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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

    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. Relationship between cranial and mandibular growth and the stages of maturation of the cervical vertebrae

    Directory of Open Access Journals (Sweden)

    Melissa Feres Damian

    2007-04-01

    Full Text Available Quantification of the expectation of craniofacial growth during the pubertal growth spurt (PGS is helpful in orthodontic diagnosis and treatment planning. Thus, this study investigated whether the stages of the vertebral maturation index (VMI would be valid for estimating cranial and mandibular growth during the initial stages of PGS, testing the null hypothesis that these structures do not demonstrate differential growth dependent on the maturation stage. A study population of 45 patients of both genders with 2 lateral cephalometric radiographs, taken at a 12-month interval, was selected from files. All patients should not have been previously submitted to orthodontic treatment and should be before or during the peak stage of PGS. The S-N and Co-Gn cephalometric measurements were traced on both radiographs of each patient, by computed cephalometric tracings, for evaluation of skull and mandible, respectively. The growth of these structures was established by the difference between the measurements obtained on both tracings. The VMI stage was also estimated on the radiographs, determining the position of patients on the PGS curve at two periods, baseline and after 12 months. Cephalometric tracings and VMI estimates were performed by two calibrated examiners. Descriptive statistics revealed that both cephalometric measurements increased during the study period, especially Co-Gn, which demonstrated (ANOVA and Tukey's test; 5% significance level, a statistically significant peak of development (p = 0.001, when the patient was in the VMI stage representing the PGS peak. It was concluded that the VMI stages were valid for the analysis of cranial growth and especially of mandibular growth at the initial stages of PGS, thus rejecting the null hypothesis.

  3. Assessment of skeletal maturation based on cervical vertebrae in CBCT.

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    Shim, Jocelyne J; Heo, Giseon; Lagravère, Manuel O

    2012-12-01

    Diagnosis of skeletal age in adolescents helps orthodontists select and time treatments. Currently this is done using lateral cephalometric radiographs. This study evaluates the application of the conventional method in cone-beam computer tomographic (CBCT) images to bring forth assessment of skeletal maturation in three-dimensions. Ninety-eight lateral cephalometric radiographs and CBCT scans were collected from orthodontic patients between 11 to 17 years of age over an 18-month period. CBCT scans were examined in seven sagittal slices based on cervical vertebral maturation staging (CVMS). Collected CVMS values were compared with those from corresponding lateral cephalometric radiograph. CVMS measured from CBCT and lateral cephalometric radiographs were the same on average. However, they were not consistent with each other and scored interclass correlation coefficient of 0.155 in validity test. Interoperator reliability was weak (0.581). Adaptation of cervical vertebrae maturation staging in CBCT requires further clarifications or modifications to become consistent with lateral cephalometric examinations and to become a reliable method. Alternatively, a completely new method may be developed consisting of maturational indicators or landmarks unique to CBCT imaging. Copyright © 2012. Published by Elsevier Masson SAS.

  4. 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......, and by use of a new method, using a "virtual cast". The cranial base was quantified by placing 12 landmarks in the posterior fossa. Procrustes analysis, principal component analysis, discriminant analysis and cross-validation test were performed. The "cast method" was found to be less accurate than...

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

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    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.

  6. Retinoic acid modulates chondrogenesis in the developing mouse cranial base.

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

    2011-12-15

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

  7. Design and development of a content-based medical image retrieval system for spine vertebrae irregularity.

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    Mustapha, Aouache; Hussain, Aini; Samad, Salina Abdul; Zulkifley, Mohd Asyraf; Diyana Wan Zaki, Wan Mimi; Hamid, Hamzaini Abdul

    2015-01-16

    Content-based medical image retrieval (CBMIR) system enables medical practitioners to perform fast diagnosis through quantitative assessment of the visual information of various modalities. In this paper, a more robust CBMIR system that deals with both cervical and lumbar vertebrae irregularity is afforded. It comprises three main phases, namely modelling, indexing and retrieval of the vertebrae image. The main tasks in the modelling phase are to improve and enhance the visibility of the x-ray image for better segmentation results using active shape model (ASM). The segmented vertebral fractures are then characterized in the indexing phase using region-based fracture characterization (RB-FC) and contour-based fracture characterization (CB-FC). Upon a query, the characterized features are compared to the query image. Effectiveness of the retrieval phase is determined by its retrieval, thus, we propose an integration of the predictor model based cross validation neural network (PMCVNN) and similarity matching (SM) in this stage. The PMCVNN task is to identify the correct vertebral irregularity class through classification allowing the SM process to be more efficient. Retrieval performance between the proposed and the standard retrieval architectures are then compared using retrieval precision (Pr@M) and average group score (AGS) measures. Experimental results show that the new integrated retrieval architecture performs better than those of the standard CBMIR architecture with retrieval results of cervical (AGS > 87%) and lumbar (AGS > 82%) datasets. The proposed CBMIR architecture shows encouraging results with high Pr@M accuracy. As a result, images from the same visualization class are returned for further used by the medical personnel.

  8. Development and Tissue Origins of the Mammalian Cranial Base

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    Iseki, S.; Bamforth, S. D.; Olsen, B. R.; Morriss-Kay, G. M.

    2008-01-01

    The vertebrate cranial base is a complex structure composed of bone, cartilage and other connective tissues underlying the brain; it is intimately connected with development of the face and cranial vault. Despite its central importance in craniofacial development, morphogenesis and tissue origins of the cranial base have not been studied in detail in the mouse, an important model organism. We describe here the location and time of appearance of the cartilages of the chondrocranium. We also examine the tissue origins of the mouse cranial base using a neural crest cell lineage cell marker, Wnt1-Cre/R26R, and a mesoderm lineage cell marker, Mesp1-Cre/R26R. The chondrocranium develops between E11 and E16 in the mouse, beginning with development of the caudal (occipital) chondrocranium, followed by chondrogenesis rostrally to form the nasal capsule, and finally fusion of these two parts via the midline central stem and the lateral struts of the vault cartilages. X-Gal staining of transgenic mice from E8.0 to 10 days post-natal showed that neural crest cells contribute to all of the cartilages that form the ethmoid, presphenoid, and basisphenoid bones with the exception of the hypochiasmatic cartilages. The basioccipital bone and non-squamous parts of the temporal bones are mesoderm derived. Therefore the prechordal head is mostly composed of neural crest-derived tissues, as predicted by the New Head Hypothesis. However, the anterior location of the mesoderm-derived hypochiasmatic cartilages, which are closely linked with the extra-ocular muscles, suggests that some tissues associated with the visual apparatus may have evolved independently of the rest of the “New Head”. PMID:18680740

  9. Trigeminal complications arising after surgery of cranial base meningiomas.

    Science.gov (United States)

    Westerlund, Ulf; Linderoth, Bengt; Mathiesen, Tiit

    2012-04-01

    Chronic severe facial pain is a feared sequel of cranial base surgery. This study explores the symptomatology, incidence and impact on the individual of postoperative de novo trigeminal nerve affection as well as the recovery potential. Out of 231 patients operated for cranial base meningiomas at the Karolinska University Hospital during 7 years, 25 complained of de novo trigeminal symptoms at clinical follow-up 3 months after surgery. Six were later lost to follow-up leaving 19 participants in the study, which was conducted using a questionnaire and a structured telephone interview. All patients complained of facial numbness, affecting the V1 branch in 10/19 patients (53%), the V2 branch in 18/19 (95%) and the V3 branch in 9/19 (47%). Surprisingly, only three (16%) suffered from trigeminal pain, which could be adequately managed by pharmacotherapy. However, five patients (26%) demonstrated ocular dysaesthetic problems. Twelve (63%) described their handicap to be mild, while seven (37%) had daily or severe symptoms. Five patients (26%) reported no improvement over time, while nine (47%) showed improvement and four (21%) stated good recovery. Only one patient (5%) claimed complete symptom remission. In the present study, 11% of the patients presented with a de novo postoperative affection of the trigeminal nerve after removal of a cranial base meningioma; 37% of these reported daily/severe symptoms. Only 26% showed good recovery, observed in patients without tumour infiltration of the nerve or intraoperative nerve damage. In spite of frequent complaints of numbness, pain was uncommon (16%) and often manageable by pharmacotherapy, while ocular symptoms turned out to be more frequent and more disabling than expected.

  10. Ardipithecus ramidus and the evolution of the human cranial base.

    Science.gov (United States)

    Kimbel, William H; Suwa, Gen; Asfaw, Berhane; Rak, Yoel; White, Tim D

    2014-01-21

    The early Pliocene African hominoid Ardipithecus ramidus was diagnosed as a having a unique phylogenetic relationship with the Australopithecus + Homo clade based on nonhoning canine teeth, a foreshortened cranial base, and postcranial characters related to facultative bipedality. However, pedal and pelvic traits indicating substantial arboreality have raised arguments that this taxon may instead be an example of parallel evolution of human-like traits among apes around the time of the chimpanzee-human split. Here we investigated the basicranial morphology of Ar. ramidus for additional clues to its phylogenetic position with reference to African apes, humans, and Australopithecus. Besides a relatively anterior foramen magnum, humans differ from apes in the lateral shift of the carotid foramina, mediolateral abbreviation of the lateral tympanic, and a shortened, trapezoidal basioccipital element. These traits reflect a relative broadening of the central basicranium, a derived condition associated with changes in tympanic shape and the extent of its contact with the petrous. Ar. ramidus shares with Australopithecus each of these human-like modifications. We used the preserved morphology of ARA-VP 1/500 to estimate the missing basicranial length, drawing on consistent proportional relationships in apes and humans. Ar. ramidus is confirmed to have a relatively short basicranium, as in Australopithecus and Homo. Reorganization of the central cranial base is among the earliest morphological markers of the Ardipithecus + Australopithecus + Homo clade.

  11. 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.

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

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    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.

  13. Clinical validation of coronal and sagittal spinal curve measurements based on three-dimensional vertebra vector parameters.

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    Somoskeöy, Szabolcs; Tunyogi-Csapó, Miklós; Bogyó, Csaba; Illés, Tamás

    2012-10-01

    For many decades, visualization and evaluation of three-dimensional (3D) spinal deformities have only been possible by two-dimensional (2D) radiodiagnostic methods, and as a result, characterization and classification were based on 2D terminologies. Recent developments in medical digital imaging and 3D visualization techniques including surface 3D reconstructions opened a chance for a long-sought change in this field. Supported by a 3D Terminology on Spinal Deformities of the Scoliosis Research Society, an approach for 3D measurements and a new 3D classification of scoliosis yielded several compelling concepts on 3D visualization and new proposals for 3D classification in recent years. More recently, a new proposal for visualization and complete 3D evaluation of the spine by 3D vertebra vectors has been introduced by our workgroup, a concept, based on EOS 2D/3D, a groundbreaking new ultralow radiation dose integrated orthopedic imaging device with sterEOS 3D spine reconstruction software. Comparison of accuracy, correlation of measurement values, intraobserver and interrater reliability of methods by conventional manual 2D and vertebra vector-based 3D measurements in a routine clinical setting. Retrospective, nonrandomized study of diagnostic X-ray images created as part of a routine clinical protocol of eligible patients examined at our clinic during a 30-month period between July 2007 and December 2009. In total, 201 individuals (170 females, 31 males; mean age, 19.88 years) including 10 healthy athletes with normal spine and patients with adolescent idiopathic scoliosis (175 cases), adult degenerative scoliosis (11 cases), and Scheuermann hyperkyphosis (5 cases). Overall range of coronal curves was between 2.4 and 117.5°. Analysis of accuracy and reliability of measurements was carried out on a group of all patients and in subgroups based on coronal plane deviation: 0 to 10° (Group 1; n=36), 10 to 25° (Group 2; n=25), 25 to 50° (Group 3; n=69), 50 to 75

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

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

    2010-06-01

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

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

    International Nuclear Information System (INIS)

    Weber, A.L.

    1991-01-01

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

  16. Temporalis Myofascial Flap for Primary Cranial Base Reconstruction after Tumor Resection

    OpenAIRE

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

    2008-01-01

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

  17. Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality

    Institute of Scientific and Technical Information of China (English)

    YI Zhi-qiang; LI Liang; MO Da-peng; ZHANG Jia-yong; ZHANG Yang; BAO Sheng-de

    2008-01-01

    @@ The extremely complex anatomic relationships among bone,tumor,blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery.Therefore.a good understanding of the patient specific anatomy and a preoperative planning are helpful and crocial for the neurosurgeons.Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore,Volume Interaction Pte Ltd,software:RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors.This system uses patient-specific,coregistered,fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment.This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.

  18. Clinical presentation of epignathus teratoma with cleft palate; and duplication of cranial base, tongue, mandible, and pituitary gland.

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    Maeda, Yujiro; Suenaga, Hideyuki; Sugiyama, Madoka; Saijo, Hideto; Hoshi, Kazuto; Mori, Yoshiyuki; Takato, Tsuyoshi

    2013-07-01

    A 2-day-old girl was diagnosed with an oral epignathus teratoma and an uncommon combination of orofacial malformations including cleft palate; tongue, mandible, cranial base, cervical vertebrae, lower lip, and pituitary gland duplications; and fistula of the glabella and lower lip. Computed tomography revealed that the mass within the nasal cavity had tooth-like calcifications and protruded into the nasopharynx and oral cavity. It was implanted on the anterior wall of the body of the sphenoid bone and was accompanied with mandibular duplication. Magnetic resonance imaging detected duplication of the pituitary gland and confirmed the absence of intracranial communication of the nasopharyngeal mass. The teratoma did not cause respiratory obstruction; however, the patient required continuous nasogastric tube feeding. Usually, an epignathus teratoma is associated with few midline defects and can be corrected with multiple interventions at different time points. The current study describes the surgical procedure comprising excision of the tumor along with reconstructive surgeries of the mandible, tongue, and fistulae undertaken when the infant reached 7 months of age. The cleft palate was repaired at 18 months of age using the Kaplan buccal flap method. Histopathologic examination confirmed a grade 0 teratoma covered with keratinized skin and containing pilosebaceous and sweat glands, adipose tissue, and smooth muscle. The long-term success of this intervention was determined at the follow-up examination conducted at 3 years of age, with no signs of the teratoma recurrence observed.

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

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

    1997-08-01

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

  20. [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

    2016-01-01

    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.

  1. [Anatomy of the skull base and the cranial nerves in slice imaging].

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    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.

  2. Anatomy of the skull base and the cranial nerves in slice imaging

    International Nuclear Information System (INIS)

    Bink, A.; Berkefeld, J.; Zanella, F.

    2009-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are suitable methods for examination of the skull base. Whereas CT is used to evaluate mainly bone destruction e.g. for planning surgical therapy, MRI is used to show pathologies in the soft tissue and bone invasion. High resolution and thin slice thickness are indispensible for both modalities of skull base imaging. Detailed anatomical knowledge is necessary even for correct planning of the examination procedures. This knowledge is a requirement to be able to recognize and interpret pathologies. MRI is the method of choice for examining the cranial nerves. The total path of a cranial nerve can be visualized by choosing different sequences taking into account the tissue surrounding this cranial nerve. This article summarizes examination methods of the skull base in CT and MRI, gives a detailed description of the anatomy and illustrates it with image examples. (orig.) [de

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

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    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

  4. Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

    Directory of Open Access Journals (Sweden)

    Seung Gee Kwon

    2012-07-01

    Full Text Available BackgroundCranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction.MethodsBetween April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability.ResultsThe mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures.ConclusionsThe reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

  5. Symptomatic lumbosacral transitional vertebra

    DEFF Research Database (Denmark)

    Holm, Emil Kongsted; Bünger, Cody; Foldager, Casper Bindzus

    2017-01-01

    Bertolotti's syndrome (BS) refers to the possible association between the congenital malformation lumbosacral transitional vertebra (LSTV), and low back pain (LBP). Several treatments have been proposed including steroid injections, resections of the LSTV, laminectomy, and lumbar spinal fusion...

  6. Direct fabrication through electron beam melting technology of custom cranial implants designed in a PHANToM-based haptic environment

    International Nuclear Information System (INIS)

    Mazzoli, Alida; Germani, Michele; Raffaeli, Roberto

    2009-01-01

    Repairing critical human skull injuries requires the production and use of customized cranial implants and involves the integration of computer aided design and manufacturing (CAD and CAM). The main causes for large cranial defects are trauma, cranial tumors, infected craniotomy bone flaps and external neurosurgical decompression. The success of reconstructive cranial surgery depends upon: the preoperative evaluation of the defect, the design and manufacturing of the implant, and the skill of the operating surgeon. Cranial implant design is usually carried out manually using CAD although this process is very time-consuming and the quality of the end product depends wholly upon the skill of the operator. This paper presents an alternative automated method for the design of custom-made cranial plates in a PHANToM ® -based haptic environment, and their direct fabrication in biocompatible metal using electron beam melting (EBM) technology.

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

    Science.gov (United States)

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

    2014-09-01

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

  8. 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.

  9. 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.

  10. Cranial nerve palsies in metastatic prostate cancer--results of base of skull radiotherapy

    International Nuclear Information System (INIS)

    O'Sullivan, Joe M.; Norman, Andrew R.; McNair, Helen; Dearnaley, David P.

    2004-01-01

    We studied the rate of response to palliative external beam radiation therapy (20 Gy/5 or 30 Gy/10 fractions) to the base of skull in 32 prostate cancer patients with cranial nerve dysfunction. Sixteen patients (50%; 95% CI, 34-66%) had a useful response to therapy. The median survival post-therapy was 3 months

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

    International Nuclear Information System (INIS)

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

    2012-01-01

    Background: 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. Purpose: To assess the accuracy of a method for numbering presacral vertebrae based on the cross-referencing of two sagittal MRI series. Material and Methods: 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. Results: 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. Conclusion: 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Paik, Nam Chull [Dept. of Radiology, Arumdaun Wooldul Spine Hospital, Ulsan (Korea, Republic of)], e-mail: srsna@freechal.com; Lim, Chun Soo; Jang, Ho Suk [Dept. of Neurosurgery, Arumdaun Wooldul Spine Hospital, Ulsan (Korea, Republic of)

    2012-09-15

    Background: 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. Purpose: To assess the accuracy of a method for numbering presacral vertebrae based on the cross-referencing of two sagittal MRI series. Material and Methods: 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. Results: 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. Conclusion: 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.

  13. Lumbosacral transitional vertebrae in dogs: classification, prevalence, and association with sacroiliac morphology.

    Science.gov (United States)

    Damur-Djuric, Natascha; Steffen, Frank; Hässig, Michael; Morgan, Joe P; Flückiger, Mark A

    2006-01-01

    The prevalence of lumbosacral transitional vertebrae (LTV) was determined by reviewing the pelvic radiographs of 4000 medium- and large-breed dogs of 144 breeds routinely screened for canine hip dysplasia. An LTV was seen in 138 (3.5%) dogs. The prevalence was higher in German Shepherd dogs and Greater Swiss Mountain dogs than in the other breeds, suggesting a genetic predisposition. There was no gender predisposition. The transverse processes of the LTV were divided into three types based on their morphological characteristics: lumbar type or type 1; intermediate type or type 2; and sacral type or type 3. In a symmetric LTV, both transverse processes are of the same type, while in an asymmetric LTV they are not. The frequency of occurrence of symmetric and asymmetric LTV was similar. In symmetric LTV, intermediate-type transverse processes predominated. Most of the asymmetric LTV had an intermediate-type transverse process combined with a lumbar or sacral type, respectively. Highly asymmetric LTV were often angled relative to the adjacent vertebrae. We hypothesize that an LTV is not the result of transformation of a lumbar into a sacral vertebra or vice versa, but rather is an autonomous intermediate type of vertebra. It occurs when the point of contact of the pelvis with the vertebral column is slightly cranial or caudal to its normal position. The resulting formative stimulus on the vertebral ossification centers, sagittally still separated, causes the various morphologies seen in LTV including the asymmetric variations.

  14. 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.

  15. Reconstruction of the cranial base in surgery for jugular foramen tumors.

    Science.gov (United States)

    Ramina, Ricardo; Maniglia, Joao J; Paschoal, Jorge R; Fernandes, Yvens B; Neto, Mauricio Coelho; Honorato, Donizeti C

    2005-04-01

    The surgical removal of a jugular foramen (JF) tumor presents the neurosurgeon with a complex management problem that requires an understanding of the natural history, diagnosis, surgical approaches, and postoperative complications. Cerebrospinal fluid (CSF) leakage is one of the most common complications of this surgery. Different surgical approaches and management concepts to avoid this complication have been described, mainly in the ear, nose, and throat literature. The purpose of this study was to review the results of CSF leakage prevention in a series of 66 patients with JF tumors operated on by a multidisciplinary cranial base team using a new technique for cranial base reconstruction. We retrospectively studied 66 patients who had JF tumors with intracranial extension and who underwent surgical treatment in our institutions from January 1987 to December 2001. Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. All patients were operated on using the same multidisciplinary surgical approach (neurosurgeons and ear, nose, and throat surgeons). A surgical strategy for reconstruction of the cranial base using vascularized flaps was carried out. The closure of the surgical wound was performed in three layers. A specially developed myofascial flap (temporalis fascia, cervical fascia, and sternocleidomastoid muscle) associated to the inferior rotation of the posterior portion of the temporalis muscle was used to reconstruct the cranial base with vascularized flaps. In this series of 66 patients, postoperative CSF leakage developed in three cases. These patients presented with very large or recurrent tumors, and the postoperative CSF fistulae were surgically closed. The cosmetic result obtained with this reconstruction was classified as excellent or good in all patients. Our results compare favorably with those reported in the literature. The surgical strategy used for cranial base reconstruction presented in this article has

  16. Determination of 3D location and rotation of lumbar vertebrae in CT images by symmetry-based auto-registration

    Science.gov (United States)

    Vrtovec, Tomaž; Likar, Boštjan; Pernuš, Franjo

    2007-03-01

    Quantitative measurement of vertebral rotation is important in surgical planning, analysis of surgical results, and monitoring of the progression of spinal deformities. However, many established and newly developed techniques for measuring axial vertebral rotation do not exploit three-dimensional (3D) information, which may result in virtual axial rotation because of the sagittal and coronal rotation of vertebrae. We propose a novel automatic approach to the measurement of the location and rotation of vertebrae in 3D without prior volume reformation, identification of appropriate cross-sections or aid by statistical models. The vertebra under investigation is encompassed by a mask in the form of an elliptical cylinder in 3D, defined by its center of rotation and the rotation angles. We exploit the natural symmetry of the vertebral body, vertebral column and vertebral canal by dividing the vertebral mask by its mid-axial, mid-sagittal and mid-coronal plane, so that the obtained volume pairs contain symmetrical parts of the observed anatomy. Mirror volume pairs are then simultaneously registered to each other by robust rigid auto-registration, using the weighted sum of absolute differences between the intensities of the corresponding volume pairs as the similarity measure. The method was evaluated on 50 lumbar vertebrae from normal and scoliotic computed tomography (CT) spinal scans, showing relatively large capture ranges and distinctive maxima at the correct locations and rotation angles. The proposed method may aid the measurement of the dimensions of vertebral pedicles, foraminae and canal, and may be a valuable tool for clinical evaluation of the spinal deformities in 3D.

  17. Establishment and evaluation of sex determination method from 12 th thoracic vertebrae based on three-dimensional reconstructed models

    International Nuclear Information System (INIS)

    Guo Ming; Hou Weibin; Jing Yue; Li Youqiong; Zhou Jianying

    2011-01-01

    Objective: To establish the method of using the 12 th vertebrae for sex determination of adult Chinese and evaluate its effect. Methods: The 12 th thoracic vertebrae were developed by the clinic abdomen CT images. A total of 25 linear measurements on 7 aspects of the vertebrae were measured and 4 ratios were calculated. The items were selected which had the significant difference to establish the sex determination equation and its effect was evaluated. Results: Of the total 29 traits, 27 were sexually dimorphic (P<0.05), the accuracy was 56.3% - 89.2%, 8 traits had the accuracies mean or over 80.0%. The trait iVL had the highest accuracy of 89.2%. A function with four variables predicting sex with 90.8% accuracy was derived by using stepwise method of discriminant function analysis: Y=2.98 x iBDsm + 1.97 x PH + 3.37 x BHp + 3.27 x sVL/BHa - 32.80 (mean centroids= -7.69). Conclusion: The method of using the selected traits for sex determination of adult Chinese is practicable and it has a relatively high accuracy. (authors)

  18. 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.

  19. 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.

  20. Virtual Reality-Based Simulators for Cranial Tumor Surgery: A Systematic Review.

    Science.gov (United States)

    Mazur, Travis; Mansour, Tarek R; Mugge, Luke; Medhkour, Azedine

    2018-02-01

    Virtual reality (VR) simulators have become useful tools in various fields of medicine. Prominent uses of VR technologies include assessment of physician skills and presurgical planning. VR has shown effectiveness in multiple surgical specialties, yet its use in neurosurgery remains limited. To examine all current literature on VR-based simulation for presurgical planning and training in cranial tumor surgeries and to assess the quality of these studies. PubMed and Embase were systematically searched to identify studies that used VR for presurgical planning and/or studies that investigated the use of VR as a training tool from inception to May 25, 2017. The initial search identified 1662 articles. Thirty-seven full-text articles were assessed for inclusion. Nine studies were included. These studies were subdivided into presurgical planning and training using VR. Prospects for VR are bright when surgical planning and skills training are considered. In terms of surgical planning, VR has noted and documented usefulness in the planning of cranial surgeries. Further, VR has been central to establishing reproducible benchmarks of performance in relation to cranial tumor resection, which are helpful not only in showing face and construct validity but also in enhancing neurosurgical training in a way not previously examined. Although additional studies are needed to better delineate the precise role of VR in each of these capacities, these studies stand to show the usefulness of VR in the neurosurgery and highlight the need for further investigation. Published by Elsevier Inc.

  1. Langerhans Cell Histiocytosis of the Cranial Base: Is Low-Dose Radiotherapy Effective?

    Directory of Open Access Journals (Sweden)

    Andreas Meyer

    2012-01-01

    Full Text Available Introduction. Langerhans cell histiocytosis (LCH is a rare disease of unknown etiology with different clinical features. A standardised treatment has not been established so far. Case Report. We report a case of a 28-year-old patient who initially presented with hypesthesia of the fifth cranial nerve and pain of the left ear. Diagnosis showed a tumour localised in the cranial base with a maximum diameter of 4.1 cm. The diagnosis of LCH was confirmed histologically by biopsy. Diagnostic workup verified the cranial lesion as the sole manifestation of LCH. A total dose of 9 Gy (single dose 1.8 Gy was delivered. The symptoms dissolved completely within 6 months after radiation; repeated CT and MRI scans revealed a reduction in size of the lesion and a remineralisation of the bone. After a followup of 13 years the patient remains free of symptoms without relapse or any side effects from therapy. Discussion. Due to the indolent course of the disease with a high rate of spontaneous remissions the choice of treatment strongly depends on the individual clinical situation. In the presented case low-dose radiotherapy was sufficient to obtain long-term local control in a region with critical structures and tissues.

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  3. Knowledge-based interpretation of cranial MR images

    International Nuclear Information System (INIS)

    Kuhn, M.H.; Menhardt, W.; Schmidt, K.H.

    1987-01-01

    A computerized system is described that can be used to evaluate an MR tomogram automatically to support clinical identification of anatomic and pathologic structures and to aid in planning MR measurements. Knowledge from three domains is used for the interpretation of an MR image: nosologic knowledge, knowledge of MR imaging parameters, and anatomic and morphologic knowledge. Nosologic information is used to generate hypotheses about possible pathologies and their locations, based on the signs and symptoms of the patient. With this information, a sequence of interpretation modules, each able to detect substructures in already detected structures with the aid of techniques from image processing, pattern recognition, and artificial intelligence, is generated and executed

  4. 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.

  5. 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.

  6. 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

  7. 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. .

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

    Science.gov (United States)

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

    2006-04-01

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

  9. Roentgenodiagnosis of vertebrae birth injury

    International Nuclear Information System (INIS)

    Mikhajlov, M.K.

    1983-01-01

    Birth injuries of vertebrae and spinal cord is the new problem of child neutropathology. Basic roentgenological symptoms of birth injuries of vertebrae and spinal cord of different localizations have been described for the first time. These data are compared with neurological, electrophysiological, and Morphological data, that enables not only to describe each symptom, but also to evaluate its clinical significance. Roeptgenological classification of birth injuries of vertebrae and spinal cord in children is suggested

  10. Imaging of cranial nerves with three-dimensional high resolution diffusion-weighted MR sequence based on SSFP technique

    International Nuclear Information System (INIS)

    Zhang Zhongwei; Chen Yingming; Meng Quanfei

    2008-01-01

    Objective: To depict the normal anatomy of cranial nerves in detail and define the exact relationships between cranial nerves and adjacent structures with three-dimensional high resolution diffusion-weighted MR sequence based on SSFP technique (3D DW-SSFP). Methods: 3D DW- SSFP sequence was performed and axial images were obtained in 12 healthy volunteers Post-processing techniques were used to generate images of cranial nerves, and the images acquired were compared with anatomical sections and diagrams of textbook. Results: In all subjects, 3D DW-SSFP sequence could produce homogeneous images and high contrast between the cranial nerves and other solid structures. The intracranial portions of all cranial nerves except olfactory nerve were identified; the extracranial portions of nerve Ⅱ-Ⅻ were identified in all subjects bilaterally. Conclusion: The 3D DW-SSFP sequence can characterize the normal MR appearance of cranial nerves and its branches and the ability to define the nerves may provide greater sensitivity and specificity in detecting abnormalities of craniofacial structure. (authors)

  11. The oblique view for spondylolysis in the growing period. X-ray projection angle to spondylolytic lumbar vertebra based on CT scanning

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Yoshimitsu; Minato, Izumi; Nagano, Junji; Inoue, Yoshiya; Takahashi, Yuji; Saito, Hidehiko [Seirei Hamamatsu General Hospital, Shizuoka (Japan)

    1996-02-01

    In this study, CT images of 239 vertebrae from 227 patients with spondylolysis in the growing period were obtained to analyze x-ray oblique separation images based on the relationship between x-ray incidence angle and CT. The age of the subjects ranged from 5 to 23 years (average 14.8 years), of which 224 patients were 18 years or lower. The CT images obtained were classified into four according to our classification, i.e., Type Ia, 112 vertebrae; Type Ib, 175; Type II, 66; Type III, 67. All patients underwent plain x-ray from 4 directions including 45deg. The angle of separation line and posterior margin of the vertebral body was obtained and the average angle of all slices was determined as separation angle. As a result, depiction level of separation line was better in 30deg oblique images than 45deg oblique images in Ia, Ib, and III groups. It is thus desirable to take the relationship between incidence angle of x-ray, separation angle, and CT classification into consideration. (S.Y.).

  12. The oblique view for spondylolysis in the growing period. X-ray projection angle to spondylolytic lumbar vertebra based on CT scanning

    International Nuclear Information System (INIS)

    Kobayashi, Yoshimitsu; Minato, Izumi; Nagano, Junji; Inoue, Yoshiya; Takahashi, Yuji; Saito, Hidehiko

    1996-01-01

    In this study, CT images of 239 vertebrae from 227 patients with spondylolysis in the growing period were obtained to analyze x-ray oblique separation images based on the relationship between x-ray incidence angle and CT. The age of the subjects ranged from 5 to 23 years (average 14.8 years), of which 224 patients were 18 years or lower. The CT images obtained were classified into four according to our classification, i.e., Type Ia, 112 vertebrae; Type Ib, 175; Type II, 66; Type III, 67. All patients underwent plain x-ray from 4 directions including 45deg. The angle of separation line and posterior margin of the vertebral body was obtained and the average angle of all slices was determined as separation angle. As a result, depiction level of separation line was better in 30deg oblique images than 45deg oblique images in Ia, Ib, and III groups. It is thus desirable to take the relationship between incidence angle of x-ray, separation angle, and CT classification into consideration. (S.Y.)

  13. Congenital lumbar vertebrae agenesis in a lamb.

    Science.gov (United States)

    Farajli Abbasi, Mohammad; Shojaei, Bahador; Azari, Omid

    2017-01-01

    Congenital agenesis of lumbar vertebrae was diagnosed in a day-old female lamb based on radiology and clinical examinations. There was no neurological deficit in hindlimb and forelimb associated with standing disability. Radiography of the abdominal region revealed absence of lumbar vertebrae. Necropsy confirmed clinical and radiographic results. No other anomaly or agenesis was seen macroscopically in the abdominal and thoracic regions as well as vertebral column. Partial absence of vertebral column has been reported in human and different animal species, as an independent occurrence or associated with other organs anomalies. The latter has been designated as caudal regression syndrome. Vertebral agenesis may arise from irregularity in the differentiation of somites to the sclerotome or sclerotome to the vertebral primordium. Most of the previously reported cases of agenesis were related to the lumbosacral region, lonely or along with other visceral absences. This case was the first report of congenital agenesis of lumbar vertebrae in a lamb.

  14. 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.)

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

    International Nuclear Information System (INIS)

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

    2014-01-01

    Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting. (orig.)

  16. Improving vertebra segmentation through joint vertebra-rib atlases

    Science.gov (United States)

    Wang, Yinong; Yao, Jianhua; Roth, Holger R.; Burns, Joseph E.; Summers, Ronald M.

