Note: This page contains sample records for the topic cranial nerve symptoms from
While these samples are representative of the content of,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of
to obtain the most current and comprehensive results.
Last update: November 12, 2013.

Cranial Nerves Model  

NSDL National Science Digital Library

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.

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



Paroxysmal staccato tinnitus: a carbamazepine responsive hyperactivity dysfunction symptom of the eighth cranial nerve.  


Hyperactive disorders related to neurovascular compression have been described for several cranial nerves of which trigeminal neuralgia and hemifacial spasm are the best known. The present report on four patients, in conjunction with previous reports, suggests that paroxysmal staccato tinnitus might be considered an auditory hyperactivity disorder of the eighth cranial nerve. The present patients reported attacks, usually lasting 10-20 s, of loud monaural tinnitus with a staccato character (eg, clattering or sounding like a machine gun). The attacks occurred very frequently, sometimes every minute. The attacks were spontaneous but they were also provoked by certain head positions or by exposure to loud sounds. Most of the patients did not reveal any significant eighth cranial nerve sensory loss and thus it is probably not advisable to rely on any specific test result for this diagnosis. Instead, it is suggested that a diagnosis of paroxysmal staccato tinnitus can be based on the history as the symptoms are both stereotypic and very specific. Furthermore, low doses of carbamazepine, although not effective for the general population of tinnitus patients, relieved the symptoms. PMID:19778910

Brantberg, Krister



Paroxysmal staccato tinnitus: a carbamazepine responsive hyperactivity dysfunction symptom of the eighth cranial nerve  

Microsoft Academic Search

Hyperactive disorders related to neurovascular compression have been described for several cranial nerves of which trigeminal neuralgia and hemifacial spasm are the best known. The present report on four patients, in conjunction with previous reports, suggests that paroxysmal staccato tinnitus might be considered an auditory hyperactivity disorder of the eighth cranial nerve. The present patients reported attacks, usually lasting 10–20

Krister Brantberg



Cranial Nerve VIII  

PubMed Central

Cranial nerve VIII brings sound and information about one's position and movement in space into the brain. The auditory and vestibular systems subserve several functions basic to clinical medicine and to psychiatry. This article covers the basics of cranial nerve VIII, hearing and vestibular systems, including common problems with hearing and balance, problems with hearing and balance that tend to be found in psychiatric patients, and some simple assessments of value in clinical practice.

Sanders, Richard D



CT-clinical approach to patients with symptoms related to the V, VII, IX-XII cranial nerves and cervical sympathetics  

SciTech Connect

Forty-three patients who had signs and symptoms possibly related to the extracranial course of cranial nerves V, VII, IX, X-XII, and the cervical sympathetics were examined prospectively using high resolution CT to obtain images of thin sections during rapid drip infusion of contrast material. Anatomic areas in the scan protocols included the posterior fossa, cavernous and paranasal sinuses, skull base, temporal bone, nasopharynx, parotid gland, tongue base, and neck. Nine of the 23 patients with possible fifth nerve deficits had extracranial structural lesions that explained the symptoms; none of these nine, however, had typical trigeminal neuralgia. Of eight patients with peripheral seventh nerve abnormalities, two had positive findings on scans. Of five patients presenting with referred ear pain, three had carcinoma of the upper aerodigestive tract. The authors' experience suggests that patients at high risk for structural lesions responsible for cranial nerve deficits can be selected by clinical criteria. Protocols for each clinical setting are presented.

Kalovidouris, A.; Mancuso, A.A.; Dillon, W.



Isolated cranial nerve palsies in multiple sclerosis  

Microsoft Academic Search

During a 10 year period 24 patients with definite multiple sclerosis with isolated cranial nerve palsies were studied (third and fourth nerve: one patient each, sixth nerve: 12 patients, seventh nerve: three patients, eighth nerve: seven patients), in whom cranial nerve palsies were the presenting sign in 14 and the only clinical sign of an exacerbation in 10 patients. MRI

Frank Thömke; Eckart Lensch; Kurt Ringel; Hanns Christian Hopf



Cranial Nerves Model - PowerPoint Presentation  

NSDL National Science Digital Library

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.

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



Cranial Nerve II  

PubMed Central

This article contains a brief review of the anatomy of the visual system, a survey of diseases of the retina, optic nerve and lesions of the optic chiasm, and other visual field defects of special interest to the psychiatrist. It also includes a presentation of the corticothalamic mechanisms, differential diagnosis, and various manifestations of visual illusions, and simple and complex visual hallucinations, as well as the differential diagnoses of these various visual phenomena.

Gillig, Paulette Marie; Sanders, Richard D.



Spontaneous carotid dissection presenting lower cranial nerve palsies.  


Cranial nerve palsy in internal carotid artery (ICA) dissection occurs in 3--12% of all patients, but in 3% of these a syndrome of hemicranias and ipsilateral cranial nerve palsy is the sole manifestation of ICA dissection, and in 0.5% of cases there is only cranial nerve palsy without headache. We present two cases of lower cranial nerve palsy. The first patient, a 49-year-old woman, developed left eleventh and twelfth cranial nerve palsies and ipsilateral neck pain. The angio-RM showed an ICA dissection with stenosis of 50%, beginning about 2 cm before the carotid channel. The patient was treated with oral anticoagulant therapy and gradually improved, until complete clinical recovery. The second patient, a 38-year-old woman, presented right hemiparesis and neck pain. The left ICA dissection, beginning 2 cm distal to the bulb, was shown by ultrasound scanning of the carotid and confirmed by MR angiogram and angiography with lumen stenosis of 90%. Following hospitalisation, 20 days from the onset of symptoms, paresis of the left trapezius and sternocleidomastoideus muscles became evident. The patient was treated with oral anticoagulant therapy and only a slight right arm paresis was present at 10 months follow-up. Cranial nerve palsy is not rare in ICA dissection, and the lower cranial nerve palsies in various combinations constitute the main syndrome, but in most cases these are present with the motor or sensory deficit due to cerebral ischemia, along with headache or Horner's syndrome. In the diagnosis of the first case, there was further difficulty because the cranial nerve palsy was isolated without hemiparesis, and the second case presented a rare association of hemiparesis and palsy of the eleventh cranial nerve alone. Compression or stretching of the nerve by the expanded artery may explain the palsies, but an alternative cause is also possible, namely the interruption of the nutrient vessels supplying the nerve, which in our patients is more likely. PMID:11239957

Guidetti, D; Pisanello, A; Giovanardi, F; Morandi, C; Zuccoli, G; Troiso, A



Cranial Nerves IX, X, XI, and XII  

PubMed Central

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.

Sanders, Richard D.



Cranial nerve palsies in spontaneous carotid artery dissection.  

PubMed Central

Two patients had isolated unilateral cranial nerve palsies due to spontaneous internal carotid artery (ICA) dissection without ischaemic cerebral involvement. One had acute glossopharyngeal and vagal, the other isolated hypoglossal nerve palsy. Reviewing all reported cases of angiographically confirmed ICA dissection in the literature, 36 additional cases with unequivocal ipsilateral cranial nerve palsies were analysed. While an isolated palsy of the IXth and Xth has not been reported previously, palsies of the XIIth nerve or the IXth to XIIth nerves were most frequently found. In these patients, lower cranial nerve palsies are probably the result of compression by an enlarging ICA due to mural haematoma. Symptoms and signs indicative of carotid dissection were concurrently present only in some reported cases. This raises the question of unrecognised carotid dissection as a cause of isolated cranial nerve palsies. When the dissection occurs in the subadventitial layer without relevant narrowing of the arterial lumen and when an aneurysm is thrombosed, angiography does not reliably yield the diagnosis. Therefore, carotid dissection might have been underestimated as a cause of isolated lower cranial nerve palsies before the advent of MRI. MRI demonstrates directly the extension of the wall haematoma in the axial and longitudinal planes. Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Images

Sturzenegger, M; Huber, P



Neurovascular compression in cranial nerve and systemic disease.  

PubMed Central

As we age, our arteries elongate and our brains "sag." As a consequence of these processes, redundant arterial loops and bridging or intrinsic hindbrain veins may cause cross-compression of cranial nerve root entry zones in the cerebellopontine angle. This pulsatile compression can be seen to produce hyperactive dysfunction of the cranial nerve. Symptoms of trigeminal or glossopharyngeal neuralgia (somatic sensory), hemifacial spasm (somatic motor), tinnitus and vertigo (special sensory) and some cases of "essential" hypertension are caused by these vessels compressing cranial nerves V, IX--X, VII, VIII, and left X and medulla oblongata. Using microsurgical techniques, the symptoms may be relieved by vascular decompression, findings and results in 695 paients are briefly reviewed and correlated. A chronic primate model of "essential" hypertension is briefly described.

Jannetta, P J



On the terminology of cranial nerves.  


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

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



Isolated third cranial nerve palsy: a rare presentation of neurocysticercosis.  


Isolated third cranial nerve palsy is usually due to vascular causes like posterior communicating artery aneurysm and it is rare in neurocysticercosis. Third cranial nerve palsy in neurocysticercosis is usually caused by supratentorial or sub-arachnoid lesions with accompanying hydrocephalus or meningitis. We report a patient who presented with isolated third cranial nerve palsy without any other brainstem signs caused by neurocysticercosis involving the midbrain. PMID:19340520

Ranjith, M P; Divya, R; Sahni, A



Peripheral third cranial nerve enhancement in multiple sclerosis.  


Cranial nerve III dysfunction in multiple sclerosis (MS) is uncommon. Seven cases of isolated cranial nerve III paresis associated with MS have been reported in the English-language literature. MR imaging was obtained in five cases demonstrating lesions within the midbrain. We present the detailed clinical and MR imaging findings of a young woman with MS and an isolated, painful pupil involving complete left cranial nerve III palsy. Initial MR imaging showed isolated enhancement of the cisternal portion of the cranial nerve III, suggesting that peripheral nervous system involvement may develop as part of the disease process in some patients with MS. PMID:12917135

Bhatti, M Tariq; Schmalfuss, Ilona M; Williams, Lorna S; Quisling, Ronald G



Cranial Nerves III, IV, and VI  

PubMed Central

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.

Sanders, Richard D.



Cranial nerves XIII and XIV: nerves in the shadows  

PubMed Central

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

Bordoni, Bruno; Zanier, Emiliano



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

Microsoft Academic Search

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

Alexandra Borges; Jan Casselman



Asymmetric Type F Botulism with Cranial Nerve Demyelination  

PubMed Central

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.

Kattan, Jessica A.; Jitendranath, Lavanya; Smith, C. Gregory; Luquez, Carolina; Phan, Quyen N.; Fagan, Ryan P.



Peripheral Third Cranial Nerve Enhancement in Multiple Sclerosis  

Microsoft Academic Search

Summary: Cranial nerve III dysfunction in multiple scle- rosis (MS) is uncommon. Seven cases of isolated cranial nerve III paresis associated with MS have been reported in the English-language literature. MR imaging was obtained in five cases demonstrating lesions within the midbrain. We present the detailed clinical and MR imaging findings of a young woman with MS and an isolated,

M. Tariq Bhatti; Ilona M. Schmalfuss; Lorna S. Williams; Ronald G. Quisling


Vascular cross-compression of the VIIth and VIIIth cranial nerves.  


A 53-year-old male patient had been suffering from severe aural symptoms (pulsatile right-sided tinnitus and paroxysmal dizziness attacks with nausea) and right hemifacial spasm. Treatment had involved stellate ganglion block with lignocaine and the injection of intravenous sodium bicarbonate solution for attacks of Menière's syndrome and facial nerve block with lidocaine for hemi-facial spasm. Despite these treatments, the dizzy attacks became more frequent, developing into the clustering state. Air CT cisternography and vertebral angiography demonstrated an enlarged and curved vertebral artery. Vascular cross-compression of the VIIth and VIIIth cranial nerves was therefore suspected. Microvascular decompression was performed. After operation, the pulsatile tinnitus, dizziness and hemifacial spasm disappeared. From the present case and a review of the literature, we conclude that vascular cross-compression of the VIIIth cranial nerve should be an indication for microvascular decompression only when symptoms of vascular cross-compression of the VIIth cranial nerve are also seen. PMID:1613373

Ohashi, N; Yasumura, S; Nakagawa, H; Mizukoshi, K; Kuze, S



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

PubMed Central

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.

Sanders, Richard D.



A transient third cranial nerve palsy as presenting sign of spontaneous intracranial hypotension  

Microsoft Academic Search

Spontaneous intracranial hypotension is an uncommon cause of sudden and persistent headache: associated symptoms are common,\\u000a among which there are cranial nerve palsies, especially of the abducens nerve. We report a case of a 21-year-old man with\\u000a a transient and isolated third nerve palsy due to spontaneous intracranial hypotension. To our knowledge, there are only few\\u000a reports in the literature

Antonio Russo; Alessandro Tessitore; Mario Cirillo; Alfonso Giordano; Rosa De Micco; Gennaro Bussone; Gioacchino Tedeschi


The Six Syndromes of the Sixth Cranial Nerve  

PubMed Central

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.

Azarmina, Mohsen; Azarmina, Hossein



Tolerance of cranial nerves of the cavernous sinus to radiosurgery  

SciTech Connect

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

Tishler, R.B.; Loeffler, J.S.; Alexander, E. III; Kooy, H.M. (Harvard Medical School, Boston, MA (United States)); Lunsford, L.D.; Duma, C.; Flickinger, J.C. (Univ. of Pittsburgh Medical Center, PA (United States))



[Herpes zoster oticus with cranial nerve affection].  


Herpes zoster oticus (HZO) with cranial polyneuropathy is also known as Ramsay Hunt syndrome (RHS). After primary varicella infection, the varicella zoster virus (VZV) remains dormant in the nervous system and can reactivate later in life causing RHS. This case describes a 56-year-old man with HZO and palsy of N. V, VII, VIII, IX, X and XII. Anti-viral agents might be effective in patients with RHS, although the only randomized controlled clinical trial on this subject found no significant benefit. There are no randomized controlled trials to support the use of corticosteroid therapy. PMID:20961509

Lauridsen, Anita Guldager; Mirz, Frank



Effective intravenous immunoglobulin therapy for Churg-Strauss syndrome (allergic granulomatous angiitis) complicated by neuropathy of the eighth cranial nerve: a case report  

PubMed Central

Introduction We report the case of a patient with Churg-Strauss syndrome with eighth cranial nerve palsy. Vestibulocochlear nerve palsy is extremely rare in Churg-Strauss syndrome. To the best of our knowledge, only one case of complicated neuropathy of the eighth cranial nerve has been described in a previous report presenting an aggregate calculation, but no differentiation between polyarteritis nodosa and Churg-Strauss syndrome was made. High-dose immunoglobulin was administered to our patient, and her neuropathy of the eighth cranial nerve showed improvement. Case presentation At the age of 46, a Japanese woman developed Churg-Strauss syndrome that later became stable with low-dose prednisolone treatment. At the age of 52, she developed sudden difficulty of hearing in her left ear, persistent severe rotary vertigo, and mononeuritis multiplex. At admission, bilateral perceptive deafness of about 80dB and eosinophilia of 4123/?L in peripheral blood were found. A diagnosis of cranial neuropathy of the eighth cranial nerve associated with exacerbated Churg-Strauss syndrome was made. Although high doses of steroid therapy alleviated the inflammatory symptoms and markers, the vertigo and bilateral hearing loss remained. Addition of a high-dose immunoglobulin finally resulted in marked alleviation of the symptoms associated with neuropathy of the eighth cranial nerve. Conclusions A high dose of immunoglobulin therapy shows favorable effects in neuropathy of the eighth cranial nerve, but no reports regarding its efficacy in cranial neuropathy have been published.



Perineural tumor spread - Interconnection between spinal and cranial nerves.  


The secondary neoplastic involvement of the cervical plexus in patients with head and neck malignancies is extremely rare. MR examination of the neck revealed the diffuse neoplastic infiltration of the right C2 root, in a 57-year-old patient with several months long pain in the right ear region and a history of the tongue squamous cell carcinoma. Associated perineural tumor spread and consequent distal involvement of great auricular nerve and vagus nerve were evident. Best of our knowledge, this is the first reported involvement of the cervical plexus in patients with head and neck cancers, associated with the clearly documented interconnection between the cervical plexus and cranial nerves via great auricular nerve. PMID:23010545

Kozi?, Duško; Njagulj, Vesna; Ga?eša, Jelena Popadi?; Semnic, Robert; Prvulovi?, Nataša



[Microsurgery, laser-assisted cranial nerve anastomosis. An experimental study].  


Recently the milliwatt-CO2-laser has been introduced into the armentarium of experimental microsurgery for performing coaptation in peripheral nerves using the thermal effect of laser energy in order to achieve an atraumatic and reliable tissue bond. Experimental studies have shown that laser-assisted nerve coaptation are equal if not superior to conventional techniques in the reduced incidence of neuroma formation as well as the regenerative capacity. In this experimental study we have investigated if the CO2-laser working in the milliwatt range can be successfully applied for performing anastomosis of cranial nerves. The right oculomotor nerve in cats was microsurgically explored along the lateral temporal fossa from its exit at the brain stem to its entrance into the rudimentary cavernous sinus. Following division of the nerve with microscissors the nerve ends were loosely approximated. Thereafter welding of the cut nerves was performed with the CO2-laser (Cooper Laser Sonics, Model 860) using a power of 80-90 milliwatts, a spot-size of 150 microns and single bursts of laser energy. Complete welding of the cut nerve ends took about one to two minutes after which the surgical wound was closed. All experimental animals were observed for a period of 12 weeks after which they were sacrificed and the welded oculomotor nerve was removed for histological examination. Functional recovery of the III. nerve during the observation period was demonstrated by examination of the resting diameter of the pupil as well as by its reaction to direct stimulation with light. Morphological regeneration of the operated nerves could be demonstrated by histological studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2338306

Seifert, V; Stolke, D; Goetz, C



Cranial Nerve Palsies: Sarcoidosis to Systemic Lupus Erythematosus  

PubMed Central

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

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



An Isolated Bee Sting Involving Multiple Cranial Nerves  

PubMed Central

Hymenoptera stings are self-limiting events or due to allergic reactions. Sometimes envenomation with Hymenoptera can cause rare complications such as acute encephalopathy, peripheral neuritis, acute renal failure, nephrotic syndrome, silent myocardial infarction, rhabdomyolysis, conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. The mechanism of peripheral nervous system damage is not clearly known. In our studied case after bee sting on face between the eyebrows with little erythema and 1 × 1?cm in size, bilateral blindness developed and gradually improved. Lateral movement of eyes was restricted with no pain. Involvement of cranial nerves including II, V, and VI was found. With conservative therapy after a year significant improvement has been achieved.

Motamed, Hassan; Forouzan, Arash; Rasooli, Fatemeh; Majidi, Alireza; Maleki Verki, Mohammadreza



Cranial nerve monitoring during subpial dissection in temporomesial surgery  

Microsoft Academic Search

Objective  Cranial nerves (CNs) crossing between the brainstem and skull base at the level of the tentorial hiatus may be at risk in\\u000a temporomesial surgery involving subpial dissection and\\/or tumorous growth leading to distorted anatomy. We aimed to identify\\u000a the surgical steps most likely to result in CN damage in this type of surgery.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Electromyographic responses obtained with standard neuromonitoring techniques

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



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

NSDL National Science Digital Library

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

Pearson, John C.



[Endoscopic assistance in microvascular decompression of cranial nerves].  


