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. Overview of the Cranial Nerves

    MedlinePLUS

    ... nerves—the cranial nerves—lead directly from the brain to various parts of the head, neck, and trunk. Some of the cranial nerves are ... cranial nerves emerge from the underside of the brain, pass through ... to parts of the head, neck, and trunk. The nerves are named and numbered, ...

  3. 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

  4. Disorders of Cranial Nerves IX and X

    PubMed Central

    Erman, Audrey B.; Kejner, Alexandra E.; Hogikyan, Norman D.; Feldman, Eva L.

    2014-01-01

    The glossopharyngeal and vagus nerves mediate the complex interplay between the many functions of the upper aerodigestive tract. Defects may occur anywhere from the brainstem to the peripheral nerve and can result in significant impairment in speech, swallowing, and breathing. Multiple etiologies can produce symptoms. This review will broadly examine the normal functions, clinical examination, and various pathologies of cranial nerves IX and X. PMID:19214937

  5. Isolated sixth cranial nerve palsy as the presenting symptom of a rapidly expanding ACTH positive pituitary adenoma: a case report

    PubMed Central

    2011-01-01

    Background Pituitary adenoma may present with neuro-ophthalmic manifestations and, typically, rapid tumor expansion is the result of apoplexy. Herein, we present the first case of an isolated sixth cranial nerve palsy as initial feature of a rapidly expanding ACTH positive silent tumor without apoplexy. Case Presentation A 44 year old female with a history of sarcoidosis presented with an isolated sixth cranial nerve palsy as the initial clinical feature of a rapidly expanding ACTH positive silent pituitary adenoma. The patient underwent emergent transsphenoidal hypophysectomy for this rapidly progressive tumor and subsequently regained complete vision and ocular motility. Despite tumor extension into the cavernous sinus, the other cranial nerves were spared during the initial presentation. Conclusions This case illustrates the need to consider a rapidly growing pituitary tumor as a possibility when presented with a rapidly progressive ophthalmoplegia. PMID:21272327

  6. 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.

  7. Strategical implications of aneurysmal cranial nerve compression.

    PubMed

    Scholtes, F; Martin, D

    2012-01-01

    Intracranial aneurysms may manifest clinically by inducing neurological symptoms, including cranial nerve dysfunction. In unruptured aneurysms, this may result from mass effect and the pulsation of the sac. Aneurysm rupture and sudden expansion of a pseudo-sac may precipitate the appearance of cranial nerve deficits. Symptomatic aneurysms should be treated. Surgery reduces mass effect and arterial pulsations, and removes clot after rupture. Endovascular treatment decreases pulsatility of the sac. Recovery has been reported after both treatments. It appears more reproducible after surgery, but the data of current literature remains weak. The possible advantage of surgery is an argument among others that must be considered in the choice of the most adequate therapeutic approach. PMID:22465139

  8. 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…

  9. Cranial Nerves IX, X, XI, and XII

    PubMed Central

    Sanders, Richard D.

    2010-01-01

    This article concludes the series on cranial nerves, with review of the final four (IX–XII). To summarize briefly, the most important and common syndrome caused by a disorder of the glossopharyngeal nerve (craniel nerve IX) is glossopharyngeal neuralgia. Also, swallowing function occasionally is compromised in a rare but disabling form of tardive dyskinesia called tardive dystonia, because the upper motor portion of the glossopharyngel nerve projects to the basal ganglia and can be affected by lesions in the basal ganglia. Vagus nerve funtion (craniel nerve X) can be compromised in schizophrenia, bulimia, obesity, and major depression. A cervical lesion to the nerve roots of the spinal accessory nerve (craniel nerve XI) can cause a cervical dystonia, which sometimes is misdiagnosed as a dyskinesia related to neuroleptic use. Finally, unilateral hypoglossal (craniel nerve XII) nerve palsy is one of the most common mononeuropathies caused by brain metastases. Supranuclear lesions of cranial nerve XII are involved in pseudobulbar palsy and ALS, and lower motor neuron lesions of cranial nerve XII can also be present in bulbar palsy and in ALS patients who also have lower motor neuron involvement. This article reviews these and other syndromes related to cranial nerves IX through XII that might be seen by psychiatry. PMID:20532157

  10. Palsies of Cranial Nerves That Control Eye Movement

    MedlinePLUS

    ... Disorders 4 Palsies of Cranial Nerves That Control Eye Movement These disorders involve paralysis of one of the cranial nerves that control eye movement (the 3rd, 4th, or 6th nerve), impairing the ...

  11. 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

  12. 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

  13. Laryngeal zoster with multiple cranial nerve palsies

    Microsoft Academic Search

    Paul Van Den Bossche; Karolien Van Den Bossche; Hilde Vanpoucke

    2008-01-01

    A young immunocompetent patient is presented with a very rare presentation of a common viral illness: herpes zoster of the\\u000a left hemilarynx with sensorial and motoric neuropathy of three ipsilateral lower cranial nerves: IX, X and XI. The mucosal\\u000a lesions were discovered during upper gastrointestinal endoscopy. PCR of erosional exsudate confirmed the clinical diagnosis.\\u000a Antiviral therapy and corticosteroids possibly contributed

  14. A Case of Transient, Isolated Cranial Nerve VI Palsy due to Skull Base Osteomyelitis.

    PubMed

    Patel, Brijesh; Souqiyyeh, Anas; Ali, Ammar

    2014-01-01

    Otitis externa affects both children and adults. It is often treated with topical antibiotics, with good clinical outcomes. When a patient fails to respond to the treatment, otitis externa can progress to malignant otitis externa. The common symptoms of skull bone osteomyelitis include ear ache, facial pain, and cranial nerve palsies. However, an isolated cranial nerve is rare. Herein, we report a case of 54-year-old female who presented with left cranial nerve VI palsy due to skull base osteomyelitis which responded to antibiotic therapy. PMID:25045551

  15. A Case of Transient, Isolated Cranial Nerve VI Palsy due to Skull Base Osteomyelitis

    PubMed Central

    Ali, Ammar

    2014-01-01

    Otitis externa affects both children and adults. It is often treated with topical antibiotics, with good clinical outcomes. When a patient fails to respond to the treatment, otitis externa can progress to malignant otitis externa. The common symptoms of skull bone osteomyelitis include ear ache, facial pain, and cranial nerve palsies. However, an isolated cranial nerve is rare. Herein, we report a case of 54-year-old female who presented with left cranial nerve VI palsy due to skull base osteomyelitis which responded to antibiotic therapy. PMID:25045551

  16. 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

  17. Twelfth cranial nerve involvement in Guillian Barre syndrome.

    PubMed

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

    2013-07-01

    Guillian Barre Syndrome (GBS) is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth). Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed. PMID:24250180

  18. Twelfth cranial nerve involvement in Guillian Barre syndrome

    PubMed Central

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

    2013-01-01

    Guillian Barre Syndrome (GBS) is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth). Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed. PMID:24250180

  19. Cranial Nerves III, IV, and VI

    PubMed Central

    Sanders, Richard D.

    2009-01-01

    Motor activity affecting the direction of gaze, the position of the eyelids, and the size of the pupils are served by cranial nerves III, IV, and VI. Unusual oculomotor activity is often encountered in psychiatric patients and can be quite informative. Evaluation techniques include casual observation and simple tests that require no equipment in addition to the sophisticated methods used in specialty clinics and research labs. This article reviews pupil size, extraocular movements, nystagmus, lid retraction, lid lag, and ptosis. Beyond screening for diseases and localizing lesions, these tests yield useful information about the individual’s higher cortical function, extrapyramidal motor functioning, and toxic/pharmacologic state. PMID:20049149

  20. Asymmetric type F botulism with cranial nerve demyelination.

    PubMed

    Filozov, Alina; Kattan, Jessica A; Jitendranath, Lavanya; Smith, C Gregory; Lúquez, Carolina; Phan, Quyen N; Fagan, Ryan P

    2012-01-01

    We report a case of type F botulism in a patient with bilateral but asymmetric neurologic deficits. Cranial nerve demyelination was found during autopsy. Bilateral, asymmetric clinical signs, although rare, do not rule out botulism. Demyelination of cranial nerves might be underrecognized during autopsy of botulism patients. PMID:22257488

  1. The Trigeminal (V) and Facial (VII) Cranial Nerves

    PubMed Central

    Sanders, Richard D.

    2010-01-01

    There are close functional and anatomical relationships between cranial nerves V and VII in both their sensory and motor divisions. Sensation on the face is innervated by the trigeminal nerves (V) as are the muscles of mastication, but the muscles of facial expression are innervated mainly by the facial nerve (VII) as is the sensation of taste. This article briefly reviews the anatomy of these cranial nerves, disorders of these nerves that are of particular importance to psychiatry, and some considerations for differential diagnosis. PMID:20386632

  2. Technical Aspects of Intraoperative Monitoring of Lower Cranial Nerve Function

    PubMed Central

    Mishler, E. Tracy; Smith, Peter G.

    1995-01-01

    The efficacy of monitoring facial nerve activity in decreasing long-term morbidity has promoted an interest in monitoring other at-risk cranial nerves during procedures that involve manipulation of the basal cranial nerves. This presentation details practical techniques for monitoring the lower cranial nerves, which have been experientially developed over the past 9 years. Emphasis is placed on the selection of electrodes and procedural changes required for reliable and safe stimulation of the basal cranial nerves. Either paired hook-wire or tethered needle electrodes can be used for monitoring glossopharyageal, accessory, and hypoglossal nerve function. Several options for monitoring vagus nerve function are discussed. Of these, the transoral placement of paired hook-wire electrodes remains the most reliable, cost-effective, and least morbid technique. Electrical stimulation of the glossopharyngeal and vagus nerves carries the risk of unanticipated, potentially irreversible disturbances in cardiovascular function. Guidelines for type and optimal placement of stimulating electrodes and recommended intensity levels to prevent unfavorable reactions are presented. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17170965

  3. Neurophysiological monitoring of cranial nerves during posterior fossa surgery.

    PubMed

    Broggi, G; Scaioli, V; Brock, S; Dones, I

    1995-01-01

    Intraoperative neurophysiological monitoring of cranial nerve functions in surgery for microvascular decompression and tumors of the posterior fossa is important for minimizing risk of permanent damage to the nerves. In particular, intraoperative BAEP and the EMG function of muscle innervated by trigeminal and facial muscle have been found useful. We report here our experiences with intraoperative monitoring of brainstem auditory evoked potentials (BAEP) and EMG recorded from muscles supplied by the trigeminal and facial nerves. PMID:8748580

  4. The Six Syndromes of the Sixth Cranial Nerve

    PubMed Central

    Azarmina, Mohsen; Azarmina, Hossein

    2013-01-01

    The sixth cranial nerve runs a long course from the brainstem to the lateral rectus muscle. Based on the location of an abnormality, other neurologic structures may be involved with the pathology related to this nerve. Sixth nerve palsy is frequently due to a benign process with full recovery within weeks, yet caution is warranted as it may portend a serious neurologic process. Hence, early diagnosis is often critical for some conditions that present with sixth nerve palsy. This article outlines a simple clinical approach to sixth nerve palsy based on its anatomy. PMID:23943691

  5. Multiple cranial nerve enhancement in mitochondrial neurogastrointestinal encephalomyopathy.

    PubMed

    Petcharunpaisan, Sasitorn; Castillo, Mauricio

    2010-01-01

    Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare disease that often presents with nonspecific white matter abnormalities on magnetic resonance imaging. Ptosis and ophthalmoparesis are a part of its clinical features. We report multiple cranial nerve contrast enhancement on magnetic resonance imaging in a patient with MNGIE and postulate that demyelination may be the responsible substrate for this previously unreported finding. This finding may also explain the cranial neuropathies that patients with MNGIE have. PMID:20351514

  6. 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

  7. Shrapnel Injury of Isolated Third Cranial Nerve

    PubMed Central

    Uluta?, Murat; Seçer, Mehmet

    2014-01-01

    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

  8. Multiple cranial nerve palsies associated with type 2 diabetes mellitus.

    PubMed

    Singh, N P; Garg, S; Kumar, S; Gulati, S

    2006-08-01

    Although isolated cranial nerve palsies are common in patients with diabetes mellitus, multiple simultaneous cranial neuropathies are rare. We report a 48-year-old man, a known case of diabetes mellitus, who presented with facial palsy, foot drop and painful ophthalmoplegia of the left eye. The initial differential diagnosis included diabetic polyneuropathy, septic cavernous sinus thrombosis, mucormycosis and the Tolosa Hunt syndrome. Magnetic resonance (MR) imaging findings were consistent with those of the Tolosa Hunt syndrome. The patient had a remarkable complete resolution of his ophthalmoplegia after four weeks of steroid treatment, with repeat MR imaging showing resolution of the initial changes. PMID:16865214

  9. Brain Mass and Cranial Nerve Size in Shrews and Moles

    PubMed Central

    Leitch, Duncan B.; Sarko, Diana K.; Catania, Kenneth C.

    2014-01-01

    We investigated the relationship between body size, brain size, and fibers in selected cranial nerves in shrews and moles. Species include tiny masked shrews (S. cinereus) weighing only a few grams and much larger mole species weighing up to 90 grams. It also includes closely related species with very different sensory specializations – such as the star-nosed mole and the common, eastern mole. We found that moles and shrews have tiny optic nerves with fiber counts not correlated with body or brain size. Auditory nerves were similarly small but increased in fiber number with increasing brain and body size. Trigeminal nerve number was by far the largest and also increased with increasing brain and body size. The star-nosed mole was an outlier, with more than twice the number of trigeminal nerve fibers than any other species. Despite this hypertrophied cranial nerve, star-nosed mole brains were not larger than predicted from body size, suggesting that magnification of their somatosensory systems does not result in greater overall CNS size. PMID:25174995

  10. Cranial nerve lesions due to base of the skull metastases in prostate carcinoma.

    PubMed

    Ransom, D T; Dinapoli, R P; Richardson, R L

    1990-02-01

    We studied 11 patients with prostate cancer metastatic to the base of skull that caused cranial nerve deficits. Patients with occipital condyle, jugular foramen, middle fossa, parasellar, and orbital syndromes are described. Other patients had combinations of these syndromes or other cranial nerve involvements. Two patients had 6th nerve palsies secondary to prepontine cistern and clivus lesions. The median survival time from the diagnosis of cranial nerve involvement was 4 months. Two patients had cranial nerve involvement and, on subsequent investigation, were found to have carcinoma of the prostate. Interestingly, these patients are still alive at 42 and 84 months after diagnosis. PMID:2297648

  11. Cranial nerve development requires co-ordinated shh and canonical wnt signaling.

    PubMed

    Kurosaka, Hiroshi; Trainor, Paul A; Leroux-Berger, Margot; Iulianella, Angelo

    2015-01-01

    Cranial nerves govern sensory and motor information exchange between the brain and tissues of the head and neck. The cranial nerves are derived from two specialized populations of cells, cranial neural crest cells and ectodermal placode cells. Defects in either cell type can result in cranial nerve developmental defects. Although several signaling pathways are known to regulate cranial nerve formation our understanding of how intercellular signaling between neural crest cells and placode cells is coordinated during cranial ganglia morphogenesis is poorly understood. Sonic Hedgehog (Shh) signaling is one key pathway that regulates multiple aspects of craniofacial development, but whether it co-ordinates cranial neural crest cell and placodal cell interactions during cranial ganglia formation remains unclear. In this study we examined a new Patched1 (Ptch1) loss-of-function mouse mutant and characterized the role of Ptch1 in regulating Shh signaling during cranial ganglia development. Ptch1Wig/ Wig mutants exhibit elevated Shh signaling in concert with disorganization of the trigeminal and facial nerves. Importantly, we discovered that enhanced Shh signaling suppressed canonical Wnt signaling in the cranial nerve region. This critically affected the survival and migration of cranial neural crest cells and the development of placodal cells as well as the integration between neural crest and placodes. Collectively, our findings highlight a novel and critical role for Shh signaling in cranial nerve development via the cross regulation of canonical Wnt signaling. PMID:25799573

  12. Cranial Nerve Development Requires Co-Ordinated Shh and Canonical Wnt Signaling

    PubMed Central

    Kurosaka, Hiroshi; Trainor, Paul A.; Leroux-Berger, Margot; Iulianella, Angelo

    2015-01-01

    Cranial nerves govern sensory and motor information exchange between the brain and tissues of the head and neck. The cranial nerves are derived from two specialized populations of cells, cranial neural crest cells and ectodermal placode cells. Defects in either cell type can result in cranial nerve developmental defects. Although several signaling pathways are known to regulate cranial nerve formation our understanding of how intercellular signaling between neural crest cells and placode cells is coordinated during cranial ganglia morphogenesis is poorly understood. Sonic Hedgehog (Shh) signaling is one key pathway that regulates multiple aspects of craniofacial development, but whether it co-ordinates cranial neural crest cell and placodal cell interactions during cranial ganglia formation remains unclear. In this study we examined a new Patched1 (Ptch1) loss-of-function mouse mutant and characterized the role of Ptch1 in regulating Shh signaling during cranial ganglia development. Ptch1Wig/ Wig mutants exhibit elevated Shh signaling in concert with disorganization of the trigeminal and facial nerves. Importantly, we discovered that enhanced Shh signaling suppressed canonical Wnt signaling in the cranial nerve region. This critically affected the survival and migration of cranial neural crest cells and the development of placodal cells as well as the integration between neural crest and placodes. Collectively, our findings highlight a novel and critical role for Shh signaling in cranial nerve development via the cross regulation of canonical Wnt signaling. PMID:25799573

  13. [A case of zoster sine herpete with involvement of the unilateral IX, X and XI cranial and upper cervical nerves].

    PubMed

    Funakawa, I; Terao, A; Koga, M

    1999-09-01

    We describe a case of unilateral IX, X and XI cranial and upper cervical nerve palsies involving zoster sine herpete (ZSH). A 63-year-old man experienced nausea, loss of appetite and general fatigue. On 4 days of illness, dysphagia, dysarthria and difficulty in elevation of his right arm appeared. Neurological examination showed the right curtain sign, a nasal voice and a decreased right gag reflex. He could hardly elevate his right arm laterally. Needle electromyography revealed positive sharp waves in his right trapezius muscle. Although no skin lesion was detected, anti-varicella-zoster virus antibodies were positive in both serum and cerebrospinal fluid. Acyclovir and a steroid were ineffective for these symptoms. Although case reports of unilateral IX, X and XI cranial nerve palsies with ZSH is very rare, ZSH should be kept in mind in the differential diagnosis of multiple cranial nerve palsies. PMID:10614162

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

    PubMed Central

    Sun, Seung-Ho

    2012-01-01

    Objective: This case report is to report the effect of Korean traditional treatment for idiopathic ninth, tenth, and twelfth cranial nerve palsy with ipsilateral headache. Methods: The medical history and imaging and laboratory test of a 39-year-old man with cranial palsy were tested to identify the cause of disease. A 0.2-mL dosage of Hwangyeonhaedoktang pharmacopuncture was administered at CV23 and CV17, respectively. Acupuncture was applied at P06, Li05, TE05, and G37 on the right side of the body. Zhuapiandutongbang (? ????) was administered at 30 minutes to 1 hour after mealtime three times a day. The symptoms were investigated using Visual Analogue Scale (VAS). Results: The results of magnetic resonance imaging (MRI), computed tomography (CT), and laboratory tests were normal. The medical history showed no trauma, other illnesses, family history of diseases, medications, smoking, drinking and so on. All symptoms disappeared at the 10th day of treatment. Conclusion: Korean traditional treatment such as acupuncture, pharmcopuncture, and herbal medicine for the treatment of ninth, tenth, and twelfth cranial nerve palsy of unknown origin is suggested to be effective even though this conclusion is based on a single.

  15. Normal - Cranial Nerves Exam - Vestibulocochlear (CN VIII) Nerve Sub-exam - Patient 1

    NSDL National Science Digital Library

    Pearson, John C.

    This video depicts the 'normal' patient responses that should occur during a cranial nerves exam. The patient in the video 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.

  16. Three-dimensional interactive atlas of cranial nerve-related disorders.

    PubMed

    Nowinski, W L; Chua, B C

    2013-06-01

    Anatomical knowledge of the cranial nerves (CN) is fundamental in education, research and clinical practice. Moreover, understanding CN-related pathology with underlying neuroanatomy and the resulting neurological deficits is of vital importance. To facilitate CN knowledge anatomy and pathology understanding, we created an atlas of CN-related disorders, which is a three-dimensional (3D) interactive tool correlating CN pathology with the underlying surface and sectional neuroanatomy as well as the resulting neurological deficits. A computer platform was developed with: 1) anatomy browser along with the normal brain atlas (built earlier); 2) simulator of CN lesions; 3) tools to label CN-related pathology; and 4) CN pathology database with lesions and disorders, and the resulting signs, symptoms and/or syndromes. The normal neuroanatomy comprises about 2,300 3D components subdivided into modules. Cranial nerves contain more than 600 components: all 12 pairs of cranial nerves (CN I - CN XII) and the brainstem CN nuclei. The CN pathology database was populated with 36 lesions compiled from clinical textbooks. The initial view of each disorder was preset in terms of lesion location and size, surrounding surface and sectional neuroanatomy, and disorder and neuroanatomy labeling. Moreover, path selection from a CN nucleus to a targeted organ further enhances pathology-anatomy relationships. This atlas of CN-related disorders is potentially useful to a wide variety of users ranging from medical students and residents to general practitioners, neuroradiologists and neurologists, as it contains both normal brain anatomy and CN-related pathology correlated with neurological disorders presented in a visual and interactive way. PMID:23859281

  17. 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

  18. Focal cranial nerve involvement in chronic inflammatory demyelinating polyneuropathy: clinical and MRI evidence of peripheral and central lesions

    Microsoft Academic Search

    H. M. Waddy; V. P. Misra; R. H. M. King; P. K. Thomas; L. Middleton; I. E. C. Ormerod

    1989-01-01

    Five cases of chronic inflammatory demyelinating polyneuropathy are described in which cranial nerve involvement accompanied a more generalized neuropathy. Clinical, electrophysiological, radiological and nerve biopsy findings are presented. Cranial nerve lesions in this form of polyneuropathy may be related to lesions of the peripheral nerves or of the central nervous system, when they may be accompanied by MRI evidence of

  19. Diffusion tensor imaging for anatomical localization of cranial nerves and cranial nerve nuclei in pontine lesions: initial experiences with 3T-MRI.

    PubMed

    Ulrich, Nils H; Ahmadli, Uzeyir; Woernle, Christoph M; Alzarhani, Yahea A; Bertalanffy, Helmut; Kollias, Spyros S

    2014-11-01

    With continuous refinement of neurosurgical techniques and higher resolution in neuroimaging, the management of pontine lesions is constantly improving. Among pontine structures with vital functions that are at risk of being damaged by surgical manipulation, cranial nerves (CN) and cranial nerve nuclei (CNN) such as CN V, VI, and VII are critical. Pre-operative localization of the intrapontine course of CN and CNN should be beneficial for surgical outcomes. Our objective was to accurately localize CN and CNN in patients with intra-axial lesions in the pons using diffusion tensor imaging (DTI) and estimate its input in surgical planning for avoiding unintended loss of their function during surgery. DTI of the pons obtained pre-operatively on a 3Tesla MR scanner was analyzed prospectively for the accurate localization of CN and CNN V, VI and VII in seven patients with intra-axial lesions in the pons. Anatomical sections in the pons were used to estimate abnormalities on color-coded fractional anisotropy maps. Imaging abnormalities were correlated with CN symptoms before and after surgery. The course of CN and the area of CNN were identified using DTI pre- and post-operatively. Clinical associations between post-operative improvements and the corresponding CN area of the pons were demonstrated. Our results suggest that pre- and post-operative DTI allows identification of key anatomical structures in the pons and enables estimation of their involvement by pathology. It may predict clinical outcome and help us to better understand the involvement of the intrinsic anatomy by pathological processes. PMID:24998855

  20. [Unusual manifestation of zoster sine herpete as unilateral caudal cranial nerve syndrome].

    PubMed

    Terborg, C; Förster, G; Sliwka, U

    2001-12-01

    Multiple lower cranial nerve palsies are a rare complication following varicella zoster virus (VZV) reactivation, especially if typical herpetic eruptions are lacking. We report a case of a 45-year-old, immunocompetent male with unilateral involvement of the cranial nerves VIII, IX, X, and XI without skin lesions. Cerebrospinal fluid (CSF) studies revealed mononuclear pleocytosis with intrathecal antibody synthesis against VZV, while polymerase chain reaction (PCR) did not detect VZV or HSV (herpes simplex virus). The patient almost completely recovered after aciclovir administration. VZV reactivation without rash (zoster sine herpete) may lead to multiple cranial nerve palsies. PCR is a useful tool to detect VZV-DNA in CSF, but negative results do not exclude a reactivation. In case of multiple cranial nerve palsies of unknown etiology with mononuclear pleocytosis in CSF tumors of the skull base, meningitis tuberculosis, and meningeosis have to be excluded, and antiviral therapy should be discussed. PMID:11789442

  1. Persistent hiccups and vomiting with multiple cranial nerve palsy in a case of zoster sine herpete.

    PubMed

    Yoshida, Takeshi; Fujisaki, Natsumi; Nakachi, Ryo; Sueyoshi, Takeshi; Suwazono, Shugo; Suehara, Masahito

    2014-01-01

    A 76-year-old man came to our hospital complaining of hiccups and vomiting lasting for five days. A neurological examination showed dysfunction of cranial nerves V, VII, VIII, IX and X on the left side. Cerebrospinal fluid polymerase chain reaction for varicella zoster virus-DNA was positive. The patient responded well to treatment with intravenous acyclovir and steroids. To the best of our knowledge, this is the first case report of zoster sine herpete presenting with persistent hiccups and vomiting. It is important to keep in mind that herpes zoster can present with symptoms that closely resemble those of intractable hiccups and nausea of neuromyelitis optica. Early detection of the virus is critical for making appropriate treatment decisions. PMID:25318806

  2. [Chronic inflammatory demyelinating polyradiculoneuropathy with hypertrophy of spinal roots, brachial plexus and cranial nerves].

    PubMed

    Aïdi, S; El Alaoui Faris, M; Amarti, A; Belaïdi, H; Jiddane, M; Guezzaz, M; Medjel, A; Chkili, T

    2002-09-01

    We report two patients who presented an atypical chronic inflammatory demyelinating polyradiculoneuropathy with massive nerve root and brachial plexus hypertrophy, and pseudotumoral supraclavicular mass. They also presented an hypertrophy of oculomotor and trigeminal nerves causing an exophthalmos and ocular palsy. Spinal root enlargement and cranial nerve hypertrophy was demonstrated by CT scanner and MRI. Brachial plexus biopsy showed a similar aspect of sural nerve, with an extensive onion bulb formation and perivascular inflammatory cell infiltration. There was an excellent response to steroids in both patients. PMID:12386527

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

    PubMed

    Jalil, Muhammad Fahmi Abdul; 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

  4. Branches of the intracavernous internal carotid artery and the blood supply of the intracavernous cranial nerves.

    PubMed

    Tekdemir, I; Tüccar, E; Cubuk, H E; Ersoy, M; Elhan, A; Deda, H

    1998-08-01

    With the increasing frequency of surgical operations to the cavernous sinus greater knowledge of the microanatomy of the cavernous sinus has become necessary. The most frequently seen complications during cavernous sinus surgery involve impairment of cranial nerves. This can occur due to direct damage or ischemia. For these reasons, it is important to know the arterial supplies to the cranial nerves in the cavernous sinus and the anatomy of these branches as well. 15 formaline fixed adult cadavers were used in this study. Before the dissections, the internal carotid artery and vertebral artery were filled with coloured latex on both sides. In this report, the intracavernous branches of internal carotid artery (I.I.C.A.) were identified based on the principles of Nomina Anatomica (1989) and compared with others. In our study we found that the segment of the abducens nerve which lies in Dorello's channel was supplied by the meningeal branch; from the point at which it pierces the cerebellar tentorium, the trochlear nerve is supplied by the tentorial cerebellar artery; the posterior cerebellar artery supplies the proximal segment of the oculomotor nerve that proceeds to the oculomotor triangle. Except for these, all the cranial nerves that were located on the lateral wall of the sinus cavernosus are supplied by the tentorial marginal branch and the branches of the lateral trunk. PMID:9728276

  5. Microsurgical anatomy of VII and VIII cranial nerves and related arteries in the cerebellopontine angle

    Microsoft Academic Search

    DB Brunsteins; AJM Ferreri

    1990-01-01

    Summary The relationships of VII and VIII cranial nerves and related arteries are reviewed in 26 preparations by microdissection techniques. These vessels may be grouped in large (AICA, PICA), medium (LA, SA, CSA, RPI) and small calibre (vasa nervorum, radicullar and medullar branches). The importance of these structures in acoustic neuroma surgery, vestibular neurectomy and cross-compression syndromes is discussed. “Vascular

  6. Acupuncture: a potential modality for the treatment of auricular pruritus in ramsay hunt syndrome with multiple cranial nerve lesions.

    PubMed

    Liu, Lan Ying; Wang, He Sheng; Sun, Jian Hua

    2015-03-01

    Auricular pruritus coexisted with multiple cranial nerve lesions in Ramsay Hunt syndrome has been rarely reported in the literature especially its treatment. However, auricular pruritus cannot be better improved along with the improvement of multiple cranial nerve lesions. We tried to solve the problem with acupuncture and got experience from it. The following 2 cases of Ramsay Hunt syndromeshow a potential modality for the treatment of auricular prurituswith acupuncture. PMID:25710744

  7. Microinjection of sigma ligands into cranial nerve nuclei produces vacuous chewing in rats

    Microsoft Academic Search

    Thuytien T. Tran; Brian R. de Costa; R. R. Matsumoto

    1998-01-01

    Many typical neuroleptics carry a high risk for producing motor side effects in humans, and have significant affinities for\\u000a sigma (?) receptors. Sigma receptors are densely concentrated in cranial nerve nuclei that comprise the final common pathways\\u000a for lingual, facial and masticatory movements; thus, they may serve as important substrates for some of the unwanted movements\\u000a that can accompany neuroleptic

  8. Central Retinal Artery Occlusion and Third Cranial Nerve Palsy Following Nasal Septoplasty

    PubMed Central

    Rao, G. Nageswar; Rout, Khageswar; Pal, Arttatrana

    2012-01-01

    Background Postoperative vision loss following routine nasal surgery is an extremely rare and devastating complication. We report a case of unilateral blindness due to central retinal artery occlusion associated with third cranial nerve following septoplasty. Case Report We report a patient who developed an unusual central retinal artery occlusion with unilateral blindness following nasal surgery under general anesthesia. A 45-year-old man underwent a nasal septal surgery for severe epistaxis. Soon after recovery, the patient noticed loss of vision in his right eye and was unable to lift his upper eyelid. Upon ophthalmic examinations, we determined that he had right-sided third cranial nerve palsy with central retinal artery obstruction and ptosis of right upper eyelid, restriction of ocular movements, and no perception of light in the right eye. Postoperative computerized tomography scan revealed multiple fractures of the left medial orbital wall, including one near the optic canal. Ptosis and ocular defects were recovered partially, but visual loss persisted until the last follow-up. Conclusion This paper highlights one case of complete unilateral blindness from direct central retinal artery occlusion associated with third cranial nerve palsy following an apparently uneventful septorhinoplasty. Ophthalmologists and otolaryngologists should therefore be aware of the possible occurrence of such complications. PMID:23139676

  9. Recurrent and self-remitting sixth cranial nerve palsy: pathophysiological insight from skull base chondrosarcoma.

    PubMed

    Frassanito, Paolo; Massimi, Luca; Rigante, Mario; Tamburrini, Gianpiero; Conforti, Giulio; Di Rocco, Concezio; Caldarelli, Massimo

    2013-12-01

    Palsy of the abducens nerve is a neurological sign that has a wide range of causes due to the nerve's extreme vulnerability. Need of immediate neuroimaging is a matter of debate in the literature, despite the risks of delaying the diagnosis of a skull base tumor. The authors present 2 cases of skull base tumors in which the patients presented with recurrent and self-remitting episodes of sixth cranial nerve palsy (SCNP). In both cases the clinical history exceeded 1 year. In a 17-year-old boy the diagnosis was made because of the onset of headache when the tumor reached a very large size. In a 12-year-old boy the tumor was incidentally diagnosed when it was still small. In both patients surgery was performed and the postoperative course was uneventful. Pathological diagnosis of the tumor was consistent with that of a chondrosarcoma in both cases. Recurrent self-remitting episodes of SCNP, resembling transitory ischemic attacks, may be the presenting sign of a skull base tumor due to the anatomical relationships of these lesions with the petroclival segment of the sixth cranial nerve. Physicians should promptly recommend neuroimaging studies if SCNP presents with this peculiar course. PMID:24138144

  10. Cranial nerve involvement in systemic sclerosis (scleroderma): a report of 10 cases.

    PubMed

    Teasdall, R D; Frayha, R A; Shulman, L E

    1980-03-01

    Ten patients with the diagnosis of systemic sclerosis developed cranial nerve involvement. A trigeminal sensory neuropathy evolved insidiously in all patients and in five of these it was a presenting complaint. The glossopharyngeal nerve was involved in one patient. Taste was impaired in one patient and a unilateral loss of taste with fasciculations of the tongue were noted in another. Tinnitus was a complaint in three patients, two of whom had bilateral impairment of hearing. Facial weakness was noted in five patients. In three, this weakness was bilateral, while in the others the weakness was unilateral, and a past history of acute onset was obtained. The microangiopathy of systemic sclerosis is felt to be primarily responsible for these neurological deficits. The deposition of fibrous tissue may be a secondary phenomenon and contribute to the process by compression of nerves. PMID:6244477

  11. 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) ...

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

    PubMed

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

    2014-01-01

    Descriptions of the anatomy of the neural communications among the cranial nerves and their branches is lacking in the literature. Knowledge of the possible neural interconnections found among these nerves may prove useful to surgeons who operate in these regions to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections among the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized in two parts. Part I concerns the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches with any other nerve trunk or branch in the vicinity. Part II concerns the anastomoses among the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or among these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part I is presented in this article. An extensive anastomotic network exists among the lower cranial nerves. Knowledge of such neural intercommunications is important in diagnosing and treating patients with pathology of the skull base. PMID:24272859

  13. Sixth cranial nerve palsy caused by gastric adenocarcinoma metastasis to the clivus.

    PubMed

    Lee, Aleum; Chang, Kee-Hyun; Hong, Hyunsook; Kim, Heekyung

    2015-03-01

    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

  14. 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.

  15. New approach to neurorehabilitation: cranial nerve noninvasive neuromodulation (CN-NINM) technology

    NASA Astrophysics Data System (ADS)

    Danilov, Yuri P.; Tyler, Mitchel E.; Kaczmarek, Kurt A.; Skinner, Kimberley L.

    2014-06-01

    Cranial Nerve NonInvasive NeuroModulation (CN-NINM) is a primary and complementary multi-targeted rehabilitation therapy that appears to initiate the recovery of multiple damaged or suppressed brain functions affected by neurological disorders. It is deployable as a simple, home-based device (portable neuromodulation stimulator, or PoNSTM) and training regimen following initial patient training in an outpatient clinic. It may be easily combined with many existing rehabilitation therapies, and may reduce or eliminate the need for more aggressive invasive procedures or possibly decrease total medication intake. CN-NINM uses sequenced patterns of electrical stimulation on the tongue. Our hypothesis is that CN-NINM induces neuroplasticity by noninvasive stimulation of two major cranial nerves: trigeminal (CN-V), and facial (CN-VII). This stimulation excites a natural flow of neural impulses to the brainstem (pons varolli and medulla), and cerebellum, to effect changes in the function of these targeted brain structures, extending to corresponding nuclei of the brainstem. CN-NINM represents a synthesis of a new noninvasive brain stimulation technique with applications in physical medicine, cognitive, and affective neurosciences. Our new stimulation method appears promising for treatment of a full spectrum of movement disorders, and for both attention and memory dysfunction associated with traumatic brain injury.

  16. Normal - Cranial Nerves Exam - Facial Nerve (CN VII) Sub-exam - Patient 1

    NSDL National Science Digital Library

    John C. Pearson, PhD

    This video provides a demonstration of a patient's facial nerve examination. The 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.

  17. The silent period induced by transcranial magnetic stimulation in muscles supplied by cranial nerves: normal data and changes in patients

    Microsoft Academic Search

    K J Werhahn; J Classen; R Benecke

    1995-01-01

    The silent period induced by transcranial magnetic stimulation of the sensorimotor cortex (Magstim 200, figure of eight coil, loop diameter 7 cm) in active muscles supplied by cranial nerves (mentalis, sternocleidomastoid, and genioglossus) was studied in 14 control subjects and nine patients with localised lesions of the sensorimotor cortex. In the patients, measurements of the silent period were also made

  18. Pilot Study of Cranial Stimulation for Symptom Management in Breast Cancer

    PubMed Central

    Lyon, Debra E.; Schubert, Christine; Taylor, Ann Gill

    2011-01-01

    Purpose/Objectives To examine the feasibility, relationships among variables, and preliminary outcomes of a self-directed complementary modality, cranial electrical stimulation (CES), for symptom management in women receiving chemotherapy for breast cancer. Design Biobehavioral pilot feasibility study. Setting Two university-based cancer centers. Sample 36 women with stage I-IIIA breast cancer scheduled to receive chemotherapy. Methods Data were collected via interview, questionnaires, and interactive voice technology (IVR). Biomarkers were measured from a blood sample taken prior to the initial chemotherapy. Main Research Variables Symptoms of depression, anxiety, fatigue, pain, and sleep disturbances; biomarkers (proinflammatory cytokines interleukin-6, tumor necrosis factor alpha [TNF-?0], interleukin-1 beta) and C-reactive protein [CRP]); and CES. Findings CES appears to be a safe and acceptable modality during chemotherapy. Recruitment and retention were adequate. IVR was associated with missing data. Symptoms of depression, anxiety, fatigue, and sleep disturbances were highly correlated with each other, and most symptoms were correlated with CRP at baseline. Depression and TNF-? had a positive, significant relationship. Levels of depression increased over time and trended toward less increase in the CES group; however, the differences among groups were not statistically significant. Conclusions The data support the feasibility of CES. Further testing in larger samples is needed to examine the efficacy of CES for symptom management of multiple, concurrent symptoms and to further develop the biobehavioral framework. Implications for Nursing Interventions that are effective at minimizing more than one target symptom are especially needed to provide optimal symptom management for women with breast cancer. PMID:20591807

  19. Lemierre syndrome associated with 12th cranial nerve palsy--a case report and review.

    PubMed

    Blessing, Kerstin; Toepfner, Nicole; Kinzer, Susanne; Möllmann, Cornelia; Geiger, Julia; Serr, Annerose; Hufnagel, Markus; Müller, Christoph; Krüger, Marcus; Ridder, Gerd J; Berner, Reinhard

    2013-09-01

    Since the widespread availability and use of antibiotics the prevalence of Lemierre syndrome (L.S.) has decreased. It is a well-described entity, consisting of postanginal septicaemia with thrombophlebitis of the internal jugular vein with metastatic infection, most commonly in the lungs. The most common causative agent is a gram-negative, non-spore-forming obligate anaerobic bacterium, Fusobacterium necrophorum (F.n.). We describe the unusual clinical features of a 12-year-old boy with Lemierre syndrome with isolated hypoglossal nerve palsy - the latter symptom is an extremely rare manifestation of this disease. PMID:23845534

  20. Sellar Chordoma Presenting as Pseudo-macroprolactinoma with Unilateral Third Cranial Nerve Palsy

    PubMed Central

    Wang, Hai-feng; Ma, Hong-xi; Ma, Cheng-yuan; Luo, Yi-nan; Ge, Peng-fei

    2012-01-01

    We described a 61-year-old female with a sellarchordoma, which presented as pseudo-macroprolactinoma with unilateral third cranial nerve palsy. Physical examination revealed that her right upper lid could not be raised by itself, right eyeball movement limited to the abduction direction, right pupil dilated to 4.5 mm with negative reaction to light, and hemianopsia in bitemporal sides. CT scanning showed a hyperdense lesion at sellar region without bone destruction. Magnetic resonance imaging (MRI) revealed the tumor was 2.3 cm×1.8 cm×2.6 cm, with iso-intensity on T1WI, hyper-intensity on T2WI and heterogeneous enhancement on contrast imaging. Endocrine examination showed her serum prolactin level increased to 1,031.49 mIU/ml. The tumor was sub-totally resected via pterional craniotomy under microscope and was histologically proven to be a chordoma. Postoperatively, she recovered uneventfully but ptosis and hemianopsia remained at the 6th month. PMID:23358442

  1. Low myelinated nerve-fibre density may lead to symptoms associated with nerve entrapment in vibration-induced neuropathy

    PubMed Central

    2014-01-01

    Prolonged exposure to hand-held vibrating tools may cause a hand-arm vibration syndrome (HAVS), sometimes with individual susceptibility. The neurological symptoms seen in HAVS are similar to symptoms seen in patients with carpal tunnel syndrome (CTS) and there is a strong relationship between CTS and the use of vibrating tools. Vibration exposure to the hand is known to induce demyelination of nerve fibres and to reduce the density of myelinated nerve fibres in the nerve trunks. In view of current knowledge regarding the clinical effects of low nerve-fibre density in patients with neuropathies of varying aetiologies, such as diabetes, and that such a low density may lead to nerve entrapment symptoms, a reduction in myelinated nerve fibres may be a key factor behind the symptoms also seen in patients with HAVS and CTS. Furthermore, a reduced nerve-fibre density may result in a changed afferent signal pattern, resulting in turn in alterations in the brain, further prompting the symptoms seen in patients with HAVS and CTS. We conclude that a low nerve-fibre density lead to symptoms associated with nerve entrapment, such as CTS, in some patients with HAVS. PMID:24606755

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

    PubMed Central

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

    2013-01-01

    Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG. PMID:23943720

  3. 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.

  4. Value of Free-Run Electromyographic Monitoring of Lower Cranial Nerves in Endoscopic Endonasal Approach to Skull Base Surgeries

    PubMed Central

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

    2012-01-01

    Objective?The main objective of this study was to evaluate the value of free-run electromyography (f-EMG) monitoring of cranial nerves (CNs) VII, IX, X, XI, and XII in skull base surgeries performed using endoscopic endonasal approach (EEA) to reduce iatrogenic CN deficits. Design?We retrospectively identified 73 patients out of 990 patients who had EEA in our institution who had at least one CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as group I and those who did not as group II. Results?We monitored a total of 342 CNs. A total of 62 nerves had SG f-EMG activity including CN VII?=?18, CN IX?=?16, CN X?=?13, CN XI?=?5, and CN XII?=?10. No nerve deficit was found in the nerves that had significant activity during procedure. A total of five nerve deficits including (CN IX?=?1, CN X?=?2, CN XII?=?2) were observed in the group that did not display SG f-EMG activity during surgery. Conclusions?f-EMG seems highly sensitive to surgical manipulations and in locating CNs. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of lower CNs during EEA procedures need to be done with both f-EMG and triggered EMG. PMID:23904999

  5. 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

  6. Evolution of different therapeutic strategies in the treatment of cranial dural arteriovenous fistulas — report of 30 cases

    Microsoft Academic Search

    G. Bavinzski; B. Richling; M. Killer; A. Gruber; D. Levy

    1996-01-01

    Summary 30 cases of cranial dural arteriovenous fistulas, treated between 1983 and 1992, are reported. Twelve presented with an aggressive clinical couse including intracranial haemorrhage, progredient neurological deficit, medically intractable seizures, and cerebellar symptoms. The other 18 patients had a more benign clinical presentation with audible bruit, exophthalmus, chemosis, and cranial nerve dysfunction. One of the latter had symptoms of

  7. 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.