    2016-03-01

    Accurate spine segmentation allows for improved identification and quantitative characterization of abnormalities of the vertebra, such as vertebral fractures. However, in existing automated vertebra segmentation methods on computed tomography (CT) images, leakage into nearby bones such as ribs occurs due to the close proximity of these visibly intense structures in a 3D CT volume. To reduce this error, we propose the use of joint vertebra-rib atlases to improve the segmentation of vertebrae via multi-atlas joint label fusion. Segmentation was performed and evaluated on CTs containing 106 thoracic and lumbar vertebrae from 10 pathological and traumatic spine patients on an individual vertebra level basis. Vertebra atlases produced errors where the segmentation leaked into the ribs. The use of joint vertebra-rib atlases produced a statistically significant increase in the Dice coefficient from 92.5 +/- 3.1% to 93.8 +/- 2.1% for the left and right transverse processes and a decrease in the mean and max surface distance from 0.75 +/- 0.60mm and 8.63 +/- 4.44mm to 0.30 +/- 0.27mm and 3.65 +/- 2.87mm, respectively.

  17. Chondroblastoma of the lumbar vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Leung, L.Y.J.; Shu, S.J.; Chan, M.K.; Chan, C.H.S. [Dept. of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong (Hong Kong)

    2001-12-01

    Chondroblastoma of the vertebra is a very rare condition. To our knowledge fewer than 20 cases have been reported in the world literature. We report a 54-year-old man with chondroblastoma of the fifth lumbar vertebra. The clinical and radiological aspects of the tumor are discussed, emphasizing the presence of an extraosseous mass suggestive of locally aggressive behavior. (orig.)

  18. Normal cranial CT anatomy

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  19. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

    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-yearold 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.

  1. 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.

  2. Prevalence of lumbosacral transitional vertebrae in Korean

    International Nuclear Information System (INIS)

    Cho, Hyun Chang; Bae, Geum Dong; Lee, Yong Chul; Kim, Kun Sang

    1990-01-01

    Controversy exists about the lumbosacral transitional vertebrae(LSTV) causing low back pain and lumbar disk abnormalities such as herniated nucleus pulposus(HNP), early disk degeneration or annulus bulging. The prevalence of the lumbosacral transitional vertebrae were evaluated. The classification of LSTV is presented based upon the radiomorphological changes of transverse process of the last presacral vertebra. The type I is dysplastic transverse process, type II is incomplete lumbarization/ sacralization, type III is complete lumbarization/ sacralization, and type IV is mixed is mixed (type II and type III). Simple radiographic findings of (804 patients including) 300 patients without low back pain. 400 patients with low back pain and 104 patients with disk abnormalities on CT scan have been analyzed. The prevalence of LSTV were 51.5% in normal control group, 40.8% in low back pain group and 46.2% in disk abnormality group. The type I is regarded as the forerunner of a true transitional vertebra and the prevalence of the true LSTB (type II, III, IV) were 11.6%, 18.3% and 13.5% on each groups. The type II and III in low back pain group and type II in disk abnormality group were relatively increased in incidence of LSTV than in normal control group. A patient with the type II or III of the LSTV may show low back pain more frequently than a patient without such a LSTV. The type II of LSTV may cause lumbar disk abnormalities more frequently

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

    Science.gov (United States)

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

    2008-07-01

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

  4. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  6. 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

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

    International Nuclear Information System (INIS)

    MacDonald, R. Lee; Thomas, Christopher G.

    2015-01-01

    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. Evaluation of the cranial base in amnion rupture sequence involving the anterior neural tube: implications regarding recurrence risk.

    Science.gov (United States)

    Jones, Kenneth Lyons; Robinson, Luther K; Benirschke, Kurt

    2006-09-01

    Amniotic bands can cause disruption of the cranial end of the developing fetus, leading in some cases to a neural tube closure defect. Although recurrence for unaffected parents of an affected child with a defect in which the neural tube closed normally but was subsequently disrupted by amniotic bands is negligible; for a primary defect in closure of the neural tube to which amnion has subsequently adhered, recurrence risk is 1.7%. In that primary defects of neural tube closure are characterized by typical abnormalities of the base of the skull, evaluation of the cranial base in such fetuses provides an approach for making a distinction between these 2 mechanisms. This distinction has implications regarding recurrence risk. The skull base of 2 fetuses with amnion rupture sequence involving the cranial end of the neural tube were compared to that of 1 fetus with anencephaly as well as that of a structurally normal fetus. The skulls were cleaned, fixed in 10% formalin, recleaned, and then exposed to 10% KOH solution. After washing and recleaning, the skulls were exposed to hydrogen peroxide for bleaching and photography. Despite involvement of the anterior neural tube in both fetuses with amnion rupture sequence, in Case 3 the cranial base was normal while in Case 4 the cranial base was similar to that seen in anencephaly. This technique provides a method for determining the developmental pathogenesis of anterior neural tube defects in cases of amnion rupture sequence. As such, it provides information that can be used to counsel parents of affected children with respect to recurrence risk.

  9. 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.

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

    Science.gov (United States)

    Nada, Rania M; Maal, Thomas J J; Breuning, K Hero; Bergé, Stefaan J; Mostafa, Yehya A; Kuijpers-Jagtman, Anne Marie

    2011-02-09

    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.

  11. 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.

  12. Remnants of occipital vertebrae: proatlas segmentation abnormalities.

    Science.gov (United States)

    Menezes, Arnold H; Fenoy, Kathleen A

    2009-05-01

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

  13. 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.

  14. Cranial base morphology and temporal bone pneumatization in Asian Homo erectus.

    Science.gov (United States)

    Balzeau, Antoine; Grimaud-Hervé, Dominique

    2006-10-01

    The external morphological features of the temporal bone are used frequently to determine taxonomic affinities of fossils of the genus Homo. Temporal bone pneumatization has been widely studied in great apes and in early hominids. However, this feature is rarely examined in the later hominids, particularly in Asian Homo erectus. We provide a comparative morphological and quantitative analysis of Asian Homo erectus from the sites of Ngandong, Sambungmacan, and Zhoukoudian, and of Neandertals and anatomically modern Homo sapiens in order to discuss causes and modalities of temporal bone pneumatization during hominid evolution. The evolution of temporal bone pneumatization in the genus Homo is more complex than previously described. Indeed, the Zhoukoudian fossils have a unique pattern of temporal bone pneumatization, whereas Ngandong and Sambungmacan fossils, as well as the Neandertals, more closely resemble the modern human pattern. Moreover, these Chinese fossils are characterized by a wide midvault and a relatively narrow occipital bone. Our results support the point of view that cell development does not play an active role in determining cranial base morphology. Instead, pneumatization is related to available space and to temporal bone morphology, and its development is related to correlated morphology and the relative disposition of the bones and cerebral lobes. Because variation in pneumatization is extensive within the same species, the phyletic implications of pneumatization are limited in the taxa considered here.

  15. 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.

  16. Chondrosarcoma of a thoracic vertebra

    International Nuclear Information System (INIS)

    Abdelwahab, I.F.; Casden, A.M.; Klein, M.J.; Spollman, A.

    1991-01-01

    Central chondrosarcoma is an uncommon primary malignancy of the axial skeleton which usually affects the posterior elements or the posterior part of a vertebral body. The authors present an unusual case of chondrosarcoma involving the anterior part of a thoracic vertebra with massive extravertebral extension into the posterior mediastinum. The roles of computed tomography and magnetic resonance imaging in identifying this pathology are emphasized

  17. 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.

  18. The role of radiosurgery in the management of chordoma and chondrosarcoma of the cranial base

    International Nuclear Information System (INIS)

    Kondziolka, D.; Lunsford, L.D.; Flickinger, J.C.

    1991-01-01

    Despite conventional multimodality treatment (surgery and fractionated radiation therapy), recurrence and clinical progression of cranial base chordomas and chondrosarcomas are common. The malignant behavior of these tumors is a result of their critical location, locally aggressive nature, and high recurrence rate. To explore the role of radiosurgery in the treatment of these skull base neoplasms, we assessed its use in four patients with chordoma and two with chondrosarcoma. In five of the patients, radiosurgery was used as adjuvant therapy for residual or recurrent tumors after surgical debulking, and in one patient with a chordoma, it was the primary treatment. No patient received fractionated external beam radiotherapy. All tumors were less than 30 mm in diameter and were treated with 20 Gy to the tumor margin. Skull base computed tomography and magnetic resonance images were essential to define the anatomic relationships between tumor and adjacent basal structures. During follow-up (mean, 22 mo; range, 8-36 mo), the authors found no progression of the treated tumor volume in any patient. Neurological deficits before treatment improved in three patients; the other three patients remained in stable neurological condition. Serial follow-up imaging studies demonstrated that two patients showed reduction in tumor size and four patients had no tumor growth. In one patient, a metastatic parietal lobe chondrosarcoma developed and was treated by microsurgery. Another patient showed tumor progression outside of the radiosurgical treatment volume. The authors results attest to the value of stereotactic radiosurgery as an adjuvant or primary treatment for selected patients with chordoma or chondrosarcoma and demonstrate its potential advantages over standard fractionated irradiation. Analysis of the long-term clinical and imaging effects after radiosurgery is warranted

  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. Preoperative magnetic resonance imaging protocol for endoscopic cranial base image-guided surgery.

    Science.gov (United States)

    Grindle, Christopher R; Curry, Joseph M; Kang, Melissa D; Evans, James J; Rosen, Marc R

    2011-01-01

    Despite the increasing utilization of image-guided surgery, no radiology protocols for obtaining magnetic resonance (MR) imaging of adequate quality are available in the current literature. At our institution, more than 300 endonasal cranial base procedures including pituitary, extended pituitary, and other anterior skullbase procedures have been performed in the past 3 years. To facilitate and optimize preoperative evaluation and assessment, there was a need to develop a magnetic resonance protocol. Retrospective Technical Assessment was performed. Through a collaborative effort between the otolaryngology, neurosurgery, and neuroradiology departments at our institution, a skull base MR image-guided (IGS) protocol was developed with several ends in mind. First, it was necessary to generate diagnostic images useful for the more frequently seen pathologies to improve work flow and limit the expense and inefficiency of case specific MR studies. Second, it was necessary to generate sequences useful for IGS, preferably using sequences that best highlight that lesion. Currently, at our institution, all MR images used for IGS are obtained using this protocol as part of preoperative planning. The protocol that has been developed allows for thin cut precontrast and postcontrast axial cuts that can be used to plan intraoperative image guidance. It also obtains a thin cut T2 axial series that can be compiled separately for intraoperative imaging, or may be fused with computed tomographic images for combined modality. The outlined protocol obtains image sequences effective for diagnostic and operative purposes for image-guided surgery using both T1 and T2 sequences. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Bony exostosis of the atlas with resultant cranial nerve palsy

    International Nuclear Information System (INIS)

    Slavotinek, J.P.; Sage, M.R.; Brophy, B.P.

    1991-01-01

    A case of tenth and twelfth nerve compression secondary to a bony exostosis of the first cervical vertebra is described. This uncommon phenomenon serves to outline the importance of imaging the course of a cranial nerve when no intracranial abnormality is demonstrable on CT or MRI. The radiologic features of spinal osteochondromas are reviewed. (orig.)

  2. Fem Modelling of Lumbar Vertebra System

    Directory of Open Access Journals (Sweden)

    Rimantas Kačianauskas

    2014-02-01

    Full Text Available The article presents modeling of human lumbar vertebra and it‘sdeformation analysis using finite elements method. The problemof tissue degradation is raised. Using the computer aided modelingwith SolidWorks software the models of lumbar vertebra(L1 and vertebra system L1-L4 were created. The article containssocial and medical problem analysis, description of modelingmethods and the results of deformation test for one vertebramodel and for model of 4 vertebras (L1-L4.

  3. 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.

  4. 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.

  5. 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. ...

  6. 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...

  7. Cranial computed tomographic appearance of chondrosarcoma of the base of the skull

    International Nuclear Information System (INIS)

    Grossman, R.I.; Davis, K.R.

    1981-01-01

    Five patients with a histologic diagnosis of chondrosarcoma are discussed, with special attention to evaluation of these lesions by cranial computed tomography (CCT). These patients displayed findings that are highly suggestive of chondrosarcoma: high absorption abnormality on plain CCT scans, contrast enhancement, and osteolytic changes of the contiguous bone. Treatment consisted of surgery and subsequent radiation therapy. CCT played an important part in diagnosing and determining the extent of the chondrosarcomas

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

    International Nuclear Information System (INIS)

    Tsukishima, Eri; Shido, Koichi

    2002-01-01

    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)

  9. 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.

  10. Thin-plate spline analysis of the cranial base in African, Asian and European populations and its relationship with different malocclusions.

    Science.gov (United States)

    Rosas, Antonio; Bastir, Markus; Alarcón, Jose Antonio; Kuroe, Kazuto

    2008-09-01

    To test the hypothesis that midline basicranial orientation and posterior cranial base length are discriminating factors between adults of different populations and its potential maxillo/mandibular disharmonies. Twenty-nine 2D landmarks of the midline cranial base, the face and the mandible of dry skull X-rays from three major populations (45 Asians, 34 Africans, 64 Europeans) were digitized and analysed by geometric morphometrics. We used, first, MANOVA to test for mean shape differences between populations; then, principal components analysis (PCA) to assess the overall variation in the sample and finally, canonical variate analysis (CVA) with jack-knife validations (N=1000) to analyse the anatomical features that best distinguished among populations. Significant mean shapes differences were shown between populations (P<0.001). CVA revealed two significant axes of discrimination (P<0.001). Jack-knife validation correctly identified 92% of 15,000 unknowns. In Africans the whole cranial base is rotated into a forward-downward position, while in Asians it is rotated in the opposite way. The Europeans occupied an intermediate position. African and Asian samples showed a maxillo/mandibular prognathism. African prognathism was produced by an anterior positioned maxilla, Asian prognathism by retruded anterior cranial base and increase of the posterior cranial base length. Europeans showed a trend towards retracted mandibles with relatively shorter posterior cranial bases. The results supported the hypothesis that basicranial orientation and posterior cranial base length are valid factors to distinguish between geographic groups. The whole craniofacial configuration underlying a particular maxillo-facial disharmony must be considered in diagnosis, growth predictions and resulting treatment planning.

  11. 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

  12. [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.

  13. 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.)

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

    International Nuclear Information System (INIS)

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

    2016-01-01

    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. (orig.)

  15. A road map to the internal carotid artery in expanded endoscopic endonasal approaches to the ventral cranial base.

    Science.gov (United States)

    Labib, Mohamed A; Prevedello, Daniel M; Carrau, Ricardo; Kerr, Edward E; Naudy, Cristian; Abou Al-Shaar, Hussam; Corsten, Martin; Kassam, Amin

    2014-09-01

    Injuring the internal carotid artery (ICA) is a feared complication of endoscopic endonasal approaches. To introduce a comprehensive ICA classification scheme pertinent to safe endoscopic endonasal cranial base surgery. Anatomic dissections were performed in 33 cadaveric specimens (bilateral). Anatomic correlations were analyzed. Based on anatomic correlations, the ICA may be described as 6 distinct segments: (1) parapharyngeal (common carotid bifurcation to ICA foramen); (2) petrous (carotid canal to posterolateral aspect of foramen lacerum); (3) paraclival (posterolateral foramen lacerum to the superomedial aspect of the petrous apex); (4) parasellar (superomedial petrous apex to the proximal dural ring); (5) paraclinoid (from the proximal to the distal dural rings); and (6) intradural (distal ring to ICA bifurcation). Corresponding surgical landmarks included the Eustachian tube, the fossa of Rosenmüller, and levator veli palatini for the parapharyngeal segment; the vidian canal and V3 for the petrous segment; the fibrocartilage of foramen lacerum, foramen rotundum, maxillary strut, lingular process of the sphenoid bone, and paraclival protuberance for the paraclival segment; the sellar floor and petrous apex for the parasellar segment; and the medial and lateral opticocarotid and lateral tubercular recesses, as well as the distal osseous arch of the carotid sulcus for the paraclinoid segment. The proposed endoscopic classification outlines key anatomic reference points independent of the vessel's geometry or the sinonasal pneumatization, thus serving as (1) a practical guide to navigate the ventral cranial base while avoiding injury to the ICA and (2) further foundation for a modular access system.

  16. 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.

  17. 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 ...

  18. Block vertebra: fusion of axis with the third cervical vertebra – a case report

    OpenAIRE

    Shankar VV; Kulkarni RR

    2011-01-01

    Skeletal abnormalities at the craniocervical junction or cervical region may result in severe neck pain and sudden unexpected death. During the osteology demonstration of cervical vertebrae for the MBBS Phase I students at M. S. Ramaiah Medical College, it was observed that the axis vertebra is fused with the 3rd cervical vertebra. In this case, the vertebral bodies, vertebral arches and spines were completely fused. This is a condition of block vertebra which has embryological importance and...

  19. 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.

  20. Normal development and growth of the human neurocranium and cranial base.

    Science.gov (United States)

    Friede, H

    1981-01-01

    The literature on normal development and growth of certain areas of the human head is reviewed, starting with the early induction of the desmal neurocranium. the development of the brain capsule with its dural reinforcement bands and their connection with the basicranium is discussed, as is the primordial chondrocranium, including its bone replacement. Growth of the calvaria and the three cranial fossae is also analysed. Special interest is focused on the anterior fossa, as knowledge of the growth in this area is very important for an understanding of pathogenesis and possibilities of treating premature craniosynostosis. Finally it is stressed that close observation of the effects of treatment on this pathology may increase our knowledge of normal growth.

  1. GIANT CELL TUMOR OF THE VERTEBRA SIMULATING VERTEBRA PLANA

    Directory of Open Access Journals (Sweden)

    B. Aalami-Harandi

    1981-07-01

    Full Text Available A case of g iant cell tumor of t he vertebra simulat ing vert ebra plana was reported . t he d i agnos i s o f t he vertebra plana should not be confirmed by t he history of the patient and radiologica l manifestation alone . it can onlybe confirmed by biopsy ."nBone l esions of the spine i s one of the most di fficul t problems t o diagnosis and t r eat . Spinal tumors a r e either primary or metastatic . Ilos t bone tumors of the spine i n t he first two decade of l i f e are primary and benign;where as a majority of the bone lesions in old people ar e me tast at1,c and rna I 1' 9n ant . 5- 11 The rnaI1' 9~ant Lee Ss 1i 0ns 0f t h e Sp1' - ne can wi t hout very great risk be excl uded f r om diagnostic considerati on in chi ldren and adoles cence (She r r a r d . 1969 12 . From 34 casps of bone l esions of the spine and the pelvis i n the f irst two decade of l i f e, reported by Thommes on and 1 3 , Paulsen (1967 ni ne were histiochtosis X, two anevr ysma l bone cyst,nine Ewi ng sar coma , two reticul um cell sar c ~ma. None were g i ant cel l tumor ."nGiant cell tumor of the spine is r a re; mo s t of t he report ed cases were in t he sacrum. J affe (1958 17repor t ed only two c ases of giant cell t umo r, one of which o c c ur r e d in the por t e d s a c r um.Of the 218 cases of the g i an t ce l l tumor re6 by Goldenbe rg and Carnpbell( 1970 there were 13 cases of g i ant c e l l tumor o f the ver t ebra , one in the cervical r e g i o n , o ne in the l umbar spi ne , and e l e ven in t he sacrum. Of '08 giant ce l l t umors studied by Coley( 19604 ,one was i n the lumba r ver t ebra and one in the s a c rum. al In a r e view of 413 tumors i nc l uding t he spine(Cohen et 3 1964 tr.ere were sixteen cases o f g i ant c e l l tumor ,one  n the c e r vica l spine , one in the l umbar r e gion and f ourte61 n the sacrum. I n thi s a r t i c l e we are going to report a case of giant cel l t umor of the s i xth thor a ci

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

    Directory of Open Access Journals (Sweden)

    Deepal H. Dalal

    2015-01-01

    Full Text Available 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.

  3. 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.

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

    International Nuclear Information System (INIS)

    Aitken, A. P.; Giese, D.; Tsoumpas, C.; Schleyer, P.; Kozerke, S.; Prieto, C.; Schaeffter, T.

    2014-01-01

    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

  5. 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.

  6. The taxonomic status of badgers (Mammalia, Mustelidae) from Southwest Asia based on cranial morphometrics, with the redescription of Meles canescens.

    Science.gov (United States)

    Abramov, Alexei V; Puzachenko, Andrey Yu

    2013-01-01

    The Eurasian badgers (Meles spp.) are widespread in the Palaearctic Region, occurring from the British Islands in the west to the Japanese Islands in the east, including the Scandinavia, Southwest Asia and southern China. The morphometric variation in 30 cranial characters of 692 skulls of Meles from across the Palaearctic was here analyzed. This craniometric analysis revealed a significant difference between the European and Asian badger phylogenetic lineages, which can be further split in two pairs of taxa: meles - canescens and leucurus - anakuma. Overall, European badger populations are very similar morphologically, particularly with regards to the skull shape, but differ notably from those from Asia Minor, the Middle East and Transcaucasia. Based on the current survey of badger specimens available in main world museums, we have recognized four distinctive, parapatric species: Meles meles, found in most of Europe; Meles leucurus from continental Asia; M. anakuma from Japan; and M. canescens from Southwest Asia and the mountains of Middle Asia. These results are in agreement with those based on recent molecular data analyses. The morphological peculiarities and distribution range of M. canescens are discussed. The origin and evolution of Meles species, which is yet poorly understood, is also briefly discussed.

  7. 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.

  8. Evaluation of Three Cases Using a Novel Titanium Mesh System-Skull-Fit with Orbital Wall (Skull-Fit WOW)-For Cranial Base Reconstructions.

    Science.gov (United States)

    Hattori, Noriko; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Yoshiaki; Ohira, Takayuki; Yoshida, Kazunari; Kawase, Takeshi; Kishi, Kazuo

    2011-09-01

    Cranial base reconstructions associated with tumor resections around the orbital wall often require that both the upper and lateral orbital walls be reconstructed during a single procedure. Previously, we used titanium mesh plates that were preoperatively fabricated based on three-dimensional models. Although these plates are precise and do not increase the probability of infection, we still had to use autologous bones to reconstruct the orbital walls. Recently, we developed a new titanium mesh plate-called Skull-Fit(®)-with orbital wall (Skull-Fit WOW(®)), enabling us to reconstruct the cranial base and orbital walls without bone grafts. Here, we report on three reconstruction cases in which the novel titanium mesh-orbital wall system was used. In all three cases, the customized titanium mesh system performed satisfactorily with little, if any, complications.

  9. Evaluation of Three Cases Using a Novel Titanium Mesh System—Skull-Fit® with Orbital Wall (Skull-Fit WOW®)—For Cranial Base Reconstructions

    Science.gov (United States)

    Hattori, Noriko; Nakajima, Hideo; Tamada, Ikkei; Sakamoto, Yoshiaki; Ohira, Takayuki; Yoshida, Kazunari; Kawase, Takeshi; Kishi, Kazuo

    2011-01-01

    Cranial base reconstructions associated with tumor resections around the orbital wall often require that both the upper and lateral orbital walls be reconstructed during a single procedure. Previously, we used titanium mesh plates that were preoperatively fabricated based on three-dimensional models. Although these plates are precise and do not increase the probability of infection, we still had to use autologous bones to reconstruct the orbital walls. Recently, we developed a new titanium mesh plate—called Skull-Fit®—with orbital wall (Skull-Fit WOW®), enabling us to reconstruct the cranial base and orbital walls without bone grafts. Here, we report on three reconstruction cases in which the novel titanium mesh-orbital wall system was used. In all three cases, the customized titanium mesh system performed satisfactorily with little, if any, complications. PMID:22451827

  10. 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.

  11. 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.

  12. 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.

  13. Dorsal and ventral changes of the occipital vertebrae

    International Nuclear Information System (INIS)

    Banki, Z.

    1981-01-01

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

  14. 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.

  15. 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.

  16. 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.

  17. Evaluation of X ray radiation doses in pediatric examinations of cranial computerized tomography based on optimization studies

    International Nuclear Information System (INIS)

    Daros, Kellen Adriana Curci

    2005-01-01

    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

  18. 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.

  19. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    Kim, Hyae Young; Chung, Eun Chul; Suh, Jeong Soo; Choi, Hye Young; Ko, Eun Joo; Lee, Myung Sook

    1997-01-01

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

  3. 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

  4. Intraoperative cranial nerve monitoring.

    Science.gov (United States)

    Harper, C Michel

    2004-03-01

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

  5. 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.

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

    DEFF Research Database (Denmark)

    Pedersen, Jens

    1997-01-01

    It is general practice among fish ecologists to use indigestible remains such as vertebrae and otoliths in fish stomachs to determine the nature and size of their prey. However, estimation of the relationship between fish length and vertebrae size is a time consuming process when using vertebrae...

  7. 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...

  8. Cranial mononeuropathy III

    Science.gov (United States)

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

  9. Cranial neuronavigation with functional monitoring

    International Nuclear Information System (INIS)

    Braun, V.; Oberle, J.; Kretschmer, T.; Richter, H.P.

    1998-01-01

    Minimise the risks is an essential objective of neurosurgery. The technological progress achieved in the last few years, especially regarding imaging methods and image processing capabilities, offers the tools to manage the risks. The authors explain initial experience obtained with microscope-based cranial neuronavigation systems combined with direct cortical monitoring methods and give an outlook on expected devlopments in the future. (orig./CB) [de

  10. Burst fracture of the fifth lumber vertebra

    International Nuclear Information System (INIS)

    Cao Hetao; Hu Zhenmin; Shi Yuxin

    1999-01-01

    Objective: To investigate the stability of the fifth lumber vertebra after burst fracture. Methods: 7 patients with burst fracture of the fifth lumber vertebra were examined by X-ray and CT, and followed for 6-36 months. The changes of wedge index, lordosis, degree of spinal canal stenosis and neurological features were observed during the episode and followed up. Results: The three spinal column structure was disrupted in 6 of 7 patients. The anterior and mid columns were involved in 1 case. Spinal stenosis of first and second degrees was seen in 3 cases, and in one case, there was no spinal canal stenosis. Lower lumber motor-root deficits were found in 2 of 7 patients and resolved in follow up. There was no tendency of progressive collapse of the vertebral body and spinal stenosis. Conclusions: Burst fracture of the fifth lumber vertebra was specific, most of them were stable fractures, although two or three columns of the spine were disrupted and accompanied by spinal canal stenosis

  11. Burst fracture of the fifth lumber vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Hetao, Cao; Zhenmin, Hu; Yuxin, Shi [Affiliated Hosptial of Nantong Medical College, JS, Nantong (China). Dept. of Radiology

    1999-04-01

    Objective: To investigate the stability of the fifth lumber vertebra after burst fracture. Methods: 7 patients with burst fracture of the fifth lumber vertebra were examined by X-ray and CT, and followed for 6-36 months. The changes of wedge index, lordosis, degree of spinal canal stenosis and neurological features were observed during the episode and followed up. Results: The three spinal column structure was disrupted in 6 of 7 patients. The anterior and mid columns were involved in 1 case. Spinal stenosis of first and second degrees was seen in 3 cases, and in one case, there was no spinal canal stenosis. Lower lumber motor-root deficits were found in 2 of 7 patients and resolved in follow up. There was no tendency of progressive collapse of the vertebral body and spinal stenosis. Conclusions: Burst fracture of the fifth lumber vertebra was specific, most of them were stable fractures, although two or three columns of the spine were disrupted and accompanied by spinal canal stenosis

  12. Negative-pressure and low-pressure hydrocephalus: the role of cerebrospinal fluid leaks resulting from surgical approaches to the cranial base.

    Science.gov (United States)

    Filippidis, Aristotelis S; Kalani, M Yashar S; Nakaji, Peter; Rekate, Harold L

    2011-11-01

    Negative-pressure and low-pressure hydrocephalus are rare clinical entities that are frequently misdiagnosed. They are characterized by recurrent episodes of shunt failure because the intracranial pressure is lower than the opening pressure of the valve. In this report the authors discuss iatrogenic CSF leaks as a cause of low- or negative-pressure hydrocephalus after approaches to the cranial base. The authors retrospectively reviewed cases of low-pressure or negative-pressure hydrocephalus presenting after cranial approaches complicated with a CSF leak at their institution. Three patients were identified. Symptoms of high intracranial pressure and ventriculomegaly were present, although the measured pressures were low or negative. A blocked communication between the ventricles and the subarachnoid space was documented in 2 of the cases and presumed in the third. Shunt revisions failed repeatedly. In all cases, temporary clinical and radiographic improvement resulted from external ventricular drainage at subatmospheric pressures. The CSF leaks were sealed and CSF communication was reestablished operatively. In 1 case, neck wrapping was used with temporary success. Negative-pressure or low-pressure hydrocephalus associated with CSF leaks, especially after cranial base approaches, is difficult to treat. The solution often requires the utilization of subatmospheric external ventricular drains to establish a lower ventricular drainage pressure than the drainage pressure created in the subarachnoid space, where the pressure is artificially lowered by the CSF leak. Treatment involves correction of the CSF leak, neck wrapping to increase brain turgor and allow the pressure in the ventricles to rise to the level of the opening pressure of the valve, and reestablishing the CSF route.

  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 ASiR was 2 (p ASiR (p 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. • Model-Based 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. 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

  15. Cranial nerve palsies

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  16. 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.

  17. 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)

  18. 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.

  19. 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.

  20. Reassessment of spiny dogfish Squalus acanthias age and growth using vertebrae and dorsal-fin spines.

    Science.gov (United States)

    Bubley, W J; Kneebone, J; Sulikowski, J A; Tsang, P C W

    2012-04-01

    Male and female spiny dogfish Squalus acanthias were collected in the western North Atlantic Ocean in the Gulf of Maine between July 2006 and June 2009. Squalus acanthias ranged from 25 to 102 cm stretch total length and were caught during all months of the year except January. Age estimates derived from banding patterns visible in both the vertebrae and second dorsal-fin spines were compared. Vertebral growth increments were visualized using a modified histological staining technique, which was verified as appropriate for obtaining age estimates. Marginal increment analysis of vertebrae verified the increment periodicity, suggesting annual band deposition. Based on increased precision and accuracy of age estimates, as well as more biologically realistic parameters generated in growth models, the current study found that vertebrae provided a more reliable and accurate means of estimating age in S. acanthias than the second dorsal-fin spine. Age estimates obtained from vertebrae ranged from acanthias. The two-parameter von Bertalanffy growth model fit to vertebrae-derived age estimates produced parameters of L∞ = 94·23 cm and k = 0·11 for males and L∞ = 100·76 cm and k = 0·12 for females. While these growth parameters differed from those previously reported for S. acanthias in the western North Atlantic Ocean, the causes of such differences were beyond the scope of the current study and remain to be determined. © 2011 The Authors. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.

  1. Cranial magnetic resonance imaging

    International Nuclear Information System (INIS)

    Elster, A.D.

    1987-01-01

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

  2. Mechanical implications of pneumatic neck vertebrae in sauropod dinosaurs

    Science.gov (United States)

    Schwarz-Wings, Daniela; Meyer, Christian A.; Frey, Eberhard; Manz-Steiner, Hans-Rudolf; Schumacher, Ralf

    2010-01-01

    The pre-sacral vertebrae of most sauropod dinosaurs were surrounded by interconnected, air-filled diverticula, penetrating into the bones and creating an intricate internal cavity system within the vertebrae. Computational finite-element models of two sauropod cervical vertebrae now demonstrate the mechanical reason for vertebral pneumaticity. The analyses show that the structure of the cervical vertebrae leads to an even distribution of all occurring stress fields along the vertebrae, concentrated mainly on their external surface and the vertebral laminae. The regions between vertebral laminae and the interior part of the vertebral body including thin bony struts and septa are mostly unloaded and pneumatic structures are positioned in these regions of minimal stress. The morphology of sauropod cervical vertebrae was influenced by strongly segmented axial neck muscles, which require only small attachment areas on each vertebra, and pneumatic epithelia that are able to resorb bone that is not mechanically loaded. The interaction of these soft tissues with the bony tissue of the vertebrae produced lightweight, air-filled vertebrae in which most stresses were borne by the external cortical bone. Cervical pneumaticity was therefore an important prerequisite for neck enlargement in sauropods. Thus, we expect that vertebral pneumaticity in other parts of the body to have a similar role in enabling gigantism. PMID:19801376

  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 (D 2  - D 98 /D 50 ) as well as median and maximum dose (D 2% ) to Plan_PTV, V 95% and minimum dose (D 99.9% ) to Plan_CTV and Test_CTV and Plan_PTV and Test_PTV, V 95% and minimum dose (D 98% ) 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 D min 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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  5. 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

  6. Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note.

    Science.gov (United States)

    Brand, Y; Lim, E; Waran, V; Prepageran, N

    2015-12-01

    Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa. A 37-year-old male patient presented with multiple areas of cranial defect with cerebrospinal fluid leak due to osteoradionecrosis following radiation for nasopharyngeal carcinoma 4 years earlier. Clinical examination showed involvement of all cranial nerves except the IInd and XIth nerves on the left side. A prior attempt to repair the cerebrospinal fluid leak with craniotomy was not successful. This case demonstrates the successful endoscopic repair of a large cranial defect with cerebrospinal fluid leak.

  7. Dual photon absorptiometry in lumbar vertebrae

    International Nuclear Information System (INIS)

    Roos, B.O.; Hansson, T.H.; Skoeldborn, H.