Microvascular decompression (MVD) is an effective method for treatment of trigeminal neuralgia (TN), hemifacial spasm (HFS), glossopharyngeal neuralgia (GPN). The aim of this study was to assess the role of endoscopic assistance in MVD for the treatment of cranial neuropathies. Since 2009 till 2011 133 patients with cranial neuropathies were treated by MVD in Burdenko Neurosurgical Institute, Moscow. In 22 patients (11 patients with HFS, 10 patients with TN, 1 with GPN) endoscopic assistance was applied during the MVD. We used minimally invasive retrosigmoid approach in a unilateral position. Cerebellopontine angle was explored by 30-degree or 70-degree telescope to visualize the root entry zone of trigeminal, facial or glossopharyngeal nerves and to locate the neurovascular conflict. In 9 patients with HFS and in 1 patient with TN and in another patient with GPN endoscopy discovered offending vessels that were not visible through the microscope. In all cases endoscope was used to exclude another site of compression and to verify decompression and to identify position of teflon and offending vessel after MVD. Immediately after the surgery excellent outcome was observed in 10 patients with HFS (89%), one patient was reoperated 1.5 years after first operation with positive effect. Relief of pain in early postoperative period was observed in patients with TN and GPN. There were no major complications and postoperative mortality in our series. Endoscopic assistance is very effective and helpful technique in MVD of cranial nerves, especially in cases with HFS. In this study the use of the endoscope allowed to identify the site of compression and to confirm the position of teflon after MVD. PMID:22708429

Shimanski?, V N; Karnaukhov, V V; Sergienko, T A; Poshataev, V K; Semenov, M S



Successful endovascular management of brain aneurysms presenting with mass effect and cranial nerve palsy.  


Aneurysms presented with mass effect are traditionally treated by surgical clipping to decompress their mass effect. The aim of this work is to discuss the efficiency of endovascular techniques in treating 47 patients with variable sizes of intracranial aneurysms presented with mass effect and/or cranial nerve palsy. There were 47 patients with 47 unruptured aneurysms. Group I includes 28 giant aneurysms; all are treated by parent vessel occlusion with or without intra-aneurysmal occlusion depending on anatomical locations. Group II includes 19 small and large aneurysms; all are treated by selective endosaccular occlusion with coils. Clinical presentations were ocular cranial nerve dysfunction (82.9%), optic nerve or chiasmatic dysfunction (21.2%), brain stem compression (8.5%), embolic (6%), epistaksis (4%), proptosis (2%), and bleeding per ear (2%). Out of 47 patients, symptoms were resolved in 31 cases (66%), improved in 10 cases (21%), and unchanged in six cases (13%). Out of 28 giant aneurysms, symptoms were resolved in 19 (68%), improved in four (14%), and unchanged in five (18%). Only four (14%) patients out of the 19 giant aneurysms with complete symptoms resolution showed significant mass reduction in MRI. Out of 19 non-giant aneurysm cases treated by selective endovascular occlusion with coils, symptoms were resolved in 12 cases (63%), improved in six (32%), and unchanged in one (5%). No complications from the treatment were observed. The longer the duration of symptoms before endovascular treatment is, the longer the duration till improvement or resolution postoperative in both groups. Recovery of aneurysm-induced mass effect occurs in most patients both after parent vessel occlusion and after selective coiling, and is comparable to results after surgical clipping. The improvement starts independent of aneurysmal shrinkage in postoperative MRI follow-ups. The arrest of pulsations and partial shrinkage within the aneurysms after endovascular treatment may be the logical reason behind neurological recovery. PMID:22782498

Hassan, Tamer; Hamimi, Ahmed



An isolated bee sting involving multiple cranial nerves.  


Hymenoptera stings are self-limiting events or due to allergic reactions. Sometimes envenomation with Hymenoptera can cause rare complications such as acute encephalopathy, peripheral neuritis, acute renal failure, nephrotic syndrome, silent myocardial infarction, rhabdomyolysis, conjunctivitis, corneal infiltration, lens subluxation, and optic neuropathy. The mechanism of peripheral nervous system damage is not clearly known. In our studied case after bee sting on face between the eyebrows with little erythema and 1 × 1?cm in size, bilateral blindness developed and gradually improved. Lateral movement of eyes was restricted with no pain. Involvement of cranial nerves including II, V, and VI was found. With conservative therapy after a year significant improvement has been achieved. PMID:23970981

Motamed, Hassan; Forouzan, Arash; Rasooli, Fatemeh; Majidi, Alireza; Maleki Verki, Mohammadreza



Indirect injury to cranial nerves after surgery with Cavitron ultrasonic surgical aspirator (CUSA). Case report  

Microsoft Academic Search

Summary The Cavitron ultrasonic surgical aspirator (CUSA) was used in a patient with an acoustic nerve tumour. After surgery she presented unilateral palsies of several cranial nerves. The nerve injuries were most likely induced by ultrasonic energy transmitted from the CUSA via the petrous bone. We suggest that when the CUSA is used in such operations care should be taken

P.-Å. Ridderheim; Cl. von Essen; B. Zetterlund



Cranial Nerve III, IV, and VI Palsies in the Cancer Patient  

Microsoft Academic Search

\\u000a Cranial nerve III, IV, and VI palsies in cancer patients can be caused by primary cranial nerve neoplasms, direct extension\\u000a from brain, brain stem and skull base tumors, direct extension or perineural spread from head and neck tumors, metastases\\u000a from tumors at distant sites, leptomeningeal disease, and other conditions, including raised intracranial pressure, radiation\\u000a effect, infection, paraneoplastic syndromes, and certain

Meghan S. Flemmons; Jade S. Schiffman


Imaging of intracranial aneurysms causing isolated third cranial nerve palsy.  


Isolated third cranial nerve palsies may be caused by compressive intracranial aneurysms located at the junction of the internal carotid and posterior communicating arteries or, less commonly, at the apex of the basilar artery or its junction with the superior cerebellar or posterior cerebral arteries. Such aneurysms typically measure at least 4 mm in diameter. Technical improvements in noninvasive techniques, including CT and MRA, have yielded a detection rate of such aneurysms that approaches that of catheter cerebral angiography (CCA), which itself carries a small but serious risk. Multidetector technology, which allows a rapid scan time, has promoted CT to the first choice for investigating aneurysms in this setting except when dye or radiation exposure is unacceptable, as with pregnant women, children, and those with renal or severe cardiac disease. Major impediments to accurate detection are a lack of availability of trained technicians, who must perform manipulation of the raw imaging data ("post-processing"), and a paucity of certified neuroradiologists with the time, skill, and experience to devote to interpreting difficult cases. To avoid diagnostic mishaps, noninvasive studies should be reviewed by at least one neuroradiologist before aneurysm is rejected as the cause or before the patient undergoes CCA. PMID:19726948

Chaudhary, Neeraj; Davagnanam, Indran; Ansari, Sameer A; Pandey, Aditya; Thompson, Byron G; Gemmete, Joseph J



Clipping of a vertebral artery aneurysm behind the hypoglossal nerve under the monitoring of lower cranial nerves.  


Under an operative view, an aneurysm of the vertebral artery is located behind the lower cranial nerves. To prevent neurological deficits we employed electrophysiological monitoring while clipping an aneurysm of the vertebral artery. A 64-year-old woman had suffered a sudden severe headache in the morning. Computed tomography (CT) revealed a subarachnoid hemorrhage (SAH) and CT angiography revealed an aneurysm at a branching point of the left vertebral artery. The condylar fossa approach was taken while recording electromyography (EMG) of the lower cranial nerves. The aneurysm was located just behind the hypoglossal nerve and could not be clipped without strong traction of the hypoglossal nerve. Therefore, the hypoglossal nerve was divided to separate the lower two bundles of the hypoglossal nerve from the other bundles, and the clip was applied to the aneurysm between the nerve bundles without any change of the tongue EMG. The patient went home 10 days after operation with no neurological deficit. In conclusion, we report a case of a ruptured aneurysm of a vertebral artery, which was clipped while monitoring the lower cranial nerves. Tongue EMG monitoring enabled us to clip the aneurysm without nerve injury and revealed that the hypoglossal nerve near the hypoglossal canal can be divided into several bands without neurological deficit. PMID:20197210

Ishikawa, Mami; Kusaka, Gen; Takashima, Kouichi; Kamochi, Haruna; Shinoda, Soji



Sucrose vs. maltose taste discrimination by rats depends on the input of the seventh cranial nerve.  


Although rats treat the taste of sucrose and maltose as perceptually similar, they nonetheless appear to be able to distinguish between the two sugars, as suggested from prior work examining the cross-generalization of conditioned taste aversions. This study explictly tested whether rats could behaviorally discriminate sucrose from maltose and examined the relative importance of the gustatory input of the seventh and ninth cranial nerves in maintaining such performance. Water-restricted rats were presurgically trained in a conditioned avoidance task to suppress licking to sucrose or maltose and to maintain licking to the other sugar. Concentration (0.05, 0.1, 0.2, and 0.4 M) was varied to make intensity an irrelevant cue. Stimuli were randomly presented in 5-s trials during 50-min sessions. Bilateral transection of the chorda tympani nerve (CT) or the glossopharyngeal nerve or sham surgery did not disrupt discrimination performance. In contrast, combined transection of the CT and greater superficial petrosal nerve, which collectively removes the taste input of the seventh cranial nerve, caused severe impairments in sugar discriminability. In these rats, performance was more disturbed at the lower concentrations. These findings confirm that rats can discriminate sucrose from maltose and that this capability relies heavily on the taste input of the seventh cranial nerve. Although the input of the ninth cranial nerve is unnecessary, it may help sustain partial competence in this task, especially at high concentrations, in the combined absence of the CT and greater superficial petrosal nerve. PMID:9140022

Spector, A C; Markison, S; St John, S J; Garcea, M



Sixth cranial nerve palsy following closed head injury in a child.  

PubMed Central

A five year old female had an isolated abducens nerve palsy following closed head injury. There was no associated skull fracture, haematoma, or other cranial nerve injury. The significance, frequency, and differential diagnosis of traumatic sixth cranial nerve injury is discussed, particularly in paediatric patients. Management is symptomatic; occlusion with an eye pad may be used if diplopia is significant. In young children alternate day occlusion of each eye will help prevent amblyopia. Most cases improve within three months and many resolve by six months. Residual palsy at six months is likely to be permanent and surgical treatment may be needed.

Hollis, G J



Ganglioside composition of the human cranial nerves, with special reference to pathophysiology of Miller Fisher syndrome.  


Total ganglioside fractions from the human cranial nerves purified on a Phenyl Sepharose column, were given mild alkaline treatment, after which their composition and amounts of lipid-bound sialic acid were determined by HPTLC-densitometry with resorcinol as the coloring reagent. The total amounts of lipid-bound sialic acid were 156.5 ng/mg of wet tissue in the Ist cranial nerve (olfactory tract) and 131.9 ng/mg in the IInd nerve, greater than the amounts in the other nerves (99.1-120.0 ng/mg). The Ist, IInd, and VIIIth nerves had GM4, but not LM1. It may reflect their histological feature of the central nervous system. The IIIrd, IVth, and VIth nerves, as well as the IInd, had significantly higher percentages of GQ1b (11.6-13.2%) than the other nerves (5.2-8.4%). The high proportion of GQ1b specific to these three cranial nerves involved in the ocular movement lends support to the role of serum anti-GQ1b antibody in the pathogenetic mechanisms of ophthalmoplegia in Miller Fisher syndrome and Guillain-Barré syndrome. PMID:9037391

Chiba, A; Kusunoki, S; Obata, H; Machinami, R; Kanazawa, I



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


Computed tomography (CT) and magnetic resonance imaging (MRI) are suitable methods for examination of the skull base. Whereas CT is used to evaluate mainly bone destruction e.g. for planning surgical therapy, MRI is used to show pathologies in the soft tissue and bone invasion. High resolution and thin slice thickness are indispensible for both modalities of skull base imaging. Detailed anatomical knowledge is necessary even for correct planning of the examination procedures. This knowledge is a requirement to be able to recognize and interpret pathologies. MRI is the method of choice for examining the cranial nerves. The total path of a cranial nerve can be visualized by choosing different sequences taking into account the tissue surrounding this cranial nerve. This article summarizes examination methods of the skull base in CT and MRI, gives a detailed description of the anatomy and illustrates it with image examples. PMID:19506829

Bink, A; Berkefeld, J; Zanella, F



Clipping of a vertebral artery aneurysm behind the hypoglossal nerve under the monitoring of lower cranial nerves  

Microsoft Academic Search

Under an operative view, an aneurysm of the vertebral artery is located behind the lower cranial nerves. To prevent neurological deficits we employed electrophysiological monitoring while clipping an aneurysm of the vertebral artery. A 64-year-old woman had suffered a sudden severe headache in the morning. Computed tomography (CT) revealed a subarachnoid hemorrhage (SAH) and CT angiography revealed an aneurysm at

Mami Ishikawa; Gen Kusaka; Kouichi Takashima; Haruna Kamochi; Soji Shinoda



The 12, 24, or is it 26 cranial nerves?  

PubMed Central

Many of our perceptions are gained through interpretative organs that we assume to be providing objective accounts. Notably, however, neither vision nor hearing provide an objective account of reality. This paper challenges the "conventional wisdoms" held regarding the optic, auditory, and hypoglossal nerves, and the nerves of eye movement.

Welsby, P



Association of lower cranial nerve schwannoma with spinal ependymoma in ? NF2.  


A 15 year old male, who had earlier been operated for intraspinal intramedullary ependymoma, subsequently developed a right cerebello pontine (CP) angle mass. A diagnosis of right CP angle ependymoma was considered, in view of established histology of previously operated spinal lesion. Histopathological examination of the well defined extra-axial mass, which was attached with ninth cranial nerve, however revealed a schwannoma. A diagnosis of Neurofibromatosis-2 (NF2) is strongly suspected, because of well established fact, that the spinal ependymomas may have association with lower cranial nerve schwannomas in NF2. Cranial and spinal MRI screening for early diagnosis of associated, asymptomatic lesions, in suspected cases of NF2, particularly in children, is recommended. PMID:10447465

Kumar, R; Sharma, K H; Chhabra, D K



Ramsay Hunt syndrome with unilateral polyneuropathy involving cranial nerves V, VII, VIII, and XII in a diabetic patient.  


Ramsay Hunt syndrome is a rare complication of the varicella zoster virus, defined as a peripheral facial palsy that typically results from involvement of the facial and auditory nerves. Ramsay Hunt syndrome can be associated with cranial nerves V, VI, IX, and X but rarely with XII. We describe an atypical case of Ramsay Hunt syndrome with multiple cranial nerve involvement of nerves V, VII, VIII, and XII. Antiviral drugs, antibiotics, insulin, and traditional Chinese drugs were administered immediately after admission. After 3 months of combination therapy, the patient had recovered satisfactorily. Herpes zoster can cause severe infections in diabetic patients and should be treated as soon after detection as possible. Ramsay Hunt syndrome should be recognized as a polycranial neuritis characterized by damage to sensory and motor nerves. In addition to facial and vestibular nerve paralysis, Ramsay Hunt syndrome may also involve cranial nerves V and XII. PMID:22026001

Sun, Wei-Lian; Yan, Jian-Liang; Chen, Li-Li


Left trochlear nerve palsy, unique symptom of an arachnoid cyst of the quadrigeminal plate. Case report.  


An arachnoid cyst of the quadrigeminal plate in a 49-year-old female is reported. This is the seventh published case of a cyst of this kind in an adult. The presenting symptom was an isolated left fourth cranial nerve palsy. Up to now, no other case with isolated superior oblique muscle palsy has been described which was caused by an arachnoidal cyst of the quadrigeminal plate. PMID:2275426

Pagni, C A; Canavero, S; Vinci, V



Silicon-substrate microelectrode arrays for parallel recording of neural activity in peripheral and cranial nerves.  


A new process for the fabrication of regeneration microelectrode arrays for peripheral and cranial nerve applications is presented. This type of array is implanted between the severed ends of nerves, the axons of which regenerate through via holes in the silicon and are thereafter held fixed with respect to the microelectrodes. The process described is designed for compatibility with industry-standard CMOS or BiCMOS processes (it does not involve high-temperature process steps nor heavily-doped etch-stop layers), and provides a thin membrane for the via holes, surrounded by a thick silicon supporting rim. Many basic questions remain regarding the optimum via hole and microelectrode geometries in terms of both biological and electrical performance of the implants, and therefore passive versions were fabricated as tools for addressing these issues in on-going work. Versions of the devices were implanted in the rat peroneal nerve and in the frog auditory nerve. In both cases, regeneration was verified histologically and it was observed that the regenerated nerves had reorganized into microfascicles containing both myelinated and unmyelinated axons and corresponding to the grid pattern of the via holes. These microelectrode arrays were shown to allow the recording of action potential signals in both the peripheral and cranial nerve setting, from several microelectrodes in parallel. PMID:7927376

Kovacs, G T; Storment, C W; Halks-Miller, M; Belczynski, C R; Della Santina, C C; Lewis, E R; Maluf, N I



Cranial Electrical Stimulation Improves Symptoms and Functional Status in Individuals with Fibromyalgia  

Microsoft Academic Search

To investigate the effects of microcurrent cranial electrical stimulation (CES) therapy on reducing pain and its associated symptoms in fibromyalgia (FM), we conducted a randomized, controlled, three-group (active CES device, sham device, and usual care alone [UC]), double-blind study to determine the potential benefit of CES therapy for symptom management in FM. Those individuals using the active CES device had

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


Pontine extension of a tentorial schwannoma without cranial nerve involvement: a case report  

PubMed Central

Introduction Intracranial schwannomas unrelated to the cranial nerves are uncommon. We report a new case of tentorial schwannoma unrelated to the cranial nerves, with extension into the pons. A literature review with discussion of the most relevant pathogenetic aspects is also performed. Case presentation A 42-year-old Caucasian man was admitted with right-sided paresthesias and weakness of his upper and lower extremities. The neurological examination revealed right hemiparesis and hemi-hypoesthesia. A brain magnetic resonance imaging scan revealed a cerebellopontine lesion, arising from the left free edge of the tentorium, and extending into his pons. A piecemeal removal was performed through a retrosigmoid approach. The lesion was not found to be associated with any cranial nerves. The histological examination revealed a schwannoma Antoni type A. His postoperative course was uneventful. At one year follow-up, the patient was neurologically intact and the magnetic resonance imaging of his brain performed at that time showed complete removal without signs of recurrence. Conclusion Tentorial schwannomas are rare clinical entities. Knowledge of their clinical, radiological and anatomical characteristics is very important for the correct diagnosis and management.



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

PubMed Central

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

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



The Jugular Dural Fold--A Helpful Skull Base Landmark to the Cranial Nerves  

PubMed Central

During a retrosigmoid (or combined retrolabyrinthine-retrosigmoid) approach to the posterior fossa for vestibular neurectomy or removal of small acoustic neuromas, a white dural fold is a consistent landmark to cranial nerves VII through XII. This fold of dura appears as a white linear structure extending from the foramen magnum across the sigmoid sinus, attaching to the posterior aspect of the temporal bone, anterior to the vestibular aqueduct. The name “jugular dural fold” is suggested for this landmark. The jugular dural fold overlies the junction of the sigmoid sinus and the jugular foramen. As measured in formalin-fixed cadaver heads, the overall length of the jugular dural fold is 20.8 mm (± 2.9 mm). The cochleovestibular nerve lies 9.9 mm (± 1.5 mm) anterior to the superior aspect of the jugular dural fold, the glossopharyngeal nerve lies 9.5 mm (± 1.6 mm) anterior to the midpoint of the jugular dural fold, and the operculum of the vestibular aqueduct lies 6.6 mm (± 0.7 mm) posterior to the jugular dural fold. Intraoperative measurements in patients undergoing combined retrolabyrinthine-retrosigmoid vestibular neurectomy show an overall length of the jugular dural fold of 16.3 mm (± 1.9 mm). The cochleovestibular nerve lies 8.6 mm (± 1.3 mm) anterior to the superior aspect of the jugular dural fold, the glossopharyngeal nerve lies 8.6 mm (± 1.3 mm) anterior to the midpoint of the jugular dural fold, and the operculum lies 7.5 mm (± 0.8 mm) posterior to the jugular dural fold. The jugular dural fold can be used as a reliable landmark for rapidly locating cranial nerves in the posterior fossa. ImagesFigure 1Figure 2Figure 3

Silverstein, Herbert; Willcox, Thomas O.; Rosenberg, Seth I.; Seidman, Michael D.



