The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

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Rusch, V.W.; Griffin, B.R.; Livingston, R.B. (Univ. of Washington, Seattle (USA))

1989-10-01

Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted.

Asymptomatic cystic changes in the brain of children after cranial irradiation: frequency, latency, and relationship to age

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Kitajima, Mika; Hirai, Toshinori; Maruyama, Natsuki; Yamura, Masayuki; Hayashida, Yoshiko; Baba, Yuji; Yamashita, Yasuyuki; Murakami, Ryuji; Korogi, Yukunori; Nakamura, Hideo; Kuratsu, Jun-ichi

2007-01-01

Although radiation therapy plays an important role in the management of children with brain tumors, radiation-induced brain damage sometimes occurs after radiation therapy. In some pediatric patients who had undergone cranial radiation therapy, we noticed cystic changes in the brain on follow-up MRI. The purpose of this study was to determine the frequency, latency, relationship with patient age, radiation dose, and serial change in the cystic changes in children after cranial irradiation. We retrospectively studied MRI in 33 children who had undergone cranial irradiation for their primary brain tumors. Postirradiation cystic change in the brain on follow-up MRI was defined as a well-demarcated, oval-shaped, CSF-like signal intensity area, and no contrast enhancement. Of the 33 patients, 6 (18.2%) had one or more cystic lesions. The latency of the cystic changes ranged from 1.5 to 7 years (mean 2.6 years). Cystic changes were found in the subcortical, periventricular and other deep white matter and the basal ganglia. The size of the lesions ranged from 1 to 10 mm at their first appearance; eight cystic lesions increased in size. None the cystic lesions reduced in size or resolved with time and none required intervention. All patients with cystic changes had received irradiation when they were 6 years of age or younger. The cystic changes occurred within the radiation field in patients treated with a radiation dose of 36 Gy or more. Asymptomatic brain parenchymal cystic changes appear to occur in children who have undergone cranial irradiation at 6 years of age or younger. (orig.)

Menstrual restoration in severe panhypopituitarism many years after cranial irradiation for suprasellar germinoma.

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Ito, Masanobu; Iwamoto, Ichiro; Hirano, Hirofumi; Douchi, Tsutomu

2015-07-01

We report a very rare case showing menstrual restoration in severe pan-hypopituitarism many years after cranial irradiation for suprasellar germinoma. A 30-year-old, almost primarily amenorrheic woman with severe panhypopituitarism presented with cyclic genital bleeding for the previous five months. She had menstruated once, when she was 13 years old. When she was 14 years old, she was diagnosed with a suprasellar germinoma measuring 10 mm in diameter, which led to diabetes insipidus. Cranial irradiation with a total dose of 24 Gy and chemotherapy resulted in complete tumor remission. She developed severe hypopituitarism [luteinizing hormone (LH) = 0.4 mIU/mL, follicle-stimulating hormone (FSH) = 1.7 mIU/mL, and serum estradiol (E2) level panhypopituitarism after cranial irradiation. A relatively low dose of irradiation and small tumor size may have contributed to the recovery of menstruation in our patient.

A novel variant of growth hormone (GH) insufficiency following low dose cranial irradiation

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Crowne, E.C.; Moore, C.; Wallace, W.H.B.; Ogilvy-Stuart, A.L.; Addison, G.M.; Morris-Jones, P.H.; Shalet, S.M. (Christie Hospital, Manchester (United Kingdom) Royal Manchester Children' s Hospital (United Kingdom))

1992-01-01

We aimed to investigate the effect of low dose (1800 cGy) prophylactic cranial irradiation on physiological growth hormone secretion. Forty-four children were studied, of whom 21 were long-term survivors of acute lymphoblastic leukaemia and 23 were normal children. In the normal children, there was a significant increase in the median (range) area under the curve (AUC) of the GH profile between the prepubertal and pubertal groups. There was also a change in the spectral analysis through puberty. The dominant frequencies were spread widely in the prepubertal and post-pubertal groups but sharply focused in the pubertal group. In the cranially irradiated children there was no significant increase in AUC between the prepubertal and pubertal groups. The wide range of dominant frequencies persisted in the pubertal cranially irradiated group due to the presence of additional high frequency pulses. The impression of a disturbance of the periodicity of GH secretion in the cranially irradiated pubertal group was further supported by the finding that the autocorrelation function in this group alone was not significantly different from that which would arise from random data. A novel form of GH insufficiency has been observed after low dose irradiation in childhood in which an abnormality of periodicity and a quantitative reduction in GH secretion appears restricted to puberty. (author).

Cognitive effects of chemotherapy and/or cranial irradiation in adults

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Welzel, G.; Wenz, F.; Steinvorth, S.

2005-01-01

Background: cognitive effects after cranial radiotherapy are widely discussed, but there is growing evidence that chemotherapy may also induce changes in neuropsychological functioning. This review summarizes the published literature regarding cognitive functioning after cancer therapy in adult patients. Material and methods: 63 reports from January 1980 to July 2003 assessing objective cognitive effects of irradiation and/or chemotherapy by neuropsychologic evaluation were analyzed. 57 studies with 3,424 patients were included for evaluation. Results: the results of this review confirm that both chemotherapy and irradiation can result in cognitive deficits. No clinically relevant differences are found for cognitive deficits, cognitive impairment rate, and single cognitive domains, when chemotherapy, cranial irradiation and combined radio- and chemotherapy were compared. Only 28 trials with 1,000 patients report quantitative data on patients with cognitive deficits after therapy. There are 44.1% (range 18-75%) of 451 patients in the chemotherapy group, 44.0% (range 29-83%) of 320 patients in the radiotherapy group, and 64.5% (range 30-100%) of 229 patients in the combined irradiation and chemotherapy group with cognitive deficits. Furthermore, cognitive functioning below average before chemo- or radiotherapy is found in subgroups of cancer patients. Conclusion: there is evidence of cognitive impairment in adult tumor patients after chemotherapy similar to effects after cranial irradiation. Cognitive functioning below average before therapy may be due to paraneoplastic effects. More prospective studies with a long-term follow-up using standardized neuropsychometric testing, assessment of premorbid intelligence, and suited control groups are needed. (orig.)

A prospective evaluation of hippocampal radiation dose volume effects and memory deficits following cranial irradiation.

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Ma, Ting Martin; Grimm, Jimm; McIntyre, Riley; Anderson-Keightly, Heather; Kleinberg, Lawrence R; Hales, Russell K; Moore, Joseph; Vannorsdall, Tracy; Redmond, Kristin J

2017-11-01

To prospectively evaluate hippocampal radiation dose volume effects and memory decline following cranial irradiation. Effects of hippocampal radiation over a wide range of doses were investigated by combining data from three prospective studies. In one, adults with small cell lung cancer received hippocampal-avoidance prophylactic cranial irradiation. In the other two, adults with glioblastoma multiforme received neural progenitor cell sparing radiation or no sparing with extra dose delivered to subventricular zone. Memory was measured by the Hopkins Verbal Learning Test-Revised Delayed Recall (HVLT-R DR) at 6 months after radiation. Dose-volume histograms were generated and dose-response data were fitted to a nonlinear model. Of 60 patients enrolled, 30 were analyzable based on HVLT-R DR testing completion status, baseline HVLT-R DR and intracranial metastasis/recurrence or prior hippocampal resection status. We observed a dose-response of radiation to the hippocampus with regard to decline in HVLT-R DR. D50% of the bilateral hippocampi of 22.1 Gy is associated with 20% risk of decline. This prospective study demonstrates an association between hippocampal dose volume effects and memory decline measured by HVLT-R DR over a wide dose range. These data support a potential benefit of hippocampal sparing and encourage continued trial enrollment. Copyright © 2017 Elsevier B.V. All rights reserved.

High-dose radiation-induced meningioma following prophylactic cranial irradiation for acute lymphoblastic leukaemia

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Matsuda, Ryosuke; Nikaido, Yuji; Yamada, Tomonori; Mishima, Hideaki; Tamaki, Ryo

2005-01-01

A 12 year-old girl was treated with prophylactic cranial irradiation for acute lymphoblastic leukaemia (ALL). At the age of 39, she was admitted to our hospital for status epilepticus. Computed tomography demonstrated two, enhancing bilateral sided intracranial tumors. After surgery, this patient presented meningiomas which histologically, were of the meningothelial type. The high cure rate in childhood ALL, attributable to aggressive chemotherapy and prophylactic cranial irradiation, is capable of inducing secondary brain tumor. Twelve cases of high-dose radiation-induced meningioma following ALL are also reviewed. (author)

High-dose radiation-induced meningioma following prophylactic cranial irradiation for acute lymphoblastic leukaemia

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Matsuda, Ryosuke; Nikaido, Yuji; Yamada, Tomonori; Mishima, Hideaki; Tamaki, Ryo [National Hospital Organization Osaka Minami Medical Center, Kawachinagano (Japan)

2005-03-01

A 12 year-old girl was treated with prophylactic cranial irradiation for acute lymphoblastic leukaemia (ALL). At the age of 39, she was admitted to our hospital for status epilepticus. Computed tomography demonstrated two, enhancing bilateral sided intracranial tumors. After surgery, this patient presented meningiomas which histologically, were of the meningothelial type. The high cure rate in childhood ALL, attributable to aggressive chemotherapy and prophylactic cranial irradiation, is capable of inducing secondary brain tumor. Twelve cases of high-dose radiation-induced meningioma following ALL are also reviewed. (author)

Risk factors of conventional irradiation-induced lower cranial neuropathy in patients with nasopharyngeal carcinoma

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Pan Jianji; Hong Jinsheng; Zhang Yu

2006-01-01

Objective: To study the risk factors of radiation-induced lower cranial neuropathy (RILCN) after conventional radiotherapy in patients with nasopharyngeal carcinoma, and to improve the radiotherapeutic planning. Methods: A hundred cases received radical radiotherapy of nasopharyngeal carcinoma and 200 individual matched controls on sex, age and time to start the radiotherapy were studied. Conditional logistic regression model was used to analyze 13 risk factors related to development of RILCN. Results: Conditional logistic regression analysis revealed that cigarette smoking, irradiation scheme, radiation close to the superior neck, neck fibrosis and acute radiation-related dermatitis of neck were risk factors of RILCN, their relative risks were 4.594, 2.629, 1.072, 4.141 and 2.531, respectively. Among three external irradiation schemes, it is found that pre-auricular portal plus whole neck tangential portal irradiation had the highest risk of RILCN. Conclusions: The study suggested that the irradiation scheme of pre-auricular portal plus whole neck tangential portal should be no longer used. (authors)

Cranial irradiation in children with lymphoblastic acute leukemia: results and damages

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Cecchetti, E.; Brandoli, V.

1979-01-01

From 1973 to 1976, 81 children with lymphoblastic acute leukemia were treated with cranial prophylactic irradiation at the Istituto di Radioterapia ''L. Galvani'' del'Universita di Bologna. We divided the patients into 6 groups according to different characteristics. At the beginning of 1978 the survival rate was 82%; 60 patients (74%) were in complete continuous remission. We studied the encephalic post irradiation syndrome that is present in children over 2 years of age only when doses are higher than 2500 rad and in children under 2 years of age when doses exceed 2000 rad. This complication occurs frequently in the experience of other authors; however, it is absent under certain doses with which it is possible to obtain the same good results. We feel that among the different techniques and methods, the best radiological treatment is daily bilateral cranial irradiation for patients early in remission; we recommend doses of 2400 rad for children above 2 years of age and 1950 rad for those under 2 years

Scattered dose to thyroid from prophylactic cranial irradiation during childhood: a Monte Carlo study

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Mazonakis, Michalis; Tzedakis, Antonis; Damilakis, John; Varveris, Haris; Kachris, Stefanos; Gourtsoyiannis, Nicholas

2006-01-01

The purpose of this study was to estimate the scattered dose to thyroid from prophylactic cranial irradiation during childhood. The MCNP transport code and mathematical phantoms representing the average individual at ages 3, 5, 10, 15 and 18 years old were employed to simulate cranial radiotherapy using two lateral opposed fields. The mean radiation dose received by the thyroid gland was calculated. A 10 cm thick lead block placed on the patient's couch to shield the thyroid was simulated by MCNP code. The Monte Carlo model was validated by measuring the scattered dose to the unshielded and shielded thyroid using three different humanoid phantoms and thermoluminescense dosimetry. For a cranial dose of 18 Gy, the thyroid dose obtained by Monte Carlo calculations varied from 47 to 79 cGy depending upon the age of the child. Appropriate placement of the couch block resulted in a thyroid dose reduction by 39 to 54%. Thyroid dose values at all possible positions of the radiosensitive gland with respect to the inferior field edge at five different patient ages were found. The mean difference between Monte Carlo results and thyroid dose measurements was 9.6%. (note)

Pituitary dysfunction in adult patients after cranial irradiation for head and nasopharyngeal tumours

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Appelman-Dijkstra, Natasha M.; Malgo, Frank; Neelis, Karen J.; Coremans, Ida; Biermasz, Nienke R.; Pereira, Alberto M.

2014-01-01

Background: Pituitary insufficiency after radiotherapy in the hypothalamic pituitary region is a well-known complication. However, endocrine assessments are not incorporated in the follow-up after cranial irradiation for head and neck tumours. Aim of the study: To evaluate pituitary function in patients cranially irradiated for non-pituitary tumours. Patients and methods: Evaluation of pituitary function in all available patients treated at our centre with cranial radiotherapy for head and neck tumours. Results: We included 80 patients. Forty patients were treated for cerebral tumours, 15 for nasopharyngeal tumours, and 25 for different tumours like meningioma or cerebral metastasis. Mean age was 47.5 (18.6–89.7) years. Mean radiation dose delivered at the pituitary region was 56.27 Gy (40.0–70.0). Pituitary insufficiency was present in 16 patients within 2 years after irradiation 23/49 patients (47%) after 5 years and 27/45 (60%) after 10 years and 31/35 patients (89%) after 15 years. Conclusion: Pituitary insufficiency is highly prevalent in adult patients treated with cranial radiotherapy for head and nasopharyngeal tumours. These prevalence rates are comparable to those observed after radiotherapy for pituitary tumours. Because hormone replacement of endocrine deficits improves quality of life and prevents potential severe complications, such as Addisonian crises, periodical evaluation of pituitary function is advocated

Secondary intracranial meningiomas after high-dose cranial irradiation: report of five cases and review of the literature

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Strojan, Primoz; Popovic, Mara; Jereb, Berta

2000-01-01

Purpose: To review cases of secondary intracranial meningiomas following high-dose cranial irradiation (≥ 10 Gy) identified in Slovenia between 1968 and 1998, to determine their histological profile and to review the literature on this topic. Methods and Materials: Personal files of patients treated for secondary intracranial meningioma during a 31-year period were reviewed. In cases which met the criteria for radiation-induced tumors, steroid hormone receptor and Ki-67 status were analyzed. For the literature review, computerized database systems and reference lists from respective publications were used. Results: Five patients (2 females, 3 males), 3-11 years old at the time of cranial irradiation, developed secondary meningioma after a latency period of 9.5-31.5 years. Three patients had multiple tumors and 2 developed recurrent disease. Of 9 histologically examined tumors, 5 were graded as benign and 4 as atypical meningiomas, with Ki-67 proliferative index 3.2 ± 3.6 and 10 ± 6, respectively. The ratio between positive and negative meningiomas regarding immunostaining for progesterone and estrogen receptors was eight-to-one and six-to-three, respectively. Cumulative actuarial risk of secondary meningioma in a cohort of 445 children 16 years or younger treated with high-dose cranial irradiation between 1968 and 1990 in Slovenia at 10, 20, and 25 years was 0.53%, 1.2%, and 8.18%, respectively. Out of 126 cases of radiation-induced meningiomas reported, 57% were females and 43% were males, with mean age at presentation 33 ± 17.3 years. The majority (68%) of patients was irradiated during childhood. The latency period was significantly shorter in those who aged 5 years or less at the time of cranial irradiation (p = 0.04), and in those with atypical/anaplastic tumor (p = 0.01). Correlation between radiation dose and latency period could not be found. Conclusion: Secondary meningiomas following high-dose cranial irradiation are characterized by younger age at

Cranial irradiation of young rats impairs later learning and growth

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Overmier, J.B.; Carroll, M.E.; Patten, R.; Krivit, W.; Kim, T.H.

1979-01-01

Young rats (26 days) were exposed to ionizing radiation of the head of 0, 1200, 2400 or 3000 rads total in 200 rads/day doses. The subsequent growth of irradiated rats was permanently impaired: such impairment was positively related to amount of irradiation. Beginning in adolescence, rats were trained on a horizontal/vertical visual discrimination in a runway task and although all four groups mastered the discrimination, they differed in their patterns of acquisition. These results indicated long term effects and are associated with a cranial irradiation regimen similar to that given to children suffering acute lymphocytic leukemia (ALL). (author)

Endocrinologic complications of cranial irradiation. Complications endocriniennes de l'irradiation cranienne

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Brauner, R.; Rappaport, R. (Hopital des Enfants Malades 75 - Paris (FR))

1989-09-01

Cranial irradiation has become one of the leading causes of growth hormone (GH) deficiency. The risk and time of onset of GH deficiency depend mainly on the dose delivered to the hypothalamo-pituitary region: GH deficiency is infrequent after doses under 20 grays and nearly constant after doses above 45 grays. For a given dose, a younger age at the time of irradiation and administration of the dose over a shorter time period increase the risk of GH deficiency. GH secretion can be adequately evaluated using rapid stimulation tests and is usually well correlated with growth, except in patients with radiation-induced precocious puberty or growth delay due to radiation-induced cartilage lesions.

A case of acute lymphoblastic leukemia with abnormal brain CT scan after cranial irradiation for central nervous system leukemia

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Sato, Junko; Abe, Takanori; Watanabe, Tsutomu

1988-01-01

A 21-year-old woman with acute lymphoblastic leukemia presented with central neurologic symptoms immediately after the second irradiation (20 Gy to the brain and 10 Gy to the spinal cord) for central nervous system (CNS)-leukemia 3 years and 2 months after the first cranial irradiation with 20 Gy. White matter was depicted as diffusely high density area on CT; histology revealed necrosis of leukemic cells. In the present patient with repeated recurrent CNS-leukemia, leukemic cells seemed to have been damaged simultaneously after irradiation because of parenchymal widespread involvement of leukemic cells, resulting in brain edema, an increased intracranial pressure and parenchymal disturbance. This finding may have an important implication for the risk of cranial irradiation in the case of widespread involvement of leukemic cells. Re-evaluation of cranial irradiation in such cases is suggested. (Namekawa, K.)

Early effects of cranial irradiation on hypothalamic-pituitary function

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Lam, K.S.; Tse, V.K.; Wang, C.; Yeung, R.T.; Ma, J.T.; Ho, J.H.

1987-01-01

Hypothalamic-pituitary function was studied in 31 patients before and after cranial irradiation for nasopharyngeal carcinoma. The estimated radiotherapy (RT) doses to the hypothalamus and pituitary were 3979 +/- 78 (+/- SD) and 6167 +/- 122 centiGrays, respectively. All patients had normal pituitary function before RT. One year after RT, there was a significant decrease in the integrated serum GH response to insulin-induced hypoglycemia. In the male patients, basal serum FSH significantly increased, while basal serum LH and testosterone did not change. Moreover, in response to LHRH, the integrated FSH response was increased while that of LH was decreased. Such discordant changes in FSH and LH may be explained by a defect in LHRH pulsatile release involving predominantly a decrease in pulse frequency. The peak serum TSH response to TRH became delayed in 28 patients, suggesting a defect in TRH release. Twenty-one patients were reassessed 2 yr after RT. Their mean basal serum T4 and plasma cortisol levels had significantly decreased. Hyperprolactinemia associated with oligomenorrhoea was found in 3 women. Further impairment in the secretion of GH, FSH, LH, TSH, and ACTH had occurred, and 4 patients had hypopituitarism. Thus, progressive impairment in hypothalamic-pituitary function occurs after cranial irradiation and can be demonstrated as early as 1 yr after RT

Practice guideline on prophylactic cranial irradiation in small-cell lung cancer

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Kotalik, Jaro; Yu, Edward; Markman, Barbara R.; Evans, William K.

2001-01-01

Purpose: To develop an evidence-based clinical practice guideline that would address the following questions: (a) What is the role of prophylactic cranial irradiation (PCI) in patients with limited or extensive stage small-cell lung cancer (SCLC) who have achieved complete remission in response to induction therapy (chemotherapy or chemoradiotherapy)? (b) What dose and fractionation schedules of PCI are optimal? (c) Does the use of PCI in patients with SCLC in complete remission affect quality of life? Survival, disease-free survival, quality of life, and adverse effects were the outcomes of interest. Methods and Materials: A systematic review of the published literature was undertaken to provide the data for an evidence-based practice guideline. Results: Six randomized controlled trials and one fully published individual patient data meta-analysis were included in the systematic review of the evidence. For patients who have achieved complete response after induction therapy, there is evidence of a disease-free survival benefit (4 of 6 trials) and an overall survival benefit (meta-analysis). There is insufficient evidence to make a definitive recommendation with respect to dose. There is some indication that 30-36 Gy in 2-3 Gy per fraction, or a biologically equivalent dose, may produce a better outcome than a lower dose or less aggressive fractionation regimen. The schedule commonly used in Canada is 25 Gy in 10 fractions over 2 weeks. Data from further research, including a trial currently ongoing that compares 25 Gy in 10 fractions with 36 Gy in 18 fractions, will be required to determine optimal dose of PCI. There is insufficient evidence to make recommendations concerning the optimal timing of PCI in relation to the administration of chemotherapy. Lung DSG members generally felt that it should be given as soon as possible after completion of chemotherapy. There is evidence from trials with data for up to 2 years of follow-up that prophylactic cranial

Cranial radiotherapy predisposes to abdominal adiposity in survivors of childhood acute lymphocytic leukemia

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Siviero-Miachon, Adriana Aparecida; Spinola-Castro, Angela Maria; Lee, Maria Lúcia de Martino; Andreoni, Solange; Geloneze, Bruno; Lederman, Henrique; Guerra-Junior, Gil

2013-01-01

Advances in treatment of acute lymphocytic leukemia increased the likelihood of developing late treatment-associated effects, such as abdominal adiposity, increasing the risk of cardiovascular disease in this population. Cranial radiotherapy is one of the factors that might be involved in this process. The aim of this study was to determine the effect of cranial radiotherapy on adiposity indexes in survivors of acute lymphocytic leukemia. A comparative cross-sectional study of 56 acute lymphocytic leukemia survivors, chronological age between 15 and 24 years, assigned into two groups according to the exposure to cranial radiotherapy (25 irradiated and 31 non-irradiated), assessed according to body fat (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, lipid profile, and insulin resistance. Cranial radiotherapy increased body fat and abdominal adipose tissue and altered lipid panel. Yet, lipids showed no clinical relevance so far. There were significantly more obese patients among those who received cranial radiotherapy (52% irradiated versus 22.6% non-irradiated), based on dual energy X-ray absorptiometry body fat measurements. Nonetheless, no association was observed between cranial radiotherapy and body mass index, waist circumference, waist-to-height ratio or insulin resistance. Adolescent and young adult survivors of childhood acute lymphocytic leukemia showed an increase in body fat and an alteration of fat distribution, which were related to cranial radiotherapy. Fat compartment modifications possibly indicate a disease of adipose tissue, and cranial radiotherapy imports in this process

Cytogenetic effects of chemotherapy and cranial irradiation on the peripheral blood lymphocytes of children with malignant disease

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Fischer, P; Vetterlein, M; Pohl-Rueling, J; Krepler, P

1977-01-01

Results of a cytogenetic analysis of peripheral blood lymphocytes of children with leukemia after massive chemotherapy and cranial irradiation, and of children with nephrosis after cortisone therapy and cyclophosphamide are presented. Prolonged intensive chemotherapy results in a significant rise in the number of chromatid aberrations after twelve months, and of chromosomal aberrations after 24 months of therapy. After cranial irradiation a sharp rise in chromosome aberrations is present for about three months. This drops after one year to levels present in cases with chemotherapy alone.

Neuropsychological study in patients with ALL. Two different CNS prevention therapies--cranial irradiation plus IT methotrexate vs. IT methotrexate alone

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Pavlovsky, S.; Fisman, N.; Arizaga, R.; Castano, J.; Chamoles, N.; Leiguarda, R.; Moreno, R.

1983-01-01

Neurological, psychopedagogic, and psychologic long-term sequelae were evaluated in two groups of ALL patients in continuous CR for more than 2 years treated with two different CNS prophylaxis schemes. Group A, 19 patients received cranial irradiation 2400 rads plus IT MTX-DMT, and group B, 23 patients IT MTX-DMT only during induction and maintenance. All the patients were evaluated by performing neurological examination, EEG, EMG with nerve conduction velocity, CT scans, CSF studies, psychometric and psychologic studies, and neuropsychological evaluation. The most important findings were: 11 patients from group A (58%) showed abnormal CT and only one patient from group B showed CT abnormalities. The neuropsychologic evaluation (performed by L. Bender technique and Picq-Vayer scale) showed more severe impairment (grade 3-4) in eight patients from group A (42%) and none in group B (p less than 0.001). Higher incidence of abnormalities in group A suggests the existence of more severe sequelae in the patients treated with cranial irradiation plus IT MTX-DMT than with IT MTX-DMT alone

Cranial irradiation in patients with brain metastasis. A retrospective study of timing

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Ampil, F.L.; Burton, G.V.; Mills, G.M.

1999-01-01

A retrospective study was conducted to determine the importance of the interval between diagnosis of brain metastasis (BRM) and cranial irradiation (CI). The charts of 92 patients with a known diagnosis of cancer and suspected BRM as shown on radioimaging studies were reviewed retrospectively. The median interval between diagnosis and the onset of CI for BRM was five days; one group of 48 individuals received CI within an interval of five days, and another group of 44 patients after an interval of five days. Symptom palliation, objective responses to CI and survival were evaluated in both groups. Neither symptomatic and objective responses to treatment nor overall survival differed significantly between the patient groups. These observations suggest that while CI is beneficial to most patients with BRM, its timing after the diagnosis of BRM may not seriously affect patient outcome. (author)

Organ and Effective Dose Coefficients for Cranial and Caudal Irradiation Geometries: Neutrons

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Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.; Hiller, M. M.

2017-09-01

With the introduction of new recommendations by ICRP Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors, and the introduction of reference sex-specific computational phantoms (ICRP Publication 110). Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT), and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for neutron irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue absorbed doses for caudal and cranial exposures to neutrons ranging in energy from 10-9 MeV to 10 GeV have been performed using the MCNP6 radiation transport code and the adult reference voxel phantoms of ICRP Publication 110. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above about 30 MeV the cranial and caudal values are greater.

[Anti-emetic effect of granisetron in patients undergoing cranial and craniospinal radiotherapy].

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Yamasaki, Fumiyuki; Watanabe, Yosuke; Nosaka, Ryo; Kenjo, Masahiro; Nakamura, Kazuhiro; Takayasu, Takeshi; Saito, Taiichi; Tominaga, Atsushi; Sugiyama, Kazuhiko; Kurisu, Kaoru

2014-01-01

Approximately 30-59% of patients undergoing cranial or craniospinal radiotherapy experience nausea and/or vomiting. Here, we evaluated the effectiveness of granisetron for controlling emesis in patients treated with cranial or craniospinal radiotherapy. Between December 2011 and January 2013, 34 patients(19 males, 15 females;age range, 3-80 years)received cranial or craniospinal radiotherapy at our department. All but one male patient, who developed meningitis during the irradiation period were enrolled in this retrospective study. Patients who experienced irradiation-induced vomiting(grade 1)or nausea(grade 2)were treated with granisetron as a rescue anti-emetic. Episodes were graded as(1)no vomiting, no nausea, no anti-emetic;(2)no vomiting, nausea, no anti-emetic;(3)no vomiting, nausea with anti-emetic;and(4)vomiting. Of the 9 patients who underwent whole-brain or whole neural-axis irradiation, 5(55.6%)experienced grade 2 nausea or vomiting. Two of 6 patients(33.3%)treated with whole ventricle irradiation experienced grade 2 nausea or vomiting. Three of 18 patients(16.7%)who underwent local-field irradiation experienced grade 2 nausea or vomiting. Patients who underwent wide-field irradiation experienced nausea, vomiting, and anorexia(pgranisetron. Four of 9 patients(44.4%)treated with granisetron experienced constipation(grade 1 or 2);its administration had no major adverse effects in our study population. Rescue therapy with granisetron is safe and effective to treat nausea and vomiting in patients subjected to cranial or craniospinal irradiation.

Organ and effective dose coefficients for cranial and caudal irradiation geometries: photons

International Nuclear Information System (INIS)

Veinot, K.G.; Eckerman, K.F.; Hertel, N.E.

2016-01-01

With the introduction of new recommendations of the International Commission on Radiological Protection (ICRP) in Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors and the introduction of reference sex-specific computational phantoms. Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT) and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for photon irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue kerma and absorbed doses for caudal and cranial exposures to photons ranging in energy from 10 keV to 10 GeV have been performed using the MCNP6.1 radiation transport code and the adult reference phantoms of ICRP Publication 110. As with calculations reported in ICRP 116, the effects of charged-particle transport are evident when compared with values obtained by using the kerma approximation. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above ∼30 MeV the cranial and caudal values are greater. (authors)

Prophylactic CNS therapy in childhood leukemia. Randomized controlled study of high-dose intravenous methotrexate and cranial irradiation

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Yokoyama, Takashi; Hiyoshi, Yasuhiko [Kurume Univ., Fukuoka (Japan). School of Medicine; Fujimoto, Takeo

1982-12-01

This study was designed to evaluate the efficacy of CNS-prophylaxis with high-dose methotrexate (MTX). Seventy children with previously untreated acute lymphoblastic leukemia (ALL) entered to this study between July 1978 and December 1980. According to initial white blood count (WBC), they were stratified to induce remission with; vincristine and prednine in low initial WBC ( lt 25,000/mm/sup 3/) group and these two agents plus adriamycin in high initial WBC ( gt 25,000/mm/sup 3/) group. After inducing remission, 62 children who achieved CR, received different CNS-prophlaxis; using a regimen of three doses of weekly high-dose MTX (1,000 mg/m/sup 2/) 6-hour infusion, which was repeated every 12 weeks-Group A (n = 14); high-dose MTX followed by 2400 rad cranial irradiation plus three doses of i.t. MT X-Group B (n = 15), 2400 rad cranial irradiation plus three doses of i.t. MTX-Group C (n = 16), and in 17 patients with high initial WBC, same as in Group A-Group D (n = 17). During an intravenous 6-h infusion of MTX at a dose of 1,000 mg/m/sup 2/, the CSF concentration of MTX rose to 2.3 +- 2.4 x 10/sup -6/M after initiation of infusion and remained in 10/sup -7/ M level for 48 hours. CNS-leukemia terminated complete remission in one of 14 children in Group A, two of 15 in Group B, two of 16 in Group C and two of 17 in Group D. The cumulative incidence of CNS-leukemia at 20 months calculated by the technique of Kaplan and Meier was 0% in Group A, 18.1% in Group B, 7.1% in Group C and 50.8% in Group D. There was no statistical difference among Groups A, B and C. These data suggested that CNS-prophylaxis with high-dose intravenous MTX was effective as well as 2400 rad cranial irradiation plus three doses of i.t. MTX in childhood ALL with low initial WBC.

Anti-emetic effect of granisetron in patients undergoing cranial and craniospinal radiotherapy

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Yamasaki, Fumiyuki; Watanabe, Yosuke; Nosaka, Ryo

2014-01-01

Approximately 30-59% of patients undergoing cranial or craniospinal radiotherapy experience nausea and/or vomiting. Here, we evaluated the effectiveness of granisetron for controlling emesis in patients treated with cranial or craniospinal radiotherapy. Between December 2011 and January 2013, 34 patients (19 males, 15 females; age range, 3-80 years) received cranial or craniospinal radiotherapy at our department. All but one male patient, who developed meningitis during the irradiation period were enrolled in this retrospective study. Patients who experienced irradiation-induced vomiting (grade 1) or nausea (grade 2) were treated with granisetron as a rescue anti-emetic. Episodes were graded as no vomiting, no nausea, no anti-emetic; no vomiting, nausea, no anti-emetic; no vomiting, nausea with anti-emetic; and vomiting. Of the 9 patients who underwent whole-brain or whole neural-axis irradiation, 5 (55.6%) experienced grade 2 nausea or vomiting. Two of 6 patients (33.3%) treated with whole ventricle irradiation experienced grade 2 nausea or vomiting. Three of 18 patients (16.7%) who underwent local-field irradiation experienced grade 2 nausea or vomiting. Patients who underwent wide-field irradiation experienced nausea, vomiting, and anorexia (p<0.05). Complete response (no vomiting, no additional rescue anti-emetic, and no nausea) was observed in 5 of 9 patients treated with granisetron. Four of 9 patients (44.4%) treated with granisetron experienced constipation (grade 1 or 2); its administration had no major adverse effects in our study population. Rescue therapy with granisetron is safe and effective to treat nausea and vomiting in patients subjected to cranial or craniospinal irradiation. (author)

Neurologic, neuropsychologic, and computed cranial tomography scan abnormalities in 2- to 10-year survivors of small-cell lung cancer.

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Johnson, B E; Becker, B; Goff, W B; Petronas, N; Krehbiel, M A; Makuch, R W; McKenna, G; Glatstein, E; Ihde, D C

1985-12-01

In order to evaluate the relationship between neurologic function and cranial irradiation, 20 patients treated on National Cancer Institute (NCI) small-cell lung cancer (SCLC) trials who were alive and free of cancer 2.4 to 10.6 years (median, 6.2) from the start of therapy were studied. All were tested with a neurologic history and examination, mental status examination, neuropsychologic testing, and review of serial computed cranial tomography (CCT) scans. Fifteen patients had been treated with prophylactic cranial irradiation (PCI), two patients with therapeutic cranial irradiation, and three received no cranial irradiation. All patients but one were ambulatory and none were institutionalized. Fifteen patients (75%) had neurologic complaints, 13 (65%) had abnormal neurologic examinations, 12 (60%) had abnormal mental status examinations, 13 (65%) had abnormal neuropsychologic testing, and 15 (75%) had abnormal CCT scans. Compared with those given low-dose maintenance chemotherapy during PCI using 200 to 300 rad per fraction, patients who were given high-dose induction chemotherapy during the time of cranial irradiation or large radiotherapy fractions (400 rad) were more likely to have abnormal mental status examinations (6/6 v 4/9) and abnormal neuropsychologic tests (6/6 v 4/9), but no major difference in CCT findings was present. CCT scans in the majority of cases (11/18) showed progressive ventricular dilatation or cerebral atrophy up to 8 years after stopping therapy. We conclude neurologic abnormalities are common in long-term survivors of SCLC, and may be more prominent in patients given high-dose chemotherapy during cranial irradiation or treated with large radiotherapy fractions. The CCT scan abnormalities are common and progressive years after prophylactic cranial irradiation and chemotherapy are stopped.

Prophylactic cranial irradiation in small cell lung cancer: a single institution experience.

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Naidoo, J; Kehoe, M; Sasiadek, W; Hacking, D; Calvert, P

2014-03-01

Prophylactic cranial irradiation (PCI) is used to prevent the development of brain metastases in small cell lung carcinoma. PCI confers an overall survival (OS) benefit in both limited and extensive stage disease. We analyze the incidence of symptomatic brain metastases, progression-free survival (PFS) and OS in a cohort of patients who received PCI, in a 5-year period. A retrospective review of all patients who had received PCI between 2006 and 2011 at the Whitfield Clinic was completed. Patient- and disease-related characteristics, the number of patients who developed brain metastases, PFS and OS data were collected. 24 patients were identified. 14 (58.3 %) patients were male, 10 (41.7 %) were female, with a mean age of 62.5 years (range 31-78). All patients were smokers. 12 (50 %) patients had limited stage small cell lung cancer (SCLC), 12 (50 %) had extensive stage disease. 2 (8.2 %) patients developed brain metastases post PCI (p = 0.478.) The median PFS for limited stage SCLC was 13 months (range 3-20) and 10 months (range 5-18) for extensive stage SCLC. Median OS was 15 months (range 4-29) in limited stage SCLC, and 11 months (range 5-29) in extensive stage SCLC. Our study demonstrated a low incidence of symptomatic brain metastases and favourable median PFS and OS in the patients that received PCI, when compared to published phase III data.

Cranial nerve damage in patients after alpha (heavy)-particle radiation to the pituitary

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Price, J.; Wei, W.C.; Chong, C.Y.

1979-01-01

The records of 161 patients were reviewed to determine if radiation damage had occurred following cranial irradiation. All of these patients had received alpha-particle radiation to their pituitary glands for diabetic retinopathy. Extraocular muscle palsy developed in 11 of these patients, iridoplegia in six, and fifth nerve damage in six. All of the palsies developed within a short period following their irradiation, and a definite dose relationship was present. The estimated doses to the third, fourth, fifth, and sixth cranial nerves was calculated at a saggital plane 13 to 15 mm from the pituitary by using computer-drawn dosimetry charts for the respective aperture size

Intracerebral cavernous hemangioma after cranial irradiation in childhood. Incidence and risk factors

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Strenger, V.; Sovinz, P.; Lackner, H.; Dornbusch, H.J.; Moser, A.; Urban, C. [Graz Medical Univ. (Austria). Div. of Pediatric Hematology and Oncology; Lingitz, H. [Graz Medical Univ. (Austria). Dept. of Therapeutic Radiology and Oncology; Eder, H.G. [Graz Medical Univ. (Austria). Dept. of Neurosurgery

2008-05-15

Background and Purpose: Radiotherapy is an integral part of various therapeutic regimens in pediatric and adult oncology. Endocrine dysfunction, neurologic and psychiatric deficits, secondary malignancies and radiation-induced necrosis are well-known possible late effects of cranial irradiation. However, only sporadic cases of radiation-induced cavernous hemangiomas (RICH) have been reported so far. Patients and Methods: Pediatric patients who underwent cranial radiation therapy for malignant diseases between January 1980 and December 2003 were retrospectively analyzed. After the end of therapy they entered a detailed follow-up program. Results: Of 171 patients, eight (three patients with medulloblastoma, three patients with acute lymphoblastic leukemia, and one patient each with ependymoma and craniopharyngioma) developed intracerebral cavernoma 2.9-18.4 years after irradiation representing a cumulative incidence (according to the Kaplan-Meier method) of 2.24%, 3.86%, 4.95%, and 6.74% within 5, 10, 15, and 20 years following radiation therapy, respectively. In patients treated in the first 10 years of life, RICH occurred with shorter latency and significantly more often (p = 0.044) resulting in an even higher cumulative incidence. Conclusion: These findings and previously published cases show that cavernous hemangiomas may occur after irradiation of the brain several years after the end of therapy irrespective of the radiation dose and type of malignancy. Particularly children < 10 years of age at the time of irradiation are at higher risk. Since patients with RICH frequently do not show symptoms but hemorrhage is a possible severe complication, imaging of the central nervous system should be performed routinely for longer follow- ups, particularly in patients who were treated as young children. (orig.)

Minimizing and measuring lens dose when giving cranial irradiation

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Woo, S.Y.; Donaldson, S.S.; Heck, R.J.; Nielson, K.L.; Shostak, C.

1989-01-01

Three different techniques of administering cranial irradiation were used to determine the dose to the lens as measured in the Rando phantom. The techniques employed were as follows: (1) the central axis of the radiation beam was placed at the thickest portion of the cranium; (2) the central axis of the radiation beam was placed at the lateral orbital rim (bon canthus); (3) the central axis of the radiation beam was placed at the thickest portion of the cranium but with the beam angled 5deg posteriorly away from the eye. Thermal luminescent dosimeters (TLD) were placed in a phantom, at a point determined from a life-sized anatomical section of the plane through the midsection of the eye, to be at the location of the posterior capsule of the lens. In addition, TLDs were placed on the outer surface of the phantom head, directly lateral to the location determined to be where the lens would lie. With equally weighted lateral opposed beams, delivering a midplane dose of 200cGy, the TLDs at the point of the lens measured 21, 9.9 and 10.6% of the midplane doses from the three techniques respectively. TLDs placed directly lateral to the lens on the surface of the phantom head gave an approximation of the lens dose, particularly when techniques 2 and 3 were used. Isodose curve generated by a General Electric treatment planning computer gave lens doses similar to those of the phantom data for each of the three different radiotherapy techniques. Cranial irradiation should be carried out by either technique 2 or technique 3 to minimize radiation dose to the lens. (author). 11 refs.; 2 figs.; 3 tabs

Differential effects of 18- and 24-Gy cranial irradiation on growth rate and growth hormone release in children with prolonged survival after acute lymphocytic leukemia

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Cicognani, A.; Cacciari, E.; Vecchi, V.; Cau, M.; Balsamo, A.; Pirazzoli, P.; Tosi, M.T.; Rosito, P.; Paolucci, G.

1988-01-01

To evaluate the effects of two different doses of cranial irradiation on growth and growth hormone (GH) release, we studied 61 children with acute lymphocytic leukemia who had survived at least five years in continuous complete remission. Forty-three children received 24 Gy (group 1) and 18 children received 18 Gy (group 2). Height was evaluated at diagnosis, at the end of treatment, and 6, 12, and 24 months later. Growth hormone release was evaluated by arginine and levodopa tests after the end of treatment. After diagnosis, the height SD score decreased significantly in both groups; two years after the end of treatment, only group 1 showed an SD score for height that was still significantly lower than at diagnosis. Group 1 showed impaired GH responses to the tests and, compared with controls, group 1 in fact included a percentage of subjects with a normal response to levodopa (ie, greater than 8 micrograms/L) that was significantly lower (56.4% vs 83.3%) and a percentage of nonresponders to both tests that was significantly higher (21.6% vs 0%). These data indicate that only patients treated with lower cranial irradiation dosage (18 Gy) had complete growth recovery and normal GH responses to pharmacologic tests

Effects of central-nervous-system irradiation on neuropsychologic functioning of children with acute lymphocytic leukemia

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Soni, S.S.; Marten, G.W.; Pitner, S.E.; Duenas, D.A.; Powazek, M.

1975-01-01

Two neuropsychologic studies were performed to determine the long-term effects of ''prophylactic'' cranial or craniospinal irradiation on the psychologic and neurologic functions of children with acute lymphocytic leukemia. In a prospective study, 34 patients with leukemia who received either craniospinal irradiation or cranial irradiation combined with intrathecal methotrexate were evaluated by standardized neurologic and psychologic examinations before and after irradiation. Their performance was compared with that of 27 controls who received irradiation to parts of the body other than the cranium. In a retrospective study, 11 patients with leukemia receiving prophylactic craniospinal irradiation and 12 controls with the disease not receiving such therapy were followed from the second year after either irradiation or the initial hematologic remission. Eighteen months after irradiation in the prospective study and four years after irradiation in the retrospective study, no noteworthy neurologic or psychologic differences were found between subjects and controls

Prophylactic cranial irradiation for squamous cell carcinoma, large cell carcinoma, and adenocarcinoma of the lung: Indications and techniques

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Cox, J.D.; Komaki, R.

1986-01-01

Intracranial metastasis is one of the most morbid manifestations of cancer of the lung. The resulting seizures, headaches, and motor loss severely compromise the individual in the remaining days of his life. The median survival of patients with brain metastasis is only three to four months. Symptoms and signs resulting from brain metastasis are reversible to some degree with cranial irradiation in most patients. Headaches and seizures are most frequently controlled, but motor loss and impaired mentation are less reversible. The high frequency with which small cell carcinoma spreads to the brain has been recognized for many years. For the past decade, prophylactic cranial irradiation has been used widely in conjunction with combination chemotherapy for small cell carcinoma

Evaluation of growth hormone release and human growth hormone treatment in children with cranial irradiation-associated short stature

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Romshe, C.A.; Zipf, W.B.; Miser, A.; Miser, J.; Sotos, J.F.; Newton, W.A.

1984-01-01

We studied nine children who had received cranial irradiation for various malignancies and subsequently experienced decreased growth velocity. Their response to standard growth hormone stimulation and release tests were compared with that in seven children with classic GH deficiency and in 24 short normal control subjects. With arginine and L-dopa stimulation, six of nine patients who received radiation had a normal GH response (greater than 7 ng/ml), whereas by design none of the GH deficient and all of the normal children had a positive response. Only two of nine patients had a normal response to insulin hypoglycemia, with no significant differences in the mean maximal response of the radiation and the GH-deficient groups. Pulsatile secretion was not significantly different in the radiation and GH-deficient groups, but was different in the radiation and normal groups. All subjects in the GH-deficient and radiation groups were given human growth hormone for 1 year. Growth velocity increased in all, with no significant difference in the response of the two groups when comparing the z scores for growth velocity of each subject's bone age. We recommend a 6-month trial of hGH in children who have had cranial radiation and are in prolonged remission with a decreased growth velocity, as there is no completely reliable combination of GH stimulation or release tests to determine their response

Hypothalmic hypopituitarism following cranial irradiation for nasopharyngeal carcinoma

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Lam, K.S.L.; Wang, C.; Yeung, R.T.T.; Ma, J.T.C.; Ho, J.H.C.; Tse, V.K.C.; Ling, N.

1986-01-01

Eight patients, one male and seven females, with no pre-existing hypothalamic-pituitary disease, who developed symptoms of hypopituitarism following cranial irradiation for nasopharyngeal carcinoma were studied 5 years or more after radiotherapy. All were GH deficient. Four of the patients with no GH response during insulin tolerance tests (ITT) showed increased GH in response to synthetic human growth hormone releasing factor (GRF-44). Four patients had impaired cortisol responses to ITT, and gradual but diminished cortisol responses to ovine corticotrophin releasing factor (CRF-41). There was no significant difference between mean peak increments in response to ITT and those in response to CRF-41. TSH responses to TRH were delayed in five and absent in two patients; four of these had low free T4 index. Prolactin was raised in all seven women and increased further in response to TRH. Two patients had impaired gonadotrophin responses to LHRH. None of the patients had clinical or biochemical evidence of diabetes insipidus. These data suggest that post-irradiation hypopituitarism in these patients results from radiation damage to the hypothalamus leading to varying degrees of deficiency of the hypothalamic releasing or inhibitory factors. (author)

Significcance of cranial nerve involvement shown by the prognosis of nasopharyngeal carcinoma

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Hui Zhouguang; Gao Li; Yi Junlin; Li Suyan; Jin Jing; Huang Xiaodong; Luo Jingwei; Xu Guozhen

2006-01-01

Objective: To analyze the cranial nerve involvement in nasophryngeal carcinoma and its relationship with the prognosis with the optimal treatment for such patients studied also. Methods: 935 untreated nasopharyngeal carcinoma patients, admitted into our hospital from January 1990 to June 1999, were analyzed retrospectively. These patients were divided into cranial nerve involved group and cranial nerve un- involved group by patients symptoms signs and/or images before the treatment. SPSS10.0 soft package was used to analyze the effect of cranial nerve involvement on the prognosis. Results: The overall percentage of cranial nerve involvement was 20.0%, of which the trigeminal nerve was most common . The 5-year local recurrence rate was 20.1% and 16.8% (P=0.465) in cranial nerve involved group and un-involved group, respectively. In the patients with cranial nerve involved, the 5-year local recurrence rates of patients who received boost skull base irradiation dose <70, 70-79 and ≥80 Gy was 38.1%, 24.5% and 16.0% (P =0.082), respectively. The 5-year distant metastasis rate was 31.6% and 19.5% (P=0.020) in cranial nerve involved group and un-involved group. The corresponding overall survival rates and disease-free survival rate was 62.2% and 78.1% (P=O.000) and 43.2%, 62.4% (P=0.000), respectively. By multivariate analysis, cranial nerve involvement was an independent factor both in overall survival (RR 1.62, P=0.001 ) and disease-free survival (RR=1.40, P=0.020). Conclusions: There are more distant metastasis, worse overall survival and disease-free survival in patients with cranial nerve involved. Boost irradiation to the involved skull base may improve the local control. Radiotherapy combined with chemotherapy for these patients may also have brighter future. (authors)

Cranial irradiation alters dendritic spine density and morphology in the hippocampus.

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Ayanabha Chakraborti

Full Text Available Therapeutic irradiation of the brain is a common treatment modality for brain tumors, but can lead to impairment of cognitive function. Dendritic spines are sites of excitatory synaptic transmission and changes in spine structure and number are thought to represent a morphological correlate of altered brain functions associated with hippocampal dependent learning and memory. To gain some insight into the temporal and sub region specific cellular changes in the hippocampus following brain irradiation, we investigated the effects of 10 Gy cranial irradiation on dendritic spines in young adult mice. One week or 1 month post irradiation, changes in spine density and morphology in dentate gyrus (DG granule and CA1 pyramidal neurons were quantified using Golgi staining. Our results showed that in the DG, there were significant reductions in spine density at both 1 week (11.9% and 1 month (26.9% after irradiation. In contrast, in the basal dendrites of CA1 pyramidal neurons, irradiation resulted in a significant reduction (18.7% in spine density only at 1 week post irradiation. Analysis of spine morphology showed that irradiation led to significant decreases in the proportion of mushroom spines at both time points in the DG as well as CA1 basal dendrites. The proportions of stubby spines were significantly increased in both the areas at 1 month post irradiation. Irradiation did not alter spine density in the CA1 apical dendrites, but there were significant changes in the proportion of thin and mushroom spines at both time points post irradiation. Although the mechanisms involved are not clear, these findings are the first to show that brain irradiation of young adult animals leads to alterations in dendritic spine density and morphology in the hippocampus in a time dependent and region specific manner.

Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children

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Freeman, A.I.; Weinberg, V.; Brecher, M.L.

1983-01-01

The authors compared two regimens with respect to their ability to prolong disease-free survival in 506 children and adolescents with acute lymphocytic leukemia. All responders to induction therapy were randomized to treatment with 2400 rad of cranial irradiation plus intrathecal methotrexate or to treatment with intermediate-dose methotrexate plus intrathecal methotrexate, as prophylaxis for involvement of the central nervous system and other sanctuary areas. Complete responders were stratified into either standard-risk or increased-risk groups on the basis of age and white-cell count at presentation. Among patients with standard risk, hematologic relapses occurred in 9 of 117 given methotrexate and 24 of 120 given irradiation. The rate of central-nervous-system relapse was higher in the methotrexate group (23 of 117) than in the irradiation group. Among patients with increased risk, radiation offered greater protection to the central nervous system than methotrexate; there was no difference in the rate of hematologic relapse. Methotrexate offered better protection against systemic relapse in standard-risk patients and better protection against testicular relapse overall, but it offered less protection against relapses in the central nervous system than cranial irradiation

Growth and endocrine disorders secondary to cranial irradiation

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Rappaport, R; Brauner, R

1989-06-01

External cranial radiation for the treatment of malignant diseases has become a frequent cause of growth hormone deficiency (GHD). The timing of occurrence and the frequency of GHD were related to the hypothalamic-pituitary radiation dose. Frequency varied from 50% in leukemia (2400 cGy) to 75% in face and neck tumors or medulloblastoma (2500-4500 cGy) and up to 100% in optic glioma (greater than 4500 cGy). The significantly more severe growth deficit in patients with GHD given higher radiation doses suggests different levels of residual GH secretion according to radiation dosage. The minimum harmful radiation dose is probably close to 1800-2000 cGy. Our data show that stimulation tests remain a useful means of defining GHD and predicting growth. A fair agreement between GH secretion and growth was found in most cases, regardless of the radiation dose. The only exception was a group of leukemic children (2400 cGy) who achieved normal prepubertal growth despite a low GH response. The 24-h spontaneous plasma GH profiles and IGF-I measurements may add information if growth is retarded despite a normal GH response. We showed that growth retardation occurring after some schedules of total body irradiation was not due to GH deficiency but rather to radiation-induced skeletal lesions. Early or true precocious puberty, generally associated with GHD, was another cause of height loss. As the role of GH deficiency in the final height reduction was demonstrated in all groups of patients after cranial radiation, we suggest that hGH therapy should be considered in any child with proven GH deficiency and significant growth retardation after such radiation. 77 references.

Brain sarcoma of meningeal origin after cranial irradiation in childhood acute lymphocytic leukemia. Case report

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Tiberin, P.; Maor, E.; Zaizov, R.; Cohen, I.J.; Hirsch, M.; Yosefovich, T.; Ronen, J.; Goldstein, J.

1984-01-01

The authors report their experience with an unusual case of intracerebral sarcoma of meningeal cell origin in an 8 1/2-year-old girl. This tumor occurred 6 1/2 years after cranial irradiation at relatively low dosage (2200 rads) had been delivered to the head in the course of a multimodality treatment for acute lymphocytic leukemia. The tumor recurred approximately 10 months after the first surgical intervention. Macroscopic total excision of the recurrent growth followed by whole-brain irradiation (4500 rads) failed to eradicate it completely and local recurrence prompted reoperation 18 months later. This complication of treatment in long-term childhood leukemia survivors is briefly discussed, as well as the pathology of meningeal sarcomas

Cranial nerve involvement in nasopharyngeal carcinoma

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Oezyar, E.; Atahan, I.L.; Akyol, F.H.; Guerkaynak, M.; Zorlu, A.F.

1994-01-01

Between 1975 and 1989, 23 nasopharyngeal carcinoma patients presenting with cranial nerve involvement (CNI) of one or more nerves at the time of diagnosis were treated and followed-up in our department. All patients were irradiated with curative intent, and total doses of 50 to 70 Gy (median 65 Gy) were delivered to the nasopharynx. Cranial nerves VI, III, V, IV, IX, and XII were the most commonly involved nerves. The total response rate of cranial nerves was 74% in a median follow-up time of 2 years, with the highest rate observed in the third and sixth cranial nerves. All complete responses except two were observed in the first month after radiotherapy. (author)

Effects of cranial radiation on hearing in children with acute lymphocytic leukemia

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Thibadoux, G.M.; Pereira, W.V.; Hodges, J.M.; Aur, R.J.

1980-01-01

The hearing sensitivity of 61 children with acute lymphocytic leukemia who were admitted to our Total Therapy IX study between December 1975 and July 1977 was studied. Their treatment included combined chemotherapy, 2400 rads of cranial radiation, and intrathecal methotrexate. Subjects initially received an otologic examination and middle ear function testing. Audiometric testing was not done until ears were free of outer or middle ear pathology. If the child had no outer or middle ear disease, audiometric thresholds were obtained for the test frequencies: 500, 1000, 2000, 4000, 6000, and 8000 Hz. Pure-tone thresholds were obtained before irradiation (61 patients) and at 6, 12, and 36 months thereafter (49, 46, and 22 patients, respectively). The median age of time of baseline testing was 10 years, 2 months. A paired sample test based on group data was used to test whether there were any significant changes from the threshold values at 6, 12, and 36 months after irradiation. Thresholds were not significantly affected for any test frequency at any test time. Assessments of individual audiograms indicated that none of the children had any significant reductions in hearing levels at the end of the third year after cranial irradiation

Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small-cell lung cancer: A Cochrane Review

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Lester, Jason Francis; MacBeth, Fergus R.; Coles, Bernadette

2005-01-01

Purpose: To investigate whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small-cell lung cancer (NSCLC) treated with curative intent. Methods and Materials: A search strategy was designed to identify randomized controlled trials (RCTs) comparing PCI with no PCI in NSCLC patients treated with curative intent. The electronic databases MEDLINE, EMBASE, LILACS, and Cancerlit were searched, along with relevant journals, books, and review articles to identify potentially eligible trials. Four RCTs were identified and reviewed. A total of 951 patients were randomized in these RCTs, of whom 833 were evaluable and reported. Forty-two patients with small-cell lung cancer were excluded, leaving 791 patients in total. Because of the small patient numbers and trial heterogeneity, no meta-analysis was attempted. Results: Prophylactic cranial irradiation did significantly reduce the incidence of brain metastases in three trials. No trial reported a survival advantage with PCI over observation. Toxicity data were poorly collected and no quality of life assessments were carried out in any trial. Conclusion: Prophylactic cranial irradiation may reduce the incidence of brain metastases, but there is no evidence of a survival benefit. It was not possible to evaluate whether any radiotherapy regimen is superior, and the effect of PCI on quality of life is not known. There is insufficient evidence to support the use of PCI in clinical practice. Where possible, patients should be offered entry into a clinical trial

Late effects of cranial irradiation on visual attention in children treated for hematologic illnesses

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Hill, D.L.

1992-01-01

A cross-sectional design was employed to assess the effects of CNS therapy including cranial irradiation (CRT) on visual attention. Forty one children between the ages of 8 and 16 years, 24 with a history of CRT, were tested. The attentional measure was a set of 14 timed, age-normed visual cancellation tasks that permitted an assessment of task-relevant motor response speed in the measurement of attentional efficiency. CRT doses ranged from 1000 to 4800 rads, administered to whole brain between 1 and 12 years prior to testing. It was found that increasing doses of CRT were associated with slower motor responding. Motor speed accounted for a significant proportion of variance in attentional task performance: slowed motor responding must be controlled by covariation in the measurement of attentional abilities in CRT-treated children. No child receiving CRT before age 4 and more than 5 years prior to testing performed above the mean overall on the attentional task, compared to several children demonstrating above-average performance who received CRT less than 5 years prior to testing. Scores for the CRT group were highly correlated with IQ and achievement results. CRT variables (dose, age at earliest CRT, time since CRT) explained half the variance in attentional task performance. Children who received CRT performed significantly below the mean on subtests with the most complex, symbolic or sequential target stimuli, a pattern that has predicted poor academic achievement in non-medically ill children. It was concluded that children receiving CRT should continue to be evaluated more than five years after treatment to monitor potential late effects of neurotoxic treatment. Longitudinal, prospective, well-controlled dose-effect research using a developmentally sensitive, theoretically grounded battery of attentional measures is needed to best compare neurotoxicity of different treatment regima in children

Neurochemical Evidence of Potential Neurotoxicity After Prophylactic Cranial Irradiation

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Kalm, Marie, E-mail: marie.kalm@neuro.gu.se [Department of Clinical Neuroscience and Rehabilitation, Insitute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Abel, Edvard [Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Wasling, Pontus [Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Nyman, Jan [Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Hietala, Max Albert [Department of Neurology, Karolinska University Hospital, Stockholm (Sweden); Bremell, Daniel; Hagberg, Lars [Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Elam, Mikael [Department of Clinical Neuroscience and Rehabilitation, Insitute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Blennow, Kaj [Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal (Sweden); Björk-Eriksson, Thomas [Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Zetterberg, Henrik [Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal (Sweden); UCL Institute of Neurology, London (United Kingdom)

2014-07-01

Purpose: To examine whether cerebrospinal fluid biomarkers for neuroaxonal damage, neuroglial activation, and amyloid β–related processes could characterize the neurochemical response to cranial radiation. Methods and Materials: Before prophylactic cranial irradiation (PCI) of patients with small cell lung cancer, each patient underwent magnetic resonance imaging of the brain, lumbar puncture, and Mini-Mental State Examination of cognitive function. These examinations were repeated at approximately 3 and 12 months after radiation. Results: The major findings were as follows. (1) Cerebrospinal fluid markers for neuronal and neuroglial injury were elevated during the subacute phase after PCI. Neurofilament and T-tau increased 120% and 50%, respectively, after PCI (P<.05). The same was seen for the neuroglial markers YKL-40 and glial fibrillary acidic protein, which increased 144% and 106%, respectively, after PCI (P<.05). (2) The levels of secreted amyloid precursor protein-α and -β were reduced 44% and 46%, respectively, 3 months after PCI, and the levels continued to decrease as long as 1 year after treatment (P<.05). (3) Mini-Mental State Examination did not reveal any cognitive decline, indicating that a more sensitive test should be used in future studies. Conclusion: In conclusion, we were able to detect radiation therapy–induced changes in several markers reflecting neuronal injury, inflammatory/astroglial activation, and altered amyloid precursor protein/amyloid β metabolism, despite the low number of patients and quite moderate radiation doses (20-30 Gy). These changes are hypothesis generating and could potentially be used to assess the individual risk of developing long-term symptoms of chronic encephalopathy after PCI. This has to be evaluated in large studies with extended clinical follow-up and more detailed neurocognitive assessments.

Neurochemical Evidence of Potential Neurotoxicity After Prophylactic Cranial Irradiation

International Nuclear Information System (INIS)

Kalm, Marie; Abel, Edvard; Wasling, Pontus; Nyman, Jan; Hietala, Max Albert; Bremell, Daniel; Hagberg, Lars; Elam, Mikael; Blennow, Kaj; Björk-Eriksson, Thomas; Zetterberg, Henrik

2014-01-01

Purpose: To examine whether cerebrospinal fluid biomarkers for neuroaxonal damage, neuroglial activation, and amyloid β–related processes could characterize the neurochemical response to cranial radiation. Methods and Materials: Before prophylactic cranial irradiation (PCI) of patients with small cell lung cancer, each patient underwent magnetic resonance imaging of the brain, lumbar puncture, and Mini-Mental State Examination of cognitive function. These examinations were repeated at approximately 3 and 12 months after radiation. Results: The major findings were as follows. (1) Cerebrospinal fluid markers for neuronal and neuroglial injury were elevated during the subacute phase after PCI. Neurofilament and T-tau increased 120% and 50%, respectively, after PCI (P<.05). The same was seen for the neuroglial markers YKL-40 and glial fibrillary acidic protein, which increased 144% and 106%, respectively, after PCI (P<.05). (2) The levels of secreted amyloid precursor protein-α and -β were reduced 44% and 46%, respectively, 3 months after PCI, and the levels continued to decrease as long as 1 year after treatment (P<.05). (3) Mini-Mental State Examination did not reveal any cognitive decline, indicating that a more sensitive test should be used in future studies. Conclusion: In conclusion, we were able to detect radiation therapy–induced changes in several markers reflecting neuronal injury, inflammatory/astroglial activation, and altered amyloid precursor protein/amyloid β metabolism, despite the low number of patients and quite moderate radiation doses (20-30 Gy). These changes are hypothesis generating and could potentially be used to assess the individual risk of developing long-term symptoms of chronic encephalopathy after PCI. This has to be evaluated in large studies with extended clinical follow-up and more detailed neurocognitive assessments

Cranial nerve damage in patients after alpha (heavy)-particle radiation to the pituitary

International Nuclear Information System (INIS)

Price, J.; Wei, W.C.; Chong, C.Y.

1979-01-01

The records of 161 patients were reviewed to determine if radiation damage had occurred following cranial irradiation. All of these patients had received alpha-particle radiation to their pituitary glands during the period when this form of therapy was given for diabetic retinopathy. Extraocular muscle palsy developed in 11 of these patients, iridoplegia in six, and fifth nerve damage in six. All of the palsies developed within a short period following their irradiation, and a definite dose relationship was present. The dose rate was approximately 100 rads/min for all cases. Fractionation varied but it is known for all cases

The Role of DNA Methylation Changes in Radiation-Induced Transgenerational Genomic Instability and Bystander Effects in cranial irradiated Mice

Science.gov (United States)

Zhang, Meng; Sun, Yeqing; Gao, Yinglong; Zhang, Baodong

Heavy-ion radiation could lead to genome instability in the germline, and therefore to transgenerational genome and epigenome instability in offspring of exposed males. The exact mechanisms of radiation-induced genome instability in directly exposed and in bystander organ remain obscure, yet accumulating evidence points to the role of DNA methylation changes in genome instability development. The potential of localized body-part exposures to affect the germline and thus induce genome and epigenome changes in the progeny has not been studied. To investigate whether or not the paternal cranial irradiation can exert deleterious changes in the protected germline and the offsprings, we studied the alteration of DNA methylation in the shielded testes tissue. Here we report that the localized paternal cranial irradiation results in a significant altered DNA methylation in sperm cells and leads to a profound epigenetic dysregulation in the unexposed progeny conceived 3 months after paternal exposure. The possible molecular mechanisms and biological consequences of the observed changes are discussed. Keywords: Heavy-ion radiation; Transgenerational effect; Genomic Instability Bystander Effects; DNA methylation.

