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Sample records for vertebrae cranial base

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

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Nolting, Dorrit; Engel, Ulla

    2009-01-01

    . In the present study, eight triploid fetuses were analyzed radiographically and histologically focusing especially on the cranial base, which borders to the spine and to which the jaws are attached. A histological analysis of the cranial base has not previously been performed in triploid cases. An enlarged...... and the uppermost vertebra in the body axis. As the notochord connects the cervical column and the cranial base in early prenatal life, molecular signaling from the notochord may in future studies support the notochord as the developmental link between abnormal development in the spine and the cranial base....

  2. Vertebra segmentation based on two-step refinement.

    Science.gov (United States)

    Courbot, Jean-Baptiste; Rust, Edmond; Monfrini, Emmanuel; Collet, Christophe

    Knowledge of vertebra location, shape, and orientation is crucial in many medical applications such as orthopedics or interventional procedures. Computed tomography (CT) offers a high contrast between bone and soft tissues, but automatic vertebra segmentation remains difficult. Hence, the wide range of shapes, aging, and degenerative joint disease alterations as well as the variety of pathological cases encountered in an aging population make automatic segmentation sometimes challenging. Besides, daily practice implies a need for affordable computation time. This paper aims to present a new automated vertebra segmentation method (using a first bounding box for initialization) for CT 3D data which tackles these problems. This method is based on two consecutive steps. The first one is a new coarse-to-fine method efficiently reducing the data amount to obtain a coarse shape of the vertebra. The second step consists in a hidden Markov chain (HMC) segmentation using a specific volume transformation within a Bayesian framework. Our method does not introduce any prior on the expected shape of the vertebra within the bounding box and thus deals with the most frequent pathological cases encountered in daily practice. We experiment this method on a set of standard lumbar, thoracic, and cervical vertebrae and on a public dataset, on pathological cases, and in a simple integration example. Quantitative and qualitative results show that our method is robust to changes in shapes and luminance and provides correct segmentation with respect to pathological cases.

  3. A morphometric study of the atlas occipitalization and coexisted congenital anomalies of the vertebrae and posterior cranial fossa with neurological importance.

    Science.gov (United States)

    Natsis, Konstantinos; Lyrtzis, Christos; Totlis, Trifon; Anastasopoulos, Nikolaos; Piagkou, Maria

    2017-01-01

    Our study highlights the morphometry of the partial and complete atlas occipitalization (AOZ), its coexistence with fusions of the 2nd and 3rd cervical vertebrae and morphological and morphometric abnormalities of the posterior cranial fossa that are of paramount neurological importance. One hundred and eighty adult dry skulls, the atlas and axis vertebrae were examined. Four skulls (2.2 %) showed AOZ. Two of them (1.1 %) presented a partial AOZ, one male skull (0.6 %) a complete AOZ and a female skull (0.6 %) had a fused left hemiatlas with the occipital bone and a fusion of the 2nd and 3rd cervical vertebrae. The inner anteroposterior and transverse diameters of the foramen magnum (FM) in the control group were 34.6 ± 3.46 and 29.3 ± 3.47 mm. Only the skull with the complete AOZ had a reduced outer anteroposterior diameter of the FM (29.8 mm), while no specimen was found with a reduced transverse diameter. A wide total decrease (range 13.1-50.9 %) in the surface area of the FM in skulls with AOZ was detected. Extracranial, the clivus length in two skulls with AOZ was smaller than the normal range. No skull was detected with a reduction in the intracranial length of the clivus. All skulls with the AOZ had a vermian fossa. The study adds important morphometric details about the partial and complete AOZ and correlates the phenomenon of synostosis with the narrowing of the FM, particularly in the case of complete AOZ. Awareness of the AOZ and other fusions of the upper cervical vertebrae and their topographical relations and attendant problems are of paramount importance to surgeons, when operate to the craniocervical junction, or interpret imaging studies to plan a safe surgery for nerve or spinal tissue decompression.

  4. Thyroxine Exposure Effects on the Cranial Base.

    Science.gov (United States)

    Durham, Emily; Howie, R Nicole; Parsons, Trish; Bennfors, Grace; Black, Laurel; Weinberg, Seth M; Elsalanty, Mohammed; Yu, Jack C; Cray, James J

    2017-09-01

    Thyroid hormone is important for skull bone growth, which primarily occurs at the cranial sutures and synchondroses. Thyroid hormones regulate metabolism and act in all stages of cartilage and bone development and maintenance by interacting with growth hormone and regulating insulin-like growth factor. Aberrant thyroid hormone levels and exposure during development are exogenous factors that may exacerbate susceptibility to craniofacial abnormalities potentially through changes in growth at the synchondroses of the cranial base. To elucidate the direct effect of in utero therapeutic thyroxine exposure on the synchondroses in developing mice, we provided scaled doses of the thyroid replacement drug, levothyroxine, in drinking water to pregnant C57BL6 wild-type dams. The skulls of resulting pups were subjected to micro-computed tomography analysis revealing less bone volume relative to tissue volume in the synchondroses of mouse pups exposed in utero to levothyroxine. Histological assessment of the cranial base area indicated more active synchondroses as measured by metabolic factors including Igf1. The cranial base of the pups exposed to high levels of levothyroxine also contained more collagen fiber matrix and an increase in markers of bone formation. Such changes due to exposure to exogenous thyroid hormone may drive overall morphological changes. Thus, excess thyroid hormone exposure to the fetus during pregnancy may lead to altered craniofacial growth and increased risk of anomalies in offspring.

  5. Cranial-base morphology in children with class III malocclusion.

    Science.gov (United States)

    Chang, Hong-Po; Hsieh, Shu-Hui; Tseng, Yu-Chuan; Chou, Tsau-Mau

    2005-04-01

    The association between cranial-base morphology and Class III malocclusion is not fully understood. The purpose of this study was to investigate the morphologic characteristics of the cranial base in children with Class III malocclusion. Lateral cephalograms from 100 children with Class III malocclusion were compared with those from 100 subjects with normal occlusion. Ten landmarks on the cranial base were identified and digitized. Cephalometric assessment using seven angular and 18 linear measurements was performed by univariate and multivariate analyses. The results revealed that the greatest between-group differences occurred in the posterior cranial-base region. It was concluded that shortening and angular bending of the cranial base, and a diminished angle between the cranial base and mandibular ramus, may lead to Class III malocclusion associated with Class III facial morphology. The association between cranial-base morphology and other types of malocclusion needs clarification. Further study of regional changes in the cranial base, with geometric morphometric analysis, is warranted.

  6. Automatic localization of vertebrae based on convolutional neural networks

    Science.gov (United States)

    Shen, Wei; Yang, Feng; Mu, Wei; Yang, Caiyun; Yang, Xin; Tian, Jie

    2015-03-01

    Localization of the vertebrae is of importance in many medical applications. For example, the vertebrae can serve as the landmarks in image registration. They can also provide a reference coordinate system to facilitate the localization of other organs in the chest. In this paper, we propose a new vertebrae localization method using convolutional neural networks (CNN). The main advantage of the proposed method is the removal of hand-crafted features. We construct two training sets to train two CNNs that share the same architecture. One is used to distinguish the vertebrae from other tissues in the chest, and the other is aimed at detecting the centers of the vertebrae. The architecture contains two convolutional layers, both of which are followed by a max-pooling layer. Then the output feature vector from the maxpooling layer is fed into a multilayer perceptron (MLP) classifier which has one hidden layer. Experiments were performed on ten chest CT images. We used leave-one-out strategy to train and test the proposed method. Quantitative comparison between the predict centers and ground truth shows that our convolutional neural networks can achieve promising localization accuracy without hand-crafted features.

  7. Cranial-Base Morphology in Children with Class III Malocclusion

    OpenAIRE

    Hong-Po Chang; Tsau-Mau Chou

    2005-01-01

    The association between cranial-base morphology and Class III malocclusion is not fully understood. The purpose of this study was to investigate the morphologic characteristics of the cranial base in children with Class III malocclusion. Lateral cephalograms from 100 children with Class III malocclusion were compared with those from 100 subjects with normal occlusion. Ten landmarks on the cranial base were identified and digitized. Cephalometric assessment using seven angular and 18 linear me...

  8. Lateral angle and cranial base sexual dimorphism

    DEFF Research Database (Denmark)

    Duquesnel Mana, Mathilde; Adalian, Pascal; Lynnerup, Niels

    2016-01-01

    SUMMARY: Previous studies have yielded very different results in sex estimation based on measurements of the lateral angle (LA) of the temporal bone. The purpose of this study was to, first, investigate if the bad results obtained by the LA method could be due to the methodology and then, second......, to examine sexual dimorphism in the relationship between the lateral angle and cranial base shape. The lateral angle method was tested using a forensic sample of 102 CT scans of the head with known sex. We measured the angle using two methods: measurements directly on the CT slide, the method usually applied...... the direct measurements. The mean angle was greater in females (48.2° ± 7.2°) than in males (45.38° ±8.06°) but the difference was not significant (t-test, p = 0.063). A statistically significant difference in cranial base shape existed between the two sexes, but the results also demonstrated a major overlap...

  9. Sex determination based on a thoracic vertebra and ribs evaluation using clinical chest radiography.

    Science.gov (United States)

    Tsubaki, Shun; Morishita, Junji; Usumoto, Yosuke; Sakaguchi, Kyoko; Matsunobu, Yusuke; Kawazoe, Yusuke; Okumura, Miki; Ikeda, Noriaki

    2017-07-01

    Our aim was to investigate whether sex can be determined from a combination of geometric features obtained from the 10th thoracic vertebra, 6th rib, and 7th rib. Six hundred chest radiographs (300 males and 300 females) were randomly selected to include patients of six age groups (20s, 30s, 40s, 50s, 60s, and 70s). Each group included 100 images (50 males and 50 females). A total of 14 features, including 7 lengths, 5 indices for the vertebra, and 2 types of widths for ribs, were utilized and analyzed for sex determination. Dominant features contributing to sex determination were selected by stepwise discriminant analysis after checking the variance inflation factors for multicollinearity. The accuracy of sex determination using a combination of the vertebra and ribs was evaluated from the selected features by the stepwise discriminant analysis. The accuracies in each age group were also evaluated in this study. The accuracy of sex determination based on a combination of features of the vertebra and ribs was 88.8% (533/600). This performance was superior to that of the vertebra or ribs only. Moreover, sex determination of subjects in their 20s demonstrated the highest accuracy (96.0%, 96/100). The features selected in the stepwise discriminant analysis included some features in both the vertebra and ribs. These results indicate the usefulness of combined information obtained from the vertebra and ribs for sex determination. We conclude that a combination of geometric characteristics obtained from the vertebra and ribs could be useful for determining sex. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Simultaneous localization of lumbar vertebrae and intervertebral discs with SVM-based MRF.

    Science.gov (United States)

    Oktay, Ayse Betul; Akgul, Yusuf Sinan

    2013-09-01

    This paper presents a method for localizing and labeling the lumbar vertebrae and intervertebral discs in mid-sagittal MR image slices. The approach is based on a Markov-chain-like graphical model of the ordered discs and vertebrae in the lumbar spine. The graphical model is formulated by combining local image features and semiglobal geometrical information. The local image features are extracted from the image by employing pyramidal histogram of oriented gradients (PHOG) and a novel descriptor that we call image projection descriptor (IPD). These features are trained with support vector machines (SVM) and each pixel in the target image is locally assigned a score. These local scores are combined with the semiglobal geometrical information like the distance ratio and angle between the neighboring structures under the Markov random field (MRF) framework. An exact localization of discs and vertebrae is inferred from the MRF by finding a maximum a posteriori solution efficiently using dynamic programming. As a result of the novel features introduced, our system can scale-invariantly localize discs and vertebra at the same time even in the existence of missing structures. The proposed system is tested and validated on a clinical lumbar spine MR image dataset containing 80 subjects of which 64 have disc- and vertebra-related diseases and abnormalities. The experiments show that our system is successful even in abnormal cases and our results are comparable to the state of the art.

  11. Patch-based Corner Detection for Cervical Vertebrae in X-ray Images

    OpenAIRE

    Slabaugh, G.G.; Gundry, M.; Knapp, K.; Asad, M.; Al Arif, S.M.M.R.

    2017-01-01

    Corners hold vital information about size, shape and morphology of a vertebra in an x-ray image, and recent literature [1, 2] has shown promising performance for detecting vertebral corners using a Hough forest-based architecture. To provide spatial context, this method generates a set of 12 patches around a vertebra and uses a machine learning approach to predict corners of a vertebral body through a voting process. In this paper, we extend this framework in terms of patch generation and pre...

  12. Cranial-Base Morphology in Children with Class III Malocclusion

    Directory of Open Access Journals (Sweden)

    Hong-Po Chang

    2005-04-01

    Full Text Available The association between cranial-base morphology and Class III malocclusion is not fully understood. The purpose of this study was to investigate the morphologic characteristics of the cranial base in children with Class III malocclusion. Lateral cephalograms from 100 children with Class III malocclusion were compared with those from 100 subjects with normal occlusion. Ten landmarks on the cranial base were identified and digitized. Cephalometric assessment using seven angular and 18 linear measurements was performed by univariate and multivariate analyses. The results revealed that the greatest between-group differences occurred in the posterior cranial-base region. It was concluded that shortening and angular bending of the cranial base, and a diminished angle between the cranial base and mandibular ramus, may lead to Class III malocclusion associated with Class III facial morphology. The association between cranialbase morphology and other types of malocclusion needs clarification. Further study of regional changes in the cranial base, with geometric morphometric analysis, is warranted.

  13. An innovative transparent cranial window based on skull optical clearing An innovative transparent cranial window

    Science.gov (United States)

    Wang, J.; Zhang, Y.; Xu, T. H.; Luo, Q. M.; Zhu, D.

    2012-06-01

    Noninvasive optical methods for viewing the structural and functional organization of cortex have been playing important roles in brain research, which usually suffer from turbid skull. Various cranial window models based on surgical operation have been proposed, but have respective limitations. Here, an innovative transparent cranial window of mouse was established by topically treatment with a skull optical clearing solution (SOCS), rather than by craniotomy. Based on the experiment of optical clearing efficacy of skull in vitro, we found that the turbid skull became transparent within 25 min after application of SOCS. The USAF target is visible through the treated skull, and the calculated resolution can achieve 8.4 μm. After the in vivo skull was topically treated with SOCS, the cortical micro-vessels can be visible clearly. The quantitative analysis indicated that the minimum resolution diameter of micro-vessels in 14.4±0.8 μm through the transparent cranial window closed to that in 12.8±0.9 μm of the exposed cortical micro-vessels. Further, preliminary results from Laser Speckle Imaging demonstrated that there was no influence on cortical blood flow distribution of mouse after topically treatment with SOCS on skull. This transparent cranial window will provide a convenient model for cortex imaging in vivo, which is very significant for neuroscience research.

  14. Level set based vertebra segmentation for the evaluation of Ankylosing Spondylitis

    Science.gov (United States)

    Tan, Sovira; Yao, Jianhua; Ward, Michael M.; Yao, Lawrence; Summers, Ronald M.

    2006-03-01

    Ankylosing Spondylitis is a disease of the vertebra where abnormal bone structures (syndesmophytes) grow at intervertebral disk spaces. Because this growth is so slow as to be undetectable on plain radiographs taken over years, it is necessary to resort to computerized techniques to complement qualitative human judgment with precise quantitative measures on 3-D CT images. Very fine segmentation of the vertebral body is required to capture the small structures caused by the pathology. We propose a segmentation algorithm based on a cascade of three level set stages and requiring no training or prior knowledge. First, the noise inside the vertebral body that often blocks the proper evolution of level set surfaces is attenuated by a sigmoid function whose parameters are determined automatically. The 1st level set (geodesic active contour) is designed to roughly segment the interior of the vertebra despite often highly inhomogeneous and even discontinuous boundaries. The result is used as an initial contour for the 2nd level set (Laplacian level set) that closely captures the inner boundary of the cortical bone. The last level set (reversed Laplacian level set) segments the outer boundary of the cortical bone and also corrects small flaws of the previous stage. We carried out extensive tests on 30 vertebrae (5 from each of 6 patients). Two medical experts scored the results at intervertebral disk spaces focusing on end plates and syndesmophytes. Only two minor segmentation errors at vertebral end plates were reported and two syndesmophytes were considered slightly under-segmented.

  15. Use of Pedicled Buccal Fat Pad for Cranial Base Reconstruction.

    Science.gov (United States)

    Gadre, Pushkar; Ghadge, Murarji Tanaji; Singh, Divya; Gadre, Kiran

    2017-03-01

    Craniofacial reconstruction for closure of skull base defects after removal of anterior cranial base lesions is challenging. Persistent skull base defect produces extremely high risk of cerebrospinal fluid leaks and consecutive infectious complications. The authors' article focuses on the use of pedicled buccal fat pad for the reconstruction of anterior cranial base defects using combined endoscope-assisted approach and Lefort I access osteotomy. High effectiveness and minimal invasiveness are principal advantages of the technique. Other benefits include proximity of donor site to defect, simplicity of surgical technique, minimal postoperative discomfort, and very low risk of benign complications. Local pedicled grafts are the preferred material for plasty, adding aesthetic results in an ablative surgery using intraoral incision and access osteotomy. Thus, the technique solves the problem of relying on complex alloplastic reconstruction of anterior craniobasal defects.

  16. Pubertal spurts in cranial base and mandible. Comparisons within individuals.

    Science.gov (United States)

    Lewis, A B; Roche, A F; Wagner, B

    1985-01-01

    Serial data from cephalometric radiographs were analyzed for 34 boys and 33 girls who had cephalometric radiographs annually near each birthday from at least age 7 through 18 years. Spurts were defined for this study as increases between successive cranial base increments that exceeded 0.75mm/year in boys or 0.5mm/year in girls. The corresponding criterion for the mandible was 1.0mm/year in either sex. Pubescence was defined as the 4- year period spanning 2 years before and after peak height velocity. Spurts during pubescence were common, tending to occur about 1.6yr earlier in girls than boys. The mean increments at first pubertal spurt (FPS) and the mean sizes of FPS were about 25% to 33% greater in the boys than in the girls. The rate of growth during the year before FPS tended to be greater in the girls, while in the year after FPS it tended to be greater in the boys. The timing of FPS in either cranial base of mandible was not closely related to the onset of ossification in the ulnar sesamoid, the age at peak height velocity, or age at menarche. FPS generally occurred after the onset of ossification of the ulnar sesamoid, but before peak height velocity and menarche. There was no evidence of difference between craniofacial EPS in children who passed rapidly or slowly through pubescence, nor was any difference noted between the size of pubertal spurts in tall or short boys. larger total increments after peak height velocity were found in the short boys. Significant correlations were identified between the cranial base and the mandible in the timing but not in the magnitude of FPS. The children were approximately equally divided between those in whom cranial base spurts occurred first, those in whom mandibular spurts were first, and those in whom FPS occurred in both areas within the same annual interval.

  17. Endoscopic endonasal cranial base surgery simulation using an artificial cranial base model created by selective laser sintering.

    Science.gov (United States)

    Oyama, Kenichi; Ditzel Filho, Leo F S; Muto, Jun; de Souza, Daniel G; Gun, Ramazan; Otto, Bradley A; Carrau, Ricardo L; Prevedello, Daniel M

    2015-01-01

    Mastery of the expanded endoscopic endonasal approach (EEA) requires anatomical knowledge and surgical skills; the learning curve for this technique is steep. To a great degree, these skills can be gained by cadaveric dissections; however, ethical, religious, and legal considerations may interfere with this paradigm in different regions of the world. We assessed an artificial cranial base model for the surgical simulation of EEA and compared its usefulness with that of cadaveric specimens. The model is made of both polyamide nylon and glass beads using a selective laser sintering (SLS) technique to reflect CT-DICOM data of the patient's head. It features several artificial cranial base structures such as the dura mater, venous sinuses, cavernous sinuses, internal carotid arteries, and cranial nerves. Under endoscopic view, the model was dissected through the nostrils using a high-speed drill and other endonasal surgical instruments. Anatomical structures around and inside the sphenoid sinus were accurately reconstructed in the model, and several important surgical landmarks, including the medial and lateral optico-carotid recesses and vidian canals, were observed. The bone was removed with a high-speed drill until it was eggshell thin and the dura mater was preserved, a technique very similar to that applied in patients during endonasal cranial base approaches. The model allowed simulation of almost all sagittal and coronal plane EEA modules. SLS modeling is a useful tool for acquiring the anatomical knowledge and surgical expertise for performing EEA while avoiding the ethical, religious, and infection-related problems inherent with use of cadaveric specimens.

  18. Posterior cranial base natural growth and development: A systematic review.

    Science.gov (United States)

    Currie, Kris; Sawchuk, Dena; Saltaji, Humam; Oh, Heesoo; Flores-Mir, Carlos; Lagravere, Manuel

    2017-11-01

    To provide a synthesis of the published studies evaluating the natural growth and development of the human posterior cranial base (S-Ba). The search was performed on MEDLINE, Embase, PubMed, and all EBM Reviews electronic databases. In addition, reference lists of the included studies were hand-searched. Articles were included if they analyzed posterior cranial-base growth in humans specifically. Study selection, data extraction, and risk of bias assessment were completed in duplicate. A meta-analysis was not justified. Finally, 23 published studies were selected: 5 cross-sectional and 18 cohort studies. Articles were published between 1955 and 2015, and all were published in English. The sample sizes varied between 20 and 397 individuals and consisted of craniofacial measurements from either living or deceased human skulls. Validity of the measurements was not determined in any of the studies, while six papers reported some form of reliability assessment. All the articles included multiple time points within the same population or data from multiple age groups. Growth of S-Ba was generally agreed to be from spheno-occipital synchondrosis growth. Basion displaced downward and backward and sella turcica moved downward and backward during craniofacial growth. Timing of cessation of S-Ba growth was not conclusive due to limited identified evidence. Current evidence suggests that S-Ba is not totally stable, as its dimensions change throughout craniofacial growth and a minor dimensional change is observed even in late adulthood.

  19. Recurring fibrous dysplasia of anthro maxillary with cranial base invasion

    Directory of Open Access Journals (Sweden)

    Sousa, Kátia Maria Marabuco de

    2009-09-01

    Full Text Available Introduction: Fibrous dysplasia is an osseous lesion with an unknown etiology. It is characterized by the osseous maturation insufficiency. It may affect any bone, but the affection of craniofacial bones is the most critical for otorhinolaryngology. Maxilla is the most affected facial bone and the orbitary invasion is an uncommon event. The symptoms are unspecific and for its low suspicion and uncommonness, the diagnosis is generally late. The monostotic form presents a slow growth and asymptomatic course and needs to be followed up. The polyostotic type has a progressive behavior and is associated to recurrence and complications. Objective: To present two cases of patients with fibrous dysplasia diagnosis and describe the clinical presentation, radiological findings and the treatment of this pathology. Cases Report: Two cases of fibrous dysplasia are reported, which initially presented unspecific symptomatology, but with characteristic radiologic signs. They were submitted to surgical treatment for resection of the lesions and evolved with frequent recurrences with extensive affection of the facial sinuses, one patient had cranial base invasion and frontal craniotomy was needed for tumoral excision. Final Comments: Fibrous dysplasia is an uncommon osteopathy. The tomography is the choice method for characterization of the tumoral expansion, and helps in the surgical planning. The surgical strategy is indicated for symptomatic lesions, functions alterations or anatomic disorders. This article describes two uncommon manifestations of recurrent fibrous dysplasia with an extensive affection of anthro maxillary, ethmoidal and sphenoid sinuses, in addition to orbitary and cranial base invasion.

  20. Asymmetric class III malocclusion: association with cranial base deformation and occult torticollis.

    Science.gov (United States)

    Yuan, Joyce T; Teng, Edward; Heller, Justin B; Kawamoto, Henry K; Bradley, James P

    2012-09-01

    The etiology of Angle class III malocclusion with facial asymmetry has not been fully elucidated. To investigate the etiology, patients with asymmetric prognathism (n = 30) from a single institution were assessed for previously undiagnosed torticollis and cranial base asymmetry. Presence of torticollis was determined by measuring restricted head movement when turning the head against a wall and cranial base tilt with upward gaze. Cranial base asymmetry was evaluated by preoperative three-dimensional computed tomography scans. Thirty-one percent of patients with prognathism presented with concurrent facial asymmetry. In patients with asymmetric prognathism, cranial base tilt was present on upward gaze in all patients; mean angle between head and wall was 31 degrees greater than that in control patients, and a 22% to 36% difference in the angle was present when comparing one side with the other. Based on these findings, all patients with asymmetric prognathism were found to be affected by torticollis. By computed tomography scan, 85% of these torticollis patients showed slight anteromedial displacement of the glenoid fossa ipsilateral to torticollis, and 73% demonstrated temporal fossa shift of 4 mm or greater. The current study demonstrates a strong association between asymmetric class III malocclusion, torticollis, and cranial base asymmetry. We conclude that undiagnosed torticollis is a likely etiology for otherwise idiopathic cranial base asymmetry and that cranial base asymmetry in turn causes facial asymmetry and malocclusion. This study highlights the importance of evaluating cranial base asymmetry and torticollis in patients with class III malocclusion to allow for earlier treatment and improved outcomes.

  1. A quantitative approach for sex estimation based on cranial morphology.

    Science.gov (United States)

    Nikita, Efthymia; Michopoulou, Efrossyni

    2017-12-19

    This paper proposes a method for the quantification of the shape of sexually dimorphic cranial traits, namely the glabella, mastoid process and external occipital protuberance. The proposed method was developed using 165 crania from the documented Athens Collection and tested on 20 Cretan crania. It is based on digital photographs of the lateral view of the cranium, drawing of the profile of three sexually dimorphic structures and calculation of variables that express the shape of these structures. The combinations of variables that provide optimum discrimination between sexes are identified by means of binary logistic regression and discriminant analysis. The best cross-validated results are obtained when variables from all three structures are combined and range from 75.8 to 85.1% and 81.1 to 94.6% for males and females, respectively. The success rate is 86.3-94.1% for males and 83.9-93.5% for females when half of the sample is used for training and the rest for prediction. Correct classification for the Cretan material based upon the standards developed for the Athens sample was 80-90% for the optimum combinations of discriminant variables. The proposed method provides an effective way to capture quantitatively the shape of sexually dimorphic cranial structures; it gives more accurate results relative to other existing methods and it does not require specialized equipment. Equations for sex estimation based on combinations of variables are provided, along with instructions on how to use the method and Excel macros for calculation of discriminant variables with automated implementation of the optimum equations. © 2017 Wiley Periodicals, Inc.

  2. A New Material Mapping Procedure for Quantitative Computed Tomography-Based, Continuum Finite Element Analyses of the Vertebra

    Science.gov (United States)

    Unnikrishnan, Ginu U.; Morgan, Elise F.

    2011-01-01

    Inaccuracies in the estimation of material properties and errors in the assignment of these properties into finite element models limit the reliability, accuracy, and precision of quantitative computed tomography (QCT)-based finite element analyses of the vertebra. In this work, a new mesh-independent, material mapping procedure was developed to improve the quality of predictions of vertebral mechanical behavior from QCT-based finite element models. In this procedure, an intermediate step, called the material block model, was introduced to determine the distribution of material properties based on bone mineral density, and these properties were then mapped onto the finite element mesh. A sensitivity study was first conducted on a calibration phantom to understand the influence of the size of the material blocks on the computed bone mineral density. It was observed that varying the material block size produced only marginal changes in the predictions of mineral density. Finite element (FE) analyses were then conducted on a square column-shaped region of the vertebra and also on the entire vertebra in order to study the effect of material block size on the FE-derived outcomes. The predicted values of stiffness for the column and the vertebra decreased with decreasing block size. When these results were compared to those of a mesh convergence analysis, it was found that the influence of element size on vertebral stiffness was less than that of the material block size. This mapping procedure allows the material properties in a finite element study to be determined based on the block size required for an accurate representation of the material field, while the size of the finite elements can be selected independently and based on the required numerical accuracy of the finite element solution. The mesh-independent, material mapping procedure developed in this study could be particularly helpful in improving the accuracy of finite element analyses of

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

    Science.gov (United States)

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

    2010-06-01

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

  4. Multimodal μCT/μMR based semiautomated segmentation of rat vertebrae affected by mixed osteolytic/osteoblastic metastases.

    Science.gov (United States)

    Hojjat, Seyed-Parsa; Foltz, Warren; Wise-Milestone, Lisa; Whyne, Cari M

    2012-05-01

    Multimodal microimaging in preclinical models is used to examine the effect of spinal metastases on bony structure; however, the evaluation of tumor burden and its effect on microstructure has thus far been mainly qualitative or semiquantitative. Quantitative analysis of multimodality imaging is a time consuming task, motivating automated methods. As such, this study aimed to develop a low complexity semiautomated multimodal μCT/μMR based approach to segment rat vertebral structure affected by mixed osteolytic/osteoblastic destruction. Mixed vertebral metastases were developed via intracardiac injection of Ace-1 canine prostate cancer cells in three 4-week-old rnu/rnu rats. μCT imaging (for high resolution bone visualization), T1-weighted μMR imaging (for bone registration), and T2-weighted μMR imaging (for osteolytic tumor visualization) were conducted on one L1, three L2, and one L3 vertebrae (excised). One sample (L1-L3) was processed for undecalcified histology and stained with Goldner's trichome. The μCT and μMR images were registered using a 3D rigid registration algorithm with a mutual information metric. The vertebral microarchitecture was segmented from the μCT images using atlas-based demons deformable registration, levelset curvature evolution, and intensity-based thresholding techniques. The μCT based segmentation contours of the whole vertebrae were used to mask the T2-weighted μMR images, from which the osteolytic tumor tissue was segmented (intensity-based thresholding). Accurate registration of μCT and μMRI modalities yielded precise segmentation of whole vertebrae, trabecular centrums, individual trabeculae, and osteolytic tumor tissue. While the algorithm identified the osteoblastic tumor attached to the vertebral pereosteal surfaces, it was limited in segmenting osteoblastic tissue located within the trabecular centrums. This semiautomated segmentation method yielded accurate registration of μCT and μMRI modalities with application

  5. Changes in Cranial Base Morphology in Class I and Class II Division 1 Malocclusions

    OpenAIRE

    Agarwal, Anirudh; Pandey, Harsh; Bajaj, Kamal; Pandey, Lavesh

    2013-01-01

    Introduction: The cranial base plays a key role in craniofacial growth; it helps to integrate spatially and functionally different patterns of growth in various adjoining regions of the skull such as components of the brain, the nasal and oral cavity and the pharynx. The aim of this study was to evaluate the difference in cranial base flexure between skeletal and dental Class I and Class II division 1.

  6. Virtual temporal bone: an interactive 3-dimensional learning aid for cranial base surgery

    OpenAIRE

    Kockro, R A; Hwang, P Y

    2009-01-01

    OBJECTIVE: We have developed an interactive virtual model of the temporal bone for the training and teaching of cranial base surgery. METHODS: The virtual model was based on the tomographic data of the Visible Human Project. The male Visible Human's computed tomographic data were volumetrically reconstructed as virtual bone tissue, and the individual photographic slices provided the basis for segmentation of the middle and inner ear structures, cranial nerves, vessels, and brainstem. These st...

  7. Cranial base and maxillary changes in patients treated with Frankel' s functional regulator (1b).

    Science.gov (United States)

    Alió-Sanz, Juan-Jose; Iglesias-Conde, Carmen; Lorenzo-Pernía, Jose; Iglesias-Linares, Alejandro; Mendoza-Mendoza, Asunción; Solano-Reina, Enrique

    2012-07-01

    The purpose of this study was to assess cranial base and maxillary growth in patients with Class II-type I malocclusions when treated with Frankel' s functional regulator (FR-1b). The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n: 28), and pubescent (n: 15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n: 19), and a pubescent group (n: 21). A computerized cephalometric study was carried out and superimpositions were done in order to assess the antero-posterior, vertical and rotational movement of the maxilla. The results indicate that anterior cranial length is not affected by the regulator but the cranial deflection of the treatment group was diminished. Although a slight counterclockwise rotation effect on the upper jaw was observed due to treatment, no growth restriction of the maxilla in a vertical or antero-posterior direction was observed compared to other non-treated Class II-type I malocclusion patients. The functional regulator does not have any effect on anterior cranial length, but it does affect the angulation of the cranial base. According to our results, the appliance has demonstrated a flattening effect of the cranial base (pfunctional regulator induces counterclockwise rotation rather than vertical or sagittal changes in the maxilla.

  8. Stature estimation in Japanese cadavers based on the second cervical vertebra measured using multidetector computed tomography.

    Science.gov (United States)

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Hayakawa, Mutsumi; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Hoshioka, Yumi; Iwase, Hirotaro

    2015-05-01

    The purpose of this study was to assess correlations between measurements of the second cervical vertebra (C2) and stature using multidetector computed tomography (MDCT) images, and to develop regression equations for estimating stature in a Japanese population. Measurements were performed on 216 Japanese subjects (116 males and 100 females) who underwent postmortem CT between May 2011 and November 2013. Sagittal images through the center of the C2 were used for assessment. The length from the top of the dens to the anteroinferior point of the vertebral body (DA), the length from the anteroinferior point of the vertebral body to the posterior point of the spinous process (AS), and the length from the top of the dens to the posterior point of the spinous process (DS) were measured. The correlation between stature and each parameter (DA, AS, and DS) was assessed using Pearson product-moment correlation coefficients and regression analysis was performed for stature estimation. All measurements of the C2 were positively correlated with stature regardless of sex. The highest correlation was observed for the DA in all cases, and the lowest correlation was observed for AS in all cases. However, the standard errors of estimate were large. Thus, our study concludes that the size of the C2 as measured with MDCT images may be useful for stature estimation only when better predictors, such as long bones, are unavailable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. [Neurophysiological identification of the cranial nerves in endoscopic endonasal surgery of skull base tumors].

    Science.gov (United States)

    Shkarubo, A N; Ogurtsova, A A; Moshchev, D A; Lubnin, A Yu; Andreev, D N; Koval', K V; Chernov, I V

    Intraoperative identification of the cranial nerves is a useful technique in removal of skull base tumors through the endoscopic endonasal approach. Searching through the scientific literature found one pilot study on the use of triggered electromyography (t-EMG) for identification of the VIth nerve in endonasal endoscopic surgery of skull base tumors (D. San-Juan, et al, 2014). The study objective was to prevent iatrogenic injuries to the cranial nerves without reducing the completeness of tumor tissue resection. In 2014, 5 patients were operated on using the endoscopic endonasal approach. Surgeries were performed for large skull base chordomas (2 cases) and trigeminal nerve neurinomas located in the cavernous sinus (3). Intraoperatively, identification of the cranial nerves was performed by triggered electromyography using a bipolar electrode (except 1 case of chordoma where a monopolar electrode was used). Evaluation of the functional activity of the cranial nerves was carried out both preoperatively and postoperatively. Tumor resection was total in 4 out of 5 cases and subtotal (chordoma) in 1 case. Intraoperatively, the IIIrd (2 patients), Vth (2), and VIth (4) cranial nerves were identified. No deterioration in the function of the intraoperatively identified nerves was observed in the postoperative period. In one case, no responses from the VIth nerve on the right (in the cavernous sinus region) were intraoperatively obtained, and deep paresis (up to plegia) of the nerve-innervated muscles developed in the postoperative period. The nerve function was not impaired before surgery. The t-EMG technique is promising and requires further research.

  10. [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.

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

    Science.gov (United States)

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

    2015-03-01

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

  12. Cranial-base morphology in adults with skeletal Class III malocclusion.

    Science.gov (United States)

    Sanggarnjanavanich, Seetala; Sekiya, Toshiko; Nomura, Yoshiaki; Nakayama, Takahiro; Hanada, Nobuhiro; Nakamura, Yoshiki

    2014-07-01

    The objectives of this study were to clarify the characteristics of cranial-base morphology in adults with skeletal Class III malocclusion and investigate factors relating to the establishment of a skeletal Class III malocclusion. Initial lateral cephalograms of women were examined. Subjects with an ANB angle of 0° to 4°, normal overjet and overbite, and a Class I molar relationship were classified as Class I (n = 86). Those with an ANB angle less than -1°, a Wits appraisal less than 2 mm, a negative overjet, and a Class III molar relationship were the Class III group (n = 86) in this study. Angular, linear, and coordinate measurements were made. Multivariate analysis of variance and the Student t test were used to analyze significant differences between the 2 groups. Discriminant analysis, logistic regression analysis, and decision analysis were used to identify which cranial-base and maxillomandibular variables influenced the establishment of a skeletal Class III malocclusion. The Class III group had smaller values for NSBa, SeSBa, FH-SSe, and FH-SBa. Sphenoidale and basion were more inferior and anterior than those of the Class I group. There was no difference in the anterior and posterior cranial-base lengths between the groups. Greater mandibular length was the first major characteristic in the Class III group, followed by smaller values for SeSBa and NSBa. Cranial-base morphology in adults with a skeletal Class III malocclusion is different from that in a skeletal Class I malocclusion. Smaller cranial-base angles, steeper posterior cranial bases, more inferiorly positioned sphenoidale, and more anteriorly positioned basion are major characteristics of skeletal Class III malocclusions. These characteristics play important roles in the establishment of a skeletal Class III malocclusion. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  13. Clinical anatomy and imaging of the cranial nerves and skull base.

    Science.gov (United States)

    Jha, Ruchira M; Klein, Joshua P

    2012-09-01

    Evaluation of patients with cranial neuropathies requires an understanding of brainstem anatomy and nerve pathways. Advances in neuroimaging, particularly high spatial resolution magnetic resonance imaging (MRI), have enabled visualization of these tiny structures and their related pathology. This review provides an approach toward using imaging in the evaluation of cranial nerve (CN) and skull base anatomy and pathology. Because brainstem nuclei are inextricably linked to the information contained within CNs, they are briefly mentioned whenever relevant; however, a comprehensive discussion of brainstem syndromes is beyond the scope of this review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. The evolution of cranial base and face in Cercopithecoidea and Hominoidea: Modularity and morphological integration.

    Science.gov (United States)

    Profico, Antonio; Piras, Paolo; Buzi, Costantino; Di Vincenzo, Fabio; Lattarini, Flavio; Melchionna, Marina; Veneziano, Alessio; Raia, Pasquale; Manzi, Giorgio

    2017-12-01

    The evolutionary relationship between the base and face of the cranium is a major topic of interest in primatology. Such areas of the skull possibly respond to different selective pressures. Yet, they are often said to be tightly integrated. In this paper, we analyzed shape variability in the cranial base and the facial complex in Cercopithecoidea and Hominoidea. We used a landmark-based approach to single out the effects of size (evolutionary allometry), morphological integration, modularity, and phylogeny (under Brownian motion) on skull shape variability. Our results demonstrate that the cranial base and the facial complex exhibit different responses to different factors, which produces a little degree of morphological integration between them. Facial shape variation appears primarily influenced by body size and sexual dimorphism, whereas the cranial base is mostly influenced by functional factors. The different adaptations affecting the two modules suggest they are best studied as separate and independent units, and that-at least when dealing with Catarrhines-caution must be posed with the notion of strong cranial integration that is commonly invoked for the evolution of their skull shape. © 2017 Wiley Periodicals, Inc.

  15. Sexual determination based on multidetector computed tomographic measurements of the second cervical vertebra in a contemporary Japanese population.

    Science.gov (United States)

    Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Yamaguchi, Rutsuko; Hashimoto, Mari; Hoshioka, Yumi; Iwase, Hirotaro

    2016-09-01

    Accurate sex estimation is important in forensic investigation to determine the identity of unknown individuals. The aim of this study was to investigate the accuracy of sex assessment based on measurements of the second cervical vertebra (C2) using computed tomographic (CT) images in a Japanese population and to develop discriminant function formulae. The data were collected from 224 Japanese cadavers (112 male subjects, 112 female subjects) on which postmortem CT scanning and subsequent forensic autopsy were performed. Nine CT measurements of the C2 were performed for CT images of each subject. The measurements were assessed using descriptive statistics and discriminant function analyses (DFA). All of the measurements demonstrated significant sexual dimorphism. Multiple DFA with stepwise variable selection resulted in multivariable models; a five-variable model reached an accuracy rate of 92.9%. Our results suggest that metric analysis based on CT images of the C2 can accurately determine the sex from the human skeletal remains in a contemporary Japanese population and may be useful for sex estimation in forensic anthropology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Effects on the maxilla and cranial base caused by cervical headgear: a longitudinal study.

    Science.gov (United States)

    Alió-Sanz, Juan; Iglesias-Conde, Carmen; Lorenzo-Pernía, José; Iglesias-Linares, Alejandro; Mendoza-Mendoza, Asunción; Solano-Reina, Enrique

    2012-09-01

    The aim of this study is to test the possible orthopedic effects of cervical headgear on the cranial base and maxilla. a sample consisting of 79 subjects with skeletal class II malocclusion was divided into two groups. The experimental group was made up of 41 patients all treated with cervical headgear. The control group included a total of 38 non-treated patients. Each one of these groups was then subdivided according to age into one of three groups: prepubescent, pubescent or post-pubescent. Cephalometric parameters were compared in both groups in order to measure the cranial base angle and the vertical and sagittal position of the maxilla. Additionally, cephalometric superimpositions taken at the beginning and end of the study were compared. results revealed significant differences in the cranial base angle and in the SNA angle (pheadgear, in addition to a retrusion of point A that does not mean there was a reduction in the maxillomandibular relationship. cervical headgear treatment induces cephalometric flattening of the cranial base and a decrease of the SNA angle.

  17. Evaluation of the relation between adenoids hypertrophy and cranial base angles

    Directory of Open Access Journals (Sweden)

    Dalili Z

    2006-07-01

    Full Text Available Background and Aim: Adenoids are normally large in children and their size starts to reduce during adolescence. Hypertrophic adenoids could be associated with allergic reactions. Enlarged adenoids result in nasal breathing difficulties and the child is forced to switch to mouth breathing. Airway obstruction causes postural alterations of jaw, tongue and head, and due to persistent obstruction, patient’s appearance changes to adenoid face. Evaluation of nasopharyngeal space in lateral cephalometic view is a simple and repeatable method for determination of the size and shape of adenoids and nasopharyngeal space which can provide a simple measurement of nasopharyngeal obstruction. The roof of nasopharyngeal space is covered by the sphenoid bone. Thus changes of nasorespiratory resistance by hypertrophic adenoids may affect the cranial base angles. In this study, the relationship between adenoid hypertrophy and cranial base angles was investigated. Materials and Methods: In this descriptive-analytic study, lateral cephalometric views of 7 to 14 y/o patients from the files of orthodontic centers in Rasht city were selected. The radiographs with proper resolution were separated for this research. Adenoid to nasorespiratory ratio (A/N Ratio was determined by Fujioka method and categorized in three groups: A (A/N 0.8, B (0.5cranial base angle (NSAr on lat cephalometric view was measured and categorized to normal, wide and narrow. Gonial angle, sum of articular, gonial & saddle angle, posterior to anterior facial height ratio and facial skeleton classification were also determined. Data were analyzed using Chi-Square and Pearson tests with p<0.05 as the limit of significance. Resuts: After evaluation of 206 lateral cephalometric views, adenoid hypertrophy (A and B groups was observed in 66% of cases whereas 34% were normal. The frequency of narrow, normal and wide cranial base angles

  18. Studies of the cranial base in 23 patients with cri-du-chat syndrome suggest a cranial developmental field involved in the condition.

    Science.gov (United States)

    Kjaer, I; Niebuhr, E

    1999-01-01

    The purpose of the present study was to investigate the cranial base on profile radiographs of patients with cri-du-chat syndrome and to relate the findings to current knowledge of brain malformation in an attempt to localize the developmental field affected in cri-du-chat syndrome. The material of profile radiographs of 23 patients was collected in Denmark in the 1970s. Twenty-two patients had terminal deletions of chromosome 5 (5p13.3, 5p14.1, 5p14.2, and 5p14.3), and one patient had an interstitial deletion. The cranial base angle (n-s-ba) was in most cases reduced and in no cases increased compared to age-related standards for normal individuals. Malformations in the bony contours of the sella turcica and the clivus occurred in cri-du-chat patients with terminal deletions. This specific cranial base region develops around the notochord at the location from where the rhombencephalic-derived brainstem, pons, and cerebellum have developed dorsally, and from where the neurons to the larynx have migrated ventrally. As the cranial base, the cerebellum and the larynx are involved in cri-du-chat syndrome, and attention is drawn to a new developmental field which comprises the dorsum sellae, clivus, cerebellum, and larynx. This field seemingly originates from the same notochordal location. The study has demonstrated a cranial base malformation in cri-du-chat patients, which ought to be elucidated in future research and combined with neurological and chromosomal investigations.

  19. Neurophysiological Identification of Cranial Nerves During Endoscopic Endonasal Surgery of Skull Base Tumors: Pilot Study Technical Report.

    Science.gov (United States)

    Shkarubo, Alexey Nikolaevich; Chernov, Ilia Valerievich; Ogurtsova, Anna Anatolievna; Moshchev, Dmitry Aleksandrovich; Lubnin, Andrew Jurievich; Andreev, Dmitry Nicolaevich; Koval, Konstantin Vladimirovich

    2017-02-01

    Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, only a small number of published papers describe the technique of trigger electromyography (t-EMG) in endoscopic endonasal removal of such tumors. To assess the effectiveness of t-EMG in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. Nine patients were operated on using the endoscopic endonasal approach within a 1-year period. The tumors included large skull base chordomas and trigeminal neurinomas localized in the cavernous sinus. During the surgical process, cranial nerve identification was carried out using monopolar and bipolar t-EMG methods. Assessment of cranial nerve functional activity was conducted both before and after tumor removal. We mapped 17 nerves in 9 patients. Third, fifth, and sixth cranial nerves were identified intraoperatively. There were no cases of postoperative functional impairment of the mapped cranial nerves. In one case we were unable to get an intraoperative response from the fourth cranial nerve and observed its postoperative transient plegia (the function was normal before surgery). t-EMG allows surgeons to control the safety of cranial nerves both during and after skull base tumor removal. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Can micro-imaging based analysis methods quantify structural integrity of rat vertebrae with and without metastatic involvement?

    Science.gov (United States)

    Hojjat, Seyed-Parsa; Beek, Maarten; Akens, Margarete K; Whyne, Cari M

    2012-09-21

    This study compares the ability of μCT image-based registration, 2D structural rigidity analyses and multimodal continuum-level finite element (FE) modeling in evaluating the mechanical stability of healthy, osteolytic, and mixed osteolytic/osteoblastic metastatically involved rat vertebrae. μMR and μCT images (loaded and unloaded) were acquired of lumbar spinal motion segments from 15rnu/rnu rats (five per group). Strains were calculated based on image registration of the loaded and unloaded μCT images and via analysis of FE models created from the μCT and μMR data. Predicted yield load was also calculated through 2D structural rigidity analysis of the axial unloaded μCT slices. Measures from the three techniques were compared to experimental yield loads. The ability of these methods to predict experimental yield loads were evaluated and image registration and FE calculated strains were directly compared. Quantitatively for all samples, only limited weak correlations were found between the image-based measures and experimental yield load. In comparison to the experimental yield load, we observed a trend toward a weak negative correlation with median strain calculated using the image-based strain measurement algorithm (r=-0.405, p=0.067), weak significant correlations (pmodes of failure. Improvements in load characterization, material properties assignments and resolution are necessary to yield a more generalized ability for image-based registration, structural rigidity and FE methods to accurately represent stability in healthy and pathologic scenarios. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Numbering of vertebrae on MRI using a PACS cross-referencing tool.

    Science.gov (United States)

    Paik, Nam Chull; Lim, Chun Soo; Jang, Ho Suk

    2012-09-01

    For the detection and documentation of numeric variations on spine magnetic resonance imaging (MRI), different techniques have previously been introduced. However, these methods require additional special imaging algorithms, software, or devices. We intend to introduce a vertebral numbering method using the existing picture archiving and communication system (PACS) and MRI system. To assess the accuracy of a method for numbering presacral vertebrae based on the cross-referencing of two sagittal MRI series. This study was a retrospective review of 224 consecutive patients who underwent both lumbar MRI with cervicothoracic scan and whole spine radiographic examinations. A radiologist and a neurosurgeon independently counted the number of presacral vertebrae in a cranial-to-caudal approach with cross-referencing of cervicothoracic and lumbar MRI sagittal series on the PACS workstation. Radiographic numbering from the cervical through the thoracic to the lumbar vertebrae, as a reference standard, was completed independently by the two reviewers. An analysis of the inter-observer and intermodality agreements of radiography and MRI was done. In all cases except one, concordant numbering existed between the two modalities of MRI cross-referencing and radiographs combination. Both observers agreed completely, with no inter-observer discordance. The number of vertebrae could be identified consistently by counting caudally from C2 with cross-referencing cervicothoracic and lumbosacral sagittal MRI scans on the PACS workstation.

  2. Lumbosacral transitional vertebra in a population-based study of 5860 individuals: Prevalence and relationship to low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Min; Yang, Xian-feng; Yang, Shang-wen; Han, Peng; Ma, Yi-ming; Yu, Hui; Zhu, Bin, E-mail: zhubinradio@163.com

    2014-09-15

    Purpose: To investigate the prevalence of lumbosacral transitional vertebra (LSTV) within the Chinese Han population, and to determine whether LSTV correlates with low back pain (LBP) and gluteal pain. Materials and methods: Typical standing pelvic radiographs were obtained for 5860 volunteers between 18 to 60 years of age. The lumbosacral region of each spine was evaluated to identify LSTV, which was classified into types I, II, III, and IV based on Castellvi's method. Histories of low back symptoms were obtained using a questionnaire. The association of different subtypes of LSTV with LBP and gluteal pain was explored. Results: LSTV was found in 15.8% (928 of 5860) of our study population. Of the 928 individuals with LSTV, 44.8% were type I (dysplastic transverse process with height >19 mm), 43.2% were type II (pseudoarticulation), 7.2% were type III (fusion), and 4.8% were type IV (a unilateral type II transition with a type III fusion on the contralateral side). Type II LSTV were closely associated with LBP and gluteal pain, with respective odds ratios (ORs) of 2.56 (95% CI: 2.17–3.89) and 5.38 (95% CI: 4.29–8.43). Similarly, types IV LSTV also demonstrated a significant correlation with LBP and gluteal pain, with respective ORs of 4.28 (95% CI: 3.21–6.35) and 6.82 (95% CI: 5.17–16.59). Conclusions: In this population-based study, the prevalence of LSTV was 15.8%, with type I being the most common. Importantly, LSTV types II and IV were significantly associated with LBP and gluteal pain.

  3. Reconstructing Age Distribution, Season of Capture and Growth Rate of Fish from Archaeological Sites Based on Otoliths and Vertebrae

    NARCIS (Netherlands)

    Neer, van W.; Lougas, L.; Rijnsdorp, A.D.

    1999-01-01

    The growth increments of otoliths and vertebrae of plaice (Pleuronectes platessa) derived from a 15th century single depositional event at Raversijde (Belgium) are analysed with the aim of reconstructing (a) the age distribution of the population, (b) the season of capture, and (c) the growth rate.

  4. Influence of the cranial base flexion on Class I, II and III malocclusions: a systematic review

    Science.gov (United States)

    de Almeida, Kélei Cristina Mathias; Raveli, Taísa Boamorte; Vieira, Camila Ivini Viana; dos Santos-Pinto, Ary; Raveli, Dirceu Barnabé

    2017-01-01

    ABSTRACT Objective: The aim of this study was to perform a systematic review on the morphological characteristics of the skull base (flexion, anterior length and posterior length) and the concomitant development of malocclusions, by comparing differences in dimorphism, ethnicity and age. Methods: The articles were selected by means of electronic search on BBO, MEDLINE and LILACS databases from 1966 to 2016. A qualitative evaluation of the methodologies used on the articles was also performed. Results: Although the literature on this topic is abundant, only 16 articles were selected for the present systematic review. The cranial base angle itself does not seem to play a significant role in the development of malocclusions. In fact, the cranial base angle is relatively stable at the ages of 5 to 15 years. Conclusions: A more obtuse angle at the skull base, in association or not with a greater anterior length of the cranial base, can contribute to the development of Class II division 1 malocclusions. On the other hand, a more acute angle at the skull base can contribute to a more anterior positioning of the mandible and to the development of Class III malocclusions. PMID:29160345

  5. Cranial base topology and basic trends in the facial evolution of Homo.

    Science.gov (United States)

    Bastir, Markus; Rosas, Antonio

    2016-02-01

    Facial prognathism and projection are important characteristics in human evolution but their three-dimensional (3D) architectonic relationships to basicranial morphology are not clear. We used geometric morphometrics and measured 51 3D-landmarks in a comparative sample of modern humans (N = 78) and fossil Pleistocene hominins (N = 10) to investigate the spatial features of covariation between basicranial and facial elements. The study reveals complex morphological integration patterns in craniofacial evolution of Middle and Late Pleistocene hominins. A downwards-orientated cranial base correlates with alveolar maxillary prognathism, relatively larger faces, and relatively larger distances between the anterior cranial base and the frontal bone (projection). This upper facial projection correlates with increased overall relative size of the maxillary alveolar process. Vertical facial height is associated with tall nasal cavities and is accommodated by an elevated anterior cranial base, possibly because of relations between the cribriform and the nasal cavity in relation to body size and energetics. Variation in upper- and mid-facial projection can further be produced by basicranial topology in which the midline base and nasal cavity are shifted anteriorly relative to retracted lateral parts of the base and the face. The zygomatics and the middle cranial fossae act together as bilateral vertical systems that are either projected or retracted relative to the midline facial elements, causing either midfacial flatness or midfacial projection correspondingly. We propose that facial flatness and facial projection reflect classical principles of craniofacial growth counterparts, while facial orientation relative to the basicranium as well as facial proportions reflect the complex interplay of head-body integration in the light of encephalization and body size decrease in Middle to Late Pleistocene hominin evolution. Developmental and evolutionary patterns of integration may

  6. Growth control of the cranial base. A study with experimentally bipedal male rats

    Energy Technology Data Exchange (ETDEWEB)

    Smit-Vis, J.H.

    1981-01-01

    In a cross-sectional study the postnatal development of the skull, particularly that of the cranial base, was studied in experimentally bipedal male rats, up to the age of 46 weeks. A total of 81 bipedal rats and a control group of 90 animals were studied. It was found that, as compared with control rats, the bipedal rats had a definitely more spherical skull. This was the result of an increased height and a stronger dorsal flexion of the anterior cranial base. As to the chondrocranial elements, the basi-occipital bone reached, on the average, the same length in bipedal rats as in controls. However, the basisphenoid bone was significantly shorter. Arguments are given to relate the latter phenomenon to the altered shape of the neurocranium. The conclusion is drawn that, in this experimental approach, chondrocranial growth at the intersphenoidal synchondrosis is controlled not only by intrinsic genetic factors but also by local epigenetic and/or environmental factors.

  7. Computer-based surgical planning and custom-made titanium implants for cranial fibrous dysplasia.

    Science.gov (United States)

    Tehli, Ozkan; Dursun, Ahmet Murat; Temiz, Caglar; Solmaz, Ilker; Kural, Cahit; Kutlay, Murat; Kacar, Yunus; Ezgu, Mehmet Can; Oguz, Erbil; Daneyemez, Mehmet K; Izci, Yusuf

    2015-06-01

    The procedure of reconstruction after the removal of cranial fibrous dysplasia (FD) must be precise to achieve good functional and aesthetic results. Intraoperative modeling of implants is difficult and may cause cosmetic disturbances. To present our experience with the treatment of cranial FD using preoperative computer-based surgical planning of tumor removal with reconstruction of the cranium with custom-made titanium implants. Four patients underwent surgical treatment for cranial FD over a 2-year period. All patients were male with a mean age of 25.25 years and had monostotic-type FD. Computed tomography (CT) with 0.5-mm slices was obtained preoperatively. Computer-based planning of the tumor removal was performed, and a template was created by the computer to determine the margins of tumor removal. After this procedure, the preoperative computer-based construction of the titanium implant was performed. The patients underwent surgical treatment, and the tumor was removed with the use of this template. Then, the titanium implant was inserted onto the bone defect and fixed with mini-screws. Patients were followed up by periodic CT scans. The histological diagnosis of all patients was FD. No intraoperative or postoperative complications have occurred. Postoperative CT scans showed complete tumor removal and confirmed appropriate cosmetic reconstruction. The mean follow-up period was 15.25 months. Computer-based surgical planning associated with the production of custom-made titanium implants is a highly promising method for the treatment of cranial FD. Better radiological and cosmetic outcomes could be obtained by this technique with interdisciplinary work with medical designers.

  8. Cranial base and airway morphology in adult malays with obstructive sleep apnoea.

    Science.gov (United States)

    Banabilh, Saeed M; Suzina, A H; Dinsuhaimi, Sidek; Singh, G D

    2007-11-01

    Obstructive sleep apnoea (OSA) has been described as a public health problem comparable to smoking in its impacts upon society. To compare the differences in cranial base and airway morphology in Malay adults with and without OSA using finite element analysis (FEM). Lateral skull radiographs of 38 adult Malays aged 18-60 years were divided into two groups of 19 (13 male, 6 female). The first group consisted of 19 patients with OSA, defined as an apnoea-hypopnea index > 5/hr of sleep, diagnosed with overnight polysomnography. The second group consisted of 19 healthy, non-OSA control subjects. For each lateral skull radiograph 27 homologous landmarks, which encompassed the naso-oropharyngeal airway, were digitised using MorphoStudio software. The mean OSA and control 2D airway configurations were computed and subjected to t-tests and FEM. The mean 2D OSA airway was statistically different from the mean control airway (p analysis revealed that the cranial base saddle angle was more acute in the OSA group (153.9 degrees +/- 3.4) compared to the control group (158.3 degrees +/- 2.5; p Functional airway impairments associated with OSA can be quantified and localised in Malay patients, and are predominantly associated with the morphology of the posterior regions of the cranial base.

  9. Changes in cranial base and craniocervical junction during growth in healthy individuals and in patients with Osteogenesis imperfecta

    OpenAIRE

    Arponen, Heidi

    2012-01-01

    Cranial base and craniocervical junction anatomy can be evaluated from CT and MR scans, and lateral skull radiographs. Cranial base anatomy changes during growth, as the form of the anatomic structures and their relative positions alter. In disorders of compromised bone quality, abnormal changes in the craniocervical junction can lead to pathological conditions with possibly life-threatening neurological complications. In this investigation these issues have first been addressed by making sku...

  10. Low-Cost Smartphone-Based Photogrammetry for the Analysis of Cranial Deformation in Infants.

    Science.gov (United States)

    Barbero-García, Inés; Lerma, José Luis; Marqués-Mateu, Ángel; Miranda, Pablo

    2017-06-01

    Cranial deformation, including deformational plagiocephaly, brachycephaly, and craniosynostosis, is a condition that affects a large number of infants. Despite its prevalence, there are no standards for the systematic evaluation of the cranial deformation. Usually, the deformation is measured manually by the use of calipers. Experts, however, do not agree on the suitability of these measurements to correctly represent the deformation. Other methodologies for evaluation include 3-dimensional (3D) photography and radiologic scanners. These techniques require either patient's sedation and ionizing radiation or high investment. The aim of this study is to develop a novel, low-cost, and minimally invasive methodology to correctly evaluate the cranial deformation using 3D imagery. A smart phone was used to record a slow motion video sequence on 5 different patients. Then, the videos were processed to create accurate 3D models of the patients' head, and the results were compared with the measurements obtained by the manual caliper. The correspondence between the manual and the photogrammetric 3D model measurements was high as far as head marks are available, with differences of 2 mm ± 0.9 mm; without marks, measurement results differed up to 20 mm. Smartphone-based photogrammetry is a low-cost, highly useful methodology to evaluate cranial deformation. This technique provides a much larger quantity of information than linear measurements with a similar accuracy as far as head marks exist. In addition, a new approach for the evaluation is pointed out: the comparison between the head 3D model and an ideal head, represented by a 3-axis ellipsoid. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The cranial base of Australopithecus afarensis: new insights from the female skull.

    Science.gov (United States)

    Kimbel, William H; Rak, Yoel

    2010-10-27

    Cranial base morphology differs among hominoids in ways that are usually attributed to some combination of an enlarged brain, retracted face and upright locomotion in humans. The human foramen magnum is anteriorly inclined and, with the occipital condyles, is forwardly located on a broad, short and flexed basicranium; the petrous elements are coronally rotated; the glenoid region is topographically complex; the nuchal lines are low; and the nuchal plane is horizontal. Australopithecus afarensis (3.7-3.0 Ma) is the earliest known species of the australopith grade in which the adult cranial base can be assessed comprehensively. This region of the adult skull was known from fragments in the 1970s, but renewed fieldwork beginning in the 1990s at the Hadar site, Ethiopia (3.4-3.0 Ma), recovered two nearly complete crania and major portions of a third, each associated with a mandible. These new specimens confirm that in small-brained, bipedal Australopithecus the foramen magnum and occipital condyles were anteriorly sited, as in humans, but without the foramen's forward inclination. In the large male A.L. 444-2 this is associated with a short basal axis, a bilateral expansion of the base, and an inferiorly rotated, flexed occipital squama--all derived characters shared by later australopiths and humans. However, in A.L. 822-1 (a female) a more primitive morphology is present: although the foramen and condyles reside anteriorly on a short base, the nuchal lines are very high, the nuchal plane is very steep, and the base is as relatively narrow centrally. A.L. 822-1 illuminates fragmentary specimens in the 1970s Hadar collection that hint at aspects of this primitive suite, suggesting that it is a common pattern in the A. afarensis hypodigm. We explore the implications of these specimens for sexual dimorphism and evolutionary scenarios of functional integration in the hominin cranial base.

  12. Skull Base Meningiomas and Cranial Nerves Contrast Using Sodium Fluorescein: A New Application of an Old Tool.

    Science.gov (United States)

    da Silva, Carlos Eduardo; da Silva, Vinicius Duval; da Silva, Jefferson Luis Braga

    2014-08-01

    Objective The identification of cranial nerves is one of the most challenging goals in the dissection of skull base meningiomas. The authors present an application of sodium fluorescein (SF) in skull base meningiomas with the purpose of improving the identification of cranial nerves. Design A prospective study within-subjects design. Setting Hospital Ernesto Dornelles, Porto Alegre, Brazil. Participants Patients with skull base meningiomas. Main Outcomes Measures Cranial nerve identification. Results The group of nine meningiomas was composed of one cavernous sinus, three petroclival, one tuberculum sellae, two sphenoid wing, one olfactory groove, and one temporal floor meningioma. The SF enhancement in all tumors was strong, and the contrast with cranial nerves clearly evident. There were one definite olfactory nerve deficit, one transient abducens deficit, and one definite hemiparesis. All lesions were resected (Simpson grades 1 and 2). The analysis of the difference of the delta SF wavelength between the meningiomas and cranial nerve contrast was performed by the Wilcoxon signed rank test and showed p = 0.011. Conclusions The contrast between the enhanced meningiomas and cranial nerves was evident and assisted in the visualization and microsurgical dissection of these structures. The anatomical preservation of these structures was improved using the contrast.

  13. On prediction of the strength levels and failure patterns of human vertebrae using quantitative computed tomography (QCT)-based finite element method.

    Science.gov (United States)

    Mirzaei, Majid; Zeinali, Ahad; Razmjoo, Arash; Nazemi, Majid

    2009-08-07

    This paper presents an effective patient-specific approach for prediction of failure initiation and growth in human vertebra using the general framework of the quantitative computed tomography (QCT)-based finite element method (FEM). The studies were carried out on 13 vertebrae (lumbar and thoracic), excised from 3 cadavers with the average age of 42 years old. Initially, 4 samples were QCT scanned and the images were directly converted into voxel-based 3D finite element models for linear and nonlinear analyses. The equivalent plastic strains obtained from the nonlinear analyses were used to predict the occurrence of local failures and development of the failure patterns. In the linear analyses, the strain energy density measure was used to identify the critical elements and predict the failure patterns. Subsequently, the samples were destructively tested in uniaxial compression and the experimental load-displacement diagrams were obtained. The plain radiographic images of the tested samples were also examined for observation of the failure patterns. In continuation, the presence of osteolytic defects in vertebrae was simulated by creation of artificial cavities within 9 remaining samples using a computer numerical control (CNC) milling machine. The same protocol was followed for scanning, modeling, and destructive testing of these samples. A strong correlation was found between the predicted and measured strengths. Finally, a typical vertebroplasty treatment was simulated by injection of low-viscosity bone cement within 3 compressed samples. The failure patterns and the associated load levels for these samples were also predicted using the QCT voxel-based FEM.

  14. Intraoperative monitoring of lower cranial nerves in skull base surgery: technical report and review of 123 monitored cases.

    Science.gov (United States)

    Topsakal, Cahide; Al-Mefty, Ossama; Bulsara, Ketan R; Williford, Veronica S

    2008-01-01

    The fundamental goal of skull base surgery is tumor removal with preservation of neurological function. Injury to the lower cranial nerves (LCN; CN 9-12) profoundly affects a patient's quality of life. Although intraoperative cranial nerve monitoring (IOM) is widely practiced for other cranial nerves, literature addressing the LCN is scant. We examined the utility of IOM of the LCN in a large patient series. One hundred twelve patients underwent 123 skull base operations with IOM between January 1994 to December 1999. The vagus nerve (n=37), spinal accessory nerve (n=118), and the hypoglossal nerve (n=83) were monitored intraoperatively. Electromyography (EMG) and compound muscle action potentials (CMAP) were recorded from the relevant muscles after electrical stimulation. This data was evaluated retrospectively. Patients who underwent IOM tended to have larger tumors with more intricate involvement of the lower cranial nerves. Worsening of preoperative lower cranial nerve function was seen in the monitored and unmonitored groups. With the use of IOM in the high risk group, LCN injury was reduced to a rate equivalent to that of the lower risk group (p>0.05). The immediate feedback obtained with IOM may prevent injury to the LCN due to surgical manipulation. It can also help identify the course of a nerve in patients with severely distorted anatomy. These factors may facilitate gross total tumor resection with cranial nerve preservation. The incidence of high false positive and negative CMAP and the variability in CMAP amplitude and threshold can vary depending on individual and technical factors.