Development of a computer-assisted cranial nerve simulation from the visible human dataset.  


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 significantly enriching anatomy education by helping students better appreciate spatial relationships, especially in areas of the body with greater anatomical complexity. Our objective was to develop an online module designed to teach the anatomy and function of the cranial nerves. A three-dimensional model of the skull, brainstem, and thalamus were reconstructed using data from the Visible Human Project and Amira®. The paths of the cranial nerves were overlaid onto this 3D reconstruction. Videos depicting these paths were then rendered using a "roller coaster-styled" camera approach. Interactive elements adding textual information and user control were inserted into the video using Adobe Creative Suite® 4, and finally, the module was exported as an Adobe Flash movie to be viewable on Internet browsers. Fourteen Flash-based modules were created in total. The primary user interface comprises a website encoded in HTML/CSS and contains links to each of the 14 Flash modules as well as a user tutorial. PMID:21438158

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



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

NSDL National Science Digital Library

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.

Pearson, John C.



Carotid and cranial nerve reconstruction after removal of cavernous sinus lesions.  


During the last 7 years, approximately 170 neoplasms, and 35 vascular lesions involving the cavernous sinus were treated by the first two authors. During the treatment of such lesions, the direct vein graft reconstruction of the internal carotid artery from the petrous to the supraclinoid or infraclinoid ICA was performed in 23 patients. Graft occlusion occurred in 3 patients and in one of these, it was successfully salvaged by placing a long venous graft from the extracranial ICA to the M3 segment of the middle cerebral artery. The latter 3 patients were neurologically normal. One patient with significant atherosclerotic disease suffered the dissection of the distal internal carotid artery with the graft being patent. The suturing technique. This patient eventually died. Two patients with severely compromised collateral circulation suffered minor strokes due to the temporary occlusion of the ICA. This has been avoided in the more recent patients by the adoption of brain protection techniques such as moderate hypothermia, induced hypertension, and barbiturate coma. Low dose heparin therapy during grafting and high dose intravenous steroids prior to the grafting also appear to be beneficial. Direct vein graft reconstruction of the intracavernous carotid artery is a valuable tool during the management of cavernous sinus lesions. The advantages and disadvantages of this technique as well as the pros and cons of other revascularization techniques will be discussed. During microsurgical removal of cavernous sinus lesions, the cranial nerves III-VI were reconstructed by direct resuture or by nerve grafting in 16 patients. In the majority of these patients, recovery of cranial nerve function was observed, which was very encouraging.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1803071

Sekhar, L N; Sen, C N; Lanzino, G; Pomonis, S



Carboxypeptidase A6 in zebrafish development and implications for VIth cranial nerve pathfinding.  


Carboxypeptidase A6 (CPA6) is an extracellular protease that cleaves carboxy-terminal hydrophobic amino acids and has been implicated in the defective innervation of the lateral rectus muscle by the VIth cranial nerve in Duane syndrome. In order to investigate the role of CPA6 in development, in particular its potential role in axon guidance, the zebrafish ortholog was identified and cloned. Zebrafish CPA6 was secreted and interacted with the extracellular matrix where it had a neutral pH optimum and specificity for C-terminal hydrophobic amino acids. Transient mRNA expression was found in newly formed somites, pectoral fin buds, the stomodeum and a conspicuous condensation posterior to the eye. Markers showed this tissue was not myogenic in nature. Rather, the CPA6 localization overlapped with a chondrogenic site which subsequently forms the walls of a myodome surrounding the lateral rectus muscle. No other zebrafish CPA gene exhibited a similar expression profile. Morpholino-mediated knockdown of CPA6 combined with retrograde labeling and horizontal eye movement analyses demonstrated that deficiency of CPA6 alone did not affect either VIth nerve development or function in the zebrafish. We suggest that mutations in other genes and/or enhancer elements, together with defective CPA6 expression, may be required for altered VIth nerve pathfinding. If mutations in CPA6 contribute to Duane syndrome, our results also suggest that Duane syndrome can be a chondrogenic rather than a myogenic or neurogenic developmental disorder. PMID:20885977

Lyons, Peter J; Ma, Leung-hang; Baker, Robert; Fricker, Lloyd D



Embryological origin for autism: developmental anomalies of the cranial nerve motor nuclei.  


The underlying brain injury that leads to autism has been difficult to identify. The diagnostic criteria of the disease are not readily associated with any brain region or system, nor are they mimicked by vascular accidents, tumors, or degenerative neurological diseases occurring in adults. Fortuitously, a recent report of autism induced by thalidomide exposure provides evidence that the disease originates by an injury at the time of closure of the neural tube. The human data suggest that the initiating lesion includes the motor cranial nerve nuclei. To test this hypothesis, we first examined motor nuclei in the brainstem of a human autistic case. The autopsy brain exhibited near-complete absence of the facial nucleus and superior olive along with shortening of the brainstem between the trapezoid body and the inferior olive. A similar deficit has been reported in Hoxa-1 gene knockout mice in which pattern formation of the hindbrain is disrupted during neurulation. Alternatively, exposure to antimitotic agents just after neural tube closure could produce the observed pattern of deficits. Thus, the lesions observed in the autopsy case appear to match those predicted by the thalidomide cases in both time of origin and central nervous system (CNS) location. To produce similar brain lesions experimentally, we exposed rat embryos to valproic acid, a second teratogen newly linked to autism. Dams received 350 mg/kg of valproic acid (VPA) on day 11.5 (the day of neural tube closure), day 12, or day 12.5 gestation. Each treatment significantly reduced the number of motor neurons counted in matched sections of the earliest-forming motor nuclei (V, XII), and progressively later exposures affected the VIth and IIIrd cranial nerve nuclei. All treatments spared the facial nucleus, which forms still later. Counts from the mesencephalic nucleus of trigeminal, the dorsal motor nucleus of the vagus, and the locus ceruleus were not affected by exposure to VPA, even though these nuclei form during the period when exposure occurred. Despite its effects on the motor nuclei, valproic acid exposure did not alter the further development of the brain in any obvious way. Treated animals were robust and had no external malformations. The autopsy data and experimental data from rats confirm that CNS injuries occurring during or just after neural tube closure can lead to a selective loss of neurons derived from the basal plate of the rhombencephalon. The results add two new lines of evidence that place the initiating injury for autism around the time of neural tube closure. PMID:8808733

Rodier, P M; Ingram, J L; Tisdale, B; Nelson, S; Romano, J



Arachnoid cysts in the middle cranial fossa: cause and treatment of progressive and non-progressive symptoms  

Microsoft Academic Search

Ten consecutive patients with arachnoid cysts in the middle cranial fossa, diagnosed by CT, were studied. They were divided into three clinical groups: (1) four patients with progressive symptoms caused by secondary bleeding, (2) five patients with non-progressive symptoms of headache or epilepsy, and (3) one asymptomatic patient. The nine symptomatic patients were operated upon and eight showed clinical improvement.

F G van der Meché; R Braakman



Magnetic resonance imaging based classification of anatomic relationship between the cochleovestibular nerve and anterior inferior cerebellar artery in patients with non-specific neuro-otologic symptoms  

Microsoft Academic Search

In this study, we aimed to assess anatomical relationship between the anterior inferior cerebellar artery (AICA) and cochleovestibular nerve (CNV) in patients with non-specific cochleovestibular symptoms using magnetic resonance imaging (MRI). One-hundred and forty patients with non-specific neuro-otologic symptoms were assessed using cranial and temporal MRI. Classification was performed according to four different types of anatomical relationship observed between the

Akif Sirikci; Yildirim Bayazit; Enver Ozer; Ayhan Ozkur; ?brahim Adaletli; M. Ali Cüce; Metin Bayram



Hearing thresholds and FMRI of auditory cortex following eighth cranial nerve surgery.  


Objective Determine whether auditory cortex (AC) organization changed following eighth cranial nerve surgery in adults with vestibular-cochlear nerve pathologies. We examined whether hearing thresholds before and after surgery correlated with increased ipsilateral activation of AC from the intact ear. Study Design During magnetic resonance imaging sessions before and 3 and 6 months after surgery, subjects listened with the intact ear to noise-like random spectrogram sounds. Setting Departments of Radiology and Otolaryngology of Washington University School of Medicine. Subjects and Methods Three patients with acoustic neuromas received Gamma Knife radiosurgery (GK); 1 patient with Meniere's disease and 5 with acoustic neuromas had surgical resections (SR); 2 of the latter also had GK. Hearing thresholds in each ear were for pure tone stimuli from 250 to 8000 Hz before and after surgery (3 and 6 months). At the same intervals, we imaged blood oxygen level-dependent responses to auditory stimulation of the intact ear using an interrupted single-event design. Results Hearing thresholds in 2 of 3 individuals treated with GK did not change. Five of 6 individuals became unilaterally deaf after SRs. Ipsilateral AC activity was present before surgery in 6 of 9 individuals with ipsilateral spatial extents greater than contralateral in 3 of 9. Greater contralateral predominance was significant especially in left compared to right ear affected individuals, including those treated by GK. Conclusion Lateralization of auditory-evoked responses in AC did not change significantly after surgery possibly due to preexisting sensory loss before surgery, indicating that less than profound loss may prompt cortical reorganization. PMID:23804630

Burton, Harold; Firszt, Jill B; Holden, Timothy



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

PubMed Central

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.

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



Paralysis of cranial nerve and striking prognosis of cervical necrotizing fasciitis.  


Necrotizing soft-tissue infection (NSTI) is a bacterial infection with necrosis of the cutaneous, subcutaneous tissue and fascia with sparing of the underlying muscle. The most frequent initiating factor reported, for necrotizing fasciitis, in the head and neck region is a primary odontogenic infection or postextraction infection, abrasion, and laceration of the face or scalp. Necrotizing fasciitis can progress rapidly to systemic toxicity and even death if not promptly diagnosed and treated. If the patient has any risk factors, this can worsen the prognosis. In this study, 2 cases of NSTI with dental pathology history (one with the spreading to mediastinum and the other spreading to suprahyoid) were discussed with a review of the literature. One of the cases had diabetes mellitus, but interestingly, she had a better prognosis, and she was discharged asymptomatic. In addition, the other case had no any risk factors, but he had a worse clinical cranial nerve paralysis (a rare complication of NSTI) and died. As a conclusion, despite the intensive therapy, large debridement, and antibiotics with large spectrum, the delay in the patient's diagnosis and treatment increased mortality. We aimed to attract attention to the importance of dental pathologies and early diagnosis. PMID:23147345

Ulu, Sahin; Ulu, Sena Memnune; Oz, Gürhan; Kaçar, Emre; Yüceda?, Fatih; Ayçiçek, Abdullah



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


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

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



[Imaging anatomy of the cranial nerves using 3.0 Tesla MRI: a practical review for clinicians].  


Magnetic resonance (MR) imaging is the method of choice to evaluate the cranial nerves (CN). These nerves constitute a group of structures that have acquired during their phylogenetic development a high degree of specialization. There are 12 pairs of CN to which we use their specific name or number. The olfactory (I) and optic (II) pairs are not real nerves but tracts from the encephalon. The spinal nerve (XI) derives from superior cervical segment of the spine. The other 9 pairs of CN are related with the brain stem. Although the skull base foramina can be seen on computed tomography, the nerves themselves can only be visualized in detail on MR. That means, in order to see the different segments of nerves I to XII, the right sequences must be used. It is important to provide detailed clinical information to the radiologist so that a tailored MR study can be performed. In this review, the basic imaging anatomy of the 12 CN is discussed and illustrated briefly with an emphasis on more advanced extra-axial anatomy, illustrated with high-resolution MR images. Clinicians looking for complete anatomic descriptions and/or MR illustrations are advised to consult specialized textbooks considering it is not possible to describe all of the anatomy in one article. This manuscript is intended to be a practical review for clinicians. PMID:22116185

Chávez-Barba, Oscar; Martínez-Martínez, Lidieth; Cazares-Arellano, José Luis; Martínez-López, Manuel; Roldan-Valadez, Ernesto


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

SciTech Connect

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.

Kong, Lin, E-mail: [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)



Multiple cranial nerve neuropathies, microcephaly, neurological degeneration, and "fork and bracket sign" in the MRI: a distinct syndrome.  


We report on two sibs with an elongated face with reduced expression, microcephaly, strabismus, wide philtrum, mild joint laxity, thumb sign, bilateral foot drop, and fixed pes cavus, absent tendinous reflexes, an unsteady gait, quick fatigue, slightly diminished limb muscle strength more pronounced distally, abnormalities of cranial nerves III, IV, VII, and most probably VI, and slowness in ideation. Previously unknown findings referred to as the "fork sign" at the pontine level and the "bracket sign" at the mesencephalic level were documented by magnetic resonance imaging. Differential diagnoses and the possibility of a hitherto unreported syndrome are discussed. PMID:20658556

Mégarbané, André; Dorison, Nathalie; Rodriguez, Diana; Tamraz, Jean



Posterior Cranial Fossa Meningiomas*  

PubMed Central

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.

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



Cranial nerve cavernous malformations causing trigeminal neuralgia and chiasmal apoplexy: Report of 2 cases and review of the literature  

PubMed Central

Background: Cavernous malformations (CMs) confined to the cranial nerves (CN) are extremely rare lesions. Case Description: The authors report 2 cases of CMs, one involving the trigeminal nerve presenting with a 3 years history of a refractory right trigeminal neuralgia that was microsurgically resected by a retromastoid approach with resolution of the neuralgia; and another CM involving the chiasma with an abrupt onset of vision loss with acute intralesional bleeding that was removed through a right pterional approach with vision improvement. Conclusion: Surgical resection is recommended in the context of progressive significant neurological deficit, emergency decompression as a result of recent hemorrhage for symptomatic relief or increase in size on serial magnetic resonance imaging (MRI).

Pereira de Morais, Nuno Miguel; Mascarenhas, Antonio Lino Rodrigues; Soares-Fernandes, Joao Paulo; Moreira da Costa, Jose Antonio




PubMed Central

ABSTRACT Purpose The clinical and molecular genetic classification of syndromes with congenital limitation of eye movements and evidence of cranial nerve dysgenesis continues to evolve. This monograph details clinical and molecular genetic data on a number of families and isolated patients with congenital fibrosis of the extraocular muscles (CFEOM) and related disorders, and presents an overview of the mechanisms of abnormal patterns of motor and sensory cranial nerve development in these rare syndromes. Methods Clinical examination of one patient with CFEOM1, one family with clinical features of CFEOM2, one family with recessive CFEOM3, one family with horizontal gaze palsy and progressive scoliosis (HGPPS), and four patients with various combinations of congenital cranial nerve abnormalities. Genotyping of families with CFEOM and HGPPS for polymorphic markers in the regions of the three known CFEOM loci and in the HGPPS region, and mutation analysis of the ARIX and KIF21A genes in patients with CFEOM were performed according to standard published protocols. Results The patient with CFEOM1 had the second most common mutation in KIF21A, a 2861 G>A mutation that resulted in an R954Q substitution. The family with CFEOM2 phenotype did not map to the CFEOM2 locus. The family with recessive CFEOM3 did not map to any of the known loci. The HGPPS family mapped to 11q23–q25. One patient had optic nerve hypoplasia and fifth nerve dysfunction. Two patients had the rare combination of Möbius syndrome and CFEOM. One patient had Möbius syndrome and fifth nerve dysfunction. Conclusions There is genetic heterogeneity in CFEOM2 and CFEOM3. Abnormalities in sensory nerves can also accompany abnormalities of motor nerves, further substantiating the effect of individual mutations on developing motor as well as sensory cranial nerve nuclei.

Traboulsi, Elias I



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

SciTech Connect

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.

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:




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...


Pain as a symptom of peripheral nerve sheath tumors: clinical significance and future therapeutic directions  

Microsoft Academic Search

Tumors arising from the supporting cells of peripheral nerve sheaths are relatively uncommon neoplasms, and as such many clinicians are unfamiliar with the details of their presentation, diagnosis and management. Further, little is known regarding the pathogenesis of these tumors, how they cause symptoms, and how to treat these symptoms. One classic symptom of peripheral nerve tumors is pain, however

Michael E Sughrue; Jon Levine; Nicholas M Barbaro



Optimal learning in a virtual patient simulation of cranial nerve palsies: The interaction between social learning context and student aptitude  

PubMed Central

Background Simulation in medical education provides students with opportunities to practice interviews, examinations, and diagnosis formulation related to complex conditions without risks to patients. Aim To examine differences between individual and team participation on learning outcomes and student perspectives through use of virtual patients (VPs) for teaching cranial nerve (CN) evaluation. Methods Fifty-seven medical students were randomly assigned to complete simulation exercises either as individuals or as members of three-person teams. Students interviewed, examined, and diagnosed VPs with possible CN damage in the Neurological Exam Rehearsal Virtual Environment (NERVE). Knowledge of CN abnormalities was assessed pre- and post-simulation. Student perspectives of system usability were evaluated post-simulation. Results An aptitude-treatment interaction (ATI) effect was detected; at pre-test scores ?50%, students in teams scored higher (83%) at post-test than did students as individuals (62%, p = 0.02). Post-simulation, students in teams reported greater confidence in their ability to diagnose CN abnormalities than did students as individuals (p = 0.02; mean rating = 4.0/5.0 and 3.4/5.0, respectively). Conclusion The ATI effect allows us to begin defining best practices for the integration of VP simulators into the medical curriculum. We are persuaded to implement future NERVE exercises with small teams of medical students.




Three-dimensional interactive and stereotactic atlas of the cranial nerves and their nuclei correlated with surface neuroanatomy, vasculature and magnetic resonance imaging.  


Knowledge of the cranial nerves and their nuclei is critical in clinical practice, medical research and education. However to our best knowledge, a comprehensive source capturing full three-dimensional (3D) relationships of the cranial nerves along with surrounding neuroanatomy is not yet available. This work addresses the construction and validation of an atlas of the cranial nerves with their nuclei, correlated with surface neuroanatomy, vasculature, and magnetic resonance imaging. The atlas is interactive, stereotactic, 3D, detailed, fully parcellated, completely labeled, consistent in 3D, electronically dissectible, and scalable. A 3D geometrical model of the 12 pairs of cranial nerves with nuclei was created from an in vivo magnetic resonance scan exploiting in-house developed tools and methods, including tubular and iso-surface modeling, interactive editing, and mesh compression. This virtual model contains 439 objects with 121 different names, labeled based on Terminologia Anatomica. The model was integrated with a 3D atlas of structure, vasculature and tracts developed earlier, and correlated with sectional magnetic resonance anatomy. The whole model or its components can be interactively rotated, zoomed, panned, and add or removed with a simple few clicks. The studied material can be adaptively selected in an in-depth manner by using controls available in the user interface. This atlas is potentially useful for anatomy browsing, user self-testing, automatic student assessment, preparing materials, and localization in clinical neurology. PMID:22425656

Nowinski, Wieslaw L; Johnson, Aleksandra; Chua, Beng Choon; Nowinska, Natalia G



Unusual aetiology of isolated lower motor neuron facial palsy: systemic lupus erythematosus presenting with cranial nerve palsy and nephritis.  


A 20-year-old woman presented with common cold symptoms was found to have a left-sided facial droop. On examination, peripheral facial nerve palsy was confirmed. Subsequent testing showed nephrotic range proteinuria and positive serologies including antinuclear antibody and anti-smith antibody. Kidney biopsy showed stage III lupus nephritis. Treatment with pulse steroids along with mycophenolate mofetil for her lupus nephritis resulted in concomitant improvement of her facial palsy. PMID:23978499

Kazzaz, Nayef Mohammed; El-Rifai, Rasha



[A case of acute polyradiculoneuritis with multiple cranial nerve palsy and cerebral lesion--possible evidence of encephalo-myelo-radiculo-neuropathy].  