    1980-01-01

    In connection with determination of the bone mineral content in the third lumbar vertebra by dual photon absorptiometry, the fat in the adipose capsules of the kidneys is assumed to cause erroneous positioning of the baseline, leading to overestimation of the bone mineral content. The bone mineral content in L3 was measured in situ (BMC 1 ) and vitro (BMC 2 ) in 14 cadavers. The difference between BMC 1 and BMC 2 was significantly greater than zero, the median value being 0.32 g/cm at the confidence level of 94.4 per cent. It is concluded that at correlation between bone mineral content and compressive strength in vitro, the in vivo strength is overestimated by about 250 N. (Auth.)

  8. Comparison of vertebral morphometry in the lumbar vertebrae by T1-weighted sagittal MRI and radiograph

    International Nuclear Information System (INIS)

    Tomomitsu, Tatsushi; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

    2005-01-01

    Purpose: In this study, we investigated the usefulness of T1-weighted sagittal MR images at the lumbar vertebrae in the vertebral morphometry, in comparison with lateral radiographs. Subjects and methods: The subjects were 42 men (mean age: 53.0 years) and 41 women (mean age: 57.9 years). Both MRI and radiography of the lumbar spine were performed within 1 month. The vertebral body heights and their ratios were measured by the semi-automatic measuring system. The frequency of a vertebral fracture and the absolute value of vertebral body height in both morphometry were compared. Results: Based on the criteria for prevalent vertebral fracture using vertebral height ratios, the vertebrae were classified into four groups. Group 1 was defined as the vertebrae without fracture (n = 347 vertebrae). Groups 2-4 were defined as the vertebrae with fracture; Group 2 by both MRI and X-ray morphometry (n = 17), Group 3 by MRI morphometry alone (n = 17), and Group 4 by X-ray morphometry alone (n = 4). The rate of prevalent vertebral fracture diagnosed by MRI morphometry (8.8%) was higher than that by X-ray morphometry (5.5%). In Group 1, the values of anterior and posterior vertebral height obtained by MRI morphometry were greater than those obtained by X-ray morphometry. On the other hand, the values of central vertebral height obtained by MRI morphometry were smaller than those obtained by X-ray morphometry. Conclusion: Severe biconcave deformity of vertebra can be detected by both MRI and X-ray morphometry, although mild biconcave deformity can be detected only by MRI morphometry

  9. 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.

  10. Fetal Tendinous Connection Between the Tensor Tympani and Tensor Veli Palatini Muscles: A Single Digastric Muscle Acting for Morphogenesis of the Cranial Base.

    Science.gov (United States)

    Rodríguez-Vázquez, José Francisco; Sakiyama, Koji; Abe, Hiroshi; Amano, Osamu; Murakami, Gen

    2016-04-01

    Some researchers contend that in adults the tensor tympani muscle (TT) connects with the tensor veli palatini muscle (TVP) by an intermediate tendon, in disagreement with the other researchers. To resolve this controversy, we examined serial sections of 50 human embryos and fetuses at 6-17 weeks of development. At 6 weeks, in the first pharyngeal arch, a mesenchymal connection was found first to divide a single anlage into the TT and TVP. At and after 7 weeks, the TT was connected continuously with the TVP by a definite tendinous tissue mediolaterally crossing the pharyngotympanic tube. At 11 weeks another fascia was visible covering the cranial and lateral sides of the tube. This "gonial fascia" had two thickened borders: the superior one corresponded to a part of the connecting tendon between the TT and TVP; the inferior one was a fibrous band ending at the os goniale near the lateral end of the TVP. In association with the gonial fascia, the fetal TT and TVP seemed to provide a functional complex. The TT-TVP complex might first help elevate the palatal shelves in association with the developing tongue. Next, the tubal passage, maintained by contraction of the muscle complex, seems to facilitate the removal of loose mesenchymal tissues from the tympanic cavity. Third, the muscle complex most likely determined the final morphology of the pterygoid process. Consequently, despite the controversial morphologies in adults, the TT and TVP seemed to make a single digastric muscle acting for the morphogenesis of the cranial base. © 2016 Wiley Periodicals, Inc.

  11. Cervical vertebrae maturation method morphologic criteria: poor reproducibility.

    Science.gov (United States)

    Nestman, Trenton S; Marshall, Steven D; Qian, Fang; Holton, Nathan; Franciscus, Robert G; Southard, Thomas E

    2011-08-01

    The cervical vertebrae maturation (CVM) method has been advocated as a predictor of peak mandibular growth. A careful review of the literature showed potential methodologic errors that might influence the high reported reproducibility of the CVM method, and we recently established that the reproducibility of the CVM method was poor when these potential errors were eliminated. The purpose of this study was to further investigate the reproducibility of the individual vertebral patterns. In other words, the purpose was to determine which of the individual CVM vertebral patterns could be classified reliably and which could not. Ten practicing orthodontists, trained in the CVM method, evaluated the morphology of cervical vertebrae C2 through C4 from 30 cephalometric radiographs using questions based on the CVM method. The Fleiss kappa statistic was used to assess interobserver agreement when evaluating each cervical vertebrae morphology question for each subject. The Kendall coefficient of concordance was used to assess the level of interobserver agreement when determining a "derived CVM stage" for each subject. Interobserver agreement was high for assessment of the lower borders of C2, C3, and C4 that were either flat or curved in the CVM method, but interobserver agreement was low for assessment of the vertebral bodies of C3 and C4 when they were either trapezoidal, rectangular horizontal, square, or rectangular vertical; this led to the overall poor reproducibility of the CVM method. These findings were reflected in the Fleiss kappa statistic. Furthermore, nearly 30% of the time, individual morphologic criteria could not be combined to generate a final CVM stage because of incompatible responses to the 5 questions. Intraobserver agreement in this study was only 62%, on average, when the inconclusive stagings were excluded as disagreements. Intraobserver agreement was worse (44%) when the inconclusive stagings were included as disagreements. For the group of subjects

  12. 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.

  13. Bertolotti's syndrome revisited. Transitional vertebrae of the lumbar spine.

    Science.gov (United States)

    Elster, A D

    1989-12-01

    Bertolotti's syndrome refers to the association of back pain with lumbosacral transitional vertebrae. Such vertebrae were observed in 140 of 2,000 adults with back pain over a 4-year period of study. Each patient had radiographic evaluation of the lumbar spine by plain films as well as a sectional imaging modality (magnetic resonance [MR] or computed tomography [CT]). The overall incidence of structural pathology (eg, spinal stenosis and disc protrusion) detected by CT or MR was not apparently higher in patients with transitional vertebrae, but the distribution of these lesions was significantly different. Disc bulge or herniation, when it occurred, was nearly nine times more common at the interspace immediately above the transitional vertebra than at any other level. Spinal stenosis and nerve root canal stenosis were more common at or near the interspace above the transitional vertebra than at any other level. Degenerative change at the articulation between the transverse process of the transitional vertebra and the pelvis was an uncommon occurrence; when seen there was no significant correlation with the reported side of pain. It is postulated that hypermobility and altered stresses become concentrated in the spine at the level immediately above a lumbar transitional vertebra. Accelerated disc and facet joint degeneration at this level may then result.

  14. Cranial magnetic resonance imaging

    International Nuclear Information System (INIS)

    Elster, A.D.

    1988-01-01

    Cranial Magnetic Resonance Imaging is comprehensive, well structured, and well written. The material is current and well referenced. The illustrations are good and complement the text well. The overall quality of publication is above average. The greatest attribute of the book is its readability. The author demonstrates ample skill in making complex subjects, such as MR physics and imaging of cerebral hemorrhage, easy to understand. The book closes with a detailed atlas on the anatomic appearance of the brain on MR images in the axial, coronal, and sagittal planes

  15. ''Tower vertebra'': a new observation in sickle cell disease

    International Nuclear Information System (INIS)

    Marlow, T.J.; Brunson, C.Y.; Jackson, S.; Schabel, S.I.

    1998-01-01

    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.)

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

    International Nuclear Information System (INIS)

    Jeung, Seung Woon; Lim, Cheong Hwan; Jung, Hong Ryang; Joo, Yeong Cheol; Park, Mi Ja; Han, Beon Hee

    2012-01-01

    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.

  17. 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.

  18. 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.

  19. Deformation Measurement Of Lumbar Vertebra By Holographic Interferometry

    Science.gov (United States)

    Matsumoto, Toshiro; Kojima, Arata; Ogawa, Ryoukei; Iwata, Koichi; Nagata, Ryo

    1988-01-01

    The mechanical properties of normal lumbar vertebra and one with the interarticular part cut off to simulate hemi-spondylolysis were measured by the double exposure holographic interferometry. In the normal lumbar vertebra, displacement due to the load applied to the inferior articular process was greater than that of superior articular process under the same load. The interarticular part was subjected to the high stress. From these points, one of the valuable data to consider the cause of spondylolysis was obtained.

  20. Literature review of cranial nerve injuries during carotid endarterectomy.

    Science.gov (United States)

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

    2007-01-01

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

  1. [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.

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  5. Terminal nerve: cranial nerve zero

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo Duque Parra

    2006-12-01

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

  6. [Acute palsy of twelfth cranial nerve].

    Science.gov (United States)

    Munoz del Castillo, F; Molina Nieto, T; De la Riva Aguilar, A; Triviño Tarradas, F; Bravo-Rodríguez, F; Ramos Jurado, A

    2005-01-01

    The hypoglossal nerve or Twelfth-nerve palsy is a rare damage with different causes: tumors or metastases in skull base, cervicals tumors, schwannoma, dissection or aneurysm carotid arteries, stroke, trauma, idiopathic cause, radiation, infections (mononucleosis) or multiple cranial neuropathy. Tumors were responsible for nearly half of the cases in different studies. We studied a female with hypoglossal nerve acute palsy. We made a differential diagnostic with others causes and a review of the literature.

  7. Augmentation of failed human vertebrae with critical un-contained lytic defect restores their structural competence under functional loading: An experimental study.

    Science.gov (United States)

    Alkalay, Ron N; von Stechow, Dietrich; Hackney, David B

    2015-07-01

    Lytic spinal lesions reduce vertebral strength and may result in their fracture. Vertebral augmentation is employed clinically to provide mechanical stability and pain relief for vertebrae with lytic lesions. However, little is known about its efficacy in strengthening fractured vertebrae containing lytic metastasis. Eighteen unembalmed human lumbar vertebrae, having simulated uncontained lytic defects and tested to failure in a prior study, were augmented using a transpedicular approach and re-tested to failure using a wedge fracture model. Axial and moment based strength and stiffness parameters were used to quantify the effect of augmentation on the structural response of the failed vertebrae. Effects of cement volume, bone mineral density and vertebral geometry on the change in structural response were investigated. Augmentation increased the failed lytic vertebral strength [compression: 85% (Paugmentation is effective in bolstering the failed lytic vertebrae compressive and axial structural competence, showing strength estimates up to 50-90% of historical values of osteoporotic vertebrae without lytic defects. This modest increase suggests that lytic vertebrae undergo a high degree of structural damage at failure, with strength only partially restored by vertebral augmentation. The positive effect of cement volume is self-limiting due to extravasation. Copyright © 2015. Published by Elsevier Ltd.

  8. Automatic labeling and segmentation of vertebrae in CT images

    Science.gov (United States)

    Rasoulian, Abtin; Rohling, Robert N.; Abolmaesumi, Purang

    2014-03-01

    Labeling and segmentation of the spinal column from CT images is a pre-processing step for a range of image- guided interventions. State-of-the art techniques have focused either on image feature extraction or template matching for labeling of the vertebrae followed by segmentation of each vertebra. Recently, statistical multi- object models have been introduced to extract common statistical characteristics among several anatomies. In particular, we have created models for segmentation of the lumbar spine which are robust, accurate, and computationally tractable. In this paper, we reconstruct a statistical multi-vertebrae pose+shape model and utilize it in a novel framework for labeling and segmentation of the vertebra in a CT image. We validate our technique in terms of accuracy of the labeling and segmentation of CT images acquired from 56 subjects. The method correctly labels all vertebrae in 70% of patients and is only one level off for the remaining 30%. The mean distance error achieved for the segmentation is 2.1 +/- 0.7 mm.

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

    Science.gov (United States)

    Villamil, Catalina I

    2018-03-01

    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.

  10. 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.

  11. The transitional vertebra and sacroiliac joint dysfunction association.

    Science.gov (United States)

    Illeez, Ozge Gulsum; Atıcı, Arzu; Ulger, Esra Bahadır; Kulcu, Duygu Geler; Ozkan, Feyza Unlu; Aktas, Ilknur

    2018-01-01

    The purpose of this study was to investigate whether transitional vertebrae contribute to the development of sacroiliac joint dysfunction. The prevalence of transitional vertebrae in patients with lumbar pain was determined during this process, and the prevalence of sacroiliac dysfunction was compared between patients with low back pain and healthy volunteers. 700 subjects, 500 with low back pain and 200 healthy volunteers were included in this study. Five tests were applied to all participants to determine sacroiliac joint dysfunction. Positivity in three tests was regarded as dysfunction. Lateral lumbosacral and Ferguson angle X-rays were taken from the group with low back pain. The patient was evaluated a specialist radiologist in terms of presence or absence of transitional vertebrae, and if identified, what type. Transitional vertebrae were determined in 26% (n = 130) of the patients with low back pain. Type 1a was determined in 20%, type 1b in 10%, type 2a in 26.9%, type 2b in 30.8%, type 3a in 0.8%, type 3b in 4.6% and type 4 in 6.9%. The prevalence of sacroiliac joint dysfunction in the low back pain group (15.4%) and the prevalence of sacroiliac joint dysfunction in cases of transitional vertebra (28.5%) were significantly higher compared to the control groups (p Sacroiliac joint dysfunction must be considered when investigating the etiology of low back pain. Particular sensitivity must be exhibited on this subject in patients with transitional vertebrae.

  12. 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.

  13. Chondroblastoma of thoracic vertebra in young adult causing paraparesis

    Directory of Open Access Journals (Sweden)

    Giri Pramod J.

    2017-09-01

    Full Text Available Chondroblastoma of spine is very rare condition. To best of our knowledge, fewer than 30 cases have been reported in the world literature. Almost all of them involved both anterior & posterior component of vertebra. There are only few reports with isolated posterior element involvement. Clinical presentation of paraparesis because of vertebral chondroblastoma is very rare. This case report presents 17 yr old male with chondroblastoma involving posterior thoracic vertebra presenting with quadriparesis which improved after successful treatment. Early diagnosis and complete excision with periodic follow up is necessary for treatment of this disease.

  14. Osteopathia striata with cranial sclerosis

    International Nuclear Information System (INIS)

    Gay, B.B.; Elsas, L.J.; Wyly, J.B.; Pasquali, M.

    1994-01-01

    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.)

  15. TH-EF-BRB-10: Dosimetric Validation of a Trajectory Based Cranial SRS Treatment Technique On a Varian TrueBeam Linac

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, B [University of British Columbia, Vancouver, BC (Canada); Vancouver Cancer Centre, Vancouver, BC (Canada); Gete, E [Vancouver Cancer Centre, Vancouver, BC (Canada)

    2016-06-15

    Purpose: This work investigates the dosimetric accuracy of a trajectory based delivery technique in which an optimized radiation beam is delivered along a Couch-Gantry trajectory that is formed by simultaneous rotation of the linac gantry and the treatment couch. Methods: Nine trajectory based cranial SRS treatment plans were created using in-house optimization software. The plans were calculated for delivery on the TrueBeam STx linac with 6MV photon beam. Dose optimization was performed along a user-defined trajectory using MLC modulation, dose rate modulation and jaw tracking. The pre-defined trajectory chosen for this study is formed by a couch rotation through its full range of 180 degrees while the gantry makes four partial arc sweeps which are 170 degrees each. For final dose calculation, the trajectory based plans were exported to the Varian Eclipse Treatment Planning System. The plans were calculated on a homogeneous cube phantom measuring 18.2×18.2×18.2 cm3 with the analytical anisotropic algorithm (AAA) using a 1mm3 calculation voxel. The plans were delivered on the TrueBeam linac via the developer’s mode. Point dose measurements were performed on 9 patients with the IBA CC01 mini-chamber with a sensitive volume of 0.01 cc. Gafchromic film measurements along the sagittal and coronal planes were performed on three of the 9 treatment plans. Point dose values were compared with ion chamber measurements. Gamma analysis comparing film measurement and AAA calculations was performed using FilmQA Pro. Results: The AAA calculations and measurements were in good agreement. The point dose difference between AAA and ion chamber measurements were within 2.2%. Gamma analysis test pass rates (2%, 2mm passing criteria) for the Gafchromic film measurements were >95%. Conclusion: We have successfully tested TrueBeam’s ability to deliver accurate trajectory based treatments involving simultaneous gantry and couch rotation with MLC and dose rate modulation along the

  16. 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.

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

    International Nuclear Information System (INIS)

    Kim, G.

    2015-01-01

    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

  18. 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.

  19. Cranial Neuropathy in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Mine Hayriye Sorgun

    2011-09-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  1. Assessment of dose in cervical vertebrae radiographic examinations

    International Nuclear Information System (INIS)

    Owrnasir, Wafa Fadol Orsud

    2014-12-01

    Reference dose levels provide a framework to reduce doses variability and aid in the optimization of radiation protection.This study was performed in Khartoum Teaching Hospital in period of January to June 2014. This study performed to assess the entrance surface dose ( ESD) received in Cervical Vertebrae radiographic examination and to analyze effective dose distributions among radiological departments under study. The study was performed in Khartoum Teaching Hospital, covering two x-ray units and a sample of 64 patients. The following parameter were recorded; age, weight, height, body mass index (BMI) derived from weight (kg) and height (m) and exposure factors. The dose was measured for Cervical Vertebrae x-ray examinations, the entrance surface dose (ESD) values were estimated from the x-ray tube output parameters for Cervical Vertebrae AP and lateral examinations. The ESD values were then calculated using IAEA calculation methods. The results of ESD values calculated showed than patient exposure were within the normal range of exposure. The mean ED values calculated were ( 3.85 ±0.04) and (4.02 ±0.05) mGy for Cervical Vertebrae AP and lateral examinations, respectively in department Na1 and (3.99± 0.15) and (4.23± 0.34) mGy, for Cervical Vertebrae Ap and lateral examinations respectively in department Na2, the IAEA standard value of ESD for cervical equal (7), (20) mGy AP and LAT, Further studies are recommended with more number of patients and using more than two modalities for comparison. (Author)

  2. Deformed Skull Morphology Is Caused by the Combined Effects of the Maldevelopment of Calvarias, Cranial Base and Brain in FGFR2-P253R Mice Mimicking Human Apert Syndrome.

    Science.gov (United States)

    Luo, Fengtao; Xie, Yangli; Xu, Wei; Huang, Junlan; Zhou, Siru; Wang, Zuqiang; Luo, Xiaoqing; Liu, Mi; Chen, Lin; Du, Xiaolan

    2017-01-01

    Apert syndrome (AS) is a common genetic syndrome in humans characterized with craniosynostosis. Apert patients and mouse models showed abnormalities in sutures, cranial base and brain, that may all be involved in the pathogenesis of skull malformation of Apert syndrome. To distinguish the differential roles of these components of head in the pathogenesis of the abnormal skull morphology of AS, we generated mouse strains specifically expressing mutant FGFR2 in chondrocytes, osteoblasts, and progenitor cells of central nervous system (CNS) by crossing Fgfr2 +/P253R-Neo mice with Col2a1-Cre, Osteocalcin-Cre (OC-Cre), and Nestin-Cre mice, respectively. We then quantitatively analyzed the skull and brain morphology of these mutant mice by micro-CT and micro-MRI using Euclidean distance matrix analysis (EDMA). Skulls of Col2a1-Fgfr2 +/P253R mice showed Apert syndrome-like dysmorphology, such as shortened skull dimensions along the rostrocaudal axis, shortened nasal bone, and evidently advanced ossification of cranial base synchondroses. The OC-Fgfr2 +/P253R mice showed malformation in face at 8-week stage. Nestin-Fgfr2 +/P253R mice exhibited increased dorsoventral height and rostrocaudal length on the caudal skull and brain at 8 weeks. Our study indicates that the abnormal skull morphology of AS is caused by the combined effects of the maldevelopment in calvarias, cranial base, and brain tissue. These findings further deepen our knowledge about the pathogenesis of the abnormal skull morphology of AS, and provide new clues for the further analyses of skull phenotypes and clinical management of AS.

  3. Influence of patient position and implant material on the stress distribution in an artificial intervertebral disc of the lumbar vertebrae

    Directory of Open Access Journals (Sweden)

    Karpiński Robert

    2017-01-01

    Full Text Available The aim of this paper was to determine the effect of using cobalt and titanium-based alloys as implant materials for the lumbar vertebrae with an artificial intervertebral disc on the stress distribution. The lumbar vertebrae were chosen for the study because they carry considerably higher loads, especially while standing or sitting. Finite element method (FEM simulations were conducted for three standard loads reflecting three patient's positions: recumbent, standing and sitting. The FEM analysis was performed using the SolidWorks Simulation module. Artificial units containing a pair of vertebrae with a prosthesis between them were designed by the Solid Edge software, based on micro-computed tomography CT scans of the patient's spine. The implant model was designed with its shape based on the geometry of surrounding vertebrae, consisting of an upper pad, a bottom pad and an insert (intervertebral disc. Two implant material configurations were studied. One involved the use of titanium alloy for the upper and bottom pads, while in the other, these pads were made of cobalt alloy. In both cases, a polyethylene insert was used. The FEM results demonstrate that both material configurations meet the requirements for prosthesis design. In both material configurations, the maximum stresses in each prosthesis element are almost twice higher in a sitting posture than in a recumbent position.

  4. Multiple Cranial Nerve Involvement In Cryptococcal Meningitis

    Directory of Open Access Journals (Sweden)

    Mahadevan A

    2000-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Heidi Bildsoe

    2016-12-01

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

  6. CT measurements of cranial growth: microcephaly

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  7. MRI findings in cranial eumycetoma

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  8. 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.

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

    International Nuclear Information System (INIS)

    Spuzyak, M.I.

    1986-01-01

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

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

    Science.gov (United States)

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

    1994-10-01

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

  11. Chondroblastoma of the Lumbar Vertebra Associated with Cauda Equina Compression

    Directory of Open Access Journals (Sweden)

    Ewe-Juan Yeap

    2013-12-01

    Full Text Available Chondroblastoma is a benign tumour, most often affecting the epiphyses of long tubular bones such as the proximal end of the humerus, femur, and tibia, as well as the distal end of the femur. Vertebral involvement is extremely rare. We report a case of chondroblastoma of the second lumbar vertebra associated with cauda equina compression. Complete excision is necessary to relieve the compression and ensure surgical clearance.

  12. A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti's Syndrome.

    Science.gov (United States)

    Jancuska, Jeffrey M; Spivak, Jeffrey M; Bendo, John A

    2015-01-01

    Lumbosacral transitional vertebrae (LSTV) are increasingly recognized as a common anatomical variant associated with altered patterns of degenerative spine changes. This review will focus on the clinical significance of LSTV, disruptions in normal spine biomechanics, imaging techniques, diagnosis, and treatment. A Pubmed search using the specific key words "LSTV," "lumbosacral transitional vertebrae," and "Bertolotti's Syndrome" was performed. The resulting group of manuscripts from our search was evaluated. LSTV are associated with alterations in biomechanics and anatomy of spinal and paraspinal structures, which have important implications on surgical approaches and techniques. LSTV are often inaccurately detected and classified on standard AP radiographs and MRI. The use of whole-spine images as well as geometric relationships between the sacrum and lumbar vertebra increase accuracy. Uncertainty regarding the cause, clinical significance, and treatment of LSTV persists. Some authors suggest an association between LSTV types II and IV and low back pain. Pseudoarticulation between the transverse process and the sacrum creates a "false joint" susceptible to arthritic changes and osteophyte formation potentially leading to nerve root entrapment. The diagnosis of symptomatic LSTV is considered with appropriate patient history, imaging studies, and diagnostic injections. A positive radionuclide study along with a positive effect from a local injection helps distinguish the transitional vertebra as a significant pain source. Surgical resection is reserved for a subgroup of LSTV patients who fail conservative treatment and whose pain is definitively attributed to the anomalous pseudoarticulation. Due to the common finding of low back pain and the wide prevalence of LSTV in the general population, it is essential to differentiate between symptoms originating from an anomalous psuedoarticulation from other potential sources of low back pain. Further studies with larger

  13. Vertebroplasty reduces progressive ׳creep' deformity of fractured vertebrae.

    Science.gov (United States)

    Luo, J; Pollintine, P; Annesley-Williams, D J; Dolan, P; Adams, M A

    2016-04-11

    Elderly vertebrae frequently develop an "anterior wedge" deformity as a result of fracture and creep mechanisms. Injecting cement into a damaged vertebral body (vertebroplasty) is known to help restore its shape and stiffness. We now hypothesise that vertebroplasty is also effective in reducing subsequent creep deformations. Twenty-eight spine specimens, comprising three complete vertebrae and the intervening discs, were obtained from cadavers aged 67-92 years. Each specimen was subjected to increasingly-severe compressive loading until one of its vertebrae was fractured, and the damaged vertebral body was then treated by vertebroplasty. Before and after fracture, and again after vertebroplasty, each specimen was subjected to a static compressive force of 1kN for 1h while elastic and creep deformations were measured in the anterior, middle and posterior regions of each adjacent vertebral body cortex, using a 2D MacReflex optical tracking system. After fracture, creep in the anterior and central regions of the vertebral body cortex increased from an average 4513 and 885 microstrains, respectively, to 54,107 and 34,378 microstrains (both increases: Pcreep in the anterior and central cortex by 61% (P=0.006) and 66% (P=0.017) respectively. Elastic strains were reduced by less than half this amount. Results suggest that the beneficial effects of vertebroplasty on the vertebral body continue long after the post-operative radiographs. Injected cement not only helps to restore vertebral shape and elastic properties, but also reduces subsequent creep deformation of the damaged vertebra. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Prevalence of extraforaminal nerve root compression below lumbosacral transitional vertebrae.

    Science.gov (United States)

    Porter, Neil A; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; Singh, Jaspreet; Cassar-Pullicino, Victor N

    2014-01-01

    Although pathology at the first mobile segment above a lumbosacral transitional vertebra (LSTV) is a known source of spinal symptoms, nerve root compression below an LSTV, has only sporadically been reported. Our objective was to assess the prevalence of nerve root entrapment below an LSTV, review the causes of entrapment, and correlate with presenting symptoms. A retrospective review of MR and CT examinations of the lumbar spine was performed over a 5.5-year period in which the words "transitional vertebra" were mentioned in the report. Nerve root compression below an LSTV was assessed as well as the subtype of transitional vertebra. Correlation with clinical symptoms at referral was made. MR and CT examinations were also reviewed to exclude any other cause of symptoms above the LSTV. One hundred seventy-four patients were included in the study. Neural compression by new bone formation below an LSTV was demonstrated in 23 patients (13%). In all of these patients, there was a pseudarthrosis present on the side of compression due to partial sacralization with incomplete fusion. In three of these patients (13%), there was symptomatic correlation with no other cause of radiculopathy demonstrated. A further 13 patients (57%) had correlating symptoms that may in part be attributable to compression below an LSTV. Nerve root compression below an LSTV occurs with a prevalence of 13% and can be symptomatic in up to 70% of these patients. This region should therefore be carefully assessed in all symptomatic patients with an LSTV.

  15. 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.

  16. 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.

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

    Science.gov (United States)

    Fiorenza, Luca; Bruner, Emiliano

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  19. 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.)

  20. Cranial imaging in child abuse

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  1. 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.

  2. Geometric morphometric evaluation of cervical vertebrae shape and its relationship to skeletal maturation.

    Science.gov (United States)

    Chatzigianni, Athina; Halazonetis, Demetrios J

    2009-10-01

    Cervical vertebrae shape has been proposed as a diagnostic factor for assessing skeletal maturation in orthodontic patients. However, evaluation of vertebral shape is mainly based on qualitative criteria. Comprehensive quantitative measurements of shape and assessments of its predictive power have not been reported. Our aims were to measure vertebral shape by using the tools of geometric morphometrics and to evaluate the correlation and predictive power of vertebral shape on skeletal maturation. Pretreatment lateral cephalograms and corresponding hand-wrist radiographs of 98 patients (40 boys, 58 girls; ages, 8.1-17.7 years) were used. Skeletal age was estimated from the hand-wrist radiographs. The first 4 vertebrae were traced, and 187 landmarks (34 fixed and 153 sliding semilandmarks) were used. Sliding semilandmarks were adjusted to minimize bending energy against the average of the sample. Principal components analysis in shape and form spaces was used for evaluating shape patterns. Shape measures, alone and combined with centroid size and age, were assessed as predictors of skeletal maturation. Shape alone could not predict skeletal maturation better than chronologic age. The best prediction was achieved with the combination of form space principal components and age, giving 90% prediction intervals of approximately 200 maturation units in the girls and 300 units in the boys. Similar predictive power could be obtained by using centroid size and age. Vertebrae C2, C3, and C4 gave similar results when examined individually or combined. C1 showed lower correlations, signifying lower integration with hand-wrist maturation. Vertebral shape is strongly correlated to skeletal age but does not offer better predictive value than chronologic age.

  3. Roentgen stereophotogrammetry for analysis of cranial growth

    International Nuclear Information System (INIS)

    Selvik, G.; Alberius, P.; Fahlman, M.

    1986-01-01

    A system of roentgen stereophotogrammetric analysis (RSA) has been developed and its value in studies of cranial growth in both man and the experimental animal (rabbit) has been delineated. This method is based on measurements from metal bone marker images on roentgenograms. Two roentgen tubes simultaneously expose the object, which is placed in one of two types of calibration cages. The object position does not need to be identical from one examination to the next. The cage, holding indicators of predetermined internal positions (in two or four planes), defines a laboratory coordinate system. Two-dimensional image coordinates are obtained by means of a highly accurate cartographic instrument. By computer reconstruction of the x-ray beams through the markers, 3-D object coordinates are calculated. For subsequent analysis of growth processes, extensive software is necessary. To control intrasegmental stability (routinely performed at each examination), a minimum of two markers is required, whereas three markers are needed in each skeletal segment for kinematic analysis using the rigid-body concept. Careful planning of marker placement before implantation minimizes implant loss and instability that otherwise might be a problem. Complications other than bone marker loosening have been nonexistent. The technical accuracy is high. Consequently, roentgen stereophotogrammetry, with the aid of metallic implants, is a superior means to obtain biometric information on cranial growth with relative ease

  4. 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

  5. Gliosarcoma of the posterior cranial fossa: MRI findings

    International Nuclear Information System (INIS)

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

    1993-01-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  7. Multiple Cranial Nerve Involvement In Cryptococcal Meningitis

    OpenAIRE

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

    2000-01-01

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

  8. 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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  10. 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…

  11. 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

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

    Directory of Open Access Journals (Sweden)

    María José Fernández-Pérez

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

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

    Science.gov (United States)

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

    2016-01-01

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

  14. 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.

  15. Prevalence of lumbosacral transitional vertebrae in dogs in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Iva Fialová

    2014-01-01

    Full Text Available Lumbosacral transitional vertebra is a common congenital anomaly of the spine in dogs. It is a predisposing factor for degeneration of the lumbosacral spine and development of cauda equina syndrome or hip dysplasia in affected dogs. The aim of the study was to determine breed predisposition, types, and prevalence of lumbosacral transitional vertebrae in the canine population in the Czech Republic. The value of laterolateral radiographs of the lumbosacral junction in the diagnosis of LTV was also evaluated. Prevalence of lumbosacral transitional vertebrae was determined by reviewing ventrodorsal radiographs of pelvis with an extended hip of 1,878 dogs. Lumbosacral transitional vertebrae were detected in 188 dogs (10%. German Shepherd, Alaskan Malamute and Bohemian Shepherd were found to be highly predisposed breeds. The most common type of lumbosacral transitional vertebra was type II with separation of the first sacral vertebra from sacrum and presence of rudimentary intervertebral space between S1 and the sacral median crest (37.8% of the lumbosacral transitional vertebrae. Type I was detected in 29.2% and the asymmetric type of the lumbosacral transitional vertebra (type III in 33%. Laterolateral radiograph of the lumbosacral spine was evaluated in 126 dogs from 188 with lumbosacral transitional vertebrae. Rudimentary intervertebral disc space between S1 and S2 in laterolateral radiographs was detected in 100% of lumbosacral transitional vertebrae with type II and III, and was not detected in type I. The findings on lumbosacral transitional vertebrae in the Czech Republic will extend knowledge about the disease. Both ventrodorsal hip-extended and laterolateral radiographs should be recommended for routine screening and reliable differentiation among the three different types of lumbosacral transitional vertebra.

