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Sample records for skull fractures

  1. Infant skull fracture (image)

    Science.gov (United States)

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent ... or blow can result in fracture of the skull and may be accompanied by injury to the ...

  2. Anisotropic composite human skull model and skull fracture validation against temporo-parietal skull fracture.

    Science.gov (United States)

    Sahoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2013-12-01

    A composite material model for skull, taking into account damage is implemented in the Strasbourg University finite element head model (SUFEHM) in order to enhance the existing skull mechanical constitutive law. The skull behavior is validated in terms of fracture patterns and contact forces by reconstructing 15 experimental cases. The new SUFEHM skull model is capable of reproducing skull fracture precisely. The composite skull model is validated not only for maximum forces, but also for lateral impact against actual force time curves from PMHS for the first time. Skull strain energy is found to be a pertinent parameter to predict the skull fracture and based on statistical (binary logistical regression) analysis it is observed that 50% risk of skull fracture occurred at skull strain energy of 544.0mJ. © 2013 Elsevier Ltd. All rights reserved.

  3. CT findings in patient with skull fractures

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Han Gi; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1988-12-15

    CT scan has been inevitable method for patient with head trauma. CT scans of 94 cases, which were confirmed skull fracture by plain film, were reviewed for better and useful dealing of CT. The results were as follows: 1. Car accident was the most frequent cause of head injury. 2. No evidence of intracranial abnormality in CT scan of skull fractures on plane film was 45.7%, and alert mentality was 46.8% of skull fracture on skull fracture on simple film. 3. Detection rate on CT scan to skull fractures was 27.7%, but detection rate to depression fractures of skull fracture was 70.2%. 4. Mortality rate of patients with skull fracture was 10.6%. 5. Associated CT findings were pneumocephalus on CT scan 3.2%, contusion of edema 4.2%, epidural hematoma 16.0%, subdural hematoma 17.0%, subdural hygroma 2.1%, intracerebral hemorrhage 4.9%, and subarachnoid hemorrhage 2.0%.

  4. Computerized tomographic diagnosis of basal skull fracture

    International Nuclear Information System (INIS)

    Tanaka, Tokutaro; Shimoyama, Ichiro; Endoh, Mitsutoshi; Ninchoji, Toshiaki; Uemura, Kenichi.

    1984-01-01

    The diagnosis of basal skull fractures used to be difficult, particularly on the basis of routine skull roentgenography alone. We have now examined the diagnostic value of conventional computerized tomography in basal skull fractures. We studied 82 cases clinically diagnosed as basal skull fractures. We examined them based on at least one of the following computerized tomographic criteria for basal skull fractures: 1) fracture line(s), 2) intracranial air, 3) fluid in the paranasal sinuses, and 4) fluid in the middle ear, including the mastoid air cells. The signs of the fracture line and of the intracranial air are definite indications of basal skull fracture, but the signs of fluid in the paranasal sinuses and/or in the middle ear are not definite. When combined, however, with such other clinical signs as black eye, Battle's sign, CSF leakage, CSF findings, and profuse nasal or ear bleeding, the diagnosis is more reliable. Seventy cases (85.4%) in this series had basal skull fractures according to our computerized tomographic criteria. Among them , 26 cases (31.7%) were diagnosed with fracture lines, 17 cases (20.7%) with intracranial air, 16 cases (19.5%) with fluid in the paranasal sinuses, 10 cases (12.2%) with fluid in the middle ear, and one case (1.2%) with fluid in both. Twelve cases (14.6%) of the 82 cases clinically diagnosed as basal skull fractures could not have been diagnosed on our computerized tomographic criteria alone. We diagnosed them because of CSF leakage, CSF findings, surgical findings, etc. (author)

  5. Paraperesis: A rare complication after depressed skull fracture ...

    African Journals Online (AJOL)

    Paraperesis: A rare complication after depressed skull fracture. ... presentations, but midline depressed skull fracture presenting as motor weakness of both lower ... Patient was managed conservatively, made remarkable recovery and was ...

  6. Periorbital skull fractures in five horses

    International Nuclear Information System (INIS)

    Caron, J.P.; Barber, S.M.; Bailey, J.V.; Fretz, P.B.; Pharr, J.W.

    1986-01-01

    Periorbital skull fractures were diagnosed in 5 horses, and were associated with ophthalmic complications including corneal ulceration, uveitis, and entrapment of the eye by retrobulbar bone fragments. Physical examination was of greater diagnostic use than radiography. Surgical repair was performed on all horses and was associated with a more favorable postoperative appearance in horses treated acutely; however, the cosmetic results were considered acceptable in all horses. Major postoperative complications were not observed

  7. Frequency of extradural haematoma in patients with linear skull fracture

    International Nuclear Information System (INIS)

    Aurangzeb, A.; Afridi, E.A.K.; Khan, S.A.

    2015-01-01

    Apparently normal looking patients after traumatic brain injury can have serious neurological deterioration, and one of the common causes of such deterioration is extradural haematomas. This study was conducted to determine the frequency of extradural hematoma and common types of trauma leading to it among patients presenting with skull fracture due to head injury. Methods: This cross-sectional study was conducted in the department of Neurosurgery Ayub Medical College, Abbottabad from June 2011 to June 2012. All patients who were suspected to have Skull fracture on X-ray skull, during the study period, were included in study after informed consent and later on CT-Scan brain was done to see for extradural hematoma. Findings were recorded on a predesigned proforma including demographic data, radiological findings and the type of head trauma. Results: Out of 114 patients 85 (74.5%) were males and 29 (225.4%) were females. Age ranged from 2 to 70 years (18.23 ± 16.5 years). Among these patients the most important cause of head injury was fall from height in 65(57%), followed by road traffic accidents in 39 (34.2%), and assault in 10 (8.8%) patients. The most common site of fracture was parietal in 49 (43%) of patients, followed by frontal bone in 28 (24.6%) of patients, occipital bone in 24 (21.1%) of patients, and temporal bone in 23 (20.2%) of patients. Frequency of extradural hematoma among linear skull fracture was in 34 (29.8%) patients. Extradural hematoma was most common with parietotemporal linear skull fractures (73.5%). Conclusion: Extradural haematoma occurs commonly with linear skull fractures, so patients with linear skull fracture should be properly evaluated with CT brain. (author)

  8. The contribution of high-resolution multiplanar reformats of the skull base to the detection of skull-base fractures

    International Nuclear Information System (INIS)

    Connor, S.E.J.; Flis, C.

    2005-01-01

    AIM: To investigate the contribution of routine review of submillimetric multiplanar reformats to the diagnosis of skull-base fractures. METHODS: A prospective analysis was performed of 407 cases referred over a 6-month period for CT of the skull following cranial trauma. The reformatted 5-mm axial sections and subsequently the high-resolution multiplanar reformats (HRMPRs) were viewed on an ADW 4.1 workstation using bone windows and algorithm. All skull-base fractures and related features, recorded by the consensus of two radiologists, were classified as anatomically significant or non-significant on the basis of eight criteria. The clinical features of skull-base injury and any subsequent treatment were noted in all cases of skull-base fracture. RESULTS: HRMPRs detected 80 separate skull-base fractures in 36/407 cases. Of these 80 fractures, 57 were visible on 5-mm axial sections. In 8 of the 36 cases, the significant anatomical features were only evident on review of the HRMPRs. In 6 of the 36 cases, none of the skull-base fractures was visible on 5-mm sections, but these individuals had only minor associated clinical features and no therapeutic requirements. Review of HRMPRs could have been confined to patients with skull-base fractures, abnormal intracranial and extracranial air collections or opacified mastoid air cells revealed by 5-mm axial sections. This policy would have led to the detection of 79/80 (99%) of skull-base fractures and all significant anatomical features. CONCLUSION: The 5-mm axial sections demonstrated 71% of skull-base fractures and 78% of skull-base fractures with significant anatomical features, using HRMPRs as a gold standard. There were no significant clinical sequelae at short-term follow-up of those fractures only evident on HRMPRs

  9. The Growing-Skull Fracture of Childhood

    African Journals Online (AJOL)

    A Black female, aged 2 months, was brought to the hospital on 20 January 1973, after being dropped from a ... A Black male, aged 16 months, was referred from. Butterworth in the Transkei, because his mother had ... Alajouanine and Thurel,' that at least some of the holes found in ancient skulls, long cited by archaeologists ...

  10. Surveillance for work-related skull fractures in Michigan.

    Science.gov (United States)

    Kica, Joanna; Rosenman, Kenneth D

    2014-12-01

    The objective was to develop a multisource surveillance system for work-related skull fractures. Records on work-related skull fractures were obtained from Michigan's 134 hospitals, Michigan's Workers' Compensation Agency and death certificates. Cases from the three sources were matched to eliminate duplicates from more than one source. Workplaces where the most severe injuries occurred were referred to OSHA for an enforcement inspection. There were 318 work related skull fractures, not including facial fractures, between 2010 and 2012. In 2012, after the inclusion of facial fractures, 316 fractures were identified of which 218 (69%) were facial fractures. The Bureau of Labor Statistic's (BLS) 2012 estimate of skull fractures in Michigan, which includes facial fractures, was 170, which was 53.8% of those identified from our review of medical records. The inclusion of facial fractures in the surveillance system increased the percentage of women identified from 15.4% to 31.2%, decreased severity (hospitalization went from 48.7% to 10.6% and loss of consciousness went from 56.5% to 17.8%), decreased falls from 48.2% to 27.6%, and increased assaults from 5.0% to 20.2%, shifted the most common industry from construction (13.3%) to health care and social assistance (15.0%) and the highest incidence rate from males 65+ (6.8 per 100,000) to young men, 20-24 years (9.6 per 100,000). Workplace inspections resulted in 45 violations and $62,750 in penalties. The Michigan multisource surveillance system of workplace injuries had two major advantages over the existing national system: (a) workplace investigations were initiated hazards identified and safety changes implemented at the facilities where the injuries occurred; and (b) a more accurate count was derived, with 86% more work-related skull fractures identified than BLS's employer based estimate. A more comprehensive system to identify and target interventions for workplace injuries was implemented using hospital and

  11. Imaging basilar skull fractures in the horse: a review

    International Nuclear Information System (INIS)

    Ramirez, O. III; Jorgensen, J.S.; Thrall, D.E.

    1998-01-01

    Due to the complex nature of the anatomy of the equine head, superimposition of numerous structures, and poor soft tissue differentiation, radiography may be of limited value in the diagnosis of basilar skull fractures. However, in many horses radiographic changes such as soft tissue opacification of the guttural pouch region, irregular bone margination at the sphenooccipital line, attenuation of the nasopharynx, ventral displacement of the dorsal pharyngeal wall and the presence of irregularly shaped bone fragments in the region of the guttural pouches are suggestive of a fracture of the skull base. These findings in conjunction with physical examination findings and historical information may lead to a presumptive diagnosis of a fracture. When available and when the patient will accommodate the equipment, computed tomography may give a definitive diagnosis owing to its superior resolution and differentiation of soft tissue structures

  12. Large intradiploic growing skull fracture of the posterior fossa

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  13. Infection in compound depressed fracture of the skull

    International Nuclear Information System (INIS)

    Rehman, L.; Ghani, E.; Hussain, A.; Shah, A.; Noman, M.A.; Zaman, U.K.

    2007-01-01

    To find out the association of wound infection with dural tear, free bone fragments and late presentation in patients operated for compound depressed fracture of the skull. There were 56 patients with compound depressed fracture of the skull, who were operated in the department. Their clinical, radiological and operative findings were studied. The postoperative condition of the wound was noted. The patients were followed up for six months. All of them were given antibiotics. The mode of trauma, time of arrival and site of fracture were noted. The mean age, male to female ratio and rate of postoperative wound infection were determined. Among the 56 patients operated for compound depressed fracture, there were 30 adults and 26 children. Male to female ratio was 4.6:1. Mean age was 21.7 years. Major mode of trauma in children was fall, while most of the adult patients presented with history of assault and RTA. There were 71.42% fractures in frontal and parietal regions. Three patients (5.35%) got wound infection postoperatively. Dural tear, free bone fragments and late presentation (more than 8 hours after trauma) were the important risk factors. Early surgery and proper debridement with antibiotic cover play an important role in reducing the rate of wound infection. (author)

  14. Brain CT findings in head injury with skull fracture

    International Nuclear Information System (INIS)

    Jeong, In Tae; Lee, Hae Kyung; Chung, Mi Kyung; Kwon, Kwi Hyang; Kim, Ki Jeong

    1982-01-01

    CT has revolutionized the evaluation and management of patients with head injuries. CT in non-invasion and rapidly provides accurate information regarding the presence, extent and nature of intracranial lesions resulting from trauma. We have reviewed the CT scans of 114 patients, who got head injury with confirmed to skull fracture in plain films. The results were as follows: 1. Of all cases, traffic accident was the most frequent cause and in children fall down was more than 50%. 2. Compound linear fracture was the most frequent type fractures in plain skull film.3. Of all 114 cases, epidural hematoma was 16%, subdural hematoma was 18.4%, intracerebral hematoma was 14.4%, subdural hygroma was 2.4%, normal finding was 50%. 4. Mortality rate was 13.2%. 5. Fracture was detected by CT about 28.9%, depression fracture was more easily detected in CT. 6. Incidence rate of counter coup lesion was 14.9% and mortality rate was higher than same site lesion. 7. The shape of epidural hematoma was biconvex in 75%, planoconvex in 25%. 8. The shape of subdural hematoma was cresentic shape 82.6%, biconvex shape 8.7%, planoconvex shape 8.7%

  15. Cerebral Venous Air Embolism due to a Hidden Skull Fracture Secondary to Head Trauma

    Directory of Open Access Journals (Sweden)

    Ai Hosaka

    2015-01-01

    Full Text Available Cerebral venous air embolism is sometimes caused by head trauma. One of the paths of air entry is considered a skull fracture. We report a case of cerebral venous air embolism following head trauma. The patient was a 55-year-old man who fell and hit his head. A head computed tomography (CT scan showed the air in the superior sagittal sinus; however, no skull fractures were detected. Follow-up CT revealed a fracture line in the right temporal bone. Cerebral venous air embolism following head trauma might have occult skull fractures even if CT could not show the skull fractures.

  16. Three-dimensional reconstruction used in the diagnosis and treatment of depressed fracture of skull

    International Nuclear Information System (INIS)

    Li Liang; Luo Zhikun; Lin Xiaohui; Liu Shuyi; Chen Xu; Liu Chenghui

    2005-01-01

    Objective: To evaluate three-dimensional reconstruction used in the diagnosis and management of depressed fracture of skull. Methods: The images of CT scan and three-dimensional reconstruction in 23 patients with depressed fracture of skull were studied. The clinical treatment was guided by the images. Results: The fracture site and depth in all 23 cases were well demonstrated in the imaging of three-dimensional reconstruction, which successfully guided the clinical management in every case. Conclusion: Three-dimensional reconstruction is a valuable modality for the diagnosis and management of depressed fracture of skull. (authors)

  17. Creation of a High-fidelity, Low-cost Pediatric Skull Fracture Ultrasound Phantom.

    Science.gov (United States)

    Soucy, Zachary P; Mills, Lisa; Rose, John S; Kelley, Kenneth; Ramirez, Francisco; Kuppermann, Nathan

    2015-08-01

    Over the past decade, point-of-care ultrasound has become a common tool used for both procedures and diagnosis. Developing high-fidelity phantoms is critical for training in new and novel point-of-care ultrasound applications. Detecting skull fractures on ultrasound imaging in the younger-than-2-year-old patient is an emerging area of point-of-care ultrasound research. Identifying a skull fracture on ultrasound imaging in this age group requires knowledge of the appearance and location of sutures to distinguish them from fractures. There are currently no commercially available pediatric skull fracture models. We outline a novel approach to building a cost-effective, simple, high-fidelity pediatric skull fracture phantom to meet a unique training requirement. © 2015 by the American Institute of Ultrasound in Medicine.

  18. Basilar skull fracture in a Thoroughbred colt: Radiography or computed tomography?

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    Chee Kin Lim

    2013-04-01

    Full Text Available A two-year-old Thoroughbred colt was presented to the Equine Clinic, Onderstepoort Veterinary Academic Hospital for head trauma after rearing and falling backwards, hitting his head on the ground. Following medical therapy for acute onset neurological impairment secondary to a suspected basilar skull fracture, the horse was anaesthetised and computed tomography of the skull was performed. A diagnosis of a comminuted basilar skull fracture was made and skull radiographs were taken for comparison. The horse was subsequently euthanased owing to the poor prognosis; necropsy findings were compatible with imaging findings. The value and limitation of computed tomography versus radiography for the diagnosis of basilar skull fracture are discussed in this report. Introduction

  19. Basilar skull fracture in a Thoroughbred colt: Radiography or computed tomography?

    Directory of Open Access Journals (Sweden)

    Chee Kin Lim

    2013-04-01

    Full Text Available A two-year-old Thoroughbred colt was presented to the Equine Clinic, Onderstepoort Veterinary Academic Hospital for head trauma after rearing and falling backwards, hitting his head on the ground. Following medical therapy for acute onset neurological impairment secondary to a suspected basilar skull fracture, the horse was anaesthetised and computed tomography of the skull was performed. A diagnosis of a comminuted basilar skull fracture was made and skull radiographs were taken for comparison. The horse was subsequently euthanased owing to the poor prognosis; necropsy findings were compatible with imaging findings. The value and limitation of computed tomography versus radiography for the diagnosis of basilar skull fracture are discussed in this report.

  20. A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

    Science.gov (United States)

    Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

    2016-06-01

    Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

  1. Skull wounds linked with blunt trauma (hammer example). A report of two depressed skull fractures--elements of biomechanical explanation.

    Science.gov (United States)

    Delannoy, Yann; Becart, Anne; Colard, Thomas; Delille, Rémi; Tournel, Gilles; Hedouin, Valéry; Gosset, Didier

    2012-09-01

    The lesions of the skull following perforating traumas can create complex fractures. The blunt traumas can, according to the swiftness and the shape of the object used, create a depressed fracture. The authors describe through two clinical cases the lesional characteristic of the blunt traumas, perforating the skull using a hammer. In both cases the cranial lesions were very typical: they were geometrical, square shaped, of the same size than the tool (head and tip of the hammer). On the outer table of the skull, the edges of the wounds were sharp and regular. On the inner table, the edges of the wounds were beveled and irregular. The bony penetration in the depressed fracture results from a rupture of the outer table of the bone under tension, in periphery, by the bend of the bone to the impact (outbending) and then, from the inner table with comminuted bony fragmentation. Breeding on the fractures of the size and the shape of the blunt objects used is inconstant and differs, that it is the objects of flat surface or wide in opposition to those of small surface area. Fractures morphologies depend on one hand on these extrinsic factors and on the other hand, of intrinsic factors (structure of the bone). To identify them, we had previously conducted experimental work on cranial bone samples. The bone was submitted to a device for three-point bending. This work had shown properties of thickness and stiffness of the various areas of the vault. Our cases are consistent with these results and illustrate the variability of bone lesions according to region and mode of use of blunt weapons. Many studies have identified criteria for identification of the weapons and the assistance of digital and biomechanical models will be an invaluable contribution with this aim in the future. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Growing skull fracture - rupture of coronal suture caused by vacuum extraction

    International Nuclear Information System (INIS)

    Hansen, K.N.; Pedersen, H.; Petersen, M.B.

    1987-01-01

    Growing skull fracture is a well known complication to calvarian fracture with underlying dural tear and brain injury in infancy and early childhood. This has been reported in three cases after forceps delivery. To our best knowledge it has never been described after disruption of a calvarian suture caused by vacuum extraction delivery. (orig.)

  3. Performance of computed tomography of the head to evaluate for skull fractures in infants with suspected non-accidental trauma

    Energy Technology Data Exchange (ETDEWEB)

    Culotta, Paige A.; Tran, Quynh-Anh; Donaruma-Kwoh, Marcella [Texas Children' s Hospital, Section of Public Health Pediatrics, Baylor College of Medicine, Houston, TX (United States); Crowe, James E.; Jones, Jeremy Y.; Mehollin-Ray, Amy R.; Tran, H.B.; Dodge, Cristina T. [Texas Children' s Hospital, The Edward B. Singleton, MD, Department of Pediatric Radiology, Baylor College of Medicine, Houston, TX (United States); Camp, Elizabeth A. [Texas Children' s Hospital, Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Cruz, Andrea T. [Texas Children' s Hospital, Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Texas Children' s Hospital, Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)

    2017-01-15

    Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma. This was a retrospective (2013-2014) cross-sectional study of infants evaluated for abusive head trauma via both skull radiographs and CT with 3-D reconstruction. The reference standard was skull radiography. All studies were read by pediatric radiologists and neuroradiologists, with ten percent read by a second radiologist to evaluate for interobserver reliability. One hundred seventy-seven children (47% female; mean/median age: 5 months) were included. Sixty-two (35%) had skull fractures by radiography. CT with 3-D reconstruction was 97% sensitive (95% confidence interval [CI]: 89-100%) and 94% specific (CI: 87-97%) for skull fracture. There was no significant difference between plain radiographs and 3-D CT scan results (P-value = 0.18). Kappa was 1 (P-value <0.001) between radiologist readings of CTs and 0.77 (P = 0.001) for skull radiographs. CT with 3-D reconstruction is equivalent to skull radiographs in identifying skull fractures. When a head CT is indicated, skull radiographs add little diagnostic value. (orig.)

  4. Congenital depressed skull fracture in the absence of trauma: case report and literature review

    Directory of Open Access Journals (Sweden)

    Tovar-Spinoza ZS

    2012-02-01

    Full Text Available Zulma S Tovar-Spinoza, Peter D KimDepartment of Neurosurgery, SUNY Upstate Medical University, Syracuse NYAbstract: There are limited reports of neonatal depressed skull fractures in the absence of any known trauma or obvious risk factors. Here we describe a male neonate with a significant frontal nontraumatic depressed fracture, his course of treatment, and a literature review. A male neonate was attended for a significant congenital depressed skull fracture in the left frontal bone. He was born full term after an uncomplicated delivery to a multiparous mother who was a human immunodeficiency syndrome (HIV-positive immigrant from sub-Saharan Africa. The pregnancy was otherwise uncomplicated. There was no history of trauma to the mother during the pregnancy or delivery. Ultrasonography had been unremarkable. No other abnormalities were noted. The patient was brought to the operating room at the age of 13 days for elevation of his fracture due to its nonreducible nature. A small linear incision was made just posterior to the coronal suture. The dura mater was stripped and a combination of Penfield and periostial elevators was used to elevate the depressed fracture. Nontraumatic depressed skull fractures are uncommon in neonates. The cause of this entity has not been identified, and many theories about its origin have been proposed. Treatment can be either surgical or conservative.Keywords: neonatal, congenital, depressed fracture, spontaneous, nontraumatic

  5. Skull Radiography

    Science.gov (United States)

    What you need to know about… Skull Radiography X-ray images of the skull are taken when it is necessary to see the cranium, facial bones or jaw bones. ... Among other things, x-ray exams of the skull can show fractures. Patient Preparation Before the examination, ...

  6. Skull and Posterior Rib Fractures with Respiratory Failure caused by Child Abuse

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    Dzulfikar Djalil Lukmanul Hakim

    2017-03-01

    Full Text Available Background: Presence of multiple fractures suggests child abuse. Skull fractures rarely occurred but posterior rib fractures are commonly found and have high specificity as a radiological finding in child abuse. A respiratory failure can occur as a result of the damage to the osseous structure of the thorax that destabilizes the rib cage and impairs spontaneous breathing mechanism. Methods: A case report of a 6-month-old boy who presented with respiratory failure, multiple bilateral parietal and occipital bone fractures, and also fractures of right rib 5–8. The patient required ventilatory support for 9 days in the Pediatric Intensive Care Unit, Dr.HasanSadikin General Hospital. Results: The patient was on ventilatory support for 9 days, and was given antibiotics for 2 weeks. Next, the patient was referred to the High Care Unit (HCU after the condition was stabilized, and then referred to the ward, for treatment by the Social Pediatric Division. The patient was still having issues about his foster care. Conclusions: Recognition of presence of fractures is important in early diagnosis and treatment of child abuse.

  7. Tip of an Iceberg: Skull Fracture as an Adult Presentation of Encephalocraniocutaneous Lipomatosis

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    Sinead Culleton

    2016-01-01

    Full Text Available The severity of seizures presenting to the emergency department ranges from benign to life threatening. There are also a wide number of possible etiologies. Computed tomography (CT emergency imaging may be required at presentation to elucidate a possible cause and assess signs of intracranial trauma. This case describes a serious seizure episode in a young man while on holiday. A CT brain showed a skull fracture as a consequence of seizure-related head trauma but unexpectedly there were image findings consistent with encephalocraniocutaneous lipomatosis. The important radiological features of encephalocraniocutaneous lipomatosis and a differential diagnosis are presented.

  8. Reappraisal of Pediatric Diastatic Skull Fractures in the 3-Dimensional CT Era: Clinical Characteristics and Comparison of Diagnostic Accuracy of Simple Skull X-Ray, 2-Dimensional CT, and 3-Dimensional CT.

    Science.gov (United States)

    Sim, Sook Young; Kim, Hyun Gi; Yoon, Soo Han; Choi, Jong Wook; Cho, Sung Min; Choi, Mi Sun

    2017-12-01

    Diastatic skull fractures (DSFs) in children are difficult to detect in skull radiographs before they develop into growing skull fractures; therefore, little information is available on this topic. However, recent advances in 3-dimensional (3D) computed tomography (CT) imaging technology have enabled more accurate diagnoses of almost all forms of skull fracture. The present study was undertaken to document the clinical characteristics of DSFs in children and to determine whether 3D CT enhances diagnostic accuracy. Two hundred and ninety-two children younger than 12 years with skull fractures underwent simple skull radiography, 2-dimensional (2D) CT, and 3DCT. Results were compared with respect to fracture type, location, associated lesions, and accuracy of diagnosis. DSFs were diagnosed in 44 (15.7%) of children with skull fractures. Twenty-two patients had DSFs only, and the other 22 had DSFs combined with compound or mixed skull fractures. The most common fracture locations were the occipitomastoid (25%) and lambdoid (15.9%). Accompanying lesions consisted of subgaleal hemorrhages (42/44), epidural hemorrhages (32/44), pneumocephalus (17/44), and subdural hemorrhages (3/44). A total of 17 surgical procedures were performed on 15 of the 44 patients. Fourteen and 19 patients were confirmed to have DSFs by skull radiography and 2D CT, respectively, but 3D CT detected DSFs in 43 of the 44 children (P skull radiography or 2D CT for detecting DSFs. This finding indicates that 3D CT should be used routinely rather than 2D CT for the assessment of pediatric head trauma. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  10. Skull fracture with effacement of the superior sagittal sinus following drone impact: a case report.

    Science.gov (United States)

    Chung, Lawrance K; Cheung, Yuri; Lagman, Carlito; Au Yong, Nicholas; McBride, Duncan Q; Yang, Isaac

    2017-09-01

    The popularity of unmanned aerial vehicles, or drones, raises safety concerns as they become increasingly common for commercial, personal, and recreational use. Collisions between drones and people may result in serious injuries. A 13-year-old male presented with a comminuted depressed skull fracture causing effacement of the superior sagittal sinus secondary to a racing drone impact. The patient experienced a brief loss of consciousness and reported lower extremity numbness and weakness after the accident. Imaging studies revealed bone fragments crossing the superior sagittal sinus with a short, focal segment of blood flow interruption. Neurosurgical intervention was deferred given the patient's improving neurological deficits, and the patient was treated conservatively. He was discharged home in stable condition. Drones may represent a hazard when operated inappropriately due to their capacity to fly at high speeds and altitudes. Impacts from drones can carry enough force to cause skull fractures and significant head injuries. The rising popularity of drones likely translates to an increased incidence of drone-related injuries. Thus, clinicians should be aware of this growing trend.

  11. Treatise on skull fractures by Berengario da Carpi (1460-1530).

    Science.gov (United States)

    Mazzola, Riccardo F; Mazzola, Isabella C

    2009-11-01

    Jacopo Berengario was born in Carpi, a medieval city close to Modena (northern Italy), circa 1460. He studied medicine at Bologna University and, in 1489, graduated in philosophy and medicine. He was appointed lecturer in anatomy and surgery at the same university, a position that he maintained for 24 years. Between 1514 and 1523, Berengario published some important anatomic and surgical works, which gave considerable fame to him.Commentaria... supra Anatomiam Mundini (Commentary... on the Anatomy of Mondino), published in 1521, constitutes the first example of an illustrated anatomic textbook ever printed. The anatomic illustrations were intended for explaining the text. Artistically speaking, the plates are typical examples of the Renaissance period and worthy of the greatest consideration.De Fractura Calvae sive Cranei (On Fracture of the Calvaria or Cranium), published in Bologna in 1518, is the first treatise devoted to head injuries ever printed. It is a landmark in the development of cranial surgery that went through numerous editions. The text was prepared in 2 months and dedicated to Lorenzo de' Medici, Duke of Urbino, who experienced a skull injury in the occipital region. Berengario wanted to demonstrate to other physicians his knowledge of anatomy and his expertise on the brain and head traumas. The book includes the illustration of an entire surgical kit or a corpus instrumentorum for performing cranial operations, which appeared for the first time in a printed book. However, Berengario's highly commendable aim was to indicate to the reader the step-by-step procedure of craniotomy for management of skull fractures along with the sequential use of the previously presented instruments.

  12. Role of preoperative 3-dimensional computed tomography reconstruction in depressed skull fractures treated with craniectomy: a case report of forensic interest.

    Science.gov (United States)

    Viel, Guido; Cecchetto, Giovanni; Manara, Renzo; Cecchetto, Attilio; Montisci, Massimo

    2011-06-01

    Patients affected by cranial trauma with depressed skull fractures and increased intracranial pressure generally undergo neurosurgical intervention. Because craniotomy and craniectomy remove skull fragments and generate new fracture lines, they complicate forensic examination and sometimes prevent a clear identification of skull fracture etiology. A 3-dimensional reconstruction based on preoperative computed tomography (CT) scans, giving a picture of the injuries before surgical intervention, can help the forensic examiner in identifying skull fracture origin and the means of production.We report the case of a 41-year-old-man presenting at the emergency department with a depressed skull fracture at the vertex and bilateral subdural hemorrhage. The patient underwent 2 neurosurgical interventions (craniotomy and craniectomy) but died after 40 days of hospitalization in an intensive care unit. At autopsy, the absence of various bone fragments did not allow us to establish if the skull had been stricken by a blunt object or had hit the ground with high kinetic energy. To analyze bone injuries before craniectomy, a 3-dimensional CT reconstruction based on preoperative scans was performed. A comparative analysis between autoptic and radiological data allowed us to differentiate surgical from traumatic injuries. Moreover, based on the shape and size of the depressed skull fracture (measured from the CT reformations), we inferred that the man had been stricken by a cylindric blunt object with a diameter of about 3 cm.

  13. Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base

    International Nuclear Information System (INIS)

    Wang, Xuhui; Xu, Minhui; Liang, Hong; Xu, Lunshan

    2011-01-01

    Multiple basilar skull fracture and cerebrospinal leak are common complications of traumatic brain injury, which required a surgical repair. But due to the complexity of basilar skull fracture after severe trauma, preoperatively an exact radiological location is always difficult. Multi-row spiral CT and MRI are currently widely applied in the clinical diagnosis. The present study was performed to compare the accuracy of cisternography by multi-row spiral CT and MRI in the diagnosis of cerebrospinal leak. A total of 23 patients with multiple basilar skull fracture after traumatic brain injury were included. The radiological and surgical data were retrospectively analyzed. 64-row CT (mm/row) scan and three-dimensional reconstruction were performed in 12 patients, while MR plain scan and cisternography were performed in another 11 patients. The location of cerebrospinal leak was diagnosed by 2 experienced physicians majoring neurological radiology. Surgery was performed in all patients. The cerebrospinal leak location was confirmed and repaired during surgery. The result was considered as accurate when cerebrospinal leak was absent after surgery. According to the surgical exploration, the preoperative diagnosis of the active cerebrospinal leak location was accurate in 9 out of 12 patients with CT scan. The location could not be confirmed by CT because of multiple fractures in 2 patients and the missed diagnosis occurred in 1 patient. The preoperative diagnosis was accurate in 10 out of 11 patients with MRI examination. MRI cisternography is more advanced than multi-row CT scan in multiple basilar skull fracture. The combination of the two examinations may increase the diagnostic ratio of active cerebrospinal leak

  14. Prediction of skull fracture risk for children 0-9 months old through validated parametric finite element model and cadaver test reconstruction.

    Science.gov (United States)

    Li, Zhigang; Liu, Weiguo; Zhang, Jinhuan; Hu, Jingwen

    2015-09-01

    Skull fracture is one of the most common pediatric traumas. However, injury assessment tools for predicting pediatric skull fracture risk is not well established mainly due to the lack of cadaver tests. Weber conducted 50 pediatric cadaver drop tests for forensic research on child abuse in the mid-1980s (Experimental studies of skull fractures in infants, Z Rechtsmed. 92: 87-94, 1984; Biomechanical fragility of the infant skull, Z Rechtsmed. 94: 93-101, 1985). To our knowledge, these studies contained the largest sample size among pediatric cadaver tests in the literature. However, the lack of injury measurements limited their direct application in investigating pediatric skull fracture risks. In this study, 50 pediatric cadaver tests from Weber's studies were reconstructed using a parametric pediatric head finite element (FE) model which were morphed into subjects with ages, head sizes/shapes, and skull thickness values that reported in the tests. The skull fracture risk curves for infants from 0 to 9 months old were developed based on the model-predicted head injury measures through logistic regression analysis. It was found that the model-predicted stress responses in the skull (maximal von Mises stress, maximal shear stress, and maximal first principal stress) were better predictors than global kinematic-based injury measures (peak head acceleration and head injury criterion (HIC)) in predicting pediatric skull fracture. This study demonstrated the feasibility of using age- and size/shape-appropriate head FE models to predict pediatric head injuries. Such models can account for the morphological variations among the subjects, which cannot be considered by a single FE human model.

  15. Persistent Neutrophilic Meningitis in an Immunocompetent Patient after Basilar Skull Fracture: Case Report

    Directory of Open Access Journals (Sweden)

    Uslan Daniel Z

    2011-05-01

    Full Text Available Abstract Background Persistent neutrophilic meningitis is an unusual form of chronic meningitis that is defined as clinical meningitis with a neutrophilic pleocytosis that persists for greater than 7 days despite empiric antimicrobial therapy. Although numerous disease processes can cause this syndrome, the majority of cases are due to opportunistic pathogens infecting immunocompromised hosts. Case Presentation A 47 year-old female presented after basilar skull fracture with persistent neutrophilic meningitis unresponsive to empiric broad-spectrum antibiotics. After more than weeks of intensive therapy, 4 hospitalizations and 3 relapses, Nocardia cyriacigeorgica was identified from cerebral spinal fluid. Induction therapy was begun with Ceftriaxone and trimethoprim-sulfamethoxazole (TMP-SMX for 6 weeks followed by therapy with TMP-SMX and doxycycline for one year. The patient made a complete recovery without sequelae. Conclusions Due to the difficulty in obtaining a microbiologic diagnosis, appropriate treatment in cases of persistent neutrophilic meningitis is often delayed leading to morbidity, This case highlights a number of the unique features of Nocardia meningitis and the importance of considering Nocardia infection as a cause of persistent neutrophilic meningitis even in immunocompetent patients.

  16. Feasibility of three-dimensional ultrashort echo time magnetic resonance imaging at 1.5 T for the diagnosis of skull fractures

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Hao; Zhong, Yu-min; Zhang, Hong; Lin, Yi; Zhu, Ming [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China); Nie, Quan-min; Guo, Lie-mei; Yang, Xi [Shanghai Jiao Tong University School of Medicine, Department of Neurosurgery Ren Ji Hospital, Shanghai (China); Chen, Wei-bo; Dai, Yong-ming [Philips Healthcare, Shanghai (China); Xu, Jian-rong [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ren Ji Hospital, Shanghai (China)

    2016-01-15

    To investigate the feasibility of ultrashort echo time (UTE) magnetic resonance imaging (MRI) for the diagnosis of skull fractures. The skull fracture models of ten Bama pigs and 364 patients with craniocerebral trauma were subjected to computed tomography (CT), UTE and conventional MRI sequences. The accuracy of UTE imaging in skull fracture diagnosis was analysed using receiver operating characteristic (ROC) curve analysis, McNemar's test and Kappa values. Differences among CT, UTE imaging and anatomical measurement (AM) values for linear fractures (LFs) and depressed fractures (DFs) were compared using one-way ANOVA and a paired-samples t-test. UTE imaging clearly demonstrated skull structures and fractures. The accuracy, validity and reliability of UTE MRI were excellent, with no significant differences between expert readings (P > 0.05; Kappa, 0.899). The values obtained for 42 LFs and 13 DFs in the ten specimens were not significantly different among CT, UTE MRI and AMs, while those obtained for 55 LFs and ten DFs in 44 patients were not significantly different between CT and UTE MRI (P > 0.05). UTE MRI sequences are feasible for the evaluation of skull structures and fractures, with no radiation exposure, particularly for paediatric and pregnant patients. (orig.)

  17. Three-dimensional fracture visualisation of multidetector CT of the skull base in trauma patients: comparison of three reconstruction algorithms

    International Nuclear Information System (INIS)

    Ringl, Helmut; Schernthaner, Ruediger; Philipp, Marcel O.; Metz-Schimmerl, Sylvia; Czerny, Christian; Weber, Michael; Steiner-Ringl, Andrea; Peloschek, Philipp; Herold, Christian J.; Schima, Wolfgang; Gaebler, Christian

    2009-01-01

    The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection. (orig.)

  18. Does preliminary optimisation of an anatomically correct skull-brain model using simple simulants produce clinically realistic ballistic injury fracture patterns?

    Science.gov (United States)

    Mahoney, P F; Carr, D J; Delaney, R J; Hunt, N; Harrison, S; Breeze, J; Gibb, I

    2017-07-01

    Ballistic head injury remains a significant threat to military personnel. Studying such injuries requires a model that can be used with a military helmet. This paper describes further work on a skull-brain model using skulls made from three different polyurethane plastics and a series of skull 'fills' to simulate brain (3, 5, 7 and 10% gelatine by mass and PermaGel™). The models were subjected to ballistic impact from 7.62 × 39 mm mild steel core bullets. The first part of the work compares the different polyurethanes (mean bullet muzzle velocity of 708 m/s), and the second part compares the different fills (mean bullet muzzle velocity of 680 m/s). The impact events were filmed using high speed cameras. The resulting fracture patterns in the skulls were reviewed and scored by five clinicians experienced in assessing penetrating head injury. In over half of the models, one or more assessors felt aspects of the fracture pattern were close to real injury. Limitations of the model include the skull being manufactured in two parts and the lack of a realistic skin layer. Further work is ongoing to address these.

  19. Surgical repair of skull fractures in four horses using cuttable bone plates.

    Science.gov (United States)

    Dowling, B A; Dart, A J; Trope, G

    2001-05-01

    Three horses with severely comminuted, open facial bone fractures and one horse with a comminuted, open orbital rim fracture were referred for treatment. Severe facial bone asymmetry and epistaxis were apparent in all cases and subcutaneous emphysema was present in two, however physical and neurological examinations were otherwise normal. Radiography and endoscopy were of some use in assessing the degree of damage, although the true extent of the damage was more apparent at surgery. Surgical reduction of the fractures was recommended to maximise cosmetic and functional outcome. After surgical debridement and reduction of the fractures the bone fragments remained unstable and were not amenable to stabilisation with interfragmentary wires alone, so 2 mm cuttable bone plates were used to maintain fracture alignment. Screw migration occurred in three horses and in one of these horses the plate had to be removed. Other complications were minor and in all horses the fractures healed with good cosmetic and functional outcome. The use of cuttable bone plates should be considered as a reasonable alternative to inter-fragmentary wiring for unstable, comminuted fractures of the facial bones, even where fractures are open.

  20. A history of depressed skull fractures from ancient times to 1800.

    Science.gov (United States)

    Ganz, Jeremy C; Arndt, Jürgen

    2014-01-01

    The story of managing depressed fractures illustrates how knowledge of proven value does not always get handed down. Celsus was the first to describe sensible management for depressed fractures. As he wrote in Latin this was forgotten. Galen's Greek writings survived forming the basis of management until the sixteenth century. In 1517, Hans von Gersdorff published a formidable illustrated surgical text. One illustration depicts an instrument for elevating depressed bone fragments. It looked dramatic but could not work and its defects were finally defined in the eighteenth century. Ambroise Paré used a bone punch just as we do today, but no later surgeon mentions this, though the instrument was well known. Elements of chance, fashion, emotionally powerful illustrations, and perhaps stubbornness had a profound effect on management delaying rational treatment for centuries.

  1. Application of computer-aided three-dimensional skull model with rapid prototyping technique in repair of zygomatico-orbito-maxillary complex fracture.

    Science.gov (United States)

    Li, Wei Zhong; Zhang, Mei Chao; Li, Shao Ping; Zhang, Lei Tao; Huang, Yu

    2009-06-01

    With the advent of CAD/CAM and rapid prototyping (RP), a technical revolution in oral and maxillofacial trauma was promoted to benefit treatment, repair of maxillofacial fractures and reconstruction of maxillofacial defects. For a patient with zygomatico-facial collapse deformity resulting from a zygomatico-orbito-maxillary complex (ZOMC) fracture, CT scan data were processed by using Mimics 10.0 for three-dimensional (3D) reconstruction. The reduction design was aided by 3D virtual imaging and the 3D skull model was reproduced using the RP technique. In line with the design by Mimics, presurgery was performed on the 3D skull model and the semi-coronal incision was taken for reduction of ZOMC fracture, based on the outcome from the presurgery. Postoperative CT and images revealed significantly modified zygomatic collapse and zygomatic arch rise and well-modified facial symmetry. The CAD/CAM and RP technique is a relatively useful tool that can assist surgeons with reconstruction of the maxillofacial skeleton, especially in repairs of ZOMC fracture.

  2. Skull (image)

    Science.gov (United States)

    The skull is anterior to the spinal column and is the bony structure that encases the brain. Its purpose ... the facial muscles. The two regions of the skull are the cranial and facial region. The cranial ...

  3. Skull Practice.

    Science.gov (United States)

    Slesnick, Irwin L.

    1988-01-01

    Disguises a lesson about skulls with some fun to cause less fear among students. Outlines strategies, questions, and answers for use. Includes a skull mask which can be photocopied and distributed to students as a learning tool and a fun Halloween treat. Also shown is a picture of skull parts. (RT)

  4. Influence of stiffness and shape of contact surface on skull fractures and biomechanical metrics of the human head of different population underlateral impacts.

    Science.gov (United States)

    Shaoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2015-07-01

    The objective of this study was to determine the responses of 5th-percentile female, and 50th- and 95th-percentile male human heads during lateral impacts at different velocities and determine the role of the stiffness and shape of the impacting surface on peak forces and derived skull fracture metrics. A state-of-the-art validated finite element (FE) head model was used to study the influence of different population human heads on skull fracture for lateral impacts. The mass of the FE head model was altered to match the adult size dummies. Numerical simulations of lateral head impacts for 45 cases (15 experiments×3 different population human heads) were performed at velocities ranging from 2.4 to 6.5m/s and three impacting conditions (flat and cylindrical 90D; and flat 40D padding). The entire force-time signals from simulations were compared with experimental mean and upper/lower corridors at each velocity, stiffness (40 and 90 durometer) and shapes (flat and cylindrical) of the impacting surfaces. Average deviation of peak force from the 50th male to 95th male and 5th female were 6.4% and 10.6% considering impacts on the three impactors. These results indicate hierarchy of variables which can be used in injury mitigation efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Skull Thickness Morphing for an Age and Sex Specific FE Model of the Skull.

    Science.gov (United States)

    Jones, Derek A; Urban, Jillian E; Lillie, Elizabeth M; Stitzel, Joel D

    2015-01-01

    Skull deformation is believed to be a contributing factor in traumatic brain injury (TBI). Furthermore, skull thickness is thought to be an important factor governing deformation of the skull and its susceptibility to fracture. Although many studies have been done to understand the mechanisms of brain injury and skull fracture, the majority of the cadaveric and finite element (FE) modeling efforts are comprised of older males and 50th percentile male skulls, respectively, which do not accurately represent the population as a whole. This study employed a set of skull table thickness regressions defined at homologous landmarks on the skull which were calculated from 123 pre-existing head CT scans (ages 20-100) using a cortical density-based algorithm. A method was developed to morph the Global Human Body Models Consortium (GHBMC) 50th percentile male skull model to age and gender specific geometries based on the full thickness regressions using a Thin Plate Spline algorithm. A quantitative measure of morphing error was devised and measured using the morphed and desired full thickness values at the homologous landmark locations. This methodology can be used to create gender and age-specific FE models of the skull and will ultimately be used to understand the relationship between cortical thickness, skull deformation, and head injury.

  6. Diseases of the skull

    International Nuclear Information System (INIS)

    Koval', G.Yu.

    1984-01-01

    Different forms of skull diseases viz. inflammatory diseases, skull tumors, primary and secondary bone tumors, are considered. Roentgenograms in some above-mentioned diseases are presented and analysed

  7. [Bilateral traumatic abducens nerve palsy without skull fracture or intracranial hematoma-a report of 3 cases and consideration of the mechanism of injury (author's transl)].

    Science.gov (United States)

    Takagi, H; Miyasaka, Y; Kuramae, T; Ohwada, T; Tsunoda, M

    1976-10-01

    Three cases of bilateral traumatic abducens nerve palsy were presented and the mechanism of damage to the abducens nerve was discussed in relation to the analysis of traumatic force at the time of impact and topographical anatomy of the abducens nerve in detail. Case 1. A 70 year old man sustained a traffic accident with one hour loss of consciousness. Physical examination revealed a contused area on the medial side of his right forehead. Neurological examination revealed bilateral abducens nerve palsy (Fig. 1). There were no ther cranial nerve abnormalities. Roentgenograms of the skull, including views of the base and orbit showed no fracture. At follow up examination 12 months later, bilateral Duane's retraction syndrome could be noticed with slight increase in size of the pupil on each side of lateral gaze (Fig. 2). Case 2. A 32 year old women sustained a traffic accident with 31 days of loss of consciousness. At the time of admission, bilateral abducens nerve palsy and slight left hemiparesis were noticed in semicomatose condition. Right carotid angiogtam showed no evidence of intracranial hematoma. One month later, the right eye began to abduct and 2 months later, the left eye began to abduct. Three months after the injury, bilateral abducens nerve palsy could no longer be demonstrated. No retraction syndrome was observed during this period. Case 3. A 3 year old boy sustained a traffic accident with 32 days of loss of consciousness. At the time of admission, neurological examination showed bilateral abducens palsy and left sided decerebrate posture in comatose condition. At the time of discharge 3 months after admission, bilateral abducens palsy, right hemiataxia, left spastic hemiparesis and scanning speach were noticed. Three months later, right eye began to abduct and 4 months later, the left eye began to abduct. At follow up examination 6 months later, there was no evidence of abducens nerve palsy. Topographical details of anatomy of the abducens nerve are

  8. Vacuum extraction as a treatment modality of neonatal skull depression in twin infant

    International Nuclear Information System (INIS)

    Amin, Adnan M.; Al-Zeky, Alaauddin M.; El-Azm, M.

    2007-01-01

    The management of depressed skull fractures in the newborn infant can be controversial. In this article, we report a case of twin pregnancy wherein one of the fetuses had depressed skull fractures that was not associated with any known trauma during the pregnancy or at delivery. This p ing-pong skull depression was treated by elevation with an obstetrical vacuum extractor. No complications occurred. The possible etiologies and treatment modalities for neonatal depressed fractures, being conservative or operative, are discussed. (author)

  9. Skull x-ray

    Science.gov (United States)

    X-ray - head; X-ray - skull; Skull radiography; Head x-ray ... There is low radiation exposure. X-rays are monitored and regulated to provide the minimum amount of radiation exposure needed to produce the image. Most ...

  10. Skull anatomy (image)

    Science.gov (United States)

    The skull is anterior to the spinal column and is the bony structure that encases the brain. Its purpose ... the facial muscles. The two regions of the skull are the cranial and facial region. The cranial ...

  11. Skull base tumours

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil, Servico de Radiologia, Rua Professor Lima Basto, 1093 Lisboa Codex (Portugal)], E-mail: borgesalexandra@clix.pt

    2008-06-15

    With the advances of cross-sectional imaging radiologists gained an increasing responsibility in the management of patients with skull base pathology. As this anatomic area is hidden to clinical exam, surgeons and radiation oncologists have to rely on imaging studies to plan the most adequate treatment. To fulfil these endeavour radiologists need to be knowledgeable about skull base anatomy, about the main treatment options available, their indications and contra-indications and needs to be aware of the wide gamut of pathologies seen in this anatomic region. This article will provide a radiologists' friendly approach to the central skull base and will review the most common central skull base tumours and tumours intrinsic to the bony skull base.

  12. Skull base tumours

    International Nuclear Information System (INIS)

    Borges, Alexandra

    2008-01-01

    With the advances of cross-sectional imaging radiologists gained an increasing responsibility in the management of patients with skull base pathology. As this anatomic area is hidden to clinical exam, surgeons and radiation oncologists have to rely on imaging studies to plan the most adequate treatment. To fulfil these endeavour radiologists need to be knowledgeable about skull base anatomy, about the main treatment options available, their indications and contra-indications and needs to be aware of the wide gamut of pathologies seen in this anatomic region. This article will provide a radiologists' friendly approach to the central skull base and will review the most common central skull base tumours and tumours intrinsic to the bony skull base

  13. Radiologic assessment of maxillofacial, mandibular, and skull base trauma

    International Nuclear Information System (INIS)

    Schuknecht, Bernhard; Graetz, Klaus

    2005-01-01

    Cranio-maxillofacial injuries affect a significant proportion of trauma patients either in isolation or concurring with other serious injuries. Contrary to maxillofacial injuries that result from a direct impact, central skull base and lateral skull base (petrous bone) fractures usually are caused by a lateral or sagittal directed force to the skull and therefore are indirect fractures. The traditional strong role of conventional images in patients with isolated trauma to the viscerocranium is decreasing. Spiral multislice CT is progressively replacing the panoramic radiograph, Waters view, and axial films for maxillofacial trauma, and is increasingly being performed in addition to conventional films to detail and classify trauma to the mandible as well. Imaging thus contributes to accurately categorizing mandibular fractures based on location, into alveolar, mandibular proper, and condylar fractures - the last are subdivided into intracapsular and extracapsular fractures. In the midface, CT facilitates attribution of trauma to the categories central, lateral, or combined centrolateral fractures. The last frequently encompass orbital trauma as well. CT is the imaging technique of choice to display the multiplicity of fragments, the degree of dislocation and rotation, or skull base involvement. Transsphenoid skull base fractures are classified into transverse and oblique types; lateral base (temporal bone) trauma is subdivided into longitudinal and transverse fractures. Supplementary MR examinations are required when a cranial nerve palsy occurs in order to recognize neural compression. Early and late complications of trauma related to the orbit, anterior cranial fossa, or lateral skull base due to infection, brain concussion, or herniation require CT to visualize the osseous prerequisites of complications, and MR to define the adjacent brain and soft tissue involvement. (orig.)

  14. The Royal Book by Haly Abbas from the 10th century: one of the earliest illustrations of the surgical approach to skull fractures.

    Science.gov (United States)

    Aciduman, Ahmet; Arda, Berna; Kahya, Esin; Belen, Deniz

    2010-12-01

    Haly Abbas was one of the pioneering physicians and surgeons of the Eastern world in the 10th century who influenced the Western world by his monumental work, The Royal Book. The book was first partly translated into Latin by Constantinus Africanus in the 11th century without citing the author's name. Haly Abbas was recognized in Europe after full translation of The Royal Book by Stephen of Antioch in 1127. The Royal Book has been accepted as an early source of jerrah-names (surgical books) in the Eastern world. The chapters regarding cranial fractures in Haly Abbas' work include unique management strategies for his period with essential quotations from Paul of Aegina's work Epitome. Both authors preferred free bone flap craniotomy in cranial fractures. Although Paul of Aegina, a Byzantine physician and surgeon, was a connection between ancient traditions and Islamic interpretation, Haly Abbas seemed to play a bridging role between the Roman-Byzantine and the School of Salerno in Europe.

  15. An accessory skull suture mimicking a skull fracture

    NARCIS (Netherlands)

    Wiedijk, J. E. F.; Soerdjbalie-Maikoe, V.; Maat, G. J. R.; Maes, A.; van Rijn, R. R.; de Boer, H. H.

    2016-01-01

    This paper describes an investigation of the sudden and unexpected death of a five-and-a-half-month-old boy. As in every Dutch case of sudden unexpected death in infancy (SUDI), a multidisciplinary diagnostic approach was used. This included post-mortem radiography, showing a linear discontinuity of

  16. Neonatal skull depression unassociated with birth trauma

    International Nuclear Information System (INIS)

    Eisenberg, D.; Kirchner, S.G.; Perrin, E.C.

    1984-01-01

    With few exceptions, a depression of the calvaria in a neonate is caused by birth trauma and often is associated with fracture. Localized depression of the skull without trauma is rare, and such a case is reported here. The cause, complications, and treatment of this condition are briefly discussed. Computed tomography (CT) was useful in clinical management. Although sizable, the depression was not associated with neurologic features and disappeared spontaneously

  17. Skull penetrating wound

    International Nuclear Information System (INIS)

    Gonzalez Orlandi, Yvei; Junco Martin, Reinel; Rojas Manresa, Jorge; Duboy Limonta, Victor; Matos Herrera, Omar; Saez Corvo, Yunet

    2011-01-01

    The cranioencephalic trauma is common in the emergence centers to care for patients with multiple traumata and it becames in a health problem in many countries. Skull penetrating trauma is located in a special place due to its low frequency. In present paper a case of male patient aged 52 severely skull-injured with penetrating wound caused by a cold steel that remained introduced into the left frontotemporal region. After an imaging study the emergence surgical treatment was applied and patient evolves adequately after 25 days of hospitalization. Nowadays, she is under rehabilitation treatment due to a residual right hemiparesis.(author)

  18. Fracture of the occipital condyle

    International Nuclear Information System (INIS)

    Wessels, L.S.

    1990-01-01

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

  19. The skull in renal osteodystrophy

    International Nuclear Information System (INIS)

    Orzincolo, C.; Tamarozzi, R.; Bedani, P.L.

    1987-01-01

    Skull X-ray of 60 patients with chronic renal failure were examined. Alterations included diminished or increased bone density, radiolucent areas, pepper pot skull and the disappearance of vascular grooves and sutures. It is suggested that the radiological aspect of the skull is of very little diagnostic use in the assessment of uremic osteopathy since specific alterations are rare and tardive and show no correlation with clinical and laboratory findings. Skull X-ray can be usefull in assessing the effects of treatment (vitamin D derivaties, parathyroidectomy) and for the identification of focal lesions (brown tumors)

  20. Role of skull radiography in the initial evaluation of minor head injury: a retrospective study

    International Nuclear Information System (INIS)

    Murshid, W.R.

    1994-01-01

    The use of skull radiography in the initial evaluation of minor head injured patients is controversial. In an attempt to evaluate its benefits, a retrospective study of 566 cases subjected to skull radiography following close minor head trauma (Glasgow Coma Scale 13-15), is presented. A skull fracture (linear vault, depressed or base of skull) was present in 64 (11%) cases. Only three (5%) who were found to have a skull fracture on skull radiography developed an intracranial injury which required surgery. Intracranial injuries developed in 19 (3%) cases and were followed by surgery in six (32%). All, except for one case, had a decreased level of consciousness and a Glasgow Coma Scale less than 15, few had focal neurological deficits. Management had not been altered by the results of skull radiography in any of the cases. We concluded that skull radiographs are unnecessary for the decision process in closed minor head injury because management decisions are based primarily on a careful neurological examination. When intracranial injuries are a concern, a CT scan should be obtained. (author)

  1. Skull base tumor model.

    Science.gov (United States)

    Gragnaniello, Cristian; Nader, Remi; van Doormaal, Tristan; Kamel, Mahmoud; Voormolen, Eduard H J; Lasio, Giovanni; Aboud, Emad; Regli, Luca; Tulleken, Cornelius A F; Al-Mefty, Ossama

    2010-11-01

    Resident duty-hours restrictions have now been instituted in many countries worldwide. Shortened training times and increased public scrutiny of surgical competency have led to a move away from the traditional apprenticeship model of training. The development of educational models for brain anatomy is a fascinating innovation allowing neurosurgeons to train without the need to practice on real patients and it may be a solution to achieve competency within a shortened training period. The authors describe the use of Stratathane resin ST-504 polymer (SRSP), which is inserted at different intracranial locations to closely mimic meningiomas and other pathological entities of the skull base, in a cadaveric model, for use in neurosurgical training. Silicone-injected and pressurized cadaveric heads were used for studying the SRSP model. The SRSP presents unique intrinsic metamorphic characteristics: liquid at first, it expands and foams when injected into the desired area of the brain, forming a solid tumorlike structure. The authors injected SRSP via different passages that did not influence routes used for the surgical approach for resection of the simulated lesion. For example, SRSP injection routes included endonasal transsphenoidal or transoral approaches if lesions were to be removed through standard skull base approach, or, alternatively, SRSP was injected via a cranial approach if the removal was planned to be via the transsphenoidal or transoral route. The model was set in place in 3 countries (US, Italy, and The Netherlands), and a pool of 13 physicians from 4 different institutions (all surgeons and surgeons in training) participated in evaluating it and provided feedback. All 13 evaluating physicians had overall positive impressions of the model. The overall score on 9 components evaluated--including comparison between the tumor model and real tumor cases, perioperative requirements, general impression, and applicability--was 88% (100% being the best possible

  2. Case of pycnodysostosis. Observation of skull by CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Anegawa, Shigetaka; Bekki, Yoshiaki; Furukawa, Yasuhiro; Yokota, Seishi; Torigoe, Ryuichiro

    1987-07-01

    A 13-year-old boy was presented to the Department of Neurosurgery, Saiseikai Fukuoka General Hospital for further examinations concerning abnormal findings in the skull radiogram taken when he struck his head. His physical features showed some characteristics the same as those of pycnodysostosis as follows - proportionate dwarfism, prominent forehead, short spoon-shaped fingers, bilateral exophthalmos. A skull radiogram revealed widely open cranial sutures with no healing of the fracture and craniotomy which was performed for an acute epidural hematoma 6 years ago. Furthermore, the mandible was hypoplastic with a virtural loss of mandibular angle. CT of the soft tissues showed somewhat dilated cortical sulci and ventricles without any structural abnormalities in the brain. CT of bone algorythum revealed specific characteristics of this disease. The paranasal sinuses were quite hypoplastic. Especially in the maxillary sinuses, frontal sinussus and mastoid air cells, none of developments of sinuses were noted, even though the middle and internal ear seemed to be normal. Moreover, the ethomoid and sphenoid sinuses were noted, although their developments were poor. The appearance of skull base was normal, including the inlets and outlets of cranial nerves or vessels and synchondroses. However, the density of the skull base, especially in the diploe, was higher than normal in Hansfield number. Furthermore, detailed measurements of skull base demonstrated that the skull base itself was also dwarfish. In our study, the development of sinuses in bones with intramembranous ossification are worse than that with endochondral ossification. Furthermore, sutures or synchondroses in the skull base were well-developed than those of the convex. So, it is considered that pycnodysostosis must be the neighboring entity of diseases such as achondroplastic dwarfism or cleidocranial dysplasia. (J.P.N.).

  3. 21 CFR 882.4750 - Skull punch.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates or...

  4. Craniometric Indices of Nigeria Skulls

    OpenAIRE

    Orish CN; Ibeachu PC

    2016-01-01

    Introduction: Craniometric indices show the percentage relationship between different dimensions. It is an important parameter for classification of race and sex of individuals of unknown identity. This study was undertaken to determine the craniometric indices of gnathic, palatal, orbital, cranial and nasal indices of Nigerian skulls. Materials and Methods: One hundred adult dry skulls, (78 males, and 22 females) free from damage and deformities from eleven Departments of Anatomy in Nige...

