age estimation using the spheno-occipital synchondrosis fusion stages. Evaluating spheno-occipital synchondrosis has a value for age estimation around the age of 18 years, which affects the legal decisions in Turkey. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Spontaneous and visually-driven high-frequency oscillations in the occipital cortex: Intracranial recording in epileptic patients

    Science.gov (United States)

    Nagasawa, Tetsuro; Juhász, Csaba; Rothermel, Robert; Hoechstetter, Karsten; Sood, Sandeep; Asano, Eishi

    2011-01-01

    SUMMARY High-frequency oscillations (HFOs) at ≧80 Hz of nonepileptic nature spontaneously emerge from human cerebral cortex. In 10 patients with extra-occipital lobe epilepsy, we compared the spectral-spatial characteristics of HFOs spontaneously arising from the nonepileptic occipital cortex with those of HFOs driven by a visual task as well as epileptogenic HFOs arising from the extra-occipital seizure focus. We identified spontaneous HFOs at ≧80 Hz with a mean duration of 330 msec intermittently emerging from the occipital cortex during interictal slow-wave sleep. The spectral frequency band of spontaneous occipital HFOs was similar to that of visually-driven HFOs. Spontaneous occipital HFOs were spatially sparse and confined to smaller areas, whereas visually-driven HFOs involved the larger areas including the more rostral sites. Neither spectral frequency band nor amplitude of spontaneous occipital HFOs significantly differed from those of epileptogenic HFOs. Spontaneous occipital HFOs were strongly locked to the phase of delta activity, but the strength of delta-phase coupling decayed from 1 to 3 Hz. Conversely, epileptogenic extra-occipital HFOs were locked to the phase of delta activity about equally in the range from 1 to 3 Hz. The occipital cortex spontaneously generates physiological HFOs which may stand out on electrocorticography traces as prominently as pathological HFOs arising from elsewhere; this observation should be taken into consideration during presurgical evaluation. Coupling of spontaneous delta and HFOs may increase the understanding of significance of delta-oscillations during slow-wave sleep. Further studies are warranted to determine whether delta-phase coupling distinguishes physiological from pathological HFOs or simply differs across anatomical locations. PMID:21432945

  16. Ictal Generalized EEG Attenuation (IGEA and hypopnea in a child with occipital type 1 cortical dysplasia - Is it a biomarker for SUDEP?

    Directory of Open Access Journals (Sweden)

    Ganne Chaitanya

    2015-01-01

    Full Text Available An interesting association of ictal hypopnea and ictal generalized EEG attenuation (IGEA as possible marker of sudden unexpected death in epilepsy (SUDEP is reported. We describe a 5-years-old girl with left focal seizures with secondary generalization due to right occipital cortical dysplasia presenting with ictal hypopnea and IGEA. She had repeated episodes of the ictal apnoea in the past requiring ventilator support and intensive care unit (ICU admission during episodes of status epilepticus. The IGEA lasted for 0.26-4.68 seconds coinciding with the ictal hypopnea during which both clinical seizure and electrical epileptic activity stopped. Review of literature showed correlation between post-ictal apnoea and post ictal generalized EEG suppression and increased risk for SUDEP. The report adds to the growing body of literature on peri-ictal apnea, about its association with IGEA might be considered as a marker for SUDEP. She is seizure free for 4 months following surgery.

  17. Occipitalization of the ventral part and the vertebralization of the dorsal part of the atlas with insufficiency of the transverse ligament

    International Nuclear Information System (INIS)

    Wackenheim, A.

    1982-01-01

    Occipitalization and vertebralization of the atlas are well known. We observed the first case of ventral occipitalization associated with dorsal vertebralization of the atlas in a 15-year-old female. (orig.)

  18. Left heart ventricular angiography

    Science.gov (United States)

    ... blood vessels. These x-ray pictures create a "movie" of the left ventricle as it contracts rhythmically. ... 22578925 www.ncbi.nlm.nih.gov/pubmed/22578925 . Review Date 9/26/2016 Updated by: Michael A. ...

  19. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  20. Distinct Oscillatory Frequencies Underlie Excitability of Human Occipital and Parietal Cortex.

    Science.gov (United States)

    Samaha, Jason; Gosseries, Olivia; Postle, Bradley R

    2017-03-15

    Transcranial magnetic stimulation (TMS) of human occipital and posterior parietal cortex can give rise to visual sensations called phosphenes. We used near-threshold TMS with concurrent EEG recordings to measure how oscillatory brain dynamics covary, on single trials, with the perception of phosphenes after occipital and parietal TMS. Prestimulus power and phase, predominantly in the alpha band (8-13 Hz), predicted occipital TMS phosphenes, whereas higher-frequency beta-band (13-20 Hz) power (but not phase) predicted parietal TMS phosphenes. TMS-evoked responses related to phosphene perception were similar across stimulation sites and were characterized by an early (200 ms) posterior negativity and a later (>300 ms) parietal positivity in the time domain and an increase in low-frequency (∼5-7 Hz) power followed by a broadband decrease in alpha/beta power in the time-frequency domain. These correlates of phosphene perception closely resemble known electrophysiological correlates of conscious perception of near-threshold visual stimuli. The regionally differential pattern of prestimulus predictors of phosphene perception suggests that distinct frequencies may reflect cortical excitability in occipital versus posterior parietal cortex, calling into question the broader assumption that the alpha rhythm may serve as a general index of cortical excitability. SIGNIFICANCE STATEMENT Alpha-band oscillations are thought to reflect cortical excitability and are therefore ascribed an important role in gating information transmission across cortex. We probed cortical excitability directly in human occipital and parietal cortex and observed that, whereas alpha-band dynamics indeed reflect excitability of occipital areas, beta-band activity was most predictive of parietal cortex excitability. Differences in the state of cortical excitability predicted perceptual outcomes (phosphenes), which were manifest in both early and late patterns of evoked activity, revealing the time

  1. Transient attenuation of visual evoked potentials during focal status epilepticus in a patient with occipital lobe epilepsy.

    Science.gov (United States)

    Tsai, Meng-Han; Hsu, Shih-Pin; Huang, Chi-Ren; Chang, Chen-Sheng; Chuang, Yao-Chung

    2010-06-01

    Seizures originating in the occipital areas are relatively uncommon. They are usually characterized by visual hallucinations and illusions or other symptoms related to the eyes and vision. In a 54-year-old woman with occipital lobe epilepsy, complex visual hallucinations, illusions, and migraine-like headache constitute the major clinical manifestations. During focal status epilepticus, ictal electroencephalography revealed rhythmic focal spikes in the right occipital region, rapidly propagating to the right parietal and contralateral occipital areas. Ictal brain single-photon emission computed topography revealed hyperperfusion of the right occipital region. Using a full-field pattern-shift visual evoked potential (VEP) study, we found that the P100 responses on both sides were markedly attenuated in amplitude during occipital focal status epilepticus, whereas the latencies of the VEPs were normal. The amplitude and morphology of P100 responses on both sides, however, returned to the normal range 7 days after cessation of the seizures. In addition to clinical seizure semiology, scalp EEG, SPECT and neuroimaging studies, VEP studies may be used as a supplementary examination tool to provide further information in the patients with occipital lobe seizures or epilepsies.

  2. Evaluation of spheno-occipital synchondrosis: A review of literature and considerations from forensic anthropologic point of view

    Science.gov (United States)

    Krishan, Kewal; Kanchan, Tanuj

    2013-01-01

    Cranial sutures and synchondrosis have long been studied by forensic scientists, human anatomists, and anthropologists for estimation of age in different population groups. Observation of the closure of spheno-occipital synchondrosis has an important role to play in the estimation of age in the examination of unknown human remains when a skull is brought for examination. The present article reviews the studies conducted on the closure of spheno-occipital synchondrosis and presents a few valuable considerations that would be essential for carrying out research related to closure of spheno-occipital synchondrosis in humans. PMID:24255553

  3. Prenatal ultrasound and MRI findings of temporal and occipital lobe dysplasia in a twin with achondroplasia.

    Science.gov (United States)

    Pugash, D; Lehman, A M; Langlois, S

    2014-09-01

    Thanatophoric dysplasia, hypochondroplasia and achondroplasia are all caused by FGFR3 (fibroblast growth factor receptor 3) mutations. Neuropathological findings of temporal lobe dysplasia are found in thanatophoric dysplasia, and temporal and occipital lobe abnormalities have been described recently in brain imaging studies of children with hypochondroplasia. We describe twins discordant for achondroplasia, in one of whom the prenatal diagnosis was based on ultrasound and fetal MRI documentation of temporal and occipital lobe abnormalities characteristic of hypochondroplasia, in addition to the finding of short long bones. Despite the intracranial findings suggestive of hypochondroplasia, achondroplasia was confirmed following postnatal clinical and genetic testing. These intracranial abnormalities have not been previously described in a fetus with achondroplasia. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  4. Occipital Lobe Gray Matter Volume in Male Patients with Chronic Schizophrenia: A Quantitative MRI Study

    Science.gov (United States)

    Onitsuka, Toshiaki; McCarley, Robert W.; Kuroki, Noriomi; Dickey, Chandlee C.; Kubicki, Marek; Demeo, Susan S.; Frumin, Melissa; Kikinis, Ron; Jolesz, Ferenc A.; Shenton, Martha E.

    2008-01-01

    Schizophrenia is characterized by deficits in cognition as well as visual perception. There have, however, been few magnetic resonance imaging (MRI) studies of the occipital lobe as an anatomically defined region of interest in schizophrenia. To examine whether or not patients with chronic schizophrenia show occipital lobe volume abnormalities, we measured gray matter volumes for both the primary visual area (PVA) and the visual association areas (VAA) using MRI based neuroanatomical landmarks and three-dimensional information. PVA and VAA gray matter volumes were measured using high-spatial resolution MRI in 25 male patients diagnosed with chronic schizophrenia and in 28 male normal controls. Chronic schizophrenia patients showed reduced bilateral VAA gray matter volume (11%), compared with normal controls, whereas patients showed no group difference in PVA gray matter volume. These results suggest that reduced bilateral VAA may be a neurobiological substrate of some of the deficits observed in early visual processing in schizophrenia. PMID:17350226

  5. Congenital occipital encephalocele with Dabska tumor: report of an unusual case.

    Science.gov (United States)

    Rumana, M; Khursheed, N; Ramzan, A

    2012-01-01

    Encephaloceles arise from developmental defects in neural tube formation. These lesions contain brain and meninges which herniate through a defect in the skull. These may present as isolated malformations or rarely be associated with brain tumors. We hereby discuss a case of an unusual association of an occipital encephalocele with papillary intralymphatic angioendothelioma or Dabska tumor arising from the sac itself. The patient underwent resection of the herniated brain tissue with repair and closure of the dural defect. Histopathological examination revealed evidence of Dabska tumor from the sac. This is the first case report of the association of an occipital encephalocele with a rare vascular tumor, i.e. papillary intralymphatic angioendothelioma. Copyright © 2012 S. Karger AG, Basel.

  6. Parietal and occipital encephalocele in same child: A rarest variety of double encephalocele.

    Science.gov (United States)

    Sharma, Somnath; Ojha, Bal Krishan; Chandra, Anil; Singh, Sunil Kumar; Srivastava, Chhitij

    2016-05-01

    An encephalocele is a protrusion of the brain and/or meninges through a defect in the skull. Based on the location of the skull defect they are classified into sincipital, basal, occipital or parietal varieties. Occurrence of more than one Encephalocele in a patient is very rare and very few cases of double encephalocele are reported. We report an interesting case where a parietal and an occipital encephalocele were present together. The patient was a 2 months boy who was brought to us with complaints of two swelling on the scalp since birth. Neuroimaging studies confirmed it to be a case of double encephalocele. The rarity of the findings prompted us to report this case. The presentation and management of the case along with and review of the relevant literature is presented. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  7. Inflammatory pseudotumor of the occipital condyle imitating a malignant neoplasm - a case report

    International Nuclear Information System (INIS)

    Sznajder, K.; Skrzelewski, S.

    2007-01-01

    Inflammatory pseudotumor is a non-neoplastic process of unknown etiology characterized by proliferation of connective tissue with an inflammatory infiltrate. IPT most frequently arises in the orbit, but can also be found in the larynx, the paranasal sinus and rarely in the skull base. We present the case of a 20-year-old patient with a 4-month history of headache and insomnia. Neurological examination showed limited head mobility and hypoglossal nerve dysfunction. The patient was afebrile and no abnormalities in blood tests were found. CT revealed the presence of a tumor mass destructing the right occipital condyle. MRI was performed and the mass was surgically removed. The histological diagnosis was non-specific chronic inflammatory granulation tissue. Inflammatory pseudotumors can often mimic malignant neoplasms, especially in cases where bone destruction is observed. IPT of the occipital condyle is a rare but aggressive lesion that should be treated by surgical excision. (author)

  8. Occipital Intraosseous Hemangioma over Torcula: Unusual Presentation with Raised Intracranial Pressure.

    Science.gov (United States)

    Rao, K V L N; Beniwal, Manish; Vazhayil, Vikas; Somanna, Sampath; Yasha, T C

    2017-12-01

    Hemangiomas of the bone are benign, uncommon, slow-growing lesions accounting for occipital hemangiomas are rare, and occipital hemangiomas presenting with features of raised intracranial tension are, with only 2 cases reported to date. In this case report, we describe the unique case of a 30-year-old male patient presenting with raised intracranial pressure due to venous obstruction at the torcula. The patient underwent excision of the lesion and became symptom free. Although these are benign lesions, they can have a varied clinical presentation. An understanding of the different clinical presentations and surgical nuances in excising such tumors can lead to early diagnosis and good patient outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. A Case of Asymptomatic Occipital Condyle Fracture with Incomplete Occipitocervical Dislocation: How Did It Happen?

    Science.gov (United States)

    Anania, Pasquale; Fiaschi, Pietro; Sbaffi, Pier Filippo; Zona, Gianluigi

    2018-01-01

    Atlanto-occipital dislocation (AOD) is a lesion rarely observed in a trauma center, because of high mortality in the preclinical phase. The number of AOD survivors is increasing thanks to the improvement in prehospital resuscitation. Our goal is to describe a case of incomplete atlanto-occipital dislocation presented without any neurologic, cardiorespiratory, or metabolic problems, which remained constant even after surgical treatment. Our purpose is also to discuss treatment approaches to minimize subsequent neurologic deficits. We recommend a rapid immobilization with spine table and cervical collar, the consensual stabilization of hemodynamic and respiratory parameters, and a successive prompt occipitocervical stabilization. C2 should be included in the stabilization because of the ligamentous conformation of craniocervical joint. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Improvement in clinical outcomes after dry needling in a patient with occipital neuralgia

    Science.gov (United States)

    Bond, Bryan M.; Kinslow, Christopher

    2015-01-01

    The primary purpose of this case report is to outline the diagnosis, intervention and clinical outcome of a patient presenting with occipital neuralgia. Upon initial presentation, the patient described a four-year history of stabbing neck pain and headaches. After providing informed consent, the patient underwent a total of four dry needling (DN) sessions over a two-week duration. During each of the treatment sessions, needles were inserted into the trapezii and suboccipital muscles. Post-intervention, the patient reported a 32-point change in her neck disability index score along with a 28-point change in her headache disability index score. Thus, it appears that subsequent four sessions of DN over two weeks, our patient experienced meaningful improvement in her neck pain and headaches. To the best of our knowledge, this is the first case report describing DN to successfully improve clinical outcomes in a patient diagnosed with occipital neuralgia. PMID:26136602

  11. Neurofibromatosis Type 1: Transcatheter Arterial Embolization for Ruptured Occipital Arterial Aneurysms

    International Nuclear Information System (INIS)

    Kanematsu, Masayuki; Kato, Hiroki; Kondo, Hiroshi; Goshima, Satoshi; Tsuge, Yusuke; Kojima, Toshiaki; Watanabe, Haruo

    2011-01-01

    Two cases of ruptured aneurysms in the posterior cervical regions associated with type-1 neurofibromatosis treated by transcatheter embolization are reported. Patients presented with acute onset of swelling and pain in the affected areas. Emergently performed contrast-enhanced CT demonstrated aneurysms and large hematomas widespread in the posterior cervical regions. Angiography revealed aneurysms and extravasations of the occipital artery. Patients were successfully treated by percutaneous transcatheter arterial microcoil embolization. Transcatheter arterial embolization therapy was found to be an effective method for treating aneurysmal rupture in the posterior cervical regions occurring in association with type-1 neurofibromatosis. A literature review revealed that rupture of an occipital arterial aneurysm, in the setting of neurofibromatosis type 1, has not been reported previously.

  12. Long-term occipital nerve stimulation for drug-resistant chronic cluster headache.

    Science.gov (United States)

    Leone, Massimo; Proietti Cecchini, Alberto; Messina, Giuseppe; Franzini, Angelo

    2017-07-01

    Introduction Chronic cluster headache is rare and some of these patients become drug-resistant. Occipital nerve stimulation has been successfully employed in open studies to treat chronic drug-resistant cluster headache. Data from large group of occipital nerve stimulation-treated chronic cluster headache patients with long duration follow-up are advantageous. Patients and methods Efficacy of occipital nerve stimulation has been evaluated in an experimental monocentric open-label study including 35 chronic drug-resistant cluster headache patients (mean age 42 years; 30 men; mean illness duration: 6.7 years). The primary end-point was a reduction in number of daily attacks. Results After a median follow-up of 6.1 years (range 1.6-10.7), 20 (66.7%) patients were responders (≥50% reduction in headache number per day): 12 (40%) responders showed a stable condition characterized by sporadic attacks, five responders had a 60-80% reduction in headache number per day and in the remaining three responders chronic cluster headache was transformed in episodic cluster headache. Ten (33.3%) patients were non-responders; half of these have been responders for a long period (mean 14.6 months; range 2-48 months). Battery depletion (21 patients 70%) and electrode migration (six patients - 20%) were the most frequent adverse events. Conclusions Occipital nerve stimulation efficacy is confirmed in chronic drug-resistant cluster headaches even after an exceptional long-term follow-up. Tolerance can occur years after improvement.

  13. Utility of pharmacologic provocative neurological testing before embolization of occipital lobe arteriovenous malformations.

    Science.gov (United States)

    Tawk, Rabih G; Tummala, Ramachandra P; Memon, Muhammad Z; Siddiqui, Adnan H; Hopkins, L Nelson; Levy, Elad I

    2011-01-01

    Endovascular treatment is an established option for treatment of cerebral arteriovenous malformations (AVMs). However, embolization has been associated with postprocedural neurological complications. We sought to evaluate the usefulness of intra-arterial pharmacologic provocative (superselective Wada) testing before embolization of occipital lobe AVMs. We performed a retrospective review of cases of occipital AVMs that were embolized at our institution (Millard Fillmore Gates Hospital) while the patient was under conscious sedation. Visual field testing was performed before and after superselective Wada testing and again after embolization. After microcatheterization of the target feeding pedicle, amobarbital (or, occasionally, methohexital) was administered, followed immediately by neurological testing. If the provocative test results were negative, the evaluated feeder was embolized with a liquid agent. Complications were categorized as transient or permanent neurological deficit, visual field loss, ischemic or hemorrhagic stroke, and death. Thirteen patients with occipital AVMs underwent 39 Wada tests of 34 pedicles before embolization during 26 endovascular treatment sessions. Patients were treated under conscious sedation with local anesthesia. The mean age of these patients was 43.5 years (range 16-62 years); 6 were women. Testing induced a neurological deficit in six patients. A positive test result led us to abort embolization attempts in four pedicles. In the two remaining cases, advancement of the catheter tip distally within the feeding pedicle allowed us to proceed with embolization after initial test failure. Neither patient developed a visual field deficit after embolization. Despite passing the Wada test before embolization, one other patient had a visual deficit that was detected a few hours after the procedure; this deficit lessened but was permanent. No further ischemic complications and no hemorrhagic complications occurred. Pharmacologic

  14. Intractable occipital lobe epilepsy: clinical characteristics, surgical treatment, and a systematic review of the literature.

    Science.gov (United States)

    Yang, Peng-Fan; Jia, Yan-Zeng; Lin, Qiao; Mei, Zhen; Chen, Zi-Qian; Zheng, Zhi-Yong; Zhang, Hui-Jian; Pei, Jia-Sheng; Tian, Jun; Zhong, Zhong-Hui

    2015-01-01

    We reported our experience in the surgical treatment of a relatively large cohort of patients with occipital lobe epilepsy (OLE). We also carried out a systematic review of the literature on OLE. Thirty-five consecutive patients who underwent occipital resection for epilepsy were included. Diagnoses were made following presurgical evaluations, including magnetic resonance imaging (MRI), fluorodeoxyglucose-positron emission tomography (FDG-PET), scalp video-electroencephalogram (EEG) monitoring, and intracranial EEG monitoring. At last follow-up, seizure outcome was classified using the Engel classification scheme. Twenty-five of 35 patients experienced/had experienced ≥1 type of aura before the seizure. Invasive recordings were used to define the epileptogenic area in 30 of 35 patients (85.7 %). All patients underwent occipital lesionectomies or topectomies. Histopathology revealed: cortical dysplasias, gliosis, dysembryoplastic neuroepithelial tumor, ganglioglioma, and tuberous sclerosis. After a mean follow-up of 44 months, 25 patients (71.4 %) were seizure free (Engel class I), 3 (8.6 %) rarely had seizures (Engel class II), 5 (14.3 %) improved more than 75 % (Engel class III), and 2 (5.7 %) had no significant improvement (Engel class IV). Preoperatively, 12 of 33 patients (36.4 %) had visual field deficits. Postoperatively, 25 patients (75.8 %) had new or aggravated visual field deficits. The management of OLE has been aided greatly by the availability of high-resolution diagnosis. Postoperative visual field deficits occur in a significant proportion of patients. Comprehensive intracranial EEG coverage of all occipital surfaces helps to define the epileptogenic area and preserve visual function, especially in cases of focal cortical dysplasia undetectable by MRI.

  15. Occipital lobe seizures: Rare hyperglycemic sequelae of type 1 diabetes mellitus.

    Science.gov (United States)

    Jalal, Muhammed Jasim Abdul; Menon, Murali Krishna; Kumar, K Arun; Gomez, Ramesh

    2015-01-01

    A 15-year-old boy presented with osmotic symptoms and photopsia. He had short-term memory impairment, visual hallucinations, and headache. His random blood sugar was 474 mg/dl, HbA1c -9.4%, and glutamic acid decarboxylase -65 >2000 IU/ml. Magnetic resonance imaging brain and cerebrospinal fluid study were normal. Digital electroencephalography was suggestive of bilateral hemispheric occipital lobe seizures. He responded well to insulin and antiepileptic medications.

