Sample records for cranial nerve symptoms

  1. Cranial Nerves Model

    NSDL National Science Digital Library

    Juliann Garza (University of Texas-Pan American Physician Assistant Studies)

    2010-08-16

    Lesson is designed to introduce students to cranial nerves through the use of an introductory lecture. Students will then create a three-dimensional model of the cranial nerves. An information sheet will accompany the model in order to help students learn crucial aspects of the cranial nerves.

  2. Neuromuscular Ultrasound of Cranial Nerves

    PubMed Central

    Tawfik, Eman A.; Cartwright, Michael S.

    2015-01-01

    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. PMID:25851889

  3. Cranial Nerves Model - PowerPoint Presentation

    NSDL National Science Digital Library

    Juliann Garza (University of Texas-Pan American Physician Assistant Studies)

    2010-08-16

    Lesson is designed to introduce students to cranial nerves through the use of an introductory lecture. Students will then create a three-dimensional model of the cranial nerves. An information sheet will accompany the model in order to help students learn crucial aspects of the cranial nerves.

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

    ERIC Educational Resources Information Center

    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…

  5. Disorders of the lower cranial nerves

    PubMed Central

    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.

  6. The cranial nerve skywalk: A 3D tutorial of cranial nerves in a virtual platform.

    PubMed

    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 is difficult using two-dimensional (2D) illustrations alone. Three-dimensional (3D) models aid the teacher in describing intricate and complex anatomical structures and help students visualize them. The study of the cranial nerves can be supplemented with 3D, which permits the students to fully visualize their distribution within the craniofacial complex. This article describes the construction and usage of a virtual anatomy platform in Second Life™, which contains 3D models of the cranial nerves III, V, VII, and IX. The Cranial Nerve Skywalk features select cranial nerves and the associated autonomic pathways in an immersive online environment. This teaching supplement was introduced to groups of pre-healthcare professional students in gross anatomy courses at both institutions and student feedback is included. PMID:24678025

  7. On the terminology of cranial nerves.

    PubMed

    Simon, František; Mare?ková-Štolcová, Elena; Pá?, Libor

    2011-10-20

    The present contribution adopts various points of view to discuss the terminology of the twelve nervi craniales. These are paired nerves and have dual names, terms with Roman ordinal numerals, i.e., the nerves are numbered in the top-to-bottom direction, and descriptive historical names. The time of origin and motivation behind the investigated terms are determined. The majority of terms come from the 17th and 18th centuries. The motivation behind most of them is (a) nerve localization, as this is in conformity with anatomical nomenclature in general, (b) nerve function, and rarely (c) nerve appearance. The occurrence of synonymous names and variants is also a focus of attention. In several cases, reference is made to the process called terminologization, meaning when a certain expression acquires technical meaning and the characteristic/feature of the term. PMID:21724380

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

    Microsoft Academic Search

    Alexandra Borges; Jan Casselman

    2007-01-01

    Many disease processes manifest either primarily or secondarily by cranial nerve deficits. Neurologists, ENT surgeons, ophthalmologists\\u000a and maxillo-facial surgeons are often confronted with patients with symptoms and signs of cranial nerve dysfunction. Seeking\\u000a the cause of this dysfunction is a common indication for imaging. In recent decades we have witnessed an unprecedented improvement\\u000a in imaging techniques, allowing direct visualization of

  9. Cranial nerves XIII and XIV: nerves in the shadows

    PubMed Central

    Bordoni, Bruno; Zanier, Emiliano

    2013-01-01

    It has been known for over a century that these cranial nerves exist, and that they are not typographical errors nor a sensational event reported in the medical literature. A number of scientific articles on anatomy highlight how textbooks on descriptive anatomy do not always consider variables such as differences related to the geographical areas where people live, and these differences do exist. This is an important concept not only for surgeons, but also for all medical professionals who use manual techniques when treating their patients, ie, osteopaths, chiropractors, physiotherapists, and other manual therapists. This paper highlights the latest developments regarding these cranial nerves, offering at the same time some ideas for further reflection when looking at clinical scenarios that appear to bear little relationship to each other. Inclusion of these concepts in everyday anamnesis is encouraged. PMID:23516138

  10. Cranial Nerves any nerve that emanates from the skull Motor = efferent

    E-print Network

    Houde, Peter

    Cranial Nerves ­ any nerve that emanates from the skull Motor = efferent somatomotor ­ to skeletal, vision, gustation, hearing, equilibrium Cranial nerves - functions nI ­ olfactory, SS nII ­ optic, SS n gustation, somatosensory nX ­ vagus, somatomotor to larynx, ANS parasympathetic throughout body nXI ­ spinal

  11. Intraoperative Monitoring of Motor Cranial Nerves in Skull Base Surgery

    PubMed Central

    Maurer, Jan; Pelster, H.; Amedee, Ronald G.; Mann, Wolf J.

    1995-01-01

    Intraoperative monitoring of cranial nerves is performed to minimize postoperative cranial nerve dysfunction. We performed electrophysiologic monitoring of motor cranial nerves with a NIM 2 unit from Xomed Treace and a patient multiplexer developed in our clinic. This multiplexer allows simultaneous monitoring of four cranial nerves and is additionally equipped with a bipolar stimulation mode. This intraoperative monitoring was used during 102 skull base operations. Of these, 44 operations were acoustic neuroma removals by translabyrinthine approach and 36 by a middle fossa approach. Various operations, including removal of tumors of the jugular foramen and the infratemporal fossa, were performed in the remaining 22 patients. The facial nerve, being the most frequently monitored nerve, was evaluated both preoperatively and intraoperatively. Electrophysiologic data were evaluated with respect to their predictive value for postoperative facial nerve function. The relative percent decrease in amplitude of the electromyogram after resection compared to that observed before resection seems to be of some predictive value for the postoperative facial nerve function. A 50 to 60% decrease or more is associated with an increase in the House classification. Intraoperative monitoring is a useful tool in skull base surgery, allowing for safer and faster identification of motor nerves in pathologic-anatomic conditions. It allows the surgeon a degree of comfort by providing immediate information regarding the status of the nerve. It may also improve postoperative nerve function and shorten operating time. Additionally, neuromonitoring provides some information about expected postoperative facial nerve function. PMID:17170943

  12. ANCA-Negative Wegener's Granulomatosis with Multiple Lower Cranial Nerve Palsies

    PubMed Central

    Kim, Sung-Hee; Park, Jin; Bae, Jung Ho; Cho, Min-Sun; Park, Kee Duk

    2013-01-01

    Wegener's granulomatosis (WG) is a systemic vasculitis affecting small and medium-sized vessels with granulomatous formation. Though it is known for respiratory tract and kidney involvement, neurologic manifestation has been also reported. Herein we report a patient who suffered pansinusitis with multiple lower cranial nerve palsies but reached remission by immunosuppressant after the diagnosis of WG. A 54-yr-old female visited with headache, hearing difficulty, and progressive bulbar symptoms. She experienced endoscopic sinus surgeries due to refractory sinusitis. Neurologic examination revealed multiple lower cranial nerve palsies. Vasculitic markers showed no abnormality. Nasal biopsy revealed granulomatous inflammation and vasculitis involving small vessels. Given cyclophosphamide and prednisolone, her symptoms were prominently improved. WG should be considered in the patient with multiple cranial nerve palsies, especially those with paranasal sinus disease. Because WG can be lethal if delayed in treatment, prompt immunosuppressant is warranted after the diagnostic tissue biopsy. PMID:24265538

  13. Motonuclear changes after cranial nerve injury and regeneration.

    PubMed

    Fernandez, E; Pallini, R; Lauretti, L; La Marca, F; Scogna, A; Rossi, G F

    1997-09-01

    Little is known about the mechanisms at play in nerve regeneration after nerve injury. Personal studies are reported regarding motonuclear changes after regeneration of injured cranial nerves, in particular of the facial and oculomotor nerves, as well as the influence that the natural molecule acetyl-L-carnitine (ALC) has on post-axotomy cranial nerve motoneuron degeneration after facial and vagus nerve lesions. Adult and newborn animal models were used. Massive motoneuron response after nerve section and reconstruction was observed in the motonuclei of all nerves studied. ALC showed to have significant neuroprotective effects on the degeneration of axotomized motoneurons. Complex quantitative, morphological and somatotopic nuclear changes occurred that sustain new hypotheses regarding the capacities of motoneurons to regenerate and the possibilities of new neuron proliferation. The particularities of such observations are described and discussed. PMID:9270896

  14. Cranial and Spinal Nerve Organization in Amphioxus and Lampreys: Evidence for an Ancestral Craniate Pattern

    Microsoft Academic Search

    B. Fritzsch; Glenn Northcutt

    1993-01-01

    The spinal nerves in amphioxus are compared with the spinal and cranial nerves in lampreys. The dorsal spinal roots in amphioxus are similar to the mixed sensory and motor dorsal roots of many cranial nerves in lampreys but not to the purely sensory dorsal spinal roots in lampreys and gnathostomes. Likewise, cranial nerves V, VII, IX and X in lampreys,

  15. Intraoperative Cranial Nerve Monitoring During Posterior Skull Base Surgery

    PubMed Central

    Kartush, Jack M.; LaRouere, Michael J.; Graham, Malcolm D.; Bouchard, Kenneth R.; Audet, Blaise V.

    1991-01-01

    Intraoperative monitoring of neurophysiologic function is rapidly evolving as an important adjunct during skull base surgery to reduce the incidence of neurologic deficit. Facial nerve monitoring is an excellent model, since electrical and mechanical evoked potentials can be directly presented to the surgeon in real-time through an acoustic loudspeaker display. The lower cranial nerves may also be monitored using similar electromyographic techniques. Auditory system monitoring is more difficult due to the low amplitude response that requires averaging and filtering to extract the evoked potential. In conjunction with auditory monitoring, improved hearing preservation may be further enhanced by concomitant facial nerve monitoring, since the surgeon is alerted to traumatic manipulations that may affect both facial and cochlear nerves. Techniques and interpretative issues are presented to maximize the efficacy and safety of cranial nerve monitoring. ImagesFigure 1Figure 2Figure 3Figure 5 PMID:17170827

  16. Direct Cranial Nerve Involvement by Gliomas: Case Series and Review of the Literature.

    PubMed

    Mabray, M C; Glastonbury, C M; Mamlouk, M D; Punch, G E; Solomon, D A; Cha, S

    2015-07-01

    Malignant gliomas are characterized by infiltrative growth of tumor cells, including along white matter tracts. This may result in clinical cranial neuropathy due to direct involvement of a cranial nerve rather than by leptomeningeal spread along cranial nerves. Gliomas directly involving cranial nerves III-XII are rare, with only 11 cases reported in the literature before 2014, including 8 with imaging. We present 8 additional cases demonstrating direct infiltration of a cranial nerve by a glioma. Asymmetric cisternal nerve expansion compared with the contralateral nerve was noted with a mean length of involvement of 9.4 mm. Based on our case series, the key imaging feature for recognizing direct cranial nerve involvement by a glioma is the detection of an intra-axial mass in the pons or midbrain that is directly associated with expansion, signal abnormality, and/or enhancement of the adjacent cranial nerves. PMID:25857757

  17. Shrapnel injury of isolated third cranial nerve.

    PubMed

    Uluta?, Murat; Seçer, Mehmet

    2014-12-01

    Isolated third nerve palsy develops in numerous intracranial pathologies such as closed head trauma, tumor, and aneurysm. Isolated oculomotor nerve palsy caused by shrapnel injury is uncommon. After a penetrating intracranial shrapnel injury, our patient with oculomotor ophthalmoplegia underwent surgery. Microsurgery removed the shrapnel that was applying pressure on the third nerve, resulting in contusion. A partial recovery associated with regeneration was observed at month 9. Extraocular muscle surgery should be planned if palsy does not resolve over a prolonged period of time. PMID:25485217

  18. Radiation-induced lower cranial nerve palsy in patients with head and neck carcinoma

    PubMed Central

    JANSSEN, STEFAN; GLANZMANN, CHRISTOPH; YOUSEFI, BITA; LOEWENICH, KARL; HUBER, GERHARD; SCHMID, STEPHAN; STUDER, GABRIELA

    2015-01-01

    Radiation-induced cranial nerve palsy (RICNP) is a severe long-term complication in patients with head and neck cancer following high-dose radiation therapy (RT). We present the case report of a patient with bilateral RICNP of the hypoglossal and vagus cranial nerves (XII/X) following postoperative RT in the era prior to the introduction of intensity-modulated RT (IMRT), and an analysis of our IMRT patient cohort at risk including the case of a XII RICNP. A total of 201 patients whose glosso-pharyngeal (IX), X and XII cranial nerves had been exposed to >65 Gy definitive IMRT in our institution between January, 2002 and December, 2012 with or without systemic therapy, were retrospectively identified. A total of 151 patients out of 201 fulfilling the following criteria were included in the analysis: Locoregionally controlled disease, with a follow-up (FU) of >24 months and >65 Gy exposure of the nerves of interest. So far, one of the assessed 151 IMRT patients at risk exhibited symptoms of RICNP after 6 years. The mean/median FU of the entire cohort was 71/68 months (range, 27–145). The results were compared with literature reports. In conclusion, RICNP appears to be a rare complication. However, a longer FU and a larger sample size are required to draw reliable conclusions on the incidence of RICNP in the era of IMRT.

  19. Pain in ischaemic ocular motor cranial nerve palsies

    Microsoft Academic Search

    S C Wilker; J C Rucker; N J Newman; V Biousse; R L Tomsak

    2009-01-01

    Aim:Pain is a common feature of microvascular ischaemic ocular motor cranial nerve palsies (MP). The natural history of pain in this condition has not been studied. The purpose of this report is to define the spectrum of pain in isolated MP, with special reference to diabetic versus non-diabetic patients.Design and methods:Retrospective and prospective chart review was performed on 87 patients

  20. Cranial Nerve Palsies: Sarcoidosis to Systemic Lupus Erythematosus

    PubMed Central

    Aslam, Fawad; Bannout, Firas; Russell, Elizabeth B.

    2013-01-01

    Cranial palsies are a very rare feature of SLE. Similarly, peripheral sensory-motor axonal neuropathy is very uncommon in SLE. The combination of the two as the presenting symptoms of SLE is a diagnostic challenge particularly in an elderly male patient with a known diagnosis of sarcoidosis. This case serves to highlight the diagnostic considerations in such a patient. The lack of response to standard therapy and the presence of subtle clues like anemia, proteinuria, and mild serositis should prompt the physician to look for alternate diagnoses. The potential association of SLE and sarcoidosis is also discussed. SLE can be present in elderly male patients with cranial and peripheral neuropathy. PMID:23401835

  1. Normal - Cranial Nerves Exam - Oculomotor, Trochlear, Abducens (CN III, IV, VI) Nerves Sub-exam

    NSDL National Science Digital Library

    John C. Pearson, PhD

    This video depicts a 'normal' cranial nerves exam. Patient is a female with no known neurological health problems who volunteered to act as a simulated patient in order to demonstrate 'normal' responses to exam techniques. Viewing the video requires installation of the free QuickTime Plug-in.

  2. Sphenoidal mucocele presenting as acute cranial nerve palsies.

    PubMed

    Cheng, Clarissa S M; Sanjay, Srinivasan; Yip, Chee Chew; Yuen, Heng-Wai

    2012-10-01

    Sphenoidal sinus mucoceles are indolent lesions that, when sufficiently large, can compress on the optic canal or superior orbital fissure, rapidly causing loss of vision, optic neuropathy, ptosis, pain, ophthalmoplegia, and diplopia. We herein report a 72-year-old gentleman who presented acutely with Cranial Nerve II, III, and IV palsies secondary to a sphenoidal sinus mucocele that was confirmed on magnetic resonance imaging and successfully treated with endoscopic drainage. This cause of orbital apex syndrome is important for clinicians to know as early diagnosis and treatment is critical in recovering visual potential. PMID:23961035

  3. Sixth cranial nerve palsy caused by compression from a dolichoectatic vertebral artery.

    PubMed

    Zhu, Ying; Thulborn, Keith; Curnyn, Kimberlee; Goodwin, James

    2005-06-01

    A 68-year-old man had an unremitting left sixth cranial nerve palsy immediately after completing a long bicycle trip. High-resolution (3 Tesla) magnetic resonance imaging disclosed a dolichoectatic vertebral artery that compressed the left sixth cranial nerve against the belly of the pons at its root exit zone. It was postulated that increased blood flow in the vessel during the unusually prolonged aerobic exercise precipitated the palsy. Compressive palsies of cranial nerves caused by a dolichoectatic basilar artery have often been documented; compressive palsy caused by a dolichoectatic vertebral artery is less well-recognized. PMID:15937439

  4. Long-Lasting Cranial Nerve III Palsy as a Presenting Feature of Chronic Inflammatory Demyelinating Polyneuropathy.

    PubMed

    Spataro, Rossella; La Bella, Vincenzo

    2015-01-01

    We describe a patient with chronic inflammatory demyelinating polyneuropathy (CIDP) in which an adduction deficit and ptosis in the left eye presented several years before the polyneuropathy. A 52-year-old man presented with a 14-year history of unremitting diplopia, adduction deficit, and ptosis in the left eye. At the age of 45 a mild bilateral foot drop and impaired sensation in the four limbs appeared, with these symptoms showing a progressive course. The diagnostic workup included EMG/ENG which demonstrated reduced conduction velocity with bilateral and symmetrical sensory and motor involvement. Cerebrospinal fluid studies revealed a cytoalbuminologic dissociation. A prolonged treatment with corticosteroids allowed a significant improvement of the limb weakness. Diplopia and ptosis remained unchanged. This unusual form of CIDP presented as a long-lasting isolated cranial nerve palsy. A diagnostic workup for CIDP should therefore be performed in those patients in which an isolated and unremitting cranial nerve palsy cannot be explained by common causes. PMID:25960744

  5. Orbital pain and unruptured carotid-posterior communicating artery aneurysms: the role of sensory fibers of the third cranial nerve.

    PubMed

    Lanzino, G; Andreoli, A; Tognetti, F; Limoni, P; Calbucci, F; Bortolami, R; Lucchi, M L; Callegari, E; Testa, C

    1993-01-01

    Intact aneurysms of the carotid siphon at the point of take-off of the posterior communicating artery may exhibit orbital pain, whether associated with oculomotor palsy or not as a warning symptom prior to rupture. In order to explain this symptom the hypothesis of a sensory pathway within the third cranial nerve, which is liable to compression by the enlarging aneurysm sac, has been investigated. Data from human autopsy material show evidence of sensory ganglion cells within the rootlets of the oculomotor nerve; furthermore, studies in animals prove that the third nerve contains sensory fibers which run proximally along the nerve bundles, enter the brainstem and reach the spinal trigeminal nucleus. These fibers come from the ophthalmic division of the fifth nerve and join the third nerve at the level of the lateral wall of the cavernous sinus. Although a number of questions remain to be solved, the presence of a sensory pattern within the third nerve could account for fronto-orbital pain from enlarging aneurysms impinging on the third nerve itself. PMID:8434520

  6. Fourth Cranial Nerve Palsy in a Collegiate Lacrosse Player: A Case Report

    PubMed Central

    Stiller-Ostrowski, Jennifer L.

    2010-01-01

    Abstract Objective: To present the case of a National Collegiate Athletic Association Division I men's lacrosse athlete with fourth cranial nerve injury as the result of a minor traumatic blow. Background: The athlete was struck on the right side of his head during a lacrosse game. On-field evaluation revealed no cervical spine involvement or loss of consciousness. He complained of headache and dizziness, with delayed reports of visual disturbance. Sideline visual acuity and cranial nerve screenings appeared within normal limits. Consultation with the team physician indicated that immediate referral to the emergency department was unnecessary. Differential Diagnosis: Concussion, third cranial nerve palsy, fourth cranial nerve palsy. Treatment: The certified athletic trainer safely removed the athlete from the playing field and monitored him on the sideline. After being seen by the team physician, the patient was referred to a neurologist, ophthalmologist, and finally a neuro-ophthalmologist before a definitive diagnosis was made. The palsy did not necessitate surgical intervention, resolving with conservative treatment. The athlete was able to return to full athletic ability at his preinjury level by 8 months postinjury. Uniqueness: Superior oblique palsy as the result of fourth cranial nerve injury is the most frequent isolated cranial nerve palsy; however, these palsies are often underdiagnosed by health professionals. Such palsies are uncommon within the athletic realm, making timely diagnosis even less likely. Conclusions: Cranial nerve palsy may present very subtly in patients. Therefore, on-field health care providers should be aware of the descriptions and types of compensations that signal nerve injury. PMID:20617917

  7. A 3-Year Review of Cranial Nerve Palsies from the University of Port Harcourt Teaching Hospital Eye Clinic, Nigeria

    PubMed Central

    Pedro-Egbe, Chinyere Nnenne; Fiebai, Bassey; Awoyesuku, Elizabeth Akon

    2014-01-01

    Purpose: To provide the types, frequency and clinical information on common cranial nerve palsies seen at the Eye Clinic at the University of Port Harcourt Teaching Hospital. Materials and Methods: A chart review was performed of patients who presented with cranial nerve palsy at the Eye Clinic over a 3-year period (January 2009-December 2011). Data were collected on age, sex, type of cranial nerve palsy, a history of systemic disease such as diabetes mellitus (DM), hypertension and cerebrovascular disease. Exclusion criteria included medical charts with incomplete data. Data was analyzed using Epi-info Version 6.04D. Statistical significance was indicated by P < 0.05. Results: Twenty-four patients had cranial nerve palsies. There were 11 males and 13 females with a mean age of 34.50 ± 18.41 years. Four patients (26.6%) had exotropia while three patients (20%) had esotropia. Complete ophthalmoplegia was noted in two patients (13.3%). The 3rd and 6th cranial nerves were affected in seven patients each (29.2%) and five patients (20.8%) had 7th cranial nerve palsy. Approximately 38% of patients with cranial nerve palsies had systemic disorders (16.7% systemic hypertension; 12.5% DM). The relationship between cranial nerve palsy and systemic disorder was statistically significant (P < 0.01). Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6th cranial nerve palsy. PMID:24791110

  8. Cranial nerve assessment in posterior fossa tumors with fast imaging employing steady-state acquisition (FIESTA).

    PubMed

    Mikami, Takeshi; Minamida, Yoshihiro; Yamaki, Toshiaki; Koyanagi, Izumi; Nonaka, Tadashi; Houkin, Kiyohiro

    2005-10-01

    Steady-state free precession is widely used for ultra-fast cardiac or abdominal imaging. The purpose of this work was to assess fast imaging employing steady-state acquisition (FIESTA) and to evaluate its efficacy for depiction of the cranial nerve affected by the tumor. Twenty-three consecutive patients with posterior fossa tumors underwent FIESTA sequence after contrast agent administration, and then displacement of the cranial nerve was evaluated. The 23 patients with posterior fossa tumor consisted of 12 schwannomas, eight meningiomas, and three cases of epidermoid. Except in the cases of epidermoid, intensity of all tumors increased on FIESTA imaging of the contrast enhancement. In the schwannoma cases, visualization of the nerve became poorer as the tumor increased in size. In cases of encapsulated meningioma, all the cranial nerves of the posterior fossa were depicted regardless of location. The ability to depict the nerves was also significantly higher in meningioma patients than in schwannoma patients (P<0.05). In cases of epidermoid, extension of the tumors was depicted clearly. Although the FIESTA sequence offers similar contrast to other heavily T2-weighted sequences, it facilitated a superior assessment of the effect of tumors on cranial nerve anatomy. FIESTA sequence was useful for preoperative simulations of posterior fossa tumors. PMID:15933875

  9. Glufosinate herbicide intoxication causing unconsciousness, convulsion, and 6th cranial nerve palsy.

    PubMed

    Park, Jae-seok; Kwak, Soo-Jung; Gil, Hyo-wook; Kim, So-Young; Hong, Sae-yong

    2013-11-01

    Although glufosinate ammonium herbicides are considered safe when used properly, ingestion of the undiluted form can cause grave outcomes. Recently, we treated a 34-yr-old man who ingested glufosinate ammonium herbicide. In the course of treatment, the patient developed apnea, mental deterioration, and sixth cranial nerve palsy; he has since been discharged with full recovery after intensive care. This case report describes the clinical features of glufosinate intoxication with a focus on sixth cranial nerve palsy. Our observation suggests that neurologic manifestations after ingestion of a "low-grade toxicity herbicide" are variable and more complex than that was previously considered. PMID:24265537

  10. An ectopic cranial nerve identified during surgery in the posterior fossa for hemifacial spasm: a word of caution.

    PubMed

    Tubbs, R Shane; Lau, Ryan R; Cohen-Gadol, Aaron A

    2010-08-01

    Variations of cranial nerve morphology may effect surgical technique and, if not appreciated, lead to complications and iatrogenic injury. The authors report an unusual course of the hypoglossal nerve within the posterior cranial fossa observed during microvascular decompression surgery for hemifacial spasm. PMID:20726758

  11. Isolated III cranial nerve palsy: a surprising presentation of an acute on chronic subdural haematoma

    PubMed Central

    Abdul Jalil, Muhammad Fahmi; Tee, Jin Wee; Han, Tiew

    2013-01-01

    Many aetiologies have been associated with isolated oculomotor nerve palsies. They are ischaemic microangiopathy, posterior communicating artery aneurysm, uncal herniation, neoplasia, traumatic and inflammatory conditions. We report the case of a patient who presented with left oculomotor cranial nerve palsy with an associated large volume left acute on chronic subdural haematoma. Coincidentally, this woman was also found to have a recent history of herpes zoster ophthalmicus. PMID:23784767

  12. Multiple concomitant cranial nerve palsies secondary to preeclampsia.

    PubMed

    Gilca, Marina; Luneau, Katie

    2015-06-01

    A 32-year-old primigravid woman developed pre-eclampsia after delivery of twins along with left fifth, sixth, and seventh cranial neuropathies. She also had evidence of hepatic and renal involvement. Results of patient evaluation were otherwise unremarkable, and the palsies completely resolved over 3 months after treatment with valacyclovir and systemic corticosteroids. PMID:25768245

  13. Issues in the Optimal Selection of a Cranial Nerve Monitoring System

    PubMed Central

    Selesnick, Samuel H.; Goldsmith, Daniel F.

    1993-01-01

    Intraoperative nerve monitoring (IONM) is a safe technique that is of clear clinical value in the preservation of cranial nerves in skull base surgery and is rapidly becoming the standard of care. Available nerve monitoring systems vary widely in capabilities and costs. A well-informed surgeon may best decide on monitoring needs based on surgical case selection, experience, operating room space, availability of monitoring personnel, and cost. Key system characteristics that should be reviewed in the decision-making process include the monitoring technique (electromyography, pressure transducer, direct nerve monitoring, brainstem auditory evoked potential) and the stimulus technique (stimulating parameters, probe selection). In the past, IONM has been primarily employed in posterior fossa and temporal bone surgery, but the value of IONM is being recognized in more skull base and head and neck surgeries. Suggested IONM strategies for specific surgeries are presented. PMID:17170916

  14. Translaminar Microendoscopic Herniotomy for Cranially Migrated Lumbar Disc Herniations Encroaching on the Exiting Nerve Root in the Preforaminal and Foraminal Zones

    PubMed Central

    Tono, Osamu; Senba, Hideyuki; Kitamura, Takahiro; Komiya, Norihiro; Oga, Masayoshi; Shidahara, Satoshi

    2013-01-01

    Study Design Case series. Purpose The aim of this study was to describe translaminar microendoscopic herniotomy (TL-MEH) for cranially migrated lumbar disc herniations encroaching on the exiting nerve root in the preforaminal and foraminal zones and to report preliminary results of the procedure. Overview of Literature Conventional interlaminar approaches for preforaminal and foraminal lumbar disc herniations result in extensive removal of the lamina and facet joint to remove disc fragments safely. More destructive approaches increase the risk of postoperative segmental instability. Methods TL-MEH is a minimally invasive procedure for herniotomy via the translaminar approach using a microendoscopic technique. TL-MEH was performed in seven patients with a cranially migrated lumbar disc herniation encroaching on the exiting nerve root. The disc fragments were located in the preforaminal zone in four patients, and in the preforaminal and foraminal zones in three. Results All patients experienced immediate relief from symptoms after surgery and satisfactory results at the final follow-up. Surgical complications, such as a dural tear, nerve injury, and surgical site infection, were not investigated. Conclusions TL-MEH seemed to be an effective and safe alternative minimally invasive surgical option for patients with a cranially migrated lumbar disc herniation encroaching the exiting nerve root in the preforaminal and foraminal zones. PMID:24066214

  15. Cranial mononeuropathy III - diabetic type

    MedlinePLUS

    Diabetic third nerve palsy; Pupil-sparing third cranial nerve palsy ... Cranial mononeuropathy III - diabetic type -- is a mononeuropathy . This means that only one nerve is damaged. The condition affects the third cranial (oculomotor) ...

  16. Recurrent cranial neuropathy as a clinical presentation of idiopathic inflammation of the dura mater: a possible relationship to Tolosa-Hunt syndrome and cranial pachymeningitis

    Microsoft Academic Search

    Hideto Miwa; Isao Koshimura; Yoshikuni Mizuno

    1998-01-01

    We report 14 patients with idiopathic recurrent cranial neuropathy, in whom multiple cranial nerves were involved recurrently, either at the same or different times, and appeared bilaterally. Oculomotor nerve involvement was most frequent, while the abducens and facial nerves were the next most frequent. Clinical courses were benign and not progressive, and the symptoms responded well to corticosteroids. Ten patients

  17. Sixth Cranial Nerve Palsy Caused by Gastric Adenocarcinoma Metastasis to the Clivus

    PubMed Central

    Chang, Kee-hyun; Hong, Hyunsook; Kim, Heekyung

    2015-01-01

    Tumors of the clivus and metastases to the clivus are very rare. Metastasis involving the clivus has previously been described in only two case reports. In skull metastasis, the breast and prostate are the most common primary foci, while metastasis from gastric carcinoma is extremely rare. A review of the English literature revealed only one published case of clivus metastases from gastric adenocarcinoma. There is no literature thoroughly explaining the differential diagnosis between chordoma and metastasis. Here we report a rare case of metastasis to the clivus from a gastric adenocarcinoma in a 42-year-old female patient with sudden blurry vision, presenting as bilateral cranial nerve VI palsy. PMID:25810862

  18. Long-standing postsurgical lower cranial nerve palsy mimicking a pharyngolaryngeal submucosal mass in an elderly patient.

    PubMed

    Pichi, Barbara; Terenzi, Valentina; Marchesi, Paolo; Vidiri, Antonello; Spriano, Giuseppe

    2011-09-01

    Changes that occur as a natural part of senescence in the complex action of deglutition predispose to dysphagia and aspiration. This dysfunction is worsened in patients with preexisting anatomic or functional alteration such as in case of a postsurgical lower cranial nerve palsy. We present the case of a 72-year-old woman who underwent surgical resection of a right jugulotympanic tumor 33 years ago, resulting in lower cranial nerve palsy, and came to our attention referring a 4 months' history of progressive dysphagia in which a pharyngolaryngeal submucosal mass was suspected. PMID:21959475

  19. Morphometric Investigations of the Connections between the Posterior C-1 Root and the Accessory Nerve in the Human Cranial Cervical Region

    Microsoft Academic Search

    U. Schneider; A. Biörnsen; R. Hagenah

    1996-01-01

    The anastomosis of the spinal section of the accessory nerve and the posterior C-1 root was examined in eight human corpses at the light-microscopical level by image analysis. The numbers of nerve fibers caudal and cranial to the anastomosis were compared. The morphometric data suggest that somatic efferent fibers of the spinal accessory nerve extend to proprioceptors in the sternocleidomastoideus

  20. Cranial electrical stimulation improves symptoms and functional status in individuals with fibromyalgia.

    PubMed

    Taylor, Ann Gill; Anderson, Joel G; Riedel, Shannon L; Lewis, Janet E; Kinser, Patricia A; Bourguignon, Cheryl

    2013-12-01

    To investigate the effects of microcurrent cranial electrical stimulation (CES) therapy on reducing pain and its associated symptoms in fibromyalgia (FM), we conducted a randomized, controlled, three-group (active CES device, sham device, and usual care alone [UC]), double-blind study to determine the potential benefit of CES therapy for symptom management in FM. Those individuals using the active CES device had a greater decrease in average pain (p = .023), fatigue (p = .071), and sleep disturbance (p = .001) than individuals using the sham device or those receiving usual care alone over time. Additionally, individuals using the active CES device had improved functional status versus the sham device and UC groups over time (p = .028). PMID:24315255

  1. Radiation-Induced Cranial Nerve Palsy: A Cross-Sectional Study of Nasopharyngeal Cancer Patients After Definitive Radiotherapy

    SciTech Connect

    Kong, Lin, E-mail: konglinj@gmail.co [Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, Shanghai (China); Lu, Jiade J. [Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, Shanghai (China); Department of Radiation Oncology, National University Cancer Institute of Singapore (Singapore); Liss, Adam L. [Department of Radiation Oncology, National University Cancer Institute of Singapore (Singapore); Penn State College of Medicine, Hershey, PA (United States); Hu Chaosu; Guo Xiaomao; Wu Yongru; Zhang Youwang [Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, Shanghai (China)

    2011-04-01

    Purpose: To address the characteristics and the causative factors of radiation-induced cranial nerve palsy (CNP) in nasopharyngeal carcinoma (NPC) patients with an extensive period of followed-up. Patients and Methods: A total of 317 consecutive and nonselected patients treated with definitive external-beam radiotherapy between November 1962 and February 1995 participated in this study. The median doses to the nasopharynx and upper neck were 71 Gy (range, 55-86 Gy) and 61 Gy (range, 34-72 Gy), respectively. Conventional fractionation was used in 287 patients (90.5%). Forty-five patients (14.2%) received chemotherapy. Results: The median follow-up was 11.4 years (range, 5.1-38.0 years). Ninety-eight patients (30.9%) developed CNP, with a median latent period of 7.6 years (range, 0.3-34 years). Patients had a higher rate of CNP (81 cases, 25.5%) in lower-group cranial nerves compared with upper group (44 cases, 13.9%) ({chi}{sup 2} = 34.444, p < 0.001). Fifty-nine cases experienced CNP in more than one cranial nerve. Twenty-two of 27 cases (68.8%) of intragroup CNP and 11 of 32 cases (40.7%) of intergroup CNP occurred synchronously ({chi}{sup 2} = 4.661, p = 0.031). The cumulative incidences of CNP were 10.4%, 22.4%, 35.5%, and 44.5% at 5, 10, 15, and 20 years, respectively. Multivariate analyses revealed that CNP at diagnosis, chemotherapy, total radiation dose to the nasopharynx, and upper neck fibrosis were independent risk factors for developing radiation-induced CNP. Conclusion: Radiation-induced fibrosis may play an important role in radiation-induced CNP. The incidence of CNP after definitive radiotherapy for NPC remains high after long-term follow-up and is dose and fractionation dependent.

  2. Posterior Cranial Fossa Meningiomas*

    PubMed Central

    Javalkar, Vijayakumar; Banerjee, Anirban Deep; Nanda, Anil

    2012-01-01

    This study evaluated the outcomes, complications, and recurrence rates of posterior cranial fossa meningiomas. We retrospectively reviewed our surgical experience with 64 posterior cranial fossa meningiomas. Mean age was 56 years with a female preponderance (67.2%). Headache was the most common symptom. Retrosigmoid approach was the commonest surgical procedure (23.4%). The incidence of cranial nerve related complications was 28%. Postoperatively facial nerve weakness was observed in 11%. The incidence of cerebrospinal fluid leak was 4.6%. Gross total resection was achieved in 37 patients (58%). Sixteen patients (25%) with residual tumors underwent Gamma knife radiosurgery. Recurrence or tumor progression was observed in 12 patients (18.7%). Operative mortality was 3.1%. At their last follow-up, 93% of the cases achieved Glasgow Outcome Scale scores 4 or 5. Total excision is the ideal goal which can be achieved with meningiomas located in certain location, such as lateral convexity, but for other posterior fossa meningiomas the close proximity of critical structures is a major obstacle in achieving this goal. In practicality, a balance between good functional outcome and extent of resection is important for posterior cranial fossa meningiomas in proximity to critical structures. PMID:23372989

  3. Changes in brainstem calcitonin gene-related peptide after VIIth and VIIIth cranial nerve lesions in guinea pig.

    PubMed

    Thompson, G C; Ross, C D; Thompson, A M; Byers, J M

    1995-06-12

    The present study investigated the effect of seventh and eight cranial nerve lesions on the prominence of calcitonin gene-related peptide in the hypoglossal (XII), facial (VII), abducens (VI), and oculomotor (III) cranial nerve nuclei. Guinea pigs were anesthetized and subjected to unilateral cochlear removal, vestibular end organ ablation, and seventh nerve transection. After a survival period ranging from 4 h to 5 days, each animal was anesthetized and perfused intracardially. Frozen sections were collected through the brainstem and stained immunohistochemically for calcitonin gene-related peptide using a polyclonal antibody with the Vectastain ABC kit and protocol. Positive cells were counted in each nucleus bilaterally and analyzed for side to side differences. Nuclei XII and III showed no significant difference in the numbers of cells staining positively for calcitonin gene-related peptide between the ipsilateral and the contralateral sides to the lesion. However, nuclei VII and VI showed elevated numbers ipsilateral to the lesion on some days, but not all. For VII, there was no significant difference before 24 h, but there were significant differences 1-5 days after the lesion. Similarly, in VI, there was no difference before 24 h, but differences were significant beginning with day 1 and continuing through day 3, and finally disappearing by day 4. Changes in the numbers of CGRP positive cells in VII measurable 24 h after the lesion and continuing for at least 5 days afterward indicate a central nervous system retrograde response to peripheral motor nerve injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7552338

  4. Treatment of Cervical Internal Carotid Artery Spontaneous Dissection with Pseudoaneurysm and Unilateral Lower Cranial Nerves Palsy by Two Silk Flow Diverters

    SciTech Connect

    Zelenak, Kamil, E-mail: zelenak@unm.sk [University Hospital, Department of Radiology (Slovakia); Zelenakova, Jana [University Hospital, Department of Neurology (Slovakia); DeRiggo, Julius [University Hospital, Department of Neurosurgery (Slovakia); Kurca, Egon; Kantorova, Ema [University Hospital, Department of Neurology (Slovakia); Polacek, Hubert [University Hospital, Department of Radiology (Slovakia)

    2013-08-01

    Internal carotid artery (ICA) lesions in the parapharyngeal space (a dissection and a pseudoaneurysm) may present as isolated lower cranial nerves (IX, X, XI, and XII) palsy (Collet-Sicard syndrome). Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Extreme vessel tortuosity makes the treatment by a stent graft impossible. Two Silk stents were used in a 46 year-old man with left lower cranial nerves (IX-XII) palsy for the treatment of left ICA spontaneous dissection with pseudoaneurysm. A follow-up angiogram 5 months later confirmed pseudoaneurysm thrombosis and patency of the left ICA. The patient recovered completely from the deficits.

  5. Causal Relation between Nerve Compression and Migraine Symptoms and the Therapeutic Role of Surgical Decompression

    PubMed Central

    Singh, Mansher; Rios Diaz, Arturo J.; Gobble, Ryan

    2015-01-01

    Background: Nerve decompression has been recently described as a therapy for migraine headaches. Multiple studies have demonstrated significant symptomatic relief or complete resolution of migraine symptoms in patients with surgical decompression. However, there is no study describing a causal relation between migraine headaches and nerve compression and resolution of symptoms with tumor removal and nerve decompression. Methods: We were presented with a biological example of compression neuropathy causing migraine headaches due to greater occipital nerve compression by a lipoma from a remote head trauma. Included is a literature review of nerve decompression therapy for migraine. Results: Migraine symptoms were completely resolved on removal of the mass and nerve decompression. The patient has not required any migraine medications since the surgery. Conclusions: This case serves as a biological example to validate the true causal relationship between greater occipital nerve compression and migraine headaches.

  6. Cranial and Cervical Muscular Weakness in Mitochondrial Myopathy Is Associated With Resolution of Migraine Headaches: Further Evidence That Muscular Compression of Cranial and Peripheral Nerves Is a Cause of Headache in a Subset of Patients With Migraine

    PubMed Central

    2015-01-01

    Objective: A significant subset of patients with migraine headaches has pain relief after neuroplasty/muscular decompression of select cranial and cervical nerves. In the majority of cases, compression occurs secondary to compression of the nerves by adjacent muscles. Previous studies have shown that both surgical decompression and chemical denervation (eg, botulinum toxin) provide relief of migraine headaches; however, controversy remains. If some migraine headaches are caused by muscular compression, then paresis of the compressing muscles by underlying myopathic/metabolic disease should result in migraine relief in some patients. Methods: We report a case of mitochondrial myopathy causing weakness primarily of the muscles of facial expression and the neck in the context of chronic migraine headaches (>20-year history). Muscle biopsy was obtained to confirm the myopathic diagnosis. Results: There was complete resolution of the patient's migraine headaches that occurred simultaneously with the onset of symptomatic paresis of the muscles of facial expression and the neck. The relief has persisted for more than 10 months. Neurologic evaluation and muscle biopsy confirmed a diagnosis of mitochondrial myopathy. Conclusions: Pathologic paresis/paralysis of facial and/or cervical muscles can result in persistent resolution of migraine headache pain, giving further evidence to the concept that peripheral and/or cranial nerve compression causes migraine headache pain in a subset of patients with a diagnosis of migraine. PMID:26171092

  7. Character changes from idiopathic cranial pachymeningoencephalitis

    Microsoft Academic Search

    Takuya Matsushita; Hiroyuki Murai; Masakazu Kawajiri; Hiroshi Muratani; Toru Iwaki; Takayuki Taniwaki; Jun-ichi Kira

    2006-01-01

    A 66-year-old man with idiopathic cranial pachymeningoencephalitis was described. He suffered from left orbital pain, and character changes. He became short tempered, and was very attached to trifles. Two years prior to these symptoms, he had developed transient left abducent nerve palsy. Head MRI showed a thickening and enhancement of the dura mater on gadolinium-enhanced T1-weighted images, and high signal

  8. Enhanced heat shock protein 25 immunoreactivity in cranial nerve motoneurons and their related fiber tracts in rats prenatally-exposed to X-irradiation.

    PubMed

    Sawada, Kazuhiko; Saito, Shigeyoshi; Horiuchi-Hirose, Miwa; Murase, Kenya

    2014-05-01

    Alterations in histoarchitecture of the brainstem were examined immunohistochemically in 4-week-old rats with a single whole body X-irradiation at a dose of 0.5, 1.0, or 1.5 Gy on embryonic day (ED) 15 using anti-heat shock protein 25 (HSP25). HSP25 immunostaining was seen in the neuronal perikarya of cranial nerve motoneurons, that is, the motor and mesencephalic nuclei of the trigeminal nerve, facial nucleus, abducens nucleus and accessory facial nucleus in the pons, and the ambiguous nucleus, dorsal nucleus of vagus nerve and hypoglossus nucleus in the medulla oblongata of intact controls. In 0.5 to 1.5 Gy-irradiated rats, HSP25 immunostaining in those neurons was more intense than in controls, while the most intense immunostaining was marked in 1.5 Gy-irradiated rats. HSP25 immunostaining was also apparent in the spinal tract of the trigeminal nerve and facial nerve tracts in 0.5 to 1.5 Gy-irradiated rats, but was faint in controls. Interestingly, HSP25 immunostaining was aberrantly enhanced in dendritic arbors in the magnocellular region of medial vestibular nucleus of 0.5-1.5 Gy-irradiated rats. Those arbors were identified as excitatory secondary vestibulo-ocular neurons by double immunofluorescence for HSP25 and SMI-32. The results suggest an increase of HSP25 expression in cranial nerve motoneurons and their related fiber tracts from prenatal exposure to ionizing irradiation. This may be an adaptive response to chronic hypoxia due to malformed brain arteries caused by prenatal ionizing irradiation. PMID:24750554

  9. Importance of Tissue Morphology Relative to Patient Reports of Symptoms and Functional Limitations Resulting From Median Nerve Pathology

    PubMed Central

    Evans, Kevin D.; Li, Xiaobai; Sommerich, Carolyn M.; Case-Smith, Jane

    2013-01-01

    Significant data exist for the personal, environmental, and occupational risk factors for carpal tunnel syndrome. Few data, however, explain the interrelationship of tissue morphology to these factors among patients with clinical presentation of median nerve pathology. Therefore, our primary objective was to examine the relationship of various risk factors that may be predictive of subjective reports of symptoms or functional deficits accounting for median nerve morphology. Using diagnostic ultrasonography, we observed real-time median nerve morphology among 88 participants with varying reports of symptoms or functional limitations resulting from median nerve pathology. Body mass index, educational level, and nerve morphology were the primary predictive factors. Monitoring median nerve morphology with ultrasonography may provide valuable information for clinicians treating patients with symptoms of median nerve pathology. Sonographic measurements may be a useful clinical tool for improving treatment planning and provision, documenting patient status, or measuring clinical outcomes of prevention and rehabilitation interventions. PMID:23245784

  10. Cranial Nerve I

    PubMed Central

    Sanders, Richard D.

    2009-01-01

    Olfactory (smell) testing is one of the most interesting and revealing individual neurologic tests in psychiatric research. It is also one of the most neglected tests in the clinical practice of psychiatry. There are several diagnostic applications of smell testing in clinical psychiatry. This review covers reasons for the psychiatrist to test olfaction, ways of testing olfaction, and how to interpret test results. PMID:19724767

  11. Microvascular Cranial Nerve Palsy

    MedlinePLUS

    ... Adults Over 60 Babies, Children & Teenagers Computer Usage Diabetes Diet & Nutrition Eye Injuries Eye Screening Guidelines Home Remedies for Simple Eye Problems Medical Marijuana for Glaucoma Pregnancy Preventing Eye Injuries Smokers Sports ...

  12. ARA 290 Improves Symptoms in Patients with Sarcoidosis-Associated Small Nerve Fiber Loss and Increases Corneal Nerve Fiber Density

    PubMed Central

    Dahan, Albert; Dunne, Ann; Swartjes, Maarten; Proto, Paolo L; Heij, Lara; Vogels, Oscar; van Velzen, Monique; Sarton, Elise; Niesters, Marieke; Tannemaat, Martijn R; Cerami, Anthony; Brines, Michael

    2013-01-01

    Small nerve fiber loss and damage (SNFLD) is a frequent complication of sarcoidosis that is associated with autonomic dysfunction and sensory abnormalities, including pain syndromes that severely degrade the quality of life. SNFLD is hypothesized to arise from the effects of immune dysregulation, an essential feature of sarcoidosis, on the peripheral and central nervous systems. Current therapy of sarcoidosis-associated SNFLD consists primarily of immune suppression and symptomatic treatment; however, this treatment is typically unsatisfactory. ARA 290 is a small peptide engineered to activate the innate repair receptor that antagonizes inflammatory processes and stimulates tissue repair. Here we show in a blinded, placebo-controlled trial that 28 d of daily subcutaneous administration of ARA 290 in a group of patients with documented SNFLD significantly improves neuropathic symptoms. In addition to improved patient-reported symptom-based outcomes, ARA 290 administration was also associated with a significant increase in corneal small nerve fiber density, changes in cutaneous temperature sensitivity, and an increased exercise capacity as assessed by the 6-minute walk test. On the basis of these results and of prior studies, ARA 290 is a potential disease-modifying agent for treatment of sarcoidosis-associated SNFLD. PMID:24136731

  13. ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density.

    PubMed

    Dahan, Albert; Dunne, Ann; Swartjes, Maarten; Proto, Paolo L; Heij, Lara; Vogels, Oscar; van Velzen, Monique; Sarton, Elise; Niesters, Marieke; Tannemaat, Martijn R; Cerami, Anthony; Brines, Michael

    2013-01-01

    Small nerve fiber loss and damage (SNFLD) is a frequent complication of sarcoidosis that is associated with autonomic dysfunction and sensory abnormalities, including pain syndromes that severely degrade the quality of life. SNFLD is hypothesized to arise from the effects of immune dysregulation, an essential feature of sarcoidosis, on the peripheral and central nervous systems. Current therapy of sarcoidosis-associated SNFLD consists primarily of immune suppression and symptomatic treatment; however, this treatment is typically unsatisfactory. ARA 290 is a small peptide engineered to activate the innate repair receptor that antagonizes inflammatory processes and stimulates tissue repair. Here we show in a blinded, placebo-controlled trial that 28 d of daily subcutaneous administration of ARA 290 in a group of patients with documented SNFLD significantly improves neuropathic symptoms. In addition to improved patient-reported symptom-based outcomes, ARA 290 administration was also associated with a significant increase in corneal small nerve fiber density, changes in cutaneous temperature sensitivity, and an increased exercise capacity as assessed by the 6-minute walk test. On the basis of these results and of prior studies, ARA 290 is a potential disease-modifying agent for treatment of sarcoidosis-associated SNFLD. PMID:24136731

  14. Monofilament Insensitivity and Small and Large Nerve Fiber Symptoms in Impaired Fasting Glucose

    PubMed Central

    Ylitalo, Kelly R.; Herman, William H.; Harlow, Siobán D.

    2014-01-01

    Aims To determine if diabetes or pre-diabetes is associated with monofilament insensitivity and peripheral neuropathy symptoms. Methods The 10-g Semmes-Weinstein monofilament test and Michigan Neuropathy Screening Instrument symptom questionnaire were administered to participants in the Study of Women’s Health Across the Nation – Michigan site (n=396). We determined the concordance of monofilament insensitivity and symptoms and used chi-square tests, ANOVA, and logistic regression to quantify the relationships among diabetes status, monofilament insensitivity, and symptoms. Results The prevalence of monofilament insensitivity was 14.3%, and 19.4% of women reported symptoms of peripheral neuropathy. With monofilament testing, 11.7% of women with normal fasting glucose, 14.4% of women with impaired fasting glucose (IFG), and 18.3% of women with diabetes had monofilament insensitivity (p-value=0.33). For symptoms, 14.0% of women with normal fasting glucose, 16.5% of women with IFG, and 31.2% of women with diabetes reported symptoms of peripheral neuropathy. Women who reported symptoms of small fiber nerve dysfunction alone were unlikely to have monofilament insensitivity. Compared to women with normal fasting glucose, women with diabetes were more likely to report peripheral neuropathy symptoms [OR 2.8 (95% CI: 1.5, 5.1)]. Women with diabetes were also more likely to report symptoms than women with IFG (p=0.02). There was no difference in the frequency of symptoms between women with normal fasting glucose and IFG. Conclusions Women with diabetes were more likely to report peripheral neuropathy symptoms. The prevalence of monofilament insensitivity and peripheral neuropathy symptoms did not differ between women with normal fasting glucose and IFG. PMID:23896181

  15. Course of symptoms and median nerve conduction values in workers performing repetitive jobs at risk for carpal tunnel syndrome

    Microsoft Academic Search

    Roberta Bonfiglioli; Stefano Mattioli; Maria Rosa Spagnolo; Francesco Saverio Violante

    To investigate the prevalence of CTS in a group of workers exposed to intensive use of the hands and the course of symptoms and median nerve conduction values after a period of reduced exposure to biomechanical risk factors. Methods CTS was assessed in assembly and non-assembly line workers by means of clinical examinations and nerve conduction studies (NCS). Ergonomic analysis

  16. Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports

    Microsoft Academic Search

    A-M Childs; J F Meaney; C D Ferrie; P C Holland

    2000-01-01

    Trigeminal neuralgia (TN) is a frequent cause of paroxysmal facial pain and headache in adults. Glossopharyngeal neuralgia (GPN) is less common, but can cause severe episodic pain in the ear and throat. Neurovascular compression of the appropriate cranial nerve as it leaves the brain stem is responsible for the symptoms in many patients, and neurosurgical decompression of the nerve is

  17. Skull base osteomyelitis presenting with an isolated hypoglossal nerve palsy

    PubMed Central

    Kasfiki, Eirini Vasileiou; Kelly, Ciaran; Smith, John; Nicolaides, Andreas

    2013-01-01

    This is the first case of skull base osteomyelitis presenting with isolated bilateral hypoglossal nerve palsy reported in the literature. A 75-year-old man presented with tongue paralysis without any other cranial nerve palsy. He was otherwise well apart from recently having a high prostate-specific antigen level recorded. Investigations for malignancy or cerebrovascular insult were negative with the diagnosis of skull base osteomyelitis confirmed using CT. Following treatment with intravenous antibiotics for 6?weeks, symptoms resolved. PMID:23853016

  18. The congenital cranial dysinnervation disorders.

    PubMed

    Gutowski, N J; Chilton, J K

    2015-07-01

    Congenital cranial dysinnervation disorders (CCDD) encompass a number of related conditions and includes Duane syndrome, congenital fibrosis of the external ocular muscles, Möbius syndrome, congenital ptosis and hereditary congenital facial paresis. These are congenital disorders where the primary findings are non-progressive and are caused by developmental abnormalities of cranial nerves/nuclei with primary or secondary dysinnervation. Several CCDD genes have been found, which enhance our understanding of the mechanisms involved in brain stem development and axonal guidance. PMID:25633065

  19. Ophthalmoplegic "migraine" or recurrent ophthalmoplegic cranial neuropathy: new cases and a systematic review.

    PubMed

    Gelfand, Amy A; Gelfand, Jeffrey M; Prabakhar, Prab; Goadsby, Peter J

    2012-06-01

    Ophthalmoplegic migraine is a poorly understood neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. By reviewing cases presenting to our centers in whom the phenotype has been carefully dissected, and systematically reviewing all published cases of ophthalmoplegic migraine in the magnetic resonance imaging (MRI) era, this review sets out to clearly define the syndrome and discuss possible etiologies. We found that in up to one-third of patients, the headache was not migrainous or associated with migrainous symptoms. In three-quarters of the cases involving the third nerve, there was focal nerve thickening and contrast enhancement on MRI. Observational data suggest systemic corticosteroids may be beneficial acutely. The etiology remains unclear, but may involve recurrent bouts of demyelination of the oculomotor nerve. "Ophthalmoplegic migraine" is a misnomer in that it is probably not a variant of migraine but rather a recurrent cranial neuralgia. A more appropriate name might be "ophthalmoplegic cranial neuropathy." PMID:22241707

  20. Transcutaneous electrical nerve stimulation (TENS) improves upper GI symptoms and balances the sympathovagal activity in scleroderma patients.