  5. Cases of Trephination in Ancient Greek Skulls

    Directory of Open Access Journals (Sweden)

    Vasiliki Ζafiri

    2012-01-01

    Full Text Available Background: Trephination, or trepanning, is considered to be one of the most ancient surgical operations with an especially extensive geographical incidence, both in the New World and in the Old. In Europe, more than 200 finds of trephination have been found, from Scandinavia to the Balkans. The technique of trephination or trepanning covers overall the last 10,000 years and exhibits great versatility and adjustability in the knowledge, technical means, therapeutic needs, prejudices and social standards of each period and of each population group. Hippocrates was the one to classify for the first time the kinds of cranial fractures and define the conditions and circumstances for carrying out a trepanning.Aim: The present research aims to investigate the Greek cranial trephinations on sculls from the collection of the Anthropological Museum of the Medical School of Athens that come from archaeological excavations.Method: Skulls were examined by macroscopic observation with reflective light. Furthermore, radiographic representation of the skulls was used.Results: The anthropological researches and the studies of anthropological skeleton remains that came out during archaeological excavations from different eras and areas have given information about the medical practices in the very important geographic area of Greece and in particular, we referred to cases of Greek trephinations.

  6. Skull base tumors

    International Nuclear Information System (INIS)

    Kikinis, R.; Matsumae, M.; Jolesz, F.A.; Black, P.M.; Cline, H.E.; Lorenson, W.E.

    1991-01-01

    This paper reports on an image processing procedure for the planning of surgery of skull base tumors that can extract bone, vessels, tumor, and brain parenchyma and that permits resolution of cranial nerves. Three-dimensional (3D) reconstructions were generated from double-echo long TR interleaved conventional spin-echo and fast-spin-echo MR imaging data. Sixteen cases have been analyzed preoperatively. Image processing consisted of a multistep procedure combining a supervised multivariate analysis with neighborhood operations such as connectivity and erosion/dilation. 3D renderings of anatomic structures of interest were then generated. Cases were evaluated preoperatively and manipulated interactively with the computer-generated images by a team consisting of neuroradiologists, neurosurgeons, and craniofacial surgeons. The preparation of 3D reconstructions required only a few hours and was performed mostly by a research assistant. The preoperative analysis of the 3D reconstructions was found to be a valuable tool, providing information complementing the surgeon's understanding of a case as derived from conventional imaging. The interactive manipulation of data proved to be a powerful way to evaluate alternative surgical approaches

  7. The skull of Chios: trepanation in Hippocratic medicine.

    Science.gov (United States)

    Tsermoulas, Georgios; Aidonis, Asterios; Flint, Graham

    2014-08-01

    Cranial trepanation is the oldest neurosurgical operation and its roots date back to prehistory. For many centuries, religion and mysticism were strongly linked to the cause of diseases, and trepanation was associated with superstitions such as releasing evil spirits from inside the skull. The Hippocratic treatise "On injuries of the head" was therefore a revolutionary work, as it presented a systematic approach to the management of cranial trauma, one that was devoid of spiritual elements. Unfortunately, there are only a limited number of skeletal findings that confirm that the practice of trepanation was performed as part of Hippocratic medicine. In this historical vignette, the authors present a trepanned skull that was found in Chios, Greece, as evidence of the procedure having been performed in accordance with the Hippocratic teaching. The skull bears a parietal bur hole in association with a linear fracture, and it is clear that the patient survived the procedure. In this analysis, the authors examine the application of the original Hippocratic teaching to the skull of Chios. The rationalization of trepanation was clearly a significant achievement in the evolution of neurosurgery.

  8. fracture of the dome of the talus associated with a fracture of the os ...

    African Journals Online (AJOL)

    1971-03-13

    Mar 13, 1971 ... region of the ankle joint is reported. Falls from a height are commonly associated with fractures of the os calcis, the distal tibia and fibula, the acetabulum, the thoracic and lumbar spine and the base of the skull. An association between a fracture of the dome of the talus on one side and a fracture of the os ...

  9. Cloverleaf skull with generalised bone dysplasia

    International Nuclear Information System (INIS)

    Kozlowski, K.; Warren, P.S.; Fisher, C.C.; Royal Hospital for Women, Camperdown

    1985-01-01

    A case of cloverleaf skull with generalised bone dysplasia is reported. The authors believe that bone dysplasia associated with cloverleaf is neither identical with thanatophoric dysplasia nor achondroplasia. Until identity of thanatophoric dysplasia and cloverleaf skull with generalised bone dysplasia is proved the diseases should be looked upon as separate entities and the wording ''thanatophoric dysplasia with cloverleaf skull'' should be abolished. (orig.)

  10. Skull development in the muscular dystrophic mouse

    DEFF Research Database (Denmark)

    Vilmann, H; Kirkeby, S; Moss, M L

    1989-01-01

    Roentgencephalometric tracings of skulls of 7-week-old normal and muscular dystrophic mice were compared. A marked size reduction of the dystrophic skulls relative to the normal ones was observed. However, the visceral parts of the dystrophic skull were more reduced in size than the neural parts....

  11. Skull trepanation in the Bismarck archipelago.

    Science.gov (United States)

    Watters, David A K

    2007-01-01

    Skull trepanation is an ancient art and has been recognized in many, if not most, primitive societies. Papua New Guinea came into contact with Europeans in the late 1800s and therefore it was possible for the art to be documented at a time when cranial surgery in Europe was still in its infancy. A reviewof published articles and accounts of those who observed skull trepanation or spoke to those who had. Review of a video of trepanation as practised today in Lihir. Richard Parkinson was a trader turned amateur anthropologist who was able to observe the surgical procedure being practised in Blanche Bay (New Britain). Trepanation was also witnessed by Rev. J.A. Crump in the Duke of Yorks. In New Britain the operation was performed for trauma but in New Ireland it was also employed on conscious patients for epilepsy or severe headache, particularly in the first five years of life. There was, however, a tendency to operate on frontal depressed and open fractures, rather than temporoparietal ones. Once the decision to operate was made the wound was irrigated in coconut juice and this was also used to wash the hands of the surgeon. Anaesthesia was not required as the traumatized patient was unconscious. The procedure is described and the tools included local materials such as obsidian, shark's tooth, a sharpened shell, rattan, coconut shell and bamboo. Of particular interest is the observation of brain pulsations and their relationship to a successful outcome. The outcomes were good, in that 70% of patients were thought to survive, contrasting with a 75% mortality for cranial surgery in London in the 1870s. There is supporting evidence in that many trepanned skulls show evidence of healing and life long after the procedure was completed. Other societies have reported similar survival rates. The good outcomes may have been due to wise case selection as well as a high level of surgical skill following sound principles of wound debridement without necessarily being able to

  12. Effects of the freezing and thawing process on biomechanical properties of the human skull.

    Science.gov (United States)

    Torimitsu, Suguru; Nishida, Yoshifumi; Takano, Tachio; Koizumi, Yoshinori; Hayakawa, Mutsumi; Yajima, Daisuke; Inokuchi, Go; Makino, Yohsuke; Motomura, Ayumi; Chiba, Fumiko; Iwase, Hirotaro

    2014-03-01

    The aim of this study was to determine if biomechanical investigations of skull samples are reliable after skulls have been subjected to a freezing and thawing process. The skulls were obtained from 105 Japanese cadavers (66 males, 39 females) of known age that were autopsied in our department between October 2012 and June 2013. We obtained bone specimens from eight sites (four bilaterally symmetrical pairs) of each skull and measured the mass of each specimen. They were then classified into three groups (A, B, C) based on the duration of freezing of the experimental samples. The left-side samples were subjected to frozen storage (experimental group). The corresponding right-side samples were their controls. Bending tests were performed on the controls immediately after they were obtained. The experimental samples were preserved by refrigeration at -20 °C for 1 day (group A), 1 month (group B), or 3 months (group C). Following refrigeration, these samples were placed at 37 °C to thaw for 1 h and then were subjected to bending tests using a three-point-bending apparatus attached to a Handy force gauge. The device recorded the fracture load automatically when the specimen fractured. Statistical analyses revealed that there were no significant differences in sample fracture loads between the frozen preserved/thawed samples and the unfrozen controls for each of the cryopreservation intervals. We eliminated any possible sample mass bias by using controls from the same skull in each case. The results suggest that the freezing/thawing process has little effect on the mechanical properties of human skulls. Thus, frozen storage for up to 3 months is a good method for preserving human skulls. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. Radiographic evaluation of maxillofacial fractures

    International Nuclear Information System (INIS)

    Litwan, M.; Fliegel, C.

    1986-01-01

    The course and configuration of typical maxillofacial fractures (type Le Fort I-III) and lateral maxillary fractures including the zygomatic arch were reconstructed in detail by application of barium paste on a bony skull and radiogrpahs in standard projections were performed and evaluated. It was obvious from the resulting radiographs that for most maxillofacial fractures a half axial or Water's view was most helpful. Lateral views only give additional information when there is a considerable degree of dislocation of fragments. Comparison with a prediatric skull of 8 years of age demonstrated that fractures of the zygomatic arch in this age group cannot be demonstrated by the typical submento-vertical view, but are shown on a Towne projection. The radiographic appearance of important maxillofacial fractures is demonstrated. The necessity of further studies in cases where reconstructive surgery appears necessary is discussed and CT rather then conventional tomography is advocated. (orig.) [de

  14. Imaging of skull base: Pictorial essay

    International Nuclear Information System (INIS)

    Raut, Abhijit A; Naphade, Prashant S; Chawla, Ashish

    2012-01-01

    The skull base anatomy is complex. Numerous vital neurovascular structures pass through multiple channels and foramina located in the base skull. With the advent of computerized tomography (CT) and magnetic resonance imaging (MRI), accurate preoperative lesion localization and evaluation of its relationship with adjacent neurovascular structures is possible. It is imperative that the radiologist and skull base surgeons are familiar with this complex anatomy for localizing the skull base lesion, reaching appropriate differential diagnosis, and deciding the optimal surgical approach. CT and MRI are complementary to each other and are often used together for the demonstration of the full disease extent. This article focuses on the radiological anatomy of the skull base and discusses few of the common pathologies affecting the skull base

  15. Cloverleaf skull with generalised bone dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Warren, P.S.; Fisher, C.C.

    1985-09-01

    A case of cloverleaf skull with generalised bone dysplasia is reported. The authors believe that bone dysplasia associated with cloverleaf is neither identical with thanatophoric dysplasia nor achondroplasia. Until identity of thanatophoric dysplasia and cloverleaf skull with generalised bone dysplasia is proved the diseases should be looked upon as separate entities and the wording ''thanatophoric dysplasia with cloverleaf skull'' should be abolished.

  16. Analysis of six Vietnamese trophy skulls.

    Science.gov (United States)

    Sledzik, P S; Ousley, S

    1991-03-01

    This report presents morphologic, metric, and contextual information on six documented trophy skull specimens confiscated from U.S. servicemen during the Vietnam War. Additional information on the history and occurrence of trophy skull collecting is provided. This sample, consisting mostly of young Vietnamese males, exhibits graffiti, painting, and other evidence of postmortem decorative modification. Identification of trophy skulls is important to medicolegal and anthropological researchers in distinguishing trophy remains from archaeological and forensic specimens.

  17. Magnetoencephalography signals are influenced by skull defects.

    Science.gov (United States)

    Lau, S; Flemming, L; Haueisen, J

    2014-08-01

    Magnetoencephalography (MEG) signals had previously been hypothesized to have negligible sensitivity to skull defects. The objective is to experimentally investigate the influence of conducting skull defects on MEG and EEG signals. A miniaturized electric dipole was implanted in vivo into rabbit brains. Simultaneous recording using 64-channel EEG and 16-channel MEG was conducted, first above the intact skull and then above a skull defect. Skull defects were filled with agar gels, which had been formulated to have tissue-like homogeneous conductivities. The dipole was moved beneath the skull defects, and measurements were taken at regularly spaced points. The EEG signal amplitude increased 2-10 times, whereas the MEG signal amplitude reduced by as much as 20%. The EEG signal amplitude deviated more when the source was under the edge of the defect, whereas the MEG signal amplitude deviated more when the source was central under the defect. The change in MEG field-map topography (relative difference measure, RDM(∗)=0.15) was geometrically related to the skull defect edge. MEG and EEG signals can be substantially affected by skull defects. MEG source modeling requires realistic volume conductor head models that incorporate skull defects. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Skull-base Osteomyelitis: a Dreaded Complication after Trivial Fall and Inadequate Management

    Directory of Open Access Journals (Sweden)

    Kundan Mittal

    2015-10-01

    Full Text Available Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

  19. Aspergillus Osteomyelitis of the Skull.

    Science.gov (United States)

    Nicholson, Simon; King, Richard; Chumas, Paul; Russell, John; Liddington, Mark

    2016-07-01

    Osteomyelitis of the craniofacial skeleton is rare, with fungal pathogens least commonly implicated. The authors present 2 patients of osteomyelitis of the skull caused by Aspergillus spp. and discuss the diagnosis, clinicopathological course, and management strategies.Late recurrence seen in this type of infection warrants long-term follow-up and a high index of suspicion for the clinical signs associated with recurrence.Such patients would benefit from their surgical debridement being planned and managed via a specialist craniofacial unit, so as to utilize the most aesthetically sensitive approach and the experience of specialists from several surgical disciplines.

  20. The epidemiology of fractures in infants--Which accidents are preventable?

    Science.gov (United States)

    Wegmann, Helmut; Orendi, Ingrid; Singer, Georg; Eberl, Robert; Castellani, Christoph; Schalamon, Johannes; Till, Holger

    2016-01-01

    In children, fractures have a huge impact on the health care system. In order to develop effective prevention strategies exact knowledge about the epidemiology of fractures is mandatory. This study aims to describe clinical and epidemiological data of fractures diagnosed in infants. A retrospective analysis of all infants (childrenfractures in an 11 years period (2001-2011) was performed. Information was obtained regarding the location of the fractures, sites of the accident, circumstances and mechanisms of injury and post-injury care. 248 infants (54% male, 46% female) with a mean age of 7 months presented with 253 fractures. In more than half of the cases skull fractures were diagnosed (n=151, 61%). Most frequently the accidents causing fractures happened at home (67%). Falls from the changing table, from the arm of the care-giver and out of bed were most commonly encountered (n=92, 37%). While the majority of skull fractures was caused from falls out of different heights, external impacts tended to lead to fractures of the extremities. 6 patients (2%) were victims of maltreatment and sustained 10 fractures (2 skull fractures, 4 proximal humeral fractures, 2 rib fractures, and 2 tibial fractures). Falls from the changing table, the arms of the caregivers and out of bed caused the majority of fractures (especially skull fracture) in infants. Therefore, awareness campaigns and prevention strategies should focus on these mechanisms of accident in order to decrease the rate of fractures in infants. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Skull base development and craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Blaser, Susan I. [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Division of Neuroradiology, Toronto (Canada); University of Toronto, Department of Otolaryngology - Head and Neck Surgery, Toronto (Canada); Padfield, Nancy [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Division of Neuroradiology, Toronto (Canada); Chitayat, David [The Hospital for Sick Children and University of Toronto, Division of Clinical and Metabolic Genetics, Toronto (Canada); Mount Sinai Hospital and University of Toronto, Prenatal Diagnosis and Medical Genetics Program, Toronto (Canada); Forrest, Christopher R. [The Hospital for Sick Children and University of Toronto, Centre for Craniofacial Care and Research, Division of Plastic and Reconstructive Surgery, Toronto (Canada)

    2015-09-15

    Abnormal skull shape resulting in craniofacial deformity is a relatively common clinical finding, with deformity either positional (positional plagiocephaly) or related to premature ossification and fusion of the skull sutures (craniosynostosis). Growth restriction occurring at a stenosed suture is associated with exaggerated growth at the open sutures, resulting in fairly predictable craniofacial phenotypes in single-suture non-syndromic pathologies. Multi-suture syndromic subtypes are not so easy to understand without imaging. Imaging is performed to define the site and extent of craniosynostosis, to determine the presence or absence of underlying brain anomalies, and to evaluate both pre- and postoperative complications of craniosynostosis. Evidence for intracranial hypertension may be seen both pre- and postoperatively, associated with jugular foraminal stenosis, sinovenous occlusion, hydrocephalus and Chiari 1 malformations. Following clinical assessment, imaging evaluation may include radiographs, high-frequency US of the involved sutures, low-dose (20-30 mAs) CT with three-dimensional reformatted images, MRI and nuclear medicine brain imaging. Anomalous or vigorous collateral venous drainage may be mapped preoperatively with CT or MR venography or catheter angiography. (orig.)

  2. The evolutionary significance of the Wajak skulls

    NARCIS (Netherlands)

    Storm, P.

    1995-01-01

    Ever since their description by Dubois (1920, 1922) the Wajak skulls Java) have played an important role in the discussions on the evolution of modern humans in Australasia. Because of the robust morphology of the skull, Wajak Man was seen as a link between Pleistocene hominids from Java (Solo) and

  3. Skull thickness in patients with clefts

    DEFF Research Database (Denmark)

    Arntsen, T; Kjaer, I; Sonnesen, L

    2010-01-01

    The purpose was to analyze skull thickness in incomplete cleft lip (CL), cleft palate (CP), and combined cleft lip and palate (UCLP).......The purpose was to analyze skull thickness in incomplete cleft lip (CL), cleft palate (CP), and combined cleft lip and palate (UCLP)....

  4. CT atlas of the skull base

    International Nuclear Information System (INIS)

    Inoue, Hiroshi; Kawafuchi, Jun-ichi; Takahashi, Kazukuni

    1980-01-01

    Although CT is generally used for lesions of the face, the orbit, the nasal and paranasal cavity, and the skull base, a CT atlas of these regions has not been reported. Furthermore, the skull base, that lies nearly tangential to the conventional axial plane of CT, can not be precisely evaluated on ordinary horizontal pictures. For the purpose of a clear demonstration of the skull-base structures by CT, a model human skull was investigated. The results and its clinical value have previously been reported. For the CT atlas of the skull base, three model human skulls (embedded in agar gel containing iodine in a manner previously reported) were also examined by EMI-CT1010 with a 5 mm thickness. The magnification and wide-window techniques were also used for demonstration. Ordinary-0 sections (scanning plane at 0 0 to Reid's base line), ordinary-25 sections (+25 0 to RBL), reverse-20 sections (-20 0 to RBL), reverse-80 sections (-80 0 to RBL; coronal sections), and sagittal sections were selected in order to illustrate the anatomical details of the skull base. Pictures of the inner aspect and the outer aspect of the skull base were also provided. Clinically it is very important to recognize osseous change and the relationship between the lesion and the skull base in three dimensions. In evaluating lesions of the skull base and those of the tentorial notch a two-plane CT examination (ordinary-25 sections and reverse-20 sections) is usually used. This method is useful in determining the surgical approach, for instance, to decide between a transsphenoidal approach or intracranial approach for a sellar lesion, or between a subtemporal approach, posterior fossa approach, or combined approach for a lesion of the tentorial notch. It is also helpful to make a map of the lesin on a plain craniogram using this two-plane method in some cases for radiotherapy and stereotactic brain biopsy. (author)

  5. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

    International Nuclear Information System (INIS)

    Makkat, S.; Vandevenne, J.E.; Parizel, P.M.; Schepper, A.M. de

    2001-01-01

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  6. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

    Energy Technology Data Exchange (ETDEWEB)

    Makkat, S.; Vandevenne, J.E.; Parizel, P.M.; Schepper, A.M. de [Dept. of Radiology, Universitair Ziekenhuis Antwerpen, Edegem (Belgium)

    2001-05-01

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  7. Estimation of skull table thickness with clinical CT and validation with microCT.

    Science.gov (United States)

    Lillie, Elizabeth M; Urban, Jillian E; Weaver, Ashley A; Powers, Alexander K; Stitzel, Joel D

    2015-01-01

    Brain injuries resulting from motor vehicle crashes (MVC) are extremely common yet the details of the mechanism of injury remain to be well characterized. Skull deformation is believed to be a contributing factor to some types of traumatic brain injury (TBI). Understanding biomechanical contributors to skull deformation would provide further insight into the mechanism of head injury resulting from blunt trauma. In particular, skull thickness is thought be a very important factor governing deformation of the skull and its propensity for fracture. Current computed tomography (CT) technology is limited in its ability to accurately measure cortical thickness using standard techniques. A method to evaluate cortical thickness using cortical density measured from CT data has been developed previously. This effort validates this technique for measurement of skull table thickness in clinical head CT scans using two postmortem human specimens. Bone samples were harvested from the skulls of two cadavers and scanned with microCT to evaluate the accuracy of the estimated cortical thickness measured from clinical CT. Clinical scans were collected at 0.488 and 0.625 mm in plane resolution with 0.625 mm thickness. The overall cortical thickness error was determined to be 0.078 ± 0.58 mm for cortical samples thinner than 4 mm. It was determined that 91.3% of these differences fell within the scanner resolution. Color maps of clinical CT thickness estimations are comparable to color maps of microCT thickness measurements, indicating good quantitative agreement. These data confirm that the cortical density algorithm successfully estimates skull table thickness from clinical CT scans. The application of this technique to clinical CT scans enables evaluation of cortical thickness in population-based studies. © 2014 Anatomical Society.

  8. Early medical skull surgery for treatment of post-traumatic osteomyelitis 5,000 years ago.

    Directory of Open Access Journals (Sweden)

    Pierpaolo Petrone

    Full Text Available Here we describe the findings of a unique example of the early techniques adopted in neurosurgery around 5000 years ago, consisting in a double well healed skull trephination associated with a post-cranial traumatic event occurring intra vitam to a young male from the Early Chalcolithic cemetery of Pontecagnano (South Italy, ca. 4,900 - 4,500 cal BP. Morphological, X-ray and 3D-CT scan skull-cap evaluation revealed that the main orifice was produced by scraping, obtained by clockwise rotary motion of a right-handed surgeon facing the patient, while the partial trephination was carried out by using a stone point as a drilling tool. In both cases, bone regrowth is indicative of the individual's prolonged postoperative survival and his near-complete recovery. The right femur shows a poorly healed mid-shaft fracture presumably induced by a high energy injury, and a resulting chronic osteomyelitis, affecting both femurs by hematogenous spread of the infection. Our observations on the visual and radiological features of skull and femur lesions, along with evidence on the timing of experimental bone regrowth vs. healing of lower limb fractures associated to long-term bone infections now suggest that this young man underwent a double skull trephination in order to alleviate his extremely painful condition induced by chronic osteomyelitis, which is thought to have been the cause of death.

  9. Broadband acoustic properties of a murine skull.

    Science.gov (United States)

    Estrada, Héctor; Rebling, Johannes; Turner, Jake; Razansky, Daniel

    2016-03-07

    It has been well recognized that the presence of a skull imposes harsh restrictions on the use of ultrasound and optoacoustic techniques in the study, treatment and modulation of the brain function. We propose a rigorous modeling and experimental methodology for estimating the insertion loss and the elastic constants of the skull over a wide range of frequencies and incidence angles. A point-source-like excitation of ultrawideband acoustic radiation was induced via the absorption of nanosecond duration laser pulses by a 20 μm diameter microsphere. The acoustic waves transmitted through the skull are recorded by a broadband, spherically focused ultrasound transducer. A coregistered pulse-echo ultrasound scan is subsequently performed to provide accurate skull geometry to be fed into an acoustic transmission model represented in an angular spectrum domain. The modeling predictions were validated by measurements taken from a glass cover-slip and ex vivo adult mouse skulls. The flexible semi-analytical formulation of the model allows for seamless extension to other transducer geometries and diverse experimental scenarios involving broadband acoustic transmission through locally flat solid structures. It is anticipated that accurate quantification and modeling of the skull transmission effects would ultimately allow for skull aberration correction in a broad variety of applications employing transcranial detection or transmission of high frequency ultrasound.

  10. 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.

  11. Management of osteomyelitis of the skull base

    International Nuclear Information System (INIS)

    Benecke, J.E. Jr.

    1989-01-01

    Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol

  12. The Genetics of Canine Skull Shape Variation

    Science.gov (United States)

    Schoenebeck, Jeffrey J.; Ostrander, Elaine A.

    2013-01-01

    A dog’s craniofacial diversity is the result of continual human intervention in natural selection, a process that began tens of thousands of years ago. To date, we know little of the genetic underpinnings and developmental mechanisms that make dog skulls so morphologically plastic. In this Perspectives, we discuss the origins of dog skull shapes in terms of history and biology and highlight recent advances in understanding the genetics of canine skull shapes. Of particular interest are those molecular genetic changes that are associated with the development of distinct breeds. PMID:23396475

  13. Subcranial approach in the surgical treatment of anterior skull base trauma.

    Science.gov (United States)

    Schaller, B

    2005-04-01

    Fractures of the anterior skull base, because of the region's anatomical relationships, are readily complicated by neurological damage to the brain or cranial nerves. This review highlights the use of a subcranial approach in the operative treatment of injuries of the anterior skull base and compares it to the more traditional neurosurgical transcranial approach. The extended anterior subcranial approach takes advantage of the specific features of injuries in this region and allows direct access to the central anterior cranial base in order to repair fractures, close CSF fistulae and relieve of optic nerve compression. It avoids extensive frontal lobe manipulation. The success of the approach in achieving the aims of surgery with low morbidity is reviewed.

  14. Skull base tumours part I: Imaging technique, anatomy and anterior skull base tumours

    International Nuclear Information System (INIS)

    Borges, Alexandra

    2008-01-01

    Advances in cross-sectional imaging, surgical technique and adjuvant treatment have largely contributed to ameliorate the prognosis, lessen the morbidity and mortality of patients with skull base tumours and to the growing medical investment in the management of these patients. Because clinical assessment of the skull base is limited, cross-sectional imaging became indispensable in the diagnosis, treatment planning and follow-up of patients with suspected skull base pathology and the radiologist is increasingly responsible for the fate of these patients. This review will focus on the advances in imaging technique; contribution to patient's management and on the imaging features of the most common tumours affecting the anterior skull base. Emphasis is given to a systematic approach to skull base pathology based upon an anatomic division taking into account the major tissue constituents in each skull base compartment. The most relevant information that should be conveyed to surgeons and radiation oncologists involved in patient's management will be discussed

  15. 21 CFR 882.4030 - Skull plate anvil.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull plate anvil. 882.4030 Section 882.4030 Food... DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4030 Skull plate anvil. (a) Identification. A skull plate anvil is a device used to form alterable skull plates in the proper shape to fit...

  16. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neurosurgical head holder (skull clamp). 882.4460... holder (skull clamp). (a) Identification. A neurosurgical head holder (skull clamp) is a device used to clamp the patient's skull to hold head and neck in a particular position during surgical procedures. (b...

  17. Imaging in tuberculosis of the skull and skull-base: case report

    International Nuclear Information System (INIS)

    Sencer, S.; Aydin, K.; Poyanli, A.; Minareci, O.; Sencer, A.; Hepguel, K.

    2003-01-01

    We report a 19-year-old girl, who presented with headache and tonic/clonic seizures. Imaging revealed a lytic parietal skull lesion with an adjacent epidural mass, masses in the right parietal lobe and a posterior skull-base mass. The diagnosis of tuberculosis was made after resection of the extradural mass and later verified with culture of Mycobacterium tuberculosis. The parenchymal and skull-base lesions resolved following antituberculous treatment. We present CT, scintigraphic, angiographic and MRI findings. (orig.)

  18. The Skull of Phyllomedusa sauvagii (Anura, Hylidae).

    Science.gov (United States)

    Ruiz-Monachesi, Mario R; Lavilla, Esteban O; Montero, Ricardo

    2016-05-01

    The hylid genus Phyllomedusa comprises charismatic frogs commonly known as monkey, leaf or green frogs, and is the most diverse genus of the subfamily Phyllomedusinae, including about 31 species. Although there is some information about the anatomy of these frogs, little is known about the osteology. Here the adult skull of Phyllomedusa sauvagii, both articulated and disarticulated, is described and the intraspecific variation is reported. Additionally, cartilage associated with the adult skull, such as the nasal capsules, auditory apparatus, and hyobranchial apparatus, are included in the analysis. Further examination of disarticulated bones reveals their remarkable complexity, specifically in the sphenethmoid and of the oocipital region. The description of disarticulated bones is useful for the identification of fossil remains as well as providing morphological characteristics that are phylogenetically informative. When comparing the skull morphology with the available information of other species of the genus, Phyllomesusa sauvagii skull resembles more that of P. vaillantii and P. venusta than P. atelopoides. © 2016 Wiley Periodicals, Inc.

  19. Skull fractures in car accidents: Types and Causes

    Directory of Open Access Journals (Sweden)

    Witold Pawłowski

    2018-03-01

    Full Text Available Brain injury may be the result of a sudden blow to the head or head impact. The result is damage at the site of application of force and damage of the remote location. The force acting on the head causes not only local effects through the oppression, but also puts in motion the head, which causes the cranial structures The aim of the study was to characterize head injuries with special attention to their types. After regaining consciousness, and coming out of immediate danger of life reveals a number of problems the nature of neurological, psychological and neuropsychological, the latter reveal the disorder is sometimes quite late due to their discrete nature A serious problem is post traumatic stress disorder in the form of fear, helplessness, feelings of constant threat. In extreme cases, they represent a permanent team apical or brain death occurs.

  20. Open depressed skull fracture with embedded human tooth in the ...

    African Journals Online (AJOL)

    Orient Journal of Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 28, No 3-4 (2016) >. Log in or Register to get access to full text downloads.

  1. Traumatic epistaxis: Skull base defects, intracranial complications and neurosurgical considerations.

    Science.gov (United States)

    Veeravagu, Anand; Joseph, Richard; Jiang, Bowen; Lober, Robert M; Ludwig, Cassie; Torres, Roland; Singh, Harminder

    2013-01-01

    Endonasal procedures may be necessary during management of craniofacial trauma. When a skull base fracture is present, these procedures carry a high risk of violating the cranial vault and causing brain injury or central nervous system infection. A 52-year-old bicyclist was hit by an automobile at high speed. He sustained extensive maxillofacial fractures, including frontal and sphenoid sinus fractures (Fig. 1). He presented to the emergency room with brisk nasopharyngeal hemorrhage, and was intubated for airway protection. He underwent emergent stabilization of his nasal epistaxis by placement of a Foley catheter in his left nare and tamponade with the Foley balloon. A six-vessel angiogram showed no evidence of arterial dissection or laceration. Imaging revealed inadvertent insertion of the Foley catheter and deployment of the balloon in the frontal lobe (Fig. 2). The balloon was subsequently deflated and the Foley catheter removed. The patient underwent bifrontal craniotomy for dural repair of CSF leak. He also had placement of a ventriculoperitoneal shunt for development of post-traumatic hydrocephalus. Although the hospital course was a prolonged one, he did make a good neurological recovery. The authors review the literature involving violation of the intracranial compartment with medical devices in the settings of craniofacial trauma. Caution should be exercised while performing any endonasal procedure in the settings of trauma where disruption of the anterior cranial base is possible. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Fracture Mechanics

    International Nuclear Information System (INIS)

    Jang, Dong Il; Jeong, Gyeong Seop; Han, Min Gu

    1992-08-01

    This book introduces basic theory and analytical solution of fracture mechanics, linear fracture mechanics, non-linear fracture mechanics, dynamic fracture mechanics, environmental fracture and fatigue fracture, application on design fracture mechanics, application on analysis of structural safety, engineering approach method on fracture mechanics, stochastic fracture mechanics, numerical analysis code and fracture toughness test and fracture toughness data. It gives descriptions of fracture mechanics to theory and analysis from application of engineering.

  3. A paediatric case of bilateral mandibular condyle fracture presenting with bloody otorrhoea following trauma.

    Science.gov (United States)

    Chan, Yat Chun; Au-Yeung, Kwan Leong

    2017-04-22

    A 7-year-old boy presented to the emergency department with bilateral bloody otorrhoea after falling from his scooter. Skull base fracture was suspected. CT showed no evidence of skull base fracture but bilateral mandibular condyle and external acoustic canals fractures. We report this case to illustrate a rare possibility of bilateral external acoustic canal fracture associated with condylar fracture in trauma patients presented with bloody otorrhoea. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. [A case of pycnodysostosis--observation of the skull by CT scan].

    Science.gov (United States)

    Anegawa, S; Bekki, Y; Furukawa, Y; Yokota, S; Torigoe, R

    1987-07-01

    A 13-year-old boy was presented to the Department of Neurosurgery, Saiseikai Fukuoka General Hospital for further examinations concerning abnormal findings in the skull radiogram taken when he struck his head. His physical features showed some characteristics the same as those of pycnodysostosis as follows--proportionate dwarfism, prominent forehead, short spoon-shaped fingers, bilateral exophthalmos. A skull radiogram revealed widely open cranial sutures with no healing of the fracture and craniotomy which was performed for an acute epidural hematoma 6 years ago. Furthermore, the mandible was hypoplastic with a virtual loss of mandibular angle. CT of the soft tissues showed somewhat dilated cortical sulci and ventricles without any structural abnormalities in the brain. CT of bone algorithm revealed specific characteristics of this disease. The paranasal sinuses were quite hypoplastic. Especially in the maxillary sinuses, frontal sinuses and mastoid air cells, none of developments of sinuses were noted, even though the middle and internal ear seemed to be normal. Moreover, the ethmoid and sphenoid sinuses were noted, although their developments were poor. The appearance of skull base was normal, including the inlets and outlets of cranial nerves or vessels and synchondroses. However, the density of the skull base, especially in the diploe, was higher than normal in Hansfield number. Furthermore, detailed measurements of skull base demonstrated that the skull base itself was also dwarfism. Pycnodysostosis is a generalized skeletal disease whose cardinal features are moderate generalized osteosclerosis and dwarfism. However, the detailed observation on the cranium by CT has not been reported. In our study, the development of sinuses in bones with intramembranous ossification are worse than that with endochondral ossification.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Functional relationship between skull form and feeding mechanics in Sphenodon, and implications for diapsid skull development.

    Directory of Open Access Journals (Sweden)

    Neil Curtis

    Full Text Available The vertebrate skull evolved to protect the brain and sense organs, but with the appearance of jaws and associated forces there was a remarkable structural diversification. This suggests that the evolution of skull form may be linked to these forces, but an important area of debate is whether bone in the skull is minimised with respect to these forces, or whether skulls are mechanically "over-designed" and constrained by phylogeny and development. Mechanical analysis of diapsid reptile skulls could shed light on this longstanding debate. Compared to those of mammals, the skulls of many extant and extinct diapsids comprise an open framework of fenestrae (window-like openings separated by bony struts (e.g., lizards, tuatara, dinosaurs and crocodiles, a cranial form thought to be strongly linked to feeding forces. We investigated this link by utilising the powerful engineering approach of multibody dynamics analysis to predict the physiological forces acting on the skull of the diapsid reptile Sphenodon. We then ran a series of structural finite element analyses to assess the correlation between bone strain and skull form. With comprehensive loading we found that the distribution of peak von Mises strains was particularly uniform throughout the skull, although specific regions were dominated by tensile strains while others were dominated by compressive strains. Our analyses suggest that the frame-like skulls of diapsid reptiles are probably optimally formed (mechanically ideal: sufficient strength with the minimal amount of bone with respect to functional forces; they are efficient in terms of having minimal bone volume, minimal weight, and also minimal energy demands in maintenance.

  6. Functional Relationship between Skull Form and Feeding Mechanics in Sphenodon, and Implications for Diapsid Skull Development

    Science.gov (United States)

    Curtis, Neil; Jones, Marc E. H.; Shi, Junfen; O'Higgins, Paul; Evans, Susan E.; Fagan, Michael J.

    2011-01-01

    The vertebrate skull evolved to protect the brain and sense organs, but with the appearance of jaws and associated forces there was a remarkable structural diversification. This suggests that the evolution of skull form may be linked to these forces, but an important area of debate is whether bone in the skull is minimised with respect to these forces, or whether skulls are mechanically “over-designed” and constrained by phylogeny and development. Mechanical analysis of diapsid reptile skulls could shed light on this longstanding debate. Compared to those of mammals, the skulls of many extant and extinct diapsids comprise an open framework of fenestrae (window-like openings) separated by bony struts (e.g., lizards, tuatara, dinosaurs and crocodiles), a cranial form thought to be strongly linked to feeding forces. We investigated this link by utilising the powerful engineering approach of multibody dynamics analysis to predict the physiological forces acting on the skull of the diapsid reptile Sphenodon. We then ran a series of structural finite element analyses to assess the correlation between bone strain and skull form. With comprehensive loading we found that the distribution of peak von Mises strains was particularly uniform throughout the skull, although specific regions were dominated by tensile strains while others were dominated by compressive strains. Our analyses suggest that the frame-like skulls of diapsid reptiles are probably optimally formed (mechanically ideal: sufficient strength with the minimal amount of bone) with respect to functional forces; they are efficient in terms of having minimal bone volume, minimal weight, and also minimal energy demands in maintenance. PMID:22216358

  7. The conductivity of neonatal piglet skulls

    International Nuclear Information System (INIS)

    Pant, Shilpa; Te, Tang; Tucker, Aaron; Sadleir, Rosalind J

    2011-01-01

    We report the first measured values of conductivities for neonatal mammalian skull samples. We measured the average radial (normal to the skull surface) conductivity of fresh neonatal piglet skull samples at 1 kHz and found it to be around 30 mS m −1 at ambient room temperatures of about 23 °C. Measurements were made on samples of either frontal or parietal cranial bone, using a saline-filled cell technique. The conductivity value we observed was approximately twice the values reported for adult skulls (Oostendorp et al 2000 IEEE Trans. Biomed. Eng. 47 1487–92) using a similar technique, but at a frequency of around 5 Hz. Further, we found that the conductivity of skull fragments increased linearly with thickness. We found evidence that this was related to differences in composition between the frontal and parietal bone samples tested, which we believe is because frontal bones contained a larger fraction of higher conductivity cancellous bone material

  8. Normal Development of Sutures and synchondroses in the central skull base : CT study

    International Nuclear Information System (INIS)

    Roh, Hong Gee; Kim, Hyung Jin; Kang, Jee Hee; Lee, Kyung Hee; Lim, Myung Kwan; Cho, Young Kuk; Ok, Cheol Su; Suh, Chang Hae

    2000-01-01

    To evaluate the developmental patterns of the sutures and synchondroses in the central skull base. We evaluated the CT scans of 109 children (age range 29 days to 15 years) with no skull base abnormality who had undergone axial CT of the skull base with 1-mm collimation. Using a five-tier scheme, we analyzed the developmental patterns of the 18 sutures and synchondroses related to the sphenoid and occipital bones. Fusion of the sutures and synchondroses related to the sphenoid bone progressed rapidly during the first two years. Thereafter, changes in the sphenoid bone were dominated by pneumatization of the sphenoid sinus. Fusion of the synchondroses within the sphenoid body, including intersphenoidal, intrapresphenoidal, intrapostsphenoidal synchondrosis occurred early and in most cases was graded ≥3D4. Fusion of the sphenosquamosal, sphenoethmoidal, and frontosphenoidal sutures was delayed, and residual sclerosis was a common finding. Except for Kerckring-supraoccipital synchondrosis, fusion of the six sutures and synchondroses related to the occipital bone occurred more gradually than that of those related to the sphenoid bone. Among these, fusion of the occipitomastoidal suture and petro-occipital synchondrosis was the last to occur. A knowledge of the developmental patterns of sutures and synchondroses can help differentiate normal conditions from those such as fracture, osseous dysplasia, or congenital malformation, which are abnormal. Our results provide certain basic information about skull base maturity in children. (author)

  9. Bone scintigraphy in lesions of the skull

    International Nuclear Information System (INIS)

    Fischer, M.; Wasilewski, A.; Deitmer, T.

    1982-01-01

    The value of 3-phase-scintigraphy in bone lesions of the skull with a new seeking agent 99mTc-2,3-dicarboxypropane-1,1-diphosphonic acid (DPD) is studied. A high soft tissue-bone-ratio of DPD is emphasized. For this reason DPD is used for bone scintigraphy of the skull, because the mass of soft tissue in relation to bone is high and a higher clearance improves the interpretation of the images of the first two phases. An increased tracer uptake is found for skeletal neoplasms (malignant and benign lesions) and for acute osteomyelitis. By contrast, the chronic inflammatory bone lesions showed normal tracer uptake. This new bone seeking agent allows to localize and differentiate tumorous or acute inflammatory lesions and chronic inflammatory bone lesions of the skull

  10. Introduction: surgical management of skull base meningiomas.

    Science.gov (United States)

    Zada, Gabriel; Başkaya, Mustafa K; Shah, Mitesh V

    2017-10-01

    Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients. Skull base meningiomas represent some of the most challenging pathology encountered by neurosurgeons, on account of their depth, invasion, vascularity, texture/consistency, and their relationship to bony anatomy, cranial nerves, and blood vessels. Resection of complex skull base meningiomas often mandates adequate bony removal to achieve sufficient exposure of the tumor and surrounding region, in order to minimize brain retraction and optimally identify, protect, control, and manipulate sensitive neurovascular structures. A variety of traditional skull base approaches has evolved to address complex skull base tumors, of which meningiomas are considered the paragon in terms of both complexity and frequency. In this supplemental video issue of Neurosurgical Focus, contributing authors from around the world provide instructional narratives demonstrating resection of a variety of skull base meningiomas arising from traditionally challenging origins, including the clinoid processes, tuberculum sellae, dorsum sellae, petroclival region, falco-tentorial region, cerebellopontine angle, and foramen magnum. In addition, two cases of extended endoscopic endonasal approaches for tuberculum sellae and dorsum sellae meningiomas are presented, representing the latest evolution in accessing the skull base for selected tumors

  11. CT of Normal Developmental and Variant Anatomy of the Pediatric Skull: Distinguishing Trauma from Normality.

    Science.gov (United States)

    Idriz, Sanjin; Patel, Jaymin H; Ameli Renani, Seyed; Allan, Rosemary; Vlahos, Ioannis

    2015-01-01

    The use of computed tomography (CT) in clinical practice has been increasing rapidly, with the number of CT examinations performed in adults and children rising by 10% per year in England. Because the radiology community strives to reduce the radiation dose associated with pediatric examinations, external factors, including guidelines for pediatric head injury, are raising expectations for use of cranial CT in the pediatric population. Thus, radiologists are increasingly likely to encounter pediatric head CT examinations in daily practice. The variable appearance of cranial sutures at different ages can be confusing for inexperienced readers of radiologic images. The evolution of multidetector CT with thin-section acquisition increases the clarity of some of these sutures, which may be misinterpreted as fractures. Familiarity with the normal anatomy of the pediatric skull, how it changes with age, and normal variants can assist in translating the increased resolution of multidetector CT into more accurate detection of fractures and confident determination of normality, thereby reducing prolonged hospitalization of children with normal developmental structures that have been misinterpreted as fractures. More important, the potential morbidity and mortality related to false-negative interpretation of fractures as normal sutures may be avoided. The authors describe the normal anatomy of all standard pediatric sutures, common variants, and sutural mimics, thereby providing an accurate and safe framework for CT evaluation of skull trauma in pediatric patients. (©)RSNA, 2015.

  12. Peculiarities of skull roentgenological picture during hyperparathyroid osteodystrophia

    International Nuclear Information System (INIS)

    Spuzyak, M.I.

    1985-01-01

    Results of the analysis of skull roentgenological pictures of 61 patients wih primary hyperparathyroidism are presented. All the patients were operated. Diagnosis is confirmed during the operation and histological examination. Alterations of skull are disclosed in 90% of patients

  13. Changes of the skull in general body diseases

    International Nuclear Information System (INIS)

    Koval', G.Yu.; Perepust, L.A.; Novikova, Eh.Z.

    1984-01-01

    Changes of the skull in the following body disease are considered. Diseases: endocrine diseases, fibrous osteodystrophy, reticulohistocytoses and noninfectious granulomas, the blood system diseases, disturbance of vitamin balance. Skull roentgenograms in some above-mentioned diseases are presented and analysed

  14. 21 CFR 882.5960 - Skull tongs for traction.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull tongs for traction. 882.5960 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5960 Skull tongs for traction. (a) Identification. Skull tongs for traction is an instrument used to immobilize a patient with a...

  15. Growth of the skull in young children in Baotou, China.

    Science.gov (United States)

    Hou, Hai-dong; Liu, Ming; Gong, Ke-rui; Shao, Guo; Zhang, Chun-Yang

    2014-09-01

    There are some controversies about the optimal time to perform skull repair in very young Chinese children because of the rapid skull growth in this stage of life. The purpose of this current study is to describe the characteristics of skull growth and to discuss the optimal time for skull repair in young Chinese children with skull defects. A total of 112 children born in the First Affiliated Hospital of Baotou Medical College were measured for six consecutive years starting in 2006. Cranial length (CL, linear distance between the eyebrows to the pillow tuberosity), cranial width (CW, double-sided linear distance of connection of external auditory canal), ear over the top line (EOTL), the eyebrows-the posterior tuberosity line (EPTL), and head circumference (HC) were measured to describe the skull growth. The most rapid period of skull growth occurs during the first year of life. The second and third most rapid periods are the second and third years, respectively. Then, the skull growth slowed and the values of the skull growth index of 6-year-old children were close to those of adults. Children 0-1 years old should not receive skull repair due to their rapid skull growth. The indexes of children 3 years old or older were close to those of the adult; therefore, 3 years old or older may receive skull repair.

  16. Skull base tumors: a kaleidoscope of challenge.

    Science.gov (United States)

    Khanna, J N; Natrajan, Srivalli; Galinde, Jyotsna

    2014-08-01

    Resection of skull base lesions has always been riddled with problems like inadequate access, proximity to major vessels, dural tears, cranial nerve damage, and infection. Understanding the modular concept of the facial skeleton has led to the development of transfacial swing osteotomies that facilitates resection in a difficult area with minimal morbidity and excellent cosmetic results. In spite of the current trend toward endonasal endoscopic management of skull base tumors, our series presents nine cases of diverse extensive skull base lesions, 33% of which were recurrent. These cases were approached through different transfacial swing osteotomies through the mandible, a midfacial swing, or a zygomaticotemporal osteotomy as dictated by the three-dimensional spatial location of the lesion, and its extent and proximity to vital structures. Access osteotomies ensured complete removal and good results through the most direct and safe route and good vascular control. This reiterated the fact that transfacial approaches still hold a special place in the management of extensive skull base lesions.

  17. Encephalocele and associated skull defects | Komolafe | West ...

    African Journals Online (AJOL)

    The case notes of the patients with encephalocele managed over a 5 year period were reviewed and the relevant data obtained. Seventy-six percent of the patients had occipital encephalocele. The average diameter of the skull defect was 1.8cm. Only 2(9.5%) of the patients had cranioplasty. Cosmesis was acceptable to all ...

  18. A critical inventory of preoperative skull replicas.

    Science.gov (United States)

    Fasel, J H D; Beinemann, J; Schaller, K; Gailloud, P

    2013-09-01

    Physical replicas of organs are used increasingly for preoperative planning. The quality of these models is generally accepted by surgeons. In view of the strong trend towards minimally invasive and personalised surgery, however, the aim of this investigation was to assess qualitatively the accuracy of such replicas, using skull models as an example. Skull imaging was acquired for three cadavers by computed tomography using clinical routine parameters. After digital three-dimensional (3D) reconstruction, physical replicas were produced by 3D printing. The facsimilia were analysed systematically and compared with the best gold standard possible: the macerated skull itself. The skull models were far from anatomically accurate. Non-conforming rendering was observed in particular for foramina, sutures, notches, fissures, grooves, channels, tuberosities, thin-walled structures, sharp peaks and crests, and teeth. Surgeons should be aware that preoperative models may not yet render the exact anatomy of the patient under consideration and are advised to continue relying, in specific conditions, on their own analysis of the native computed tomography or magnetic resonance imaging.

  19. Skull base tumours part I: Imaging technique, anatomy and anterior skull base tumours

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Servico de Radiologia, Rua Professor Lima Basto, 1093 Lisboa Codex (Portugal)], E-mail: borgesalexandra@clix.pt

    2008-06-15

    Advances in cross-sectional imaging, surgical technique and adjuvant treatment have largely contributed to ameliorate the prognosis, lessen the morbidity and mortality of patients with skull base tumours and to the growing medical investment in the management of these patients. Because clinical assessment of the skull base is limited, cross-sectional imaging became indispensable in the diagnosis, treatment planning and follow-up of patients with suspected skull base pathology and the radiologist is increasingly responsible for the fate of these patients. This review will focus on the advances in imaging technique; contribution to patient's management and on the imaging features of the most common tumours affecting the anterior skull base. Emphasis is given to a systematic approach to skull base pathology based upon an anatomic division taking into account the major tissue constituents in each skull base compartment. The most relevant information that should be conveyed to surgeons and radiation oncologists involved in patient's management will be discussed.

  20. Modeling skull's acoustic attenuation and dispersion on photoacoustic signal

    Science.gov (United States)

    Mohammadi, L.; Behnam, H.; Nasiriavanaki, M. R.

    2017-03-01

    Despite the great promising results of a recent new transcranial photoacoustic brain imaging technology, it has been shown that the presence of the skull severely affects the performance of this imaging modality. In this paper, we investigate the effect of skull on generated photoacoustic signals with a mathematical model. The developed model takes into account the frequency dependence attenuation and acoustic dispersion effects occur with the wave reflection and refraction at the skull surface. Numerical simulations based on the developed model are performed for calculating the propagation of photoacoustic waves through the skull. From the simulation results, it was found that the skull-induced distortion becomes very important and the reconstructed image would be strongly distorted without correcting these effects. In this regard, it is anticipated that an accurate quantification and modeling of the skull transmission effects would ultimately allow for skull aberration correction in transcranial photoacoustic brain imaging.

  1. Skull defect reconstruction based on a new hybrid level set.

    Science.gov (United States)

    Zhang, Ziqun; Zhang, Ran; Song, Zhijian

    2014-01-01

    Skull defect reconstruction is an important aspect of surgical repair. Historically, a skull defect prosthesis was created by the mirroring technique, surface fitting, or formed templates. These methods are not based on the anatomy of the individual patient's skull, and therefore, the prosthesis cannot precisely correct the defect. This study presented a new hybrid level set model, taking into account both the global optimization region information and the local accuracy edge information, while avoiding re-initialization during the evolution of the level set function. Based on the new method, a skull defect was reconstructed, and the skull prosthesis was produced by rapid prototyping technology. This resulted in a skull defect prosthesis that well matched the skull defect with excellent individual adaptation.

  2. Statistical analysis of biomechanical properties of the adult skull and age-related structural changes by sex in a Japanese forensic sample.

    Science.gov (United States)

    Torimitsu, Suguru; Nishida, Yoshifumi; Takano, Tachio; Koizumi, Yoshinori; Makino, Yohsuke; Yajima, Daisuke; Hayakawa, Mutsumi; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Otsuka, Katsura; Kobayashi, Kazuhiro; Odo, Yuriko; Iwase, Hirotaro

    2014-01-01

    The purpose of this research was to investigate the biomechanical properties of the adult human skull and the structural changes that occur with age in both sexes. The heads of 94 Japanese cadavers (54 male cadavers, 40 female cadavers) autopsied in our department were used in this research. A total of 376 cranial samples, four from each skull, were collected. Sample fracture load was measured by a bending test. A statistically significant negative correlation between the sample fracture load and cadaver age was found. This indicates that the stiffness of cranial bones in Japanese individuals decreases with age, and the risk of skull fracture thus probably increases with age. Prior to the bending test, the sample mass, the sample thickness, the ratio of the sample thickness to cadaver stature (ST/CS), and the sample density were measured and calculated. Significant negative correlations between cadaver age and sample thickness, ST/CS, and the sample density were observed only among the female samples. Computerized tomographic (CT) images of 358 cranial samples were available. The computed tomography value (CT value) of cancellous bone which refers to a quantitative scale for describing radiodensity, cancellous bone thickness and cortical bone thickness were measured and calculated. Significant negative correlation between cadaver age and the CT value or cortical bone thickness was observed only among the female samples. These findings suggest that the skull is substantially affected by decreased bone metabolism resulting from osteoporosis. Therefore, osteoporosis prevention and treatment may increase cranial stiffness and reinforce the skull structure, leading to a decrease in the risk of skull fractures. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Augmented reality-assisted skull base surgery.

    Science.gov (United States)

    Cabrilo, I; Sarrafzadeh, A; Bijlenga, P; Landis, B N; Schaller, K

    2014-12-01

    Neuronavigation is widely considered as a valuable tool during skull base surgery. Advances in neuronavigation technology, with the integration of augmented reality, present advantages over traditional point-based neuronavigation. However, this development has not yet made its way into routine surgical practice, possibly due to a lack of acquaintance with these systems. In this report, we illustrate the usefulness and easy application of augmented reality-based neuronavigation through a case example of a patient with a clivus chordoma. We also demonstrate how augmented reality can help throughout all phases of a skull base procedure, from the verification of neuronavigation accuracy to intraoperative image-guidance. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Imaging of the central skull base.

    Science.gov (United States)

    Borges, Alexandra

    2009-11-01

    The central skull base (CSB) constitutes a frontier between the extracranial head and neck and the middle cranial fossa. The anatomy of this region is complex, containing most of the bony foramina and canals of the skull base traversed by several neurovascular structures that can act as routes of spread for pathologic processes. Lesions affecting the CSB can be intrinsic to its bony-cartilaginous components; can arise from above, within the intracranial compartment; or can arise from below, within the extracranial head and neck. Crosssectional imaging is indispensable in the diagnosis, treatment planning, and follow-up of patients with CSB lesions. This review focuses on a systematic approach to this region based on an anatomic division that takes into account the major tissue constituents of the CSB.

  5. Hemangioendothelioma of the skull: A case report

    International Nuclear Information System (INIS)

    Gana, R.; Fatemi, N.; Sghiar, J.; Maaqili, R.; Bellakhdar, F.

    2008-01-01

    Hemangioendothelioma is a rare vascular tumour of endothelial cell origin. It may involve bone or soft tissues and can behave like a benign or malignant tumour. A 54-year-old man presented with localized swelling over the parietal and occipital bones. He was neurologically intact. Radiographic images showed an expansible osteolytic lesion in the parietal-occipital bones. The patient was treated by wide surgical resection. This report contributes to the scarce literature on these tumours in the skull

  6. INFRAORBITAL SULCUS: A STUDY IN 100 SKULLS

    OpenAIRE

    Roshni; . Jayanthi; Shubha

    2014-01-01

    INTRODUCTION: A study was done on 100 intact, unsexed human skulls in the Department of Anatomy, KIMS, Bangalore, to observe and record the presence of a groove in the lateral wall of the orbit, synonymous with infra orbital sulcus. This entity has been described by the fortieth edition of Gray’s text book of Anatomy to extend from the lateral end of superior orbital fissure to the orbital floor. It sometimes contains an anastomosis between middle meningeal artery and infr...

  7. Congenital malformations of the skull and meninges.

    Science.gov (United States)

    Kanev, Paul M

    2007-02-01

    The surgery and management of children who have congenital malformations of the skull and meninges require multidisciplinary care and long-term follow-up by multiple specialists in birth defects. The high definition of three-dimensional CT and MRI allows precise surgery planning of reconstruction and management of associated malformations. The reconstruction of meningoencephaloceles and craniosynostosis are challenging procedures that transform the child's appearance. The embryology, clinical presentation, and surgical management of these malformations are reviewed.

  8. Chronic imaging through "transparent skull" in mice.

    Directory of Open Access Journals (Sweden)

    Anna Steinzeig

    Full Text Available Growing interest in long-term visualization of cortical structure and function requires methods that allow observation of an intact cortex in longitudinal imaging studies. Here we describe a detailed protocol for the "transparent skull" (TS preparation based on skull clearing with cyanoacrylate, which is applicable for long-term imaging through the intact skull in mice. We characterized the properties of the TS in imaging of intrinsic optical signals and compared them with the more conventional cranial window preparation. Our results show that TS is less invasive, maintains stabile transparency for at least two months, and compares favorably to data obtained from the conventional cranial window. We applied this method to experiments showing that a four-week treatment with the antidepressant fluoxetine combined with one week of monocular deprivation induced a shift in ocular dominance in the mouse visual cortex, confirming that fluoxetine treatment restores critical-period-like plasticity. Our results demonstrate that the TS preparation could become a useful method for long-term visualization of the living mouse brain.

  9. The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

    Science.gov (United States)

    Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

    2014-04-01

    Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

  10. 'Do not touch' lesions of the skull base

    International Nuclear Information System (INIS)

    Dobre, Mircea C.; Fischbein, Nancy

    2014-01-01

    Imaging of the skull base presents many challenges due to its anatomical complexity, numerous normal variants and lack of familiarity to many radiologists. As the skull base is a region which is not amenable to physical examination and as lesions of the skull base are generally difficult to biopsy and even more difficult to operate on, the radiologist plays a major role in directing patient management via accurate image interpretation. Knowledge of the skull base should not be limited to neuroradiologists and head and neck radiologists, however, as the central skull base is routinely included in the field of view when imaging the brain, cervical spine, or head and neck with computed tomography or magnetic resonance imaging, and hence, its nuances should be familiar to general radiologists as well. We herein review the imaging findings of a subcategory of lesions of the central skull base, the 'do not touch' lesions.

  11. Quality criteria in diagnostic radiology of the skull

    International Nuclear Information System (INIS)

    Friedmann, G.

    1985-01-01

    Diagnostic survey radiology of the skull relies on pictures to be taken if indicated and to meet all conceivable requirements. Those radiograph directions and projections were selected out of the profusion of known and described ones which allow both as small a number of pictures and as comprehensive a demonstration of all skull sections and1structures as possible. With this in mind, quality criteria for plain radiographs of the skull taken laterally and sagittably, for partial radiographs of the visceral cranium including orbit and of the base of the skull including petrons bone are described. (orig./MG) [de

  12. A large, switchable optical clearing skull window for cerebrovascular imaging

    Science.gov (United States)

    Zhang, Chao; Feng, Wei; Zhao, Yanjie; Yu, Tingting; Li, Pengcheng; Xu, Tonghui; Luo, Qingming; Zhu, Dan

    2018-01-01

    Rationale: Intravital optical imaging is a significant method for investigating cerebrovascular structure and function. However, its imaging contrast and depth are limited by the turbid skull. Tissue optical clearing has a great potential for solving this problem. Our goal was to develop a transparent skull window, without performing a craniotomy, for use in assessing cerebrovascular structure and function. Methods: Skull optical clearing agents were topically applied to the skulls of mice to create a transparent window within 15 min. The clearing efficacy, repeatability, and safety of the skull window were then investigated. Results: Imaging through the optical clearing skull window enhanced both the contrast and the depth of intravital imaging. The skull window could be used on 2-8-month-old mice and could be expanded from regional to bi-hemispheric. In addition, the window could be repeatedly established without inducing observable inflammation and metabolic toxicity. Conclusion: We successfully developed an easy-to-handle, large, switchable, and safe optical clearing skull window. Combined with various optical imaging techniques, cerebrovascular structure and function can be observed through this optical clearing skull window. Thus, it has the potential for use in basic research on the physiopathologic processes of cortical vessels. PMID:29774069

  13. Evolutionary morphology of the rabbit skull

    Directory of Open Access Journals (Sweden)

    Brian Kraatz

    2016-09-01

    Full Text Available The skull of leporids (rabbits and hares is highly transformed, typified by pronounced arching of the dorsal skull and ventral flexion of the facial region (i.e., facial tilt. Previous studies show that locomotor behavior influences aspects of cranial shape in leporids, and here we use an extensive 3D geometric morphometrics dataset to further explore what influences leporid cranial diversity. Facial tilt angle, a trait that strongly correlates with locomotor mode, significantly predicts the cranial shape variation captured by the primary axis of cranial shape space, and describes a small proportion (13.2% of overall cranial shape variation in the clade. However, locomotor mode does not correlate with overall cranial shape variation in the clade, because there are two district morphologies of generalist species, and saltators and cursorial species have similar morphologies. Cranial shape changes due to phyletic size change (evolutionary allometry also describes a small proportion (12.5% of cranial shape variation in the clade, but this is largely driven by the smallest living leporid, the pygmy rabbit (Brachylagus idahoensis. By integrating phylogenetic history with our geometric morphometric data, we show that the leporid cranium exhibits weak phylogenetic signal and substantial homoplasy. Though these results make it difficult to reconstruct what the ‘ancestral’ leporid skull looked like, the fossil records suggest that dorsal arching and facial tilt could have occurred before the origin of the crown group. Lastly, our study highlights the diversity of cranial variation in crown leporids, and highlights a need for additional phylogenetic work that includes stem (fossil leporids and includes morphological data that captures the transformed morphology of rabbits and hares.