We report a case of acute polyradiculoneuritis with multiple cranial nerve palsy and cerebral lesions. A boy, born on July 26, 1987, developed unusual sensation on the extremities, backache and sleep disturbance on June 23, 1996. On July 2, following a complaint of blindness he developed a convulsion and was admitted to our hospital. Neurological examination revealed intact consciousness, severe external ophthalmoplegia, bifacial palsy and generalized areflexia. On the next day, flaccid tetraplegia and respiratory dysfunction developed and progressed without disturbance of consciousness. After tracheal intubation he was under mechanical ventilation. A lumbar puncture examination showed clear CSF with increased protein 166 mg/dl. no cells and normal myelin basic protein. Serum antibodies against gangliosides (GM1, asialo-GM1, GD1b and GQ1b) were not detected. A posterior tibial nerve conduction velocity was mildly delayed with disappearance of F- wave. On the other hand, very slow background activity was shown by EEG, extensive focal hypoperfusion of cerebral blood flow by SPECT and supratentorial multiple high intensity lesions by T2 weighted MRI of the brain. There were no abnormal signals in the brainstem and cerebellum on MRI. His condition dramatically improved after plasmapheresis. The abnormal findings of SPECT and MRI promptly disappeared within 3 weeks, although abnormal signs on EEG persisted. He was successfully weaned off the respirator and recovered strength of the limbs. He was discharged on August 28, 1996, with supported walk and bifacial palsy, then he completely recovered by 7 months. The condition of case was compatible with 'encephalo-myelo-radiculo-neuropathy', a disease entity that had previously been reported in a few patients in whom with Guillain-Barré or Fisher syndrome and cerebral symptoms co-existed. PMID:9780746

Itokazu, N; Kodama, Y; Kontani, S; Inoue, S; Sugimoto, T; Ohi, T



Two cases of pharyngolaryngeal zoster advanced to multiple cranial neuropathy.  


Varicella zoster virus (VZV) infection of the head and neck region may present with various symptoms. I present two cases of VZV infection of the pharynx and larynx with multiple cranial nerve neuropathies. Their initial symptoms such as sore throat, odynophagia, and dysphasia were complicated by otalgia, dizziness, hearing loss, or ipsilateral facial nerve paralysis. All of these lesions tended to lateralize to the ipsilateral side and endoscopic findings suggested VZV infections, which were confirmed by serial serologic examinations. PMID:23398729

Choi, Jeong Hwan



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

PubMed Central

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.

Tsai, Tzu-Hsun; Demer, Joseph L.



Three-dimensional interactive and stereotactic atlas of head muscles and glands correlated with cranial nerves and surface and sectional neuroanatomy.  


Three-dimensional (3D) relationships between head muscles and cranial nerves innervating them are complicated. Existing sources present these relationships in illustrations, radiologic scans, or autopsy photographs, which are limited for learning and use. Developed electronic atlases are limited in content, quality, functionality, and/or presentation. We create a truly 3D interactive, stereotactic and high quality atlas, which provides spatial relationships among head muscles, glands and cranial nerves, and correlates them to surface and sectional neuroanatomy. The head muscles and glands were created from a 3T scan by contouring them and generating 3D models. They were named and structured according to Terminologia anatomica. The muscles were divided into: extra-ocular, facial, masticatory and other muscles, and glands into mouth and other glands. The muscles, glands (and also head) were placed in a stereotactic coordinate system. This content was integrated with cranial nerves and neuroanatomy created earlier. To explore this complex content, a scalable user interface was designed with 12 modules including central nervous system (cerebrum, cerebellum, brainstem, spinal cord), cranial nerves, muscles, glands, arterial system, venous system, tracts, deep gray nuclei, ventricles, white matter, visual system, head. Anatomy exploration operations include compositing/decompositing, individual/group selection, 3D view-index mapping, 3D labeling, highlighting, distance measuring, 3D brain cutting, and axial/coronal/sagittal triplanar display. To our best knowledge, this is the first truly 3D, stereotactic, interactive, fairly complete atlas of head muscles, and the first attempt to create a 3D stereotactic atlas of glands. Its use ranges from education of students and patients to research to potential clinical applications. PMID:23416136

Nowinski, Wieslaw L; Chua, Beng Choon; Johnson, Aleksandra; Qian, Guoyu; Poh, Lan Eng; Yi, Su Hnin Wut; Bivi, Aminah; Nowinska, Natalia G



Delayed Pneumocephalus-Induced Cranial Neuropathy  

PubMed Central

Pneumocephalus is a common occurrence after cranial surgery, with patients typically remaining asymptomatic from a moderate amount of intracranial air. Postsurgical pneumocephalus rarely causes focal neurological deficits; furthermore, cranial neuropathy from postsurgical pneumocephalus is exceedingly uncommon. Only 3 cases have been previously reported that describe direct cranial nerve compression from intracranial air resulting in an isolated single cranial nerve deficit. The authors present a patient who developed dysconjugate eye movements from bilateral oculomotor nerve palsy. Direct cranial nerve compression occurred as a result of postoperative pneumocephalus in the interpeduncular cistern. The isolated cranial neuropathy gradually recovered as the intracranial air was reabsorbed.

Marupudi, Neena I.



Pathological contrast enhancement of the oculomotor and trigeminal nerves caused by intracranial hypotension syndrome.  


The typical symptom of intracranial hypotension syndrome is orthostatic headache. The headache may also be accompanied by neck pain and stiffness, low backache, radicular symptoms, quadriplegia, interscapular pain, nausea/vomiting, and cranial nerve involvement symptoms (hearing and visual problems, face pain and numbness, hypogeusia). Radiologically, on cranial magnetic resonance imaging, intracranial hypotension syndrome is characterized by dural thickening and contrast enhancement, subdural effusion, engorgement of the venous structures, sagging or downward displacement of the brain, and pituitary hyperemia. Although clinical findings related to cranial nerves 3 and 5 have been described in intracranial hypotension, pathological contrast enhancement of these nerves has not. We present a 32-year-old patient whose cranial magnetic resonance imaging shows bilateral pathological contrast enhancement of cranial nerves 3 and 5 and describe a new imaging finding in intracranial hypotension syndrome. PMID:21521210

Albayram, Sait; Asik, Murat; Hasiloglu, Zehra Isik; Dikici, Atilla Suleyman; Erdemli, Halil Eren; Altintas, Ayse




Microsoft Academic Search

Population-based studies are needed to better define the effectiveness of commonly elicited symptoms and provocative testing in screening for and diagnosing median nerve neuropathy. This report details baseline sensitivity, specificity, and predictive value data of median nerve signs and symptoms from an ongoing prospective cohort study. Workers (n=851) from both Wisconsin and Utah have been enrolled in a prospective cohort

Laura R. Kaufman; Matthew S. Thiese; Kurt T. Hegmann


A Catecholaminergic Sensory Neuron Phenotype in Cranial Derivatives of the Neural Crest: Regulation by Cell Aggregation and Nerve Growth Factor  

Microsoft Academic Search

Tyrosine hydroxylase (TH) is transiently detectable in cells distributed throughout cranial sensory ganglia during early stages of gangliogenesis (embryonic day (E) 10.5-15.51. Although TH cells appear in embryonic ganglia of both neural crest and placode origin, mature cranial sensory neurons that express catecholaminergic properties are restricted to placode derivatives. The mechanism(s) underlying the loss of TH expression in crest-derived sensory

David M. Katz



Nitecapone reduces development and symptoms of neuropathic pain after spinal nerve ligation in rats  

Microsoft Academic Search

Neuropathic pain is caused by damage or malfunctioning of the nervous system. It is fairly common and more resistant to treatment than other types of pain. Since nitecapone, an inhibitor of catechol-O-methyl-transferase (COMT), has decreased neuropathic symptoms in diabetic rats, we studied its effects in another model of neuropathic pain, the spinal nerve ligation (SNL) model. Spinal nerves L5–6 were

Oleg Kambur; Pekka T. Männistö; Anne M. Pusa; Mikko Käenmäki; Eija A. Kalso; Vesa K. Kontinen



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


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

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



Peripheral Afferent Nerve Stimulation for Treatment of Lower Urinary Tract Irritative Symptoms  

Microsoft Academic Search

Objectives: To assess the efficacy of posterior tibial nerve stimulation for treatment of lower urinary tract irritative symptoms (urgency, frequency, urge incontinence and pelvic pain).Patients and Methods: 51 female patients with a mean age of 55 years were enrolled in the study. The patients presented with the following symptoms: Frequency\\/urgency 26 patients (50.98%), urge incontinence 22 (43.13%) and interstitial cystitis

B. Congregado Ruiz; X. M. Pena Outeiriño; P. Campoy Mart??nez; E. León Dueñas; A. Leal López



IVIG- responsive multiple cranial neuropathy: a pharyngo-facial variant of Guillain-Barré syndrome.  


We report a case with symptoms of facial swelling, bilateral facial paralysis, dysphagia and aspiration. On electrophysiological studies, the right facial nerve was not excitable. The left facial nerve compound muscle action potential (CMAP) amplitude was severely dispersed and latency was mildly prolonged, consistent with demyelination. Cerebrospinal fluid examinations were normal. Anti-ganglioside antibodies and tumor markers were negative. Bickerstaff brainstem encephalitis, stroke, diabetes mellitus, vasculitis, sarcoidosis, Sjögren's syndrome, Melkersson-Rosenthal Syndrome, trauma, infectious diseases, toxicity, neoplasm, facial onset sensory and motor neuronopathy (FOSMN) and other degenerative diseases were excluded. Intravenous immunoglobulin therapy resolved symptoms of lower cranial nerve dysfunction. Clinically incomplete improvement of bilateral facial paralysis was observed. We conclude that IVIg therapy may improve the symptoms of multiple cranial nerve palsies due to pharyngo-facial variant of Guillain-Barré syndrome. PMID:20120214

Unal-Cevik, Isin; Onal, Mehmet Zulkuf; Odabasi, Zeki; Tan, Ersin



Usefulness of Leksell GammaPlan for preoperative planning of brain tumor resection: delineation of the cranial nerves and fusion of the neuroimaging data, including diffusion tensor imaging.  


Leksell GammaPlan (LGP) software was initially designed for Gamma Knife radiosurgery, but it can be successfully applied to planning of the open neurosurgical procedures as well. We present our initial experience of delineating the cranial nerves in the vicinity of skull base tumors, combined visualization of the implanted subdural electrodes and cortical anatomy to facilitate brain mapping, and fusion of structural magnetic resonance imaging and diffusion tensor imaging performed with the use of LGP before removal of intracranial neoplasms. Such preoperative information facilitated choosing the optimal approach and general surgical strategy, and corresponded well to the intraoperative findings. Therefore, LGP may be helpful for planning open neurosurgical procedures in cases of both extraaxial and intraaxial intracranial tumors. PMID:23417477

Tamura, Manabu; Konishi, Yoshiyuki; Tamura, Noriko; Hayashi, Motohiro; Nakao, Naoyuki; Uematsu, Yuji; Itakura, Toru; Régis, Jean; Mangin, Jean François; Muragaki, Yoshihiro; Iseki, Hiroshi



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

PubMed Central

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.

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



Cranial sutures  


... sit up). Without flexible sutures and fontanelles, the child's brain would be constricted in the cranial bones and could not grow enough. The child would develop brain damage. Feeling the cranial sutures and fontanelles is ...


["Left hemicranium, the cranial nerves" by Tramond: An anatomical model in wax from the Delmas, Orfila and Rouvière's Museum in Paris: description and tri-dimensional photographic reconstruction (TDPR)].  


An anatomical model in wax made by Tramond (middle of the 19th century) represented the cranial nerves of a left hemicranium. The aim of the study was to verify its anatomical veracity, to realize a tri-dimensional visualization by computer, and finally to numerize and to diffuse it to the general public in the purpose of culture on the internet. The model belonged to the Delmas, Orfila and Rouvière Museum (Paris Descartes university). It represented the cranial nerves especially the facial and the trigeminal nerves and their branches. To perform the photographic rotation every 5° along 360°, we used a special device made of two identical superimposed marble disks linked by a ball bearing. A digital camera and the Quick Time Virtual Reality software were used. Seventy-two pictures were shot. This wax was realized with a great morphological accuracy from a true cranium as a support for the cranial nerves. The work of numerization and its free diffusion on the Internet permitted to deliver to everybody the images of this sample of the collection of the Orfila Museum, the pieces of which were evacuated on December 2009 after its closure. PMID:21493118

Paravey, S; Le Floch-Prigent, P



Magnetic resonance imaging based classification of anatomic relationship between the cochleovestibular nerve and anterior inferior cerebellar artery in patients with non-specific neuro-otologic symptoms.  


In this study, we aimed to assess anatomical relationship between the anterior inferior cerebellar artery (AICA) and cochleovestibular nerve (CNV) in patients with non-specific cochleovestibular symptoms using magnetic resonance imaging (MRI). One-hundred and forty patients with non-specific neuro-otologic symptoms were assessed using cranial and temporal MRI. Classification was performed according to four different types of anatomical relationship observed between the AICA and CVN. In type 1 (point compression), the AICA compresses only a limited portion of the CVN. In type 2 (longitudinal compression), the AICA approaches the CVN as both traverse parallel to each other. In type 3 (loop compression), the vascular loop of the AICA encircles the CVN. In type 4 (indentation), the AICA compresses the CVN so as to make an indentation in the nerve. The anatomical relationship between the CVN and AICA was encountered in 19 out of 140 (13.6%) patients (20 ears). The VCC was unilateral in 18 patients (94.7%) and bilateral in one patient (5.3%). There was no other vascular structure causing VCC to the CVN except for vertebral artery that was seen in 2 out of 140 patients (1.4%). These were unilateral cases. There were tinnitus, vertigo or dizziness, hearing loss, and both hearing loss and vertigo in 5 (25%), 13 (65%), 1 (5%) and 1 (5%) ears of 20 patients, respectively. There was no relationship between the cochleovestibular symptoms and type of compression (p>0.05). Neurovascular relationship between the CVN and AICA can be imaged properly using MR and MR based classification may help reporting this relationship in a standard way. Although, MR images can show the anatomical relationship accurately, diagnosis of vascular conflict should not be based on imaging findings alone. PMID:16322942

Sirikci, Akif; Bayazit, Yildirim; Ozer, Enver; Ozkur, Ayhan; Adaletli, Ibrahim; Cüce, M Ali; Bayram, Metin



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


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

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



Transcutaneous electrical posterior tibial nerve stimulation for faecal incontinence: effects on symptoms and quality of life  

Microsoft Academic Search

Purpose  Faecal incontinence is a disabling symptom which may be particularly difficult to treat. Recent studies showed that transcutaneous\\u000a electrical posterior tibial nerve stimulation may improve faecal continence. In this study, we aimed to evaluate the effectiveness\\u000a of this technique and tried to individualize predictive factors of success.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Twenty-four patients suffering from faecal incontinence were treated 20 min per day by applying

Vitton Veronique; Damon Henri; Roman Sabine; Mion François



Nitecapone reduces development and symptoms of neuropathic pain after spinal nerve ligation in rats.  


Neuropathic pain is caused by damage or malfunctioning of the nervous system. It is fairly common and more resistant to treatment than other types of pain. Since nitecapone, an inhibitor of catechol-O-methyl-transferase (COMT), has decreased neuropathic symptoms in diabetic rats, we studied its effects in another model of neuropathic pain, the spinal nerve ligation (SNL) model. Spinal nerves L5-6 were ligated in male Wistar rats under anaesthesia to produce the SNL model of neuropathic pain. Nitecapone (30 mg/kg, i.p.) or vehicle was administered once daily starting either 1h before or 2 days after surgery and continued for 14-19 days. Threshold for mechanical allodynia was measured with the digital von Frey test and responses to cold stimuli with the acetone test, before surgery and every other day after it 1h before drug administration. Mechanical and cold allodynia developed in all study groups. Both nitecapone treatments significantly reduced mechanical allodynia and withdrawal thresholds were 80-95% higher compared with the control group. In the acetone test, both nitecapone groups also showed less signs of cold allodynia than the control groups. In nitecapone-naïve animals a single dose of nitecapone also reduced mechanical allodynia on the 14th day after the surgery. Nitecapone reduced the symptoms of neuropathic pain after the SNL, which is in line with the earlier study. Our results suggest that nitecapone and other COMT inhibitors should be studied further in the treatment of neuropathic pain. PMID:21216640

Kambur, Oleg; Männistö, Pekka T; Pusa, Anne M; Käenmäki, Mikko; Kalso, Eija A; Kontinen, Vesa K



Transcutaneous Electrical Nerve Stimulation (TENS) Improves Upper GI Symptoms and Balances the Sympathovagal Activity in Scleroderma Patients  

Microsoft Academic Search

To assess the impact of transcutaneous electrical nerve stimulation (TENS) at gastrointestinal (GI) acupoints on GI symptoms\\u000a and quality of life in scleroderma patients, 17 patients filled out SF-36 and GI symptom questionnaires before the electrocardiogram\\u000a was recorded for two intervals: baseline and TENS. At home, patients applied TENS for 14 days, then were reassessed.\\u000a \\u000a Acutely, TENS application significantly increased

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



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


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 < 0.05). After TENS treatment, SS symptom severity significantly decreased and the subjects were more able to concentrate and made fewer cognitive test errors (p < 0.05). CONCLUSIONS: Sympathetic activity increased and parasympathetic activity decreased after simulator exposure. TENS was effective in reducing SS symptoms and alleviating cognitive impairment.Trial registration number: Australia and New Zealand Clinical Trials Register: ACTRN12612001172897. PMID:23587135

Chu, Hsin; Li, Min-Hui; Huang, Yu-Cheng; Lee, Shih-Yu



Signs and Symptoms vs Nerve Conduction Studies to Diagnose Diabetic Sensorimotor Polyneuropathy  

PubMed Central

Introduction Test whether physicians can validly and reproducibly diagnose diabetic sensorimotor polyneuropathy (DSPN). Methods Twelve physicians assessed 24 patients with diabetes mellitus (DM) on consecutive days (576 examinations) with physical features and voice disguised. Results were compared to gold standard 75% group diagnosis and a nerve conduction score (? 5 NC nds). Results Masking of patients was achieved. Reproducibility measured by the kappa coefficient and compared to ? 5 NC nd varied considerably among physicians: median and ranges: signs 0.8 (0.32 to 1.0); symptoms 0.79 (0.36 to 1.0) and diagnoses 0.47 (0.33 to 0.84) – both low and high scores indicating poor performance. There was substantial agreement between 75% group dx and confirmed NC abnormality. As compared to ? 5 NC, individual physicians’ clinical diagnosis was excessively variable and frequently inaccurate. Discussion Study physician diagnosis from signs and symptoms were excessively variable, often over-estimating DSPN. Specific approaches to improving proficiency should be tested.



Dorsal Genital Nerve Stimulation for the Treatment of Overactive Bladder Symptoms  

PubMed Central

Aim To evaluate percutaneous placement of electrodes adjacent to the dorsal genital nerve (DGN) and measure the effects of electrical stimulation on symptoms of urge incontinence during 1 week of home use. Methods Prospective, multicenter study. Subjects with urge incontinence underwent percutaneous placement of an electrode using local anesthetic. Test stimulation was applied to confirm electrode placement and cystometry was conducted with and without application of electrical stimulation. A 7-day testing period with the electrode connected to an external pulse generator was performed and was followed by a 3-day post-treatment test period. Bladder diaries, 24 hr pad tests, and adverse event queries were obtained. Results Twenty-one women were enrolled with an average age of 52.7 years and average duration of incontinence of 6 years. Percutaneous electrode placement required 5–10 min and was well tolerated. There was no relationship between the acute effects of stimulation on cystometry and the results during home use. Pad weight was reduced by ?50% in 13 of 17 subjects (76%) (4 did not complete 24 hr pad testing) and 47% of subjects reported ?50% reduction in incontinence episodes. Of the subjects who reported severe urgency at baseline, 81% experienced a 50% or greater improvement. Seven subjects experienced nine adverse events ranging from skin irritation to pain and bruising around the electrode exit site. Conclusions Electrodes to stimulate the DGN can be placed percutaneously and a home testing period showed a reduction in overactive bladder symptoms with DGN stimulation.