  8. Parenchymal Anaplastic Astrocytoma presenting with Visual Symptoms due to Bilateral Optic Nerve Sheath Involvement

    PubMed Central

    Bui, Kelly M; Farooq, Asim V; Valyi-Nagy, Tibor; Villano, J. Lee; Moss, Heather E

    2013-01-01

    A 23 year old man presented with transient visual obscurations and was found to have optic nerve edema and a thalamic lesion that did not enhance on magnetic resonance imaging. Lumbar puncture opening pressure was normal. Subsequent magnetic resonance images demonstrated optic nerve sheath enhancement. Pathological diagnosis of the thalamic mass was anaplastic astrocytoma (WHO grade III). Visual symptoms were attributed to spread of high grade parenchymal glioma to the optic nerve sheaths causing intraorbital optic nerve compression. PMID:23838764

  9. Nasopharyngeal carcinoma with cranial nerve palsy: The importance of MRI for radiotherapy

    SciTech Connect

    Chang, Joseph T.-C. [Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Lin, C.-Y. [Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Chen, T.-M. [Department of Ear, Nose, and Throat, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Kang, C.-J. [Department of Ear, Nose, and Throat, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Ng, S.-H. [Department of 1st Radiology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Chen, I.-H. [Department of Ear, Nose, and Throat, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Wang, H.-M. [Department of Hematology/Oncology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Cheng, A.-J. [Department of Medical Technology, Chang Gung University, Taoyuan, Taiwan (China); Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China); Liao, C.-T. [Department of Ear, Nose, and Throat, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China) and Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan (China)]. E-mail: cgmhnog@yahoo.com

    2005-12-01

    Purpose: To evaluate various prognostic factors and the impact of imaging modalities on tumor control in patients with nasopharyngeal cancer (NPC) with cranial nerve (China) palsy. Material and Methods: Between September 1979 and December 2000, 330 NPC patients with CN palsy received radical radiotherapy (RT) by the conventional opposing technique at Chang Gung Memorial Hospital-Linkou. Imaging methods used varied over that period, and included conventional tomography (Tm) for 47 patients, computerized tomography (CT) for 195 patients, and magnetic resonance image (MRI) for 88 patients. Upper CN (II-VI) palsy was found in 268 patients, lower CN (IX-XII) in 13, and 49 patients had both. The most commonly involved CN were V or VI or both (23%, 12%, and 16%, respectively). All patients had good performance status (World Health Organization <2). The median external RT dose was 70.2 Gy (range, 63-77.5 Gy). Brachytherapy was also given to 156 patients in addition to external RT, delivered by the remote after-loading, high-dose-rate technique. A total of 139 patients received cisplatin-based chemotherapy, in 115 received as neoadjuvant or adjuvant chemotherapy and in 24 concomitant with RT. Recovery from CN palsy occurred in 171 patients during or after radiotherapy. Patients who died without a specific cause identified were regarded as having died with persistent disease. Results: The 3-year, 5-year, and 10-year overall survival was 47.1%, 34.4%, and 22.2%. The 3-year, 5-year, and 10-year disease-specific survival (DSS) rates were 50.4%, 37.8%, and 25.9%. The 5-year DSS for patients staged with MRI, CT, and Tm were 46.9%, 36.7%, and 21.9%, respectively (p = 0.016). The difference between MRI and CT was significant (p = 0.015). The 3-year and 5-year local control rates were 62% and 53%, respectively. The 5-year local control was 68.2% if excluding patients who died without a specific cause. Patients who had an MRI had a significantly better tumor control rate than those evaluated with CT or Tm, with a 15-30% improvement in local tumor control and survival. Patients with extensive CN palsy had worse survival than those with only lower CN or upper CN involvement (5-year DSS 20.4% vs. 43.2% and 40.4%, respectively; p < 0.001). Patients who recovered from CN palsy had better survival than those who did not (47% vs. 26%, p < 0.001). Brachytherapy was associated with poorer local control, whereas a total external dose of more than 70 Gy improved local tumor control and marginally improved DSS. Subgroup analysis in CT and MRI patients group, either DSS or OS was significantly associated with imaging modality, N stage, or location of or remission of CN palsy. Conclusion: The use of MRI was associated with improved tumor control and survival of patients with NPC causing CN palsy. Patients recovering from CN palsy had better survival. A higher radiation dose delivered by external beam may achieve better tumor control than brachytherapy.

  10. HINDBRAIN AND CRANIAL NERVE DYSMORPHOGENESIS RESULT FROM ACUTE MATERNAL ETHANOL ADMINISTRATION

    EPA Science Inventory

    Acute exposure of mouse embryos to ethanol during stages of hindbrain segmentation results in excessive cell death in specific cell populations. This study details the ethanol-induced cell loss and defines the subsequent effects of this early insult on rhombomere and cranial ner...

  11. [Intraoperative monitoring of brainstem auditory evoked potentials during microvascular decompression of cranial nerves in cerebellopontine angle].

    PubMed

    Polo, G; Fischer, C

    2009-04-01

    Brainstem auditory evoked potentials (BAEP) monitoring is a useful tool to decrease the danger of hearing loss during pontocerebellar angle surgery, particularly in microvascular decompression (MVD). Critical complications arising during MVD surgery are the stretching of the VIII nerve - the main cause of hearing loss - labyrinthine artery manipulation, direct trauma with instruments, or a nearby coagulation, and at end of the surgery neocompression of the cochlear nerve by the prosthesis positioned between the conflicting vessel(s) and the VIIth-VIIIth nerve complex. All these dangers warrant the use of BEAP monitoring during the surgical team's training period. Based on delay in latency of peak V, we established warning thresholds that can provide useful feedback to the surgeon to modify the surgical strategy: the initial signal at 0.4 ms is considered the safety limit. A second signal threshold at 0.6 ms (warning signal for risk) corresponds to the group of patients without resultant hearing loss. The third threshold characterized by the delay of peak V is at 1 ms (warning signal for a potentially critical situation). BAEP monitoring provides the surgeon with information on the functional state of the auditory pathways and should help avoid or correct manoeuvres that can harm hearing function. BAEP monitoring during VIIth-VIIIth complex surgery, particularly in MVD of facial nerves for HFS is very useful during the learning period. PMID:19298982

  12. Myofibroma in the Palm Presenting with Median Nerve Compression Symptoms

    PubMed Central

    Sarkozy, Heidi

    2014-01-01

    Summary: A myofibroma is a benign proliferation of myofibroblasts in the connective tissue. Solitary myofibromas are a rare finding especially in an adult. We report a case of a 23-year-old man presenting with an enlarging mass over his right palm. The patient is an active weight lifter. He reported numbness and tingling in the median nerve distribution. Nerve conduction studies and magnetic resonance imaging scans suggested a tumor involving or compressing the median nerve. The final diagnosis of myofibroma was made only after the histopathological diagnosis. PMID:25426387

  13. Non-aneurysmal Cranial Nerve Compression As Cause of Neuropathic Strabismus: Evidence from High-resolution Magnetic Resonance Imaging

    PubMed Central

    Tsai, Tzu-Hsun; Demer, Joseph L.

    2011-01-01

    Purpose To seek evidence of neurovascular compression of motor cranial nerve (CN) in otherwise idiopathic neuropathic strabismus using high resolution magnetic resonance imaging (MRI). Design Prospective, observational case series. Methods High-resolution, surface coil orbital MRI was performed in 10 strabismic patients with idiopathic oculomotor (CN3) or abducens (CN6) palsy. Relationships between CNs and intracranial arteries were demonstrated by 0.8 mm thick, 162 micron resolution, heavily T2 weighted MRI in fast imaging employing steady state acquisition sequence. Images were digitally analyzed to evaluate cross-sectional areas of extraocular muscles. Results In one patient with CN3 palsy, an ectatic posterior communicating artery markedly flattened and thinned the ipsilateral subarachnoid CN3. Cross-sections of the affected medial, superior and inferior rectus muscles 10 mm posterior to the globe-optic nerve junction were 17.2 ±2. 5 mm2, 15.5 ± 1.3 mm2, and 9.9 ± 0.8 mm2, significantly smaller than the values of 23.6 ± 1.9, 30.4 ± 4.1, 28.8 ± 4.6 mm2 of the unaffected side (P < 0.001). In two patients with otherwise unexplained CN6 palsy, ectatic basilar arteries contacted CN6. Mean cross-sections of affected lateral rectus muscles were 24.0 ± 2.3 and 29.8 ± 3.1 mm2, significantly smaller than the values of 33.5 ± 4.1 mm2 and 36.9 ± 1.6 mm2 in unaffected contralateral eyes (P < 0.05). Conclusions Non-aneurysmal motor CN compression should be considered as a cause of CN3 and CN6 paresis with neurogenic muscle atrophy, when MRI demonstrates vascular distortion of the involved CN. Demonstration of a benign vascular etiology can terminate continuing diagnostic investigations and expedite rational management of the strabismus. PMID:21861970

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

    E-print Network

    Gruber, Charles M.

    1912-06-01

    and l e a v e s the t i ssues unal tered in funct ion . I t i » p o s s i b l e that i t may be of p r a c t i c a l and va luab l e a i d in surgery or f o r experimental purposes t I wish .to thank Dr. Ida H. Hyde f o r sugges t ing the sub­ j e c... e n t and e f f e r e n t f i b r e s in the phrenic nerve . A t t h e suggest ion of Dr . C, S. Sherr ing ton , s e ve ra l years ago B r * Hyde began experimentinp with the phrenic n e r v e . At her re que a t I have repeated and completed her...

  15. Stellate ganglion block can relieve symptoms and pain and prevent facial nerve damage

    PubMed Central

    Gogia, Anoop Raj; Chandra, Kumar Naren

    2015-01-01

    Ramsay hunt syndrome[1] is a varicella zoster virus infection of the geniculate ganglion of the facial nerve. It is typically associated with a red rash and blister (inflamed vesicles or tiny water filled sacks in the skin) in or around the ear and eardrum and sometimes on the roof of the mouth or tongue. Corticosteroid, oral acyclovir, and anticonvulsant are used for treatment of this. In addition to this sympathetic neural blockade via stellate ganglion block is used to prevent facial nerve damage and relieve symptoms. We present a case of Ramsay hunt syndrome in which pain and symptoms are not relieved by oral medication but by daily sittings of stellate ganglion block with local anesthetic and steroid, pain, and other symptoms are relieved, and facial nerve damage is prevented.

  16. 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

  17. Influence of nerve growth factor in endometriosis-associated symptoms.

    PubMed

    Barcena de Arellano, Maria L; Arnold, Julia; Vercellino, Giuseppe F; Chiantera, Vito; Ebert, Andreas D; Schneider, Achim; Mechsner, Sylvia

    2011-12-01

    To investigate the role of the nerve growth factor (NGF) in the development of dysmenorrhea/pelvic pain in patients with endometriosis, we performed a prospective, clinical, blind study. Peritoneal fluids (PFs) were obtained from patients with histologically proven endometriosis. Patients with endometriosis were divided into 7 different groups depending on their preoperative pain score and symptomatology: patients with no pain, patients with minimal pain (dysmenorrhea, pelvic pain, or both), and patients with severe pain (dysmenorrhea, pelvic pain, or both) and were used for the neuronal growth assay with cultured chicken dorsal root ganglia (DRG) and for Western blot analyses. Dorsal root ganglia were stained with anti-calcitonin gene-related peptide (CGRP) and anti-growth-associated protein 43 (GAP 43). Peritoneal fluids from patients with endometriosis induce neurite outgrowth. There was no significant difference in the outgrowth between the 7 pain groups. Western blot analyses showed a moderate NGF expression in the PFs from patients with endometriosis, without significant differences in the 7 pain groups. The present study suggests that the neurotrophic properties of endometriotic tissues are endometriosis- and not pain-associated. PMID:21673280

  18. Microvascular Cranial Nerve Palsy

    MedlinePLUS

    ... Cataracts Contact Lens-Related Infections Detached & Torn Retina Diabetic Retinopathy Dry Eye Floaters & Flashes Glaucoma Hyperopia (Farsightedness) Low ... Eye M.D.-approved information from EyeSmart My Diabetic Retinopathy Journey - Eye M.D.-approved information from EyeSmart ...

  19. 3T MRI and 128-slice dual-source CT cisternography images of the cranial nerves a brief pictorial review for clinicians.

    PubMed

    Roldan-Valadez, Ernesto; Martinez-Anda, Jaime J; Corona-Cedillo, Roberto

    2014-01-01

    There is a broad community of health sciences professionals interested in the anatomy of the cranial nerves (CNs): specialists in neurology, neurosurgery, radiology, otolaryngology, ophthalmology, maxillofacial surgery, radiation oncology, and emergency medicine, as well as other related fields. Advances in neuroimaging using high-resolution images from computed tomography (CT) and magnetic resonance (MR) have made highly-detailed visualization of brain structures possible, allowing normal findings to be routinely assessed and nervous system pathology to be detected. In this article we present an integrated perspective of the normal anatomy of the CNs established by radiologists and neurosurgeons in order to provide a practical imaging review, which combines 128-slice dual-source multiplanar images from CT cisternography and 3T MR curved reconstructed images. The information about the CNs includes their origin, course (with emphasis on the cisternal segments and location of the orifices at the skull base transmitting them), function, and a brief listing of the most common pathologies affecting them. The scope of the article is clinical anatomy; readers will find specialized texts presenting detailed information about particular topics. Our aim in this article is to provide a helpful reference for understanding the complex anatomy of the cranial nerves. PMID:24302433

  20. Palatal tremor, progressive multiple cranial nerve palsies, and cerebellar ataxia: a case report and review of literature of palatal tremors in neurodegenerative disease.

    PubMed

    Kulkarni, P K; Muthane, U B; Taly, A B; Jayakumar, P N; Shetty, R; Swamy, H S

    1999-07-01

    We describe a patient with an unusual clinical presentation of progressive multiple cranial nerve palsies, cerebellar ataxia, and palatal tremor (PT) resulting from an unknown etiology. Magnetic resonance imaging showed evidence of hypertrophy of the inferior olivary nuclei, brain stem atrophy, and marked cerebellar atrophy. This combination of progressive multiple cranial nerve palsies, cerebellar ataxia, and PT has never been reported in the literature. We have also reviewed the literature of PT secondary to neurodegenerative causes. In a total of 23 patients, the common causes are sporadic olivopontocerebellar atrophy (OPCA; 22%), Alexander's disease (22%), unknown etiology (43.4%), and occasionally progressive supranuclear palsy (4.3%) and spinocerebellar degeneration (4.3%). Most patients present with progressive cerebellar ataxia and approximately two thirds of them have rhythmic tremors elsewhere. Ear clicks are observed in 13% and evidence of hypertrophy of the inferior olivary nucleus in 25% of the patients. The common neurodegenerative causes of PT are OPCA/multiple system atrophy, Alexander's disease, and, in most of them, the result of an unknown cause. PMID:10435510

  1. 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

  2. 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

  3. Oculomotor Nerve Palsy Caused by Posterior Communicating Artery Aneurysm: Evaluation of Symptoms after Endovascular Treatment

    PubMed Central

    Ko, J.H.; Kim, Y-J.

    2011-01-01

    Summary We report the outcome of endovascular treatment in a series of patients presenting with posterior communicating artery aneurysm causing ocular motor nerve palsy. A retrospective study was made of ten patients who were treated by coil embolization of posterior communicating artery aneurysm caused by oculomotor nerve palsy. The assessed parameters were as follows: patient’s age, presence of subarachnoid hemorrhage, aneurysm size, preoperative severity of symptoms, and timing of treatment after onset of symptoms. Improvement of oculomotor nerve palsy after treatment was noted in eight patients (80.0%). Complete recovery was noted in seven patients (70.0%), partial recovery in one patient (10.0%), and no recovery in two patients (20%). Clinical presentations with early management (?2 days) were significant in influencing recovery. Complete recovery from ocular motor nerve palsy was significantly higher in patients with initial incomplete palsy compared with initial complete palsy patients (6/6 versus 1/4). Early treatment and initial partial palsy are relevant to improving prognoses. Endovascular treatment is favored method for treating oculomotor palsy. PMID:22192543

  4. Chiropractic management of a patient with ulnar nerve compression symptoms: a case report

    PubMed Central

    Illes, Jennifer D.; Johnson, Theodore L.

    2013-01-01

    Objective The purpose of this case report is to describe chiropractic management of a patient with arm and hand numbness and who was suspected to have ulnar nerve compression. Clinical Features A 41-year-old woman presented with hand weakness and numbness along the medial aspect of her right forearm and the 3 most medial fingers. The onset of symptoms presented suddenly, 3 weeks prior, when she woke up in the morning and assumed she had “slept wrong.” The patient’s posture showed protracted shoulders and moderate forward head carriage. Orthopedic assessment revealed symptomatic right elevated arm stress test, grip strength asymmetry, and a Tinel sign at the right cubital tunnel. Intervention and Outcome The patient was treated using chiropractic care, which consisted of manipulative therapy, myofascial therapy, and elastic therapeutic taping. Active home care included performing postural exercises and education about workstation ergonomics. She demonstrated immediate subjective improvement of her numbness and weakness after the first treatment. Over a series of 11 treatments, her symptoms resolved completely; and she was able to perform work tasks without dysfunction. Conclusion Chiropractic treatment consisting of manipulation, soft tissue mobilizations, exercise, and education of workstation ergonomics appeared to reduce the symptoms of ulnar nerve compression symptoms for this patient. PMID:24294148

  5. Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome

    PubMed Central

    2013-01-01

    Background To inform the clinical management of patients with suspected carpal tunnel syndrome (CTS) and case definition for CTS in epidemiological research, we explored the relation of symptoms and signs to sensory nerve conduction (SNC) measurements. Methods Patients aged 20–64 years who were referred to a neurophysiology service for investigation of suspected CTS, completed a symptom questionnaire (including hand diagrams) and physical examination (including Tinel’s and Phalen’s tests). Differences in SNC velocity between the little and index finger were compared according to the anatomical distribution of symptoms in the hand and findings on physical examination. Results Analysis was based on 1806 hands in 908 patients (response rate 73%). In hands with numbness or tingling but negative on both Tinel’s and Phalen’s tests, the mean difference in SNC velocities was no higher than in hands with no numbness or tingling. The largest differences in SNC velocities occurred in hands with extensive numbness or tingling in the median nerve sensory distribution and both Tinel’s and Phalen’s tests positive (mean 13.8, 95% confidence interval (CI) 12.6-15.0 m/s). Hand pain and thumb weakness were unrelated to SNC velocity. Conclusions Our findings suggest that in the absence of other objective evidence of median nerve dysfunction, there is little value in referring patients of working age with suspected CTS for nerve conduction studies if they are negative on both Tinel’s and Phalen’s tests. Alternative case definitions for CTS in epidemiological research are proposed according to the extent of diagnostic information available and the relative importance of sensitivity and specificity. PMID:23947775

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

    PubMed Central

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

    2013-01-01

    Acute multiple cranial neuropathies are considered as variant of Guillain-Barre syndrome, which are immune-mediated diseases triggered by various cases. It is a rare disease which is related to infectious, inflammatory or systemic diseases. According to previous case reports, those affected can exhibit almost bilateral facial nerve palsy, then followed by bulbar dysfunctions (cranial nerves IX and X) accompanied by limb weakness and walking difficulties due to motor and/or sensory dysfunctions. Furthermore, reported cases of the acute multiple cranial neuropathies show electrophysiological abnormalities compatible with the typical Guillain-Barre syndromes (GBS). We recently experienced a patient with a benign infectious disease who subsequently developed symptoms of variant GBS. Here, we describe the case of a 48-year-old male patient who developed multiple symptoms of cranial neuropathy without limb weakness. His laboratory findings showed a positive result for anti-GQ1b IgG antibody. As compared with previously described variants of GBS, the patient exhibited widespread cranial neuropathy, which included neuropathies of cranial nerves III-XII, without limb involvement or ataxia. PMID:24236266

  7. Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report

    PubMed Central

    2012-01-01

    Introduction Bilateral third nerve palsy secondary to a hemorrhagic stroke is exceptional. To the best of our knowledge, no similar case has been reported in the literature. Case presentation We describe the case of a 69-year-old Moroccan man who presented with isolated sudden bilateral third nerve palsy. Computed tomography (CT) of the brain revealed a midbrain hematoma. The oculomotor function gradually and completely improved over eight months of follow-up. Conclusion Stroke should be included in the differential diagnosis of sudden isolated oculomotor paralysis even when it is bilateral because of the severity of the underlying disease and the importance of its therapeutic implications. PMID:22800468

  8. [Invasive aspergillosis of sphenoidal sinus in a patient in Djibouti, revealed by palsy of cranial nerves: a case report].

    PubMed

    Crambert, A; Gauthier, J; Vignal, R; Conessa, C; Lombard, B

    2013-05-01

    The authors report a case of invasive aspergillosis of a sphenoid sinus mucocele revealed in a patient with diabetes in Djibouti by homolateral palsy of the 3rd, 4th, 5th and 6th nerves. This rare condition occurs preferentially in immunodeficient subjects. Because of its clinical polymorphism, its diagnosis is difficult and is often not made until complications develop. Endonasal surgery with anatomopathological and mycological examination is both a diagnostic and therapeutic procedure. It must be performed early, to avoid functional or even life-threatening complications. PMID:23803589

  9. Simultaneous transcutaneous electrical nerve stimulation mitigates simulator sickness symptoms in healthy adults: a crossover study

    PubMed Central

    2013-01-01

    Background Flight simulators have been used to train pilots to experience and recognize spatial disorientation, a condition in which pilots incorrectly perceive the position, location, and movement of their aircrafts. However, during or after simulator training, simulator sickness (SS) may develop. Spatial disorientation and SS share common symptoms and signs and may involve a similar mechanism of dys-synchronization of neural inputs from the vestibular, visual, and proprioceptive systems. Transcutaneous electrical nerve stimulation (TENS), a maneuver used for pain control, was found to influence autonomic cardiovascular responses and enhance visuospatial abilities, postural control, and cognitive function. The purpose of present study was to investigate the protective effects of TENS on SS. Methods Fifteen healthy young men (age: 28.6?±?0.9 years, height: 172.5?±?1.4 cm, body weight: 69.3?±?1.3 kg, body mass index: 23.4?±?1.8 kg/m2) participated in this within-subject crossover study. SS was induced by a flight simulator. TENS treatment involved 30 minutes simultaneous electrical stimulation of the posterior neck and the right Zusanli acupoint. Each subject completed 4 sessions (control, SS, TENS, and TENS?+?SS) in a randomized order. Outcome indicators included SS symptom severity and cognitive function, evaluated with the Simulator Sickness Questionnaire (SSQ) and d2 test of attention, respectively. Sleepiness was rated using the Visual Analogue Scales for Sleepiness Symptoms (VAS-SS). Autonomic and stress responses were evaluated by heart rate, heart rate variability (HRV) and salivary stress biomarkers (salivary alpha-amylase activity and salivary cortisol concentration). Results Simulator exposure increased SS symptoms (SSQ and VAS-SS scores) and decreased the task response speed and concentration. The heart rate, salivary stress biomarker levels, and the sympathetic parameter of HRV increased with simulator exposure, but parasympathetic parameters decreased (p?symptom severity significantly decreased and the subjects were more able to concentrate and made fewer cognitive test errors (p?symptoms and alleviating cognitive impairment. Trial registration number Australia and New Zealand Clinical Trials Register: http://ACTRN12612001172897 PMID:23587135

  10. Clinical Assessment of the Ulnar Nerve at the Elbow: Reliability of Instability Testing and the Association of Hypermobility with Clinical Symptoms

    PubMed Central

    Calfee, Ryan P.; Manske, Paul R.; Gelberman, Richard H.; Van Steyn, Marlo O.; Steffen, Jennifer; Goldfarb, Charles A.

    2010-01-01

    Background: Ulnar nerve hypermobility has been reported to be present in 2% to 47% of asymptomatic individuals. To our knowledge, the physical examination technique for diagnosing ulnar nerve hypermobility has not been standardized. This study was designed to quantify the interobserver reliability of the physical examination for ulnar nerve hypermobility and to determine whether ulnar nerve hypermobility is associated with clinical symptoms. Methods: Four hundred elbows in 200 volunteer participants were examined. Each participant was queried regarding symptoms attributable to the ulnar nerve. Three examiners, unaware of reported symptoms, independently performed a standardized examination of both elbows to assess ulnar nerve hypermobility. Ulnar nerves were categorized as stable or as hypermobile, which was further subclassified as perchable, perching, or dislocating. Provocative maneuvers, consisting of the Tinel test and flexion compression testing, were performed, and structural measurements were recorded. Kappa values quantified the examination's interobserver reliability. Unpaired t tests, chi-square tests, Wilcoxon tests, and Fisher exact tests were utilized to compare data between those with hypermobile nerves and those with stable nerves. Results: Ulnar nerve hypermobility was identified in 37% (148) of the 400 elbows. Hypermobility was bilateral in 30% (fifty-nine) of the 200 subjects. For the three examiners, weighted kappa values on the right and left sides were 0.70 and 0.74, respectively. Elbows with nerve hypermobility did not experience a higher prevalence of subjective symptoms (snapping, pain, and tingling) than did elbows with stable nerves. Provocative physical examination testing for ulnar nerve irritability, however, showed consistent trends toward heightened irritability in hypermobile nerves (p = 0.04 to 0.16). Demographic data and anatomic measurements were similar between the subjects with stable nerves and those with hypermobile nerves. Conclusions: Ulnar nerve hypermobility occurs in over one-third of the adult population. Utilizing a standardized physical examination, a diagnosis of ulnar nerve hypermobility can be established with substantial interobserver reliability. In the general population, ulnar nerve hypermobility does not appear to be associated with an increased symptomatology attributable to the ulnar nerve. Clinical Relevance: The results of this study demonstrate the reliability of clinically diagnosing ulnar nerve hypermobility and the lack of association of ulnar nerve hypermobility with symptoms. PMID:21123610

  11. Diagnosis and microsurgical treatment of chondromas and chondrosarcomas of the cranial base

    PubMed Central

    GENG, SUMIN; ZHANG, JUNTING; ZHANG, LI-WEI; WU, ZHEN; JIA, GUIJUN; XIAO, XINRU; HAO, SHUYU

    2014-01-01

    Chondromas and chondrosarcomas of the cranial base are rare neoplastic diseases. The aim of the present study was to evaluate the diagnosis and microsurgical treatment of these difficult cranial base tumors. A total of 19 patients who underwent microsurgery were pathologically diagnosed with cranial base chondromas or chondrosarcomas and their clinical data was reviewed. The chondromas and chondrosarcomas of the cranial base in the present study commonly originated in the sphenopetrosal, sphenoclival or petroclival junctions, and the majority were located in the parasellar region of the middle cranial base extradurally. The most frequent symptoms were headaches and cranial nerve palsy, and the Karnofsky performance score (KPS), assessed pre-operatively, averaged at 87.1. A frontotemporal or preauricular subtemporal-infratemporal approach was used in 11 cases, a tempo-occipital transtentorial or presigmoid supratentorial-infratentorial approach was employed in six further cases, and the far-lateral or retrosigmoid approach was applied in the remaining two cases. A total or near-total tumor removal was secured in 13 cases, while a subtotal removal was obtained in another five and a partial removal was achieved in one case. The most common post-operative complications included cranial nerve palsy and cerebrospinal fluid leakage, but there were no post-operative fatalities. A total of 15 patients were followed up for a mean of 67.2 months (range, 5–140 months), and 13 (76.5%) of these patients were living normal lives (KPS, 80–90). There were two patients with recurrent tumors. The neuroradiological examinations and the presenting symptoms and signs allow the pre-operative diagnosis to be presumed for the majority of cranial base chondromas or chondrosarcomas. Surgical resection is the key treatment for these tumors, and this treatment is known to improve the survival rates. PMID:24959265

  12. The Effect of Exercise on Neuropathic Symptoms, Nerve Function, and Cutaneous Innervation in People with Diabetic Peripheral Neuropathy

    PubMed Central

    Kluding, Patricia M.; Pasnoor, Mamatha; Singh, Rupali; Jernigan, Stephen; Farmer, Kevin; Rucker, Jason; Sharma, Neena; Wright, Douglas E.

    2012-01-01

    Although exercise can significantly reduce the prevalence and severity of diabetic complications, no studies have evaluated the impact of exercise on nerve function in people with diagnosed diabetic peripheral neuropathy (DPN). The purpose of this pilot study was to examine feasibility and effectiveness of a supervised, moderately intense aerobic and resistance exercise program in people with DPN. We hypothesize that the exercise intervention can improve neuropathic symptoms, nerve function, and cutaneous innervation. Methods A pre-test post-test design was to assess change in outcome measures following participation in a 10-week aerobic and strengthening exercise program. Seventeen subjects with diagnosed DPN (8 males/9 females; age 58.4±5.98; duration of diabetes 12.4±12.2 years) completed the study. Outcome measures included pain measures (visual analog scale), Michigan Neuropathy Screening Instrument (MNSI) questionnaire of neuropathic symptoms, nerve function measures, and intraepidermal nerve fiber (IENF) density and branching in distal and proximal lower extremity skin biopsies. Results Significant reductions in pain (?18.1±35.5 mm on a 100 mm scale, p=0.05), neuropathic symptoms (?1.24±1.8 on MNSI, p=0.01), and increased intraepidermal nerve fiber branching (+0.11±0.15 branch nodes/fiber, p=?.008) from a proximal skin biopsy were noted following the intervention. Conclusions This is the first study to describe improvements in neuropathic and cutaneous nerve fiber branching following supervised exercise in people with diabetic peripheral neuropathy. These findings are particularly promising given the short duration of the intervention, but need to be validated by comparison with a control group in future studies. PMID:22717465

  13. Bilateral chronic subdural hematomas resulting in unilateral oculomotor nerve paresis and brain stem symptoms after operation--case report.

    PubMed

    Okuchi, K; Fujioka, M; Maeda, Y; Kagoshima, T; Sakaki, T

    1999-05-01

    An 85-year-old male presented with bilateral chronic subdural hematomas (CSDHs) resulting in unilateral oculomotor nerve paresis and brainstem symptoms immediately after removal of both hematomas in a single operation. Initial computed tomography on admission demonstrated marked thick bilateral hematomas buckling the brain parenchyma with a minimal midline shift. Almost simultaneous removal of the hematomas was performed with the left side was decompressed first with a time difference of at most 2 minutes. However, the patient developed right oculomotor nerve paresis, left hemiparesis, and consciousness disturbance after the operation. The relatively marked increase in pressure on the right side may have caused transient unilateral brain stem compression and herniation of unilateral medial temporal lobe during the short time between the right and left procedures. Another factor was the vulnerability of the oculomotor nerve resulting from posterior replacement of the brain stem and stretching of the oculomotor nerves as seen on sagittal magnetic resonance (MR) images. Axial MR images obtained at the same time demonstrated medial deflection of the distal oculomotor nerve after crossing the posterior cerebral artery, which indicates previous transient compression of the nerve and the brain stem. Gradual and symmetrical decompression without time lag is recommended for the treatment of huge bilateral CSDHs. PMID:10481440

  14. Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms-The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow.

    PubMed

    Inoue, Motohiro; Kitakoji, Hiroshi; Yano, Tadashi; Ishizaki, Naoto; Itoi, Megumi; Katsumi, Yasukazu

    2008-06-01

    To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i) Ex-B2 (at the disordered level), (ii) electrical acupuncture (EA) on the pudendal nerve and (iii) EA at the nerve root. Primary outcome measurements were pain and dysesthesia [evaluated with a visual analogue scale (VAS)] and continuous walking distance. In the animal study, sciatic nerve blood flow was measured with laser-Doppler flowmetry at, before and during three kinds of stimulation (manual acupuncture on lumber muscle, electrical stimulation on the pudendal nerve and electrical stimulation on the sciatic nerve) in anesthetized rats. For the clinical trial, approximately half of the patients who received Ex-B2 revealed amelioration of the symptoms. EA on the pudendal nerve was effective for the symptoms which had not improved by Ex-B2. Considerable immediate and sustained relief was observed in patients who received EA at the nerve root. For the animal study, increase in sciatic nerve blood flow was observed in 56.9% of the trial with lumber muscle acupuncture, 100% with pudendal nerve stimulation and 100% with sciatic nerve stimulation. Sciatic nerve stimulation sustained the increase longer than pudendal nerve stimulation. One mechanism of action of acupuncture and electrical acupuncture stimulation could be that, in addition to its influence on the pain inhibitory system, it participates in causing a transient change in sciatic nerve blood blow, including circulation to the cauda equine and nerve root. PMID:18604251

  15. Cranial sutures

    MedlinePLUS

    ... The cranial bones remain separate for about 12-18 months. They then grow together as part of normal ... fontanelle usually closes sometime between 9 months and 18 months. The sutures and fontanelles are needed for the ...

  16. Detection of third and sixth cranial nerve palsies with a novel method for eye tracking while watching a short film clip.

    PubMed

    Samadani, Uzma; Farooq, Sameer; Ritlop, Robert; Warren, Floyd; Reyes, Marleen; Lamm, Elizabeth; Alex, Anastasia; Nehrbass, Elena; Kolecki, Radek; Jureller, Michael; Schneider, Julia; Chen, Agnes; Shi, Chen; Mendhiratta, Neil; Huang, Jason H; Qian, Meng; Kwak, Roy; Mikheev, Artem; Rusinek, Henry; George, Ajax; Fergus, Robert; Kondziolka, Douglas; Huang, Paul P; Smith, R Theodore

    2015-03-01

    OBJECT Automated eye movement tracking may provide clues to nervous system function at many levels. Spatial calibration of the eye tracking device requires the subject to have relatively intact ocular motility that implies function of cranial nerves (CNs) III (oculomotor), IV (trochlear), and VI (abducent) and their associated nuclei, along with the multiple regions of the brain imparting cognition and volition. The authors have developed a technique for eye tracking that uses temporal rather than spatial calibration, enabling detection of impaired ability to move the pupil relative to normal (neurologically healthy) control volunteers. This work was performed to demonstrate that this technique may detect CN palsies related to brain compression and to provide insight into how the technique may be of value for evaluating neuropathological conditions associated with CN palsy, such as hydrocephalus or acute mass effect. METHODS The authors recorded subjects' eye movements by using an Eyelink 1000 eye tracker sampling at 500 Hz over 200 seconds while the subject viewed a music video playing inside an aperture on a computer monitor. The aperture moved in a rectangular pattern over a fixed time period. This technique was used to assess ocular motility in 157 neurologically healthy control subjects and 12 patients with either clinical CN III or VI palsy confirmed by neuro-ophthalmological examination, or surgically treatable pathological conditions potentially impacting these nerves. The authors compared the ratio of vertical to horizontal eye movement (height/width defined as aspect ratio) in normal and test subjects. RESULTS In 157 normal controls, the aspect ratio (height/width) for the left eye had a mean value ± SD of 1.0117 ± 0.0706. For the right eye, the aspect ratio had a mean of 1.0077 ± 0.0679 in these 157 subjects. There was no difference between sexes or ages. A patient with known CN VI palsy had a significantly increased aspect ratio (1.39), whereas 2 patients with known CN III palsy had significantly decreased ratios of 0.19 and 0.06, respectively. Three patients with surgically treatable pathological conditions impacting CN VI, such as infratentorial mass effect or hydrocephalus, had significantly increased ratios (1.84, 1.44, and 1.34, respectively) relative to normal controls, and 6 patients with supratentorial mass effect had significantly decreased ratios (0.27, 0.53, 0.62, 0.45, 0.49, and 0.41, respectively). These alterations in eye tracking all reverted to normal ranges after surgical treatment of underlying pathological conditions in these 9 neurosurgical cases. CONCLUSIONS This proof of concept series of cases suggests that the use of eye tracking to detect CN palsy while the patient watches television or its equivalent represents a new capacity for this technology. It may provide a new tool for the assessment of multiple CNS functions that can potentially be useful in the assessment of awake patients with elevated intracranial pressure from hydrocephalus or trauma. PMID:25495739

  17. [A case of hypertrophic cranial pachymeningitis].

    PubMed

    Okimura, Y; Tanno, H; Karasudani, H; Suda, S; Ono, J; Isobe, K

    1991-03-01

    A case of hypertrophic cranial pachymeningitis was reported. A 58-year-old female presented the symptoms of headache and vomiting. At the age of 27, she had suffered from tuberculosis. Neurological examination on admission revealed bilateral papilledema, bilateral hearing disturbance, right hypoglossal nerve palsy, ataxic gait, and bilateral intentional tremor. CT scan showed dilatation of the lateral and third ventricles, and compression of the fourth ventricle with marked enhancement of cerebellar tentorium. A ventriculoperitoneal shunt was installed bringing about improvement in bilateral papilledema, ataxic gait, and bilateral intentional tremor. One month later, ataxic gait and bilateral intentional tremor recurred, and monoparesis of the left upper extremity developed. MRI demonstrated hypertrophic dura mater in the posterior fossa and compressed cervical spinal cord. Decompressive surgery was performed bringing about remarkable clinical improvement. The pathological specimen showed thickening of the dura mater with concentric layers of dense fibrous tissue infiltrated with plasma cells. A diagnosis of hypertrophic cranial pachymeningitis was established. Three years later, the clinical features were found unchanged, but contrast enhancement of cerebellar tentorium had progressed markedly. Hypertrophic pachymeningitis is a uncommon disease. But it should be noted that intracranial involvement is very rare. The etiology, symptomatology, neuroradiology, and treatment are discussed and the literature is reviewed. PMID:2038416

  18. Glaucoma Symptoms

    MedlinePLUS

    ... angle, there are no discernible symptoms until the optic nerve is damaged and side (peripheral) vision is ... eye builds up gradually. At some point, the optic nerve is damaged and side vision (peripheral vision) ...

  19. Symptoms

    MedlinePLUS

    ... Wheat Soy Fish Shellfish Other Symptoms Diagnosis & Testing Proven Methods Skin Prick Tests Blood Tests Oral Food ... Wheat Soy Fish Shellfish Other Symptoms Diagnosis & Testing Proven Methods Skin Prick Tests Blood Tests Oral Food ...

  20. 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

  1. 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

  2. [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

  3. CELL ADHESION MOLECULE CADHERIN-6 FUNCTION IN ZEBRAFISH CRANIAL AND LATERAL LINE GANGLIA DEVELOPMENT

    PubMed Central

    Liu, Q.; Dalman, M. R.; Sarmah, S.; Chen, S.; Chen, Y.; Hurlbut, A. K.; Spencer, M. A.; Pancoe, L.; Marrs, J. A.

    2015-01-01

    Cadherins regulate the vertebrate nervous system development. We previously showed that cadherin-6 message (cdh6) was strongly expressed in the majority of the embryonic zebrafish cranial and lateral line ganglia during their development. Here, we present evidence that cdh6 has specific functions during cranial and lateral line ganglia and nerve development. We analyzed the consequences of cdh6 loss-of-function on cranial ganglion and nerve differentiation in zebrafish embryos. Embryos injected with zebrafish cdh6 specific antisense morpholino oligonucleotides (MOs, which suppress gene expression during development; cdh6 morphant embryos) displayed a specific phenotype, including (i) altered shape and reduced development of a subset of the cranial and lateral line ganglia (e.g. the statoacoustic ganglion and vagal ganglion) and (ii) cranial nerves were abnormally formed. This data illustrates an important role for cdh6 in the formation of cranial ganglia and their nerves. PMID:21584906

  4. Resection of an oculomotor nerve cavernous angioma

    PubMed Central

    Obaid, Sami; Li, Shu; Denis, Daniel; Weil, Alexander G.; Bojanowski, Michel W.

    2014-01-01

    Background: Cavernous angiomas (CAs) of cranial nerves are rare, and their occurrence on the third cranial nerve is particularly rare. Surgical management of such CAs involving the third nerve is controversial. We describe a case of a symptomatic CA of the oculomotor nerve and review the literature in order to ascertain the relevance of surgical intervention. Case Description: A 71-year-old male patient presented with a 2-month history of progressive oculomotor nerve paralysis. CA of the oculomotor nerve was suspected on magnetic resonance imaging (MRI). The patient underwent complete resection of the CA through a subtemporal approach, preserving the integrity of the nerve. Histopathological analysis confirmed the diagnosis of CA. Despite optimal resection, the patient did not improve postoperatively. Conclusion: CAs of cranial nerves can cause rapid or progressive neurological deterioration. Whereas delayed treatment often leads to irreversible deficits, early nerve-sparing surgical excision of the CAs may potentially restore function. PMID:25184101

  5. 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

  6. Differences in risk factors for neurophysiologically confirmed carpal tunnel syndrome and illness with similar symptoms but normal median nerve function: a case–control study

    PubMed Central

    2013-01-01

    Background To explore whether risk factors for neurophysiologically confirmed carpal tunnel syndrome (CTS) differ from those for sensory symptoms with normal median nerve conduction, and to test the validity and practical utility of a proposed definition for impaired median nerve conduction, we carried out a case–control study of patients referred for investigation of suspected CTS. Methods We compared 475 patients with neurophysiological abnormality (NP+ve) according to the definition, 409 patients investigated for CTS but classed as negative on neurophysiological testing (NP-ve), and 799 controls. Exposures to risk factors were ascertained by self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Results NP+ve disease was associated with obesity, use of vibratory tools, repetitive movement of the wrist or fingers, poor mental health and workplace psychosocial stressors. NP-ve illness was also related to poor mental health and occupational psychosocial stressors, but differed from NP+ve disease in showing associations also with prolonged use of computer keyboards and tendency to somatise, and no relation to obesity. In direct comparison of NP+ve and NP-ve patients (the latter being taken as the reference category), the most notable differences were for obesity (OR 2.7, 95 % CI 1.9-3.9), somatising tendency (OR 0.6, 95% CI 0.4-0.9), diabetes (OR 1.6, 95% CI 0.9-3.1) and work with vibratory tools (OR 1.4, 95% CI 0.9-2.2). Conclusions When viewed in the context of earlier research, our findings suggest that obesity, diabetes, use of hand-held vibratory tools, and repeated forceful movements of the wrist and hand are causes of impaired median nerve function. In addition, sensory symptoms in the hand, whether from identifiable pathology or non-specific in origin, may be rendered more prominent and distressing by hand activity, low mood, tendency to somatise, and psychosocial stressors at work. These differences in associations with risk factors support the validity of our definition of impaired median nerve conduction. PMID:23947720

  7. Collagen nerve wrap for median nerve scarring.

    PubMed

    Kokkalis, Zinon T; Mavrogenis, Andreas F; Ballas, Efstathios G; Papagelopoulos, Panayiotis J; Soucacos, Panayotis N

    2015-02-01

    Nerve wrapping materials have been manufactured to inhibit nerve tissue adhesions and diminish inflammatory and immunologic reactions in nerve surgery. Collagen nerve wrap is a biodegradable type I collagen material that acts as an interface between the nerve and the surrounding tissues. Its main advantage is that it stays in place during the period of tissue healing and is then gradually absorbed once tissue healing is completed. This article presents a surgical technique that used a collagen nerve wrap for the management of median nerve tissue adhesions in 2 patients with advanced carpal tunnel syndrome due to median nerve scarring and adhesions. At last follow-up, both patients had complete resolution with no recurrence of their symptoms. Complications related to the biodegradable material were not observed. PMID:25665110

  8. Pediatric neuroradiology: Cerebral and cranial diseases

    SciTech Connect

    Diebler, C.; Dulac, O.

    1987-01-01

    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index.

  9. Cranial CT scan

    MedlinePLUS

    Brain CT; Head CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial ... printed on film. Three-dimensional models of the head area can be created by stacking the slices ...

  10. Painful ophthalmoplegia with normal cranial imaging

    PubMed Central

    2014-01-01

    Background Painful ophthalmoplegia with normal cranial imaging is rare and confined to limited etiologies. In this study, we aimed to elucidate these causes by evaluating clinical presentations and treatment responses. Methods Cases of painful ophthalmoplegia with normal cranial MRI at a single center between January 2001 and June 2011 were retrospectively reviewed. Diagnoses of painful ophthalmoplegia were made according to the recommendations of the International Headache Society. Results Of the 58 painful ophthalmoplegia cases (53 patients), 26 (44.8%) were diagnosed as ocular diabetic neuropathy, 27 (46.6%) as benign Tolosa-Hunt syndrome (THS), and 5 (8.6%) as ophthalmoplegic migraine (OM). Patients with ocular diabetic neuropathy were significantly older (62.8?±?7.8 years) than those with benign THS (56.3 ±12.0 years) or OM (45.8?±?23.0 years) (p?Cranial nerve involvement was similar among groups. Pupil sparing was dominant in each group. Patients with benign THS and OM responded exquisitely to glucocorticoid treatment with resolved diplopia, whereas patients with ocular diabetic neuropathy didn’t (p?cranial imaging. Patient outcomes were generally good. PMID:24400984

  11. Isolated partial, transient hypoglossal nerve injury following acupuncture

    PubMed Central

    Harrison, A.M.; Hilmi, O.J.