  16. Vertebra identification using template matching modelmp and K-means clustering.

    Science.gov (United States)

    Larhmam, Mohamed Amine; Benjelloun, Mohammed; Mahmoudi, Saïd

    2014-03-01

    Accurate vertebra detection and segmentation are essential steps for automating the diagnosis of spinal disorders. This study is dedicated to vertebra alignment measurement, the first step in a computer-aided diagnosis tool for cervical spine trauma. Automated vertebral segment alignment determination is a challenging task due to low contrast imaging and noise. A software tool for segmenting vertebrae and detecting subluxations has clinical significance. A robust method was developed and tested for cervical vertebra identification and segmentation that extracts parameters used for vertebra alignment measurement. Our contribution involves a novel combination of a template matching method and an unsupervised clustering algorithm. In this method, we build a geometric vertebra mean model. To achieve vertebra detection, manual selection of the region of interest is performed initially on the input image. Subsequent preprocessing is done to enhance image contrast and detect edges. Candidate vertebra localization is then carried out by using a modified generalized Hough transform (GHT). Next, an adapted cost function is used to compute local voted centers and filter boundary data. Thereafter, a K-means clustering algorithm is applied to obtain clusters distribution corresponding to the targeted vertebrae. These clusters are combined with the vote parameters to detect vertebra centers. Rigid segmentation is then carried out by using GHT parameters. Finally, cervical spine curves are extracted to measure vertebra alignment. The proposed approach was successfully applied to a set of 66 high-resolution X-ray images. Robust detection was achieved in 97.5 % of the 330 tested cervical vertebrae. An automated vertebral identification method was developed and demonstrated to be robust to noise and occlusion. This work presents a first step toward an automated computer-aided diagnosis system for cervical spine trauma detection.

  17. Optimization of spinal implant screw for lower vertebra through finite element studies.

    Science.gov (United States)

    Biswas, Jayanta; Karmakar, Santanu; Majumder, Santanu; Banerjee, Partha Sarathi; Saha, Subrata; Roychowdhury, Amit

    2014-01-01

    The increasing older population is suffering from an increase in age-related spinal degeneration that causes tremendous pain. Spine injury is mostly indicated at the lumbar spine (L3-L5) and corresponding intervertebral disks. Finite element analysis (FEA) is now one of the most efficient and accepted tools used to simulate these pathological conditions in computer-assisted design (CAD) models. In this study, L3-L5 spines were modeled, and FEA was performed to formulate optimal remedial measures. Three different loads (420, 490.5, and 588.6 N) based on three body weights (70, 90, and 120 kg) were applied at the top surface of the L3 vertebra, while the lower surface of the L5 vertebra remained fixed. Models of implants using stainless steel and titanium alloy (Ti6Al4V) pedicle screws and rods with three different diameters (4, 5, and 6 mm) were inserted into the spine models. The relative strengths of bone (very weak, weak, standard, strong, and very strong) were considered to determine the patient-specific effect. A total of 90 models were simulated, and von Mises stress and strain, shear stress, and strain intensity contour at the bone-implant interface were analyzed. Results of these analyses indicate that the 6-mm pedicle screw diameter is optimal for most cases. Experimental and clinical validation are needed to confirm these theoretical results.

  18. 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.)

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

    International Nuclear Information System (INIS)

    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 < 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.)

  20. Determination of calcium in foot, hand and vertebrae of man by neutron activation

    International Nuclear Information System (INIS)

    Zajchik, V.E.; Kondrashev, A.E.; Dubrovin, A.P.; Korelo, A.M.; Morukov, B.V.; Orlov, O.I.

    1990-01-01

    Methods and devices for in vivo neutron activation determination of calcium content in human foot, hand and vertebrae were developed. It is ascertained that calcium content in skeleton is subjected to seasonal cyclicity. Bones of foot have the minimum content of the element in winter-spring period and the maximum one in summer-autumn period. For vertebrae and hand the inverse dependence is characteristic. Average level of seasonal variations in calcium content in the bones of hand and vertebrae is 10-11%, that of foot - 18-19%. Amplitudes of seasonal variations in the content of calcium in vertebrae, hand and foot are interrelated. 5 refs.; 1 tab

  1. Butterfly vertebra. A case report and a short review of the literature.

    Science.gov (United States)

    Kapetanakis, S; Giovannopoulou, E; Nastoulis, E; Demetriou, T

    2016-01-01

    A butterfly vertebra is a rare congenital anomaly, encountered as isolated finding or as part of syndromic diseases. We report a case of a 40-year- old female presenting with low back pain and sciatica due to 'butterfly' dysplasia of the first sacral vertebra. This novel case includes posterolateral displacement of the completely separated hemivertebrae, causing left lateral recess stenosis and compression of S1 nerve root. Additionally, we conducted a short review of the literature. Few cases are reported in literature. Only one refers to a sacral vertebra. There is no previous case of a butterfly vertebra that accounts for narrowing of the lateral recess and associated radiculopathy.

  2. [Cranial trepanation in primitive cultures].

    Science.gov (United States)

    González-Darder, José Manuel

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

  3. Multiple cranial nerve palsies complicating tympanomastoiditis: case ...

    African Journals Online (AJOL)

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

  4. Teleradiology for emergency cranial computed tomography

    International Nuclear Information System (INIS)

    Stranzinger, E.; Treumann, T.C.; Dreier, D.; Allgayer, B.

    2003-01-01

    Purpose: We report our experience with the teleradiologic service provided by a center hospital (CH) for emergency cranial computed tomography (CCT) in two regional hospitals (RH) during a 12-month period. The clinical and economic impact of teleradiology will be discussed as well as the acceptance by the clinicians of the regional hospitals. Material and Methods: In 2001, 213 CT-scans in 202 patients were performed and reported using teleradiology. Teleradiologic and final medical diagnosis were analysed by the medical reports. The transferral of the patients to a CH and their further treatment were checked. The referring physicians in the RH were questionnaired about the teleradiological support. Results: 18 (9%) patients had to be urgently transferred to a CH based on the CT findings in the teleradiological reports. 24 patients (11%) were transferred to a center hospital during further treatment. 80% of patients were treated in the RH. (orig.) [de

  5. Cranial nerves III, IV and VI

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  6. Geometrical properties of the human child cervical spine with a focus on the C1 vertebra.

    Science.gov (United States)

    Yoganandan, Narayan; Pintar, Frank A; Lew, Sean M; Rao, Raj D

    2014-01-01

    Child dummies and injury criteria used in automotive crashworthiness environments are based on scaling from the adult and/or between children of different ages. Cartilage-to-bone ossification, spinal canal and joint developments of the spine, and strength attainments do not grow linearly from birth to maturity. Though this is known to medical professionals, age-based quantitative analyses are needed to accurately model the pediatric spine. The objective of this study was to quantify longitudinal growths of various regions of the first cervical vertebrae, responsible for transmitting the axial load from the base of the skull through the condyles to the neck/torso. Computed tomography (CT) images of 54 children from one day to 18 years of age were retrospectively used to determine the following geometrical properties: bilateral neurocentral synchondroses widths, the width of posterior synchondrosis, outer and inner anteroposterior and transverse diameters, spinal canal area, and depths of the anterior and posterior arches of the C1 vertebra. Both axial and sagittal CT images were used in the analysis. Sagittal images were used to quantify data for the anterior and posterior arches and axial images were used for all described cross-sectional parameters. Geometrical properties were extracted and reported for the various parameters at 6 months; one year; 18 months; and 3, 6, and 10 years of age corresponding to the dummy family ages routinely used in motor vehicle crashworthiness research and other applications. The outer transverse diameter ranged from 4.97 to 7.08 cm; outer and inner antero-posterior diameters ranged from 2.99 to 4.18 and 2.19 to 3.03 mm; and spinal canal area ranged from 4.34 to 6.68 mm(2). Other data are given in the body of the article. The growths of the first cervical vertebra quantified in terms of the above variables occurred nonlinearly with age and the degree of nonlinearity depended on the type of the geometrical parameter. Growths did not

  7. 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

  8. Solitary myofibroma of the lumbar vertebra: adult case

    International Nuclear Information System (INIS)

    Konishi, E.; Yanagisawa, A.; Mazaki, T.; Urata, Y.; Tanaka, K.; Kanoe, H.; Ikenaga, M.; Hayakawa, K.

    2007-01-01

    We present the first known adult case of solitary myofibroma of bone, which affected a lumbar vertebra in a 33-year-old male. Radiography identified a purely lytic lesion with a sclerotic rim in the right pedicle of L1. CT showed an expansile lytic lesion with a sclerotic rim. MRI of the lesion revealed an isointense signal on T1-weighted images, an inhomogeneously hyperintense signal on T2-weighted images, and marked enhancement with gadolinium. Pathological study showed a mixed picture of nodular proliferation of spindle-shaped myoid cells and hemangiopericytomatous proliferation of short spindle/small round cells. The tumor cells were immunoreactive for smooth muscle actin and immunonegative for desmin. This case of solitary myofibroma of bone is exceptionally rare because of its occurrence in an adult older than 20 years of age and its location at an extra-craniofacial site. (orig.)

  9. Solitary myofibroma of the lumbar vertebra: adult case

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, E.; Yanagisawa, A. [Kyoto Prefectural University of Medicne, Department of Pathology, Kyoto (Japan); Mazaki, T.; Urata, Y. [Kyoto City Hospital, Department of Pathology, Kyoto (Japan); Tanaka, K.; Kanoe, H.; Ikenaga, M. [Kyoto City Hospital, Department of Orthopedic Surgery, Kyoto (Japan); Hayakawa, K. [Kyoto City Hospital, Department of Radiology, Kyoto (Japan)

    2007-06-15

    We present the first known adult case of solitary myofibroma of bone, which affected a lumbar vertebra in a 33-year-old male. Radiography identified a purely lytic lesion with a sclerotic rim in the right pedicle of L1. CT showed an expansile lytic lesion with a sclerotic rim. MRI of the lesion revealed an isointense signal on T1-weighted images, an inhomogeneously hyperintense signal on T2-weighted images, and marked enhancement with gadolinium. Pathological study showed a mixed picture of nodular proliferation of spindle-shaped myoid cells and hemangiopericytomatous proliferation of short spindle/small round cells. The tumor cells were immunoreactive for smooth muscle actin and immunonegative for desmin. This case of solitary myofibroma of bone is exceptionally rare because of its occurrence in an adult older than 20 years of age and its location at an extra-craniofacial site. (orig.)

  10. Case report 351: Aggressive osteoblastoma of the third lumbar vertebra

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Frankel, V.H.; Klein, M.J.

    1986-02-01

    In summary, a case is presented of an aggressive osteoblastoma affecting the third lumbar vertebra in a 65-year-old man. Because of the age of the patient, the aggressive, destructive nature of the tumor and the extensive involvement of the vertebral body, metastatic carcinoma as well as several primary malignancies were entertained in the differential diagnosis (e.g. plasmacytoma, chordoma, primary lymphoma of bone). However, the destructive, expanding nature of the lesion, the focal calcification within the area of destroyed bone, the production of new bone with dense sclerosis, raised the possibility of an osteoblastoma, despite the advanced age of the patient. Without the histological material, the type of osteoblastoma (aggressive) could not be diagnosed. (orig./SHA).

  11. Case report 351: Aggressive osteoblastoma of the third lumbar vertebra

    International Nuclear Information System (INIS)

    Abdelwahab, I.F.; Frankel, V.H.; Klein, M.J.

    1986-01-01

    In summary, a case is presented of an aggressive osteoblastoma affecting the third lumbar vertebra in a 65-year-old man. Because of the age of the patient, the aggressive, destructive nature of the tumor and the extensive involvement of the vertebral body, metastatic carcinoma as well as several primary malignancies were entertained in the differential diagnosis (e.g. plasmacytoma, chordoma, primary lymphoma of bone). However, the destructive, expanding nature of the lesion, the focal calcification within the area of destroyed bone, the production of new bone with dense sclerosis, raised the possibility of an osteoblastoma, despite the advanced age of the patient. Without the histological material, the type of osteoblastoma (aggressive) could not be diagnosed. (orig./SHA)

  12. Cranial nerve palsies in childhood parameningeal rhabdomyosarcoma.

    Science.gov (United States)

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

    2012-12-15

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

  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. Endocrinologic complications of cranial irradiation

    International Nuclear Information System (INIS)

    Brauner, R.; Rappaport, R.

    1990-01-01

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

  15. Endocrinologic complications of cranial irradiation

    International Nuclear Information System (INIS)

    Brauner, R.; Rappaport, R.

    1989-01-01

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

  16. 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.

  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...... it can yield similar correction while preserving more lumbar mobility and growth potential....

  18. Aberrant regeneration of the third cranial nerve.

    Science.gov (United States)

    Shrestha, U D; Adhikari, S

    2012-01-01

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

  19. 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.

  20. Cranial nerve palsies in Nigerian children

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2014-01-08

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

  1. Cranial MR finding of reversible eclampsia

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-05-15

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

  2. Cranial nerve involvement in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  3. CT measurments of cranial growth: normal subjects

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  4. Normal computed tomographic anatomy of the cisterns and cranial nerves

    International Nuclear Information System (INIS)

    Manelfe, C.; Bonafe, A.

    1980-01-01

    This study, based on the normal CT anatomy of the cisterns investigated with Metrizamide, aims at attempting to find out with accuracy which plane of section is the most suitable for the investigation of each group of cisterns (posterior fossa, mesencephalon, suprasellar). Moreover we felt it necessary to include our study the normal appearance of the cranial nerves as their normal CT anatymy - optic nerves expected - is not well known yet. (orig./AJ) [de

  5. Ophthalmople gic cranial neuropathy: clinical case

    OpenAIRE

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

    2018-01-01

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

  6. Application of Thinned-Skull Cranial Window to Mouse Cerebral Blood Flow Imaging Using Optical Microangiography

    Science.gov (United States)

    Wang, Ruikang K.

    2014-01-01

    In vivo imaging of mouse brain vasculature typically requires applying skull window opening techniques: open-skull cranial window or thinned-skull cranial window. We report non-invasive 3D in vivo cerebral blood flow imaging of C57/BL mouse by the use of ultra-high sensitive optical microangiography (UHS-OMAG) and Doppler optical microangiography (DOMAG) techniques to evaluate two cranial window types based on their procedures and ability to visualize surface pial vessel dynamics. Application of the thinned-skull technique is found to be effective in achieving high quality images for pial vessels for short-term imaging, and has advantages over the open-skull technique in available imaging area, surgical efficiency, and cerebral environment preservation. In summary, thinned-skull cranial window serves as a promising tool in studying hemodynamics in pial microvasculature using OMAG or other OCT blood flow imaging modalities. PMID:25426632

  7. 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.

  8. Identification and classification of spine vertebrae by automated methods

    Science.gov (United States)

    Long, L. Rodney; Thoma, George R.

    2001-07-01

    We are currently working toward developing computer-assisted methods for the indexing of a collection of 17,000 digitized x-ray images by biomedical content. These images were collected as part of a nationwide health survey and form a research resource for osteoarthitis and bone morphometry. This task requires the development of algorithms to robustly analyze the x-ray contents for key landmarks, to segment the vertebral bodies, to accurately measure geometric features of the individual vertebrae and inter-vertebral areas, and to classify the spine anatomy into normal or abnormal classes for conditions of interest, including anterior osteophytes and disc space narrowing. Subtasks of this work have been created and divided among collaborators. In this paper, we provide a technical description of the overall task, report on progress made by collaborators, and provide the most recent results of our own research into obtaining first-order location of the spine region of interest by automated methods. We are currently concentrating on images of the cervical spine, but will expand the work to include the lumbar spine as well. Development of successful image processing techniques for computer-assisted indexing of medical image collections is expected to have a significant impact within the medical research and patient care systems.

  9. Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain.

    Science.gov (United States)

    Brault, J S; Smith, J; Currier, B L

    2001-01-15

    Case report of surgically treated mechanical low back pain from the facet joint contralateral to a unilateral anomalous lumbosacral articulation (Bertolotti's syndrome). To describe the clinical presentation, diagnostic evaluation, and management of facet-related low back pain in a 17-year-old cheerleader and its successful surgical treatment with resection of a contralateral anomalous articulation. Lumbosacral transitional vertebrae are common in the general population. Bertolotti's syndrome is mechanical low back pain associated with these transitional segments. Little is known about the pathophysiology and mechanics of these vertebral segments and their propensity to be pain generators. Treatment of this syndrome is controversial, and surgical intervention has been infrequently reported. A retrospective chart analysis and radiographic review were performed. Repeated fluoroscopically guided injections implicated a symptomatic L6-S1 facet joint contralateral to an anomalous lumbosacral articulation. Eventually, a successful surgical outcome was achieved with resection of the anomalous articulation. Clinicians should consider the possibility that mechanical low back pain may occur from a facet contralateral to a unilateral anomalous lumbosacral articulation, even in a young patient. Although reports of surgical treatment of Bertolotti's syndrome are infrequent, resection of the anomalous articulation provided excellent results in this patient, presumably because of reduced stresses on the symptomatic facet.

  10. 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

  11. Moderate climate signature in cranial anatomy of late holocene human populations from Southern South America.

    Science.gov (United States)

    Paula Menéndez, Lumila

    2018-02-01

    The aim of this study is to analyze the association between cranial variation and climate in order to discuss their role during the diversification of southern South American populations. Therefore, the specific objectives are: (1) to explore the spatial pattern of cranial variation with regard to the climatic diversity of the region, and (2) to evaluate the differential impact that the climatic factors may have had on the shape and size of the diverse cranial structures studied. The variation in shape and size of 361 crania was studied, registering 62 3D landmarks that capture shape and size variation in the face, cranial vault, and base. Mean, minimum, and maximum annual temperature, as well as mean annual precipitation, but also diet and altitude, were matched for each population sample. A PCA, as well as spatial statistical techniques, including kriging, regression, and multimodel inference were employed. The facial skeleton size presents a latitudinal pattern which is partially associated with temperature diversity. Both diet and altitude are the variables that mainly explain the skull shape variation, although mean annual temperature also plays a role. The association between climate factors and cranial variation is low to moderate, mean annual temperature explains almost 40% of the entire skull, facial skeleton and cranial vault shape variation, while annual precipitation and minimum annual temperature only contribute to the morphological variation when considered together with maximum annual temperature. The cranial base is the structure less associated with climate diversity. These results suggest that climate factors may have had a partial impact on the facial and vault shape, and therefore contributed moderately to the diversification of southern South American populations, while diet and altitude might have had a stronger impact. Therefore, cranial variation at the southern cone has been shaped both by random and nonrandom factors. Particularly, the

  12. Robotic Stereotaxy in Cranial Neurosurgery: A Qualitative Systematic Review.

    Science.gov (United States)

    Fomenko, Anton; Serletis, Demitre

    2017-12-14

    Modern-day stereotactic techniques have evolved to tackle the neurosurgical challenge of accurately and reproducibly accessing specific brain targets. Neurosurgical advances have been made in synergy with sophisticated technological developments and engineering innovations such as automated robotic platforms. Robotic systems offer a unique combination of dexterity, durability, indefatigability, and precision. To perform a systematic review of robotic integration for cranial stereotactic guidance in neurosurgery. Specifically, we comprehensively analyze the strengths and weaknesses of a spectrum of robotic technologies, past and present, including details pertaining to each system's kinematic specifications and targeting accuracy profiles. Eligible articles on human clinical applications of cranial robotic-guided stereotactic systems between 1985 and 2017 were extracted from several electronic databases, with a focus on stereotactic biopsy procedures, stereoelectroencephalography, and deep brain stimulation electrode insertion. Cranial robotic stereotactic systems feature serial or parallel architectures with 4 to 7 degrees of freedom, and frame-based or frameless registration. Indications for robotic assistance are diversifying, and include stereotactic biopsy, deep brain stimulation and stereoelectroencephalography electrode placement, ventriculostomy, and ablation procedures. Complication rates are low, and mainly consist of hemorrhage. Newer systems benefit from increasing targeting accuracy, intraoperative imaging ability, improved safety profiles, and reduced operating times. We highlight emerging future directions pertaining to the integration of robotic technologies into future neurosurgical procedures. Notably, a trend toward miniaturization, cost-effectiveness, frameless registration, and increasing safety and accuracy characterize successful stereotactic robotic technologies. Copyright © 2017 by the Congress of Neurological Surgeons

  13. 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.

  14. Estimating cranial musculoskeletal constraints in theropod dinosaurs.

    Science.gov (United States)

    Lautenschlager, Stephan

    2015-11-01

    Many inferences on the biology, behaviour and ecology of extinct vertebrates are based on the reconstruction of the musculature and rely considerably on its accuracy. Although the advent of digital reconstruction techniques has facilitated the creation and testing of musculoskeletal hypotheses in recent years, muscle strain capabilities have rarely been considered. Here, a digital modelling approach using the freely available visualization and animation software Blender is applied to estimate cranial muscle length changes and optimal and maximal possible gape in different theropod dinosaurs. Models of living archosaur taxa (Alligator mississippiensis, Buteo buteo) were used in an extant phylogenetically bracketed framework to validate the method. Results of this study demonstrate that Tyrannosaurus rex, Allosaurus fragilis and Erlikosaurus andrewsi show distinct differences in the recruitment of the jaw adductor musculature and resulting gape, confirming previous dietary and ecological assumptions. While the carnivorous taxa T. rex and Allo. fragilis were capable of a wide gape and sustained muscle force, the herbivorous therizinosaurian E. andrewsi was constrained to small gape angles.

  15. 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.

  16. 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.

  17. Observation on the role of osteoporotic vertebra augmented with calcium sulfate cement in vivo

    International Nuclear Information System (INIS)

    Zhu Xuesong; Shi Qin; Zhang Zhiming; Geng Dechun; Mao Haiqing; Chen Chunmao; Wang Genlin; Yang Huilin

    2010-01-01

    Objective: To observe the biomechanical and histological performance of calcium sulfate cement (CSC) in osteoporotic vertebral bodies. Methods: Bone voids were created in L 2 ∼ L 5 vertebras of twelve female osteoporotic mature sheep. CSC and polymethylmethacrylate (PMMA) were injected into one bone voids randomly, L 1 and L 6 vertebrae served as the normal control. Six sheep were sacrificed at the 2nd week and the 24th week after operation respectively. Overall observation,biomechanical test and undecalcified bone histology analyses were performed. Results: Biomechanical analysis showed that the vertebrae could be augmented by CSC and PMMA. The biomechanical properties of the vertebrae augmented with CSC were weakened more than that in the PMMA and normal group at the 2nd week, increased significantly at the 24th week. Histological observation showed that CSC was mostly absorbed at the 24th week, mature bone trabecula was seen in the defect area. Conclusion: The osteoporotic vertebrae can be augmented instantly by CSC. As time goes on, CSC can promote bone remodeling, and enhance the vertebrae. It is an alternation for vertebroplasty and kyphoplasty. (authors)

  18. 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.

  19. 弥散张量成像的脑神经示踪重建及临床应用研究%Three-dimensional reconstruction of cranial nerves and clinical exploration based on diffusion tensor tractography

    Institute of Scientific and Technical Information of China (English)

    马峻; 苏少波; 赵岩; 李勇刚; 岳树源

    2014-01-01

    目的 探讨应用弥散张量成像进行脑神经(CNs)纤维束示踪、可视化重建的可行性,并尝试将其应用于颅底肿瘤术前规划.方法 利用3.0T磁共振对10例健康志愿者,10例颅底肿瘤患者进行稳态采集快速成像、弥散张量成像扫描,3D Slicer软件完成脑神经纤维示踪、重建,病变患者重建肿瘤三维影像,通过手术观察及神经电生理监测确认脑神经的位置.结果 CNⅡ、Ⅲ、Ⅴ、Ⅵ、Ⅶ~Ⅷ、Ⅹ、Ⅻ成像良好,肿瘤、水肿与相关脑神经的三维空间关系通过纤维示踪与三维重建得以呈现,经过手术验证准确无误.结论联合应用弥散张量成像及3D Slicer软件是正常及病理状态下脑神经可视化重建切实可行的方案,具有良好的临床应用前景.%Objective To investigate the feasibility of 3-dimensional reconstruction of cranial nerves (CNs) via diffusion imaging tractography,and attempt to apply in the preoperative plan of skull base tumor.Methods 3-Tesla magnetic resonance imaging scans,including 3D-FSPGR,FIESTA and DTI,were used to collect information of 10 healthy subjects and 10 skull base tumor patients.DTI data were integrated into the 3D-Slicer for fiber tracking,overlapped anatomic images to determine course of nerves.3D reconstructions of tumors were achieved to perform neighbor,encasing,invading relationship between lesion and nerves whose location was then recorded during surgery by surgical observation and neurophysiological monitoring.Results Detailed fibers of the cranialnerves were depicted.Optic pathway showed perfect 3D streamline body,especially the posterior of optic chiasm.Oculomotor nerve coursed from the brainstem to the cavernous sinus distally,which also had high fidelity.Trigeminal nerve allowed visualization of gasserian ganglion as cisternal segment.Cisternal parts of abducent nerve,facial/ vestibulocochlear nerve,vagus nerve,hypoglossal nerve were also imaged well.Moreover,the 3D

  20. 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.

  1. Isovaleric acidaemia: cranial CT and MRI findings

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  2. 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.)

  3. 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.

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  5. Evaluation of bone mineral density measurement of lumbar vertebrae by volumetric quantitative CT in postmenopausal women

    International Nuclear Information System (INIS)

    Cai Yuezeng; Wang Liying; Lan Jing; Li Jingxue; Wu Shengyong

    2009-01-01

    Objective: To demonstrate the validity of volumetric QCT and dual energy X-ray absorptiometry(DXA) in bone mineral density (BMD) measurement and compare the difference in discriminating osteoporotic postmenopausal women with and without vertebral fracture. Methods: One hundred and eighteen postmenopausal women [mean age (62.1±7.0) years] who received thoracolumbar radiographic examination were enrolled and divided into four groups (normal, osteopenia, osteoporotic and osteoporotic fractured group) also based on their BMD value of lumbar vertebra(AP-SPINE) measured by DXA: >(x-bar)-1s, (x-bar)-1s-(x-bar)-2s, 3 . Apparent bone volume to total volume ratio (App BV/TV% ) was calculated on the base of trabecular bone whose CT values were among 60 HU, 80 HU, 100 HU, 120- 400 HU, respectively. Analysis of covariance (ANCOVA) and calculation of coefficient of determination (R 2 ) were performed for each parameter among the 4 groups. Results: The values of 2D-TRAB, 3D-INT, 3D-TRAB, App 60 BV/TV%, App 80 BV/TV%, App 100 BV/TV% and App 120 BV/TV% in osteoporotic fractured group [(48.8 ± 24.9) mg/cm 3 , (94.4 ± 20.2) mg/cm 3 , (59.3 ± 28.0) mg/cm 3 , (56.1 ± 22.8)%, (43.2 ± 22.2)%, (31.3 ± 19.4)%, (21.3 ± 15.6)%] were significantly lower than those in osteoporotic group [(74.9 ± 21.0) mg/cm 3 , (115.0 ± 14.3) mg/cm 3 , (82.0 ± 23.7) mg//cm 3 , (75.2 ± 16.8)%, (62.6 ± 20.5)%, (48.8 ± 21.7)%, (35.5 ± 20.1)%], osteopenia group [(89.2 ± 23.8) mg/cm 3 , (126.9 ± 12.9)mg/cm 3 , (97.8 ± 25.2) mg/cm 3 , (85.1 ± 13.7)%, (75.1 ± 17.9)%, (62.8 ± 20.9)%, (49.2 ± 21.9)%], and normal group [(120.6 ± 19.4) mg/cm 3 , (154.0 ± 16.3) mg/cm 3 , (131.1 ± 21.1)mg/cm 3 , (95.6 ± 5.3)%, (91.4 ± 8.7)%, (84.7 ± 12.4)% (75.2 ± 15.5)%], P 2 ] and osteoporotic groups [(0.85 ± 0.06) g//cm 2 , P>0.05]. In osteoporotic groups, AP-SPINE was not correlated significantly with other variables except 3D-CORT (R 2 =0.189, P 60,80,100,120 BV/TV% were correlated significantly with 3D

  6. Multimodal Navigation in Endoscopic Transsphenoidal Resection of Pituitary Tumors Using Image-Based Vascular and Cranial Nerve Segmentation: A Prospective Validation Study.

    Science.gov (United States)

    Dolati, Parviz; Eichberg, Daniel; Golby, Alexandra; Zamani, Amir; Laws, Edward

    2016-11-01

    Transsphenoidal surgery (TSS) is the most common approach for the treatment of pituitary tumors. However, misdirection, vascular damage, intraoperative cerebrospinal fluid leakage, and optic nerve injuries are all well-known complications, and the risk of adverse events is more likely in less-experienced hands. This prospective study was conducted to validate the accuracy of image-based segmentation coupled with neuronavigation in localizing neurovascular structures during TSS. Twenty-five patients with a pituitary tumor underwent preoperative 3-T magnetic resonance imaging (MRI), and MRI images loaded into the navigation platform were used for segmentation and preoperative planning. After patient registration and subsequent surgical exposure, each segmented neural or vascular element was validated by manual placement of the navigation probe or Doppler probe on or as close as possible to the target. Preoperative segmentation of the internal carotid artery and cavernous sinus matched with the intraoperative endoscopic and micro-Doppler findings in all cases. Excellent correspondence between image-based segmentation and the endoscopic view was also evident at the surface of the tumor and at the tumor-normal gland interfaces. Image guidance assisted the surgeons in localizing the optic nerve and chiasm in 64% of cases. The mean accuracy of the measurements was 1.20 ± 0.21 mm. Image-based preoperative vascular and neural element segmentation, especially with 3-dimensional reconstruction, is highly informative preoperatively and potentially could assist less-experienced neurosurgeons in preventing vascular and neural injury during TSS. In addition, the accuracy found in this study is comparable to previously reported neuronavigation measurements. This preliminary study is encouraging for future prospective intraoperative validation with larger numbers of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 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.

  8. Multimodal Navigation in Endoscopic Transsphenoidal Resection of Pituitary Tumors using Image-based Vascular and Cranial Nerve Segmentation: A Prospective Validation Study

    Science.gov (United States)

    Dolati, Parviz; Eichberg, Daniel; Golby, Alexandra; Zamani, Amir; Laws, Edward

    2016-01-01

    Introduction Transsphenoidal surgery (TSS) is a well-known approach for the treatment of pituitary tumors. However, lateral misdirection and vascular damage, intraoperative CSF leakage, and optic nerve and vascular injuries are all well-known complications, and the risk of adverse events is more likely in less experienced hands. This prospective study was conducted to validate the accuracy of image-based segmentation in localization of neurovascular structures during TSS. Methods Twenty-five patients with pituitary tumors underwent preoperative 3TMRI, which included thin-sectioned 3D space T2, 3D Time of Flight and MPRAGE sequences. Images were reviewed by an expert independent neuroradiologist. Imaging sequences were loaded in BrainLab iPlanNet (16/25 cases) or Stryker (9/25 cases) image guidance platforms for segmentation and pre-operative planning. After patient registration into the neuronavigation system and subsequent surgical exposure, each segmented neural or vascular element was validated by manual placement of the navigation probe on or as close as possible to the target. The audible pulsations of the bilateral ICA were confirmed using a micro-Doppler probe. Results Pre-operative segmentation of the ICA and cavernous sinus matched with the intra-operative endoscopic and micro-Doppler findings in all cases (Dice Similarity Coefficient =1). This information reassured the surgeons with regard to the lateral extent of bone removal at the sellar floor and the limits of lateral exploration. Excellent correspondence between image-based segmentation and the endoscopic view was also evident at the surface of the tumor and at the tumor-normal gland interfaces. This assisted in preventing unnecessary removal of the normal pituitary gland. Image-guidance assisted the surgeons in localizing the optic nerve and chiasm in 64% of the cases and the diaphragma sella in 52% of cases, which helped to determine the limits of upward exploration and to decrease the risk of CSF

  9. [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.

  10. 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...

  11. Correction of severe post-traumatic kyphosis by posterior vertebra column resection.

    Science.gov (United States)

    Zhang, Xue-song; Zhang, Yong-gang; Wang, Zheng; Chen, Chao; Wang, Yan

    2010-03-20

    Post-traumatic kyphosis is a common potential complication of spinal trauma and correct management of this problem is becoming ever more important. Although posterior vertebra column resection has been increasingly adopted to correct severe spinal deformity, no series of reports were found on severe post-traumatic kyphosis in the thoracolumbar region. Therefore, the present cohort retrospective study is presented to evaluate the clinical and radiographic results of posterior vertebra column resection with instrument fusion performed in patients with severe post-traumatic kyphosis. From May 2004 to May 2006, 53 patients (38 male, 15 female) at an average age of 37.6 years (range, 24 to 66 years), were surgically treated for symptomatic post-traumatic thoracolumbar kyphosis with a posterior wedge closing osteotomy at our hospital. Among them, 5 consecutive adult patients with severe post-traumatic kyphosis were included in this study. Operation time, blood loss and complications were noted in each case. Radiographic documentation was made on the basis of standing anterior-posterior (AP) and lateral views and three dimensional reconstruction images of computed tomography (CT) scans were used to further identify the apex region of a sharp angular deformity. Sagittal correction was assessed in terms of effective regional deformity (ERD) for the injury level. Assessment of radiological fusion at follow-up was based on the presence of trabecular bone bridging at the osteotomy site according to Brantigan. Preoperative and postoperative clinical assessments were performed by using Oswestry disability index (ODI), back pain was rated in all patients by the visual analog scale (VAS) preoperatively, postoperatively and at the latest follow-up. The mean operating time was 265 minutes (220 - 408 minutes), with an average blood loss of 1362 ml (870 - 2570 ml). Each patient finished at least two years of follow-up. The average ERD significantly decreased from 69 degrees (58

  12. Multiple cranial nerve dysfunction caused by neurosarcoidosis

    NARCIS (Netherlands)

    Loor, Rivkah G. J.; van Tongeren, Joost; Derks, Wynia

    2012-01-01

    Neurosarcoidosis is a rare identity and occurs in only 5% to 15% of patients with sarcoidosis. It can manifest in many different ways, and therefore, diagnosis may be complicated. We report a case presented in a very unusual manner with involvement of 3 cranial nerves; anosmia (NI), facial palsy

  13. 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...