Goldman, Howard B.; Amundsen, Cindy L.; Mangel, Jeffrey; Grill, Julie; Bennett, Maria; Gustafson, Kenneth J.; Grill, Warren M.



Cranial polyneuropathy with elevated serum antiganglioside antibody  

Microsoft Academic Search

We report a 6-year-old girl with cranial polyneuropathy with elevated serum levels of antiganglioside antibodies. She manifested herpetic vesicles around the right upper eyelid and mouth without antecedent infection. She developed facial asymmetry and double vision 5 days after the first apperance of the vesicles. Neurological examination on admission disclosed palsies of the bilateral sixth and twelfth cranial nerves and

Kousaku Matsubara; Hiroyuki Nigami; Hidekazu Harigaya; Kunizou Baba



Outbreak of clinically mild botulism type E illness from home-salted fish in patients presenting with predominantly gastrointestinal symptoms.  


Five persons consumed home-salted fish and then presented with gastrointestinal symptoms to 3 hospitals; 2 of the patients had minimal cranial nerve palsies. Early serum samples obtained from all patients were negative for botulinum toxin. Remnant fish tested positive for botulinum toxin type E. In patients exposed to low doses of botulinum toxin type E, gastrointestinal symptoms may predominate. PMID:17578769

Sobel, J; Malavet, M; John, S



Tumors of the cranial base: Diagnosis and treatment  

SciTech Connect

The first section of this book highlights the differences and similarities in the pathology and biology of the various types of neoplasms of the cranial base. The second section covers improvements in radiological diagnosis with the advent of computed tomography, magnetic resonance imaging and a better knowledge of radiological anatomy. It also examines the significance and proper evaluation of minor symptoms to enable earlier diagnosis, as well as the advances in interventional radiology that have produced the balloon occlusion text and tumor embolization. Section three is on advanced neuroanesthetic techniques and intraoperative neurophysiological monitoring. Section four describes specialized treatment modalities including microsurgical resection with the laser, radiation therapy and chemotherapy. Section five reviews the latest techniques for reconstruction of the cranial base following resection, as well as the preservation and reconstruction of cranial nerves and cerebral blood vessels exposed during the surgery. The final three sections examine the lesions and surgical techniques specific to the different anatomical regions, i.e, the anterior, middle and posterior cranial base.

Sekhar, L.N.; Schramm, V.L.



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

PubMed Central

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

Jepsen, Jorgen R; Thomsen, Gert



Percutaneous sacral third nerve root neurostimulation improves symptoms and normalizes urinary HB-EGF levels and antiproliferative activity in patients with interstitial cystitis  

Microsoft Academic Search

Objectives. A highly effective treatment for interstitial cystitis (IC) remains elusive. We determined whether sacral third nerve root (S3) percutaneous neurostimulation (PNS) might be effective in relieving symptoms of IC, as well as in normalizing urinary factors that are specifically altered in IC.Methods. Six consecutive patients with symptoms and cystoscopic findings compatible with IC underwent 5 days of continuous S3

Toby C Chai; Chen-Ou Zhang; John W Warren; Susan Keay



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

Microsoft Academic Search

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

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



Patterning and axon guidance of cranial motor neurons  

Microsoft Academic Search

The cranial motor nerves control muscles involved in eye, head and neck movements, feeding, speech and facial expression. The generic and specific properties of cranial motor neurons depend on a matrix of rostrocaudal and dorsoventral patterning information. Repertoires of transcription factors, including Hox genes, confer generic and specific properties on motor neurons, and endow subpopulations at various axial levels with

Sarah Guthrie



Improved Mood and Remission of Symptoms in Long-term Major Depression Using Vagus Nerve Stimulation  

PubMed Central

This is a case study of a 68-year-old woman with previously unremitting depression. The patient came to our care in 1994 following a series of treatment interventions that did not alter the course of chronic depression. We report our treatment approach and results seen with this patient, including her tepid response to traditional antidepressants and the positive results seen in the past year using vagus nerve stimulation (VNS) therapy. The patient experienced broad gains in measures of depression severity and well-being under her current treatment regimen. She has had no serious adverse events associated with the regimen, which includes VNS therapy and decreased doses of common antidepressant medications.

Patel, Amita R.; Wozniak, Shannon M.





... at increased risk for having type 2 diabetes . Gestational Diabetes Women with gestational diabetes often have no symptoms , which is why it's ... the proper time during pregnancy. Learn more about gestational diabetes. Symptoms of Diabetes Complications Have you already been ...


Cranial and spinal tumors with meningitic onset  

Microsoft Academic Search

We review the literature on cases of cranial or spinal tumor presenting with meningitic symptoms. Embryonal tumors — dermoid cysts, epidermoid, epidermoid cysts, craniopharyngiomas, teratomas - and malignant gliomas were the cause of most of the episodes of chemical meningitis, single or multiple in patients with no neurological symptoms. Differential diagnosis from aseptic meningitis, especially from Mollaret aseptic meningitis, is

P. Lunardi; P. Missori



Glossopharyngeal Nerve Schwannoma  

PubMed Central

Complete resection with conservation of cranial nerves is the primary goal of contemporary surgery for lower cranial nerve tumors. We describe the case of a patient with a schwannoma of the left glossopharyngeal nerve, operated on in our Neurosurgical Unit. The far lateral approach combined with laminectomy of the posterior arch of C1 was done in two steps. The procedure allowed total tumor resection and was found to be better than classic unilateral suboccipital or combined supra- and infratentorial approaches. The advantages and disadvantages of the far lateral transcondylar approach, compared to the other more common approaches, are discussed. ImagesFigure 1Figure 2

Puzzilli, F.; Mastronardi, L.; Agrillo, U.; Nardi, P.





... Advanced MS Pediatric MS Related Conditions Symptoms In multiple sclerosis , damage to the myelin in the central nervous ... Depression Depression is common during the course of multiple sclerosis. In fact, studies have suggested that clinical depression, ...


[A case of Fisher syndrome with multiple cranial neuropathy and abnormal EEG findings].  


A 69-year-old woman was admitted because of unconsciousness and multiple cranial neuropathy. She had suffered diarrhea 2 weeks previously. On examination, she was noted to have total external and internal ophthalmoplegia, bilateral facial palsy, dysphagia, dysarthria, neck weakness, distal motor weakness of all limbs, and ataxia. She had also presented with hyporeflexia and hypoesthesia, but with a bilateral pyramidal tract sign. A study of her cerebrospinal fluid revealed albuminocytologic dissociation, and nerve conduction study revealed demyelination of her peripheral nerves. Moreover, electroencephalography findings were abnormal and anti-GQ1b antibody was positive. We diagnosed Fisher syndrome with Guillain-Barré syndrome and Bickerstaff brainstem encephalitis. We administered intravenous immunoglobulin treatment for 5 days and her symptoms gradually improved. However, her external ophthalmoplegia continued for several months. PMID:23268979

Ochi, Masayuki; Shinohara, Nako; Kamogawa, Kenji; Okada, Yoko; Nagai, Tokihisa; Taguchi, Keiko; Takita, Rie; Igase, Michiya; Kohara, Katsuhiko; Miki, Tetsuro



A large dumbbell glossopharyngeal schwannoma involving the vagus nerve: a case report and review of the literature  

PubMed Central

Introduction Schwannoma arising from the glossopharyngeal nerve is a rare intracranial tumor. Fewer than 40 cases have been reported. Accurate pre-operative diagnosis and optimal treatment are still difficult. Case presentation We present one case of schwannoma originating from the ninth cranial nerve with palsies of the trigeminal nerve, facial-acoustic nerve complex, and vagus nerve in addition to ninth nerve dysfunction. Magnetic resonance imaging showed tumors located in the cerebellopontine angle with extracranial extension via the jugular foramen, with evident enhancement on post-contrast scan. Surgical management single-staged with the help of gamma knife radiosurgery achieved total removal. Conclusion Glossopharyngeal schwannoma is devoid of clinical symptoms and neurological signs. High resolution magnetic resonance imaging may play a key role as an accurate diagnostic tool. A favorable option of approach and appropriate planning of surgical strategy should be the goal of operation for this benign tumor.

Zhao, Hongyu; Li, Xiaodong; Lv, Qingjie; Yuan, Yuhui; Yu, Hongwei



[Cerebrospinal rhinorrhea 8 years after cranial injury].  


The authors present a case of posttraumatic cerebrospinal fluid rhinorrhoea developing 8 years after skull trauma. The rarity is discussed of the development of remote traumatic rhinorrhoea without previous symptoms of cerebrospinal fluid fistula, and the diagnostic difficulties are stressed in cases of such late rhinorrhoea. A new preparation used for plastic operation on the anterior cranial fossa floor is described. PMID:3658103

Marchel, A; Sadowski, Z


Alpha-synuclein pathology and axonal degeneration of the peripheral motor nerves innervating pharyngeal muscles in Parkinson disease.  


Parkinson disease (PD) is a neurodegenerative disease primarily characterized by cardinal motor manifestations and CNS pathology. Current drug therapies can often stabilize these cardinal motor symptoms, and attention has shifted to the other motor and nonmotor symptoms of PD that are resistant to drug therapy. Dysphagia in PD is perhaps the most important drug-resistant symptom because it leads to aspiration and pneumonia, the leading cause of death. Here, we present direct evidence for degeneration of the pharyngeal motor nerves in PD. We examined the cervical vagal nerve (cranial nerve X), pharyngeal branch of nerve X, and pharyngeal plexus innervating the pharyngeal muscles in 14 postmortem specimens, that is, from 10 patients with PD and 4 age-matched control subjects. Synucleinopathy in the pharyngeal nerves was detected using an immunohistochemical method for phosphorylated ?-synuclein. Alpha-synuclein aggregates were revealed in nerve X and the pharyngeal branch of nerve X, and immunoreactive intramuscular nerve twigs and axon terminals within the neuromuscular junctions were identified in all of the PD patients but in none of the controls. These findings indicate that the motor nervous system of the pharynx is involved in the pathologic process of PD. Notably, PD patients who have had dysphagia had a higher density of ?-synuclein aggregates in the pharyngeal nerves than those without dysphagia. These findings indicate that motor involvement of the pharynx in PD is one of the factors leading to oropharyngeal dysphagia commonly seen in PD patients. PMID:23334595

Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Adler, Charles H; Shill, Holly A; Caviness, John N; Samanta, Johan E; Beach, Thomas G



Embryonic Origin of Gustatory Cranial Sensory Neurons  

PubMed Central

Cranial nerves VII, IX and X provide both gustatory (taste) and non-gustatory (touch, pain, temperature) innervation to the oral cavity of vertebrates. Gustatory neurons innervate taste buds and project centrally to the rostral nucleus of the solitary tract (NTS), while neurons providing general epithelial innervation to the oropharynx project to non-gustatory hindbrain regions, i.e., spinal trigeminal nucleus. In addition to this dichotomy in function, cranial ganglia VII, IX and X have dual embryonic origins, comprising sensory neurons derived from both cranial neural crest and epibranchial placodes. We used a fate mapping approach to test the hypothesis that epibranchial placodes give rise to gustatory neurons, while the neural crest generates non-gustatory cells. Placodal ectoderm or neural crest was grafted from Green Fluorescent Protein (GFP) expressing salamander embryos into unlabeled hosts, allowing us to discern the postembryonic central and peripheral projections of each embryonic neuronal population. Neurites that innervate taste buds are exclusively placodal in origin, and their central processes project to the NTS, consistent with a gustatory fate. In contrast, neural crest-derived neurons do not innervate taste buds; instead, neurites of these sensory neurons terminate as free nerve endings within the oral epithelium. Further, the majority of centrally directed fibers of neural crest neurons terminate outside the NTS, in regions that receive general epithelial afferents. Our data provide empirical evidence that embryonic origin dictates mature neuron function within cranial sensory ganglia: specifically, gustatory neurons derive from epibranchial placodes while neural crest-derived neurons provide general epithelial innervation to the oral cavity.

Harlow, Danielle E.; Barlow, Linda A.



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

PubMed Central

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

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



Chronic meningitis with multiple cranial neuropathies: A rare initial presentation of Wegener's granulomatosis  

PubMed Central

Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis that affects the small blood vessels. It mainly affects the upper and lower respiratory tract and kidneys. Central nervous system (CNS) involvement is rare, and has been reported only in about 8% of cases during the course of illness. Initial presentation with neurologic affection, particularly chronic hypertrophic meningitis is very unusual. We report the case of a 34 year old male who presented with chronic hypertrophic meningitis and multiple cranial nerve involvement as the initial manifestation, without respiratory and renal symptoms. This case highlights the difficulties in diagnosing a rare disease with rarer presentation, and at the same time illustrates that Wegener's granulomatosis should be considered in the differential diagnosis of chronic meningitis.

Gupta, Vikas; Sharma, Anjani Kumar; Sureka, Rajendra Kumar; Bhuyan, Sushant Kumar; Singh, Prashant Kumar



Neurological Signs and Symptoms in Fibromyalgia  

PubMed Central

Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM.

Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.



Role of cranial bone mobility in cranial compliance.  


Increases in intracranial pressure are normally buffered by the displacement of blood and cerebrospinal fluid from the cranium when there is an increase in intracranial volume (ICV). How much pressure increases with an increase in ICV is expressed in the calculation of cranial compliance (delta ICV/delta P, where delta P is change in pressure) and elastance (delta P/delta ICV). Data reported here indicate that the movement of the cranial bones at their sutures is an additional factor defining total cranial compliance. Using controlled bolus injections of artificial cerebrospinal fluid into a lateral cerebral ventricle in anesthetized cats and a newly developed instrument to quantify cranial bone movement at the midline sagittal suture where the bilateral parietal bones meet, we show that these cranial bones move in association with increases in ICV along with corresponding peak intracranial pressures and changes in intracranial pressure. External restraints to the head restrict these movements and reduce the compliance characteristics of the cranium. We propose that total cranial compliance depends on the mobility of intracranial fluid volumes of blood and cerebrospinal fluid when there is an increase in ICV, but it also varies as a function of cranial compliance attributable to the movement of the cranial bones at their sutures. Our data indicate that although the cranial bones move apart even with small (nominally 0.2 ml) increases in ICV, total cranial compliance depends more on fluid migration from the cranium when ICV increases are less than approximately 3% of total cranial volume. Cranial bone mobility plays a progressively larger role in total cranial compliance with larger ICV increases. PMID:8264886

Heisey, S R; Adams, T



Glossopharyngeal nerve injury complicating carotid endarterectomy.  


Injury can occur to several of the cranial nerves during carotid endarterectomy. Among these, glossopharyngeal nerve injury is an uncommon complication because it is remote from the field of dissection in most carotid procedures. From more than 2000 carotid operations four cases of symptomatic ninth cranial nerve injury were identified. Analysis revealed that dissection cephalad to the level of the hypoglossal nerve was a common feature of each and severe functional disability can result from glossopharyngeal nerve paresis. When mobilization of this nerve and division of the posterior belly of the digastric muscle and styloid process become necessary for additional exposure, the risk of glossopharyngeal nerve injury increases. Specific recommendations are made regarding management and maneuvers to help reduce the incidence of this uncommon, yet potentially serious, complication. PMID:3509601

Rosenbloom, M; Friedman, S G; Lamparello, P J; Riles, T S; Imparato, A M



Midline shift, seizures and acute neurological deterioration due to cranial vault metastases from prostatic carcinoma.  


Intracranial metastases from prostatic cancer are rare, but cranial vault metastases are not. Most patients who have vault metastases present with local symptoms such as pain. We describe a patient who presented with acute neurological symptoms as well as a midline shift, seizures and secondary intracranial effects as a result of the extensive cranial vault metastases from prostate cancer; the symptoms mimicked those of intracranial metastases. PMID:19651516

Weerakkody, Y D; Feltham, R L; Leigh, A J



Relationship between Focal Inflammation and Symptom Exacerbation after Endovascular Coil Embolization for Symptomatic Intracranial Aneurysms  

PubMed Central

Summary As endovascular surgery (EVS) of symptomatic unruptured aneurysms can result in symptom exacerbation due to intra-aneurysmal thrombosis or lump formation by coils, this treatment remains controversial. We present five women ranging in age from 58 to 76 years (mean 65.6 years) who suffered post-EVS symptom exacerbation attributable to local inflammation. The aneurysms measured from 8 to 25 mm (mean 19 mm) and were located at the cavernous portion in four patients and at the origin of the ophthalmic artery in one. All underwent endosaccular embolization under local anesthesia. Immediately after embolization, 24 h anti-coagulation therapy was started via the continuous injection of heparin; they also received anti-platelet therapy. At one to three days post-EVS, all five patients manifested worsening of their cranial nerve symptoms. In three other patients the symptoms were improved after EVS. We posit that inflammation induced by coil embolization may worsen cranial nerve symptoms transiently. Our findings suggest that post-EVS follow-up is necessary and that patients exhibiting an inflammatory reaction be treated with anti-inflammatory drugs.

Suzuki, S.; Kurata, A.; Iwamoto, K.; Yamada, M.; Niki, J.; Miyazaki, T.; Oka, H.; Fujii, K.; Kan, S:



Trigeminal neuralgia and facial nerve paralysis.  


The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves. PMID:15690205

Borges, Alexandra



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

PubMed Central

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

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



Stereotactic Radiotherapy for Intracranial Nonacoustic Schwannomas Including Facial Nerve Schwannoma  

SciTech Connect

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

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



Effect of anesthesia of the chorda tympani nerve on taste perception in humans  

Microsoft Academic Search

Individuals who have sustained considerable damage to parts of the taste system often fail to experience changes in everyday taste experience. The two halves of the tongue are independently innervated: the chorda tympani (branch of the facial or VIIth cranial nerve) innervating the anterior two-thirds and the glossopharyngeal (IXth cranial nerve) innervating the posterior one-third. Anesthesia of the chorda tympani

C. D. Lehman; L. M. Bartoshuk; F. C. Catalanotto; J. F. Kveton; R. A. Lowlicht



Cranial dystonia, blepharospasm and hemifacial spasm: clinical features and treatment, including the use of botulinum toxin.  

PubMed Central

Blepharospasm, the most frequent feature of cranial dystonia, and hemifacial spasm are two involuntary movement disorders that affect facial muscles. The cause of blepharospasm and other forms of cranial dystonia is not known. Hemifacial spasm is usually due to compression of the seventh cranial nerve at its exit from the brain stem. Cranial dystonia may result in severe disability. Hemifacial spasm tends to be much less disabling but may cause considerable distress and embarrassment. Patients affected with these disorders are often mistakenly considered to have psychiatric problems. Although the two disorders are quite distinct pathophysiologically, therapy with botulinum toxin has proven very effective in both. We review the clinical features, proposed pathophysiologic features, differential diagnosis and treatment, including the use of botulinum toxin, of cranial dystonia and hemifacial spasm. Images Fig. 2 Fig. 3

Kraft, S P; Lang, A E



Understanding facial nerve paralysis.  


Facial nerve paralysis has many causes and can be acute or chronic. Understanding the signs and symptoms, performing a careful patient evaluation, and obtaining appropriate diagnostic testing can help guide clinicians and improve outcomes. PMID:24153089

Matthaeus, Jaime; Hayden, Richard; Kim, Michael; Donald, Carrlene



Microsurgical reconstruction of the trigeminal nerve.  