    2014-01-01

    We report a case of isolated unilateral hypoglossal nerve injury following ipsilateral acupuncture for migraines in a 53-year-old lady. The palsy was partial, with no associated dysarthria, and transient. Further examination and imaging was negative. Cranial nerve injuries secondary to acupuncture are not reported in the literature, but are a theoretical risk given the location of the cranial nerves in the neck. Anatomical knowledge is essential in those administering the treatment, and those reviewing patients with possible complications. PMID:24876519

  12. Cranial mononeuropathy VI

    MedlinePLUS

    ... no clear cause. Because there are common nerve pathways through the skull, the same disorder that damages ... with diabetes may benefit from close control of blood sugar levels . Until the nerve heals, wearing an eye ...

  13. [Cranial hyperostosis as a metastasic adenocarcinoma presentation form].

    PubMed

    Suárez Alvarez, L; Muelas Gómez, N; Todolí Parra, J A; Sevilla Mantecón, T; Calabuig Alborch, J R

    2004-11-01

    Hyperostosis is a volume-unit osseous increase of very diverse etiology. We present the case of a 68-year woman with a cranial hyperostosis debuting with frontal protrusion, headache and neurologic symptoms. Image proves demonstrated a hyperostosis in the calotte and meningeal enhancement, without intracerebral lesions nor malignant cells in the cerebrospinal fluid. Analytic data were unspecific. Cranial biopsy showed huge neoplastic infiltration in bone and meninges. Primary site remained unknown after a CAT and a mammography. PMID:15538905

  14. 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.

  15. Optical stimulation of the facial nerve: a surgical tool?

    Microsoft Academic Search

    Claus-Peter Richter; Ingo Ulrik Teudt; Adam E. Nevel; Agnella D. Izzo; Joseph T. Walsh Jr.

    2008-01-01

    One sequela of skull base surgery is the iatrogenic damage to cranial nerves. Devices that stimulate nerves with electric current can assist in the nerve identification. Contemporary devices have two main limitations: (1) the physical contact of the stimulating electrode and (2) the spread of the current through the tissue. In contrast to electrical stimulation, pulsed infrared optical radiation can

  16. Cranial nasal bone grafts

    Microsoft Academic Search

    Geoffrey G. Hallock

    1989-01-01

    Reconstitution of the nasal scaffolding with maintainence of soft tissue proportions either following severe facial trauma or as a sequela to aesthetic rhinoplasty misadventures frequently is best achieved using the stability afforded by bone grafts. Split cranial bone grafts offer many advantages and may be the donor site of choice, and may even allow such surgery to be performed on

  17. Common peroneal nerve dysfunction

    MedlinePLUS

    ... people: Who are very thin (for example, from anorexia nervosa ) Who have conditions such as diabetic neuropathy or ... other tests are done depend on the suspected cause of nerve dysfunction, and the person's symptoms and ...

  18. Cranial neuralgias: from physiopathology to pharmacological treatment.

    PubMed

    De Simone, Roberto; Ranieri, Angelo; Bilo, Leonilda; Fiorillo, Chiara; Bonavita, Vincenzo

    2008-05-01

    Cranial neuralgias are paroxysmal painful disorders of the head characterised by some shared features such as unilaterality of symptoms, transience and recurrence of attacks, superficial and "shock-like" quality of pain and the presence of triggering factors. Although rare, these disorders must be promptly recognised as they harbour a relatively high risk for underlying compressive or inflammatory disease. Nevertheless, misdiagnosis is frequent. Trigeminal and glossopharyngeal neuralgias are sustained in most cases by a neurovascular conflict in the posterior fossa resulting in a hyperexcitability state of the trigeminal circuitry. If the aetiology of trigeminal neuralgia (TN) and other typical neuralgias must be brought back to the peripheral injury, their pathogenesis could involve central allodynic mechanisms, which, in patients with inter-critical pain, also engage the nociceptive neurons at the thalamic-cortical level. Currently available medical treatments for TN and other cranial neuralgias are reviewed. PMID:18545902

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

    PubMed

    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 8(th) 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

  20. Optic nerve compression due to aneurysmal bone cyst.

    PubMed

    Yee, R D; Cogan, D G; Thorp, T R; Schut, L

    1977-12-01

    A 10-year-old boy developed loss of central vision in both eyes due to compression of the optic nerves by a mass arising from the sphenoid and ethmoid sinuses. Histopathologic examination of biopsy specimens showed a fibrous matrix composed of spindle-shaped cells interspersed with small and large channels, characteristic of an aneurysmal bons cyst. One year after partial excision of the intracranial and extracranial portions fo the lesions, vision had returned to nearly normal levels. Aneurysmal bone cysts rarely involve the orbits or other cranial bones to produce ocular signs and symptoms. However, since this lesion probably represents reactive proliferation of bony tissues, rather than neoplasia, the prognosis for vision and life is good. PMID:588110

  1. Cranial neuropathies in granulomatosis with polyangiitis (Wegener's): a case-based review.

    PubMed

    Söderström, Ana; Revaz, Sylvie; Dudler, Jean

    2015-03-01

    The purpose of this case-based review is to highlight cranial nerve involvement in granulomatosis with polyangiitis (Wegener's). In this disease, cranial nerve involvement may be less frequent than other neurological manifestations, but often goes unrecognized by physicians as a sign of the disease, and its prevalence and importance is likely underestimated. Awareness of this aspect of the disease is necessary to make the proper diagnosis rapidly, as it can be a major feature of a patient's presentation. We also briefly discuss the known pathogenic mechanisms, which could be important when selecting the best therapeutic option. PMID:24352751

  2. [Babies with cranial deformity].

    PubMed

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

    2009-01-01

    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option. PMID:19857299

  3. [Dynamics of lagophthalmos depending on facial nerve repair and its intraoperative monitoring in neurosurgical patients].

    PubMed

    Tabachnikova, T V; Serova, N K; Shimansky, V N

    2014-01-01

    Over 200 patients with acoustic neuromas and over 100 patients with posterior cranial fossa meningiomas are annually operated on at the N.N. Burdenko Neurosurgical Institute. Intraoperative monitoring of the facial nerve function is used in most patients with tumors of the posterior cranial fossa to identify the facial nerve in the surgical wound. If the anatomical integrity of the facial nerve in the cranial cavity cannot be retained, facial nerve repair is performed to restore the facial muscle function. Intraoperative electrical stimulation of the facial nerve has a great prognostic significance to evaluate the dynamics of lagophthalmos in the late postoperative period and to select the proper method for lagophthalmos correction. When the facial nerve was reinnervated by the descending branch or trunk of the hypoglossal nerve, sufficient eyelid closure was observed only in 3 patients out of 17. PMID:25406811

  4. The vagus nerve and the nicotinic anti-inflammatory pathway

    Microsoft Academic Search

    Luis Ulloa

    2005-01-01

    Physiological anti-inflammatory mechanisms are selected by evolution to effectively control the immune system and can be exploited for the treatment of inflammatory disorders. Recent studies indicate that the vagus nerve (which is the longest of the cranial nerves and innervates most of the peripheral organs) can modulate the immune response and control inflammation through a 'nicotinic anti-inflammatory pathway' dependent on

  5. Spinal and cranial hypertrophic neuropathy in multiple sclerosis.

    PubMed

    Quan, Dianna; Pelak, Victoria; Tanabe, Jody; Durairaj, Vikram; Kleinschmidt-Demasters, B K

    2005-06-01

    Two patients with multiple sclerosis developed symptomatic chronic inflammatory demyelinating polyneuropathy with massive spinal or cranial nerve hypertrophy revealed by neuroimaging. Sural nerve biopsy in one showed only moderate demyelination, axonal loss, and onion-bulb formation, illustrating dichotomy between severe proximal and milder distal nerve involvement. Patients with coexistent central and peripheral demyelination usually are symptomatic from dysfunction at one site or the other, but not from both. Our patients showed minimal response to steroids, intravenous immunoglobulin, or azathioprine. These cases suggest that the mechanism of disease in symptomatic central and peripheral demyelination may differ from that of disease in only one region, and that optimal therapy in this situation must be explored further. PMID:15793846

  6. Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms—The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow

    Microsoft Academic Search

    Motohiro Inoue; Hiroshi Kitakoji; Tadashi Yano; Naoto Ishizaki; Megumi Itoi; Yasukazu Katsumi

    2008-01-01

    To investigate the clinical efficacy of acupuncture treatment for lumbar spinal canal stenosis and herniated lumbar disc and to clarify the mechanisms in an animal experiment that evaluated acupuncture on sciatic nerve blood flow. In the clinical trial, patients with lumbar spinal canal stenosis or herniated lumbar disc were divided into three treatment groups; (i) Ex-B2 (at the disordered level),

  7. 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

  8. 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

    Kumka, Myroslava

    2015-03-01

    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

  9. Peripheral nerve function in chronic liver disease

    Microsoft Academic Search

    K. N. Seneviratne; O. A. Peiris

    1970-01-01

    Peripheral nerve function has been studied in 50 patients with chronic liver disease. An increase in the latency or a reduction in the response amplitude of the evoked sensory potential of the median nerve was detected in 34 of the 50 subjects. This was in striking contrast to the paucity of neurological signs and symptoms suggestive of peripheral nerve damage

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

    PubMed

    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

  11. 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

  12. Cyberknife radiosurgery for cranial plasma cell tumor.

    PubMed

    Alafaci, Cetty; Grasso, Giovanni; Conti, Alfredo; Caffo, Mariella; Salpietro, Francesco Maria; Tomasello, Francesco

    2014-01-01

    Cranial and intracranial involvement by myelomatous disease is relatively uncommon. Furthermore, systemic manifestations of multiple myeloma are present in the majority of these cases at the time of symptom onset. The authors report the case of a patient with serial appearance of multiple intracranial plasma cell tumor localizations as the first manifestations of a multiple myeloma. The patient was treated with CyberKnife radiosurgery for a lesion localized at the clivus and sella turcica with complete local control. With such a technique, based on high-dose conformality, the tumor was centered with an ablative dose of radiation and, at the same time, with a low dose spreading to the surrounding critical structures. The radiosensitivity of plasma cell tumors renders this treatment modality particularly advantageous for their localized manifestation. A technical description of this case is provided. To our knowledge, this is the first case of successful Cyberknife radiosurgery of multifocal intracranial plasmacytoma. PMID:24831374

  13. Alarin in cranial autonomic ganglia of human and rat.

    PubMed

    Schrödl, Falk; Kaser-Eichberger, Alexandra; Trost, Andrea; Strohmaier, Clemens; Bogner, Barbara; Runge, Christian; Bruckner, Daniela; Krefft, Karolina; Kofler, Barbara; Brandtner, Herwig; Reitsamer, Herbert A

    2015-02-01

    Extrinsic and intrinsic sources of the autonomic nervous system contribute to choroidal innervation, thus being responsible for the control of choroidal blood flow, aqueous humor production or intraocular pressure. Neuropeptides are involved in this autonomic control, and amongst those, alarin has been recently introduced. While alarin is present in intrinsic choroidal neurons, it is not clear if these are the only source of neuronal alarin in the choroid. Therefore, we here screened for the presence of alarin in human cranial autonomic ganglia, and also in rat, a species lacking intrinsic choroidal innervation. Cranial autonomic ganglia (i.e., ciliary, CIL; pterygopalatine, PPG; superior cervical, SCG; trigeminal ganglion, TRI) of human and rat were prepared for immunohistochemistry against murine and human alarin, respectively. Additionally, double staining experiments for alarin and choline acetyltransferase (ChAT), tyrosine hydroxilase (TH), substance P (SP) were performed in human and rat ganglia for unequivocal identification of ganglia. For documentation, confocal laser scanning microscopy was used, while quantitative RT-PCR was applied to confirm immunohistochemical data and to detect alarin mRNA expression. In humans, alarin-like immunoreactivity (alarin-LI) was detected in intrinsic neurons and nerve fibers of the choroidal stroma, but was lacking in CIL, PPG, SCG and TRI. In rat, alarin-LI was detected in only a minority of cranial autonomic ganglia (CIL: 3.5%; PPG: 0.4%; SCG: 1.9%; TRI: 1%). qRT-PCR confirmed the low expression level of alarin mRNA in rat ganglia. Since alarin-LI was absent in human cranial autonomic ganglia, and only present in few neurons of rat cranial autonomic ganglia, we consider it of low impact in extrinsic ocular innervation in those species. Nevertheless, it seems important for intrinsic choroidal innervation in humans, where it could serve as intrinsic choroidal marker. PMID:25497346

  14. Ancient Legacy of Cranial Surgery

    PubMed Central

    Ghannaee Arani, Mohammad; Fakharian, Esmaeil; Sarbandi, Fahimeh

    2012-01-01

    Cranial injury, as it is known today, is not a new concern of modern medicine. On stepping on the earth, the man was in reality encountered with various types of injuries, particularly those of a cranial nature. Leading a life, whether wild or civilized, has always been associated with injuries for human race from the very beginning of birth. Therefore, managing cases of this type has gradually forced him to establish and fix strategies and approaches to handle the dilemma. This study is thus focused on tracing the first documented traumatized cranial cases ever reported, ranging from those trials attributed to our ancient predecessors to the identical examples in the present time. PMID:24396747

  15. Calcifying Pseudoneoplasms of the Skull Base Presenting with Cranial Neuropathies: Case Report and Literature Review

    PubMed Central

    Nonaka, Yoichi; Aliabadi, Hamid R.; Friedman, Allan H.; Odere, Fred G.; Fukushima, Takanori

    2012-01-01

    Objectives?We report our institutional experience with calcifying pseudoneoplasms of the skull base that presented with cranial neuropathies. These lesions are also known as fibro-osseous lesions, cerebral calculi, or brain stones. Results?One patient presented with facial numbness and retro-orbital pain secondary to compression of the maxillary branch of the trigeminal nerve at the anterior portion of the infratemporal fossa. The other patient presented with occipital headaches and hypoglossal nerve palsy. This patient was found to have a calcified lesion in the posterior fossa, which eroded the left occipital condyle. Conclusion?Calcifying pseudoneoplasms are benign, slow-growing masses that are apparently cured by gross total resection. Even with incomplete tumor resection, the prognosis is considered to be favorable. We advocate a minimally invasive surgical resection of such tumors involving the cranial nerves. PMID:23946925

  16. 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

  17. Cranial thickness in American females and males.

    PubMed

    Ross, A H; Jantz, R L; McCormick, W F

    1998-03-01

    To date, numerous studies have examined the range of cranial thickness variation in modern humans. The purpose of this investigation is to present a new method that would be easier to replicate, and to examine sex and age variation in cranial thickness in a white sample. The method consists of excising four cranial segments from the frontal and parietal regions. The sample consists of 165 specimens collected at autopsy and 15 calvarial specimens. An increase in cranial thickness with age was observed. The results suggest that cranial thickness is not sexually dimorphic outside the onset of hyperostosis frontalis interna (HFI). PMID:9544534

  18. 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

  19. Peripheral nerve hyperexcitability syndromes.

    PubMed

    Küçükali, Cem Ismail; Kürtüncü, Murat; Akçay, Halil ?brahim; Tüzün, Erdem; Öge, Ali Emre

    2015-01-01

    Peripheral nerve hyperexcitability (PNH) syndromes can be subclassified as primary and secondary. The main primary PNH syndromes are neuromyotonia, cramp-fasciculation syndrome (CFS), and Morvan's syndrome, which cause widespread symptoms and signs without the association of an evident peripheral nerve disease. Their major symptoms are muscle twitching and stiffness, which differ only in severity between neuromyotonia and CFS. Cramps, pseudomyotonia, hyperhidrosis, and some other autonomic abnormalities, as well as mild positive sensory phenomena, can be seen in several patients. Symptoms reflecting the involvement of the central nervous system occur in Morvan's syndrome. Secondary PNH syndromes are generally seen in patients with focal or diffuse diseases affecting the peripheral nervous system. The PNH-related symptoms and signs are generally found incidentally during clinical or electrodiagnostic examinations. The electrophysiological findings that are very useful in the diagnosis of PNH are myokymic and neuromyotonic discharges in needle electromyography along with some additional indicators of increased nerve fiber excitability. Based on clinicopathological and etiological associations, PNH syndromes can also be classified as immune mediated, genetic, and those caused by other miscellaneous factors. There has been an increasing awareness on the role of voltage-gated potassium channel complex autoimmunity in primary PNH pathogenesis. Then again, a long list of toxic compounds and genetic factors has also been implicated in development of PNH. The management of primary PNH syndromes comprises symptomatic treatment with anticonvulsant drugs, immune modulation if necessary, and treatment of possible associated dysimmune and/or malignant conditions. PMID:25719304

  20. 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

  1. Effects of lead acetate on guinea pig - cochear microphonics, action potential, and motor nerve conduction velocity

    SciTech Connect

    Yamamura, K.; Maehara, N.; Terayama, K.; Ueno, N.; Kohyama, A.; Sawada, Y.; Kishi, R.

    1987-04-01

    Segmental demyelination and axonal degeneration of motor nerves induced by lead exposure is well known in man, and animals. The effect of lead acetate exposure to man may involve the cranial nerves, since vertigo and sensory neuronal deafness have been reported among lead workers. However, there are few reports concerning the dose-effects of lead acetate both to the peripheral nerve and the cranial VII nerve with measurement of blood lead concentration. The authors investigated the effects of lead acetate to the cochlea and the VIII nerve using CM (cochlear microphonics) and AP (action potential) of the guinea pigs. The effects of lead acetate to the sciatic nerve were measured by MCV of the sciatic nerve with measurement of blood lead concentration.

  2. Effects of annular cranial vault modification on the cranial base and face.

    PubMed

    Kohn, L A; Leigh, S R; Jacobs, S C; Cheverud, J M

    1993-02-01

    Artificial modification of the cranial vault was practiced by a number of prehistoric and protohistoric populations, frequently during an infant's first year of life. We test the hypothesis that, in addition to its direct effects on the cranial vault, annular cranial vault modification has a significant indirect effect on cranial base and facial morphology. Two skeletal series from the Pacific Northwest Coast, which include both nonmodified and modified crania, were used: the Kwakiutl (62 nonmodified, 45 modified) and Nootka (28 nonmodified, 20 modified). Three-dimensional coordinates of 53 landmarks were obtained using a diagraph, and 36 landmarks were used to define nine finite elements in the cranial vault, cranial base, and face. Finite element scaling was used to compare average nonmodified and average modified crania, and the significance of the results were evaluated using a bootstrap test. Annular modification of the cranial vault produces significant effects on the morphology of the cranial base and face. Annular modification in the Kwakiutl resulted in restrictions of the cranial vault in the medial-lateral and superior-inferior dimensions and an increase in anterior-posterior growth. Similar dimensional changes are observed in the cranial base. The Kwakiutl face is increased anterior-posteriorly and reduced anterior-laterally to posterior-medially. Similar effects of modification are observed in the Nootka cranial vault and cranial base, though not in the face. These results demonstrate the developmental interdependence of the cranial vault, cranial base, and face. PMID:8430751

  3. A comprehensive review with potential significance during skull base and neck operations, Part II: glossopharyngeal, vagus, accessory, and hypoglossal nerves and cervical spinal nerves 1-4.

    PubMed

    Shoja, Mohammadali M; Oyesiku, Nelson M; Shokouhi, Ghaffar; Griessenauer, Christoph J; Chern, Joshua J; Rizk, Elias B; Loukas, Marios; Miller, Joseph H; Tubbs, R Shane

    2014-01-01

    Knowledge of the possible neural interconnections found between the lower cranial and upper cervical nerves may prove useful to surgeons who operate on the skull base and upper neck regions in order to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections between the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized into two parts. Part I discusses the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches and other nerve trunks or branches in the vicinity. Part II deals with the anastomoses between the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or between these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part II is presented in this article. Extensive and variable neural anastomoses exist between the lower cranial nerves and between the upper cervical nerves in such a way that these nerves with their extra-axial communications can be collectively considered a plexus. PMID:24272888

  4. “ Meganthropus ” cranial fossils from Java

    Microsoft Academic Search

    D. E. Tyler

    2001-01-01

    There are now twelve significant hominid cranial fossils from the Lower and Middle Pleistocene of Java, all but two being\\u000a from the Sangiran site. Most of this material is well-known in the literature, but three skulls, possibly representing “Meganthropus” are here described in detail for the first time. Most scholars have assigned them all toHomo erectus, while others have suggested

  5. 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

  6. Microsurgical results with large vestibular schwannomas with preservation of facial and cochlear nerve function as the primary aim

    Microsoft Academic Search

    C. Raftopoulos; B. Abu Serieh; T. Duprez; M. A. Docquier; J. M. Guérit

    2005-01-01

    Summary Objective. To evaluate our microsurgical results in dealing with vestibular schwannomas (VS) greater than or equal to 30?mm when preservation of cranial nerve function was considered more important than total tumour removal.

  7. Common and less common peripheral nerve disorders associated with diabetes.

    PubMed

    Knopp, Michael; Rajabally, Yusuf A

    2012-05-01

    Diabetes can be associated with a number of peripheral nerve disorders. The commonest is slowly-progressive axonal distal symmetrical sensori-motor neuropathy. Sensory loss and positive sensory symptoms are its main manifestations. Lumbosacral radiculoplexus neuropathy (LSRPN) is a distinct entity, accompanied by severe lumbar, hip, leg pain and weight loss, with subsequent weakness. Although typically unilateral, bilaterality is described, with spontaneous recovery usual over several months. The upper limb counterpart, cervical radiculoplexus neuropathy is rare. Acute painful neuropathies, including "diabetic neuropathic cachexia", are infrequent. Accompanying weight loss is usual and burning pains in the extremities are severe. Insulin-triggered acute painful neuropathy is well-described although infrequent and still poorly-understood. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) represents an immune-mediated treatable disorder, usually causing prominent diffuse motor weakness, which was described as more common in diabetics. More recent epidemiological data have however been conflicting and it is possible that CIDP is no more frequent in diabetics than in the general population. Diagnosis is made by electrophysiology and cerebrospinal fluid analysis. A painless diabetic motor neuropathy, thought to be caused by ischaemic injury and microvasculitis, has recently been postulated as separate from LSRPN and CIDP. Other focal and multifocal neuropathies that can occur in diabetics are cranial or truncal. Entrapment neuropathies are more often of median and ulnar nerves, and may in some cases benefit from decompression. Finally, autonomic neuropathies are well-described in diabetes and can be diverse in presentation with cardiovascular, gastrointestinal, urogenital and sudomotor manifestations. Their management can be difficult with debilitating symptoms despite treatment. PMID:22283678

  8. Nerve sheath ganglion of the tibial nerve presenting as a Baker's cyst: a case report.

    PubMed

    Tseng, Kuo-Fung; Hsu, Horng-Chaung; Wang, Fu-Cheng; Fong, Yi-Chin

    2006-09-01

    Nerve sheath ganglion is a relatively rare clinical entity commonly found in the peroneal nerve in the lower limb or the ulnar nerve in the upper extremity. It is rarely found in the tibial nerve. The occurrence of a nerve sheath ganglion in a patient's tibial nerve has been identified. The initial presentation of the tumor mass has been very similar to that of a Baker's cyst, namely a soft undulating popliteal mass. Yet, the case also presented symptoms and signs of tibial nerve compressive neuropathy. We present here a rare case of nerve sheath ganglion of the tibial nerve. Clinical courses of the patient were reviewed, and relevant issues were discussed with a thorough literature review. PMID:16570194

  9. 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

  10. Electrical Stimulation as a Therapeutic Option to Improve Eyelid Function in Chronic Facial Nerve Disorders

    Microsoft Academic Search

    John Gittins; Kevin Martin; James Sbeldrick; Ashwin Reddy; Leonard Tbean

    PURPOSE. TO establish whether it is possible to improve orbicularis oculi muscle function in the eyelids of patients with a chronic seventh cranial nerve palsy by using transcutaneous electrical stimulation to the point at which electrical stimulation induces a functional blink. METHODS. Ten subjects (one woman, nine men) aged 36 to 76 with chronic, moderate to severe facial nerve palsy

  11. Multi-unit recording from regenerated bullfrog eighth nerve using implantable silicon-substrate microelectrodes

    Microsoft Academic Search

    Charles C Della Santina; Gregory T. A Kovacs; Edwin R Lewis

    1997-01-01

    Multi-microelectrode silicon devices were developed for extracellular recording from multiple axons in regenerated eighth cranial nerves of American bullfrogs. Each includes a photolithographically defined array of holes and adjacent metal microelectrodes. A device is implanted within a transected eighth nerve; regenerating fibers grow through the holes en route to the brainstem. Multiple spike trains were recorded from two animals at

  12. Hypoglossal nerve paralysis in a burn patient following mechanical ventilation

    PubMed Central

    Weissman, O.; Weissman, O.; Farber, N.; Berger, E.; Grabov Nardini, G.; Zilinsky, I.; Winkler, E.; Haik, J.

    2013-01-01

    Summary Traumatic injury resulting in isolated dysfunction of the hypoglossal nerve is relatively rare and described in few case reports. We present a patient with isolated unilateral palsy of the twelfth cranial nerve (CN XII) resulting from recurrent airway intervention following extensive burn injuries. The differential diagnosis for paralysis of the CN XII is also discussed herein. This case illustrates the significance of comprehensive diagnostic evaluation and the need for refined airway manipulation in patients that require multiple endotracheal intubations PMID:24133402

  13. Differential sensitivity of cranial and limb motor function to nigrostriatal dopamine depletion

    PubMed Central

    Plowman, Emily K.; Maling, Nicholas; Rivera, Benjamin J.; Larson, Krista; Thomas, Nagheme J.; Fowler, Stephen C.; Manfredsson, Fredric P.; Shrivastav, Rahul; Kleim, Jeffrey A.

    2012-01-01

    The present study determined the differential effects of unilateral striatal dopamine depletion on cranial motor versus limb motor function. Forty male Long Evans rats were first trained on a comprehensive motor testing battery that dissociated cranial versus limb motor function and included: cylinder forepaw placement, single pellet reaching, vermicelli pasta handling; sunflower seed opening, pasta biting acoustics, and a licking task. Following baseline testing, animals were randomized to either a 6-hydroxydopamine (6-OHDA) (n = 20) or control (n = 20) group. Animals in the 6-OHDA group received unilateral intrastriatal 6-OHDA infusions to induce striatal dopamine depletion. Six-weeks following infusion, all animals were re-tested on the same battery of motor tests. Near infrared densitometry was performed on sections taken through the striatum that were immunohistochemically stained for tyrosine hydroxylase (TH). Animals in the 6-OHDA condition showed a mean reduction in TH staining of 88.27%. Although 6-OHDA animals were significantly impaired on all motor tasks, limb motor deficits were more severe than cranial motor impairments. Further, performance on limb motor tasks was correlated with degree of TH depletion while performance on cranial motor impairments showed no significant correlation. These results suggest that limb motor function may be more sensitive to striatal dopaminergic depletion than cranial motor function and is consistent with the clinical observation that therapies targeting the nigrostriatal dopaminergic system in Parkinson’s disease are more effective for limb motor symptoms than cranial motor impairments. PMID:23018122

  14. Cranial magnetic resonance imaging in chronic demyelinating polyneuropathy.

    PubMed Central

    Hawke, S H; Hallinan, J M; McLeod, J G

    1990-01-01

    Twenty one patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and five patients with chronic demyelinating polyneuropathy associated with benign monoclonal paraproteinaemia none of whom had signs or symptoms of central nervous system disease, had cranial magnetic resonance imaging (MRI) on a 1.5 Tesla unit. Areas of increased white matter signal intensity were seen in one of 10 patients aged less than 50 years and in five of 16 patients aged more than 50 years. In only two of the patients (8%), neither of whom had paraproteinaemia, did the appearance strongly suggest demyelination. The only clinical variable that predicted MRI changes was age (p less than 0.01). Images PMID:2123236

  15. Spontaneous intraneural hematoma of the sural nerve.

    PubMed

    Richardson, Shawn S; McLawhorn, Alexander S; Mintz, Douglas N; DiCarlo, Edward F; Weiland, Andrew J

    2015-04-01

    Symptomatic intraneural hemorrhage occurs rarely. It presents with pain and/or weakness in the distribution following the anatomic innervation pattern of the involved nerve. When a purely sensory nerve is affected, the symptoms can be subtle. We present a previously healthy 36-year-old female who developed an atraumatic, spontaneous intraneural hematoma of her sural nerve. Sural dysfunction was elicited from the patient's history and physical examination. The diagnosis was confirmed with magnetic resonance imaging, and surgical decompression provided successful resolution of her preoperative symptoms. To our knowledge, this entity has not been reported previously. Our case highlights the importance of having a high index of suspicion for nerve injury or compression in patients whose complaints follow a typical peripheral nerve distribution. Prior studies have shown that the formation of intraneural hematoma and associated compression of nerve fibers result in axonal degeneration, and surgical decompression decreases axonal degeneration and aids functional recovery. PMID:25311865

  16. Cranial Variability in Amazonian Marmosets

    E-print Network

    Aguiar, John Marshall

    2011-02-22

    in their diet, saps and gums from a great variety of trees, lianas and vines. But there is a major division within the clade as to how they approach and exploit these resources, a division which manifests in their behavior, their skeletal and soft... (Lacher et al., 1981; de Faria, 1984a,b; Fonseca and Lacher, 1984; Lacher et al., 1984; Rylands 1984, 1993). The division between gouging and non-gouging callitrichids is evident in their cranial and mandibular design; the gouging marmosets have a...

  17. Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports

    Microsoft Academic Search

    Lisa D. Blankenship; Jeffrey R. Basford; Jeffrey A. Strommen; Renee J. Andersen

    2002-01-01

    Blankenship LD, Basford JR, Strommen JA, Andersen RJ. Hypoglossal nerve palsy from cervical spine involvement in rheumatoid arthritis: 3 case reports. Arch Phys Med Rehabil 2002;83:269-72. Rheumatoid arthritis (RA) involvement of the cervical spine is a well-known but perhaps underappreciated phenomenon. Neurologic complications of this involvement include pain, myelopathy, and cranial nerve (CN) palsies. However, hypoglossal nerve palsy (CN XII)

  18. Cranial osteopathy: its fate seems clear

    Microsoft Academic Search

    Steve E Hartman

    2006-01-01

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

  19. Topographical anatomy and desensitization of the pudendal nerve in adult male dromedary camels.

    PubMed

    Ahmed, A F; Al-Sobayil, F A; Al-Halag, M A

    2011-09-01

    The objectives of this study were to describe the topographical anatomy of the pudendal nerve and to develop techniques of its blocking in adult male dromedary camels. Two cadavers and 30 adult male dromedary camels were used for the description of topographical anatomy and pudendal nerve block techniques, respectively. Results revealed that the pudendal nerve arises from the ventral branches of the 2(nd) and 3(rd) sacral spinal nerves. The nerve had three divisions; dorsal, middle, and ventral. The caudal rectal nerve was a branch of the dorsal division. Three blocking techniques were developed according to the results of topographical anatomy. The first technique was 15 cm cranial to the tail base and 7 cm lateral to the midline. The second was 12 cm cranial to the tail base and 7 cm lateral to the midline. The third was about 3 cm on either sides of the anus. Details and complications of each technique were reported. In conclusion, the anatomy of the pudendal nerve was different from that of cattle and horse. The second technique (12 cm cranial to the tail base and 7 cm lateral to the midline) for pudendal nerve block was superior among the three methods. Duration of nerve blocking was suitable for examination and for performing some surgical procedures in male dromedary camels. PMID:21705059

  20. 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

  1. Nerve Blocks

    MedlinePLUS

    ... doctor. By performing a nerve block and then monitoring how the patient responds to the injection, the ... and/or imaging guidance. He or she will clean the area with antiseptic solution, and then the ...

  2. Models of cranial suture biology.

    PubMed

    Grova, Monica; Lo, David D; Montoro, Daniel; Hyun, Jeong S; Chung, Michael T; Wan, Derrick C; Longaker, Michael T

    2012-11-01

    Craniosynostosis is a common congenital defect caused by premature fusion of cranial sutures. The severe morphologic abnormalities and cognitive deficits resulting from craniosynostosis and the potential morbidity of surgical correction espouse the need for a deeper understanding of the complex etiology for this condition. Work in animal models for the past 20 years has been pivotal in advancing our understanding of normal suture biology and elucidating pathologic disease mechanisms. This article provides an overview of milestone studies in suture development, embryonic origins, and signaling mechanisms from an array of animal models including transgenic mice, rats, rabbits, fetal sheep, zebrafish, and frogs. This work contributes to an ongoing effort toward continued development of novel treatment strategies. PMID:23154351

  3. Benign recurrent VI nerve palsy in childhood.

    PubMed

    Bixenman, W W; von Noorden, G K

    1981-01-01

    The case of a child with six documented episodes of benign recurrent unilateral VI nerve palsy between the ages of 2 1/2 months and 3 years is presented. Despite the recognized self-limiting course of this disorder, its possible evolution into a comitant esotropia makes close follow-up mandatory. The practical aspects of management including maintenance occlusion therapy are stressed as well as the need for prompt surgical intervention once the acquired stabismus has become stabilized. The etiology of benign VI nerve palsy of childhood may have the same immunological basis as other cases of para-infectious neuropathy. This isolated postinfective cranial mononeuropathy easily blends into the continuum of neurological involvement seen with the Landry-Guillian-Barre syndrome. With recovery from the initial episode, the abducens nerve may have become predisposed to recurrent inflammatory episodes and recurrent loss of function. Most often these recurrences are triggered by febrile illnesses of childhood. PMID:7264848

  4. 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

  5. Entrapment neuropathy of the ulnar nerve.

    PubMed

    Elhassan, Bassem; Steinmann, Scott P

    2007-11-01

    Ulnar nerve entrapment is the second most common nerve entrapment syndrome of the upper extremity. Although it may occur at any location along the length of the nerve, it is most common in the cubital tunnel. Ulnar nerve entrapment produces numbness in the ring and little fingers and weakness of the intrinsic muscles in the hand. Patient presentation and symptoms vary according to the site of entrapment. Treatment options are often determined by the site of pathology. Many patients benefit from nonsurgical treatment (eg, physical therapy, bracing, injection). When these methods fail or when sensory or motor impairment progresses, surgical release of the nerve at the site of entrapment should be considered. Surgical release may be done alone or with nerve transposition at the elbow. Most patients report symptomatic relief following surgery. PMID:17989418

  6. 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. ...

  7. Cranial bone deformity after forehead tissue expansion.

    PubMed

    Wang, Huan; You, Jianjun; Wang, Sheng; Fan, Fei

    2015-03-01

    The expanded forehead flap is frequently used for nasal reconstruction. When expanding the forehead tissue, the underlying cranial bones are compressed by the inserted expander. Many effects of tissue expansion on the bone have been reported including bone remolding, erosion, displacement, and so forth. In this work, we report a peculiar patient of cranial bone deformity after forehead tissue expansion, which demanded a surgical revision. PMID:25723659

  8. Symptom Management

    Cancer.gov

    Symptom Management & Quality of Life Concept Design This video covers a variety of practical considerations for developing a symptom management concept for clinical research.. Co-sponsored by the National Cancer Institute Symptom Management and Health

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

    PubMed Central

    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

    ABSTRACT 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

  10. [Computed tomography and cranial paleoanthropology].

    PubMed

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

    2007-06-01

    Since its invention in 1972, computed tomography (C.T.) has significantly evolved. With the advent of multi-slice detectors (500 times more sensitive than conventional radiography) and high-powered computer programs, medical applications have also improved. CT is now contributing to paleoanthropological research. Its non-destructive nature is the biggest advantage for studying fossil skulls. The second advantage is the possibility of image analysis, storage, and transmission. Potential disadvantages include the possible loss of files and the need to keep up with rapid technological advances. Our experience since the late 1970s, and a recent PhD thesis, led us to describe routine applications of this method. The main contributions of CT to cranial paleoanthropology are five-fold: --Numerical anatomy with rapid acquisition and high spatial resolution (helicoidal and multidetector CT) offering digital storage and stereolithography (3D printing). --Numerical biometry (2D and 3D) can be used to create "normograms" such as the 3D craniofacial reference model used in maxillofacial surgery. --Numerical analysis offers thorough characterization of the specimen and its state of conservation and/or restoration. --From "surrealism" to virtual imaging, anatomical structures can be reconstructed, providing access to hidden or dangerous zones. --The time dimension (4D imaging) confers movement and the possibility for endoscopic simulation and internal navigation (see Iconography). New technical developments will focus on data processing and networking. It remains our duty to deal respectfully with human fossils. PMID:18402165

  11. Nerve Racking

    NSDL National Science Digital Library

    Integrated Teaching and Learning Program,

    This lesson describes the function and components of the human nervous system. It helps students understand the purpose of our brain, spinal cord, nerves and the five senses. How the nervous system is affected during spaceflight is also discussed in this lesson.

  12. Prolonged Bilateral Reactive Miosis as a Symptom of Severe Insulin Intoxication

    PubMed Central

    Gradwohl-Matis, Ilse; Pann, Jakob; Schmittinger, Christian A.; Brunauer, Andreas; Dankl, Daniel; Dünser, Martin W.

    2015-01-01

    Patient: Female, 64 Final Diagnosis: Insulin self poisoning Symptoms: Coma Medication: — Clinical Procedure: Supportive care Specialty: Critical Care Medicine Objective: Unusual clinical course Background: Miosis occurs following exposure to toxins that decrease the sympathomimetic tone, increase the cholinergic tone, or exert sedative-hypnotic effects, but has not been reported in insulin poisoning. Case Report: A 64-year- old woman without co-morbidities was found unconscious next to an empty insulin pen. Her Glasgow Coma Scale was 3 with absent reflexes, bilateral reactive miosis, and injection marks across the abdominal wall. The patient was endotracheally intubated, mechanically ventilated, and transferred to this hospital. At admission, the blood glucose level was 34 mg/dL. Glasgow Coma Scale remained at 3, with persistent bilateral reactive miosis. The toxicology screening was negative for ethanol, barbiturates, tricyclic antidepressants, phenothiazines, amphetamines, cannabinoids, salicylates, acetaminophen, and cocaine. Cranial computed tomography with angiography and magnetic resonance imaging (MRI) did not show any structural brain lesions. Intravenous glucose was continued at 6–14 g/h for 3 days. On repeated neurological examinations, the patient remained deeply comatose, with partial loss of cranial nerve function. Bilateral reactive miosis persisted for 4 days. From day 5 on, the patient awoke progressively. At discharge, the patient was fully alert and orientated, without a focal neurological deficit. Conclusions: Prolonged bilateral reactive miosis can be a clinical symptom accompanying metabolic encephalopathy in severe insulin poisoning. Functional impairment of the pons due to relative hypoperfusion during hypoglycemia may serve as a reasonable pathophysiologic explanation for this phenomenon. PMID:25556593

  13. Dural neurogenic inflammation induced by neuropathic pain is specific to cranial region.

    PubMed

    Filipovi?, B; Matak, I; Lackovi?, Z

    2014-05-01

    Up to now, dural neurogenic inflammation (DNI) has been studied primarily as a part of migraine pain pathophysiology. A recent study from our laboratory demonstrated the occurrence of DNI in response to peripheral trigeminal nerve injury. In this report, we characterize the occurrence of DNI after different peripheral nerve injuries in and outside of the trigeminal region. We have used the infraorbital nerve constriction injury model (IoNC) as a model of trigeminal neuropathic pain. Greater occipital nerve constriction injury (GoNC), partial transection of the sciatic nerve (ScNT) and sciatic nerve constriction injury (SCI) were employed to characterize the occurrence of DNI in response to nerve injury outside of the trigeminal region. DNI was measured as colorimetric absorbance of Evans blue plasma protein complexes. In addition, cellular inflammatory response in dural tissue was histologically examined in IoNC and SCI models. In comparison to the strong DNI evoked by IoNC, a smaller but significant DNI has been observed following the GoNC. However, DNI has not been observed either in cranial or in lumbar dura following ScNT and SCI. Histological evidence has demonstrated a dural proinflammatory cell infiltration in the IoNC model, which is in contrast to the SCI model. Inflammatory cell types (lymphocytes, plasma cells, and monocytes) have indicated the presence of sterile cellular inflammatory response in the IoNC model. To our knowledge, this is the first observation that the DNI evoked by peripheral neuropathic pain is specific to the trigeminal area and the adjacent occipital area. DNI after peripheral nerve injury consists of both plasma protein extravasation and proinflammatory cell infiltration. PMID:24366531

  14. Pinched Nerve

    MedlinePLUS

    ... symptoms of numbness, pain, and tingling in the hands or feet but without pain in the neck or back. These can include peripheral neuropathy, carpal tunnel syndrome, and tennis elbow. The extent of such injuries ...

  15. Endoscopic ulnar nerve release and transposition.

    PubMed

    Morse, Levi P; McGuire, Duncan T; Bain, Gregory I

    2014-03-01

    The most common site of ulnar nerve compression is within the cubital tunnel. Surgery has historically involved an open cubital tunnel release with or without transposition of the nerve. A comparative study has demonstrated that endoscopic decompression is as effective as open decompression and has the advantages of being less invasive, utilizing a smaller incision, producing less local symptoms, causing less vascular insult to the nerve, and resulting in faster recovery for the patient. Ulnar nerve transposition is indicated with symptomatic ulnar nerve instability or if the ulnar nerve is located in a "hostile bed" (eg, osteophytes, scarring, ganglions, etc.). Transposition has previously been performed as an open procedure. The authors describe a technique of endoscopic ulnar nerve release and transposition. Extra portals are used to allow retractors to be inserted, the medial intermuscular septum to be excised, cautery to be used, and a tape to control the position of the nerve. In our experience this minimally invasive technique provides good early outcomes. This report details the indications, contraindications, surgical technique, and rehabilitation of the endoscopic ulnar nerve release and transposition. PMID:24296546

  16. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings Neurological Conditions and Convulsive Disorders § 4.123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of reflexes,...

  17. 38 CFR 4.123 - Neuritis, cranial or peripheral.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings Neurological Conditions and Convulsive Disorders § 4.123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of reflexes,...

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings Neurological Conditions and Convulsive Disorders § 4.124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings Neurological Conditions and Convulsive Disorders § 4.124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull...

  20. Repeatability of Nerve conduction Measurements using Automation

    Microsoft Academic Search

    Xuan Kong; Eugene A. Lesser; J. Thomas Megerian; Shai N. Gozani

    2006-01-01

    Objective  To quantify nerve conduction study (NCS) reproducibility utilizing an automated NCS system (NC-stat®, NeuroMetrix, Inc.).\\u000a \\u000a \\u000a \\u000a Method  Healthy volunteers without neuropathic symptoms participated in the study. Their median, ulnar, peroneal, and tibial nerves\\u000a were tested twice (7 days apart) by the same technician with an NC-stat® instrument. Pre-fabricated electrode arrays specific to each nerve were used. Both motor responses (compound motor action\\u000a potential

  1. Cranial Electrical Stimulation Potential Use in Reducing Sleep and Mood Disturbances in Persons With Dementia and Their Family Caregivers

    PubMed Central

    Rose, Karen M.; Taylor, Ann Gill; Bourguignon, Cheryl; Utz, Sharon W.; Goehler, Lisa E.

    2009-01-01

    Family caregivers of persons with dementia and their care recipients frequently experience sleep and mood disturbances throughout their caregiving and disease trajectories. Because conventional pharmacologic treatments of sleep and mood disturbances pose numerous risks and adverse effects to elderly persons, the investigation of other interventions is warranted. As older adults use complementary and alternative medicine interventions for the relief of sleep and mood disturbances, cranial electrical stimulation, an energy-based complementary and alternative medicine, may be a viable intervention. The proposed mechanism of action and studies that support cranial electrical stimulation as a modality to reduce distressing symptoms are reviewed. Directions for research are proposed. PMID:18552605

  2. Syphilis Symptoms

    MedlinePLUS

    ... the infection will move to the next stages. Latent syphilis The latent (hidden) stage of syphilis begins when symptoms of secondary syphilis are over. In early latent syphilis, you might notice that signs and symptoms ...

  3. Symptom Management

    MedlinePLUS

    ... TBI Educational Materials Research DVBIC Locations Press Symptom Management A brain injury can affect a person physically ... Diagnosis and Assessment Treatment and Recovery Caregiving Symptom Management Life After TBI Defense and Veterans Brain Injury ...