    PubMed

    Sallam, Hanaa; McNearney, Terry A; Doshi, Dipti; Chen, J D Z

    2007-05-01

    To assess the impact of transcutaneous electrical nerve stimulation (TENS) at gastrointestinal (GI) acupoints on GI symptoms and quality of life in scleroderma patients, 17 patients filled out SF-36 and GI symptom questionnaires before the electrocardiogram was recorded for two intervals: baseline and TENS. At home, patients applied TENS for 14 days, then were reassessed. Acutely, TENS application significantly increased sympathetic and vagal activities vs. baseline (P=0.02 and P=0.004), respectively. Prolonged TENS application normalized the sympathovagal balance (P=0.04), decreased GI symptom scores (P=0.02) and increased the physical functioning score (SF36), which strongly correlated with the change in the sympathovagal balance (r=0.6, P=0.02). In conclusion, TENS at GI acupoints offers a potential option in the treatment of upper GI symptoms, but further study is necessary. PMID:17372833

  1. Changes in Cholinesterase Activity, Nerve Conduction Velocity, and Clinical Signs and Symptoms in Termite Control Operators Exposed to Chlorpyrifos

    Microsoft Academic Search

    Masahiro GOTOH; Isao SAITO; Jian HUANG; Yukio FUKAYA; Tadao MATSUMOTO; Naomi HISANAGA; Eiji SHIBATA; Gaku ICHIHARA; Michihiro KAMIJIMA; Yasuhiro TAKEUCHI

    2001-01-01

    Changes in Cholinesterase Activity, Nerve Conduction Velocity, and Clinical Signs and Symptoms in Termite Control Operators Exposed to Chlorpyrifos: Masahiro GOTOH, et al. Asahi Rosai Hospital—We have surveyed periodical medical examinations for pest and termite control operators (n=64) exposed to chlorpyrifos and other organophosphate pesticides. Distribution of serum butyrylcholinesterase (BuChE) activities of all workers ranged 0.01-1.18 (? pH). Serum BuChE

  2. Prevention of upper limb symptoms and signs of nerve afflictions in computer operators: The effect of intervention by stretching

    PubMed Central

    Jepsen, Jorgen R; Thomsen, Gert

    2008-01-01

    Background In a previous study of computer operators we have demonstrated the relation of upper limb pain to individual and patterns of neurological findings (reduced function of muscles, sensory deviations from normal and mechanical allodynia of nerve trunks). The identified patterns were in accordance with neural afflictions at three specific locations (brachial plexus at chord level, posterior interosseous and median nerve on elbow level). We have introduced an intervention program aiming to mobilize nerves at these locations and tested its efficacy. Methods 125 and 59, respectively, computer operators in two divisions of an engineering consultancy company were invited to answer a questionnaire on upper limb symptoms and to undergo a blinded neurological examination. Participants in one division were subsequently instructed to participate in an upper limb stretching course at least three times during workdays in a six month period. Subjects from the other division served as controls. At the end of the intervention both groups were invited to a second identical evaluation by questionnaire and physical examination. Symptoms and findings were studied in the right upper limb. Perceived changes of pain were recorded and individual and patterns of physical findings assessed for both groups at baseline and at follow-up. In subjects with no or minimal preceding pain we additionally studied the relation of incident pain to the summarized findings for parameters contained in the definition of nerve affliction at the three locations. Results Summarized pain was significantly reduced in the intervention group but unchanged in controls. After the intervention, fewer neurological abnormalities in accordance with nerve affliction were recorded for the whole material but no conclusion could be drawn regarding the relation to the intervention of this reduction. Incident pain correlated to findings in accordance with the three locations of nerve affliction. Conclusion A six month course of stretching seems to reduce upper limb symptoms in computer operators but we could not demonstrate an influence on neurological physical findings in this sample. The relation of incident symptoms to identified neurological patterns provides additional support to the construct validity of the employed neurological examination. PMID:18179682

  3. Cranial nerves palsy as an initial feature of an early onset distal hereditary motor neuropathy – A new distal hereditary motor neuropathy phenotype

    Microsoft Academic Search

    J. Haberlová; K. G. Claeys; P. De Jonghe; P. Seeman

    2009-01-01

    Distal hereditary motor neuropathy is a heterogeneous group of disorders characterised by a pure motor axonal neuropathy. It is occasionally associated with additional signs such as facial weakness, vocal cord paralysis, weakness of the diaphragm, and pyramidal signs. Although predominantly the inheritance is autosomal dominant, all types of inheritance have been described. Here we report a Czech family with cranial

  4. Vagus nerve stimulation for pharmacoresistant epilepsy: clinical symptoms with end of service

    Microsoft Academic Search

    W. O. Tatum IV; J. A. Ferreira; S. R. Benbadis; L. S. Heriaud; M. Gieron; N. T. Rodgers-Neame; F. L. Vale

    2004-01-01

    Purpose. Limited capability exists to predict when vagus nerve stimulation (VNS) battery deterioration becomes significant. Initial models last 2–5 years. We evaluated the first 18 patients with pharmacoresistent epilepsy after reimplantation to examine the clinical course observed during VNS end of service (EOS).Methods. Of 72 patients with VNS, 18 patients had generator replacement. EOS was estimated based on duration of

  5. Glomus jugulare presenting with isolated facial nerve palsy.

    PubMed

    Nunez, Angelica A; Ramos-Duran, Luis R; Cuetter, Albert C

    2014-01-01

    Glomus jugulare is a rare slow growing tumor occurring within the jugular foramen that rarely presents with isolated symptoms. Although histologically benign, these tumors are locally destructive because of their proximity to the petrous bone, the lower cranial nerves, and the major vascular structures (Miller et al. (2009) and Silverstone (1973)). We wish to report a glomus jugulare tumor eroding the petrous bone and producing an ipsilateral peripheral facial weakness. The mechanism of this erosion is discussed. PMID:25374954

  6. Glomus Jugulare Presenting with Isolated Facial Nerve Palsy

    PubMed Central

    Nunez, Angelica A.; Ramos-Duran, Luis R.; Cuetter, Albert C.

    2014-01-01

    Glomus jugulare is a rare slow growing tumor occurring within the jugular foramen that rarely presents with isolated symptoms. Although histologically benign, these tumors are locally destructive because of their proximity to the petrous bone, the lower cranial nerves, and the major vascular structures (Miller et al. (2009) and Silverstone (1973)). We wish to report a glomus jugulare tumor eroding the petrous bone and producing an ipsilateral peripheral facial weakness. The mechanism of this erosion is discussed. PMID:25374954

  7. Acute Cranial Neuropathies Heralding Neurosyphilis in a Human Immunodeficiency Virus-Infected Patient

    PubMed Central

    Alqahtani, Saeed

    2014-01-01

    Patient: Male, 31 Final Diagnosis: Neurosyphilis Symptoms: Diplopia •facial droop • facial nerve palsy • headache Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Unusual clinical course Background: Symptomatic early neurosyphilis with isolated acute multiple cranial nerves palsy as initial manifestation of HIV infection is very rare. It is caused by direct invasion of the central nervous system by the spirochete Treponema pallidum. Case Report: A 31-year-old African-American homosexual man presented with bilateral hearing loss, constant vertigo, intermittent horizontal diplopia, and bilateral facial droop, which was associated with occipital headache without fever. Neurological examination revealed bilateral vestibulocochlear and facial nerve palsy. On brain magnetic resonance imaging (MRI) before and after administration of gadolinium, he was found to have extensive isolated basilar meningeal enhancement involving the midbrain, pons along the seven and eight nerves complex bilaterally, consistent with basal meningoencephalitis. Conclusions: Neurosyphilis can present as initial manifestation of HIV infection with early involvement of basal meninges and cranial nerves. It is important to understand that neurosyphilis is still a significant disease with complex neurological presentation. Early diagnosis and treatment of neurosyphilis is crucial due to potential persistent disabilities that can be easily treated or even prevented. PMID:25265092

  8. Precraniate origin of cranial motoneurons

    PubMed Central

    Dufour, Héloïse D.; Chettouh, Zoubida; Deyts, Carole; de Rosa, Renaud; Goridis, Christo; Joly, Jean-Stéphane; Brunet, Jean-François

    2006-01-01

    The craniate head is innervated by cranial sensory and motor neurons. Cranial sensory neurons stem from the neurogenic placodes and neural crest and are seen as evolutionary innovations crucial in fulfilling the feeding and respiratory needs of the craniate “new head.” In contrast, cranial motoneurons that are located in the hindbrain and motorize the head have an unclear phylogenetic status. Here we show that these motoneurons are in fact homologous to the motoneurons of the sessile postmetamorphic form of ascidians. The motoneurons of adult Ciona intestinalis, located in the cerebral ganglion and innervating muscles associated with the huge “branchial basket,” express the transcription factors CiPhox2 and CiTbx20, whose vertebrate orthologues collectively define cranial motoneurons of the branchiovisceral class. Moreover, Ciona's postmetamorphic motoneurons arise from a hindbrain set aside during larval life and defined as such by its position (caudal to the prosensephalic sensory vesicle) and coexpression of CiPhox2 and CiHox1, whose orthologues collectively mark the vertebrate hindbrain. These data unveil that the postmetamorphic ascidian brain, assumed to be a derived feature, in fact corresponds to the vertebrate hindbrain and push back the evolutionary origin of cranial nerves to before the origin of craniates. PMID:16735475

  9. Primary glioblastoma of the trigeminal nerve root entry zone: case report.

    PubMed

    Breshears, Jonathan D; Ivan, Michael E; Cotter, Jennifer A; Bollen, Andrew W; Theodosopoulos, Phillip V; Berger, Mitchel S

    2015-01-01

    Gliomas of the cranial nerve root entry zone are rare clinical entities. There have been 11 reported cases in the literature, including only 2 glioblastomas. The authors report the case of a 67-year-old man who presented with isolated facial numbness and was found to have a glioblastoma involving the trigeminal nerve root entry zone. After biopsy the patient completed treatment with conformal radiation and concomitant temozolomide, and at 23 weeks after surgery he demonstrated symptom progression despite the treatment described. This is the first reported case of a glioblastoma of the trigeminal nerve root entry zone. PMID:25380115

  10. The vestibulocochlear nerve (VIII).

    PubMed

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

    2013-10-01

    The vestibulocochlear nerve (8th cranial nerve) is a sensory nerve. It is made up of two nerves, the cochlear, which transmits sound and the vestibular which controls balance. It is an intracranial nerve which runs from the sensory receptors in the internal ear to the brain stem nuclei and finally to the auditory areas: the post-central gyrus and superior temporal auditory cortex. The most common lesions responsible for damage to VIII are vestibular Schwannomas. This report reviews the anatomy and various investigations of the nerve. PMID:24095603

  11. A study of Guillain–Barré syndrome with reference to cranial neuropathy and its prognostic implication

    PubMed Central

    Bhargava, Amita; Banakar, Basavaraj F.; Pujar, Guruprasad S.; Khichar, Shubhakaran

    2014-01-01

    Background: Focused studies on cranial neuropathy in Guillain–Barré syndrome (GBS) and its prognostic implication are not done previously. Aim: To study the clinical profile of GBS patients with special reference to cranial neuropathy and its prognostic implication. Materials and Methods: The study included 61 patients with GB syndrome, fulfilling Asbury Cornblath's criteria for GB syndrome. A pre-designed semi-structured questionnaire was used to obtain data regarding demographic profile and clinical profile. All patients underwent detailed neurological examination, investigations including nerve conduction studies and CSF examination and treated according to the severity of the illness. Patients were followed up for 6 months. During analysis two groups were made depending on cranial nerve involvement, and compared with respect to various parameters. Results: Out of 61 patients 38 (62.3%) patients had cranial nerve palsies, in that 25 had multiple cranial nerve palsies, and 13 had single isolated nerve palsy. A majority of 30 (49.2%) had bulbar palsy, 28 (46%) had facial nerve palsy, and all had bilateral involvement except 3 patients who had unilateral palsy. Hypoglossal nerve involvement was seen in six (10%) patients and four (6.5%) patients had ophthalmoplegia. Only one had bilateral vestibulocochlear nerve palsy. On comparing various clinico-electrophysiological parameters among patients of GB syndrome with and without cranial nerve involvement, the presence of respiratory paralysis, IVIg and ventilatory support requirement had significant association with cranial nerve involvement in GBS. Conclusion: Our study found a correlation between cranial nerve palsies and severity of the illness. Cranial nerve innervated muscles recover earlier as compared to distal limb muscles. No association was found between outcome at 6 months and cranial nerve involvement. PMID:25540538

  12. Multiple cranial neuropathies in cerebral venous sinus thrombosis

    PubMed Central

    Mubbashir Shariff, Erum; Alhameed, Majed

    2014-01-01

    Clinical presentation of cerebral venous sinus thrombosis (CVST) is varied and often mimics many neurological disorders, making it a diagnostic challenge, and cranial nerve palsy in CVST is rare and its pathophysiology remains unclear. We report a case of a 19-year-old male with a history of whiplash injury, admitted with extensive CVST, developed right facial nerve palsy with extension of thrombus into the ipsilateral transverse sinus, sigmoid sinus and internal jugular vein. Later, he developed left facial nerve palsy with partial left occulomotor weakness. We suggest that either reversible compromised oxygen or glucose consumption within the intrinsic vascular system of the nerve, resulting in cranial nerve abnormalities. CVST should be considered in cases of trivial trauma, even in the absence of hyper-coagulable states, and it can have atypical presentation like multiple cranial neuropathies. PMID:25988013

  13. [Congenital cranial dysinnervation disorders (CCDD)].

    PubMed

    Nentwich, M M; Nentwich, M F; Maertz, J; Brandlhuber, U; Rudolph, G

    2015-03-01

    Knowledge about hereditary eye diseases has been substantially increased by means of genetic testing during the last decade. This has resulted in a new classification of a number of disease patterns, which are characterised by non-progressive restrictive disorders of the oculomotor system, formerly classified as "congenital fibrosis syndromes". Based on the results of genetic testing, these ocular motility disorders are now referred to as "congenital cranial dysinnervation disorders" (CCDDs). They are caused by an impaired innervation of extraocular muscles because of a dysgenesis of the nuclei of the affected cranial nerves in the brainstem and pons and not by primary fibrosis of the extraocular muscles. In this review, congenital fibrosis of the extraocular muscles (CFEOM), Duane syndrome, horizontal gaze palsy with progressive scoliosis, congenital ptosis and Moebius syndrome are presented and basic principles of intracellular transport mechanisms and kinesins are discussed. PMID:25803556

  14. Macro anatomical investigations of the cranial cervical ganglion in domestic pig (Sus scrofa domesticus).

    PubMed

    Kabak, M; Orhan, I O; Haziroglu, R M

    2005-06-01

    In this study, the left and right cranial cervical ganglia (ganglion cervicale craniale) of eight young (four male, four female) domestic pigs weighing around 70-80 kg were inspected macro anatomically. The cranial cervical ganglion (CCG) was found cranio-ventrally of the distal ganglion of the vagus nerve, medial of the jugular process extremity, ventral of the atlas, dorsal of the epiglottis base and medial of the common root (CR) established by the internal carotid and occipital arteries. The internal carotid nerve and jugular nerve ramified from the cranial part of CCG. The jugular nerve gave branches that merged with the vagus and glossopharyngeal nerves. Other nerve branches originating from the cranial part of the ganglion reached to the external carotid artery and CR. The internal carotid nerve varied among cadavers in number of branches (two to four). These branches did not travel along the side of the internal carotid artery. The central part of CCG gave thin nerve branches that reached to various anatomical structures including the first and second cervical nerves, wall of the pharynx, accessory nerve, hypoglossal nerve, vagus nerve, external carotid artery and CR. The caudal part of CCG gave nerve branches that merged with the vagus, cranial laryngeal nerves, and common carotid artery. The external carotid nerves, which were two or three in number, also originated from the caudal part of CCG. In conclusion, the nerves ramifying from CCG of the pig varied in number among cadavers. Compared with literature raised in other species, there are also differences in number of nerve branches and course pattern of these nerves. PMID:15929737

  15. Primate cranial diversity.

    PubMed

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

    2010-08-01

    Many studies in primate and human evolution focus on aspects of cranial morphology to address issues of systematics, phylogeny, and functional anatomy. However, broad analyses of cranial diversity within Primates as an Order are notably absent. In this study, we present a 3D geometric morphometric analysis of primate cranial morphology, providing a multivariate comparison of the major patterns of cranial shape change during primate evolution and quantitative assessments of cranial diversity among different clades. We digitized a set of 18 landmarks designed to capture overall cranial shape on male and female crania representing 66 genera of living primates. The landmark data were aligned using a Generalized Procrustes Analysis and then subjected to a principal components analysis to identify the major axes of cranial variation. Cranial diversity among clades was compared using multivariate measurements of variance. The first principal component axis reflects differences in cranial flexion, orbit size and orientation, and relative neurocranial volume. In general, it separates strepsirrhines from anthropoids. The second axis reflects differences in relative cranial height and snout length and primarily describes differences among anthropoids. Eulemur, Mandrillus, Pongo, and Homo are among the extremes in cranial shape. Anthropoids, catarrhines, and haplorhines show a higher variance than prosimians or strepsirrhines. Hominoids show the highest variance in cranial shape among extant primate clades, and much of this diversity is driven by the unique cranium of Homo sapiens. PMID:20186744

  16. Concordance between epidermal nerve fiber density and sensory examination in patients with symptoms of idiopathic small fiber neuropathy

    Microsoft Academic Search

    David Walk; Gwen Wendelschafer-Crabb; Cynthia Davey; William R. Kennedy

    2007-01-01

    Quantitation of epidermal nerve fiber (ENF) density is an objective diagnostic test of small fiber neuropathy (SFN). For a diagnostic test to be clinically useful it should correspond well with clinically meaningful physical findings. We performed a retrospective analysis of the concordance between foot ENF density and clinical findings in all patients seen at our institution with possible idiopathic SFN

  17. Trichloroethylene cranial neuropathy: is it really a toxic neuropathy or does it activate latent herpes virus?

    Microsoft Academic Search

    J B Cavanagh; P H Buxton

    1989-01-01

    The mechanism of the cranial neuropathy associated with heavy exposure to trichloroethylene (or dichloroethylene) is unknown. In severe cases there is destructive spread of the neuropathic process from the Vth cranial nerve nuclei up and down the brain stem in a manner that is difficult to explain on accepted neurotoxicological principles. However, there is a close association reported of this

  18. Tolosa-hunt syndrome versus recurrent cranial neuropathy

    Microsoft Academic Search

    F. Barontini; S. Maurri; E. Marrapodi

    1987-01-01

    Two patients are described who had suffered for 12 years from episodes of painful ophthalmoplegia consistent with a Tolosa-Hunt syndrome (THS) alternating with palsies of cranial nerves other than the oculomotor (fifth motor and seventh on both sides). These two cases, as well as other similar ones previously reported in the literature, suggest that THS may sometimes be a variant

  19. Facial and Lower Cranial Neuropathies after Preoperative Embolization of Jugular Foramen Lesions with Ethylene Vinyl Alcohol

    PubMed Central

    Gartrell, Brian C; Hansen, Marlan R; Gantz, Bruce J; Gluth, Michael B; Mowry, Sarah E; Aagaard-Kienitz, Beverly L; Baskaya, Mustafa K; Gubbels, Samuel P

    2013-01-01

    Objective To report three unique cases of cranial neuropathy after super-selective arterial embolization of jugular foramen vascular tumors with ethylene vinyl alcohol. Study Design Clinical capsule report Setting Three tertiary academic referral hospitals Patients Three patients who underwent superselective arterial embolization (SSE) of head and neck paragangliomas with ethylene vinyl alcohol are described. One individual was treated with primary SSE, while the remaining tumors were treated with preoperative SSE followed by surgical extirpation within 72 hours. All patients were found to have new cranial nerve deficits following SSE. Results One patient with isolated complete cranial nerve VII palsy demonstrated no return of function. One individual experienced cranial nerve VII, X, and XII palsies and demonstrated partial recovery of function of the involved facial nerve after 19 months. One subject experienced ipsilateral cranial nerve X and XI palsies after SSE and recovered full function of the spinal accessory nerve within one week, but failed to demonstrate mobility of the ipsilateral true vocal fold. Conclusion We present the first report documenting facial and lower cranial neuropathies after super-selective embolization of head and neck paragangliomas with EVA. Although it is difficult to draw conclusions from this small number of cases, it is plausible that use of ethylene vinyl alcohol during SSE may result in a higher risk of permanent cranial neuropathy than the use of other well-established and more temporary agents. Knowledge of the arterial supply to the cranial nerves can help the clinician to choose the embolization agent that will provide maximal occlusion while minimizing the risk of complications. PMID:22801041

  20. Cranial Neuropathy due to Intradural Disc Herniation

    PubMed Central

    Rapoport, Benjamin I.; Hartl, Roger; Schwartz, Theodore H.

    2014-01-01

    Background and Importance Herniated intervertebral disc fragments rarely penetrate the thecal sac, and intracranial hypotension attributable to such penetrating fragments is even more unusual. We describe the first reported case of a cranial neuropathy due to intradural herniation of a disc fragment, in which intracranial hypotension from a resulting cerebrospinal fluid leak caused bilateral abducens palsies. Clinical Presentation A 45-year-old man presented with a positional headache after having experienced a “popping” sensation in his back while lifting a heavy object. He also complained of blurred vision and was noted to have lateral gaze palsies bilaterally. Magnetic resonance imaging (MRI) of the brain revealed bilateral subdural collections, abnormal pachymeningeal enhancement, and cerebellar tonsillar herniation, suggesting intracranial hypotension. T2-weighted MRI of the spine revealed extrusion of the T12-L1 disc and suggested the presence of a disc fragment in the intradural space, displacing the caudal nerve roots. A myelogram demonstrated a filling defect extending into the subarachnoid space adjacent to the disc herniation, consistent with a free disc fragment in the intradural space. A diagnosis of intracranial hypotension due to a cerebrospinal fluid leak resulting from an intradural herniated disc was made. The diagnosis was confirmed intraoperatively. Conclusion Surgical removal of the herniated disc fragment and repair of the dural defect resulted in complete resolution of the cranial neuropathy. This rare etiology of a cranial neuropathy, arising from pathology in the thoracolumbar spine, illustrates the clinical teaching that the sixth cranial nerves are highly sensitive to deformation induced by intracranial hypotension. PMID:24535263

  1. Facial nerve paralysis: A case report of rare complication in uncontrolled diabetic patient with mucormycosis

    PubMed Central

    Shekar, Vandana; Sikander, Jeelani; Rangdhol, Vishwanath; Naidu, Madhulika

    2015-01-01

    Mucormycosis is a rare opportunistic aggressive and fatal infection caused by mucor fungus. Seven types of mucormycosis are identified based on the extension and involvement of the lesion, of which the rhino orbital mucormycosis is most common in the head and neck region. Although it is widely spread in nature, clinical cases are rare and observed only in immunocompromised patients and patients with uncontrolled diabetes mellitus. Early symptoms include fever, nasal ulceration or necrosis, periorbital edema or facial swelling, paresthesia and reduced vision. Involvement of cranial nerves although not common, facial nerve palsy is a rare finding. The infection may spread through cribriform plate to the brain resulting in extensive cerebellar infarctions. Timely diagnosis and early recognition of the signs and symptoms, correction of underlying medical disorders, and aggressive medical and surgical intervention are necessary for successful therapeutic outcome. PMID:25810669

  2. Neuromuscular hamartoma of the sciatic nerve: Case report and review of the literature

    PubMed Central

    Lam, Sandi; Grandhi, Ramesh; Wong, Ricky; Hamilton, Ronald; Greene, Stephanie

    2013-01-01

    Background: Neuromuscular hamartomas are rare benign tumors with mature skeletal elements mixed with mature neural elements. They present typically as solitary lesions in childhood and have been reported to be associated with cranial nerves or large peripheral nerves such as the brachial plexus, median nerve, and sciatic nerve. To date, eight cases of sciatic nerve neuromuscular hamartomas have been reported. We present a case along with an outline for the natural history of the disease with a review of the literature of the reported cases dating back to 1895. Case Description: An 11-year-old boy presented with progressive right lower extremity pain and atrophy. Magnetic resonance imaging revealed a large right sciatic nerve mass, and electromyography demonstrated evidence of ongoing denervation and reinnervation. Initial computed tomography-guided biopsy was unrevealing and subsequent open biopsy was consistent with neuromuscular choristoma. Conclusion: Neuromuscular choristomas represent a rare disease. Symptoms of foot deformity, leg size discrepancy, and pain merit a complete work-up including spinal and peripheral nerve etiologies. PMID:23493803

  3. Stereotactic Radiotherapy for Intracranial Nonacoustic Schwannomas Including Facial Nerve Schwannoma

    SciTech Connect

    Nishioka, Kentaro; Abo, Daisuke; Aoyama, Hidefumi [Department of Radiology, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Furuta, Yasushi [Department of Oto-laryngology, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Onimaru, Rikiya; Onodera, Shunsuke [Department of Radiology, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Sawamura, Yutaka [Department of Neuro-surgery, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Ishikawa, Masayori [Department of Medical Physics, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Fukuda, Satoshi [Department of Oto-laryngology, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Shirato, Hiroki, E-mail: shirato@med.hokudai.ac.j [Department of Radiology, Graduate School of Medicine, Hokkaido University, Sapporo (Japan)

    2009-12-01

    Purpose: Although the effectiveness of stereotactic radiosurgery for nonacoustic schwannomas is currently being assessed, there have been few studies on the efficacy of stereotactic radiotherapy (SRT) for these tumors. We investigated the long-term outcome of SRT for nonacoustic intracranial nerve schwannomas. Methods and Materials: Seventeen patients were treated between July 1994 and December 2006. Of these patients, 7 had schwannomas located in the jugular foramen, 5 in the trigeminal nerve, 4 in the facial nerve, and 1 in the oculomotor nerve. Radiotherapy was used as an initial treatment without surgery in 10 patients (59%) and after initial subtotal resection in the remaining patients. The tumor volume ranged from 0.3 to 31.3 mL (mean, 8.2 mL). The treatment dose was 40 to 54 Gy in 20 to 26 fractions. The median follow-up period was 59.5 months (range, 7.4-122.6 months). Local control was defined as stable or decreased tumor size on follow-up magnetic resonance imaging. Results: Tumor size was decreased in 3 patients, stable in 13, and increased in 1 after SRT. Regarding neurologic symptoms, 8 patients (47%) had improvement and 9 patients were unchanged. One patient had an increase in tumor size and received microsurgical resection at 32 months after irradiation. No patient had worsening of pre-existing neurologic symptoms or development of new cranial nerve deficits at the last follow-up. Conclusions: SRT is an effective alternative to surgical resection for patients with nonacoustic intracranial nerve schwannomas with respect to not only long-term local tumor control but also neuro-functional preservation.

  4. Regulation of Cranial Suture Morphogenesis

    Microsoft Academic Search

    Roy C. Ogle; Sunil S. Tholpady; Kathryn A. McGlynn; Rebecca A. Ogle

    2004-01-01

    The cranial sutures are the primary sites of bone formation during skull growth. Morphogenesis and phenotypic maintenance of the cranial sutures are regulated by tissue interactions, especially those with the underlying dura mater. Removal of the dura mater in fetuses causes abnormal suture development and premature suture obliteration. The dura mater interacts with overlying tissues of the cranial vault by

  5. Cranial magnetic resonance imaging

    SciTech Connect

    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.

  6. On the maxillary nerve.

    PubMed

    Higashiyama, Hiroki; Kuratani, Shigeru

    2014-01-01

    The trigeminal, the fifth cranial nerve of vertebrates, represents the rostralmost component of the nerves assigned to pharyngeal arches. It consists of the ophthalmic and maxillomandibular nerves, and in jawed vertebrates, the latter is further divided into two major branches dorsoventrally. Of these, the dorsal one is called the maxillary nerve because it predominantly innervates the upper jaw, as seen in the human anatomy. However, developmentally, the upper jaw is derived not only from the dorsal part of the mandibular arch, but also from the premandibular primordium: the medial nasal prominence rostral to the mandibular arch domain. The latter component forms the premaxillary region of the upper jaw in mammals. Thus, there is an apparent discrepancy between the morphological trigeminal innervation pattern and the developmental derivation of the gnathostome upper jaw. To reconcile this, we compared the embryonic developmental patterns of the trigeminal nerve in a variety of gnathostome species. With the exception of the diapsid species studied, we found that the maxillary nerve issues a branch (nasopalatine nerve in human) that innervates the medial nasal prominence derivatives. Because the trigeminal nerve in cyclostomes also possesses a similar branch, we conclude that the vertebrate maxillomandibular nerve primarily has had a premandibular branch as its dorsal element. The presence of this branch would thus represent the plesiomorphic condition for the gnathostomes, implying its secondary loss within some lineages. The branch for the maxillary process, more appropriately called the palatoquadrate component of the maxillary nerve (V(2)), represents the apomorphic gnathostome trait that has evolved in association with the acquisition of an upper jaw. PMID:24151219

  7. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    PubMed Central

    Krishnan, Shyam Sundar; Bojja, Sivaram; Vasudevan, Madabhushi Chakravarthy

    2015-01-01

    Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8th cranial nerve (the vestibulo-cochlear nerve) followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed. PMID:25552867

  8. Petrositis With Bilateral Abducens Nerve Palsies complicated by Acute Otitis Media

    PubMed Central

    Choi, Kyu Young

    2014-01-01

    Petrous apicitis is a rare but fatal complication of otitis media. An infection within the middle ear can extend within the temporal bone into the air cells of the petrous apex. With only the thin dura mater separating the trigeminal ganglion and the 6th cranial nerve from the bony petrous apex, they are vulnerable to inflammatory processes, resulting in deep facial pain, lateral rectus muscle paralysis, and diplopia. In 1904, Gradenigo described a triad of symptoms related to petrous apicitis, including acute suppurative otitis media, deep facial pain resulting from trigeminal involvement, and abducens nerve palsy. It has traditionally been treated with surgery, but recent advances in imaging, with improved antibiotic treatment, allow conservative management. In this case report, we describe a clinical and neuroradiological evolution of a child with a petrous apicitis after acute otitis media, which was managed medically with a positive outcome. PMID:24587883

  9. Isolated acute sphenoid sinusitis presenting with hemicranial headache and ipsilateral abducens nerve palsy.

    PubMed

    Gupta, Rahul; Shukla, Rakesh; Mishra, Anupam; Parihar, Anit

    2015-01-01

    Isolated sphenoid sinusitis is a rare disorder and may present with complications due to its anatomical location and proximity to the intracranial and orbital contents. It is frequently misdiagnosed, because the sphenoid sinus is not visualised adequately with routine sinus radiographs and is not accessible to direct clinical examination. We report a case who presented with hemicranial headache and ipsilateral abducens nerve palsy as the presenting feature of sphenoid sinusitis. The symptoms disappeared within a week of conservative treatment. Sphenoid sinusitis should be kept in the differential diagnosis of isolated sixth cranial nerve palsy, especially in the presence of headache, and all patients should be investigated with CT/MRI brain. Prompt diagnosis and management before intracranial extension can prevent devastating complications. PMID:26055599

  10. Traumatic Acute Subdural Hematoma Extending from the Posterior Cranial Fossa to the Cerebellopontine Angle

    PubMed Central

    Sonmez, Erkin; Yilmaz, Cem; Altinors, Nur

    2009-01-01

    Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin (acetylsalicylic acid). In addition, partial evacuation and waiting for the resorption of the hematoma may help to prevent damage to the 7th and 8th cranial nerves. PMID:19844633

  11. 21 CFR 882.5970 - Cranial orthosis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Cranial orthosis. 882.5970 Section 882.5970 Food...Therapeutic Devices § 882.5970 Cranial orthosis. (a) Identification. A cranial orthosis is a device that is intended for...

  12. 21 CFR 882.5970 - Cranial orthosis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Cranial orthosis. 882.5970 Section 882.5970 Food...Therapeutic Devices § 882.5970 Cranial orthosis. (a) Identification. A cranial orthosis is a device that is intended for...

  13. Radiation-induced malignant and atypical peripheral nerve sheath tumors

    SciTech Connect

    Foley, K.M.; Woodruff, J.M.; Ellis, F.T.; Posner, J.B.

    1980-04-01

    The reported peripheral nerve complications of therapeutic irradiation in humans include brachial and lumbar plexus fibrosis and cranial and peripheral nerve atrophy. We have encountered 9 patients with malignant (7) and atypical (2) peripheral nerve tumors occurring in an irradiated site suggesting that such tumors represent another delayed effect of radiation treatment on peripheral nerve. In all instances the radio-theray was within an acceptable radiation dosage, yet 3 patients developed local radiation-induced skin and bony abnormalities. The malignant peripheral nerve sheath tumors developed only in the radiation port. Animal studies support the clinical observation that malignant peripheral nerve sheath tumors can occur as a delayed effect of irradiation.

  14. Peripheral facial nerve communications and their clinical implications.

    PubMed

    Diamond, Mark; Wartmann, Christopher T; Tubbs, R Shane; Shoja, Mohammadali M; Cohen-Gadol, Aaron A; Loukas, Marios

    2011-01-01

    The facial nerve (CN VII) nerve follows a torturous and complex path from its emergence at the pontomedullary junction to its various destinations. It exhibits a highly variable and complicated branching pattern and forms communications with several other cranial nerves. The facial nerve forms most of these neural intercommunications with branches of all three divisions of the trigeminal nerve (CN V), including branches of the auriculotemporal, buccal, mental, lingual, infraorbital, zygomatic, and ophthalmic nerves. Furthermore, CN VII also communicates with branches of the vestibulocochlear nerve (CN VIII), glossopharyngeal nerve (CN IX), and vagus nerve (CN X) as well as with branches of the cervical plexus such as the great auricular, greater, and lesser occipital, and transverse cervical nerves. This review intends to explore the many communications between the facial nerve and other nerves along its course from the brainstem to its peripheral branches on the human face. Such connections may have importance during clinical examination and surgical procedures of the facial nerve. Knowledge of the anatomy of these neural connections may be particularly important in facial reconstructive surgery, neck dissection, and various nerve transfer procedures as well as for understanding the pathophysiology of various cranial, skull base, and neck disorders. PMID:20941708

  15. Stimulation of the human auditory nerve with optical radiation

    Microsoft Academic Search

    Andrew Fishman; Piotr Winkler; Jozef Mierzwinski; Wojciech Beuth; Agnella Izzo Matic; Zygmunt Siedlecki; Ingo Teudt; Hannes Maier; Claus-Peter Richter

    2009-01-01

    A novel, spatially selective method to stimulate cranial nerves has been proposed: contact free stimulation with optical radiation. The radiation source is an infrared pulsed laser. The Case Report is the first report ever that shows that optical stimulation of the auditory nerve is possible in the human. The ethical approach to conduct any measurements or tests in humans requires

  16. A comparative study of three cranial sensory ganglia projecting into the oral cavity: in situ hybridization analyses of neurotrophin receptors and thermosensitive cation channels

    Microsoft Academic Search

    Ichiro Matsumoto; Yasufumi Emori; Yuzo Ninomiya; Keiko Abe

    2001-01-01

    Peripheral cranial sensory nerves projecting into the oral cavity receive food intake stimuli and transmit sensory signals to the central nervous system. To describe and compare the features of the cranial sensory ganglia that innervate the oral cavity, i.e., the trigeminal, petrosal, and geniculate ganglia (TG, PG, and GG, respectively), in situ hybridization was conducted using riboprobes for neurotrophin receptors

  17. Lingual nerve neuropraxia following use of the Laryngeal Mask Airway Supreme.

    PubMed

    Thiruvenkatarajan, Venkatesan; Van Wijk, Roelof M A W; Elhalawani, Islam; Barnes, Ann-Maree

    2014-02-01

    Cranial nerve injury is a rare complication with the use of supraglottic airway devices. A case of lingual nerve injury following the use of a Laryngeal Mask Airway Supreme in a 45 year old woman is presented. A review of the literature regarding lingual nerve injury as a complication of the supraglottic airway is also presented. PMID:24444986

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

    PubMed

    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. Anat Rec, 298:1479-1491, 2015. © 2015 Wiley Periodicals, Inc. PMID:25950508

  19. Analysis and Visualization of Nerve Vessel Contacts for Neurovascular Decompression

    NASA Astrophysics Data System (ADS)

    Süßmuth, Jochen; Piazza, Alexander; Enders, Frank; Naraghi, Ramin; Greiner, Günther; Hastreiter, Peter

    Neurovascular compression syndromes are caused by a pathological contact between cranial nerves and vascular structures at the surface of the brainstem. Aiming at improved pre-operative analysis of the target structures, we propose calculating distance fields to provide quantitative information of the important nerve-vessel contacts. Furthermore, we suggest reconstructing polygonal models for the nerves and vessels. Color-coding with the respective distance information is used for enhanced visualization. Overall, our new strategy contributes to a significantly improved clinical understanding.

  20. CUTTING-EDGE COMMUNICATIONS A Stable Cranial Neural Crest Cell Line from Mouse

    E-print Network

    Winfree, Erik

    nerves, as well as mesenchymal cell types, including skeletal bone, cartilage, dentin, smooth muscle crest cells give rise to ectomesenchymal derivatives such as cranial bones, cartilage, smooth muscle, smooth muscle cells, and glial cells. Whole-genome expression profiling of O9-1 cells revealed

  1. Transitional Nerve: A New and Original Classification of a Peripheral Nerve Supported by the Nature of the Accessory Nerve (CN XI)

    PubMed Central

    Benninger, Brion; McNeil, Jonathan

    2010-01-01

    Classically, the accessory nerve is described as having a cranial and a spinal root. Textbooks are inconsistent with regard to the modality of the spinal root of the accessory nerve. Some authors report the spinal root as general somatic efferent (GSE), while others list a special visceral efferent (SVE) modality. We investigated the comparative, anatomical, embryological, and molecular literature to determine which modality of the accessory nerve was accurate and why a discrepancy exists. We traced the origin of the incongruity to the writings of early comparative anatomists who believed the accessory nerve was either branchial or somatic depending on the origin of its target musculature. Both theories were supported entirely by empirical observations of anatomical and embryological dissections. We find ample evidence including very recent molecular experiments to show the cranial and spinal root are separate entities. Furthermore, we determined the modality of the spinal root is neither GSE or SVE, but a unique peripheral nerve with a distinct modality. We propose a new classification of the accessory nerve as a transitional nerve, which demonstrates characteristics of both spinal and cranial nerves. PMID:21318044

  2. Efficacy and safety of nerve growth factor for the treatment of neurological diseases: a meta-analysis of 64 randomized controlled trials involving 6,297 patients

    PubMed Central

    Zhao, Meng; Li, Xiao-yan; Xu, Chun-ying; Zou, Li-ping

    2015-01-01

    OBJECTIVE: China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine. More than 10 years ago, in 2003, nerve growth factor injection was listed as a national drug. The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases. DATA RETRIEVAL: A computer-based retrieval was performed from six databases, including the Cochrane Library, PubMed, EMBASE, Sino Med, CNKI, and the VIP database, searching from the clinical establishment of nerve growth factor for treatment until December 31, 2013. The key words for the searches were “nerve growth factor, randomized controlled trials” in Chinese and in English. DATA SELECTION: Inclusion criteria: any study published in English or Chinese referring to randomized controlled trials of nerve growth factor; patients with neurological diseases such as peripheral nerve injury, central nerve injury, cranial neuropathy, and nervous system infections; patients older than 7 years; similar research methods and outcomes assessing symptoms; and measurement of nerve conduction velocities. The meta-analysis was conducted using Review Manager 5.2.3 software. MAIN OUTCOME MEASURES: The total effective rate, the incidence of adverse effects, and the nerve conduction velocity were recorded for each study. RESULTS: Sixty-four studies involving 6,297 patients with neurological diseases were included. The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group (P < 0.0001, RR: 1.35, 95%CI: 1.30–1.40). The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group (P < 0.00001, MD: 4.59 m/s, 95%CI: 4.12–5.06). The incidence of pain or scleroma at the injection site in the nerve growth factor group was also higher than that in the control group (P < 0.00001, RR: 6.30, 95%CI: 3.53–11.27), but such adverse effects were mild. CONCLUSION: Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective. PMID:26109961

  3. A variant extensor indicis muscle and the branching pattern of the deep radial nerve could explain hand functionality and clinical symptoms in the living patient

    PubMed Central

    Kumka, Myroslava

    2015-01-01

    The purpose of this study is to document the topographic anatomy of an extensor indicis (EI) muscle with a double tendon and the associated distribution of the deep branch of the radial nerve (DBRN). Both EI tendons were positioned deep to the tendons of the extensor digitorum as they traversed the dorsal osseofibrous tunnel. They then joined the medial slips of the extensor expansion of the second and third digits. In all other dissected forearms, a tendon of the EI muscle joined the medial slip of the extensor expansion to the index finger. The DBRN provided short branches to the superficial extensor muscles, long branches to the abductor pollicis longus and extensor pollicis brevis muscles, and terminated as the posterior interosseous nerve. Descending deep to the extensor pollicis longus muscle, the posterior interosseous nerve sent branches to the extensor pollicis brevis and EI muscles. Understanding of the topographic anatomy of an EI with a double tendon, and the associated distribution of the DBRN, may contribute to accurate diagnosis and treatment of hand lesions. PMID:25729087

  4. The truth is in the water: metastatic prostate cancer presenting as an intermittent facial nerve palsy.

    PubMed

    Wooles, N; Gupta, S; Wilkin-Crowe, H; Juratli, A

    2015-01-01

    An elderly man presented to the acute ear, nose and throat (ENT) services with a history of intermittent, self-limiting facial nerve palsy. Full ENT examination was normal, with all cranial nerves and peripheral neurology intact. Multiple imaging modalities suggested an aggressive bony lesion, secondary to locally advanced prostate malignancy with extensive metastatic infiltration. Prostate cancer is known to preferentially metastasise to bone and has been known to cause multiple cranial nerve palsies and ophthalmoplegia. This is the first case described in the literature of metastatic prostate cancer presenting with intermittent facial nerve palsy. PMID:25911361

  5. Direct intraoperative confirmation of penetration of ethylene vinyl alcohol copolymer (Onyx) into the vasa nervosa of the facial nerve.

    PubMed

    Chen, James; Crane, Benjamin; Niparko, John; Gandhi, Dheeraj

    2012-11-01

    The case history is described of a patient referred to our institution with facial nerve palsy following embolization of a middle cranial fossa dural arteriovenous fistula using ethylene vinyl alcohol copolymer (EVOH). Facial nerve decompression was performed which showed evidence of extensive penetration of EVOH into the vasa nervosa of the facial nerve. Facial nerve palsy is a debilitating complication that can be avoided by attention to the lower cranial nerve arterial supply during careful procedural planning and consideration of alternative strategies for fistula obliteration in cases where eloquent feeders are involved. PMID:21990543

  6. Massive nerve root enlargement in chronic inflammatory demyelinating polyneuropathy

    Microsoft Academic Search

    W Schady; P J Goulding; B R Lecky; R H King; C M Smith

    1996-01-01

    OBJECTIVE: To report three patients with chronic inflammatory demyelinating polyneuropathy (CIDP) presenting with symptoms suggestive of cervical (one patient) and lumbar root disease. METHODS: Nerve conduction studies, EMG, and nerve biopsy were carried out, having found the nerve roots to be very enlarged on MRI, CT myelography, and at surgery. RESULTS: Clinically, peripheral nerve thickening was slight or absent. Subsequently

  7. Cranial sutures and diploae morphology.

    PubMed

    Corega, Claudia; Vaida, Ligia; Ilia?, Ioana Tiberia; Bertossi, D; Dasc?lu, Ionela Teodora

    2013-01-01

    The aim of the study was to assess the normal cranial suture and bone diploae ultrastructural morphology. Two types of sutures from different specimens were collected. The micro-CT scanning provided a three-dimensional view of the sutures at a microscopic level thus allowing the evaluation of the development stage and a rapid analysis evaluation of bone and diploae morphology. In the meantime, the micro-CT is able to generate more slices than the normal histology preserving the analyzed specimens and became one of the most powerful tools in the craniofacial area. The micro-CT analysis generated structure-orientated slices that in conjunction with the histological sections provide a high quality quantitative analysis of all cranial sutures and of the cranial bones diploae. PMID:24399017

  8. Longitudinal Excursion and Strain in the Median Nerve during Novel Nerve Gliding Exercises for Carpal Tunnel Syndrome

    Microsoft Academic Search

    Michel W. Coppieters; Ali M. Alshami

    2006-01-01

    Nerve and tendon gliding exercises are advocated in the conservative and post- operative management of carpal tunnel syndrome (CTS). However, traditionally advocated exercises elongate the nerve bedding substantially, which may induce a potentially deleterious strain in the median nerve with the risk of symptom exacerbation in some patients and reduced benefits from nerve gliding. This study aimed to evaluate various

  9. A case of hypertrophic cranial pachymeningitis associated with invasive Aspergillus mastoiditis.

    PubMed

    Okada, Masahiro; Hato, Naohito; Okada, Yoko; Sato, Eriko; Yamada, Hiroyuki; Hakuba, Nobuhiro; Gyo, Kiyofumi

    2015-12-01

    We report a rare case of hypertrophic cranial pachymeningitis (HCP) associated with invasive Aspergillus mastoiditis. A 63-year-old man with diabetes mellitus underwent mastoidectomy because of chronic discharge from his left ear. The mastoidectomy was unsuccessful in resolving purulent otorrhea; moreover, 7 months later, the patient developed left abducens nerve palsy. Magnetic resonance imaging revealed HCP at the left middle cranial fossa. Although the pathogen could not be identified, an Aspergillus infection was considered based on elevated serum ?-d-glucan and a positive Aspergillus antigen test result. Voriconazole treatment resolved diplopia and left otorrhea and dramatically improved HCP. PMID:26003880

  10. Nerve and Nerve Root Biomechanics

    Microsoft Academic Search

    Kristen J. Nicholson; Beth A. Winkelstein

    \\u000a Together, the relationship between the mechanical response of neural tissues and the related mechanisms of injury provide\\u000a a foundation for defining relevant thresholds for injury. The nerves and nerve roots are biologic structures with specific\\u000a and important functions, and whose response to mechanical loading can have immediate, long-lasting and widespread consequences.\\u000a In particular, when nerves or nerve roots are mechanically

  11. Multiple Cranial Nerve Palsies as the First Presentation of Sarcoidosis

    PubMed Central

    Ahmad, Zahoor; Snow, Barry

    2014-01-01

    Sarcoidosis is a disease process which predominantly affects the lungs but can involve virtually any organ in the human body. Neurosarcoidosis is a rare manifestation which can present in a variety of ways. There is no single diagnostic test for sarcoidosis; hence, the diagnosis is based on combined clinical, laboratorial, and radiological grounds. We describe a rare case where a patient presented with dysphagia, hoarseness, hearing loss, and unsteadiness. PMID:24790763

  12. The controversy of cranial bone motion.

    PubMed

    Rogers, J S; Witt, P L

    1997-08-01

    Cranial bone motion continues to stimulate controversy. This controversy affects the general acceptance of some intervention methods used by physical therapists, namely, cranial osteopathic and craniosacral therapy techniques. Core to these intervention techniques is the belief that cranial bone mobility provides a compliant system where somatic dysfunction can occur and therapeutic techniques can be applied. Diversity of opinion over the truth of this concept characterizes differing viewpoints on the anatomy and physiology of the cranial complex. Literature on cranial bone motion was reviewed for the purpose of better understanding this topic. Published research overall was scant and inconclusive. Animal and human studies demonstrate a potential for small magnitude motion. Physical therapists should carefully scrutinize the literature presented as evidence for cranial bone motion. Further research is needed to resolve this controversy. Outcomes research, however, is needed to validate cranial bone mobilization as an effective treatment. PMID:9243408

  13. Solitary paraganglioma of the hypoglossal nerve: A case report with magnetic resonance imaging findings

    PubMed Central

    Beyazal, Mehmet; Yavuz, Alpaslan; Ünal, Özkan; Çankaya, Hakan; Y?lmaz, Deniz

    2013-01-01

    Patient: Female, 58 Final Diagnosis: Solitary paraganglioma of the hypoglossal nerve Symptoms: Neck pain Medication: — Clinical Procedure: Surgical resection Specialty: Otolaryngology Objective: Rare disease Background: Paragangliomas are rare neuroendocrine tumors originating in the neural crest. Only a few cases of hypoglossal paraganglioma have been reported in the published literature. The localization of hypoglossal paragangliomas close to the carotid artery precludes determination of tumor origin preoperatively. Case Report: A 58-year-old female patient was admitted due to neck pain. During physical examination, a significant mass could not be palpated in the upper left part of the neck, despite sensitivity during palpation. Atrophy and left deviation of the left half of the tongue was observed. MRI of the neck revealed a lesion located superior to the carotid bifurcation between the left internal carotid artery and external carotid artery. There was atrophy in the left half of the tongue. The neck mass displaced the left internal carotid artery anteriorly and medially. The operation was performed with left lateral cervical access. This lesion, which derived from the hypoglossal nerve, was excised. Following histopathological evaluation, the lesion was diagnosed as paraganglioma. Conclusions: Hypoglossal paraganglioma is quite rare and there are no established criteria for preoperative diagnosis. Hypoglossal paraganglioma must be considered to determine treatment options if a lateral neck mass and ipsilateral tongue atrophy are present at the level of the 12th cranial nerve tract. PMID:24349604

  14. Stroke Awareness in Luxemburg: Deficit Concerning Symptoms and Risk Factors

    PubMed Central

    Droste, Dirk W; Safo, Jacqueline; Metz, René J; Osada, Nani

    2014-01-01

    BACKGROUND Awareness of stroke risk factors is important for stroke prevention. Knowledge of stroke symptoms and awareness regarding the necessity of seeking urgent stroke treatment are vital to provide rapid admission to a stroke unit. Data on this specific knowledge in Luxemburg are lacking. METHODS We investigated 420 patients from the Department of Neurology and their relatives using a questionnaire. There were 44% men and 56% women; 25% were immigrants and 75% Luxemburgish nationals; 13% already had had a stroke or transient ischemic attack (TIA); and the mean age was 55 years ranging from 18 to 87 years. RESULTS A total of 88% of participants knew that a stroke occurs in the head/brain. In all, 10% of participants did not know any symptom of a stroke. The most frequently quoted symptoms (>15%) were paralysis/weakness (36%), speech disorders (32%), cranial nerve deficit (16%), vertigo (15%), and visual disorders (15%). Sensory deficits were mentioned by only 4% of patients. Known risk factors (>15%) were smoking (40%), hypertension (32%), alcohol (32%), poor nutrition (28%), high cholesterol (26%), stress (23%), and lack of exercise (19%). Age (4%), diabetes (6%), carotid stenosis (2%), and heart disease (1%) were less frequently known. In all, 11% of participants did not know any risk factor of a stroke. A total of 89% of participants would correctly call the 112 (emergency phone number). The following groups were better informed: Luxemburgish nationals, younger people, and participants with higher education level. Stroke/TIA patients were better informed concerning stroke symptoms, but unfortunately not concerning how to react in the case of a stroke. There was no relevant gender difference. DISCUSSION Although most of the participants knew what to do in the case of a stroke, they did not know the relevant stroke symptoms and risk factors. Future campaigns should therefore focus on risk factors and symptoms, and should address immigrants, elderly persons, less-educated persons, and patients who had already suffered a stroke/TIA. PMID:25452703

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

    PubMed

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

    2015-01-01

    Mastery of the expanded endoscopic endonasal approach (EEA) requires anatomical knowledge and surgical skills; the learning curve for this technique is steep. To a great degree, these skills can be gained by cadaveric dissections; however, ethical, religious, and legal considerations may interfere with this paradigm in different regions of the world. We assessed an artificial cranial base model for the surgical simulation of EEA and compared its usefulness with that of cadaveric specimens. The model is made of both polyamide nylon and glass beads using a selective laser sintering (SLS) technique to reflect CT-DICOM data of the patient's head. It features several artificial cranial base structures such as the dura mater, venous sinuses, cavernous sinuses, internal carotid arteries, and cranial nerves. Under endoscopic view, the model was dissected through the nostrils using a high-speed drill and other endonasal surgical instruments. Anatomical structures around and inside the sphenoid sinus were accurately reconstructed in the model, and several important surgical landmarks, including the medial and lateral optico-carotid recesses and vidian canals, were observed. The bone was removed with a high-speed drill until it was eggshell thin and the dura mater was preserved, a technique very similar to that applied in patients during endonasal cranial base approaches. The model allowed simulation of almost all sagittal and coronal plane EEA modules. SLS modeling is a useful tool for acquiring the anatomical knowledge and surgical expertise for performing EEA while avoiding the ethical, religious, and infection-related problems inherent with use of cadaveric specimens. PMID:25323096

  16. Central Trigeminal and Posterior Eighth Nerve Projections in the Turtle Chrysemys picta Studied in vitro

    Microsoft Academic Search

    James L. Herrick; Joyce Keifer

    1998-01-01

    Recent electrophysiological studies in the turtle Chrysemys picta have suggested that a neural correlate of the eye-blink reflex can be evoked in an in vitro brainstem-cerebellum preparation by electrical rather than natural stimulation of the cranial nerves. Discharge recorded in the abducens nerve, which is similar to EMG recordings from extraocular muscles during eye retraction, is triggered by a brief

  17. Anterior cranial base glioneuronal heterotopia

    Microsoft Academic Search

    Dattatraya Muzumdar; Jean Michaud; Enrique C. G. Ventureyra

    2006-01-01

    Background  Cranial base glioneuronal heterotopia is a nest or linear array of glioneuronal tissue within the basal meninges. It is thought to arise from aberrant migration of embryonic neuroepithelial tissues into the subarachnoid space. It frequently mimics tumors and may extend through basal skull bones into extracranial soft tissues.Case report  We describe a case of intracranial anterior skull base leptomeningeal glioneuronal heterotopia

  18. [Polyneuropathies--symptoms, causes and diagnostic procedure].

    PubMed

    Neundörfer, B

    1993-11-01

    The diagnosis of a polyneuropathy (PNP) is particularly a clinically based diagnosis. The polyneuropathic syndrome consists of typical symptoms like paraesthesias, pain, cramps and fasciculations as well as characteristic signs like loss of tendon reflexes, weakness and wasting of muscles, sensory loss, cranial nerve palsy and alterations of the autonomic nervous system. The analysis of manifestation-types is very important for the differential diagnosis. The symmetrical sensory type of manifestation can be found in the beginning of almost all toxic neuropathies as well as in uremic and diabetic neuropathy. The symmetrical-motor type of manifestation can be a further development of the symmetrical sensory type of manifestation or exists from the beginning in the case for example of Guillain-Barré-Syndrome. The asymmetric type of manifestation can be observed in the vascular neuropathies and in some types of inflammatory neuropathies like the neuroborrelioses or the neuralgic amyotrophy. The investigation of the CSF, electromyography and electroneurography as well as a great number of chemical lab tests are important for the etiological classification. According to the etiology, the polyneuropathies can be subdivided into four groups such as inflammatory, vascular, exotoxic and endotoxic-metabolic-hereditary diseases. The most frequent etiologies are diabetes mellitus and chronic alcoholism. PMID:8191381

  19. Cranial base fracture and rhino cerebrospinmal fluid leakage. A case report.

    PubMed

    Magliulo, G; Celebrini, A; Cuiuli, G; Parlotto, D

    2007-01-01

    Oto cerebrospinal fluid leakage occurs frequently in skull base fractures but it is not always recognized which may produce potentially serious consequences on the prognosis. The aim of this study is to present a case of an extended skull base fracture with bad defined symptoms. A male in coma was admitted to our hospital following a road accident. Imaging revealed a fracture that transversally crossed the squamous occipital bone and petrous portions of temporal bone on the right, the sphenoid bone, and the left zygomatic bone. Ten days later the patient regained consciousness presenting symptoms of right complete hearing loss, cephalalgia and fever. Lumbar puncture showed a Gram negative germ growth. After specific antibiotic treatment he underwent surgery with exclusion of the middle ear and the mastoid from outside by obliterating the Eustachian tube, sealing the surgical cavity (subtotal petrosectomy) with abdominal fat and closing the external auditory canal as a blind sac. At the same time, nasal fibroendoscopy was also performed to close the fistulas in the sphenoid region. Since the cephalalgia persisted further CT examination was performed and revealed another fracture rima in the ethmoid bone. Nasal fibroendoscopy was performed again to close this fistula. The symptoms thus disappeared and the patient has continued to be symptom-free during the two years follow-up. Skull base fractures may involve various bone structure (petrous portion of temporal bone, ethmoid, sphenoid, parietal bone). As a result of the complex anatomy of the skull base, the fracture may damage numerous vital structures (cranial nerves, internal carotid artery, cavernous sinus, jugular vein etc) and the dura mater, causing cerebrospinal fluid leak. When the fracture in the petrous bone is transversal, it is highly important not to delay surgery. In fact the otic capsule does not repair but the bone step is covered by a thin layer of fibrous tissue. For this reason patients, with clear damage to the otic capsule, risk meningitis. Fistulas in the ethmoid are the most difficult to diagnose and the easiest to underestimate. It is fundamental to follow the appropriate diagnostic procedure. PMID:17405457

  20. Painful ophthalmoplegia caused by idiopathic hypertrophic cranial pachymeningitis in the cavernous sinus

    Microsoft Academic Search

    Koichi Terada; Norio Misu; Yoshiharu Nara

    1998-01-01

    A 73-year-old man presenting with painful unilateral ophthalmoplegia is reported. Magnetic resonance imaging demonstrated a mass in the cavernous sinus extending to the floor of the middle cranial fossa. After resection of the lesion and anti-tuberculous chemotherapy his symptoms improved. Pathological examination revealed extensive caseous necrosis.