  14. Evolutionary origin of the turtle skull.

    Science.gov (United States)

    Bever, G S; Lyson, Tyler R; Field, Daniel J; Bhullar, Bhart-Anjan S

    2015-09-10

    Transitional fossils informing the origin of turtles are among the most sought-after discoveries in palaeontology. Despite strong genomic evidence indicating that turtles evolved from within the diapsid radiation (which includes all other living reptiles), evidence of the inferred transformation between an ancestral turtle with an open, diapsid skull to the closed, anapsid condition of modern turtles remains elusive. Here we use high-resolution computed tomography and a novel character/taxon matrix to study the skull of Eunotosaurus africanus, a 260-million-year-old fossil reptile from the Karoo Basin of South Africa, whose distinctive postcranial skeleton shares many unique features with the shelled body plan of turtles. Scepticism regarding the status of Eunotosaurus as the earliest stem turtle arises from the possibility that these shell-related features are the products of evolutionary convergence. Our phylogenetic analyses indicate strong cranial support for Eunotosaurus as a critical transitional form in turtle evolution, thus fortifying a 40-million-year extension to the turtle stem and moving the ecological context of its origin back onto land. Furthermore, we find unexpected evidence that Eunotosaurus is a diapsid reptile in the process of becoming secondarily anapsid. This is important because categorizing the skull based on the number of openings in the complex of dermal bone covering the adductor chamber has long held sway in amniote systematics, and still represents a common organizational scheme for teaching the evolutionary history of the group. These discoveries allow us to articulate a detailed and testable hypothesis of fenestral closure along the turtle stem. Our results suggest that Eunotosaurus represents a crucially important link in a chain that will eventually lead to consilience in reptile systematics, paving the way for synthetic studies of amniote evolution and development.

  15. Leonardo da Vinci's "A Skull Sectioned" : Skull and dental formula revisited

    NARCIS (Netherlands)

    Gerrits, Peter O.; Veening, Jan G.

    What can be learned from historical anatomical drawings and how to incorporate these drawings into anatomical teaching? The drawing A skull sectioned (RL 19058v) by Leonardo da Vinci (14521519), hides more detailed information than reported earlier. A well-chosen section cut explores sectioned

  16. Leonardo da Vinci's "A Skull Sectioned": Skull and dental formula revisited

    NARCIS (Netherlands)

    Gerrits, P.O.; Veening, J.G.

    2013-01-01

    What can be learned from historical anatomical drawings and how to incorporate these drawings into anatomical teaching? The drawing "A skull sectioned" (RL 19058v) by Leonardo da Vinci (1452-1519), hides more detailed information than reported earlier. A well-chosen section cut explores sectioned

  17. Adenoidal size in lateral roentgenogram of skull

    International Nuclear Information System (INIS)

    Won, H. S.; Byun, Y. S.; Hahm, C. K.; Kim, J. J.

    1983-01-01

    Adenoid is a kind of tonsil located in the posterior wall of the nasopharynx. Enlargement of the adenoid can produce obstruction of the nasopharynx and eustachian tube. Disturbance in discharge of nasal and paranasal secretions can be a cause of chronic rhinitis, sinusitis and otitis media. The diagnosis of enlarged adenoid by inspection is difficult due to its location. In the lateral roentgenogram of the skull the anterior wall of the adenoid is sharply delineated by air in the nasopharynx. The authors measured the sizes of adenoid and nasopharynx and calculated the adenoid-nasopharyngeal ratio (AN ratio) from 1,000 simple skull lateral roentgenograms of the children between the age of 0 to 16 years. Adenoid size is gradually increasing in the children up to 9 years of age but almost uncharged in the older age group. The AN ratio is highest in the age group of 8-9 years. In the age groups above 9 years of age the AN ratio is gradually decreased due to atrophic changes of the adenoid

  18. Adenoidal size in lateral roentgenogram of skull

    Energy Technology Data Exchange (ETDEWEB)

    Won, H. S.; Byun, Y. S.; Hahm, C. K.; Kim, J. J. [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1983-03-15

    Adenoid is a kind of tonsil located in the posterior wall of the nasopharynx. Enlargement of the adenoid can produce obstruction of the nasopharynx and eustachian tube. Disturbance in discharge of nasal and paranasal secretions can be a cause of chronic rhinitis, sinusitis and otitis media. The diagnosis of enlarged adenoid by inspection is difficult due to its location. In the lateral roentgenogram of the skull the anterior wall of the adenoid is sharply delineated by air in the nasopharynx. The authors measured the sizes of adenoid and nasopharynx and calculated the adenoid-nasopharyngeal ratio (AN ratio) from 1,000 simple skull lateral roentgenograms of the children between the age of 0 to 16 years. Adenoid size is gradually increasing in the children up to 9 years of age but almost uncharged in the older age group. The AN ratio is highest in the age group of 8-9 years. In the age groups above 9 years of age the AN ratio is gradually decreased due to atrophic changes of the adenoid.

  19. Skull base osteomyelitis: current microbiology and management.

    Science.gov (United States)

    Spielmann, P M; Yu, R; Neeff, M

    2013-01-01

    Skull base osteomyelitis typically presents in an immunocompromised patient with severe otalgia and otorrhoea. Pseudomonas aeruginosa is the commonest pathogenic micro-organism, and reports of resistance to fluoroquinolones are now emerging, complicating management. We reviewed our experience of this condition, and of the local pathogenic organisms. A retrospective review from 2004 to 2011 was performed. Patients were identified by their admission diagnostic code, and computerised records examined. Twenty patients were identified. A facial palsy was present in 12 patients (60 per cent). Blood cultures were uniformly negative, and culture of ear canal granulations was non-diagnostic in 71 per cent of cases. Pseudomonas aeruginosa was isolated in only 10 (50 per cent) cases; one strain was resistant to ciprofloxacin but all were sensitive to ceftazidime. Two cases of fungal skull base osteomyelitis were identified. The mortality rate was 15 per cent. The patients' treatment algorithm is presented. Our treatment algorithm reflects the need for multidisciplinary input, early microbial culture of specimens, appropriate imaging, and prolonged and systemic antimicrobial treatment. Resolution of infection must be confirmed by close follow up and imaging.

  20. The Radiological Diagnosis of Defects of the Skull Vault

    African Journals Online (AJOL)

    scalp and its inner relationship to meninges and brain. Brain lesions which produce skull defects usually present as brain lesions and scalp lesions which produce skull defects always present as scalp lesions. This leave" us with the same general principle, that, though there may be 40 more or less common diseases which ...

  1. Bilaterally symmetric Fourier approximations of the skull outlines of ...

    Indian Academy of Sciences (India)

    Present work illustrates a scheme of quantitative description of the shape of the skull outlines of temnospondyl amphibians using bilaterally symmetric closed Fourier curves. Some special points have been identified on the Fourier fits of the skull outlines, which are the local maxima, or minima of the distances from the ...

  2. The copper-beaten skull | Mahomed | SA Journal of Radiology

    African Journals Online (AJOL)

    The copper-beaten skull appearance is typically associated with craniosynostosis, where premature fusion of the cranial bone sutures results in the growing brain exerting pressure on the malleable cranium, producing a pattern known as the copper-beaten skull appearance. SA JOURNAL OF RADIOLOGY • February 2012 ...

  3. The Development of Skull Prosthesis Through Active Contour Model.

    Science.gov (United States)

    Chen, Yi-Wen; Shih, Cheng-Ting; Cheng, Chen-Yang; Lin, Yu-Cheng

    2017-09-09

    Skull defects result in brain infection and inadequate brain protection and pose a general danger to patient health. To avoid these situations and prevent re-injury, a prosthesis must be constructed and grafted onto the deficient region. With the development of rapid customization through additive manufacturing and 3D printing technology, skull prostheses can be fabricated accurately and efficiently prior to cranioplasty. However, an unfitted skull prosthesis made with a metal implant can cause repeated infection, potentially necessitating secondary surgery. This paper presents a method of creating suitably geometric graphics of skull defects to be applied in skull repair through active contour models. These models can be adjusted in each computed tomography slice according to the graphic features, and the curves representing the skull defect can be modeled. The generated graphics can adequately mimic the natural curvature of the complete skull. This method will enable clinical surgeons to rapidly implant customized prostheses, which is of particular importance in emergency surgery. The findings of this research can help surgeons provide patients with skull defects with treatment of the highest quality.

  4. Skull's acoustic attenuation and dispersion modeling on photoacoustic signal

    Science.gov (United States)

    Mohammadi, Leila; Behnam, Hamid; Tavakkoli, Jahan; Nasiriavanaki, Mohammadreza

    2018-02-01

    Despite the promising results of the recent novel transcranial photoacoustic (PA) brain imaging technology, it has been demonstrated that the presence of the skull severely affects the performance of this imaging modality. We theoretically investigate the effects of acoustic heterogeneity induced by skull on the PA signals generated from single particles, with firstly developing a mathematical model for this phenomenon and then explore experimental validation of the results. The model takes into account the frequency dependent attenuation and dispersion effects occur with wave reflection, refraction and mode conversion at the skull surfaces. Numerical simulations based on the developed model are performed for calculating the propagation of photoacoustic waves through the skull. The results show a strong agreement between simulation and ex-vivo study. The findings are as follow: The thickness of the skull is the most PA signal deteriorating factor that affects both its amplitude (attenuation) and phase (distortion). Also we demonstrated that, when the depth of target region is low and it is comparable to the skull thickness, however, the skull-induced distortion becomes increasingly severe and the reconstructed image would be strongly distorted without correcting these effects. It is anticipated that an accurate quantification and modeling of the skull transmission effects would ultimately allow for aberration correction in transcranial PA brain imaging.

  5. Diffusely increased uptake in the skull in normal bone scans

    International Nuclear Information System (INIS)

    Suematsu, Toru; Yoshida, Shoji; Motohara, Tomofumi; Fujiwara, Hirofumi; Nishii, Hironori; Komiyama, Toyozo; Yanase, Masakazu; Mizutani, Masahiro

    1992-01-01

    Diffusely increased skull uptake (a hot skull) is often seen in patients with bone metastases and metabolic disease. This finding is also, however, noticed in normal bone scans of aged women. To determine whether the hot skull could be considered a normal variant in elderly women and is associated to menopause, we studied 282 normal bone scans (166 women and 116 men without metabolic and hormonal disease; age range 11 to 84 yr). We divided the patients into eight age groups--ages 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 yrs. Measurements of skull uptake were obtained from anterior total body views using contrast-to-noise ratio (CNR). CNR for the skull was calculated using an equation. The sex dependent difference in skull uptake began to develop in the age group 30-39 yrs (p<0.05). The skull showed greater activity in women than in men for age groups from 30-39 to 80-89 yrs. In the age groups 50-59 and 60-69, the difference was particularly large (p<0.001). For women, the 50-59 yr age group had a significantly higher CNR than the 40-49 yr (p<0.01), 30-39 yr (p<0.05), and 20-29 yr age group (p<0.05). On the other hand, there was no significant difference between the 20-29 yr, 30-39 yr and 40-49 yr age groups. For men, the skull uptake was virtually unchanged with age. Our data strongly suggested that the hot skull in normal bone scan is related to menopausal estrogen deficiency. One should not necessarily regard it abnormal that elderly women suffer hot skull. (J.P.N.)

  6. Hip Fracture

    Science.gov (United States)

    ... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

  7. Skulls and Human Evolution: The Use of Casts of Anthropoid Skulls in Teaching Concepts of Human Evolution.

    Science.gov (United States)

    Gipps, John

    1991-01-01

    Proposes the use of a series of 11 casts of fossil skulls as a method of teaching about the theory of human evolution. Students explore the questions of which skulls are "human" and which came first in Homo Sapien development, large brain or upright stance. (MDH)

  8. Osteomyelitis of the base of the skull

    International Nuclear Information System (INIS)

    Chandler, J.R.; Grobman, L.; Quencer, R.; Serafini, A.

    1986-01-01

    Infection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well-developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long-term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism

  9. The Curious History of the Talgai Skull

    Directory of Open Access Journals (Sweden)

    Jim Allen

    2010-11-01

    Full Text Available In the Australian winter of 1886 William Naish, a shearer in summer and a fencing contractor in the winter, erected a farm fence along Dalrymple Creek on East Talgai Station, c.125 km southwest of Brisbane. Work was interrupted by six days of torrential rain. On returning to the site Naish found that the rain had extended an erosion channel which he now had to cross walking to work, and from the extended section he retrieved a skull, heavily encrusted in carbonate, but clearly of human origin. Although it would take three decades to recognise and a further five to confirm, Naish had discovered the first direct proof of the Pleistocene antiquity of humans in Australia. Details of this history of Talgai are taken principally and extensively from Macintosh (1963, 1965, 1967a, 1967b, 1969, Elkin (1978, Gill (1978 and Langham (1978.

  10. Trans-skull ultrasonic Doppler system aided by fuzzy logic

    Science.gov (United States)

    Hata, Yutaka; Nakamura, Masato; Yagi, Naomi; Ishikawa, Tomomoto

    2012-06-01

    This paper describes a trans-skull ultrasonic Doppler system for measuring the blood flow direction in brain under skull. In this system, we use an ultrasonic array probe with the center frequency of 1.0 MHz. The system determines the fuzzy degree of blood flow by Doppler Effect, thereby it locates blood vessel. This Doppler Effect is examined by the center of gravity shift of the frequency magnitudes. In in-vitro experiment, a cow bone was employed as the skull, and three silicon tubes were done as blood vessels, and bubble in water as blood. We received the ultrasonic waves through a protein, the skull and silicon tubes in order. In the system, fuzzy degrees are determined with respect to the Doppler shift, amplitude of the waves and attenuation of the tissues. The fuzzy degrees of bone and blood direction are calculated by them. The experimental results showed that the system successfully visualized the skull and flow direction, compared with the location and flow direction of the phantom. Thus, it detected the flow direction by Doppler Effect under skull, and automatically extracted the region of skull and blood vessel.

  11. New insights into the skull of Istiodactylus latidens (Ornithocheiroidea, Pterodactyloidea.

    Directory of Open Access Journals (Sweden)

    Mark P Witton

    Full Text Available The skull of the Cretaceous pterosaur Istiodactylus latidens, a historically important species best known for its broad muzzle of interlocking, lancet-shaped teeth, is almost completely known from the broken remains of several individuals, but the length of its jaws remains elusive. Estimates of I. latidens jaw length have been exclusively based on the incomplete skull of NHMUK R3877 and, perhaps erroneously, reconstructed by assuming continuation of its broken skull pieces as preserved in situ. Here, an overlooked jaw fragment of NHMUK R3877 is redescribed and used to revise the skull reconstruction of I. latidens. The new reconstruction suggests a much shorter skull than previously supposed, along with a relatively tall orbital region and proportionally slender maxilla, a feature documented in the early 20(th century but ignored by all skull reconstructions of this species. These features indicate that the skull of I. latidens is particularly distinctive amongst istiodactylids and suggests greater disparity between I. latidens and I. sinensis than previously appreciated. A cladistic analysis of istiodactylid pterosaurs incorporating new predicted I. latidens skull metrics suggests Istiodactylidae is constrained to five species (Liaoxipterus brachyognathus, Lonchengpterus zhoai, Nurhachius ignaciobritoi, Istiodactylus latidens and Istiodactylus sinensis defined by their distinctive dentition, but excludes the putative istiodactylids Haopterus gracilis and Hongshanopterus lacustris. Istiodactylus latidens, I. sinensis and Li. brachyognathus form an unresolved clade of derived istiodactylids, and the similarity of comparable remains of I. sinensis and Li. brachyognathus suggest further work into their taxonomy and classification is required. The new skull model of I. latidens agrees with the scavenging habits proposed for these pterosaurs, with much of their cranial anatomy converging on that of habitually scavenging birds.

  12. Hand in glove: brain and skull in development and dysmorphogenesis

    Science.gov (United States)

    Flaherty, Kevin

    2013-01-01

    The brain originates relatively early in development from differentiated ectoderm that forms a hollow tube and takes on an exceedingly complex shape with development. The skull is made up of individual bony elements that form from neural crest- and mesoderm-derived mesenchyme that unite to provide support and protection for soft tissues and spaces of the head. The meninges provide a protective and permeable membrane between brain and skull. Across evolutionary and developmental time, dynamic changes in brain and skull shape track one another so that their integration is evidenced in two structures that fit soundly regardless of changes in biomechanical and physiologic functions. Evidence for this tight correspondence is also seen in diseases of the craniofacial complex that are often classified as diseases of the skull (e.g., craniosynostosis) or diseases of the brain (e.g., holoprosencephaly) even when both tissues are affected. Our review suggests a model that links brain and skull morphogenesis through coordinated integration of signaling pathways (e.g., FGF, TGFβ, Wnt) via processes that are not currently understood, perhaps involving the meninges. Differences in the earliest signaling of biological structure establish divergent designs that will be enhanced during morphogenesis. Signaling systems that pattern the developing brain are also active in patterning required for growth and assembly of the skull and some members of these signaling families have been indicated as causal for craniofacial diseases. Because cells of early brain and skull are sensitive to similar signaling families, variation in the strength or timing of signals or shifts in patterning boundaries that affect one system (neural or skull) could also affect the other system and appropriate co-adjustments in development would be made. Interactions of these signaling systems and of the tissues that they pattern are fundamental to the consistent but labile functional and structural association

  13. New Insights into the Skull of Istiodactylus latidens (Ornithocheiroidea, Pterodactyloidea)

    Science.gov (United States)

    Witton, Mark P.

    2012-01-01

    The skull of the Cretaceous pterosaur Istiodactylus latidens, a historically important species best known for its broad muzzle of interlocking, lancet-shaped teeth, is almost completely known from the broken remains of several individuals, but the length of its jaws remains elusive. Estimates of I. latidens jaw length have been exclusively based on the incomplete skull of NHMUK R3877 and, perhaps erroneously, reconstructed by assuming continuation of its broken skull pieces as preserved in situ. Here, an overlooked jaw fragment of NHMUK R3877 is redescribed and used to revise the skull reconstruction of I. latidens. The new reconstruction suggests a much shorter skull than previously supposed, along with a relatively tall orbital region and proportionally slender maxilla, a feature documented in the early 20th century but ignored by all skull reconstructions of this species. These features indicate that the skull of I. latidens is particularly distinctive amongst istiodactylids and suggests greater disparity between I. latidens and I. sinensis than previously appreciated. A cladistic analysis of istiodactylid pterosaurs incorporating new predicted I. latidens skull metrics suggests Istiodactylidae is constrained to five species (Liaoxipterus brachyognathus, Lonchengpterus zhoai, Nurhachius ignaciobritoi, Istiodactylus latidens and Istiodactylus sinensis) defined by their distinctive dentition, but excludes the putative istiodactylids Haopterus gracilis and Hongshanopterus lacustris. Istiodactylus latidens, I. sinensis and Li. brachyognathus form an unresolved clade of derived istiodactylids, and the similarity of comparable remains of I. sinensis and Li. brachyognathus suggest further work into their taxonomy and classification is required. The new skull model of I. latidens agrees with the scavenging habits proposed for these pterosaurs, with much of their cranial anatomy converging on that of habitually scavenging birds. PMID:22470442

  14. The MDP skull uptake test: A new diagnostic tool

    International Nuclear Information System (INIS)

    Ell, P.J.; Jarritt, P.H.; Cullum, I.; Lui, D.

    1984-01-01

    An original approach to the measurement of bone turnover is presented. With SPECT, the authors have measured in pgr/ml, the uptake of MDP by the skull in man. The Cleon 710 scanner, ring phantoms and bone biopsies were used for ultimate in vivo/in vitro count recovery correlation and calibration. A normal range for 24 patients was found: 8.5 to 19.5 pgr/ml with a mean of 14. For patients with bony metastases (12), the values were: 22.5 to 50, mean of 30. For 5 patients with osteomalacia, the values were 46 to 68, mean of 62: for 12 patients with hyperparathyroidism, the values were 37 to 48.5, mean of 43. In 3 patients with Pagets disease, the values were 58.5 to 75, with a mean of 65. In 76 patients with metastatic disease to bone, the conventional wholebody bone scan was investigated against the following: 24h wholebody retention of MDP (WBR), skull uptake as described and GFR by Cr-51-DTPA. There is a correlation between GFR and WBR - r=0.67. There is a lesser correlation between GFR and skull uptake - r=0.3. There is no correlation between skull uptake and WBR - r=0.1. The comparison of skull uptake data with normal whole body bone scans leads to a significant proportion of cancer patients with positive skull uptake data. Monostotic disease (especially if metabolic in nature) expresses itself by abnormal skull uptake even if the clinical site of abnormality lies outside the skull. This new technique is ideal as a tool to investigate phosphonate concentration in bone. With it, the authors have shown the effect of specific activity of label on skull uptake, which increases as the specific activity of labelled MDP decreases

  15. Epigenetic control of skull morphogenesis by histone deacetylase 8

    Science.gov (United States)

    Haberland, Michael; Mokalled, Mayssa H.; Montgomery, Rusty L.; Olson, Eric N.

    2009-01-01

    Histone deacetylases (Hdacs) are transcriptional repressors with crucial roles in mammalian development. Here we provide evidence that Hdac8 specifically controls patterning of the skull by repressing a subset of transcription factors in cranial neural crest cells. Global deletion of Hdac8 in mice leads to perinatal lethality due to skull instability, and this is phenocopied by conditional deletion of Hdac8 in cranial neural crest cells. Hdac8 specifically represses the aberrant expression of homeobox transcription factors such as Otx2 and Lhx1. These findings reveal how the identity and patterning of vertebrate-specific portions of the skull are epigenetically controlled by a histone deacetylase. PMID:19605684

  16. Chordoma of skull base presenting as nasopharyngeal mass

    Directory of Open Access Journals (Sweden)

    Sant Prakash Kataria

    2013-01-01

    Full Text Available While the nasopharynx is most commonly regarded by the otolaryngologist as a primary site of neoplastic involvement, it is also an avenue of spread of base-of-the-skull tumors presenting as bulging nasopharyngeal masses. Chordoma is a relatively rare tumor of the skull base and sacrum thought to originate from embryonic remnants of the notochord. Chordomas arising from the skull base/clivus are typically locally aggressive with lytic bone destruction. The optimal treatment may be photon/proton radiotherapy alone or combined with a gross total resection, when feasible. We report a case of intracranial chordoma presenting as nasopharyngeal mass.

  17. Imaging of the skull base anatomy; Schnittbildanatomie der Schaedelbasis

    Energy Technology Data Exchange (ETDEWEB)

    Wuest, Wolfgang; Uder, Michael; Lell, Michael [Erlangen-Nuernberg Univ., Universitaetsklinikum (Germany). Radiologisches Institut

    2016-09-15

    The skull base divides the extracranial from the intracranial compartment and contains a multiplicity of bony and soft tissue structures. For evaluating the skull base profound knowledge of the complex anatomy is mandatory. To limit the number of differential diagnosis it is important to be familiar with the contents of the different compartments. Due to the technical progress and the difficulty in assessing the skull base clinically imaging plays a significant role in diagnosis. For imaging both MRI and CT are used, which represent not competing but complementary methods.

  18. Observation of skull-guided acoustic waves in a water-immersed murine skull using optoacoustic excitation

    Science.gov (United States)

    Estrada, Héctor; Rebling, Johannes; Razansky, Daniel

    2017-02-01

    The skull bone, a curved solid multilayered plate protecting the brain, constitutes a big challenge for the use of ultrasound-mediated techniques in neuroscience. Ultrasound waves incident from water or soft biological tissue are mostly reflected when impinging on the skull. To this end, skull properties have been characterized for both high-intensity focused ultrasound (HIFU) operating in the narrowband far-field regime and optoacoustic imaging applications. Yet, no study has been conducted to characterize the near-field of water immersed skulls. We used the thermoelastic effect with a 532 nm pulsed laser to trigger a wide range of broad-band ultrasound modes in a mouse skull. In order to capture the waves propagating in the near-field, a thin hydrophone was scanned in close proximity to the skull's surface. While Leaky pseudo-Lamb waves and grazing-angle bulk water waves are clearly visible in the spatio-temporal data, we were only able to identify skull-guided acoustic waves after dispersion analysis in the wavenumber-frequency space. The experimental data was found to be in a reasonable agreement with a flat multilayered plate model.

  19. A case of bilateral lower cranial nerve palsies after base of skull trauma with complex management issues: case report and review of the literature.

    Science.gov (United States)

    Lehn, Alexander Christoph; Lettieri, Jennie; Grimley, Rohan

    2012-05-01

    Fractures of the skull base can cause lower cranial nerve palsies because of involvement of the nerves as they traverse the skull. A variety of syndromes have been described, often involving multiple nerves. These are most commonly unilateral, and only a handful of cases of bilateral cranial nerve involvement have been reported. We describe a 64-year-old man with occipital condylar fracture complicated by bilateral palsies of IX and X nerves associated with dramatic physiological derangement causing severe management challenges. Apart from debilitating postural hypotension, he developed dysphagia, severe gastrointestinal dysmotility, issues with airway protection as well as airway obstruction, increased oropharyngeal secretions and variable respiratory control. This is the first report of a patient with traumatic bilateral cranial nerve IX and X nerve palsies. This detailed report and the summary of all 6 previous case reports of traumatic bilateral lower cranial nerve palsies illustrate clinical features, treatment strategies, and outcomes of these rare events.

  20. Rib Fractures

    Science.gov (United States)

    ... Video) Achilles Tendon Tear Additional Content Medical News Rib Fractures By Thomas G. Weiser, MD, MPH, Associate Professor, ... Tamponade Hemothorax Injury to the Aorta Pulmonary Contusion Rib Fractures Tension Pneumothorax Traumatic Pneumothorax (See also Introduction to ...

  1. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  2. Radiological skull diagnosing - questions of the neurosurgeon to the radiologist

    International Nuclear Information System (INIS)

    Fahlbusch, R.; Hamburger, C.; Ringel, K.

    1982-01-01

    A well-adjusted overall picture of the skull is very important to the neurosurgeon for diagnosis and therapy. Without an overall picture of the skull the neurosurgeon is hardly likely to begin a trepanation. There are, however, still same questions open in radiological diagnostics. A solution of the problem might be offered soon by computerized radiography which might even replace the conventional X-ray examination of the skull. The radiological CT-total skeletal examination of polytraumatised patients, which can be carried out in 30 seconds by modern CT equipment makes it possible to also obtain overall pictures of the skull and the upper cervical vertebral column. An advantage in addition to the fast information is the significant reduction of the radiation exposure in comparison to conventional methods. (orig./APR) [de

  3. Bilaterally symmetric Fourier approximations of the skull outlines of ...

    Indian Academy of Sciences (India)

    Unknown

    These points denotes break in curvature of the outline and their positions can be compared to .... temnospondyl skull outlines by their shape variations. 2. .... their dentition are related to the feeding habits. Future ... pondyl families is not easy.

  4. Aplasia cutis congenita, skull defect, brain heterotopia, and intestinal lymphangiectasia

    NARCIS (Netherlands)

    Bonioli, Eugenio; Hennekam, Raoul C.; Spena, Gianantonio; Morcaldi, Guido; Di Stefano, Antonio; Serra, Giovanni; Bellini, Carlo

    2005-01-01

    We describe a female infant with a previously unreported combination of manifestations characterized by aplasia cutis, skull defect, brain heterotopia, mild congenital lymphedema, and intestinal lymphangiectasia. The association of intestinal lymphangiectasia and aplasia cutis, and the association

  5. Sagittal synostosis: I. Preoperative morphology of the skull

    DEFF Research Database (Denmark)

    Guimaraes-Ferreira, J.; Gewalli, F.; David, L.

    2006-01-01

    The aim of this study was to characterise the preoperative morphology of the skull in sagittal synostosis in an objective and quantified way. The shapes of the skulls of 105 patients with isolated premature synostosis of the sagittal suture ( SS group) were studied and compared with those......, skull base, and orbit ( 42 in the lateral and 46 in the frontal projections), the production of plots of mean shape for each group, and the intergroup comparison of a series of 81 variables ( linear distance between selected landmarks, and angles defined by groups of three landmarks). Data from...... skull width. Comparison of the mean values of an SS subgroup to age-matched normative data showed a longer (p differ significantly...

  6. CHONDROID SKULL BASE TUMORS (A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    T. G. Gasparyan

    2012-01-01

    Full Text Available Chondroid skull base tumors are a rare and little studied pathology; many problems of their classification, diagnosis and treatment remain to be solved. This group of neoplasms is referred to as bone tumors arising from the cartilaginous tissue of the skull base bones, particularly from the bones formed during chondral osteogenesis. The paper details the clinical picture, X-ray and morphological diagnosis of chondroid tumors. Particular attention is given to surgery and radiotherapy for this category of tumors.

  7. Epigenetic control of skull morphogenesis by histone deacetylase 8

    OpenAIRE

    Haberland, Michael; Mokalled, Mayssa H.; Montgomery, Rusty L.; Olson, Eric N.

    2009-01-01

    Histone deacetylases (Hdacs) are transcriptional repressors with crucial roles in mammalian development. Here we provide evidence that Hdac8 specifically controls patterning of the skull by repressing a subset of transcription factors in cranial neural crest cells. Global deletion of Hdac8 in mice leads to perinatal lethality due to skull instability, and this is phenocopied by conditional deletion of Hdac8 in cranial neural crest cells. Hdac8 specifically represses the aberrant expression of...

  8. Radiation dose and cancer risk to children undergoing skull radiography

    International Nuclear Information System (INIS)

    Mazonakis, Michael; Damilakis, John; Raissaki, Maria; Gourtsoyiannis, Nicholas

    2004-01-01

    Background: Limited data exist in the literature concerning the patient-effective dose from paediatric skull radiography. No information has been provided regarding organ doses, patient dose during PA skull projection, risk of cancer induction and dose to comforters, i.e. individuals supporting children during exposure. Objective: To estimate patient-effective dose, organ doses, lifetime cancer mortality risk to children and radiation dose to comforters associated with skull radiography. Materials and methods: Data were collected from 136 paediatric examinations, including AP, PA and lateral skull radiographs. Entrance-surface dose (ESD) and dose to comforters were measured using thermoluminescent dosimeters. Patients were divided into the following age groups: 0.5-2, 3-7, 8-12 and 13-18 years. The patient-effective dose and corresponding organ doses were calculated using data from the NRPB and Monte Carlo techniques. The risk for fatal cancer induction was assessed using appropriate risk coefficients. Results: For AP, PA and lateral skull radiography, effective dose ranges were 8.8-25.4, 8.2-27.3 and 8.4-22.7 μSv respectively, depending upon the age of the child. For each skull projection, the organs receiving doses above 10 μGy are presented. The number of fatal cancers was found to be less than or equal to 2 per 1 million children undergoing a skull radiograph. The mean radiation dose absorbed by the hands of comforters was 13.4 μGy. Conclusions: The current study provides detailed tabular and graphical data on ESD, effective dose, organ doses and lifetime cancer mortality risk to children associated with AP, PA and lateral skull projections at all patient ages. (orig.)

  9. Stress Fractures

    Science.gov (United States)

    Stress fractures Overview Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of ...

  10. CT findings of skull tumors forming subcutaneous masses

    International Nuclear Information System (INIS)

    Niida, Hirohito; Takeda, Norio; Onda, Kiyoshi; Tanaka, Ryuichi

    1991-01-01

    Some characteristics of CT findings in 27 patients with skull tumors forming subcutaneous tumors were studied. There were sixteen metastatic skull tumors, six primary skull tumors, and five meningiomas. A CT scan was found to be helpful in the diagnosis of the lesions. Especially, bone-window CT images proved very sensitive in the detection of destructive and permeative lesions of the skull. In 19 of the 27 cases, some lytic lesions were observed. In all cases with skull metastasis from carcinomas, a complete osteolytic change of the skull was observed. Furthermore, all of the metastatic tumors from thyroid carcinoma showed well circumscribed and homogeneously enhanced lesions, in contrast with the other metastatic carcinomas, which usually showed heterogeneously enhanced lesions with irregular margins. Osteoblastic changes were characteristically observed in all cases of meningiomas, osteosarcoma, and chondrosarcoma. Meningiomas were located mainly in the intracranial region and extended extracranially. In one case of malignant lymphoma, one of a neuroblastoma, and one of leukemia, there was little or no gross cortical bone change, despite a large mass. (author)

  11. Peramorphic traits in the tokay gecko skull.

    Science.gov (United States)

    Daza, Juan D; Mapps, Aurelia A; Lewis, Patrick J; Thies, Monte L; Bauer, Aaron M

    2015-08-01

    Traditionally, geckos have been conceived to exhibit paedomorphic features relative to other lizards (e.g., large eyes, less extensively ossified skulls, and amphicoelous and notochordal vertebrae). In contrast, peramorphosis has not been considered an important process in shaping their morphology. Here, we studied different sized specimens of Gekko gecko to document ontogenetic changes in cranial anatomy, especially near maturity. Comparison of this species with available descriptions of other geckos resulted in the identification of 14 cranial characteristics that are expressed more strongly with size increase. These characteristics become move evident in later stages of post-hatching development, especially near maturation, and are, therefore, attributed to peramorphosis (hyperossification). ACCTRAN and DELTRAN character optimizations were applied to these characters using a tree of 11 genera derived from a gekkotan molecular phylogeny. This analysis revealed that G. gecko expresses the majority of these putative peramorphic features near maturity, and that some of these features are also expressed in species closely related to G. gecko. The characters studied have the potential to be applied in future phylogenetic and taxonomic studies of this group of lizards. © 2015 Wiley Periodicals, Inc.

  12. Inflammatory Myofibroblastic Tumour of the Skull Base

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Maire

    2013-01-01

    Full Text Available Inflammatory myofibroblastic tumors (IMTs are rare benign clinical and pathological entities. IMTs have been described in the lungs, abdomen, retroperitoneum, and extremities but rarely in the head and neck region. A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of the right sphenoid and clivus. MR imaging showed a large tumor of the skull base which was invading the sella turcica, right cavernous sinus, and sphenoidal sinus. A biopsy was performed and revealed an IMT. Corticosteroids were given for 3 months but were inefficient. In the framework of our pluridisciplinary consultation, fractionated conformal radiotherapy (FRT was indicated at a low dose; 20 Gy in 10 fractions of 2 Gy over 12 days were delivered. Clinical response was complete 3 months after FRT. Radiological response was subtotal 6 months after FRT. Two years later, the patient is well.

  13. Alterations of the skull Usher's syndrome

    International Nuclear Information System (INIS)

    Popsavov, P.; Medzhidieva, D.; Zahov, Vl.; Tonchev, Z.

    2004-01-01

    Usher's syndrome is relatively often met. It is cited that it comprehends 2/3 of the recessive hereditary diseases in otology. Sensorineural hearing loss, vestibular dysfunction and hemeralopia are not so rarely met in our country, but their connection to this syndrome are scarcely cited in the newer specialized literature. In it we didn't find description of the characteristic, as we consider them, osteolytic focuses in the flat bones. The cases presented by us were monitored clinically and roentrgenographically for long years. Periodically were performed roentgenograms, CT and MRI of the skull, where the changes are most often met. We analyzed the imaging information that was found in our patients and compared it with the citations in world literature, which are not too many. It is analysed the course of the clinical signs and the algorithm of the imaging techniques to be evaluated the progress of the disease and the results of the applied therapy. We consider that the diagnostic and differential-diagnostic analysis of the cases will be helpful for the popularisation and the more precise diagnose of this serious disease

  14. Malocclusions in a juvenile medieval skull material.

    Science.gov (United States)

    Larsson, E

    1983-01-01

    From a mostly medieval skull material--the "Schreiner collections" in Oslo--juvenile crania were selected as follows: Group A: Crania with complete and intact primary dentition. n = 20. Group B: Crania with early mixed dentition. Incisors only erupted or under eruption. n = 47. Group C: Crania with late mixed dentition. n = 14. The author recorded visually: Sagittal and transversal dental relation, frontal dental contact, anterior cross-bite, rotation and crowding. There was good basal stability. Sagittally 1 moderately postnormal dentition was recorded, transversally there were no anomalies. Slight anterior cross-bite was recorded in 1 case, anterior cross-bite of one and two lateral incisors respectively in 2 others, and tête-à-tête contact in 3 cases. Crowding was recorded in 6 cases, in one of them being general, in the others located solely in the mandibular incisor segment. Broken contact and more or less pronounced rotation occurred in these dentitions. Rotation was also recorded in 2 other cases. The prevalence of malocclusions of the type that can be related to continuing finger-sucking or sucking of dummylike objects was very low in this material. This observation prompted the author to discuss a hypothesis concerning the aetiology of dummy- and finger-sucking habits.

  15. Traumas of the middle skull base with TMJ involvement. Case report.

    Science.gov (United States)

    Bottini, D J; Gnoni, G; De Angelis, B; Savo, P; Trimarco, A; Cervelli, G; Cervelli, V

    2006-03-01

    The authors report their experience with temporomandibular joint (TMJ) traumas involving breakage of the roof of the glenoid cavity, an infrequent event that occurs in those cases in which, as a result of the condylar neck not fracturing, the traumatic energy is transmitted to the middle skull base. As the literature contains no valid series for establishing standardized protocols for the treatment of these fractures, we propose our own orthopedic-functional approach. The patient observed by us had suffered a cranio-facial trauma and presented the classical symptoms and signs of TMJ traumas and complete bilateral Bell paralysis. He was subjected to a CAT scan and then to 2-stage treatment consisting of functional rest with liquid diet followed by physiotherapy. An almost total recovery in TMJ function was observed after 1 month. At 1-year follow-up the facial paralysis had resolved completely. On the basis of our experience, breakages of the glenoid cavity can be compared, in terms of treatment procedure, to intracapsular fractures of the TMJ with surgery confined to cases of ankylosis sequelae. To avoid the onset of ankylosis careful control of clinical, functional and radiological follow-up is required.

  16. Ballistic impacts on an anatomically correct synthetic skull with a surrogate skin/soft tissue layer.

    Science.gov (United States)

    Mahoney, Peter; Carr, Debra; Arm, Richard; Gibb, Iain; Hunt, Nicholas; Delaney, Russ J

    2018-03-01

    The aim of this work was to further develop a synthetic model of ballistic head injury by the addition of skin and soft tissue layers to an anatomically correct polyurethane skull filled with gelatine 10% by mass. Six head models were impacted with 7.62 x 39 mm full metal jacket mild steel core (FMJ MSC) bullets with a mean velocity of 652 m/s. The impact events were filmed with high-speed cameras. The models were imaged pre- and post-impact using computed tomography. The models were assessed post impact by two experienced Home Office pathologists and the images assessed by an experienced military radiologist. The findings were scored against real injuries. The entry wounds, exit wounds and fracture patterns were scored positively, but the synthetic skin and soft tissue layer was felt to be too extendable. Further work is ongoing to address this.

  17. Leonardo da Vinci's "A skull sectioned": skull and dental formula revisited.

    Science.gov (United States)

    Gerrits, Peter O; Veening, Jan G

    2013-05-01

    What can be learned from historical anatomical drawings and how to incorporate these drawings into anatomical teaching? The drawing "A skull sectioned" (RL 19058v) by Leonardo da Vinci (1452-1519), hides more detailed information than reported earlier. A well-chosen section cut explores sectioned paranasal sinuses and ductus nasolacrimalis. A dissected lateral wall of the maxilla is also present. Furthermore, at the level of the foramen mentale, the drawing displays compact and spongious bony components, together with a cross-section through the foramen mentale and its connection with the canalis mandibulae. Leonardo was the first to describe a correct dental formula (6424) and made efforts to place this formula above the related dental elements. However, taking into account, the morphological features of the individual elements of the maxilla, it can be suggested that Leonardo sketched a "peculiar dental element" on the position of the right maxillary premolar in the dental sketch. The fact that the author did not make any comment on that special element is remarkable. Leonardo could have had sufficient knowledge of the precise morphology of maxillary and mandibular premolars, since the author depicted these elements in the dissected skull. The fact that the author also had access to premolars in situ corroborates our suggestion that "something went wrong" in this part of the drawing. The present study shows that historical anatomical drawings are very useful for interactive learning of detailed anatomy for students in medicine and dentistry. Copyright © 2012 Wiley Periodicals, Inc.

  18. Algorithm of imaging modalities in cases of mandibular fractures

    International Nuclear Information System (INIS)

    Mihailova, H.

    2009-01-01

    Mandibular fracture is the most common bone fracture of maxillo-facial trauma. Up to now the main method for examination of the mandible is radiography. The aim of the issue is to present an algorithm of imaging modalities for investigation of patients in cases of mandibular trauma. It consists of series of X ray techniques and views of the facial skull named mandibulo-facial. This standardizes mandibulo-facial series includes exactly determined four projections done by conventional X ray techniques: posterior-anterior view of skull (PA or AP), oblique view of the left mandible; oblique view of the right mandible; occipito-mental view. Using these four planned radiograms is obligatory for each mandibular trauma. Panoramic X-ray is obligatory in cases of apparatus availability; this abolish only oblique views (left and right). Occipito-mental view of the skull gives anatomically better the coronoid process of the mandible, the zygoma complex, the orbital edges and maxillar sinus than Waters projection. So mandibulo-facial series of four planned radiograms is not only for diagnostic of mandibular fractures, but as a screening of mandibulo-facial trauma too. Thus using algorithm of imaging modalities in cases of mandibular fracture leads to optimization of diagnostic process in patients with mandibular trauma. (author)

  19. Acetabular Fracture

    Directory of Open Access Journals (Sweden)

    Chad Correa

    2017-09-01

    Full Text Available History of present illness: A 77-year-old female presented to her primary care physician (PCP with right hip pain after a mechanical fall. She did not lose consciousness or have any other traumatic injuries. She was unable to ambulate post-fall, so X-rays were ordered by her PCP. Her X-rays were concerning for a right acetabular fracture (see purple arrows, so the patient was referred to the emergency department where a computed tomography (CT scan was ordered. Significant findings: The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows, with associated obturator muscle hematoma (blue oval. Discussion: Acetabular fractures are quite rare. There are 37 pelvic fractures per 100,000 people in the United States annually, and only 10% of these involve the acetabulum. They occur more frequently in the elderly totaling an estimated 4,000 per year. High-energy trauma is the primary cause of acetabular fractures in younger individuals and these fractures are commonly associated with other fractures and pelvic ring disruptions. Fractures secondary to moderate or minimal trauma are increasingly of concern in patients of advanced age.1 Classification of acetabular fractures can be challenging. However, the approach can be simplified by remembering the three basic types of acetabular fractures (column, transverse, and wall and their corresponding radiologic views. First, column fractures should be evaluated with coronally oriented CT images. This type of fracture demonstrates a coronal fracture line running caudad to craniad, essentially breaking the acetabulum into two halves: a front half and a back half. Secondly, transverse fractures should be evaluated by sagittally oriented CT images. By definition, a transverse fracture separates the acetabulum into superior and inferior halves with the fracture line extending from anterior to posterior

  20. Earliest directly-dated human skull-cups.

    Directory of Open Access Journals (Sweden)

    Silvia M Bello

    Full Text Available BACKGROUND: The use of human braincases as drinking cups and containers has extensive historic and ethnographic documentation, but archaeological examples are extremely rare. In the Upper Palaeolithic of western Europe, cut-marked and broken human bones are widespread in the Magdalenian (∼15 to 12,000 years BP and skull-cup preparation is an element of this tradition. PRINCIPAL FINDINGS: Here we describe the post-mortem processing of human heads at the Upper Palaeolithic site of Gough's Cave (Somerset, England and identify a range of modifications associated with the production of skull-cups. New analyses of human remains from Gough's Cave demonstrate the skilled post-mortem manipulation of human bodies. Results of the research suggest the processing of cadavers for the consumption of body tissues (bone marrow, accompanied by meticulous shaping of cranial vaults. The distribution of cut-marks and percussion features indicates that the skulls were scrupulously 'cleaned' of any soft tissues, and subsequently modified by controlled removal of the facial region and breakage of the cranial base along a sub-horizontal plane. The vaults were also 'retouched', possibly to make the broken edges more regular. This manipulation suggests the shaping of skulls to produce skull-cups. CONCLUSIONS: Three skull-cups have been identified amongst the human bones from Gough's Cave. New ultrafiltered radiocarbon determinations provide direct dates of about 14,700 cal BP, making these the oldest directly dated skull-cups and the only examples known from the British Isles.

  1. Morphological convergence in ‘river dolphin’ skulls

    Directory of Open Access Journals (Sweden)

    Charlotte E. Page

    2017-11-01

    Full Text Available Convergent evolution can provide insights into the predictability of, and constraints on, the evolution of biodiversity. One striking example of convergence is seen in the ‘river dolphins’. The four dolphin genera that make up the ‘river dolphins’ (Inia geoffrensis, Pontoporia blainvillei, Platanista gangetica and Lipotes vexillifer do not represent a single monophyletic group, despite being very similar in morphology. This has led many to using the ‘river dolphins’ as an example of convergent evolution. We investigate whether the skulls of the four ‘river dolphin’ genera are convergent when compared to other toothed dolphin taxa in addition to identifying convergent cranial and mandibular features. We use geometric morphometrics to uncover shape variation in the skulls of the ‘river dolphins’ and then apply a number of phylogenetic techniques to test for convergence. We find significant convergence in the skull morphology of the ‘river dolphins’. The four genera seem to have evolved similar skull shapes, leading to a convergent morphotype characterised by elongation of skull features. The cause of this morphological convergence remains unclear. However, the features we uncover as convergent, in particular elongation of the rostrum, support hypotheses of shared feeding mode or diet and thus provide the foundation for future work into convergence within the Odontoceti.

  2. Imaging diagnosis of Granulocytic Sarcoma in the skull base

    International Nuclear Information System (INIS)

    Zheng Shaoyan; Xie Jiming; Yang Zhiyun; Zhou Zhou; Li Shurong

    2010-01-01

    Objective: To improve the understanding and imaging diagnosis of granulocytic sarcoma in the skull base. Methods: Three cases of granulocytic sarcomas in the skull base are reported. The clinical features and imaging findings were analyzed. Results: The three cases occurred in children with acute myeloid leukemia. Two patients presented with oculomotor paralysis before the diagnosis of leukemia, the third patient with history of leukemia presented with headache. Diffuse infiltration of basal skull bone marrow and extracranial soft tissue masses were shown on MRI. The signal intensities of the masses were similar to that of gray matter on T 1 WI and T 2 WI with marked contrast enhancement. The soft tissue masses were located in the para-sellar region and surrounded the lateral wall of the maxillary sinus in one case. The soft tissue mass of the second case infiltrated the orbital cavity, cavernous sinus and oculomotor nerve. Tumor infiltrating the meninges, cranial nerves and paranasal sinuses was seen in the third patient. Conclusion: Cranial nerve paralysis can be the presenting symptom of basal skull granulocytic sarcoma in children. Granulocytic sarcoma should be considered in the different diagnosis when diffuse abnormal signal intensities in the basal skull bone marrow with solitary or multiple soft tissue masses are shown on MRI. (authors)

  3. Flip-avoiding interpolating surface registration for skull reconstruction.

    Science.gov (United States)

    Xie, Shudong; Leow, Wee Kheng; Lee, Hanjing; Lim, Thiam Chye

    2018-03-30

    Skull reconstruction is an important and challenging task in craniofacial surgery planning, forensic investigation and anthropological studies. Existing methods typically reconstruct approximating surfaces that regard corresponding points on the target skull as soft constraints, thus incurring non-zero error even for non-defective parts and high overall reconstruction error. This paper proposes a novel geometric reconstruction method that non-rigidly registers an interpolating reference surface that regards corresponding target points as hard constraints, thus achieving low reconstruction error. To overcome the shortcoming of interpolating a surface, a flip-avoiding method is used to detect and exclude conflicting hard constraints that would otherwise cause surface patches to flip and self-intersect. Comprehensive test results show that our method is more accurate and robust than existing skull reconstruction methods. By incorporating symmetry constraints, it can produce more symmetric and normal results than other methods in reconstructing defective skulls with a large number of defects. It is robust against severe outliers such as radiation artifacts in computed tomography due to dental implants. In addition, test results also show that our method outperforms thin-plate spline for model resampling, which enables the active shape model to yield more accurate reconstruction results. As the reconstruction accuracy of defective parts varies with the use of different reference models, we also study the implication of reference model selection for skull reconstruction. Copyright © 2018 John Wiley & Sons, Ltd.

  4. Skull repair materials applied in cranioplasty: History and progress

    Institute of Scientific and Technical Information of China (English)

    Qingsheng Yu; Lin Chen; Zhiye Qiu; Yuqi Zhang; Tianxi Song; Fuzhai Cui

    2017-01-01

    The skull provides protection and mechanical support, and acts as a container for the brain and its accessory organs. Some defects in the skull can fatally threaten human life. Many efforts have been taken to repair defects in the skull, among which cranioplasty is the most prominent technique. To repair the injury, numerous natural and artificial materials have been adopted by neurosurgeons. Many cranioprostheses have been tried in the past decades, from autoplast to bioceramics. Neurosurgeons have been evaluating their advantages andshortages through clinical practice. Among those prostheses, surgeons gradually prefer bionic ones due to their marvelous osteoconductivity, osteoinductivity, biocompatibility,and biodegradability. Autogeneic bone has been widely recognized as the"gold standard" for renovating large-sized bone defects. However, the access to this technique is restricted by limited availability and complications associated with its use. Many metal and polymeric materials with mechanical characteristics analogous to natural bones were consequently applied to cranioplasty. But most of them were unsatisfactory concerning osteoconductiion and biodegradability owe to their intrinsic properties. With the microstructures almost identical to natural bones, mineralized collagen hasbiological performance nearly identical to autogeneic bone, such as osteoconduction. Implants made of mineralized collagen can integrate themselves into the newly formed bones through a process called"creeping substitution". In this review, the authors retrospect the evolution of skull repair material applied in cranioplasty. The ultimate skull repair material should have microstructure and bioactive qualities that enable osteogenesis induction and intramembranous ossification.

  5. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    International Nuclear Information System (INIS)

    O'Malley, Bert W.; Weinstein, Gregory S.

    2007-01-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development

  6. Mandible Fractures.

    Science.gov (United States)

    Pickrell, Brent B; Serebrakian, Arman T; Maricevich, Renata S

    2017-05-01

    Mandible fractures account for a significant portion of maxillofacial injuries and the evaluation, diagnosis, and management of these fractures remain challenging despite improved imaging technology and fixation techniques. Understanding appropriate surgical management can prevent complications such as malocclusion, pain, and revision procedures. Depending on the type and location of the fractures, various open and closed surgical reduction techniques can be utilized. In this article, the authors review the diagnostic evaluation, treatment options, and common complications of mandible fractures. Special considerations are described for pediatric and atrophic mandibles.

  7. Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma: A clinical report.

    Science.gov (United States)

    Hoekstra, Jitske; Vissink, Arjan; Raghoebar, Gerry M; Visser, Anita

    2017-05-01

    Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted of resecting the tumor and external part of the skull bone. To protect the brain and to cover the defect of the hairy skull, an acrylic resin skull prosthesis with hair was designed to mask the defect. The skull prosthesis was retained on 8 extraoral implants placed at the margins of the defect in the skull bone. The patient was satisfied with the treatment outcome. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  8. [Extensive tumor of the skull base: sphenoid sinus adenocarcinoma].

    Science.gov (United States)

    Kallel, Souha; Sellami, Moncef

    2017-01-01

    We report a rare case of adenocarcinoma of the sphenoid sinus manifesting as extended skull base tumor. The patient included in the study was a 42-year old woman presenting with unilateral right symptomatology consisting of nasal obstruction, diplopia and hemifacial neuralgias. Clinical examination showed paralysis of the cranial nerve pairs V and VI. Brain scanner showed voluminous heterogeneous sphenoid and clival mass reaching the right cavernous sinus, with a peripheral tissue component at the level of the sphenoid sinus. Biopsy was performed under general anesthesia, through endonasal sphenoidotomy approach. Histological examination showed non-intestinal adenocarcinoma. The patient died due to impaired general condition occurred during examinations. Skull base adenocarcinomas mainly occur in the ethmoid bone. Sphenoid origin is exceptional. Radiological appearance is not specific and suggests malignancy. Diagnosis should be suspected in patients with aggressive tumor, even when it occurs in the midline skull base.

  9. Sex estimation in forensic anthropology: skull versus postcranial elements.

    Science.gov (United States)

    Spradley, M Katherine; Jantz, Richard L

    2011-03-01

    When the pelvis is unavailable, the skull is widely considered the second best indicator of sex. The goals of this research are to provide an objective hierarchy of sexing effectiveness of cranial and postcranial elements and to test the widespread notion that the skull is superior to postcranial bones. We constructed both univariate and multivariate discriminant models using data from the Forensic Anthropology Data Bank. Discriminating effectiveness was assessed by cross-validated classification, and in the case of multivariate models, Mahalanobis D(2). The results clearly indicate that most postcranial elements outperform the skull in estimating sex. It is possible to correctly sex 88-90% of individuals with joint size, up to 94% with multivariate models of the postcranial bones. The best models for the cranium do not exceed 90%. We conclude that postcranial elements are to be preferred to the cranium for estimating sex when the pelvis is unavailable. © 2011 American Academy of Forensic Sciences.

  10. Properties and architecture of the sperm whale skull amphitheatre.

    Science.gov (United States)

    Alam, Parvez; Amini, Shahrouz; Tadayon, Maryam; Miserez, Ali; Chinsamy, Anusuya

    2016-02-01

    The sperm whale skull amphitheatre cradles an enormous two-tonne spermaceti organ. The amphitheatre separates this organ from the cranium and the cervical vertebrae that lie in close proximity to the base of the skull. Here, we elucidate that this skull amphitheatre is an elastic, flexible, triple-layered structure with mechanical properties that are conjointly guided by bone histology and the characteristics of pore space. We contend that the amphitheatre will flex elastically to equilibrate forces transmitted via the spermaceti organ that arise through diving. We find that collisions from sperm whale aggression do not cause the amphitheatre to bend, but rather localise stress to the base of the amphitheatre on its anterior face. We consider, therefore, that the uniquely thin and extended construction of the amphitheatre, has relevance as an energy absorptive structure in diving. Copyright © 2015 Elsevier GmbH. All rights reserved.

  11. The ecological origins of snakes as revealed by skull evolution.

    Science.gov (United States)

    Da Silva, Filipe O; Fabre, Anne-Claire; Savriama, Yoland; Ollonen, Joni; Mahlow, Kristin; Herrel, Anthony; Müller, Johannes; Di-Poï, Nicolas

    2018-01-25

    The ecological origin of snakes remains amongst the most controversial topics in evolution, with three competing hypotheses: fossorial; marine; or terrestrial. Here we use a geometric morphometric approach integrating ecological, phylogenetic, paleontological, and developmental data for building models of skull shape and size evolution and developmental rate changes in squamates. Our large-scale data reveal that whereas the most recent common ancestor of crown snakes had a small skull with a shape undeniably adapted for fossoriality, all snakes plus their sister group derive from a surface-terrestrial form with non-fossorial behavior, thus redirecting the debate toward an underexplored evolutionary scenario. Our comprehensive heterochrony analyses further indicate that snakes later evolved novel craniofacial specializations through global acceleration of skull development. These results highlight the importance of the interplay between natural selection and developmental processes in snake origin and diversification, leading first to invasion of a new habitat and then to subsequent ecological radiations.

  12. SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

    International Nuclear Information System (INIS)

    Damle, Nishikant Avinash; Kumar, Rakesh; Kumar, Praveen; Jaganthan, Sriram; Patnecha, Manish; Bal, Chandrasekhar; Bandopadhyaya, Gurupad; Malhotra, Arun

    2011-01-01

    Skull base osteomyelitis is a potentially fatal disease. We demonstrate here the utility of SPECT/CT in diagnosing this entity, which was not obvious on a planar bone scan. A 99mT c MDP bone scan with SPECT/CT was carried out on a patient with clinically suspected skull base osteomyelitis. Findings were correlated with contrast enhanced CT (CECT) and MRI. Planar images were equivocal, but SPECT/CT showed intense uptake in the body of sphenoid and petrous temporal bone as well as the atlas corresponding to irregular bone destruction on CT and MRI. These findings indicate that SPECT/CT may have an additional role beyond planar imaging in the detection of skull base osteomyelitis.

  13. Facial Fractures.

    Science.gov (United States)

    Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy

    2018-06-01

    The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.

  14. Skull Defects in Finite Element Head Models for Source Reconstruction from Magnetoencephalography Signals

    Science.gov (United States)

    Lau, Stephan; Güllmar, Daniel; Flemming, Lars; Grayden, David B.; Cook, Mark J.; Wolters, Carsten H.; Haueisen, Jens

    2016-01-01

    Magnetoencephalography (MEG) signals are influenced by skull defects. However, there is a lack of evidence of this influence during source reconstruction. Our objectives are to characterize errors in source reconstruction from MEG signals due to ignoring skull defects and to assess the ability of an exact finite element head model to eliminate such errors. A detailed finite element model of the head of a rabbit used in a physical experiment was constructed from magnetic resonance and co-registered computer tomography imaging that differentiated nine tissue types. Sources of the MEG measurements above intact skull and above skull defects respectively were reconstructed using a finite element model with the intact skull and one incorporating the skull defects. The forward simulation of the MEG signals reproduced the experimentally observed characteristic magnitude and topography changes due to skull defects. Sources reconstructed from measured MEG signals above intact skull matched the known physical locations and orientations. Ignoring skull defects in the head model during reconstruction displaced sources under a skull defect away from that defect. Sources next to a defect were reoriented. When skull defects, with their physical conductivity, were incorporated in the head model, the location and orientation errors were mostly eliminated. The conductivity of the skull defect material non-uniformly modulated the influence on MEG signals. We propose concrete guidelines for taking into account conducting skull defects during MEG coil placement and modeling. Exact finite element head models can improve localization of brain function, specifically after surgery. PMID:27092044

  15. The relationship between skull asymmetry and CT findings

    International Nuclear Information System (INIS)

    Yamori, Yuriko; Yuge, Mariko; Kanda, Toyoko; Ashida, Hiromi; Fukase, Hiroshi

    1987-01-01

    In order to clarify the relationship between brain damage and skull asymmetry or supine head position preference, we classified CT findings of 330 cases with cerebral palsy or risk of motor disturbance into 6 groups according to skull shape. Those were severe (I, n = 37) and mild (II, n = 114) grades in the right occipital flatness, severe (III, n = 34) and mild (IV, n = 58) grades in the left occipital flatness, long skull with temporal flatness (V, n = 33) and symmetric round skull (control, n = 54). It was considered that the asymmetry of cortical atrophy in appearance was formed physicaly by skull asymmetry but that the asymmetric dilatation in appearance of lateral ventricle was related to the asymmetry of brain damage. The severity and the asymmetry of brain damage were tend to increase the grade of skull asymmetry. The incidence of cases with the right occipital flatness was 1.6 times more frequently than the left sided. The incidence of cases whose left (lateral) ventricle was larger than the right was 4.1 times more than the cases whose right ventricle was larger than the left. The cases with occipital flatness in the contralateral side of the larger lateral ventricle were found more than the cases with occipital flatness in the ipsilateral side of the larger ventricle, that is to say, the direction of supine head position preference during early infant was suspected to be the more severely disturbed side of body. These results suggest that the supine head position preference to the right in newborn babies and infants with scoliosis or cerebral palsy might be the result of transient or permanent asymmetric (left > right) brain dysfunction. (author)

  16. Craniomaxillofacial fractures during recreational baseball and softball.

    Science.gov (United States)

    Bak, Matthew J; Doerr, Timothy D

    2004-10-01

    Baseball and softball are leading causes of sports-related facial trauma in the United States. We review our institutional experience (Strong Memorial Hospital, Rochester, NY) with these injuries and discuss measures to reduce their incidence. We review our institutions experience with facial fractures sustained during the course of a softball or baseball game over a 12-year period. A total of 38 patients were identified and medical records analyzed for patient demographics, type of impact, and fracture location. The male-to-female ratio was 3.2:1; mean age was 24.2 years, with 17 (45%) of the injuries occurring in the pediatric population. The majority of the injuries were caused by direct impact with the ball (68%), while player-player collisions (18%) and impact from a swung bat (13%) were responsible for the remaining injuries. There were a total of 39 fractures; 18 fractures (46%) involved the midface (level 2), skull (level 1) fractures accounted for 12 (31%), while 9 (23%) were mandibular (level 3) fractures. With 68% of the injuries resulting from a ball impact, we endorse the recommendations of the Consumer Product Safety Commission for the use of low-impact National Operating Committee on Standards for Athletic Equipment-approved baseballs and softballs for youth and recreational leagues.