  15. [Stature estimation for Sichuan Han nationality female based on X-ray technology with measurement of lumbar vertebrae].

    Science.gov (United States)

    Qing, Si-han; Chang, Yun-feng; Dong, Xiao-ai; Li, Yuan; Chen, Xiao-gang; Shu, Yong-kang; Deng, Zhen-hua

    2013-10-01

    To establish the mathematical models of stature estimation for Sichuan Han female with measurement of lumbar vertebrae by X-ray to provide essential data for forensic anthropology research. The samples, 206 Sichuan Han females, were divided into three groups including group A, B and C according to the ages. Group A (206 samples) consisted of all ages, group B (116 samples) were 20-45 years old and 90 samples over 45 years old were group C. All the samples were examined lumbar vertebrae through CR technology, including the parameters of five centrums (L1-L5) as anterior border, posterior border and central heights (x1-x15), total central height of lumbar spine (x16), and the real height of every sample. The linear regression analysis was produced using the parameters to establish the mathematical models of stature estimation. Sixty-two trained subjects were tested to verify the accuracy of the mathematical models. The established mathematical models by hypothesis test of linear regression equation model were statistically significant (Pstature estimation for Sichuan Han females.

  16. Radiographic cephalometry assessment of the linear and angular parameters on cranial base in children with skeletal class III

    Directory of Open Access Journals (Sweden)

    Stojanović Zdenka M.

    2007-01-01

    Full Text Available Background/Aim. In malocclusion of skeletal class III, mandible is located in front of maxilla in sagital plain, which is manifested by a lower value of the sagital inter-jaw angle than in skeletal class I, where the jaw sagital relation is normal. Apart from the deformities on mandible and/or maxilla, in skeletal class III deformities are also frequent on the cranial base. The aim of this research was to find the differences in the parameter values on the cranial base among the children with skeletal class III and the children with skeletal class I in the period of mixed dentition. Methods. After clinical examination and orthopan-tomography, profile radiography of the head was analyzed in 60 examinees, aged from 6−12 years. The examinees were divided into two groups: group 1 - the children with skeletal class III; group 2 - the children with skeletal class I. Both linear and angular parameters on the cranial base were measured, as well as the angles of maxillary and mandible prognatism and the angle of sagital inter-jaw relation. The level of difference in the parameter values between the groups was estimated and the degree of correlation of the main angle of the cranial base with the angles of sagital position of the jaws in each of the two groups was established. Results. A significant difference between the groups was found only in the average values of the angles of maxillary prognatism and sagital interjaw relation. In the group 1, the main angle of the cranial base was in a significant correlation with the angles of sagital positions of the jaws, while in the group 2, such significance was not found. Conclusion. There were no significant differences in the parameter values on the cranial base between the groups. There was a significant correlation of the main angle of the cranial base with the angles of sagital position of the jaws in the group 1 only. .

  17. A cephalometric analysis of the cranial base and frontal part of the face in patients with mandibular prognathism

    Directory of Open Access Journals (Sweden)

    Čutović Tatjana

    2014-01-01

    Full Text Available Bacground/Aim. The literature suggests different views on the correlation between the cranial base morphology and size and saggital intermaxillary relationships. The aim of this study was to investigate the cranial base morphology, including the frontal facial part in patients with mandibular prognathism, to clarify a certain ambiguities, in opposing viewspoints in the literature. Methods. Cephalometric radiographies of 60 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18-35 years, with no previous orthodontic treatment. On the basis of dental and sceletal relations of jaws and teeth, the patients were divided into two groups: the group P (patients with mandibular prognathism and the group E (the control group or eugnathic patients. A total of 15 cephalometric parametres related to the cranial base, frontal part of the face and sagittal intermaxillary relationships were measured and analyzed. Results. The results show that cranial base dimensions and the angle do not play a significant role in the development of mandibular prognathism. Interrelationship analysis indicated a statistically significant negative correlation between the cranial base angle (NSAr and the angles of maxillary (SNA and mandibular (SNB prognathism, as well as a positive correlation between the angle of inclination of the ramus to the cranial base (GoArNS and the angle of sagittal intermaxillary relationships (ANB. Sella turcica dimensions, its width and depth, as well as the nasal bone length were significantly increased in the patients with mandibular prognathism, while the other analyzed frontal part dimensions of the face were not changed by the malocclusion in comparison with the eugnathic patients. Conclusion. This study shows that the impact of the cranial base and the frontal part of the face on the development of profile in patients with mandibular prognathism is much smaller, but

  18. Effects on the maxilla and cranial base caused by cervical headgear: A longitudinal study

    OpenAIRE

    Alió-Sanz, Juan; Iglesias-Conde, Carmen; Lorenzo-Pernía, José; Iglesias-Linares, Alejandro; Mendoza-Mendoza, Asunción; Solano-Reina, Enrique

    2012-01-01

    Objectives: The aim of this study is to test the possible orthopedic effects of cervical headgear on the cranial base and maxilla. Study design: a sample consisting of 79 subjects with skeletal class II malocclusion was divided into two groups. The experimental group was made up of 41 patients all treated with cervical headgear. The control group included a total of 38 non-treated patients. Each one of these groups was then subdivided according to age into one of three groups: prepubescent, p...

  19. Cranial base and maxillary changes in patients treated with Fankel s functional regulator (1b)

    OpenAIRE

    Alió Sanz, Juan José; Iglesias Conde, Carmen; Lorenzo Pernía, José; Iglesias Linares, Alejandro; Mendoza Mendoza, Asunción; Solano Reina, Enrique

    2012-01-01

    Objectives: The purpose of this study was to assess cranial base and maxillary growth in patients with Class II-type I malocclusions when treated with Frankel’s functional regulator (FR-1b). Study Design: The treatment group was made up of 43 patients that were divided into two groups: prepubescent (n: 28), and pubescent (n: 15). The control group included 40 patients who did not receive any kind of treatment and were likewise divided into a prepubescent group (n: 19), and a pubescent group (...

  20. 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.)

  1. A Computed Tomography-Based Comparison of Abnormal Vertebrae Pedicles Between Dystrophic and Nondystrophic Scoliosis in Neurofibromatosis Type 1.

    Science.gov (United States)

    Li, Ying; Luo, Ming; Wang, Wengang; Shen, Mingkui; Xu, Genzhong; Gao, Jianbo; Xia, Lei

    2017-10-01

    To explore the prevalence and distribution of abnormal vertebral pedicles in scoliosis secondary to neurofibromatosis type 1 (NF1-S) and to compare the abnormal vertebrae pedicles between dystrophic and nondystrophic scoliosis. Using computed tomography images, we carefully measured 2652 vertebral pedicles from 56 patients with NF1-S with dystrophic scoliosis and 22 patients with NF1-S with nondystrophic scoliosis. Pedicle morphology was classified as follows: type A, a cancellous channel of >4 mm; type B, a cancellous channel of 2 to 4 mm; type C, a cancellous channel of scoliosis compared with nondystrophic scoliosis (70% vs. 59%, P scoliosis compared with nondystrophic ones. The described pedicle classification system could serve as an objective tool to guide preoperative assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Fabrication of a radiotherapeutic carrier for a case of fibrosarcoma invaded to the left cranial base

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Ryo [Tokyo Medical and Dental Univ. (Japan). Graduate School; Inoue, Takaaki; Mukohyama, Hitoshi [and others

    2000-06-01

    Radiotherapy has the advantage in treating the malignant tumor developed in head and neck region, especially in preserving the function and shape of the tissue. Since 1981, we have cooperated with radiotherapists in fabricating various kinds of custom-made radiotherapy prostheses such as shields, spacers, carriers and molds. The purpose of a carrier is to place the radioactive source close to the tumor so that a concentrated dose is delivered to the tumor tissue with minimum irradiation of healthy tissue. We fabricated a radiotherapy appliance (a carrier) for a fibrosarcoma that had developed in the left cranial base. Since the maxillary defect was large and connected to oral cavity, the carrier was designed to introduce Gold-198 grains to the tumor while being anchored with a plate section. A satisfactory treatment result was obtained with this design of carrier. This article describes the fabrication procedure of this carrier, which comprised an anchoring plate attached to the remaining palate and teeth, and a carrier section extending from the anchoring plate to the cranial base where the fibrosarcoma had invaded. (author)

  3. Prospective evaluation of a web-based three-dimensional cranial nerve simulation.

    Science.gov (United States)

    Yeung, Jeffrey C; Fung, Kevin; Wilson, Timothy D

    2012-12-01

    Advancements in technology and personal computing afford the development of novel teaching modalities such as online Web-based modules. These modules are currently being incorporated into undergraduate medical curricula and, in some paradigms, have been shown to be superior to traditional methods of instruction. The purpose of this study was to evaluate the ability of a computer-assisted learning (CAL) module to demonstrate content and spatial information in the context of cranial nerve anatomy. Undergraduate anatomy students. A prospective, randomized, controlled trial was conducted comparing a CAL module to traditional text-/image-based learning supplements. Indications of the participants' ability to translate spatial relationships between the trigeminal nerve and the craniofacial skeleton were assessed via a postintervention knowledge quiz. No significant difference was identified between the CAL module and the control group. Students in both groups performed poorly in questions testing spatial relationships. The CAL module used in the present study did not objectively contribute to the understanding of spatial anatomic relationships of the cranial nerves in novice students. Despite this, these modules may help pique student interest and motivation and, as such, may be used in the context of supplemental learning resources in existing university curricula.

  4. Hepatocellular carcinoma metastasizing to the skull base involving multiple cranial nerves.

    Science.gov (United States)

    Kim, Soo Ryang; Kanda, Fumio; Kobessho, Hiroshi; Sugimoto, Koji; Matsuoka, Toshiyuki; Kudo, Masatoshi; Hayashi, Yoshitake

    2006-11-07

    We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-year-old woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI) disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

  5. Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement.

    Science.gov (United States)

    Dröge, L H; Hinsche, T; Canis, M; Alt-Epping, B; Hess, C F; Wolff, H A

    2014-02-01

    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.

  6. Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.

    Science.gov (United States)

    Coll, Guillaume; Lemaire, Jean-Jacques; Di Rocco, Federico; Barthélémy, Isabelle; Garcier, Jean-Marc; De Schlichting, Emmanuel; Sakka, Laurent

    2016-11-01

    To date, no study has compared the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification. To illustrate these features in healthy children. The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan. The mean FMA of 6.49 cm in girls was significantly inferior to the FMA of 7.67 cm in boys (P < .001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P < .001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously. The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P ≤ .02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P = .01). AIOS, anterior interoccipital synchondrosesFMA, foramen magnum areaLS, lambdoid suturesOMS, occipitomastoidal synchondrosesPCFV, posterior cranial fossa volumePIOS, posterior interoccipital synchondrosesPOS, petro-occipital synchondrosesSOS, spheno-occipital synchondrosisyo, years old.

  7. Dynamic trajectory-based couch motion for improvement of radiation therapy trajectories in cranial SRT

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald, R. Lee [Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada); Thomas, Christopher G., E-mail: Chris.Thomas@cdha.nshealth.ca [Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada); Department of Medical Physics, Nova Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia B3H 1V7 (Canada); Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada); Department of Radiology, Dalhousie University, Halifax, Nova Scotia B3H 4R2 (Canada)

    2015-05-15

    Purpose: To investigate potential improvement in external beam stereotactic radiation therapy plan quality for cranial cases using an optimized dynamic gantry and patient support couch motion trajectory, which could minimize exposure to sensitive healthy tissue. Methods: Anonymized patient anatomy and treatment plans of cranial cancer patients were used to quantify the geometric overlap between planning target volumes and organs-at-risk (OARs) based on their two-dimensional projection from source to a plane at isocenter as a function of gantry and couch angle. Published dose constraints were then used as weighting factors for the OARs to generate a map of couch-gantry coordinate space, indicating degree of overlap at each point in space. A couch-gantry collision space was generated by direct measurement on a linear accelerator and couch using an anthropomorphic solid-water phantom. A dynamic, fully customizable algorithm was written to generate a navigable ideal trajectory for the patient specific couch-gantry space. The advanced algorithm can be used to balance the implementation of absolute minimum values of overlap with the clinical practicality of large-scale couch motion and delivery time. Optimized cranial cancer treatment trajectories were compared to conventional treatment trajectories. Results: Comparison of optimized treatment trajectories with conventional treatment trajectories indicated an average decrease in mean dose to the OARs of 19% and an average decrease in maximum dose to the OARs of 12%. Degradation was seen for homogeneity index (6.14% ± 0.67%–5.48% ± 0.76%) and conformation number (0.82 ± 0.02–0.79 ± 0.02), but neither was statistically significant. Removal of OAR constraints from volumetric modulated arc therapy optimization reveals that reduction in dose to OARs is almost exclusively due to the optimized trajectory and not the OAR constraints. Conclusions: The authors’ study indicated that simultaneous couch and gantry motion

  8. Benign cranial dural arteriovenous fistulas : outcome of conservative management based on the natural history of the lesion

    NARCIS (Netherlands)

    Satomi, J; van Dijk, JMC; TerBrugge, KG; Willinsky, RA; Wallace, M C

    2002-01-01

    Object. Cranial dural arteriovenous fistulas (DAVFs) can be classified into benign or aggressive, based on their patterns of venous drainage. A benign condition requires the absence of cortical venous drainage (CVD). The clinical and angiographic features of a consecutive single-center group of 117

  9. Fully endoscopic supraorbital keyhole approach to the anterior cranial base: A cadaveric study

    Directory of Open Access Journals (Sweden)

    Mehmet Osman Akçakaya

    2015-01-01

    Full Text Available Introduction: The supraorbital keyhole approach for anterior cranial base lesions has been increasingly used in clinical practice. Anatomical studies focusing on the endoscopic anatomy via this approach are few, although the microscopic anatomy has been well studied. The aim of this study is to describe the anatomical features and surgical exposure provided by the endoscopic supraorbital keyhole approach using quantitative measurements. Materials and Methods: Nine formalin-fixed human cadavers from the inventory of the Anatomy department were used. A total of 18 supraorbital keyhole cranitomies were conducted. The distances between the target anatomical structures and the dura mater at the craniotomy site, and the distances between deep anatomical structures were measured with purpose-designed hooks. Results: The distance between the dura mater and optic canal was measured as 69.5 ± 6.7 mm (62-83 mm; optic chiasm as 76.2 ± 5.4 mm (67-86 mm; anterior communicating artery as 82.6 ± 6.1 mm (71-93 mm; internal carotid artery (ICA bifurcation as 74.7 ± 6.0 mm (66-84 mm and the basilar tip as 94.9 ± 7.0 mm (87-111 mm. The mean diameter of the optic canal was 7.4 ± 1.3 mm (6-11 mm, whereas the mean diameter of diaphragma sellae was measured as 8.4 ± 1.1 mm (7-10 mm. Conclusions: The results of this study showed that the anterior anda medial aspects of the anterior cranial fossa can be visualized properly. Dissection of the ipsilateral arteries of Circle of Willis can be performed easily using an endoscopic supraorbital keyhole approach.

  10. Hominid evolution of the arteriovenous system through the cranial base and its relevance for craniosynostosis.

    Science.gov (United States)

    Kunz, Alexandra R; Iliadis, Charalampos

    2007-12-01

    This paper discusses how the evolving hominid architecture of the arteriovenous system through the cranial base diverted foreseeable pathology in the human brain. Bipedal upright posture was an early adaptation in mosaic morphological pattern changes in hominid evolution; a key feature, the ability of blood to flow either to vertebral or internal jugular venous systems. Encephalization punctuated hominid evolution, its vulnerable feature, a lower threshold for thermal damage. Comparative analysis of ape and human skulls show "fingerprint" structures, revealing big changes in pattern complexity of the cranial vascular tree. Clues to structural/functional changes span data for apes, humans, and hominid fossils. Here, the increasing vascular network, Australopithecus to Homo sapiens, necessitated changes in the blood flow patterns. The transverse-sigmoid (T/S) and occipital-marginal (O/M) venous networks accommodated hydrostatic changes of blood flow, regulating temperature uniquely: the O/M system enlarged, allowing blood to flow straight down into the vertebral plexus without cooling, and added a vast network of emissary/diploic veins, acting as a brain cooling "radiator." This O/M system was fixed in the Australopithecus robustus lineage, p = 0.000001; high frequencies of emissary foramen were selected for over time. Ontologically, the human neonatal O/M system is fully developed; emissary/diploic veins are established by age 5, setting conditions for selective brain cooling. The Radiator Theory is the evolution of the functionally efficient brain cooling system, fixed in the A. robustus lineage, tying hydrostatic consequences of bipedalism with release of a "thermal constraint" on the encephalizing brain, and reflected in our own ontogeny.

  11. Comparison of closure times for cranial base synchondroses in mesaticephalic, brachycephalic, and Cavalier King Charles Spaniel dogs.

    Science.gov (United States)

    Schmidt, Martin J; Volk, Holger; Klingler, Melanie; Failing, Klaus; Kramer, Martin; Ondreka, Nele

    2013-01-01

    Premature closure of cranial base synchondroses has been proposed as the mechanism for brachycephaly in dogs and caudal occipital malformation syndrome (COMS) in Cavalier King Charles Spaniels. The purpose of this retrospective study was to compare times of closure for cranial base synchondroses in mesaticephalic, brachycephalic, and Cavalier King Charles Spaniel dogs. Cranial magnetic resonance imaging studies were retrieved for client-owned dogs less than 18 months of age. Breed, age, skull conformation, and the open or closed state of cranial base synchondroses were independently recorded by two observers. For dogs with a unanimous observer agreement, regression analysis was used to test effects of age and gender on the open or closed status of synchondroses and differences between groups. A total of 174 dogs were included in MRI interpretations and 165 dogs were included in the regression analysis. Statistically significant differences in closure time of the spheno-occipital synchondrosis were identified between brachycephalic and mesaticephalic dogs (P = 0.016), Cavalier King Charles Spaniels and mesaticephalic dogs (P Spaniels and brachycephalic dogs (P = 0.014). Findings from the current study supported the theory that morphological changes leading to the skull phenotype of the Cavalier King Charles Spaniels could be due to an earlier closure of the spheno-occipital synchondrosis. © 2013 Veterinary Radiology & Ultrasound.

  12. 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.

  13. Construction of a three-dimensional interactive model of the skull base and cranial nerves.

    Science.gov (United States)

    Kakizawa, Yukinari; Hongo, Kazuhiro; Rhoton, Albert L

    2007-05-01

    The goal was to develop an interactive three-dimensional (3-D) computerized anatomic model of the skull base for teaching microneurosurgical anatomy and for operative planning. The 3-D model was constructed using commercially available software (Maya 6.0 Unlimited; Alias Systems Corp., Delaware, MD), a personal computer, four cranial specimens, and six dry bones. Photographs from at least two angles of the superior and lateral views were imported to the 3-D software. Many photographs were needed to produce the model in anatomically complex areas. Careful dissection was needed to expose important structures in the two views. Landmarks, including foramen, bone, and dura mater, were used as reference points. The 3-D model of the skull base and related structures was constructed using more than 300,000 remodeled polygons. The model can be viewed from any angle. It can be rotated 360 degrees in any plane using any structure as the focal point of rotation. The model can be reduced or enlarged using the zoom function. Variable transparencies could be assigned to any structures so that the structures at any level can be seen. Anatomic labels can be attached to the structures in the 3-D model for educational purposes. This computer-generated 3-D model can be observed and studied repeatedly without the time limitations and stresses imposed by surgery. This model may offer the potential to create interactive surgical exercises useful in evaluating multiple surgical routes to specific target areas in the skull base.

  14. Original Research. Correlation Between Cranial Base Morphology And Various Types Of Skeletal Anomalies

    Directory of Open Access Journals (Sweden)

    Panainte Irinel

    2017-03-01

    Full Text Available Background: Previous studies regarding various types of malocclusions have found correlations between the angle of the base of the skull and prognathism. Aim of the study: This cephalometric study sought to investigate the function of the cranium base angle in different types of malocclusion on a group of Romanian subjects. Materials and methods: Forty-four cephalometric radiographs were selected from patients referred to orthodontic treatment. The cephalometric records were digitized, and with the CorelDRAW Graphics Suite X5 software 22 landmarks have been marked on each radiograph. A number of linear and angular variables were calculated. Results: The angle of the base of the skull was found to be higher in Class II Division 1 subjects compared to the Class I group. The cranial base lengths, N-S and S-Ba, were significantly larger in both categories of Class II malocclusion than in Class I patients, but measurements were comparable in Class I and Class III. The SNA angle showed no considerable variation between Class I subjects and the other groups. SNA-SNP was significantly increased above Class I values in Class II Division1 and Class II Division 2 groups. No significant dissimilarities were observed for these lengths between Class I and Class III patients. Conclusions: The angle of the cranium base (S-N-Ba, S-N-Ar does not have a major role in the progression of malocclusion. In Angle Class II malocclusion the SNA angle is increased, and SNB is increased in malocclusion Class III. The anterior skull base length is increased in Class II anomalies. The length of the maxillary bone base is increased in Class II malocclusions type; in Class III type of malocclusion the length of the mandible bone is increased.

  15. Anterior and middle cranial fossa skull base reconstruction using microvascular free tissue techniques: surgical complications and functional outcomes.

    Science.gov (United States)

    Chiu, Ernest S; Kraus, Dennis; Bui, Duc T; Mehrara, Babak J; Disa, Joseph J; Bilsky, Mark; Shah, Jatin P; Cordeiro, Peter G

    2008-05-01

    Surgical ablation for oncologic disease requiring skull base resection can result in both facial disfigurement and a complex wound defect with exposed orbital content, oral cavity, bone, and dural lining. Inadequate reconstruction can result in brain abscesses, meningitis, osteomyelitis, visual disturbances, speech impairment, and altered oral intake. This study assesses the functional outcomes of patients who undergo anterior and middle cranial fossa skull base reconstruction using microsurgical free tissue transfer techniques. Using a prospectively maintained database, a 10-year, single institution retrospective chart review was performed on patients who had surgery for anterior and middle cranial base tumor resections. The type of resection, reconstruction method, complication rate, and functional outcomes were reviewed. From 1992 to 2003, 70 patients (49 men, 21 women) with a mean age of 54 (age 6-78) underwent anterior and middle cranial skull base tumor resection and reconstruction. The patients were divided into the following groups: maxillectomy with orbital content preservation (n = 21), orbitomaxillectomy with palatal preservation (n = 26), and orbitomaxillectomy with palatal resection (n = 23). The average length of hospital stay was 12.6 days. The vertical rectus abdominis myocutaneous flap was used in the majority of cases to correct midface defects. Two flaps required emergent re-exploration; however, there were no flap failures. Early and late postoperative complications were investigated. Cerebrospinal fluid was observed infrequently (7%) and did not require additional surgical intervention. Intracranial abscesses were encountered rarely (1.4%). Patients who had maxillectomy with orbital preservation and reconstruction had minor ophthalmologic eyelid changes that occurred frequently. Patients who required palatal reconstruction had a normal or intelligible speech (93%) and unrestricted or soft diet (88%). Using a multidisciplinary surgical team

  16. Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study.

    Science.gov (United States)

    Dolati, Parviz; Gokoglu, Abdulkerim; Eichberg, Daniel; Zamani, Amir; Golby, Alexandra; Al-Mefty, Ossama

    2015-01-01

    Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured. Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases. Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients.

  17. Covariation between midline cranial base, lateral basicranium, and face in modern humans and chimpanzees: a 3D geometric morphometric analysis.

    Science.gov (United States)

    Neaux, Dimitri; Guy, Franck; Gilissen, Emmanuel; Coudyzer, Walter; Ducrocq, Stéphane

    2013-04-01

    Previous studies showed that in modern humans the basicranium is formed of two modules: the midline cranial base and the lateral basicranium which are integrated with the face in very different ways. The study of the relationship between these structures is of prime interest in the context of hominids craniofacial evolutionary history. In this study, we aim to test if the relationship between the midline cranial base and the face on one hand and the lateral basicranium and the face on the other hand are qualitatively and quantitatively different in modern humans and chimpanzees: two phylogenetically close but morphologically different hominids. This work is performed using three-dimensional (3D) landmarks to take into account the face and basicranium 3D shape. Modern humans and chimpanzees both exhibit a significant relationship between lateral basicranium and face, and a nonsignificant relationship between midline cranial base and face. However, the patterns of integration are different for the two species. These results underscore the essential role of the lateral basicranial shape in the setting of the facial morphology in modern humans and chimpanzees. The important differences in the patterns of integration may be related to the genetic, developmental, and functional requirements of each taxon, acquired along their respective evolution. From a common, tight, relationship between lateral basicranium, and face, each taxon may develop different patterns of integration in order to adapt to particular functions and morphologies. Copyright © 2013 Wiley Periodicals, Inc.

  18. Imaging of lumbosacral transitional vertebrae

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, R.J.; Saifuddin, A. E-mail: asaifuddin@aol.com

    2004-11-01

    Lumbosacral transitional vertebrae (LSTV) are a common finding in the general population. Their clinical significance is controversial with no consensus as to their relationship to low back pain or disc prolapse. However, on magnetic resonance imaging (MRI) they may be difficult to positively identify on sagittal sequences and can lead to confusion with respect to numbering of lumbar discs and vertebrae, with the consequent risk of surgical intervention at an inappropriate level. The imaging findings of LSTV on plain radiography and MRI are reviewed and their clinical significance discussed.

  19. A revised cranial description of Massospondylus carinatus Owen (Dinosauria: Sauropodomorpha based on computed tomographic scans and a review of cranial characters for basal Sauropodomorpha

    Directory of Open Access Journals (Sweden)

    Kimberley E.J. Chapelle

    2018-01-01

    Full Text Available Massospondylus carinatus is a basal sauropodomorph dinosaur from the early Jurassic Elliot Formation of South Africa. It is one of the best-represented fossil dinosaur taxa, known from hundreds of specimens including at least 13 complete or nearly complete skulls. Surprisingly, the internal cranial anatomy of M. carinatus has never been described using computed tomography (CT methods. Using CT scans and 3D digital representations, we digitally reconstruct the bones of the facial skeleton, braincase, and palate of a complete, undistorted cranium of M. carinatus (BP/1/5241. We describe the anatomical features of the cranial bones, and compare them to other closely related sauropodomorph taxa such as Plateosaurus erlenbergiensis, Lufengosaurus huenei, Sarahsaurus aurifontanalis and Efraasia minor. We identify a suite of character states of the skull and braincase for M. carinatus that sets it apart from other taxa, but these remain tentative due to the lack of comparative sauropodomorph braincase descriptions in the literature. Furthermore, we hypothesize 27 new cranial characters useful for determining relationships in non-sauropodan Sauropodomorpha, delete five pre-existing characters and revise the scores of several existing cranial characters to make more explicit homology statements. All the characters that we hypothesized or revised are illustrated. Using parsimony as an optimality criterion, we then test the relationships of M. carinatus (using BP/1/5241 as a specimen-level exemplar in our revised phylogenetic data matrix.

  20. Cranial electrotherapy stimulation and transcranial pulsed current stimulation: a computer based high-resolution modeling study.

    Science.gov (United States)

    Datta, Abhishek; Dmochowski, Jacek P; Guleyupoglu, Berkan; Bikson, Marom; Fregni, Felipe

    2013-01-15

    The field of non-invasive brain stimulation has developed significantly over the last two decades. Though two techniques of noninvasive brain stimulation--transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS)--are becoming established tools for research in neuroscience and for some clinical applications, related techniques that also show some promising clinical results have not been developed at the same pace. One of these related techniques is cranial electrotherapy stimulation (CES), a class of transcranial pulsed current stimulation (tPCS). In order to understand further the mechanisms of CES, we aimed to model CES using a magnetic resonance imaging (MRI)-derived finite element head model including cortical and also subcortical structures. Cortical electric field (current density) peak intensities and distributions were analyzed. We evaluated different electrode configurations of CES including in-ear and over-ear montages. Our results confirm that significant amounts of current pass the skull and reach cortical and subcortical structures. In addition, depending on the montage, induced currents at subcortical areas, such as midbrain, pons, thalamus and hypothalamus are of similar magnitude than that of cortical areas. Incremental variations of electrode position on the head surface also influence which cortical regions are modulated. The high-resolution modeling predictions suggest that details of electrode montage influence current flow through superficial and deep structures. Finally we present laptop based methods for tPCS dose design using dominant frequency and spherical models. These modeling predictions and tools are the first step to advance rational and optimized use of tPCS and CES. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. PARAMETRIC MODEL OF LUMBAR VERTEBRA

    Directory of Open Access Journals (Sweden)

    CAPPETTI Nicola

    2010-11-01

    Full Text Available The present work proposes the realization of a parametric/variational CAD model of a normotype lumbar vertebra, which could be used for improving the effectiveness of actual imaging techniques in informational augmentation of the orthopaedic and traumatological diagnosis. In addition it could be used for ergonomic static and dynamical analysis of the lumbar region and vertebral column.

  2. Cranial mononeuropathy VI

    Science.gov (United States)

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

  3. Accuracy and reproducibility of voxel based superimposition of cone beam computed tomography models on the anterior cranial base and the zygomatic arches.

    Directory of Open Access Journals (Sweden)

    Rania M Nada

    Full Text Available Superimposition of serial Cone Beam Computed Tomography (CBCT scans has become a valuable tool for three dimensional (3D assessment of treatment effects and stability. Voxel based image registration is a newly developed semi-automated technique for superimposition and comparison of two CBCT scans. The accuracy and reproducibility of CBCT superimposition on the anterior cranial base or the zygomatic arches using voxel based image registration was tested in this study. 16 pairs of 3D CBCT models were constructed from pre and post treatment CBCT scans of 16 adult dysgnathic patients. Each pair was registered on the anterior cranial base three times and on the left zygomatic arch twice. Following each superimposition, the mean absolute distances between the 2 models were calculated at 4 regions: anterior cranial base, forehead, left and right zygomatic arches. The mean distances between the models ranged from 0.2 to 0.37 mm (SD 0.08-0.16 for the anterior cranial base registration and from 0.2 to 0.45 mm (SD 0.09-0.27 for the zygomatic arch registration. The mean differences between the two registration zones ranged between 0.12 to 0.19 mm at the 4 regions. Voxel based image registration on both zones could be considered as an accurate and a reproducible method for CBCT superimposition. The left zygomatic arch could be used as a stable structure for the superimposition of smaller field of view CBCT scans where the anterior cranial base is not visible.

  4. 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.

  5. Cranial computed tomography associated with development of functional dependence in a community-based elderly population

    Energy Technology Data Exchange (ETDEWEB)

    Tsukishima, Eri; Shido, Koichi [Hokkaido Univ., Sapporo (Japan). Graduate School of Medicine; Saito, Hiroya [Asahikawa Kosei General Hospital (Japan)] (and others)

    2002-03-01

    The purpose of this study was to investigate whether changes at computed tomography (CT) imaging in the ageing brain are associated with future risks for functional dependence. One hundred sixty residents aged 69 years and older at the cranial CT and were independently living in a rural community in Hokkaido, Japan. Cranial CT was performed between 1991 and 1993, graded for ventricular enlargement, sulcal enlargement, white matter change, and small infarction. Functional status was reassessed in 1998 in each participant. Multiple logistic regression analysis was performed to estimate the association of CT changes in the ageing brain with development of functional dependence over six years. Functional dependence was found in 19 residents at the second survey. After adjusting for age, sex, medical conditions, and cognitive functioning, small infarction and ventricular enlargement were significantly associated with development of functional dependence (adjusted odds ratio=9.27 and 4.62). After controlling for age, the age-related changes on cranial CT have significant association on development of functional dependence. (author)

  6. Eustachian tube-tensor veli palatini muscle-cranial base relationships in children and adults: an osteological study.

    Science.gov (United States)

    Doyle, William J; Swarts, J Douglas

    2010-09-01

    The vector relationships between the Eustachian tube, Tensor veli palatini muscle and cranial base constrain the efficiency of middle ear pressure-regulation and are required parameters for computational modeling of Eustachian tube function. Here, those relationships were reconstructed from skulls and compared between children and adults. Reconstructions were made using modifications of previously described techniques for 18 child skulls aged 3-4 years and 20 adult skulls (10 females, 10 males; >18 years). Measured and calculated variables were compared between groups using a Student's t-test. Consistent with previous reports, certain variables for adult skulls exhibited sexual dimorphism. Between children and adults, significant differences were documented for measures of cranial base length and width; hard palate width; nasopharyngeal height, width and depth; Eustachian tube length; the maximum and minimum Tensor veli palatini muscle lengths; the angles of deviation of the Tensor veli palatini muscle from the Eustachian tube, and the surface area of the Tensor veli palatini muscle. There were no between-group differences in the angle of Eustachian tube decent from the cranial base, Eustachian tube deviation from the parasagittal plane or the lateral component of the Tensor veli palatine muscle-Eustachian tube angle. The differences between children and adults that could account for the observed poorer Eustachian tube function in children include their shorter Eustachian tube, lesser Tensor veli palatine muscle-Eustachian tube vectors, and the lesser Tensor veli palatine muscle surface area. Other observed differences are attributable to growth and development of the craniofacial complex. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Anatomy of the skull base and the cranial nerves in slice imaging; Anatomie der Schaedelbasis und Hirnnerven in der Schnittbildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Bink, A.; Berkefeld, J.; Zanella, F. [Klinikum der Goethe-Universitaet Frankfurt, Institut fuer Neuroradiologie, Frankfurt am Main (Germany)

    2009-07-15

    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.) [German] Zur Untersuchung der Schaedelbasis sind sowohl die Computertomographie (CT) als auch Magnetresonanztomographie (MRT) geeignet. Waehrend mittels CT vorzugsweise die exakte knoecherne Ausbreitung von Pathologien z. B. zur operativen Therapieplanung erfasst werden, dient die MRT sowohl der Darstellung von Pathologien bzgl. ihrer Ausbreitung im Weichteilgewebe als auch dem Nachweis knoecherner Infiltration. Bei der Untersuchung der Schaedelbasis wird eine hochaufloesende Darstellung mit geringer Schichtdicke fuer beide Modalitaeten angestrebt. Die genaue Kenntnis der Anatomie ist bereits bei der Untersuchungsplanung notwendig. Sie ist zudem Voraussetzung fuer das Erkennen und die korrekte Interpretation von Pathologien. Die MRT ist die bildgebende Methode der Wahl zur Abklaerung von Pathologien der Hirnnerven. Dabei ist es durch gezielte Sequenzauswahl, die sich nach den die Hirnnerven umgebenen Strukturen richtet, moeglich, den gesamten Verlauf der Hirnnerven zu beurteilen. Dieser Artikel beschreibt die Untersuchung der Schaedelbasis

  8. Automatic segmentation of vertebrae from radiographs

    DEFF Research Database (Denmark)

    Mysling, Peter; Petersen, Peter Kersten; Nielsen, Mads

    2011-01-01

    Segmentation of vertebral contours is an essential task in the design of automatic tools for vertebral fracture assessment. In this paper, we propose a novel segmentation technique which does not require operator interaction. The proposed technique solves the segmentation problem in a hierarchical...... is constrained by a conditional shape model, based on the variability of the coarse spine location estimates. The technique is evaluated on a data set of manually annotated lumbar radiographs. The results compare favorably to the previous work in automatic vertebra segmentation, in terms of both segmentation...

  9. [Imaging anatomy of cranial nerves].

    Science.gov (United States)

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

    2009-04-01

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

  10. Three Dimensional (3D Lumbar Vertebrae Data Set

    Directory of Open Access Journals (Sweden)

    H. Bennani

    2016-08-01

    Full Text Available 3D modelling can be used for a variety of purposes, including biomedical modelling for orthopaedic or anatomical applications. Low back pain is prevalent in society yet few validated 3D models of the lumbar spine exist to facilitate assessment. We therefore created a 3D surface data set for lumbar vertebrae from human vertebrae. Models from 86 lumbar vertebrae were constructed using an inexpensive method involving image capture by digital camera and reconstruction of 3D models via an image-based technique. The reconstruction method was validated using a laser-based arm scanner and measurements derived from real vertebrae using electronic callipers. Results show a mean relative error of 5.2% between image-based models and real vertebrae, a mean relative error of 4.7% between image-based and arm scanning models and 95% of vertices’ errors are less than 3.5 millimetres with a median of 1.1 millimetres. The accuracy of the method indicates that the generated models could be useful for biomechanical modelling or 3D visualisation of the spine.

  11. 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.

  12. Clinical evaluation of a dose monitoring software tool based on Monte Carlo Simulation in assessment of eye lens doses for cranial CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Guberina, Nika; Suntharalingam, Saravanabavaan; Nassenstein, Kai; Forsting, Michael; Theysohn, Jens; Wetter, Axel; Ringelstein, Adrian [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2016-10-15

    The aim of this study was to verify the results of a dose monitoring software tool based on Monte Carlo Simulation (MCS) in assessment of eye lens doses for cranial CT scans. In cooperation with the Federal Office for Radiation Protection (Neuherberg, Germany), phantom measurements were performed with thermoluminescence dosimeters (TLD LiF:Mg,Ti) using cranial CT protocols: (I) CT angiography; (II) unenhanced, cranial CT scans with gantry angulation at a single and (III) without gantry angulation at a dual source CT scanner. Eye lens doses calculated by the dose monitoring tool based on MCS and assessed with TLDs were compared. Eye lens doses are summarized as follows: (I) CT angiography (a) MCS 7 mSv, (b) TLD 5 mSv; (II) unenhanced, cranial CT scan with gantry angulation, (c) MCS 45 mSv, (d) TLD 5 mSv; (III) unenhanced, cranial CT scan without gantry angulation (e) MCS 38 mSv, (f) TLD 35 mSv. Intermodality comparison shows an inaccurate calculation of eye lens doses in unenhanced cranial CT protocols at the single source CT scanner due to the disregard of gantry angulation. On the contrary, the dose monitoring tool showed an accurate calculation of eye lens doses at the dual source CT scanner without gantry angulation and for CT angiography examinations. The dose monitoring software tool based on MCS gave accurate estimates of eye lens doses in cranial CT protocols. However, knowledge of protocol and software specific influences is crucial for correct assessment of eye lens doses in routine clinical use. (orig.)

  13. Clinical evaluation of a dose monitoring software tool based on Monte Carlo Simulation in assessment of eye lens doses for cranial CT scans.

    Science.gov (United States)

    Guberina, Nika; Suntharalingam, Saravanabavaan; Naßenstein, Kai; Forsting, Michael; Theysohn, Jens; Wetter, Axel; Ringelstein, Adrian

    2016-10-01

    The aim of this study was to verify the results of a dose monitoring software tool based on Monte Carlo Simulation (MCS) in assessment of eye lens doses for cranial CT scans. In cooperation with the Federal Office for Radiation Protection (Neuherberg, Germany), phantom measurements were performed with thermoluminescence dosimeters (TLD LiF:Mg,Ti) using cranial CT protocols: (I) CT angiography; (II) unenhanced, cranial CT scans with gantry angulation at a single and (III) without gantry angulation at a dual source CT scanner. Eye lens doses calculated by the dose monitoring tool based on MCS and assessed with TLDs were compared. Eye lens doses are summarized as follows: (I) CT angiography (a) MCS 7 mSv, (b) TLD 5 mSv; (II) unenhanced, cranial CT scan with gantry angulation, (c) MCS 45 mSv, (d) TLD 5 mSv; (III) unenhanced, cranial CT scan without gantry angulation (e) MCS 38 mSv, (f) TLD 35 mSv. Intermodality comparison shows an inaccurate calculation of eye lens doses in unenhanced cranial CT protocols at the single source CT scanner due to the disregard of gantry angulation. On the contrary, the dose monitoring tool showed an accurate calculation of eye lens doses at the dual source CT scanner without gantry angulation and for CT angiography examinations. The dose monitoring software tool based on MCS gave accurate estimates of eye lens doses in cranial CT protocols. However, knowledge of protocol and software specific influences is crucial for correct assessment of eye lens doses in routine clinical use.

  14. Microvascular Cranial Nerve Palsy

    Science.gov (United States)

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

  15. Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey

    2013-06-01

    Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG.

  16. New phylogenetic analysis of the family elephantidae based on cranial-dental morphology.

    Science.gov (United States)

    Todd, Nancy E

    2010-01-01

    In 1973, Vincent Maglio published a seminal monograph on the evolution of the Elephantidae, in which he revised and condensed the 100+ species named by Henry Fairfield Osborn in 1931. Michel Beden further revised the African Elephantidae in 1979, but little systematic work has been done on the family since this publication. With addition of new specimens and species and revisions of chronology, a new analysis of the phylogeny and systematics of this family is warranted. A new, descriptive character dataset was generated from studies of modern elephants for use with fossil species. Parallel evolution in cranial and dental characters in all three lineages of elephants creates homoplastic noise in cladistic analysis, but new inferences about evolutionary relationships are possible. In this analysis, early Loxodonta and early African Mammuthus are virtually indistinguishable in dental morphology. The Elephas lineage is not monophyletic, and results from this analysis suggest multiple migration events out of Africa into Eurasia, and possibly back into Africa. New insight into the origin of the three lineages is also proposed, with Stegotetrabelodon leading to the Mammuthus lineage, and Primelephas as the ancestor of Loxodonta and Elephas. These new results suggest a much more complex picture of elephantid origins, evolution, and paleogeography. (c) 2009 Wiley-Liss, Inc.

  17. Developmental Changes in Morphology of the Middle and Posterior External Cranial Base in Modern Homo sapiens.

    Science.gov (United States)

    Dalal, Deepal H; Smith, Heather F

    2015-01-01

    The basicranium has been described as phylogenetically informative, developmentally stable, and minimally affected by external factors and consequently plays an important role in cranial size and shape in subadult humans. Here basicranial variation of subadults from several modern human populations was investigated and the impact of genetic relatedness on basicranial morphological similarities was investigated. Three-dimensional landmark data were digitized from subadult basicrania from seven populations. Published molecular data on short tandem repeats were statistically compared to morphological data from three ontogenetic stages. Basicranial and temporal bone morphology both reflect genetic distances in childhood and adolescence (5-18 years), but not in infancy (<5 years). The occipital bone reflects genetic distances only in adolescence (13-18 years). The sphenoid bone does not reflect genetic distances at any ontogenetic stage but was the most diagnostic region evaluated, resulting in high rates of correct classification among populations. These results suggest that the ontogenetic processes driving basicranial development are complex and cannot be succinctly summarized across populations or basicranial regions. However, the fact that certain regions reflect genetic distances suggests that the morphology of these regions may be useful in reconstructing population history in specimens for which direct DNA evidence is unavailable, such as archaeological sites.

  18. Injectable PLGA based Colloidal Gels for Zero-order Dexamethasone Release in Cranial Defects

    Science.gov (United States)

    Wang, Qun; Wang, Jinxi; Lu, Qinghua; Detamore, Michael S.; Berkland, Cory

    2010-01-01

    Bone fillers have emerged as an alternative to the invasive surgery often required to repair skeletal defects. Achieving controlled release from these materials is desired for accelerating healing. Here, oppositely-charged Poly (d,l-lactic-co-glycolic acid) (PLGA) nanoparticles were used to create a cohesive colloidal gel as an injectable drug-loaded filler to promote healing in bone defects. The colloid self-assembled through electrostatic forces resulting in a stable 3-D network that may be extruded or molded to the desired shape. The colloidal gel demonstrated shear-thinning behavior due to the disruption of interparticle interactions as the applied shear force was increased. Once the external force was removed, the cohesive property of the colloidal gel was recovered. Similar reversibility and shear-thinning behavior were also observed in colloidal gels loaded with dexamethasone. Near zero-order dexamethasone release was observed over two months when the drug was encapsulated in PLGA nanoparticles and simply blending the drug with the colloidal gel showed similar kinetics for one month. Surgical placement was facilitated by the pseudoplastic material properties and in vivo observations demonstrated that the PLGA colloidal gels stimulated osteoconductive bone formation in rat cranial bone defects. PMID:20303585

  19. The "no-drill" technique of anterior clinoidectomy: a cranial base approach to the paraclinoid and parasellar region.

    Science.gov (United States)

    Chang, Dongwoo John

    2009-03-01

    A high-speed power-drilling technique of anterior clinoidectomy has been advocated in all publications on paraclinoid region surgery. The entire shaft of the power drill is exposed in the operative field; thus, all neurovascular structures in proximity to any portion of the full length of the rotating drill bit are at risk for direct mechanical and/or thermal injury. Ultrasonic bone removal has recently been developed to mitigate the potential complications of the traditional power-drilling technique of anterior clinoidectomy. However, ultrasound-related cranial neuropathies are recognized complications of its use, as well as the increased cost of device acquisition and maintenance. A retrospective review of a cerebrovascular/cranial base fellowship-trained neurosurgeon's 45 consecutive cases of anterior clinoidectomy using the "no-drill" technique is presented. Clinical indications have been primarily small to giant aneurysms of the proximal internal carotid artery; however, in addition to ophthalmic segment aneurysms, selected internal carotid artery-posterior communicating artery aneurysms and internal carotid artery bifurcation aneurysms, and other large/giant/complex anterior circulation aneurysms, this surgical series of "no-drill" anterior clinoidectomy includes tuberculum sellae meningiomas, clinoidal meningiomas, cavernous sinus lesions, pituitary macroadenomas with significant suprasellar extension, other perichiasmal lesions (sarcoid), and fibrous dysplasia. A bony opening is made in the mid-to posterior orbital roof after the initial pterional craniotomy. Periorbita is dissected off the bone from inside the orbital compartment. Subsequent piecemeal resection of the medial sphenoid wing, anterior clinoid process, optic canal roof, and optic strut is performed with bone rongeurs of various sizes via the bony window made in the orbital roof. No power drilling was used in this surgical series of anterior clinoidectomies. Optimal microsurgical exposure was

  20. 76 FR 48062 - Effective Date of Requirement for Premarket Approval for Cranial Electrotherapy Stimulator

    Science.gov (United States)

    2011-08-08

    ... Approval for Cranial Electrotherapy Stimulator AGENCY: Food and Drug Administration, HHS. ACTION: Proposed... Cranial Electrotherapy Stimulator. The Agency is also summarizing its proposed findings regarding the... classification of the cranial electrotherapy stimulator based on new information. This action implements certain...

  1. Primate cranial diversity.

    Science.gov (United States)

    Fleagle, John G; Gilbert, Christopher C; Baden, Andrea L

    2010-08-01

    Many studies in primate and human evolution focus on aspects of cranial morphology to address issues of systematics, phylogeny, and functional anatomy. However, broad analyses of cranial diversity within Primates as an Order are notably absent. In this study, we present a 3D geometric morphometric analysis of primate cranial morphology, providing a multivariate comparison of the major patterns of cranial shape change during primate evolution and quantitative assessments of cranial diversity among different clades. We digitized a set of 18 landmarks designed to capture overall cranial shape on male and female crania representing 66 genera of living primates. The landmark data were aligned using a Generalized Procrustes Analysis and then subjected to a principal components analysis to identify the major axes of cranial variation. Cranial diversity among clades was compared using multivariate measurements of variance. The first principal component axis reflects differences in cranial flexion, orbit size and orientation, and relative neurocranial volume. In general, it separates strepsirrhines from anthropoids. The second axis reflects differences in relative cranial height and snout length and primarily describes differences among anthropoids. Eulemur, Mandrillus, Pongo, and Homo are among the extremes in cranial shape. Anthropoids, catarrhines, and haplorhines show a higher variance than prosimians or strepsirrhines. Hominoids show the highest variance in cranial shape among extant primate clades, and much of this diversity is driven by the unique cranium of Homo sapiens. Copyright 2010 Wiley-Liss, Inc.

  2. Improved UTE-based attenuation correction for cranial PET-MR using dynamic magnetic field monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Aitken, A. P.; Giese, D.; Tsoumpas, C.; Schleyer, P.; Kozerke, S.; Prieto, C.; Schaeffter, T., E-mail: Tobias.Schaeffter@kcl.ac.uk [Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King' s College London, King' s Health Partners, St. Thomas Hospital, London SE1 7EH (United Kingdom)

    2014-01-15

    Purpose: Ultrashort echo time (UTE) MRI has been proposed as a way to produce segmented attenuation maps for PET, as it provides contrast between bone, air, and soft tissue. However, UTE sequences require samples to be acquired during rapidly changing gradient fields, which makes the resulting images prone to eddy current artifacts. In this work it is demonstrated that this can lead to misclassification of tissues in segmented attenuation maps (AC maps) and that these effects can be corrected for by measuring the true k-space trajectories using a magnetic field camera. Methods: The k-space trajectories during a dual echo UTE sequence were measured using a dynamic magnetic field camera. UTE images were reconstructed using nominal trajectories and again using the measured trajectories. A numerical phantom was used to demonstrate the effect of reconstructing with incorrect trajectories. Images of an ovine leg phantom were reconstructed and segmented and the resulting attenuation maps were compared to a segmented map derived from a CT scan of the same phantom, using the Dice similarity measure. The feasibility of the proposed method was demonstrated inin vivo cranial imaging in five healthy volunteers. Simulated PET data were generated for one volunteer to show the impact of misclassifications on the PET reconstruction. Results: Images of the numerical phantom exhibited blurring and edge artifacts on the bone–tissue and air–tissue interfaces when nominal k-space trajectories were used, leading to misclassification of soft tissue as bone and misclassification of bone as air. Images of the tissue phantom and thein vivo cranial images exhibited the same artifacts. The artifacts were greatly reduced when the measured trajectories were used. For the tissue phantom, the Dice coefficient for bone in MR relative to CT was 0.616 using the nominal trajectories and 0.814 using the measured trajectories. The Dice coefficients for soft tissue were 0.933 and 0.934 for the

  3. Role of Anatomical Landmarks in Identifying Normal and Transitional Vertebra in Lumbar Spine Magnetic Resonance Imaging.

    Science.gov (United States)

    Jagannathan, Devimeenal; Indiran, Venkatraman; Hithaya, Fouzal; Alamelu, M; Padmanaban, S

    2017-06-01

    Retrospective study. Identification of transitional vertebra is important in spine imaging, especially in presurgical planning. Pasted images of the whole spine obtained using high-field magnetic resonance imaging (MRI) are helpful in counting vertebrae and identifying transitional vertebrae. Counting vertebrae and identifying transitional vertebrae is challenging in isolated studies of lumbar spine and in studies conducted in low-field MRI. An incorrect evaluation may lead to wrong-level treatment. Here, we identify the location of different anatomical structures that can help in counting and identifying vertebrae. Many studies have assessed the vertebral segments using various anatomical structures such as costal facets (CF), aortic bifurcation (AB), inferior vena cava confluence (IC), right renal artery (RRA), celiac trunk (CT), superior mesenteric artery root (SR), iliolumbar ligament (ILL) psoas muscle (PM) origin, and conus medullaris. However, none have yielded any consistent results. We studied the locations of the anatomical structures CF, AB, IC, RRA, CT, SR, ILL, and PM in patients who underwent whole spine MRI at our department. In our study, 81.4% patients had normal spinal segmentation, 14.7% had sacralization, and 3.8% had lumbarization. Vascular landmarks had variable origin. There were caudal and cranial shifts with respect to lumbarization and sacralization. In 93.8% of cases in the normal group, ILL emerged from either L5 alone or the adjacent disc. In the sacralization group, ILL was commonly seen in L5. In the lumbarization group, ILL emerged from L5 and the adjacent disc (66.6%). CFs were identified at D12 in 96.9% and 91.7% of patients in the normal and lumbarization groups, respectively. The PM origin was observed from D12 or D12-L1 in most patients in the normal and sacralization groups. CF, PM, and ILL were good identification markers for D12 and L5, but none were 100% accurate.

  4. Automated Extraction of Cranial Landmarks from Computed Tomography Data using a Combined Method of Knowledge and Pattern Based Approaches

    Directory of Open Access Journals (Sweden)

    Roshan N. RAJAPAKSE

    2016-03-01

    Full Text Available Accurate identification of anatomical structures from medical imaging data is a significant and critical function in the medical domain. Past studies in this context have mainly utilized two main approaches, the knowledge and learning methodologies based methods. Further, most of previous reported studies have focused on identification of landmarks from lateral X-ray Computed Tomography (CT data, particularly in the field of orthodontics. However, this study focused on extracting cranial landmarks from large sets of cross sectional CT slices using a combined method of the two aforementioned approaches. The proposed method of this study is centered mainly on template data sets, which were created using the actual contour patterns extracted from CT cases for each of the landmarks in consideration. Firstly, these templates were used to devise rules which are a characteristic of the knowledge based method. Secondly, the same template sets were employed to perform template matching related to the learning methodologies approach. The proposed method was tested on two landmarks, the Dorsum sellae and the Pterygoid plate, using CT cases of 5 subjects. The results indicate that, out of the 10 tests, the output images were within the expected range (desired accuracy in 7 instances and acceptable range (near accuracy for 2 instances, thus verifying the effectiveness of the combined template sets centric approach proposed in this study.

  5. Dermatome variations in patients with transitional vertebrae

    OpenAIRE

    Seyfert, S.

    1997-01-01

    OBJECTIVES—To test whether the position of lumbosacral dermatomes varies in the presence of transitional vertebrae.
MATERIAL AND METHODS—Fifty consecutive male patients were tested for thoracolumbar and lumbosacral transitional vertebrae by radiography and for the position of the dermatome gap between the lumbar dermatomes Ll, L2, L3, and the sacral dermatomes S2 and S3. The dermatome gap was documented with the use of the cremasteric reflex, the receptive field of which end...

  6. Automated identification of spinal cord and vertebras on sagittal MRI

    Science.gov (United States)

    Zhou, Chuan; Chan, Heang-Ping; Dong, Qian; He, Bo; Wei, Jun; Hadjiiski, Lubomir M.; Couriel, Daniel

    2014-03-01

    We are developing an automated method for the identification of the spinal cord and the vertebras on spinal MR images, which is an essential step for computerized analysis of bone marrow diseases. The spinal cord segment was first enhanced by a newly developed hierarchical multiscale tubular (HMT) filter that utilizes the complementary hyper- and hypo- intensities in the T1-weighted (T1W) and STIR MRI sequences. An Expectation-Maximization (EM) analysis method was then applied to the enhanced tubular structures to extract candidates of the spinal cord. The spinal cord was finally identified by a maximum-likelihood registration method by analysis of the features extracted from the candidate objects in the two MRI sequences. Using the identified spinal cord as a reference, the vertebras were localized based on the intervertebral disc locations extracted by another HMT filter applied to the T1W images. In this study, 5 and 30 MRI scans from 35 patients who were diagnosed with multiple myeloma disease were collected retrospectively with IRB approval as training and test set, respectively. The vertebras manually outlined by a radiologist were used as reference standard. A total of 422 vertebras were marked in the 30 test cases. For the 30 test cases, 100% (30/30) of the spinal cords were correctly segmented with 4 false positives (FPs) mistakenly identified on the back muscles in 4 scans. A sensitivity of 95.0% (401/422) was achieved for the identification of vertebras, and 5 FPs were marked in 4 scans with an average FP rate of 0.17 FPs/scan.

  7. Homology of the cranial vault in birds: new insights based on embryonic fate-mapping and character analysis.

    Science.gov (United States)

    Maddin, Hillary C; Piekarski, Nadine; Sefton, Elizabeth M; Hanken, James

    2016-08-01

    Bones of the cranial vault appear to be highly conserved among tetrapod vertebrates. Moreover, bones identified with the same name are assumed to be evolutionarily homologous. However, recent developmental studies reveal a key difference in the embryonic origin of cranial vault bones between representatives of two amniote lineages, mammals and birds, thereby challenging this view. In the mouse, the frontal is derived from cranial neural crest (CNC) but the parietal is derived from mesoderm, placing the CNC-mesoderm boundary at the suture between these bones. In the chicken, this boundary is located within the frontal. This difference and related data have led several recent authors to suggest that bones of the avian cranial vault are misidentified and should be renamed. To elucidate this apparent conflict, we fate-mapped CNC and mesoderm in axolotl to reveal the contributions of these two embryonic cell populations to the cranial vault in a urodele amphibian. The CNC-mesoderm boundary in axolotl is located between the frontal and parietal bones, as in the mouse but unlike the chicken. If, however, the avian frontal is regarded instead as a fused frontal and parietal (i.e. frontoparietal) and the parietal as a postparietal, then the cranial vault of birds becomes developmentally and topologically congruent with those of urodeles and mammals. This alternative hypothesis of cranial vault homology is also phylogenetically consistent with data from the tetrapod fossil record, where frontal, parietal and postparietal bones are present in stem lineages of all extant taxa, including birds. It further implies that a postparietal may be present in most non-avian archosaurs, but fused to the parietal or supraoccipital as in many extant mammals.

  8. Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey

    2012-08-01

    Objective The main objective of this study was to evaluate the value of free-run electromyography (f-EMG) monitoring of cranial nerves (CNs) VII, IX, X, XI, and XII in skull base surgeries performed using endoscopic endonasal approach (EEA) to reduce iatrogenic CN deficits. Design We retrospectively identified 73 patients out of 990 patients who had EEA in our institution who had at least one CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as group I and those who did not as group II. Results We monitored a total of 342 CNs. A total of 62 nerves had SG f-EMG activity including CN VII = 18, CN IX = 16, CN X = 13, CN XI = 5, and CN XII = 10. No nerve deficit was found in the nerves that had significant activity during procedure. A total of five nerve deficits including (CN IX = 1, CN X = 2, CN XII = 2) were observed in the group that did not display SG f-EMG activity during surgery. Conclusions f-EMG seems highly sensitive to surgical manipulations and in locating CNs. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of lower CNs during EEA procedures need to be done with both f-EMG and triggered EMG.

  9. Lower cranial nerves.

    Science.gov (United States)

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

    2014-02-01

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

  10. Comparative evaluation of cranial base and facial morphology of cleft lip and palate patients with normal individuals in cone beam computed tomography.

    Science.gov (United States)

    Jahanbin, Arezoo; Eslami, Neda; Hoseini Zarch, Hosein; Kobravi, Sepehr

    2015-05-01

    This study aimed to compare the cranial base and facial morphology of cleft lip and palate (CLP) patients with individuals with no cleft. Thirty-two adult individuals including 9 patients without cleft, 14 patients with unilateral CLP, and 9 patients with bilateral CLP participated in the study. The average age of participants was 18.71 ± 2.1 years. Full skull cone-beam computed tomography of all of the participants was taken. Anatomic landmarks were traced in the midsagittal, coronal, and axial planes, and craniofacial height and width-related parameters were compared among the 3 groups. Analysis of variance and Tukey test were used for comparison. P palatal plane was significantly increased in both unilateral (P = 0.013) and bilateral (P = 0.00) cases compared with individuals with no cleft. However, S-N to the palatal plane significantly increased in bilateral cases compared with unilateral clefts (P = 0.028). Based on the results of the current study, adult patients with CLP showed relatively distinctive morphological features in maxillofacial and cranial base regions. It seems that less dysmorphic characteristics are observed in transverse dimensions of the face and basicranium in both types of cleft. On the other hand, lateral cranial base is more affected by CLP compared with the middle basicranium.

  11. 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.

  12. 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.

  13. A method for automatic feature points extraction of human vertebrae three-dimensional model

    Science.gov (United States)

    Wu, Zhen; Wu, Junsheng

    2017-05-01

    A method for automatic extraction of the feature points of the human vertebrae three-dimensional model is presented. Firstly, the statistical model of vertebrae feature points is established based on the results of manual vertebrae feature points extraction. Then anatomical axial analysis of the vertebrae model is performed according to the physiological and morphological characteristics of the vertebrae. Using the axial information obtained from the analysis, a projection relationship between the statistical model and the vertebrae model to be extracted is established. According to the projection relationship, the statistical model is matched with the vertebrae model to get the estimated position of the feature point. Finally, by analyzing the curvature in the spherical neighborhood with the estimated position of feature points, the final position of the feature points is obtained. According to the benchmark result on multiple test models, the mean relative errors of feature point positions are less than 5.98%. At more than half of the positions, the error rate is less than 3% and the minimum mean relative error is 0.19%, which verifies the effectiveness of the method.

  14. Dimensional accuracy of 3D printed vertebra

    Science.gov (United States)

    Ogden, Kent; Ordway, Nathaniel; Diallo, Dalanda; Tillapaugh-Fay, Gwen; Aslan, Can

    2014-03-01

    3D printer applications in the biomedical sciences and medical imaging are expanding and will have an increasing impact on the practice of medicine. Orthopedic and reconstructive surgery has been an obvious area for development of 3D printer applications as the segmentation of bony anatomy to generate printable models is relatively straightforward. There are important issues that should be addressed when using 3D printed models for applications that may affect patient care; in particular the dimensional accuracy of the printed parts needs to be high to avoid poor decisions being made prior to surgery or therapeutic procedures. In this work, the dimensional accuracy of 3D printed vertebral bodies derived from CT data for a cadaver spine is compared with direct measurements on the ex-vivo vertebra and with measurements made on the 3D rendered vertebra using commercial 3D image processing software. The vertebra was printed on a consumer grade 3D printer using an additive print process using PLA (polylactic acid) filament. Measurements were made for 15 different anatomic features of the vertebral body, including vertebral body height, endplate width and depth, pedicle height and width, and spinal canal width and depth, among others. It is shown that for the segmentation and printing process used, the results of measurements made on the 3D printed vertebral body are substantially the same as those produced by direct measurement on the vertebra and measurements made on the 3D rendered vertebra.

  15. Poly(trimethylene carbonate)-based composite materials for reconstruction of critical-sized cranial bone defects in sheep

    NARCIS (Netherlands)

    Zeng, Ni; van Leeuwen, Anne C.; Grijpma, Dirk W.; Bos, Ruud R. M.; Kuijer, Roel

    Purpose: The use of ceramic materials in repair of bone defects is limited to non-load -bearing sites. We tested poly(trimethylene carbonate) (PTMC) combined with beta-tricalcium phosphate or biphasic calcium phosphate particles for reconstruction of cranial defects. Materials and methods:

  16. Poly(trimethylene carbonate)-based composite materials for reconstruction of critical-sized cranial bone defects in sheep

    NARCIS (Netherlands)

    Zeng, Ni; van Leeuwen, Anne C.; Grijpma, Dirk W.; Bos, Ruud R.M.; Kuijer, Roel

    2017-01-01

    Purpose The use of ceramic materials in repair of bone defects is limited to non-load-bearing sites. We tested poly(trimethylene carbonate) (PTMC) combined with β-tricalcium phosphate or biphasic calcium phosphate particles for reconstruction of cranial defects. Materials and methods PTMC-calcium

  17. Analysis of translational errors in frame-based and frameless cranial radiosurgery using an anthropomorphic phantom

    Directory of Open Access Journals (Sweden)

    Taynná Vernalha Rocha Almeida

    2016-04-01

    Full Text Available Abstract Objective: To evaluate three-dimensional translational setup errors and residual errors in image-guided radiosurgery, comparing frameless and frame-based techniques, using an anthropomorphic phantom. Materials and Methods: We initially used specific phantoms for the calibration and quality control of the image-guided system. For the hidden target test, we used an Alderson Radiation Therapy (ART-210 anthropomorphic head phantom, into which we inserted four 5mm metal balls to simulate target treatment volumes. Computed tomography images were the taken with the head phantom properly positioned for frameless and frame-based radiosurgery. Results: For the frameless technique, the mean error magnitude was 0.22 ± 0.04 mm for setup errors and 0.14 ± 0.02 mm for residual errors, the combined uncertainty being 0.28 mm and 0.16 mm, respectively. For the frame-based technique, the mean error magnitude was 0.73 ± 0.14 mm for setup errors and 0.31 ± 0.04 mm for residual errors, the combined uncertainty being 1.15 mm and 0.63 mm, respectively. Conclusion: The mean values, standard deviations, and combined uncertainties showed no evidence of a significant differences between the two techniques when the head phantom ART-210 was used.

  18. Analysis of translational errors in frame-based and frameless cranial radiosurgery using an anthropomorphic phantom

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    Almeida, Taynna Vernalha Rocha [Faculdades Pequeno Principe (FPP), Curitiba, PR (Brazil); Cordova Junior, Arno Lotar; Almeida, Cristiane Maria; Piedade, Pedro Argolo; Silva, Cintia Mara da, E-mail: taynnavra@gmail.com [Centro de Radioterapia Sao Sebastiao, Florianopolis, SC (Brazil); Brincas, Gabriela R. Baseggio [Centro de Diagnostico Medico Imagem, Florianopolis, SC (Brazil); Marins, Priscila; Soboll, Danyel Scheidegger [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil)

    2016-03-15

    Objective: To evaluate three-dimensional translational setup errors and residual errors in image-guided radiosurgery, comparing frameless and frame-based techniques, using an anthropomorphic phantom. Materials and Methods: We initially used specific phantoms for the calibration and quality control of the image-guided system. For the hidden target test, we used an Alderson Radiation Therapy (ART)-210 anthropomorphic head phantom, into which we inserted four 5- mm metal balls to simulate target treatment volumes. Computed tomography images were the taken with the head phantom properly positioned for frameless and frame-based radiosurgery. Results: For the frameless technique, the mean error magnitude was 0.22 ± 0.04 mm for setup errors and 0.14 ± 0.02 mm for residual errors, the combined uncertainty being 0.28 mm and 0.16 mm, respectively. For the frame-based technique, the mean error magnitude was 0.73 ± 0.14 mm for setup errors and 0.31 ± 0.04 mm for residual errors, the combined uncertainty being 1.15 mm and 0.63 mm, respectively. Conclusion: The mean values, standard deviations, and combined uncertainties showed no evidence of a significant differences between the two techniques when the head phantom ART-210 was used. (author)

  19. Analysis of translational errors in frame-based and frameless cranial radiosurgery using an anthropomorphic phantom*

    Science.gov (United States)

    Almeida, Taynná Vernalha Rocha; Cordova Junior, Arno Lotar; Piedade, Pedro Argolo; da Silva, Cintia Mara; Marins, Priscila; Almeida, Cristiane Maria; Brincas, Gabriela R. Baseggio; Soboll, Danyel Scheidegger

    2016-01-01

    Objective To evaluate three-dimensional translational setup errors and residual errors in image-guided radiosurgery, comparing frameless and frame-based techniques, using an anthropomorphic phantom. Materials and Methods We initially used specific phantoms for the calibration and quality control of the image-guided system. For the hidden target test, we used an Alderson Radiation Therapy (ART)-210 anthropomorphic head phantom, into which we inserted four 5mm metal balls to simulate target treatment volumes. Computed tomography images were the taken with the head phantom properly positioned for frameless and frame-based radiosurgery. Results For the frameless technique, the mean error magnitude was 0.22 ± 0.04 mm for setup errors and 0.14 ± 0.02 mm for residual errors, the combined uncertainty being 0.28 mm and 0.16 mm, respectively. For the frame-based technique, the mean error magnitude was 0.73 ± 0.14 mm for setup errors and 0.31 ± 0.04 mm for residual errors, the combined uncertainty being 1.15 mm and 0.63 mm, respectively. Conclusion The mean values, standard deviations, and combined uncertainties showed no evidence of a significant differences between the two techniques when the head phantom ART-210 was used. PMID:27141132

  20. Seasonal Variation, Cranial Autonomic Symptoms, and Functional Disability in Migraine: A Questionnaire-Based Study in Tertiary Care.