Postradiation motor neuron syndrome of the upper cervical region - a manifestation of the combined effect of cranial irradiation and intrathecal chemotherapy

Energy Technology Data Exchange (ETDEWEB)

Tan, S.V.; Pye, I.F. (Leicester Royal Infirmary (United Kingdom))

1991-05-01

The authors present a brief case report of neurogenic amyotropy apparently resulting from damage to the anterior horn cells of the upper cervical cord and lower brainstem during cranial irradiation which occurred as part of the patient's treatment for acute leukaemia. (Author).

Serial histopathological changes in irradiated guinea pig lung receiving conventional fractionated and hyperfractionated irradiation

International Nuclear Information System (INIS)

Itoh, Satoshi; Inomata, Taisuke; Ogawa, Yasuhiro; Yoshida, Shoji; Sonobe, Hiroshi; Ohtsuki, Yuji

1999-01-01

The purpose of this study is to determine serial histopathological differences in guinea pig lungs receiving the same total dose as clinically used between conventional fractionated and hyperfractionated irradiation. The guinea pigs received 80 Gy in 40 daily fractions of 2 Gy each (conventional fractionation), 80 Gy in 80 fractions of 1 Gy each twice a day (hyperfractionation), 81 Gy in 27 daily fractions of 3 Gy each (conventional fractionation), or 81 Gy in 54 fractions of 1.5 Gy each twice a day (hyperfractionation). We evaluated the histopathological changes of irradiated guinea pig lungs at 1, 2, 3, 6, 9, and 12 months after irradiation. The guinea pig lungs that received 81 Gy in 27 daily fractions showed histopathological changes of inflammation including formation of lymph follicles after 6 months. The lungs which received 81 Gy in 54 fractions showed similar but slightly less pronounced changes than those that received 81 Gy in 27 daily fractions. The guinea pig lungs of other groups showed no histopathological changes during the observation period. In hyperfractionated irradiation the damage to the guinea pig lung is quantitatively less than that occurring as a result of conventional fractionated irradiation of the same total dose. (author)

Serial histopathological changes in irradiated guinea pig lung receiving conventional fractionated and hyperfractionated irradiation

Energy Technology Data Exchange (ETDEWEB)

Itoh, Satoshi; Inomata, Taisuke; Ogawa, Yasuhiro; Yoshida, Shoji; Sonobe, Hiroshi; Ohtsuki, Yuji [Kochi Medical School, Nankoku (Japan)

1999-05-01

The purpose of this study is to determine serial histopathological differences in guinea pig lungs receiving the same total dose as clinically used between conventional fractionated and hyperfractionated irradiation. The guinea pigs received 80 Gy in 40 daily fractions of 2 Gy each (conventional fractionation), 80 Gy in 80 fractions of 1 Gy each twice a day (hyperfractionation), 81 Gy in 27 daily fractions of 3 Gy each (conventional fractionation), or 81 Gy in 54 fractions of 1.5 Gy each twice a day (hyperfractionation). We evaluated the histopathological changes of irradiated guinea pig lungs at 1, 2, 3, 6, 9, and 12 months after irradiation. The guinea pig lungs that received 81 Gy in 27 daily fractions showed histopathological changes of inflammation including formation of lymph follicles after 6 months. The lungs which received 81 Gy in 54 fractions showed similar but slightly less pronounced changes than those that received 81 Gy in 27 daily fractions. The guinea pig lungs of other groups showed no histopathological changes during the observation period. In hyperfractionated irradiation the damage to the guinea pig lung is quantitatively less than that occurring as a result of conventional fractionated irradiation of the same total dose. (author)

Serial cranial computed-tomography scans in children with leukemia given two different forms of central nervous system therapy

International Nuclear Information System (INIS)

Ochs, J.J.; Parvey, L.S.; Whitaker, J.N.; Bowman, W.P.; Ch'ien, L.; Campbell, M.; Coburn, T.

1983-01-01

Cranial computed tomography (CT) was used to estimate the frequency and permanence of brain abnormalities in 108 consecutive children with acute lymphoblastic leukemia (ALL). Fifty-five patients received cranial irradiation (1,800 rad) with intrathecal methotrexate (RT group) and 53 patients received intravenous and intrathecal methotrexate without irradiation (IVIT group). Continuation treatment included sequential drug pairs for the RT group and periodic IVIT methotrexate for the other group. After 12 to 24 months of serial evaluation, five (9%) of the 55 patients in the RT group have had CT scan abnormalities, compared to 10 (19%) of 52 in the IVIT group (p . 0.171). Fourteen of the 15 patients with CT scan abnormalities had focal or diffuse white-matter hypodensity; these have reverted to normal in most cases, reflecting a dynamic process. While such CT findings are of concern and may be an early indicator of central nervous system toxicity, this remains to be proven. Therapy should not be altered on the basis of abnormal CT scans alone but in the context of the entire clinical situation

Comparable effects of 1800- and 2400-rad (18- and 24-Gy) cranial irradiation on height and weight in children treated for acute lymphocytic leukemia

International Nuclear Information System (INIS)

Starceski, P.J.; Lee, P.A.; Blatt, J.; Finegold, D.; Brown, D.

1987-01-01

To examine the effects of low-dose cranial irradiation on growth and to determine if one can predict patients in whom growth will be most affected, we studied 47 children with acute lymphocytic leukemia who had been treated with 2400 rad (24 Gy), 1800 rad (18 Gy), or no whole-brain irradiation. Serial measurements of height, weight, and weight for height were obtained by retrospective chart review. The effects of 1800 rad (18 Gy) and 2400 rad (24 Gy) treatment were indistinguishable. Height percentiles among irradiated patients decreased by a mean of 12% six months after diagnosis, and growth generally did not catch up. Moreover, although 33 irradiated patients maintained heights within the normal range, In 11 patients (33%) a dramatic falloff occurred such that by three years following diagnosis their height for age was more than 30 percentiles below the original value. These patients were all identifiable at six months since their height percentiles had already decreased by more than 15%. Although weight percentiles did not change following irradiation, the weight-for-height ratio increased and patients were relatively stockier three years after therapy than they had been at diagnosis. In patients who had received chemotherapy alone, the weight-for-height ratio also increased, but this appeared to be due to a disproportionate increase in weight. Longer follow-up and evaluation of larger cohorts of patients treated with 1800 rad (18 Gy) will be needed to confirm these results

Low doses of prophylactic cranial irradiation effective in limited stage small cell carcinoma of the lung

International Nuclear Information System (INIS)

Rubenstein, James H.; Dosoretz, Daniel E.; Katin, Michael J.; Blitzer, Peter H.; Salenius, Sharon A.; Floody, Patrick A.; Harwin, William N.; Teufel, Thomas E.; Raymond, Michael G.; Reeves, James A.; Hart, Lowell L.; McCleod, Michael J.; Pizarro, Alejandro; Gabarda, Antonio L.; Rana, Van G.

1995-01-01

Purpose: Prophylactic cranial irradiation (PCI) for the prevention of brain metastasis in small cell lung cancer remains controversial, both in terms of efficacy and the optimal dose-fractionation scheme. We performed this study to evaluate the efficacy of PCI at low doses. Methods and Materials: One hundred and ninety-seven patients were referred to our institution for treatment of limited stage small cell carcinoma of the lung between June 1986 and December 1992. Follow-up ranged from 1.1 to 89.8 months, with a mean of 19 months. Eighty-five patients received PCI. Results: Patients receiving PCI exhibited brain failure in 15%, while 38% of untreated patients developed metastases. This degree of prophylaxis was achieved with a median total dose of 25.20 Gy and a median fraction size of 1.80 Gy. At these doses, acute and late complications were minimal. Patients receiving PCI had significantly better 1-year and 2-year overall survivals (68% and 46% vs. 33% and 13%). However, patients with a complete response (CR) to chemotherapy and better Karnofsky performance status (KPS) were overrepresented in the PCI group. In an attempt to compare similar patients in both groups (PCI vs. no PCI), only patients with KPS ≥ 80, CR or near-CR to chemotherapy, and treatment with attempt to cure, were compared. In this good prognostic group, survival was still better in the PCI group (p = 0.0018). Conclusion: In this patient population, relatively low doses of PCI have accomplished a significant reduction in the incidence of brain metastasis with little toxicity. Whether such treatment truly improves survival awaits the results of additional prospective randomized trials

Comparison of central nervous system prophylaxis with cranial radiation and intrathecal methotrexate versus intrathecal methotrexate alone in acute lymphoblastic leukemia

International Nuclear Information System (INIS)

Muriel, F.S.; Svarch, E.; Pavlovsky, S.

1983-01-01

In acute lymphoblastic leukemia, central nervous system prophylaxis with irradiation plus intrathecal methotrexate (i.t. MTX) reduces the incidence of CNS relapse to 7%-15%. However, increased evidence of CNS delayed toxicity was recognized mainly in children as CT scan abnormalities and neuropsychologic alterations. Two questions were analyzed: (1) Will further doses of i.t. methotraxate and dexamethasone (i.t. MTX-DMT) decrease the incidence of CNS relapse. (2) Is i.t. MTX-DMT given during induction and maintenance as effective as cranium irradiation plus i.t. MTX-DMT. Incidence of primary CNS relapse in i.t. MTX-DMT-treated patients with a WBC count 50,000, it was 16% in the treated group and 19% in the control group. These patients were compared with patients which had received 3 doses of i.t. MTX-DMT alone during induction, 3 doses weekly during the first month of remission, and quarterly thereafter. The incidence of leukemia at 60 mo in patients with a WBC count 50,000 at 48 mo was 28% and 42% in the irradiated and nonirradiated group respectively. Complete remission remained at 15% and 16% respectively of patients disease-free at 48 mo. We conclude that (A) after cranial irradiation plus i.t. MTX-DMT X 5, the use of additional doses of i.t. MTX-DMT is not of further benefit in preventing CNS relapse; (B) use of i.t. MTX-DMT alone compares with cranial irradiation plus i.t. MTX-DMT in incidence of CNS relapse; and (C) relapse-free survival and survival in patients with a WBC count < 50.000 were significantly longer in those without cranial irradiation

Progressive multiple cranial neuropathies presenting as a delayed complication of radiotherapy in infancy.

OpenAIRE

Pall, H. S.; Nightingale, S.; Clough, C. G.; Spooner, D.

1988-01-01

A 38 year old woman who had undergone irradiation during infancy for a left facial cutaneous arteriovenous malformation sequentially developed complete palsies of the ipsilateral VII, V, XI, IX, X, XII and VI cranial nerves. Apart from optic and olfactory nerve damage there are few reports of radiotherapy causing cranial nerve injury. We link the unusually extensive and progressive neural damage and the prolonged latency to the patient's age at time of irradiation.

Late neurological complications after prophylactic cranial irradiation in patients with small-cell lung cancer: The Toronto experience

International Nuclear Information System (INIS)

Lishner, M.; Feld, R.; Payne, D.G.; Sagman, U.; Sculier, J.P.; Pringle, J.F.; Yeoh, J.L.; Evans, W.K.; Shepherd, F.A.; Maki, E.

1990-01-01

We retrospectively analyzed the charts of 58 long-term survivors of small-cell lung cancer (SCLC) (greater than 2 years) for neurological complications and their impact on the well-being of these patients. We also attempted to have patients complete a questionnaire regarding any possible neurological problems. This was done in 14 patients. Metastasis to the CNS occurred significantly less often in patients who received prophylactic cranial irradiation (PCI) in a dose of 20 Gy in five equal fractions (two of 48), compared with patients who did not receive it (four of 10) (P less than .006). Delayed neurological complications occurred in nine of 48 (19%) patients who received PCI. However, in only two patients did PCI appear to be responsible for progressive dementia. In the other seven patients (one with weakness in the arms and legs, one with transient left hemiparesis, two with hearing loss, and three with various visual disturbances), chemotherapeutic agents (mainly cisplatin and vincristine) and underlying diseases probably contributed significantly to the occurrence of these complications. In addition, these neurological disturbances were transient or ran a stable course and did not adversely affect the daily life of these patients. In comparison, among the 10 patients who did not receive PCI one had progressive dementia and another had hemiparesis secondary to probable brain embolism. We conclude that the use of PCI in these doses was effective in reducing the frequency of CNS metastases and had an adverse effect on the daily life and well-being only in a minority of the patients. Until results of controlled randomized studies show otherwise, PCI should continue to be used as a part of the combined modality treatment of completely responding patients with limited SCLC

Effect of Osteopathic Cranial Manipulative Medicine on Visual Function.

Science.gov (United States)

Sandhouse, Mark E; Shechtman, Diana; Fecho, Gregory; Timoshkin, Elena M

2016-11-01

The effects of osteopathic cranial manipulative medicine (OCMM) on visual function have been poorly characterized in the literature. Based on a pilot study conducted by their research group, the authors conducted a study that examined whether OCMM produced a measurable change in visual function in adults with cranial asymmetry. Randomized, controlled, double-blinded clinical trial. The intervention and control (sham therapy) were applied during 8 weekly visits, and participants in both groups received 8 weekly follow-up visits. Adult volunteers aged between 18 and 35 years with unremarkable systemic or ocular history were recruited. Inclusion criteria were refractive error between 6 diopters of myopia and 5 diopters of hyperopia, regular astigmatism of any amount, and cranial somatic dysfunction. All participants were evaluated for cranial asymmetry and randomly assigned to the treatment or sham therapy group. The treatment group received OCMM to correct cranial dysfunctions, and the sham therapy group received light pressure applied to the cranium. Preintervention and postintervention ophthalmic examinations consisted of distance visual acuity testing, accommodative system testing, local stereoacuity testing, pupillary size measurements, and vergence system testing. A χ2 analysis was performed to determine participant masking. Analysis of variance was performed for all ophthalmic measures. Eighty-nine participants completed the trial, with 47 in the treatment group and 42 in the sham therapy group. A hierarchical analysis of variance revealed statistically significant within-groups effects (Psize under bright light in the left eye and in near point of convergence break. Osteopathic cranial manipulative medicine may affect visual function in adults with cranial asymmetry. Active motion testing of the cranium for somatic dysfunction may affect the cranial system to a measurable level and explain interrater reliability issues in cranial studies. (Clinical

Leukoencephalopathy and cortical leminar necrosis associated with intrathecal methotrexate and cranial irridiation

International Nuclear Information System (INIS)

Iqbal, Yasir; Al-Sudairy, Reem; Abdullah, Mohammad F.

2003-01-01

With the advent of chemotherapy, mortality rates in children with acute lymphoblastic leukemia have decreased . Though prophylactic treatment of central nervous system (CNS) to prevent leukemic infiltration has reduced the incidence of CNS relapse and improved the survival in pediatric acute lymphoblastic leukemia. We studied a unique case of neurotoxicity associated with prophylactic cranial irradiation and intrathecal MTX. This is the first reported case of pure MTX-related CLN.Perhaps the combination of MTX along with cranial irradiation, can result in increased neurotoxic effects. (author)

Effect of Prophylactic Cranial Irradiation in Acute Lymphoblastic Leukemia in Children

International Nuclear Information System (INIS)

Kim, Il Han; Choi, Doo Ho; Kim, Jong Hoon; Ha, Sung Whan; Park, Charn Il; Ahn, Hyo Seop

1989-01-01

CNS prophylaxis with 18 or 24 Gy cranial irradiation plus intrathecal methotrexate was given to 134 childhood acute lymphoblastic leukemia patients who had got bone marrow remission(M1) after remission induction chemotherapy from August 1979 to December 1986. The rate of initial total CNS relapse was 14.2%(19/134), the rate of isolated CNS relapse was 5.2%(7/134), and the rate of CNS relapse concomitantly combined with bone marrow relapse or testicular relapse was 9%(12/134). Male sex or older age was associated with higher CNS relapses and the initial peripheral leukocyte count over 50,000/ul had higher relapse rate. Relapse with radiation dose of 18 Gy was somewhat lower than that with 24 Gy. Within 4 years after CNS prophylaxis occurred 89% of the total CNS relapses, 100% of the isolated CNS relapses, and 83% of the combined CNS relapses. Adjusted to exposed cases to risk of CNS relapse, the total CNS relapse rate was 11.9% during maintenance chemotherapy and 4.9% after maintenance chemotherapy

Long-term consequences of growth hormone replacement and cranial radiation on pituitary function

NARCIS (Netherlands)

Appelman-Dijkstra, Natasha Mireille

2015-01-01

This thesis covers the consequences of cranial irradiation of non-pituitary tumors, eg nasopharyngeal carcinoma, on pituitary function. In chapter 2 we have performed a meta-analysis of available data reported in literature on pituitary function after cranial radiotherapy for head and neck and

Evolution of growth hormone neurosecretory disturbance after cranial irradiation for childhood brain tumours: a prospective study

International Nuclear Information System (INIS)

Spoudeas, H.A.; Hindmarsh, P.C.; Brook, C.G.D.; Matthews, D.R.

1996-01-01

To determine the aetiopathology of post-irradiation growth hormone (GH) deficiency, we performed a mixed longitudinal analysis of 56 24 h serum GH concentration profiles and 45 paired insulin-induced hypoglycaemia tests (ITT) in 35 prepubertal children, aged 1.5-11.8 years, with brain tumours in the posterior foss (n = 25) or cerebral hemispheres (n 10). Assessments were made before (n = 16), 1 year (n = 25) and 2 to 5 years (n = 15) after a cranial irradiation (DXR) dose of at least 30 Gy. Fourier transforms, occupancy percentage, first-order derivatives (FOD) and mean concentrations were determined from the GH profiles taken after neurosurgery but before radiotherapy (n = 16) and in three treatment groups: Group 1: neurosurgery only without DXR 9n 9); Group 2: ≥ 30 Gy DXR only (n = 22); Group 3: ≥ 30 Gy DXR with additional chemotherapy (n = 9). Results were compared with those from 26 short normally growing (SN) children. (author)

Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

Energy Technology Data Exchange (ETDEWEB)

Watkins, E.B.; Findlay, P.; Gelmann, E.; Lane, H.C.; Zabell, A.

1987-09-01

The oropharynx and hypopharynx are common sites of involvement in AIDS patients with mucocutaneous Kaposi's sarcoma. The radiotherapist is often asked to intervene with these patients due to problems with pain, difficulty in swallowing, or impending airway obstruction. We have noted an unexpected decrease in normal tissue tolerance of the oropharyngeal mucosa to irradiation in AIDS patients treated in our department. Data on 12 patients with AIDS and Kaposi's sarcoma receiving oropharyngeal irradiation are presented here. Doses ranged from 1000 cGy to 1800 cGy delivered in 150-300 cGy fractions. Seven of eight patients receiving doses of 1200 cGy or more developed some degree of mucositis, four of these developed mucositis severe enough to require termination of treatment. All patients in this study received some form of systemic therapy during the course of their disease, but no influence on mucosal response to irradiation was noted. Four patients received total body skin electron treatments, but no effect on degree of mucositis was seen. Presence or absence of oral candidiasis was not an obvious factor in the radiation response of the oral mucosa in these patients. T4 counts were done on 9 of the 12 patients. Although the timing of the T4 counts was quite variable, no correlation with immune status and degree of mucositis was found. The degree of mucositis seen in these patients occurred at doses much lower than expected based on normal tissue tolerances seen in other patient populations receiving head and neck irradiations. We believe that the ability of the oral mucosa to repair radiation damage is somehow altered in patients with AIDS.

Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

International Nuclear Information System (INIS)

Watkins, E.B.; Findlay, P.; Gelmann, E.; Lane, H.C.; Zabell, A.

1987-01-01

The oropharynx and hypopharynx are common sites of involvement in AIDS patients with mucocutaneous Kaposi's sarcoma. The radiotherapist is often asked to intervene with these patients due to problems with pain, difficulty in swallowing, or impending airway obstruction. We have noted an unexpected decrease in normal tissue tolerance of the oropharyngeal mucosa to irradiation in AIDS patients treated in our department. Data on 12 patients with AIDS and Kaposi's sarcoma receiving oropharyngeal irradiation are presented here. Doses ranged from 1000 cGy to 1800 cGy delivered in 150-300 cGy fractions. Seven of eight patients receiving doses of 1200 cGy or more developed some degree of mucositis, four of these developed mucositis severe enough to require termination of treatment. All patients in this study received some form of systemic therapy during the course of their disease, but no influence on mucosal response to irradiation was noted. Four patients received total body skin electron treatments, but no effect on degree of mucositis was seen. Presence or absence of oral candidiasis was not an obvious factor in the radiation response of the oral mucosa in these patients. T4 counts were done on 9 of the 12 patients. Although the timing of the T4 counts was quite variable, no correlation with immune status and degree of mucositis was found. The degree of mucositis seen in these patients occurred at doses much lower than expected based on normal tissue tolerances seen in other patient populations receiving head and neck irradiations. We believe that the ability of the oral mucosa to repair radiation damage is somehow altered in patients with AIDS

Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation

Energy Technology Data Exchange (ETDEWEB)

Komaki, Ritsuko; Meyers, Christina A; Shin, Dong M; Garden, Adam S; Byrne, Kevin; Nickens, Judy A; Cox, James D

1995-08-30

Purpose: Cognitive deficits after treatment for small cell lung cancer (SCLC) have been attributed to prophylactic cranial irradiation (PCI). A prospective study of neuropsychological function was undertaken to document the evolution and magnitude of neuropsychologic deficits. Methods and Materials: Thirty patients with limited stage SCLC who responded well (29 complete response (CR), 1 partial response (PR)) to combination chemotherapy plus thoracic irradiation or resection were studied with neuropsychological tests in the cognitive domains of intelligence, frontal lobe function, language, memory, visual-perception, and motor dexterity prior to a planned course of PCI. Nine patients had a neurologic history that could influence testing. Results: An unexpected 97% (29 out of 30) of patients had evidence of cognitive dysfunction prior to PCI. The most frequent impairment was verbal memory, followed by frontal lobe dysfunction, and fine motor incoordination. Of the patients with no prior neurologic or substance abuse history, 20 out of 21 (95%) had impairments on neuropsychological assessment. This neurologically normal group was just as impaired as the group with such a history with respect to delayed verbal memory and frontal lobe executive function. Eleven patients had neuropsychological testing 6 to 20 months after PCI; no significant differences were found from their pretreatment tests. Conclusions: A high proportion of neurologically normal patients with limited SCLC and favorable responses to combination chemotherapy have specific cognitive deficits before receiving PCI. Short-term (6 to 20 months) observations after PCI have shown no significant deterioration.

Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation

International Nuclear Information System (INIS)

Komaki, Ritsuko; Meyers, Christina A.; Shin, Dong M.; Garden, Adam S.; Byrne, Kevin; Nickens, Judy A.; Cox, James D.

1995-01-01

Purpose: Cognitive deficits after treatment for small cell lung cancer (SCLC) have been attributed to prophylactic cranial irradiation (PCI). A prospective study of neuropsychological function was undertaken to document the evolution and magnitude of neuropsychologic deficits. Methods and Materials: Thirty patients with limited stage SCLC who responded well (29 complete response (CR), 1 partial response (PR)) to combination chemotherapy plus thoracic irradiation or resection were studied with neuropsychological tests in the cognitive domains of intelligence, frontal lobe function, language, memory, visual-perception, and motor dexterity prior to a planned course of PCI. Nine patients had a neurologic history that could influence testing. Results: An unexpected 97% (29 out of 30) of patients had evidence of cognitive dysfunction prior to PCI. The most frequent impairment was verbal memory, followed by frontal lobe dysfunction, and fine motor incoordination. Of the patients with no prior neurologic or substance abuse history, 20 out of 21 (95%) had impairments on neuropsychological assessment. This neurologically normal group was just as impaired as the group with such a history with respect to delayed verbal memory and frontal lobe executive function. Eleven patients had neuropsychological testing 6 to 20 months after PCI; no significant differences were found from their pretreatment tests. Conclusions: A high proportion of neurologically normal patients with limited SCLC and favorable responses to combination chemotherapy have specific cognitive deficits before receiving PCI. Short-term (6 to 20 months) observations after PCI have shown no significant deterioration

Comparison of central nervous system prophylaxis with cranial radiation and intrathecal methotrexate versus intrathecal methotrexate alone in acute lymphoblastic leukemia

Energy Technology Data Exchange (ETDEWEB)

Muriel, F.S.; Svarch, E.; Pavlovsky, S.; Eppinger-Helft, M.; Braier, J.; Vergara, B.; Garay, G.; Kvicala, R.; Divito, J.M.; Failace, R.

1983-08-01

In acute lymphoblastic leukemia, central nervous system prophylaxis with irradiation plus intrathecal methotrexate (i.t. MTX) reduces the incidence of CNS relapse to 7%-15%. However, increased evidence of CNS delayed toxicity was recognized mainly in children as CT scan abnormalities and neuropsychologic alterations. Two questions were analyzed: (1) Will further doses of i.t. methotraxate and dexamethasone (i.t. MTX-DMT) decrease the incidence of CNS relapse. (2) Is i.t. MTX-DMT given during induction and maintenance as effective as cranium irradiation plus i.t. MTX-DMT. Incidence of primary CNS relapse in i.t. MTX-DMT-treated patients with a WBC count < 50,000 and in the untreated group was 11%. In patients with a WBC count > 50,000, it was 16% in the treated group and 19% in the control group. These patients were compared with patients which had received 3 doses of i.t. MTX-DMT alone during induction, 3 doses weekly during the first month of remission, and quarterly thereafter. The incidence of leukemia at 60 mo in patients with a WBC count < 50,000 was 20% in the irradiated group and 32% in the group with i.t. MTX-DMT alone. The relapse-free survival at 60 mo was 26% and 41%, respectively, (p < 0.0005). The incidence in patients with a WBC count > 50,000 at 48 mo was 28% and 42% in the irradiated and nonirradiated group respectively. Complete remission remained at 15% and 16% respectively of patients disease-free at 48 mo. We conclude that (A) after cranial irradiation plus i.t. MTX-DMT X 5, the use of additional doses of i.t. MTX-DMT is not of further benefit in preventing CNS relapse; (B) use of i.t. MTX-DMT alone compares with cranial irradiation plus i.t. MTX-DMT in incidence of CNS relapse; and (C) relapse-free survival and survival in patients with a WBC count < 50.000 were significantly longer in those without cranial irradiation.

Acute neurocognitive impairment during cranial radiation therapy in patients with intracranial tumors

International Nuclear Information System (INIS)

Welzel, Grit; Mai, Sabine K.; Hermann, Brigitte; Kraus-Tiefenbacher, Uta; Wenz, Frederik; Fleckenstein, Katharina; Duke University Medical Center Durham, NC

2008-01-01

The objective of the current study was to evaluate the acute effects of cranial radiation therapy (CNS-RT) using different radiation doses (0, 1.8, 2, 3, ≤ 20 Gy) on cognitive function with special emphasis on memory. We assessed patients with and without intracranial tumors to distinguish between direct and indirect radiation effects on brain tissue. Eighty-two patients were evaluated with neuropsychological testing before and acutely after radiotherapy (RT). Sixty-four patients received RT to the brain (55 with, 9 without intracranial tumor). Eighteen patients treated with RT to the breast served as controls. Patients with intracranial tumor demonstrated attention (19-38th percentile) and verbal memory scores (34-46th percentile) below the population average at baseline. The average Verbal Memory score was significantly different between patients with intracranial tumor and controls both at baseline (38th vs. 58th percentile) and after irradiation (27th vs. 52th percentile). Patients with preexisting peritumoral edema performed worse than patients without edema and controls. Radiation dose-related deficits were seen for working memory performance in patients with intracranial tumor. Our data indicate no measurable impairment of cognitive functioning acutely after prophylactic cranial irradiation. Patients with intracranial tumor show a deterioration of almost all memory functions with a dose-dependent impairment in working memory. Patients with preexisting peritumoral brain edema show the strongest deterioration. (orig.)

Acute neurocognitive impairment during cranial radiation therapy in patients with intracranial tumors

Energy Technology Data Exchange (ETDEWEB)

Welzel, Grit; Mai, Sabine K.; Hermann, Brigitte; Kraus-Tiefenbacher, Uta; Wenz, Frederik [University Medical Center Mannheim, Heidelberg Univ. (Germany). Dept. of Radiation Oncology; Fleckenstein, Katharina [University Medical Center Mannheim, Heidelberg Univ. (Germany). Dept. of Radiation Oncology]|[Duke University Medical Center Durham, NC (United States). Dept. of Radiation Oncology

2008-12-15

The objective of the current study was to evaluate the acute effects of cranial radiation therapy (CNS-RT) using different radiation doses (0, 1.8, 2, 3, {<=} 20 Gy) on cognitive function with special emphasis on memory. We assessed patients with and without intracranial tumors to distinguish between direct and indirect radiation effects on brain tissue. Eighty-two patients were evaluated with neuropsychological testing before and acutely after radiotherapy (RT). Sixty-four patients received RT to the brain (55 with, 9 without intracranial tumor). Eighteen patients treated with RT to the breast served as controls. Patients with intracranial tumor demonstrated attention (19-38th percentile) and verbal memory scores (34-46th percentile) below the population average at baseline. The average Verbal Memory score was significantly different between patients with intracranial tumor and controls both at baseline (38th vs. 58th percentile) and after irradiation (27th vs. 52th percentile). Patients with preexisting peritumoral edema performed worse than patients without edema and controls. Radiation dose-related deficits were seen for working memory performance in patients with intracranial tumor. Our data indicate no measurable impairment of cognitive functioning acutely after prophylactic cranial irradiation. Patients with intracranial tumor show a deterioration of almost all memory functions with a dose-dependent impairment in working memory. Patients with preexisting peritumoral brain edema show the strongest deterioration. (orig.)

Temporalis myofascial flap for primary cranial base reconstruction after tumor resection.

Science.gov (United States)

Eldaly, Ahmed; Magdy, Emad A; Nour, Yasser A; Gaafar, Alaa H

2008-07-01

To evaluate the use of the temporalis myofascial flap in primary cranial base reconstruction following surgical tumor ablation and to explain technical issues, potential complications, and donor site consequences along with their management. Retrospective case series. Tertiary referral center. Forty-one consecutive patients receiving primary temporalis myofascial flap reconstructions following cranial base tumor resections in a 4-year period. Flap survival, postoperative complications, and donor site morbidity. Patients included 37 males and 4 females ranging in age from 10 to 65 years. Two patients received preoperative and 18 postoperative radiation therapy. Patient follow-up ranged from 4 to 39 months. The whole temporalis muscle was used in 26 patients (63.4%) and only part of a coronally split muscle was used in 15 patients (36.6%). Nine patients had primary donor site reconstruction using a Medpor((R)) (Porex Surgical, Inc., Newnan, GA) temporal fossa implant; these had excellent aesthetic results. There were no cases of complete flap loss. Partial flap dehiscence was seen in six patients (14.6%); only two required surgical débridement. None of the patients developed cerebrospinal leaks or meningitis. One patient was left with complete paralysis of the temporal branch of the facial nerve. Three patients (all had received postoperative irradiation) developed permanent trismus. The temporalis myofascial flap was found to be an excellent reconstructive alternative for a wide variety of skull base defects following tumor ablation. It is a very reliable, versatile flap that is usually available in the operative field with relatively low donor site aesthetic and functional morbidity.

Ocular cranial nerve palsies secondary to sphenoid sinusitis

Institute of Scientific and Technical Information of China (English)

Aiman El Mograbi; Ethan Soudry

2017-01-01

Objective:The clinical presentation of sphenoid sinusitis can be highly variable.Rarely,sphenoid sinusitis may present with cranial nerve complications due to the proximity of these structures to the sphenoid sinus.Method:A case series from Rabin Medical Center and all cases of cranial nerves palsies secondary to sphenoid sinusitis that have been reported in the literature were reviewed.Results:Seventeen patients were identified.The abducent nerve was the most common cranial nerve affected (76％),followed by the oculomotor nerve (18％).One patient had combined oculomotor,trochlear and abducent palsies.The most common pathology was isolated purulent sphenoid sinusitis in 64％ followed by allergic fungal sinusitis (AFS) in 18％,and fungal infection in 18％.94％ had an acute presentation.The majority (85％) received a combined intravenous antibiotics and surgical treatment.The remainder received conservative treatment alone.Complete recovery of cranial nerve palsy was noted in 82％ during follow up.Conclusion:Sphenoid sinusitis presenting as diplopia and headaches is rare.A neoplastic process must be ruled out and early surgical intervention with intravenous antimicrobial therapy carry an excellent outcome with complete resolution of symptoms.

Longitudinal growth in children with non-Hodgkin's lymphoma and children with acute lymphoblastic leukemia: Comparison between unirradiated and irradiated patients

International Nuclear Information System (INIS)

Marky, I.; Samuelsson, B.O.; Mellander, L.; Karlberg, J.

1991-01-01

Longitudinal growth was studied in children treated for non-Hodgkin's lymphoma (NHL). The aim of the study was to compare these children's growth velocity with findings in a previous study we performed on age-matched children with acute lymphoblastic leukemia (ALL) who received cranial irradiation. Nine children with NHL with an onset time of treatment between 4 and 9 years of age (mean 6.5 years) were studied with annual body measurements taken from the time of the diagnosis and thereafter annually during the following 4 years. None of the children received cranial irradiation. During the first treatment year a significantly low mean height velocity was observed (-1.4 standard deviation score [SDS]) for the NHL group. The consecutive two 1 year periods showed a normalization of the mean height velocity. For the group of children with ALL, there was a more prominent negative effect on height during the first 2 years of treatment than for the NHL group in the present study. After the cessation of therapy, the children with NHL showed a reduced catch-up growth compared with the children with ALL. The explanation offered is that cranial irradiation has a heavier impact on growth than chemotherapy during the first 2 years of treatment, but an intense chemotherapy during the maintenance period could have a considerable impact in blunting growth

Application of probabilistic fiber-tracking method of MR imaging to measure impact of cranial irradiation on structural brain connectivity in children treated for medulloblastoma

Science.gov (United States)

Duncan, Elizabeth C.; Reddick, Wilburn E.; Glass, John O.; Hyun, Jung Won; Ji, Qing; Li, Yimei; Gajjar, Amar

2016-03-01

We applied a modified probabilistic fiber-tracking method for the extraction of fiber pathways to quantify decreased white matter integrity as a surrogate of structural loss in connectivity due to cranial radiation therapy (CRT) as treatment for pediatric medulloblastoma. Thirty subjects were examined (n=8 average-risk, n=22 high-risk) and the groups did not differ significantly in age at examination. The pathway analysis created a structural connectome focused on sub-networks within the central executive network (CEN) for comparison between baseline and post-CRT scans and for comparison between standard and high dose CRT. A paired-wise comparison of the connectivity between baseline and post-CRT scans showed the irradiation did have a significant detrimental impact on white matter integrity (decreased fractional anisotropy (FA) and decreased axial diffusivity (AX)) in most of the CEN sub-networks. Group comparisons of the change in the connectivity revealed that patients receiving high dose CRT experienced significant AX decreases in all sub-networks while the patients receiving standard dose CRT had relatively stable AX measures across time. This study on pediatric patients with medulloblastoma demonstrated the utility of this method to identify specific sub-networks within the developing brain affected by CRT.

Actuarial risk of isolated CNS involvement in Ewing's sarcoma following prophylactic cranial irradiation and intrathecal methotrexate

International Nuclear Information System (INIS)

Trigg, M.E.; Makuch, R.; Glaubiger, D.

1985-01-01

Records of 154 patients with Ewing's sarcoma treated at the National Cancer Institute were reviewed to assess the incidence and risk of developing isolated central nervous system (CNS) Ewing's sarcoma. Sixty-two of the 154 patients had received CNS irradiation and intrathecal (i.t.) methotrexate as part of their initial therapy to prevent the occurrence of isolated CNS Ewing's sarcoma. The risk of developing isolate CNS Ewing's sarcoma was greatest within the first two years after diagnosis and was approximately 10%. The overall risk of CNS recurrence in the group of patients receiving DNS treatment was similar to the group receiving no therapy directed to the CNS. The occurrence of isolated CNS involvement was not prevented by the use of CNS irradiation and i.t. methotrexate. Because of a lack of efficacy to the CNS irradiation regimen, current treatment regimens do not include therapy directed to CNS

Arterial supply of the lower cranial nerves: a comprehensive review.

Science.gov (United States)

Hendrix, Philipp; Griessenauer, Christoph J; Foreman, Paul; Loukas, Marios; Fisher, Winfield S; Rizk, Elias; Shoja, Mohammadali M; Tubbs, R Shane

2014-01-01

The lower cranial nerves receive their arterial supply from an intricate network of tributaries derived from the external carotid, internal carotid, and vertebrobasilar territories. A contemporary, comprehensive literature review of the vascular supply of the lower cranial nerves was performed. The vascular supply to the trigeminal, facial, vestibulocochlear, glossopharyngeal, vagus, spinal accessory, and hypoglossal nerves are illustrated with a special emphasis on clinical issues. Frequently the external carotid, internal carotid, and vertebrobasilar territories all contribute to the vascular supply of an individual cranial nerve along its course. Understanding of the vasculature of the lower cranial nerves is of great relevance for skull base surgery. Copyright © 2013 Wiley Periodicals, Inc.

Does Receiving a Blood Transfusion Predict for Length of Stay in Children Undergoing Cranial Vault Remodeling for Craniosynostosis? Outcomes Using the Pediatric National Surgical Quality Improvement Program Dataset.

Science.gov (United States)

Markiewicz, Michael R; Alden, Tord; Momin, Mohmed Vasim; Olsson, Alexis B; Jurado, Ray J; Abdullah, Fizan; Miloro, Michael

2017-08-01

Recent interventions have aimed at reducing the need for blood transfusions in the perioperative period in patients with craniosynostosis undergoing cranial vault remodeling. However, little is known regarding whether the receipt of a blood transfusion influences the length of hospital stay. The purpose of this study was to assess whether the receipt of a blood transfusion in patients undergoing cranial vault remodeling is associated with an increased length of stay. To address the research purposes, we designed a retrospective cohort study using the 2014 Pediatric National Surgical Quality Improvement Program (NSQIP Peds) dataset. The primary predictor variable was whether patients received a blood transfusion during cranial vault remodeling. The primary outcome variable was length of hospital stay after the operation. The association between the receipt of blood transfusions and length of stay was assessed using the Student t test. The association between other covariates and the outcome variable was assessed using linear regression, analysis of variance, and the Tukey test for post hoc pair-wise comparisons. The sample was composed of 756 patients who underwent cranial vault remodeling: 503 who received blood transfusions and 253 who did not. The primary predictor variable of blood transfusion was associated with an increased length of stay (4.1 days vs 3.0 days, P = .03). Other covariates associated with an increased length of stay included race, American Society of Anesthesiologists status, premature birth, presence of a congenital malformation, and number of sutures involved in craniosynostosis. The receipt of a blood transfusion in the perioperative period in patients with craniosynostosis undergoing cranial vault remodeling was associated with an increased length of stay. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Pathogenesis of irradiation-induced cognitive dysfunction

International Nuclear Information System (INIS)

Abayomi, O.K.

1996-01-01

Neurocognitive dysfunction is a common sequela of cranial irradiation that is especially severe in young children. The underlying mechanisms of this disorder have not been described. The present review describes the role of the hippocampus and the anatomically related cortex in memory function and its marked susceptibility to ischemic and hypoxic injury. Based on studies of animal models of human amnesia and histopathological findings in the irradiated brain, the neurocognitive sequela of cranial irradiation can be seen to be mediated through vascular injury, resulting in ischemia and hypoxia in the hippocampal region. Recognition of the site and mechanisms of this injury may lead to the development of techniques to minimize the risks. (orig.)

Pathogenesis of irradiation-induced cognitive dysfunction

Energy Technology Data Exchange (ETDEWEB)

Abayomi, O.K. [Howard Univ. Hospital, Washington, DC (United States). Dept. of Radiation Oncology

1996-12-31

Neurocognitive dysfunction is a common sequela of cranial irradiation that is especially severe in young children. The underlying mechanisms of this disorder have not been described. The present review describes the role of the hippocampus and the anatomically related cortex in memory function and its marked susceptibility to ischemic and hypoxic injury. Based on studies of animal models of human amnesia and histopathological findings in the irradiated brain, the neurocognitive sequela of cranial irradiation can be seen to be mediated through vascular injury, resulting in ischemia and hypoxia in the hippocampal region. Recognition of the site and mechanisms of this injury may lead to the development of techniques to minimize the risks. (orig.).

Cranial irradiation of leukaemia in childhood

International Nuclear Information System (INIS)

Gyenes, Gy.; Sator, G.; Varjas, G.

1979-01-01

The fundamental combined cytostatic treatment, initiated immediatly after the diagnosis, of the acute lymphoid leukaemia in the childhood is the method of choice. The haematologic remission, however, does not signify recovery, the starting-place of the relapse is mostly in the central nervous system. Telecobalt irradiation of the neurocranium using the known ray-physical and ray-biological advantages regularly distroys the leukaemia cells hidden in this region. In the paper the experiences gained with the irradiation of 151 children are reported. Further ulterior informations could be obtained by the authors only from 66 patients, out of them meningeosis leukaemia developed in 12%. (author)

Effect of irradiation on facial growth: a 7- to 25-year follow-up

International Nuclear Information System (INIS)

Guyuron, B.; Dagys, A.P.; Munro, I.R.; Ross, R.B.

1983-01-01

This retrospective study is a review of 41 patients who had received irradiation to the head and face during the growth period. Not only is growth of soft tissue and bone of the irradiated area noticeably affected, but other parts of the face can also be involved, especially if the dose is to the upper face and the cranial base. We were able to define a definite cutoff point for a harmful dose for growing facial bones, but the harmful dose for soft tissue could not be determined and may be as low as 400 rads

Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

Energy Technology Data Exchange (ETDEWEB)

Gondi, Vinai, E-mail: vgondi@chicagocancer.org [Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Paulus, Rebecca [Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States); Bruner, Deborah W. [Nell Hodgson Woodfull School of Nursing, Emory University, Atlanta, Georgia (United States); Meyers, Christina A. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Wolfson, Aaron [University of Miami School of Medicine, Miami, Florida (United States); Werner-Wasik, Maria [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Sun, Alexander Y. [Princess Margaret Hospital, Toronto, ON (Canada); Choy, Hak [University of Texas Southwestern Moncreif Cancer Center, Fort Worth, Texas (United States); Movsas, Benjamin [Henry Ford Health System, Detroit, Michigan (United States)

2013-07-15

Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and at 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum.

Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

International Nuclear Information System (INIS)

Gondi, Vinai; Paulus, Rebecca; Bruner, Deborah W.; Meyers, Christina A.; Gore, Elizabeth M.; Wolfson, Aaron; Werner-Wasik, Maria; Sun, Alexander Y.; Choy, Hak; Movsas, Benjamin

2013-01-01

Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and at 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum

Cranial mononeuropathy VI

Science.gov (United States)

... Abducens palsy; Lateral rectus palsy; VIth nerve palsy; Cranial nerve VI palsy; Sixth nerve palsy; Neuropathy - sixth nerve ... Cranial mononeuropathy VI is damage to the sixth cranial nerve. This nerve is also called the abducens nerve. ...

Long-term effects of cranial irradiation on endocrine function in children with brain tumors. A prospective study

International Nuclear Information System (INIS)

Duffner, P.K.; Cohen, M.E.; Voorhess, M.L.; MacGillivray, M.H.; Brecher, M.L.; Panahon, A.; Gilani, B.B.

1985-01-01

This study prospectively evaluated the endocrine function of 11 children treated with cranial irradiation (CRT) for brain tumors. All tumors were remote from the hypothalamic-pituitary axis. Children were studied before treatment and at 3, 6, and 12 months after the completion of CRT. T4, thyroid-stimulating hormone, prolactin, plasma cortisol, and urinary follicle-stimulating hormone and luteinizing hormone values were normal before and after treatment in all patients. Growth hormone (GH) deficiency was identified in 0 of 7 patients before treatment, in 2 of 7 patients 3 months post-CRT, in 9 of 11 patients 6 months post-CRT, and in 7 of 8 patients 12 months post-CRT. Growth deceleration was identified in five of seven prepubertal patients. GH deficiency is an extremely common sequelae of CRT, beginning as early as 3 months after the completion of CRT. The deficit is progressive over time

Temporalis Myofascial Flap for Primary Cranial Base Reconstruction after Tumor Resection

OpenAIRE

Eldaly, Ahmed; Magdy, Emad A.; Nour, Yasser A.; Gaafar, Alaa H.

2008-01-01

Objective: To evaluate the use of the temporalis myofascial flap in primary cranial base reconstruction following surgical tumor ablation and to explain technical issues, potential complications, and donor site consequences along with their management. Design: Retrospective case series. Setting: Tertiary referral center. Participants: Forty-one consecutive patients receiving primary temporalis myofascial flap reconstructions following cranial base tumor resections in a 4-year period. Main Out...

Microvascular Cranial Nerve Palsy

Science.gov (United States)

... Español Eye Health / Eye Health A-Z Microvascular Cranial Nerve Palsy Sections What Is Microvascular Cranial Nerve Palsy? ... Microvascular Cranial Nerve Palsy Treatment What Is Microvascular Cranial Nerve Palsy? Leer en Español: ¿Qué es una parálisis ...

WE-EF-BRA-10: Prophylactic Cranial Irradiation Reduces the Incidence of Brain Metastasis in a Mouse Model of Metastatic Breast Cancerr

Energy Technology Data Exchange (ETDEWEB)

Smith, D; Debeb, B; Larson, R; Diagaradjane, P; Woodward, W [MD Anderson Cancer Center, Houston, TX (United States)

2015-06-15

Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with acute lymphoblastic leukemia and small-cell lung cancer. We examined whether PCI could benefit breast cancer patients at high risk of developing brain metastases. Methods: We utilized our mouse model in which 500k green fluorescent protein (GFP)-labeled breast cancer cells injected into the tail vein of SCID/Beige mice resulted in brain metastases in approximately two-thirds of untreated mice. To test the efficacy of PCI, one set of mice was irradiated five days after cell injection with a single fraction of 4-Gy (two 2-Gy opposing fields) whole-brain irradiation on the XRAD 225Cx small-animal irradiator. Four controls were included: a non-irradiated group, a group irradiated two days prior to cell injection, and two groups irradiated 3 or 6 weeks after cell injection. Mice were sacrificed four and eight weeks post-injection and were evaluated for the presence of brain metastases on a fluorescent stereomicroscope. Results: The incidence of brain metastasis in the non-irradiated group was 77% and 90% at four and eight weeks, respectively. The PCI group had a significantly lower incidence, 20% and 30%, whereas the other three control groups had incidence rates similar to the non-treated control (70% to 100%). Further, the number of metastases and the metastatic burden were also significantly lower in the PCI group compared to all other groups. Conclusion: The timing of irradiation to treat subclinical disease is critical, as a small dose of whole-brain irradiation given five days after cell injection abrogated tumor burden by greater than 90%, but had no effect when administered twenty-one days after cell injection. PCI is likely to benefit breast cancer patients at high risk of developing brain metastases and should be strongly considered in the clinic.

Radiation therapy in leukemia (total body irradiation excluded); Irradiations pour leucemie a l`exclusion de l`irradiation corporelle totale

Energy Technology Data Exchange (ETDEWEB)

Peiffert, D.; Hoffstetter, S. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France). Dept. de Radiotherapie

1999-03-01

Radiation techniques and indications in leukemias have been described in detail, yet prophylactic cranial irradiation in acute leukemia still has few indications. Cerebrospinal and testicular irradiation are reserved for relapsing disease. Radiation usually results in rapid functional improvement when used in neurologic emergencies and symptomatic neurologic or gross tumors relapses. Nevertheless, the improvements recently obtained by systemic chemotherapy have resulted in the reduction in the use of irradiation, especially in children, where it was considered deleterious with neuropsychological sequelae. Splenic irradiation remains useful for symptomatic myelo-proliferative syndrome. (authors)

Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin

International Nuclear Information System (INIS)

Delattre, J.Y.; Safai, B.; Posner, J.B.

1988-01-01

In 15 months we encountered eight patients with intracranial tumors who developed erythema multiforme (EM) or erythema multiforme bullosa (Stevens-Johnson syndrome). All occurred shortly after use of phenytoin (DPH) and brain radiation therapy (WBRT). The clinical picture differed from the classic form of EM in that the erythema began on the scalp and spread to the extremities, progressing in three cases to extensive bullous formation. There were no cases of EM among patients who received either DPH or radiotherapy alone. The combination of DPH, WBRT, and tapering of steroids seems to predispose to EM. The pathogenesis of the disorder is probably immunologic. In the absence of seizures, anticonvulsants should not be given routinely to patients with brain tumors. When anticonvulsants are necessary in patients scheduled for WBRT, DPH may not be the drug of choice

Lower cranial nerves.

Science.gov (United States)

Soldatos, Theodoros; Batra, Kiran; Blitz, Ari M; Chhabra, Avneesh

2014-02-01

Imaging evaluation of cranial neuropathies requires thorough knowledge of the anatomic, physiologic, and pathologic features of the cranial nerves, as well as detailed clinical information, which is necessary for tailoring the examinations, locating the abnormalities, and interpreting the imaging findings. This article provides clinical, anatomic, and radiological information on lower (7th to 12th) cranial nerves, along with high-resolution magnetic resonance images as a guide for optimal imaging technique, so as to improve the diagnosis of cranial neuropathy. Copyright © 2014 Elsevier Inc. All rights reserved.

Mediastinal radiotherapy after multidrug chemotherapy and prophylactic cranial irradiation in patients with SCLC - treatment results after long-term follow-up and literature overview

International Nuclear Information System (INIS)

Herrmann, M.K.A.; Bloch, E.; Overbeck, T.; Wolff, H.A.; Hille, A.; Hess, C.F.; Christiansen, H.; Koerber, W.; Vorwerk, H.; Muller, M.; Pradier, O.

2011-01-01

Introduction. - Curative therapy for patients with small-cell lung cancer (SCLC) is based on multidrug chemotherapy combinations and radiotherapy. After a long time follow-up, the aim of the study was to evaluate the efficacy and toxicity of sequential chemo-radiotherapy and the effect of prophylactic cranial irradiation (PCI). Methods. - From 1995-2005, 96 patients with SCLC (64 limited-disease [LD], 32 extensive-disease [ED]; median age 61 years [range 39-79]) were treated at our department with varying chemotherapy regimens and sequential mediastinal radiotherapy (50 Gy + 10 Gy boost in case of residual disease after chemotherapy). Afterwards, 15 patients with LD, good general condition and at least partial response after local treatment received PCI (30 Gy). Results. - After a median follow-up of 78.6 months, 20 patients remained alive (20.8%, median survival time 18.2 months). The 2-/5-year overall survival rates were 33.8% and 12.6%, the 2-/5-year loco-regional control rates were 30.3% and 24.5%, respectively. Distant metastases occurred in 43 patients (24 cerebral). Cerebral metastasis occurred in 6.7% and 27.2% of the patients with PCI and without PCI respectively. Only tumor stage showed a statistically significant impact on overall survival and loco-regional control in multivariate analysis. Radiotherapy was well tolerated. Grade 3/4 toxicity occurred in seven patients. Prognosis of patients with SCLC remains poor. Administration of PCI in selected patients bears a decrease in the incidence of cerebral metastases. Alternative chemotherapy schemes as well as irradiation schemes and techniques should be the substance of future randomized trials. (authors)

Effects of ACNU and cranial irradiation on the mouse immune system

Energy Technology Data Exchange (ETDEWEB)

Yamanaka, Ryuya; Tanaka, Ryuichi; Yoshida, Seiichi; Mori, Hiroshi; Takeda, Norio; Satoh, Mitsuya [Niigata Univ. (Japan). Brain Research Inst.

1993-02-01

The effects of 1-(4-amino-2-methyl-5-pyrimidinyl)-methyl- 3-(2-chloroethyl)-3-nitrosourea (ACNU) and cranial irradiation on the immune system were studied in three groups of 90 mice: Group A, intraperitoneal injection of ACNU (30 mg/kg); Group B, single exposure of 10 Gy to the head; and Group C, intraperitoneal injection of ACNU (30 mg/kg) and single exposure of 10 Gy to the head. Peripheral white blood cell counts, spleen cell subsets, natural killer (NK) cell activity, lymphocyte blastogenesis, and production of interferon (IFN)-[gamma] were analyzed once a week for 6 weeks after treatment. In Group A, NK cell activity decreased between weeks 4-5, concanavalin A blastogenesis decreased during weeks 1-5, and the levels of L3T4 (CD4) and Lyt2 cells (CD8) and IFN-[gamma] production decreased during weeks 2-5. However, all tested parameters returned to the normal range at 6 weeks. In Group B, all parameters except for the L3T4 cell level and the IFN-[gamma] production decreased during week 1, and returned to the normal range thereafter. The concentration of L3T4 cells decreased during week 2 and between weeks 5-6. The IFN-[gamma] production increased during week 1, decreased during week 2, and returned to the normal range thereafter. In Group C, the suppressive effects were severe and continued for a longer period than in either Group A or B. Concanavalin A blastogenesis, L3T4 cell concentration, and IFN-[gamma] production were still suppressed after 6 weeks. Therefore, intensive radiochemotherapy for brain tumor may suppress the immunological function. (author).

Alternative causes of hypopituitarism: traumatic brain injury, cranial irradiation, and infections.

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Pekic, Sandra; Popovic, Vera

2014-01-01

Hypopituitarism often remains unrecognized due to subtle clinical manifestations. Anterior pituitary hormone deficiencies may present as isolated or multiple and may be transient or permanent. Traumatic brain injury (TBI) is recognized as a risk factor for hypopituitarism, most frequently presenting with isolated growth hormone deficiency (GHD). Data analysis shows that about 15% of patients with TBI have some degree of hypopituitarism which if not recognized may be mistakenly ascribed to persistent neurologic injury and cognitive impairment. Identification of predictors for hypopituitarism after TBI is important, one of them being the severity of TBI. The mechanisms involve lesions in the hypothalamic-pituitary axis and inflammatory changes in the central nervous system (CNS). With time, hypopituitarism after TBI may progress or reverse. Cranial irradiation is another important risk factor for hypopituitarism. Deficiencies in anterior pituitary hormone secretion (partial or complete) occur following radiation damage to the hypothalamic-pituitary region, the severity and frequency of which correlate with the total radiation dose delivered to the region and the length of follow-up. These radiation-induced hormone deficiencies are irreversible and progressive. Despite numerous case reports, the incidence of hypothalamic-pituitary dysfunction following infectious diseases of the CNS has been underestimated. Hypopituitarism usually relates to the severity of the disease, type of causative agent (bacterial, TBC, fungal, or viral) and primary localization of the infection. Unrecognized hypopituitarism may be misdiagnosed as postencephalitic syndrome, while the presence of a sellar mass with suprasellar extension may be misdiagnosed as pituitary macroadenoma in a patient with pituitary abscess which is potentially a life-threatening disease. © 2014 Elsevier B.V. All rights reserved.

Food irradiation receives international acceptance

Energy Technology Data Exchange (ETDEWEB)

Beddoes, J M [Atomic Energy of Canada Ltd., Ottawa, Ontario. Commercial Products

1982-04-01

Irradiation has advantages as a method of preserving food, especially in the Third World. The author tabulates some examples of actual use of food irradiation with dates and tonnages, and tells the story of the gradual acceptance of food irradiation by the World Health Organization, other international bodies, and the U.S. Food and Drug Administration (USFDA). At present, the joint IAEA/FAO/WHO standard permits an energy level of up to 5 MeV for gamma rays, well above the 1.3 MeV energy level of /sup 60/Co. The USFDA permits irradiation of any food up to 10 krad, and minor constituents of a diet may be irradiated up to 5 Mrad. The final hurdle to be cleared, that of economic acceptance, depends on convincing the food processing industry that the process is technically and economically efficient.

Clinical treatment of traumatic brain injury complicated by cranial nerve injury.

Science.gov (United States)

Jin, Hai; Wang, Sumin; Hou, Lijun; Pan, Chengguang; Li, Bo; Wang, Hui; Yu, Mingkun; Lu, Yicheng

2010-09-01

To discuss the epidemiology, diagnosis and surgical treatment of cranial nerve injury following traumatic brain injury (TBI) for the sake of raising the clinical treatment of this special category of TBI. A retrospective analysis was made of 312 patients with cranial nerve injury among 3417 TBI patients, who were admitted for treatment in this hospital. A total of 312 patients (9.1%) involving either a single nerve or multiple nerves among the 12 pairs of cranial nerves were observed. The extent of nerve injury varied and involved the olfactory nerve (66 cases), optic nerve (78 cases), oculomotor nerve (56 cases), trochlear nerve (8 cases), trigeminal nerve (4 cases), abducent nerve (12 cases), facial nerve (48 cases), acoustic nerve (10 cases), glossopharyngeal nerve (8 cases), vagus nerve (6 cases), accessory nerve (10 cases) and hypoglossal nerve (6 cases). Imaging examination revealed skull fracture in 217 cases, complicated brain contusion in 232 cases, epidural haematoma in 194 cases, subarachnoid haemorrhage in 32 cases, nasal cerebrospinal fluid (CSF) leakage in 76 cases and ear CSF leakage in 8 cases. Of the 312 patients, 46 patients died; the mortality rate associated with low cranial nerve injury was as high as 73.3%. Among the 266 surviving patients, 199 patients received conservative therapy and 67 patients received surgical therapy; the curative rates among these two groups were 61.3% (122 patients) and 86.6% (58 patients), respectively. TBI-complicated cranial nerve injury is subject to a high incidence rate, a high mortality rate and a high disability rate. Our findings suggest that the chance of recovery may be increased in cases where injuries are amenable to surgical decompression. It is necessary to study all 12 pairs of cranial nerves systematically. Clinically, it is necessary to standardise surgical indications, operation timing, surgical approaches and methods for the treatment of TBI-complicated cranial nerve injury. 2010 Elsevier Ltd. All

Traumatic superior orbital fissure syndrome: assessment of cranial nerve recovery in 33 cases.

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Chen, Chien-Tzung; Wang, Theresa Y; Tsay, Pei-Kwei; Huang, Faye; Lai, Jui-Pin; Chen, Yu-Ray

2010-07-01

Superior orbital fissure syndrome is a rare complication that occurs in association with craniofacial trauma. The characteristics of superior orbital fissure syndrome are attributable to a constellation of cranial nerve III, IV, and VI palsies. This is the largest series describing traumatic superior orbital fissure syndrome that assesses the recovery of individual cranial nerve function after treatment. In a review from 1988 to 2002, 33 patients with superior orbital fissure syndrome were identified from 11,284 patients (0.3 percent) with skull and facial fractures. Severity of cranial nerve injury and functional recovery were evaluated by extraocular muscle movement. Patients were evaluated on average 6 days after initial injury, and average follow-up was 11.8 months. There were 23 male patients. The average age was 31 years. The major mechanism of injury was motorcycle accident (67 percent). Twenty-two received conservative treatment, five were treated with steroids, and six patients underwent surgical decompression of the superior orbital fissure. After initial injury, cranial nerve VI suffered the most damage, whereas cranial nerve IV sustained the least. In the first 3 months, recovery was greatest in cranial nerve VI. At 9 months, function was lowest in cranial nerve VI and highest in cranial nerve IV. Eight patients (24 percent) had complete recovery of all cranial nerves. Functional recovery of all cranial nerves reached a plateau at 6 months after trauma. Cranial nerve IV suffered the least injury, whereas cranial nerve VI experienced the most neurologic deficits. Cranial nerve palsies improved to their final recovery endpoints by 6 months. Surgical decompression is considered when there is evidence of bony compression of the superior orbital fissure.

Dexamethasone minimizes the risk of cranial nerve injury during CEA.

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Regina, Guido; Angiletta, Domenico; Impedovo, Giovanni; De Robertis, Giovanni; Fiorella, Marialuisa; Carratu', Maria Rosaria

2009-01-01

The incidence of cranial and cervical nerve injury during carotid endarterectomy (CEA) ranges from less than 7.6% to more than 50%. Lesions are mainly due to surgical maneuvers such as traction, compression, tissue electrocoagulation, clamping, and extensive dissections. The use of dexamethasone (DEX) and its beneficial effects in spinal cord injuries have already been described. We investigated whether DEX could also be beneficial to minimize the incidence of cranial and cervical nerve injury during CEA. To evaluate whether dexamethasone is able to reduce the incidence of cranial nerve injuries. From March 1999 through April 2006, 1126 patients undergoing CEA because of high-grade carotid stenosis were enrolled and randomized by predetermined randomization tables into two groups. The first group, "A", included 586 patients that all received an intravenous administration of dexamethasone following a therapeutic scheme. The second group, "B", included 540 control subjects that received the standard pre- and postoperative therapy. All patients were submitted to a deep cervical plexus block, eversion carotid endarterectomy, and selective shunting. Three days after the operation, an independent neurologist and otorhinolaryngologist evaluated the presence of cranial nerve deficits. All patients (group A and group B) showing nerve injuries continued the treatment (8 mg of dexamethasone once in the morning) for 7 days and were re-evaluated after 2 weeks, 30 days, and every 3 months for 1 year. Recovery time took from 2 weeks to 12 months, with a mean time of 3.6 months. The chi(2) test was used to compare the two groups and to check for statistical significance. The incidence of cranial nerve dysfunction was higher in group B and the statistical analysis showed a significant effect of dexamethasone in preventing the neurological damage (P = .0081). The incidence of temporary lesions was lower in group A and the chi(2) test yielded a P value of .006. No statistically

A phase-I clinical trial for cranial BNCT at Harvard-MIT

International Nuclear Information System (INIS)

Busse, P.M.; Palmer, M.R.; Harling, O.K.

2000-01-01

Phase I trial designed to determine the maximum tolerable dose to normal tissue for cranial BNCT (Boron Neutron Capture Therapy) irradiations was recently completed at Harvard Medical School and MIT. Twenty-two subjects diagnosed with either glioblastoma multiforme or intracranial melanoma were treated between 1996 and 1999. Subjects received either one or two administrations of boronophenylalanine intravenously at doses between 250 and 350 mg/kg body weight, then exposed in one, two or three fields to epithermal neutrons at the MIT Research Reactor in one or two fractions. Over the course of the study, the maximum normal tissue dose target was increased from 8.8 to 14.2 RBE (Relative Biological Effectiveness) Gy in 10% increments. Subjects have been followed clinically and radiographically. Of those patients surviving beyond six months, no MRI (Magnetic Resonance Image) white-matter changes were observed and no long-term complications attributable to BNCT were evident. Tumor responses were observed, particularly with the melanoma subjects. With increasing doses, difficulties arose from long irradiation times (approximately 3 hours) and the emergence of acute reactions in the skin and mucosa. The trial was stopped in May 1999. Future trials will be initiated with the new high intensity, low background fission converter beam at MIT. (author)

Assessment of doses due to secondary neutrons received by patient treated by proton therapy

International Nuclear Information System (INIS)

Sayah, R.; Martinetti, F.; Donadille, L.; Clairand, I.; Delacroix, S.; De Oliveira, A.; Herault, J.