  1. [Sensory sensitization, part II: Pathophysiology in dysfunctional disorders. Understanding the inner life of the nerve pathways may explain hitherto unexplainable symptoms].

    PubMed

    Levander, Hans

    2003-04-30

    This article is based on a vast clinical experience from patients presenting with widespread pain syndromes as well as dysfunctional symptoms from inner organs. A literature survey has been performed. Allodynia and hyperalgesia that partly explain the fibromyalgia and local myalgia syndromes seem to arise from a pathophysiological process of nociceptive sensitisation. It is proposed that the concept of "sensory sensitisation dysfunctional disorders" be applied to conditions like bronchial hyperreactivity, Da Costas syndrome, Dercum's disease (Adipositas dolorosa), dry eyes and mouth syndrome, fibromyalgia, gastralgia, globus hystericus, interstitial cystitis, chronic prostatitis, irritable bowel syndrome, photo- and phonosensitivity, rhinitis, tension headache, tinnitus, vestibulitis syndrome. These dysfunctional disorders cannot be satisfactorily explained by presently known pathophysiological models like ongoing inflammatory process, tissue degeneration, fibrosis, blood vessel diseases, tumours, immune reactions, toxic or deficiency conditions, metabolic disturbances. Neurogenic mechanisms also seem to play an important role in the pathophysiology of arthritic conditions, and might be worthwhile to include in forthcoming discussions concerning the aetiology of chronic inflammatory disease. PMID:12789809

  2. The relation between cranial capacity, relative cranial capacity and intelligence in school children

    Microsoft Academic Search

    G. H. Estabrooks

    1928-01-01

    The cranial capacity was calculated by the Pearson-Lee formula, which is a function of length, breadth and height; the two forms were used for the sexes, but no correction was applied for the age of the subjects (the formula having been derived for adults). Relative cranial capacity is the quotient obtained by dividing cranial capacity by stature. Intelligence quotients were

  3. [Anatomic and topographical characteristics of the correlations between glossopharyngeal nerve and autonomic nervous system in Canidae and Mustelidae].

    PubMed

    Iudichev, Iu F; Zaveleva, E V

    2002-01-01

    Using macro-microanatomical approach, the study of glossopharyngeal nerve was performed on carcasses of fur animals belonging to Canidae and Mustelidae families (mink, sable, sable polar fox, fox). The species peculiarities of interconnections of tympanic nerve with inner carotid nerve and ear branch of vagus nerve were established. The characteristics of the course and connection of the carotid sinus branch of glossopharyngeal nerve with sympathetic branches of cranial cervical ganglion, were defined. The variants of total absence of vagal pharyngeal branch with significant development of similar branch of glossopharyngeal nerve, were noted. PMID:12630089

  4. Surgical approach to the superior vestibular nerve in guinea pigs.

    PubMed

    Hildesheimer, M; Muchnik, C; Rubinstein, M

    1987-12-01

    The superior vestibular nerve carries homo- and contra-lateral efferent fibers to the cochlea. The subarcuate fossa, a tube-like structure in the temporal bone of the guinea pig, can be used to reach the superior vestibular nerve at the level of the internal acoustic meatus. Normally, this structure accommodates the dorsal and ventral floccular extension of the cerebellum. This technique has several advantages. Firstly, a reduced cranial opening is necessary; secondly, less cerebellar tissue is sacrificed. Then there is the relative insulation of the operative field, and finally, it presents a straight guide to the internal auditory meatus and vestibular nerve. PMID:3446675

  5. Toxic epidermal necrolysis associated with antiepileptic drugs and cranial radiation therapy.

    PubMed

    Elazzazy, Shereen; Abu Hassan, Taghrid; El Seid, Ashraf; Jacob, Cicy Mary

    2013-01-01

    Case reports on the development of toxic epidermal necrolysis (TEN) associated with concurrent administration of phenytoin with cranial radiation therapy (Ahmed (2004), Criton et al. (1997), and Rzany et al. (1996)), but reports about erythema multiforme, which can develop in patients treated with levetiracetam and cranial irradiation, are very limited. This paper presents evidence that TEN may be induced by concurrent use of radiation with both phenytoin and levetiracetam. Our case is a 42-year-old male patient, a case of gliosarcoma who developed purpuric dermatitis associated with phenytoin when combined with cranial radiation therapy; although phenytoin was discontinued and switched to levetiracetam, the patient had more severe symptoms of toxic epidermal necrolysis (TEN) on levetiracetam; the patient improved with aggressive symptom management, discontinuation of antiepileptic drugs (AEDs), and holding radiotherapy. Although TEN is a rare toxicity, physicians should pay a special attention to the monitoring of brain tumor patients on antiepileptic prophylaxis during cranial irradiation; furthermore, patients should be counselled to notify their physicians if they develop any new or unusual symptoms. PMID:23984137

  6. Toxic Epidermal Necrolysis Associated with Antiepileptic Drugs and Cranial Radiation Therapy

    PubMed Central

    Abu Hassan, Taghrid; El Seid, Ashraf; Jacob, Cicy Mary

    2013-01-01

    Case reports on the development of toxic epidermal necrolysis (TEN) associated with concurrent administration of phenytoin with cranial radiation therapy (Ahmed (2004), Criton et al. (1997), and Rzany et al. (1996)), but reports about erythema multiforme, which can develop in patients treated with levetiracetam and cranial irradiation, are very limited. This paper presents evidence that TEN may be induced by concurrent use of radiation with both phenytoin and levetiracetam. Our case is a 42-year-old male patient, a case of gliosarcoma who developed purpuric dermatitis associated with phenytoin when combined with cranial radiation therapy; although phenytoin was discontinued and switched to levetiracetam, the patient had more severe symptoms of toxic epidermal necrolysis (TEN) on levetiracetam; the patient improved with aggressive symptom management, discontinuation of antiepileptic drugs (AEDs), and holding radiotherapy. Although TEN is a rare toxicity, physicians should pay a special attention to the monitoring of brain tumor patients on antiepileptic prophylaxis during cranial irradiation; furthermore, patients should be counselled to notify their physicians if they develop any new or unusual symptoms. PMID:23984137

  7. Optic Nerve Drusen

    MedlinePLUS

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Drusen En Español Read in Chinese What are optic nerve drusen? Optic nerve drusen are abnormal globular ...

  8. Abducens nerve schwannoma in cerebellopontine angle mimicking acoustic neuroma.

    PubMed

    Wang, Ming; Huang, Hongguang; Zhou, Yongqing

    2015-03-01

    The abducens nerve schwannoma is one kind of rare intracranial tumor. We report an interesting case of abducens nerve schwannoma in the right cerebellopontine angle in a 68-year-old male patient presenting only vertigo and headache, without any symptom of abducens nerve palsy. This is the oldest patient with abducens nerve schwannoma to date. The patient received a craniectomy via suboccipital retrosigmoid approach and had total surgical excision. PMID:25759926

  9. Growth of cranial volume: an anthropometric study.

    PubMed

    Purkait, Ruma

    2011-05-01

    The aim of the study is to follow the growth dynamics of cranial volume from birth to 18 years of age among 1623 central Indian subjects. Anthropometric technique was adopted to estimate the cranial volume using maximum length, width and auricular height of head. The mean cranial volume at birth is 376 cc in male and 308 cc in female i.e. 28% and 26% of the 18 years old volume. Within a year the volume reaches 65% in male and 59% in female of the adult size due to very rapid growth during the first six months after birth. The adult cranial volume at 18 years is 1329 cc in males and 1193 cc in females, approximately 3.5 and 4 times of the birth size respectively. The cranial volume reaches its adult size in females at 16 years of age and a year later in males. The present study has generated metrical norms for all growing ages and also the growth dynamics for cranial volume of Indian subjects which will be useful to physicians as a guideline in correcting cranial deformity. PMID:21315671

  10. Peripheral Nerve Disorders

    MedlinePLUS

    ... spinal cord. Like static on a telephone line, peripheral nerve disorders distort or interrupt the messages between the brain ... body. There are more than 100 kinds of peripheral nerve disorders. They can affect one nerve or many nerves. ...

  11. A boy with homozygous microdeletion of NEUROG1 presents with a congenital cranial dysinnervation disorder [Moebius syndrome variant

    PubMed Central

    2013-01-01

    Background We report on a 6-year-old Turkish boy with profound sensorineural deafness, balance disorder, severe disorder of oral motor function, and mild developmental delay. Further findings included scaphocephaly, plagiocephaly, long palpebral fissures, high narrow palate, low-set posteriorly rotated ears, torticollis, hypoplastic genitalia and faulty foot posture. Parents were consanguineous. Methods and results Computed tomography and magnetic resonance imaging showed bilateral single widened cochlear turn, narrowing of the internal auditory canal, and bilateral truncation of the vestibulo-cochlear nerve. Microarray analysis and next generation sequencing showed a homozygous deletion of chromosome 5q31.1 spanning 115.3 kb and including three genes: NEUROG1 (encoding neurogenin 1), DCNP1 (dendritic cell nuclear protein 1, C5ORF20) and TIFAB (TIFA-related protein). The inability to chew and swallow, deafness and balance disorder represented congenital palsies of cranial nerves V (trigeminal nerve) and VIII (vestibulo-cochlear nerve) and thus a congenital cranial dysinnervation disorder. Conclusions Based on reported phenotypes of neurog1 null mutant mice and other vertebrates, we strongly propose NEUROG1 as the causative gene in this boy. The human NEUROG1 resides within the DFNB60 locus for non-syndromic autosomal recessive deafness on chromosome 5q22-q31, but linkage data have excluded it from being causative in the DFNB60 patients. Given its large size (35 Mb, >100 genes), the 5q22-q31 area could harbor more than one deafness gene. We propose NEUROG1 as a new gene for syndromic autosomal recessive hearing loss and congenital cranial dysinnervation disorder including cranial nerves V and VIII. PMID:23419067

  12. Cervico-mediastinal schwannoma of the vagus nerve: resection with intraoperative nerve monitoring.

    PubMed

    Imperatori, Andrea; Dionigi, Gianlorenzo; De Monte, Lavinia; Conti, Valentina; Rotolo, Nicola

    2011-03-01

    Schwannomas are usually benign, single, encapsulated, slow-growing tumours originating from cranial or spinal nerve sheaths. The vagus nerve involvement at the mediastinal inlet is very uncommon. For anatomical reasons, the resection of cervical and mediastinal schwannoma of the vagus nerve has a high risk of vocal fold paralysis. We describe the case of a 67-year-old female with a cervico-mediastinal schwannoma of the vagus nerve that we removed using the intraoperative neuromonitoring technique. The patient presented with mild hoarseness and complained of discomfort behind the jugular notch. Neck and chest computerized tomography described a 35 × 30 mm solid lesion behind the left clavi-sternal junction; preoperative fine needle aspiration cytology revealed schwannoma. Resection of the mass was performed with a cervical approach and the vagus nerve tumour was completely removed under continuous neuromonitoring (NIM-3(®) System), preserving the vagus and the recurrent laryngeal nerve function. Pathology on the resected mass documented A-type schwannoma with "ancient schwannoma" areas. The intraoperative neurostimulation and neuromonitoring approach for the resection of vagus schwannoma are recommended because it may reduce the risk of injury to the vagus and to the recurrent laryngeal nerve. PMID:21210273

  13. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 90:147-168 (1993) Effects of Annular Cranial Vault Modification on the Cranial Base

    E-print Network

    Cheverud, James M.

    1993-01-01

    AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 90:147-168 (1993) Effects of Annular Cranial Vault vault was practiced by a number of prehistoric and protohistoric populations, frequently during on the cranial vault, annular cranial vault modification has a signifi- cant indirect effect on cranial base

  14. Proper migration and axon outgrowth of zebrafish cranial motoneuron subpopulations require the cell adhesion molecule MDGA2A.

    PubMed

    Ingold, Esther; Vom Berg-Maurer, Colette M; Burckhardt, Christoph J; Lehnherr, André; Rieder, Philip; Keller, Philip J; Stelzer, Ernst H; Greber, Urs F; Neuhauss, Stephan C F; Gesemann, Matthias

    2015-01-01

    The formation of functional neuronal circuits relies on accurate migration and proper axonal outgrowth of neuronal precursors. On the route to their targets migrating cells and growing axons depend on both, directional information from neurotropic cues and adhesive interactions mediated via extracellular matrix molecules or neighbouring cells. The inactivation of guidance cues or the interference with cell adhesion can cause severe defects in neuronal migration and axon guidance. In this study we have analyzed the function of the MAM domain containing glycosylphosphatidylinositol anchor 2A (MDGA2A) protein in zebrafish cranial motoneuron development. MDGA2A is prominently expressed in distinct clusters of cranial motoneurons, especially in the ones of the trigeminal and facial nerves. Analyses of MDGA2A knockdown embryos by light sheet and confocal microscopy revealed impaired migration and aberrant axonal outgrowth of these neurons; suggesting that adhesive interactions mediated by MDGA2A are required for the proper arrangement and outgrowth of cranial motoneuron subtypes. PMID:25572423

  15. Neurophysiological evaluation of trigeminal and facial nerves in patients with chronic inflammatory demyelinating polyneuropathy.

    PubMed

    Kokubun, Norito; Hirata, Koichi

    2007-02-01

    Cranial neuropathy is clinically uncommon in patients with chronic inflammatory demyelinating polyneuropathy (CIDP), but there is little information on the neurophysiological examination of cranial nerve involvement. To determine the incidence of trigeminal and facial nerve involvement in patients with CIDP, the direct response of the orbicularis oculi muscle to percutaneous electric stimulation of the facial nerve and the blink reflex (induced by stimulation of the supraorbital nerve) were examined in 20 CIDP patients. The latency of the direct response was increased in 12 patients (60%) and an abnormal blink reflex was observed in 17 patients (85%). There was no correlation between electrophysiological findings and the latencies of the direct and R1 responses and disease duration or clinical grade in CIDP patients. Nevertheless, the prevalence of subclinical trigeminal and facial neuropathy is extremely high in patients with CIDP when examined by neurophysiological tests. PMID:17063459

  16. Entrapment of the superficial peroneal nerve: an anatomical insight.

    PubMed

    Tzika, Maria; Paraskevas, George; Natsis, Konstantinos

    2015-03-01

    Entrapment of the superficial peroneal nerve is an uncommon neuropathy that may occur because of mechanical compression of the nerve, usually at its exit from the crural fascia. The symptoms include sensory alterations over the distribution area of the superficial peroneal nerve. Clinical examination, electrophysiologic findings, and imaging techniques can establish the diagnosis. Variations in the superficial peroneal sensory innervation over the dorsum of the foot may lead to variable results during neurologic examination and variable symptomatology in patients with nerve entrapment or lesions. Knowledge of the nerve's anatomy at the lower leg, foot, and ankle is of essential significance for the neurologist and surgeon intervening in the area. PMID:25815655

  17. Symptom Management

    MedlinePLUS

    Symptom Management A brain injury can affect a person physically and psychologically, and sometimes the symptoms don't appear ... Diagnosis and Assessment Treatment and Recovery Caregiving Symptom Management Life After TBI Defense and Veterans Brain Injury ...

  18. Unusually large quiescent ancient schwannoma of hypoglossal nerve.

    PubMed

    Wanjari, Sangeeta P; Wanjari, Panjab V; Parwani, Rajkumar N; Tekade, Satyajitraje A

    2013-01-01

    Ancient schwannoma is considered as a variant of schwannoma, comprising about 10% of all schwanommas. Schwannoma is a benign neoplasm derived from the nerve sheath of peripheral motor, sensory and sympathetic nerves and from the cranial nerve pairs. It usually presents as a solitary soft-tissue lesion which is slow growing, encapsulated and is often associated with nerve attached peripherally. Diagnosis is often confirmed with the microscopic examination. The long standing schwannoma attributes to degenerative changes and is termed "ancient" schwannoma. Present case is of a 68-year-old female patient who reported with an asymptomatic large swelling below mandible on the left side since last 23 years. The lesion was surgically excised under general anesthesia. PMID:24552945

  19. A note on the anastomoses between the hypoglossal nerve and the cervical plexus

    Microsoft Academic Search

    Ph Caliot; D Dumont; V Bousquet; D Midy

    1986-01-01

    Summary  A series of 80 dissections was performed to define the anastomoses between the cervical plexus and the hypoglossal nerve (XII),\\u000a the superior anastomosis between the trunk of XII and the ansa of the atlas from the cervical plexus; the ansa cervicalis,\\u000a traditionally known as the ansa of the XIIth cranial nerve or hypoglossal ansa, formed by the direct junctional anastomosis

  20. Suprascapular nerve release for treatment of shoulder and periscapular pain following intracranial spinal accessory nerve injury.

    PubMed

    Flores, Leandro Pretto

    2008-11-01

    Iatrogenic injury to the spinal accessory nerve is one of the most common causes of trapezius muscle palsy. Dysfunction of this muscle can be a painful and disabling condition because scapular winging may impose traction on the soft tissues of the shoulder region, including the suprascapular nerve. There are few reports regarding therapeutic options for an intracranial injury of the accessory nerve. However, the surgical release of the suprascapular nerve at the level of the scapular notch is a promising alternative approach for treatment of shoulder pain in these cases. The author reports on 3 patients presenting with signs and symptoms of unilateral accessory nerve injury following resection of posterior fossa tumors. A posterior approach was used to release the suprascapular nerve at the level of the scapular notch, transecting the superior transverse scapular ligament. All patients experienced relief of their shoulder and scapular pain following the decompressive surgery. In 1 patient the primary dorsal branch of the C-2 nerve root was transferred to the extracranial segment of the accessory nerve, and in the other 2 patients a tendon transfer (the Eden-Lange procedure) was used. Results from this report show that surgical release of the suprascapular nerve is an effective treatment for shoulder and periscapular pain in patients who have sustained an unrepairable injury to the accessory nerve. PMID:18976092

  1. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Convulsive Disorders § 4.123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided...

  2. Femoral nerve dysfunction

    MedlinePLUS

    Neuropathy - femoral nerve; Femoral neuropathy ... Felice, KJ. Focal neuropathies of the femoral, obturator, lateral femoral cutaneous and other nerves of the thigh and pelvis. In: Bromberg MB, Smith ...

  3. Follow-up evaluation with ultrasonography of peripheral nerve injuries after an earthquake

    PubMed Central

    Lu, Man; Wang, Yue; Yue, Linxian; Chiu, Jack; He, Fanding; Wu, Xiaojing; Zang, Bin; Lu, Bin; Yao, Xiaoke; Jiang, Zirui

    2014-01-01

    Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efficient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgical repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonography. The concordance rate of ultrasonographic findings with those of surgical findings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only five nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which verified that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves. PMID:25206859

  4. [Two surgically treated cases with dural arteriovenous malformation in the anterior cranial fossa].

    PubMed

    Yamaguchi, Shintaro; Takeuchi, Yasuharu; Nakayama, Kenji; Arakawa, Masahiro; Shigemori, Minoru

    2005-12-01

    Dural arteriovenous fistulae(dAVF) in the anterior cranial fossa comprise about 6% of all dAVFs, and is usually detected after intracranial hemorrhage. However, non-hemorrhagic symptoms are uncommon. We encountered two patients with hemorrhagic and non-hemorrhagic dAVF in the anterior cranial fossa. Both cases were successfully treated using craniotomy and histopathological examination was performed. A 71-year-old male experienced sudden onset of nausea and headache, followed by progression of left hemiparesis and disturbance of consciousness due to intracerebral and subdural hematoma in 2005. Intracerebral venous aneurysm adjacent to the intracerebral hematoma originated from the draining cortical red vein was identified and successfully treated by operation. Histopathological examination revealed disappearance of the internal elastic lamina and scant muscle tissue in the venous aneurysmal wall originating from draining cortical vein. A 69-year-old male suffered sudden onset of mild headache, followed by progression of bruits in 2005. MRI suggested dAVF in the left anterior cranial fossa. 123I-IMP SPECT revealed an area of low perfusion in the left frontotemporal region. Histopathological examination after surgical treatment revealed thickening of the intima and an indistinct lamina elastica interna, indicating progressive degenerative changes of the arterialized vein likely to result in hemorrhage. Surgical obliteration of fistulae is reasonable even in the dAVF of the anterior cranial fossa with ischemic onset. PMID:16359034

  5. C-peptide improves autonomic nerve function in IDDM patients

    Microsoft Academic Search

    B. L. Johansson; K. Borg; E. Fernqvist-Forbes; T. Odergren; S. Remahl; J. Wahren

    1996-01-01

    Summary  In order to determine the possible influence of C-peptide on nerve function, 12 insulin-dependent diabetic (IDDM) patients with symptoms of diabetic polyneuropathy were studied twice under euglycaemic conditions. Tests of autonomic nerve function (respiratory heart rate variability, acceleration and brake index during tilting), quantitative sensory threshold determinations, nerve conduction studies and clinical neurological examination were carried out before and during

  6. Management of traumatic facial nerve paralysis with carotid artery cavernous sinus fistula

    Microsoft Academic Search

    J. T. Roland Jr; P. E. Hammerschlag; W. S. Lewis; I. Choi; A. Berenstein

    1994-01-01

    Massive skull base injuries require detailed preoperative neurological and neurovascular assessment prior to undertaking surgical repair of isolated cranial nerve deficits. We present the management of a patient with traumatic facial paralysis, cerebrospinal fluid leak, and carotid artery cavernous sinus fistula as the result of a gunshot wound to the skull base. The carotid artery cavernous sinus fistula was ultimately

  7. Cranial pneumatic anatomy of Ornithomimus edmontonicus (Ornithomimidae: Theropoda)

    Microsoft Academic Search

    Rui Tahara; Hans C. E. Larsson

    2011-01-01

    Modern archosaurs have extensive pneumatic diverticula originating from paranasal and tympanic sinuses. This complex anatomy is present in many fossil archosaurs, but few descriptions of the complete cranial pneumatic system exist. The cranial pneumatic morphology of birds and non-avian theropods are the best studied, but complete description of this anatomy for an ornithomimid was lacking. We describe the cranial pneumaticity

  8. Familial Aggregation of Cranial Tremor in Familial Essential Tremor

    PubMed Central

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

    2013-01-01

    Background Essential tremor (ET) is often familial and phenotypic features may be shared within families. Cranial (neck, voice, jaw) tremor is an important feature of ET. We examined whether cranial tremor aggregates in ET families, after controlling for other factors (age, tremor severity and duration). Methods Among ET probands and relatives enrolled in a genetic study at Columbia University (95 subjects in 28 families), we assessed the degree to which occurrence of cranial tremor in the proband predicted occurrence of cranial tremor in affected relatives. Results Forty-five (47.4%) subjects had cranial tremor on neurological examination (probands 66.7%, relatives 39.7%). Among 28 families, 23 (82.1%) contained individuals with and individuals without cranial tremor, indicating a high degree of within-family heterogeneity. In comparison to subjects without cranial tremor, those with cranial tremor had higher total tremor scores (p<0.001), were older (p=0.003), and had tremor of longer duration (p=0.01). In logistic regression models, the odds of cranial tremor in a relative was not related to occurrence of cranial tremor in the proband (p>0.24). Conclusions Cranial tremor did not aggregate in families with ET; the major predictor of this disease feature was tremor severity rather than presence of cranial tremor in another family member. PMID:23712245

  9. A Case of Hemifacial Spasm Caused by an Artery Passing Through the Facial Nerve

    PubMed Central

    Oh, Chang Hyun; Shim, Yu Shik; Park, Hyeonseon

    2015-01-01

    Hemifacial spasm (HFS) is a clinical syndrome characterized by unilateral facial nerve dysfunction. The usual cause involves vascular compression of the seventh cranial nerve, but compression by an artery passing through the facial nerve is very unusual. A 20-year-old man presented with left facial spasm that had persisted for 4 years. Compression of the left facial nerve root exit zone by the anterior inferior cerebellar artery (AICA) was revealed on magnetic resonance angiography. During microvascular decompression surgery, penetration of the distal portion of the facial nerve root exit zone by the AICA was observed. At the penetrating site, the artery was found to have compressed the facial nerve and to be immobilized. The penetrated seventh cranial nerve was longitudinally split about 2 mm. The compressing artery was moved away from the penetrating site and the decompression was secured by inserting Teflon at the operative site. Although the facial spasm disappeared in the immediate postoperative period, the patient continued to show moderate facial weakness. At postoperative 12 months, the facial weakness had improved to a mild degree. Prior to performing microvascular decompression of HFS, surgeons should be aware of a possibility for rare complex anatomy, such as compression by an artery passing through the facial nerve, which cannot be observed by modern imaging techniques. PMID:25810866

  10. Miniature piezoelectric triaxial accelerometer measures cranial accelerations

    NASA Technical Reports Server (NTRS)

    Deboo, G. J.; Rogallo, V. L.

    1966-01-01

    Tiny triaxial accelerometer whose sensing elements are piezoelectric ceramic beams measures human cranial accelerations when a subject is exposed to a centrifuge or other simulators of g environments. This device could be considered for application in dental, medical, and automotive safety research.

  11. Entrainment and the cranial rhythmic impulse.

    PubMed

    McPartland, J M; Mein, E A

    1997-01-01

    Entrainment is the integration or harmonization of oscillators. All organisms pulsate with myriad electrical and mechanical rhythms. Many of these rhythms emanate from synchronized pulsating cells (eg, pacemaker cells, cortical neurons). The cranial rhythmic impulse is an oscillation recognized by many bodywork practitioners, but the functional origin of this impulse remains uncertain. We propose that the cranial rhythmic impulse is the palpable perception of entrainment, a harmonic frequency that incorporates the rhythms of multiple biological oscillators. It is derived primarily from signals between the sympathetic and parasympathetic nervous systems. Entrainment also arises between organisms. The harmonizing of coupled oscillators into a single, dominant frequency is called frequency-selective entrainment. We propose that this phenomenon is the modus operandi of practitioners who use the cranial rhythmic impulse in craniosacral treatment. Dominant entrainment is enhanced by "centering," a technique practiced by many healers, for example, practitioners of Chinese, Tibetan, and Ayurvedic medicine. We explore the connections between centering, the cranial rhythmic impulse, and craniosacral treatment. PMID:8997803

  12. Cranial trauma following birth in term infants

    Microsoft Academic Search

    S J KING; A E BOOTHROYD

    The purpose of this pictorial review is to demonstrate the imaging features of a range of cranial injuries associated with birth at term. Scalp and skull injuries include simple cephalhaema- toma, osteomyelitis of the skull vault from infected cephalhaematoma, subgaleal haemorrhage and skull fracture. Intracranial injuries include extradural, subdural and subarachnoid haemorrhage, leptomeningeal cyst and brain infarct. Radiologists need to

  13. 21 CFR 882.5970 - Cranial orthosis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...that is intended for medical purposes to apply pressure to prominent regions of an infant's cranium in order to improve cranial symmetry and/or shape in infants from 3 to 18 months of age, with moderate to severe nonsynostotic positional plagiocephaly,...

  14. 21 CFR 882.5970 - Cranial orthosis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...that is intended for medical purposes to apply pressure to prominent regions of an infant's cranium in order to improve cranial symmetry and/or shape in infants from 3 to 18 months of age, with moderate to severe nonsynostotic positional plagiocephaly,...

  15. 21 CFR 882.5970 - Cranial orthosis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...that is intended for medical purposes to apply pressure to prominent regions of an infant's cranium in order to improve cranial symmetry and/or shape in infants from 3 to 18 months of age, with moderate to severe nonsynostotic positional plagiocephaly,...

  16. Posterior cranial fossa tumours in childhood

    Microsoft Academic Search

    T. Chang; M. M. H. Teng; J. F. Lirng

    1993-01-01

    We reviewed clinical and CT findings in 133 posterior cranial fossa tumours in children. All had histological diagnosis, apart from 20 cases of brain stem glioma. The majority were intra-axial tumours, including 53 medulloblastomas (40%), 31 cerebellar astrocytomas (23%), 28 brain stem gliomas (21%), 14 ependymomas (11%), and single cases of ganglioglioma, haemangioblastoma and teratoma. Extra-axial tumours formed only 3%,

  17. Application and histology-driven refinement of active contour models to functional region and nerve delineation: towards a digital brainstem atlas

    NASA Astrophysics Data System (ADS)

    Patel, Nirmal; Sultana, Sharmin; Rashid, Tanweer; Krusienski, Dean; Audette, Michel A.

    2015-03-01

    This paper presents a methodology for the digital formatting of a printed atlas of the brainstem and the delineation of cranial nerves from this digital atlas. It also describes on-going work on the 3D resampling and refinement of the 2D functional regions and nerve contours. In MRI-based anatomical modeling for neurosurgery planning and simulation, the complexity of the functional anatomy entails a digital atlas approach, rather than less descriptive voxel or surface-based approaches. However, there is an insufficiency of descriptive digital atlases, in particular of the brainstem. Our approach proceeds from a series of numbered, contour-based sketches coinciding with slices of the brainstem featuring both closed and open contours. The closed contours coincide with functionally relevant regions, whereby our objective is to fill in each corresponding label, which is analogous to painting numbered regions in a paint-by-numbers kit. Any open contour typically coincides with a cranial nerve. This 2D phase is needed in order to produce densely labeled regions that can be stacked to produce 3D regions, as well as identifying the embedded paths and outer attachment points of cranial nerves. Cranial nerves are modeled using an explicit contour based technique called 1-Simplex. The relevance of cranial nerves modeling of this project is two-fold: i) this atlas will fill a void left by the brain segmentation communities, as no suitable digital atlas of the brainstem exists, and ii) this atlas is necessary to make explicit the attachment points of major nerves (except I and II) having a cranial origin. Keywords: digital atlas, contour models, surface models

  18. Review of cranial radiotherapy-induced vasculopathy.

    PubMed

    Murphy, Erin S; Xie, Hao; Merchant, Thomas E; Yu, Jennifer S; Chao, Samuel T; Suh, John H

    2015-05-01

    Cranial radiation can impact the cerebral vasculature in many ways, with a wide range of clinical manifestations. The incidence of these late effects including cerebrovascular accidents (CVAs), lacunar lesions, vascular occlusive disease including moyamoya syndrome, vascular malformations, and hemorrhage is not well known. This article reviews the preclinical findings regarding the pathophysiology of late radiation-induced vascular damage, and discusses the clinical incidence and risk factors for each type of vasculopathy. The pathophysiology is complex and dependent on the targeted blood vessels, and upregulation of pro-inflammatory and hypoxia-related genes. The risk factors for adult CVAs are similar to those for patients not exposed to cranial radiotherapy. For children, risks for late vascular complications include young age at radiotherapy, radiotherapy dose, NF1, tumor location, chemotherapy, and endocrine abnormalities. The incidence of late vascular complications of radiotherapy may be impacted by improved technology, therapeutic interventions, and appropriate follow up. PMID:25670390

  19. Slow Pressure Waves in the Cranial Enclosure

    Microsoft Academic Search

    J. J. Lemaire; T. Khalil; F. Cervenansky; G. Gindre; J. Y. Boire; J. E. Bazin; B. Irthum; J. Chazal

    2002-01-01

    Summary.  \\u000a ?Slowly varying pressure oscillations in the cranial enclosure are well known, especially intracranial pressure waves as best\\u000a described by the pioneering works of Janny and Lundberg. Nevertheless, in spite of over twenty five years research on intracranial\\u000a pressure waves, their origin and regulation remain unclear but are often considered only as pathological. Our aim was to review\\u000a data on

  20. Iatrogenic nerve injuries.

    PubMed

    Kretschmer, Thomas; Heinen, Christian W; Antoniadis, Gregor; Richter, Hans-Peter; König, Ralph W

    2009-01-01

    As long as humans have been medically treated, unfortunate cases of inadvertent injury to nerves afflicted by the therapist have occurred. Most microsurgically treated iatrogenic nerve injuries occur directly during an operation. Certain nerves are at a higher risk than others, and certain procedures and regions of the body are more prone to sustaining nerve injury. A high degree of insecurity regarding the proper measures to take can be observed among medical practitioners. A major limiting factor in successful treatment is delayed referral for evaluation and reconstructive surgery. This article on iatrogenic nerve injuries intends to focus on relevant aspects of management from a nerve surgeon's perspective. PMID:19064181

  1. Neurophysiologic intraoperative monitoring of the vestibulocochlear nerve.

    PubMed

    Simon, Mirela V

    2011-12-01

    Neurosurgical procedures involving the skull base and structures within can pose a significant risk of damage to the brain stem and cranial nerves. This can have life-threatening consequences and/or result in devastating neurologic deficits. Over the past decade, intraoperative neurophysiology has significantly evolved and currently offers a great tool for live monitoring of the integrity of nervous structures. Thus, dysfunction can be identified early and prompt modification of the surgical management or operating conditions, leads to avoidance of permanent structural damage.Along these lines, the vestibulocochlear nerve (CN VIII) and, to a greater extent, the auditory pathways as they pass through the brain stem are especially at risk during cerebelopontine angle (CPA), posterior/middle fossa, or brain stem surgery. CN VIII can be damaged by several mechanisms, from vascular compromise to mechanical injury by stretch, compression, dissection, and heat injury. Additionally, cochlea itself can be significantly damaged during temporal bone drilling, by noise, mechanical destruction, or infarction, and because of rupture, occlusion, or vasospasm of the internal auditory artery.CN VIII monitoring can be successfully achieved by live recording of the function of one of its parts, the cochlear or auditory nerve (AN), using the brain stem auditory evoked potentials (BAEPs), electrocochleography (ECochG), and compound nerve action potentials (CNAPs) of the cochlear nerve.This is a review of these techniques, their principle, applications, methodology, interpretation of the evoked responses, and their change from baseline, within the context of surgical and anesthesia environments, and finally the appropriate management of these changes. PMID:22146352

  2. Repair of peripheral nerve with vein wrapping*

    PubMed Central

    LEUZZI, S.; ARMENIO, A.; LEONE, L.; DE SANTIS, V.; DI TURI, A.; ANNOSCIA, P.; BUFANO, L.; PASCONE, M.

    2014-01-01

    Objective The post–traumatic neuro-anastomosis must be protected from the surrounding environment. This barrier must be biologically inert, biodegradable, not compressing but protecting the nerve. Formation of painful neuroma is one of the major issues with neuro-anastomosis; currently there is no consensus on post-repair neuroma prevention. Aim of this study is to evaluate the efficacy of neuroanastomosis performed with venous sheath to reduce painful neuromas formation, improve the electrical conductivity of the repaired nerve, and reduce the discrepancies of the sectioned nerve stumps. Patients and methods From a trauma population of 320 patients treated in a single centre between January 2008 and December 2011, twenty-six patients were identified as having an injury to at least one of the peripheral nerves of the arm and enrolled in the study. Patients were divided into two groups. In the group A (16 patients) the end-to-end nerve suture was wrapped in a vein sheath and compared with the group B (10 patients) in which a simple end-to-end neurorrhaphy was performed. The venous segment used to cover the nerve micro-suture was harvested from the superficial veins of the forearm. The parameters analyzed were: functional recovery of motor nerves, sensitivity and pain. Results Average follow-up was 14 months (range: 12–24 months). The group A showed a more rapid motor and sensory recovery and a reduction of the painful symptoms compared to the control group (B). Conclusions The Authors demonstrated that, in their experience, the venous sheath provides a valid solution to avoid the dispersion of the nerve fibres, to prevent adherent scars and painful neuromas formation. Moreover it can compensate the different size of two nerve stumps, allowing, thereby, a more rapid functional and sensitive recovery without expensive devices. PMID:24841688

  3. Electromechanical Nerve Stimulator

    NASA Technical Reports Server (NTRS)

    Tcheng, Ping; Supplee, Frank H., Jr.; Prass, Richard L.

    1993-01-01

    Nerve stimulator applies and/or measures precisely controlled force and/or displacement to nerve so response of nerve measured. Consists of three major components connected in tandem: miniature probe with spherical tip; transducer; and actuator. Probe applies force to nerve, transducer measures force and sends feedback signal to control circuitry, and actuator positions force transducer and probe. Separate box houses control circuits and panel. Operator uses panel to select operating mode and parameters. Stimulator used in research to characterize behavior of nerve under various conditions of temperature, anesthesia, ventilation, and prior damage to nerve. Also used clinically to assess damage to nerve from disease or accident and to monitor response of nerve during surgery.

  4. Ulnar nerve damage (image)

    MedlinePLUS

    ... arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near ... surface of the body where it crosses the elbow, so prolonged pressure on the elbow or entrapment ...

  5. Engineering Peripheral Nerve Repair

    PubMed Central

    Marquardt, Laura; Sakiyama-Elbert, Shelly E.

    2013-01-01

    Current approaches for treating peripheral nerve injury have resulted in promising, yet insufficient functional recovery compared to the clinical standard of care, autologous nerve grafts. In order to design a construct that can match the regenerative potential of the autograft, all facets of nerve tissue must be incorporated in a combinatorial therapy. Engineered biomaterial scaffolds in the future will have to promote enhanced regeneration and appropriate reinnervation by targeting the highly sensitive response of regenerating nerves to their surrounding microenvironment. PMID:23790730

  6. Studies on experimental malignant nerve sheath tumors maintained in tissue and organ culture systems II. Electron microscopy observations

    Microsoft Academic Search

    Frances K. Conley; Lucien J. Rubinstein; Alexander M. Spence

    1976-01-01

    The sequential electron microscopic features of six malignant nerve sheath tumors (three cranial and three spinal) induced in rats by transplacental ethylnitrosourea and maintained in organ culture systems were compared with those of a human acoustic Schwannoma similarly cultured. After 4 weeks in vitro, the malignant tumor cells often showed progressive elongation of their processes, with the development of an

  7. Optic Nerve Imaging

    MedlinePLUS

    ... machines can help monitor and detect loss of optic nerve fibers. The Heidelberg Retina Tomograph (HRT) is a special ... can directly measure the thickness of the nerve fiber layer and create a three dimensional representation of the optic nerve. Last reviewed on May 02, 2012 Was ...

  8. HIV Symptoms

    MedlinePLUS

    ... Submit Home > HIV/AIDS > What is HIV/AIDS? HIV/AIDS This information in Spanish ( en español ) HIV symptoms Photo courtesy of AIDS.gov Facing AIDS ... and brain Return to top More information on HIV symptoms Explore other publications and websites Basic Information ...

  9. Late Hardware-induced Sciatic Nerve Lesions After Acetabular Revision

    PubMed Central

    Ylinen, Pekka; Puusa, Asko; Paavilainen, Timo

    2008-01-01

    We encountered late hardware-induced sciatic nerve lesions after acetabular revision in six patients. There were five female patients and one male patient. The mean age of the patients at the time of index acetabular revision was 59.3 years (range, 42–76 years). The interval from the index acetabular revision to the onset of sciatic nerve symptoms averaged 9.4 months (range, 4–16 months) and that from the onset of symptoms to nerve release was 11.3 months (range, 8–13 months), except in two patients with intermittent symptoms in which it was 9 and 10.5 years, respectively. Sciatic nerve release was successful in two patients, but in four patients, the nerve had been partly or entirely cut by the metallic hardware resulting in a permanent deficit. The minimum followup was 2 years (mean, 4 years; range, 2–7 years). Mechanical irritation should be suspected in the case of any late sign of peroneal neuropathy after acetabular revision with a macrocup or antiprotrusion device, and plate fixation of the posterior column. We recommend exploration and nerve release before a permanent lesion of the nerve has developed. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18299949

  10. Cranial mediastinal liposarcoma in a horse.

    PubMed

    Kondo, H; Wickins, S C; Conway, J A; Mallicote, M F; Sanchez, L C; Agnew, D W; Farina, L L; Abbott, J R

    2012-11-01

    A 23-year-old Anglo-Arabian mare was presented with tachypnea, dyspnea, and pitting edema of the ventral thoracic subcutis. On necropsy, a tan to red, friable, irregularly shaped mass (23 × 20 × 18 cm) occupied the cranial mediastinum. Histologically, the mass was classified as a liposarcoma and was composed of short interlacing bundles of spindle-shaped to irregularly rounded cells with discrete, variably sized, clear cytoplasmic vacuoles, which were stained with oil red O in frozen sections of formalin-fixed tissue. PMID:22287648

  11. Host records and tissue locations for Diplostomum mordax (metacercariae) inhabiting the cranial cavity of fishes from Lake Titicaca, Peru.

    PubMed

    Heckmann, R A

    1992-06-01

    Metacercariae of Diplostomum mordax were found in the cranial cavity of Orestias agasii, Orestias olivaceous, Orestias luteus, and Basilichthys bonariensis, fishes from Lake Titicaca, Peru. Metacercariae were not found in Oncorhynchus mykiss introduced into the lake during 1939 and 1940. Compression of neural tissue within and on the surface of the brain was observed in all infected fishes. Metacercariae migrating into the cerebrum and cerebellum of the piscine host caused hemorrhaging, cell necrosis, inflammation, fiber formation, and nerve fiber disruption. The presence of D. mordax in B. bonariensis and the 3 species of Orestias constitute new host records. Infections in the cerebrum and cerebellum add new information on specific parasite location. PMID:1597806

  12. Effects of graded mechanical compression of rabbit sciatic nerve on nerve blood flow and electrophysiological properties.

    PubMed

    Yayama, Takafumi; Kobayashi, Shigeru; Nakanishi, Yoshitaka; Uchida, Kenzo; Kokubo, Yasuo; Miyazaki, Tsuyoshi; Takeno, Kenichi; Awara, Kosuke; Mwaka, Erisa S; Iwamoto, Yukihide; Baba, Hisatoshi

    2010-04-01

    Entrapment neuropathy is a frequent clinical problem that can be caused by, among other factors, mechanical compression; however, exactly how a compressive force affects the peripheral nerves remains poorly understood. In this study, using a rabbit model of sciatic nerve injury (n=12), we evaluated the time-course of changes in intraneural blood flow, compound nerve action potentials, and functioning of the blood-nerve barrier during graded mechanical compression. Nerve injury was applied using a compressor equipped with a custom-made pressure transducer. Cessation of intraneural blood flow was noted at a mean compressive force of 0.457+/-0.022 N (+/-SEM), and the compound action potential became zero at 0.486+/-0.031 N. Marked extravasation of Evans blue albumin was noted after 20 min of intraneural ischemia. The functional changes induced by compression are likely due to intraneural edema, which could subsequently result in impairment of nerve function. These changes may be critical factors in the development of symptoms associated with nerve compression. PMID:20122834

  13. Cranial mechanics and feeding in Tyrannosaurus rex.

    PubMed Central

    Rayfield, Emily J.

    2004-01-01

    It has been suggested that the large theropod dinosaur Tyrannosaurus rex was capable of producing extremely powerful bite forces and resisting multi-directional loading generated during feeding. Contrary to this suggestion is the observation that the cranium is composed of often loosely articulated facial bones, although these bones may have performed a shock-absorption role. The structural analysis technique finite element analysis (FEA) is employed here to investigate the functional morphology and cranial mechanics of the T. rex skull. In particular, I test whether the skull is optimized for the resistance of large bi-directional feeding loads, whether mobile joints are adapted for the localized resistance of feeding-induced stress and strain, and whether mobile joints act to weaken or strengthen the skull overall. The results demonstrate that the cranium is equally adapted to resist biting or tearing forces and therefore the 'puncture-pull' feeding hypothesis is well supported. Finite-element-generated stress-strain patterns are consistent with T. rex cranial morphology: the maxilla-jugal suture provides a tensile shock-absorbing function that reduces localized tension yet 'weakens' the skull overall. Furthermore, peak compressive and shear stresses localize in the nasals rather than the fronto-parietal region as seen in Allosaurus, offering a reason why robusticity is commonplace in tyrannosaurid nasals. PMID:15306316

  14. Transcriptional regulation of cranial sensory placode development

    PubMed Central

    Moody, Sally A.; LaMantia, Anthony-Samuel

    2015-01-01

    Cranial sensory placodes derive from discrete patches of the head ectoderm, and give rise to numerous sensory structures. During gastrulation, a specialized “neural border zone” forms around the neural plate in response to interactions between the neural and non-neural ectoderm and signals from adjacent mesodermal and/or endodermal tissues. This zone subsequently gives rise to two distinct precursor populations of the peripheral nervous system: the neural crest and the pre-placodal ectoderm (PPE). The PPE is a common field from which all cranial sensory placodes arise (adenohypophyseal, olfactory, lens, trigeminal, epibranchial, otic). Members of the Six family of transcription factors are major regulators of PPE specification, in partnership with co-factor proteins such as Eya. Six gene activity also maintains tissue boundaries between the PPE, neural crest and epidermis by repressing genes that specify the fates of those adjacent ectodermally-derived domains. As the embryo acquires anterior-posterior identity, the PPE becomes transcriptionally regionalized, and it subsequently subdivides into specific placodes with distinct developmental fates in response to signaling from adjacent tissues. Each placode is characterized by a unique transcriptional program that leads to the differentiation of highly specialized cells, such as neurosecretory cells, somatic sensory receptor cells, chemosensory neurons, peripheral glia and supporting cells. In this review, we summarize the transcriptional and signaling factors that regulate key steps of placode development, influence subsequent sensory neuron specification, and discuss what is known about mutations in some of the essential PPE genes that underlie human congenital syndromes. PMID:25662264

  15. Roentgen stereophotogrammetry for analysis of cranial growth

    SciTech Connect

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

    1986-04-01

    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.

  16. The contribution of subsistence to global human cranial variation.

    PubMed

    Noback, Marlijn L; Harvati, Katerina

    2015-03-01

    Diet-related cranial variation in modern humans is well documented on a regional scale, with ample examples of cranial changes related to the agricultural transition. However, the influence of subsistence strategy on global cranial variation is less clear, having been confirmed only for the mandible, and dietary effects beyond agriculture are often neglected. Here we identify global patterns of subsistence-related human cranial shape variation. We analysed a worldwide sample of 15 populations (n = 255) with known subsistence strategies using 3-D landmark datasets designed to capture the shape of different units of the cranium. Results show significant correlations between global cranial shape and diet, especially for temporalis muscle shape and general cranial shape. Importantly, the differences between populations with either a plant- or an animal-based diet are more pronounced than those between agriculturalists and hunter-gatherers, suggesting that the influence of diet as driver of cranial variation is not limited to Holocene transitions to agricultural subsistence. Dental arch shape did not correlate with subsistence pattern, possibly indicating the high plasticity of this region of the face in relation to age, disease and individual use of the dentition. Our results highlight the importance of subsistence strategy as one of the factors underlying the evolution of human geographic cranial variation. PMID:25661439

  17. Cranial Growth Unrestricted during Treatment of Deformational Plagiocephaly

    Microsoft Academic Search

    Kevin M. Kelly; Timothy R. Littlefield; Jeanne K. Pomatto; Kim H. Manwaring; Stephen P. Beals

    1999-01-01

    Objectives: The Dynamic Orthotic Cranioplasty (DOC) BandTM is a cranial orthosis used to treat deformational plagiocephaly. The ability of this device to redirect growth and thus, improve craniofacial asymmetry has raised concerns regarding the potential restriction of cranial growth. The purpose of this study was to evaluate the growth of the head during correction of plagiocephaly. Methods: The study sample

  18. Salmonellosis Symptoms

    MedlinePLUS

    ... Funding About NIAID News & Events NIAID > Health & Research Topics > Salmonellosis Salmonellosis Cause Transmission Symptoms Diagnosis Treatment Prevention Complications Research Skip Website Tools Website Tools Print this page Get email updates Order publications Related Links Foodborne ...

  19. Norovirus Symptoms

    MedlinePLUS

    ... Norovirus Infection, National Institutes of Health NoroCORE Food Virology Symptoms Recommend on Facebook Tweet Share Compartir Prevent ... Norovirus Infection, National Institutes of Health NoroCORE Food Virology File Formats Help: How do I view different ...

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

    PubMed Central

    Schmidt, Jennifer; Piekarski, Nadine; Olsson, Lennart

    2013-01-01

    Our research on the evolution of the vertebrate head focuses on understanding the developmental origins of morphological novelties. Using a broad comparative approach in amphibians, and comparisons with the well-studied quail-chicken system, we investigate how evolutionarily conserved or variable different aspects of head development are. Here we review research on the often overlooked development of cranial muscles, and on its dependence on cranial cartilage development. In general, cranial muscle cell migration and the spatiotemporal pattern of cranial muscle formation appears to be very conserved among the few species of vertebrates that have been studied. However, fate-mapping of somites in the Mexican axolotl revealed differences in the specific formation of hypobranchial muscles (tongue muscles) in comparison to the chicken. The proper development of cranial muscles has been shown to be strongly dependent on the mostly neural crest-derived cartilage elements in the larval head of amphibians. For example, a morpholino-based knock-down of the transcription factor FoxN3 in Xenopus laevis has drastic indirect effects on cranial muscle patterning, although the direct function of the gene is mostly connected to neural crest development. Furthermore, extirpation of single migratory streams of cranial neural crest cells in combination with fate-mapping in a frog shows that individual cranial muscles and their neural crest-derived connective tissue attachments originate from the same visceral arch, even when the muscles attach to skeletal components that are derived from a different arch. The same pattern has also been found in the chicken embryo, the only other species that has been thoroughly investigated, and thus might be a conserved pattern in vertebrates that reflects the fundamental nature of a mechanism that keeps the segmental order of the head in place despite drastic changes in adult anatomy. There is a need for detailed comparative fate-mapping of pre-otic paraxial mesoderm in amphibians, to determine developmental causes underlying the complicated changes in cranial muscle development and architecture within amphibians, and in particular how the novel mouth apparatus in frog tadpoles evolved. This will also form a foundation for further research into the molecular mechanisms that regulate rostral head morphogenesis. Our empirical studies are discussed within a theoretical framework concerned with the evolutionary origin and developmental basis of novel anatomical structures in general. We argue that a common developmental origin is not a fool-proof guide to homology, and that a view that sees only structures without homologs as novel is too restricted, because novelties must be produced by changes in the same framework of developmental processes. At the level of developmental processes and mechanisms, novel structures are therefore likely to have homologs, and we need to develop a hierarchical concept of novelty that takes this into account. PMID:22780231

  1. A fate-map for cranial sensory ganglia in the sea lamprey?

    PubMed Central

    Modrell, Melinda S.; Hockman, Dorit; Uy, Benjamin; Buckley, David; Sauka-Spengler, Tatjana; Bronner, Marianne E.; Baker, Clare V.H.

    2014-01-01

    Cranial neurogenic placodes and the neural crest make essential contributions to key adult characteristics of all vertebrates, including the paired peripheral sense organs and craniofacial skeleton. Neurogenic placode development has been extensively characterized in representative jawed vertebrates (gnathostomes) but not in jawless fishes (agnathans). Here, we use in vivo lineage tracing with DiI, together with neuronal differentiation markers, to establish the first detailed fate-map for placode-derived sensory neurons in a jawless fish, the sea lamprey Petromyzon marinus, and to confirm that neural crest cells in the lamprey contribute to the cranial sensory ganglia. We also show that a pan-Pax3/7 antibody labels ophthalmic trigeminal (opV, profundal) placode-derived but not maxillomandibular trigeminal (mmV) placode-derived neurons, mirroring the expression of gnathostome Pax3 and suggesting that Pax3 (and its single Pax3/7 lamprey ortholog) is a pan-vertebrate marker for opV placode-derived neurons. Unexpectedly, however, our data reveal that mmV neuron precursors are located in two separate domains at neurula stages, with opV neuron precursors sandwiched between them. The different branches of the mmV nerve are not comparable between lampreys and gnatho-stomes, and spatial segregation of mmV neuron precursor territories may be a derived feature of lampreys. Nevertheless, maxillary and mandibular neurons are spatially segregated within gnathostome mmV ganglia, suggesting that a more detailed investigation of gnathostome mmV placode development would be worthwhile. Overall, however, our results highlight the conservation of cranial peripheral sensory nervous system development across vertebrates, yielding insight into ancestral vertebrate traits. PMID:24513489

  2. Nerve Conduction Velocity of Small Components in Human Sensory Nerves

    Microsoft Academic Search

    W. Tackmann; R. Minkenberg

    1977-01-01

    Slow conducted components of sensory nerve action potentials were investigated in median and in sural nerves of controls and in patients with peripheral nerve diseases. In the normal group the slow components showed no relation to age which is in contrast to the maximum velocity. In both the median nerve and sural nerve of about 20% of the patients with

  3. Complete Oculomotor Nerve Palsy Caused by Direct Compression of the Posterior Cerebral Artery.

    PubMed

    Jo, Yoon-Sik; Kim, Shin Kyoung; Kim, Dae Ho; Kim, Jae-Hwan; Na, Sang-Jun

    2015-07-01

    Oculomotor nerve palsy frequently occurs because of external compression by an internal carotid-posterior communicating artery aneurysm and diabetes mellitus. In addition, pontine infarction, cavernous sinus tumors, demyelinating disease, and autoimmune disorder are well-known causes of oculomotor nerve palsy. However, cases of complete oculomotor nerve palsy by neurovascular conflicts presented with a sudden onset of clinical symptoms are extremely rare. We experienced a rare case of complete oculomotor nerve palsy because of direct vascular compression of the oculomotor nerve by the posterior cerebral artery. PMID:25939862

  4. [Common and not so common nerve entrapment syndromes: diagnostics, clinical aspects and therapy].

    PubMed

    Schulte-Mattler, W J; Grimm, T

    2015-02-01

    Altogether, nerve entrapment syndromes have a very high incidence. Neurological deficits attributable to a focal peripheral nerve lesion lead to the clinical diagnosis. Frequently, pain is the dominant symptom but is often not confined to the nerve supply area. Electroneurography, electromyography, and more recently also neurosonography are the most important diagnostic tools. In most patients surgical therapy is necessary, which should be carried out in a timely manner. The entrapment syndromes discussed are suprascapular nerve entrapment, carpal tunnel syndrome, cubital tunnel syndrome, meralgia paraesthetica, thoracic outlet syndrome and anterior interosseous nerve syndrome. PMID:25526716

  5. Sensory nerves and pancreatitis

    PubMed Central

    Li, Qingfu

    2014-01-01

    Sensory nerves are a kind of nerve that conduct afferent impulses from the periphery receptors to the central nervous system (CNS) and are able to release neuromediators from the activated peripheral endings. Sensory nerves are particularly important for microcirculatory response, and stimulation of pancreatic sensory nerves releases a variety of neuropeptides such as substance P (SP), calcitonin gene-related peptide (CGRP), etc., leading to neurogenic inflammation characterized as the local vasodilatation and plasma extravasation. Deactivation of sensory nerves often leads to the disturbances of pancreatic microcirculation. Pancreatitis is a common digestive disease that can lead to severe complications and even death if it goes untreated. Experimental studies in animals and tissue analysis in patients with pancreatitis have shown significant changes in sensory nerves supplying the pancreatic gland. Thus making clear the whole mechanism of pancreatitis is essential to treat and cure it. Sensory nerves may have a close correlation with the development of pancreatitis, and knowing more about the role of sensory nerve in pancreatitis is important for the treatment for pancreatitis. This review is aimed to summarize the relationship between sensory nerves and pancreatitis. PMID:25493260

  6. Distal median nerve dysfunction

    MedlinePLUS

    ... type of distal median nerve dysfunction is carpal tunnel syndrome . ... repetitive movements increase the chance of developing carpal tunnel entrapment. Conditions that affect connective tissue or cause ...