  16. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats

    OpenAIRE

    Stephen P. Chelko; Chad W. Schmiedt; Tristan H. Lewis; Tom P. Robertson; Stephen J. Lewis

    2014-01-01

    This study compared the contractile responses elicited by angiotensin II (AII), arginine vasopressin (AVP), and 5-hydroxytryptamine (5-HT) in isolated occipital arteries (OAs) from sham-operated (SHAM) and 2-kidney, 1-clip (2K-1C) hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery) and distal segments (closer to the nodose ganglion) and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, hea...

  17. AN ANATOMICAL PERSPECTIVE OF HUMAN OCCIPITAL CONDYLES AND FORAMEN MAGNUM WITH NEUROSURGICAL CORRELATES

    OpenAIRE

    Gaurav; Divya; Abha

    2014-01-01

    AIMS: Knowledge of condylar anatomy helps the surgeon in making important decisions regarding extent and direction of condylar drilling and minimizing injury and retraction of neural structures. Important preoperative information includes length, width, axis/directions and overriding of occipital condyle in foramen magnum, relationships of condyles to foramen magnum and to hypoglossal canal. The antero-posterior and transverse diameters of foramen magnum and amount of over...

  18. Occipital cortical proton MRS at 4 Tesla in human moderate MDMA polydrug users

    OpenAIRE

    Cowan, Ronald L.; Bolo, Nicolas R.; Dietrich, Mary; Haga, Erica; Lukas, Scott E.; Renshaw, Perry F.

    2007-01-01

    The recreational drug MDMA (3,4, methylenedioxymethamphetamine; sold under the street name of Ecstasy) is toxic to serotonergic axons in some animal models of MDMA administration. In humans, MDMA use is associated with alterations in markers of brain function that are pronounced in occipital cortex. Among neuroimaging methods, magnetic resonance spectroscopy (MRS) studies of brain metabolites N-acetylaspartate (NAA) and myoinositol (MI) at a field strength of 1.5 Tesla (T) reveal inconsistent...

  19. Lateralized occipital degeneration in posterior cortical atrophy predicts visual field deficits.

    Science.gov (United States)

    Millington, Rebecca S; James-Galton, Merle; Maia Da Silva, Mari N; Plant, Gordon T; Bridge, Holly

    2017-01-01

    Posterior cortical atrophy (PCA), the visual variant of Alzheimer's disease, leads to high-level visual deficits such as alexia or agnosia. Visual field deficits have also been identified, but often inconsistently reported. Little is known about the pattern of visual field deficits or the underlying cortical changes leading to this visual loss. Multi-modal magnetic resonance imaging was used to investigate differences in gray matter volume, cortical thickness, white matter microstructure and functional activity in patients with PCA compared to age-matched controls. Additional analyses investigated hemispheric asymmetries in these metrics according to the visual field most affected by the disease. Analysis of structural data indicated considerable loss of gray matter in the occipital and parietal cortices, lateralized to the hemisphere contralateral to the visual loss. This lateralized pattern of gray matter loss was also evident in the hippocampus and parahippocampal gyrus. Diffusion-weighted imaging showed considerable effects of PCA on white matter microstructure in the occipital cortex, and in the corpus callosum. The change in white matter was only lateralized in the occipital lobe, however, with greatest change in the optic radiation contralateral to the visual field deficit. Indeed, there was a significant correlation between the laterality of the optic radiation microstructure and visual field loss. Detailed brain imaging shows that the asymmetric visual field deficits in patients with PCA reflect the pattern of degeneration of both white and gray matter in the occipital lobe. Understanding the nature of both visual field deficits and the neurodegenerative brain changes in PCA may improve diagnosis and understanding of this disease.

  20. Occipital cephalocele with neural crest remnants? Radiological and pathological findings in a newborn boy.

    Science.gov (United States)

    Arishima, Hidetaka; Neishi, Hiroyuki; Kikuta, Ken-Ichiro

    2016-06-01

    A cephalocele is a congenital anomaly involving the herniation of intracranial tissue from a skull defect. The sac containing the central nervous system (CNS) with the ventricle system is called the encephalocystocele. An atretic cephalocele is thought to be an abortive form of cephalocele, and the essential nature is still controversial. Here, we report the case of a newborn boy with an occipital cephalocele containing a small cystic component which was composed of ependymal cells and the immature CNS tissue. A newborn boy was admitted to our hospital because of an occipital mass, which was about 2.5 cm in diameter, located at the posterior midline, and covered with alopetic skin without CSF leakage. He had a cleft palate. Magnetic resonance imaging (MRI) clearly showed an occipital cephalocele with a tiny cystic component connecting to the subarachnoid space. MRI also showed mild hydrocephalus, hypoplasia of the corpus callosum and tentorium cerebelli, dropping down of the bilateral occipital lobes and vermicular agenesis. We performed the extirpation of the subscalp module under general anesthesia and histologically examined the resected mass. On immunohistopathological examination, most part of the subscalp module was fibrous tissue with numerous vessels and meningeal origin cells. In a small part of the innermost layer, we found a small island consisting of CNS tissue and a tiny cyst lined with a single layer of ependymal cells. Based on radiological and immunohistopathological findings, we speculate that the cystic component at the base of the nodule seems to correspond to neural crest remnants but not to true herniation of the brain and cerebral ventricles.

  1. Duplicated middle cerebral artery

    Science.gov (United States)

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion. PMID:22140405

  2. The effects of left and right monocular viewing on hemispheric activation.

    Science.gov (United States)

    Wang, Chao; Burtis, D Brandon; Ding, Mingzhou; Mo, Jue; Williamson, John B; Heilman, Kenneth M

    2018-03-01

    Prior research has revealed that whereas activation of the left hemisphere primarily increases the activity of the parasympathetic division of the autonomic nervous system, right-hemisphere activation increases the activity of the sympathetic division. In addition, each hemisphere primarily receives retinocollicular projections from the contralateral eye. A prior study reported that pupillary dilation was greater with left- than with right-eye monocular viewing. The goal of this study was to test the alternative hypotheses that this asymmetric pupil dilation with left-eye viewing was induced by activation of the right-hemispheric-mediated sympathetic activity, versus a reduction of left-hemisphere-mediated parasympathetic activity. Thus, this study was designed to learn whether there are changes in hemispheric activation, as measured by alteration of spontaneous alpha activity, during right versus left monocular viewing. High-density electroencephalography (EEG) was recorded from healthy participants viewing a crosshair with their right, left, or both eyes. There was a significantly less alpha power over the right hemisphere's parietal-occipital area with left and binocular viewing than with right-eye monocular viewing. The greater relative reduction of right-hemisphere alpha activity during left than during right monocular viewing provides further evidence that left-eye viewing induces greater increase in right-hemisphere activation than does right-eye viewing.

  3. Dissociation between Conceptual and Perceptual Implicit Memory: Evidence from Patients with Frontal and Occipital Lobe Lesions.

    Science.gov (United States)

    Gong, Liang; Wang, JiHua; Yang, XuDong; Feng, Lei; Li, Xiu; Gu, Cui; Wang, MeiHong; Hu, JiaYun; Cheng, Huaidong

    2015-01-01

    The latest neuroimaging studies about implicit memory (IM) have revealed that different IM types may be processed by different parts of the brain. However, studies have rarely examined what subtypes of IM processes are affected in patients with various brain injuries. Twenty patients with frontal lobe injury, 25 patients with occipital lobe injury, and 29 healthy controls (HC) were recruited for the study. Two subtypes of IM were investigated by using structurally parallel perceptual (picture identification task) and conceptual (category exemplar generation task) IM tests in the three groups, as well as explicit memory (EM) tests. The results indicated that the priming of conceptual IM and EM tasks in patients with frontal lobe injury was poorer than that observed in HC, while perceptual IM was identical between the two groups. By contrast, the priming of perceptual IM in patients with occipital lobe injury was poorer than that in HC, whereas the priming of conceptual IM and EM was similar to that in HC. This double dissociation between perceptual and conceptual IM across the brain areas implies that occipital lobes may participate in perceptual IM, while frontal lobes may be involved in processing conceptual memory.

  4. Temporal and occipital lobe features in children with hypochondroplasia/FGFR3 gene mutation.

    Science.gov (United States)

    Philpott, Cristina M; Widjaja, Elysa; Raybaud, Charles; Branson, Helen M; Kannu, Peter; Blaser, Susan

    2013-09-01

    Thanatophoric dysplasia (TD) and hypochondroplasia are both caused by FGFR3 (fibroblast growth factor receptor 3) gene mutations. Temporal lobe dysplasia has been well described in thanatophoric dysplasia; however, only a couple of anecdotal cases of temporal lobe dysplasia in hypochondroplasia have been described. To define temporal lobe abnormalities in patients with hypochondroplasia, given that they share the same genetic mutation. We identified brain imaging studies of nine children with hypochondroplasia. The temporal lobes were assessed on CT and MRI for size and configuration of the temporal horn and aberrant sulcation of the inferior surface of the temporal lobe. All children had a triangular-shape temporal horn and deep transverse fissures of the inferior temporal lobe surface. Neuroimaging in our cohort revealed enlarged temporal lobes and oversulcation of the mesial temporal and occipital lobes, with abnormal inferomedial orientation of these redundant gyri. Hippocampal dysplasia was also universal. We confirmed frequent inferomesial temporal and occipital lobe abnormalities in our cohort of children with hypochondroplasia. Murine models with mutant fgfr3 display increased neuroprogenitor proliferation, cortical thickness and surface area in the temporo-occipital cortex. This is thought to result in excessive convolution and likely explains the imaging findings in this patient cohort. (Note that fgfr3 is the same genetic mutation in mice as FGFR3 is in humans.).

  5. Measurement of the occipital alpha rhythm and temporal tau rhythm by using magnetoencephalography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. E.; Gohel, Bakul; Kim, K.; Kwon, H.; An, Kyung Min [Center for Biosignals, Korea Research Institute of Standards and Science(KRISS), Daejeon (Korea, Republic of)

    2015-12-15

    Developing Magnetoencephalography (MEG) based on Superconducting Quantum Interference Device (SQUID) facilitates to observe the human brain functions in non-invasively and high temporal and high spatial resolution. By using this MEG, we studied alpha rhythm (8-13 Hz) that is one of the most predominant spontaneous rhythm in human brain. The 8–13 Hz rhythm is observed in several sensory region in the brain. In visual related region of occipital, we call to alpha rhythm, and auditory related region of temporal call to tau rhythm, sensorimotor related region of parietal call to mu rhythm. These rhythms are decreased in task related region and increased in task irrelevant regions. This means that these rhythms play a pivotal role of inhibition in task irrelevant region. It may be helpful to attention to the task. In several literature about the alpha-band inhibition in multi-sensory modality experiment, they observed this effect in the occipital and somatosensory region. In this study, we hypothesized that we can also observe the alpha-band inhibition in the auditory cortex, mediated by the tau rhythm. Before that, we first investigated the existence of the alpha and tau rhythm in occipital and temporal region, respectively. To see these rhythms, we applied the visual and auditory stimulation, in turns, suppressed in task relevant regions, respectively.

  6. Measurement of the occipital alpha rhythm and temporal tau rhythm by using magnetoencephalography

    International Nuclear Information System (INIS)

    Kim, J. E.; Gohel, Bakul; Kim, K.; Kwon, H.; An, Kyung Min

    2015-01-01

    Developing Magnetoencephalography (MEG) based on Superconducting Quantum Interference Device (SQUID) facilitates to observe the human brain functions in non-invasively and high temporal and high spatial resolution. By using this MEG, we studied alpha rhythm (8-13 Hz) that is one of the most predominant spontaneous rhythm in human brain. The 8–13 Hz rhythm is observed in several sensory region in the brain. In visual related region of occipital, we call to alpha rhythm, and auditory related region of temporal call to tau rhythm, sensorimotor related region of parietal call to mu rhythm. These rhythms are decreased in task related region and increased in task irrelevant regions. This means that these rhythms play a pivotal role of inhibition in task irrelevant region. It may be helpful to attention to the task. In several literature about the alpha-band inhibition in multi-sensory modality experiment, they observed this effect in the occipital and somatosensory region. In this study, we hypothesized that we can also observe the alpha-band inhibition in the auditory cortex, mediated by the tau rhythm. Before that, we first investigated the existence of the alpha and tau rhythm in occipital and temporal region, respectively. To see these rhythms, we applied the visual and auditory stimulation, in turns, suppressed in task relevant regions, respectively

  7. Occipital cortical proton MRS at 4 Tesla in human moderate MDMA polydrug users.

    Science.gov (United States)

    Cowan, Ronald L; Bolo, Nicolas R; Dietrich, Mary; Haga, Erica; Lukas, Scott E; Renshaw, Perry F

    2007-08-15

    The recreational drug MDMA (3,4, methylenedioxymethamphetamine; sold under the street name of Ecstasy) is toxic to serotonergic axons in some animal models of MDMA administration. In humans, MDMA use is associated with alterations in markers of brain function that are pronounced in occipital cortex. Among neuroimaging methods, magnetic resonance spectroscopy (MRS) studies of brain metabolites N-acetylaspartate (NAA) and myoinositol (MI) at a field strength of 1.5 Tesla (T) reveal inconsistent results in MDMA users. Because higher field strength proton MRS has theoretical advantages over lower field strengths, we used proton MRS at 4.0 T to study absolute concentrations of occipital cortical NAA and MI in a cohort of moderate MDMA users (n=9) versus non-MDMA using (n=7) controls. Mean NAA in non-MDMA users was 10.47 mM (+/-2.51), versus 9.83 mM (+/-1.94) in MDMA users. Mean MI in non-MDMA users was 7.43 mM (+/-.68), versus 6.57 mM (+/-1.59) in MDMA users. There were no statistical differences in absolute metabolite levels for NAA and MI in occipital cortex of MDMA users and controls. These findings are not supportive of MDMA-induced alterations in NAA or MI levels in this small sample of moderate MDMA users. Limitations to this study suggest caution in the interpretation of these results.

  8. [Transient charles bonnet syndrome after excision of a right occipital meningioma: a case report].

    Science.gov (United States)

    Arai, Takao; Hasegawa, Yuzuru; Tanaka, Toshihide; Kato, Naoki; Watanabe, Mitsuyoshi; Nakamura, Aya; Murayama, Yuichi

    2014-05-01

    Charles Bonnet syndrome is a condition characterized by visual hallucinations. These simple or complex visual hallucinations are more common in elderly individuals with impaired peripheral vision. The current report describes a case of transient Charles Bonnet syndrome appearing after the removal of a meningioma. The patient was a 61-year-old man who already had impaired visual acuity due to diabetic retinopathy. Brain MRI revealed a cystic tumor severely compressing the right occipital lobe. Starting on day 2 postoperatively, the patient was troubled by recurring visual hallucinations involving people, flowers, pictures, and familiar settings(the train and a coffee shop). These continued for 3.5 months. This period roughly coincided with the time for the occipital lobe to recover from the compression caused by the tumor, a fact that was confirmed by several MRI scans. ¹²³I-IMP SPECT performed 1 month after the surgical operation showed an area of hypoperfusion in the right parieto-occipital lobe. Based on the patient's clinical course and MRI findings, the mechanism of onset of visual hallucinations in this patient was put forward. The release of pressure in the brain by tumor removal and subsequent recovery changed the blood flow to the brain. This triggered visual hallucinations in the patient, who was already predisposed to developing Charles Bonnet syndrome because of diabetic retinopathy. This case is interesting since it indicates that central neurological factors, as well as visual deficits, may induce the appearance of visual hallucinations in Charles Bonnet syndrome.

  9. The Disruption of Geniculocalcarine Tract in Occipital Neoplasm: A Diffusion Tensor Imaging Study

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    Yan Zhang

    2016-01-01

    Full Text Available Aim. Investigate the disruption of geniculocalcarine tract (GCT in different occipital neoplasm by diffusion tensor imaging (DTI. Methods. Thirty-two subjects (44.1 ± 3.6 years who had single occipital neoplasm (9 gliomas, 6 meningiomas, and 17 metastatic tumors with ipsilateral GCT involved and thirty healthy subjects (39.2 ± 3.3 years underwent conventional sequences scanning and diffusion tensor imaging by a 1.5T MR scanner. The diffusion-sensitive gradient direction is 13. Compare the fractional anisotropy (FA and mean diffusivity (MD values of healthy GCT with the corresponding values of GCT in peritumoral edema area. Perform diffusion tensor tractography (DTT on GCT by the line propagation technique in all subjects. Results. The FA values of GCT in peritumoral edema area decreased (P=0.001 while the MD values increased (P=0.002 when compared with healthy subjects. There was no difference in the FA values across tumor types (P=0.114 while the MD values of GCT in the metastatic tumor group were higher than the other groups (P=0.001. GCTs were infiltrated in all the 9 gliomas cases, with displacement in 2 cases and disruption in 7 cases. GCTs were displaced in 6 meningiomas cases. GCTs were displaced in all the 7 metastatic cases, with disruption in 7 cases. Conclusions. DTI represents valid markers for evaluating GCT’s disruption in occipital neoplasm. The disruption of GCT varies according to the properties of neoplasm.

  10. Morphometric Evaluation of Occipital Condyles: Defining Optimal Trajectories and Safe Screw Lengths for Occipital Condyle-Based Occipitocervical Fixation in Indian Population.

    Science.gov (United States)

    Bosco, Aju; Venugopal, Prakash; Shetty, Ajoy Prasad; Shanmuganathan, Rajasekaran; Kanna, Rishi Mugesh

    2018-04-01

    Computed tomographic (CT) morphometric analysis. To assess the feasibility and safety of occipital condyle (OC)-based occipitocervical fixation (OCF) in Indians and to define anatomical zones and screw lengths for safe screw placement. Limitations of occipital squama-based OCF has led to development of two novel OC-based OCF techniques. Morphometric analysis was performed on the OCs of 70 Indian adults. The feasibility of placing a 3.5-mm-diameter screw into OCs was investigated. Safe trajectories and screw lengths for OC screws and C0-C1 transarticular screws without hypoglossal canal or atlantooccipital joint compromise were estimated. The average screw length and safe sagittal and medial angulations for OC screws were 19.9±2.3 mm, ≤6.4°±2.4° cranially, and 31.1°±3° medially, respectively. An OC screw could not be accommodated by 27% of the population. The safe sagittal angles and screw lengths for C0-C1 transarticular screw insertion (48.9°±5.7° cranial, 26.7±2.9 mm for junctional entry technique; 36.7°±4.6° cranial, 31.6±2.7 mm for caudal C1 arch entry technique, respectively) were significantly different than those in other populations. The risk of vertebral artery injury was high for the caudal C1 arch entry technique. Screw placement was uncertain in 48% of Indians due to the presence of aberrant anatomy. There were significant differences in the metrics of OC-based OCF between Indian and other populations. Because of the smaller occipital squama dimensions in Indians, OC-based OCF techniques may have a higher application rate and could be a viable alternative/salvage option in selected cases. Preoperative CT, including three-dimensional-CT-angiography (to delineate vertebral artery course), is imperative to avoid complications resulting from aberrant bony and vascular anatomy. Our data can serve as a valuable reference guide in placing these screws safely under fluoroscopic guidance.

  11. MEG reveals a fast pathway from somatosensory cortex to occipital areas via posterior parietal cortex in a blind subject

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    Andreas A Ioannides

    2013-08-01

    Full Text Available Cross-modal activity in visual cortex of blind subjects has been reported during performance of variety of non-visual tasks. A key unanswered question is through which pathways non-visual inputs are funneled to the visual cortex. Here we used tomographic analysis of single trial magnetoencephalography (MEG data recorded from one congenitally blind and two sighted subjects after stimulation of the left and right median nerves at three intensities: below sensory threshold, above sensory threshold and above motor threshold; the last sufficient to produce thumb twitching. We identified reproducible brain responses in the primary somatosensory (S1 and motor (M1 cortices at around 20 ms post-stimulus, which were very similar in sighted and blind subjects. Time-frequency analysis revealed strong 45 to 70 Hz activity at latencies of 20 to 50 ms in S1 and M1, and posterior parietal cortex Brodmann areas (BA 7 and 40, which compared to lower frequencies, were substantially more pronounced in the blind than the sighted subjects. Critically, at frequencies from α-band up to 100 Hz we found clear, strong and widespread responses in the visual cortex of the blind subject, which increased with the intensity of the somatosensory stimuli. Time-delayed mutual information (MI revealed that in blind subject the stimulus information is funneled from the early somatosensory to visual cortex through posterior parietal BA 7 and 40, projecting first to visual areas V5 and V3, and eventually V1. The flow of information through this pathway occured in stages characterized by convergence of activations into specific cortical regions. In sighted subjects, no linked activity was found that led from the somatosensory to the visual cortex through any of the studied brain regions. These results provide the first evidence from MEG that in blind subjects, tactile information is routed from primary somatosensory to occipital cortex via the posterior parietal cortex.

  12. MEG reveals a fast pathway from somatosensory cortex to occipital areas via posterior parietal cortex in a blind subject.

    Science.gov (United States)

    Ioannides, Andreas A; Liu, Lichan; Poghosyan, Vahe; Saridis, George A; Gjedde, Albert; Ptito, Maurice; Kupers, Ron

    2013-01-01

    Cross-modal activity in visual cortex of blind subjects has been reported during performance of variety of non-visual tasks. A key unanswered question is through which pathways non-visual inputs are funneled to the visual cortex. Here we used tomographic analysis of single trial magnetoencephalography (MEG) data recorded from one congenitally blind and two sighted subjects after stimulation of the left and right median nerves at three intensities: below sensory threshold, above sensory threshold and above motor threshold; the last sufficient to produce thumb twitching. We identified reproducible brain responses in the primary somatosensory (S1) and motor (M1) cortices at around 20 ms post-stimulus, which were very similar in sighted and blind subjects. Time-frequency analysis revealed strong 45-70 Hz activity at latencies of 20-50 ms in S1 and M1, and posterior parietal cortex Brodmann areas (BA) 7 and 40, which compared to lower frequencies, were substantially more pronounced in the blind than the sighted subjects. Critically, at frequencies from α-band up to 100 Hz we found clear, strong, and widespread responses in the visual cortex of the blind subject, which increased with the intensity of the somatosensory stimuli. Time-delayed mutual information (MI) revealed that in blind subject the stimulus information is funneled from the early somatosensory to visual cortex through posterior parietal BA 7 and 40, projecting first to visual areas V5 and V3, and eventually V1. The flow of information through this pathway occurred in stages characterized by convergence of activations into specific cortical regions. In sighted subjects, no linked activity was found that led from the somatosensory to the visual cortex through any of the studied brain regions. These results provide the first evidence from MEG that in blind subjects, tactile information is routed from primary somatosensory to occipital cortex via the posterior parietal cortex.