2010-01-01

Proton therapy is a specific technique of radiotherapy which aims at destroying cancerous cells by irradiating them with a proton beam. Nuclear reactions in the device and in the patient himself induce secondary radiations involving mainly neutrons which contribute to an additional dose for the patient. The author reports a study aimed at the assessment of these doses due to secondary neutrons in the case of ophthalmological and intra-cranial treatments. He presents a Monte Carlo simulation of the room and of the apparatus, reports the experimental validation of the model (dose deposited by protons in a water phantom, ambient dose equivalent due to neutrons in the treatment room, absorbed dose due to secondary particles in an anthropomorphic phantom), and the assessment with a mathematical phantom of doses dues to secondary neutrons received by organs during an ophthalmological treatment. He finally evokes current works of calculation of doses due to secondary neutrons in the case of intra-cranial treatments

Technique for sparing previously irradiated critical normal structures in salvage proton craniospinal irradiation

International Nuclear Information System (INIS)

McDonald, Mark W; Wolanski, Mark R; Simmons, Joseph W; Buchsbaum, Jeffrey C

2013-01-01

Cranial reirradiation is clinically appropriate in some cases but cumulative radiation dose to critical normal structures remains a practical concern. The authors developed a simple technique in 3D conformal proton craniospinal irradiation (CSI) to block organs at risk (OAR) while minimizing underdosing of adjacent target brain tissue. Two clinical cases illustrate the use of proton therapy to provide salvage CSI when a previously irradiated OAR required sparing from additional radiation dose. The prior radiation plan was coregistered to the treatment planning CT to create a planning organ at risk volume (PRV) around the OAR. Right and left lateral cranial whole brain proton apertures were created with a small block over the PRV. Then right and left lateral “inverse apertures” were generated, creating an aperture opening in the shape of the area previously blocked and blocking the area previously open. The inverse aperture opening was made one millimeter smaller than the original block to minimize the risk of dose overlap. The inverse apertures were used to irradiate the target volume lateral to the PRV, selecting a proton beam range to abut the 50% isodose line against either lateral edge of the PRV. Together, the 4 cranial proton fields created a region of complete dose avoidance around the OAR. Comparative photon treatment plans were generated with opposed lateral X-ray fields with custom blocks and coplanar intensity modulated radiation therapy optimized to avoid the PRV. Cumulative dose volume histograms were evaluated. Treatment plans were developed and successfully implemented to provide sparing of previously irradiated critical normal structures while treating target brain lateral to these structures. The absence of dose overlapping during irradiation through the inverse apertures was confirmed by film. Compared to the lateral X-ray and IMRT treatment plans, the proton CSI technique improved coverage of target brain tissue while providing the least

Changes in intellect associated with cranial radiation therapy

International Nuclear Information System (INIS)

Mulhern, R.K.; Ochs, J.; Kun, L.E.

1991-01-01

The direct effects of irradiation on the central nervous system (CNS) were not carefully studies until the mid- to late-1930s. Since that time, increasingly specific information has become available concerning the adverse late effects of irradiation on the CNS that mediates what we commonly considered human intelligence. The purpose of this chapter is to review the literature associating CNS irradiation and its effect on intelligence, to identify factors that place individuals at greater or lesser risk of intellectual impairment after irradiation, and to make recommendations for patient care and further research in this area. This paper presents findings from the child as well as adult literature, but an emphasis will be placed on the children because of the greater frequency of research reports as well as our own clinical experiences. the review will be limited to chronic or late effects, as opposed to acute or subacute effects, of external beam ionizing irradiation. The paper concentrates on the more frequent applications of cranial radiation therapy (CRT) and its potential late effects. These include the use of irradiation as CNS prophylaxis for acute lymphoblastic leukemia (ALL) and lung-carcinoma, and as a primary therapeutic modality for CNS leukemia and brain tumors

Risk of First and Recurrent Stroke in Childhood Cancer Survivors Treated With Cranial and Cervical Radiation Therapy

International Nuclear Information System (INIS)

Mueller, Sabine; Sear, Katherine; Hills, Nancy K.; Chettout, Nassim; Afghani, Shervin; Gastelum, Erica; Haas-Kogan, Daphne; Fullerton, Heather J.

2013-01-01

Purpose: To assess, in a retrospective cohort study, rates and predictors of first and recurrent stroke in patients treated with cranial irradiation (CRT) and/or cervical irradiation at ≤18 years of age. Methods and Materials: We performed chart abstraction (n=383) and phone interviews (n=104) to measure first and recurrent stroke in 383 patients who received CRT and/or cervical radiation at a single institution between 1980 and 2009. Stroke was defined as a physician diagnosis and symptoms consistent with stroke. Incidence of first stroke was number of first strokes per person-years of observation after radiation. We used survival analysis techniques to determine cumulative incidence of first and recurrent stroke. Results: Among 325 subjects with sufficient follow-up data, we identified 19 first strokes (13 ischemic, 4 hemorrhagic, 2 unknown subtype) occurring at a median age of 24 years (interquartile range 17-33 years) in patients treated with CRT. Imaging was reviewed when available (n=13), and the stroke was confirmed in 12. Overall rate of first stroke was 625 (95% confidence interval [CI] 378-977) per 100,000 person-years. The cumulative incidence of first stroke was 2% (95% CI 0.01%-5.3%) at 5 years and 4% (95% CI 2.0%-8.4%) at 10 years after irradiation. With each 100-cGy increase in the radiation dose, the stroke hazard increased by 5% (hazard ratio 1.05; 95% CI 1.01-1.09; P=.02). We identified 6 recurrent strokes; 5 had available imaging that confirmed the stroke. Median time to recurrence was 15 months (interquartile range 6 months-3.2 years) after first stroke. The cumulative incidence of recurrent stroke was 38% (95% CI 17%-69%) at 5 years and 59% (95% CI 27%-92%) at 10 years after first stroke. Conclusion: Cranial irradiation puts childhood cancer survivors at high risk of both first and recurrent stroke. Stroke prevention strategies for these survivors are needed

Anatomically shaped cranial collimation (ACC) for lateral cephalometric radiography: a technical report.

Science.gov (United States)

Hoogeveen, R C; van der Stelt, P F; Berkhout, W E R

2014-01-01

Lateral cephalograms in orthodontic practice display an area cranial of the base of the skull that is not required for diagnostic evaluation. Attempts have been made to reduce the radiation dose to the patient using collimators combining the shielding of the areas above the base of the skull and below the mandible. These so-called "wedge-shaped" collimators have not become standard equipment in orthodontic offices, possibly because these collimators were not designed for today's combination panoramic-cephalometric imaging systems. It also may be that the anatomical variability of the area below the mandible makes this area unsuitable for standardized collimation. In addition, a wedge-shaped collimator shields the cervical vertebrae; therefore, assessment of skeletal maturation, which is based on the stage of development of the cervical vertebrae, cannot be performed. In this report, we describe our investigations into constructing a collimator to be attached to the cephalostat and shield the cranial area of the skull, while allowing the visualization of diagnostically relevant structures and markedly reducing the size of the irradiated area. The shape of the area shielded by this "anatomically shaped cranial collimator" (ACC) was based on mean measurements of cephalometric landmarks of 100 orthodontic patients. It appeared that this collimator reduced the area of irradiation by almost one-third without interfering with the imaging system or affecting the quality of the image. Further research is needed to validate the clinical efficacy of the collimator.

Food irradiation receives international acceptance

International Nuclear Information System (INIS)

Beddoes, J.M.

1982-01-01

Irradition has advantages as a method of preserving food, especially in the Third World. The author tabulates some examples of actual use of food irradiation with dates and tonnages, and tells the story of the gradual acceptance of food irradiation by the World Health Organization, other international bodies, and the U.S. Food and Drug Administration (USFDA). At present, the joint IAEA/FAO/WHO standard permits an energy level of up to 5 MeV for gamma rays, well above the 1.3 MeV energy level of 60 Co. The USFDA permits irradiation of any food up to 10 krad, and minor constituents of a diet may be irradiated up to 5 Mrad. The final hurdle to be cleared, that of economic acceptance, depends on convincing the food processing industry that the process is technically and economically efficient

Imaging of Cranial Nerves III, IV, VI in Congenital Cranial Dysinnervation Disorders.

Science.gov (United States)

Kim, Jae Hyoung; Hwang, Jeong Min

2017-06-01

Congenital cranial dysinnervation disorders are a group of diseases caused by abnormal development of cranial nerve nuclei or their axonal connections, resulting in aberrant innervation of the ocular and facial musculature. Its diagnosis could be facilitated by the development of high resolution thin-section magnetic resonance imaging. The purpose of this review is to describe the method to visualize cranial nerves III, IV, and VI and to present the imaging findings of congenital cranial dysinnervation disorders including congenital oculomotor nerve palsy, congenital trochlear nerve palsy, Duane retraction syndrome, Möbius syndrome, congenital fibrosis of the extraocular muscles, synergistic divergence, and synergistic convergence. © 2017 The Korean Ophthalmological Society.

Stevens-Johnson syndrome in patients on phenytoin and cranial radiotherapy

International Nuclear Information System (INIS)

Khafaga, Y.M.; Jamshed, A.; Allam, A.A.K.; Ezzat, A.; Gray, A.J.; Schultz, H.; Mourad, W.A.; Al Eisa, A.

1999-01-01

The use of phenytoin as a prophylactic anticonvulsant after brain surgery, particularly for brain tumors, is a common practice, regardless of whether the patient has a previous history of convulsions. This treatment policy assumes that the benefits exceed the risks. Four cases are described of adverse reactions of phenytoin during the cocomitant use of cranial radiotherapy. In one patient this proved fatal. There is increasing anecdotal support in the literature for a synergistic effect between phenytoin therapy and cranial radiotherapy that can result in the life-threatening Stevens-Johnson syndrome. While the association is uncommon, four cases within 24 months in one department suggest that the routine use of postoperative phenytoin as a prophylactic anticonvulsant in the absence of a history of seizures may not be warranted, particularly if the patient is to receive cranial radiotherapy. (orig.)

Schwannoma originating from lower cranial nerves: report of 4 cases.

Science.gov (United States)

Oyama, Hirofumi; Kito, Akira; Maki, Hideki; Hattori, Kenichi; Noda, Tomoyuki; Wada, Kentaro

2012-02-01

Four cases of schwannoma originating from the lower cranial nerves are presented. Case 1 is a schwannoma of the vagus nerve in the parapharyngeal space. The operation was performed by the transcervical approach. Although the tumor capsule was not dissected from the vagus nerve, hoarseness and dysphagia happened transiently after the operation. Case 2 is a schwannoma in the jugular foramen. The operation was performed by the infralabyrinthine approach. Although only the intracapsular tumor was enucleated, facial palsy, hoarseness, dysphagia and paresis of the deltoid muscle occurred transiently after the operation. The patient's hearing had also slightly deteriorated. Case 3 is a dumbbell-typed schwannoma originating from the hypoglossal nerve. The hypoglossal canal was markedly enlarged by the tumor. As the hypoglossal nerves were embedded in the tumor, the tumor around the hypoglossal nerves was not resected. The tumor was significantly enlarged for a while after stereotactic irradiation. Case 4 is an intracranial cystic schwannoma originating from the IXth or Xth cranial nerves. The tumor was resected through the cerebello-medullary fissure. The tumor capsule attached to the brain stem was not removed. Hoarseness and dysphagia happened transiently after the operation. Cranial nerve palsy readily occurs after the removal of the schwannoma originating from the lower cranial nerves. Mechanical injury caused by retraction, extension and compression of the nerve and heat injury during the drilling of the petrous bone should be cautiously avoided.

Effects of neck radiation therapy on extra-cranial carotid arteries atherosclerosis disease prevalence: systematic review and a meta-analysis.

Directory of Open Access Journals (Sweden)

Khalid Bashar

Full Text Available Radiation arteritis following neck irradiation as a treatment for head and neck malignancy has been well documented. The long-term sequelae of radiation exposure of the carotid arteries may take years to manifest clinically, and extra-cranial carotid artery (ECCA stenosis is a well-recognised vascular complication. These carotid lesions should not be regarded as benign and should be treated in the same manner as standard carotid stenosis. Previous studies have noted increased cerebrovascular events such as stroke in this cohort of patients because of high-grade symptomatic carotid stenosis resulting in emboli.To evaluate the effect of radiation therapy on ECCA atherosclerosis progression.Online search for case-control studies and randomised clinical trials that reported on stenosis in extra-cranial carotid arteries in patients with neck malignancies who received radiation therapy (RT comparing them to patients with neck malignancies who did not receive RT.Eight studies were included in the final analysis with total of 1070 patients - 596 received RT compared to 474 in the control group. There was statistically significant difference in overall stenosis rate (Pooled risk ratio  =  4.38 [2.98, 6.45], P  =  0.00001 and severe stenosis (Pooled risk ratio  =  7.51 [2.78, 20.32], P <0.0001, both being higher in the RT group. Pooled analysis of the five studies that reported on mild stenosis also showed significant difference (Pooled risk ratio  =  2.74 [1.75, 4.30], 95% CI, P  =  0.0001.The incidence of severe ECCA stenosis is higher among patients who received RT for neck malignancies. Those patients should be closely monitored and screening programs should be considered in all patients who receive neck RT.

Fast neutron irradiation deteriorates hippocampus-related memory ability in adult mice.

Science.gov (United States)

Yang, Miyoung; Kim, Hwanseong; Kim, Juhwan; Kim, Sung-Ho; Kim, Jong-Choon; Bae, Chun-Sik; Kim, Joong-Sun; Shin, Taekyun; Moon, Changjong

2012-03-01

Object recognition memory and contextual fear conditioning task performance in adult C57BL/6 mice exposed to cranial fast neutron irradiation (0.8 Gy) were examined to evaluate hippocampus-related behavioral dysfunction following acute exposure to relatively low doses of fast neutrons. In addition, hippocampal neurogenesis changes in adult murine brain after cranial irradiation were analyzed using the neurogenesis immunohistochemical markers Ki-67 and doublecortin (DCX). In the object recognition memory test and contextual fear conditioning, mice trained 1 and 7 days after irradiation displayed significant memory deficits compared to the sham-irradiated controls. The number of Ki-67- and DCX-positive cells decreased significantly 24 h post-irradiation. These results indicate that acute exposure of the adult mouse brain to a relatively low dose of fast neutrons interrupts hippocampal functions, including learning and memory, possibly by inhibiting neurogenesis.

Tolerance of cranial nerves of the cavernous sinus to radiosurgery

International Nuclear Information System (INIS)

Tishler, R.B.; Loeffler, J.S.; Alexander, E. III; Kooy, H.M.; Lunsford, L.D.; Duma, C.; Flickinger, J.C.

1993-01-01

Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery for 62 patients (42/62 with meningiomas) treated for lesions within or near the cavernous sinus. Twenty-nine patients were treated with a modified 6 MV linear accelerator (Joint Center for Radiation Therapy) and 33 were treated with the Gamma Knife (University of Pittsburgh). Three-dimensional treatment plans were retrospectively reviewed and maximum doses were calculated for the cavernous sinus and the optic nerve and chiasm. Median follow-up was 19 months (range 3-49). New cranial neuropathies developed in 12 patients from 3-41 months following radiosurgery. Four of these complications involved injury to the optic system and 8 (3/8 transient) were the result of injury to the sensory or motor nerves of the cavernous sinus. There was no clear relationship between the maximum dose to the cavernous sinus and the development of complications for cranial nerves III-VI over the dose range used (1000-4000 cGy). For the optic apparatus, there was a significantly increased incidence of complications with dose. Four of 17 patients (24%) receiving greater than 800 cGy to any part of the optic apparatus developed visual complications compared with 0/35 who received less than 800 cGy (p = 0.009). Radiosurgery using tumor-controlling doses of up to 4000 cGy appears to be a relatively safe technique in treating lesions within or near the sensory and motor nerves (III-VI) of the cavernous sinus. The dose to the optic apparatus should be limited to under 800 cGy. 21 refs., 4 tabs

SU-F-T-188: A Robust Treatment Planning Technique for Proton Pencil Beam Scanning Cranial Spinal Irradiation

Energy Technology Data Exchange (ETDEWEB)

Zhu, M; Mehta, M; Badiyan, S; Young, K; Malyapa, R; Regine, W; Langen, K [University of Maryland School of Medicine, Baltimore, MD (United States); Yam, M [University of Florida Proton Therapy Institute, Jacksonville, FL (United States)

2016-06-15

Purpose: To propose a proton pencil beam scanning (PBS) cranial spinal irradiation (CSI) treatment planning technique robust against patient roll, isocenter offset and proton range uncertainty. Method: Proton PBS plans were created (Eclipse V11) for three previously treated CSI patients to 36 Gy (1.8 Gy/fractions). The target volume was separated into three regions: brain, upper spine and lower spine. One posterior-anterior (PA) beam was used for each spine region, and two posterior-oblique beams (15° apart from PA direction, denoted as 2PO-15) for the brain region. For comparison, another plan using one PA beam for the brain target (denoted as 1PA) was created. Using the same optimization objectives, 98% CTV was optimized to receive the prescription dose. To evaluate plan robustness against patient roll, the gantry angle was increased by 3° and dose was recalculated without changing the proton spot weights. On the re-calculated plan, doses were then calculated using 12 scenarios that are combinations of isocenter shift (±3mm in X, Y, and Z directions) and proton range variation (±3.5%). The worst-case-scenario (WCS) brain CTV dosimetric metrics were compared to the nominal plan. Results: For both beam arrangements, the brain field(s) and upper-spine field overlap in the T2–T5 region depending on patient anatomy. The maximum monitor unit per spot were 48.7%, 47.2%, and 40.0% higher for 1PA plans than 2PO-15 plans for the three patients. The 2PO-15 plans have better dose conformity. At the same level of CTV coverage, the 2PO-15 plans have lower maximum dose and higher minimum dose to the CTV. The 2PO-15 plans also showed lower WCS maximum dose to CTV, while the WCS minimum dose to CTV were comparable between the two techniques. Conclusion: Our method of using two posterior-oblique beams for brain target provides improved dose conformity and homogeneity, and plan robustness including patient roll.

Effects of ACNU and cranial irradiation on the immune system of mice

Energy Technology Data Exchange (ETDEWEB)

Yamanaka, Ryuya (Niigata Univ. (Japan). Brain Research Inst.)

1992-02-01

Effects of ACNU and cranial irradiation on the mouse immune system were studied. The mice were divided into three groups according to the treatments, that is, Group A; injection of ACNU (30 mg/kg) intraperitoneally, Group B; single exposure of 10 Gy on the head, Group C; both ACNU (30 mg/kg) injection intraperitoneally and single exposure of 10 Gy on the head. Peripheral white blood cell counts, spleen cell subsets, NK cell activity, lymphocyte blastogenesis and production of IFN-{gamma} were analyzed serially once a week for 6 weeks after treatments. Results were as follows, in the group A, NK cell activity decreased during the 4{approx}5 weeks, con A blastogenesis during the 1{approx}4 weeks, L3T4 Cells, Lyt 2 Cells and production of IFN-{gamma} during the 2{approx}5 weeks respectively. However those returned to normal range at the 6 weeks. In the group B, each parameters, excepts for L3T4 Cells and production of IFN-{gamma}, decreased for up to the 1st week, and returned to normal range thereafter. L3T4 Cells decreased at the 2nd and during the 5{approx}6 weeks. Production of IFN-{gamma} increased at the 1st week, decreased during the 2{approx}3 weeks and returned to normal range thereafter. In the group C, suppressive effects were severe and continued longer period than in groups A and B. Con A blastogenesis, L3T4 Cells and production of IFN-{gamma} were still suppressed at the 6th week. Therfore, intensive treatments of radiochemotherapy to the brain tumor may be considered to suppress patient's immunological function. We should take into account for patient's immunological function including lymphocytic function in the treatment for brain tumor. (author).

The Cranial Nerve Skywalk: A 3D Tutorial of Cranial Nerves in a Virtual Platform

Science.gov (United States)

Richardson-Hatcher, April; Hazzard, Matthew; Ramirez-Yanez, German

2014-01-01

Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways…

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

International Nuclear Information System (INIS)

Jafri Malim Abdullah

1999-01-01

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

Estimate of absorbed dose received by individuals irradiated with neutrons

International Nuclear Information System (INIS)

Fonseca, E.S. da; Mauricio, C.L.P.

1995-01-01

An innovating methodology is proposed to estimate the absorbed dose received by individuals irradiated with neutrons in an accident, even in the case that the victim is not using any kind of neutron dosemeter. The method combines direct measurements of 24 Na and 32 P activated in the human body. The calculation method was developed using data taken from previously published papers and experimental measurements. Other irradiations results in different neutron spectra prove the validity of the methodology here proposed. Using a whole body counter to measure 24 Na activity, it is possible to evaluate neutron absorbed doses in the order of 140 μGy of very soft (thermal) spectra. For fast neutron fields, the lower limit for neutron dose detection increases, but the present method continues to be very useful in accidents, with higher neutron doses. (author). 5 refs., 1 fig., 4 tabs

The cranial-spinal junction in medulloblastoma: does it matter?

International Nuclear Information System (INIS)

Narayana, Ashwatha; Jeswani, Sam; Paulino, Arnold C.

1999-01-01

Purpose: Late effects of treatment in children and young adults with medulloblastoma can be influenced by the technique employed in radiating the craniospinal axis. The purpose of this study is to determine whether the placement of the cranial-spinal junction has an impact on dose to the cervical spinal cord and surrounding organs. Methods and Materials: Five patients underwent computed tomography (CT) simulation in the prone position for craniospinal irradiation. A dose of 36 Gy was prescribed to the entire neuraxis. The doses to the cervical spinal cord and surrounding organs were calculated using a cranial-spinal junction at the C1-C2 vertebral interspace (high junction) or at the lowest point in the neck, with exclusion of the shoulders in the lateral cranial fields (low junction).The volume of critical organs at risk, as well as dose to these structures using the cranial and spinal field(s) were outlined and calculated using the CMS FOCUS 3-dimensional treatment planning system. Results: The average dose to the cervical spinal cord was 11.9% higher than the prescribed dose with the low junction, and 6.7% higher with the high junction. However, doses to the thyroid gland, mandible, pharynx, and larynx were increased by an average of 29.6%, 75.8%, 70.6%, and 227.7%, respectively, by the use of the high junction compared to the low junction. Conclusion: A higher dose to the cervical spinal cord can be minimized by using a high junction. However, this would be at the cost of substantially increased doses to surrounding organs such as the thyroid gland, mandible, pharynx, and larynx. This can be critical in children and young adults, where hypothyroidism, mandibular hypoplasia, and development of second malignancies may be a late sequela of radiation therapy

Determination of dose received by bladder and rectum in external cervical irradiation

International Nuclear Information System (INIS)

Omer, Mohamed Ahmed Ali

2001-12-01

The cervical carcinoma is the common type of malignant tumor among sudanese females during the last years. The conventional external irradiation therapy is the common model of treatment for cervical carcinoma in (RICK). The irradiation of such cases implemented via four fields (box technique), two anterior and posterior and two lateral opposed fields, as central dose calculation, giving a dose of 5000 c Gy fractionated into 25 to 30 fractions. The parameter of the fields lie at the promontory of the sacral cephalic and at the obturators foramen caudally and laterally at the bony pelvic by one centimeter. The aim of the research is to determine the dose received by the rectum and bladder (critical organs), out of central dose calculation versus off axis dose calculation to (Day's method). The data obtained by using simulator and radiation oncological computerized system (Rocs). The results are analyzed by using statistical processing for social science program (SPSS) that shows the mean dose received by the bladder is 3821 cGy, due to central dose calculation that accompanied by an un-optimum encompassment of treatment line and 4210.6 c Gy. due to Off Axis Dose calculation dose 3324.4 c Gy and 3712.1 c Gy due to central dose calculation. The increment of dose received by the rectum and the bladder is due to utilizing of wider width of the filed size for lateral irradiation. To score the aim of International Atomic Energy Agency (IAEA) and (ALARA) principle A s Low As As Reasonable Available , we have to use the simulator to obtain the anatomical structures on the contour, or will be better to use CT. Scan for calculation of dose at the side of interest. (Author)

Detection of TT Virus Among Thalassaemic Children With Chronic Viral Hepatitis B and C Receiving Irradiated and Non Irradiated RBCs

International Nuclear Information System (INIS)

El-Maghraby, D.F.; EL-Shafie, A.I.; El-Sayed, S.A.; Alkady, M.M.

2010-01-01

TTV was first identified in the serum of a patient with post transfusion hepatitis of unknown etiology in 1997.As a consequence of the high prevalence of TTV in blood donors, thalassemia patients frequently acquire various genotypes of this virus through therapeutic blood transfusions.TTV as a cause of chronic hepatitis has not yet determined . Ten healthy and twenty-eight poly-transfused thalassemia children were evolved in this study where ten patients were receiving irradiated RBCs and eighteen receiving non irradiated ones.TTV was detected in serum samples by semi-nested polymerase chain reaction (PCR) using TTV-specific primer. Transaminases levels, hepatitis B and C virus markers were interpreted for possible association with TTV infection. As a result, TTV was found in 50% of thalassemia patients and in 20 % of the controls. Among thalassemia patients, isolated HBsAG, isolated HCV-AB, HBsAG and TTV-DNA and HCV-AB and TTV-DNA distributions were: 6 (21.43%) ,8 ( 28.57%) , 4 ( 14.29%) and 10 (35.7%) respectively. Regarding thalassemia patients receiving irradiated RBCs, the frequency of viral infections were 8(80%), 2(20%) and 0% for TTV co-infections, isolated HBV and isolated HCV, respectively. On the other hand, the prevalence of viral infections among patients receiving non irradiated RBCs were 6(33.3%), 4(22.2%) and 8(44.5%) for TTV co-infection, isolated HBV and isolated HCV, respectively. These data may give evidence that radiation raises the levels of blood safety especially regarding HCV. Furthermore, liver transaminase levels were significantly higher in all patients versus the controls, meanwhile, transaminase values were not different in HBsAG-positive subjects as compared with subjects who had both HBsAG and TTV-DNA positive. Also, there was no significant difference between isolated HCV infection and HCV and TTV co-infection. So, no convincing evidence was found to support TTV involvement in the D. F. EL-MAGHRABY, et al. / J. Rad. Res. Appl. Sci

Normal cranial CT anatomy

International Nuclear Information System (INIS)

Gado, M.H.; Rao, K.C.V.G.

1987-01-01

The human brain consists of well-known anatomical components. Some parts of these components have been shown to be concerned with certain functions. A complete cranial CT examination consists of a series of several slices obtained in a sequence usually from the base to the vertex of the cranial vault, in the axial mode. The ultimate goal of this chapter is to pinpoint those slices that depict a given anatomical structure or several structures that deal with a given function. To achieve this goal, the discussion of CT cranial anatomy is presented in three sections

Intraoperative cranial nerve monitoring.

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Harper, C Michel

2004-03-01

The purpose of intraoperative monitoring is to preserve function and prevent injury to the nervous system at a time when clinical examination is not possible. Cranial nerves are delicate structures and are susceptible to damage by mechanical trauma or ischemia during intracranial and extracranial surgery. A number of reliable electrodiagnostic techniques, including nerve conduction studies, electromyography, and the recording of evoked potentials have been adapted to the study of cranial nerve function during surgery. A growing body of evidence supports the utility of intraoperative monitoring of cranial nerve nerves during selected surgical procedures.

Cranial Neuropathy in Multiple Sclerosis

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Mine Hayriye Sorgun

2011-09-01

Full Text Available OBJECTIVE: It has been reported that cranial neuropathy findings could be seen in the neurologic examination of multiple sclerosis (MS patients, although brain magnetic resonance imaging (MRI may not reveal any lesion responsible for the cranial nerve involvement. The aim of this study was to determine the frequency of brainstem and cranial nerve involvement, except for olfactory and optic nerves, during MS attacks, and to investigate the rate of an available explanation for the cranial neuropathy findings by lesion localization on brain MRI. METHODS: Ninety-five attacks of 86 MS patients were included in the study. The patients underwent a complete neurological examination, and cranial nerve palsies (CNP were determined during MS attacks. RESULTS: CNP were found as follows: 3rd CNP in 7 (7.4%, 4th CNP in 1 (1.1%, 5th CNP in 6 (6.3%, 6th CNP in 12 (12.6%, 7th CNP in 5 (5.3%, 8th CNP in 4 (4.2%, and 9th and 10th CNP in 2 (2.1% out of 95 attacks. Internuclear ophthalmoplegia (INO was detected in 5 (5.4%, nystagmus in 37 (38.9%, vertigo in 9 (6.3%, and diplopia in 14 (14.7% out of 95 attacks. Pons, mesencephalon and bulbus lesions were detected in 58.7%, 41.5% and 21.1% of the patients, respectively, on the brain MRI. Cranial nerve palsy findings could not be explained by the localization of the lesions on brainstem MRI in 5 attacks; 2 of them were 3rd CNP (1 with INO, 2 were 6th CNP and 1 was a combination of 6th, 7th and 8th CNP. CONCLUSION: The most frequently affected cranial nerve and brainstem region in MS patients is the 6th cranial nerve and pons, respectively. A few of the MS patients have normal brainstem MRI, although they have cranial neuropathy findings in the neurologic examination.

Calculation of cranial nerve complication probability for acoustic neuroma radiosurgery

International Nuclear Information System (INIS)

Meeks, Sanford L.; Buatti, John M.; Foote, Kelly D.; Friedman, William A.; Bova, Francis J.

2000-01-01

Purpose: Estimations of complications from stereotactic radiosurgery usually rely simply on dose-volume or dose-diameter isoeffect curves. Due to the sparse clinical data available, these curves have typically not considered the target location in the brain, target histology, or treatment plan conformality as parameters in the calculation. In this study, a predictive model was generated to estimate the probability of cranial neuropathies as a result of acoustic schwannoma radiosurgery. Methods and Materials: The dose-volume histogram reduction scheme was used to calculate the normal tissue complication probability (NTCP) from brainstem dose-volume histograms. The model's fitting parameters were optimized to provide the best fit to the observed complication data for acoustic neuroma patients treated with stereotactic radiosurgery at the University of Florida. The calculation was then applied to the remainder of the patients in the database. Results: The best fit to our clinical data was obtained using n = 0.04, m = 0.15, and no. alphano. /no. betano. = 2.1 Gy -1 . Although the fitting parameter m is relatively consistent with ranges found in the literature, both the volume parameter, n, and no. alphano. /no. betano. are much smaller than the values quoted in the literature. The fit to our clinical data indicates that brainstem, or possibly a specific portion of the brainstem, is more radiosensitive than the parameters in the literature indicate, and that there is very little volume effect; in other words, irradiation of a small fraction of the brainstem yields NTCPs that are nearly as high as those calculated for entire volume irradiation. These new fitting parameters are specific to acoustic neuroma radiosurgery, and the small volume effect that we observe may be an artifact of the fixed relationship of acoustic tumors to specific regions of the brainstem. Applying the model to our patient database, we calculate an average NTCP of 7.2% for patients who had no

Comparison of the effectiveness of ''late'' and ''early'' prophylactic cranial irradiation in patients with limited-stage small cell lung cancer

International Nuclear Information System (INIS)

Sas-Korczynska, Beata; Korzeniowski, Stanislaw; Wojcik, Ewa

2010-01-01

Purpose: to evaluate the effectiveness of timing of application of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer in limited stage of disease (LS SCLC). Patients and methods: between 1995 and 2004, 129 patients with LS SCLC were treated within two consecutive phase II studies assessing different schedules of combined treatment. All patients received chemotherapy and concurrent thoracic radiotherapy. In 86 patients (66.7%) who developed complete response in the thorax, PCI was performed either after chemoradiotherapy (''late'' PCI, n = 45 [52.4%]) or during chemoradiotherapy (''early'' PCI, n = 41 [47.7%]). In the latter case, PCI was given immediately after the end of thoracic radiotherapy and prior to the last cycles of chemotherapy to a total dose of 30 Gy in 2-Gy fractions to the whole brain. The results were evaluated with regard to 4-year rates of overall survival, disease-free survival, and brain metastases-free survival. Additionally, the prognostic role of PCI application and its time delay in relation to survival rates and incidence of brain metastases was estimated. Results: the 4-year survival rates were 25.5% for overall survival, 26.8% for disease-free survival, and 67.8% for brain metastases-free survival. During the observation period, 32 patients (24.8%) developed brain metastases, which occured in 20 of 43 patients (46.5%) without and only in twelve out of 86 patients (14%) with PCI. The 4-year brain metastases-free survival rates were 81.8%, if PCI was applied, versus 32.2%, if no such procedure was used (for p = 0.0000). The timing of PCI appeared to be an important factor in terms of decreasing the incidence of brain metastases. Conclusion: PCI significantly decreases the incidence of brain metastases and delays their development in patients with LS SCLC. ''Early'' PCI is more effective than PCI applied after combined therapy. (orig.)

Cranial nerve palsies

International Nuclear Information System (INIS)

Ruggieri, P.; Adelizzi, J.; Modic, M.T.; Ross, J.S.; Tkach, J.; Masaryk, T.J.

1990-01-01

This paper evaluates the utility of multiplanar reconstructions (MPRs) of three-dimensional (3D) MR angiography data sets in the examination of patients with cranial nerve palsies. The authors hypothesis was that 3D data could be reformatted to highlight the intricate spatial relationships of vessels to adjacent neural tissues by taking advantage of the high vessel-parenchyma contrast in high-resolution 3D time-of-flight sequences. Twenty patients with cranial nerve palsies and 10 asymptomatic patients were examined with coronal T1-weighted and axial T2-weighted imaging plus a gadolinium-enhanced 3D MRA sequence (40/7/15 degrees, axial 60-mm volume, 0.9-mm isotropic resolution). Cranial nerves II-VIII were subsequently evaluated on axial and reformatted coronal and/or sagittal images

Neuromuscular ultrasound of cranial nerves.

Science.gov (United States)

Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

2015-04-01

Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

Outcome and patterns of failure following limited-volume irradiation for malignant astrocytomas

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Garden, A.S.; Maor, M.H.; Yung, W.K.A.; Bruner, J.M.; Woo, Shiao Y.; Moser, R.P.; Lee, Ya-Yen (Anderson (M.D.) Hospital and Tumor Inst., Houston, TX (USA))

1991-02-01

Between January 1982 and June 1986, 60 consecutive patients with high-grade astrocytomas (39 glioblastoma multiforme (GBM), 21 anaplastic astrocytoma (AA)) were treated with radiation therapy after biopsy (13 patients) or resection (47 patients). 53 patients were treated with limited-volume irradiation, 7 received whole-brain irradiation. The mean tumor dose was 65.4 Gy. In 35 patients, chemotherapy was given as part of their initial treatment. The 1- and 2-year survivals for GBM patients were 40 and 14 percent, respectively. Survival figures for AA patients were 76 and 52 percent at 1 and 2 years, respectively. The progression-free rate at 1 year was 13 percent in GBM and 29 percent in AA patients. 34 of 48 patients who received limited-volume irradiation had evidence of progression on postirradiation CT scans. 6 patients (3 GBM, 3 AA) had evidence of a new intracranial metastatic site on CT scan. In 3 patients the metastasis was within the previously irradiated volume, and in 3 other patients, it was outside this volume. All 6 had evidence of progression of their primary tumor at the original location on CT scan prior to the discovery of the metastatic site. 21 patients (15 GBM, 6 AA) had at least 1 postirradiation reoperation for a recurrent mass. 19 patients had recurrent tumors in the primary site, and 2 patients had necrosis but no tumor. Patients who received limited-volume irradiation for high-grade astrocytomas achieved the same survival results as patients treated previously with whole brain irradiation. New intra-cranial metastases did not influence the outcome, since these were always antedated by tumor progression at the primary site. (author). 16 refs.; 8 figs.; 2 tabs.

Reconstrução do ligamento cruzado cranial em cães, associado ou não ao sulfato de condroitina Cranial cruciate ligament reconstruction in dogs associated or not to chondroitin sulfate

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F. Biasi

2005-08-01

Full Text Available Avaliou-se o efeito da reconstrução do ligamento cruzado cranial, associado ou não ao sulfato de condroitina, na evolução da osteoartrite induzida experimentalmente em cães. Vinte cães hígidos, sem raça definida, machos e fêmeas, com peso corpóreo entre 19 e 25kg, foram submetidos à desmotomia do ligamento cruzado cranial. Trinta dias após, foram separados em dois grupos de 10 animais. Um grupo foi submetido à reconstrução do ligamento cruzado com uso de aloenxerto de ligamento patelar congelado, o outro não. Trinta e um dias após a desmotomia, cada grupo foi dividido em dois subgrupos de cinco animais. Um recebeu sulfato de condroitina, o outro não. Os cães foram avaliados clínica e radiograficamente antes da desmotomia e aos 30, 60 e 90 dias após a desmotomia. No último momento foram realizados exames macro e microscópico. Nos cães submetidos somente à desmotomia e tratados com sulfato de condroitina houve redução na progressão das alterações ósseas, ao exame radiográfico. A reconstrução do ligamento cruzado cranial melhorou a função do membro e, quando associada ao sulfato de condroitina, houve melhor resposta. Não houve diferença entre os subgrupos quanto aos exames macro e microscópico.The effect of cranial cruciate ligament reconstruction, associated or not to chondroitin sulfate, on the evolution of experimentally induced osteoarthritis in dogs was studied. Twenty healthy mixed dogs, weighing between 19 and 25kg were submitted to cranial cruciate desmotomy. Thirty days later, the animals were divided into two groups with ten dogs each. One was submitted to cranial cruciate ligament reconstruction using frozen patellar tendon allograft and the other received no surgical treatment. Thirty one days after desmotomy, each group was divided into two subgroups with five animals each. One subgroup for each group received chondroitin sulfate and the other received no medical treatment. The dogs were

LACK OF INFLATED RADII FOR KEPLER GIANT PLANET CANDIDATES RECEIVING MODEST STELLAR IRRADIATION

International Nuclear Information System (INIS)

Demory, Brice-Olivier; Seager, Sara

2011-01-01

The most irradiated transiting hot Jupiters are characterized by anomalously inflated radii, sometimes exceeding Jupiter's size by more than 60%. While different theoretical explanations have been applied, none of them provide a universal resolution to this observation, despite significant progress in the past years. We refine the photometric transit light curve analysis of 115 Kepler giant planet candidates based on public Q0-Q2 photometry. We find that 14% of them are likely false positives, based on their secondary eclipse depth. We report on planet radii versus stellar flux. We find an increase in planet radii with increased stellar irradiation for the Kepler giant planet candidates, in good agreement with existing hot Jupiter systems. We find that in the case of modest irradiation received from the stellar host, giant planets do not have inflated radii, and appear to have radii independent of the host star incident flux. This finding suggests that the physical mechanisms inflating hot Jupiters become ineffective below a given orbit-averaged stellar irradiation level of ∼2 × 10 8 erg s –1 cm –2 .

Terminal nerve: cranial nerve zero

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Jorge Eduardo Duque Parra

2006-12-01

Full Text Available It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH. In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a common nerve that integrates the terminal nerve with the olfactory nerves and the vomeronasals nerves which seem to carry out the odors detection function as well as in the food search, pheromone detection and nasal vascular regulation.

CT measurements of cranial growth: microcephaly

International Nuclear Information System (INIS)

Hahn, F.J.; Chu, W.K.; Torkelson, R.D.

1984-01-01

Computed tomographic (CT) head scans were measured to determine the cranial dimensions of four children with microcephaly. These measurements were compared with cranial dimensions of normal children. CT proved to be useful in determining the developmental status of children with neurologic problems relative to their normal counterparts on the basis on cranial dimensions

The response of the Advisory Committee on Irradiated and Novel Foods (ACINF) to comments received on the ''Report on the safety and wholesomeness of irradiated foods'' (HMSO -ISBN 0 11 321059 0)

International Nuclear Information System (INIS)

1987-11-01

The Advisory Committee on Irradiated and Novel Foods (ACINF) replies to comments received on the publication of the Report on the Safety and Wholesomeness of Irradiated Foods. Comments were received concerning the assessment of the potential risks of food irradiation versus possible benefits, the effects of irradiation on vitamin levels, the production of free radicals and toxic substances, the likelihood of the irradiation of unfit foods, the effects on food additives and packaging, dose rates and radioactivity levels. The ACINF did not consider any of the fears to be justified or any comments would cause a change in advice given in the report. Recommendations were made. (U.K.)

Cranial nerves III, IV and VI

International Nuclear Information System (INIS)

Laine, I.J.; Smoker, W.R.; Kuta, A.J.; Felton, W.L.

1991-01-01

Because of advances in CT and MR imaging, accurate identification and evaluation of cranial nerve lesions is now possible. Cranial nerves III, IV, and VI, providing motor and sensory control of the eye, can be evaluated as a unit. In this paper, the authors present an overview of the anatomy and pathology of these cranial nerves. We first illustrate their normal anatomic pathways from the brain stem to the orbit. This is followed by clinical examples of patients with a variety of isolated and complex palsies of these three cranial nerves. This is accomplished by inclusion of ocular photographs, correlative imaging studies, and the use of diagrams. Knowledge of the gross and imaging anatomy and the ophthalmologic manifestations of pathology affecting these three cranial nerves permits a tailored approach to their evaluation

Cranial radiation in childhood acute lymphocytic leukemia. Neuropsychologic sequelae

International Nuclear Information System (INIS)

Whitt, J.K.; Wells, R.J.; Lauria, M.M.; Wilhelm, C.L.; McMillan, C.W.

1984-01-01

A battery of neuropsychologic tests was administered ''blindly'' to 18 children with acute lymphocytic leukemia (ALL) who had been randomly assigned to treatment regimens with or without cranial radiation. These children were all in complete continuous remission for more than 3 1/2 years and were no longer receiving therapy. The results indicated no substantial differences between groups as a function of radiation therapy. However, decreased neuropsychologic performance was found when the entire sample was compared with population norms. These data do not support the hypothesis that cranial radiation therapy is responsible for the neuropsychologic sequelae seen in these survivors of ALL. Post hoc multiple regression analysis indicated that parental education levels accounted for more of the neuropsychologic variability seen in these children than other factors such as age at diagnosis, type of therapy, or sex of child

Endocrine disorders and growth after cranial radiation

International Nuclear Information System (INIS)

Rappaport, R.; Brauner, R.

1988-01-01

Several groups of children were investigated in whom various radiation doses were delivered to the hypothalamic and pituitary regions. The frequency of growth hormone (GH) deficiency varied from 100% in patients receiving more than 4,500 cGy to 52% in the group of leukemic patients receiving 2,400 cGy. Complete anterior pituitary deficiency occurred only in the group of patients receiving radiation doses superior to 4,500 cGy, with few exception. In a prospective study investigating the changes in GH secretion, 40% of the children were low responders to AITT (peak below 8 ng/ml) two years after irradiation. Growth hormone deficiency had remained asymptomatic during this early post irradiation period. Only 50% of the patients who were low reponders to AITT had a retarded growth. TSH secretion was impaired in 20% of the patients irradiated with doses superior to 2,500 cGy. The study of GH secretion in patients receiving various radiation doses to the hypothalamic pituitary region provided a model of GH secretory dysfunction. It also allowed a comparison with growth. It is recommended that hGH therapy be started only two years after irradiation, after completion of chemotherapy. (N.K)

[Imaging anatomy of cranial nerves].

Science.gov (United States)

Hermier, M; Leal, P R L; Salaris, S F; Froment, J-C; Sindou, M

2009-04-01

Knowledge of the anatomy of the cranial nerves is mandatory for optimal radiological exploration and interpretation of the images in normal and pathological conditions. CT is the method of choice for the study of the skull base and its foramina. MRI explores the cranial nerves and their vascular relationships precisely. Because of their small size, it is essential to obtain images with high spatial resolution. The MRI sequences optimize contrast between nerves and surrounding structures (cerebrospinal fluid, fat, bone structures and vessels). This chapter discusses the radiological anatomy of the cranial nerves.

Feasibility of small animal cranial irradiation with the microRT system

International Nuclear Information System (INIS)

Kiehl, Erich L.; Stojadinovic, Strahinja; Malinowski, Kathleen T.; Limbrick, David; Jost, Sarah C.; Garbow, Joel R.; Rubin, Joshua B.; Deasy, Joseph O.; Khullar, Divya; Izaguirre, Enrique W.; Parikh, Parag J.; Low, Daniel A.; Hope, Andrew J.

2008-01-01

Purpose: To develop and validate methods for small-animal CNS radiotherapy using the microRT system. Materials and Methods: A custom head immobilizer was designed and built to integrate with a pre-existing microRT animal couch. The Delrin couch-immobilizer assembly, compatible with multiple imaging modalities (CT, microCT, microMR, microPET, microSPECT, optical), was first imaged via CT in order to verify the safety and reproducibility of the immobilization method. Once verified, the subject animals were CT-scanned while positioned within the couch-immobilizer assembly for treatment planning purposes. The resultant images were then imported into CERR, an in-house-developed research treatment planning system, and registered to the microRTP treatment planning space using rigid registration. The targeted brain was then contoured and conformal radiotherapy plans were constructed for two separate studies: (1) a whole-brain irradiation comprised of two lateral beams at the 90 degree sign and 270 degree sign microRT treatment positions and (2) a hemispheric (left-brain) irradiation comprised of a single A-P vertex beam at the 0 degree sign microRT treatment position. During treatment, subject animals (n=48) were positioned to the CERR-generated treatment coordinates using the three-axis microRT motor positioning system and were irradiated using a clinical Ir-192 high-dose-rate remote after-loading system. The radiation treatment course consisted of 5 Gy fractions, 3 days per week. 90% of the subjects received a total dose of 30 Gy and 10% received a dose of 60 Gy. Results: Image analysis verified the safety and reproducibility of the immobilizer. CT scans generated from repeated reloading and repositioning of the same subject animal in the couch-immobilizer assembly were fused to a baseline CT. The resultant analysis revealed a 0.09 mm average, center-of-mass translocation and negligible volumetric error in the contoured, murine brain. The experimental use of the head

Predicted risks of second malignant neoplasm incidence and mortality due to secondary neutrons in a girl and boy receiving proton craniospinal irradiation

International Nuclear Information System (INIS)

Taddei, Phillip J; Mirkovic, Dragan; Zhang Rui; Giebeler, Annelise; Harvey, Mark; Newhauser, Wayne D; Mahajan, Anita; Kornguth, David; Woo, Shiao

2010-01-01

The purpose of this study was to compare the predicted risks of second malignant neoplasm (SMN) incidence and mortality from secondary neutrons for a 9-year-old girl and a 10-year-old boy who received proton craniospinal irradiation (CSI). SMN incidence and mortality from neutrons were predicted from equivalent doses to radiosensitive organs for cranial, spinal and intracranial boost fields. Therapeutic proton absorbed dose and equivalent dose from neutrons were calculated using Monte Carlo simulations. Risks of SMN incidence and mortality in most organs and tissues were predicted by applying risks models from the National Research Council of the National Academies to the equivalent dose from neutrons; for non-melanoma skin cancer, risk models from the International Commission on Radiological Protection were applied. The lifetime absolute risks of SMN incidence due to neutrons were 14.8% and 8.5%, for the girl and boy, respectively. The risks of a fatal SMN were 5.3% and 3.4% for the girl and boy, respectively. The girl had a greater risk for any SMN except colon and liver cancers, indicating that the girl's higher risks were not attributable solely to greater susceptibility to breast cancer. Lung cancer predominated the risk of SMN mortality for both patients. This study suggests that the risks of SMN incidence and mortality from neutrons may be greater for girls than for boys treated with proton CSI.

Multiple Cranial Nerve Involvement In Cryptococcal Meningitis

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Mahadevan A

2000-01-01

Full Text Available Cryptococcal meningitis is an uncommon cause of multiple cranial nerve palsies. This case report illustrates one such case of cryptococcal meningitis clinically manifesting with extensive cranial nerve involvement in an HIV seronegative individual. Histology revealed infiltration of the cranial nerves by cryptococci causing axonal disruption with secondary demyelination in the absence of any evidence of inflammation or vasculitis. We believe that axonal damage underlies the pathogenesis of cranial nerve involvement in cryptococcal meningitis.

Cranial Bosses of Choerosaurus dejageri (Therapsida, Therocephalia): Earliest Evidence of Cranial Display Structures in Eutheriodonts.

Science.gov (United States)

Benoit, Julien; Manger, Paul R; Fernandez, Vincent; Rubidge, Bruce S

2016-01-01

Choerosaurus dejageri, a non-mammalian eutheriodont therapsid from the South African late Permian (~259 Ma), has conspicuous hemispheric cranial bosses on the maxilla and the mandible. These bosses, the earliest of this nature in a eutheriodont, potentially make C. dejageri a key species for understanding the evolutionary origins of sexually selective behaviours (intraspecific competition, ritualized sexual and intimidation displays) associated with cranial outgrowths at the root of the clade that eventually led to extant mammals. Comparison with the tapinocephalid dinocephalian Moschops capensis, a therapsid in which head butting is strongly supported, shows that the delicate structure of the cranial bosses and the gracile structure of the skull of Choerosaurus would be more suitable for display and low energy combat than vigorous head butting. Thus, despite the fact that Choerosaurus is represented by only one skull (which makes it impossible to address the question of sexual dimorphism), its cranial bosses are better interpreted as structures involved in intraspecific selection, i.e. low-energy fighting or display. Display structures, such as enlarged canines and cranial bosses, are widespread among basal therapsid clades and are also present in the putative basal therapsid Tetraceratops insignis. This suggests that sexual selection may have played a more important role in the distant origin and evolution of mammals earlier than previously thought. Sexual selection may explain the subsequent independent evolution of cranial outgrowths and pachyostosis in different therapsid lineages (Biarmosuchia, Dinocephalia, Gorgonopsia and Dicynodontia).

Cranial Bosses of Choerosaurus dejageri (Therapsida, Therocephalia: Earliest Evidence of Cranial Display Structures in Eutheriodonts.

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Julien Benoit

Full Text Available Choerosaurus dejageri, a non-mammalian eutheriodont therapsid from the South African late Permian (~259 Ma, has conspicuous hemispheric cranial bosses on the maxilla and the mandible. These bosses, the earliest of this nature in a eutheriodont, potentially make C. dejageri a key species for understanding the evolutionary origins of sexually selective behaviours (intraspecific competition, ritualized sexual and intimidation displays associated with cranial outgrowths at the root of the clade that eventually led to extant mammals. Comparison with the tapinocephalid dinocephalian Moschops capensis, a therapsid in which head butting is strongly supported, shows that the delicate structure of the cranial bosses and the gracile structure of the skull of Choerosaurus would be more suitable for display and low energy combat than vigorous head butting. Thus, despite the fact that Choerosaurus is represented by only one skull (which makes it impossible to address the question of sexual dimorphism, its cranial bosses are better interpreted as structures involved in intraspecific selection, i.e. low-energy fighting or display. Display structures, such as enlarged canines and cranial bosses, are widespread among basal therapsid clades and are also present in the putative basal therapsid Tetraceratops insignis. This suggests that sexual selection may have played a more important role in the distant origin and evolution of mammals earlier than previously thought. Sexual selection may explain the subsequent independent evolution of cranial outgrowths and pachyostosis in different therapsid lineages (Biarmosuchia, Dinocephalia, Gorgonopsia and Dicynodontia.

Dataset of TWIST1-regulated genes in the cranial mesoderm and a transcriptome comparison of cranial mesoderm and cranial neural crest

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Heidi Bildsoe

2016-12-01

Full Text Available This article contains data related to the research article entitled “Transcriptional targets of TWIST1 in the cranial mesoderm regulate cell-matrix interactions and mesenchyme maintenance” by Bildsoe et al. (2016 [1]. The data presented here are derived from: (1 a microarray-based comparison of sorted cranial mesoderm (CM and cranial neural crest (CNC cells from E9.5 mouse embryos; (2 comparisons of transcription profiles of head tissues from mouse embryos with a CM-specific loss-of-function of Twist1 and control mouse embryos collected at E8.5 and E9.5; (3 ChIP-seq using a TWIST1-specific monoclonal antibody with chromatin extracts from TWIST1-expressing MDCK cells, a model for a TWIST1-dependent mesenchymal state.

Prophylactic Cranial Irradiation (PCI) versus Active MRI Surveillance for Small Cell Lung Cancer: The Case for Equipoise.

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Rusthoven, Chad G; Kavanagh, Brian D

2017-12-01

Prophylactic cranial irradiation (PCI) for SCLC offers a consistent reduction in the incidence of brain metastases at the cost of measurable toxicity to neurocognitive function and quality of life, in the setting of characteristic pathologic changes to the brain. The sequelae of PCI have historically been justified by the perception of an overall survival advantage specific to SCLC. This rationale has now been challenged by a randomized trial in extensive-stage SCLC demonstrating equivalent progression-free survival and a trend toward improved overall survival with PCI omission in the context of modern magnetic resonance imaging (MRI) staging and surveillance. In this article, we critically examine the randomized trials of PCI in extensive-stage SCLC and discuss their implications on the historical data supporting PCI for limited-stage SCLC from the pre-MRI era. Further, we review the toxicity of moderate doses of radiation to the entire brain that underlie the growing interest in active MRI surveillance and PCI omission. Finally, the evidence supporting prospective investigation of radiosurgery for limited brain metastases in SCLC is reviewed. Overall, our aim is to provide an evidence-based assessment of the debate over PCI versus active MRI surveillance and to highlight the need for contemporary trials evaluating optimal central nervous system management in SCLC. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Thyroid dysfunction and neoplasia in children receiving neck irradiation for cancer

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Fleming, I.D.; Black, T.L.; Thompson, E.I.; Pratt, C.; Rao, B.; Hustu, O.

1985-01-01

The reported relationship of radiation exposure and thyroid carcinoma stimulated this retrospective study of 298 patients treated at St. Jude Children's Hospital with radiation therapy to the neck for childhood cancer to identify patients who developed subsequent thyroid abnormalities. This series includes 153 patients with Hodgkin's disease, 95 with acute lymphocytic leukemia, 28 with lymphoepithelioma, and 22 with miscellaneous tumors. Inclusion in the study required 5 years of disease-free survival following therapy for their original tumor, which included thyroid irradiation. Follow-up has been 100%. Most patients also received chemotherapy. Seventeen patients were found to have decreased thyroid reserve with normal levels of free triiodothyroxine (T3) or free thyroxin, (T4) and an elevated level of thyroid-stimulating hormone (TSH). In nine patients hypothyroidism developed, with decreased T3 or T4 levels and an elevated level of TSH. One hyperthyroid patient was identified. Two patients had thyroiditis, and seven had thyroid neoplasms: (carcinoma in two, adenoma in two, colloid nodule in one, and undiagnosed nodules in two). This survey has demonstrated an increased incidence of thyroid dysfunction and thyroid neoplasia when compared to the general population. The importance of long-term follow-up for thyroid disease is emphasized in patients who have received thyroid irradiation. The possible role of subclinical hypothyroidism with TSH elevation coupled with radiation damage to the thyroid gland as a model for the development of neoplastic disease is discussed

Epidemiological approach to emergent cranial surgery of cranial traumas

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Hülagü Kaptan

2008-03-01

Full Text Available

Objective: In this study, we aim to define the emergent cranial surgery of cranial trauma cases in terms of the reason of occurance, diagnosis, prognostic factors and results. Methods: 153 cases hospitalized in our clinic during a four year period were statistically analysed in accordance with trauma etiology, age, gender, application GCS (Glascow Coma Score mortality rate, location and established patology.

Results: 76% (116 of the 153 cases were male. The most frequent etiological reasons were, in descending order, traffic accident 52% (n = 80, fall 34% (n = 53, direct trauma to the head 14(n =20. 45% (n = 69 were diagnosed epidural haematomas, 26% (n = 40 were diagnosed depression fractures and 3% (n = 5 were diagnosed intracerebral haematomas. A meaningful statistical difference was found in the comparison of the diagnosis regarding gender (p=0,012 age group (p=0,0282 and GCS (p=0,0001.

Conclusions: In order to prevent cranial traumas, studies aimed at minimizing traffic accidents should be undertaken. The most essential action after the accident has occured is triage, and this is of great importance in order to establish communication among the health institutions.

Familial Idiopathic Cranial Neuropathy in a Chinese Family.

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Zhang, Li; Liang, Jianfeng; Yu, Yanbing

Cranial neuropathy is usually idiopathic and familial cases are uncommon. We describe a family with 5 members with cranial neuropathy over 3 generations. All affected patients were women, indicating an X-linked dominant or an autosomal dominant mode of inheritance. Our cases and a review of the literature suggest that familial idiopathic cranial neuropathy is a rare condition which may be related to autosomal dominant vascular disorders (e.g. vascular tortuosity, sclerosis, elongation or extension), small posterior cranial fossas, anatomical variations of the posterior circulation, hypersensitivity of cranial nerves and other abnormalities. Moreover, microvascular decompression is the treatment of choice because vascular compression is the main factor in the pathogenesis. To the best of our knowledge, this is the first report of familial cranial neuropathy in China.

Use of Multidirectional Cranial Distraction Osteogenesis for Cranial Expansion in Syndromic Craniosynostosis

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Ataru Sunaga, MD

2017-12-01

Full Text Available Summary:. Patients with syndromic craniosynostosis often require a large amount of cranial expansion to avoid intracranial hypertension, but the surgical procedure remains controversial. A patient of severe syndromic craniosynostosis with multiple bony defects and anomalous venous drainage at the occipital region was treated by multidirectional cranial distraction osteogenesis (MCDO at the age of 8 months. Distraction started 5 days after surgery and ceased on postoperative day 16. The distraction devices were removed 27 days after completing distraction. After device removal, the increase of intracranial volume was 155 ml and the cephalic index was improved from 115.5 to 100.5. The resultant cranial shape was well maintained with minimal relapse at postoperative 9 months. In cases of syndromic craniosynostosis with multiple bony defects and/or anomalous venous drainage at the occipital region, expansion of the anterior cranium by MCDO is a viable alternative to conventional methods.

Efficacy of prophylactic cranial irradiation in patients with limited-disease small-cell lung cancer who were confirmed to have no brain metastasis via magnetic resonance imaging after initial chemoradiotherapy

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Mamesaya, Nobuaki; Wakuda, Kazushige; Omae, Katsuhiro; Miyawaki, Eriko; Kotake, Mie; Fujiwara, Takumi; Kawamura, Takahisa; Kobayashi, Haruki; Nakashima, Kazuhisa; Omori, Shota; Ono, Akira; Kenmotsu, Hirotsugu; Naito, Tateaki; Murakami, Haruyasu; Mori, Keita; Harada, Hideyuki; Endo, Masahiro; Nakajima, Takashi; Takahashi, Toshiaki

2018-01-01

Background Prophylactic cranial irradiation (PCI) is recommended for patients with limited-disease small-cell lung cancer (LD-SCLC) who achieved good response to definitive chemoradiotherapy. However, most clinical studies lacked brain imaging scans before PCI. Our study aimed to investigate whether PCI has a survival benefit in patients who have no brain metastases (BM) confirmed via magnetic resonance imaging (MRI) before PCI. Results Eighty patients were included in this study. Sixty patients received PCI (PCI group) and 20 patients did not (non-PCI group). OS was not significantly different between the two groups. The median OS time was 4.3 years (95% CI: 2.6 years–8.6 years) in the PCI group and was not reached (NR) (95% CI: 1.9 years–NR) in the non-PCI group (p = 0.542). Moreover, no differences were observed in the 3-year rates of PFS (46.2% and 44.4%, p = 0.720) and cumulative incidence of BM (24.0% vs. 27%, p = 0.404). Conclusions Our result suggests that PCI may not have a survival benefit in patients with LD-SCLC confirmed to have no BM after initial therapy, even if patients achieve a good response to definitive chemoradiotherapy. Patients and Methods We retrospectively evaluated patients with LD-SCLC who were confirmed to have no BM via MRI after initial chemoradiotherapy at the Shizuoka Cancer Center between September 2002 and August 2015. The overall survival (OS), progression-free survival (PFS), and cumulative incidence of BM were estimated using the Kaplan–Meier method between patients who received PCI and those who did not. Propensity score matching was used to balance baseline characteristics. PMID:29707139

Tolerance of the central nervous system to photon irradiation

International Nuclear Information System (INIS)

Wigg, D.R.; Murray, R.M.L.; Koschel, K.

1982-01-01

Dose-response isoeffect equations have been determined for hypothalamic pituitary insufficiency following cranial irradiation. Of particular importance is the occurrence of complications at doses substantially less than those commonly used for the treatment of central nervous system tumors. Such complications may be severe and potentially life threatening. These complications occur when a small midline 'target' volume containing the pituitary gland, infundibulum and adjacent inferior hypothalamic structures is irradiated. Direct pituitary irradiation is unlikely to be a factor, at least in some cases. The possible role of incidental hypothalamic irradiation in the control of acromegaly and pituitary dependent Cushing's syndrome is discussed. (Auth.)

Electrophysiology of Cranial Nerve Testing: Cranial Nerves IX and X.

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Martinez, Alberto R M; Martins, Melina P; Moreira, Ana Lucila; Martins, Carlos R; Kimaid, Paulo A T; França, Marcondes C

2018-01-01

The cranial nerves IX and X emerge from medulla oblongata and have motor, sensory, and parasympathetic functions. Some of these are amenable to neurophysiological assessment. It is often hard to separate the individual contribution of each nerve; in fact, some of the techniques are indeed a composite functional measure of both nerves. The main methods are the evaluation of the swallowing function (combined IX and X), laryngeal electromyogram (predominant motor vagal function), and heart rate variability (predominant parasympathetic vagal function). This review describes, therefore, the techniques that best evaluate the major symptoms presented in IX and X cranial nerve disturbance: dysphagia, dysphonia, and autonomic parasympathetic dysfunction.

Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: results of a multicentre randomised trial

International Nuclear Information System (INIS)

Gregor, A.; Cull, A.; Stephens, R.J.; Girling, D.J.; Machin, D.; Kirkpatrick, J.A.; Yarnold, J.R.; Macbeth, F.R.; Stout, R.