  17. Skull lichens: a curious chapter in the history of phytotherapy.

    Science.gov (United States)

    Modenesi, P

    2009-04-01

    Lichens growing on skulls were known in late medieval times as usnea or moss of a dead man's skull and were recommended as highly beneficial in various diseases. They were, in addition, the main ingredient of Unguentum armariun, a liniment used in a curious medical practice: the magnetic cure of wounds. We can place this chapter of the history of phytotherapy within the wider cultural context of the period, which saw the definition of nature become increasingly more fluid and open to a variety of novel interpretations.

  18. Interspecific variation of ontogeny and skull shape among porpoises (Phocoenidae)

    DEFF Research Database (Denmark)

    Galatius-Jørgensen, Anders; Berta, Annalisa; Frandsen, Marie Michele Schou

    2011-01-01

    . dioptrica, for which large series were available, were further compared in terms of ontogeny of cranial shape by three-dimensional geometric morphometrics. Ph. dalli and P. dioptrica generally showed further development of cranial sutures than the other species. Postnatal skull shape development was similar...... was detected; in species with pelagic preference the position and orientation of the foramen magnum aligned the skull with the vertebral column; the rostrum showed less ventral inclination, and the facial region was larger and more concave in lateral aspect. J. Morphol., 2011. © 2010 Wiley-Liss, Inc....

  19. Fracture sacrum.

    Directory of Open Access Journals (Sweden)

    Dogra A

    1995-04-01

    Full Text Available An extremely rare case of combined transverse and vertical fracture of sacrum with neurological deficit is reported here with a six month follow-up. The patient also had an L1 compression fracture. The patient has recovered significantly with conservative management.

  20. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

    Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering.  He teaches applied mechanics and his research t...

  1. Temporal bone fracture following blunt trauma caused by a flying fish.

    Science.gov (United States)

    Goldenberg, D; Karam, M; Danino, J; Flax-Goldenberg, R; Joachims, H Z

    1998-10-01

    Blunt trauma to the temporal region can cause fracture of the skull base, loss of hearing, vestibular symptoms and otorrhoea. The most common causes of blunt trauma to the ear and surrounding area are motor vehicle accidents, violent encounters, and sports-related accidents. We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus.

  2. Segmentation, surface rendering, and surface simplification of 3-D skull images for the repair of a large skull defect

    Science.gov (United States)

    Wan, Weibing; Shi, Pengfei; Li, Shuguang

    2009-10-01

    Given the potential demonstrated by research into bone-tissue engineering, the use of medical image data for the rapid prototyping (RP) of scaffolds is a subject worthy of research. Computer-aided design and manufacture and medical imaging have created new possibilities for RP. Accurate and efficient design and fabrication of anatomic models is critical to these applications. We explore the application of RP computational methods to the repair of a pediatric skull defect. The focus of this study is the segmentation of the defect region seen in computerized tomography (CT) slice images of this patient's skull and the three-dimensional (3-D) surface rendering of the patient's CT-scan data. We see if our segmentation and surface rendering software can improve the generation of an implant model to fill a skull defect.

  3. If the skull fits: magnetic resonance imaging and microcomputed tomography for combined analysis of brain and skull phenotypes in the mouse

    Science.gov (United States)

    Blank, Marissa C.; Roman, Brian B.; Henkelman, R. Mark; Millen, Kathleen J.

    2012-01-01

    The mammalian brain and skull develop concurrently in a coordinated manner, consistently producing a brain and skull that fit tightly together. It is common that abnormalities in one are associated with related abnormalities in the other. However, this is not always the case. A complete characterization of the relationship between brain and skull phenotypes is necessary to understand the mechanisms that cause them to be coordinated or divergent and to provide perspective on the potential diagnostic or prognostic significance of brain and skull phenotypes. We demonstrate the combined use of magnetic resonance imaging and microcomputed tomography for analysis of brain and skull phenotypes in the mouse. Co-registration of brain and skull images allows comparison of the relationship between phenotypes in the brain and those in the skull. We observe a close fit between the brain and skull of two genetic mouse models that both show abnormal brain and skull phenotypes. Application of these three-dimensional image analyses in a broader range of mouse mutants will provide a map of the relationships between brain and skull phenotypes generally and allow characterization of patterns of similarities and differences. PMID:22947655

  4. Difficulties of clinical radiodiagnosis of concomitant injuries of fornix and base of the skull

    International Nuclear Information System (INIS)

    Krutitskij, A.G.; Semisalov, S.Ya.

    1987-01-01

    Clinical radiological semiotics in 234 patients with injuries of fornix and base of the skull is studied. Among skull injuries the most critical are those of fornix and base of anterior parts of the skull. Severity of state doesn't exclude, but requires an obligatory X-ray examination, at least - review radiographs of the skull. When choosing the volume of surgical intervention the data on X-ray examination along with clinical pattern should be taken account of

  5. Single-layer skull approximations perform well in transcranial direct current stimulation modeling

    NARCIS (Netherlands)

    Rampersad, S.M.; Stegeman, D.F.; Oostendorp, T.F.

    2013-01-01

    In modeling the effect of transcranial direct current stimulation, the representation of the skull is an important factor. In a spherical model, we compared a realistic skull modeling approach, in which the skull consisted of three isotropic layers, to anisotropic and isotropic single-layer

  6. Positional skull deformation in infants: heading towards evidence-based practice

    NARCIS (Netherlands)

    van Wijk, Renske

    2014-01-01

    The shape of a young infant’s skull can deform as a result of prolonged external forces. The prevalence of positional skull deformation increased dramatically during the last decades. The primary aim of this dissertation was to provide a stronger evidence base for the treatment of skull deformation.

  7. Viscoelastic finite-element analysis of human skull - dura mater ...

    African Journals Online (AJOL)

    SERVER

    2008-03-18

    Mar 18, 2008 ... The elastic-viscous mechanical characteristics must be used for the skull. The viscous strains .... different actions for fresh human dura mater (L0 = 23 mm, θ = 370). f. Creep compliance .... 3180±300. 4026±372. *. 1. 0. E. E.

  8. Automated human skull landmarking with 2D Gabor wavelets

    Science.gov (United States)

    de Jong, Markus A.; Gül, Atilla; de Gijt, Jan Pieter; Koudstaal, Maarten J.; Kayser, Manfred; Wolvius, Eppo B.; Böhringer, Stefan

    2018-05-01

    Landmarking of CT scans is an important step in the alignment of skulls that is key in surgery planning, pre-/post-surgery comparisons, and morphometric studies. We present a novel method for automatically locating anatomical landmarks on the surface of cone beam CT-based image models of human skulls using 2D Gabor wavelets and ensemble learning. The algorithm is validated via human inter- and intra-rater comparisons on a set of 39 scans and a skull superimposition experiment with an established surgery planning software (Maxilim). Automatic landmarking results in an accuracy of 1–2 mm for a subset of landmarks around the nose area as compared to a gold standard derived from human raters. These landmarks are located in eye sockets and lower jaw, which is competitive with or surpasses inter-rater variability. The well-performing landmark subsets allow for the automation of skull superimposition in clinical applications. Our approach delivers accurate results, has modest training requirements (training set size of 30–40 items) and is generic, so that landmark sets can be easily expanded or modified to accommodate shifting landmark interests, which are important requirements for the landmarking of larger cohorts.

  9. Evaluation of radiation dose received in skull radiographic examination

    International Nuclear Information System (INIS)

    Omer, Noora Elshiekh

    2014-12-01

    Diagnostic X-ray examination play an important role in the health care of the population. These examinations may involve significant irradiation of the patient and probably represent the largest mam-made source of radiation exposure for the population. This study was performed in Khartoum Teaching Hospital in period of January to June 2014. This study was performed to assess the effective dose (ED) received in skull radiographic examination and to analyze effective dose distributions among radiological department under study. The study was performed in Khartoum Teaching Hospital, covering two x-ray units and a sample of 50 patients. The following parameters were recorded: age, weight, height, body mass index (BMI) derived from weight (kg) and (height (m)) and exposure factors. The dose was measured for skull x-ray examinations. For effective dose calculation, the entrance surface dose (ESD) values were estimated from the x-ray tube output parameters for skull AP and lateral examinations. The ED values were then calculated from the obtained ESD values using IAEA calculation methods. Effective doses were calculated from energy imparted using ED conversion factors proposed were within the normal range of exposure. The mean ED values calculated were 3.03±0.08 and 4.23±0.61 for skull AP and lateral examination, respectively. Further studies are recommended with more number of patients and using more than two modalities for comparison. (Author)

  10. Osteochondroma of the skull base: MRI and histological correlation

    International Nuclear Information System (INIS)

    Sato, K.; Kodera, T.; Kitai, R.; Kubota, T.

    1996-01-01

    A skull base osteochondroma (benign exostosis) in a 38-year-old man is reported. MRI was not only very useful for determining the extent of the tumour, but also showed its far content and, on contrast-enhanced fat-suppressed images, its vascularity. (orig.)

  11. Osteoradionecrosis of the skull base after radiotherapy for nasopharynx cancer

    International Nuclear Information System (INIS)

    Mnejja, W.; Siala, W.; Daoud, J.; Boudawara, T.; Ghorbel, A.; Frikha, M.

    2009-01-01

    The purpose of this work was to study the incidence and the risk factors of osteoradionecrosis occurrence at the skull base after radiotherapy for nasopharynx cancer. It is often asymptomatic. Its incidence is not low. The systematic realisation of radiological examinations during the surveillance allows to detect the asymptomatic forms. No factor of risk was identified in the study. (N.C.)

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

    Science.gov (United States)

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

    2018-01-01

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

  13. Thin-section CT of the skull base

    International Nuclear Information System (INIS)

    Beyer-Enke, S.A.; Goerich, J.; Gamroth, A.; Tiedemann, K.

    1987-01-01

    High-resolution CT-images of the skull base are depicted and anatomical structures are described. A large variety of osseous and soft tissue structures can be differentiated in the temporal bone, nasopharynx and orbita. Knowledge of the anatomical structures is essential for the recognition of pathological changes and also plays an essential role for the diagnostically involved radiologist. (orig.) [de

  14. Effects of the murine skull in optoacoustic brain microscopy.

    Science.gov (United States)

    Kneipp, Moritz; Turner, Jake; Estrada, Héctor; Rebling, Johannes; Shoham, Shy; Razansky, Daniel

    2016-01-01

    Despite the great promise behind the recent introduction of optoacoustic technology into the arsenal of small-animal neuroimaging methods, a variety of acoustic and light-related effects introduced by adult murine skull severely compromise the performance of optoacoustics in transcranial imaging. As a result, high-resolution noninvasive optoacoustic microscopy studies are still limited to a thin layer of pial microvasculature, which can be effectively resolved by tight focusing of the excitation light. We examined a range of distortions introduced by an adult murine skull in transcranial optoacoustic imaging under both acoustically- and optically-determined resolution scenarios. It is shown that strong low-pass filtering characteristics of the skull may significantly deteriorate the achievable spatial resolution in deep brain imaging where no light focusing is possible. While only brain vasculature with a diameter larger than 60 µm was effectively resolved via transcranial measurements with acoustic resolution, significant improvements are seen through cranial windows and thinned skull experiments. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Skull and cerebrospinal fluid effects on microwave radiation propagation in human brain

    Science.gov (United States)

    Ansari, M. A.; Zarei, M.; Akhlaghipour, N.; Niknam, A. R.

    2017-12-01

    The determination of microwave absorption distribution in the human brain is necessary for the detection of brain tumors using thermo-acoustic imaging and for removing them using hyperthermia treatment. In contrast to ionizing radiation, hyperthermia treatment can be applied to remove tumors inside the brain without the concern of including secondary malignancies, which typically form from the neuronal cells of the septum pellucidum. The aim of this study is to determine the microwave absorption distribution in an adult human brain and to study the effects of skull and cerebrospinal fluid on the propagation of microwave radiation inside the brain. To this end, we simulate the microwave absorption distribution in a realistic adult brain model (Colin 27) using the mesh-based Monte Carlo (MMC) method. This is because in spite of there being other numerical methods, the MMC does not require a large memory, even for complicated geometries, and its algorithm is simple and easy to implement with low computational cost. The brain model is constructed using high-resolution (1 mm isotropic voxel) and low noise magnetic resonance imaging (MRI) scans and its volume contains 181×217×181 voxels, covering the brain completely. Using the MMC method, the radiative transport equation is solved and the absorbed microwave energy distribution in different brain regions is obtained without any fracture or anomaly. The simulation results show that the skull and cerebrospinal fluid guide the microwave radiation and suppress its penetration through deep brain compartments as a shielding factor. These results reveal that the MMC can be used to predict the amount of required energy to increase the temperature inside the tumour during hyperthermia treatment. Our results also show why a deep tumour inside an adult human brain cannot be efficiently treated using hyperthermia treatment. Finally, the accuracy of the presented numerical method is verified using the signal flow graph technique.

  16. Micrometeorite Impacts in Beringian Mammoth Tusks and a Bison Skull

    Energy Technology Data Exchange (ETDEWEB)

    Hagstrum, Jonathon T.; Firestone, Richard B; West, Allen; Stefanka, Zsolt; Revay, Zsolt

    2010-02-03

    We have discovered what appear to be micrometeorites imbedded in seven late Pleistocene Alaskan mammoth tusks and a Siberian bison skull. The micrometeorites apparently shattered on impact leaving 2 to 5 mm hemispherical debris patterns surrounded by carbonized rings. Multiple impacts are observed on only one side of the tusks and skull consistent with the micrometeorites having come from a single direction. The impact sites are strongly magnetic indicating significant iron content. We analyzed several imbedded micrometeorite fragments from both tusks and skull with laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and X-ray fluorescence (XRF). These analyses confirm the high iron content and indicate compositions highly enriched in nickel and depleted in titanium, unlike any natural terrestrial sources. In addition, electron microprobe (EMP) analyses of a Fe-Ni sulfide grain (tusk 2) show it contains between 3 and 20 weight percent Ni. Prompt gamma-ray activation analysis (PGAA) of a particle extracted from the bison skull indicates ~;;0.4 mg of iron, in agreement with a micrometeorite ~;;1 mm in diameter. In addition, scanning electron microscope (SEM) images and XRF analyses of the skull show possible entry channels containing Fe-rich material. The majority of tusks (5/7) have a calibrated weighted mean 14C age of 32.9 +- 1.8 ka BP, which coincides with the onset of significant declines<36 ka ago in Beringian bison, horse, brown bear, and mammoth populations, as well as in mammoth genetic diversity. It appears likely that the impacts and population declines are related events, although their precise nature remains to be determined.

  17. Fracture mechanics

    CERN Document Server

    Perez, Nestor

    2017-01-01

    The second edition of this textbook includes a refined presentation of concepts in each chapter, additional examples; new problems and sections, such as conformal mapping and mechanical behavior of wood; while retaining all the features of the original book. The material included in this book is based upon the development of analytical and numerical procedures pertinent to particular fields of linear elastic fracture mechanics (LEFM) and plastic fracture mechanics (PFM), including mixed-mode-loading interaction. The mathematical approach undertaken herein is coupled with a brief review of several fracture theories available in cited references, along with many color images and figures. Dynamic fracture mechanics is included through the field of fatigue and Charpy impact testing. Explains computational and engineering approaches for solving crack-related problems using straightforward mathematics that facilitate comprehension of the physical meaning of crack growth processes; Expands computational understandin...

  18. Fracture analysis

    International Nuclear Information System (INIS)

    Ueng, Tzoushin; Towse, D.

    1991-01-01

    Fractures are not only the weak planes of a rock mass, but also the easy passages for the fluid flow. Their spacing, orientation, and aperture will affect the deformability, strength, heat transmittal, and fluid transporting properties of the rock mass. To understand the thermomechanical and hydrological behaviors of the rock surrounding the heater emplacement borehole, the location, orientation, and aperture of the fractures of the rock mass should be known. Borehole television and borescope surveys were performed to map the location, orientation, and aperture of the fractures intersecting the boreholes drilled in the Prototype Engineered Barrier System Field Tests (PEBSFT) at G-Tunnel. Core logging was also performed during drilling. However, because the core was not oriented and the depth of the fracture cannot be accurately determined, the results of the core logging were only used as reference and will not be discussed here

  19. Facial Fractures.

    Science.gov (United States)

    Ricketts, Sophie; Gill, Hameet S; Fialkov, Jeffery A; Matic, Damir B; Antonyshyn, Oleh M

    2016-02-01

    After reading this article, the participant should be able to: 1. Demonstrate an understanding of some of the changes in aspects of facial fracture management. 2. Assess a patient presenting with facial fractures. 3. Understand indications and timing of surgery. 4. Recognize exposures of the craniomaxillofacial skeleton. 5. Identify methods for repair of typical facial fracture patterns. 6. Discuss the common complications seen with facial fractures. Restoration of the facial skeleton and associated soft tissues after trauma involves accurate clinical and radiologic assessment to effectively plan a management approach for these injuries. When surgical intervention is necessary, timing, exposure, sequencing, and execution of repair are all integral to achieving the best long-term outcomes for these patients.

  20. Pisiform fractures

    International Nuclear Information System (INIS)

    Fleege, M.A.; Jebson, P.J.; Renfrew, D.L.; El-Khoury, G.Y.; Steyers, C.M. Jr.

    1991-01-01

    Fractures of the pisiform are often missed due to improper radiographic evaluation and a tendency to focus on other, more obvious injuries. Delayed diagnosis may result in disabling sequelae. A high index of clinical suspicion and appropriate radiographic examination will establish the correct diagnosis. Ten patients with pisiform fracture are presented. The anatomy, mechanism of injury, clinical presentation, radiographic features, and evaluation of this injury are discussed. (orig.)

  1. Stress fractures

    International Nuclear Information System (INIS)

    Berquist, T.H.; Cooper, K.L.; Pritchard, D.J.

    1985-01-01

    The diagnosis of a stress fracture should be considered in patients presented with pain after a change in activity, especially if the activity is strenuous and the pain is in the lower extremities. Since evidence of the stress fracture may not be apparent for weeks on routine radiographs, proper use of other imaging techniques will allow an earlier diagnosis. Prompt diagnosis is especially important in the femur, where displacement may occur

  2. Surgical outcomes after reoperation for recurrent skull base meningiomas.

    Science.gov (United States)

    Magill, Stephen T; Lee, David S; Yen, Adam J; Lucas, Calixto-Hope G; Raleigh, David R; Aghi, Manish K; Theodosopoulos, Philip V; McDermott, Michael W

    2018-05-04

    OBJECTIVE Skull base meningiomas are surgically challenging tumors due to the intricate skull base anatomy and the proximity of cranial nerves and critical cerebral vasculature. Many studies have reported outcomes after primary resection of skull base meningiomas; however, little is known about outcomes after reoperation for recurrent skull base meningiomas. Since reoperation is one treatment option for patients with recurrent meningioma, the authors sought to define the risk profile for reoperation of skull base meningiomas. METHODS A retrospective review of 2120 patients who underwent resection of meningiomas between 1985 and 2016 was conducted. Clinical information was extracted from the medical records, radiology data, and pathology data. All records of patients with recurrent skull base meningiomas were reviewed. Demographic data, presenting symptoms, surgical management, outcomes, and complications data were collected. Kaplan-Meier analysis was used to evaluate survival after reoperation. Logistic regression was used to evaluate for risk factors associated with complications. RESULTS Seventy-eight patients underwent 100 reoperations for recurrent skull base meningiomas. Seventeen patients had 2 reoperations, 3 had 3 reoperations, and 2 had 4 or more reoperations. The median age at diagnosis was 52 years, and 64% of patients were female. The median follow-up was 8.5 years. Presenting symptoms included cranial neuropathy, headache, seizure, proptosis, and weakness. The median time from initial resection to first reoperation was 4.4 years and 4.1 years from first to second reoperation. Seventy-two percent of tumors were WHO grade I, 22% were WHO grade II, and 6% were WHO grade III. The sphenoid wing was the most common location (31%), followed by cerebellopontine angle (14%), cavernous sinus (13%), olfactory groove (12%), tuberculum sellae (12%), and middle fossa floor (5%). Forty-four (54%) tumors were ≥ 3 cm in maximum diameter at the time of the first

  3. Scaphoid Fracture

    Directory of Open Access Journals (Sweden)

    Esther Kim, BS

    2018-04-01

    Full Text Available History of present illness: A 25-year-old, right-handed male presented to the emergency department with left wrist pain after falling from a skateboard onto an outstretched hand two-weeks prior. He otherwise had no additional concerns, including no complaints of weakness or loss of sensation. On physical exam, there was tenderness to palpation within the anatomical snuff box. The neurovascular exam was intact. Plain films of the left wrist and hand were obtained. Significant findings: The anteroposterior (AP plain film of this patient demonstrates a full thickness fracture through the middle third of the scaphoid (red arrow, with some apparent displacement (yellow lines and subtle angulation of the fracture fragments (blue line. Discussion: The scaphoid bone is the most commonly fractured carpal bone accounting for 70%-80% of carpal fractures.1 Classically, it is sustained following a fall onto an outstretched hand (FOOSH. Patients should be evaluated for tenderness with palpation over the anatomical snuffbox, which has a sensitivity of 100% and specificity of 40%.2 Plain films are the initial diagnostic modality of choice and have a sensitivity of 70%, but are commonly falsely negative in the first two to six weeks of injury (false negative of 20%.3 The Mayo classification organizes scaphoid fractures as involving the proximal, mid, and distal portions of the scaphoid bone with mid-fractures being the most common.3 The proximal scaphoid is highly susceptible to vascular compromise because it depends on retrograde blood flow from the radial artery. Therefore, disruption can lead to serious sequelae including osteonecrosis, arthrosis, and functional impairment. Thus, a low threshold should be maintained for neurovascular evaluation and surgical referral. Patients with non-displaced scaphoid fractures should be placed in a thumb spica splint.3 Patients with even suspected scaphoid fractures should be placed in a thumb spica splint and re

  4. Skull base, orbits, temporal bone, and cranial nerves: anatomy on MR imaging.

    Science.gov (United States)

    Morani, Ajaykumar C; Ramani, Nisha S; Wesolowski, Jeffrey R

    2011-08-01

    Accurate delineation, diagnosis, and treatment planning of skull base lesions require knowledge of the complex anatomy of the skull base. Because the skull base cannot be directly evaluated, imaging is critical for the diagnosis and management of skull base diseases. Although computed tomography (CT) is excellent for outlining the bony detail, magnetic resonance (MR) imaging provides better soft tissue detail and is helpful for evaluating the adjacent meninges, brain parenchyma, and bone marrow of the skull base. Thus, CT and MR imaging are often used together for evaluating skull base lesions. This article focuses on the radiologic anatomy of the skull base pertinent to MR imaging evaluation. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Open Approaches to the Anterior Skull Base in Children: Review of the Literature.

    Science.gov (United States)

    Wasserzug, Oshri; DeRowe, Ari; Ringel, Barak; Fishman, Gadi; Fliss, Dan M

    2018-02-01

    Introduction  Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective  This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods  Comprehensive literature review. Results  Extensive intracranial-intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion  Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a

  6. Death due to fracture of thin calvarial bones after a fall: A forensic approach

    Directory of Open Access Journals (Sweden)

    Georgios Sioutas

    2017-06-01

    Full Text Available A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skull base. The patient's death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature.

  7. Proton therapy for tumors of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Munzenrider, J.E.; Liebsch, N.J. [Dept. of Radiation Oncology, Harvard Univ. Medical School, Boston, MA (United States)

    1999-06-01

    Charged particle beams are ideal for treating skull base and cervical spine tumors: dose can be focused in the target, while achieving significant sparing of the brain, brain stem, cervical cord, and optic nerves and chiasm. For skull base tumors, 10-year local control rates with combined proton-photon therapy are highest for chondrosarcomas, intermediate for male chordomas, and lowest for female chordomas (94%, 65%, and 42%, respectively). For cervical spine tumors, 10-year local control rates are not significantly different for chordomas and chondrosarcomas (54% and 48%, respectively), nor is there any difference in local control between males and females. Observed treatment-related morbidity has been judged acceptable, in view of the major morbidity and mortality which accompany uncontrolled tumor growth. (orig.)

  8. How to perform 3D reconstruction of skull base tumours.

    Science.gov (United States)

    Bonne, N-X; Dubrulle, F; Risoud, M; Vincent, C

    2017-04-01

    The surgical management of skull base lesions is difficult due to the complex anatomy of the region and the intimate relations between the lesion and adjacent nerves and vessels. Minimally invasive approaches are increasingly used in skull base surgery to ensure an optimal functional prognosis. Three-dimensional (3D) computed tomography (CT) reconstruction facilitates surgical planning by visualizing the anatomical relations of the lesions in all planes (arteries, veins, nerves, inner ear) and simulation of the surgical approach in the operating position. Helical CT angiography is performed with optimal timing of the injection in terms of tumour and vessel contrast enhancement. 3D definition of each structure is based on colour coding by automatic thresholding (bone, vessels) or manual segmentation on each slice (tumour, nerves, inner ear). Imaging is generally presented in 3 dimensions (superior, coronal, sagittal) with simulation of the surgical procedure (5 to 6 reconstructions in the operating position at different depths). Copyright © 2016. Published by Elsevier Masson SAS.

  9. Proton therapy for tumors of the skull base

    International Nuclear Information System (INIS)

    Munzenrider, J.E.; Liebsch, N.J.

    1999-01-01

    Charged particle beams are ideal for treating skull base and cervical spine tumors: dose can be focused in the target, while achieving significant sparing of the brain, brain stem, cervical cord, and optic nerves and chiasm. For skull base tumors, 10-year local control rates with combined proton-photon therapy are highest for chondrosarcomas, intermediate for male chordomas, and lowest for female chordomas (94%, 65%, and 42%, respectively). For cervical spine tumors, 10-year local control rates are not significantly different for chordomas and chondrosarcomas (54% and 48%, respectively), nor is there any difference in local control between males and females. Observed treatment-related morbidity has been judged acceptable, in view of the major morbidity and mortality which accompany uncontrolled tumor growth. (orig.)

  10. Phenotypic Covariation And Morphological Diversification In The Ruminant Skull

    OpenAIRE

    Haber, Annat

    2015-01-01

    Differences among clades in their diversification patterns result from a combination of extrinsic and intrinsic factors. In this study I examined the role of intrinsic factors in the morphological diversification of ruminants in general, and in the differences between bovids and cervids in particular. Using skull morphology, which embodies many of the adaptations that distinguish bovids and cervids, I examined 132 of the 200 extant ruminant species. As a proxy for intrinsic constraints I quan...

  11. The first skull of the earliest giant panda

    OpenAIRE

    Jin, Changzhu; Dong, Wei; Hunt, Jr., Robert M.; Liu, Jinyi; Jaeger, Marc; Zhu, Qizhi

    2007-01-01

    Fossils of the giant panda Ailuropoda (Order Carnivora, Family Ursidae) are largely isolated teeth, mandibles, and a few rare skulls, known from the late Pliocene to late Pleistocene in China and Southeast Asia. Much of this material represents a Pleistocene chronospecies, Ailuropoda baconi, an animal larger than the living giant panda, Ailuropoda melanoleuca. The earliest certain record of Ailuropoda is the late Pliocene chronospecies, Ailuropoda microta, smaller than either A. baconi or A. ...

  12. Streamlined, Inexpensive 3D Printing of the Brain and Skull.

    Science.gov (United States)

    Naftulin, Jason S; Kimchi, Eyal Y; Cash, Sydney S

    2015-01-01

    Neuroimaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) collect three-dimensional data (3D) that is typically viewed on two-dimensional (2D) screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM) images to stereolithography (STL) files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3-4 in consumable plastic filament as described, and the total process takes 14-17 hours, almost all of which is unsupervised (preprocessing = 4-6 hr; printing = 9-11 hr, post-processing = Printing a matching portion of a skull costs $1-5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes.

  13. Streamlined, Inexpensive 3D Printing of the Brain and Skull.

    Directory of Open Access Journals (Sweden)

    Jason S Naftulin

    Full Text Available Neuroimaging technologies such as Magnetic Resonance Imaging (MRI and Computed Tomography (CT collect three-dimensional data (3D that is typically viewed on two-dimensional (2D screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM images to stereolithography (STL files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3-4 in consumable plastic filament as described, and the total process takes 14-17 hours, almost all of which is unsupervised (preprocessing = 4-6 hr; printing = 9-11 hr, post-processing = <30 min. Printing a matching portion of a skull costs $1-5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes.

  14. Skull shapes of the Lissodelphininae: radiation, adaptation and asymmetry.

    Science.gov (United States)

    Galatius, Anders; Goodall, R Natalie P

    2016-06-01

    Within Delphinidae, the sub-family Lissodelphininae consists of 8 Southern Ocean species and 2 North Pacific species. Lissodelphininae is a result of recent phylogenetic revisions based on molecular methods. Thus, morphological radiation within the taxon has not been investigated previously. The sub-family consists of ecologically diverse groups such as (1) the Cephalorhynchus genus of 4 small species inhabiting coastal and shelf waters, (2) the robust species in the Lagenorhynchus genus with the coastal La. australis, the offshore La. cruciger, the pelagic species La. obscurus and La. obliquidens, and (3) the morphologically aberrant genus Lissodelphis. Here, the shapes of 164 skulls from adults of all 10 species were compared using 3-dimensional geometric morphometrics. The Lissodelphininae skulls were supplemented by samples of Lagenorhynchus albirostris and Delphinus delphis to obtain a context for the variation found within the subfamily. Principal components analysis was used to map the most important components of shape variation on phylogeny. The first component of shape variation described an elongation of the rostrum, lateral and dorsoventral compression of the neurocranium and smaller temporal fossa. The two Lissodelphis species were on the high extreme of this spectrum, while Lagenorhynchus australis, La. cruciger and Cephalorhynchus heavisidii were at the low extreme. Along the second component, La. cruciger was isolated from the other species by its expanded neurocranium and concave facial profile. Shape variation supports the gross phylogenetic relationships proposed by recent molecular studies. However, despite the great diversity of ecology and external morphology within the subfamily, shape variation of the feeding apparatus was modest, indicating a similar mode of feeding across the subfamily. All 10 species were similar in their pattern of skull asymmetry, but interestingly, two species using narrowband high frequency clicks (La. cruciger and C

  15. Fungal Infection of the Sinus and Anterior Skull Base

    Directory of Open Access Journals (Sweden)

    Morteza Javadi

    2008-11-01

    Full Text Available   Abstract   Background: Invasive fungal infection is an opportunistic infection caused commonly   by mucoraccae and aspergillus. It mostly occurs in patients with underlying disease.   Since it has a high mortality and morbidity rate, considering a treatment strategy seems   necessary.   Objective: Since there has not been a clear protocol for treating these patients, we decided   to establish a protocol for fungal infection of sinus and anterior skull base management.   Methods: This retrospective and descriptive case study series included 30 patients.   After confirming the pathogen, the authors came to a proper protocol for treatment which   is mentioned later.   Results: The site involvement included nose and orbital cavity (53.3%, anterior skull   base and brain in conjunction with sinonasal (36.6% and simple nasal cavity involvement   (10%. 86.6% of the patients had underlying diseases. 56.6% of patients had diabetes   as a single underlying disease, while 13.3% had both diabetes and renal failure in   combination. Acute lymphocytic leukemia was present in 6.6%, renal failure in 3.3%, lupus   in 3.3% and chronic lymphocytic leukemia in 3.3% of patients. Mortality rate was   40%. We categorized the patients into 3 groups: only sinonasal, sinonasal and orbit, and   associated anterior skull base and brain involvement.   Conclusion: Early diagnosis is an important factor in improving survival. Anterior   skull base and brain involvement has a very poor prognosis.  

  16. Isolated Petroclival Craniopharyngioma with Aggressive Skull Base Destruction

    Science.gov (United States)

    Lee, Young-Hen; Lim, Dong-Jun; Park, Jung-Yul; Chung, Yong-Gu; Kim, Young-Sik

    2009-01-01

    We report a rare case of petroclival craniopharyngioma with no connection to the sellar or suprasellar region. MRI and CT images revealed a homogenously enhancing retroclival solid mass with aggressive skull base destruction, mimicking chordoma or aggressive sarcoma. However, there was no calcification or cystic change found in the mass. Here, we report the clinical features and radiographic investigation of this uncommon craniopharyngioma arising primarily in the petroclival region. PMID:19881982

  17. Management of Benign Skull Base Meningiomas: A Review

    OpenAIRE

    Mendenhall, William M.; Friedman, William A.; Amdur, Robert J.; Foote, Kelly D.

    2004-01-01

    The optimal management of benign meningiomas of the skull base is reviewed. Elderly patients with small, asymptomatic tumors can be observed and treatment can be initiated if and when progression occurs. Patients with tumors that appear to be amenable to complete resection with an acceptable rate of morbidity are optimally treated with surgery. Decompression of more extensive tumors through conservative subtotal resection and preservation of the involved cranial nerves may result in improved ...

  18. Streamlined, Inexpensive 3D Printing of the Brain and Skull

    Science.gov (United States)

    Cash, Sydney S.

    2015-01-01

    Neuroimaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) collect three-dimensional data (3D) that is typically viewed on two-dimensional (2D) screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM) images to stereolithography (STL) files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3–4 in consumable plastic filament as described, and the total process takes 14–17 hours, almost all of which is unsupervised (preprocessing = 4–6 hr; printing = 9–11 hr, post-processing = Printing a matching portion of a skull costs $1–5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes. PMID:26295459

  19. Skull base chordoid meningioma: Imaging features and pathology

    International Nuclear Information System (INIS)

    Soo, Mark Y.S.; Gomes, Lavier; Ng, Thomas; Cruz, Malville Da; Dexter, Mark

    2004-01-01

    The clinical, imaging and pathological features of a skull base chordoid meningioma (CM) are described. The huge tumour resulted in obstructive hydrocephalus and partial erosion of the clivus such that a chordoma was suspected. The lesion's MRI findings were similar to those of a meningioma. Light microscopic, immunohistochemistry and ultrastructural features were diagnostic of CM. Chordoid meningioma is a rare subtype of meningioma and has a great tendency to recur should surgical resection be incomplete Copyright (2004) Blackwell Publishing Asia Pty Ltd

  20. Skull infarction in a patient with malignant fibrous histiocytoma.

    Science.gov (United States)

    Nagle, C E; Morayati, S J; LeDuc, M A

    1987-09-01

    The authors describe a case of a skull infarction initially suspected to be an isolated, remote metastasis in a patient diagnosed with soft tissue malignant fibrous histiocytoma. Osseous malignant fibrous histiocytoma has been reported to occur within a bone infarction but the presence of a benign bone infarction remote from a soft tissue malignant fibrous histiocytoma has not been reported previously. Bone infarctions and malignant fibrous histiocytomas are briefly reviewed.

  1. Trochanteric fractures

    International Nuclear Information System (INIS)

    Herrlin, K.; Stroemberg, T.; Lidgren, L.; Walloee, A.; Pettersson, H.; Lund Univ.

    1988-01-01

    Four hundred and thirty trochanteric factures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group. (orig.)

  2. Fracture Blisters

    Directory of Open Access Journals (Sweden)

    Uebbing, Claire M

    2011-02-01

    Full Text Available Fracture blisters are a relatively uncommon complication of fractures in locations of the body, such as the ankle, wrist elbow and foot, where skin adheres tightly to bone with little subcutaneous fat cushioning. The blister that results resembles that of a second degree burn.These blisters significantly alter treatment, making it difficult to splint or cast and often overlying ideal surgical incision sites. Review of the literature reveals no consensus on management; however, most authors agree on early treatment prior to blister formation or delay until blister resolution before attempting surgical correction or stabilization. [West J Emerg Med. 2011;12(1;131-133.

  3. Implant-retained skull prosthesis to cover a large defect of the hairy skull resulting from treatment of a basal cell carcinoma : A clinical report

    NARCIS (Netherlands)

    Hoekstra, Jitske; Vissink, Arjan; Raghoebar, Gerry M; Visser, Anita

    Skin carcinoma, particularly basal cell carcinoma, and its treatment can result in large defects of the hairy skull. A 53-year-old man is described who was surgically treated for a large basal cell carcinoma invading the skin and underlying tissue at the top of the hairy skull. Treatment consisted

  4. Does nasal echolocation influence the modularity of the mammal skull?

    Science.gov (United States)

    Santana, S E; Lofgren, S E

    2013-11-01

    In vertebrates, changes in cranial modularity can evolve rapidly in response to selection. However, mammals have apparently maintained their pattern of cranial integration throughout their evolutionary history and across tremendous morphological and ecological diversity. Here, we use phylogenetic, geometric morphometric and comparative analyses to test the hypothesis that the modularity of the mammalian skull has been remodelled in rhinolophid bats due to the novel and critical function of the nasal cavity in echolocation. We predicted that nasal echolocation has resulted in the evolution of a third cranial module, the 'nasal dome', in addition to the braincase and rostrum modules, which are conserved across mammals. We also test for similarities in the evolution of skull shape in relation to habitat across rhinolophids. We find that, despite broad variation in the shape of the nasal dome, the integration of the rhinolophid skull is highly consistent with conserved patterns of modularity found in other mammals. Across their broad geographical distribution, cranial shape in rhinolophids follows two major divisions that could reflect adaptations to dietary and environmental differences in African versus South Asian distributions. Our results highlight the potential of a relatively simple modular template to generate broad morphological and functional variation in mammals. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

  5. Clinical results of proton beam therapy for skull base chordoma

    International Nuclear Information System (INIS)

    Igaki, Hiroshi; Tokuuye, Koichi; Okumura, Toshiyuki; Sugahara, Shinji; Kagei, Kenji; Hata, Masaharu; Ohara, Kiyoshi; Hashimoto, Takayuki; Tsuboi, Koji; Takano, Shingo; Matsumura, Akira; Akine, Yasuyuki

    2004-01-01

    Purpose: To evaluate clinical results of proton beam therapy for patients with skull base chordoma. Methods and materials: Thirteen patients with skull base chordoma who were treated with proton beams with or without X-rays at the University of Tsukuba between 1989 and 2000 were retrospectively reviewed. A median total tumor dose of 72.0 Gy (range, 63.0-95.0 Gy) was delivered. The patients were followed for a median period of 69.3 months (range, 14.6-123.4 months). Results: The 5-year local control rate was 46.0%. Cause-specific, overall, and disease-free survival rates at 5 years were 72.2%, 66.7%, and 42.2%, respectively. The local control rate was higher, without statistical significance, for those with preoperative tumors <30 mL. Partial or subtotal tumor removal did not yield better local control rates than for patients who underwent biopsy only as the latest surgery. Conclusion: Proton beam therapy is effective for patients with skull base chordoma, especially for those with small tumors. For a patient with a tumor of <30 mL with no prior treatment, biopsy without tumor removal seems to be appropriate before proton beam therapy

  6. Human skulls with turquoise inlays: pre hispanic origin or replicas?

    International Nuclear Information System (INIS)

    Silva V, Y.; Castillo M, M.T.; Bautista M, J.P.; Arenas A, J.

    2006-01-01

    The lack of archaeological context determining if the manufacture of two human skulls adorned with turquoise inlays have pre-Columbian origin or not (replicas), led to perform other studies. Under these conditions, besides orthodox methodology commonly used to assign chronology and cultural aspects as form, style, decoration, iconography, etc., it was necessary to obtain more results based on the use of characterization techniques. The techniques employed were Scanning Electron Microscopy (SEM), X-Ray Energy Dispersive Spectroscopy (EDS), Transmission Electron Microscopy (TEM) and Fourier Transform Infrared Spectroscopy (FTIR), in order to determine the manufacture techniques and chemical composition of the materials used for the cementant. SEM analysis showed the presence of zones composed by Ca, O, C and Al. In some cases Mg, Cl, Fe and Pb were identified. High concentration of Cu was present in all samples, due to residues of turquoise inlays (CuAI 6 (PO 4 ) 4 (OH) 8 (H 2 O) 4 ) with which the skulls were decorated. In the cementant was identified the Ca as base element of the cementant, as well as particles < 100 nm with irregular morphology and other amorphous zones. FTIR spectrums indicated the presence of organic substances that could be used as agglutinating in the cementant. The current work shows a progress identifying involved techniques in the manufacturing of two human skulls with turquoise inlays. (Author)

  7. Creating physical 3D stereolithograph models of brain and skull.

    Directory of Open Access Journals (Sweden)

    Daniel J Kelley

    2007-10-01

    Full Text Available The human brain and skull are three dimensional (3D anatomical structures with complex surfaces. However, medical images are often two dimensional (2D and provide incomplete visualization of structural morphology. To overcome this loss in dimension, we developed and validated a freely available, semi-automated pathway to build 3D virtual reality (VR and hand-held, stereolithograph models. To evaluate whether surface visualization in 3D was more informative than in 2D, undergraduate students (n = 50 used the Gillespie scale to rate 3D VR and physical models of both a living patient-volunteer's brain and the skull of Phineas Gage, a historically famous railroad worker whose misfortune with a projectile tamping iron provided the first evidence of a structure-function relationship in brain. Using our processing pathway, we successfully fabricated human brain and skull replicas and validated that the stereolithograph model preserved the scale of the VR model. Based on the Gillespie ratings, students indicated that the biological utility and quality of visual information at the surface of VR and stereolithograph models were greater than the 2D images from which they were derived. The method we developed is useful to create VR and stereolithograph 3D models from medical images and can be used to model hard or soft tissue in living or preserved specimens. Compared to 2D images, VR and stereolithograph models provide an extra dimension that enhances both the quality of visual information and utility of surface visualization in neuroscience and medicine.

  8. Shape similarities and differences in the skulls of scavenging raptors.

    Science.gov (United States)

    Guangdi, S I; Dong, Yiyi; Ma, Yujun; Zhang, Zihui

    2015-04-01

    Feeding adaptations are a conspicuous feature of avian evolution. Bill and cranial shape as well as the jaw muscles are closely related to diet choice and feeding behaviors. Diurnal raptors of Falconiformes exhibit a wide range of foraging behaviors and prey preferences, and are assigned to seven dietary groups in this study. Skulls of 156 species are compared from the dorsal, lateral and ventral views, by using geometric morphometric techniques with those landmarks capturing as much information as possible on the overall shape of cranium, bill, orbits, nostrils and attachment area for different jaw muscles. The morphometric data showed that the skull shape of scavengers differ significantly from other raptors, primarily because of different feeding adaptations. As a result of convergent evolution, different scavengers share generalized common morphology, possessing relatively slender and lower skulls, longer bills, smaller and more sideward orbits, and more caudally positioned quadrates. Significant phylogenetic signals suggested that phylogeny also played important role in shape variation within scavengers. New World vultures can be distinguished by their large nostrils, narrow crania and small orbits; Caracaras typically show large palatines, crania and orbits, as well as short, deep and sharp bill.

  9. Anatomic study of the pterion in Nigerian dry human skulls.

    Science.gov (United States)

    Ukoha, U; Oranusi, C K; Okafor, J I; Udemezue, O O; Anyabolu, A E; Nwamarachi, T C

    2013-01-01

    The pterion is a point of sutural confluence seen in the norma lateralis of the skull. The site is an important landmark in surgical approaches to the anterior and middle cranial fossa. This study was designed to determine the frequency of pterion types and anatomic positions of the pterion in dry human skulls of Nigerians in the South Eastern Zone. Specific measurements were taken on both sides of 56 Nigerian human skulls of unknown sex, obtained from the Department of Anatomy, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria. All the four types of the pterion were present, i.e. sphenoparietal, frontotemporal, stellate, and epipteric. The study showed that the sphenoparietal type was 75% on the right side, 76% on the left side, the frontotemporal type was 19.6% on both sides, the stellate type was 1.8% on the right side and absent on the left side. The epipteric type was 3.6% on both sides. The distances from the centre of pterion to the frontozygomatic suture were 2.74 ± 0.07 cm on the right side and 2.74 ± 0.06 cm on the left side. The pterion was 4.02 ± 0.05 and 4.01 ± 0.03 cm above the midpoint of the zygomatic arch on the right and left sides, respectively. These findings are important for the surgeon as the pterion junction is a common extracranial landmark in neurosurgical and surgical approaches.

  10. Micro-mechanical properties of different sites on woodpecker's skull.

    Science.gov (United States)

    Ni, Yikun; Wang, Lizhen; Liu, Xiaoyu; Zhang, Hongquan; Lin, Chia-Ying; Fan, Yubo

    2017-11-01

    The uneven distributed microstructure featured with plate-like spongy bone in woodpecker's skull has been found to further help reduce the impact during woodpecker's pecking behavior. Therefore, this work was to investigate the micro-mechanical properties and composition on different sites of Great Spotted woodpecker's (GSW) skull. Different sites were selected on forehead, tempus and occiput, which were also compared with those of Eurasian Hoopoe (EH) and Lark birds (LB). Micro structural parameters assessed from micro computed tomography (μCT) occurred significantly difference between GSW, EH and LB. The micro finite element (micro-FE) models were developed and the simulation was performed as a compression process. The maximal stresses of GSW's micro-FE models were all lower than those of EH and LB respectively and few concentrated stresses were noticed on GSW's trabecular bone. Fourier transform infrared mapping suggesting a greater organic content in the occiput of GSW's cranial bone compared with others. The nano-hardness of the GSW's occiput was decreasing from forehead to occiput. The mechanical properties, site-dependent hardness distribution and special material composition of GSW's skull bone are newly found in this study. These factors may lead to a new design of bulk material mimicking these characteristics.

  11. Immediate, but Not Delayed, Microsurgical Skull Reconstruction Exacerbates Brain Damage in Experimental Traumatic Brain Injury Model

    Science.gov (United States)

    Lau, Tsz; Kaneko, Yuji; van Loveren, Harry; Borlongan, Cesario V.

    2012-01-01

    Moderate to severe traumatic brain injury (TBI) often results in malformations to the skull. Aesthetic surgical maneuvers may offer normalized skull structure, but inconsistent surgical closure of the skull area accompanies TBI. We examined whether wound closure by replacement of skull flap and bone wax would allow aesthetic reconstruction of the TBI-induced skull damage without causing any detrimental effects to the cortical tissue. Adult male Sprague-Dawley rats were subjected to TBI using the controlled cortical impact (CCI) injury model. Immediately after the TBI surgery, animals were randomly assigned to skull flap replacement with or without bone wax or no bone reconstruction, then were euthanized at five days post-TBI for pathological analyses. The skull reconstruction provided normalized gross bone architecture, but 2,3,5-triphenyltetrazolium chloride and hematoxylin and eosin staining results revealed larger cortical damage in these animals compared to those that underwent no surgical maneuver at all. Brain swelling accompanied TBI, especially the severe model, that could have relieved the intracranial pressure in those animals with no skull reconstruction. In contrast, the immediate skull reconstruction produced an upregulation of the edema marker aquaporin-4 staining, which likely prevented the therapeutic benefits of brain swelling and resulted in larger cortical infarcts. Interestingly, TBI animals introduced to a delay in skull reconstruction (i.e., 2 days post-TBI) showed significantly reduced edema and infarcts compared to those exposed to immediate skull reconstruction. That immediate, but not delayed, skull reconstruction may exacerbate TBI-induced cortical tissue damage warrants a careful consideration of aesthetic repair of the skull in TBI. PMID:22438975

  12. A Bullet Entered through the Open Mouth and Ended Up in the Parapharyngeal Space and Skull Base

    Directory of Open Access Journals (Sweden)

    Saileswar Goswami

    2015-01-01

    Full Text Available Shot from a revolver from a close range, a bullet pierced the chest of a policeman and entered through the open mouth of a young male person standing behind. The entry wound was found in the cheek mucosa adjacent to the left lower third molar. After hitting and fracturing the body and the ramus of the mandible, the bullet was deflected and was finally lodged in the parapharyngeal space and skull base, anterolateral to the transverse process of the atlas. The great vessels of the neck were not injured. The patient’s condition was very critical but his life could be saved. The bullet was approached through a modified Blair’s incision and was found to be lying over the carotid sheath. It was removed safely and the patient recovered completely.

  13. The efficacy of diagnostic radiation uses in pediatrics using the example of skull survey radiographs after skull brain traumas

    International Nuclear Information System (INIS)

    Mueller, H.

    1987-01-01

    This work is a retrospective efficacy study, where efficiency is left out of consideration. The goal of this work is to examine the efficacy of the radiodiagnostic of skull brain traumas in children and under consideration of the literature already present on this theme to find eventually possibilities for the limitation of the routine radiology or respectively to increase the predictive value by means of the making of a list containing highly effective criteria. (orig./MG) [de

  14. Elbow Fractures

    Science.gov (United States)

    ... is also an important factor when treating elbow fractures. Casts are used more frequently in children, as their risk of developing elbow stiffness is small; however, in an adult, elbow stiffness is much more likely. Rehabilitation directed by your doctor is often used to ...

  15. Wrist Fractures

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Wrist Fractures Email to a friend * required fields ...

  16. Shoulder Fractures

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Shoulder Fractures Email to a friend * required fields ...

  17. 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

  18. The Role of Interface on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model.

    Science.gov (United States)

    Deland, Trevor S; Niespodziewanski, Emily; Fenton, Todd W; Haut, Roger C

    2016-01-01

    The role of impact interface characteristics on the biomechanics and patterns of cranial fracture has not been investigated in detail, and especially for the pediatric head. In this study, infant porcine skulls aged 2-19 days were dropped with an energy to cause fracturing onto four surfaces varying in stiffness from a rigid plate to one covered with plush carpeting. Results showed that heads dropped onto the rigid surface produced more extensive cranial fracturing than onto carpeted surfaces. Contact forces generated at fracture initiation and the overall maximum contact forces were generally lower for the rigid than carpeted impacts. While the degree of cranial fracturing from impacts onto the heavy carpeted surface was comparable to that of lower-energy rigid surface impacts, there were fewer diastatic fractures. This suggests that characteristics of the cranial fracture patterns may be used to differentiate energy level from impact interface in pediatric forensic cases. © 2015 American Academy of Forensic Sciences.

  19. X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures.

    Science.gov (United States)

    Chen, L-J; Zhao, M-C; Pan, X-F; Wei, Y-Q; Wang, D-Y

    2013-09-01

    This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function of patients. Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.

  20. Shape and mechanics in thalattosuchian (Crocodylomorpha) skulls: implications for feeding behaviour and niche partitioning

    Science.gov (United States)

    Pierce, S E; Angielczyk, K D; Rayfield, E J

    2009-01-01

    Variation in modern crocodilian and extinct thalattosuchian crocodylomorph skull morphology is only weakly correlated with phylogeny, implying that factors other than evolutionary proximity play important roles in determining crocodile skull shape. To further explore factors potentially influencing morphological differentiation within the Thalattosuchia, we examine teleosaurid and metriorhynchid skull shape variation within a mechanical and dietary context using a combination of finite element modelling and multivariate statistics. Patterns of stress distribution through the skull were found to be very similar in teleosaurid and metriorhynchid species, with stress peaking at the posterior constriction of the snout and around the enlarged supratemporal fenestrae. However, the magnitudes of stresses differ, with metriorhynchids having generally stronger skulls. As with modern crocodilians, a strong linear relationship between skull length and skull strength exists, with short-snouted morphotypes experiencing less stress through the skull than long-snouted morphotypes under equivalent loads. Selection on snout shape related to dietary preference was found to work in orthogonal directions in the two families: diet is associated with snout length in teleosaurids and with snout width in metriorhynchids, suggesting that teleosaurid skulls were adapted for speed of attack and metriorhynchid skulls for force production. Evidence also indicates that morphological and functional differentiation of the skull occurred as a result of dietary preference, allowing closely related sympatric species to exploit a limited environment. Comparisons of the mechanical performance of the thalattosuchian skull with extant crocodilians show that teleosaurids and long-snouted metriorhynchids exhibit stress magnitudes similar to or greater than those of long-snouted modern forms, whereas short-snouted metriorhynchids display stress magnitudes converging on those found in short-snouted modern

  1. Trepanation and enlarged parietal foramen on skulls from the Loyalty Islands (Melanesia).

    Science.gov (United States)

    Vasilyev, Sergey V; Sviridov, Alexey A

    2017-06-01

    The goal of this study is a comprehensive examination of openings discovered on two skulls in the collection of skeletal remains from the Loyalty Islands (Melanesia). The skull No. 1524 displayed an evidence of successful trepanation, and the skull No. 7985 revealed openings that were reminiscent of a trepanation, however, we are inclined to believe that in the latter case we are dealing with a rare genetic anomaly - enlarged parietal foramen.

  2. Morphological and Radiographic Studies on the Skull of Indian Blackbuck (Antilope cervicapra)

    OpenAIRE

    Choudhary, Om Prakash; Singh, Ishwer

    2016-01-01

    The phenotypic appearance of the head of animal species depends strongly on the shape of the skull. The present study has been carried out on morphological and radiographic characteristics of skull of the Indian Blackbuck. The skull comprised of cranial and facial bones. The cranial bones included occipital, sphenoid, ethmoid, interparietal, parietal, frontal and temporal. The occipital was a single bone surrounding the foramen magnum. The sphenoid was a single bone and situated between the o...

  3. CT and magnetic resonance imaging finding of lipomatous hemanioperisytoma of skull base: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Girl; Yu, In Kyu; Kim, Han Kyu; Kim, Seung Min; Kang, Dong Wook [Eulji University Hospital, Daejeon (Korea, Republic of)

    2013-07-15

    Lipomatous hemangiopericytoma (LHPC) is recently recognized as a rare hemangiopericytoma variant. To our knowledge, imaging features of LHPC involving skull base have not yet been reported. We present the imaging features of LHPC of skull base in a 44-year-old female, along with a literature review CT and magnetic resonance imagings showed well-enhanced fatty issues containing temporal skull base masses, with pressure bony erosions.

  4. Analysis of skull asymmetry in different historical periods using radiological examinations

    International Nuclear Information System (INIS)

    Gawlikowska, A.; Czerwinski, F.; Dzieciolowska, E.; Miklaszewska, D.; Adamiec, E.; Szczurowski, J.

    2007-01-01

    Asymmetry is a very common phenomenon in nature. Occurrence of asymmetry and knowledge of correct structure, especially a range of variability which is not a pathology but only an individual variation, are the basis for interpretation of results of radiological examination of the skulls both in research work and in diagnostic examinations, which are widely performed in modern medicine. There are many methods of estimation of the asymmetry. The aim of this study was to estimate the symmetry of skulls from selected historic populations. The studied material consisted of two skull populations - contemporary consisting of 82 skulls and medieval - 77 skulls from Grodek. X-rays in P-A and skull-base projections were performed. The images were scanned and calibrated by means of MicroStation 95 Academic Edition software. Using tools for measurement of vector elements, distances between selected bilateral points of the skull were taken. All data were analyzed statistically. Asymmetry was observed in the skulls of both populations. Some diameters were higher on the left side, some on the right side. High levels of asymmetry index in the superior facial part and in the posterior part of the skull base were observed. The levels of the asymmetry indexes in both groups were similar. Radiological pictures in two projections should be taken for correct analysis of the skull asymmetry. The examination of the asymmetry of the landmarks should be based on the analysis of diameters from two different points of reference. The human skull does not demonstrate a clear domination of one side. The largest variations were observed in the shape and localization of the foramina of the skull . It is associated with the differences of the position of the neurovascular elements which pass through these foramina. (author)

  5. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  6. Contributions to the functional morphology of caudate skulls: kinetic and akinetic forms

    Directory of Open Access Journals (Sweden)

    Nikolay Natchev

    2016-09-01

    Full Text Available A strongly ossified and rigid skull roof, which prevents parietal kinesis, has been reported for the adults of all amphibian clades. Our μ-CT investigations revealed that the Buresch’s newt (Triturus ivanbureschi possess a peculiar cranial construction. In addition to the typical amphibian pleurokinetic articulation between skull roof and palatoquadrate associated structures, we found flexible connections between nasals and frontals (prokinesis, vomer and parasphenoid (palatokinesis, and between frontals and parietals (mesokinesis. This is the first description of mesokinesis in urodelans. The construction of the skull in the Buresch’s newts also indicates the presence of an articulation between parietals and the exocipitals, discussed as a possible kind of metakinesis. The specific combination of pleuro-, pro-, meso-, palato-, and metakinetic skull articulations indicate to a new kind of kinetic systems unknown for urodelans to this date. We discuss the possible neotenic origin of the skull kinesis and pose the hypothesis that the kinesis in T. ivanbureschi increases the efficiency of fast jaw closure. For that, we compared the construction of the skull in T. ivanbureschi to the akinetic skull of the Common fire salamander Salamandra salamandra. We hypothesize that the design of the skull in the purely terrestrial living salamander shows a similar degree of intracranial mobility. However, this mobility is permitted by elasticity of some bones and not by true articulation between them. We comment on the possible relation between the skull construction and the form of prey shaking mechanism that the species apply to immobilize their victims.

  7. A small skull from Flores dated to the 20th century

    DEFF Research Database (Denmark)

    Villa, Chiara; Persson, Liselott; Alexandersen, Verner

    2012-01-01

    A human skull with mandible from the Ngada District on the island of Flores, Indonesia, is described in order to contribute to the knowledge of variation in cranial architecture, which is important in interpretations of evolutionary cerebralisation. The skull was excavated in 1924 and sent...... to the National Museum in Copenhagen. The "Copenhagen Flores" (CF) male skull is radiocarbon-dated and of modern age. The cranium is small, but larger than e.g. Liang Bua skull (LB1) in every measurement. The (CT-scan based) cranial capacity of 1258 ml is normal for modern humans, but somewhat lower than values...

  8. Fracture mechanics

    International Nuclear Information System (INIS)

    Miannay, D.P.

    1995-01-01

    This book entitle ''Fracture Mechanics'', the first one of the monograph ''Materiologie'' is geared to design engineers, material engineers, non destructive inspectors and safety experts. This book covers fracture mechanics in isotropic homogeneous continuum. Only the monotonic static loading is considered. This book intended to be a reference with the current state of the art gives the fundamental of the issues under concern and avoids the developments too complicated or not yet mastered for not making reading cumbersome. The subject matter is organized as going from an easy to a more complicated level and thus follows the chronological evolution in the field. Similarly the microscopic scale is considered before the macroscopic scale, the physical understanding of phenomena linked to the experimental observation of the material preceded the understanding of the macroscopic behaviour of structures. In this latter field the relatively recent contribution of finite element computations with some analogy with the experimental observation is determining. However more sensitive analysis is not skipped

  9. [Management of occult malformations at the lateral skull base].

    Science.gov (United States)

    Bryson, E; Draf, W; Hofmann, E; Bockmühl, U

    2005-12-01

    Occult malformations of the lateral skull base are rare anomalies, but can cause severe complications such as recurrent meningitis. Therefore, they need to be precisely delineated and sufficient surgical closure is mandatory. Between 1986 and 2004 twenty patients (10 children and 10 adults) with occult malformations at the lateral skull base were treated surgically at the ENT-Department of the Hospital Fulda gAG. Of these 3 Mondini-malformations, 11 defects of the tegmen tympani or the mastoidal roof, 2 dural lesions to the posterior fossa and 4 malformations within the pyramidal apex have been found. Four patients have had multiple anomalies. Routing symptom was in all cases at least one previous meningitis. Radiological diagnostics included high-resolution computed tomography (CT) and magnetic resonance imaging (MRI) as well as CT- or MR-cisternography. Depending on type and localisation of the defect the following surgical algorithm was carried out: The trans-mastoidal approach was used in all cases of Mondini-malformation (including obliteration of the ear), in case of lesions to the posterior fossa as well as partly in anomalies at the tegmen tympani and mastoidal roof, respectively. Defects of the pyramidal apex should be explored via the trans-mastoidal way if the lesion is located caudally to the inner auditory canal (IAC), whereas the trans-temporal approach should be used if the lesion is situated ventral to the IAC and dorso-medially to the internal carotid artery (ICA). The trans-temporal approach was also performed in large defects of the tegmen tympani and mastoidal roof as well as in recurrences. In all cases of recurrent meningitis caused by agents of the upper airway tract the basic principle should be to search for occult skull base malformations radiologically as well as by sodium fluorescein endoscopy as long as the anomaly is detected.