  13. No Community Left Behind

    Science.gov (United States)

    Schlechty, Phillip C.

    2008-01-01

    The debate over the reauthorization of No Child Left Behind (NCLB) generally overlooks--or looks past--what may be the most fundamental flaw in that legislation. As the law is now written, decisions regarding what the young should know and be able to do are removed from the hands of parents and local community leaders and turned over to officials…

  14. The Children Left Behind

    Science.gov (United States)

    Gillard, Sarah A.; Gillard, Sharlett

    2012-01-01

    This article explores some of the deficits in our educational system in regard to non-hearing students. It has become agonizingly clear that non-hearing students are being left out of the gallant sweep to enrich our children's educations. The big five areas of literacy, at best, present unique challenges for non-hearing students and, in some…

  15. Left atrial appendage occlusion

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    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  16. A case of congenital dermal sinus of the occipital region detected by CT at the onset of meningitis

    International Nuclear Information System (INIS)

    Fujiwara, Katsuhiko; Esumi, Noriko; Nishimura, Osamu

    1985-01-01

    A 4-year-old girl who was found to have congenital dermal sinus of the occipital region by CT at the second onset of meningitis is reported. CT at the first onset of meningitis (at the age of 3 years and 9 months) revealed only small, oval low density areas in the posterior fossa of the occipital region. CT at the second onset showed an abscess in the posterior fossa and dissociation in the posterior part of the cranium. Skin examination in the occipital region disclosed induration of the median area. Thus, congenital dermal sinus was suspected. Further CT disclosed that the patient subsequently developed hydrocephalus despite the intravenous and intrameningeal administration of antibiotics. Therefore, she underwent excision of a cyst and was pathologically diagnosed as having dermoid associated with abscess in the tip of the dermal sinus, which was followed by induration of the occipital skin. (Namekawa, K.)

  17. Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.

    Science.gov (United States)

    Kivelev, Juri; Koskela, Elina; Setälä, Kirsi; Niemelä, Mika; Hernesniemi, Juha

    2012-08-01

    Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. Of the 390 consecutive patients with cavernomas who were treated at Helsinki University Central Hospital between 1980 and 2011, 19 (5%) had occipital cavernomas. Sixteen patients (4%) were surgically treated and are included in this study. The median age was 39 years (range 3-59 years). Seven patients (56%) suffered from hemorrhage preoperatively, 5 (31%) presented with visual field deficits, 11 (69%) suffered from seizures, and 4 (25%) had multiple cavernomas. Surgery was indicated for progressive neurological deterioration. The median follow-up after surgery was 5.25 years (range 0.5-14 years). All patients underwent thorough neuroophthalmological assessment to determine visual outcome after surgery. Visual fields were classified as normal, mild homonymous visual field loss (not disturbing the patient, driving allowed), moderate homonymous visual field loss (disturbing the patient, driving prohibited), and severe visual field loss (total homonymous hemianopia or total homonymous quadrantanopia). At the last follow-up, 4 patients (25%) had normal visual fields, 6 (38%) had a mild visual field deficit, 1 (6%) complained of moderate visual field impairment, and 5 (31%) had severe homonymous visual field loss. Cavernomas seated deeper than 2 cm from the pial surface carried a 4.4-fold risk of postoperative visual field deficit relative to superficial ones (p = 0.034). Six (55%) of the 11 patients presenting with seizures were seizure-free postoperatively. Eleven (69%) of 16 patients had no disability during the long-term follow-up. Surgical removal of occipital cavernomas may carry a

  18. Analysis of the volumetric relationship among human ocular, orbital and fronto-occipital cortical morphology

    Science.gov (United States)

    Masters, Michael; Bruner, Emiliano; Queer, Sarah; Traynor, Sarah; Senjem, Jess

    2015-01-01

    Recent research on the visual system has focused on investigating the relationship among eye (ocular), orbital, and visual cortical anatomy in humans. This issue is relevant in evolutionary and medical fields. In terms of evolution, only in modern humans and Neandertals are the orbits positioned beneath the frontal lobes, with consequent structural constraints. In terms of medicine, such constraints can be associated with minor deformation of the eye, vision defects, and patterns of integration among these features, and in association with the frontal lobes, are important to consider in reconstructive surgery. Further study is therefore necessary to establish how these variables are related, and to what extent ocular size is associated with orbital and cerebral cortical volumes. Relationships among these anatomical components were investigated using magnetic resonance images from a large sample of 83 individuals, which also included each subject’s body height, age, sex, and uncorrected visual acuity score. Occipital and frontal gyri volumes were calculated using two different cortical parcellation tools in order to provide a better understanding of how the eye and orbit vary in relation to visual cortical gyri, and frontal cortical gyri which are not directly related to visual processing. Results indicated that ocular and orbital volumes were weakly correlated, and that eye volume explains only a small proportion of the variance in orbital volume. Ocular and orbital volumes were also found to be equally and, in most cases, more highly correlated with five frontal lobe gyri than with occipital lobe gyri associated with V1, V2, and V3 of the visual cortex. Additionally, after accounting for age and sex variation, the relationship between ocular and total visual cortical volume was no longer statistically significant, but remained significantly related to total frontal lobe volume. The relationship between orbital and visual cortical volumes remained significant for

  19. Analysis of the volumetric relationship among human ocular, orbital and fronto-occipital cortical morphology.

    Science.gov (United States)

    Masters, Michael; Bruner, Emiliano; Queer, Sarah; Traynor, Sarah; Senjem, Jess

    2015-10-01

    Recent research on the visual system has focused on investigating the relationship among eye (ocular), orbital, and visual cortical anatomy in humans. This issue is relevant in evolutionary and medical fields. In terms of evolution, only in modern humans and Neandertals are the orbits positioned beneath the frontal lobes, with consequent structural constraints. In terms of medicine, such constraints can be associated with minor deformation of the eye, vision defects, and patterns of integration among these features, and in association with the frontal lobes, are important to consider in reconstructive surgery. Further study is therefore necessary to establish how these variables are related, and to what extent ocular size is associated with orbital and cerebral cortical volumes. Relationships among these anatomical components were investigated using magnetic resonance images from a large sample of 83 individuals, which also included each subject's body height, age, sex, and uncorrected visual acuity score. Occipital and frontal gyri volumes were calculated using two different cortical parcellation tools in order to provide a better understanding of how the eye and orbit vary in relation to visual cortical gyri, and frontal cortical gyri which are not directly related to visual processing. Results indicated that ocular and orbital volumes were weakly correlated, and that eye volume explains only a small proportion of the variance in orbital volume. Ocular and orbital volumes were also found to be equally and, in most cases, more highly correlated with five frontal lobe gyri than with occipital lobe gyri associated with V1, V2, and V3 of the visual cortex. Additionally, after accounting for age and sex variation, the relationship between ocular and total visual cortical volume was no longer statistically significant, but remained significantly related to total frontal lobe volume. The relationship between orbital and visual cortical volumes remained significant for a

  20. Hypoplastic left heart syndrome

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    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  1. Mature teratoma in association with neural tube defect (occipital encephalocele): series of four cases and review of the literature.

    Science.gov (United States)

    Goyal, Nishant; Singh, Pankaj Kumar; Kakkar, Aanchal; Sharma, Meher Chand; Mahapatra, Ashok Kumar

    2012-01-01

    Both occipital encephalocele and teratomas are midline congenital malformations. Encephalocele is a form of neural tube defect in which there is a congenital defect of the cranium through which occurs a protrusion of brain matter or meninges, while teratoma is a tumor derived from all three germ layers. The association between occipital encephalocele and teratoma has not been reported to date. In the present study, the authors present a series of four such cases. Copyright © 2012 S. Karger AG, Basel.

  2. Occipital Nerve Stimulation for Refractory Chronic Migraine: Results of a Long-Term Prospective Study.

    Science.gov (United States)

    Rodrigo, Dolores; Acin, Pilar; Bermejo, Pedro

    2017-01-01

    Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine. Prospective, long-term, open-label, uncontrolled observational study. Single public university hospital. Patients who met the International Headache Society criteria for chronic migraine, all of them having been previously treated with other therapeutic alternatives, and who met all inclusion and exclusion criteria for neurostimulation, received the implantation of an ONS system after a positive psychological evaluation and a positive response to a preliminary occipital nerve blockage. The implantation was performed in 2 phases: a 10 day trial with implanted occipital leads connected to an external stimulator and, if more than 50% pain relief was obtained, permanent pulse generator implantation and connection to the previously implanted leads. After the surgery, the patients were thoroughly evaluated annually using different scales: pain Visual Analogue Scale (VAS), number of migraine attacks per month, sleep quality, functionality in social and labor activities, reduction in pain medication, patient satisfaction, tolerability, and reasons for termination. The average follow-up time was 9.4 ± 6.1 years, and 31 patients completed a 7-year follow-up period. Thirty-seven patients were enrolled and classified according to the location and quality of their pain, accompanying symptoms, work status, and psychological effects. Substantial pain reduction was obtained in most patients, and the VAS decreased by 4.9 ± 2

  3. Anatomical basis for simultaneous block of greater and third occipital nerves, with an ultrasound-guided technique.

    Science.gov (United States)

    Kariya, Ken; Usui, Yosuke; Higashi, Naoko; Nakamoto, Tatsuo; Shimbori, Hironobu; Terada, Satoshi; Takahashi, Hideo; Ueta, Hisashi; Kitazawa, Yusuke; Sawanobori, Yasushi; Okuda, Yasuhisa; Matsuno, Kenjiro

    2017-11-13

    In some headache disorders, for which the greater occipital nerve block is partly effective, the third occipital nerve is also suggested to be involved. We aimed to establish a simple technique for simultaneously blocking the greater and third occipital nerves. We performed a detailed examination of dorsal neck anatomy in 33 formalin-fixed cadavers, and deduced two candidate target points for blocking both the greater and third occipital nerves. These target points were tested on three Thiel-fixed cadavers. We performed ultrasound-guided dye injections into these points, examined the results by dissection, and selected the most suitable injection point. Finally, this target point was tested in three healthy volunteers. We injected 4 ml of local anesthetic and 1 ml of radiopaque material at the selected point, guided with a standard ultrasound system. Then, the pattern of local anesthetic distribution was imaged with computed tomography. We deduced that the most suitable injection point was the medial head of the semispinalis capitis muscle at the C1 level of the cervical vertebra. Both nerves entered this muscle, in close proximity, with little individual variation. In healthy volunteers, an anesthetic injected was confined to the muscle and induced anesthesia in the skin areas innervated by both nerves. The medial head of the semispinalis capitis muscle is a suitable landmark for blocking the greater and third occipital nerves simultaneously, by which occipital nerve involvement in various headache disorders may be rapidly examined and treated.

  4. Spinal movement and dural sac compression during airway management in a cadaveric model with atlanto-occipital instability.

    Science.gov (United States)

    Liao, Shiyao; Schneider, Niko R E; Weilbacher, Frank; Stehr, Anne; Matschke, Stefan; Grützner, Paul A; Popp, Erik; Kreinest, Michael

    2017-12-01

    To analyze the compression of the dural sac and the cervical spinal movement during performing different airway interventions in case of atlanto-occipital dislocation. In six fresh cadavers, atlanto-occipital dislocation was performed by distracting the opened atlanto-occipital joint capsule and sectioning the tectorial membrane. Airway management was done using three airway devices (direct laryngoscopy, video laryngoscopy, and insertion of a laryngeal tube). The change of dural sac's width and intervertebral angulation in stable and unstable atlanto-occipital conditions were recorded by video fluoroscopy with myelography. Three-dimensional overall movement of cervical spine was measured in a wireless human motion track system. Compared with a mean dural sac compression of - 0.5 mm (- 0.7 to - 0.3 mm) in stable condition, direct laryngoscopy caused an increased dural sac compression of - 1.6 mm (- 1.9 to - 0.6 mm, p = 0.028) in the unstable atlanto-occipital condition. No increased compression on dural sac was found using video laryngoscopy or the laryngeal tube. Moreover, direct laryngoscopy caused greater overall extension and rotation of cervical spine than laryngeal tube insertion in both stable and unstable conditions. Among three procedures, the insertion of a laryngeal tube took the shortest time. In case of atlanto-occipital dislocation, intubation using direct laryngoscopy exacerbates dural sac compression and may cause damage to the spinal cord.

  5. Left Ventricular Assist Devices

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    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  6. Survival Analysis of Occipital Nerve Stimulator Leads Placed under Fluoroscopic Guidance with and without Ultrasonography.

    Science.gov (United States)

    Jones, James H; Brown, Alison; Moyse, Daniel; Qi, Wenjing; Roy, Lance

    2017-11-01

    Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. We hypothesized that occipital neurostimulator (ONS) leads placed with ultrasonography combined with fluoroscopy would demonstrate increased survival rates and times when compared to ONS leads placed with fluoroscopy alone. A 2-arm retrospective chart review. A single academic medical center. This retrospective chart review analyzed the procedure notes and demographic data of patients who underwent the permanent implant of an ONS lead between July 2012 and August 2015. Patient data included the diagnosis (reason for implant), smoking tobacco use, disability, and age. ONS lead data included the date of permanent implant, the imaging modality used during permanent implant (fluoroscopy with or without ultrasonography), and, if applicable, the date and reason for lead removal. A total of 21 patients (53 leads) were included for the review. Chi-squared tests, Fishers exact tests, 2-sample t-tests, and Wilcoxon rank-sum tests were used to compare fluoroscopy against combined fluoroscopy and ultrasonography as implant methods with respect to patient demographics. These tests were also used to evaluate the primary aim of this study, which was to compare the survival rates and times of ONS leads placed with combined ultrasonography and fluoroscopy versus those placed with fluoroscopy alone. Survival analysis was used to assess the effect of implant method, adjusted for patient demographics (age, smoking tobacco use, and disability), on the risk of lead explant. Data from 21 patients were collected, including a total of 53 ONS leads. There was no statistically significant difference in the lead survival rate or time, disability, or patient age

  7. Rotatory Subluxation and Facet Deformity in the Atlanto-occipital Joint in Patients with Chronic Atlantoaxial Rotatory Fixation: Two Case Reports.

    Science.gov (United States)

    Kashii, Masafumi; Masuhara, Kenta; Kaito, Takashi; Iwasaki, Motoki

    2017-01-01

    The relationship between the morphometry of atlantoaxial joint and chronic atlantoaxial rotatory fixation (AARF) is well known, but disorders in the atlanto-occipital joint in chronic AARF are not fully elucidated. The authors report two rare cases of secondary deformities in the atlanto-occipital joint in chronic AARF. Two patients with chronic AARF were treated with closed manipulation, skull traction and halo-vest immobilization. Clinical outcomes and radiographs were reviewed retrospectively, focusing on pathological changes in the atlanto-occipital joint using multiplanar reconstruction computed tomography and three-dimensional computed tomography images. Case 1 (12-year-old girl) had rotatory subluxation with a superior facet deformity of the atlas in the atlanto-occipital joint before the initiation of treatment. After a series of conservative treatments, both atlantoaxial and atlanto-occipital rotatory fixation could not be reduced, and both the superior facet deformity of the atlas and osteoarthritic changes in the atlanto-occipital developed. She was monitored without surgery because the disorder progressed to the spontaneous fusion of the occipital bone to the axis. Case 2 (13-year-old boy) had rotatory subluxation without facet deformity of the atlas in the atlanto-occipital joint before the initiation of treatment. However, both the superior facet deformity of the atlas and osteoarthritic changes in the atlanto-occipital developed over time, and both atlantoaxial and atlanto-occipital rotatory fixation could not be reduced after a series of conservative treatments. He still had severe neck pain and severely restricted neck mobility and underwent spinal fusion. Atlanto-occipital rotatory subluxation and facet deformity in the atlanto-occipital joint may occur after prolonged AARF. It is necessary to pay attention to pathological changes not only in the atlantoaxial joint but also in the atlanto-occipital joint, when orthopedic surgeons treat patients

  8. Differential involvement of left prefrontal cortex in inductive and deductive reasoning.

    Science.gov (United States)

    Goel, Vinod; Dolan, Raymond J

    2004-10-01

    While inductive and deductive reasoning are considered distinct logical and psychological processes, little is known about their respective neural basis. To address this issue we scanned 16 subjects with fMRI, using an event-related design, while they engaged in inductive and deductive reasoning tasks. Both types of reasoning were characterized by activation of left lateral prefrontal and bilateral dorsal frontal, parietal, and occipital cortices. Neural responses unique to each type of reasoning determined from the Reasoning Type (deduction and induction) by Task (reasoning and baseline) interaction indicated greater involvement of left inferior frontal gyrus (BA 44) in deduction than induction, while left dorsolateral (BA 8/9) prefrontal gyrus showed greater activity during induction than deduction. This pattern suggests a dissociation within prefrontal cortex for deductive and inductive reasoning.

  9. The Safe Area in the Parieto-Occipital Lobe in the Human Brain: Diffusion Tensor Tractography.

    Science.gov (United States)

    Jang, Sung Ho; Kim, Seong Ho; Kwon, Hyeok Gyu

    2015-06-01

    A recent study reported on the relatively safe area in the frontal lobe for performance of neurological interventions; however, no study on the posterior safe area has been reported. In this study, using diffusion tensor tractography, we attempted to identify the safe area in the parieto-occipital lobe in healthy subjects. A total of 47 healthy subjects were recruited for this study. Eleven neural tracts were reconstructed in and around the parieto-occipital area of the brain using diffusion tensor tractography. The safe area, which is free from any trajectory of 10 neural tracts, was measured anteriorly and medially from the line of the most posterior and lateral margin of the brain at 5 axial levels (from the cerebral cortex to the corona radiata). The anterior boundaries of the safe area in the upper cerebral cortex, lower cerebral cortex, centrum semiovale, upper corona radiata, and lower corona radiata levels were located at 31.0, 32.6, 32.7, 35.1, and 35.2 mm anteriorly from the line of the most posterior margin of the brain, respectively, and the medial boundaries were located at an average of 34.7, 38.1, 39.2, 36.1, and 33.6 mm medially from the line of the most lateral margin of the brain, respectively. According to our findings, the safe area was located in the posterolateral portion of the parieto-occipital lobe in the shape of a triangle. However, we found no safe area in the deep white matter around the lateral ventricle. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Abnormal activation of the occipital lobes during emotion picture processing in major depressive disorder patients

    Science.gov (United States)

    Li, Jianying; Xu, Cheng; Cao, Xiaohua; Gao, Qiang; Wang, Yan; Wang, Yanfang; Peng, Juyi; Zhang, Kerang

    2013-01-01

    A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe, temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for

  11. Neonatal apneic seizure of occipital lobe origin: continuous video-EEG recording.

    Science.gov (United States)

    Castro Conde, José Ramón; González-Hernández, Tomás; González Barrios, Desiré; González Campo, Candelaria

    2012-06-01

    We present 2 term newborn infants with apneic seizure originating in the occipital lobe that was diagnosed by video-EEG. One infant had ischemic infarction in the distribution of the posterior cerebral artery, extending to the cingulate gyrus. In the other infant, only transient occipital hyperechogenicity was observed by using neurosonography. In both cases, although the critical EEG discharge was observed at the occipital level, the infants presented no clinical manifestations. In patient 1, the discharge extended to the temporal lobe first, with subtle motor manifestations and tachycardia, then synchronously to both hemispheres (with bradypnea/hypopnea), and the background EEG activity became suppressed, at which point the infant experienced apnea. In patient 2, background EEG activity became suppressed right at the end of the focal discharge, coinciding with the appearance of apnea. In neither case did the clinical description by observers coincide with video-EEG findings. The existence of connections between the posterior limbic cortex and the temporal lobe and midbrain respiratory centers may explain the clinical symptoms recorded in these 2 cases. The novel features reported here include video-EEG capture of apneic seizure, ischemic lesion in the territory of the posterior cerebral artery as the cause of apneic seizure, and the appearance of apnea when the epileptiform ictal discharge extended to other cerebral areas or when EEG activity became suppressed. To date, none of these clinical findings have been previously reported. We believe this pathology may in fact be fairly common, but that video-EEG monitoring is essential for diagnosis.

  12. Value of analyzing deep gray matter and occipital lobe perfusion to differentiate dementia with Lewy bodies from Alzheimer's disease.

    Science.gov (United States)

    Shimizu, Soichiro; Hanyu, Haruo; Hirao, Kentaro; Sato, Tomohiko; Iwamoto, Toshihiko; Koizumi, Kiyoshi

    2008-12-01

    Dementia with Lewy bodies (DLB) is generally characterized by a decrease in regional cerebral blood flow (rCBF) in the occipital lobe. However, not all patients with DLB have this feature. We explored characteristics of rCBF pattern changes to improve the identification of DLB, in addition to occipital hypoperfusion. The study population comprised 30 patients with probable DLB and 49 patients with probable Alzheimer's disease (AD) who underwent single-photon emission computed tomography. The data were analyzed using Neurological Statistical Image Analysis Software (NEUROSTAT). We established a template of the region of interest (ROI) presenting the parietal lobe, posterior cingulate, striatum, thalamus, and occipital lobe on the standard brain atlas. We then compared the mean Z scores in each ROI between DLB and AD. Moreover, we investigated the value of analyzing relative rCBF changes in both the deep gray matter and occipital lobe in differentiating DLB from AD. The DLB group showed a significant relative rCBF increase in the bilateral striatum and thalamus, and a significant relative rCBF decrease in the bilateral occipital lobe when compared with the AD group. Receiver-operating characteristic analysis revealed that determining the hyperperfusion in the thalamus together with the hypoperfusion in the occipital lobe enabled a more accurate differentiation between DLB and AD than studying individual areas. Studying the relative increase of rCBF in the deep gray matter, and the relative decrease of that in the occipital lobe achieved a high differentiation between DLB and AD. This suggests that determining both an increase and a decrease in rCBF pattern may be important in differentiating between the two diseases.