  4. 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

  5. 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.

  6. Cranial Anatomy and Baboon CLIFFORD JOLLY*

    E-print Network

    Delson, Eric

    COMMENTARY Cranial Anatomy and Baboon Diversity CLIFFORD JOLLY* Department of Anthropology, New. The baboons are a particularly interesting example of mammalian evolution in tropical Africa. They have been, the study of baboons has the added interest that the place, time-frame, and ecological setting

  7. Post-operative cranial pressure monitoring system

    NASA Technical Reports Server (NTRS)

    Fager, C. A., Jr.; Long, L. E.; Trent, R. L.

    1970-01-01

    System for monitoring of fluidic pressures in cranial cavity uses a miniaturized pressure sensing transducer, combined with suitable amplification means, a meter with scale calibrated in terms of pressures between minus 100 and plus 900 millimeters of water, and a miniaturized chart recorder covering similar range of pressures.

  8. 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

  9. Nerve Impulses in Plants

    ERIC Educational Resources Information Center

    Blatt, F. J.

    1974-01-01

    Summarizes research done on the resting and action potential of nerve impulses, electrical excitation of nerve cells, electrical properties of Nitella, and temperature effects on action potential. (GS)

  10. 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

  11. Radiosurgery of Epidermoid Tumors with Gamma Knife: Possibility of Radiosurgical Nerve Decompression

    Microsoft Academic Search

    Y. Kida; M. Yoshimoto; T. Hasegawa; S. Fujitani

    2006-01-01

    Long-term results of radiosurgery for epidermoid tumors are reported. There are 7 cases including 2 males and 5 females, ages ranging from 6 to 46 (mean: 33.3 years). At radiosurgery whole tumor was covered in 4 and partially covered in 3 for the attempt of relieving cranial nerve dysfunctions like trigeminal neuralgia and facial spasm. The mean maximum and marginal

  12. Central topography of cranial motor nuclei controlled by differential cadherin expression.

    PubMed

    Astick, Marc; Tubby, Kristina; Mubarak, Waleed M; Guthrie, Sarah; Price, Stephen R

    2014-11-01

    Neuronal nuclei are prominent, evolutionarily conserved features of vertebrate central nervous system (CNS) organization. Nuclei are clusters of soma of functionally related neurons and are located in highly stereotyped positions. Establishment of this CNS topography is critical to neural circuit assembly. However, little is known of either the cellular or molecular mechanisms that drive nucleus formation during development, a process termed nucleogenesis. Brainstem motor neurons, which contribute axons to distinct cranial nerves and whose functions are essential to vertebrate survival, are organized exclusively as nuclei. Cranial motor nuclei are composed of two main classes, termed branchiomotor/visceromotor and somatomotor. Each of these classes innervates evolutionarily distinct structures, for example, the branchial arches and eyes, respectively. Additionally, each class is generated by distinct progenitor cell populations and is defined by differential transcription factor expression; for example, Hb9 distinguishes somatomotor from branchiomotor neurons. We characterized the time course of cranial motornucleogenesis, finding that despite differences in cellular origin, segregation of branchiomotor and somatomotor nuclei occurs actively, passing through a phase of each being intermingled. We also found that differential expression of cadherin cell adhesion family members uniquely defines each motor nucleus. We show that cadherin expression is critical to nucleogenesis as its perturbation degrades nucleus topography predictably. PMID:25308074

  13. 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

  14. A case of hemifacial spasm caused by an artery passing through the facial nerve.

    PubMed

    Oh, Chang Hyun; Shim, Yu Shik; Park, Hyeonseon; Kim, Eun-Young

    2015-03-01

    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

  15. Evaluation of a multi-component approach to cognitive-behavioral therapy (CBT) using guided visualizations, cranial electrotherapy stimulation, and vibroacoustic sound.

    PubMed

    Rogers, Donna R B; Ei, Sue; Rogers, Kim R; Cross, Chad L

    2007-05-01

    This pilot study examines the use of guided visualizations that incorporate both cognitive and behavioral techniques with vibroacoustic therapy and cranial electrotherapy stimulation to form a multi-component therapeutic approach. This multi-component approach to cognitive-behavioral therapy (CBT) was used to treat patients presenting with a range of symptoms including anxiety, depression, and relationship difficulties. Clients completed a pre- and post-session symptom severity scale and CBT skills practice survey. The program consisted of 16 guided visualizations incorporating CBT techniques that were accompanied by vibroacoustic therapy and cranial electrotherapy stimulation. Significant reduction in symptom severity was observed in pre- and post-session scores for anxiety symptoms, relationship difficulties, and depressive symptoms. The majority of the clients (88%) reported use of CBT techniques learned in the guided visualizations at least once per week outside of the sessions. PMID:17400144

  16. [Differential diagnosis between melanotic schwannoma of gasserian ganglion and metastatic melanoma of middle cranial fossa].

    PubMed

    Nenashev, E A; Rotin, D A; Stepanian, M A; Kadasheva, A B; Cherekaev, V A

    2012-01-01

    We present a case of a rare tumor--melanotic schwannoma of trigeminal nerve root and gasserian ganglion. Differential diagnosis between metastatic melanoma and melanotic schwannoma (MS) is associated with serious difficulties and high responsibility. Metastatic melanoma is a high grade tumor while most MS are benign lesions with good outcome. By the date 105 cases of these tumors are described in the world literature, 3 of them originated from trigeminal nerve root and gasserian ganglion. MS predominantly occur in relatively young patients, they are characterized by presence of Carney's complex and psammomatous bodies and absence of primary focus. MS and metastatic melanoma have similar appearance on MRI due to presence of melanin granules. Indirect signs evident for MS include cystic structure and dumbbell-shaped growth. Metastatic melanoma of cranial nerves is more typical in people older than 40, primary focus in the face in the zone of innervation of affected nerve is common. In case of absence of the listed features differential diagnosis is based on immunohistochemical analysis and electron microscopy of tissue samples. PMID:22708436

  17. Frizzled3 controls axonal development in distinct populations of cranial and spinal motor neurons

    PubMed Central

    Hua, Zhong L; Smallwood, Philip M; Nathans, Jeremy

    2013-01-01

    Disruption of the Frizzled3 (Fz3) gene leads to defects in axonal growth in the VIIth and XIIth cranial motor nerves, the phrenic nerve, and the dorsal motor nerve in fore- and hindlimbs. In Fz3?/? limbs, dorsal axons stall at a precise location in the nerve plexus, and, in contrast to the phenotypes of several other axon path-finding mutants, Fz3?/? dorsal axons do not reroute to other trajectories. Affected motor neurons undergo cell death 2 days prior to the normal wave of developmental cell death that coincides with innervation of muscle targets, providing in vivo evidence for the idea that developing neurons with long-range axons are programmed to die unless their axons arrive at intermediate targets on schedule. These experiments implicate planar cell polarity (PCP) signaling in motor axon growth and they highlight the question of how PCP proteins, which form cell–cell complexes in epithelia, function in the dynamic context of axonal growth. DOI: http://dx.doi.org/10.7554/eLife.01482.001 PMID:24347548

  18. High noon back pain- severe pseudoradicular pain as a lead symptom of superficial siderosis: a case report

    PubMed Central

    Siglienti, Ines; Gold, Ralf; Schlamann, Marc; Hindy, Nicolai El; Sure, Ulrich; Forsting, Michael

    2014-01-01

    A superficial siderosis of the central nervous system following a traumatic cervical nerve root avulsion usually leads to gait difficulties and hearing loss, whereas back pain is described only rarely. Here we report on the first case with circadian occurrence of severe back pain as the only symptom of a superficial siderosis. We present a case with the most severe pseudoradicular lumbosacral pain occurring daily at noon for the past 5 weeks. The 48-year-old male white patient did not complain of pain in the morning. A traumatic root avulsion 26 years earlier led to a brachial plexus palsy and Horner’s syndrome in this patient. Superficial hemosiderosis in cranial MRI and examination of the cerebrospinal fluid revealing massive red blood cells as well as xanthochromia and elevated protein levels (742 mg/l) led to the diagnosis of a superficial siderosis. A pseudomeningocele caused by a cervical nerve root avulsion is described as a rare reason for superficial siderosis. Surgery on a pseudomeningocele, diagnosed by MRI, led to an immediate disappearance of complaints in our case. Regular neurological investigation and possibly repeated lumbar puncture to exclude superficial siderosis should be considered in cases with severe back pain and a history of traumatic root avulsion. Modern susceptibility weighted MR imaging (SWI) techniques, sensible to the detection of superficial hemosiderosis, might be helpful in the making of a diagnosis. PMID:25371709

  19. Chronic inflammatory demyelinating polyneuropathy with multiple hypertrophic nerves in intracranial, and intra- and extra-spinal segments.

    PubMed

    Niino, M; Tsuji, S; Tashiro, K

    1999-05-01

    Hypertrophic nerves have occasionally been seen in chronic inflammatory demyelinating polyneuropathy (CIDP), but most are in the cauda equina. We report a case with CIDP in whom magnetic resonance imaging (MRI) with gadolinium diethylene triamine penta-acetic acid (Gd-DTPA) enhancement demonstrated hypertrophy of various peripheral nerves including multiple cranial nerves. Interestingly, none showed neurological signs corresponding to the lesions, except for clinical signs consistent with CIDP. MRI can be useful for the detection of silent, but abnormal nerve involvement in CIDP. PMID:10397086

  20. Facial Translocation Approach to the Cranial Base

    PubMed Central

    Arriaga, Moises A.; Janecka, Ivo P.

    1991-01-01

    Surgical exposure of the nasopharyngeal region of the cranial base is difficult because of its proximity to key anatomic structures. Our laboratory study outlines the anatomic basis for a new approach to this complex topography. Dissections were performed on eight cadaver halves and two fresh specimens injected with intravascular silicone rubber compound. By utilizing facial soft tissue translocation combined with craniofacial osteotomies; a wide surgical field can be obtained at the skull base. The accessible surgical field extends from the contralateral custachian tube to the ipsilateral geniculate ganglion, including the nasopharyax; clivus, sphonoid, and cavernous sinuses, the entire infratemporal fossa, and superior orbital fissure. The facial translocation approach offers previously unavailable wide and direct exposure, with a potential for immediate reconstruction, of this complex region of the cranial base. ImagesFigure 4Figure 5Figure 7Figure 8Figure 9 PMID:17170817

  1. Nerve entrapments associated with postmastectomy lymphedema

    Microsoft Academic Search

    A. Ganel; J. Engel; M. Sela; M. Brooks

    1979-01-01

    Ninety females underwent mastectomy for breast cancer and were thereafter investigated to determine whether nerve entrapments were responsible for some of the disabling symptoms in their arms. The majority of these patients suffered from fullness (edema), numbness, paraesthesia, weakness and pain of the arm on the mastectomized side. Lymphedema of varying degrees found in 50% of these patients was associated

  2. Ulnar Nerve Entrapment Due to Epitrochleoanconeus Muscle

    Microsoft Academic Search

    P. D. HODGKINSON; N. R. MCLEAN

    1994-01-01

    Two cases are described of ulnar nerve compression at the elbow due to an anomalous muscle—the epitrochleo-anconeus. In both cases the onset of symptoms may have been related to a period of excessive exercise of the upper limb. Both cases recovered rapidly and completely following medial epicondylectomy and excision of the abnormal muscle.

  3. 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 ...

  4. Cranial Osteology of Meiglyptini (Aves: Piciformes: Picidae)

    PubMed Central

    Donatelli, Reginaldo José

    2012-01-01

    The Meiglyptini comprise eight species grouped into three genera: Meiglyptes and Mulleripicus, with three species each, and Hemicircus, with two species. The aim of the present study was to describe the cranial osteology of six species and three genera of Meiglyptini and to compare them to each other, as well as with other species of woodpeckers and other bird groups. The cranial osteology varied among the investigated species, but the most markedly distinct characteristics were: (1) a frontal overhang is only observed in the middle portion of the frontale of H. concretus; (2) the Proc. zygomaticus and suprameaticus are thick and long in species of the genus Mulleripicus, but short in other species; (3) the Pes pterygoidei is relatively larger in species of the genus Mulleripicus, while it is narrow, thin and relatively smaller in species of the genus Meiglyptes and indistinct in H. concretus; (4) the bony projection of the ectethmoidale is relatively short and thin in species of Mulleripicus and more developed in H. concretus. It appears that the greatest structural complexity of the cranial osteology is associated with the birds' diet, with the frugivorous H. concretus being markedly different from the insectivorous species. PMID:22567317

  5. Fourth and sixth nerve palsies due to herpes simplex 1 infection.

    PubMed

    Anagnostou, Evangelos; Mouka, Vasiliki; Kemanetzoglou, Elisabet; Kararizou, Evangelia

    2015-03-01

    : Ocular motor cranial nerve palsies of viral etiology are uncommon and, when accompanied by skin lesions, zoster ophthalmicus is the most frequent diagnosis. We describe the case of a 68-year-old woman who developed fourth and sixth nerve palsies 3 days after appearance of a painful vesicular skin rash on the left side of her forehead. Neuroimaging was normal but polymerase chain reaction (PCR) testing of the cerebrospinal fluid was positive for Herpes Simplex 1 and negative for Varicella Zoster. The patient was treated with intravenous acyclovir, and the cranial nerve palsies resolved over 7 weeks. Although the similarity of the cutaneous vesicular eruption in our patient to that seen with zoster might have led to an incorrect diagnosis, acyclovir seems to be safe and effective for both viral etiologies. PMID:25313788

  6. A review of the thoracic splanchnic nerves and celiac ganglia.

    PubMed

    Loukas, Marios; Klaassen, Zachary; Merbs, William; Tubbs, R Shane; Gielecki, Jerzy; Zurada, Anna

    2010-07-01

    Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body. Thoracic splanchnic nerves are derived from medial branches of the lower seven thoracic sympathetic ganglia, with the greater splanchnic nerve comprising the more cranial contributions, the lesser the middle branches, and the least splanchnic nerve usually T11 and/or T12. Much of the early anatomical research of the thoracic splanchnic nerves revolved around elucidating the nerve root level contributing to each of these nerves. The celiac plexus is a major interchange for autonomic fibers, receiving many of the thoracic splanchnic nerve fibers as they course toward the organs of the abdomen. The location of the celiac ganglia are usually described in relation to surrounding structures, and also show variation in size and general morphology. Clinically, the thoracic splanchnic nerves and celiac ganglia play a major role in pain management for upper abdominal disorders, particularly chronic pancreatitis and pancreatic cancer. Splanchnicectomy has been a treatment option since Mallet-Guy became a major proponent of the procedure in the 1940s. Splanchnic nerve dissection and thermocoagulation are two common derivatives of splanchnicectomy that are commonly used today. Celiac plexus block is also a treatment option to compliment splanchnicectomy in pain management. Endoscopic ultrasonography (EUS)-guided celiac injection and percutaneous methods of celiac plexus block have been heavily studied and are two important methods used today. For both splanchnicectomies and celiac plexus block, the innovation of ultrasonographic imaging technology has improved efficacy and accuracy of these procedures and continues to make pain management for these diseases more successful. PMID:20235178

  7. Peripheral nerve entrapment and injury in the upper extremity.

    PubMed

    Neal, Sara; Fields, Karl B

    2010-01-15

    Peripheral nerve injury of the upper extremity commonly occurs in patients who participate in recreational (e.g., sports) and occupational activities. Nerve injury should be considered when a patient experiences pain, weakness, or paresthesias in the absence of a known bone, soft tissue, or vascular injury. The onset of symptoms may be acute or insidious. Nerve injury may mimic other common musculoskeletal disorders. For example, aching lateral elbow pain may be a symptom of lateral epicondylitis or radial tunnel syndrome; patients who have shoulder pain and weakness with overhead elevation may have a rotator cuff tear or a suprascapular nerve injury; and pain in the forearm that worsens with repetitive pronation activities may be from carpal tunnel syndrome or pronator syndrome. Specific history features are important, such as the type of activity that aggravates symptoms and the temporal relation of symptoms to activity (e.g., is there pain in the shoulder and neck every time the patient is hammering a nail, or just when hammering nails overhead?). Plain radiography and magnetic resonance imaging are usually not necessary for initial evaluation of a suspected nerve injury. When pain or weakness is refractory to conservative therapy, further evaluation (e.g., magnetic resonance imaging, electrodiagnostic testing) or surgical referral should be considered. Recovery of nerve function is more likely with a mild injury and a shorter duration of compression. Recovery is faster if the repetitive activities that exacerbate the injury can be decreased or ceased. Initial treatment for many nerve injuries is nonsurgical. PMID:20082510

  8. Plague Symptoms

    MedlinePLUS

    ... message, please visit this page: About CDC.gov . Plague Plague Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics Info ... Clinicians Public Health Officials Veterinarians Prevention History of Plague Resources FAQ Related Links USGS National Wildlife Health ...

  9. 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 ...

  10. 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

  11. Infra-orbital nerve schwannoma: Report and review

    PubMed Central

    Kumar, Nilesh

    2015-01-01

    Extra-cranial schwannomas although common in head and neck region are very rarely seen originating from the infra-orbital nerve. We report a case of schwannoma arising from infra-orbital nerve in a 40-year-old male patient. The case presented as an isolated, asymptomatic, slow growing sub-cutaneous nodular swelling over left side of mid-face. On ultrasonography, a localized lesion within the sub-cutaneous tissue of cheek was observed, without involvement of orbital, maxillary sinus or underlying bone. Aspiration biopsy of the lesion showed spindle shaped cells predominantly arranged in Antoni A pattern around verocay bodies, with less organized Antoni B tissue in few places. Diagnosis of schwannoma, probably arising from terminal branch of infra-orbital nerve was established. The tumor was approached through skin incision. At the time of exploration, the lesion was found to emanate from the nerve trunk of peripheral branch of infra-orbital nerve, which was dissected and preserved. We correlate our experience with previously reported cases of infra-orbital nerve schwannoma.

  12. Quantitative analysis of the anatomy of the epineurium of the canine recurrent laryngeal nerve

    PubMed Central

    BARKMEIER, JULIE M.; LUSCHEI, ERICH S.

    2000-01-01

    The purpose of this investigation was to determine the amount of epineurium surrounding the recurrent laryngeal nerve (RLN) compared with a limb nerve, that to flexor hallicus longus (NFHL). Nerve samples were obtained from 10 adult dogs and studied using scanning electron microscopy and light microscopy to measure the relative proportion of epineurium and the relative proportions of adipose and collagenous tissue comprising the epineurium in both nerves. Significantly greater relative epineurial cross-sectional areas and adipose content were found in the RLN than in the NFHL. Based on observations on noncranial peripheral nerves, the findings indicate that the RLN is better protected against deformational forces associated with compression than stretching forces. The RLN may not be structured well for successful reinnervation after injury. The patterns observed for adipose tissue in RLN epineurial tissue appeared unique compared with those previously reported in peripheral nerves. The primary role associated with adipose tissue is to ‘package’ the nerve for protection. The RLN is considered to be a vital nerve in the body, as are other cranial nerves. The large proportions of adipose tissue in the epineurium may relate to the importance of protecting this nerve from injury. PMID:10697291

  13. [A clinicopathological study of the cranial "histiocytosis X" (AUTHOR'S TRANSL)].

    PubMed

    Imagawa, K; Asai, A; Hayashi, M; Toda, I; Morikawa, A

    1976-08-01

    A clinicopathological study of 13 cases of cranial histiocytosis X was discussed. The patients were mostly infants, and those under 15 years of age numbered eight. Hematological, blood chemistrical, and other laboratorical prodedures have produced no direct diagnostic value. Radiographically, this lesion in skull appeared to be a lytic defect in all cases. Histologically, they were unified by a localized or generalized histiocytic proliferation. Eosinophilic cells were also found throughout the lesional tissue. There were some slight histological variations from case to case, for instance, in the degree of infiltration by eosinophilic cells, and the number of the histiocytic cells. However, the basic histological pattern remained the same in all cases. The lesion may already have extended into the neighboring osseous tissues. Sections of the neighboring osseous tissues showed the intertrabecular spaces to be infiltrated by the same type of lesion. The patient related trauma to the onset of symptoms in 6 cases, but it is true that we know nothing of the etiology of this lesion. The treatment of choice is the adequate surgical extirpation. It seems fair to conclude that wide surgical excision with postoperative irradiation or with chemotherapy may be expected to affect a clinical cure. PMID:1085428

  14. 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.

  15. Nerve conduction velocity

    MedlinePLUS

    ... to determine the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

  16. Ulnar nerve damage (image)

    MedlinePLUS

    ... elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where it crosses the elbow, so prolonged pressure on the elbow or entrapment of the nerve may cause damage. Damage to ...

  17. Distal median nerve dysfunction

    MedlinePLUS

    ... is necessary to look for an underlying medical problem that can affect nerves. Medical conditions such as diabetes and kidney disease can damage nerves. In these cases, treatment is directed at the underlying medical condition. Physical ...

  18. Nerve Injuries in Athletes.

    ERIC Educational Resources Information Center

    Collins, Kathryn; And Others

    1988-01-01

    Over a two-year period this study evaluated the condition of 65 athletes with nerve injuries. These injuries represent the spectrum of nerve injuries likely to be encountered in sports medicine clinics. (Author/MT)

  19. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2011-01-01

    ABSTRACT Objectives The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies. Results In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement. Conclusions The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management. PMID:24421983

  20. 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

  1. Postoperative Hydrocephalus in Cranial Base Surgery

    PubMed Central

    Duong, Duc H.; O'Malley, Sean; Sekhar, Laligam N.; Wright, Donald G.

    2000-01-01

    The incidence of postoperative hydrocephalus and factors relating to it were analyzed in 257 patients undergoing cranial base surgery for tumor resection. A total of 21 (8%) patients developed postoperative hydrocephalus, and all required shunting, Forty-two (17%) patients developed cerebrospinal fluid (CSF) leak that required placement of external drainage systems (ventriculostomy or lumbar drain, or both); 10 (23%) of these 42 patients eventually needed shunt placement to stop the leak because of hydrocephalus. Prior craniotomy, prior radiation therapy, and postoperative CSF infection were also associated with an increased risk of developing hydrocephalus (48% versus 6%, 19% versus 8%, and 14% versus 7%, respectively). Prior radiation and postoperative CSF infection increased the risk of CSF leak in patients with hydrocephalus (30% versus 18% and 30% versus 9%, respectively). CSF leak and hydrocephalus commonly occurred in patients who underwent resection of a glomus tumor. In conclusion, 8% of patients who underwent cranial base surgery for tumors developed de novo hydrocephalus; half of them also had CSF leak in addition to hydrocephalus; and all required shunt placement for CSF diversion. PMID:17171147

  2. Cranial mechanics and feeding in Tyrannosaurus rex.

    PubMed

    Rayfield, Emily J

    2004-07-22

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

  3. Transcriptional regulation of cranial sensory placode development.

    PubMed

    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 nonneural 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 preplacodal 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 cofactor 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 becomes subdivided 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, 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

  4. 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

  5. Phylogeny, Neoteny and Growth of the Cranial Base in Hominoids

    Microsoft Academic Search

    M. C. Dean; B. A. Wood

    1984-01-01

    This study tests the hypothesis that there is a general pattern in the growth of the cranial base of Homo sapiens that is ‘essentially neotenous’ [Gould, 1977]. Juvenile and adult crania of Homo sapiens, Gorilla gorilla, Pan troglodytes and Pongo pygmaeus were studied and the cross-sectional growth curves for 10 measurements made on the cranial base (as viewed in norma

  6. 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

  7. Ultrasonography of peripheral nerves.

    PubMed

    Martinoli, C; Bianchi, S; Derchi, L E

    2000-06-01

    With recent improvements in ultrasound (US) imaging equipment and refinements in scanning technique, an increasing number of peripheral nerves and related pathologic conditions can be identified. US imaging can support clinical and electrophysiologic testing for detection of nerve abnormalities caused by trauma, tumors, and a variety of nonneoplastic conditions, including entrapment neuropathies. This article addresses the normal US appearance of peripheral nerves and discusses the potential role of US nerve imaging in specific clinical settings. A series of US images of diverse pathologic processes involving peripheral nerves is presented. PMID:10994689

  8. 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

  9. Osteichthyan-like cranial conditions in an Early Devonian stem gnathostome.

    PubMed

    Giles, Sam; Friedman, Matt; Brazeau, Martin D

    2015-04-01

    The phylogeny of Silurian and Devonian (443-358 million years (Myr) ago) fishes remains the foremost problem in the study of the origin of modern gnathostomes (jawed vertebrates). A central question concerns the morphology of the last common ancestor of living jawed vertebrates, with competing hypotheses advancing either a chondrichthyan- or osteichthyan-like model. Here we present Janusiscus schultzei gen. et sp. nov., an Early Devonian (approximately 415 Myr ago) gnathostome from Siberia previously interpreted as a ray-finned fish, which provides important new information about cranial anatomy near the last common ancestor of chondrichthyans and osteichthyans. The skull roof of Janusiscus resembles that of early osteichthyans, with large plates bearing vermiform ridges and partially enclosed sensory canals. High-resolution computed tomography (CT) reveals a braincase bearing characters typically associated with either chondrichthyans (large hypophyseal opening accommodating the internal carotid arteries) or osteichthyans (facial nerve exiting through jugular canal, endolymphatic ducts exiting posterior to the skull roof) but lacking a ventral cranial fissure, the presence of which is considered a derived feature of crown gnathostomes. A conjunction of well-developed cranial processes in Janusiscus helps unify the comparative anatomy of early jawed vertebrate neurocrania, clarifying primary homologies in 'placoderms', osteichthyans and chondrichthyans. Phylogenetic analysis further supports the chondrichthyan affinities of 'acanthodians', and places Janusiscus and the enigmatic Ramirosuarezia in a polytomy with crown gnathostomes. The close correspondence between the skull roof of Janusiscus and that of osteichthyans suggests that an extensive dermal skeleton was present in the last common ancestor of jawed vertebrates, but ambiguities arise from uncertainties in the anatomy of Ramirosuarezia. The unexpected contrast between endoskeletal structure in Janusiscus and its superficially osteichthyan-like dermal skeleton highlights the potential importance of other incompletely known Siluro-Devonian 'bony fishes' for reconstructing patterns of trait evolution near the origin of modern gnathostomes. PMID:25581798

  10. External QX-314 inhibits evoked cranial primary afferent synaptic transmission independent of TRPV1.

    PubMed

    Hofmann, Mackenzie E; Largent-Milnes, Tally M; Fawley, Jessica A; Andresen, Michael C

    2014-12-01

    The cell-impermeant lidocaine derivative QX-314 blocks sodium channels via intracellular mechanisms. In somatosensory nociceptive neurons, open transient receptor potential vanilloid type 1 (TRPV1) receptors provide a transmembrane passageway for QX-314 to produce long-lasting analgesia. Many cranial primary afferents express TRPV1 at synapses on neurons in the nucleus of the solitary tract and caudal trigeminal nucleus (Vc). Here, we investigated whether QX-314 interrupts neurotransmission from primary afferents in rat brain-stem slices. Shocks to the solitary tract (ST) activated highly synchronous evoked excitatory postsynaptic currents (ST-EPSCs). Application of 300 ?M QX-314 increased the ST-EPSC latency from TRPV1+ ST afferents, but, surprisingly, it had similar actions at TRPV1- ST afferents. Continued exposure to QX-314 blocked evoked ST-EPSCs at both afferent types. Neither the time to onset of latency changes nor the time to ST-EPSC failure differed between responses for TRPV1+ and TRPV1- inputs. Likewise, the TRPV1 antagonist capsazepine failed to prevent the actions of QX-314. Whereas QX-314 blocked ST-evoked release, the frequency and amplitude of spontaneous EPSCs remained unaltered. In neurons exposed to QX-314, intracellular current injection evoked action potentials suggesting a presynaptic site of action. QX-314 acted similarly at Vc neurons to increase latency and block EPSCs evoked from trigeminal tract afferents. Our results demonstrate that QX-314 blocked nerve conduction in cranial primary afferents without interrupting the glutamate release mechanism or generation of postsynaptic action potentials. The TRPV1 independence suggests that QX-314 either acted extracellularly or more likely entered these axons through an undetermined pathway common to all cranial primary afferents. PMID:25185814

  11. Multivariate assessment of site of lingual nerve.

    PubMed

    Dias, G J; de Silva, R K; Shah, T; Sim, E; Song, N; Colombage, S; Cornwall, J

    2015-04-01

    Injury to the lingual nerve can cause debilitating symptoms. The nerve lies in the retromolar region and its anatomical site can vary within patients and according to sex, age, and dentate status. To our knowledge, no previous studies have recorded its course from multiple bony landmarks and examined the association between age, dentate status, and sex, in the same sample. We dissected 30 white cadavers and took primary and secondary reference points from the internal oblique ridge. We measured the distance to the lingual nerve in sagittal, vertical, and horizontal planes, and recorded the position where the nerve was closest to the lingual plate. We dissected 46 hemimandibles (23 male, mean age 79 years, range 52-100) of which 26 were from the left side. Mean (SD) sagittal, vertical, and horizontal distances from the primary reference point were 9.29 (3.41)mm, 9.15 (3.87)mm, and 0.57 (0.56)mm, respectively. Mean (SD) vertical and horizontal distances from the secondary point were 7.79 (5.45) mm and 0.59 (0.64)mm, respectively. The proximity of the nerve to the lingual plate varied widely (range -13.00 to 15.17mm from the primary reference point). Dentate status was significant for the sagittal measurement from the primary point, and the vertical measurement from the secondary point. Differences in age, sex, or site of the contralateral nerve were not significant (n=16 pairs). Our findings suggest that the site of the nerve is consistent between and within subjects for sex and age, but not for dentate status. The association between the nerve and the lingual plate varied, which suggests that care must be taken when operating in the area. PMID:25662169

  12. Optic Nerve Elongation

    PubMed Central

    Alvi, Aijaz; Janecka, Ivo P.; Kapadia, Silloo; Johnson, Bruce L.; McVay, William

    1996-01-01

    The length of the optic nerves is a reflection of normal postnatal cranio-orbital development. Unilateral elongation of an optic nerve has been observed in two patients with orbital and skull base neoplasms. In the first case as compared to the patient's opposite, normal optic nerve, an elongated length of the involved optic nerve of 45 mm was present. The involved optic nerve in the second patient was 10 mm longer than the normal opposite optic nerve. The visual and extraocular function was preserved in the second patient. The first patient had only light perception in the affected eye. In this paper, the embryology, anatomy, and physiology of the optic nerve and its mechanisms of stretch and repair are discussed. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 13 PMID:17170975

  13. Myosin-X is required for cranial neural crest cell migration in Xenopus laevis

    PubMed Central

    Hwang, Yoo-Seok; Luo, Ting; Xu, Yanhua; Sargent, Thomas D.

    2010-01-01

    Myosin-X (MyoX) belongs to a large family of unconventional, non-muscle, actin-dependent motor proteins. We show that MyoX is predominantly expressed in cranial neural crest (CNC) cells in embryos of Xenopus laevis and is required for head and jaw cartilage development. Knockdown of MyoX expression using antisense morpholino oligonucleotides resulted in retarded migration of CNC cells into the pharyngeal arches, leading to subsequent hypoplasia of cartilage and inhibited outgrowth of the CNC-derived trigeminal nerve. In vitro migration assays on fibronectin using explanted CNC cells showed significant inhibition of filopodia formation, cell attachment, spreading and migration, accompanied by disruption of the actin cytoskeleton. These data support the conclusion that MyoX has an essential function in CNC migration in the vertebrate embryo. PMID:19718754

  14. Optical stimulation of the facial nerve: a surgical tool?

    NASA Astrophysics Data System (ADS)

    Richter, Claus-Peter; Teudt, Ingo Ulrik; Nevel, Adam E.; Izzo, Agnella D.; Walsh, Joseph T., Jr.

    2008-02-01

    One sequela of skull base surgery is the iatrogenic damage to cranial nerves. Devices that stimulate nerves with electric current can assist in the nerve identification. Contemporary devices have two main limitations: (1) the physical contact of the stimulating electrode and (2) the spread of the current through the tissue. In contrast to electrical stimulation, pulsed infrared optical radiation can be used to safely and selectively stimulate neural tissue. Stimulation and screening of the nerve is possible without making physical contact. The gerbil facial nerve was irradiated with 250-?s-long pulses of 2.12 ?m radiation delivered via a 600-?m-diameter optical fiber at a repetition rate of 2 Hz. Muscle action potentials were recorded with intradermal electrodes. Nerve samples were examined for possible tissue damage. Eight facial nerves were stimulated with radiant exposures between 0.71-1.77 J/cm2, resulting in compound muscle action potentials (CmAPs) that were simultaneously measured at the m. orbicularis oculi, m. levator nasolabialis, and m. orbicularis oris. Resulting CmAP amplitudes were 0.3-0.4 mV, 0.15-1.4 mV and 0.3-2.3 mV, respectively, depending on the radial location of the optical fiber and the radiant exposure. Individual nerve branches were also stimulated, resulting in CmAP amplitudes between 0.2 and 1.6 mV. Histology revealed tissue damage at radiant exposures of 2.2 J/cm2, but no apparent damage at radiant exposures of 2.0 J/cm2.

  15. Ulnar Nerve Entrapment at the Wrist.

    PubMed

    Earp, Brandon E; Floyd, W Emerson; Louie, Dexter; Koris, Mark; Protomastro, Paul

    2014-11-01

    Presentation of ulnar nerve entrapment at the wrist varies based on differential anatomy and the site or sites of compression. Therefore, an understanding of the anatomy of the Guyon canal is essential for diagnosis in patients presenting with motor and/or sensory deficits in the hand. The etiologies of ulnar nerve compression include soft-tissue tumors; repetitive or acute trauma; the presence of anomalous muscles and fibrous bands; arthritic, synovial, endocrine, and metabolic conditions; and iatrogenic injury. In addition to a thorough history and physical examination, which includes motor, sensory, and vascular assessments, imaging and electrodiagnostic studies facilitate the diagnosis of ulnar nerve lesions at the wrist. Nonsurgical management is appropriate for a distal compression lesion caused by repetitive activity, but surgical decompression is indicated if symptoms persist or worsen over 2 to 4 months. PMID:25344595

  16. The spinal accessory nerve plexus, the trapezius muscle, and shoulder stabilization after radical neck cancer surgery.

    PubMed Central

    Brown, H; Burns, S; Kaiser, C W

    1988-01-01

    A clinical and anatomic study of the spinal accessory, the eleventh cranial nerve, and trapezius muscle function of patients who had radical neck cancer surgery was conducted. This study was done not only to document the indispensibility of the trapezius muscle to shoulder-girdle stability, but also to clarify the role of the eleventh cranial nerve in the variable motor and sensory changes occurring after the loss of this muscle. Seventeen male patients, 49-69 years of age, (average of 60 years of age) undergoing a total of 23 radical neck dissections were examined for upper extremity function, particularly in regard to the trapezius muscle, and for subjective signs of pain. The eleventh nerve, usually regarded as the sole motor innervation to the trapezius, was cut in 17 instances because of tumor involvement. Dissection of four fresh and 30 preserved adult cadavers helped to reconcile the motor and sensory differences in patients who had undergone loss of the eleventh nerve. The dissections and clinical observations corroborate that the trapezius is a key part of a "muscle continuum" that stabilizes the shoulder. Variations in origins and insertions of the trapezius may influence its function in different individuals. As regards the spinal accessory nerve, it is concluded that varying motor and sensory connections form a plexus with the eleventh nerve, accounting, in part, for the variations in motor innervation and function of the trapezius, as well as for a variable spectrum of sensory changes when the eleventh nerve is cut. For this reason, it is suggested that the term "spinal accessory nerve plexus" be used to refer to the eleventh nerve when it is considered in the context of radical neck cancer surgery. Images Fig. 4. Fig. 6. Fig. 7. Fig. 8. PMID:3056289

  17. Delayed diagnosed posterior interosseous nerve palsy due to intramuscular myxoma

    PubMed Central

    Kursumovic, A; Mattiassich, G; Rath, S

    2013-01-01

    We present a case of posterior interosseous nerve palsy after bowel surgery associated with intramuscular myxoma of the supinator muscle. The initial symptoms of swelling of the forearm made it difficult to distinguish the condition from extravasations after intravenous cannulation. The diagnosis was finally established with nerve conduction studies and MRI 3?months after symptom onset. The patient underwent surgery for removal of the tumour and decompression of the posterior interosseous nerve. The histological examination identified the tumour as intramuscular myxoma and the patient made a full recovery with no recurrence of the lesion until present. Every swelling on the forearm causing neurological disorders is tumour suspected and should be examined clinically as well as electrophysically and radiographically. Early surgery and nerve decompression should follow immediately after the diagnosis. In case of intramuscular myxoma, good recovery of function after surgery with low recurrence risk may be expected. PMID:23576649

  18. Updates on the diagnosis and treatment of intracranial nerve malignant peripheral nerve sheath tumors

    PubMed Central

    L’Heureux-Lebeau, Bénédicte; Saliba, Issam

    2013-01-01

    Background: Malignant peripheral nerve sheath tumors (MPNSTs) are rare entities and MPNSTs of intracranial nerves are even more sporadic. MPNSTs present diagnosis and treatment challenges since there are no defined diagnosis criteria and no established therapeutic strategies. Methods: We reviewed literature for MPNST-related articles. We found 45 relevant studies in which 60 cases were described. Results: We identified 60 cases of intracranial nerve MPNSTs. The age ranged from 3 to 75 years old. Male to female ratio was 1.5:1. The most involved cranial nerves (CNs) were CN VIII (60%), CN V (27%), and CN VII (10%). Most of the MPNSTs reported (47%) arose sporadically, 40% arose from a schwannoma, 8% arose from a neurofibroma, and 6% arose from an unspecified nerve tumor. Twenty patients had a history of radiation exposure, four patients had neurofibromatosis type 1 (NF1), four patients had neurofibromatosis type 2 (NF2), and NF2 was suspected in two other patients. Twenty-two patients were treated with radiotherapy and presented a higher survival rate. Seventy-two percent of patients died of their disease while 28% of patients survived. One-year survival rate was 33%. Forty-five percent of tumors recurred and 19% of patients had metastases. Conclusion: MPNSTs involving CNs are very rare. Diagnosis is made in regards to the histological and pathological findings. Imaging may help orient the diagnosis. A preexisting knowledge of the clinical situation is more likely to lead to a correct diagnosis. The mainstay of treatment is radical surgical resection with adjuvant radiotherapy. Since these tumors are associated with a poor prognosis, a close follow-up is mandatory. PMID:23667313

  19. Symptoms of Aspergillosis

    MedlinePLUS

    ... Share Compartir Symptoms of Aspergillosis Symptoms of allergic bronchopulmonary aspergillosis (ABPA) are similar to asthma The different ... cause different symptoms. 1 The symptoms of allergic bronchopulmonary aspergillosis (ABPA) are similar to asthma symptoms, including: ...

  20. 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

  1. 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

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

    PubMed

    Snell-Rood, Emilie C; Wick, Naomi

    2013-10-22

    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

  3. Ulnar nerve palsy associated with closed midshaft forearm fractures.

    PubMed

    Suganuma, Seigo; Tada, Kaoru; Hayashi, Hiroyuki; Segawa, Takeshi; Tsuchiya, Hiroyuki

    2012-11-01

    Ulnar nerve palsy is a rare complication of closed midshaft forearm fractures; only 8 cases have been reported. This article describes a case of ulnar nerve palsy associated with a midshaft forearm fracture. A 12-year-old girl sustained a right midshaft forearm fracture. Whether she had a peripheral nerve injury was unknown due to strong pain. She underwent emergency manual reduction and intramedullary pinning. However, ulnar nerve palsy was remarkable postoperatively and gradually worsened. Therefore, neurolysis was performed 9 weeks later. The nerve had adhered to surrounding scar tissue. Six months after a second surgery, she had no motor dysfunction. The pathogenesis of ulnar nerve palsy complicated with midshaft forearm fractures varies and may be the result of direct contusion, direct damage by a bony spike, bony entrapment after closed reduction, and entrapment by a scar. In the current case, the patient was uncooperative at initial examination. Therefore, it is unknown whether she presented with immediate ulnar nerve palsy after the fracture. However, the ulnar nerve was not entrapped at the fracture site, and the surrounding muscle was intact but adhered to the surrounding scar tissue. The etiology of this case was considered to be entrapment by scar formation. According to a literature search, the authors recommend exploring the nerve approximately 8 to 10 weeks after primary surgery, after which neurological symptoms do not tend to improve. PMID:23127466

  4. Ethmoidal Mucocele Presenting as Oculomotor Nerve Paralysis

    PubMed Central

    Kim, Dae Woo; Sohn, Hee-Young; Jeon, Sea-Yuong; Kim, Jin-Pyeong; Ahn, Seong-Ki; Park, Jung Je; Woo, Seung Hoon

    2013-01-01

    A 56-year-old male was admitted with an acute headache and sudden ptosis on the right side. No ophthalmological or neurological etiologies were apparent. A mucocele of the right posterior ethmoid sinus was observed with radiology. After the marsupialization of the mucocele via a transnasal endoscopic approach, the patient's symptoms (oculomotor nerve paralysis and headache) resolved in 4 weeks. Oculomotor paralysis is a rare symptom of an ethmoidal mucocele. In this article, we report this rare case along with a literature review. PMID:23799169

  5. Transient Delayed Facial Nerve Palsy After Inferior Alveolar Nerve Block Anesthesia

    PubMed Central

    Tzermpos, Fotios H.; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis

    2012-01-01

    Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution. PMID:22428971

  6. [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

  7. Management of peripheral facial nerve palsy

    Microsoft Academic Search

    Josef Finsterer

    2008-01-01

    Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell’s palsy). Three quarters\\u000a of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections,\\u000a trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the\\u000a presence of typical symptoms

  8. The Furcal Nerve Revisited

    PubMed Central

    Dabke, Harshad V.