  10. The pioneering contribution of italian surgeons to skull base surgery.

    Science.gov (United States)

    Priola, Stefano M; Raffa, Giovanni; Abbritti, Rosaria V; Merlo, Lucia; Angileri, Filippo F; La Torre, Domenico; Conti, Alfredo; Germanò, Antonino; Tomasello, Francesco

    2014-01-01

    The origin of neurosurgery as a modern, successful, and separate branch of surgery could be dated back to the end of the 19th century. The most important development of surgery occurred in Europe, particularly in Italy, where there was a unique environment, allowing brilliant open-minded surgeons to perform, with success, neurosurgical operations. Neurosurgery began at the skull base. In everyday practice, we still pay tribute to early Italian neuroanatomists and pioneer neurosurgeons who represented a starting point in a new, obscure, and still challenging field of medicine and surgery during their times. In this paper, we report at a glance the contributions of Tito Vanzetti from Padua (1809-1888), for his operation on a destructive skull base cyst that had, indeed, an intracranial expansion; of Davide Giordano (1864-1954) from Venice, who described the first transnasal approach to the pituitary gland; and, most importantly, of Francesco Durante from Messina (1844-1934), who was the first surgeon in the history of neurosurgery to successfully remove a cranial base meningioma. They carried out the first detailed reported surgical excision of intracranial lesions at the skull base, diagnosed only through clinical signs; used many of the advances of the 19th century; and conceived and performed new operative strategies and approaches. Their operations were radical enough to allow the patient to survive the surgery and, in the case of Durante, for the first time, to obtain more than 12 years of good survival at a time when a tumor of this type would have been fatal. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Endovascular treatment for arterial injuries of skull base

    International Nuclear Information System (INIS)

    Li Tianxiao; Bai Weixing; Zai Suiting; Wang Ziliang; Xue Jiangyu

    2008-01-01

    Objective: To explore the role of endovascular techniques in treatment for arterial injuries of skull base. Methods: A total of 53 consecutive cases suffered from skull base arterial injuries were enrolled in our hospital from Oct 2004 to May 2007, including 44 male and 9 female cases with average age of 23.3 years. Thirty-nine cases presented with pulsatile exophthalmos and intracranial vascular murmur, cerchnus and dysphagia in another 9, epistaxis in the remaining 5 cases. Diagnosis of 39 carotid cavernous fistulae (CCF)and 14 carotid pseudoaneurysm were performed by angiography (DSA). Alternative endovascular procedures were performed depending on lesions characteristics and follow-up was done by telephone and outpatient work up. Results: Procedures were performed involving 56 carotid arteries in all 53 cases including 34 CCF with embolization of detachable balloon(33 cases), 3 with balloon and coils, and 3 by stent-graft placement. 8 carotid pseudoaneurysms were cured by parent artery occlusion with balloon, 2 experienced endovascular isolation with balloon and coils, and 4 with stent-graft. Follow-up for mean 9.5 months (range from 2 to 25 months) revealed that the chief symptoms of 45 cases (85%) were relieved within 6 months after the procedure but ocular movement and visual disorder remained in 8 cases (15%)till 12 months. Six pseudoaneurysms and 3 residual leak were found in reexamination, of which 2 cases underwent intervention again 2 and 3 months later due to dural arterial-venous fistula in cavernous sinus, respectively. Conclusions: Endovascular treatment is safe and effective therapeutic option with minimal invasion for skull base arterial injuries. Detachable balloon embolization is the first choice for CCF and carotid pseudoaneurysm. Spring coil packing and stent-graft implantation should be in alternation as combination for special cases. (authors)

  12. Do Muscles Constrain Skull Shape Evolution in Strepsirrhines?

    Science.gov (United States)

    Fabre, Anne-Claire; Perry, Jonathan M G; Hartstone-Rose, Adam; Lowie, AuróLien; Boens, Andy; Dumont, MaÏtena

    2018-02-01

    Despite great interest and decades of research, the musculoskeletal relationships of the masticatory system in primates are still not fully understood. However, without a clear understanding of the interplay between muscles and bones it remains difficult to understand the functional significance of morphological traits of the skeleton. Here, we aim to study the impacts of the masticatory muscles on the shape of the cranium and the mandible as well as their co-variation in strepsirrhine primates. To do so, we use 3D geometric morphometric approaches to assess the shape of each bone of the skull of 20 species for which muscle data are available in the literature. Impacts of the masticatory muscles on the skull shape were assessed using non-phylogenetic regressions and phylogenetic regressions whereas co-variations were assessed using two-blocks partial least square (2B-PLS) and phylogenetic 2B-PLS. Our results show that there is a phylogenetic signal for skull shape and masticatory muscles. They also show that there is a significant impact of the masticatory muscles on cranial shape but not as much as on the mandible. The co-variations are also stronger between the masticatory muscles and cranial shape even when taking into account phylogeny. Interestingly, the results of co-variation between the masticatory muscles and mandibular shape show a more complex pattern in two different directions to get strong muscles associated with mandibular shape: a folivore way (with the bamboo lemurs and sifakas) and a hard-object eater one (with the aye-aye). Anat Rec, 301:291-310, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  13. Standardization of thorax, skull and pelvis radiographic images

    International Nuclear Information System (INIS)

    Pina, D.R.; Ghilardi Netto, T.; Trad, C.S.; Brochi, M.A. Corte; Duarte, S.B.; Pina, S.R.

    2001-01-01

    The radiographic techniques for production of chest, skull and pelvis exam were determined for the standard patient. These techniques produced the quality image with smaller dose, for a standard patient, at any conventional X-ray equipment. The radiographic contrast produced for these techniques was measured utilizing the realistic-analytic phantom and classified as an ideal radiographic contrast. This work has the aim to keep the standard of the quality image, for any thickness of patients usually found in clinic routine of the radiodiagnosis service, satisfying the relation risk-benefit for the patient and cost- benefit for the institution. (author)

  14. A checklist for endonasal transsphenoidal anterior skull base surgery.

    Science.gov (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  15. [Application of neuroendoscope in the treatment of skull base chordoma].

    Science.gov (United States)

    Zhang, Ya-Zhuo; Wang, Zong-Cheng; Zong, Xu-Yi; Wang, Xin-Sheng; Gui, Song-Bai; Zhao, Peng; Li, Chu-Zhong; He, Yue; Wang, Hong-Yun

    2011-07-05

    To further explore the application, approach, indication and prognosis of neuroendoscope treatment for skull base chordoma. A total of 101 patients of skull base chordoma were admitted at our hospital from May 2000 to April 2010. There were 59 males and 42 females. Their major clinical manifestations included headache, cranial nerve damage and dyspnea. They were classified according to the patterns of tumor growth: Type I (n = 13): tumor location at a single component of skull base, i. e. clivus or sphenoid sinus with intact cranial dura; Type II (n = 56): tumor involving more than two components of skull e. g clivus, sphenoid and nasal/oral cavity, etc. But there was no intracranial invasion; Type III (n = 32) : tumor extending widely and intradurally forming compression of brain stems and multiple cranial nerves. Based on the types of chordoma, different endoscopic approaches were employed, viz. transnasal, transoral, trans-subtemporal fossa and plus microsurgical craniotomy for staging in some complex cases. Among all patients, total resection was achieved (n = 19), subtotal (n = 58) and partial (n = 24). In partial resection cases, 16 cases were considered to be subtotal due to a second-stage operation. Most cases had conspicuous clinical improvements. Self-care recovery within one week post-operation accounted for 58.4%, two weeks 30.7%, one month 6.9% and more than one month 1.9%. Postoperative complications occurred in 13 cases (12.8%) and included CSF leakage (n = 4) cranial nerve palsy (n = 5), hemorrhagic nasal wounds (n = 3) and delayed intracranial hemorrhage (n = 1). All of these were cured or improved after an appropriate treatment. A follow-up of 6 - 60 months was conducted in 56 cases. Early detection and early treatment are crucial for achieving a better outcome in chordoma. Neuroendoscopic treatment plays an important role in managing those complicated cases. Precise endoscopic techniques plus different surgical approaches and staging procedures

  16. The Incidence and Topographic Distribution of Sutures Including Wormian Bones in Human Skulls.

    Science.gov (United States)

    Cirpan, Sibel; Aksu, Funda; Mas, Nuket

    2015-07-01

    The Wormian Bones are accessory bones located within the cranial sutures and fontanelles. The present article examines the incidence of Wormian Bones and compares the number and topographic distribution between the sutures including Wormian Bones in skulls of West Anatolian Population. One hundred fifty crania were examined. The parameters evaluated in the present study were as follows: the rate of skulls including Wormian Bones; the topographic distribution and frequencies of the sutures including Wormian Bones; the number of these sutures for each skull; the name and number of sutures that were bilaterally and symmetrically located on the right and left side of skull (paired sutures) and which coincidentally had Wormian Bones for each skull; the differences of frequencies between the paired sutures including Wormian Bones. The rate of skulls including Wormian Bones was determined as 59.3%. The maximum and minimum numbers of sutures, including Wormian Bones, were 6 in 1 skull and 1 in each of 30 skulls, respectively. The maximum and minimum rates of sutures that had Wormian Bones were found in left lambdoid 40.7% and right occipitomastoid 1.3% sutures, respectively. There was only a significant difference between the rate of right and left squamous sutures (P = 0.04). Forty-five skulls were including 55 pairs of bilaterally and symmetrically located sutures that coincidentally had Wormian Bones in each pair. Each of 35 skulls had 1 pair of sutures including Wormian Bones and each of 10 skulls had 2 pairs. In the present study, the rate of Wormian Bones was determined as 59.3% in West Anatolian Population. This incidence rate is considerably lower than the other reports, and it may be as a result of racial variations. These divergent bones were more frequently found in left lambdoid sutures (40.7%) and less frequently in right occipitomastoid sutures (1.3%). This study may guide the investigators dealing with the neurosurgery, orthopedy, radiology, anatomy, and

  17. Does skull morphology constrain bone ornamentation? A morphometric analysis in the Crocodylia.

    Science.gov (United States)

    Clarac, F; Souter, T; Cubo, J; de Buffrénil, V; Brochu, C; Cornette, R

    2016-08-01

    Previous quantitative assessments of the crocodylians' dermal bone ornamentation (this ornamentation consists of pits and ridges) has shown that bone sculpture results in a gain in area that differs between anatomical regions: it tends to be higher on the skull table than on the snout. Therefore, a comparative phylogenetic analysis within 17 adult crocodylian specimens representative of the morphological diversity of the 24 extant species has been performed, in order to test if the gain in area due to ornamentation depends on the skull morphology, i.e. shape and size. Quantitative assessment of skull size and shape through geometric morphometrics, and of skull ornamentation through surface analyses, produced a dataset that was analyzed using phylogenetic least-squares regression. The analyses reveal that none of the variables that quantify ornamentation, be they on the snout or the skull table, is correlated with the size of the specimens. Conversely, there is more disparity in the relationships between skull conformations (longirostrine vs. brevirostrine) and ornamentation. Indeed, both parameters GApit (i.e. pit depth and shape) and OArelat (i.e. relative area of the pit set) are negatively correlated with snout elongation, whereas none of the values quantifying ornamentation on the skull table is correlated with skull conformation. It can be concluded that bone sculpture on the snout is influenced by different developmental constrains than on the skull table and is sensible to differences in the local growth 'context' (allometric processes) prevailing in distinct skull parts. Whatever the functional role of bone ornamentation on the skull, if any, it seems to be restricted to some anatomical regions at least for the longirostrine forms that tend to lose ornamentation on the snout. © 2016 Anatomical Society.

  18. A Three-Dimensional Statistical Average Skull: Application of Biometric Morphing in Generating Missing Anatomy.

    Science.gov (United States)

    Teshima, Tara Lynn; Patel, Vaibhav; Mainprize, James G; Edwards, Glenn; Antonyshyn, Oleh M

    2015-07-01

    The utilization of three-dimensional modeling technology in craniomaxillofacial surgery has grown exponentially during the last decade. Future development, however, is hindered by the lack of a normative three-dimensional anatomic dataset and a statistical mean three-dimensional virtual model. The purpose of this study is to develop and validate a protocol to generate a statistical three-dimensional virtual model based on a normative dataset of adult skulls. Two hundred adult skull CT images were reviewed. The average three-dimensional skull was computed by processing each CT image in the series using thin-plate spline geometric morphometric protocol. Our statistical average three-dimensional skull was validated by reconstructing patient-specific topography in cranial defects. The experiment was repeated 4 times. In each case, computer-generated cranioplasties were compared directly to the original intact skull. The errors describing the difference between the prediction and the original were calculated. A normative database of 33 adult human skulls was collected. Using 21 anthropometric landmark points, a protocol for three-dimensional skull landmarking and data reduction was developed and a statistical average three-dimensional skull was generated. Our results show the root mean square error (RMSE) for restoration of a known defect using the native best match skull, our statistical average skull, and worst match skull was 0.58, 0.74, and 4.4  mm, respectively. The ability to statistically average craniofacial surface topography will be a valuable instrument for deriving missing anatomy in complex craniofacial defects and deficiencies as well as in evaluating morphologic results of surgery.

  19. Relevance of Whitnall's tubercle and auditory meatus in diagnosing exclusions during skull-photo superimposition.

    Science.gov (United States)

    Jayaprakash, Paul T; Hashim, Natassha; Yusop, Ridzuan Abd Aziz Mohd

    2015-08-01

    Video vision mixer based skull-photo superimposition is a popular method for identifying skulls retrieved from unidentified human remains. A report on the reliability of the superimposition method suggested increased failure rates of 17.3 to 32% to exclude and 15 to 20% to include skulls while using related and unrelated face photographs. Such raise in failures prompted an analysis of the methods employed for the research. The protocols adopted for assessing the reliability are seen to vary from those suggested by the practitioners in the field. The former include overlaying the skull- and face-images on the basis of morphology by relying on anthropometric landmarks on the front plane of the face-images and evaluating the goodness of match depending on mix-mode images; the latter consist of orienting the skull considering landmarks on both the eye and ear planes of the face- and skull-images and evaluating the match utilizing images seen in wipe-mode in addition to those in mix-mode. Superimposition of a skull with face-images of five living individuals in two sets of experiments, one following the procedure described for the research on reliability and the other applying the methods suggested by the practitioners has shown that overlaying the images on the basis of morphology depending on the landmarks on the front plane alone and assessing the match in mix-mode fails to exclude the skull. However, orienting the skull relying on the relationship between the anatomical landmarks on the skull- and face-images such as Whitnall's tubercle and exocanthus in the front (eye) plane and the porion and tragus in the rear (ear) plane as well as assessing the match using wipe-mode images enables excluding that skull while superimposing with the same set of face-images. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Isolated Transverse Clivus Fracture without Neurodeficit: Case Report and Review of Literature

    International Nuclear Information System (INIS)

    Akar, Ömer; Yaldiz, Can; Özdemir, Nail; Yaman, Onur; Dalbayrak, Sedat

    2015-01-01

    Clivus is a bony surface in the posterior cranial fossa, serving as the support of the brainstem and thus neighboring important structures because of its location. Skull base fractures that cannot be shown by conventional radiography can be clearly imaged by high-resolution bone window computed tomography. A 44 years-old male referred to the emergency department because of a traffic accident in the car. His only complaint was a severe neckache. His X-ray examination showed no pathology. The computed tomographic examination showed no parenchymal pathology, but a isolated transverse fracture in the clivus. The computed tomographic examination showed isolated transverse fracture in the clivus our case presented in this paper is the first case of transverse clivus fracture without additional cranial bone fracture and neurologic deficit in the literature

  1. Juvenile psammomatoid ossifying fibroma in paranasal sinus and skull base.

    Science.gov (United States)

    Wang, Mingjie; Zhou, Bing; Cui, Shunjiu; Li, Yunchuan

    2017-07-01

    The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence. JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely. This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014. All patients were followed by endoscopic and CT scan evaluations during follow-up. All of the 11 cases were boys, with a mean age of 11.8 years (range = 6-17 years). The size of mass in the paranasal sinus ranged from 2.5-4.6 cm in greatest dimension (mean = 3.7 cm), and the medial orbital wall and cranial base were involved in all patients. All 11 patients received successful operation and were relieved from symptoms without mortality and major complications. During follow-up (range from 17-67 months; mean follow-up = 25.8 months), only one patient was recurrent in local position. The skull base partial resected during surgery was found to rebuild after 1 year.

  2. Radiation exposure with 3D rotational angiography of the skull

    International Nuclear Information System (INIS)

    Gosch, D.; Deckert, F.; Schulz, T.; Kahn, T.; Kurze, W.; Patz, A.

    2006-01-01

    Purpose: determination and comparison of radiation exposure for examinations of the skull with unsubtracted 3D rotational angiography (3D RA) and 2D digital subtraction angiography (2D DSA). Materials and methods: measurements were carried out with a skull of an Alderson phantom for 3D RA and for 2D DSA in p.a. and lateral projections using an Innova 4100 angiography system with a digital flat panel detector from GE Healthcare. 45 thermoluminescent dosimeters TLD 100H from Harshaw were placed inside the phantom to measure organ doses. In addition the dose area product was recorded and the effective dose was calculated using the Monte Carlo program PCXMC. Results: for a biplanar DSA run (lateral and p.a. projection), the organ doses were 4 to 5 times higher and the effective dose was 4 times higher than for a 3D RA even though the number of images for the two DSA runs was only half of that for 3D RA. Conclusion: the radiation exposure for unsubtracted 3D RA using a flat panel detector is significantly lower than for biplanar DSA. Using 3D RA in place of 2D DSA can reduce the radiation exposure of patients in neuroradiology procedures. (orig.)

  3. Modified three-dimensional skull base model with artificial dura mater, cranial nerves, and venous sinuses for training in skull base surgery: technical note.

    Science.gov (United States)

    Mori, Kentaro; Yamamoto, Takuji; Oyama, Kazutaka; Ueno, Hideaki; Nakao, Yasuaki; Honma, Keiichirou

    2008-12-01

    Experience with dissection of the cavernous sinus and the temporal bone is essential for training in skull base surgery, but the opportunities for cadaver dissection are very limited. A modification of a commercially available prototype three-dimensional (3D) skull base model, made by a selective laser sintering method and incorporating surface details and inner bony structures such as the inner ear structures and air cells, is proposed to include artificial dura mater, cranial nerves, venous sinuses, and the internal carotid artery for such surgical training. The transpetrosal approach and epidural cavernous sinus surgery (Dolenc's technique) were performed on this modified model using a high speed drill or ultrasonic bone curette under an operating microscope. The model could be dissected in almost the same way as a real cadaver. The modified 3D skull base model provides a good educational tool for training in skull base surgery.

  4. [The Base of the Skull. Rudolf Virchow between Pathology and Anthropology].

    Science.gov (United States)

    Seemann, Sophie

    2016-01-01

    Throughout his scientific career, the pathologist and anthropologist Rudolf Virchow (1821-1902) examined countless skulls, gradually changing his perspective on this object of research. Initially, he was mainly concerned with pathologically deformed skulls. From the 1850s onwards, he gradually developed a more anthropological approach, and anthropology increasingly came to dominate his scientific interest. This article shows how different influences became central for the establishment of his specific and dynamic model of the human skull development and its successful application in anthropology. Crucial for this process were Virchow's collaboration with his teacher Robert Froriep (1804-1861) in the department of pathology of the Charité, his research on cretinism and rickets, as well as his description of the base of the skull as the center of skull development. His research work was attended by and showed a reciprocal interaction with the buildup of large skull collections. This article uses Virchow's original publications on skull pathology as well as his still preserved skull specimens from the collection of the Berlin Museum of Medical History at the Charité for an integrated text and object based analysis.

  5. An historical skull collection and its use in forensic odontology and anthropology

    DEFF Research Database (Denmark)

    Sejrsen, B; Lynnerup, N; Hejmadi, M

    2005-01-01

    The Institute of Forensic Medicine, Copenhagen, houses a collection of historical skulls of unclear origin, marked with a general geographic or "racial descriptor". Would these historical skulls be of any value for the forensic odontologist and anthropologist concerned with teaching and casework?...

  6. Poetic devices as part of the trauma narrative in Country of My Skull ...

    African Journals Online (AJOL)

    This article investigates the role of poetic devices in a trauma narrative like Country of My Skull. The nature and characteristics of a trauma narrative are described with reference to Country of My Skull and Antjie Krog's style as poet and journalist. The theory and role of figurative language in trauma narratives suggest an ...

  7. Study of Mastoid Canals and Grooves in North Karnataka Human Skulls

    OpenAIRE

    Hadimani, Gavishiddappa Andanappa; Bagoji, Ishwar Basavantappa

    2013-01-01

    Introduction: This study was undertaken to observe the frequency of mastoid canals and grooves in north Karnataka dry human skulls. 100 dry human skulls of unknown age and sex from the department of Anatomy were selected and observed for the present study.

  8. Skull metastases detecting on arterial spin labeling perfusion: Three case reports and review of literature.

    Science.gov (United States)

    Ryu, Kyeong H; Baek, Hye J; Cho, Soo B; Moon, Jin I; Choi, Bo H; Park, Sung E; An, Hyo J

    2017-11-01

    Detection of skull metastases is as important as detection of brain metastases because early diagnosis of skull metastases is a crucial determinant of treatment. However, the skull can be a blind spot for assessing metastases on routine brain magnetic resonance imaging (MRI). To the best of our knowledge, the finding of skull metastases on arterial spin labeling (ASL) has not been reported. ASL is a specific MRI sequence for evaluating cerebral blood flow using magnetized endogenous inflow blood. This study uses ASL as a routine sequence of brain MRI protocol and describes 3 clinical cases of skull metastases identified by ASL. The study also highlights the clinical usefulness of ASL in detecting skull metastases. Three patients with known malignancy underwent brain MRI to evaluate for brain metastases. All of the skull metastases were conspicuously depicted on routine ASL images, and the lesions correlated well with other MRI sequences. Three patients received palliative chemotherapy. Three patients are being followed up regularly at the outpatient department. The routine use of ASL may help to detect lesions in blind spots, such as skull metastases, and to facilitate the evaluation of intracranial pathologies without the use of contrast materials in exceptional situations.

  9. How We Got Here: Evolutionary Changes in Skull Shape in Humans & Their Ancestors

    Science.gov (United States)

    Price, Rebecca M.

    2012-01-01

    This activity uses inquiry to investigate how large changes in shape can evolve from small changes in the timing of development. Students measure skull shape in fetal, infant, juvenile, and adult chimpanzees and compare them to adult skulls of "Homo sapiens," "Homo erectus," and "Australopithecus afarensis." They conclude by re-interpreting their…

  10. Can skull form predict the shape of the temporomandibular joint? A study using geometric morphometrics on the skulls of wolves and domestic dogs.

    Science.gov (United States)

    Curth, Stefan; Fischer, Martin S; Kupczik, Kornelius

    2017-11-01

    The temporomandibular joint (TMJ) conducts and restrains masticatory movements between the mammalian cranium and the mandible. Through this functional integration, TMJ morphology in wild mammals is strongly correlated with diet, resulting in a wide range of TMJ variations. However, in artificially selected and closely related domestic dogs, dietary specialisations between breeds can be ruled out as a diversifying factor although they display an enormous variation in TMJ morphology. This raises the question of the origin of this variation. Here we hypothesise that, even in the face of reduced functional demands, TMJ shape in dogs can be predicted by skull form; i.e. that the TMJ is still highly integrated in the dog skull. If true, TMJ variation in the dog would be a plain by-product of the enormous cranial variation in dogs and its genetic causes. We addressed this hypothesis using geometric morphometry on a data set of 214 dog and 60 wolf skulls. We digitized 53 three-dimensional landmarks of the skull and the TMJ on CT-based segmentations and compared (1) the variation between domestic dog and wolf TMJs (via principal component analysis) and (2) the pattern of covariation of skull size, flexion and rostrum length with TMJ shape (via regression of centroid size on shape and partial least squares analyses). We show that the TMJ in domestic dogs is significantly more diverse than in wolves: its shape covaries significantly with skull size, flexion and rostrum proportions in patterns which resemble those observed in primates. Similar patterns in canids, which are carnivorous, and primates, which are mostly frugivorous imply the existence of basic TMJ integration patterns which are independent of dietary adaptations. However, only limited amounts of TMJ variation in dogs can be explained by simple covariation with overall skull geometry. This implies that the final TMJ shape is gained partially independently of the rest of the skull. Copyright © 2017 Elsevier Gmb

  11. Patterns of integration in the canine skull: an inside view into the relationship of the skull modules of domestic dogs and wolves.

    Science.gov (United States)

    Curth, Stefan; Fischer, Martin S; Kupczik, Kornelius

    2017-12-01

    The skull shape variation in domestic dogs exceeds that of grey wolves by far. The artificial selection of dogs has even led to breeds with mismatching upper and lower jaws and maloccluded teeth. For that reason, it has been advocated that their skulls (including the teeth) can be divided into more or less independent modules on the basis of genetics, development or function. In this study, we investigated whether the large diversity of dog skulls and the frequent occurrence of orofacial disproportions can be explained by a lower integration strength between the modules of the skull and by deviations in their covariation pattern when compared to wolves. For that purpose, we employed geometric morphometric methods on the basis of 99 3D-landmarks representing the cranium (subdivided into rostrum and braincase), the mandible (subdivided into ramus and corpus), and the upper and lower tooth rows. These were taken from CT images of 196 dog and wolf skulls. First, we calculated the shape disparity of the mandible and the cranium in dogs and wolves. Then we tested whether the integration strength (measured by RV coefficient) and the covariation pattern (as analysed by partial least squares analysis) of the modules subordinate to the cranium and the mandible can explain differing disparity results. We show, contrary to our expectations, that the higher skull shape diversity in dogs is not explained by less integrated skull modules. Also, the pattern of their covariation in the dog skull can be traced back to similar patterns in the wolf. This shows that existing differences between wolves and dogs are at the utmost a matter of degree and not absolute. Copyright © 2017 Elsevier GmbH. All rights reserved.

  12. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  13. Experimental study of transmission of a pulsed focused beam through a skull phantom in nonlinear regime

    Energy Technology Data Exchange (ETDEWEB)

    Tsysar, S. A., E-mail: sergey@acs366.phys.msu.ru; Nikolaeva, A. V.; Khokhlova, V. A.; Yuldashev, P. V. [Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991 (Russian Federation); Svet, V. D. [Andreyev Acoustics Institute, 4, Shvernik Street, Moscow 117036 (Russian Federation); Sapozhnikov, O. A. [Physics Faculty, Moscow State University, Leninskie Gory, Moscow 119991 (Russian Federation); Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, 1013 NE 40th Street, Seattle, WA 98105 (United States)

    2015-10-28

    In the paper the use of receiving and radiating system, which allows to determine the parameters of bone by nonlinear pulse-echo technique and to image of brain structures through the skull bones, was proposed. Accuracy of the skull bone characterization is due to higher measured harmonic and is significantly better than in linear case. In the experimental part focused piezoelectric transducer with diameter 100 mm, focal distance 100 mm, the frequency of 1.092 MHz was used. It was shown that skull bone profiling can be performed with the use of 3rd harmonic since 1st harmonic can be used for visualization of the underlying objects. The use of wideband systems for both skull profiling and brain visualization is restricted by skull attenuation and resulting low effective sensitivity.

  14. Experimental study of transmission of a pulsed focused beam through a skull phantom in nonlinear regime

    International Nuclear Information System (INIS)

    Tsysar, S. A.; Nikolaeva, A. V.; Khokhlova, V. A.; Yuldashev, P. V.; Svet, V. D.; Sapozhnikov, O. A.

    2015-01-01

    In the paper the use of receiving and radiating system, which allows to determine the parameters of bone by nonlinear pulse-echo technique and to image of brain structures through the skull bones, was proposed. Accuracy of the skull bone characterization is due to higher measured harmonic and is significantly better than in linear case. In the experimental part focused piezoelectric transducer with diameter 100 mm, focal distance 100 mm, the frequency of 1.092 MHz was used. It was shown that skull bone profiling can be performed with the use of 3rd harmonic since 1st harmonic can be used for visualization of the underlying objects. The use of wideband systems for both skull profiling and brain visualization is restricted by skull attenuation and resulting low effective sensitivity

  15. Clinicopathological and Molecular Histochemical Review of Skull Base Metastasis from Differentiated Thyroid Carcinoma

    International Nuclear Information System (INIS)

    Matsuno, Akira; Murakami, Mineko; Hoya, Katsumi; Yamada, Shoko M.; Miyamoto, Shinya; Yamada, So; Son, Jae-Hyun; Nishido, Hajime; Ide, Fuyuaki; Nagashima, Hiroshi; Sugaya, Mutsumi; Hirohata, Toshio; Mizutani, Akiko; Okinaga, Hiroko; Ishii, Yudo; Tahara, Shigeyuki; Teramoto, Akira; Osamura, R. Yoshiyuki; Yamazaki, Kazuto; Ishida, Yasuo

    2013-01-01

    Skull base metastasis from differentiated thyroid carcinoma including follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC) is a rare clinical entity. Eighteen FTC cases and 10 PTC cases showing skull base metastasis have been reported. The most common symptom of skull base metastasis from FTC and PTC is cranial nerve dysfunction. Bone destruction and local invasion to the surrounding soft tissues are common on radiological imaging. Skull base metastases can be the initial clinical presentation of FTC and PTC in the presence of silent primary sites. The possibility of skull base metastasis from FTC and PTC should be considered in patients with the clinical symptoms of cranial nerve dysfunction and radiological findings of bone destruction. A variety of genetic alterations in thyroid tumors have been identified to have a fundamental role in their tumorigenesis. Molecular histochemical studies are useful for elucidating the histopathological features of thyroid carcinoma. Recent molecular findings may provide novel molecular-based treatment strategies for thyroid carcinoma

  16. Normal Brain-Skull Development with Hybrid Deformable VR Models Simulation.

    Science.gov (United States)

    Jin, Jing; De Ribaupierre, Sandrine; Eagleson, Roy

    2016-01-01

    This paper describes a simulation framework for a clinical application involving skull-brain co-development in infants, leading to a platform for craniosynostosis modeling. Craniosynostosis occurs when one or more sutures are fused early in life, resulting in an abnormal skull shape. Surgery is required to reopen the suture and reduce intracranial pressure, but is difficult without any predictive model to assist surgical planning. We aim to study normal brain-skull growth by computer simulation, which requires a head model and appropriate mathematical methods for brain and skull growth respectively. On the basis of our previous model, we further specified suture model into fibrous and cartilaginous sutures and develop algorithm for skull extension. We evaluate the resulting simulation by comparison with datasets of cases and normal growth.

  17. Proximal femoral fractures.

    Science.gov (United States)

    Webb, Lawrence X

    2002-01-01

    Fractures of the proximal femur include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region which is exposed to large compressive stresses. Implants used to address these fractures must be able to accommodate significant loads while the fractures consolidate. Complications secondary to these injuries produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

  18. [Skull cult. Trophy heads and tzantzas in pre-Columbian America].

    Science.gov (United States)

    Carod-Artal, F J

    2012-07-16

    The skull cult is a cultural tradition that dates back to at least Neolithic times. Its main manifestations are trophy heads, skull masks, moulded skulls and shrunken heads. The article reviews the skull cult in both pre-Columbian America and the ethnographic present from a neuro-anthropological perspective. The tradition of shaping and painting the skulls of ancestors goes back to the Indo-European Neolithic period (Natufian culture and Gobekli Tepe). In Mesoamerica, post-mortem decapitation was the first step of a mortuary treatment that resulted in a trophy head, a skull for the tzompantli or a skull mask. The lithic technology utilised by the Mesoamerican cultures meant that disarticulation had to be performed in several stages. Tzompantli is a term that refers both to a construction where the heads of victims were kept and to the actual skulls themselves. Skull masks are skulls that have been artificially modified in order to separate and decorate the facial part; they have been found in the Templo Mayor of Tenochtitlan. The existence of trophy heads is well documented by means of iconographic representations on ceramic ware and textiles belonging to the Paraca, Nazca and Huari cultures of Peru. The Mundurucu Indians of Brazil and the Shuar or Jivaroan peoples of Amazonian Ecuador have maintained this custom down to the present day. The Shuar also shrink heads (tzantzas) in a ritual process. Spanish chroniclers such as Fray Toribio de Benavente 'Motolinia' and Gaspar de Carvajal spoke of these practices. In pre-Columbian America, the tradition of decapitating warriors in order to obtain trophy heads was a wide-spread and highly developed practice.

  19. Virtual surgical planning in endoscopic skull base surgery.

    Science.gov (United States)

    Haerle, Stephan K; Daly, Michael J; Chan, Harley H L; Vescan, Allan; Kucharczyk, Walter; Irish, Jonathan C

    2013-12-01

    Skull base surgery (SBS) involves operative tasks in close proximity to critical structures in a complex three-dimensional (3D) anatomy. The aim was to investigate the value of virtual planning (VP) based on preoperative magnetic resonance imaging (MRI) for surgical planning in SBS and to compare the effects of virtual planning with 3D contours between the expert and the surgeon in training. Retrospective analysis. Twelve patients with manually segmented anatomical structures based on preoperative MRI were evaluated by eight surgeons in a randomized order using a validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Multivariate analysis revealed significant reduction of workload when using VP (PNASA-TLX differences (P.05). Preoperative anatomical segmentation with virtual surgical planning using contours in endoscopic SBS significantly reduces the workload for the expert and the surgeon in training. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  20. [The growing skull. Part I. Neurocranium. Statistical considerations (author's transl)].

    Science.gov (United States)

    Gefferth, K

    1976-01-01

    Measurements were made on the radiographs of the skull of 540 boys and 496 girls obtained in the years 1951-1968. Distances and angles were established with the Tuberculum sellae as the centre. The subjects ranged in age from the first day of life till late puberty. They were divided into 26 groups comprising smaller periods in earlier life, and increasing with age. Results are presented of measurements of 9 distances and 3 angles exclusively concerning the neurocranium. The neurocranium of the girls is smaller than that of the boys from the first day of life and the difference is growing with age. The angles displayed little sex differences. The greater part of the growth of distance takes place in the earliest period of life.

  1. Skull base chordomas: analysis of dose-response characteristics

    International Nuclear Information System (INIS)

    Niemierko, Andrzej; Terahara, Atsuro; Goitein, Michael

    1997-01-01

    Objective: To extract dose-response characteristics from dose-volume histograms and corresponding actuarial survival statistics for 115 patients with skull base chordomas. Materials and Methods: We analyzed data for 115 patients with skull base chordoma treated with combined photon and proton conformal radiotherapy to doses in the range 66.6Gy - 79.2Gy. Data set for each patient included gender, histology, age, tumor volume, prescribed dose, overall treatment time, time to recurrence or time to last observation, target dose-volume histogram, and several dosimetric parameters (minimum/mean/median/maximum target dose, percent of the target volume receiving the prescribed dose, dose to 90% of the target volume, and the Equivalent Uniform Dose (EUD). Data were analyzed using the Kaplan-Meier survivor function estimate, the proportional hazards (Cox) model, and parametric modeling of the actuarial probability of recurrence. Parameters of dose-response characteristics were obtained using the maximum likelihood method. Results: Local failure developed in 42 (36%) of patients, with actuarial local control rates at 5 years of 59.2%. The proportional hazards model revealed significant dependence of gender on the probability of recurrence, with female patients having significantly poorer prognosis (hazard ratio of 2.3 with the p value of 0.008). The Wilcoxon and the log-rank tests of the corresponding Kaplan-Meier recurrence-free survival curves confirmed statistical significance of this effect. The Cox model with stratification by gender showed significance of tumor volume (p=0.01), the minimum target dose (p=0.02), and the EUD (p=0.02). Other parameters were not significant at the α level of significance of 0.05, including the prescribed dose (p=0.21). Parametric analysis using a combined model of tumor control probability (to account for non-uniformity of target dose distribution) and the Weibull failure time model (to account for censoring) allowed us to estimate

  2. British Museum Exhibition Review: The Jericho Skull, Creating an Ancestor

    Directory of Open Access Journals (Sweden)

    Cara Hirst

    2017-03-01

    Full Text Available The temporary exhibit at the British Museum, open 15th December-19th February, and located to the right of the main entrance in the Raymond and Beverly Sackler Gallery (Room 59; is dedicated to a single Neolithic crania from Jericho, known as the Jericho Skull. This exhibit demonstrates the value of relatively recent technologies in archaeological research, highlighting the previously hidden information made possible through CT scanning and the value of these methods in both archaeological research but also in communicating archaeology in a visually stimulating manner which allows an exhibit to take a single item, and create an in depth exhibit featuring both the original material and two cranial 3D prints along with a facial reconstruction.

  3. A modified transcondylar screw to accommodate anatomical skull base variations.

    Science.gov (United States)

    Ghaly, R F; Lissounov, A

    2017-01-01

    Occipitocervical instability may be attributed to congenital, bony/ligamentous abnormalities, trauma, neoplasm, degenerative bone disease, and failed atlantoaxial fixation. Indications for occipitocervical fixation include the prevention of disabling pain, cranial nerve dysfunction, paralysis, or even sudden death. The screw trajectory for the modified transcondylar screw (mTCS) is optimally planned utilizing a three-dimensional skull reconstructed image. The modified mTCS technique is helpful where there is a loss of bone, such as after prior suboccipital craniotomy and/or an inadequate occipital condyle. The new proposed technique is similar to the classical transcondylar screw placement but follows a deeper course along the bony lip of foramen magnum toward clivus from a dorsolateral approach. The modified mTCS technique allows for direct visualization and, therefore, helps to avoid damage to the hypoglossal nerve and lateral aspect of brain stem.

  4. Reconstruction of complicated skull base defects utilizing free tissue transfer.

    Science.gov (United States)

    Djalilian, Hamid R; Gapany, Markus; Levine, Samuel C

    2002-11-01

    We managed five patients with large skull base defects complicated by complex infections with microvascular free tissue transfer. The first patient developed an infection, cerebrospinal fluid (CSF) leak, and meningitis after undergoing a translabyrinthine resection of an acoustic neuroma. The second patient had a history of a gunshot wound to the temporal bone, with a large defect and an infected cholesteatoma that caused several episodes of meningitis. The third through the fifth patients had persistent CSF leakage and infection refractory to conventional therapy. In all cases prior attempts of closure with fat grafts or regional flaps had failed. Rectus abdominis myofascial free flap, radial forearm free flap or a gracilis muscle free flap was used after debridement of the infected cavities. The CSF leaks, local infections, and meningitis were controlled within a week. In our experience, microvascular free tissue provides the necessary bulk of viable, well-vascularized tissue, which not only assures a mechanical seal but also helps clear the local infection.

  5. Brainstem tolerance to conformal radiotherapy of skull base tumors

    International Nuclear Information System (INIS)

    Debus, J.; Hug, E.B.; Liebsch, N.J.; O'Farrel, D.; Finkelstein, D.; Efird, J.; Munzenrider, J.E.

    1997-01-01

    Purpose: The aim of this study was to analyze the long-term incidence of brainstem toxicity in patients treated for skull base tumors with high dose conformal radiotherapy. Methods and Materials: Between 1974 and 1995, 367 patients with chordomas (n = 195) and chondrosarcomas (n = 172) of the base of skull have been treated with combined megavoltage photon and 160 MeV proton radiotherapy. Following 3D treatment planning with delineation of target volumes and critical nontarget structures dose distributions and dose-volume histograms were calculated. Radiotherapy was given an 1.8 Gy or CGE (=Cobalt Gray Equivalent) dose per fraction, with prescribed target doses ranging from 63 CGE to 79.2 CGE (mean = 67.8 CGE). Doses to the brainstem surface were limited to ≤64 CGE and to the brainstem center to ≤53 CGE. Results: Follow-up time ranged from 6 months to 21.4 years (mean = 42.5 months). Brainstem toxicity was observed in 17 of 367 patients attributable to treatment, resulting in death of three patients. Actuarial rates of 5 and 10-year high-grade toxicity-free survival were 94 and 88%, respectively. Increased risk of brainstem toxicity was significantly associated with maximum dose to brainstem, volume of brainstem receiving ≥50 CGE, ≥55 CGE, and ≥60 CGE, number of surgical procedures, and prevalence of diabetes or high blood pressure. Multivariate analysis identified three independent factors as important prognosticators: number of surgical procedures (p < 0.001), volume of the brainstem receiving 60 CGE (p < 0.001), and prevalence of diabetes (p < 0.01). Conclusions: Tolerance of brainstem to fractionated radiotherapy appears to be a steep function of tissue volume included in high dose regions rather than the maximum dose of brainstem alone. In addition, presence of predisposing factors as well as extent of surgical manipulation can significantly lower brainstem tolerance in the individual patient

  6. Interspecific variation of ontogeny and skull shape among porpoises (Phocoenidae).

    Science.gov (United States)

    Galatius, Anders; Berta, Annalisa; Frandsen, Marie Schou; Goodall, R Natalie P

    2011-02-01

    All extant members of Phocoenidae (porpoises) have been characterized as pedomorphic based on skeletal characters. To investigate the ontogenetic background for pedomorphosis and assess interspecific differences in ontogeny among phocoenids, samples of the six extant species were compared in terms of development of both epiphyseal and cranial suture fusion. Across all species, full maturity of the vertebral column was rare. Vertebral epiphyseal development did not progress so far in most Phocoena phocoena as in Phocoenoides dalli and Phocoena dioptrica. P. phocoena, Phocoena spinipinnis, Ph. dalli, and P. dioptrica, for which large series were available, were further compared in terms of ontogeny of cranial shape by three-dimensional geometric morphometrics. Ph. dalli and P. dioptrica generally showed further development of cranial sutures than the other species. Postnatal skull shape development was similar for all species studied; the majority of interspecific shape differences are present at parturition. Smaller species had a higher rate of shape development relative to growth in size than Ph. dalli and P. dioptrica, but they still showed less allometric development due to less postnatal growth. Interspecific shape differences indicate phylogenetic relationships similar to that proposed based on morphology or convergent evolution of the two pelagic species, Ph. dalli and P. dioptrica, under the scenarios suggested by recent molecular studies. A shape trend coinciding with habitat preference was detected; in species with pelagic preference the position and orientation of the foramen magnum aligned the skull with the vertebral column; the rostrum showed less ventral inclination, and the facial region was larger and more concave in lateral aspect. Copyright © 2010 Wiley-Liss, Inc.

  7. Herida penetrante del cráneo Skull penetrating wound

    Directory of Open Access Journals (Sweden)

    Yvei González Orlandi

    2011-06-01

    Full Text Available El traumatismo craneoencefálico es común en los servicios de urgencia de instituciones que atienden a pacientes politraumatizados y se ha convertido en un problema de salud para muchos países. El traumatismo penetrante del cráneo ocupa un lugar especial por su baja frecuencia. En este trabajo se presenta el caso de un paciente varón, de 52 años de edad, que sufrió una herida penetrante del cráneo producida por un arma blanca que quedó retenida en la región frontotemporal izquierda. Tras un estudio imaginológico se procedió al tratamiento quirúrgico de urgencia, y el paciente evoluciona satisfactoriamente después de 25 días de hospitalización. En la actualidad se encuentra en tratamiento de rehabilitación por una hemiparesia derecha residual.The cranioencephalic trauma is common in the emergence centers to care for patients with multiple traumata and it becames in a health problem in many countries. Skull penetrating trauma is located in a special place due to its low frequency. In present paper a case of male patient aged 52 severely skull-injured with penetrating wound caused by a cold steel that remained introduced into the left frontotemporal region. After an imaging study the emergence surgical treatment was applied and patient evolves adequately after 25 days of hospitalization. Nowadays, she is under rehabilitation treatment due to a residual right hemiparesis.

  8. [Congenital skull base defect causing recurrent bacterial meningitis].

    Science.gov (United States)

    Berliner, Elihay; Bar Meir, Maskit; Megged, Orli

    2012-08-01

    Bacterial meningitis is a life threatening disease. Most patients will experience only one episode throughout life. Children who experience bacterial meningitis more than once, require further immunologic or anatomic evaluation. We report a 9 year old child with five episodes of bacterial meningitis due to a congenital defect of the skull base. A two and a half year old boy first presented to our medical center with pneumococcal meningitis. He was treated with antibiotics and fully recovered. Two months later he presented again with a similar clinical picture. Streptococcus pneumoniae grew in cerebrospinal fluid (CSF) culture. CT scan and later MRI of the brain revealed a defect in the anterior middle fossa floor, with protrusion of brain tissue into the sphenoidal sinus. Corrective surgery was recommended but the parents refused. Three months later, a third episode of pneumococcal meningitis occurred. The child again recovered with antibiotics and this time corrective surgery was performed. Five years later, the boy presented once again with clinical signs and symptoms consistent with bacterial meningitis. CSF culture was positive, but the final identification of the bacteria was conducted by broad spectrum 16S ribosomal RNA PCR (16S rRNA PCR) which revealed a sequence of Neisseria lactamica. CT and MRI showed recurrence of the skull base defect with encephalocele in the sphenoid sinus. The parents again refused neurosurgical intervention. A year later the patient presented with bacterial meningitis. CSF culture obtained after initiation of antibiotics was negative, but actinobacillus was identified in the CSF by 16S rRNA PCR. The patient is scheduled for neurosurgical intervention. In patients with recurrent bacterial meningitis caused by organisms colonizing the oropharynx or nasopharynx, an anatomical defect should be carefully sought and surgically repaired.

  9. Skull registration for prone patient position using tracked ultrasound

    Science.gov (United States)

    Underwood, Grace; Ungi, Tamas; Baum, Zachary; Lasso, Andras; Kronreif, Gernot; Fichtinger, Gabor

    2017-03-01

    PURPOSE: Tracked navigation has become prevalent in neurosurgery. Problems with registration of a patient and a preoperative image arise when the patient is in a prone position. Surfaces accessible to optical tracking on the back of the head are unreliable for registration. We investigated the accuracy of surface-based registration using points accessible through tracked ultrasound. Using ultrasound allows access to bone surfaces that are not available through optical tracking. Tracked ultrasound could eliminate the need to work (i) under the table for registration and (ii) adjust the tracker between surgery and registration. In addition, tracked ultrasound could provide a non-invasive method in comparison to an alternative method of registration involving screw implantation. METHODS: A phantom study was performed to test the feasibility of tracked ultrasound for registration. An initial registration was performed to partially align the pre-operative computer tomography data and skull phantom. The initial registration was performed by an anatomical landmark registration. Surface points accessible by tracked ultrasound were collected and used to perform an Iterative Closest Point Algorithm. RESULTS: When the surface registration was compared to a ground truth landmark registration, the average TRE was found to be 1.6+/-0.1mm and the average distance of points off the skull surface was 0.6+/-0.1mm. CONCLUSION: The use of tracked ultrasound is feasible for registration of patients in prone position and eliminates the need to perform registration under the table. The translational component of error found was minimal. Therefore, the amount of TRE in registration is due to a rotational component of error.

  10. [The reduction of the radiation dosage by means of storage phosphor-film radiography compared to a conventional film-screen system with a grid cassette on a skull phantom].

    Science.gov (United States)

    Heyne, J P; Merbold, H; Sehner, J; Neumann, R; Freesmeyer, M; Jonetz-Mentzel, L; Kaiser, W A

    1999-07-01

    How much can the radiation dose be reduced for skull radiography by using digital luminescence radiography (DLR) compared to a conventional screen film system with a grid cassette? A skull phantom (3M) was x-rayed in anterior-posterior orientation using both a conventional screen film system with grid cassette and DLR (ADC-70, Agfa). The tube current time product (mAs) was diminished gradually while keeping the voltage constant. The surface entrance dose was measured by a sensor of Dosimax (Wellhöfer). Five investigators evaluated the images by characteristic and critical features, spatial resolution and contrast. The surface entrance dose at 73 kV/22 mAs was 0.432 mGy in conventional screen film system and 0.435 mGy in DLR. The images could be evaluated very well down to an average dose of 71% (0.308 mGy; SD 0.050); sufficient images were obtained down to an average dose of 31% (0.136 mGy; SD 0.065). The resolution of the line pairs were reduced down to 2 levels depending on the investigator. Contrast was assessed as being very good to sufficient. The acceptance of the postprocessed images (MUSICA-software) was individually different and resulted in an improvement of the assessment of bone structures and contrast in higher dose ranges only. For the sufficient assessment of a possible fracture/of paranasal sinuses/of measurement of the skull the dose can be reduced to at least 56% (phi 31%; SD 14.9%)/40% (phi 27%; SD 9.3%)/18% (phi 14%; SD 4.4%). Digital radiography allows question-referred exposure parameters with clearly reduced dose, so e.g. for fracture exclusion 73 kV/12.5 mAs and to skull measurement 73 kV/4 mAs.

  11. Radiological assessment of skull base changes in children with syndromic craniosynostosis: role of ''minor'' sutures

    International Nuclear Information System (INIS)

    Calandrelli, Rosalinda; D'Apolito, Gabriella; Gaudino, Simona; Stefanetti, Mariangela; Colosimo, Cesare; Massimi, Luca; Di Rocco, Concezio

    2014-01-01

    This study aims to identify the premature synostosis of ''major'' and ''minor'' sutures of the four ''sutural arches'' of the skull and to perform a morphometric analysis in children with syndromic craniosynostosis in order to evaluate changes in the skull base linked with premature suture synostosis. We reviewed multiplanar high-resolution CT images, implemented with 3D reconstructions, from 18 patients with complex syndromic craniosynostosis and compared them with 18 age-matched healthy subjects. We assessed the calvarial sutures and their extension to the skull base, and then we correlated specific types of synostosis with the size, shape and symmetry of the cranial fossae. We found a marked asymmetry of the skull base growth in all patients. The synostotic involvement around the coronal ring caused a reduction in the growth of the anterior and middle fossae. The size of the posterior cranial fossa was related not only to ''major'' but also to ''minor'' suture synostosis of the lambdoid and parieto-squamosal arches. Changes in the skull base and craniofacial axis symmetry are due to structural and functional relationships between ''major'' and ''minor'' skull sutures, suggesting a structural and functional relationship between the neurocranium and basicranium. The early recognition of prematurely closed skull base sutures may help clinicians and neurosurgeons to establish correct therapeutic approaches. (orig.)

  12. Coexistence of Wormian Bones With Metopism, and Vice Versa, in Adult Skulls.

    Science.gov (United States)

    Cirpan, Sibel; Aksu, Funda; Mas, Nuket; Magden, Abdurrahman Orhan

    2016-03-01

    The aim of the study is to investigate coexistence of Wormian bones with metopism, and vice versa, in adult skulls. A total of 160 dry adult human skulls of unknown sex and ages were randomly selected from the Gross Anatomy Laboratory of Medical School of Dokuz Eylul University. The skulls were examined for presence of metopism, Wormian bones (WB), and coexistence of WBs with metopism and vice versa. Topographic distribution of the WBs was macroscopically evaluated within the skulls including metopism. The photographs were being taken with Canon 400B (55 mm objective). The frequency of metopism and WBs in 160 skulls is 7.50% (12/160) and 59.3% (95/160), respectively, P coexistence of WBs with metopism was found as 11 of 12 skulls (91.66%), whereas the incidence of coexistence of metopism with WBs was found as 11 of 95 skulls (11.58%), P coexistence of WBs with metopism (11/12, 91.66%) and coexistence of metopism with WBs (11/95, 11.58%). The factors leading to metopism may also lead to WBs, whereas that the factors leading to WBs may not lead to metopism.

  13. Study of mastoid canals and grooves in north karnataka human skulls.

    Science.gov (United States)

    Hadimani, Gavishiddappa Andanappa; Bagoji, Ishwar Basavantappa

    2013-08-01

    This study was undertaken to observe the frequency of mastoid canals and grooves in north Karnataka dry human skulls. 100 dry human skulls of unknown age and sex from the department of Anatomy were selected and observed for the present study. The mastoid regions of dry skulls were observed for the presence of mastoid canals and grooves, if any. A metallic wire was passed through the canal for its confirmation and then the length was measured. The Mastoid canals were present in 53% of the total 100 skulls observed either bilaterally or unilaterally. Mastoid grooves were present in 18% of the total skulls (100) observed. Double mastoid canal was found in 01% of total skull studied and both Mastoid canals & Mastoid grooves together were present in 02% of the total skulls (100) observed. The knowledge of mastoid canals and grooves is very important for otolaryngologists and neurosurgeons. Because they contain an arterial branch of occipital artery with its accompanying vein which is liable to injury resulting into severe bleeding.

  14. The ontogenetic origins of skull shape disparity in the Triturus cristatus group.

    Science.gov (United States)

    Cvijanović, Milena; Ivanović, Ana; Kalezić, Miloš L; Zelditch, Miriam L

    2014-09-01

    Comparative studies of ontogenies of closely related species provide insights into the mechanisms responsible for morphological diversification. Using geometric morphometrics, we investigated the ontogenetic dynamics of postlarval skull shape and disparity in three closely related crested newt species. The skull shapes of juveniles just after metamorphosis (hereafter metamorphs) and adult individuals were sampled by landmark configurations that describe the shape of the dorsal and ventral side of the newt skull, and analyzed separately. The three species differ in skull size and shape in metamorphs and adults. The ontogenies of dorsal and ventral skull differ in the orientation but not lengths of the ontogenetic trajectories. The disparity of dorsal skull shape increases over ontogeny, but that of ventral skull shape does not. Thus, modifications of ontogenetic trajectories can, but need not, increase the disparity of shape. In species with biphasic life-cycles, when ontogenetic trajectories for one stage can be decoupled from those of another, increases and decreases in disparity are feasible, but our results show that they need not occur. © 2014 Wiley Periodicals, Inc.

  15. Traumatic thoracolumbar spine fractures

    NARCIS (Netherlands)

    J. Siebenga (Jan)

    2013-01-01

    textabstractTraumatic spinal fractures have the lowest functional outcomes and the lowest rates of return to work after injury of all major organ systems.1 This thesis will cover traumatic thoracolumbar spine fractures and not osteoporotic spine fractures because of the difference in fracture

  16. Fractures in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1991-01-01

    In a cross-sectional study of 299 MS patients 22 have had fractures and of these 17 after onset of MS. The fractures most frequently involved the femoral neck and trochanter (41%). Three patients had had more than one fracture. Only 1 patient had osteoporosis. The percentage of fractures increase...

  17. Assessment of fracture risk

    International Nuclear Information System (INIS)

    Kanis, John A.; Johansson, Helena; Oden, Anders; McCloskey, Eugene V.

    2009-01-01

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  18. Osteomas of the skull. Comparison of magnetic resonance imaging and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Yasushi; Matsumura, Akira; Yoshii, Yoshihiko; Nose, Tadao [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine

    1995-01-01

    Magnetic resonance (MR) images of five patients with osteomas of the skull and six patients with other primary skull tumors were reviewed. All osteomas appeared as low-intensity areas on T{sub 1}-weighted images. T{sub 2}-weighted images showed homogeneous low-intensity areas in two dense osteomas, a high-intensity area in one spongy osteoma, and mixed intensity areas in two mixed spongy and dense osteomas, respectively. The signal intensities of osteomas on T{sub 2}-weighted MR images correlated well with the histological findings. Other skull tumors showed no specific MR imaging appearance. (author).

  19. [The anatomy of a reduced skull model--visualisation of Leonardo da Vinci's anthropology].

    Science.gov (United States)

    Ahner, E

    2008-04-02

    The article focuses on a rare example of a miniature skull of unknown origin. The profoundness of the anatomical details, conjoint with outstanding virtuosity, reminds of Leonardo da Vinci's anatomical skull studies and asks for additional interpretation beside the emblematic "memento mori"-character. Following the miscellaneous topics of his skull studies an anatomical-anthropological interpretation is proposed. For such a project the mergence of anthropology, history of medicine and history of art was mandatory. Concerning some discrepancies within the anatomical realism, the depiction of a pathology is discussed and beyond the visualisation of a historic concept of brain function.

  20. Size and shape variability in the skull of Myotis nigricans (Schinz, 1821 (Chiroptera: Vespertilionidae from two geographic areas in Brazil

    Directory of Open Access Journals (Sweden)

    R. Bornholdt

    Full Text Available We present a quantitative analysis of sexual dimorphism and geographic variation in the skull of Myotis nigricans (Schinz, 1821 assessed by geometric morphometrics. Differences in size and shape of skulls were investigated using 30 landmarks plotted on two-dimensional images of lateral and ventral views. Results of geometric morphometrics revealed sexual dimorphism in the centroid size of the skull in both views. Females were larger than males. Nevertheless, there was no sexual dimorphism in skull shape of M. nigricans. Geographic variation was detected in size and shape of the skull. South Brazilian specimens were significantly larger than Ceará specimens only in the lateral view. Differences in skull shape were statistically significant in both views: specimens from South Brazil were brevirostri and presented a more expanded skull in the posterior region while Ceará specimens were longirostri and do not present any expansion in the brain case. Ecological factors for these phenomena are discussed in the text.

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  2. Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation - A first step to create reliable customized simulators.

    Directory of Open Access Journals (Sweden)

    Valentin Favier

    Full Text Available Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training.Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor, polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling.All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error. Local accuracy was better in polycarbonate (0.09mm and polyamide (0.15mm than in Multicolor (0.90mm and resin (0.86mm. Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6-3.5 times higher than in bone. For polycarbonate, forces applied were 1.6-2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor.Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.

  3. Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation - A first step to create reliable customized simulators.

    Science.gov (United States)

    Favier, Valentin; Zemiti, Nabil; Caravaca Mora, Oscar; Subsol, Gérard; Captier, Guillaume; Lebrun, Renaud; Crampette, Louis; Mondain, Michel; Gilles, Benjamin

    2017-01-01

    Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training. Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor), polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling. All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error). Local accuracy was better in polycarbonate (0.09mm) and polyamide (0.15mm) than in Multicolor (0.90mm) and resin (0.86mm). Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6-3.5 times higher than in bone. For polycarbonate, forces applied were 1.6-2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor. Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.

  4. Paratrooper's ankle fracture: posterior malleolar fracture.

    Science.gov (United States)

    Young, Ki Won; Kim, Jin-su; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-03-01

    We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to

  5. Fractures from trampolines: results from a national database, 2002 to 2011.

    Science.gov (United States)

    Loder, Randall T; Schultz, William; Sabatino, Meagan

    2014-01-01

    No study specifically analyzes trampoline fracture patterns across a large population. The purpose of this study was to determine such patterns. We queried the National Electronic Injury Surveillance System database for trampoline injuries between 2002 and 2011, and the patients were analyzed by age, sex, race, anatomic location of the injury, geographical location of the injury, and disposition from the emergency department (ED). Statistical analyses were performed with SUDAAN 10 software. Estimated expenses were determined using 2010 data. There were an estimated 1,002,735 ED visits for trampoline-related injuries; 288,876 (29.0%) sustained fractures. The average age for those with fractures was 9.5 years; 92.7% were aged 16 years or younger; 51.7% were male, 95.1% occurred at home, and 9.9% were admitted. The fractures were located in the upper extremity (59.9%), lower extremity (35.7%), and axial skeleton (spine, skull/face, rib/sternum) (4.4%-spine 1.0%, skull/face 2.9%, rib/sternum 0.5%). Those in the axial skeleton were older (16.5 y) than the upper extremity (8.7 y) or lower extremity (10.0 y) (Pfractures were more frequently female (54.0%) (Pfractures were most frequently admitted (20.0%). The tibia/fibula (39.5%) and ankle (31.5%) were most common in the lower extremity; femur fractures were most frequently admitted (57.9%). Cervical (36.4%) and lumbar (24.7%) were most common locations in the spine; cervical fractures were the most frequently admitted (75.6%). The total ED expense for all trampoline injuries over this 10-year period was $1.002 billion and $408 million for fractures. Trampoline fractures most frequently involve the upper extremity followed by the lower extremity, >90% occur in children. The financial burden to society is large. Further efforts for prevention are needed.

  6. The First AO Classification System for Fractures of the Craniomaxillofacial Skeleton: Rationale, Methodological Background, Developmental Process, and Objectives.

    Science.gov (United States)

    Audigé, Laurent; Cornelius, Carl-Peter; Di Ieva, Antonio; Prein, Joachim

    2014-12-01

    Validated trauma classification systems are the sole means to provide the basis for reliable documentation and evaluation of patient care, which will open the gateway to evidence-based procedures and healthcare in the coming years. With the support of AO Investigation and Documentation, a classification group was established to develop and evaluate a comprehensive classification system for craniomaxillofacial (CMF) fractures. Blueprints for fracture classification in the major constituents of the human skull were drafted and then evaluated by a multispecialty group of experienced CMF surgeons and a radiologist in a structured process during iterative agreement sessions. At each session, surgeons independently classified the radiological imaging of up to 150 consecutive cases with CMF fractures. During subsequent review meetings, all discrepancies in the classification outcome were critically appraised for clarification and improvement until consensus was reached. The resulting CMF classification system is structured in a hierarchical fashion with three levels of increasing complexity. The most elementary level 1 simply distinguishes four fracture locations within the skull: mandible (code 91), midface (code 92), skull base (code 93), and cranial vault (code 94). Levels 2 and 3 focus on further defining the fracture locations and for fracture morphology, achieving an almost individual mapping of the fracture pattern. This introductory article describes the rationale for the comprehensive AO CMF classification system, discusses the methodological framework, and provides insight into the experiences and interactions during the evaluation process within the core groups. The details of this system in terms of anatomy and levels are presented in a series of focused tutorials illustrated with case examples in this special issue of the Journal.