Head and neck tumor surgery or traumatic injuries in the maxillofacial region often result in discontinuity defects of peripheral branches of the trigeminal (fifth cranial) nerve, causing loss of sensation to those areas of the face, mouth, or jaws supplied by this important nerve. Injuries to the peripheral branches of the trigeminal nerve can be repaired by microsurgical techniques, either at the time of the original injury or ablative operation if conditions are favorable, or at a later date. Repair of a peripheral nerve injury has a good chance of a satisfactory outcome if done in a timely fashion. PMID:23510602

Meyer, Roger A; Bagheri, Shahrokh C



Gastric mucosal nerve density  

PubMed Central

Background: Autonomic neuropathy is a frequent diagnosis for the gastrointestinal symptoms or postural hypotension experienced by patients with longstanding diabetes. However, neuropathologic evidence to substantiate the diagnosis is limited. We hypothesized that quantification of nerves in gastric mucosa would confirm the presence of autonomic neuropathy. Methods: Mucosal biopsies from the stomach antrum and fundus were obtained during endoscopy from 15 healthy controls and 13 type 1 diabetic candidates for pancreas transplantation who had secondary diabetic complications affecting the eyes, kidneys, and nerves, including a diagnosis of gastroparesis. Neurologic status was evaluated by neurologic examination, nerve conduction studies, and skin biopsy. Biopsies were processed to quantify gastric mucosal nerves and epidermal nerves. Results: Gastric mucosal nerves from diabetic subjects had reduced density and abnormal morphology compared to control subjects (p < 0.05). The horizontal and vertical meshwork pattern of nerve fibers that normally extends from the base of gastric glands to the basal lamina underlying the epithelial surface was deficient in diabetic subjects. Eleven of the 13 diabetic patients had residual food in the stomach after overnight fasting. Neurologic abnormalities on clinical examination were found in 12 of 13 diabetic subjects and nerve conduction studies were abnormal in all patients. The epidermal nerve fiber density was deficient in skin biopsies from diabetic subjects. Conclusions: In this observational study, gastric mucosal nerves were abnormal in patients with type 1 diabetes with secondary complications and clinical evidence of gastroparesis. Gastric mucosal biopsy is a safe, practical method for histologic diagnosis of gastric autonomic neuropathy.

Selim, M.M.; Wendelschafer-Crabb, G.; Redmon, J.B.; Khoruts, A.; Hodges, J.S.; Koch, K.; Walk, D.; Kennedy, W.R.



Hypertrophic granulomatous cranial pachymeningitis causing progressive blindness in a chronic dialysis patient  

Microsoft Academic Search

A patient on chronic haemodialysis because of renal failure developed progressive visual field loss and eventual blindness. A postmortem examination indicated that the blindness was caused by granulomatous thickening of the pachymeninges which constricted the optic nerves as they passed through the optic foramina. Exhaustive bacteriological and histopathological studies failed to identify a specific cause for this hypertrophic cranial pachymeningitis.

E R Feringa; L Weatherbee



A rare cause of facial nerve palsy in children: hyperostosis corticalis generalisata (Van Buchem disease). Three new pediatric cases and a literature review.  


Differential diagnosis of facial nerve palsy in children is extensive. We report on three pediatric cases presenting with facial nerve palsy caused by hyperostosis corticalis generalisata (Van Buchem disease). This autosomal recessive disease is characterized by progressive bone overgrowth, with narrowing of the neuroforamina in the skull causing cranial neuropathies. These three new cases of Van Buchem disease are of interest because of exceptionally early presentation of symptoms. Furthermore, this is the first report describing bilateral papilledema in a child with Van Buchem disease. Head computerized tomography (CT) scan revealed thickened calvarium, skull base and mandible in all three children, with narrowed facial nerve canals. Bone mineral density (BMD) was markedly increased at all measured points and biochemical markers of bone formation were significantly elevated. Diagnosis of Van Buchem disease was genetically confirmed. The cases are unique in that these are the first well-documented pediatric cases of Van Buchem disease. PMID:22445802

van Egmond, M E; Dikkers, F G; Boot, A M; van Lierop, A H J M; Papapoulos, S E; Brouwer, O F



The vagus nerve and the nicotinic anti-inflammatory pathway  

Microsoft Academic Search

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

Luis Ulloa



Third nerve palsy associated with preeclampsia and HELLP syndrome.  


Preeclampsia can cause myriad organ dysfunction, including cranial nerve palsies that pose diagnostic and management dilemmas. We present an unusual case of third nerve palsy, (presenting as diplopia, ptosis) with hypertension, hyperreflexia, proteinuria, easy bruising in a parturient at 34 + 6/52 weeks of twins gestation. She was treated as for severe preeclampsia and HELLP syndrome; intravenous magnesium sulphate and labetalol commenced and emergent cesarean delivery performed under general anesthesia due to concerns of low platelets and for airway protection should her glascow coma scale (GCS) deteriorate. Postoperatively, stroke, aneurysm and intra-cerebral causes of third nerve palsy were excluded, with subsequent recovery of symptoms upon blood pressure normalization. The eye signs are postulated to be due to two preeclamptic mechanisms involving disordered cerebral autoregulation: (1) hyperperfusion and breakdown of the blood-brain barrier that occurs with rising hypertension, causing fluid/blood product extravasation into brain parenchyma, or (2) focal reactive vasoconstriction and local hypoperfusion, contributed to by endothelial dysfunction. PMID:23478950

Chutatape, Anuntapon; Teoh, Wendy H L



Evidence for cranial endothermy in the opah (Lampris guttatus).  


Cranial endothermy evolved independently in lamnid sharks, billfishes and tunas, and is thought to minimize the effects of ambient temperature change on both vision and neural function during deep dives. The opah, Lampris guttatus, is a large epipelagic-mesopelagic predator that makes repeated dives into cool waters to forage. To determine if L. guttatus exhibits cranial endothermy, we measured cranial temperatures in live, decked fish and identified potential sources of heat and mechanisms to conserve heat. In 40 opah (95.1+/-7.6 cm fork length), the temperature of the tissue behind the eye was elevated by a mean (+/-s.e.m.) of 2.1+/-0.3 degrees C and a maximum of 6.3 degrees C above myotomal muscle temperature (T(m)), used as a proxy for ambient temperature. Cranial temperature varied significantly with T(m) and temperature elevation was greater at lower T(m). The proximal region of the paired lateral rectus extraocular muscle appears to be the primary source of heat. This muscle is the largest extraocular muscle, is adjacent to the optic nerve and brain and is separated from the brain only by a thin layer of bone. The proximal lateral rectus muscle is darker red in color and has a higher citrate synthase activity, indicating a higher capacity for aerobic heat production, than all other extraocular muscles. Furthermore, this muscle has a layer of fat insulating it from the gill cavity and is perfused by a network of arteries and veins that forms a putative counter-current heat exchanger. Taken together, these results support the hypothesis that the opah can maintain elevated cranial temperatures. PMID:19181893

Runcie, Rosa M; Dewar, Heidi; Hawn, Donald R; Frank, Lawrence R; Dickson, Kathryn A



Large facial nerve schwannomas without facial palsy: case reports and review of the literature  

Microsoft Academic Search

Although approximately 30% of facial nerve schwannoma cases present with no facial palsy, a large facial nerve schwannoma extending to the middle and posterior cranial fossa quite rarely presents without facial palsy. The authors encountered two patients with large facial nerve schwannoma who presented with only hearing impairment and no facial palsy. The first patient was a 64-year-old woman who

Yuichi Kubota; Takakazu Kawamata; Osami Kubo; Hidetoshi Kasuya; Yoshihiro Muragaki; Tomokatsu Hori



Phrenic nerve palsy in a patient of Churg Strauss syndrome and mononeuritis multiplex.  


Neurological manifestations like mononeuritis multiplex are seen commonly in patients with Churg Strauss syndrome. Cranial nerve involvement and central nervous system involvement are also reported, although infrequently. Phrenic nerve involvement has not been reported so far. We report a patient with Churg Strauss syndrome who presented with mononeuritis multiplex and developed left-sided phrenic nerve palsy subsequently. PMID:17786498

Sharma, Aman; Bambery, Pradeep; Bettadapura Shamanna, Suryanarayana; Wanchu, Ajay; Singh, Surjit



Anatomy of the extraneural blood supply to the intracranial oculomotor nerve  

Microsoft Academic Search

AIMS: An anatomical study was undertaken to determine the extraneural blood supply to the intracranial oculomotor nerve. METHODS: Human tissue blocks containing brainstem, cranial nerves II-VI, body of sphenoid, and associated cavernous sinuses were obtained, injected with contrast material, and dissected using a stereoscopic microscope. RESULTS: Eleven oculomotor nerves were dissected, the intracranial part being divided into proximal, middle, and

M Cahill; J Bannigan; P Eustace



Cranial Kinesis in Lepidosaurs: Skulls in Motion  

Microsoft Academic Search

This chapter reviews various aspects of cranial kinesis, or the presence of moveable joints within the cranium, with a concentration on lepidosaurs. Previous studies tend to focus on morphological correlates of cranial kinesis, without taking into account experimental evidence supporting or refuting the presence of the various forms of cranial kinesis in these taxa. By reviewing experimental and anatomical evidence,

Keith Metzger


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

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),

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



Congenital innervation dysgenesis syndrome (CID)/congenital cranial dysinnervation disorders (CCDDs)  

PubMed Central

Congenital loss of innervation to the extra-ocular muscles (EOMs) can have a profound effect on the target muscle. This has been well recognised in Duane's retraction syndrome. However, it has been less emphasised in other congenital oculo-motor disorders. Such congenital ocular motor defects have been expanded to include DRS, congenital fibrosis of EOMs, monocular elevation defect, Möbius syndrome, as well as several other non-ocular muscles supplied by cranial nerves such as facial muscles. Such loss of innervation to motor muscles can be unified as a defined clinical entity, which can be labelled as congenital innervation dysgenesis syndrome or CID for short. CID may also affect other muscles supplied by nerves other than the cranial nerves and may be sensory as well as motor.

Assaf, A A



Cranial components of startle behavior in larval and adult lampreys.  


Larval lampreys (Petromyzon marinus) exhibit a combination of cranial reflexes during their vibration-evoked startle response, including strong contractions of the gill chamber, velum and oral hood. These reflexes were confirmed by applying brief vibratory stimuli to an otic capsule and recording movement and electromyograms in moving preparations and efferent cranial nerve activity in curarized preparations. Vibration elicited efferent discharge in cranial nerves V, IX and X on both sides. The responses were lost following labyrinthectomy. The larval startle response results in water from the contracting gill chamber being expelled through the mouth and temporarily reduces head width. Reduced head width may facilitate the rapid withdrawal which is observed during startle behavior in burrowed larvae [S. Currie (1985) Neurosci. Abstr. 11, 268; S. Currie and R. C. Carlsen J. exp. Biol. (in Press)]. Adult lampreys (Entosphenus tridentata) attached to the wall of an aquarium by their suctorial disc, exhibited a brief but intense suction increase following a vibratory stimulus initiated by a tap to the aquarium wall. Oral suction (negative pressure) ranged from -0.6 to -10 cm H2O at rest and increased to values as high as -160 cm H2O during the vibration response. Suction intensity increased in direct proportion to the amplitude of the vibratory stimulus. Most of the suction response was lost following labyrinthectomy. Electromyographic recordings from the pharyngeal dilator m. basilaris and the lingual retractor m. cardioapicalis revealed stimulus-locked activity which preceded increased suction in adults, however, no vibration-evoked electromyogram responses were noted while recording from the gill chamber musculature or funnel. Stimulus-locked efferent activity was observed in the V-basilaris and V-apicalis branches of both trigeminal nerves following vibration of an otic capsule. Efferent vibration-evoked activity was lost in the trigeminal nerve after labyrinthectomy. No vibration-evoked activity was observed in nerves IX or X. Sudden vibration evoked dramatically different responses in larval and adult lampreys. Larvae contracted their gill chambers and expelled water from their mouths while adults exhibited a powerful suction reflex and no gill contraction. The trigeminal components of these behaviors (including velum and oral hood movement in larvae, pharynx and apicalis movement in adults) are difficult to compare. All of the larval trigeminal muscles degenerate during metamorphosis and are replaced by new adult muscles [M. W. Hardisty and C. M. Rovainen (1982) In The Biology of Lampreys, Vol. 4A. Academic Press, London].(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3362357

Currie, S N; Carlsen, R C



The controversy of cranial bone motion.  


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

Rogers, J S; Witt, P L



Recent Progress in Understanding Congenital Cranial Dysinnervation Disorders  

PubMed Central

Background In 2002 the new term congenital cranial dysinnervation disorder (CCDD) was proposed as a substitute for the traditional concept of congenital fibrosis of the extraocular muscles based on mounting genetic, neuropathology, and imaging evidence suggesting that many, if not all, of these disorders result from a primary neurologic maldevelopment rather than from a muscle abnormality. This report provides an update eight years after that original report. Evidence acquisition Review of pertinent articles published from Jan 2003 until June 2010 describing CCDD variants identified under PubMed MeSH terms congenital fibrosis of the extraocular muscles, congenital cranial dysinnervation disorders, individual phenotypes included under the term CCDD, and congenital ocular motility disorders. Results At present a total of seven disease genes and 10 phenotypes fall under the CCDD umbrella. A number of additional loci and phenotypes still await gene elucidation, with the anticipation that more syndromes and genes will be identified in the future. Identification of genes and their function, along with advances in neuro-imaging, have expanded our understanding of the mechanisms underlying several anomalous eye movement patterns. Conclusions Current evidence still supports the concept that the CCDDs are primarily due to neurogenic disturbances of brainstem or cranial nerve development. Several CCDDs are now known to have non-ophthalmologic associations involving neurologic, neuroanatomic, cerebrovascular, cardiovascular, and skeletal abnormalities.

Oystreck, Darren T.; Engle, Elizabeth C.; Bosley, Thomas M.



Is migraine with cranial nerve palsy an ophthalmoplegic migraine?  

Microsoft Academic Search

\\u000a Abstract\\u000a   Ophthalmoplegic migraine (OM) is a rare form of primary headache. Because of its rarity, only a few cases, mostly symptomatic,\\u000a are reported. We analyse nine cases among 52 973 adults who suffer from headaches with an oculomotor palsy firstly considered\\u000a as OM. The study was retrospective and multicentric in a database set up in France. The aim of our

Pierric Giraud; Dominique Valade; Michel Lanteri-Minet; Anne Donnet; Gilles Geraud; Evelyne Guégan-Massardier



Morphometric aspects of peripheral nerves in adults and the elderly.  


There have been inconsistencies among reports of age-related differences in human peripheral nerves (PNs). For such studies, normal control values are necessary. Moreover, the diversity of methods employed makes it difficult to compare results. We used the same histological procedures and methods to measure 12 PNs: 8 in the cranial nerves, 2 motor nerves in the lower limb, and 2 nerves in the autonomic system. We performed a morphometric analysis of nerve fibers and estimated the change in the total number (TN) and average transverse area (ATA) of myelinated axons from adulthood to old age. The spinal nerves demonstrated notable age-related changes in TN and ATA. Most of the cranial nerves also demonstrated notable age-related changes in TN and ATA. However, some nerves demonstrated no such age-related changes and were affected more by other factors. With regards to the autonomic nerves, the lesser splanchnic nerve indicated age-related changes in TN, but the greater splanchnic nerve indicated no age-related changes in either TN or ATA. The autonomic nerves were affected not only by the aging process but also by the pathological changes to the peripheral tissues that they innervate. PMID:17868247

Moriyama, Hiroshi; Amano, Kaori; Itoh, Masahiro; Shimada, Kazuyuki; Otsuka, Naruhito



Cranial mononeuropathy III - diabetic type  


... problems related to the nerves in the eye (neuro-ophthalmologist). ... Baloh RW. Neuro-ophthalmology. In: Goldman L, Ausiello D, eds. Cecil Medicine . 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 450.


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


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

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



Prophylactic Cranial Irradiation in Extensive Disease Small-Cell Lung Cancer: Short-Term Health-Related Quality of Life and Patient Reported Symptoms--Results of an International Phase III Randomized Controlled Trial by the EORTC Radiation Oncology and Lung Cancer Groups  

PubMed Central

Purpose Prophylactic cranial irradiation (PCI) in patients with extensive-disease small-cell lung cancer (ED-SCLC) leads to significantly fewer symptomatic brain metastases and improved survival. Detailed effects of PCI on health-related quality of life (HRQOL) are reported here. Patients and Methods Patients (age, 18 to 75 years; WHO ? 2) with ED-SCLC, and any response to chemotherapy, were randomly assigned to either observation or PCI. Health-related quality of life (HRQOL) and patient-reported symptoms were secondary end points. The European Organisation for the Research and Treatment of Cancer core HRQOL tool (Quality of Life Questionnaire C30) and brain module (Quality of Life Questionnaire Brain Cancer Module) were used to collect self-reported patient data. Six HRQOL scales were selected as primary HRQOL end points: global health status; hair loss; fatigue; and role, cognitive and emotional functioning. Assessments were performed at random assignment, 6 weeks, 3 months, and then 3-monthly up to 1 year and 6-monthly thereafter. Results Compliance with the HRQOL assessment was 93.7% at baseline and dropped to 60% at 6 weeks. Short-term results up to 3 months showed that there was a negative impact of PCI on selected HRQOL scales. The largest mean difference between the two arms was observed for fatigue and hair loss. The impact of PCI on global health status as well as on functioning scores was more limited. For global health status, the observed mean difference was eight points on a scale 0 to 100 at 6 weeks (P = .018) and 3 months (P = .055). Conclusion PCI should be offered to all responding ED SCLC patients. Patients should be informed of the potential adverse effects from PCI. Clinicians should be alert to these; monitor their patients; and offer appropriate support, clinical, and psychosocial care.

Slotman, Berend J.; Mauer, Murielle E.; Bottomley, Andrew; Faivre-Finn, Corinne; Kramer, Gijs W.P.M.; Rankin, Elaine M.; Snee, Michael; Hatton, Matthew; Postmus, Pieter E.; Collette, Laurence; Senan, Suresh



Traumatic facial nerve injuries: review of diagnosis and treatment.  


Both blunt and penetrating craniofacial trauma may lead to severe facial nerve injury and sequelae of facial paralysis. Initial evaluation involves quantitation of motor deficits using a clinical grading system, such as the House-Brackmann scale. High resolution computed tomography is used for localization of nerve injury in suspected cases of temporal bone trauma. In the absence of gross radiographic abnormalities, electrophysiologic testing helps predict the likelihood of spontaneous recovery. In patients with deteriorating facial nerve injuries by electroneuronography, surgical exploration is the preferred management. Primary end-to-end neurorrhaphy is the preferred management for transection injuries, while facial nerve decompression may benefit other forms of high-grade nerve trauma. Secondary facial reanimation procedures, such as cranial nerve crossovers, dynamic muscle slings or various static procedures, are useful adjuncts when initial facial nerve repair is unsuccessful or impossible. A review of facial nerve trauma management and case illustrations are presented. PMID:11951487

Davis, R E; Telischi, F F



[Nerve entrapment syndromes in athletes].  


Sports-related injuries most commonly involve the musculoskeletal system. However, physicians are less familiar with damage to the peripheral nerves attributable to particular sports activities. Nerve entrapment syndromes associated with physical activity may affect all nerves for which entrapment syndromes are known. Peripheral nerve lesions are serious and may delay or preclude the athletes' return to sports, especially in cases with a delayed diagnosis. The aim of the paper is to give an overview of chronic sports-related nerve lesions. Acute nerve injuries are not the focus of this review. A literature search regarding sports-related nerve lesions was conducted. Due to the lack of prospective epidemiological studies, case reports were included (evidence level 4). Nerve entrapment syndromes specific for particular sports activities are described including clinical presentation, diagnostic work-up and treatment. Repetitive and vigorous use or overuse makes the athlete vulnerable to disorders of the peripheral nerves, additionally sports equipment may cause compression of the nerves. The treatment is primarily conservative and includes modification of movements and sports equipment, shoe inserts, splinting, antiphlogistic drugs and local administration of glucocorticoids. Most often cessation of the offending physical activity is necessary. When symptoms are refractory to conservative therapy a referral to surgery is indicated. The outcome of surgical treatment regarding the return of the athlete to competitive sports is not sufficiently investigated in many nerve entrapment -syndromes.This article was primarily published in "Akt Neurol 2012; 6: 292-308". PMID:24030432

Reuter, I; Mehnert, S



Bnsu surveillance project: congenital cranial dysinnervation disorders.  