  7. The extracisternal approach in vestibular schwannoma surgery and facial nerve preservation.

    PubMed

    Vellutini, Eduardo A S; Beer-Furlan, André; Brock, Roger S; Gomes, Marcos Q T; Stamm, Aldo; Cruz, Oswaldo Laercio M

    2014-12-01

    The classical surgical technique for the resection of vestibular schwannomas (VS) has emphasized the microsurgical anatomy of cranial nerves. We believe that the focus on preservation of the arachnoid membrane may serve as a safe guide for tumor removal. Method The extracisternal approach is described in detail. We reviewed charts from 120 patients treated with this technique between 2006 and 2012. Surgical results were evaluated based on the extension of resection, tumor relapse, and facial nerve function. Results Overall gross total resection was achieved in 81% of the patients. The overall postoperative facial nerve function House-Brackmann grades I-II at one year was 93%. There was no recurrence in 4.2 years mean follow up. Conclusion The extracisternal technique differs from other surgical descriptions on the treatment of VS by not requiring the identification of the facial nerve, as long as we preserve the arachnoid envelope in the total circumference of the tumor. PMID:25465777

  8. Signet ring cell adenocarcinoma and bilateral leptomeningeal involvement of optic nerve sheaths.

    PubMed

    Mbekeani, Joyce N; Haseeb, Mohammed Q; Tulbah, Asma M; Hamed, Salem H; Al Hazzaa, Selwa A; Dogar, Mohammad A

    2015-06-01

    Signet ring cell adenocarcinoma has a propensity for leptomeningeal carcinomatosis, and although bilateral optic nerve involvement is rare, this may occur with or without obvious signs of diffuse leptomeningeal involvement. We describe a 41-year-old woman who presented with a brief history of simultaneous bilateral visual deterioration and a distended abdomen. Examination revealed bilateral no light perception vision and bilateral optic disc edema. Radiologic work-up showed large multiple pelvic masses involving the ovaries, multifocal boney deposits, and widespread central nervous system carcinomatosis, involving the optic nerves and the first, fifth, and eighth cranial nerves. Biopsy of an ovarian mass demonstrated islands of signet ring cells. Signet cell adenocarcinomatous infiltration of the leptomeningeal space should be considered in cases of bilateral simultaneous vision loss with signs suggestive of leptomeningeal infiltration of the optic nerve sheath. PMID:25839780

  9. Primary cranial mediastinal hemangiosarcoma in a young dog

    PubMed Central

    2014-01-01

    Primary cranial mediastinal hemangiosarcomas are uncommon tumors. A 30-kg, 2-year-old, intact female German shepherd was presented for evaluation of cachexia and respiratory distress of a few days’ duration. Lateral radiographic projection of the thorax revealed significant pleural effusion. Computed tomography revealed a cranial mediastinal mass effect adjacent to the heart. On surgical exploration, a pedunculated mass attached to the esophagus, trachea, brachiocephalic trunk, left subclavian artery and cranial vena cava without attachment to the right atrium and auricular appendage was removed and debrided by use of blunt dissection and dry gauzes, respectively. Histopathology results described the cranial mediastinal mass as hemangiosarcoma. At 8 months and 5 days post-operatively, the patient died. Primary cranial mediastinal hemangiosarcomas, although a seemingly rare cause of thoracic pathology in young dogs, should be considered in the differential diagnosis for pleural effusion and soft tissue mass effect in the cranial mediastinum. This is the first case report in a dog to describe primary cranial mediastinal hemangiosarcoma. PMID:25089185

  10. Anthropogenic environments exert variable selection on cranial capacity in mammals

    PubMed Central

    Snell-Rood, Emilie C.; Wick, Naomi

    2013-01-01

    It is thought that behaviourally flexible species will be able to cope with novel and rapidly changing environments associated with human activity. However, it is unclear whether such environments are selecting for increases in behavioural plasticity, and whether some species show more pronounced evolutionary changes in plasticity. To test whether anthropogenic environments are selecting for increased behavioural plasticity within species, we measured variation in relative cranial capacity over time and space in 10 species of mammals. We predicted that urban populations would show greater cranial capacity than rural populations and that cranial capacity would increase over time in urban populations. Based on relevant theory, we also predicted that species capable of rapid population growth would show more pronounced evolutionary responses. We found that urban populations of two small mammal species had significantly greater cranial capacity than rural populations. In addition, species with higher fecundity showed more pronounced differentiation between urban and rural populations. Contrary to expectations, we found no increases in cranial capacity over time in urban populations—indeed, two species tended to have a decrease in cranial capacity over time in urban populations. Furthermore, rural populations of all insectivorous species measured showed significant increases in relative cranial capacity over time. Our results provide partial support for the hypothesis that urban environments select for increased behavioural plasticity, although this selection may be most pronounced early during the urban colonization process. Furthermore, these data also suggest that behavioural plasticity may be simultaneously favoured in rural environments, which are also changing because of human activity. PMID:23966638

  11. Communication between radial nerve and medial cutaneous nerve of forearm

    PubMed Central

    Marathe, RR; Mankar, SR; Joshi, M; Sontakke, YA

    2010-01-01

    Radial nerve is usually a branch of the posterior cord of the brachial plexus. It innervates triceps, anconeous, brachialis, brachioradialis, extensor carpi radialis longus muscles and gives the posterior cutaneous nerve of the arm, lower lateral cutaneous nerve of arm, posterior cutaneous nerve of forearm; without exhibiting any communication with the medial cutaneous nerve of forearm or any other nerve. We report communication between the radial nerve and medial cutaneous nerve of forearm on the left side in a 58-year-old male cadaver. The right sided structures were found to be normal. Neurosurgeons should keep such variations in mind while performing the surgeries of axilla and upper arm. PMID:21799623

  12. [A 65-year-old woman with headache, facial pain, and progressive multiple cranial neuropathy].

    PubMed

    Miyasaka, H; Nohara, C; Ohtani, H; Suda, K; Mori, H; Nakajima, Y; Mizuno, Y

    1994-11-01

    We report a 65-year-old woman with progressive multiple cranial neuropathy. She had been suffered from bronchial asthma since 1979 for which prednisolone had been prescribed. She noted an onset of pain around her nose in October, 1989, which extended into the periorbital regions bilaterally. In February, 1990, she was treated with stellate ganglion block and trigeminal nerve block; these treatments partially alleviated her pain. In May of 1991, she noted a difficulty in swallowing solid foods. In November of the same year, she developed right facial paresis; two weeks later, she noted numbness in her left face, and was hospitalized to our service on December 16, 1991. On admission, she was afebrile and general physical examination was unremarkable except for piping rales in her both lung fields. On neurologic examination, she was alert and oriented to all spheres; higher cerebral functions were intact. In the cranial nerves, her olfactory sense was lost bilaterally; her vision was markedly diminished bilaterally only to recognize hand movements; the optic fundi appeared normal; the pupils were isocoric and reacted to light promptly. The extraocular muscles were moderately weak to most of the directions more on the left; no nystagmus was present. Facial sensation was diminished bilaterally; the jaw deviated to right; right facial paresis of peripheral type was present; her hearing was diminished bilaterally more on the right. The movement of the soft palate was diminished on the right side; dysphagia was present; her voice was horse; the gag reflex was diminished. The sternocleidomastoid muscle was weak bilaterally; the tongue appeared normal. Examination of gait was differed because of headache, however, no apparent motor weakness was present. No ataxia or involuntary movement was noted. Deep reflexes were normally elicited and symmetric. Plantar response was flexor. Sensation in the extremities was intact. Kernig's sign was positive at 70 degree leg extension; eyeball tenderness was also present bilaterally, however, no nuchal stiffness was noted. Following abnormalities were present in the laboratory examination: WBC 11,400/microliters, ESR 50 mm/hr, CRP 6.1 mg/dl. The lumbar CSF was under a normal pressure containing 29 WBC/microliters (neutrophils 7, lymphocytes 20, others 2), 67 mg/dl of protein, and 53 mg/dl of sugar; cultures for acid-fast bacilli as well as for other bacteria were negative; no malignant cells were found. A cranial CT scan revealed an isodensity mass in the orbit and ill-defined low density areas in the white matters of the frontal lobes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7873285

  13. Nerve injury induces the expression of syndecan-1 heparan sulfate proteoglycan in primary sensory neurons.

    PubMed

    Murakami, K; Tanaka, T; Bando, Y; Yoshida, S

    2015-08-01

    Heparan sulfate proteoglycans (HSPGs) have important functions in development of the central nervous system; however, their functions in nerve injury are not yet fully understood. We previously reported the expression of syndecan-1, a type of HSPG, in cranial motor neurons after nerve injury, suggesting the importance of syndecan-1 in the pathology of motor nerve injury. In this study, we examined the expression of syndecan-1, a type of HSPG, in primary sensory neurons after nerve injury in mice. Sciatic nerve axotomy strongly induced the expression of syndecan-1 in a subpopulation of injured dorsal root ganglion (DRG) neurons, which were small in size and had CGRP- or isolectin B4-positive fibers. Syndecan-1 was also distributed in the dorsal horn of the spinal cord ipsilateral to the axotomy, and located on the membrane of axons in lamina II of the dorsal horn. Not only sciatic nerve axotomy, infraorbital nerve axotomy also induced the expression of syndecan-1 in trigeminal ganglion neurons. Moreover, syndecan-1 knockdown in cultured DRG neurons induced a shorter neurite extension. These results suggest that syndecan-1 expression in injured primary sensory neurons may have functional roles in nerve regeneration and synaptic plasticity, resulting in the development of neuropathic pain. PMID:26002314

  14. Fibrolipomatous Hamartoma of the Nerve Arising in the Neck: A Case Report With Review of the Literature and Differential Diagnosis.

    PubMed

    Philp, Lauren; Naert, Karen A; Ghazarian, Danny

    2015-07-01

    We report an unusual case of a fibrolipomatous hamartoma that arose in a nuchal nerve. Typically, fibrolipomatous hamartoma, otherwise known as a neural fibrolipoma or lipomatosis of nerve, arises in the median nerve, brachial plexus, cranial nerves, or plantar nerves. The differential diagnosis is broad and includes benign and malignant spindle cell lesions, such as spindle cell lipoma, perineurioma, and myxoid liposarcoma. We were able to identify the lesion based on the typical histology, including triphasic composition with spindle cell, neural, and adipocytic components and whorled architecture. Because of the atypical location in the neck, detailed immunohistochemical staining was performed. The lesional spindle cells were negative for SMA, CD10, CD68, EMA, S100, PGP9.5, CD34, CD56, and beta-catenin. Colloidal iron stain highlighted marked intralesional mucin deposition. This detailed immunohistochemical profile is a useful diagnostic aid and to our knowledge has not been previously described. PMID:25033011

  15. Motor nerve transplantation.

    PubMed

    Gray, W P; Keohane, C; Kirwan, W O

    1997-10-01

    The motor nerve transplantation (MNT) technique is used to transfer an intact nerve into a denervated muscle by harvesting a neurovascular pedicle of muscle containing motor endplates from the motor endplate zone of a donor muscle and implanting it into a denervated muscle. Thirty-six adult New Zealand White rabbits underwent reinnervation of the left long peroneal (LP) muscle (fast twitch) with a motor nerve graft from the soleus muscle (slow twitch). The right LP muscle served as a control. Reinnervation was assessed using microstimulatory single-fiber electromyography (SFEMG), alterations in muscle fiber typing and grouping, and isometric response curves. Neurofilament antibody was used for axon staining. The neurofilament studies provided direct evidence of nerve growth from the motor nerve graft into the adjacent denervated muscle. Median motor endplate jitter was 13 microsec preoperatively, and 26 microsec at 2 months, 29.5 microsec at 4 months, and 14 microsec at 6 months postoperatively (p < 0.001). Isometric tetanic tension studies showed a progressive functional recovery in the reinnervated muscle over 6 months. There was no histological evidence of aberrant reinnervation from any source outside the nerve pedicle. Isometric twitch responses and adenosine triphosphatase studies confirmed the conversion of the reinnervated LP muscle to a slow-type muscle. Acetylcholinesterase studies confirmed the presence of functioning motor endplates beneath the insertion of the motor nerve graft. It is concluded that the MNT technique achieves motor reinnervation by growth of new nerve fibers across the pedicle graft into the recipient muscle. PMID:9322851

  16. Safety of intraoperative electrophysiological monitoring (TES and EMG) for spinal and cranial lesions.

    PubMed

    Gazzeri, Roberto; Faiola, Andrea; Neroni, Massimiliano; Fiore, Claudio; Callovini, Giorgio; Pischedda, Mauro; Galarza, Marcelo

    2013-09-01

    Intraoperative motor evoked potentials (MEP) and electromyography (EMG) monitoring in patients with spinal and cranial lesions is a valuable tool for prevention of postoperative motor deficits. The purpose of this study was to determine whether electrophysiological monitoring during skull base, spinal cord, and spinal surgery might be useful for predicting postoperative motor deterioration. From January 2012 to March 2013, thirty-three consecutive patients were studied using intraoperative monitoring (Nuvasive NV-M5 System) to check the integrity of brainstem, spinal cord, and nerve roots, recording transcranial motor evoked potentials (TcMEPs) and electromyography. Changes in MEPs and EMGs were related to postoperative deficits. Preoperative diagnosis included skull base and brainstem lesions (6 patients), spinal tumors (11 patients), spinal deformity (16 cases). Using TcMEPs and EMG is a practicable and safe method. MEPs are useful in any surgery in which the brainstem and spinal cord are at risk. EMG stimulation helps to identify an optimal trans-psoas entry point for an extreme lateral lumbar interbody fusion (XLIF) approach to protect against potential nerve injury. This neural navigation technique via a surgeon-interpreted interface assists the surgical team in safely removing lesions and accessing the intervertebral disc space for minimally invasive spinal procedures. PMID:24085510

  17. Ecological correlates to cranial morphology in Leporids (Mammalia, Lagomorpha).

    PubMed

    Kraatz, Brian P; Sherratt, Emma; Bumacod, Nicholas; Wedel, Mathew J

    2015-01-01

    The mammalian order Lagomorpha has been the subject of many morphometric studies aimed at understanding the relationship between form and function as it relates to locomotion, primarily in postcranial morphology. The leporid cranial skeleton, however, may also reveal information about their ecology, particularly locomotion and vision. Here we investigate the relationship between cranial shape and the degree of facial tilt with locomotion (cursoriality, saltation, and burrowing) within crown leporids. Our results suggest that facial tilt is more pronounced in cursors and saltators compared to generalists, and that increasing facial tilt may be driven by a need for expanded visual fields. Our phylogenetically informed analyses indicate that burrowing behavior, facial tilt, and locomotor behavior do not predict cranial shape. However, we find that variables such as bullae size, size of the splenius capitus fossa, and overall rostral dimensions are important components for understanding the cranial variation in leporids. PMID:25802812

  18. Developmental Simulation of the Adult Cranial Morphology of Australopithecus sediba 

    E-print Network

    Carlson, Keely Britt

    2014-07-25

    The present study involves the developmental simulation of the adult cranial morphology of the newly discovered species, Australopithecus sediba. Au. sediba has been the focus of considerable discussion and debate in paleoanthropology, following its...

  19. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... A cranial electrotherapy stimulator is a device that applies electrical current to a patient's head to treat insomnia, depression, or anxiety. (b) Classification. Class III (premarket approval). (c) Date a PMA or notice of completion...

  20. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... . A cranial electrotherapy stimulator is a device that applies electrical current to a patient's head to treat insomnia, depression, or anxiety. (b) Classification. Class III (premarket approval). (c) Date a PMA or notice of completion...

  1. Permanent alopecia after cranial irradiation: Dose–response relationship

    Microsoft Academic Search

    Brian D. Lawenda; Havaleh M. Gagne; David P. Gierga; Andrzej Niemierko; Winnifred M. Wong; Nancy J. Tarbell; George T. Y. Chen; Fred H. Hochberg; Jay S. Loeffler

    2004-01-01

    PurposeTo develop a dose–response relationship for the occurrence of permanent alopecia after cranial irradiation and to analyze potential confounding variables that may contribute to this unwanted and often unavoidable complication of treatment.

  2. 21 CFR 882.4370 - Pneumatic cranial drill motor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  3. 21 CFR 882.4370 - Pneumatic cranial drill motor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  4. 21 CFR 882.4370 - Pneumatic cranial drill motor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  5. 21 CFR 882.4360 - Electric cranial drill motor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...electric cranial drill motor is an electrically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  6. 21 CFR 882.4370 - Pneumatic cranial drill motor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  7. 21 CFR 882.4360 - Electric cranial drill motor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...electric cranial drill motor is an electrically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  8. 21 CFR 882.4370 - Pneumatic cranial drill motor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  9. 21 CFR 882.4360 - Electric cranial drill motor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...electric cranial drill motor is an electrically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  10. 21 CFR 882.4360 - Electric cranial drill motor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...electric cranial drill motor is an electrically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b) Classification. Class II (performance...

  11. A Stable Cranial Neural Crest Cell Line from Mouse

    PubMed Central

    Ishii, Mamoru; Arias, Athena C.; Liu, Liqiong; Chen, Yi-Bu; Bronner, Marianne E.

    2012-01-01

    Cranial neural crest cells give rise to ectomesenchymal derivatives such as cranial bones, cartilage, smooth muscle, dentin, as well as melanocytes, corneal endothelial cells, and neurons and glial cells of the peripheral nervous system. Previous studies have suggested that although multipotent stem-like cells may exist during the course of cranial neural crest development, they are transient, undergoing lineage restriction early in embryonic development. We have developed culture conditions that allow cranial neural crest cells to be grown as multipotent stem-like cells. With these methods, we obtained 2 independent cell lines, O9-1 and i10-1, which were derived from mass cultures of Wnt1-Cre; R26R-GFP-expressing cells. These cell lines can be propagated and passaged indefinitely, and can differentiate into osteoblasts, chondrocytes, smooth muscle cells, and glial cells. Whole-genome expression profiling of O9-1 cells revealed that this line stably expresses stem cell markers (CD44, Sca-1, and Bmi1) and neural crest markers (AP-2?, Twist1, Sox9, Myc, Ets1, Dlx1, Dlx2, Crabp1, Epha2, and Itgb1). O9-1 cells are capable of contributing to cranial mesenchymal (osteoblast and smooth muscle) neural crest fates when injected into E13.5 mouse cranial tissue explants and chicken embryos. These results suggest that O9-1 cells represent multipotent mesenchymal cranial neural crest cells. The O9-1 cell line should serve as a useful tool for investigating the molecular properties of differentiating cranial neural crest cells. PMID:22889333

  12. Haptic rendering of volumetric data for cranial implant modeling.

    PubMed

    Ai, Zhuming; Evenhouse, Ray; Rasmussen, Mary

    2005-01-01

    A force feedback algorithm for cranial implant design is presented in this paper. The algorithm is applied directly on volumetric data. It is a proxy-based algorithm, and a spherical proxy is used to accurately calculate the force between the sculpting tool and the skull. Based on this algorithm a cranial implant modeling system is implemented, and an implant for a simulated defect is designed. PMID:17281400

  13. Hypothalamic-Pituitary-Adrenal Function following Cranial Irradiation

    Microsoft Academic Search

    Sharon E Oberfield; Anita Nirenberg; Jeffrey C. Allen; Henry Cohen; Bernadine Donahue; Veeramac Prasad; Robin Schiff; Songya Pang; Fereshteh Ghavimi; Raphael David; George Chrousos; Charles Sklar

    1997-01-01

    We assessed the effect of cranial irradiation on hypothalamic-pituitary (HP)-adrenal function in 17 patients (12 females, 5 males) treated with cranial\\/ craniospinal irradiation for acute leukemia (2 patients) or tumors distant from the hypothalamus and pituitary (8 medulloblastoma, 3 astrocytoma, 3 rhabdo-myosarcoma, 1 ependymoma). Estimated doses of radiation (RT) to the HP region ranged from 18 to 72 Gy. Thirteen

  14. A Comparison of Cranial and Artificially Aroused Impulses Under the Influence of Nerve Blocks

    E-print Network

    Gruber, Charles M.

    1912-06-01

    : 910 p 116 e . Gad: Arch, f P h i s i o l 1 8 8 0 S 1 . 5. Schenck: P f l ü g e r s Archiv . 1905 Bd. 106 h a f t 8 & 9,S 368. 6 . P f l ü c k e r : P f lugars Archiv; 1905 Bd 106 h a f t 8 & 9 S 372 7. .Fröhlich: P f l ü g e r s Archiv . 1906 Bd.... 113 ha f t 7 & 8,3.433 P f l ü g e r s A r ch i v 1906 Bd. 113 ha f t 7 & 8,3.418 8 . A c h e l l e : P f l ü g e r s Arch, 1905, Bd. 106 h a f t 8 & 9 . 9 . Ban i l eaky : Zeu t ra lh l f P h y s i o l o g i e 1895 Bd. 9 . 10 . Schatemi t fcfw: Z...

  15. Development of a Computer-Assisted Cranial Nerve Simulation From the Visible Human Dataset

    NSDL National Science Digital Library

    2011-03-01

    This article describes the development of a three-dimensional model of the skull, brainstem and thalamus. The development of the model and learning modules are discussed. The goal of this project was to provide medical students with another tool to improve their visual spatial reasoning skills.

  16. Development of a Computer-Assisted Cranial Nerve Simulation from the Visible Human Dataset

    ERIC Educational Resources Information Center

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

    2011-01-01

    Advancements in technology and personal computing have allowed for the development of novel teaching modalities such as online web-based modules. These modules are currently being incorporated into medical curricula and, in some paradigms, have been shown to be superior to classroom instruction. We believe that these modules have the potential of…

  17. EMBRYOLOGICAL ORIGIN FOR AUTISM: DEVELOPMENTAL ANOMALIES OF THE CRANIAL NERVE MOTOR NUCLEI. (R824758)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  18. Artificial cranial deformation in Pleistocene Australians: the Coobool Creek sample.

    PubMed

    Durband, Arthur C

    2008-06-01

    Several authors have suggested that some Pleistocene Australian crania have been altered by artificial cranial deformation. The large sample from Coobool Creek has featured prominently in this debate. The present study reevaluates the evidence for artificial cranial deformation in this population using both a larger cranial sample and a more comprehensive set of measurements than those used in earlier work on this subject. Additionally, random expectation statistics are used to calculate statistical significance for these examinations. The results of this study agree with prior work indicating that a portion of this sample shows evidence for artificial deformation of the cranial vault. Many Coobool Creek crania display strong shape similarities with a population of known deformed individuals from New Britain. Coobool Creek crania 1, 41, 65, and 66 show the strongest evidence for deformation, but several other individuals from this sample also show clear evidence for culturally manipulated changes in cranial shape. This project provides added support for the argument that at least some Pleistocene Australian groups were practicing artificial cranial deformation. PMID:18243276

  19. Neurulation in the cranial region – normal and abnormal

    PubMed Central

    Copp, Andrew J

    2005-01-01

    Cranial neurulation is the embryonic process responsible for formation of the brain primordium. In the mouse embryo, cranial neurulation is a piecemeal process with several initiation sites and two neuropores. Variation in the pattern of cranial neurulation occurs in different mouse strains, and a simpler version of this morphogenetic scheme has been described in human embryos. Exencephaly is more common in females than in males, an unexplained phenomenon seen in both mice and humans. As the cranial neural tube closes, a critical morphogenetic event is the formation of dorsolateral bending points near the neural fold tips, which enables subsequent midline fusion of the neural folds. Many mutant and gene-targeted mouse strains develop cranial neural tube defects, and analysis of the underlying molecular defects identifies several requirements for normal dorsolateral bending. These include a functional actin cytoskeleton, emigration of the cranial neural crest, spatio-temporally regulated apoptosis, and a balance between cell proliferation and the onset of neuronal differentiation. A small number of mouse mutants exhibit craniorachischisis, a combined brain and spine neurulation defect. Recent studies show that disturbance of a single molecular signalling cascade, the planar cell polarity pathway, is implicated in mutants with this defect. PMID:16313396

  20. Tortuous axillary artery aneurysm causing median nerve compression.

    PubMed

    Ortiz-Pomales, Yan; Smith, Jennifer; Weiss, Jeffrey; Casey, Kevin

    2014-01-01

    Axillary artery aneurysms are rare entities that warrant surgical intervention. Reported complications include thrombosis, distal embolization, and debilitating neurologic symptoms caused by median nerve compression. Common etiologies include trauma or repetition injuries. Less recognized associations include atherosclerotic, connective tissue, or mycotic processes. We report a case of a rare tortuous axillary artery aneurysm causing neurologic symptoms in a woman with an unused arteriovenous fistula. PMID:24189011

  1. Nerve fiber planimetry in acute and chronic nerve lesions and in nerve lesions in continuity.

    PubMed

    Guelinckx, P J; Boeckx, W D; Dom, R; Gruwez, J A

    1985-10-01

    The level of resection of damaged nerve tissue in acute and chronic nerve lesions was determined on the basis of the vascular structure, the consistency of the nerve during palpation, the amount of interfascicular connective tissue, and the mushroom formation of the fascicles. Intraoperative electrophysiologic recordings were performed on the cut nerve ends to determine the function of the axons. Postoperative planimetric analyses of cross sections made through the resected nerve stumps were performed to measure axonal and endoneural tube diameters and to correlate these results with the clinical criteria used through the operating microscope. Axons in the proximal nerve ends of acute and chronic nerve lesions displayed a similar mean diameter. Endoneural tubes in chronic nerve lesions shrunk significantly as nerve repair was delayed. In several nerve lesions in continuity, axons remained present across the injured site despite absence of electrical conduction. When comparing the results of axonal or endoneural tube diameters of chronic nerve lesions to the results of other studies or acute nerve lesions, we demonstrated that careful examination through the operating microscope provided valid information about the proper management and resection level of chronic nerve lesions. Electrophysiologic evaluation aided the surgical management but was not useful for the resection of the distal damaged nerve segment. The presence of an evoked potential in the proximal nerve ends guaranteed a nearly normal nerve fiber diameter distribution, while the absence of such a potential in the distal nerve ends indicated an abnormal, absent, or disturbed endoneural tube diameter histogram. PMID:4034768

  2. Suprascapular nerve entrapment.

    PubMed

    Corò, L; Azuelos, A; Alexandre, A

    2005-01-01

    It is important to be aware of neuropathy involving the suprascapular nerve. While direct trauma to the suprascapular nerve is the usual cause (direct blow to the base of the neck or posterior shoulder, shoulder dislocation or fracture), the problem may result from overuse injuries (such as repetitive tennis serving or spiking of a volley ball), excessive horizontal adduction, weight lifting, backpacking or no apparent reason. These last three years we have operated 8 cases of suprascapular nerve neurolysis at the level of suprascapular incision, and section of the transverse scapular ligament through the back supraspinal approach. PMID:15830964

  3. Intracranial facial nerve reconstruction.

    PubMed

    Yammine, F G; Dufour, J J; Mohr, G

    1999-06-01

    Surgery for tumours of the cerebellopontine angle (CPA) or the internal auditory canal (IAC) is sometimes complicated by the severing of the seventh nerve. Many procedures are available for facial reanimation. Among these, primary intracranial VII-VII reanastomosis is considered as the method of choice. This series reviews all the cases of primary intracranial facial nerve reconstruction that we have performed either directly or with the use of a nerve graft interposition. Functional results are analyzed according to the House-Brackmann grading scale. The advantages and benefits of this technique are discussed as compared with other methods of facial reanimation, namely, the hypoglossal-facial anastomosis. PMID:10410348

  4. Ulnar nerve dysfunction

    MedlinePLUS

    ... surface of the body where it crosses the elbow. The damage destroys the nerve covering ( myelin sheath) ... be caused by: Long-term pressure on the elbow An elbow fracture or dislocation Temporary pain and ...

  5. Diabetic Nerve Problems

    MedlinePLUS

    ... the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get it. ... change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling ...

  6. Vagus Nerve Stimulation

    PubMed Central

    Howland, Robert H.

    2014-01-01

    The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality. PMID:24834378

  7. Vagus Nerve Stimulation.

    PubMed

    Howland, Robert H

    2014-06-01

    The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality. PMID:24834378

  8. [Rosai-Dorfman disease with spinal and cranial tumors. A clinical case reported].

    PubMed

    Molina-Carrión, Luis Enrique; Mendoza-Álvarez, Sergio Alberto; Vera-Lastra, Olga Lidia; Caldera-Duarte, Agustín; Lara-Torres, Héctor; Hernández-González, Claudia

    2014-01-01

    Rosai-Dorfman disease, known as well as sinus histiocytosis with massive lymphadenopathy, is a histiocytic proliferative disorder which may affect, with an extranodal presentation, the central nervous system, in 5 % of cases with exceptional reports of simultaneous development of spinal and cranial tumors. When it affects the central nervous system it appears more in men and it is shown as a mass in the cranial dura mater or in the spinal cord. The clinical symptoms of Rosai-Dorfman disease are fever, general malayse, weight loss, and nocturnal diaphoresis. Also, when Rosai-Dorfman disease affects the spinal cord, it has an impact on the thoracic spine, which causes paraparesis, quadriparesis, and sensory disorder. Histopathologically, the lymph nodes show emperipolesis. The diagnosis of Rosai-Dorfman disease is usually good, since 40 % of the patients present a spontaneous remission if they are treated with oral corticosteroids, even though the lesion can be managed with fractionated radiotherapy or with radical surgery. We report the case of a 34-year-old male who started with spinal injuries, and a year later showed intracranial lesions. PMID:24758863

  9. Sural nerve defects after nerve biopsy or nerve transfer as a sensory regeneration model for peripheral nerve conduit implantation.

    PubMed

    Radtke, C; Kocsis, J D; Reimers, K; Allmeling, C; Vogt, P M

    2013-09-01

    Nerve repair after injury can be effectively accomplished by direct suture approximation of the proximal and distal segments. This is more successful if coadaptation can be achieved without tension. Currently, the gold standard repair of larger deficits is the transplantation of an autologous sensory sural nerve graft. However, a significant disadvantage of this technique is the inevitable donor morbidity (sensory loss, neuroma and scar formation) after harvesting of the sural nerve. Moreover, limitation of autologous donor nerve length and fixed diameter of the available sural nerve are major drawbacks of current autograft treatment. Another approach that was introduced for nerve repair is the implantation of alloplastic nerve tubes made of, for example, poly-L-lactide. In these, nerve stumps of the transected nerves are surgically bridged using the biosynthetic conduit. A number of experimental studies, primarily in rodents, indicate axonal regeneration and remyelination after implantation of various conduits. However, only limited clinical studies with conduit implantation have been performed in acute peripheral nerve injuries particularly on digital nerves. Clinical transfer of animal studies, which can be carefully calibrated for site and extent of injury, to humans is difficult to interpret due to the intrinsic variability in human nerve injuries. This prevents effective quantification of improvement and induces bias in the study. Therefore, standardization of lesion/repair in human studies is warranted. Here we propose to use sural nerve defects, induced due to nerve graft harvesting or from diagnostic nerve biopsies as a model site to enable standardization of nerve conduit implantation. This would help better with the characterization of the implants and its effectiveness in axonal regeneration and remyelination. Nerve regeneration can be assessed, for example, by recovery of sensation, measured non-invasively by threshold to von Frey filaments and cold allodynia. Moreover, the implantation of nerve conduits may not only serve as a model to examine nerve repair, but it could also prevent neuroma formation, which is a major morbidity of sural nerve extraction. PMID:23867139

  10. Nerve biopsy findings in two cases of Tangier disease

    Microsoft Academic Search

    R. S. Kocen; R. H. M. King; P. K. Thomas; L. F. Haas

    1973-01-01

    Nerve biopsy findings are recorded for two previously reported patients with Tangier disease (hereditary high density lipoprotein deficiency). Both cases showed unusual clinical manifestations in comparison with other reported cases. The neurological disorder, symptoms from which began in the third decade, gave rise to a lower motor neuron deficit of unique distribution, which was accompanied by progressive sensory impairment limited

  11. A review of hedgehog signaling in cranial bone development

    PubMed Central

    Pan, Angel; Chang, Le; Nguyen, Alan; James, Aaron W.

    2013-01-01

    During craniofacial development, the Hedgehog (HH) signaling pathway is essential for mesodermal tissue patterning and differentiation. The HH 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 (HPE), 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 IHH 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. PMID:23565096

  12. Optic nerve aspergillosis.

    PubMed

    Yuan, Lisi; Prayson, Richard A

    2015-07-01

    We report a 55-year-old woman with optic nerve Aspergillosis. Aspergillus is an ubiquitous airborne saprophytic fungus. Inhaled Aspergillus conidia are normally eliminated in the immunocompetent host by innate immune mechanisms; however, in immunosuppressed patients, they can cause disease. The woman had a past medical history of hypertension and migraines. She presented 1year prior to death with a new onset headache behind the left eye and later developed blurred vision and scotoma. A left temporal artery biopsy was negative for giant cell arteritis. One month prior to the current admission, she had an MRI showing optic nerve thickening with no other findings. Because of the visual loss and a positive antinuclear antibody test, she was given a trial of high dose steroids and while it significantly improved her headache, her vision did not improve. At autopsy, the left optic nerve at the level of the cavernous sinus and extending into the optic chiasm was enlarged in diameter and there was a 1.3cm firm nodule surrounding the left optic nerve. Histologically, an abscess surrounded and involved the left optic nerve. Acute angle branching, angioinvasive fungal hyphae were identified on Grocott's methenamine silver stained sections, consistent with Aspergillus spp. No gross or microscopic evidence of systemic vasculitis or infection was identified in the body. The literature on optic nerve Aspergillosis is reviewed. PMID:25861888

  13. Ultrasound in Dual Nerve Impairment after Proximal Radial Nerve Lesion

    PubMed Central

    Lämmer, Alexandra B; Schwab, Stefan; Schramm, Axel

    2015-01-01

    Introduction Sonography in classical nerve entrapment syndromes is an established and validated method. In contrast, few publications highlight lesions of the radial nerve, particularly of the posterior interosseus nerve (PIN). Method Five patients with a radial nerve lesion were investigated by electromyography, nerve conduction velocity and ultrasound. Further normative values of 26 healthy subjects were evaluated. Results Four patients presented a clinical and electrophysiological proximal axonal radial nerve lesion and one patient showed a typical posterior interosseous nerve syndrome (PINS). The patient with PINS presented an enlargement of the PIN anterior to the supinator muscle. However four patients with proximal lesions showed an unexpected significant enlargement of the PIN within the supinator muscle. Conclusion High-resolution sonography is a feasible method to demonstrate the radial nerve including its distal branches. At least in axonal radial nerve lesions, sonography might reveal abnormalities far distant from a primary proximal lesion site clearly distinct from the appearance in classical PINS. PMID:25992766

  14. Genetically induced abnormal cranial development in human trisomy 18 with holoprosencephaly: comparisons with the normal tempo of osteogenic-neural development.

    PubMed

    Reid, Shaina N; Ziermann, Janine M; Gondré-Lewis, Marjorie C

    2015-07-01

    Craniofacial malformations are common congenital defects caused by failed midline inductive signals. These midline defects are associated with exposure of the fetus to exogenous teratogens and with inborn genetic errors such as those found in Down, Patau, Edwards' and Smith-Lemli-Opitz syndromes. Yet, there are no studies that analyze contributions of synchronous neurocranial and neural development in these disorders. Here we present the first in-depth analysis of malformations of the basicranium of a holoprosencephalic (HPE) trisomy 18 (T18; Edwards' syndrome) fetus with synophthalmic cyclopia and alobar HPE. With a combination of traditional gross dissection and state-of-the-art computed tomography, we demonstrate the deleterious effects of T18 caused by a translocation at 18p11.31. Bony features included a single developmentally unseparated frontal bone, and complete dual absence of the anterior cranial fossa and ethmoid bone. From a superior view with the calvarium plates removed, there was direct visual access to the orbital foramen and hard palate. Both the eyes and the pituitary gland, normally protected by bony structures, were exposed in the cranial cavity and in direct contact with the brain. The middle cranial fossa was shifted anteriorly, and foramina were either missing or displaced to an abnormal location due to the absence or misplacement of its respective cranial nerve (CN). When CN development was conserved in its induction and placement, the respective foramen developed in its normal location albeit with abnormal gross anatomical features, as seen in the facial nerve (CNVII) and the internal acoustic meatus. More anteriorly localized CNs and their foramina were absent or heavily disrupted compared with posterior ones. The severe malformations exhibited in the cranial fossae, orbital region, pituitary gland and sella turcica highlight the crucial involvement of transcription factors such as TGIF, which is located on chromosome 18 and contributes to neural patterning, in the proper development of neural and cranial structures. Our study of a T18 specimen emphasizes the intricate interplay between bone and brain development in midline craniofacial abnormalities in general. PMID:26018729

  15. Misdiagnosis of plexiform neurofibroma of the medial plantar nerve: case report.

    PubMed

    D'Orazi, Valerio; Venditto, Teresa; Panunzi, Andrea; Anichini, Silvia; Manzini, Gabriele; Tallarico, Arturo; Bernetti, Andrea; Paoloni, Marco

    2014-09-01

    Plexiform neurofibromas are benign tumors of the peripheral nerve. Diagnosis may be challenging, if they present mimicking other peripheral nerve pathologies. We report the case of a patient who had severe foot pain, which progressively hampered her walking ability, erroneously attributed to recurrent Morton's neuroma. Diagnosis of plexiform neurofibroma of her right medial plantar nerve was made 15 years after the appearance of symptoms. Pain and function recovered after radical neurotomy of the medial plantar nerve. A correct diagnosis is an essential starting point in the treatment of neurofibromas and a misdiagnosis may lead to an inappropriate treatment. PMID:25024003

  16. Chinese Medicine in Diabetic Peripheral Neuropathy: Experimental Research on Nerve Repair and Regeneration

    PubMed Central

    Piao, Yuanlin; Liang, Xiaochun

    2012-01-01

    Diabetic peripheral neuropathy (DPN) is one of the most common complications of chronic diabetes mellitus. Pathological characteristics of DPN include axonal atrophy, nerve demyelination, and delayed regeneration of peripheral sensory nerve fibers. The goal of treatment in DPN is not only to ameliorate neurological symptoms but also to slow or reverse the underlying neurodegenerative process. Schwann cells and neurotrophic factors play important roles in the repair and regeneration of peripheral nerves. The present paper reviews current studies and evidence regarding the neurological effects of traditional Chinese medicine, with an emphasis on recent developments in the area of nerve repair and regeneration in DPN. PMID:22927874

  17. Postoperative cranial vault growth in premature sagittal craniosynostosis.

    PubMed

    Metzler, Philipp; Zemann, Wolfgang; Jacobsen, Christine; Grätz, Klaus Wilhelm; Obwegeser, Joachim Anton

    2013-01-01

    Various techniques for the correction of sagittal craniosynostosis have been described in the literature. Nevertheless, there is a lack of consensus regarding surgical procedure and timing, although a long-term anthropometric analysis may shed light on this controversy. The aim of the current study was to collect serial anthropometric data of children before and after total cranial vault remodeling and to evaluate cranial vault growth pattern. Twenty-nine Swiss children with a surgical age between 8 and 10 months were included in this 5-year follow-up. Anthropologic data of sex- and age-matched healthy Swiss children served as a control. A standardized time protocol (before, after, 6 wk after surgery, 6 mo after surgery, and then annually until the age of six) for anthropometric skull measurements (head circumference, cranial length, breadth, and cephalic index) was used. Data were converted into the z score for standardized intercenter comparison. Postoperatively, all patients showed a marked benefit in cranial vault shape. Significant differences in long-term cranial growth pattern could be seen and a relapse into a dolichocephal skull growth. Both observations were rated as clinically irrelevant. PMID:23348273

  18. Symptoms of Acoustic Neuroma

    MedlinePLUS

    ... Search ANAUSA.org Connect with us! Symptoms of Acoustic Neuroma Early symptoms are easily overlooked, thus making ... are symptoms, however, indicating the possibility of an acoustic neuroma . The first symptom in 90% of those ...

  19. Mechanisms underlying the neuronal-based symptoms of allergy.

    PubMed

    Undem, Bradley J; Taylor-Clark, Thomas

    2014-06-01

    Persons with allergies present with symptoms that often are the result of alterations in the nervous system. Neuronally based symptoms depend on the organ in which the allergic reaction occurs but can include red itchy eyes, sneezing, nasal congestion, rhinorrhea, coughing, bronchoconstriction, airway mucus secretion, dysphagia, altered gastrointestinal motility, and itchy swollen skin. These symptoms occur because mediators released during an allergic reaction can interact with sensory nerves, change processing in the central nervous system, and alter transmission in sympathetic, parasympathetic, and enteric autonomic nerves. In addition, evidence supports the idea that in some subjects this neuromodulation is, for reasons poorly understood, upregulated such that the same degree of nerve stimulus causes a larger effect than seen in healthy subjects. There are distinctions in the mechanisms and nerve types involved in allergen-induced neuromodulation among different organ systems, but general principles have emerged. The products of activated mast cells, other inflammatory cells, and resident cells can overtly stimulate nerve endings, cause long-lasting changes in neuronal excitability, increase synaptic efficacy, and also change gene expression in nerves, resulting in phenotypically altered neurons. A better understanding of these processes might lead to novel therapeutic strategies aimed at limiting the suffering of those with allergies. PMID:24433703

  20. [Extreme lateral lumbar intervertebral disk displacement. Incidence, symptoms and therapy].

    PubMed

    Ebeling, U; Mattle, H; Reulen, H J

    1990-04-01

    Upper lumbar nerve root compression or a femoralgia is often caused by extreme lateral lumbar disc herniation. This type of lumbar disc herniation compresses the nerve root inside or laterally to the intervertebral canal, while mediolateral disc herniations squeeze it in the lateral recess. Pain radiating obliquely over the thigh is the dominant clinical symptom. Bending the body to the ipsilateral side usually increases the pain. When neurologic signs are present, motor deficits tend to be more prominent than sensory and the deficits never affect more than one nerve root. Most frequently a weakness of knee extension occurs. PMID:2191229

  1. Repair of sciatic nerve defects using tissue engineered nerves

    PubMed Central

    Zhang, Caishun; Lv, Gang

    2013-01-01

    In this study, we constructed tissue-engineered nerves with acellular nerve allografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cells of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tissue-engineered nerves was similar to that after autologous nerve grafting, and was higher than that after repair with acellular nerve allografts. Immunohistochemical staining revealed that motor endplates with acetylcholinesterase-positive nerve fibers were orderly arranged in the middle and superior parts of the gastrocnemius muscle; regenerated nerve tracts and sprouted branches were connected with motor endplates, as shown by acetylcholinesterase histochemistry combined with silver staining. The wet weight ratio of the tibialis anterior muscle at the affected contralateral hind limb was similar to the sciatic nerve after repair with autologous nerve grafts, and higher than that after repair with acellular nerve allografts. The hind limb motor function at the affected side was significantly improved, indicating that acellular nerve allografts combined with bone marrow mesenchymal stem cell bridging could promote functional recovery of rats with sciatic nerve defects. PMID:25206507

  2. Vesicourethral function in diabetic patients: association of abnormal nerve conduction velocity with vesicourethral dysfunction.

    PubMed

    Mitsui, T; Kakizaki, H; Kobayashi, S; Morita, H; Matsumura, K; Koyanagi, T

    1999-01-01

    This study was undertaken to examine diabetic vesicourethral dysfunction in association with nerve conduction velocity. Uroflowmetry, water cystometry, International Prostate Symptom Score (IPSS), and nerve conduction velocity were analyzed in 29 diabetic patients (21 men and eight women; a mean age, 58.0 years). Nerve conduction velocity was measured for sensory nerve conduction velocity (SCV) of the sural nerve and motor nerve conduction velocity (MCV) of the peroneal nerve. Normal voiding was defined as continuous flow at the normal flow rate and residual urine <50 mL. Results of uroflowmetry and cystometry were compared with those of nerve conduction velocity. Eleven of 29 patients (38%) had voiding dysfunction. A vesical denervation supersensitivity test was negative in all patients. The mean IPSS was not significant different between patients with or without voiding dysfunction. Incidence of bladder volume at first desire to void >300 mL and maximum bladder capacity >500 mL were significantly higher in patients with abnormal SCV than those with normal SCV (P < 0.03 and 0.001, respectively). Eleven of 16 patients with abnormal MCV showed voiding dysfunction, whereas all patients with normal MCV showed normal voiding (P < 0.001). These results suggest that lower urinary tract symptoms alone cannot predict diabetic vesicourethral dysfunction and that diabetic vesicourethral dysfunction is highly correlated with abnormal nerve conduction velocity. Neurourol. Urodynam. 18:639-645, 1999. PMID:10529712

  3. Spinal accessory nerve injury.

    PubMed

    Wiater, J M; Bigliani, L U

    1999-11-01

    Injury to the spinal accessory nerve can lead to dysfunction of the trapezius. The trapezius is a major scapular stabilizer and is composed of three functional components. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The superficial course of the spinal accessory nerve in the posterior cervical triangle makes it susceptible to injury. Iatrogenic injury to the nerve after a surgical procedure is one of the most common causes of trapezius palsy. Dysfunction of the trapezius can be a painful and disabling condition. The shoulder droops as the scapula is translated laterally and rotated downward. Patients present with an asymmetric neckline, a drooping shoulder, winging of the scapula, and weakness of forward elevation. Evaluation should include a complete electrodiagnostic examination. If diagnosed within 1 year of the injury, microsurgical reconstruction of the nerve should be considered. Conservative treatment of chronic trapezius paralysis is appropriate for older patients who are sendentary. Active and healthy patients in whom 1 year of conservative treatment has failed are candidates for surgical reconstruction. Studies have shown the Eden-Lange procedure, in which the insertions of the levator scapulae, rhomboideus minor, and rhomboideus major muscles are transferred, relieves pain, corrects deformity, and improves function in patients with irreparable injury to the spinal accessory nerve. PMID:10613148

  4. Middle fossa arachnoid cysts and inner ear symptoms: Are they related?

    PubMed Central

    Proimos, E; Chimona, TS; Memtsas, Z; Papadakis, CE

    2014-01-01

    Background: Arachnoid cysts most frequently occur in the middle cranial fossa and when they are symptomatic, patients present with central nervous symptoms. Nevertheless, a large proportion of arachnoid cysts are incidentally diagnosed during neuroimaging in cases with nonspecific symptoms. Report of cases: The cases of two males with middle cranial fossa arachnoid cysts with nonspecific inner ear symptoms were retrospectively reviewed. The first patient presented with mild headache, nausea, vertigo, unsteadiness, and tinnitus on the left ear while the second patient’s main complaint was left sided tinnitus. Both patients (initially managed for peripheral disorders) underwent a thorough clinical and electrophysiological evaluation. Because of the patients’ persistent clinical symptoms, and indications of CNS disorder in the first case, neuroimaging by brain MRI was performed revealing a middle cranial fossa arachnoid cyst in both patients. Conclusion: Occasionally, patients with arachnoid cysts may present with mild, atypical or intermittent and irrelevant symptoms which can mislead diagnosis. Otorhinolaryngologists should be aware of the fact that atypical, recurrent or intermittent symptoms may masquerade a CNS disorder. Hippokratia 2014; 18 (2):168-171. PMID:25336883

  5. Monkey median nerve repaired by nerve graft or collagen nerve guide tube.

    PubMed

    Archibald, S J; Shefner, J; Krarup, C; Madison, R D

    1995-05-01

    Nerve regeneration was followed in 15 median and 1 ulnar nerve of eight Macaca fascicularis monkeys by serial electrophysiological assessments over a period of three and a half years. Nerve gaps of 5 mm at the wrist were bridged by collagen-based nerve guides, nerve autografts, or direct suture repairs. Thenar muscle reinnervation occurred between 50 and 70 d for all groups, indicating axonal elongation rates of approximately 1 mm/d. The recovery rates of the compound muscle action potential (CMAP) and the compound sensory action potential (CSAP) amplitudes were significantly slower after direct suture repair compared to the other two procedures, although the final levels of recovery were all comparable. Similar results were achieved in one median and one ulnar nerve following nerve guide repair of a 15 mm nerve gap. The functional reinnervation of Pacinian corpuscles was detected in all cases following either nerve graft or nerve guide repair, with similar amplitudes and latencies of the tactile evoked CSAP for both types of repair. Histological analysis demonstrated a significant increase in the number of myelinated axons in the median nerve distal to the nerve lesions following both nerve graft and nerve guide repairs compared to proximal and normal controls, with significant reductions of fiber diameter and corresponding increases in g-ratio. The return of a bimodal frequency distribution of myelinated axon fiber diameter was confirmed by three-dimensional surface plots which illustrate the frequency distribution of the relationship between fiber diameter and g-ratio. These combined results demonstrate that nerve regeneration after repair of a 5 mm nerve gap with a collagen nerve guide in the nonhuman primate is similar to that after graft repair, and the final level of physiological recovery for both repair procedures is comparable to direct suture repair of the median nerve. PMID:7751969

  6. Endoscopic removal of foreign body from the anterior cranial fossa.

    PubMed

    Thomas, S; Daudia, A; Jones, N S

    2007-08-01

    Intracranial foreign bodies are typically removed via a craniotomy, which carries significant peri-operative risks. Nasal endoscopy for removal of intracranial foreign bodies is rare and has been attempted only a few times. Here, we describe a case in which nasal endoscopy was employed to successfully remove an air rifle pellet from the anterior cranial fossa, with subsequent repair of the associated cerebrospinal fistula. We thus advocate nasal endoscopy as an alternate line of management for the removal of foreign bodies from the anterior cranial fossa when possible, due to its significantly lower associated morbidity, provided adequate neurosurgical backup is available if required. PMID:17367560

  7. Treatment of cranial synostosis: the directive growth approach.

    PubMed

    Mann, Robert J; Burton, Michael E

    2014-07-01

    Reconstruction for single sutural synostosis typically involves cranial reshaping to correct for compensatory growth changes. Current remodeling techniques involve obliteration of both pathologic and normal sutures. Presented here is a case report describing a new approach to the treatment of single cranial synostosis. The concept involves excision of the offending suture and transient plating of the remaining functional sutures. Compensatory sutures are then allowed to direct the growth forces to the area of the synostosis, leading to the reversal of the compensatory shape deformity. This more natural approach leaves functioning sutures intact and allows for their active participation in the reshaping process. PMID:25006948

  8. Selective Tracing of Auditory Fibers in the Avian Embryonic Vestibulocochlear Nerve

    PubMed Central

    Allen-Sharpley, Michelle R.; Tjia, Michelle; Cramer, Karina S.

    2013-01-01

    The embryonic chick is a widely used model for the study of peripheral and central ganglion cell projections. In the auditory system, selective labeling of auditory axons within the VIIIth cranial nerve would enhance the study of central auditory circuit development. This approach is challenging because multiple sensory organs of the inner ear contribute to the VIIIth nerve 1. Moreover, markers that reliably distinguish auditory versus vestibular groups of axons within the avian VIIIth nerve have yet to be identified. Auditory and vestibular pathways cannot be distinguished functionally in early embryos, as sensory-evoked responses are not present before the circuits are formed. Centrally projecting VIIIth nerve axons have been traced in some studies, but auditory axon labeling was accompanied by labeling from other VIIIth nerve components 2,3. Here, we describe a method for anterograde tracing from the acoustic ganglion to selectively label auditory axons within the developing VIIIth nerve. First, after partial dissection of the anterior cephalic region of an 8-day chick embryo immersed in oxygenated artificial cerebrospinal fluid, the cochlear duct is identified by anatomical landmarks. Next, a fine pulled glass micropipette is positioned to inject a small amount of rhodamine dextran amine into the duct and adjacent deep region where the acoustic ganglion cells are located. Within thirty minutes following the injection, auditory axons are traced centrally into the hindbrain and can later be visualized following histologic preparation. This method provides a useful tool for developmental studies of peripheral to central auditory circuit formation. PMID:23542875

  9. Overview of Optic Nerve Disorders

    MedlinePLUS

    ... each optic nerve splits, and half of its fibers cross over to the other side. Because of this anatomic arrangement, damage along the optic nerve pathway causes specific patterns of vision loss. ...

  10. Conjugate Gaze Palsies

    MedlinePLUS

    ... Nerve Disorders Overview of the Cranial Nerves Internuclear Ophthalmoplegia Conjugate Gaze Palsies Palsies of Cranial Nerves That ... Nerve Disorders Overview of the Cranial Nerves Internuclear Ophthalmoplegia Conjugate Gaze Palsies Palsies of Cranial Nerves That ...