  7. Effect of Skull Resistivity on the Relative Sensitivity Distributions of EEG and MEG Measurements

    National Research Council Canada - National Science Library

    Malmivuo, J

    2001-01-01

    The authors have previously published calculations that show that, despite the high resistivity of the skull, the spatial sensitivity of magnetoencephalography, MEG, is no better than that of electroencephalography, EEG...

  8. Alignment of CT images of skull dysmorphology using anatomy-based perpendicular axes

    International Nuclear Information System (INIS)

    Yoo, Sun K; Kim, Yong O; Kim, Hee-Joung; Kim, Nam H; Jang, Young Beom; Kim, Kee-Deog; Lee, Hye-Yeon

    2003-01-01

    Rigid body registration of 3D CT scans, based on manual identification of homologous landmarks, is useful for the visual analysis of skull dysmorphology. In this paper, a robust and simple alignment method was proposed to allow for the comparison of skull morphologies, within and between individuals with craniofacial anomalies, based on 3D CT scans, and the minimum number of anatomical landmarks, under rigidity and uniqueness constraints. Three perpendicular axes, extracted from anatomical landmarks, define the absolute coordinate system, through a rigid body transformation, to align multiple CT images for different patients and acquisition times. The accuracy of the alignment method depends on the accuracy of the localized landmarks and target points. The numerical simulation generalizes the accuracy requirements of the alignment method. Experiments using a human dried skull specimen, and ten sets of skull CT images (the pre- and post-operative CT scans of four plagiocephaly, and one fibrous dysplasia patients), demonstrated the feasibility of the technique in clinical practice

  9. A Comparative Taphonomic Analysis of 24 Trophy Skulls from Modern Forensic Cases.

    Science.gov (United States)

    Yucha, Josephine M; Pokines, James T; Bartelink, Eric J

    2017-09-01

    Cranial remains retained from fallen enemies are commonly referred to as "trophy skulls," and many such crania were acquired as souvenirs by U.S. servicemembers during WWII and the Vietnam conflict. These remains increasingly have become the subject of forensic anthropological analysis as their possessors, typically veterans or their relatives, try to discard or repatriate them. The present research uses a qualitative analytical approach to review 24 cases of reported trophy skulls (14 previously unpublished cases and 10 from the literature) to determine which perimortem and postmortem characteristics are most useful for generating a taphonomic profile. Overall, the taphonomic signature of trophy remains includes traits relating to acquisition and preparation, ornamental display, and subsequent curation. Contextual evidence and the biological profile also are considered when determining the possible origin of human cranial remains as a trophy skull. Thorough taphonomic analysis will aid in identifying these types of remains as trophy skulls. © 2017 American Academy of Forensic Sciences.

  10. Juvenile nasopharyngeal angiofibroma with skull base invasion : intratumoral direct puncture embolization

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hye Young; Kim, Sun Yong; Suh, Jung Ho; Park, Kee Hyun [Ajou Univ., Suwon (Korea, Republic of). Coll. of Medicine

    1998-04-01

    The purpose of this study is to demonstrate the utility and efficacy of percutaneous direct glue embolization for juvenile nasopharyngeal angiofibromas with skull base invasion. In nine cases of juvenile nasopharyngeal angiofibromas with invasion of the skull base, embolization under general anethesia was performed. Using an 18G spinal needle, direct puncture were made via the transnasal or mandibular sciatic notch. A glue-lipiodol mixture (1:1 -1:3) was injected slowly for 15 to 30 seconds under fluoroscopic control; the number of post-embolization angiography and the distribution of embolic materials was assessed on CT within 1-3 days. The mass was surgically removed 3 to 7 days after embolization. Direct glue embolization of juvenile angiofibroma with skull base invasion appears to be a simple and safe procedure. The technique could be used for other hypervascular lesions in the base of the skull or parapharyngeal space. (author). 19 refs., 1 tab., 2 figs.

  11. Juvenile nasopharyngeal angiofibroma with skull base invasion : intratumoral direct puncture embolization

    International Nuclear Information System (INIS)

    Shin, Hye Young; Kim, Sun Yong; Suh, Jung Ho; Park, Kee Hyun

    1998-01-01

    The purpose of this study is to demonstrate the utility and efficacy of percutaneous direct glue embolization for juvenile nasopharyngeal angiofibromas with skull base invasion. In nine cases of juvenile nasopharyngeal angiofibromas with invasion of the skull base, embolization under general anethesia was performed. Using an 18G spinal needle, direct puncture were made via the transnasal or mandibular sciatic notch. A glue-lipiodol mixture (1:1 -1:3) was injected slowly for 15 to 30 seconds under fluoroscopic control; the number of post-embolization angiography and the distribution of embolic materials was assessed on CT within 1-3 days. The mass was surgically removed 3 to 7 days after embolization. Direct glue embolization of juvenile angiofibroma with skull base invasion appears to be a simple and safe procedure. The technique could be used for other hypervascular lesions in the base of the skull or parapharyngeal space. (author). 19 refs., 1 tab., 2 figs

  12. Response to pediatric physical therapy in infants with positional preference and skull deformation

    NARCIS (Netherlands)

    Wijk, R.M. van; Pelsma, M.; Groothuis-Oudshoorn, C.G.; IJzerman, M.J.; Vlimmeren, L.A. van; Boere-Boonekamp, M.M.

    2014-01-01

    BACKGROUND: Pediatric physical therapy seems to reduce skull deformation in infants with positional preference. However, not all infants show improvement. OBJECTIVE: The study objective was to determine which infant and parent characteristics were related to responses to pediatric physical therapy

  13. CT and MRI of the skull base, including the cranial nerves

    International Nuclear Information System (INIS)

    Weber, A.L.

    1991-01-01

    Some considerations about nuclear magnetic resonance and computerized tomography, essential for examining skull base lesions are treated here, including the cranial nerves. Neoplasms such as meningiomas, adenomas, chordomas, chondrosarcomas and others tumors are also cited, mentioning some commentaries. (author)

  14. Variations of patient dose in CT scan of skull using a female phantom

    International Nuclear Information System (INIS)

    Estanislau, Bruno A.; Mourao, Arnaldo P.

    2013-01-01

    This paper presents a comparison between the doses deposited in organs in CT scans of the skull when using different protocols in operating the TC unit. The protocols differ in the currents and voltages of the X-ray tube

  15. Treatment experience of surgical repair for long-term skull defect

    Directory of Open Access Journals (Sweden)

    Shou-cheng FAN

    2015-12-01

    Full Text Available Retrospective analysis was performed on 30 patients of skull defect who underwent surgical repair. Intraoperative and postoperative curative effect was evaluated on those patients, and the results showed that the incidence rate of intraoperative dura mater defect (P = 0.001, early postoperative complications [new epilepsy (P = 0.035 and effusion (P = 0.021] and late postoperative complications [foreign body sensation (P = 0.035 and dizziness and headache (P = 0.050] in long-term skull defect group were all higher than those in control group. In conclusion, surgical repair of long-term skull defect incurring high risk and various complications will not be an ideal management. Therefore, early surgical treatment for skull defect is suggested. DOI: 10.3969/j.issn.1672-6731.2015.12.016

  16. Functional Imaging of Human Vestibular Cortex Activity Elicited by Skull Tap and Auditory Tone Burst

    Science.gov (United States)

    Noohi, Fatemeh; Kinnaird, Catherine; Wood, Scott; Bloomberg, Jacob; Mulavara, Ajitkumar; Seidler, Rachael

    2014-01-01

    The aim of the current study was to characterize the brain activation in response to two modes of vestibular stimulation: skull tap and auditory tone burst. The auditory tone burst has been used in previous studies to elicit saccular Vestibular Evoked Myogenic Potentials (VEMP) (Colebatch & Halmagyi 1992; Colebatch et al. 1994). Some researchers have reported that airconducted skull tap elicits both saccular and utricle VEMPs, while being faster and less irritating for the subjects (Curthoys et al. 2009, Wackym et al., 2012). However, it is not clear whether the skull tap and auditory tone burst elicit the same pattern of cortical activity. Both forms of stimulation target the otolith response, which provides a measurement of vestibular function independent from semicircular canals. This is of high importance for studying the vestibular disorders related to otolith deficits. Previous imaging studies have documented activity in the anterior and posterior insula, superior temporal gyrus, inferior parietal lobule, pre and post central gyri, inferior frontal gyrus, and the anterior cingulate cortex in response to different modes of vestibular stimulation (Bottini et al., 1994; Dieterich et al., 2003; Emri et al., 2003; Schlindwein et al., 2008; Janzen et al., 2008). Here we hypothesized that the skull tap elicits the similar pattern of cortical activity as the auditory tone burst. Subjects put on a set of MR compatible skull tappers and headphones inside the 3T GE scanner, while lying in supine position, with eyes closed. All subjects received both forms of the stimulation, however, the order of stimulation with auditory tone burst and air-conducted skull tap was counterbalanced across subjects. Pneumatically powered skull tappers were placed bilaterally on the cheekbones. The vibration of the cheekbone was transmitted to the vestibular cortex, resulting in vestibular response (Halmagyi et al., 1995). Auditory tone bursts were also delivered for comparison. To validate

  17. Avian skull morphological evolution: exploring exo- and endocranial covariation with two-block partial least squares.

    Science.gov (United States)

    Marugán-Lobón, Jesús; Buscalioni, Angela D

    2006-01-01

    While rostral variation has been the subject of detailed avian evolutionary research, avian skull organization, characterized by a flexed or extended appearance of the skull, has eventually become neglected by mainstream evolutionary inquiries. This study aims to recapture its significance, evaluating possible functional, phylogenetic and developmental factors that may be underlying it. In order to estimate which, and how, elements of the skull intervene in patterning the skull we tested the statistical interplay between a series of old mid-sagittal angular measurements (mostly endocranial) in combination with newly obtained skull metrics based on landmark superimposition methods (exclusively exocranial shape), by means of the statistic-morphometric technique of two-block partial least squares. As classic literature anticipated, we found that the external appearance of the skull corresponds to the way in which the plane of the caudal cranial base is oriented, in connection with the orientations of the plane of the foramen magnum and of the lateral semicircular canal. The pattern of covariation found between metrics conveys flexed or extended appearances of the skull implicitly within a single and statistically significant dimension of covariation. Marked shape changes with which angles covary concentrate at the supraoccipital bone, the cranial base and the antorbital window, whereas the plane measuring the orientation of the anterior portion of the rostrum does not intervene. Statistical covariance between elements of the caudal cranial base and the occiput inplies that morphological integration underlies avian skull macroevolutionary organization as a by-product of the regional concordance of such correlated elements within the early embryonic chordal domain of mesodermic origin.

  18. Gamma titanium aluminide production using the Induction Skull Melting (ISM) process

    International Nuclear Information System (INIS)

    Reed, S.

    1995-01-01

    Since 1985, more than 2,000 titanium aluminide heats have been produced using the Induction Skull Melting (ISM) process. The history of ISM/Gamma production will be discussed in this paper. Gamma titanium aluminide processing with Induction Skull Melting offers many advantages over other types of reactive alloy melting methods. These advantages will be discussed as well as drawbacks. Also, potential markets and applications for ISM/Gamma will be presented

  19. One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique

    Directory of Open Access Journals (Sweden)

    Jae Young Cho

    2012-03-01

    Full Text Available BackgroundAn area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion.MethodsFrom January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling.ResultsThe mean age of patients was 49.9±12.2 years, with 8 male and 2 female. The size of the burn wound was an average of 119.6±36.7 cm2. The mean expansion duration was 65.5±5.6 days, and the inflation volume was an average of 615±197.6 mL. Mean defect size was 122.2±34.9 cm2. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision.ConclusionsSuccessful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.

  20. A Review of Stereotactic Radiosurgery Practice in the Management of Skull Base Meningiomas

    OpenAIRE

    Vera, Elena; Iorgulescu, J. Bryan; Raper, Daniel M.S.; Madhavan, Karthik; Lally, Brian E.; Morcos, Jacques; Elhammady, Samy; Sherman, Jonathan; Komotar, Ricardo J.

    2014-01-01

    Gross total resection of skull base meningiomas poses a surgical challenge due to their proximity to neurovascular structures. Once the gold standard therapy for skull base meningiomas, microsurgery has been gradually replaced by or used in combination with stereotactic radiosurgery (SRS). This review surveys the safety and efficacy of SRS in the treatment of cranial base meningiomas including 36 articles from 1991 to 2010. SRS produces excellent tumor control with low morbidity rates compare...

  1. Age Effect in the Morphological Traits Performance for Sex Determination in Human Skulls and Mandibles

    OpenAIRE

    Suazo Galdames, Iván; Zavando, Daniela

    2012-01-01

    In this study we tested the hypothesis that diagnostic performance of the morphological indicators for sexual dimorphism are reduced as they are applied in skull and mandibles of older subjects. We used 275 adult human skulls, 250 of these with mandible, all subjects with sex and age registry. Sixteen classic morphological indicators of sexual dimorphism were evaluated, this information was compared with the registry and results noted in terms of precision. The best general performance of mor...

  2. [Development of a Striatal and Skull Phantom for Quantitative 123I-FP-CIT SPECT].

    Science.gov (United States)

    Ishiguro, Masanobu; Uno, Masaki; Miyazaki, Takuma; Kataoka, Yumi; Toyama, Hiroshi; Ichihara, Takashi

    123 Iodine-labelled N-(3-fluoropropyl) -2β-carbomethoxy-3β-(4-iodophenyl) nortropane ( 123 I-FP-CIT) single photon emission computerized tomography (SPECT) images are used for differential diagnosis such as Parkinson's disease (PD). Specific binding ratio (SBR) is affected by scattering and attenuation in SPECT imaging, because gender and age lead to changes in skull density. It is necessary to clarify and correct the influence of the phantom simulating the the skull. The purpose of this study was to develop phantoms that can evaluate scattering and attenuation correction. Skull phantoms were prepared based on the measuring the results of the average computed tomography (CT) value, average skull thickness of 12 males and 16 females. 123 I-FP-CIT SPECT imaging of striatal phantom was performed with these skull phantoms, which reproduced normal and PD. SPECT images, were reconstructed with scattering and attenuation correction. SBR with partial volume effect corrected (SBR act ) and conventional SBR (SBR Bolt ) were measured and compared. The striatum and the skull phantoms along with 123 I-FP-CIT were able to reproduce the normal accumulation and disease state of PD and further those reproduced the influence of skull density on SPECT imaging. The error rate with the true SBR, SBR act was much smaller than SBR Bolt . The effect on SBR could be corrected by scattering and attenuation correction even if the skull density changes with 123 I-FP-CIT on SPECT imaging. The combination of triple energy window method and CT-attenuation correction method would be the best correction method for SBR act .

  3. Scalp and skull influence on near infrared photon propagation in the Colin27 brain template.

    Science.gov (United States)

    Strangman, Gary E; Zhang, Quan; Li, Zhi

    2014-01-15

    Near-infrared neuromonitoring (NIN) is based on near-infrared spectroscopy (NIRS) measurements performed through the intact scalp and skull. Despite the important effects of overlying tissue layers on the measurement of brain hemodynamics, the influence of scalp and skull on NIN sensitivity are not well characterized. Using 3555 Monte Carlo simulations, we estimated the sensitivity of individual continuous-wave NIRS measurements to brain activity over the entire adult human head by introducing a small absorption perturbation to brain gray matter and quantifying the influence of scalp and skull thickness on this sensitivity. After segmenting the Colin27 template into five tissue types (scalp, skull, cerebrospinal fluid, gray matter and white matter), the average scalp thickness was 6.9 ± 3.6 mm (range: 3.6-11.2mm), while the average skull thickness was 6.0 ± 1.9 mm (range: 2.5-10.5mm). Mean NIN sensitivity - defined as the partial path length through gray matter divided by the total photon path length - ranged from 0.06 (i.e., 6% of total path length) at a 20mm source-detector separation, to over 0.19 at 50mm separations. NIN sensitivity varied substantially around the head, with occipital pole exhibiting the highest NIRS sensitivity to gray matter, whereas inferior frontal regions had the lowest sensitivity. Increased scalp and skull thickness were strongly associated with decreased sensitivity to brain tissue. Scalp thickness always exhibited a slightly larger effect on sensitivity than skull thickness, but the effect of both varied with SD separation. We quantitatively characterize sensitivity around the head as well as the effects of scalp and skull, which can be used to interpret NIN brain activation studies as well as guide the design, development and optimization of NIRS devices and sensors. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Numerical evaluation of the skull for human neuromodulation with transcranial focused ultrasound

    Science.gov (United States)

    Mueller, Jerel K.; Ai, Leo; Bansal, Priya; Legon, Wynn

    2017-12-01

    Objective. Transcranial focused ultrasound is an emerging field for human non-invasive neuromodulation, but its dosing in humans is difficult to know due to the skull. The objective of the present study was to establish modeling methods based on medical images to assess skull differences between individuals on the wave propagation of ultrasound. Approach. Computational models of transcranial focused ultrasound were constructed using CT and MR scans to solve for intracranial pressure. We explored the effect of including the skull base in models, different transducer placements on the head, and differences between 250 kHz or 500 kHz acoustic frequency for both female and male models. We further tested these features using linear, nonlinear, and elastic simulations. To better understand inter-subject skull thickness and composition effects we evaluated the intracranial pressure maps between twelve individuals at two different skull sites. Main results. Nonlinear acoustic simulations resulted in virtually identical intracranial pressure maps with linear acoustic simulations. Elastic simulations showed a difference in max pressures and full width half maximum volumes of 15% at most. Ultrasound at an acoustic frequency of 250 kHz resulted in the creation of more prominent intracranial standing waves compared to 500 kHz. Finally, across twelve model human skulls, a significant linear relationship to characterize intracranial pressure maps was not found. Significance. Despite its appeal, an inherent problem with the use of a noninvasive transcranial ultrasound method is the difficulty of knowing intracranial effects because of the skull. Here we develop detailed computational models derived from medical images of individuals to simulate the propagation of neuromodulatory ultrasound across the skull and solve for intracranial pressure maps. These methods allow for a much better understanding of the intracranial effects of ultrasound for an individual in order to

  5. Preformed titanium cranioplasty after resection of skull base meningiomas - a technical note.

    Science.gov (United States)

    Schebesch, Karl-Michael; Höhne, Julius; Gassner, Holger G; Brawanski, Alexander

    2013-12-01

    Meningiomas of the fronto-basal skull are difficult to manage as the treatment usually includes extensive resection of the lesion, consecutive reconstruction of the meninges and of the skull. Especially after removal of spheno-orbital and sphenoid-wing meningiomas, the cosmetic result is of utmost importance. In this technical note, we present our institutional approach in the treatment of skull base meningiomas, focussing on the reconstruction of the neurocranium with individually preformed titanium cranioplasty (CRANIOTOP(®), CL Instruments, Germany). Two female patients (40 years, 64 years) are presented. Both patients presented with skull base lesions suggestive of meningiomas. The preoperative thin-sliced CT scan was processed to generate a 3D-model of the skull. On it, the resection was mapped and following a simulated resection, the cranioplasty was manufactured. Intra-operatively, the titanium plate served as a template for the skull resection and was implanted after microsurgical tumour removal, consecutively. The cosmetic result was excellent. Immediate postoperative CT scan revealed accurate fitting and complete tumour removal. Control Magnetic Resonance Imaging (MRI) within 12 weeks was possible without any artifacts. The comprehensive approach described indicates only one surgical procedure for tumour removal and for reconstruction of the skull. The titanium plate served as an exact template for complete resection of the osseous parts of the tumour. Cosmetic outcome was excellent and control MRI was possible post operatively. CRANIOTOP(®) cranioplasty is a safe and practical tool for reconstruction of the skull after meningioma surgery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. Accurate 3-D Profile Extraction of Skull Bone Using an Ultrasound Matrix Array.

    Science.gov (United States)

    Hajian, Mehdi; Gaspar, Robert; Maev, Roman Gr

    2017-12-01

    The present study investigates the feasibility, accuracy, and precision of 3-D profile extraction of the human skull bone using a custom-designed ultrasound matrix transducer in Pulse-Echo. Due to the attenuative scattering properties of the skull, the backscattered echoes from the inner surface of the skull are severely degraded, attenuated, and at some points overlapped. Furthermore, the speed of sound (SOS) in the skull varies significantly in different zones and also from case to case; if considered constant, it introduces significant error to the profile measurement. A new method for simultaneous estimation of the skull profiles and the sound speed value is presented. The proposed method is a two-folded procedure: first, the arrival times of the backscattered echoes from the skull bone are estimated using multi-lag phase delay (MLPD) and modified space alternating generalized expectation maximization (SAGE) algorithms. Next, these arrival times are fed into an adaptive sound speed estimation algorithm to compute the optimal SOS value and subsequently, the skull bone thickness. For quantitative evaluation, the estimated bone phantom thicknesses were compared with the mechanical measurements. The accuracies of the bone thickness measurements using MLPD and modified SAGE algorithms combined with the adaptive SOS estimation were 7.93% and 4.21%, respectively. These values were 14.44% and 10.75% for the autocorrelation and cross-correlation methods. Additionally, the Bland-Altman plots showed the modified SAGE outperformed the other methods with -0.35 and 0.44 mm limits of agreement. No systematic error that could be related to the skull bone thickness was observed for this method.

  7. The Making of a Skull Base Team and the Value of Multidisciplinary Approach in the Management of Sinonasal and Ventral Skull Base Malignancies.

    Science.gov (United States)

    Snyderman, Carl H; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A

    2017-04-01

    The management of sinonasal and ventral skull base malignancies is best performed by a team. Although the composition of the team may vary, it is important to have multidisciplinary representation. There are multiple obstacles, both individual and institutional, that must be overcome to develop a highly functioning team. Adequate training is an important part of team-building and can be fostered with surgical telementoring. A quality improvement program should be incorporated into the activities of a skull base team. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Fracture mechanical materials characterisation

    International Nuclear Information System (INIS)

    Wallin, K.; Planman, T.; Nevalainen, M.

    1998-01-01

    The experimental fracture mechanics development has been focused on the determination of reliable lower-bound fracture toughness estimates from small and miniature specimens, in particular considering the statistical aspects and loading rate effects of fracture mechanical material properties. Additionally, materials aspects in fracture assessment of surface cracks, with emphasis on the transferability of fracture toughness data to structures with surface flaws have been investigated. Further a modified crack-arrest fracture toughness test method, to increase the effectiveness of testing, has been developed. (orig.)

  9. Gender differences in D-aspartic acid content in skull bone.

    Science.gov (United States)

    Torikoshi-Hatano, Aiko; Namera, Akira; Shiraishi, Hiroaki; Arima, Yousuke; Toubou, Hirokazu; Ezaki, Jiro; Morikawa, Masami; Nagao, Masataka

    2012-12-01

    In forensic medicine, the personal identification of cadavers is one of the most important tasks. One method of estimating age at death relies on the high correlation between racemization rates in teeth and actual age, and this method has been applied successfully in forensic odontology for several years. In this study, we attempt to facilitate the analysis of racemized amino acids and examine the determination of age at death on the basis of the extent of aspartic acid (Asp) racemization in skull bones. The specimens were obtained from 61 human skull bones (19 females and 42 males) that underwent judicial autopsy from October 2010 to May 2012. The amount of D-Asp and L-Asp, total protein, osteocalcin, and collagen I in the skull bones was measured. Logistic regression analysis was performed for age, sex, and each measured protein. The amount of D-Asp in the female skull bones was significantly different from that in the male skull bones (p = 0.021), whereas the amount of L-Asp was similar. Thus, our study indicates that the amount of D-Asp in skull bones is different between the sexes.

  10. The Maturation of Skulls in Postnatal Risso’s Dolphins (Grampus griseus from Taiwanese Waters

    Directory of Open Access Journals (Sweden)

    Ing Chen

    2011-09-01

    Full Text Available The degree of fusion between bones is a useful indicator of skeletal and sexual maturity for cetacean specimens preserved in museum collections. The aim of this study was twofold: first, to examine the degree of fusion between bony elements in skulls of Risso’s dolphins (Grampus griseus Cuvier, 1812 from Taiwanese waters; and second, to analyze the relationship between skull maturity, body length, sexual maturity, and estimated age, with the aim of determining a useful skull predictor for maturity in Risso’s dolphins. The stage of fusion of 20 superficial sutures or joints between selected skull bones was examined on 33 clean, dry skulls, which were salvaged from stranded or bycaught dead Risso’s dolphins in Taiwanese waters during the years of 1994 – 2001. The bones of the caudoventral braincase fused early in development (basioccipital-exoccipital synchondrosis, supraoccipital- exoccipital suture, whereas fusion along the nuchal crest (fronto-interparietal and fronto-parietal sutures occurred later. Some sutures remained open in some adult specimens (lacrimal/maxilla-frontal, squamosal-parietal, squamosal-exoccipital sutures, and the intermandibular symphysis. Bilateral asymmetry of the fusion process was not detected. Advanced fusion occurred in the fronto-interparietal suture along the medial aspect of the nuchal crest, and in the rostral nasal-frontal and distal maxilla-incisive sutures at total body length > 250 cm, and may be useful skull indicators of sexual maturity.

  11. Automatic Sex Determination of Skulls Based on a Statistical Shape Model

    Directory of Open Access Journals (Sweden)

    Li Luo

    2013-01-01

    Full Text Available Sex determination from skeletons is an important research subject in forensic medicine. Previous skeletal sex assessments are through subjective visual analysis by anthropologists or metric analysis of sexually dimorphic features. In this work, we present an automatic sex determination method for 3D digital skulls, in which a statistical shape model for skulls is constructed, which projects the high-dimensional skull data into a low-dimensional shape space, and Fisher discriminant analysis is used to classify skulls in the shape space. This method combines the advantages of metrical and morphological methods. It is easy to use without professional qualification and tedious manual measurement. With a group of Chinese skulls including 127 males and 81 females, we choose 92 males and 58 females to establish the discriminant model and validate the model with the other skulls. The correct rate is 95.7% and 91.4% for females and males, respectively. Leave-one-out test also shows that the method has a high accuracy.

  12. Segmentation of human skull in MRI using statistical shape information from CT data.

    Science.gov (United States)

    Wang, Defeng; Shi, Lin; Chu, Winnie C W; Cheng, Jack C Y; Heng, Pheng Ann

    2009-09-01

    To automatically segment the skull from the MRI data using a model-based three-dimensional segmentation scheme. This study exploited the statistical anatomy extracted from the CT data of a group of subjects by means of constructing an active shape model of the skull surfaces. To construct a reliable shape model, a novel approach was proposed to optimize the automatic landmarking on the coupled surfaces (i.e., the skull vault) by minimizing the description length that incorporated local thickness information. This model was then used to locate the skull shape in MRI of a different group of patients. Compared with performing landmarking separately on the coupled surfaces, the proposed landmarking method constructed models that had better generalization ability and specificity. The segmentation accuracies were measured by the Dice coefficient and the set difference, and compared with the method based on mathematical morphology operations. The proposed approach using the active shape model based on the statistical skull anatomy presented in the head CT data contributes to more reliable segmentation of the skull from MRI data.

  13. Application of CUSA Excel ultrasonic aspiration system in resection of skull base meningiomas.

    Science.gov (United States)

    Tang, Hailiang; Zhang, Haishi; Xie, Qing; Gong, Ye; Zheng, Mingzhe; Wang, Daijun; Zhu, Hongda; Chen, Xiancheng; Zhou, Liangfu

    2014-12-01

    Here, we introduced our short experience on the application of a new CUSA Excel ultrasonic aspiration system, which was provided by Integra Lifesciences corporation, in skull base meningiomas resection. Ten patients with anterior, middle skull base and sphenoid ridge meningioma were operated using the CUSA Excel ultrasonic aspiration system at the Neurosurgery Department of Shanghai Huashan Hospital from August 2014 to October 2014. There were six male and four female patients, aged from 38 to 61 years old (the mean age was 48.5 years old). Five cases with tumor located at anterior skull base, three cases with tumor on middle skull base, and two cases with tumor on sphenoid ridge. All the patents received total resection of meningiomas with the help of this new tool, and the critical brain vessels and nerves were preserved during operations. All the patients recovered well after operation. This new CUSA Excel ultrasonic aspiration system has the advantage of preserving vital brain arteries and cranial nerves during skull base meningioma resection, which is very important for skull base tumor operations. This key step would ensure a well prognosis for patients. We hope the neurosurgeons would benefit from this kind of technique.

  14. Prediction and near-field observation of skull-guided acoustic waves.

    Science.gov (United States)

    Estrada, Héctor; Rebling, Johannes; Razansky, Daniel

    2017-06-21

    Ultrasound waves propagating in water or soft biological tissue are strongly reflected when encountering the skull, which limits the use of ultrasound-based techniques in transcranial imaging and therapeutic applications. Current knowledge on the acoustic properties of the cranial bone is restricted to far-field observations, leaving its near-field unexplored. We report on the existence of skull-guided acoustic waves, which was herein confirmed by near-field measurements of optoacoustically-induced responses in ex-vivo murine skulls immersed in water. Dispersion of the guided waves was found to reasonably agree with the prediction of a multilayered flat plate model. We observed a skull-guided wave propagation over a lateral distance of at least 3 mm, with a half-decay length in the direction perpendicular to the skull ranging from 35 to 300 μm at 6 and 0.5 MHz, respectively. Propagation losses are mostly attributed to the heterogenous acoustic properties of the skull. It is generally anticipated that our findings may facilitate and broaden the application of ultrasound-mediated techniques in brain diagnostics and therapy.

  15. Skull morphometry and vault sutures of Myrmecophaga tridactyla and Tamandua tetradactyla

    Directory of Open Access Journals (Sweden)

    Camila M. de S. Hossotani

    2017-10-01

    Full Text Available ABSTRACT This study aimed to examine the relationship between skull size and the level of cranial vault suture closure. A total of 50 Myrmecophaga tridactyla Linnaeus, 1758 and 178 Tamandua tetradactyla Linnaeus, 1758 skulls were analyzed in relation to 18 skull dimensions. The skulls were grouped into three levels of suture closure: no sutures closed (level 0, one or all the fallowing sutures closed: interfrontalis, sagitalis and coronalis (level 1 and all sutures closed (level 2. The results indicated that among the 18 variables measured, 17 showed significant differences (p ≤ 0.01 between level 0 and level 1 skulls of T. tetradactyla; as well as between level 0 and level 1, and level 0 and level 2 skulls of M. tridactyla. M. tridactyla level 1 and level 2 had no significant difference among any of the 18 dimensions. The foramen magnum height in both species showed no significant difference (p > 0.05 among any suture categories. In principle, suture closure level and cranial dimensions are related. The specimens with larger cranial dimensions showed greater number of cranial vault sutures closed for both species of anteaters. Tamandua tetradactyla and M. tridactyla specimens with none of the cranial vault suture closed have a foramen magnum height similar to those with cranial vault suture closed.

  16. A statistical skull geometry model for children 0-3 years old.

    Directory of Open Access Journals (Sweden)

    Zhigang Li

    Full Text Available Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO. To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.

  17. A statistical skull geometry model for children 0-3 years old.

    Science.gov (United States)

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.

  18. Developmental changes in the skull morphology of common minke whales Balaenoptera acutorostrata.

    Science.gov (United States)

    Nakamura, Gen; Kato, Hidehiro

    2014-10-01

    We investigated growth-related and sex-related morphological changes in the skulls of 144 North Pacific common minke whales Balaenoptera acutorostrata. Measurement was conducted at 39 points on the skull and mandible to extract individual allometric equations relating the length and zygomatic width of the skull. The results revealed no significant differences in skull morphology by sex except for width of occipital bone. The size relative to the skull of the anatomical parts involved in feeding, such as the rostrum and mandible, increased after birth. In contrast, the sensory organs and the anatomical regions involved in neurological function, such as the orbit, tympanic bullae, and foramen magnum, were fully developed at birth, and their relative size reduced over the course of development. This is the first study to investigate developmental changes in the skull morphology using more than 100 baleen whale specimens, and we believe the results of this study will contribute greatly to multiple areas of baleen whale research, including taxonomy and paleontology. © 2014 Wiley Periodicals, Inc.

  19. Prediction and near-field observation of skull-guided acoustic waves

    Science.gov (United States)

    Estrada, Héctor; Rebling, Johannes; Razansky, Daniel

    2017-06-01

    Ultrasound waves propagating in water or soft biological tissue are strongly reflected when encountering the skull, which limits the use of ultrasound-based techniques in transcranial imaging and therapeutic applications. Current knowledge on the acoustic properties of the cranial bone is restricted to far-field observations, leaving its near-field unexplored. We report on the existence of skull-guided acoustic waves, which was herein confirmed by near-field measurements of optoacoustically-induced responses in ex-vivo murine skulls immersed in water. Dispersion of the guided waves was found to reasonably agree with the prediction of a multilayered flat plate model. We observed a skull-guided wave propagation over a lateral distance of at least 3 mm, with a half-decay length in the direction perpendicular to the skull ranging from 35 to 300 μm at 6 and 0.5 MHz, respectively. Propagation losses are mostly attributed to the heterogenous acoustic properties of the skull. It is generally anticipated that our findings may facilitate and broaden the application of ultrasound-mediated techniques in brain diagnostics and therapy.

  20. Phenotypic Covariation and Morphological Diversification in the Ruminant Skull.

    Science.gov (United States)

    Haber, Annat

    2016-05-01

    Differences among clades in their diversification patterns result from a combination of extrinsic and intrinsic factors. In this study, I examined the role of intrinsic factors in the morphological diversification of ruminants, in general, and in the differences between bovids and cervids, in particular. Using skull morphology, which embodies many of the adaptations that distinguish bovids and cervids, I examined 132 of the 200 extant ruminant species. As a proxy for intrinsic constraints, I quantified different aspects of the phenotypic covariation structure within species and compared them with the among-species divergence patterns, using phylogenetic comparative methods. My results show that for most species, divergence is well aligned with their phenotypic covariance matrix and that those that are better aligned have diverged further away from their ancestor. Bovids have dispersed into a wider range of directions in morphospace than cervids, and their overall disparity is higher. This difference is best explained by the lower eccentricity of bovids' within-species covariance matrices. These results are consistent with the role of intrinsic constraints in determining amount, range, and direction of dispersion and demonstrate that intrinsic constraints can influence macroevolutionary patterns even as the covariance structure evolves.

  1. Ecomorphology of the eyes and skull in zooplanktivorous labrid fishes

    Science.gov (United States)

    Schmitz, L.; Wainwright, P. C.

    2011-06-01

    Zooplanktivory is one of the most distinct trophic niches in coral reef fishes, and a number of skull traits are widely recognized as being adaptations for feeding in midwater on small planktonic prey. Previous studies have concluded that zooplanktivores have larger eyes for sharper visual acuity, reduced mouth structures to match small prey sizes, and longer gill rakers to help retain captured prey. We tested these three traditional hypotheses plus two novel adaptive hypotheses in labrids, a clade of very diverse coral reef fishes that show multiple independent evolutionary origins of zooplanktivory. Using phylogenetic comparative methods with a data set from 21 species, we failed to find larger eyes in three independent transitions to zooplanktivory. Instead, an impression of large eyes may be caused by a size reduction of the anterior facial region. However, two zooplanktivores ( Clepticus parrae and Halichoeres pictus) possess several features interpreted as adaptations to zooplankton feeding, namely large lens diameters relative to eye axial length, round pupil shape, and long gill rakers. The third zooplanktivore in our analysis, Cirrhilabrus solorensis, lacks all above features. It remains unclear whether Cirrhilabrus shows optical specializations for capturing planktonic prey. Our results support the prediction that increased visual acuity is adaptive for zooplanktivory, but in labrids increases in eye size are apparently not part of the evolutionary response.

  2. A Decision Tree for Nonmetric Sex Assessment from the Skull.

    Science.gov (United States)

    Langley, Natalie R; Dudzik, Beatrix; Cloutier, Alesia

    2018-01-01

    This study uses five well-documented cranial nonmetric traits (glabella, mastoid process, mental eminence, supraorbital margin, and nuchal crest) and one additional trait (zygomatic extension) to develop a validated decision tree for sex assessment. The decision tree was built and cross-validated on a sample of 293 U.S. White individuals from the William M. Bass Donated Skeletal Collection. Ordinal scores from the six traits were analyzed using the partition modeling option in JMP Pro 12. A holdout sample of 50 skulls was used to test the model. The most accurate decision tree includes three variables: glabella, zygomatic extension, and mastoid process. This decision tree yielded 93.5% accuracy on the training sample, 94% on the cross-validated sample, and 96% on a holdout validation sample. Linear weighted kappa statistics indicate acceptable agreement among observers for these variables. Mental eminence should be avoided, and definitions and figures should be referenced carefully to score nonmetric traits. © 2017 American Academy of Forensic Sciences.

  3. Three-dimensional stereotactic atlas of the adult human skull correlated with the brain, cranial nerves, and intracranial vasculature.

    Science.gov (United States)

    Nowinski, Wieslaw L; Thaung, Thant Shoon Let; Chua, Beng Choon; Yi, Su Hnin Wut; Ngai, Vincent; Yang, Yili; Chrzan, Robert; Urbanik, Andrzej

    2015-05-15

    Although the adult human skull is a complex and multifunctional structure, its 3D, complete, realistic, and stereotactic atlas has not yet been created. This work addresses the construction of a 3D interactive atlas of the adult human skull spatially correlated with the brain, cranial nerves, and intracranial vasculature. The process of atlas construction included computed tomography (CT) high-resolution scan acquisition, skull extraction, skull parcellation, 3D disarticulated bone surface modeling, 3D model simplification, brain-skull registration, 3D surface editing, 3D surface naming and color-coding, integration of the CT-derived 3D bony models with the existing brain atlas, and validation. The virtual skull model created is complete with all 29 bones, including the auditory ossicles (being among the smallest bones). It contains all typical bony features and landmarks. The created skull model is superior to the existing skull models in terms of completeness, realism, and integration with the brain along with blood vessels and cranial nerves. This skull atlas is valuable for medical students and residents to easily get familiarized with the skull and surrounding anatomy with a few clicks. The atlas is also useful for educators to prepare teaching materials. It may potentially serve as a reference aid in the reading and operating rooms. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

    Zhou Jianjun; Xia Xiwei; Shi Yimin; Yang Yilin

    2000-01-01

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

  5. Fractures (Broken Bones): First Aid

    Science.gov (United States)

    First aid Fractures (broken bones) Fractures (broken bones): First aid By Mayo Clinic Staff A fracture is a ... 10, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-fractures/basics/ART-20056641 . Mayo Clinic ...

  6. Fracture toughness correlations

    International Nuclear Information System (INIS)

    Wallin, Kim

    1986-09-01

    In this study existing fracture parameter correlations are reviewed. Their applicability and reliability are discussed in detail. A new K IC -CVN-correlation, based on a theoretical brittle fracture model, is presented

  7. Rib fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000539.htm Rib fracture - aftercare To use the sharing features on this page, please enable JavaScript. A rib fracture is a crack or break in one or ...

  8. Sprains, Strains and Fractures

    Science.gov (United States)

    ... fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ankle ... feet and ankles and take a complete medical history. He or she will also order tests, including ...

  9. Ankle fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this page, please enable JavaScript. An ankle fracture is a break in 1 or more ankle ...

  10. Atraumatic First Rib Fracture

    OpenAIRE

    Koray Aydogdu

    2014-01-01

    Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  11. Variations in leopard cat (Prionailurus bengalensis skull morphology and body size: sexual and geographic influences

    Directory of Open Access Journals (Sweden)

    Fernando L. Sicuro

    2015-10-01

    Full Text Available The leopard cat, Prionailurus bengalensis (Kerr, 1792, is one of the most widespread Asian cats, occurring in continental eastern and southeastern Asia. Since 1929, several studies have focused on the morphology, ecology, and taxonomy of leopard cats. Nevertheless, hitherto there has been no agreement on basic aspects of leopard cat biology, such as the presence or absence of sexual dimorphism, morphological skull and body differences between the eleven recognized subspecies, and the biogeography of the different morphotypes. Twenty measurements on 25 adult leopard cat skulls from different Asian localities were analyzed through univariate and multivariate statistical approaches. Skull and external body measurements from studies over the last 77 years were assembled and organized in two categories: full data and summary data. Most of this database comprises small samples, which have never been statistically tested and compared with each other. Full data sets were tested with univariate and multivariate statistical analyses; summary data sets (i.e., means, SDs, and ranges were analyzed through suitable univariate approaches. The independent analyses of the data from these works confirmed our original results and improved the overview of sexual dimorphism and geographical morphological variation among subspecies. Continental leopard cats have larger skulls and body dimensions. Skulls of Indochinese morphotypes have broader and higher features than those of continental morphotypes, while individuals from the Sunda Islands have skulls with comparatively narrow and low profiles. Cranial sexual dimorphism is present in different degrees among subspecies. Most display subtle sex-related variations in a few skull features. However, in some cases, sexual dimorphism in skull morphology is absent, such as in P. b. sumatranus and P. b. borneoensis. External body measurement comparisons also indicate the low degree of sexual dimorphism. Apart from the gonads

  12. Non-invasive examination of a skull fragment recovered from a World War Two aircraft crash site.

    Science.gov (United States)

    Gapert, René; Rieder, Kurt

    2013-09-01

    The discovery of human remains dating to the time of the Second World War is a common occurrence in Europe and the Pacific regions. This case report demonstrates the analysis of a bone fragment recovered from a Luftwaffe crash site in Austria during the summer of 2007. Eye-witness statements and official reports were used to reconstruct the historical background of the case. A recovered German military identity tag helped to identify the pilot. Aircraft parts, also discovered at the crash site in 2007, aided the identification of the aircraft type and corroborated the eye-witness reports of the final moments before and during the crash. The bone was analyzed chiefly to establish its human or non-human origin and to identify from which anatomic region the fragment could have arisen. It was identified as part of a human adult skull which exhibited peri-mortem fractures and heat damage as well as post-mortem vegetation staining. The historical background information in connection with the morphological analysis led to the presumptive identification of the cranial fragment as belonging to a downed German pilot.

  13. Metatarsal stress fractures - aftercare

    Science.gov (United States)

    ... Metatarsal stress fracture. In: Safran MR, Zachazewski J, Stone DA, eds. Instructions for Sports Medicine Patients . 2nd ed. Elsevier Saunders; 2012:648-652. Smith MS. Metatarsal fractures. In: Eiff PM, Hatch R, eds. Fracture Management for Primary Care . 3rd ed. ...

  14. Relationships between fractures

    Science.gov (United States)

    Peacock, D. C. P.; Sanderson, D. J.; Rotevatn, A.

    2018-01-01

    Fracture systems comprise many fractures that may be grouped into sets based on their orientation, type and relative age. The fractures are often arranged in a network that involves fracture branches that interact with one another. Interacting fractures are termed geometrically coupled when they share an intersection line and/or kinematically coupled when the displacements, stresses and strains of one fracture influences those of the other. Fracture interactions are characterised in terms of the following. 1) Fracture type: for example, whether they have opening (e.g., joints, veins, dykes), closing (stylolites, compaction bands), shearing (e.g., faults, deformation bands) or mixed-mode displacements. 2) Geometry (e.g., relative orientations) and topology (the arrangement of the fractures, including their connectivity). 3) Chronology: the relative ages of the fractures. 4) Kinematics: the displacement distributions of the interacting fractures. It is also suggested that interaction can be characterised in terms of mechanics, e.g., the effects of the interaction on the stress field. It is insufficient to describe only the components of a fracture network, with fuller understanding coming from determining the interactions between the different components of the network.

  15. Obesity and fracture risk

    OpenAIRE

    Gonnelli, Stefano; Caffarelli, Carla; Nuti, Ranuccio

    2014-01-01

    Obesity and osteoporosis are two common diseases with an increasing prevalence and a high impact on morbidity and mortality. Obese women have always been considered protected against osteoporosis and osteoporotic fractures. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures.

  16. Imaging of insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, Christian [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)], E-mail: christian.krestan@meduniwien.ac.at; Hojreh, Azadeh [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)

    2009-09-15

    This review focuses on the occurrence, imaging and differential diagnosis of insufficiency fractures. Prevalence, the most common sites of insufficiency fractures and their clinical implications are discussed. Insufficiency fractures occur with normal stress exerted on weakened bone. Postmenopausal osteoporosis is the most common cause of insufficiency fractures. Other conditions which affect bone turnover include osteomalacia, hyperparathyroidism, chronic renal failure and high-dose glucocorticoid therapy. It is a challenge for the radiologist to detect and diagnose insufficiency fractures, and to differentiate them from other bone lesions. Radiographs are still the most widely used imaging method for identification of insufficiency fractures, but sensitivity is limited, depending on the location of the fractures. Magnetic resonance imaging (MRI) is a very sensitive tool to visualize bone marrow abnormalities associated with insufficiency fractures. Thin section, multi-detector computed tomography (MDCT) depicts subtle fracture lines allowing direct visualization of cortical and trabecular bone. Bone scintigraphy still plays a role in detecting fractures, with good sensitivity but limited specificity. The most important differential diagnosis is underlying malignant disease leading to pathologic fractures. Bone densitometry and clinical history may also be helpful in confirming the diagnosis of insufficiency fractures.

  17. Repairing skull defects in children with nano-hap/collagen composites:A clinical report of thirteen cases

    Institute of Scientific and Technical Information of China (English)

    Tuoyu Chen; Fuzhai Cui; Yuqi Zhang; Huancong Zuo; Yapeng Zhao; Chaoqiang Xue; Bin Luo; Qinglin Zhang; Jin Zhu; Xiumei Wang

    2016-01-01

    Objective: To evaluate the clinical results of repairing skull defects with biomimetic bone (nano-hap/collagen composites, NHACs) in children. Methods:Thirteen children with skull defects were treated with NHACs in our hospital. The NHACs molded with the help of a 3D printer were used in the operations. Results: All 13 operations were successful, and patients recovered without infection. Only one patient suffered from subcutaneous hydrops post-operation. The implanted NHACs remained fixed well after 1 year, and their CT HU values raised gradually. Skull shapes of children developed normally. Recovery of neurological and cognitive function was significant. Conclusions:NHAC, chosen to repair skull defects in children, can coexist with normal skull and reduce the negative effects on growth and development. NHAC could be a good choice for children with skull defects.

  18. Intraoperative biopsy of the major cranial nerves in the surgical strategy for adenoid cystic carcinoma close to the skull base.

    Science.gov (United States)

    Tarsitano, Achille; Pizzigallo, Angelo; Gessaroli, Manlio; Sturiale, Carmelo; Marchetti, Claudio

    2012-02-01

    Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base. During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection. The percentage of actuarial local control at 5 years for patients with a positive named nerve and skull base infiltration was 12.5%, compared with 90.0% in patients who were named nerve-negative and without infiltration of the skull base (P = .001). Our study shows that local control of disease for patients who are named nerve-positive with skull base infiltration is significantly more complex compared with patients who are named nerve-negative without infiltration of the skull base. Copyright © 2012. Published by Mosby, Inc.

  19. Brainstem tolerance to conformal radiotherapy of skull base tumors

    International Nuclear Information System (INIS)

    Debus, J.; Hug, E.B.; Munzenrider, J.E.; Liebsch, N.J.; O'Farrell, D.; Efird, J.; Daly, W.; Suit, H.D.

    1996-01-01

    Purpose/Objective: Brainstem tolerance to inhomogenous radiation doses applied by modern conformal radiotherapy has not yet been examined. The aim of this study was to analyse the incidence of brainstem toxicity in patients treated for skull base tumors with high dose conformal radiotherapy. Materials and Methods: Between 1974 and 1995, 367 patients with chordomas (n=195) and chondrosarcomas (n=172) of the base of skull have been treated with combined megavoltage photon and 160 MeV proton radiotherapy. All patients had previously undergone biopsy, subtotal or total tumor removal. 104 patients had two or more surgical procedures before radiotherapy. Following 3D treatment planning with delineation of target volumes and critical non-target structures, dose distributions and dose volume histograms were calculated [at the time of treatment delivery]. Radiotherapy was given once a day, 1.8 Gy or CGE (Cobalt Gy Equivalent: Proton Gy X 1.1) per fraction, 5 fractions per week, with prescribed target doses ranging from 63 CGE to 79.2 CGE (mean = 67.8 CGE). Doses to the brainstem surface were limited to ≤64 CGE and to the brainstem center to ≤53 CGE. Dose distributions were developed to limit dose to brainstem surface and center; current plans limit dose to surface and center to ≤64 CGE and ≤53 CGE, respectively. Brainstem toxicity was scored according to the RTOG grading system. Results: Follow-up ranged from 6 months to 21.4 years (mean = 42.5 months). Brainstem symptoms, attributable to the treatment, developed in 17 of 282 patients with local tumor control (6.0%), resulting in death of three patients. The mean time to onset of symptoms was 17 months (range: 4.5 to 177 months). These symptoms appeared in 89.5% within 3 years. Grading of the brainstem toxicity is listed in table 1. Actuarial rates of 5 and 10 year toxicity free survival were 87% and 82% respectively. Increased risk of brainstem toxicity was significantly associated with maximum brainstem dose

  20. Proton radiotherapy in management of pediatric base of skull tumors

    International Nuclear Information System (INIS)

    Hug, Eugen B.; Sweeney, Reinhart A.; Nurre, Pamela M.; Holloway, Kitty C.; Slater, Jerry D.; Munzenrider, John E.

    2002-01-01

    Purpose: Primary skull base tumors of the developing child are rare and present a formidable challenge to both surgeons and radiation oncologists. Gross total resection with negative margins is rarely achieved, and the risks of functional, structural, and cosmetic deficits limit the radiation dose using conventional radiation techniques. Twenty-nine children and adolescents treated with conformal proton radiotherapy (proton RT) were analyzed to assess treatment efficacy and safety. Methods and Materials: Between July 1992 and April 1999, 29 patients with mesenchymal tumors underwent fractionated proton (13 patients) or fractionated combined proton and photon (16 patients) irradiation. The age at treatment ranged from 1 to 19 years (median 12); 14 patients were male and 15 female. Tumors were grouped as malignant or benign. Twenty patients had malignant histologic findings, including chordoma (n=10), chondrosarcoma (n=3), rhabdomyosarcoma (n=4), and other sarcomas (n=3). Target doses ranged between 50.4 and 78.6 Gy/cobalt Gray equivalent (CGE), delivered at doses of 1.8-2.0 Gy/CGE per fraction. The benign histologic findings included giant cell tumors (n=6), angiofibromas (n=2), and chondroblastoma (n=1). RT doses for this group ranged from 45.0 to 71.8 Gy/CGE. Despite maximal surgical resection, 28 (97%) of 29 patients had gross disease at the time of proton RT. Follow-up after proton RT ranged from 13 to 92 months (mean 40). Results: Of the 20 patients with malignant tumors, 5 (25%) had local failure; 1 patient had failure in the surgical access route and 3 patients developed distant metastases. Seven patients had died of progressive disease at the time of analysis. Local tumor control was maintained in 6 (60%) of 10 patients with chordoma, 3 (100%) of 3 with chondrosarcoma, 4 (100%) of 4 with rhabdomyosarcoma, and 2 (66%) of 3 with other sarcomas. The actuarial 5-year local control and overall survival rate was 72% and 56%, respectively, and the overall survival

  1. Oldest known pantherine skull and evolution of the tiger.

    Science.gov (United States)

    Mazák, Ji H; Christiansen, Per; Kitchener, Andrew C

    2011-01-01

    The tiger is one of the most iconic extant animals, and its origin and evolution have been intensely debated. Fossils attributable to extant pantherine species-lineages are less than 2 MYA and the earliest tiger fossils are from the Calabrian, Lower Pleistocene. Molecular studies predict a much younger age for the divergence of modern tiger subspecies at tigers would likely have differed markedly anatomically from extant tigers. Such inferences are hampered by the fact that well-known fossil tiger material is middle to late Pleistocene in age. Here we describe a new species of pantherine cat from Longdan, Gansu Province, China, Panthera zdanskyi sp. nov. With an estimated age of 2.55-2.16 MYA it represents the oldest complete skull of a pantherine cat hitherto found. Although smaller, it appears morphologically to be surprisingly similar to modern tigers considering its age. Morphological, morphometric, and cladistic analyses are congruent in confirming its very close affinity to the tiger, and it may be regarded as the most primitive species of the tiger lineage, demonstrating the first unequivocal presence of a modern pantherine species-lineage in the basal stage of the Pleistocene (Gelasian; traditionally considered to be Late Pliocene). This find supports a north-central Chinese origin of the tiger lineage, and demonstrates that various parts of the cranium, mandible, and dentition evolved at different rates. An increase in size and a reduction in the relative size of parts of the dentition appear to have been prominent features of tiger evolution, whereas the distinctive cranial morphology of modern tigers was established very early in their evolutionary history. The evolutionary trend of increasing size in the tiger lineage is likely coupled to the evolution of its primary prey species.

  2. STUDY ON NORTHERN AND SOUTHERN INDIA VARIATIONS OF HUMAN SKULL- A SECONDARY RESEARCH

    Directory of Open Access Journals (Sweden)

    Jameskutty Baby Jacob Kaithackal

    2016-12-01

    Full Text Available BACKGROUND Identity of a human being with regard to sex, race, age etc. can be revealed if the skull is suitably examined. The general concept of ethnic and geographic variations being reflected in the body as variations in size, shape, etc. can be checked for in the case of skeleton also. This article is formed out of a term paper study submitted by myself in 2016 to the Yenepoya University, Mangalore, Karnataka, as part of the postgraduate diploma course in Forensic Anthropology. The research was based on a question whether there is a significant difference between human skulls from North and South India. The aims/objectives were bi-fold: to analyse the difference in male and female skull from North Indian and South Indian regions from review of scholarly literature and to explore the possibility identification of individuals from cranial features unique to North and South India. MATERIALS AND METHODS The original articles available on this type of work were extensively reviewed to recognise any traits that differentiated the skulls with regard to their regional variation. RESULTS At the end of the scrutiny of such papers, a summary of the features that distinguished skulls as belonging to northern or southern parts of India was tried. The Indian cranial series, though varied widely in shape, the absence of any statistically significant difference between them made it unreliable to predict skull as male or female by morphometric estimation. The studies by different scholars did not propose for a uniform distinctiveness between north and south Indian skulls. CONCLUSION It was concluded that analysing a single specimen to be of a distinct geographic origin should be done more cautiously when compared to a setting of series analysis where variability might be there of course.

  3. Endoscopic skull base training using 3D printed models with pre-existing pathology.

    Science.gov (United States)

    Narayanan, Vairavan; Narayanan, Prepageran; Rajagopalan, Raman; Karuppiah, Ravindran; Rahman, Zainal Ariff Abdul; Wormald, Peter-John; Van Hasselt, Charles Andrew; Waran, Vicknes

    2015-03-01

    Endoscopic base of skull surgery has been growing in acceptance in the recent past due to improvements in visualisation and micro instrumentation as well as the surgical maturing of early endoscopic skull base practitioners. Unfortunately, these demanding procedures have a steep learning curve. A physical simulation that is able to reproduce the complex anatomy of the anterior skull base provides very useful means of learning the necessary skills in a safe and effective environment. This paper aims to assess the ease of learning endoscopic skull base exposure and drilling techniques using an anatomically accurate physical model with a pre-existing pathology (i.e., basilar invagination) created from actual patient data. Five models of a patient with platy-basia and basilar invagination were created from the original MRI and CT imaging data of a patient. The models were used as part of a training workshop for ENT surgeons with varying degrees of experience in endoscopic base of skull surgery, from trainees to experienced consultants. The surgeons were given a list of key steps to achieve in exposing and drilling the skull base using the simulation model. They were then asked to list the level of difficulty of learning these steps using the model. The participants found the models suitable for learning registration, navigation and skull base drilling techniques. All participants also found the deep structures to be accurately represented spatially as confirmed by the navigation system. These models allow structured simulation to be conducted in a workshop environment where surgeons and trainees can practice to perform complex procedures in a controlled fashion under the supervision of experts.

  4. Skull-base invasion of nasopharyngeal carcinoma: magnetic resonance imaging findings and therapeutic implications

    International Nuclear Information System (INIS)

    Nishioka, Takeshi; Shirato, Hiroki; Kagei, Kenji; Abe, Satoru; Hashimoto, Seiko; Ohmori, Keiichi; Yamazaki, Akira; Fukuda, Satoshi; Miyasaka, Kazuo

    2000-01-01

    Purpose: To evaluate the value of skull-base abnormality on MRI for predicting local recurrence in nasopharyngeal carcinoma. Materials and Methods: Between November 1988 and February 1997, 48 patients with NPC were examined with both MRI (1.5 T) and CT prior to radiation therapy. T classification (1987 UICC) based on physical examination and CT findings were T1 in 3 cases, T2 in 22, T3 in 9, and T4 in 14. On MRI, low-intensity tissue with Gd enhancement in the marrow of the skull was considered to be a suspicious finding of skull-base invasion. CT simulation was performed in all patients. The total dose to the primary tumor was 60-75 Gy (mean, 67 Gy). The mean follow-up period was 42 months. Results: All 14 T4 patients had abnormal tissue in the marrow of the skull base on MRI. Thirty-eight percent (13 of 34) of T1-3 patients were suspected to have skull-base invasion based on MRI (0% for T1, 27% [6 of 22] for T2, and 78% [7 of 9] for T3). The 5-year local control rate was significantly different between T1-3 and T4 tumors (97% vs. 69%, p < 0.025) but was not different by the presence of the MRI abnormality in the skull base. Conclusion: Skull-base invasion suspected solely by MRI does not relate to local recurrence provided that careful treatment planning is performed with the aid of MRI and CT simulator

  5. Computer vision and soft computing for automatic skull-face overlay in craniofacial superimposition.

    Science.gov (United States)

    Campomanes-Álvarez, B Rosario; Ibáñez, O; Navarro, F; Alemán, I; Botella, M; Damas, S; Cordón, O

    2014-12-01

    Craniofacial superimposition can provide evidence to support that some human skeletal remains belong or not to a missing person. It involves the process of overlaying a skull with a number of ante mortem images of an individual and the analysis of their morphological correspondence. Within the craniofacial superimposition process, the skull-face overlay stage just focuses on achieving the best possible overlay of the skull and a single ante mortem image of the suspect. Although craniofacial superimposition has been in use for over a century, skull-face overlay is still applied by means of a trial-and-error approach without an automatic method. Practitioners finish the process once they consider that a good enough overlay has been attained. Hence, skull-face overlay is a very challenging, subjective, error prone, and time consuming part of the whole process. Though the numerical assessment of the method quality has not been achieved yet, computer vision and soft computing arise as powerful tools to automate it, dramatically reducing the time taken by the expert and obtaining an unbiased overlay result. In this manuscript, we justify and analyze the use of these techniques to properly model the skull-face overlay problem. We also present the automatic technical procedure we have developed using these computational methods and show the four overlays obtained in two craniofacial superimposition cases. This automatic procedure can be thus considered as a tool to aid forensic anthropologists to develop the skull-face overlay, automating and avoiding subjectivity of the most tedious task within craniofacial superimposition. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. The relationship between skull morphology, masticatory muscle force and cranial skeletal deformation during biting.