Congenital cranial dysinnervation disorders: including Duane syndrome, Möbius syndrome, congenital ptosis, congenital fibrosis of the external ocular muscles and Marcus Gunn jaw winking. Surveillance started for Duane syndrome (prevalence 1:10000) and expanded to include other less common congenital cranial dysinnervation disorders: Möbius syndrome, congenital ptosis, congenital fibrosis of the external ocular muscles (CFEOM) and Marcus Gunn jaw winking. It is UK Clinical Research Network approved as a comprehensive study (number 4477). The name Congenital Cranial Dysinnervation Disorders (CCDDs) was chosen at the 110th European Neuromuscular Centre International Workshop in 2002, initiated by Nick Gutowski, reflecting the belief that there is a group of disorders resulting from developmental errors in ocular and facial muscle innervation that could have a genetic basis. An international consortium was formed to study these congenital neuromuscular diseases characterised by abnormal eye, eyelid, and/or facial movement. The aim is to determine those genes which contribute to CCDDs and to delineate their function. The study is straightforward for notifying clinicians: it involves keeping a note of patients, BNSU notification, passing on initial study information to the patient and providing clinical information to Exeter when patient consent is forthcoming. On receiving BNSU notification, study information is sent to the notifying clinician from Exeter to pass onto their patient. If the patient is willing to be contacted then consent will be requested from Exeter for study inclusion. When consent is obtained, relevant clinical details are requested from clinicians, including the general practitioner. Patients are asked whether other family members may be willing to help using, initial contact through the patient. Obtaining DNA samples is straightforward and painless; spit pots (assisted sample pots for young children) are provided from Exeter and processed in Exeter. DNA is processed in the Molecular Genetics Laboratory, Royal Devon and Exeter Foundation Hospital. The laboratory led by Professor Sian Ellard is a leading edge research laboratory and an NHS diagnostic laboratory, allowing known CCDD genes (currently CHN1, SALL4, HOXA1, KIF21A, TUBB3, ROBO3) to be provided as a diagnostic service to UK clinicians. Functional work is undertaken by Dr John Chilton, University of Exeter Medical School with collaborators in King's College London and Harvard. With BNSU help and other reporting sources by December 2012, 463 DNA samples were obtained from those with a CCDD and control family members (77% Duane's related samples, including 19 Duane families). Referring clinicians and their associations include Clinical Geneticists, Ophthalmologists and Orthoptists, with some direct approaches from patients. With collaborators we have been able to confirm the genetic cause of CCDDs in patients and families, aiding diagnostic certainty, but the function of the known genes still needs to be elucidated fully. Further genes await discovery. Understanding CCDDs provide a means to decipher how the myriad of intricate nervous system connections develop and are maintained. Despite many thousands of gene products that must be involved in brain wiring, there are few examples of the identification of genes responsible in humans. Studying eye muscle innervation is a relatively straightforward anatomical system in which to generate and test hypotheses about how nerves find their correct target during development. Support has kindly been provided by The Northcott Devon Medical Foundation, The Royal Society, The Wellcome Trust and the NIHR. PMID:24109047

Gutowski, Nick



Cranial reossification with absorbable plates.  


The purpose of this study was to examine the effect of Lactosorb absorbable plates on bone healing across cranial bone defects in the rabbit skull. Two 10-mm diameter parietal skull defects were created in each of 20 rabbits, with one defect being placed on either side of the sagittal suture. In 10 rabbits, an absorbable plate was placed across both the inner and outer cortices of the left defect, and in the other 10 rabbits, an absorbable plate was placed across the outer cortex only of the left defect. The right defect always served as the control side, with no plate being placed across it. Rabbits were killed an average of 25 weeks postoperatively. Areas of reossification in the experimental and control defects of each rabbit were then measured, examined histologically, and compared. Growth across defects spanned by one plate was also compared with growth across defects spanned by two plates. Histologic and statistical analyses revealed no significant differences in reossification between the control and experimental defects in each animal and between the defects spanned by one versus two plates. This study suggests that these copolymer absorbable plates neither inhibit nor facilitate reossification across 10-mm diameter rabbit cranial defects. PMID:11304603

Ascherman, J; Knowles, S; Marin, V; Prisant, N; Hu, G; Chiu, D T



Parkinson disease affects peripheral sensory nerves in the pharynx.  


Dysphagia is very common in patients with Parkinson disease (PD) and often leads to aspiration pneumonia, the most common cause of death in PD. Current therapies are largely ineffective for dysphagia. Because pharyngeal sensation normally triggers the swallowing reflex, we examined pharyngeal sensory nerves in PD patients for Lewy pathology.Sensory nerves supplying the pharynx were excised from autopsied pharynges obtained from patients with clinically diagnosed and neuropathologically confirmed PD (n = 10) and healthy age-matched controls (n = 4). We examined the glossopharyngeal nerve (cranial nerve IX), the pharyngeal sensory branch of the vagus nerve (PSB-X), and the internal superior laryngeal nerve (ISLN) innervating the laryngopharynx. Immunohistochemistry for phosphorylated ?-synuclein was used to detect Lewy pathology. Axonal ?-synuclein aggregates in the pharyngeal sensory nerves were identified in all of the PD subjects but not in the controls. The density of ?-synuclein-positive lesions was greater in PD patients with dysphagia versus those without dysphagia. In addition, ?-synuclein-immunoreactive nerve fibers in the ISLN were much more abundant than those in cranial nerve IX and PSB-X. These findings suggest that pharyngeal sensory nerves are directly affected by pathologic processes in PD. These abnormalities may decrease pharyngeal sensation, thereby impairing swallowing and airway protective reflexes and contributing to dysphagia and aspiration. PMID:23771215

Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Nyirenda, Themba; Adler, Charles H; Shill, Holly A; Caviness, John N; Samanta, Johan E; Sue, Lucia I; Beach, Thomas G



Nerve and Nerve Root Biomechanics  

Microsoft Academic Search

\\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

Kristen J. Nicholson; Beth A. Winkelstein


The management of cranial injuries in antiquity and beyond.  


Cranial injuries were among the earliest neurosurgical problems faced by ancient physicians and surgeons. In this review, the authors trace the development of neurosurgical theory and practice for the treatment of cranial injuries beginning from the earliest ancient evidence available to the collapse of the Greco-Roman civilizations. The earliest neurosurgical procedure was trephination, which modern scientists believe was used to treat skull fractures in some civilizations. The Egyptian papyri of Edwin Smith provide a thorough description of 27 head injuries with astute observations of clinical signs and symptoms, but little information on the treatment of these injuries. Hippocrates offered the first classification of skull fractures and discussion of which types required trephining, in addition to refining this technique. Hippocrates was also the first to understand the basis of increased intracranial pressure. After Hippocrates, the physicians of the Alexandrian school provided further insight into the clinical evaluation of patients with head trauma, including the rudiments of a Glasgow Coma Scale. Finally, Galen of Pergamon, a physician to fallen gladiators, substantially contributed to the understanding of the neuroanatomy and physiology. He also described his own classification system for skull fractures and further refined the surgical technique of trephination. From the study of these important ancient figures, it is clearly evident that the knowledge and experience gained from the management of cranial injuries has laid the foundation not only for how these injuries are managed today, but also for the development of the field of neurosurgery. PMID:17961060

Kshettry, Varun R; Mindea, Stefan A; Batjer, H Hunt



Nerve conduits for nerve reconstruction  

Microsoft Academic Search

Although autogenous nerve grafting remains the gold standard for repair of peripheral nerve defects, the use of various conduits can be a substitute provided these conduits meet the above-mentioned prerequisites. For the moment, autogenous vein grafts or denatured muscle grafts can be used to bridge short defects, especially in distal sensory nerves. Incorporation of muscle into a vein graft expands

Huan Wang; William C. Lineaweaver



Malignant peripheral nerve sheath tumor of the trigeminal nerve: Clinicopathologic features in a young adult patient.  


Malignant peripheral nerve sheath tumors (MPNSTs) arising from cranial nerves are rare and usually affect adults. Here we report the clinicopathologic features of a young adult patient with a trigeminal nerve MPNST, in whom another tumor involving the oculomotor nerve on the contralateral side was evident. The patient, an 18-year-old woman, had suffered recurrent paroxysmal sharp stabbing pain over her cheek and forehead on the right side for 1 month. A brain MRI study disclosed a mass, 35?mm in diameter, in the right Meckel's cave, and another mass, 10?mm in diameter, involving the intracranial portion of the left oculomotor nerve. Following gadolinium administration, the former and latter tumors exhibited strong and weak enhancement, respectively. The patient had no clinical stigmata characteristic of neurofibromatosis type 1. Following a tentative diagnosis of schwannoma, total resection of the trigeminal nerve tumor was performed. Histologically, the tumor consisted of highly cellular, spindle-shaped cells arranged in a fascicular pattern, with occasional mitotic figures, nuclear pleomorphism and necrosis. Immunohistochemically, the tumor cells showed variable intensities and frequencies of reactivity for S-100 protein, myelin basic protein, CD34, podoplanin and p53, but no reactivity for Smarcb1. Thus, the tumor exhibited features of MPNST. This case appears to provide information that is useful for accurate diagnosis and surgical planning in patients with bilateral or multiple cranial nerve tumors. PMID:23279368

Nakayama, Yoko; Watanabe, Masatoshi; Suzuki, Kenji; Usuda, Hiroyuki; Emura, Iwao; Ogura, Ryosuke; Shiga, Atsushi; Toyoshima, Yasuko; Takahashi, Hitoshi; Kawaguchi, Tadashi; Kakita, Akiyoshi



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

SciTech Connect

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.

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



Arachnoid cyst of the cranial posterior fossa causing sensorineural hearing loss and tinnitus: a case report  

Microsoft Academic Search

Arachnoid cysts are developmental collections of cerebrospinal fluid covered by layers of arachnoidal epithelium and are usually located in the middle cranial fossa. Localizations in the posterior fossa are uncommon and generally remain asymptomatic or cause vague and non-specific symptoms. We here report the unusual case of a young patient with an arachnoid cyst of the posterior fossa that had

Francesco Ottaviani; Cesare Bartolomeo Neglia; Alberto Scotti; Pasquale Capaccio



[Lipofibromatous hamartoma of the median nerve].  


Lipofibromatous hamartoma of the nerve is a very uncommon, congenital, benign, peripheral nerve tumor. It is mostly encountered in the extremities of young adults, involving the median nerve in the majority of cases. The nerve tissue is infiltrated by diffuse fibroadipose tissue which dissociates the fasciculi without invasion. Patients with lipofibromatous hamartoma of the median nerve usually present with symptoms of carpal tunnel syndrome, usually accompanied by marked macrodactyly. Lipofibromatous hamartoma of the median nerve was encountered in an 18-year-old female patient, involving the wrist, causing macrodactyly of the index finger, and resulting in symptoms of carpal tunnel syndrome. Median nerve release and partial excision of the adipose tissue along the mass were performed. Fourteen months postoperatively, the patient had no complaints and the mass decreased in size without any motor or sensory functional losses. PMID:12510101

Bagatur, A Erdem



Clival giant cell tumor presenting with isolated trigeminal nerve involvement.  


Giant cell tumour (GCT) constitutes about 5 % of all skeletal tumors. They rarely occur in the skull. When involved, they preferentially involve the sphenoid or temporal bones. Skull-base GCTs generally present with multiple cranial nerves involvement, most commonly sixth followed by the third cranial nerve. We describe a case of clival GCT presenting with an isolated trigeminal nerve involvement in a 19-year-old man which was managed by surgery and adjuvant radiation. At 18 months of follow-up, the patient is clinically asymptomatic. Clival GCT should also be considered in the differential diagnosis of any isolated trigeminal nerve palsy. Adjuvant radiation has an important role to play in managing this tumour. PMID:23143505

Roy, Soumyajit; Joshi, Nikhil P; Sigamani, Elanthenral; Malik, Anita; Sharma, Meher C; Mohanti, Bidhu K; Sharma, Suresh C



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

Microsoft Academic Search

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

James L. Herrick; Joyce Keifer



Hypoglossal nerve paralysis in a burn patient following mechanical ventilation  

PubMed Central

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

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



A Unique Case of Intradural Communicating Branches between the Accessory Nerve and the Dorsal Roots of the Cervical Spinal Nerves.  


Objective The accessory nerve has cranial and spinal roots. The cranial roots emerge from the medulla, whereas the spinal roots arise from motor cells within the ventral horn of C1-C7 segments of the spinal cord. Communications have been described between the spinal accessory nerve rootlets and the dorsal rootlets of cervical spinal nerves. In the present case, we report a communication that has not been reported before and discuss the functional anatomy.Materials and Methods During the dissection of the craniovertebral junction of a 67-year-old formalin-fixed adult male cadaver, a connection between the spinal accessory nerve rootlets and the dorsal rootlets of the cervical spinal nerves was observed.Results A communication between the spinal rootlets of the accessory nerve and the dorsal roots of cervical spinal nerves was present on the right and left side. On the right, a communication between the accessory nerve spinal rootlet and the dorsal rootlet of the fourth cervical spinal nerve existed. On the left, there were two branches from the lowest accessory nerve spinal rootlet, one run ventrally and the other dorsally to the spinal rootlet and reached the dorsal root of third cervical spinal nerve. The dorsal root of C1 did not exist on either the right or the left side. Further, an unusual spinal accessory nerve formation was also observed.Discussion This case does not fit into any of the previously described classifications in the literature. Therefore, the different variations concerning the communications between the spinal rootlets of the accessory nerve and the cervical spinal nerves should be kept in mind during both surgical, especially radical neck dissections, and nonsurgical evaluations. PMID:23397124

Seker, A?k?n; Ceylan, Davut; Tatarl?, Necati; Abdullaev, Tuychiboy; Gülbar, Seda; Konya, Deniz; Bayri, Yasar; Kele?, Evren; K?l?ç, Türker; Cavdar, Safiye



Peripheral Nerve Tumors  

Microsoft Academic Search

\\u000a Peripheral nerve tumors (PNTs) are rare soft tissue lesions that can arise anywhere on the body and as a result have a wide\\u000a differential diagnosis, which is often confirmed to be a PNT only at surgery. PNTs occur both sporadically and within the\\u000a context of genetically predisposing syndromes; hence, a thorough history of the mass and associated symptoms, with a

Joseph Wiley; Asis Kumar Bhattacharyya; Gelareh Zadeh; Patrick Shannon; Abhijit Guha


Toxic Epidermal Necrolysis Associated with Antiepileptic Drugs and Cranial Radiation Therapy  

PubMed Central

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

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



Nerve agents: implications for anesthesia providers.  


Anesthesia providers may be called to treat injuries from chemical weapons or spills, for which prompt treatment is vital. It is therefore important to understand the mechanism of action of nerve agents and the resultant pathophysiology and to be able to quickly recognize the signs and symptoms of nerve agent exposure. This review article addresses the different types of nerve agents that are currently being manufactured as well as the symptomatic and definitive treatment of the patient who presents with acute nerve agent toxicity. This article also reviews the physiology of the neuromuscular junction and the autonomic nervous system receptors that nerve agent toxicity affects. PMID:18478812

Hrobak, Paula Kay



CT measurments of cranial growth: normal subjects  

SciTech Connect

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

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



[Computed tomography and cranial paleoanthropology].  


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

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



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

Microsoft Academic Search

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)

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



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

PubMed Central

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



Reconsideration of the autonomic cranial ganglia: an immunohistochemical study of mid-term human fetuses.  


The cranial parasympathetic ganglia have been reported to paradoxically contain the sympathetic nerve marker, tyrosine hydroxylase (TH), in addition to neurons expressing parasympathetic markers such as vasoactive intestinal peptide (VIP) and neuronal nitric oxide synthase (nNOS). However, the distribution of these molecules in the cranial ganglia of human fetuses has not yet been examined. Using paraffin sections from 10 mid-term human fetuses (12-15 weeks), we performed immunohistochemistry for TH, VIP, and nNOS in the parasympathetic ciliary, pterygopalatine, otic, and submandibular ganglia, and for comparison, the sensory inferior vagal ganglion. The ciliary and submandibular ganglia contained abundant TH-positive neurons. In the former, TH-positive neurons were much more numerous than nNOS-positive neurons, whereas in the latter, nNOS immunoreactivity was extremely strong. No or a few cells in the pterygopalatine, otic, and inferior vagal ganglia expressed TH. Ciliary TH neurons appeared to compensate for classically described sympathetic fibers arising from the superior cervical ganglion, whereas in the submandibular ganglion, nNOS-positive neurons as well as TH neurons might innervate the lingual artery in addition to the salivary glands. Significant individual variations in the density of all these markers suggested differences in sensitivity to medicine affecting autonomic nerve function. Consequently, in the human cranial autonomic ganglia, it appears that there is no simple dichotomy between sympathetic and parasympathetic function. PMID:22095632

Kiyokawa, Hiromichi; Katori, Yukio; Cho, Kwang Ho; Murakami, Gen; Kawase, Tetsuaki; Cho, Baik Hwan



Facial nerve hemangioma: a case report.  


Although hemangiomas are relatively common in the head and neck, those that originate in the facial nerve are extremely rare. These benign tumors have the potential to compress or invade the adjacent facial nerve and thereby produce facial paralysis and other associated symptoms. We present a case of facial nerve hemangioma in a 15-year-old girl that initially manifested as unilateral facial weakness. We also discuss the diagnostic imaging and management options. PMID:23780592

Wu, Edward C; Rothholtz, Vanessa S; Zardouz, Shawn; Lee, Alice D; Djalilian, Hamid R



Intracranial Hypertension after Cranial Vault Decompression for Craniosynostosis  

Microsoft Academic Search

A 3-year-old boy with chronic papilledema, bilateral coronal synostosis and Pfeiffer syndrome underwent an orbitofrontal advancement. One month post-operatively, his papilledema had resolved, however, his vision progressively deteriorated over the ensuing 3 months to legal blindness. He had no symptoms or signs of increased pressure. Multiple imaging studies were unremarkable except for dilatation of the optic nerve sheaths. A lumbar

Jeffrey W. Campbell; A. Leland Albright; Wolfgang Losken; Albert W. Biglan



Giant left middle fossa VII nerve schwannoma associated with amnesia.  


The facial nerve is the third most frequent location of intracranial schwannomas, with facial paresis the most common sign.(1,2) A 77-year-old woman presented with amnesia; the Mini-Mental State Examination score was 26, with normal cranial nerve function. A giant multicystic VII nerve schwannoma was identified in the left middle fossa, with components of the tumor in the temporal bone facial canal, geniculate ganglion, and internal auditory canal (figure). Compression of the hippocampus may have accounted for the clinical presentation. The middle fossa component of the tumor was resected for mass effect relief, with iatrogenic facial palsy. PMID:23918862

Cunha, André; Seixas, Daniela; Mascarenhas, Lino; Resende, Mário; Furtado, Antónia; Figueiredo Ribeiro, António Rui



Total facial nerve decompression: technique to avoid complications.  


Exposure of the facial nerve from the brainstem to the parotid can be accomplished without injury to the nerve, tympanic membrane, external auditory canal, ossicular chain, inner ear or structures within the cerebello-pontine angle. The procedure has reliably provided good results for patients who have had the proper indications with facial paralysis from Bell's palsy, herpes zoster oticus, infection, hemi-facial spasm, temporal bone fracture and tumors. The current technique for exposure through the mastoid, middle cranial fossa and retrolabyrinthine combined approaches are described. This technique, properly performed, is a valuable treatment for facial nerve lesions. PMID:8764701

Pulec, J L



Pinched Nerve  


... take about one hour: Nerve conduction study. Patch-style electrodes are placed on your skin to stimulate ... not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not ...


Nerve Injuries  


... educated." After the nerve has recovered, sensory re-education may be needed to improve feeling to the hand or finger. This involves physician therapy and the appropriate therapy based on the nature of the injury will be recommended ...