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

  9. The furcal nerve revisited.

    PubMed

    Harshavardhana, Nanjundappa S; Dabke, Harshad V

    2014-08-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

  10. [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

  11. Chronic fatigue syndrome from vagus nerve infection: a psychoneuroimmunological hypothesis.

    PubMed

    VanElzakker, Michael B

    2013-09-01

    Chronic fatigue syndrome (CFS) is an often-debilitating condition of unknown origin. There is a general consensus among CFS researchers that the symptoms seem to reflect an ongoing immune response, perhaps due to viral infection. Thus, most CFS research has focused upon trying to uncover that putative immune system dysfunction or specific pathogenic agent. However, no single causative agent has been found. In this speculative article, I describe a new hypothesis for the etiology of CFS: infection of the vagus nerve. When immune cells of otherwise healthy individuals detect any peripheral infection, they release proinflammatory cytokines. Chemoreceptors of the sensory vagus nerve detect these localized proinflammatory cytokines, and send a signal to the brain to initiate sickness behavior. Sickness behavior is an involuntary response that includes fatigue, fever, myalgia, depression, and other symptoms that overlap with CFS. The vagus nerve infection hypothesis of CFS contends that CFS symptoms are a pathologically exaggerated version of normal sickness behavior that can occur when sensory vagal ganglia or paraganglia are themselves infected with any virus or bacteria. Drawing upon relevant findings from the neuropathic pain literature, I explain how pathogen-activated glial cells can bombard the sensory vagus nerve with proinflammatory cytokines and other neuroexcitatory substances, initiating an exaggerated and intractable sickness behavior signal. According to this hypothesis, any pathogenic infection of the vagus nerve can cause CFS, which resolves the ongoing controversy about finding a single pathogen. The vagus nerve infection hypothesis offers testable hypotheses for researchers, animal models, and specific treatment strategies. PMID:23790471

  12. Nerve and Blood Vessels

    Microsoft Academic Search

    Maura Valle; Maria Pia Zamorani

    From the histologic point of view, nerves are round or flattened cords, with a complex internal structure made of myelinated\\u000a and unmyelinated nerve fibers, containing axons and Schwann cells grouped in fascicles (Fig. 4.1a) (Erickson 1997). Along the course of the nerve, fibers can traverse from one fascicle to another and fascicles can split and merge. Based\\u000a on the fascicular

  13. Long-term observation on the changes of somatotopy in the facial nucleus after nerve suture in the cat: Morphological studies using retrograde labeling

    Microsoft Academic Search

    T Asahara; M Lin; Y Kumazawa; K Takeo; T Akamine; Y Nishimura; T Kayahara; T Yamamoto

    1999-01-01

    To examine the time course of plasticity of the cranial nucleus during axonal regeneration, we followed the topographical reorganization of the cat facial nucleus (FN) up to 24 months after facio-facial nerve suture using retrograde labeling methods. The trunk of the temporal-zygomatico-orbital and both superior and inferior buccolabial branches (defined as main branch) of the facial nerve was cut and

  14. Malignant schwannoma of the obturator nerve.

    PubMed

    Kanta, M; Petera, J; Ehler, E; Prochazka, E; Lastovicka, D; Habalova, J; Valis, M; Rehak, S

    2013-01-01

    Lesions of obturator nerve are rare. Tumours and mainly malignant schwannoma of this nerve are extremely rare. The authors describe an unusual case of a gigantic schwannoma of the obturator nerve in 69 year old woman. Due to tumour expansion in the proximal part of the thigh MRI was performed and demonstrated extensive tumour originating most probably from the obturator nerve. The patient had no neurological symptoms. Biopsy from the lesion was taken at the Department of Orthopaedics with the following conclusion: malignant schwannoma. The patient received neoadjuvant chemotherapy due to diffuse metastatic spread on the chest X ray, after which metastatic spread subsided. The main lesion reduced its size by 1 cm. In 4 months after biopsy the patient was referred for operation to neurosurgery. The tumour was removed along its borders and except of minimal weakness of adduction of the right thigh there was no neurological deterioration. She was subsequently referred for further care to oncology and radiotherapy.The goal of this work is to emphasize the extremely rare occurrence of tumours of this nerve and suggest therapeutic options (Fig. 4, Ref. 11). PMID:24156686

  15. The rabbit brachial plexus as a model for nerve repair surgery--histomorphometric analysis.

    PubMed

    Reichert, Pawe?; Kie?bowicz, Zdzis?aw; Dzi?giel, Piotr; Pu?a, Bartosz; Kuryszko, Jan; Gosk, Jerzy; Boche?ska, Aneta

    2015-02-01

    One of the most devastating injuries to the upper limb is trauma caused by the avulsion. The anatomical structure of the rabbit's brachial plexus is similar to the human brachial plexus. The aim of our study was to analyze the microanatomy and provide a detailed investigation of the rabbit's brachial plexus. The purpose of our research project was to evaluate the possibility of utilizing rabbit's plexus as a research model in studying brachial plexus injury. Studies included histomorphometric analysis of sampled ventral branches of spinal nerves C5, C6, C7, C8, and Th1, the cranial trunk, the medial part of the caudal trunk, the lateral part of the caudal trunk and peripheral nerve. Horizontal and vertical analysis was done considering following features: the axon diameter, fiber diameter and myelin sheath. The number of axons, nerve area, myelin fiber density and minimal diameter of myelin fiber, minimal axon diameter and myelin area was marked for each element. The changes between ventral branches of spinal nerves C5-Th1, trunks and peripheral nerve in which the myelin sheath, axon diameter and fiber diameter was assessed were statistically significant. It was found that the g-ratio has close value in the brachial plexus as in the peripheral nerve. The peak of these parameters was found in nerve trunks, and then decreased coherently with the nerves travelling peripherally. PMID:25284580

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

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

    PubMed Central

    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

  3. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Identification . 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...

  4. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Identification . 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...

  5. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Identification . 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...

  6. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Identification. 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...

  7. 21 CFR 882.5800 - Cranial electrotherapy stimulator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Identification . 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...

  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, 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...

  10. 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...

  11. 21 CFR 882.4360 - Electric cranial drill motor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  12. 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

    2014-07-15

    : 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

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

    PubMed Central

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

    2013-01-01

    In order to replicate the fracture behavior of the intact human skull under impact it becomes necessary to develop a material having the mechanical properties of cranial bone. The most important properties to replicate in a surrogate human skull were found to be the fracture toughness and tensile strength of the cranial tables as well as the bending strength of the three-layer (inner table-diplöe-outer table) architecture of the human skull. The materials selected to represent the surrogate cranial tables consisted of two different epoxy resins systems with random milled glass fiber to enhance the strength and stiffness and the materials to represent the surrogate diplöe consisted of three low density foams. Forty-one three-point bending fracture toughness tests were performed on nine material combinations. The materials that best represented the fracture toughness of cranial tables were then selected and formed into tensile samples and tested. These materials were then used with the two surrogate diplöe foam materials to create the three-layer surrogate cranial bone samples for three-point bending tests. Drop tower tests were performed on flat samples created from these materials and the fracture patterns were very similar to the linear fractures in pendulum impacts of intact human skulls, previously reported in the literature. The surrogate cranial tables had the quasi-static fracture toughness and tensile strength of 2.5?MPa? m and 53?±?4.9?MPa, respectively, while the same properties of human compact bone were 3.1?±?1.8?MPa? m and 68?±?18?MPa, respectively. The cranial surrogate had a quasi-static bending strength of 68?±?5.7?MPa, while that of cranial bone was 82?±?26?MPa. This material/design is currently being used to construct spherical shell samples for drop tower and ballistic tests. PMID:25023222

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

    PubMed

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

    2013-01-01

    In order to replicate the fracture behavior of the intact human skull under impact it becomes necessary to develop a material having the mechanical properties of cranial bone. The most important properties to replicate in a surrogate human skull were found to be the fracture toughness and tensile strength of the cranial tables as well as the bending strength of the three-layer (inner table-diplöe-outer table) architecture of the human skull. The materials selected to represent the surrogate cranial tables consisted of two different epoxy resins systems with random milled glass fiber to enhance the strength and stiffness and the materials to represent the surrogate diplöe consisted of three low density foams. Forty-one three-point bending fracture toughness tests were performed on nine material combinations. The materials that best represented the fracture toughness of cranial tables were then selected and formed into tensile samples and tested. These materials were then used with the two surrogate diplöe foam materials to create the three-layer surrogate cranial bone samples for three-point bending tests. Drop tower tests were performed on flat samples created from these materials and the fracture patterns were very similar to the linear fractures in pendulum impacts of intact human skulls, previously reported in the literature. The surrogate cranial tables had the quasi-static fracture toughness and tensile strength of 2.5?MPa? m and 53?±?4.9?MPa, respectively, while the same properties of human compact bone were 3.1?±?1.8?MPa? m and 68?±?18?MPa, respectively. The cranial surrogate had a quasi-static bending strength of 68?±?5.7?MPa, while that of cranial bone was 82?±?26?MPa. This material/design is currently being used to construct spherical shell samples for drop tower and ballistic tests. PMID:25023222

  15. Cranial suture morphology and its relationship to diet in Cebus.

    PubMed

    Byron, Craig D

    2009-12-01

    Cranial sutures are complex morphological structures. Four Cebus species (C. albifrons, C. apella, C. capucinus, C. olivaceus) are used here to test the hypothesis that sagittal suture complexity is enhanced in animals that eat materially challenging foods. These primates are ideal for such comparative studies because they are closely related and some are known to exhibit differences in the material properties of the foods they ingest and masticate. Specifically, Cebus apella is notable among members of this genus for ingesting food items of high toughness as well as consistently demonstrating a relatively robust cranial morphology. Consistent with previous studies, C. apella demonstrates significantly more robust mandibular and temporal fossa morphology. Also, C. apella possesses sagittal sutures that are more complex than congenerics. These data are used to support the hypothesis that cranial suture complexity is increased in response to consuming diets with more obdurate material properties. One interpretation of this hypothesis is that, compared to non-apelloids, total strain in the apelloid cranial suture connective tissue environment is elevated due to increased jaw muscle activity by increases in either force magnitudes or the number of chewing events. It is argued that greater masticatory function enhances the growth and modeling of cranial suture interdigitation. These data show that cranial suture complexity is one more hard tissue feature from the skull that might be used to inform hypotheses of dietary functional morphology. PMID:19833377

  16. Potential toxicities of prophylactic cranial irradiation

    PubMed Central

    Giordano, Frank A.; Welzel, Grit; Abo-Madyan, Yasser

    2012-01-01

    Prophylactic cranial irradiation (PCI) with total doses of 20-30 Gy reduces the incidence of brain metastasis (BM) and increases survival of patients with limited and extensive-disease small-cell lung cancer (SCLC) that showed any response to chemotherapy. PCI is currently not applied in non-small-cell lung cancer (NSCLC) since it has not proven to significantly improve OS rates in stage IIIA/B, although novel data suggest that subgroups that could benefit may exist. Here we briefly review potential toxicities of PCI which have to be considered before prescribing PCI. They are mostly difficult to delineate from pre-existing risk factors which include preceding chemotherapy, patient age, paraneoplasia, as well as smoking or atherosclerosis. On the long run, this will force radiation oncologists to evaluate each patient separately and to estimate the individual risk. Where PCI is then considered to be of benefit, novel concepts, such as intensity-modulated radiotherapy and/or neuroprotective drugs with potential to lower the rates of side effects will eventually be superior to conventional therapy. This in turn will lead to a re-evaluation whether benefits might then outweigh the (lowered) risks.

  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. 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…

  19. 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.

  20. Benign occipital unicameral bone cyst causing lower cranial nerve palsies complicated by iophendylate arachnoiditis

    PubMed Central

    Bradley, W. G.; Kalbag, R. M.; Ramani, P. S.; Tomlinson, B. E.

    1974-01-01

    A 20 year old girl presented with a history of neck and occipital pain for six weeks, which was found to be due to a unicameral bone cyst of the left occipital condylar region. The differential diagnosis of bone cysts in the skull is discussed. Six months after the operation, the patient again presented with backache due to adhesive arachnoiditis. The latter was believed to have arisen as a result of a combination of spinal infective meningitis and intrathecal ethyl iodophenyl undecylate (iophendylate, Myodil, Pantopaque). The nature of meningeal reactions to iophendylate and the part played by intrathecal corticosteroids in relieving the arachnoiditis in the present case are discussed. Images

  1. Ulnar subluxation of the median nerve following carpal tunnel release: a case report.

    PubMed

    L'Heureux-Lebeau, B; Odobescu, A; Moser, T; Harris, P G; Danino, M A

    2012-04-01

    Complications of carpal tunnel release, while infrequent, include incomplete release resulting in persistent symptoms or recurrence due to postoperative scarring, as well as iatrogenic damage to nerves and vessels. We present the case of a patient who underwent carpal tunnel release with resolution of symptoms in the immediate postoperative period. At one and a half years post release he started to experience numbness and tingling in a median nerve distribution triggered by repetitive ulnar to radial deviation of the wrist, with no symptoms at rest. Dynamic ultrasound showed a subluxation of the median nerve from one side of the palmaris longus tendon to the other. The patient's symptoms were triggered as the median nerve squeezed in between the palmaris longus and flexor digitorum superficialis tendons. PMID:22227502

  2. Quantitative computed tomography and cranial burr holes: a model to evaluate the quality of cranial reconstruction in humans.

    PubMed

    Worm, Paulo Valdeci; Ferreira, Nelson Pires; Ferreira, Marcelo Paglioli; Kraemer, Jorge Luiz; Lenhardt, Rene; Alves, Ronnie Peterson Marcondes; Wunderlich, Ricardo Castilho; Collares, Marcus Vinicius Martins

    2012-05-01

    Current methods to evaluate the biologic development of bone grafts in human beings do not quantify results accurately. Cranial burr holes are standardized critical bone defects, and the differences between bone powder and bone grafts have been determined in numerous experimental studies. This study evaluated quantitative computed tomography (QCT) as a method to objectively measure cranial bone density after cranial reconstruction with autografts. In each of 8 patients, 2 of 4 surgical burr holes were reconstructed with autogenous wet bone powder collected during skull trephination, and the other 2 holes, with a circular cortical bone fragment removed from the inner table of the cranial bone flap. After 12 months, the reconstructed areas and a sample of normal bone were studied using three-dimensional QCT; bone density was measured in Hounsfield units (HU). Mean (SD) bone density was 1535.89 (141) HU for normal bone (P < 0.0001), 964 (176) HU for bone fragments, and 453 (241) HU for bone powder (P < 0.001). As expected, the density of the bone fragment graft was consistently greater than that of bone powder. Results confirm the accuracy and reproducibility of QCT, already demonstrated for bone in other locations, and suggest that it is an adequate tool to evaluate cranial reconstructions. The combination of QCT and cranial burr holes is an excellent model to accurately measure the quality of new bone in cranial reconstructions and also seems to be an appropriate choice of experimental model to clinically test any cranial bone or bone substitute reconstruction. PMID:22565868

  3. Abnormalities of nerve conduction studies in myotonic dystrophy type 1: primary involvement of nerves or incidental coexistence?

    PubMed

    Bae, Jong Seok; Kim, Oeung-Kyu; Kim, Sang-Jin; Kim, Byoung Joon

    2008-10-01

    The involvement of peripheral nerves in myotonic dystrophy type 1 (DM1) is controversial and the features of peripheral neuropathy (PN) are not well known. The aim of this study was to assess the frequency of abnormal nerve conduction findings and the electrophysiological characteristics of PN in DM1. We analyzed medical records, data from nerve conduction studies (NCS), and the results of genetic analysis of 18 patients with DM1 and 30 healthy individuals. The early changes identified in NCS were determined using the sural/ulnar sensory nerve action potential amplitude ratio (SUAR). To correlate the neuropathic changes with cardiac abnormality, we compared the corrected Q-wave/T-wave interval (QTc) with the NCS parameters. Eight of 18 patients had abnormal NCS findings. Of these, abnormal peroneal motor nerve conduction and H-reflex abnormalities were most common. Only one patient complained of sensory symptoms and had abnormal sensory and motor nerve conduction compatible with sensorimotor axonal polyneuropathy. There were no significant correlations between SUAR and disease duration, age, gene CTG repeats, or the QTc. The presence of diabetes was not related to abnormal nerve conduction or SUAR. The frequency of PN or abnormal NCS results was lower in our patients with DM1 than in previous studies. Our findings suggest that most abnormal NCS results in DM1 patients are more likely to result from myopathic changes, coincidental neuropathies, or radiculopathies than from primary involvement of the nerve. PMID:18657426

  4. [Multiple peripheral nerve tumors: update and review of the literature].

    PubMed

    Chick, G; Alnot, J Y; Silbermann-Hoffman, O

    2003-06-01

    Multiple tumours of the peripheral nerves are seen only in neurofibromatosis. They are hereditary. They present and develop in a variety of different ways. Three main groups are distinguished: von Recklinghausen neurofibromatosis or type 1; bilateral acoustic neurofibromatosis or type 2 and schwannomatosis recently defined as type 3. The aim of this study was to clarify the clinical outcome of neurofibromatosis. The diagnosis is made purely on clinical grounds. Cranial MRI and slit lamp examination are useful for classification. Surgical management for peripheral nerve tumours is similar. Any new and rapid change noted at clinical examination (increase in volume, pain or neurological deficit) requires surgery because of potential malignant transformation of the neurofibroma into neurofibrosarcoma (type 1 only). The definitive treatment depends on the resectable character of the tumour which is usually only known after epineurotomy under operating microscope. In the event of resectable tumour (schwannoma) enucleation must be performed, preserving nerve continuity. In the event of unresectable tumour (neurofibroma), tumour resection is impossible without sacrificing nerve tissue. An epineurotomy must be performed. It prevents further deterioration. Interfascicular biopsy confirms the histological type. Our results are similar to those in other recorded studies. The unpredictable clinical course of neurofibromatosis makes prolonged follow-up mandatory. PMID:12889267

  5. Transorbital Neuroendoscopic Management of Sinogenic Complications Involving the Frontal Sinus, Orbit, and Anterior Cranial Fossa

    PubMed Central

    Lim, Jae H.; Sardesai, Maya G.; Ferreira, Manuel; Moe, Kris S.

    2012-01-01

    Transnasal endoscopic surgery has remained at the forefront of surgical management of sinogenic complications involving the frontal sinus, orbit, and anterior skull base. However, the difficulty in accessing certain areas of these anatomical regions can potentially limit its use. Transorbital neuroendoscopic surgery (TONES) was recently introduced to transgress the limits of transnasal endoscopic surgery; the access that it provides could add additional surgical pathways for treating sinogenic complications involving the frontal sinus, orbit, and anterior cranial fossa. We describe a prospective series of 13 patients who underwent TONES for the management of various sinogenic complications, including epidural abscess, orbital abscess, and fronto-orbital mucocele or mucopyocele, as well as subperiosteal abscess presenting with orbital apex syndrome. The primary outcome measurement was the efficacy of TONES in treating these pathologies. TONES provided effective access to the frontal sinus, orbit, and the anterior cranial fossa. All patients demonstrated postoperative resolution of initial clinical symptoms with well-hidden surgical scars. There were no ophthalmologic complications or recurrence of pathology. Based on our experience, TONES appears to provide a valuable addition to the current surgical armamentarium for treating selected complications of sinusitis. PMID:24294556

  6. Asymptomatic Brain Lesions on Cranial Magnetic Resonance Imaging in Inflammatory Bowel Disease

    PubMed Central

    Guleryuzlu, Yuksel; Uygur-Bayramicli, Oya; Ahishali, Emel; Dabak, Resat

    2013-01-01

    Background/Aims This study aimed to examine the frequency and type of asymptomatic neurological involvement in inflammatory bowel disease (IBD) using cranial magnetic resonance imaging (MRI). Methods Fifty-one IBD patients with no known neurological diseases or symptoms and 30 controls with unspecified headaches without neurological origins were included. Patients and controls underwent cranial MRI assessments for white matter lesions, sinusitis, otitis-mastoiditis, and other brain parenchymal findings. Results The frequencies of white matter lesions, other brainstem parenchymal lesions, and otitis-mastoiditis were similar in IBD patients and controls (p>0.05), whereas sinusitis was significantly more frequent in IBD patients (56.9% vs 33.3%, p=0.041). However, among those subjects with white matter lesions, the number of such lesions was significantly higher in IBD patients compared to controls (12.75±9.78 vs 3.20±2.90, p<0.05). The incidence of examined pathologies did not differ significantly with disease activity (p>0.05 for all). Conclusions The incidence of white matter lesions seemed to be similar in IBD patients and normal healthy individuals, and the lesions detected did not pose any clinical significance. However, long-term clinical follow-up of the lesions is warranted. PMID:23560152

  7. Advances in nerve repair.

    PubMed

    Khuong, Helene T; Midha, Rajiv

    2013-01-01

    Patients with peripheral nerve injuries face unpredictable and often suboptimal functional outcome, even following standard microsurgical nerve repair. The challenge of improving such outcomes following nerve surgical procedures has interested many research teams, in both clinical and fundamental fields. Some innovative treatments are presently being applied to a widening range of patients, whereas others will require further development before translation to human subjects. This article presents several recent advances in emerging therapies at various stages of clinical application. Nerve transfers have been successfully used in clinical settings, but new indications are being described, enlarging the range of patients who might benefit from them. Brief direct nerve electrical stimulation has been shown to improve nerve regeneration and outcome in animal models and in a small cohort of patients. Further clinical trials are warranted to prove the efficacy of this exciting and easily applicable approach. Animal studies also suggest a tremendous potential for stem and precursor cell therapy. Further studies will lead to a better understanding of their mechanisms of action in nerve repair and potential applications for human patients. PMID:23250767

  8. Changes in nerve microcirculation following peripheral nerve compression?

    PubMed Central

    Gao, Yueming; Weng, Changshui; Wang, Xinglin

    2013-01-01

    Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation. PMID:25206398

  9. 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

  10. Anterior interosseous nerve syndrome

    PubMed Central

    Bäumer, Philipp; Meinck, Hans-Michael; Schiefer, Johannes; Weiler, Markus; Bendszus, Martin; Kele, Henrich

    2014-01-01

    Objective: We sought to determine lesion sites and spatial lesion patterns in spontaneous anterior interosseous nerve syndrome (AINS) with high-resolution magnetic resonance neurography (MRN). Methods: In 20 patients with AINS and 20 age- and sex-matched controls, MRN of median nerve fascicles was performed at 3T with large longitudinal anatomical coverage (upper arm/elbow/forearm): 135 contiguous axial slices (T2-weighted: echo time/repetition time 52/7,020 ms, time of acquisition: 15 minutes 48 seconds, in-plane resolution: 0.25 × 0.25 mm). Lesion classification was performed by visual inspection and by quantitative analysis of normalized T2 signal after segmentation of median nerve voxels. Results: In all patients and no controls, T2 lesions of individual fascicles were observed within upper arm median nerve trunk and strictly followed a somatotopic/internal topography: affected were those motor fascicles that will form the anterior interosseous nerve further distally while other fascicles were spared. Predominant lesion focus was at a mean distance of 14.6 ± 5.4 cm proximal to the humeroradial joint. Discriminative power of quantitative T2 signal analysis and of qualitative lesion rating was high, with 100% sensitivity and 100% specificity (p < 0.0001). Fascicular T2 lesion patterns were rated as multifocal (n = 17), monofocal (n = 2), or indeterminate (n = 1) by 2 independent observers with strong agreement (kappa = 0.83). Conclusion: It has been difficult to prove the existence of fascicular/partial nerve lesions in spontaneous neuropathies using clinical and electrophysiologic findings. With MRN, fascicular lesions with strict somatotopic organization were observed in upper arm median nerve trunks of patients with AINS. Our data strongly support that AINS in the majority of cases is not a surgically treatable entrapment neuropathy but a multifocal mononeuropathy selectively involving, within the main trunk of the median nerve, the motor fascicles that continue distally to form the anterior interosseous nerve. PMID:24415574

  11. [Nerve injuries in children].

    PubMed

    Legré, R; Iniesta, A; Toméi, F; Gay, A

    2013-09-01

    Management of peripheral nerve lesions in children does not differ fundamentally from that in adults. Nevertheless, difficulty to perform an extensive clinical examination can explain initial misdiagnosis and postoperative follow up can be tricky. The poor compliance of the children in the postoperative care makes a postoperative immobilization mandatory. If the peripheral nerve injuries involving children have a better prognosis reputation than in adults, fundamental studies results do not comfort this conventional wisdom, but rather claim for a better adaptability of the child to the relapses left by the peripheral nerves lesions. PMID:23751426

  12. Corneal confocal microscopy: A novel means to detect nerve fibre damage in idiopathic small fibre neuropathy

    PubMed Central

    Tavakoli, Mitra; Marshall, Andrew; Pitceathly, Robert; Gow, David; Roberts, Mark E; Malik, Rayaz A

    2009-01-01

    Patients with idiopathic small fibre neuropathy (ISFN) have been shown to have significant intraepidermal nerve fibre loss and an increased prevalence of impaired glucose tolerance (IGT). It has been suggested that the dysglycemia of IGT and additional metabolic risk factors may contribute to small nerve fibre damage in these patients. 25 patients with ISFN and 12 aged-matched control subjects underwent a detailed evaluation of neuropathic symptoms, neurological deficits (Neuropathy deficit score (NDS); Nerve Conduction Studies (NCS); Quantitative Sensory Testing (QST) and Corneal Confocal Microscopy (CCM) to quantify small nerve fibre pathology. 8 (32%) of patients had IGT. Whilst all patients with ISFN had significant neuropathic symptoms, NDS, NCS and QST except for warm thresholds were normal. Corneal sensitivity was reduced and CCM demonstrated a significant reduction in corneal nerve fibre density (NFD) (P<0.0001), nerve branch density (NBD) (P<0.0001), nerve fibre length (NFL) (P<0.0001) and an increase in nerve fibre tortuosity (NFT) (P<0.0001). However these parameters did not differ between ISFN patients with and without IGT, nor did they correlate with BMI, lipids and blood pressure. Corneal confocal microscopy provides a sensitive non-invasive means to detect small nerve fibre damage in patients with ISFN and metabolic abnormalities do not relate to nerve damage. PMID:19748505

  13. Techniques of peripheral nerve repair.

    PubMed

    Dahlin, L B

    2008-01-01

    Nerve injuries extend from simple nerve compression lesions to complete nerve injuries and severe lacerations of the nerve trunks. A specific problem is brachial plexus injuries where nerve roots can be ruptured, or even avulsed from the spinal cord, by traction. An early and correct diagnosis of a nerve injury is important. A thorough knowledge of the anatomy of the peripheral nerve trunk as well as of basic neurobiological alterations in neurons and Schwann cells induced by the injury are crucial for the surgeon in making adequate decisions on how to repair and reconstruct nerves. The technique of peripheral nerve repair includes four important steps (preparation of nerve end, approximation, coaptation and maintenance). Nerves are usually repaired primarily with sutures applied in the different tissue components, but various tubes are available. Nerve grafts and nerve transfers are alternatives when the injury induces a nerve defect. Timing of nerve repair is essential. An early repair is preferable since it is advantageous for neurobiological reasons. Postoperative rehabilitation, utilising the patients' own coping strategies, with evaluation of outcome are additional important steps in treatment of peripheral nerve injuries. in the rehabilitation phase adequate handling of pain, allodynia and cold intolerance are emphasised. PMID:19211385

  14. Attentional ability among survivors of leukaemia treated without cranial irradiation

    PubMed Central

    Rodgers, J; Marckus, R; Kearns, P; Windebank, K

    2003-01-01

    Background: Previous research has indicated that children who have received treatment for leukaemia which includes cranial irradiation exhibit deficits in their ability to focus attention. It has been suggested that the use of cranial irradiation may have a role to play in long term sequelae. Aims: To investigate neuropsychological functioning among children treated for leukaemia without cranial irradiation. Methods: In a cross sectional study, 17 leukaemic patients and their sibling controls were assessed using a neuropsychological model of attention. All were treated on the UKALL XI protocol and none had received cranial irradiation. Participants completed the Arithmetic subtest and Digit Span subtest of the Weschler Intelligence Scale for Children–Revised to assess focus–encode elements of attention; the Coding subtest and the Speed of Information subtest of the BAS to assess focus–execute aspects of attention; the VIGIL computerised battery to assess sustain elements of attention; and the Wisconsin Card Sorting test to assess the ability to shift attention. Results: These children did not exhibit the deficits witnessed in previous cohorts, and were performing at comparable levels to their controls on all measures of attention Conclusions: These findings suggest that children who have received treatment for leukaemia without the use of cranial irradiation do not show the neuropsychological insult found in earlier treatment groups. PMID:12538320

  15. Calvarial reconstruction using high-density porous polyethylene cranial hemispheres

    PubMed Central

    Mokal, Nitin J.; Desai, Mahinoor F.

    2011-01-01

    Aims: Cranial vault reconstruction can be performed with a variety of autologous or alloplastic materials. We describe our experience using high-density porous polyethylene (HDPE) cranial hemisphere for cosmetic and functional restoration of skull defects. The porous nature of the implant allows soft tissue ingrowth, which decreases the incidence of infection. Hence, it can be used in proximity to paranasal sinuses and where previous alloplastic cranioplasties have failed due to implant infection. Materials and Methods: We used the HDPE implant in seven patients over a three-year period for reconstruction of moderate to large cranial defects. Two patients had composite defects, which required additional soft tissue in the form of free flap and tissue expansion. Results: In our series, decompressive craniectomy following trauma was the commonest aetiology and all defects were located in the fronto-parieto-temporal region. The defect size was 10 cm on average in the largest diameter. All patients had good post-operative cranial contour and we encountered no infections, implant exposure or implant migration. Conclusions: Our results indicate that the biocompatibility and flexibility of the HDPE cranial hemisphere implant make it an excellent alternative to existing methods of calvarial reconstruction. PMID:22279274

  16. Ulnar nerve entrapment in Guyon's canal due to a lipoma.

    PubMed

    Ozdemir, O; Calisaneller, T; Gerilmez, A; Gulsen, S; Altinors, N

    2010-09-01

    Guyon's canal syndrome is an ulnar nerve entrapment at the wrist or palm that can cause motor, sensory or combined motor and sensory loss due to various factors . In this report, we presented a 66-year-old man admitted to our clinic with a history of intermittent pain in the left palm and numbness in 4th and 5th finger for two years. His neurological examination revealed a sensory impairment in the right fifth finger. Also, physical examination displayed a subcutaneous mobile soft tissue in ulnar side of the wrist. Electromyographic examination confirmed the diagnosis of type-1 Guyon's canal syndrome. Under axillary blockage, a lipoma compressing the ulnar nerve was excised totally and ulnar nerve was decompressed. The symptoms were improved after the surgery and patient was symptom free on 3rd postoperative week. PMID:21423081

  17. Degenerative Nerve Diseases

    MedlinePLUS

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  18. 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 ...

  19. 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

  20. Optic Nerve Decompression

    MedlinePLUS

    ... sinuses directly beside the eye. In particular, the ethmoid and sphenoid sinuses are directly adjacent to the ... double vision, inadequate decompression of the optic nerve, bleeding around the eye, carotid artery injury, leakage of ...

  1. Extratemporal facial nerve injury.

    PubMed

    Sternbach, G L; Rosen, P; Meislin, H W

    1976-04-01

    Isolated traumatic facial nerve injury, frequently seen in wartime combat, may also be encountered among civilians. The clinical picture occurring as a result of such injury may be confusing because partial, or incomplete, damage to the peripheral nerve may mimic impairment of the central facial motor mechanism. In treating the patient with facial injury, life-threatening aspects of the injury must be assessed and stabilized first. Then, attention may be focused on the injured facial nerve, for which prompt surgical repair is the treatment of choice. Prior to surgery, the assessment of taste and hearing, as well as mastoid and skull x-ray films and electrodiagnostic tests are helpful in localizing the facial nerve injury. PMID:933404

  2. Ulnar nerve dysfunction

    MedlinePLUS

    Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice . 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012: ...

  3. Tibial nerve dysfunction

    MedlinePLUS

    Katitji B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76. ...

  4. Axillary nerve dysfunction

    MedlinePLUS

    ... Body-wide (systemic) disorders that cause nerve inflammation Deep infection Fracture of the upper arm bone (humerus) Pressure from casts or splints Improper use of crutches Shoulder dislocation In some cases, no cause can be found.

  5. Bladder Activation by Selective Stimulation of Pudendal Nerve Afferents in the Cat

    PubMed Central

    Yoo, Paul B.; Woock, John P.; Grill, Warren M.

    2008-01-01

    Bladder contractions evoked by pudendal nerve stimulation in both spinal intact and spinal transected cats support the possibility of restoring urinary function in persons with chronic spinal cord injury (SCI). However, electrically evoked bladder responses in persons with SCI were limited to transient contractions at relatively low pressures. This prompted the present study, which presents a detailed quantification of the responses evoked by selective stimulation of individual branches of the pudendal nerve at different stimulation frequencies. In spinal intact cats anesthetized with ?-chloralose, selective frequency dependent electrical activation of the sensory (2 Hz ? f ? 50 Hz), cranial sensory (f ? 5 Hz), dorsal genital (f ? 20 Hz) and rectal perineal (f ? 10 Hz) branches of the pudendal nerve evoked sustained bladder contractions dependent on the stimulation frequency. Contractions evoked by selective electrical stimulation resulted in significant increases in voiding efficiency compared to bladder emptying by distension evoked contractions (pANOVA < 0.05). Acute spinal transection abolished reflex bladder contractions evoked by low frequency stimulation of the cranial sensory or rectal perineal branches, whereas contractions evoked by high frequency stimulation of the dorsal genital branch remained intact. This study presents evidence for two distinct micturition pathways (spino-bulbo-spinal vs. spinal reflexes) activated by selective afferent pudendal nerve stimulation, the latter of which may be applied to restore bladder function in persons with SCI. PMID:18502417

  6. 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

  7. Dentoalveolar nerve injury.

    PubMed

    Auyong, Thomas G; Le, Anh

    2011-08-01

    Nerve injury associated with dentoalveolar surgery is a complication contributing to the altered sensation of the lower lip, chin, buccal gingivae, and tongue. This surgery-related sensory defect is a morbid postoperative outcome. Several risk factors have been proposed. This article reviews the incidence of trigeminal nerve injury, presurgical risk assessment, classification, and surgical coronectomy versus conventional extraction as an approach to prevent neurosensory damage associated with dentoalveolar surgery. PMID:21798439

  8. Bedside saccadometry as an objective and quantitative measure of hemisphere-specific neurological function in patients undergoing cranial surgery.

    PubMed

    Saleh, Y; Marcus, H J; Iorga, R; Nouraei, R; Carpenter, R H; Nandi, D

    2015-02-01

    Cranial surgery continues to carry a significant risk of neurological complications. New bedside tools that can objectively and quantitatively evaluate cerebral function may allow for earlier detection of such complications, more rapid initiation of therapy, and improved patient outcomes. We assessed the potential of saccadic eye movements as a measure of cerebral function in patients undergoing cranial surgery peri-operatively. Visually evoked saccades were measured in 20 patients before (-12 hours) and after (+2 and +5 days) undergoing cranial surgery. Hemisphere specific saccadic latencies were measured using a simple step-task and saccadic latency distributions were compared using the Kolmogorov-Smirnov test. Saccadic latency values were incorporated into an empirically validated mathematical model (Linear Approach to Threshold with Ergodic Rate [LATER] model) for further analysis (using Wilcoxon signed rank test). Thirteen males and seven females took part in our study (mean age 55 ± 4.9 years). Following cranial surgery, saccades initiated by the cerebral hemisphere on the operated side demonstrated significant deteriorations in function after 2 days (p < 0.01) that normalised after 5 days. Analysis using the LATER model confirmed these findings, highlighting decreased cerebral information processing as a potential mechanism for noted changes (p < 0.05). No patients suffered clinical complications after surgery. To conclude, bedside saccadometry can demonstrate hemisphere-specific changes after surgery in the absence of clinical symptoms. The LATER model confirms these findings and offers a mechanistic explanation for this change. Further work will be necessary to assess the practical validity of these changes in relation to clinical complications after surgery. PMID:25282394

  9. Nerve conduction study of the medial and lateral plantar nerves.

    PubMed

    Antunes, A C; Nobrega, J A; Manzano, G M

    2000-01-01

    The medial and lateral plantar nerves may be evaluated through the recordings of the compound sensory nerve action potentials (CSNAP), compound mixed nerve action potentials (CMNAP) and compound muscular action potentials (CMAP). As some of these potentials are not easily and always obtainable in normal individuals, our purpose was to verify the consistency of these potentials for the study of these nerves. Fifty-one normal adult volunteers were examined. The CSNAP, CMNAP and CMAP, related to the medial and lateral plantar nerves were evaluated bilaterally. CSNAP were not obtained in 7.8% and in 17.6% from the medial and lateral plantar nerves respectively. CMNAP from the lateral plantar nerve were not obtained in 15.6%. CMNAP from the medial plantar nerves and CMAPs from the abductor hallucis and abductor digiti quinti were obtained for all nerves tested. Our results, therefore, suggest that these last 3 parameters are the ones more reliable for clinical application. PMID:10812535

  10. Tissue compatibility of methylmethacrylate in cranial prostheses: a preliminary investigation.

    PubMed

    Gary, J J; Mitchell, D L; Steifel, S M; Hale, M L

    1991-10-01

    An in vivo study using 48 disease-free male Lewis rats was conducted to determine the histologic difference between an alloplastic cranial prosthesis made with a monomer directly from the manufacturer and a triple-distilled monomer. The histologic difference in the tissue reaction between a cranial prosthesis sterilized with ethylene oxide and one sterilized with cobalt-60 irradiation was also evaluated. Histologic tissue biopsies of the cranium and brain tissues were obtained at 1, 3, 6, and 12 weeks. Tissue biopsies after the third week showed minimal inflammation and the microscopic findings were consistent with the reparative stage of wound healing. The findings also suggest that distillation of the monomer in heat-polymerized methyl-methacrylate is unnecessary for cranial prostheses. Cobalt-60 irradiation was found to be an effective alternative method of sterilization for such prostheses. PMID:1791566

  11. Histopathological effects of radiosurgery on a human trigeminal nerve

    PubMed Central

    Al-Otaibi, Faisal; Alhindi, Hindi; Alhebshi, Adnan; Albloushi, Monirah; Baeesa, Saleh; Hodaie, Mojgan

    2013-01-01

    Background: Radiosurgery is a well-established treatment modality for medically refractory trigeminal neuralgia. The exact mechanism of pain relief after radiosurgery is not clearly understood. Histopathology examination of the trigeminal nerve in humans after radiosurgery is rarely performed and has produced controversial results. Case Description: We report on a 45-year-old female who received radiosurgery treatment for trigeminal neuralgia by Cyberknife. A 6-mm portion of the cisternal segment of trigeminal nerve received a dose of 60 Gy. The clinical benefit started 10 days after therapy and continued for 8 months prior to a recurrence of her previous symptoms associated with mild background pain. She underwent microvascular decompression and partial sensory root sectioning. Atrophied trigeminal nerve rootlets were grossly noted intraoperatively under surgical microscope associated with changes in trigeminal nerve color to gray. A biopsy from the inferolateral surface of the nerve proximal to the midcisternal segment showed histological changes in the form of fibrosis and axonal degeneration. Conclusion: This case study supports the evidence of histological damage of the trigeminal nerve fibers after radiosurgery therapy. Whether or not the presence and degree of nerve damage correlate with the degree of clinical benefit and side effects are not revealed by this study and need to be explored in future studies. PMID:24605252

  12. Cranial and spinal magnetic resonance imaging: A guide and atlas

    SciTech Connect

    Daniels, D.L.; Haughton, V.M.

    1987-01-01

    This atlas provides a clinical guide to interpreting cranial and spinal magnetic resonance images. The book includes coverage of the cerebrum, temporal bone, and cervical, thoracic, and lumbar spine, with more than 400 scan images depicting both normal anatomy and pathologic findings. Introductory chapters review the practical physics of magnetic resonance (MR) imaging, offer guidelines for interpreting cranial MR scans, and provide coverage of each anatomic region of the cranium and spine. For each region, scans accompanied by captions, show normal anatomic sections matched with MR images. These are followed by MR scans depicting various disease states.

  13. Typewriter tinnitus: a carbamazepine-responsive syndrome related to auditory nerve vascular compression.

    PubMed

    Levine, Robert Aaron

    2006-01-01

    Six subjects with similar unilateral tinnitus that was fully suppressed by carbamazepine have been identified. Their ages at the time of the sudden onset of their tinnitus ranged from 39 to 87 years (mean 67). The 3 men had right ear tinnitus. Two of the 3 women had left ear tinnitus. All 6 described a staccato quality of their intermittent tinnitus ('like a typewriter in the background, pop corn, Morse code'). Five of the 6 subjects had no other hearing or vestibular complaints; their audiograms were symmetric and consistent with their ages. Vascular compression of the auditory nerve ipsilateral to the tinnitus was detected in 4 of the 5 subjects imaged. The similarities between typewriter tinnitus and other cranial nerve syndromes associated with vascular compression (trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia) suggest that surgical decompression of the auditory nerve can relieve medication-refractive cases of typewriter tinnitus. PMID:16514262

  14. Acellular Nerve Allografts in Peripheral Nerve Regeneration: A Comparative Study

    PubMed Central

    Moore, Amy M.; MacEwan, Matthew; Santosa, Katherine B.; Chenard, Kristofer E.; Ray, Wilson Z.; Hunter, Daniel A.; Mackinnon, Susan E.; Johnson, Philip J.

    2011-01-01

    Background Processed nerve allografts offer a promising alternative to nerve autografts in the surgical management of peripheral nerve injuries where short deficits exist. Methods Three established models of acellular nerve allograft (cold-preserved, detergent-processed, and AxoGen® -processed nerve allografts) were compared to nerve isografts and silicone nerve guidance conduits in a 14 mm rat sciatic nerve defect. Results All acellular nerve grafts were superior to silicone nerve conduits in support of nerve regeneration. Detergent-processed allografts were similar to isografts at 6 weeks post-operatively, while AxoGen®-processed and cold-preserved allografts supported significantly fewer regenerating nerve fibers. Measurement of muscle force confirmed that detergent-processed allografts promoted isograft-equivalent levels of motor recovery 16 weeks post-operatively. All acellular allografts promoted greater amounts of motor recovery compared to silicone conduits. Conclusions These findings provide evidence that differential processing for removal of cellular constituents in preparing acellular nerve allografts affects recovery in vivo. PMID:21660979

  15. Repair of sciatic nerve defects using tissue engineered nerves.

    PubMed

    Zhang, Caishun; Lv, Gang

    2013-07-25

    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

  16. 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 & ...

  17. Contralateral facial nerve palsy following mandibular second molar removal: is there co-relation or just coincidence?

    PubMed Central

    Zalagh, Mohammed; Boukhari, Ali; Attifi, Hicham; Hmidi, Mounir; Messary, Abdelhamid

    2014-01-01

    Peripheral facial nerve palsy (FNP) is the most common cranial nerves neuropathy. It is very rare during dental treatment. Classically, it begins immediately after the injection of local anaesthetic into the region of inferior dental foramen and it's homolateral to the injection. Recovery takes a few hours, normally as long the anaesthetic lasts. The authors present a 44-year-old patient who presented a contralateral delayed-onset facial paralysis arising from dental procedure and discuss the plausible pathogenesis mechanism of happen and a possible relationship between dental procedure and contralateral FNP. PMID:25419300

  18. Using intact nerve to bridge peripheral nerve defects: an alternative to the use of nerve grafts.

    PubMed

    McCallister, W V; Cober, S R; Norman, A; Trumble, T E

    2001-03-01

    This preliminary study was conducted to determine whether a regenerating peripheral nerve in a rat model can use the epineurium of an intact nerve to bridge a nerve gap defect. To create the intact nerve bridge a 1-cm segment of the peroneal nerve is resected leaving a gap defect. The proximal and distal peroneal nerve stumps are sutured 1-cm apart, in an end-to-side fashion, to the epineurium of the intact tibial nerve. The following experimental groups were used (n = 12): group A, immediate primary repair of resected segment; group B, intact nerve bridge technique; group C, nerve autograft; and group D, gap in situ control. Evaluation 12 weeks after surgery included measurement of the tibialis anterior muscle contraction force, axonal counting, wet weight of the tibialis anterior muscle, and histologic examination. The results of this animal study support 3 main conclusions: regenerating axons can use the epineurium of an intact nerve to bridge a gap in nerve continuity; when using functional recovery to assess regeneration, there is no significant difference between standard nerve autografts and the intact nerve bridge technique; and based on histologic examination, the intact nerve bridge technique does not injure the intact tibial nerve used to bridge the gap defect. Taken together, the results of this preliminary animal study suggest that the intact nerve bridge technique may be a potential alternative to standard nerve autografts in appropriate circumstances. Further investigation in a higher animal model is warranted before considering clinical application of the intact nerve bridge technique. PMID:11279579

  19. Transcutaneous cranial electrical stimulation (TCES): A review 1998

    Microsoft Academic Search

    A. Limoge; C. Robert; T. H. Stanley

    1999-01-01

    The Transcutaneous Cranial Electrical Stimulation (TCES) technique appeared at the beginning of the 1960s and is aimed to act at the level of the central nervous system. The current, composed of high frequency pulses interrupted with a repetitive low frequency, is delivered through three electrodes (a negative electrode placed between the eyebrows while two positive electrodes are located in the

  20. The taxonomic implications of cranial shape variation in Homo erectus

    Microsoft Academic Search

    Karen L. Baab

    2008-01-01

    The taxonomic status of Homo erectus sensu lato has been a source of debate since the early 1980s, when a series of publications suggested that the early African fossils may represent a separate species, H. ergaster. To gain further resolution regarding this debate, 3D geometric morphometric data were used to quantify overall shape variation in the cranial vault within H.

  1. A quantitative approach to the cranial ontogeny of the puma

    Microsoft Academic Search

    Norberto P. Giannini; Valentina Segura; María Isabel Giannini; David Flores

    2010-01-01

    The cranial ontogeny of specialized mammals is relevant to the understanding of the connection of form and function in a developmental, ecological, and evolutionary context. As highly specialized carnivores, felids are of especial interest. We studied the postnatal ontogeny of the skull in Puma concolor (Mammalia: Carnivora: Felidae) using a quantitative approach. We interpreted our results in the light of

  2. RESEARCH Open Access Trans-cranial focused ultrasound without hair

    E-print Network

    Paris-Sud XI, Université de

    RESEARCH Open Access Trans-cranial focused ultrasound without hair shaving: feasibility study made of human hair was sonicated using 220- and 710-kHz head transducers to evaluate the feasibility. Results showed that the hair had a negligible effect on focal spot thermal rise at 220 kHz and a 17% drop

  3. 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.