  11. Endodontic periapical lesion-induced mental nerve paresthesia.

    PubMed

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  12. Endodontic periapical lesion-induced mental nerve paresthesia

    PubMed Central

    Shadmehr, Elham; Shekarchizade, Neda

    2015-01-01

    Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

  13. Cranial helminths of Mustela vison Schreber, 1777 in Spain

    Microsoft Academic Search

    J. Torres; J. Miquel; S. Mañas; V. Asensio; C. Eira; S. Palazón

    2006-01-01

    A survey was carried out to investigate the presence of cranial helminths in 337 American minks (Mustela vison) from Spain. This information was obtained partly in order to evaluate potential conservation problems and sanitary risks to the congeneric European mink (Mustela lutreola), one of the most endangered carnivores in the world. Skulls and rectal faeces of each specimen were simultaneously

  14. Cranial helminths of Mustela vison Schreber, 1777 in Spain.

    PubMed

    Torres, J; Miquel, J; Mañas, S; Asensio, V; Eira, C; Palazón, S

    2006-04-30

    A survey was carried out to investigate the presence of cranial helminths in 337 American minks (Mustela vison) from Spain. This information was obtained partly in order to evaluate potential conservation problems and sanitary risks to the congeneric European mink (Mustela lutreola), one of the most endangered carnivores in the world. Skulls and rectal faeces of each specimen were simultaneously analysed. Troglotrema acutum and Skrjabingylus nasicola were found in 5.6% of the M. vison analysed. No cranial lesions were seen in any of the examined skulls. The finding of both helminths in Spanish free-living M. vison specimens enlarges their natural definitive host spectrum in Western Europe. One relatively important focus of T. acutum in M. vison was detected (30.4%) in the Spanish Alava province while S. nasicola was found to be very infrequent. The suitability of both analytical methods was assessed in order to know to what degree coprological analysis reflects the real prevalence of cranial helminths in this host. It is possible to conclude that coprological analysis can be used instead of necropsies to analyse the possible incidence of pathogenic cranial helminths in mustelids. This aspect is very important and useful when trying to analyse the helminthological status of endangered species such as the native mink (M. lutreola) particularly in areas where both congeneric species are present and strict competition occurs. PMID:16490319

  15. Cranial-base repair using endoscopic laser welding.

    PubMed

    Bleier, Benjamin S; Palmer, James N

    2009-10-01

    As the scope of transnasal cranial-base surgery expands, reconstruction of the complex residual defects remains a challenge. Laser welding is a novel technology that can be performed endoscopically and offers the potential of producing instantaneous, watertight repairs using a chromophore-doped biologic solder. PMID:19909868

  16. Evolution of the Cranial Computed Tomography Scan in Child Abuse.

    ERIC Educational Resources Information Center

    Feldman, Kenneth W.; And Others

    1995-01-01

    A retrospective review of medical charts for 34 children with a diagnosis of child abuse, who had cranial computed tomography scans performed, revealed that some scans initially interpreted as normal were subsequently reinterpreted as abnormal, and some children's repeat scannings were interpreted as abnormal, modifying the medical and legal…

  17. RESEARCH ARTICLE Evolution of Cranial Shape in Caecilians (Amphibia

    E-print Network

    Klingenberg, Christian Peter

    RESEARCH ARTICLE Evolution of Cranial Shape in Caecilians (Amphibia: Gymnophiona) Emma Sherratt of morphological variation in the skull of caecilian amphibians, a major clade of verte- brates. Because caecilians cor- respond to the main caecilian clades, and each cluster is separated by unoccupied morphospace

  18. Cranial trauma and the assessment of posttraumatic survival time.

    PubMed

    Steyn, M; De Boer, H H; Van der Merwe, A E

    2014-11-01

    Assessment of trauma on skeletal remains can be very difficult, especially when it comes to the estimation of posttraumatic survival time in partially healed lesions. The ability to reliably estimate the time an individual has survived after sustaining an injury is especially important in cases of child abuse and torture, but can also aid in determining the association between an injury and eventual death. Here a case from South Africa is reported, where the skeletal remains of an unknown individual were found with cranial and scapular fractures. These fractures all presented with macroscopic features indicative of healing. Using recently published data on the timing of fractures by De Boer et al., the two sets of cranial trauma and the scapular fracture were assessed by means of radiology, histology and microCT scanning. This was primarily done in order to obtain more information on the events surrounding the death of this individual, but also to assess the usability of the published methods on cranial fractures. It was found that the initial trauma was most likely sustained at least two weeks before death, whilst a neurosurgical procedure was performed at least one week before death. It seems that cranial fractures, especially if stable, may show some different healing features than postcranial fractures. The individual has since been identified, but unfortunately as is often the case in South Africa, limited information is available and the medical records could not be found. PMID:25217847

  19. Cranial Drilling Tool with Retracting Drill Bit Upon Skull Penetration

    E-print Network

    Cranial Drilling Tool with Retracting Drill Bit Upon Skull Penetration Paul Loschak1 , Kechao Xiao1, Harvard University, Boston, MA 3 Beth Israel Deaconess Medical Center 1 Background Penetrating the skull as a injury [1]. The risk of pressure induced damage can be reduced by penetrating the skull with a small

  20. Bilateral internuclear ophthalmoplegia after intrathecal chemotherapy and cranial irradiation

    SciTech Connect

    Lepore, F.E.; Nissenblatt, M.J.

    1981-12-01

    A 26-year-old man developed transient bilateral internuclear ophthalmoplegia with exotropia after cranial irradiation and intrathecal administration of methotrexate for lymphoma. Resolution of the ophthalmoplegia and the decrease in abnormally high levels of cerebrospinal fluid myelin basic protein after discontinuation of intrathecal medication suggested demyelination from chemotherapy and irradiation.

  1. Brain Size, Cranial Morphology, Climate, and Time Machines

    Microsoft Academic Search

    Kenneth L. Beals; Courtland L. Smith; Stephen M. Dodd

    1984-01-01

    INCREASING CRANIAL CAPACITY has historically been associ- ated with increasing complexity of society. The resultant ten- dency has been to think of humans with larger brains as mentally more capable. Gene-pool (racial affinity) and somatic (body- size) explanations have also been advanced to account for the braincase variation. We offer an alternative hypothesis that suggests that hominid expansion into regions

  2. Vagus Nerve Stimulation

    Microsoft Academic Search

    Arun Paul Amar; Michael L. Levy; Charles Y. Liu; Michael L. J. Apuzzo

    2008-01-01

    Vagus nerve stimulation (VNS) is a safe and reliable treatment adjunct for patients with medically intractable epilepsy. It is both a preventive and an abortive form of therapy, potentially effective against both partial and generalized seizures in adults and children. VNS also has a number of serendipitous effects on mood, memory, and attention and has been approved for the treatment

  3. Ischemic Nerve Block.

    ERIC Educational Resources Information Center

    Williams, Ian D.

    This experiment investigated the capability for movement and muscle spindle function at successive stages during the development of ischemic nerve block (INB) by pressure cuff. Two male subjects were observed under six randomly ordered conditions. The duration of index finger oscillation to exhaustion, paced at 1.2Hz., was observed on separate…

  4. Assessment of nerve involvement in the lumbar spine: agreement between magnetic resonance imaging, physical examination and pain drawing findings

    Microsoft Academic Search

    Bo C Bertilson; Eva Brosjö; Hans Billing; Lars-Erik Strender

    2010-01-01

    BACKGROUND: Detection of nerve involvement originating in the spine is a primary concern in the assessment of spine symptoms. Magnetic resonance imaging (MRI) has become the diagnostic method of choice for this detection. However, the agreement between MRI and other diagnostic methods for detecting nerve involvement has not been fully evaluated. The aim of this diagnostic study was to evaluate

  5. SEVENTH CERVICAL NERVE ROOT TRANSFER FROM THE CONTRALATERAL HEALTHY SIDE FOR TREATMENT OF BRACHIAL PLEXUS ROOT AVULSION

    Microsoft Academic Search

    Y. D. GU; G. M. ZHANG; D. S. CHEN; J. G. YAN; X. M. CHENG; L. CHEN

    1992-01-01

    Cervical root nerve transfer from the contralateral side has been used for the treatment of brachial plexus root avulsion in 49 patients. Resection of C7 root from the healthy side has produced no long-term symptoms or signs. Nine patients with ten recipient nerves have been followed up for more than two years and seven have obtained a functional recovery. This

  6. Management of peripheral facial nerve palsy

    PubMed Central

    2008-01-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell’s palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell’s palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell’s palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell’s palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell’s palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae. PMID:18368417

  7. The cranial anatomy of the neornithischian dinosaur Thescelosaurus neglectus.

    PubMed

    Boyd, Clint A

    2014-01-01

    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 the South American taxon Gasparinisaura, but never both at the same time. The new morphological observations presented herein, combined with re-examination of the holotype of Parksosaurus, suggest that Parksosaurus shares a closer relationship with Thescelosaurus than with Gasparinisaura, and that many of the features previously cited to support a relationship with the latter taxon are either also present in Thescelosaurus, are artifacts of preservation, or are the result of incomplete preparation and inaccurate interpretation of specimens. Additionally, the overall morphology of the skull and lower jaws of both Thescelosaurus and Parksosaurus also closely resemble the Asian taxa Changchunsaurus and Haya, though the interrelationships of these taxa have yet to be tested in a phylogenetic analysis that includes these new morphological data for T. neglectus. PMID:25405076

  8. Amplitude of sensory nerve action potential in early stage diabetic peripheral neuropathy: an analysis of 500 cases

    PubMed Central

    Zhang, Yunqian; Li, Jintao; Wang, Tingjuan; Wang, Jianlin

    2014-01-01

    Early diagnosis of diabetic peripheral neuropathy is important for the successful treatment of diabetes mellitus. In the present study, we recruited 500 diabetic patients from the Fourth Affiliated Hospital of Kunming Medical University in China from June 2008 to September 2013: 221 cases showed symptoms of peripheral neuropathy (symptomatic group) and 279 cases had no symptoms of peripheral impairment (asymptomatic group). One hundred healthy control subjects were also recruited. Nerve conduction studies revealed that distal motor latency was longer, sensory nerve conduction velocity was slower, and sensory nerve action potential and amplitude of compound muscle action potential were significantly lower in the median, ulnar, posterior tibial and common peroneal nerve in the diabetic groups compared with control subjects. Moreover, the alterations were more obvious in patients with symptoms of peripheral neuropathy. Of the 500 diabetic patients, neural conduction abnormalities were detected in 358 cases (71.6%), among which impairment of the common peroneal nerve was most prominent. Sensory nerve abnormality was more obvious than motor nerve abnormality in the diabetic groups. The amplitude of sensory nerve action potential was the most sensitive measure of peripheral neuropathy. Our results reveal that varying degrees of nerve conduction changes are present in the early, asymptomatic stage of diabetic peripheral neuropathy. PMID:25221597

  9. Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome.

    PubMed

    Zhang, J; Liu, N; Wang, Y W; Zhang, Z C; Zheng, L N; Zhu, J

    2015-01-01

    Many carpal tunnel syndrome (CTS) patients have symptoms in both the median and ulnar digits more frequently than in the median digits alone. This is possibly because of close anatomical contiguity of the carpal tunnel and Guyon's canal, and the high pressure may also affect the latter, causing indirect compression of ulnar nerve fibers. Thus, we evaluated the functional status of the ulnar nerve in patients with CTS in order to investigate the relationship between ulnar nerve impairment and sensory symptoms of the ulnar territory. Electrophysiological studies were conducted in CTS patients and healthy controls. CTS patients were divided into the mild/moderate group and severe group; they were further divided into the symptomatic and asymptomatic subgroups according to the sensory symptom of the fifth digit region. The findings suggest that CTS patients could have coexisting ulnar nerve wrist entrapments that might exacerbate the severity of CTS. Sensory impairment in the ulnar territory was observed more frequently in the mild/moderate stage of CTS, which is associated with ulnar nerve involvement. These findings also suggest that damage to the ulnar nerve fibers caused by compression forces in Guyon's canal may underlie the ulnar spread of symptoms in CTS. PMID:25966136

  10. Extreme Cranial Ontogeny in the Upper Cretaceous Dinosaur Pachycephalosaurus

    PubMed Central

    Horner, John R.; Goodwin, Mark B.

    2009-01-01

    Background Extended neoteny and late stage allometric growth increase morphological disparity between growth stages in at least some dinosaurs. Coupled with relatively low dinosaur density in the Upper Cretaceous of North America, ontogenetic transformational representatives are often difficult to distinguish. For example, many hadrosaurids previously reported to represent relatively small lambeosaurine species were demonstrated to be juveniles of the larger taxa. Marginocephalians (pachycephalosaurids + ceratopsids) undergo comparable and extreme cranial morphological change during ontogeny. Methodology/Principal Findings Cranial histology, morphology and computer tomography reveal patterns of internal skull development that show the purported diagnostic characters for the pachycephalosaurids Dracorex hogwartsia and Stygimoloch spinifer are ontogenetically derived features. Coronal histological sections of the frontoparietal dome of an adult Pachycephalosaurus wyomingensis reveal a dense structure composed of metaplastic bone with a variety of extremely fibrous and acellular tissue. Coronal histological sections and computer tomography of a skull and frontoparietal dome of Stygimoloch spinifer reveal an open intrafrontal suture indicative of a subadult stage of development. These dinosaurs employed metaplasia to rapidly grow and change the size and shape of their horns, cranial ornaments and frontoparietal domes, resulting in extreme cranial alterations during late stages of growth. We propose that Dracorex hogwartsia, Stygimoloch spinifer and Pachycephalosaurus wyomingensis are the same taxon and represent an ontogenetic series united by shared morphology and increasing skull length. Conclusions/Significance Dracorex hogwartsia (juvenile) and Stygimoloch spinifer (subadult) are reinterpreted as younger growth stages of Pachycephalosaurus wyomingensis (adult). This synonymy reduces the number of pachycephalosaurid taxa from the Upper Cretaceous of North America and demonstrates the importance of cranial ontogeny in evaluating dinosaur diversity and taxonomy. These growth stages reflect a continuum rather than specific developmental steps defined by “known” terminal morphologies. PMID:19859556

  11. Quality of life after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

    PubMed

    Scheich, Matthias; Ginzkey, Christian; Reuter, Edith; Harnisch, Wilma; Ehrmann, Desiree; Hagen, Rudolf

    2014-07-01

    The aim of this study was to analyse the quality of life (QOL) of patients who had undergone microsurgery for vestibular schwannomas (VS). A questionnaire was sent to 117 consecutive patients who had been operated on using the middle cranial fossa (MCF) approach between October 2005 and June 2011. The response rate was 91/117 (78%) of which 86 were suitable for analysis. The questionnaire consisted of the Short Form-36 (SF-36) Health Survey including a self-designed, disease-specific section. Demographic data, tumour size, hearing status and facial nerve function were extracted from our VS database. Patients scored significantly lower in seven of the eight subscales of the SF-36 compared to German normative QOL data. But when compared to a normative group of patients with hearing loss, only two subscales were affected. The alteration of the subscales was correlated with objective and subjective parameters. Vertigo and postoperative hearing status could be identified as the parameters with the strongest influence on QOL. PMID:24061568

  12. Impact of phrenic nerve paralysis on the surgical outcome of intercostal nerve transfer.

    PubMed

    Kita, Yusuke; Tajiri, Yasuhito; Hoshikawa, Shinya; Hara, Yukinori; Iijima, Junichi

    2015-01-01

    Brachial plexus injuries (BPI) can be complicated by diaphragmatic paralysis (DP). This study determined the influence of DP on biceps brachii (BB) recovery after intercostal nerve transfer (ICNT) for BPI and investigated the respiratory complications of ICNT. The study included 100 patients, 84 showing no DP in preoperative and early postoperative chest radiographic images (non-DP group) and 16 with DP that persisted for over one year after surgery (DP group). The postoperative reinnervation time did not differ between groups. BB strength one year after surgery was lower in the DP group than non-DP group (p = 0.0007). No differences were observed 2-3 years after surgery. In the DP group, four patients had respiratory symptoms that affected daily activities and their outcomes deteriorated (p = 0.04). Phrenic nerve transfer should not be combined with ICNT in patients with poor respiratory function because of the high incidence of respiratory complications. PMID:25609274

  13. Symptoms of Pneumocystis pneumonia

    MedlinePLUS

    ... gov . Fungal Diseases Share Compartir Symptoms of Pneumocystis pneumonia The symptoms of PCP are fever, dry cough, ... Diagnosis & Testing Treatment & Outcomes Statistics Additional Information Pneumocystis pneumonia Definition Symptoms People at Risk & Prevention Sources Diagnosis & ...

  14. Quantitative analysis of the Kawase versus the modified Dolenc-Kawase approach for middle cranial fossa lesions with variable anteroposterior extension.

    PubMed

    Tripathi, Manjul; Deo, Rama Chandra; Suri, Ashish; Srivastav, Vinkle; Baby, Britty; Kumar, Subodh; Kalra, Prem; Banerjee, Subhashis; Prasad, Sanjiva; Paul, Kolin; Roy, Tara Sankar; Lalwani, Sanjeev

    2015-07-01

    OBJECT The surgical corridor to the upper third of the clivus and ventral brainstem is hindered by critical neurovascular structures, such as the cavernous sinus, petrous apex, and tentorium. The traditional Kawase approach provides a 10 × 5-mm fenestration at the petrous apex of the temporal bone between the 5th cranial nerve and internal auditory canal. Due to interindividual variability, sometimes this area proves to be insufficient as a corridor to the posterior cranial fossa. The authors describe a modification to the technique of the extradural anterior petrosectomy consisting of additional transcavernous exploration and medial mobilization of the cisternal component of the trigeminal nerve. This approach is termed the modified Dolenc-Kawase (MDK) approach. METHODS The authors describe a volumetric analysis of temporal bones with 3D laser scanning of dry and drilled bones for respective triangles and rhomboid areas, and they compare the difference of exposure with traditional versus modified approaches on cadaver dissection. Twelve dry temporal bones were laser scanned, and mesh-based volumetric analysis was done followed by drilling of the Kawase triangle and MDK rhomboid. Five cadaveric heads were drilled on alternate sides with both approaches for evaluation of the area exposed, surgical freedom, and angle of approach. RESULTS The MDK approach provides an approximately 1.5 times larger area and 2.0 times greater volume of bone at the anterior petrous apex compared with the Kawase's approach. Cadaver dissection objectified the technical feasibility of the MDK approach, providing nearly 1.5-2 times larger fenestration with improved view and angulation to the posterior cranial fossa. Practical application in 6 patients with different lesions proves clinical applicability of the MDK approach. CONCLUSIONS The larger fenestration at the petrous apex achieved with the MDK approach provides greater surgical freedom at the Dorello canal, gasserian ganglion, and prepontine area and better anteroposterior angulation than the traditional Kawase approach. Additional anterior clinoidectomy and transcavernous exposure helps in dealing with basilar artery aneurysms. PMID:25839921

  15. Development of Phantom Limb Pain after Femoral Nerve Block

    PubMed Central

    Sifonios, Anthony N.; Martinez, Marc E.; Eloy, Jean D.; Kaufman, Andrew G.

    2014-01-01

    Historically, phantom limb pain (PLP) develops in 50–80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussion on the theory that symptoms of phantom limb pain are of neuropathic origin and attempt to elaborate the link between regional anesthesia and PLP. Further investigation and understanding of PLP itself will hopefully uncover a relationship between peripheral nerve blocks targeting an affected limb and the subsequent development of this phenomenon, allowing physicians to take appropriate steps in prevention and treatment. PMID:24872817

  16. Cannabis use in HIV for pain and other medical symptoms.

    PubMed

    Woolridge, Emily; Barton, Simon; Samuel, Jonathon; Osorio, Jess; Dougherty, Andrew; Holdcroft, Anita

    2005-04-01

    Despite the major benefits of antiretroviral therapy on survival during HIV infection, there is an increasing need to manage symptoms and side effects during long-term drug therapy. Cannabis has been reported anecdotally as being beneficial for a number of common symptoms and complications in HIV infections, for example, poor appetite and neuropathy. This study aimed to investigate symptom management with cannabis. Following Ethics Committee approval, HIV-positive individuals attending a large clinic were recruited into an anonymous cross-sectional questionnaire study. Up to one-third (27%, 143/523) reported using cannabis for treating symptoms. Patients reported improved appetite (97%), muscle pain (94%), nausea (93%), anxiety (93%), nerve pain (90%), depression (86%), and paresthesia (85%). Many cannabis users (47%) reported associated memory deterioration. Symptom control using cannabis is widespread in HIV outpatients. A large number of patients reported that cannabis improved symptom control. PMID:15857739

  17. Myelinated Nerve Fibre, Myelin

    Microsoft Academic Search

    Margit Pavelka; Jürgen Roth

    \\u000a Nerve fibres designed for particularly rapid and efficient conduction of action potentials are equipped with a myelin sheath,\\u000a a lipid-enriched layer, produced by specialised glial cells, the oligodendrocytes in the central nervous system, and the Schwann\\u000a cells in the peripheral nervous system. The myelin sheath isolates the axon from the surrounding compartments. It reduces\\u000a the current flow across the axonal

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

    PubMed Central

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

    2009-01-01

    Quantitative craniometrical traits have been successfully incorporated into population genetic methods to provide insight into human population structure. However, little is known about the degree of genetic and non-genetic influences on the phenotypic expression of functionally based traits. Many studies have assessed the heritability of craniofacial traits, but complex patterns of correlation among traits have been disregarded. This is a pitfall as the human skull is strongly integrated. Here we reconsider the evolutionary potential of craniometric traits by assessing their heritability values as well as their patterns of genetic and phenotypic correlation using a large pedigree-structured skull series from Hallstatt (Austria). The sample includes 355 complete adult skulls that have been analysed using 3D geometric morphometric techniques. Heritability estimates for 58 cranial linear distances were computed using maximum likelihood methods. These distances were assigned to the main functional and developmental regions of the skull. Results showed that the human skull has substantial amounts of genetic variation, and a t-test showed that there are no statistically significant differences among the heritabilities of facial, neurocranial and basal dimensions. However, skull evolvability is limited by complex patterns of genetic correlation. Phenotypic and genetic patterns of correlation are consistent but do not support traditional hypotheses of integration of the human shape, showing that the classification between brachy- and dolicephalic skulls is not grounded on the genetic level. Here we support previous findings in the mouse cranium and provide empirical evidence that covariation between the maximum widths of the main developmental regions of the skull is the dominant factor of integration in the human skull. PMID:19166470

  19. Diabetes and nerve damage

    MedlinePLUS

    Diabetic neuropathy; Diabetes - neuropathy ... provider if you develop any symptoms of diabetic neuropathy. ... al. Evidence-based guideline: Treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the ...

  20. Ultrasound guidance of uncommon nerve blocks

    PubMed Central

    Thallaj, Ahmed

    2011-01-01

    In the past nerve stimulation was considered the standard tool for anesthesiologists to locate the peripheral nerve for nerve blocks. However, with the recent introduction of ultrasound (US) technology for regional anesthesia, the use of nerve stimulation has become a rarity nowadays. There is a growing interest by most anesthesiologists in using US for nerve blocks because of its simplicity and accuracy. US is now available in most hospitals practicing regional anesthesia and is a popular tool for performance of nerve blocks. Although nerve stimulation became a rarity, however the use of it is now limited to identify small nerve structures, such as greater auricular nerve and medial antebrachial cutaneous nerve of the forearm. However, in this review article we discuss the role of ultrasonography for greater auricular and antebrachial cutaneous nerve blocks, which could replace nerve stimulation technique. We look at the available literature on the role of US for the performance of uncommon nerve blocks and its benefits. PMID:22144927

  1. The age-related emergence of cranial morphological variation.

    PubMed

    Wood, Carolan

    2015-06-01

    Evaluation of ancestry from skeletal remains is problematic for subadults because of a lack of systematic research on the topic. This paper addresses the need for systematic research into geographical variation through childhood and puberty through the examination of the emergence of cranial morphological traits through an analysis of 756 subadults from 4 months in utero to <20 years of age. The first appearance of a trait, changes in the morphology of a trait through time, age stability as related to the age of maturation of the structure, and the developmental mechanisms and processes that cause traits to appear together are addressed. Most traits are influenced by patterns of growth and development and become age stable in conjunction with the larger growth complexes of which they are a part. Geographic cranial variation is present from an early age. Population specific differences in the expression of most traits are apparent from their first appearance. PMID:25921212

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

    SciTech Connect

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

    1984-08-01

    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.

  3. A validated finite element analysis of nerve root stress in degenerative lumbar scoliosis

    Microsoft Academic Search

    Ho-Joong Kim; Heoung-Jae Chun; Kyoung-Tak Kang; Hwan-Mo Lee; Hak-Sun Kim; Eun-Su Moon; Jin-Oh Park; Bo-Hyun Hwang; Ju-Hyun Son; Seong-Hwan Moon

    2009-01-01

    Few studies have shown the relationship between the curve pattern and nerve root symptoms in degenerative lumbar scoliosis,\\u000a and its mechanism remains unclear. We developed a finite element model of two patterns of scoliotic curves (isolated lateral\\u000a bending curve, lateral bending combined with rotation curve). The stress on the nerve root was calculated on both sides (right\\u000a and left) of

  4. Osteoclastic resorption of equine cranial and postcranial bone in vitro

    Microsoft Academic Search

    Virginia J. Kingsmill; Colin Gray; Alan Boyde

    2000-01-01

    :   To address possible differences in the resorbability of cranial and postcranial bone, slices of equine frontal bone and leg\\u000a (first phalanx or third metacarpus) were seeded with embryonic chick bone cells and cultured for 20–24 h. After removing the\\u000a cells and drying the specimens, the areas and volumes of more than 800 resorption pits in each set were measured

  5. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    Microsoft Academic Search

    Xianli Lv; Youxiang Li; Zhongxue Wu

    2008-01-01

    We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas\\u000a (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic\\u000a artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid\\u000a embolic system (Onyx-18, MTI) in

  6. Cranial Aneurysmal Bone Cyst “With Special Emphasis on Endovascular Management”

    Microsoft Academic Search

    B. Y. Sheikh

    1999-01-01

    Summary  ?Objective and Method. Most of the literature about cranial aneurysmal bone cyst represents case reports, the aim of this paper is to gather information\\u000a in solid clear statements about this disease in the region of the skull. This is a retrospective analysis of all available\\u000a case reports on aneurysmal bone cyst involving the skull between 1960 and June 1998. The

  7. Contributions to the cranial morphology of selected Australian Leptodactylidae (Anura) 

    E-print Network

    Bassinger, Clarence Alfred

    1969-01-01

    . Transverse section in the region of the foramen acusticum posterior 55 M. fasciolatus. Transverse section in the posterior region of the fossa fenestra ovalis 55 17. M. fasciolatus. Transverse section in the region of the foramen perilymphaticum superius... perilymphaticus that protrudes posteriorly beyond the limits of the condyloid fossa. In Philoria a thin ligament separates the two perilymphatic foramina, extending from the edge of the floor of the cavum vestibulare to the lower end of the cranial wall...

  8. Ependymomas of the posterior cranial fossa: CT and MRI findings

    Microsoft Academic Search

    P. Tortori-Donati; M. P. Fondelli; A. Cama; M. L. Garrè; A. Rossi; L. Andreussi

    1995-01-01

    We studied nine children with posterior cranial fossa ependymomas to identify specific neuroradiological features. Patients were studied preoperatively with CT and MRI; T1-, T2-and proton-density (PD)-weighted images were obtained. All children underwent surgery and a definite histopathological diagnosis was made. All the tumours grew into the fourth ventricle and caused dilatation of its upper part, which resembled a cap. All

  9. Ependymomas of the posterior cranial fossa: CT and MRI findings

    Microsoft Academic Search

    P. Tortori-Donati; M. P. Fondelli; A. Cama; M. L. Garrè; A. Rossi; L. Andreussi

    1995-01-01

    We studied nine children with posterior cranial fossa ependymomas to identify specific neuroradiological features. Patients were studied preoperatively with CT and MRI; T1-, T2- and proton-density (PD)-weighted images were obtained. All children underwent surgery and a definite histopathological diagnosis was made. All the tumours grew into the fourth ventricle and caused dilatation of its upper part, which resembled a cap.

  10. Nerve Cross-Bridging to Enhance Nerve Regeneration in a Rat Model of Delayed Nerve Repair

    PubMed Central

    2015-01-01

    There are currently no available options to promote nerve regeneration through chronically denervated distal nerve stumps. Here we used a rat model of delayed nerve repair asking of prior insertion of side-to-side cross-bridges between a donor tibial (TIB) nerve and a recipient denervated common peroneal (CP) nerve stump ameliorates poor nerve regeneration. First, numbers of retrogradely-labelled TIB neurons that grew axons into the nerve stump within three months, increased with the size of the perineurial windows opened in the TIB and CP nerves. Equal numbers of donor TIB axons regenerated into CP stumps either side of the cross-bridges, not being affected by target neurotrophic effects, or by removing the perineurium to insert 5-9 cross-bridges. Second, CP nerve stumps were coapted three months after inserting 0-9 cross-bridges and the number of 1) CP neurons that regenerated their axons within three months or 2) CP motor nerves that reinnervated the extensor digitorum longus (EDL) muscle within five months was determined by counting and motor unit number estimation (MUNE), respectively. We found that three but not more cross-bridges promoted the regeneration of axons and reinnervation of EDL muscle by all the CP motoneurons as compared to only 33% regenerating their axons when no cross-bridges were inserted. The same 3-fold increase in sensory nerve regeneration was found. In conclusion, side-to-side cross-bridges ameliorate poor regeneration after delayed nerve repair possibly by sustaining the growth-permissive state of denervated nerve stumps. Such autografts may be used in human repair surgery to improve outcomes after unavoidable delays. PMID:26016986

  11. Neuromuscular choristoma of the sciatic nerve. Case report.

    PubMed

    Maher, Cormac O; Spinner, Robert J; Giannini, Caterina; Scheithauer, Bernd W; Crum, Brian A

    2002-06-01

    The authors report the findings of a neuromuscular choristoma of the sciatic nerve in an otherwise healthy 18-year-old man who presented with sensorimotor symptoms and deformities of the right leg and foot. Only a few cases of this rare tumor, also known as "neuromuscular hamartoma" or "benign triton tumor," have been reported in the surgical literature. The authors discuss the clinical presentation, radiological findings, pathological diagnosis, and surgical rationale for this case and review the associated literature. PMID:12066915

  12. Magnetic property of the nerve.

    PubMed

    Varga, L; Barrett, J S; Keszthelyi, L; Madarász, E

    1978-01-01

    An electromagnet of inhomogeneous magneticfield has been used to measure the magnetic susceptibility of the frog's nerve. Specimen of frog sciatic nerve were attached to a thin tungsten wire hanging into the inhomogeneous magnetic field, and from the deviation of this pendulum from the perpendicular position the magnetic susceptibility of the nerve has been determined to be -0.8 . 10(-6) cm3g-1 in a good agreement with the known magnetic property of the constituents of the nerve. PMID:754499

  13. Nerve Agents: A Comprehensive Review

    Microsoft Academic Search

    Sage W. Wiener; Robert S. Hoffman

    2004-01-01

    Nerve agents are perhaps the most feared of potential agents of chemical attack. The authors review the history, physical characteristics, pharmacology, clinical effects, and treatment of these agents.

  14. Facial nerve neuromas: radiologic evaluation.

    PubMed

    Latack, J T; Gabrielsen, T O; Knake, J E; Kemink, J L; Graham, M D; Gebarski, S S; Yang, P J

    1983-12-01

    Eight patients who had facial nerve neuromas were examined, and the radiographic findings are reported. Thin section tomography, high resolution computed tomography, posterior fossa computed tomography, and cerebellopontine angle cisternography using Pantopaque (iophendylate) demonstrated bone erosions and soft tissue masses conforming to the course of the facial nerve. The lesions generally exhibited either a proximal or a distal pattern of nerve involvement. Radiologic imaging frequently permits a correct preoperative diagnosis and accurate definition of the extent of facial nerve neuromas, assessments that are important for proper patient management. PMID:6606188

  15. Nerve conduction and electromyography studies.

    PubMed

    Kane, N M; Oware, A

    2012-07-01

    Nerve conduction studies (NCS) and electromyography (EMG), often shortened to 'EMGs', are a useful adjunct to clinical examination of the peripheral nervous system and striated skeletal muscle. NCS provide an efficient and rapid method of quantifying nerve conduction velocity (CV) and the amplitude of both sensory nerve action potentials (SNAPs) and compound motor action potentials (cMAPs). The CV reflects speed of propagation of action potentials, by saltatory conduction, along large myelinated axons in a peripheral nerve. The amplitude of SNAPs is in part determined by the number of axons in a sensory nerve, whilst amplitude of cMAPs reflects integrated function of the motor axons, neuromuscular junction and striated muscle. Repetitive nerve stimulation (RNS) can identify defects of neuromuscular junction (NMJ) transmission, pre- or post-synaptic. Needle EMG examination can detect myopathic changes in muscle and signs of denervation. Combinations of these procedures can establish if motor and/or sensory nerve cell bodies or peripheral nerves are damaged (e.g. motor neuronopathy, sensory ganglionopathy or neuropathy), and also indicate if the primary target is the axon or the myelin sheath (i.e. axonal or demyelinating neuropathies). The distribution of nerve damage can be determined as either generalised, multifocal (mononeuropathy multiplex) or focal. The latter often due to compression at the common entrapment sites (such as the carpal tunnel, Guyon's canal, cubital tunnel, radial groove, fibular head and tarsal tunnel, to name but a few of the reported hundred or so 'entrapment neuropathies'). PMID:22614870

  16. 38 CFR 4.124 - Neuralgia, cranial or peripheral.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected...

  17. 38 CFR 4.124 - Neuralgia, cranial or peripheral.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected...

  18. 38 CFR 4.124 - Neuralgia, cranial or peripheral.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected...

  19. 38 CFR 4.124 - Neuralgia, cranial or peripheral.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected...

  20. 38 CFR 4.124 - Neuralgia, cranial or peripheral.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...same scale, with a maximum equal to moderate incomplete paralysis. See nerve involved for diagnostic code number and rating. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected...

  1. The near-nerve sensory nerve conduction in tarsal tunnel syndrome

    Microsoft Academic Search

    S J Oh; H S Kim; B K Ahmad

    1985-01-01

    The near-nerve sensory nerve conduction in the medial and lateral plantar nerves was studied in 25 cases of tarsal tunnel syndrome. Sensory nerve conduction was abnormal in 24 cases (96%) The most common abnormalities were slow nerve conduction velocities and dispersion phenomenon (prolonged duration of compound nerve action potentials). These two electrophysiological abnormalities are indicative of a focal segmental demyelination

  2. Assessment of nerve involvement in the lumbar spine: agreement between magnetic resonance imaging, physical examination and pain drawing findings

    PubMed Central

    2010-01-01

    Background Detection of nerve involvement originating in the spine is a primary concern in the assessment of spine symptoms. Magnetic resonance imaging (MRI) has become the diagnostic method of choice for this detection. However, the agreement between MRI and other diagnostic methods for detecting nerve involvement has not been fully evaluated. The aim of this diagnostic study was to evaluate the agreement between nerve involvement visible in MRI and findings of nerve involvement detected in a structured physical examination and a simplified pain drawing. Methods Sixty-one consecutive patients referred for MRI of the lumbar spine were - without knowledge of MRI findings - assessed for nerve involvement with a simplified pain drawing and a structured physical examination. Agreement between findings was calculated as overall agreement, the p value for McNemar's exact test, specificity, sensitivity, and positive and negative predictive values. Results MRI-visible nerve involvement was significantly less common than, and showed weak agreement with, physical examination and pain drawing findings of nerve involvement in corresponding body segments. In spine segment L4-5, where most findings of nerve involvement were detected, the mean sensitivity of MRI-visible nerve involvement to a positive neurological test in the physical examination ranged from 16-37%. The mean specificity of MRI-visible nerve involvement in the same segment ranged from 61-77%. Positive and negative predictive values of MRI-visible nerve involvement in segment L4-5 ranged from 22-78% and 28-56% respectively. Conclusion In patients with long-standing nerve root symptoms referred for lumbar MRI, MRI-visible nerve involvement significantly underestimates the presence of nerve involvement detected by a physical examination and a pain drawing. A structured physical examination and a simplified pain drawing may reveal that many patients with "MRI-invisible" lumbar symptoms need treatment aimed at nerve involvement. Factors other than present MRI-visible nerve involvement may be responsible for findings of nerve involvement in the physical examination and the pain drawing. PMID:20831785

  3. Peripheral nerve tumours: 30-year experience in the surgical treatment.

    PubMed

    Gosk, Jerzy; Gutkowska, Olga; Mazurek, Piotr; Koszewicz, Magdalena; Zió?kowski, Piotr

    2015-07-01

    Peripheral nerve tumours are relatively rare type of soft tissue tumours. The aim of this work is to present our experience with surgical treatment of this type of lesions. Clinical material consists of 94 patients (56 females, 38 males), in whom 101 tumours deriving from peripheral nervous system were removed. The patients underwent surgical treatment between 1983 and 2012. Tumours occurred mainly in the upper extremity (72 tumours), less often in the lower extremity (25 tumours). Lesions developed in major peripheral nerves (51 tumours) and small nerve branches (50 tumours). The most common symptoms reported before surgery included presence of tumour mass (100 %), positive Hoffmann-Tinel sign (95.6 %) and paraesthesia (93.4 %). Less often sensory deficit (89.1 %) and pain (71.7 %) were observed. Motor deficit was the least common manifestation (41.3 %). Benign tumours prevailed in presented material (94 tumours). In 7 cases, malignant peripheral nerve sheath tumour (MPNST) was identified. As a result of surgical treatment in the group of tumours deriving from major peripheral nerves, in 87.8 % of the patients, pain relief was achieved; in 84 %, Hoffmann-Tinel sign was negative; and in 79 %, paraesthesia resolved. Sensory function improvement was observed in 51.2 % of the patients while motor function improved in 26.3 % of the patients. None of the patients experienced tumour relapse. In the group of tumours deriving from small nerve branches, 47 patients had no signs of tumour recurrence. One female patient diagnosed with MPNST suffered a relapse. Obtaining satisfactory results of peripheral nerve tumour treatment requires both careful differential diagnosis and well thought-out strategy at every stage of therapeutic management. PMID:25727458

  4. Acute subdural hematoma caused by a ruptured cavernous internal carotid artery giant aneurysm following abducens nerve palsy: case report and review of the literature.

    PubMed

    Shigematsu, Hideaki; Sorimachi, Takatoshi; Aoki, Rie; Osada, Takahiro; Srivatanakul, Kittipong; Matsumae, Mitsunori

    2015-07-01

    The authors report a 61-year-old female patient with a giant cavernous aneurysm in the right internal carotid artery (ICA) leading to acute subdural hematoma (ASDH) 7 days after the occurrence of abducens nerve palsy. She underwent ICA occlusion associated with high-flow bypass. In all five reported patients with a cavernous ICA aneurysm causing ASDH, the size of the aneurysm was giant and cranial nerve signs preceded the rupture. When a patient with a symptomatic cavernous ICA giant aneurysm experiences sudden-onset headache and/or consciousness disturbance, rupture of the aneurysm should be differentiated, even though a cavernous ICA aneurysm rarely causes ASDH. PMID:25948076

  5. Otitis complicated by Jacod's syndrome with unusal facial nerve involvement: Case report and review of literature.

    PubMed

    Abdulkadir, Kocer; Buket, Sanlisoy; Dilek, Agircan; Munevver, Okay; Ayse, Aralasmak

    2015-04-01

    Otitis media is a well-known condition and its infra-temporal and intracranial complications are extremely rare because of the widespread usage of antibiotic treatment. We report a case of 63-year-old female with complaints of right-sided facial pain and diplopia. She had a history of acute otitis media before 4 months of admission to our neurology unit. Neurological examination showed that total ophthalmoplegia with ptosis, mydriasis, decreased vision and loss of pupil reflex on the right side. In addition, there was involvement of 5th and 7th cranial nerves. Neurological and radiological follow-up examinations demonstrated Jacod's Syndrome with unusual facial nerve damage and infection in aetiology. Sinusitis is the most common aetiology, but there are a few cases reported Jacod's Syndrome originating from otitis media. PMID:25976583

  6. Understanding the Extraocular Muscles and Oculomotor, Trochlear, and Abducens Nerves Through a Simulation in Physical Examination Training

    PubMed Central

    Zhang, Niu; He, Xiaohua

    2010-01-01

    Purpose: The purpose of this study was to investigate the effect of an innovative exhibitory eye model simulation in a physical examination laboratory format on explaining Listing's Law concerning the individual extraocular muscle action and the rationale for cranial nerve testing. Methods: Participants were 71 volunteers in the third quarter of a chiropractic training program. The study involved a specially designed eyeball model used to explain the movements of individual extraocular muscles based on Listing's law and their cranial innervations in conjunction with the physical examination. Pre- and post-written tests were used to assess participants' understanding of the subjects taught. The test results were compared with those of nonparticipants who also took the same pre- and posttests. Results: An independent samples t-test of the posttest showed a significant difference between the groups. The study group students achieved higher scores than their counterparts in the control group. Conclusion: Using an innovative approach to explain Listing's law and rationale for cranial nerve tests can improve physical examination skill and help produce more effective written test results. PMID:21048877

  7. Nervous System, Neurons, Nerves

    NSDL National Science Digital Library

    How does the nervous system work? It is a question that has engaged the minds of scientists, doctors, and others for centuries. The National Science Teachers Association (NSTA) has created this tour of the nervous system for teachers and students. First-time visitors can start with the Explore a Nerve Cell area, which goes over the membrane, nucleus, axon, dendrites, and the synapse in exquisite detail with interactive graphics. Moving on, The Basics area provides summaries of the operation of the nervous system and a rather illustrative area named Ouch! The site is rounded out by the Nervous Systems Explorations section, which has some nice simulations covering Brainstorms and Simple Reflexes.

  8. Demyelinating hypertrophic inferior alveolar nerve mimicking a nerve tumor.

    PubMed

    Fujita, Hiroaki; Kokubun, Norito; Sada, Tsubasa; Nagashima, Takahide; Komagamine, Tomoko; Kawabe, Kiyokazu; Hirata, Koichi

    2015-01-01

    We herein report a patient with demyelinating inferior alveolar nerve hypertrophy, which was initially suspected to have a nerve tumor. A 39-year-old woman with childhood-onset polyneuropathy presented with tooth pain and visited a dental clinic. An X-ray examination of the mandible revealed enlargement of the mandibular canal, and a nerve tumor was suspected. CT scan and MRI showed hypertrophy of the inferior alveolar nerve along its entire length. We diagnosed the patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which was supported by the spontaneous recovery reported in her childhood, the results from a nerve conduction study and MRI data. CIDP should be considered in the differential diagnosis of mandibular canal enlargement. PMID:25948359

  9. Short-term timecourse of bilateral pudendal nerve injury on leak-point pressure in female rats.

    PubMed

    Ahn, Helen; Lin, Dan Li; Esparza, Nereida; Damaser, Margot S

    2005-01-01

    The pudendal nerve innervates the external urethral sphincter and, when injured, can contribute to incontinence development. This experiment was designed to study the time course of functional changes in the urethra after pudendal nerve crush in rats. Leak-point pressure (LPP) was measured 2, 4, 7, or 14 days after bilateral pudendal nerve crush and was compared to that of a control group. LPP at all four time points after nerve injury was significantly decreased compared to control values. A minimum was reached 4 days after injury, and LPP appeared to trend upward with increasing time after injury, suggesting that nerve function may begin to recover or compensatory changes in the urethra may occur. Pudendal nerve crush induces decreased LPP in female rats, mimicking the clinical symptoms of stress incontinence. When fully characterized, this model could be useful for preclinical testing of treatment and rehabilitation protocols. PMID:15742255

  10. THE FINE STRUCTURE OF NERVE CELL BODIES AND THEIR MYELIN SHEATHS IN THE EIGHTH NERVE GANGLION OF THE GOLDFISH

    PubMed Central

    Rosenbluth, Jack; Palay, Sanford L.

    1961-01-01

    The eighth cranial nerve ganglion consists of bipolar nerve cell bodies each occupying part of an internodal segment. The perikaryal sheaths range from a single layer of Schwann cell cytoplasm on the smallest cells to typical thick compact myelin on the largest. On most perikarya, the sheath displays an intermediate form, consisting of multiple layers of Schwann cell cytoplasm (loose myelin), or of loose and compact myelin continuous with each other. Internodes beyond the one containing the cell body bear only compact myelin. In loose myelin the thickness of each layer of Schwann cell cytoplasm is about 100 A. It may be much greater (? 3000 A) particularly in the outermost layers of the sheath, or the cytoplasm may thin and even disappear with formation of a major dense line. The cytoplasmic layers are separated from each other by a light zone, 40 to 200 A wide, which in its broader portions may contain an intermediate line. Desmosomes sometimes occur between lamellae. In addition to the usual organelles, the perikaryal cytoplasm contains granular and membranous inclusions. Large cells covered by compact myelin have a consistently higher concentration of neurofilaments, and some of the largest cells, in addition, show a reduced concentration of ribosomes. The functional significance and possible origins of perikaryal myelin sheaths are discussed. PMID:13743432

  11. The Optical Stretcher Nerve Regeneration

    E-print Network

    Steiner, Ullrich

    standing paradigm that neurons in the CNS cannot regenerate is gone (after 3500 years). While most research!"# $ %& ' "!((! )# The Optical Stretcher Nerve Regeneration Cells as Optical Fibres Novel Imaging present after neurological trauma to see whether those pose mechanical barriers to nerve regeneration. We

  12. Temporal Adaptation Silicon Auditory Nerve

    E-print Network

    Lazzaro, John

    Temporal Adaptation in a Silicon Auditory Nerve John Lazzaro CS Division UC Berkeley 571 Evans Hall Berkeley, CA 94720 Abstract Many auditory theorists consider the temporal adaptation of the auditory nerve localization and pitch perception also suggest temporal adaptation is an important ele- ment of practical

  13. NERVE INJURY AFTER LAPAROSCOPIC VARICOCELECTOMY

    Microsoft Academic Search

    KRISTIN CHROUSER; DAVID VANDERSTEEN; JULIE CROCKER; YURI REINBERG

    2004-01-01

    Purpose:Laparoscopic varicocelectomy is a minimally invasive option for varicoceles in children. Occasional reports of nerve injury after inguinal laparoscopic procedures have been published. There is anatomical variation in the sensory innervation of the anterior thigh and variable branching patterns of the nerves involved. We report a retrospective analysis of our patients, focusing on the incidence of sensory changes on the

  14. Lesions of the optic nerve

    Microsoft Academic Search

    Edward J. Atkins; Nancy J. Newman; Valerie Biousse

    2011-01-01

    As experts on the central nervous system, neurologists are expected to be familiar with the many conditions that can result in visual loss arising from lesions of the optic nerve. The optic nerves are unique central nervous system structures in terms of surrounding anatomy, size, location, and blood supply; therefore, they are uniquely vulnerable to every pathological process that can

  15. Nerve Regeneration After Radiofrequency Application

    Microsoft Academic Search

    Nobuyasu Ochiai; James P. Tasto; Seiji Ohtori; Norimasa Takahashi; Hideshige Moriya; David Amiel

    Background: Many patients with chronic tendinosis have experienced early pain relief after application of bipolar radiofrequency treatment. It is hypothesized that the mechanism of action may be the acute degeneration and\\/or ablation of sensory nerve fibers. Hypothesis: After ablation or degeneration by bipolar radiofrequency, nerve fibers will have the ability to regenerate with time. Study Design: Controlled laboratory study. Methods:

  16. Adipose derived stem cells and nerve regeneration

    PubMed Central

    Faroni, Alessandro; Smith, Richard JP; Reid, Adam J

    2014-01-01

    Injuries to peripheral nerves are common and cause life-changing problems for patients alongside high social and health care costs for society. Current clinical treatment of peripheral nerve injuries predominantly relies on sacrificing a section of nerve from elsewhere in the body to provide a graft at the injury site. Much work has been done to develop a bioengineered nerve graft, precluding sacrifice of a functional nerve. Stem cells are prime candidates as accelerators of regeneration in these nerve grafts. This review examines the potential of adipose-derived stem cells to improve nerve repair assisted by bioengineered nerve grafts. PMID:25221589

  17. Peripheral nerve lengthening as a regenerative strategy

    PubMed Central

    Vaz, Kenneth M.; Brown, Justin M.; Shah, Sameer B.

    2014-01-01

    Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial financial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, including a novel internal fixator device that enables rapid and distal reconnection of proximal and distal nerve stumps. PMID:25317163

  18. Nerve Growth Factor and Diabetic Neuropathy

    PubMed Central

    Vinik, Aaron

    2003-01-01

    Neuropathy is one of the most debilitating complications of both type 1 and type 2 diabetes, with estimates of prevalence between 50–90% depending on the means of detection. Diabetic neuropathies are heterogeneous and there is variable involvement of large myelinated fibers and small, thinly myelinated fibers. Many of the neuronal abnormalities in diabetes can be duplicated by experimental depletion of specific neurotrophic factors, their receptors or their binding proteins. In experimental models of diabetes there is a reduction in the availability of these growth factors, which may be a consequence of metabolic abnormalities, or may be independent of glycemic control. These neurotrophic factors are required for the maintenance of the neurons, the ability to resist apoptosis and regenerative capacity. The best studied of the neurotrophic factors is nerve growth factor (NGF) and the related members of the neurotrophin family of peptides. There is increasing evidence that there is a deficiency of NGF in diabetes, as well as the dependent neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) that may also contribute to the clinical symptoms resulting from small fiber dysfunction. Similarly, NT3 appears to be important for large fiber and IGFs for autonomic neuropathy. Whether the observed growth factor deficiencies are due to decreased synthesis, or functional, e.g. an inability to bind to their receptor, and/or abnormalities in nerve transport and processing, remains to be established. Although early studies in humans on the role of neurotrophic factors as a therapy for diabetic neuropathy have been unsuccessful, newer agents and the possibilities uncovered by further studies should fuel clinical trials for several generations. It seems reasonable to anticipate that neurotrophic factor therapy, specifically targeted at different nerve fiber populations, might enter the therapeutic armamentarium. PMID:14668049

  19. Autologous Fat Grafting Improves Facial Nerve Function

    PubMed Central

    Klinger, Marco; Lisa, Andrea; Caviggioli, Fabio; Maione, Luca; Murolo, Matteo; Vinci, Valeriano; Klinger, Francesco Maria

    2015-01-01

    We describe the case of a 45-year-old male patient who presented a retractile and painful scar in the nasolabial fold due to trauma which determined partial motor impairment of the mouth movements. We subsequently treated him with autologous fat grafting according to Coleman's technique. Clinical assessments were performed at 5 and 14 days and 1, 3, and 6 months after surgical procedure and we observed a progressive release of scar retraction together with an important improvement of pain symptoms. A second procedure was performed 6 months after the previous one. We observed total restoration of mimic movements within one-year follow-up. The case described confirms autologous fat grafting regenerative effect on scar tissue enlightening a possible therapeutic effect on peripheral nerve activity, hypothesizing that its entrapment into scar tissue can determine a partial loss of function.

  20. Gastrointestinal autonomic nerve tumor of the stomach

    PubMed Central

    Meshikhes, Abdul-Wahed N.; Al-Garni, Ayed A.; Al-Momen, Sami A.; Al-Nahawi, Mamdouh; Abu Subaih, Jawad

    2014-01-01

    Patient: Female, 32 Final Diagnosis: Gastrintestinal Autonomic Nerve Tumor (GANT) Symptoms: anemia • anorexia • fatigue • fever • hearburn • nausea • weight loss Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Gastrointestinal autonomic nerve tumors (GANT) are extremely rare tumors that are related to gastrointestinal autonomic nervous plexuses. They are distinguished from stromal tumors by their unique ultrastructural features. Hence, their diagnosis is usually made on electron microscopy and immunohistochemical analyses. Although they are apparently slow-growing tumors, they run an aggressive clinical course and often associated with poor prognosis which eventually leads to death. Case Report: We report on a case of gastric GANT in a young female who was treated surgically by total gastrectomy. The disease, however ran an aggressive course with the development of distant (nodal, liver, lung, adrenal and musculo-skeletal) metastases two months after the radical resection. Conclusions: We believe this could be the first reported case of adrenal and musculo-skeletal metastases from gastric GANT soon after the radical gastric resection. PMID:24454975

  1. Bedbugs: Signs and Symptoms

    MedlinePLUS

    ... Diseases and treatments A - D Bedbugs Signs, symptoms Bedbugs: Signs and symptoms Bedbug bites : The bites often ... hiding place. Serious and life-threatening reactions to bedbug bites Although less common, it is possible to ...

  2. Cranial radiation necessary for CNS prophylaxis in pediatric NHL

    SciTech Connect

    Mandell, L.R.; Wollner, N.; Fuks, Z.

    1987-03-01

    The records of 95 consecutive children less than or equal to 21 years of age with previously untreated diffuse histology NHL registered in our protocols from 1978 to 1983 were reviewed. Seventy-nine patients were considered eligible for analysis. The histologic subtypes represented included lymphoblastic (LB) 37%; histiocytic (DHL) 29%; undifferentiated (DU) 19%; poorly differentiated (DPDL) 9%; and unclassified (UNHL) 6%. Distribution of the patients according to stage showed Stage I, 0%; Stage II, 11%; Stage III, 53%; Stage IV, 36%. Four different Memorial Hospital protocols for systemic chemotherapy were used (LSA2L2 73%; L10 9%; L17 10%; L17M 8%); however, the IT (intrathecal) chemotherapy was uniform (Methotrexate: 6.0-6.25 mg/M2 per treatment course) and was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was included in the induction, consolidation, and maintenance phases of all treatment protocols. Cranial radiation was not included in the CNS prophylaxis program. The overall median time of follow-up was 43 months. The overall CNS relapse rate was 6.3%; however, the incidence of CNS lymphoma presenting as the first isolated site of relapse in patients in otherwise complete remission (minimum follow-up of 19 months with 97% of patients off treatment) was only 1/58 (1.7%). Our data suggest that IT chemotherapy when given in combination with modern aggressive systemic combination chemotherapy, and without cranial radiation appears to be a highly effective modality for CNS prophylaxis regardless of stage, histology, or bone marrow or mediastinal involvement. (Abstract Truncated)

  3. Spontaneous Spinal Subdural Hematoma with Simultaneous Cranial Subarachnoid Hemorrhage

    PubMed Central

    Jung, Hwan-Su; Kim, Sang Woo

    2015-01-01

    Spontaneous spinal subdural hematoma is reported at a rare level of incidence, and is frequently associated with underlying coagulopathy or those receiving anticoagulant or antiplatelet agents; some cases accompany concomitant intracranial hemorrhage. The spontaneous development of spinal subdural hemorrhage (SDH) is a neurological emergency; therefore, early diagnosis, the discontinuation of anticoagulant, and urgent surgical decompression are required to enable neurological recovery. In this report, we present a simultaneous spinal subdural hematoma and cranial subarachnoid hemorrhage, which mimicked an aneurysmal origin in a female patient who had been taking warfarin due to aortic valve replacement surgery.

  4. Contributions to the cranial morphology of American Bufonidae (Anura)

    E-print Network

    Baldauf, Richard John

    1956-01-01

    of a 9 mm0 stage of Bufo americana (sic) in his monograph on the amphibian nasal organ. In 1.928 Lapage described the septomaxil).. ary bone and its relationship to the structures of the nasal capsule in Bo marinas? An excellent account... and is not accepted by other workers * Nevertheless, Bolkay was the first worker to recognize the real need for a comparative study of the osseous elements of the anurans. Sanders recognized the possibilities held by a critical analysis of the cranial bones...

  5. Neurological Symptoms of Sarcoidosis-induced Small Fiber Neuropathy Effectively Relieved with High-dose Steroid Pulse Therapy.

    PubMed

    Saito, Hiroaki; Yamaguchi, Tetsuo; Adachi, Yuta; Yamashita, Takaaki; Wakai, Yoko; Saito, Kazuhito; Shinohara, Yoko; Suzuki, Keiko; Yagihashi, Soroku; Terada, Jiro; Tatsumi, Koichiro

    2015-01-01

    A 59-year-old woman was admitted to our hospital for an evaluation of a 10-day history of progressive pain and hypoesthesia of the right lower back associated with fever and constipation. Sarcoidosis was confirmed on mediastinal lymph node and skin biopsies. Although the neurological symptoms were suspected due to sarcoidosis-induced nerve dysfunction, nerve conduction studies and other routine examinations did not show any abnormalities. The intraepidermal nerve fiber density assessed on a skin biopsy was significantly reduced, suggesting small-fiber neuropathy (SFN). The patient was finally diagnosed with sarcoidosis-induced SFN, and her neurological symptoms were effectively relieved with high-dose steroid therapy. PMID:25986271

  6. Slower nerve conduction velocity in individuals with functional ankle instability.

    PubMed

    Simon, J; Docherty, C

    2014-08-01

    The purpose of this study is to quantify nerve conduction velocity differences in individuals with functional ankle instability compared to a "healthy" population. 38 participants ages 18-30 were recruited from a large university with approximately 43,000 students. 19 subjects (9 men and 10 women; age=21.0±1.4 years; height=172.0±9.3?cm; mass=74.4±1 2.4?kg) with symptoms of functional ankle instability were in the functional ankle instability group. 19 subjects (10 men, 9 women; age=22.0±2.6 years; height=169.8±9.1?cm; mass=69.0±14.8?kg) with "healthy" ankles were in the control group. Nerve conduction velocity was conducted using one trial at 2 different sites: posterior to the fibular head (fibular), and 10?cm superior/posterior of the first site (popliteal). Nerve conduction velocity (m/sec) was assessed using a SierraWave II system (Cadwell Laboratories; Kennewick, WA). A MANCOVA was performed on the two dependent variables (fibular and popliteal). Covariates included surface temperature of the leg, body mass index, and age. The independent variable was group (functional ankle instability and control). The effect of group was significantly related to nerve conduction velocity at the fibular site (F(1, 27)?=16.49, p=0.01) and popliteal site (F(1, 27)=4.51, p=0.01), with responses significantly faster for individuals in the control group than the functional ankle instability group. These results indicate that patients with functional ankle instability might have damage to the peroneal nerve which results in slower peroneal nerve conduction velocity. PMID:24577859

  7. Peripheral Neuropathy: Symptoms and Signs

    MedlinePLUS

    ... Loss of balance and coordination Muscle weakness Difficulty walking or moving the arms Unusual sweating Abnormalities in blood pressure ... nerve damage can lead to muscle weakness, difficulty walking or moving the arms, cramps and spasms. Sensory nerves send ...