    Science.gov (United States)

    Shin, Yong-Won; Park, Hyun-Jung; Shim, Ji-Young; Oh, Min-Jung; Kim, Manho

    2015-09-01

    Seasonal variation of migraine attack frequency has been described as a phenomenon. We aimed to compare functional disability and the occurrence of cranial autonomic symptoms (CASs) in patients who reported a seasonal variation in their migraine attack frequency with those who did not. We conducted a questionnaire-based observational study on patients with migraine without aura who visited our institution from January 2005 to December 2013. Patient demographics, headache characteristics, and accompanying symptoms were recorded, and functional disability was evaluated by Migraine Disability Assessment (MIDAS) Questionnaire. Of 4423 patients screened, 769 were eligible for analysis, and 104 (13.5%) of them reported seasonal variation. Several CAS features such as conjunctival injection (25.0% vs 14.0%), lacrimation (20.2% vs 10.8%), eyelid edema (20.2% vs 10.2%), forehead and facial sweating (22.1% vs 11.4%), and ptosis (23.1% vs 11.4%) were more prominent in this subset of patients. They showed higher MIDAS scores (15.4 ± 23.5) than the other migraineurs (10.4 ± 16.9), with a 1.77-fold increased risk (95% confidence interval 1.06-2.96) of severe functional disability (MIDAS score ≥21) after adjustment for age group, sex, headache frequency, intensity, and duration. The higher the number of CASs, the greater also was the proportion of patients with severe functional disability. Patients who reported seasonal variation in migraine also reported more CASs and had more severe functional disability. The profound functional disability in the migraineurs reporting seasonal variation or CAS also provides direction for proactive clinical management in these patients. © 2015 American Headache Society.

  1. Superior interhemispheric approach for midline meningioma from the anterior cranial base.

    Science.gov (United States)

    Lévêque, S; Derrey, S; Martinaud, O; Gérardin, E; Langlois, O; Fréger, P; Hannequin, D; Castel, H; Proust, F

    2011-07-01

    For suprasellar meningioma, the fronto-basal exposure is considered the standard approach. The superior interhemispheric (IH) approach is less described in the literature. To assess the surgical complications, functional outcome (visual, olfaction), morbidity and mortality rates and late recurrence, after resection by superior IH approach of midline skull base meningioma. Between 1998 and 2008, 52 consecutive patients with midline meningioma on the anterior portion of the skull base (mean age: 63.8 ± 13.1; sex ratio F/M: 3.7) were operated on via the superior IH approach. After a mean follow-up of 56.9 ± 32.9 months, an independent neurosurgeon proposed a prospective examination of functional outcome to each patient, as well as a visual and olfactory function assessment. Fifty-two patients were divided into a group with olfactory groove meningioma (n=34) and another with tuberculum sellae meningioma (n=18). The outcome was characterized by postoperative complications in 13 patients (25%), mortality rate in two (3.8%) and long-term morbidity at in 17 (37%) of 50 surviving patients. Based on multivariate analysis, no prognosis factor was significant as regards the favorable outcome. The mean postoperative KPS score (86.6 ± 9.4) was significantly improved. However, dysexecutive syndrome was observed in four patients (8%), hyposmia-anosmia in 34 (68%) and visual acuity deteriorated in one (2%). The superior IH approach could be considered a safe anteriorly orientated midline approach for removal OGM and TSM meningioma. Copyright © 2011. Published by Elsevier Masson SAS.

  2. Anastomoses between lower cranial and upper cervical nerves: a comprehensive review with potential significance during skull base and neck operations, part I: trigeminal, facial, and vestibulocochlear nerves.

    Science.gov (United States)

    Shoja, Mohammadali M; Oyesiku, Nelson M; Griessenauer, Christoph J; Radcliff, Virginia; Loukas, Marios; Chern, Joshua J; Benninger, Brion; Rozzelle, Curtis J; Shokouhi, Ghaffar; Tubbs, R Shane

    2014-01-01

    Descriptions of the anatomy of the neural communications among the cranial nerves and their branches is lacking in the literature. Knowledge of the possible neural interconnections found among these nerves may prove useful to surgeons who operate in these regions to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections among the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized in two parts. Part I concerns the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches with any other nerve trunk or branch in the vicinity. Part II concerns the anastomoses among the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or among these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part I is presented in this article. An extensive anastomotic network exists among the lower cranial nerves. Knowledge of such neural intercommunications is important in diagnosing and treating patients with pathology of the skull base. Copyright © 2013 Wiley Periodicals, Inc.

  3. Acute injuries of the axis vertebra

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    Burke, J.T. (United General Hospital, Sedro Woolley, WA (USA)); Harris, J.H. (Texas Univ., Houston, TX (USA). Dept. of Radiology)

    1989-08-01

    A retrospective analysis of 165 patients admitted to Hermann Hospital with acute injuries of the axis vertebra revealed 68 (41%) dens fractures, 62 (38%) cases of traumatic spondylolisthesis ('hangman's' fracture), 21 (13%) extension teardrop fractures, 10 (6%) hyperextension dislocations, and 2 (1.0%) fractures each of the laminae and spinous processes. Of the axis injuries 31 (18%) were limited to the axis body alone. Of these, 21 (61%) were hyperextension teardrop fractures and 10 (32%) were hyperextension dislocations. Axis injuries were associated with acute injuries of other cervical vertebrae in 14 (8%) of the patients. (orig./GDG).

  4. Skull-base foramina of the middle cranial fossa : assessment of normal variation with high-resolution CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyae Young [Ewha Woman' s Univ. Hospital, Seoul (Korea, Republic of); Chung, Eun Chul [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Suh, Jeong Soo; Choi, Hye Young [Ewha Woman' s Univ. College of Medicine, Seoul (Korea, Republic of); Ko, Eun Joo [Eulgi Medical Center, Seoul (Korea, Republic of); Lee, Myung Sook [Samsung Cheil Hospital, Seoul (Korea, Republic of)

    1997-05-01

    To recognize foraminal variants of the foraminae of the skull base in the middle cranial fossa, and to thus understand and distinguish normal and potentially abnormal structures. We analysed 163 patients without intracranial disease who had undergone CT scanning. These comprised 82 men and 81 women with a mean age of 39 years (range, 4-73 years). HRCT was performed, using a GE 9800 scanner. All CT scans were obtained 6-7 slices at the base of the skull, with 1.5mm collimation at 1.5mm intervals parallel to the infraorbital line. We analysed the foraminae by closesly correlating imaging findings and established anatomic knowledge. In 45 cases (27.6%) the foramen ovale was 5-10mm in diameter and asymmetrical. Deficiency of the medial bony wall including persistent foramen lacerum medius was seen in five cases (3.1%). Confluence of the foramen ovale and the foramen spinosum was seen in 13 cases (8%) and confluence of the foramen ovale and the foramen of Vesalius in 23 (14.1%). Posterolateral groove for the accessory meningeal artery was observed in 36 cases (22%). The foramen spinosum was asymmetrical in 42 cases (25.8%). A small or absent foramen spinosum with a larger ipsilateral foramen ovale was observed in 11 cases (6.7%). Medial bony defect was seen in 16 cases (9.8%). The foramen spinosum was absent in four cases (2.5%). In 74 cases (45.4%), the foramen of Vesalius was absent; it was present unilaterally and bilaterally in 55 (33.7%) and 34 cases (20.9%), respectively. Five cases showed duplicated foramina. Canaliculus innominatus was seen in 14 cases (8.9%) and was present bilaterally in three (1.8%). HRCT clearly delineates bony structure and is well able to display the rich spectrum of anatomic variation found in the base of the skull. The recognition of these normal variants will result in a better understanding of skull base neurovascular anatomy and diminish speculation as to their true nature during the interpretation of CT images.

  5. Tumors Presenting as Multiple Cranial Nerve Palsies

    Directory of Open Access Journals (Sweden)

    Kishore Kumar

    2017-04-01

    Full Text Available Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor.

  6. Comparative analysis of the anterior and posterior length and deflection angle of the cranial base, in individuals with facial Pattern I, II and III

    Directory of Open Access Journals (Sweden)

    Guilherme Thiesen

    2013-02-01

    Full Text Available OBJECTIVE: This study evaluated the variations in the anterior cranial base (S-N, posterior cranial base (S-Ba and deflection of the cranial base (SNBa among three different facial patterns (Pattern I, II and III. METHOD: A sample of 60 lateral cephalometric radiographs of Brazilian Caucasian patients, both genders, between 8 and 17 years of age was selected. The sample was divided into 3 groups (Pattern I, II and III of 20 individuals each. The inclusion criteria for each group were the ANB angle, Wits appraisal and the facial profile angle (G'.Sn.Pg'. To compare the mean values obtained from (SNBa, S-N, S-Ba each group measures, the ANOVA test and Scheffé's Post-Hoc test were applied. RESULTS AND CONCLUSIONS: There was no statistically significant difference for the deflection angle of the cranial base among the different facial patterns (Patterns I, II and III. There was no significant difference for the measures of the anterior and posterior cranial base between the facial Patterns I and II. The mean values for S-Ba were lower in facial Pattern III with statistically significant difference. The mean values of S-N in the facial Pattern III were also reduced, but without showing statistically significant difference. This trend of lower values in the cranial base measurements would explain the maxillary deficiency and/or mandibular prognathism features that characterize the facial Pattern III.OBJETIVO: o presente estudo avaliou as variações da base craniana anterior (S-N, base craniana posterior (S-Ba, e ângulo de deflexão da base do crânio (SNBa entre três diferentes padrões faciais (Padrão I, II e III. MÉTODOS: selecionou-se uma amostra de 60 telerradiografias em norma lateral de pacientes brasileiros leucodermas, de ambos os sexos, com idades entre 8 anos e 17 anos. A amostra foi dividida em três grupos (Padrão I, II e III, sendo cada grupo constituído de 20 indivíduos. Os critérios de seleção dos indivíduos para cada grupo

  7. Adaptive geodesic transform for segmentation of vertebrae on CT images

    Science.gov (United States)

    Gaonkar, Bilwaj; Shu, Liao; Hermosillo, Gerardo; Zhan, Yiqiang

    2014-03-01

    Vertebral segmentation is a critical first step in any quantitative evaluation of vertebral pathology using CT images. This is especially challenging because bone marrow tissue has the same intensity profile as the muscle surrounding the bone. Thus simple methods such as thresholding or adaptive k-means fail to accurately segment vertebrae. While several other algorithms such as level sets may be used for segmentation any algorithm that is clinically deployable has to work in under a few seconds. To address these dual challenges we present here, a new algorithm based on the geodesic distance transform that is capable of segmenting the spinal vertebrae in under one second. To achieve this we extend the theory of the geodesic distance transforms proposed in1 to incorporate high level anatomical knowledge through adaptive weighting of image gradients. Such knowledge may be provided by the user directly or may be automatically generated by another algorithm. We incorporate information 'learnt' using a previously published machine learning algorithm2 to segment the L1 to L5 vertebrae. While we present a particular application here, the adaptive geodesic transform is a generic concept which can be applied to segmentation of other organs as well.

  8. Poly(trimethylene carbonate)-based composite materials for reconstruction of critical-sized cranial bone defects in sheep.

    Science.gov (United States)

    Zeng, Ni; van Leeuwen, Anne C; Grijpma, Dirk W; Bos, Ruud R M; Kuijer, Roel

    2017-02-01

    The use of ceramic materials in repair of bone defects is limited to non-load-bearing sites. We tested poly(trimethylene carbonate) (PTMC) combined with β-tricalcium phosphate or biphasic calcium phosphate particles for reconstruction of cranial defects. PTMC-calcium phosphate composite matrices were implanted in cranial defects in sheep for 3 and 9 months. Micro-computed tomography quantification and histological observation were performed for analysis. No differences were found in new bone formation among the defects left unfilled, filled with PTMC scaffolds, or filled with either kind of PTMC-calcium phosphate composite scaffolds. Porous β-TCP scaffolds as control led to a larger amount of newly formed bone in the defects than all other materials. Histology revealed abundant new bone formation in the defects filled with porous β-TCP scaffolds. New bone formation was limited in defects filled with PTMC scaffolds or different PTMC-calcium phosphate matrices. PTMC matrices were degraded uneventfully. New bone formation within the defects followed an orderly pattern. PTMC did not interfere with bone regeneration in sheep cranial defects and is suitable as a polymer matrix for incorporating calcium phosphate particles. Increasing the content of calcium phosphate particles in the composite matrices may enhance the beneficial effects of the particles on new bone formation. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Cranial Nerve Disorders in Children: MR Imaging Findings.

    Science.gov (United States)

    Hwang, Jae-Yeon; Yoon, Hye-Kyung; Lee, Jeong Hyun; Yoon, Hee Mang; Jung, Ah Young; Cho, Young Ah; Lee, Jin Seong; Yoon, Chong Hyun

    2016-01-01

    Cranial nerve disorders are uncommon disease conditions encountered in pediatric patients, and can be categorized as congenital, inflammatory, traumatic, or tumorous conditions that involve the cranial nerve itself or propagation of the disorder from adjacent organs. However, determination of the normal course, as well as abnormalities, of cranial nerves in pediatric patients is challenging because of the small caliber of the cranial nerve, as well as the small intracranial and skull base structures. With the help of recently developed magnetic resonance (MR) imaging techniques that provide higher spatial resolution and fast imaging techniques including three-dimensional MR images with or without the use of gadolinium contrast agent, radiologists can more easily diagnose disease conditions that involve the small cranial nerves, such as the oculomotor, abducens, facial, and hypoglossal nerves, as well as normal radiologic anatomy, even in very young children. If cranial nerve involvement is suspected, careful evaluation of the cranial nerves should include specific MR imaging protocols. Localization is an important consideration in cranial nerve imaging, and should cover entire pathways and target organs as much as possible. Therefore, radiologists should be familiar not only with the various diseases that cause cranial nerve dysfunction, and the entire course of each cranial nerve including the intra-axial nuclei and fibers, but also the technical considerations for optimal imaging of pediatric cranial nerves. In this article, we briefly review normal cranial nerve anatomy and imaging findings of various pediatric cranial nerve dysfunctions, as well as the technical considerations of pediatric cranial nerve imaging. Online supplemental material is available for this article. (©)RSNA, 2016.

  10. Variations in Transverse Foramina of Cervical Vertebrae: Morphology & Clinical Importance

    Directory of Open Access Journals (Sweden)

    Vaishakhi Gonsai

    2015-12-01

    Full Text Available Background: The purpose of this study is to investigate variations in transverse foramina in the cervical vertebrae and its morphological and clinical importance. Materials and Method : The variations in the number and size of transverse foramina was studied in total 200 human dried cervical vertebrae, which were taken from the Department of Anatomy, B.J.Medical College, Ahmedabad. All the vertebrae were observed for variation in number and size of transverse foramina. Results: Out of 200 cervical vertebrae, complete double transverse foramina were observed in 40 vertebrae (20%, among them unilateral double foramina were found in 31 vertebrae (15.5% and the bilateral double foramina were found in 9 vertebrae (4.5%. Incomplete double transverse foramina were observed in 22 vertebrae (11%, among them unilateral double foramina were found in 16 vertebrae (8% and bilateral double foramina were observed in 6 vertebrae (3%. Conclusion: Complete unilateral double transverse foramina of cervical vertebrae were more common than bilateral. Also unilateral small size transverse foramina of cervical vertebrae were also common. This variation is important for the neurosurgeon during cervical surgery. Under such condition the course of the vertebral artery may be distorted. It is also useful for Radiologist during CT and MRI scan.

  11. Multiple congenital cranial hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Koulouris, George [Alfred Hospital, Department of Radiology, Prahran, Victoria (Australia); Rao, Padma [Royal Children' s Hospital, Department of Radiology, Parkville, Victoria (Australia)

    2005-08-01

    Though cranial hemangiomas are second only to vertebral hemangiomas in frequency, such lesions are rarely congenital and multiple. It is probable that the true incidence of congenital calvarial hemangiomas is higher than that reported in the literature, as they are unlikely to undergo imaging, most being asymptomatic and without a significant soft tissue component. We present a case of multiple congenital calvarial and skull base cavernous-type hemangiomas, diagnosed in a 4-day-old female, involving the right zygoma, maxilla, frontal and petrous temporal bones and contralateral squamous temporal bone. Surgical biopsy confirmed the radiological diagnosis as well as the concomitant multiple subcutaneous capillary-type hemangiomas which were identified clinically. No specific clinical syndrome or chromosomal abnormality was identified and the underlying cerebral parenchyma was normal with no intra-axial involvement. With conservative treatment, two lesions completely resolved and a further two lesions subsequently decreased in both size and degree of enhancement. To the best of our knowledge, this is the first case of multiple congenital hemangiomas involving the calvarium and skull base. Despite this, the radiological features, combined with the clinical findings of multiple capillary hemangiomas, were characteristic enough to permit an accurate preoperative diagnosis. Osseous hemangiomas should feature prominently in any differential diagnosis of multiple hypervascular lesions, as they are common, more so when limited to an anatomical region, irrespective of site or age. (orig.)

  12. Vertebrae classification models - Validating classification models that use morphometrics to identify ancient salmonid (Oncorhynchus spp.) vertebrae to species

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Using morphometric characteristics of modern salmonid (Oncorhynchus spp.) vertebrae, we have developed classification models to identify salmonid vertebrae to the...

  13. Image quality of iterative reconstruction in cranial CT imaging: comparison of model-based iterative reconstruction (MBIR) and adaptive statistical iterative reconstruction (ASiR).

    Science.gov (United States)

    Notohamiprodjo, S; Deak, Z; Meurer, F; Maertz, F; Mueck, F G; Geyer, L L; Wirth, S

    2015-01-01

    The purpose of this study was to compare cranial CT (CCT) image quality (IQ) of the MBIR algorithm with standard iterative reconstruction (ASiR). In this institutional review board (IRB)-approved study, raw data sets of 100 unenhanced CCT examinations (120 kV, 50-260 mAs, 20 mm collimation, 0.984 pitch) were reconstructed with both ASiR and MBIR. Signal-to-noise (SNR) and contrast-to-noise (CNR) were calculated from attenuation values measured in caudate nucleus, frontal white matter, anterior ventricle horn, fourth ventricle, and pons. Two radiologists, who were blinded to the reconstruction algorithms, evaluated anonymized multiplanar reformations of 2.5 mm with respect to depiction of different parenchymal structures and impact of artefacts on IQ with a five-point scale (0: unacceptable, 1: less than average, 2: average, 3: above average, 4: excellent). MBIR decreased artefacts more effectively than ASiR (p iterative reconstruction (MBIR) effectively decreased artefacts in cranial CT. • MBIR reconstructed images were rated with significantly higher scores for image quality. • Model-Based iterative reconstruction may allow reduced-dose diagnostic examination protocols.

  14. Expanded endonasal endoscopic approach for resection of a large skull base aneurysmal bone cyst in a pediatric patient with extensive cranial fibrous dysplasia.

    Science.gov (United States)

    Salmasi, Vafi; Blitz, Ari M; Ishii, Masaru; Gallia, Gary L

    2011-04-01

    Aneurysmal bone cysts (ABCs) are uncommon non-neoplastic, hemorrhagic, and expansile osseous lesions. These lesions most commonly occur in the first two decades of life and affect the long bones and spinal column. Skull base involvement is rare. The authors report the case of a 16-year-old boy who presented with acute visual decline and was found to have a large skull base ABC centered in the sphenoid sinus. In addition, the patient had extensive cranial fibrous dysplasia. The patient underwent a staged expanded endonasal endoscopic approach for complete resection of this lesion with excellent return of his vision. This case adds to the growing body of evidence supporting a role for expanded endonasal endoscopic procedures in pediatric patients with skull base pathologies.

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  17. The cervical spine of the American barn owl (Tyto furcata pratincola: I. Anatomy of the vertebrae and regionalization in their S-shaped arrangement.

    Directory of Open Access Journals (Sweden)

    Markus Krings

    Full Text Available BACKGROUND: Owls possess an extraordinary neck and head mobility. To understand this mobility it is necessary to have an anatomical description of cervical vertebrae with an emphasis on those criteria that are relevant for head positioning. No functional description specific to owls is available. METHODOLOGY/PRINCIPAL FINDINGS: X-ray films and micro-CT scans were recorded from American barn owls (Tyto furcata pratincola and used to obtain three-dimensional head movements and three-dimensional models of the 14 cervical vertebrae (C1-C14. The diameter of the vertebral canal, the zygapophyseal protrusion, the distance between joint centers, and the pitching angle were quantified. Whereas the first two variables are purely osteological characteristics of single vertebrae, the latter two take into account interactions between vertebrae. These variables change in characteristic ways from cranial to caudal. The vertebral canal is wide in the cranial and caudal neck regions, but narrow in the middle, where both the zygapophyseal protrusion and the distance between joint centers are large. Pitching angles are more negative in the cranial and caudal neck regions than in the middle region. Cluster analysis suggested a complex regionalization. Whereas the borders (C1 and C13/C14 formed stable clusters, the other cervical vertebrae were sorted into 4 or 5 additional clusters. The borders of the clusters were influenced by the variables analyzed. CONCLUSIONS/SIGNIFICANCE: A statistical analysis was used to evaluate the regionalization of the cervical spine in the barn owl. While earlier measurements have shown that there appear to be three regions of flexibility of the neck, our indicators suggest 3-7 regions. These many regions allow a high degree of flexibility, potentially facilitating the large head turns that barn owls are able to make. The cervical vertebral series of other species should also be investigated using statistical criteria to further

  18. The cervical spine of the American barn owl (Tyto furcata pratincola): I. Anatomy of the vertebrae and regionalization in their S-shaped arrangement.

    Science.gov (United States)

    Krings, Markus; Nyakatura, John A; Fischer, Martin S; Wagner, Hermann

    2014-01-01

    Owls possess an extraordinary neck and head mobility. To understand this mobility it is necessary to have an anatomical description of cervical vertebrae with an emphasis on those criteria that are relevant for head positioning. No functional description specific to owls is available. X-ray films and micro-CT scans were recorded from American barn owls (Tyto furcata pratincola) and used to obtain three-dimensional head movements and three-dimensional models of the 14 cervical vertebrae (C1-C14). The diameter of the vertebral canal, the zygapophyseal protrusion, the distance between joint centers, and the pitching angle were quantified. Whereas the first two variables are purely osteological characteristics of single vertebrae, the latter two take into account interactions between vertebrae. These variables change in characteristic ways from cranial to caudal. The vertebral canal is wide in the cranial and caudal neck regions, but narrow in the middle, where both the zygapophyseal protrusion and the distance between joint centers are large. Pitching angles are more negative in the cranial and caudal neck regions than in the middle region. Cluster analysis suggested a complex regionalization. Whereas the borders (C1 and C13/C14) formed stable clusters, the other cervical vertebrae were sorted into 4 or 5 additional clusters. The borders of the clusters were influenced by the variables analyzed. A statistical analysis was used to evaluate the regionalization of the cervical spine in the barn owl. While earlier measurements have shown that there appear to be three regions of flexibility of the neck, our indicators suggest 3-7 regions. These many regions allow a high degree of flexibility, potentially facilitating the large head turns that barn owls are able to make. The cervical vertebral series of other species should also be investigated using statistical criteria to further characterize morphology and the potential movements associated with it.

  19. Ivory vertebra: imaging findings in different diagnoses

    Energy Technology Data Exchange (ETDEWEB)

    Braun, Richard Andreas; Goldman, Suzan Menasce; Fernandes, Eloy de Avila [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Milito, Carlos Felipe do Rego Barros, E-mail: braunrich@gmail.com [Universidade de Sao Paulo (InRad/HC/FM/USP), Sao Paulo, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas. Institutlo de Radiologia

    2016-03-15

    Low back pain is often managed at all levels of health care. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases. (author)

  20. Ivory vertebra: imaging findings in different diagnoses

    Directory of Open Access Journals (Sweden)

    Richard Andreas Braun

    2016-04-01

    Full Text Available Abstract Low back pain is often managed at all levels of healthcare. In general, diagnostic investigation begins with radiography of the lumbar spine. In addition to the most common findings, radiologists can identify increased density of a vertebral body, referred to as ivory vertebra. The objective of this study was to describe the main diseases that can present with this radiologic sign, such as Hodgkin lymphoma, Paget's disease, metastatic prostate cancer, breast cancer, and osteomyelitis. It is extremely important that radiologists be aware of this finding in order to inform the requesting physician of the possible etiologies, given that it can be the initial radiologic presentation for these diseases.

  1. Assessment of frontal lobe sagging after endoscopic endonasal transcribriform resection of anterior skull base tumors: is rigid structural reconstruction of the cranial base defect necessary?

    Science.gov (United States)

    Eloy, Jean Anderson; Shukla, Pratik A; Choudhry, Osamah J; Singh, Rahul; Liu, James K

    2012-12-01

    The endoscopic endonasal transcribriform approach (EETA) is a viable alternative option for resection of selected anterior skull base (ASB) tumors. However, this technique results in the creation of large cribriform defects. Some have reported the use of a rigid substitute for ASB reconstruction to prevent postoperative frontal lobe sagging. We evaluate the degree of frontal lobe sagging using our triple-layer technique [fascia lata, acellular dermal allograft, and pedicled nasoseptal flap (PNSF)] without the use of rigid structural reconstruction for large cribriform defects. Retrospective analysis. Nine patients underwent an EETA for resection of large ASB tumors from August 2010 to November 2011. The degree of frontal lobe displacement after EETA, defined as the ASB position, was calculated based on the most inferior position of the frontal lobe relative to the nasion-sellar line defined on preoperative and postoperative imaging. A positive value signified upward displacement, and a negative value represented inferior displacement of the frontal lobe. The average cribriform defect size was 9.3 cm(2) (range, 5.0-13.8 cm(2) ). The average distance of postoperative frontal lobe displacement was 0.2 mm (range, -3.9 to 2.9 mm) without any cases of significant brain sagging. The mean follow-up period was 10.1 months (range, 4-19 months). There were no postoperative CSF leaks. Rigid structural repair may not be necessary for ASB defect repair after endoscopic endonasal resection of the cribriform plate. Our technique for multilayer cranial base reconstruction appears to be satisfactory in preventing delayed frontal lobe sagging. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  2. Relación entre las fracturas de base craneal y la electronistagmografía Relation between the cranial base and the electro-nystagmography

    Directory of Open Access Journals (Sweden)

    Eulalia Alfonso Muñoz

    2011-12-01

    Full Text Available Introducción: la electronistagmografía se usa en la actualidad con fines de diagnóstico, es el proceso por el cual se hace un registro de la posición y movimiento del globo ocular, para identificar cambios en el campo eléctrico alrededor del ojo al modificar su posición. Objetivo: evaluar la utilidad de la electronistagmografía, al compararla con la prueba vestibular tradicional para el diagnóstico topográfico de las secuelas audiológicas vestibulares presentes en pacientes con fractura de base craneal. Métodos: se realizó un estudio observacional, analítico, de corte transversal, en el Hospital Militar "Dr. Carlos Juan Finlay", en el período comprendido de enero de 2006 a enero de 2008. El universo estuvo representado por 210 pacientes, divididos en 2 grupos: uno de estudio con secuelas auditivas vestibulares posteriores a fractura de base de cráneo, y otro de control, con sujetos sanos. Resultados: el síntoma que se encontró en el 100 % de los pacientes fue el vértigo. Del total de 118 casos con electronistagmografía positiva, 47 (39,8 % habían arrojado resultados negativos en la prueba vestibular. Conclusiones: la electronistagmografía resultó positiva en el mayor número de casos estudiados, y presentó una alta sensibilidad, al demostrar, que casos con debilidad laberíntica y preponderancia direccional presentes, no fueron diagnosticados con la prueba vestibular tradicional.Introduction: nowadays, the electro-nystagmography is used for diagnosis; it is the process by which it is possible to register the position and movement of ocular eyeball to identify the changes in the electric field around the eye in modifying its position. Objective: to assess the usefulness of the electro-nystagmography in comparison with the traditional vestibular test for topographic diagnosis of auditory sequelae present in the patients presenting with cranial base fracture. Methods: a cross-sectional, analytical and observational study was

  3. Highly Conformal Craniospinal Radiotherapy Techniques Can Underdose the Cranial Clinical Target Volume if Leptomeningeal Extension through Skull Base Exit Foramina is not Contoured.

    Science.gov (United States)

    Noble, D J; Ajithkumar, T; Lambert, J; Gleeson, I; Williams, M V; Jefferies, S J

    2017-07-01

    Craniospinal irradiation (CSI) remains a crucial treatment for patients with medulloblastoma. There is uncertainty about how to manage meningeal surfaces and cerebrospinal fluid (CSF) that follows cranial nerves exiting skull base foramina. The purpose of this study was to assess plan quality and dose coverage of posterior cranial fossa foramina with both photon and proton therapy. We analysed the radiotherapy plans of seven patients treated with CSI for medulloblastoma and primitive neuro-ectodermal tumours and three with ependymoma (total n = 10). Four had been treated with a field-based technique and six with TomoTherapy™. The internal acoustic meatus (IAM), jugular foramen (JF) and hypoglossal canal (HC) were contoured and added to the original treatment clinical target volume (Plan_CTV) to create a Test_CTV. This was grown to a test planning target volume (Test_PTV) for comparison with a Plan_PTV. Using Plan_CTV and Plan_PTV, proton plans were generated for all 10 cases. The following dosimetry data were recorded: conformity (dice similarity coefficient) and homogeneity index (D2 - D98/D50) as well as median and maximum dose (D2%) to Plan_PTV, V95% and minimum dose (D99.9%) to Plan_CTV and Test_CTV and Plan_PTV and Test_PTV, V95% and minimum dose (D98%) to foramina PTVs. Proton and TomoTherapy™ plans were more conformal (0.87, 0.86) and homogeneous (0.07, 0.04) than field-photon plans (0.79, 0.17). However, field-photon plans covered the IAM, JF and HC PTVs better than proton plans (P = 0.002, 0.004, 0.003, respectively). TomoTherapy™ plans covered the IAM and JF better than proton plans (P = 0.000, 0.002, respectively) but the result for the HC was not significant. Adding foramen CTVs/PTVs made no difference for field plans. The mean Dmin dropped 3.4% from Plan_PTV to Test_PTV for TomoTherapy™ (not significant) and 14.8% for protons (P = 0.001). Highly conformal CSI techniques may underdose meninges and CSF in the dural reflections of

  4. Distraction of lumbar vertebrae in gravitational traction.

    Science.gov (United States)

    Tekeoglu, I; Adak, B; Bozkurt, M; Gürbüzoglu, N

    1998-05-01

    Experimental study of 30 patients diagnosed with low back pain resulting from lumbar disc herniation, disc degeneration, and segmental instability. Patients underwent gravitational traction, and widening of the intervertebral space and posterior facets was measured on radiographs. This same procedure was performed with a group of 30 healthy individuals. To determine the effect of gravitational traction on the widening of the intervertebral space and the other vertebral structures in patients with low back pain and in healthy individuals. Gravitational traction is performed by suspending the patient in a hanging, upright position for an extended period of time. In spite of disagreement among authors about the effect of lumbar traction, recent innovations have enabled the distraction of vertebrae. A specially designed apparatus was used to apply gravitational traction. Pre- and post-traction radiographs were obtained to study the changes in the L2-L3, L3-L4, L4-L5, and L5-S1 intervertebral spaces; Ferguson's angle; L1-S1 total distance; and blood pressure. Distraction was more than approximately 3 mm in each intervertebral space in both groups. Gravitational traction had a very apparent effect on intervertebral space and was found to be an effective method to distract lumbar vertebrae. Discomfort experienced by the patient during suspension may be overcome by making biomedical changes to the suspension corset.

  5. Predictability of the future development of aggressive behavior of cranial dural arteriovenous fistulas based on decision tree analysis.

    Science.gov (United States)

    Satomi, Junichiro; Ghaibeh, A Ammar; Moriguchi, Hiroki; Nagahiro, Shinji

    2015-07-01

    The severity of clinical signs and symptoms of cranial dural arteriovenous fistulas (DAVFs) are well correlated with their pattern of venous drainage. Although the presence of cortical venous drainage can be considered a potential predictor of aggressive DAVF behaviors, such as intracranial hemorrhage or progressive neurological deficits due to venous congestion, accurate statistical analyses are currently not available. Using a decision tree data mining method, the authors aimed at clarifying the predictability of the future development of aggressive behaviors of DAVF and at identifying the main causative factors. Of 266 DAVF patients, 89 were eligible for analysis. Under observational management, 51 patients presented with intracranial hemorrhage/infarction during the follow-up period. The authors created a decision tree able to assess the risk for the development of aggressive DAVF behavior. Evaluated by 10-fold cross-validation, the decision tree's accuracy, sensitivity, and specificity were 85.28%, 88.33%, and 80.83%, respectively. The tree shows that the main factor in symptomatic patients was the presence of cortical venous drainage. In its absence, the lesion location determined the risk of a DAVF developing aggressive behavior. Decision tree analysis accurately predicts the future development of aggressive DAVF behavior.

  6. Evaluation of a scoring system based on conformation factors to predict cranial cruciate ligament disease in Labrador Retrievers.

    Science.gov (United States)

    Griffon, Dominique J; Cunningham, Devin; Gordon-Evans, Wanda J; Tanaka, Rei; Bruecker, K A; Boudrieau, Randy J

    2017-02-01

    To determine the association of a radiographic score derived from tibial plateau angle (TPA) and femoral anteversion (FAA) with an outcome of cranial cruciate ligament deficiency (CCLD) in large dogs. Cross-sectional study. 167 Labrador Retrievers. Hind limbs of sound Labrador Retrievers over 6 years of age were considered at low risk for CCLD. Limbs were considered high risk for CCLD if they were affected or predisposed (sound contralateral limb in dogs with unilateral CCLD). The radiographic CCLD score was calculated for each limb. The TPA, FAA, and CCLD scores were compared between limbs of the same dog and between risk categories. A contingency table was used to evaluate the association of the CCLD score with the CCLD status of limbs. TPA, FAA, and CCLD scores were greater in limbs categorized as high risk for CCLD than in normal limbs. The sensitivity and specificity of the CCLD score was 87% and 79%, respectively. The positive predictive value was 69% and the negative predictive value was 92%. Scores were similar between paired right and left limbs, but did not agree for predicted status in 14/106 dogs. Our study supports an association between TPA, FAA, and CCLD in Labrador Retrievers. The negative predictive value of the CCLD score supports its application for screening dogs considered at low risk for CCLD. Positive CCLD scores should be interpreted with caution and the status of a dog may be undetermined if scores obtained on each limb disagree. © 2016 The American College of Veterinary Surgeons.

  7. Regional changes in vertebra morphology during ontogeny reflect the life history of Atlantic cod (Gadus morhua L.)

    Science.gov (United States)

    Fjelldal, Per G; Totland, Geir K; Hansen, Tom; Kryvi, Harald; Wang, Xiyuan; Søndergaard, Jens L; Grotmol, Sindre

    2013-01-01

    This study examined vertebra formation, morphology, regional characters, and bending properties of the vertebral column of Atlantic cod throughout its life cycle (0–6 years). The first structure to form was the foremost neural arch, 21 days post hatching (dph), and the first vertebra centrum to form – as a chordacentrum – was the 3rd centrum at 28 dph. Thereafter, the notochord centra developed in a regular sequence towards the head and caudal fin. All vertebrae were formed within 50 dph. The vertebral column consisted of 52 (± 2) vertebrae (V) and could be divided into four distinct regions: (i) the cervical region (neck) (V1 and V2), characterized by short vertebra centra, prominent neural spines and absence of articulations with ribs; (ii) the abdominal region (trunk) (V3–V19), characterized by vertebrae with wing-shaped transverse processes (parapophyses) that all articulate with a rib; (iii) the caudal region (tail) (V20–V40), where the vertebra centra have haemal arches with prominent haemal spines; (iv) the ural region (V41 to the last vertebra), characterized by broad neural and haemal spines, providing sites of origin for muscles inserting on the fin rays – lepidotrichs – of the tail fin. The number of vertebrae in the cervical, abdominal and caudal regions was found to be constant, whereas in the ural region, numbers varied from 12 to 15. Geometric modelling based on combination of vertebra lengths, diameters and intervertebral distances showed an even flexibility throughout the column, except in the ural region, where flexibility increased. Throughout ontogeny, the vertebra centra of the different regions followed distinct patterns of growth; the relative length of the vertebrae increased in the cervical and abdominal regions, and decreased in the caudal and ural regions with increasing age. This may reflect changes in swimming mode with age, and/or that the production of large volumes of gametes during sexual maturation requires a

  8. Foramen arcuale: a rare morphological variation located in atlas vertebrae.

    Science.gov (United States)

    Cirpan, Sibel; Yonguc, Goksin Nilufer; Edizer, Mete; Mas, Nuket Gocmen; Magden, A Orhan

    2017-03-15

    To investigate the incidence of foramen arcuale in dry atlas vertebrae which may cause clinical problems. Eighty-one dry human cervical vertebrae were examined. The evaluated parameters of two atlas vertebrae including foramen arcuale were as follows: maximum antero-posterior, transverse diameters and areas of the right and left superior articular facets and transverse foramina; maximum antero-posterior diameters, heights, areas and central sagittal thickness of bony arch forming roof of foramen arcuale, respectively. All parameters were measured with caliper in milimeters. Thirteen of eighty-one cervical vertebrae specimens (13/81, 16.05%) were atlas and the two of thirteen atlas vertebrae (2/13, 15.38%) had macroscopically complete foramen arcuale. Each of the two atlas vertebrae was including one foramen arcuale (one on the left and one on the right side). There was a statistically significant difference (p = 0.04) between the mean antero-posterior diameter of superior articular facet located on each side of atlas vertebrae, whereas not (p = 0.51) between mean antero-posterior diameter of transverse foramina. There was not any significant difference between the mean transverse diameters and areas of superior articular facets and transverse foramina located on each side of atlas vertebrae, respectively. Each of the areas of transverse foramina located on the same sides with foramen arcuale in two atlas vertebrae was less than the mean areas of transverse foramina located ipsilateral side with each foramen arcuale in thirteen atlas vertebrae. The present study provides additional information about the incidence and topography of the atlas vertebrae including foramen arcuale.

  9. Cranial surgery without head shaving.

    Science.gov (United States)

    Tokimura, Hiroshi; Tajitsu, Kenichiro; Tsuchiya, Masahiro; Yamahata, Hitoshi; Taniguchi, Ayumi; Takayama, Kenji; Kaji, Masatomo; Hirabaru, Masashi; Hirayama, Takahisa; Shinsato, Tomomi; Arita, Kazunori

    2009-12-01

    Based on a series of 632 patients who underwent craniotomy without head shaving, we report the efficacy and safety of our simplified procedure and document the usefulness of the electrosurgical scalpel. After brushing a chlorhexidine-alcohol solution onto the craniotomy site, the hair was parted from the incision line and fixed with adhesive paper drapes. In recent cases, electrosurgical scalpels were used for scalp- and subcutaneous dissection. At the end of surgery, the wound was closed in the usual manner, taking care that no hair was in the wound and the hair and wound were rinsed with clean water in the operating room. We did not apply disinfectant for postoperative wound care, rather, the hair was shampooed on the 2nd, 4th, and 6th postoperative day. Among 632 patients who underwent cranial surgery without head shaving, only 7 (1.1%) developed postoperative wound infections. None of the 34 patients who underwent craniotomy using the electrosurgical scalpel developed wound infections. Our simplified cranial surgery without head shaving does not increase the risk of wound infection. Because the use of the electrosurgical scalpel for skin and soft tissue dissection minimizes bleeding, the probability of wound infection appears to be reduced.

  10. Comparison of vertebrae and otoliths measured directly and from radiographs

    DEFF Research Database (Denmark)

    Pedersen, Jens

    1997-01-01

    from macerated fish. The present study shows that measurement of vertebrae from radiographs of intact fish is a reliable and quick method for estimating the relationship between vertebral length and fish length from a number of reference fish. The relationship between vertebrae size and fish length...

  11. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

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

    2015-04-01

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

  12. Congenital cranial dysinnervation disorders.

    Science.gov (United States)

    Singh, Anupam; Pandey, P K; Agrawal, Ajai; Mittal, Sanjeev Kumar; Rana, Kartik Maheshbhai; Bahuguna, Chirag

    2017-12-01

    The European Neuromuscular Centre (ENMC) derived the term Congenital Cranial Dysinnervation Disorders in 2002 at an international workshop for a group of congenital neuromuscular diseases. CCDDs are congenital, non-progressive ophthalmoplegia with restriction of globe movement in one or more fields of gaze. This group of sporadic and familial strabismus syndromes was initially referred to as the 'congenital fibrosis syndromes' because it was assumed that the primary pathologic process starts in the muscles of eye motility. Over the last few decades, evidence has accumulated to support that the primary pathologic process of these disorders is neuropathic rather than myopathic. This is believed that for normal development of extra ocular muscles and for preservation of muscle fiber anatomy, normal intra-uterine development of the innervation to these muscles is essential. Congenital dysinnervation to these EOMs can lead to abnormal muscle structure depending upon the stage and the extent of such innervational defects. Over last few years new genes responsible for CCDD have been identified, permitting a better understanding of associated phenotypes, which can further lead to better classification of these disorders. Introduction of high-resolution MRI has led to detailed study of cranial nerves courses and muscles supplied by them. Thus, due to better understanding of pathophysiology and genetics of CCDDs, various treatment modalities can be developed to ensure good ocular alignment and better quality of life for patients suffering from the same.

  13. Pediatric cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, H.

    1984-01-01

    The introduction of CT in the investigation of intercranial pathology has revolutionized the approach to clinical neurological and neurosurgical practice. This book applies the advances of cranial CT to the pediatric patient. The test is divided into two sections. The first portion describes the practical methodology, anatomy and normal and abnormal CT scan appearance, including high or low density lesions, cystic lesions and ventricular or subarachnoid space dilation. The characteristic scans for various neurological diseases are presented and discussed. The author has given special attention to the CT diagnosis of congenital malformations and cerebral neoplasms. Partial Contents: Normal Computed Tomographic Anatomy/ High Density Lesions/Low Density Lesions/Cystic Lesions; Supratentorial/Cystic Lesions; Infratentorial/Increased Head Circumference/Increased Ventricular Size/Small Ventricular Size/Cranial Lesions/Spinal Lesions/CT Cisternography/Part II CT in Neonates/Congenital Craniocerebral Malformations/Hydrocephalus/Craniosynostosis/Head Trauma/Cerebrovascular Lesions/Intracranial Lesions/Seizure Disorders/Intracranial and Other Chronic Neurological Disorders.

  14. Abnormal foramina on the posterior arch of atlas vertebra

    Directory of Open Access Journals (Sweden)

    Nayak SB

    2008-10-01

    Full Text Available Atlas is the first cervical vertebra. It articulates with the occipital bone above and the axis vertebra below. It plays an important role in movement of the skull and the neck. We found a rare variation of the atlas vertebra. The posterior arch of the atlas had one accessory foramen just behind each lateral mass. Foramen on the right side was larger than that of the left. The knowledge of this variation may be of importance to orthopedic surgeons, neurosurgeons, radiologists and anthropologists.

  15. [Babies with cranial deformity].

    Science.gov (United States)

    Feijen, Michelle M W; Claessens, Edith A W M Habets; Dovens, Anke J Leenders; Vles, Johannes S; van der Hulst, Rene R W J

    2009-01-01

    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option.

  16. Pediatric cerebral sinovenous thrombosis following cranial surgery.

    Science.gov (United States)

    Petrov, Dmitriy; Uohara, Michael Y; Ichord, Rebecca; Ali, Zarina; Jastrzab, Laura; Lang, Shih-Shan; Billinghurst, Lori

    2017-03-01

    Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014. Thirteen subjects were retrospectively analyzed for clinical presentation, surgical details, radiographic characteristics, laboratory study results, treatment, and outcome. Diagnostic testing and treatment adhered to a consensus-based institutional stroke protocol. Cranial vault reconstruction, subdural empyema evacuation, and tumor resection were each observed in three subjects. Eleven (85%) subjects had sinus exposure during surgery, and eight (73%) developed thrombus in a sinus within or adjacent to the operative field. Two (15%) had documented iatrogenic sinus injury. On post-operative testing, ten (77%) subjects had prothrombotic abnormalities. Seven (54%) were treated with anti-coagulation therapy (ACT) starting on a median of post-operative day (POD) 3 (IQR 1-3) for a median of 2.9 months (IQR 2.4-5.4). Median time to imaging evidence of partial or complete recanalization was 2.4 months (IQR 0.7-5.1). No symptomatic hemorrhagic complications were encountered. Pediatric CSVT may be encountered after cranial surgery, and decisions related to anti-coagulation are challenging. The risk of CSVT should be considered in pre-surgical planning and post-operative evaluation of cases with known risk factors. In our study, judicious use of ACT was safe in the post-operative period.

  17. MEMO1 drives cranial endochondral ossification and palatogenesis.

    Science.gov (United States)

    Van Otterloo, Eric; Feng, Weiguo; Jones, Kenneth L; Hynes, Nancy E; Clouthier, David E; Niswander, Lee; Williams, Trevor

    2016-07-15

    The cranial base is a component of the neurocranium and has a central role in the structural integration of the face, brain and vertebral column. Consequently, alteration in the shape of the human cranial base has been intimately linked with primate evolution and defective development is associated with numerous human facial abnormalities. Here we describe a novel recessive mutant mouse strain that presented with a domed head and fully penetrant cleft secondary palate coupled with defects in the formation of the underlying cranial base. Mapping and non-complementation studies revealed a specific mutation in Memo1 - a gene originally associated with cell migration. Expression analysis of Memo1 identified robust expression in the perichondrium and periosteum of the developing cranial base, but only modest expression in the palatal shelves. Fittingly, although the palatal shelves failed to elevate in Memo1 mutants, expression changes were modest within the shelves themselves. In contrast, the cranial base, which forms via endochondral ossification had major reductions in the expression of genes responsible for bone formation, notably matrix metalloproteinases and markers of the osteoblast lineage, mirrored by an increase in markers of cartilage and extracellular matrix development. Concomitant with these changes, mutant cranial bases showed an increased zone of hypertrophic chondrocytes accompanied by a reduction in both vascular invasion and mineralization. Finally, neural crest cell-specific deletion of Memo1 caused a failure of anterior cranial base ossification indicating a cell autonomous role for MEMO1 in the development of these neural crest cell derived structures. However, palate formation was largely normal in these conditional mutants, suggesting a non-autonomous role for MEMO1 in palatal closure. Overall, these findings assign a new function to MEMO1 in driving endochondral ossification in the cranium, and also link abnormal development of the cranial base

  18. A Study of Radiation Incidence Angle in Anteroposterior Cervical Vertebra Examination

    Energy Technology Data Exchange (ETDEWEB)

    Jeung, Seung Woon; Lim, Cheong Hwan; Jung, Hong Ryang; Joo, Yeong Cheol; Park, Mi Ja [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of); Han, Beon Hee [Dept. of Radiological Science, Seonam University, Namwon (Korea, Republic of)

    2012-06-15

    of cervical vertebra, OID, axis angle, and FID, all of them were shown to have correlations with the incidence angle (p<.01). Conclusively, it was shown that the incidence angle was measured differently from average length of cervical vertebra, OID, FID, and axis slope, as well as from age and sex. Therefore, it can be suggested that the anteroposterior radiation test for cervical vertebra should be conducted by different incidence angles based on age and sex. The data of this study may be used as reference in determining the incidence angle of cervical vertebra tests for the future.

  19. ``Tower vertebra``: a new observation in sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

    Marlow, T.J. [Department of Radiology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425 (United States); Brunson, C.Y. [Department of Internal Medicine, Division of Hematology/Oncology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425 (United States); Jackson, S. [Department of Pediatrics, Division of Hematology/Oncology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425 (United States); Schabel, S.I. [Department of Radiology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425 (United States)

    1998-04-01

    Background. Skeletal abnormalities are common in sickle cell anemia. Ischemia, infarction, and growth disturbance of the thoracic and lumbar vertebral bodies are among the most common abnormalities, and can suggest the diagnosis radiographically. Design and patients. We recently encountered two adult patients in whom vertebrae had grown abnormally in height adjacent to infarcted short vertebrae. We then reviewed the thoracic and lumbar spine radiographs of 54 more adult patients with sickle cell anemia. Results and conclusion. A total of eight patients (14%) displayed infarcted vertebrae with compensatory vertical growth of at least one adjacent vertebrae. These resemble the elongated vertebral bodies associated with other conditions. We can find no prior report of this finding in association with sickle cell anemia. (orig.) With 3 figs., 10 refs.

  20. Fish vertebra from Miocene beds at Govce, Slovenia

    Directory of Open Access Journals (Sweden)

    Vasja Mikuž

    2014-07-01

    Full Text Available The article discusses a vertebra and a small shark tooth found in the Miocene Govce sandstone near Govce west of Laško in central Slovenia. The vertebra belongs to a shark of the superorder Galeomorphii but we could not determine it with greater precision. The small tooth was assigned to Carcharias cf. taurus Rafinesque, 1810. The nannofossils in the sample are scarce and did not allow dating at biozone precision.

  1. Structural and micro-anatomical changes in vertebrae associated with idiopathic-type spinal curvature in the curveback guppy model

    Directory of Open Access Journals (Sweden)

    Wallis Rob

    2010-06-01

    Full Text Available Abstract Background The curveback lineage of guppy is characterized by heritable idiopathic-type spinal curvature that develops during growth. Prior work has revealed several important developmental similarities to the human idiopathic scoliosis (IS syndrome. In this study we investigate structural and histological aspects of the vertebrae that are associated with spinal curvature in the curveback guppy and test for sexual dimorphism that might explain a female bias for severe curve magnitudes in the population. Methods Vertebrae were studied from whole-mount skeletal specimens of curved and non-curved adult males and females. A series of ratios were used to characterize structural aspects of each vertebra. A three-way analysis of variance tested for effects of sex, curvature, vertebral position along the spine, and all 2-way interactions (i.e., sex and curvature, sex and vertebra position, and vertebra position and curvature. Histological analyses were used to characterize micro-architectural changes in affected vertebrae and the intervertebral region. Results In curveback, vertebrae that are associated with curvature demonstrate asymmetric shape distortion, migration of the intervertebral ligament, and vertebral thickening on the concave side of curvature. There is sexual dimorphism among curved individuals such that for several vertebrae, females have more slender vertebrae than do males. Also, in the region of the spine where lordosis typically occurs, curved and non-curved females have a reduced width at the middle of their vertebrae, relative to males. Conclusions Based on similarities to human spinal curvatures and to animals with induced curves, the concave-convex biases described in the guppy suggest that there is a mechanical component to curve pathogenesis in curveback. Because idiopathic-type curvature in curveback is primarily a sagittal deformity, it is structurally more similar to Scheuermann kyphosis than IS. Anatomical

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

    Science.gov (United States)

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

    2009-08-01

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

  3. Two immigrants with tuberculosis of the ear, nose, and throat region with skull base and cranial nerve involvement

    NARCIS (Netherlands)

    Richardus, R.A.; Jansen, J.C.; Steens, S.C.A.; Arend, S.M.

    2011-01-01

    We report two immigrants with tuberculosis of the skull base and a review of the literature. A Somalian man presented with bilateral otitis media, hearing loss, and facial and abducens palsy. Imaging showed involvement of both mastoid and petrous bones, extending via the skull base to the

  4. Primary Cranial Vault Lymphoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, So Hee; Kim, Myung Soon; Kim, Young Ju [Dept. of Radiology, Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju (Korea, Republic of)

    2012-09-15

    Cranial vault involvement in primary lymphoma is extremely rare in immunocompetent subjects. However, it should be considered as a differential diagnosis in the presence of a lesion involving all three compartments of the cranial vault, including the scalp, skull, and pachymeninges. We report a case of primary cranial vault lymphoma involving all three compartments of the cranial vault in an immunocompetent patient.

  5. Cranial Autonomic Symptoms in Migraine

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-11-01

    Full Text Available Cranial autonomic symptoms (CAS in patients with migraine and cluster headaches (CH were characterized and compared in a prospective study of consecutive patients attending a headache clinic at Taipei Veterans General Hospital, Taiwan.

  6. The computed cranial focal point

    NARCIS (Netherlands)

    Jong, G.A. de; Maal, T.J.J.; Delye, H.

    2015-01-01

    INTRODUCTION: Stereophotogrammetry is a radiation-free method for monitoring skull development after craniosynostosis repair. Lack of clear fixed reference points complicate longitudinal comparison of 3D photographs. Therefore we developed the 'computed cranial focal point' (CCFP). METHODS: The CCFP

  7. Two Immigrants with Tuberculosis of the Ear, Nose, and Throat Region with Skull Base and Cranial Nerve Involvement

    Directory of Open Access Journals (Sweden)

    Renate A. Richardus

    2011-01-01

    Full Text Available We report two immigrants with tuberculosis of the skull base and a review of the literature. A Somalian man presented with bilateral otitis media, hearing loss, and facial and abducens palsy. Imaging showed involvement of both mastoid and petrous bones, extending via the skull base to the nasopharynx, suggesting tuberculosis which was confirmed by characteristic histology and positive auramine staining, while Ziehl-Neelsen staining and PCR were negative. A Sudanese man presented with torticollis and deviation of the uvula due to paresis of N. IX and XI. Imaging showed a retropharyngeal abscess and lysis of the clivus. Histology, acid-fast staining, and PCR were negative. Both patients had a positive Quantiferon TB Gold in-tube result and improved rapidly after empiric treatment for tuberculosis. Cultures eventually yielded M. tuberculosis. These unusual cases exemplify the many faces of tuberculosis and the importance to include tuberculosis in the differential diagnosis of unexplained problems.

  8. Evc works in chondrocytes and osteoblasts to regulate multiple aspects of growth plate development in the appendicular skeleton and cranial base.

    Science.gov (United States)

    Pacheco, María; Valencia, María; Caparrós-Martín, José A; Mulero, Francisca; Goodship, Judith A; Ruiz-Perez, Victor L

    2012-01-01

    Ellis-van Creveld syndrome protein homolog (Evc) was previously shown to mediate expression of Indian hedgehog (Ihh) downstream targets in chondrocytes. Consequently disruption of the Ihh/Pthrp axis was demonstrated in Evc(-/-) mice, but the full extent of Evc involvement in endochondral development was not totally characterized. Herein we have examined further the Evc(-/-) growth plate in a homogeneous genetic background and show that Evc promotes chondrocyte proliferation, chondrocyte hypertrophy and the differentiation of osteoblasts in the perichondrium, hence implicating Evc in both Pthrp-dependent and Pthrp-independent Ihh functions. We also demonstrate that Evc, which localizes to osteoblast primary cilia, mediates Hedgehog (Hh) signaling in the osteoblast lineage. In spite of this, bone collar development is mildly affected in Evc(-/-) mutants. The onset of perichondrial osteoblastogenesis is delayed at the initial stages of endochondral ossification in Evc(-/-) mice, and in later stages, the leading edge of expression of osteoblast markers and Wnt/β-catenin signaling components is located closer to the primary spongiosa in the Evc(-/-) perichondrium owing to impaired osteoblast differentiation. Additionally we have used Ptch1-LacZ reporter mice to learn about the different types of Hh-responsive cells that are present in the perichondrium of normal and Evc(-/-) mice. Evc mediates Hh target gene expression in inner perichondrial cells, but it is dispensable in the external layers of the perichondrium. Finally, we report cranial base defects in Evc(-/-) mice and reveal that Evc is essential for intrasphenoidal synchondrosis development. Copyright © 2011. Published by Elsevier Inc.

  9. Osteopathia striata with cranial sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Gay, B.B. [Emory Univ., Atlanta, GA (United States). Dept. of Radiology; Elsas, L.J. [Emory Univ., Atlanta, GA (United States). Dept. of Pediatrics; Wyly, J.B. [Emory Univ., Atlanta, GA (United States). Dept. of Radiology; Pasquali, M. [Emory Univ., Atlanta, GA (United States). Dept. of Pediatrics

    1994-03-01

    Osteopathia striata with cranial sclerosis (OS-CS) is a specific bone dysplasia manifested by hypertelorism, flat nasal bridge, frontal bossing, large head, hypoplastic maxilla, palate anomalies, chronic otitis media, hearing deficits, nasal obstruction, and neurological changes of deafness, facial palsy, ophthalmoplegia, and mental retardation. We will review the clinical and radiologic findings in a new patient from birth to 20 years; this is believed to be the thirty-fifth patient reported. OS-CS is 2.5 times more common in females and occurs as an autosomal dominant condition or a sporadic dominant mutation with patients presenting for evaluation from the newborn period to the fifth decade. Skeletal abnormalities are distinctive including sclerosis of the skull base and calvarium, linear striated densities in the long bones and pelvis, and poor development of the mastoid and sinus air cells. Radionuclide bone scans with SPECT indicated in our patient increased bone turnover which was supported by biochemical findings of increased pyridinoline excretion. The major complications are due to constriction of essential foramina at the skull base. The condition is not life-threatening but can produce disability. (orig.)

  10. WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

    Energy Technology Data Exchange (ETDEWEB)

    Kim, G. [University of California, San Diego (United States)

    2015-06-15

    The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.

  11. Sci—Sat AM: Stereo — 05: The Development of Quality Assurance Methods for Trajectory based Cranial SRS Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, B; Duzenli, C; Gete, E [BC Cancer Agency, Vancouver Cancer Centre (Canada); Teke, T [BC Cancer Agency, Centre for the Southern Interior (Canada)

    2014-08-15

    The goal of this work was to develop and validate non-planar linac beam trajectories defined by the dynamic motion of the gantry, couch, jaws, collimator and MLCs. This was conducted on the Varian TrueBeam linac by taking advantage of the linac's advanced control features in a non-clinical mode (termed developers mode). In this work, we present quality assurance methods that we have developed to test for the positional and temporal accuracy of the linac's moving components. The first QA method focuses on the coordination of couch and gantry. For this test, we developed a cylindrical phantom which has a film insert. Using this phantom we delivered a plan with dynamic motion of the couch and gantry. We found the mean absolute deviation of the entrance position from its expected value to be 0.5mm, with a standard deviation of 0.5mm. This was within the tolerances set by the machine's mechanical accuracy and the setup accuracy of the phantom. We also present an altered picket fence test which has added dynamic and simultaneous rotations of the couch and the collimator. While the test was shown to be sensitive enough to discern errors 1° and greater, we were unable to identify any errors in the coordination of the linacs collimator and couch. When operating under normal conditions, the Varian TrueBeam linac was able to pass both tests and is within tolerances acceptable for complex trajectory based treatments.

  12. Phenotypic integration of the cervical vertebrae in the Hominoidea (Primates).

    Science.gov (United States)

    Villamil, Catalina I

    2018-01-23

    Phenotypic integration and modularity represent important factors influencing evolutionary change. The mammalian cervical vertebral column is particularly interesting in regards to integration and modularity because it is highly constrained to seven elements, despite widely variable morphology. Previous research has found a common pattern of integration among quadrupedal mammals, but integration patterns also evolve in response to locomotor selective pressures like those associated with hominin bipedalism. Here, I test patterns of covariation in the cervical vertebrae of three hominoid primates (Hylobates, Pan, Homo) who engage in upright postures and locomotion. Patterns of integration in the hominoid cervical vertebrae correspond generally to those previously found in other mammals, suggesting that integration in this region is highly conserved, even among taxa that engage in novel positional behaviors. These integration patterns reflect underlying developmental as well as functional modules. The strong integration between vertebrae suggests that the functional morphology of the cervical vertebral column should be considered as a whole, rather than in individual vertebrae. Taxa that display highly derived morphologies in the cervical vertebrae are likely exploiting these integration patterns, rather than reorganizing them. Future work on vertebrates without cervical vertebral number constraints will further clarify the evolution of integration in this region. © 2018 The Author(s). Evolution © 2018 The Society for the Study of Evolution.

  13. Alternative classification and screening protocol for transitional lumbosacral vertebra in German shepherd dogs

    Directory of Open Access Journals (Sweden)

    Lappalainen Anu K

    2012-05-01

    Full Text Available Abstract Background Lumbosacral transitional vertebra (LTV is a common congenital and hereditary anomaly in many dog breeds. It predisposes to premature degeneration of the lumbosacral junction, and is a frequent cause of cauda equina syndrome, especially in German shepherd dogs. Ventrodorsal hip radiographs are most often used in diagnosis of LTV in screening programs. In this study, value of laterolateral lumbar spine radiographs as additions to ventrodorsal radiographs in diagnosis of LTV, and characteristics of LTV and the eighth lumbar vertebra (L8 in laterolateral radiographs were studied. Additionally, computed tomography (CT features of different types of LTV were elucidated. Methods The ventrodorsal pelvic and laterolateral lumbar spine radiographs of 228 German shepherd dogs were evaluated for existence and type of LTV. Morphology of transverse processes was used in classification of LTV in ventrodorsal radiographs. The relative length of sixth (L6 and seventh (L7 vertebrae (L6/L7 was used in characterization of these vertebrae in laterolateral radiographs. CT studies were available for 16 dogs, and they were used for more detailed characterization of different types of LTV. Non-parametric χ2 statistics, generalized logit model for multinomial data, and one-way analysis of variance was used for statistical analyses. Results In all, 92 (40% dogs had a LTV, the most common type being separation of first spinous process from the median crest of the sacrum in 62 dogs (67% of LTV. Eight dogs had eight lumbar vertebrae. Those dogs with LTV had longer L7 in relation to L6 than dogs with normal lumbosacral junctions. When L6/L7 decreased by 0.1 units, the proportion of dogs belonging to the group with L8 was 14-fold higher than in the group with normal lumbosacral junctions. L8 resembled first sacral vertebra (S1 in length and position and was therefore classified as one type of LTV. With CT it was shown that categorizing LTV, based on shape

  14. Effect of Osteopathic Cranial Manipulative Medicine on Visual Function.

    Science.gov (United States)

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

    2016-11-01

    The effects of osteopathic cranial manipulative medicine (OCMM) on visual function have been poorly characterized in the literature. Based on a pilot study conducted by their research group, the authors conducted a study that examined whether OCMM produced a measurable change in visual function in adults with cranial asymmetry. Randomized, controlled, double-blinded clinical trial. The intervention and control (sham therapy) were applied during 8 weekly visits, and participants in both groups received 8 weekly follow-up visits. Adult volunteers aged between 18 and 35 years with unremarkable systemic or ocular history were recruited. Inclusion criteria were refractive error between 6 diopters of myopia and 5 diopters of hyperopia, regular astigmatism of any amount, and cranial somatic dysfunction. All participants were evaluated for cranial asymmetry and randomly assigned to the treatment or sham therapy group. The treatment group received OCMM to correct cranial dysfunctions, and the sham therapy group received light pressure applied to the cranium. Preintervention and postintervention ophthalmic examinations consisted of distance visual acuity testing, accommodative system testing, local stereoacuity testing, pupillary size measurements, and vergence system testing. A χ2 analysis was performed to determine participant masking. Analysis of variance was performed for all ophthalmic measures. Eighty-nine participants completed the trial, with 47 in the treatment group and 42 in the sham therapy group. A hierarchical analysis of variance revealed statistically significant within-groups effects (Ptherapy group, a statistically significant effect (Pmanipulative medicine may affect visual function in adults with cranial asymmetry. Active motion testing of the cranium for somatic dysfunction may affect the cranial system to a measurable level and explain interrater reliability issues in cranial studies. (ClinicalTrials.gov number NCT02728713).

  15. The Morphogenesis of Cranial Sutures in Zebrafish.

    Directory of Open Access Journals (Sweden)

    Jolanta M Topczewska

    Full Text Available Using morphological, histological, and TEM analyses of the cranium, we provide a detailed description of bone and suture growth in zebrafish. Based on expression patterns and localization, we identified osteoblasts at different degrees of maturation. Our data confirm that, unlike in humans, zebrafish cranial sutures maintain lifelong patency to sustain skull growth. The cranial vault develops in a coordinated manner resulting in a structure that protects the brain. The zebrafish cranial roof parallels that of higher vertebrates and contains five major bones: one pair of frontal bones, one pair of parietal bones, and the supraoccipital bone. Parietal and frontal bones are formed by intramembranous ossification within a layer of mesenchyme positioned between the dermal mesenchyme and meninges surrounding the brain. The supraoccipital bone has an endochondral origin. Cranial bones are separated by connective tissue with a distinctive architecture of osteogenic cells and collagen fibrils. Here we show RNA in situ hybridization for col1a1a, col2a1a, col10a1, bglap/osteocalcin, fgfr1a, fgfr1b, fgfr2, fgfr3, foxq1, twist2, twist3, runx2a, runx2b, sp7/osterix, and spp1/ osteopontin, indicating that the expression of genes involved in suture development in mammals is preserved in zebrafish. We also present methods for examining the cranium and its sutures, which permit the study of the mechanisms involved in suture patency as well as their pathological obliteration. The model we develop has implications for the study of human disorders, including craniosynostosis, which affects 1 in 2,500 live births.