  13. Value of analyzing deep gray matter and occipital lobe perfusion to differentiate dementia with Lewy bodies from Alzheimer's disease

    International Nuclear Information System (INIS)

    Shimizu, Soichiro; Hanyu, Haruo; Hirao, Kentaro; Sato, Tomohiko; Iwamoto, Toshihiko; Koizumi, Kiyoshi

    2008-01-01

    Dementia with Lewy bodies (DLB) is generally characterized by a decrease in regional cerebral blood flow (rCBF) in the occipital lobe. However, not all patients with DLB have this feature. We explored characteristics of rCBF pattern changes to improve the identification of DLB, in addition to occipital hypoperfusion. The study population comprised 30 patients with probable DLB and 49 patients with probable Alzheimer's disease (AD) who underwent single-photon emission computed tomography. The data were analyzed using Neurological Statistical Image Analysis Soft-ware (NEUROSTAT). We established a template of the region of interest (ROI) presenting the parietal lobe, posterior cingulate, striatum, thalamus, and occipital lobe on the standard brain atlas. We then compared the mean Z scores in each ROI between DLB and AD. Moreover, we investigated the value of analyzing relative rCBF changes in both the deep gray matter and occipital lobe in differentiating DLB from AD. The DLB group showed a significant relative rCBF increase in the bilateral striatum and thalamus, and a significant relative rCBF decrease in the bilateral occipital lobe when compared with the AD group. Receiver-operating characteristic analysis revealed that determining the hyperperfusion in the thalamus together with the hypoperfusion in the occipital lobe enabled a more accurate differentiation between DLB and AD than studying individual areas. Studying the relative increase of rCBF in the deep gray matter, and the relative decrease of that in the occipital lobe achieved a high differentiation between DLB and AD. This suggests that determining both an increase and a decrease in rCBF pattern may be important in differentiating between the two diseases. (author)

  14. Significance of the Tentorial Alignment in Protecting the Occipital Lobe with the Poppen Approach for Tentorial or Pineal Area Meningiomas.

    Science.gov (United States)

    Li, Deling; Zhang, Haoyu; Jia, Wang; Zhang, Liwei; Zhang, Junting; Liu, Weiming; Ni, Ming; Jia, Guijun

    2017-12-01

    We aimed to identify the factors that can predict the risk of occipital lobe damage preoperatively when resecting tumors located at the tentorial or pineal regions with the occipital-transtentorial approach (Poppen approach). In 27 consecutive patients who underwent tumor resection with the Poppen approach for tentorial or pineal region meningiomas, the following morphologic parameters were assessed on a preoperative magnetic resonance imaging: (1) tentorial angle, (2) tentorial length, and (3) the shortest distance from the confluence of the sinus to the tumor. These parameters, together with tumor size, texture, and resection extent, were correlated with occipital lobe damage by using the one-way analysis of variance, χ 2 , or Fisher's exact tests. The mean value was 55.3° ± 5.6° (range, 45°-66°) for the tentorial angle, which was significantly associated with the occipital lobe damage grades (P = 0.008), but this was not the case for the tentorial length (P = 0.802) and the shortest distance from the confluence of the sinus to the tumor (P = 0.695). Interestingly, age was also strongly associated with occipital lobe damage risk (P = 0.020). The patients in the subgroup with no occipital damage (grade 4) were the youngest (aged 47.3 years), compared with other grades, with age of 58.0 years for grade 1, 54.3 years for grade 2, and 58.6 years for grade 3. These 2 parameters were also significant after multivariate analysis. No correlation was observed between either tumor nature or the extent of resection and damage grades. The risk of occipital lobe damage increases in the presence of a steep tentorial angle during the Poppen approach for tentorial or pineal area tumors. Awareness of such anatomic features preoperatively is important for minimizing operative complications. Copyright © 2017. Published by Elsevier Inc.

  15. Occipital nerve stimulation in medically intractable, chronic cluster headache. The ICON study

    DEFF Research Database (Denmark)

    Wilbrink, Leopoldine A; Teernstra, Onno Pm; Haan, Joost

    2013-01-01

    study is performed. DISCUSSION: The ICON study will show if ONS is an effective preventive therapy for patients suffering medically intractable chronic cluster headache and if there is a difference between high- and low-amplitude stimulation. The innovative design of the study will, for the first time......BACKGROUND: About 10% of cluster headache patients have the chronic form. At least 10% of this chronic group is intractable to or cannot tolerate medical treatment. Open pilot studies suggest that occipital nerve stimulation (ONS) might offer effective prevention in these patients. Controlled...

  16. Alpha2-adrenoceptor modulation of long-term potentiation elicited in vivo in rat occipital cortex.

    Science.gov (United States)

    Mondaca, Mauricio; Hernández, Alejandro; Pérez, Hernán; Valladares, Luis; Sierralta, Walter; Fernández, Victor; Soto-Moyano, Rubén

    2004-09-24

    Pretreatment with the alpha(2)-adrenoceptor agonist clonidine (31.25, 62.5, or 125 microg/kg, i.p.) dose-dependently reduced long-term potentiation (LTP) elicited in vivo in the occipital cortex of anesthetized rats, whereas pretreatment with the alpha(2)-adrenoceptor antagonist yohimbine (0.133, 0.4, or 1.2 mg/kg, i.p.) increased neocortical LTP in a dose-dependent fashion. These effects could be related to the reported disruptive and facilitatory actions induced on memory formation by pretreatment with alpha(2)-adrenoceptor agonists and antagonists, respectively.

  17. "Capgras" Delusions Involving Belongings, Not People, and Evolving Visual Hallucinations Associated with Occipital Lobe Seizures.

    Science.gov (United States)

    Lilly, Brandon; Maynard, Erika; Melvin, Kelly; Holroyd, Suzanne

    2018-01-01

    Capgras syndrome is characterized by the delusional belief that a familiar person has been replaced by a visually similar imposter or replica. Rarely, the delusional focus may be objects rather than people. Numerous etiologies have been described for Capgras to include seizures. Similarly, visual hallucinations, both simple and complex, can occur secondary to seizure activity. We present, to our knowledge, the first reported case of visual hallucinations and Capgras delusions for objects that developed secondary to new onset occipital lobe epilepsy. We then discuss the possible underlying neurologic mechanisms responsible for the symptomatology.

  18. Left regular bands of groups of left quotients

    International Nuclear Information System (INIS)

    El-Qallali, A.

    1988-10-01

    A semigroup S which has a left regular band of groups as a semigroup of left quotients is shown to be the semigroup which is a left regular band of right reversible cancellative semigroups. An alternative characterization is provided by using spinned products. These results are applied to the case where S is a superabundant whose set of idempotents forms a left normal band. (author). 13 refs

  19. Multimodal imaging of language reorganization in patients with left temporal lobe epilepsy.

    Science.gov (United States)

    Chang, Yu-Hsuan A; Kemmotsu, Nobuko; Leyden, Kelly M; Kucukboyaci, N Erkut; Iragui, Vicente J; Tecoma, Evelyn S; Kansal, Leena; Norman, Marc A; Compton, Rachelle; Ehrlich, Tobin J; Uttarwar, Vedang S; Reyes, Anny; Paul, Brianna M; McDonald, Carrie R

    2017-07-01

    This study explored the relationships among multimodal imaging, clinical features, and language impairment in patients with left temporal lobe epilepsy (LTLE). Fourteen patients with LTLE and 26 controls underwent structural MRI, functional MRI, diffusion tensor imaging, and neuropsychological language tasks. Laterality indices were calculated for each imaging modality and a principal component (PC) was derived from language measures. Correlations were performed among imaging measures, as well as to the language PC. In controls, better language performance was associated with stronger left-lateralized temporo-parietal and temporo-occipital activations. In LTLE, better language performance was associated with stronger right-lateralized inferior frontal, temporo-parietal, and temporo-occipital activations. These right-lateralized activations in LTLE were associated with right-lateralized arcuate fasciculus fractional anisotropy. These data suggest that interhemispheric language reorganization in LTLE is associated with alterations to perisylvian white matter. These concurrent structural and functional shifts from left to right may help to mitigate language impairment in LTLE. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  1. Neutrosophic Left Almost Semigroup

    Directory of Open Access Journals (Sweden)

    Mumtaz Ali

    2014-06-01

    Full Text Available In this paper we extend the theory of neutrosophy to study left almost semigroup shortly LAsemigroup. We generalize the concepts of LA-semigroup to form that for neutrosophic LA-semigroup. We also extend the ideal theory of LA-semigroup to neutrosophy and discuss different kinds of neutrosophic ideals. We also find some new type of neutrosophic ideal which is related to the strong or pure part of neutrosophy. We have given many examples to illustrate the theory of neutrosophic LA-semigroup and display many properties of neutrosophic LA-semigroup in this paper.

  2. Aphasia following left thalamic hemorrhage. A study by Western Aphasia Battery and single photon emission CT

    Energy Technology Data Exchange (ETDEWEB)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro

    1984-07-01

    A report is given of 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months) in which language disorders were examined by Western Aphasia Battery (WAB) and cerebral blood flow was measured by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in the left temporooccipital region and low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, emission CT showed slight low flow area at the temporo-occipital region similar to the case with transcortical sensory aphasia. In another case with anomic aphasia there was a wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. In all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus.

  3. Relative signal intensity changes of frontal and occipital white matters on T 2 weighted axial MR image : correlation with age

    International Nuclear Information System (INIS)

    Kim, You Me; Kim, Seung Cheol

    1998-01-01

    The purpose of this study is to assess relative signal intensity changes in frontal and occipital white matter with age, as seen on T 2 weighted axial MR images. Thirty eight normal adults (20-29 years old) and 114 children (0-11 years old) were investigated. All had nonspecific neurologic symptoms and their MR images, obtained using a 1.5 T system (Signa, GE Medical Systems, Milwaukee, U.S.A.), appeared to be normal. The signal intensities of frontal and occipital white matter were evaluated on T2 weighted axial images at the level of the foramen of Monro. When the signal intensity of white matter was higher than that of gray matter, grade 0 was assigned; when the opposite situation pertained, this was graded I - III. Grade I indicated that the signal intensity of occipital white matter was lower than that of frontal white matter; grade II, that the signal intensity of white matter of both lobes was similar. When the signal intensity of frontal white matter was lower than that of occipital age, and by one year after 2 years of age, and then determined grade according to age, age distribution according to grade, and the ages at which signal intensities were similar to those of adults. On T2-weighted MR images, the signal intensity of frontal white matter ultimately shows a lower signal intensity than that of occipital white matter. (author). 11 refs., 6 figs

  4. Correlation of neuropsychological and metabolic changes after epilepsy surgery in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis.

    Science.gov (United States)

    Güvenç, Canan; Dupont, Patrick; Van den Stock, Jan; Seynaeve, Laura; Porke, Kathleen; Dries, Eva; Van Bouwel, Karen; van Loon, Johannes; Theys, Tom; Goffin, Karolien E; Van Paesschen, Wim

    2018-04-12

    Epilepsy surgery often causes changes in cognition and cerebral glucose metabolism. Our aim was to explore relationships between pre- and postoperative cerebral metabolism as measured with 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological test scores in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), who were rendered seizure-free after epilepsy surgery. Thirteen patients were included. All had neuropsychological testing and an interictal FDG-PET scan of the brain pre- and postoperative. Correlations between changes in neuropsychological test scores and metabolism were examined using statistical parametric mapping (SPM). There were no significant changes in the neuropsychological test scores pre- and postoperatively at the group level. Decreased metabolism was observed in the left mesial temporal regions and occipital lobe. Increased metabolism was observed in the bi-frontal and right parietal lobes, temporal lobes, occipital lobes, thalamus, cerebellum, and vermis. In these regions, we did not find a correlation between changes in metabolism and neuropsychological test scores. A significant negative correlation, however, was found between metabolic changes in the precuneus and Boston Naming Test (BNT) scores. There are significant metabolic decreases in the left mesial temporal regions and increases in the bi-frontal lobes; right parietal, temporal, and occipital lobes; right thalamus; cerebellum; and vermis in patients with left MTLE-HS who were rendered seizure-free after epilepsy surgery. We could not confirm that these changes translate into significant cognitive changes. A significant negative correlation was found between changes in confrontation naming and changes in metabolism in the precuneus. We speculate that the precuneus may play a compensatory role in patients with postoperative naming difficulties after left TLE surgery. Understanding of these neural mechanisms may aid in

  5. Clinical and electroencephalographic characteristics of benign occipital epilepsy of childhood in two tertiary Brazilian hospitals

    Directory of Open Access Journals (Sweden)

    Soniza Vieira Alves-Leon

    2011-08-01

    Full Text Available This study intended to investigate the clinical and electroencephalographic benign occipital epilepsy of childhood (BOEC characteristics in a population sample of patients from two tertiary Brazilian hospitals. We analyzed retrospectively 4912 electroencephalograms (EEGs records, and the included patients were submitted to a new clinical and EEG evaluation. Were included 12 (0.92% patients; 4 (33.3% with criteria for early BOEC; 6 (50% for late form and 2 (16.7% with superimposed early and late onset forms. After new investigation, 2 (16.7% had normal EEG; 4 (33.3% had paroxysms over the occipital region; 3 (25% over the temporal posterior regions and 3 (25% over the posterior regions. Sharp waves were the predominant change, occurring in 8 (66.6%; spike and slow wave complexes in 1 (8.3% and sharp and slow wave complexes in 1 (8.3%. Vomiting, headache and visual hallucinations were the most common ictal manifestations, presented in 100% of patients with superimposed forms. Vomiting were absent in the late form and headache was present in all forms of BOEC.

  6. [Chronic subdural hematoma (CSH) complicated by bilateral occipital lobe infarction: two case reports].

    Science.gov (United States)

    Kudo, Kanae; Naraoka, Masato; Shimamura, Norihito; Ohkuma, Hiroki

    2013-04-01

    Chronic subdural hematoma (CSH) is a common disease that is treated with burr hole drainage by neurosurgeons. The outcome of CSH is mostly favorable. We treated 2 cases with bilateral occipital lobe infarction due to CSH. A 57-year-old woman was ambulatory when she visited a clinic for evaluation of headache. One hour after the CT was taken, she developed acute impairment of consciousness, so that she was referred to our hospital. The second patient was a 73-year-old woman with a history of depression who was involved in a traffic accident 5 weeks before admission to our hospital. She was at first admitted to a psychiatric hospital for evaluation of gait disturbance. Three weeks after she was admitted to the psychiatric hospital, she fell into a coma. She was referred to our hospital. Their brain CT on admission revealed compressed ambient and interpeduncular cistern and bilateral CSH. Although burr hole drainage surgery was performed, the 2 patients developed severe sequelae due to occipital lobe infarction caused by central transtentorial herniation.

  7. The Classical Pathways of Occipital Lobe Epileptic Propagation Revised in the Light of White Matter Dissection.

    Science.gov (United States)

    Latini, Francesco; Hjortberg, Mats; Aldskogius, Håkan; Ryttlefors, Mats

    2015-01-01

    The clinical evidences of variable epileptic propagation in occipital lobe epilepsy (OLE) have been demonstrated by several studies. However the exact localization of the epileptic focus sometimes represents a problem because of the rapid propagation to frontal, parietal, or temporal regions. Each white matter pathway close to the supposed initial focus can lead the propagation towards a specific direction, explaining the variable semiology of these rare epilepsy syndromes. Some new insights in occipital white matter anatomy are herein described by means of white matter dissection and compared to the classical epileptic patterns, mostly based on the central position of the primary visual cortex. The dissections showed a complex white matter architecture composed by vertical and longitudinal bundles, which are closely interconnected and segregated and are able to support specific high order functions with parallel bidirectional propagation of the electric signal. The same sublobar lesions may hyperactivate different white matter bundles reemphasizing the importance of the ictal semiology as a specific clinical demonstration of the subcortical networks recruited. Merging semiology, white matter anatomy, and electrophysiology may lead us to a better understanding of these complex syndromes and tailored therapeutic options based on individual white matter connectivity.

  8. Alfred Walter Campbell and the visual functions of the occipital cortex.

    Science.gov (United States)

    Macmillan, Malcolm

    2014-07-01

    In his pioneering cytoarchitectonic studies of the human brain, Alfred Walter Campbell identified two structurally different areas in the occipital lobes and assigned two different kinds of visual functions to them. The first area, the visuosensory, was essentially on the mesial surface of the calcarine fissure. It was the terminus of nervous impulses generated in the retina and was where simple visual sensations arose. The second area, the visuopsychic, which surrounded or invested the first, was where sensations were interpreted and elaborated into visual perceptions. I argue that Campbell's distinction between the two areas was the starting point for the eventual differentiation of areas V1-V5. After a brief outline of Campbell's early life and education in Australia and of his Scottish medical education and early work as a pathologist at the Lancashire County Lunatic Asylum at Rainhill near Liverpool, I summarise his work on the human brain. In describing the structures he identified in the occipital lobes, I analyse the similarities and differences between them and the related structures identified by Joseph Shaw Bolton. I conclude by proposing some reasons for how that work came to be overshadowed by the later studies of Brodmann and for the more general lack of recognition given Campbell and his work. Those reasons include the effect of the controversies precipitated by Campbell's alliance with Charles Sherrington over the functions of the sensory and motor cortices. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Greater Occipital Nerve Block for Acute Treatment of Migraine Headache: A Large Retrospective Cohort Study.

    Science.gov (United States)

    Allen, Sorcha M; Mookadam, Farouk; Cha, Stephen S; Freeman, John A; Starling, Amaal J; Mookadam, Martina

    2018-01-01

    Greater occipital nerve (GON) blocks are frequently used to treat migraine headaches, although a paucity of supporting clinical evidence exists. The objective of this study was to assess the efficacy of GON block in acute treatment of migraine headache, with a focus on pain relief. This retrospective cohort study was undertaken between January 2009 and August 2014 and included patients who underwent at least 1 GON block and attended at least 1 follow-up appointment. Change in the 11-point numeric pain rating scale (NPRS) was used to assess the response to GON block. Response was defined as "minimal" (50% NPRS point reduction). A total of 562 patients met inclusion criteria; 423 were women (75%). Mean age was 58.6 ± 16.7 years. Of these 562, 459 patients (82%) rated their response to GON block as moderate or significant. No statistically significant relationship existed between previous treatment regimens and response to GON block. GON block was equally effective across the different age and sex groups. Greater occipital block seems to be an effective option for acute management of migraine headache, with promising reductions in pain scores. © Copyright 2018 by the American Board of Family Medicine.

  10. Mento-occipital-open mouth view in the vertebral magnification angiography

    International Nuclear Information System (INIS)

    Fujikawa, Tsumoru; Ohoka, Akio; Yuasa, Yasuo; Kashima, Jitsuyoshi; Matsuyama, Shinya

    1979-01-01

    Cerebral magnification angiography with a intensifying screen system of the specific rare earths, has lately been introduced and been requested to discriminate more minute vascular structures. Routine vertebral magnification angiography (VMG) with the screen system provides half-axial and lateral views or sometimes antero-posterior and lateral views. However, in the half-axial and lateral views, accurate. X-ray reading of the vascular system in posterior cranial fossa is in trouble. In 1973 a mento-occipital open mouth view in the vertebral angiography started at our department and since 1975 the view has been provided with a magnification and the intensifying screen system. The mento-occipital-open mouth view in the VMG, X-ray vertically projected to basilar artery and decreased overshadow of the facial bones. The demonstration of the vertebro-basilar system, especially the junction point or beginning portion of arteria cerebelli inferior posterior (PICA) was more excellent than in the routine views. The reduction in the length of the vessels was reasonablly decreased. The half-axial view longitudinally reduces the vertebro-basilar vasculo-system and the lateral view blurs the vascular portion from the stem of basilar A to vertebral branching of the PICA because of overshadows of bilateral petrous temporalis. Clinically the author's view was effective to analyze the vascular arrangement in the VMG. (author)

  11. The Classical Pathways of Occipital Lobe Epileptic Propagation Revised in the Light of White Matter Dissection

    Science.gov (United States)

    Latini, Francesco; Hjortberg, Mats; Aldskogius, Håkan; Ryttlefors, Mats

    2015-01-01

    The clinical evidences of variable epileptic propagation in occipital lobe epilepsy (OLE) have been demonstrated by several studies. However the exact localization of the epileptic focus sometimes represents a problem because of the rapid propagation to frontal, parietal, or temporal regions. Each white matter pathway close to the supposed initial focus can lead the propagation towards a specific direction, explaining the variable semiology of these rare epilepsy syndromes. Some new insights in occipital white matter anatomy are herein described by means of white matter dissection and compared to the classical epileptic patterns, mostly based on the central position of the primary visual cortex. The dissections showed a complex white matter architecture composed by vertical and longitudinal bundles, which are closely interconnected and segregated and are able to support specific high order functions with parallel bidirectional propagation of the electric signal. The same sublobar lesions may hyperactivate different white matter bundles reemphasizing the importance of the ictal semiology as a specific clinical demonstration of the subcortical networks recruited. Merging semiology, white matter anatomy, and electrophysiology may lead us to a better understanding of these complex syndromes and tailored therapeutic options based on individual white matter connectivity. PMID:26063964

  12. Occipital plagiocephaly: deformation or lambdoid synostosis ? II. a unifying theory regarding pathogenesis

    International Nuclear Information System (INIS)

    Dias, M.S.; Klein, D.M.

    1997-01-01

    Occipital plagiocephaly is characterized by both unilateral occipital flattening and ipsilateral frontal prominence with anterior deviation of the ipsilateral ear, yielding a characteristic parallelogram shape to the cranium. Radiographic changes in the lambdoid suture are often evident, but the lambdoid suture is usually patent over most or all of its length on skull X-rays and/or CT scans. Both lambdoid synostosis and deformational forces have been implicated as potentially causal in the pathogenesis of this deformity. We propose a unifying theory which incorporates a common pathogenesis for both deformational plagiocephaly and most cases of lambdoid ''synostosis''. According to this hypothesis, intrauterine and/or postnatal deformational forces are responsible for the primary calvarial deformation. These forces initially act in a reversible manner to produce the typical parallelogram-shaped skull deformity. How-ever, with continued deformation, more enduring secondary pathological changes may eventually occur in the lambdoid suture and basicranium which are more difficult to correct even if the offending deformational forces are subsequently removed or reversed. (authors)

  13. Recruitment of occipital cortex during sensory substitution training linked to subjective experience of seeing in people with blindness.