  8. Nerve Agents ATSDR ? General Information 1

    E-print Network

    Baloh, Bob

    Nerve Agents ATSDR ? General Information 1 Nerve Agents Tabun (GA) CAS 77-81-6; Sarin (GB) CAS 107-diisopropylaminoethyl methylphosphonothiolate ? Persons whose skin or clothing is contaminated with nerve agent can contaminate rescuers by direct contact orthrough off-gassing vapor. Persons whose skin is exposed only to nerve agent vapor pose

  9. Endometriotic lesions of the lower troncular nerves.

    PubMed

    Niro, J; Fournier, M; Oberlin, C; Le Tohic, A; Panel, P

    2014-10-01

    Although exceptional, endometriotic lesions of the troncular nerves of the lower limb may occur and are often diagnosed with delay. We report, hereby, the first case of femoral nerve endometriosis the treatment of which consisted of radical resection with femoral nerve transplant. We completed a review of the literature on sciatic nerve endometriotic lesions and discussed the physiopathology and surgical treatment. PMID:25267476

  10. Ancient Schwannoma of superficial peroneal nerve presenting as intermittent leg pain: A case report

    PubMed Central

    Nascimento, Germano; Nomi, Thaís; Marques, Raquel; Leiria, João; Silva, Carmen; Periquito, Jorge

    2014-01-01

    INTRODUCTION Schwannomas are benign, encapsulated, slow-growing and usually solitary tumors originating from Schwann cells of the peripheral nerve sheath. Schwannomas of the superficial peroneal nerves are very rare, and therefore scarcely documented in the literature. The authors report a case of a diagnosed superficial fibular nerve sheath tumor with an unreported clinical presentation. PRESENTATION OF CASE A 52-year-old Caucasian female arrived to our Orthopedics Department complaining of pain and numbness of the lateral aspect of her left leg. These symptoms were present for a year and were more evident at the end of the day, or after a long time in the orthostatic position. No evidence of other medical illnesses was found. There was no record of prior traumatic events related to that limb. Diagnosis of a benign peripheral nerve tumor was achieved and the patient was treated by surgical excision of the lesion. DISCUSSION The intermittent symptomatology presentation on this case suggest a mechanical compression etiology, allied to classical pain and paresthesia often exhibited by this kind of the tumor. An intracompartimental pressure elevation could explain why the symptoms disclosed an episodic pattern, due to a constricted, inclosed nerve. CONCLUSION We describe a rare case of a patient with an unusual superficial peroneal nerve Schwannoma clinical presentation. Literature on this topic is scarce and, therefore, this case report intends to add further data about this kind of lesion. PMID:25506844

  11. Heterochrony and patterns of cranial suture closure in hystricognath rodents

    PubMed Central

    Wilson, Laura A B; Sánchez-Villagra, Marcelo R

    2009-01-01

    Sutures, joints that allow one bone to articulate with another through intervening fibrous connective tissue, serve as major sites of bone expansion during postnatal craniofacial growth in the vertebrate skull and represent an aspect of cranial ontogeny which may exhibit functional and phylogenetic correlates. Suture evolution among hystricognath rodents, an ecologically diverse group represented here by 26 species, is examined using sequence heterochrony methods, i.e. event pairing and parsimov. Although minor nuances in suture closure sequence exist between species, the overall sequence was found to be conserved both across the hystricognath group and, to an increasing degree, within selected clades. At species level, suture closure pattern exhibited a significant positive correlation with patterns previously reported for hominoids. Patterns for most clades revealed the first sutures to close are those contacting the exoccipital, interparietal, and palatine bones. Heterochronic shifts were found along 19 of 35 branches within the hystricognath phylogeny. The number of shifts per node ranged from one to seven events and, overall, involved 21 of 34 suture sites. The topology generated by parsimony analyses of the event pair matrix yielded only one grouping that was congruent with the evolutionary relationships, compiled from morphological and molecular studies, taken as framework. Sutures contacting the exoccipital displayed the highest levels of most complete closure across all species. Level of suture closure is negatively correlated with cranial length (P < 0.05). Differing life history and locomotory strategies are coupled in part with differing suture closure patterns among several species. PMID:19245501

  12. Cranial implant design using augmented reality immersive system.

    PubMed

    Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

    2007-01-01

    Software tools that utilize haptics for sculpting precise fitting cranial implants are utilized in an augmented reality immersive system to create a virtual working environment for the modelers. The virtual environment is designed to mimic the traditional working environment as closely as possible, providing more functionality for the users. The implant design process uses patient CT data of a defective area. This volumetric data is displayed in an implant modeling tele-immersive augmented reality system where the modeler can build a patient specific implant that precisely fits the defect. To mimic the traditional sculpting workspace, the implant modeling augmented reality system includes stereo vision, viewer centered perspective, sense of touch, and collaboration. To achieve optimized performance, this system includes a dual-processor PC, fast volume rendering with three-dimensional texture mapping, the fast haptic rendering algorithm, and a multi-threading architecture. The system replaces the expensive and time consuming traditional sculpting steps such as physical sculpting, mold making, and defect stereolithography. This augmented reality system is part of a comprehensive tele-immersive system that includes a conference-room-sized system for tele-immersive small group consultation and an inexpensive, easily deployable networked desktop virtual reality system for surgical consultation, evaluation and collaboration. This system has been used to design patient-specific cranial implants with precise fit. PMID:17377223

  13. Outcome Analysis of Cranial Molding Therapy in Nonsynostotic Plagiocephaly

    PubMed Central

    Yoo, Han-Su; Rah, Dong Kyun

    2012-01-01

    Background It 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. Methods A 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. Results The 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. Conclusions This 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. PMID:22872837

  14. Preclinical pathways to treatment in infants with positional cranial deformity.

    PubMed

    Kluba, S; Lypke, J; Kraut, W; Krimmel, M; Haas-Lude, K; Reinert, S

    2014-10-01

    Positional plagiocephaly in infants is frequent. As well as positioning, physiotherapy, and osteopathy, helmet therapy is an effective treatment option. The outcome also depends on the timely initiation of treatment. We investigated the preclinical pathways to treatment. Parents of 218 affected children were interviewed. Data were collected regarding detection and the treatments used prior to the first craniofacial consultation at the study clinic in Germany. Descriptive and statistical analyses were performed. For 78.4% of the children, the cranial deformities were first detected at ?4 months of age. One hundred and twenty-two children received helmet therapy. Parents consulted the paediatrician with a mean latency of 0.4 months; 3.3 months passed until the first craniofacial consultation. Approximately 90% were treated with repositioning and 75.2% received additional physiotherapy or osteopathy prior to presentation. Children treated with physiotherapy/osteopathy presented significantly later (P=0.023). The time lapse to craniofacial consultation was not significantly different between children with and without later helmet therapy. We identified a relevant delay between the detection of positional cranial deformity and consultation with a craniofacial specialist. For affected children, this may potentially compromise the outcome of helmet therapy. Early referral to a specialist and if necessary the simultaneous application of different treatments should be preferred. PMID:25034514

  15. Distribution of sodium channels during nerve elongation in rat peripheral nerve

    Microsoft Academic Search

    Harumitsu Ichimura; Takashi Shiga; Ichiro Abe; Yuki Hara; Naoto Terui; Akihito Tsujino; Naoyuki Ochiai

    2005-01-01

    A number of studies have investigated electrophysiological and morphological changes of peripheral nerves during gradual elongation. There has been, however, no report on the distribution of sodium channels at Ranvier’s nodes during peripheral nerve elongation. We investigated peripheral nerve injury after the gradual elongation of rat sciatic nerves. Indirect nerve elongation was induced by leg lengthening at a rate of

  16. Tissue-engineered Rabbit Cranial Suture from Autologous Fibroblasts and BMP2

    Microsoft Academic Search

    L. Hong; J. J. Mao

    2004-01-01

    Craniosynostosis is a congenital disorder of premature ossification of cranial sutures, occurring in one of approximately every 2500 live human births. This work addressed a hypothesis that a cranial suture can be tissue-engineered from autologous cells. Dermal fibroblasts were isolated subcutaneously from growing rabbits, culture-expanded, and seeded in a gelatin scaffold. We fabricated a composite tissue construct by sandwiching the

  17. Morphometry of the Cranial Base in Subjects with Class III Malocclusion

    Microsoft Academic Search

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

    1997-01-01

    The significance of the cranial base in the development of Class III malocclusion remains uncertain. The purpose of this study was to determine whether the form of the cranial base differs between prepubertal Class I and Class III subjects. Lateral cephalographs of 73 children of European-American descent aged between 5 and 11 years with Class III malocclusion were compared with

  18. Comparison of Findings on Cranial Ultrasound and Magnetic Resonance Imaging in Preterm Infants

    Microsoft Academic Search

    Elia F. Maalouf; Philip J. Duggan; Serena J. Counsell; Mary A. Rutherford; Frances Cowan; Denis Azzopardi; A. David Edwards

    2009-01-01

    Objective. To compare findings on hard copies of cranial ultrasound (US) and magnetic resonance imaging (MRI) obtained between birth and term in a group of preterm infants. Participants and Methods. Infants born at or below a gestational age of 30 weeks who underwent cranial US scan and MRI on the same day were eligible for this study. Infants underwent, whenever

  19. Subclassification of Anencephalic Human Fetuses According to Morphology of the Posterior Cranial Fossa

    Microsoft Academic Search

    Jens Fog Lomholt; Birgit Fischer-Hansen; Jean W. Keeling; Ingermarie Reintoft; Inger Kjær

    2004-01-01

    Anencephaly is a designation for congenital absence of the cranial vault with cerebral hemispheres completely missing or decreased to small masses attached to the base of the skull. The etiology is unknown. Whether the bony tissue or soft brain tissue is a primary factor is also unknown. The present study has focused on the posterior cranial fossa in anencephaly. The

  20. Implications of predatory specialization for cranial form and function in canids

    E-print Network

    Dumont, Elizabeth R.

    . Selection for increased bite force, bite speed or skull strength may all affect cranial morphology. We investigated the relationship between cranial form and function in the trophically diverse dog family, Canidae specialists appear to reflect selection for fast jaw closure at the expense of bite force. Generalists have

  1. PREDISPOSITION OF DOG BREEDS TO RUPTURE OF THE CRANIAL CRUCIATE LIGAMENT

    Microsoft Academic Search

    A. NEâAS; J. ZATLOUKAL; H. KECOVÁ; M. DVO

    Neãas A., J. Zatloukal, H. Kecová, M. Dvofiák: Predisposition of Dog Breeds to Rupture of Cranial Cruciate Ligament. Acta Vet. Brno 2000, 69: 305-310. Obtaining more data on breed predisposition of dogs to the cranial cruciate ligament (CCL) rupture and data on accompanying abnormalities of joints of pelvic limbs affected by the CCL rupture may help in answering some questions

  2. Accuracy of Interpretation of Cranial Computed Tomography Scans in an Emergency Medicine Residency Program

    Microsoft Academic Search

    Dennis Alfaro; M. Andrew Levitt; David K English; Virgil Williams; Ronald Eisenberg

    1995-01-01

    Study objectives: To determine the concordance of emergency physicians and radiologists in interpreting cranial computed tomography (CT) scans. The study also sought to determine the clinical significance of misinterpretations of cranial CT scans by emergency physicians.Design: Prospective cohort study. Setting: A county hospital emergency medicine residency program. Participants: Five hundred fifty-five patients undergoing CT scanning during emergency department evaluation. Results:

  3. Bone Augmentation and Nerve Repositioning

    MedlinePLUS

    ... Types of Bone-Augmentation Procedures Nerve Repositioning For dental implants to be successful, the jawbone must have enough ... of procedures used to "build" bone so that dental implants can be placed. These procedures typically involve grafting ( ...

  4. Ion Channels in Nerve Membranes

    ERIC Educational Resources Information Center

    Ehrenstein, Gerald

    1976-01-01

    Discusses research that indicates that nerve membranes, which play a key role in the conduction of impulses, are traversed by protein channels with ion pathways opened and closed by the membrane electric field. (Author/MLH)

  5. Selective measurement of digital nerve conduction velocity

    Microsoft Academic Search

    Yuji Terai; Masuo Senda; Hiroyuki Hashizume; Hiroaki Nagashima; Hajime Inoue

    2001-01-01

    We developed a new method to measure the nerve conduction velocity of a single digital nerve. In 27 volunteers (27 hands),\\u000a we separately stimulated each digital nerve on the radial and ulnar sides of the middle and ring fingers. A double-peaked\\u000a potential was recorded above the median nerve at the wrist joint when either the radial-side nerve or the ulnar-side

  6. Contralateral femoral nerve compression: An unrecognized complication after extreme lateral interbody fusion (XLIF).

    PubMed

    Papanastassiou, Ioannis D; Eleraky, Mohammad; Vrionis, Frank D

    2011-01-01

    Extreme lateral interbody fusion (XLIF) is a relatively new procedure for the treatment of degenerative disc disease avoiding the morbidity of anterior approaches. Ipsilateral L2-5 nerve root irritation and injury are well-described complications. We describe two patients with contralateral extremity symptoms, not reported so far. In the first patient the injury was caused by a displaced endplate fragment compressing the contralateral nerve root; in the second patient, the injury resulted from a far-lateral herniation after the XLIF procedure. Both patients experienced resolution of their symptoms after being reoperated. Overall, this complication was encountered in 2/32 levels treated during the study period. Overzealous endplate removal and breaking of the osteophytes in the opposite corner of the intervertebral disc, although desirable for maximal coronal deformity correction, may lead to irritation of the contralateral nerve roots. Attention is needed especially where the interbody cage is placed posteriorly or diagonally towards the neuralforamen. PMID:20965732

  7. Histological comparison of the third interdigital nerve in patients with Morton's metatarsalgia and control patients.

    PubMed

    Bourke, G; Owen, J; Machet, D

    1994-06-01

    This study compares the histology of the plantar-digital nerve supplying the third web space in asymptomatic patients with those who have clinically diagnosed Morton's metatarsalgia. Despite several studies concentrating on the histological changes in the interdigital nerve, the relevance of these changes is a matter of contention while the exact pathological process responsible for the symptoms has not been determined. The histological findings in control patients were identical to Morton's patients with the exception of demyelination, which was more common in the Morton's group. This suggests that the characteristic nodule and fibrotic changes seen in the interdigital nerves of patients with Morton's neuroma cannot account for the symptoms and that the changes seen in the neurovascular bundle are degenerative in origin and are found in asymptomatic patients. PMID:7516653

  8. JAMA Patient Page: Vaginal Symptoms

    MedlinePLUS

    ... of the American Medical Association JAMA PATIENT PAGE Vaginal Symptoms V aginal symptoms are one of the ... includes an article about diagnosing vaginal symptoms. DIAGNOSING VAGINAL SYMPTOMS FOR MORE INFORMATION • American College of Obstetricians ...

  9. Nerve Regeneration After Radiofrequency Application

    Microsoft Academic Search

    Nobuyasu Ochiai; James P. Tasto; Seiji Ohtori; Norimasa Takahashi; Hideshige Moriya; David Amiel

    2007-01-01

    Background: Many patients with chronic tendinosis have experienced early pain relief after application of bipolar radiofrequency treatment. It is hypothesized that the mechanism of action may be the acute degeneration and\\/or ablation of sensory nerve fibers.Hypothesis: After ablation or degeneration by bipolar radiofrequency, nerve fibers will have the ability to regenerate with time.Study Design: Controlled laboratory study.Methods: Eighteen Sprague-Dawley rats

  10. Transcutaneous electrical nerve stimulation in the management of painful muscle spasm in patients with multiple sclerosis

    Microsoft Academic Search

    PG Mattison

    1993-01-01

    Transcutaneous electrical nerve stimulation (TENS) was used to treat eight patients with multiple sclerosis who presented with painful lower limb muscle spasms. All eight had experienced a deterioration in functional ability following initial treatment with spasmolytic agents which had produced an undesirable fall in resting muscle tone. Six of the eight patients experienced a significant improvement in symptoms with TENS

  11. The digital nerve stretch test: A sensitive indicator of Morton's neuroma and neuritis

    Microsoft Academic Search

    D. J. Cloke; M. E. Greiss

    2006-01-01

    We describe a physical sign not previously reported, which adds a sensitive and specific tool to assist the clinical diagnosis of interdigital neuralgia in the foot including Morton's entrapment neuropathy.A prospective record was kept of symptoms and signs in patients treated for Morton's neuroma or neuritis, including the web space pressure test, metatarsal approximation, Mulder's click and the digital nerve

  12. Altered Function of Lumbar Nerve Roots in Patients With Transitional Lumbosacral Vertebrae

    Microsoft Academic Search

    Han Soo Chang; Hiroshi NAKAGAWA

    2004-01-01

    STUDY DESIGN: A retrospective study was conducted on the preoperative neurologic symptoms of patients with lumbar herniated discs. OBJECTIVE: To evaluate the possibility that the muscle innervation pattern and the sensory dermatomes of lumbar nerve roots are altered when a lumbosacral transitional vertebra is present. SUMMARY OF BACKGROUND DATA: In 1962, McCulloch et al suggested with intraoperative recordings that the

  13. Cold-induced peripheral nerve damage: involvement of touch receptors of the foot.

    PubMed

    Carter, J L; Shefner, J M; Krarup, C

    1988-10-01

    A 31-year-old male developed paresthesia and numbness of mainly the right foot following exposure to nonfreezing temperatures under moist conditions over a period of 1 week. The symptoms gradually improved over several months. When seen for electrophysiological studies 6 months after the injury, there was no sensory loss on clinical examination, although he continued to complain of distal numbness of the right foot. The right extensor digitorum brevis muscle was atrophic, and the distal motor latency in the peroneal nerve was prolonged. Conduction studies of the right sural nerve showed a predominantly distal diminution of the SAP evoked by electrical stimulation at the dorsum pedis. Action potentials evoked by tactile stimulation of Pacinian corpuscles showed a prolonged latency on the symptomatic side, suggesting that the most pronounced pathological changes in immersion injury may be localized to the very distal portion of the nerve at the nerve fiber-receptor junction. PMID:3185601

  14. Pathology of Peripheral Nerve Sheath Tumors: Diagnostic Overview and Update on Selected Diagnostic Problems

    PubMed Central

    Rodriguez, Fausto J.; Folpe, Andrew L.; Giannini, Caterina; Perry, Arie

    2013-01-01

    Peripheral nerve sheath tumors are common neoplasms, with classic identifiable features, but on occasion, they are diagnostically challenging. Although well defined subtypes of peripheral nerve sheath tumors were described early in the history of surgical pathology, controversies regarding the classification and grading of these tumors persist. Advances in molecular biology have provided new insights into the nature of the various peripheral nerve sheath tumors, and have begun to suggest novel targeted therapeutic approaches. In this review we discuss current concepts and problematic areas in the pathology of peripheral nerve sheath tumors. Diagnostic criteria and differential diagnosis for the major categories of nerve sheath tumors are proposed, including neurofibroma, schwannoma, and perineurioma. Diagnostically challenging variants, including plexiform, cellular and melanotic schwannomas are highlighted. A subset of these affects the childhood population, and has historically been interpreted as malignant, although current evidence and outcome data suggests they represent benign entities. The growing current literature and the authors experience with difficult to classify borderline or “hybrid tumors” are discussed and illustrated. Some of these classification gray zones occur with frequency in the gastrointestinal tract, an anatomical compartment that must always be entertained when examining these neoplasms. Other growing recent areas of interest include the heterogeneous group of pseudoneoplastic lesions involving peripheral nerve composed of mature adipose tissue and/or skeletal muscle, such as the enigmatic neuromuscular choristoma. Malignant peripheral nerve sheath tumors (MPNST) represent a diagnostically controversial group; difficulties in grading and guidelines to separate “atypical neurofibroma” from MPNST are provided. There is an increasing literature of MPNST mimics which neuropathologists must be aware of, including synovial sarcoma and ossifying fibromyxoid tumor. Finally, we discuss entities that are lacking from the section on cranial and paraspinal nerves in the current WHO classification, and that may warrant inclusion in future classifications. In summary, although the diagnosis and classification of most conventional peripheral nerve sheath tumors are relatively straightforward for the experienced observer, borderline and difficult to classify neoplasms continue to be problematic. In the current review, we attempt to provide some useful guidelines for the surgical neuropathologist to help navigate these persistent, challenging problems. PMID:22327363

  15. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems.

    PubMed

    Rodriguez, Fausto J; Folpe, Andrew L; Giannini, Caterina; Perry, Arie

    2012-03-01

    Peripheral nerve sheath tumors are common neoplasms, with classic identifiable features, but on occasion, they are diagnostically challenging. Although well-defined subtypes of peripheral nerve sheath tumors were described early in the history of surgical pathology, controversies regarding the classification and grading of these tumors persist. Advances in molecular biology have provided new insights into the nature of the various peripheral nerve sheath tumors, and have begun to suggest novel targeted therapeutic approaches. In this review, we discuss current concepts and problematic areas in the pathology of peripheral nerve sheath tumors. Diagnostic criteria and differential diagnosis for the major categories of nerve sheath tumors are proposed, including neurofibroma, schwannoma, and perineurioma. Diagnostically challenging variants, including plexiform, cellular and melanotic schwannomas are highlighted. A subset of these affects the childhood population, and has historically been interpreted as malignant, although current evidence and outcome data suggest they represent benign entities. The growing current literature and the author's experience with difficult to classify borderline or "hybrid tumors" are discussed and illustrated. Some of these classification gray zones occur with frequency in the gastrointestinal tract, an anatomical compartment that must always be entertained when examining these neoplasms. Other growing recent areas of interest include the heterogeneous group of pseudoneoplastic lesions involving peripheral nerve composed of mature adipose tissue and/or skeletal muscle, such as the enigmatic neuromuscular choristoma. Malignant peripheral nerve sheath tumors (MPNST) represent a diagnostically controversial group; difficulties in grading and guidelines to separate "atypical neurofibroma" from MPNST are provided. There is an increasing literature of MPNST mimics which neuropathologists must be aware of, including synovial sarcoma and ossifying fibromyxoid tumor. Finally, we discuss entities that are lacking from the section on cranial and paraspinal nerves in the current WHO classification, and that may warrant inclusion in future classifications. In summary, although the diagnosis and classification of most conventional peripheral nerve sheath tumors are relatively straightforward for the experienced observer, yet borderline and difficult-to-classify neoplasms continue to be problematic. In the current review, we attempt to provide some useful guidelines for the surgical neuropathologist to help navigate these persistent, challenging problems. PMID:22327363

  16. Optic Nerve Monitoring

    PubMed Central

    Schumann, Paul; Kokemüller, Horst; Tavassol, Frank; Lindhorst, Daniel; Lemound, Juliana; Essig, Harald; Rücker, Martin; Gellrich, Nils-Claudius

    2013-01-01

    Orbital and anterior skull base surgery is generally performed close to the prechiasmatic visual pathway, and clear strategies for detecting and handling visual pathway damage are essential. To overcome the common problem of a missed clinical examination because of an uncooperative or unresponsive patient, flash visual evoked potentials and electroretinograms should be used. These electrophysiologic examination techniques can provide evidence of intact, pathologic, or absent conductivity of the visual pathway when clinical assessment is not feasible. Visual evoked potentials and electroretinograms are thus essential diagnostic procedures not only for primary diagnosis but also for intraoperative evaluation. A decision for or against treatment of a visual pathway injury has to be made as fast as possible due to the enormous importance of the time elapsed with such injuries; this can be achieved additionally using multislice spiral computed tomography. The first-line conservative treatment of choice for such injuries is megadose methylprednisolone therapy. Surgery is used to decompress the orbital compartment by exposure of the intracanalicular part of the optic nerve in the case of optic canal compression. Modern craniomaxillofacial surgery requires detailed consideration of the diagnosis and treatment of traumatic visual pathway damage with the ultimate goal of preserving visual acuity. PMID:24436741

  17. The symptom index

    Microsoft Academic Search

    Swarnjit Singh; Joel E. Richter; Laurence A. Bradley; Julie M. Haile

    1993-01-01

    The symptom index is a quantitative measure developed for assessing the relationship between gastroesophageal reflux and symptoms. Controversy exists, however, over its accuracy and the appropriate threshold for defining acid-related symptoms of heartburn and chest pain. Therefore, a retrospective review was done of 153 consecutive patients referred to our esophageal laboratory. Three groups were identified: patients with normal 24-hr pH

  18. Locating the target nerve and injectate spread in rabbit sciatic nerve block

    Microsoft Academic Search

    Duk Hyun Sung

    2004-01-01

    Background and objectivesThe purpose of this study is to determine how close the needle tip is placed to the target nerve using a nerve stimulator and to determine how far the injectate spreads in percutaneous nerve blocks.

  19. Prostate Cancer Symptoms

    MedlinePLUS

    ... My Bridge 4 Life Clinical Trials Guides Newsletters Nutrition & Wellness PCF Spotlight Glossary African American Men Understanding Prostate Cancer Prostate Cancer Symptoms English | Español Not everyone experiences ...

  20. Robust frameless stereotactic localization in extra-cranial radiotherapy

    SciTech Connect

    Riboldi, Marco; Baroni, Guido; Spadea, Maria Francesca; Bassanini, Fabio; Tagaste, Barbara; Garibaldi, Cristina; Orecchia, Roberto; Pedotti, Antonio [TBMLab, Department of Bioengineering, Politecnico di Milano University, P.za Leonardo da Vinci 32, Milan 20133 (Italy); Medical Physics, European Institute of Oncology, Via Ripamonti 435, Milan 20141 (Italy); Radiotherapy Division, European Institute of Oncology, Via Ripamonti 435, Milan 20141 (Italy) and Instituto di Scienze Radiologiche, Polo Universitario H S. Paolo, Via Rudini 8, Milan 20142 (Italy); TBMLab, Department of Bioengineering, Politecnico di Milano University, P.za Leonardo da Vinci 32, Milan 20133 (Italy)

    2006-04-15

    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 weighted strategy isocentric positioning correction provided the reduction of fiducial registration errors, featuring up to 61.7% decrease in median values (versus 46.8% for the unweighted strategy) of initial displacements. The weighted strategy proved high performance in minimizing the effects of fiducial localization errors, showing a great potential in improving patient setup. The clinical data analysis revealed that the application of a robust reconstruction algorithm may provide high-quality results in patient setup verification, by properly managing external fiducials localization errors.

  1. Lipofibromatous Hamartoma of the Median Nerve in Association with or without Macrodactyly.

    PubMed

    Kini, Jyoti R; Kini, Hema; Rau, Aarathi; Kamath, Jagannath; Kini, Anand

    2014-11-01

    Lipofibromatous hamartoma is a rare tumour-like condition involving the peripheral nerves, particularly the median nerve. It commonly affects the volar aspect of the hands, wrists and forearms of young adults. Most patients present either early with macrodactyly or later with a forearm mass lesion or symptoms consistent with compressive neuropathy of the involved nerve. The clinical and histomorphological findings of five patients with lipofibromatous hamartoma of the median nerve are analysed. The presentation, pathological features and differential diagnosis of neural lipofibromas are discussed along with a brief review of the literature. Of the five cases of lipofibromatous hamartoma, all were seen to involve the median nerve, occurring in four women and one man. Three of these cases had associated macrodactyly which was congenital in two and was seen from childhood in one. Microscopic examination showed fibrofatty tissue surrounding and infiltrating along the epineurium and perineurium. The nerve bundles were splayed apart by the infiltrating adipose tissue. Neural fibrolipomatous hamartoma is a benign condition. Most respond to conservative management with surgical exploration, biopsy and carpal tunnel release to decompress the nerve. Correct diagnosis of this uncommon lesion is important as surgical excision of the lesion may lead to loss of neurological function. PMID:25371022

  2. Ultrasound of the nerves of the knee region: Technique of examination and normal US appearance

    PubMed Central

    Bianchi, S.; Martinoli, C.; Demondion, X.

    2007-01-01

    The diagnosis of disorders of the peripheral nerves (PN) has traditionally been based on clinical and electrophysiological data since nerve tissue cannot be visualized on standard radiographs. More recently, however, nerve structures have been evaluated with magnetic resonance imaging (MRI) and ultrasound (US). The former modality is expensive and not available in all institutions. There are also some contraindications to its use, and the assessment of long nerves can be time-consuming since different coils must be used. Thanks to recent advances in sonographic software and hardware, US can now be used for in-depth assessment of the PN of the upper and lower limbs. Most knee disorders involve lesions to the cruciate ligaments and/or the menisci, which are difficult to evaluate with US. However, similar symptoms may be caused by compression of one or more nerves in the knee region or intrinsic disorders involving these structures. Because of their superficial positions, the nerves around the knee can be clearly visualized with US. A thorough knowledge of the normal anatomy of this region and a careful scanning technique are essential for a successful diagnostic US examination. In this article, we will review the normal gross and microscopic anatomy of the nerves in the knee region, the US technique used for their examination, and their normal US appearance. PMID:23396637

  3. Entrapment of the saphenous nerve at the adductor canal affecting the infrapatellar branch – a report on two cases

    PubMed Central

    Porr, Jason; Chrobak, Karen; Muir, Brad

    2013-01-01

    Objective: To present 2 cases of entrapment of the saphenous nerve at the adductor canal affecting the infrapatellar branch, and to provide insight into the utilization of nerve tension testing for the diagnosis of nerve entrapments in a clinical setting. Rationale: Saphenous nerve entrapments are a very rare condition within today’s body of literature, and the diagnosis remains controversial. Clinical Features: Two cases of chronic knee pain that were unresponsive to previous treatment. The patients were diagnosed with an entrapment of the saphenous nerve at the adductor canal affecting the infrapatellar branch using nerve tension techniques along with a full clinical examination. Intervention and Outcome: Manual therapy and rehabilitation programs were initiated including soft tissue therapy, nerve gliding techniques and gait retraining which resulted in 90% improvement in one case and complete resolution of symptoms in the second. Conclusion: Nerve tension testing may prove to be an aid in the diagnosis of saphenous nerve entrapments within a clinical setting in order to decrease time to diagnosis and proper treatment. PMID:24302782

  4. Loss of the Sall3 Gene Leads to Palate Deficiency, Abnormalities in Cranial Nerves, and Perinatal Lethality

    Microsoft Academic Search

    M. Parrish; T. Ott; C. Lance-Jones; G. Schuetz; A. Schwaeger-Nickolenko; A. P. Monaghan

    2004-01-01

    Members of the Spalt gene family encode putative transcription factors characterized by seven to nine C2H2 zinc finger motifs. Four genes have been identified in mice—Spalt1 to Spalt4 (Sall1 to Sall4). Spalt homologues are widely expressed in neural and mesodermal tissues during early embryogenesis. Sall3 is normally expressed in mice from embryonic day 7 (E7) in the neural ectoderm and

  5. Hyperfractionated Low-Dose (21 Gy) Radiotherapy for Cranial Skeletal Metastases in Patients With High-Risk Neuroblastoma

    SciTech Connect

    Kushner, Brian H., E-mail: kushnerb@mskcc.or [Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Cheung, Nai-Kong V. [Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Barker, Christopher A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Kramer, Kim; Modak, Shakeel; Yataghene, Karima [Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Wolden, Suzanne L. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2009-11-15

    Purpose: To present a large experience (73 patients) using a standard radiotherapy (RT) protocol to prevent relapse in cranial sites where measurable metastatic neuroblastoma (NB), an adverse prognostic marker, is common. Methods and Materials: High-risk NB patients with measurable cranial disease at diagnosis or residual cranial disease after induction therapy had those sites irradiated with hyperfractionated 21 Gy; a brain-sparing technique was used for an extensive field. The patients were grouped according to the response to systemic therapy. Thus, when irradiated, Group 1 patients were in complete remission and Group 2 patients had primary refractory disease. Follow-up was from the start of cranial RT. Results: At 3 years, the 39 Group 1 patients had a progression-free survival rate of 51%; control of cranial disease was 79%. Two relapses involved irradiated cranial sites. Two other patients relapsed in the irradiated cranial sites 6 and 12 months after a systemic relapse. At 3 years, the 34 Group 2 patients had a progression-free survival rate of 33%; control of cranial disease was 52%. Group 2 included 19 patients who had residual cranial (with or without extracranial) disease. The cranial sites showed major (n = 13), minor (n = 2), or no response (n = 4) to RT. Five patients had progression in the cranial RT field at 10-27 months. Group 2 also included 15 patients who had persistent NB in extracranial, but not cranial, sites. Of these 15 patients, 2 relapsed in the irradiated cranial sites and elsewhere at 8 and 14 months. Cranial RT was well tolerated, with no Grade 2 or greater toxicity. Conclusion: Hyperfractionated 21-Gy cranial RT might help control NB and is feasible without significant toxicity in children.

  6. Cranial neurosurgical 30-day readmissions by clinical indication.

    PubMed

    Moghavem, Nuriel; Morrison, Doug; Ratliff, John K; Hernandez-Boussard, Tina

    2015-07-01

    OBJECT Postsurgical readmissions are common and vary by procedure. They are significant drivers of increased expenditures in the health care system. Reducing readmissions is a national priority that has summoned significant effort and resources. Before the impact of quality improvement efforts can be measured, baseline procedure-related 30-day all-cause readmission rates are needed. The objects of this study were to determine population-level, 30-day, all-cause readmission rates for cranial neurosurgery and identify factors associated with readmission. METHODS The authors identified patient discharge records for cranial neurosurgery and their 30-day all-cause readmissions using the Agency for Healthcare Research and Quality (AHRQ) State Inpatient Databases for California, Florida, and New York. Patients were categorized into 4 groups representing procedure indication based on ICD-9-CM diagnosis codes. Logistic regression models were developed to identify patient characteristics associated with readmissions. The main outcome measure was unplanned inpatient admission within 30 days of discharge. RESULTS A total of 43,356 patients underwent cranial neurosurgery for neoplasm (44.23%), seizure (2.80%), vascular conditions (26.04%), and trauma (26.93%). Inpatient mortality was highest for vascular admissions (19.30%) and lowest for neoplasm admissions (1.87%; p < 0.001). Thirty-day readmissions were 17.27% for the neoplasm group, 13.89% for the seizure group, 23.89% for the vascular group, and 19.82% for the trauma group (p < 0.001). Significant predictors of 30-day readmission for neoplasm were Medicaid payer (OR 1.33, 95% CI 1.15-1.54) and fluid/electrolyte disorder (OR 1.44, 95% CI 1.29-1.62); for seizure, male sex (OR 1.74, 95% CI 1.17-2.60) and index admission through the emergency department (OR 2.22, 95% CI 1.45-3.43); for vascular, Medicare payer (OR 1.21, 95% CI 1.05-1.39) and renal failure (OR 1.52, 95% CI 1.29-1.80); and for trauma, congestive heart failure (OR 1.44, 95% CI 1.16-1.80) and coagulopathy (OR 1.51, 95% CI 1.25-1.84). Many readmissions had primary diagnoses identified by the AHRQ as potentially preventable. CONCLUSIONS The frequency of 30-day readmission rates for patients undergoing cranial neurosurgery varied by diagnosis between 14% and 24%. Important patient characteristics and comorbidities that were associated with an increased readmission risk were identified. Some hospital-level characteristics appeared to be associated with a decreased readmission risk. These baseline readmission rates can be used to inform future efforts in quality improvement and readmission reduction. PMID:25658784

  7. Scoring of nonmetric cranial traits: a methodological approach

    PubMed Central

    GUALDI-RUSSO, E.; TASCA, M. A.; BRASILI, P.

    1999-01-01

    The purpose of the present study was to analyse the replicability of the scoring of discontinuous traits. This was assessed on a sample of 100 skulls from the Frassetto collection (Dipartimento di Biologia Evoluzionistica Sperimentale of Bologna University) analysed through intraobserver comparisons: the discontinuous traits were determined on the same skulls and by the same observer on 3 separate occasions. The scoring was also assessed through interobserver comparisons: 3 different observers performed an independent survey on the same skulls. The results show that there were no significant differences in the discontinuous trait frequencies between the 3 different scorings by the same observer, but there were sometimes significant differences between different observers. Caution should thus be taken in applying the frequencies of these traits to population research. After an indispensable control of material conditions (subject age included), consideration must be given to standardisation procedures between observers, otherwise this may be an additional source of variability in cranial discontinuous trait scoring. PMID:10634693

  8. Superquadric modeling of cranial and cerebral shape and asymmetry.

    PubMed

    Sommer, H J; Eckhardt, R B; Shiang, T Y

    2006-02-01

    A new method for quantifying cranial and cerebral shape and asymmetry fits symmetric superquadric geometric models to three-dimensional coordinate measurements. Asymmetry is quantified as radial residuals of the surface data points from their best-fit superquadric models. Twenty human crania, 10 magnetic resonance imaging (MRI) exocranial surfaces, and 10 corresponding MRI cerebral surfaces as well as two infant head casts were digitized and modeled using superquadrics. Superquadric parameters have simple geometric interpretation, are very reproducible, and demonstrated statistically significant differences between crania of Amerindian ancestry and MRI exocranial surfaces of European ancestry used in this study. Superquadric models demonstrated strong congruence between MRI exocranial and cerebral surfaces. Typical asymmetry was 1-5 mm. Lastly, polar contour plots of radial residuals for head casts before and after orthotic cranioplasty demonstrated the efficacy of using superquadrics to quantify positional plagiocephaly and synostosis of infant crania. PMID:16323182

  9. In vivo porcine training model for cranial neurosurgery.

    PubMed

    Regelsberger, Jan; Eicker, Sven; Siasios, Ioannis; Hänggi, Daniel; Kirsch, Matthias; Horn, Peter; Winkler, Peter; Signoretti, Stefano; Fountas, Kostas; Dufour, Henry; Barcia, Juan A; Sakowitz, Oliver; Westermaier, Thomas; Sabel, Michael; Heese, Oliver

    2015-01-01

    Supplemental education is desirable for neurosurgical training, and the use of human cadaver specimen and virtual reality models is routine. An in vivo porcine training model for cranial neurosurgery was introduced in 2005, and our recent experience with this unique model is outlined here. For the first time, porcine anatomy is illustrated with particular respect to neurosurgical procedures. The pros and cons of this model are described. The aim of the course was to set up a laboratory scenery imitating an almost realistic operating room in which anatomy of the brain and neurosurgical techniques in a mentored environment free from time constraints could be trained. Learning objectives of the course were to learn about the microsurgical techniques in cranial neurosurgery and the management of complications. Participants were asked to evaluate the quality and utility of the programme via standardized questionnaires by a grading scale from A (best) to E (worst). In total, 154 residents have been trained on the porcine model to date. None of the participants regarded his own residency programme as structured. The bleeding and complication management (97%), the realistic laboratory set-up (89%) and the working environment (94%) were favoured by the vast majority of trainees and confirmed our previous findings. After finishing the course, the participants graded that their skills in bone drilling, dissecting the brain and preserving cerebral vessels under microscopic magnification had improved to level A and B. In vivo hands-on courses, fully equipped with microsurgical instruments, offer an outstanding training opportunity in which bleeding management on a pulsating, vital brain represents a unique training approach. Our results have shown that education programmes still lack practical training facilities in which in vivo models may act as a complementary approach in surgical training. PMID:25240530

  10. The temporal and spatial expression pattern of the LGI1 epilepsy predisposition gene during mouse embryonic cranial development

    PubMed Central

    2011-01-01

    Background Mutations in the LGI1 gene predispose to a rare, hereditary form of temporal epilepsy. Currently, little is known about the temporal and spatial expression pattern of Lgi1 during normal embryogenesis and so to define this more clearly we used a transgenic mouse line that expresses GFP under the control of Lgi1 cis-regulatory elements. Results During embryonic brain growth, high levels of Lgi1 expression were found in the surface ectoderm, the neuroepithelium, mesenchymal connective tissue, hippocampus, and sensory organs, such as eye, tongue, and the olfactory bulb. Lgi1 was also found in the cranial nerve nuclei and ganglia, such as vestibular, trigeminal, and dorsal ganglia. Expression of Lgi1 followed an orchestrated pattern during mouse development becoming more subdued in areas of the neocortex of the mid- and hind-brain in early postnatal animals, although high expression levels were retained in the choroid plexus and hippocampus. In late postnatal stages, Lgi1 expression continued to be detected in many areas in the brain including, hippocampus, paraventricular thalamic nuclei, inferior colliculus, and the cerebral aqueduct. We also showed that Lgi1-expressing cells co-express nestin, DCX, and beta-III tubulin suggesting that Lgi1-expressing cells are migratory neuroblasts. Conclusion These observations imply that Lgi1 may have a role in establishing normal brain architecture and neuronal functions during brain development suggesting that it may be involved in neurogenesis and neuronal plasticity, which become more specifically defined in the adult animal. PMID:21569517

  11. Tinnitus in fourth nerve palsy: an indicator for an intra-axial lesion.

    PubMed

    Choi, Seo Young; Song, Jae Jin; Hwang, Jeong Min; Kim, Ji Soo

    2010-12-01

    Accompanying neurological symptoms and signs are diagnostic hallmarks of fourth nerve palsy (4NP) from an intra-axial lesion. Due to the proximity of the trochlear nucleus and fascicles to the inferior colliculus (IC), auditory symptoms including tinnitus may occur with an intra-axial 4NP. A 53-year-old man with hypertension and diabetes developed right 4NP with a sudden worsening of tinnitus. MRI disclosed an infarction involving the trochlear fascicle and IC in the left dorsal midbrain. Tinnitus may be a symptom indicating an intra-axial lesion causing a 4NP. PMID:20581691

  12. Cranial musculature in the larva of the caecilian, Ichthyophis kohtaoensis (Lissamphibia: Gymnophiona).

    PubMed

    Kleinteich, Thomas; Haas, Alexander

    2007-01-01

    Within the Gymnophiona (caecilians) oviparous species with biphasic life-cycles possess a free living semi-aquatic larval stage that feeds in aquatic habitats. The larvae pass through a metamorphosis to a purely terrestrial adult stage. It is likely that the cranial morphology of caecilian larvae has specializations for aquatic feeding. However, little is known about the cranial morphology, and the cranial musculature is especially neglected in the literature. This study provides a detailed description of the jaw and hyobranchial musculature in larval stages of a caecilian. We studied late embryonic and early larval specimens of Ichthyophis kohtaoensis. Furthermore, we compared and homologized the cranial muscles found in larval I. kohtaoensis with the muscles described for adult caecilians. Most cranial muscles of larval I. kohtaoensis are also present in the adult, except for the m. levator mandibulae externus and the m. subarcualis obliquus II. Our results were compared with the data available for larval frogs and salamanders in order to hypothesize the cranial musculature in the larva of the most recent common ancestor of the Lissamphibia. Larval caecilians, frog tadpoles, and salamander larvae share many characters in their cranial musculature, which, consequently, can be assigned to the lissamphibian ground pattern. However, the m. pterygoideus and the m. levator quadrati are unique to the Gymnophiona. PMID:17154285

  13. [A case of bilateral ophthalmoplegia caused by focal idiopathic hypertrophic pachymeningitis on the anterior cranial fossa].

    PubMed

    Teramoto, Hiroko; Hara, Makoto; Morita, Akihiko; Kamei, Satoshi

    2015-01-01

    A previously healthy 63-year-old man presented with a 2-weeks history of diplopia without headache. Neurological examination revealed total external ophthalmoplegia of the left eye and limitation of abduction of the right eye. Initial cranial MRI showed thickening and enhancement of the dura mater only on the anterior cranial fossa but unremarkable on the cavernous sinus. Idiopathic hypertrophic cranial pachymeningitis was diagnosed in the absence of demonstrable underlying infective, neoplastic, or systemic autoimmune disease by his clinical findings, laboratory tests and radiological examinations. Corticosteroid therapy was initiated with methylprednisolone (1,000?mg/day for 3 days), followed by oral prednisolone and tapering off. Eye movements improved with treatment and completely recovered within 4 weeks after starting administration, and cranial MRI at the 15 days after starting treatment showed improvement. We suggest that his ophthalmoplegia was caused by the inflammation of dura on the cavernous sinus beyond the thickening lesion of cranial MRI. In a case of bilateral ophthalmoplegia with or without headache, it is required to examine the dural thickening and enhancement on the anterior cranial fossa by cranial MRI. PMID:25672863

  14. Hypoglossal nerve stimulation improves obstructive sleep apnea: 12-month outcomes.

    PubMed

    Kezirian, Eric J; Goding, George S; Malhotra, Atul; O'Donoghue, Fergal J; Zammit, Gary; Wheatley, John R; Catcheside, Peter G; Smith, Philip L; Schwartz, Alan R; Walsh, Jennifer H; Maddison, Kathleen J; Claman, David M; Huntley, Tod; Park, Steven Y; Campbell, Matthew C; Palme, Carsten E; Iber, Conrad; Eastwood, Peter R; Hillman, David R; Barnes, Maree

    2014-02-01

    Reduced upper airway muscle activity during sleep is a key contributor to obstructive sleep apnea pathogenesis. Hypoglossal nerve stimulation activates upper airway dilator muscles, including the genioglossus, and has the potential to reduce obstructive sleep apnea severity. The objective of this study was to examine the safety, feasibility and efficacy of a novel hypoglossal nerve stimulation system (HGNS; Apnex Medical, St Paul, MN, USA) in treating obstructive sleep apnea at 12 months following implantation. Thirty-one subjects (35% female, age 52.4 ± 9.4 years) with moderate to severe obstructive sleep apnea and unable to tolerate positive airway pressure underwent surgical implantation and activation of the hypoglossal nerve stimulation system in a prospective single-arm interventional trial. Primary outcomes were changes in obstructive sleep apnea severity (apnea-hypopnea index, from in-laboratory polysomnogram) and sleep-related quality of life [Functional Outcomes of Sleep Questionnaire (FOSQ)]. Hypoglossal nerve stimulation was used on 86 ± 16% of nights for 5.4 ± 1.4 h per night. There was a significant improvement (P < 0.001) from baseline to 12 months in apnea-hypopnea index (45.4 ± 17.5 to 25.3 ± 20.6 events h(-1) ) and Functional Outcomes of Sleep Questionnaire score (14.2 ± 2.0 to 17.0 ± 2.4), as well as other polysomnogram and symptom measures. Outcomes were stable compared with 6 months following implantation. Three serious device-related adverse events occurred: an infection requiring device removal; and two stimulation lead cuff dislodgements requiring replacement. There were no significant adverse events with onset later than 6 months following implantation. Hypoglossal nerve stimulation demonstrated favourable safety, feasibility and efficacy. PMID:24033656

  15. Nerve hyperplasia: a unique feature of ketamine cystitis

    PubMed Central

    2013-01-01

    Background There is an emerging association between ketamine abuse and the development of urological symptoms including dysuria, frequency and urgency, which have a neurological component. In addition, extreme cases are associated with severe unresolving bladder pain in conjunction with a thickened, contracted bladder and an ulcerated/absent urothelium. Here we report on unusual neuropathological features seen by immunohistology in ketamine cystitis. Results In all cases, the lamina propria was replete with fine neurofilament protein (NFP+) nerve fibres and in most patients (20/21), there was prominent peripheral nerve fascicle hyperplasia that showed particular resemblance to Morton’s neuroma. The nerve fascicles, which were positive for NFP, S100 and the p75 low-affinity nerve growth factor receptor (NGFR), were generally associated with a well-developed and in places, prominent, epithelial membrane antigen+/NGFR+ perineurium. This peripheral nerve fascicle hyperplasia is likely to account for the extreme pain experienced by ketamine cystitis patients. Urothelial damage was a notable feature of all ketamine cystitis specimens and where urothelium remained, increased NGFR expression was observed, with expansion from a basal-restricted normal pattern of expression into the suprabasal urothelium. Conclusions The histological findings were distinguishing features of ketamine cystitis and were not present in other painful bladder conditions. Ketamine cystitis afflicts predominantly young patients, with unknown long-term consequences, and requires a strategy to control severe bladder pain in order to remove a dependency on the causative agent. Our study indicates that the development of pain in ketamine cystitis is mediated through a specific neurogenic mechanism that may also implicate the urothelium. PMID:24252413

  16. Neurovascular study of the trigeminal nerve at 3?t MRI.

    PubMed

    Docampo, Jorge; Gonzalez, Nadia; Muñoz, Alexandra; Bravo, Fernando; Sarroca, Daniel; Morales, Carlos

    2015-02-01

    This study aimed to show a novel visualization method to investigate neurovascular compression of the trigeminal nerve (TN) using a volume-rendering fusion imaging technique of 3D fast imaging employing steady-state acquisition (3D FIESTA) and coregistered 3D time of flight MR angiography (3D TOF MRA) sequences, which we called "neurovascular study of the trigeminal nerve". We prospectively studied 30 patients with unilateral trigeminal neuralgia (TN) and 50 subjects without symptoms of TN (control group), on a 3 Tesla scanner. All patients were assessed using 3D FIESTA and 3D TOF MRA sequences centered on the pons, as well as a standard brain protocol including axial T1, T2, FLAIR and GRE sequences to exclude other pathologies that could cause TN. Post-contrast T1-weighted sequences were also performed. All cases showing arterial imprinting on the trigeminal nerve (n?=?11) were identified on the ipsilateral side of the pain. No significant relationship was found between the presence of an artery in contact with the trigeminal nerve and TN. Eight cases were found showing arterial contact on the ipsilateral side of the pain and five cases of arterial contact on the contralateral side. The fusion imaging technique of 3D FIESTA and 3D TOF MRA sequences, combining the high anatomical detail provided by the 3D FIESTA sequence with the 3D TOF MRA sequence and its capacity to depict arterial structures, results in a tool that enables quick and efficient visualization and assessment of the relationship between the trigeminal nerve and the neighboring vascular structures. PMID:25924169

  17. Pudendal nerve decompression in perineology : a case series

    PubMed Central

    Beco, Jacques; Climov, Daniela; Bex, Michèle

    2004-01-01

    Background Perineodynia (vulvodynia, perineal pain, proctalgia), anal and urinary incontinence are the main symptoms of the pudendal canal syndrome (PCS) or entrapment of the pudendal nerve. The first aim of this study was to evaluate the effect of bilateral pudendal nerve decompression (PND) on the symptoms of the PCS, on three clinical signs (abnormal sensibility, painful Alcock's canal, painful "skin rolling test") and on two neurophysiological tests: electromyography (EMG) and pudendal nerve terminal motor latencies (PNTML). The second aim was to study the clinical value of the aforementioned clinical signs in the diagnosis of PCS. Methods In this retrospective analysis, the studied sample comprised 74 female patients who underwent a bilateral PND between 1995 and 2002. To accomplish the first aim, the patients sample was compared before and at least one year after surgery by means of descriptive statistics and hypothesis testing. The second aim was achieved by means of a statistical comparison between the patient's group before the operation and a control group of 82 women without any of the following signs: prolapse, anal incontinence, perineodynia, dyschesia and history of pelvi-perineal surgery. Results When bilateral PND was the only procedure done to treat the symptoms, the cure rates of perineodynia, anal incontinence and urinary incontinence were 8/14, 4/5 and 3/5, respectively. The frequency of the three clinical signs was significantly reduced. There was a significant reduction of anal and perineal PNTML and a significant increase of anal richness on EMG. The Odd Ratio of the three clinical signs in the diagnosis of PCS was 16,97 (95% CI = 4,68 – 61,51). Conclusion This study suggests that bilateral PND can treat perineodynia, anal and urinary incontinence. The three clinical signs of PCS seem to be efficient to suspect this diagnosis. There is a need for further studies to confirm these preliminary results. PMID:15516268

  18. The relationship between the cranial base and jaw base in a Chinese population

    PubMed Central

    2014-01-01

    Introduction The cranial base plays an important role in determining how the mandible and maxilla relate to each other. This study assessed the relationship between the cranial base and jaw base in a Chinese population. Methods This study involved 83 subjects (male: 27; female: 56; age: 18.4?±?4.2 SD years) from Hong Kong, who were classified into 3 sagittal discrepancy groups on the basis of their ANB angle. A cephalometric analysis of the angular and linear measurements of their cranial and jaw bases was carried out. The morphological characteristics of the cranial and jaw bases in the three groups were compared and assessments were made as to whether a relationship existed between the cranial base and the jaw base discrepancy. Results Significant differences were found in the cranial base angles of the three groups. Skeletal Class II cases presented with a larger NSBa, whereas skeletal Class III cases presented with a smaller NSBa (P?cranial base angle NSBa and the SNB for the whole sample, (r?=?-0.523, P?cranial base appears to have a certain correlation with the jaw base relationship in a southern Chinese population. The correlation between cranial base and jaw base tends to be closer in skeletal Class III cases. PMID:25129070

  19. Facial-hypoglossal nerve anastomosis using laser nerve welding.

    PubMed

    Hwang, Kun; Kim, Sun Goo; Kim, Dae Joong

    2006-07-01

    The aim of this study is to compare laser nerve welding to microsurgical suturing of hypoglossal-facial nerve anastomosis (HFA), and a result of immediate to delayed repair, and to evaluate the effect of laser nerve welding on HFA for reanimation of facial palsy. The first group of five rats underwent immediate HFA by microsurgical suturing and the second group of five rats by CO2 laser welding. The third group of five rats underwent delayed HFA by microsurgical suturing, and the fourth group of five rats by laser nerve welding. The fifth group of five rats served as controls, with intact hypoglossal and facial nerve. In all rats of the four different treatment groups, cholera toxin B subunit (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative 6th week and in the normal hypoglossal nerve in the five rats of the control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically, and the numbers were counted. In the immediate HFA groups, CTb-positive neurons were 751 +/- 247 in the laser welding group (n = 5) and 888 +/- 60 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.117). In the delayed HFA groups, CTb-positive neurons were 749 +/- 54 in the laser welding group (n = 5) and 590 +/- 169 in the microsurgical suturing group (n = 5). The difference was not significant (P = 0.116). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.600), but there was significance between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.009). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1,003 +/- 52. No dehiscence in the laser welding site of nerve anastomosis was seen at the time of re-exploration for injection of CTb in all 10 rats. This study shows that the regeneration of anastomosed hypoglossal-facial nerve was affected similarly by laser welding and microsurgical suturing, and more effective, especially in delayed repair. PMID:16877915

  20. Facial and Cochlear Nerve Complications following Microsurgical Resection of Vestibular Schwannomas in a Series of 221 Cases.