1997-01-01

Prophylactic cranial irradiation (PCI) reduces the risk of cranial metastasis in small cell lung cancer (SCLC), but the magnitude and value of this reduction, the risks of radiation morbidity and whether PCI influences survival are unclear. We conducted a randomised trial in patients with limited-stage SCLC who had had a complete response to induction therapy. Initially, patients were randomised equally to (1) PCI 36 Gy in 18 daily fractions, (2) PCI 24 Gy in 12 fractions and (3) no PCI; subsequently, to increase the rate of accrual, randomisation was to clinicians' choice of PCI regimen versus no PCI (at a 3:2 ratio). The endpoints were appearance of brain metastases, survival, cognitive function, and quality of life (QoL). Three hundred and fourteen patients (194 PCI, 120 No PCI) were randomised. In the revised design, the most commonly used PCI regimens were 30 Gy in 10 fractions and 8 Gy in a single dose. With PCI, there was a large and highly significant reduction in brain metastases (HR = 0.44, 95% CI 0.29-0.67), a significant advantage in brain-metastasis-free survival (HR = 0.75, 95% CI 0.58-0.96) and a non-significant overall survival advantage (HR 0.86, 95% CI 0.66-1.12). In both groups, there was impairment of cognitive function and QoL before PCI and additional impairment of 6 months and 1 year, butt no consistent difference between the two groups and thus no evidence over 1 year of major impairment attributable to PCI. PCI can safely reduce the risk of brain metastases. Further research is needed to define optimal dose and fractionation and to clarify the effect on survival. Patients with SCLC achieving a complete response to induction therapy should be offered PCI. (author)

Assessment of cognitive functions after prophylactic and therapeutic whole brain irradiation using neuropsychological testing

International Nuclear Information System (INIS)

Penitzka, S.; Wannenmacher, M.; Steinvorth, S.; MIT, Cambridge, MT; Sehlleier, S.; Universitaetsklinikum Wuerzburg; Fuss, M.; Texas Univ., San Antonio, TX; Wenz, F.; Universitaetsklinikum Mannheim

2002-01-01

Purpose: Aim of this study was the assessment of neuropsychological changes after whole brain irradiation. Patients and Method: 64 patients were tested before, and 29 after whole brain irradiation, including 28 patients with small cell lung cancer (SCLC) before prophylactic cranial irradiation (PCI) and 36 patients with cerebral metastases before therapeutic cranial irradiation (TCI), as well as 14 patients after PCI and 15 after TCI (Table 1). Intelligence, attention and memory were assessed applying a 90-minute test battery of standardized, neuropsychological tests (Table 3). Results: Patients with SCLC showed test results significantly below average before PCI (n=28, mean IQ=83, SD=17). Neither after PCI, nor after TCI the tested neuropsychological functions decreased significantly (Tables 4, 5). A comparison between SCLC-patients with and without cerebral metastases before whole brain irradiation showed better test-results in patients with cerebral metastases and fewer cycles of preceding chemotherapy (Table 7). Conclusion: Neuropsychological capacity in patients with SCLC was impaired even before PCI. Possible reason is the preceding chemotherapy. Whole brain irradiation did not induce a significant decline of cognitive functions in patients with PCI or TCI. A decline in a longer follow-up nevertheless seems possible. (orig.) [de

Multiple Cranial Nerve Involvement In Cryptococcal Meningitis

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Mahadevan A; Kumar A; Santosh V; Satishchandra P; Shankar S.K

2000-01-01

Cryptococcal meningitis is an uncommon cause of multiple cranial nerve palsies. This case report illustrates one such case of cryptococcal meningitis clinically manifesting with extensive cranial nerve involvement in an HIV seronegative individual. Histology revealed infiltration of the cranial nerves by cryptococci causing axonal disruption with secondary demyelination in the absence of any evidence of inflammation or vasculitis. We believe that axonal damage underlies the pathogenesis of...

Differential radiodiagnosis of cranial lesions in hyperparathyroid and deforming asteodystrophy, fibrous osteoplasia, multiple myeloma and tumor metastases to the cranial bones

International Nuclear Information System (INIS)

Spuzyak, M.I.

1986-01-01

The results of an analysis of craniographic findings were provided for 58 patients with primary hyperparathyrosis, 12 with fibrous osteodysplasia, 6 with deforming osteodystrophy, 14 with multiple myeloma and 16 with tumor metastases to the cranial bones. A study was made of some features of roentgenological semiotics (changes in the structure thickness and shapes of the cranial bones) of cranial bone lesions in the above diseases. Differential radiodiagnosis of cranial lesions in hypeparathyroid and deforming osteodystrophy, fibrous osteodysplasia, multiple myeloma and metastatic lesions of the cranial bones should be based not on single signs but on the symptom-complex (x-ray syndrome). For each of the analysed diseases x-ray syndromes were described

Radiation-induced leukopenia in breast cancer patients receiving prophylactic irradiation, and analysis of the effects of some drugs

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Ohkawa, T; Tsuya, A; Kaneda, K [Japanese Foundation for Cancer Research, Tokyo. Hospital

1975-06-01

Radiation-induced leukopenia was analyzed and assessed in breast cancer patients receiving prophylactic irradiation after radical mastectomy. Average white blood cell counts decreased to about 67 percent of the initial value after irradiation, and the ratio of the decrease was greater when the initial value was higher. During the course of the irradiation, white blood cell counts decreased to the lowest value by the middle of treatment time and stayed at the same level for one month after irradiation. The restorative or protective effects of taurine and cytochrome C were assessed by an open study, and that of DNA-spermidine by a double blind test, and the significant effects of each was observed.

Phosphorylation of histone H2AX as an indicator of received dose of gamma radiation after whole-body irradiation of rats

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Radim Havelek

2011-01-01

Full Text Available The aim of our study was to determine whether phosphorylation of histone H2AX can be used as an indicator of received dose of gamma radiation after whole-body irradiation of rats. Wistar rats were irradiated by 1-10 Gy of gamma radiation by 60Co source. Value LD50/60 was 7.37 (4.68-8.05 Gy. Histone H2AX is phosphorylated by ATM kinase on serine 139 (γH2AX quickly after the irradiation. It forms microscopically visible foci in the site of double strand breaks of DNA. Flow-cytometric method was used for quantitative detection. This study is the first one that evaluated dose-dependency of H2AX phosphorylation in peripheral lymphocytes of rats irradiated by whole-body dose 1-10 Gy. Our data show a dose-dependent increase in γH2AX in rat peripheral blood lymphocytes 1 h after whole-body irradiation by the dose of 1-10 Gy. We proved that phosphorylation of histone H2AX is a prompt and reliable indicator of the received radiation dose suitable for rapid measurement before the number of lymphocytes in peripheral blood starts to decrease. It can be used already 1 h after the irradiation for an estimation of the received dose of radiation. Blood samples can be stored in 4 °C for 23 h without significantly affecting the result.

21 CFR 882.4360 - Electric cranial drill motor.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source used...

Twelfth cranial nerve involvement in Guillian Barre syndrome.

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Nanda, Subrat Kumar; Jayalakshmi, Sita; Ruikar, Devashish; Surath, Mohandas

2013-07-01

Guillian Barre Syndrome (GBS) is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth). Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed.

Twelfth cranial nerve involvement in Guillian Barre syndrome

OpenAIRE

Subrat Kumar Nanda; Sita Jayalakshmi; Devashish Ruikar; Mohandas Surath

2013-01-01

Guillian Barre Syndrome (GBS) is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth). Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is...

Cranial MR finding of reversible eclampsia

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Sohn, Seok Ho; Hwang, Mi Young; Kim, Kyu Hwa; Kim, Seon Goo; Lee, Sung Moon; Kim, Hong; Joo, Yang Goo; Suh, Soo Ji [College of Medicine, Keimyung University, Daegu (Korea, Republic of)

1994-05-15

To evaluate clinical usefulness of cranial magnetic resonance imaging(MRI) in diagnosis and for follow-up of reversible eclampsia. Cranial MRI was performed on four consecutive pregnant patients(ante-partum 3 cases, postpartum 1 cases), who had generalized tonic-clonic seizure caused by eclampsia. One of the four patients underwent follow-up MRI. Cranial MRI typically demonstrated bilateral hyperintense lesions on T2-weighted images and iso-to hypointense lesions on T1-weighted images. MRI abnormalities were most commonly located in the distribution of the posterior cerebral artery circulation and were associated with symptoms of visual disturbance. Most cranial lesions of eclampsia demonstrated in MRI were reversible. MRI with its capability to detect even subtle abnormalities in the brain that are not visible on CT, and may be the technique of choice for evaluating the cerebral the pathology of pregnant women with eclampsia.

Increased health care utilization by survivors of childhood lymphoblastic leukemia is confined to those treated with cranial or total body irradiation: a case cohort study

International Nuclear Information System (INIS)

Holmqvist, Anna Sällfors; Moëll, Christian; Hjorth, Lars; Lindgren, Anna; Garwicz, Stanislaw; Wiebe, Thomas; Øra, Ingrid

2014-01-01

Previous studies have indicated that survivors of childhood acute lymphoblastic leukemia (ALL) have an increased morbidity measured in terms of health care utilization. However, earlier studies have several potentially important limitations. To overcome some of these, we investigated hospital contact rates, and predictors thereof, among 5-year survivors of ALL in a population-based setting, and compared them to a control cohort regarding outcome measures from a comprehensive nation-wide health register. All individuals diagnosed with ALL before the age of 18 in Southern Sweden during 1970–1999 and alive January 2007 (n = 213; male = 107) were identified through the Swedish Cancer Register. Each subject was matched to fifty controls, identified in the Swedish Population Register. All study subjects were linked to the National Hospital Register and detailed information was obtained on all hospital contacts (hospital admissions and outpatients visits) starting five years after cancer diagnosis, and the corresponding date for the controls, until 2009. The median follow-up among the 5-year survivors of ALL was 16 years (range 5–33), accruing a total of 3,527 person-years. Of the 213 5-year survivors, 105 (49.3%) had at least one hospital contact compared to 3,634 (34.1%) of the controls (p < 0.001). Survivors had more hospital contacts (3 [1–6] vs. 2 [1–4] contacts, p < 0.001) and more total days in hospital (6 [2–18] vs. 3 [1–7] days, p < 0.001) than the controls during the study period. Logistic regression analysis showed that survivors treated with cranial irradiation and/or total body irradiation (45% and 7%, respectively) had an increased risk of at least one hospital contact (OR 2.3, 95%CI; 1.5–3.6 and OR 11.0, 95%CI; 3.2–50.7, respectively), while there was no significant difference between the non-irradiated survivors and controls. We show that irradiated survivors of childhood ALL have an increased morbidity measured in terms of hospital

Twelfth cranial nerve involvement in Guillian Barre syndrome

Directory of Open Access Journals (Sweden)

Subrat Kumar Nanda

2013-01-01

Full Text Available Guillian Barre Syndrome (GBS is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth. Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed.

Cranial nerves - spectrum of inflammatory and tumorous changes

International Nuclear Information System (INIS)

Nemec, S.F.; Kasprian, G.; Nemec, U.; Czerny, C.

2009-01-01

Inflammatory processes as well as primary and secondary tumorous changes may involve cranial nerves causing neurological deficits. In addition to neurologists, ENT physicians, ophthalmologists and maxillofacial surgeons, radiologists play an important role in the investigation of patients with cranial nerve symptoms. Multidetector computed tomography (MDCT) and particularly magnetic resonance imaging (MRI) allow the depiction of the cranial nerve anatomy and pathological neural changes. This article briefly describes the imaging techniques in MDCT and MRI and is dedicated to the radiological presentation of inflammatory and tumorous cranial nerve pathologies. (orig.) [de

Secular trends in Cherokee cranial morphology: Eastern vs Western bands.

Science.gov (United States)

Sutphin, Rebecca; Ross, Ann H; Jantz, Richard L

2014-01-01

The research objective was to examine if secular trends can be identified for cranial data commissioned by Boas in 1892, specifically for cranial breadth and cranial length of the Eastern and Western band Cherokee who experienced environmental hardships. Multiple regression analysis was used to test the degree of relationship between each of the cranial measures: cranial length, cranial breadth and cephalic index, along with predictor variables (year-of-birth, location, sex, admixture); the model revealed a significant difference for all craniometric variables. Additional regression analysis was performed with smoothing Loess plots to observe cranial length and cranial breadth change over time (year-of-birth) separately for Eastern and Western Cherokee band females and males born between 1783-1874. This revealed the Western and Eastern bands show a decrease in cranial length over time. Eastern band individuals maintain a relatively constant head breadth, while Western Band individuals show a sharp decline beginning around 1860. These findings support negative secular trend occurring for both Cherokee bands where the environment made a detrimental impact; this is especially marked with the Western Cherokee band.

The naming of the cranial nerves: a historical review.

Science.gov (United States)

Davis, Matthew C; Griessenauer, Christoph J; Bosmia, Anand N; Tubbs, R Shane; Shoja, Mohammadali M

2014-01-01

The giants of medicine and anatomy have each left their mark on the history of the cranial nerves, and much of the history of anatomic study can be viewed through the lens of how the cranial nerves were identified and named. A comprehensive literature review on the classification of the cranial names was performed. The identification of the cranial nerves began with Galen in the 2nd century AD and evolved up through the mid-20th century. In 1778, Samuel Sömmerring, a German anatomist, classified the 12 cranial nerves as we recognize them today. This review expands on the excellent investigations of Flamm, Shaw, and Simon et al., with discussion of the historical identification as well as the process of naming the human cranial nerves. Copyright © 2013 Wiley Periodicals, Inc.

Cranial nerve palsies in childhood parameningeal rhabdomyosarcoma.

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Zorzi, Alexandra P; Grant, Ronald; Gupta, Abha A; Hodgson, David C; Nathan, Paul C

2012-12-15

Children with parameningeal rhabdomyosarcoma (PM RMS) and cranial nerve palsy (CNP) are at risk for permanent neurologic dysfunction. Clinicians often consider the use of emergent therapies such as expedited radiation and/or corticosteroids; however, there is a paucity of information describing the natural history of CNP in PM RMS. We sought to describe the clinical features of patients with PM RMS plus associated CNP and to evaluate the patient, disease, and treatment-related factors that impacted neurologic recovery. We conducted a retrospective review of PM RMS cases treated at the Hospital for Sick Children between 1985 and 2010. Thirty-five children were treated for PM RMS, 19 (54%) of whom presented with CNP. Children with CNP were nine times more likely to have other high-risk features (cranial base bony erosion and/or intracranial extension) at the time of presentation than children without CNP (OR 9.6, 95% CI 1.69, 54.79, P = 0.013). In addition to commencing chemotherapy, 13 patients (68%) received expedited RT and corticosteroids, four (21%) corticosteroids alone, and two (11%) received only standard chemotherapy and RT. At last follow up of the 11 survivors, neurologic recovery was complete in five (45%), partial in five (45%), and absent in one (9%). In our cohort, recovery of PM RMS associated CNP was often incomplete despite multi-modal therapy. A larger cohort of patients is required to determine the utility of emergent initiation of radiation or corticosteroids. This study will facilitate the counseling of future families on the long-term neurologic recovery CNP in PM RMS. Copyright © 2012 Wiley Periodicals, Inc.

Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

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Rong, X.; Tang, Y.; Lu, K.; Peng, Y. [Sun Yat-sen Memorial Hospital, Guangzhou (China). Dept. of Neurology; Chen, M. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Nasopharyngeal Carcinoma

2012-03-15

The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

International Nuclear Information System (INIS)

Rong, X.; Tang, Y.; Lu, K.; Peng, Y.; Chen, M.

2012-01-01

The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

CT measurments of cranial growth: normal subjects

International Nuclear Information System (INIS)

Hahn, F.J.; Chu, W.K.; Cheung, J.Y.

1984-01-01

Growth patterns of the cranium measured directly as head circumference have been well documented. With the availability of computed tomography (CT) , cranial dimensions can be obtained easily. The objective of this project was to establish the mean values and their normal variance of CT cranial area of subjects at different ages. Cranial area and its long and short axes were measured on CT scans for 215 neurologic patients of a wide age range who presented no evidence of abnormal growth of head size. Growth patterns of the cranial area as well as the numeric product of it linear dimensions were determined via a curve fitting process. The patterns resemble that of the head circumference growth chart, with the most rapid growth observed in the first 12 months of age and reaching full size during adolescence

An investigation into the regulation of intra-cranial pressure and its influence upon the surrounding cranial bones.

Science.gov (United States)

Gard, Graham

2009-07-01

The aim of this study is to present a rational coherent hypothesis to explain the palpable involuntary movements of the cranium. The arterial and venous anatomy inside and around the skull and spinal column presents a complete vascular system with the capacity to regulate intra-cranial pressure to a level of equilibrium slightly higher than atmospheric pressure. Variations in cerebrospinal fluid (csf) pressure control the volume of blood draining through the cavernous sinus and hence into the inter-vertebral venous plexus in relation to the jugular vein. Stable intra-cranial pressure is maintained by a controlled release of venous blood through the inter-vertebral venous plexus (slow) and the jugular vein (fast) in the cavernous sinus. Any distortion of the skull from its healthy state will lead to reduced intra-cranial volume. The process of release from the state of compression has been interpreted as "cranial rhythm" but may be a mechanical adjustment increasing the internal volume of the skull, aided by the continual maintenance of stable intracranial pressure. This involuntary movement is capable of being assisted manually.

[From anatomy to image: the cranial nerves at MRI].

Science.gov (United States)

Conforti, Renata; Marrone, Valeria; Sardaro, Angela; Faella, Pierluigi; Grassi, Roberta; Cappabianca, Salvatore

2013-01-01

In this article, we review the expected course of each of the 12 cranial nerves. Traditional magnetic resonance imaging depicts only the larger cranial nerves but SSFP sequences of magnetic resonance imaging are capable of depicting the cisternal segments of 12 cranial nerves and also provide submillimetric spatial resolution.

Infant Positioning, Baby Gear Use, and Cranial Asymmetry.

Science.gov (United States)

Zachry, Anne H; Nolan, Vikki G; Hand, Sarah B; Klemm, Susan A

2017-12-01

Objectives This study aimed to identify predictors of cranial asymmetry. We hypothesize that among infants diagnosed with cranial asymmetry in the sampled region, there is an association between exposure to more time in baby gear and less awake time in prone and side-lying than in infants who do not present with this condition. Methods The study employed a cross sectional survey of caregivers of typically developing infants and infants diagnosed with cranial asymmetry. Results A mutivariable model reveals that caregivers of children who are diagnosed with cranial asymmetry report their children spending significantly less time in prone play than those children without a diagnosis of cranial asymmetry. Side-lying and time spent in baby gear did not attain statistical significance. Conclusions for Practice Occupational therapists, physical therapists, pediatricians, nurses and other health care professionals must provide parents with early education about the importance of varying positions and prone play in infancy and address fears and concerns that may serve as barriers to providing prone playtime.

Cranial joint histology in the mallard duck (Anas platyrhynchos): new insights on avian cranial kinesis.

Science.gov (United States)

Bailleul, Alida M; Witmer, Lawrence M; Holliday, Casey M

2017-03-01

The evolution of avian cranial kinesis is a phenomenon in part responsible for the remarkable diversity of avian feeding adaptations observable today. Although osteological, developmental and behavioral features of the feeding system are frequently studied, comparatively little is known about cranial joint skeletal tissue composition and morphology from a microscopic perspective. These data are key to understanding the developmental, biomechanical and evolutionary underpinnings of kinesis. Therefore, here we investigated joint microstructure in juvenile and adult mallard ducks (Anas platyrhynchos; Anseriformes). Ducks belong to a diverse clade of galloanseriform birds, have derived adaptations for herbivory and kinesis, and are model organisms in developmental biology. Thus, new insights into their cranial functional morphology will refine our understanding of avian cranial evolution. A total of five specimens (two ducklings and three adults) were histologically sampled, and two additional specimens (a duckling and an adult) were subjected to micro-computed tomographic scanning. Five intracranial joints were sampled: the jaw joint (quadrate-articular); otic joint (quadrate-squamosal); palatobasal joint (parasphenoid-pterygoid); the mandibular symphysis (dentary-dentary); and the craniofacial hinge (a complex flexion zone involving four different pairs of skeletal elements). In both the ducklings and adults, the jaw, otic and palatobasal joints are all synovial, with a synovial cavity and articular cartilage on each surface (i.e. bichondral joints) ensheathed in a fibrous capsule. The craniofacial hinge begins as an ensemble of patent sutures in the duckling, but in the adult it becomes more complex: laterally it is synovial; whereas medially, it is synostosed by a bridge of chondroid bone. We hypothesize that it is chondroid bone that provides some of the flexible properties of this joint. The heavily innervated mandibular symphysis is already fused in the

Re-irradiation: Outcome, cumulative dose and toxicity in patients retreated with stereotactic radiotherapy in the abdominal or pelvic region

NARCIS (Netherlands)

H. Abusaris (Huda); M.S. Hoogeman (Mischa); J.J.M.E. Nuyttens (Joost)

2012-01-01

textabstractThe purpose of the present study was to explore the outcome, cumulative dose in tumor and organs at risk and toxicity after extra-cranial stereotactic re-irradiation. Twenty-seven patients were evaluated who had been re-irradiated with stereotactic body radiotherapy (SBRT) after

Fibrous dysplasia of the cranial vault: quantitative analysis based on neural networks

International Nuclear Information System (INIS)

Arana, E.; Marti-Bonmati, L.; Paredes, R.; Molla, E.

1998-01-01

To assess the utility of statistical analysis and neural networks in the quantitative analysis of fibrous dysplasia of the cranial vault. Ten patients with fibrous dysplasia (six women and four men with a mean age of 23.60±17.85 years) were selected from a series of 167 patients with lesions of the cranial vault evaluated by plain radiography and computed tomography (CT). Nineteen variables were taken from their medical records and radiological study. Their characterization was based on statistical analysis and neural network, and was validated by means of the leave-one-out method. The performance of the neural network was estimated by means of receiver operating characteristics (ROC) curves, using as a parameter the area under the curve A z . Bivariate analysis identified age, duration of symptoms, lytic and sclerotic patterns, sclerotic margin, ovoid shape, soft-tissue mas and periosteal reaction as significant variables. The area under the neural network curve was 0.9601±0.0435. The network selected the matrix and soft-tissue mass a variables that were indispensable for diagnosis. The neural network presents a high performance in the characterization of fibrous dysplasia of the cranial vault, disclosing occult interactions among the variables. (Author) 24 refs

SCLC extensive disease – treatment guidance by extent or/and biology of response?

International Nuclear Information System (INIS)

Eckert, Franziska; Müller, Arndt-Christian

2008-01-01

In extensive disease of small cell lung cancer a doubling of the one-year-survival rate was reported in August 2007 by prophylactic cranial irradiation applied to patients who experienced any response to initial chemotherapy. We discuss the treatment concept of extensive disease in the face of the latest results and older studies with additional thoracic irradiation in this subgroup. A randomized trial with prophylactic cranial irradiation published in 1999 demonstrated an improvement of 5-year-overall-survival for complete responders (at least at distant levels) receiving additional thoracic radiochemotherapy compared to chemotherapy alone (9.1% vs. 3.7%). But, these results were almost neglected and thoracic radiotherapy was not further investigated for good responders of extensive disease. However, in the light of current advances by prophylactic cranial irradiation these findings are noteworthy on all accounts. Considering both, a possible interpretation of these data could be a survival benefit of local control by simultaneous thoracic radiochemotherapy in the case of improved distant control due to chemotherapy and prophylactic cranial irradiation. Furthermore the question arises whether the tumor biology indicated by the response to chemotherapy should be integrated in the present classification

Tolerance of the central nervous system to photon irradiation. Endocrine complications

Energy Technology Data Exchange (ETDEWEB)

Wigg, D.R.; Murray, R.M.L.; Koschel, K. (Royal Adelaide Hospital (Australia))

1982-01-01

Dose-response isoeffect equations have been determined for hypothalamic pituitary insufficiency following cranial irradiation. Of particular importance is the occurrence of complications at doses substantially less than those commonly used for the treatment of central nervous system tumors. Such complications may be severe and potentially life threatening. These complications occur when a small midline 'target' volume containing the pituitary gland, infundibulum and adjacent inferior hypothalamic structures is irradiated. Direct pituitary irradiation is unlikely to be a factor, at least in some cases. The possible role of incidental hypothalamic irradiation in the control of acromegaly and pituitary dependent Cushing's syndrome is discussed.

Aberrant regeneration of the third cranial nerve.

Science.gov (United States)

Shrestha, U D; Adhikari, S

2012-01-01

Aberrant regeneration of the third cranial nerve is most commonly due to its damage by trauma. A ten-month old child presented with the history of a fall from a four-storey building. She developed traumatic third nerve palsy and eventually the clinical features of aberrant regeneration of the third cranial nerve. The adduction of the eye improved over time. She was advised for patching for the strabismic amblyopia as well. Traumatic third nerve palsy may result in aberrant regeneration of the third cranial nerve. In younger patients, motility of the eye in different gazes may improve over time. © NEPjOPH.

Cranial imaging in child abuse

Energy Technology Data Exchange (ETDEWEB)

Demaerel, P.; Wilms, G. [Department of Radiology, University Hospitals, Leuven (Belgium); Casteels, I. [Department of Ophthalmology, University Hospitals, Leuven (Belgium)

2002-04-01

Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Opthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma. (orig.)

Cranial imaging in child abuse

International Nuclear Information System (INIS)

Demaerel, P.; Wilms, G.; Casteels, I.

2002-01-01

Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Opthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma. (orig.)

Craniospinal axis irradiation: an improved electron technique for irradiation of the spinal axis

International Nuclear Information System (INIS)

Chun Li; Vijayakumar, S.; Myrianthopoulos, L.C.; Kuchnir, F.T.; Muller-Runkel, R.

1994-01-01

The authors review dosimetric features of craniospinal axis irradiation in the areas of matching cranial and spinal fields, with reference to normal structures within the spinal field. The implications of the use of photon or electron modalities for the spinal port were evaluated. A novel method of matching the cranial photon and the spinal electron fields involving a computer-aided junction design is presented, involving moving the photon beam in three steps to degrade its penumbra to match that of the electron field. Thermoluminescent dosimetry in a Rando phantom and computed tomography-based dose-volume histogram study for an illustrative paediatric case were used to compare dose to normal structures within the spinal field. Results show that the use of electrons for the spinal field leads to better sparing of deep seated normal structures. For bone marrow, the use of a customized bolus for the spinal field results in an improved dose distribution, making electrons potentially superior to photons for radiobiological reasons. (author)

Cranial mononeuropathy III

Science.gov (United States)

... in the skull. This is one of the cranial nerves that control eye movement. Causes may include: Brain aneurysm Infections Abnormal blood vessels (vascular malformations) Sinus thrombosis Tissue damage from loss of blood flow (infarction) Trauma (from ...

Neuropsychological effects of irradiation and chemotherapy treatments upon children with acute lymphoblastic leukemia: a case study of monozygotic twins

International Nuclear Information System (INIS)

Prince, M.T.; Souheaver, G.T.; Berry, D.H.

1988-01-01

Numerous attempts have been made to determine the effects of irradiation and chemotherapy upon cognitive functioning when used for treatment of acute lymphoblastic leukemia (ALL). While many studies have demonstrated a deleterious effect, others have found no significant changes in neuropsychological functioning. The uncertainty regarding the cognitive effects of these treatments is exemplified via a presentation of monozygotic twins who were evaluated via neuropsychological tests. The children received similar induction-consolidation therapy which included intrathecal methotrexate and cranial irradiation. Neuropsychological tests yielded almost identical I.Q. patterns, however, subtle differences were noted between the children when abstract reasoning abilities, achievement tests scores, motor speed, grip strength, performance on complex tasks requiring haptic sensitivity, and fingertip sensitivity were observed. This discussion also summarizes the previous findings related to cognitive function after chemotherapy and radiation therapy and some of the confounding factors which have been noted

Growth hormone response to GRF 1-44 in children following cranial irradiation for central nervous system tumors

International Nuclear Information System (INIS)

Oberfield, S.E.; Kirkland, J.L.; Frantz, A.; Allen, J.C.; Levine, L.S.

1987-01-01

The growth hormone (GH) responses to (A) GRF 1-44, 1 microgram/kg i.v., (B) L-dopa and either arginine, insulin, or glucagon, and (C) exercise were evaluated in 10 children (3 girls, 7 boys; ages 10 years to 15 years, 8 months), 2-10.75 years following cranial irradiation for medulloblastoma (8 patients), pineoblastoma (1 patient), and a fourth ventricular ependymoma (1 patient). Nine of the 10 children had abnormal growth rates. All children were euthyroid at the time of the study. The mean 0-60-min peak GH response to GRF (10.06 +/- 2.6 ng/ml) in the patients was less than the mean peak GH response (29 +/- 2.3 ng/ml) in the control children (n = 7). In 6 patients (5 with poor growth rates), a decreased GH response was noted to GRF and all other tests. Of the remaining patients, all with poor growth rates, two patients demonstrated an adequate response to GRF and pharmacologic testing; one patient had a normal GH response to GRF with a low GH response to pharmacologic testing; and one patient had a low response to GRF, despite a normal response to both exercise and pharmacologic testing. The decrease in mean peak GH response to GRF in the patient population confirms that radiation to the hypothalamic-pituitary region produces abnormalities in growth hormone release. Furthermore, in these patients, discordant GH responses to GRF and pharmacologic or physiologic tests can be observed. The abnormality in growth hormone release may result from a hypothalamic dysfunction in GRF release and/or damage to GH secretory pituicytes

In Vivo Bystander Effect: Cranial X-Irradiation Leads to Elevated DNA Damage, Altered Cellular Proliferation and Apoptosis, and Increased p53 Levels in Shielded Spleen

International Nuclear Information System (INIS)

Koturbash, Igor; Loree, Jonathan; Kutanzi, Kristy; Koganow, Clayton; Pogribny, Igor; Kovalchuk, Olga

2008-01-01

Purpose: It is well accepted that irradiated cells may 'forward' genome instability to nonirradiated neighboring cells, giving rise to the 'bystander effect' phenomenon. Although bystander effects were well studied by using cell cultures, data for somatic bystander effects in vivo are relatively scarce. Methods and Materials: We set out to analyze the existence and molecular nature of bystander effects in a radiation target-organ spleen by using a mouse model. The animal's head was exposed to X-rays while the remainder of the body was completely protected by a medical-grade shield. Using immunohistochemistry, we addressed levels of DNA damage, cellular proliferation, apoptosis, and p53 protein in the spleen of control animals and completely exposed and head-exposed/body bystander animals. Results: We found that localized head radiation exposure led to the induction of bystander effects in the lead-shielded distant spleen tissue. Namely, cranial irradiation led to increased levels of DNA damage and p53 expression and also altered levels of cellular proliferation and apoptosis in bystander spleen tissue. The observed bystander changes were not caused by radiation scattering and were observed in two different mouse strains; C57BL/6 and BALB/c. Conclusion: Our study proves that bystander effects occur in the distant somatic organs on localized exposures. Additional studies are required to characterize the nature of an enigmatic bystander signal and analyze the long-term persistence of these effects and possible contribution of radiation-induced bystander effects to secondary radiation carcinogenesis

Morphometric characteristics of caudal cranial nerves at petroclival region in fetuses.

Science.gov (United States)

Ozdogmus, Omer; Saban, Enis; Ozkan, Mazhar; Yildiz, Sercan Dogukan; Verimli, Ural; Cakmak, Ozgur; Arifoglu, Yasin; Sehirli, Umit

2016-06-01

Morphometric measurements of cranial nerves in posterior cranial fossa of fetus cadavers were carried out in an attempt to identify any asymmetry in their openings into the cranium. Twenty-two fetus cadavers (8 females, 14 males) with gestational age ranging between 22 and 38 weeks (mean 30 weeks) were included in this study. The calvaria were removed, the brains were lifted, and the cranial nerves were identified. The distance of each cranial nerve opening to midline and the distances between different cranial nerve openings were measured on the left and right side and compared. The mean clivus length and width were 21.2 ± 4.4 and 13.2 ± 1.5 mm, respectively. The distance of the twelfth cranial nerve opening from midline was shorter on the right side when compared with the left side (6.6 ± 1.1 versus 7.1 ± 0.8 mm, p = 0.038). Openings of other cranial nerves did not show such asymmetry with regard to their distance from midline, and the distances between different cranial nerves were similar on the left and right side. Cranial nerves at petroclival region seem to show minimal asymmetry in fetuses.

Ophthalmople gic cranial neuropathy: clinical case

OpenAIRE

N. S. Dozorova; A. S. Kotov; E. V. Mukhina

2018-01-01

Ophthalmoplegic cranial neuropathy (OCN) is a disease with unknown etiology, which manifests itself by episodes of intense headache, accompanied by completely or partially reversible dysfunction of the oculomotor nerve: ptosis, mydriasis and ophthalmoplegia. It is assumed that the pathology is demyelinating in nature, therefore in the International classification of headaches OCN excluded from rubric migraine and related to the painful cranial neuropathies. The question of the prevention and ...

Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

International Nuclear Information System (INIS)

Dijk, Irma W.E.M. van; Cardous-Ubbink, Mathilde C.; Pal, Helena J.H. van der; Heinen, Richard C.; Leeuwen, Flora E. van; Oldenburger, Foppe; Os, Rob M. van; Ronckers, Cécile M.; Schouten–van Meeteren, Antoinette Y.N.; Caron, Huib N.; Koning, Caro C.E.; Kremer, Leontien C.M.

2013-01-01

Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD 2 ). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 years after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD 2 in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD 2 , we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD 2 instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience

Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

Energy Technology Data Exchange (ETDEWEB)

Dijk, Irma W.E.M. van, E-mail: i.w.vandijk@amc.uva.nl [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Cardous-Ubbink, Mathilde C. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Pal, Helena J.H. van der [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Heinen, Richard C. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Leeuwen, Flora E. van [Department of Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Oldenburger, Foppe; Os, Rob M. van [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Ronckers, Cécile M. [Dutch Childhood Oncology Group, Long-term Effects after Childhood Cancer, The Hague (Netherlands); Schouten–van Meeteren, Antoinette Y.N. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Caron, Huib N. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Koning, Caro C.E. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Kremer, Leontien C.M. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands)

2013-03-01

Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 years after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD{sub 2} in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD{sub 2}, we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD{sub 2} instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience.

Treatment for delayed brain injury after pituitary irradiation

International Nuclear Information System (INIS)

Fujii, Takashi; Misumi, Shuzoh; Shibasaki, Takashi; Tamura, Masaru; Kunimine, Hideo; Hayakawa, Kazushige; Niibe, Hideo; Miyazaki, Mizuho; Miyagi, Osamu.

1988-01-01

Treatment for delayed brain injury after pituitary irradiation is discussed. Six cases with delayed brain injury were treated with a combination of dexamethasone or betamethasone, with heparin, glycerol, dextran 40 and some vasodilators. Two cases with temporal lobe syndrome were treated in the early stages of brain injury for a period of over 12 months were almost completely cured, another two cases with chiasma syndrome were treated in the relatively late stages, showed a partial improvement. One case which was irradiated 120 GY during 13 years did not improve. The final case treated with steroids for a short period also resulted in failure and the patient underwent an operation for the removal of the necrotic mass three years after the radiotherapy. Steroid therapy started in the early stages of brain injury after irradiation for over the 12 months is thought to be effective. Heparin therapy was also effective in one out of three cases, but in one of the cases subarachnoid hemorrhage from a traumatic aneurysm occurred during the therapy. In an acute phase, showing edematous change of the injured brain, the administration of glycerol is also thought to be useful. But the effectiveness of the other medicines containing some vasodilators was obscure or doubtful. We propose the following : (1) A meticulous observation is essential for the patients who received high doses of irradiation to diagnose brain injury in the early reversible stage. (2) Steroids should be given immediately in this reversible stage of brain injury before the irreversible ''necrosis'' occurs. (3) Steroids should be maintained for a long period over 12 months. (4) Heparin therapy is also thought to be effective, but careful precautions to avoid hemorrhagic complications before the therapy should be scheduled. This recommended plan may also be used for the treatment of brain injuries after cranial irradiation for other intracranial tumors. (author)

Multiple cranial nerve palsies complicating tympanomastoiditis: case ...

African Journals Online (AJOL)

Otitis media either acute or chronic, is not uncommon in childhood. Multiple cranial nerve palsies occuring as a complication of either form of otitis media is unusual. A case of a nine year old boy with chronic suppurative otitis media with associated mastoiditis complicated with ipsilateral multiple cranial nerve palsies is ...

Abrogation of Early Apoptosis Does Not Alter Late Inhibition of Hippocampal Neurogenesis After Irradiation

International Nuclear Information System (INIS)

Li Yuqing; Aubert, Isabelle; Wong, C. Shun

2010-01-01

Purpose: Irradiation of the adult brain results in acute apoptosis of neural progenitors and vascular endothelial cells, as well as late dysfunction of neural progenitors and inhibition of neurogenesis. We sought to determine whether the early apoptotic response has a causative role in late inhibition of neurogenesis after cranial irradiation. Methods and Materials: Using a genetic approach with p53 and smpd1 transgenic mice and a pharmacologic approach with basic fibroblast growth factor (bFGF) to abrogate the early apoptotic response, we evaluated the late inhibition of neurogenesis in the hippocampal dentate gyrus after cranial irradiation. Results: In dentate gyrus, subgranular neural progenitors underwent p53-dependent apoptosis within 24 h after irradiation. Despite a near abrogation of neural progenitor apoptosis in p53-/- mice, the reduction in newborn neurons in dentate gyrus at 9 weeks after irradiation in p53-/- mice was not different from that observed in wildtype controls. Endothelial cell apoptosis after radiation is mediated by membrane damage initiated by activation of acid sphingomyelinase (ASMase). Deletion of the smpd1 gene (which encodes ASMase) attenuated the apoptotic response of endothelial cells. At 9 weeks after irradiation, the inhibition of hippocampal neurogenesis was not rescued by ASMase deficiency. Intravenous administration of bFGF protected both endothelial cells and neural progenitors against radiation-induced apoptosis. There was no protection against inhibition of neurogenesis at 9 weeks after irradiation in bFGF-treated mice. Conclusion: Early apoptotic death of neural progenitors, endothelial cells, or both does not have a causative association with late inhibition of neurogenesis after irradiation.

Cranial osteopathy: its fate seems clear

Directory of Open Access Journals (Sweden)

Hartman Steve E

2006-06-01

Full Text Available Abstract Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown. In spite of almost uniformly negative research findings, "cranial" methods remain popular with many practitioners and patients. Summary Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.

Literature review of cranial nerve injuries during carotid endarterectomy.

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Sajid, M S; Vijaynagar, B; Singh, P; Hamilton, G

2007-01-01

In the recent prospective randomised trials on carotid endarterectomy (CEA), the incidence of cranial nerve injuries (CNI) are reported to be higher than in previously published studies. The objective of this study is to review the incidence of post CEA cranial nerve injury and to discover whether it has changed in the last 25 years after many innovations in vascular surgery. Generic terms including carotid endarterectomy, cranial nerve injuries, post CEA complications and cranial nerve deficit after neck surgery were used to search a variety of electronic databases. Based on selection criteria, decisions regarding inclusion and exclusion of primary studies were made. The incidence of CNI before and after 1995 was compared. We found 31 eligible studies from the literature. Patients who underwent CEA through any approach were included in the study. All patients had cranial nerves examined both before and after surgery. The total number of patients who had CEA before 1995 was 3521 with 10.6% CNI (352 patients) and after 1995, 7324 patients underwent CEA with 8.3% CNI (614 patients). Cranial nerves XII, X and VII were most commonly involved (rarely IX and XI). Statistical analysis showed that the incidence of CNI has decreased (X(2) = 5.89 + 0.74 = 6.63 => p-value = 0.0100). CNI is still a significant postoperative complication of carotid endarterectomy. Despite increasing use of CEA, the incidence of CNI has decreased probably because of increased awareness of the possibility of cranial nerve damage.

Arterial supply of the upper cranial nerves: a comprehensive review.

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Hendrix, Philipp; Griessenauer, Christoph J; Foreman, Paul; Shoja, Mohammadali M; Loukas, Marios; Tubbs, R Shane

2014-11-01

The arterial supply to the upper cranial nerves is derived from a complex network of branches derived from the anterior and posterior cerebral circulations. We performed a comprehensive literature review of the arterial supply of the upper cranial nerves with an emphasis on clinical considerations. Arteries coursing in close proximity to the cranial nerves regularly give rise to small vessels that supply the nerve. Knowledge of the arteries supplying the cranial nerves is of particular importance during surgical approaches to the skull base. © 2014 Wiley Periodicals, Inc.

Robo signaling regulates the production of cranial neural crest cells.

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Li, Yan; Zhang, Xiao-Tan; Wang, Xiao-Yu; Wang, Guang; Chuai, Manli; Münsterberg, Andrea; Yang, Xuesong

2017-12-01

Slit/Robo signaling plays an important role in the guidance of developing neurons in developing embryos. However, it remains obscure whether and how Slit/Robo signaling is involved in the production of cranial neural crest cells. In this study, we examined Robo1 deficient mice to reveal developmental defects of mouse cranial frontal and parietal bones, which are derivatives of cranial neural crest cells. Therefore, we determined the production of HNK1 + cranial neural crest cells in early chick embryo development after knock-down (KD) of Robo1 expression. Detection of markers for pre-migratory and migratory neural crest cells, PAX7 and AP-2α, showed that production of both was affected by Robo1 KD. In addition, we found that the transcription factor slug is responsible for the aberrant delamination/EMT of cranial neural crest cells induced by Robo1 KD, which also led to elevated expression of E- and N-Cadherin. N-Cadherin expression was enhanced when blocking FGF signaling with dominant-negative FGFR1 in half of the neural tube. Taken together, we show that Slit/Robo signaling influences the delamination/EMT of cranial neural crest cells, which is required for cranial bone development. Copyright © 2017. Published by Elsevier Inc.

Accounting for cranial vault growth in experimental design.

Science.gov (United States)

Power, Stephanie M; Matic, Damir B; Holdsworth, David W

2014-05-01

Earlier studies have not accounted for continued growth when using the rat calvarial defect model to evaluate bone healing in vivo. The purpose of this study was: 1) to calculate rat cranial vault growth over time; and 2) to determine the effects of accounting for growth on defect healing. Bilateral parietal defects were created in 10 adult Wistar rats. Serial microscopic computerized tomography scans were performed. Bone mineral content (BMC) measured according to standard technique and repeated accounting for cranial growth over time was compared with the use of parametric and nonparametric tests. Cranial vault growth continued through 22 weeks of age, increasing 7.5% in width and 9.1% in length, and calvarial defects expanded proportionately. BMC was greater within defects accounting for growth 2-12 weeks postoperatively (P accounting for cranial growth given advances in serial imaging techniques. Crown Copyright © 2014. Published by Mosby, Inc. All rights reserved.

Multiple cranial neuropathies without limb involvements: guillain-barre syndrome variant?

Science.gov (United States)

Yu, Ju Young; Jung, Han Young; Kim, Chang Hwan; Kim, Hyo Sang; Kim, Myeong Ok

2013-10-01

Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunctions. Furthermore, reported cases of the acute multiple cranial neuropathies show electrophysiological abnormalities compatible with the typical Guillain-Barre syndromes (GBS). We recently experienced a patient with a benign infectious disease who subsequently developed symptoms of variant GBS. Here, we describe the case of a 48-year-old male patient who developed multiple symptoms of cranial neuropathy without limb weakness. His laboratory findings showed a positive result for anti-GQ1b IgG antibody. As compared with previously described variants of GBS, the patient exhibited widespread cranial neuropathy, which included neuropathies of cranial nerves III-XII, without limb involvement or ataxia.

SU-F-T-645: To Test Spatial Anddosimetric Accuracy of Small Cranial Target Irradiation Based On 1.5 T MRIscans Using Static Arcs with MLCDefined Fields

International Nuclear Information System (INIS)

Brezovich, I; Wu, X; Popple, R; Shen, S; Cardan, R; Bolding, M; Fiveash, J; Kraus, J; Spencer, S

2016-01-01

Purpose: To test spatial and dosimetric accuracy of small cranial target irradiation based on 1.5 T MRI scans using static arcs with MLC-defined fields Methods: A plastic (PMMA) phantom simulating a small brain lesion was mounted on a GammaKnife headframe equipped with MRI localizer. The lesion was a 3 mm long, 3.175 mm diameter cylindrical cavity filled with MRI contrast. Radiochromic film passing through the cavity was marked with pin pricks at the cavity center. The cavity was contoured on an MRI image and fused with CT to simulate treatment of a lesion not visible on CT. The transfer of the target to CT involved registering the MRI contrast cannels of the localizer that were visible on both modalities. Treatments were planned to deliver 800 cGy to the cavity center using multiple static arcs with 5.0×2.4 mm MLC-defined fields. The phantom was aligned on a STx accelerator by registering the conebeam CT with the planning CT. Films from coronal and sagittal planes were scanned and evaluated using ImageJ software Results: Geographic errors in treatment based on 1.5 T scans agreed within 0.33, −0.27 and 1.21 mm in the vertical, lateral and longitudinal dimensions, respectively. The doses delivered to the cavity center were 7.2% higher than planned. The dose distributions were similar to those of a GammaKnife. Conclusion: Radiation can be delivered with an accelerator at mm accuracy to small cranial targets based on 1.5 MRI scans fused to CTs using a standard GammaKnife headframe and MRI localizer. MLC-defined static arcs produce isodose lines very similar to the GammaKnife.

Novel Use of the Contura for High Dose Rate Cranial Brachytherapy

International Nuclear Information System (INIS)

Scanderbeg, Daniel J.; Alksne, John F.; Lawson, Joshua D.; Murphy, Kevin T.

2011-01-01

A popular choice for treatment of recurrent gliomas was cranial brachytherapy using the GliaSite Radiation Therapy System. However, this device was taken off the market in late 2008, thus leaving a treatment void. This case study presents our experience treating a cranial lesion for the first time using a Contura multilumen, high-dose-rate (HDR) brachytherapy balloon applicator. The patient was a 47-year-old male who was diagnosed with a recurrent right frontal anaplastic oligodendroglioma. Previous radiosurgery made him a good candidate for brachytherapy. An intracavitary HDR balloon brachytherapy device (Contura) was placed in the resection cavity and treated with a single fraction of 20 Gy. The implant, treatment, and removal of the device were all completed without incident. Dosimetry of the device was excellent because the dose conformed very well to the target. V90, V100, V150, and V200 were 98.9%, 95.7%, 27.2, and 8.8 cc, respectively. This patient was treated successfully using the Contura multilumen balloon. Contura was originally designed for deployment in a postlumpectomy breast for treatment by accelerated partial breast irradiation. Being an intracavitary balloon device, its similarity to the GliaSite system makes it a viable replacement candidate. Multiple lumens in the device also make it possible to shape the dose delivered to the target, something not possible before with the GliaSite applicator.

Cranial computerized tomography in children suffering from acute leukemia

International Nuclear Information System (INIS)

Metz, O.

1981-01-01

Cranial computerized (axial) tomography permits a more complete neurologic supervision of children with acute leukemia and a better knowledge of the frequency and varieties of cerebral complications in leukemia. Endocranial complications in acute leukemia are essentially infiltrative, hemorrhagic, infectious or iatrogenic. Cranial computerized tomography can demonstrate cerebral changes in meningeal leukemia, hemorrhages, calcifications, brain atrophy or leukencephalopathy. The preliminary results of cranial computerized tomography in childhood leukemia suggest that the iatrogenic main lesion of the brain due to combined radiation-chemotherapy is atrophy whereas that of the intrathecal cytostatic therapy is demyelination. Accurate diagnostics and control of possible cerebral complications in therapy of leukemia is essentially for appropriate therapeutic management. For that cranial computerized tomography is the best method to a effective supervision of the brain. (author)

Should patients with laryngeal small cell neuroendocrine carcinoma receive prophylactic cranial irradiation?

NARCIS (Netherlands)

Coca-Pelaz, Andres; Devaney, Kenneth O.; Rodrigo, Juan P.; Halmos, Gyorgy B.; Strojan, Primoz; Mendenhall, William M.; Eisbruch, Avraham; Smee, Robert; Kusafuka, Kimihide; Rinaldo, Alessandra; Ferlito, Alfio

2016-01-01

While small cell neuroendocrine carcinomas (SCNCs) most often arise in the lung, extrapulmonary SCNCs arise in a variety of locations-including the head and neck region. In particular, laryngeal SCNCs-while rare tumors-are nevertheless recognized as distinct lesions. The rarity of laryngeal SCNC

Cellular and Behavioral Effects of Cranial Irradiation of the Subventricular Zone in Adult Mice

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Lazarini, Françoise; Mouthon, Marc-André; Gheusi, Gilles; de Chaumont, Fabrice; Olivo-Marin, Jean-Christophe; Lamarque, Stéphanie; Abrous, Djoher Nora; Boussin, François D.; Lledo, Pierre-Marie

2009-01-01

Background In mammals, new neurons are added to the olfactory bulb (OB) throughout life. Most of these new neurons, granule and periglomerular cells originate from the subventricular zone (SVZ) lining the lateral ventricles and migrate via the rostral migratory stream toward the OB. Thousands of new neurons appear each day, but the function of this ongoing neurogenesis remains unclear. Methodology/Principal Findings In this study, we irradiated adult mice to impair constitutive OB neurogenesis, and explored the functional impacts of this irradiation on the sense of smell. We found that focal irradiation of the SVZ greatly decreased the rate of production of new OB neurons, leaving other brain areas intact. This effect persisted for up to seven months after exposure to 15 Gray. Despite this robust impairment, the thresholds for detecting pure odorant molecules and short-term olfactory memory were not affected by irradiation. Similarly, the ability to distinguish between odorant molecules and the odorant-guided social behavior of irradiated mice were not affected by the decrease in the number of new neurons. Only long-term olfactory memory was found to be sensitive to SVZ irradiation. Conclusion/Significance These findings suggest that the continuous production of adult-generated neurons is involved in consolidating or restituting long-lasting olfactory traces. PMID:19753118

Cellular and behavioral effects of cranial irradiation of the subventricular zone in adult mice.

Directory of Open Access Journals (Sweden)

Françoise Lazarini

2009-09-01

Full Text Available In mammals, new neurons are added to the olfactory bulb (OB throughout life. Most of these new neurons, granule and periglomerular cells originate from the subventricular zone (SVZ lining the lateral ventricles and migrate via the rostral migratory stream toward the OB. Thousands of new neurons appear each day, but the function of this ongoing neurogenesis remains unclear.In this study, we irradiated adult mice to impair constitutive OB neurogenesis, and explored the functional impacts of this irradiation on the sense of smell. We found that focal irradiation of the SVZ greatly decreased the rate of production of new OB neurons, leaving other brain areas intact. This effect persisted for up to seven months after exposure to 15 Gray. Despite this robust impairment, the thresholds for detecting pure odorant molecules and short-term olfactory memory were not affected by irradiation. Similarly, the ability to distinguish between odorant molecules and the odorant-guided social behavior of irradiated mice were not affected by the decrease in the number of new neurons. Only long-term olfactory memory was found to be sensitive to SVZ irradiation.These findings suggest that the continuous production of adult-generated neurons is involved in consolidating or restituting long-lasting olfactory traces.

Prophylactic cranial irradiation could improve overall survival in patients with extensive small cell lung cancer. A retrospective study

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Chen, Yi [Tsinghua University, Medical Center Tsinghua University, Beijing (China); Li, Jinyu; Hu, Yi; Lin, Zhi; Jiao, Shunchang [Chinese PLA General Hospital, Department of Medical Oncology, Beijing (China); Zhang, Yibao [Peking University Cancer Hospital and Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiotherapy, Beijing (China); Zhao, Zhifei [Chinese PLA General Hospital, Department of Radiation Oncology, Beijing (China)

2016-12-15

To evaluate the effect of prophylactic cranial irradiation (PCI) on overall survival (OS) in patients with extensive small cell lung cancer (ESCLC). Between April 2005 and May 2014, 204 patients with ESCLC who had any response (according to RECIST 1.1) to initial chemotherapy were reviewed. All patients had undergone appropriate imaging tests to exclude brain metastases before initial chemotherapy. PCI was performed on 45 patients (22.1 %) and the remaining patients (77.9 %) received no such treatment (control group). Primary endpoint was OS. The incidence of brain metastases, brain metastases-free survival (BMFS), and adverse effects were also evaluated. Survival data of the 204 patients were analyzed statistically. PCI significantly prolonged median OS from 12.6 to 16.5 months as compared to the control group (hazard ratio, HR, 0.63; 95 % confidence interval, CI, 0.41 to 0.96; p = 0.033). PCI significantly lowered the risk of brain metastases (HR 0.48; 95 % CI 0.30 to 0.76; p = 0.001). The 1-year incidence of brain metastases was 17.1 and 55.9 % in the PCI and control group, respectively. PCI significantly correlated with the increased median BMFS (p = 0.002). Additionally, multivariate analyses demonstrated that PCI was a favorable independent predictor of OS, BMFS, and the incidence of brain metastases. Acute and chronic adverse effects were generally low grade and well tolerated in patients receiving PCI. PCI after any response to initial chemotherapy significantly improved OS of ESCLC patients analyzed in this study. (orig.) [German] Beurteilung des Effekts der prophylaktischen kranialen Bestrahlung (PCI) auf das Gesamtueberleben (OS) bei Patienten mit ausgedehntem kleinzelligem Lungenkarzinom (ESCLC). Zwischen April 2005 und Mai 2014 wurden 204 Patienten mit ESCLC nach Ansprechen auf eine initiale Chemotherapie (gemaess RECIST 1.1) untersucht. Vor der Chemotherapie wurden bei allen Patienten Untersuchungen mit entsprechenden Bildgebungsverfahren

MR imaging of cranial nerve schwannomas

International Nuclear Information System (INIS)

Shapiro, M.; Peyster, R.; Cross, R.R.; Charles, J.; Murtagh, R.; Shapiro, R.; Chyatte, D.

1988-01-01

One of the major advantages of magnetic resonance (MR) imaging over other imaging modalities is direct visualization of the cranial nerves. This is best accomplished with thin-section, contiguous T1-weighted images. They report a series of 75 cranial nerve neuromas, including 47 of the eighth nerve and a mixture of schwannomas involving all other cranial nerves (excluding the fourth). All tumors demonstrated at least some area of increased signal (equal to or greater than that of cerebrospinal fluid) on T2-weighted images. This fact enabled them to differentiate schwannomas from neoplasms (lymphoma, meningioma, sarcoma) that may be isointense on T2-weighted pulse sequences. Many of the lesions had areas of low signal intermixed with predominantly high signal (on T2-weighted images). The pathologic evaluation of these areas of decreased signal revealed predominant fibrosis. In addition, some of the neuromas had a cystic component. Gadolinium-enhanced MR imaging may permit detection when the nerve is still normal in size

Cranial involvement in sickle cell disease

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Alkan, Ozlem, E-mail: yalinozlem@hotmail.com [Department of Radiology, Faculty of Medicine, Baskent University, Ankara (Turkey); Kizilkilic, Ebru, E-mail: ebru90@yahoo.com [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey); Kizilkilic, Osman, E-mail: ebos90@hotmail.com [Department of Radiology, Faculty of Medicine, Baskent University, Ankara (Turkey); Yildirim, Tulin, E-mail: ytulin@hotmail.com [Department of Radiology, Faculty of Medicine, Baskent University, Ankara (Turkey); Karaca, Sibel, E-mail: sibelkaraca@hotmail.com [Department of Neurology, Faculty of Medicine, Baskent University, Ankara (Turkey); Yeral, Mahmut, E-mail: mahmutyeral@hotmail.com [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey); Kasar, Mutlu, E-mail: mutlukasar@hotmail.com [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey); Ozdogu, Hakan, E-mail: hakanozdogu@hotmail.com [Department of Hematology, Faculty of Medicine, Baskent University, Ankara (Turkey)

2010-11-15

Purpose: To evaluate cranial findings in patients with neurologically symptomatic sickle cell disease (SCD). Materials and methods: We studied 50 consecutive patients with SCD and neurologic symptoms. All patients underwent brain MR examinations: all 50 underwent classic MR imaging; 42, diffusion-weighted MR imaging; 10, MR angiography; four, MR venography; and three patients, digital subtraction angiography. Results: Of the 50 SCD patients, 19 (38%) had normal MR findings, and 31 (62%) showed abnormalities on brain MR images. Of the 50 patients, 16 (32%) had ischemic lesions; two (4%), subarachnoid hemorrhage; one (2%), moya-moya pattern; one (2%), posterior reversible encephalopathy; one (2%), dural venous sinus thrombosis; 12 (24%), low marrow signal intensity and thickness of the diploic space; 12 (24%), cerebral atrophy; and two (4%), osteomyelitis. Twenty-seven patients (54%) presented with headache, which was the most common clinical finding. Conclusions: The cranial involvement is one of the most devastating complications of SCD. Early and accurate diagnosis is important in the management of cranial complications of SCD.

Headache and Vascular Events with Brain Tumors

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J Gordon Millichap

2013-05-01

Full Text Available Investigators at the Children's Hospital of Philadelphia, PA, performed a retrospective study of 265 children with brain tumors who received cranial irradiation and developed severe recurrent headache.

A review of hedgehog signaling in cranial bone development

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Angel ePan

2013-04-01

Full Text Available During craniofacial development, the Hedgehog (HH signaling pathway is essential for mesodermal tissue patterning and differentiation. The Hedgehog family consists of three protein ligands: Sonic Hedgehog (SHH, Indian Hedgehog (IHH, and Desert Hedgehog (DHH, of which two are expressed in the craniofacial complex (IHH and SHH. Dysregulations in HH signaling are well documented to result in a wide range of craniofacial abnormalities, including holoprosencephaly, hypotelorism, and cleft lip/palate. Furthermore, mutations in HH effectors, co-receptors, and ciliary proteins result in skeletal and craniofacial deformities. Cranial suture morphogenesis is a delicate developmental process that requires control of cell commitment, proliferation and differentiation. This review focuses on both what is known and what remains unknown regarding HH signaling in cranial suture morphogenesis and intramembranous ossification. As demonstrated from murine studies, expression of both SHH and IHH is critical to the formation and fusion of the cranial sutures and calvarial ossification. SHH expression has been observed in the cranial suture mesenchyme and its precise function is not fully defined, although some postulate SHH to delay cranial suture fusion. IHH expression is mainly found on the osteogenic fronts of the calvarial bones, and functions to induce cell proliferation and differentiation. Unfortunately, neonatal lethality of deficient mice precludes a detailed examination of their postnatal calvarial phenotype. In summary, a number of basic questions are yet to be answered regarding domains of expression, developmental role, and functional overlap of HH morphogens in the calvaria. Nevertheless, SHH and IHH ligands are integral to cranial suture development and regulation of calvarial ossification. When HH signaling goes awry, the resultant suite of morphologic abnormalities highlights the important roles of HH signaling in cranial development.

Androgen action during male sex differentiation includes suppression of cranial suspensory ligament development

NARCIS (Netherlands)

J.M.A. Emmen (Judith); A. McLuskey; J.A. Grootegoed (Anton); A.O. Brinkmann (Albert)

1998-01-01

textabstractThe cranial suspensory ligament is located on the border of the cranial (mesonephric) mesentery in adult female mammals, which runs between the cranial pole of the internal genitalia and the dorsal abdominal wall. Absence of the cranial suspensory ligament

21 CFR 882.4370 - Pneumatic cranial drill motor.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pneumatic cranial drill motor. 882.4370 Section 882.4370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... drill motor. (a) Identification. A pneumatic cranial drill motor is a pneumatically operated power...

Lack of efficacy of levetiracetam in oromandibular and cranial dystonia.

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Park, J E; Srivanitchapoom, P; Maurer, C W; Mathew, P; Sackett, J; Paine, R; Ramos, V L; Hallett, M

2017-08-01

To determine the efficacy of levetiracetam in oromandibular or cranial dystonia. We recruited seven subjects with oromandibular or cranial dystonia. Five completed the study, median age was 71 years (range 42-79 years), median disease duration was 12 years (range 2-30 years). Participants were randomized to receive levetiracetam or placebo and were then crossed over. They titrated up to a total daily dose of 4000 mg or the maximum tolerated dose over 3 weeks and maintained that dose for another 3 weeks. The primary endpoint was the percent change of the eyes, mouth, speech, and swallowing Burke-Fahn-Marsden (BFM) subscores from baseline to weeks 6 and 14. Additional endpoints included the BFM subscore at weeks 3 and 11, and the global dystonia severity (GDS) subscore at weeks 3, 6, 11, and 14, as well as all adverse side effects. The mean percent increase in the BFM subscore (placebo: 31.25%, levetiracetam: 12.16%) was not significantly different between the two arms according to the Friedman analysis. The Wilcoxon signed-rank test showed that these percent changes were not significant, indicating that there was no statistical clinical worsening in either arm. The mean percent change of the BFM subscore at weeks 3 and 11 and the mean percent change of the GDS subscore at weeks 3, 6, 11, and 14 were not significantly different between the two arms, and the Wilcoxon signed-rank test did not show statistical significance. Levetiracetam does not appear to be efficacious in patients with oromandibular or cranial dystonia. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Imaging of muscular denervation secondary to motor cranial nerve dysfunction

International Nuclear Information System (INIS)

Connor, S.E.J.; Chaudhary, N.; Fareedi, S.; Woo, E.K.

2006-01-01

The effects of motor cranial nerve dysfunction on the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of head and neck muscles are reviewed. Patterns of denervation changes are described and illustrated for V, VII, X, XI and XII cranial nerves. Recognition of the range of imaging manifestations, including the temporal changes in muscular appearances and associated muscular grafting or compensatory hypertrophy, will avoid misinterpretation as local disease. It will also prompt the radiologist to search for underlying cranial nerve pathology, which may be clinically occult. The relevant cranial nerve motor division anatomy will be described to enable a focussed search for such a structural abnormality

Imaging of muscular denervation secondary to motor cranial nerve dysfunction

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Connor, S.E.J. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom)]. E-mail: sejconnor@tiscali.co.uk; Chaudhary, N. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Fareedi, S. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Woo, E.K. [Neuroradiology Department, Kings College Hospital, Denmark Hill, London SE5 9RS (United Kingdom)

2006-08-15

The effects of motor cranial nerve dysfunction on the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of head and neck muscles are reviewed. Patterns of denervation changes are described and illustrated for V, VII, X, XI and XII cranial nerves. Recognition of the range of imaging manifestations, including the temporal changes in muscular appearances and associated muscular grafting or compensatory hypertrophy, will avoid misinterpretation as local disease. It will also prompt the radiologist to search for underlying cranial nerve pathology, which may be clinically occult. The relevant cranial nerve motor division anatomy will be described to enable a focussed search for such a structural abnormality.

Evaluation of paracavernous cranial nerves (3rd to 6th) with CT

International Nuclear Information System (INIS)

Tsuha, Mitsuru; Okamura, Tomomi; Abiko, Seisho; Aoki, Hideo

1984-01-01

We have now used CT to evaluate the cavernous sinuses, especially the 3rd, 4th, 5th, and 6th cranial nerves. adjacent to them. Twenty cases, presumably all having sellar or parasellar lesions, were examined by means of thin-slice (2-4 mm) axial and coronal (including both direct and reconstructed methods) CT studies. Moreover, three blocks of the sellar region obtained from adult cadavers were examined beforehand by CT scan, and the courses of the respective paracavernous cranial nerves were confirmed by microsurgical dissection. As a result, the following conclusions were obtained. 1. It was valuable to perform a post-enhanced direct coronal study for the definite identification of the paracavernous cranial nerves (3rd to 6th cranial nerves). 2. Also valuable was a magnified CT film of the parasellar regions, which made the identification of the parasellar cranial nerves clearer. 3. In the clinical cases showing a normal shape of the cavernous sinuses on CT, each cranial nerve was evaluated. In the axial studies (almost 10 to 15 degrees anterior to Reid's basal line), the frequencies of the identification of the 3rd, 5th, and 6th cranial nerves were 76%, 97% (as to the Gasserian ganglion), and 21% respectively. None of the 4th cranial nerve was visualized in the cases examined. On the other hand, the frequencies of the identification of the 3rd, 5th, and 6th cranial nerves were 83%, 86%, and 21% respectively in the direct coronal studies and 62%, 57%, and 4% in those of the reconstructed films. The visualization of each cranial nerve in the direct coronal study was better than when the reconstructed method was used. Finally, a schematic presentation of the cranial nerves adjacent to the cavernous sinuses was made in the axial and coronal projections. (J.P.N.)