  4. RESEARCH ARTICLE Ontogeny of feeding behavior and cranial morphology

    E-print Network

    Motta, Philip J.

    RESEARCH ARTICLE Ontogeny of feeding behavior and cranial morphology in the whitespotted development of the feeding apparatus over early ontogeny can profoundly affect the ability of an organism a strike decreased over ontogeny and the feeding modality became more suction-dominated. Kinematic

  5. Vertebrate Cranial Placodes as Evolutionary Innovations-The Ancestor's Tale.

    PubMed

    Schlosser, Gerhard

    2015-01-01

    Evolutionary innovations often arise by tinkering with preexisting components building new regulatory networks by the rewiring of old parts. The cranial placodes of vertebrates, ectodermal thickenings that give rise to many of the cranial sense organs (ear, nose, lateral line) and ganglia, originated as such novel structures, when vertebrate ancestors elaborated their head in support of a more active and exploratory life style. This review addresses the question of how cranial placodes evolved by tinkering with ectodermal patterning mechanisms and sensory and neurosecretory cell types that have their own evolutionary history. With phylogenetic relationships among the major branches of metazoans now relatively well established, a comparative approach is used to infer, which structures evolved in which lineages and allows us to trace the origin of placodes and their components back from ancestor to ancestor. Some of the core networks of ectodermal patterning and sensory and neurosecretory differentiation were already established in the common ancestor of cnidarians and bilaterians and were greatly elaborated in the bilaterian ancestor (with BMP- and Wnt-dependent patterning of dorsoventral and anteroposterior ectoderm and multiple neurosecretory and sensory cell types). Rostral and caudal protoplacodal domains, giving rise to some neurosecretory and sensory cells, were then established in the ectoderm of the chordate and tunicate-vertebrate ancestor, respectively. However, proper cranial placodes as clusters of proliferating progenitors producing high-density arrays of neurosecretory and sensory cells only evolved and diversified in the ancestors of vertebrates. PMID:25662263

  6. Sphenoid shortening and the evolution of modern human cranial shape.

    PubMed

    Lieberman, D E

    1998-05-14

    Crania of 'anatomically modern' Homo sapiens from the Holocene and Upper Pleistocene epochs differ from those of other Homo taxa, including Neanderthals, by only a few features. These include a globular braincase, a vertical forehead, a dimunitive browridge, a canine fossa and a pronounced chin. Humans are also unique among mammals in lacking facial projection: the face of the adult H. sapiens lies almost entirely beneath the anterior cranial fossa, whereas the face in all other adult mammals, including Neanderthals, projects to some extent in front of the braincase. Here I use radiographs and computed tomography to show that many of these unique human features stem partly from a single, ontogenetically early reduction in the length of the sphenoid, the central bone of the cranial base from which the face grows forward. Sphenoid reduction, through its effects on facial projection and cranial shape, may account for the apparently rapid evolution of modern human cranial form, and suggests that Neanderthals and other archaic Homo should be excluded from H. sapiens. PMID:9603517

  7. 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

  8. Cranial Radiation Therapy and Damage to Hippocampal Neurogenesis

    ERIC Educational Resources Information Center

    Monje, Michelle

    2008-01-01

    Cranial radiation therapy is associated with a progressive decline in cognitive function, prominently memory function. Impairment of hippocampal neurogenesis is thought to be an important mechanism underlying this cognitive decline. Recent work has elucidated the mechanisms of radiation-induced failure of neurogenesis. Potential therapeutic…

  9. Electronic temperature monitoring during the decompression surgery of the facial nerve.

    PubMed

    Paula, Patricia M C; Rodrigues, Suelia S R; Altoe, Mirella Lorrainy; Santos, Larissa S; Rocha, Adson F

    2010-01-01

    Despite of its apparent protection by being located deep in a bony canal, the facial nerve is a cranial pair of nerves more vulnerable to traumatic injuries. The surgical accidents are the most frequent causes of intratemporal complications of the facial nerve. Among the postoperative sequelae, the thermal injuries are common due to overheating of the otologic burr resulting in facial paralysis. For the prevention of thermal injuries in the facial nerve was designed a data acquisition board to obtain the temperature measured by thermocouples using a PC and parallel communication. The signals from the temperature sensors passed through conditioning for amplification and analog to digital data conversion. Afterwards, they were stored on a computer for the statistical analysis and the visualization of the curves of variation of the measured temperatures. These curves provide the verification of the facial nerve temperature ascending and descending time during surgery steps to access the nerve. These data provide a substantial safe working margin to the surgeon. PMID:21095674

  10. Facial Pain Followed by Unilateral Facial Nerve Palsy: A Case Report with Literature Review

    PubMed Central

    GV, Sowmya; Goel, Saurabh; Singh, Mohit Pal; Astekar, Madhusudan

    2014-01-01

    Peripheral facial nerve palsy is the commonest cranial nerve motor neuropathy. The causes range from cerebrovascular accident to iatrogenic damage, but there are few reports of facial nerve paralysis attributable to odontogenic infections. In majority of the cases, recovery of facial muscle function begins within first three weeks after onset. This article reports a unique case of 32-year-old male patient who developed facial pain followed by unilateral facial nerve paralysis due to odontogenic infection. The treatment included extraction of the associated tooth followed by endodontic treatment of the neighboring tooth which resulted in recovery of facial nerve plasy. A thorough medical history and physical examination are the first steps in making any diagnosis. It is essential to rule out other causes of facial paralysis before making the definitive diagnosis, which implies the intervention. The authors hereby, report a case of 32-year-old male patient who developed unilateral facial nerve paralysis due to odontogenic infection with a good prognosis after appropriate treatment. PMID:25302280

  11. 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

  12. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

  13. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

  14. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

  15. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

  16. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Neurological Therapeutic Devices § 882.5275 Nerve cuff. (a) Identification. A nerve cuff is a tubular silicone rubber sheath used to encase a nerve for aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue)...

  17. The cranial anatomy of the neornithischian dinosaur Thescelosaurus neglectus

    PubMed Central

    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

  18. Brainstem abnormalities and vestibular nerve enhancement in acute Neuroborreliosis

    PubMed Central

    2013-01-01

    Background Borreliosis is a widely distributed disease. Neuroborreliosis may present with unspecific symptoms and signs and often remains difficult to diagnose in patients with central nervous system symptoms, particularly if the pathognomonic erythema chronica migrans does not develop or is missed. Thus, vigilance is mandatory in cases with atypical presentation of the disease and with potentially severe consequences if not recognized early. We present a patient with neuroborreliosis demonstrating brain stem and vestibular nerve abnormalities on magnetic resonance imaging. Case presentation A 28-year-old Caucasian female presented with headaches, neck stiffness, weight loss, nausea, tremor, and gait disturbance. Magnetic resonance imaging showed T2-weighted hyperintense signal alterations in the pons and in the vestibular nerves as well as bilateral post-contrast enhancement of the vestibular nerves. Serologic testing of the cerebrospinal fluid revealed the diagnosis of neuroborreliosis. Conclusion Patients infected with neuroborreliosis may present with unspecific neurologic symptoms and magnetic resonance imaging as a noninvasive imaging tool showing signal abnormalities in the brain stem and nerve root enhancement may help in establishing the diagnosis. PMID:24359885

  19. Laryngeal nerve monitoring.

    PubMed

    Kartush, Jack M; Naumann, Ilka

    2014-09-01

    Intraoperative neurophysiological monitoring of the vagus and recurrent laryngeal nerves is increasingly used during thyroidectomy, parathyroidectomy, skull base surgery, and cervical discectomy with fusion. Monitoring can assist in nerve localization and in reducing the incidence of neural trauma. To be effective, however, monitoring must be correctly implemented and the results interpreted based on an in-depth understanding of technique and the surgical structures at risk. Because "poor monitoring is worse than no monitoring" all members of the surgical monitoring team must have training specific to laryngeal recording to maximize its benefit and minimize pitfalls. This publication will review pertinent anatomy and neurophysiology as well as technical and interpretative factors. PMID:25351033

  20. 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.

    of Anthropology, Northwestern University, Euanston, lllinois 60201 (S.R.L.) KEY WORDS Nootka, Artificial and modified crania, were used: the Kwakiutl (62 nonmodified, 45 modified) and Nootka (28 nonmodified, 20-medially. Similar effects of modification are observed in the Nootka cra- nial vault and cranial base, though

  1. 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.

  2. 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

  3. Vestibular nerve section.

    PubMed

    Silverstein, Herbert; Jackson, Lance E

    2002-06-01

    When the vertigo of Meniere's disease becomes refractory to medical management, a variety of surgical options are available. If intratympanic gentamicin has failed or is not recommended and serviceable hearing is present, sectioning the vestibular nerve is an excellent option in terms of vertigo control, hearing preservation, and postoperative quality of life. Transection of the vestibular nerve has gone through a metamorphosis since attempted by Krause over a century ago. The microsurgical posterior fossa vestibular neurectomy has undergone an evolution, resulting in the combined RRVN. This is essentially a retrosigmoid approach with exposure of the lateral venous sinus to allow forward retraction of the sinus and better exposure. This technique has the advantages of minimization of required mastoid and suboccipital bone work, elimination of the need for cerebellar retraction, improved exposure, ability to achieve watertight dural closure to minimize incidence of CSF leakage, low incidence of postoperative headache, and low overall complication rate. If a cleavage plain cannot be readily identified, then the superior half of the eighth nerve is sectioned near the brainstem. The results are essentially the same whether the vestibular nerve is cut in the IAC or the posterior fossa. Vertigo has been completely controlled in 85% and hearing has been preserved at the preoperative level in 80% of patients. Combined RRVN is a direct and safe technique, with high success in properly selected patients. PMID:12486846

  4. 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…

  5. Cervical Radiculopathy (Pinched Nerve)

    MedlinePLUS

    ... sometimes referred to as a “pinched” nerve. The medical term for this condition is cervical radiculopathy. Understanding your ... worn for short periods of time, because long-term wear can decrease the strength of neck ... and is not intended to serve as medical advice. Anyone seeking speci? c orthopaedic advice or ...

  6. 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

  7. Segmental thoracic lipomatosis of nerve with nerve territory overgrowth.

    PubMed

    Mahan, Mark A; Amrami, Kimberly K; Howe, B Matthew; Spinner, Robert J

    2014-05-01

    Lipomatosis of nerve (LN), or fibrolipomatous hamartoma, is a rare condition of fibrofatty enlargement of the peripheral nerves. It is associated with bony and soft tissue overgrowth in approximately one-third to two-thirds of cases. It most commonly affects the median nerve at the carpal tunnel or digital nerves in the hands and feet. The authors describe a patient with previously diagnosed hemihypertrophy of the trunk who had a history of large thoracic lipomas resected during infancy, a thoracic hump due to adipose proliferation within the thoracic paraspinal musculature, and scoliotic deformity. She had fatty infiltration in the thoracic spinal nerves on MRI, identical to findings pathognomonic of LN at better-known sites. Enlargement of the transverse processes at those levels and thickened ribs were also found. This case appears to be directly analogous to other instances of LN with overgrowth, except that this case involved axial nerves rather than the typical appendicular nerves. PMID:24506247

  8. [The effect of transsection of the inferior alveolar nerve on neurogenic inflammation of the oral mucosa. I. Functional studies].

    PubMed

    Fazekas, A; Györfi, A; Pósch, E; Rosivall, L

    1991-01-01

    Vascular effects of local capsaicin treatment has been studied on the 2nd and 14th days subsequent to unilateral inferior alveolar nerve (IAN) transection in the oral mucosa of rats. The results suggest, that the symptoms of neurogenic inflammation were influenced by the transection of IAN in a different way. The reason of that is the different mechanism in the development of the symptoms and/or the different compensatory capacity of the accessorial nerves. PMID:1999254

  9. Anatomical bases of superior gluteal nerve entrapment syndrome in the suprapiriformis foramen.

    PubMed

    Diop, M; Parratte, B; Tatu, L; Vuillier, F; Faure, A; Monnier, G

    2002-01-01

    Observation of a 60 year-old-man with superior gluteal nerve (SGN) entrapment neuropathy in the suprapiriformis foramen encouraged us to explore, through anatomical dissection, the possible morphological etiologies of this condition. Ten SGNs in five embalmed cadavers were dissected via gluteal and pelvic access. The origin, course and distribution of the nervous trunk and its relations were studied. In most cases, the nerve fibers of the SGN arose from ventral branches of L4, L5 and S1 to constitute the nervous trunk in the pelvis, then reached the gluteal area and divided into two branches, cranial and caudal. By running through the suprapiriformis foramen with the cranial gluteal vascular pedicle, the nervous trunk was always up between the superior edge of the piriformis muscle and the greater sciatic notch; rarely some of the nerve fibers went through the muscle. Bone, muscular and vascular morphological factors liable to cause SGN entrapment syndrome, and the circumstances of discovery, were analyzed. The role of hypertrophy of the piriformis muscle, resulting in a narrow suprapiriformis foramen, was confirmed through surgery. PMID:12375066

  10. The Epicardial Neural Ganglionated Plexus of the Ovine Heart: Anatomical Basis for Experimental Cardiac Electrophysiology and Nerve Protective Cardiac Surgery

    PubMed Central

    Saburkina, Inga; Rysevaite, Kristina; Pauziene, Neringa; Mischke, Karl; Schauerte, Patrick; Jalife, José; Pauza, Dainius H.

    2011-01-01

    Summary BACKGROUND The sheep is routinely used in experimental cardiac electrophysiology and surgery. OBJECTIVE We aimed at (1) ascertaining the topography and architecture of the ovine epicardial neural plexus (ENP), (2) determining the relationships of the ENP with the vagal and sympathetic cardiac nerves and ganglia, and (3) evaluating gross anatomical differences and similarities among ENPs in humans, sheep and other species. METHODS The ovine ENP, extrinsic sympathetic and vagal nerves were revealed histochemically for acetylcholinesterase on whole heart and/or thorax-dissected preparations from 23 newborn lambs with subsequent examination by a stereomicroscope. RESULTS The intrinsic cardiac nerves extend from the venous part of the ovine heart hilum (HH) along the roots of the cranial (superior) caval and left azygos veins to both atria and ventricles via five epicardial routes; i.e. the dorsal right atrial (DRA), middle (MD), left dorsal (LD), right ventral (VR) and ventral left atrial (VLA) nerve subplexuses. Intrinsic nerves proceeding from the arterial part of the HH along the roots of the aorta and pulmonary trunk extend exclusively into the ventricles as the right and left coronary subplexuses. The DRA, RV, and MD subplexuses receive the main extrinsic neural input from the right cervicothoracic and the right thoracic sympathetic T2, T3 ganglia, as well as from the right vagal nerve. The LD is supplied by sizeable extrinsic nerves from the left thoracic T4-T6 sympathetic ganglia and the left vagal nerve. Sheep hearts contained on average 769±52 epicardial ganglia. Cumulative areas of epicardial ganglia on the root of the cranial vena cava and on the wall of the coronary sinus were the largest of all regions (p<0.05). CONCLUSION Despite substantial interindividual variability in the morphology of the ovine ENP, the right-sided epicardial neural subplexuses supplying the sinuatrial and atrioventricular nodes are mostly concentrated at a fat pad between the right pulmonary veins and the cranial vena cava. This is in sharp contrast with a solely left lateral neural input to the human atrioventricular node which extends mainly from the LD and MD subplexuses. The abundance of epicardial ganglia distributed widely along the ovine ventricular nerves over respectable distances below the coronary groove implies a distinctive neural control of the ventricles in human and sheep hearts. PMID:20197118

  11. Pulsed radiofrequency of the median nerve under ultrasound guidance.

    PubMed

    Haider, Naeem; Mekasha, Daniel; Chiravuri, Srinivas; Wasserman, Ronald

    2007-11-01

    Neuropathy of the median nerve within the carpal tunnel (carpal tunnel syndrome) has an age adjusted incidence of 105 cases per 100,000 person years. Treatment of carpal tunnel syndrome ranges from conservative management with medication and exercise to surgical release of the median nerve. Conservative treatment accounts for a significant portion of resources utilized and includes splinting, nerve gliding, ultrasound, and carpal bone mobilization. Recurrent symptoms of carpal tunnel syndrome have been shown to occur in 0% to 19% of patients following carpal tunnel release, with up to 12% requiring re-exploration. Prognosis for re-exploration is not as good as for primary carpal tunnel release, with a high recurrence rate in some populations. Ultrasound has seen increasing use in regional anesthesia and has been shown to improve the quality of regional anesthetic blocks. Pulsed radiofrequency was developed with the goal of providing reduction in pain from the use of electrical fields in the absence of neural injury. The use of ultrasound guidance for positioning radiofrequency probes over peripheral nerves has not been reported. This case report describes the use of ultrasound guided pulsed radiofrequency in the treatment of recurrent carpal tunnel syndrome. Following revision carpal tunnel surgery, the patient in this report was unable to obtain relief of pain in either hand with medication therapy alone. After a successful diagnostic median nerve block at the cubital fossa, pulsed radiofrequency of the median nerve was performed on the left side at the cubital fossa, under ultrasound guidance. Radiofrequency probe adjustment around the nerve was conducted under live ultrasound guidance and multiple pulsed treatments were applied at anatomically distinct sites over the nerve. A 70% reduction in pain was reported over the follow up period of 12 weeks. PMID:17987099

  12. Atypical Presentation of Cavernous Sinus Infection with Intracavernous ICA Aneurysm.

    PubMed

    Pant, Bhawana; Joshi, H C K; Isser, D K

    2014-01-01

    In a typical presentation of intracavernous internal carotid artery aneurysm and cavernous sinus infection there is involvement of 3rd, 4th and 6th cranial nerves along with 2nd and 5th cranial nerve. Here we present a case of a 32 years old male with unilateral mycotic intracavernous internal carotid artery aneurysm with a history of head injury. Atypical features in this case was involvement of distantly situated multiple cranial nerves and sparing the 5th cranial nerve and optic nerve which are more near and commonly involved. Besides this patient has marked sphenoid sinusitis on left side but having no sign and symptoms. PMID:24605316

  13. 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.

  14. Neanderthal cranial ontogeny and its implications for late hominid diversity.

    PubMed

    Ponce de León, M S; Zollikofer, C P

    2001-08-01

    Homo neanderthalensis has a unique combination of craniofacial features that are distinct from fossil and extant 'anatomically modern' Homo sapiens (modern humans). Morphological evidence, direct isotopic dates and fossil mitochondrial DNA from three Neanderthals indicate that the Neanderthals were a separate evolutionary lineage for at least 500,000 yr. However, it is unknown when and how Neanderthal craniofacial autapomorphies (unique, derived characters) emerged during ontogeny. Here we use computerized fossil reconstruction and geometric morphometrics to show that characteristic differences in cranial and mandibular shape between Neanderthals and modern humans arose very early during development, possibly prenatally, and were maintained throughout postnatal ontogeny. Postnatal differences in cranial ontogeny between the two taxa are characterized primarily by heterochronic modifications of a common spatial pattern of development. Evidence for early ontogenetic divergence together with evolutionary stasis of taxon-specific patterns of ontogeny is consistent with separation of Neanderthals and modern humans at the species level. PMID:11484052

  15. Encephalization and diversification of the cranial base in platyrrhine primates.

    PubMed

    Aristide, Leandro; Dos Reis, Sergio F; Machado, Alessandra C; Lima, Inaya; Lopes, Ricardo T; Perez, S Ivan

    2015-04-01

    The cranial base, composed of the midline and lateral basicranium, is a structurally important region of the skull associated with several key traits, which has been extensively studied in anthropology and primatology. In particular, most studies have focused on the association between midline cranial base flexion and relative brain size, or encephalization. However, variation in lateral basicranial morphology has been studied less thoroughly. Platyrrhines are a group of primates that experienced a major evolutionary radiation accompanied by extensive morphological diversification in Central and South America over a large temporal scale. Previous studies have also suggested that they underwent several evolutionarily independent processes of encephalization. Given these characteristics, platyrrhines present an excellent opportunity to study, on a large phylogenetic scale, the morphological correlates of primate diversification in brain size. In this study we explore the pattern of variation in basicranial morphology and its relationship with phylogenetic branching and with encephalization in platyrrhines. We quantify variation in the 3D shape of the midline and lateral basicranium and endocranial volumes in a large sample of platyrrhine species, employing high-resolution CT-scans and geometric morphometric techniques. We investigate the relationship between basicranial shape and encephalization using phylogenetic regression methods and calculate a measure of phylogenetic signal in the datasets. The results showed that phylogenetic structure is the most important dimension for understanding platyrrhine cranial base diversification; only Aotus species do not show concordance with our molecular phylogeny. Encephalization was only correlated with midline basicranial flexion, and species that exhibit convergence in their relative brain size do not display convergence in lateral basicranial shape. The evolution of basicranial variation in primates is probably more complex than previously believed, and understanding it will require further studies exploring the complex interactions between encephalization, brain shape, cranial base morphology, and ecological dimensions acting along the species divergence process. PMID:25743433

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

    E-print Network

    Baldauf, Richard John

    1956-01-01

    on the examination of serial sections, starting with the olfactory capsule and proceeding toward the rear of the head. 10 DESCRIPTION OF THE CRANIAL ANATOMY OF BUFO W. WOODHOUSEI OLFACTORY REGION The olfactory sacs are separated by a substantial septum nasi... sections. Short, paired prechoanal sacs (prch. s.) appear in the region of the upturned solum nasi (Fig. 32). The epithelial and connective tissues serving to separate the sac from the buccal cavity soon disappear, leav? ing a large prechoanal groove...

  17. Extended Middle Cranial Fossa Approach for Acoustic Neuroma Surgery

    PubMed Central

    Wigand, Malte E.; Haid, Toni; Berg, Michael; Schuster, Bernd; Goertzen, Winfried

    1991-01-01

    The enlarged middle cranial fossa approach was used for removal of acoustic neuromas in 209 cases. Complete tumor removal was accomplished in 96% of cases. Hearing was preserved in 51% of cases, with better results in smaller tumors. Our experience with the enlarged middle fossa approach has led us to discard the translabyrinthine approach for removal of acoustic neuromas. ImagesFigure 1Figure 2 PMID:17170810

  18. Endoscopic approaches to the cranial base: perspectives and realities

    Microsoft Academic Search

    D. Locatelli; P. Castelnuovo; L. Santi; M. Cerniglia; M. Maghnie; L. Infuso

    2000-01-01

    We describe the development of transnasal endoscopic approaches to the cranial base in an interdisciplinary series of 103\\u000a patients, including 13 in the pediatric age group. Our aim was to define, with the aid of different case reports, the possibilities\\u000a of endoscopic techniques in tumor resection, fistula repair, the treatment of mucoceles and meningoceles, and of combined\\u000a intracranial and endoscopic

  19. Endoscopic robotic decompression of the ulnar nerve at the elbow.

    PubMed

    Garcia, Jose Carlos; de Souza Montero, Edna Frasson

    2014-06-01

    Ulnar nerve entrapment can be treated by a number of surgical techniques when necessary. Endoscopic techniques have recently been developed to access the ulnar nerve by use of a minimally invasive approach. However, these techniques have been considered difficult and, many times, dangerous procedures, reserved for experienced elbow arthroscopic surgeons only. We have developed a new endoscopic approach using the da Vinci robot (Intuitive Surgical, Sunnyvale, CA) that may be easier and safer. Standardization of the technique was previously developed in cadaveric models to achieve the required safety, reliability, and organization for this procedure, and the technique was then used in a live patient. In this patient the nerve entrapment symptoms remitted after the surgical procedure. The robotic surgical procedure presented a cosmetic advantage, as well as possibly reduced scar formation. This is the first note on this surgical procedure; the procedure needs to be tested and even evolved until a state-of-the-art standard is reached. PMID:25126508

  20. Endoscopic Robotic Decompression of the Ulnar Nerve at the Elbow

    PubMed Central

    Garcia, Jose Carlos; de Souza Montero, Edna Frasson

    2014-01-01

    Ulnar nerve entrapment can be treated by a number of surgical techniques when necessary. Endoscopic techniques have recently been developed to access the ulnar nerve by use of a minimally invasive approach. However, these techniques have been considered difficult and, many times, dangerous procedures, reserved for experienced elbow arthroscopic surgeons only. We have developed a new endoscopic approach using the da Vinci robot (Intuitive Surgical, Sunnyvale, CA) that may be easier and safer. Standardization of the technique was previously developed in cadaveric models to achieve the required safety, reliability, and organization for this procedure, and the technique was then used in a live patient. In this patient the nerve entrapment symptoms remitted after the surgical procedure. The robotic surgical procedure presented a cosmetic advantage, as well as possibly reduced scar formation. This is the first note on this surgical procedure; the procedure needs to be tested and even evolved until a state-of-the-art standard is reached. PMID:25126508

  1. 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

  2. Cranial neural crest cell migration in cockatiel Nymphicus hollandicus (Aves: Psittaciformes).

    PubMed

    Tokita, Masayoshi

    2006-03-01

    Parrots have developed unique jaw muscles in their evolutionary history. The M. pseudomasseter, which completely covers the lateral side of the jugal bar, is regarded as a jaw muscle unique to parrots. In a previous study, I presented a hypothesis on the relevance of modifications in the regulation of cranial neural crest cell (NCC) development to the generation of this novel jaw muscle based on histological analyses (Tokita [2004] J Morphol 259:69-81). In the present study, I investigated distribution and migration patterns of cranial neural crest cells (NCCs) through parrot embryogenesis with immunohistochemical techniques to further understand the role of cranial NCCs in the evolution of the M. pseudomasseter, and to provide new information on the relative plasticity in cranial NCC migration at early stages of avian development. The basic nature of cranial NCC development was mostly conserved between chick and parrot. In both, cranial NCCs migrated from the dorsal tip of the neural tube in a ventral direction. Three major populations were identified in their cranial NCCs. Migration pathways of these cells were almost identical between chick and parrot. The principal difference was seen in the relative timing of cranial NCC migration. In the parrot, cranial NCC migration into the first pharyngeal arch was more advanced than in the chick at early stages of development. Such a temporal shift in cranial NCC migration might influence architectural patterning of parrot jaw muscles that generates new muscle like M. pseudomasseter. PMID:16342077

  3. Morphometric Analysis of Cranial Shape in Fossil and Recent Euprimates

    PubMed Central

    Bennett, C. Verity; Goswami, Anjali

    2012-01-01

    Quantitative analysis of morphology allows for identification of subtle evolutionary patterns or convergences in anatomy that can aid ecological reconstructions of extinct taxa. This study explores diversity and convergence in cranial morphology across living and fossil primates using geometric morphometrics. 33 3D landmarks were gathered from 34 genera of euprimates (382 specimens), including the Eocene adapiforms Adapis and Leptadapis and Quaternary lemurs Archaeolemur, Palaeopropithecus, and Megaladapis. Landmark data was treated with Procrustes superimposition to remove all nonshape differences and then subjected to principal components analysis and linear discriminant function analysis. Haplorhines and strepsirrhines were well separated in morphospace along the major components of variation, largely reflecting differences in relative skull length and width and facial depth. Most adapiforms fell within or close to strepsirrhine space, while Quaternary lemurs deviated from extant strepsirrhines, either exploring new regions of morphospace or converging on haplorhines. Fossil taxa significantly increased the area of morphospace occupied by strepsirrhines. However, recent haplorhines showed significantly greater cranial disparity than strepsirrhines, even with the inclusion of the unusual Quaternary lemurs, demonstrating that differences in primate cranial disparity are likely real and not simply an artefact of recent megafaunal extinctions. PMID:22611497

  4. Brief communication: Artificial cranial modification in Kow Swamp and Cohuna.

    PubMed

    Durband, Arthur C

    2014-09-01

    The crania from Kow Swamp and Cohuna have been important for a number of debates in Australian paleoanthropology. These crania typically have long, flat foreheads that many workers have cited as evidence of genetic continuity with archaic Indonesian populations, particularly the Ngandong sample. Other scientists have alleged that at least some of the crania from Kow Swamp and the Cohuna skull have been altered through artificial modification, and that the flat foreheads possessed by these individuals are not phylogenetically informative. In this study, several Kow Swamp crania and Cohuna are compared to known modified and unmodified comparative samples. Canonical variates analyses and Mahalanobis distances are generated, and random expectation statistics are used to calculate statistical significance for these tests. The results of this study agree with prior work indicating that a portion of this sample shows evidence for artificial modification of the cranial vault. Many Kow Swamp crania and Cohuna display shape similarities with a population of known modified individuals from New Britain. Kow Swamp 1, 5, and Cohuna show the strongest evidence for modification, but other individuals from this sample also show evidence of 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 modification, and suggests that caution should be used when including these individuals in phylogenetic studies. PMID:24964764

  5. Heterochrony and developmental modularity of cranial osteogenesis in lipotyphlan mammals

    PubMed Central

    2011-01-01

    Background Here we provide the most comprehensive study to date on the cranial ossification sequence in Lipotyphla, the group which includes shrews, moles and hedgehogs. This unique group, which encapsulates diverse ecological modes, such as terrestrial, subterranean, and aquatic lifestyles, is used to examine the evolutionary lability of cranial osteogenesis and to investigate the modularity of development. Results An acceleration of developmental timing of the vomeronasal complex has occurred in the common ancestor of moles. However, ossification of the nasal bone has shifted late in the more terrestrial shrew mole. Among the lipotyphlans, sequence heterochrony shows no significant association with modules derived from developmental origins (that is, neural crest cells vs. mesoderm derived parts) or with those derived from ossification modes (that is, dermal vs. endochondral ossification). Conclusions The drastic acceleration of vomeronasal development in moles is most likely coupled with the increased importance of the rostrum for digging and its use as a specialized tactile surface, both fossorial adaptations. The late development of the nasal in shrew moles, a condition also displayed by hedgehogs and shrews, is suggested to be the result of an ecological reversal to terrestrial lifestyle and reduced functional importance of the rostrum. As an overall pattern in lipotyphlans, our results reject the hypothesis that ossification sequence heterochrony occurs in modular fashion when considering the developmental patterns of the skull. We suggest that shifts in the cranial ossification sequence are not evolutionarily constrained by developmental origins or mode of ossification. PMID:22040374

  6. Spontaneous healing capacity of rabbit cranial defects of various sizes

    PubMed Central

    Sohn, Joo-Yeon; Park, Jung-Chul; Um, Yoo-Jung; Jung, Ui-Won; Kim, Chang-Sung; Cho, Kyoo-Sung

    2010-01-01

    Purpose This study evaluated the spontaneous healing capacity of surgically produced cranial defects in rabbits with different healing periods in order to determine the critical size defect (CSD) of the rabbit cranium. Methods Thirty-two New Zealand white rabbits were used in this study. Defects of three sizes (6, 8, and 11 mm) were created in each of 16 randomly selected rabbits, and 15-mm defects were created individually in another 16 rabbits. The defects were analyzed using radiography, histologic analysis, and histometric analysis after the animal was sacrificed at 2, 4, 8, or 12 weeks postoperatively. Four samples were analyzed for each size of defect and each healing period. Results The radiographic findings indicated that defect filling gradually increased over time and that smaller defects were covered with a greater amount of radiopaque substance. Bony islands were observed at 8 weeks at the center of the defect in both histologic sections and radiographs. Histometrical values show that it was impossible to determine the precise CSD of the rabbit cranium. However, the innate healing capacity that originates from the defect margin was found to be constant regardless of the defect size. Conclusions The results obtained for the spontaneous healing capacity of rabbit cranial defects over time and the underlying factors may provide useful guidelines for the development of a rabbit cranial model for in vivo investigations of new bone materials. PMID:20827327

  7. Ultrasound of Peripheral Nerves

    PubMed Central

    Suk, Jung Im; Walker, Francis O.; Cartwright, Michael S.

    2013-01-01

    Over the last decade, neuromuscular ultrasound has emerged as a useful tool for the diagnosis of peripheral nerve disorders. This article reviews sonographic findings of normal nerves including key quantitative ultrasound measurements that are helpful in the evaluation of focal and possibly generalized peripheral neuropathies. It also discusses several recent papers outlining the evidence base for the use of this technology, as well as new findings in compressive, traumatic, and generalized neuropathies. Ultrasound is well suited for use in electrodiagnostic laboratories where physicians, experienced in both the clinical evaluation of patients and the application of hands-on technology, can integrate findings from the patient’s history, physical examination, electrophysiological studies, and imaging for diagnosis and management. PMID:23314937

  8. Occurrence of Trochlear Nerve Palsy after Epiduroscopic Laser Discectomy and Neural Decompression

    PubMed Central

    Lee, Eun Ha; Kim, Su Hwa; Noh, Mi Sun

    2013-01-01

    Epiduroscopic laser discectomy and neural decompression (ELND) is known as an effective treatment for intractable lumbar pain and radiating pain which develop after lumbar surgery, as well as for herniation of the intervertebral disk and spinal stenosis. However, various complications occur due to the invasiveness of this procedure and epidural adhesion, and rarely, cranial nerve damage can occur due to increased intracranial pressure. Here, the authors report case in which double vision occurred after epiduroscopic laser discectomy and neural decompression in a patient with failed back surgery syndrome (FBSS). PMID:23614087

  9. Medial Plantar Nerve Entrapment

    MedlinePLUS

    ... Drug Information, Search Drug Names, Generic and Brand Natural Products, Search Drug ... symptoms, drugs, procedures, news and more, written in everyday language. * This page is for Consumers * Doctors: Tap here ...

  10. Optic Nerve Imaging

    MedlinePLUS

    ... Glaucoma Facts and Stats Glossary Symptoms of Open-Angle Glaucoma Types of Glaucoma » See All Articles Help ... org 251 Post Street, Suite 600 San Francisco , CA 94108 (415) 986-3162 (800) 826-6693 question@ ...

  11. Nerves in a pinch: imaging of nerve compression syndromes.

    PubMed

    Hochman, Mary G; Zilberfarb, Jeffrey L

    2004-01-01

    Nerve compression is a common entity that can result in considerable disability. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although the appropriate diagnosis is often determined by clinical examination, the diagnosis may be more difficult when the presentation is atypical, or when anatomic and technical limitations intervene. In these instances, imaging can have an important role in helping to define the site and etiology of nerve compression or in establishing an alternative diagnosis. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. For both modalities, the use of high-resolution techniques is important. Bony abnormalities contributing to nerve compression are best assessed by radiographs or CT. For the radiologist, knowledge of the anatomy of the fibro-osseous tunnels, familiarity with the causes of nerve compression, and an understanding of specialized imaging techniques are important for successful diagnosis of nerve compression. PMID:15049533

  12. Optic nerve hypoplasia.

    PubMed

    Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B S; Rastogi, Anju; Kamlesh

    2013-05-01

    Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

  13. Optic nerve hypoplasia

    PubMed Central

    Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B. S.; Rastogi, Anju; Kamlesh

    2013-01-01

    Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

  14. Lower extremity nerve blocks.

    PubMed

    Dilger, J A

    2000-06-01

    Lower extremity nerve blocks have not become as popular as upper extremity blocks for anesthesia; however, the use of lower extremity nerve blocks will become more widespread, as teaching programs are now providing more regional anesthesia experiences for their trainees so that the anesthesia provider will have the familiarity to use these blocks. To increase the enthusiasm among our surgical colleagues, we must begin to use these blocks for surgery, and if the block must be supplemented with local anesthetic or a light general anesthetic, we must educate them that the block is not a failure but a success, as it will provide analgesia after surgery in a method of multimodal pain control. Lower extremity nerve blocks will become more popular when it is realized that they are an effective way of increasing operating room efficiency. Because the block may be placed in an induction room, there is no induction or emergence in the operating room. Patients may be discharged without the need for pain medications, thus lowering the incidence of nausea postoperatively and decreasing PACU and discharge times. PMID:10935013

  15. E. coli Symptoms

    MedlinePLUS

    ... JavaScript on. Read more information on enabling JavaScript. E. coli Skip Content Marketing Share this: Main Content Area Symptoms Shiga toxin-producing E. coli (STEC) can cause the following symptoms: Nausea Severe ...

  16. Listeriosis: Definition and Symptoms

    MedlinePLUS

    ... Dairy Products Recall & Advice to Consumers Case Count Maps Epi Curves Signs & Symptoms Key Resources Crave Brothers Farmstead Cheeses Recall & Advice to Consumers Case Count Maps Epi Curves Signs & Symptoms Key Resources Imported Frescolina ...

  17. Signs and Symptoms

    MedlinePLUS

    ... Progress Search form Search Charcot-Marie-Tooth Disease (CMT) Signs and Symptoms Partly because there are different types of Charcot-Marie-Tooth disease (CMT) , the exact symptoms vary greatly from person to ...

  18. General IC Symptoms

    MedlinePLUS

    General IC Symptoms Symptoms of interstitial cystitis (IC) differ from person to person and may even vary in the ... with IC pain . Revised January 12, 2010 About IC What is Interstitial Cystitis? 4 to 12 Million ...

  19. Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery

    PubMed Central

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

    2014-01-01

    Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P < 0.001) and an increased 30-day morbidity rate of 25.9% versus 14.14% in non-anemic patients (P < 0.001). The 30-day morbidity rates for all patients undergoing cranial procedures were stratified by diagnosis: 26.5% aneurysm, 24.7% sellar tumor, 19.7% extra-axial tumor, 14.8% intra-axial tumor, 14.4% arteriovenous malformation, and 5.6% pain. Following multivariable regression, the 30-day mortality in anemic patients was threefold higher than in non-anemic patients (4.1% vs 1.3%; OR = 2.77; 95% CI: 1.65-4.66). The odds of postoperative morbidity in anemic patients were significantly higher than in non-anemic patients (OR = 1.29; 95% CI: 1.03-1.61). There was a significant difference in postoperative morbidity event odds with a hematocrit level above (OR = 1.07; 95% CI: 0.78-1.48) and below (OR = 2.30; 95% CI: 1.55-3.42) 33% [hemoglobin (Hgb) 11 g/dl]. Conclusions: Preoperative anemia in elective cranial neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity. PMID:25422784

  20. Determination of nerve conduction abnormalities in patients with impaired glucose tolerance

    Microsoft Academic Search

    Sevki Sahin; Sibel Karsidag; Sunay Ayalp; Ahmet Sengul; Onder Us; Kubilay Karsidag

    2009-01-01

    Recent studies have shown that impaired glucose tolerance (IGT) is associated with dysfunction in the peripheral and autonomic\\u000a nerves. The aim of this study was to determine the electrophysiological abnormalities of IGT. To determine electrophysiological\\u000a abnormality in the large sensorimotor and sudomotor autonomic nerves with IGT patients, 43 patients and 34 healthy subjects\\u000a have been studied. Subjective neuropathy symptoms, neurological

  1. Use of a pedicled adipose flap as a sling for anterior subcutaneous transposition of the ulnar nerve.

    PubMed

    Danoff, Jonathan R; Lombardi, Joseph M; Rosenwasser, Melvin P

    2014-03-01

    In patients with primary cubital tunnel syndrome, we hypothesize that using a vascularized adipose sling to secure the ulnar nerve during anterior subcutaneous transposition will lead to improved patient outcomes. The adipose flap is designed to surround the ulnar nerve with a pliable, vascularized fat envelope, mimicking the natural fatty environment of peripheral nerves. This technique may offer advantages in securing the anteriorly transposed ulnar nerve and reducing instances of postoperative perineural scarring. Patients experience good functional outcomes; most experience resolution of symptoms. PMID:24503232

  2. Preactivation of the quadriceps muscle could limit cranial tibial translation in a cranial cruciate ligament deficient canine stifle.

    PubMed

    Ramirez, Juan M; Lefebvre, Michael; Böhme, Beatrice; Laurent, Cédric; Balligand, Marc

    2015-02-01

    Cranial cruciate ligament (CrCL) deficiency is the leading cause of lameness of the canine stifle. Application of tension in the quadriceps muscle could trigger cranial tibial translation in case of CrCL rupture. We replaced the quadriceps muscle and the gastrocnemius muscle by load cells and turn-buckles. First, eight canine limbs were placed in a servo-hydraulic testing machine, which applied 50% of body weight (BW). In a second phase, the CrCL was transected, and the limbs were tested in a similar manner. In a third phase, a quadriceps pretension of 15% BW was applied and limbs were again tested in a similar manner. Cranial tibial translation was significantly decreased in CrCL deficient stifles (p?

  3. Accessory Branch of Median Nerve Supplying the Brachialis Muscle: A Case Report and Clinical Significance

    PubMed Central

    Anastasopoulos, Nikolaos; Nitsa, Zoi; Kitsoulis, Panagiotis; Spyridakis, Ioannis

    2014-01-01

    A very rare case of an accessory branch of the median nerve taking its origin in the region of the right arm was observed to supply the infero-medial portion of the brachialis muscle in a male cadaver. Simultaneously, the ipsilateral musculocutaneous nerve was innervating the muscles of the anterior compartment of the arm. Such an aberrant muscular branch of the median nerve for the brachialis muscle is very rarely reported in the literature. Lesion of the median nerve proximal to the branch’s origin site could induce weak flexion of the elbow, whereas injury of the musculocutaneous nerve could lead to misinterpretation of symptoms. We discuss the patterns of brachialis muscle innervation as well as the clinical applications of such a variant. PMID:25653932

  4. Neutralizing IL-17 protects the optic nerve from autoimmune pathology and prevents retinal nerve fiber layer atrophy during experimental autoimmune encephalomyelitis.