  16. Cranial mediastinal carcinomas in nine dogs.

    Science.gov (United States)

    Liptak, J M; Kamstock, D A; Dernell, W S; Ehrhart, E J; Rizzo, S A; Withrow, S J

    2008-03-01

    Nine dogs were diagnosed with cranial mediastinal carcinomas. Based on histological and immunohistochemical analysis, four dogs were diagnosed with ectopic follicular cell thyroid carcinomas, one dog with ectopic medullary cell thyroid carcinoma, two dogs with neuroendocrine carcinomas and two dogs with anaplastic carcinomas. Clinical signs and physical examination findings were associated with a space-occupying mass, although one dog was diagnosed with functional hyperthyroidism. Surgical resection was attempted in eight dogs. The cranial mediastinal mass was invasive either into the heart or into the cranial vena cava in three dogs. Resection was complete in six dogs and unresectable in two dogs. All dogs survived surgery, but four dogs developed pulmonary thromboembolism and two dogs died of respiratory complications postoperatively. Adjunctive therapies included pre-operative radiation therapy (n=1) and postoperative chemotherapy (n=3). Three dogs had metastasis at the time of diagnosis, but none developed metastasis following surgery. The overall median survival time was 243 days. Local invasion, pleural effusion and metastasis did not have a negative impact on survival time in this small case series.

  17. Lowest instrumented vertebra selection in Lenke 3C and 6C scoliosis

    DEFF Research Database (Denmark)

    Wang, Yu; Bünger, Cody; Zhang, Yanqun

    2012-01-01

    PURPOSE: The aim of this study was to investigate whether or not post-op curve behaviour differs due to different choices of lowest instrumented vertebra (LIV) with reference to lumbar apical vertebra (LAV) in Lenke 3C and 6C scoliosis. METHODS: We reviewed all the AIS cases surgically treated...... in our institution from 2002 through 2008. Inclusion criteria were as follows: (1) patients with Lenke 3C or 6C scoliosis who were treated with posterior pedicle screw-only constructs; (2) 2-year radiographic follow-up. All the included patients were categorized into three groups based on the relative...... surgery. No significant differences were found in thoracic or lumbar correction rate, global coronal balance and incidence rate of trunk shift among the three groups. CONCLUSION: In conclusion, in Lenke 3C and 6C scoliosis, post-op lumbar curve behaviour differs due to different choices of LIV...

  18. Relationship between transitional lumbosacral vertebrae and eight lumbar vertebrae in a breeding colony of Labrador Retrievers and Labrador Crosses.

    Science.gov (United States)

    Moeser, C F; Wade, C M

    2017-01-01

    Transitional lumbosacral vertebrae (TLSV) is a hereditary malformation of the spinal column diagnosed in various dog breeds. The aim of this study was to explore whether different lumbosacral phenotypes have an inherited basis. Radiographs of all dogs within a breeding colony were performed and assessed. A comparison of the incidence of TLSV, eight lumbar vertebrae (8LV), and fusion of the first caudal vertebrae to the sacrum or near fusion of this area was made between litters of normal parentage and litters where one or both of the parents had an anomaly. Of the 119 puppies included in the study, 69 had normal conformation, 9 had 8LV, 9 had TLSV and 32 had fusion of the first caudal vertebra (Ca1) to the caudal sacral segment or a reduced joint space in this area. Results indicated that all the abnormal types likely had common underlying genetic causes. Compared with the population as a whole, significantly more progeny were observed to have abnormalities of the sacral region when both parents were affected by either fusion of Ca1 to the third sacral vertebra (S3) and/or had 8LV. Significantly more progeny were normal compared with the entire study population when both parents were normal. Strong similarity between parental and progeny phenotypes suggested that the characteristics were heritable and likely influenced by major gene effects. When performing screening radiographs for TLSV, assessment for 8LV and fusion of Ca1 to S3 should be included. © 2017 Australian Veterinary Association.

  19. Evaluation of thoracic vertebrae rotation in patients with pectus excavatum.

    Science.gov (United States)

    Tomaszewski, Ryszard; Wiktor, Łukasz; Machała, Ludwina

    2017-07-01

    The aim of our study was to evaluate thoracic vertebrae rotation in patients with pectus excavatum. Moreover, we wanted to assess the prevalence, the severity and relationship between pectus excavatum and adolescent idiopathic scoliosis (AIS). We performed retrospective analysis of 82 preoperative chest CT in children with pectus excavatum performed between January 2008 and December 2011. For each patient Haller Index and Cobb angle was measured. To evaluate the severity of thoracic scoliosis we measured vertebral rotation for Th8 and for vertebra at the level of highest chest deformation using Aaro-Dahlborn method. From the group of 54 patients with pectus excavatum enrolled in the study AIS was diagnosed in 8 patients (14,81%). In patients with symmetric deformation, Th8 rotation was found in 21 patients; the rotation of the apical vertebra was found in 20 patients. In patients with asymmetric deformation Th8 rotation was found in 10 patients; the rotation of the apical vertebra was found in 8 patients. 1. We have confirmed the higher prevalence of pectus excavatum in boys; 2. We have found a significant relationship between pectus excavatum and adolescent idiopathic scoliosis; 3. We have shown that deformation of the anterior chest wall enforces rotation of the thoracic spine; 4. We haven't found the relationship between the severity of the chest deformity (HI measured) and severity of AIS (Cobb angle measured); 5. We have shown a significant association between HI measured and rotation of thoracic vertebra at the level of highest chest deformation (apical vertebra) in symmetric pectus excavatum. Level IV, Diagnostic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  20. A multi-vertebrae CT to US registration of the lumbar spine in clinical data.

    Science.gov (United States)

    Nagpal, Simrin; Abolmaesumi, Purang; Rasoulian, Abtin; Hacihaliloglu, Ilker; Ungi, Tamas; Osborn, Jill; Lessoway, Victoria A; Rudan, John; Jaeger, Melanie; Rohling, Robert N; Borschneck, Dan P; Mousavi, Parvin

    2015-09-01

    Spinal needle injections are widely applied to alleviate back pain and for anesthesia. Current treatment is performed either blindly with palpation or using fluoroscopy or computed tomography (CT). Both fluoroscopy and CT guidance expose patients to ionizing radiation. Ultrasound (US) guidance for spinal needle procedures is becoming more prevalent as an alternative. It is challenging to use US as the sole imaging modality for intraoperative guidance of spine needle injections due to the acoustic shadows created by the bony structures of the vertebra that limit visibility of the target areas for injection. We propose registration of CT and the US images to augment anatomical visualization for the clinician during spinal interventions guided by US. The proposed method involves automatic global and multi-vertebrae registration to find the closest alignment between CT and US data. This is performed by maximizing the similarity between the two modalities using voxel intensity information as well as features extracted from the input volumes. In our method, the lumbar spine is first globally aligned between the CT and US data using intensity-based registration followed by point-based registration. To account for possible curvature change of the spine between the CT and US volumes, a multi-vertebrae registration step is also performed. Springs are used to constrain the movement of the individually transformed vertebrae to ensure the optimal alignment is a pose of the lumbar spine that is physically possible. Evaluation of the algorithm is performed on 10 clinical patient datasets. The registration approach was able to align CT and US datasets from initial misalignments of up to 25 mm, with a mean TRE of 1.37 mm. These results suggest that the proposed approach has the potential to offer a sufficiently accurate registration between clinical CT and US data.

  1. Cranial anatomy of the spade-headed amphisbaenian Diplometopon zarudnyi (Squamata, Amphisbaenia) based on high-resolution X-ray computed tomography.

    Science.gov (United States)

    Maisano, Jessica Anderson; Kearney, Maureen; Rowe, Timothy

    2006-01-01

    The skull of the trogonophid amphisbaenian Diplometopon zarudnyi is described from high-resolution X-ray computed tomographic (HRXCT) imagery of a whole museum specimen preserved in ETOH. The skull was digitally resliced and disarticulated into individual elements, producing novel visualizations that allow detailed morphological analysis of its three-dimensionally complex structure. The prefrontal and jugal are absent in Diplometopon. The septomaxilla is present but hidden entirely from superficial view. In contrast to previous studies, we recognize a splenial fused to the compound bone of the mandible and a squamosal fused to the otic-occipital complex. Comparison of Diplometopon to the two other amphisbaenians previously described in comparable detail, Rhineura hatcherii and Amphisbaena alba, reveals a mosaic of cranial similarities and differences. Both Diplometopon and Rhineura exhibit a craniofacial angulation and expanded rostral blade related to use of the head as a digging tool, but the detailed architecture of these features is quite different. Additionally, whereas the snout of Rhineura exhibits a high degree of sculpturing and sensory innervation, this is not the case in Diplometopon. Unlike in Rhineura and Amphisbaena, the cranial elements of Diplometopon do not exhibit an extensive degree of overlap or complex interlocking sutures; instead, most of the cranial elements lie in loose apposition to each other. The degree to which this mosaic of features reflects functional demands, shared ancestry, and/or convergence is unclear in the absence of a stable hypothesis of amphisbaenian phylogeny. (c) 2004 Wiley-Liss, Inc.

  2. Compression fractures of the vertebrae during a "bumpy" boat ride.

    LENUS (Irish Health Repository)

    Chukwunyerenwa, C K

    2012-01-31

    INTRODUCTION: Compression fracture of the vertebrae is common, often the result of falls from height and motor vehicle accidents in the younger age groups. It can occur following minor trauma in the elderly and in those with osteoporosis. MATERIALS AND METHODS: We present an interesting case of compression fracture of the vertebral bodies occurring simultaneously in a couple during a boat ride while on holiday. One individual had fracture of the T8, while the other fractured the L1 vertebrae. Both injuries were treated conservatively with Taylor braces. CONCLUSION: We highlight one of the potential hazards of this recreational activity, and the almost identical fracture pattern in this couple.

  3. Automatic localization of target vertebrae in spine surgery using fast CT-to-fluoroscopy (3D-2D) image registration

    Science.gov (United States)

    Otake, Y.; Schafer, S.; Stayman, J. W.; Zbijewski, W.; Kleinszig, G.; Graumann, R.; Khanna, A. J.; Siewerdsen, J. H.

    2012-02-01

    Localization of target vertebrae is an essential step in minimally invasive spine surgery, with conventional methods relying on "level counting" - i.e., manual counting of vertebrae under fluoroscopy starting from readily identifiable anatomy (e.g., the sacrum). The approach requires an undesirable level of radiation, time, and is prone to counting errors due to the similar appearance of vertebrae in projection images; wrong-level surgery occurs in 1 of every ~3000 cases. This paper proposes a method to automatically localize target vertebrae in x-ray projections using 3D-2D registration between preoperative CT (in which vertebrae are preoperatively labeled) and intraoperative fluoroscopy. The registration uses an intensity-based approach with a gradient-based similarity metric and the CMA-ES algorithm for optimization. Digitally reconstructed radiographs (DRRs) and a robust similarity metric are computed on GPU to accelerate the process. Evaluation in clinical CT data included 5,000 PA and LAT projections randomly perturbed to simulate human variability in setup of mobile intraoperative C-arm. The method demonstrated 100% success for PA view (projection error: 0.42mm) and 99.8% success for LAT view (projection error: 0.37mm). Initial implementation on GPU provided automatic target localization within about 3 sec, with further improvement underway via multi-GPU. The ability to automatically label vertebrae in fluoroscopy promises to streamline surgical workflow, improve patient safety, and reduce wrong-site surgeries, especially in large patients for whom manual methods are time consuming and error prone.

  4. An Aneurysmal Bone Cyst in the Skull Base.

    Science.gov (United States)

    Kim, Sangjun; Jung, Dong Won; Pak, Min Gyoung; Song, Young Jin; Bae, Woo Yong

    2017-10-01

    An aneurysmal bone cyst (ABC) is believed to be attributable to intraosseous circulatory disturbance. An ABC is a vascular tumor of the bone caused by bony expansion after partial vascular occlusion and congestion. Most ABCs are found in adolescents (approximately 75% of ABCs are observed in patients under 20 years of age). The most common ABC sites are the long bones of the limbs, the vertebrae, and the cranial bone. Aneurysmal bone cysts in the skull base or ethmoid sinus have been but rarely reported worldwide. The authors report on a patient with a very large ABC in the skull base and the ethmoid sinus; this was successfully managed by a neurosurgeon.

  5. The congenital cranial dysinnervation disorders.

    Science.gov (United States)

    Gutowski, N J; Chilton, J K

    2015-07-01

    Congenital cranial dysinnervation disorders (CCDD) encompass a number of related conditions and includes Duane syndrome, congenital fibrosis of the external ocular muscles, Möbius syndrome, congenital ptosis and hereditary congenital facial paresis. These are congenital disorders where the primary findings are non-progressive and are caused by developmental abnormalities of cranial nerves/nuclei with primary or secondary dysinnervation. Several CCDD genes have been found, which enhance our understanding of the mechanisms involved in brain stem development and axonal guidance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Automatic segmentation of lumbar vertebrae in CT images

    Science.gov (United States)

    Kulkarni, Amruta; Raina, Akshita; Sharifi Sarabi, Mona; Ahn, Christine S.; Babayan, Diana; Gaonkar, Bilwaj; Macyszyn, Luke; Raghavendra, Cauligi

    2017-03-01

    Lower back pain is one of the most prevalent disorders in the developed/developing world. However, its etiology is poorly understood and treatment is often determined subjectively. In order to quantitatively study the emergence and evolution of back pain, it is necessary to develop consistently measurable markers for pathology. Imaging based measures offer one solution to this problem. The development of imaging based on quantitative biomarkers for the lower back necessitates automated techniques to acquire this data. While the problem of segmenting lumbar vertebrae has been addressed repeatedly in literature, the associated problem of computing relevant biomarkers on the basis of the segmentation has not been addressed thoroughly. In this paper, we propose a Random-Forest based approach that learns to segment vertebral bodies in CT images followed by a biomarker evaluation framework that extracts vertebral heights and widths from the segmentations obtained. Our dataset consists of 15 CT sagittal scans obtained from General Electric Healthcare. Our main approach is divided into three parts: the first stage is image pre-processing which is used to correct for variations in illumination across all the images followed by preparing the foreground and background objects from images; the next stage is Machine Learning using Random-Forests, which distinguishes the interest-point vectors between foreground or background; and the last step is image post-processing, which is crucial to refine the results of classifier. The Dice coefficient was used as a statistical validation metric to evaluate the performance of our segmentations with an average value of 0.725 for our dataset.

  7. Identification and tracking of vertebrae in ultrasound using deep networks with unsupervised feature learning

    Science.gov (United States)

    Hetherington, Jorden; Pesteie, Mehran; Lessoway, Victoria A.; Abolmaesumi, Purang; Rohling, Robert N.

    2017-03-01

    Percutaneous needle insertion procedures on the spine often require proper identification of the vertebral level in order to effectively deliver anesthetics and analgesic agents to achieve adequate block. For example, in obstetric epidurals, the target is at the L3-L4 intervertebral space. The current clinical method involves "blind" identification of the vertebral level through manual palpation of the spine, which has only 30% accuracy. This implies the need for better anatomical identification prior to needle insertion. A system is proposed to identify the vertebrae, assigning them to their respective levels, and track them in a standard sequence of ultrasound images, when imaged in the paramedian plane. Machine learning techniques are developed to identify discriminative features of the laminae. In particular, a deep network is trained to automatically learn the anatomical features of the lamina peaks, and classify image patches, for pixel-level classification. The chosen network utilizes multiple connected auto-encoders to learn the anatomy. Pre-processing with ultrasound bone enhancement techniques is done to aid the pixel-level classification performance. Once the lamina are identified, vertebrae are assigned levels and tracked in sequential frames. Experimental results were evaluated against an expert sonographer. Based on data acquired from 15 subjects, vertebrae identification with sensitivity of 95% and precision of 95% was achieved within each frame. Between pairs of subsequently analyzed frames, matches of predicted vertebral level labels were correct in 94% of cases, when compared to matches of manually selected labels

  8. Accessory Transversarium Foramen of Cervical Vertebrae: A Case ...

    African Journals Online (AJOL)

    The anatomical variations of the cervical vertebrae as reported in most classical anatomical textbooks mainly include: cervical ribs, non fusion of the halves of the posterior arch of the atlas, presence of articular facets on the superior margin of the anterior arch of the atlas incase of presence of a third occipital condyle. A male ...

  9. Invasive cranial mycosis our experiences

    Directory of Open Access Journals (Sweden)

    Tapas Kumbhkar

    2013-01-01

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

  10. Overview of the Cranial Nerves

    Science.gov (United States)

    ... Swallowing, the gag reflex, and speech Control of muscle in some internal organs and the heart rate This function is not tested as part of the cranial nerve examination. 11th Accessory Neck turning and shoulder shrugging The person is asked to turn the ...

  11. Cranial muscles in amphibians: development, novelties and the role of cranial neural crest cells

    Science.gov (United States)

    Schmidt, Jennifer; Piekarski, Nadine; Olsson, Lennart

    2013-01-01

    Our research on the evolution of the vertebrate head focuses on understanding the developmental origins of morphological novelties. Using a broad comparative approach in amphibians, and comparisons with the well-studied quail-chicken system, we investigate how evolutionarily conserved or variable different aspects of head development are. Here we review research on the often overlooked development of cranial muscles, and on its dependence on cranial cartilage development. In general, cranial muscle cell migration and the spatiotemporal pattern of cranial muscle formation appears to be very conserved among the few species of vertebrates that have been studied. However, fate-mapping of somites in the Mexican axolotl revealed differences in the specific formation of hypobranchial muscles (tongue muscles) in comparison to the chicken. The proper development of cranial muscles has been shown to be strongly dependent on the mostly neural crest-derived cartilage elements in the larval head of amphibians. For example, a morpholino-based knock-down of the transcription factor FoxN3 in Xenopus laevis has drastic indirect effects on cranial muscle patterning, although the direct function of the gene is mostly connected to neural crest development. Furthermore, extirpation of single migratory streams of cranial neural crest cells in combination with fate-mapping in a frog shows that individual cranial muscles and their neural crest-derived connective tissue attachments originate from the same visceral arch, even when the muscles attach to skeletal components that are derived from a different arch. The same pattern has also been found in the chicken embryo, the only other species that has been thoroughly investigated, and thus might be a conserved pattern in vertebrates that reflects the fundamental nature of a mechanism that keeps the segmental order of the head in place despite drastic changes in adult anatomy. There is a need for detailed comparative fate-mapping of pre

  12. Cranial muscles in amphibians: development, novelties and the role of cranial neural crest cells.

    Science.gov (United States)

    Schmidt, Jennifer; Piekarski, Nadine; Olsson, Lennart

    2013-01-01

    Our research on the evolution of the vertebrate head focuses on understanding the developmental origins of morphological novelties. Using a broad comparative approach in amphibians, and comparisons with the well-studied quail-chicken system, we investigate how evolutionarily conserved or variable different aspects of head development are. Here we review research on the often overlooked development of cranial muscles, and on its dependence on cranial cartilage development. In general, cranial muscle cell migration and the spatiotemporal pattern of cranial muscle formation appears to be very conserved among the few species of vertebrates that have been studied. However, fate-mapping of somites in the Mexican axolotl revealed differences in the specific formation of hypobranchial muscles (tongue muscles) in comparison to the chicken. The proper development of cranial muscles has been shown to be strongly dependent on the mostly neural crest-derived cartilage elements in the larval head of amphibians. For example, a morpholino-based knock-down of the transcription factor FoxN3 in Xenopus laevis has drastic indirect effects on cranial muscle patterning, although the direct function of the gene is mostly connected to neural crest development. Furthermore, extirpation of single migratory streams of cranial neural crest cells in combination with fate-mapping in a frog shows that individual cranial muscles and their neural crest-derived connective tissue attachments originate from the same visceral arch, even when the muscles attach to skeletal components that are derived from a different arch. The same pattern has also been found in the chicken embryo, the only other species that has been thoroughly investigated, and thus might be a conserved pattern in vertebrates that reflects the fundamental nature of a mechanism that keeps the segmental order of the head in place despite drastic changes in adult anatomy. There is a need for detailed comparative fate-mapping of pre

  13. Prognostication of traumatic brain injury outcomes in older trauma patients: A novel risk assessment tool based on initial cranial CT findings.

    Science.gov (United States)

    Stawicki, Stanislaw P; Wojda, Thomas R; Nuschke, John D; Mubang, Ronnie N; Cipolla, James; Hoff, William S; Hoey, Brian A; Thomas, Peter G; Sweeney, Joan; Ackerman, Daniel; Hosey, Jonathan; Falowski, Steven

    2017-01-01

    Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e.g., morbidity and mortality) in the older (age 45+ years) TBI patient subset. We hypothesized that increasing number of categorical CCT findings is independently associated with NSI, morbidity, and mortality in older patients with severe TBI. After IRB approval, a retrospective study of patients 45 years and older was performed using our Regional Level 1 Trauma Center registry data between June 2003 and December 2013. Collected variables included patient demographics, Injury Severity Score (ISS), Abbreviated Injury Scale Head (AISh), brain injury characteristics on CCT, Glasgow Coma Scale (GCS), Intensive Care Unit (ICU) and hospital length of stay (LOS), all-cause morbidity and mortality, functional independence scores, as well as discharge disposition. A novel CCT scoring tool (CCTST, scored from 1 to 8+) was devised, with one point given for each of the following findings: subdural hematoma, epidural hematoma, subarachnoid blood, intraventricular blood, cerebral contusion/intraparenchymal blood, skull fracture, pneumocephalus, brain edema/herniation, midline shift, and external (skin/face) trauma. Descriptive statistics and univariate analyses were conducted with 30-day mortality, in-hospital morbidity, and need for NSI as primary end-points. Secondary end-points included the length of stay in the ICU (ICULOS), step-down unit (SDLOS), and the hospital (HLOS) as well as patient functional outcomes, and postdischarge destination. Factors associated with the need for NSI were determined

  14. Epidemiological approach to emergent cranial surgery of cranial traumas

    Directory of Open Access Journals (Sweden)

    Hülagü Kaptan

    2008-03-01

    Full Text Available

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

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

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

  15. An osteological and histological investigation of cranial joints in geckos.

    Science.gov (United States)

    Payne, Samantha L; Holliday, Casey M; Vickaryous, Matthew K

    2011-03-01

    Cranial kinesis is a widespread feature of gekkotan lizards. Previous studies of kinesis in lizards often described the relevant, mobile joints as synovial, thus characterized by the presence of a synovial cavity lined with articular cartilage. To date however, detailed investigations of cranial joint histology are lacking. We examined eight cranial joints (quadrate-articular, quadrate-pterygoid, quadrate-otooccipital, quadrate-squamosal, epipterygoid-prootic, epipterygoid-pterygoid, basisphenoid-pterygoid, and frontal-parietal) in five gekkotan species (Oedura lesueuerii, Eublepharis macularius, Hemitheconyx caudicinctus, Tarentola annularis, and Chondrodactylous bibronii) using microcomputed tomography and serial histology. Particular focus was given to the relationship between the bony and soft-tissue components of the joint. Our results demonstrate that only three of these joints are synovial: the quadrate-articular, epipterygoid-pterygoid, and basisphenoid-pterygoid joints. The frontal-parietal and quadrate-pterygoid joints are syndesmosis (fibrous), the epipterygoid-prootic and quadrate-otooccipital joints are synchondroses (cartilaginous without a synovial cavity) and the quadrate-squamosal joint was not present. Based on previous descriptions, we determine that the structure of some cranial joints is variable among lizard taxa. We caution that osteology does not necessarily predict cranial joint histology. Although the functional implications of these findings remain to be explored we note that the development of synovial joints appears to be associated with a neural crest origin for the elements involved. Copyright © 2011 Wiley-Liss, Inc.

  16. Posttraumatic Cranial Cystic Fibrous Dysplasia

    Directory of Open Access Journals (Sweden)

    Arata Tomiyama

    2011-01-01

    Full Text Available A 14-year-old was girl admitted to our hospital with a subcutaneous mass of the occipital head. The mass had grown for 6 years, after she had sustained a head injury at the age of 6, and was located directly under a previous wound. Skull X-ray Photograph (xp, computed tomography (CT, and magnetic resonance imaging (MRI showed a bony defect and cystic changes in the skull corresponding to a subcutaneous mass. Bone scintigraphy revealed partial accumulation. The patient underwent total removal of the skull mass, and the diagnosis from the pathological findings of the cyst wall was fibrous dysplasia (FD. The radiographic findings for cystic cranial FD can be various. Progressive skull disease has been reported to be associated with head trauma, but the relationship between cranial FD and head trauma has not been previously reported. Previous studies have suggested that c-fos gene expression is a key mechanism in injury-induced FD.

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

    Science.gov (United States)

    Fiorenza, Luca; Bruner, Emiliano

    2017-12-05

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

  18. Morphometric Study of the Atlas Vertebra using Manual Method

    Directory of Open Access Journals (Sweden)

    Shilpa N Gosavi

    2012-07-01

    Full Text Available The atlas (first cervical vertebra has undergone many structural modifications. It is critically located and close to the ‘life centres’. For this study, one hundred dried intact human atlas vertebrae from the Indian population were measured using a digital Vernier calliper that provides accurate resolution up to 0.01 mm. The distance between the tips of the transverse process, the outer and the inner distance between the foramen transversaria and various diameters of vertebral foramen were measured. The mean width of the measured atlases was 69.37 mm. The mean distance between the lateral margins of foramen transversaria was 55.66 mm and the inner distance was 45.93 mm. The mean thickness of vertebral artery grooves was 3.72 + 1.06 mm. The observations made in the present study may help in improving understanding of various bony dimensions while operating close to important structures like nerve roots and the vertebral artery.

  19. Cranial computed tomography in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Boltshauser, E. (Zuerich Univ. (Switzerland). Kinderklinik)

    1984-01-01

    This paper deals mainly with methodical aspects (such as sedation, intravenous and intrathecal application of contrast media) and with common difficulties in interpretation of computed tomography images. The indications for cranial CT are discussed in respect to probable therapeutic consequences and expected diagnostic yield. In the view of the author CT is, as a rule, not required in assessing chronic headache, generalised epileptic convulsions, non-specific mental retardation and cerebral palsy.

  20. Cranial kinesis in palaeognathous birds.

    Science.gov (United States)

    Gussekloo, Sander W S; Bout, Ron G

    2005-09-01

    Cranial kinesis in birds is induced by muscles located caudal on the cranium. These forces are transferred onto the moveable parts of the skull via the Pterygoid-Palatinum Complex (PPC). This bony structure therefore plays an essential role in cranial kinesis. In palaeognathous birds the morphology of the PPC is remarkably different from that of neognathous birds and is thought to be related to the specific type of cranial kinesis in palaeognaths known as central rhynchokinesis. We determined whether clear bending zones as found in neognaths are present in the upper bill of paleognaths, and measured bending forces opposing elevation of the upper bill. A static force model was used to calculate the opening forces that can be produced by some of the palaeognathous species. We found that no clear bending zones are present in the upper bill, and bending is expected to occur over the whole length of the upper bill. Muscle forces are more than sufficient to overcome bending forces and to elevate the upper bill. The resistance against bending by the bony elements alone is very low, which might indicate that bending of bony elements can occur during food handling when muscles are not used to stabilise the upper bill. Model calculations suggest that the large processi basipterygoidei play a role in stabilizing the skull elements, when birds have to resist external opening forces on the upper bill as might occur during tearing leafs from plants. We conclude that the specific morphology of the palaeognathous upper bill and PPC are not designed for active cranial kinesis, but are adapted to resist external forces that might cause unwanted elevation of the upper bill during feeding.

  1. Neonatal cranial ultrasound: current perspectives

    Directory of Open Access Journals (Sweden)

    Franco A

    2013-09-01

    Full Text Available Arie Franco, Kristopher Neal Lewis Department of Radiology, Medical College of Georgia at Georgia Regents University, Augusta, GA, USA Abstract: Ultrasound is the most common imaging tool used in the neonatal intensive care unit. It is portable, readily available, and can be used at bedside. It is the least expensive cross sectional imaging modality and the safest imaging device used in the pediatric population due to its lack of ionizing radiation. There are well established indications for cranial ultrasound in many neonatal patient groups including preterm infants and term infants with birth asphyxia, seizures, congenital infections, etc. Cranial ultrasound is performed with basic grayscale imaging, using a linear array or sector transducer via the anterior fontanel in the coronal and sagittal planes. Additional images can be obtained through the posterior fontanel in preterm newborns. The mastoid fontanel can be used for assessment of the posterior fossa. Doppler images may be obtained for screening of the vascular structures. The normal sonographic neonatal cranial anatomy and normal variants are discussed. The most common pathological findings in preterm newborns, such as germinal matrix-intraventricular hemorrhage and periventricular leukomalacia, are described as well as congenital abnormalities such as holoprosencephaly and agenesis of the corpus callosum. New advances in sonographic equipment enable high-resolution and three-dimensional images, which facilitate obtaining very accurate measurements of various anatomic structures such as the ventricles, the corpus callosum, and the cerebellar vermis. Limited studies have been performed to predict that longitudinal measurements of these anatomic structures might predict the clinical outcome of high-risk preterm newborns. Hemodynamic Doppler studies may offer the potential for early intervention and treatment to counter the hazards of developmental delay and a moribund clinical outcome

  2. Automatic Detection of Wild-type Mouse Cranial Sutures

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Darvann, Tron Andre; Hermann, Nuno V.

    In the study of craniofacial malformations, the cranial sutures are often of interest. The premature fusion of sutures occurring in e.g. Crouzon and Apert syndrome can lead to asymmetric head shape, enlarged intracranial pressure and blindness. In large population studies of such syndromes......, automatic detection of the cranial sutures becomes important. We have previously built a craniofacial, wild-type mouse atlas from a set of 10 Micro CT scans using a B-spline-based nonrigid registration method by Rueckert et al. Subsequently, all volumes were registered nonrigidly to the atlas. Using...... these transformations, any annotation on the atlas can automatically be transformed back to all cases. For this study, two rounds of tracing seven of the cranial sutures, were performed on the atlas by one observer. The average of the two rounds was automatically propagated to all the cases. For validation...

  3. Morphometric analysis of the uncinate processes of the cervical vertebrae.

    Science.gov (United States)

    Kocabiyik, N; Ercikti, N; Tunali, S

    2017-01-01

    Uncinate processes (UPs) are distinct features unique to cervical vertebrae. They are consistently found on posterolateral aspect of the superior end plate of 3rd to 7th cervical vertebrae. In this study, we investigated the morphology of the UPs with a particular emphasis on the regional anatomy and clinical significance. The study included 63 vertebrae. The width, height and length of UPs were measured with a digital calliper. We also assessed inclination angle of UP relative to sagittal plane, angle between medial surface of UP and superior surface of vertebra, angle between long axis of the UP and frontal plane, angle between long axis of UP and sagittal plane. Average width of the UPs ranged from 4.25 mm at C3 to 6.33 mm at T1; average height ranged from 4.88 mm at T1 to 7.54 mm at C4; and average length ranged from 6.88 mm at T1 to 11.46 mm at C4. We measured the inclination angle of UP relative to sagittal plane, and found it to be relatively constant with T1 having the largest value. The average angle was 41.39°, and the range was 17° to 85°. The angle between the long axis of the UP and the sagittal plane was increasing signifi-cantly from C5 to T1. The average angle was 20.74° and the range was 6° to 65°. Anatomy of UPs is significant for surgeon who operates on the cervical spine. Hopefully, the information presented herein would decrease complications during surgical approaches to the cervical spine.

  4. Method for analysing the deformation and stress of vertebra assembly

    Directory of Open Access Journals (Sweden)

    Spanu Alina Rodica

    2017-01-01

    Full Text Available The paper presents a method for testing the deformation and stress values of the vertebra assembly when variable forces are applied on the body surface. The working points have very well-known positions and they could be changed, so the compression force, torsional or bending couples could act. The system is actuated by an electrical stepper motor controlled with Arduino. The force and displacement sensors were used.

  5. Cranial imaging in child abuse

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-04-01

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

  6. Cranial functional (psychogenic) movement disorders.

    Science.gov (United States)

    Kaski, Diego; Bronstein, Adolfo M; Edwards, Mark J; Stone, Jon

    2015-12-01

    Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or palate--are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient. Identification of the positive features of cranial functional movement disorders such as convergence and unilateral platysmal spasm might lend diagnostic weight to a suspected functional neurological disorder. Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management. Increased understanding of these disorders is also crucial to drive clinical trials and studies of individually tailored therapies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Cranial Chordoma: A New Preoperative Grading System.

    Science.gov (United States)

    Brito da Silva, Harley; Straus, David; Barber, Jason K; Rostomily, Robert C; Ferreira, Manuel; Sekhar, Laligam N

    2017-11-03

    Chordomas are rare but challenging neoplasms involving the skull base. A preoperative grading system will be useful to identify both areas for treatment and risk factors, and correlate to the degree of resection, complications, and recurrence. To propose a new grading system for cranial chordomas designed by the senior author. Its purpose is to enable comparison of different tumors with a similar pathology to clivus chordoma, and statistically correlate with postoperative outcomes. The numerical grading system included tumor size, site of the tumor, vascular encasement, intradural extension, brainstem invasion, and recurrence of the tumor either after surgery or radiotherapy with a range of 2 to 25 points; it was used in 42 patients with cranial chordoma. The grading system was correlated with number of operations for resection, degree of resection, number and type of complications, recurrence, and survival. We found 3 groups: low-risk 0 to 7 points, intermediate-risk 8 to 12 points, and high-risk ≥13 points in the grading system. The 3 groups were correlated with the following: extent of resection (partial, subtotal, or complete; P system itself correlated with the outcome (P = .005). The proposed chordoma grading system can help surgeons to predict the difficulty of the case and know which areas of the skull base will need attention to plan further therapy.

  8. Tract-based Spatial Statistics and fMRI Analysis in Patients with Small Cell Lung Cancer before Prophylactic Cranial Irradiation

    Science.gov (United States)

    Benezi, S.; Bromis, K.; Karavasilis, E.; Karanasiou, I. S.; Koutsoupidou, M.; Matsopoulos, G.; Ventouras, E.; Uzunoglu, N.; Kouloulias, V.; Papathanasiou, M.; Foteineas, A.; Efstathopoulos, E.; Kelekis, N.; Kelekis, D.

    2015-09-01

    Prophylactic cranial irradiation (PCI) is known to increase life expectancy to a significant degree in Small Cell Lung Cancer (SCLC) patients. The overall scope of this research is to investigate changes in structural and functional connectivity between SCLC patients and controls before and after PCI treatment. In the current study specifically we use diffusion tensor imaging (DTI) and functional Magnetic Resonance (fMRI) to identify potential alterations in white matter structure and brain function respectively, in SCLC patients before PCI compared to healthy participants. The results in DTI analysis have showed lower fractional anisotropy (FA) and higher eigenvalues in white matter regions in the patient group. Similarly, in fMRI analysis a lower level of activation in the primary somatosensory cortex was reported. The results presented herein are subject to further investigation with larger patient and control groups.

  9. Clinical validation and applications for CT-based atlas for contouring the lower cranial nerves for head and neck cancer radiation therapy.

    Science.gov (United States)

    Mourad, Waleed F; Young, Brett M; Young, Rebekah; Blakaj, Dukagjin M; Ohri, Nitin; Shourbaji, Rania A; Manolidis, Spiros; Gámez, Mauricio; Kumar, Mahesh; Khorsandi, Azita; Khan, Majid A; Shasha, Daniel; Blakaj, Adriana; Glanzman, Jonathan; Garg, Madhur K; Hu, Kenneth S; Kalnicki, Shalom; Harrison, Louis B

    2013-09-01

    Radiation induced cranial nerve palsy (RICNP) involving the lower cranial nerves (CNs) is a serious complication of head and neck radiotherapy (RT). Recommendations for delineating the lower CNs on RT planning studies do not exist. The aim of the current study is to develop a standardized methodology for contouring CNs IX-XII, which would help in establishing RT limiting doses for organs at risk (OAR). Using anatomic texts, radiologic data, and guidance from experts in head and neck anatomy, we developed step-by-step instructions for delineating CNs IX-XII on computed tomography (CT) imaging. These structures were then contoured on five consecutive patients who underwent definitive RT for locally-advanced head and neck cancer (LAHNC). RT doses delivered to the lower CNs were calculated. We successfully developed a contouring atlas for CNs IX-XII. The median total dose to the planning target volume (PTV) was 70Gy (range: 66-70Gy). The median CN (IX-XI) and (XII) volumes were 10c.c (range: 8-12c.c) and 8c.c (range: 7-10c.c), respectively. The median V50, V60, V66, and V70 of the CN (IX-XI) and (XII) volumes were (85, 77, 71, 65) and (88, 80, 74, 64) respectively. The median maximal dose to the CN (IX-XI) and (XII) were 72Gy (range: 66-77) and 71Gy (range: 64-78), respectively. We have generated simple instructions for delineating the lower CNs on RT planning imaging. Further analyses to explore the relationship between lower CN dosing and the risk of RICNP are recommended in order to establish limiting doses for these OARs. Published by Elsevier Ltd.

  10. Three-dimensional morphometrics of thoracic vertebrae in Neandertals and the fossil evidence from El Sidrón (Asturias, Northern Spain).

    Science.gov (United States)

    Bastir, Markus; García Martínez, Daniel; Rios, Luis; Higuero, Antonio; Barash, Alon; Martelli, Sandra; García Tabernero, Antonio; Estalrrich, Almudena; Huguet, Rosa; de la Rasilla, Marco; Rosas, Antonio

    2017-07-01

    Well preserved thoracic vertebrae of Neandertals are rare. However, such fossils are important as their three-dimensional (3D) spatial configuration can contribute to the understanding of the size and shape of the thoracic spine and the entire thorax. This is because the vertebral body and transverse processes provide the articulation and attachment sites for the ribs. Dorsal orientation of the transverse processes relative to the vertebral body also rotates the attached ribs in a way that could affect thorax width. Previous research indicates possible evidence for greater dorsal orientation of the transverse processes and small vertebral body heights in Neandertals, but their 3D vertebral structure has not yet been addressed. Here we present 15 new vertebral remains from the El Sidrón Neandertals (Asturias, Northern Spain) and used 3D geometric morphometrics to address the above issues by comparing two particularly well preserved El Sidrón remains (SD-1619, SD-1641) with thoracic vertebrae from other Neandertals and a sample of anatomically modern humans. Centroid sizes of El Sidrón vertebrae are within the human range. Neandertals have larger T1 and probably also T2. The El Sidrón vertebrae are similar in 3D shape to those of other Neandertals, which differ from Homo sapiens particularly in central-lower regions (T6-T10) of the thoracic spine. Differences include more dorsally and cranially oriented transverse processes, less caudally oriented spinous processes, and vertebral bodies that are anteroposteriorly and craniocaudally short. The results fit with current reconstructions of Neandertal thorax morphology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Thoracic pedicle morphometry in vertebrae from scoliotic spines.

    Science.gov (United States)

    Parent, Stefan; Labelle, Hubert; Skalli, Wafa; de Guise, Jacques

    2004-02-01

    A morphometric analysis of thoracic pedicles in vertebrae from scoliotic specimens. The objective of this study was to quantify the changes occurring in thoracic pedicles affected by a scoliotic deformity. There exists a lot of controversy in the literature concerning the shape and size of thoracic pedicles in idiopathic scoliosis. In recent years, thoracic pedicle screws are being used more frequently in corrective spine surgery, but few studies have evaluated the morphology of scoliotic thoracic pedicles. Thirty scoliotic specimens with curves presenting various degrees of severity were studied using a three-dimensional digitizing protocol developed to create a precise three-dimensional reconstruction of the vertebrae. Twenty-two parameters describing specifically the pedicles were then calculated for each vertebra from these reconstructions. Every scoliotic specimen was then matched with a normal specimen to provide for a representative control group and comparisons were made on pedicle width, length, height, surface, and orientation. A total of 683 thoracic vertebrae were measured (325 scoliotic and 358 normal vertebrae). Pedicles located on the concavity of typical right thoracic curves were found to be significantly thinner than their normal counterparts with a maximal mean difference of 1.37 mm at T8. The pedicles on the concavity of the high thoracic compensatory curve were also found to be significantly diminished with a maximal mean difference of 1.68 mm at T4. Mean left pedicle width at T8 (concavity) and mean right pedicle width at T4 (concavity) were found to be 4.08 mm and 2.60 mm, respectively. Pedicle length was found to be slightly increased, and pedicle height was found to be slightly decreased in pedicles from scoliotic spines with no preference for concavity or convexity. Pedicle orientation and inclination were unchanged with respect to each corresponding vertebral body. These results are of critical importance for clinicians performing spinal

  12. Recovering missing data: estimating position and size of caudal vertebrae in Staurikosaurus pricei Colbert, 1970

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    Orlando N. Grillo

    2011-03-01

    Full Text Available Missing data is a common problem in paleontology. It makes it difficult to reconstruct extinct taxa accurately and restrains the inclusion of some taxa on comparative and biomechanical studies. Particularly, estimating the position of vertebrae on incomplete series is often non-empirical and does not allow precise estimation of missing parts. In this work we present a method for calculating the position of preserved middle sequences of caudal vertebrae in the saurischian dinosaur Staurikosaurus pricei, based on the length and height of preserved anterior and posterior caudal vertebral centra. Regression equations were used to estimate these dimensions for middle vertebrae and, consequently, to assess the position of the preserved middle sequences. It also allowed estimating these dimensions for non-preserved vertebrae. Results indicate that the preserved caudal vertebrae of Staurikosaurus may correspond to positions 1-3, 5, 7, 14-19/15-20, 24-25/25-26, and 29-47, and that at least 25 vertebrae had transverse processes. Total length of the tail was estimated in 134 cm and total body length was 220-225 cm.Dados lacunares são um problema comum na paleontologia. Eles dificultam a reconstrução acurada de táxons extintos e limitam a inclusão de alguns táxons em estudos comparativose biomecânicos. Particularmente, estimar a posição de vértebras em séries incompletas tem sido feito com base em métodos não empíricos que não permitem estimar corretamente as partes ausentes. Neste trabalho apresentamos uma metodologia que permite estimar a posição de sequências médias preservadas de vértebras caudais no dinossauro saurísquio Staurikosaurus pricei, com base no comprimento e altura dos centros das vértebras anteriores e posteriores preservadas. Equações de regressão foram usadas para estimar essas dimensões para as vértebras médias e, consequentemente, para posicionar as sequências médias preservadas e para estimar o tamanho das

  13. Cranial nerve functional neurosurgery : Evaluation of surgical practice

    NARCIS (Netherlands)

    Le Guerinel, C.; Sindou, M.; Auque, J.; Blondet, E.; Brassier, G.; Chazal, J.; Cuny, E.; Devaux, B.; Fontaine, D.; Finiels, P. -J.; Fuentes, J. -M.; D'Haens, J.; Massager, N.; Mercier, Ph.; Mooij, J.; Nuti, C.; Rousseaux, P.; Serrie, A.; Stecken, J.; de Waele, L.; Keravel, Y.

    We report the results of an investigation carried out on the activity of functional neurosurgery of the cranial nerves in the French-speaking countries, based on the analysis of a questionnaire addressed to all the members of the SNCLF Eighteen centers responded to this questionnaire., which showed

  14. Prevalence of and risk factors for cranial ultrasound abnormalities in ...

    African Journals Online (AJOL)

    Controls were matched 1:2 based on birth weight and gender. Results. Only 55% (856/1 562) of VLBW infants had undergone cranial ... Antenatal care attendance was lower in the cases (71% v. 79%; p=0.039). Sepsis, ventilation, metabolic acidosis and patent ductus arteriosus were all significantly higher in the cases.

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

    Science.gov (United States)

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

    2014-01-01

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

  16. The earliest ossicone and post-cranial record of Giraffa.

    Science.gov (United States)

    Danowitz, Melinda; Barry, John C; Solounias, Nikos

    2017-01-01

    The oldest Giraffa material presently known consists of dental specimens. The oldest post-cranial Giraffa material belongs to the Plio-Pleistocene taxon Giraffa sivalensis, where the holotype is a third cervical vertebra. We describe three non-dental specimens from the Early Late Miocene of the Potwar Plateau, including an 8.1 million year old ossicone, 9.4 million year old astragalus, and 8.9 million year old metatarsal and refer them to Giraffa. The described ossicone exhibits remarkable similarities with the ossicones of a juvenile modern giraffe, including the distribution of secondary bone growth, posterior curvature, and concave pitted undersurface where the ossicone would attach to the skull. The astragalus has a notably flat grove of the trochlea, medial twisting between the trochlea and the head, and a square-shaped sustentacular facet, all of which characterize the astragalus of Giraffa camelopardalis. The newly described astragalus is narrow and rectangular, unlike the boxy shaped bone of the modern giraffe. The metatarsal is large in size and has a shallow central trough created by thin medial and lateral ridges, a feature unique to Giraffa and Sivatherium. Our described material introduce the earliest non-dental material of Giraffa, a genus whose extinct representation is otherwise dominated by teeth, and demonstrate that the genus has been morphologically consistent over 9 million years.

  17. Accuracy and reproducibility of voxel based superimposition of cone beam computed tomography models on the anterior cranial base and the zygomatic arches

    NARCIS (Netherlands)

    Nada, R.M.; Maal, T.J.J.; Breuning, K.H.; Berge, S.J.; Mostafa, Y.A.; Kuijpers-Jagtman, A.M.

    2011-01-01

    Superimposition of serial Cone Beam Computed Tomography (CBCT) scans has become a valuable tool for three dimensional (3D) assessment of treatment effects and stability. Voxel based image registration is a newly developed semi-automated technique for superimposition and comparison of two CBCT scans.

  18. Cranial bones and atlas of titanosaurs (Dinosauria, Sauropoda) from Late Cretaceous (Bauru Group) of Uberaba, Minas Gerais State, Brazil

    Science.gov (United States)

    Martinelli, Agustín G.; Marinho, Thiago da Silva; Filippi, Leonardo S.; Ribeiro, Luiz Carlos Borges; Ferraz, Mara Lúcia da Fonseca; Cavellani, Camila Lourencini; Teixeira, Vicente de Paula Antunes

    2015-08-01

    Isolated left prefrontal, left squamosal and atlas of titanosaur dinosaurs are described and compared. They come from the Late Cretaceous Serra da Galga Member of the Marília Formation at the Serra do Veadinho region, Peirópolis (Uberaba County, Minas Gerais State, Brazil). Due to the sparse cranial elements of titanosaurs already known from Brazil, these specimens are noticeable to be presented. In addition, the atlas vertebra is described for the first time for Brazilian titanosaurs. The morphology of the cranial bones closely resembles lithostratian titanosaurs, such as Rapetosaurus, rather than basal titanosaurs. The atlas is similar to that of other titanosaurs, suggesting that the anatomy of this element seems to be more conservative than other vertebral elements, in which vertebral laminae play an important rule in titanosaur taxonomy.

  19. Evaluation of X ray radiation doses in pediatric examinations of cranial computerized tomography based on optimization studies; Avaliacao das doses de radiacao X em exames pediatricos de tomografia computadorizada de cranio com base em estudos de otimizacao

    Energy Technology Data Exchange (ETDEWEB)

    Daros, Kellen Adriana Curci

    2005-07-01

    This paper identifies the technical conditions for CT examination which offers lowest absorbed dose and to attend the manufacturer recommendations as far the spatial resolution is concerned. The paper evaluates the absorbed dose during cranial CT in up to 6 years children satisfying the technical condition recommended by the manufacturer and routine clinical conditions. The paper also established a quantitative relationship among the absorbed dose and its distribution in the cranial regions of pediatric patients up to 6 years old in a way to estimate the doses subject to optimized conditions

  20. Image quality of iterative reconstruction in cranial CT imaging: comparison of model-based iterative reconstruction (MBIR) and adaptive statistical iterative reconstruction (ASiR)

    Energy Technology Data Exchange (ETDEWEB)

    Notohamiprodjo, S.; Deak, Z.; Meurer, F.; Maertz, F.; Mueck, F.G.; Geyer, L.L.; Wirth, S. [Ludwig-Maximilians University Hospital of Munich, Institute for Clinical Radiology, Munich (Germany)

    2015-01-15

    The purpose of this study was to compare cranial CT (CCT) image quality (IQ) of the MBIR algorithm with standard iterative reconstruction (ASiR). In this institutional review board (IRB)-approved study, raw data sets of 100 unenhanced CCT examinations (120 kV, 50-260 mAs, 20 mm collimation, 0.984 pitch) were reconstructed with both ASiR and MBIR. Signal-to-noise (SNR) and contrast-to-noise (CNR) were calculated from attenuation values measured in caudate nucleus, frontal white matter, anterior ventricle horn, fourth ventricle, and pons. Two radiologists, who were blinded to the reconstruction algorithms, evaluated anonymized multiplanar reformations of 2.5 mm with respect to depiction of different parenchymal structures and impact of artefacts on IQ with a five-point scale (0: unacceptable, 1: less than average, 2: average, 3: above average, 4: excellent). MBIR decreased artefacts more effectively than ASiR (p < 0.01). The median depiction score for MBIR was 3, whereas the median value for ASiR was 2 (p < 0.01). SNR and CNR were significantly higher in MBIR than ASiR (p < 0.01). MBIR showed significant improvement of IQ parameters compared to ASiR. As CCT is an examination that is frequently required, the use of MBIR may allow for substantial reduction of radiation exposure caused by medical diagnostics. (orig.)

  1. Classification of neurons by dendritic branching pattern. A categorisation based on Golgi impregnation of spinal and cranial somatic and visceral afferent and efferent cells in the adult human.

    Science.gov (United States)

    Abdel-Maguid, T E; Bowsher, D

    1984-06-01

    Neurons from adult human brainstem and spinal cord, fixed by immersion in formalin, were impregnated by a Golgi method and examined in sections 100 micron thick. Objective numerical criteria were used to classify completely impregnated neurons. Only the parameters mentioned below were found to be valid. Neurons in 100 micron sections were classified on the basis of (i) the primary dendrite number, indicated by a Roman numeral and called group; (ii) the dendritic branching pattern, comprising the highest branching order seen, indicated by an Arabic numeral and called category; the lowest dendritic branching order observed in complete neurons, indicated by an upper case letter and called class; and the number of branching orders seen between the two preceding, indicated by a lower case letter and called subclass. On the basis of the above characteristics, all neurons seen in the grey matter of the spinal cord and cranial nerve nuclei could be classified into thirteen 'families'. The results of other investigations (Abdel-Maguid & Bowsher, 1979, 1984) showed that this classification has functional value.

  2. Epitransverse process: A rare outgrowth from atlas vertebra

    Directory of Open Access Journals (Sweden)

    Kaushal P

    2010-08-01

    Full Text Available Acute injuries of the upper cervical spine as a cause of severe disability and death following trauma has at all times been an interesting phase of anatomical study. The present case study describes a rare outgrowth from the left transverse process of the atlas vertebra. This process referred to as epitransverse process can be of high importance to many specialties and especially to surgeons performing radical neck dissections, radiologists for accurate diagnosis of bony malformations and manipulative therapists, as it may markedly influence the posture, stability and mobility at the atlanto-occipital joint.

  3. Osteoid Osteoma of Cervical Spine in two adjacent Vertebrae

    Directory of Open Access Journals (Sweden)

    MR Etemadifar

    2005-09-01

    Full Text Available Osteoid osteoma is a benign bone tumor, mainly seen in 10-30 years male. Spine is a relatively common site and almost always, posterior elements are involved. Plain X-Ray-, CT scan and Isotope scan help to identify and localize spine lesions. We described one 18 years old boy with 3 years low neck pain. Isotope scan, MRI and CT scan showed two lesions in C7 and T1. Gross inspection and histopathology examination confirmed osteoid osteoma in two adjacent vertebrae which has not been reported elsewhere in the literature. Key words: Osteoid Osteoma, Spine, Multifocal

  4. Biomaterials for reconstruction of cranial defects

    Science.gov (United States)

    Song, Tao; Qiu, Zhi-Ye; Cui, Fu-Zhai

    2015-12-01

    Reconstruction of cranial defect is commonly performed in neurosurgical operations. Many materials have been employed for repairing cranial defects. In this paper, materials used for cranioplasty, including autografts, allografts, and synthetic biomaterials are comprehensively reviewed. This paper also gives future perspective of the materials and development trend of manufacturing process for cranioplasty implants.

  5. Unconstrained cranial evolution in Neandertals and modern humans compared to common chimpanzees

    Science.gov (United States)

    Weaver, Timothy D.; Stringer, Chris B.

    2015-01-01

    A variety of lines of evidence support the idea that neutral evolutionary processes (genetic drift, mutation) have been important in generating cranial differences between Neandertals and modern humans. But how do Neandertals and modern humans compare with other species? And how do these comparisons illuminate the evolutionary processes underlying cranial diversification? To address these questions, we used 27 standard cranial measurements collected on 2524 recent modern humans, 20 Neandertals and 237 common chimpanzees to estimate split times between Neandertals and modern humans, and between Pan troglodytes verus and two other subspecies of common chimpanzee. Consistent with a neutral divergence, the Neandertal versus modern human split-time estimates based on cranial measurements are similar to those based on DNA sequences. By contrast, the common chimpanzee cranial estimates are much lower than DNA-sequence estimates. Apparently, cranial evolution has been unconstrained in Neandertals and modern humans compared with common chimpanzees. Based on these and additional analyses, it appears that cranial differentiation in common chimpanzees has been restricted by stabilizing natural selection. Alternatively, this restriction could be due to genetic and/or developmental constraints on the amount of within-group variance (relative to effective population size) available for genetic drift to act on. PMID:26468243

  6. Unconstrained cranial evolution in Neandertals and modern humans compared to common chimpanzees.

    Science.gov (United States)

    Weaver, Timothy D; Stringer, Chris B

    2015-10-22

    A variety of lines of evidence support the idea that neutral evolutionary processes (genetic drift, mutation) have been important in generating cranial differences between Neandertals and modern humans. But how do Neandertals and modern humans compare with other species? And how do these comparisons illuminate the evolutionary processes underlying cranial diversification? To address these questions, we used 27 standard cranial measurements collected on 2524 recent modern humans, 20 Neandertals and 237 common chimpanzees to estimate split times between Neandertals and modern humans, and between Pan troglodytes verus and two other subspecies of common chimpanzee. Consistent with a neutral divergence, the Neandertal versus modern human split-time estimates based on cranial measurements are similar to those based on DNA sequences. By contrast, the common chimpanzee cranial estimates are much lower than DNA-sequence estimates. Apparently, cranial evolution has been unconstrained in Neandertals and modern humans compared with common chimpanzees. Based on these and additional analyses, it appears that cranial differentiation in common chimpanzees has been restricted by stabilizing natural selection. Alternatively, this restriction could be due to genetic and/or developmental constraints on the amount of within-group variance (relative to effective population size) available for genetic drift to act on. © 2015 The Author(s).

  7. An unusual case of congenital scoliosis associated with rib agenesis in the upper part of the concavity treated by VEPTR vertebra to vertebra.

    Science.gov (United States)

    Burnei, Gheorghe; Gavriliu, Traian-Stefan; Georgescu, Ileana; Vlad, Costel; Burnei, Cristian

    2013-11-01

    Rib agenesis in congenital scoliosis is rarely encountered, and its disposal in the application area of the proximal vertical expandable prosthetic titanium rib (VEPTR) module is a challenge to the orthopedic surgeon. To present a case in which known treatment methods in early-onset scoliosis were not possible to apply. Case report. A patient aged 1 year and 10 months, presenting a congenital scoliosis with the following characteristics: left T3 hemisegmented hemivertebra, T5-T6-T7 hemivertebral segment, T9, T10 trapezoidal vertebrae, right side I-IV rib agenesis with T1-T2-T4 hemivertebral hypoplasia (T3 agenesis) and bilateral XIIth rib agenesis, and V-VI and VII-VIII-IX fused ribs on the right side. We applied a standard VEPTR in a new construct, vertebra to vertebra. The VEPTR vertebra to vertebra proved to be an efficient and stabile construct after 1.5 years of follow-up and three device distractions in a row. The curve corrected from 100 to 58 Cobb degrees. We believe that the vertebra-to-vertebra construct with eventual modifications may be a solution in the treatment of early-onset scoliosis needing surgery, which associate rib agenesis in the area where the proximal module has to be applied. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Brucellosis with cervical vertebrae and pulmonary involvement: A rare case

    Directory of Open Access Journals (Sweden)

    Gül Karagöz

    2015-12-01

    Full Text Available The spine is the most common site of musculoskeletal involvement of brucellosis. However, there is no case report presented in the literature of both cervical vertebrae spondylodiscitis and pulmonary involvement of brucella.We reported a 52-year-old woman complaining for one month of fever with rigors, fatigue, malaise, pain on the neck and arm, and sweating. The Wright agglutination test for brucella was positive at titers of 1/640. MRI of the cervical vertebrae was consistent with spondylodiscitis and paravertebral and epidural abscesses. Ground glass opacity was seen in the left upper lobe on CT scanning of the chest. Percutaneous image-guided biopsy was performed and Brucella melitensis was isolated. The patient was treated with streptomycin for 3 weeks, plus doxycycline and rifampicin for 3 months. We recommend tissue culture for rucella patients with lung lesions. Isolation of the microorganism from a biopsy material provides conclusive evidence. J Microbiol Infect Dis 2015;5(4: 173-175

  9. Histomorphometry of Trabecular Bone of Caudal Vertebrae During Rat Pregnancy

    Directory of Open Access Journals (Sweden)

    S.M. Shahtaheri

    2003-04-01

    Full Text Available Pregnancy make demands upon maternal calcium hemeostasis and the extent to which the maternal bone mass is effected remains uncertain. Recently changes in the bone mass during human pregnancy have been associated also with the transformation of the cancellous architecture and the bone surface available for exchange. These jistomorphometrical structural changes were examined further in an animal model. Using uniparous laboratory rats fed at libitum, the histomorphometry of cancellous bone was compared in undecalcified of caudal vertebrae. Between 3 and 6 sections (8 m were analysed by an automated trabecular analysis system (TAS which measures a comprehensive range of structural variables including the trabecular separation, number, connectivity and width. There was an early stimulation of bone formation that was indicated by generation of thicker and interconnected trabeculae. However in caudal vertebrae, there were architectural changes in cancellous bone commencing with a significant increase in the trabecular separation. ‌‌ It was concluded that strengthens the cancellous component of the maternal skeleton possibly to counter increased load and to facilitate mineral mobilisation in maternal/neonate exchange during the subsequent lactation period.

  10. Quantitative morphometric study of the subaxial cervical vertebrae end plate.

    Science.gov (United States)

    Feng, Hang; Fang, Xiangyi; Huang, Dageng; Yu, Chengcheng; Zhao, Songchuan; Hao, Dingjun

    2017-02-01

    Cervical disc arthroplasty has been gradually adopted as an alternative for the treatment of cervical degenerative disease. However, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical end plates. This study aimed to accurately and comprehensively quantify the three-dimensional (3D) anatomic morphology of the cervical vertebral end plate and provide a theoretical basis for designing appropriate disc prostheses. Moreover, we introduced a novel geometric and mechanical model for 3D reconstruction techniques of the cervical end plate. A descriptive study of the geometry of the middle and lower cervical vertebral end plates in cadaveric spines was carried out. A total of 138 cervical vertebral end plates were digitized using an optical 3D range scanning system, and then each end plate was reconstructed using the digitized image. For each end plate, the morphologic characteristics of six surface curves and the end plate concavity depth were symmetrically chosen and depicted. The cranial end plates (relative to the disc) were concave and the caudal end plates were relatively flat at all disc levels, with mean concavity depths of 2.04 and 0.69 mm, respectively. For the caudal end plates, the end plate concavity apex was most often (81.42%) located in the posterior portion, whereas in the cranial end plates, the distribution was relatively even. For the sagittal curves, the foremost point and the rearmost point on the middle curve had a more forward position than those in the left curve and the right curve. Regarding the frontal plane curves, the length of the middle curve was longer than that of the anterior curve and posterior curve. For the cranial end plate, the maximal mean depth was the middle curve, whereas for the caudal end plate, the maximum depth was the posterior curve. There is marked morphologic asymmetry, in that the cranial end plate is more concave than the corresponding

  11. Estudo cefalométrico da correlação da anatomia da base craniana com o padrão facial e as bases apicais Cephalometric study of the cranial base anatomy correlation with the facial pattern and apical bases

    Directory of Open Access Journals (Sweden)

    Marcelo Calvo de Araújo

    2008-08-01

    Full Text Available OBJETIVOS: este estudo transversal foi realizado com o objetivo de avaliar cefalometricamente a correlação da anatomia da base craniana com o padrão facial e as bases apicais. METODOLOGIA: foram utilizadas 88 telerradiografias de norma lateral de jovens leucodermas brasileiros com média de idade de 10,3 anos. Utilizou-se o índice VERT de Ricketts para a determinação do padrão facial, distribuindo a amostra em: 37 para o grupo M (mesofaciais, 34 para o grupo D (dolicofaciais e 17 para o grupo B (braquifaciais. Realizaram-se, manualmente: o desenho anatômico, a demarcação de pontos, o traçado de linhas e planos e a aferição de medidas lineares e angulares. As medidas da base do crânio utilizadas foram S-N, N.S.Ba e S-N.Po-Or, e as medidas das bases apicais foram S.N.A, S.N.B e A.N.B. RESULTADOS E CONCLUSÕES: concluiu-se que, na correlação entre a base craniana e o padrão facial, houve significância entre a variável N.S.Ba e o índice VERT. Na correlação entre a base craniana e as bases apicais, houve significância entre N.S.Ba e as variáveis S.N.A e S.N.B, e entre S-N.Po-Or e as variáveis S.N.A e S.N.B.AIM: This cross-sectional study was conducted with the object of making a cephalometric evaluation of the cranial base anatomy correlation with the facial pattern and apical bases. METHODS: 88 lateral teleradiographies of young white Brazilian with mean age of 10.3 years were used. The Ricketts VERT index was used to determine the facial pattern, and the sample was distributed as follows: 37 in group M (mesofacial, 34 in group D (dolicofacial and 17 in group B (brachyfacial. The anatomic drawing, demarcation of points, line and plane tracings, and linear and angular measurement gauging were done manually. The cranial base measurements used were S-N, N.S.Ba and S-N.Po-Or and the apical base measurements were S.N.A, S.N.B and A.N.B. RESULTS AND CONCLUSION: It was concluded that, in the correlation between the cranial base and

  12. The cranial anatomy of the neornithischian dinosaur Thescelosaurus neglectus

    Directory of Open Access Journals (Sweden)

    Clint A. Boyd

    2014-11-01

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

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

    Science.gov (United States)

    Surchev, N

    2008-09-01

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

  14. Spiral swimming behavior due to cranial and vertebral lesions associated with Cytophaga psychrophila infections in salmonid fishes

    Science.gov (United States)

    Kent, M.L.; Groff, J.M.; Morrison, J.K.; Yasutake, W.T.; Holt, R.A.

    1989-01-01

    C. psychrophila infections of the cranium and anterior vertebrae in salmonid fishes were associated with ataxia, spiral swimming along the axis of the fish, and death. The syndrome was observed in 2-10% of underyearling coho salmon Oncorhynchus kisutch, rainbow troutSalmo gairdneri, and steelhead trout S. gairdneri at several private, state, and federal hatcheries in Washington and Oregon, USA, between 1963 and 1987. Affected fish did not recover and ultimately died. Histological examination consistently revealed subacute to chronic periostitis, osteitis, meningitis, and ganglioneuritis. Inflammation and periosteal proliferation of the anterior vertebrae at the junction of the vertebral column with the cranium with extension into the cranial case was a consistent feature. The adjacent nervous tissue, particularly the medulla, was often compressed by the proliferative lesion, and this may have caused the ataxia. Though bacteria were seldom observed in these lesions. C. psychrophilawas isolated in culture from the cranial cavity of all affected fish that were tested. Epidemiological observations suggested that this bacterium is the causative agent because the spiral swimming behaviour and lesions were observed only in populations that had recovered from acute C. psychrophila infections.

  15. Chordoma of the thoracic vertebrae in a Bengal tiger (Panthera tigris tigris).

    Science.gov (United States)

    Kuramochi, Mizuki; Izawa, Takeshi; Hori, Mayuka; Kusuda, Kayo; Shimizu, Junichiro; Iseri, Toshie; Akiyoshi, Hideo; Ohashi, Fumihito; Kuwamura, Mitsuru; Yamate, Jyoji

    2015-07-01

    A 19-year-old female Bengal tiger (Panthera tigris tigris) was presented with hind limb weakness, ataxia and respiratory distress. Computed tomography revealed a mass between the left side of the T7 vertebra and the base of the left 7th rib. The tiger then died, and necropsy was performed. Grossly, the vertebral mass was 6 × 5.7 × 3 cm, and invaded the adjacent vertebral bone and compressed the T7 spinal cord. Histologically, the mass was composed of large, clear, vacuolated and polygonal cells with osteochondral matrix. Cellular and nuclear atypia were moderate. The vacuolated cells stained positively for cytokeratin and vimentin and negatively for S-100. Based on these findings, the present case was diagnosed as a vertebral chordoma; the first report in a tiger.

  16. Vertebrae length and ultra-structure measurements of collagen fibrils and mineral content in the vertebrae of lordotic gilthead seabreams (Sparus aurata).