Development of a Human Cranial Bone Surrogate for Impact Studies

International Nuclear Information System (INIS)

Roberts, Jack C.; Merkle, Andrew C.; Carneal, Catherine M.; Voo, Liming M.; Johannes, Matthew S.; Paulson, Jeff M.; Tankard, Sara; Uy, O. Manny

2013-01-01

In order to replicate the fracture behavior of the intact human skull under impact it becomes necessary to develop a material having the mechanical properties of cranial bone. The most important properties to replicate in a surrogate human skull were found to be the fracture toughness and tensile strength of the cranial tables as well as the bending strength of the three-layer (inner table-diplöe-outer table) architecture of the human skull. The materials selected to represent the surrogate cranial tables consisted of two different epoxy resins systems with random milled glass fiber to enhance the strength and stiffness and the materials to represent the surrogate diplöe consisted of three low density foams. Forty-one three-point bending fracture toughness tests were performed on nine material combinations. The materials that best represented the fracture toughness of cranial tables were then selected and formed into tensile samples and tested. These materials were then used with the two surrogate diplöe foam materials to create the three-layer surrogate cranial bone samples for three-point bending tests. Drop tower tests were performed on flat samples created from these materials and the fracture patterns were very similar to the linear fractures in pendulum impacts of intact human skulls, previously reported in the literature. The surrogate cranial tables had the quasi-static fracture toughness and tensile strength of 2.5 MPa√ m and 53 ± 4.9 MPa, respectively, while the same properties of human compact bone were 3.1 ± 1.8 MPa√ m and 68 ± 18 MPa, respectively. The cranial surrogate had a quasi-static bending strength of 68 ± 5.7 MPa, while that of cranial bone was 82 ± 26 MPa. This material/design is currently being used to construct spherical shell samples for drop tower and ballistic tests.

Multiple Cranial Nerve Palsy Due to Cerebral Venous Thrombosis

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Esra Eruyar

2017-04-01

Full Text Available Cerebral venous thrombosis (CVT is a rare clinical condition between cerebrovasculer diases. The most common findings are headache, seizure and focal neurological deficit. Multiple cranial nerve palsy due to CVT is rarely seen and it is not clear pathology. A pathology that could explain the lack of cranial nerve imaging is carrying suspected diagnosis but the disease is known to provide early diagnosis and treatment. We want to emphasize with this case multipl cranial nerve palsy due to CVT is seen rarely and good response to treatment.

The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit.

Science.gov (United States)

Mazensky, David; Petrovova, Eva; Danko, Jan

2013-01-01

The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%). In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%). We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%). The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

The effects of laser radiation on the descendants of irradiated rats

International Nuclear Information System (INIS)

Hernandez, J.W.R.; Barbosa, C.A.A.; Moderno, L.A.O.; Parizzotto, N.A.

1991-01-01

The effects of low energy laser radiation on the descendants of irradiated rats were investigated by comparing natimortality and the frequency of congenital malformations in three experimental and a control group. Natimortality was not significantly different among the groups. However, cardiomegaly, anophtalmia, dilated abdominal viscera, and premature closures of cranial sutures were recorded only in the experimental groups. (author)

Cranial vasculature in zebrafish forms by angioblast cluster-derived angiogenesis.

Science.gov (United States)

Proulx, Kira; Lu, Annie; Sumanas, Saulius

2010-12-01

Formation of embryonic vasculature involves vasculogenesis as endothelial cells differentiate and aggregate into vascular cords and angiogenesis which includes branching from the existing vessels. In the zebrafish which has emerged as an advantageous model to study vasculogenesis, cranial vasculature is thought to originate by a combination of vasculogenesis and angiogenesis, but how these processes are coordinated is not well understood. To determine how angioblasts assemble into cranial vasculature, we generated an etsrp:GFP transgenic line in which GFP reporter is expressed under the promoter control of an early regulator of vascular and myeloid development, etsrp/etv2. By utilizing time-lapse imaging we show that cranial vessels originate by angiogenesis from angioblast clusters, which themselves form by the mechanism of vasculogenesis. The two major pairs of bilateral clusters include the rostral organizing center (ROC) which gives rise to the most rostral cranial vessels and the midbrain organizing center (MOC) which gives rise to the posterior cranial vessels and to the myeloid and endocardial lineages. In Etsrp knockdown embryos initial cranial vasculogenesis proceeds normally but endothelial and myeloid progenitors fail to initiate differentiation, migration and angiogenesis. Such angioblast cluster-derived angiogenesis is likely to be involved during vasculature formation in other vertebrate systems as well. Copyright © 2010 Elsevier Inc. All rights reserved.

National survey on prophylactic cranial irradiation: differences in practice patterns between medical and radiation oncologists

International Nuclear Information System (INIS)

Cmelak, Anthony J.; Choy, Hak; Shyr, Yu; Mohr, Peter; Glantz, Michael J.; Johnson, David H.

1999-01-01

Purpose: Prophylactic cranial irradiation (PCI) in the treatment of small cell lung cancer (SCLC) patients remains controversial in the oncology community because of its potential for long-term toxicity and unproven survival benefit in randomized trials. A national survey of 9176 oncologists was conducted to characterize the use of PCI with regard to physician demographics, patient characteristics, and oncologists' beliefs. Methods: Data was collected via a questionnaire letter survey. Biographical data, treatment patterns, and clinical impressions were analyzed by the generalized linear model and generalized estimating equations method. Results: There were 1231 responders overall (13.4% of those surveyed), including 628 (51%) radiation oncologists (RO), 587 (48%) medical oncologists (MO), 8 (0.6%) surgical oncologists, and 8 (0.6%) from other oncology subspecialties. Of respondents, 74% overall recommend PCI in limited-stage patients, including 65% of MO and 82% RO (p = 0.001). Of responders who recommend PCI in limited-stage patients, 67% do so only after complete response to initial therapy. Only 30% of respondents recommend PCI for extensive-stage SCLC patients (p = 0.001), and 94% of these recommend PCI only when those patients have a complete response after initial therapy. Interestingly, 38% of responding MO feel that PCI improves survival of limited-stage patients, but only 11% believe PCI improves quality of life. Of the RO, 48% believe PCI improves survival in limited-stage SCLC, and 36% feel PCI improves quality of life (p < 0.05 and p < 0.01, respectively). MO responders believe PCI causes late neurological sequelae more often than do RO responders (95% vs. 84%, p < 0.05), with impaired memory (37%), chronic fatigue (19%), and loss of motivation (13%) as most commonly seen side effects. Only 1.5% overall, however, routinely obtain neuropsychiatric testing in PCI patients, and 42% overall never obtain them. Conclusion: Results confirm that oncologic

Forces necessary for the disruption of the cisternal segments of cranial nerves II through XII.

Science.gov (United States)

Tubbs, R Shane; Wellons, John C; Blount, Jeffrey P; Salter, E George; Oakes, W Jerry

2007-04-01

Manipulation of the cisternal segment of cranial nerves is often performed by the neurosurgeon. To date, attempts at quantifying the forces necessary to disrupt these nerves in situ, to our knowledge, has not been performed. The present study seeks to further elucidate the forces necessary to disrupt the cranial nerves while within the subarachnoid space. The cisternal segments of cranial nerves II through XII were exposed in six unfixed cadavers, all less than 6 hr postmortem. Forces to failure were then measured. Mean forces necessary to disrupt nerves for left sides in increasing order were found for cranial nerves IX, VII, IV, X, XII, III, VIII, XI, VI, V, and II, respectively. Mean forces for right-sided cranial nerves in increasing order were found for cranial nerves IX, VII, IV, X, XII, VIII, V, VI, XI, III, and II, respectively. Overall, cranial nerves requiring the least amount of force prior to failure included cranial nerves IV, VII, and IX. Those requiring the highest amount of force included cranial nerves II, V, VI, and XI. There was an approximately ten-fold difference between the least and greatest forces required to failure. Cranial nerve III was found to require significantly (P cranial nerves II through XII. We found that cranial nerve IX consistently took the least amount of force until its failure and cranial nerve II took the greatest. Other cranial nerves that took relatively small amount of force prior to failure included cranial nerves IV and VII. Although in vivo damage can occur prior to failure of a cranial nerve, our data may serve to provide a rough estimation for the maximal amount of tension that can be applied to a cranial nerve that is manipulated while within its cistern.

The effect of the cranial bone CT numbers on the brain CT numbers

Energy Technology Data Exchange (ETDEWEB)

Fukuda, Hitoshi; Kobayashi, Shotai; Koide, Hiromi; Yamaguchi, Shuhei; Okada, Kazunori; Shimote, Koichi; Tsunematsu, Tokugoro (Shimane Medical Univ., Izumo (Japan))

1989-06-01

The effects of the cranial size and the computed tomography (CT) numbers of the cranial bone on that of the brain were studied in 70 subjects, aged from 30 to 94 years. The subjects had no histories of cerebrovascular accidents and showed no abnormalities in the central nervous system upon physical examinations and a CT scan. We measured the average attenuation values (CT numbers) of each elliptical region (165 pixels, 0.39 cm{sup 2}) at the bilateral thalamus and at twelve areas of the deep white matter. Multiple regression analysis was used to assess the effects of age, cranial size, and cranial bone CT numbers on the brain CT numbers. The effect of the cranial bone CT numbers on the brain CT numbers was statistically significant. The brain CT numbers increased with the increase in the cranial bone CT numbers. There was, however, no significant correlation between brain CT numbers and cranial size. In measuring the brain CT numbers, it is desirable that consideration be given to the cranial bone CT numbers. (author).

Mapping genetic variants for cranial vault shape in humans

DEFF Research Database (Denmark)

Roosenboom, Jasmien; Lee, Myoung Keun; Hecht, Jacqueline T

2018-01-01

The shape of the cranial vault, a region comprising interlocking flat bones surrounding the cerebral cortex, varies considerably in humans. Strongly influenced by brain size and shape, cranial vault morphology has both clinical and evolutionary relevance. However, little is known about the geneti...

Neurovascular compression syndrome of the eighth cranial nerve

International Nuclear Information System (INIS)

Itoh, Akinori

2010-01-01

Neurovascular compression syndrome (NVCS) involves neuropathy due to intracranial blood vessels compressing the cranial nerves. NVCS of the eighth cranial nerve is less reportedly established as a clinical entity than that of the fifth and seventh cranial nerves. We report 17 cases of NVCS of the eighth cranial nerve and their clinical features. Clinical symptoms and test findings among our subjects indicated that most were aged more than 65 years, were unilateral, had intermittent tinnitus, suffered attacks lasting a few seconds dozens of times a day, experienced dizziness concomitantly with tinnitus, aggravated tinnitus and dizziness when tilting the head toward the affected side and looking downward (positional tinnitus, positional dizziness), heard specific tinnitus sounds such as crackling differing from those in cochlear tinnitus, had mild or no hearing loss, were diagnosed with retrocochlear hearing disturbance due to an interpeak latency delay between waves I and III of the auditory brainstem response (ABR), often had no nystagmus or canal paresis (CP), were found in constructive interference steady state magnetic resonance imaging (CISS MRI) to have compression of the eighth cranial nerve by the vertebral artery (VA) or the anterior inferior cerebellar artery (AICA), rarely had concomitant facial spasms, and had tinnitus and dizziness markedly suppressed by carbamazepine. With the number of elderly individuals continuing to increase, cases of NVCS due to arteriosclerotic changes in cerebral blood vessels are expected to increase, making it necessary to consider NVCS in elderly subjects with dizziness, tinnitus, and hearing loss. (author)

Neurovascular compression syndrome of the eighth cranial nerve

Energy Technology Data Exchange (ETDEWEB)

Itoh, Akinori [Saitama Medical Univ., Faculty of Medicine, Moroyama, Saitama (Japan)

2010-04-15

Neurovascular compression syndrome (NVCS) involves neuropathy due to intracranial blood vessels compressing the cranial nerves. NVCS of the eighth cranial nerve is less reportedly established as a clinical entity than that of the fifth and seventh cranial nerves. We report 17 cases of NVCS of the eighth cranial nerve and their clinical features. Clinical symptoms and test findings among our subjects indicated that most were aged more than 65 years, were unilateral, had intermittent tinnitus, suffered attacks lasting a few seconds dozens of times a day, experienced dizziness concomitantly with tinnitus, aggravated tinnitus and dizziness when tilting the head toward the affected side and looking downward (positional tinnitus, positional dizziness), heard specific tinnitus sounds such as crackling differing from those in cochlear tinnitus, had mild or no hearing loss, were diagnosed with retrocochlear hearing disturbance due to an interpeak latency delay between waves I and III of the auditory brainstem response (ABR), often had no nystagmus or canal paresis (CP), were found in constructive interference steady state magnetic resonance imaging (CISS MRI) to have compression of the eighth cranial nerve by the vertebral artery (VA) or the anterior inferior cerebellar artery (AICA), rarely had concomitant facial spasms, and had tinnitus and dizziness markedly suppressed by carbamazepine. With the number of elderly individuals continuing to increase, cases of NVCS due to arteriosclerotic changes in cerebral blood vessels are expected to increase, making it necessary to consider NVCS in elderly subjects with dizziness, tinnitus, and hearing loss. (author)

Effects of hyperbaric oxygen and irradiation on experimental skin flaps in rats

International Nuclear Information System (INIS)

Nemiroff, P.M.; Merwin, G.E.; Brant, T.; Cassisi, N.J.

1985-01-01

This study investigated the effects of hyperbaric oxygen (HBO) and irradiation (RT) on experimental skin flaps in rats under varying conditions. Animals were assigned at random to 1 of 15 groups that represented all possible ordering effects of HBO, RT, and flap, as well as controls that included flap-only, RT-only, and HBO-only groups. Cranially based skin flaps measuring 3 x 9 cm were elevated on the dorsum. The surviving length was evaluated with fluorescein dye 7 days after the operation. Depending on the treatment condition, HBO was given either 48 hours or 24 hours before flap elevation, or within 4 hours or 48 hours after flap elevation. Rats receiving RT ( 60 Co) were given a single dose of 1000 rads to the dorsum. Results showed that all groups receiving HBO within 4 hours after flap elevation had significantly greater flap survival length, with as much as a 22% greater length of surviving flap. HBO given 48 hours before flap elevation also significantly improved flap survival over controls. RT appeared to have no immediate significant effect on flap survival. However, rats receiving RT, regardless of other factors, gained significantly less weight than did controls. Findings clearly indicate that, to be effective, HBO needs to be given as soon after surgery as possible

Radiation-induced cranial nerve palsy and its causative factors in nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Kong Lin; Zhang Youwang; Wu Yongru; Guo Xiaomao; Li Longgen

2005-01-01

Objective: To analyze the incidence and causative factors of radiation-induced cranial nerve palsy in patients with nasopharyngeal carcinoma (NPC). Methods: 512 NPC patients who underwent radiotherapy from January 1, 1989 to December 31, 1990 and from January 1, 1994 to December 31, 1995 were retrospectively analyzed. According to Fuzhou' 92 NPC Staging Classification, there are 31 patients in stage I, 212 in stage II, 198 in stage III and 71 in stage IV. All patients were treated by 60 Co or 6 MV X-ray with faciocervical fields or pre-auricular fields to primary area. Some patients were boosted by post-auricular fields or cranial fields. The median dose to the nasopharyngeal region was 7130 cGy by external beam radiotherapy. Thirty-four patients were boosted by brachytherapy. The medial dose to cervical lymph nodes was 6410 cGy as definitive treatment and 5480 cGy as prophylactic treatment. 101 patients were treated with combined chemotherapy. Results: The median follow-up was 6.7 years . Radiation-induced cranial nerve palsies occurred in 81 among the 512 patients. The 5- and 10-year cumulative incidences were 10.3%, 25.4%, respectively. The most common affected nerve was XII. On multivariates analysis, cranial nerve invasion before radiation, chemotherapy, dose to the nasopharyngeal region and age were the independent factors of radiation-induced cranial nerve palsy on nerve I-VII, while the N stage and the radiation fields were independent factors on nerve IX-XII. The cumulative incidence of cranial nerve I-VII palsies increased in patients with cranial nerve invasion, chemotherapy and the dose to the nasopharyngeal region (>7000 cGy). The cumulative incidence of cranial nerve IX- XII palsies increased in patients with advanced N stage. Patients in the first group of treatment field had the highest risk to progress cranial nerve IX-XII palsies, followed by the second group, and the third group had the lowest risk. Only 1 in 34 patients with brachytherapy

Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for non-sinonasal neuroendocrine carcinoma of the upper airways

International Nuclear Information System (INIS)

Franco, Pierfrancesco; La Porta, Maria Rosa; Girelli, Giuseppe; Borca, Valeria Casanova; Pasquino, Massimo; Tofani, Santi; Ozzello, Franca; Ricardi, Umberto; Numico, Gianmauro; Migliaccio, Fernanda; Catuzzo, Paola; Cante, Domenico; Ceroni, Paola; Sciacero, Piera; Carassai, Pierpaolo; Canzi, Paolo

2012-01-01

Non-sinonasal neuroendocrine carcinomas (NSNECs) of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure. We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects. One year after the end of the whole combined modality approach, the patient achieved complete remission, with no treatment-related sub-acute and late effects. The present report highlights the importance of multidisciplinary management for NSNECs of the head and neck, as the possibility to achieve substantial cure rates with mild side effects with modern radiotherapy techniques

Novel use of the Contura for high dose rate cranial brachytherapy.

Science.gov (United States)

Scanderbeg, Daniel J; Alksne, John F; Lawson, Joshua D; Murphy, Kevin T

2011-01-01

A popular choice for treatment of recurrent gliomas was cranial brachytherapy using the GliaSite Radiation Therapy System. However, this device was taken off the market in late 2008, thus leaving a treatment void. This case study presents our experience treating a cranial lesion for the first time using a Contura multilumen, high-dose-rate (HDR) brachytherapy balloon applicator. The patient was a 47-year-old male who was diagnosed with a recurrent right frontal anaplastic oligodendroglioma. Previous radiosurgery made him a good candidate for brachytherapy. An intracavitary HDR balloon brachytherapy device (Contura) was placed in the resection cavity and treated with a single fraction of 20 Gy. The implant, treatment, and removal of the device were all completed without incident. Dosimetry of the device was excellent because the dose conformed very well to the target. V90, V100, V150, and V200 were 98.9%, 95.7%, 27.2, and 8.8 cc, respectively. This patient was treated successfully using the Contura multilumen balloon. Contura was originally designed for deployment in a postlumpectomy breast for treatment by accelerated partial breast irradiation. Being an intracavitary balloon device, its similarity to the GliaSite system makes it a viable replacement candidate. Multiple lumens in the device also make it possible to shape the dose delivered to the target, something not possible before with the GliaSite applicator. Copyright © 2011 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Hypofractionated high-energy proton-beam irradiation is an alternative treatment for WHO grade I meningiomas.

Science.gov (United States)

Vlachogiannis, Pavlos; Gudjonsson, Olafur; Montelius, Anders; Grusell, Erik; Isacsson, Ulf; Nilsson, Kristina; Blomquist, Erik

2017-12-01

Radiation treatment is commonly employed in the treatment of meningiomas. The aim of this study was to evaluate the effectiveness and safety of hypofractionated high-energy proton therapy as adjuvant or primary treatment for WHO grade I meningiomas. A total of 170 patients who received irradiation with protons for grade I meningiomas between 1994 and 2007 were included in the study. The majority of the tumours were located at the skull base (n = 155). Eighty-four patients were treated post subtotal resection, 42 at tumour relapse and 44 with upfront radiotherapy after diagnosis based on the typical radiological image. Irradiation was given in a hypofractionated fashion (3-8 fractions, usually 5 or 6 Gy) with a mean dose of 21.9 Gy (range, 14-46 Gy). All patients were planned for follow-up with clinical controls and magnetic resonance imaging scans at 6 months and 1, 2, 3, 5, 7 and 10 years after treatment. The median follow-up time was 84 months. Age, gender, tumour location, Simpson resection grade and target volume were assessed as possible prognostic factors for post-irradiation tumour progression and radiation related complications. The actuarial 5- and 10-year progression-free survival rates were 93% and 85% respectively. Overall mortality rate was 13.5%, while disease-specific mortality was 1.7% (3/170 patients). Older patients and patients with tumours located in the middle cranial fossa had a lower risk for tumour progression. Radiation-related complications were seen in 16 patients (9.4%), with pituitary insufficiency being the most common. Tumour location in the anterior cranial fossa was the only factor that significantly increased the risk of complications. Hypofractionated proton-beam radiation therapy may be used particularly in the treatment of larger World Health Organisation grade I meningiomas not amenable to total surgical resection. Treatment is associated with high rates of long-term tumour growth control and acceptable risk for

Modification of the radiological technique of Parma for reduction of irradiation dose

Energy Technology Data Exchange (ETDEWEB)

Stampfel, G.; Ionesco-Farco, F.

1982-04-01

A modified radiological technique to demonstrate the temporo-mandibular joint is presented. An ordinary X-ray tube put on the skin is directed 10/sup 0/ dorso-ventrally and 10/sup 0/ caudo-cranially to the temporo-mandibular joint. The irradiation skin dose applied is ten times smaller than by using the conventional contact technique.

The evolution and development of cranial form in Homo sapiens

OpenAIRE

Lieberman, Daniel E.; McBratney, Brandeis M.; Krovitz, Gail

2002-01-01

Despite much data, there is no unanimity over how to define Homo sapiens in the fossil record. Here, we examine cranial variation among Pleistocene and recent human fossils by using a model of cranial growth to identify unique derived features (autapomorphies) that reliably distinguish fossils attributed to “anatomically modern” H. sapiens (AMHS) from those attributed to various taxa of “archaic” Homo spp. (AH) and to test hypotheses about the changes in cranial development that underlie the ...

FGF9 can induce endochondral ossification in cranial mesenchyme

Directory of Open Access Journals (Sweden)

Overbeek Paul A

2006-02-01

Full Text Available Abstract Background The flat bones of the skull (i.e., the frontal and parietal bones normally form through intramembranous ossification. At these sites cranial mesenchymal cells directly differentiate into osteoblasts without the formation of a cartilage intermediate. This type of ossification is distinct from endochondral ossification, a process that involves initial formation of cartilage and later replacement by bone. Results We have analyzed a line of transgenic mice that expresses FGF9, a member of the fibroblast growth factor family (FGF, in cranial mesenchymal cells. The parietal bones in these mice show a switch from intramembranous to endochondral ossification. Cranial cartilage precursors are induced to proliferate, then hypertrophy and are later replaced by bone. These changes are accompanied by upregulation of Sox9, Ihh, Col2a1, Col10a1 and downregulation of CbfaI and Osteocalcin. Fate mapping studies show that the cranial mesenchymal cells in the parietal region that show a switch in cell fate are likely to be derived from the mesoderm. Conclusion These results demonstrate that FGF9 expression is sufficient to convert the differentiation program of (at least a subset of mesoderm-derived cranial mesenchyme cells from intramembranous to endochondral ossification.

Evaluation of FSE and FSPGR MRI imaging methods for planning cranial stereotactic irradiation of a metastatic brain tumor

International Nuclear Information System (INIS)

Terada, Masaki; Tanoi, Chiharu

2003-01-01

Cranial stereotactic irradiation (STI) of a metastatic brain tumor (BT) was planned by fusing CT images with MRI images using the landmark method of the X-Knife System. The MRI images revealed the BT, the critical optic nerve and brain stem of structures and the eyeball and blood vessels that are landmarks. It was important to improve visibility of the BT with sufficient contrast. Therefore, comparison examinations were performed using the two dimensions fast spin echo (2DFSE), the two dimensions fast spoiled gradient echo (2DFSPGR), and the three dimensions fast spoiled gradient echo (3DFSPGR) methods of T1-weighted imaging with Gd-DTPA contrast. Critical structures and the internal structures of the landmark method were suitable for planning STI when the results of three or more points were combined in visual evaluations. However, the 2DFSE method could showed three or more points. The BT also be visually evaluated using three or less points by the FSPGR method, but had reduced visibility. From detailed contents, the fall of visual evaluation by the small thin and solid BT of the diameter of a BT was characteristic. In the whole signal noise ratio (SNR), the 3DFSPGR method is excellent in images analysis, and the 2DFSE method was excellent in contrast noise ratio (CNR) of a BT. The cystic BT accompanied by dropsy was images with clear and good depiction in all scan parameter. However, the FSPGR method was the boundary not clear in the small solid BT, the FSE method was able to recognize the maximum of the diameter of BT most, and depiction was good. Artifacts of blood flow and motion of the FSE method is a fault. However, the FSE method had the highest useful depiction ability of all BT in the STI plan. (author)

Idiopathic hypertrophic cranial pachymeningitis associated with Sweet's Syndrome

International Nuclear Information System (INIS)

Cano, Antonio; Ribes, Ramon; Riva, Andres de la; Rubio, Fernando Lopez; Sanchez, Carmen; Sancho, Jose L.

2002-01-01

A case of hypertrophic cranial pachymeningitis associated with Sweet's Syndrome is presented. Both entities have been described in association with several other chronic systemic inflammatory diseases and autoimmune conditions. To our knowledge the coexistence between Sweet's Syndrome and hypertrophic cranial pachymeningitis has not been reported up to date. We suggest a possible autoimmune or dysimmune mechanism in the pathogenesis of these two entities

Small cell lung cancer and prophylactic cranial irradiation (PCI): perhaps the question is not who needs PCI but who wants PCI

Energy Technology Data Exchange (ETDEWEB)

Le Chevalier, T.; Arriagada, R. [Institut Gustave-Roussy, Medicine Dept., Villejuif, 94 (France)

1997-10-01

With 175 000 new cases annually, lung cancer is the most frequent malignancy in adults in the European Community. Approximately 20% of these tumours are of the small cell subtype and roughly a third, chiefly when disease is confined to the thorax, will be in complete remission after aggressive induction therapy combining multidrug chemotherapy (CT) and thoracic radiation therapy. However, the majority of these patients will relapse and ultimately only 15-20% of complete responders will be long-term survivors (i.e. alive beyond 30 months). The central nervous system (CNS) is one of the main organs invaded by small cell lung cancer (SCLC) and a frequent site of relapse. CNS metastases are found in up to 65% of patients at autopsy with the brain traditionally being considered a sanctuary for tumour cells. Although the blood-brain barrier is supposed to bar the entry to harmful substances (in particular most cytotoxic agents) and thus protect the CNS, this shield does not function systematically since dramatic responses to CT have been achieved in brain metastases from SCLC and brain metastases also arise even when clear responses are being observed at all other sites. Alternatively, the spectacular radiosensitivity of SCLC, which has been well established for decades, prompted the strategy of delivering prophylactic cranial irradiation (PCI) during induction treatment in order to prevent the development of metastases and their cohort of clinical symptoms. (author).

Small cell lung cancer and prophylactic cranial irradiation (PCI): perhaps the question is not who needs PCI but who wants PCI

International Nuclear Information System (INIS)

Le Chevalier, T.; Arriagada, R.

1997-01-01

With 175 000 new cases annually, lung cancer is the most frequent malignancy in adults in the European Community. Approximately 20% of these tumours are of the small cell subtype and roughly a third, chiefly when disease is confined to the thorax, will be in complete remission after aggressive induction therapy combining multidrug chemotherapy (CT) and thoracic radiation therapy. However, the majority of these patients will relapse and ultimately only 15-20% of complete responders will be long-term survivors (i.e. alive beyond 30 months). The central nervous system (CNS) is one of the main organs invaded by small cell lung cancer (SCLC) and a frequent site of relapse. CNS metastases are found in up to 65% of patients at autopsy with the brain traditionally being considered a sanctuary for tumour cells. Although the blood-brain barrier is supposed to bar the entry to harmful substances (in particular most cytotoxic agents) and thus protect the CNS, this shield does not function systematically since dramatic responses to CT have been achieved in brain metastases from SCLC and brain metastases also arise even when clear responses are being observed at all other sites. Alternatively, the spectacular radiosensitivity of SCLC, which has been well established for decades, prompted the strategy of delivering prophylactic cranial irradiation (PCI) during induction treatment in order to prevent the development of metastases and their cohort of clinical symptoms. (author)

Ewing's sarcoma of the cranial vault: a case report.

Science.gov (United States)

Feki, Jihene; Guermazi, Zeineb; Kammoun, Brahim; Khanfir, Afef; Toumi, Nabil; Boudawara, Tahiya; Boudawara, Zaher; Daoud, Jamel; Frikha, Mounir

2017-12-01

Ewing's sarcoma is a malignant tumor that mainly affects young patients. It represents 10% of primary malignant tumors of the bone and 3% of malignant tumors of the child. Cranial localization is extremely rare representing less than 1% of all the localizations. We report a case of a 10-year-old girl who presented with an intracranial hypertension syndrome with left parietal mass of progressive installation. The X-ray skull showed a lytic lesion with irregular margins involving the left parietal bone. Brain magnetic resonance imaging revealed extensive parietal bone destruction involving both the inner and outer tables. The girl was operated in emergency. Histological examination concluded to Ewing's Sarcoma. The resection was incomplete (R1). The girl received induction's chemotherapy. The cerebral scanner evaluation showed no abnormalities. Then, she received consolidation's chemotherapy with concomitant local radiation therapy. Currently, the girl is in complete remission with a seven-month decline.

Lithium protects hippocampal progenitors, cognitive performance and hypothalamus-pituitary function after irradiation to the juvenile rat brain

NARCIS (Netherlands)

Zhou, Kai; Xie, Cuicui; Wickström, Malin; Dolga, Amalia M; Zhang, Yaodong; Li, Tao; Xu, Yiran; Culmsee, Carsten; Kogner, Per; Zhu, Changlian; Blomgren, Klas

2017-01-01

Cranial radiotherapy in children typically causes delayed and progressive cognitive dysfunction and there is no effective preventive strategy for radiation-induced cognitive impairments. Here we show that lithium treatment reduced irradiation-induced progenitor cell death in the subgranular zone of

Random genetic drift, natural selection, and noise in human cranial evolution.

Science.gov (United States)

Roseman, Charles C

2016-08-01

This study assesses the extent to which relationships among groups complicate comparative studies of adaptation in recent human cranial variation and the extent to which departures from neutral additive models of evolution hinder the reconstruction of population relationships among groups using cranial morphology. Using a maximum likelihood evolutionary model fitting approach and a mixed population genomic and cranial data set, I evaluate the relative fits of several widely used models of human cranial evolution. Moreover, I compare the goodness of fit of models of cranial evolution constrained by genomic variation to test hypotheses about population specific departures from neutrality. Models from population genomics are much better fits to cranial variation than are traditional models from comparative human biology. There is not enough evolutionary information in the cranium to reconstruct much of recent human evolution but the influence of population history on cranial variation is strong enough to cause comparative studies of adaptation serious difficulties. Deviations from a model of random genetic drift along a tree-like population history show the importance of environmental effects, gene flow, and/or natural selection on human cranial variation. Moreover, there is a strong signal of the effect of natural selection or an environmental factor on a group of humans from Siberia. The evolution of the human cranium is complex and no one evolutionary process has prevailed at the expense of all others. A holistic unification of phenome, genome, and environmental context, gives us a strong point of purchase on these problems, which is unavailable to any one traditional approach alone. Am J Phys Anthropol 160:582-592, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Influence of age on radioinduced cognitive disorders: Experimental studies with cerebral irradiation of 30 Gy in 10 sessions and 12 days in the Wistar rat at 1.5, 4 and 18 months; Influence de l'age sur les troubles cognitifs radioinduits : etudes experimentales avec irradiation cerebrale de 30 Gy en 10 seances et 12 jours chez le rat Wistar de 1 1/2, 4 et 18 mois

Energy Technology Data Exchange (ETDEWEB)

Lamproglou, I. [Lab. de Chimie et Biophysique des Traceurs, Faculte de Medecine Xavier Bichat, Paris (France); Baillet, F.; Boisserie, G.; Mazeron, J.J. [Service de Radiotherapie, Hopital de la Pitie-Salpetriere, Paris (France); Delattre, J.Y. [Dept. of Neurology and Inst. National de la Sante et de la Recherche Medicale, INSERM, Hopital de la Pitie-Salpetriere, Paris (France)

2002-07-01

The objective of this study was to determine the influence of age on the learning and memory dysfunction induced by cranial radiation in the male Wistar rat. Ninety-six 45-day-old, 70 4-month-old, and 78 18-month-old male rats were divided in two equal groups: (i) irradiated and (ii) control. A course of whole-brain radiation therapy (30 Gy in 10 fractions over 12 days) was administered to the irradiated group, while the control group received sham irradiation. Sequential behavioral studies including one and two-way avoidance tests were undertaken before and after the 7 months following radiation. The results suggest that radiation induced progressive and irreversible memory dysfunction in elderly (18-month-old) rats, but this effect was partial or almost reversible in the 4-month-old and 45-day-old rats, respectively. In return, the learning dysfunction was age non-dependent despite the fact that is occurs more rapidly in the young (45 days, 4 months) rats. (author)

Cranial pole nephrectomy in the pig model: anatomic analysis of arterial injuries in tridimensional endocasts.

Science.gov (United States)

Pereira-Sampaio, Marco A; Henry, Robert W; Favorito, Luciano A; Sampaio, Francisco J B

2012-06-01

To assess the intrarenal arteries injuries after cranial pole nephrectomy in a pig model to compare these findings with those in humans. Polyester resin was injected through the ureter and the renal artery to make three-dimensional casts of 61 pig kidneys. The cranial pole of the kidneys was sectioned at four different sites before the solidification of the resin, and the casts were examined for arterial damage. Section performed through the hilus (15 kidneys): The cranial division of the renal artery was sectioned in two (13.33%) cases, the ventral branch of the cranial division of the renal artery was sectioned in 13 (86.7%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 11 (73.34%) cases. Section at 0.5 cm cranial to the hilus (16 kidneys): The cranial division of the renal artery was sectioned in 1 (6.25%) case, the ventral branch of the cranial division of the renal artery was sectioned in 14 (87.5%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 13 (81.25%) cases. Section at 1.0 cm cranial to the hilus (15 kidneys): The ventral branch of the cranial division of the renal artery was sectioned in five (33.33%) cases, and the dorsal branch of the cranial division of the renal artery was injured in five (33.33%) cases. Section at 1.5 cm cranial to the hilus (15 kidneys): No lesions were found in the main arteries, only in the interlobular branches. As previously demonstrated in humans, sections at 1.0 cm or more cranially to the hilus in pigs also showed a significant decrease in damage to the major intrarenal arteries. Therefore, as regards arterial damage, the pig kidney is a useful model for partial nephrectomy in the cranial (upper) pole.

The prophylactic effect of neck irradiation combined with intra-oral electron beam irradiation for early tongue cancer

International Nuclear Information System (INIS)

Kawamori, Jiro; Kamata, Rikisaburo; Sanuki, Eiichi

1993-01-01

Between 1967 and 1988, 102 patients with Stage T1-2N0 squamous cell carcinoma of the tongue were treated with uneven fractional irradiation therapy (intra-oral electron beam irradiation with and without prophylactic ipsilateral upper neck irradiation at the Dept. of Radiology, Nihon University School of Medicine. Of 102 primary lesions, 89 cases were controlled with this therapy. In this study, these 89 cases were investigated in order to analyze the prophylactic effect of upper neck irradiation. Of the 89 patients, 42 received only intra-oral electron beam irradiation, while the remaining 47 received a combination of intra-oral electron beam irradiation and prophylactic irradiation to the ipsilateral upper neck. Twenty three of the 89 (25.8%) developed metastasis to the neck after the radiotherapy. A breakdown of these 23 cases reveals that 3/21 (14.3%) received 40-50 Gy to the neck, 9/26 (34.6%) received 20-40 Gy to the neck, and 11/42 (26.2%) received no irradiation to the neck (p<0.05 between first and second groups, and between first and third groups). The neck metastasis was classified into one of three categories based on the region in which it first appeared (ipsilateral upper neck, ipsilateral lower neck or contralateral neck). The first metastasis was seen in the ipsilateral upper neck, in the ipsilateral lower neck and in the contralateral neck in 17, 4 and 2 patients, respectively. In 1/19 who had received 40-50 Gy, in 5/21 who had received 20-40 Gy and in 11/42 who had not received neck irradiation the first metastasis appeared in the ipsilateral upper neck. The five year survival rate was 94%, 75% and 85% in the patients receiving 40-50 Gy, 20-40 Gy and no neck irradiation, respectively. These results suggest that prophylactic irradiation of 40-50 Gy to the ipsilateral upper neck might decrease the incidence of neck metastasis and slightly prolong survival time. (author)

Influence of age on radioinduced cognitive disorders: Experimental studies with cerebral irradiation of 30 Gy in 10 sessions and 12 days in the Wistar rat at 1.5, 4 and 18 months

International Nuclear Information System (INIS)

Lamproglou, I.; Baillet, F.; Boisserie, G.; Mazeron, J.J.; Delattre, J.Y.

2002-01-01

The objective of this study was to determine the influence of age on the learning and memory dysfunction induced by cranial radiation in the male Wistar rat. Ninety-six 45-day-old, 70 4-month-old, and 78 18-month-old male rats were divided in two equal groups: (i) irradiated and (ii) control. A course of whole-brain radiation therapy (30 Gy in 10 fractions over 12 days) was administered to the irradiated group, while the control group received sham irradiation. Sequential behavioral studies including one and two-way avoidance tests were undertaken before and after the 7 months following radiation. The results suggest that radiation induced progressive and irreversible memory dysfunction in elderly (18-month-old) rats, but this effect was partial or almost reversible in the 4-month-old and 45-day-old rats, respectively. In return, the learning dysfunction was age non-dependent despite the fact that is occurs more rapidly in the young (45 days, 4 months) rats. (author)

Cranial suture biology of the Aleutian Island inhabitants.

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Cray, James; Mooney, Mark P; Siegel, Michael I

2011-04-01

Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations. Copyright © 2011 Wiley-Liss, Inc.

Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

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Jang, Ji Hye [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Choi, Woo Suk; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, Sung Sang; Heo, Sung Hyuk [Dept. of Neurology, Kyung Hee University Hospital, Seoul (Korea, Republic of)

2012-01-15

Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

International Nuclear Information System (INIS)

Jang, Ji Hye; Choi, Woo Suk; Kim, Eui Jong; Yoon, Sung Sang; Heo, Sung Hyuk

2012-01-01

Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

A STUDY OF TUMOURS OF THE CRANIAL NERVE AND PARASPINAL NERVE

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Sudesh Shetty

2016-03-01

Full Text Available INTRODUCTION One of the frequent sites of tumour formation is the cranial nerves and paraspinal nerves. The cranial nerves perform a plethora of functions and so the signs and symptoms caused may be different. They are mainly classified into four different types. The aim of the study is: 1. To study the tumours arising from the cranial nerves in an epidemiological point of view. 2. To study the tumours histopathologically. 3. To classify the tumours according to WHO classification. Thirty-eight brain tumor cases were studied in the Department of Medicine, A. J. Shetty Institute of Medical Sciences, Mangalore. Cranial nerve tumours accounts for 4(10% among the intracranial tumours. Schwannomas makes up 3(7.39% among the Intracranial tumours. and constituted 3(75% among cranial nerve tumours. All the 3 schwannomas were located in CP angle. The geographic distribution of cases was found to be 28 cases from Mangalore and 10 cases from Kerala.

Electrophysiology of Extraocular Cranial Nerves: Oculomotor, Trochlear, and Abducens Nerve.

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Hariharan, Praveen; Balzer, Jeffery R; Anetakis, Katherine; Crammond, Donald J; Thirumala, Parthasarathy D

2018-01-01

The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during skull base surgeries poses a risk of injury to multiple cranial nerves, including those innervating extraocular muscles. Because tumors distort normal anatomic relationships, it becomes particularly challenging to identify cranial nerve structures. Studies have reported the benefits of using intraoperative spontaneous electromyographic recordings and compound muscle action potentials evoked by electrical stimulation in preventing postoperative neurologic deficits. Apart from surgical applications, electromyography of extraocular muscles has also been used to guide botulinum toxin injections in patients with strabismus and as an adjuvant diagnostic test in myasthenia gravis. In this article, we briefly review the rationale, current available techniques to monitor extraocular cranial nerves, technical difficulties, clinical and surgical applications, as well as future directions for research.

The Anatomical Correlation between the Internal Venous Vertebral System and the Cranial Venae Cavae in Rabbit

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David Mazensky

2013-01-01

Full Text Available The aim of this study was to describe the possible variations in the connection between the internal venous vertebral system and the cranial vena cava in rabbit using corrosion technique. The study was carried out on 40 adult New Zealand white rabbits. The venous system was injected by using Batson's corrosion casting kit number 17. We found the connection between the internal venous vertebral system and the cranial vena cava by means of the vertebral veins and the right azygos vein. The vertebral vein was present as independent tributary in 36 cases (90%. In the rest of the cases, it was found as being double, being triple, or forming a common trunk with other veins. The azygos vein was present as independent tributary of the cranial vena cava in 39 cases (97.5%. We found also a common trunk formed by the junction of the deep cervical vein, the right vertebral vein, and the azygos vein in one case (2.5%. The azygos vein received 6, 7, 8, or 9 pairs of dorsal intercostal veins. Documenting the anatomical variations in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

Gender differences in current received during transcranial electrical stimulation

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Michael eRussell

2014-08-01

Full Text Available Low current transcranial electrical stimulation is an effective but somewhat inconsistent tool for augmenting neuromodulation. In this study, we used 3D MRI guided electrical transcranial stimulation (GETS modeling to estimate the range of current intensities received at cortical brain tissues. Combined T1, T2, Proton Density MRIs from 24 adult subjects (12 male and 12 female were modeled with virtual electrodes placed at F3, F4, C3 and C4. Two sizes of electrodes 20 mm round and 50 x 45 mm square were examined at 0.5, 1 and 2 mA input currents. The intensity of current received was sampled in a one centimeter sphere placed at the cortex directly under each scalp electrode. There was a tenfold range in the current received by individuals. A large gender difference was observed with female subjects receiving significantly less current at targeted parietal cortex than male subjects when stimulated at identical current levels (P <0.05. Larger electrodes delivered somewhat larger amounts of current then the smaller ones (P <0.01. Electrodes in the frontal regions delivered less current than those in the parietal region (P<0.05. There were large individual differences in current levels the subjects received. Analysis of the cranial bone showed that the gender difference and the frontal parietal differences are due to differences in cranial bone. Males have more cancellous parietal bone and females more dense parietal bone (p<0.01. These differences should be considered when planning transcranial electrical stimulation studies and call into question earlier reports of gender differences due to hormonal influences.

Cranial shape variation in adult howler monkeys (Alouatta seniculus).

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Fiorenza, Luca; Bruner, Emiliano

2018-01-01

Howler monkeys (genus Alouatta) display a distinctive cranial architecture characterized by airorhynchy (or retroflexion of the facial skeleton on the cranial base), a small braincase, and a posteriorly oriented foramen magnum. This configuration has been associated with distinct factors including a high folivory diet, locomotion, and the presence of a specialized vocal tract characterized by large hyoid bone. However, the morphological relationships between the facial and neurocranial blocks in Alouatta have been scarcely investigated. In this study we quantitatively analyzed the cranial shape variation in Alouatta seniculus, to evaluate possible influences and constraints in face and braincase associated with airorhynchy. We also considered the structural role of the pteric area within the cranial functional matrix. We applied landmark-based analysis and multivariate statistics to 31 adult crania, computing shape analyses based on 3D coordinates registration as well as the analysis of the Euclidean distance matrix to investigate patterns of intraspecific morphological variability. Our results suggest that allometry is the main source of variation involved in shaping cranial morphology in howlers, influencing the degree of facial proportions and braincase flattening, and generating the main sexual differences. Larger individuals are characterized by a higher degree of airorhynchy, neurocranial flattening, and expansion of the zygomatic arch. Allometric variations influence the skull as a whole, without distinct patterns for face and braincase, which behave as an integrated morphological unit. A preliminary survey on the pteric pattern suggests that the morphology of this area may be the result of variations in the vertical growth rates between face and braincase. Future studies should be dedicated to the ontogenetic series and focus on airorhynchy in terms of differential growth among distinct cranial districts. © 2017 Wiley Periodicals, Inc.

The effect of total body irradiation and bone marrow transplantation during childhood and adolescence on growth and endocrine function

International Nuclear Information System (INIS)

Leiper, A.D.; Stanhope, R.; Lau, T.; Grant, D.B.; Blacklock, H.; Chessells, J.M.; Plowman, P.N.

1987-01-01

Seventeen children with acute leukaemia and myeloproliferative disorders were investigated for growth and endocrine dysfunction. All had undergone bone marrow transplantation prepared with cyclophosphamide and single fraction total body irradiation (900-1000 cGy) between 1.5 and 3.8 (mean 2.2) years previously. The majority exhibited growth failure, of multiple aetiology. Ten patients, of whom eight had had previous prophylactic cranial irradiation, had evidence of growth hormone deficiency based on reduced growth hormone reponse to insulin induced hypoglycaemia. Three had evidence of hypothalamic damage. Gonadal failure was common. All four girls of adolescent age (10.6-14.1 years) had ovarian failure requiring sex steroid replacement. Of eight boys of adolescent age (12.3-18.3 years), two had testicular failure requiring sex steroid supplements. Both had had previous testicular irradiation. Five others had compensated gonadal failure; one had normal Leydig cell function. Abnormalities of the TSH response to TRH occurred in 10 patients but only three had overt hypothyroidism. Unlike growth hormone deficiency, gonadal and thyroid dysfunction showed no correlation with previous cranial radiotherapy. (author)

Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination.

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Wessely, Marlis; Reese, Sven; Schnabl-Feichter, Eva

2017-06-01

Objectives The aim of this study was to examine histologically intact and ruptured cranial cruciate ligaments in cats, in order to evaluate whether degeneration is a prerequisite for rupture. Methods We performed a histological examination of 50 intact and 19 ruptured cranial cruciate ligaments in cadaver or client-owned cats, respectively, using light microscopy. Cats with stifle pathology were further divided into five age groups in order to investigate the relationship of changes in the ligament with lifespan. Cats with ruptured cranial cruciate ligaments were divided into two groups according to medical history (with presumed history of trauma or without any known history of trauma) in order to investigate the relationship of ligament rupture with a traumatic event. Data from 200 healthy cats were selected randomly and reviewed to make a statistical comparison of cats with and without cranial cruciate ligament rupture (reference group). Results On histological examination, the intact cranial cruciate ligaments showed basic parallel arrangement of the collagen fibres, with no relation to age. While cats of a more advanced age showed fibrocartilage in the middle of the cranial cruciate ligament - a likely physiological reaction to compression forces over the lifespan - degenerative changes within the fibrocartilage were absent in all cases, regardless of age or rupture status. Cats suffering from cranial cruciate ligament rupture without history of trauma were significantly older than cats in the reference group. Conclusions and relevance This study showed that differentiation of fibrocartilage in the middle of the cranial cruciate ligament is likely a physiological reaction to compressive forces and not a degenerative change associated with greater risk of rupture in advanced age. This finding in cats is distinct from the known decrease in differentiation of fibrocartilage in dogs with cranial cruciate ligament rupture. Furthermore, the histological examination

An unusual case of isolated sixth cranial nerve palsy in leprosy.

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Vaishampayan, Sanjeev; Borde, Priyanka

2012-08-15

Cranial nerve involvement is not common in leprosy. The fifth and seventh cranial nerves are the most commonly affected in leprosy. Herein we present a patient with Hansen disease (BL) with type I reaction who developed isolated involvement of the sixth cranial nerve leading to lateral rectus muscle palsy. He responded to timely anti-reactional therapy and it produced a good response. Careful observation of patients with lepra reaction is needed to avoid damage to important organs.

Determinants of ototoxicity in 451 platinum-treated Dutch survivors of childhood cancer : A DCOG late-effects study

NARCIS (Netherlands)

Clemens, Eva; de Vries, Andrica C.; Pluijm, Saskia F.; Zehnhoff-Dinnesen, Antoinette Am; Tissing, Wim J.; Loonen, Jacqueline J.; van Dulmen-den Broeder, Eline; Bresters, Dorine; Versluys, Birgitta; Kremer, Leontien C.; van der Pal, Heleen J.; van Grotel, Martine; van den Heuvel-Eibrink, Marry M.

2016-01-01

Platinum-containing chemotherapeutics are efficacious for a variety of pediatric malignancies, nevertheless these drugs can induce ototoxicity. However, ototoxicity data on large cohorts of childhood cancer survivors (CCSs) who received platinum agents, but not cranial irradiation are scarce.

Early cranial ultrasound changes as predictors of outcome during first year of life in term infants with perinatal asphyxia.

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Boo, N Y; Chandran, V; Zulfiqar, M A; Zamratol, S M; Nyein, M K; Haliza, M S; Lye, M S

2000-08-01

To identify the types of early cranial ultrasound changes that were significant predictors of adverse outcome during the first year of life in asphyxiated term infants. This was a prospective cohort study. Shortly after birth, cranial ultrasonography was carried out via the anterior fontanelles of 70 normal control infants and 104 asphyxiated infants with a history of fetal distress and Apgar scores of less than 6 at 1 and 5 min of life, or requiring endotracheal intubation and manual intermittent positive pressure ventilation for at least 5 min after birth. Neurodevelopmental assessment was carried out on the survivors at 1 year of age. Abnormal cranial ultrasound changes were detected in a significantly higher proportion (79.8%, or n = 83) of asphyxiated infants than controls (39.5%, or n = 30) (P < 0.0001). However, logistic regression analysis showed that only three factors were significantly associated with adverse outcome at 1 year of life among the asphyxiated infants. These were: (i) decreasing birthweight (for every additional gram of increase in birthweight, adjusted odds ratio (OR) = 0.999, 95% confidence interval (CI) 0.998, 1.000; P = 0.047); (ii) a history of receiving ventilatory support during the neonatal period (adjusted OR = 8.3; 95%CI 2.4, 28.9; P = 0.0009); and (iii) hypoxic-ischaemic encephalopathy stage 2 or 3 (adjusted OR = 5.8; 95%CI 1.8, 18.6; P = 0.003). None of the early cranial ultrasound changes was a significant predictor. Early cranial ultrasound findings, although common in asphyxiated infants, were not significant predictors of adverse outcome during the first year of life in asphyxiated term infants.

Late effects of treatment in survivors of childhood acute lymphoblastic leukaemia

International Nuclear Information System (INIS)

Roux, P.

1987-01-01

The overall aim of this study was a comprehensive assessment of the nature and severity of the late effects of treatment in a group of children surviving acute lymphoblastic leukaemia. In the absence of damage preceding treatment, late effects could be ascribed to treatment. Cranial irradiation, methotrexate, L-asparaginase and cytosine arabinoside are therapeutic modalities most likely to cause injury to the central nervous system. Survivors of childhood leukaemia also showed an increase in weight-for-height during and after therapy which appeared to be the consequence of a loss in statural growth as well as increasing weight-for-age. Assessment of endocrine function in leukaemia survivors indicated abnormalities in the regulation of growth hormone and thyroid stimulating hormone in some patients. Survivors of childhood leukaemia were shown to have an intellectual deficit compared with their siblings and a high incidence of visual-perceptual defects. The intellectual effects of lower doses of cranial irradiation are as yet unknown. A variety of minor neurological abnormalities were detected among leukaemia survivors and thought to be related to preceding central nervous system 'prophylactic' chemotherapy and irradiation. A new instrument, the functional deficit score, was derived to reflect overall outcome in survivors of childhood leukaemia. With few exceptions, leukaemia survivors in this study had received 2400 rads of deep x-ray therapy as cranial irradiation. This dosage has since been reduced world-wide. Current cranial irradiation 'prophylaxis' consists of 1800 rad of megavoltage radiotherapy

Late effects of treatment in survivors of childhood acute lymphoblastic leukaemia

Energy Technology Data Exchange (ETDEWEB)

Roux, P

1987-01-01

The overall aim of this study was a comprehensive assessment of the nature and severity of the late effects of treatment in a group of children surviving acute lymphoblastic leukaemia. In the absence of damage preceding treatment, late effects could be ascribed to treatment. Cranial irradiation, methotrexate, L-asparaginase and cytosine arabinoside are therapeutic modalities most likely to cause injury to the central nervous system. Survivors of childhood leukaemia also showed an increase in weight-for-height during and after therapy which appeared to be the consequence of a loss in statural growth as well as increasing weight-for-age. Assessment of endocrine function in leukaemia survivors indicated abnormalities in the regulation of growth hormone and thyroid stimulating hormone in some patients. Survivors of childhood leukaemia were shown to have an intellectual deficit compared with their siblings and a high incidence of visual-perceptual defects. The intellectual effects of lower doses of cranial irradiation are as yet unknown. A variety of minor neurological abnormalities were detected among leukaemia survivors and thought to be related to preceding central nervous system 'prophylactic' chemotherapy and irradiation. A new instrument, the functional deficit score, was derived to reflect overall outcome in survivors of childhood leukaemia. With few exceptions, leukaemia survivors in this study had received 2400 rads of deep x-ray therapy as cranial irradiation. This dosage has since been reduced world-wide. Current cranial irradiation 'prophylaxis' consists of 1800 rad of megavoltage radiotherapy.

Neoplasia in beagles that received whole-body irradiation during prenatal or postnatal development

International Nuclear Information System (INIS)

Benjamin, S.A.; Angleton, G.M.; Lee, A.C.; Saunders, W.J.; Miller, G.K.; Jaenke, R.S.; Brewster, R.D.; Long, R.I.

1986-01-01

Sensitivity to radiation carcinogenesis is being studied in 1680 beagle dogs that received whole-body 60 Co gamma radiation exposures during development. Eight treatment groups of 120 dogs each received 0.16 or 0.83 Gy at one of three prenatal (8, 28, or 55 days postcoitus) ages or at one postnatal (2 days postpartum) age. One treatment group of 120 dogs received 0.83 Gy as juveniles at 70 days postpartum, and one treatment group of 240 young adult dogs received 0.83 Gy at 365 days postpartum. Three-hundred-sixty control dogs were sham irradiated. Of the 1680 dogs, 1058 are dead. Approximately 25% of these deaths were related to malignant neoplasia. The age-related incidence of neoplasia is being evaluated. While the incidence of all neoplasms is being studied, particular emphasis is being placed on types of cancer with known susceptibility to induction by radiation such as those of breast, thyroid, and hematopoietic tissues. Neoplasms are classed as (1) incidental, i.e., those found at necropsy in dogs that died of an unrelated cause; (2) mortality independent, i.e., those seen in live dogs and removed surgically, or (3) fatal, i.e., those directly or indirectly responsible for death. Analyses of incidental tumors are done by a prevalence method, whereas analyses of mortality-independent and fatal tumors use an onset-rate or death-rate method. The results of these methods are then combined to give a composite age-related incidence of specific neoplasms. Analyses also are done on disease subgroups to attempt to delineate the effect of intercurrent disease on tumor incidence. The results of such analyses support the concept that age at exposure is an important factor in radiation carcinogenesis. 28 refs., 7 tabs

Forecasting of the lethality in cases of nonuniform accidental irradiation (experimental studies at external gamma irradiation of rats)

International Nuclear Information System (INIS)

Ingilizova, K.

1983-01-01

A model is suggested that enables the prediction of death probability for the body (L) within the whole lethality dose range (DL 0 -DL 100 ), on the basis of predetermined physical characteristics: in cases of uneven external wholebody irradiation. Some biological effects of 4 variants of uneven irradiation have been studied, i.e. ventro-dorsal (V-D), dorso-ventral (D-V), cranio-caudal (Cr-Ca) and caudo-cranial (Ca-Cr). The following basic conclusions have been drawn: 1. The study of the biological effects of uneven irradiation, when estimated by the lethality factor, points out the lower efficiency of the former, if compared to even irradiation. 2. The even irradiation lethality in the conducted experiments, according to the ALE data and the postradiation mortality dynamics, is determined basically by the damage of the bloodforming tissue and the animals die of bone marrow syndrome. 3. The uneven irradiation, estimated by the total weight factor, is of lower efficiency than the even one. 4. The radiation-induced hypoplasia of the studied organs is exponential in character. 5. An original model for predicting radiation mortality in cases of uneven irradiation has been constructed. The model gives the possibility of relating the alterations in the index of biological efficiency reduction to the wholebody irradiation factor, as well as to the two systems with highest radiosensitivity: red bone marrow and the small intestine. The model helps determining the numerical value of death probability, depending on the average body irradiation doses and the integral unevenness factors for RBM. (author)

Vasculopathic Cranial Ocular Motor Neuropathy Following Sudden Emotional Stress

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Purvin, Valerie

2010-01-01

We describe three patients who experienced onset of a microvascular ocular motor nerve palsy in the setting of sudden emotional stress. Such emotional states are accompanied by a marked increase in sympathetic tone in some individuals. Mechanisms by which these autonomic changes might produce an ischemic cranial nerve palsy include intra-cranial vasoconstriction and transient systemic hypotension due to alterations in cardiac function.

[Rapidly progressive compromise of cranial pairs as neurosyphilis manifestation].

Science.gov (United States)

Baccaro, Fernando; Moldes, Sofía; Novelli Poisson, Paola; Arduin, Julieta; Valerga, Mario

2012-01-01

Syphilis remains a common disease throughout the world, being neurosyphilis a relatively common manifestation. A case of a 34 years old male with HIV and neurosyphilis is presented, characterized by a clinical course evidenced by progressive palsy of cranial nerves. This case is unusual and a rare presentation of progressive cranial involvement with swallowing deficit, have found no similar data in the literature.

Stereotactic radiotherapy using Novalis for skull base metastases developing with cranial nerve symptoms.

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Mori, Yoshimasa; Hashizume, Chisa; Kobayashi, Tatsuya; Shibamoto, Yuta; Kosaki, Katsura; Nagai, Aiko

2010-06-01

Skull base metastases are challenging situations because they often involve critical structures such as cranial nerves. We evaluated the role of stereotactic radiotherapy (SRT) which can give high doses to the tumors sparing normal structures. We treated 11 cases of skull base metastases from other visceral carcinomas. They had neurological symptoms due to cranial nerve involvement including optic nerve (3 patients), oculomotor (3), trigeminal (6), abducens (1), facial (4), acoustic (1), and lower cranial nerves (1). The interval between the onset of cranial nerve symptoms and Novalis SRT was 1 week to 7 months. Eleven tumors of 8-112 ml in volume were treated by Novalis SRT with 30-50 Gy in 10-14 fractions. The tumors were covered by 90-95% isodose. Imaging and clinical follow-up has been obtained in all 11 patients for 5-36 months after SRT. Seven patients among 11 died from primary carcinoma or other visceral metastases 9-36 months after Novalis SRT. All 11 metastatic tumors were locally controlled until the end of the follow-up time or patient death, though retreatment for re-growth was done in 1 patient. In 10 of 11 patients, cranial nerve deficits were improved completely or partially. In some patients, the cranial nerve symptoms were relieved even during the period of fractionated SRT. Novalis SRT is thought to be safe and effective treatment for skull base metastases with involvement of cranial nerves and it may improve cranial nerve symptoms quickly.

Isolated unilateral sixth cranial nerve palsy: A rare presentation of dengue fever

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Yang Liang Boo

2016-11-01

Full Text Available Dengue fever is a common mosquito-borne viral infection endemic in tropical and subtropical countries. Neurological manifestations in dengue infection are relatively uncommon, and include encephalitis, encephalopathy, neuromuscular disorders and neuro-ocular disorders. Cranial mononeuropathy is a rare manifestation of dengue infection. A 40-year-old man was diagnosed with isolated, unilateral sixth cranial nerve palsy complicating dengue infection. The patient was managed accordingly, and full ocular recovery was observed. This was the first reported case of isolated sixth cranial nerve palsy associated with dengue fever in Malaysia. It is important for clinicians to consider dengue as a differential diagnosis in patients presenting with fever and sixth cranial nerve palsy.

Long-term effects of treatment on endocrine function in children with brain tumors

International Nuclear Information System (INIS)

Duffner, P.K.; Cohen, M.E.; Anderson, S.W.; Voorhess, M.L.; MacGillivray, M.H.; Panahon, A.; Brecher, M.L.

1983-01-01

Fourteen children with brain tumors received endocrine evaluations at least one year following completion of cranial irradiation. Treatment consisted of operation (13 patients), craniospinal irradiation (6), whole brain irradiation (5), posterior fossa irradiation (3), and chemotherapy (10). Endocrine evaluation included bone age roentgenography and measurement of growth hormone (using sequential arginine and insulin stimulation), thyroxine, thyroid-stimulating hormone, plasma cortisol, testosterone, prolactin, and urinary follicle-stimulating hormone and luteinizing hormone. Ten of 12 children (83%) had abnormal responses to both tests of growth hormone stimulation. All growth hormone-deficient patients treated prior to puberty and tested at least 2 years following completion of cranial irradiation had decelerated linear growth. Results of thyroid function tests were abnormal in 4 patients: 2 patients had evidence of primary hypothyroidism, and 2 showed secondary or tertiary hypothyroidism. Two patients had inadequate cortisol responses to insulin hypoglycemia. Urinary follicle-stimulating hormone and luteinizing hormone, serum prolactin, and serum testosterone levels were appropriate for age in all patients

Prophylactic cranial irradiation may impose a detrimental effect on overall survival of patients with nonsmall cell lung cancer: a systematic review and meta-analysis.

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Shuan-shuan Xie

Full Text Available To determine the role of brain metastases (BM and overall survival (OS in patients with non-small cell lung cancer (NSCLC by performing a meta-analysis of the RCTs (randomized controlled clinical trials and non-RCTs (non-randomized controlled clinical trials published in the literature.A meta-analysis was performed using trials identified through PubMed, EMBASE and Cochrane databases. Two investigators independently assessed the quality of the trials and extracted data. The outcomes included BM, OS, median survival (MS, response rate (RR, Hazard ratios (HRs and odds ratios (ORs, and their 95% confidence intervals (CIs were pooled using ReMan software.Twelve trials (6 RCTs and 6 non-RCTs involving 1,718 NSCLC patients met the inclusion criteria. They were grouped on the basis of study design for separate Meta-analyses. The results showed that prophylactic cranial irradiation (PCI reduced the risk of BM as compared with non-PCI in NSCLC patients (OR = 0.30, 95% [CI]: 0.21-0.43, p<0.00001. However, HRs for OS favored non-PCI (HR = 1.19, 95% [CI]: 1.06-1.33, p = 0.004, without evidence of heterogeneity between the studies.Our results suggest that although PCI decreased the risk of BM, it may impose a detrimental effect on OS of NSCLC patients.

Cranial nerve injury after Le Fort I osteotomy.

Science.gov (United States)

Kim, J-W; Chin, B-R; Park, H-S; Lee, S-H; Kwon, T-G

2011-03-01

A Le Fort I osteotomy is widely used to correct dentofacial deformity because it is a safe and reliable surgical method. Although rare, various complications have been reported in relation to pterygomaxillary separation. Cranial nerve damage is one of the serious complications that can occur after Le Fort I osteotomy. In this report, a 19-year-old man with unilateral cleft lip and palate underwent surgery to correct maxillary hypoplasia, asymmetry and mandibular prognathism. After the Le Fort I maxillary osteotomy, the patient showed multiple cranial nerve damage; an impairment of outward movement of the eye (abducens nerve), decreased vision (optic nerve), and paraesthesia of the frontal and upper cheek area (ophthalmic and maxillary nerve). The damage to the cranial nerve was related to an unexpected sphenoid bone fracture and subsequent trauma in the cavernous sinus during the pterygomaxillary osteotomy. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

X-ray appearance of cranial lesions in hyperparathyroid osteodystuophy

International Nuclear Information System (INIS)

Spuzyak, M.M.; Tsarikovskaya, K.G.; Tkach, F.S.; David'yants, L.S.