    PubMed

    Zhang, Jun; Xu, Bai-Nan; Hou, Yuan-Zheng; Sun, Guo-Chen; Jiang, Yan

    2015-01-01

    BACKGROUND Despite improvements in microsurgical technique and the use of intraoperative electrophysiological monitoring, the potential for facial and cochlear nerve injury remains a possibility in the resection of vestibular schwannomas (VS). We reviewed a series of 221 cases of VS resected via a retrosigmoid approach at our institution from October 2008 to April 2014 and determined the incidence of postoperative facial and cochlear deficits. MATERIAL AND METHODS A total of 221 patients - 105 (47.5%) male and 116 (52.5%) female - with a mean age of 46.1 years (range 29-73 years), with VS ?3 cm (n=183, 82.8%) and <3 cm (n=38, 17.2%) underwent surgical resection via a retrosigmoid approach and were evaluated for postoperative facial and cochlear nerve deficits. RESULTS Near-total resection (>95% removal) was achieved in 199 cases (90%) and subtotal resection (>90% removal) in 22 cases (10%). At 6 month follow-up, House-Brackmann grades I-III were observed in 183 cases (82.8%), grade IV in 16 cases (7.2%), and grade V in 22 cases (10%). Of the 10 patients that had preoperative functional hearing, 3 (33%) retained hearing postoperatively. Cerebrospinal fluid leakage occurred in 6 patients (2.7%), lower cranial nerve palsies in 9 patients (4.1%), and intracranial hematomas 3 cases (1.4%). CONCLUSIONS The observed incidence of persistent postoperative nerve deficits is very low. Meticulous microsurgical dissection of and around the facial and cochlear nerves with the aid of intraoperative electrophysiological nerve monitoring in the retrosigmoid approach allows for near-total resection of medium and large VS with the possibility of preservation of facial and cochlear nerve function. PMID:26056168

  1. Burkholderia pseudomallei Penetrates the Brain via Destruction of the Olfactory and Trigeminal Nerves: Implications for the Pathogenesis of Neurological Melioidosis

    PubMed Central

    St. John, James A.; Ekberg, Jenny A. K.; Dando, Samantha J.; Meedeniya, Adrian C. B.; Horton, Rachel E.; Batzloff, Michael; Owen, Suzzanne J.; Holt, Stephanie; Peak, Ian R.; Ulett, Glen C.; Mackay-Sim, Alan; Beacham, Ifor R.

    2014-01-01

    ABSTRACT Melioidosis is a potentially fatal disease that is endemic to tropical northern Australia and Southeast Asia, with a mortality rate of 14 to 50%. The bacterium Burkholderia pseudomallei is the causative agent which infects numerous parts of the human body, including the brain, which results in the neurological manifestation of melioidosis. The olfactory nerve constitutes a direct conduit from the nasal cavity into the brain, and we have previously reported that B. pseudomallei can colonize this nerve in mice. We have now investigated in detail the mechanism by which the bacteria penetrate the olfactory and trigeminal nerves within the nasal cavity and infect the brain. We found that the olfactory epithelium responded to intranasal B. pseudomallei infection by widespread crenellation followed by disintegration of the neuronal layer to expose the underlying basal layer, which the bacteria then colonized. With the loss of the neuronal cell bodies, olfactory axons also degenerated, and the bacteria then migrated through the now-open conduit of the olfactory nerves. Using immunohistochemistry, we demonstrated that B. pseudomallei migrated through the cribriform plate via the olfactory nerves to enter the outer layer of the olfactory bulb in the brain within 24 h. We also found that the bacteria colonized the thin respiratory epithelium in the nasal cavity and then rapidly migrated along the underlying trigeminal nerve to penetrate the cranial cavity. These results demonstrate that B. pseudomallei invasion of the nerves of the nasal cavity leads to direct infection of the brain and bypasses the blood-brain barrier. PMID:24736221

  2. Management of the Facial Nerve in Lateral Skull Base Surgery Analytic Retrospective Study

    PubMed Central

    El Shazly, Mohamed A.; Mokbel, Mahmoud A.M.; Elbadry, Amr A.; Badran, Hatem S.

    2011-01-01

    Background: Surgical approaches to the jugular foramen are often complex and lengthy procedures associated with significant morbidity based on the anatomic and tumor characteristics. In addition to the risk of intra-operative hemorrhage from vascular tumors, lower cranial nerves deficits are frequently increased after intra-operative manipulation. Accordingly, modifications in the surgical techniques have been developed to minimize these risks. Preoperative embolization and intra-operative ligation of the external carotid artery have decreased the intraoperative blood loss. Accurate identification and exposure of the cranial nerves extracranially allows for their preservation during tumor resection. The modification of facial nerve mobilization provides widened infratemporal exposure with less postoperative facial weakness. The ideal approach should enable complete, one stage tumor resection with excellent infratemporal and posterior fossa exposure and would not aggravate or cause neurologic deficit. The aim of this study is to present our experience in handling jugular foramen lesions (mainly glomus jugulare) without the need for anterior facial nerve transposition. Methods: In this series we present our experience in Kasr ElEini University hospital (Cairo—Egypt) in handling 36 patients with jugular foramen lesions over a period of 20 years where the previously mentioned preoperative and operative rules were followed. The clinical status, operative technique and postoperative care and outcome are detailed and analyzed in relation to the outcome. Results: Complete cure without complications was achieved in four cases of congenital cholesteatoma and four cases with class B glomus. In advanced cases of glomus jugulare (28 patients) (C and D stages) complete cure was achieved in 21 of them (75%). The operative complications were also related to this group of 28 patients, in the form of facial paralysis in 20 of them (55.6%) and symptomatic vagal paralysis in 18 of them (50%). Conclusions: Total anterior rerouting of the facial nerve carries a high risk of facial paralysis. So it should be reserved for cases where the lesion extends beyond the vertical ICA. Otherwise, for less extensive lesions and less aggressive pathologies, less aggressive approaches could be adopted with less hazards. PMID:24179402

  3. Association of Low PON1 Type Q (Type A) Arylesterase Activity with Neurologic Symptom Complexes in Gulf War Veterans

    Microsoft Academic Search

    Robert W. Haley; Scott Billecke; Bert N. La Du

    1999-01-01

    Previously Haley et al. described six possible syndromes identified by factor analysis of symptoms in Gulf War veterans and demonstrated that veterans with these symptom complexes were more neurologically impaired than age–sex–education-matched well controls. They also uncovered strong associations (relative risks 4–8) suggesting that these symptom complexes were related to wartime exposure to combinations of organophosphate pesticides, chemical nerve agents,

  4. A precision mechanical nerve stimulator

    NASA Astrophysics Data System (ADS)

    Tcheng, Ping; Supplee, Frank H., Jr.; Prass, Richard L.

    1988-11-01

    An electromechanical device, used to apply and monitor stimulating pulses to a mammalian motor nerve, has been successfully developed at NASA Langley Research Center. Two existing force transducers, a flight skin friction balance and a miniature skin friction balance which were designed for making aerodynamic drag measurements, were modified and incorporated to form this precision instrument. The nerve stimulator is a type one servomechanism capable of applying and monitoring stimulating pulses of 0 to 10 grams with a precision of better than +/- 0.05 grams. Additionally, the device can be independently used to apply stimulating pulses by displacing the nerve from 0 to 0.25 mm with a precision of better than +/- 0.001 mm while measuring the level of the load applied.

  5. Nerve blocks in palliative care.

    PubMed

    Chambers, W A

    2008-07-01

    Although between 85% and 90% of patients with advanced cancer can have their pain well controlled with the use of analgesic drugs and adjuvants, there are some patients who will benefit from an interventional procedure. This includes a variety of nerve blocks and also some neurosurgical procedures. Approximately 8-10% of patients may benefit from a peripheral nerve block and around 2% from a central neuraxial block. The most common indication is because opioid dose escalation is limited by signs of opioid toxicity but some patients will benefit from one component of their pain being relieved by a simple peripheral block. Most patients about to undergo these procedures are already taking high doses of opiods and obtaining valid consent may pose problems. The use of peripheral nerve blocks, epidural and intrathecal infusions, and plexus blocks is discussed. PMID:18495677

  6. Neurosteroid 3?-Androstanediol Efficiently Counteracts Paclitaxel-Induced Peripheral Neuropathy and Painful Symptoms

    PubMed Central

    Taleb, Omar; Mensah-Nyagan, Ayikoe Guy

    2013-01-01

    Painful peripheral neuropathy belongs to major side-effects limiting cancer chemotherapy. Paclitaxel, widely used to treat several cancers, induces neurological symptoms including burning pain, allodynia, hyperalgesia and numbness. Therefore, identification of drugs that may effectively counteract paclitaxel-induced neuropathic symptoms is crucial. Here, we combined histopathological, neurochemical, behavioral and electrophysiological methods to investigate the natural neurosteroid 3?-androstanediol (3?-DIOL) ability to counteract paclitaxel-evoked peripheral nerve tissue damages and neurological symptoms. Prophylactic or corrective 3?-DIOL treatment (4 mg/kg/2days) prevented or suppressed PAC-evoked heat-thermal hyperalgesia, cold-allodynia and mechanical allodynia/hyperalgesia, by reversing to normal, decreased thermal and mechanical pain thresholds of PAC-treated rats. Electrophysiological studies demonstrated that 3?-DIOL restored control values of nerve conduction velocity and action potential peak amplitude significantly altered by PAC-treatment. 3?-DIOL also repaired PAC-induced nerve damages by restoring normal neurofilament-200 level in peripheral axons and control amount of 2’,3’-cyclic-nucleotide-3’-phosphodiesterase in myelin sheaths. Decreased density of intraepidermal nerve fibers evoked by PAC-therapy was also counteracted by 3?-DIOL treatment. More importantly, 3?-DIOL beneficial effects were not sedation-dependent but resulted from its neuroprotective ability, nerve tissue repairing capacity and long-term analgesic action. Altogether, our results showing that 3?-DIOL efficiently counteracted PAC-evoked painful symptoms, also offer interesting possibilities to develop neurosteroid-based strategies against chemotherapy-induced peripheral neuropathy. This article shows that the prophylactic or corrective treatment with 3?-androstanediol prevents or suppresses PAC-evoked painful symptoms and peripheral nerve dysfunctions in rats. The data suggest that 3?-androstanediol-based therapy may constitute an efficient strategy to explore in humans for the eradication of chemotherapy-induced peripheral neuropathy. PMID:24260511

  7. The cutaneous cervical plexus nerves of the crab-eating macaque (Macaca fascicularis), eastern grey kangaroo (Macropus giganteus), and koala (Phascolarctos cinereus).

    PubMed

    Kato, K; Hopwood, P; Sato, T

    1990-12-01

    The origin, course and distribution of the cutaneous nerves of the cervical plexus were examined in the crab-eating macaque (4 body-halves), the grey kangaroo (5 body-halves) and koala (3 body-halves). The cutaneous nerves, n. auricularis magnus, nn. supraclaviculares, n. transversus colli, and n. transversus cervicis, were recognized. Cranial and caudal branches were identified in the latter 2 nerves. Some intermediate, relatively small branches were recognized between these main nerves. The n. occipitalis minor was not recognized in all our specimens. Four segmental nerves, C2 to C5, gave rise to all the cutaneous nerves and branches of the cervical plexus described. However, between species there was some variation. In the crab-eating macaque the n. auricularis magnus and n. transversus colli tended to arise from a lower segment than in the grey kangaroo and koala. In the grey kangaroo the nn. supraclaviculares arose from a lower segment than in the crab-eating macaque and koala. PMID:2093157

  8. Neuromodulation of the suprascapular nerve.

    PubMed

    Elahi, Foad; Reddy, Chandan G

    2014-01-01

    The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. The painful limitation of shoulder motion affects hand and arm motion as well; therefore, it significantly influences work performance and everyday activities as well as the quality of life. Therefore, the treatment of patients with chronic shoulder pain has major social and health economic implications. In this article we present a patient with a complex history of shoulder pathology including 7 surgeries that left the patient with chronic debilitating shoulder pain. She was suffering from chronic pain and limited mobility of the shoulder joint due to adhesive shoulder capsulitis. She was treated with a multimodality approach with the goals of increasing shoulder range of motion and decreasing her pain. This did not provide significant improvement. The suprascapular nerve supplies motor and sensory innervation to the shoulder, and can be easily accessible in the supraspinatus fossa. A suprascapular nerve block dramatically decreased her pain. This clinical observation along with confirmatory nerve block play an important role during the decision-making process for a trial period of electrical neuromodulation. She was followed for 3 months after the permanent implantation of a suprascapular nerve stimulator. Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge. PMID:25415792

  9. Severe acute inflammatory demyelinating polyradiculoneuropathy with persistent weakness associated with tumor-like nerve root enlargement.

    PubMed

    Stoll, Sharon S; Rakocevic, Goran

    2015-06-01

    We report a 23-year-old woman with rapid onset of proximal and distal limb weakness and areflexia, associated with tumor-like spinal nerve root enlargement and markedly elevated cerebrospinal fluid protein. Our patient developed the inability to walk within days, without preceding illness. Within two weeks, she had near-complete bilateral wrist and foot drop. Her cranial nerves and respiratory function remained intact. She received intravenous immunoglobulin early on for suspected Guillain-barre syndrome but remained wheelchair-bound until 6 Plasma exchange sessions were completed. After that, she continued to improve with intravenous immunoglobulin dosed every 3-4 weeks. Prominent demyelinating features were found on NCS, with cerebrospinal fluid protein of 415 mg/dL. Comprehensive infectious work-up was negative. Magnetic resonance imaging of lumbosacral and cervical spine showed tumor-like masses mistaken for neurofibromatosis (axial diameter, 7.5-10 mm). Repeated magnetic resonance imaging 6 months later showed persistent nerve root enlargement, despite the patient's improved functional status. PMID:25996968

  10. Dissociative symptoms and epilepsy.

    PubMed

    Medford, Nick

    2014-01-01

    This article considers the relationship between various types of dissociative symptoms, including symptoms of depersonalization, derealization, and conversion disorders, and epilepsy. After introductory remarks concerning dissociation, this relationship is discussed through two main themes: firstly, the phenomenology and mechanisms of so-called 'dreamy states' in epilepsy and their closest analogs in psychiatric disorders, and secondly, the similarities and differences between epileptic seizures and psychogenic nonepileptic attacks. Although epileptic and dissociative symptoms may appear similar to observers, they arise through different mechanisms and have different experiential qualities. PMID:24196397

  11. Nerve lesioning with direct current

    NASA Astrophysics Data System (ADS)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  12. [Ultrasound-guided sciatic nerve block].

    PubMed

    Ota, Junichi; Hara, Kaoru

    2008-05-01

    Theoretically, sciatic nerve block can be used alone or in combination with lumbar plexus block or femoral nerve block for anesthesia and/or analgesia of lower limb surgery. However, clinical use of sciatic nerve block was limited by technical difficulties in performing the block since techniques used relies only on surface anatomical landmarks. Recent advances in ultrasound technology allow direct visualization of nerves and other surrounding structures and have increased the interest in performing many kinds of peripheral nerve blocks including sciatic nerve block. Preliminary data suggest that ultrasound-guided technique can help perform the sciatic nerve block more reliably and safely. In this article we describe the anatomy of the sciatic nerve, sonographic features, and technique of three major approaches including subgluteal, anterior, and popliteal approaches. The use of this technique for postoperative analgesia is also discussed. PMID:18516885

  13. Electromagnetic mechanism of magnetic nerve stimulation

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Masuhiro; Yamada, Satoshi; Daimon, Nobuo; Yamamoto, Isao; Kawakami, Tadashi; Takenaka, Toshibumi

    1989-08-01

    Rabbit sciatic nerves were stimulated by pulsed magnetic fields and nerve responses were analyzed on the basis of electromagnetic theory to understand the dominant factors in magnetic stimulation. Some conducting substance surrounding the nerve is required to induce the currents exciting it. The strength of a magnetic stimulus is evaluated by the rate of change in the vector potential at the nerve, dA/dt, which equals the magnitude of the induced electric field E. The minimum strength of dA/dt for exciting the nerve is 18 Wb/ms (18 V/m) in the agar with a conductivity of 0.6 S/m. The induced current density of 10 A/m2 is comparable to that used in the electric stimulation of peripheral nerves. The component of the vector potential parallel to the nerve is more effective in stimulating the nerve than the component perpendicular to it.

  14. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  15. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  16. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  17. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  18. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  19. Voluntary Nerve Signals from Severed Mammalian Nerves: Long-Term Recordings

    E-print Network

    De Luca, Carlo J.

    and peroneal nerves in rabbits. This electrode may prove suitable for implantation in human amputeesVoluntary Nerve Signals from Severed Mammalian Nerves: Long-Term Recordings Abstract. An electrode unit capable ofdetecting voluntarily elicited nerve signals for prolonged periods oftime has been

  20. Microsurgical anatomy of the ocular motor nerves

    Microsoft Academic Search

    Yi ZhangHao; Hao Liu; En-Zhong Liu; You-Zhi Lin; Shi-Guang Zhao; Guo-Hua Jing

    2010-01-01

    This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital\\u000a operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections\\u000a were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the\\u000a nerve

  1. 21 CFR 882.4300 - Manual cranial drills, burrs, trephines, and their accessories

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments that are used without a power source on a patient's skull. (b) Classification. Class II (performance...

  2. 21 CFR 882.4300 - Manual cranial drills, burrs, trephines, and their accessories

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments that are used without a power source on a patient's skull. (b) Classification. Class II (performance...

  3. 21 CFR 882.4300 - Manual cranial drills, burrs, trephines, and their accessories

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments that are used without a power source on a patient's skull. (b) Classification. Class II (performance...

  4. 21 CFR 882.4300 - Manual cranial drills, burrs, trephines, and their accessories

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments that are used without a power source on a patient's skull. (b) Classification. Class II (performance...

  5. 21 CFR 882.4300 - Manual cranial drills, burrs, trephines, and their accessories

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...cranial drills, burrs, trephines, and their accessories are bone cutting and drilling instruments that are used without a power source on a patient's skull. (b) Classification. Class II (performance...

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

    PubMed Central

    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. Symptoms of Ovarian Cancer

    MedlinePLUS

    ... Home What Are the Symptoms of Ovarian Cancer? Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ... Should I Know About Screening? Â Stay Informed Language: English Español (Spanish) File Formats Help: How do I ...

  8. Brain Tumor Symptoms

    MedlinePLUS

    ... Financials Board of Directors Scientific Advisory Council & Reviewers Leadership News Careers Brain Tumor Information Brain Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors Tumor Grade Risk Factors Brain Tumor ...

  9. SELECTIVE STIMULATION OF THE HUMAN OPTIC NERVE

    Microsoft Academic Search

    C. Veraart; J. Delbeke; M.-C. Wanet-Defalque; A. Vanlierde; G. Michaux; S. Parrini; O. Glineur; M. Verleysen; C. Trullemans; J. T. Mortimer

    1999-01-01

    A blind volunteer affected with retinitis pigmentosa was intracranially implanted with a self- sizing cuff electrode around her right optic nerve. The nerve cuff electrode included 4 monopolar contacts. Its leads were brought through the skin where they ended in an external connector12. After recovery from surgery, electrical activation of the implanted optic nerve was undertaken. A specially dedicated Computer

  10. Action of Quaternary Ammonium Salts on Nerve

    Microsoft Academic Search

    S. L. Cowan

    1933-01-01

    EXPERIMENTS similar to those of Fromherz with curare on medullated nerve, referred to by Prof. A. V. Hill in his article on ``The Physical Nature of the Nerve Impulse'',1 in NATURE of April 8, have been made with pure quaternary ammonium salts prepared by Dr. H. R. Ing. These have a curare-like action, preventing transmission of excitation from nerve to

  11. [Neurological symptoms in poisoning].

    PubMed

    Neu, I

    1980-10-01

    Acute and chronic intoxications become manifest in primary neurological symptoms. After a definition of poisoning the autonomic, neurological and psychological disturbances are briefly discussed and the therapeutic measures presented in a table. Later, the neurological symptoms are described with reference to oberservations of cases of lead, thallium, E 605 (parathion), carbon monoxide, mercury, amphetamine and botulin poisoning. Four table and 9 figures supplement the text. PMID:6775212

  12. Split Cranial Bone Grafting in Children Younger Than 3 Years Old: Debunking a Surgical Myth

    PubMed Central

    Vercler, Christian J.; Sugg, Kristoffer B.; Buchman, Steven R.

    2015-01-01

    Background In cranioplasty patients split cranial bone provides excellent structural support and fundamentally “replaces like with like.” However, traditional teaching in craniofacial surgery is that cranial bone cannot be split before the age of 3 years because of the lack of diploic space. The authors have found this not to be the case and describe their experience with splitting cranial bone in children with craniosynostosis younger than 3 years. Methods The authors completed a retrospective review of 418 cranioplasties performed between 1997 and 2013 by a single surgeon on patients younger than 3 years with syndromic and nonsyndromic craniosynostosis. Average patient age at the time of the procedure was 328 days. The youngest patient was 58 days old. Results Of the 418 cranial procedures performed in this study, cranial bone could be split and used as bone graft in every case. Although the presence of Lückenschädel prevented a complete split of the inner table from the outer table of the bone flap, split cranial bone grafting could still be performed, providing significant grafting material to foster reconstruction. No complications from split cranial harvest were observed. Conclusions Contrary to popular belief and the misconception perpetuated by the Plastic Surgery In-Service Examination, the cranium of children younger than 3 years can indeed be safely and predictably split between the inner and outer cortex. This important finding provides the craniofacial surgeon with a valuable, expanded source of rigid bone for cranial vault remodeling in the pediatric patient population. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV. PMID:24867741

  13. IGF1 Promoter Polymorphism and Cranial Growth in Individuals Born Very Preterm

    Microsoft Academic Search

    Anne M. Euser; Martijn J. J. Finken; Aan V. Kharagjitsingh; Behrooz Z. Alizadeh; Bart O. Roep; Ingrid Meulenbelt; Friedo W. Dekker; Jan M. Wit

    2011-01-01

    Background: Major defects in the IGF1 gene are associated with severely reduced cranial and linear growth. The association between IGF1 promoter polymorphisms and growth is uncertain. Aims: To test the effect of the IGF1 192-bp allele on cranial and linear growth and body mass index (BMI) from birth until age 5 years, and on IQ and serum IGF-1 at age

  14. Use of pericranial flaps in the management of cranial base trauma.

    PubMed

    Polley, J W; Penney, D; Cohen, M

    1993-01-01

    Pericranial flaps based on the musuloaponeurotic or myofacial layers of the scalp have great utility in the management of acquired and congenital craniofacial deformities. Their use in traumatic deformities is indicated in the presence of craniopharyngeal communications and significant anterior cranial fossa dead space created from frontal sinus obliteration. The indications and operative techniques and the results of the use of these flaps in 10 consecutive patient with extensive cranial base trauma are presented. PMID:17170889

  15. Subclassification of anencephalic human fetuses according to morphology of the posterior cranial fossa

    Microsoft Academic Search

    Jens Fog Lomholt; Birgit Fischer-Hansen; Jean W. Keeling; Ingermarie Reintoft; Inger Kjær

    2004-01-01

    Anencephaly is a designation for congenital absence of the cranial vault with cerebral hemispheres completely missing or decreased\\u000a to small masses attached to the base of the skull. The etiology is unknown. Whether the bony tissue or soft brain tissue is\\u000a a primary factor is also unknown. The present study has focused on the posterior cranial fossa in anencephaly. The

  16. System behavior of cranial cruciate reconstruction autografts commonly used in the canine stifle 

    E-print Network

    Johnson, Stuart Glenn

    1989-01-01

    SYSTEM BEHAVIOR OF CRANIAL CRUCIATE RECONSTRUCTION AUTOGRAFTS COFWONLY USED IN THE CANINE STIFLE A Thesis by STUART GLENN JOHNSON Submitted to the Office of Graduate Studies of Texas ARM University in partial fulfillment of the requirements... for the degree of MASTER OF SCIENCE August 1989 Major Subject: Veterinary Medicine and Surgery SYSTEM BEHAVIOR OF CRANIAL CRUCIATE RECONSTRUCTION AUTOGRAFTS COMMONLY USED IN THE CANINE STIFLE A Thesis by STUART GLENN JOHNSON Approved as to style...

  17. Sex assessment using odontometry and cranial anthropometry: evaluation in an Indian sample

    Microsoft Academic Search

    Raveena Thapar; Punnya V. Angadi; Seema Hallikerimath; Alka D. Kale

    Crania and teeth are considered to be useful adjuncts for sex assessment and in construction of a postmortem profile, however,\\u000a there is very little information regarding the relationship between tooth and cranial size. The purpose of this study was\\u000a to demonstrate the extent of sexual dimorphism of teeth and cranial size in an adult Indian population and their potential\\u000a in

  18. Contact Dermatitis: Signs and Symptoms

    MedlinePLUS

    ... treatments A - D Contact dermatitis Signs and symptoms Contact dermatitis: Signs and symptoms Allergic contact dermatitis : Testing ... these symptoms, you need immediate medical care. Allergic contact dermatitis This skin condition occurs when you have ...

  19. Effects of Electroacupuncture on Facial Nerve Function and HSV-1 DNA Quantity in HSV-1 Induced Facial Nerve Palsy Mice

    PubMed Central

    Tang, Hongzhi; Feng, Shuwei; Chen, Jiao; Yang, Mingxiao; Zhong, Zhendong; Li, Ying; Liang, Fanrong

    2014-01-01

    Acupuncture is a common and effective therapeutic method to treat facial nerve palsy (FNP). However, its underlying mechanism remains unclear. This study was aimed to investigate the effects of electroacupuncture on symptoms and content of HSV-1 DNA in FNP mice. Mice were randomized into four groups, an electroacupuncture treatment group, saline group, model animal group, and blank control group. Electroacupuncture was applied at Jiache (ST6) and Hegu (LI4) in electroacupuncture group once daily for 14 days, while electroacupuncture was not applied in model animal group. In electroacupuncture group, mice recovered more rapidly and HSV-1 DNA content also decreased more rapidly, compared with model animal group. We conclude that electroacupuncture is effective to alleviate symptoms and promote the reduction of HSV-1 in FNP. PMID:24991226

  20. A flexible platform for biofeedback-driven control and personalization of electrical nerve stimulation therapy.

    PubMed

    Ward, Matthew P; Qing, Kurt Y; Otto, Kevin J; Worth, Robert M; John, Simon W M; Irazoqui, Pedro P

    2015-05-01

    Electrical vagus nerve stimulation is a treatment alternative for many epileptic and depressed patients whose symptoms are not well managed with pharmaceutical therapy. However, the fixed stimulus, open loop dosing mechanism limits its efficacy and precludes major advances in the quality of therapy. A real-time, responsive form of vagus nerve stimulation is needed to control nerve activation according to therapeutic need. This personalized approach to therapy will improve efficacy and reduce the number and severity of side effects. We present autonomous neural control, a responsive, biofeedback-driven approach that uses the degree of measured nerve activation to control stimulus delivery. We demonstrate autonomous neural control in rats, showing that it rapidly learns how to most efficiently activate any desired proportion of vagal A, B, and/or C fibers over time. This system will maximize efficacy by minimizing patient response variability and by minimizing therapeutic failures resulting from longitudinal decreases in nerve activation with increasing durations of treatment. The value of autonomous neural control equally applies to other applications of electrical nerve stimulation. PMID:25167554

  1. Pathology of the optic nerves

    Microsoft Academic Search

    Y. Doron; A. Behar

    1968-01-01

    The optic nerves and chiasma were examined histologically in 124 unselected autopsy cases with clinical histories of arteriosclerotic cardiovascular disease (ASCVD), hypertensive cardiovascular disease (HCVD) and liver parenchymal damage (LPD) with a view to find out possible changes particularly associated with one of the three respective conditions. Statistical test applied to our material revealed, as was to be expected, a

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

    PubMed

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

    2015-04-01

    We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern. PMID:25468011

  3. Chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor promotes sciatic nerve repair

    PubMed Central

    Zhang, Yanru; Zhang, Hui; Katiella, Kaka; Huang, Wenhua

    2014-01-01

    A chemically extracted acellular allogeneic nerve graft can reduce postoperative immune rejection, similar to an autologous nerve graft, and can guide neural regeneration. However, it remains poorly understood whether a chemically extracted acellular allogeneic nerve graft combined with neurotrophic factors provides a good local environment for neural regeneration. This study investigated the repair of injured rat sciatic nerve using a chemically extracted acellular allogeneic nerve graft combined with ciliary neurotrophic factor. An autologous nerve anastomosis group and a chemical acellular allogeneic nerve bridging group were prepared as controls. At 8 weeks after repair, sciatic functional index, evoked potential amplitude of the soleus muscle, triceps wet weight recovery rate, total number of myelinated nerve fibers and myelin sheath thickness were measured. For these indices, values in the three groups showed the autologous nerve anastomosis group > chemically extracted acellular nerve graft + ciliary neurotrophic factor group > chemical acellular allogeneic nerve bridging group. These results suggest that chemically extracted acellular nerve grafts combined with ciliary neurotrophic factor can repair sciatic nerve defects, and that this repair is inferior to autologous nerve anastomosis, but superior to chemically extracted acellular allogeneic nerve bridging alone. PMID:25221592

  4. State of the art cranial ultrasound imaging in neonates.

    PubMed

    Ecury-Goossen, Ginette M; Camfferman, Fleur A; Leijser, Lara M; Govaert, Paul; Dudink, Jeroen

    2015-01-01

    Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal intensive care units, these possibilities are not optimally used. We present a comprehensive approach for neonatal CUS, focusing on optimal settings, different probes, multiple acoustic windows and Doppler techniques. This approach is suited for both routine clinical practice and research purposes. In a live demonstration, we show how this technique is performed in the neonatal intensive care unit. Using optimal settings and probes allows for better imaging quality and improves the diagnostic value of CUS in experienced hands. Traditionally, images are obtained through the anterior fontanel. Use of supplemental acoustic windows (lambdoid, mastoid, and lateral fontanels) improves detection of brain injury. Adding Doppler studies allows screening of patency of large intracranial arteries and veins. Flow velocities and indices can be obtained. Doppler CUS offers the possibility of detecting cerebral sinovenous thrombosis at an early stage, creating a window for therapeutic intervention prior to thrombosis-induced tissue damage. Equipment, data storage and safety aspects are also addressed. PMID:25742241

  5. Genetic basis of cranial cruciate ligament rupture (CCLR) in dogs.

    PubMed

    Baird, Arabella Elizabeth Gardiner; Carter, Stuart D; Innes, John F; Ollier, William E; Short, Andrea D

    2014-08-01

    Cranial Cruciate Ligament rupture (CCLR) is one of the most common forms of lameness in dogs and is analogous to rupture of the anterior cruciate ligament in humans, for which it can serve as a model. As there is a strong breed-related predisposition to CCLR in dogs, a study was undertaken to consider putative genetic components in susceptible dog breeds. A candidate gene, single nucleotide polymorphism (SNP) genotyping approach using MALDI-TOF mass spectrometry (Sequenom Ltd) was designed to investigate several CCLR-susceptible dog breeds and identify CCLR-associated genes/gene regions that may confer susceptibility or resistance. A meta-analysis was performed using the breed case/control candidate gene data to identify SNP associations that were common to the whole cohort of susceptible dogs. We identified SNPs in key genes involved in ligament strength, stability and extracellular matrix formation (COL5A1, COL5A2, COL1A1, COL3A1, COL11A1, COL24A1, FBN1, LOX, LTBP2) which were significantly associated with CCLR susceptibility across the dog breeds used in this study. These SNPs could have an involvement in CCLR due to a detrimental effect on ligament structure and strength. This is the first published candidate gene study that has revealed significant genetic associations with canine CCLR. PMID:24684544

  6. Cranial dimensions and forces of biting in the domestic dog

    PubMed Central

    Ellis, Jennifer Lynn; Thomason, Jeffrey; Kebreab, Ermias; Zubair, Kasim; France, James

    2009-01-01

    The purpose of this paper is to analyse the effects of cranial size and shape in domestic dogs (Canis familiaris) on predicted forces of biting. In addition to continuous size-shape analysis, nine size-shape groups were developed based on three skull shape categories and three skull size categories. Bite forces were predicted from measurements made on dried skulls using two lever models of the skull, as well as simple models derived by regression analysis. Observed bite force values were not available for the database used in this study, so only comparisons between categories and models were undertaken. The effects of shape and size on scaled predicted bite forces were evaluated. Results show that bite force increases as size increases, and this effect was highly significant (P < 0.0001). The effect of skull shape on bite force was significant in medium and large dogs (P < 0.05). Significant differences were not evident in small dogs. Size × shape interactions were also significant (P < 0.05). Bite force predictions by the two lever models were relatively close to each other, whereas the regression models diverged slightly with some negative numbers for very small dogs. The lever models may thus be more robust across a wider range of skull size-shapes. Results obtained here would be useful to the pet food industry for food product development, as well as to paleontologists interested in methods of estimating bite force from dry skulls. PMID:19245503

  7. Cranial trauma in ancient Greece: from Homer to classical authors.

    PubMed

    Konsolaki, Eleni; Astyrakaki, Elisabeth; Stefanakis, George; Agouridakis, Panos; Askitopoulou, Helen

    2010-12-01

    This article presents literary evidence on traumatic cranio-cerebral injuries in ancient Greece from about 900 B.C. to 100 B.C. The main sources of information are epic and classic Greek texts of that period. Homer provides the first literary source of head trauma, which he portrayed in his epic poems The Iliad and The Odyssey. He describes 41 injuries of the head, face and cervical spine, of which all but two were fatal. Subsequently, other classical authors like Plato, Plutarch and others illustrate cases of cranial trauma that occurred mainly in the battlefields, during athletic games or in unusual accidents. They describe some interesting cases of head trauma in prominent men, such as the poet Aeschylos, the kings Pyrrhos and Kyros and Alexander the Great. Most of these descriptions show that the ancient Greeks possessed very good knowledge of the anatomy of the head and neck region and also of the pathophysiological consequences of trauma in the region. PMID:20303279

  8. [RGSS-IDJ and its application to cranial computed tomography].

    PubMed

    Ikeda, M; Sakuma, S; Maruyama, K

    1989-04-25

    RGSS-IDJ is developed as the Japanese version of Report Generation Support System for Imaging Diagnosis (RGSS-ID), which is a developmental computer system that applies artificial intelligence (AI) methods to a reporting system. Now RGSS-IDJ supports the report generation of cranial computed tomography. A representation scheme called Generalized Finding Representation (GFR) is proposed, to bridge the gap between natural language expressions in the radiographic report and AI methods. GRF for RGSS-IDJ is the same as for RGSS-ID. The basic style for entering the findings on the radiograph is the dialogue system with the routine of query and answering it by selecting items with a mouse. This system encodes the input findings into the network expressions, which are represented as the list form in the LISP computer language. And, it reserves them into the knowledge data base. The content of the report will be able to be utilized for various analyses within AI paradigm. The final radiographic report is made in the natural Japanese language. PMID:2798047

  9. Ontogeny of the cranial system in Laonastes aenigmamus

    PubMed Central

    Herrel, Anthony; Fabre, Anne-Claire; Hugot, Jean-Pierre; Keovichit, Kham; Adriaens, Dominique; Brabant, Loes; Van Hoorebeke, Luc; Cornette, Raphael

    2012-01-01

    Rodents, together with bats, are among the ecologically most diverse and most speciose groups of mammals. Moreover, rodents show elaborate specializations of the feeding apparatus in response to the predominantly fore-aft movements of the lower jaw. The Laotian rock rat Laonastes aenigmamus was recently discovered and originally thought to belong to a new family. The difficulties in classifying L. aenigmamus based on morphological characters stem from the fact that it presents a mixture of sciurognathous and hystricognathous characteristics, including the morphology of the jaw adductors. The origin of the unusual muscular organization in this species remains, however, unclear. Here, we investigate the development of the masticatory system in Laonastes to better understand the origin of its derived morphology relative to other rodents. Our analyses show that skull and mandible development is characterized by an overall elongation of the snout region. Muscle mass increases with positive allometry during development and growth, and so does the force-generating capacity of the jaw adductor muscles (i.e. physiological cross-sectional area). Whereas fetal crania and musculature are more similar to those of typical rodents, adults diverge in the elongation of the rostral part of the skull and the disproportionate development of the zygomaticomandibularis. Our data suggest a functional signal in the development of the unusual cranial morphology, possibly associated with the folivorous trophic ecology of the species. PMID:22607030

  10. Cranial size variation and lineage diversity in early Pleistocene Homo.

    PubMed

    Scott, Jeremiah E

    2014-03-01

    A recent article in this journal concluded that a sample of early Pleistocene hominin crania assigned to genus Homo exhibits a pattern of size variation that is time dependent, with specimens from different time periods being more different from each other, on average, than are specimens from the same time period. The authors of this study argued that such a pattern is not consistent with the presence of multiple lineages within the sample, but rather supports the hypothesis that the fossils represent an anagenetically evolving lineage (i.e., an evolutionary species). However, the multiple-lineage models considered in that study do not reflect the multiple-species alternatives that have been proposed for early Pleistocene Homo. Using simulated data sets, I show that fossil assemblages that contain multiple lineages can exhibit the time-dependent pattern of variation specified for the single-lineage model under certain conditions, particularly when temporal overlap among fossil specimens attributed to the lineages is limited. These results do not reject the single-lineage hypothesis, but they do indicate that rejection of multiple lineages in the early Pleistocene Homo fossil record is premature, and that other sources of variation, such as differences in cranial shape, should be considered. PMID:24588348

  11. Cranial neural crest: migratory cell behavior and regulatory networks.

    PubMed

    Gong, Siew-Ging

    2014-07-15

    Defects of the head and neck region account for a substantial portion of all human birth disorders. The high incidence of malformations in this region may be attributed in part to the intricate means by which the facial region is assembled during embryonic development. The starting constituent for the majority of skeletal and connective tissues in the face is a pluripotent population of cells, the cranial neural crest (CNC) cells. This population of cells exhibit remarkable migratory abilities and diversity of potential cell types. This review draws on extensive research that has been done in the field, focusing specifically on findings generated in the last decade on cell behavior and the gene regulatory networks of migratory CNC cells. In the later part of this review, the importance of the CNC cells in the overall development of the craniofacial region will be illustrated with a discussion of a craniofacial birth defect, the Treacher Collins syndrome. The next decade will most likely herald in an era of greater understanding of the integrative molecular networks at different stages of the development of the CNC cells. Such new information is essential towards a better understanding the etiology and pathogenesis of the many craniofacial birth defects and will ultimately lead to new therapeutic modalities. PMID:24680987

  12. Disabling Vertigo and Tinnitus Caused by Intrameatal Compression of the Anterior Inferior Cerebellar Artery on the Vestibulocochlear Nerve: A Case Report, Surgical Considerations, and Review of the Literature

    PubMed Central

    Borghei-Razavi, Hamid; Darvish, Omid; Schick, Uta

    2013-01-01

    Microvascular compression of the vestibulocochlear nerve is known as a cause of tinnitus and vertigo in the literature, but our review of the literature shows that the compression is usually located in the cerebellopontine angle and not intrameatal. We present a case of intrameatal compression of the anterior inferior cerebellar artery (AICA) on the vestibulocochlear nerve of a 40-year-old woman with symptoms of disabling vertigo and intermittent high-frequency tinnitus on the left side without any hearing loss for ? 4 years. Magnetic resonance imaging of the brain did not show any abnormality, but magnetic resonance angiography showed a left intrameatal AICA loop as a possible cause of the disabling symptoms. After the exclusion of other possible reasons for disabling vertigo, surgery was indicated. The intraoperative findings proved the radiologic findings. The large AICA loop was found extending into the internal auditory canal and compressing the vestibulocochlear nerve. The AICA loop was mobilized and separated from the vestibulocochlear nerve. The patient's symptoms resolved immediately after surgery, and no symptoms were noted during 2 years of follow-up in our clinic. Her hearing was not affected by the surgery. In addition to other common reasons, such as acoustic neuroma, disabling vertigo and tinnitus can occur from an intrameatal arterial loop compression of the vestibulocochlear nerve and may be treated successfully by drilling the internal acoustic meatus and separating the arterial conflict from the vestibulocochlear nerve. PMID:25083388

  13. Neuromodulation by Implant for Treating Lower Urinary Tract Symptoms and Dysfunction

    Microsoft Academic Search

    Bart L. H. Bemelmans; Anthony R. Mundy; Michael D. Craggs

    1999-01-01

    Objective: Patients with irritative micturition complaints, pelvic pain, involuntary urine loss or urinary retention are sometimes difficult to treat. The advent of direct sacral nerve stimulation offers a therapeutic alternative if conservative measures fail and surgery is considered. This paper reviews therapeutic neuromodulation by implant for treating lower urinary tract symptoms and dysfunction. Methods: The international literature is reviewed on

  14. Pharmacology of airway afferent nerve activity

    PubMed Central

    Undem, Bradley J; Carr, Michael J

    2001-01-01

    Afferent nerves in the airways serve to regulate breathing pattern, cough, and airway autonomic neural tone. Pharmacologic agents that influence afferent nerve activity can be subclassified into compounds that modulate activity by indirect means (e.g. bronchial smooth muscle spasmogens) and those that act directly on the nerves. Directly acting agents affect afferent nerve activity by interacting with various ion channels and receptors within the membrane of the afferent terminals. Whether by direct or indirect means, most compounds that enter the airspace will modify afferent nerve activity, and through this action alter airway physiology. PMID:11686889

  15. [The nerve agent sarin: history, clinical manifestations, and treatment].

    PubMed

    Yanagisawa, Nobuo

    2014-05-01

    Organic phosphate pesticides were used worldwide after World War II and experiences on poisoning and treatment have been accumulated. An organic phosphate "nerve agent" Sarin was used in two terrorist attacks in Japan in the 1990s. Sarin effects on humans were well documented in these two incidents. Sarin gas inhalation caused instantaneous death by respiratory arrest in several victims in Matsumoto. Severely injured victims presenting with coma and generalized convulsion were resuscitated and recovered rapidly without sequelae. Miosis and blurred-dark vision, ocular pain, copious secretions from respiratory and gastrointestinal tract (muscarinic effects), and headache were common in severely to slightly affected victims. Plasma cholinesterase (ChE) activity decreased in parallel with the severity of signs and symptoms in victims. Oximes, atropine sulphate, diazepam, and ample intravenous infusion were effective treatments. Follow-up examinations on victims were conducted up to 10 years in Matsumoto, and 5 years in Tokyo. No neurological sequelae or abnormalities were observed after 1 year, except for a few EEG abnormalities or delay in sensory nerve conduction velocity. Posttraumatic stress disorder (PTSD) was observed in several of the victims in the 5-year follow up, irrespective of the severity of poisoning at Matsumoto. Psychological symptoms continue in victims of both incidents. PMID:24807372

  16. Cranial muscles of the anurans Leiopelma hochstetteri and Ascaphus truei and the homologies of the mandibular adductors in Lissamphibia and other gnathostomes.

    PubMed

    Johnston, Peter

    2011-12-01

    The frogs Ascaphus truei and Leiopelma hochstetteri are members of the most basal lineages of extant anurans. Their cranial muscles have not been previously described in full and are investigated here by dissection. Comparison of these taxa is used to review a controversy regarding the homologies of the jaw adductor muscles in Lissamphibia, to place these homologies in a wider gnathostome context, and to define features that may be useful for cladistic analysis of Anura. A new muscle is defined in Ascaphus and is designated m. levator anguli oris. The differences noted between Ascaphus and Leiopelma are in the penetration of the jaw adductor muscles by the mandibular nerve (V3). In the traditional view of this anatomy, the paths of the trigeminal nerve branches define homologous muscles. This scheme results in major differences among frogs, salamanders, and caecilians. The alternative view is that the topology of origins, insertions, and fiber directions are defining features, and the nerves penetrate the muscle mass in a variable way. The results given here support the latter view. A new model is proposed for Lissamphibia, whereby the adductor posterior (levator articularis) is a separate entity, and the rest of the adductor mass is configured around it as a folded sheet. This hypothesis is examined in other gnathostomes, including coelacanth and lungfish, and a possible sequence for the evolution of the jaw muscles is demonstrated. In this system, the main jaw adductor in teleost fish is not considered homologous with that of tetrapods. This hypothesis is consistent with available data on the domain of expression of the homeobox gene engrailed 2, which has previously not been considered indicative of homology. Terminology is discussed, and "adductor mandibulae" is preferred to "levator mandibulae" to align with usage in other gnathostomes. PMID:21845732

  17. Isolated oculomotor nerve palsy: a rare manifestation of internal carotid artery dissection.

    PubMed

    Santos, Telma; Morais, Hugo; Oliveira, Gustavo; Barros, Pedro

    2014-01-01

    A 58-year-old man reported sudden-onset binocular double vision that appeared 3?days earlier. He denied history of headache/cervical pain or trauma. He had a medical history of well-controlled diabetes, hypertension and dyslipidaemia. Neurological examination revealed a left-sided ptosis and binocular horizontal diplopia in dextroversion without apparent extraocular-muscle paresis or pupillary involvement. Other cranial nerves were spared as well as motor, sensory and coordination systems. There were no signs of ocular erythema, proptosis or palpable orbital mass. Brain MR angiography revealed a crescent-shaped mural hyperintensity in left internal carotid artery (ICA) at skull base, extending to intrapetrous segment, with reduced calibre and flow, suggesting a left ICA dissection. The patient was started on antiaggregation therapy. A year later he was asymptomatic and CT angiography confirmed ICA recanalisation. PMID:25323280

  18. Amniotic membrane covering for facial nerve repair?

    PubMed Central

    Karaman, Murat; Tuncel, Arzu; Sheidaei, Shahrouz; ?enol, Mehmet Güney; Karabulut, Murat Hakan; Deveci, Ildem; Karaman, Nihan

    2013-01-01

    Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair. PMID:25206390

  19. Neurological Complications in Thyroid Surgery: A Surgical Point of View on Laryngeal Nerves

    PubMed Central

    Varaldo, Emanuela; Ansaldo, Gian Luca; Mascherini, Matteo; Cafiero, Ferdinando; Minuto, Michele N.

    2014-01-01

    The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB) is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle) varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified, the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN) runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction, and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve, which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a low range. PMID:25076936

  20. Neuro-ophthalmological approach to facial nerve palsy.

    PubMed

    Portelinha, Joana; Passarinho, Maria Picoto; Costa, João Marques

    2015-01-01

    Facial nerve palsy is associated with significant morbidity and can have different etiologies. The most common causes are Bell's palsy, Ramsay-Hunt syndrome and trauma, including surgical trauma. Incidence varies between 17 and 35 cases per 100,000. Initial evaluation should include accurate clinical history, followed by a comprehensive investigation of the head and neck, including ophthalmological, otological, oral and neurological examination, to exclude secondary causes. Routine laboratory testing and diagnostic imaging is not indicated in patients with new-onset Bell's palsy, but should be performed in patients with risk factors, atypical cases or in any case without resolution within 4 months. Many factors are involved in determining the appropriate treatment of these patients: the underlying cause, expected duration of nerve dysfunction, anatomical manifestations, severity of symptoms and objective clinical findings. Systemic steroids should be offered to patients with new-onset Bell's palsy to increase the chance of facial nerve recovery and reduce synkinesis. Ophthalmologists play a pivotal role in the multidisciplinary team involved in the evaluation and rehabilitation of these patients. In the acute phase, the main priority should be to ensure adequate corneal protection. Treatment depends on the degree of nerve lesion and on the risk of the corneal damage based on the amount of lagophthalmos, the quality of Bell's phenomenon, the presence or absence of corneal sensitivity and the degree of lid retraction. The main therapy is intensive lubrication. Other treatments include: taping the eyelid overnight, botulinum toxin injection, tarsorrhaphy, eyelid weight implants, scleral contact lenses and palpebral spring. Once the cornea is protected, longer term planning for eyelid and facial rehabilitation may take place. Spontaneous complete recovery of Bell's palsy occurs in up to 70% of cases. Long-term complications include aberrant regeneration with synkinesis. FNP after acoustic neuroma surgery remains the most common indication for FN rehabilitation. PMID:25859138

  1. Free vascularized deep peroneal nerve grafts.

    PubMed

    Koshima, I; Okumoto, K; Umeda, N; Moriguchi, T; Ishii, R; Nakayama, Y

    1996-04-01

    An ideal donor site for vascularized nerve grafts should have a constant anatomy, minimal functional loss after the nerve has been sacrificed, and a dependable blood supply parallel to the nerve over a relatively long distance. Creating a pedicle for a free vascularized deep peroneal nerve graft with the anterior tibial vessels seems to be a most suitable method for repairing long nerve gaps of over 20 cm and digital nerve defects with severe finger damage. Applications of this nerve graft to digital nerve losses with severely scarred beds created by avulsion injury, and two-stage reconstruction in some partial brachial plexus palsies (free vascularized nerve graft in the first stage and free vascularized muscle graft in the second stage) are well indicated. Advantages of this technique are: (1) A long nerve graft (up to 25 cm) can be obtained, and anomalies are rare (the nerve is absent in only 4 percent of cases). (2) The caliber of the vascular pedicle is large (approximately equal to 3 mm). (3) The nerve has a sufficient blood supply from the collateral blood vessels. (4) The graft can be easily obtained in the supine position. (5) A monitoring skin flap, based on the inferior lateral peroneal artery, can be attached to the nerve graft. (6) Sensory loss resulting from the sacrifice of the nerve covers a minimal area. (7) A donor scar on the anterior aspect of the lower leg is more acceptable than one on the posterior aspect because of less movement in walking. Disadvantages of this technique are: (1) Sacrifice of the large vessels in the lower leg may result in circulatory complications in the donor foot; to avoid this problem, preoperative angiography is recommended. (2) The donor scar is in an exposed area in female patients. (3) There may be temporary postoperative edema and disability in the donor leg. PMID:8726331

  2. Effects of age on nerve fibers in the rhesus monkey optic nerve.

    PubMed

    Sandell, J H; Peters, A

    2001-01-22

    During normal aging there is a reduction in white matter volume in the cerebral hemispheres and structural abnormalities in myelin in some parts of the central nervous system, but whether nerve fibers are lost with age and whether the myelin changes are ubiquitous is not known. Studying the optic nerve, which is a circumscribed bundle of nerve fibers, offers an opportunity to gain further insight into the effects of normal aging on white matter. The present study examined the optic nerves from young (4-10 years) and old (27-33 years) rhesus monkeys using light and electron microscopy. These nerves had been perfused transcardially to obtain optimal preservation of the tissue. Varying degrees of degeneration were encountered in all the optic nerves from the old monkeys. The changes included myelin abnormalities, similar to those reported in other parts of the central nervous system; the presence of degenerating axons and their sheaths; changes in neuroglial cells; and thickening of the trabeculae of connective tissue in the nerve. The total number of nerve fibers was reduced from an average of 1.6 x 10(6) in the young optic nerves to as few as 4 x 10(5) in one old monkey, and with one exception in all of the old optic nerves the packing density of nerve fibers was less than in any of the young optic nerves. The degenerative changes were most marked in those optic nerves that contained the fewest nerve fibers. PMID:11135234

  3. Dopaminergic symptoms in migraine.

    PubMed

    Barbanti, Piero; Fofi, L; Aurilia, C; Egeo, G

    2013-05-01

    Migraine pain is often preceded, accompanied and followed by dopaminergic symptoms (premonitory yawning and somnolence, accompanying nausea and vomiting, postdromal somnolence, euphoria and polyuria). After reviewing evidence from pharmacological, biochemical, genetic and animal experimental studies on the relationship between dopamine and migraine, and matching these data with patients' clinical features, we postulate that migraine attacks could be characterized by an ictal dopamine release in a subject with dopamine receptor hypersensitivity due to a chronic dopaminergic deficit synergistic to serotoninergic impairment. Our review suggests that when the attack begins, a low dopamine plasma concentration stimulates hypersensitive central presynaptic dopamine receptors thus causing prodromal symptoms such as yawning and somnolence. Increasing dopamine levels, though still insufficient to stop trigeminovascular activation, stimulate postsynaptic dopamine receptors thus inducing nausea, vomiting and hypotension. Finally, dopamine levels slowly return to baseline, giving rise to somnolence and fatigue, but, in some cases, continue to rise triggering postdromal symptoms such as euphoria and polyuria. PMID:23695049

  4. Asthma Outcomes: Asthma Symptoms

    PubMed Central

    Krishnan, Jerry A.; Lemanske, Robert F.; Canino, Glorisa J.; Elward, Kurtis S.; Kattan, Meyer; Matsui, Elizabeth C.; Mitchell, Herman; Sutherland, E. Rand; Minnicozzi, Michael

    2014-01-01

    Background Respiratory symptoms are commonly used to assess the impact of patient-centered interventions. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to propose which measurements of asthma symptoms should be used as a standardized measure in future clinical research studies. Methods Asthma symptom instruments were classified as daily diaries (prospectively recording symptoms between research visits) or retrospective questionnaires (completed at research visits). We conducted a systematic search in PubMed and a search for articles that cited key studies describing development of instruments. We classified outcome instruments as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results Four instruments (3 daily diaries, 1 for adults and 2 for children; and 1 retrospective questionnaire for adults) were identified. Minimal clinically important differences have not been established for these instruments, and validation studies were only conducted in a limited number of patient populations. Validity of existing instruments may not be generalizable across racial-ethnic or other subgroups. Conclusions An evaluation of symptoms should be a core asthma outcome measure in clinical research. However, available instruments have limitations that preclude selection of a core instrument. The working group participants propose validation studies in diverse populations, comparisons of diaries versus retrospective questionnaires, and evaluations of symptom assessment alone versus composite scores of asthma control. PMID:22386505

  5. In vivo detection of nerve injury in familial amyloid polyneuropathy by magnetic resonance neurography

    PubMed Central

    Hund, Ernst; Hornung, Benjamin; Hegenbart, Ute; Schönland, Stefan O.; Kimmich, Christoph; Kristen, Arnt V.; Purrucker, Jan; Röcken, Christoph; Heiland, Sabine; Bendszus, Martin; Pham, Mirko