  14. Cranial shape transformation in the evolution of the giant panda ( Ailuropoda melanoleuca)

    Science.gov (United States)

    Figueirido, Borja; Palmqvist, Paul; Pérez-Claros, Juan A.; Dong, Wei

    2011-02-01

    In this study, landmark-based methods of geometric morphometrics are used for investigating the main aspects of cranial shape transformation in the evolution of the giant panda, Ailuropoda melanoleuca. Specifically, we explore if the highly derived cranial adaptations for bamboo feeding of the living panda were developed early in the panda's lineage. Results obtained show that the overall cranial morphologies of the oldest known panda, the "pygmy" Ailuropoda microta, and the late Pleistocene Ailuropoda baconi are both very similar to that of their closest living relative, A. melanoleuca, which agrees with a previous proposal based on qualitative criteria. However, we also describe several differences between the crania of A. microta, A. baconi, and A. melanoleuca, including the development of the postorbital process, the orientation of the occipital region, and the expansion of the braincase. As a result, the cranial morphology of A. microta shows a less specialized morphology toward a fibrous and durophagous diet compared to the giant panda. These results are confirmed by a comparative analysis of the dimensions of the upper teeth in bears, which has revealed differences in relative tooth size between A. microta and A. melanoleuca, most probably as a result of mosaic evolution. Therefore, we conclude that cranial shape did not remain essentially uniform in the Ailuropoda lineage, as previously thought, but underwent a number of changes during more than 2 Myr.

  15. Normal cranial bone marrow MR imaging pattern with age-related ADC value distribution

    International Nuclear Information System (INIS)

    Li Qi; Pan Shinong; Yin Yuming; Li Wei; Chen Zhian; Liu Yunhui; Wu Zhenhua; Guo Qiyong

    2011-01-01

    Objective: To determine MRI appearances of normal age-related cranial bone marrow and the relationship between MRI patterns and apparent diffusion coefficient (ADC) values. Methods: Five hundred subjects were divided into seven groups based on ages. Cranial bone marrow MRI patterns were performed based on different thickness of the diploe and signal intensity distribution characteristics. ADC values of the frontal, parietal, occipital and temporal bones on DWI were measured and calculated. Correlations between ages and ADC values, between patterns and ADC values, as well as the distribution of ADC values were analyzed. Results: Normal cranial bone marrow was divided into four types and six subtypes, Type I, II, III and IV, which had positive correlation with age increasing (χ 2 = 266.36, P 0.05). In addition, there was significant negative correlation between the ADC values and MRI patterns in the normal parietal and occipital bones (r = -0.691 and -0.750, P < 0.01). Conclusion: The combination of MRI features and ADC values changes in different cranial bones showed significant correlation with age increasing. Familiar with the MRI appearance of the normal bone marrow conversion pattern in different age group and their ADC value will aid the diagnosis and differential of the cranial bone pathology.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Julien Benoit

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

  18. Localized zinc distribution in shark vertebrae suggests differential deposition during ontogeny and across vertebral structures.

    Science.gov (United States)

    Raoult, Vincent; Howell, Nicholas; Zahra, David; Peddemors, Victor M; Howard, Daryl L; de Jonge, Martin D; Buchan, Benjamin L; Williamson, Jane E

    2018-01-01

    The development of shark vertebrae and the possible drivers of inter- and intra-specific differences in vertebral structure are poorly understood. Shark vertebrae are used to examine life-history traits related to trophic ecology, movement patterns, and the management of fisheries; a better understanding of their development would be beneficial to many fields of research that rely on these calcified structures. This study used Scanning X-ray Fluorescence Microscopy to observe zinc distribution within vertebrae of ten shark species from five different orders. Zinc was mostly localised within the intermedialis and was generally detected at levels an order of magnitude lower in the corpus calcareum. In most species, zinc concentrations were higher pre-birth mark, indicating a high rate of pre-natal zinc deposition. These results suggest there are inter-specific differences in elemental deposition within vertebrae. Since the deposition of zinc is physiologically-driven, these differences suggest that the processes of growth and deposition are potentially different in the intermedialis and corpus calcareum, and that caution should be taken when extrapolating information such as annual growth bands from one structure to the other. Together these results suggest that the high inter-specific variation in vertebral zinc deposition and associated physiologies may explain the varying effectiveness of ageing methodologies applied to elasmobranch vertebrae.

  19. A case of marked short-neck with fusion of cervical vertebrae in a Holstein cow

    International Nuclear Information System (INIS)

    Ogawa, J.; Ando, T.; Otsuka, H.; Paku, T.; Yoshioka, I.; Saruyama, Y.; Yamada, H.; Iso, H.; Oyamada, T.; Watanabe, D.

    2007-01-01

    An 11-month old Holstein cow with congenitally shortened neck was subjected to clinical, radiographic and myelographic examination, and also autopsy and histopathological examination. Skeletal preparations of the cervical region were made to investigate the abnormality of the vertebrae. The cow was growing normally, and no critical neurological signs were observed. Radiographic examination showed marked kyphosis of the cervical spine, and fusion of posterior cervical vertebrae was suspected. Myelographic examination showed curvature of the spinal cord, but no narrowing at any part. Atrophy, hyaline degeneration, and hydropic degeneration of muscle fibers were seen in the dorsal part of the cervical region in the histopathological examination, but there was no abnormality in the cervical spinal cord. Deformation, fusion, and hypoplasia of the cervical vertebrae and posterior thoracic vertebrae were observed. It is suggested that in the organ system-wise classification of congenital abnormalities, this may be classified as a case of defective vertebrae with the coexisting congenital anomalies of kyphosis, scoliosis and vertebral fusion. The cause of this defect was not clear, but the observed vertebral fusion and hypoplasia indicated defective development of the vertebral segment during the early fetal stage

  20. Localized zinc distribution in shark vertebrae suggests differential deposition during ontogeny and across vertebral structures.

    Directory of Open Access Journals (Sweden)

    Vincent Raoult

    Full Text Available The development of shark vertebrae and the possible drivers of inter- and intra-specific differences in vertebral structure are poorly understood. Shark vertebrae are used to examine life-history traits related to trophic ecology, movement patterns, and the management of fisheries; a better understanding of their development would be beneficial to many fields of research that rely on these calcified structures. This study used Scanning X-ray Fluorescence Microscopy to observe zinc distribution within vertebrae of ten shark species from five different orders. Zinc was mostly localised within the intermedialis and was generally detected at levels an order of magnitude lower in the corpus calcareum. In most species, zinc concentrations were higher pre-birth mark, indicating a high rate of pre-natal zinc deposition. These results suggest there are inter-specific differences in elemental deposition within vertebrae. Since the deposition of zinc is physiologically-driven, these differences suggest that the processes of growth and deposition are potentially different in the intermedialis and corpus calcareum, and that caution should be taken when extrapolating information such as annual growth bands from one structure to the other. Together these results suggest that the high inter-specific variation in vertebral zinc deposition and associated physiologies may explain the varying effectiveness of ageing methodologies applied to elasmobranch vertebrae.

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

    Directory of Open Access Journals (Sweden)

    Gedik Sonay

    2017-01-01

    Full Text Available 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. Radiologic-anatomic correlation of thoracic vertebrae and rib shadows in chest digital radiograph

    International Nuclear Information System (INIS)

    Yamaguchi, Isao; Itoh, Harumi

    2007-01-01

    The purpose of this study was to provide an introduction to parsing the radiologic appearance of thoracic vertebrae and ribs. In the study, the radiologic-anatomic correlation technique was applied to promote further understanding of normal chest radiographs. The thoracic vertebrae and ribs of chest radiographs were compared with each macroscopic radiologic and computed tomography (CT) image. The rib parsed the linear shadow of the body of the rib. The macroscopic and radiologic images of thoracic vertebrae and ribs were evaluated to explain their normal radiologic findings. The results of such correlation were summarized as follows: The lamina of the vertebral arch was visualized due to anterior rotation of the upper thoracic vertebrae. The density ratio of the thoracic-vertebrae shadow was almost the same in the vertebral body and vertebral arch. The linear shadow superimposed on the rib corresponded to the inferior margin of the rib. The radiologic-anatomic correlation technique was useful to evaluate normal radiologic findings, and the study was useful to radiological technologists. (author)

  3. Automatic Detection of Wild-type Mouse Cranial Sutures

    DEFF Research Database (Denmark)

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

    , 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......, the observer traced the sutures on each of the mouse volumes as well. The observer outperforms the automatic approach by approximately 0.1 mm. All mice have similar errors while the suture error plots reveal that suture 1 and 2 are cumbersome, both for the observer and the automatic approach. These sutures can...

  4. 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.

  5. 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.

  6. Comparison of middle phalanx of the middle finger and cervical vertebrae as skeletal maturity indicators

    Directory of Open Access Journals (Sweden)

    Pavitra Tripura Javangula

    2017-01-01

    Full Text Available Objectives: To investigate the relationship between chronological age and the stages of maturation of cervical vertebrae maturation index (CVMI and the middle phalanx of the middle finger (MP3 and to determine the correlation between CVMI and MP3. Materials and Methods: A cross-sectional study included 100 children (boys - 50, girls - 50 aged 8–14 years based on nonprobability quota sampling. The study included digital radiographs of the MP3 of the right hand and conventional lateral cephalograms. Chronological age was assessed by the date of birth, MP3 maturation by Rajagopal and Kansal's criteria, and CVMI development by Hassel and Farman's method. Statistical Analysis: Spearman's rank-order correlation coefficient was applied to measure the association between stages of MP3 and CVMI. Results: Progressive stages of MP3 and CVMI were seen as chronological age advanced. Girls showed an advanced trend than boys in both MP3 and CVMI stages. MP3 and CVMI stages showed a strong positive correlation (r + 0.836, P < 0.01. Conclusions: MP3 and CVMI both are equally good indicators of skeletal maturity. Assessment of skeletal maturity on lateral cephalogram (CVMI is advantageous as it avoids the need for an additional radiograph.

  7. A comparison between cervical vertebrae and modified MP3 stages for the assessment of skeletal maturity.

    Science.gov (United States)

    Prasad, Mandava; Ganji, Venkata Suresh Kumar; George, Suja Ani; Talapaneni, Ashok Kumar; Shetty, Sharath Kumar

    2013-01-01

    Evaluation of skeletal maturity in human individuals is an important aspect in orthodontics and dentofacial orthopedics because, growth guidance and fundamental structural changes are essential for treatment of skeletal discrepancies in all the three planes. Among various growth assessment methods, cervical vertebra maturation stages and hand wrist have been correlated with the individual growth changes during puberty. The purpose of this study is to determine correlation of the CVM index with the modified median phalanx index (MP3) as described by Rajagopal and Kansal. 200 subjects (100 males and 100 females) of Nellore, Indian origin boys aged between 10 to 19 years and girls of 8 to 16 years were selected for the study. The subjects are selected randomly from patients visiting the Departments of Orthodontics and Dentofacial Orthopedics, Pediatric dentistry and Oral medicine and Radiology at Narayana Dental College and Hospital. Nellore. Radiographs of left hand MP3 and lateral cephalogram were taken. Cohen's kappa statistic was used to assess the agreement between the two measurements based on categorical variables. There was a good concordance between 6 stages of CVMI (Hassel and Farman) and the 6 stages of MP3 (Rajagopal and Kansal). Physiological maturity was earlier in females than in males when compared to the individuals of opposite sex of same chronological age. Chronological age was not a valid predictor of assessing the skeletal maturity because of significant variations in the distribution of CVMI and MP3 stages with respect to individual chronological age distribution.

  8. The skeletal maturation status estimated by statistical shape analysis: axial images of Japanese cervical vertebra.

    Science.gov (United States)

    Shin, S M; Kim, Y-I; Choi, Y-S; Yamaguchi, T; Maki, K; Cho, B-H; Park, S-B

    2015-01-01

    To evaluate axial cervical vertebral (ACV) shape quantitatively and to build a prediction model for skeletal maturation level using statistical shape analysis for Japanese individuals. The sample included 24 female and 19 male patients with hand-wrist radiographs and CBCT images. Through generalized Procrustes analysis and principal components (PCs) analysis, the meaningful PCs were extracted from each ACV shape and analysed for the estimation regression model. Each ACV shape had meaningful PCs, except for the second axial cervical vertebra. Based on these models, the smallest prediction intervals (PIs) were from the combination of the shape space PCs, age and gender. Overall, the PIs of the male group were smaller than those of the female group. There was no significant correlation between centroid size as a size factor and skeletal maturation level. Our findings suggest that the ACV maturation method, which was applied by statistical shape analysis, could confirm information about skeletal maturation in Japanese individuals as an available quantifier of skeletal maturation and could be as useful a quantitative method as the skeletal maturation index.

  9. 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

  10. As solid as a rock-comparison of CE- and MPS-based analyses of the petrosal bone as a source of DNA for forensic identification of challenging cranial bones.

    Science.gov (United States)

    Kulstein, Galina; Hadrys, Thorsten; Wiegand, Peter

    2018-01-01

    Short tandem repeat (STR) typing from skeletal remains can be a difficult task. Dependent on the environmental conditions of the provenance of the bones, DNA can be degraded and STR typing inhibited. Generally, dense and compact bones are known to preserve DNA better. Several studies already proved that femora and teeth have high DNA typing success rates. Unfortunately, these elements are not present in all cases involving skeletal remains. Processing partial or singular skeletal elements, it is favorable to select bone areas where DNA preservation is comparably higher. Especially, cranial bones are often accidentally discovered during criminal investigations. The cranial bone is composed of multiple parts. In this examination, we evaluated the potential of the petrous bone for human identification of skeletal remains in forensic case work. Material from different sections of eight unknown cranial bones and-where available-additionally other skeletal elements, collected at the DNA department of the Institute of Legal Medicine in Ulm, Germany, from 2010 to 2017, were processed with an optimized DNA extraction and STR typing strategy. The results highlight that STR typing from the petrous bones leads to reportable profiles in all individuals, even in cases where the analysis of the parietal bone failed. Moreover, the comparison of capillary electrophorese (CE) typing to massively parallel sequencing (MPS) analysis shows that MPS has the potential to analyze degraded human remains and is even capable to provide additional information about phenotype and ancestry of unknown individuals.

  11. Effect analysis of percutaneous osteoplasty for the treatment of malignant osteolytic lesions outside the vertebrae

    International Nuclear Information System (INIS)

    Zhou Bing; Wu Chungen; Cheng Yongde; Li Minghua; Gu Yifeng; Wang Jue; Zhang Peilei

    2009-01-01

    Objective: To assess the clinical efficacy and safety of percutaneous osteoplasty (POP) in treating malignant osteolytic lesions outside the vertebrae. Methods: From Jan. 2005 to Dec. 2008, POP was performed in 11 patients with malignant osteolytic lesions outside the vertebrae. Biopsy was carried out before POP when the lesion's pathology was undefined. A follow-up was made for at least 6 months. Brief Pain Inventory (BPI) was used to evaluate the clinical efficacy, and a statistic analysis was made with the help of software SAS 6.12. Results: POPS were successfully performed in all 11 patients, with the technical successful rate of 100%. Cement leakage was found in 3 patients, but did not cause serious complications. Obvious pain relief was revealed clinically with a significant difference in BPI before and after POP (P 0.05). Conclusion: POP is an effective and safe technique in treating malignant osteolytic lesions outside the vertebrae. (authors)

  12. Lumbosacral transitional vertebra causing Bertolotti’s syndrome: a case report and review of the literature

    Science.gov (United States)

    Koutras, Georgios; Natsis, Konstantinos

    2009-01-01

    Introduction Lumbosacral transitional vertebra is an anatomical variation of the fifth lumbar vertebra in which an enlarged transverse process can form a joint or fusion with the sacrum or ilium. The association of that variant with low back pain and the change in the biomechanical properties of the lumbar spine is called Bertolotti’s syndrome. Case presentation We report a case of a 40-year-old male patient with chronic low back pain extending to the left buttock, just above the ipsilateral sacroiliac joint. Radiographic investigation revealed an anomalous enlargement of the left transverse process of the fifth lumbar vertebra forming a pseudarthrosis with the infrajacent ala of the sacrum. Conclusion In young patients with back pain the possibility of Bertolotti’s syndrome should always be taken in account. PMID:19830065

  13. Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature.

    Science.gov (United States)

    Paraskevas, Georgios; Tzaveas, Alexandros; Koutras, Georgios; Natsis, Konstantinos

    2009-07-06

    Lumbosacral transitional vertebra is an anatomical variation of the fifth lumbar vertebra in which an enlarged transverse process can form a joint or fusion with the sacrum or ilium. The association of that variant with low back pain and the change in the biomechanical properties of the lumbar spine is called Bertolotti's syndrome. We report a case of a 40-year-old male patient with chronic low back pain extending to the left buttock, just above the ipsilateral sacroiliac joint. Radiographic investigation revealed an anomalous enlargement of the left transverse process of the fifth lumbar vertebra forming a pseudarthrosis with the infrajacent ala of the sacrum. In young patients with back pain the possibility of Bertolotti's syndrome should always be taken in account.

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

    Directory of Open Access Journals (Sweden)

    Hossein Dehghani

    2011-09-01

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

  15. Morphometrical investigation of radiographs of lumbar vertebrae of boxers with and without spondylosis

    International Nuclear Information System (INIS)

    Eichelberg, H.; Veit, C.; Loeffler, K.; Brehm, H.

    1989-01-01

    Length and height measurement of the third lumbar vertebra in 286 radiographs of 140 male and 146 female Boxers was carried out to defect differences between dogs with and dogs without spondylosis. No differences could be established. However, there were statistically significant differences in the length of the vertebra between male and female dogs within the age groups (below two years and above 5 years) and between bitches younger than two years and bitches older than 5 years. Length-height-proportions did not change. Female Boxers were more often affected with spondylosis than males

  16. 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.

  17. 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.

  18. On the roentgenomorphological correlations of cranial sutures

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  19. Imaging characteristics of primary cranial Ewing sarcoma

    International Nuclear Information System (INIS)

    Li, Wai-Yung; Saunders, Dawn E.; Brock, Penelope

    2005-01-01

    Ewing sarcoma accounts for 10-15% of all childhood malignant bone tumours and is second in prevalence to osteosarcoma. The skull bones are an unusual site of origin of primary Ewing sarcoma in children. Previous reports concentrate on the neurosurgical aspects and relatively good outcome compared to other bone tumours of the calvarium. Reported cases mainly describe the imaging characteristics on CT. To describe the MRI and CT features of primary cranial Ewing sarcoma. The neuroimaging of three cases of primary cranial Ewing sarcoma are reviewed. Our three cases show an extra-axial mass that is high attenuation on CT and low signal on T2-weighted MRI. Haemorrhagic components, dural extension and contrast enhancement are also characteristic features. CT attenuation and magnetic resonance signal characteristics reflect sheets of densely packed cells seen in Ewing sarcoma. (orig.)

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

    DEFF Research Database (Denmark)

    Nowack, Rainer; Wachtler, Paul; Kunz, Jürgen

    2009-01-01

    The problem of diagnosing vasculitic neuropathy is discussed based on case reports of two patients with Wegener's granulomatosis. One patient developed de novo 6(th) nerve palsy as an isolated relapse manifestation and the second patient a sequence of multiple cranial nerve palsies. Brain imaging...... by the overall clinical presentations. Cranial neuropathy may be the first obvious vasculitic manifestation preceding other organ disease, and since single reliable tests for its diagnosis are lacking, a multidisciplinary approach is advocated here to detect vasculitic manifestations in other organs....

  1. Cranial computed tomography of xeroderma pigmentosum

    International Nuclear Information System (INIS)

    Harada, Koshi; Imakita, Satoru; Kawai, Ryuji; Mitomo, Masanori; Miura, Takashi; Mimaki, Takashi; Satoh, Kenji

    1986-01-01

    Brain CTs of 15 patients with complementation group A xeroderma pigmentosum were reviewed. The CT findings were cerebral atrophy and brain stem atrophy, and were more prominent in the older patients. Cranial bone change (microcephaly, calvarial thickening and so on) secondary to brain atrophy becomes overt in the patients older than 8 years. Cerebellar atrophy was not detected with CT in any case. There were neither intracranial calcification nor space occupying lesion. (author)

  2. Role of cranial imaging in epileptic status

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  3. Role of cranial imaging in epileptic status

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-06-15

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

  4. An expert system for the interpretation of cranial CTSCAN images

    International Nuclear Information System (INIS)

    Kumar, R.; Srihari, S.N.

    1985-01-01

    An experimental system for Interpretation of Cranial CT SCAN Images has been developed. Given a Cranial CT SCAN slice of a patient the system (which is an artificial intelligence (AI) based computer program) finds and labels neuroanatomical landmarks e.g. skull bone, CSF cavities, tissue and distinct abnormalities, present within the CT slice. If abnormalities are found, the system determines the kind of abnormality present e.g. hematoma, tumor, edema, etc., and where the abnormality was detected. The system described is a rule-based one. The rules are knowledge engineered from the radiologist. The system can be viewed as a series of mappings beginning from the matrix of ct numbers, representing a ct slice of a patient, to a symbolic description of the image in terms of black and white regions and their properties. The rules operate on this symbolic description and diagnose each region to be normal or abnormal, and if abnormal then the kind of abnormality present. The system developed so far is an experimental one and far from routine clinical applications. Essentially, the report presents a frame-work for labeling regions in each ct slice

  5. Microstructure and mechanical properties of porous titanium structures fabricated by electron beam melting for cranial implants.

    Science.gov (United States)

    Moiduddin, Khaja

    2018-02-01

    The traditional methods of metallic bone implants are often dense and suffer from adverse reactions, biomechanical mismatch and lack of adequate space for new bone tissue to grow into the implant. The objective of this study is to evaluate the customized porous cranial implant with mechanical properties closer to that of bone and to improve the aesthetic outcome in cranial surgery with precision fitting for a better quality of life. Two custom cranial implants (bulk and porous) are digitally designed based on the Digital Imaging and Communications in Medicine files and fabricated using additive manufacturing. Initially, the defective skull model and the implant were fabricated using fused deposition modeling for the purpose of dimensional validation. Subsequently, the implant was fabricated using titanium alloy (Ti6Al4V extra low interstitial) by electron beam melting technology. The electron beam melting-produced body diagonal node structure incorporated in cranial implant was evaluated based on its mechanical strength and structural characterization. The results show that the electron beam melting-produced porous cranial implants provide the necessary framework for the bone cells to grow into the pores and mimic the architecture and mechanical properties closer to the region of implantation. Scanning electron microscope and micro-computed tomography scanning confirm that the produced porous implants have a highly regular pattern of porous structure with a fully interconnected network channel without any internal defect and voids. The physical properties of the titanium porous structure, containing the compressive strength of 61.5 MPa and modulus of elasticity being 1.20 GPa, represent a promising means of reducing stiffness and stress-shielding effect on the surrounding bone. This study reveals that the use of porous structure in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength and structural characteristics

  6. 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.

  7. MR imaging of cranial nerve schwannomas

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Lordotic vertebrae in sea bass (Dicentrarchus labrax L.) are adapted to increased loads

    NARCIS (Netherlands)

    Kranenbarg, S.; Waarsing, J.H.; Muller, M.; Weinans, H.; Leeuwen, van J.L.

    2005-01-01

    Lordosis in fish is an abnormal ventral curvature of the vertebral column, accompanied by abnormal calcification of the afflicted vertebrae. Incidences of lordosis are a major problem in aquaculture and often correlate with increased swimming activity. To understand the biomechanical causes and

  12. Cervical vertebrae staging in pre-orthodontic patients in Benin City ...

    African Journals Online (AJOL)

    Method: The first six cervical vertebrae of 105 untreated orthodontic patients attending the clinic of the University of Benin Teaching Hospital were assessed on the cephalometric radiograph to determine the stages of maturation. Correlations between age, gender, type of malocclusion and skeletal maturation stages were ...

  13. Primary spondylolysis of the axis vertebra (C2) in the children, including one with pyknodysostosis

    International Nuclear Information System (INIS)

    Currarino, G.; Texas Univ., Dallas, TX

    1989-01-01

    This report describes 3 children with a cleft in the pedicles of the second cervical vertebra of uncertain cause. One of these patients had pyknodysostosis. Previous instances of such defects in the literature are reviewed with some considerations on the possible nature of the lesion. (orig.)

  14. 2D-3D Registration of CT Vertebra Volume to Fluoroscopy Projection: A Calibration Model Assessment

    Directory of Open Access Journals (Sweden)

    P. Bifulco

    2010-01-01

    Full Text Available This study extends a previous research concerning intervertebral motion registration by means of 2D dynamic fluoroscopy to obtain a more comprehensive 3D description of vertebral kinematics. The problem of estimating the 3D rigid pose of a CT volume of a vertebra from its 2D X-ray fluoroscopy projection is addressed. 2D-3D registration is obtained maximising a measure of similarity between Digitally Reconstructed Radiographs (obtained from the CT volume and real fluoroscopic projection. X-ray energy correction was performed. To assess the method a calibration model was realised a sheep dry vertebra was rigidly fixed to a frame of reference including metallic markers. Accurate measurement of 3D orientation was obtained via single-camera calibration of the markers and held as true 3D vertebra position; then, vertebra 3D pose was estimated and results compared. Error analysis revealed accuracy of the order of 0.1 degree for the rotation angles of about 1 mm for displacements parallel to the fluoroscopic plane, and of order of 10 mm for the orthogonal displacement.

  15. 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.

  16. 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.

  17. Cranial CT revisited: do we really need contrast enhancement?

    International Nuclear Information System (INIS)

    Demaerel, P.; Buelens, C.; Wilms, G.; Baert, A.L.

    1998-01-01

    The aim of this study was to define guidelines for intravenous contrast administration in cranial CT, as currently there are no recent guidelines based on a large series of patients. In 1900 consecutive patients (1480 adults and 420 children) pre- and post-contrast scan was analysed in order to assess the contribution of contrast enhancement to the diagnosis. The findings were grouped according to whether abnormalities were seen on the pre- and/or post-contrast scan, or whether no abnormalities were seen at all. Sensitivity, specificity, positive predictive value, negative predictive value and accurracy of a pre-contrast scan were used to determine validity. Intravenous contrast enhancement only contributes to the diagnosis if a suspicious abnormality is seen on the unenhanced scan or in the appropriate clinical setting (33.6 %). In the remaining patients (65.6 %) there is no diagnostic contribution, except for a small number of abnormalities (0.8 %). These are often anatomical variants and have no therapeutic impact. The number of contrast-enhanced cranial CT examinations can significantly be reduced by using four general guidelines for contrast administration resulting in considerable cost savings without affecting the quality of service to the patient. These guidelines are defined by the clinical findings/presentation or by the findings on the unenhanced scan. The number of contrast-related complications will be reduced, which may have medicolegal implications. These guidelines can be applied in any radiology department. (orig.) (orig.)

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

    Science.gov (United States)

    Acharya, Aanand N; Rajan, Gunesh P

    2015-03-01

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

  19. Neuroanatomy of cranial computed tomography

    International Nuclear Information System (INIS)

    Kretschmann, H.J.; Weinrich, W.

    1985-01-01

    Based on the fundamental structures visualized by means of computed tomography, the authors present the functional systems which are relevant in neurology by means of axial cross-sections. All drawings were prepared from original preparations by means of a new technique which is similar to the grey values of X-ray CT and nuclear magnetic resonance tomography. A detailed description is given of the topics of neurofunctional lesions

  20. 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.

  1. 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.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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. Primary osteopathy of vertebrae in a neurofibromatosis type 1 murine model.

    Science.gov (United States)

    Zhang, Wei; Rhodes, Steven D; Zhao, Liming; He, Yongzheng; Zhang, Yingze; Shen, Yong; Yang, Dalong; Wu, Xiaohua; Li, Xiaohong; Yang, Xianlin; Park, Su-Jung; Chen, Shi; Turner, Charles; Yang, Feng-Chun

    2011-06-01

    Neurofibromatosis type 1 (NF1) is a common autosomal dominant genetic disorder caused by mutation of the NF1 tumor suppressor gene. Spinal deformities are common skeletal manifestations in patients with NF1. To date, the mechanism of vertebral abnormalities remains unclear because of the lack of appropriate animal models for the skeletal manifestations of NF1. In the present study, we report a novel murine NF1 model, Nf1(flox/-);Col2.3Cre(+) mice. These mice display short vertebral segments. In addition, a significant reduction in cortical and trabecular bone mass of the vertebrae was observed in Nf1(flox/-);Col2.3Cre(+) mice as measured by dual-energy X-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT). Peak stress and peak load were also significantly reduced in Nf1(flox/-);Col2.3Cre(+) mice as compared to controls. Furthermore, the lumbar vertebrae showed enlargement of the inter-vertebral canal, a characteristic feature of lumbar vertebrae in NF1 patients. Finally, histologic analysis demonstrated increased numbers of osteoclasts and decreased numbers of osteoblasts in the vertebrae of Nf1(flox/-);Col2.3Cre(+) mice in comparison to controls. In summary, Nf1(flox/-);Col2.3Cre(+) mice demonstrate multiple structural and functional abnormalities in the lumbar vertebrae which recapitulate the dystrophic vertebral changes in NF1 patients. This novel murine model provides a platform to understand the cellular and molecular mechanisms underlying the pathogenesis of spinal deficits in NF1 patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. L5 vertebrectomy for the surgical treatment of tumoral and traumatic lesions of L5 vertebra

    Directory of Open Access Journals (Sweden)

    Tuncay Kaner

    2012-02-01

    Full Text Available We retrospectively reviewed the clinical characteristics and the surgical results of seven patients treated with L5 vertebrectomy. The pathologies, clinical characteristics, preoperative and postoperative radiological findings, surgical techniques, and instrumentation for seven patients operated on between 1998 and 2009 are presented in this article. Biopsies were performed on all patients except those involving trauma. Patients were followed up at three-month intervals in the first year, at 6- month intervals in the second year, and on a regular basis afterward. One patient had a traumatic L5 burst fracture; the other six had tumoral pathologies in the L5 vertebrae. One tumoral lesion was a chordoma, another was a hemangioma, and the remaining four were metastatic lesions. Radiotherapy and chemotherapy were performed for the metastatic tumor patients during the postoperative period. Patients with renal cancer and chordoma survived for 3 years; patients with lung cancer and bladder cancer survived for 1 year; and patients with breast cancer survived for 16 months. The lumbosacral region presents significant stabilization problems because of the presence of sacral slope. In our opinion, if the lesion involves only the L5 vertebra, anterior cage-filled bone cement or bone graft should be performed, as dictated by the pathology and posterior transpedicular instrumentation. If the lesion involves the L4 vertebra or the sacrum and the L5 vertebra, the instrumentation can be extended to cover other segments with sacral attachments. The present cases involved only L5 vertebra and treatment with short-segment stabilization covering the anterior and posterior columns.

  6. The evolution and development of cranial form in Homo sapiens

    OpenAIRE

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

    2002-01-01

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

  7. 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

    2016-01-01

    Background 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. Objectives 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). Patients and Methods 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. Results 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. Conclusion The level of agreement between the two methods was low; thus, they cannot be

  8. Diagnostic strategy in segmentation defect of the vertebrae: a retrospective study of 73 patients.

    Science.gov (United States)

    Lefebvre, Mathilde; Dieux-Coeslier, Anne; Baujat, Geneviève; Schaefer, Elise; Judith, Saint-Onge; Bazin, Anne; Pinson, Lucile; Attie-Bitach, Tania; Baumann, Clarisse; Fradin, Melanie; Pierquin, Genevieve; Julia, Sophie; Quélin, Chloé; Doray, Bérénice; Berg, Sylvie; Vincent-Delorme, Catherine; Lambert, Laetitia; Bachmann, Nadine; Lacombe, Didier; Isidor, Bertrand; Laurent, Nicole; Joelle, Roume; Blanchet, Patricia; Odent, Sylvie; Kervran, Dominique; Leporrier, Nathalie; Abel, Carine; Segers, Karine; Guiliano, Fabienne; Ginglinger-Fabre, Emmanuelle; Selicorni, Angelo; Goldenberg, Alice; El Chehadeh, Salima; Francannet, Christine; Demeer, Benedicte; Duffourd, Yannis; Thauvin-Robinet, Christel; Verloes, Alain; Cormier-Daire, Valerie; Riviere, Jean Baptiste; Faivre, Laurence; Thevenon, Julien

    2018-02-19

    Segmentation defects of the vertebrae (SDV) are non-specific features found in various syndromes. The molecular bases of SDV are not fully elucidated due to the wide range of phenotypes and classification issues. The genes involved are in the Notch signalling pathway, which is a key system in somitogenesis. Here we report on mutations identified in a diagnosis cohort of SDV. We focused on spondylocostal dysostosis (SCD) and the phenotype of these patients in order to establish a diagnostic strategy when confronted with SDV. We used DNA samples from a cohort of 73 patients and performed targeted sequencing of the five known SCD-causing genes ( DLL3 , MESP2 , LFNG , HES7 and TBX6 ) in the first 48 patients and whole-exome sequencing (WES) in 28 relevant patients. Ten diagnoses, including four biallelic variants in TBX6 , two biallelic variants in LFNG and DLL3 , and one in MESP2 and HES7 , were made with the gene panel, and two diagnoses, including biallelic variants in FLNB and one variant in MEOX1, were made by WES. The diagnostic yield of the gene panel was 10/73 (13.7%) in the global cohort but 8/10 (80%) in the subgroup meeting the SCD criteria; the diagnostic yield of WES was 2/28 (8%). After negative array CGH, targeted sequencing of the five known SCD genes should only be performed in patients who meet the diagnostic criteria of SCD. The low proportion of candidate genes identified by WES in our cohort suggests the need to consider more complex genetic architectures in cases of SDV. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Cranial morphological variation in Peromyscus maniculatus over nearly a century of environmental change in three areas of California.