1983-01-01

Craniographic data on 58 patients with hyperparathyroid osteodystrophy weere analyzed. Cranial changes revealed in 52 patients. Some data on the nature apd frequency of X-ray signs of cranial lesion in hyperparathyroid osteodystrophy are presented. The most frequent and typical X-ray signs of cranial lesions in hyperparathyroid osteodystrophy, are granular osteoporosis of the facial tectum and bones, the blurred contour of the internal tectum plate, foci of osteoclasia, osteoporosis of the elements of the Turkish saddle, resorption of the closing plates of the dental cavities, alterration of the thickness of the vault bones, symmetrical thinning, irregularity and obscurity of the external tectum plate, subperiosteal resorption of the cortical layer of the mandible (34.5%), partial resorption of the alveolar process of the jaw and epulis of the mandible

Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia

International Nuclear Information System (INIS)

Said, J.A.; Waters, B.G.; Cousens, P.; Stevens, M.M.

1989-01-01

We assessed neuropsychologically 106 children with acute lymphoblastic leukemia (ALL) who had all received cranial irradiation for the prevention of central nervous system (CNS) leukemia 1-13 years previously. Children were assessed for adverse late effects of their therapy, using age-appropriate Wechsler measures of overall intellectual ability and supplementary tests. Forty-five siblings near in age to the patients were tested as controls. The patients who had had the most intensive central nervous system (CNS) prophylaxis were found to have a WISC-R Full Scale IQ 17 points lower than the sibling control group. Performance IQ was more affected than verbal IQ. The patients were more easily distracted and less able to concentrate. The severity of the aftereffects was related to younger age at the time of CNS prophylaxis and to a higher dose of cranial irradiation but not to time since CNS prophylaxis. CNS prophylaxis using a combination of cranial irradiation and intrathecal methotrexate has lowered the incidence of CNS relapse in childhood ALL but is associated with considerable long-term morbidity in survivors

Cranial magnetic resonance imaging

International Nuclear Information System (INIS)

Elster, A.D.

1987-01-01

This illustrated work covers the diagnosis of central nervous system diseases by MRI. It focuses on strategies for detecting a wide range of intracranial disorders and includes protocols for cranial MRI. For each disease discussed, characteristic MR findings are described, and contrasted with CT and angiography where appropriate. Offers useful appendices on functional neuroanatomy and a glossary of terminology and abbreviations

Imaging assessment of isolated lesions affecting cranial nerve III

International Nuclear Information System (INIS)

Garcia, Marcelo de Mattos; Martins, Jose Carlos Tadeu

2005-01-01

The aim of this study is to review the anatomy and main pathologic conditions affecting cranial nerve III using imaging studies, particularly magnetic resonance imaging. Imaging methods are essential in the evaluation of patients with suspected lesions of the oculomotor nerve once signs and symptoms are unspecific and a large number of diseases can affect cranial nerve III. A brief review of the literature is also presented. (author)

Minocycline ameliorates cognitive impairment induced by whole-brain irradiation: an animal study

International Nuclear Information System (INIS)

Zhang, Liyuan; Li, Kun; Sun, Rui; Zhang, Yuan; Ji, JianFeng; Huang, Peigeng; Yang, Hongying; Tian, Ye

2014-01-01

It has been long recognized that cranial irradiation used for the treatment of primary and metastatic brain tumor often causes neurological side-effects such as intellectual impairment, memory loss and dementia, especially in children patients. Our previous study has demonstrated that whole-brain irradiation (WBI) can cause cognitive decline in rats. Minocycline is an antibiotic that has shown neuroprotective properties in a variety of experimental models of neurological diseases. However, whether minocycline can ameliorate cognitive impairment induced by ionizing radiation (IR) has not been tested. Thus this study aimed to demonstrate the potential implication of minocycline in the treatment of WBI-induced cognitive deficits by using a rat model. Sprague Dawley rats were cranial irradiated with electron beams delivered by a linear accelerator with a single dose of 20 Gy. Minocycline was administered via oral gavages directly into the stomach before and after irradiation. The open field test was used to assess the anxiety level of rats. The Morris water maze (MWM) was used to assess the spatial learning and memory of rats. The level of apoptosis in hippocampal neurons was measured using immunohistochemistry for caspase-3 and relative markers for mature neurons (NeuN) or for newborn neurons (Doublecortin (DCX)). Neurogenesis was determined by BrdU incorporation method. Neither WBI nor minocycline affected the locomotor activity and anxiety level of rats. However, compared with the sham-irradiated controls, WBI caused a significant loss of learning and memory manifest as longer latency to reach the hidden platform in the MWM task. Minocycline intervention significantly improved the memory retention of irradiated rats. Although minocycline did not rescue neurogenesis deficit caused by WBI 2 months post-IR, it did significantly decreased WBI-induced apoptosis in the DCX positive neurons, thereby resulting in less newborn neuron depletion 12 h after irradiation

Isovaleric acidaemia: cranial CT and MRI findings

International Nuclear Information System (INIS)

Sogut, Ayhan; Acun, Ceyda; Tomsac, Nazan; Demirel, Fatma; Aydin, Kubilay; Aktuglu, Cigdem

2004-01-01

Isovaleric acidaemia is an inborn error of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase, which results in accumulation of isovaleric acid in body fluids. There are acute and chronic-intermittent forms of the disease. We present the cranial CT and MRI findings of a 19-month-old girl with the chronic-intermittent form of isovaleric acidaemia. She presented with severe metabolic acidosis, hyperglycaemia, glycosuria, ketonuria and acute encephalopathy. Cranial CT revealed bilateral hypodensity of the globi pallidi. MRI showed signal changes in the globi pallidi and corticospinal tracts of the mesencephalon, which were hypointense on T1-weighted and hyperintense on T2-weighted images. (orig.)

Isovaleric acidaemia: cranial CT and MRI findings

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Sogut, Ayhan; Acun, Ceyda; Tomsac, Nazan; Demirel, Fatma [Department of Paediatrics, Karaelmas University, Zonguldak (Turkey); Aydin, Kubilay [Department of Radiology, Istanbul Medical School, Istanbul University, Camlikyolu, B. mehmetpasa sokak yavuz apt. No:10/10, Etiler, Istanbul (Turkey); Aktuglu, Cigdem [Department of Paediatrics, Cerrahpasa Medical School, Istanbul University, Istanbul (Turkey)

2004-02-01

Isovaleric acidaemia is an inborn error of leucine metabolism due to deficiency of isovaleryl-CoA dehydrogenase, which results in accumulation of isovaleric acid in body fluids. There are acute and chronic-intermittent forms of the disease. We present the cranial CT and MRI findings of a 19-month-old girl with the chronic-intermittent form of isovaleric acidaemia. She presented with severe metabolic acidosis, hyperglycaemia, glycosuria, ketonuria and acute encephalopathy. Cranial CT revealed bilateral hypodensity of the globi pallidi. MRI showed signal changes in the globi pallidi and corticospinal tracts of the mesencephalon, which were hypointense on T1-weighted and hyperintense on T2-weighted images. (orig.)

Neurologic disturbances in case of breast cancer disseminated into cranial bones

International Nuclear Information System (INIS)

Tarasyuk, S.V.; Letyagin, V.P.

1986-01-01

The paper presents data on 52 cases of breast cancer disseminated into cranial vault bones (2 into the orbit). Metastases into the brain (2) and meninges (6) were detected in 17 cases with the aid of computerized tomography of the brain and examination of cerebrospinal fluid. The latter cases were not included into the study group. Metastases into cranial bones were identified by craniography and scanning of the skeleton. Half the patients (18 out of 35) revealed the following neurologic syndromes which were determined by the site of metastases into cranial vault bones and tumour growth pattern (into cranial cavity or soft tissues of the head): lesions in ramus primus nervi trigemini, greater occipital nerve, migraine, pseudotumorous and pseudoencephalitic syndromes. Cases of such neurologic disorders require an all-round examination including ophthalmooscopy, EEG, computerized tomography of the brain, craniography and scanning of the skeleton

Cranial nerve palsies in Nigerian children

African Journals Online (AJOL)

PROF. EZECHUKWU

2014-01-08

Jan 8, 2014 ... Introduction. Cranial nerve palsy is a common clinical problem ... Methodology ... The two cases with three-nerve involvement were re- lated to viral encephalitis and cerebral contusion from ... RTA = road traffic accident.

Macrostructure of the Cranial Cervical Ganglion in the River Buffalo (Bubalus Bubalis

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Hossein Dehghani

2011-09-01

Full Text Available AbstractThe autonomic nervous system consists of a vast range of nerves and ganglions. Anatomical studies have demonstrated that the sympathetic innervations of the head and neck are affected by the neurons that ramify from the cranial cervical ganglion (CCG. The CCG is the end of the sympathetic cervical trunk, which runs with the vagal nerve during its cervical course. In this study sixteen adult (2 - 5 year river buffalo of both sexes (eight male, eight female weighing around 250 - 450 kg were dissected to investigate the weight, situation and arrangement of nerve branches of the cranial cervical ganglion bilaterally. The ganglions showed a fusiform shape and reddish in color. The cranial cervical ganglion covered by the digastricus muscle. It lies in dorsal region of the base of epiglottic cartilage, ventromedial to tympanic bulla and ventrally to atlantic fossa, and medial of the occipital artery. This study showed that the cranial cervical ganglions in river buffalo were well-developed structure. The main branches of cranial cervical ganglion included the internal carotid, external carotid and jugular nerves.

3D Printed, Customized Cranial Implant for Surgical Planning

Science.gov (United States)

Bogu, Venkata Phanindra; Ravi Kumar, Yennam; Asit Kumar, Khanra

2018-06-01

The main objective of the present work is to model cranial implant and printed in FDM machine (printer model used: mojo). Actually this is peculiar case and the skull has been damaged in frontal, parietal and temporal regions and a small portion of frontal region damaged away from saggital plane, complexity is to fill this frontal region with proper curvature. The Patient CT-data (Number of slices was 381 and thickness of each slice is 0.488 mm) was processed in mimics14.1 software, mimics file was sent to 3-matic software and calculated thickness of skull at different sections where cranial implant is needed then corrected the edges of cranial implant to overcome CSF (cerebrospinal fluid) leakage and proper fitting. Finally the implant average thickness is decided as 2.5 mm and printed in FDM machine with ABS plastic.

High-resolution cranial ultrasound in the shaken-baby syndrome

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Chen, C.Y.; Chin, S.C.; Lee, C.C.; Lee, K.W. [Dept. of Radiology, Tri-Service General Hospital and National Defence Medical Centre, Taipei, Taiwan (Taiwan); Huang, C.C. [Dept. of Paediatrics, National Cheng Kung University Hospital, Tainan (Taiwan); Zimmerman, R.A. [Dept. of Radiology, Children' s Hospital of Philadelphia, PA (United States); Yuh, Y.S.; Chen, S.J. [Dept. of Paediatrics, Tri-Service General Hospital and National Defence Medical Centre, Neihu, Taipei (Taiwan)

2001-08-01

With limited near-field resolution and accessible acoustic windows, sonography has not been advocated for assessing central nervous system injuries in the shaken-baby syndrome. Our purpose was to correlate high-resolution ultrasonographic characteristics of central nervous system injuries in whiplash injuries and the shaken-baby-syndrome with MRI and CT. Ultrasonographic images of 13 infants, aged 2-12 months, with whiplash or shaking cranial trauma were reviewed and compared with MRI in 10 and CT in 10. Five patients had serial ultrasonography and MRI or CT follow-up from 1 to 4 months after the initial injury. With ultrasonography we identified 20 subdural haematomas. MRI and CT in 15 of these showed that four were hyperechoic in the acute stage, three were mildly echogenic in the subacute stage, and that one subacute and seven chronic lesions were echo-free. Five patients had acute focal or diffuse echogenic cortical oedema which evolved into subacute subcortical hyperechoic haemorrhage in four, and well-defined chronic sonolucent cystic or noncystic encephalomalacia was seen at follow-up in two. Using ultrasonography we were unable to detect two posterior cranial fossa subdural haematomas or subarachnoid haemorrhage in the basal cisterns in three cases, but did show blood in the interhemispheric cistern and convexity sulci in two. Ultrasonography has limitations in demonstrating abnormalities remote from the high cerebral convexities but may be a useful adjunct to CT and MRI in monitoring the progression of central nervous system injuries in infants receiving intensive care. (orig.)

High-resolution cranial ultrasound in the shaken-baby syndrome

International Nuclear Information System (INIS)

Chen, C.Y.; Chin, S.C.; Lee, C.C.; Lee, K.W.; Huang, C.C.; Zimmerman, R.A.; Yuh, Y.S.; Chen, S.J.

2001-01-01

With limited near-field resolution and accessible acoustic windows, sonography has not been advocated for assessing central nervous system injuries in the shaken-baby syndrome. Our purpose was to correlate high-resolution ultrasonographic characteristics of central nervous system injuries in whiplash injuries and the shaken-baby-syndrome with MRI and CT. Ultrasonographic images of 13 infants, aged 2-12 months, with whiplash or shaking cranial trauma were reviewed and compared with MRI in 10 and CT in 10. Five patients had serial ultrasonography and MRI or CT follow-up from 1 to 4 months after the initial injury. With ultrasonography we identified 20 subdural haematomas. MRI and CT in 15 of these showed that four were hyperechoic in the acute stage, three were mildly echogenic in the subacute stage, and that one subacute and seven chronic lesions were echo-free. Five patients had acute focal or diffuse echogenic cortical oedema which evolved into subacute subcortical hyperechoic haemorrhage in four, and well-defined chronic sonolucent cystic or noncystic encephalomalacia was seen at follow-up in two. Using ultrasonography we were unable to detect two posterior cranial fossa subdural haematomas or subarachnoid haemorrhage in the basal cisterns in three cases, but did show blood in the interhemispheric cistern and convexity sulci in two. Ultrasonography has limitations in demonstrating abnormalities remote from the high cerebral convexities but may be a useful adjunct to CT and MRI in monitoring the progression of central nervous system injuries in infants receiving intensive care. (orig.)

Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery.

Science.gov (United States)

Reponen, Elina; Tuominen, Hanna; Hernesniemi, Juha; Korja, Miikka

2015-11-01

Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

Thyroid neoplasia in beagles receiving whole-body irradiation during development

International Nuclear Information System (INIS)

Stephens, L.C.; Norrdin, R.W.; Hargis, A.M.; Benjamin, S.A.

1979-01-01

Twenty malignant and 17 benign thyroid neoplasms have been diagnosed in 37 Segment III beagles. Nine males and 8 females had follicular adenomas, and 7 males and 13 females had thyroid carcinomas. The dogs ranged in age from 5.16 to 10.66 years. Twenty-nine of the 37 dogs (78.4 percent) were hypothyroid. Twenty-six (70.3 percent) dogs were irradiated. Of the 26 irradiated dogs 15 had malignant tumors. Fourteen (37.8 percent) of the 37 dogs had the same sire

[Cranial nerve palsy caused by tumours of the head and neck

NARCIS (Netherlands)

Delsing, C.P.; Verbist, B.M.; Hoogen, F.J.A. van den

2013-01-01

Cranial nerve palsy is a diagnostic guiding symptom, but often goes unrecognized. The differential diagnosis includes a variety of diseases, including malignant tumours of the head and neck. Here we describe three cases of cranial nerve palsy. In two of the cases the palsy was recognized following

Multi cranial nerve palsies as the presenting features of prostate carcinoma

International Nuclear Information System (INIS)

Mitchell, D.M.; Wynne, C.J.; Cowan, I.

2008-01-01

Full text: Cranial nerve palsies have previously been reported in metastatic prostate carcinoma, usually occurring late in the course of the disease. We describe the case of a 55-year-old man whose diagnosis of prostate cancer was made following investigation of multiple cranial nerve palsies.

Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery.

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Walmsley, J P

1995-01-01

Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cranially and abaxially and its torn edges were debrided. Radiographically, 6 cases had proliferative new bone on the cranial aspect of the intercondylar eminence of the tibia and 3 had calcified soft tissue densities in the cranial, medial or lateral femorotibial joint. Following surgery and a 6 month period of rest and controlled exercise, 3 horses returned to full competition work, one was usable for hacking, 2 are convalescing and one is lame after one year. It is postulated that this could be a characteristic meniscal injury in horses which can benefit from arthroscopic surgery. Better techniques for accessing the body and caudal pole of the menisci are needed if a more complete diagnosis and treatment of meniscal injuries are to be achieved.

Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery

International Nuclear Information System (INIS)

Walmsley, J.P.

1995-01-01

Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cranially and abaxially and its torn edges were debrided. Radiographically, 6 cases had proliferative new bone on the cranial aspect of the intercondylar eminence of the tibia and 3 had calcified soft tissue densities in the cranial, medial or lateral femorotibial joint. Following surgery and a 6 month period of rest and controlled exercise, 3 horses returned to full competition work, one was usable for hacking, 2 are convalescing and one is lame after one year. It is postulated that this could be a characteristic meniscal injury in horses which can benefit from arthroscopic surgery. Better techniques for accessing the body and caudal pole of the menisci are needed if a more complete diagnosis and treatment of meniscal injuries are to be achieved

Bony cranial ornamentation linked to rapid evolution of gigantic theropod dinosaurs

Science.gov (United States)

Gates, Terry A.; Organ, Chris; Zanno, Lindsay E.

2016-09-01

Exaggerated cranial structures such as crests and horns, hereafter referred to collectively as ornaments, are pervasive across animal species. These structures perform vital roles in visual communication and physical interactions within and between species. Yet the origin and influence of ornamentation on speciation and ecology across macroevolutionary time scales remains poorly understood for virtually all animals. Here, we explore correlative evolution of osseous cranial ornaments with large body size in theropod dinosaurs using a phylogenetic comparative framework. We find that body size evolved directionally toward phyletic giantism an order of magnitude faster in theropod species possessing ornaments compared with unadorned lineages. In addition, we find a body mass threshold below which bony cranial ornaments do not originate. Maniraptoriform dinosaurs generally lack osseous cranial ornaments despite repeatedly crossing this body size threshold. Our study provides novel, quantitative support for a shift in selective pressures on socio-sexual display mechanisms in theropods coincident with the evolution of pennaceous feathers.

Classification of Porcine Cranial Fracture Patterns Using a Fracture Printing Interface,.

Science.gov (United States)

Wei, Feng; Bucak, Serhat Selçuk; Vollner, Jennifer M; Fenton, Todd W; Jain, Anil K; Haut, Roger C

2017-01-01

Distinguishing between accidental and abusive head trauma in children can be difficult, as there is a lack of baseline data for pediatric cranial fracture patterns. A porcine head model has recently been developed and utilized in a series of studies to investigate the effects of impact energy level, surface type, and constraint condition on cranial fracture patterns. In the current study, an automated pattern recognition method, or a fracture printing interface (FPI), was developed to classify cranial fracture patterns that were associated with different impact scenarios documented in previous experiments. The FPI accurately predicted the energy level when the impact surface type was rigid. Additionally, the FPI was exceedingly successful in determining fractures caused by skulls being dropped with a high-level energy (97% accuracy). The FPI, currently developed on the porcine data, may in the future be transformed to the task of cranial fracture pattern classification for human infant skulls. © 2016 American Academy of Forensic Sciences.

The cranial anatomy of the neornithischian dinosaur Thescelosaurus neglectus

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Clint A. Boyd

2014-11-01

Full Text Available Though the dinosaur Thescelosaurus neglectus was first described in 1913 and is known from the relatively fossiliferous Lance and Hell Creek formations in the Western Interior Basin of North America, the cranial anatomy of this species remains poorly understood. The only cranial material confidently referred to this species are three fragmentary bones preserved with the paratype, hindering attempts to understand the systematic relationships of this taxon within Neornithischia. Here the cranial anatomy of T. neglectus is fully described for the first time based on two specimens that include well-preserved cranial material (NCSM 15728 and TLAM.BA.2014.027.0001. Visual inspection of exposed cranial elements of these specimens is supplemented by detailed CT data from NCSM 15728 that enabled the examination of otherwise unexposed surfaces, facilitating a complete description of the cranial anatomy of this species. The skull of T. neglectus displays a unique combination of plesiomorphic and apomorphic traits. The premaxillary and ‘cheek’ tooth morphologies are relatively derived, though less so than the condition seen in basal iguanodontians, suggesting that the high tooth count present in the premaxillae, maxillae, and dentaries may be related to the extreme elongation of the skull of this species rather than a retention of the plesiomorphic condition. The morphology of the braincase most closely resembles the iguanodontians Dryosaurus and Dysalotosaurus, especially with regard to the morphology of the prootic. One autapomorphic feature is recognized for the first time, along with several additional cranial features that differentiate this species from the closely related and contemporaneous Thescelosaurus assiniboiensis. Published phylogenetic hypotheses of neornithischian dinosaur relationships often differ in the placement of the North American taxon Parksosaurus, with some recovering a close relationship with Thescelosaurus and others with

Role of cranial imaging in epileptic status

International Nuclear Information System (INIS)

Nair, Pradeep P.; Kalita, Jayantee; Misra, Usha K.

2009-01-01

Introduction: There is paucity of studies evaluating the role of cranial imaging in the management of status epilepticus (SE); therefore this study evaluates the role of imaging in predicting the outcome of SE. Methods: Consecutive patients with SE were prospectively evaluated. Clinical evaluation, blood counts, serum chemistry and cerebrospinal fluid (CSF) were carried out. Cranial CT scan was performed on a spiral CT and MRI on a 1.5 T scanner. Patients were treated with IV sodium valproate, phenytoin and benzodiazepines as per fixed protocol. Outcome was defined as seizure control at 1 h and mortality. Various clinical and radiological parameters were correlated. Results: There were 99 patients with SE whose mean age was 35 (1-78) years, 40 females and 17 were below 12 years of age. Fifty six patients had central nervous system (CNS) infections, 15 strokes, 13 metabolic encephalopathy, 5 drug default and in the remaining 10 patients various acute symptomatic causes were present. Cranial imaging was abnormal in 59% patients. CT was abnormal in 21 (47.7%) out of 44 patients whereas MRI was abnormal in 26 (63.4%) out of 41 patients. Both MRI and CT were carried out in 14 patients and 12 revealed abnormalities; 2 had abnormality only on MRI. Imaging revealed cortical lesions in 10, subcortical in 19 and both cortical as well as subcortical in 30 patients. One hour seizure control was achieved in 60, seizures recurred within 24 h in 38 and 27 patients died during hospital stay. Seizure type, duration of SE, seizure control at 1 h and mortality did not correlate with radiological abnormalities. Conclusion: Cranial imaging reveals structural abnormality in 59% patients with SE and was not related to SE control and mortality.

Role of cranial imaging in epileptic status

Energy Technology Data Exchange (ETDEWEB)

Nair, Pradeep P; Kalita, Jayantee [Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014 (India); Misra, Usha K. [Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014 (India)], E-mail: drukmisra@rediffmail.com

2009-06-15

Introduction: There is paucity of studies evaluating the role of cranial imaging in the management of status epilepticus (SE); therefore this study evaluates the role of imaging in predicting the outcome of SE. Methods: Consecutive patients with SE were prospectively evaluated. Clinical evaluation, blood counts, serum chemistry and cerebrospinal fluid (CSF) were carried out. Cranial CT scan was performed on a spiral CT and MRI on a 1.5 T scanner. Patients were treated with IV sodium valproate, phenytoin and benzodiazepines as per fixed protocol. Outcome was defined as seizure control at 1 h and mortality. Various clinical and radiological parameters were correlated. Results: There were 99 patients with SE whose mean age was 35 (1-78) years, 40 females and 17 were below 12 years of age. Fifty six patients had central nervous system (CNS) infections, 15 strokes, 13 metabolic encephalopathy, 5 drug default and in the remaining 10 patients various acute symptomatic causes were present. Cranial imaging was abnormal in 59% patients. CT was abnormal in 21 (47.7%) out of 44 patients whereas MRI was abnormal in 26 (63.4%) out of 41 patients. Both MRI and CT were carried out in 14 patients and 12 revealed abnormalities; 2 had abnormality only on MRI. Imaging revealed cortical lesions in 10, subcortical in 19 and both cortical as well as subcortical in 30 patients. One hour seizure control was achieved in 60, seizures recurred within 24 h in 38 and 27 patients died during hospital stay. Seizure type, duration of SE, seizure control at 1 h and mortality did not correlate with radiological abnormalities. Conclusion: Cranial imaging reveals structural abnormality in 59% patients with SE and was not related to SE control and mortality.

Electrophysiology of Cranial Nerve Testing: Spinal Accessory and Hypoglossal Nerves.

Science.gov (United States)

Stino, Amro M; Smith, Benn E

2018-01-01

Multiple techniques have been developed for the electrodiagnostic evaluation of cranial nerves XI and XII. Each of these carries both benefits and limitations, with more techniques and data being available in the literature for spinal accessory than hypoglossal nerve evaluation. Spinal accessory and hypoglossal neuropathy are relatively uncommon cranial mononeuropathies that may be evaluated in the outpatient electrodiagnostic laboratory setting. A review of available literature using PubMed was conducted regarding electrodiagnostic technique in the evaluation of spinal accessory and hypoglossal nerves searching for both routine nerve conduction studies and repetitive nerve conduction studies. The review provided herein provides a resource by which clinical neurophysiologists may develop and implement clinical and research protocols for the evaluation of both of these lower cranial nerves in the outpatient setting.

MRI findings in cranial eumycetoma

International Nuclear Information System (INIS)

Ahmed, Munawwar; Sureka, Jyoti; Chacko, Geeta; Eapen, Anu

2011-01-01

Cranial eumycetoma (CE) due to direct inoculation of Madurella grisea into the scalp is extremely rare. We describe a case of CE caused by direct inoculation of M. grisea with the characteristic MRI findings of the “dot-in-circle” sign and a conglomeration of multiple, extremely hypointense “dots.”

Latitudinal variation in cranial dimorphism in Macaca fascicularis.

Science.gov (United States)

Schillaci, Michael A

2010-02-01

This study examines latitudinal and insular variation in the expression of sexual dimorphism in cranial length in three geographical groupings of Macaca fascicularis. In addition, the relationship between cranial length dimorphism (CLD) and sex-specific size is examined. The results of the study identified a significant relationship between CLD and latitude for only one of the three geographic groupings. Sex-specific relationships between cranial length and CLD were detected. The pattern of these relationships varied by geographic grouping. This study is important because it demonstrates that despite very similar levels of CLD in a single primate species, there exists important geographic variability in the correlates of that dimorphism. I suggest that geographically varying ecological factors may influence sex-specific natural selection and the intensity of CLD in M. fascicularis. Gaining a better understanding of this geographical variability will require that future research examines morphological variation, including CLD, within its corresponding ecological and social contexts. Such research should be comparative, and incorporate multiple geographically separated populations with disparate environmental settings.

Structural and mechanical characterization of custom design cranial implant created using additive manufacturing

OpenAIRE

Khaja Moiduddin; Saied Darwish; Abdulrahman Al-Ahmari; Sherif ElWatidy; Ashfaq Mohammad; Wadea Ameen

2017-01-01

Background: Reconstruction of customized cranial implants with a mesh structure using computer-assisted design and additive manufacturing improves the implant design, surgical planning, defect evaluation, implant-tissue interaction and surgeon's accuracy. The objective of this study is to design, develop and fabricate cranial implant with mechanical properties closer to that of bone and drastically decreases the implant failure and to improve the esthetic outcome in cranial surgery with preci...

Cervical vertebrae, cranial base, and mandibular retrognathia in human triploid fetuses

DEFF Research Database (Denmark)

Sonnesen, Liselotte; Nolting, Dorrit; Engel, Ulla

2009-01-01

and the uppermost vertebra in the body axis. As the notochord connects the cervical column and the cranial base in early prenatal life, molecular signaling from the notochord may in future studies support the notochord as the developmental link between abnormal development in the spine and the cranial base....

Positive pressure ventilation and cranial volume in newborn infants.

OpenAIRE

Milligan, D W

1981-01-01

The relationship between changes in airways pressure, pleural pressure, and cranial volume was studied in a group of sick newborn infants requiring ventilatory assistance. Cranial volume increased appreciably only when lung compliance was such that more than 20% of the applied airways pressure was transmitted to the pleural space, or if the absolute pleural pressure was greater than 4 cmH2O above atmospheric pressure. The findings stress the need for more-critical monitoring during periods of...

Depression of T lymphocyte function in chimpanzees receiving thymectomy and irradiation

International Nuclear Information System (INIS)

Gilbertsen, R.B.; Metzgar, R.S.

1978-01-01

In studies analogous to those in which the thymus dependency of immune functions in murine systems was determined, three chimpanzees were thymectomized, splenectomized, exposed to lethal doses of whole body x-irradiation with limited bone marrow shielding, and subsequently evaluated for lymphocyte markers and functions over a period of years. In the oldest animal studied (Irena, 7.2 years at surgery), the percentage of peripheral blood T cells decreased to about 60% of control values and remained at that level for approximately 1 1 / 2 years before returning to normal. In the two youngest chimpanzees T cell rosette values dropped to 15 to 40% of control values after irradiation. T cell percentages in one of these young chimpanzees returned to about 75% of the controls 2 1 / 2 years after x-irradiation. Phytohemagglutinin and concanavalin A mitogen responses were less affected in the oldest chimpanzee. However, even in the oldest animal, the responses to phytohemagglutinin and concanavalin A began to show a gradual and consistent decline 1 1 / 2 years after irradiation. Mixed leukocyte culture responsiveness was most affected by the experimental procedures, being greatly reduced in all three chimpanzees during varying time intervals. In general, the effects of the experimental procedures used to produce T cell deficiencies varied with the age of the chimpanzee at surgery, the time after irradiation when the animal was tested, and the lymphocyte marker or function studied

Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery

Science.gov (United States)

Bydon, Mohamad; Abt, Nicholas B.; Macki, Mohamed; Brem, Henry; Huang, Judy; Bydon, Ali; Tamargo, Rafael J.

2014-01-01

Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity. PMID:25422784

Evaluation of an animation tool developed to supplement dental student study of the cranial nerves.

Science.gov (United States)

Lone, M; McKenna, J P; Cryan, J F; Vagg, T; Toulouse, A; Downer, E J

2017-12-30

The structure/function of the cranial nerves is a core topic for dental students. However, due to the perceived complexity of the subject, it is often difficult for students to develop a comprehensive understanding of key concepts using textbooks and models. It is accepted that the acquisition of anatomical knowledge can be facilitated by visualisation of structures. This study aimed to develop and assess a novel cranial nerve animation as a supplemental learning aid for dental students. A multidisciplinary team of anatomists, neuroscientists and a computer scientist developed a novel animation depicting the cranial nerves. The animation was viewed by newly enrolled first-year dental students, graduate entry dental students (year 1) and dental hygiene students (year 1). A simple life scenario employing the use of the cranial nerves was developed using a cartoon-type animation with a viewing time of 3.58 minutes. The animation was developed with emphasis on a life scenario. The animation was placed online for 2 weeks with open access or viewed once in a controlled laboratory setting. Questionnaires were designed to assess the participants' attitude towards the animation and their knowledge of the cranial nerves before and after visualisation. This study was performed before the delivery of core lectures on the cranial nerves. Our findings indicate that the use of the animation can act as a supplemental tool to improve student knowledge of the cranial nerves. Indeed, data indicate that a single viewing of the animation, in addition to 2-week access to the animation, can act as a supplemental learning tool to assist student understanding of the structure and function of cranial nerves. The animation significantly enhanced the student's opinion that their cranial nerve knowledge had improved. From a qualitative point of view, the students described the animation as an enjoyable and useful supplement to reading material/lectures and indicated that the animation was a

Retinoic acid modulates chondrogenesis in the developing mouse cranial base.

Science.gov (United States)

Kwon, Hyuk-Jae; Shin, Jeong-Oh; Lee, Jong-Min; Cho, Kyoung-Won; Lee, Min-Jung; Cho, Sung-Won; Jung, Han-Sung

2011-12-15

The retinoic acid (RA) signaling pathway is known to play important roles during craniofacial development and skeletogenesis. However, the specific mechanism involving RA in cranial base development has not yet been clearly described. This study investigated how RA modulates endochondral bone development of the cranial base by monitoring the RA receptor RARγ, BMP4, and markers of proliferation, programmed cell death, chondrogenesis, and osteogenesis. We first examined the dynamic morphological and molecular changes in the sphenooccipital synchondrosis-forming region in the mouse embryo cranial bases at E12-E16. In vitro organ cultures employing beads soaked in RA and retinoid-signaling inhibitor citral were compared. In the RA study, the sphenooccipital synchondrosis showed reduced cartilage matrix and lower BMP4 expression while hypertrophic chondrocytes were replaced with proliferating chondrocytes. Retardation of chondrocyte hypertrophy was exhibited in citral-treated specimens, while BMP4 expression was slightly increased and programmed cell death was induced within the sphenooccipital synchondrosis. Our results demonstrate that RA modulates chondrocytes to proliferate, differentiate, or undergo programmed cell death during endochondral bone formation in the developing cranial base. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.

Visualization of the lower cranial nerves by 3D-FIESTA

International Nuclear Information System (INIS)

Okumura, Yusuke; Suzuki, Masayuki; Takemura, Akihiro; Tsujii, Hideo; Kawahara, Kazuhiro; Matsuura, Yukihiro; Takada, Tadanori

2005-01-01

MR cisternography has been introduced for use in neuroradiology. This method is capable of visualizing tiny structures such as blood vessels and cranial nerves in the cerebrospinal fluid (CSF) space because of its superior contrast resolution. The cranial nerves and small vessels are shown as structures of low intensity surrounded by marked hyperintensity of the CSF. In the present study, we evaluated visualization of the lower cranial nerves (glossopharyngeal, vagus, and accessory) by the three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) sequence and multiplanar reformation (MPR) technique. The subjects were 8 men and 3 women, ranging in age from 21 to 76 years (average, 54 yeas). We examined the visualization of a total of 66 nerves in 11 subjects by 3D-FIESTA. The results were classified into four categories ranging from good visualization to non-visualization. In all cases, all glossopharyngeal and vagus nerves were identified to some extent, while accessory nerves were visualized either partially or entirely in only 16 cases. The total visualization rate was about 91%. In conclusion, 3D-FIESTA may be a useful method for visualization of the lower cranial nerves. (author)

CRANIAL OSTEOLOGY OF CYCLARHIS GUJANENSIS (AVES: VIREONIDAE

Directory of Open Access Journals (Sweden)

DIEGO MATIUSSI PREVIATTO

2015-01-01

Full Text Available The small passerine Cyclaris gujanensis can tear into small pieces large or heavy-bodied preys that could not be swallowed whole such as frogs, snakes, bats and birds. However there are few studies on the cranial anatomy of this species. Thus, we focused on the description of the cranial osteology to contribute to the anatomical knowledge of this species and to make some assumptions about functional anatomy. The fossa temporalis is shallow but broad and the fossa of os palatinum is deepened. The os quadratum processes are long and thick. The os pterygoideum is enlarged and the upper jaw is strongly inclined ventrally (140° with reference to the skull. The rostral extremity of rhamphotheca is hooked with ventral concavity to fit the mandible (pincer form. The mandible fossae are deepened and broad and its bulky medial process probably provides mandible stability and strong support to the muscles attached on it. All these peculiar characteristics probably indicate a considerable force in the C. gujanensis jaws and partially explain its distinctive feeding habit compared with the other Vireonidae. Nevertheless, new studies with functional approaches to analysis the forces of the muscle fibers and the cranial kinesis are needed to prove the hypotheses mentioned above.

The lower cranial nerves: IX, X, XI, XII.

Science.gov (United States)

Sarrazin, J-L; Toulgoat, F; Benoudiba, F

2013-10-01

The lower cranial nerves innervate the pharynx and larynx by the glossopharyngeal (CN IX) and vagus (CN X) (mixed) nerves, and provide motor innervation of the muscles of the neck by the accessory nerve (CN XI) and the tongue by the hypoglossal nerve (CN XII). The symptomatology provoked by an anomaly is often discrete and rarely in the forefront. As with all cranial nerves, the context and clinical examinations, in case of suspicion of impairment of the lower cranial nerves, are determinant in guiding the imaging. In fact, the impairment may be located in the brain stem, in the peribulbar cisterns, in the foramens or even in the deep spaces of the face. The clinical localization of the probable seat of the lesion helps in choosing the adapted protocol in MRI and eventually completes it with a CT-scan. In the bulb, the intra-axial pathology is dominated by brain ischemia (in particular, with Wallenberg syndrome) and multiple sclerosis. Cisternal pathology is tumoral with two tumors, schwannoma and meningioma. The occurrence is much lower than in the cochleovestibular nerves as well as the leptomeningeal nerves (infectious, inflammatory or tumoral). Finally, foramen pathology is tumoral with, outside of the usual schwannomas and meningiomas, paragangliomas. For radiologists, fairly hesitant to explore these lower cranial pairs, it is necessary to be familiar with (or relearn) the anatomy, master the exploratory technique and be aware of the diagnostic possibilities. Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Testing the cranial evolutionary allometric 'rule' in Galliformes.

Science.gov (United States)

Linde-Medina, M

2016-09-01

Recent comparative studies have indicated the existence of a common cranial evolutionary allometric (CREA) pattern in mammals and birds, in which smaller species have relatively smaller faces and bigger braincases than larger species. In these studies, cranial allometry was tested using a multivariate regression between shape (described using landmarks coordinates) and size (i.e. centroid size), after accounting for phylogenetic relatedness. Alternatively, cranial allometry can be determined by comparing the sizes of two anatomical parts using a bivariate regression analysis. In this analysis, a slope higher or lower than one indicates the existence of positive or negative allometry, respectively. Thus, in those species that support the CREA 'rule', positive allometry is expected for the association between face size and braincase size, which would indicate that larger species have disproportionally larger faces. In this study, I applied these two approaches to explore cranial allometry in 83 Galliformes (Aves, Galloanserae), ranging in mean body weight from 30 g to 2.5 kg. The multivariate regression between shape and centroid size revealed the existence of a significant allometric pattern resembling CREA, whereas the second analysis revealed a negative allometry for beak size and braincase size (i.e. contrary to the CREA 'rule', larger galliform species have disproportionally shorter beaks than smaller galliform species). This study suggests that the presence of CREA may be overestimated when using cranium size as the standard measurement. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

Anosmin-1 is essential for neural crest and cranial placodes formation in Xenopus.

Science.gov (United States)

Bae, Chang-Joon; Hong, Chang-Soo; Saint-Jeannet, Jean-Pierre

2018-01-15

During embryogenesis vertebrates develop a complex craniofacial skeleton associated with sensory organs. These structures are primarily derived from two embryonic cell populations the neural crest and cranial placodes, respectively. Neural crest cells and cranial placodes are specified through the integrated action of several families of signaling molecules, and the subsequent activation of a complex network of transcription factors. Here we describe the expression and function of Anosmin-1 (Anos1), an extracellular matrix protein, during neural crest and cranial placodes development in Xenopus laevis. Anos1 was identified as a target of Pax3 and Zic1, two transcription factors necessary and sufficient to generate neural crest and cranial placodes. Anos1 is expressed in cranial neural crest progenitors at early neurula stage and in cranial placode derivatives later in development. We show that Anos1 function is required for neural crest and sensory organs development in Xenopus, consistent with the defects observed in Kallmann syndrome patients carrying a mutation in ANOS1. These findings indicate that anos1 has a conserved function in the development of craniofacial structures, and indicate that anos1-depleted Xenopus embryos represent a useful model to analyze the pathogenesis of Kallmann syndrome. Copyright © 2017. Published by Elsevier Inc.

Synergism of X irradiation and radiographic contrast medium

Energy Technology Data Exchange (ETDEWEB)

Carr, D; Walker, A; Tannahill, A J; White, R G [Glasgow Western Infirmary (UK)

1981-10-01

The results indicate that rabbits which had received abdominal x irradiation (750 rad) two hours before RCM (/sup 125/I-labelled meglumine ioglycamate) administration retained a significantly larger amount of RCM in the kidney, liver, spleen and plasma compared with animals which had received RCM with no prior x irradiation. There was no significant difference between the group receiving RCM alone and the group receiving RCM 24 h post-irradiation. With two insignificant exceptions, endotoxin assays were negative.

Idiopathic hypertrophic cranial pachymeningitis associated with Sweet's Syndrome

Energy Technology Data Exchange (ETDEWEB)

Cano, Antonio E-mail: acano@hrs.sas.junta-andalucia.es; Ribes, Ramon; Riva, Andres de la; Rubio, Fernando Lopez; Sanchez, Carmen; Sancho, Jose L

2002-11-01

A case of hypertrophic cranial pachymeningitis associated with Sweet's Syndrome is presented. Both entities have been described in association with several other chronic systemic inflammatory diseases and autoimmune conditions. To our knowledge the coexistence between Sweet's Syndrome and hypertrophic cranial pachymeningitis has not been reported up to date. We suggest a possible autoimmune or dysimmune mechanism in the pathogenesis of these two entities.

Clinical application of transvenous temporary cardiac pacemaker in performing extra-cranial carotid angiography and stent implantation

International Nuclear Information System (INIS)

Liu Juan; Yao Guoen; Zhou Huadong; Jiang Xiaojiang; Chen Qiao

2012-01-01

Objective: To assess the safety and effectiveness of transvenous temporary cardiac pacemaker in preventing hemodynamic instability occurred during the perioperative period of extra-cranial carotid angiography and stent implantation. Methods: Preoperative install of temporary cardiac pacemaker via left femoral vein was carried out in 41 patients who were at high risk for developing hemodynamic instability, which was followed by extra-cranial carotid angiography and stent implantation. The pacing rhythm of the pacemaker was fixed at 60 beats/min. During and after the procedure the patients were under close observation for the signs of discomfort symptoms as well as the changes in blood pressure and heart rate. The working condition of the pacemaker was also monitored. Results: All the installed pacemakers were technically and hemodynamically effective in producing electrical ventricular responses in all 25 patients who had received balloon dilatation of carotid in advance. Transient pacemaker activation appeared in 25 patients. The longest activation time was one day. During pacemaker activation, one patient developed symptomatic hypotension. The longest duration of hypotension lasted for 4 days. No pacemaker-related or procedure-related complications occurred. Conclusion: Hemodynamic instability is a common complication occurred during perioperative period of extra-cranial carotid angiography and stent implantation. As a prophylactic measure, preoperative placement of temporary cardiac pacemaker can promptly and effectively correct the hemodynamic disorders and prevent perioperative complications such as stroke, etc. Therefore, this technique is worth employing in clinical practice, and it is especially useful for patients with high risks. (authors)

Fine-structural effects of 1200-R abdominal x irradiation on rat intestinal epithelium

International Nuclear Information System (INIS)

Lieb, R.J.; McDonald, T.F.; McKenney, J.R.

1977-01-01

Male Charles River CD rats were shielded from the xiphoid process cranially with lead and were exposed to 1200-R abdominal x irradiation. Animals were sacrificed at 1 through 4 days following irradiation and tissues from both ileum and jejunum were prepared for electron microscopic examination. At the fine-structural level early changes were confined to a proliferation and dilation of smooth endoplasmic reticulum and to an increase in the number of lysosomes. At 4 days postirradiation, cells covering the villi were cuboidal rather than columnar and appeared to be immature crypt-type cells. The appearance of these cells was coincident with the onset of diarrhea in these animals

[Maxillary swing approach in the management of tumors in the central and lateral cranial base].

Science.gov (United States)

Liao, Hua; Hua, Qing-quan; Wu, Zhan-yuan

2006-04-01

A retrospective review of seventeen patients who were operated through the maxillary swing approach was carried out to assess the efficacy of this approach in the management of tumors of the central and lateral cranial base. From May 2000 to January 2005, 17 patients with primary or recurrent neoplasms involving the central cranial or lateral base underwent surgical resection via maxillary swing approach. Ten patients were male, and other seven patients were female, and age range was 7 to 58 years, with a mean age of 42. 6 years. Eight patients had tumors originally involving lateral cranial base, and nine patients had tumors originated from central cranial base. The pathology spectrum was very wide. Among them, five suffered from chordoma, two had rhabdomyosarcoma, two had squamous cell carcinoma, one had malignant fibrous histiocytoma, one had malignant melanoma, one had esthesioneuroblastoma, one had invaded hypophysoma, two had schwannoma, one had pleomorphic adenoma, and one had angiofibroma. Three patients had received previous surgery, two patients had previous radiation therapy and nine patients received postoperative radiotherapy. Sixteen of all seventeen patients had oncologically complete resection, one had near-total resection. This group patients was followed up from 10 to 60 months, with a median follow-up time of 28 months. Two patients died 14 and 26 months after surgery respectively, as a result of local recurrence and metastasis. One patient defaulted follow-up at 12 months after operation, and the other 14 patients were alive at the time of analysis. Of the 12 malignant tumors, the 1-and 2-year survival rate were 91.67% and 72.92%, respectively. The facial wounds of all patients healed primarily, and there were no necrosis of the maxilla, damage of the temporal branch of the facial nerve, lower-lid ectropion, and facial deformity. Epiphora and facial hypoesthesia were detected in all patients. Four patients (23.5%) developed palatal fistula, ten

The Biomechanics of Cranial Forces During Figure Skating Spinning Elements.

Science.gov (United States)

Wang, David H; Kostyun, Regina O; Solomito, Matthew J

2015-03-01

Several facets of figure skating, such as the forces associated with jumping and landing, have been evaluated, but a comprehensive biomechanical understanding of the cranial forces associated with spinning has yet to be explored. The purpose of this case study was to quantify the cranial rotational acceleration forces generated during spinning elements. This case report was an observational, biomechanical analysis of a healthy, senior-level, female figure skating athlete who is part of an on-going study. A triaxial accelerometer recorded the gravitational forces (G) during seven different spinning elements. Our results found that the layback spin generated significant cranial force and these forces were greater than any of the other spin elements recorded. These forces led to physical findings of ruptured capillaries, dizziness, and headaches in our participant.

Study on preventive effects of i.v. administration of flavin adenine dinucleotide (FAD) before irradiation on radiation stomatitis

International Nuclear Information System (INIS)

Nagai, Masao; Houzawa, Jiro; Hakamada, Masaru

1984-01-01

In order to compare the preventive effect on radiation stomatitis, flavin adenine dinucleotide (FAD) or vitamin C was administered intravenously until the blood level reached the maximum at the time of irradiation. Thirtyfive patients with cranial or cervical tumors were allocated into the group with FAD (15), the group with vitamin C (10), and the group with irradiation alone (10). The incidence of stomititis was significantly lower and the number of patients in whom the drug was withdrawn due to stomatitis was extremely smaller in the group with FAD than in the other groups. FAD administered before irradiation was considered very useful in preventing radiation stomatitis. (Namekawa, K.)

[Cranial trepanation in primitive cultures].

Science.gov (United States)

González-Darder, José Manuel

A review is presented on cranial trepanations performed by primitive cultures. The scientific interest in this topic began after the discovery in 1965 by Ephraim G. Squier of a pre-Columbian trepanated skull, and studied by Paul Broca in Paris. Pseudotrepanation and other types of cranial manipulation are reviewed. The techniques, technology, and instruments for every type of trepanation are well known. There are a surprisingly high percentage of cases showing signs of post-trepanation survival. Indications for trepanation are speculative, perhaps magic. Although trepanation in primitive cultures is widespread around the world, and throughout time, the main fields of interest are the Neolithic Period in Europe, the pre-Columbian Period in Andean South America, and some contemporaneous Pacific and African tribes. This particular trepanation procedure has no relationship with modern Neurosurgery, or with trepanations with therapeutic purposes performed since the Greco-Roman period in Europe, and afterwards around the world. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Problems of cranial computer-tomography

Energy Technology Data Exchange (ETDEWEB)

Seitz, D [Allgemeines Krankenhaus St. Georg, Hamburg (Germany, F.R.). Neurologische Abt.

1979-07-01

The author discusses the problems that have cropped up since the introduction of computerized tomography 5 years ago. To begin with, problems of contrast and object resolution are discussed with a special view to the importance of amipague imaging of cisterns, in particular in the detection of basal growing and displacing, intracranial processes. After this, the tasks of computerized tomography in neurological and neurosurgical emergencies, cerebrocranial injuries, cerebral circulation disturbances, inflammatory diseases of the central nervous systems, epileptic seizures, and chronical headaches are reviewed. Special regard is given to the problem of recurrent examinations and course control, especially in cerebral tumours and aresorptive hydrocephalus. Another paragraph deals with the correlation between CT findings, clinical symptoms, and clinical findings. The importance of cranial CT for neurological diagnoses is illustrated by the change of indications for conventional methods of examination. The limits of the method are shown and it is pointed out that cranial CT is not a search technique but that it requires previous examinations by a neurologist, neurosurgeon, or neuropaediatrician.

Problems of cranial computer-tomography

International Nuclear Information System (INIS)

Seitz, D.

1979-01-01

The author discusses the problems that have cropped up since the introduction of computerized tomography 5 years ago. To begin with, problems of contrast and object resolution are discussed with a special view to the importance of amipague imaging of cisterns, in particular in the detection of basal growing and displacing, intracranial processes. After this, the tasks of computerized tomography in neurological and neurosurgical emergencies, cerebrocranial injuries, cerebral circulation disturbances, inflammatory diseases of the central nervous systems, epileptic seizures, and chronical headaches are reviewed. Special regard is given to the problem of recurrent examinations and course control, especially in cerebral tumours and aresorptive hydrocephalus. Another paragraph deals with the correlation between CT findings, clinical symptoms, and clinical findings. The importance of cranial CT for neurological diagnoses is illustrated by the change of indications for conventional methods of examination. The limits of the method are shown and it is pointed out that cranial CT is not a search technique but that it requires previous examinations by a neurologist, neurosurgeon, or neuropaediatrician. (orig.) [de

Cranial base pathology in pediatric osteogenesis imperfecta patients treated with bisphosphonates.

Science.gov (United States)

Arponen, Heidi; Vuorimies, Ilkka; Haukka, Jari; Valta, Helena; Waltimo-Sirén, Janna; Mäkitie, Outi

2015-03-01

Cranial base pathology is a serious complication of osteogenesis imperfecta (OI). Our aim was to analyze whether bisphosphonate treatment, used to improve bone strength, could also prevent the development of craniocervical junction pathology (basilar impression, basilar invagination, or platybasia) in children with OI. In this single-center retrospective study the authors analyzed the skull base morphology from lateral skull radiographs and midsagittal MR images (total of 94 images), obtained between the ages of 0 and 25 years in 39 bisphosphonate-treated OI patients. The results were compared with age-matched normative values and with findings in 70 OI patients who were not treated with bisphosphonates. In addition to cross-sectional data, longitudinal data were available from 22 patients with an average follow-up period of 7.6 years. The patients, who had OI types I, III, IV, VI, and VII, had been treated with zoledronic acid, pamidronate, or risedronate for 3.2 years on average. Altogether 33% of the 39 bisphosphonate-treated patients had at least 1 cranial base anomaly, platybasia being the most prevalent diagnosis (28%). Logistic regression analysis suggested a higher risk of basilar impression or invagination in patients with severe OI (OR 22.04) and/or older age at initiation of bisphosphonate treatment (OR 1.45), whereas a decreased risk was associated with longer duration of treatment (OR 0.28). No significant associations between age, height, or cumulative bisphosphonate dose and the risk for cranial base anomaly were detected. In longitudinal evaluation, Kaplan-Meier curves suggested delayed development of cranial base pathology in patients treated with bisphosphonates but the differences from the untreated group were not statistically significant. These findings indicate that cranial base pathology may develop despite bisphosphonate treatment. Early initiation of bisphosphonate treatment may delay development of craniocervical junction pathology

On the roentgenomorphological correlations of cranial sutures

International Nuclear Information System (INIS)

Verkhoglyadova, T.P.; Koval', G.Yu.; Shuaa, T.I.

1986-01-01

The authors explain the essence of the zone of excessive transparence along the cranial sutures visualized on the X-ray pictures during the first year of life by presence of large number of rough-fiber bone in the marginal regions. The zone of ''physiological sclerosis'' is postulated as a result of summation of the bone margin shadows consisting of compact substance (osteones). Microscopic examination of skull in brain tumors revealed a delay in the formation of bone margins in the suture region with an excessive amount of connective and osteoid tissue while in craniostenosis closure of cranial sutures being with intensive bone formation as well as by closure of the bone margins by newly formed bone tissue around the vessels of the connective layer of the suture

Imaging the cranial nerves: Part I: Methodology, infectious and inflammatory, traumatic and congenital lesions

Energy Technology Data Exchange (ETDEWEB)

Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil- Centro de Lisboa, Department of Radiology, Lisboa Codex (Portugal); Casselman, Jan [A.Z. St. Jan Brugge Hospital, Department of Radiology, Brugge (Belgium); A.Z. St. Augustinus Antwerpen Hospitals, Department of Radiology, Antwerpen (Belgium)

2007-08-15

Many disease processes manifest either primarily or secondarily by cranial nerve deficits. Neurologists, ENT surgeons, ophthalmologists and maxillo-facial surgeons are often confronted with patients with symptoms and signs of cranial nerve dysfunction. Seeking the cause of this dysfunction is a common indication for imaging. In recent decades we have witnessed an unprecedented improvement in imaging techniques, allowing direct visualization of increasingly small anatomic structures. The emergence of volumetric CT scanners, higher field MR scanners in clinical practice and higher resolution MR sequences has made a tremendous contribution to the development of cranial nerve imaging. The use of surface coils and parallel imaging allows sub-millimetric visualization of nerve branches and volumetric 3D imaging. Both with CT and MR, multiplanar and curved reconstructions can follow the entire course of a cranial nerve or branch, improving tremendously our diagnostic yield of neural pathology. This review article will focus on the contribution of current imaging techniques in the depiction of normal anatomy and on infectious and inflammatory, traumatic and congenital pathology affecting the cranial nerves. A detailed discussion of individual cranial nerves lesions is beyond the scope of this article. (orig.)

Imaging the cranial nerves: Part I: Methodology, infectious and inflammatory, traumatic and congenital lesions

International Nuclear Information System (INIS)

Borges, Alexandra; Casselman, Jan

2007-01-01

Many disease processes manifest either primarily or secondarily by cranial nerve deficits. Neurologists, ENT surgeons, ophthalmologists and maxillo-facial surgeons are often confronted with patients with symptoms and signs of cranial nerve dysfunction. Seeking the cause of this dysfunction is a common indication for imaging. In recent decades we have witnessed an unprecedented improvement in imaging techniques, allowing direct visualization of increasingly small anatomic structures. The emergence of volumetric CT scanners, higher field MR scanners in clinical practice and higher resolution MR sequences has made a tremendous contribution to the development of cranial nerve imaging. The use of surface coils and parallel imaging allows sub-millimetric visualization of nerve branches and volumetric 3D imaging. Both with CT and MR, multiplanar and curved reconstructions can follow the entire course of a cranial nerve or branch, improving tremendously our diagnostic yield of neural pathology. This review article will focus on the contribution of current imaging techniques in the depiction of normal anatomy and on infectious and inflammatory, traumatic and congenital pathology affecting the cranial nerves. A detailed discussion of individual cranial nerves lesions is beyond the scope of this article. (orig.)

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

International Nuclear Information System (INIS)

Wang Wenhua; Zhou Youxin; Zhu Fengqing; Zhou Dai

2000-01-01

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

Anatomic and pathologic features of third cranial nerve disorders according to magnetic resonance studies

International Nuclear Information System (INIS)

Ruiz, Y.; Torres, J.; Ramos, M.; Caniego, J.L.; Manzanares, R.; Fresno, L.F.

1998-01-01

The objective of this report is to demonstrate the utility of magnetic resonance (MR) in the diagnosis of disorders involving the third cranial nerves. We have selected MR studies corresponding to patients with an anomaly affecting the third cranial nerves, whether alone or in combination with other cranial nerves. In order to better study the pathology of these cranial nerves, we considered four different segments of the nerves: mesencephalic, cisternal, cavernous and orbital. We present the MR features of the anatomy of the third cranial nerves and the most representative lesions affecting the different intracranial segments: infraction, multiple sclerosis, glioma and cavernoma in the mesencephalon; posterior communicating artery aneurysm, neuritis, neurinomas and meningioma in the cisternal segment; aneurysm of the internal carotid artery, cavernous carotid fistula, metastasis and meningioma in the cavernous sinus and Tolosa-Hunt syndrome in the orbital apex. (Author) 11 refs

Roentgenological investigation of cavernous sinus structure with special reference to paracavernous cranial nerves

International Nuclear Information System (INIS)

Tsuha, M.; Aoki, H.; Okamura, T.

1987-01-01

We have evaluated the anatomical structure of cavernous sinuses in parasellar blocks obtained from adult cadavers to gain clinically useful information. Ten microdissectional studies of parasellar blocks (20 sides of cavernous sinus) were carried out with special emphasis on the course of paracavernous cranial nerves (3rd to 6th). These were also examined on plain radiographs. Secondly, CT investigations of the cavernous sinuses (notably as to paracavernous cranial nerves) were undertaken in twenty clinical cases having presumed parasellar lesions and in three parasellar blocks from cadavers. The results from microdisectional studies and plain radiographs were as follows. It was found that the 3rd cranial nerve entered the lateral wall of the cavernous sinus close to the antero-inferior part of the posterior clinoid on lateral projection. The 4th cranial nerve, on the other hand, entered near the postero-inferior portion of the posterior clinoid on the same view. Variations in Parkinson's triangle were fairly often noted, although marked asymmetry was not seen in individual cases. From CT findings, it was found that a postenhanced, magnified direct coronal study was essential for identifying paracavernous cranial nerves more clearly. The 3rd and 5th cranial nerves were fairly well identified on axial and coronal projections. Careful radiological investigation including plain skull radiographs and CT seems to be of value for those who diagnose or treat parasellar lesions. (orig.)

A study of cranial variations based on craniometric indices in a South Indian population.

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Kanchan, Tanuj; Krishan, Kewal; Gupta, Anadi; Acharya, Jenash

2014-09-01

Human skull has been the most extensively studied bone for establishing the taxonomies at evolutionary levels. Crania are also the most commonly used skeletal elements in population studies because they are known to be more genetically driven and less affected by environmental factors. The craniofacial indices are considered as clinical anthropometric parameters used in the investigation of craniofacial skeletal deformities and brain development. The present research is an attempt to study the cranial indices in the South Indian population. The sample for the study included 118 dry adult crania. All the osteometric measurements were taken using standard anthropometric instruments, and 3 indices, namely, cranial index, orbital index (OI), and index of foreman magnum (FMI), were calculated. Cranial index is calculated as (maximum cranial breadth / maximum cranial length) × 100, OI as (orbital height / orbital breadth) × 100, and FMI as (transverse diameter / anteroposterior diameter) × 100. The crania were further classified based on these indices. The cranial index ranged between 66.67 and 85.71 (mean, 78.57 [SD, 4.11]), the OI ranged between 68.89 and 102.63 (mean, 84.23 [SD, 6.64]), and the FMI ranged between 68.57 and 96.88 (mean, 79.71 [SD, 6.98]). Cranial index did not show any significant correlation with the OI (r = -0.162, P = 0.081) or the FMI (r = -0.045, P = 0.626). A statistically significant correlation was, however, observed between OI and FMI (r = -0.232, P = 0.012). The current study developed population-specific classification of crania using cranial indices. This craniometric baseline data pertaining to the craniofacial indices may be useful in presurgical planning and the postsurgical evaluation. It may also assist the forensic anthropologists in the categorization of human skulls, which may be an important component in identification of highly decomposed dead bodies and skeletal remains. More such studies need to be conducted to understand the

Genetic and Environmental Contributions to Cranial Capacity in Black and White Adolescents.

Science.gov (United States)

Rushton, J. Philippe; Osborne, R. Travis

1995-01-01

Data from 236 pairs of black twins and white twins aged 13-17 years were used to examine genetic and environmental factors influencing cranial size, an indirect estimate of brain volume. Genetic factors are required to account for the phenotypic variance in cranial capacity. (SLD)

Myological variability in a decoupled skeletal system: batoid cranial anatomy.

Science.gov (United States)

Kolmann, Matthew A; Huber, Daniel R; Dean, Mason N; Grubbs, R Dean

2014-08-01

Chondrichthyans (sharks, batoids, and chimaeras) have simple feeding mechanisms owing to their relatively few cranial skeletal elements. However, the indirect association of the jaws to the cranium (euhyostylic jaw suspension) has resulted in myriad cranial muscle rearrangements of both the hyoid and mandibular elements. We examined the cranial musculature of an abbreviated phylogenetic representation of batoid fishes, including skates, guitarfishes and with a particular focus on stingrays. We identified homologous muscle groups across these taxa and describe changes in gross morphology across developmental and functional muscle groups, with the goal of exploring how decoupling of the jaws from the skull has effected muscular arrangement. In particular, we focus on the cranial anatomy of durophagous and nondurophagous batoids, as the former display marked differences in morphology compared to the latter. Durophagous stingrays are characterized by hypertrophied jaw adductors, reliance on pennate versus fusiform muscle fiber architecture, tendinous rather than aponeurotic muscle insertions, and an overall reduction in mandibular kinesis. Nondurophagous stingrays have muscles that rely on aponeurotic insertions onto the skeletal structure, and display musculoskeletal specialization for jaw protrusion and independent lower jaw kinesis, relative to durophagous stingrays. We find that among extant chondrichthyans, considerable variation exists in the hyoid and mandibular muscles, slightly less so in hypaxial muscles, whereas branchial muscles are overwhelmingly conserved. As chondrichthyans occupy a position sister to all other living gnathostomes, our understanding of the structure and function of early vertebrate feeding systems rests heavily on understanding chondrichthyan cranial anatomy. Our findings highlight the incredible variation in muscular complexity across chondrichthyans in general and batoids in particular. © 2014 Wiley Periodicals, Inc.

Development and Functional Organization of the Cranial Nerves in Lampreys.

Science.gov (United States)

Pombal, Manuel A; Megías, Manuel

2018-04-16

Lampreys, together with hagfishes, are the only extant representatives of the oldest branch of vertebrates, the agnathans, which are the sister group of gnathostomes; therefore, studies on these animals are of great evolutionary significance. Lampreys exhibit a particular life cycle with remarkable changes in their behavior, concomitant, in part, with important modifications in the head and its musculature, which might influence the development of the cranial nerves. In this context, some cranial nerves such as the optic nerve and the ocular motor nerves, which develop slowly during an extremely long larval period lasting more than five years, have been more thoroughly investigated; however, much less experimental information is available about others, such as the facial or the hypoglossal nerves. In addition, the possible existence of a "true" accessory nerve in these animals is still a matter of conjecture. Although growing in last decades, investigations on the physiology of the lamprey cranial nerves is scanty. This review focuses on past and recent findings that have contributed to characterize the anatomical organization of the cranial nerves in lampreys, including their components and nuclei, and their relations in the brain; in addition, comments on their development and functional role are also included. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

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

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Surchev, N

2008-09-01

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

The Use of Canine Stifle Orthotics for Cranial Cruciate Ligament Insufficiency

Directory of Open Access Journals (Sweden)

Brittany Jean Carr

2016-01-01

Full Text Available Objective: To assess weight bearing of dogs treated for unilateral cranial cruciate ligament insufficiency with a custom stifle orthotic.Background: Cranial cruciate ligament (CCL insufficiency is the most common cause of hind limb lameness in dogs. While there are numerous options for surgical management, surgery is not always an option. Recently, the use of canine stifle orthotics has also emerged as a means to non-surgically manage patients with cranial cruciate ligament insufficiency.  Evidentiary value:  This is a retrospective study of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic.Methods: Medical records (January 2005- December 2012 of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic were reviewed.  Temporospatial gait analysis was performed using a pressure sensing walkway at baseline and 90 days or greater post orthotic placement to identify weight bearing with total pressure index % (TPI%.Results: TPI% improved significantly by 5.1% in the affected limb when compared to baseline (p = 0.0020. At final gait analysis, TPI% significantly improved by 3% in the affected limb with the orthotic off when compared to the unaffected limb (p = 0.0020.Conclusion: Custom canine stifle orthotics allow for improved weight bearing in the affected limb.Application: Custom canine stifle orthotics should be considered for cases with concurrent medical conditions or financial constraints that do not allow for surgical intervention.