    Directory of Open Access Journals (Sweden)

    Tomás Ortiz

    Full Text Available Over three months of intensive training with a tactile stimulation device, 18 blind and 10 blindfolded seeing subjects improved in their ability to identify geometric figures by touch. Seven blind subjects spontaneously reported 'visual qualia', the subjective sensation of seeing flashes of light congruent with tactile stimuli. In the latter subjects tactile stimulation evoked activation of occipital cortex on electroencephalography (EEG. None of the blind subjects who failed to experience visual qualia, despite identical tactile stimulation training, showed EEG recruitment of occipital cortex. None of the blindfolded seeing humans reported visual-like sensations during tactile stimulation. These findings support the notion that the conscious experience of seeing is linked to the activation of occipital brain regions in people with blindness. Moreover, the findings indicate that provision of visual information can be achieved through non-visual sensory modalities which may help to minimize the disability of blind individuals, affording them some degree of object recognition and navigation aid.

  14. Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient.

    Science.gov (United States)

    Bonini, Francesca; Egeo, Gabriella; Fattouch, Jinan; Fanella, Martina; Morano, Alessandra; Giallonardo, Anna Teresa; di Bonaventura, Carlo

    2014-04-01

    Idiopathic photosensitive occipital lobe epilepsy (IPOE) is an idiopathic localization-related epilepsy characterized by age-related onset, specific mode of precipitation, occipital photic-induced seizures--frequently consisting of visual symptoms--and good prognosis. This uncommon epilepsy, which usually starts in childhood or adolescence, has rarely been observed in families in which idiopathic generalized epilepsy also affects other members. We describe a nuclear family in which the proband showed electro-clinical features of idiopathic photosensitive occipital lobe epilepsy in childhood, which subsequently evolved into absences and a single generalized tonico-clonic seizure in early adolescence. His mother had features suggestive of juvenile myoclonic epilepsy. This case illustrates a continuum between focal and generalized entities in the spectrum of the so-called idiopathic (genetically determined) epileptic syndromes. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  15. Recruitment of occipital cortex during sensory substitution training linked to subjective experience of seeing in people with blindness.

    Science.gov (United States)

    Ortiz, Tomás; Poch, Joaquín; Santos, Juan M; Requena, Carmen; Martínez, Ana M; Ortiz-Terán, Laura; Turrero, Agustín; Barcia, Juan; Nogales, Ramón; Calvo, Agustín; Martínez, José M; Córdoba, José L; Pascual-Leone, Alvaro

    2011-01-01

    Over three months of intensive training with a tactile stimulation device, 18 blind and 10 blindfolded seeing subjects improved in their ability to identify geometric figures by touch. Seven blind subjects spontaneously reported 'visual qualia', the subjective sensation of seeing flashes of light congruent with tactile stimuli. In the latter subjects tactile stimulation evoked activation of occipital cortex on electroencephalography (EEG). None of the blind subjects who failed to experience visual qualia, despite identical tactile stimulation training, showed EEG recruitment of occipital cortex. None of the blindfolded seeing humans reported visual-like sensations during tactile stimulation. These findings support the notion that the conscious experience of seeing is linked to the activation of occipital brain regions in people with blindness. Moreover, the findings indicate that provision of visual information can be achieved through non-visual sensory modalities which may help to minimize the disability of blind individuals, affording them some degree of object recognition and navigation aid.

  16. Condylar Joint Fusion and Stabilization (by Screws and Plates) in Nontraumatic Atlanto-Occipital Dislocation: Technical Report of 2 Cases.

    Science.gov (United States)

    Chowdhury, Forhad H; Haque, Mohammod Raziul; Alam, Sarwar Murshed; Khaled Chowdhury, S M Noman; Khan, Shamsul Islam; Goel, Atul

    2017-11-01

    Nontraumatic spontaneous atlanto-occipital dislocation (AOD) is rare. In this report, we discuss the technical steps of condylar joint fusion and stabilization (by screws and plates) in nontraumatic AOD. To the best of our knowledge, it is the first report of such techniques. A young girl and a young man with progressive quadriparesis due to nontraumatic spontaneous atlanto-occipital dislocation were managed by microsurgical reduction, fusion, and stabilization of the joint by occipital condylar and C1 lateral mass screw and plate fixation after mobilization of vertebral artery. In both cases, condylar joints fixation and fusion were done successfully. Condylar joint stabilization and fusion may be a good or alternative option for AOD. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Normal Development and Measurements of the Occipital Condyle-C1 Interval in Children and Young Adults.

    Science.gov (United States)

    Smith, P; Linscott, L L; Vadivelu, S; Zhang, B; Leach, J L

    2016-05-01

    Widening of the occipital condyle-C1 interval is the most specific and sensitive means of detecting atlanto-occipital dislocation. Recent studies attempting to define normal measurements of the condyle-C1 interval in children have varied substantially. This study was performed to test the null hypothesis that condyle-C1 interval morphology and joint measurements do not change as a function of age. Imaging review of subjects undergoing CT of the upper cervical spine for reasons unrelated to trauma or developmental abnormality was performed. Four equidistant measurements were obtained for each bilateral condyle-C1 interval on sagittal and coronal images. The cohort was divided into 7 age groups to calculate the mean, SD, and 95% CIs for the average condyle-C1 interval in both planes. The prevalence of a medial occipital condyle notch was calculated. Two hundred forty-eight joints were measured in 124 subjects with an age range of 2 days to 22 years. The condyle-C1 interval varies substantially by age. Average coronal measurements are larger and more variable than sagittal measurements. The medial occipital condyle notch is most prevalent from 1 to 12 years and is uncommon in older adolescents and young adults. The condyle-C1 interval increases during the first several years of life, is largest in the 2- to 4-year age range, and then decreases through late childhood and adolescence. A single threshold value to detect atlanto-occipital dissociation may not be sensitive and specific for all age groups. Application of this normative data to documented cases of atlanto-occipital injury is needed to determine clinical utility. © 2016 by American Journal of Neuroradiology.

  18. The time course of retrograde trans-synaptic degeneration following occipital lobe damage in humans.

    Science.gov (United States)

    Jindahra, Panitha; Petrie, Aviva; Plant, Gordon T

    2012-02-01

    Following damage to the human post-geniculate visual pathway retrograde trans-synaptic degeneration of the optic nerve fibres occurs. It has been known for some time from investigations carried out in primates that a decline in the number of retinal ganglion cells follows occipital lobectomy. However, this is not detectable in all species studied and whether this occurs in humans was controversial until recent studies that have shown that following lesions of the occipital lobe, the retinal nerve fibre layer thickness measured by optical coherence tomography is reduced and corresponding shrinkage of the optic tract can be demonstrated by magnetic resonance imaging. The time course of the degeneration in humans is, however, unknown. In the present study, we have used optical coherence tomography to demonstrate for the first time progressive thinning of the retinal nerve fibre layer following occipital lobe/optic radiation damage due to stroke. First, in a group of 38 patients the measurement was taken on a single occasion at a known time interval since the stroke, ranging from 6 days to 67 years. Here, a negative straight line relationship (linear regression r = 0.54, P < 0.001) was found between nerve fibre layer thickness and elapsed time since injury in log years, giving a rate of decline of 9.08 µm per log year after adjusting for age. This indicates a decelerating rate of loss that differs from the rate of decline found with chronological age in this same group, which shows a steady rate of thinning by 0.4 µm per year (P = 0.006) after adjusting for duration of the disease. In a second study serial measurements were taken following the acute event in a group of seven patients with homonymous hemianopia; here a negative straight line relationship was found between time and nerve fibre layer thickness in micrometres over a period of data collection beginning at a mean of 36.9 days post-stroke (range 5-112) and ending at a mean of 426.6 days post

  19. Human Occipital and Parietal GABA Selectively Influence Visual Perception of Orientation and Size.

    Science.gov (United States)

    Song, Chen; Sandberg, Kristian; Andersen, Lau Møller; Blicher, Jakob Udby; Rees, Geraint

    2017-09-13

    GABA is the primary inhibitory neurotransmitter in human brain. The level of GABA varies substantially across individuals, and this variability is associated with interindividual differences in visual perception. However, it remains unclear whether the association between GABA level and visual perception reflects a general influence of visual inhibition or whether the GABA levels of different cortical regions selectively influence perception of different visual features. To address this, we studied how the GABA levels of parietal and occipital cortices related to interindividual differences in size, orientation, and brightness perception. We used visual contextual illusion as a perceptual assay since the illusion dissociates perceptual content from stimulus content and the magnitude of the illusion reflects the effect of visual inhibition. Across individuals, we observed selective correlations between the level of GABA and the magnitude of contextual illusion. Specifically, parietal GABA level correlated with size illusion magnitude but not with orientation or brightness illusion magnitude; in contrast, occipital GABA level correlated with orientation illusion magnitude but not with size or brightness illusion magnitude. Our findings reveal a region- and feature-dependent influence of GABA level on human visual perception. Parietal and occipital cortices contain, respectively, topographic maps of size and orientation preference in which neural responses to stimulus sizes and stimulus orientations are modulated by intraregional lateral connections. We propose that these lateral connections may underlie the selective influence of GABA on visual perception. SIGNIFICANCE STATEMENT GABA, the primary inhibitory neurotransmitter in human visual system, varies substantially across individuals. This interindividual variability in GABA level is linked to interindividual differences in many aspects of visual perception. However, the widespread influence of GABA raises the

  20. Human Occipital and Parietal GABA Selectively Influence Visual Perception of Orientation and Size

    Science.gov (United States)

    Andersen, Lau Møller; Blicher, Jakob Udby

    2017-01-01

    GABA is the primary inhibitory neurotransmitter in human brain. The level of GABA varies substantially across individuals, and this variability is associated with interindividual differences in visual perception. However, it remains unclear whether the association between GABA level and visual perception reflects a general influence of visual inhibition or whether the GABA levels of different cortical regions selectively influence perception of different visual features. To address this, we studied how the GABA levels of parietal and occipital cortices related to interindividual differences in size, orientation, and brightness perception. We used visual contextual illusion as a perceptual assay since the illusion dissociates perceptual content from stimulus content and the magnitude of the illusion reflects the effect of visual inhibition. Across individuals, we observed selective correlations between the level of GABA and the magnitude of contextual illusion. Specifically, parietal GABA level correlated with size illusion magnitude but not with orientation or brightness illusion magnitude; in contrast, occipital GABA level correlated with orientation illusion magnitude but not with size or brightness illusion magnitude. Our findings reveal a region- and feature-dependent influence of GABA level on human visual perception. Parietal and occipital cortices contain, respectively, topographic maps of size and orientation preference in which neural responses to stimulus sizes and stimulus orientations are modulated by intraregional lateral connections. We propose that these lateral connections may underlie the selective influence of GABA on visual perception. SIGNIFICANCE STATEMENT GABA, the primary inhibitory neurotransmitter in human visual system, varies substantially across individuals. This interindividual variability in GABA level is linked to interindividual differences in many aspects of visual perception. However, the widespread influence of GABA raises the

  1. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

    Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

  2. Individual structural differences in left inferior parietal area are associated with schoolchildrens’ arithmetic scores

    Directory of Open Access Journals (Sweden)

    Yongxin eLi

    2013-12-01

    Full Text Available Arithmetic skill is of critical importance for academic achievement, professional success and everyday life, and childhood is the key period to acquire this skill. Neuroimaging studies have identified that left parietal regions are a key neural substrate for representing arithmetic skill. Although the relationship between functional brain activity in left parietal regions and arithmetic skill has been studied in detail, it remains unclear about the relationship between arithmetic achievement and structural properties in left inferior parietal area in schoolchildren. The current study employed a combination of voxel-based morphometry (VBM for high-resolution T1-weighted images and fiber tracking on diffusion tensor imaging (DTI to examine the relationship between structural properties in the inferior parietal area and arithmetic achievement in 10-year-old schoolchildren. VBM of the T1-weighted images revealed that individual differences in arithmetic scores were significantly and positively correlated with the grey matter (GM volume in the left intraparietal sulcus (IPS. Fiber tracking analysis revealed that the forceps major, left superior longitudinal fasciculus (SLF, bilateral inferior longitudinal fasciculus (ILF and inferior fronto-occipital fasciculus (IFOF were the primary pathways connecting the left IPS with other brain areas. Furthermore, the regression analysis of the probabilistic pathways revealed a significant and positive correlation between the fractional anisotropy (FA values in the left SLF, ILF and bilateral IFOF and arithmetic scores. The brain structure-behavior correlation analyses indicated that the GM volumes in the left IPS and the FA values in the tract pathways connecting left IPS were both related to children’s arithmetic achievement. The present findings provide evidence that individual structural differences in the left IPS are associated with arithmetic scores in schoolchildren.

  3. [Left-handedness and health].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  4. Representation of Semantic Similarity in the Left Intraparietal Sulcus: Functional Magnetic Resonance Imaging Evidence

    Directory of Open Access Journals (Sweden)

    Veerle Neyens

    2017-08-01

    Full Text Available According to a recent study, semantic similarity between concrete entities correlates with the similarity of activity patterns in left middle IPS during category naming. We examined the replicability of this effect under passive viewing conditions, the potential role of visuoperceptual similarity, where the effect is situated compared to regions that have been previously implicated in visuospatial attention, and how it compares to effects of object identity and location. Forty-six subjects participated. Subjects passively viewed pictures from two categories, musical instruments and vehicles. Semantic similarity between entities was estimated based on a concept-feature matrix obtained in more than 1,000 subjects. Visuoperceptual similarity was modeled based on the HMAX model, the AlexNet deep convolutional learning model, and thirdly, based on subjective visuoperceptual similarity ratings. Among the IPS regions examined, only left middle IPS showed a semantic similarity effect. The effect was significant in hIP1, hIP2, and hIP3. Visuoperceptual similarity did not correlate with similarity of activity patterns in left middle IPS. The semantic similarity effect in left middle IPS was significantly stronger than in the right middle IPS and also stronger than in the left or right posterior IPS. The semantic similarity effect was similar to that seen in the angular gyrus. Object identity effects were much more widespread across nearly all parietal areas examined. Location effects were relatively specific for posterior IPS and area 7 bilaterally. To conclude, the current findings replicate the semantic similarity effect in left middle IPS under passive viewing conditions, and demonstrate its anatomical specificity within a cytoarchitectonic reference frame. We propose that the semantic similarity effect in left middle IPS reflects the transient uploading of semantic representations in working memory.

  5. Bilateral occipital lobe infarction with altitudinal field loss following radiofrequency cardiac catheter ablation

    Directory of Open Access Journals (Sweden)

    Chen Celia S

    2010-03-01

    Full Text Available Abstract Background Bilateral stroke following radiofrequency catheter ablation is an unusual complication and may result in bilateral altitudinal visual field defects. Bilateral altitudinal visual field defects usually result from prechiasmal pathology causing damage to both retinas or optic nerves and rarely from bilateral symmetric damage to the post chiasmal visual pathways. Case presentation A 48-year-old man complained of visual disturbance on wakening following radiofrequency catheter ablation. The patient had a CHADS score of 1 pre-operatively and no complications were noted intra-operatively. Examination revealed a bilateral superior altitudinal defect and MRI of the brain showed multifocal areas of infarction predominantly involving the occipital lobes which correlated to with the visual deficits. Conclusion While the risk of thromboembolism and perioperative stroke during radiofrequency catheter ablation is small, it is not insignificant.

  6. The Lateral Occipital Complex shows no net response to object familiarity.

    Science.gov (United States)

    Margalit, Eshed; Shah, Manan P; Tjan, Bosco S; Biederman, Irving; Keller, Brenton; Brenner, Rorry

    2016-09-01

    In 1995, Malach et al. discovered an area whose fMRI BOLD response was greater when viewing intact, familiar objects than when viewing their scrambled versions (resembling texture). Since then hundreds of studies have explored this late visual region termed the Lateral Occipital Complex (LOC), which is now known to be critical for shape perception (James, Culham, Humphrey, Milner, & Goodale, 2003). Malach et al. (1995) discounted a role of familiarity by showing that "abstract" Henry Moore sculptures, unfamiliar to the subjects, also activated this region. This characterization of LOC as a region that responds to shape independently of familiarity has been accepted but never tested with control of the same low-level features. We assessed LOC's response to objects that had identical parts in two different arrangements, one familiar and the other novel. Malach was correct: There is no net effect of familiarity in LOC. However, a multivoxel correlation analysis showed that LOC does distinguish familiar from novel objects.

  7. Three cases of acute encephalopathy with low density areas in the occipital lobes on CT

    International Nuclear Information System (INIS)

    Nakajima, Masako; Nakano, Chizuko; Takakura, Hiroki; Otani, Kyoichi.

    1985-01-01

    Three female infants with acute encephalopathy (aged from 5 months to 1 year and 8 months) are presented in whom peculiar features were obtained on cranial CT. Disturbances of consciousness and spasm were seen in all patients. Although two patients had been in good health until the onset, the other patient had had nodular sclerosis. Laboratory data showed no evidence of inflammation in the spinal fluid, but increased levels of transaminase and LDH. CT around 7 days after the onset revealed diffuse low density areas. This was noted in the temporal and occipital lobes, mainly resulting from edema. Follow-up CT examinations revealed localized low density areas corresponding to the surface area, being probably attributable to disturbances of the arterial and venous circulations. In two patients with severe disturbances of consciousness, low density areas became more marked with time. (Namekawa, K.)

  8. Conceito anátomo-fisiológico do lobo occipital

    Directory of Open Access Journals (Sweden)

    M. Caetano de Barros

    1972-03-01

    Full Text Available Apenas do ponto de vista estritamente anatômico o lobo occipital pode ser delimitado com relativa facilidade. Aparentemente constitui uma unidade morfológica, séde de estruturas basicamente relacionados com a percepção visual, aí entendidos também certos mecanismos integrativos óculo-motores que, em última análise, não são senão componentes dêste complexo fenômeno perceptivo. Depois de revistos alguns detalhes da anatomia convencional do lobo occipital (limites, área cortical estriada, peri-estriada e para-estriada é feita uma tentativa, à base de estudo da literatura, no sentido de indicar as principais conexões destas áreas (radiações ópticas, feixes de associação, fibras de projeção e fibras comissurais com diferentes estruturas do sistema nervoso central. A vascularização do lobo occipital é revisada com o auxílio de preparações anátomo-radiológicas seriadas e seletivas de diferentes troncos arteriais, nas quais se constatam intercomunicações entre os setores "terminais" dos sistemas das artérias cerebral posterior, média e anterior. Algumas variações morfológicas dos cornos occipitais são também postas em evidência com recursos de técnicas anátomo-radiológicas. Todavia, dados puramente anatômicos não são suficientes para compreensão das funções psico-fisiológicas do lobo occipital que pode ser conceituado como parte de um sistema perceptivo — o sistema óptico — altamente complexo, funcionando integradamente com múltiplos sectores do sistema nervoso e envolvendo diferentes mecanismos. Muito provàvelmente êste sistema, à maneira de muitos outros sistemas biológicos, está composto de vários circuitos mutuamente conjugados agindo sob o princípio de servo-mecanismos, devendo sua ação ser encaixada dentro do conceito das "totalidades" (Gestalten, cuja funcionalidade não deriva da soma dos seus componentes, mas da relação funcional que estes mantém entre sí para a atua

  9. Agnosia integrativa causada por una epilepsia focal occipital izquierda: estudio de caso

    Directory of Open Access Journals (Sweden)

    Óscar Mauricio Aguilar Mejía

    2011-01-01

    Full Text Available La agnosia integrativa es un tipo de agnosia visual asociada a lesiones occipitales bilaterales que se caracteriza por la incapacidad para identificar estímulos en fondos complejos, especialmente, cuando se trata de formas superpuestas o entrelazadas. Existen dificultades para codificar y agrupar el todo a partir de las partes del estímulo. Se presenta un caso de una paciente de 14 años, con una agnosia integrativa como consecuencia de una epilepsia focal sintomática refractaria, con un foco epileptogénico occipital izquierdo. Se plantean las características clínicas de la paciente y se hace un análisis de sus procesos de reconocimiento visual discutidos a partir de los diferentes modelos teóricos que tratan de explicar la percepción visual.

  10. Imaging sensory effects of occipital nerve stimulation: a new computer-based method in neuromodulation.

    Science.gov (United States)

    Göbel, Anna; Göbel, Carl H; Heinze, Axel; Heinze-Kuhn, Katja; Petersen, Inga; Meinecke, Christoph; Clasen, Svenja; Niederberger, Uwe; Rasche, Dirk; Mehdorn, Hubertus M; Göbel, Hartmut

    2015-01-01

    Within the last years, occipital nerve stimulation (ONS) has proven to be an important method in the treatment of severe therapy-resistant neurological pain disorders. The correspondence between lead placement as well as possible stimulation parameters and the resulting stimulation effects remains unclear. The method aims to directly relate the neuromodulatory mechanisms with the clinical treatment results, to achieve insight in the mode of action of neuromodulation, to identify the most effective stimulation sets and to optimize individual treatment effects. We describe a new computer-based imaging method for mapping the spatial, cognitive and affective sensory effects of ONS. The procedure allows a quantitative and qualitative analysis of the relationship between lead positioning, the stimulation settings as well as the sensory and clinical stimulation effects. A regular mapping of stimulation and sensory parameters allows a coordinated monitoring. The stimulation results can be reviewed and compared with regards to clinical effectiveness. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. A case report of aneurysmal bone cyst in involving occipital bone

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Hae Soon; Lee, Won Hyong; Yoo, Seong Yul; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    Majority of the aneurysmal bone cyst affects tubular bones. The vertebra are also a frequent site of aneurysmal bone cyst where they are usually found as an expanding, nutiloculated new growth in the lamina or within the vertebral body. We present an aneurysmal bone cyst of cranial bone which is relatively rare. A 33 month old girl was admitted to SNUH, complaining of progressive growing occipital mass of 14 months duration. A round, rubbery, child fist sized mass was situated at the suboccipital area. The mass was not tender, nor pulsatile and bruits were not audible. Simple skull roentgenogram showed the huge, blown-out osteolytic lesion at the suboccipital area. No vascularity within the mass was noted on the right brachial angiography.