    Science.gov (United States)

    Holmes, Michael W; Boykins, Genevieve K R; Bowie, Rauri C K; Lacey, Eileen A

    2016-01-01

    Determining how species respond to prolonged environmental change is critical to understanding both their evolutionary biology and their conservation needs. In general, organisms can respond to changing environmental conditions by moving, by adapting in situ, or by going locally or globally extinct. Morphological changes, whether plastic or adaptive, are one way that species may respond in situ to local environmental change. Because cranial morphology is influenced by selective pressures arising from an organism's abiotic and biotic environments, including aspects of thermal physiology, diet, and sensory ecology, studies of cranial morphology may generate important insights into how species are responding to environmental change. To assess potential response of deer mice (Peromyscus maniculatus) to changing conditions in the Sierra Nevada Mountains of California, we quantified cranial variation in museum specimens of this species collected approximately 100 years apart. Specifically, we examined how cranial morphology varies in three populations of this geographically widespread, ecological generalist over elevation and time. Our analyses indicate that cranial morphology does not differ with elevation within either modern or historical samples but does vary between time periods, suggesting that in situ responses to environmental change have occurred. Contrary to predictions based on Bergmann's rule, we found no consistent relationship between body size and either elevation or time, suggesting that morphological differences detected between historic and modern specimens are specific to factors influencing cranial structure. Collectively, these analyses demonstrate the potential importance of in situ changes in morphology as a response to changing environmental conditions. © 2015 Wiley Periodicals, Inc.

  10. Twelfth cranial nerve involvement in Guillian Barre syndrome.

    Science.gov (United States)

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

    2013-07-01

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

  11. Twelfth cranial nerve involvement in Guillian Barre syndrome

    OpenAIRE

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

    2013-01-01

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

  12. Twelfth cranial nerve involvement in Guillian Barre syndrome

    Directory of Open Access Journals (Sweden)

    Subrat Kumar Nanda

    2013-01-01

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

  13. Cranial nerves - spectrum of inflammatory and tumorous changes

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  15. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  17. 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.

  18. Intermittent cranial lung herniation in two dogs.

    Science.gov (United States)

    Guglielmini, Carlo; De Simone, Antonio; Valbonetti, Luca; Diana, Alessia

    2007-01-01

    Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.

  19. 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)

  20. Robust frameless stereotactic localization in extra-cranial radiotherapy

    International Nuclear Information System (INIS)

    Riboldi, Marco; Baroni, Guido; Spadea, Maria Francesca; Bassanini, Fabio; Tagaste, Barbara; Garibaldi, Cristina; Orecchia, Roberto; Pedotti, Antonio

    2006-01-01

    In the field of extra-cranial radiotherapy, several inaccuracies can make the application of frameless stereotactic localization techniques error-prone. When optical tracking systems based on surface fiducials are used, inter- and intra-fractional uncertainties in marker three-dimensional (3D) detection may lead to inexact tumor position estimation, resulting in erroneous patient setup. This is due to the fact that external fiducials misdetection results in deformation effects that are poorly handled in a rigid-body approach. In this work, the performance of two frameless stereotactic localization algorithms for 3D tumor position reconstruction in extra-cranial radiotherapy has been specifically tested. Two strategies, unweighted versus weighted, for stereotactic tumor localization were examined by exploiting data coming from 46 patients treated for extra-cranial lesions. Measured isocenter displacements and rotations were combined to define isocentric procedures, featuring 6 degrees of freedom, for correcting patient alignment (isocentric positioning correction). The sensitivity of the algorithms to uncertainties in the 3D localization of fiducials was investigated by means of 184 numerical simulations. The performance of the implemented isocentric positioning correction was compared to conventional point-based registration. The isocentric positioning correction algorithm was tested on a clinical dataset of inter-fractional and intra-fractional setup errors, which was collected by means of an optical tracker on the same group of patients. The weighted strategy exhibited a lower sensitivity to fiducial localization errors in simulated misalignments than those of the unweighted strategy. Isocenter 3D displacements provided by the weighted strategy were consistently smaller than those featured by the unweighted strategy. The peak decrease in median and quartile values of isocenter 3D displacements were 1.4 and 2.7 mm, respectively. Concerning clinical data, the

  1. 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.

  2. 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.

  3. Problems of cranial computer-tomography

    Energy Technology Data Exchange (ETDEWEB)

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

    1979-07-01

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

  4. Problems of cranial computer-tomography

    International Nuclear Information System (INIS)

    Seitz, D.

    1979-01-01

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

  5. Ophthalmople gic cranial neuropathy: clinical case

    Directory of Open Access Journals (Sweden)

    N. S. Dozorova

    2018-01-01

    Full Text Available Ophthalmoplegic cranial neuropathy (OCN is a disease with unknown etiology, which manifests itself by episodes of intense headache, accompanied by completely or partially reversible dysfunction of the oculomotor nerve: ptosis, mydriasis and ophthalmoplegia. It is assumed that the pathology is demyelinating in nature, therefore in the International classification of headaches OCN excluded from rubric migraine and related to the painful cranial neuropathies. The question of the prevention and treatment of this disease is still controversial, the issue of the appointment of corticosteroids, calcium channel blockers and β-blockers, methods of surgical correction of strabismus and botulin therapy.The article describes OCN in an 11-year-old boy. In the clinical picture headache attacks were observed. These attacks were with signs of selective lesions of the oculomotor nerve on one side. These functional changes are recurrent, and fully regress between attacks. Laboratory and instrumental examinations revealed no pathology that could cause this symptom, including myasthenia. The described case demonstrates the classical picture of OCN with a favorable course and the partial damage of the oculomotor nerve on one side.

  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. PMID:26167022

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

    Science.gov (United States)

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

    2012-01-01

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

  8. Vasculopathic Cranial Ocular Motor Neuropathy Following Sudden Emotional Stress

    OpenAIRE

    Purvin, Valerie

    2010-01-01

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

  9. Mapping genetic variants for cranial vault shape in humans

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  10. 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...

  11. Idiopathic hypertrophic cranial pachymeningitis associated with Sweet's Syndrome

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  12. Single fraction prophylactic cranial irradiation for small cell carcinoma of the lung

    International Nuclear Information System (INIS)

    Brewster, A.E.; Hopwood, P.; Stout, R.; Burt, P.A.; Thatcher, N.

    1995-01-01

    The effectiveness of a single 8-Gy fraction prophylactic cranial irradiation regime was assessed in 106 patients with small-cell carcinoma of the lung. All patients had limited stage disease and received combination chemotherapy consisting of either cisplatin or carboplatin with ifosfamide, etoposide, and vincristine (VICE). Cranial irradiation was administered 48 h after the first cycle of chemotherapy and was well tolerated. Actual 2-year survival was 35% and cranial relapse occurred in 22% of those patients who achieved complete remission. This compares favourably with a cranial relapse rate of 45% incomplete remitters previously reported with the same chemotherapy regime after a minimum follow-up of 2 years where PCI was not used. Formal psychometric testing was performed retrospectively on a series of 25 long-term survivors of whom 14 were taken from this reported series. Whilst 75% of patients were impaired on at least one test with 68% performing badly in the most complex task, this was not associated with clinically detectable neurological damage and the patients did not complain of memory or concentration difficulties. In conclusion, single fraction PCI, when used with platinum based combination chemotherapy, appears to be equally effective but may be less neurotoxic than the more standard fractionated regimes

  13. 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.

  14. Chondromyxoid Fibroma of Two Cervical Vertebrae with Involvement of Surrounding Soft Tissue: Radiologic Diagnostic Dilemma

    International Nuclear Information System (INIS)

    Taghipour Zahir, Shokouh; Sefidrokh Sharahjin, Naser; Sadlu Parizi, Farzad; Rahmani, Koorosh

    2015-01-01

    Chondromyxoid fibroma is a rare benign cartilaginous neoplasm that mostly affects the metaphyseal region of the long bones. The tibia, small tubular bones of the foot, the distal femur and pelvis are common locations, but involvement of the vertebral bones, especially the cervical vertebra, is very rare. Radiographic features show typical characteristics and this tumor often presents as a lobulated, eccentric radiolucent lesion with no periosteal reaction. In addition, geographic bone destruction is seen in all cases. We present an adult female with a one-year history of neck pain, and ultrasound findings that suggest a right paravertebral muscular lesion due to inflammatory or neoplastic origins. The histopathological studies confirmed that the biopsied specimen was a chondromyxoid fibroma of the cervical vertebrae laminae and spinous processes (C3 and C4) with abutting soft tissue. Despite the unusual location and soft tissue presentation, a chondromyxoid fibroma should be considered in the differential diagnosis of a cervical bone lesion

  15. 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.

  16. Bizarre tubercles on the vertebrae of Eocene fossil birds indicate an avian disease without modern counterpart

    Science.gov (United States)

    Mayr, Gerald

    2007-08-01

    Remains of fossil birds with numerous bony tubercles on the cervical vertebrae are reported from the Middle Eocene of Messel in Germany and the Late Eocene of the Quercy fissure fillings in France. These structures, which are unknown from extant birds and other vertebrates, were previously described for an avian skeleton from Messel but considered a singular feature of this specimen. The new fossils are from a different species of uncertain phylogenetic affinities and show that tuberculated vertebrae have a wider taxonomic, temporal, and geographic distribution. In contrast to previous assumptions, they are no ontogenetic feature and arise from the vertebral surface. It is concluded that they are most likely of pathologic origin and the first record of a Paleogene avian disease. Their regular and symmetrical arrangement over most of the external vertebral surface indicates a systemic disorder caused by factors that do not affect extant birds, such as especially high-dosed phytohormones or extinct pathogens.

  17. Electrophysiology of Cranial Nerve Testing: Trigeminal and Facial Nerves.

    Science.gov (United States)

    Muzyka, Iryna M; Estephan, Bachir

    2018-01-01

    The clinical examination of the trigeminal and facial nerves provides significant diagnostic value, especially in the localization of lesions in disorders affecting the central and/or peripheral nervous system. The electrodiagnostic evaluation of these nerves and their pathways adds further accuracy and reliability to the diagnostic investigation and the localization process, especially when different testing methods are combined based on the clinical presentation and the electrophysiological findings. The diagnostic uniqueness of the trigeminal and facial nerves is their connectivity and their coparticipation in reflexes commonly used in clinical practice, namely the blink and corneal reflexes. The other reflexes used in the diagnostic process and lesion localization are very nerve specific and add more diagnostic yield to the workup of certain disorders of the nervous system. This article provides a review of commonly used electrodiagnostic studies and techniques in the evaluation and lesion localization of cranial nerves V and VII.

  18. Radiographic assessment of cranial cruciate ligament rupture in the dairy cow: a retrospective study

    International Nuclear Information System (INIS)

    Huhn, J.C.; Kneller, S.K.; Nelson, D.R.

    1986-01-01

    Case records and radiographs of 37 dairy cows presented to the University of Illinois Veterinary Medicine Teaching Hospital with a diagnosis of cranial cruciate ligament rupture were reviewed. Signalment, history, duration of lameness prior to clinical presentation, and physical examination findings were evaluated. Survey radiographs were examined and radiographic lesions were documented. Individual cows were classified into groups (A, B, C) based on the severity of radiographic lesions, with Group A cows having minimal radiographic lesions. Cows in Groups A and B had radiographic lesions similar to Class I in beef bulls reported in another study.3,4 An attempt was made to relate the severity of radiographic lesions with age and duration of lameness. Group A animals tended to be younger cows (x@@= 4.58 years) with a short duration of lameness. Group B cows were older (x@@= 7.87 years) with a somewhat longer duration of lameness. Group C cows were slightly younger (x@@= 7.30 years) than Group B cows; however, their duration of lameness was much longer (x@@= 57.2 weeks vs 6.35 weeks for Group B and 2.54 weeks for Group A). The pathogenesis of cranial cruciate ligament rupture and its associated lameness appeared to differ in dairy cows from beef bulls. The majority of animals in this study had radiographic lesions of mild to moderate severity (Groups A and B). In contrast, based on previous work, beef bulls had a greater tendency to be similar to our Group C designation. Beef bulls became lame with cranial cruciate ligament rupture only after severe lesions of degenerative joint disease had already occurred. It has been stated that lameness associated with cranial cruciate ligament rupture in the beef bull is, therefore, secondary to degenerative joint disease. In contrast, the syndrome in dairy cows, as evidenced here, differs, since they often presented with cranial cruciate ligament rupture with little or no radiographic evidence of degenerative joint disease

  19. 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.

  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. Morphometry of lower lumbar vertebrae as seen on CT scans: newly recognized characteristics

    International Nuclear Information System (INIS)

    van Schaik, J.J.P.; Verbiest, H.; van Schaik, F.D.J.

    1985-01-01

    Transaxial computed tomographic (CT) sections represent a new approach to vertebral morphometry, allowing certain measurements to be made in vivo for the first time. The cross-sectional morphology of the bodies and pedicles of L3, L4, and L5 was studied in a series of 213 vertebrae. This revealed that the pedicles of L5 arise more laterally from the body of L5 than from L3. Further, the lateral surfaces of the L5 body are inclined obliquely, unlike those of L3. L4 is transitional in form between L3 and L5, more closely resembling the former. This morphology explains the fact, hitherto unnoticed, that the lateral outlines of the pedicles and the lateral borders of the body of L5 are not normally imaged on plain anteroposterior radiographs. It is evident that pathologic changes of the lateral borders of the body of L5 may be invisible also. In cases of transitional vertebrae in the lumbosacral region the presence or absence of the lateral outlines of the pedicles and of the lateral borders of the vertebral body may be of help in identifying the vertebrae on conventional projections

  2. Identification of apical vertebra for grading of idiopathic scoliosis using image processing.

    Science.gov (United States)

    Anitha, H; Prabhu, G K

    2012-02-01

    Scoliosis is a 3-D deformity of spinal column, characterized by both lateral curvature and vertebral rotation. The disease can be caused by congenital, developmental, or degenerative problems; but most cases of scoliosis actually have no known cause, and this is known as idiopathic scoliosis. Vertebral rotation has become increasingly prominent in the study of scoliosis and the most deformed vertebra is named as apical vertebra. Apical vertebral deformity demonstrates significance in both preoperative and postoperative assessment, providing better appreciation of the impact of bracing or surgical interventions. Precise measurement of apical vertebral rotation in terms of grading is most valuable for the determination of reference value in normal and pathological conditions for better understanding of scoliosis. Routine quantitative evaluation of vertebral rotation is difficult and error prone due to limitations of observer characteristic and specific imaging property. This paper proposes automatic identification of the apical vertebra and its parameter that depends on the objective criteria of measurement using active contour models. The proposed technique is more accurate and is a reliable measurement compared to manual and computer-assisted system.

  3. Determination of isoniazid concentration in rabbit vertebrae by isotope tracing technique in conjunction with HPLC.

    Science.gov (United States)

    Liu, Peng; Fu, Zhaozong; Jiang, Jianming; Yuan, Liang; Lin, Zhen

    2013-09-01

    Medications compounded with isoniazid (INH) are usually applied to surgical sites at the completion of surgery to locally kill postoperative residual tubercle bacilli. However, the distribution and elimination of INH in the vertebrae in vivo are not known. In this study, isotope tracing was used in conjunction with high-pressure liquid chromatography (HPLC) to address this. INH and technetium-99 m-labeled INH were applied to the vertebrae of rabbits. After 2 and 6 h, osseous tissues containing INH, as determined by radionuclide imaging, were collected for detection with HPLC. The results showed that INH mainly stayed around the vertebrae 6 h after its application and did not permeate widely into the blood or other organs, except for the kidneys. The standard deviations of INH concentrations in the technetium-99 m-INH group were approximately four-fold smaller than those in the INH group. This method of coupling isotope tracing and HPLC can effectively limit experimental error during sample collection, allowing accurate and reliable identification of the concentration levels of INH in osseous tissues in vivo. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Morphometric variations of the 7th cervical vertebrae of Zulu, White, and Colored South Africans.

    Science.gov (United States)

    Kibii, Job M; Pan, Rualing; Tobias, Phillip V

    2010-05-01

    The 7th cervical vertebrae of 240 cadavers of South African Zulu, White, and Colored population groups were examined to determine morphometric variation. White and Colored females had statistically significant narrower cervical anteroposterior diameters than their male counterparts, whereas no statistically significant difference between sexes of the Zulu population group was observed in this variable. In addition, although Zulu and Colored females had statistically significant narrower cervical transverse diameters than their male counterparts, there was no statistically significant variation between South African white males and females in this respect. The findings indicate that sexual dimorphism is more apparent in the vertebral centrum, across the three population groups, where males had significantly larger dimensions in centrum anteroposterior diameter, height, and width than their female counterparts. The study further reveals that sexual dimorphism is more apparent when one compares aspects of the 7th cervical vertebra between sexes within the same population group. Overall, the dimensions of the various variates of the vertebra are substantially smaller in women than in men. The smaller dimensions, particularly of the centrum, may be the result of lower skeletal mass in women and render them more vulnerable to fractures resulting from compression forces. 2010 Wiley-Liss, Inc.

  5. 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.

  6. Disk degenerative disease in childhood: Scheuermann's disease, Schmorl's nodes, and the limbus vertebra: MRI findings in 12 patients

    International Nuclear Information System (INIS)

    Swischuk, L.E.; John, S.D.; Allbery, S.

    1998-01-01

    Twelve pediatric patients were studied with MRI. All had various disk problems including Scheuermann's disease, Schmorl's nodes and limbus vertebrae. All patients shared loss of disk height, altered disk hydration and variable herniation of nuclear material. (orig.)

  7. High-resolution whole-genome analysis of skull base chordomas implicates FHIT loss in chordoma pathogenesis.

    Science.gov (United States)

    Diaz, Roberto Jose; Guduk, Mustafa; Romagnuolo, Rocco; Smith, Christian A; Northcott, Paul; Shih, David; Berisha, Fitim; Flanagan, Adrienne; Munoz, David G; Cusimano, Michael D; Pamir, M Necmettin; Rutka, James T

    2012-09-01

    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.

  8. 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.

  9. Cranial nerve monitoring during subpial dissection in temporomesial surgery.

    Science.gov (United States)

    Ortler, Martin; Fiegele, Thomas; Walser, Gerald; Trinka, Eugen; Eisner, Wilhelm

    2011-06-01

    Cranial nerves (CNs) crossing between the brainstem and skull base at the level of the tentorial hiatus may be at risk in temporomesial surgery involving subpial dissection and/or tumorous growth leading to distorted anatomy. We aimed to identify the surgical steps most likely to result in CN damage in this type of surgery. Electromyographic responses obtained with standard neuromonitoring techniques and a continuous free-running EMG were graded as either contact activity or pathological spontaneous activity (PSA) during subpial resection of temporomesial structures in 16 selective amygdalohippocampectomy cases. Integrity of peripheral motor axons was tested by transpial/transarachnoidal electrical stimulation while recording compound muscle action potentials from distal muscle(s). Continuous EMG showed pathological activity in five (31.2%) patients. Nine events with PSA (slight activity, n = 8; strong temporary activity, n = 1) were recorded. The oculomotor nerve was involved three times, the trochlear nerve twice, the facial nerve once, and all monitored nerves on three occasions. Surgical maneuvers associated with PSA were the resection of deep parts of the hippocampus and parahippocampal gyrus (CN IV, twice; CN III, once), lining with or removing cotton patties from the resection cavity (III, twice; all channels, once) and indirect exertion of tension on the intact pia/arachnoid of the uncal region while mobilizing the hippocampus and parahippocampal gyrus en bloc (all channels, once; III, once). CMAPs were observed at 0.3 mA in two patients and at 0.6 mA in one patient, and without registering the exact amount of intensity in three patients. The most dangerous steps leading to cranial nerve damage during mesial temporal lobe surgery are the final stages of the intervention while the resection is being completed in the deep posterior part and the resection cavity is being lined with patties. Distant traction may act on nerves crossing the tentorial

  10. Dose estimation for paediatric cranial computed tomography

    International Nuclear Information System (INIS)

    Curci Daros, K.A.; Bitelli Medeiros, R.; Curci Daros, K.A.; Oliveira Echeimberg, J. de

    2006-01-01

    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 ρ((p)=7.9(4)x10 -2 +7(5)x10 -5 p 4.5(4) cm -1 ; exposed to primary X-ray for the posterior fossa region defined by position

  11. 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

  12. 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.

  13. Cranial modularity and sequence heterochrony in mammals.

    Science.gov (United States)

    Goswami, Anjali

    2007-01-01

    Heterochrony, the temporal shifting of developmental events relative to each other, requires a degree of autonomy among those processes or structures. Modularity, the division of larger structures or processes into autonomous sets of internally integrated units, is often discussed in relation to the concept of heterochrony. However, the relationship between the developmental modules derived from studies of heterochrony and evolutionary modules, which should be of adaptive importance and relate to the genotype-phenotype map, has not been explicitly studied. I analyzed a series of sectioned and whole cleared-and-stained embryological and neonatal specimens, supplemented with published ontogenetic data, to test the hypothesis that bones within the same phenotypic modules, as determined by morphometric analysis, are developmentally integrated and will display coordinated heterochronic shifts across taxa. Modularity was analyzed in cranial bone ossification sequences of 12 therian mammals. A dataset of 12-18 developmental events was used to assess if modularity in developmental sequences corresponds to six phenotypic modules, derived from a recent morphometric analysis of cranial modularity in mammals. Kendall's tau was used to measure rank correlations, with randomization tests for significance. If modularity in developmental sequences corresponds to observed phenotypic modules, bones within a single phenotypic module should show integration of developmental timing, maintaining the same timing of ossification relative to each other, despite differences in overall ossification sequences across taxa. Analyses did not find any significant conservation of developmental timing within the six phenotypic modules, meaning that bones that are highly integrated in adult morphology are not significantly integrated in developmental timing.

  14. The variation of cancellous bones at lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep.

    Science.gov (United States)

    Zhang, Yongqiang; Li, Yongfeng; Gao, Qi; Shao, Bo; Xiao, Jianrui; Zhou, Hong; Niu, Qiang; Shen, Mingming; Liu, Baolin; Hu, Kaijin; Kong, Liang

    2014-07-01

    This study aimed to compare the variation of cancellous bones at four skeletal sites: lumbar vertebra, femoral neck, mandibular angle and rib in ovariectomized sheep. Sixteen adult sheep were randomly divided into two groups: eight sheep were ovariectomized served as experimental group; the other eight untreated sheep were served as control group. Bone mineral density was assessed by dual-energy X-ray absorptiometry on lumbar vertebrae at baseline and twelve months after ovariectomy. After 12 months, lumbar vertebrae L3 and L4, femoral necks, mandibular angles and the fourth ribs were harvested for micro-CT scanning, histological analysis and biomechanical test. The results showed that bone mineral density of lumbar vertebra decreased significantly in twelfth month (pbone volume/total volume decreased by 45.6%, 36.1% 21.3% and 18.7% in lumbar vertebrae, femoral necks, mandibular angles and ribs in experimental group (pbones to oestrogen deficiency in ovariectomized sheep was site-specific on a pattern as follows: lumbar vertebra, femoral neck, mandibular angle and rib. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Robo signaling regulates the production of cranial neural crest cells.

    Science.gov (United States)

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

    2017-12-01

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

  16. 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.

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

    NARCIS (Netherlands)

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

    1998-01-01

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

  18. Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

    Science.gov (United States)

    Keskin, Fatih; Erdi, Fatih; Nayman, Alaaddin; Babaoglu, Ozan; Erdal, Kalkan; Ozer, Ali Fahir

    2015-01-01

    Context: This study was designed to understand and define the special radio-anatomic morphometry of C7 vertebra by using multidetector computed tomography (MDCT). Aims: The major aim of the study was to detect the gender- and side-related morphometric differences of C7 vertebra among subjects. Setting and design: Our radiology unit database scanned for MDCT sections of the C7 vertebra. Materials and Methods: A total of 214 patients (134 men, 80 women) were selected. A detailed morphometric evaluation of C7 was done. Statistical analysis used: T test, ANOVA. Lamina length (P < 0.001), pedicle length (P < 0.001), outer cortical (P = 0.01) and inner cancellous pedicle (P < 0.001) width, pedicle angle to sagittal plane (P < 0.001) values were statistically significantly different on the right versus left side. When the results were stratified by gender, lamina length, inner cancellous lamina height, pedicle length, inner cancellous pedicle height, outer cortical pedicle width, lateral mass anteroposterior length, anteroposterior length of C7 corpus, height of C7 corpus (P < 0.001), C6-7 (P = 0.013) and C7-T1disc height (P = 0.04), transverse foramina perpendicular width at C7 (P = 0.046) values were found to be statistically significantly different. Vertebral artery most commonly enters into the transverse foramina at C6 level. Conclusions: Gender and side differences are important factors for preoperative planning and showed significant differences among subjects. MDCT is a practical option for investigating the exact anatomical features of osseous structures. PMID:25788818

  19. Assessment of the bone mineral density in the lumbar vertebrae of newborns by quantitative computed tomography

    International Nuclear Information System (INIS)

    Braillon, P.M.; Lapillonne, A.; Ho, P.S.; Bouvier, R.; Bochu, M.; Salle, B.L.

    1996-01-01

    Objective. To assess the true mineral density (BMD, in g/cm 3 ) of the lumbar spine in newborns. Design and patients. A post-mortem analysis of five infants with gestational ages ranging from 35 to 40 weeks, and birth weights from 2765 to 3200 g, was conducted using dual-energy quantitative computed tomography (QCT; Siemens Somatom DR). A 2 or 4 mm thick slice was obtained for each lumbar vertebra from L1 to L4. The density measured in these vertebrae was corrected by reference to a solid phantom (Osteo-CT) measured simultaneously. A three-dimensional image of the spine (Elscint CT Twin), as well as a photomicrograph of histological preparation from L2 vertebra, were also obtained in another term baby for comparison with the CT results. Results and conclusions. In the range of values studied, the vertebral densities were not dependent on birth weight. BMD values measured in L2, L3 and L4 were not significantly different, but were 10% lower than in L1 in four of five infants. The spatial resolution of the QCT protocol used (0.4 mm) did not permit the differentiation of trabecular and cortical bone, and the vertebral bodies appeared very homogeneous and dense, with a mean density value of 210±30 mg Ca/cm 3 , which is 2.5 times higher than the mean maximum value found in young normal adults. These preliminary results highlight the potential of QCT in neonatology. Special protocols will, however, need to be developed for in vivo measurements in this particular paediatric field. (orig.). With 4 figs., 2 tabs

  20. Radiological anatomy of the C7 vertebra: Clinical implications in spine surgery

    Directory of Open Access Journals (Sweden)

    Fatih Keskin

    2015-01-01

    Full Text Available Context: This study was designed to understand and define the special radio-anatomic morphometry of C7 vertebra by using multidetector computed tomography (MDCT. Aims: The major aim of the study was to detect the gender- and side-related morphometric differences of C7 vertebra among subjects. Setting and design: Our radiology unit database scanned for MDCT sections of the C7 vertebra. Materials and Methods: A total of 214 patients (134 men, 80 women were selected. A detailed morphometric evaluation of C7 was done. Statistical analysis used: T test, ANOVA. Lamina length (P < 0.001, pedicle length (P < 0.001, outer cortical (P = 0.01 and inner cancellous pedicle (P < 0.001 width, pedicle angle to sagittal plane (P < 0.001 values were statistically significantly different on the right versus left side. When the results were stratified by gender, lamina length, inner cancellous lamina height, pedicle length, inner cancellous pedicle height, outer cortical pedicle width, lateral mass anteroposterior length, anteroposterior length of C7 corpus, height of C7 corpus (P < 0.001, C6-7 (P = 0.013 and C7-T1disc height (P = 0.04, transverse foramina perpendicular width at C7 (P = 0.046 values were found to be statistically significantly different. Vertebral artery most commonly enters into the transverse foramina at C6 level. Conclusions: Gender and side differences are important factors for preoperative planning and showed significant differences among subjects. MDCT is a practical option for investigating the exact anatomical features of osseous structures.

  1. Variability of the cranial and dental phenotype in Williams syndrome.

    Science.gov (United States)

    Axelsson, Stefan

    2005-01-01

    Williams syndrome (WS) is a rare congenital disorder involving the cardiovascular system, connective tissue, and the central nervous system, resulting in mild to moderate mental retardation, a specific cognitive profile, unique personality characteristics, distinctive facial features, and cardiovascular disease. The majority of individuals with a clinical diagnosis of WS have a contiguous gene deletion at chromosome 7 (7q11.23). Physical features include characteristic facial features with full prominent cheeks, wide mouth, long philtrum, small nose with depressed nasal bridge, heavy orbital ridges, medial eyebrow flare, dental abnormalities, hoarse voice, growth retardation, and cardiovascular abnormalities (most commonly supravalvular aortic stenosis and/or peripheral pulmonary artery stenosis). The cognitive profile is distinctive, consisting of strengths in auditory memory, language, and face-processing, but extreme weakness in visuospatial, numerical and problem-solving abilities. Neurological studies have identified a significantly decreased brain volume in adult individuals with WS with relatively normal development of the limbic, frontal and cerebellar structures. The aims were to analyse the neurocranium, the craniofacial region, and the dentition in a well defined Norwegian group of individuals with WS. In order to accomplish this, normative cephalometric standards for the neurocranium, including the cranial base and the sella turcica, were established for Norwegian males and females from 6 to 21 years of age, using lateral radiographic cephalograms from the Oslo University Craniofacial Growth Archive. The study material comprised radiographic lateral cephalograms, orthopantomograms and dental casts from 62 individuals with WS ranging from 4 to 44 years. The lateral cephalograms, orthopantomograms and dental casts were analysed using standard methods reported in the literature. Neurocranium: The results from the cephalometric analyses showed that the size

  2. Cranial computerized tomography in children suffering from acute leukemia

    International Nuclear Information System (INIS)

    Metz, O.

    1981-01-01

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

  3. 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.

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

    African Journals Online (AJOL)

    weight (LBW), gestational age (GA), prematurity, lack of antenatal ... To assess how many very low birth weight (VLBW) infants had cranial ultrasound screening at .... large number of infants who were ≤750 g and who had not undergone.

  5. Case report 868. Congenital bilateral spondylolysis and spondylolisthesis of the fourth cervical vertebra.

    Science.gov (United States)

    Jeyapalan, K; Chavda, S V

    1994-10-01

    A case of congenital bilateral spondylolysis of fourth cervical vertebra was reported and the characteristic radiological features shown. Although the diagnosis is often suggested by the plain films, demonstration of the typical CT findings is often necessary to reach a final diagnosis. Awareness of this entity and its specific radiological features will help to differentiate this relatively benign cervical anomaly from other, more ominous, unstable causes of cervical spondylolisthesis such as those related to acute cervical injury. It may also prevent any inappropriate treatment from being undertaken.

  6. 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.

  7. [Research advances of three-dimension printing technology in vertebrae and intervertebral disc tissue engineering].

    Science.gov (United States)

    Yang, Zechuan; Li, Chunde; Sun, Haolin

    2016-03-01

    Three-dimensional (3D) printing technology is characterized by "inside-out" stack manufacturing. Compared with conventional technologies, 3D printing has the advantage of personalization and precision. Therefore, the shape and internal structure of the scaffolds made by 3D printing technology are highly biomimetic. Besides, 3D bioprinting can precisely deposit the biomaterials, seeding cells and cytokines at the same time, which is a breakthrough in printing technique and material science. With the development of 3D printing, it will make great contributions to the reconstruction of vertebrae and intervertebral disc in the future.

  8. Case report 357: Chordoma of the fourth lumbar vertebra metastasizing to the thoracic spine and ribs

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Zwass, A.; O' Leary, P.F.; Steiner, G.C.

    1986-03-01

    In summary a fascinating case is presented in a 54-year-old man who developed a chordoma of the fourth lumbar vertebra which was treated by radiotherapy, with good results. The man remained asymptomatic relatively for several years and then presented with recurrence of back pain and neurological deficits. Plain films, CT and myelography showed considerable destruction of the body of L4 with a sclerotic pattern suggesting the effects of previous radiotherapy. A large paraspinal tissue mass extending into the spinal canal was present. Most interestingly the patient developed metastatic disease in the thoracic spine and ribs but no metastases other than in the skeleton. (orig./SHA).