    Science.gov (United States)

    Berillis, Panagiotis; Panagiotopoulos, Nikolaos; Boursiaki, Vaia; Karapanagiotidis, Ioannis T; Mente, Eleni

    2015-08-01

    Skeletal deformities of gilthead seabream (Sparus aurata) are a major factor affecting the production cost, the external morphology and survival and growth of the fish. Adult individuals of S. aurata were collected from a commercial fish farm in Greece and were divided into two groups: one with the presence of lordosis, a skeletal deformity, and one without any skeletal deformity. Fishes were X-rayed, and cervical, abdominal and caudal vertebrae lengths were measured. Vertebrae were taken from the site of the vertebral column where lordosis occurred. One part was decalcified and prepared for collagen examination with transmission electron microscopy, and the rest were incinerated, and the Ca and P contents were measured. The stoichiometries of the samples were obtained by EDS (Energy Dispersive Spectroscopy). The same procedure was followed for fish without skeletal deformities (vertebrae were taken from the middle region of the vertebral column). The decalcified vertebrae parts were examined with TEM, collagen micrographs were taken and the fibrils' periods and diameters were measured. There were no significant differences for both Ca and P or the collagen fibrils' periods between the two fish groups. The mean lengths of the cervical, abdominal and caudal vertebrae where lordosis occurred were similar to the lengths of the respective regions of the individuals without the skeletal deformity. The TEM examination showed a significantly smaller mean vertebrae collagen fibril diameter from the fishes with lordosis compared with those from the controls, revealing the significance of collagen to bone structure. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Kim, Jae Hyoung; Hwang, Jeong Min

    2017-06-01

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

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

    Science.gov (United States)

    Kim, Jae Hyoung

    2017-01-01

    Congenital cranial dysinnervation disorders are a group of diseases caused by abnormal development of cranial nerve nuclei or their axonal connections, resulting in aberrant innervation of the ocular and facial musculature. Its diagnosis could be facilitated by the development of high resolution thin-section magnetic resonance imaging. The purpose of this review is to describe the method to visualize cranial nerves III, IV, and VI and to present the imaging findings of congenital cranial dysinnervation disorders including congenital oculomotor nerve palsy, congenital trochlear nerve palsy, Duane retraction syndrome, Möbius syndrome, congenital fibrosis of the extraocular muscles, synergistic divergence, and synergistic convergence. PMID:28534340

  19. Cranial osteopathy: its fate seems clear

    OpenAIRE

    Hartman, Steve E

    2006-01-01

    Abstract Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little ho...

  20. Cranial MRI in neonatal hypernatraemic dehydration

    Energy Technology Data Exchange (ETDEWEB)

    Korkmaz, A.; Yigit, S.; Oran, O. [Neonatology Unit, University of Hacettepe, Ankara (Turkey); Firat, M. [Dept. of Radiology, University of Hacettepe, Ankara (Turkey)

    2000-05-01

    Severe neonatal hypernatraemia is a life-threatening electrolyte disorder because of its neurological complications. These are brain oedema, intracranial haemorrhages, haemorrhagic infarcts and thromboses. There are few reports concerning the radiological findings in the central nervous system in severe neonatal hypernatraemia. Cranial MRI findings in hypernatraemia have been reported in an older child, but have not been described in newborn infants. We report the cranial MRI findings in a newborn infant with acute renal failure and severe hypernatraemia. (orig.)

  1. Primary pedicle screw augmentation in osteoporotic lumbar vertebrae: biomechanical analysis of pedicle fixation strength.

    Science.gov (United States)

    Burval, Daniel J; McLain, Robert F; Milks, Ryan; Inceoglu, Serkan

    2007-05-01

    Pedicle screw pullout testing in osteoporotic and control human cadaveric vertebrae, comparing augmented and control vertebrae. To compare the pullout strengths of pedicle screws fixed in osteoporotic vertebrae using polymethyl methacrylate delivered by 2 augmentation techniques, a standard transpedicular approach and kyphoplasty type approach. Pedicle screw instrumentation of the osteoporotic spine carries an increased risk of screw loosening, pullout, and fixation failure. Osteoporosis is often cited as a contraindication for pedicle screw fixation. Augmentation of the vertebral pedicle and body using polymethyl methacrylate may improve fixation strength and construct survival in the osteoporotic vertebrae. While the utility of polymethyl methacrylate has been demonstrated for salvage of screws that have been pulled out, the effect of the cement technique on pullout strength in osteoporotic vertebrae has not been previously studied. Thirteen osteoporotic and 9 healthy human lumbar vertebrae were tested. All specimens were instrumented with pedicle screws using a uniform technique. Osteoporotic pedicles were augmented with polymethyl methacrylate using either a kyphoplasty type technique or a transpedicular augmentation technique. Screws were tested in a paired testing array, randomly assigning the augmentation techniques to opposite sides of each vertebra. Pullout to failure was performed either primarily or after a 5000-cycle tangential fatigue conditioning exposure. After testing, following screw removal, specimens were cut in the axial plane through the center of the vertebral body to inspect the cement distribution. Pedicle screws placed in osteoporotic vertebrae had higher pullout loads when augmented with the kyphoplasty technique compared to transpedicular augmentation (1414 +/- 338 versus 756 +/- 300 N, respectively; P cycling. Pedicle screw augmentation with polymethyl methacrylate improves the initial fixation strength and fatigue strength of

  2. [Computed tomography and cranial paleoanthropology].

    Science.gov (United States)

    Cabanis, Emmanuel Alain; Badawi-Fayad, Jackie; Iba-Zizen, Marie-Thérèse; Istoc, Adrian; de Lumley, Henry; de Lumley, Marie-Antoinette; Coppens, Yves

    2007-06-01

    Since its invention in 1972, computed tomography (C.T.) has significantly evolved. With the advent of multi-slice detectors (500 times more sensitive than conventional radiography) and high-powered computer programs, medical applications have also improved. CT is now contributing to paleoanthropological research. Its non-destructive nature is the biggest advantage for studying fossil skulls. The second advantage is the possibility of image analysis, storage, and transmission. Potential disadvantages include the possible loss of files and the need to keep up with rapid technological advances. Our experience since the late 1970s, and a recent PhD thesis, led us to describe routine applications of this method. The main contributions of CT to cranial paleoanthropology are five-fold: --Numerical anatomy with rapid acquisition and high spatial resolution (helicoidal and multidetector CT) offering digital storage and stereolithography (3D printing). --Numerical biometry (2D and 3D) can be used to create "normograms" such as the 3D craniofacial reference model used in maxillofacial surgery. --Numerical analysis offers thorough characterization of the specimen and its state of conservation and/or restoration. --From "surrealism" to virtual imaging, anatomical structures can be reconstructed, providing access to hidden or dangerous zones. --The time dimension (4D imaging) confers movement and the possibility for endoscopic simulation and internal navigation (see Iconography). New technical developments will focus on data processing and networking. It remains our duty to deal respectfully with human fossils.

  3. Cranial trepanation in The Egyptian.

    Science.gov (United States)

    Collado-Vázquez, S; Carrillo, J M

    2014-09-01

    Medicine and literature have been linked from ancient times; proof of this shown by the many doctors who have made contributions to literature and the many writers who have described medical activities and illnesses in their works. An example is The Egyptian, the book by Mika Waltari that provides a masterly narration of the protagonist's medical activity and describes the trepanation technique. The present work begins with the analysis of trepanations since prehistory and illustrates the practice of the trepanation in The Egyptian. The book mentions trepanation frequently and illustrates how to practice it and which instruments are required to perform it. Trepanation is one of the oldest surgical interventions carried out as treatment for cranial trauma and neurological diseases, but it also had the magical and religious purpose of expelling the evil spirits which caused the mental illness, epilepsy, or migraine symptoms. Trepanation is a surgical practice that has been carried out since prehistory to treat post-traumatic epilepsy, migraine, and psychiatric illness. The Egyptian is a book that illustrates the trepan, the trepanation technique, and the required set of instruments in full detail. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  4. FORAMINA OF THE POSTERIOR CRANIAL BASE: A STUDY OF ADULT INDIAN SKULLS. 89\tLas foraminas de la base posterior del cráneo: Un estudio en cráneos de indios adultos

    Directory of Open Access Journals (Sweden)

    Namita A Sharma

    2016-03-01

    Full Text Available Introducción: Las foraminas craneales son los únicos puntos de entrada a un cráneo que, de otra manera, permanecería cerrado. La evaluación de estas foraminas es una parte muy importante para el diagnóstico médico y debería ayudar al clínico en su  enfoque quirúrgico a esta delicada región. El presente estudio se centra en las foraminas de la base posterior del cráneo incluyendo los pares de fosas yugulares, el agujero estilomastoideo, el canal hipogloso; el impar agujero magno y otras foraminas auxiliares tales como el agujero mastoideo y el canal condíleo posterior. Material y Método: El estudio se llevo a cabo en 50 cráneos adultos, secos y macerados, pertenecientes todos ellos al subcontinente indio. Para ello se utilizó un calibre vernier con una precisión de 0.01 mm. Resultados: Se obtuvo una amplia variación en las dimensiones de la fosa yugular. La diferencia máxima bilateral en el mismo cráneo fue de 6.72 mm. La bóveda y la septación incompleta existían en un 20% de los cráneos. El tamaño del agujero estilomastoideo osciló entre 0.9-5.3 mm. Una de las 100 foraminas estudiadas se mostró estenosada. La duplicación se vio en el 4% de los cráneos. Las septaciones en el canal hipogloso se produjeron exclusivamente en el aspecto endocraneal y se observó bilateralmente en un 4% y unilateralmente en un 20% de los cráneos. En uno de los cráneos se encontró occipitalización del atlas. La salida del agujero magno estaba deformada y estenosada. Este fue el único cráneo con un índice en el agujero magno menor de 1. El agujero mastoideo  estuvo presente bilateralmente en un 74% y unilateralmente en un 16% de los cráneos, mientras que las cifras correspondientes para el  canal condíleo posterior fueron de 62% y 26% respectivamente. Introduction: Cranial foramina are the only portals to an otherwise closed cranium. Evaluation of these foramina is an important part of diagnostic medicine and would aid the

  5. Major cranial changes during Triceratops ontogeny.

    Science.gov (United States)

    Horner, John R; Goodwin, Mark B

    2006-11-07

    This is the first cranial ontogenetic assessment of Triceratops, the well-known Late Cretaceous dinosaur distinguished by three horns and a massive parietal-squamosal frill. Our analysis is based on a growth series of 10 skulls, ranging from a 38 cm long baby skull to about 2 m long adult skulls. Four growth stages correspond to a suite of ontogenetic characters expressed in the postorbital horns, frill, nasal, epinasal horn and epoccipitals. Postorbital horns are straight stubs in early ontogeny, curve posteriorly in juveniles, straighten in subadults and recurve anteriorly in adults. The posterior margin of the baby frill is deeply scalloped. In early juveniles, the frill margin becomes ornamented by 17-19 delta-shaped epoccipitals. Epoccipitals are dorsoventrally compressed in subadults, strongly compressed and elongated in adults and ultimately merge onto the posterior frill margin in older adults. Ontogenetic trends within and between growth stages include: posterior frill margin transitions from scalloped to wavy and smooth; progressive exclusion of the supraoccipital from the foramen magnum; internal hollowing at the base of the postorbital horns; closure of the midline nasal suture; fusion of the epinasal onto the nasals; and epinasal expansion into a morphologically variable nasal horn. We hypothesize that the changes in horn orientation and epoccipital shape function to allow visual identity of juveniles, and signal their attainment of sexual maturity.

  6. Cranial electrotherapy stimulation and fibromyalgia.

    Science.gov (United States)

    Gilula, Marshall F

    2007-07-01

    Cranial electrotherapy stimulation (CES) is a well-documented neuroelectrical modality that has been proven effective in some good studies of fibromyalgia (FM) patients. CES is no panacea but, for some FM patients, the modality can be valuable. This article discusses aspects of both CES and FM and how they relate to the individual with the condition. FM frequently has many comorbidities such as anxiety, depression, insomnia and a great variety of different rheumatologic and neurological symptoms that often resemble multiple sclerosis, dysautonomias, chronic fatigue syndrome and others. However, despite long-standing criteria from the American College of Rheumatology for FM, some physicians believe there is probably no single homogeneous condition that can be labeled as FM. Whether it is a disease, a syndrome or something else, sufferers feel like they are living one disaster after another. Active self-involvement in care usually enhances the therapeutic results of various treatments and also improves the patient's sense of being in control of the condition. D-ribose supplementation may prove to significantly enhance energy, sleep, mental clarity, pain control and well-being in FM patients. A form of evoked potential biofeedback, the EPFX, is a powerful stress reduction technique which assesses the chief stressors and risk factors for illness that can impede the FM patient's built-in healing abilities. Future healthcare will likely expand the diagnostic criteria of FM and/or illuminate a group of related conditions and the ways in which the conditions relate to each other. Future medicine for FM and related conditions may increasingly involve multimodality treatment that features CES as one significant part of the therapeutic regimen. Future medicine may also include CES as an invaluable, cost-effective add-on to many facets of clinical pharmacology and medical therapeutics.

  7. Functional implications of dicynodont cranial suture morphology.

    Science.gov (United States)

    Jasinoski, Sandra C; Rayfield, Emily J; Chinsamy, Anusuya

    2010-06-01

    Cranial suture morphology of Lystrosaurus and the generalized dicynodont Oudenodon was investigated to determine the strain environment during mastication, which in turn may indicate a difference in cranial function between the two taxa. Finite element (FE) analysis indicated that less strain accumulated in the cranium of Lystrosaurus during orthal bite simulations than in Oudenodon. Despite the overall difference in strain magnitude, moderate to high FE-predicted strain accumulated in similar areas of the cranium of both taxa. The suture morphology in these cranial regions of Lystrosaurus and Oudenodon was investigated further by examination of histological sections and supplemented by observations of serial sections and computed tomography (CT) scans. The predominant type of strain from selected blocks of finite elements that contain sutures was determined, enabling comparison of suture morphology to strain type. Drawing from strain-suture correlations established in extant taxa, the observed patterns of sutural morphology for both dicynodonts were used to deduce cranial function. The moderate to high compressive and tensile strain experienced by the infraorbital bar, zygomatic arch, and postorbital bar of Oudenodon and Lystrosaurus may have been decreased by small adjustive movements at the scarf sutures in those regions. Disparities in cranial suture morphology between the two taxa may reflect differences in cranial function. For instance, the tongue and groove morphology of the postorbital-parietal suture in Oudenodon could have withstood the higher FE-predicted tensile strain in the posterior skull roof. The scarf premaxilla-nasal suture of Lystrosaurus provided an additional region of sutural mobility in the anterior surface of the snout, suggesting that Lystrosaurus may have employed a different biting regime than Oudenodon. The morphology of several sutures sampled in this study correlated with the FE-predicted strain, although other cranial functional

  8. Fourth cranial nerve palsy and Brown syndrome: two interrelated congenital cranial dysinnervation disorders?

    Science.gov (United States)

    Kaeser, Pierre-François; Brodsky, Michael C

    2013-06-01

    Based on neuroimaging data showing absence of the trochlear nerve, congenital superior oblique palsy is now classified as a congenital cranial dysinnervation disorder. A similar absence of the abducens nerve is accompanied by misinnervation to the lateral rectus muscle from a branch of oculomotor nerve in the Duane retraction syndrome. This similarity raises the question of whether some cases of Brown syndrome could arise from a similar synkinesis between the inferior and superior oblique muscles in the setting of congenital superior oblique palsy. This hypothesis has gained support from the confluence of evidence from a number of independent studies. Using Duane syndrome as a model, we critically review the accumulating evidence that some cases of Brown syndrome are ultimately attributable to dysgenesis of the trochlear nerve.

  9. Lumbosacral transitional vertebra and S1 radiculopathy: the value of coronal MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bezuidenhout, Abraham Fourie; Lotz, Jan Willem [Stellenbosch University, Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Tygerberg (South Africa)

    2014-06-15

    The association of a lumbosacral transitional vertebra with accelerated degeneration of the disc above has been described. Lumbosacral transitional vertebrae have also been reported as a cause of extraforaminal entrapment of the L5 nerve root between the transverse segment of the transitional vertebra and the sacral ala optimally demonstrated by coronal MRI. The association of the lumbosacral transitional vertebra pseudoarthroses and S1 nerve root entrapment due to degenerative stenosis of the nerve root canal has never been described. We present 12 patients with lumbosacral transitional vertebrae that were referred for symptoms and signs of S1 nerve root radiculopathy in which the sagittal and axial MRI sequences failed to identify a plausible cause for the patients' S1 nerve root symptoms. A coronal T1-weighted imaging (T1WI) MRI sequence was consequently added to the investigation. The coronal T1WI MRI sequence demonstrated hypertrophic degenerative stenosis of the S1 nerve root canal at the level of the lumbosacral transitional vertebra pseudoarthrosis, with entrapment of the respective S1 nerve root in all patients. We emphasize the value of coronal T1WI MRI of the lumbosacral junction and sacrum if the cause for S1 radicular symptoms was not identified on conventional sagittal and axial MRI sequences in patients with lumbosacral transitional vertebrae. (orig.)

  10. Endplate indentation of the fourth lumbar vertebra - biomed 2010.

    Science.gov (United States)

    Ash, Joseph H; Kerrigan, Jason R; Arregui-Dalmases, Carlos; Del Pozo, Eduardo; Crandall, Jeff

    2010-01-01

    This study presents the results of indentation tests on the superior vertebral endplate of the 4th lumbar vertebra (L4) of eleven male cadaveric subjects (65 +/- 7 years). Three locations on the superior endplate surface were loaded with a 7.9 mm spherical indentor at either a low (1 mm/s) or high (1000 mm/s) rate. Anterior midline and posterior right and left indentation locations were chosen to prevent local deformations and fractures from influencing the results of subsequent and preceding tests. Peak forces were higher in the dynamic tests (498 +/- 261 N) than in the quasi-static tests (451 +/- 256 N) on the posterior side, although the difference was not significant (p = 0.139). However, the peak forces in the anterior tests (304 +/-166 N) were significantly lower (p =0.0157) than in the posterior tests with the same loading rate. The variation in failure forces in the current study correlates with the variation in thickness of endplate cortical bone (between specimens and between anterior and posterior locations on the same specimen) as measured from small field of view computed tomography scans.

  11. Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins.

    Science.gov (United States)

    Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton

    2015-04-01

    We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern.

  12. Morphological evolution through integration: a quantitative study of cranial integration in Homo, Pan, Gorilla and Pongo.

    Science.gov (United States)

    Singh, Nandini; Harvati, Katerina; Hublin, Jean-Jacques; Klingenberg, Christian P

    2012-01-01

    Morphological integration refers to coordinated variation among traits that are closely related in development and/or function. Patterns of integration can offer important insight into the structural relationship between phenotypic units, providing a framework to address questions about phenotypic evolvability and constraints. Integrative features of the primate cranium have recently become a popular subject of study. However, an important question that still remains under-investigated is: what is the pattern of cranial shape integration among closely related hominoids? To address this question, we conducted a Procrustes-based geometric morphometrics study to quantify and analyze shape covariation patterns between different cranial regions in Homo, Pan, Gorilla and Pongo. A total of fifty-six 3D landmarks were collected on 407 adult individuals. We then sub-divided the landmarks corresponding to cranial units as outlined in the 'functional matrix hypothesis.' Sub-dividing the cranium in this manner allowed us to explore patterns of covariation between the face, basicranium and cranial vault, using the two-block partial least squares approach. Our results suggest that integrated shape changes in the hominoid cranium are complex, but that the overall pattern of integration is similar among human and non-human apes. Thus, despite having very distinct morphologies the way in which the face, basicranium and cranial vault covary is shared among these taxa. These results imply that the pattern of cranial integration among hominoids is conserved. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. An unusual case of cranial image recognition.

    Science.gov (United States)

    Ghosh, A K; Sinha, P

    2005-03-10

    We encountered an unusual practical case of craniofacial identification recently. The peculiarity of the case was that the skull itself was not available for examination unlike other such common cases. The supplied material exhibits were, a nearly front view photograph of a skeletonized face and a front view face photograph of the suspected victim. Further, the condition of the skull during taking its photograph was such that its lower and the upper jaws were not in a normal closed condition. The procedure involved in dealing with such a complicated craniofacial identification problem would be quite interesting from a forensic investigator's point of view, since standard methods of skull identification like photo/video superimposition techniques were not at all applicable here. As such, the present case report provides the details of the multiphase procedure adapted by us in dealing with this abnormal case. A solution to this unprecedented craniofacial identification problem was worked out by appropriate exploration of a newly introduced digital image processing technique that is based on craniofacial symmetry perception. The procedure leads to the reconstruction of a superimposable cranial image with upper and lower teeth in normal closed condition for establishment of its identity in usual way.

  14. Cranial thickness changes in early childhood

    Science.gov (United States)

    Gajawelli, Niharika; Deoni, Sean; Shi, Jie; Dirks, Holly; Linguraru, Marius George; Nelson, Marvin D.; Wang, Yalin; Lepore, Natasha

    2017-11-01

    The neurocranium changes rapidly in early childhood to accommodate the developing brain. However, developmental disorders may cause abnormal growth of the neurocranium, the most common one being craniosynostosis, affecting about 1 in 2000 children. It is important to understand how the brain and neurocranium develop together to understand the role of the neurocranium in neurodevelopmental outcomes. However, the neurocranium is not as well studied as the human brain in early childhood, due to a lack of imaging data. CT is typically employed to investigate the cranium, but, due to ionizing radiation, may only be used for clinical cases. However, the neurocranium is also visible on magnetic resonance imaging (MRI). Here, we used a large dataset of MRI images from healthy children in the age range of 1 to 2 years old and extracted the neurocranium. A conformal geometry based analysis pipeline is implemented to determine a set of statistical atlases of the neurocranium. A growth model of the neurocranium will help us understand cranial bone and suture development with respect to the brain, which will in turn inform better treatment strategies for neurocranial disorders.

  15. Cranial osteopathy: its fate seems clear

    Science.gov (United States)

    Hartman, Steve E

    2006-01-01

    Background According to the original model of cranial osteopathy, intrinsic rhythmic movements of the human brain cause rhythmic fluctuations of cerebrospinal fluid and specific relational changes among dural membranes, cranial bones, and the sacrum. Practitioners believe they can palpably modify parameters of this mechanism to a patient's health advantage. Discussion This treatment regime lacks a biologically plausible mechanism, shows no diagnostic reliability, and offers little hope that any direct clinical effect will ever be shown. In spite of almost uniformly negative research findings, "cranial" methods remain popular with many practitioners and patients. Summary Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere. PMID:16762070

  16. Cranial osteopathy: its fate seems clear

    Directory of Open Access Journals (Sweden)

    Hartman Steve E

    2006-06-01

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

  17. Cranial symmetry in baleen whales (Cetacea, Mysticeti) and the occurrence of cranial asymmetry throughout cetacean evolution.

    Science.gov (United States)

    Fahlke, Julia M; Hampe, Oliver

    2015-10-01

    Odontoceti and Mysticeti (toothed and baleen whales) originated from Eocene archaeocetes that had evolved from terrestrial artiodactyls. Cranial asymmetry is known in odontocetes that can hear ultrasound (>20,000 Hz) and has been linked to the split function of the nasal passage in breathing and vocalization. Recent results indicate that archaeocetes also had asymmetric crania. Their asymmetry has been linked to directional hearing in water, although hearing frequencies are still under debate. Mysticetes capable of low-frequency and infrasonic hearing (<20 Hz) are assumed to have symmetric crania. This study aims to resolve whether mysticete crania are indeed symmetric and whether mysticete cranial symmetry is plesiomorphic or secondary. Cranial shape was analyzed applying geometric morphometrics to three-dimensional (3D) cranial models of fossil and modern mysticetes, Eocene archaeocetes, modern artiodactyls, and modern odontocetes. Statistical tests include analysis of variance, principal components analysis, and discriminant function analysis. Results suggest that symmetric shape difference reflects general trends in cetacean evolution. Asymmetry includes significant fluctuating and directional asymmetry, the latter being very small. Mysticete crania are as symmetric as those of terrestrial artiodactyls and archaeocetes, without significant differences within Mysticeti. Odontocete crania are more asymmetric. These results indicate that (1) all mysticetes have symmetric crania, (2) archaeocete cranial asymmetry is not conspicuous in most of the skull but may yet be conspicuous in the rostrum, (3) directional cranial asymmetry is an odontocete specialization, and (4) directional cranial asymmetry is more likely related to echolocation than hearing.

  18. Cranial symmetry in baleen whales (Cetacea, Mysticeti) and the occurrence of cranial asymmetry throughout cetacean evolution

    Science.gov (United States)

    Fahlke, Julia M.; Hampe, Oliver

    2015-10-01

    Odontoceti and Mysticeti (toothed and baleen whales) originated from Eocene archaeocetes that had evolved from terrestrial artiodactyls. Cranial asymmetry is known in odontocetes that can hear ultrasound (>20,000 Hz) and has been linked to the split function of the nasal passage in breathing and vocalization. Recent results indicate that archaeocetes also had asymmetric crania. Their asymmetry has been linked to directional hearing in water, although hearing frequencies are still under debate. Mysticetes capable of low-frequency and infrasonic hearing (cranial symmetry is plesiomorphic or secondary. Cranial shape was analyzed applying geometric morphometrics to three-dimensional (3D) cranial models of fossil and modern mysticetes, Eocene archaeocetes, modern artiodactyls, and modern odontocetes. Statistical tests include analysis of variance, principal components analysis, and discriminant function analysis. Results suggest that symmetric shape difference reflects general trends in cetacean evolution. Asymmetry includes significant fluctuating and directional asymmetry, the latter being very small. Mysticete crania are as symmetric as those of terrestrial artiodactyls and archaeocetes, without significant differences within Mysticeti. Odontocete crania are more asymmetric. These results indicate that (1) all mysticetes have symmetric crania, (2) archaeocete cranial asymmetry is not conspicuous in most of the skull but may yet be conspicuous in the rostrum, (3) directional cranial asymmetry is an odontocete specialization, and (4) directional cranial asymmetry is more likely related to echolocation than hearing.

  19. COMPLETE FUSION OF FIFTH LUMBAR VERTEBRA WITH SACRUM: AN OSTEOLOGICAL CASE REPORT

    National Research Council Canada - National Science Library

    Shiksha; Ranjana S; Shashi

    2015-01-01

    ...’ s syndrome and difficulty during labor. To highlight the complication of sacralization and its related impact on the body, we report a case of complete fusion of 5 th lumbar vertebra with sacrum ( sacralization...

  20. Sexual dimorphism in the 7th cervical and 12th thoracic vertebrae from a Mediterranean population.

    Science.gov (United States)

    Amores, Anabel; Botella, Miguel C; Alemán, Inmaculada

    2014-03-01

    Sex determination is an important task in physical anthropology and forensic medicine. The study sample comprised 121 individuals of known sex, age, and cause of death from San Jose cemetery in Granada (Spain). Eight dimensions were analyzed, and discriminant function analysis was performed for each vertebra to obtain discriminating functions and study the percentage of correct assignations of these functions. The percentage accuracy was approximately 80% for both vertebrae, but varied according to the sex, being higher for the 7th cervical in males and higher for the 12th thoracic in females. As reported in other populations, the greatest dimorphism values were found for the length of the inferior surface of the vertebral body and the width and length of the vertebral foramen of the 7th cervical vertebra and for the length of the inferior surface of the vertebral body of the 12th thoracic vertebra. © 2013 American Academy of Forensic Sciences.

  1. The distribution of cervical vertebrae anomalies among dental malocclusions

    Directory of Open Access Journals (Sweden)

    Hasan Kamak

    2015-01-01

    Full Text Available Aims: The aims of our study were to investigate the distribution of cervical vertebrae anomalies (CVAs among dental Angle Class I, II, and III malocclusions in Turkish population and whether a correlation between CVA and dental malocclusion. Materials and Methods: The study was performed on lateral cephalometric radiographs which were taken at the Department of Orthodontics, Faculty of Dentistry, Kirikkale University. The final sample of 318 orthodontic patients was included in the study. Dental malocclusions were performed according to Angle classification. CVAs were categorized: (1 fusion and (2 posterior arch deficiency (PAD. The Chi-square test was used to the analysis of the potential differences among dental malocclusions. Results: The final sample of 318 patients was examined. CVA was observed in 42 individuals (of 26 [8.17%] had fusion and 16 [5.03%] had PAD, with a frequency of 13.2%. Of the 26 fusion defect, 8 (30.7% had Angle Class I, 8 (30.7% had Angle Class II, and 10 (38.4% had Angle Class III malocclusion. Of the 16 PAD, 8 (50% had Angle Class I, 8 (50% had Angle Class II but no patients with Angle Class III malocclusion was observed. The distribution of dental malocclusions regarding CVA was not statistically significant (P = 0.076. Of these 42 individuals with CVA, 52.3% (15 fusions and 7 PAD were females and 47.7% (11 fusions and 9 PAD were males. Conclusion: In our study, the prevalence of fusion and PAD were found 8.1% and 5.0% in Turkish population, respectively. Besides, no statistically significant correlation between CVA and Angle Class I, II, and III malocclusions were found. Our findings support the studies showing no gender dimorphism.

  2. Imaging findings in congenital cranial dysinnervation disorders.

    Science.gov (United States)

    Ferreira, Rafael Martins; Amaral, Lazaro L F; Gonçalves, Marcus V M; Lin, Katia

    2011-12-01

    In 2002, the term congenital cranial dysinnervation disorders (CCDDs) was proposed to group heterogeneous syndromes with congenital abnormalities of ocular muscle and facial innervations. The concept of neurogenic etiology has been supported by discovery of genes that are essential to the normal development of brainstem, cranial nerves, and their axonal connections. The CCDDs include Duane retraction syndrome, congenital fibrosis of the extraocular muscles, Möbius syndrome, horizontal gaze palsy with progressive scoliosis, the human homeobox-related disorders, pontine cap tegmental dysplasia, and an expanding list. The purpose of this review was to update the imaging features, as well as clinical and genetic information, regarding cases of CCDDs.

  3. Isovaleric acidaemia: cranial CT and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-02-01

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

  4. COMPLEX TREATMENT OF PATIENT WITH MULTIPLE FRACTURES OF THE VERTEBRAE IN THE THORACIC SPINE

    Directory of Open Access Journals (Sweden)

    S. V. Vissarionov

    2012-01-01

    Full Text Available The authors presented an example of a complex treatment of pediatric patient with multiple fractures of the vertebrae in the thoracic spine. The child was operated on the burst fracture of a Th5 vertebra. Due to the presence of vertebral compression fractures Th8 a course of conservative treatment by the orthosis in hyperextension brace. Follow-up was 15 months.

  5. Extraction of the Cervical Vertebrae from Panoramic X-ray image

    OpenAIRE

    山本, 純平; Yamamoto, Junpei

    2015-01-01

    The purpose of this study is to remove the cervical vertebrae from a dental panoramic x-ray image with a tomosynthesis method. We developed a new method to remove the cervical vertebrae from a dental panoramic x-ray image. In this paper, we removed artifacts caused by metalic objects in the teeth raw. To detect these areas, we used a photon counting x-ray detector. The accuracy of the proposed method was validated with clinical data.

  6. Improvement in Scoliosis Top View: Evaluation of Vertebrae Localization in Scoliotic Spine-Spine Axial Presentation

    Directory of Open Access Journals (Sweden)

    Paweł Główka

    2016-11-01

    Full Text Available Morphological analysis of the scoliotic spine is based on two-dimensional X-rays: coronal and sagittal. The three-dimensional character of scoliosis has raised the necessity for analyzing scoliosis in three planes. We proposed a new user-friendly method of graphical presentation of the spine in the third plane–the Spine Axial Presentation (SAP. Eighty-five vertebrae of patients with scoliosis were analyzed. Due to different positions during X-rays (standing and computer tomography (CT (supine, the corresponding measurements cannot be directly compared. As a solution, a software creating Digital Reconstructed Radiographs (DRRs from CT scans was developed to replace regular X-rays with DRRs. Based on the measurements performed on DRRs, the coordinates of vertebral bodies central points were defined. Next, the geometrical centers of vertebral bodies were determined on CT scans. The reproducibility of measurements was tested with Intraclass Correlation Coefficient (ICC, using p = 0.05. The intra-observer reproducibility and inter-observer reliability for vertebral body central point’s coordinates (x, y, z were high for results obtained based on DRRs and CT scans, as well as for comparison results obtained based on DRR and CT scans. Based on two standard radiographs, it is possible to localize vertebral bodies in 3D space. The position of vertebral bodies can be present in the Spine Axial Presentation.

  7. Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-01-15

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

  8. Bone Lose of the Ancient Mediterranean lumbar vertebrae : Iasos, 6th century ad.

    Science.gov (United States)

    Kaya, Serdar; Solmaz, Ilker; Ilıca, A. Turan; Karaçalıoğlu, Özgür; Damla Yılmaz, Nalan; Başoğlu, Okşan; Kılıc, Selim; Izci, Yusuf

    Evaluation of bone mineral density (BMD) of the ancient peoples has received great interest by anthropologists. The aims of this study are to investigate the lumbar vertebrae of the Iasos people during the Byzantine period, in order to determine the prevalence of bone loss and to interpret dietary conditions of ancient Mediterranean populations. Lumbar vertebrae belonging to twenty eight skeletons of the 6th c AD were analyzed by radiographs and dual energy X-ray absorptiometry. The BMD values for each biologic sex and age group were compared. The correlation between the BMD and radiological features was also analyzed. The mean BMD was 0.940 g/cm2. BMD was decreased by aging in both sexes, but it was not significant. Osteopenia was found in 11 (39%) and osteoporosis in 4 (14.3%) out 28 vertebrae. The BMD was normal in 13 (46%) out of 28 vertebrae. Osteopenia was present in 7 (38%) of 18 male vertebrae and 4 (40%) of 10 female vertebrae. The spine score was high in the male group and there was a strong positive correlation between the BMD and spine score for both sexes. This study revealed that the BMD decreased by aging and that osteopenia was a problem in both sexes of the Iasos people during the 6th c AD. There was no correlation between the BMD and radiological features for age groups and biological sexes.

  9. Skeletal maturation of the cervical vertebrae: association with various types of malocclusion

    Directory of Open Access Journals (Sweden)

    Mônica Costa Armond

    2012-04-01

    Full Text Available The identification of the skeletal maturation stage of the cervical vertebrae has proven an important reference for orthodontic diagnosis. The aim of the present study was to determine the association between the skeletal maturation stage of the cervical vertebrae and types of malocclusion according to the age and gender of participants. A total of 361 individuals (168 males and 193 females between 8 and 14 years of age were selected from a convenience sample. Malocclusions were diagnosed through study models using the Angle classification. Maturation stages of the cervical vertebrae were determined using the method proposed by Hassel and Farman. Statistical analysis involved the chi-square test (p £ 0.05 and multiple logistic regression (forward stepwise procedure. Significant differences were observed between the stage of skeletal maturation of the cervical vertebrae and gender at ages 11, 12 and 14 years. Males with Class II malocclusion were twice as likely to be in Stage 1 or 2 of cervical vertebra maturation than individuals with Class I malocclusion (OR = 2.1 [CI 95%, 1.33-3.18]. There were no differences between individuals with Class I and Class III malocclusions. The association between skeletal maturation of the cervical vertebrae and type of malocclusion was significant, suggesting a skeletal component in the determination of Class II malocclusions.

  10. Localized cranial hyperostosis of meningiomas: a result of neoplastic enzymatic activity?

    DEFF Research Database (Denmark)

    Heick, A.; Mosdal, C.; Klinken, Leif

    1993-01-01

    Neuropathology, alkaline phosphatase, cranial hyperostosis, meningioma, ossifying enzymatic activity......Neuropathology, alkaline phosphatase, cranial hyperostosis, meningioma, ossifying enzymatic activity...

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

    Science.gov (United States)

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

    2013-01-01

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

  12. 21 CFR 882.4360 - Electric cranial drill motor.

    Science.gov (United States)

    2010-04-01

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

  13. Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy.

    OpenAIRE

    V. Anderson; Smibert, E; Ekert, H; Godber, T

    1994-01-01

    Cognitive and educational sequelae are inconsistently reported in children treated with cranial irradiation for acute lymphoblastic leukaemia. This study investigated differences in these skills after cranial irradiation, controlling the effects of chemotherapy and psychosocial factors. Three groups were evaluated: 100 children diagnosed with acute lymphoblastic leukaemia and treated with cranial irradiation and chemotherapy; 50 children diagnosed with acute lymphoblastic leukaemia or other c...

  14. Familial Aggregation of Cranial Tremor in Familial Essential Tremor

    Science.gov (United States)

    Louis, Elan D.; Hernandez, Nora; Clark, Lorraine N.; Ottman, Ruth

    2013-01-01

    Background Essential tremor (ET) is often familial and phenotypic features may be shared within families. Cranial (neck, voice, jaw) tremor is an important feature of ET. We examined whether cranial tremor aggregates in ET families, after controlling for other factors (age, tremor severity and duration). Methods Among ET probands and relatives enrolled in a genetic study at Columbia University (95 subjects in 28 families), we assessed the degree to which occurrence of cranial tremor in the proband predicted occurrence of cranial tremor in affected relatives. Results Forty-five (47.4%) subjects had cranial tremor on neurological examination (probands 66.7%, relatives 39.7%). Among 28 families, 23 (82.1%) contained individuals with and individuals without cranial tremor, indicating a high degree of within-family heterogeneity. In comparison to subjects without cranial tremor, those with cranial tremor had higher total tremor scores (ptremor of longer duration (p=0.01). In logistic regression models, the odds of cranial tremor in a relative was not related to occurrence of cranial tremor in the proband (p>0.24). Conclusions Cranial tremor did not aggregate in families with ET; the major predictor of this disease feature was tremor severity rather than presence of cranial tremor in another family member. PMID:23712245

  15. POSTERIOR CRANIAL FOSSA TUMOURS IN CHILDREN AT ...

    African Journals Online (AJOL)

    hi-tech

    2004-05-05

    May 5, 2004 ... symptoms were the most common mode of presentation (30%) followed by headaches and vomiting. Twenty percent of our patients ... paediatric posterior fossa tumours are medulloblastoma. (20%) astrocytoma (15%) ... cranial nerve palsies, headaches, vomiting and blindness due to raised intracranial ...

  16. Detection and Labeling of Vertebrae in MR Images Using Deep Learning with Clinical Annotations as Training Data.

    Science.gov (United States)

    Forsberg, Daniel; Sjöblom, Erik; Sunshine, Jeffrey L

    2017-08-01

    The purpose of this study was to investigate the potential of using clinically provided spine label annotations stored in a single institution image archive as training data for deep learning-based vertebral detection and labeling pipelines. Lumbar and cervical magnetic resonance imaging cases with annotated spine labels were identified and exported from an image archive. Two separate pipelines were configured and trained for lumbar and cervical cases respectively, using the same setup with convolutional neural networks for detection and parts-based graphical models to label the vertebrae. The detection sensitivity, precision and accuracy rates ranged between 99.1-99.8, 99.6-100, and 98.8-99.8% respectively, the average localization error ranges were 1.18-1.24 and 2.38-2.60 mm for cervical and lumbar cases respectively, and with a labeling accuracy of 96.0-97.0%. Failed labeling results typically involved failed S1 detections or missed vertebrae that were not fully visible on the image. These results show that clinically annotated image data from one image archive is sufficient to train a deep learning-based pipeline for accurate detection and labeling of MR images depicting the spine. Further, these results support using deep learning to assist radiologists in their work by providing highly accurate labels that only require rapid confirmation.

  17. Pullout strength of misplaced pedicle screws in the thoracic and lumbar vertebrae - A cadaveric study

    Directory of Open Access Journals (Sweden)

    Shyam K Saraf

    2013-01-01

    Full Text Available Background: The objective of this cadaveric study was to analyze the effects of iatrogenic pedicle perforations from screw misplacement on the mean pullout strength of lower thoracic and lumbar pedicle screws. We also investigated the effect of bone mineral density (BMD, diameter of pedicle screws, and the region of spine on the pullout strength of pedicle screws. Materials and Methods: Sixty fresh human cadaveric vertebrae (D10-L2 were harvested. Dual-energy X-ray absorptiometry (DEXA scan of vertebrae was done for BMD. Titanium pedicle screws of different diameters (5.2 and 6.2 mm were inserted in the thoracic and lumbar segments after dividing the specimens into three groups: a standard pedicle screw (no cortical perforation; b screw with medial cortical perforation; and c screw with lateral cortical perforation. Finally, pullout load of pedicle screws was recorded using INSTRON Universal Testing Machine. Results: Compared with standard placement, medially misplaced screws had 9.4% greater mean pullout strength and laterally misplaced screws had 47.3% lesser mean pullout strength. The pullout strength of the 6.2 mm pedicle screws was 33% greater than that of the 5.2 mm pedicle screws. The pullout load of pedicle screws in lumbar vertebra was 13.9% greater than that in the thoracic vertebra ( P = 0.105, but it was not statistically significant. There was no significant difference between pullout loads of vertebra with different BMD ( P = 0.901. Conclusion: The mean pullout strength was less with lateral misplaced pedicle screws while medial misplaced pedicle screw had more pullout strength. The pullout load of 6.2 mm screws was greater than that of 5.2 mm pedicle screws. No significant correlation was found between bone mineral densities and the pullout strength of vertebra. Similarly, the pullout load of screw placed in thoracic and lumbar vertebrae was not significantly different.

  18. Comparison of probabilistic and deterministic fiber tracking of cranial nerves.

    Science.gov (United States)

    Zolal, Amir; Sobottka, Stephan B; Podlesek, Dino; Linn, Jennifer; Rieger, Bernhard; Juratli, Tareq A; Schackert, Gabriele; Kitzler, Hagen H

    2017-09-01

    OBJECTIVE The depiction of cranial nerves (CNs) using diffusion tensor imaging (DTI) is of great interest in skull base tumor surgery and DTI used with deterministic tracking methods has been reported previously. However, there are still no good methods usable for the elimination of noise from the resulting depictions. The authors have hypothesized that probabilistic tracking could lead to more accurate results, because it more efficiently extracts information from the underlying data. Moreover, the authors have adapted a previously described technique for noise elimination using gradual threshold increases to probabilistic tracking. To evaluate the utility of this new approach, a comparison is provided with this work between the gradual threshold increase method in probabilistic and deterministic tracking of CNs. METHODS Both tracking methods were used to depict CNs II, III, V, and the VII+VIII bundle. Depiction of 240 CNs was attempted with each of the above methods in 30 healthy subjects, which were obtained from 2 public databases: the Kirby repository (KR) and Human Connectome Project (HCP). Elimination of erroneous fibers was attempted by gradually increasing the respective thresholds (fractional anisotropy [FA] and probabilistic index of connectivity [PICo]). The results were compared with predefined ground truth images based on corresponding anatomical scans. Two label overlap measures (false-positive error and Dice similarity coefficient) were used to evaluate the success of both methods in depicting the CN. Moreover, the differences between these parameters obtained from the KR and HCP (with higher angular resolution) databases were evaluated. Additionally, visualization of 10 CNs in 5 clinical cases was attempted with both methods and evaluated by comparing the depictions with intraoperative findings. RESULTS Maximum Dice similarity coefficients were significantly higher with probabilistic tracking (p cranial nerves. Probabilistic tracking with a gradual

  19. Adolescent Scoliosis 1A001: Radiographic Results of Selecting the Touched Vertebra as the Lowest Instrumented Vertebra in Lenke Type 1 (Main Thoracic) & Type 2 (Double Thoracic) Curves at a Minimum 5-year Follow-up

    OpenAIRE

    Lenke, Lawrence; Newton, Peter; Lehman, Ronald; Kelly, Michael; Clements, David; Errico, Thomas; Betz, Randall; Samdani, Amer; Blanke, Kathy; Oggiano, Leonardo; Sessa, Sergio; Rosa, Guido La; Guler, Umit Ozgur; Ozalay, Metin; Eyvazov, Kamil

    2017-01-01

    Introduction: A prior study showed the touched vertebra (TV), defined as the most cephalad thoracolumbar/lumbar vertebra “touched” by the center sacral vertical line (CSVL), as a potential landmark vertebra & recommended lowest instrumented vertebra (LIV) as well. We evaluated a large cohort of Lenke type 1 & 2 cases to determine if selecting the TV as the LIV will produce optimal positioning at a min. 5 yrs postoperative. Our hypothesis was that it would and that fusing short of the TV would...

  20. Do modern humans and Neandertals have different patterns of cranial integration?

    Science.gov (United States)

    Roseman, Charles C; Weaver, Timothy D; Stringer, Christopher B

    2011-06-01

    Studies of cranial differences between modern humans and Neandertals have identified several characteristics for which the two groups differ in their mean values, the proportional relationships with other traits, or both. However, the limited number of fairly complete Neandertals has hindered investigations into patterns of integration - covariance and correlation among traits - in this fossil group. Here, we use multiple approaches specifically designed to deal with fragmentary fossils to test if metric cranial traits in Neandertals fit modern human patterns of integration. Based on 37 traits collected from a sample of 2524 modern humans from Howells' data set and 20 Neandertals, we show that overall patterns of cranial integration are significantly different between Neandertals and modern humans. However, at the same time, Neandertals are consistent with a modern human pattern of integration for more than three-quarters of the traits. Additionally, the differences between the predicted and actual values for the deviating traits are rather small, indicating that the differences in integration are subtle. Traits for which Neandertals deviate from modern human integration patterns tend to be found in regions where Neandertals and modern humans are known to also differ in their mean values. We conclude that the evolution of patterns of cranial integration is a cause for caution but also presents an opportunity for understanding cranial differences between modern humans and Neandertals. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Comparison of 3DCRT,VMAT and IMRT techniques in metastatic vertebra radiotherapy: A phantom Study

    Science.gov (United States)

    Gedik, Sonay; Tunc, Sema; Kahraman, Arda; Kahraman Cetintas, Sibel; Kurt, Meral

    2017-09-01

    Vertebra metastases can be seen during the prognosis of cancer patients. Treatment ways of the metastasis are radiotherapy, chemotherapy and surgery. Three-dimensional conformal therapy (3D-CRT) is widely used in the treatment of vertebra metastases. Also, Intensity Modulated Radiotherapy (IMRT) and Volumetric Arc Therapy (VMAT) are used too. The aim of this study is to examine the advantages and disadvantages of the different radiotherapy techniques. In the aspect of this goal, it is studied with a randophantom in Uludag University Medicine Faculty, Radiation Oncology Department. By using a computerized tomography image of the phantom, one 3DCRT plan, two VMAT and three IMRT plans for servical vertebra and three different 3DCRT plans, two VMAT and two IMRT plans for lomber vertebra are calculated. To calculate 3DCRT plans, CMS XiO Treatment System is used and to calculate VMAT and IMRT plans Monaco Treatment Planning System is used in the department. The study concludes with the dosimetric comparison of the treatment plans in the spect of critical organ doses, homogeneity and conformity index. As a result of this study, all critical organ doses are suitable for QUANTEC Dose Limit Report and critical organ doses depend on the techniques which used in radiotherapy. According to homogeneity and conformity indices, VMAT and IMRT plans are better than one in 3DCRT plans in servical and lomber vertebra radiotherapy plans.

  2. Population-Stratified Analysis of Bone Mineral Density Distribution in Cervical and Lumbar Vertebrae of Chinese from Quantitative Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yong [Department of Radiology, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Zhou, Zhuang [Department of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051 (China); Wu, Cheng' ai; Zhao, Danhui; Wang, Chao [Beijing Institute of Traumatology and Orthopedics, Beijing 100035 (China); Cheng, Xiaoguang; Cai, Wei; Wang, Ling; Duanmu, Yangyang; Zhang, Chenxin [Department of Radiology, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Tian, Wei [Department of Spine Surgery, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China)

    2016-11-01

    To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2–7 and L2–4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2–5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62–0.94; males: r = 0.63–0.94) and lumbar vertebrae (males: r = 0.93–0.98; females: r = 0.82–0.97) were statistically significant at each age group. The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.

  3. Population=stratified analysis of bone mineral density distribution in cervical and lumbar vertebrae of chinese from quantitative computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yong; Cheng, Xiaoguang; Cai, Wei; Wang, Ling; Duanmu, Yangyang; Zhang, Chen Xin [Dept. of Radiology, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing (China); Zhou, Zhuang [Dept. of Orthopedic Oncology, The Third Hospital of Hebei Medical University, Shijiazhuang (China); Wu, Cheng' ai; Zhao, Danhui; Wang, Chao [Beijing Institute of Traumatology and Orthopedics, Beijing (China); Tian, Wei [Dept. of Spine Surgery, The Fourth Clinical Medical College of Peking University, Beijing Jishuitan Hospital, Beijing (China)

    2016-09-15

    To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2–7 and L2–4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2–5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62–0.94; males: r = 0.63–0.94) and lumbar vertebrae (males: r = 0.93–0.98; females: r = 0.82–0.97) were statistically significant at each age group. The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.

  4. Population-Stratified Analysis of Bone Mineral Density Distribution in Cervical and Lumbar Vertebrae of Chinese from Quantitative Computed Tomography.

    Science.gov (United States)

    Zhang, Yong; Zhou, Zhuang; Wu, Cheng'ai; Zhao, Danhui; Wang, Chao; Cheng, Xiaoguang; Cai, Wei; Wang, Ling; Duanmu, Yangyang; Zhang, Chenxin; Tian, Wei

    2016-01-01

    To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2-7 and L2-4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2-5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62-0.94; males: r = 0.63-0.94) and lumbar vertebrae (males: r = 0.93-0.98; females: r = 0.82-0.97) were statistically significant at each age group. The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.

  5. Vertebrae localization in pathological spine CT via dense classification from sparse annotations.

    Science.gov (United States)

    Glocker, Ben; Zikic, Darko; Konukoglu, Ender; Haynor, David R; Criminisi, Antonio

    2013-01-01

    Accurate localization and identification of vertebrae in spinal imaging is crucial for the clinical tasks of diagnosis, surgical planning, and post-operative assessment. The main difficulties for automatic methods arise from the frequent presence of abnormal spine curvature, small field of view, and image artifacts caused by surgical implants. Many previous methods rely on parametric models of appearance and shape whose performance can substantially degrade for pathological cases. We propose a robust localization and identification algorithm which builds upon supervised classification forests and avoids an explicit parametric model of appearance. We overcome the tedious requirement for dense annotations by a semi-automatic labeling strategy. Sparse centroid annotations are transformed into dense probabilistic labels which capture the inherent identification uncertainty. Using the dense labels, we learn a discriminative centroid classifier based on local and contextual intensity features which is robust to typical characteristics of spinal pathologies and image artifacts. Extensive evaluation is performed on a challenging dataset of 224 spine CT scans of patients with varying pathologies including high-grade scoliosis, kyphosis, and presence of surgical implants. Additionally, we test our method on a heterogeneous dataset of another 200, mostly abdominal, CTs. Quantitative evaluation is carried out with respect to localization errors and identification rates, and compared to a recently proposed method. Our approach is efficient and outperforms state-of-the-art on pathological cases.

  6. Cranial Imaging Findings of Hypertension in Pregnancy

    Directory of Open Access Journals (Sweden)

    Yusuf Tamam

    2005-01-01

    Full Text Available The aim of this study was to find out the cranial imaging findings of complicated hypertensive disorders of pregnancy. Forty two patients with preeclampsia, eclampsia and HELLP syndrome were admitted to the study at Obstetrics Division of Dicle University from January 2001 to December 2004. Computed Tomography was made to the forty two patients. The Computed Tomograpy findings of 20 (47.62% patients were normal whereas computed Tomograpy findings of 22 (52.28% patients were pathological. Eight patients (19% had intracranial hemorrhage, 5 (11.9 % patients had infarct, 9 (21.42% patients had specific lesions. A wide imaging spectrum from ischemic area to intracranial hemorrhages can be detected in hypertensive disorders of pregnancy. Thus it is essential to make cranial imaging in patients with symptoms and neurological deficit.

  7. Neurosonography of cranial lesions in infants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Seok; Lee, Sung Sik; Lee, Soon Il [Sowha Children' s Hospital, Seoul (Korea, Republic of); Lee, Seung Ro [Hanyang University College of Medicine, Seoul (Korea, Republic of); Chi, Je Geun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-04-15

    Since early 1980's, high resolution ultrasound has been world-widely used for detection of cranial lesions in infants but not widely used in Korea. Authors prospectively analysed ultrasonographic findings of 107 cases which were confirmed by CT, autopsy or follow-up studies as supplement. The distribution of 107 cases was intracranial hematoma 40 cases, hydrocephalus 36 cases, hypoxic-ischemic encephalopathy 10 cases, porencephalic cyst 5 cases, cephalhematoma 5 case, agenesis of corpus callosum 4 cases, medulloblastoma 2 cases and each one case of A-V malformation, intraventricular cyst, Dandy Walker cyst, lipoma and hydranencephaly. We could conclude that neurosonography of infants was very useful and effective method in detection of cranial lesions such as intracranial hematoma, especially germinal matrix hemorrhage or intraventricular hemorrhage in preterm infant, hydrocephalus, hypoxic-ischemic encephalopathy and congenital anomalies.

  8. The relative efficacy of functional and developmental cranial modules for reconstructing global human population history.

    Science.gov (United States)

    von Cramon-Taubadel, Noreen

    2011-09-01

    This study tests the relative efficacy of human cranial modules, defined on the basis of developmental and functional criteria, for reconstructing neutral genetic population history. Specifically, two hypotheses were tested: 1) The "basicranial hypothesis" predicts that the endochondrally ossifying basicranium will be more reliable for reconstructing population history than intramembranously ossifying regions of the human cranium. This is based on the assumption that early ossification of the basicranium and its distinct functional constraints produce a cranial structure that is relatively immune to non-neutral evolutionary forces. 2) The "single function hypothesis" predicts that cranial regions associated with a single (sensory) function are less reliable indicators of neutral genetic history. Here the prediction is based on the logic that complex, multi-functional, integrated cranial regions are less likely toexhibit homoplasy and, therefore, provide a more accurate morphological proxy for genetic relationships. The congruence between craniometric affinity matrices and neutral genetic population matrices based on autosomal microsatellite and classical markers was assessed using a series of Mantel and Dow-Cheverud tests. The results did not support the predictions of the "basicranial hypothesis," as the endochondrally ossifying basicranium was not significantly more congruent with the genetic data than intramembraneously ossifying modules. Moreover, although the results provided some support for the "single function hypothesis," defining cranial modules on the basis of anatomical or functional complexity did not provide a consistent means of predicting their phylogenetic efficacy. These results have important implications for building an accurate inference model of cranial evolution in the human fossil record. 2011 Wiley-Liss, Inc.

  9. Role of cranial imaging in epileptic status

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

    2009-06-15

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

  10. [Chondroma adjacent to Meckel's cave mimicking a fifth cranial nerve neurinoma. A case report].

    Science.gov (United States)

    Narro-Donate, Jose María; Huete-Allut, Antonio; Velasco-Albendea, Francisco J; Escribano-Mesa, Jose A; Mendez-Román, Paddy; Masegosa-González, Jose

    2016-01-01

    Cranial chondromas are tumours arising from chondrocyte embryonic remnants cells that usually appear in the skull base synchondrosis. In contrast to the rest of the organism, where chondroid tumours are the most common primary bone tumour just behind the haematopoietic lineage ones, they are a rarity at cranial level, with an incidence of less than 1% of intracranial tumours. The case is reported on a 42 year-old male referred to our clinic due to the finding of an extra-axial lesion located close to the Meckel's cave region, with extension to the posterior fossa and brainstem compression after progressive paraparesis of 6 months onset. With the diagnosis of trigeminal schwannoma, a subtotal tumour resection was performed using a combined supra-infratentorial pre-sigmoidal approach. The postoperative histopathology report confirmed the diagnosis of cranial chondroma. Copyright © 2016 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  11. Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

    Science.gov (United States)

    Borji, Hassan; Moosavi, Zahra; Ahmadi, Fatemeh

    2014-09-01

    Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

  12. Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus.

    Directory of Open Access Journals (Sweden)

    Hassan Borji

    2014-09-01

    Full Text Available Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

  13. Intraosseous monitoring of drilling in lumbar vertebrae by ultrasound: An experimental feasibility study.

    Science.gov (United States)

    Rosenberg, Nahum; Halevy-Politch, Jacob

    2017-01-01

    The rationale for this project is to evaluate the efficiency of a novel sonographic method for measurements of interosseous distances. The method utilizes a propagating ultrasonic beam through aqueous milieu which is directed as a jet into a drilled tract. We used a plastic model of human L5 vertebra and ex vivo specimen of L5 porcine vertebra and generated 2 mm in diameter tracts in vertebral pedicles. The tracts were created in the "desired" central direction and in the "wrong" medial and lateral directions. The drilled tracts and the residual, up to opposite cortex, distances were measured sonographically and mechanically and compared statistically. We show that "true" mechanical measurements can be predicted from sonographic measurements with correction of 1-3 mm. The correct central route can be distinguished from the wrong misplaced routes. By using the sonographic measurements, a correct direction of drilling in the pedicle of lumbar L5 vertebra can be efficiently monitored.

  14. Cranial involvement in sickle cell disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-15

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

  15. Studing cranial vault modifications in ancient Mesoamerica.

    Science.gov (United States)

    Tiesler, Vera

    2012-01-01

    The artificial modification of infant cranial vaults through massages or by means of constriction and compression devices constitutes a readily visible, permanent body modification that has been employed cross-culturally to express identity, ethnicity, beauty, status and gender. For those ancient societies that staged head shaping, these cultural correlates may be ascertained by examining cranial shapes together with other data sets from the archaeological record. Studies of skulls modified for cultural reasons also provide important clues for understanding principles in neural growth and physiopathological variation in cranial expansion. This paper focuses on head shaping techniques in Mesoamerica, where the practice was deeply rooted and widespread before the European conquest. It provides a comprehensive review of the Mesoamericanistic research on shaping techniques, implements and taxonomies. An up-dated, interdisciplinary examination of the physiological implications and the cultural meanings of artificially produced head shapes in different times and culture areas within Mesoamerica leads to a discussion of the scope, caveats, and future directions involved in this kind of research in the region and beyond.

  16. CRANIAL OSTEOLOGY OF CYCLARHIS GUJANENSIS (AVES: VIREONIDAE

    Directory of Open Access Journals (Sweden)

    DIEGO MATIUSSI PREVIATTO

    2015-01-01

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

  17. Cranial Osteology of Meiglyptini (Aves: Piciformes: Picidae

    Directory of Open Access Journals (Sweden)

    Reginaldo José Donatelli

    2012-01-01

    Full Text Available The Meiglyptini comprise eight species grouped into three genera: Meiglyptes and Mulleripicus, with three species each, and Hemicircus, with two species. The aim of the present study was to describe the cranial osteology of six species and three genera of Meiglyptini and to compare them to each other, as well as with other species of woodpeckers and other bird groups. The cranial osteology varied among the investigated species, but the most markedly distinct characteristics were: (1 a frontal overhang is only observed in the middle portion of the frontale of H. concretus; (2 the Proc. zygomaticus and suprameaticus are thick and long in species of the genus Mulleripicus, but short in other species; (3 the Pes pterygoidei is relatively larger in species of the genus Mulleripicus, while it is narrow, thin and relatively smaller in species of the genus Meiglyptes and indistinct in H. concretus; (4 the bony projection of the ectethmoidale is relatively short and thin in species of Mulleripicus and more developed in H. concretus. It appears that the greatest structural complexity of the cranial osteology is associated with the birds’ diet, with the frugivorous H. concretus being markedly different from the insectivorous species.

  18. SURGICAL TREATMENT OF L5-SPONDYLOLISTHESIS VERTEBRAE IN CHILDREN. BENEFITS OF POSTERIOR APPROACH

    OpenAIRE

    Сергей Валентинович Виссарионов; Владислав Валерьевич Мурашко; Сергей Михайлович Белянчиков; Дмитрий Николаевич Кокушин; Ирина Юрьевна Солохина; Ирина Анатольевна Гусева; Татьяна Валерьевна Мурашко; Мария Сергеевна Павлова

    2014-01-01

    Objective to develop current options of surgical treatment of L5-spondylolisthesis in children. Materials and methods: 48 patients were observed and underwent surgical treatment at age of 10-17 years. In 9 patients spondylolisthesis of L5 was grade 2, in 14 - grade 3, in 12 - grade 4. 9 patients had spondyloptosis of the body of L5-vertebra. The article presents different options of surgical treatment of spondylolisthesis in children depending on the degree of vertebrae body shift and the mai...

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

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    Ataru Sunaga, MD

    2017-12-01

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

  20. Preservation of cranial nerves during removal of the brain for an enhanced student experience in neuroanatomy classes.

    Science.gov (United States)

    Long, Jennifer; Roberts, David J H; Pickering, James D

    2014-01-01

    Neuroanatomy teaching at the University of Leeds includes the examination of isolated brains by students working in small groups. This requires the prosected brains to exhibit all 12 pairs of cranial nerves. Traditional methods of removing the brain from the skull involve elevating the frontal lobes and cutting each cranial nerve as the brain is reflected posteriorly. This can leave a substantial length of each nerve attached to the skull base rather than to the removed brain. We have found a posterior approach more successful. In this study, five adult heads were disarticulated at the level of the thyroid cartilage and placed, prone, in a head stand. A wedge of bone from the occipital region was removed before the cerebellum and brainstem were elevated to visualize the cranial nerves associated with the medulla oblongata, cerebellopontine angle and mesencephalic-pontine junction prior to cutting them as close to the skull as possible. Five brains were successfully removed from the skull, each having a full complement of cranial nerves of good length attached to them. This approach significantly increases the length and number of cranial nerves remaining attached to the brain, which supports student education. For integration into head and neck dissection courses, careful consideration will be required to ensure the necks are suitably dissected and to decide whether the cranial nerves are best left attached to the skull base or brain. Copyright © 2013 Wiley Periodicals, Inc.

  1. The naming of the cranial nerves: a historical review.

    Science.gov (United States)

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

    2014-01-01

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

  2. Familial Idiopathic Cranial Neuropathy in a Chinese Family.

    Science.gov (United States)

    Zhang, Li; Liang, Jianfeng; Yu, Yanbing

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

  3. Dosimetric comparison of intensity modulated radiosurgery with dynamic conformal arc radiosurgery for small cranial lesions

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    Juan F Calvo-Ortega

    2016-01-01

    Conclusions: We have shown that IMRS provides the dosimetric advantages compared with DCARS. Based on the dosimetric findings in this study, fixed gantry IMRS technique can be adopted as a standard procedure for cranial SRS when micro-MLC technology is not available on the linear accelerator.

  4. Cranial nerve palsy in Wegener's granulomatosis--lessons from clinical cases

    DEFF Research Database (Denmark)

    Nowack, Rainer; Wachtler, Paul; Kunz, Jürgen

    2009-01-01

    The problem of diagnosing vasculitic neuropathy is discussed based on case reports of two patients with Wegener's granulomatosis. One patient developed de novo 6(th) nerve palsy as an isolated relapse manifestation and the second patient a sequence of multiple cranial nerve palsies. Brain imaging...

  5. Should patients with extrapulmonary small-cell carcinoma receive prophylactic cranial irradiation?

    LENUS (Irish Health Repository)

    Naidoo, Jarushka

    2013-09-01

    Extrapulmonary small-cell carcinoma (EPSCC) is a rare disease. Management is based on small-cell lung carcinoma. Prophylactic cranial irradiation (PCI) is not routinely administered in EPSCC. This study investigates the role of PCI in EPSCC, by analyzing the incidence, treatment, and survival of patients with brain metastases in a national cohort. Disease biology and epidemiology are also investigated.

  6. Characterization of a Composite Material to Mimic Human Cranial Bone

    Science.gov (United States)

    2015-09-01

    with using real human tissue. 1 INTRODUCTION Prevention of head injury is receiving growing attention in the sporting arena as well as the...M. Alem, Mechanical properties of cranial bone. Journal of Biomechanics , 1970. 3(5): p. 497-511. 3. Wood, Jack L., Dynamic response of human...cranial bone. Journal of Biomechanics , 1971. 4(1): p. 1-12. 4. Wood, Jack L., Mechanical properties of human cranial bone in tension, in Department of

  7. A distinct development programme for the cranial paraxial mesoderm

    OpenAIRE

    Hacker, A; Guthrie, S.

    1998-01-01

    Cells of the cranial paraxial mesoderm give rise to parts of the skull and muscles of the head. Some mesoderm cells migrate from locations close to the hindbrain into the branchial arches where they undergo muscle differentiation. We have characterised these migratory pathways in chick embryos either by DiI-labelling cells before migration or by grafting quail cranial paraxial mesoderm orthotopically. These experiments demonstrate that depending on their initial rostrocaudal position, cranial...

  8. Imaging of muscular denervation secondary to motor cranial nerve dysfunction

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-08-15

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

  9. Twelfth cranial nerve involvement in Guillian Barre syndrome

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    Subrat Kumar Nanda

    2013-01-01

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

  10. Ontogenetic allometry constrains cranial shape of the head-first burrowing worm lizard Cynisca leucura (Squamata: Amphisbaenidae).