    Science.gov (United States)

    Toro-Ibacache, Viviana; Zapata Muñoz, Víctor; O'Higgins, Paul

    2016-01-01

    The human skull is gracile when compared to many Middle Pleistocene hominins. It has been argued that it is less able to generate and withstand high masticatory forces, and that the morphology of the lower portion of the modern human face correlates most strongly with dietary characteristics. This study uses geometric morphometrics and finite element analysis (FEA) to assess the relationship between skull morphology, muscle force and cranial deformations arising from biting, which is relevant in understanding how skull morphology relates to mastication. The three-dimensional skull anatomies of 20 individuals were reconstructed from medical computed tomograms. Maximal contractile muscle forces were estimated from muscular anatomical cross-sectional areas (CSAs). Fifty-nine landmarks were used to represent skull morphology. A partial least squares analysis was performed to assess the association between skull shape and muscle force, and FEA was used to compare the deformation (strains) generated during incisor and molar bites in two individuals representing extremes of morphological variation in the sample. The results showed that only the proportion of total muscle CSA accounted for by the temporalis appears associated with skull morphology, albeit weekly. However, individuals with a large temporalis tend to possess a relatively wider face, a narrower, more vertically oriented maxilla and a lower positioning of the coronoid process. The FEAs showed that, despite differences in morphology, biting results in similar modes of deformation for both crania, but with localised lower magnitudes of strains arising in the individual with the narrowest, most vertically oriented maxilla. Our results suggest that the morphology of the maxilla modulates the transmission of forces generated during mastication to the rest of the cranium by deforming less in individuals with the ability to generate proportionately larger temporalis muscle forces. Copyright © 2015 Elsevier GmbH. All

  7. Effect of Random Natural Fractures on Hydraulic Fracture Propagation Geometry in Fractured Carbonate Rocks

    Science.gov (United States)

    Liu, Zhiyuan; Wang, Shijie; Zhao, Haiyang; Wang, Lei; Li, Wei; Geng, Yudi; Tao, Shan; Zhang, Guangqing; Chen, Mian

    2018-02-01

    Natural fractures have a significant influence on the propagation geometry of hydraulic fractures in fractured reservoirs. True triaxial volumetric fracturing experiments, in which random natural fractures are created by placing cement blocks of different dimensions in a cuboid mold and filling the mold with additional cement to create the final test specimen, were used to study the factors that influence the hydraulic fracture propagation geometry. These factors include the presence of natural fractures around the wellbore, the dimension and volumetric density of random natural fractures and the horizontal differential stress. The results show that volumetric fractures preferentially formed when natural fractures occurred around the wellbore, the natural fractures are medium to long and have a volumetric density of 6-9%, and the stress difference is less than 11 MPa. The volumetric fracture geometries are mainly major multi-branch fractures with fracture networks or major multi-branch fractures (2-4 fractures). The angles between the major fractures and the maximum horizontal in situ stress are 30°-45°, and fracture networks are located at the intersections of major multi-branch fractures. Short natural fractures rarely led to the formation of fracture networks. Thus, the interaction between hydraulic fractures and short natural fractures has little engineering significance. The conclusions are important for field applications and for gaining a deeper understanding of the formation process of volumetric fractures.

  8. Role of MRI in hip fractures, including stress fractures, occult fractures, avulsion fractures

    International Nuclear Information System (INIS)

    Nachtrab, O.; Cassar-Pullicino, V.N.; Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J.

    2012-01-01

    MR imaging plays a vital role in the diagnosis and management of hip fractures in all age groups, in a large spectrum of patient groups spanning the elderly and sporting population. It allows a confident exclusion of fracture, differentiation of bony from soft tissue injury and an early confident detection of fractures. There is a spectrum of MR findings which in part is dictated by the type and cause of the fracture which the radiologist needs to be familiar with. Judicious but prompt utilisation of MR in patients with suspected hip fractures has a positive therapeutic impact with healthcare cost benefits as well as social care benefits.

  9. Anatomical and Radiographic Study on the Skull and Mandible of the Common Opossum (Didelphis Marsupialis Linnaeus, 1758 in the Caribbean

    Directory of Open Access Journals (Sweden)

    Reda Mohamed

    2018-04-01

    Full Text Available Common opossums (Didelphis marsupialis are found throughout the Caribbean island of Trinidad and Tobago. The present work was conducted on 10 skulls and mandibles of the common opossum to describe the osteology and foramina of these skulls and mandibles grossly and radiographically. The information that is garnered can be used to detect, diagnose, and treat head affections, as well as for comparative studies with the skulls and mandibles of other similar species. The skulls and mandibles were prepared and cleaned using standard method. All of the characteristic features of various standards views of the skulls bones, including dorsal, lateral, caudal and midsagittal, and the lateral and caudal views of the mandibles as well as the foramina of the skulls and mandibles were described and discussed. Each skull was divided into long facial and short cranial regions. No supraorbital foramen was observed in the skulls. The tympanic bulla was absent while there was the tympanic process of the alisphenoid. The temporal process of the zygomatic bone, zygomatic process of maxilla, and zygomatic process of the squamosal bone formed the zygomatic arch. The dental formula was confirmed. The bones and foramina of the skull and mandible were similar to other marsupial species and were homologue to that of other mammals.

  10. Orbital fractures: a review

    Directory of Open Access Journals (Sweden)

    Jeffrey M Joseph

    2011-01-01

    Full Text Available Jeffrey M Joseph, Ioannis P GlavasDivision of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, School of Medicine, New York University, New York, NY, USA; Manhattan Eye, Ear, and Throat Hospital, New York, NY, USAAbstract: This review of orbital fractures has three goals: 1 to understand the clinically relevant orbital anatomy with regard to periorbital trauma and orbital fractures, 2 to explain how to assess and examine a patient after periorbital trauma, and 3 to understand the medical and surgical management of orbital fractures. The article aims to summarize the evaluation and management of commonly encountered orbital fractures from the ophthalmologic perspective and to provide an overview for all practicing ophthalmologists and ophthalmologists in training.Keywords: orbit, trauma, fracture, orbital floor, medial wall, zygomatic, zygomatic complex, zmc fracture, zygomaticomaxillary complex fractures 

  11. Mechanics of Hydraulic Fractures

    Science.gov (United States)

    Detournay, Emmanuel

    2016-01-01

    Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.

  12. Fracture in Soft Materials

    DEFF Research Database (Denmark)

    Hassager, Ole

    Fracture is a phenomenon that is generally associated with solids. A key element in fracture theory is the so-called weakest link idea that fracture initiates from the largest pre-existing material imperfection. However, recent work has demonstrated that fracture can also happen in liquids, where...... surface tension will act to suppress such imperfections. Therefore, the weakest link idea does not seem immediately applicable to fracture in liquids. This presentation will review fracture in liquids and argue that fracture in soft liquids is a material property independent of pre-existing imperfections....... The following questions then emerge: What is the material description needed to predict crack initiation, crack speed and crack shape in soft materials and liquids....

  13. Skull base osteomyelitis: role of three phase and hybrid SPECT/CT bone scintigraphy

    International Nuclear Information System (INIS)

    Chakraborty, D.; Bhattacharaya, A.; Kamaleshwaran, K.K.; Mittal, B.R.; Aggarwal, K.; Singh, B.; Bhoil, A.

    2010-01-01

    Full text: Skull base osteomyelitis is the infection that has spread to the skull base, beyond the external auditory canal and seen in advanced stage of malignant otitis externa. Early diagnosis of this condition includes the use of bone scintigraphy since clinical assessment alone cannot differentiate the skull base osteomyelitis from the severe type of otitis externa in which there is no extension to the adjacent bone. Objective: To determine the role of three phase bone scintigraphy and delayed SPECT/CT in detection of skull base osteomyelitis in patients with malignant otitis externa. Material and Methods: Clinical records of 20 patients (14 Males and 6 Females; mean age 72 yrs) of otitis externa with suspected skull base involvement referred for bone scintigraphies were analyzed retrospectively. Three phase bone scintigraphy was acquired under dual detector gamma camera after intravenous injection of 20 mCi (740 MBq) 99m Tc-MDP followed by SPECT/CT of the skull. Scintigraphic findings were compared with clinical symptoms, signs and diagnostic CT scan findings. Results: All the patients except one were diabetic and having elevated ESR. 18 patients presented with bilateral symptoms and rest unilateral. Cranial nerves were involved in 8 patients (40%). Ear discharge culture sensitivity report was found in three patients; it was positive for Pseudomonas aeruginosa for two patients and in Diptheroids for one. In 9 patients (45%) increased flow of tracer and 10 patients (50%) increased blood pool phase in the temporal region was found. Delayed phase images showed increased uptake in skull bone in 19 patients (95%). Hybrid SPECT/CT of the skull localized areas of increased tracer uptake to the mastoid part in 15 patients (75%), petrous part in 11 patients (55%), sphenoid in 3 patients (15%) and zygomatic bone in one patient (5%) with CT showing destructive changes in 5 patients (25%) which were corroborated with diagnostic CT findings. SPECT/CT along with three phase

  14. The remarkable convergence of skull shape in crocodilians and toothed whales.

    Science.gov (United States)

    McCurry, Matthew R; Evans, Alistair R; Fitzgerald, Erich M G; Adams, Justin W; Clausen, Philip D; McHenry, Colin R

    2017-03-15

    The striking resemblance of long-snouted aquatic mammals and reptiles has long been considered an example of morphological convergence, yet the true cause of this similarity remains untested. We addressed this deficit through three-dimensional morphometric analysis of the full diversity of crocodilian and toothed whale (Odontoceti) skull shapes. Our focus on biomechanically important aspects of shape allowed us to overcome difficulties involved in comparing mammals and reptiles, which have fundamental differences in the number and position of skull bones. We examined whether diet, habitat and prey size correlated with skull shape using phylogenetically informed statistical procedures. Crocodilians and toothed whales have a similar range of skull shapes, varying from extremely short and broad to extremely elongate. This spectrum of shapes represented more of the total variation in our dataset than between phylogenetic groups. The most elongate species (river dolphins and gharials) are extremely convergent in skull shape, clustering outside of the range of the other taxa. Our results suggest the remarkable convergence between long-snouted river dolphins and gharials is driven by diet rather than physical factors intrinsic to riverine environments. Despite diverging approximately 288 million years ago, crocodilians and odontocetes have evolved a remarkably similar morphological solution to feeding on similar prey. © 2017 The Author(s).

  15. Teamwork in skull base surgery: An avenue for improvement in patient care.

    Science.gov (United States)

    McLaughlin, Nancy; Carrau, Ricardo L; Kelly, Daniel F; Prevedello, Daniel M; Kassam, Amin B

    2013-01-01

    During the past several decades, numerous centers have acquired significant expertise in the treatment of skull base pathologies. Favorable outcomes are not only due to meticulous surgical planning and execution, but they are also related to the collaborative efforts of multiple disciplines. We review the impact of teamwork on patient care, elaborate on the key processes for successful teamwork, and discuss its challenges. Pubmed and Medline databases were searched for publications from 1970 to 2012 using the following keywords: "teamwork", "multidisciplinary", "interdisciplinary", "surgery", "skull base", "neurosurgery", "tumor", and "outcome". Current literature testifies to the complexity of establishing and maintaining teamwork. To date, few reports on the impact of teamwork in the management of skull base pathologies have been published. This lack of literature is somewhat surprising given that most patients with skull base pathology receive care from multiple specialists. Common factors for success include a cohesive and well-integrated team structure with well-defined procedural organization. Although a multidisciplinary work force has clear advantages for improving today's quality of care and propelling research efforts for tomorrow's cure, teamwork is not intuitive and requires training, guidance, and executive support. Teamwork is recommended to improve quality over the full cycle of care and consequently patient outcomes. Increased recognition of the value of an integrated team approach for skull base pathologies will hopefully encourage centers, physicians, allied health caregivers, and scientists devoted to treating these patients and advancing the field of knowledge to invest the time, effort, and resources to optimize and organize their collective expertise.

  16. Anatomical and radiographic study of the white-eared opossum (Didelphis albiventris skull1

    Directory of Open Access Journals (Sweden)

    Bruno C. Schimming

    Full Text Available ABSTRACT: This study was made to investigate the anatomical features of the white-eared opossum skull, by osteology and radiographic anatomy. For this, five animals were used without sexual distinction. The skull was examined by radiographic and macroscopic characteristics. The skulls were then subjected to maceration. The skull was described macroscopically according to standard views, i.e. dorsal and caudal, lateral, ventral, and midsagittal. The skull can be divided into facial (viscerocranium and cranial (neurocranium regions. The facial region was elongated and more developed than neurocranium. The supraorbital foramen was absent. The tympanic bulla is not well developed. The zygomatic arch was formed by zygomatic process of the temporal bone, zygomatic process of the maxilla, and temporal process of the zygomatic bone. There was no significant difference between bones found in this study when compared with those described for others mammals. These findings may contribute to the better understanding of the anatomy and biology of the white-eared opossum.

  17. Inca - interparietal bones in neurocranium of human skulls in central India.

    Science.gov (United States)

    Marathe, Rr; Yogesh, As; Pandit, Sv; Joshi, M; Trivedi, Gn

    2010-01-01

    Inca bones are accessory bones found in neurocranium of human skulls. Occurrence of Inca bones is rare as compared to other inter sutural bones such as wormian bones. These Inca ossicles are regarded as variants of the normal. The reporting of such occurrences is inadequate from Central India. To find the incidence of Inca variants in Central India. In the present study, 380 dried adult human skulls were examined. All specimen samples were procured from various Medical colleges of Central India. They were analyzed for gross incidence, sexual dimorphism and number of fragments of Inca bones. Gross incidence of Inca bones was found to be 1.315 %. Incidence rate was higher in male skulls than female skulls (male: 1.428%; female: 1.176%). The Inca bones frequently occurred signally. Out of the five observed Inca ossicles, two were fragmented. This data gives idea regarding gross incidence, sexual dimorphism and number of fragments of Inca bones in neurocranium of human skulls from Central India. The knowledge of this variable is useful for neurosurgeons, anthropologists and radiologists.

  18. Inca - interparietal bones in neurocranium of human skulls in central India

    Directory of Open Access Journals (Sweden)

    R R Marathe

    2010-01-01

    Full Text Available Inca bones are accessory bones found in neurocranium of human skulls. Occurrence of Inca bones is rare as compared to other inter sutural bones such as wormian bones. These Inca ossicles are regarded as variants of the normal. The reporting of such occurrences is inadequate from Central India. Objectives: To find the incidence of Inca variants in Central India. Materials and Methods: In the present study, 380 dried adult human skulls were examined. All specimen samples were procured from various Medical colleges of Central India. They were analyzed for gross incidence, sexual dimorphism and number of fragments of Inca bones. Results: Gross incidence of Inca bones was found to be 1.315 %. Incidence rate was higher in male skulls than female skulls (male: 1.428%; female: 1.176%. The Inca bones frequently occurred signally. Out of the five observed Inca ossicles, two were fragmented. Conclusions: This data gives idea regarding gross incidence, sexual dimorphism and number of fragments of Inca bones in neurocranium of human skulls from Central India. The knowledge of this variable is useful for neurosurgeons, anthropologists and radiologists.

  19. Independent instances of "souvenir" Asian skulls from the Tampa Bay area.

    Science.gov (United States)

    Wienker, C W; Wood, J E; Diggs, C A

    1990-05-01

    In the summer of 1984, police in Pinellas County, Florida, confiscated six identically colored imported Asian skulls (in a shipping case) from a private citizen. In May 1988, in nearby Hillsborough County, police confiscated a very similar skull from another private citizen, who allegedly had found it in an abandoned house. Aside from slight color differences between the six found in Pinellas County and the one found in Hillsborough County, the skulls are virtually identical in their osteological characteristics and condition and in the vital statistics derived from each. Each skull is as clean and dry as those typically sold by commercial scientific supply outlets in the United States. Each is edentulous (primarily premortem), between approximately 20 and 60 years of age at death, and morphologically Asian. Five of the seven are morphologically male, one is morphologically female, and one is a mosaic with respect to gender-related features. Police, medical examiners, coroners, and forensic anthropologists should be aware of such "souvenir" specimens, in the event that they encounter similar skulls. Discriminant function analyses for race and sex yield considerably conflicting results, which underscores the need for using extreme caution when interpreting forensic science estimates based on such techniques.

  20. Multi-atlas and label fusion approach for patient-specific MRI based skull estimation.

    Science.gov (United States)

    Torrado-Carvajal, Angel; Herraiz, Joaquin L; Hernandez-Tamames, Juan A; San Jose-Estepar, Raul; Eryaman, Yigitcan; Rozenholc, Yves; Adalsteinsson, Elfar; Wald, Lawrence L; Malpica, Norberto

    2016-04-01

    MRI-based skull segmentation is a useful procedure for many imaging applications. This study describes a methodology for automatic segmentation of the complete skull from a single T1-weighted volume. The skull is estimated using a multi-atlas segmentation approach. Using a whole head computed tomography (CT) scan database, the skull in a new MRI volume is detected by nonrigid image registration of the volume to every CT, and combination of the individual segmentations by label-fusion. We have compared Majority Voting, Simultaneous Truth and Performance Level Estimation (STAPLE), Shape Based Averaging (SBA), and the Selective and Iterative Method for Performance Level Estimation (SIMPLE) algorithms. The pipeline has been evaluated quantitatively using images from the Retrospective Image Registration Evaluation database (reaching an overlap of 72.46 ± 6.99%), a clinical CT-MR dataset (maximum overlap of 78.31 ± 6.97%), and a whole head CT-MRI pair (maximum overlap 78.68%). A qualitative evaluation has also been performed on MRI acquisition of volunteers. It is possible to automatically segment the complete skull from MRI data using a multi-atlas and label fusion approach. This will allow the creation of complete MRI-based tissue models that can be used in electromagnetic dosimetry applications and attenuation correction in PET/MR. © 2015 Wiley Periodicals, Inc.

  1. Topographic analysis of the skull vibration-induced nystagmus test with piezoelectric accelerometers and force sensors.

    Science.gov (United States)

    Dumas, Georges; Lion, Alexis; Perrin, Philippe; Ouedraogo, Evariste; Schmerber, Sébastien

    2016-03-23

    Vibration-induced nystagmus is elicited by skull or posterior cervical muscle stimulations in patients with vestibular diseases. Skull vibrations delivered by the skull vibration-induced nystagmus test are known to stimulate the inner ear structures directly. This study aimed to measure the vibration transfer at different cranium locations and posterior cervical regions to contribute toward stimulus topographic optimization (experiment 1) and to determine the force applied on the skull with a hand-held vibrator to study the test reproducibility and provide recommendations for good clinical practices (experiment 2). In experiment 1, a 100 Hz hand-held vibrator was applied on the skull (vertex, mastoids) and posterior cervical muscles in 11 healthy participants. Vibration transfer was measured by piezoelectric sensors. In experiment 2, the vibrator was applied 30 times by two experimenters with dominant and nondominant hands on a mannequin equipped to measure the force. Experiment 1 showed that after unilateral mastoid vibratory stimulation, the signal transfer was higher when recorded on the contralateral mastoid than on the vertex or posterior cervical muscles (Pskull vibration-induced nystagmus test in patients with unilateral vestibular lesions and enables a stronger stimulation of the healthy side. In clinical practice, the vibrator should be placed on the mastoid and should be held by the clinician's dominant hand.

  2. Computed tomography of Paget disease of the skull versus fibrous dysplasia

    International Nuclear Information System (INIS)

    Tehranzadeh, J.; Anavim, A.; Pribram, H.W.; Fung Ying; Donohue, M.

    1998-01-01

    Objective. Radiologists are often challenged to review CT examinations of the skull without pertinent clinical information or plain radiographs. Skull lesions of fibrous dysplasia (FD) may often be confused with Paget disease (PD). The purpose of this article is to evaluate radiographic similarities and to find the signs that can differentiate PD from FD of the skull on head CT and to describe the CT imaging features of PD and FD. Design and patients. CT scans of the skull in eight cases of PD, 18 cases of FD (13 cases of skull and facial bones, five cases of only facial bones) and 10 normals were studied retrospectively. Results. Ten features were found to be similar in PD and FD and 10 other features were found to be dissimilar. The frequency of the 10 differentiating features was evaluated to determine their reliability in distinguishing one disorder from the other. The differentiating features in order of significance include: (1) ''groundglass'' appearance, (2) symmetry, (3) involvement of the paranasal sinuses, (4) thickness of the cranial cortices, (5) involvement of the sphenoid bone, (6) orbital involvement, (7) nasal cavity involvement, (8) presence of a soft tissue mass, (9) maxillary involvement, and (10) the presence of cyst-like changes. Conclusion. These 10 signs improve the radiologist's skill in differentiating FD and PD. (orig.)

  3. Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note.

    Science.gov (United States)

    Dolci, Ricardo Landini Lutaif; Todeschini, Alexandre Bossi; Santos, Américo Rubens Leite Dos; Lazarini, Paulo Roberto

    2018-04-19

    One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy. Step by step description of the endoscopic double flap technique (nasoseptal and pericranial vascularized flaps and fascia lata free graft) as used and illustrated in two patients with an olfactory groove meningioma who underwent an endoscopic approach. Both patients achieved a gross total resection: subsequent reconstruction of the anterior skull base was performed with the nasoseptal and pericranial flaps onlay and a fascia lata free graft inlay. Both patients showed an excellent recovery, no signs of cerebrospinal fluid leak, meningitis, flap necrosis, chronic meningeal or sinonasal inflammation or cerebral herniation having developed. This endoscopic double flap technique we have described is a viable, versatile and safe option for anterior skull base reconstructions, decreasing the incidence of complications in endoscopic endonasal approaches. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Ballistic fractures: indirect fracture to bone.

    Science.gov (United States)

    Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia

    2011-11-01

    Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.

  5. A complete skull of an early cretaceous sauropod and the evolution of advanced titanosaurians.

    Directory of Open Access Journals (Sweden)

    Hussam Zaher

    Full Text Available Advanced titanosaurian sauropods, such as nemegtosaurids and saltasaurids, were diverse and one of the most important groups of herbivores in the terrestrial biotas of the Late Cretaceous. However, little is known about their rise and diversification prior to the Late Cretaceous. Furthermore, the evolution of their highly-modified skull anatomy has been largely hindered by the scarcity of well-preserved cranial remains. A new sauropod dinosaur from the Early Cretaceous of Brazil represents the earliest advanced titanosaurian known to date, demonstrating that the initial diversification of advanced titanosaurians was well under way at least 30 million years before their known radiation in the latest Cretaceous. The new taxon also preserves the most complete skull among titanosaurians, further revealing that their low and elongated diplodocid-like skull morphology appeared much earlier than previously thought.

  6. Skull Base Osteomyelitis from Otitis Media Presenting as the Collet-Sicard Syndrome

    Directory of Open Access Journals (Sweden)

    Wong-Kein Low

    2018-01-01

    Full Text Available Skull base osteomyelitis can involve the jugular foramen and its associated cranial nerves resulting in specific clinical syndromes. The Collet-Sicard syndrome describes the clinical manifestations of palsies involving cranial nerves IX, X, XI, and XII. We present a rare atypical case of skull base osteomyelitis originating from infection of the middle ear and causing the Collet-Sicard syndrome. Caused by Pseudomonas aeruginosa and Klebsiella pneumoniae, this occurred in an elderly diabetic man subsequent to retention of a cotton swab in an ear with chronic suppurative otitis media. This case report illustrates the possibility of retained cotton swabs contributing to the development of otitis media, skull base osteomyelitis, and ultimately the Collet-Sicard syndrome in the ears of immune-compromised patients with chronically perforated eardrums.

  7. Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

    Directory of Open Access Journals (Sweden)

    Harminder Singh

    2016-01-01

    Full Text Available Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory evoked potentials. Methodological considerations as well as benefits and limitations are discussed. The authors argue that, while individual modalities have their limitations, multimodality neuromonitoring provides a real-time, comprehensive assessment of nervous system function and allows for safer, more aggressive management of skull base tumors via the endonasal route.

  8. Temporalis muscle hypertrophy and reduced skull eccentricity in Duchenne muscular dystrophy.

    Science.gov (United States)

    Straathof, C S M; Doorenweerd, N; Wokke, B H A; Dumas, E M; van den Bergen, J C; van Buchem, M A; Hendriksen, J G M; Verschuuren, J J G M; Kan, H E

    2014-10-01

    Muscle hypertrophy and muscle weakness are well known in Duchenne muscular dystrophy. Decreased muscle force can have secondary effects on skeletal growth and development such as facial and dental morphology changes. In this study, we quantified temporal muscle thickness, circumference, and eccentricity of the skull and the head on T1-weighted magnetic resonance imaging (MRI) scans of the head of 15 Duchenne muscular dystrophy patients and 15 controls. Average temporal muscle thickness was significantly increased in patients (12.9 ± 5.2 mm) compared to controls (6.8 ± 1.4 mm) (P muscle thickness and skull eccentricity were significantly negatively correlated in patients, and positively in controls. Hypertrophy of the temporal muscles and changes in skull eccentricity appear to occur early in the course of Duchenne muscular dystrophy. Further studies in younger patients are needed to confirm a causal relationship. © The Author(s) 2014.

  9. Cartilaginous metaplasia and overgrowth of neurocranium skull after X-irradiation in utero.

    Science.gov (United States)

    Schmahl, W; Meyer, I; Kriegel, H; Tempel, K H

    1979-01-01

    Prenatal X-irradiation of mice in the late organogenesis stage either with a fractionated or a single exposure dose (3 X 160 R or 200 R) leads to remarkable, previously undescribed malformations of the skull. These malformations range from mild hyperostotic nodule formation in about 90% of the offspring to excessive formation of desmal bony tissues, which extend deep into the forebrain and are thus only detectable in histological sections. Metaplastic and hyperplastic formation of cartilage in all the neurocranial regions is observed in about 10% of the offspring. The pathogenesis of these overgrowth phenomena is presumably related to a growth disturbance of both the mesenchymal skull primordium and the brain. While malformation of the latter leads to a decrease of intracranial pressure and consequently to altered growth activity of the skull sutures, the reparative and proliferative capacities of the mesenchyme are also stimulated, in a hyperplastic direction, by X-irradiation.

  10. A new head phantom with realistic shape and spatially varying skull resistivity distribution.

    Science.gov (United States)

    Li, Jian-Bo; Tang, Chi; Dai, Meng; Liu, Geng; Shi, Xue-Tao; Yang, Bin; Xu, Can-Hua; Fu, Feng; You, Fu-Sheng; Tang, Meng-Xing; Dong, Xiu-Zhen

    2014-02-01

    Brain electrical impedance tomography (EIT) is an emerging method for monitoring brain injuries. To effectively evaluate brain EIT systems and reconstruction algorithms, we have developed a novel head phantom that features realistic anatomy and spatially varying skull resistivity. The head phantom was created with three layers, representing scalp, skull, and brain tissues. The fabrication process entailed 3-D printing of the anatomical geometry for mold creation followed by casting to ensure high geometrical precision and accuracy of the resistivity distribution. We evaluated the accuracy and stability of the phantom. Results showed that the head phantom achieved high geometric accuracy, accurate skull resistivity values, and good stability over time and in the frequency domain. Experimental impedance reconstructions performed using the head phantom and computer simulations were found to be consistent for the same perturbation object. In conclusion, this new phantom could provide a more accurate test platform for brain EIT research.

  11. Radiation-induced osteosarcoma of the jaw treated with skull base surgery

    International Nuclear Information System (INIS)

    Yamamoto, Misaki; Asato, Ryo; Torii, Hiroko; Kanda, Tomoko; Tamura, Yoshihiro; Hirano, Shigeru; Ito, Juichi; Tanaka, Shinzou

    2009-01-01

    Head and neck osteosarcomas are rare. A 33-year-old woman received radiation therapy for lymphoepithelioma of the epipharynx in her childhood. After twenty-two years, she presented with a swelling of the right cheek. We did a work up, and diagnosed her radiation-induced osteosarcoma of the jaw. We treated her with neoadjuvant chemotherapy, surgery including skull base resection, and adjuvant chemo-therapy. A small skin recurrence developed after one year, but it was resected under local anesthesia, and there have been no recurrences since. We think that skull base surgery with a combined approach is a useful method in therapy for osteosarcomas in the skull base region. (author)

  12. Osteometrical and CT examination of the Japanese wolf [Canis hodophilax] skull

    International Nuclear Information System (INIS)

    Endo, H.; Obara, I.; Yoshida, T.; Kurohmaru, M.; Hayshi, Y.; Suzuki, N.

    1997-01-01

    The skulls of Japanese wolf (Canis hodophilax) were osteometrically examined and compared with those of Akita-Inu. The skull total length was not statistically different between two species. However, significant differences were demonstrated between two species in some ratios concerning the frontal bone. CT examination was carried out in the Japanese wolf skull. The data indicated that the frontal sinus is not be largely developed and compressed in the dorso-ventral direction in parasagittal area. The narrow frontal sinus fitted to external shape of the frontal bone. The cribriform plate had a well-developed complicated structure in a caudal part of the ethmoid bone. These data will be useful to examine the respiratory function and the olfactory sense in the Japanese wolf

  13. Interference of scalp and skull with dynamic isotope studies of brain

    International Nuclear Information System (INIS)

    Oldendorf, W.H.

    1972-01-01

    The overlying scalp and skull create artifacts in external brain counting measurements in which isotope appears in these tissues. It is much less of a problem in dynamic studies since high levels of superficial isotope are not found in the first few seconds after introduction into the blood by any anatomic route. Diffusible tracers concentrate somewhat less in the scalp and skull than in the brain immediately after injection by any route. Nondiffusible tracers of low molecular weight attain a much higher concentration in the scalp than the brain only after about the first minute because of passage from plasma to scalp extracellular fluid. This equilibration does not occur in brain because of the blood-brain barrier. Scalp and skull thus create much less of a problem with brief dynamic studies than with chronic long-term studies. Some physical considerations of external collimation are discussed, and means are suggested to minimize superficial isotope contributions to brain counts. (U.S.)

  14. [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.

  15. 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

  16. Anatomic study of cranial nerve emergence and associated skull foramina in cats using CT and MRI.

    Science.gov (United States)

    Gomes, Eymeric; Degueurce, Christophe; Ruel, Yannick; Dennis, Ruth; Begon, Dominique

    2009-01-01

    Magnetic resonance (MR) images of the brain of four normal cats were reviewed retrospectively to assess the emergence and course of the cranial nerves (CNs). Two-millimeter-thick images were obtained in transverse, sagittal, and dorsal planes using a 1.5 T unit. CN skull foramina, as anatomic landmarks for MR imaging, were identified by computed tomography performed on an isolated cat skull using thin wire within each skull foramen. Thin slice (1 mm slice thickness) images were obtained with a high-resolution bone filter scan protocol. The origins of CNs II, V, VII, and VIII and the group of IX, X, XI, and XII could be identified. The pathway and proximal divisions of CNs V were described. CNs III, IV, and VI were not distinguished from each other but could be seen together in the orbital fissure. CN V was characterized by slight contrast enhancement.

  17. An Account of the Inaugural Tessier Skull Exhibition at the University of Paris Descartes.

    Science.gov (United States)

    Dusseldorp, Joseph Richard; Firmin, Françoise

    2015-10-01

    Paul Tessier is widely regarded as the father of modern craniofacial surgery. Upon his passing in 2008, his private collection of human skulls was purchased by the French Association of Facial Surgeons to ensure the collection would remain in France. The first public exhibition of the skulls was held in the medical museum of the University of Paris Descartes in April 2014. From this collection of skulls and the imagination of Tessier an entirely new specialty was created. Modern craniofacial surgery, now is an integral part of any pediatric plastic surgery department. Cranial and facial osteotomies have also become commonplace in both traumatic and aesthetic surgery. The goals for craniofacial deformity are now a return to completely normal appearance and function, as Tessier always believed they should be.

  18. Functional Imaging of Human Vestibular Cortex Activity Elicited by Skull Tap and Auditory Tone Burst

    Science.gov (United States)

    Noohi, F.; Kinnaird, C.; Wood, S.; Bloomberg, J.; Mulavara, A.; Seidler, R.

    2016-01-01

    The current study characterizes brain activation in response to two modes of vestibular stimulation: skull tap and auditory tone burst. The auditory tone burst has been used in previous studies to elicit either the vestibulo-spinal reflex (saccular-mediated colic Vestibular Evoked Myogenic Potentials (cVEMP)), or the ocular muscle response (utricle-mediated ocular VEMP (oVEMP)). Some researchers have reported that air-conducted skull tap elicits both saccular and utricle-mediated VEMPs, while being faster and less irritating for the subjects. However, it is not clear whether the skull tap and auditory tone burst elicit the same pattern of cortical activity. Both forms of stimulation target the otolith response, which provides a measurement of vestibular function independent from semicircular canals. This is of high importance for studying otolith-specific deficits, including gait and balance problems that astronauts experience upon returning to earth. Previous imaging studies have documented activity in the anterior and posterior insula, superior temporal gyrus, inferior parietal lobule, inferior frontal gyrus, and the anterior cingulate cortex in response to different modes of vestibular stimulation. Here we hypothesized that skull taps elicit similar patterns of cortical activity as the auditory tone bursts, and previous vestibular imaging studies. Subjects wore bilateral MR compatible skull tappers and headphones inside the 3T GE scanner, while lying in the supine position, with eyes closed. Subjects received both forms of the stimulation in a counterbalanced fashion. Pneumatically powered skull tappers were placed bilaterally on the cheekbones. The vibration of the cheekbone was transmitted to the vestibular system, resulting in the vestibular cortical response. Auditory tone bursts were also delivered for comparison. To validate our stimulation method, we measured the ocular VEMP outside of the scanner. This measurement showed that both skull tap and auditory

  19. Primary Ewing's sarcoma of the skull: radical resection and immediate cranioplasty after chemotherapy. A technical note.

    Science.gov (United States)

    Castle, Maria; Rivero, Mónica; Marquez, Javier

    2013-02-01

    The current standard treatment of Ewing's sarcoma is chemotherapy followed by surgery, making an immediate cranial reconstruction in a one-step surgical procedure possible. We describe the technique used to repair a cranial defect after the resection of a primary Ewing's sarcoma of the skull in a one-step surgical procedure. Bone repair with a custom-made cranioplasty immediately after resection of a primary Ewing's sarcoma of the skull avoids deformities and late complications associated with reconstructive surgery after radiotherapy and not interfere with radiotherapy and neither with follow-up. A one-step surgical procedure after chemotherapy for primary Ewing's sarcoma of the skull could be safer, less aggressive and more radical; avoiding deformities and late complications.

  20. Comparison of SPECT and CT in detecting skull base invasion in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Zhang Li; Wang Jinchuan; Pu Nuo; Song Wenzhong; Chen Mingxi

    2002-01-01

    Objective: To investigate the detecting ability of single photon emission computed tomography (SPECT) and CT in skull base invasion in nasopharyngeal carcinoma. Methods: Sixty-three patients with nasopharyngeal carcinoma were examined by whole body and skull base SPECT and CT of nasopharynx and skull base before radiotherapy. The results were double-blind compared and evaluated. Results: The overall positive rates of skull base invasion detected by SPECT and CT were 63.5% and 25.4%. In patients with headache, cranial nerve palsy and both, they were 87.9%, 93.3%, 92.3% and 42.4%, 46.7%, 46.2%. In patients with T 1 + T 2 and T 3 + T 4 lesions, they were 37.5%, 90.3% and 0.0%, 51.6%. In patients with N 0 + N 1 and N 2 + N 3 lesions, they were 63.9%, 63.0% and 19.4%, 33.3%. The positive rates of SPECT were higher than those of CT (McNemar Test, P < 0.05). The conformation rate between SPECT and CT was 61.9% and the dissimilitude rate was 38.1%. Binary Logistic regression analysis showed that headache and T stages were risk factors of positive SPECT rate (ORheadache = 3.864, ORTstage= 6.422) while Tstage and Nstage were the risk factors for positive CT rate (ORTstage = 48.932, ORNstage = 2.860). Conclusions: The detection sensitivity of SPECT in skull base invasion in nasopharyngeal carcinoma is superior to that of CT. But its specificity is inferior to that of CT. The detecting results in SPECT are better related to symptoms, signs and stage. Combining headache and cranial nerve palsy with T and N stage, the authors may much improve the results of SPECT and CT in the detection of skull base invasion in nasopharyngeal carcinoma. Further study is warranted

  1. The Role of Skull Modeling in EEG Source Imaging for Patients with Refractory Temporal Lobe Epilepsy.

    Science.gov (United States)

    Montes-Restrepo, Victoria; Carrette, Evelien; Strobbe, Gregor; Gadeyne, Stefanie; Vandenberghe, Stefaan; Boon, Paul; Vonck, Kristl; Mierlo, Pieter van

    2016-07-01

    We investigated the influence of different skull modeling approaches on EEG source imaging (ESI), using data of six patients with refractory temporal lobe epilepsy who later underwent successful epilepsy surgery. Four realistic head models with different skull compartments, based on finite difference methods, were constructed for each patient: (i) Three models had skulls with compact and spongy bone compartments as well as air-filled cavities, segmented from either computed tomography (CT), magnetic resonance imaging (MRI) or a CT-template and (ii) one model included a MRI-based skull with a single compact bone compartment. In all patients we performed ESI of single and averaged spikes marked in the clinical 27-channel EEG by the epileptologist. To analyze at which time point the dipole estimations were closer to the resected zone, ESI was performed at two time instants: the half-rising phase and peak of the spike. The estimated sources for each model were validated against the resected area, as indicated by the postoperative MRI. Our results showed that single spike analysis was highly influenced by the signal-to-noise ratio (SNR), yielding estimations with smaller distances to the resected volume at the peak of the spike. Although averaging reduced the SNR effects, it did not always result in dipole estimations lying closer to the resection. The proposed skull modeling approaches did not lead to significant differences in the localization of the irritative zone from clinical EEG data with low spatial sampling density. Furthermore, we showed that a simple skull model (MRI-based) resulted in similar accuracy in dipole estimation compared to more complex head models (based on CT- or CT-template). Therefore, all the considered head models can be used in the presurgical evaluation of patients with temporal lobe epilepsy to localize the irritative zone from low-density clinical EEG recordings.

  2. Congenital muscle dystrophy and diet consistency affect mouse skull shape differently.

    Science.gov (United States)

    Spassov, Alexander; Toro-Ibacache, Viviana; Krautwald, Mirjam; Brinkmeier, Heinrich; Kupczik, Kornelius

    2017-11-01

    The bones of the mammalian skull respond plastically to changes in masticatory function. However, the extent to which muscle function affects the growth and development of the skull, whose regions have different maturity patterns, remains unclear. Using muscle dissection and 3D landmark-based geometric morphometrics we investigated the effect of changes in muscle function established either before or after weaning, on skull shape and muscle mass in adult mice. We compared temporalis and masseter mass and skull shape in mice with a congenital muscle dystrophy (mdx) and wild type (wt) mice fed on either a hard or a soft diet. We found that dystrophy and diet have distinct effects on the morphology of the skull and the masticatory muscles. Mdx mice show a flattened neurocranium with a more dorsally displaced foramen magnum and an anteriorly placed mandibular condyle compared with wt mice. Compared with hard diet mice, soft diet mice had lower masseter mass and a face with more gracile features as well as labially inclined incisors, suggesting reduced bite strength. Thus, while the early-maturing neurocranium and the posterior portion of the mandible are affected by the congenital dystrophy, the late-maturing face including the anterior part of the mandible responds to dietary differences irrespective of the mdx mutation. Our study confirms a hierarchical, tripartite organisation of the skull (comprising neurocranium, face and mandible) with a modular division based on development and function. Moreover, we provide further experimental evidence that masticatory loading is one of the main environmental stimuli that generate craniofacial variation. © 2017 Anatomical Society.

  3. Distinct features of intraspecific and intrapopulation variability of the skull size in the red fox.

    Science.gov (United States)

    Gos'kov, A M; Bol'shakov, V N; Korytin, N S

    2017-05-01

    The range of chronographic variability of the average size of the skull in the red fox (data collected by the authors) from a compact area in the Middle Urals has been assessed for a 30-year period, and the results obtained have been compared with the published data on the geographical variability within the vast species range. The range of changes of the average dimensions of the skull over time spanned almost the entire range of geographical variability. Therefore, the problem of search for factors that determine the morphological diversity arises.

  4. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

    Directory of Open Access Journals (Sweden)

    Ming Jie Wang, MD, PhD

    2016-06-01

    Full Text Available Chondroblastoma with secondary aneurysmal bone cyst (ABC, especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review this rare case and discuss the clinical presentation and surgical treatment.

  5. Complex single step skull reconstruction in Gorham's disease - a technical report and review of the literature.

    Science.gov (United States)

    Ohla, Victoria; Bayoumi, Ahmed B; Hefty, Markus; Anderson, Matthew; Kasper, Ekkehard M

    2015-03-11

    Gorham's disease is a rare osteolytic disorder characterized by progressive resorption of bone and replacement of osseous matrix by a proliferative non-neoplastic vascular or lymphatic tissue. A standardized treatment protocol has not yet been defined due to the unpredictable natural history of the disease and variable clinical presentations. No single treatment has proven to be superior in arresting the course of the disease. Trials have included surgery, radiation and medical therapies using drugs such as calcium salts, vitamin D supplements and hormones. We report on our advantageous experience in the management of this osteolyic disorder in a case when it affected only the skull vault. A brief review of pertinent literature about Gorham's disease with skull involvement is provided. A 25-year-old Caucasian male presented with a skull depression over the left fronto-temporal region. He noticed progressive enlargement of the skull defect associated with local pain and mild headache. Physical examination revealed a tender palpable depression of the fronto-temporal convexity. Conventional X-ray of the skull showed widespread loss of bone substance. Subsequent CT scans showed features of patchy erosions indicative of an underlying osteolysis. MRI also revealed marginal enhancement at the site of the defect. The patient was in need of a pathological diagnosis as well as complex reconstruction of the afflicted area. A density graded CT scan was done to determine the variable degrees of osteolysis and a custom made allograft was designed for cranioplasty preoperatively to allow for a single step excisional craniectomy with synchronous skull repair. Gorham's disease was diagnosed based on histopathological examination. No neurological deficit or wound complications were reported postoperatively. Over a two-year follow up period, the patient had no evidence of local recurrence or other systemic involvement. A single step excisional craniectomy and cranioplasty can be an

  6. Eosinophilic granuloma of the skull base: patient with unique clinical moreover, radiographic presentation.

    Directory of Open Access Journals (Sweden)

    Hosein Dalili

    2015-01-01

    Full Text Available This case report presents an eight-year-old girl having periauricular swelling and severe pain during mouth opening on the right-side temporomandibular joint (TMJ. CBCT showed extensive destruction of the base of the skull and the roof of the glenoid fossa on the right side. The findings based on CT and MRI images with and without contrast are discussed herein. This report highlights a skull base eosinophilic granuloma that mimics TMJ disorder and the importance of proper evaluation of CBCT images to make an early diagnosis.

  7. Resolution of "salt and pepper" appearance of the skull with vitamin D therapy

    Directory of Open Access Journals (Sweden)

    Gursimran Kaur

    2013-01-01

    Full Text Available Chronic hypovitaminosis D leads to state of decreased mineralization and generalized osteomalacia. It also results in secondary hyperparathyroidism causing increased bone turn over and decreased bone mass, manifested radiologically as a "salt and pepper" appearance in skull, subperiosteal resorption, bone cysts and lytic lesions. In this case, a young male patient with hypovitaminosis D and secondary hyperparathyroidism, radiological features show resolution of "salt and pepper" appearance of the skull with vitamin D in 11 months and regression of other lytic lesions.

  8. Evaluation of Three Cases Using a Novel Titanium Mesh System-Skull-Fit with Orbital Wall (Skull-Fit WOW)-For Cranial Base Reconstructions.

    Science.gov (United States)

    Hattori, Noriko; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Yoshiaki; Ohira, Takayuki; Yoshida, Kazunari; Kawase, Takeshi; Kishi, Kazuo

    2011-09-01

    Cranial base reconstructions associated with tumor resections around the orbital wall often require that both the upper and lateral orbital walls be reconstructed during a single procedure. Previously, we used titanium mesh plates that were preoperatively fabricated based on three-dimensional models. Although these plates are precise and do not increase the probability of infection, we still had to use autologous bones to reconstruct the orbital walls. Recently, we developed a new titanium mesh plate-called Skull-Fit(®)-with orbital wall (Skull-Fit WOW(®)), enabling us to reconstruct the cranial base and orbital walls without bone grafts. Here, we report on three reconstruction cases in which the novel titanium mesh-orbital wall system was used. In all three cases, the customized titanium mesh system performed satisfactorily with little, if any, complications.

  9. Evaluation of Three Cases Using a Novel Titanium Mesh System—Skull-Fit® with Orbital Wall (Skull-Fit WOW®)—For Cranial Base Reconstructions

    Science.gov (United States)

    Hattori, Noriko; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Yoshiaki; Ohira, Takayuki; Yoshida, Kazunari; Kawase, Takeshi; Kishi, Kazuo

    2011-01-01

    Cranial base reconstructions associated with tumor resections around the orbital wall often require that both the upper and lateral orbital walls be reconstructed during a single procedure. Previously, we used titanium mesh plates that were preoperatively fabricated based on three-dimensional models. Although these plates are precise and do not increase the probability of infection, we still had to use autologous bones to reconstruct the orbital walls. Recently, we developed a new titanium mesh plate—called Skull-Fit®—with orbital wall (Skull-Fit WOW®), enabling us to reconstruct the cranial base and orbital walls without bone grafts. Here, we report on three reconstruction cases in which the novel titanium mesh-orbital wall system was used. In all three cases, the customized titanium mesh system performed satisfactorily with little, if any, complications. PMID:22451827

  10. Heat and mass transfer during the inductive skull melting process of glasses and oxides; Waerme- und Stofftransport beim induktiven Skull-Schmelzen von Glaesern und Oxiden

    Energy Technology Data Exchange (ETDEWEB)

    Nacke, Bernard; Niemann, Benjamin [Leibniz Univ. Hannover (Germany). Inst. fuer Elektroprozesstechnik; Schlesselmann, Dirk [Auer Lighting GmbH, Bad Gandersheim (Germany)

    2013-03-15

    The skull melting technology is a melting process for innovative materials in the range of glasses. A hitherto unknown problem under glass melting by means of this technology is the fact that the processes in the interior of the molten mass are still unknown. Under this aspect, the authors of the contribution under consideration present an overview of the inductive melting process for glasses in an inductor crucible developed at the Institute for Electrotechnology (Hanover, Federal Republic of Germany). A newly developed numerical model is presented in order to simulate the heat and mass transfer in a molten glass. This simulation enables a future optimization of the design of the inductor crucible and the melting process. The transient three-dimensional melting flow during the melting of glasses and oxides by means of the skull meeting process also can be simulated by the newly developed numerical model.

  11. Areal and volumetric Bone Mineral Density and risk of multiple types of fracture in older men

    Science.gov (United States)

    Chalhoub, Didier; Orwoll, Eric S.; Cawthon, Peggy M.; Ensrud, Kristine E.; Boudreau, Robert; Greenspan, Susan; Newman, Anne B.; Zmuda, Joseph; Bauer, Douglas; Cummings, Steven; Cauley, Jane A.

    2016-01-01

    Although many studies have examined the association between low bone mineral density (BMD) and fracture risk in older men, none have simultaneously studied the relationship between multiple BMD sites and risk of different types of fractures. Using data from the Osteoporotic Fractures in Men study, we evaluated the association between areal BMD (aBMD) by dual-energy X-ray absorptiometry (DXA) and volumetric BMD (vBMD) by quantitative computed tomography (QCT) measurements, and different types of fractures during an average of 9.7 years of follow up. Men answered questionnaires about fractures every 4 months (>97% completions). Fractures were confirmed by centralized review of radiographic reports; pathological fractures were excluded. Risk of fractures was assessed at the hip, spine, wrist, shoulder, rib/chest/sternum, ankle/foot/toe, arm, hand/finger, leg, pelvis/coccyx, skull/face and any non-spine fracture. Age and race adjusted Cox proportional-hazards modeling was used to assess the risk of fracture in 3301 older men with both aBMD (at the femoral neck (FN) and lumbar spine) and vBMD (at the trabecular spine and FN, and cortical FN) measurements, with hazard ratios (HRs) expressed per standard deviation (SD) decrease. Lower FN and spine aBMD were associated with an increased risk of fracture at the hip, spine, wrist, shoulder, rib/chest/sternum, arm, and any non-spine fracture (statistically significant HRs per SD decrease ranged from 1.24 - 3.57). Lower trabecular spine and FN vBMD were associated with increased risk of most fractures with statistically significant HRs ranging between 1.27 and 3.69. There was a statistically significant association between FN cortical vBMD and fracture risk at the hip (HR=1.55) and spine sites (HR=1.26), but no association at other fracture sites. In summary, both lower aBMD and vBMD were associated with increased fracture risk. The stronger associations observed for trabecular vBMD than cortical vBMD may reflect the greater

  12. Tourette syndrome increases risk of bone fractures: a population-based cohort study.

    Science.gov (United States)

    Lu, Yuan-Yuan; Wang, Ming-Yu; Wei, I-Hua; Lin, Che-Chen; Huang, Chih-Chia

    2017-05-01

    This study assesses the risk of fractures among children with Tourette syndrome (TS), and identifies the effects of comorbidities and antipsychotics. We randomly sampled the claims data of 1 million enrollees in the National Health Insurance program of Taiwan, and identified 1258 children with TS diagnosed between 2000 and 2010. Additionally, 12,580 children without TS who were frequency matched for sex, age, residential area, parental occupation, and index year were identified for comparison. The children's cases were followed until December 31, 2010, or censored to ascertain incident fractures cases and associations with comorbidities of attention-deficit/hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD) and treatments with antipsychotics, antidepressants, or clonidine. The TS cohort had a 1.27-fold higher incidence of fractures than did the comparison cohort (190.37 vs. 149.94 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.28 [95% confidence interval (CI) 1.06-1.55] based on multivariable Cox regression analysis. This increased risk of fractures was apparent for fractures of the skull, neck, and spine. Comorbid ADHD and OCD did not result in an additional risk of fractures. The children without both ADHD and OCD were also at a higher risk of fractures, indicating that TS alone increases the risk of fractures. The children taking antipsychotics had a reduced risk of fractures, and the adjusted HR decreased to 1.17 (95% CI 0.90-1.52). Children with TS have an increased risk of fractures. ADHD and OCD do not increase the risk further.

  13. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures

    International Nuclear Information System (INIS)

    Darling, Stephen E.; Done, Stephen L.; Friedman, Seth D.; Feldman, Kenneth W.

    2014-01-01

    Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma. We conducted a retrospective review of rib fractures caused by documented abuse or accidents from 2003 to 2010 in children treated at Seattle Children's Hospital and Harborview Medical Center. A senior pediatric radiologist and radiology fellow independently reviewed the imaging. Children with bone demineralization were excluded. Descriptive and simple comparative statistics were used. Seventy-two percent (47/65) of infants and toddlers with rib fractures were abused. Abused children had more rib fractures than accidentally injured children (5.55 vs. 3.11, P = 0.012). However intrathoracic injuries as a whole (55.6% vs. 12.8%, P < 0.001) and individual types of intrathoracic injuries were more common with accidents. Rates of other thoracic cage injuries did not differ substantially (27.8% accidents vs. 12.8% abuse, P = 0.064). Intracranial and intra-abdominal injuries and skull fractures were equally frequent, but other extrathoracic fractures were more common with abuse (70.2% vs. 16.7%, P < 0.001). Abused infants and toddlers have fewer intrathoracic injuries but more rib fractures than accidentally injured peers. This likely reflects different injury mechanics. Lack of intrathoracic injuries in abused children with rib fractures does not imply bone fragility. (orig.)

  14. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures

    Energy Technology Data Exchange (ETDEWEB)

    Darling, Stephen E. [Kapiolani Children' s Hospital, The Department of Radiology, Honolulu, HI (United States); Done, Stephen L.; Friedman, Seth D. [Seattle Children' s Hospital, The Department' s of Radiology, Seattle, WA (United States); University of Washington School of Medicine, Seattle, WA (United States); Feldman, Kenneth W. [Seattle Children' s Hospital, Pediatrics, General Pediatrics Division, Seattle, WA (United States); Seattle Children' s Protection Program, Children' s Protection Program, M/S M2-10, Seattle, WA (United States); University of Washington School of Medicine, Seattle, WA (United States)

    2014-10-15

    Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma. We conducted a retrospective review of rib fractures caused by documented abuse or accidents from 2003 to 2010 in children treated at Seattle Children's Hospital and Harborview Medical Center. A senior pediatric radiologist and radiology fellow independently reviewed the imaging. Children with bone demineralization were excluded. Descriptive and simple comparative statistics were used. Seventy-two percent (47/65) of infants and toddlers with rib fractures were abused. Abused children had more rib fractures than accidentally injured children (5.55 vs. 3.11, P = 0.012). However intrathoracic injuries as a whole (55.6% vs. 12.8%, P < 0.001) and individual types of intrathoracic injuries were more common with accidents. Rates of other thoracic cage injuries did not differ substantially (27.8% accidents vs. 12.8% abuse, P = 0.064). Intracranial and intra-abdominal injuries and skull fractures were equally frequent, but other extrathoracic fractures were more common with abuse (70.2% vs. 16.7%, P < 0.001). Abused infants and toddlers have fewer intrathoracic injuries but more rib fractures than accidentally injured peers. This likely reflects different injury mechanics. Lack of intrathoracic injuries in abused children with rib fractures does not imply bone fragility. (orig.)

  15. Clinicopathological significance of p16, cyclin D1, Rb and MIB-1 levels in skull base chordoma and chondrosarcoma

    Directory of Open Access Journals (Sweden)

    Jun-qi Liu

    2015-09-01

    Full Text Available Objective: To investigate the expression of p16, cyclin D1, retinoblastoma tumor suppressor protein (Rb and MIB-1 in skull base chordoma and chondrosarcoma tissues, and to determine the clinicopathological significance of the above indexes in these diseases. Methods: A total of 100 skull base chordoma, 30 chondrosarcoma, and 20 normal cartilage tissue samples were analyzed by immunohistochemistry. The expression levels of p16, cyclinD1, Rb and MIB-1 proteins were assessed for potential correlation with the clinicopathological features. Results: As compared to normal cartilage specimen (control, there was decreased expression of p16, and increased expression of cyclin D1, Rb and MIB-1 proteins, in both skull base chordoma and chondrosarcoma specimens. MIB-1 LI levels were significantly increased in skull base chordoma specimens with negative expression of p16, and positive expression of cyclin D1 and Rb (P  0.05. However, p16 and MIB-1 levels correlated with the intradural invasion, and expression of p16, Rb and MIB-1 correlated with the number of tumor foci (P < 0.05. Further, the expression of p16 and MIB-1 appeared to correlate with the prognosis of patients with skull base chordoma. Conclusions: The abnormal expression of p16, cyclin D1 and Rb proteins might be associated with the tumorigenesis of skull base chordoma and chondrosarcoma. Keywords: p16, Cyclin D1, Rb, MIB-1, Skull base chordoma, Skull base chondrosarcoma

  16. Proton Therapy for Skull Base Chordomas: An Outcome Study from the University of Florida Proton Therapy Institute

    OpenAIRE

    Deraniyagala, Rohan L.; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng; Morris, Christopher G.; Mendenhall, Nancy P.; Okunieff, Paul; Malyapa, Robert S.

    2013-01-01

    Objectives Skull base chordoma is a rare, locally aggressive tumor located adjacent to critical structures. Gross total resection is difficult to achieve, and proton therapy has the conformal advantage of delivering a high postoperative dose to the tumor bed. We present our experience using proton therapy to treat 33 patients with skull base chordomas.

  17. The skull of Chamaeleo nasutus adds more information to the relationship of Chamaeleo with Rhampholeon and Brookesia (Chamaeleonidae, Reptilia)

    NARCIS (Netherlands)

    Hillenius, D.

    1988-01-01

    The form of the skull of Chamaeleo nasutus, especially the broad, trigonal parietal, is strikingly similar to the skull of Rhampholeon. This supports the hypothesis (Hillenius, 1986) that of all chameleons the group of species around Ch. nasutus is the most closely related to Rhampholeon.

  18. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu

    2014-12-01

    Full Text Available Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  19. Fracture mechanics safety approaches

    International Nuclear Information System (INIS)

    Roos, E.; Schuler, X.; Eisele, U.

    2004-01-01

    Component integrity assessments require the knowledge of reliable fracture toughness parameters characterising the initiation of the failure process in the whole relevant temperature range. From a large number of fracture mechanics tests a statistically based procedure was derived allowing to quantify the initiation of fracture toughness as a function of temperature as a closed function as well as the temperature dependence of the cleavage instability parameters. Alternatively to the direct experimental determination one also can use a correlation between fracture toughness and notch impact energy. (orig.)

  20. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

    Full Text Available Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011. The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

  1. Pathological fractures in children

    Science.gov (United States)

    De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

    2012-01-01

    Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

  2. Radiological and acetomorphine analysis of the symmetry and direction of evolution of skulls from some historic populations

    International Nuclear Information System (INIS)

    Gawlikowska-Sroka, A.

    2006-01-01

    Introduction: Asymmetry is a common phenomenon in nature. It is typical for the human body and for the skull as its part. Knowledge of asymmetry and normal anatomy, especially of variability which does not represent pathology but distinguishes individuals is the basis for correct interpretation of radiological findings concerning the skull both in research and diagnostic examinations widely performed in surgery, neurology, neurosurgery, internal medicine, or pediatrics. Analysis of fluctuating asymmetry reveals the influence of stress factors on human development and the ability of the organism to defend itself against stress.The aim of this work was to analyse the asymmetry of skulls from some historic populations and to describe changes in their anatomy over the ages. Material and methods: The material consisted of three skull groups: one contemporary with 82 skulls and two mediaeval (52 skulls from Cedynia and 77 skulls from Grodek on Bug). Direct measurements were done and the skull was X-rayed in the Posterior-Anterior and skull-base projections. Images were scanned and calibrated with MicroStation 95 Academic Edition software. Helmert's transformation with first-order polynomial was done to attain a suitable geometry. Vectorisation of axes and areas was performed on reference material. Using tools for measurement of vector elements, the distance between bilateral points of both sides of the skull were obtained. Data were analysed statistically. Results: The results of measurements were used to study the directional and fluctuating asymmetry. It was found that asymmetry of the skull was present in both historic populations. The following conclusions were drawn: changes in the distribution of directional and fluctuating asymmetry for individual dimensions have taken place over the ages. A high level of directional asymmetry in the facial part and fluctuating asymmetry in the calvaria is typical for contemporary skulls. The reverse is true for relations in the

  3. Fracture of the styloid process associated with the mandible fracture

    Directory of Open Access Journals (Sweden)

    K N Dubey

    2013-01-01

    Full Text Available Fracture of the styloid process (SP of temporal bone is an uncommon injuries. Fracture of the SP can be associated with the facial injuries including mandible fracture. However, injury to the SP may be concealed and missed diagnosis may lead to the improper or various unnecessary treatments. A rare case of SP fracture associated with the ipsilateral mandibular fracture and also the diagnostic and management considerations of the SP fracture are discussed.

  4. Death due to fracture of thin calvarial bones after a fall: A forensic approach.

    Science.gov (United States)

    Sioutas, Georgios; Karakasi, Maria-Valeria; Kapetanakis, Stylianos; Pavlidis, Pavlos

    2017-06-01

    A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skull base. The patient's death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  5. The Process of Hydraulic Fracturing

    Science.gov (United States)

    Hydraulic fracturing, know as fracking or hydrofracking, produces fractures in a rock formation by pumping fluids (water, proppant, and chemical additives) at high pressure down a wellbore. These fractures stimulate the flow of natural gas or oil.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-01-01

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

  7. Beringian Megafaunal Extinctions at ~37 ka B.P.: Do Micrometeorites Embedded in Fossil Tusks and Skulls Indicate an Extraterrestial Precursor to the Younger Dryas Event?

    Science.gov (United States)

    Hagstrum, J. T.; Firestone, R. B.; West, A.

    2009-12-01

    Studies of Late Pleistocene megafaunal fossils and their ancient DNA from Beringia (eastern Siberia, Alaska, and the emerged Bering Strait) indicate sharp declines in steppe bison population diversity and horse body size, extinction of the Alaskan wild ass, and local extinctions of brown bear and woolly mammoth genetic lines beginning at about 37 ka B.P. Beringia is also well known for its remarkably preserved Late Pleistocene frozen animal mummies. 14C ages of these mummies are bimodally distributed, having peaks coincident with the earlier ~37 ka B.P., and ~13 ka B.P. Younger Dryas, onset extinction events. Associated with the ~37 ka B.P. event are, for example, the Berezovka mammoth, headless Selerikan horse, steppe bison “Blue Babe”, and baby mammoths “Dima” and “Lyuba”. Analyses of these and other mummies indicate that they died instantly, in mostly healthy condition, with gut contents and high fat reserves indicative of a late summer to autumn season. An assortment of uneaten limbs and other body parts from a variety of species have also been found. Uniformitarian death scenarios inadequately account for the lack of evidence of normal predation and scavenging. Extensive internal injuries (e.g. large bone fractures, hemorrhaging) and apparent rapid burial of the mummies also indicate that something truly unusual happened at the time of these extinction events. We have discovered what appear to be micrometeorites embedded in seven Alaskan mammoth tusks and a Siberian bison skull acquired from commercial sources. 14C ages for five of these fossils have a weighted mean age of 33 ± 2 ka B.P. Laser ablation ICP-MS and XRF analyses of the particles indicate high Fe contents with compositions enriched in Ni and depleted in Ti, similar to Fe meteorites and unlike any natural terrestrial sources. Microprobe analyses of a Fe-Ni sulfide grain from tusk 2 also show that it contains between 3 and 20 weight percent Ni. SEM images and XRF analyses of a bison

  8. Does hearing in response to soft-tissue stimulation involve skull vibrations? A within-subject comparison between skull vibration magnitudes and hearing thresholds.