  9. Growth Patterns of the Neurocentral Synchondrosis (NCS) in Immature Cadaveric Vertebra.

    Science.gov (United States)

    Blakemore, Laurel; Schwend, Richard; Akbarnia, Behrooz A; Dumas, Megan; Schmidt, John

    2018-03-01

    Gross anatomic study of osteological specimens. To evaluate the age of closure for the neurocentral synchondrosis (NCS) in all 3 regions of the spine in children aged 1 to 18 years old. The ossification of the human vertebra begins from a vertebral body ossification center and a pair of neural ossification centers located within the centrum called the NCS. These bipolar cartilaginous centers of growth contribute to the growth of the vertebral body, spinal canal, and posterior elements of the spine. The closure of the synchondroses is dependent upon location of the vertebra and previous studies range from 2 to 16 years of age. Although animal and cadaveric studies have been performed regarding NCS growth and early instrumentation's effect on its development, the effects of NCS growth disturbances are still not completely understood. The vertebrae of 32 children (1 to 18 y old) from the Hamann-Todd Osteological collection were analyzed (no 2 or 9 y old specimens available). Vertebrae studied ranged from C1 to L5. A total of 768 vertebral specimens were photographed on a background grid to allow for measurement calibration. Measurements of the right and left NCS, pedicle width at the NCS, and spinal canal area were taken using Scandium image-analysis software (Olympus Soft Imaging Solutions, Germany). The percentage of the growth plate still open was found by dividing the NCS by the pedicle width and multiplying by 100. Data were analyzed with JMP 11 software (SAS Institute Inc., Cary, NC). The NCS was 100% open in all 3 regions of the spine in the 1- to 3-year age group. The cervical NCS closed first with completion around 5 years of age. The lumbar NCS was nearly fully closed by age 11. Only the thoracic region remained open through age 17 years. The left and right NCS closed simultaneously as there was no statistical difference between them. In all regions of the spine, the NCS appeared to close sooner in males than in females. Spinal canal area increased with age

  10. Malignant tumor of the parotid gland with metastasis into the cervical vertebra

    International Nuclear Information System (INIS)

    Kimura, Jun; Tsuchiya, Keiichi; Utsumi, Takehiko; Furuki, Shin; Asano, Hisashi.

    1979-01-01

    A patient with malignant tumor of the parotid gland with metastasis into the cervical vertebra was found. Because spinal symptoms were observed at first and the symptoms and the course of the disease were not typical, it was so difficult to diagnose it. For this patient, a parotid gland scintigram with sup(99m)Tc was very useful to diagnose the lesion. The patient was treated with chemotherapy, 60 Co beam therapy and immuno-chemo-therapy and survived about one year and two months more. Cyclo-C (cyclocytidine) was very effective to control the primary lesion in the parotid gland. (Nishio, M.)

  11. 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

  12. An unusual cause of chest pain: Fused cervical vertebra (C3-C4

    Directory of Open Access Journals (Sweden)

    Daipayan Chatterjee

    2014-01-01

    Full Text Available Cervicogenic angina is paroxysmal precordialgia usually due to lower cervical vertebral involvement. But upper cervical vertebral segmental anomaly causing cervicogenic angina is rare. Herein, we report a case of cervicogenic angina due to fused 3 rd and 4 th cervical vertebra in a 37-year female, which was initially misdiagnosed as angina and treated likewise. But, persistence of symptoms led to evaluation of her cervical spine and subsequent diagnosis. Cervical traction, physiotherapy and posture training relieved her of her symptoms with no recurrence till 6 months of follow-up. Fused C3-C4 can be a cause of precordialgia and physicians should be aware of it.

  13. Positive pressure ventilation and cranial volume in newborn infants.

    OpenAIRE

    Milligan, D W

    1981-01-01

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

  14. Imaging assessment of isolated lesions affecting cranial nerve III

    International Nuclear Information System (INIS)

    Garcia, Marcelo de Mattos; Martins, Jose Carlos Tadeu

    2005-01-01

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

  15. Development of a Human Cranial Bone Surrogate for Impact Studies

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  16. Endoscopic transnasal resection of anterior cranial fossa meningiomas.

    Science.gov (United States)

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

    2008-01-01

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

  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. Cranial computed tomography in infantile spasms

    International Nuclear Information System (INIS)

    Howitz, P.; Neergaard, K.; Pedersen, H.

    1990-01-01

    Out of 109 children with infantile spasms (IS), prospectively tested during the years 1976 to 1979 in Denmark, 52 children were examined by cranial computed tomography (CT). The classification of IS into cryptogenic (CR), symptomatic (SY) and doubtful (DO) was done clinically without considering the CT-finding. Sixty per cent of the scannings were abnormal. Only 6/30 (20%) of the children in ACTH treatment were found to develop cerebral atrophy which means that this finding is not an obligatory side-effect of ACTH treatment of children with IS. Normal CT-findings were found in 50% of the CR and 50% of the SY + DO-groups, and could not be used as a prognostic tool for estimating the mental development. This was also the case for children with cerebral atrophy. Abnormal CT-findings (minus atrophy) were highly correlated to the group with clinical symptoms and indicate an extremely unsatisfying long-term mental prognosis. CT-scanning is a valuable tool for the examination of clearing children with infantile spasms. (authors)

  19. Radiation-induced cranial nerve palsy

    International Nuclear Information System (INIS)

    Berger, P.S.; Bataini, J.P.

    1977-01-01

    Twenty-five patients with 35 cranial nerve palsies were seen at the Fondation Curie during follow-up after radical radiotherapy for head and neck tumors. The twelfth nerve was involved in 19 cases, the tenth in nine, and the eleventh in five; the fifth and second nerves were involved once each and in the same patient. The twelfth nerve was involved alone in 16 patients and the tenth nerve alone in three, with multiple nerves involved in the remaining six patients. The palsy was noted from 12 to 145 months after diagnosis of the tumor. The latency period could be correlated with dose so that the least square fit equation representing NSD vs delay is NSD = 2598--Delay (in months) x 4.6, with a correlation coefficient of -0.58. The distinction between tumor recurrence and radiation-induced nerve palsy is critical. It can often be inferred from the latency period but must be confirmed by observation over a period of time

  20. Sagittal synostosis: II. Cranial morphology and growth after the modified pi-plasty

    DEFF Research Database (Denmark)

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

    2006-01-01

    The aim of this study was to characterise the postoperative cranial growth and morphology after a modified pi-plasty for sagittal synostosis. The shape of the skull of 82 patients with isolated premature synostosis of the sagittal suture ( SS group) operated on with a modified pi-plasty was studied...... developed by Kreiborg, which included the digitisation of 89 landmarks of the calvaria, cranial base, and orbit ( 43 in the lateral and 46 in the frontal projections), the production of mean shape plots for each group, and the intergroup comparison of a series of 78 variables ( linear distance between...... selected landmarks, and angles defined by groups of three landmarks). Paired and unpaired t tests were used to assess the differences between the variables studied. These were accepted as significant for values of p...

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  2. [Localized invasive intracranial aspergillosis with multiple cranial nerve failure -- case report and review of the literature].

    Science.gov (United States)

    Winkler, F; Seelos, K; Hempel, J M; Pfister, H-W

    2002-12-01

    Contrary to the more frequent hematogenously spread cerebral aspergillosis, localized invasive intracranial aspergillosis is a fungal infection that can also occur in patients who are not severely immunosuppressed. This illness can be effectively treated in some of these patients by early and rigorous therapy. Localized invasion of the fungus, generally from one of the nasal sinuses, causes intracranial growth mainly along the base of the skull and larger vessels,where fibrous, granulomatous tissue develops. This generally leads to damage of the cranial nerves (primarily I-VI) as well as localized pain syndromes. We report on the clinical course documented by MRI of a patient with localized invasive intracranial aspergillosis who had multiple failure of cranial nerves following surgery for an aspergilloma of the maxillary sinus. Clinical course, imaging findings, and treatment of the illness are discussed with a review of the relevant literature.

  3. An Investigation into the Relationship between Human Cranial and Pelvic Sexual Dimorphism.

    Science.gov (United States)

    Best, Kaleigh C; Garvin, Heather M; Cabo, Luis L

    2017-10-16

    When faced with commingled remains, it might be assumed that a more "masculine" pelvis is associated with a more "masculine" cranium, but this relationship has not been specifically tested. This study uses geometric morphometric analyses of pelvic and cranial landmarks to assess whether there is an intra-individual relationship between the degrees of sexual expression in these two skeletal regions. Principal component and discriminant function scores were used to assess sexual dimorphism in 113 U.S. Black individuals. Correlation values and partial least squares regression (PLS) were used to evaluate intra-individual relationships. Results indicate that the os coxae is more sexually dimorphic than the cranium, with element shape being more sexually dimorphic than size. PLS and correlation results suggest no significant intra-individual relationship between pelvic and cranial sexual size or shape expression. Thus, in commingled situations, associations between these skeletal elements cannot be inferred based on degree of "masculinity." © 2017 American Academy of Forensic Sciences.

  4. Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship?

    Science.gov (United States)

    Uysal, Tancan; Ramoglu, Sabri Ilhan; Basciftci, Faruk Ayhan; Sari, Zafer

    2006-11-01

    The aims of this study were (1) to investigate the relationship between chronologic age and maturation of cervical vertebrae, (2) to identify the relationship between chronologic age and maturation stage evaluated by hand-wrist radiographs, and (3) to determine whether the maturation of cervical vertebrae correlates with maturation indicated by hand-wrist radiographs in a Turkish population. The samples were derived from lateral cephalometric and hand-wrist radiographs of 503 subjects (213 male, 290 female; ages, 5.3-24.1 years). Cervical vertebral development was evaluated by the method of Hassel and Farman. Skeletal maturation of each hand-wrist radiograph was determined according to the method described by Björk and Grave, and Brown's system. The Spearman rank-order correlation coefficients were estimated separately for males and females to measure the relationships among chronologic age, cervical vertebral maturation, and the skeletal maturation measured at the hand-wrist. The Spearman correlation coefficients were 0.72 (P cervical vertebrae skeletal maturation, and 0.79 (P maturation via hand-wrist radiographs. The correlation coefficient between hand-wrist and cervical-vertebrae maturation was 0.86 (P cervical-vertebrae maturation stages are clinically useful maturity indicators of the pubertal growth period Turkish subjects.

  5. 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.

  6. The correlation between R2' and bone mineral measurements in human vertebrae: an in vitro study

    International Nuclear Information System (INIS)

    Brismar, T.B.; Karlsson, M.; Li, T.Q.; Ringertz, H.

    1999-01-01

    The aim of this study was to investigate whether MR imaging of trabecular bone structure using magnetic inhomogeneity measurements is related to the amount of bone mineral in human vertebrae. Weight, bone mineral content (BMC DXA ), bone mineral per area (BMA DXA ) and bone mineral density (BMD CT ) were determined in 12 defatted human lumbar vertebrae (L2-L4) by weighing, dual X-ray absorptiometry (DXA) and CT. Inhomogeneity caused by susceptibility differences between trabecular bone and surrounding water was studied with MR imaging at 1.5 T using the GESFIDE sequence. The pulse sequence determines the transverse relaxation rate R2 * and its two components, the non-reversible transverse relaxation rate (R2) and the reversible transverse relaxation rate (R2'; i. e. relaxation rate due to magnetic susceptibility) in a single scan. Voxel size was 0.9 x 1.9 x 5.0 mm. Positive significant correlations between R2' and weight, BMC DXA , BMA DXA and BMD CT were observed (r > 0.61 and p DXA and BMD CT (r > 0.66 and p DXA . Thus, R2' measurements are related to the amount of bone mineral, but they also provide information which is not obtainable from bone mineral measurements. (orig.) (orig.)

  7. 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.

  8. A review of hedgehog signaling in cranial bone development

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    Angel ePan

    2013-04-01

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

  9. Cranial MR findings in Wilson's disease

    International Nuclear Information System (INIS)

    Saatci, I.; Topcu, M.; Baltaoglu, F.F.; Koese, G.; Yalaz, K.; Renda, Y.; Besim, A.

    1997-01-01

    Purpose: To define various cranial MR appearances in Wilson's disease (WD). Material and Methods: MR examinations of 30 patients (9-44 years old) with WD were retrospectively reviewed. Six patients were asymptomatic siblings. Three other patients had isolated hepatic involvement, one with no symptoms. The remaining 21 patients had neurological involvement, 7 of whom had the mixed form of the disease. Nine patients had hepatic dysfunction, the 3 with isolated hepatic involvement and 6 of the 7 with the mixed form. Results: All symptomatic patients (n=23) had abnormal MR examinations. Atrophy was present in the majority of them. The most frequently involved sites were putamen (18/21) and pons (18/21) in patients with neurological abnormality. The putaminal lesions showed a consistent pattern of symmetric, bilateral, concentric-laminar T2 hyperintensity. Putaminal lesions were lacking in only 3 patients with neurological involvement, all of whom were relatively old and had had the disease for a longer duration. Most of the patients with hepatic dysfunction (8/9) had increased T1 signal intensity in the basal ganglia, particularly in the globus pallidus. Pontine involvement always included the dorsal aspect of the pons, however, in some cases the central portion of pons was also affected but ventrolateral longitudinal fibers were spared. Midbrain (16/21), thalamic (10/21) and caudate nucleus lesions (9/21) were also encountered. In a few patients cortical and subcortical white matter lesions were present with a predilection to the frontal lobe, particularly the precentral region. In one patient, a hemorrhagic focus was identified within the white matter lesion. (orig./VHE)

  10. The cranial MRI in severe cerebral palsy

    International Nuclear Information System (INIS)

    Yamada, Kazutaka; Itoh, Masahiro; Fueki, Noboru; Hirasawa, Kyoko; Suzuki, Noriko; Kurata, Kiyoko; Sato, Junichi; Morimatsu, Yoshio; Yagishita, Akira.

    1993-01-01

    The magnetic resonance examination was performed in 38 patients with severe cerebral palsy (CP; 15 males and 23 females) who had both motor delay (unable to move anywhere) and mental retardation (I.Q. or D.Q. below 30). Neuroimaging findings were compared with the CP type, etiology, and grade of understanding of language. Cranial magnetic resonance imagings (MRI) in CP were divided into five types. In type 1, nine predominantly showed cyst-liked ventricles and periventricular hyperintensity on T 2 -weighted imaging (PVH) and only scarred basal ganglia and thalamus were visible. All suffered from neonatal asphyxia and the clinical type was rigospastic tetraplegia (RST). In type 2, eleven predominantly showed PVH and hyperintensity on T 2 -weighted (HT2) in basal ganglia and thalamus. All suffered from neonatal asphyxia and the clinical type was RST or rigospastic diplegia. In type 3, five showed PVH and three had cortical atrophy. All suffered from neonatal asphyxia and the clinical type was spastic diplegia. In type 4, four predominantly showed HT2 in putamen and thalamus. Three had cortical atrophy. All suffered from neonatal asphyxia. The clinical type was athetotic CP (ATH). In type 5, nine predominantly showed HT2 in globus pallidus. Four had cortical atrophy and two had hippocampal atrophy. All suffered from neonatal jaundice and the clinical type was ATH. All patients who suffered from neonatal asphyxia and spastic CP had MRI in PVH. All patients who suffered from neonatal asphyxia and ATH showed HT2 in putamen and thalamus. Almost patients who suffered from neonatal jaundice and ATH showed HT2 in globus pallidus. With athetotic CP, cases with atrophy of the cerebral cortex and/or hippocampus were lower grade of understanding of language than no atrophy of both. The results of studies of MRI are in agreement with neuropathological findings. (author)

  11. 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

  12. 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.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  14. 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

  15. Verifying three-dimensional skull model reconstruction using cranial index of symmetry.

    Science.gov (United States)

    Kung, Woon-Man; Chen, Shuo-Tsung; Lin, Chung-Hsiang; Lu, Yu-Mei; Chen, Tzu-Hsuan; Lin, Muh-Shi

    2013-01-01

    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). 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. 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% (ppairs signed rank test). These data evidenced the highly accurate symmetry of these CAD models with regular contours. 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.

  16. Idiopathic Ninth, Tenth, and Twelfth Cranial Nerve Palsy with Ipsilateral Headache: A Case Report

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. C7 vertebra homeotic transformation in domestic dogs - are Pug dogs breaking mammalian evolutionary constraints?

    Science.gov (United States)

    Brocal, J; De Decker, S; José-López, R; Manzanilla, E G; Penderis, J; Stalin, C; Bertram, S; Schoenebeck, J J; Rusbridge, C; Fitzpatrick, N; Gutierrez-Quintana, R

    2018-05-14

    The number of cervical vertebrae in mammals is almost constant at seven, regardless of their neck length, implying that there is selection against variation in this number. Homebox (Hox) genes are involved in this evolutionary mammalian conservation, and homeotic transformation of cervical into thoracic vertebrae (cervical ribs) is a common phenotypic abnormality when Hox gene expression is altered. This relatively benign phenotypic change can be associated with fatal traits in humans. Mutations in genes upstream of Hox, inbreeding and stressors during organogenesis can also cause cervical ribs. The aim of this study was to describe the prevalence of cervical ribs in a large group of domestic dogs of different breeds, and explore a possible relation with other congenital vertebral malformations (CVMs) in the breed with the highest prevalence of cervical ribs. By phenotyping we hoped to give clues as to the underlying genetic causes. Twenty computed tomography studies from at least two breeds belonging to each of the nine groups recognized by the Federation Cynologique Internationale, including all the brachycephalic 'screw-tailed' breeds that are known to be overrepresented for CVMs, were reviewed. The Pug dog was more affected by cervical ribs than any other breed (46%; P < 0.001), and was selected for further analysis. No association was found between the presence of cervical ribs and vertebral body formation defect, bifid spinous process, caudal articular process hypoplasia/aplasia and an abnormal sacrum, which may infer they have a different aetiopathogenesis. However, Pug dogs with cervical ribs were more likely to have a transitional thoraco-lumbar vertebra (P = 0.041) and a pre-sacral vertebral count of 26 (P < 0.001). Higher C7/T1 dorsal spinous processes ratios were associated with the presence of cervical ribs (P < 0.001), supporting this is a true homeotic transformation. Relaxation of the stabilizing selection has likely occurred, and

  19. FGF9 can induce endochondral ossification in cranial mesenchyme

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    Overbeek Paul A

    2006-02-01

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

  20. 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.

  1. Neurovascular compression syndrome of the eighth cranial nerve

    International Nuclear Information System (INIS)

    Itoh, Akinori

    2010-01-01

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

  2. Neurovascular compression syndrome of the eighth cranial nerve

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-04-15

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

  3. 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).

  4. Quantification of bone mineral density at 3rd lumbar vertebra by dual photon absorptiometry

    International Nuclear Information System (INIS)

    Fukunaga, Masao; Otsuka, Nobuaki; Ono, Shimato; Nagai, Kiyohisa; Muranaka, Akira; Furukawa, Takako; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Morita, Rikushi

    1987-01-01

    To know bone mineral content of both cortical and spongy bones with aging and pathologic changes, bone mineral density (BMD) in the 3rd lumbar vertebra (L3) and distal radius (DR) was measured using dual photon absorptiometry and single photon absorptiometry, respectively, in 151 normal subjects (N) and four patients with primary hyperparathyroidism (PHP). In the N group, BMD in both L3 and DR decreased with aging. This was more noted, and occurred earlier in L3, irrespective of sex, than DR. In three PHP patients manifested as bone type, BMD was high in L3, and low in DR. Such a tendency was not seen in the remaining one patient with stone type PHP. The findings suggest the need to measure BMD in both cortical (L3) and spongy (DR) bones for elucidating bone pathophysiology in metabolic bone disease. (Namekawa, K.)

  5. 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.

  6. Fat-containing lesions in vertebrae and spinal canal: a pictorial review

    International Nuclear Information System (INIS)

    Jeon, Jeong A; Yoo, Won Jong; Lim, Yeon Soo; Kim, Young Joo; Lee, Eun Ja; Sung, Mi Sook; Chung, Myung Hee; Lee, Hae Giu

    2007-01-01

    The recent development of image techniques, including computed tomography and magnetic resonance imaging, plays an important role in the diagnosis and treatment of spinal disease. A variety of lesions in the spine may contain fat tissue, and these lesions have the possibility of being benign or malignancy. The principle of treatment varies depending on the characteristics of the lesions. The purpose of this pictorial assay is to document the radiologic findings to help physicians make the correct diagnosis, to confirm the characteristics and the extent of the lesion, to anticipate the prognosis and to select and decide upon the therapeutic method when a fat-containing lesion is located in the spinal vertebrae and/or spinal canal

  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. Transitional Vertebra and Spina Bifida Occulta Related with Chronic Low Back Pain in a Young Patient.

    Science.gov (United States)

    Kundi, Maryam; Habib, Maham; Babar, Sumbal; Kundi, Asif K; Assad, Salman; Sheikh, Amjad

    2016-10-19

    Bertolotti's syndrome (BS) must be considered as a differential diagnosis in a young patient presenting with low back pain (LBP). We present a case of a 26-year-old male complaining of mild chronic LBP for six years, radiating to his left thigh for the past six months. He has been taking non-steroidal anti-inflammatory drugs (NSAIDs) with skeletal muscle relaxants for pain relief. The X-ray and computed tomography (CT) imagings showed congenital enlargement of the left transverse process of the fifth lumbar (L5) vertebra forming pseudo-articulation with the sacrum and unilateral pars interarticularis defect at the L4 level on the left side, respectively. He has managed with gabapentin 100 mg three times a day for his neuropathic left leg pain. On follow-up, the patient reported that his pain has improved with gabapentin and it decreased from 8/10 to 4/10 on the visual analogue scale.

  9. Maturation of the middle phalanx of the third finger and cervical vertebrae: a comparative and diagnostic agreement study.

    Science.gov (United States)

    Perinetti, G; Perillo, L; Franchi, L; Di Lenarda, R; Contardo, L

    2014-11-01

    Diagnostic agreement on individual basis between the third middle phalanx maturation (MPM) method and the cervical vertebral maturation (CVM) method has conjecturally been based mainly on overall correlation analyses. Herein, the true agreement between methods according to stage and sex has been evaluated through a comprehensive diagnostic performance analysis. Four hundred and fifty-one Caucasian subjects were included in the study, 231 females and 220 males (mean age, 12.2 ± 2.5 years; range, 7.0-17.9 years). The X-rays of the middle phalanx of the third finger and the lateral cephalograms were examined for staging by blinded operators, blinded for MPM stages and subjects' age. The MPM and CVM methods based on six stages, two pre-pubertal (1 and 2), two pubertal (3 and 4), and two post-pubertal (5 and 6), were considered. Specifically, for each MPM stage, the diagnostic performance in the identification of the corresponding CVM stage was described by Bayesian statistics. For both sexes, overall agreement was 77.6%. Most of the disagreement was due to 1 stage apart. Slight disagreement was seen for the stages 5 and 6, where the third middle phalanx shows an earlier maturation. The two maturational methods show an overall satisfactorily diagnostic agreement. However, at post-pubertal stages, the middle phalanx of the third finger appears to mature earlier than the cervical vertebrae. Post-pubertal growth phase should thus be based on the presence of stage 6 in MPM. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2007-04-01

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

  11. Radiographic assessment of skeletal maturation stages for orthodontic patients: hand-wrist bones or cervical vertebrae?

    Science.gov (United States)

    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

    2008-04-01

    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. 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 709 lateral cephalometric radiographs were analyzed. Hand-wrist maturation stages were assessed using National Taiwan University Hospital Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages were determined by the latest Cervical Vertebral Maturation Stage (CVMS) Index. Spearman's rank correlation was used to correlate the respective maturation stages assessed from the hand-wrist bones and the cervical vertebrae. The values of Spearman's rank correlation were 0.910 for males and 0.937 for females, respectively. These data confirmed a strong and significant correlation between CVMS and NTUH-SMI systems (p less than 0.001). After comparison of the mean ages of subjects in different stages of CVMS and NTU-SMI systems, we found that CVMS I corresponded to NTUH-SMI stages 1 and 2, CVMS II to NTUH-SMI stage 3, CVMS III to NTUHSMI stage 4, CVMS IV to NTUH-SMI stage 5, CVMS V to NTUH-SMI stages 6, 7 and 8, and CVMS VI to NTUH-SMI stage 9. Our results indicate that cervical vertebral maturation stages can be used to replace hand-wrist bone maturation stages for evaluation of skeletal maturity in Taiwanese individuals.

  12. 3D Printed, Customized Cranial Implant for Surgical Planning

    Science.gov (United States)

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

    2018-06-01

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

  13. X-ray appearance of cranial lesions in hyperparathyroid osteodystuophy

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  14. The Biomechanics of Cranial Forces During Figure Skating Spinning Elements.

    Science.gov (United States)

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

    2015-03-01

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

  15. Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery

    Science.gov (United States)

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

    2014-01-01

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

  16. Cranial nerve injury after Le Fort I osteotomy.

    Science.gov (United States)

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

    2011-03-01

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

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

    Science.gov (United States)

    Stino, Amro M; Smith, Benn E

    2018-01-01

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

  18. Cranial computed tomography in patients with Bourneville-Pringle phacomatosis

    International Nuclear Information System (INIS)

    Takada, Minoru; Kurata, Yukio; Hirone, Takae

    1987-01-01

    Cranial computed tomography (CT) was undertaken in 17 patients (0 - 38 years) with Bourneville-Pringle phacomatosis, some of whom presented with epilepsy episodes and mental retardation. Intracranial calcification was seen on CT in 10 patients (59 %), including a 2-month-old baby. This suggests the potential of CT in the diagnosis of tuberous sclerosis for infants, which has been considered difficult by conventional roentgenography. The most frequent site of calcilfication was ventricular wall. High incidences of eye lesions (67 %), psycho-neurologic symptoms (80 %), and abnormal EEG (50 %) were found in patients with cranial calficication on CT, in contrast to patients without it (0 %, 0 %, and 40 %, respectively). (Namekawa, K.)

  19. Triptans and CGRP blockade - impact on the cranial vasculature

    DEFF Research Database (Denmark)

    Benemei, Silvia; Cortese, Francesca; Labastida-Ramírez, Alejandro

    2017-01-01

    and vascular tone. Thirty years after discovery of agonists for serotonin 5-HT1B and 5-HT1D receptors (triptans) and less than fifteen after the proof of concept of the gepant class of CGRP receptor antagonists, we are still a long way from understanding their precise site and mode of action in migraine....... The effect on cranial vasculature is relevant, because all specific anti-migraine drugs and migraine pharmacological triggers may act in perivascular space. This review reports the effects of triptans and CGRP blocking molecules on cranial vasculature in humans, focusing on their specific relevance...

  20. Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia.

    Science.gov (United States)

    Kirsch, Daniel L; Nichols, Francine

    2013-03-01

    Cranial electrotherapy stimulation is a prescriptive medical device that delivers a mild form of electrical stimulation to the brain for the treatment of anxiety, depression, and insomnia. It is supported by more than 40 years of research demonstrating its effectiveness in several mechanistic studies and greater than 100 clinical studies. Adverse effects are rare (<1%), mild, and self-limiting, consisting mainly of skin irritation under the electrodes and headaches. Often used as a stand-alone therapy, because results are usually seen from the first treatment, cranial electrotherapy stimulation may also be used as an adjunctive therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. [Cranial nerve damage after neuroaxial methods of anesthesia in puerperas].

    Science.gov (United States)

    Floka, S E; Shifman, E M

    2007-01-01

    The paper describes cranial nerve damage, a rare complication of neuroaxial anesthesia in obstetric care. In the literature, there are summarized data on 17 cases of neurological deficit developing after subarachnoidal or epidural anesthesia in puerperas. The etiological and pathogenetic factors of the above complications may be suggested to be the high disposition of a local anesthetic, arterial hypotension due to neuroaxial anesthetics, the outflow of cerebrospinal fluid after pachymeningeal puncture (including after unintended puncture during epidural anesthesia), and ischemic injury after the blood packing performed to relieve postpuncture headache. Closer consideration of these risk factors seems to reduce the incidence of cranial nerve damage in puerperas.

  2. Primary spondylolysis of the axis vertebra (C/sub 2/) in the children, including one with pyknodysostosis

    Energy Technology Data Exchange (ETDEWEB)

    Currarino, G.

    1989-08-01

    This report describes 3 children with a cleft in the pedicles of the second cervical vertebra of uncertain cause. One of these patients had pyknodysostosis. Previous instances of such defects in the literature are reviewed with some considerations on the possible nature of the lesion. (orig.).

  3. Genetic factors have a major effect on growth, number of vertebrae and otolith shape in Atlantic herring (Clupea harengus).

    Science.gov (United States)

    Berg, Florian; Almeland, Oda W; Skadal, Julie; Slotte, Aril; Andersson, Leif; Folkvord, Arild

    2018-01-01

    Atlantic herring, Clupea harengus, have complex population structures. Mixing of populations is known, but the extent of connectivity is still unclear. Phenotypic plasticity results in divergent phenotypes in response to environmental factors. A marked salinity gradient occurs from Atlantic Ocean (salinity 35) into the Baltic Sea (salinity range 2-12). Herring from both habitats display phenotypic and genetic variability. To explore how genetic factors and salinity influence phenotypic traits like growth, number of vertebrae and otolith shape an experimental population consisting of Atlantic purebreds and Atlantic/Baltic F1 hybrids were incubated and co-reared at two different salinities, 16 and 35, for three years. The F1-generation was repeatedly sampled to evaluate temporal variation. A von Bertalanffy growth model indicated that reared Atlantic purebreds had a higher maximum length (26.2 cm) than Atlantic/Baltic hybrids (24.8 cm) at salinity 35, but not at salinity 16 (25.0 and 24.8 cm, respectively). In contrast, Atlantic/Baltic hybrids achieved larger size-at-age than the wild caught Baltic parental group. Mean vertebral counts and otolith aspect ratios were higher for reared Atlantic purebreds than Atlantic/Baltic hybrids, consistent with the differences between parental groups. There were no significant differences in vertebral counts and otolith aspect ratios between herring with the same genotype but raised in different salinities. A Canonical Analysis of Principal Coordinates was applied to analyze the variation in wavelet coefficients that described otolith shape. The first discriminating axis identified the differences between Atlantic purebreds and Atlantic/Baltic hybrids, while the second axis represented salinity differences. Assigning otoliths based on genetic groups (Atlantic purebreds vs. Atlantic/Baltic hybrids) yielded higher classification success (~90%) than based on salinities (16 vs. 35; ~60%). Our results demonstrate that otolith shape and

  4. Genetic factors have a major effect on growth, number of vertebrae and otolith shape in Atlantic herring (Clupea harengus.

    Directory of Open Access Journals (Sweden)

    Florian Berg

    Full Text Available Atlantic herring, Clupea harengus, have complex population structures. Mixing of populations is known, but the extent of connectivity is still unclear. Phenotypic plasticity results in divergent phenotypes in response to environmental factors. A marked salinity gradient occurs from Atlantic Ocean (salinity 35 into the Baltic Sea (salinity range 2-12. Herring from both habitats display phenotypic and genetic variability. To explore how genetic factors and salinity influence phenotypic traits like growth, number of vertebrae and otolith shape an experimental population consisting of Atlantic purebreds and Atlantic/Baltic F1 hybrids were incubated and co-reared at two different salinities, 16 and 35, for three years. The F1-generation was repeatedly sampled to evaluate temporal variation. A von Bertalanffy growth model indicated that reared Atlantic purebreds had a higher maximum length (26.2 cm than Atlantic/Baltic hybrids (24.8 cm at salinity 35, but not at salinity 16 (25.0 and 24.8 cm, respectively. In contrast, Atlantic/Baltic hybrids achieved larger size-at-age than the wild caught Baltic parental group. Mean vertebral counts and otolith aspect ratios were higher for reared Atlantic purebreds than Atlantic/Baltic hybrids, consistent with the differences between parental groups. There were no significant differences in vertebral counts and otolith aspect ratios between herring with the same genotype but raised in different salinities. A Canonical Analysis of Principal Coordinates was applied to analyze the variation in wavelet coefficients that described otolith shape. The first discriminating axis identified the differences between Atlantic purebreds and Atlantic/Baltic hybrids, while the second axis represented salinity differences. Assigning otoliths based on genetic groups (Atlantic purebreds vs. Atlantic/Baltic hybrids yielded higher classification success (~90% than based on salinities (16 vs. 35; ~60%. Our results demonstrate that

  5. SU-F-T-642: Sub Millimeter Accurate Setup of More Than Three Vertebrae in Spinal SBRT with 6D Couch

    International Nuclear Information System (INIS)

    Wang, X; Zhao, Z; Yang, J; Yang, J; McAleer, M; Brown, P; Li, J; Ghia, A

    2016-01-01

    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.

  6. 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.

  7. Cross sectional CT morphology of the three lower lumbar vertebrae: with contributions to a more accurate interpretation of AP radiographs of the lumbar spine

    International Nuclear Information System (INIS)

    Schaik, J.P.J. van.

    1984-01-01

    This thesis is concerned with a cross-sectional morphological analysis of certain structures contained in the bony portion of the motion segments between L3 and S1, the vertebral bodies included. Measurements of lengths and angles were based on the use of constant reference points, which permitted comparative studies. Reference points were selected which were sufficiently well defined as to avoid gross errors in measurements. The lateral borders of the vertebral body of L3 are well visualized in AP radiographs, as well as the entire circumference of the pedicles. The bony cortical margins of these structures are more or less orientated in a sagittal direction, and are therefore caught by the X ray beam tangentially over the major part of their length. This tangential projection results in a sharp definition of these margins. Radiographic analysis of wired specimens of lumbar vertebrae showed that the shadow cast by the spinous process in the AP projection corresponds with its posterior portion. (Auth.)