    PubMed

    Knier, Benjamin; Rothhammer, Veit; Heink, Sylvia; Puk, Oliver; Graw, Jochen; Hemmer, Bernhard; Korn, Thomas

    2015-01-01

    Optic neuritis is a common inflammatory manifestation of multiple sclerosis (MS). In experimental autoimmune encephalomyelitis (EAE), the optic nerve is affected as well. Here, we investigated whether autoimmune inflammation in the optic nerve is distinct from inflammation in other parts of the central nervous system (CNS). In our study, inflammatory infiltrates in the optic nerve and the brain were characterized by a high fraction of Ly6G(+) granulocytes whereas in the spinal cord, macrophage infiltrates were predominant. At the peak of disease, IL-17 mRNA abundance was highest in the optic nerve as compared with other parts of the CNS. The ratio of IL-17 vs IFN-? producing CD4(+) T cells was higher in the optic nerve and brain than in the spinal cord and more effector CD4(+) T cells were committed to the Th17 transcriptional program in the optic nerve than in the spinal cord. IL-17 producing ?? T cells but rather not Ly6G(+) granulocytes themselves contributed to IL-17 production. Optical coherence tomography (OCT) studies on murine eyes revealed a decline in thickness of the retinal nerve fiber layer (RNFL) and the common layer of ganglion cells and inner plexiform layer (GCL+) after the recovery from motor symptoms indicating that autoimmune inflammation induced a significant atrophy of optic nerve fibers during EAE. Neutralization of IL-17 by treatment with anti-IL-17 antibodies reduced but did not abrogate motor symptoms of EAE. However, RNFL and GCL+ atrophy were completely prevented by blocking IL-17. Thus, the optic nerve compartment is particularly prone to support IL-17 mediated inflammatory responses during CNS autoimmunity and structural integrity of the retina can be preserved by neutralizing IL-17. PMID:25282335

  5. Optic nerve injury in a patient with chronic allergic conjunctivitis.

    PubMed

    Hazin, Ribhi; Elia, Christopher J; Putruss, Maria; Bazzi, Amanda

    2014-01-01

    Manipulation of the optic nerve can lead to irreversible vision changes. We present a patient with a past medical history of skin allergy and allergic conjunctivitis (AC) who presented with insidious unexplained unilateral vision loss. Physical exam revealed significant blepharospasm, mild lid edema, bulbar conjunctival hyperemia, afferent pupillary defect, and slight papillary hypertrophy. Slit lamp examination demonstrated superior and inferior conjunctival scarring as well as superior corneal scarring but no signs of external trauma or neurological damage were noted. Conjunctival cultures and cytologic evaluation demonstrated significant eosinophilic infiltration. Subsequent ophthalmoscopic examination revealed optic nerve atrophy. Upon further questioning, the patient admitted to vigorous itching of the affected eye for many months. Given the presenting symptoms, history, and negative ophthalmological workup, it was determined that the optic nerve atrophy was likely secondary to digital pressure from vigorous itching. Although AC can be a significant source of decreased vision via corneal ulceration, no reported cases have ever described AC-induced vision loss of this degree from vigorous itching and chronic pressure leading to optic nerve damage. Despite being self-limiting in nature, allergic conjunctivitis should be properly managed as extreme cases can result in mechanical compression of the optic nerve and compromise vision. PMID:25317346

  6. Optic Nerve Injury in a Patient with Chronic Allergic Conjunctivitis

    PubMed Central

    Hazin, Ribhi; Elia, Christopher J.; Putruss, Maria; Bazzi, Amanda

    2014-01-01

    Manipulation of the optic nerve can lead to irreversible vision changes. We present a patient with a past medical history of skin allergy and allergic conjunctivitis (AC) who presented with insidious unexplained unilateral vision loss. Physical exam revealed significant blepharospasm, mild lid edema, bulbar conjunctival hyperemia, afferent pupillary defect, and slight papillary hypertrophy. Slit lamp examination demonstrated superior and inferior conjunctival scarring as well as superior corneal scarring but no signs of external trauma or neurological damage were noted. Conjunctival cultures and cytologic evaluation demonstrated significant eosinophilic infiltration. Subsequent ophthalmoscopic examination revealed optic nerve atrophy. Upon further questioning, the patient admitted to vigorous itching of the affected eye for many months. Given the presenting symptoms, history, and negative ophthalmological workup, it was determined that the optic nerve atrophy was likely secondary to digital pressure from vigorous itching. Although AC can be a significant source of decreased vision via corneal ulceration, no reported cases have ever described AC-induced vision loss of this degree from vigorous itching and chronic pressure leading to optic nerve damage. Despite being self-limiting in nature, allergic conjunctivitis should be properly managed as extreme cases can result in mechanical compression of the optic nerve and compromise vision. PMID:25317346

  7. Cranial Palpation Pressures Used by Osteopathy Students: Effects of Standardized Protocol Training

    Microsoft Academic Search

    Rafael Zegarra-Parodi; Pierre de Chauvigny de Blot; Luke D. Rickards

    2009-01-01

    Zegarra-Parodi et alOriginal Contribution Context: Descriptions of subtle palpatory perceptions in osteo- pathic cranial palpation can be misperceived by students. Thus, adequate dissemination and replication of cranial pal- patory techniques is challenging for osteopathy students. Objective: To evaluate the effects of standardized protocol training on cranial palpation of the frontomalar suture. Methods: Fourth-year osteopathy students from the Euro- pean Center

  8. NEGATIVE SYMPTOMS IN DEPRESSION

    PubMed Central

    Chaturvedi, Santosh K.; Sarmukaddam, Sanjeev

    1985-01-01

    SUMMARY Negative symptoms have been assessed in 34 cases of major depression (ROC) using the scale for assessment of negative symptoms. Negative symptoms were found to be quite frequently observed in these cases; common negative symptoms were inability to enjoy recreational interests and activities (76%), feelings of anhedonia (64.7%) and physical anergia (55.9%). Poverty of speech was found to be more in younger patients (P < .001). Avolition was seen more frequently in unmarried (P < .05) patients. No other signiticant correlation was noticed between demographic variables and negative symptoms. The implications of evaluating negative symptoms systematically in depressives are for future research especially for prognostication, treatment responses and classification of depression based on such symptoms. PMID:21927088

  9. Large middle ear schwannoma of the Jacobson's nerve with intracranial extension.

    PubMed

    Mohamed, Aboshanif; Omi, Eigo; Honda, Kohei; Suzuki, Shinsuke; Ishikawa, Kazuo; Takahasi, Masataka; Oda, Masaya

    2014-10-01

    The patient is a 64-year-old woman who developed a sensation of right ear fullness and hearing loss in early November 2010. Physical examination revealed a painless reddish granular lesion filling in the right external auditory canal. Her right ear was deaf, and no facial palsy was noted. Computed tomography, magnetic resonance imaging and positron emission tomography revealed a middle ear mass extending to the external auditory canal with intracranial invasion causing temporal lobe retraction and inferiorly extending just anterior to the jugular bulb as well. A combination of transmastoid and middle cranial fossa approach along with anterior rerouting of the facial nerve was employed for a near-total removal of the tumor. Based upon the operative findings, it was deemed that the tumor could have arisen from the Jacobson's nerve. PMID:24882584

  10. Dejerine-Sottas neuropathy with multiple nerve roots enlargement and hypomyelination associated with a missense mutation of the transmembrane domain of MPZ/P0.

    PubMed

    Simonati, Alessandro; Fabrizi, Gian Maria; Taioli, Federica; Polo, Alberto; Cerini, Roberto; Rizzuto, Nicolò

    2002-09-01

    In a patient affected with a slowly progressive, severe form of Dejerine-Sottas syndrome, symmetric enlargement of cranial nerves and focal hypertrophy of cervical and caudal roots were detected following MRI. Neuropathological features of the sural nerve disclosed a dramatic loss of myelinated fibres, with skewed-to-the-left, unimodal distribution of the few residual fibres, consistent with the diagnosis of congenital hypomyelination neuropathy. Genetic analysis revealed this condition to be associated with a heterozygous G to A transition at codon 167 in the exon 4 of the MPZ/P0 gene causing a Gly138Arg substitution in the transmembrane domain of the mature MPZ/P0 protein. Focal enlargement of the nerve trunks in demyelinating, hereditary motor and sensory neuropathies (HMSN) was previously reported in both asymptomatic and symptomatic cases with root compression, but peculiar to this case is the diffuse involvement of both cranial and spinal nerves. We believe that the relevance of nerve trunk hypertrophy in HMSN is probably underevaluated: therefore MRI investigation of the head and spine should be included in the diagnostic study of selected HMSN patients. Molecular analysis of peripheral myelin genes will help to rule out misdiagnosed cases. PMID:12242557

  11. Dural arteriovenous fistula in the anterior cranial fossa: four case reports.

    PubMed

    Tanei, Takafumi; Fukui, Kazuhiro; Wakabayashi, Kenichi; Mitsui, Yuki; Inoue, Norio; Watanabe, Masao

    2008-12-01

    Three of 4 cases of dural arteriovenous fistulas (DAVFs) in the anterior cranial fossa were detected incidentally by magnetic resonance (MR) imaging, and one case manifested as intracerebral hemorrhage. Cerebral angiography revealed fistulas located in the anterior cranial fossa. Three patients underwent surgery, and the fistulas were successfully obliterated. One patient with nonruptured DAVF requested conservative medical management. Incidental detection of asymptomatic or nonruptured DAVFs in the anterior cranial fossa has increased with the wider use of MR imaging. Increase in the size of a venous varix is the indicator for aggressive therapeutic intervention in a patient receiving conservative medical management for asymptomatic or nonruptured DAVFs in the anterior cranial fossa. PMID:19106494

  12. CT-scan imaging of iron marked chorda tympani nerve: anatomical study and educational perspectives.

    PubMed

    Trost, Olivier; Rouchy, René-Charles; Teyssier, Charles; Kazemi, Apolline; Zwetyenga, Narcisse; Malka, Gabriel; Cheynel, Nicolas; Trouilloud, Pierre

    2011-08-01

    The chorda tympani nerve (CTN) is the last collateral branch of the facial nerve in its third intraosseous portion just over the stylomastoid foramen. After a curved course against the medial aspect of the tympanum where it is likely to be injured in middle ear surgery, CTN reaches the lingual nerve in the infratemporal fossa. Knowledge of CTN topographic anatomy is not easily achieved by the students because of the deep location of this thin structure. The aim of this study was to assess the spatial relationships of the CTN in the infratemporal fossa. Therefore, ten nerves were dissected in five fresh cadavers. All the nerves were catheterized with a 3/0 wire. After a meticulous repositioning of surrounding structures, standard X-ray and CT scan examinations were performed with multiplanar acquisitions and three-dimensional surface rendering reconstructions. Ventral projection of the CTN corresponded to the middle of the maxillary sinus. Lateral landmark was the mandibular condyle. The CTN was present and unique in all the dissections. The average length of the nerve, as measured on CT scans, was 31.8 mm (29-34, standard deviation of 1.62); the anastomosis of the CTN to the lingual nerve was located at a mean 24.9 mm below the skull base (24-27, standard deviation of 0.99), approximately in the same horizontal plane as the lower part of the mandibular notch. The acute angle opened dorsally and cranially between CTN and LN measured mean 63.2° (60-65, standard deviation of 1.67). Three-dimensional volumetric reconstructions using surface rendering technique provided realistic educational support at the students' disposal. PMID:21416387

  13. In vivo nerve-macrophage interactions following peripheral nerve injury

    PubMed Central

    Rosenberg, Allison; Wolman, Marc A.; Franzini-Armstrong, Clara; Granato, Michael

    2012-01-01

    In vertebrates, the peripheral nervous system has retained its regenerative capacity, enabling severed axons to reconnect with their original synaptic targets. While it is well documented that a favorable environment is critical for nerve regeneration, the complex cellular interactions between injured nerves with cells in their environment, as well as the functional significance of these interactions, have not been determined in vivo and in real time. Here we provide the first minute-by-minute account of cellular interactions between laser transected motor nerves and macrophages in live intact zebrafish. We show that macrophages arrive at the lesion site long before axon fragmentation, much earlier than previously thought. Moreover, we find that axon fragmentation triggers macrophage invasion into the nerve to engulf axonal debris, and that delaying nerve fragmentation in a Wlds model does not alter macrophage recruitment but induces a previously unknown ‘nerve scanning’ behavior, suggesting that macrophage recruitment and subsequent nerve invasion are controlled by separate mechanisms. Finally, we demonstrate that macrophage recruitment, thought to be dependent on Schwann cell derived signals, occurs independently of Schwann cells. Thus, live cell imaging defines novel cellular and functional interactions between injured nerves and immune cells. PMID:22423110

  14. Nerve-pulse interactions

    SciTech Connect

    Scott, A.C.

    1982-01-01

    Some recent experimental and theoretical results on mechanisms through which individual nerve pulses can interact are reviewed. Three modes of interactions are considered: (1) interaction of pulses as they travel along a single fiber which leads to velocity dispersion; (2) propagation of pairs of pulses through a branching region leading to quantum pulse code transformations; and (3) interaction of pulses on parallel fibers through which they may form a pulse assembly. This notion is analogous to Hebb's concept of a cell assembly, but on a lower level of the neural hierarchy.

  15. 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.

  16. Dumb-bell shaped tuberculous abscess across the greater sciatic notch compressing both sciatic nerves.

    PubMed

    Baba, H; Okumura, Y; Furusawa, N; Omori, H; Kawahara, H; Fujita, T; Katayama, K; Noriki, S

    1998-08-01

    We report an instructive case of a 65-year-old man who presented with a dumb-bell shaped tuberculous abscess across the greater sciatic notch bilaterally compressing both sciatic nerves. Clinical symptoms progressed slowly and mimicked lumbar radiculopathy, thus delaying an accurate diagnosis. Anterolateral retroperitoneal and posterolateral gluteal approaches of the greater sciatic notch as well as the acetabulum on both sides were followed in order to provide safe viewing and resection of the abscess. The abscess wall was adherent to the sciatic nerve and surrounding blood vessels. The symptoms completely disappeared after resection of the abscess. PMID:9713929

  17. Effects of nerve growth factor on nerve regeneration after corneal nerve damage

    PubMed Central

    Ma, Ke; Yan, Naihong; Huang, Yongzhi; Cao, Guiqun; Deng, Jie; Deng, Yingping

    2014-01-01

    The study aims to determine the relation between the effects of mouse nerve growth factor (mNGF) and nerve regeneration after corneal surgery nerve damage. Mechanical nerve injury animal model was established by LASIK (the excimer laser keratomileusis) surgery in 12 Belgian rabbits. mNGF and the balanced salt solution (BBS) were alternatively administered in the left and right eye two times every day for 8 weeks. The morphous and growth of the sub-basal nerve plexus and superficial stroma were observed by in vivo confocal microscopy at the end of weeks 1, 2, 4 and 8 after the surgery. The animal model is successfully established. The morphology and density of corneal nerve have been observed and demonstrated by confocal microscopy. A systematic administration of mNGF can significantly promote the nerve regeneration at the end of weeks 1, 2, 4 and 8, which comparing to the administration of balanced salt solution (P < 0.05). mNGF has effect on sub-basal nerve plexus and superficial stroma after corneal nerve damage which is caused by LASIK. The experimental results suggested that the mNGF may solve the problem of dry eye after LASIK. PMID:25550989

  18. Compressive neuropathy of the tibial nerve and peroneal nerve by a Baker's cyst: case report.

    PubMed

    Ji, Jong-Hun; Shafi, Mohamed; Kim, Weon-Yoo; Park, Se Hun; Cheon, Jang Ok

    2007-06-01

    We report a case of Baker's cyst that induced compression of both the tibial and common peroneal nerves. The patient presented with calf atrophy and foot drop over a 6-month period. These signs and symptoms could have been mistaken for those of spinal origin. Based on an electrodiagnostic study and magnetic resonance imaging, compression of nerves by an asymptomatic Baker's cyst measuring 6x4 cm was confirmed. This cyst communicated with the articular joint which was also associated with a medial meniscal lesion. We treated the patient arthroscopically by performing partial medial meniscectomy, and through the posterolateral and the posteromedial portal, decompression of the Baker's cyst was performed. Approximately 6 weeks after the arthroscopic decompression, the cyst recurred. Therefore open resection was performed. At 1-year follow-up, the patient had considerable improvement in motor as well as sensory function and showed no evidence of recurrence. Although the electrodiagnostic studies showed an improvement in symptoms, the patient continued to complain of lower leg weakness owing to delayed diagnosis and cyst decompression. We believe that Baker's cysts should also be considered in the differential diagnoses of patients who present with neuromuscular dysfunction in the calf and leg. PMID:17300942

  19. Unruptured Internal Carotid-Posterior Communicating Artery Aneurysm Splitting the Oculomotor Nerve: A Case Report and Literature Review

    PubMed Central

    Toyota, Shingo; Taki, Takuyu; Wakayama, Akatsuki; Yoshimine, Toshiki

    2014-01-01

    Objective?To report a rare case of unruptured internal carotid-posterior communicating artery (IC-PC) aneurysm splitting the oculomotor nerve treated by clipping and to review the previously published cases. Case Presentation?A 42-year-old man suddenly presented with left oculomotor paresis. Three-dimensional digital subtraction angiography (3D DSA) demonstrated a left IC-PC aneurysm with a bulging part. During surgery, it was confirmed that the bulging part split the oculomotor nerve. After the fenestrated oculomotor nerve was dissected from the bulging part with a careful microsurgical technique, neck clipping was performed. After the operation, the symptoms of oculomotor nerve paresis disappeared within 2 weeks. Conclusions?We must keep in mind the possibility of an anomaly of the oculomotor nerve, including fenestration, and careful observation and manipulation should be performed to preserve the nerve function during surgery, even though it is very rare. PMID:25083381

  20. Use of cranial CT to identify a new infarct in patients with a transient ischemic attack

    PubMed Central

    Al-Khaled, Mohamed; Matthis, Christine; Münte, Thomas F; Eggers, Jürgen

    2012-01-01

    Research on infarct detection by noncontrast cranial computed tomography (CCT) in patients with transient ischemic attack (TIA) is sparse. However, the aims of this study are to determine the frequency of new infarcts in patients with TIA, to evaluate the independent predictors of infarct detection, and to investigate the association between a new infarct and early short-term risk of stroke during hospitalization. We prospectively evaluated 1533 consecutive patients (mean age, 75.3 ± 11 years; 54% female; mean National Institutes of Health Stroke Scale [NIHSS] score, 1.7 ± 2.9) with TIA who were admitted to hospital within 48 h of symptom onset. A new infarct was detected by CCT in 47 (3.1%) of the 1533 patients. During hospitalization, 17 patients suffered a stroke. Multivariate logistic regression analysis revealed the following independent predictors for infarct detection: NIHSS score ?10 (odds ratio [OR], 4.8), time to CCT assessment >6 h (OR 2.2), and diabetes (OR 2.3). The evidence of a new infarct was not associated with the risk of stroke after TIA. The frequency of a new infarct in patients with TIA using CCT is low. The use of the CCT tool to predict the stroke risk during hospitalization in patients with TIA is found to be inappropriate. The estimated clinical predictors are easy to use and may help clinicians in the TIA work up. PMID:22950041

  1. Giant Tricholemmal Squamous Cell Carcinoma with Cranial Infiltration

    PubMed Central

    Bayyoud, Yousef; Kittner, Thomas; Dürig, Eberhard

    2011-01-01

    Tricholemmal squamous cell carcinoma is a rare variant of squamous cell carcinoma thought to follow a more benign course. The authors present the case of a 67-year-old man with a giant tricholemmal squamous cell carcinoma on his scalp. Further investigations demonstrated a skull destruction and cranial invasion. Curative treatment was impossible, but tumor mass reduction and wound closure by sandwich split-thickness skin mesh graft transplantation using a dermal template was performed. Problems of advanced squamous cell carcinoma on the scalp are discussed. PMID:21532876

  2. Repair of tegmen defect using cranial particulate bone graft.

    PubMed

    Greene, Arin K; Poe, Dennis S

    2015-01-01

    Bone paté is used to repair cranial bone defects. This material contains bone-dust collected during the high-speed burring of the cranium. Clinical and experimental studies of bone dust, however, have shown that it does not have biological activity and is resorbed. We describe the use of bone paté using particulate bone graft. Particulate graft is harvested with a hand-driven brace and 16mm bit; it is not subjected to thermal injury and its large size resists resorption. Bone paté containing particulate graft is much more likely than bone dust to contain viable osteoblasts capable of producing new bone. PMID:25465655

  3. Rehabilitation following motor nerve transfers.

    PubMed

    Novak, Christine B

    2008-11-01

    Cortical mapping and relearning are key factors in optimizing patient outcome following motor nerve transfers. To maximize function following nerve transfers, the rehabilitation program must include motor reeducation to initiate recruitment of the weak reinnervated muscles and to establish new motor patterns and cortical mapping. Patient education and a home program are essential to obtain the optimal functional result. PMID:18928890

  4. Neuromas of the calcaneal nerves.

    PubMed

    Kim, J; Dellon, A L

    2001-11-01

    A neuroma of a calcaneal nerve has never been reported. A series of 15 patients with heel pain due to a neuroma of a calcaneal nerve are reviewed. These patients previously had either a plantar fasciotomy (n = 4), calcaneal spur removal (n = 2), ankle fusion (n = 2), or tarsal tunnel decompression (n = 7). Neuromas occurred on calcaneal branches that arose from either the posterior tibial nerve (n = 1), lateral plantar nerve (n = 1), the medial plantar nerve (n = 9), or more than one of these nerves (n = 4). Operative approach was through an extended tarsal tunnel incision to permit identification of all calcaneal nerves. The neuroma was resected and implanted into the flexor hallucis longus muscle. Excellent relief of pain occurred in 60%, and good relief in 33%. One patient (17%) had no improvement and required resection of the lateral plantar nerve. Awareness that the heel may be innervated by multiple calcaneal branches suggests that surgery for heel pain of neural origin employ a surgical approach that permits identification of all possible calcaneal branches. PMID:11722141

  5. 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

  6. 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

  7. 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

  8. 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

  9. Somatization or psychosomatic symptoms?

    PubMed

    Avila, Lazslo Antonio

    2006-01-01

    The author describes some problems emerging from the approach to and comprehension of somatization symptoms, discussing ambiguities regarding somatization seen in the current classification manuals (ICD-10 and DSM-IV). Then the author presents a case report of a man who presented with a bizarre symptom of feminization that was successfully treated with psychotherapy. The author ends with a discussion of the relationship between meaning and symptom. PMID:16508030

  10. Malignant peripheral nerve sheath tumors.

    PubMed

    Gupta, Gaurav; Maniker, Allen

    2007-01-01

    Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue sarcomas of ectomesenchymal origin. The World Health Organization coined the term MPNST to replace previous heterogeneous and often confusing terminology, such as "malignant schwannoma," "malignant neurilemmoma," "neurogenic sarcoma," and "neurofibrosarcoma." Malignant peripheral nerve sheath tumors arise from major or minor peripheral nerve branches or sheaths of peripheral nerve fibers, and are derived from Schwann cells or pluripotent cells of neural crest origin. The Schwann cell is thought to be the major contributor to the formation of benign as well as malignant neoplasms of the nerve sheath. While this fact remains essentially true, the identity of cell of origin of the MPNST remains elusive, and has not yet been conclusively identified. It has been suggested that these tumors may have multiple cell line origins. In this review, the authors discuss the epidemiology, diagnosis, management, and treatment of MPNSTs. PMID:17613203

  11. Kwashiorkor symptoms (image)

    MedlinePLUS

    ... resulting from inadequate protein intake. Early symptoms include fatigue, irritability, and lethargy. As protein deprivation continues, one sees growth failure, loss of muscle mass, generalized swelling (edema), and ...

  12. Axonal degeneration of the ulnar nerve secondary to carpal tunnel syndrome: fact or fiction?

    PubMed

    Azmy, Radwa Mahmoud; Labib, Amira Ahmed; Elkholy, Saly Hassan

    2013-05-25

    The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4(th) and 5(th) fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4(th) and 5(th) fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4(th) and 5(th) fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve. PMID:25206437

  13. Axonal degeneration of the ulnar nerve secondary to carpal tunnel syndrome: fact or fiction??

    PubMed Central

    Azmy, Radwa Mahmoud; Labib, Amira Ahmed; Elkholy, Saly Hassan

    2013-01-01

    The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve. PMID:25206437

  14. Efficiency of Posterior Tibial Nerve Stimulation in Category IIIB Chronic Prostatitis\\/Chronic Pelvic Pain: A Sham-Controlled Comparative Study

    Microsoft Academic Search

    Sahin Kabay; Sibel Canbaz Kabay; Mehmet Yucel; Hilmi Ozden

    2009-01-01

    Objectives: To evaluate the efficacy of percutaneous posterior tibial nerve stimulation (PTNS) for treatment of the patients with category IIIB chronic non-bacterial prostatitis\\/chronic pelvic pain syndrome. Methods: A total of 89 patients with therapy-resistant pelvic pain were randomized to receive either nerve stimulation (n = 45) or sham treatment (n = 44). The National Institutes of Health Chronic Prostatitis Symptom

  15. [Pathogenesis of lumbo-sacral nerve root lesion: from the view point of thermographic findings of the lower limbs].

    PubMed

    Igarashi, K

    1990-09-01

    Pathogenesis of the lumbo-sacral nerve roots lesion is discussed especially on the role of the sympathetic nerve using thermographic investigation of the lower limbs. 50 persons without any lumbar symptom were selected as control, and 97 patients with lumbo-sacral nerve roots lesion, including 64 with lumbar disc herniation (LDH) and 33 with lumbar canal stenosis (LCS), were the subjects of this study. In 33 patients group thermography was taken before and after selective nerve root block. The thermograms of the control group showed almost symmetrical thermatome. 49 (76.6%) of LDH group had hypothermal area on the affected limb, however, particularity of the hypothermal area did not define between L5 and S1 nerve root lesion. The patients with hypothermal area of the lower limb were characterised as having apparent neurological deficits and longer duration of the history from the onset, compared with the group without hypothermal area. 25 (75.8%) of LCS group showed not only hypothermal but also complicated thermographic findings. The patients with the complicated findings tended to have severer neurological deficits. Through thermographic findings after nerve root block, it is suggested that skin distribution of the particular nerve root, for example L5 or S1 nerve root distribution, exists in the lower limbs probably related to sympathetic nerve. This study concludes that thermograms of the lower limbs reflect pathogenesis of lumbo-sacral nerve root lesion in some extent, and probably indicate the prognosis of the lesion. PMID:1966740

  16. Lithium treatment prevents neurocognitive deficit resulting from cranial irradiation.

    PubMed

    Yazlovitskaya, Eugenia M; Edwards, Eric; Thotala, Dinesh; Fu, Allie; Osusky, Kate L; Whetsell, William O; Boone, Braden; Shinohara, Eric T; Hallahan, Dennis E

    2006-12-01

    Curative cancer treatment regimens often require cranial irradiation, resulting in lifelong neurocognitive deficiency in cancer survivors. This deficiency is in part related to radiation-induced apoptosis and decreased neurogenesis in the subgranular zone of the hippocampus. We show that lithium treatment protects irradiated hippocampal neurons from apoptosis and improves cognitive performance of irradiated mice. The molecular mechanism of this effect is mediated through multiple pathways, including Akt/glycogen synthase kinase-3beta (GSK-3beta) and Bcl-2/Bax. Lithium treatment of the cultured mouse hippocampal neurons HT-22 induced activation of Akt (1.5-fold), inhibition of GSK-3beta (2.2-fold), and an increase in Bcl-2 protein expression (2-fold). These effects were sustained when cells were treated with lithium in combination with ionizing radiation. In addition, this combined treatment led to decreased expression (40%) of the apoptotic protein Bax. The additional genes regulated by lithium were identified by microarray, such as decorin and Birc1f. In summary, we propose lithium treatment as a novel therapy for prevention of deleterious neurocognitive consequences of cranial irradiation. PMID:17145862

  17. Cisplatin and Cranial Irradiation-Related Hearing Loss in Children

    PubMed Central

    Warrier, Rajasekharan; Chauhan, Aman; Davluri, Murali; Tedesco, Sonya L.; Nadell, Joseph; Craver, Randall

    2012-01-01

    Background: High doses of cisplatin and cranial radiotherapy (CRT) have been reported to cause irreversible hearing loss. The objective of this study was to examine the influence of cranial irradiation on cisplatin-associated ototoxicity in children with pediatric malignancies. Methods: Serial audiograms were obtained for 33 children, age <16 years, treated with cisplatin-based chemotherapy (90-120 mg/m2 per cycle) with or without CRT. Eligible patients included those with normal baseline audiometric evaluations and without significant exposure to other ototoxic drugs. We defined significant hearing loss as a hearing threshold ?30 dB at 2,000-8,000 Hz frequencies. Results: The median age of our study population was 4.9 years (range 6 weeks to 16 years), and the male to female ratio was 0.8:1. The study population consisted of 15 Caucasians, 17 African-Americans, and 1 Hispanic. Fourteen patients had brain tumors, and 19 had other solid tumors. Thirteen patients were exposed to CRT, and 20 were not. Bilateral hearing loss was observed in 24/33 (73%) patients, with severe/profound (?70 dB) impairment in 10/33 (30%) of all patients. Young age (<5 years), CRT, and brain tumors were independent prognostic factors predicting hearing loss. Conclusion: The study demonstrated a high incidence of hearing loss in children treated with cisplatin and CRT. Consequently, we recommend monitoring these children for the early detection of hearing loss. PMID:23049454

  18. Early effects of cranial irradiation on hypothalamic-pituitary function

    SciTech Connect

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

    1987-03-01

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

  19. Dural arteriovenous malformations in the anterior cranial fossa.

    PubMed

    Ba?kaya, M K; Suzuki, Y; Seki, Y; Negoro, M; Ahmed, M; Sugita, K

    1994-01-01

    Two cases of dural arteriovenous malformation (DAVM) fed by the anterior ethmoidal artery in the anterior cranial fossa are reported, one of them examined by magnet resonance imaging (MRI). Only one other case with MRI findings so far has been published. Fourty-eight previously reported cases are reviewed. One of our patients presented with subdural haematoma (SDH) without subarachnoid or intracerebral haemorrhage. The other patient had a nasal bleed without any neurological manifestations. In comparison with previously reported cases, the clinical manifestation of our cases is infrequent (1 patient with nasal bleed, and 2 patients with pure SDH that is 2 and 4%, respectively, in the literature). Feeder was the anterior ethmoidal artery either unilateral or bilateral. Drainage of DAVMs was through a markedly dilated vascular sac into the superior sagittal sinus (SSS). The high incidence of haemorrhage from DAVM in the anterior fossa is related to this vascular sac. Magnetic resonance imaging (MRI) showed a flow void area in the left frontal region on T 1-weighted images in one case. These cases were treated by surgical excision of the malformation with good results. Aetiology, clinical presentation, and treatment of these rare DAVMs in the anterior cranial fossa is discussed. PMID:7847155

  20. Cranial neural crest cells form corridors prefiguring sensory neuroblast migration

    PubMed Central

    Freter, Sabine; Fleenor, Stephen J.; Freter, Rasmus; Liu, Karen J.; Begbie, Jo

    2013-01-01

    The majority of cranial sensory neurons originate in placodes in the surface ectoderm, migrating to form ganglia that connect to the central nervous system (CNS). Interactions between inward-migrating sensory neuroblasts and emigrant cranial neural crest cells (NCCs) play a role in coordinating this process, but how the relationship between these two cell populations is established is not clear. Here, we demonstrate that NCCs generate corridors delineating the path of migratory neuroblasts between the placode and CNS in both chick and mouse. In vitro analysis shows that NCCs are not essential for neuroblast migration, yet act as a superior substrate to mesoderm, suggesting provision of a corridor through a less-permissive mesodermal territory. Early organisation of NCC corridors occurs prior to sensory neurogenesis and can be recapitulated in vitro; however, NCC extension to the placode requires placodal neurogenesis, demonstrating reciprocal interactions. Together, our data indicate that NCC corridors impose physical organisation for precise ganglion formation and connection to the CNS, providing a local environment to enclose migrating neuroblasts and axonal processes as they migrate through a non-neural territory. PMID:23942515

  1. 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

  2. Human cranial anatomy and the differential preservation of population history and climate signatures

    Microsoft Academic Search

    Katerina Harvati; Timothy D. Weaver

    2006-01-01

    Cranial morphology is widely used to reconstruct evolutionary rela- tionships, but its reliability in reflecting phylogeny and population history has been questioned. Some cranial regions, particularly the face and neu- rocranium, are believed to be influenced by the environment and prone to convergence. Others, such as the temporal bone, are thought to reflect more accurately phylogenetic relationships. Direct testing of

  3. A Preliminary Investigation of Postoperative Molding to Improve the Result of Cranial Vault Remodeling

    Microsoft Academic Search

    Stephen Higuera; Larry H. Hollier; Phillip M. Stevens

    2005-01-01

    Craniosynostoses most frequently require correction by craniotomy and cranial vault remodeling to facilitate neurologic development and normal cranial shape. Although the skull can be fairly accurately contoured intraoperatively, the final shape is dependent on many factors, including bone and brain growth and bone resorption. Although molding helmets have been used for positional head molding and in the management of endoscopic

  4. Major cranial changes during Triceratops ontogeny John R. Horner1,* and Mark B. Goodwin2

    E-print Network

    Goodwin, Mark B.

    Major cranial changes during Triceratops ontogeny John R. Horner1,* and Mark B. Goodwin2 1 Museum ontogeny, curve posteriorly in juveniles, straighten in subadults and recurve anteriorly in adults, and signal their attainment of sexual maturity. Keywords: dinosaurs; cranial ontogeny; Triceratops; Late

  5. THE SMALLEST KNOWN TRICERATOPS SKULL: NEW OBSERVATIONS ON CERATOPSID CRANIAL ANATOMY AND ONTOGENY

    E-print Network

    Goodwin, Mark B.

    THE SMALLEST KNOWN TRICERATOPS SKULL: NEW OBSERVATIONS ON CERATOPSID CRANIAL ANATOMY AND ONTOGENY squamosals. Previous assessments of ontogeny in Triceratops are based on an isolated juvenile postorbital of Triceratops ontogeny based on a very complete cranial growth series in the collections of the MOR and UCMP

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

    E-print Network

    Winfree, Erik

    to cranial mesenchymal (osteoblast and smooth muscle) neural crest fates when injected into E13.5 mouse, neural crest cells fall into 3 populations, cranial, cardiac, and trunk, each with a unique developmental, and corneal endothelial cells [6]. Trunk neural crest cells form a more limited set of cell types, including

  7. The question of robusticity and the relationship between cranial size and shape in Homo sapiens

    Microsoft Academic Search

    Richard V. S. Wright

    1996-01-01

    Although cranial gracility is generally considered to be a characteristic feature of modern skulls, a quantification of the degree of development of cranial superstructures discloses varying levels of robusticity in certain recent and sub-recent populations. In order to account for these structures, biomechanical interpretations in terms of masticatory stress and the effects of structural constraints have been put forward. This

  8. Widely Infiltrating Epithelioid Malignant Peripheral Nerve Sheath Tumour of Skull Base

    PubMed Central

    Parampalli Srinivas, Srilatha; Rao, Lakshmi; Nayak, Deepak Ranjan

    2013-01-01

    The epithelioid variant of malignant peripheral nerve sheath tumours is a rare histological entity, and the occurrence of a malignant peripheral nerve sheath tumour in the skull base is even more unusual. We report a case of a 52-year-old man who presented with reduced hearing in the left ear, giddiness and left-sided facial weakness of short duration. He was a known hypertensive. On examination, left-sided 7th to 12th cranial nerve palsies were noted. Computed tomography (CT) and brain magnetic resonance imaging (MRI) were reported as an ill-defined heterogeneously enhancing mass left skull base suggestive of chondrosarcoma. Left tympanotomy and biopsy of the lesion were carried out. On light microscopy and immunohistochemical examination of the biopsy, a diagnosis of epithelioid malignant peripheral nerve sheath tumour was established. The patient underwent left extended modified radical mastoidectomy and selective neck dissection. Histopathological study of the resected surgical specimen confirmed left-sided extensive tumour involvement of skull base structures, as well as neck nodal metastases. PMID:23983583

  9. Widely infiltrating epithelioid malignant peripheral nerve sheath tumour of skull base.

    PubMed

    Parampalli Srinivas, Srilatha; Rao, Lakshmi; Nayak, Deepak Ranjan

    2013-03-01

    The epithelioid variant of malignant peripheral nerve sheath tumours is a rare histological entity, and the occurrence of a malignant peripheral nerve sheath tumour in the skull base is even more unusual. We report a case of a 52-year-old man who presented with reduced hearing in the left ear, giddiness and left-sided facial weakness of short duration. He was a known hypertensive. On examination, left-sided 7th to 12th cranial nerve palsies were noted. Computed tomography (CT) and brain magnetic resonance imaging (MRI) were reported as an ill-defined heterogeneously enhancing mass left skull base suggestive of chondrosarcoma. Left tympanotomy and biopsy of the lesion were carried out. On light microscopy and immunohistochemical examination of the biopsy, a diagnosis of epithelioid malignant peripheral nerve sheath tumour was established. The patient underwent left extended modified radical mastoidectomy and selective neck dissection. Histopathological study of the resected surgical specimen confirmed left-sided extensive tumour involvement of skull base structures, as well as neck nodal metastases. PMID:23983583

  10. Occipital nerve stimulation.

    PubMed

    Mammis, Antonios; Agarwal, Nitin; Mogilner, Alon Y

    2015-01-01

    Occipital nerve stimulation (ONS) is a form of neuromodulation therapy aimed at treating intractable headache and craniofacial pain. The therapy utilizes neurostimulating electrodes placed subcutaneously in the occipital region and connected to a permanently implanted programmable pulse generator identical to those used for dorsal column/spinal cord stimulation. The presumed mechanisms of action involve modulation of the trigeminocervical complex, as well as closure of the physiologic pain gate. ONS is a reversible, nondestructive therapy, which can be tailored to a patient's individual needs. Typically, candidates for successful ONS include those patients with migraines, Chiari malformation, or occipital neuralgia. However, recent MRSA infections, unrealistic expectations, and psychiatric comorbidities are generally contraindications. As with any invasive procedure, complications may occur including lead migration, infection, wound erosion, device failure, muscle spasms, and pain. The success of this therapy is dependent on careful patient selection, a preimplantation trial, meticulous implantation technique, programming strategies, and complication avoidance. PMID:25411143

  11. ?-Synuclein in cutaneous autonomic nerves

    PubMed Central

    Wang, Ningshan; Gibbons, Christopher H.; Lafo, Jacob

    2013-01-01

    Objective: To develop a cutaneous biomarker for Parkinson disease (PD). Methods: Twenty patients with PD and 14 age- and sex-matched control subjects underwent examinations, autonomic testing, and skin biopsies at the distal leg, distal thigh, and proximal thigh. ?-Synuclein deposition and the density of intraepidermal, sudomotor, and pilomotor nerve fibers were measured. ?-Synuclein deposition was normalized to nerve fiber density (the ?-synuclein ratio). Results were compared with examination scores and autonomic function testing. Results: Patients with PD had a distal sensory and autonomic neuropathy characterized by loss of intraepidermal and pilomotor fibers (p < 0.05 vs controls, all sites) and morphologic changes to sudomotor nerve fibers. Patients with PD had greater ?-synuclein deposition and higher ?-synuclein ratios compared with controls within pilomotor nerves and sudomotor nerves (p < 0.01, all sites) but not sensory nerves. Higher ?-synuclein ratios correlated with Hoehn and Yahr scores (r = 0.58–0.71, p < 0.01), with sympathetic adrenergic function (r = ?0.40 to ?0.66, p < 0.01), and with parasympathetic function (r = ?0.66 to ?0.77, p > 0.01). Conclusions: We conclude that ?-synuclein deposition is increased in cutaneous sympathetic adrenergic and sympathetic cholinergic fibers but not sensory fibers of patients with PD. Higher ?-synuclein deposition is associated with greater autonomic dysfunction and more advanced PD. These data suggest that measures of ?-synuclein deposition in cutaneous autonomic nerves may be a useful biomarker in patients with PD. PMID:24089386

  12. Epithelioid Sarcoma of the Forearm Arising from Perineural Sheath of Median Nerve Mimicking Carpal Tunnel Syndrome

    PubMed Central

    Fujii, Hiromasa; Honoki, Kanya; Yajima, Hiroshi; Kido, Akira; Kobata, Yasunori; Kaji, Daisuke; Takakura, Yoshinori

    2009-01-01

    We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8 × 4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma. Radical surgical resection was performed in conjunction with adjuvant chemotherapy. The function of the flexors were restored by the multiple tendon transfers (EIP ? FDS; ECRL ? FDP; BrR ? FPL; EDM ? opponens) with superficial cutaneous branch of radial nerve transfer to the resected median nerve. The function of the affected hand showed excellent with the DASH disability/symptom score of 22.5, and both the grasp power and sensory of the median nerve area has recovered up to 50% of the normal side. The patient returned to his original vocation and alive with continuous disease free at 3.5-year follow-up since initial treatment. PMID:19381344

  13. Nerve entrapment syndromes in musicians.

    PubMed

    Wilson, Robert J; Watson, Jeffry T; Lee, Donald H

    2014-09-01

    Nerve entrapment syndromes are common in instrumental musicians. Carpal tunnel syndrome, ulnar neuropathy at the elbow, and thoracic outlet syndrome appear to be the most common. While electrodiagnostic studies may confirm the diagnosis of nerve entrapment, they may be falsely normal in musicians. Non-operative treatment with instrument and technique modification may help. Involvement with the musician's teacher to implement appropriate treatment is recommended. Outcomes for both non-operative and operative treatment for various nerve entrapment syndromes have yielded mostly good to excellent results, similar to the general population. PMID:24644143

  14. Nanofibrous nerve conduit-enhanced peripheral nerve regeneration.

    PubMed

    Jiang, Xu; Mi, Ruifa; Hoke, Ahmet; Chew, Sing Yian

    2014-05-01

    Fibre structures represent a potential class of materials for the formation of synthetic nerve conduits due to their biomimicking architecture. Although the advantages of fibres in enhancing nerve regeneration have been demonstrated, in vivo evaluation of fibre size effect on nerve regeneration remains limited. In this study, we analyzed the effects of fibre diameter of electrospun conduits on peripheral nerve regeneration across a 15-mm critical defect gap in a rat sciatic nerve injury model. By using an electrospinning technique, fibrous conduits comprised of aligned electrospun poly (?-caprolactone) (PCL) microfibers (981?±?83 nm, Microfiber) or nanofibers (251?±?32 nm, Nanofiber) were obtained. At three months post implantation, axons regenerated across the defect gap in all animals that received fibrous conduits. In contrast, complete nerve regeneration was not observed in the control group that received empty, non-porous PCL film conduits (Film). Nanofiber conduits resulted in significantly higher total number of myelinated axons and thicker myelin sheaths compared to Microfiber and Film conduits. Retrograde labeling revealed a significant increase in number of regenerated dorsal root ganglion sensory neurons in the presence of Nanofiber conduits (1.93 ± 0.71 × 10(3) vs. 0.98 ± 0.30 × 10(3) in Microfiber, p?nerve regeneration. These results could provide useful insights for future nerve guide designs. PMID:22700359

  15. Nerve conduction studies in hand surgery

    Microsoft Academic Search

    David J Slutsky

    2003-01-01

    The treatment of nerve disorders of the upper extremity has become a highly specialized area. There has been an evolution in the electrodiagnostic approach for evaluating patients with these disorders. Portable automated nerve conduction testing systems are becoming popular for limited nerve conduction testing in the office. Differential latency testing can aid in the diagnosis of dynamic nerve entrapment disorders

  16. Electrodiagnostic confirmation of long thoracic nerve palsy

    Microsoft Academic Search

    P E Kaplan

    1980-01-01

    Long thoracic nerve latencies were measured in 25 normal subjects. The nerve was stimulated at Erb's point. Monopolar electrodes were used to record the motor evoked response from the serratus anterior muscle. The mean long thoracic nerve latency was 3.9 +\\/- 0.6 ms. Four athletes with unilateral, isolated long thoracic nerve palsies were compared with the control group and with

  17. Symptom clusters: the new frontier in symptom management research.

    PubMed

    Miaskowski, Christine; Dodd, Marylin; Lee, Kathryn

    2004-01-01

    The majority of clinical studies on pain, fatigue, and depression associated with cancer are focused on one symptom. Although this approach has led to some advances in our understanding of a particular symptom, patients rarely present with a single symptom. Therefore, even though research focused on single symptoms needs to continue, it is imperative that symptom management research begins to focus on evaluating multiple symptoms, using cross-sectional and longitudinal study designs. In addition, research needs to focus on evaluating the relationships among multiple symptoms, specific interventions, and patient outcomes. One of the initial challenges in research regarding multiple symptoms is the terminology that should be used to describe the concept (e.g., symptom cluster, symptom constellation). Another significant area related to this aspect of symptom management research is determining the nature of clinically significant clusters of symptoms and their associated prevalence rates. Equally important is the need to determine what types of tools/instruments will provide the most valid and reliable data for the assessment of symptom clusters. Other areas that need to be considered as related to the assessment of symptom clusters include the establishment of cut points for symptom severity that would qualify a symptom for inclusion in a cluster; the focus of the assessment; and the choice of the outcome measures that will be used to judge the effect of a symptom cluster on the patient. In the area of intervention studies for symptom clusters, research will need to build on the limited number of clinical trials with single symptoms. Additional considerations related to research on symptom clusters include the determination of the mechanisms underlying the development of symptom clusters; the timing of the measurements for symptom clusters; and statistical challenges in the evaluation of symptom clusters. Research on symptom clusters in patients with cancer is cutting-edge science and a new frontier in symptom management research, and it needs to be done in tandem with research on single symptoms. PMID:15263036

  18. Surgical management of painful peripheral nerves.

    PubMed

    Elliot, David

    2014-07-01

    This article deals with the classification, assessment, and management of painful nerves of the distal upper limb. The author's preferred surgical and rehabilitation techniques in managing these conditions are discussed in detail and include (1) relocation of end-neuromas to specific sites, (2) division and relocation of painful nerves in continuity (neuromas-in-continuity and scar-tethered nerves) involving small nerves to the same sites, and (3) fascial wrapping of painful nerves in continuity involving larger nerves such as the median and ulnar nerves. The results of these treatments are presented as justification for current use of these techniques. PMID:24996473

  19. Evaluation on the Antipruritic Role of Transcutaneous Electrical Nerve Stimulation in the Treatment of Pruritic Dermatoses

    Microsoft Academic Search

    William Yuk Ming Tang; Loi Yuen Chan; Kuen Kong Lo; Tze Wai Wong

    1999-01-01

    Background: Pruritus is a common and sometimes distressing symptom in many dermatological conditions. Response to conventional pharmaceutical agents may not be satisfactory, and adverse effects are real problems. Objective: To evaluate the short-term efficacy and adverse effects of transcutaneous electrical nerve stimulation (TENS) for ameliorating pruritus in patients with dermatoses. Methods: A prospective 1-week study using TENS given once daily

  20. Overview of Optic Nerve Disorders

    MedlinePLUS

    ... Resources for Help and Information The One-Page Merck Manual of Health Medical Terms Conversion Tables Manuals available ... Papilledema Optic Neuritis Ischemic Optic Neuropathy Toxic Amblyopia Merck Manual > Patients & Caregivers > Eye Disorders > Optic Nerve Disorders 4 ...