    2015-01-01

    Transthyretin familial amyloid polyneuropathy is a rare, autosomal-dominant inherited multisystem disorder usually manifesting with a rapidly progressive, axonal, distally-symmetric polyneuropathy. The detection of nerve injury by nerve conduction studies is limited, due to preferential involvement of small-fibres in early stages. We investigated whether lower limb nerve-injury can be detected, localized and quantified in vivo by high-resolution magnetic resonance neurography. We prospectively included 20 patients (12 male and eight female patients, mean age 47.9 years, range 26–66) with confirmed mutation in the transthyretin gene: 13 with symptomatic polyneuropathy and seven asymptomatic gene carriers. A large age- and sex-matched cohort of healthy volunteers served as controls (20 male and 20 female, mean age 48.1 years, range 30–73). All patients received detailed neurological and electrophysiological examinations and were scored using the Neuropathy Impairment Score–Lower Limbs, Neuropathy Deficit and Neuropathy Symptom Score. Magnetic resonance neurography (3 T) was performed with large longitudinal coverage from proximal thigh to ankle-level and separately for each leg (140 axial slices/leg) by using axial T2-weighted (repetition time/echo time = 5970/55 ms) and dual echo (repetition time 5210 ms, echo times 12 and 73 ms) turbo spin echo 2D sequences with spectral fat saturation. A 3D T2-weighted inversion-recovery sequence (repetition time/echo time 3000/202 ms) was acquired for imaging of the spinal nerves and lumbar plexus (50 axial slice reformations). Precise manual segmentation of the spinal/sciatic/tibial/common peroneal nerves was performed on each slice. Histogram-based normalization of nerve–voxel signal intensities was performed using the age- and sex-matched control group as normative reference. Nerve-voxels were subsequently classified as lesion-voxels if a threshold of >1.2 (normalized signal-intensity) was exceeded. At distal thigh level, where a predominant nerve–lesion–voxel burden was observed, signal quantification was performed by calculating proton spin density and T2-relaxation time as microstructural markers of nerve tissue integrity. The total number of nerve–lesion voxels (cumulated from proximal-to-distal) was significantly higher in symptomatic patients (20 405 ± 1586) versus asymptomatic gene carriers (12 294 ± 3199; P = 0.036) and versus controls (6536 ± 467; P < 0.0001). It was also higher in asymptomatic carriers compared to controls (P = 0.043). The number of nerve–lesion voxels was significantly higher at thigh level compared to more distal levels (lower leg/ankle) of the lower extremities (f-value = 279.22, P < 0.0001). Further signal-quantification at this proximal site (thigh level) revealed a significant increase of proton-density (P < 0.0001) and T2-relaxation-time (P = 0.0011) in symptomatic patients, whereas asymptomatic gene-carriers presented with a significant increase of proton-density only. Lower limb nerve injury could be detected and quantified in vivo on microstructural level by magnetic resonance neurography in symptomatic familial amyloid polyneuropathy, and also in yet asymptomatic gene carriers, in whom imaging detection precedes clinical and electrophysiological manifestation. Although symptoms start and prevail distally, the focus of predominant nerve injury and injury progression was found proximally at thigh level with strong and unambiguous lesion-contrast. Imaging of proximal nerve lesions, which are difficult to detect by nerve conduction studies, may have future implications also for other distally-symmetric polyneuropathies. PMID:25526974

  6. Sexual dimorphism in cranial morphology among modern South Africans.

    PubMed

    Krüger, Gabriele Christa; L'Abbé, Ericka N; Stull, Kyra E; Kenyhercz, Michael W

    2015-07-01

    Pattern expressions of morphoscopic cranial traits vary across populations with classification accuracies being highly dependent on the reference collection to which unknown skulls are compared. Despite recent developments in population-specific standards for South Africans, researchers have not addressed the accuracy of morphological methods. Several studies demonstrate differences in sexual dimorphism between South Africans and North Americans, warranting a need to re-evaluate sex estimation methods in South Africa. The purposes of this study were to test the reliability and accuracy of the Walker (2008) method and to examine patterns of sexual dimorphism among South Africans. A total of 245 modern Black and White South African male and female crania from the Pretoria Bone Collection, University of Pretoria, were scored using the Walker (2008) methodology. Cohen's kappa was used to evaluate reliability of the method, and percent correct assessed validity of the method. Logistic regression was utilised to create modified population-specific formulae. Inter- and intra-observer agreement was moderate to excellent (0.60-0.90), except for the mental eminence (0.40). The percent correct results for sex were 80 % or higher for combinations of glabella, mastoid and menton and between 68 % and 73 % for menton, mastoid, orbital and nuchal margin using logistic equations of Walker (2008). White males had the highest (94-97 %) and White females had the lowest (31-62 %) percent correct. The low accuracies obtained when using Walker's (2008) equations emphasised the need for population-specific sex estimation models. Modified formulae for South Africans were created, yielding higher classification rates (84-93 %) than when North American standards were employed. PMID:25394745

  7. Skeletogenic fate of zebrafish cranial and trunk neural crest.

    PubMed

    Kague, Erika; Gallagher, Michael; Burke, Sally; Parsons, Michael; Franz-Odendaal, Tamara; Fisher, Shannon

    2012-01-01

    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. PMID:23155370

  8. Skeletogenic Fate of Zebrafish Cranial and Trunk Neural Crest

    PubMed Central

    Burke, Sally; Parsons, Michael; Franz-Odendaal, Tamara; Fisher, Shannon

    2012-01-01

    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. PMID:23155370

  9. Does the cranial suspensory ligament have a role in cryptorchidism?

    PubMed

    Kassim, Normadiah M; Russell, D A; Payne, A P

    2010-01-01

    The cranial suspensory ligament (CSL) is a fibromuscular structure anchoring the embryonic gonad to the posterior abdominal wall in male and female mammals. Its persistence in females is believed to be responsible for retaining the ovaries within the abdomen, while its regression in males permits testis descent. Embryonic loss of the CSL in males is believed to be an androgen-dependent event, and failure of this process has been proposed as a cause of cryptorchidism. The present study demonstrates that the nuclei of mesenchymal cells in the caudal part of the CSL are immunoreactively positive for androgen receptor. We examined the effects of exposure of the non-steroidal antiandrogen flutamide during the period from gestational day 10 to birth on the development of the CSL and on testis descent. Exposure of male Albino Swiss rats to the antiandrogen flutamide during this period resulted in feminization of the external genitalia and the suppression of growth of the testes and male reproductive tracts. In adulthood, testes were found to be located in diverse positions including normal scrotal (50%), intra-abdominal (10%) and ectopic suprainguinal (40%). The CSL of the testis persisted into adulthood in all flutamide-treated males, regardless of testis location. In all cases, the ligament consisted of bundles of smooth muscle fibres in the retroperitoneal fat of the posterior abdominal wall. These findings suggest that androgen blockade during embryonic development interferes with testicular descent, but that maldescent cannot be correlated with either the persistence of the CSL of the testis or its structure. PMID:19940435

  10. Mechanics of cranial sutures during simulated cyclic loading.

    PubMed

    Jasinoski, S C; Reddy, B D

    2012-07-26

    Previous computational and experimental analyses revealed that cranial sutures, fibrous joints between the bones, can reduce the strain experienced by the surrounding skull bones during mastication. This damping effect reflects the importance of including sutures in finite element (FE) analyses of the skull. Using the FE method, the behaviour of three suture morphologies of increasing complexity (butt-ended, moderate interdigitated, and complex interdigitated) during static loading was recently investigated, and the sutures were assumed to have linear elastic properties. In the current study, viscoelastic properties, derived from published experimental results of the nasofrontal suture of young pigs (Sus scrofa), are applied to the three idealised bone-suture models. The effects of suture viscoelasticity on the stress, strain, and strain energy in the models were computed for three different frequencies (corresponding to periods of 1, 10, and 100s) and compared to the results of a static, linear elastic analysis. The range of applied frequencies broadly represents different physiological activities, with the highest frequency simulating mastication and the lowest frequency simulating growth and pressure of the surrounding tissues. Comparing across all three suture morphologies, strain energy and strain in the suture decreased with the increase in suture complexity. For each suture model, the magnitude of strain decreased with an increase in frequency, and the magnitudes were similar for both the elastic and 1s frequency analyses. In addition, a viscous response is less apparent in the higher frequency analyses, indicating that viscous properties are less important to the behaviour of the suture during those analyses. The FE results suggest that implementation of viscoelastic properties may not be necessary for computational studies of skull behaviour during masticatory loading but instead might be more relevant for studies examining lower frequency physiological activities. PMID:22703899

  11. Effects of cranial electrotherapy stimulation on resting state brain activity

    PubMed Central

    Feusner, Jamie D; Madsen, Sarah; Moody, Teena D; Bohon, Cara; Hembacher, Emily; Bookheimer, Susan Y; Bystritsky, Alexander

    2012-01-01

    Cranial electrotherapy stimulation (CES) is a U.S. Food and Drug Administration (FDA)-approved treatment for insomnia, depression, and anxiety consisting of pulsed, low-intensity current applied to the earlobes or scalp. Despite empirical evidence of clinical efficacy, its mechanism of action is largely unknown. The goal was to characterize the acute effects of CES on resting state brain activity. Our primary hypothesis was that CES would result in deactivation in cortical and subcortical regions. Eleven healthy controls were administered CES applied to the earlobes at subsensory thresholds while being scanned with functional magnetic resonance imaging in the resting state. We tested 0.5- and 100-Hz stimulation, using blocks of 22 sec “on” alternating with 22 sec of baseline (device was “off”). The primary outcome measure was differences in blood oxygen level dependent data associated with the device being on versus baseline. The secondary outcome measures were the effects of stimulation on connectivity within the default mode, sensorimotor, and fronto-parietal networks. Both 0.5- and 100-Hz stimulation resulted in significant deactivation in midline frontal and parietal regions. 100-Hz stimulation was associated with both increases and decreases in connectivity within the default mode network (DMN). Results suggest that CES causes cortical brain deactivation, with a similar pattern for high- and low-frequency stimulation, and alters connectivity in the DMN. These effects may result from interference from high- or low-frequency noise. Small perturbations of brain oscillations may therefore have significant effects on normal resting state brain activity. These results provide insight into the mechanism of action of CES, and may assist in the future development of optimal parameters for effective treatment. PMID:22741094

  12. Concomitant abducens and facial nerve palsies following blunt head trauma associated with bone fracture.

    PubMed

    Ji, Min-Jeong; Han, Sang-Beom; Lee, Seung-Jun; Kim, Moosang

    2015-01-01

    A 22-year-old man was referred for horizontal diplopia that worsened on left gaze. He had been admitted for a head trauma caused by a traffic accident. Brain CT scan showed a longitudinal fracture of the left temporal bone with extension to the left carotid canal and central skull base, including sphenoid lateral wall and roof, and left orbit medial wall non-displaced fracture. Prism cover test revealed 20 prism diopters of esotropia and abduction limitation in the left eye. Hess screening test results were compatible with left abducens nerve paralysis. Symptoms suggesting complete lower motor neuron palsy of the left facial nerve, such as unilateral facial drooping, inability to raise the eyebrow and difficulty closing the eye, were present. As there was no improvement in facial paralysis, the patient received surgical intervention using a transmastoidal approach. Three months postoperatively, prism cover test showed orthotropia, however, the facial nerve palsy persisted. PMID:26178005

  13. [Intraneural cysts of the peroneal nerve in childhood: report of 2 cases and literature review].

    PubMed

    Robla-Costales, J; Socolovsky, M; Dubrovsky, A; Astorino, F; Fernández-Fernández, J; Ibáñez-Plágaro, J; García-Cosamalón, J

    2011-08-01

    Intraneural cysts are benign lesions filled with mucinous content and located inside the epineurum of the peripheral nerves. Peroneal nerve is the most affected nerve. The entity is rare and its ethiopathology still remains to be definitely elucidated. In 2003 Spinner et al published their articular theory, implicated in the formation and frequent recurrence of these lesions after surgical treatment. The practical application of this theory, nowadays almost universally accepted, generated an important diminution in the recurrence rate after surgical evacuation of this lesions, previously very elevated. Most of the cases of this entity are described in adults. In the present paper we describe two pediatric cases and analyze the clinical aspects of these cysts in pediatric and adults patients. Peroneal intraneural cysts are one of the differential diagnoses in foot drop, and an adequate treatment concludes in a complete remission of the symptoms. PMID:21858406

  14. Optogenetic control of nerve growth

    PubMed Central

    Park, Seongjun; Koppes, Ryan A.; Froriep, Ulrich P.; Jia, Xiaoting; Achyuta, Anil Kumar H.; McLaughlin, Bryan L.; Anikeeva, Polina

    2015-01-01

    Due to the limited regenerative ability of neural tissue, a diverse set of biochemical and biophysical cues for increasing nerve growth has been investigated, including neurotrophic factors, topography, and electrical stimulation. In this report, we explore optogenetic control of neurite growth as a cell-specific alternative to electrical stimulation. By investigating a broad range of optical stimulation parameters on dorsal root ganglia (DRGs) expressing channelrhodopsin 2 (ChR2), we identified conditions that enhance neurite outgrowth by three-fold as compared to unstimulated or wild-type (WT) controls. Furthermore, optogenetic stimulation of ChR2 expressing DRGs induces directional outgrowth in WT DRGs co-cultured within a 10?mm vicinity of the optically sensitive ganglia. This observed enhancement and polarization of neurite growth was accompanied by an increased expression of neural growth and brain derived neurotrophic factors (NGF, BDNF). This work highlights the potential for implementing optogenetics to drive nerve growth in specific cell populations. PMID:25982506

  15. Spatial packing, cranial base angulation, and craniofacial shape variation in the mammalian skull: testing a new model using mice

    PubMed Central

    Lieberman, Daniel E; Hallgrímsson, Benedikt; Liu, Wei; Parsons, Trish E; Jamniczky, Heather A

    2008-01-01

    The hypothesis that variation in craniofacial shape within and among species is influenced by spatial packing has a long history in comparative anatomy, particularly in terms of primates. This study develops and tests three alternative models of spatial packing to address how and to what extent the cranial base angle is influenced by variation in brain and facial size. The models are tested using mouse strains with different mutations affecting craniofacial growth. Although mice have distinctive crania with small brains, long faces, and retroflexed cranial bases, the results of the study indicate that the mouse cranial base flexes to accommodate larger brain size relative to cranial base length. In addition, the mouse cranial base also extends, but to a lesser degree, to accommodate larger face size relative to cranial base length. In addition, interactions between brain size, face size, and the widths and lengths of the components of the cranial base account for a large percentage of variation in cranial base angle. The results illustrate the degree to which the cranial base is centrally embedded within the covariation structure of the craniofacial complex as a whole. PMID:18510502

  16. A comparison of nerve conduction velocities and current perception thresholds as correlates of clinical severity of diabetic sensory neuropathy

    Microsoft Academic Search

    M S Rendell; J J Katims; R Richter; F Rowland

    1989-01-01

    Nerve conduction velocities (NCVs) are the standard measurements used to confirm the presence or absence of diabetic neuropathy. NCVs were contrasted with the newer technique of measurement of alternating current perception thresholds (CPTs) in assessing the quantitative level of correlation with severity of diabetic sensory neuropathy. A very detailed, scored neurological history (symptoms) and physical examination, emphasising sensory assessment, was

  17. Evaluation of Real-Time PCR in CSF and Nerve Sheath Biopsy Compared to EM Examination in Neuro-Leprosy

    Microsoft Academic Search

    Heba M. Dia; Shereen B. El Sayed; Rasha G. Abusinna

    Background. The diagnosis of pure neural leprosy (PNL) is difficult especially with absence of dermatological symptoms and signs. It is overlooked by many physicians and the patient is usually diagnosed as neural leprosy by exclusion of other possibilities that is expensive and misleading. Objective. To evaluate the sensitivity of Real-Time polymerase chain reaction (PCR) in diagnosis of PNL in nerve

  18. Transverse Ultrasound Assessment of Median Nerve Deformation and Displacement in the Human Carpal Tunnel during Wrist Movements

    PubMed Central

    Wang, Yuexiang; Zhao, Chunfeng; Passe, Sandra M.; Filius, Anika; Thoreson, Andrew R.; An, Kai-Nan; Amadio, Peter C.

    2013-01-01

    The symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. In order to better understand the biomechanics of the abnormal nerve, it is first necessary to understand normal nerve movement. The purpose of this study was to evaluate the deformation and displacement of the normal median nerve at the proximal carpal tunnel level on transverse ultrasound images during different wrist movements, in order to have a baseline for comparison with abnormal movements. Dynamic ultrasound images were obtained in both wrists of 10 asymptomatic volunteers during wrist maximal flexion, extension and ulnar deviation. In order to simplify the analysis, the initial and final shape and position of the median nerve were measured and analyzed. The circularity of the median nerve was significantly increased and the aspect ratio and perimeter were significantly decreased in the final image compared to that in the first image during wrist flexion with finger extension, wrist flexion with finger flexion and wrist ulnar deviation with finger extension (p<0.01). There were significant differences in median nerve displacement vector between finger flexion, wrist flexion with finger extension and wrist ulnar deviation with finger extension (all p<0.001). The mean amplitudes of the median nerve motion in wrist flexion with finger extension (2.36±0.79 NU), wrist flexion with finger flexion (2.46±0.84 NU) and wrist ulnar deviation with finger extension (2.86±0.51 NU) were higher than those in finger flexion (0.82±0.33 NU), wrist extension with finger extension (0.77±0.46 NU) and wrist extension with finger flexion (0.81±0.58 NU) (p<0.0001). In the normal carpal tunnel, wrist flexion and ulnar deviation could induce significant transverse displacement and deformation of the median nerve. PMID:24210862

  19. Mechanisms of nerve injury in leprosy.

    PubMed

    Scollard, David M; Truman, Richard W; Ebenezer, Gigi J

    2015-01-01

    All patients with leprosy have some degree of nerve involvement. Perineural inflammation is the histopathologic hallmark of leprosy, and this localization may reflect a vascular route of entry of Mycobacterium leprae into nerves. Once inside nerves, M. leprae are ingested by Schwann cells, with a wide array of consequences. Axonal atrophy may occur early in this process; ultimately, affected nerves undergo segmental demyelination. Knowledge of the mechanisms of nerve injury in leprosy has been greatly limited by the minimal opportunities to study affected nerves in man. The nine-banded armadillo provides the only animal model of the pathogenesis of M. leprae infection. New tools available for this model enable the study and correlation of events occurring in epidermal nerve fibers, dermal nerves, and nerve trunks, including neurophysiologic parameters, bacterial load, and changes in gene transcription in both neural and inflammatory cells. The armadillo model is likely to enhance understanding of the mechanisms of nerve injury in leprosy and offers a means of testing proposed interventions. PMID:25432810

  20. Initial Symptoms of ALS

    MedlinePLUS

    ... variable from one person to another. Although the mean survival time with ALS is three to five years, many people live five, 10 or more years. Symptoms can begin in the muscles that control speech and swallowing or in the hands, arms, ...

  1. Tetanus: Symptoms and Complications

    MedlinePLUS

    ... materials (aspiration pneumonia) Breathing difficulty, possibly leading to death (10-20% of cases are fatal) Â Top of Page Related Page Symptoms/Complications for Clinicians Related Links Tetanus Vaccination Maternal and Neonatal Tetanus Elimination File Formats Help: How do I ...

  2. E. coli Symptoms

    MedlinePLUS

    ... 5 days after eating contaminated food or drinking contaminated liquids. Symptoms may last for 8 days, and most people recover completely from the disease. Last Updated November 16, 2011 Stay Connected: Home | Contact Us | Help | Site Map | Accessibility | Privacy Policy | Disclaimer | Website Links & Policies | ...

  3. Bullying and PTSD Symptoms

    ERIC Educational Resources Information Center

    Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

    2012-01-01

    PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

  4. An alternative to the classical nerve graft for the management of the short nerve gap.

    PubMed

    Dellon, A L; Mackinnon, S E

    1988-11-01

    Reconstruction of a short nerve gap by a nerve graft produces donor-site scarring, loss of donor nerve function, and neuroma formation. This study compared the regeneration achieved after 1 year in 16 monkeys across a 3-cm upper arm ulnar nerve gap with a bioabsorbable polyglycolic acid nerve conduit with the regeneration achieved with a classical interfascicular interpositional sural nerve graft. The results demonstrated electrophysiologic and histologic evidence of neural regeneration across the gaps in all experimental groups. The bioabsorbable nerve conduit groups and the sural nerve graft group had mean fiber diameters, amplitudes, and conduction velocities each significantly less than those of normal control ulnar nerves. There was, however, no significant difference between any of the experimental groups. Electromyography demonstrated recovery of 19 of the 28 (68 percent) intrinsic muscles studied. These results demonstrate that the primate peripheral nerve can regenerate across short nerve gaps when guided by an appropriate nerve conduit, suggesting that a single-stage biodegradable polyglycolic acid conduit may be used as an alternative to a short interfascicular nerve graft. PMID:2845455

  5. Use of nerve elongator to repair short-distance peripheral nerve defects: a prospective randomized study

    PubMed Central

    Bai, Lu; Wang, Tian-bing; Wang, Xin; Zhang, Wei-wen; Xu, Ji-hai; Cai, Xiao-ming; Zhou, Dan-ya; Cai, Li-bing; Pan, Jia-dong; Tian, Min-tao; Chen, Hong; Zhang, Dian-ying; Fu, Zhong-guo; Zhang, Pei-xun; Jiang, Bao-guo

    2015-01-01

    Repair techniques for short-distance peripheral nerve defects, including adjacent joint flexion to reduce the distance between the nerve stump defects, “nerve splint” suturing, and nerve sleeve connection, have some disadvantages. Therefore, we designed a repair technique involving intraoperative tension-free application of a nerve elongator and obtained good outcomes in the repair of short-distance peripheral nerve defects in a previous animal study. The present study compared the clinical outcomes between the use of this nerve elongator and performance of the conventional method in the repair of short-distance transection injuries in human elbows. The 3-, 6-, and 12-month postoperative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group, but no significant difference in long-term neurological function recovery was detected between the two groups. In the nerve elongation group, the nerves were sutured without tension, and the duration of postoperative immobilization of the elbow was decreased. Elbow function rehabilitation was significantly better in the nerve elongation group than in the control group. Moreover, there were no security risks. The results of this study confirm that the use of this nerve elongator for repair of short-distance peripheral nerve defects is safe and effective. PMID:25788924

  6. Sciatic nerve regeneration using a nerve growth factor-containing fibrin glue membrane

    PubMed Central

    Ma, Shengzhong; Peng, Changliang; Wu, Shiqing; Wu, Dongjin; Gao, Chunzheng

    2013-01-01

    Our previous findings confirmed that the nerve growth factor-containing fibrin glue membrane provides a good microenvironment for peripheral nerve regeneration; however, the precise mechanism remains unclear. p75 neurotrophin receptor (p75NTR) plays an important role in the regulation of peripheral nerve regeneration. We hypothesized that a nerve growth factor-containing fibrin glue membrane can promote neural regeneration by up-regulating p75NTR expression. In this study, we used a silicon nerve conduit to bridge a 15 mm-long sciatic nerve defect and injected a mixture of nerve growth factor and fibrin glue at the anastomotic site of the nerve conduit and the sciatic nerve. Through RT-PCR and western blot analysis, nerve growth factor-containing fibrin glue membrane significantly increased p75NTR mRNA and protein expression in the Schwann cells at the anastomotic site, in particular at 8 weeks after injection of the nerve growth factor/fibrin glue mixture. These results indicate that nerve growth factor-containing fibrin glue membrane can promote peripheral nerve regeneration by up-regulating p75NTR expression in Schwann cells. PMID:25206664

  7. Nanofibrous nerve conduits for repair of 30-mm-long sciatic nerve defects

    PubMed Central

    Biazar, Esmaeil; Keshel, Saeed Heidari; Pouya, Majid; Rad, Hadi; Nava, Melody Omrani; Azarbakhsh, Mohammad; Hooshmand, Shirin

    2013-01-01

    It has been confirmed that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit can promote peripheral nerve regeneration in rats. However, its efficiency in repair of over 30-mm-long sciatic nerve defects needs to be assessed. In this study, we used a nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit to bridge a 30-mm-long gap in the rat sciatic nerve. At 4 months after nerve conduit implantation, regenerated nerves were cally observed and histologically assessed. In the nanofibrous graft, the rat sciatic nerve trunk had been reconstructed by restoration of nerve continuity and formation of myelinated nerve fiber. There were Schwann cells and glial cells in the regenerated nerves. Masson's trichrome staining showed that there were no pathological changes in the size and structure of gastrocnemius muscle cells on the operated side of rats. These findings suggest that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit is suitable for repair of long-segment sciatic nerve defects. PMID:25206536

  8. Compartmentalization of immune responses during Staphylococcus aureus cranial bone flap infection.

    PubMed

    Cheatle, Joseph; Aldrich, Amy; Thorell, William E; Boska, Michael D; Kielian, Tammy

    2013-08-01

    Decompressive craniectomy is often required after head trauma, stroke, or cranial bleeding to control subsequent brain swelling and prevent death. The infection rate after cranial bone flap replacement ranges from 0.8% to 15%, with an alarming frequency caused by methicillin-resistant Staphylococcus aureus, which is problematic because of recalcitrance to antibiotic therapy. Herein we report the establishment of a novel mouse model of S. aureus cranial bone flap infection that mimics several aspects of human disease. Bacteria colonized bone flaps for up to 4 months after infection, as revealed by scanning electron microscopy and quantitative culture, demonstrating the chronicity of the model. Analysis of a human cranial bone flap with confirmed S. aureus infection by scanning electron microscopy revealed similar structural attributes as the mouse model, demonstrating that it closely parallels structural facets of human disease. Inflammatory indices were most pronounced within the subcutaneous galeal compartment compared with the underlying brain parenchyma. Specifically, neutrophil influx and chemokine expression (CXCL2 and CCL5) were markedly elevated in the galea, which demonstrated substantial edema on magnetic resonance images, whereas the underlying brain parenchyma exhibited minimal involvement. Evaluation of immune mechanisms required for bacterial containment and inflammation revealed critical roles for MyD88-dependent signaling and neutrophils. This novel mouse model of cranial bone flap infection can be used to identify key immunologic and therapeutic mechanisms relevant to persistent bone flap infection in humans. PMID:23747950

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed Central

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

    2012-01-01

    Objectives: The aim of this study is to test the possible orthopedic effects of cervical headgear on the cranial base and maxilla. Study design: a sample consisting of 79 subjects with skeletal class II malocclusion was divided into two groups. The experimental group was made up of 41 patients all treated with cervical headgear. The control group included a total of 38 non-treated patients. Each one of these groups was then subdivided according to age into one of three groups: prepubescent, pubescent or post-pubescent. Cephalometric parameters were compared in both groups in order to measure the cranial base angle and the vertical and sagittal position of the maxilla. Additionally, cephalometric superimpositions taken at the beginning and end of the study were compared. Results: results revealed significant differences in the cranial base angle and in the SNA angle (p<0.05). However, no differences were observed in the variables that measure the maxillomandibular relationship. While no changes were noted in the palatal plane slope, a flattening of the cranial base was found caused by the cervical headgear, in addition to a retrusion of point A that does not mean there was a reduction in the maxillomandibular relationship. Conclusions: cervical headgear treatment induces cephalometric flattening of the cranial base and a decrease of the SNA angle. Key words:Orthodontics, cervical headgear, class II treatment, cephalometry, superimposition. PMID:22322499

  11. Molecular basis of cranial suture biology and disease: Osteoblastic and osteoclastic perspectives

    PubMed Central

    Beederman, Maureen; Farina, Evan M.; Reid, Russell R.

    2014-01-01

    The normal growth and development of the skull is a tightly regulated process that occurs along the osteogenic interfaces of the cranial sutures. Here, the borders of the calvarial bones and neighboring tissues above and below, function as a complex. Through coordinated remodeling efforts of bone deposition and resorption, the cranial sutures maintain a state of patency from infancy through early adulthood as the skull continues to grow and accommodate the developing brain's demands for expansion. However, when this delicate balance is disturbed, a number of pathologic conditions ensue; and if left uncorrected, may result in visual and neurocognitive impairments. A prime example includes craniosynostosis, or premature fusion of one or more cranial and/or facial suture(s). At the present time, the only therapeutic measure for craniosynostosis is surgical correction by cranial vault reconstruction. However, elegant studies performed over the past decade have identified several genes critical for the maintenance of suture patency and induction of suture fusion. Such deeper understandings of the pathogenesis and molecular mechanisms that regulate suture biology may provide necessary insights toward the development of non-surgical therapeutic alternatives for patients with cranial suture defects. In this review, we discuss the intricate cellular and molecular interplay that exists within the suture among its three major components: dura mater, osteoblastic related molecular pathways and osteoclastic related molecular pathways. PMID:25426492

  12. Functional and structural nerve fiber findings in heterozygote patients with Fabry disease.

    PubMed

    Torvin Møller, Anette; Winther Bach, Flemming; Feldt-Rasmussen, Ulla; Rasmussen, Ase; Hasholt, Lis; Lan, He; Sommer, Claudia; Kølvraa, Steen; Ballegaard, Martin; Staehelin Jensen, Troels

    2009-09-01

    Fabry disease is an X-linked inherited lysosomal disorder with dysfunction of the lysosomal enzyme alpha-galactosidase A causing accumulation of glycolipids in multiple organs including the nervous system. Pain and somatosensory disturbances are prominent manifestations of this disease. Until recently disease manifestations in female carriers of Fabry disease have been questioned. To explore the frequency of symptoms and the functional and structural involvement of the nervous system in female patients we examined the presence of pain, manifestations of peripheral neuropathy and nerve density in skin biopsies in 19 female patients with Fabry disease and 19 sex- and age-matched controls. Diaries, quantitative sensory testing, neurophysiologic tests and skin biopsies were performed. Daily pain was present in 63% of patients, with a median VAS score of 4.0. Tactile detection threshold and pressure pain threshold were lower and cold detection thresholds increased in patients. Sensory nerve action potential amplitude and maximal sensory conduction velocity were not different, whereas there was a highly significant reduction in intraepidermal nerve fiber density. We found no correlation between pain VAS score, quantitative sensory testing and intraepidermal nerve fiber density. Our study demonstrates that careful evaluation of symptoms in female Fabry patients is important as small fiber disease manifestations are present, which in some cases is only detected by skin biopsy. PMID:19665302

  13. Posterior approach for both spinal accessory nerve to suprascapular nerve and triceps branch to axillary nerve for upper plexus injuries.

    PubMed

    Bhandari, P S; Deb, Prabal

    2013-01-01

    Restoration of stability and movements at the shoulder joint are the 2 most important goals in the management of brachial plexus injuries. The 2 nerves that are preferentially targeted for this purpose are the suprascapular (SSN) and the axillary (AXN) nerves. These nerve transfers have conventionally been performed by the anterior approach, but recently transfers performed by posterior incisions have been gaining popularity, by virtue of being selective and located close to the target muscles. Herein, we describe the technical details of spinal accessory nerve (SAN) to SSN and triceps branch to AXN for upper plexus injuries, both performed by the posterior approach. PMID:23261196

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

    PubMed

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

    2015-07-01

    OBJECT 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. METHODS Of 266 DAVF patients, 89 were eligible for analysis. Under observational management, 51 patients presented with intracranial hemorrhage/infarction during the follow-up period. RESULTS 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. CONCLUSIONS Decision tree analysis accurately predicts the future development of aggressive DAVF behavior. PMID:25859811

  15. Saphenous nerve innervation of the medial ankle

    PubMed Central

    Clendenen, Steven R; Whalen, Joseph L

    2013-01-01

    Background The distal saphenous nerve is commonly known to provide cutaneous innervation of the medial side of the ankle and distally to the base of the great toe. We hypothesize that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule. Methods Five fresh limbs were dissected and the saphenous nerve was traced distally with magnification. The medial malleolus, talus, and soft tissue were fixed in formaldehyde, decalcified, and embedded in paraffin and sectioned. Histologic slides were then prepared using S100 antibody nerve stains. Results Histologic slides were examined and myelinated nerves could be observed within the medial capsule and periosteum in all the specimens. Conclusion We have demonstrated that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule. PMID:23630434

  16. Imaging the Facial Nerve: A Contemporary Review

    PubMed Central

    Gupta, Sachin; Mends, Francine; Hagiwara, Mari; Fatterpekar, Girish; Roehm, Pamela C.

    2013-01-01

    Imaging plays a critical role in the evaluation of a number of facial nerve disorders. The facial nerve has a complex anatomical course; thus, a thorough understanding of the course of the facial nerve is essential to localize the sites of pathology. Facial nerve dysfunction can occur from a variety of causes, which can often be identified on imaging. Computed tomography and magnetic resonance imaging are helpful for identifying bony facial canal and soft tissue abnormalities, respectively. Ultrasound of the facial nerve has been used to predict functional outcomes in patients with Bell's palsy. More recently, diffusion tensor tractography has appeared as a new modality which allows three-dimensional display of facial nerve fibers. PMID:23766904

  17. The Effects of Irreversible Electroporation (IRE) on Nerves

    Microsoft Academic Search

    Wei Li; Qingyu Fan; Zhenwei Ji; Xiuchun Qiu; Zhao Li; Ilya Ulasov

    2011-01-01

    BackgroundIf a critical nerve is circumferentially involved with tumor, radical surgery intended to cure the cancer must sacrifice the nerve. Loss of critical nerves may lead to serious consequences. In spite of the impressive technical advancements in nerve reconstruction, complete recovery and normalization of nerve function is difficult to achieve. Though irreversible electroporation (IRE) might be a promising choice to

  18. Cough Sensors. III. Opioid and Cannabinoid Receptors on Vagal Sensory Nerves

    Microsoft Academic Search

    M. G. Belvisi; D. J. Hele

    Cough is a persistent symptom of many inflammatory airways' diseases. Cough is mediated by receptors sited on sensory nerves\\u000a and then through vagal afferent pathways, which terminate in the brainstem respiratory centre. Cough is often described as\\u000a an unmet clinical need. Opioids are the only prescription-based anti-tussives currently available in the UK. They possess\\u000a limited efficacy and exhibit serious unwanted

  19. The clinical significance of gadolinium enhancement of lumbar disc herniations and nerve roots on preoperative MRI

    Microsoft Academic Search

    P. C. A. J. Vroomen; S. J. M. Van Hapert; R. E. H. Van Acker; E. A. M. Beuls; A. G. H. Kessels; J. T. Wilmink

    1998-01-01

    The clinical significance of preoperative gadolinium DPTA enhancement around disc herniations and in the epidural space on\\u000a MRI is not clear. The relation of nerve root enhancement to dysfunction also remains controversial. To investigate the clinical\\u000a significance of contrast enhancement we looked at the symptoms and signs and gadolinium DPTA-enhanced images of 71 consecutive\\u000a surgical candidates in a standardised fashion.

  20. Contralateral femoral nerve compression: An unrecognized complication after extreme lateral interbody fusion (XLIF)

    Microsoft Academic Search

    Ioannis D. Papanastassiou; Mohammad Eleraky; Frank D. Vrionis

    2011-01-01

    Extreme lateral interbody fusion (XLIF) is a relatively new procedure for the treatment of degenerative disc disease avoiding the morbidity of anterior approaches. Ipsilateral L2–5 nerve root irritation and injury are well-described complications. We describe two patients with contralateral extremity symptoms, not reported so far. In the first patient the injury was caused by a displaced endplate fragment compressing the

  1. Renal tubular acidosis and nerve deafness.

    PubMed Central

    Dunger, D B; Brenton, D P; Cain, A R

    1980-01-01

    Two brothers are described with renal tubular acidosis and nerve deafness: the elder also had rickets and hypokalaemia. The parents were unaffected. Studies of urinary acidification and bicarbonate excretion were consistent with a distal tubular abnormality. This report strengthens the view previously proposed in similar cases that nerve deafness and renal tubular acidosis constitute a genetic entity. Examination for nerve deafness is indicated in any child with renal tubular acidosis. Images Fig. 2 PMID:7387165

  2. Nerve Conduction Studies in Multiple System Atrophy

    Microsoft Academic Search

    Michael Abele; Jörg B. Schulz; Katrin Bürk; Helge Topka; Johannes Dichgans; Thomas Klockgether

    2000-01-01

    To study the frequency and severity of peripheral neuropathy in multiple system atrophy (MSA), we performed nerve conduction studies in 42 MSA patients suffering from either cerebellar MSA (MSA-C) or parkinsonian MSA (MSA-P). Abnormal nerve conduction was present in 24% of the patients. Abnormalities were significantly more frequent in MSA-P (43%) compared to MSA-C (14%). Motor nerve conduction velocities were

  3. Bladder reinnervation using a primarily motor donor nerve (femoral nerve branches) is functionally superior to using a primarily sensory donor nerve (genitofemoral nerve)

    PubMed Central

    Gomez-Amaya, Sandra M.; Barbe, Mary F.; Brown, Justin M.; Lamarre, Neil S.; Braverman, Alan S.; Massicotte, Vicky S.; Ruggieri, Michael R.

    2014-01-01

    Purpose To determine whether transfer of a primarily motor nerve (Femoral, F) to the anterior vesicle branch of the pelvic nerve (PN) allows more effective bladder reinnervation than a primarily sensory nerve (genitofemoral, GF). Methods Forty-one female mongrel hounds underwent bladder decentralization, decentralization and then bilateral nerve transfer (GFNT and FNT) or were sham/unoperated controls. Decentralization was achieved by bilateral transection of all sacral roots that induce bladder contractions upon electrical stimulation. The retrograde neuronal labeling dye fluorogold was injected into the bladder 3 weeks prior to euthanasia. Results Increased detrusor pressure after direct stimulation of the transferred nerve, lumbar spinal cord or spinal roots was observed in 12/17 GFNT dogs (mean detrusor pressure = 7.6±1.4 cmH2O) and in 9/10 FNT-V dogs (mean detrusor pressure = 11.7±3.1 cm H2O). The mean detrusor pressures after direct electrical stimulation of transferred femoral nerves were statistically significantly greater than after stimulation of the transferred genitofemoral nerves. Retrogradely labeled neurons from the bladder observed in upper lumbar cord segments after GFNT and FNT confirmed bladder reinnervation as did labeled axons at the nerve transfer site. Conclusions While transfer of either a mixed sensory and motor nerve (GFN) or a primarily motor nerve (FN) can reinnervate the bladder, using a primarily motor nerve provides greater return of nerve-evoked detrusor contraction. This surgical approach may be useful for patients with lower motor spinal cord injury to accomplish bladder emptying. PMID:25066874

  4. Hyperalgesic actions of cytokines on peripheral nerves

    Microsoft Academic Search

    Robert R. Myers; Rochelle Wagner; Linda S. Sorkin

    \\u000a The relationship between nerve injury and pain is pervasive in medicine, being both a simple, common experience and an important\\u000a diagnostic tool. Acute trauma to a nerve is almost always painful and has been experienced by many people in association with\\u000a sports and workplace activities. In these cases, injuries occur usually because of nerve stretching or compression, damaging\\u000a sensory axons

  5. Nerve Signal Processing using Artificial Neural Nets

    Microsoft Academic Search

    Martin Bogdan; Alexei Babanine; Jörg Kaniecki; Wolfgang Rosenstiel

    1995-01-01

    In this paper we review the aim of the INTER1-project (Intelligent Neural InTERface), especiallyfrom the point of view of Artificial Neural Nets (ANN). We also propose a modus operandi to processreal nerve signals using ANN. We present a method to simulate nerve signals, first experience inseparating nerve signals from multi-array recorded data as well as first experiences using an artificialneural

  6. Staphylococcus aureus infection of the optic nerve.

    PubMed

    Osmanovic, Senad; Al-Heeti, Omar M; Lin, Amy Y; Zivin, Sean P; Justo, Julie Ann; Mayer, Stockton M; Aakalu, Vinay K; Moss, Heather E; Patel, Mahesh C

    2015-03-01

    A 71-year-old woman presented with painful vision loss in the right eye followed by ophthalmoplegia. Magnetic resonance imaging demonstrated optic nerve sheath enlargement and enhancement. Biopsy of the optic nerve sheath revealed purulent and necrotic material that was positive for methicillin-sensitive Staphylococcus aureus. The patient underwent enucleation of the right eye and was treated with systemic antibiotics with clinical stabilization. Imaging, pathological and treatment aspects of optic nerve sheath abscess are discussed. PMID:25383588

  7. Use new PLGL-RGD-NGF nerve conduits for promoting peripheral nerve regeneration

    PubMed Central

    2012-01-01

    Background Nerve conduits provide a promising strategy for peripheral nerve injury repair. However, the efficiency of nerve conduits to enhance nerve regeneration and functional recovery is often inferior to that of autografts. Nerve conduits require additional factors such as cell adhesion molecules and neurotrophic factors to provide a more conducive microenvironment for nerve regeneration. Methods In the present study, poly{(lactic acid)-co-[(glycolic acid)-alt-(L-lysine)]} (PLGL) was modified by grafting Gly-Arg-Gly-Asp-Gly (RGD peptide) and nerve growth factor (NGF) for fabricating new PLGL-RGD-NGF nerve conduits to promote nerve regeneration and functional recovery. PLGL-RGD-NGF nerve conduits were tested in the rat sciatic nerve transection model. Rat sciatic nerves were cut off to form a 10 mm defect and repaired with the nerve conduits. All of the 32 Wistar rats were randomly divided into 4 groups: group PLGL-RGD-NGF, group PLGL-RGD, group PLGL and group autograft. At 3 months after surgery, the regenerated rat sciatic nerve was evaluated by footprint analysis, electrophysiology, and histologic assessment. Experimental data were processed using the statistical software SPSS 10.0. Results The sciatic function index value of groups PLGL-RGD-NGF and autograft was significantly higher than those of groups PLGL-RGD and PLGL. The nerve conduction velocities of groups PLGL-RGD-NGF and autograft were significantly faster than those of groups PLGL-RGD and PLGL. The regenerated nerves of groups PLGL-RGD-NGF and autograft were more mature than those of groups PLGL-RGD and PLGL. There was no significant difference between groups PLGL-RGD-NGF and autograft. Conclusions PLGL-RGD-NGF nerve conduits are more effective in regenerating nerves than both PLGL-RGD nerve conduits and PLGL nerve conduits. The effect is as good as that of an autograft. This work established the platform for further development of the use of PLGL-RGD-NGF nerve conduits for clinical nerve repair. PMID:22776032

  8. Sciatic nerve repair by acellular nerve xenografts implanted with BMSCs in rats xenograft combined with BMSCs.

    PubMed

    Jia, Hua; Wang, Ying; Tong, Xiao-Jie; Liu, Gui-Bo; Li, Qi; Zhang, Li-Xin; Sun, Xiao-Hong

    2012-03-01

    Acellular nerves possess the structural and biochemical features similar to those of naive endoneurial tubes, and have been proved bioactive for allogeneil graft in nerve tissue engineering. However, the source of allogenic donators is restricted in clinical treatment. To explore sufficient substitutes for acellular nerve allografts (ANA), we investigated the effectiveness of acellular nerve xenografts (ANX) combined with bone marrow stromal cells (BMSCs) on repairing peripheral nerve injuries. The acellular nerves derived from Sprague-Dawley rats and New Zealand rabbits were prepared, respectively, and BMSCs were implanted into the nerve scaffolds and cultured in vitro. All the grafts were employed to bridge 1 cm rat sciatic nerve gaps. Fifty Wistar rats were randomly divided into five groups (n = 10 per group): ANA group, ANX group, BMSCs-laden ANA group, BMSCs-laden ANX group, and autologous nerve graft group. At 8 weeks post-transplantation, electrophysiological study was performed and the regenerated nerves were assayed morphologically. Besides, growth-promoting factors in the regenerated tissues following the BMSCs integration were detected. The results indicated that compared with the acellular nerve control groups, nerve regeneration and functional rehabilitation for the xenogenic nerve transplantation integrated with BMSCs were advanced significantly, and the rehabilitation efficacy was comparable with that of the autografting. The expression of neurotrophic factors in the regenerated nerves, together with that of brain-derived neurotrophic factor (BDNF) in the spinal cord and muscles were elevated largely. In conclusion, ANX implanted with BMSCs could replace allografts to promote nerve regeneration effectively, which offers a reliable approach for repairing peripheral nerve defects. PMID:22127791

  9. A Middle Cranial Fossa Dermoid Cyst Treated by an Endonasal Endoscopic Approach.

    PubMed

    Durmaz, Abdullah; Yildizo?lu, Üzeyir; Polat, Bahtiyar; Binar, Murat

    2015-06-01

    Dermoid cysts are rare, benign, congenital ectodermal inclusion cysts in the skull base, comprising skin supplements surrounded by squamous epithelium. In the period of embryological development, the cysts originate from ectodermal cells left behind in the cranial region by the closure of the neural tube and are primarily located at the midline, especially in the subarachnoid spaces. These lesions are usually asymptomatic and diagnosed incidentally. When the cysts reach large sizes, they can be symptomatic due to infection, rupture, or mass effect around neurovascular tissue. The cysts typically demonstrate accurate radiological diagnostic features. In this case report, we present a rare dermoid cyst in the middle cranial fossa, treated by an endonasal endoscopic approach. The endonasal endoscopic management of appropriate middle cranial fossa is discussed as a recent advance in the extended applications of endoscopic sinus surgery. PMID:26080254

  10. Removable cranial windows for long-term imaging in awake mice.

    PubMed

    Goldey, Glenn J; Roumis, Demetris K; Glickfeld, Lindsey L; Kerlin, Aaron M; Reid, R Clay; Bonin, Vincent; Schafer, Dorothy P; Andermann, Mark L

    2014-11-01

    Cranial window implants in head-fixed rodents are becoming a preparation of choice for stable optical access to large areas of the cortex over extended periods of time. Here we provide a highly detailed and reliable surgical protocol for a cranial window implantation procedure for chronic wide-field and cellular imaging in awake, head-fixed mice, which enables subsequent window removal and replacement in the weeks and months after the initial craniotomy. This protocol has facilitated awake, chronic imaging in adolescent and adult mice over several months from a large number of cortical brain regions; targeted virus and tracer injections from data obtained using prior awake functional mapping; and functionally targeted two-photon imaging across all cortical layers in awake mice using a microprism attachment to the cranial window. Collectively, these procedures extend the reach of chronic imaging of cortical function and dysfunction in behaving animals. PMID:25275789

  11. Long-term imaging in awake mice using removable cranial windows

    PubMed Central

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

    2015-01-01

    Cranial window implants in head-fixed rodents are becoming a preparation of choice for stable optical access to large areas of cortex over extended periods of time. Here, we provide a highly detailed and reliable surgical protocol for a cranial window implantation procedure for chronic widefield and cellular imaging in awake, head-fixed mice, which enables subsequent window removal and replacement in the weeks and months following the initial craniotomy. This protocol has facilitated awake, chronic imaging in adolescent as well as adult mice over several months from a large number of cortical brain regions; targeted virus and tracer injections from data obtained using prior awake functional mapping; and functionally-targeted two-photon imaging across all cortical layers in awake mice using a microprism attachment to the cranial window. Collectively, these procedures extend the reach of chronic imaging of cortical function and dysfunction in behaving animals. PMID:25275789

  12. [Determination of prospective tooth positions by means of model analysis--the Staub Cranial System].

    PubMed

    Teubner, Eckart; Marinello, Carlo P

    2006-01-01

    In modern reconstructive dentistry, practitioners delivering removable or fixed dentures still face problems when determining prospective tooth arch and tooth positions. Certain anatomical planes and reference lines, such as Camper's plane, interpupillary axis, etc. have been established as a guide. However, the ability and experience of the dentist remain essential. Adjusting the tooth arches is time-consuming and, therefore, expensive. To simplify and standardise the procedure, dental technicians and dentists may use the Staub Cranial System. It consists of three devices (Positionierer Ortho 1A, Einbaustativ Ortho 2A and Cranialstativ Ortho 3A) and the Staub Cranial software. With its aid, dental casts are surveyed and a penta-area is calculated. This penta-area, three-dimensionally adjusted, may define exactly the site and position of the dental arch. In this article, the Staub Cranial System is presented and documented by a clinical case. PMID:16900994

  13. Multiple spinal and cranial meningiomas: A case report and review of literature.

    PubMed

    Jain, S K; Sundar, I Vijay; Sharma, Vinod; Goel, Ravishankar S; Prasanna, K L

    2015-01-01

    Though meningiomas are common neoplasms of the nervous system, the occurrence of multiple meningiomas in different neuraxial compartments is rather rare. We report a case of a 62-year-old female who presented with spastic paraparesis in both lower limbs, and was found to have multiple homogenously enhancing tumors of dorsolumbar spine. Cranial magnetic resonance imaging (MRI) revealed multiple bilateral supratentorial meningiomas. She underwent multiple level laminectomy and total removal of spinal tumors after which power improved in both lower limbs. Histopathology revealed psammomatous meningiomas. Only around 19 cases of multiple cranial and spinal meningiomas have been reported, of which, only five cases have more than one spinal meningioma. The implication of the incidence of such multiple meningiomas in the same patient with relevance to investigations and decision making are discussed along with a brief review of literature of cases with multiple spinal and cranial meningiomas. PMID:25972948

  14. Raman microspectroscopy for visualization of peripheral nerves

    NASA Astrophysics Data System (ADS)

    Minamikawa, Takeo; Harada, Yoshinori; Koizumi, Noriaki; Takamatsu, Tetsuro

    2013-02-01

    The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery is essential for improving quality of life of patients. To preserve peripheral nerves, detection of ne peripheral nerves that cannot be identi ed by human eye or under white light imaging is necessary. In this study, we sought to provide a proof-of-principle demonstration of a label-free detection technique of peripheral nerve tissues against adjacent tissues that employs spontaneous Raman microspectroscopy. A line-illumination confocal Raman microscope was used for the experiment. A laser operating at the wavelength of 532 nm was used as an excitation laser light. We obtained Raman spectra of peripheral nerve, brous connective tissue, skeletal muscle, blood vessel, and adipose tissue of Wistar rats, and extracted speci c spectral features of peripheral nerves and adjacent tissues. By applying multivariate image analysis, peripheral nerves were clearly detected against adjacent tissues without any preprocessing neither xation nor staining. These results suggest the potential of the Raman spectroscopic observation for noninvasive and label-free nerve detection, and we expect this method could be a key technique for nerve-sparing surgery.

  15. Nerve conduction in Frogs and Humans

    NSDL National Science Digital Library

    Elizabeth Vizsolyi (Univ. of British Columbia; )

    1988-06-13

    These exercises are taken from a vertebrate physiology course, and use either a human subject or a dissected frog, thus providing relatively simply alternatives that may suit your needs. Nerve conduction velocity can be measured in the frog sciatic nerve with recordings of the biphasic action potential on the outside of the nerve trunk. Absolute and relative refractory periods can also be determined. Conduction velocity in the human can be obtained from electromyograms taken from the fourth and fifth fingers following stimulation of the ulnar nerve.

  16. Tissue engineered constructs for peripheral nerve surgery

    PubMed Central

    Johnson, P. J.; Wood, M. D.; Moore, A. M.; Mackinnon, S. E.

    2013-01-01

    Summary Background Tissue engineering has been defined as “an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function or a whole organ”. Traumatic peripheral nerve injury resulting in significant tissue loss at the zone of injury necessitates the need for a bridge or scaffold for regenerating axons from the proximal stump to reach the distal stump. Methods A review of the literature was used to provide information on the components necessary for the development of a tissue engineered peripheral nerve substitute. Then, a comprehensive review of the literature is presented composed of the studies devoted to this goal. Results Extensive research has been directed toward the development of a tissue engineered peripheral nerve substitute to act as a bridge for regenerating axons from the proximal nerve stump seeking the distal nerve. Ideally this nerve substitute would consist of a scaffold component that mimics the extracellular matrix of the peripheral nerve and a cellular component that serves to stimulate and support regenerating peripheral nerve axons. Conclusions The field of tissue engineering should consider its challenge to not only meet the autograft “gold standard” but also to understand what drives and inhibits nerve regeneration in order to surpass the results of an autograft. PMID:24385980

  17. Ectopic thyroid tissue surrounding the right laryngeal nerve: a case report

    PubMed Central

    He, Bin; Li, Peng; Yang, Kai; Shan, Yunfeng

    2014-01-01

    Ectopic thyroid tissue (ETT) is a rare developmental anomaly of the thyroid tissue which is defined as the presence of thyroid tissue in locations other than the pretracheal area. However, ectopic thyroid tissue in the lateral neck surrounding the recurrent laryngeal nerve is unusually found. Here we describe a case of a 64-year-old woman who was found bilateral thyroid goiter by the ultrasound examination. The total thyroidectomy plus a modified radical neck dissection was performed. Surprisingly we also found a nodule surrounding the right recurrent laryngeal nerve at the same time. Nevertheless the diagnosis of the nodule was confirmed by pathology and Histologic examination demonstrating that it was ectopic thyroid tissue. Ectopic thyroid tissue surrounding recurrent laryngeal nerve is a rare finding, with hardly any cases reported. For it is generally thought that any thyroid tissue found in the lateral aspect of the neck may indicate metastatic deposits from well-differentiated thyroid carcinoma. Although pathogenesis of ectopic thyroid tissue surrounding recurrent laryngeal nerve without any symptoms remains unknown, our case could suggest ectopic thyroid tissue should not be excluded in the differential diagnosis of lateral neck masses especially when the recurrent laryngeal nerves were surrounded by the nodules. PMID:25197416

  18. Ancient schwannoma involving the median nerve: a case report and review of the literature.

    PubMed

    Malizos, Konstantinos; Ioannou, Maria; Kontogeorgakos, Vasileios

    2013-04-01

    Ancient schwannomas are benign long standing schwannomas of the neural sheaths. Histological findings are these seen as in conventional schwannomas, but ancient schwannomas additionally demonstrate cystic hemorrhagic changes and degenerative nuclei with pleomorphism and hyperchromasia. Due to the nuclear atypia, and cystic degeneration, ancient schwannomas might be confused with malignant tumors on histology and imaging, leading to a radical surgical approach. The median nerve is rarely affected. We present a rare case of an ancient schwannoma involving the median nerve at the mid humerus. The tumor slowly grew up within ten years and become symptomatic with local pain, mild numbness in the distribution of the median nerve in the palm and Tinel's test. The tumor was successfully removed by separating it from the nerve fascicles to negative margins. Post-operatively local symptoms relieved but minor sensory loss in the median nerve distribution in the palm was noticed which improved in the following six months. Ancient schwannomas can be misdiagnosed as sarcomas due to specific imaging and histologic findings. Patients' physical examination, history and fine radiologic and pathology features should be cautiously interpreted in order to achieve correct diagnosis and avoid unnecessary wide tumor excisions. PMID:23546803

  19. Unilateral hypoglossal nerve palsy after use of the laryngeal mask airway supreme.

    PubMed

    Takahoko, Kenichi; Iwasaki, Hajime; Sasakawa, Tomoki; Suzuki, Akihiro; Matsumoto, Hideki; Iwasaki, Hiroshi

    2014-01-01

    Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA) is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4?LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60?cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%), and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery. PMID:25254120

  20. Protecting the genitofemoral nerve during direct/extreme lateral interbody fusion (DLIF/XLIF) procedures.

    PubMed

    Jahangiri, Faisal R; Sherman, Jonathan H; Holmberg, Andrea; Louis, Robert; Elias, Jeff; Vega-Bermudez, Francisco

    2010-12-01

    A 77-year-old male presented with a history of severe lower back pain for 10 years with radiculopathy, positive claudication type symptoms in his calf with walking, and severe "burning" in his legs bilaterally with walking. Magnetic resonance imaging (MRI) revealed lumbar stenosis at the L3-L4 and L4-L5 levels. During the direct or extreme lateral interbody fusion (DLIF/XLIF) procedure, bilateral posterior tibial, femoral, and ulnar nerve somatosensory evoked potentials (SSEPs) were recorded with good morphology of waveforms observed. Spontaneous electromyography (S-EMG) and triggered electromyography (T-EMG) were recorded from cremaster and ipsilateral leg muscles. A left lateral retroperitoneal transpsoas approach was used to access the anterior disc space for complete discectomy, distraction, and interbody fusion. T-EMG ranging from 0.05 to 55.0 mA with duration of 200 microsec was used for identification of the genitofemoral nerve using a monopolar stimulator during the approach. The genitofemoral nerve (L1-L2) was identified, and the guidewire was redirected away from the nerve. Post-operatively, the patient reported complete pain relief and displayed no complications from the procedure. Intraoperative SSEPs, S-EMG, and T-EMG were utilized effectively to guide the surgeon's approach in this DLIF thereby preventing any post-operative neurological deficits such as damage to the genitofemoral nerve that could lead to groin pain. PMID:21313792