    Science.gov (United States)

    Hipsley, Christy A; Rentinck, Marc-Nicolas; Rödel, Mark-Oliver; Müller, Johannes

    2016-09-01

    Amphisbaenians are fossorial, predominantly limbless squamate reptiles with distinct cranial shapes corresponding to specific burrowing behaviors. Due to their cryptic lifestyles and the scarcity of museum specimens, little is known of their intraspecific variation, particularly regarding cranial osteology. This represents a critical lack of information, because the majority of morphological investigations of squamate relationships are based on cranial characters. We investigated cranial variation in the West African Coast Worm Lizard Cynisca leucura, a round-headed member of the Amphisbaenidae. Using geometric morphometric analyses of three-dimensional computed tomographic scans, we found that cranial osteology of C. leucura is highly conserved, with the majority of shape changes occurring during growth as the cranium becomes more slender and elongate, accompanied by increasing interdigitation among the dermal roofing bones. Elements of the ventral portion of the cranium remain loosely connected in adults, possibly as a protective mechanism against repeated compression and torsion during burrow excavation. Intraspecific variation was strongly correlated with size change from juveniles to adults, indicating a dominant role of ontogenetic allometry in determining cranial shape. We found no evidence of sexual dimorphism, either during growth or among adults. Given the fossorial habits of C. leucura, we hypothesize that cranial allometry is under strong stabilizing selection to maintain adequate proportions for head-first digging, thereby constraining the ability of individuals to respond to differing selection pressures, including sexual selection and variation in diet or microhabitat. For species in which digging imposes less mechanical stress (e.g., in softer sand), allometric associations during growth may be weakened, allowing changes to the ontogenetic trajectory and subsequent morphological traits. Such developmental dissociation between size and shape, known

  11. Quantitative assessment of the normal adult spinal canal at the fourth lumbar vertebra by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Senel, A. (Dept. of Neurosurgery, Ondokuz Mayis Univ., Faculty of Medicine, Samsun (Turkey)); Tanik, A. (Dept. of Radiology, Ondokuz Mayis Univ., Samsun (Turkey)); Akan, H. (Dept. of Radiology, Ondokuz Mayis Univ., Samsun (Turkey))

    1994-01-01

    We reviewed the computed tomographic (CT) studies of 105 adults with various complaints. Spinal canal diameters were measured by CT using both the conventional and Jones-Thomson (JT) techniques at the level of the fourth lumbar vertebra. The data were statistically assessed in an attempt to define spinal stenosis. (orig.)

  12. Estimating height from the first and second cervical vertebrae in a Spanish population.

    Science.gov (United States)

    Rodríguez, Sonia; Rodríguez-Calvo, María S; González, Antonio; Febrero-Bande, Manuel; Muñoz-Barús, José I

    2016-03-01

    One of the roles of forensic anthropology is the identification of skeletal remains and over the years many methods have been developed to obtain specific details of a corpse such as an estimation of age and height. The femur and tibia are ideal for this purpose but unfortunately they are often missing or badly fragmented. For this reason, in this present study, we used the smaller bones of the first and second cervical vertebrae, which are often better preserved than the long bones. Direct measurement of these bones has been found to be misleading, largely due to the remains of a covering of soft tissue, and to overcome this all measurements were taken from tomographic images. The aim of this study is to provide an auxiliary diagnostic method to evaluate the association of different anthropometric measurements taken with tomographic imagery of both the first cervical and second cervical vertebra with body height within a sample of the Spanish population. Measurements were taken from tomographic images taken with a dental CT of 203 healthy individuals from a Spanish population. The best correlation was obtained in the case of unknown sex using four measurements: two of the first cervical vertebra and two of the second vertebra using the following regression formula S=49.02+1.02O+1.58DO+0.49V+0.67I. All formulae provided statistically significant results and can be applied to any skeletal remains belonging to a Spanish population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. EX VIVO COMPUTED TOMOGRAPHIC EVALUATION OF MORPHOLOGY VARIATIONS IN EQUINE CERVICAL VERTEBRAE

    NARCIS (Netherlands)

    Veraa, Stefanie; Bergmann, Wilhelmina; van den Belt, Antoon Jan; Wijnberg, Inge; Back, Willem

    2016-01-01

    Diagnostic imaging is one of the pillars in the clinical workup of horses with clinical signs of cervical spinal disease. An improved awareness of morphologic variations in equine cervical vertebrae would be helpful for interpreting findings. The aim of this anatomic study was to describe CT

  14. Andreas Vesalius on the anatomy and function of the lower thoracic vertebrae.

    Science.gov (United States)

    Biesbrouck, Maurits; Vanden Berghe, Alex

    2016-04-01

    Some remarkable statements made by Andreas Vesalius (1514-1564) in his principal work De Humani Corporis Fabrica (1543) about the anatomy and function of the lower thoracic vertebrae are discussed in the light of information from the literature. Their accuracy is evaluated on the basis of several pieces of anatomical evidence and clinical cases.

  15. A Late Cretaceous theropod caudal vertebra from the Sultanate of Oman

    NARCIS (Netherlands)

    Schulp, Anne S.; Hanna, Samir S.; Hartman, Axel Frans; Jagt, John W M

    2000-01-01

    A caudal vertebra collected from conglomerates of the Al-Khod Formation (Late Cretaceous) in the Al-Khod area, Sultanate of Oman, is assigned to a medium-sized theropod dinosaur. The Al-Khod discovery represents one of the very few dinosaur records from the Middle East.

  16. Vertebra disc ratio as a parameter for bone marrow involvement and its application in Gaucher disease

    NARCIS (Netherlands)

    Vlieger, Erik-Jan P.; Maas, Mario; Akkerman, Erik M.; Hollak, Carla E. M.; den Heeten, Gerard J.

    2002-01-01

    Objective: To establish the vertebra disc ratio (VDR), the ratio of the average T1-weighted gray value of disc L3 and intervertebral disc L3/L4, as a parameter for bone marrow involvement. To explore its value as alternative for bone marrow fat fraction measured with Dixon Quantitative Chemical

  17. Differential scaling patterns of vertebrae and the evolution of neck length in mammals.

    Science.gov (United States)

    Arnold, Patrick; Amson, Eli; Fischer, Martin S

    2017-06-01

    Almost all mammals have seven vertebrae in their cervical spines. This consistency represents one of the most prominent examples of morphological stasis in vertebrae evolution. Hence, the requirements associated with evolutionary modifications of neck length have to be met with a fixed number of vertebrae. It has not been clear whether body size influences the overall length of the cervical spine and its inner organization (i.e., if the mammalian neck is subject to allometry). Here, we provide the first large-scale analysis of the scaling patterns of the cervical spine and its constituting cervical vertebrae. Our findings reveal that the opposite allometric scaling of C1 and C2-C7 accommodate the increase of neck bending moment with body size. The internal organization of the neck skeleton exhibits surprisingly uniformity in the vast majority of mammals. Deviations from this general pattern only occur under extreme loading regimes associated with particular functional and allometric demands. Our results indicate that the main source of variation in the mammalian neck stems from the disparity of overall cervical spine length. The mammalian neck reveals how evolutionary disparity manifests itself in a structure that is otherwise highly restricted by meristic constraints. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  18. SURGICAL TREATMENT OF L5-SPONDYLOLISTHESIS VERTEBRAE IN CHILDREN. BENEFITS OF POSTERIOR APPROACH

    Directory of Open Access Journals (Sweden)

    Сергей Валентинович Виссарионов

    2014-09-01

    Full Text Available Objective to develop current options of surgical treatment of L5-spondylolisthesis in children. Materials and methods: 48 patients were observed and underwent surgical treatment at age of 10-17 years. In 9 patients spondylolisthesis of L5 was grade 2, in 14 - grade 3, in 12 - grade 4. 9 patients had spondyloptosis of the body of L5-vertebra. The article presents different options of surgical treatment of spondylolisthesis in children depending on the degree of vertebrae body shift and the main clinical manifestations. During surgery the anatomy of the vertebral canal and the normal interposition in the pathological segment were reconstructed. It resulted in normalization of the body balance and regression of neurological symptoms. Results: in spondylolisthesis grade 2 and 3 full reduction was achieved. In patients with grade 4 spondylolisthesis deformity was reduced to grade 2-3. Pain and radicular syndromes regressed in 2-3 days after surgery. In patients with monoparesis and contractures regression of neurological deficit took 1-1,5 months. Conclusions: The method of surgical treatment in patients with spondylolisthesis of L5 vertebrae depends on the degree of vertebrae shifting presence of segmental instability and neurological sighns.

  19. Minimally Invasive Supraorbital Key-hole Approach for the Treatment of Anterior Cranial Fossa Meningiomas

    Science.gov (United States)

    IACOANGELI, Maurizio; NOCCHI, Niccolò; NASI, Davide; DI RIENZO, Alessandro; DOBRAN, Mauro; GLADI, Maurizio; COLASANTI, Roberto; ALVARO, Lorenzo; POLONARA, Gabriele; SCERRATI, Massimo

    2016-01-01

    The most important target of minimally invasive surgery is to obtain the best therapeutic effect with the least iatrogenic injury. In this background, a pivotal role in contemporary neurosurgery is played by the supraorbital key-hole approach proposed by Perneczky for anterior cranial base surgery. In this article, it is presented as a possible valid alternative to the traditional craniotomies in anterior cranial fossa meningiomas removal. From January 2008 to January 2012 at our department 56 patients underwent anterior cranial base meningiomas removal. Thirty-three patients were submitted to traditional approaches while 23 to supraorbital key-hole technique. A clinical and neuroradiological pre- and postoperative evaluation were performed, with attention to eventual complications, length of surgical procedure, and hospitalization. Compared to traditional approaches the supraorbital key-hole approach was associated neither to a greater range of postoperative complications nor to a longer surgical procedure and hospitalization while permitting the same lesion control. With this technique, minimization of brain exposition and manipulation with reduction of unwanted iatrogenic injuries, neurovascular structures preservation, and a better aesthetic result are possible. The supraorbital key-hole approach according to Perneckzy could represent a valid alternative to traditional approaches in anterior cranial base meningiomas surgery. PMID:26804334

  20. The role of cranial kinesis in birds.

    Science.gov (United States)

    Bout, R G; Zweers, G A

    2001-12-01

    In birds, the ability to move the upper beak relative to the braincase has been the subject of many functional morphological investigations, but in many instances the adaptive significance of cranial kinesis remains unclear. Alternatively, cranial kinesis may be considered a consequence of the general design of the skull, rather than an adaptive trait as such. The present study reviews some results related to the mechanism and functional significance of cranial kinesis in birds. Quantitative three-dimensional X-ray has shown that in skulls morphologically as divers as paleognaths and neognaths the mechanism for elevation of the upper beak is very similar. One of the mechanisms proposed for avian jaw movement is a mechanical coupling of the upper and the lower jaw movement by the postorbital ligament. Such a mechanical coupling would necessitate upper beak elevation. However, independent control of upper and lower jaw has been shown to occur during beak movements in birds. Moreover, kinematic modeling and force measurements suggests that the maximum extensibility of collagen, in combination with the short distance of the insertion of the postorbital ligament to the quadrato-mandibular articulation do not constitute a block to lower jaw depression. The lower jaw ligaments serve to limit the maximal extension of the mandibula. It is suggested here that cranial kinesis in avian feeding may have evolved as a consequence of an increase in eye size. This increase in size led to a reduction of bony bars in the lateral aspect of the skull enabling the transfer of quadrate movement to the upper jaw. The selective forces favoring the development of a kinetic upper beak in birds may be subtle and act in different ecological contexts. Simultaneous movement of the upper and lower jaw not only increases the velocity of beak movements, but with elevated upper beak also less force is required to open the lower jaw. However, the penalty of increased mobility of elements in a

  1. Comparison of effectiveness of kyphoplasty and vertebroplasty in patients with osteoporotic vertebra fractures.

    Science.gov (United States)

    Ateş, Ahmet; Gemalmaz, Halil Can; Deveci, Mehmet Ali; Şimşek, Sezai Aykın; Çetin, Engin; Şenköylü, Alpaslan

    2016-12-01

    The aim of this study was to compare the functional and radiological outcomes of vertebroplasty and kyphoplasty in patients with osteoporotic vertebra fractures. The files of the patients who underwent vertebroplasty or kyphoplasty for osteoporotic vertebrae fractures were retrieved from the archives. Forty-three patients with complete follow-up data were included in the study group. The patients were evaluated for radiological outcomes in terms of local kyphosis angle, wedging index, compression ratio, visual analog pain scale (VAS) and Oswestry Disability Index (ODI). In the study group, kyphoplasty was performed on 24 vertebrae of 22 patients (17 females, 5 males; mean age: 73 years) whereas vertebroplasty was applied on 24 vertebrae of 21 (16 females, 5 males; mean age: 74.7 years) patients. The mean follow-up time was 26 months. When the VAS and ODI values of the groups were analyzed, both groups showed statistically significant progress after the operation. Radiological data showed that the kyphoplasty group showed statistically significant improvement in the sagittal index values whereas the vertebroplasty group did not. The overall complication ratio was 4%. Both vertebroplasty and kyphoplasty are effective treatment methods for functional recovery and pain relief in osteoporotic fractures of the vertebra. Although radiological outcomes of the kyphoplasty seem to be better, this does not have any clinical relevance. We suggest vertebroplasty over kyphoplasty since it is an easier method to manage. Level III, Therapeutic study. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  2. Heritability of human cranial dimensions: comparing the evolvability of different cranial regions.

    Science.gov (United States)

    Martínez-Abadías, Neus; Esparza, Mireia; Sjøvold, Torstein; González-José, Rolando; Santos, Mauro; Hernández, Miquel

    2009-01-01

    Quantitative craniometrical traits have been successfully incorporated into population genetic methods to provide insight into human population structure. However, little is known about the degree of genetic and non-genetic influences on the phenotypic expression of functionally based traits. Many studies have assessed the heritability of craniofacial traits, but complex patterns of correlation among traits have been disregarded. This is a pitfall as the human skull is strongly integrated. Here we reconsider the evolutionary potential of craniometric traits by assessing their heritability values as well as their patterns of genetic and phenotypic correlation using a large pedigree-structured skull series from Hallstatt (Austria). The sample includes 355 complete adult skulls that have been analysed using 3D geometric morphometric techniques. Heritability estimates for 58 cranial linear distances were computed using maximum likelihood methods. These distances were assigned to the main functional and developmental regions of the skull. Results showed that the human skull has substantial amounts of genetic variation, and a t-test showed that there are no statistically significant differences among the heritabilities of facial, neurocranial and basal dimensions. However, skull evolvability is limited by complex patterns of genetic correlation. Phenotypic and genetic patterns of correlation are consistent but do not support traditional hypotheses of integration of the human shape, showing that the classification between brachy- and dolicephalic skulls is not grounded on the genetic level. Here we support previous findings in the mouse cranium and provide empirical evidence that covariation between the maximum widths of the main developmental regions of the skull is the dominant factor of integration in the human skull.

  3. Comparative Evaluation of the Efficacy of Hand-Wrist and Cervical Vertebrae Radiography for the Determination of Skeletal Age.

    Science.gov (United States)

    Hoseini, Mohammadhashem; Zamaheni, Sara; Bashizadeh Fakhar, Hourieh; Akbari, Forough; Chalipa, Javad; Rahmati, Afsaneh

    2016-07-01

    Prediction of skeletal growth is necessary for growth modification and surgical orthodontic treatments and is usually done by assessing skeletal maturity indicators in hand-wrist radiographs. The use of growth stages of cervical vertebrae in lateral cephalograms has been suggested to avoid overexposure. This study seeks to assess the degree of agreement between hand-wrist and cervical vertebrae maturation stages for skeletal age determination and prediction of the peak growth spurt (PGS). This cross-sectional study was conducted with 67 boys and 66 girls between 8 and 18 years of age, divided into 11 age groups; 266 hand-wrist radiographs and lateral cephalograms were obtained and analyzed. Hand-wrist maturation stages were evaluated according to the Grave and Brown, Bjork system (stages 1 - 9). The cervical vertebral maturation stage (CVMS) was determined on lateral cephalograms based on a system described by Baccetti et al. (CVMS 1-5). To apply the Cohen's kappa index, the stages of growth were reduced to 5 intervals (A - E) to relate the 5 CVMS to the 9 stages of Bjork hand-wrist analysis. In all age groups, the skeletal maturity stages of the hand and wrist bones and the cervical vertebrae of the girls were ahead of the boys. Cohen's kappa test revealed a low level of agreement between the two methods [Kappa (95% CI) = 0.312 (0.290 - 0.377)]; concordance was slightly higher in males (K = 0.33 for males versus 0.27 for females). Evaluation of concordance coefficients between the stages determined by the two methods indicated the highest concordance in 8- and 9-year-olds and the lowest in 12- and 14-year-olds. The level of agreement between the two methods was only acceptable in 8- and 9-year-olds of both genders and 10-year-old boys. The level of agreement between the two methods in other age groups was not acceptable. The level of agreement between the two methods was low; thus, they cannot be used alternatively to estimate patients' skeletal age or to predict

  4. On the relationship between stature and anthropometric measurements of lumbar vertebrae.

    Science.gov (United States)

    Klein, Anke; Nagel, Katrin; Gührs, Julian; Poodendaen, Chanasorn; Püschel, Klaus; Morlock, Michael M; Huber, Gerd

    2015-12-01

    Stature estimation is important for identifying human remains. Analysis of body parts has become an important forensic tool during global operations in the context of cases in which human remains have been dismembered, mutilated or decomposed. However, unless almost the full skeleton or at least a long bone of the lower limb is available, accuracy is still limited to approximate body height. Especially with respect to single vertebral measurements, only a rough prediction is possible. Due to their complex geometry, vertebral measurements are possible at various locations. Nine locations have been considered in this study. Regression equations for stature estimation using lumbar vertebral geometry from computed tomography scans have been evaluated to identify the measurement which gives the most reliable body height estimation. The study group comprised a representative sample of a German metropolitan male population (42 autopsied individuals). Comparing the influence of various vertebral geometry measurements with body height resulted in a coefficient of correlation (R) of 0.19-0.53 and a 95% confidence interval (CI) of ± 11.6 up to ± 13.1cm. The largest correlation with a single vertebral measurement was achieved with the central height of the vertebral body of L2 as predictor; the standard error (SE) of the estimate was 5.9 cm. Using models from CT scans appeared superior to current invasive procedures that use direct measurements of the vertebral body, in terms of reproducibility and time efficiency. For fragmented non-skeletonized human bodies, height prediction based on an all-virtual model of the vertebrae is possible. However, the regression coefficient may be similar to classic caliper measurements that prove easier if skeletonized bones are available. Copyright © 2015 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Sex determination using anthropometric measurements from multi-slice computed tomography of the 12th thoracic and the first lumbar vertebrae among adult Egyptians

    Directory of Open Access Journals (Sweden)

    Fatma M.M. Badr El Dine

    2015-09-01

    Conclusion: Finally, it was concluded that the 12th thoracic vertebra is more accurate for sex determination than the first lumbar vertebra in the Egyptian population, which means that bone dimensions are population specific.

  6. Disorders of the lower cranial nerves.

    Science.gov (United States)

    Finsterer, Josef; Grisold, Wolfgang

    2015-01-01

    Lesions of the lower cranial nerves (LCN) are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid, or the tongue muscles. To correctly assess manifestations of LCN lesions, precise knowledge of the anatomy and physiology of the area is required.

  7. Flightlessness affects cranial morphology in birds.

    Science.gov (United States)

    Gussekloo, Sander W S; Cubo, Jorge

    2013-04-01

    Flightless birds belonging to phylogenetically distant clades share several morphological features in the pectoral and pelvic apparatus. There are indications that skull morphology is also influenced by flightlessness. In this study we used a large number of flightless species to test whether flightlessness in modern birds does indeed affect cranial morphology. Discriminant analyses and variation partitioning show evidence for a relationship between skull morphology and the flightless condition in birds. A possible explanation for the change in cranial morphology can be linked to the reduced selective force for light-weight skulls in flightless birds. This makes an increase in muscle mass, and therefore an enlargement of muscle insertion areas on the skull, possible. We also compared the ontogenetic trajectory of Gallus with the adult morphology of a sample of flightless species to see whether the apomorphic features characterizing the skull of flightless birds share the same developmental basis, which would indicate convergent evolution by parallelism. Skull morphology (expressed as principal component scores) of palaeognathous flightless birds (ratites) is dissimilar (higher scores) to juvenile stages of the chicken and therefore seem peramorphic (overdeveloped). Principal component scores of adult neognathous flightless birds fall within the range of chicken development, so no clear conclusions about the ontogenetic trajectories leading to their sturdier skull morphology could be drawn. Copyright © 2012 Elsevier GmbH. All rights reserved.

  8. Giant cell arteritis (cranial arteritis, polymyalgia rheumatica).

    Science.gov (United States)

    Mumenthaler, M

    1978-08-25

    Giant cell arteritis, which is probably due to disturbed immune mechanisms, has a spectrum of clinical symptoms in elderly people. In nearly all cases such general signs as loss of appetite, loss of weight and fever are present. The sedimentation rate is almost without exception about 100 mm in the first hour. The two most frequent and typical clinical syndromes are polymyalgia rheumatica and cranial arteritis. The polymyalgia rheumatica is characterized by periarticular pain which is mostly symmetrical and accentuated in the shoulder girdle. Increasingly severe temporal headache and ocular distrubances are found with cranial arteritis in more than 50% of cases. A combination of both diseases is frequent. Other arterial branches are rarely involved. The course of the disease is over a period of 1 1/2 to 2 years. Treatment with corticosteroids is indicated mainly because of the severe ocular complications with blindness. It should begin immediately, be intensive and last over a long period. Regular followup is necessary over several years in order to avoid relapses.

  9. Cranial mechanics and feeding in Tyrannosaurus rex.

    Science.gov (United States)

    Rayfield, Emily J

    2004-07-22

    It has been suggested that the large theropod dinosaur Tyrannosaurus rex was capable of producing extremely powerful bite forces and resisting multi-directional loading generated during feeding. Contrary to this suggestion is the observation that the cranium is composed of often loosely articulated facial bones, although these bones may have performed a shock-absorption role. The structural analysis technique finite element analysis (FEA) is employed here to investigate the functional morphology and cranial mechanics of the T. rex skull. In particular, I test whether the skull is optimized for the resistance of large bi-directional feeding loads, whether mobile joints are adapted for the localized resistance of feeding-induced stress and strain, and whether mobile joints act to weaken or strengthen the skull overall. The results demonstrate that the cranium is equally adapted to resist biting or tearing forces and therefore the 'puncture-pull' feeding hypothesis is well supported. Finite-element-generated stress-strain patterns are consistent with T. rex cranial morphology: the maxilla-jugal suture provides a tensile shock-absorbing function that reduces localized tension yet 'weakens' the skull overall. Furthermore, peak compressive and shear stresses localize in the nasals rather than the fronto-parietal region as seen in Allosaurus, offering a reason why robusticity is commonplace in tyrannosaurid nasals. Copyright 2004 The Royal Society

  10. Probabilistic Tractography of the Cranial Nerves in Vestibular Schwannoma.

    Science.gov (United States)

    Zolal, Amir; Juratli, Tareq A; Podlesek, Dino; Rieger, Bernhard; Kitzler, Hagen H; Linn, Jennifer; Schackert, Gabriele; Sobottka, Stephan B

    2017-11-01

    Multiple recent studies have reported on diffusion tensor-based fiber tracking of cranial nerves in vestibular schwannoma, with conflicting results as to the accuracy of the method and the occurrence of cochlear nerve depiction. Probabilistic nontensor-based tractography might offer advantages in terms of better extraction of directional information from the underlying data in cranial nerves, which are of subvoxel size. Twenty-one patients with large vestibular schwannomas were recruited. The probabilistic tracking was run preoperatively and the position of the potential depictions of the facial and cochlear nerves was estimated postoperatively by 3 independent observers in a blinded fashion. The true position of the nerve was determined intraoperatively by the surgeon. Thereafter, the imaging-based estimated position was compared with the intraoperatively determined position. Tumor size, cystic appearance, and postoperative House-Brackmann score were analyzed with regard to the accuracy of the depiction of the nerves. The probabilistic tracking showed a connection that correlated to the position of the facial nerve in 81% of the cases and to the position of the cochlear nerve in 33% of the cases. Altogether, the resulting depiction did not correspond to the intraoperative position of any of the nerves in 3 cases. In a majority of cases, the position of the facial nerve, but not of the cochlear nerve, could be estimated by evaluation of the probabilistic tracking results. However, false depictions not corresponding to any nerve do occur and cannot be discerned as such from the image only. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Carotid artery and lower cranial nerve exposure with increasing surgical complexity to the parapharyngeal space.

    Science.gov (United States)

    Lemos-Rodriguez, Ana M; Sreenath, Satyan B; Rawal, Rounak B; Overton, Lewis J; Farzal, Zainab; Zanation, Adam M

    2017-03-01

    To investigate the extent of carotid artery exposure attained, including the identification of the external carotid branches and lower cranial nerves in five sequential external approaches to the parapharyngeal space, and to provide an anatomical algorithm. Anatomical study. Six latex-injected adult cadaver heads were dissected in five consecutive approaches: transcervical approach with submandibular gland removal, posterior extension of the transcervical approach, transcervical approach with parotidectomy, parotidectomy with lateral mandibulotomy, and parotidectomy with mandibulectomy. The degree of carotid artery exposure attained, external carotid branches, and lower cranial nerves visualized was documented. The transcervical approach exposed 1.5 cm (Standard Deviation (SD) 0.5) of internal carotid artery (ICA) and 1.25 cm (SD 0.25) of external carotid artery (ECA). The superior thyroid and facial arteries and cranial nerve XII and XI were identified. The posterior extension exposed 2.9 cm (SD 0.7) of ICA and 2.7 cm (SD 1.0) of ECA. Occipital and ascending pharyngeal arteries were visualized. The transparotid approach exposed 4.0 cm (SD 1.1) of ICA and 3.98 cm (SD 1.8) of ECA. Lateral mandibulotomy exposed the internal maxillary artery, cranial nerve X, the sympathetic trunk, and 4.6 cm (SD 2.4) of ICA. Mandibulectomy allowed for complete ECA exposure, cranial nerve IX, lingual nerve, and 6.9 cm (SD 1.3) of ICA. Approaches for the parapharyngeal space must be based on anatomic and biological patient factors. This study provides a guide for the skull base surgeon for an extended approach based on the desired anatomic exposure. N/A. Laryngoscope, 127:585-591, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. 21 CFR 882.4370 - Pneumatic cranial drill motor.

    Science.gov (United States)

    2010-04-01

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

  13. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    Science.gov (United States)

    2010-07-01

    ... peripheral. 4.123 Section 4.123 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

  14. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... electrotherapy stimulator. (a) Identification. A cranial electrotherapy stimulator is a device that applies...

  15. Cranial nerve palsies in Nigerian children | Eyong | Nigerian Journal ...

    African Journals Online (AJOL)

    Background: Cranial nerve palsies are common clinical problem routinely encountered in neurological practice; the dysfunction can occur at any point in the course of the nerve and may point to serious pathology. The aim of this study was to determine the pattern and underlying aetiology of cranial nerve palsies in Nigerian ...

  16. Comparison between cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs.

    Science.gov (United States)

    Gaitero, Luis; Nykamp, Stephanie; Daniel, Rob; Monteith, Gabrielle

    2013-01-01

    Cranial thoracic intervertebral disc herniations have been reported to be rare in dogs due to the presence of the intercapital ligament, however some studies have proposed they may not be uncommon in German Shepherd dogs. The purpose of this retrospective study was to compare cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs (control group). Medical records at the Ontario Veterinary College were searched for German Shepherd dogs and other large breed dogs that had magnetic resonance imaging studies including the T1-T9 region. For each dog and each disc space from T1-T9, three variables (compression, disc degeneration, and herniation) were recorded and graded based on review of sagittal T2-weighted images. Twenty-three German Shepherd dogs and 47 other large breed dogs met inclusion criteria. The German Shepherd dog group had higher scores than the control group for compression (P = 0.0099) and herniation (P dog group, intervertebral discs T2-T3 and T4-T5 had an increased risk for compression and T3-T4 had an increased risk for compression and herniation. Findings from this study indicated that German Shepherd dogs may be more likely than other large breed dogs to have spinal cord compression due to cranial thoracic disc herniations. Imaging of the cranial thoracic spine, including T2-T3, is recommended for German Shepherd dogs with T3-L3 neurological signs. © 2012 Veterinary Radiology & Ultrasound.

  17. Cranial vault reconstruction using computer-designed polyetheretherketone (PEEK) implant: case report.

    Science.gov (United States)

    Chacón-Moya, Erika; Gallegos-Hernández, José Francisco; Piña-Cabrales, Sandra; Cohn-Zurita, Fabricio; Goné-Fernández, Alberto

    2009-01-01

    Reconstruction of the bones of the skull is a complex procedure and represents a challenge for the surgical team. It is generally performed in patients who have loss of the cranial vault secondary to chronic infection or uncontrolled osteoradionecrosis, indicating a greater chance of failure or rejection of the materials used for repair of the defect. Selection of material to replace the cranial vault is complex due to the diversity of existing products. The ideal material is inert, lightweight, easy to fit and adaptable to the defect, offering the best aesthetic and functional results. Computer design of the implant makes this process easier by providing an implant specific to each individual patient and defect. We report the case of a patient who was diagnosed with esthesioneuroblastoma and was treated with anterior craniofacial resection and radiotherapy. Osteomyelitis and osteoradionecrosis were consequent complications with loss of the cranial vault in the frontal region. The defect was reconstructed with a polyetheretherketone (PEEK) computer-designed implant based on the defect evaluated by computed tomography. Results obtained are shown below. The PEEK computer-designed implant is a safe and easy to use alternative with great adaptability to cranial vault defects.

  18. A population of caudally migrating cranial neural crest cells: functional and evolutionary implications.

    Science.gov (United States)

    McGonnell, I M; McKay, I J; Graham, A

    2001-08-15

    The deployment of the cranial neural crest is central to the patterning of the skeletomuscular elements of the vertebrate head, with cranial muscles invariably attaching to skeletal elements formed by crest from the same axial level. Here we demonstrate, through gene expression analysis, ablation studies and fate-mapping, the existence of a population of caudally migrating cranial crest that arise from the postotic neural tube. As with the rest of the postotic crest, these cells express the transcription factor Mafb, and this marker can be used to highlight their posterior migration. They pass out between the anterior somite and the otic vesicle, before turning caudally and running along the base of the somites. With long-term fate mapping, we show that these cells migrate to the clavicle and settle at the site of formation of the attachment point for the cleidohyoid muscle. As such, the influence of the cranial neural crest in organising skeletomuscular connectivity seems to extend beyond the head into the trunk. These results are of further importance as they help explain how, even though the pectoral girdle and the skull became physically dissociated during tetrapod evolution, skeletomuscular connectivity has been maintained. Copyright 2001 Academic Press.

  19. Neonatal cranial sonography: A concise review for clinicians

    Science.gov (United States)

    Gupta, Pankaj; Sodhi, Kushaljit Singh; Saxena, Akshay Kumar; Khandelwal, Niranjan; Singhi, Pratibha

    2016-01-01

    Cranial sonography continues to hold an important place in neonatal care. Attributes favorable to sonography that make it almost indispensable for routine care of the newborn includes easy access, low cost, portability, lack of ionizing radiations and exemption from sedation or anaesthesia. Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL); hydrocephalus resulting from multitude of causes and hemorrhage. Not withstanding this, cranial sonography has yielded results for a repertoire of indications. Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation. Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma. In this review, we discuss the technique, normal and variant anatomy as well as disease entities of neonatal cranial sonography. PMID:27195026

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

    Science.gov (United States)

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

    2017-03-01

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

  1. Application of cement on strategic vertebrae in the treatment of the osteoporotic spine.

    Science.gov (United States)

    Erdem, Mehmet Nuri; Karaca, Sinan; Sarı, Seckin; Yumrukcal, Feridun; Tanli, Ruhat; Aydogan, Mehmet

    2017-03-01

    The application of pedicle screws with cement to strengthen the fixation of the osteoporotic spine has increasingly gained popularity. However, the technique has also led to an increase in cement-related complications. The aim of the present study was to compare the clinical and radiological results of the patients with degenerative spinal pathologies who were treated with pedicle screws and cement injections on all segments versus those who were treated with cement injections only on the strategic vertebrae selected. A retrospective clinical study. The sample consists of 31 patients who underwent spinal surgery due to degenerative spinal pathologies. Patients were assessed for the adequate spinal fusion and cement-related complication parameters. Thirty-one patients with a minimum follow-up period of 2 years were divided into two groups and evaluated. Group A consisted of 17 patients (14 females, 3 males; mean age: 68.1 years) with cemented pedicle screws and Group B consisted of 14 patients (12 females, 2 males; mean age: 67.2 years) with cemented screws on selected vertebrae alone. Selection of the strategic vertebrae was made by taking the most stressed regions in the fusion site into account. Prophylactic vertebroplasty was performed in all patients in Group A and on strategic segments in Group B to avoid an adjacent segment fracture. Early- and late-term complications during the follow-up period were recorded. Mean follow-up period was 51.8 (range: 31 to 80) months in Group A and 41.2 (range: 26 to 61) months in Group B. Cemented pedicle screws were bilaterally placed on 94 vertebrae in Group A. In Group B, cement was applied on 28 of 80 vertebrae. Including the prophylactic vertebroplasties, a total of 111 cement applications were performed in Group A and 38 in Group B. Cement embolism, symptomatic chest discomfort, and duration of surgery were significantly higher in Group A (pstrategic vertebrae alone will enhance the fixation strength and endurance and

  2. Outcome Analysis of Cranial Molding Therapy in Nonsynostotic Plagiocephaly

    Directory of Open Access Journals (Sweden)

    Han-Su Yoo

    2012-07-01

    Full Text Available BackgroundIt is known that nonsynostotic plagiocephaly does not spontaneously improve, and the craniofacial deformities that result from it. This study was conducted to analyze the effectiveness of helmet therapy for the nonsynostotic plagiocephaly patient, and to suggest a new treatment strategy based on this analysis.MethodsA total of 108 pediatric patients who had undergone helmet therapy after being diagnosed with nonsynostotic plagiocephaly were included in this study. The patients were classified according to the initiation age of the helmet therapy, severity, and helmet wearing time. The treatment effect was compared using cranial vault asymmetry (CVA and the cranial vault asymmetry index (CVAI, which were obtained from diagonal measurements before and after therapy.ResultsThe discrepancy of CVA and CVAI of all the patients significantly decreased after helmet therapy. According to the initiation time of helmet therapy, the treatment effect was best at 5 months old or less. The helmet wearing time per day was proportional to the treatment effect up to 20 hours. In addition, the rate of the successful treatment (final CVA ≤5 mm significantly decreased when the initiation age was 9.1 months or older and the treatment period was less than 7.83 months.ConclusionsThis study showed the effectiveness of the helmet therapy for nonsynostotic plagiocephaly patients. Based on analysis of this study, helmet therapy should be started at the age of 9 months or younger for 7.83 months or more, and the helmet wearing time should be more than 20 hours a day.

  3. Experimental dosimetric evaluation of inhomogeneity effects caused by thoracic vertebrae; Avaliacao dosimetrica experimental de efeitos de inomogeneidade causados por vertebras toracicas

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Andre L.S.; Thompson, Larissa; Campos, Tarcisio P.R., E-mail: radioterapia.andre@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear; Instituto de Radioterapia Sao Francisco, Belo Horizonte, MG (Brazil); Centro de Tratamento em Radioterapia, Betim, MG (Brazil)

    2017-11-01

    The presence of tissue inhomogeneities alters the absorbed dose distribution, which magnitude depends on the physical properties of these tissues and the quality of the radiation. Incorrect assessment of dose distribution may affect local tumor control or increase the normal tissue complication probabilities. The aim of this study was to investigate the influence of the thoracic vertebrae inhomogeneous effects on the dose absorbed by the surrounding soft tissue. The values predicted by the treatment planning system (TPS) were compared to the experimental measurements with EBT-2 radiochromic films positioned on a simulator consisting of only water and inserted axially into a thoracic phantom made of synthetic bone and water. There was a significant change in the dose distribution pattern, increased absorbed dose at the bone-soft tissue interface and high point doses adjacent to the bone compared to the results obtained for the films in homogeneous medium and TPS. The experimental measurements in the water agreed with the TPS within 1.0% with respect to the modal dose whereas the biggest difference found for the medium containing the vertebrae was of 4.6%, however, both values are within the experimental uncertainty. (author)

  4. Bilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report.

    Science.gov (United States)

    Koakutsu, Tomoaki; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin; Itoi, Eiji

    2012-03-01

    Lumbar spondylolysis, a well known cause of low back pain, usually affects the pars interarticularis of a lower lumbar vertebra and rarely involves the articular processes. We report a rare case of bilateral spondylolysis of inferior articular processes of L4 vertebra that caused spinal canal stenosis with a significant segmental instability at L4/5 and scoliosis. A 31-year-old male who had suffered from low back pain since he was a teenager presented with numbness of the right lower leg and scoliosis. Plain X-rays revealed bilateral spondylolysis of inferior articular processes of L4, anterolisthesis of the L4 vertebral body, and right lateral wedging of the L4/5 disc with compensatory scoliosis in the cephalad portion of the spine. MR images revealed spinal canal stenosis at the L4/5 disc level. Posterior lumbar interbody fusion of the L4/5 was performed, and his symptoms were relieved.

  5. Grade 4 spondylolisthesis of the L5 vertebra associated with dural ectasia in neurofibromatosis.

    Science.gov (United States)

    Modi, H N; Srinivasalu, S; Suh, S W; Yang, J H

    2009-08-01

    Spondylolisthesis associated with neurofibromatosis is rare, and only 12 cases have been reported so far. However, only one report of grade 4 spondylolisthesis with neurofibromatosis has been reported in the literature. A 15-year-old boy with neurofibromatosis was admitted for back pain and neurological claudication. Radiograph showed grade 4 spondylolisthesis of the L5 vertebra with scalloping of the L4-L5 vertebrae. L4-L5 laminectomy, reduction, L3-S1 posterior instrumentation and fusion were performed. The reduction of the spondylisthesis was done entirely from the posterior approach using pedicle screws. Radiography at four months showed a broken S1 screw with a loss of reduction. The patient was re-operated on, to provide additional stability with pelvic fixation. He was pain-free with a good fusion at the two-year follow-up. Adequate posterior stabilisation with fusion gives good results in grade 4 spondylolisthesis associated with neurofibromatosis and dural ectasia.

  6. An unusual orbito-cranial foreign body

    Directory of Open Access Journals (Sweden)

    Misra Madhumati

    1992-01-01

    Full Text Available The rarity of orbito-cranial gun shot injury in both war and civilian practice has been reported. In a large series of 351 missile head injuries in the Vietnam war, orbital penetration was noted in 0.6% cases only. Review of literature shows that orbital injury was ipsilateral to the cerebral injury in most reported cases. We have previously reported a rare case of left parieto-occipital lobe injury due to gun shot wound of the contralateral (right orbit. The case reported here sustained a bullet injury to the left frontal bone but the missile was located below the contralateral (right optic canal. The rarity of the case prompted this report.

  7. Cranial vault metastasis of giant cell tumor.

    Science.gov (United States)

    Notarianni, Christina; Abreo, Fluerette; Nanda, Anil

    2008-08-01

    Giant cell tumors are benign bony tumors involving the epiphysis of long bones. Here, we present a case of giant cell tumor involving the parietal bone that had metastasized from the sacrum. A 36-year-old healthy woman presented to neurosurgery clinic in April 2005 reporting a "bump" over the left parietal area that had been increasing in size over the past 6 months. The lesion was nontender, and the patient had no other associated neurological symptoms. As we have presented here, cranial vault metastases can occur and should be considered in a differential diagnosis of bony lesions found in this location. These distant metastases, although relatively uncommon, must be managed aggressively. Newer radiation treatments seem to be a promising favorable adjunct to wide local resection and should be investigated further for these tumors.

  8. Dose estimation for paediatric cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Curci Daros, K.A.; Bitelli Medeiros, R. [Sao Paulo Univ. Federal (Brazil); Curci Daros, K.A.; Oliveira Echeimberg, J. de [Centro Univ. Sao Camilo, Sao Paulo (Brazil)

    2006-07-01

    In the last ten years, the number of paediatric computed tomography (CT) scans have increased worldwide, contributing to higher population radiation dose. Technique diversification in paediatrics and different CT equipment technologies have led to various exposure levels complicating precise evaluation of doses and operational conditions necessary for good quality images. The objective of this study was to establish a quantitative relationship between absorbed dose and cranial region in children up to 6 years old undergoing CT exams. Methods: X-ray was measured on the cranial surface of 64 patients undergoing CT using thermoluminescent (T.L.) dosimeters. Forty T.L.D.100 thermoluminescent dosimeters (T.L.D.) were evenly distributed on each patients skin surface along the sagittal axis. Measurements were performed in facial regions exposed to scatter radiation and in the supratentorial and posterior fossa regions, submitted to primary radiation. T.L.D. were calibrated for 120 kV X-ray over the acrylic phantom. T.L. measurements were made with a Harshaw 4000 system. Patient mean T.L. readings were determined for position, pi, of T.L.D. and normalized to the maximum supratentorial reading. From integrating the linear T.L. density function (?) resulting from radiation distribution in each of the three exposed regions, dose fraction was determined in the region of interest, along with total dose under the technical conditions used in that specific exam protocol. For each T.L.D. position along the patient cranium, there were n T.L. measurements with 2% uncertainty due to T.L. reader, and 5% due to thermal treatment of dosimeters. Also, mean T.L. readings and their uncertainties were calculated for each patient at each position, p. Results: Mean linear T.L. density for the region exposed to secondary radiation defined by position, 0.3{<=}p{<=}6 cm, was {rho}((p)=7.9(4)x10{sup -2}+7(5)x10{sup -5}p{sup 4.5(4)} cm{sup -1}; exposed to primary X-ray for the posterior fossa

  9. Cranial computed tomography in acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Thajeb, P.; Chen, S.T.

    1989-03-01

    Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory disorder of the nervous system. The appearance of ADEM on cranial CT scans has rarely been reported. The author reports seven cases in two institutions during a period of seven years. Only four of the seven patients had hypodense lesions in the white matter and six patients showed spotty, nodular, or gyral enhancement after contrast injections. The enhancement resolved with steroid therapy, leaving some persistent hypoattenuated areas even after 10 months follow-up, these findings support the dual components of the pathogenesis of ADEM. The vasculitic component may be responsive to steroids, nevertheless the demyelinating or necrotic areas may not, and the latter may be responsible for the sequelae of ADEM.

  10. Sirenomelia sequence according to the distance between the first sacral vertebra and the ilia

    DEFF Research Database (Denmark)

    Kjær, Klaus Wilbrandt; Keeling, Jean W; Opitz, John M

    2003-01-01

    the ilia caudally and medially and that the degree of this displacement might correlate with the severity of the iliac and lower limb defects. Thus the purpose of the study was to test this hypothesis in a sample of 12 sirenomelic fetuses. The fetuses GA 16-39 weeks, spontaneously or therapeutically...... aborted, were radiographed in the frontal projection as part of a requested autopsy. From each radiograph, a line was drawn connecting the most cranial part or the two ilia. After that the distance was measured vertically between this line and the most cranial part of the first sacral vertebral body...

  11. Hemiplegic peripheral neuropathy accompanied with multiple cranial nerve palsy

    Directory of Open Access Journals (Sweden)

    Hirohisa Okuma

    2012-03-01

    Full Text Available A 32-year-old man experienced double vision around January, 2010, followed by weakness of his left upper and lower extremities. Articulation disorders and loss of hearing in his left ear developed, and he was admitted to our hospital on February 14, 2010. Physical examination was normal, and neurological examination showed clear consciousness with no impairment of cognitive function, but with articulation disorders. Olfactory sensation was reduced. Left ptosis and left gaze palsy, complete left facial palsy, perceptive deafness of the left ear, and muscle weakness of the left trapezius muscle were observed. Paresis in the left upper and lower extremities was graded 4/5 through manual muscle testing. Sensory system evaluation revealed complete left-side palsy, including the face. Deep tendon reflexes were slightly diminished equally on both sides; no pathologic reflex was seen. No abnormality of the brain parenchyma, cerebral nerves or cervicothoracolumbar region was found on brain magnetic resonance imaging. On electroencephalogram, alpha waves in the main frequency band of 8 to 9 Hz were recorded, indicating normal findings. Brain single photon emission computed tomography (SPECT scan showed reduced blood flow in the right inner frontal lobe and both occipital lobes. Nerve biopsy (left sural nerve showed reduction of nerve density by 30%, with demyelination. The patient also showed manifestations of multiple cranial nerve disorder, i.e., of the trigeminal nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve. Whole-body examination was negative. Finally, based on ischemic brain SPECT images, spinal fluid findings and nerve biopsy results, peripheral neuropathy accompanied with multiple cranial nerve palsy was diagnosed.

  12. Asymmetric lumbosacral transitional vertebra and subsequent disc protrusion in a cocker spaniel.

    Science.gov (United States)

    Archer, Rebecca; Sissener, Thomas; Connery, Neil; Spotswood, Tim

    2010-03-01

    A 10-year-old cocker spaniel bitch presented with severe lumbosacral pain and acute onset left pelvic limb lameness. A diagnosis of asymmetric lumbosacral transitional vertebra with disc protrusion at L6-L7 was made by computed tomography. The cauda equina and left L6 nerve root were surgically decompressed with a dorsal laminectomy and lateral foraminotomy, which led to rapid resolution of the clinical signs.

  13. The Mammalian Cervical Vertebrae Blueprint Depends on the T (brachyury) Gene

    OpenAIRE

    Kromik, Andreas; Ulrich, Reiner; Kusenda, Marian; Tipold, Andrea; Stein, Veronika M.; Hellige, Maren; Dziallas, Peter; Hadlich, Frieder; Widmann, Philipp; Goldammer, Tom; Baumgärtner, Wolfgang; Rehage, Jürgen; Segelke, Dierck; Weikard, Rosemarie; Kühn, Christa

    2015-01-01

    A key common feature of all but three known mammalian genera is the strict seven cervical vertebrae blueprint, suggesting the involvement of strong conserving selection forces during mammalian radiation. This is further supported by reports indicating that children with cervical ribs die before they reach reproductive age. Hypotheses were put up, associating cervical ribs (homeotic transformations) to embryonal cancer (e.g., neuroblastoma) or ascribing the constraint in cervical vertebral cou...

  14. Radiographic Assessment of Skeletal Maturation Stages for Orthodontic Patients: Hand-wrist Bones or Cervical Vertebrae?

    OpenAIRE

    Lai, Eddie Hsiang-Hua; Liu, Jen-Pei; Chang, Jenny Zwei-Chieng; Tsai, Shih-Jaw; Yao, Chung-Chen Jane; Chen, Mu-Hsiung; Chen, Yi-Jane; Lin, Chun-Pin

    2008-01-01

    The skeletal maturation status of a growing patient can influence the selection of orthodontic treatment procedures. Either lateral cephalometric or hand-wrist radiography can be used to assess skeletal development. In this study, we examined the correlation between the maturation stages of cervical vertebrae and hand-wrist bones in Taiwanese individuals. Methods: The study group consisted of 330 male and 379 female subjects ranging in age from 8 to 18 years. A total of 709 hand-wrist and ...

  15. Extraction of the Cervical Vertebrae from Panoramic X-ray image

    OpenAIRE

    山本, 純平; Yamamoto, Junpei

    2015-01-01

    AbstractThe purpose of this study is to remove the cervical vertebrae from a dental panoramic x-ray image with a tomosynthesis method. We developed a new method to remove the cervicalvertebrae from dental panoramic x-ray image. In this paper we removed artifacts causedby metalic objects in the teeth raw. To detect this area, we used a photon counting x-ray detector. The accuracy of the proposed method was validated with clinical data.

  16. Comparison of Cranial Facet Joint Violation Rate Between Percutaneous and Open Pedicle Screw Placement

    Science.gov (United States)

    Wang, Liang; Wang, Yipeng; Yu, Bin; Li, Zhengyao; Li, Ye

    2015-01-01

    Abstract Percutaneous and open pedicle screw placements have been widely used in lumbar fusion surgery. However, there are conflicting reports of cranial facet joint violation rate for the 2 techniques. To better determine the rate of cranial facet joint violation, a systematic review and meta-analysis was performed in the present study. We searched the established electronic literature databases including MEDLINE, EMBASE, World of Science, and the Cochrane Central Register of Controlled Trials databases for trials involving the 2 pedicle screw placement techniques. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Four comparative trials with a cumulative sample size of 881 patients and 1755 cranial pedicle screws were identified and analyzed. The results showed that cranial facet joint violation rate was 18.18% (154/847) in percutaneous group and 18.72% (170/908) in open group. The pooled data revealed that there was no significant difference in the violation rate (OR 0.75, 95% CI 0.24–2.30, P = 0.62). In addition, there was also no significant difference for the rate of severe violation between the 2 techniques (OR 1.20, 95% CI 0.55–2.62, P = 0.64, random effect model). Based on the current data, the meta-analysis shows that similar cranial facet joint violation rate occurs during the percutaneous and open pedicle screw placement techniques. In addition, taking the limitations of this study into consideration, it was still not appropriate to draw such a strong conclusion. More well-designed prospective randomized controlled trials are needed to assess violation rate for the 2 techniques in the future. PMID:25654397

  17. A head phantom study for intraocular dose evaluation of 64-slice multidetector CT examination in patients with suspected cranial trauma

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Kosuke, E-mail: matsuk@mhs.mp.kanazawa-u.ac.jp [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Koshida, Kichiro [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Noto, Kimiya; Takata, Tadanori [Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Suzuki, Masayuki [Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Shimono, Tetsunori [Department of Radiology, Hoshigaoka Koseinenkin Hospital, Hirakata, Osaka (Japan); Yamamoto, Tomoyuki [Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Matsui, Osamu [Department of Radiology, Faculty of Medicine, Kanazawa University, Kanazawa, Ishikawa (Japan)

    2011-08-15

    Purpose: In cases of suspected cranial trauma, cranial CT examinations should be performed to rule out pathology. There are some methods available for reducing intraocular doses; however, it is difficult for the operators to conduct the necessary measurements because of restrictions in time and patient mobility, especially in high-energy trauma cases. Therefore, we performed a head phantom study for intraocular dose evaluation of 64-slice multidetector CT examination in patients with suspected cranial trauma. Materials and methods: Assuming that the orbitomeatal (OM) line and bed were vertical, a head phantom was tilted from 10 degrees caudally to 25 degrees cranially at 5-degree intervals. At each tilted position, the phantom was examined using a 64-section multidetector CT device using three acquisition protocols. Intraocular doses during each examination were measured using small dosimeters. Results: Assuming that the OM line and bed were vertical, intraocular doses varied between 52 and 140%, 17-138%, and 90-142% during helical, non-helical, and helical CT angiographic examinations, respectively. Intraocular doses increased when the phantom was tilted cranially. Conclusion: If possible, the best way to reduce the intraocular dose is by angling the gantry cranially, tilting the head of each patient caudally and adopting a non-helical acquisition method. During procedure, the acquisition angle should be angled cranially more than 0 degrees based on the OM line. The estimation of intraocular dose using the acquisition angle and displayed volumetric CT dose index might be useful to evaluate the deterministic effect risks and to inform patients about the associated risks.

  18. EDGE DETECTION OF THE SCOLIOTIC VERTEBRAE USING X-RAY IMAGES

    Directory of Open Access Journals (Sweden)

    P. MOHANKUMAR

    2016-02-01

    Full Text Available Bones act as a mineral storage reservoir for calcium and phosphorus. Proper well grown bones give a perfect posture to the human body. In other case, if the bone has an improper growth, it might lead to an abnormal posture or an awkward posture. Scoliosis is a condition where the scoliotic vertebrae are wedge shaped and differ with the shape of normal vertebrae. Treatment for scoliosis depends on Cobb angle which can be measured using spine X-rays. Recent development in the medical imaging techniques brought us to a new research area in image processing which includes medical image enhancement, detailed visualization of internal organs & tissues and edge detection. Bone edges are important feature in an X-ray image. The purpose of application of segmentation in medical imaging is to develop a detailed framework on human anatomy, whose primary objective is to outline the anatomical structures. Whereas edge detection is a technique which extracts vital features like corners, lines, angles and curves from an image. In this study, we are going to deal with the edge detection technique on scoliotic vertebrae. The objective of this paper is to compare the performance of edge detectors using filters and operators.

  19. Mechanical properties of sand tiger shark (Carcharias taurus) vertebrae in relation to spinal deformity.

    Science.gov (United States)

    Huber, Daniel R; Neveu, Danielle E; Stinson, Charlotte M; Anderson, Paul A; Berzins, Ilze K

    2013-11-15

    Approximately 35% of sand tiger sharks (Carcharias taurus) in public aquaria exhibit spinal deformities ranging from compressed vertebrae and loss of intervertebral space to dislocated spines with vertebral degeneration and massive spondylosis caused by excessive mineralization both within vertebrae and outside the notochordal sheath. To identify the mechanical basis of these deformities, vertebral centra from affected (N=12) and non-affected (N=9) C. taurus were subjected to axial compression tests on an MTS 858 Bionix material testing system, after which mineral content was determined. Vertebral centra from affected sharks had significantly lower mineral content and material behavior in nearly all variables characterizing elasticity, plasticity and failure. These mechanical deficiencies are correlated with size at capture, capture method, vitamin C and zinc deficiency, aquarium size and swimming behavior in public aquaria. Non-affected C. taurus had greater stiffness and toughness even though these properties are generally incompatible in mineralized structures, suggesting that the biphasic (mineralized, unmineralized phases) nature of chondrichthyan vertebrae yields material behavior not otherwise observed in vertebrate skeletons. However, vertebral centra from non-affected sharks had lower mineral content (33%), stiffness (167 MPa), yield strain (14%) and ultimate strength (16 MPa) than other species of sharks and bony vertebrates, indicating that biomechanical precautions must be taken in the husbandry of this species.

  20. Cranial shape and correlated characters in crocodilian evolution.

    Science.gov (United States)

    Sadleir, Rudyard W; Makovicky, Peter J

    2008-11-01

    Crocodilians show a high degree of cranial variation and convergence throughout their 80 million-year fossil record that complicates their phylogenetic reconstruction. Conflicting phylogenetic results from different data partitions and character homoplasies typify crocodilian phylogeny, and differences between molecular and morphological phylogenetic hypotheses are believed to be associated with the slender-snout skull shape of Gavialis gangeticus and Tomistoma schlegelii. Slender-snout skulls are one of five identified eusuchian cranial ecomorph shape categories (ESCs) thought to reflect functional or ecological specialization. This paper tested the effect of transitions among general, blunt and slender ESCs on cranial character-state distributions in phylogeny using the concentrated changes test. In addition, 'tree-free' character compatibility analysis of character independence was conducted on the morphological character matrix to determine if character correlations are observed independent of specific tree topologies. Results suggest cranial ESCs do affect cranial character-state gains in phylogeny. Concentrated changes identify a broad suite of character-state changes that significantly correlate with transitions to slender, general and blunt ESCs on morphological, molecular and combined-data tree topologies, but numbers of correlated characters for each category differ according to topology. Character compatibility analysis results do not mirror the concentrated changes test results and reflect hierarchically distributed support throughout the data. As cranial ESCs affect character-state transitions, it is possible that nonphylogenetic variables could affect inferences of crocodilian phylogeny by affecting cranial morphology.

  1. Primary cranial mediastinal hemangiosarcoma in a young dog

    Science.gov (United States)

    2014-01-01

    Primary cranial mediastinal hemangiosarcomas are uncommon tumors. A 30-kg, 2-year-old, intact female German shepherd was presented for evaluation of cachexia and respiratory distress of a few days’ duration. Lateral radiographic projection of the thorax revealed significant pleural effusion. Computed tomography revealed a cranial mediastinal mass effect adjacent to the heart. On surgical exploration, a pedunculated mass attached to the esophagus, trachea, brachiocephalic trunk, left subclavian artery and cranial vena cava without attachment to the right atrium and auricular appendage was removed and debrided by use of blunt dissection and dry gauzes, respectively. Histopathology results described the cranial mediastinal mass as hemangiosarcoma. At 8 months and 5 days post-operatively, the patient died. Primary cranial mediastinal hemangiosarcomas, although a seemingly rare cause of thoracic pathology in young dogs, should be considered in the differential diagnosis for pleural effusion and soft tissue mass effect in the cranial mediastinum. This is the first case report in a dog to describe primary cranial mediastinal hemangiosarcoma. PMID:25089185

  2. Spontaneous carotid dissection presenting lower cranial nerve palsies.

    Science.gov (United States)

    Guidetti, D; Pisanello, A; Giovanardi, F; Morandi, C; Zuccoli, G; Troiso, A

    2001-03-01

    Cranial nerve palsy in internal carotid artery (ICA) dissection occurs in 3--12% of all patients, but in 3% of these a syndrome of hemicranias and ipsilateral cranial nerve palsy is the sole manifestation of ICA dissection, and in 0.5% of cases there is only cranial nerve palsy without headache. We present two cases of lower cranial nerve palsy. The first patient, a 49-year-old woman, developed left eleventh and twelfth cranial nerve palsies and ipsilateral neck pain. The angio-RM showed an ICA dissection with stenosis of 50%, beginning about 2 cm before the carotid channel. The patient was treated with oral anticoagulant therapy and gradually improved, until complete clinical recovery. The second patient, a 38-year-old woman, presented right hemiparesis and neck pain. The left ICA dissection, beginning 2 cm distal to the bulb, was shown by ultrasound scanning of the carotid and confirmed by MR angiogram and angiography with lumen stenosis of 90%. Following hospitalisation, 20 days from the onset of symptoms, paresis of the left trapezius and sternocleidomastoideus muscles became evident. The patient was treated with oral anticoagulant therapy and only a slight right arm paresis was present at 10 months follow-up. Cranial nerve palsy is not rare in ICA dissection, and the lower cranial nerve palsies in various combinations constitute the main syndrome, but in most cases these are present with the motor or sensory deficit due to cerebral ischemia, along with headache or Horner's syndrome. In the diagnosis of the first case, there was further difficulty because the cranial nerve palsy was isolated without hemiparesis, and the second case presented a rare association of hemiparesis and palsy of the eleventh cranial nerve alone. Compression or stretching of the nerve by the expanded artery may explain the palsies, but an alternative cause is also possible, namely the interruption of the nutrient vessels supplying the nerve, which in our patients is more likely.

  3. High-resolution Whole-Genome Analysis of Skull Base Chordomas Implicates FHIT Loss in Chordoma Pathogenesis

    Directory of Open Access Journals (Sweden)

    Roberto Jose Diaz

    2012-09-01

    Full Text Available Chordoma is a rare tumor arising in the sacrum, clivus, or vertebrae. It is often not completely resectable and shows a high incidence of recurrence and progression with shortened patient survival and impaired quality of life. Chemotherapeutic options are limited to investigational therapies at present. Therefore, adjuvant therapy for control of tumor recurrence and progression is of great interest, especially in skull base lesions where complete tumor resection is often not possible because of the proximity of cranial nerves. To understand the extent of genetic instability and associated chromosomal and gene losses or gains in skull base chordoma, we undertook whole-genome single-nucleotide polymorphism microarray analysis of flash frozen surgical chordoma specimens, 21 from the clivus and 1 from C1 to C2 vertebrae. We confirm the presence of a deletion at 9p involving CDKN2A, CDKN2B, and MTAP but at a much lower rate (22% than previously reported for sacral chordoma. At a similar frequency (21%, we found aneuploidy of chromosome 3. Tissue microarray immunohistochemistry demonstrated absent or reduced fragile histidine triad (FHIT protein expression in 98% of sacral chordomas and 67%of skull base chordomas. Our data suggest that chromosome 3 aneuploidy and epigenetic regulation of FHIT contribute to loss of the FHIT tumor suppressor in chordoma. The finding that FHIT is lost in a majority of chordomas provides new insight into chordoma pathogenesis and points to a potential new therapeutic target for this challenging neoplasm.

  4. Selection of distal fusion level in posterior instrumentation and fusion of Scheuermann kyphosis: is fusion to sagittal stable vertebra necessary?

    National Research Council Canada - National Science Library

    Yanik, Hakan Serhat; Ketenci, Ismail Emre; Coskun, Tamer; Ulusoy, Ayhan; Erdem, Sevki

    2016-01-01

    .... The purpose of this study was to investigate the occurrence of DJK in relation to distal fusion level selection in SK surgery by investigating the relationship between the sagittal stable vertebra (SSV...

  5. Estado de maduracion osea de las vertebras cervicales en una poblacion colombiana con y sin labio y paladar fisurado

    National Research Council Canada - National Science Library

    Gonzalez Carrera, Maria Clara; Martinez, Claudia Marcela; Mora Diaz, Ingrid; Bautista Mendoza, Gloria Rocio; Palmet Orozco, Sara

    2014-01-01

    Proposito: Comparar el estado de maduracion osea en radiografias de perfil en una poblacion colombiana con y sin labio y paladar fisurado por medio del analisis de maduracion de vertebras cervicales (MVC). Metodos...

  6. Multiple Cranial Nerve Palsy Due to Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Esra Eruyar

    2017-04-01

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

  7. Patterns of cranial venous system from the comparative anatomy in vertebrates. Part I, introduction and the dorsal venous system.

    Science.gov (United States)

    Aurboonyawat, T; Suthipongchai, S; Pereira, V; Ozanne, A; Lasjaunias, P

    2007-12-01

    Many classifications of the cerebral venous system are found in the literature but they are seldom based on phylogenic study. Among vertebrates, venous drainage of the brain vesicles differs depending on the species. Due to the variability, poorly descriptive articles, and many different names used for the veins, the comparative study of the cranial venous system can hardly be performed in detail. The cranial venous system in vertebrates can be divided into three systems based on the evolution of the meninges and structures of the brain vesicles: the dorsal, lateral-ventral and ventricular systems. This study proposes a new classification of the venous drainage of brain vesicles using knowledge from a comparative study of vertebrates and focusing on the dorsal venous system. We found that the venous drainage of the neopallium and neocerebellum is involved with this system which may be a recent acquisition of cranial venous evolution.

  8. VARIATION IN THE MORPHOLOGY OF ATLAS VERTEBRAE IN DIFFERENT SKELETAL PATTERNS: A THREE – DIMENSIONAL COMPUTED TOMOGRAPHY EVALUATION

    OpenAIRE

    Prajakta; Sunita,; Ranjit H; Narendra

    2015-01-01

    OBJECTIVE : The morphology of the atlas vertebrae seems to be affected by the head posture , age , congenital anomalies and the skeletal growth pattern. The present study was carried out to assess the variation in the morphology of atlas vertebrae in different vertical skeletal patterns MATERIAL AND METHOD: Cone - beam computed tomography images of 45 adu lt subjects aged 18 to 35 years were evaluated. Subjects constituted three groups: group 1; avera...

  9. [Clinical observation on auricular point sticking for treatment of 25 children of semiluxation of circo-axis vertebrae].

    Science.gov (United States)

    Chang, Ying; Liu, Ya-Bin; He, Jun-Jun

    2006-10-01

    To search for the best method for child semiluxation of circo-axis vertebrae. Fifty cases were randomly divided into a treatment group of 25 cases treated with auricular point sticking, and a control group of 25 cases treated with normal acupuncture. The total effective rate was 92.0% in the treatment group and 64.0% in the control group with a significant difference between the two groups (P circo-axis vertebrae.

  10. Role of cranial computed tomography in human immunodeficiency ...

    African Journals Online (AJOL)

    Role of cranial computed tomography in human immunodeficiency virus-positive patients with generalised seizures. ... examination remains controversial, with the general impression being that emergency imaging is necessary because immunosuppression may blur clinical indicators of acute intracranial pathology.

  11. Ecological correlates to cranial morphology in Leporids (Mammalia, Lagomorpha

    Directory of Open Access Journals (Sweden)

    Brian P. Kraatz

    2015-03-01

    Full Text Available The mammalian order Lagomorpha has been the subject of many morphometric studies aimed at understanding the relationship between form and function as it relates to locomotion, primarily in postcranial morphology. The leporid cranial skeleton, however, may also reveal information about their ecology, particularly locomotion and vision. Here we investigate the relationship between cranial shape and the degree of facial tilt with locomotion (cursoriality, saltation, and burrowing within crown leporids. Our results suggest that facial tilt is more pronounced in cursors and saltators compared to generalists, and that increasing facial tilt may be driven by a need for expanded visual fields. Our phylogenetically informed analyses indicate that burrowing behavior, facial tilt, and locomotor behavior do not predict cranial shape. However, we find that variables such as bullae size, size of the splenius capitus fossa, and overall rostral dimensions are important components for understanding the cranial variation in leporids.

  12. Accounting for cranial vault growth in experimental design.

    Science.gov (United States)

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

    2014-05-01

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

  13. Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review.

    Science.gov (United States)

    Jäkel, Anne; von Hauenschild, Phillip

    2011-12-01

    Cranial osteopathic manipulative medicine (OMM) involves the manipulation of the primary respiratory mechanism to improve structure and function in children and adults. To identify and critically evaluate the literature regarding the clinical efficacy of cranial OMM. The clinical keywords "cranial manipulation" OR "osteopathy in the cranial field" OR "cranial osteopathy" OR "craniosacral technique" were searched in the following electronic databases: EMBASE, MEDLINE In-Process & Other Non-Indexed Citations, The Cochrane Central Register of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and AMED (Alternative Medicine). Searches were conducted in April 2011 with no date restriction for when the studies were completed. Randomized controlled trials and observational studies that measured the effectiveness of cranial OMM on humans were included in the study. Exclusion criteria included non-English language articles, studies not relevant to cranial OMM, animal studies, and studies in which there was no clear indication of the use of cranial OMM. Studies that described the use of cranial OMM with other treatment modalities and that did not perform subgroup analysis were also excluded. The present study did not have criteria regarding type of disease. Outcome measures on pain, sleep, quality of life, motor function, and autonomic nervous system function were extracted. The methodological quality of the trials was assessed using the Downs and Black checklist. Of the 8 studies that met the inclusion criteria, 7 were randomized controlled trials and 1 was an observational study. A range of cranial OMM techniques used for the management of a variety of conditions were identified in the included studies. Positive clinical outcomes were reported for pain reduction, change in autonomic nervous system function, and improvement of sleeping patterns. Methodological Downs and Black quality scores ranged from 14 to 23 points out of a maximum of

  14. Upper Thoracic versus Lower Thoracic as Site of Upper Instrumented Vertebrae for Long Fusion Surgery in Adult Spinal Deformity: A Meta-Analysis of Proximal Junctional Kyphosis.