    Science.gov (United States)

    Chordekar, Shai; Perez, Ronen; Adelman, Cahtia; Sohmer, Haim; Kishon-Rabin, Liat

    2018-04-03

    Hearing can be elicited in response to bone as well as soft-tissue stimulation. However, the underlying mechanism of soft-tissue stimulation is under debate. It has been hypothesized that if skull vibrations were the underlying mechanism of hearing in response to soft-tissue stimulation, then skull vibrations would be associated with hearing thresholds. However, if skull vibrations were not associated with hearing thresholds, an alternative mechanism is involved. In the present study, both skull vibrations and hearing thresholds were assessed in the same participants in response to bone (mastoid) and soft-tissue (neck) stimulation. The experimental group included five hearing-impaired adults in whom a bone-anchored hearing aid was implanted due to conductive or mixed hearing loss. Because the implant is exposed above the skin and has become an integral part of the temporal bone, vibration of the implant represented skull vibrations. To ensure that middle-ear pathologies of the experimental group did not affect overall results, hearing thresholds were also obtained in 10 participants with normal hearing in response to stimulation at the same sites. We found that the magnitude of the bone vibrations initiated by the stimulation at the two sites (neck and mastoid) detected by the laser Doppler vibrometer on the bone-anchored implant were linearly related to stimulus intensity. It was therefore possible to extrapolate the vibration magnitudes at low-intensity stimulation, where poor signal-to-noise ratio limited actual recordings. It was found that the vibration magnitude differences (between soft-tissue and bone stimulation) were not different than the hearing threshold differences at the tested frequencies. Results of the present study suggest that bone vibration magnitude differences can adequately explain hearing threshold differences and are likely to be responsible for the hearing sensation. Thus, the present results support the idea that bone and soft

  9. [Trochanteric femoral fractures].

    Science.gov (United States)

    Douša, P; Čech, O; Weissinger, M; Džupa, V

    2013-01-01

    At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (pfractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (pfractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (pTrochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (pfractures were treated with a proximal femoral nail; a short nail was used in 1260 and a long nail in 134 of them. A dynamic hip screw (DHS) was employed to treat 947 fractures. Distinguishing between pertrochanteric (21-A1

  10. Hand fracture - aftercare

    Science.gov (United States)

    ... an orthopedic surgeon if: Your metacarpal bones are broken and shifted out of place Your fingers do not line up correctly Your fracture nearly went through the skin Your fracture went through the skin Your pain is severe or becoming worse Self-care at Home You may have pain and swelling for 1 ...

  11. TIBIAL SHAFT FRACTURES.

    Science.gov (United States)

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2011-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.

  12. Physeal Fractures in Foals.

    Science.gov (United States)

    Levine, David G; Aitken, Maia R

    2017-08-01

    Physeal fractures are common musculoskeletal injuries in foals and should be included as a differential diagnosis for the lame or nonweightbearing foal. Careful evaluation of the patient, including precise radiographic assessment, is paramount in determining the options for treatment. Prognosis mostly depends on the patient's age, weight, and fracture location and configuration. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Contribution of bone and brain scintigraphy to diagnosis of the extension and nature of skull lesions

    International Nuclear Information System (INIS)

    Akerman, M.; Tovar, G. de; Derome, P.

    The combination of bone and brain scintigraphy provides a vast amount of information in the study of lesions of the skull. It is especially valuable as a means to circumscribe the invasion of the bones, distinguish between bone and intracranial invasion, diagnose the nature of the lesion, estimate its degree of vascularization and detect remote localisations [fr

  14. The Mystery of the Skulls: What Can Old Bones Tell Us about Hominin Evolution?

    Science.gov (United States)

    Yerky, Mike Darwin; Wilczynski, Carolyn J.

    2014-01-01

    In this activity, students examine nine hominin skulls for specialized features and take measurements that will enable them to determine the relatedness of these species. They will ultimately place each specimen on a basic phylogenetic tree that also reveals the geological time frame in which each species lived. On the basis of their data, and…

  15. Rare case of solitary plasmacytoma of the skull in a young male ...

    African Journals Online (AJOL)

    Solitary plasmacytoma of bone without signs of multiple myeloma is a rare entity. It usually presents as an osteolytic lesion in the axial skeleton of an elderly patient. Here, we report a case of solitary plasmacytoma in the skull of a young male patient which emphasises the need to consider it in the differential diagnosis of a ...

  16. Morphologic and osteometric analysis of the skull of markhoz goat (Iranian angora).

    Science.gov (United States)

    Goodarzi, Nader; Shah Hoseini, Toraj

    2014-01-01

    This study provides some comprehensive osteometric and morphologic descriptions of the skull region of the Markhoz goat. Totally, 17 osteometric parameters of eight skulls of Markhoz goat were measured and expressed as mean ± SD. A skull length of 18.67 ± 0.66, a cranial length of 11.1 ± 0.38, a facial length of 10.23 ± 0.76, a skull index of 47.77 ± 1.96, a cranial index of 54.04 ± 2.29, a facial index of 100.77 ± 6.85 and a foramen magnum index of 89.32 ± 14.1 were recorded. Morphologically frontal bone did not constitute the caudal extent of frontal surface; rather it was formed by the parietal bone. There were two supraorbital foramina in both sides. The prominent facial tuberosity lies dorsally to the 3rd cheek tooth. The infraorbital foramen was single on either side which was located directly dorsally to the junction of the first and second upper premolar. The orbits were round and complete and located on a frontolateral oblique plane. The basilar part of the occipital bone was surrounded by two pairs of muscular tubercles with similar size. The temporal line was continuous of the temporal crest and ran over the parietal bone. In conclusion, the morphologic and osteometric data of Markhoz goat are comparable to other ruminants.

  17. Morphologic and Osteometric Analysis of the Skull of Markhoz Goat (Iranian Angora

    Directory of Open Access Journals (Sweden)

    Nader Goodarzi

    2014-01-01

    Full Text Available This study provides some comprehensive osteometric and morphologic descriptions of the skull region of the Markhoz goat. Totally, 17 osteometric parameters of eight skulls of Markhoz goat were measured and expressed as mean ± SD. A skull length of 18.67 ± 0.66, a cranial length of 11.1±0.38, a facial length of 10.23±0.76, a skull index of 47.77±1.96, a cranial index of 54.04±2.29, a facial index of 100.77±6.85 and a foramen magnum index of 89.32±14.1 were recorded. Morphologically frontal bone did not constitute the caudal extent of frontal surface; rather it was formed by the parietal bone. There were two supraorbital foramina in both sides. The prominent facial tuberosity lies dorsally to the 3rd cheek tooth. The infraorbital foramen was single on either side which was located directly dorsally to the junction of the first and second upper premolar. The orbits were round and complete and located on a frontolateral oblique plane. The basilar part of the occipital bone was surrounded by two pairs of muscular tubercles with similar size. The temporal line was continuous of the temporal crest and ran over the parietal bone. In conclusion, the morphologic and osteometric data of Markhoz goat are comparable to other ruminants.

  18. Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement

    Energy Technology Data Exchange (ETDEWEB)

    Droege, L.H.; Hinsche, T.; Hess, C.F.; Wolff, H.A. [University Hospital of Goettingen, Department of Radiotherapy and Radiation Oncology, Goettingen (Germany); Canis, M. [University of Goettingen, Department of Otorhinolaryngology, Head and Neck Surgery, Goettingen (Germany); Alt-Epping, B. [University of Goettingen, Department of Palliative Medicine, Goettingen (Germany)

    2014-02-15

    Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting. (orig.)

  19. The application of finite element analysis in the skull biomechanics and dentistry.

    Science.gov (United States)

    Prado, Felippe Bevilacqua; Rossi, Ana Cláudia; Freire, Alexandre Rodrigues; Ferreira Caria, Paulo Henrique

    2014-01-01

    Empirical concepts describe the direction of the masticatory stress dissipation in the skull. The scientific evidence of the trajectories and the magnitude of stress dissipation can help in the diagnosis of the masticatory alterations and the planning of oral rehabilitation in the different areas of Dentistry. The Finite Element Analysis (FEA) is a tool that may reproduce complex structures with irregular geometries of natural and artificial tissues of the human body because it uses mathematical functions that enable the understanding of the craniofacial biomechanics. The aim of this study was to review the literature on the advantages and limitations of FEA in the skull biomechanics and Dentistry study. The keywords of the selected original research articles were: Finite element analysis, biomechanics, skull, Dentistry, teeth, and implant. The literature review was performed in the databases, PUBMED, MEDLINE and SCOPUS. The selected books and articles were between the years 1928 and 2010. The FEA is an assessment tool whose application in different areas of the Dentistry has gradually increased over the past 10 years, but its application in the analysis of the skull biomechanics is scarce. The main advantages of the FEA are the realistic mode of approach and the possibility of results being based on analysis of only one model. On the other hand, the main limitation of the FEA studies is the lack of anatomical details in the modeling phase of the craniofacial structures and the lack of information about the material properties.

  20. Skull ontogeny and modularity in two species of Lagenorhynchus: Morphological and ecological implications.

    Science.gov (United States)

    Del Castillo, Daniela L; Viglino, Mariana; Flores, David A; Cappozzo, Humberto L

    2017-02-01

    Comparisons of skull shape between closely related species can provide information on the role that phylogeny and function play in cranial evolution. We used 3D-anatomical landmarks in order to study the skull ontogeny of two closely related species, Lagenorhynchus obscurus and Lagenorhynchus australis, with a total sample of 52 skulls. We found shared trends between species, such as the relative compression of the neurocranium and the enlargement of the rostrum during ontogeny. However, these are common mammalian features, associated with prenatal brain development and sensory capsules. Moreover, we found a posterior displacement of the external nares and infraorbital foramina, and a strong development of the rostrum in an anteroposterior direction. Such trends are associated with the process of telescoping and have been observed in postnatal ontogeny of other odontocetes, suggesting a constraint in the pattern. Interspecific differences related to the deepness of facial region, robustness of the feeding apparatus and rostrum orientation may be related with the specific lifestyles of L. obscurus and L. australis. We also tested the presence of three different modules in the skull (basicranium, neurocranium, rostrum), all of which presented strong integration. Only the rostrum showed a different ontogenetic trajectory between species. Even though we detected directional asymmetry, changes in this feature along ontogeny were not detectable. Because asymmetry may be related to echolocation, our results suggest a functional importance of directional asymmetry from the beginning of postnatal life. J. Morphol. 278:203-214, 2017. © 2016 Wiley Periodicals,Inc. © 2016 Wiley Periodicals, Inc.

  1. Surgical resection of a huge cemento-ossifying fibroma in skull base by intraoral approach.

    Science.gov (United States)

    Cheng, Xiao-Bing; Li, Yun-Peng; Lei, De-Lin; Li, Xiao-Dong; Tian, Lei

    2011-03-01

    Cemento-ossifying fibroma, also known as ossifying fibroma, usually occurs in the mandible and less commonly in the maxilla. The huge example in the skull base is even rare. We present a case of a huge cemento-ossifying fibroma arising below the skull base of a 30-year-old woman patient. Radiologic investigations showed a giant, lobulated, heterogeneous calcified hard tissue mass, which is well circumscribed and is a mixture of radiolucent and radiopaque, situated at the rear of the right maxilla to the middle skull base. The tumor expands into the right maxillary sinus and the orbital cavity, fusing with the right maxilla at the maxillary tuberosity and blocking the bilateral choanas, which caused marked proptosis and blurred vision. The tumor was resected successfully by intraoral approach, and pathologic examination confirmed the lesion to be a cemento-ossifying fibroma. This case demonstrates that cemento-ossifying fibroma in the maxilla, not like in the mandible, may appear more aggressive because the extensive growth is unimpeded by anatomic obstacles and that the intraoral approach can be used to excise the tumor in the skull base.

  2. The role of stereotactic radiosurgery in the treatment of malignant skull base tumors

    International Nuclear Information System (INIS)

    Miller, Robert C.; Foote, Robert L.; Coffey, Robert J.; Gorman, Deborah A.; Earle, John D.; Schomberg, Paula J.; Kline, Robert W.

    1997-01-01

    Purpose: To determine the efficacy and toxicity of stereotactic radiosurgery in the treatment of malignant skull base tumors. Methods and Materials: Thirty-two patients with 35 newly diagnosed or recurrent malignant skull base tumors ≤33.5 cm 3 were treated using the Leksell Gamma unit. Tumor histologies included: adenoid cystic carcinoma, basal cell carcinoma, chondrosarcoma, chordoma, nasopharyngeal carcinoma, osteogenic sarcoma, and squamous cell carcinoma. Results: After a median follow-up of 2.3 years, 83% ± 15% (±95% confidence interval) of patients experienced a symptomatic response to treatment. Local control at the skull base was 95 ± 9% at 2 years and 78 ± 23% at 3 years. Local-regional control above the clavicles was 75 ± 15% at 1 year and 51 ± 20% at 2 years. Overall and cause specific survival were identical, 82 ± 13% at 1 year, 76 ± 14% at 2 years, and 72 ± 16% at 3 years. One patient developed a radiation-induced optic neuropathy 12 months after radiosurgery. Conclusion: Stereotactic radiosurgery using the Leksell Gamma Unit can provide durable tumor control and symptomatic relief with acceptable toxicity in the majority of patients with malignant tumors 4 cm or less in size involving the skull base. Further evaluation of more patients with longer follow-up is warranted

  3. [Applicability of the da Vinci robotic system in the skull base surgical approach. Preclinical investigation].

    Science.gov (United States)

    Fernandez-Nogueras Jimenez, Francisco J; Segura Fernandez-Nogueras, Miguel; Jouma Katati, Majed; Arraez Sanchez, Miguel Ángel; Roda Murillo, Olga; Sánchez Montesinos, Indalecio

    2015-01-01

    The role of robotic surgery is well established in various specialties such as urology and general surgery, but not in others such as neurosurgery and otolaryngology. In the case of surgery of the skull base, it has just emerged from an experimental phase. To investigate possible applications of the da Vinci surgical robot in transoral skull base surgery, comparing it with the authors' experience using conventional endoscopic transnasal surgery in the same region. A transoral transpalatal approach to the nasopharynx and medial skull base was performed on 4 cryopreserved cadaver heads. We used the da Vinci robot, a 30° standard endoscope 12mm thick, dual camera and dual illumination, Maryland forceps on the left terminal and curved scissors on the right, both 8mm thick. Bone drilling was performed manually. For the anatomical study of this region, we used 0.5cm axial slices from a plastinated cadaver head. Various skull base structures at different depths were reached with relative ease with the robot terminals Transoral robotic surgery with the da Vinci system provides potential advantages over conventional endoscopic transnasal surgery in the surgical approach to this region. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  4. Influence of thickening of the inner skull table on intracranial volume measurement in older people.

    Science.gov (United States)

    Royle, N A; Hernández, M C Valdés; Maniega, S Muñoz; Arabisala, B S; Bastin, M E; Deary, I J; Wardlaw, J M

    2013-07-01

    It is generally assumed that intracranial volume (ICV) remains constant after peaking in early adulthood. Thus ICV is used as a 'proxy' for original brain size when trying to estimate brain atrophy in older people in neuroimaging studies. However, physiological changes in the skull, such as thickening of the frontal inner table, are relatively common in older age and will reduce ICV. The potential influence that inner table skull thickening may have on ICV measurement in old age has yet to be investigated. We selected 60 (31 males, 29 females) representative older adults aged 71.1-74.3years from a community-dwelling ageing cohort, the Lothian Birth Cohort 1936. A semi-automatically derived current ICV measurement obtained from high resolution T1-weighted volume scans was compared to the estimated original ICV by excluding inner skull table thickening using expert manual image processing. Inner table skull thickening reduced ICV from an estimated original 1480.0ml to a current 1409.1ml, a median decrease of 7.3% (Z=-6.334; pestimated original ICV is required for research into brain ageing. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Sinonasal outcomes following endoscopic anterior skull base surgery with nasoseptal flap reconstruction: a prospective study.

    Science.gov (United States)

    Hanson, M; Patel, P M; Betz, C; Olson, S; Panizza, B; Wallwork, B

    2015-07-01

    To assess nasal morbidity resulting from nasoseptal flap use in the repair of skull base defects in endoscopic anterior skull base surgery. Thirty-six patients awaiting endoscopic anterior skull base surgery were prospectively recruited. A nasoseptal flap was used for reconstruction in all cases. Patients were assessed pre-operatively and 90 days post-operatively via the Sino-Nasal Outcome Test 20 questionnaire and visual analogue scales for nasal obstruction, pain, secretions and smell; endoscopic examination findings and mucociliary clearance times were also recorded. Sino-Nasal Outcome Test 20 questionnaire data and visual analogue scale scores for pain, smell and secretions showed no significant differences between pre- and post-operative outcomes, with visual analogue scale scores for nasal obstruction actually showing a significant improvement (p = 0.0007). A significant deterioration for both flap and non-flap sides was demonstrated post-operatively on endoscopic examination (p = 0.002 and p = 0.02 respectively). Whilst elevation of a nasoseptal flap in endoscopic surgery of the anterior skull base engendered significant clinical deterioration on examination post-operatively, quality of life outcomes showed that no such deterioration was subjectively experienced by the patient. In fact, there was significant nasal airway improvement following nasoseptal flap reconstruction.

  6. Relationships between head fixation pins for radiosurgery and the skull bone. Usefulness of a torque wrench

    International Nuclear Information System (INIS)

    Toyota, Shun; Seta, Hidetoshi; Muramatsu, Masatoshi; Kubo, Hitoshi; Takeda, Kan

    2003-01-01

    In stereotactic radiosurgery (SRS), fixation devices are secured to the patient's head with pins. However, there have been no standards for the use of such pins, which must be inserted with appropriate torque based on the surgeon's clinical judgment. Therefore, the pins may sometimes be tightened excessively and penetrate too deeply into the patient's skull. To improve safety in SRS, a torque wrench was used for pin insertion. The usefulness of the torque wrench was then evaluated by examining the relationships between the pins and skull bone and identifying differences according to the wrench used and the patient's bone thickness. CT images of patients who had previously undergone SRS were used to assess the relationships between the pins and skull bone. Differences according to the wrench used and pin insertion site were investigated. Compared with a standard wrench, use of the torque wrench decreased the insertion depth of pins in the skull bone. In terms of site, pins in the forehead were inserted more deeply. No differences related to the frontal sinus were observed. The use of a torque wrench improved safety during pin insertion for SRS procedures. (author)

  7. A fiducial skull marker for precise MRI-based stereotaxic surgery in large animal models.

    Science.gov (United States)

    Glud, Andreas Nørgaard; Bech, Johannes; Tvilling, Laura; Zaer, Hamed; Orlowski, Dariusz; Fitting, Lise Moberg; Ziedler, Dora; Geneser, Michael; Sangill, Ryan; Alstrup, Aage Kristian Olsen; Bjarkam, Carsten Reidies; Sørensen, Jens Christian Hedemann

    2017-06-15

    Stereotaxic neurosurgery in large animals is used widely in different sophisticated models, where precision is becoming more crucial as desired anatomical target regions are becoming smaller. Individually calculated coordinates are necessary in large animal models with cortical and subcortical anatomical differences. We present a convenient method to make an MRI-visible skull fiducial for 3D MRI-based stereotaxic procedures in larger experimental animals. Plastic screws were filled with either copper-sulfate solution or MRI-visible paste from a commercially available cranial head marker. The screw fiducials were inserted in the animal skulls and T1 weighted MRI was performed allowing identification of the inserted skull marker. Both types of fiducial markers were clearly visible on the MRÍs. This allows high precision in the stereotaxic space. The use of skull bone based fiducial markers gives high precision for both targeting and evaluation of stereotaxic systems. There are no metal artifacts and the fiducial is easily removed after surgery. The fiducial marker can be used as a very precise reference point, either for direct targeting or in evaluation of other stereotaxic systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Rare case of solitary plasmacytoma of the skull in a young male ...

    African Journals Online (AJOL)

    2017-04-21

    Apr 21, 2017 ... SA Journal of Radiology ... X-rays of the skull showed a well-defined lytic lesion in the left parietal bone with an associated large soft ... it in the differential diagnosis of a destructive calvarial mass lesion even in this age group.

  9. Cranial Suture Closure in Domestic Dog Breeds and Its Relationships to Skull Morphology.

    Science.gov (United States)

    Geiger, Madeleine; Haussman, Sinah

    2016-04-01

    Bulldog-type brachycephalic domestic dog breeds are characterized by a relatively short and broad skull with a dorsally rotated rostrum (airorhynchy). Not much is known about the association between a bulldog-type skull conformation and peculiar patterns of suture and synchondrosis closure in domestic dogs. In this study, we aim to explore breed-specific patterns of cranial suture and synchondrosis closure in relation to the prebasial angle (proxy for airorhynchy and thus bulldog-type skull conformation) in domestic dogs. For this purpose, we coded closure of 18 sutures and synchondroses in 26 wolves, that is, the wild ancestor of all domestic dogs, and 134 domestic dogs comprising 11 breeds. Comparisons of the relative amount of closing and closed sutures and synchondroses (closure scores) in adult individuals showed that bulldog-type breeds have significantly higher closure scores than non-bulldog-type breeds and that domestic dogs have significantly higher closure scores than the wolf. We further found that the prebasial angle is significantly positively correlated with the amount of closure of the basispheno-presphenoid synchondrosis and sutures of the nose (premaxillo-nasal and maxillo-nasal) and the palate (premaxillo-maxillary and interpalatine). Our results show that there is a correlation between patterns of suture and synchondrosis closure and skull shape in domestic dogs, although the causal relationships remain elusive. © 2016 Wiley Periodicals, Inc.

  10. The use of the eyes protection for dose reduction in CT scans of skull

    International Nuclear Information System (INIS)

    Mourao, Arnaldo P.; Silva, Teogenes A.; Alonso, Thessa C.

    2013-01-01

    The technique for imaging the brain scans of the skull by computed tomography (CT) scanning is the volume bounded by the foramen magnum and the apex of the skull. The lenses are radiosensitive tissues and CT scans of the head deposited significant doses on them, since they are in the region of incidence of the primary beam of X-rays. Thus, the variation of the dose deposited in the crystalline skull CT scans for diagnostic imaging of the brain was investigated. Cranial scans were performed using the acquisition protocol routine with or without the use of bismuth to shield the eyes. To carry out the scans we used a male anthropomorphic phantom, Alderson Rando model and dosimeters (TLD-100) were used to record the doses. These TLDs were used to record specific doses internally to the phantom in specific organs (crystalline, pituitary, thyroid, spinal cord and breasts). The scans were performed on a GE machine, model 64 Discovery channels. The data obtained allowed to observe the variation of dose in organs. The highest dose was recorded in the lens (26,18 mGy), followed by spinal cord (17,79 mGy). Comparing the doses of the two scans it was significant variation in the crystal. Scan using bismuth shield generated smaller doses in the eyes and in the eyes occurred the higher dose reduction, about 37%. The results may contribute to spread a suitable procedure for the optimization of CT scans of the skull

  11. Skull base tumors: a comprehensive review of transfacial swing osteotomy approaches.

    Science.gov (United States)

    Moreira-Gonzalez, Andrea; Pieper, Daniel R; Cambra, Jorge Balaguer; Simman, Richard; Jackson, Ian T

    2005-03-01

    Numerous techniques have been proposed for the resection of skull base tumors, each one unique with regard to the region exposed and degree of technical complexity. This study describes the use of transfacial swing osteotomies in accessing lesions located at various levels of the cranial base. Eight patients who underwent transfacial swings for exposure and resection of cranial base lesions between 1996 and 2002 were studied. The mandible was the choice when wide exposure of nasopharyngeal and midline skull base tumors was necessary, especially when they involved the infratemporal fossa. The midfacial swing osteotomy was an option when access to the entire clivus was necessary. An orbital swing approach was used to access large orbital tumors lying inferior to the optic nerve and posterior to the globe, a region that is often difficult to visualize. Gross total tumor excision was possible in all patients. Six patients achieved disease control and two had recurrences. The complications of cerebrospinal fluid leak, infection, hematoma, or cranial nerve damage did not occur. After surgery, some patients experienced temporary symptoms caused by local swelling. The aesthetic result was considered good. Transfacial swing osteotomies provide a wide exposure to tumors that occur in the central skull base area. Excellent knowledge of the detailed anatomy of this region is paramount to the success of this surgery. The team concept is essential; it is built around the craniofacial surgeon and an experienced skull base neurosurgeon.

  12. Skull traction for cervical spinal injury in Enugu: A 5‑year ...

    African Journals Online (AJOL)

    2015-11-05

    Nov 5, 2015 ... Background: Treatment of cervical spine injury is the most challenging of all the injuries of the spine, and there is yet no agreement on the best method of care. Objective: We studied the complications and outcome of two skull traction devices used to treat cases of cervical spine injury in three centers in ...

  13. Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement

    International Nuclear Information System (INIS)

    Droege, L.H.; Hinsche, T.; Hess, C.F.; Wolff, H.A.; Canis, M.; Alt-Epping, B.

    2014-01-01

    Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting. (orig.)

  14. Cranial nerve palsies in metastatic prostate cancer--results of base of skull radiotherapy

    International Nuclear Information System (INIS)

    O'Sullivan, Joe M.; Norman, Andrew R.; McNair, Helen; Dearnaley, David P.

    2004-01-01

    We studied the rate of response to palliative external beam radiation therapy (20 Gy/5 or 30 Gy/10 fractions) to the base of skull in 32 prostate cancer patients with cranial nerve dysfunction. Sixteen patients (50%; 95% CI, 34-66%) had a useful response to therapy. The median survival post-therapy was 3 months

  15. Preoperative Visualization of Cranial Nerves in Skull Base Tumor Surgery Using Diffusion Tensor Imaging Technology.

    Science.gov (United States)

    Ma, Jun; Su, Shaobo; Yue, Shuyuan; Zhao, Yan; Li, Yonggang; Chen, Xiaochen; Ma, Hui

    2016-01-01

    To visualize cranial nerves (CNs) using diffusion tensor imaging (DTI) with special parameters. This study also involved the evaluation of preoperative estimates and intraoperative confirmation of the relationship between nerves and tumor by verifying the accuracy of visualization. 3T magnetic resonance imaging scans including 3D-FSPGR, FIESTA, and DTI were used to collect information from 18 patients with skull base tumor. DTI data were integrated into the 3D slicer for fiber tracking and overlapped anatomic images to determine course of nerves. 3D reconstruction of tumors was achieved to perform neighboring, encasing, and invading relationship between lesion and nerves. Optic pathway including the optic chiasm could be traced in cases of tuberculum sellae meningioma and hypophysoma (pituitary tumor). The oculomotor nerve, from the interpeduncular fossa out of the brain stem to supraorbital fissure, was clearly visible in parasellar meningioma cases. Meanwhile, cisternal parts of trigeminal nerve and abducens nerve, facial nerve were also imaged well in vestibular schwannomas and petroclival meningioma cases. The 3D-spatial relationship between CNs and skull base tumor estimated preoperatively by tumor modeling and tractography corresponded to the results determined during surgery. Supported by DTI and 3D slicer, preoperative 3D reconstruction of most CNs related to skull base tumor is feasible in pathological circumstances. We consider DTI Technology to be a useful tool for predicting the course and location of most CNs, and syntopy between them and skull base tumor.

  16. Patients cured of acromegaly do not experience improvement of their skull deformities.

    Science.gov (United States)

    Rick, Jonathan W; Jahangiri, Arman; Flanigan, Patrick M; Aghi, Manish K

    2017-04-01

    Acromegaly is a rare disease that is associated with many co-morbidities. This condition also causes progressive deformity of the skull which includes frontal bossing and cranial thickening. Surgical and/or medical management can cure this condition in many patients, but it is not understood if patients cured of acromegaly experience regression of their skull deformities. We performed a retrospective analysis on patients treated at our dedicated pituitary center from 2009 to 2014. We looked at all MRI images taken during the treatment of these patients and recorded measurements on eight skull dimensions. We then analyzed these measurements for changes over time. 29 patients underwent curative treatment for acromegaly within our timeframe. The mean age for this population was 45.0 years old (range 19-70) and 55.2 % (n = 16) were female. All of these patients were treated with a transsphenoidal resection for a somatotropic pituitary adenoma. 9 (31.1%) of these patients required further medical therapy to be cured. We found statically significant variation in the coronal width of the sella turcica after therapy, which is likely attributable to changes from transsphenoidal surgery. None of the other dimensions had significant variation over time after cure. Patients cured of acromegaly should not expect natural regression of their skull deformities. Our study suggests that both frontal bossing and cranial thickening do not return to normal after cure.

  17. Visual outcome after fractionated stereotactic radiation therapy of benign anterior skull base tumors

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Wiencke, Anne Katrine; Munck af Rosenschold, Per

    2014-01-01

    To determine visual outcome including the occurrence of radiation induced optic neuropathy (RION) as well as tumor control after fractionated stereotactic radiation therapy (FSRT) of benign anterior skull base meningiomas or pituitary adenomas. Thirty-nine patients treated with FSRT for anterior...

  18. Chemical characteristics and antithrombotic effect of chondroitin sulfates from sturgeon skull and sturgeon backbone.

    Science.gov (United States)

    Gui, Meng; Song, Juyi; Zhang, Lu; Wang, Shun; Wu, Ruiyun; Ma, Changwei; Li, Pinglan

    2015-06-05

    Chondroitin sulfates (CSs) were extracted from sturgeon skull and backbone, and their chemical composition, anticoagulant, anti-platelet and thrombolysis activities were evaluated. The average molecular weights of CS from sturgeon skull and backbone were 38.5kDa and 49.2kDa, respectively. Disaccharide analysis indicated that the sturgeon backbone CS was primarily composed of disaccharide monosulfated in position four of the GalNAc (37.8%) and disaccharide monosulfated in position six of the GalNAc (59.6%) while sturgeon skull CS was primarily composed of nonsulfated disaccharide (74.2%). Sturgeon backbone CS showed stronger antithrombotic effect than sturgeon skull CS. Sturgeon backbone CS could significantly prolong activated partial thromboplastin time (APTT) and thrombin time (TT), inhibited ADP-induced platelet aggregation and dissolved platelet plasma clots in vitro. The results suggested that sturgeon backbone CS can be explored as a functional food with antithrombotic function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Developmental Toxicity Studies with Pregabalin in Rats: Significance of Alterations in Skull Bone Morphology.

    Science.gov (United States)

    Morse, Dennis C; Henck, Judith W; Bailey, Steven A

    2016-04-01

    Pregabalin was administered to pregnant Wistar rats during organogenesis to evaluate potential developmental toxicity. In an embryo-fetal development study, compared with controls, fetuses from pregabalin-treated rats exhibited increased incidence of jugal fused to maxilla (pregabalin 1250 and 2500 mg/kg) and fusion of the nasal sutures (pregabalin 2500 mg/kg). The alterations in skull development occurred in the presence of maternal toxicity (reduced body weight gain) and developmental toxicity (reduced fetal body weight and increased skeletal variations), and were initially classified as malformations. Subsequent investigative studies in pregnant rats treated with pregabalin during organogenesis confirmed the advanced jugal fused to maxilla, and fusion of the nasal sutures at cesarean section (gestation day/postmating day [PMD] 21) in pregabalin-treated groups. In a study designed to evaluate progression of skull development, advanced jugal fused to maxilla and fusion of the nasal sutures was observed on PMD 20-25 and PMD 21-23, respectively (birth occurs approximately on PMD 22). On postnatal day (PND) 21, complete jugal fused to maxilla was observed in the majority of control and 2500 mg/kg offspring. No treatment-related differences in the incidence of skull bone fusions occurred on PND 21, indicating no permanent adverse outcome. Based on the results of the investigative studies, and a review of historical data and scientific literature, the advanced skull bone fusions were reclassified as anatomic variations. Pregabalin was not teratogenic in rats under the conditions of these studies. © 2016 Wiley Periodicals, Inc.

  20. Management of Anterior Skull Base Defect Depending on Its Size and Location

    Science.gov (United States)

    Bernal-Sprekelsen, Manuel; Rioja, Elena; Enseñat, Joaquim; Enriquez, Karla; Viscovich, Liza; Agredo-Lemos, Freddy Enrique; Alobid, Isam

    2014-01-01

    Introduction. We present our experience in the reconstruction of these leaks depending on their size and location. Material and Methods. Fifty-four patients who underwent advanced skull base surgery (large defects, >20 mm) and 62 patients with CSF leaks of different origin (small, 2–10 mm, and midsize, 11–20 mm, defects) were included in the retrospective study. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata. In small and midsized leaks. Fascia lata in an underlay position was used for its reconstruction covered with mucoperiosteum of either the middle or the inferior turbinate. Results. The most frequent etiology for small and midsized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%). The success rate after the first surgical reconstruction was 91% and 98% in large skull base defects and small/midsized, respectively. Rescue surgery achieved 100%. Conclusions. Endoscopic surgery for any type of skull base defect is the gold standard. The size of the defects does not seem to play a significant role in the success rate. Fascia lata and mucoperiosteum of the turbinate allow a two-layer reconstruction of small and midsized defects. For larger skull base defects, a combination of fat, fascia lata, and nasoseptal pedicled flaps provides a successful reconstruction. PMID:24895567

  1. Postnatal brain and skull growth in an Apert syndrome mouse model

    Science.gov (United States)

    Hill, Cheryl A.; Martínez-Abadías, Neus; Motch, Susan M.; Austin, Jordan R.; Wang, Yingli; Jabs, Ethylin Wang; Richtsmeier, Joan T.; Aldridge, Kristina

    2012-01-01

    Craniofacial and neural tissues develop in concert throughout pre- and postnatal growth. FGFR-related craniosynostosis syndromes, such as Apert syndrome (AS), are associated with specific phenotypes involving both the skull and the brain. We analyzed the effects of the FGFR P253R mutation for Apert syndrome using the Fgfr2+/P253R mouse to evaluate the effects of this mutation on these two tissues over the course of development from day of birth (P0) to postnatal day 2 (P2). Three-dimensional magnetic resonance microscopy and computed tomography images were acquired from Fgfr2+/P253R mice and unaffected littermates at P0 (N=28) and P2 (N=23). 3D coordinate data for 23 skull and 15 brain landmarks were statistically compared between groups. Results demonstrate that the Fgfr2+/P253R mice show reduced growth in the facial skeleton and the cerebrum, while the height and width of the neurocranium and caudal regions of the brain show increased growth relative to unaffected littermates. This localized correspondence of differential growth patterns in skull and brain point to their continued interaction through development and suggest that both tissues display divergent postnatal growth patterns relative to unaffected littermates. However, the change in the skull-brain relationship from P0 to P2 implies that each tissue affected by the mutation retains a degree of independence, rather than one tissue directing the development of the other. PMID:23495236

  2. Intraoperative Magnetic Resonance Imaging in Skull Base Surgery: A Review of 71 Consecutive Cases.

    Science.gov (United States)

    Ashour, Ramsey; Reintjes, Stephen; Park, Michael S; Sivakanthan, Sananthan; van Loveren, Harry; Agazzi, Siviero

    2016-09-01

    Although intraoperative magnetic resonance imaging (iMRI) increasingly is used during glioma resection, its role in skull base surgery has not been well documented. In this study, we evaluate our experience with iMRI for skull base surgery. Medical records were reviewed retrospectively on all neurosurgical cases performed at our institution in the IMRIS iMRI suite between April 2014 and July 2015. During the study period, the iMRI suite was used for 71 skull base tumors. iMRI was performed in 23 of 71 cases. Additional tumor resection was pursued after scanning in 7 of 23 patients. There was a significant difference in procedure length between the scanned versus nonscanned groups, and this was likely attributable to a greater proportion of petroclival meningiomas in the scanned group. Further analyses revealed significant increases in procedure length for the following scanned subgroups: anterolateral approach, anterolateral and petroclival lesion locations, and meningiomas. The rate of non-neurologic complications was significantly greater in the scanned group, particularly for patients with tumors >3 cm. Despite the unique challenges associated with skull base tumor surgery, iMRI can be safely obtained while adding a modest although not prohibitive amount of time to the procedure. The immediate evidence of residual tumor with a patient still in position to have additional resection may influence the surgeon to alter the surgical plan and attempt further resection in a critical area. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Treatment of midfacial fractures

    International Nuclear Information System (INIS)

    Schubert, J.

    2007-01-01

    Fractures of the midface constitute half of all traumas involving facial bones. Computed tomography is very useful in primary diagnosis. Isolated fractures of the nasal bone and lateral midfacial structures may be diagnosed sufficiently by conventional X-rays. An exact description of the fracture lines along the midfacial buttresses is essential for treatment planning. For good aesthetics and function these have to be reconstructed accurately, which can be checked with X-rays. The treatment of midfacial fractures has been revolutionized over the last two decades. A stable three-dimensional reconstruction of the facial shape is now possible and the duration of treatment has shortened remarkably. The frequently occurring isolated fractures in the lateral part of the midface may be treated easily and effectively by semisurgical methods such as the Gillies procedure or hook-repositioning. (orig.)

  4. Dating fractures in infants

    Energy Technology Data Exchange (ETDEWEB)

    Halliday, K.E., E-mail: kath.halliday@nuh.nhs.uk [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Broderick, N J; Somers, J M [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Hawkes, R [Department of Radiology, Paul O' Gorman Building, Bristol (United Kingdom)

    2011-11-15

    Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.

  5. Dating fractures in infants

    International Nuclear Information System (INIS)

    Halliday, K.E.; Broderick, N.J.; Somers, J.M.; Hawkes, R.

    2011-01-01

    Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.

  6. Tibial Plateau Fractures

    DEFF Research Database (Denmark)

    Elsøe, Rasmus

    This PhD thesis reported an incidence of tibial plateau fractures of 10.3/100,000/year in a complete Danish regional population. The results reported that patients treated for a lateral tibial plateau fracture with bone tamp reduction and percutaneous screw fixation achieved a satisfactory level...... with only the subgroup Sport significantly below the age matched reference population. The thesis reports a level of health related quality of life (Eq5d) and disability (KOOS) significantly below established reference populations for patients with bicondylar tibial plateau fracture treated with a ring...... fixator, both during treatment and at 19 months following injury. In general, the thesis demonstrates that the treatment of tibial plateau fractures are challenging and that some disabilities following these fractures must be expected. Moreover, the need for further research in the area, both with regard...

  7. Fracturing formations in wells

    Energy Technology Data Exchange (ETDEWEB)

    Daroza, R A

    1964-05-15

    This well stimulation method comprises introducing through the well bore a low-penetrating, dilatant fluid, and subjecting the fluid to sufficient pressure to produce fractures in the formation. The fluid is permitted to remain in contact with the formation so as to become diluted by the formation fluids, and thereby lose its properties of dilatancy. Also, a penetrating fluid, containing a propping agent suspended therein, in introduced into contact with the fractures at a pressure substantially reduced with respect to that pressure which would have been required, prior to the fracturing operation performed using the low-penetrating dilatant fluid. The propping agent is deposited within the fractures, and thereafter, fluid production is resumed from the fractured formation. (2 claims)

  8. Skull deformations in craniosynostosis and endocrine disorders: morphological and tomographic analysis of the skull from the crypt of the Silesian Piasts in Brzeg (16th-17th century), Poland.

    Science.gov (United States)

    Kozłowski, T; Cybulska, M; Błaszczyk, B; Krajewska, M; Jeśman, C

    2014-10-01

    of morphological and tomographic (CT) studies of the skull that was found in the crypt of the Silesian Piasts in the St. Jadwiga church in Brzeg (Silesia, Poland) are presented and discussed here. The established date of burial of probably a 20-30 years old male was 16th-17th century. The analyzed skull showed premature obliteration of the major skull sutures. It resulted in the braincase deformation, similar to the forms found in oxycephaly and microcephaly. Tomographic analysis revealed gross pathology. Signs of increased intracranial pressure, basilar invagination and hypoplasia of the occipital bone were observed. Those results suggested the occurrence of the very rare Arnold-Chiari syndrome. Lesions found in the sella turcica indicated the development of pituitary macroadenoma, which resulted in the occurrence of discreet features of acromegaly in the facial bones. The studied skull was characterized by a significantly smaller size of the neurocranium (horizontal circumference 471 mm, cranial capacity ∼ 1080 ml) and strongly expressed brachycephaly (cranial index=86.3), while its height remained within the range for non-deformed skulls. A narrow face, high eye-sockets and prognathism were also observed. Signs of alveolar process hypertrophy with rotation and displacement of the teeth were noted. The skull showed significant morphological differences compared to both normal and other pathological skulls such as those with pituitary gigantism, scaphocephaly and microcephaly. Copyright © 2014 Elsevier GmbH. All rights reserved.

  9. Comparative skull analysis suggests species-specific captivity-related malformation in lions (Panthera leo).

    Science.gov (United States)

    Saragusty, Joseph; Shavit-Meyrav, Anat; Yamaguchi, Nobuyuki; Nadler, Rona; Bdolah-Abram, Tali; Gibeon, Laura; Hildebrandt, Thomas B; Shamir, Merav H

    2014-01-01

    Lion (Panthera leo) populations have dramatically decreased worldwide with a surviving population estimated at 32,000 across the African savannah. Lions have been kept in captivity for centuries and, although they reproduce well, high rates of stillbirths as well as morbidity and mortality of neonate and young lions are reported. Many of these cases are associated with bone malformations, including foramen magnum (FM) stenosis and thickened tentorium cerebelli. The precise causes of these malformations and whether they are unique to captive lions remain unclear. To test whether captivity is associated with FM stenosis, we evaluated 575 lion skulls of wild (N = 512) and captive (N = 63) origin. Tiger skulls (N = 276; 56 captive, 220 wild) were measured for comparison. While no differences were found between males and females or between subadults and adults in FM height (FMH), FMH of captive lions (17.36±3.20 mm) was significantly smaller and with greater variability when compared to that in wild lions (19.77±2.11 mm). There was no difference between wild (18.47±1.26 mm) and captive (18.56±1.64 mm) tigers in FMH. Birth origin (wild vs. captive) as a factor for FMH remained significant in lions even after controlling for age and sex. Whereas only 20/473 wild lions (4.2%) had FMH equal to or smaller than the 5th percentile of the wild population (16.60 mm), this was evident in 40.4% (23/57) of captive lion skulls. Similar comparison for tigers found no differences between the captive and wild populations. Lions with FMH equal to or smaller than the 5th percentile had wider skulls with smaller cranial volume. Cranial volume remained smaller in both male and female captive lions when controlled for skull size. These findings suggest species- and captivity-related predisposition for the pathology in lions.

  10. Reconstruction for Skull Base Defect Using Fat-Containing Perifascial Areolar Tissue.

    Science.gov (United States)

    Choi, Woo Young; Sung, Ki Wook; Kim, Young Seok; Hong, Jong Won; Roh, Tai Suk; Lew, Dae Hyun; Chang, Jong Hee; Lee, Kyu Sung

    2017-06-01

    Skull base reconstruction is a challenging task. The method depends on the anatomical complexity and size of the defect. We obtained tissue by harvesting fat-containing perifascial areolar tissue (PAT) for reconstruction of limited skull base defects and volume augmentation. We demonstrated the effective option for reconstruction of limited skull base defects and volume augmentation. From October 2013 to November 2015, 5 patients underwent operations using fat-containing PAT to fill the defect in skull base and/or perform volume replacement in the forehead. Perifascial areolar tissue with 5- to 10-mm fat thickness was harvested from the inguinal region. The fat-containing PAT was grafted to the defect contacting the vascularized wound bed. Patients were followed up in terms of their clinical symptoms and postoperative magnetic resonance imaging findings. Four patients were treated using fat-containing PAT after tumor resection. One patient was treated for a posttraumatic forehead depression deformity. The fat-containing PAT included 5- to 9-mm fat thickness in all cases. The mean size of grafted PAT was 65.6 cm (28-140 cm). The mean follow-up period was 18.6 months (12-31 months). There was no notable complication. There was no donor site morbidity. We can harvest PAT with fat easily and obtain the sufficient volume to treat the defect. It also could be used with other reconstructive method, such as a free flap or a regional flap to fill the left dead space. Therefore, fat-containing PAT could be additional options to reconstruction of skull base defect.

  11. 3D shape recovery of a newborn skull using thin-plate splines.

    Science.gov (United States)

    Lapeer, R J; Prager, R W

    2000-01-01

    The objective of this paper is to construct a mesh-model of a newborn skull for finite element analysis to study its deformation when subjected to the forces present during labour. The current state of medical imaging technology has reached a level which allows accurate visualisation and shape recovery of biological organs and body-parts. However, a sufficiently large set of medical images cannot always be obtained, often because of practical or ethical reasons, and the requirement to recover the shape of the biological object of interest has to be met by other means. Such is the case for a newborn skull. A method to recover the three-dimensional (3D) shape from (minimum) two orthogonal atlas images of the object of interest and a homologous object is described. This method is based on matching landmarks and curves on the orthogonal images of the object of interest with corresponding landmarks and curves on the homologous or 'master'-object which is fully defined in 3D space. On the basis of this set of corresponding landmarks, a thin-plate spline function can be derived to warp from the 'master'-object space to the 'slave'-object space. This method is applied to recover the 3D shape of a newborn skull. Images from orthogonal view-planes are obtained from an atlas. The homologous object is an adult skull, obtained from CT-images made available by the Visible Human Project. After shape recovery, a mesh-model of the newborn skull is generated.

  12. Comparative skull analysis suggests species-specific captivity-related malformation in lions (Panthera leo.

    Directory of Open Access Journals (Sweden)

    Joseph Saragusty

    Full Text Available Lion (Panthera leo populations have dramatically decreased worldwide with a surviving population estimated at 32,000 across the African savannah. Lions have been kept in captivity for centuries and, although they reproduce well, high rates of stillbirths as well as morbidity and mortality of neonate and young lions are reported. Many of these cases are associated with bone malformations, including foramen magnum (FM stenosis and thickened tentorium cerebelli. The precise causes of these malformations and whether they are unique to captive lions remain unclear. To test whether captivity is associated with FM stenosis, we evaluated 575 lion skulls of wild (N = 512 and captive (N = 63 origin. Tiger skulls (N = 276; 56 captive, 220 wild were measured for comparison. While no differences were found between males and females or between subadults and adults in FM height (FMH, FMH of captive lions (17.36±3.20 mm was significantly smaller and with greater variability when compared to that in wild lions (19.77±2.11 mm. There was no difference between wild (18.47±1.26 mm and captive (18.56±1.64 mm tigers in FMH. Birth origin (wild vs. captive as a factor for FMH remained significant in lions even after controlling for age and sex. Whereas only 20/473 wild lions (4.2% had FMH equal to or smaller than the 5th percentile of the wild population (16.60 mm, this was evident in 40.4% (23/57 of captive lion skulls. Similar comparison for tigers found no differences between the captive and wild populations. Lions with FMH equal to or smaller than the 5th percentile had wider skulls with smaller cranial volume. Cranial volume remained smaller in both male and female captive lions when controlled for skull size. These findings suggest species- and captivity-related predisposition for the pathology in lions.

  13. Dog behavior co-varies with height, bodyweight and skull shape.

    Science.gov (United States)

    McGreevy, Paul D; Georgevsky, Dana; Carrasco, Johanna; Valenzuela, Michael; Duffy, Deborah L; Serpell, James A

    2013-01-01

    Dogs offer unique opportunities to study correlations between morphology and behavior because skull shapes and body shape are so diverse among breeds. Several studies have shown relationships between canine cephalic index (CI: the ratio of skull width to skull length) and neural architecture. Data on the CI of adult, show-quality dogs (six males and six females) were sourced in Australia along with existing data on the breeds' height, bodyweight and related to data on 36 behavioral traits of companion dogs (n = 8,301) of various common breeds (n = 49) collected internationally using the Canine Behavioral Assessment and Research Questionnaire (C-BARQ). Stepwise backward elimination regressions revealed that, across the breeds, 33 behavioral traits all but one of which are undesirable in companion animals correlated with either height alone (n = 14), bodyweight alone (n = 5), CI alone (n = 3), bodyweight-and-skull shape combined (n = 2), height-and-skull shape combined (n = 3) or height-and-bodyweight combined (n = 6). For example, breed average height showed strongly significant inverse relationships (psensitivity, urination when left alone, dog-directed fear, separation-related problems, non-social fear, defecation when left alone, owner-directed aggression, begging for food, urine marking and attachment/attention-seeking, while bodyweight showed strongly significant inverse relationships (p<0.001) with excitability and being reported as hyperactive. Apart from trainability, all regression coefficients with height were negative indicating that, across the breeds, behavior becomes more problematic as height decreases. Allogrooming increased strongly (p<0.001) with CI and inversely with height. CI alone showed a strong significant positive relationship with self-grooming (p<0.001) but a negative relationship with chasing (p = 0.020). The current study demonstrates how aspects of CI (and therefore brain shape), bodyweight and height co-vary with behavior. The

  14. Postnatal development of the anterior skull base and nasal septum: CT study

    International Nuclear Information System (INIS)

    Kim, Kwan Soo; Kim, Hyung Jin; Lee, Kyung Hee; Roh, Hong Gee; Lim, Myung Kwan

    2002-01-01

    To know the normal CT appearance of the anterior skull base and nasal septum after birth. Coronal CT scans with a helical mode were performed from the nasal bone to the sphenoid sinus in 99 children whose ages ranged from 27 days to 14 years. We investigated the CT appearance of the developing anterior skull base and nasal septum with particular attention to the anteroposterior length of the anterior skull base and the ossification patterns of the cribriform plate, perpendicular plate, crista galli, and vomer. The anteroposterior length of the anterior skull base statistically significantly increased with age. The cribriform plate showed partial or complete ossification in at least one segment at more than 3 months of age and in all three segments at more than 6 months of age. Ossification of the cribriform plate occurred earlier in the middle segment than in the anterior and posterior segments. It began exclusively in the region of the lateral mass of the ethmoid and proceeded medially toward the crista galli. Partial ossification of the perpendicular plate was noted as early as 9 months of age, and complete ossification as early as 13 months of age. All children at 18 months and older showed at least partial ossification of the perpendicular plate. Partial ossification of the crista galli was noted as early as 27 days of age, and complete ossification as early as 3 months of age. CT showed complete ossification of the crista galli in all but two children at 6 months and older. The superior aspect of the vomer exhibited a V- or Y-shape on all CT scans in 66%(65/99) of children at any age. It appeared as an undivided single lump anteriorly and a V or Y posteriorly in 34%(34/99). Knowledge of the normal developing patterns of ossification of the anterior skull base and nasal septum could help prevent errors in interpreting CT scans in this region, especially in infants and young children

  15. A discussion of current issues and concepts in the practice of skull-photo/craniofacial superimposition.

    Science.gov (United States)

    Gordon, G M; Steyn, M

    2016-05-01

    A recent review paper on cranio-facial superimposition (CFS) stated that "there have been specific conceptual variances" from the original methods used in the practice of skull-photo superimposition, leading to poor results as far as accuracy is concerned. It was argued that the deviations in the practice of the technique have resulted in the reduced accuracies (for both failure to include and failure to exclude) that are noted in several recent studies. This paper aims to present the results from recent research to highlight the advancement of skull-photo/cranio-facial superimposition, and to discuss some of the issues raised regarding deviations from original techniques. The evolving methodology of CFS is clarified in context with the advancement of technology, forensic science and specifically within the field of forensic anthropology. Developments in the skull-photo/cranio-facial superimposition techniques have largely focused on testing reliability and accuracy objectively. Techniques now being employed by forensic anthropologists must conform to rigorous scientific testing and methodologies. Skull-photo/cranio-facial superimposition is constantly undergoing accuracy and repeatability testing which is in line with the principles of the scientific method and additionally allows for advancement in the field. Much of the research has indicated that CFS is useful in exclusion which is consistent with the concept of Popperian falsifiability - a hypothesis and experimental design which is falsifiable. As the hypothesis is disproved or falsified, another evolves to replace it and explain the new observations. Current and future studies employing different methods to test the accuracy and reliability of skull-photo/cranio-facial superimposition will enable researchers to establish the contribution the technique can have for identification purposes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Potential effect of skull thickening on the associations between cognition and brain atrophy in ageing.

    Science.gov (United States)

    Aribisala, Benjamin Segun; Royle, Natalie A; Valdés Hernández, Maria C; Murray, Catherine; Penke, Lars; Gow, Alan; Maniega, Susana Muñoz; Starr, John M; Bastin, Mark; Deary, Ian; Wardlaw, Joanna

    2014-09-01

    intracranial volume (ICV) is commonly used as a marker of premorbid brain size in neuroimaging studies as it is thought to remain fixed throughout adulthood. However, inner skull table thickening would encroach on ICV and could mask actual brain atrophy. we investigated the effect that thickening might have on the associations between brain atrophy and cognition. the sample comprised 57 non-demented older adults who underwent structural brain MRI at mean age 72.7 ± 0.7 years and were assessed on cognitive ability at mean age 11 and 73 years. Principal component analysis was used to derive factors of general cognitive ability (g), information processing speed and memory from the recorded cognitive ability data. The total brain tissue volume and ICV with (estimated original ICV) and without (current ICV) adjusting for the effects of inner table skull thickening were measured. General linear modelling was used to test for associations. all cognitive ability variables were significantly (P skull thickening (g: η(2) = 0.177, speed: η(2) = 0.264 and memory: η(2) = 0.132). After accounting for skull thickening, only speed was significantly associated with percentage total brain volume in ICV (η(2) = 0.085, P = 0.034), not g or memory. not accounting for skull thickening when computing ICV can distort the association between brain atrophy and cognitive ability in old age. Larger samples are required to determine the true effect. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Which radiological investigations should be performed to identify fractures in suspected child abuse?

    International Nuclear Information System (INIS)

    Kemp, A.M.; Butler, A.; Morris, S.; Mann, M.; Kemp, K.W.; Rolfe, K.; Sibert, J.R.; Maguire, S.

    2006-01-01

    Aims: To determine which radiological investigations should be performed and which children should be investigated. Materials and methods: An all language literature search of original articles; from 1950-October 2005. Two reviewers independently reviewed each article. A third was carried out on disagreement. Each study was assessed using standardised data extraction, critical appraisal and evidence forms. Results: Thirty-four studies were included. Fifteen addressed the question: which investigation has a higher yield, skeletal surveys (SS) or bone scintigraphy (BS)? Studies gave conflicting results. Overall neither investigation is as good as the two combined. BS predominately missed skull, metaphyseal and epiphyseal fractures, whereas SS commonly missed rib fractures. Two studies showed that a repeat SS 2 weeks after the initial study provided significant additional information about tentative findings, the number and age of fractures. A comparative study evaluated additional oblique views of ribs in 73 children and showed improved diagnostic sensitivity, specificity and accuracy. Four studies addressed the diagnostic yield for occult fractures with respect to age. This was significant for children under 2-years old. Conclusions: In children under 2-years old, where physical abuse is suspected, diagnostic imaging of the skeleton should be mandatory. SS or BS alone is inadequate to identify all fractures. It is recommended that all SS should include oblique views of the ribs. This review suggests that the following options would optimize the diagnostic yield. However, each needs to be evaluated prospectively: SS that includes oblique views, SS and BS, a SS with repeat SS or selected images 2 weeks later or a BS plus skull radiography and coned views of metaphyses and epiphyses

  18. Which radiological investigations should be performed to identify fractures in suspected child abuse?

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, A.M.; Butler, A.; Morris, S.; Mann, M.; Kemp, K.W.; Rolfe, K.; Sibert, J.R.; Maguire, S

    2006-09-15

    Aims: To determine which radiological investigations should be performed and which children should be investigated. Materials and methods: An all language literature search of original articles; from 1950-October 2005. Two reviewers independently reviewed each article. A third was carried out on disagreement. Each study was assessed using standardised data extraction, critical appraisal and evidence forms. Results: Thirty-four studies were included. Fifteen addressed the question: which investigation has a higher yield, skeletal surveys (SS) or bone scintigraphy (BS)? Studies gave conflicting results. Overall neither investigation is as good as the two combined. BS predominately missed skull, metaphyseal and epiphyseal fractures, whereas SS commonly missed rib fractures. Two studies showed that a repeat SS 2 weeks after the initial study provided significant additional information about tentative findings, the number and age of fractures. A comparative study evaluated additional oblique views of ribs in 73 children and showed improved diagnostic sensitivity, specificity and accuracy. Four studies addressed the diagnostic yield for occult fractures with respect to age. This was significant for children under 2-years old. Conclusions: In children under 2-years old, where physical abuse is suspected, diagnostic imaging of the skeleton should be mandatory. SS or BS alone is inadequate to identify all fractures. It is recommended that all SS should include oblique views of the ribs. This review suggests that the following options would optimize the diagnostic yield. However, each needs to be evaluated prospectively: SS that includes oblique views, SS and BS, a SS with repeat SS or selected images 2 weeks later or a BS plus skull radiography and coned views of metaphyses and epiphyses.

  19. Computed tomograms of blowout fracture

    International Nuclear Information System (INIS)

    Ito, Haruhide; Hayashi, Minoru; Shoin, Katsuo; Hwang, Wen-Zern; Yamamoto, Shinjiro; Yonemura, Taizo.

    1985-01-01

    We studied 18 cases of orbital fractures, excluding optic canal fracture. There were 11 cases of pure blowout fracture and 3 of the impure type. The other 4 cases were orbital fractures without blowout fracture. The cardinal syndromes were diplopia, enophthalmos, and sensory disturbances of the trigeminal nerve in the pure type of blowout fracture. Many cases of the impure type of blowout fracture or of orbital fracture showed black eyes or a swelling of the eyelids which masked enophthalmos. Axial and coronal CT scans demonstrated: 1) the orbital fracture, 2) the degree of enophthalmos, 3) intraorbital soft tissue, such as incarcerated or prolapsed ocular muscles, 4) intraorbital hemorrhage, 5) the anatomical relation of the orbital fracture to the lacrimal canal, the trochlea, and the trigeminal nerve, and 6) the lesions of the paranasal sinus and the intracranial cavity. CT scans play an important role in determining what surgical procedures might best be employed. Pure blowout fractures were classified by CT scans into these four types: 1) incarcerating linear fracture, 2) trapdoor fracture, 3) punched-out fracture, and 4) broad fracture. Cases with severe head injury should be examined to see whether or not blowout fracture is present. If the patients are to hope to return to society, a blowout fracture should be treated as soon as possible. (author)

  20. Computed tomograms of blowout fracture

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Haruhide; Hayashi, Minoru; Shoin, Katsuo; Hwang, Wen-Zern; Yamamoto, Shinjiro; Yonemura, Taizo

    1985-02-01

    We studied 18 cases of orbital fractures, excluding optic canal fracture. There were 11 cases of pure blowout fracture and 3 of the impure type. The other 4 cases were orbital fractures without blowout fracture. The cardinal syndromes were diplopia, enophthalmos, and sensory disturbances of the trigeminal nerve in the pure type of blowout fracture. Many cases of the impure type of blowout fracture or of orbital fracture showed black eyes or a swelling of the eyelids which masked enophthalmos. Axial and coronal CT scans demonstrated: 1) the orbital fracture, 2) the degree of enophthalmos, 3) intraorbital soft tissue, such as incarcerated or prolapsed ocular muscles, 4) intraorbital hemorrhage, 5) the anatomical relation of the orbital fracture to the lacrimal canal, the trochlea, and the trigeminal nerve, and 6) the lesions of the paranasal sinus and the intracranial cavity. CT scans play an important role in determining what surgical procedures might best be employed. Pure blowout fractures were classified by CT scans into these four types: 1) incarcerating linear fracture, 2) trapdoor fracture, 3) punched-out fracture, and 4) broad fracture. Cases with severe head injury should be examined to see whether or not blowout fracture is present. If the patients are to hope to return to society, a blowout fracture should be treated as soon as possible. (author).