  12. Neck and Occipital Pain Caused by Deep Cervical Intramuscular Lipoma: A Surgical Case.

    Science.gov (United States)

    Kogure, Kazunari; Yamazaki, Michio; Tamaki, Tomonori; Node, Yoji; Morita, Akio

    2017-01-01

    A lipoma is a slow-growing, benign tumor and is usually asymptomatic; hence, surgical intervention can often be avoided in patients with these tumors in the cervical and cranial area. Lipomas arise most commonly in the subcutaneous fat, but occasionally in muscle tissue. Intramuscular lipomas in the cervico-cranial area have rarely been reported. We describe here a patient with a large intramuscular lipoma in the deep cervical tissue. The patient experienced troublesome pain in the neck and occipital area, and surgical treatment was therefore suggested. Particularly in the cervical area, intramuscular lipomas sometimes invade the surrounding muscles and tissue layers and develop into an irregular mass, despite being benign. In addition, the cervical area has one of the most complex muscle structures. Nevertheless, surgical management of intramuscular lipoma in the cervical and cranial area is sometimes indicated, for example, in patients with clinical symptoms or masses with a tendency to grow large.

  13. The presence of occipital hair in the pilonidal sinus cavity-a triple approach to proof.

    Science.gov (United States)

    Doll, Dietrich; Bosche, F; Hauser, A; Moersdorf, P; Sinicina, I; Grunwald, J; Reckel, F; Luedi, M M

    2018-05-01

    Hair in the pilonidal sinus is not growing within the sinus cavity, as hair follicles are not present there. Not few pilonidal patients do not have intergluteal hair, which is said to be the causative agent of folliculitis and pilonidal genesis. So, what is the real source of the hair forming the typical pilonidal hair nest? A trifold approach was used: First, axial hair strength testing of pilonidal hair and body hair harvested from head, lower back (glabella sacralis), and cranial third of intergluteal fold. Hair strength match was compared clinically. Second, comparative morphological examination by expert forensic biologist of hair from sinus and dorsal body hair. Third, statistical Bayesian classification of every single sinus hair based on its strength was done to determine the most probable region of origin. Using clinical hair strength comparison, in 13/20 patients, head hair is the stiffest hair, followed by intergluteal hair. Only in 6/20 patients, this is the case with hair from the glabella sacralis. According to comparative morphological comparison, a minimum of 5 of 13 hair nests with possible hair allocation examined contain hair from the occiput. In 5/18 nests, hair could not be determined to a specific location though. Statistical classification with correction for multiple testing shows that 2 nests have hair samples that are at least 100 times more probable to originate from head or lower back than from intergluteal fold. We saw our null hypothesis that "hair in the sinus cavity is from the intergluteal region" rejected by each of three different approaches. There is strong evidence that occipital hair is present regularly in pilonidal sinus nests. We should start thinking of occipital hair as an important hair source for the development of the pilonidal hair nest.

  14. Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report.

    Science.gov (United States)

    Vanikieti, Kavin; Poonyathalang, Anuchit; Jindahra, Panitha; Cheecharoen, Piyaphon; Chokthaweesak, Wimonwan

    2018-02-02

    Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i.e., subarachnoid hemorrhage, cerebral infarction, or carotid cavernous fistula). Moreover, concurrent presentation with posterior circulation cerebral infarction is even rarer, given different circulation territory from CCA. Here, we report on a patient with bilateral giant CCAs who presented with both typical and atypical symptoms. An 88-year-old hypertensive woman presented with acute vertical oblique binocular diplopia, followed by complete ptosis of the right eye. Ophthalmic examination showed dysfunction of the right third, fourth, and sixth cranial nerves. Further examination revealed hypesthesia of the areas supplied by the ophthalmic (V1) and maxillary (V2) branches of the right trigeminal nerve. Bilateral giant cavernous carotid aneurysms, with a concurrent subacute right occipital lobe infarction, were discovered on brain imaging and angiogram. Additionally, a prominent right posterior communicating artery (PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention. Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V 1 ) and maxillary (V 2 ) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral

  15. Timing and rate of spheno-occipital synchondrosis closure and its relationship to puberty

    Science.gov (United States)

    Vargas, Eduardo; Palomo, J. Martin; Hans, Mark; Latimer, Bruce; Simpson, Scott

    2017-01-01

    Objectives This study examines the relationship between spheno-occipital synchondrosis (SOS) closure and puberty onset in a modern American population. It also investigates the timing and the rate of SOS closure in males and females. Materials and methods The sample includes cross-sectional and longitudinal 3D Cone Beam Computed Tomography (CBCT) scans of 741 individuals (361 males and 380 females) aged 6–20 years. Each CBCT scan is visualized in the mid-sagittal plane, and the spheno-occipital synchondrosis (SOS) is scored as completely open, partially fused, mostly fused, and completely fused. The Menarche commencement is used as an indicator of puberty onset in females. Results Mean ages of open, partially-fused, mostly-fused, and completely fused SOS were 11.07, 12.95, 14.44, and 16.41 years in males, and 9.75, 11.67, 13.25, and 15.25 in females, respectively. The results show there is a significant association between the SOS closure stage and the commencement of menarche (Fisher's Exact Test p < 0.001). It was found that females had a higher SOS closure rate (38.60%) per year than males at the age of 10 years. The closure rate in males appears slower than females at age 10, but it lasts a longer time, ranging between 22 and 26% per year from age 11 to 14 years. Conclusion There is a significant relationship between puberty onset and SOS closure, suggesting its closure is at least partially affected by systemic, hormonal changes in the growing adolescent. Also, SOS closure occurs at a faster rate and at an earlier age in females compared to males. PMID:28827837

  16. Altered functional connectivity differs in stroke survivors with impaired touch sensation following left and right hemisphere lesions

    Directory of Open Access Journals (Sweden)

    Peter Goodin

    Full Text Available One in two survivors experience impairment in touch sensation after stroke. The nature of this impairment is likely associated with changes associated with the functional somatosensory network of the brain; however few studies have examined this. In particular, the impact of lesioned hemisphere has not been investigated. We examined resting state functional connectivity in 28 stroke survivors, 14 with left hemisphere and 14 with right hemisphere lesion, and 14 healthy controls. Contra-lesional hands showed significantly decreased touch discrimination. Whole brain functional connectivity (FC data was extracted from four seed regions, i.e. primary (S1 and secondary (S2 somatosensory cortices in both hemispheres. Whole brain FC maps and Laterality Indices (LI were calculated for subgroups. Inter-hemispheric FC was greater in healthy controls compared to the combined stroke cohort from the left S1 seed and bilateral S2 seeds. The left lesion subgroup showed decreased FC, relative to controls, from left ipsi-lesional S1 to contra-lesional S1 and to distributed temporal, occipital and parietal regions. In comparison, the right lesion group showed decreased connectivity from contra-lesional left S1 and bilateral S2 to ipsi-lesional parietal operculum (S2, and to occipital and temporal regions. The right lesion group also showed increased intra-hemispheric FC from ipsi-lesional right S1 to inferior parietal regions compared to controls. In comparison to the left lesion group, those with right lesion showed greater intra-hemispheric connectivity from left S1 to left parietal and occipital regions and from right S1 to right angular and parietal regions. Laterality Indices were significantly greater for stroke subgroups relative to matched controls for contra-lesional S1 (left lesion group and contra-lesional S2 (both groups. We provide evidence of altered functional connectivity within the somatosensory network, across both hemispheres, and to other

  17. Altered functional connectivity differs in stroke survivors with impaired touch sensation following left and right hemisphere lesions.

    Science.gov (United States)

    Goodin, Peter; Lamp, Gemma; Vidyasagar, Rishma; McArdle, David; Seitz, Rüdiger J; Carey, Leeanne M

    2018-01-01

    One in two survivors experience impairment in touch sensation after stroke. The nature of this impairment is likely associated with changes associated with the functional somatosensory network of the brain; however few studies have examined this. In particular, the impact of lesioned hemisphere has not been investigated. We examined resting state functional connectivity in 28 stroke survivors, 14 with left hemisphere and 14 with right hemisphere lesion, and 14 healthy controls. Contra-lesional hands showed significantly decreased touch discrimination. Whole brain functional connectivity (FC) data was extracted from four seed regions, i.e. primary (S1) and secondary (S2) somatosensory cortices in both hemispheres. Whole brain FC maps and Laterality Indices (LI) were calculated for subgroups. Inter-hemispheric FC was greater in healthy controls compared to the combined stroke cohort from the left S1 seed and bilateral S2 seeds. The left lesion subgroup showed decreased FC, relative to controls, from left ipsi-lesional S1 to contra-lesional S1 and to distributed temporal, occipital and parietal regions. In comparison, the right lesion group showed decreased connectivity from contra-lesional left S1 and bilateral S2 to ipsi-lesional parietal operculum (S2), and to occipital and temporal regions. The right lesion group also showed increased intra-hemispheric FC from ipsi-lesional right S1 to inferior parietal regions compared to controls. In comparison to the left lesion group, those with right lesion showed greater intra-hemispheric connectivity from left S1 to left parietal and occipital regions and from right S1 to right angular and parietal regions. Laterality Indices were significantly greater for stroke subgroups relative to matched controls for contra-lesional S1 (left lesion group) and contra-lesional S2 (both groups). We provide evidence of altered functional connectivity within the somatosensory network, across both hemispheres, and to other networks in stroke

  18. A case of left-sided unilateral spatial neglect owing to the cerebral infarction in the distribution of the right posterior cerebral artery

    International Nuclear Information System (INIS)

    Odagaki, Yuji; Oka, Iori; Kon, Yutaka; Asano, Yutaka

    1985-01-01

    We report a case of left-sided unilateral spatial neglect (USN) induced by the cerebral infarction in the distribution of right posterior cerebral artery (PCA). A 69-year-old, right-handed man, who had had a sudden onset of left hemiparesis in August 1983, was admitted to our hospital on January 16, 1984, because of nocturnal delirium. He became alert a few days after admission, but was euphoric and sometimes irritable. Neurologic examination disclosed left homonymous hemianopsia, dysarthria, left central facial weakness, spastic left hemiparesis, hyperactive reflexes on the left with no Babinski sign, left hemisensory loss, and left thalamic pain. On neuropsychologic examination it was revealed that he had a tendency to neglect the left half of his extrapersonal space. When asked to locate cities on a blank map of Japan, he located most of them not only on the right side of the map but also incorrectly. He also had a severe acalculia. There was gradual improvement in these neuropsychologic symptoms. CT demonstrated an area of decreased density in the territory of the right PCA, posterolateral portion of the right thalamus, and the posterior limb of right internal capsule, sparing parietal and temporal lobes. Single-photon emission computed tomography (SPECT) using the Xenon-133 inhalation method showed, however, diminished regional cerebral blood flow (rCBF) in an area larger than the area of infarction demonstrated by CT, including the right parieto-temporo-occipital junctional area, which has been considerd to be responsible for left-sided USN. The authors ascribed the patient's left-sided USN to the lesion of this area that was revealed not morphologically by CT but functionally by SPECT, although the possibility that the lesions of the medial portion of the right occipital lobe and/or subcortical lesions of such areas as the thalamus and the internal capsule more or less influenced the neuropsychologic symptoms could not be excluded. (author)

  19. Surgical Treatment for Occipital Condyle Fracture, C1 Dislocation, and Cerebellar Contusion with Hemorrhage after Blunt Head Trauma

    Directory of Open Access Journals (Sweden)

    Shigeo Ueda

    2016-01-01

    Full Text Available Occipital condyle fractures (OCFs have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT and magnetic resonance imaging (MRI. The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs. When the patient was transferred to our hospital, the occipital bone remained defective extensively due to surgical treatment of cerebellar hemorrhage. For this reason, concurrent cranioplasty was performed with resin in order to fix the occipital bone plate strongly. The resin-made occipital bone was used to secure a titanium plate and screws enabled us to perform posterior fusion of the craniovertebral junction. Although the patient wore a halo vest for 3 months after surgery, lower cranial nerve symptoms, including not only neck pain but also paralysis of the throat and larynx, improved postoperatively. No complications were detected during outpatient follow-up, which continued for 5 years postoperatively.

  20. Development of the micro-architecture and mineralization of the basilar part of the pig occipital bone

    NARCIS (Netherlands)

    Sips, R.J.A.; Mulder, L.; Koolstra, J.H.; Eijden, van T.M.G.J.

    2008-01-01

    In this study, the development of the architecture and the degree and distribution of mineralization in the basilar part of the pig occipital bone, one of the contact points between the spine and skull base, was investigated. Multiple regions of the basiocciput of pig specimens of different

  1. Comparing TMS perturbations to occipital and parietal cortices in concurrent TMS-fMRI studies-Methodological considerations

    DEFF Research Database (Denmark)

    Leitao, Joana; Thielscher, Axel; Tuennerhoff, Johannes

    2017-01-01

    the effect of transient perturbations on functional brain organization. This concurrent TMS-fMRI study applied TMS perturbation to occipital and parietal cortices with the aim to 'mimick' neglect and hemianopia. Based on the challenges and interpretational limitations of our own study we aim to provide...

  2. Working memory training in congenitally blind individuals results in an integration of occipital cortex in functional networks.

    Science.gov (United States)

    Gudi-Mindermann, Helene; Rimmele, Johanna M; Nolte, Guido; Bruns, Patrick; Engel, Andreas K; Röder, Brigitte

    2018-08-01

    The functional relevance of crossmodal activation (e.g. auditory activation of occipital brain regions) in congenitally blind individuals is still not fully understood. The present study tested whether the occipital cortex of blind individuals is integrated into a challenged functional network. A working memory (WM) training over four sessions was implemented. Congenitally blind and matched sighted participants were adaptively trained with an n-back task employing either voices (auditory training) or tactile stimuli (tactile training). In addition, a minimally demanding 1-back task served as an active control condition. Power and functional connectivity of EEG activity evolving during the maintenance period of an auditory 2-back task were analyzed, run prior to and after the WM training. Modality-specific (following auditory training) and modality-independent WM training effects (following both auditory and tactile training) were assessed. Improvements in auditory WM were observed in all groups, and blind and sighted individuals did not differ in training gains. Auditory and tactile training of sighted participants led, relative to the active control group, to an increase in fronto-parietal theta-band power, suggesting a training-induced strengthening of the existing modality-independent WM network. No power effects were observed in the blind. Rather, after auditory training the blind showed a decrease in theta-band connectivity between central, parietal, and occipital electrodes compared to the blind tactile training and active control groups. Furthermore, in the blind auditory training increased beta-band connectivity between fronto-parietal, central and occipital electrodes. In the congenitally blind, these findings suggest a stronger integration of occipital areas into the auditory WM network. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Diabetic brain or retina? Visual psychophysical performance in diabetic patients in relation to GABA levels in occipital cortex.

    Science.gov (United States)

    Sanches, Mafalda; Abuhaiba, Sulaiman I; d'Almeida, Otília C; Quendera, Bruno; Gomes, Leonor; Moreno, Carolina; Guelho, Daniela; Castelo-Branco, Miguel

    2017-06-01

    Visual impairment is one of the most feared complications of Type 2 Diabetes Mellitus. Here, we aimed to investigate the role of occipital cortex γ-aminobutyric acid (GABA) as a predictor of visual performance in type 2 diabetes. 18 type 2 diabetes patients were included in a longitudinal prospective one-year study, as well as 22 healthy age-matched controls. We collected demographic data, HbA1C and used a novel set of visual psychophysical tests addressing color, achromatic luminance and speed discrimination in both groups. Psychophysical tests underwent dimension reduction with principle component analysis into three synthetic variables: speed, achromatic luminance and color discrimination. A MEGA-PRESS magnetic resonance brain spectroscopy sequence was used to measure occipital GABA levels in the type 2 diabetes group. Retinopathy grading and retinal microaneurysms counting were performed in the type 2 diabetes group for single-armed correlations. Speed discrimination thresholds were significantly higher in the type 2 diabetes group in both visits; mean difference (95% confidence interval), [0.86 (0.32-1.40) in the first visit, 0.74 (0.04-1.44) in the second visit]. GABA from the occipital cortex predicted speed and achromatic luminance discrimination thresholds within the same visit (r = 0.54 and 0.52; p = 0.02 and 0.03, respectively) in type 2 diabetes group. GABA from the occipital cortex also predicted speed discrimination thresholds one year later (r = 0.52; p = 0.03) in the type 2 diabetes group. Our results suggest that speed discrimination is impaired in type 2 diabetes and that occipital cortical GABA is a novel predictor of visual psychophysical performance independently from retinopathy grade, metabolic control or disease duration in the early stages of the disease.

  4. OCCIPITAL SOURCES OF RESTING STATE ALPHA RHYTHMS ARE RELATED TO LOCAL GRAY MATTER DENSITY IN SUBJECTS WITH AMNESIC MILD COGNITIVE IMPAIRMENT AND ALZHEIMER’S DISEASE

    Science.gov (United States)

    Claudio, Babiloni; Claudio, Del Percio; Marina, Boccardi; Roberta, Lizio; Susanna, Lopez; Filippo, Carducci; Nicola, Marzano; Andrea, Soricelli; Raffaele, Ferri; Ivano, Triggiani Antonio; Annapaola, Prestia; Serenella, Salinari; Rasser Paul, E; Erol, Basar; Francesco, Famà; Flavio, Nobili; Görsev, Yener; Durusu, Emek-Savaş Derya; Gesualdo, Loreto; Ciro, Mundi; Thompson Paul, M; Rossini Paolo, M.; Frisoni Giovanni, B

    2014-01-01

    Occipital sources of resting state electroencephalographic (EEG) alpha rhythms are abnormal, at the group level, in patients with amnesic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Here we evaluated the hypothesis that amplitude of these occipital sources is related to neurodegeneration in occipital lobe as measured by magnetic resonance imaging (MRI). Resting-state eyes-closed EEG rhythms were recorded in 45 healthy elderly (Nold), 100 MCI, and 90 AD subjects. Neurodegeneration of occipital lobe was indexed by weighted averages of gray matter density (GMD), estimated from structural MRIs. EEG rhythms of interest were alpha 1 (8–10.5 Hz) and alpha 2 (10.5–13 Hz). EEG cortical sources were estimated by low resolution brain electromagnetic tomography (LORETA). Results showed a positive correlation between occipital GMD and amplitude of occipital alpha 1 sources in Nold, MCI and AD subjects as a whole group (r=0.3, p=0.000004, N=235). Furthermore, there was a positive correlation between amplitude of occipital alpha 1 sources and cognitive status as revealed by Mini Mental State Evaluation (MMSE) score across all subjects (r=0.38, p=0.000001, N=235). Finally, amplitude of occipital alpha 1 sources allowed a moderate classification of individual Nold and AD subjects (sensitivity: 87.8%; specificity: 66.7%; area under the Receiver Operating Characteristic (ROC) curve: 0.81). These results suggest that the amplitude of occipital sources of resting state alpha rhythms is related to AD neurodegeneration in occipital lobe along pathological aging. PMID:25442118

  5. Left-handedness and health

    Directory of Open Access Journals (Sweden)

    Milenković Sanja

    2010-01-01

    Full Text Available Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome, developmental disorders (autism, dislexia and sttutering and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about 'anomalous' cerebral domination, as a consequence of hormonal disbalance. .

  6. Aberrant internal carotid artery in the middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Keun Tak; Kang, Hyun Koo [Dept. of Radiology, Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2014-10-15

    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  7. Aberrant internal carotid artery in the middle ear

    International Nuclear Information System (INIS)

    Roh, Keun Tak; Kang, Hyun Koo

    2014-01-01

    The knowledge about the aberrant internal carotid artery (ICA) in the middle ear is essential for clinicians, because a misdiagnosis of the aberrant ICA could have serious consequences such as excessive aural bleeding during a middle ear surgery. A 38-year-old woman presented with tinnitus and hearing difficulties of the left ear that had started 5 years ago. During otoscopy, an anteroinferior bluish mass was seen in the tympanic space. Computed tomography and magnetic resonance imaging demonstrated a left-side aberrant ICA with bony dehiscence of the carotid canal in the middle ear and a reduced diameter of the tympanic ICA. Herein we report a case of an aberrant ICA in the middle ear. We also review the literature regarding this important vascular anomaly of the temporal bone which may lead to disastrous surgical complications.

  8. The association between hemispheric specialization for language production and for spatial attention depends on left-hand preference strength.

    Science.gov (United States)

    Zago, Laure; Petit, Laurent; Mellet, Emmanuel; Jobard, Gaël; Crivello, Fabrice; Joliot, Marc; Mazoyer, Bernard; Tzourio-Mazoyer, Nathalie

    2016-12-01

    Cerebral lateralization for language production and spatial attention and their relationships with manual preference strength (MPS) were assessed in a sample of 293 healthy volunteers, including 151 left-handers, using fMRI during covert sentence production (PROD) and line bisection judgment (LBJ) tasks, as compared to high- and low-level reference tasks. At the group level, we found the expected complementary hemispheric specialization (HS) with leftward asymmetries for PROD within frontal and temporal regions and rightward asymmetries for LBJ within frontal and posterior occipito-parieto-temporal regions. Individual hemispheric (HLI) and regional (frontal and occipital) lateralization indices (LI) were then calculated on the activation maps for PROD and LBJ. We found a correlation between the degree of rightward cerebral asymmetry and the leftward behavioral attentional bias recorded during LBJ task. This correlation was found when LBJ-LI was computed over the hemispheres, in the frontal lobes, but not in the occipital lobes. We then investigated whether language production and spatial attention cerebral lateralization relate to each other, and whether manual preference was a variable that impacted the complementary HS of these functions. No correlation was found between spatial and language LIs in the majority of our sample of participants, including right-handers with a strong right-hand preference (sRH, n=97) and mixed-handers (MH, n=97), indicating that these functions lateralized independently. By contrast, in the group of left-handers with a strong left-hand preference (sLH, n= 99), a negative correlation was found between language and spatial lateralization. This negative correlation was found when LBJ-LI and PROD-LI were computed over the hemispheres, in the frontal lobes and between the occipital lobes for LBJ and the frontal lobes for PROD. These findings underline the importance to include sLH in the study sample to reveal the underlying mechanisms of

  9. Dominant lymph drainage patterns in the occipital and parietal regions: evaluation of lymph nodes in patients with skin cancer of the head.