  1. Central sensitization in carpal tunnel syndrome with extraterritorial spread of sensory symptoms.

    PubMed

    Zanette, Giampietro; Cacciatori, Carlo; Tamburin, Stefano

    2010-02-01

    Extraterritorial spread of sensory symptoms is frequent in carpal tunnel syndrome (CTS). Animal models suggest that this phenomenon may depend on central sensitization. We sought to obtain psychophysical evidence of sensitization in CTS with extraterritorial symptoms spread. We recruited 100 unilateral CTS patients. After selection to rule out concomitant upper-limb causes of pain, 48 patients were included. The hand symptoms distribution was graded with a diagram into median and extramedian pattern. Patients were asked on proximal pain. Quantitative sensory testing (QST) was performed in the territory of injured median nerve and in extramedian territories to document signs of sensitization (hyperalgesia, allodynia, wind-up). Extramedian pattern and proximal pain were found in 33.3% and 37.5% of patients, respectively. The QST profile associated with extramedian pattern includes: (1) thermal and mechanic hyperalgesia in the territory of the injured median nerve and in those of the uninjured ulnar and radial nerves and (2) enhanced wind-up. No signs of sensitization were found in patients with the median distribution and those with proximal symptoms. Different mechanisms may underlie hand extramedian and proximal spread of symptoms, respectively. Extramedian spread of symptoms in the hand may be secondary to spinal sensitization but peripheral and supraspinal mechanisms may contribute. Proximal spread may represent referred pain. Central sensitization may be secondary to abnormal activity in the median nerve afferents or the consequence of a predisposing trait. Our data may explain the persistence of sensory symptoms after median nerve surgical release and the presence of non-anatomical sensory patterns in neuropathic pain. PMID:20004060

  2. Dural arteriovenous malformation in the anterior cranial fossa.

    PubMed

    Gliemroth, J; Nowak, G; Arnold, H

    1999-03-01

    Two cases of dural arteriovenous malformation (AVM) at the base of the anterior cranial fossa are described. In both cases an intracerebral hematoma following the rupture of the AVM was the first indication of the disease. In one case, the malformation was supplied both by the anterior ethmoidal artery and frontopolar artery draining into the superior sagittal sinus. In the second case, the right anterior ethmoidal artery with draining veins into the superior sagittal sinus and sphenoparietal sinus was the feeding vessel. Surgical evacuation of the hematoma and excision of the malformation was performed on both patients. The typical clinical signs and radiological findings are described. A review of the pertinent literature is given. PMID:10350203

  3. Bilateral, Bipedicled DIEP Flap for Staged Reconstruction of Cranial Deformity.

    PubMed

    Slater, Julia C; Sosin, Michael; Rodriguez, Eduardo D; Bojovic, Branko

    2014-12-01

    The deep inferior epigastric perforator (DIEP) adipocutaneous flap is a versatile flap that has been most popularly used in breast reconstruction. However, it has been applied to many other anatomic areas and circumstances that require free-tissue transfer. We present a case report of the use of the DIEP flap for the reconstruction of severe craniomaxillofacial deformity complicated by indolent infection in a gentleman with infected hardware and methyl methacrylate overlay used in previous repair of traumatic injuries suffered from a motor vehicle collision. The reconstruction was done in a staged, two-step fashion that allowed for adequate infection eradication and treatment using a bilateral, bipedicled DIEP flap for tissue coverage and intravenous antibiotics before the delayed insertion of a polyetheretherketone cranioplasty for reconstruction of the cranial defect. PMID:25383155

  4. [Tumors of the phrenic nerve].

    PubMed

    Le Pimpec-Barthes, F; Martinod, E; Riquet, M; Saint-Blancard, P; Jancovici, R

    1998-02-01

    A schwannoma of the phrenic nerve is a rare disorder which presents as a tumour of the anterior mediastinum. It is seen in adults and is usually latent. We report two cases in elderly subjects in whom the phrenic nerve tumour had achieved a significant size. One of these schwannomas had degenerated into sarcomatous change which is the first case reported to the present time. PMID:9551520

  5. Sports and peripheral nerve injury

    Microsoft Academic Search

    Yasusuke Hirasawa; Kisaburo Sakakida

    1983-01-01

    Peripheral nerve injury is one of the serious compli cations of athletic injuries; however, they have rarely been reported. According to the report by Takazawa et al.,6 there were only 28 cases of peripheral nerve injury among 9,550 cases of sports injuries which had been treated in the previous 5 years at the clinic of the Japanese Athletic Association.The authors

  6. Nerve conduction in relation to vibration exposure - a non-positive cohort study

    PubMed Central

    2010-01-01

    Background Peripheral neuropathy is one of the principal clinical disorders in workers with hand-arm vibration syndrome. Electrophysiological studies aimed at defining the nature of the injury have provided conflicting results. One reason for this lack of consistency might be the sparsity of published longitudinal etiological studies with both good assessment of exposure and a well-defined measure of disease. Against this background we measured conduction velocities in the hand after having assessed vibration exposure over 21 years in a cohort of manual workers. Methods The study group consisted of 155 male office and manual workers at an engineering plant that manufactured pulp and paper machinery. The study has a longitudinal design regarding exposure assessment and a cross-sectional design regarding the outcome of nerve conduction. Hand-arm vibration dose was calculated as the product of self-reported occupational exposure, collected by questionnaire and interviews, and the measured or estimated hand-arm vibration exposure in 1987, 1992, 1997, 2002, and 2008. Distal motor latencies in median and ulnar nerves and sensory nerve conduction over the carpal tunnel and the finger-palm segments in the median nerve were measured in 2008. Before the nerve conduction measurement, the subjects were systemically warmed by a bicycle ergometer test. Results There were no differences in distal latencies between subjects exposed to hand-arm vibration and unexposed subjects, neither in the sensory conduction latencies of the median nerve, nor in the motor conduction latencies of the median and ulnar nerves. Seven subjects (9%) in the exposed group and three subjects (12%) in the unexposed group had both pathological sensory nerve conduction at the wrist and symptoms suggestive of carpal tunnel syndrome. Conclusion Nerve conduction measurements of peripheral hand nerves revealed no exposure-response association between hand-arm vibration exposure and distal neuropathy of the large myelinated fibers in a cohort of male office and manual workers. PMID:20642848

  7. 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.

  8. [A swelling in the knee cavity, not caused by a Baker's cyst but by a nerve sheath tumour].

    PubMed

    de Jonge, M; Deutman, R; van Raay, J J A M

    2005-02-01

    In a woman, aged 30 years, who presented with a right popliteal mass, a Baker's cyst (popliteal cyst) was diagnosed. Five years later she developed symptoms that were attributed to compression of the peroneal nerve by the mass. Because of the troublesome nature of these symptoms, it was decided to excise the mass. Immediately after the operation, a complete loss offunction ofthe common peroneal nerve was apparent. Histopathologic examination revealed an ancient schwannoma (nerve sheath tumour). The most important reason for not having diagnosed the schwannoma was that it was not considered in the differential diagnosis of the popliteal mass. Although Baker's cysts are the most common popliteal masses, nerve sheath tumours should also be considered in the differential diagnosis. PMID:15730041

  9. Self-reported outcome following anterior transposition of ulnar nerve in the elderly.

    PubMed

    Sreedharan, S; Yam, A K T; Tay, S C

    2010-01-01

    Cubital tunnel syndrome is a common entrapment neuropathy of the upper limb. This condition can result in significant sensory disturbances and motor deficits in the distribution of the ulnar nerve. Surgical management of cubital tunnel syndrome is indicated when non-operative measures fail. However, in the elderly population, there may be a tendency to avoid surgery as nerve healing has been found to be poor. In our study, we reviewed the results of anterior transposition of ulnar nerve in patients 60 years of age and older. Our results were based on a self-reported outcome at a minimum of one year after surgery - 94.7% of our surgeries resulted in some improvement in symptoms experienced by the patients while there was an overall satisfaction rate of 83.3%. Based on our results, we recommend ulnar nerve transposition in the management of cubital tunnel syndrome in this group of patients if non-operative measures fail. PMID:21089190

  10. An unusual presentation of whiplash injury: long thoracic and spinal accessory nerve injury

    PubMed Central

    Omar, N.; Srinivasan, M. S.

    2007-01-01

    Whiplash injuries from motor vehicle accidents are very common. The usual presentation and course of this condition normally results in resolution of symptoms within a few weeks. Brachial plexus traction injuries without any bone or joint lesion of the cervical spine have been reported before. We report a case where a gentleman was involved in a rear end vehicle collision, sustained a whiplash injury and was later found to have a long thoracic nerve palsy and spinal accessory nerve palsy. Although isolated injuries of both nerves following a whiplash injury have been reported, combined injury of the two nerves following a whiplash injury is very uncommon and is being reported for the first time. PMID:17587067

  11. Development of a new three-dimensional cranial imaging system.

    PubMed

    Littlefield, Timothy R; Kelly, Kevin M; Cherney, Jennifer C; Beals, Stephen P; Pomatto, Jeanne K

    2004-01-01

    The development of a new three-dimensional (3D) imaging system designed to obtain a digital image of an infant's cranium is described. This system is intended to replace the manual plaster-casting technique currently used during the process of fabricating cranial remodeling bands. The system uses 18 triangulated digital cameras and the projection of random infrared patterns to capture a 360 degrees image of an infant's cranium instantaneously, including the face and top of the head. Accuracy was calculated by comparing models digitized with this system with the same models digitized with high-precision inspection equipment. Safety was documented under guidelines established by the American Council of Governmental Industrial Hygienists. Images were acquired in 0.008 seconds and processed for viewing in software within 2.5 minutes. Accuracy was calculated to be +/-0.236 mm. Hazard analysis confirmed the system to be safe for direct continuous exposure. The data acquired may be viewed as a point cloud, wire frame, or surface on which a digital photograph (ie, texture) is automatically overlaid. Physical models are created by exporting the digital data to a multiaxis milling machine or stereolithography machine. Quantitative data (linear and surface measurements, curvature, and volumes) can be obtained directly from the digital data. The cranial imaging system is a safe and accurate method of obtaining digital 3D images of an infant's cranium. Along with the obvious clinical and manufacturing benefits, it also has significant potential as a research tool for documenting the natural history and evaluating the treatment of plagiocephaly. PMID:14704586

  12. Different Cranial Ontogeny in Europeans and Southern Africans

    PubMed Central

    Sardi, Marina L.; Ramírez Rozzi, Fernando V.

    2012-01-01

    Modern human populations differ in developmental processes and in several phenotypic traits. However, the link between ontogenetic variation and human diversification has not been frequently addressed. Here, we analysed craniofacial ontogenies by means of geometric-morphometrics of Europeans and Southern Africans, according to dental and chronological ages. Results suggest that different adult cranial morphologies between Southern Africans and Europeans arise by a combination of processes that involve traits modified during the prenatal life and others that diverge during early postnatal ontogeny. Main craniofacial changes indicate that Europeans differ from Southern Africans by increasing facial developmental rates and extending the attainment of adult size and shape. Since other studies have suggested that native subsaharan populations attain adulthood earlier than Europeans, it is probable that facial ontogeny is linked with other developmental mechanisms that control the timing of maturation in other variables. Southern Africans appear as retaining young features in adulthood. Facial ontogeny in Europeans produces taller and narrower noses, which seems as an adaptation to colder environments. The lack of these morphological traits in Neanderthals, who lived in cold environments, seems a paradox, but it is probably the consequence of a warm-adapted faces together with precocious maturation. When modern Homo sapiens migrated into Asia and Europe, colder environments might establish pressures that constrained facial growth and development in order to depart from the warm-adapted morphology. Our results provide some answers about how cranial growth and development occur in two human populations and when developmental shifts take place providing a better adaptation to environmental constraints. PMID:22558270

  13. Different cranial ontogeny in Europeans and Southern Africans.

    PubMed

    Sardi, Marina L; Ramírez Rozzi, Fernando V

    2012-01-01

    Modern human populations differ in developmental processes and in several phenotypic traits. However, the link between ontogenetic variation and human diversification has not been frequently addressed. Here, we analysed craniofacial ontogenies by means of geometric-morphometrics of Europeans and Southern Africans, according to dental and chronological ages. Results suggest that different adult cranial morphologies between Southern Africans and Europeans arise by a combination of processes that involve traits modified during the prenatal life and others that diverge during early postnatal ontogeny. Main craniofacial changes indicate that Europeans differ from Southern Africans by increasing facial developmental rates and extending the attainment of adult size and shape. Since other studies have suggested that native subsaharan populations attain adulthood earlier than Europeans, it is probable that facial ontogeny is linked with other developmental mechanisms that control the timing of maturation in other variables. Southern Africans appear as retaining young features in adulthood. Facial ontogeny in Europeans produces taller and narrower noses, which seems as an adaptation to colder environments. The lack of these morphological traits in Neanderthals, who lived in cold environments, seems a paradox, but it is probably the consequence of a warm-adapted faces together with precocious maturation. When modern Homo sapiens migrated into Asia and Europe, colder environments might establish pressures that constrained facial growth and development in order to depart from the warm-adapted morphology. Our results provide some answers about how cranial growth and development occur in two human populations and when developmental shifts take place providing a better adaptation to environmental constraints. PMID:22558270

  14. Osteology and cranial musculature of Caiman latirostris (crocodylia: Alligatoridae).

    PubMed

    Bona, Paula; Desojo, Julia Brenda

    2011-07-01

    Caiman latirostris Daudin is one of the extant species of Caimaninae alligatorids characterized taxonomically only by external morphological features. In the present contribution, we describe the cranial osteology and myology of this species and its morphological variation. Several skull dissections and comparisons with other caimans were made. Although jaw muscles of living crocodiles show the same general "Bauplan" and alligatorids seem to have a similar cranial musculature pattern, we describe some morphological variations (e.g., in C. latirostris the superficial portion of the M. adductor mandibulae externus did not reach the postorbital; the M. adductor mandibulae internus pars pterygoideus dorsalis did not reach the pterygoid and lacrimal and contrary to the case of C. crocodilus the M. adductor mandibulae internus pars pterygoideus ventralis attaches to the posterodorsal surface of the pterygoid and the pterygoid aponeurosis, without contacting the dorsal and ventral surface of the pterygoid margin; the M. intermandibularis is attached to the anterior half of the splenial and posteriorly inserts medially by a medial raphe that serves as attachment zone for M. constrictor colli, and the M. constrictor colli profundus presents a medial notch in its anterior margin). In addition, the skull of C. latirostris differs from that of other caimans and possesses several characters that are potential diagnostic features of this species (e.g., outline of glenoid cavity in dorsal view, extension of the rostral ridges, and occlusion of the first dentary tooth). Nevertheless, these characters should be analyzed within the phylogenetic context of the Caimaninae to evaluate its evolutionary implications for the history of the group. PMID:21491476

  15. 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

  16. Nerve conduction during Wallerian degeneration in the baboon

    Microsoft Academic Search

    R. W. Gilliatt; R. J. Hjorth

    1972-01-01

    Conduction in the lateral popliteal nerve of the baboon was studied during the course of Wallerian degeneration. Six nerves were examined. In each case the muscle response to nerve stimulation and the ascending nerve action potential were recorded daily until the nerve became inexcitable. The muscle response to nerve stimulation disappeared after four to five days, but ascending nerve action

  17. Ipsilateral facial sensory and motor responses to basal fronto-temporal cortical stimulation: Evidence suggesting direct activation of cranial nerves

    Microsoft Academic Search

    Tahamina Begum; Akio Ikeda; Masao Matsuhashi; Nobuhiro Mikuni; Susumu Miyamoto; Nobuo Hashimoto; Takashi Nagamine; Hidenao Fukuyama; Hiroshi Shibasaki

    2006-01-01

    To clarify the generator mechanism of sensory and motor facial responses ipsilateral to electrical stimulation of the inferior fronto-temporal cortex in epilepsy patients. Out of 30 patients who have been evaluated with chronically implanted subdural electrodes for medically intractable partial seizure or brain tumor involving the basal frontal or temporal cortex, 4 patients (age ranging 24–57 years) showed sensory and

  18. Module 3 – Symptoms

    Cancer.gov

    Module three of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study Original Version presents approaches to and management of commonly encountered symptoms and syndromes of cancer patients.

  19. Frontotemporal Disorders: Common Symptoms

    MedlinePLUS

    ... business meeting or laugh at a funeral. Compulsive eating —Gorging on food, especially starchy foods like bread ... a call. Language Symptoms Aphasia —A language disorder in which the ability to use or understand words ...

  20. Initial Symptoms of ALS

    MedlinePLUS

    Home About ALS About Us Our Research In Your Community Advocate Help fight ALS Donate About ALS What is ALS? Facts You Should Know Who does ALS affect? Diagnosing ALS Symptoms Forms of ALS Genetic ...

  1. Symptoms, Diagnosis & Treatment

    MedlinePLUS

    ... biotherapy or immunotherapy. Watchful waiting is closely monitoring a patient's condition without giving any treatment until symptoms appear or change. Summer 2008 Issue: Volume 3 Number 3 Page 11

  2. Coping with Symptoms

    MedlinePLUS

    ... Team Finding Resources Parkinson's HelpLine Learn More Educational Materials Do you want to know more about Parkinson's? PDF's materials provide information about symptoms, medications, resources & more. Order ...

  3. Mitochondrial Disease: Possible Symptoms

    MedlinePLUS

    ... Disease Possible Symptoms Getting a Diagnosis Treatments & Therapies Replacement Therapy EPI-743 Other Diseases Linked to Mitochondrial Disease ... Coordinators Ambassador Program NAMDC RDCRN Medical/Scientific Meetings Replacement Therapy EPI-743 Research Grants Grand Rounds National Symposium ...

  4. Signs and Symptoms

    MedlinePLUS

    ... syncope), irregular heartbeats (arrhythmias), or sudden cardiac death. Children with cardiomyopathies of a metabolic nature may have additional symptoms of low blood sugar (hypoglycemia), excessive acidity in the blood (metabolic acidosis) ...

  5. [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

  6. Prefabricated Patient-Matched Cranial Implants for Reconstruction of Large Skull Defects

    PubMed Central

    Sundseth, Jarle; Berg-Johnsen, Jon

    2013-01-01

    Cranial defects can be caused by injury, infection, or tumor invasion. Large defects should be reconstructed to protect the brain and normalize the cerebral hemodynamics. The conventional method is to cover the defect with bone cement. Custom-made implants designed for the individual patient are now available. We report our experience with one such product in patients with large cranial defects (>7.6 cm in diameter). A CT scan with 2 mm slices and a three-dimensional reconstruction were obtained from the patient. This information was dispatched to the company and used as a template to form the implant. The cranial implant was received within four weeks. From 2005 to 2010, custom-made cranial implants were used in 13 patients with large cranial defects. In 10 of the 13 patients, secondary deep infection was the cause of the cranial defect. All the implants fitted well or very well to the defect. No infections were seen after implantation; however, one patient was reoperated on for an epidural hematoma. A custom-made cranial implant is considerably more expensive than an implant made of bone cement, but ensures that the defect is optimally covered. The use of custom-made implants is straightforward and timesaving, and they provide an excellent medical and cosmetic result. PMID:23650475

  7. 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

  8. 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

  9. [Carpal tunnel syndrome and other nerve entrapment syndromes].

    PubMed

    Gouzou, Stéphanie; Liverneaux, Philippe

    2013-11-01

    The carpal tunnel syndrome is the most common entrapment syndrome of the upper limb. Compression of the median nerve is most often idiopathic and typically occurs in women aged 50. The diagnosis is clinical and must look for signs of gravity (hypoesthesia, thenar atrophy). The electromyogram is not required but recommended for surgical indication, It assesses the severity of the disease and identifies other injury. Conservative treatment is available in the beginner to moderate forms. In case of failure of this treatment or with severe objective signs, treatment is surgical. The ulnar nerve at the elbow comes in the second position of the upper limb entrapment syndromes. Clinical examination looks for signs of serious problems with objectives symptoms. Treatment is usually surgical. PMID:24422297

  10. Dermatological and immunological conditions due to nerve lesions

    PubMed Central

    Bove, Domenico; Lupoli, Amalia; Caccavale, Stefano; Piccolo, Vincenzo; Ruocco, Eleonora

    2013-01-01

    Summary Some syndromes are of interest to both neurologists and dermatologists, because cutaneous involvement may harbinger symptoms of a neurological disease. The aim of this review is to clarify this aspect. The skin, because of its relationships with the peripheral sensory nervous system, autonomic nervous system and central nervous system, constitutes a neuroimmunoendocrine organ. The skin contains numerous neuropeptides released from sensory nerves. Neuropeptides play a precise role in cutaneous physiology and pathophysiology, and in certain skin diseases. A complex dysregulation of neuropeptides is a feature of some diseases of both dermatological and neurological interest (e.g. cutaneous and nerve lesions following herpes zoster infection, cutaneous manifestations of carpal tunnel syndrome, trigeminal trophic syndrome). Dermatologists need to know when a patient should be referred to a neurologist and should consider this option in those presenting with syndromes of unclear etiology. PMID:24125557

  11. Nerve conduits and growth factor delivery in peripheral nerve repair.

    PubMed

    Pfister, Lukas A; Papaloïzos, Michaël; Merkle, Hans P; Gander, Bruno

    2007-06-01

    Peripheral nerves possess the capacity of self-regeneration after traumatic injury. Transected peripheral nerves can be bridged by direct surgical coaptation of the two nerve stumps or by interposing autografts or biological (veins) or synthetic nerve conduits (NC). NC are tubular structures that guide the regenerating axons to the distal nerve stump. Early synthetic NC have primarily been made of silicone because of the relative flexibility and biocompatibility of this material and because medical-grade silicone tubes were readily available in various dimensions. Nowadays, NC are preferably made of biodegradable materials such as collagen, aliphatic polyesters, or polyurethanes. Although NC assist in guiding regenerating nerves, satisfactory functional restoration of severed nerves may further require exogenous growth factors. Therefore, authors have proposed NC with integrated delivery systems for growth factors or growth factor-producing cells. This article reviews the most important designs of NC with integrated delivery systems for localized release of growth factors. The various systems discussed comprise NC with growth factors being released from various types of matrices, from transplanted cells (Schwann cells or mesenchymal stem cells), or through genetic modification of cells naturally present at the site of injured tissue. Acellular delivery systems for growth factors include the NC wall itself, biodegradable microspheres seeded onto the internal surface of the NC wall, or matrices that are filled into the lumen of the NC and immobilize the growth factors through physical-chemical interactions or specific ligand-receptor interactions. A very promising and elegant system appears to be longitudinally aligned fibers inserted in the lumen of a NC that deliver the growth factors and provide additional guidance for Schwann cells and axons. This review also attempts to appreciate the most promising approaches and emphasize the importance of growth factor delivery kinetics. PMID:17565531

  12. 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

  13. Negative symptoms in schizophrenia.

    PubMed

    Boutros, Nash N; Mucci, Armida; Diwadkar, Vaibhav; Tandon, Rajiv

    2014-04-01

    Clinical heterogeneity is a confound common to all of schizophrenia research. Deficit schizophrenia has been proposed as a homogeneous disease entity within the schizophrenia syndrome. Utilizing the Schedule for the Deficit Syndrome (SDS) has allowed the definition of a subgroup dominated by persistent clusters of negative symptoms. While a number of studies have appeared over the years examining the electrophysiological correlates of the cluster of negative symptoms in schizophrenia, only a few studies have actually focused on the deficit syndrome (DS). PubMed as well as MEDLINE were searched for all reports indexed for "negative symptoms" or "deficit syndrome" and one of the following electrophysiology assessment tools: electroencephalography (EEG), evoked potentials (EPs), or polysomnography (PSG). While this line of research is evidently in its infancy, two significant trends emerge. First, spectral EEG studies link increased slow wave activity during wakefulness to the prevalence of negative symptoms. Secondly, sleep studies point to an association between decrease in slow wave sleep and prevalence of negative symptoms. Several studies also indicate a relationship of negative symptoms with reduced alpha activity. A host of other abnormalities--including sensory gating and P300 attenuation--are less consistently reported. Two studies specifically addressed electrophysiology of the DS. Both studies provided evidence suggesting that the DS may be a separate disease entity and not simply a severe form of schizophrenia. PMID:23428787

  14. Symptom Management Concept Design Webinar

    Cancer.gov

    Objectives Describe the review process for a symptom management concept Identify the required elements included in a symptom management concept Identify key statistical considerations for a symptom management concept Describe issues to consider

  15. 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 ...

  16. Diphtheritic neuropathy, an analysis based on muscle and nerve biopsy and repeated neurophysiological and autonomic function tests.

    PubMed Central

    Solders, G; Nennesmo, I; Persson, A

    1989-01-01

    A patient with diphtheritic neuropathy was investigated with repeated tests of parasympathetic and sympathetic vasomotor and sudomotor functions for one year after the onset of symptoms. Somatic nerve function was tested with nerve conduction studies and an index based on ten variables was used to follow the course of the neuropathy. Sural nerve and anterior tibial muscle biopsies were performed. A severe but shortlasting impairment of the parasympathetic vagal reflex arc was found. The recovery of this function paralleled the clinical course. Sympathetic functions were normal. The neurophysiological variables of somatic nerve function showed signs of a mainly demyelinating mixed sensory/motor neuropathy. The recovery of these variables was slow. The nerve and muscle biopsies demonstrated mild changes consistent with a mixed, demyelinating, non-inflammatory neuropathy. Images PMID:2549201

  17. Ulnar nerve at the elbow – normative nerve conduction study

    PubMed Central

    2013-01-01

    Introduction A goal of our work was to perform nerve conduction studies (NCSs) of the ulnar nerve focused on the nerve conduction across the elbow on a sufficiently large cohort of healthy subjects in order to generate reliable reference data. Methods We examined the ulnar nerve in a position with the elbow flexion of 90o from horizontal. Motor response was recorded from the abductor digiti minimi muscle (ADM) and the first dorsal interosseous muscle (FDI). Results In our sample of 227 healthy volunteers we have examined 380 upper arms with the following results: amplitude (Amp)-CMAP(wrist) for ADM 9.6 ± 2.3 mV, MNCV at the forearm 60.4 ± 5.2 m/s, MNCV across the elbow 57.1 ± 5.9 m/s. Discussion Our study showed that motor NCSs of the ulnar nerve above elbow (AE) and below elbow (BE) in a sufficiently large cohort using methodology recommended by AANEM gave results well comparable for registration from FDI and ADM. PMID:23398737

  18. Re-emergent Tongue Tremor as the Presenting Symptom of Parkinson’s Disease

    PubMed Central

    Delil, ?akir; Bölükba??, Feray; Yeni, Naz; K?z?ltan, Güne?

    2015-01-01

    Background: The most common symptom of Parkinson’s disease is the unilateral, typically resting tremor in body parts, most commonly in the upper extremities. However, this finding can spread to the other parts of the body like lips, chin, jaw and tongue during the course of the disease. Nevertheless, we have not come across any Parkinson’s disease case presenting with tongue tremor in the literature. Case Report: Here, we present a 58 year-old man with Parkinson’s disease presenting with tongue tremor, his striking response to the levodopa test and his follow-up data. Conclusion: The topography of motor symptoms at onset in Parkinson’s disease is presumably determined by the severity of the Lewy body neuronal degeneration in distinct parts of the substantia nigra. Therefore, patterns of somatic symptom progression in Parkinson’s disease indicate that involvement of the cranial structures always follows the development of symptoms in the extremities. However, in our case, cranial structures seem to precede the involvement of extremity-related areas.

  19. A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression

    PubMed Central

    2014-01-01

    Background Our previous studies have demonstrated the treatment benefits of dense cranial electroacupuncture stimulation (DCEAS), a novel brain stimulation therapy in patients with major depression, postpartum depression and obsessive-compulsive disorder. The purpose of the present study was to further evaluate the effectiveness of DCEAS combined with body acupuncture and selective serotonin reuptake inhibitors (SSRIs) in patients with post-stroke depression (PSD). Methods In a single-blind, randomized controlled trial, 43 patients with PSD were randomly assigned to 12 sessions of DCEAS plus SSRI plus body electroacupuncture (n?=?23), or sham (non-invasive cranial electroacupuncture, n-CEA) plus SSRI plus body electroacupuncture (n?=?20) for 3 sessions per week over 4 weeks. Treatment outcomes were measured using the 17-item Hamilton Depression Rating Scale (HAMD-17), the Clinical Global Impression - Severity scale (CGI-S) and Barthel Index (BI), a measure used to evaluate movement ability associated with daily self-caring activity. Results DCEAS produced a significantly greater reduction of both HAMD-17 and CGI-S as early as week 1 and CGI-S at endpoint compared to n-CEA, but subjects of n-CEA group exhibited a significantly greater improvement on BI at week 4 than DCEAS. Incidence of adverse events was not different in the two groups. Conclusions These results indicate that DCEAS could be effective in reducing stroke patients’ depressive symptoms. Superficial electrical stimulation in n-CEA group may be beneficial in improving movement disability of stroke patients. A combination of DCEAS and body acupuncture can be considered a treatment option for neuropsychiatric sequelae of stroke. Trial registration http://www.clinicaltrials.gov, NCT01174394. PMID:25038733

  20. Chitosan conduits combined with nerve growth factor microspheres repair facial nerve defects

    PubMed Central

    Liu, Huawei; Wen, Weisheng; Hu, Min; Bi, Wenting; Chen, Lijie; Liu, Sanxia; Chen, Peng; Tan, Xinying

    2013-01-01

    Microspheres containing nerve growth factor for sustained release were prepared by a compound method, and implanted into chitosan conduits to repair 10-mm defects on the right buccal branches of the facial nerve in rabbits. In addition, chitosan conduits combined with nerve growth factor or normal saline, as well as autologous nerve, were used as controls. At 90 days post-surgery, the muscular atrophy on the right upper lip was more evident in the nerve growth factor and normal sa-line groups than in the nerve growth factor-microspheres and autologous nerve groups. physiological analysis revealed that the nerve conduction velocity and amplitude were significantly higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. Moreover, histological observation illustrated that the di-ameter, number, alignment and myelin sheath thickness of myelinated nerves derived from rabbits were higher in the nerve growth factor-microspheres and autologous nerve groups than in the nerve growth factor and normal saline groups. These findings indicate that chitosan nerve conduits bined with microspheres for sustained release of nerve growth factor can significantly improve facial nerve defect repair in rabbits. PMID:25206635

  1. Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury: electrophysiological characteristics

    PubMed Central

    Liu, Ying; Xu, Xun-cheng; Zou, Yi; Li, Su-rong; Zhang, Bin; Wang, Yue

    2015-01-01

    Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we performed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduction function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regenerated potentials first appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ‘excellent’ and ‘good’ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The functional recovery of a transplanted nerve can be dynamically observed after the surgery.

  2. Successful surgical treatment of an intraneural ganglion of the common peroneal nerve.

    PubMed

    Sobol, Garret L; Lipschultz, Todd M

    2015-04-01

    Intraneural ganglion cysts of peripheral nerves occurring within the epineural sheath are rare, and their mechanism of formation and treatment options are debated. We present a case of a 41-year-old man who presented with a complaint of lateral-sided left knee pain with numbness on the lateral side of the foot who was diagnosed with an intraneural ganglion of the common peroneal nerve (CPN). He was treated initially with common peroneal epineural decompression only to have symptoms recur 6 weeks postoperatively. The patient was subsequently treated utilizing the suggestions of the "unified articular theory," which proposes a small recurrent articular branch of the CPN as the source of cyst fluid. This branch was surgically detached, leading to complete alleviation of his symptoms. When the patient was reevaluated 2 years postoperatively, his preoperative symptoms had resolved, and a follow-up magnetic resonance image showed resolution of the enlargement of the CPN. PMID:25844595

  3. Differences between Cervical Schwannomas of the Anterior and Posterior Nerve Roots in Relation to the Incidence of Postoperative Radicular Dysfunction

    PubMed Central

    Ohnishi, Yu-Ichiro; Ohkawa, Toshika; Ninomiya, Koshi; Moriwaki, Takashi; Yoshimine, Toshiki

    2015-01-01

    Study Design A retrospective study. Purpose To assess the case files of patients who underwent surgery for cervical dumbbell schwannoma for determining the differences between schwannomas of the anterior and posterior nerve roots with respect to the incidence of postoperative radicular dysfunction. Overview of Literature The spinal roots giving origin to schwannoma are frequently nonfunctional, but there is a risk of postoperative neurological deficit once these roots are resected during surgery. Methods Fifteen patients with cervical dumbbell schwannomas were treated surgically. Ten men and 5 women, who were 35-79 years old (mean age, 61.5 years), presented with neck pain (n=6), radiculopathy (n=10), and myelopathy (n=11). Results Fourteen patients underwent gross total resection and exhibited no recurrence. Follow-ups were performed for a period of 6-66 months (mean, 28 months). Preoperative symptoms resolved in 11 patients (73.3%) but they persisted partially in 4 patients (26.7%). Six patients had tumors of anterior nerve root origin, and 9 patients had tumors of posterior nerve root origin. Two patients who underwent total resection of anterior nerve root tumors (33.3%) displayed minor postoperative motor weakness. One patient who underwent total resection of a posterior nerve root tumor (11.1%) showed postoperative numbness. Conclusions Appropriate tumor removal improved the neurological symptoms. In this study, the incidence of radicular dysfunction was higher in patients who underwent resection of anterior nerve root tumors than in patients who underwent resection of posterior nerve root tumors. PMID:25901239

  4. Juxtamalleolar lipoma with intermediate dorsal cutaneous nerve entrapment.

    PubMed

    Nicklas, B J; Schwein, J

    1991-10-01

    From a review of the literature, it would appear that lipomas of the foot are relatively rare and that, when they do exist, they are of little clinical significance other than cosmetic appearance. The authors presented a case in which the size, location, and character of the mass predisposed the patient to entrapment syndrome of the intermediate dorsal cutaneous nerve. It is important to emphasize, however, that in these cases symptoms are related to a pressure phenomenon and are not a direct result of tumor physiology. PMID:1774645

  5. Ulnar Neuropathy With Normal Electrodiagnosis and Abnormal Nerve Ultrasound

    PubMed Central

    Yoon, Joon Shik; Walker, Francis O.; Cartwright, Michael S.

    2010-01-01

    Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy. It is diagnosed with electrodiagnostic studies, but they can yield false-negative results. Ultrasound was used to examine 4 patients with UNE and negative electrodiagnostic findings, and it showed ulnar nerve enlargement near the elbow in all cases, with a mean cross-sectional area of 20.1mm2. This indicates that ultrasound may be a useful tool for assessing those with UNE symptoms and normal electrodiagnostic findings. PMID:20159139

  6. Ulnar neuropathy with normal electrodiagnosis and abnormal nerve ultrasound.

    PubMed

    Yoon, Joon Shik; Walker, Francis O; Cartwright, Michael S

    2010-02-01

    Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy. It is diagnosed with electrodiagnostic studies, but they can yield false-negative results. Ultrasound was used to examine 4 patients with UNE and negative electrodiagnostic findings, and it showed ulnar nerve enlargement near the elbow in all cases, with a mean cross-sectional area of 20.1 mm. This indicates that ultrasound may be a useful tool for assessing those with UNE symptoms and normal electrodiagnostic findings. PMID:20159139

  7. An electrical cause of stridor: pediatric vagal nerve stimulators.

    PubMed

    Kelts, Gregory; O'Connor, Peter D; Hussey, Richard W; Maturo, Stephen

    2015-02-01

    Vagal nerve stimulators (VNS) are surgically implantable medical devices which are approved by the food and drug administration (FDA) for treatment of medically refractory epilepsy in children. Two children with seizures disorders presented to the pediatric otolaryngology clinic with complaints of stridor and sleep apnea following implantation of VNS devices. Both children were evaluated with flexible laryngoscopy, direct laryngoscopy and bronchoscopy. The children were noted to have contraction of their vocal folds and supraglottis and the settings of their VNS were adjusted until no further contractions were noted. Each child had resolution of their symptoms following adjustment. PMID:25500186

  8. Ultrasound of tendons and nerves.

    PubMed

    Martinoli, Carlo; Bianchi, Stefano; Dahmane, M'Hamed; Pugliese, Francesca; Bianchi-Zamorani, Maria Pia; Valle, Maura

    2002-01-01

    Tendons and nerves represent probably one of the best application of musculoskeletal US due to the high lesion detection rate and accuracy of US combined with its low cost, wide availability, and ease of use. The refinement of high-frequency broadband linear-array transducers, and sensitive color and power Doppler technology, have improved the ability of US to detect fine textural abnormalities of these structures as well as to identify a variety of pathological conditions. Characteristic echotextural patterns, closely resembling the histological ones, are typically depicted in these structures using high US frequencies. In tendon imaging, US can assess dislocations, degenerative changes and tendon tears, including intrasubstance tears, longitudinal splits, partial and complete rupture, inflammatory conditions and tendon tumors, as well as postoperative findings. In nerve imaging, US can support clinical and electrophysiological testing for detection of compressing lesions caused by nerve entrapment in a variety of osteofibrous tunnels of the limbs and extremities. Congenital anomalies, nerve tears, and neurogenic tumors can also be diagnosed. Overall, US is an effective technique for imaging tendons and nerves. In most cases, a focused US examination can be performed more rapidly and efficiently than MR imaging. PMID:11868073

  9. Oculomotor nerve injury induces nuerogenesis in the oculomotor and Edinger-Westphal nucleus of adult dog.

    PubMed

    Zhu, Ningxi; Zhang, Chunmei; Li, Zhen; Meng, Youqiang; Feng, Baohui; Wang, Xuhui; Yang, Min; Wan, Liang; Ning, Bo; Li, Shiting

    2013-11-01

    Technical developments have extensively promoted experimental and clinical studies on cranial nerve regeneration, but intracranial nerve recovery is still an unexplored research area compared to peripheral nerve repair. In this study, we researched whether neurogenesis occurs in adult oculomotor (OMN) and Edinger-Westphal nucleus (EWN) or not after oculomotor nerve injury. To assess cell proliferation in response to unilateral oculomotor nerve crush (ONC) in adult beagle dog, repetitive 5-bromo-2'-deoxyuridine (BrdU) intravenous injections were performed during 3 or 7 days before the dogs were euthanized 2 h after the last injection on days 3, 7, 14, and 28 post-ONC. The proliferating cell types were investigated with three cell phenotypic markers and confocal microscopy on serial sections throughout the whole extent of OMN and EWN. BrdU-positive nuclei were detected in bilateral OMNs and EWNs from 3 to 28 days after ONC with the peak value at 3 days. Confocal analysis revealed that partial BrdU-positive cells colocalized with nestin or ?III-tubulin or GFAP, and the number of every kind of double-labeled cell maintained an increased tendency from 3 to 28 days post-ONC. Neither single-labeled BrdU-positive nuclei nor double-labeled cells were detected in the subependymal layer of cerebral aqueduct (SELCA) of all unilateral ONC dogs; also, they were not observed in the OMNs, EWNs, and SELCA of intact and sham-operated dog. These findings demonstrate that ONC can trigger continual mitotic activity, proliferation of NSCs, neurogenesis, and astrogliogenesis in the OMN and EWN of adult dogs. PMID:23832509

  10. Overcoming peripheral nerve gap defects using an intact nerve bridge in a rabbit model.

    PubMed

    McCallister, Wren V; McCallister, Erika L; Trumble, Stacey A; Trumble, Thomas E

    2005-04-01

    This study investigated the intact nerve bridge technique for overcoming peripheral nerve gap defects in a rabbit model. To create the intact nerve bridge, a 1-cm segment of the peroneal nerve is resected leaving a gap defect. The proximal and distal peroneal nerve stumps are sutured 1 cm apart, in an end-to-side fashion, to the intact tibial nerve epineurium. Four experimental groups were used (n = 10): primary repair of resected segment; intact nerve bridge; nerve autograft; and gap in situ control. Evaluation after 12 weeks included measurement of isometric muscle contraction force, axonal counting, wet muscle weights, and histologic examination. The results of this study support two main conclusions, in a rabbit model: (a) regenerating axons can use the epineurium of an intact nerve to bridge a gap defect; (b) there is no significant difference in the functional recovery between standard nerve autografts and the intact nerve bridge technique. PMID:15880300

  11. 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

  12. 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

  13. 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...

  14. 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...

  15. 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...

  16. A MULTISCALE COMPUTATIONAL MODEL FOR THE GROWTH OF THE CRANIAL VAULT IN CRANIOSYNOSTOSIS

    PubMed Central

    Lee, Chanyoung; Richtsmeier, Joan T.; Kraft, Reuben H.

    2015-01-01

    Craniosynostosis is a condition defined by premature closure of cranial vault sutures, which is associated with abnormalities of the brain and skull. Many causal relationships between discovered mutations and premature suture closure have been proposed but an understanding of the precise mechanisms remains elusive. This article describes a computational framework of biological processes underlying cranial growth that will enable a hypothesis driven investigation of craniosynostosis phenotypes using reaction-diffusion-advection methods and the finite element method. Primary centers of ossification in cranial vault are found using activator-substrate model that represents the behavior of key molecules for bone formation. Biomechanical effects due to the interaction between growing bone and soft tissue is investigated to elucidate the mechanism of growth of cranial vault.

  17. 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...

  18. 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...

  19. Epineurial repair of an iatrogenic facial nerve neurotmesis after total ear canal ablation and lateral bulla osteotomy in a dog with concurrent cranio-mandibular osteopathy.

    PubMed

    Calvo, Ignacio; Espadas, Irene; Hammond, Gawain; Pratschke, Kathryn

    2014-01-01

    A 7-year-old male entire West Highland white terrier was referred to the Small Animal Hospital at the University of Glasgow for bilateral, chronic, medically unresponsive otitis media and externa. A history of cranio-mandibular osteopathy was also reported. Bilateral total ear canal ablation and lateral bulla osteotomy was performed with the aid of a pneumatic burr. Extensive bone proliferation was present bilaterally originating from the caudal mandibular ramus and tympanic bulla which incorporated the horizontal canal on each side. The right facial nerve was identified leaving the stylomastoid foramen and running in a cranial direction through a 1.5 cm diameter cuff of bone surrounding the horizontal canal and external acoustic meatus. Despite careful dissection, a facial nerve neurotmesis ensued which required microsurgical epineurial repair. Neurologic examination performed 12 h post-operatively revealed abnormalities consistent with right facial nerve paralysis. At 3 months, the facial nerve function was found to have improved significantly and was assessed to be normal four months after surgery. To the authors' knowledge, this clinical communication described the first reported clinical case where unilateral facial nerve paralysis resulting from iatrogenic facial nerve neurotmesis was successfully treated by microsurgical epineurial repair. PMID:25686402

  20. Multi-unit recording from regenerated bullfrog eighth nerve using implantable silicon-substrate microelectrodes.

    PubMed

    Della Santina, C C; Kovacs, G T; Lewis, E R

    1997-03-01

    Multi-microelectrode silicon devices were developed for extracellular recording from multiple axons in regenerated eighth cranial nerves of American bullfrogs. Each includes a photolithographically defined array of holes and adjacent metal microelectrodes. A device is implanted within a transected eighth nerve; regenerating fibers grow through the holes en route to the brainstem. Multiple spike trains were recorded from two animals at up to 21 weeks after implantation. Single units were tracked for over 8 h. Some responded to sound with tuning typical of fibers innervating the amphibian and basilar papillae. Units of vestibular origin also were recorded. Action potentials were 30-140 microV P-P amid noise of 5 10 microV RMS, an adequate signal-to-noise ratio for spike detection and sorting. Histology confirmed that bundles of myelinated fibers grew through holes near electrodes that recorded activity. The implantation success rate was low, due to surgical morbidity, device extrusion, and lack of nerve regeneration through some devices. Future designs will address these issues and incorporate transistor amplifiers on devices to increase signal-to-noise ratios. The potential of implanted silicon devices to simultaneously record from many axons offers an opportunity for multicellular studies of auditor, vestibular and seismic signal processing in the vertebrate inner ear. PMID:9128171