    Science.gov (United States)

    Luo, Ming; Wang, Pu; Wang, Wengang; Shen, Mingkui; Xu, Genzhong; Xia, Lei

    2017-06-01

    A meta-analysis was performed to compare incidence rates of radiographic and surgical proximal junctional kyphosis (PJK) between upper thoracic (UT) and lower thoracic (LT) vertebrae as site of upper instrumented vertebrae (UIV) endpoints for long fusion surgery in adult spinal deformity (ASD). MEDLINE, Embase, and Cochrane Library databases were searched for English-language articles that addressed UT versus LT fixation strategies. The division of the UT and LT groups was based on UIV. Two reviewers independently assessed the quality of the studies using the Newcastle-Ottawa Scale. Data on incidence rates of radiographic and surgical PJK were extracted from the included studies. RevMan 5.3 was used for data pooling and analysis. Ten retrospective studies comprising 1230 patients were included. Pooled data on radiographic PJK were available in 9 studies comprising 1032 patients, and total radiographic PJK rate was 32.2%. Pooled data on surgical PJK were available in 6 studies comprising 732 patients, and total surgical PJK rate was 6.7%. Decreased radiographic PJK (95% confidence interval, 0.49-0.85; P = 0.002; I2 = 48%) and surgical PJK (95% confidence interval, 0.18-0.76; P = 0.007; I2 = 22%) were found in the UT group. Radiographic PJK is a very common complication of long fusion surgery in adult spinal deformity with an incidence rate of 32.2%. Surgical PJK has an incidence rate of 6.7% and should be seriously considered. The pooled results indicate that choosing UT vertebrae as the site of UIV could decrease the incidence rates of radiographic and surgical PJK. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Cranial shape evolution in adaptive radiations of birds: comparative morphometrics of Darwin's finches and Hawaiian honeycreepers

    OpenAIRE

    Tokita, Masayoshi; Yano, Wataru; James, Helen F.; Abzhanov, Arhat

    2017-01-01

    Adaptive radiation is the rapid evolution of morphologically and ecologically diverse species from a single ancestor. The two classic examples of adaptive radiation are Darwin's finches and the Hawaiian honeycreepers, which evolved remarkable levels of adaptive cranial morphological variation. To gain new insights into the nature of their diversification, we performed comparative three-dimensional geometric morphometric analyses based on X-ray microcomputed tomography (µCT) scanning of dried ...

  16. Cranial Electrotherapy Stimulation and Influence of the Hart Rate Variability

    OpenAIRE

    Līcis, Renārs; Molotanovs, Andris; Žīdens, Jānis

    2015-01-01

    Before the competition are very important to be in optimal functional position. We were using CES to perform the functional position of optimization. Also we use CES to prescribe autonomic nervous system, analyzing the 11 handball players. After using cranial electrotherapy stimulation, we can see fundamental changes of heart rate, statistical analysis and spectral analysis indicator. After using electro cranial therapy stimulation, in one hour maximize autonomic nervous system tonus and para...

  17. Anatomic variation of cranial parasympathetic ganglia

    Directory of Open Access Journals (Sweden)

    Selma Siéssere

    2008-06-01

    Full Text Available Having broad knowledge of anatomy is essential for practicing dentistry. Certain anatomical structures call for detailed studies due to their anatomical and functional importance. Nevertheless, some structures are difficult to visualize and identify due to their small volume and complicated access. Such is the case of the parasympathetic ganglia located in the cranial part of the autonomic nervous system, which include: the ciliary ganglion (located deeply in the orbit, laterally to the optic nerve, the pterygopalatine ganglion (located in the pterygopalatine fossa, the submandibular ganglion (located laterally to the hyoglossus muscle, below the lingual nerve, and the otic ganglion (located medially to the mandibular nerve, right beneath the oval foramen. The aim of this study was to present these structures in dissected anatomic specimens and perform a comparative analysis regarding location and morphology. The proximity of the ganglia and associated nerves were also analyzed, as well as the number and volume of fibers connected to them. Human heads were dissected by planes, partially removing the adjacent structures to the point we could reach the parasympathetic ganglia. With this study, we concluded that there was no significant variation regarding the location of the studied ganglia. Morphologically, our observations concur with previous classical descriptions of the parasympathetic ganglia, but we observed variations regarding the proximity of the otic ganglion to the mandibular nerve. We also observed that there were variations regarding the number and volume of fiber bundles connected to the submandibular, otic, and pterygopalatine ganglia.

  18. Custom implant design for large cranial defects.

    Science.gov (United States)

    Marreiros, Filipe M M; Heuzé, Y; Verius, M; Unterhofer, C; Freysinger, W; Recheis, W

    2016-12-01

    The aim of this work was to introduce a computer-aided design (CAD) tool that enables the design of large skull defect (>100 [Formula: see text]) implants. Functional and aesthetically correct custom implants are extremely important for patients with large cranial defects. For these cases, preoperative fabrication of implants is recommended to avoid problems of donor site morbidity, sufficiency of donor material and quality. Finally, crafting the correct shape is a non-trivial task increasingly complicated by defect size. We present a CAD tool to design such implants for the neurocranium. A combination of geometric morphometrics and radial basis functions, namely thin-plate splines, allows semiautomatic implant generation. The method uses symmetry and the best fitting shape to estimate missing data directly within the radiologic volume data. In addition, this approach delivers correct implant fitting via a boundary fitting approach. This method generates a smooth implant surface, free of sharp edges that follows the main contours of the boundary, enabling accurate implant placement in the defect site intraoperatively. The present approach is evaluated and compared to existing methods. A mean error of 89.29 % (72.64-100 %) missing landmarks with an error less or equal to 1 mm was obtained. In conclusion, the results show that our CAD tool can generate patient-specific implants with high accuracy.

  19. The cranial morphometrics of the wildfowl (Anatidae

    Directory of Open Access Journals (Sweden)

    Pecsics Tibor

    2017-06-01

    Full Text Available Wildfowl (Anatidae are a diverse group of birds and globally distributed. These birds feed by widely varying methods, there are generalist and specialist species. In a number of vertebrate taxa trophic specializations have led to distinct differences in the morphology of the skull, like in birds. Our knowledge and understanding of the relationship between cranial morphology and feeding mechanism of wildfowl are limited. The aim of this article is to increase our knowledge of the relationship between skull shape and foraging habits and find the identifiable attributes of the differently adapted groups. We used morphometric methods with 7 linear measurements of the skull. We used principal component (PC analysis to identify the groups with different foraging habits. The PCs were related to measurements which represent the demanded muscle mass for feeding and the amount of capable food items. The grazers have a narrower bill and bigger bone surface which requires more muscle tissue than the broad billed filter-feeders. We observed the structural and functional differences between grazers and filter-feeders. There are no important differences in the bill measurements between omnivore dabbling and diving ducks. Only the bill is not enough to deduce the foraging habits.

  20. Spinopelvic alignment and sagittal balance of asymptomatic adults with 6 lumbar vertebrae.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kawabata, Shinji; Kuroiwa, Toshihiko

    2016-11-01

    The purpose of this study was to evaluate total spinal alignment in asymptomatic individuals with 6 lumbar vertebrae (LVs). The present study comprised 167 Japanese adult volunteers with no spinal symptoms. In all individuals, standing radiographs of the entire spine were taken to measure the pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), C7 sagittal vertical axis (C7SVA), T1 slope, thoracic kyphosis (TK), C2-C7 sagittal vertical axis (C2-C7 SVA), and C2-C7 lordosis (C2-C7L). We used these parameters to compare individuals with 5LVs to those with 6LVs. We performed additional investigations regarding the relationship between L6 morphological characteristics and parameters. Out of 167 individuals, 6LVs were present in 29 (17.4 %). PI was significantly greater in individuals with 6LVs (64.8° ± 9.54°) than in those with 5LVs (51.3° ± 10.1°, P < 0.0001). Individuals with 6LVs also had significantly larger SS, PT, and C7SVA values (SS: P = 0.0125, PT: P < 0.0001, C7SVA: P = 0.0172). LL tended to be nonsignificantly greater in individuals with 6LVs (P = 0.1588). All of these changes were more noticeable in individuals in whom the L6 vertebra was classified as type II and III according to the Castellvi classification. Meanwhile, the presence of 6LVs has little influence on the alignment of the superior lumber vertebrae. Asymptomatic individuals with 6LVs presented with different spinopelvic alignment compared to those with 5LVs. We need to establish a treatment strategy for symptomatic 6LV cases.

  1. The mammalian cervical vertebrae blueprint depends on the T (brachyury) gene.

    Science.gov (United States)

    Kromik, Andreas; Ulrich, Reiner; Kusenda, Marian; Tipold, Andrea; Stein, Veronika M; Hellige, Maren; Dziallas, Peter; Hadlich, Frieder; Widmann, Philipp; Goldammer, Tom; Baumgärtner, Wolfgang; Rehage, Jürgen; Segelke, Dierck; Weikard, Rosemarie; Kühn, Christa

    2015-03-01

    A key common feature all but three known mammalian genera is the strict seven cervical vertebrae blueprint, suggesting the involvement of strong conserving selection forces during mammalian radiation. This is further supported by reports indicating that children with cervical ribs die before they reach reproductive age. Hypotheses were put up, associating cervical ribs (homeotic transformations) to embryonal cancer (e.g., neuroblastoma) or ascribing the constraint in cervical vertebral count to the development of the mammalian diaphragm. Here, we describe a spontaneous mutation c.196A > G in the Bos taurus T gene (also known as brachyury) associated with a cervical vertebral homeotic transformation that violates the fundamental mammalian cervical blueprint, but does not preclude reproduction of the affected individual. Genome-wide mapping, haplotype tracking within a large pedigree, resequencing of target genome regions, and bioinformatic analyses unambiguously confirmed the mutant c.196G allele as causal for this previously unknown defect termed vertebral and spinal dysplasia (VSD) by providing evidence for the mutation event. The nonsynonymous VSD mutation is located within the highly conserved T box of the T gene, which plays a fundamental role in eumetazoan body organization and vertebral development. To our knowledge, VSD is the first unequivocally approved spontaneous mutation decreasing cervical vertebrae number in a large mammal. The spontaneous VSD mutation in the bovine T gene is the first in vivo evidence for the hypothesis that the T protein is directly involved in the maintenance of the mammalian seven-cervical vertebra blueprint. It therefore furthers our knowledge of the T-protein function and early mammalian notochord development. Copyright © 2015 by the Genetics Society of America.

  2. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study.

    Science.gov (United States)

    Bakris, G; Dickholtz, M; Meyer, P M; Kravitz, G; Avery, E; Miller, M; Brown, J; Woodfield, C; Bell, B

    2007-05-01

    Anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischaemia of the brainstem circulation and increased blood pressure (BP). Manual correction of this mal-alignment has been associated with reduced arterial pressure. This pilot study tests the hypothesis that correcting mal-alignment of the Atlas vertebra reduces and maintains a lower BP. Using a double blind, placebo-controlled design at a single center, 50 drug naïve (n=26) or washed out (n=24) patients with Stage 1 hypertension were randomized to receive a National Upper Cervical Chiropractic (NUCCA) procedure or a sham procedure. Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8, with a 90% power to detect an 8/5 mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.7+/-9.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-17+/-9 mm Hg, NUCCA versus -3+/-11 mm Hg, placebo; Pdisplacement of Atlas vertebra (1.0, baseline versus 0.04 degrees week 8, NUCCA versus 0.6, baseline versus 0.5 degrees , placebo; P=0.002). Heart rate was not reduced in the NUCCA group (-0.3 beats per minute, NUCCA, versus 0.5 beats per minute, placebo). No adverse effects were recorded. We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.

  3. Sutherland's legacy in the new millennium: the osteopathic cranial model and modern osteopathy.

    Science.gov (United States)

    Bordoni, Bruno; Zanier, Emiliano

    2015-01-01

    The concept of cranial osteopathy was introduced by W. G. Sutherland, DO, and became the foundation for setting the rules for use of skull palpation and many other techniques in the many types of dysfunctional patterns that craniosacral therapy treats. Sutherland's theories enabled modern osteopathy to develop and improve. The mechanism of primary respiration as well as the motion of neurocranial and viscerocranial sutures are phenomena intrinsic to the field and can be found in every living organism, independent of thoracic breathing and cardiac impulse. The sphenobasilar synchondrosis (ie, the joint between the base of the occiput and the body of the sphenoid bone) is the pillar supporting the concepts of craniosacral therapy. This article compares the cranial model devised by Sutherland with the present, relevant scientific research, aiming at clarifying the possibility of applying the craniosacral model in the new millennium.

  4. Assessment of lumbar vertebrae morphology by magnetic resonance imaging in osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Tosun, Oezguer [Near East University, Department of Radiodiagnostics, Faculty of Medicine, Lefkosa, Mersin (Turkey); Fidan, Fatma; Ardicoglu, Oezge [Ankara Atatuerk Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Ankara (Turkey); Erdil, Filiz; Karaoglanoglu, Mustafa [Ankara Atatuerk Education and Research Hospital, Department of Radiodiagnostics, Ankara (Turkey); Tosun, Aliye [Near East University, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Lefkosa, Mersin (Turkey)

    2012-12-15

    To investigate the lumbar spinal morphology in patients with and without osteoporosis by comparing the endplate changes, intervertebral disc changes, and vertebral heights. This is a retrospective study. Medical records of the 3,530 patients admitted to the Physical Medicine and Rehabilitation outpatient clinics with low back pain between August 2010 and August 2011 were retrospectively reviewed. A total of 64 patients of whom 57 were females (89.1 %) and seven were males (10.9 %) were included in the study. Participants were divided into an osteoporosis group, an osteopenia group, and a nonosteoporotic control group, according to bone mineral densities. In this study, mid heights of L3, L4, and L5 vertebrae were found to be higher in the normal group than in both the osteopenic and osteoporotic groups. Mid part heights of L1-2, L2-3, and L5-S1 intervertebral discs were significantly lower in the normal group when compared to the osteopenic and osteoporotic groups. End-plate marrow abnormality was detected in L1 lower end plate in 75 % of normal subjects, 40.6 % of osteopenics, and 25 % of osteoporotics. Statistically significant difference in the presence of Schmorl nodes in L5 vertebra lower end plates was present between groups; 58.3 % of normals, 34.4 % of osteopenics and 15 % of osteoporotics had Schmorl nodes in L5 vertebra lower end plates. There was a significant difference regarding disc degeneration and intradiscal gas presence in L5-S1 intervertebral discs between groups; 66.7 % of normals, 28.1 % of osteopenics, and 25 % of osteoporotics had severe disc degeneration and intradiscal gas was present in L5-S1 intervertebral discs. Significant changes in morphology of the lumbar spine and intervertebral discs were found. It was revealed that the effects of osteoporosis are not limited to the bone but also present in the intervertebral discs. Mid heights of intervertebral discs were higher in the osteoporotic and osteopenic groups when compared to normal

  5. Chondrosarcoma of T2 Vertebrae Treated by Combined Anterior and Posterior Approach: A Case Report

    Directory of Open Access Journals (Sweden)

    K Norazian

    2010-11-01

    Full Text Available Chondrosarcoma of the spine is rare; it presents predominantly in very young males and presentation with neurological deficit is uncommon. Treatment of this type of tumour is mainly through surgery as adjuvant therapy is ineffective. En bloc resection of tumours in the spine are difficult although it remains the recommended treatment for chondrosarcoma. We report here presentation of a female with paresis (Frankel C whom was diagnosed with a large chondrosarcoma of the T2 vertebra extending to the right upper thoracic cavity. The patient underwent radical excision through an anterior and posterior approach to the spine.

  6. Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach.

    Science.gov (United States)

    Borghei-Razavi, Hamid; Tomio, Ryosuke; Fereshtehnejad, Seyed-Mohammad; Shibao, Shunsuke; Schick, Uta; Toda, Masahiro; Yoshida, Kazunari; Kawase, Takeshi

    2016-02-01

    Objectives Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Method A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used. The anatomical variations of cranial nerves IV-VI related to the tumor were divided into several location categories: superior lateral (SL), inferior lateral (IL), superior medial (SM), inferior medial (IM), and encased (E). These data were then analyzed taking into consideration pathologic subgroups of meningioma, epidermoid, and schwannoma. Results In 41% of meningiomas, the trigeminal nerve is encased by the tumor. In 38% of the meningiomas, the trigeminal nerve is in the SL part of the tumor, and it is in 20% of the IL portion of the tumor. In 38% of the meningiomas, the trochlear nerve is encased by the tumor. The abducens nerve is not always visible (35%). The pathologic nerve pattern differs from that of meningiomas for epidermoid and trigeminal schwannomas. Conclusion The pattern of cranial nerves IV-VI is linked to the type of petroclival tumor. In a meningioma, tumor origin (cavernous, upper clival, tentorial, and petrous apex) is the most important predictor of the location of cranial nerves IV-VI. Classification of four subtypes of petroclival meningiomas using magnetic resonance imaging is very useful to predict the location of deviated cranial nerves IV-VI intraoperatively.

  7. Metamorphosis of human lumbar vertebrae induced by VEPTR growth modulation and stress shielding.

    Science.gov (United States)

    Hasler, Carol C; Studer, Daniel; Büchler, Philippe

    2015-08-01

    Distraction-based spinal growth modulation by growing rods or vertical expandable prosthetic titanium ribs (VEPTRs) is the mainstay of instrumented operative strategies to correct early onset spinal deformities. In order to objectify the benefits, it has become common sense to measure the gain in spine height by assessing T1-S1 distance on anteroposterior (AP) radiographs. However, by ignoring growth changes on vertebral levels and by limiting measurement to one plane, valuable data is missed regarding the three-dimensional (3D) effects of growth modulation. This information might be interesting when it comes to final fusion or, even more so, when the protective growing implants are removed and the spine re-exposed to physiologic forces at the end of growth. The goal of this retrospective radiographic study was to assess the growth modulating impact of year-long, distraction-based VEPTR treatment on the morphology of single vertebral bodies. We digitally measured lumbar vertebral body height (VBH) and upper endplate depth (VBD) at the time of the index procedure and at follow-up in nine patients with rib-to-ileum constructs (G1) spanning an anatomically normal lumbar spine. Nine patients with congenital thoracic scoliosis and VEPTR rib-to-rib constructs, but uninstrumented lumbar spines, served as controls (G2). All had undergone more than eight half-yearly VEPTR expansions. A Wilcoxon signed-rank test was used for statistical comparison of initial and follow-up VBH, VBD and height/depth (H/D) ratio (significance level 0.05). The average age was 7.1 years (G1) and 5.2 year (G2, p > 0.05) at initial surgery; the average overall follow-up time was 5.5 years (p = 1). In both groups, VBH increased significantly without a significant intergroup difference. Group 1 did not show significant growth in depth, whereas VBD increased significantly in the control group. As a consequence, the H/D ratio increased significantly in group 1 whereas it remained unchanged in

  8. The relative correspondence of cranial and genetic distances in papionin taxa and the impact of allometric adjustments.

    Science.gov (United States)

    Smith, Heather F; von Cramon-Taubadel, Noreen

    2015-08-01

    The reconstruction of phylogenetic relationships in the primate fossil record is dependent upon a thorough understanding of the phylogenetic utility of craniodental characters. Here, we test three previously proposed hypotheses for the propensity of primate craniomandibular data to exhibit homoplasy, using a study design based on the relative congruence between cranial distance matrices and a consensus genetic distance matrix ("genetic congruence") for papionin taxa: 1) matrices based on cranial regions subjected to less masticatory strain are more genetically congruent than high-strain cranial matrices; 2) matrices based on cranial regions developing earlier in ontogeny are more genetically congruent than matrices based on regions that develop later; and 3) matrices based on cranial regions with greater anatomical/functional complexity are more genetically congruent than matrices based on anatomically simpler regions. Morphological distance matrices based on the shape of 15 different cranial regions, delineated on the basis of previous catarrhine studies, were statistically compared to a matrix of known genetic distances in papionins. Since sexual dimorphism and allometry are known to characterize this clade, several analytical iterations were conducted: 1) mixed-sex, male-only, and female-only analyses and 2) with and without an allometric scaling adjustment. Across all datasets, the chondrocranium matrix was the most consistently correlated with genetic distances, which is also consistent with previous studies of cercopithecoid taxa; however, there was no support for the internal predictions of the three hypotheses tested. Allometric scaling corrections had the largest impact on the genetic congruence of facial shape matrices, a result consistent with previous studies that have described facial homoplasy in papionin taxa. These findings differ from patterns described for hominoid taxa, suggesting that no single predictive criterion can explain phylogenetic

  9. Morphometric and radiological assessments of dimensions of Axis in dry vertebrae: A study in Indian population

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    Raman Mohan Sharma

    2015-01-01

    Material and Methods: 38 dry axis vertebrae from adult South Indian population were subjected to morphometric measurement and CT scan analysis. Height of posterior arch, midlaminar width(bilateral in upper 1/3rd, middle 1/3rd and lower 1/3rd were measured using high precision Vernier Calipers. Each vertebra was subjected to a spiral CT scan (Philips brilliance 16 slice thin 0.5 mm slices were taken and reconstruction was done in coronal and sagittal plane. Analysis was done on a CT work station. Using axial slices, sagittal cuts were reconstructed in plane perpendicular to the lamina at the mid laminar point and upper-middle and lower 1/3rd width of the lamina measured. Height of the posterior arch was measured in the sagittal plane. Intralaminar angle was measured bilaterally. Results: Middle 1/3rd lamina was the thickest portion (mean 5.17 mm +/− 1.42 mm. A total of 32 (84.2% specimen were having midlaminar width in both lamina greater than 4 mm, however only 27 (71% out of them had spinous process more than 9 mm. CT scan measurement in middle and lower 1/3rd lamina was found to be strongly correlated with the direct measurement. Conclusion: There is high variability in the thickness of the C2 lamina. As compared to western population, the axis bones used in the present study had smaller profiles. Hence the safety margin for translaminar screw insertion is low.

  10. Osteoporosis affects both post-yield microdamage accumulation and plasticity degradation in vertebra of ovariectomized rats

    Science.gov (United States)

    Li, Siwei; Niu, Guodong; Dong, Neil X.; Wang, Xiaodu; Liu, Zhongjun; Song, Chunli; Leng, Huijie

    2017-04-01

    Estrogen withdrawal in postmenopausal women increases bone loss and bone fragility in the vertebra. Bone loss with osteoporosis not only reduces bone mineral density (BMD), but actually alters bone quality, which can be comprehensively represented by bone post-yield behaviors. This study aimed to provide some information as to how osteoporosis induced by estrogen depletion could influence the evolution of post-yield microdamage accumulation and plastic deformation in vertebral bodies. This study also tried to reveal the part of the mechanisms of how estrogen deficiency-induced osteoporosis would increase the bone fracture risk. A rat bilateral ovariectomy (OVX) model was used to induce osteoporosis. Progressive cyclic compression loading was developed for vertebra testing to elucidate the post-yield behaviors. BMD, bone volume fraction, stiffness degradation, and plastic deformation evolution were compared among rats raised for 5 weeks (ovx5w and sham5w groups) and 35 weeks (ovx35w and sham35w groups) after sham surgery and OVX. The results showed that a higher bone loss in vertebral bodies corresponded to lower stiffness and higher plastic deformation. Thus, osteoporosis could increase the vertebral fracture risk probably through microdamage accumulation and plastic deforming degradation.

  11. Relevance of discrete traits in forensic anthropology: From the first cervical vertebra to the pelvic girdle.

    Science.gov (United States)

    Verna, Emeline; Piercecchi-Marti, Marie-Dominique; Chaumoitre, Kathia; Adalian, Pascal

    2015-08-01

    In forensic anthropology, identification begins by determining the sex, age, ancestry and stature of the individuals. Asymptomatic variations present on the skeleton, known as discrete traits, can be useful to identify individuals, or at least contribute to complete their biological profile. We decided to focus our work on the upper part of the skeleton, from the first vertebra to the pelvic girdle, and we chose to present 8 discrete traits (spina bifida occulta, butterfly vertebra, supraclavicular nerve foramen, coracoclavicular joint, os acromiale, suprascapular foramen, manubrium foramen and pubic spine), because they show a frequency lower than 10%. We examined 502 anonymous CT scans from polytraumatized individuals, aged 15 to 65 years, in order to detect the selected discrete traits. Age and sex were known for each subject. Thin sections in the axial, coronal and sagittal planes and 3D volume rendering images were created and examined for the visualization of the selected discrete traits. Supraclavicular foramina were found only in males and only on the left clavicle. Coracoclavicular joints were observed only in males. The majority of individuals with a suprascapular foramen were older than 50 years of age. Pubic spines were observed mostly in females. Other traits did not present significant association with sex, age and laterality. No association between traits was highlighted. Better knowledge of human skeletal variations will help anthropologists come closer to a positive identification, especially if these variations are rare, therefore making them more discriminant. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. The Accuracy of Locating Lumbar Vertebrae When Using Palpation Versus Ultrasonography.

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    Mieritz, Rune Mygind; Kawchuk, Gregory Neil

    2016-01-01

    The purpose of this study was to determine the accuracy of locating lumbar vertebrae using palpation vs ultrasonography. In this study, ultrasonic imaging was used by 2 experienced clinicians to identify the third lumbar spinous process (target) of a female participant. The target was then located by 16 undergraduate chiropractic students using clinical palpation techniques learned in their academic program (with participant seated and prone) and ultrasonic imaging learned through a 5-minute training video. Presumed target locations identified by students were recorded by infrared motion capture equipment. The coordinates of the presumed target site were then compared statistically. There was no significant difference between the presumed target position identified by the students using sitting and prone palpation (P = .346). These positions were significantly different from the target location identified by expert clinicians using ultrasonic imaging (P palpation resulted in the students mistakenly identifying the L4 spinous process as the target vertebra. This study found that ultrasonography provided more accurate identification of a lumbar spinal landmark when compared with palpation. In addition, our data suggest that ultrasonic imaging to identify spinal landmarks can be learned easily and can improve accuracy of landmark detection. Although the time to use ultrasonic imaging was greater than with palpation, these results suggest that this procedure could potentially be used in clinical practice to identify spinal landmarks. Copyright © 2016. Published by Elsevier Inc.

  13. COMPLETE FUSION OF FIFTH LUMBAR VERTEBRA WITH SACRUM: AN OSTEOLOGICAL CASE REPORT

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    Shiksha

    2015-07-01

    Full Text Available Lumbosacral region of the body not only protects the spinal cord and related structures but also transmit the body weight to lower extremity and maintains the body posture. Sacralization of the 5 th lumbar vertebrae, is a congenital vertebral anomaly of the lumbosacral region and may be unilateral or bilateral. Although, sacralization is not a serious anomaly, perhaps no more than an anatomical variant, the fusion of the lumbrosacral joint may cause low back pain, disc herniation, cervical ribs, Bertollotti’ s syndrome and difficulty during labor. To highlight the complication of sacralization and its related impact on the body, we report a case of complete fusion of 5 th lumbar vertebra with sacrum ( sacralization . The relationship between incidence of sacrali zation with low back pain is debatable but still the present study may help anatomists, clinicians and surgeons to know the complications of sacralization and its impact on the body that in turn help in diagnostic and therapeutic management of illness arou nd lumbosacral region. Future studies need to focus on identifying other parameters that are relevant to distinguishing lumbosacral variations and associated disorders.

  14. Racial and sex differences in timing of the cervical vertebrae maturation stages.

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    Montasser, Mona A; Viana, Grace; Evans, Carla A

    2017-04-01

    Our objective was to investigate skeletal maturation of female and male subjects from different racial groups by comparing the cervical vertebrae maturation (CVM) stages. The study included 3 racial groups: white, African American, and Hispanic subjects. Each group was subdivided into female and male. The age range of the subjects was between 7 and 18 years. The sample included 60 lateral cephalographs for each subgroup. Skeletal maturation of the cervical vertebrae was assessed according to a method that described 6 CVM stages. Racial differences were evident in the mean ages of CVM stages 2, 3, 4, and 5 (P = 0.002; P = 0.003; P = 0.001; and P = 0.001, respectively) among females; among males, only stage 3 was different (P = 0.001). Sex differences in the mean ages of stages 1, 2, and 3 in Hispanic subjects (P differences were not apparent between whites and African Americans, but differences were evident between Hispanics vs both whites and African Americans. Sex differences were apparent between the sexes in each of the 3 ethnic groups in CVM stages 2 and 3. No sex differences were detected in stages 4, 5, or 6 in any of the 3 racial groups. It is recommended to consider racial and sex differences when using the CVM stage as a skeletal maturation indicator. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  15. Variable morphology of the axis vertebrae in 100 specimens: implications for clinical palpation and diagnostic imaging.

    Science.gov (United States)

    Ji-Hong, Fan; Li-Ping, Wu; Yi-Kai, Li; Bo-Jin, Liang; Das, Manas; Xiao-Yong, Fu

    2010-02-01

    The purpose of this study was to investigate and measure the variable morphologies of axis vertebrae and explore the clinical significance of variations as it may pertain to clinical palpation and diagnostic imaging. The common variable morphologies in 100 specimens of intact dry adult axis vertebrae (Chinese) were investigated and measured. The frequencies in deviation of odontoid processes, deviation of spinous processes, and presence of bifid spinous processes were observed. The distances between the apices of transverse processes and inferior articular facets were also measured. Variable morphologies of C2 that we observed were deviation of odontoid processes (14 cases, 14.0%), deviation of spinous processes (3 cases, 3.0%), and bifid spinous processes (95 cases, 95.0%). Of the bifid spinous processes, 56 had a process on the left side equal to the right side, 21 were longer on the left, and 18 were longer on the right. The distances between apices of transverse processes and inferior articular facets in the left side of C2 were 17.67 +/- 2.47 mm, and that of the right side were 17.81 +/- 2.55 mm. Because variable morphology of the axis is common, congenital deviation of the odontoid process, deviation of the spinous process, and asymmetrical bifid spinous processes should be taken into account during clinical palpation and diagnostic imaging. (c) 2010 Elsevier Inc. All rights reserved.

  16. Jack-of-all-trades master of all? Snake vertebrae have a generalist inner organization

    Science.gov (United States)

    Houssaye, Alexandra; Boistel, Renaud; Böhme, Wolfgang; Herrel, Anthony

    2013-11-01

    Snakes are a very speciose group of squamates that adapted to various habitats and ecological niches. Their ecological diversity is of particular interest and functional demands associated with their various styles of locomotion are expected to result in anatomical specializations. In order to explore the potential adaptation of snakes to their environment we here analyze variation in vertebral structure at the microanatomical level in species with different locomotor adaptations. Vertebrae, being a major element of the snake body, are expected to display adaptations to the physical constraints associated with the different locomotor modes and environments. Our results revealed a rather homogenous vertebral microanatomy in contrast to what has been observed for other squamates and amniotes more generally. We here suggest that the near-absence of microanatomical specializations in snake vertebrae might be correlated to their rather homogeneous overall morphology and reduced range of morphological diversity, as compared to lizards. Thus, snakes appear to retain a generalist inner morphology that allows them to move efficiently in different environments. Only a few ecologically highly specialized taxa appear to display some microanatomical specializations that remain to be studied in greater detail.

  17. A new horned dinosaur reveals convergent evolution in cranial ornamentation in Ceratopsidae.

    Science.gov (United States)

    Brown, Caleb M; Henderson, Donald M

    2015-06-15

    Ceratopsid (horned) dinosaurs are an iconic group of large-bodied, quadrupedal, herbivorous dinosaurs that evolved in the Late Cretaceous and were largely restricted to western North America [1-5]. Ceratopsids are easily recognized by their cranial ornamentation in the form of nasal and postorbital horns and frill (capped by epiossifications); these structures show high morphological disparity and also represent the largest cranial display structures known to have evolved [2, 4]. Despite their restricted occurrence in time and space, this group has one of the best fossil records within Dinosauria, showing a rapid diversification in horn and frill morphology [1]. Here a new genus and species of chasmosaurine ceratopsid is described based on a nearly complete and three-dimensionally preserved cranium recovered from the uppermost St. Mary River Formation (Maastrichtian) of southwestern Alberta. Regaliceratops peterhewsi gen. et sp. nov. exhibits many unique characters of the frill and is characterized by a large nasal horncore, small postorbital horncores, and massive parietal epiossifications. Cranial morphology, particularly the epiossifications, suggests close affinity with the late Campanian/early Maastrichian taxon Anchiceratops, as well as with the late Maastrichtian taxon Triceratops. A median epiparietal necessitates a reassessment of epiossification homology and results in a more resolved phylogeny. Most surprisingly, Regaliceratops exhibits a suite of cranial ornamentations that are superficially similar to Campanian centrosaurines, indicating both exploration of novel display morphospace in Chasmosaurinae, especially Maastrichtian forms, and convergent evolution in horn morphology with the recently extinct Centrosaurinae. This marks the first time that evolutionary convergence in horn-like display structures has been demonstrated between dinosaur clades, similar to those seen in fossil and extant mammals [6]. Copyright © 2015 Elsevier Ltd. All rights

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

    Science.gov (United States)

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

    2017-09-01

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

  19. Estudo da inclinação do plano palatino em relação à base posterior do crânio em indivíduos portadores de oclusão normal Study of palatal plane inclination related to the posterior cranial base in subjects with normal occlusion

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    Cássia T. Lopes de Alcântara Gil

    2006-10-01

    Full Text Available OBJETIVO: estudar a relação entre o plano palatino e a região posterior da base do crânio, em indivíduos portadores de oclusão normal. METODOLOGIA: a amostra foi constituída por telerradiografias em norma lateral de 95 indivíduos portadores de oclusão normal natural. O plano palatino foi determinado pelos pontos Ena e Enp (Espinha Nasal Anterior e Posterior. Utilizou-se o ponto mais posterior e inferior do osso occipital (OPI, para definição da região póstero-inferior da base do crânio. Avaliou-se o comportamento do ângulo formado pelos planos OPI-Ena e Ena-Enp, denominado ângulo OPI.Ena.Enp, tendo como vértice o ponto Ena. Desta forma, valores angulares próximos a 0º indicaram tendência à coincidência entre os planos OPI-Ena e Ena-Enp, o que equivale a dizer que, nestes casos, a extensão do plano palatino tangencia a base posterior do crânio, representada pelo Ponto OPI. RESULTADOS: a média de valor encontrada em relação ao ângulo OPI.Ena.Enp na referida amostra foi de -0,13º, valor próximo a zero, indicando tendência à coincidência entre os planos OPI-Ena e Ena-Enp. CONCLUSÃO: os resultados indicam que em pacientes portadores de oclusão normal natural, o prolongamento do plano palatino tende a tangenciar a região posterior da base do crânio, o que se revela uma característica estrutural em crânios de indivíduos portadores de oclusão equilibrada.AIM: to study the inclination of the palatal plane in 95 subjects with clinically normal occlusion. METHODS: the study was made using lateral headfilms and the results showed that in normal occlusion the extension of the palatal plane (ANS-PNS passes trough the most posterior and inferior region of the skull, defined as Point "OPI". RESULTS: OPI.Ena.Enp mean value was -0.13º, close to zero. CONCLUSION: the results indicated that in normal occlusion patients the palatal plane presents a tendency to be tangent with posterior cranial base.

  20. Idiopathic Ninth, Tenth, and Twelfth Cranial Nerve Palsy with Ipsilateral Headache: A Case Report

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    Sun Seung-Ho

    2012-12-01

    Full Text Available Objective: This case report is to report the effect of Korean traditional treatment for idiopathic ninth, tenth, and twelfth cranial nerve palsy with ipsilateral headache. Methods: The medical history and imaging and laboratory test of a 39-year-old man with cranial palsy were tested to identify the cause of disease. A 0.2-mL dosage of Hwangyeonhaedoktang pharmacopuncture was administered at CV23 and CV17, respectively. Acupuncture was applied at P06, Li05, TE05, and G37 on the right side of the body. Zhuapiandutongbang (左偏頭痛方 was administered at 30 minutes to 1 hour after mealtime three times a day. The symptoms were investigated using Visual Analogue Scale (VAS. Results: The results of magnetic resonance imaging (MRI, computed tomography (CT, and laboratory tests were normal. The medical history showed no trauma, other illnesses, family history of diseases, medications, smoking, drinking and so on. All symptoms disappeared at the 10th day of treatment. Conclusion: Korean traditional treatment such as acupuncture, pharmcopuncture, and herbal medicine for the treatment of ninth, tenth, and twelfth cranial nerve palsy of unknown origin is suggested to be effective even though this conclusion is based on a single.

  1. Cranial shape evolution in adaptive radiations of birds: comparative morphometrics of Darwin's finches and Hawaiian honeycreepers.

    Science.gov (United States)

    Tokita, Masayoshi; Yano, Wataru; James, Helen F; Abzhanov, Arhat

    2017-02-05

    Adaptive radiation is the rapid evolution of morphologically and ecologically diverse species from a single ancestor. The two classic examples of adaptive radiation are Darwin's finches and the Hawaiian honeycreepers, which evolved remarkable levels of adaptive cranial morphological variation. To gain new insights into the nature of their diversification, we performed comparative three-dimensional geometric morphometric analyses based on X-ray microcomputed tomography (µCT) scanning of dried cranial skeletons. We show that cranial shapes in both Hawaiian honeycreepers and Coerebinae (Darwin's finches and their close relatives) are much more diverse than in their respective outgroups, but Hawaiian honeycreepers as a group display the highest diversity and disparity of all other bird groups studied. We also report a significant contribution of allometry to skull shape variation, and distinct patterns of evolutionary change in skull morphology in the two lineages of songbirds that underwent adaptive radiation on oceanic islands. These findings help to better understand the nature of adaptive radiations in general and provide a foundation for future investigations on the developmental and molecular mechanisms underlying diversification of these morphologically distinguished groups of birds.This article is part of the themed issue 'Evo-devo in the genomics era, and the origins of morphological diversity'. © 2016 The Authors.

  2. A soft, transparent, freely accessible cranial window for chronic imaging and electrophysiology

    Science.gov (United States)

    Heo, Chaejeong; Park, Hyejin; Kim, Yong-Tae; Baeg, Eunha; Kim, Yong Ho; Kim, Seong-Gi; Suh, Minah

    2016-01-01

    Chronic in vivo imaging and electrophysiology are important for better understanding of neural functions and circuits. We introduce the new cranial window using soft, penetrable, elastic, and transparent, silicone-based polydimethylsiloxane (PDMS) as a substitute for the skull and dura in both rats and mice. The PDMS can be readily tailored to any size and shape to cover large brain area. Clear and healthy cortical vasculatures were observed up to 15 weeks post-implantation. Real-time hemodynamic responses were successfully monitored during sensory stimulation. Furthermore, the PDMS window allowed for easy insertion of microelectrodes and micropipettes into the cortical tissue for electrophysiological recording and chemical injection at any location without causing any fluid leakage. Longitudinal two-photon microscopic imaging of Cx3Cr1+/− GFP transgenic mice was comparable with imaging via a conventional glass-type cranial window, even immediately following direct intracortical injection. This cranial window will facilitate direct probing and mapping for long-term brain studies. PMID:27283875

  3. Effects of developmental and functional interactions on mouse cranial variability through late ontogeny.

    Science.gov (United States)

    Willmore, Katherine Elizabeth; Leamy, Larry; Hallgrímsson, Benedikt

    2006-01-01

    The mammalian skull performs a variety of functions and its growth and development mirrors this complexity. Cranial growth and development have been actively studied for many years. Despite this interest, the variation in the patterns and processes of skull growth has attracted little attention. An important and unanswered question is the extent to which patterns of cranial covariation and variation are dynamically reworked throughout postnatal growth. To address this question, we examine patterns of variability in random-bred mouse skulls aged 35, 90, and 150 days. Using a battery of both Procrustes coordinate and Euclidean distance-based methods, we measure mean shape, canalization, developmental stability, and morphological integration in these skulls. We predict that the patterns of variability are dynamic, particularly between the youngest and the two oldest age groups due to the influence of functional effects such as postweaning mastication. We also hypothesize that patterns of variability are structured by the same functional and developmental factors that have been shown to influence cranial growth in primates. Our results indicate that contrary to our predictions, patterns of canalization, developmental stability, and morphological integration are stabilized before 35 days. The mean shape, however, changed significantly with growth. We found that only the facial region showed significant integration as predicted by the functional matrix model used in other studies of integration. These results indicate that phenotypic integration in these mice does not closely match those found for primate species, suggesting that comparisons between species should be made with care.

  4. Cranial ultrasound findings in preterm infants predict the development of cerebral palsy.

    Science.gov (United States)

    Skovgaard, Ann Lawaetz; Zachariassen, Gitte

    2017-02-01

    Our aim was to evaluate any association between gestational age, birth weight and findings on cranial ultrasounds during hospitalisation in very preterm infants and mortality and neurological outcome in childhood. This study was a retrospective cohort study based on a patient record review. The cohort consisted of very preterm born children (gestational age ≤ 32 + 0) born from 2004 to 2008. For each infant, we obtained results from all cranial ultrasounds performed during hospitalisation. In 2014, patient records were evaluated for cerebral palsy, Gross Motor Function Classification System, blindness and deafness. A total of 249 infants were included. The mortality rate was 9.2%. In all, 217 children were evaluated at 5-9 years of age. Four children were diagnosed with germinal matrix haemorrhage - intraventricular haemorrhage grade 3 (GMH-IVH3) and periventricular haemorrhagic infarction (PVHI), of whom two developed cerebral palsy. Nine children were diagnosed with periventricular leukomalacia (PVL), of whom six developed cerebral palsy. Cerebral palsy was detected in 14 children (6.4%), and one (0.5%) child was in need of a hearing assistive device. Severe brain injury (GMH-IVH3, PVHI or PVL) (p = 0.000) and being of male gender (p = 0.03) were associated with cerebral palsy in childhood. Severe brain injuries detected by neonatal cranial ultrasound in very preterm infants is associated with development of cerebral palsy in childhood. none. TRAIL REGISTRATION: not relevant.

  5. Comparison of unipedicular and bipedicular kyphoplasty on the stiffness and biomechanical balance of compression fractured vertebrae.

    Science.gov (United States)

    Chen, BaiLing; Li, YiQiang; Xie, DengHui; Yang, XiaoXi; Zheng, ZhaoMin

    2011-08-01

    Percutaneous kyphoplasty (PKP) has been used to treat osteoporotic vertebral compression fractures for over 10 years; however, clinically speaking it is still controversial as to whether the use of unipedicular PKP or bipedicular PKP is best. Our study aimed to compare the different effects of unipedicular PKP and bipedicular PKP on the stiffness of compression fractured vertebral bodies (VBs), as well as to assess how cement distribution affect the bilateral biomechanical balance of the VBs. During this study, 30 thoracic VBs were compressed, creating vertebral compression fracture models; then they were augmented by unipedicular (group A and B) PKP and bipedicular (group C) PKP. In group A (unipedicular PKP), the cement was injected into one side and the augmentation was limited to the same side of the VB. In group B (unipedicular PKP), the cement was injected at only one side but the augmentation extended across the midline and filled both sides of the VB. In group C (bipedicular PKP), the cement was injected into both sides and thus achieved the bilateral augmentation. For the unipedicular PKP, the amount of cement injected was 15% of the original VB volume; while in bipedicular PKP, the amount of cement injected was a total of 20% of the original VB volume (10% was injected into each side). Using a MTS-858, we examined three phases of the VBs (intact, pre-augmented, post-augmented), by applying loads axially to the total vertebra and bilateral sides of the vertebra for each of three cycles, respectively. The changes of force and displacement were then recorded and the stiffness of the total vertebra and bilateral sides of the vertebra were calculated. For the pre-augmentation stage, the total VB stiffness of groups A, B and C significantly decreased when the compression fracture models were established (P < 0.05). After the cement augmentation (the post-augmentation stage), both groups A and B, showed that the stiffness could be restored to the initial

  6. WITHDRAWN: Cranial irradiation for preventing brain metastases of small cell lung cancer in patients in complete remission.

    Science.gov (United States)

    2018-02-06

    Prophylactic cranial irradiation halves the rate of brain metastases in patients with small cell lung cancer. Individual randomized trials conducted on patients in complete remission were unable to clarify whether this treatment improves survival. This study aims to test whether prophylactic cranial irradiation prolongs survival of patients with small cell lung cancer in complete remission. Published and unpublished trials were eligible. Electronic databases (Medline, Cancerlit, Excerpta Medica, Biosis from 1965 to 1998), reference lists of trial publications, review articles and relevant books were used to identify potentially eligible trials. The search was also guided by discussions with investigators and experts, and the examination of meeting proceedings and of the Physician Data Query clinical trial registry. Randomized trials comparing prophylactic cranial irradiation with no prophylactic cranial irradiation in patients with small cell lung cancer in complete remission. Meta-analysis based on updated individual data. The main endpoint was survival. Seven trials with a total of 987 participants were included. The relative risk of death in the treatment group compared to the control group was 0.84 (95% confidence interval=0.73 to 0.97, P=0.01), corresponding to a 5.4 percent increase in the 3-year survival rate (from 15.3 percent in the control group to 20.7 percent in the treatment group). Prophylactic cranial irradiation also increased disease-free survival (relative risk=0.75, 95% confidence interval=0.65 to 0.86, P<0.001) and decreased the risk of brain metastases (relative risk=0.46, 95% confidence interval=0.38 to 0.57, P<0.001). Increasing doses of irradiation decreased the risk of brain metastases when four groups (8 Gy, 24-25 Gy, 30 Gy, 36-40 Gy) were analyzed [trend test, P=0.02], but the effect on survival did not differ significantly according to the dose. We found a trend (P=0.01) for a decrease in the brain metastasis risk in favour of earlier

  7. Eighth cranial nerve dysfunction in hyperostosis cranialis interna.

    Science.gov (United States)

    Manni, J J; Huygen, P L; Noten, J F; Kuijpers, W

    1992-01-01

    Hyperostosis cranialis interna is a recently described autosomal dominant bone disorder characterised by hyperostosis and osteosclerosis confined to the skull, especially the calvarium and the skull base. In the affected family members, we found variable simultaneous involvement of cranial nerves I, II, VII and VIII from late childhood onwards, most likely due to nerve entrapment. Auditory and vestibular functions were followed in 3 young family members for 8 years. At the first examination, pure tone audiograms were normal in all 3 cases and case 1 showed no caloric response in the right ear. During follow-up, this ear developed severe hearing loss progressing to deafness. The left ear showed transient sensorineural hearing loss and a temporarily diminished caloric response. Similar observations were made in case 2. Both cases showed abnormal brain stem auditory-evoked responses during and after the sudden hearing loss, in which initially only wave I was preserved and later on wave V returned with significantly prolonged I-V interval. The latter phenomenon was also observed in case 3 on both sides in the presence of normal audiograms during and after transient unilateral facial nerve paralysis, which was accompanied by bilateral diminished caloric responses.

  8. Ontogeny of the cranial system in Laonastes aenigmamus

    Science.gov (United States)

    Herrel, Anthony; Fabre, Anne-Claire; Hugot, Jean-Pierre; Keovichit, Kham; Adriaens, Dominique; Brabant, Loes; Van Hoorebeke, Luc; Cornette, Raphael

    2012-01-01

    Rodents, together with bats, are among the ecologically most diverse and most speciose groups of mammals. Moreover, rodents show elaborate specializations of the feeding apparatus in response to the predominantly fore-aft movements of the lower jaw. The Laotian rock rat Laonastes aenigmamus was recently discovered and originally thought to belong to a new family. The difficulties in classifying L. aenigmamus based on morphological characters stem from the fact that it presents a mixture of sciurognathous and hystricognathous characteristics, including the morphology of the jaw adductors. The origin of the unusual muscular organization in this species remains, however, unclear. Here, we investigate the development of the masticatory system in Laonastes to better understand the origin of its derived morphology relative to other rodents. Our analyses show that skull and mandible development is characterized by an overall elongation of the snout region. Muscle mass increases with positive allometry during development and growth, and so does the force-generating capacity of the jaw adductor muscles (i.e. physiological cross-sectional area). Whereas fetal crania and musculature are more similar to those of typical rodents, adults diverge in the elongation of the rostral part of the skull and the disproportionate development of the zygomaticomandibularis. Our data suggest a functional signal in the development of the unusual cranial morphology, possibly associated with the folivorous trophic ecology of the species. PMID:22607030

  9. Attentional ability among survivors of leukaemia treated without cranial irradiation.

    Science.gov (United States)

    Rodgers, J; Marckus, R; Kearns, P; Windebank, K

    2003-02-01

    Previous research has indicated that children who have received treatment for leukaemia which includes cranial irradiation exhibit deficits in their ability to focus attention. It has been suggested that the use of cranial irradiation may have a role to play in long term sequelae. To investigate neuropsychological functioning among children treated for leukaemia without cranial irradiation. In a cross sectional study, 17 leukaemic patients and their sibling controls were assessed using a neuropsychological model of attention. All were treated on the UKALL XI protocol and none had received cranial irradiation. Participants completed the Arithmetic subtest and Digit Span subtest of the Weschler Intelligence Scale for Children-Revised to assess focus-encode elements of attention; the Coding subtest and the Speed of Information subtest of the BAS to assess focus-execute aspects of attention; the VIGIL computerised battery to assess sustain elements of attention; and the Wisconsin Card Sorting test to assess the ability to shift attention. These children did not exhibit the deficits witnessed in previous cohorts, and were performing at comparable levels to their controls on all measures of attention These findings suggest that children who have received treatment for leukaemia without the use of cranial irradiation do not show the neuropsychological insult found in earlier treatment groups.

  10. Ets-1 Confers Cranial Features on Neural Crest Delamination

    Science.gov (United States)

    Théveneau, Eric; Duband, Jean-Loup; Altabef, Muriel

    2007-01-01

    Neural crest cells (NCC) have the particularity to invade the environment where they differentiate after separation from the neuroepithelium. This process, called delamination, is strikingly different between cranial and trunk NCCs. If signalings controlling slow trunk delamination start being deciphered, mechanisms leading to massive and rapid cranial outflow are poorly documented. Here, we show that the chick cranial NCCs delamination is the result of two events: a substantial cell mobilization and an epithelium to mesenchyme transition (EMT). We demonstrate that ets-1, a transcription factor specifically expressed in cranial NCCs, is responsible for the former event by recruiting massively cranial premigratory NCCs independently of the S-phase of the cell cycle and by leading the gathered cells to straddle the basal lamina. However, it does not promote the EMT process alone but can cooperate with snail-2 (previously called slug) to this event. Altogether, these data lead us to propose that ets-1 plays a pivotal role in conferring specific cephalic characteristics on NCC delamination. PMID:17987123

  11. Ets-1 confers cranial features on neural crest delamination.

    Directory of Open Access Journals (Sweden)

    Eric Théveneau

    Full Text Available Neural crest cells (NCC have the particularity to invade the environment where they differentiate after separation from the neuroepithelium. This process, called delamination, is strikingly different between cranial and trunk NCCs. If signalings controlling slow trunk delamination start being deciphered, mechanisms leading to massive and rapid cranial outflow are poorly documented. Here, we show that the chick cranial NCCs delamination is the result of two events: a substantial cell mobilization and an epithelium to mesenchyme transition (EMT. We demonstrate that ets-1, a transcription factor specifically expressed in cranial NCCs, is responsible for the former event by recruiting massively cranial premigratory NCCs independently of the S-phase of the cell cycle and by leading the gathered cells to straddle the basal lamina. However, it does not promote the EMT process alone but can cooperate with snail-2 (previously called slug to this event. Altogether, these data lead us to propose that ets-1 plays a pivotal role in conferring specific cephalic characteristics on NCC delamination.

  12. Infant Positioning, Baby Gear Use, and Cranial Asymmetry.

    Science.gov (United States)

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

    2017-12-01

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

  13. [Therapeutic effect of conservative treatment of refracture in cemented vertebrae after percutaneous vertebroplasty for osteoporotic vertebral compression fractures].

    Science.gov (United States)

    Wang, Jing; Chen, Min; DU, Jiang

    2016-02-01

    To evaluate the therapeutic effects of conservative treatment of refracture in cemented vertebrae after percutaneous vertebroplasty for osteoporotic vertebral compression fractures in elderly patients. Between January, 2012 and August, 2014, a total of 324 elderly patients (381 vertebrae) received percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Of these patients, 12 patients (14 vertebrae) complained of recurrence of back pain and were confirmed to have refracture in the cemented vertebrae by imaging examination. Seven of these 12 patients (9 vertebrae), who were all female with an average refracture time of 8±6.7 weeks (range 2-20 weeks), received conservative treatments with analgesics, osteoporosis medication, bracing and physical therapy, and their visual analogue scale (VAS) scores and Oswestry disability index (ODI) at 7 days and 1, 3 and 12 months after the treatment were measured. The 7 patients were followed up for 21.3±11.2 months (range 13-29 months) after conservative treatments. Their VAS score and ODI decreased significantly over time after the treatment (P0.05). The average VAS score and ODI before treatments were 8.3±0.8 and (88.3±3.2)%, 3.1±1.2 and (56.3±7.7)% at 1 month, and 0.8±0.7 and (5.9±2.8)% at 3 months during the follow-up, respectively.No such complications as phlebothrombosis of the leg, decubitus, or hypostatic pneumonia occurred in these cases. Though with a relatively low incidence rate, refracture in the cemented vertebrae is one of the important causes of recurrence of back pain following percutaneous vertebroplasty. Conservative treatment is effective in relieving pain and improving the spine function in such cases without obvious complications.

  14. The effect of intraosseous injection of calcium sulfate on microstructure and biomechanics of osteoporotic lumbar vertebrae in sheep

    Directory of Open Access Journals (Sweden)

    Da LIU

    2014-10-01

    Full Text Available Objective To investigate the effect of calcium sulfate (CS on improvement of microstructure and biomechanical performance of osteoporotic lumbar vertebrae in sheep. Methods Osteoporosis model was reproduced in 8 female sheep by bilateral ovariectomy and methylprednisolone administration. Then the lumbar vertebrae (L1-L4 in each sheep were randomly divided into CS group and blank group (2 vertebrae in each sheep. CS was injected into the vertebral bodies through the pedicle in CS group, and no treatment was given in blank group. All of the animals were sacrificed 3 months later, and vertebrae L1-L4 were harvested. The microstructure and biomechanical performance of vertebral bodies were assessed by micro-CT scanning, histological observation and biomechanical test. Results After ovariectomy and methylprednisolone administration, the mean bone mineral density of the lumbar vertebrae in the sheep was significantly decreased (>25% compared with that before induction (P<0.05, demonstrating a successful reproduction of osteoporosis model. Three months after injection, it was shown that CS was completely degraded without any remnant in the bone tissue. The quality of the bone tissue (trabecular number and tissue mineral density in CS group was significantly better than that in blank group (P<0.05, and the biomechanical performance in CS group was significantly superior to that in blank group (P<0.05. Conclusions  Local injection of CS could significantly improve the microstructure and biomechanical performance of osteoporotic vertebrae, and it may decrease the risk of fracture of patients with osteoporosis. DOI: 10.11855/j.issn.0577-7402.2014.09.02

  15. Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventionalist needs to know.

    Science.gov (United States)

    Geibprasert, S; Pongpech, S; Armstrong, D; Krings, T

    2009-09-01

    Transarterial embolization in the external carotid artery (ECA) territory has a major role in the endovascular management of epistaxis, skull base tumors, and dural arteriovenous fistulas. Knowledge of the potential anastomotic routes, identification of the cranial nerve supply from the ECA, and the proper choice of embolic material are crucial to help the interventionalist avoid neurologic complications during the procedure. Three regions along the skull base constitute potential anastomotic routes between the extracranial and intracranial arteries: the orbital, the petrocavernous, and the upper cervical regions. Branches of the internal maxillary artery have anastomoses with the ophthalmic artery and petrocavernous internal carotid artery (ICA), whereas the branches of the ascending pharyngeal artery are connected to the petrocavernous ICA. Branches of both the ascending pharyngeal artery and the occipital artery have anastomoses with the vertebral artery. To avoid cranial nerve palsy, one must have knowledge of the supply to the lower cranial nerves: The petrous branch of the middle meningeal artery and the stylomastoid branch of the posterior auricular artery form the facial arcade as the major supply to the facial nerve, and the neuromeningeal trunk of the ascending pharyngeal artery supplies the lower cranial nerves (CN IX-XII).

  16. Surgical treatment of a proximal diaphyseal tibial deformity associated with partial caudal and cranial cruciate ligament deficiency and patella baja.

    Science.gov (United States)

    Vincenti, S; Knell, S; Pozzi, A

    2017-04-01

    Caudal cruciate ligament injury can be a complication following tibial plateau leveling osteotomy (TPLO) (Slocum und Slocum, 1993) especially if the post-operative Tibial Plateau Angle (TPA) is less than 5 degree. We describe a case of negative TPA associated with partial cranial and caudal ligament rupture treated with a center of rotation of angulation (CORA) based cranial tibial opening wedge osteotomy and tibial tuberosity transposition. A 13 kg, mixed breed dog was presented for right pelvic limb lameness. Radiographically a bilateral patella baja and a malformed tibia tuberosity along with a bilateral TPA of -8 degree were detected. Arthroscopically a partial rupture of the cranial and caudal cruciate ligaments were found. A cranial tibial opening wedge osteotomy of 23 degree and a fibular ostectomy were performed. The osteotomy was fixed with a 8 holes ALPS 9 (KYON, Switzerland) and a 3-holes 2.0mm UniLock plate (Synthes, Switzerland). Then a proximal tibial tuberosity transposition of 10mm was performed and fixed with a pin and tension band construct. The postoperative TPA was 15 degree. The radiographic controls at 6, 10 weeks, 6 months and 1 year after surgery revealed an unchanged position of the implants and progressive healing of the osteotomies. At the 6 and 12 months recheck evaluation the dog had no evidence of lameness or stifle pain and radiographs revealed complete healing of the osteotomy site and no implant failure. The diaphyseal CORA based osteotomy allowed accurate correction of a proximal tibial deformity associated with negative TPA.

  17. Functional electrical stimulation improves brain perfusion in cranial trauma patients

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim

    2011-08-01

    Full Text Available OBJECTIVE: Demonstrate brain perfusion changes due to neuronal activation after functional electrical stimulation (FES. METHOD: It was studied 14 patients with hemiplegia who were submitted to a program with FES during fourteen weeks. Brain perfusion SPECT was performed before and after FES therapy. These patients were further separated into 2 groups according to the hemiplegia cause: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM. RESULTS: There was a significant statistical difference between the two groups related to patient's ages and extent of hypoperfusion in the SPECT. Patients with cranial trauma had a reduction in the hypoperfused area and patients with major vascular insult had an increase in the hypoperfused area after FES therapy. CONCLUSION: FES therapy can result in brain perfusion improvement in patients with brain lesions due to cranial trauma but probably not in patients with major vascular insults with large infarct area.

  18. Signaling mechanisms implicated in cranial sutures pathophysiology: Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Maria A. Katsianou

    2016-12-01

    Full Text Available Normal extension and skull expansion is a synchronized process that prevails along the osteogenic intersections of the cranial sutures. Cranial sutures operate as bone growth sites allowing swift bone generation at the edges of the bone fronts while they remain patent. Premature fusion of one or more cranial sutures can trigger craniosynostosis, a birth defect characterized by dramatic manifestations in appearance and functional impairment. Up until today, surgical correction is the only restorative measure for craniosynostosis associated with considerable mortality. Clinical studies have identified several genes implicated in the pathogenesis of craniosynostosis syndromes with useful insights into the underlying molecular signaling events that determine suture fate. In this review, we exploit the intracellular signal transduction pathways implicated in suture pathobiology, in an attempt to identify key signaling molecules for therapeutic targeting.

  19. Application of statistical shape analysis for the estimation of bone and forensic age using the shapes of the 2nd, 3rd, and 4th cervical vertebrae in a young Japanese population.

    Science.gov (United States)

    Rhee, Chang-Hoon; Shin, Sang Min; Choi, Yong-Seok; Yamaguchi, Tetsutaro; Maki, Koutaro; Kim, Yong-Il; Kim, Seong-Sik; Park, Soo-Byung; Son, Woo-Sung

    2015-12-01

    From computed tomographic images, the dentocentral synchondrosis can be identified in the second cervical vertebra. This can demarcate the border between the odontoid process and the body of the 2nd cervical vertebra and serve as a good model for the prediction of bone and forensic age. Nevertheless, until now, there has been no application of the 2nd cervical vertebra based on the dentocentral synchondrosis. In this study, statistical shape analysis was used to build bone and forensic age estimation regression models. Following the principles of statistical shape analysis and principal components analysis, we used cone-beam computed tomography (CBCT) to evaluate a Japanese population (35 males and 45 females, from 5 to 19 years old). The narrowest prediction intervals among the multivariate regression models were 19.63 for bone age and 2.99 for forensic age. There was no significant difference between form space and shape space in the bone and forensic age estimation models. However, for gender comparison, the bone and forensic age estimation models for males had the higher explanatory power. This study derived an improved objective and quantitative method for bone and forensic age estimation based on only the 2nd, 3rd and 4th cervical vertebral shapes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. T9 versus T10 as the upper instrumented vertebra for correction of adult deformity-rationale and recommendations.

    Science.gov (United States)

    Hey, Hwee Weng Dennis; Tan, Kimberly-Anne; Neo, Christabel Shao-En; Lau, Eugene Tze-Chun; Choong, Denise Ai-Wen; Lau, Leok-Lim; Liu, Gabriel Ka-Po; Wong, Hee-Kit

    2017-05-01

    Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage. This study aimed to characterize the range of motion (ROM) of each vertebral segment from T7 to S1 to determine if T10 is truly the lowest immobile thoracic vertebra. This is a prospective, comparative study. Seventy-nine adults (mean age of 45.4 years) presenting with low back pain or lower limb radiculopathy or both, without previous spinal intervention, metastases, fractures, infection, or congenital deformities of the spine, were included in the study. A ROM >5° across two vertebral segments as determined by the Cobb method from radiographs. Lumbar flexion-extension and neutral erect radiographs were obtained in randomized order using a slot scanner. Segmental ROM was measured from T7-T8 to L5-S1 and analyzed for significant differences using t tests. Age, gender, radiographical indices such as standard spinopelvic parameters, sagittal vertical axis (SVA), C7-T12 SVA, T1 slope, thoracic kyphosis (TK), and lumbar lordosis (LL) were studied via multivariate analysis to identify predictive factors for >5° change in ROM at the various segmental levels. There were no sources of funding and no conflicts of interest associated with this study. In the thoracolumbar spine, significant decreases in ROM when compared with the adjacent caudad segment occurs up to T9-T10, with mean total ROM of 1.98±1.47° (p5°. Lumbar spine flexion-extension ROM decreases as it approaches the thoracolumbar junction

  1. Fatal cranial injuries caused by an electric angle grinder.

    Science.gov (United States)

    Telmon, N; Allery, J P; Scolan, V; Rougé, D

    2001-03-01

    A case of fatal cranial injuries caused by an angle grinder is reported. The scalp lesions were typical of those produced by a cutting disk in a side-slipping movement. On the cranial vault were two bony losses of substance, one of which was deep enough for intracranial penetration of the disk. Signs of deflection of the disk, identical to those found on the scalp, were observed on the external bony table. Because of the circumstances in which the victim was discovered, in particular the damage to the machine which had a broken handle, and the lack of any indication of homicide or suicide, an accident is the most likely hypothesis.

  2. Use of cranial fixation pins in pediatric neurosurgery.

    Science.gov (United States)

    Berry, Cherisse; Sandberg, David I; Hoh, Daniel J; Krieger, Mark D; McComb, J Gordon

    2008-04-01

    Cranial fixation using pins during neurosurgical procedures is commonplace; however, parameters for the application of these devices in pediatric patients are not well defined. Variability in the thickness of the developing cranium necessitates age-specific considerations to reduce the risk of adverse events. To suggest possible guidelines for the use of cranial fixation pins in children, we surveyed neurosurgeons treating pediatric patients regarding their experience with such devices. An Institutional Review Board-approved, 30-item multiple choice survey was provided by electronic mail to 605 neurosurgeons treating pediatric patients. The survey included specific questions regarding their experience with cranial fixation pins with respect to age ranges of patients, selection of pin size, type of pin pressure applied, and complications encountered. One hundred sixty-four (27%) responses were received. One hundred fifty-eight of the 164 (96%) neurosurgeons reported using cranial fixation pins in their pediatric practice. Forty-four of the 164 (27%) apply fixation pins in patients aged 1 to 2 years. Eighty-two (50%) apply pins in patients aged 2 to 3 years, and 89 (54%) apply pins in patients aged 3 to 4 years. For patients aged 2 to 5 years old, the majority of responders use between 10 and 40 pounds of pressure, whereas for those older than 5 years of age, most use between 30 and 40 pounds of pressure. After age 10, patients are treated as adults. Eighty-nine of the 164 (54%) responders reported complications directly related to the use of cranial fixation pins, including cranial fracture, epidural or subdural hematoma, scalp laceration, or cerebrospinal fluid leak. One hundred fifty-four of the 164 (94%) neurosurgeons responded that they are not aware of any standard guidelines for cranial fixation pin use in pediatric patients. Seven (4%) who stated that they were aware of guidelines did not describe where they obtained those guidelines. Cranial fixation pins

  3. Hemicrania continua with contralateral cranial autonomic features: a case report.

    Science.gov (United States)

    Prakash, Sanjay; Rathore, Chaturbhuj; Makwana, Prayag

    2015-03-11

    Hemicrania continua is characterized by continuous strictly unilateral head pain with episodic exacerbations. Episodic exacerbations are associated with ipsilateral cranial autonomic features. We report a 24-year female with a 2-year history of continuous right-sided headache with superimposed exacerbations. Episodic exacerbations were associated with marked agitation and contralateral cranial autonomic features. The patient showed a complete response to indomethacin within 8 hours. The dichotomy of pain and autonomic features is in accordance with the concept about the possibility of two separate pathways for pain and autonomic features in trigeminal autonomic cephalalgias.

  4. Repair of a mandibular defect with a free vascularized coccygeal vertebra transfer in a dog.

    Science.gov (United States)

    Yeh, L S; Hou, S M

    1994-01-01

    Bilateral mandibular defects in a male mongrel dog were repaired. On the left side, a free vascularized coccygeal bone graft that included the median caudal artery and caudal vein was used to correct the defect. On the right side, the defect was bridged with a bone plate and screws. For further immobilization, the muzzle was temporarily taped for 3 weeks and a pharyngostomy tube was used for nutritional support. The dog was able to eat dry commercial food satisfactorily within 2 months of surgery despite mild malocclusion. Radiographs taken 2 months and 18 months postoperatively showed bony union with graft hypertrophy in the left mandible, whereas the right mandibular defect showed protracted nonunion. The results indicate that vascularized coccygeal vertebra transfer provides an alternative for the management of canine mandibular defects.