    Science.gov (United States)

    Maeda, Taku; Yamamoto, Yuhei; Furukawa, Hiroshi; Oyama, Akihiko; Funayama, Emi; Murao, Naoki; Hayashi, Toshihiko

    2017-08-01

    The purpose of this study was to evaluate the superficial lymph drainage patterns of primary skin cancers of the head arising from the occipital or parietal region. The dominant patterns of lymph drainage were retrospectively reviewed in eight patients aged 36-85 years with skin cancers in the occipital or parietal region in whom sentinel lymph node biopsy or lymph node dissection had been performed at Hokkaido University Hospital between January 1981 and December 2015. Lymph drainage was mainly to the occipital (6/8, 75%), level II (5/8, 63%), and level V lymph nodes (5/8, 63%). Of the six patients with drainage to the occipital lymph nodes, four (67%) also had drainage to level V nodes. The dominant lymph drainage pattern in patients with skin cancer arising from the occipital or parietal region was to the occipital, level II, and level V lymph nodes. Further, lymph tended to drain directly from the occipital region to the level V lymph nodes.

  10. What Is Actually Affected by the Scrambling of Objects When Localizing the Lateral Occipital Complex?

    Science.gov (United States)

    Margalit, Eshed; Biederman, Irving; Tjan, Bosco S; Shah, Manan P

    2017-09-01

    The lateral occipital complex (LOC), the cortical region critical for shape perception, is localized with fMRI by its greater BOLD activity when viewing intact objects compared with their scrambled versions (resembling texture). Despite hundreds of studies investigating LOC, what the LOC localizer accomplishes-beyond distinguishing shape from texture-has never been resolved. By independently scattering the intact parts of objects, the axis structure defining the relations between parts was no longer defined. This led to a diminished BOLD response, despite the increase in the number of independent entities (the parts) produced by the scattering, thus indicating that LOC specifies interpart relations, in addition to specifying the shape of the parts themselves. LOC's sensitivity to relations is not confined to those between parts but is also readily apparent between objects, rendering it-and not subsequent "place" areas-as the critical region for the representation of scenes. Moreover, that these effects are witnessed with novel as well as familiar intact objects and scenes suggests that the relations are computed on the fly, rather than being retrieved from memory.

  11. Benign occipital epilepsy of childhood: Panayiotopoulos syndrome in a 3 year old child

    Directory of Open Access Journals (Sweden)

    Menon Narayanankutty Sunilkumar , Vadakut Krishnan Parvathy

    2014-11-01

    Full Text Available Panayiotopoulos syndrome (PS is a relatively frequent and benign epileptic syndrome seen in children in the age group of 3-6 years and is characterised by predominantly autonomic symptoms and/or simple motor focal seizures followed or not by impairment of consciousness. Although multifocal spikes with high amplitude sharp-slow wave complexes at various locations can be present in the EEG, interictal electroencephalogram (EEG in children with this particular type of epilepsy characteristically shows occipital spikes. This syndrome has known to be a masquerader and can imitate gastroenteritis, encephalitis, syncope, migraine, sleep disorders or metabolic diseases. In the absence of thorough knowledge of types of benign epilepsy syndromes and their various clinical presentations, epilepsy such as PS can be easily missed. The peculiar aspects of this type of epilepsy in children should be known not only by paediatricians but also by general doctors because a correct diagnosis would avoid aggressive interventions and concerns on account of its benign outcome. In this case study, we report a case of PS in a 3 year old child.

  12. Cognitive dysfunctions in occipital lobe epilepsy compared to temporal lobe epilepsy.

    Science.gov (United States)

    Santangelo, Gabriella; Trojano, Luigi; Vitale, Carmine; Improta, Ilaria; Alineri, Irma; Meo, Roberta; Bilo, Leonilda

    2017-06-01

    To compare cognitive profiles of occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE) and to investigate whether impairment of visuospatial functions is a specific deficit of OLE. Eighteen patients with OLE, 18 patients with TLE, and 18 controls underwent a neuropsychological battery assessing memory, visuospatial functions, and frontal/executive functions. Multivariate analysis evidenced poorer performance of patients with TLE and patients with OLE relative to controls on tasks assessing verbal and non-verbal long-term memory, frontal functions, and visuospatial functions. Patients with OLE had poorer performance than patients with TLE on visuospatial tasks, whereas patients with TLE performed worse than patients with OLE on verbal long-term memory test. Discriminant analysis identified two canonical discriminant functions: The first explained 53.3% of the variance, and the second explained 46.7% of the variance. The first function included verbal and non-verbal memory tests distinguishing controls from both OLE and TLE, whereas the second factor including a visuoconstructional test distinguished OLE from TLE and controls. The results demonstrate that visuoconstructional dysfunction is related to OLE and support the idea that alterations of occipito-parietal stream may be specific to patients with OLE. © 2015 The British Psychological Society.

  13. Catheter placement via the occipital artery to achieve superselective intra-arterial chemotherapy for oral cancer

    International Nuclear Information System (INIS)

    Iwai, Toshinori; Mitsudo, Kenji; Fukui, Takafumi

    2008-01-01

    Superselective intra-arterial chemotherapy via the superficial temporal artery (STA) has become useful for oral cancer. However, this method can not be performed if catheter placement via the STA is impossible. Therefore, we report a surgical method for catheter placement via the occipital artery (OA) to achieve retrograde superselective intra-arterial chemotherapy. Preoperatively, three-dimensional computed tomography angiography was performed to identify the course of the external carotid artery and the relationship between OA and the target artery. Ten patients with oral cancer underwent catheter placement via the OA with Doppler ultrasound and Harmonic Scalpel under local anesthesia. Catheter placement via the OA was superselectively successful in all the patients. The mean exposure time of OA and mean operating time were 17.5 min and 70.5 min, respectively. Catheter placement via the OA is useful when catheter placement via the STA is impossible. Three-dimensional vascular mapping and the use of Doppler ultrasound and Harmonic Scalpel can shorten the surgical time. (author)

  14. Neural associations of the early retinotopic cortex with the lateral occipital complex during visual perception.

    Directory of Open Access Journals (Sweden)

    Delong Zhang

    Full Text Available Previous studies have demonstrated that the early retinotopic cortex (ERC, i.e., V1/V2/V3 is highly associated with the lateral occipital complex (LOC during visual perception. However, it remains largely unclear how to evaluate their associations in quantitative way. The present study tried to apply a multivariate pattern analysis (MVPA to quantify the neural activity in ERC and its association with that of the LOC when participants saw visual images. To this end, we assessed whether low-level visual features (Gabor features could predict the neural activity in the ERC and LOC according to a voxel-based encoding model (VBEM, and then quantified the association of the neural activity between these regions by using an analogical VBEM. We found that the Gabor features remarkably predicted the activity of the ERC (e.g., the predicted accuracy was 52.5% for a participant instead of that of the LOC (4.2%. Moreover, the MVPA approach can also be used to establish corresponding relationships between the activity patterns in the LOC and those in the ERC (64.2%. In particular, we found that the integration of the Gabor features and LOC visual information could dramatically improve the 'prediction' of ERC activity (88.3%. Overall, the present study provides new evidences for the possibility of quantifying the association of the neural activity between the regions of ERC and LOC. This approach will help to provide further insights into the neural substrates of the visual processing.

  15. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats.

    Science.gov (United States)

    Chelko, Stephen P; Schmiedt, Chad W; Lewis, Tristan H; Robertson, Tom P; Lewis, Stephen J

    2014-01-01

    This study compared the contractile responses elicited by angiotensin II (AII), arginine vasopressin (AVP), and 5-hydroxytryptamine (5-HT) in isolated occipital arteries (OAs) from sham-operated (SHAM) and 2-kidney, 1-clip (2K-1C) hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery) and distal segments (closer to the nodose ganglion) and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, heart rates, and plasma renin concentrations than SHAM rats. The contractile responses to AII were markedly diminished in both proximal and distal segments of OAs from 2K-1C rats as compared to those from SHAM rats. The responses elicited by AVP were substantially greater in distal than in proximal segments of OAs from SHAM rats and that AVP elicited similar responses in OA segments from 2K-1C rats. The responses elicited by 5-HT were similar in proximal and distal segments from SHAM and 2K-1C rats. These results demonstrate that continued exposure to circulating AII and AVP in 2K-1C rats reduces the contractile efficacy of AII but not AVP or 5-HT. The diminished responsiveness to AII may alter the physiological status of OAs in vivo.

  16. Vasopressin-induced constriction of the isolated rat occipital artery is segment dependent.

    Science.gov (United States)

    Chelko, Stephen P; Schmiedt, Chad W; Lewis, Tristan H; Lewis, Stephen J; Robertson, Tom P

    2013-01-01

    Circulating factors delivered to the nodose ganglion (NG) by the occipital artery (OA) have been shown to affect vagal afferent activity, and thus the contractile state of the OA may influence blood flow to the NG. OA were isolated and bisected into proximal and distal segments relative to the external carotid artery. Bisection highlighted stark differences between maximal contractile responses and OA sensitivity. Specifically, maximum responses to vasopressin and the V1 receptor agonist were significantly higher in distal than proximal segments. Distal segments were significantly more sensitive to 5-hydroxytryptamine (5-HT) and the 5-HT2 receptor agonist than proximal segments. Angiotensin II (AT)2, V2 and 5-HT(1B/1D) receptor agonists did not elicit vascular responses. Additionally, AT1 receptor agonists elicited mild, yet not significantly different maximal responses between segments. The results of this study are consistent with contractile properties of rat OA being mediated via AT1, V1 and 5-HT2 receptors and dependent upon the OA segment. Furthermore, vasopressin-induced constriction of the OA, regardless of a bolus dose or a first and second concentration-response curve, retained this unique segmental difference. We hypothesize that these segmental differences may be important in the regulation of blood flow through the OA in health and disease. © 2013 S. Karger AG, Basel.

  17. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats

    Directory of Open Access Journals (Sweden)

    Stephen P. Chelko

    2014-01-01

    Full Text Available This study compared the contractile responses elicited by angiotensin II (AII, arginine vasopressin (AVP, and 5-hydroxytryptamine (5-HT in isolated occipital arteries (OAs from sham-operated (SHAM and 2-kidney, 1-clip (2K-1C hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery and distal segments (closer to the nodose ganglion and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, heart rates, and plasma renin concentrations than SHAM rats. The contractile responses to AII were markedly diminished in both proximal and distal segments of OAs from 2K-1C rats as compared to those from SHAM rats. The responses elicited by AVP were substantially greater in distal than in proximal segments of OAs from SHAM rats and that AVP elicited similar responses in OA segments from 2K-1C rats. The responses elicited by 5-HT were similar in proximal and distal segments from SHAM and 2K-1C rats. These results demonstrate that continued exposure to circulating AII and AVP in 2K-1C rats reduces the contractile efficacy of AII but not AVP or 5-HT. The diminished responsiveness to AII may alter the physiological status of OAs in vivo.

  18. Vasopressin-induced constriction of the isolated rat occipital artery is segment-dependent

    Science.gov (United States)

    Chelko, Stephen P.; Schmiedt, Chad W.; Lewis, Tristan H.; Lewis, Stephen J.; Robertson, Tom P.

    2014-01-01

    Background Circulating factors delivered to the nodose ganglion (NG) by the occipital artery (OA) have shown to affect vagal afferent activity, and thus the contractile state of the OA may influence blood flow to the NG. Methods OA were isolated and bisected into proximal and distal segments, relative to the external carotid artery. Results Bisection, highlighted stark differences between maximal contractile responses and OA sensitivity. Specifically, maximum responses to vasopressin and the V1 receptor agonist, were significantly higher in distal than proximal segments. Distal segments were significantly more sensitive to 5-HT and the 5-HT2 receptor agonist than proximal segments. AT2, V2 and 5-HT1B/1D receptor agonists did not elicit vascular responses. Additionally, AT1 receptor agonists elicited mild, yet not significantly different maximal responses between segments. Conclusion The results of this study are consistent with contractile properties of rat OA being mediated via AT1, V1 and 5-HT2 receptors, and are dependent upon the OA segment. Furthermore, vasopressin-induced constriction of the OA, regardless of a bolus dose or a first and second concentration response curve retained this unique segmental difference and therefore we hypothesize this may be a pathophysiological response in the regulation of blood flow through the OA. PMID:24192548

  19. Evaluation of Posterior Hippocampal Epileptogenicity During Epilepsy Surgery For Temporal Lobe Cavernoma by the Occipital Approach.

    Science.gov (United States)

    Akiyama, Yukinori; Suzuki, Kengo; Ochi, Satoko; Miyamoto, Susumu; Mikuni, Nobuhiro

    2015-11-01

    Cavernomas frequently are associated with intractable epilepsy. When cavernomas located in the temporal lobe are associated with intractable epilepsy, the hippocampus also may have an epileptic focus. The objective in the present study was to clarify the importance of evaluation of the posterior hippocampal epileptogenicity during epilepsy surgery for posteromedial temporal lobe cavernoma. In this study, we describe 2 rare cases of medically intractable epilepsy in patients with posteromedial temporal lobe cavernomas who underwent surgery via the occipital approach. Using longitudinal insertion of depth electrodes into the hippocampus, we evaluated epileptogenicity in both patients from the cavernoma cavity and its surrounding hemosiderin, as well as from the posterior hippocampus near the cavernoma. We show that the transoccipital approach to the posteromedial temporal lobe is compatible with depth electrode insertion and subdural electrode placement on the temporal lobe, enabling an accurate evaluation of potential epileptogenic zones in the posterior part of the hippocampus. Both patients did not experience any seizures and had no postoperative neurologic deficits, and their cognitive functions were intact. The transoccipital approach enables the optimization of the extent of posterior hippocampectomy while avoiding unnecessary resection for seizure control. We suggest resecting the posterior part of the hippocampus in addition to the cavernoma and surrounding areas in patients with medically refractory epilepsy due to a posteromedial temporal cavernoma. Tailored systematic resection guided by intraoperative electrocorticography and electroencephalography with a depth electrode was important and necessary in the present cases. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Greater occipital nerve infiltration under MR guidance. Feasibility study and preliminary results

    International Nuclear Information System (INIS)

    Kastler, Adrian; Perolat, Romain; Kastler, Bruno; Maindet-Dominici, Caroline; Fritz, Jan; Benabid, Alim Louis; Chabardes, Stephan; Krainik, Alexandre

    2018-01-01

    To assess the feasibility of greater occipital nerve (GON) intermediate site infiltration with MRI guidance. Eleven consecutive patients suffering from chronic refractory cranio-facial pain who underwent 16 GON infiltrations were included in this prospective study. All of the procedures were performed on an outpatient basis in the research facility of our institution, with a 1.5 T scanner. The fatty space between inferior obliquus and semispinalis muscles at C1-C2 level was defined as the target. Technical success was defined as the ability to accurately inject the products at the target, assessed by post-procedure axial and sagittal proton density-weighted sequences. Clinical success was defined as a 50% pain decrease at 1 month. Technical success was 100%. GON was depicted in 6/11 cases on planning MRI sequences. Mean duration of procedure was 22.5 min (range 16-41). Clinical success was obtained in 7/11 included patients (63.6%) with a mean self-reported improvement of 78%. Interventional MR-guidance for GON infiltration is a feasible technique offering similar results to an already established effective procedure. It may appear as a useful tool in specific populations, such as young patients and repeat infiltrations, and should be considered in these settings. (orig.)

  1. Experienced Mindfulness Meditators Exhibit Higher Parietal-Occipital EEG Gamma Activity during NREM Sleep

    Science.gov (United States)

    Ferrarelli, Fabio; Smith, Richard; Dentico, Daniela; Riedner, Brady A.; Zennig, Corinna; Benca, Ruth M.; Lutz, Antoine; Davidson, Richard J.; Tononi, Giulio

    2013-01-01

    Over the past several years meditation practice has gained increasing attention as a non-pharmacological intervention to provide health related benefits, from promoting general wellness to alleviating the symptoms of a variety of medical conditions. However, the effects of meditation training on brain activity still need to be fully characterized. Sleep provides a unique approach to explore the meditation-related plastic changes in brain function. In this study we performed sleep high-density electroencephalographic (hdEEG) recordings in long-term meditators (LTM) of Buddhist meditation practices (approximately 8700 mean hours of life practice) and meditation naive individuals. We found that LTM had increased parietal-occipital EEG gamma power during NREM sleep. This increase was specific for the gamma range (25–40 Hz), was not related to the level of spontaneous arousal during NREM and was positively correlated with the length of lifetime daily meditation practice. Altogether, these findings indicate that meditation practice produces measurable changes in spontaneous brain activity, and suggest that EEG gamma activity during sleep represents a sensitive measure of the long-lasting, plastic effects of meditative training on brain function. PMID:24015304

  2. The occipital face area is causally involved in the formation of identity-specific face representations.

    Science.gov (United States)

    Ambrus, Géza Gergely; Dotzer, Maria; Schweinberger, Stefan R; Kovács, Gyula

    2017-12-01

    Transcranial magnetic stimulation (TMS) and neuroimaging studies suggest a role of the right occipital face area (rOFA) in early facial feature processing. However, the degree to which rOFA is necessary for the encoding of facial identity has been less clear. Here we used a state-dependent TMS paradigm, where stimulation preferentially facilitates attributes encoded by less active neural populations, to investigate the role of the rOFA in face perception and specifically in image-independent identity processing. Participants performed a familiarity decision task for famous and unknown target faces, preceded by brief (200 ms) or longer (3500 ms) exposures to primes which were either an image of a different identity (DiffID), another image of the same identity (SameID), the same image (SameIMG), or a Fourier-randomized noise pattern (NOISE) while either the rOFA or the vertex as control was stimulated by single-pulse TMS. Strikingly, TMS to the rOFA eliminated the advantage of SameID over DiffID condition, thereby disrupting identity-specific priming, while leaving image-specific priming (better performance for SameIMG vs. SameID) unaffected. Our results suggest that the role of rOFA is not limited to low-level feature processing, and emphasize its role in image-independent facial identity processing and the formation of identity-specific memory traces.

  3. Augmenting distractor filtering via transcranial magnetic stimulation of the lateral occipital cortex.

    Science.gov (United States)

    Eštočinová, Jana; Lo Gerfo, Emanuele; Della Libera, Chiara; Chelazzi, Leonardo; Santandrea, Elisa

    2016-11-01

    Visual selective attention (VSA) optimizes perception and behavioral control by enabling efficient selection of relevant information and filtering of distractors. While focusing resources on task-relevant information helps counteract distraction, dedicated filtering mechanisms have recently been demonstrated, allowing neural systems to implement suitable policies for the suppression of potential interference. Limited evidence is presently available concerning the neural underpinnings of these mechanisms, and whether neural circuitry within the visual cortex might play a causal role in their instantiation, a possibility that we directly tested here. In two related experiments, transcranial magnetic stimulation (TMS) was applied over the lateral occipital cortex of healthy humans at different times during the execution of a behavioral task which entailed varying levels of distractor interference and need for attentional engagement. While earlier TMS boosted target selection, stimulation within a restricted time epoch close to (and in the course of) stimulus presentation engendered selective enhancement of distractor suppression, by affecting the ongoing, reactive instantiation of attentional filtering mechanisms required by specific task conditions. The results attest to a causal role of mid-tier ventral visual areas in distractor filtering and offer insights into the mechanisms through which TMS may have affected ongoing neural activity in the stimulated tissue. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Atypical Balance between Occipital and Fronto-Parietal Activation for Visual Shape Extraction in Dyslexia

    Science.gov (United States)

    Zhang, Ying; Whitfield-Gabrieli, Susan; Christodoulou, Joanna A.; Gabrieli, John D. E.

    2013-01-01

    Reading requires the extraction of letter shapes from a complex background of text, and an impairment in visual shape extraction would cause difficulty in reading. To investigate the neural mechanisms of visual shape extraction in dyslexia, we used functional magnetic resonance imaging (fMRI) to examine brain activation while adults with or without dyslexia responded to the change of an arrow’s direction in a complex, relative to a simple, visual background. In comparison to adults with typical reading ability, adults with dyslexia exhibited opposite patterns of atypical activation: decreased activation in occipital visual areas associated with visual perception, and increased activation in frontal and parietal regions associated with visual attention. These findings indicate that dyslexia involves atypical brain organization for fundamental processes of visual shape extraction even when reading is not involved. Overengagement in higher-order association cortices, required to compensate for underengagment in lower-order visual cortices, may result in competition for top-down attentional resources helpful for fluent reading. PMID:23825653

  5. Greater occipital nerve infiltration under MR guidance. Feasibility study and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Kastler, Adrian; Perolat, Romain [Grenoble Alpes University Hospital, Neuroradiology and MRI Unit, Grenoble (France); CLINATEC Research Facility, LETI, CEA Grenoble (France); Kastler, Bruno [Paris V University, Adult Radiology Department, Necker Hospital, Paris (France); Maindet-Dominici, Caroline [Grenoble Alpes University Hospital, Pain Management Unit, Grenoble (France); Fritz, Jan [The Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Benabid, Alim Louis [CLINATEC Research Facility, LETI, CEA Grenoble (France); Chabardes, Stephan [CLINATEC Research Facility, LETI, CEA Grenoble (France); Grenoble Alpes University Hospital, Neurosurgery Unit, Grenoble (France); Krainik, Alexandre [Grenoble Alpes University Hospital, Neuroradiology and MRI Unit, Grenoble (France)

    2018-02-15

    To assess the feasibility of greater occipital nerve (GON) intermediate site infiltration with MRI guidance. Eleven consecutive patients suffering from chronic refractory cranio-facial pain who underwent 16 GON infiltrations were included in this prospective study. All of the procedures were performed on an outpatient basis in the research facility of our institution, with a 1.5 T scanner. The fatty space between inferior obliquus and semispinalis muscles at C1-C2 level was defined as the target. Technical success was defined as the ability to accurately inject the products at the target, assessed by post-procedure axial and sagittal proton density-weighted sequences. Clinical success was defined as a 50% pain decrease at 1 month. Technical success was 100%. GON was depicted in 6/11 cases on planning MRI sequences. Mean duration of procedure was 22.5 min (range 16-41). Clinical success was obtained in 7/11 included patients (63.6%) with a mean self-reported improvement of 78%. Interventional MR-guidance for GON infiltration is a feasible technique offering similar results to an already established effective procedure. It may appear as a useful tool in specific populations, such as young patients and repeat infiltrations, and should be considered in these settings. (orig.)