Multiple Cranial Neuropathies Without Limb Involvements: Guillain-Barre Syndrome Variant?

OpenAIRE

Yu, Ju Young; Jung, Han Young; Kim, Chang Hwan; Kim, Hyo Sang; Kim, Myeong Ok

2013-01-01

Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunction...

Donepezil for Irradiated Brain Tumor Survivors: A Phase III Randomized Placebo-Controlled Clinical Trial.

Science.gov (United States)

Rapp, Stephen R; Case, L Doug; Peiffer, Ann; Naughton, Michelle M; Chan, Michael D; Stieber, Volker W; Moore, Dennis F; Falchuk, Steven C; Piephoff, James V; Edenfield, William J; Giguere, Jeffrey K; Loghin, Monica E; Shaw, Edward G

2015-05-20

Neurotoxic effects of brain irradiation include cognitive impairment in 50% to 90% of patients. Prior studies have suggested that donepezil, a neurotransmitter modulator, may improve cognitive function. A total of 198 adult brain tumor survivors ≥ 6 months after partial- or whole-brain irradiation were randomly assigned to receive a single daily dose (5 mg for 6 weeks, 10 mg for 18 weeks) of donepezil or placebo. A cognitive test battery assessing memory, attention, language, visuomotor, verbal fluency, and executive functions was administered before random assignment and at 12 and 24 weeks. A cognitive composite score (primary outcome) and individual cognitive domains were evaluated. Of this mostly middle-age, married, non-Hispanic white sample, 66% had primary brain tumors, 27% had brain metastases, and 8% underwent prophylactic cranial irradiation. After 24 weeks of treatment, the composite scores did not differ significantly between groups (P = .48); however, significant differences favoring donepezil were observed for memory (recognition, P = .027; discrimination, P = .007) and motor speed and dexterity (P = .016). Significant interactions between pretreatment cognitive function and treatment were found for cognitive composite (P = .01), immediate recall (P = .05), delayed recall (P = .004), attention (P = .01), visuomotor skills (P = .02), and motor speed and dexterity (P < .001), with the benefits of donepezil greater for those who were more cognitively impaired before study treatment. Treatment with donepezil did not significantly improve the overall composite score, but it did result in modest improvements in several cognitive functions, especially among patients with greater pretreatment impairments. © 2015 by American Society of Clinical Oncology.

An animal model to study toxicity of central nervous system therapy for childhood acute lymphoblastic leukemia: Effects on growth and craniofacial proportion

International Nuclear Information System (INIS)

Schunior, A.; Zengel, A.E.; Mullenix, P.J.; Tarbell, N.J.; Howes, A.; Tassinari, M.S.

1990-01-01

Many long term survivors of childhood acute lymphoblastic leukemia have short stature, as well as craniofacial and dental abnormalities, as side effects of central nervous system prophylactic therapy. An animal model is presented to assess these adverse effects on growth. Cranial irradiation (1000 cGy) with and without prednisolone (18 mg/kg i.p.) and methotrexate (2 mg/kg i.p.) was administered to 17- and 18-day-old Sprague-Dawley male and female rats. Animals were weighed 3 times/week. Final body weight and body length were measured at 150 days of age. Femur length and craniofacial dimensions were measured directly from the bones, using calipers. For all exposed groups there was a permanent suppression of weight gain with no catch-up growth or normal adolescent growth spurt. Body length was reduced for all treated groups, as were the ratios of body weight to body length and cranial length to body length. Animals subjected to cranial irradiation exhibited microcephaly, whereas those who received a combination of radiation and chemotherapy demonstrated altered craniofacial proportions in addition to microcephaly. Changes in growth patterns and skeletal proportions exhibited sexually dimorphic characteristics. The results indicate that cranial irradiation is a major factor in the growth failure in exposed rats, but chemotherapeutic agents contribute significantly to the outcome of growth and craniofacial dimensions

[Involvement of cranial pairs as manifestation of prostatic cancer].

Science.gov (United States)

Ripa Saldias, L M; Ayuso Blanco, T; Delpon Pérez, E; Sarria Octavio de Toledo, L

1994-10-01

Two cases of prostate cancer (PC) which presented clinically with affectation of the cranial pairs due to skull base metastasis. In both cases, existence of intraparenchimatous brain metastasis was excluded. Initial improvement with hormonal therapy was followed by clinical, analytical and radiological relapse due to spread of process until death, at 11 and 36 months from diagnosis. Although PC's bone metastasis are frequent, their location at the skull base is uncommon. Even more rare are the cases which present with changes in the cranial pairs in the absence of signs and symptoms of prostatism.

Invasive cranial mycosis our experiences

Directory of Open Access Journals (Sweden)

Tapas Kumbhkar

2013-01-01

Full Text Available Fungi can cause serious cranial infections in immunocompromised and diabetic patients. Common pathogens mainly include Aspergillus and Mucor. These organisms cause tissue invasion and destruction of adjacent structures (e.g. orbit, ethmoid, sphenoid, maxillary & cavernous sinuses. Mortality and morbidity rate is high despite combined surgical, antifungal and antidiabetic treatment. We present our experience of six cases with such infection.

Imaging the cranial nerves: part II: primary and secondary neoplastic conditions and neurovascular conflicts

International Nuclear Information System (INIS)

Borges, Alexandra; Casselman, Jan

2007-01-01

There have been unprecedented improvements in cross-sectional imaging in the last decades. The emergence of volumetric CT, higher field MR scanners and higher resolution MR sequences is largely responsible for the increasing diagnostic yield of imaging in patients presenting with cranial nerve deficits. The introduction of parallel MR imaging in combination with small surface coils allows the depiction of submillimetric nerves and nerve branches, and volumetric CT and MR imaging is able to provide high quality multiplanar and curved reconstructions that can follow the often complex course of cranial nerves. Seeking the cause of a cranial nerve deficit is a common indication for imaging, and it is not uncommon that radiologists are the first specialists to see a patient with a cranial neuropathy. To increase the diagnostic yield of imaging, high-resolution studies with smaller fields of view are required. To keep imaging studies within a reasonable time frame, it is mandatory to tailor the study according to neuro-topographic testing. This review article focuses on the contribution of current imaging techniques in the depiction of primary and secondary neoplastic conditions affecting the cranial nerves as well as on neurovascular conflicts, an increasingly recognized cause of cranial neuralgias. (orig.)

Imaging the cranial nerves: part II: primary and secondary neoplastic conditions and neurovascular conflicts

Energy Technology Data Exchange (ETDEWEB)

Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil- Centro de Lisboa, Radiology Department, Lisboa Codex (Portugal); Casselman, Jan [A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals, Department of Radiology, Antwerp (Belgium)

2007-09-15

There have been unprecedented improvements in cross-sectional imaging in the last decades. The emergence of volumetric CT, higher field MR scanners and higher resolution MR sequences is largely responsible for the increasing diagnostic yield of imaging in patients presenting with cranial nerve deficits. The introduction of parallel MR imaging in combination with small surface coils allows the depiction of submillimetric nerves and nerve branches, and volumetric CT and MR imaging is able to provide high quality multiplanar and curved reconstructions that can follow the often complex course of cranial nerves. Seeking the cause of a cranial nerve deficit is a common indication for imaging, and it is not uncommon that radiologists are the first specialists to see a patient with a cranial neuropathy. To increase the diagnostic yield of imaging, high-resolution studies with smaller fields of view are required. To keep imaging studies within a reasonable time frame, it is mandatory to tailor the study according to neuro-topographic testing. This review article focuses on the contribution of current imaging techniques in the depiction of primary and secondary neoplastic conditions affecting the cranial nerves as well as on neurovascular conflicts, an increasingly recognized cause of cranial neuralgias. (orig.)

Subtotal resection for management of large jugular paragangliomas with functional lower cranial nerves.

Science.gov (United States)

Wanna, George B; Sweeney, Alex D; Carlson, Matthew L; Latuska, Richard F; Rivas, Alejandro; Bennett, Marc L; Netterville, James L; Haynes, David S

2014-12-01

To evaluate tumor control following subtotal resection of advanced jugular paragangliomas in patients with functional lower cranial nerves and to investigate the utility of salvage radiotherapy for residual progressive disease. Case series with planned chart review. Tertiary academic referral center. Patients who presented with advanced jugular paragangliomas and functional lower cranial nerves were analyzed. Primary outcome measures included extent of resection, long-term tumor control, need for additional treatment, and postoperative lower cranial nerve function. Twelve patients (mean age, 46.2 years; 7 women, 58.3%) who met inclusion criteria were evaluated between 1999 and 2013. The mean postoperative residual tumor volume was 27.7% (range, 3.5%-75.0%) of the preoperative volume. When the residual tumor volume was less than 20% of the preoperative volume, no tumor growth occurred over an average of 44.6 months of follow-up (P cranial neuropathy as a result of surgery. Subtotal resection of jugular paragangliomas with preservation of the lower cranial nerves is a viable management strategy. If more than 80% of the preoperative tumor volume is resected, the residual tumor seems less likely to grow. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Thin-plate spline analysis of the cranial base in subjects with Class III malocclusion.

Science.gov (United States)

Singh, G D; McNamara, J A; Lozanoff, S

1997-08-01

The role of the cranial base in the emergence of Class III malocclusion is not fully understood. This study determines deformations that contribute to a Class III cranial base morphology, employing thin-plate spline analysis on lateral cephalographs. A total of 73 children of European-American descent aged between 5 and 11 years of age with Class III malocclusion were compared with an equivalent group of subjects with a normal, untreated, Class I molar occlusion. The cephalographs were traced, checked and subdivided into seven age- and sex-matched groups. Thirteen points on the cranial base were identified and digitized. The datasets were scaled to an equivalent size, and statistical analysis indicated significant differences between average Class I and Class III cranial base morphologies for each group. Thin-plate spline analysis indicated that both affine (uniform) and non-affine transformations contribute toward the total spline for each average cranial base morphology at each age group analysed. For non-affine transformations, Partial warps 10, 8 and 7 had high magnitudes, indicating large-scale deformations affecting Bolton point, basion, pterygo-maxillare, Ricketts' point and articulare. In contrast, high eigenvalues associated with Partial warps 1-3, indicating localized shape changes, were found at tuberculum sellae, sella, and the frontonasomaxillary suture. It is concluded that large spatial-scale deformations affect the occipital complex of the cranial base and sphenoidal region, in combination with localized distortions at the frontonasal suture. These deformations may contribute to reduced orthocephalization or deficient flattening of the cranial base antero-posteriorly that, in turn, leads to the formation of a Class III malocclusion.

Long-term imaging in awake mice using removable cranial windows

Science.gov (United States)

Glickfeld, Lindsey L.; Kerlin, Aaron M.; Reid, R. Clay; Bonin, Vincent; Schafer, Dorothy P.; Andermann, Mark L.

2015-01-01

Cranial window implants in head-fixed rodents are becoming a preparation of choice for stable optical access to large areas of cortex over extended periods of time. Here, we provide a highly detailed and reliable surgical protocol for a cranial window implantation procedure for chronic widefield and cellular imaging in awake, head-fixed mice, which enables subsequent window removal and replacement in the weeks and months following the initial craniotomy. This protocol has facilitated awake, chronic imaging in adolescent as well as adult mice over several months from a large number of cortical brain regions; targeted virus and tracer injections from data obtained using prior awake functional mapping; and functionally-targeted two-photon imaging across all cortical layers in awake mice using a microprism attachment to the cranial window. Collectively, these procedures extend the reach of chronic imaging of cortical function and dysfunction in behaving animals. PMID:25275789

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

Institute of Scientific and Technical Information of China (English)

SAI Ke; CHEN Zhong-ping

2007-01-01

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

Moderate climate signature in cranial anatomy of late holocene human populations from Southern South America.

Science.gov (United States)

Paula Menéndez, Lumila

2018-02-01

The aim of this study is to analyze the association between cranial variation and climate in order to discuss their role during the diversification of southern South American populations. Therefore, the specific objectives are: (1) to explore the spatial pattern of cranial variation with regard to the climatic diversity of the region, and (2) to evaluate the differential impact that the climatic factors may have had on the shape and size of the diverse cranial structures studied. The variation in shape and size of 361 crania was studied, registering 62 3D landmarks that capture shape and size variation in the face, cranial vault, and base. Mean, minimum, and maximum annual temperature, as well as mean annual precipitation, but also diet and altitude, were matched for each population sample. A PCA, as well as spatial statistical techniques, including kriging, regression, and multimodel inference were employed. The facial skeleton size presents a latitudinal pattern which is partially associated with temperature diversity. Both diet and altitude are the variables that mainly explain the skull shape variation, although mean annual temperature also plays a role. The association between climate factors and cranial variation is low to moderate, mean annual temperature explains almost 40% of the entire skull, facial skeleton and cranial vault shape variation, while annual precipitation and minimum annual temperature only contribute to the morphological variation when considered together with maximum annual temperature. The cranial base is the structure less associated with climate diversity. These results suggest that climate factors may have had a partial impact on the facial and vault shape, and therefore contributed moderately to the diversification of southern South American populations, while diet and altitude might have had a stronger impact. Therefore, cranial variation at the southern cone has been shaped both by random and nonrandom factors. Particularly, the

White and Gray Matter Abnormalities After Cranial Radiation in Children and Mice

Energy Technology Data Exchange (ETDEWEB)

Nieman, Brian J., E-mail: brian.nieman@utoronto.ca [Department of Physiology & Experimental Medicine, Hospital for Sick Children, Toronto, Ontario (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario (Canada); Ontario Institute for Cancer Research, Toronto, Ontario (Canada); Guzman, A. Elizabeth de [Department of Physiology & Experimental Medicine, Hospital for Sick Children, Toronto, Ontario (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario (Canada); Gazdzinski, Lisa M. [Department of Physiology & Experimental Medicine, Hospital for Sick Children, Toronto, Ontario (Canada); Lerch, Jason P. [Department of Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Ontario (Canada); Department of Medical Biophysics, University of Toronto, Toronto, Ontario (Canada); Chakravarty, M. Mallar [Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec (Canada); Departments of Psychiatry and Biomedical Engineering, McGill University, Montreal, Quebec (Canada); Pipitone, Jon [Kimel Family Translational Imaging Genetics Research Laboratory, Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario (Canada); Strother, Douglas [Alberta Children' s Hospital, Calgary, Alberta (Canada); Departments of Oncology and Pediatrics, University of Calgary, Calgary, Alberta (Canada); Fryer, Chris [Division of Oncology/Hematology/BMT British Columbia Children' s Hospital and British Columbia Women' s Hospital and Health Centre, Vancouver, British Columbia (Canada); Department of Pediatrics, University of British Columbia, Vancouver, British Columbia (Canada); Bouffet, Eric [Department of Physiology & Experimental Medicine, Hospital for Sick Children, Toronto, Ontario (Canada); Department of Paediatrics, University of Toronto, Toronto, Ontario (Canada); and others

2015-11-15

Purpose: Pediatric patients treated with cranial radiation are at high risk of developing lasting cognitive impairments. We sought to identify anatomical changes in both gray matter (GM) and white matter (WM) in radiation-treated patients and in mice, in which the effect of radiation can be isolated from other factors, the time course of anatomical change can be established, and the effect of treatment age can be more fully characterized. Anatomical results were compared between species. Methods and Materials: Patients were imaged with T{sub 1}-weighted magnetic resonance imaging (MRI) after radiation treatment. Nineteen radiation-treated patients were divided into groups of 7 years of age and younger (7−) and 8 years and older (8+) and were compared to 41 controls. C57BL6 mice were treated with radiation (n=52) or sham treated (n=52) between postnatal days 16 and 36 and then assessed with in vivo and/or ex vivo MRI. In both cases, measurements of WM and GM volume, cortical thickness, area and volume, and hippocampal volume were compared between groups. Results: WM volume was significantly decreased following treatment in 7− and 8+ treatment groups. GM volume was unchanged overall, but cortical thickness was slightly increased in the 7− group. Results in mice mostly mirrored these changes and provided a time course of change, showing early volume loss and normal growth. Hippocampal volume showed a decreasing trend with age in patients, an effect not observed in the mouse hippocampus but present in the olfactory bulb. Conclusions: Changes in mice treated with cranial radiation are similar to those in humans, including significant WM and GM alterations. Because mice did not receive any other treatment, the similarity across species supports the expectation that radiation is causative and suggests mice provide a representative model for studying impaired brain development after cranial radiation and testing novel treatments.

White and Gray Matter Abnormalities After Cranial Radiation in Children and Mice

International Nuclear Information System (INIS)

Nieman, Brian J.; Guzman, A. Elizabeth de; Gazdzinski, Lisa M.; Lerch, Jason P.; Chakravarty, M. Mallar; Pipitone, Jon; Strother, Douglas; Fryer, Chris; Bouffet, Eric

2015-01-01

Purpose: Pediatric patients treated with cranial radiation are at high risk of developing lasting cognitive impairments. We sought to identify anatomical changes in both gray matter (GM) and white matter (WM) in radiation-treated patients and in mice, in which the effect of radiation can be isolated from other factors, the time course of anatomical change can be established, and the effect of treatment age can be more fully characterized. Anatomical results were compared between species. Methods and Materials: Patients were imaged with T_1-weighted magnetic resonance imaging (MRI) after radiation treatment. Nineteen radiation-treated patients were divided into groups of 7 years of age and younger (7−) and 8 years and older (8+) and were compared to 41 controls. C57BL6 mice were treated with radiation (n=52) or sham treated (n=52) between postnatal days 16 and 36 and then assessed with in vivo and/or ex vivo MRI. In both cases, measurements of WM and GM volume, cortical thickness, area and volume, and hippocampal volume were compared between groups. Results: WM volume was significantly decreased following treatment in 7− and 8+ treatment groups. GM volume was unchanged overall, but cortical thickness was slightly increased in the 7− group. Results in mice mostly mirrored these changes and provided a time course of change, showing early volume loss and normal growth. Hippocampal volume showed a decreasing trend with age in patients, an effect not observed in the mouse hippocampus but present in the olfactory bulb. Conclusions: Changes in mice treated with cranial radiation are similar to those in humans, including significant WM and GM alterations. Because mice did not receive any other treatment, the similarity across species supports the expectation that radiation is causative and suggests mice provide a representative model for studying impaired brain development after cranial radiation and testing novel treatments.

Cranial shape transformation in the evolution of the giant panda ( Ailuropoda melanoleuca)

Science.gov (United States)

Figueirido, Borja; Palmqvist, Paul; Pérez-Claros, Juan A.; Dong, Wei

2011-02-01

In this study, landmark-based methods of geometric morphometrics are used for investigating the main aspects of cranial shape transformation in the evolution of the giant panda, Ailuropoda melanoleuca. Specifically, we explore if the highly derived cranial adaptations for bamboo feeding of the living panda were developed early in the panda's lineage. Results obtained show that the overall cranial morphologies of the oldest known panda, the "pygmy" Ailuropoda microta, and the late Pleistocene Ailuropoda baconi are both very similar to that of their closest living relative, A. melanoleuca, which agrees with a previous proposal based on qualitative criteria. However, we also describe several differences between the crania of A. microta, A. baconi, and A. melanoleuca, including the development of the postorbital process, the orientation of the occipital region, and the expansion of the braincase. As a result, the cranial morphology of A. microta shows a less specialized morphology toward a fibrous and durophagous diet compared to the giant panda. These results are confirmed by a comparative analysis of the dimensions of the upper teeth in bears, which has revealed differences in relative tooth size between A. microta and A. melanoleuca, most probably as a result of mosaic evolution. Therefore, we conclude that cranial shape did not remain essentially uniform in the Ailuropoda lineage, as previously thought, but underwent a number of changes during more than 2 Myr.

Ophthalmoplegic and lower cranial nerve variants merge into each other and into classical Guillain-Barre syndrome

NARCIS (Netherlands)

ter Bruggen, JP; van der Meche, FGA; de Jager, AEJ; Polman, CH

We delineated the place of cranial nerve variants within the concept of clinically defined Guillain-Barre syndrome (GBS), In the ophthalmoplegic variant (n = 7) the oculomotor nerves were early involved, In a lower cranial nerve variant (n = 9) the cranial nerves IX, X, and XI were early involved.

Neurophysiological Identification of Cranial Nerves During Endoscopic Endonasal Surgery of Skull Base Tumors: Pilot Study Technical Report.

Science.gov (United States)

Shkarubo, Alexey Nikolaevich; Chernov, Ilia Valerievich; Ogurtsova, Anna Anatolievna; Moshchev, Dmitry Aleksandrovich; Lubnin, Andrew Jurievich; Andreev, Dmitry Nicolaevich; Koval, Konstantin Vladimirovich

2017-02-01

Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, only a small number of published papers describe the technique of trigger electromyography (t-EMG) in endoscopic endonasal removal of such tumors. To assess the effectiveness of t-EMG in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. Nine patients were operated on using the endoscopic endonasal approach within a 1-year period. The tumors included large skull base chordomas and trigeminal neurinomas localized in the cavernous sinus. During the surgical process, cranial nerve identification was carried out using monopolar and bipolar t-EMG methods. Assessment of cranial nerve functional activity was conducted both before and after tumor removal. We mapped 17 nerves in 9 patients. Third, fifth, and sixth cranial nerves were identified intraoperatively. There were no cases of postoperative functional impairment of the mapped cranial nerves. In one case we were unable to get an intraoperative response from the fourth cranial nerve and observed its postoperative transient plegia (the function was normal before surgery). t-EMG allows surgeons to control the safety of cranial nerves both during and after skull base tumor removal. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of Unshaven Hair with Absorbable Sutures and Early Postoperative Shampoo on Cranial Surgery Site Infection.

Science.gov (United States)

Oh, Won-Oak; Yeom, Insun; Kim, Dong-Seok; Park, Eun-Kyung; Shim, Kyu-Won

2018-01-01

Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study. A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison. Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site. Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation. © 2017 S. Karger AG, Basel.

Phylogeny, diet, and cranial integration in australodelphian marsupials.

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Anjali Goswami

2007-10-01

Full Text Available Studies of morphological integration provide valuable information on the correlated evolution of traits and its relationship to long-term patterns of morphological evolution. Thus far, studies of morphological integration in mammals have focused on placentals and have demonstrated that similarity in integration is broadly correlated with phylogenetic distance and dietary similarity. Detailed studies have also demonstrated a significant correlation between developmental relationships among structures and adult morphological integration. However, these studies have not yet been applied to marsupial taxa, which differ greatly from placentals in reproductive strategy and cranial development and could provide the diversity necessary to assess the relationships among phylogeny, ecology, development, and cranial integration. This study presents analyses of morphological integration in 20 species of australodelphian marsupials, and shows that phylogeny is significantly correlated with similarity of morphological integration in most clades. Size-related correlations have a significant affect on results, particularly in Peramelia, which shows a striking decrease in similarity of integration among species when size is removed. Diet is not significantly correlated with similarity of integration in any marsupial clade. These results show that marsupials differ markedly from placental mammals in the relationships of cranial integration, phylogeny, and diet, which may be related to the accelerated development of the masticatory apparatus in marsupials.

Prophylactic cranial irradiation in patients with small cell lung cancer

DEFF Research Database (Denmark)

Ramlov, Anne; Tietze, Anna; Khalil, Azza Ahmed

2012-01-01

BACKGROUND: Prophylactic cerebral irradiation (PCI) is a standard treatment for all small cell lung cancer (SCLC) patients with response to chemotherapy. The aims of this study were: to evaluate patients undergoing PCI with regard to cerebral recurrence rate, site of recurrence, and overall...... retrospectively with regard to disease stage, treatment, date of PCI, steroid dose during PCI, toxicity, time to recurrence, site of recurrence and time of death. The median follow up time was 16.6months (range 3-54months). RESULTS: Of the 118 patients undergoing PCI, 74 had limited disease (LD-SCLC) and 44 had...... extensive disease (ED-SCLC). The median age was 65years (range 46-80years). The median overall survival of all patients from the time of diagnosis was 16.0months (CI 95% 13.0-19.0), in LD-SCLC it was 24.0months (CI 95% 19.6-28.3), and in ED-SCLC it was 12.0months (CI 95% 9.6-14.4). Twenty-one patients (17...

Cranial neuronavigation with functional monitoring

International Nuclear Information System (INIS)

Braun, V.; Oberle, J.; Kretschmer, T.; Richter, H.P.

1998-01-01

Minimise the risks is an essential objective of neurosurgery. The technological progress achieved in the last few years, especially regarding imaging methods and image processing capabilities, offers the tools to manage the risks. The authors explain initial experience obtained with microscope-based cranial neuronavigation systems combined with direct cortical monitoring methods and give an outlook on expected devlopments in the future. (orig./CB) [de

Triptans and CGRP blockade - impact on the cranial vasculature

DEFF Research Database (Denmark)

Benemei, Silvia; Cortese, Francesca; Labastida-Ramírez, Alejandro

2017-01-01

and vascular tone. Thirty years after discovery of agonists for serotonin 5-HT1B and 5-HT1D receptors (triptans) and less than fifteen after the proof of concept of the gepant class of CGRP receptor antagonists, we are still a long way from understanding their precise site and mode of action in migraine....... The effect on cranial vasculature is relevant, because all specific anti-migraine drugs and migraine pharmacological triggers may act in perivascular space. This review reports the effects of triptans and CGRP blocking molecules on cranial vasculature in humans, focusing on their specific relevance...

Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality

Institute of Scientific and Technical Information of China (English)

YI Zhi-qiang; LI Liang; MO Da-peng; ZHANG Jia-yong; ZHANG Yang; BAO Sheng-de

2008-01-01

@@ The extremely complex anatomic relationships among bone,tumor,blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery.Therefore.a good understanding of the patient specific anatomy and a preoperative planning are helpful and crocial for the neurosurgeons.Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore,Volume Interaction Pte Ltd,software:RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors.This system uses patient-specific,coregistered,fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment.This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.

A revised cranial description of Massospondylus carinatus Owen (Dinosauria: Sauropodomorpha based on computed tomographic scans and a review of cranial characters for basal Sauropodomorpha

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Kimberley E.J. Chapelle

2018-01-01

Full Text Available Massospondylus carinatus is a basal sauropodomorph dinosaur from the early Jurassic Elliot Formation of South Africa. It is one of the best-represented fossil dinosaur taxa, known from hundreds of specimens including at least 13 complete or nearly complete skulls. Surprisingly, the internal cranial anatomy of M. carinatus has never been described using computed tomography (CT methods. Using CT scans and 3D digital representations, we digitally reconstruct the bones of the facial skeleton, braincase, and palate of a complete, undistorted cranium of M. carinatus (BP/1/5241. We describe the anatomical features of the cranial bones, and compare them to other closely related sauropodomorph taxa such as Plateosaurus erlenbergiensis, Lufengosaurus huenei, Sarahsaurus aurifontanalis and Efraasia minor. We identify a suite of character states of the skull and braincase for M. carinatus that sets it apart from other taxa, but these remain tentative due to the lack of comparative sauropodomorph braincase descriptions in the literature. Furthermore, we hypothesize 27 new cranial characters useful for determining relationships in non-sauropodan Sauropodomorpha, delete five pre-existing characters and revise the scores of several existing cranial characters to make more explicit homology statements. All the characters that we hypothesized or revised are illustrated. Using parsimony as an optimality criterion, we then test the relationships of M. carinatus (using BP/1/5241 as a specimen-level exemplar in our revised phylogenetic data matrix.

Imaging characteristics of primary cranial Ewing sarcoma

International Nuclear Information System (INIS)

Li, Wai-Yung; Saunders, Dawn E.; Brock, Penelope

2005-01-01

Ewing sarcoma accounts for 10-15% of all childhood malignant bone tumours and is second in prevalence to osteosarcoma. The skull bones are an unusual site of origin of primary Ewing sarcoma in children. Previous reports concentrate on the neurosurgical aspects and relatively good outcome compared to other bone tumours of the calvarium. Reported cases mainly describe the imaging characteristics on CT. To describe the MRI and CT features of primary cranial Ewing sarcoma. The neuroimaging of three cases of primary cranial Ewing sarcoma are reviewed. Our three cases show an extra-axial mass that is high attenuation on CT and low signal on T2-weighted MRI. Haemorrhagic components, dural extension and contrast enhancement are also characteristic features. CT attenuation and magnetic resonance signal characteristics reflect sheets of densely packed cells seen in Ewing sarcoma. (orig.)

HIT'91 (prospective, co-operative study for the treatment of malignant brain tumors in childhood): accuracy and acute toxicity of the irradiation of the craniospinal axis

International Nuclear Information System (INIS)

Kortmann, R.D.; Timmermann, B.; Bamberg, M.; Kuehl, J.; Willich, N.; Flentje, M.; Meisner, C.

1999-01-01

Background: It was the aim of the quality control program of the randomized trial HIT '91 (intensive chemotherapy before irradiation versus maintenance chemotherapy after irradiation) to assess prospectively the quality of neuroaxis irradiation with respect to the protocol guidelines and to evaluate acute toxicity with respect to treatment arm. Patients, Materials and Methods: Data of 134 patients undergoing irradiation of the craniospinal axis were available. Positioning aids, shielding techniques, treatment machines, choice of energy, total dose and fractionation were evaluated. A total of 651 simulation and verification films were analyzed to assess the coverage of the clinical target volume (whole brain, posterior fossa, sacral nerve roots) and deviations of field alignment between simulation and verification of first treatment. Field matching between whole brain and adjacent cranial spinal fields was analyzed with respect to site and width of junction. Acute maximal side effects were evaluated according to a modified WHO score for neurotoxicity, infections, skin, mucosa and myelotoxicity. Results: In 91.3% of patients contemporary positioning aids and individualized shielding techniques were used to assure a reproducible treatment. In 98 patients (73.1%) linear accelerators and in 36 patients (26.8%) 60 Cobalt machines were used. Single and total dose were administered according to the protocol guidelines in more than 90% of patients. In 20.2% of patients the cribriform plate, in 1.4% the middle cranial fossa and in 21.1% the posterior fossa and in 4.5% the 2nd sacral segment were incompletely encompassed by the treatment portals. Ninety-five percent of deviations of field alignment were less than 13.0 mm (whole brain) and 12 mm (cranial spinal field) with a random error between 4.9 and 7.6 mm (whole brain) and 6.9 mm and 9.9 mm (spinal canal), respectively. In 77.5% of patients the junctions between whole brain and cranial spinal fields were placed without a

Hypoglossal motoneurons in newborn mice receive respiratory drive from both sides of the medulla

DEFF Research Database (Denmark)

Tarras-Wahlberg, S; Rekling, J C

2009-01-01

Respiratory motor output in bilateral cranial nerves is synchronized, but the underlying synchronizing mechanisms are not clear. We used an in vitro slice preparation from newborn mice to investigate the effect of systematic transsections on respiratory activity in bilateral XII nerves. Complete...... in bilateral XII nerves. Hypoglossal motoneurons receive respiratory drive from both sides of the medulla, possibly mediated by contralaterally projecting dendrites....

Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis

International Nuclear Information System (INIS)

Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya

2009-01-01

Computed tomography (CT) is the 'gold standard' for evaluation of the cranial sutures. While prenatal cranial suture evaluation with ultrasound (US) is common, US has not been established as a postnatal screening tool. We evaluated the effectiveness of US for diagnosis of craniosynostosis (CS). During 2006, 24 infants with questionable CS were assessed with US of the sagittal, metopic, and bilateral coronal and lambdoid sutures. US findings and clinical records were reviewed retrospectively. Sixteen boys and eight girls (ages 1-11 months, mean 4.3) underwent US. The correct diagnosis was provided in 23 (95%), with equivocal findings in one patient. Cranial sutures appeared normal in 15 infants, who had normal clinical presentation at mean 5.8 months follow-up; CT confirmation was obtained in two. In eight children, US identified premature closure of one or more cranial sutures. Three-dimensional CT was performed as a preparation for surgery in four, with classical CS findings. In one case with inconclusive US findings, CT showed narrow but open sutures. Sonographic examination of cranial sutures may serve as a first imaging tool for evaluation of craniosynostosis. CT may be reserved for children with abnormal or equivocal ultrasound and for preoperative planning. (orig.)

Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis

Energy Technology Data Exchange (ETDEWEB)

Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya [Hadassah Hebrew University Medical Center, Department of Medical Imaging, Mount, Scopus, P.O. Box 24035, Jerusalem (Israel)

2009-03-15

Computed tomography (CT) is the 'gold standard' for evaluation of the cranial sutures. While prenatal cranial suture evaluation with ultrasound (US) is common, US has not been established as a postnatal screening tool. We evaluated the effectiveness of US for diagnosis of craniosynostosis (CS). During 2006, 24 infants with questionable CS were assessed with US of the sagittal, metopic, and bilateral coronal and lambdoid sutures. US findings and clinical records were reviewed retrospectively. Sixteen boys and eight girls (ages 1-11 months, mean 4.3) underwent US. The correct diagnosis was provided in 23 (95%), with equivocal findings in one patient. Cranial sutures appeared normal in 15 infants, who had normal clinical presentation at mean 5.8 months follow-up; CT confirmation was obtained in two. In eight children, US identified premature closure of one or more cranial sutures. Three-dimensional CT was performed as a preparation for surgery in four, with classical CS findings. In one case with inconclusive US findings, CT showed narrow but open sutures. Sonographic examination of cranial sutures may serve as a first imaging tool for evaluation of craniosynostosis. CT may be reserved for children with abnormal or equivocal ultrasound and for preoperative planning. (orig.)

Normal cranial bone marrow MR imaging pattern with age-related ADC value distribution

International Nuclear Information System (INIS)

Li Qi; Pan Shinong; Yin Yuming; Li Wei; Chen Zhian; Liu Yunhui; Wu Zhenhua; Guo Qiyong

2011-01-01

Objective: To determine MRI appearances of normal age-related cranial bone marrow and the relationship between MRI patterns and apparent diffusion coefficient (ADC) values. Methods: Five hundred subjects were divided into seven groups based on ages. Cranial bone marrow MRI patterns were performed based on different thickness of the diploe and signal intensity distribution characteristics. ADC values of the frontal, parietal, occipital and temporal bones on DWI were measured and calculated. Correlations between ages and ADC values, between patterns and ADC values, as well as the distribution of ADC values were analyzed. Results: Normal cranial bone marrow was divided into four types and six subtypes, Type I, II, III and IV, which had positive correlation with age increasing (χ 2 = 266.36, P 0.05). In addition, there was significant negative correlation between the ADC values and MRI patterns in the normal parietal and occipital bones (r = -0.691 and -0.750, P < 0.01). Conclusion: The combination of MRI features and ADC values changes in different cranial bones showed significant correlation with age increasing. Familiar with the MRI appearance of the normal bone marrow conversion pattern in different age group and their ADC value will aid the diagnosis and differential of the cranial bone pathology.

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

Institute of Scientific and Technical Information of China (English)

徐启武; 车晓明; 胡杰; 杨伯捷

2004-01-01

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

Preventing lower cranial nerve injuries during fourth ventricle tumor resection by utilizing intraoperative neurophysiological monitoring.

Science.gov (United States)

Jahangiri, Faisal R; Minhas, Mazhar; Jane, John

2012-12-01

We present two cases illustrating the benefit of utilizing intraoperative neurophysiological monitoring (IONM) for prevention of injuries to the lower cranial nerves during fourth ventricle tumor resection surgeries. Multiple cranial nerve nuclei are located on the floor of the fourth ventricle with a high risk of permanent damage. Two male patients (ages 8 and 10 years) presented to the emergency department and had brain magnetic resonance imaging (MRI) scans showing brainstem/fourth ventricle tumors. During surgery, bilateral posterior tibial and median nerve somatosensory evoked potentials (SSEPs); four-limb and cranial nerves transcranial electrical motor evoked potentials (TCeMEPs); brainstem auditory evoked responses (BAERs); and spontaneous electromyography (s-EMG) were recorded. Electromyography (EMG) was monitored bilaterally from cranial nerves V VII, IX, X, XI, and XII. Total intravenous anesthesia was used. Neuromuscular blockade was used only for initial intubation. Pre-incision baselines were obtained with good morphology of waveforms. After exposure the floor of the fourth ventricle was mapped by triggered-EMG (t-EMG) using 0.4 to 1.0 mA. In both patients the tumor was entangled with cranial nerves VII to XII on the floor of the fourth ventricle. The surgeon made the decision not to resect the tumor in one case and limited the resection to 70% of the tumor in the second case on the basis of neurophysiological monitoring. This decision was made to minimize any post-operative neurological deficits due to surgical manipulation of the tumor involving the lower cranial nerves. Intraoperative spontaneous and triggered EMG was effectively utilized in preventing injuries to cranial nerves during surgical procedures. All signals remained stable during the surgical procedure. Postoperatively both patients were well with no additional cranial nerve weakness. At three months follow-up, the patients continued to have no deficits.

Total lymphoid irradiation assessed for possible enhancement of immunosuppression in hyperimmunized dogs receiving renal allografts

Energy Technology Data Exchange (ETDEWEB)

Sonoda, Kazuhiko (Yamato Seiwa Hospital, Kanagawa (Japan)); Rapaport, F.T.

1992-12-01

With performed antibodies to human leukocyte antigens (HLA) appearing in an increasing number of patients today, hyperimmunization constitutes a major problem in clinical transplantation. In adult beagle dogs hyperimmunized with skin allografts and buffy coat injection, we performed renal allograft transplantation to assess the efficacy of total lymphoid irradiation (TLI) employed as a preoperative measure in combination with cyclosporine (CyA) and methyl-prednisolone (MPL) in effecting immunosuppression. The mean survival period were 6.5 days in dogs withheld preliminary treatment, 9.0 days in the dogs receiving CyA and MPL, 26.7 days in those administered one-stage TLI, and 68 days (terminated by euthanasia) of the dogs given two-stage TLI. TLI administered two stages is considered an effective method of enhancing immunosuppression sufficiently to enable the attenuation of adverse reaction to renal allograft in hyperimmunized recipients. (author).

Total lymphoid irradiation assessed for possible enhancement of immunosuppression in hyperimmunized dogs receiving renal allografts

International Nuclear Information System (INIS)

Sonoda, Kazuhiko; Rapaport, F.T.

1992-01-01

With performed antibodies to human leukocyte antigens (HLA) appearing in an increasing number of patients today, hyperimmunization constitutes a major problem in clinical transplantation. In adult beagle dogs hyperimmunized with skin allografts and buffy coat injection, we performed renal allograft transplantation to assess the efficacy of total lymphoid irradiation (TLI) employed as a preoperative measure in combination with cyclosporine (CyA) and methyl-prednisolone (MPL) in effecting immunosuppression. The mean survival period were 6.5 days in dogs withheld preliminary treatment, 9.0 days in the dogs receiving CyA and MPL, 26.7 days in those administered one-stage TLI, and 68 days (terminated by euthanasia) of the dogs given two-stage TLI. TLI administered two stages is considered an effective method of enhancing immunosuppression sufficiently to enable the attenuation of adverse reaction to renal allograft in hyperimmunized recipients. (author)

Cranial nerve palsy in Wegener's granulomatosis--lessons from clinical cases

DEFF Research Database (Denmark)

Nowack, Rainer; Wachtler, Paul; Kunz, Jürgen

2009-01-01

The problem of diagnosing vasculitic neuropathy is discussed based on case reports of two patients with Wegener's granulomatosis. One patient developed de novo 6(th) nerve palsy as an isolated relapse manifestation and the second patient a sequence of multiple cranial nerve palsies. Brain imaging...... by the overall clinical presentations. Cranial neuropathy may be the first obvious vasculitic manifestation preceding other organ disease, and since single reliable tests for its diagnosis are lacking, a multidisciplinary approach is advocated here to detect vasculitic manifestations in other organs....

Clinical significance of neonatal parafrontal horn cysts detected by cranial sonography

International Nuclear Information System (INIS)

Woo, Jeong Joo; Jung, Myung Ja; Kim, Eun Ryung

2005-01-01

The describe the significance, incidence and characteristics of sonographic findings and long term outcomes of parafrontal horn cysts detected by screening cranial sonography done within the first week following birth. 2122 first cranial ultrasound scans performed over a five year period were retrospectively evaluated and 23 neonates with parafrontal horn cysts were found (which are different from secondary cystic lesions). 17 cases had a birth weight of 2400 gm with gestation between 34 and 41 weeks. The size, shape and location of the parafrontal horn cysts and other associated abnormalities shown on the cranial sonogram were evaluated and sequential ultrasound study, maternal records, neonatal events and neurodevelopmental evaluations were retrospectively assessed. Of the 23 subjects, 21 had isolated parafrontal horn cysts and 2 had subependymal hemorrhages. There was no record of any abnormal perinatal history. The cysts were bilateral in 20 neonates and unilateral in the others. The size of the cysts ranged from 3 to 18 mm in diameter (mean 9 mm). Sonographic features of the parafrontal horn cysts were distinctive morphology (elliptical, thin walled) and location (adjacent to the tip of the frontal horn). In 17 of the cases a follow-up cranial sonography was performed, and all parafrontal horn cysts disappeared within 3 to 6 months. Neurodevelopmental outcomes were normal in those 17 cases. Screening cranial sonography of neonates discovers isolated parafrontal horn cyst. The incidence of parafrontal horn cysts in neonates in our study was 1.1%. They are present in the first week following birth and resolve themselves without medical treatment within a few months. In addition, they show normal neurodevelopment. The parafrontal cysts are suspected to be a benign variant of normal neurodevelopment

Austin: austenitic steel irradiation E 145-02 Irradiation Report

International Nuclear Information System (INIS)

Genet, F.; Konrad, J.

1987-01-01

Safety measures for nuclear reactors require that the energy which might be liberated in a reactor core during an accident should be contained within the reactor pressure vessel, even after very long irradiation periods. Hence the need to know the mechanical properties at high deformation velocity of structure materials that have received irradiation damage due to their utilization. The stainless steels used in the structures of reactors undergo damage by both thermal and fast neutrons, causing important changes in the mechanical properties of these materials. Various austenitic steels available as structural materials were irradiated or are under irradiation in various reactors in order to study the evolution of the mechanical properties at high deformation velocity as a function of the irradiation damage rate. The experiment called AUSTIN (AUstenitic STeel IrradiatioN) 02 was performed by the JRC Petten Establishment on behalf of Ispra in support of the reactor safety programme

Development and Tissue Origins of the Mammalian Cranial Base

Science.gov (United States)

Iseki, S.; Bamforth, S. D.; Olsen, B. R.; Morriss-Kay, G. M.

2008-01-01

The vertebrate cranial base is a complex structure composed of bone, cartilage and other connective tissues underlying the brain; it is intimately connected with development of the face and cranial vault. Despite its central importance in craniofacial development, morphogenesis and tissue origins of the cranial base have not been studied in detail in the mouse, an important model organism. We describe here the location and time of appearance of the cartilages of the chondrocranium. We also examine the tissue origins of the mouse cranial base using a neural crest cell lineage cell marker, Wnt1-Cre/R26R, and a mesoderm lineage cell marker, Mesp1-Cre/R26R. The chondrocranium develops between E11 and E16 in the mouse, beginning with development of the caudal (occipital) chondrocranium, followed by chondrogenesis rostrally to form the nasal capsule, and finally fusion of these two parts via the midline central stem and the lateral struts of the vault cartilages. X-Gal staining of transgenic mice from E8.0 to 10 days post-natal showed that neural crest cells contribute to all of the cartilages that form the ethmoid, presphenoid, and basisphenoid bones with the exception of the hypochiasmatic cartilages. The basioccipital bone and non-squamous parts of the temporal bones are mesoderm derived. Therefore the prechordal head is mostly composed of neural crest-derived tissues, as predicted by the New Head Hypothesis. However, the anterior location of the mesoderm-derived hypochiasmatic cartilages, which are closely linked with the extra-ocular muscles, suggests that some tissues associated with the visual apparatus may have evolved independently of the rest of the “New Head”. PMID:18680740

Bilateral involvement of a single cranial nerve: analysis of 578 cases.

Science.gov (United States)

Keane, James R

2005-09-27

The author reviewed 34 years of personal experience with inpatients in a large municipal hospital to analyze the seats and causes of involvement of single pairs of cranial nerves. Among 578 cases, the sixth (n = 234) and second (211) nerves predominated, followed by the fourth (48), seventh (30), third (27), and eighth (18) cranial nerves. Trauma (99), infection (94), tumor (92), increased intracranial pressure (85), vascular disease (74), and demyelination (66) were common causes.

Tay-Sachs disease with conspicuous cranial computerized tomographic appearances

International Nuclear Information System (INIS)

Watanabe, Kishichiro; Mukawa, Akio; Muto, Kazuhiko; Nishikawa, Jiro; Takahashi, Shigeko.

1985-01-01

An autopsy case of a 3-year-old female infant with Tay-Sachs disease was presented. A cherry red spot in the fundus and a deficiency of N-acetyl-β-hexosaminidase A in the white blood cells were revealed soon after admission at the age of one year. Her parents and sister were found to be healthy carriers. The patient showed a typical clinical course with marked cranial swelling. In addition to the marked ballooning of neurons on light microscope, membranous cytoplasmic body (MCB) on electron microscope and abnormal accumulation of GM 2 ganglioside in the cerebral cortex by thin layer chromatography were confirmed in the autopsy specimens. In the late stage of her clinical course, the cranial computerized tomography (CT) demonstrated symmetric and deep-wavy hyperdense cerebral cortical zones, diffuse hypodensity and diminished volume of cerebral white matter, mild to moderate ventricular dilatation, and a small cerebellum and brainstem. These conspicuous appearances of the cranial CT seem to be characteristic of Tay-Sachs disease in the late stage, and they are derived from abnormal accumulation of GM 2 ganglioside in the cerebral cortex, and diffuse intense demyelination (dysmyelinating demyelination) of the cerebral white matter. (author)

Ophthalmople gic cranial neuropathy: clinical case

Directory of Open Access Journals (Sweden)

N. S. Dozorova

2018-01-01

Full Text Available Ophthalmoplegic cranial neuropathy (OCN is a disease with unknown etiology, which manifests itself by episodes of intense headache, accompanied by completely or partially reversible dysfunction of the oculomotor nerve: ptosis, mydriasis and ophthalmoplegia. It is assumed that the pathology is demyelinating in nature, therefore in the International classification of headaches OCN excluded from rubric migraine and related to the painful cranial neuropathies. The question of the prevention and treatment of this disease is still controversial, the issue of the appointment of corticosteroids, calcium channel blockers and β-blockers, methods of surgical correction of strabismus and botulin therapy.The article describes OCN in an 11-year-old boy. In the clinical picture headache attacks were observed. These attacks were with signs of selective lesions of the oculomotor nerve on one side. These functional changes are recurrent, and fully regress between attacks. Laboratory and instrumental examinations revealed no pathology that could cause this symptom, including myasthenia. The described case demonstrates the classical picture of OCN with a favorable course and the partial damage of the oculomotor nerve on one side.

Cranial computed tomography in patients with Bourneville-Pringle phacomatosis

International Nuclear Information System (INIS)

Takada, Minoru; Kurata, Yukio; Hirone, Takae

1987-01-01

Cranial computed tomography (CT) was undertaken in 17 patients (0 - 38 years) with Bourneville-Pringle phacomatosis, some of whom presented with epilepsy episodes and mental retardation. Intracranial calcification was seen on CT in 10 patients (59 %), including a 2-month-old baby. This suggests the potential of CT in the diagnosis of tuberous sclerosis for infants, which has been considered difficult by conventional roentgenography. The most frequent site of calcilfication was ventricular wall. High incidences of eye lesions (67 %), psycho-neurologic symptoms (80 %), and abnormal EEG (50 %) were found in patients with cranial calficication on CT, in contrast to patients without it (0 %, 0 %, and 40 %, respectively). (Namekawa, K.)

Increased mortality by septicemia, interstitial pneumonitis and pulmonary fibrosis among bone marrow transplant recipients receiving an increased mean dose rate of total irradiation

International Nuclear Information System (INIS)

Ringden, O.; Baaryd, I.; Johansson, B.

1983-01-01

Seven bone marrow transplant recipients with acute lymphoblastic leukemia receiving a mean dose rate of 0.07 Gy/min of total body irradiation towards the pelvic midpoint and the lungs had an increased (p<0.01) overall death rate of 86 per cent compared with 33 per cent among 27 patients with acute non-lymphoblastic leukemia or acute lymphoblastic leukemia treated with a mean dose rate of 0.04 Gy/min. Among the patients receiving the higher dose rate there was an increased mortality in causes related to radiation toxicity like early septicemia, interstitial pneumonitis and pulmonary fibrosis, compared with all patients receiving the lower dose rate (p<0.01) and also with 10 patients from this group with acute lymphoblastic leukemia (p<0.02). (Auth.)

Cranial magnetic resonance imaging

International Nuclear Information System (INIS)

Elster, A.D.

1988-01-01

Cranial Magnetic Resonance Imaging is comprehensive, well structured, and well written. The material is current and well referenced. The illustrations are good and complement the text well. The overall quality of publication is above average. The greatest attribute of the book is its readability. The author demonstrates ample skill in making complex subjects, such as MR physics and imaging of cerebral hemorrhage, easy to understand. The book closes with a detailed atlas on the anatomic appearance of the brain on MR images in the axial, coronal, and sagittal planes

Problems following hippocampal irradiation in interventional radiologists - doses and potential effect:a Monte Carlo simulation

International Nuclear Information System (INIS)

Cumak, V.; Morgun, A.; Bakhanova, O.; Loganovs'kij, K.; Loganovs'ka, T.; Marazziti, D.

2015-01-01

This study aimed at investigating radiation exposure of hippocampus in interventional medical professionals irradiated in the operating room, and to compare doses in the hippocampus with the effective dose (protection quantity), as well as with the doses measured by individual dosimeter, in order to estimate probability of reaching levels of radiation induced cognitive and other neuropsychiatric alterations during their working career, through a Monte Carlo simulation. The results showed that cranial irradiation was very heterogeneous and depended on the projection: doses of left and right hippocampi may be different up to a factor of 2.5; under certain conditions, the dose of the left hippocampus may be twice the effective dose, estimated by conventional double dosimetry algorithm. The professional span doses of the irradiated hippocampus may overcome the threshold able to provoke possible cognitive and emotional-behavioral impairment. Therefore, in-depth studies of the effects of brain irradiation in occupationally exposed interventional medical personnel appear urgently needed and crucial

Frequency of brain metastasis in adenocarcinoma and large cell carcinoma of the lung: correlation with survival

International Nuclear Information System (INIS)

Komaki, R.; Cox, J.D.; Stark, R.

1983-01-01

From January 1970 through December 1981, 469 patients with histologically or cytologically proven adenocarcinoma (AC) (349) and large cell carcinoma (LC) (120) of the lung were seen at the Department of Radiation Oncology, Medical College of Wisconsin Affiliated Hospitals. One quarter (126/469) of these patients had brain metastasis: 48 patients presented with brain metastasis and 78 patients subsequently developed brain metastasis. Brain was the dominant site of metastasis in 82 patients who received only cranial + thoracic irradiation; 37 patients (17 simultaneous, 20 metachronous) also required irradiation of other sites of metastasis. All 17 patients with LC, and 47/61 (77%) with AC who developed metachronous brain metastasis did so within one year. The cumulative probability of brain metastasis increased with survival to the levels predicted by autopsy studies. Therapeutic brain irradiation may result in long-term survival in patients with single organ brain metastasis. Since patients with AC and LC so frequently develop brain metastasis and the brain may be the only site of metastasis, prophylactic cranial irradiation may significantly reduce morbidity and mortality from these diseases

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

International Nuclear Information System (INIS)

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

1993-01-01

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

Radiation-induced cranial nerve palsy: hypoglossal nerve and vocal cord palsies

International Nuclear Information System (INIS)

Takimoto, Toru; Saito, Yasuo; Suzuki, Masayuki; Nishimura, Toshirou

1991-01-01

Cranial nerve palsies are an unexpected complication of radiotherapy for head and neck tumours. We present a case of this radiation-induced cranial palsy. An 18-year-old female with nasopharyngeal carcinoma developed a right hypoglossal nerve palsy 42 months after cancericidal doses of radiotherapy. In addition, she developed a bilateral vocal cord palsy 62 months after the therapy. Follow-up over four years has demonstrated no evidence of tumour recurrence and no sign of neurological improvement. (author)

Clinical significance of neonatal parafrontal horn cysts detected by cranial sonography

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Woo, Jeong Joo [Eulji University of Medicine, Daejeon (Korea, Republic of); Jung, Myung Ja [Sanggye Paik Hospital, Inje University of Medicine, Seoul (Korea, Republic of); Kim, Eun Ryung [Sungae General Hospital, Seoul (Korea, Republic of)

2005-07-15

The describe the significance, incidence and characteristics of sonographic findings and long term outcomes of parafrontal horn cysts detected by screening cranial sonography done within the first week following birth. 2122 first cranial ultrasound scans performed over a five year period were retrospectively evaluated and 23 neonates with parafrontal horn cysts were found (which are different from secondary cystic lesions). 17 cases had a birth weight of < 2400 gm with gestation between 30 and 35 weeks, 6 cases had a birth weight of > 2400 gm with gestation between 34 and 41 weeks. The size, shape and location of the parafrontal horn cysts and other associated abnormalities shown on the cranial sonogram were evaluated and sequential ultrasound study, maternal records, neonatal events and neurodevelopmental evaluations were retrospectively assessed. Of the 23 subjects, 21 had isolated parafrontal horn cysts and 2 had subependymal hemorrhages. There was no record of any abnormal perinatal history. The cysts were bilateral in 20 neonates and unilateral in the others. The size of the cysts ranged from 3 to 18 mm in diameter (mean 9 mm). Sonographic features of the parafrontal horn cysts were distinctive morphology (elliptical, thin walled) and location (adjacent to the tip of the frontal horn). In 17 of the cases a follow-up cranial sonography was performed, and all parafrontal horn cysts disappeared within 3 to 6 months. Neurodevelopmental outcomes were normal in those 17 cases. Screening cranial sonography of neonates discovers isolated parafrontal horn cyst. The incidence of parafrontal horn cysts in neonates in our study was 1.1%. They are present in the first week following birth and resolve themselves without medical treatment within a few months. In addition, they show normal neurodevelopment. The parafrontal cysts are suspected to be a benign variant of normal neurodevelopment.

Reconstruction of the cranial base in surgery for jugular foramen tumors.

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Ramina, Ricardo; Maniglia, Joao J; Paschoal, Jorge R; Fernandes, Yvens B; Neto, Mauricio Coelho; Honorato, Donizeti C

2005-04-01

The surgical removal of a jugular foramen (JF) tumor presents the neurosurgeon with a complex management problem that requires an understanding of the natural history, diagnosis, surgical approaches, and postoperative complications. Cerebrospinal fluid (CSF) leakage is one of the most common complications of this surgery. Different surgical approaches and management concepts to avoid this complication have been described, mainly in the ear, nose, and throat literature. The purpose of this study was to review the results of CSF leakage prevention in a series of 66 patients with JF tumors operated on by a multidisciplinary cranial base team using a new technique for cranial base reconstruction. We retrospectively studied 66 patients who had JF tumors with intracranial extension and who underwent surgical treatment in our institutions from January 1987 to December 2001. Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. All patients were operated on using the same multidisciplinary surgical approach (neurosurgeons and ear, nose, and throat surgeons). A surgical strategy for reconstruction of the cranial base using vascularized flaps was carried out. The closure of the surgical wound was performed in three layers. A specially developed myofascial flap (temporalis fascia, cervical fascia, and sternocleidomastoid muscle) associated to the inferior rotation of the posterior portion of the temporalis muscle was used to reconstruct the cranial base with vascularized flaps. In this series of 66 patients, postoperative CSF leakage developed in three cases. These patients presented with very large or recurrent tumors, and the postoperative CSF fistulae were surgically closed. The cosmetic result obtained with this reconstruction was classified as excellent or good in all patients. Our results compare favorably with those reported in the literature. The surgical strategy used for cranial base reconstruction presented in this article has

A CLINICAL STUDY ON EXTRA CRANIAL COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA

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Devi Prasad

2015-06-01

Full Text Available OBJECTIVES : The Objective is to study the risk of extra - cranial complications in cases of CSOM and to study the common extra - cranial complications of CSOM with respect to age , sex and socio - economic status . METHODS: The present study comprises of 60 patients with extra - cranial complications secondary to Chronic Suppurative Otitis media who attended to the Dept . o f E. N. T S rivenkateswara G overnment General Hospital, T irupathi . An analysis was made regarding the demographic profile , clinical features , surgical techniques , operative findings , and the outcome of the study . RESULTS : In this study of 60 cases , the most common ext racranial complication of CSOM is Postauralabscess . These extra cranial complications are associated with 15% of intracranial complications of which Meningitis is most common . The complications are more commonly seen in the younger population in second to third decades of life with Male predominance . The duration of ear discharge is not associated with the increasing number of complications . Cholesteatoma is commonly responsible for the development of Extracranial complications of CSOM . Pseudomonas aerugino sa is the commonest organism found in the complications . Canal wall down surgery is the main mode of treatment in this category of patients . The Facial canal dehiscence is associated with a poor outcome in the cases of Facial nerve paralysis . CONCLUSION: The extra - cranial complications of CSOM pose a great challenge to the Developing countries despite its declining incidence . It is in this situation that early diagnosis and prompt surgical intervention are most important for the decreased morbidity and mor tality of patients .

Dentate gyrus neurogenesis ablation via cranial irradiation enhances morphine self-administration and locomotor sensitization.

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Bulin, Sarah E; Mendoza, Matthew L; Richardson, Devon R; Song, Kwang H; Solberg, Timothy D; Yun, Sanghee; Eisch, Amelia J

2018-03-01

Adult dentate gyrus (DG) neurogenesis is important for hippocampal-dependent learning and memory, but the role of new neurons in addiction-relevant learning and memory is unclear. To test the hypothesis that neurogenesis is involved in the vulnerability to morphine addiction, we ablated adult DG neurogenesis and examined morphine self-administration (MSA) and locomotor sensitization. Male Sprague-Dawley rats underwent hippocampal-focused, image-guided X-ray irradiation (IRR) to eliminate new DG neurons or sham treatment (Sham). Six weeks later, rats underwent either MSA (Sham = 16, IRR = 15) or locomotor sensitization (Sham = 12, IRR = 12). Over 21 days of MSA, IRR rats self-administered ~70 percent more morphine than Sham rats. After 28 days of withdrawal, IRR rats pressed the active lever 40 percent more than Sham during extinction. This was not a general enhancement of learning or locomotion, as IRR and Sham groups had similar operant learning and inactive lever presses. For locomotor sensitization, both IRR and Sham rats sensitized, but IRR rats sensitized faster and to a greater extent. Furthermore, dose-response revealed that IRR rats were more sensitive at a lower dose. Importantly, these increases in locomotor activity were not apparent after acute morphine administration and were not a byproduct of irradiation or post-irradiation recovery time. Therefore, these data, along with other previously published data, indicate that reduced hippocampal neurogenesis confers vulnerability for multiple classes of drugs. Thus, therapeutics to specifically increase or stabilize hippocampal neurogenesis could aid in preventing initial addiction as well as future relapse. © 2017 Society for the Study of Addiction.

Long-term cerebral metabolite changes on proton magnetic resonance spectroscopy in patients cured of acute lymphoblastic leukemia with previous intrathecal methotrexate and cranial irradiation prophylaxis

International Nuclear Information System (INIS)

Chan Yuleung; Roebuck, Derek J.; Yuen Manpan; Yeung Kawai; Lau Kamying; Li Chikong; Chik Kiwai

2001-01-01

Purpose: To evaluate the long-term brain metabolite changes on 1 H-MRS in acute lymphoblastic leukemia (ALL) patients who had intrathecal methotrexate (ITMTX) and cranial irradiation (CRT) for central nervous system (CNS) prophylaxis against CNS relapse. Methods and Materials: Thirty-seven ALL patients (12 females, 25 males) with history of ITMTX and CRT for CNS prophylaxis were studied. Age ranges at the time of diagnosis and at magnetic resonance examination were 0.8-13 years and 12-27 years, respectively. The interval since diagnosis was 5.6-19 years. T2-weighted and gradient-recalled echo (GRE) magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy ( 1 H-MRS) were performed to assess brain injury. Results: On MRI, 3 leukoencephalopathy (LEP) and 1 infarct were detected. Twenty-two patients had evidence of hemosiderin. On 1 H-MRS no statistically significant difference in choline (Cho)/creatine (Cr) and N-acetylaspartate (NAA)/Cr was associated with LEP. A lower Cho/Cr (p=0.006) and NAA/Cr (p=0.078) was observed in brains with hemosiderin. Linear-regression analysis showed no statistically significant relationship between NAA/Cr or Cho/Cr with age at diagnosis, but there was a statistically significant decreasing trend of NAA/Cr and Cho/Cr with the interval since diagnosis. Conclusion: Long-term brain injury in ALL survivors after CNS prophylaxis with ITMTX and CRT was reflected by decreasing NAA/Cr and Cho/Cr with the interval since diagnosis. The lower Cho/Cr associated with hemosiderin but not LEP suggested a different pathophysiology for these brain lesions

Neuroprotective effect of lurasidone via antagonist activities on histamine in a rat model of cranial nerve involvement.