  8. Clinical and cranial computed tomography scan findings in adults ...

    African Journals Online (AJOL)

    Headache was the most common clinical variable followed by dizziness and aphasia. The most common CT characteristic was extra cerebral haemorrhage followed by brain oedema and raised Intra-cranial pressure (ICP). Intra-cerebral haemorrhage was commonest in the frontal lobe followed by parietal lobe. Conclusion: ...

  9. Clinical and cranial computed tomography scan findings in adults ...

    African Journals Online (AJOL)

    Results: Seventy seven percent of the respondents were between 18- 39 years. ... cerebral haemorrhage followed by brain oedema and raised Intra-cranial pressure (ICP). ... like advocacy and education of the population on safe and responsible road usage ... studies were done over ten years ago, could the pattern of head ...

  10. Development of Cranial Bone Surrogate Structures Using Stereolithographic Additive Manufacturing

    Science.gov (United States)

    2017-09-29

    Additive Manufacturing by Jared M Gardner and Thomas A Plaisted Approved for public release; distribution is unlimited...Laboratory Development of Cranial Bone Surrogate Structures Using Stereolithographic Additive Manufacturing by Thomas A Plaisted Weapons...Structures Using Stereolithographic Additive Manufacturing 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jared

  11. 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

  12. 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.

  13. 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

  14. 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 ...

  15. Is phenytoin contraindicated in patients receiving cranial irradiation?

    International Nuclear Information System (INIS)

    Borg, M.F.; Probert, J.C.; Zwi, L.J.

    1995-01-01

    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

  16. Development and Functional Organization of the Cranial Nerves in Lampreys.

    Science.gov (United States)

    Pombal, Manuel A; Megías, Manuel

    2018-04-16

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

  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. Postnatal cranial ultrasonographic findings in feto-fetal transfusion syndrome.

    NARCIS (Netherlands)

    Breysem, L.; Naulaers, G.; Deprest, J.; Schoubroeck, D.V.; Daniels, H.; Lammens, M.M.Y.; Smet, M.H.

    2002-01-01

    Our objective was a retrospective evaluation of cranial US in survivors of twin pregnancy with feto-fetal transfusion syndrome (FFTS), with knowledge of prenatal treatment and neonatal/postnatal clinical data. In 18 pregnancies with FFTS (January 1996 to May 2000), pregnancy management and outcome,

  19. Ocular cranial nerve palsies secondary to sphenoid sinusitis

    Institute of Scientific and Technical Information of China (English)

    Aiman El Mograbi; Ethan Soudry

    2017-01-01

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

  20. Testing the cranial evolutionary allometric 'rule' in Galliformes.

    Science.gov (United States)

    Linde-Medina, M

    2016-09-01

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

  1. Dexamethasone minimizes the risk of cranial nerve injury during CEA.

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2012-06-01

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

  3. 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.

  4. Tolerance of cranial nerves of the cavernous sinus to radiosurgery

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  5. Cranial suture biology of the Aleutian Island inhabitants.

    Science.gov (United States)

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

    2011-04-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

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

    Science.gov (United States)

    Gard, Graham

    2009-07-01

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

  8. Relationship between fractures of the vertebrae and presence of spinal haematoma

    Energy Technology Data Exchange (ETDEWEB)

    Boroda, L; Stankovic, D [Urgent Centre, University Clinical Centre, Pasterova 2, Belgrade, Serbia, Yugoslavia (Yugoslavia); Drndarski, B [Institute of Oncology and Radiology, Pasterova 144, Belgrade, Serbia, Yugoslavia (Yugoslavia); Bajic, R [Department of Radiology, Institute of Neurosurgery, University Clinical Centre, Visegradska, Belgrade, Serbia, Yugoslavia (Yugoslavia)

    1994-12-31

    Thirty-eight patients with fractured vertebrae were involved in our study. Patients were evaluated by standard plain radiographs of the spine, myelographies and post-myelographic computed tomographies of the damaged part of the spine. The aim of the study was to give an answer to the question if there is difference between frequency of the appearance of spinal haematoma in patients with fractured vertebral bodies and in patients with fractured vertebral arches. For that reason all patients were divided into two groups. Trauma of the spine was followed by spinal haematoma in the first group of the patients, whereas in the second group of patients spinal haematoma was not evidenced. The number of the fractured vertebral bodies and fractured vertebral arches in both groups of the patients were determined. Differences between these numbers were tested by chi square test. We concluded that fractures of the vertebral bodies and of the vertebral arches are followed by spinal haematoma in the same degree. (authors). 6 refs., 2 figs.

  9. Relationship between fractures of the vertebrae and presence of spinal haematoma

    International Nuclear Information System (INIS)

    Boroda, L.; Stankovic, D.; Drndarski, B.; Bajic, R.

    1994-01-01

    Thirty-eight patients with fractured vertebrae were involved in our study. Patients were evaluated by standard plain radiographs of the spine, myelographies and post-myelographic computed tomographies of the damaged part of the spine. The aim of the study was to give an answer to the question if there is difference between frequency of the appearance of spinal haematoma in patients with fractured vertebral bodies and in patients with fractured vertebral arches. For that reason all patients were divided into two groups. Trauma of the spine was followed by spinal haematoma in the first group of the patients, whereas in the second group of patients spinal haematoma was not evidenced. The number of the fractured vertebral bodies and fractured vertebral arches in both groups of the patients were determined. Differences between these numbers were tested by chi square test. We concluded that fractures of the vertebral bodies and of the vertebral arches are followed by spinal haematoma in the same degree. (authors)

  10. Unicameral bone cyst in the spinous process of a thoracic vertebra.

    Science.gov (United States)

    Tsirikos, Athanasios I; Bowen, J Richard

    2002-10-01

    Unicameral bone cysts affecting the spine are extremely rare and tend to be misdiagnosed. We report on a 17-year-old female patient who presented with a 2-year history of persistent low back pain. The radiographic evaluation and bone scan failed to reveal a pathologic process. Magnetic resonance of the painful area and subsequent computed tomography scan showed a well-circumscribed osteolytic lesion originating from the spinous process and extending into both laminae of T9 vertebra. Aneurysmal bone cyst or osteoblastoma was considered to be the most probable diagnosis. The patient underwent excisional biopsy of the tumor. The intraoperative findings were suggestive of solitary bone cyst, a diagnosis that was confirmed histologically. Because the tumor had not invaded the articular facets, no posterolateral spine fusion was required. The patient had an unremarkable postoperative clinical course. Her symptoms resolved and she returned to her previous level of physical activities. Unicameral bone cysts, although uncommon, should be included in the differential diagnosis of an osteolytic lesion involving the spine.

  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. Transverse maxillary deficit and its influence on the cervical vertebrae maturation index.

    Science.gov (United States)

    Cossellu, G; Farronato, G; Nicotera, O; Biagi, R

    2016-06-01

    The aim of this study is to evaluate whether a transverse maxillary deficit can cause an alteration of vertebral development and therefore of the skeletal maturation comparing the cervical maturation stages index with the hand-wrist index. For the study were selected 200 patients aged 7-14 years, equally distributed by gender and divided into 100 study subjects with maxillary deficit and 100 controls without maxillary deficit. The skeletal maturation index (SM according to Fishman) was evaluated and compared with the hand-wrist x-rays and the cervical vertebrae maturation (CVM according to Hassel and Farmann). Forty-one per cent of the subjects in the test group show a discrepancy between CVM and SM. Among these 73% (30 subjects) present an advanced stage of CVM compared with the corresponding SM. Only 16% of the subjects in the control group show a discrepancy between CVM and SM. Among these 69% (11 subjects) appear in an advanced CVM stage. The analysis of the CVM stage in subjects with transverse maxillary deficit appears to be altered compared with the SM identified through a hand-wrist x-ray. In the case of individuals with transverse maxillary deficit it is advisable to use also a hand-wrist x-ray, thus not relying only on CVM for the evaluation of the skeletal growth stages.

  13. Usefulness of pinhole collimator in differential diagnosis of metastatic disease and degenerative joint disease in the vertebrae

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Kawahara, Syunji; Ishibashi, Akihiko; Tamura, Kohei; Tsukatani, Yasushi; Fujii, Hiroshi; Kubo, Atsushi; Hashimoto, Shozo.

    1989-01-01

    In order to evaluate the diagnostic efficacy of pinhole collimator (PHC) imaging combined with an X-ray for vertebral metastasis, our prospective study has employed receiver operating characteristics (ROC) analysis in 21 patients, 11 with osseous metastasis and 15 with degenerative joint disease in the lumbar vertebrae. PHC imaging provided better anatomic information on the extent of 99m Tc-MDP accumulation. PHC vertebral scintigraphy had a considerable impact on the decision-making process, although with variations and not very satisfactory results among the physicians with little experience. Our study suggests that PHC imaging and X-ray film are useful in differentiating between osseous metastasis and degenerative joint disease in the vertebra. (author)

  14. Early injuries on the tibia and vertebrae of the mouse after incorporation of thorium 227 and radium 224

    Energy Technology Data Exchange (ETDEWEB)

    Poemsl, H

    1974-08-06

    After incorporation of 5 and 50 ..mu..Ci/kg thorium 227 as well as 25 ..mu..Ci/kg radium 224, the tibia and lumbar vertebrae of the mouse were histologically and, using cell counting, morphometrically investigated within a period of 12 weeks. Osteoblasts and mesenchymal cells proved to be the most sensitive to radiation. They were temporarily decimated after 25 ..mu..Ci/kg radium 224 in the tibial metaphysis, but soon regenerated. After 5 ..mu..Ci/kg thorium 227, osteoblasts and mesenchymal cells were only slightly reduced, but more so in the lumbar vertebrae than in the tibia. The cells of osteogenic tissue were almost completely killed by 50 ..mu..Ci/kg thorium 227. In the subsequent regeneration phase, larger regions of atypical bone occured in the tibia metaphysis which was pushed off in the further course by newly formed compact substance of epiphysial cartilage.

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  16. Bone-marrow densitometry: Assessment of marrow space of human vertebrae by single energy high resolution-quantitative computed tomography

    International Nuclear Information System (INIS)

    Peña, Jaime A.; Damm, Timo; Bastgen, Jan; Barkmann, Reinhard; Glüer, Claus C.; Thomsen, Felix; Campbell, Graeme M.

    2016-01-01

    Purpose: Accurate noninvasive assessment of vertebral bone marrow fat fraction is important for diagnostic assessment of a variety of disorders and therapies known to affect marrow composition. Moreover, it provides a means to correct fat-induced bias of single energy quantitative computed tomography (QCT) based bone mineral density (BMD) measurements. The authors developed new segmentation and calibration methods to obtain quantitative surrogate measures of marrow-fat density in the axial skeleton. Methods: The authors developed and tested two high resolution-QCT (HR-QCT) based methods which permit segmentation of bone voids in between trabeculae hypothesizing that they are representative of bone marrow space. The methods permit calculation of marrow content in units of mineral equivalent marrow density (MeMD). The first method is based on global thresholding and peeling (GTP) to define a volume of interest away from the transition between trabecular bone and marrow. The second method, morphological filtering (MF), uses spherical elements of different radii (0.1–1.2 mm) and automatically places them in between trabeculae to identify regions with large trabecular interspace, the bone-void space. To determine their performance, data were compared ex vivo to high-resolution peripheral CT (HR-pQCT) images as the gold-standard. The performance of the methods was tested on a set of excised human vertebrae with intact bone marrow tissue representative of an elderly population with low BMD. Results: 86% (GTP) and 87% (MF) of the voxels identified as true marrow space on HR-pQCT images were correctly identified on HR-QCT images and thus these volumes of interest can be considered to be representative of true marrow space. Within this volume, MeMD was estimated with residual errors of 4.8 mg/cm 3 corresponding to accuracy errors in fat fraction on the order of 5% both for GTP and MF methods. Conclusions: The GTP and MF methods on HR-QCT images permit noninvasive

  17. Bone-marrow densitometry: Assessment of marrow space of human vertebrae by single energy high resolution-quantitative computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Peña, Jaime A.; Damm, Timo; Bastgen, Jan; Barkmann, Reinhard; Glüer, Claus C., E-mail: glueer@rad.uni-kiel.de [Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Campus Kiel, Kiel 24118 (Germany); Thomsen, Felix [Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Sur, Bahía Blanca 8000 (Argentina); Campbell, Graeme M. [Sektion Biomedizinische Bildgebung, Klinik für Radiologie und Neuroradiologie, Christian-Albrechts-Universität zu Kiel, Campus Kiel, Kiel 24118, Germany and Institut für Biomechanik, Technische Universität Hamburg-Harburg (TUHH), Hamburg 21073 (Germany)

    2016-07-15

    Purpose: Accurate noninvasive assessment of vertebral bone marrow fat fraction is important for diagnostic assessment of a variety of disorders and therapies known to affect marrow composition. Moreover, it provides a means to correct fat-induced bias of single energy quantitative computed tomography (QCT) based bone mineral density (BMD) measurements. The authors developed new segmentation and calibration methods to obtain quantitative surrogate measures of marrow-fat density in the axial skeleton. Methods: The authors developed and tested two high resolution-QCT (HR-QCT) based methods which permit segmentation of bone voids in between trabeculae hypothesizing that they are representative of bone marrow space. The methods permit calculation of marrow content in units of mineral equivalent marrow density (MeMD). The first method is based on global thresholding and peeling (GTP) to define a volume of interest away from the transition between trabecular bone and marrow. The second method, morphological filtering (MF), uses spherical elements of different radii (0.1–1.2 mm) and automatically places them in between trabeculae to identify regions with large trabecular interspace, the bone-void space. To determine their performance, data were compared ex vivo to high-resolution peripheral CT (HR-pQCT) images as the gold-standard. The performance of the methods was tested on a set of excised human vertebrae with intact bone marrow tissue representative of an elderly population with low BMD. Results: 86% (GTP) and 87% (MF) of the voxels identified as true marrow space on HR-pQCT images were correctly identified on HR-QCT images and thus these volumes of interest can be considered to be representative of true marrow space. Within this volume, MeMD was estimated with residual errors of 4.8 mg/cm{sup 3} corresponding to accuracy errors in fat fraction on the order of 5% both for GTP and MF methods. Conclusions: The GTP and MF methods on HR-QCT images permit noninvasive

  18. Comparison of Expansive Pedicle Screw and Polymethylmethacrylate-Augmented Pedicle Screw in Osteoporotic Sheep Lumbar Vertebrae: Biomechanical and Interfacial Evaluations

    OpenAIRE

    Liu, Da; Zhang, Yi; Zhang, Bo; Xie, Qing-yun; Wang, Cai-ru; Liu, Jin-biao; Liao, Dong-fa; Jiang, Kai; Lei, Wei; Pan, Xian-ming

    2013-01-01

    BACKGROUND: It was reported that expansive pedicle screw (EPS) and polymethylmethacrylate-augmented pedicle screw (PMMA-PS) could be used to increase screw stability in osteoporosis. However, there are no studies comparing the two kinds of screws in vivo. Thus, we aimed to compare biomechanical and interfacial performances of EPS and PMMA-PS in osteoporotic sheep spine. METHODOLOGY/PRINCIPAL FINDINGS: After successful induction of osteoporotic sheep, lumbar vertebrae in each sheep were random...

  19. Contribution on the causes of increased degrees of density in the cervical vertebrae during routine skeletal scintiscanning

    International Nuclear Information System (INIS)

    Winkler, U.

    1987-01-01

    On the basis of the findings revealed by this study the scintigraphic image and site of degenerative changes in the in region of the cervical vertebrae (routine examinations in a total of 61 patients) were rated as typical enough to permit benign skeletal diseases to be diagnosed and identified in the majority of cases, the additional use of X-ray procedures thus being rendered superfluous. (TRV) [de

  20. Protective role of lycopene against damage induced in liver, lung and vertebrae of gamma irradiated rat fetus

    International Nuclear Information System (INIS)

    Ismail, N.H.; Ramadan, F.L.

    2007-01-01

    The present study was designed to investigate the protective effects of lycopene (0.9 mg/100 g/day) orally given pre and post gamma irradiation on the histological changes in the liver, lung and vertebrae of fetuses. Four groups of pregnant female rats were irradiated as follows: first group represented control (C), second group treated with lycopene (L), third group exposed to radiation (R) and fourth group exposed to radiation and treated with lycopene (R+L). Pregnant female rats of group 3 and 4 were exposed to gamma irradiation at a dose level of 1.5 Gy at day 5 and 1.5 Gy at day 10 of gestation. All groups were sacrificed on day 20 of gestation. Histological results showed serious injury in the liver after exposure to gamma irradiation, where hemo siderosis was noted surrounding the dilated central vein and hepatocytes were atrophied with depression in the hemopoiesis process. Lung sections of fetuses maternally subjected to 1.5 Gy at day 5 and at day 10 of gestation and inspected on day 20 of gestation exhibited dilated and atrophied air alveoli with flattened lining epithelium. Vertebrae of these fetuses showed reductions in number of mitoses and disorderly maturation followed by the asymptomatic degeneration and necrosis of less mature element and bleeding in the periosteum of vertebra. Oral administration of lycopene pre and post gamma irradiation markedly reduced the radiation injury and showed marked protection against the liver and lung damaging effects of irradiation. On the other hand, the vertebrae sections showed no protective role of lycopene from the irradiation damage. Therefore, it may be suggested that lycopene, a potent antioxidant, can attenuate radiation injuries in certain organ

  1. Validity of the assessment method of skeletal maturation by cervical vertebrae: a systematic review and meta-analysis

    Science.gov (United States)

    Bittencourt, M A V; Paranhos, L R

    2015-01-01

    Objectives: To perform a systematic review with meta-analysis to answer the question: is the cervical vertebrae maturation index (CVMI) effective to replace hand–wrist radiograph (gold standard) in determining the pubertal growth spurt in patients undergoing bone growth? Methods: A search in three databases was performed, in which studies were selected that compared one of the two main assessment methods for cervical vertebrae (Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995; 107: 58–66, or Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002; 72: 316–23) to a carpal assessment method. The main methodological data from each of the texts were collected and tabulated after. Later, the meta-analysis of the correlation coefficients obtained was performed. Results: 19 articles were selected from an initial 206 articles collected. Regardless of the method used, the results of the meta-analysis showed that every article selected presented a positive correlation between skeletal maturation assessment performed by cervical vertebrae and carpal methods, with discrepancy of values between genders indicating higher correlation for the female gender (0.925; 0.878) than for the male (0.879; 0.842). When the assessment was performed without gender separation, correlation was significant (0.592; 0.688) but lower in the cases when genders were separated. Conclusions: With the results of this meta-analysis, it is safe to affirm that both CVMIs used in the present study are reliable to replace the hand–wrist radiograph in predicting the pubertal growth spurt, considering that the highest values were found in female samples, especially in the method by Hassel and Farman. PMID:25521202

  2. Osteology of the dorsal vertebrae of the giant titanosaurian sauropod dinosaur Dreadnoughtus schrani from the Late Cretaceous of Argentina

    Directory of Open Access Journals (Sweden)

    Kristyn K. Voegele

    2017-11-01

    Full Text Available Many titanosaurian dinosaurs are known only from fragmentary remains, making comparisons between taxa difficult because they often lack overlapping skeletal elements. This problem is particularly pronounced for the exceptionally large-bodied members of this sauropod clade. Dreadnoughtus schrani is a well-preserved giant titanosaurian from the Upper Cretaceous (Campanian–Maastrichtian Cerro Fortaleza Formation of southern Patagonia, Argentina. Numerous skeletal elements are known for Dreadnoughtus, including seven nearly complete dorsal vertebrae and a partial dorsal neural arch that collectively represent most of the dorsal sequence. Here we build on our previous preliminary description of these skeletal elements by providing a detailed assessment of their serial positional assignments, as well as comparisons of the dorsal vertebrae of Dreadnoughtus with those of other exceptionally large-bodied titanosaurians. Although the dorsal elements of Dreadnoughtus probably belong to two individuals, they exhibit substantial morphological variation that suggests that there is minimal, if any, positional overlap among them. Dreadnoughtus therefore preserves the second-most complete dorsal vertebral series known for a giant titanosaurian that has been described in detail, behind only that of Futalognkosaurus. The dorsal sequence of Dreadnoughtus provides valuable insight into serial variation along the vertebral column of these enormous sauropods. Such variation includes the variable presence of divided spinodiapophyseal laminae and associated spinodiapophyseal fossae. Given that dorsal vertebrae are the only elements that overlap between known remains of most giant titanosaurian taxa, the dorsal series of Dreadnoughtus provides a means to directly compare the morphologies of these sauropods. The dorsal vertebrae of Dreadnoughtus and Futalognkosaurus have dorsoventrally narrow transverse processes, unlike the condition in Puertasaurus. Further

  3. Validity of the assessment method of skeletal maturation by cervical vertebrae: a systematic review and meta-analysis.

    Science.gov (United States)

    Cericato, G O; Bittencourt, M A V; Paranhos, L R

    2015-01-01

    To perform a systematic review with meta-analysis to answer the question: is the cervical vertebrae maturation index (CVMI) effective to replace hand-wrist radiograph (gold standard) in determining the pubertal growth spurt in patients undergoing bone growth? A search in three databases was performed, in which studies were selected that compared one of the two main assessment methods for cervical vertebrae (Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995; 107: 58-66, or Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002; 72: 316-23) to a carpal assessment method. The main methodological data from each of the texts were collected and tabulated after. Later, the meta-analysis of the correlation coefficients obtained was performed. 19 articles were selected from an initial 206 articles collected. Regardless of the method used, the results of the meta-analysis showed that every article selected presented a positive correlation between skeletal maturation assessment performed by cervical vertebrae and carpal methods, with discrepancy of values between genders indicating higher correlation for the female gender (0.925; 0.878) than for the male (0.879; 0.842). When the assessment was performed without gender separation, correlation was significant (0.592; 0.688) but lower in the cases when genders were separated. With the results of this meta-analysis, it is safe to affirm that both CVMIs used in the present study are reliable to replace the hand-wrist radiograph in predicting the pubertal growth spurt, considering that the highest values were found in female samples, especially in the method by Hassel and Farman.

  4. Symptomatic lumbosacral transitional vertebra: a review of the current literature and clinical outcomes following steroid injection or surgical intervention

    OpenAIRE

    Holm Emil Kongsted; Bünger Cody; Foldager Casper Bindzus

    2017-01-01

    Bertolotti’s syndrome (BS) refers to the possible association between the congenital malformation lumbosacral transitional vertebra (LSTV), and low back pain (LBP). Several treatments have been proposed including steroid injections, resections of the LSTV, laminectomy, and lumbar spinal fusion. The aim of this review was to compare the clinical outcomes in previous trials and case reports for these treatments in patients with LBP and LSTV. A PubMed search was conducted. We included English st...

  5. 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.

  6. 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.

  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. Detailed Anatomy of the Cranial Cervical Ganglion in the Dromedary Camel (Camelus dromedarius).

    Science.gov (United States)

    Nourinezhad, Jamal; Mazaheri, Yazdan; Biglari, Zahra

    2015-08-01

    The detailed morphology and topography of the cranial cervical ganglion (CCG) with its surrounding structures were studied in 10 sides of five heads of adult one-humped camel to determine its general arrangement as well as its differences and similarities to other animals. The following detailed descriptions were obtained: (1) the bilateral CCG was constantly present caudal to cranial base at the rostroventral border of the occipital condyle over the caudolateral part of nasopharynx; (2) the CCG was always in close relations medially with the longus capitis muscle, rostrolaterally with the internal carotid artery, and caudally with the vagus nerve; and (3) the branches of the CCG were the internal carotid and external carotid nerves, jugular nerve, cervical interganglionic branch, laryngopharyngeal branch, carotid sinus branch and communicating branches to the vagus, and first spinal nerves. In conclusion, there was no variation regarding topography of dromedary CCG among the specimens, in spite of typical variations in number, and mainly in origin of nerve branches ramifying from the CCG. In comparative anatomy aspect, the close constant relations, and presence of major nerves (internal/external carotid and jugular nerves) of dromedary CCG exhibited a typical reported animal's pattern. However, the shape, structures lateral to the CCG, the origin and course pattern of external carotid and jugular nerves, the number of the major nerves branches, the communicating branches of the CCG to the spinal and cranial nerves, and the separation of most rostral parts of vagosympathetic trunk of dromedary were different from those of most reported animals. © 2015 Wiley Periodicals, Inc.

  9. Skeletal maturation in individuals with Down's syndrome: Comparison between PGS curve, cervical vertebrae and bones of the hand and wrist

    Directory of Open Access Journals (Sweden)

    Glauber Carinhena

    2014-08-01

    Full Text Available INTRODUCTION: This study was conducted with the aim of adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the pubertal growth spurt (PGS curve. It also aimed to test the reliability and agreement between those methods and the method of hand and wrist radiograph when compared two by two and all together. METHODS: The sample comprised 72 radiographs, with 36 lateral radiographs of the head and 36 hand-wrist radiographs of 36 subjects with Down's syndrome (DS, 13 female and 23 male, aged between 8 years and 6 months and 18 years and 7 months, with an average age of 13 years and 10 months. RESULTS AND CONCLUSIONS: Results revealed that adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the curve of PGS is practical and useful in determining the stage of growth and development of individuals. The stages of maturation evaluated by cervical vertebrae and ossification centers observed in radiographs of the hand and wrist were considered reliable, with excellent level of agreement between the methods by Hassel and Farman as well as Baccetti, Franchi and McNamara Jr and Martins and Sakima. Additionally, results revealed an agreement that ranged between reasonable to good for the three methods used to assess the skeletal maturation, showing statistical significance.

  10. MRI in patients with tuberculous spondylitis presenting as vertebra plana: A retrospective analysis and review of literature

    International Nuclear Information System (INIS)

    Sureka, J.; Samuel, S.; Keshava, S.N.; Venkatesh, K.; Sundararaj, G.D.

    2013-01-01

    Aim: To present the magnetic resonance imaging (MRI) findings of 10 patients with histopathologically proven tuberculous spondylitis (TS) presenting as vertebra plana (VP) on radiographs. Material and methods: Radiographs of 451 adult TS patients were reviewed. In this consecutive series, there were 11 patients who presented as VP. MRI of 10 of these patients was available for review. Results: VP-like collapse of a single vertebral body of the dorsal spine with preserved endplates and disc was seen in all cases. Epidural, pre- and para-vertebral soft tissue was found in all patients. Epidural soft tissue presenting on sagittal images as a convexity of the posterior longitudinal ligament was also found in all the signal of which was different from the involved vertebra on axial images. All patients showed posterior element involvement, which was characterized by preserved cortical outline without expansion. Conclusion: TS presenting with VP-like collapse of the bone is rare, accounting for 2.4% of the cases in the present series. MRI may show a collapsed vertebra with preserved endplates and disc. MRI findings that are suggestive of TS include: (1) signal intensity of the epidural soft-tissue mass on axial images, which is different from the vertebral body; (2) presence of a thin, T2-weighted hypointense capsule of the para-vertebral soft tissue; (3) posterior element involvement characterized by intact hypointense cortical outline without expansion; and (4) involvement of the costovertebral joint.

  11. Skeletal maturation in individuals with Down's syndrome: Comparison between PGS curve, cervical vertebrae and bones of the hand and wrist

    Science.gov (United States)

    Carinhena, Glauber; Siqueira, Danilo Furquim; Sannomiya, Eduardo Kazuo

    2014-01-01

    Introduction This study was conducted with the aim of adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the pubertal growth spurt (PGS) curve. It also aimed to test the reliability and agreement between those methods and the method of hand and wrist radiograph when compared two by two and all together. Methods The sample comprised 72 radiographs, with 36 lateral radiographs of the head and 36 hand-wrist radiographs of 36 subjects with Down's syndrome (DS), 13 female and 23 male, aged between 8 years and 6 months and 18 years and 7 months, with an average age of 13 years and 10 months. Results and Conclusions Results revealed that adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the curve of PGS is practical and useful in determining the stage of growth and development of individuals. The stages of maturation evaluated by cervical vertebrae and ossification centers observed in radiographs of the hand and wrist were considered reliable, with excellent level of agreement between the methods by Hassel and Farman as well as Baccetti, Franchi and McNamara Jr and Martins and Sakima. Additionally, results revealed an agreement that ranged between reasonable to good for the three methods used to assess the skeletal maturation, showing statistical significance. PMID:25279522

  12. Penentuan Garis Interkrista Iliaka terhadap Vertebra dengan Teknik Palpasi untuk Kepentingan Blokade Neuroaksial yang Diproyeksikan oleh Pencitraan Ultrasonografi

    Directory of Open Access Journals (Sweden)

    Rian Safirta

    2015-04-01

    Full Text Available In order to perform neuraxial block, a marker is needed as a puncture guide. One of the markers used worldwide is the intercristal line or Tuffier’s line. Many studies have shown that the line location in vertebrae is variable; hence this study was conducted to identify the intercristal line location through palpation towards the vertebrae in Indonesian people, which was measured by ultrasound imaging. This study was a categorical descriptive research conducted prospectively towards 56 people who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung from January to February 2014. The subject’s age, sex, height, and weight were directly measured and recorded and body mass index was also calculated. The intercristal line was then drawn and ultrasonography was performed to identify the vertebral level of the line. The results were categorized according to the previous parameters. It was shown that most of the intercrestal lines were located in lumbar 3 and they were mostly in men with above average height. In conclusion, sex and height are some of the factors that affect the intercristal line location towards the vertebra

  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. Ioversol 350: clinical experience in cranial computed tomography

    International Nuclear Information System (INIS)

    Theron, J.; Paugam, J.P.; Courtheoux, P.

    1991-01-01

    A single, open trial was conducted in 40 patients to evaluate the diagnostic efficacy and safety, in cranial computed tomography, of ioversol (350 mgl/ml), a new nonionic, monomeric, low-osmolality contrast medium. Ioversol is characterized by a hydrophilicity which is not only the highest of all nonionic agents available to date, but also evenly distributed among the various sides of the benzene ring. Diagnosis was possible in 100 % of cases with a mean degree of certainty of 90.8 %. Six minor adverse reactions requiring no treatment we recorded, of which two were observed by the investigator and four reported by the patients. No pain sensation was found and heat sensations were of minor intensity. Ioversol 350, which showed good diagnostic efficacy and proved to be well tolerated, is therefore suitable for cranial computed tomography at a mean dose of 1 ml/kg

  15. 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).

  16. Cranial radiation in childhood acute lymphocytic leukemia. Neuropsychologic sequelae

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  17. STUDY OF EXTRA CRANIAL COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Sanal Mohan

    2016-10-01

    socio-economic group which amounted to thirty nine cases. Nine cases belonged to middle class and six cases belonged to high socio-economic group. Based on extra cranial complications, twenty one cases presented with acute mastoiditis features, nineteen cases presented with discharging sinuses. Eight cases presented with features of petrositis, four cases presented with features of labyrinthitis, and two cases presented with facial nerve palsy. CONCLUSION In this study it was noted that usually the poor who suffer, may be because of financial constraints, lack of health care facilities or general neglect on the patient’s part. Maintaining proper hygiene and early treatment can reduce the number of complications in such cases.

  18. SU-F-T-613: Multi-Lesion Cranial SRS VMAT Plan Quality

    International Nuclear Information System (INIS)

    Ballangrud, A; Kuo, L; Happersett, L; Lim, S; Li, X; Beal, K; Yamada, Y; LoSasso, T; Mechalakos, J

    2016-01-01

    Purpose: Cranial SRS VMAT plans must have steep dose gradient around each target to reduce dose to normal brain. This study reports on the correlation between gradient index (GI=V50%/V100%), target size and target dose heterogeneity index (HI=PTV Dmax/prescription dose) for multi-lesion cranial SRS VMAT plans. Methods: VMAT plans for 10 cranial cases with 3 to 6 lesions (total 39 lesions) generated in Varian Eclipse V11.0.47 with a fine-tuned AAA beam model and 0.125 cm dose grid were analyzed. One or two iso centers were used depending on the spatial distribution of lesions. Two to nine coplanar and non-coplanar arcs were used per isocenter. Conformity index (CI= V100%/VPTV), HI, and GI were determined for each lesion. Dose to critical structures were recorded. Results: Lesion size ranged from 0.05–11.00 cm3. HI ranged from 1.2–1.4, CI ranged from 1.0–2.8 and GI from 3.1–8.4. Maximum dose to brainstem, chiasm, lenses, optic nerves and eyes ranged from 120–1946 cGy, 47–463 cGy, 9–121 cGy, 14–512 cGy, and 17–294 cGy, respectively. Brain minus PTV (Brain-PTV) V7Gy was in the range 1.1–6.5%, and Brain-PTV Dmean was in the range 94–324 cGy. Conclusion: This work shows that a GI 0.4cc. For smaller lesions, GI increases rapidly. GI is lower when HI is increased. Based on this study, recommend HI is 1.4, and recommended GI is for volumes 1.0cc GI<4. CI is < 1.3 for all lesions except for targets < 0.1cc. Cranial SRS VMAT plans must be optimized to lower the GI to reduce the dose to normal brain tissue.

  19. SU-F-T-613: Multi-Lesion Cranial SRS VMAT Plan Quali