  6. Bidirectional electric communication between the inferior occipital gyrus and the amygdala during face processing.

    Science.gov (United States)

    Sato, Wataru; Kochiyama, Takanori; Uono, Shota; Matsuda, Kazumi; Usui, Keiko; Usui, Naotaka; Inoue, Yushi; Toichi, Motomi

    2017-09-01

    Faces contain multifaceted information that is important for human communication. Neuroimaging studies have revealed face-specific activation in multiple brain regions, including the inferior occipital gyrus (IOG) and amygdala; it is often assumed that these regions constitute the neural network responsible for the processing of faces. However, it remains unknown whether and how these brain regions transmit information during face processing. This study investigated these questions by applying dynamic causal modeling of induced responses to human intracranial electroencephalography data recorded from the IOG and amygdala during the observation of faces, mosaics, and houses in upright and inverted orientations. Model comparisons assessing the experimental effects of upright faces versus upright houses and upright faces versus upright mosaics consistently indicated that the model having face-specific bidirectional modulatory effects between the IOG and amygdala was the most probable. The experimental effect between upright versus inverted faces also favored the model with bidirectional modulatory effects between the IOG and amygdala. The spectral profiles of modulatory effects revealed both same-frequency (e.g., gamma-gamma) and cross-frequency (e.g., theta-gamma) couplings. These results suggest that the IOG and amygdala communicate rapidly with each other using various types of oscillations for the efficient processing of faces. Hum Brain Mapp 38:4511-4524, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. Ontogeny of the spheno-occipital synchondrosis in a modern Queensland, Australian population using computed tomography.

    Science.gov (United States)

    Lottering, Nicolene; MacGregor, Donna M; Alston, Clair L; Gregory, Laura S

    2015-05-01

    Due to disparity regarding the age at which skeletal maturation of the spheno-occipital synchondrosis occurs in forensic and biological literature, this study provides recalibrated multislice computed tomography (MSCT) age standards for the Australian (Queensland) population, using a Bayesian statistical approach. The sample comprises retrospective cranial/cervical MSCT scans obtained from 448 males and 416 females aged birth to 20 years from the Skeletal Biology and Forensic Anthropology Research Osteological Database. Fusion status of the synchondrosis was scored using a modified six-stage scoring tier on an MSCT platform, with negligible observer error (κ = 0.911 ± 0.04, intraclass correlation coefficient = 0.994). Bayesian transition analysis indicates that females are most likely to transition to complete fusion at 13.1 years and males at 15.6 years. Posterior densities were derived for each morphological stage, with complete fusion of the synchondrosis attained in all Queensland males over 16.3 years of age and females aged 13.8 years and older. The results demonstrate significant sexual dimorphism in synchondrosis fusion and are suggestive of intrapopulation variation between major geographic regions in Australia. This study contributes to the growing repository of contemporary anthropological standards calibrated for the Queensland milieu to improve the efficacy of the coronial process for medicolegal death investigation. As a stand-alone age indicator, the basicranial synchondrosis may be consulted as an exclusion criterion when determining the age of majority that constitutes 17 years in Queensland forensic practice. © 2014 Wiley Periodicals, Inc.

  8. The vertical occipital fasciculus: A century of controversy resolved by in vivo measurements

    Science.gov (United States)

    Yeatman, Jason D.; Weiner, Kevin S.; Pestilli, Franco; Rokem, Ariel; Mezer, Aviv; Wandell, Brian A.

    2014-01-01

    The vertical occipital fasciculus (VOF) is the only major fiber bundle connecting dorsolateral and ventrolateral visual cortex. Only a handful of studies have examined the anatomy of the VOF or its role in cognition in the living human brain. Here, we trace the contentious history of the VOF, beginning with its original discovery in monkey by Wernicke (1881) and in human by Obersteiner (1888), to its disappearance from the literature, and recent reemergence a century later. We introduce an algorithm to identify the VOF in vivo using diffusion-weighted imaging and tractography, and show that the VOF can be found in every hemisphere (n = 74). Quantitative T1 measurements demonstrate that tissue properties, such as myelination, in the VOF differ from neighboring white-matter tracts. The terminations of the VOF are in consistent positions relative to cortical folding patterns in the dorsal and ventral visual streams. Recent findings demonstrate that these same anatomical locations also mark cytoarchitectonic and functional transitions in dorsal and ventral visual cortex. We conclude that the VOF is likely to serve a unique role in the communication of signals between regions on the ventral surface that are important for the perception of visual categories (e.g., words, faces, bodies, etc.) and regions on the dorsal surface involved in the control of eye movements, attention, and motion perception. PMID:25404310

  9. First-drug treatment failures in 42 Turkish children with idiopathic childhood occipital epilepsies.

    Science.gov (United States)

    Incecik, Faruk; Herguner, Ozlem M; Altunbasak, Sakir

    2015-01-01

    The early and late benign occipital epilepsies of childhood (BOEC) are described as two discrete electro-clinical syndromes, eponymously known as Panayiotopoulos and Gastaut syndromes. The purpose of this study was to identify predictors of failure to respond to the initial antiepileptic drug (AED). A total of 42 children with BOEC were enrolled. Predictive factors were analyzed by survival methods. Among the 42, 25 patients (59.5%) were boys and 17 (40.5%) were girls and the mean age at the seizure onset was 7.46 ± 2.65 years (4-14 years). Of the 42 patients, 34 (81.0%) were treated relatively successfully with the first AED treatment, and 8 (19.0%) were not responded initial AED treatment. There was no correlation between response to initial AED treatment and sex, consanguinity, epilepsy history of family, age of seizure onset, frequency of seizures, history of status epilepticus, duration of starting first treatment, findings on electroencephalogram. However, history of febrile seizure and type of BOEC were significantly associated with failure risk. Factors predicting failure to respond to the AED were history of febrile seizure and type of BOEC in children with BOEC.

  10. MRI in occipital lobe infarcts: classification by involvement of the striate cortex

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, M. [Department of Radiology, Kumamoto University School of Medicine, Kumamoto (Japan)]|[Department of Radiology, Kumamoto Rousai Hospital, Kumamoto (Japan); Korogi, Y.; Takahashi, M. [Department of Radiology, Kumamoto University School of Medicine, Kumamoto (Japan); Kido, T.; Ikeda, O.; Morishita, S. [Department of Radiology, Kumamoto Rousai Hospital, Kumamoto (Japan)

    1998-11-01

    We reviewed the MRI studies of 25 patients with occipital lobe infarcts to clarify the distribution of infarcts in the posterior cerebral arterial territory, focussing on their relationship to the striate cortex. Visual field defects and MRI findings were also correlated in 16 patients. On coronal and/or sagittal images, the distribution of the infarct and its relationship to the striate cortex were classified. Involvement of the cortex of both upper and lower lips of the calcarine fissure was observed in 10 patients, and involvement of the lower lip alone in 15. The upper cortical lesions were always accompanied by lower cortical lesions. The visual field defects were complete hemianopia in nine patients, superior quadrantanopia in six and hemianopia with a preserved temporal crescent in one. All patients with superior quadrantanopia had involvement of the lower cortex alone; there were no cases of inferior quadrantanopia. The characteristic vascular anatomy, and poor development of the collateral circulation in the lower cortical area, may explain the vulnerability of this area to infarcts. (orig.) With 6 figs., 21 refs.

  11. Synaptic proteome changes in the superior frontal gyrus and occipital cortex of the alcoholic brain.

    Science.gov (United States)

    Etheridge, Naomi; Lewohl, Joanne M; Mayfield, R Dayne; Harris, R Adron; Dodd, Peter R

    2009-06-24

    Cognitive deficits and behavioral changes that result from chronic alcohol abuse are a consequence of neuropathological changes which alter signal transmission through the neural network. To focus on the changes that occur at the point of connection between the neural network cells, synaptosomal preparations from post-mortem human brain of six chronic alcoholics and six non-alcoholic controls were compared using 2D-DIGE. Functionally affected and spared regions (superior frontal gyrus, SFG, and occipital cortex, OC, respectively) were analyzed from both groups to further investigate the specific pathological response that alcoholism has on the brain. Forty-nine proteins were differentially regulated between the SFG of alcoholics and the SFG of controls and 94 proteins were regulated in the OC with an overlap of 23 proteins. Additionally, the SFG was compared to the OC within each group (alcoholics or controls) to identify region specific differences. A selection were identified by MALDI-TOF mass spectrometry revealing proteins involved in vesicle transport, metabolism, folding and trafficking, and signal transduction, all of which have the potential to influence synaptic activity. A number of proteins identified in this study have been previously related to alcoholism; however, the focus on synaptic proteins has also uncovered novel alcoholism-affected proteins. Further exploration of these proteins will illuminate the mechanisms altering synaptic plasticity, and thus neuronal signaling and response, in the alcoholic brain.

  12. First-drug treatment failures in 42 Turkish children with idiopathic childhood occipital epilepsies

    Directory of Open Access Journals (Sweden)

    Faruk Incecik

    2015-01-01

    Full Text Available Background: The early and late benign occipital epilepsies of childhood (BOEC are described as two discrete electro-clinical syndromes, eponymously known as Panayiotopoulos and Gastaut syndromes. The purpose of this study was to identify predictors of failure to respond to the initial antiepileptic drug (AED. Materials and Methods: A total of 42 children with BOEC were enrolled. Predictive factors were analyzed by survival methods. Results: Among the 42, 25 patients (59.5% were boys and 17 (40.5% were girls and the mean age at the seizure onset was 7.46 ± 2.65 years (4-14 years. Of the 42 patients, 34 (81.0% were treated relatively successfully with the first AED treatment, and 8 (19.0% were not responded initial AED treatment. There was no correlation between response to initial AED treatment and sex, consanguinity, epilepsy history of family, age of seizure onset, frequency of seizures, history of status epilepticus, duration of starting first treatment, findings on electroencephalogram. However, history of febrile seizure and type of BOEC were significantly associated with failure risk. Conclusions: Factors predicting failure to respond to the AED were history of febrile seizure and type of BOEC in children with BOEC.

  13. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  14. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...... becomes clear from the analytical chapters is the emergence of the new cross-ideological alliance of The New Regressive Left. This emerging coalition between Shia Muslims, religious minorities, parts of the Arab Left, secular cultural producers, and the remnants of the political,strategic resistance...

  15. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  17. Apraxia in left-handers.

    Science.gov (United States)

    Goldenberg, Georg

    2013-08-01

    In typical right-handed patients both apraxia and aphasia are caused by damage to the left hemisphere, which also controls the dominant right hand. In left-handed subjects the lateralities of language and of control of the dominant hand can dissociate. This permits disentangling the association of apraxia with aphasia from that with handedness. Pantomime of tool use, actual tool use and imitation of meaningless hand and finger postures were examined in 50 consecutive left-handed subjects with unilateral hemisphere lesions. There were three aphasic patients with pervasive apraxia caused by left-sided lesions. As the dominant hand is controlled by the right hemisphere, they constitute dissociations of apraxia from handedness. Conversely there were also three patients with pervasive apraxia caused by right brain lesions without aphasia. They constitute dissociations of apraxia from aphasia. Across the whole group of patients dissociations from handedness and from aphasia were observed for all manifestations of apraxia, but their frequency depended on the type of apraxia. Defective pantomime and defective tool use occurred rarely without aphasia, whereas defective imitation of hand, but not finger, postures was more frequent after right than left brain damage. The higher incidence of defective imitation of hand postures in right brain damage was mainly due to patients who had also hemi-neglect. This interaction alerts to the possibility that the association of right hemisphere damage with apraxia has to do with spatial aptitudes of the right hemisphere rather than with its control of the dominant left hand. Comparison with data from right-handed patients showed no differences between the severity of apraxia for imitation of hand or finger postures, but impairment on pantomime of tool use was milder in apraxic left-handers than in apraxic right-handers. This alleviation of the severity of apraxia corresponded with a similar alleviation of the severity of aphasia as

  18. Vascular complications (splenic and hepatic artery aneurysms) in the occipital horn syndrome: report of a patient and review of the literature

    International Nuclear Information System (INIS)

    Mentzel, H.-J.; Seidel, J.; Vogt, L.; Vogt, S.; Kaiser, W.A.

    1999-01-01

    We report an 18-year-old boy with occipital horn syndrome who developed aneurysms of the splenic and hepatic arteries. Occipital horn syndrome, also called X-linked cutis laxa or Ehlers-Danlos syndrome (EDS) type IX, is characterised by a skeletal dysplasia which includes occipital horns, broad clavicles, deformed radii, ulnae and humeri, narrow rib cage, undercalcified long bones and coxa valga. Distinctive features common to all patients are unusual facial appearance, hypermobility of finger joints, limitation of extension of elbows, chronic diarrhoea and genitourinary abnormalities. In this case report we describe the difficulties encountered in the diagnostic management of patients with EDS-related vascular lesions. (orig.)

  19. Right colon cancer: Left behind.

    Science.gov (United States)

    Gervaz, P; Usel, M; Rapiti, E; Chappuis, P; Neyroud-Kaspar, I; Bouchardy, C

    2016-09-01

    Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC. We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation. Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Atlanto-occipital fusion and spondylolisthesis in an Anasazi skeleton from Bright Angel Ruin, Grand Canyon National Park, Arizona.

    Science.gov (United States)

    Merbs, C F; Euler, R C

    1985-08-01

    The skeleton of a middle-aged female showing an unusual pattern of congenital, traumatic, and degenerative pathology was recovered from a small Kayenta Anasazi site located near the confluence of Bright Angel Creek with the Colorado River in the Inner Gorge of Grand Canyon. The atlas is fused with the base of the skull and C2 is fused with C3. The cervical region was subjected to hyperextension, perhaps through use of a tumpline, with resultant reduction of the neural canal to 8 mm, a condition that quite likely led to neurological problems. The skeleton also includes a depression fracture of the lateral condyle of the left tibia. Complete, bilateral spondylolysis of L5 led to an olisthesis of approximately 15 mm. The disc between L5 and S1 then ossified, most likely from staphylococcus bacteremia, making the olisthesis permanent and thereby creating a unique arachaeological specimen. Although spondylolysis is usually viewed as a stress fracture, the general pattern of pathology in this individual makes it necessary to consider an etiology of acute trauma.

  1. Parieto-occipital hypoperfusion in late whiplash syndrome: first quantitative SPET study using technetium-99m bicisate (ECD)

    International Nuclear Information System (INIS)

    Otte, A.; Ettlin, T.; Fierz, L.; Mueller-Brand, J.

    1996-01-01

    Brain single-photon emission tomography (SPET) with N,N''-1,2-ethylene-diylbis-L-cysteine diethyl ester dihydrochloride (ECD) was performed on ten patients with a clinically high grade late whiplash syndrome and on 11 controls. Two independent readers blinded to the clinical diagnosis were able to separate the ten patients from normal controls. All these patients had qualitative bilateral parieto-occipital hypoperfusion. To confirm this, the perfusion rate of parieto-occipital over global (perfusion index) was calculated after drawing elliptical regions of interest in transversal-oblique slices. The perfusion indices in patients were significantly lower than in controls as tested by the Mann-Whitney U test. This quantitative study proves our recent qualitatively analysed observation. (orig./MG)

  2. Parieto-occipital hypoperfusion in late whiplash syndrome: first quantitative SPET study using technetium-99m bicisate (ECD)

    Energy Technology Data Exchange (ETDEWEB)

    Otte, A. [Inst. of Nuclear Medicine, Univ. Hospital Basel (Switzerland); Ettlin, T. [Rehabilitation Clinic, Rheinfelden (Switzerland); Fierz, L.; Mueller-Brand, J.

    1996-01-01

    Brain single-photon emission tomography (SPET) with N,N``-1,2-ethylene-diylbis-L-cysteine diethyl ester dihydrochloride (ECD) was performed on ten patients with a clinically high grade late whiplash syndrome and on 11 controls. Two independent readers blinded to the clinical diagnosis were able to separate the ten patients from normal controls. All these patients had qualitative bilateral parieto-occipital hypoperfusion. To confirm this, the perfusion rate of parieto-occipital over global (perfusion index) was calculated after drawing elliptical regions of interest in transversal-oblique slices. The perfusion indices in patients were significantly lower than in controls as tested by the Mann-Whitney U test. This quantitative study proves our recent qualitatively analysed observation. (orig./MG)

  3. Multifocal epilepsy: the role of palliative resection - intractable frontal and occipital lobe epilepsy secondary to radiotherapy for acute lymphoblastic leukaemia.

    Science.gov (United States)

    Radhakrishnan, Ashalatha; Sithinamsuwan, Pasiri; Harvey, A Simon; Flanagan, Danny; Fitt, Gregory; Berlangieri, Sam; Jackson, Graeme D; Berkovic, Samuel F; Scheffer, Ingrid E

    2008-12-01

    Patients with multifocal epilepsy are often considered unsuitable for epilepsy surgery. We report an adolescent with intractable frontal and occipital lobe seizures, secondary to complications of treatment for acute lymphoblastic leukaemia as a young child. Chemotherapy and radiotherapy were complicated by bilateral, posterior leukoencephalopathy and later an acquired frontal cerebral cavernous malformation (CCM). Detailed electro-clinical and imaging studies showed multiple, frontal lobe seizures per day with less frequent and non-debilitating, simple, occipital lobe seizures. Focal resection of the frontal CCM abolished the socially-disabling seizures with resultant marked improvement in the patient's quality of life at 12 months. Careful analysis of the type and impact of focal seizures in the setting of multifocal epilepsy may demonstrate that one seizure type is more deleterious to quality of life and may be amenable to surgery. In this situation, the patient may benefit significantly from surgery to resect the more active epileptic focus.

  4. MRI of the tectorial and posterior atlanto-occipital membranes in the late stage of whiplash injury

    Energy Technology Data Exchange (ETDEWEB)

    Krakenes, J.; Moen, G.; Nordli, H.; Rorvik, J. [Department of Radiology, University of Bergen and Haukeland University Hospital, 5021, Bergen (Norway); Kaale, B.R. [Firda Medical Centre, 6823, Sandane (Norway); Gilhus, N.E. [Department of Neurology, University of Bergen and Haukeland University Hospital, 5021, Bergen (Norway)

    2003-09-01

    Our aim was to characterise and classify permanent structural changes in the tectorial and posterior atlanto-occipital membranes several years after a whiplash injury, and to evaluate the reliability of our classification. We obtained sagittal proton density-weighted images of the craniovertebral junction of 92 whiplash-injured and 30 uninjured individuals. Structural abnormalities in the two membranes were classified as grades 1-3 independently by three radiologists blinded for clinical information. Grading criteria were based on reduced tectorial membrane thickness, and elongation or rupture of the posterior atlanto-occipital membrane/dura mater complex. The same images were reassessed 4 months later. Image quality was graded good in 104 cases, slightly reduced in 13 and unsatisfactory in five. Of 117 tectorial membranes 31 (26.5%) showed grade 2 or 3 lesions, in the uninjured group none were grade 3 and only three were grade 2. Pair-wise interobserver agreement (weighted kappa) was moderate (0.47-0.50), while the intraobserver agreement was moderate to good (0.51-0.70). Of 117 posterior atlanto-occipital membranes 20 (17.1%) had grade 2 or 3 lesions; there was no grade 3 and only one grade 2 lesion in the uninjured group. Inter- and intraobserver agreement was good (0.61-0.74 and 0.65-0.86, respectively). Reduced image quality was the main reason for disagreement, but partial thinning and lateral tapering, as normal tectorial membrane variations, created difficulties in some cases. This study strongly indicates that whiplash trauma can damage the tectorial and posterior atlanto-occipital membranes; this can be shown on high-resolution MRI. Better knowledge of normal anatomical variations and improved image quality should increase the reliability of lesion classification. (orig.)

  5. Subcomponents and Connectivity of the Inferior Fronto-Occipital Fasciculus Revealed by Diffusion Spectrum Imaging Fiber Tracking

    OpenAIRE

    Wu, Yupeng; Sun, Dandan; Wang, Yong; Wang, Yibao

    2016-01-01

    The definitive structure and functional role of the inferior fronto-occipital fasciculus (IFOF) are still controversial. In this study, we aimed to investigate the connectivity, asymmetry, and segmentation patterns of this bundle. High angular diffusion spectrum imaging (DSI) analysis was performed on 10 healthy adults and a 90-subject DSI template (NTU-90 Atlas). In addition, a new tractography approach based on the anatomic subregions and two regions of interest (ROI) was evaluated for the ...

  6. Atlanto-axial approach for cervical myelography in a Thoroughbred horse with complete fusion of the atlanto-occipital bones

    Science.gov (United States)

    Aleman, Monica; Dimock, Abigail N.; Wisner, Erik R.; Prutton, Jamie W.; Madigan, John E.

    2014-01-01

    A 2-year-old Thoroughbred gelding with clinical signs localized to the first 6 spinal cord segments (C1 to C6) had complete fusion of the atlanto-occipital bones which precluded performing a routine myelogram. An ultrasound-assisted myelogram at the intervertebral space between the atlas and axis was successfully done and identified a marked extradural compressive myelopathy at the level of the atlas and axis, and axis and third cervical vertebrae. PMID:25392550

  7. An adult case of the developmental apraxia, agnosia, Gerstmann's syndrome with bilateral parieto-temporo-occipital lesions in brain CT

    International Nuclear Information System (INIS)

    Suzuki, Toshihito; Shiraishi, Hiroyasu; Koizumi, Junzo; Ichikawa, Tadahiko; Hayakawa, Tatsuo.

    1986-01-01

    A 36-year-old woman with a history of cerebral meningitis had various neuropsychological disorders, such as Gerstmann's syndrome, developmental apraxia and agnosia and difficulty in reading, in addition to moderate mental retardation and epileptoid. Cranial CT showed bilateral low-density areas with temporo-parieto-occipital extension. It seems that these lesions result from meningitis and are responsible for the occurrence of neuropsychological disorders. (Namekawa, K.)

  8. MRI of the tectorial and posterior atlanto-occipital membranes in the late stage of whiplash injury

    International Nuclear Information System (INIS)

    Krakenes, J.; Moen, G.; Nordli, H.; Rorvik, J.; Kaale, B.R.; Gilhus, N.E.

    2003-01-01

    Our aim was to characterise and classify permanent structural changes in the tectorial and posterior atlanto-occipital membranes several years after a whiplash injury, and to evaluate the reliability of our classification. We obtained sagittal proton density-weighted images of the craniovertebral junction of 92 whiplash-injured and 30 uninjured individuals. Structural abnormalities in the two membranes were classified as grades 1-3 independently by three radiologists blinded for clinical information. Grading criteria were based on reduced tectorial membrane thickness, and elongation or rupture of the posterior atlanto-occipital membrane/dura mater complex. The same images were reassessed 4 months later. Image quality was