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He, Baoming; Yu, Liang; Li, Suping; Xu, Fei; Yang, Lili; Ma, Shuai; Guo, Yi

2018-04-01

Cranial nerve involvement frequently involves neuron damage and often leads to psychiatric disorder caused by multiple inducements. Lurasidone is a novel antipsychotic agent approved for the treatment of cranial nerve involvement and a number of mental health conditions in several countries. In the present study, the neuroprotective effect of lurasidone by antagonist activities on histamine was investigated in a rat model of cranial nerve involvement. The antagonist activities of lurasidone on serotonin 5‑HT7, serotonin 5‑HT2A, serotonin 5‑HT1A and serotonin 5‑HT6 were analyzed, and the preclinical therapeutic effects of lurasidone were examined in a rat model of cranial nerve involvement. The safety, maximum tolerated dose (MTD) and preliminary antitumor activity of lurasidone were also assessed in the cranial nerve involvement model. The therapeutic dose of lurasidone was 0.32 mg once daily, administered continuously in 14‑day cycles. The results of the present study found that the preclinical prescriptions induced positive behavioral responses following treatment with lurasidone. The MTD was identified as a once daily administration of 0.32 mg lurasidone. Long‑term treatment with lurasidone for cranial nerve involvement was shown to improve the therapeutic effects and reduce anxiety in the experimental rats. In addition, treatment with lurasidone did not affect body weight. The expression of the language competence protein, Forkhead‑BOX P2, was increased, and the levels of neuroprotective SxIP motif and microtubule end‑binding protein were increased in the hippocampal cells of rats with cranial nerve involvement treated with lurasidone. Lurasidone therapy reinforced memory capability and decreased anxiety. Taken together, lurasidone treatment appeared to protect against language disturbances associated with negative and cognitive impairment in the rat model of cranial nerve involvement, providing a basis for its use in the clinical treatment of

Imaging of cranial nerves with three-dimensional high resolution diffusion-weighted MR sequence based on SSFP technique

International Nuclear Information System (INIS)

Zhang Zhongwei; Chen Yingming; Meng Quanfei

2008-01-01

Objective: To depict the normal anatomy of cranial nerves in detail and define the exact relationships between cranial nerves and adjacent structures with three-dimensional high resolution diffusion-weighted MR sequence based on SSFP technique (3D DW-SSFP). Methods: 3D DW- SSFP sequence was performed and axial images were obtained in 12 healthy volunteers Post-processing techniques were used to generate images of cranial nerves, and the images acquired were compared with anatomical sections and diagrams of textbook. Results: In all subjects, 3D DW-SSFP sequence could produce homogeneous images and high contrast between the cranial nerves and other solid structures. The intracranial portions of all cranial nerves except olfactory nerve were identified; the extracranial portions of nerve Ⅱ-Ⅻ were identified in all subjects bilaterally. Conclusion: The 3D DW-SSFP sequence can characterize the normal MR appearance of cranial nerves and its branches and the ability to define the nerves may provide greater sensitivity and specificity in detecting abnormalities of craniofacial structure. (authors)

Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

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Seung Gee Kwon

2012-07-01

Full Text Available BackgroundCranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction.MethodsBetween April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability.ResultsThe mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures.ConclusionsThe reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

Chemodectomas arising in temporal bone structures

International Nuclear Information System (INIS)

Dickens, W.J.; Million, R.R.; Cassisi, N.J.; Singleton, G.T.

1982-01-01

Eighteen patients with chemodectomas arising in temporal bone structures were evaluated and treated at the University of Florida. Seventeen patients have each been followed a minimum of 3 years. Patients were retrospectively staged as having ''local'' or ''advanced'' disease, depending on the presence or absence of bone destruction and/or cranial nerve involvement. Fourteen of the patients received radiation therapy as all or part of their therapy; 6 patients were treated with radiation therapy alone, 3 patients were irradiated immediately postoperatively for residual disease, and 5 patients had radiation therapy for recurrence after operation. They were treated with cobalt-60 radiation with doses ranging from 3760 to 5640 rad. All irradiated patients demonstrated evidence of tumor regression, and none have had tumor recurrence with followup of 3-12 years. Of the 8 patients with cranial nerve paralysis prior to therapy, 5 had return of function of 1 or more cranial nerves. One of 6 patients treated initially with radiation therapy had a complication, while 6 of 8 patients irradiated postoperatively had complications. None of the complications were fatal. Three patients treated by operation for early disease limited to the hypotympanum had the disease controlled for 11-12 years. Guidelines for the selection of initial therapy are discussed

Cranial nerves in the Australian lungfish, Neoceratodus forsteri, and in fossil relatives (Osteichthyes: Dipnoi).

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Kemp, A

2017-02-01

Three systems, two sensory and one protective, are present in the skin of the living Australian lungfish, Neoceratodus forsteri, and in fossil lungfish, and the arrangement and innervation of the sense organs is peculiar to lungfish. Peripheral branches of nerves that innervate the sense organs are slender and unprotected, and form before any skeletal structures appear. When the olfactory capsule develops, it traps some of the anterior branches of cranial nerve V, which emerged from the chondrocranium from the lateral sphenotic foramen. Cranial nerve I innervates the olfactory organ enclosed within the olfactory capsule and cranial nerve II innervates the eye. Cranial nerve V innervates the sense organs of the snout and upper lip, and, in conjunction with nerve IX and X, the sense organs of the posterior and lateral head. Cranial nerve VII is primarily a motor nerve, and a single branch innervates sense organs in the mandible. There are no connections between nerves V and VII, although both emerge from the brain close to each other. The third associated system consists of lymphatic vessels covered by an extracellular matrix of collagen, mineralised as tubules in fossils. Innervation of the sensory organs is separate from the lymphatic system and from the tubule system of fossil lungfish. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical trials of CCLSG L874 and I874 protocols without cranial irradiation for standard-risk acute lymphoblastic leukemia in childhood

International Nuclear Information System (INIS)

Koizumi, Shoichi; Fujimoto, Takeo; Tsurusawa, Masahito

1992-01-01

In the CCLSG-874 protocol for children with low-risk (LR) and intermediate-risk (IR) acute lymphoblastic leukemia (ALL), two regimens with or without cranial irradiation (CI) were compared with respect to their ability to prevent central nervous system (CNS) leukemia and to improve overall outcome of ALL. From 1987 to 1990, 82 and 109 evaluable patients were registered into L874 and I874 protocols for LR and IR patients, respectively. All responders to induction therapy were randomized to treatment with 18 Gy of CI plus intrathecal methotrexate (MTX it) or to treatment with high-dose MTX plus MTX it. Patients were then treated with standard maintenance regimens of L874 and I874. At a median follow-up of 39 months (range 14-58 months) there was no difference in the rate of hematologic relapse between the CI group and MTX group. The rate of CNS relapse in the MTX group seemed to be higher (3 of 39 in L874 and 2 of 54 in I874) than that in the CI group (1 of 43 in L874 and 0 of 55 in I874), but these data were not statistically significant. The rates of 4-year event-free survival (EFS) in L874 were 81.1±7.6% (mean±SE) and 75.2±7.9% (ns) for the CI and MTX group, respectively, and the rates of EFS in I874 were 70.0±13.6% and 70.0±9.0% (ns) for the CI and MTX group, respectively. These data suggest that MTX alone may be as effective as CI to prolong disease-free survival in LR and IR ALL although further continuous studies are needed. Analysis of serial CCLSG protocols for ALL from 1981 revealed that the rate of EFS of ALL allover including all risk groups has gradually been increasing from 44.2±3.6% for 811 protocol and 53.1±3.5% for 841 to 65.5±3.6% for the present 874 protocol. (author)

Effectiveness of osteopathic manipulative treatment versus osteopathy in the cranial field in temporomandibular disorders - a pilot study.

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Gesslbauer, Christina; Vavti, Nadja; Keilani, Mohammad; Mickel, Michael; Crevenna, Richard

2018-03-01

Temporomandibular disorders are a common musculoskeletal condition causing severe pain, physical and psychological disability. The effect and evidence of osteopathic manipulative treatment and osteopathy in the cranial field is scarce and their use are controversial. The purpose of this pilot study was to evaluate the effectiveness of osteopathic manipulative treatment and osteopathy in the cranial field in temporomandibular disorders. A randomized clinical trial in patients with temporomandibular disorders was performed. Forty female subjects with long-term temporomandibular disorders (>3 months) were included. At enrollment, subjects were randomly assigned into two groups: (1) osteopathic manipulative treatment group (20 female patients) and (2) osteopathy in the cranial field group (20 female patients). Examination was performed at baseline (E0) and at the end of the last treatment (E1), consisting of subjective pain intensity with the Visual Analog Scale, Helkimo Index and SF-36 Health Survey. Subjects had five treatments, once a week. 36 subjects completed the study (33.7 ± 10.3 y). Patients in both groups showed significant reduction in Visual Analog Scale score (osteopathic manipulative treatment group: p = 0.001; osteopathy in the cranial field group: posteopathy in the cranial field group: p = 0.003) and a significant improvement in the SF-36 Health Survey - subscale "Bodily Pain" (osteopathic manipulative treatment group: p = 0.04; osteopathy in the cranial field group: p = 0.007) after five treatments (E1). All subjects (n = 36) also showed significant improvements in the above named parameters after five treatments (E1): Visual Analog Scale score (posteopathy in the cranial field as an effective treatment modality in patients with temporomandibular disorders. The positive results in both treatment groups should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field and support the

The role of radiosurgery in the management of chordoma and chondrosarcoma of the cranial base

International Nuclear Information System (INIS)

Kondziolka, D.; Lunsford, L.D.; Flickinger, J.C.

1991-01-01

Despite conventional multimodality treatment (surgery and fractionated radiation therapy), recurrence and clinical progression of cranial base chordomas and chondrosarcomas are common. The malignant behavior of these tumors is a result of their critical location, locally aggressive nature, and high recurrence rate. To explore the role of radiosurgery in the treatment of these skull base neoplasms, we assessed its use in four patients with chordoma and two with chondrosarcoma. In five of the patients, radiosurgery was used as adjuvant therapy for residual or recurrent tumors after surgical debulking, and in one patient with a chordoma, it was the primary treatment. No patient received fractionated external beam radiotherapy. All tumors were less than 30 mm in diameter and were treated with 20 Gy to the tumor margin. Skull base computed tomography and magnetic resonance images were essential to define the anatomic relationships between tumor and adjacent basal structures. During follow-up (mean, 22 mo; range, 8-36 mo), the authors found no progression of the treated tumor volume in any patient. Neurological deficits before treatment improved in three patients; the other three patients remained in stable neurological condition. Serial follow-up imaging studies demonstrated that two patients showed reduction in tumor size and four patients had no tumor growth. In one patient, a metastatic parietal lobe chondrosarcoma developed and was treated by microsurgery. Another patient showed tumor progression outside of the radiosurgical treatment volume. The authors results attest to the value of stereotactic radiosurgery as an adjuvant or primary treatment for selected patients with chordoma or chondrosarcoma and demonstrate its potential advantages over standard fractionated irradiation. Analysis of the long-term clinical and imaging effects after radiosurgery is warranted

Multiple cranial nerve dysfunction caused by neurosarcoidosis

NARCIS (Netherlands)

Loor, Rivkah G. J.; van Tongeren, Joost; Derks, Wynia

2012-01-01

Neurosarcoidosis is a rare identity and occurs in only 5% to 15% of patients with sarcoidosis. It can manifest in many different ways, and therefore, diagnosis may be complicated. We report a case presented in a very unusual manner with involvement of 3 cranial nerves; anosmia (NI), facial palsy

Response of irradiated diet fed rats to whole body X irradiation

International Nuclear Information System (INIS)

Hasan, S.S.; Kushwaha, A.K.S.

1985-01-01

The response to whole body X irradiation has been studied in the brain of rats fed both on a normal diet (consisting of equal parts of wheat and gram flour) and on a low protein irradiated diet (consisting of a part of normal diet and three parts of wheat). The activity of enzymes related to the glucose metabolism (glucose 6-phosphate dehydrogenase and fructose diphosphate aldolase) is reduced, while that of peroxidant enzymes (catalase and lipid peroxidase) increased in the brain of rats that received a diet poor in proteins and irradiated diets (normal or hypoproteic). DNA and RNA levels and protein content show a significant reduction in the brain of rats with hypoproteic and irradiated diets. The total body irradiation causes serious alterations in the brain in animals with a hypoproteic malnutritions due both to a low protein and an irradiated diet. The brain of rats fed on a low protein and irradiated diet exhibits after whole body irradiation damages more severe than those in rats fed on a normal irradiated diet

Direct fabrication through electron beam melting technology of custom cranial implants designed in a PHANToM-based haptic environment

International Nuclear Information System (INIS)

Mazzoli, Alida; Germani, Michele; Raffaeli, Roberto

2009-01-01

Repairing critical human skull injuries requires the production and use of customized cranial implants and involves the integration of computer aided design and manufacturing (CAD and CAM). The main causes for large cranial defects are trauma, cranial tumors, infected craniotomy bone flaps and external neurosurgical decompression. The success of reconstructive cranial surgery depends upon: the preoperative evaluation of the defect, the design and manufacturing of the implant, and the skill of the operating surgeon. Cranial implant design is usually carried out manually using CAD although this process is very time-consuming and the quality of the end product depends wholly upon the skill of the operator. This paper presents an alternative automated method for the design of custom-made cranial plates in a PHANToM ® -based haptic environment, and their direct fabrication in biocompatible metal using electron beam melting (EBM) technology.

Cranial and caudal mesenteric arteries of the paca (Cuniculus paca, L. 1766

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Isabela Cristina de Souza Marques

2013-03-01

Full Text Available The paca (Cuniculus paca, Linnaeus, 1766 is a medium-sized rodent that occurs in Brazil; however, there is little information regarding its morphology. The goal of this study was to describe the origin and branching of the cranial and caudal mesenteric arteries of this rodent in order to contribute to comparative anatomy studies. Ten animals (males and females were used. After death, their thoracic inlet was opened between the fourth and sixth ribs to expose the thoracic aorta, which was cannulated caudally. A stained, neoprene latex solution was then injected, in order to fill the arterial system, and the preparations were fixed in a 10% aqueous formalin solution for over 72h. The fixed specimens were dissected to identify the cranial and caudal mesenteric arteries. The cranial mesenteric artery started at the abdominal aorta, caudally to the celiac artery, and originated in the following arterial branches: caudal pancreatic duodenal, pancreatic, jejunal, ileum colic and cecal. The origin of the caudal mesenteric artery occurred next to the end of abdominal aorta and this vessel issued the left colic artery and cranial rectal artery from which the sigmoid arteries initiated. It was found that there was little difference in the branching pattern of the arteries compared to other rodents and domestic mammals.

Radiation-induced ocular motor cranial nerve palsies in patients with pituitary tumor.

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Vaphiades, Michael S; Spencer, Sharon A; Riley, Kristen; Francis, Courtney; Deitz, Luke; Kline, Lanning B

2011-09-01

Radiation therapy is often used in the treatment of pituitary tumor. Diplopia due to radiation damage to the ocular motor cranial nerves has been infrequently reported as a complication in this clinical setting. Retrospective case series of 6 patients (3 men and 3 women) with pituitary adenoma, all of whom developed diplopia following transsphenoidal resection of pituitary adenoma with subsequent radiation therapy. None had evidence of tumor involvement of the cavernous sinus. Five patients developed sixth nerve palsies, 3 unilateral and 2 bilateral, and in 1 patient, a sixth nerve palsy was preceded by a fourth cranial nerve palsy. One patient developed third nerve palsy. Five of the 6 patients had a growth hormone-secreting pituitary tumor with acromegaly. Following transsphenoidal surgery in all 6 patients (2 had 2 surgeries), 4 had 2 radiation treatments consisting of either radiosurgery (2 patients) or external beam radiation followed by radiosurgery (2 patients). Patients with pituitary tumors treated multiple times with various forms of radiation therapy are at risk to sustain ocular motor cranial nerve injury. The prevalence of acromegalic patients in this study reflects an aggressive attempt to salvage patients with recalcitrant growth hormone elevation and may place the patient at a greater risk for ocular motor cranial nerve damage.

Long-term effects of cranial irradiation and intrathecal chemotherapy in treatment of childhood leukemia: a MEG study of power spectrum and correlated cognitive dysfunction

Science.gov (United States)

2012-01-01

Background Prophylaxis to prevent relapses in the central nervous system after childhood acute lymphoblastic leukemia (ALL) used to consist of both intrathecal chemotherapy (CT) and cranial irradiation (CRT). CRT was mostly abolished in the eighties because of its neurotoxicity, and replaced with more intensive intrathecal CT. In this study, a group of survivors treated with CRT before 1983 and another group treated without CRT thereafter are investigated 20–25 years later, giving a much stronger perspective on long-term quality of life than previous studies. The outcomes will help to better understand these groups’ current needs and will aid in anticipating late effects of prophylactic CRT that is currently applied for other diseases. This study evaluates oscillatory neuronal activity in these long-term survivors. Power spectrum deviations are hypothesized to correlate with cognitive dysfunction. Methods Resting state eyes-closed magnetoencephalography (MEG) recordings were obtained from 14 ALL survivors treated with CT + CRT, 18 treated with CT alone and 35 controls. Relative spectral power was calculated in the δ, θ, α1, α2, β and γ frequency bands. The Amsterdam Neuropsychological Tasks (ANT) program was used to assess cognition in the executive functions domain. MEG data and ANT scores were correlated. Results In the CT + CRT group, relative θ power was slightly increased (p = 0.069) and α2 power was significantly decreased (p = 0.006). The CT + CRT group performed worse on various cognitive tests. A deficiency in visuomotor accuracy, especially of the right hand, could be clearly associated with the deviating regional θ and α2 powers (0.471 < r < 0.697). A significant association between decreased regional α2 power and less attentional fluctuations was found for CT + CRT patients as well as controls (0.078 < r < 0.666). Patients treated with CT alone displayed a power spectrum similar to controls, except

MR of acoustic neuromas; Relationship to cranial nerves

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Suzuki, Masayuki; Takashima, Tsutomu; Kadoya, Masumi; Takahashi, Shiroh; Miyayama, Shiroh; Taira, Sakae; Kashihara, Kengo; Yamashima, Tetsumori; Itoh, Haruhide [Kanazawa Univ. (Japan). School of Medicine

1989-08-01

In this report, the relationship of acoustic neuromas to the adjacent cranial nerves is discussed. On T{sub 1}-weighted images, the trigeminal nerve was detected in all 13 cases. Mild to marked compression of these nerves by the tumors was observed in eight cases. The extent of compression did not always correspond to the clinical symptoms. In four cases with a maximum tumor diameter of 2 cm or less, the 7th and 8th cranial nerves were identified. There was no facial palsy in these patients. Two patients with a tumor diameter of more than 2 cm also had no facial palsy. All patients, including those with small tumors, complained of hearing loss and/or tinnitus. While MR imaging has some limitations, it is an effective imaging modality for showing the relationship between tumors and nerves. (author).

Ioversol 350: clinical experience in cranial computed tomography

International Nuclear Information System (INIS)

Theron, J.; Paugam, J.P.; Courtheoux, P.

1991-01-01

A single, open trial was conducted in 40 patients to evaluate the diagnostic efficacy and safety, in cranial computed tomography, of ioversol (350 mgl/ml), a new nonionic, monomeric, low-osmolality contrast medium. Ioversol is characterized by a hydrophilicity which is not only the highest of all nonionic agents available to date, but also evenly distributed among the various sides of the benzene ring. Diagnosis was possible in 100 % of cases with a mean degree of certainty of 90.8 %. Six minor adverse reactions requiring no treatment we recorded, of which two were observed by the investigator and four reported by the patients. No pain sensation was found and heat sensations were of minor intensity. Ioversol 350, which showed good diagnostic efficacy and proved to be well tolerated, is therefore suitable for cranial computed tomography at a mean dose of 1 ml/kg

Protective effects of hydroxysaffor yellow A on brain injury in mice irradiated by 300 MeV/n 12C6+ ions

International Nuclear Information System (INIS)

Gan Lu; Wang Zhenhua; Zhang Hong; Ma Chengjun; Li Guang

2012-01-01

Radiation encephalopathy is the main complication of cranial radiotherapy. It can cause necrosis of brain tissue and cognitive dysfunction, to which no ideal prevention method is available until now. Hydroxysaffor yellow A (HSYA) is the main active ingredient of the traditional Chinese medicine safflower, with protective effects against cerebral ischemic injury. In this work, we investigated the protective effects of HSYA on brain injury in mice irradiated by 300 MeV/u 12 C 6+ ion beam. The whole head of male Kunming mouse was irradiated to 4.0 Gy after receiving daily intra-peritoneal injection HSYA for 3 d. One month later, the Morris water maze test was used to detect the spatial memory in mice. The Evans blue was used as the tracer to evaluate the permeability of blood-brain barrier. The SOD activity and MDA content in brain tissue were assayed by test kits. The results showed that the 12 C 6+ irradiation significantly impaired the spatial learning and memory in mice, increased the permeability of blood-brain barrier and the MDA content in brain tissue, whereas decreased the SOD activity in brain tissue. The pretreatment with HSYA could improve the spatial memory deficits and inhibit the changes of the blood-brain barrier, the SOD activity and the MDA content in brain tissue in mice. All these demonstrate that HSYA possesses the protective effect against brain injury induced by 12 C 6+ particle therapy. (authors)

Internal carotid artery aneurysms, cranial nerve dysfunction and headache: the role of deformation and pulsation

Energy Technology Data Exchange (ETDEWEB)

Rodriguez-Catarino, M.; Wikholm, G.; Svendsen, P. [Interventional Neuroradiology, Sahlgrenska Hospital, Goeteborg (Sweden); Frisen, L. [Ophthalmology Dept., Sahlgrenska Hospital, Goeteborg (Sweden); Elfverson, J. [Neurosurgery Dept., Sahlgrenska Hospital, Goeteborg (Sweden); Quiding, L. [Medical Physics and Biomedical Engineering Dept., Sahlgrenska Hospital, Goeteborg (Sweden)

2003-04-01

Cranial nerve dysfunction and headache may occur with unruptured aneurysms of the cavernous and supraclinoid portions of the internal carotid artery. Nerve deformation (mass effect) and transmitted pulsations have been suggested as pathogenetic mechanisms. Differentiation may be possible by studying effects of endovascular treatment with Guglielmi detachable coils. Symptoms and signs of cranial neuropathy were retrospectively contrasted with angiographic aneurysm volumes before and after treatment in 10 patients. Mean follow-up was 36 months. Symptoms improved in three of four patients with cranial nerve dysfunction and in all patients with headache: None of the other patients, one with cranial nerve dysfunction, and three who were asymptomatic, developed any new symptoms after treatment. Aneurysm volume ranged from 0.1 to 2.7 cm{sup 3} before and 0.2 to 5.7 cm{sup 3} after treatment; the size thus increased by 15 to 110%, a change which was statistically significant (P = 0.004). The consistent increase in aneurysm volume with treatment is not associated with clinical deterioration, suggesting that deformation and displacement play a minor role in cranial neuropathy and that transmitted pulsations may be more important. (orig.)

Internal carotid artery aneurysms, cranial nerve dysfunction and headache: the role of deformation and pulsation

International Nuclear Information System (INIS)

Rodriguez-Catarino, M.; Wikholm, G.; Svendsen, P.; Frisen, L.; Elfverson, J.; Quiding, L.

2003-01-01

Cranial nerve dysfunction and headache may occur with unruptured aneurysms of the cavernous and supraclinoid portions of the internal carotid artery. Nerve deformation (mass effect) and transmitted pulsations have been suggested as pathogenetic mechanisms. Differentiation may be possible by studying effects of endovascular treatment with Guglielmi detachable coils. Symptoms and signs of cranial neuropathy were retrospectively contrasted with angiographic aneurysm volumes before and after treatment in 10 patients. Mean follow-up was 36 months. Symptoms improved in three of four patients with cranial nerve dysfunction and in all patients with headache: None of the other patients, one with cranial nerve dysfunction, and three who were asymptomatic, developed any new symptoms after treatment. Aneurysm volume ranged from 0.1 to 2.7 cm 3 before and 0.2 to 5.7 cm 3 after treatment; the size thus increased by 15 to 110%, a change which was statistically significant (P = 0.004). The consistent increase in aneurysm volume with treatment is not associated with clinical deterioration, suggesting that deformation and displacement play a minor role in cranial neuropathy and that transmitted pulsations may be more important. (orig.)

Depression of T lymphocyte function in chimpanzees receiving thymectomy and irradiation. [X Radiation

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Gilbertsen, R.B.; Metzgar, R.S.

1978-03-01

In studies analogous to those in which the thymus dependency of immune functions in murine systems was determined, three chimpanzees were thymectomized, splenectomized, exposed to lethal doses of whole body x-irradiation with limited bone marrow shielding, and subsequently evaluated for lymphocyte markers and functions over a period of years. In the oldest animal studied (Irena, 7.2 years at surgery), the percentage of peripheral blood T cells decreased to about 60% of control values and remained at that level for approximately 1/sup 1///sub 2/ years before returning to normal. In the two youngest chimpanzees T cell rosette values dropped to 15 to 40% of control values after irradiation. T cell percentages in one of these young chimpanzees returned to about 75% of the controls 2/sup 1///sub 2/ years after x-irradiation. Phytohemagglutinin and concanavalin A mitogen responses were less affected in the oldest chimpanzee. However, even in the oldest animal, the responses to phytohemagglutinin and concanavalin A began to show a gradual and consistent decline 1/sup 1///sub 2/ years after irradiation. Mixed leukocyte culture responsiveness was most affected by the experimental procedures, being greatly reduced in all three chimpanzees during varying time intervals. In general, the effects of the experimental procedures used to produce T cell deficiencies varied with the age of the chimpanzee at surgery, the time after irradiation when the animal was tested, and the lymphocyte marker or function studied.

Gliosarcoma of the posterior cranial fossa: MRI findings

International Nuclear Information System (INIS)

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

1993-01-01

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

Enhancement of multiple cranial and spinal nerves in vanishing white matter: expanding the differential diagnosis.

Science.gov (United States)

Eluvathingal Muttikkal, Thomas Jose; Montealegre, Denia Ramirez; Matsumoto, Julie Ann

2018-03-01

Abnormal cranial or spinal nerve contrast enhancement on MRI in cases of suspected pediatric leukodystrophy is recognized as an important clue to the diagnosis of either metachromatic leukodystrophy or globoid cell leukodystrophy (Krabbe disease). We report a case of genetically confirmed childhood vanishing white matter with enhancement of multiple cranial and spinal nerves in addition to the more typical intracranial findings. This case expands the limited differential diagnosis of cranial nerve or spinal nerve enhancement in cases of suspected leukodystrophy and may aid in more efficient work-up and earlier diagnosis of vanishing white matter.

Diagnosis and interventional neuroradiology in cranial emergencies. Neuroradiologische Notfalldiagnostik und -therapie kranieller Erkrankungen

Energy Technology Data Exchange (ETDEWEB)

Wakhloo, A.K.; Schumacher, M. (Freiburg Univ. (Germany, F.R.). Sektion Neuroradiologie)

1991-01-01

The most efficient diagnostic procedures are described for cases of intracranial mass, cerebral sinus and venous thrombosis, thrombosis of vertebral and basilar arteries, subarachnoid hemorrhage, carotid-cavernous fistulas, intractable epistaxis, Wernicke's encephalopathy and inflammatory cranial diseases. The importance of CT, MRI and angiography is discussed for these cranial emergencies. The different forms of interventional therapy possible are specified. (orig.).

Assessment of functional status in children with brain tumors

International Nuclear Information System (INIS)

Sugita, Yasuo; Kobayashi, Seiichi; Uegaki, Masami; Katayama, Masahiko; Miyagi, Jun; Iryo, Osamu; Shigemori, Minoru; Kuramoto, Shinken; Ootsubo, Masaaki

1987-01-01

Thirty children treated for brain tumors between 1978 - 1985 at Kurume university hospital were evaluated for alternation in intellectual, emotional, and social function. They were 15 males and 15 females, aged 3 to 16 years, on the averaged 1.7 years after treatment. Twenty-eight children had no neurological deficits and 2 children had slight neurological deficits. It was possible for twenty-eight children to be evaluated for intelligence quotient by Wechsler Intelligence Scale for Children-revised and Tanaka-Binet. The median score and standard deviation of intelligence quotient (IQ) test in children with brain tumors were as follows; verbal IQ: 84 ± 16, performance IQ: 77 ± 20, full scale IQ: 80 ± 20. There children with brain tumors obtained significant low IQ scores than children (t-test, P < 0.01). Twenty-one (72 %) children showed subnormal IQ scores (IQ < 90) and 7 children showed normal IQ scores (IQ ≥ 90). Concerning social and emotional function, twelve children (45.7 %) showed abnormal behaviour. The median scores and standard deviation of IQ scores in cranial irradiated patients were as follows; verbal IQ: 79 ± 13, performance IQ: 71 ± 15, full scale IQ: 71 ± 14. Especially, ten of twelve cranial irradiated patients showed subnormal IQ scores. Also, cranial irradiated patients obtained significant low IQ scores than non-cranial irradiated patients (t-test, P < 0.05). Serial evaluation of three cranial irradiated patients revealed further deterioration without recurrence of tumor and hydrocephalus. The results are discussed to: (1) the effects and mechanism of cranial irradiation on cognitive development: (2) the relationship between cognitive dysfunction and irradiation methods. The effects and mechanism of cranial irradiation on cognitive dysfunction is considered to be not only injury of cortex but also injury of fiber tracts. Also, cognitive dysfunction is apt to be related to age of irradiated patients. (J.P.N.)

Assessment of functional status in children with brain tumors

Energy Technology Data Exchange (ETDEWEB)

Sugita, Yasuo; Kobayashi, Seiichi; Uegaki, Masami; Katayama, Masahiko; Miyagi, Jun; Iryo, Osamu; Shigemori, Minoru; Kuramoto, Shinken; Ootsubo, Masaaki

1987-06-01

Thirty children treated for brain tumors between 1978 - 1985 at Kurume university hospital were evaluated for alternation in intellectual, emotional, and social function. They were 15 males and 15 females, aged 3 to 16 years, on the averaged 1.7 years after treatment. Twenty-eight children had no neurological deficits and 2 children had slight neurological deficits. It was possible for twenty-eight children to be evaluated for intelligence quotient by Wechsler Intelligence Scale for Children-revised and Tanaka-Binet. The median score and standard deviation of intelligence quotient (IQ) test in children with brain tumors were as follows; verbal IQ: 84 +- 16, performance IQ: 77 +- 20, full scale IQ: 80 +- 20. There children with brain tumors obtained significant low IQ scores than children (t-test, P < 0.01). Twenty-one (72 %) children showed subnormal IQ scores (IQ < 90) and 7 children showed normal IQ scores (IQ greater than or equal to 90). Concerning social and emotional function, twelve children (45.7 %) showed abnormal behaviour. The median scores and standard deviation of IQ scores in cranial irradiated patients were as follows; verbal IQ: 79 +- 13, performance IQ: 71 +- 15, full scale IQ: 71 +- 14. Especially, ten of twelve cranial irradiated patients showed subnormal IQ scores. Also, cranial irradiated patients obtained significant low IQ scores than non-cranial irradiated patients (t-test, P < 0.05). Serial evaluation of three cranial irradiated patients revealed further deterioration without recurrence of tumor and hydrocephalus. The results are discussed to: (1) the effects and mechanism of cranial irradiation on cognitive development: (2) the relationship between cognitive dysfunction and irradiation methods. The effects and mechanism of cranial irradiation on cognitive dysfunction is considered to be not only injury of cortex but also injury of fiber tracts. Also, cognitive dysfunction is apt to be related to age of irradiated patients. (J.P.N.).

Reduced hypothalamic blood flow after radiation treatment of nasopharyngeal cancer: SPECT studies in 34 patients

International Nuclear Information System (INIS)

Chieng, P.U.; Huang, T.S.; Chang, C.C.; Chong, P.N.; Tien, R.D.; Su, C.T.

1991-01-01

To determine the effect of cranial irradiation on hypothalamic blood flow, the authors performed 44 regional cerebral blood flow studies with 99mTc hexamethyl propyleneamine oxime (HMPAO) single-photon emission CT (SPECT) on four normal volunteers and 34 patients with pathologically proved nasopharyngeal cancer. Twenty-three men and 15 women, 30-65 years old, were divided into four study groups: group 1 served as a control and consisted of four normal volunteers and six patients studied prior to cranial irradiation; group 2 patients had cranial irradiation half a year before the SPECT study (n = 12, one from group 1); group 3 patients were irradiated 1 year before the study (n = 13, three from group 1 and two from group 2); and group 4 patients were irradiated at least 5 years before SPECT imaging (n = 9). Six patients were studied twice. Quantification of the 99mTc-HMPAO brain SPECT studies was done separately by three radiologists to obtain the hypothalamus/occipital (H/O) and hypothalamus/parasagittal (H/P) ratios. Endocrinologic studies were performed in all cases and the hypothalamus-thyrotroph-thyroid, hypothalamus-gonadotroph-testis (ovary), hypothalamus-lactotroph, hypothalamus-somatotroph, and hypothalamus-corticotroph-adrenal axes were evaluated separately. They determined that regional hypothalamic blood flow was reduced after cranial irradiation in patients with nasopharyngeal cancer. The H/O ratio of groups 3 and 4 did not differ from that of group 2 (one-half year after cranial irradiation). The H/O ratio was significantly reduced 6 months and 1 year after cranial irradiation; mean ± SD = 0.5801 ± 0.0829 (p less than .025), 0.5725 ± 0.0791 (p less than .01) versus 0.6477 ± 0.0458 before cranial irradiation, respectively

Cranial epidural hematomas: A case series and literature review of this rare complication associated with sickle cell disease.

Science.gov (United States)

Hamm, Jennifer; Rathore, Nisha; Lee, Pearlene; LeBlanc, Zachary; Lebensburger, Jeffrey; Meier, Emily Riehm; Kwiatkowski, Janet L

2017-03-01

Patients with sickle cell disease (SCD) may experience many complications of the central nervous system (CNS) including stroke, silent cerebral infarcts, and neuropsychological deficits. Cranial epidural hematoma is a rare but potentially serious complication. Case series of cranial epidural hematomas in children with SCD from three different institutions is considered, along with a literature review of cranial epidural hematomas in this population. Seven children with SCD with cranial epidural hematomas were identified from three different institutions. All patients were male and the age at presentation ranged from 10 to 18 years. Two patients presented with headache (28.6%), while the rest had no neurologic symptoms at presentation. Four patients required urgent neurosurgical intervention (57.1%) and one patient died (14.3%). A literature review identified 18 additional cases of cranial epidural hematomas in children with SCD. Of these, treatment ranged from supportive care to neurosurgical intervention. Twelve patients completely recovered (66.7%), one patient had long-term cognitive impairment (5.6%), and four patients died (22.2%). Combined with our data, cranial epidural hematomas have a mortality rate of 20.0%. Although rare, cranial epidural hematoma can be fatal and should be considered in patients with acute neurological symptoms. © 2016 Wiley Periodicals, Inc.

Brief Communication: Quantitative- and molecular-genetic differentiation in humans and chimpanzees: implications for the evolutionary processes underlying cranial diversification.

Science.gov (United States)

Weaver, Timothy D

2014-08-01

Estimates of the amount of genetic differentiation in humans among major geographic regions (e.g., Eastern Asia vs. Europe) from quantitative-genetic analyses of cranial measurements closely match those from classical- and molecular-genetic markers. Typically, among-region differences account for ∼10% of the total variation. This correspondence is generally interpreted as evidence for the importance of neutral evolutionary processes (e.g., genetic drift) in generating among-region differences in human cranial form, but it was initially surprising because human cranial diversity was frequently assumed to show a strong signature of natural selection. Is the human degree of similarity of cranial and DNA-sequence estimates of among-region genetic differentiation unusual? How do comparisons with other taxa illuminate the evolutionary processes underlying cranial diversification? Chimpanzees provide a useful starting point for placing the human results in a broader comparative context, because common chimpanzees (Pan troglodytes) and bonobos (Pan paniscus) are the extant species most closely related to humans. To address these questions, I used 27 cranial measurements collected on a sample of 861 humans and 263 chimpanzees to estimate the amount of genetic differentiation between pairs of groups (between regions for humans and between species or subspecies for chimpanzees). Consistent with previous results, the human cranial estimates are quite similar to published DNA-sequence estimates. In contrast, the chimpanzee cranial estimates are much smaller than published DNA-sequence estimates. It appears that cranial differentiation has been limited in chimpanzees relative to humans. © 2014 Wiley Periodicals, Inc.

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

International Nuclear Information System (INIS)

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

1995-01-01

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

Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia.

Science.gov (United States)

Kirsch, Daniel L; Nichols, Francine

2013-03-01

Cranial electrotherapy stimulation is a prescriptive medical device that delivers a mild form of electrical stimulation to the brain for the treatment of anxiety, depression, and insomnia. It is supported by more than 40 years of research demonstrating its effectiveness in several mechanistic studies and greater than 100 clinical studies. Adverse effects are rare (<1%), mild, and self-limiting, consisting mainly of skin irritation under the electrodes and headaches. Often used as a stand-alone therapy, because results are usually seen from the first treatment, cranial electrotherapy stimulation may also be used as an adjunctive therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

[Cranial nerve damage after neuroaxial methods of anesthesia in puerperas].

Science.gov (United States)

Floka, S E; Shifman, E M

2007-01-01

The paper describes cranial nerve damage, a rare complication of neuroaxial anesthesia in obstetric care. In the literature, there are summarized data on 17 cases of neurological deficit developing after subarachnoidal or epidural anesthesia in puerperas. The etiological and pathogenetic factors of the above complications may be suggested to be the high disposition of a local anesthetic, arterial hypotension due to neuroaxial anesthetics, the outflow of cerebrospinal fluid after pachymeningeal puncture (including after unintended puncture during epidural anesthesia), and ischemic injury after the blood packing performed to relieve postpuncture headache. Closer consideration of these risk factors seems to reduce the incidence of cranial nerve damage in puerperas.

Application of Thinned-Skull Cranial Window to Mouse Cerebral Blood Flow Imaging Using Optical Microangiography

Science.gov (United States)

Wang, Ruikang K.

2014-01-01

In vivo imaging of mouse brain vasculature typically requires applying skull window opening techniques: open-skull cranial window or thinned-skull cranial window. We report non-invasive 3D in vivo cerebral blood flow imaging of C57/BL mouse by the use of ultra-high sensitive optical microangiography (UHS-OMAG) and Doppler optical microangiography (DOMAG) techniques to evaluate two cranial window types based on their procedures and ability to visualize surface pial vessel dynamics. Application of the thinned-skull technique is found to be effective in achieving high quality images for pial vessels for short-term imaging, and has advantages over the open-skull technique in available imaging area, surgical efficiency, and cerebral environment preservation. In summary, thinned-skull cranial window serves as a promising tool in studying hemodynamics in pial microvasculature using OMAG or other OCT blood flow imaging modalities. PMID:25426632

Whole abdominal irradiation following chemotherapy in advanced ovarian carcinoma

International Nuclear Information System (INIS)

Kuten, A.; Stein, M.; Steiner, M.; Rubinov, R.; Epelbaum, R.; Cohen, Y.

1988-01-01

One hundred and sixteen patients with advanced ovarian carcinoma, who underwent primary cytoreductive surgery, received 6-11 courses of chemotherapy by cis-platin (50 mg/m2) and adriamycin (50 mg/m2) every 21 days. This was followed by second look laparotomy in 66 patients with no clinical evidence of disease. Consolidation abdominal irradiation was administered to 43 patients. Two techniques of irradiation were employed: between 1980-1983 whole abdominal irradiation was used and patients were to receive 3000 cGy in 4 weeks (Schedule I). Due to myelosuppression only 13 of 26 patients (50%) completed the planned dose of radiation. Between 1983-1985 the target volume was divided into upper and lower parts. First, the lower abdomen received 3000 cGy in 3 weeks, and then the upper abdomen received the same dose (Schedule II). Sixteen of seventeen patients (94%) thus treated, completed the planned dose of radiation. The actuarial survival for all 116 patients was 28% of 5 years. Irradiated patients with negative second look laparotomy had a survival probability of 100% at 24 months. Irradiated patients with microscopic disease at second look operation had an actuarial 5-year survival of 66%. Patients with minimal residual disease at second look laparotomy, receiving consolidation abdominal irradiation, had an actuarial survival of 5% only at 36 months. It is concluded that consolidation radiotherapy is effective in patients with negative or microscopic residual disease at second-look laparotomy. In regard to bone marrow tolerance, split field technique of irradiation is preferred

[Anatomy of the skull base and the cranial nerves in slice imaging].

Science.gov (United States)

Bink, A; Berkefeld, J; Zanella, F

2009-07-01

Computed tomography (CT) and magnetic resonance imaging (MRI) are suitable methods for examination of the skull base. Whereas CT is used to evaluate mainly bone destruction e.g. for planning surgical therapy, MRI is used to show pathologies in the soft tissue and bone invasion. High resolution and thin slice thickness are indispensible for both modalities of skull base imaging. Detailed anatomical knowledge is necessary even for correct planning of the examination procedures. This knowledge is a requirement to be able to recognize and interpret pathologies. MRI is the method of choice for examining the cranial nerves. The total path of a cranial nerve can be visualized by choosing different sequences taking into account the tissue surrounding this cranial nerve. This article summarizes examination methods of the skull base in CT and MRI, gives a detailed description of the anatomy and illustrates it with image examples.

Anatomy of the skull base and the cranial nerves in slice imaging

International Nuclear Information System (INIS)

Bink, A.; Berkefeld, J.; Zanella, F.

2009-01-01

Computed tomography (CT) and magnetic resonance imaging (MRI) are suitable methods for examination of the skull base. Whereas CT is used to evaluate mainly bone destruction e.g. for planning surgical therapy, MRI is used to show pathologies in the soft tissue and bone invasion. High resolution and thin slice thickness are indispensible for both modalities of skull base imaging. Detailed anatomical knowledge is necessary even for correct planning of the examination procedures. This knowledge is a requirement to be able to recognize and interpret pathologies. MRI is the method of choice for examining the cranial nerves. The total path of a cranial nerve can be visualized by choosing different sequences taking into account the tissue surrounding this cranial nerve. This article summarizes examination methods of the skull base in CT and MRI, gives a detailed description of the anatomy and illustrates it with image examples. (orig.) [de

Association of fetal cranial shape with shoulder dystocia

NARCIS (Netherlands)

Belfort, M. A.; White, G. L.; Vermeulen, F. M.

Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk

Role of blink reflex in diagnosis of subclinical cranial neuropathy in diabetic mellitus type II.

Science.gov (United States)

Kazem, Shakouri S; Behzad, Davoudi

2006-05-01

Peripheral neuropathy (PN) is one of the late complications of diabetes mellitus. Cranial nerves III, VII, and V are among the most commonly affected in diabetic patients. Traditional electrodiagnosis (Edx) studies are a useful method for diagnosis of PN and symptomatic cranial neuropathy, and may not be useful for detecting subclinical involvement of cranial nerves. The main objective of this study is to evaluate the role of blink reflex (BR) for early diagnosis of cranial neuropathy in diabetic patients with PN. A prospective study was performed on NIDDM patients with PN. One hundred eighty-eight subjects were included in our study in which 142 acted as healthy subjects and 46 as diabetic patients. Patients were excluded with prior history of cranial nerve lesions, stroke, or any other disease with polyneuropathy or drug-induced neuropathy. Routine nerve conduction studies were performed, and only patients with PN were included in this study. Abnormalities were found in 54.4% of patients. R1, IR2, and CR2 were prolonged relative to the healthy group. Statistically there was no significant difference in R/D ratio of patients (P=0.201). Also, there was a positive correlation between R1, IR2, and CR2 latencies with duration of diabetes and severity of polyneuropathy, but not for R/D. The greatest correlation was shown in R1 latency (69.9% abnormality). BR is a noninvasive and very useful method for the evaluation and diagnosis of subclinical cranial nerve involvement in diabetic patients.

Propriedades biomecânicas da fáscia lata e do ligamento cruzado cranial de cães Biomechanical properties of canine fascia lata and cranial cruciate ligament

Directory of Open Access Journals (Sweden)

A.P. Brendolan

2001-02-01

Full Text Available Preparações bilaterais do ligamento cruzado cranial e da fáscia lata de 15 cães foram testadas na máquina Instron, modelo 4482. Os animais, de ambos os sexos, idade entre um e quatro anos, pesavam em média 11,80 ± 1,99kg. Os retalhos de fáscia lata foram testados retilíneos e torcidos e o ligamento cruzado cranial foi testado mantendo um ângulo de 135° entre a tíbia e o fêmur e 0°, 15° de rotação externa e 15° de rotação interna da tíbia em relação ao fêmur. A velocidade dos testes de tração foi de 8,47mm por segundo. A força máxima dos retalhos de fáscia lata foi aproximadamente de 290 Newtons, e a tensão máxima, 28 Megapascal. A torção não influenciou na resistência dos retalhos de fáscia lata. A rotação externa e interna da tíbia de 15º também não influenciou na força máxima do ligamento cruzado cranial, que foi aproximadamente de 660 Newtons, nem na tensão máxima, que foi cerca de 75 Megapascal. Os retalhos de fáscia lata apresentaram 44% da força máxima e 37% da tensão máxima do ligamento, no entanto, os retalhos torcidos mostraram maior deformação do que os retalhos retilíneos, alcançando cerca de 70% da deformação do ligamento, sendo essa forma a mais indicada na substituição do ligamento cruzado cranial.Bilateral preparations of fascia lata and cranial cruciate ligament from 15 dogs were tested in Instron machine, model 4482. Dogs were from both sexes, between one and four years of age and weighing in average about 11.80 ± 1.99kg. Fascia lata strips were tested straight and twisted and the cranial cruciate ligaments were tested with an angle of 135° between the femur and tibia and 0°, 15° of external tibial rotation and 15° of internal tibial rotation in relation to femur. The traction test velocity was 8.47mm per second. The maximum force of fascia lata strips was of approximately 290 Newtons and the maximum stress, 28 Megapascal. Similar results of strength and stress

A Simple Technique of Supine Craniospinal Irradiation

International Nuclear Information System (INIS)

Munshi, Anusheel; Jalali, Rakesh

2008-01-01

We describe a simple procedure of craniospinal irradiation in supine position. The procedure was carried out with a 100-cm isocenter linear accelerator and compatible simulator. Treatment was with a 1 or 2 posteroanterior (PA)-directed spinal fields abutting lateral-directed cranial fields. Abutment of the fields was established by placement of markers on the neck of the patient, which provided a measure of the divergence of the spinal field. The precision and reproducibility of this technique, including the placement of junctions, appeared to be as good as for treatment in the prone position. The same could be verified with port films. We conclude that this new technique of supine craniospinal treatment is a simple and convenient alternative to traditional treatment in the prone position

Surgical pitfalls with custom-made porous hydroxyapatite cranial implants

Directory of Open Access Journals (Sweden)

Bruno Zanotti

2015-03-01

Full Text Available Aim: Cranioplasty implants are used primarily in cases of surgical cranial decompression following pathological elevations of intracranial pressure. Available bone substitutes include porous hydroxyapatite (HA and polymethylmethacrylate. Whichever material is used, however, prosthetic cranial implants are susceptible to intra- and postsurgical complications and even failure. The aim of this study was to investigate such occurrences in HA cranioplasty implants, seeking not only to determine the likely causes (whether correlated or not with the device itself but also, where possible, to suggest countermeasures. Methods: We analyzed information regarding failures or complications reported in postmarketing surveillance and clinical studies of patients treated worldwide with custom-made HA cranial implants (Custom Bone Service Fin-Ceramica Faenza, Italy in the period 1997-2013. Results: The two most common complications were implant fractures (84 cases, 2.9% of the total fitted and infections (51 cases, 1.77%. Conclusion: Although cranioplasties are superficial and not difficult types of surgery, and use of custom-made implants are often considered the "easy" option from a surgical perspective, these procedures are nonetheless plagued by potential pitfalls. If performed well they yield more than satisfactory results from the points of view of both the patient and surgeon, but lack of appropriate care can open the door to numerous potential sources of failure, which can compromise-even irreparably-the ability to heal.

Cranial nerves - spectrum of inflammatory and tumorous changes; Hirnnerven - Spektrum entzuendlicher und tumoroeser Veraenderungen

Energy Technology Data Exchange (ETDEWEB)

Nemec, S.F.; Kasprian, G.; Nemec, U.; Czerny, C. [Universitaetsklinik fuer Radiodiagnostik, Medizinische Universitaet Wien, Klinische Abteilung fuer Neuroradiologie und muskuloskelettale Radiologie, Wien (Austria)

2009-07-15

Inflammatory processes as well as primary and secondary tumorous changes may involve cranial nerves causing neurological deficits. In addition to neurologists, ENT physicians, ophthalmologists and maxillofacial surgeons, radiologists play an important role in the investigation of patients with cranial nerve symptoms. Multidetector computed tomography (MDCT) and particularly magnetic resonance imaging (MRI) allow the depiction of the cranial nerve anatomy and pathological neural changes. This article briefly describes the imaging techniques in MDCT and MRI and is dedicated to the radiological presentation of inflammatory and tumorous cranial nerve pathologies. (orig.) [German] Entzuendliche Prozesse sowie primaere und sekundaere tumoroese Veraenderungen koennen Hirnnerven mitbeteiligen und so zu neurologischen Defiziten fuehren. Neben dem Neurologen, HNO-Arzt, Augenarzt und Kiefer-Gesichts-Chirurgen kommt dem Radiologen eine besondere Bedeutung bei der Abklaerung von Patienten mit Hirnnervensymptomatik zu. Die Multidetektorcomputertomographie (MDCT) und insbesondere die Magnetresonanztomographie (MRT) ermoeglichen die Darstellung der Hirnnervenanatomie sowie der nervalen pathologischen Veraenderungen. Der vorliegende Artikel beschreibt kurz gefasst die bildgebenden Techniken von MDCT und MRT und widmet sich der radiologischen Bildgebung entzuendlicher und tumoroeser Hirnnervenveraenderungen. (orig.)

The imaging anatomical consideration of the resonance of the cranial cavity

International Nuclear Information System (INIS)

Lee, Dong Myoung

2000-01-01

Because vocal technique is the basis of singing a song beautifully, so this study was undertaken to use the scientific and correct technique in order to get much better musical expressions. Shimadzu X-ray remote control TV system was used for checking the supporting state of diaphragmatic respiration after 5, 10, 15, 20, 25 and 30 sec during phonation in the state of full inhalation between professional singer and non-professional singer. Shimadzu Magnet nex-α(SMT-50CX/H) was used for examining the scattering state from the resonance of nasal caity to that of cranial cavity on the basis of diaphragmatic respiration. The results obtained were summerized as follows: 1. The resonance of cranial cavity must be scattered by the energy of diaphragmatic respiration after gathering the foci of the fundamental 5 vowels. 2. While raising the epiglottis, the resonance of nasal cavity must be clearly in order to maintain the resonance of cranial cavity beautifully. 3. We can get musical expressions by maintaining the elasticity of diaphragmatic respiration.=20

The evolution of cerebellar tonsillar herniation after cranial vault remodeling surgery.

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Leikola, J; Hukki, A; Karppinen, A; Valanne, L; Koljonen, V

2012-10-01

We sought to examine the pre- and postoperative changes of cerebellar tonsillar herniation by MR imaging in asymptomatic pediatric patients with nonsyndromic, single-suture craniosynostosis (N-SSSC), who underwent cranial vault remodeling surgery without suboccipital decompression. We required cerebellar tonsillar herniation through foramen magnum ≥3 mm for Chiari type I malformation (CMI). We hypothesized that the increase of intracranial volume by cranial vault remodeling would correct the asymptomatic CMI. We identified 9 patients among 121 N-SSSC children undergoing craniofacial surgery from January 2004 to October 2010 with CMI. However, two of them were excluded from the study due to missing postoperative MR images. In the final study population, six were males, five were scaphocephalic, while two were diagnosed with coronal synostosis. In four of the cases, the CMI was decreased in postoperative MR imaging varying from 6 to 12 mm. In three cases, the herniation remained stable. The median change of cerebellar tonsillar herniation was -6.5 mm. We conclude that asymptomatic patients with existing CMI may benefit from cranial vault remodeling surgery alone increasing the intracranial volume.

[Neurological paleopathology in the pre-Columbian cultures of the coast and the Andean plateau (I). Artificial cranial deformation].

Science.gov (United States)

Carod Artal, F J; Vázquez Cabrera, C B

The aim of this work was to study the cranial trepanations and deformations carried out by the ancient Paraca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. Cranial deformation was more common in the Andean regions and was performed by putting little pieces of wood or compressive bandages on newborn infants' heads in order to modify the growth axis of the cranial cavity. Cranial deformations were performed for aesthetic and magic religious reasons, but were also used as a means of ethnic or social identification, as a symbol of nobility or to distinguish the ruling classes. The immediate consequence of such deformation was the modification of the normal process by which the cranial sutures close. There is a significant correlation between the presence of posterior and lateral wormian bones, according to the degree of artificial deformation. The persistence of metopic suture and exostosis of the outer ear canal have been found in 5% of the skulls belonging to pre Columbine mummies. Other paleopathological findings include cranial fractures (7%), porotic hyperostosis (25% of children's skulls), spina bifida occulta, signs of spinal disk arthrosis and Pott's disease. Artificial cranial deformation was a very widespread practice in the Andean regions in pre Columbine times.

Skull Base Meningiomas and Cranial Nerves Contrast Using Sodium Fluorescein: A New Application of an Old Tool.

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da Silva, Carlos Eduardo; da Silva, Vinicius Duval; da Silva, Jefferson Luis Braga

2014-08-01

Objective The identification of cranial nerves is one of the most challenging goals in the dissection of skull base meningiomas. The authors present an application of sodium fluorescein (SF) in skull base meningiomas with the purpose of improving the identification of cranial nerves. Design A prospective study within-subjects design. Setting Hospital Ernesto Dornelles, Porto Alegre, Brazil. Participants Patients with skull base meningiomas. Main Outcomes Measures Cranial nerve identification. Results The group of nine meningiomas was composed of one cavernous sinus, three petroclival, one tuberculum sellae, two sphenoid wing, one olfactory groove, and one temporal floor meningioma. The SF enhancement in all tumors was strong, and the contrast with cranial nerves clearly evident. There were one definite olfactory nerve deficit, one transient abducens deficit, and one definite hemiparesis. All lesions were resected (Simpson grades 1 and 2). The analysis of the difference of the delta SF wavelength between the meningiomas and cranial nerve contrast was performed by the Wilcoxon signed rank test and showed p = 0.011. Conclusions The contrast between the enhanced meningiomas and cranial nerves was evident and assisted in the visualization and microsurgical dissection of these structures. The anatomical preservation of these structures was improved using the contrast.

Intracranial schwannomas arising from cranial nerves: Case series and review of literature

Directory of Open Access Journals (Sweden)

Rashmeet Kaur

2017-01-01

Full Text Available Tumors arising from the cranial nerve sheath are common intracranial neoplasms, with only few articles describing their imaging characteristics. In this present study of four cases of schwannomas originating from the cranial nerves in the head region, we are discussing the radiological features on imaging with the clinical presentation and contrasting them with other differentials in their respective locations. Magnetic resonance imaging and computed tomography were done in these cases and correlated with clinical and biopsy findings.

Potential Involvement of Draxin in the Axonal Projection of Cranial Nerves, Especially Cranial Nerve X, in the Chick Hindbrain.

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Zhang, Sanbing; Cui, Huixian; Wang, Lei; Kang, Lin; Huang, Guannan; Du, Juan; Li, Sha; Tanaka, Hideaki; Su, Yuhong

2016-07-01

The appropriate projection of axons within the nervous system is a crucial component of the establishment of neural circuitry. Draxin is a repulsive axon guidance protein. Draxin has important functions in the guidance of three commissures in the central nervous system and in the migration of neural crest cells and dI3 interneurons in the chick spinal cord. Here, we report that the distribution of the draxin protein and the location of 23C10-positive areas have a strong temporal and spatial correlation. The overexpression of draxin, especially transmembrane draxin, caused 23C10-positive axon bundles to misproject in the dorsal hindbrain. In addition, the overexpression of transmembrane draxin caused abnormal formation of the ganglion crest of the IX and X cranial nerves, misprojection of some anti-human natural killer-1 (HNK-1)-stained structures in the dorsal roof of the hindbrain, and a simultaneous reduction in the efferent nerves of some motoneuron axons inside the hindbrain. Our data reveal that draxin might be involved in the fascicular projection of cranial nerves in the hindbrain. © 2016 The Histochemical Society.

Disorders of the lower cranial nerves

Science.gov (United States)

Finsterer, Josef; Grisold, Wolfgang

2015-01-01

Lesions of the lower cranial nerves (LCN) are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid, or the tongue muscles. To correctly assess manifestations of LCN lesions, precise knowledge of the anatomy and physiology of the area is required. PMID:26167022

Prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results

International Nuclear Information System (INIS)

Packer, R.J.; Sutton, L.N.; Atkins, T.E.; Radcliffe, J.; Bunin, G.R.; D'Angio, G.; Siegel, K.R.; Schut, L.

1989-01-01

As survival rates have risen for children with malignant primary brain tumors, so has the concern that many survivors have significant permanent cognitive deficits. Cranial irradiation (CRT) has been implicated as the major cause for cognitive dysfunction. To clarify the etiology, incidence, and severity of intellectual compromise in children with brain tumors after CRT, a prospective study was undertaken comparing the neuropsychological outcome in 18 consecutive children with malignant brain tumors treated with CRT to outcome in 14 children harboring brain tumors in similar sites in the nervous system who had not received CRT. Children with cortical or subcortical brain tumors were not eligible for study. Neuropsychological testing was performed after surgery prior to radiotherapy, after radiotherapy, and at 1- and 2-year intervals thereafter. Children who had received CRT had a mean full-scale intelligence quotient (FSIQ) of 105 at diagnosis which fell to 91 by Year 2. Similar declines were noted in their performance intelligence quotient (IQ) and verbal IQ. After CRT, patients demonstrated a statistically significant decline from baseline in FSIQ (p less than 0.02) and verbal IQ (p less than 0.04). Children who had not received CRT did not demonstrate a fall in any cognitive parameter over time. The decline between baseline testing and testing performed at Year 2 in patients who had CRT was inversely correlated with age (p less than 0.02), as younger children demonstrated the greatest loss of intelligence. Children less than 7 years of age at diagnosis had a mean decline in FSIQ of 25 points 2 years posttreatment. No other clinical parameter correlated with the overall IQ or decline in IQ. After CRT, children demonstrated a wide range of dysfunction including deficits in fine motor, visual-motor, and visual-spatial skills and memory difficulties

Ruptura do ligamento cruzado cranial em um gato: reconstituição com fáscia lata Cranial cruciate ligament rupture in a cat: reconstitution with fascia lata

Directory of Open Access Journals (Sweden)

Érika Fernanda Villamayor Garcia

2012-08-01

Full Text Available Em gatos, a ruptura do ligamento cruzado cranial (RLCC trata-se de diagnóstico raro e a correção cirúrgica propicia o retorno mais rápido à função do membro. Foi atendida, no Hospital Veterinário da Universidade Federal de Santa Maria (UFSM, uma gata apresentando claudicação aguda e dor à palpação do joelho direito. O diagnóstico de RLCC foi realizado através dos testes de compressão tibial e gaveta cranial positivos e confirmado na cirurgia. Optou-se por realizar a reconstituição do ligamento com fáscia lata e, após achados clínicos pós-operatórios e em longo prazo concluiu-se que a técnica apresentou resultados satisfatórios neste caso.The cranial cruciate ligament rupture (CCLR is rare diagnosis in cats and the surgical correction provides a faster return to limb function. A cat with acute lameness and pain on palpation of the right stifle was attended at the Veterinary Hospital of UFSM. The diagnosis of CCLR was performed by positive tibial compression test and positive cranial drawer sign and confirmed by surgery. We chose to perform the reconstruction of the ligament with fascia lata and after of the observe clinical postoperative and in the long-term it was concluded that the technique showed satisfactory results in this case.

Motor palsies of cranial nerves (excluding VII) after vaccination: reports to the US Vaccine Adverse Event Reporting System.

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Woo, Emily Jane; Winiecki, Scott K; Ou, Alan C

2014-01-01

We reviewed cranial nerve palsies, other than VII, that have been reported to the US Vaccine Adverse Event Reporting System (VAERS). We examined patterns for differences in vaccine types, seriousness, age, and clinical characteristics. We identified 68 reports of cranial nerve palsies, most commonly involving the oculomotor (III), trochlear (IV), and abducens (VI) nerves. Isolated cranial nerve palsies, as well as palsies occurring as part of a broader clinical entity, were reported. Forty reports (59%) were classified as serious, suggesting that a cranial nerve palsy may sometimes be the harbinger of a broader and more ominous clinical entity, such as a stroke or encephalomyelitis. There was no conspicuous clustering of live vs. inactivated vaccines. The patient age range spanned the spectrum from infants to the elderly. Independent data may help to clarify whether, when, and to what extent the rates of cranial nerve palsies following particular vaccines may exceed background levels.

Clinical anatomy and imaging of the cranial nerves and skull base.

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Jha, Ruchira M; Klein, Joshua P

2012-09-01

Evaluation of patients with cranial neuropathies requires an understanding of brainstem anatomy and nerve pathways. Advances in neuroimaging, particularly high spatial resolution magnetic resonance imaging (MRI), have enabled visualization of these tiny structures and their related pathology. This review provides an approach toward using imaging in the evaluation of cranial nerve (CN) and skull base anatomy and pathology. Because brainstem nuclei are inextricably linked to the information contained within CNs, they are briefly mentioned whenever relevant; however, a comprehensive discussion of brainstem syndromes is beyond the scope of this review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Radiation therapy for pineal tumors: 30-year experience at Thomas Jefferson University Hospital

International Nuclear Information System (INIS)

Dickerson, G.A.; Tupchong, L.; Moylan, D.J.; Kramer, S.

1987-01-01

Eighteen tumors of the pineal region were treated at Thomas Jefferson University Hospital since 1957. Preoperative evaluation included CT scan in 11 patients and cerebrospinal fluid cytology in four. Histologic diagnosis was obtained in nine patients. Diagnosis in two other patients was based on CT scan response at 2,000 cGY. Fifteen patients received whole-brain irradiation with a boost, one each with limited-field and whole-brain irradiation only. One patient with melanoma received craniospinal irradiation. Median pineal dose was 55 Gy; range, 50-60 Gy. Five treatment failures occurred, four local and one distant. Actuarial survival was 80%, 70%, and 65% at 5, 10, and 20 years. Median follow-up was 8.8 years. Cranial radiotherapy alone appears to control the majority of pineal tumors

Cranial thickness in relation to age, sex and general body build in a Danish forensic sample

DEFF Research Database (Denmark)

Lynnerup, N

2001-01-01

thickness and these parameters. This study, thus, adds to other studies showing that cranial thickness cannot be used in aging or sexing human remains. Likewise, in a forensic pathological setting, cranial thickness cannot be inferred from the individuals stature and build, which may be an issue in cases......The cranial thickness was measured in 64 individuals (43 males, 21 females) autopsied at our institute. The thickness was measured by taking a biopsy with a trephine at four specific locations on the skull. Complete medical records and pathologic autopsy results were available. While none...

Brief communication: human cranial variation fits iterative founder effect model with African origin.

Science.gov (United States)

von Cramon-Taubadel, Noreen; Lycett, Stephen J

2008-05-01

Recent studies comparing craniometric and neutral genetic affinity matrices have concluded that, on average, human cranial variation fits a model of neutral expectation. While human craniometric and genetic data fit a model of isolation by geographic distance, it is not yet clear whether this is due to geographically mediated gene flow or human dispersal events. Recently, human genetic data have been shown to fit an iterative founder effect model of dispersal with an African origin, in line with the out-of-Africa replacement model for modern human origins, and Manica et al. (Nature 448 (2007) 346-349) have demonstrated that human craniometric data also fit this model. However, in contrast with the neutral model of cranial evolution suggested by previous studies, Manica et al. (2007) made the a priori assumption that cranial form has been subject to climatically driven natural selection and therefore correct for climate prior to conducting their analyses. Here we employ a modified theoretical and methodological approach to test whether human cranial variability fits the iterative founder effect model. In contrast with Manica et al. (2007) we employ size-adjusted craniometric variables, since climatic factors such as temperature have been shown to correlate with aspects of cranial size. Despite these differences, we obtain similar results to those of Manica et al. (2007), with up to 26% of global within-population craniometric variation being explained by geographic distance from sub-Saharan Africa. Comparative analyses using non-African origins do not yield significant results. The implications of these results are discussed in the light of the modern human origins debate. (c) 2007 Wiley-Liss, Inc.