  5. SURGICAL TREATMENT OF CHILDREN WITH CONGENITAL IMPAIRED FORMATION OF VERTEBRAE IN THE LUMBAR SPINE

    Directory of Open Access Journals (Sweden)

    S. V. Vissarionov

    2012-01-01

    Full Text Available A description of the surgical correction technology and the results of surgical treatment of 26 patients with an isolated violation of the vertebrae formation (lateral and posterolateral hemivertebra at the lumbar spine in Russia and Kazakhstan are presented. The age of patients ranged from 1 year 6 months to 8 years 4 months. After instrumental correction of spinal deformity on the background of the lateral hemivertebrae scoliosis angle ranged from 0 to 6°. The degree of correction ranged from 94 to 100%. After extirpation of the posterolateral hemivertebrae the residual angle of scoliotic deformity ranged from 0 to 4° (average 2,5°, the degree of correction ranged from 95 to 100%, the kyphotic angle of the component from 9 to -6° (average 2,2°. Results were studied in terms from 2 to 7 years after surgery.

  6. Asymmetrical lumbosacral transitional vertebrae in dogs may promote asymmetrical hip joint development.

    Science.gov (United States)

    Flückiger, Mark A; Steffen, Frank; Hässig, Michael; Morgan, Joseph P

    2017-03-20

    This study examines the relationship between the morphology of the lumbosacral transitional vertebra (LTV) and asymmetrical development of the hip joints in dogs. A total of 4000 dogs which had been consecutively scored for canine hip dysplasia were checked for the presence of a LTV. A LTV was noted in 138 dogs and classified depending on the morphology of the transverse processes and the degree of contact with the ilium. In dogs with an asymmetrical LTV, the hip joint was significantly more predisposed to subluxation and malformation on the side of the intermediate or sacral-like transverse process (p hip joint conformation was less affected on the side featuring a free transverse process (p hip joint, and secondary osteoarthritis. Asymmetrical hip conformation may therefore be the sequela of a LTV and mask or aggravate genetically induced canine hip dysplasia.

  7. Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits.

    Science.gov (United States)

    Onu, David O; Hunn, Andrew W; Bohmer, Robert D

    2014-01-08

    The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review.

  8. Segmentation anomalies of the vertebras and ribs: a developmental field defect: epidemiologic evidence.

    Science.gov (United States)

    Martínez-Frías, M L; Urioste, M

    1994-01-01

    Opitz has defined developmental field defects (DFD) as "any dysmorphogenetically reactive unit of the developing organism that leads to final structure." We have incorporated in our coding system specific codes to identify individual DFDs in each child, irrespective of the cause or type of the MCA pattern (i.e., chromosomal, mendelian, environmental, or unknown). Using this approach, we can analyze the group of defects included in the expression of each DFD as a discrete unit. To confirm our hypothesis that vertebral and rib anomalies constitute a DFD, we have studied all of our cases with segmentation anomalies of the spine and ribs, including hemivertebrae, fused or absent vertebrae, and "crab-like" thorax, all of which fall into the loosely defined groups of spondylothoracic dysplasia, costovertebral dysplasia, Jarcho-Levin syndrome, and others. The study was performed using the 18,743 malformed children from the ECEMC data files, 110 of them having vertebral/rib anomalies.

  9. CT guidance is needed to achieve reproducible positioning of the mouse head for repeat precision cranial irradiation.

    Science.gov (United States)

    Armour, M; Ford, E; Iordachita, I; Wong, J

    2010-01-01

    To study the effects of cranial irradiation, we have constructed an all-plastic mouse bed equipped with an immobilizing head holder. The bed integrates with our in-house Small Animal Radiation Research Platform (SARRP) for precision focal irradiation experiments and cone-beam CT. We assessed the reproducibility of our head holder to determine the need for CT-based targeting in cranial irradiation studies. To measure the holder's reproducibility, a C57BL/6 mouse was positioned and CT-scanned nine times. Image sets were loaded into the Pinnacle(3) radiation treatment planning system and were registered to one another by one investigator using rigid body alignment of the cranial regions. Rotational and translational offsets were measured. The average vector shift between scans was 0.80 +/- 0.49 mm. Such a shift is too large to selectively treat subregions of the mouse brain. In response, we use onboard imaging to guide cranial irradiation applications that require sub-millimeter precision.

  10. Custom made bioceramic implants in complex and large cranial reconstruction: a two-year follow-up.

    Science.gov (United States)

    Staffa, Guido; Barbanera, Andrea; Faiola, Andrea; Fricia, Marco; Limoni, Paolo; Mottaran, Ruggero; Zanotti, Bruno; Stefini, Roberto

    2012-04-01

    Large cranial defects still represent a challenge in neurosurgery. Currently different biomaterials are available for cranial reconstruction including titanium, acrylic mesh and different types of calcium phosphate-based bone grafts. The goal of surgery is a perfect fit of the implant without infection and absorption, and a good aesthetic result. This paper describes a surgical method for cranioplasty, using a customised porous hydroxyapatite (HA) prosthesis. Sixty patients treated surgically with a customised porous-HA prosthesis for large cranial defects, were followed retrospectively. A two-year follow-up was carried out with periodic visits and CT scans. Safety (the incidence of adverse events and fractures of the implant) and clinical performance (biological and cosmetic results) were evaluated. Fifty one patients were followed-up, no rejection occurred and only one case of infection was recorded. Five patients had minor surgery-related complications, and no spontaneous implant fractures or mobilisation were reported. Three patients exhibited implant fractures as a result of trauma and all healed spontaneously. All patients showed a satisfactory clinical outcome with good cosmetic appearance in the early postoperative period and after a long-term follow-up. Cranioplasty performed with a customised porous-HA prosthesis gave a positive outcome, showing it to be an appropriate technique for use in large and complex cranial reconstruction. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Cement interdigitation and bone-cement interface after augmenting fractured vertebrae: A cadaveric study

    Science.gov (United States)

    Krüger, Antonio; Oberkircher, Ludwig; Kratz, Marita; Baroud, Gamal; Becker, Stephan; Ruchholtz, Steffen

    2012-01-01

    Background The treatment of painful osteoporotic vertebral compression fractures with transpedicular cement augmentation has grown significantly over the last 20 years. There is still uncertainty about long-term and midterm effects of polymethyl methacrylate in trabecular bone. Preservation of the trabecular structures, as well as interdigitation of the cement with the surrounding bone, therefore has been gaining increasing attention. Interdigitation of cement is likely relevant for biological healing and the biomechanical augmentation process. In this study a cutting and grinding technique was used to evaluate the interdigitation for 4 augmentation techniques. Methods By use of a standardized protocol, wedge fractures were created in vertebrae taken from a fresh-frozen spine. Thereafter the vertebrae were assigned to 1 of 4 similar groups with regard to the vertebral size and force required to produce the fracture. The 4 groups were randomized to the following augmentation techniques: balloon kyphoplasty, radiofrequency (RF) kyphoplasty, shield kyphoplasty, and vertebral stenting. Histologic analysis was designed to examine the bone structure and interdigitation after the augmentation. Results For the void-creating procedures, the distance between bone and cement was 341.4 ± 173.7 µm and 413.6 ± 167.6 µm for vertebral stenting and balloon kyphoplasty, respectively. Specifically, the trabecular bone was condensed around the cement, forming a shield of condensed bone. The procedures without a balloon resulted in shorter distances of 151.2 ± 111.4 µm and 228.1 ± 183.6 µm for RF and shield kyphoplasty, respectively. The difference among the groups was highly significant (P kyphoplasty, 20.5% ± 12.9% for vertebral stenting, 66.45% ± 12.35% for RF kyphoplasty, and 48.61% ± 20.56% for shield kyphoplasty. The difference among the groups was highly significant (P < .00001). Conclusions Cavity-creating procedures reduce the cement interdigitation significantly

  12. Cranial dystonia, blepharospasm and hemifacial spasm: clinical features and treatment, including the use of botulinum toxin.

    OpenAIRE

    Kraft, S. P.; Lang, A E

    1988-01-01

    Blepharospasm, the most frequent feature of cranial dystonia, and hemifacial spasm are two involuntary movement disorders that affect facial muscles. The cause of blepharospasm and other forms of cranial dystonia is not known. Hemifacial spasm is usually due to compression of the seventh cranial nerve at its exit from the brain stem. Cranial dystonia may result in severe disability. Hemifacial spasm tends to be much less disabling but may cause considerable distress and embarrassment. Patient...

  13. A Sequential Developmental Field Defect of the Vertebrae, Ribs, and Sternum, in a Young Woman of the 12th Century AD

    DEFF Research Database (Denmark)

    Christensen, Mette Nørregaard; Usher, Bethany

    2000-01-01

    . These extra elements in turn led to problems in union and differentiation, and later chondrification and ossification of the vertebra. The malformations of the vertebrae also induced changes in the ribs and sternum. The initial error of segmentation is identified as a developmental field defect...

  14. Cranial Nerve Development Requires Co-Ordinated Shh and Canonical Wnt Signaling

    Science.gov (United States)

    Kurosaka, Hiroshi; Trainor, Paul A.; Leroux-Berger, Margot; Iulianella, Angelo

    2015-01-01

    Cranial nerves govern sensory and motor information exchange between the brain and tissues of the head and neck. The cranial nerves are derived from two specialized populations of cells, cranial neural crest cells and ectodermal placode cells. Defects in either cell type can result in cranial nerve developmental defects. Although several signaling pathways are known to regulate cranial nerve formation our understanding of how intercellular signaling between neural crest cells and placode cells is coordinated during cranial ganglia morphogenesis is poorly understood. Sonic Hedgehog (Shh) signaling is one key pathway that regulates multiple aspects of craniofacial development, but whether it co-ordinates cranial neural crest cell and placodal cell interactions during cranial ganglia formation remains unclear. In this study we examined a new Patched1 (Ptch1) loss-of-function mouse mutant and characterized the role of Ptch1 in regulating Shh signaling during cranial ganglia development. Ptch1Wig/ Wig mutants exhibit elevated Shh signaling in concert with disorganization of the trigeminal and facial nerves. Importantly, we discovered that enhanced Shh signaling suppressed canonical Wnt signaling in the cranial nerve region. This critically affected the survival and migration of cranial neural crest cells and the development of placodal cells as well as the integration between neural crest and placodes. Collectively, our findings highlight a novel and critical role for Shh signaling in cranial nerve development via the cross regulation of canonical Wnt signaling. PMID:25799573

  15. Is cranial molding preventable in preterm infants? A systematic literature review of the effectiveness of interventions

    NARCIS (Netherlands)

    J.M. Wielenga (Joke); K. Helder MScN (Onno); P. Mansvelt (Petri); A. van den Hoogen (Agnes)

    2011-01-01

    textabstractAims: A systematic review of published studies was conducted to study the evidence supporting interventions to prevent or reduce cranial molding of the preterm infant in Neonatal Intensive Care Units. Background: Incidence of cranial molding has increased over recent decades. Cranial

  16. Routine Cranial Computed Tomography before Lumbar Puncture in ...

    African Journals Online (AJOL)

    Background: Current international guidelines recommend that a cranial computed tomography (CT) be performed on all HIV-positive patients presenting with new onset seizures, before a lumbar puncture (LP) is performed. In the South African setting, however this delay could be life threatening. The present study sought to ...

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

    Science.gov (United States)

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

    2012-02-01

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

  18. Routine cranial computed tomography before lumbar puncture in ...

    African Journals Online (AJOL)

    2015-07-03

    Jul 3, 2015 ... How to cite this article: Moolla S ... cranial computed tomography (CT) be performed on all HIV-positive patients presenting with new onset seizures ... an expanding mass such as a space-occupying lesion (SOL), cerebral oedema or hydrocephalus.5. Read online: Scan this QR code with your smart phone ...

  19. A reassessment of human cranial plasticity: Boas revisited

    Science.gov (United States)

    Sparks, Corey S.; Jantz, Richard L.

    2002-01-01

    In 1912, Franz Boas published a study demonstrating the plastic nature of the human body in response to changes in the environment. The results of this study have been cited for the past 90 years as evidence of cranial plasticity. These findings, however, have never been critiqued thoroughly for their statistical and biological validity. This study presents a reassessment of Boas' data within a modern statistical and quantitative genetic framework. The data used here consist of head and face measurements on over 8,000 individuals of various European ethnic groups. By using pedigree information contained in Boas' data, narrow sense heritabilities are estimated by the method of maximum likelihood. In addition, a series of t tests and regression analyses are performed to determine the statistical validity of Boas' original findings on differentiation between American and European-born children and the prolonged effect of the environment on cranial form. Results indicate the relatively high genetic component of the head and face diameters despite the environmental differences during development. Results point to very small and insignificant differences between European- and American-born offspring, and no effect of exposure to the American environment on the cranial index in children. These results contradict Boas' original findings and demonstrate that they may no longer be used to support arguments of plasticity in cranial morphology. PMID:12374854

  20. Middle cranial fossa variations including bilateral foramina entering ...

    African Journals Online (AJOL)

    The current observation indicated the presence of unusual bilateral foramina in the middle cranial fossa communicating with the sphenoid air sinuses. They were located anterolateral to the sella turcica and medial to the superior orbital fissure behind the optic canal. The complexity of sphenoid bone development and non ...

  1. Penetrating cranial nail injury an unusual domestic assault: Case ...

    African Journals Online (AJOL)

    A rare case of intracranial nail injury caused by domestic violence is presented. The 35-year old female patient was found unconscious with a 12cm nail almost completely buried into her skull. Xray of the skull showed the nail in the cranial cavity. A burr hole was made and the nail removed. Immediate post-operative period ...

  2. State of the art cranial ultrasound imaging in neonates

    NARCIS (Netherlands)

    Ecury-Goossen, Ginette M; Camfferman, Fleur A; Leijser, Lara M; Govaert, Paul; Dudink, Jeroen

    2015-01-01

    Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal

  3. Cranial Radiation Therapy and Damage to Hippocampal Neurogenesis

    Science.gov (United States)

    Monje, Michelle

    2008-01-01

    Cranial radiation therapy is associated with a progressive decline in cognitive function, prominently memory function. Impairment of hippocampal neurogenesis is thought to be an important mechanism underlying this cognitive decline. Recent work has elucidated the mechanisms of radiation-induced failure of neurogenesis. Potential therapeutic…

  4. Cranial helminths of Mustela vison Schreber, 1777 in Spain.

    Science.gov (United States)

    Torres, J; Miquel, J; Mañas, S; Asensio, V; Eira, C; Palazón, S

    2006-04-30

    A survey was carried out to investigate the presence of cranial helminths in 337 American minks (Mustela vison) from Spain. This information was obtained partly in order to evaluate potential conservation problems and sanitary risks to the congeneric European mink (Mustela lutreola), one of the most endangered carnivores in the world. Skulls and rectal faeces of each specimen were simultaneously analysed. Troglotrema acutum and Skrjabingylus nasicola were found in 5.6% of the M. vison analysed. No cranial lesions were seen in any of the examined skulls. The finding of both helminths in Spanish free-living M. vison specimens enlarges their natural definitive host spectrum in Western Europe. One relatively important focus of T. acutum in M. vison was detected (30.4%) in the Spanish Alava province while S. nasicola was found to be very infrequent. The suitability of both analytical methods was assessed in order to know to what degree coprological analysis reflects the real prevalence of cranial helminths in this host. It is possible to conclude that coprological analysis can be used instead of necropsies to analyse the possible incidence of pathogenic cranial helminths in mustelids. This aspect is very important and useful when trying to analyse the helminthological status of endangered species such as the native mink (M. lutreola) particularly in areas where both congeneric species are present and strict competition occurs.

  5. Cranial arterial patterns of the alpaca (Camelidae: Vicugna pacos).

    Science.gov (United States)

    O'Brien, Haley D

    2017-03-01

    Artiodactyl cranial arterial patterns deviate significantly from the standard mammalian pattern, most notably in the possession of a structure called the carotid rete (CR)-a subdural arterial meshwork that is housed within the cavernous venous sinus, replacing the internal carotid artery (ICA). This relationship between the CR and the cavernous sinus facilitates a suite of unique physiologies, including selective brain cooling. The CR has been studied in a number of artiodactyls; however, to my knowledge, only a single study to date documents a subset of the cranial arteries of New World camelids (llamas, alpacas, vicugñas and guanacoes). This study is the first complete description of the cranial arteries of a New World camelid species, the alpaca (Vicugna pacos), and the first description of near-parturition cranial arterial morphology within New World camelids. This study finds that the carotid arterial system is conserved between developmental stages in the alpaca, and differs significantly from the pattern emphasized in other long-necked ruminant artiodactyls in that a patent, homologous ICA persists through the animal's life.

  6. Cranial Computed Tomographic (CT) findings in HIV-positive Nigerian

    African Journals Online (AJOL)

    rological symptoms constitute a management challenge. Objective: T0 describe the pattern of cranial computed tomographic (CT) findings in neurosurgical patients with HIV infection. Study design: Retrospective analysis. Patients and method: A total of 1907 patients were adn mitted from October 1996 to October 2001.

  7. Zuigelingen met een scheef hoofd [Babies with cranial deformity

    NARCIS (Netherlands)

    Feijen, M.M.; Claessens, E.A.; Dovens, A.J.; Vles, J.S.; van der Hulst, R.R.

    2009-01-01

    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet

  8. Cranial arterial patterns of the alpaca (Camelidae: Vicugna pacos)

    Science.gov (United States)

    2017-01-01

    Artiodactyl cranial arterial patterns deviate significantly from the standard mammalian pattern, most notably in the possession of a structure called the carotid rete (CR)—a subdural arterial meshwork that is housed within the cavernous venous sinus, replacing the internal carotid artery (ICA). This relationship between the CR and the cavernous sinus facilitates a suite of unique physiologies, including selective brain cooling. The CR has been studied in a number of artiodactyls; however, to my knowledge, only a single study to date documents a subset of the cranial arteries of New World camelids (llamas, alpacas, vicugñas and guanacoes). This study is the first complete description of the cranial arteries of a New World camelid species, the alpaca (Vicugna pacos), and the first description of near-parturition cranial arterial morphology within New World camelids. This study finds that the carotid arterial system is conserved between developmental stages in the alpaca, and differs significantly from the pattern emphasized in other long-necked ruminant artiodactyls in that a patent, homologous ICA persists through the animal's life. PMID:28405385

  9. Association of fetal cranial shape with shoulder dystocia

    NARCIS (Netherlands)

    Belfort, M. A.; White, G. L.; Vermeulen, F. M.

    Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk

  10. Challenges and outcome of cranial neuroendoscopic surgery in a ...

    African Journals Online (AJOL)

    Challenges and outcome of cranial neuroendoscopic surgery in a resource constrained developing African country. ... Major challenges experienced were patient dependent in 28 ± 1.0 patients (95% CL), learning curve related in 21 ± 0.4 patients, and poor endoscopy support infrastructure in 15 ± 0.5 patients.

  11. Is phenytoin contraindicated in patients receiving cranial irradiation?

    Energy Technology Data Exchange (ETDEWEB)

    Borg, M.F. [Royal Adelaide Hospital, SA (Australia); Probert, J.C. [Auckland Hospital, Auckland (New Zealand). Dept. of Radiation Oncology; Zwi, L.J. [Auckland Univ. (New Zealand). Dept. of Medicine and Surgery

    1995-02-01

    Three recent publications have reported the development of erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens-Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens-Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation. 21 refs., 2 tabs., 3 figs.

  12. Challenges and outcome of cranial neuroendoscopic surgery in a ...

    African Journals Online (AJOL)

    2016-03-20

    Mar 20, 2016 ... Background: Cranial neuroendoscopy has been safely applied to the surgical treatment of different lesions of the brain in our center ... Conclusion: Highlighted are the myriad obstacles which interface the successful set up of neuroendoscopy service .... advancement in optics and computer technology.[1].

  13. Proposal for establishment of the UK Cranial Reconstruction Registry (UKCRR).

    Science.gov (United States)

    Kolias, Angelos G; Bulters, Diederik O; Cowie, Christopher J; Wilson, Mark H; Afshari, Fardad T; Helmy, Adel; Broughton, Ellie; Joannides, Alexis J; Zebian, Bassel; Harrisson, Stuart E; Hill, Ciaran S; Ahmed, Animul I; Barone, Damiano G; Thakur, Bhaskar; McMahon, Catherine J; Adlam, David M; Bentley, Robert P; Tolias, Christos M; Mitchell, Patrick M; Whitfield, Peter C; Critchley, Giles R; Belli, Antonio; Brennan, Paul M; Hutchinson, Peter J

    2014-06-01

    The increasing utilisation of decompressive craniectomy for traumatic brain injury and stroke has led to an increase in the number of cranioplasties undertaken. Cranioplasty is also undertaken following excision of tumours originating from or invading the skull vault, removal of bone flaps due to post-operative infection, and decompressive craniectomy for the management of rarer causes of brain oedema and/or refractory intracranial hypertension. The existing literature which mainly consists of single-centre, retrospective studies, shows a significant variation in practice patterns and a wide range of morbidity. There also exists a need to measure the outcome as perceived by the patients themselves with patient reported outcome measures (PROMs; functional outcome, quality of life, satisfaction with cosmesis). In the UK, the concept of long-term surveillance of neurosurgical implants is well established with the UK shunt registry. Based on this background, we propose to establish the UK Cranial Reconstruction Registry (UKCRR). The overarching aim of the UKCRR is to collect high-quality data about cranioplasties undertaken across the UK and Ireland in order to improve outcomes for patients. Any patient undergoing reconstruction of the skull vault with autologous bone, titanium, or synthetic material in participating units will be eligible for inclusion. Data will be submitted directly by participating units to the Outcome Registry Intervention and Operation Network secure platform. A Steering Committee will be responsible for overseeing the strategic direction and running of the UKCRR. These will include re-operation due to a cranioplasty-related issue, surgical site infection, re-admission due to a cranioplasty-related issue, unplanned post-operative escalation of care, adverse events, length of stay in admitting unit, destination at discharge from admitting unit, mortality at discharge from admitting unit, neurological status and PROMs during routine follow-up. The

  14. Skeletogenic fate of zebrafish cranial and trunk neural crest.

    Directory of Open Access Journals (Sweden)

    Erika Kague

    Full Text Available The neural crest (NC is a major contributor to the vertebrate craniofacial skeleton, detailed in model organisms through embryological and genetic approaches, most notably in chick and mouse. Despite many similarities between these rather distant species, there are also distinct differences in the contribution of the NC, particularly to the calvariae of the skull. Lack of information about other vertebrate groups precludes an understanding of the evolutionary significance of these differences. Study of zebrafish craniofacial development has contributed substantially to understanding of cartilage and bone formation in teleosts, but there is currently little information on NC contribution to the zebrafish skeleton. Here, we employ a two-transgene system based on Cre recombinase to genetically label NC in the zebrafish. We demonstrate NC contribution to cells in the cranial ganglia and peripheral nervous system known to be NC-derived, as well as to a subset of myocardial cells. The indelible labeling also enables us to determine NC contribution to late-forming bones, including the calvariae. We confirm suspected NC origin of cartilage and bones of the viscerocranium, including cartilages such as the hyosymplectic and its replacement bones (hymandibula and symplectic and membranous bones such as the opercle. The cleithrum develops at the border of NC and mesoderm, and as an ancestral component of the pectoral girdle was predicted to be a hybrid bone composed of both NC and mesoderm tissues. However, we find no evidence of a NC contribution to the cleithrum. Similarly, in the vault of the skull, the parietal bones and the caudal portion of the frontal bones show no evidence of NC contribution. We also determine a NC origin for caudal fin lepidotrichia; the presumption is that these are derived from trunk NC, demonstrating that these cells have the ability to form bone during normal vertebrate development.

  15. Evidence for the use of preoperative risk assessment scores in elective cranial neurosurgery: a systematic review of the literature.

    Science.gov (United States)

    Reponen, Elina; Tuominen, Hanna; Korja, Miikka

    2014-08-01

    Preoperative risk scores are designed to guide patient management by providing a means of predicting operative outcome. Several risk scores are used in neurosurgery, but studies on their clinical relevance are scarce. Therefore, it is not clear whether these risk scores are beneficial or helpful in predicting outcome after elective cranial neurosurgery. In this review, we summarize the current scientific evidence for using preoperative risk scores in elective cranial neurosurgery. A systematic review of the MEDLINE, Embase, and PubMed databases in November 2013 yielded 25 relevant studies with a minimum of 30 patients per study. The studies evaluated the value of the preoperative ASA physical status classification, the Karnofsky performance score (KPS), the Charlson comorbidity score, the modified Rankin Scale and the sex, KPS, ASA physical status classification, location, and edema (SKALE) score in assessing postoperative outcome in cranial neurosurgery. Surgery-related and nonsurgical complications were assessed separately whenever reported in the original article. For this purpose, the studies were placed into 4 categories based on the reported outcome: surgery-related outcome, nonsurgical outcome, morbidity, and mortality. The Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines for systematic reviews were followed. KPS has the strongest support in the literature for predicting surgery-related outcomes. There is no strong support in the literature for the use of any preoperative scores in predicting nonsurgical outcomes after elective craniotomies. KPS and ASA physical status classification seem to predict early (≤ 30-day) morbidity of intracranial tumor patients. The Charlson comorbidity score may be applicable in predicting mortality of elective intracranial aneurysm patients. Only 4 studies were prospective in design. Large prospective studies are needed to validate the use of the reviewed risk scores in elective cranial

  16. SU-F-T-642: Sub Millimeter Accurate Setup of More Than Three Vertebrae in Spinal SBRT with 6D Couch

    Energy Technology Data Exchange (ETDEWEB)

    Wang, X; Zhao, Z; Yang, J; Yang, J; McAleer, M; Brown, P; Li, J; Ghia, A [MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose: To assess the initial setup accuracy in treating more than 3 vertebral body levels in spinal SBRT using a 6D couch. Methods: We retrospectively analyzed last 20 spinal SBRT patients (4 cervical, 9 thoracic, 7 lumbar/sacrum) treated in our clinic. These patients in customized immobilization device were treated in 1 or 3 fractions. Initial setup used ExacTrac and Brainlab 6D couch to align target within 1 mm and 1 degree, following by a cone beam CT (CBCT) for verification. Our current standard practice allows treating a maximum of three continuous vertebrae. Here we assess the possibility to achieve sub millimeter setup accuracy for more than three vertebrae by examining the residual error in every slice of CBCT. The CBCT had a range of 17.5 cm, which covered 5 to 9 continuous vertebrae depending on the patient and target location. In the study, CBCT from the 1st fraction treatment was rigidly registered with the planning CT in Pinnacle. The residual setup error of a vertebra was determined by expanding the vertebra contour on the planning CT to be large enough to enclose the corresponding vertebra on CBCT. The margin of the expansion was considered as setup error. Results: Out of the 20 patients analyzed, initial setup accuracy can be achieved within 1 mm for a span of 5 or more vertebrae starting from T2 vertebra to inferior vertebra levels. 2 cervical and 2 upper thoracic patients showed the cervical spine was difficult to achieve sub millimeter accuracy for multi levels without a customized immobilization headrest. Conclusion: If the curvature of spinal columns can be reproduced in customized immobilization device during treatment as simulation, multiple continuous vertebrae can be setup within 1 mm with the use of a 6D couch.

  17. Predictive factors for a distal adjacent disorder with L3 as the lowest instrumented vertebra in Lenke 5C patients.

    Science.gov (United States)

    Ando, Kei; Imagama, Shiro; Ito, Zenya; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ito, Kenyu; Tsushima, Akito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Nishida, Yoshihiro; Ishiguro, Naoki

    2016-01-01

    To investigate what type of Lenke 5C patient benefits most from a fusion to L3 as the LIV. The subjects were 16 patients who underwent fusion surgery to L3 as the lowest instrumented vertebra (LIV), and who were then observed for a minimum of 2 years postoperatively. We considered an unsatisfactory radiologic outcome for the distal adjacent curve (DAD) to be an L3 or L4 tilt angle less than 10° or L3/4 disc wedging less than 10°. Patients were divided into 2 groups based on the radiologic outcome of the distal curve: the distal adjacent disorder+ (DAD+) and the distal adjacent disorder-(DAD-). We compared global balance, Cobb angles (thoracic and lumbar), L3 and L4 tilt angles and L3/4/5 disc angles between the 2 groups on preoperative, postoperative and final radiographs. Seven patients (43.8 %) met the criteria for the DAD+ group. On preoperative radiographs, there was a significant difference in the L3/4 disc angle: the DAD+ group opened to the preoperative convex side (-2.1° ± 3.0°) and the DAD- group opened to the preoperative concave side (4.7° ± 5.1°). The standing L3- and L4-CSVL and the L4-CSVL under traction were significantly different. In Lenke 5C patients who underwent fusion surgery to L3 as the LIV, preoperative LIV (L3), LIV + 1 (L4) translation and L3/4 disc angle on standing, plus LIV + 1 translation under traction were very important parameters correlating with postoperative global coronal balance.

  18. Morphometric study of the T6 vertebra and its three ossification centers in the human fetus.

    Science.gov (United States)

    Szpinda, Michał; Baumgart, Mariusz; Szpinda, Anna; Woźniak, Alina; Mila-Kierzenkowska, Celestyna; Dombek, Małgorzata; Kosiński, Adam; Grzybiak, Marek

    2013-12-01

    Knowledge on the normative growth of the spine is critical in the prenatal detection of its abnormalities. We aimed to study the size of T6 vertebra in human fetuses with the crown-rump length of 115-265 mm. Using the methods of computed tomography (Biograph mCT), digital image analysis (Osirix 3.9) and statistics, the normative growth of the T6 vertebral body and the three ossification centers of T6 vertebra in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17-30 weeks were studied. Neither male-female nor right-left significant differences were found. The height, transverse, and sagittal diameters of the T6 vertebral body followed natural logarithmic functions as y = -4.972 + 2.732 × ln(age) ± 0.253 (R (2) = 0.72), y = -14.862 + 6.426 × ln(age) ± 0.456 (R (2) = 0.82), and y = -10.990 + 4.982 × ln(age) ± 0.278 (R (2) = 0.89), respectively. Its cross-sectional area (CSA) rose proportionately as y = -19.909 + 1.664 × age ± 2.033 (R (2) = 0.89), whereas its volumetric growth followed the four-degree polynomial function y = 19.158 + 0.0002 × age(4) ± 7.942 (R (2) = 0.93). The T6 body ossification center grew logarithmically in both transverse and sagittal diameters as y = -14.784 + 6.115 × ln(age) ± 0.458 (R (2) = 0.81) and y = -12.065 + 5.019 × ln(age) ± 0.315 (R (2) = 0.87), and proportionately in both CSA and volume like y = -15.591 + 1.200 × age ± 1.470 (R (2) = 0.90) and y = -22.120 + 1.663 × age ± 1.869 (R (2) = 0.91), respectively. The ossification center-to-vertebral body volume ratio was gradually decreasing with age. On the right and left, the neural ossification centers revealed the following models: y = -15.188 + 6.332 × ln(age) ± 0.629 (R (2) = 0.72) and y = -15.991 + 6.600 × ln(age) ± 0.629 (R (2) = 0.74) for length, y = -6.716 + 2.814 × ln(age) ± 0.362 (R (2) = 0.61) and y = -7.058 + 2

  19. Reliability of Diagnosis and Clinical Efficacy of Cranial Osteopathy: A Systematic Review.

    Science.gov (United States)

    Guillaud, Albin; Darbois, Nelly; Monvoisin, Richard; Pinsault, Nicolas

    2016-01-01

    In 2010, the World Health Organization released benchmarks for training in osteopathy in which they considered cranial osteopathy as an important osteopathic skill. However, the evidence supporting the reliability of diagnosis and the efficacy of treatment in this field appears scientifically weak and inconsistent. To identify and critically evaluate the scientific literature dealing with the reliability of diagnosis and the clinical efficacy of techniques and therapeutic strategies used in cranial osteopathy. Relevant keywords were used to search the electronic databases MEDLINE, PEDro, OSTMED.DR, Cochrane Library, and in Google Scholar, Journal of American Osteopathy Association and International Journal of Osteopathic Medicine websites. Searches were conducted up to end June 2016 with no date restriction as to when the studies were completed. As a complementary approach we explored the bibliography of included articles and consulted available previous reviews dealing with this topic. Regarding diagnostic processes in cranial osteopathy, we analyzed studies that compared the results obtained by at least two examiners or by the same examiner on at least two occasions. For efficacy studies, only randomized-controlled-trials or crossover-studies were eligible. We excluded articles that were not in English or French, and for which the full-text version was not openly available. We also excluded studies with unsuitable study design, in which there was no clear indication of the use of techniques or therapeutic strategies concerning the cranial field, looked at combined treatments, used a non-human examiner and subjects or used healthy subjects for efficacy studies. There was no restriction regarding the type of disease. In our electronic search we found 1280 references concerning reliability of diagnosis studies plus four references via our complementary strategy. Based on the title 18 articles were selected for analysis. Nine were retained after applying our

  20. Reliability of Diagnosis and Clinical Efficacy of Cranial Osteopathy: A Systematic Review

    Science.gov (United States)

    Darbois, Nelly; Monvoisin, Richard

    2016-01-01

    Context In 2010, the World Health Organization released benchmarks for training in osteopathy in which they considered cranial osteopathy as an important osteopathic skill. However, the evidence supporting the reliability of diagnosis and the efficacy of treatment in this field appears scientifically weak and inconsistent. Objectives To identify and critically evaluate the scientific literature dealing with the reliability of diagnosis and the clinical efficacy of techniques and therapeutic strategies used in cranial osteopathy. Methods Relevant keywords were used to search the electronic databases MEDLINE, PEDro, OSTMED.DR, Cochrane Library, and in Google Scholar, Journal of American Osteopathy Association and International Journal of Osteopathic Medicine websites. Searches were conducted up to end June 2016 with no date restriction as to when the studies were completed. As a complementary approach we explored the bibliography of included articles and consulted available previous reviews dealing with this topic. Study selection Regarding diagnostic processes in cranial osteopathy, we analyzed studies that compared the results obtained by at least two examiners or by the same examiner on at least two occasions. For efficacy studies, only randomized-controlled-trials or crossover-studies were eligible. We excluded articles that were not in English or French, and for which the full-text version was not openly available. We also excluded studies with unsuitable study design, in which there was no clear indication of the use of techniques or therapeutic strategies concerning the cranial field, looked at combined treatments, used a non-human examiner and subjects or used healthy subjects for efficacy studies. There was no restriction regarding the type of disease. Search Results In our electronic search we found 1280 references concerning reliability of diagnosis studies plus four references via our complementary strategy. Based on the title 18 articles were selected

  1. Do different disparity proxies converge on a common signal? Insights from the cranial morphometrics and evolutionary history of Pterosauria (Diapsida: Archosauria).

    Science.gov (United States)

    Foth, C; Brusatte, S L; Butler, R J

    2012-05-01

    Disparity, or morphological diversity, is often quantified by evolutionary biologists investigating the macroevolutionary history of clades over geological timescales. Disparity is typically quantified using proxies for morphology, such as measurements, discrete anatomical characters, or geometric morphometrics. If different proxies produce differing results, then the accurate quantification of disparity in deep time may be problematic. However, despite this, few studies have attempted to examine disparity of a single clade using multiple morphological proxies. Here, as a case study for this question, we examine the disparity of the volant Mesozoic fossil reptile clade Pterosauria, an intensively studied group that achieved substantial morphological, ecological and taxonomic diversity during their 145+ million-year evolutionary history. We characterize broadscale patterns of cranial morphological disparity for pterosaurs for the first time using landmark-based geometric morphometrics and make comparisons to calculations of pterosaur disparity based on alternative metrics. Landmark-based disparity calculations suggest that monofenestratan pterosaurs were more diverse cranially than basal non-monofenestratan pterosaurs (at least when the aberrant anurognathids are excluded), and that peak cranial disparity may have occurred in the Early Cretaceous, relatively late in pterosaur evolution. Significantly, our cranial disparity results are broadly congruent with those based on whole skeleton discrete character and limb proportion data sets, indicating that these divergent approaches document a consistent pattern of pterosaur morphological evolution. Therefore, pterosaurs provide an exemplar case demonstrating that different proxies for morphological form can converge on the same disparity signal, which is encouraging because often only one such proxy is available for extinct clades represented by fossils. Furthermore, mapping phylogeny into cranial morphospace

  2. Post-operative central nervous system infections after cranial surgery in China: incidence, causative agents, and risk factors in 1,470 patients.

    Science.gov (United States)

    Zhan, R; Zhu, Y; Shen, Y; Shen, J; Tong, Y; Yu, H; Wen, L

    2014-05-01

    A post-operative central nervous system infection (PCNSI) is a dangerous complication after cranial surgery. Although a large number of neurosurgical procedures are performed in hospitals in China, PCNSI-related data from this country are rarely reported. To address this issue, we examined the incidence of PCNSI after cranial surgery, the potential risk factors, and the offending etiologic agents in a large Chinese population. The medical records and post-operative courses for patients >16 years of age who underwent elective or emergency cranial surgeries between May 2010 and May 2012 and who survived for >7 days were reviewed retrospectively. Pre-operative data, surgery-related records, and post-operative variables were evaluated as risk factors for PCNSI after cranial surgery. Among 1,470 surgeries, 1,340 were craniotomies and 130 involved the cerebrospinal fluid (CSF). There were 109 patients with PCNSIs, resulting in a total infection rate of 7.4 %. The dominant Gram-positive organism isolated (Staphylococcus aureus) was the most common pathogen isolated. Based on multivariate analysis, the risk of PCNSI was increased by a CSF leak [odds ratio (OR), 3.545; 95 % confidence interval (CI), 2.053-6.122; p China. CSF leakage, CSF drainage of any kind, subsequent short-term surgery, and surgery duration were major risk factors, indicating that surgery-focused management might be the most effective way to minimize the risk for PCNSI after cranial surgery.

  3. Crescimento da base craniana nos diferentes tipos faciais nos relacionamentos maxilomandibulares ortopédicos de Classe I, II e III: parte 1 Cranial base growth in different facial types in Class I, II and III orthopedic maxillomandibular relationship: part 1

    Directory of Open Access Journals (Sweden)

    Lucelma Vilela Pieri

    2007-02-01

    Full Text Available OBJETIVO: este estudo retrospectivo avaliou o crescimento médio anual da base craniana nos diferentes tipos faciais nos relacionamentos maxilomandibulares ortopédicos de Classe I, II e III. METODOLOGIA: uma amostra aleatória de 300 pacientes brasileiros leucodermas (131 do gênero masculino, 169 do gênero feminino, com idade média inicial de 10 anos e 2 meses (dentadura mista e final de 14 anos e 8 meses (segundos molares em oclusão e tempo médio de observação de 4 anos e 5 meses, foi selecionada em uma clínica particular, em São Paulo, Brasil. Havia 118 Classe I, 151 Classe II e 31 Classe III. Todas as 600 radiografias cefalométricas laterais foram obtidas no mesmo aparelho de raios-x. As análises de Ricketts e Schwarz modificadas por Faltin foram usadas. As medidas lineares (Ba-Na, CC-Na, CC-Ba e CF-Po foram feitas pelo mesmo examinadora em T1 e T2. Os tipos faciais e de relacionamentos foram estudados juntos com a amostragem total e subdividida por gêneros. Os testes de Levene e t de Student foram aplicados. RESULTADOS E CONCLUSÕES: os resultados confirmaram os valores de Langlade, porém mostraram dimorfismo sexual, com o gênero masculino crescendo significativamente mais que o feminino. Este estudo será de grande aplicação para a previsão de crescimento, prognóstico e o plano de tratamento de pacientes em crescimento.AIM: to assess the cranial base annual mean growth in different facial types in Class I, II and III orthopedic maxillomandibular relationship. METHODS: a random sample of 300 Brazilian Caucasian patients (131 males, 169 females, with 10 years and 2 months (mixed dentition initial mean age, 14 years and 8 months (second molar occlusion final mean age and 4 years and 5 months mean observation time was selected at a private clinic in São Paulo - Brazil. There were 118 Class I, 151 Class II and 31 Class III. All 600 lateral cephalometric radiographs were taken using the same x-rays equipment. Ricketts and

  4. Cross-sectional study of the neural ossification centers of vertebrae C1-S5 in the human fetus.

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    Szpinda, Michał; Baumgart, Mariusz; Szpinda, Anna; Woźniak, Alina; Mila-Kierzenkowska, Celestyna

    2013-10-01

    An understanding of the normal evolution of the spine is of great relevance in the prenatal detection of spinal abnormalities. This study was carried out to estimate the length, width, cross-sectional area and volume of the neural ossification centers of vertebrae C1-S5 in the human fetus. Using the methods of CT (Biograph mCT), digital-image analysis (Osirix 3.9) and statistics (the one-way ANOVA test for paired data, the Kolmogorov-Smirnov test, Levene's test, Student's t test, the one-way ANOVA test for unpaired data with post hoc RIR Tukey comparisons) the size for the neural ossification centers throughout the spine in 55 spontaneously aborted human fetuses (27 males, 28 females) at ages of 17-30 weeks was studied. The neural ossification centers were visualized in the whole pre-sacral spine, in 74.5 % for S1, in 61.8 % for S2, in 52.7 % for S3, and in 12.7 % for S4. Neither male-female nor right-left significant differences in the size of neural ossification centers were found. The neural ossification centers were the longest within the cervical spine. The maximum values referred to the axis on the right, and to C5 vertebra on the left. There was a gradual decrease in length for the neural ossification centers of T1-S4 vertebrae. The neural ossification centers were the widest within the proximal thoracic spine and narrowed bi-directionally. The growth dynamics for CSA of neural ossification centers were found to parallel that of volume. The largest CSAs and volumes of neural ossification centers were found in the C3 vertebra, and decreased in the distal direction. The neural ossification centers show neither male-female nor right-left differences. The neural ossification centers are characterized by the maximum length for C2-C6 vertebrae, the maximum width for the proximal thoracic spine, and both the maximum cross-sectional area and volume for C3 vertebra. There is a sharp decrease in size of the neural ossification centers along the sacral spine. A

  5. [A comparative study on treatment of thoracolumbar fracture with injured vertebra pedicle instrumentation and cross segment pedicle instrumentation].

    Science.gov (United States)

    Yin, Fei; Sun, Zhenzhong; Yin, Qudong; Liu, Jun; Gu, Sanjun; Zhang, Shaodong

    2014-02-01

    To compare the effective of short-segment pedicle instrumentation with bone grafting and pedicle screw implanting in injured vertebra and cross segment pedicle instrumentation with bone grafting in injured vertebra for treating thoracolumbar fractures. A prospective randomized controlled study was performed in 40 patients with thoracolumbar fracture who were in accordance with the inclusive criteria between June 2010 and June 2012. Of 40 patients, 20 received treatment with short-segment pedicle screw instrumentation with bone grafting and pedicle screw implanting in injured vertebra in group A, and 20 received treatment with cross segment pedicle instrumentation with bone grafting in injured vertebra in group B. There was no significant difference in gender, age, affected segment, disease duration, Frankel grade, Cobb angle, compression rate of anterior verterbral height, visual analogue scale (VAS) score, and Japanese Orthopaedic Association (JOA) score between 2 groups before operation (P > 0.05). The operation time, blood loss, Cobb angle, compression rate of anterior vertebral height, loss of disc space height, Frankel grade, VAS and JOA scores were compared between 2 groups. There was no significant difference in the operation time and blood loss between 2 groups (P > 0.05). Primary healing of incision was obtained in all patients, and no early complication of infection or lower limb vein thrombus occurred. Forty patients were followed up 12-16 months (mean, 14.8 months). No breaking or displacement of internal fixation was observed. The improvement of Frankel grading score was 0.52 +/- 0.72 in group A and 0.47 +/- 0.63 in group B, showing no significant difference (t = 0.188, P = 0.853) at 12 months after operation. The Cobb angle, compression rate of anterior verterbral height, and VAS score at 1 week and 12 months, and JOA score at 12 months were significantly improved when compared with preoperative ones in 2 groups (P 0.05), but the compression rate of

  6. Dosimetric comparison of intensity modulated radiosurgery with dynamic conformal arc radiosurgery for small cranial lesions.

    Science.gov (United States)

    Calvo-Ortega, Juan F; Delgado, David; Moragues, Sandra; Pozo, Miquel; Casals, Joan

    2016-01-01

    To dosimetrically compare the fixed gantry intensity modulated radiosurgery (IMRS) with dynamic conformal arc radiosurgery (DCARS) for cranial lesions. This study investigates whether IMRS can be an adequate dosimetric alternative to DCARS for cranial stereotactic radiosurgery (SRS). Forty-five SRS procedures for solitary brain metastasis (range: 0.44-29.18 cm 3) performed at our institution were selected for this study. Two plans were generated per patient: One IMRS plan using a multileaf collimation (MLC) of 5 mm, and one DCARS plan designed with a 3 mm micro-MLC. Dosimetric comparison metrics include the target coverage (Cov), conformity index (CI), homogeneity index (HI), gradient index (GI), and volume of the normal brain tissue receiving ≥12 Gy (V12). In addition, maximum doses to organs at risk (OAR) (brainstem, optic apparatus and cochlea) were compared for both techniques. Compared to DCARS, IMRS improved mean CI (IMRS: 0.81 vs. 0.63, P 0.05), HI (IMRS: 1.22 vs. 1.24, P > 0.05), GI (IMRS: 5.44 vs. 5.44, P > 0.05). A weak significant difference in V12 (IMRS: 4.6 cm 3 vs. 5.2 cm 3, P = 0.033) was obtained. Subgroup analysis per target volume (small: dose to the OAR. We have shown that IMRS provides the dosimetric advantages compared with DCARS. Based on the dosimetric findings in this study, fixed gantry IMRS technique can be adopted as a standard procedure for cranial SRS when micro-MLC technology is not available on the linear accelerator.

  7. Verifying three-dimensional skull model reconstruction using cranial index of symmetry.

    Directory of Open Access Journals (Sweden)

    Woon-Man Kung

    Full Text Available BACKGROUND: Difficulty exists in scalp adaptation for cranioplasty with customized computer-assisted design/manufacturing (CAD/CAM implant in situations of excessive wound tension and sub-cranioplasty dead space. To solve this clinical problem, the CAD/CAM technique should include algorithms to reconstruct a depressed contour to cover the skull defect. Satisfactory CAM-derived alloplastic implants are based on highly accurate three-dimensional (3-D CAD modeling. Thus, it is quite important to establish a symmetrically regular CAD/CAM reconstruction prior to depressing the contour. The purpose of this study is to verify the aesthetic outcomes of CAD models with regular contours using cranial index of symmetry (CIS. MATERIALS AND METHODS: From January 2011 to June 2012, decompressive craniectomy (DC was performed for 15 consecutive patients in our institute. 3-D CAD models of skull defects were reconstructed using commercial software. These models were checked in terms of symmetry by CIS scores. RESULTS: CIS scores of CAD reconstructions were 99.24±0.004% (range 98.47-99.84. CIS scores of these CAD models were statistically significantly greater than 95%, identical to 99.5%, but lower than 99.6% (p<0.001, p = 0.064, p = 0.021 respectively, Wilcoxon matched pairs signed rank test. These data evidenced the highly accurate symmetry of these CAD models with regular contours. CONCLUSIONS: CIS calculation is beneficial to assess aesthetic outcomes of CAD-reconstructed skulls in terms of cranial symmetry. This enables further accurate CAD models and CAM cranial implants with depressed contours, which are essential in patients with difficult scalp adaptation.

  8. Non-coplanar automatic beam orientation selection in cranial IMRT: a practical methodology

    Energy Technology Data Exchange (ETDEWEB)

    Llacer, Jorge [EC Engineering Consultants LLC, 130 Forest Hill Drive, Los Gatos, CA 95032 (United States); Li Sicong [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68198 (United States); Agazaryan, Nzhde; Solberg, Timothy D [Department of Radiation Oncology, University of California, Los Angeles, CA 90095 (United States); Promberger, Claus [BrainLAB AG, Kapellenstrasse 12, 85622 Feldkirchen (Germany)], E-mail: escalivat@jllacer.com, E-mail: sl1@unmc.edu, E-mail: NAgazaryan@mednet.ucla.edu, E-mail: claus.promberger@brainlab.com, E-mail: Timothy.Solberg@utsouthwestern.edu

    2009-03-07

    This paper proposes a method for automatic selection of beam orientations in non-coplanar cranial IMRT. Methods of computer vision, beam's eye view techniques and neural networks are used to define a new geometry-based methodology that leads to treatment plans for cranial lesions that are comparable in quality to those generated by experienced radiation physicists. The automatic beam selection (ABS) process can be carried out in clinically useful computation times, in 1 min or less for most cases. In the process of describing the ABS process, it is shown that the cranial beam orientation optimization problem is mathematically ill posed, with the expectation that a large number of solutions will lead to similar results. Nevertheless, there are better and worse solutions and we show that the proposed ABS process, by its design, has to lead to one of the better ones. We have carried out extensive tests with 14 patients with beam selection tasks ranging from the rather simple to quite complex. The ABS process has always yielded optimizations with results that are considered good for clinic use. Seven-beam coplanar optimizations for some of the patients have also been investigated. Comparisons with non-coplanar optimizations indicate in which cases the simpler coplanar plans can be used to advantage. Parameters used in the comparisons are dose-volume histograms, minimum and maximum PTV doses, equivalent uniform doses for the PTV and OARs, and treatment volume, conformity and normal tissue indices. It is felt that the current ABS methodology is ready for extensive clinical tests.

  9. Nell1-deficient mice have reduced expression of extracellular matrix proteins causing cranial and vertebral defects

    Energy Technology Data Exchange (ETDEWEB)

    Desai, Jayashree [University of Tennessee, Knoxville (UTK) & Oak Ridge National Laboratory (ORNL); Shannon, Mark E. [Applied Biosystems; Johnson, Mahlon D. [University of Tennessee Graduate School of Medicine; Ruff, David W. [Applied Biosystems; Hughes, Lori A [ORNL; Kerley, Marilyn K [ORNL; Carpenter, D A [ORNL; Johnson, Dabney K [ORNL; Rinchik, Eugene M. [University of Tennessee, Knoxville (UTK) & Oak Ridge National Laboratory (ORNL); Culiat, Cymbeline T [ORNL

    2006-01-01

    The mammalian Nell1 gene encodes a protein kinase C-b1 (PKC-b1) binding protein that belongs to a new class of cell-signaling molecules controlling cell growth and differentiation. Over-expression of Nell1 in the developing cranial sutures in both human and mouse induces craniosynostosis, the premature fusion of the growing cranial bone fronts. Here, we report the generation, positional cloning and characterization of Nell16R, a recessive, neonatal-lethal point mutation in the mouse Nell1 gene, induced by N-ethyl-N-nitrosourea. Nell16R has a T!A base change that converts a codon for cysteine into a premature stop codon [Cys(502)Ter], resulting in severe truncation of the predicted protein product and marked reduction in steady-state levels of the transcript. In addition to the expected alteration of cranial morphology, Nell16R mutants manifest skeletal defects in the vertebral column and ribcage, revealing a hitherto undefined role for Nell1 in signal transduction in endochondral ossification. Real-time quantitative reverse transcription-PCR assays of 219 genes showed an association between the loss of Nell1 function and reduced expression of genes for extracellular matrix (ECM) proteins critical for chondrogenesis and osteogenesis. Several affected genes are involved in the human cartilage disorder Ehlers-Danlos Syndrome and other disorders associated with spinal curvature anomalies. Nell16R mutant mice are a new tool for elucidating basic mechanisms in osteoblast and chrondrocyte differentiation in the developing skull and vertebral column and understanding how perturbations in the production of ECM proteins can lead to anomalies in these structures.

  10. What do cranial bones of LB1 tell us about Homo floresiensis?

    Science.gov (United States)

    Balzeau, Antoine; Charlier, Philippe

    2016-04-01

    Cranial vault thickness (CVT) of Liang Bua 1, the specimen that is proposed to be the holotype of Homo floresiensis, has not yet been described in detail and compared with samples of fossil hominins, anatomically modern humans or microcephalic skulls. In addition, a complete description from a forensic and pathological point of view has not yet been carried out. It is important to evaluate scientifically if features related to CVT bring new information concerning the possible pathological status of LB1, and if it helps to recognize affinities with any hominin species and particularly if the specimen could belong to the species Homo sapiens. Medical examination of the skull based on a micro-CT examination clearly brings to light the presence of a sincipital T (a non-metrical variant of normal anatomy), a scar from an old frontal trauma without any evident functional consequence, and a severe bilateral hyperostosis frontalis interna that may have modified the anterior morphology of the endocranium of LB1. We also show that LB1 displays characteristics, related to the distribution of bone thickness and arrangements of cranial structures, that are plesiomorphic traits for hominins, at least for Homo erectus s.l. relative to Homo neanderthalensis and H. sapiens. All the microcephalic skulls analyzed here share the derived condition of anatomically modern H. sapiens. Cranial vault thickness does not help to clarify the definition of the species H. floresiensis but it also does not support an attribution of LB1 to H. sapiens. We conclude that there is no support for the attribution of LB1 to H. sapiens as there is no evidence of systemic pathology and because it does not have any of the apomorphic traits of our species. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. A Simple Bone Cyst in Cervical Vertebrae of an Adolescent Patient

    Directory of Open Access Journals (Sweden)

    Adriana Bruges Boude

    2017-01-01

    Full Text Available Introduction. Spinal simple bone cysts, also known as solitary cysts, are extremely unusual benign primary bone tumors with few cases reported in the literature. Case Presentation. Incidental Magnetic Resonance Imaging (MRI finding of a C2 Simple bone cyst in a 13-year-old female patient is reported. Complementary studies suggested the benign nature of the lesion. Patient underwent cervical curettage followed by tumor excision. A lateral submandibular approach to the upper cervical spine was used and careful bone resection was possible with a radiofrequency assisted burr and no instrumentation or fixation was required. The stability of the defect was ensured by filling it with bone allograft and by prescribing a postsurgical plastic cervical collar to maintain neck immobilization. Histological examination supported the diagnosis of simple bone cyst. At 6–12-month follow-up the patient presented no recurrence or symptomatology. Conclusions. Solitary bone cysts are infrequent entities in the cervical vertebrae and preservation of spine stability without instrumentation to avoid neurological complications is often challenging. In this case, the proximity of the cyst to the right vertebral artery and the risk of injury were high; however the surgical approach used was successful and no recurrence or instability was evidenced on postoperative MRI.

  12. Plexin a4 expression in adult rat cranial nerves.

    Science.gov (United States)

    Gutekunst, Claire-Anne; Gross, Robert E

    2014-11-01

    PlexinsA1-A4 participate in class 3 semaphorin signaling as co-receptors to neuropilin 1 and 2. PlexinA4 is the latest member of the PlexinA subfamily to be identified. In previous studies, we described the expression of PlexinA4 in the brain and spinal cord of the adult rat. Here, antibodies to PlexinA4 were used to reveal immunolabeling in most of the cranial nerve surveyed. Labeling was found in the olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, and hypoglossal nerves. This is the first detailed description of the cellular and subcellular distribution of PlexinA4 in the adult cranial nerves. The findings will set the basis for future studies on the potential role of PlexinA4 in regeneration and repair of the adult central and peripheral nervous system. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Congenital multiple cranial neuropathies: Relevance of orofacial electromyography in infants.

    Science.gov (United States)

    Renault, Francis; Flores-Guevara, Roberto; Baudon, Jean-Jacques; Vazquez, Marie-Paule

    2015-11-01

    The aim of this study was to assess diagnoses and outcomes of infants with 2 or more cranial neuropathies identified using orofacial electromyography (EMG). This retrospective study involved 90 patients. Diagnoses took into account clinical, radiological, and genetic data. EMG examined the orbicularis oculi, genioglossus, and levator veli palatini muscles, and blink responses. To evaluate outcome, neurological disability, respiratory complications, and feeding difficulties were recorded. The patients had malformation syndromes (59), encephalopathies (29), or no underlying disorders (2). Neurogenic EMG signs were detected in a mean of 4 muscles, reflecting a mean of 3 affected nerves. EMG identified a higher number of neuropathies than clinical examination alone (82 vs. 31, facial; 56 vs. 2, pharyngeal; 25 vs. 3, hypoglossal). Poor outcome and death were more frequent when EMG identified ≥4 affected nerves (P = 0.02). EMG highlights multiple cranial neuropathies that can be clinically silent in infants with malformation syndromes or encephalopathies. © 2015 Wiley Periodicals, Inc.

  14. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies.

    Science.gov (United States)

    Byju, N; Jose, James; Saifudheen, K; Gafoor, V Abdul; Jithendranath, P

    2012-10-01

    Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9(th), 10(th), and 12(th) cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.

  15. Cranial electrotherapy stimulation for the treatment of depression.

    Science.gov (United States)

    Gunther, Mary; Phillips, Kenneth D

    2010-11-01

    More prevalent in women than men, clinical depression affects approximately 15 million American adults in a given year. Psychopharmaceutical therapy accompanied by psychotherapy and wellness interventions (e.g., nutrition, exercise, counseling) is effective in 80% of diagnosed cases. A lesser known adjunctive therapy is that of cranial electrotherapy stimulation (CES). The major hypothesis for the use of CES in depression is that it may reset the brain to pre-stress homeostasis levels. It is conjectured that the pulsed electrical currents emitted by cranial electrical stimulators affect changes in the limbic system, the reticular activating system, and/or the hypothalamus that result in neurotransmitter secretion and downstream hormone production. While evidence is good for applied research, basic research about the mechanisms of action for CES remains in its infancy. A review of the literature provides an overview of current research findings and implications for clinical mental health practice.

  16. MR of acoustic neuromas; Relationship to cranial nerves

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Masayuki; Takashima, Tsutomu; Kadoya, Masumi; Takahashi, Shiroh; Miyayama, Shiroh; Taira, Sakae; Kashihara, Kengo; Yamashima, Tetsumori; Itoh, Haruhide (Kanazawa Univ. (Japan). School of Medicine)

    1989-08-01

    In this report, the relationship of acoustic neuromas to the adjacent cranial nerves is discussed. On T{sub 1}-weighted images, the trigeminal nerve was detected in all 13 cases. Mild to marked compression of these nerves by the tumors was observed in eight cases. The extent of compression did not always correspond to the clinical symptoms. In four cases with a maximum tumor diameter of 2 cm or less, the 7th and 8th cranial nerves were identified. There was no facial palsy in these patients. Two patients with a tumor diameter of more than 2 cm also had no facial palsy. All patients, including those with small tumors, complained of hearing loss and/or tinnitus. While MR imaging has some limitations, it is an effective imaging modality for showing the relationship between tumors and nerves. (author).

  17. A new mathematical model for pattern formation by cranial sutures.

    Science.gov (United States)

    Yoshimura, Kenji; Kobayashi, Ryo; Ohmura, Tomohisa; Kajimoto, Yoshinaga; Miura, Takashi

    2016-11-07

    Cranial sutures are narrow mesenchymal tissues that connect skull bones to each other. Given that they serve as growth centers in the skull, these undifferentiated tissues play crucial roles in skull development. Cranial sutures are also of clinical importance, because the premature fusion of skull bones results in a pathological condition called craniosynostosis. In newborns, skull sutures are wide and straight; during adolescence, they become thinner and start winding to form an interdigitating pattern. From a functional aspect, as the degree of interdigitation becomes larger, the strength of the connection between bones increases. However, the mechanisms underlying the maintenance of mesenchymal narrow bands or formation of interdigitation remain poorly understood. In the present study, we presented a new mathematical model that can reproduce the suture width maintenance and interdigitation formation. We can predict the width of the mesenchyme bands and wavelengths of suture interdigitations from the model. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Cranial Nerve Palsies: Sarcoidosis to Systemic Lupus Erythematosus

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    Fawad Aslam

    2013-01-01

    Full Text Available Cranial palsies are a very rare feature of SLE. Similarly, peripheral sensory-motor axonal neuropathy is very uncommon in SLE. The combination of the two as the presenting symptoms of SLE is a diagnostic challenge particularly in an elderly male patient with a known diagnosis of sarcoidosis. This case serves to highlight the diagnostic considerations in such a patient. The lack of response to standard therapy and the presence of subtle clues like anemia, proteinuria, and mild serositis should prompt the physician to look for alternate diagnoses. The potential association of SLE and sarcoidosis is also discussed. SLE can be present in elderly male patients with cranial and peripheral neuropathy.

  19. Potential Therapeutic Use of Relaxin in Healing Cranial Bone Defects

    Science.gov (United States)

    2016-08-01

    Osmotic pump implantation 2. Necropsy 3 A. Subtasks (i) Tail blood (ii) Heart puncture and exsanguination (iii) Bone harvest (iv) Bone processing and...the cranial defect to circulating values. 2. To reproducibly create bilateral, parietal defects of comparable diameter. Using a dental burr and a... implantations . Yanpeng Diao, PhD Role: Co-I Research ID: NA Nearest person month work: 1.2 Contribution to project: harvesting of bones from GFP

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

    Science.gov (United States)

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

    2013-10-01

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

  1. The age-related emergence of cranial morphological variation.

    Science.gov (United States)

    Wood, Carolan

    2015-06-01

    Evaluation of ancestry from skeletal remains is problematic for subadults because of a lack of systematic research on the topic. This paper addresses the need for systematic research into geographical variation through childhood and puberty through the examination of the emergence of cranial morphological traits through an analysis of 756 subadults from 4 months in utero to Population specific differences in the expression of most traits are apparent from their first appearance. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Severe cranial neuropathies caused by falls from heights in children.

    Science.gov (United States)

    Zahavi, A; Luckman, J; Yassur, I; Michowiz, S; Goldenberg-Cohen, N

    2016-04-01

    Falls from heights are the most common traumatic event associated with emergency department visits in children. This study investigated the incidence and clinical course of cranial neuropathies caused by falls from heights in children. The computerized records of a tertiary pediatric medical center were searched for all patients admitted to the emergency department in 2004-2014 with a head injury caused by falling from a height. Those with cranial neuropathies involving optic and eye-motility disturbances were identified, and their clinical, imaging, and outcome data were evaluated. Of the estimated 61,968 patients who presented to the emergency department during the study period because of a fall, 18,758 (30.3 %) had head trauma. Only 12 (seven boys, five girls, average age 6.7 years) had a visual disturbance. Eight were diagnosed with traumatic optic neuropathy, one after a 6-month delay, including two with accompanying cranial nerve (CN) III injuries. Five patients had anisocoria or an abnormal pupillary response to light at presentation, one patient had CN VI paralysis and temporary vision loss, and one patient had an isolated CN III injury diagnosed on follow-up. Visual improvement varied among the patients. Cranial neuropathies due to falls from heights are rare in children and are associated with high visual morbidity. Vision or ocular motility impairment, especially monocular vision loss, may be missed during acute intake to the emergency department, and a high index of suspicion is needed. Assessment of the pupillary response to light is essential.

  3. Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia.

    Science.gov (United States)

    Kirsch, Daniel L; Nichols, Francine

    2013-03-01

    Cranial electrotherapy stimulation is a prescriptive medical device that delivers a mild form of electrical stimulation to the brain for the treatment of anxiety, depression, and insomnia. It is supported by more than 40 years of research demonstrating its effectiveness in several mechanistic studies and greater than 100 clinical studies. Adverse effects are rare (electrotherapy stimulation may also be used as an adjunctive therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. SCHWANNOMA ORIGINATING FROM LOWER CRANIAL NERVES: REPORT OF 4 CASES

    OpenAIRE

    OYAMA, HIROFUMI; KITO, AKIRA; MAKI, HIDEKI; HATTORI, KENICHI; NODA, TOMOYUKI; WADA, KENTARO

    2012-01-01

    ABSTRACT Four cases of schwannoma originating from the lower cranial nerves are presented. Case 1 is a schwannoma of the vagus nerve in the parapharyngeal space. The operation was performed by the transcervical approach. Although the tumor capsule was not dissected from the vagus nerve, hoarseness and dysphagia happened transiently after the operation. Case 2 is a schwannoma in the jugular foramen. The operation was performed by the infralabyrinthine approach. Although only the intracapsular ...

  5. The management of cranial injuries in antiquity and beyond.

    Science.gov (United States)

    Kshettry, Varun R; Mindea, Stefan A; Batjer, H Hunt

    2007-01-01

    Cranial injuries were among the earliest neurosurgical problems faced by ancient physicians and surgeons. In this review, the authors trace the development of neurosurgical theory and practice for the treatment of cranial injuries beginning from the earliest ancient evidence available to the collapse of the Greco-Roman civilizations. The earliest neurosurgical procedure was trephination, which modern scientists believe was used to treat skull fractures in some civilizations. The Egyptian papyri of Edwin Smith provide a thorough description of 27 head injuries with astute observations of clinical signs and symptoms, but little information on the treatment of these injuries. Hippocrates offered the first classification of skull fractures and discussion of which types required trephining, in addition to refining this technique. Hippocrates was also the first to understand the basis of increased intracranial pressure. After Hippocrates, the physicians of the Alexandrian school provided further insight into the clinical evaluation of patients with head trauma, including the rudiments of a Glasgow Coma Scale. Finally, Galen of Pergamon, a physician to fallen gladiators, substantially contributed to the understanding of the neuroanatomy and physiology. He also described his own classification system for skull fractures and further refined the surgical technique of trephination. From the study of these important ancient figures, it is clearly evident that the knowledge and experience gained from the management of cranial injuries has laid the foundation not only for how these injuries are managed today, but also for the development of the field of neurosurgery.

  6. Morphometric Analysis of Cranial Shape in Fossil and Recent Euprimates

    Directory of Open Access Journals (Sweden)

    C. Verity Bennett

    2012-01-01

    Full Text Available Q