Nerve conduction  

MedlinePLUS Videos and Cool Tools

... fascicles) that contain hundreds of individual nerve fibers (neurons). Neurons consist of dendrites, axon, and cell body. The ... tree-like structures that receive signals from other neurons and from special sensory cells that sense the ...


Middle cranial fossa cystic schwannoma.  


The authors present the unusual case of a 37-year-old man, with a history of hepatitis C, presenting with a 3 year history of progressive trigeminal, facial and vestibular nerve defects. Intracranial imaging demonstrated a cystic middle and posterior fossa lesion, that was ultimately diagnosed as a cystic trigeminal schwannoma. Due to the uncertainties of diagnosis he was managed in two stages with an open biopsy and then a subsequent partial resection. Surveillance of the tumour remnant is planned. The rare nature of this diagnosis is discussed, along with the more common findings in intracranial schwannoma, and the wide differential to be considered. Briefly, the authors describe the surgical option for a complex multi-fossa schwannoma and the importance of the multi-disciplinary team in the diagnosis and management of such patients. PMID:22778464

Acharya, Vikas; Williams, Adam; Adams, William; Hilton, David; Whitfield, Peter C



Laparoscopic obturator nerve neurolysis after pelvic lymphadenectomy  

Microsoft Academic Search

Postoperative neuropathy is a known complication of major pelvic oncologic surgery. Obturator nerve injury complicating pelvic lymph node dissection has been reported in the literature. Severity and duration of symptoms are determined by the severity of the initial nerve lesion. Different management options have been described in the literature. We report here on a patient who developed right obturator neuropathy

Arash Rafii; Denis Querleu



Symmetric Lipofibromatous Hamartoma Affecting Digital Nerves  

PubMed Central

Lipofibromatous hamartoma of the nerve is a benign tumor, which affects the major nerves and their branches in the human body. It is often found in the median nerve of the hand and is commonly associated with macrodactyly, but it is rarely found in the digital nerves at the peripheral level. This tumor is often found in young adults and may go through a self-limiting course. However, operation is indicated when the tumor size is large or when the associated nerve compressive symptoms are present. We have experienced a rare case of lipofibromatous hamartoma that symmetrically involved the volar digital nerves of both index fingers on the ulnar side. With the aid of a microscope, we dissected and removed the tumor as much as possible without sacrificing the nerve. No sensory change occurred in both fingers and no sign of recurrence was observed upon follow-up.

Jung, Sung-No; Yim, Youngmin



Social attitudes toward shaving for cranial neurosurgery.  


Unshaved cranial neurological surgery has been successfully performed at Songklanagarind Hospital. However, within the Buddhist community, shaving is one of the traditional procedures for cleanliness and purification, and the unshaved method may have a cultural effect on social beliefs. Knowledge of social attitudes toward shaving or not shaving for cranial neurological surgery has implications for informed consent process prior to cranial operation. The attitudes of shaving were surveyed in the communities of Songkhla Province where Songklanagarind Hospital is situated. Of 1128 respondents, the female to male ratio was 3:2, their age was mostly under 40 years old and 91% were Buddhist. Sixty per cent of the respondents were in favour of shaving. After knowing the equivalent result of surgery either by shaved or unshaved method, the group favouring unshaved cranial surgery increased from 12 to 37%. Statistical analysis, through ordinal and multinomial logit, identified the young age, female and more educated who needed to socialize, and frequently meet many people were the groups who preferred or were ready to change their choice to the unshaved method. The neurosurgeon should give an advice to the patient not only the indications and results of surgery, but also a choice of shaved or unshaved cranial neurological surgery. PMID:11360376

Ratanalert, S; Sriplung, H



Inhalational exposure to nerve agents.  


The respiratory system plays a major role in the pathogenesis of nerve agent toxicity. It is the major route of entry and absorption of nerve agent vapor, and respiratory failure is the most common cause of death follow-ing exposure. Respiratory symptoms are mediated by chemical irritation,muscarinic and nicotinic receptor overstimulation, and central nervous system effects. Recent attacks have demonstrated that most patients with an isolated vapor exposure developed respiratory symptoms almost immediately. Most patients had only mild and transient respiratory effects, and those that did develop significant respiratory compromise did so rapidly. These observations have significant ramifications on triage of patients in a mass-casualty situation, because patients with mild-to-moderate exposure to nerve agent vapor alone do not require decontamination and are less likely to develop progressive symptoms following initial antidote therapy. Limited data do not demonstrate significant long-term respiratory effects following nerve agent exposure and treatment. Provisions for effective respiratory protection against nerve agents is a vital consideration in any emergency preparedness or health care response plan against a chemical attack. PMID:15062227

Niven, Alexander S; Roop, Stuart A



The Relative Concentration of Solids in the Nucleolus, Nucleus, and Cytoplasm of the Developing Nerve Cell of the Chick  

Microsoft Academic Search

Growing and differentiating nerve cells of the fifth cranial ganglion of the chick embryo were studied by several means. During the period of 70 hours to 11 days of incubation (Hamburger-Hamilton stages 19 to 37) average cell mass increased more than 4.5 times while cells changed from relatively undifferentiated neuroblasts to morphologically characteristic nerve cells with long processes. By making

R. W. Merriam; WILLIAM E. KOCH



Cranial and non-cranial embolism: incidence in hospitalised patients in Germany.  


Using the information of the federal statistics, a detailed description of the hospitalisation rate for cranial and non-cranial embolic events in Germany is given for the years 2005-2010. Detailed lists of the ICD codes I63.0 (stroke) and I74 (arterial embolism and thrombosis) as principal diagnosis and of I48.0 (atrial fibrillation) as additional diagnosis for the years 2005-2010 were provided by the Federal Statistical Office. In the 6 years period total number of cases hospitalised for stroke increased by 24 % (from 185.026 to 229.798) and those hospitalised for embolic events by 60 % (from 64,106 to 92,428). The number of atrial fibrillation as a major cause of arterial embolism documented as additional diagnosis increased by 38 % (from 1.06 to 1.48 Mio). Considering the rate per 100,000 inhabitants, intra-cranial embolism showed the most relevant increase with about 56 % since 2005. Cranial embolism is around 2.5 to 4 times more frequent than non-cranial embolism in females aged 70 to 80 years, but only two times in females aged 40-50, 50-60 and 90 years and older. Males showed a similar distribution with a broader peak. From 2005 to 2010 the total number of embolic events increased, with a higher increase in cranial embolism compared to non-cranial embolism. PMID:23381463

Moysidis, Theodoros; Santosa, Frans; Stallinger, Christian; Kröger, Knut



Repair of a median nerve transection injury using multiple nerve transfers, with long-term functional recovery.  


Complete loss of median nerve motor function is a rare but devastating injury. Loss of median motor hand function and upper-extremity pronation can significantly impact a patient's ability to perform many activities of daily living independently. The authors report the long-term follow-up in a case of median nerve motor fiber transection that occurred during an arthroscopic elbow procedure, which was then treated with multiple nerve transfers. Motor reconstruction used the nerves to the supinator and extensor carpi radialis brevis to transfer to the anterior interosseous nerve and pronator. Sensory sensation was restored using the lateral antebrachial cutaneous (LABC) nerve to transfer to a portion of the sensory component of the median nerve, and a second cable of LABC nerve as a direct median nerve sensory graft. The patient ultimately recovered near normal motor function of the median nerve, but had persistent pain symptoms 4 years postinjury. PMID:22978538

Murphy, Rory K J; Ray, Wilson Z; Mackinnon, Susan E



Afferents of cranial sensory ganglia pathfind to their target independent of the site of entry into the hindbrain.  


In vertebrates, sensory neurons interconnect a variety of peripheral tissues and central targets, conveying sensory information from different types of sensory receptors to appropriate second-order neurons in the central nervous system (CNS). To explore the possibility that the different rhombomere environments where sensory neurons enter into the hindbrain affect the pathfinding capability of growth cones, we studied the development of the VIIIth ganglion afferent both in vivo and in vitro. We focused on the vestibular nerve because it is the only cranial nerve projecting to the cerebellum, allowing for ready identification from its pattern of projection. Embryonic rat brain was cut along the dorsal midline and, with the VIIIth and Vth ganglia still attached, flat mounted and visualized with antibodies specific for sensory ganglia. Axons reached the cerebellar primordium at embryonic day (E) 13, then splayed out towards the edges of the rhombic lip of rostral hindbrain. In vitro, the VIIIth ganglion showed development similar to that in vivo and innervated the cerebellum, an appropriate target, indicating that mechanisms for axon guidance and target recognition are preserved in vitro. When the VIIIth ganglion was transplanted to the position of the Vth ganglion, axons from the transplanted ganglion entered the cerebellar primordium with a trajectory characteristic of the VIIIth nerve. These results indicate that the central projection pattern of the VIIIth nerve is not affected by the environment of nerve entry into the brainstem, suggesting that axons of sensory cranial ganglion intrinsically possess the capacity to find their target correctly. PMID:10701868

Tashiro, Y; Endo, T; Shirasaki, R; Miyahara, M; Heizmann, C W; Murakami, F



38 CFR 4.123 - Neuritis, cranial or peripheral.  

Code of Federal Regulations, 2013 CFR

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



Pudendal nerve decompression in perineology : a case series  

Microsoft Academic Search

BACKGROUND: Perineodynia (vulvodynia, perineal pain, proctalgia), anal and urinary incontinence are the main symptoms of the pudendal canal syndrome (PCS) or entrapment of the pudendal nerve. The first aim of this study was to evaluate the effect of bilateral pudendal nerve decompression (PND) on the symptoms of the PCS, on three clinical signs (abnormal sensibility, painful Alcock's canal, painful \\

Jacques Beco; Daniela Climov; Michèle Bex



21 CFR 882.5970 - Cranial orthosis.  

Code of Federal Regulations, 2013 CFR

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



Cranial Bone Fixation in Infants and Children  

Microsoft Academic Search

A technique is described for fixing cranial bone flaps with absorbable sutures and bone shims. This technique is a cost-efficient method of rapidly achieving rigid structural stability with excellent cosmetic results. The kerf created by the craniotome is bridged at multiple sites by bone chips harvested from the inner edge of the bone flap. Solid bony union is documented on

Ken R. Winston; Marjorie C. Wang



Hemimasticatory spasm --a peripheral paroxysmal cranial neuropathy?  

PubMed Central

The clinical and electrophysiological features of a case of hemimasticatory spasm are presented. The findings are in many respects similar to those described in hemifacial spasm. A peripheral cranial neuropathy as proposed in hemifacial spasm also may be responsible for hemimasticatory spasm. Images

Thompson, PD; Carroll, WM



The first 5 minutes after greater occipital nerve block.  


We performed greater occipital nerve blocks on 24 migraineurs with unilateral migraine and trigeminal nerve distribution allodynia. Using a visual analog scale for migraine pain, brush allodynia in the trigeminal nerve distribution and photophobia were reduced 64%, 75%, and 67%, respectively, after 5 minutes. Allodynia improved faster than headache. The results of this study suggest that greater occipital nerve blocks initiate an inhibitory process that shuts down several symptom generators. PMID:18549410

Young, William; Cook, Brianna; Malik, Shahram; Shaw, James; Oshinsky, Michael



Cranial pneumatic anatomy of Ornithomimus edmontonicus (Ornithomimidae: Theropoda)  

Microsoft Academic Search

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

Rui Tahara; Hans C. E. Larsson



Nerve Racking  

NSDL National Science Digital Library

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.

Integrated Teaching And Learning Program


Pharmacological characterisation of the spared nerve injury model of neuropathic pain  

Microsoft Academic Search

The spared nerve injury (SNI) model involves a lesion of two of the three terminal branches of the sciatic nerve (tibial and common peroneal nerves) leaving the sural nerve intact. The changes in pain-like sensation of the injured animals appear to correlate with a number of symptoms presented in human patients with neuropathic pain syndromes. In order to characterise the

Helle Kirstein Erichsen; Gordon Blackburn-Munro



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

PubMed Central

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.

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



Peripheral nerve regeneration through optic nerve grafts  

Microsoft Academic Search

Grafts of optic nerve were placed end-toend with the proximal stumps of severed common peroneal nerves in inbred mice. It was found that fraying the proximal end of adult optic nerve grafts to disrupt the glia limitans increased their chances of being penetrated by regenerating peripheral nerve fibres. Suturing grafts to the proximal stump also enhanced their penetration by axons.

P. N. Anderson; P. Woodham; M. Turmaine



Facial nerve palsy—an unusual complication after evacuation of a subdural haematoma or hygroma in children  

Microsoft Academic Search

Objective  This paper reports and discusses on the possible etiology of postoperative contralateral facial nerve palsy after uneventful evacuation of a subdural haematoma or hygroma after mild head trauma in two children with pre-existing middle cranial fossa subarachnoid cysts.Results  Two 14- and 15-year-old boys had prolonged headaches after mild head injuries. CT showed a right-sided middle cranial fossa arachnoid cyst in each

Andrea Klein; Bettina Balmer; Ulrike Brehmer; Thierry A. G. M. Huisman; Eugen Boltshauser



Considerations in nerve repair  

Microsoft Academic Search

ome nerve injuries require repair in order to regain sen- sory or motor function. Although this article focuses pri- marily on trigeminal nerve (TN) injuries and repairs, the facts presented may apply to any peripheral nerve repair. The primary indications for nerve repair or grafting are 1) an injury or continuity defect in a nerve, as a result of trauma,



Giant dumbbell-shaped intra- and extracranial nerve schwannoma in a child presenting with glossopharyngeal neuralgia syncope syndrome: a case report and review of the literature.  


Lower cranial nerve schwannomas are benign tumors of the neurolemmocytes of the cranial nerves. Among children, cranial nerve schwannomas are extremely rare and are predominantly associated with neurofibromatosis (NF) type 2. The purpose of the current case report is to describe a unique giant extra- and intracranial foramen jugular schwannoma in a young boy with lower cranial nerve deficits and glossopharyngeal neuralgia syncope syndrome and to review the pertinent literature. In the current case report, we illustrate the course of disease in a 14-year-old boy with a 4-month history of recurrent syncope and a big bulge on the left side of his neck. Audiometry showed deafness of the left ear. Magnetic resonance imaging (MRI) demonstrated a giant unilateral dumbbell-shaped intra- and extracranial foramen jugular schwannoma with a volume of 156 cm3 causing severe brain stem compression and obstructive hydrocephalus. The tumor was removed completely in a two-step surgery. The tumor was confirmed during surgery to originate from the glossopharyngeal nerve. The histological examination revealed the characteristic features of a schwannoma. The MRI 3 months after the second surgery confirmed complete tumor removal. The genetic examination for NF was negative. Review of literature showed that dumbbell-shaped lower cranial nerve schwannomas in the childhood population are rare. PMID:23104590

Sarikaya-Seiwert, Sevgi; Klenzner, Thomas; Schipper, Jörg; Steiger, Hans-Jakob; Haenggi, Daniel



Rathke's cleft cyst presenting as bilateral abducens nerve palsy.  


We present a patient with a Rathke's cleft cyst who presented with rapidly progressive bilateral 6th nerve palsy. A 20-year-old woman with a history of cleft palate, hypertension, and hydronephrotic kidneys presented with a one month history of headache, associated with dizziness and diplopia on horizontal gaze. Examination was significant for profound bilateral 6th nerve palsies. Magnetic resonance imaging showed a hypodense mass that filled the sella and compressed the right cavernous sinus without contacting the optic chiasm. Pituitary function was normal. An endoscopic, transnasal transsphenoidal resection of the lesion was performed; microscopic examination revealed a Rathke's cleft cyst. Surgical excision resulted in near complete resolution of the bilateral 6th nerve palsy. Rathke's cleft cysts are an unusual cause of bilateral sixth nerve palsy and represent a potential cause of cranial neuropathy. PMID:19621262

Grover, Vinni; Hamrahian, Amir H; Prayson, Richard A; Weil, Robert J



Are the post-inspiratory neurons in the decerebrate rat cranial motoneurons or interneurons?  


We examined the membrane potentials of 63 respiratory neurons in the ventrolateral medulla of decerebrate rats, whose trajectories had the characteristics of the post-inspiratory neurons, i.e. exhibiting hyperpolarization during inspiration, rapid depolarization at end-inspiration and progressive repolarization with a decrementing pattern during the intervals between phrenic bursts. Synaptic responses of 6 post-inspiratory neurons which were tested by stimulation of cervical vagus or superior laryngeal nerves were excitatory. Eleven of these 63 post-inspiratory neurons were labeled by intracellular injection of horseradish peroxidase (HRP). Ten of these 11 labeled neurons were motoneurons since their axons exited the medulla after joining the roots of cranial nerves. However, only one of these motoneurons was antidromically activated by stimulation of the ipsilateral cervical vagus nerve. We assumed that most of the post-inspiratory medullary neurons of the present study were motoneurons, but not interneurons, although antidromic invasion was not possible after stimulation of the cervical vagus and superior laryngeal nerves. Two post-inspiratory neurons of this sample had bulbospinal axons, which were revealed by antidromical activation of spinal cord and HRP labeling, respectively. The axon of the labeled bulbospinal neuron had axonal collaterals which were distributed within the region of the nucleus ambiguous of the ipsilateral medulla. The functional significance of this type of post-inspiratory neuron is discussed. PMID:1913156

Zheng, Y; Barillot, J C; Bianchi, A L



Sciatic Nerve Injury Associated with Acetabular Fractures  

Microsoft Academic Search

Sciatic nerve injuries associated with acetabular fractures may be a result of the initial trauma or injury at the time of\\u000a surgical reconstruction. Patients may present with a broad range of symptoms ranging from radiculopathy to foot drop. There\\u000a are several posttraumatic, perioperative, and postoperative causes for sciatic nerve palsy including fracture–dislocation\\u000a of the hip joint, excessive tension or inappropriate

Paul S. Issack; David L. Helfet



Nerve conduction velocity  


Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. ... travel between electrodes are used to determine the speed of the nerve signals. Electromyography (recording from needles ...


Connection types between the spinal root of the accessory nerve and the posterior roots of the C2–C6 spinal nerves  

Microsoft Academic Search

Purpose  The aim of this study was to demonstrate the connection types and frequency between the accessory nerve and the posterior\\u000a roots of the C2–C6 cervical nerves.\\u000a \\u000a \\u000a \\u000a Methods  The cranial cervical regions of 49 specimens from 27 human cadavers were used for the present study under an operating microscope.\\u000a \\u000a \\u000a \\u000a Results  Five different connection types between the accessory nerve and the posterior roots of

Canan Y. Saylam; Mustafa Orhan; Z. Asl? Aktan Ikiz; Hülya Uçerler; Mehmet Zileli



Myeloma Symptoms  


... caused by accumulation of plasma cells and weakened bone structures Proper positioning and support; increasing physical activity in ... immunoglobulin therapy Nervous system dysfunction Weakening and collapsing bone structures may impinge on nerves, producing severe pain, tingling ...


Nerve Impulses in Plants  

ERIC Educational Resources Information Center

|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)|

Blatt, F. J.



Nerve Impulses in Plants  

ERIC Educational Resources Information Center

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)

Blatt, F. J.



Syphilis Symptoms  


... 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 ...


Recognizing Symptoms  


... My Cart | Register | Sign In Home What Is IBS? Introduction to IBS Facts About IBS Frequently Asked Questions Post-infectious IBS Other Disorders Signs & Symptoms Overview Recognizing Symptoms Pain ...


Visual Symptoms  


... that JavaScript is enabled in your browser. National Multiple Sclerosis Society Accessibility Navigation: Skip to resource navigation Skip ... Pages Assistance Animals Book: Managing the Symptoms of Multiple Sclerosis Optic Neuritis Visual Symptoms Related Documents Article - Low ...


Gonorrhea Symptoms  


... severe Swollen or painful testicles If left untreated, men could experience prostate complications and epididymitis (inflammation of the testicles). Symptoms of rectal infection include discharge, anal itching, and occasional painful bowel movements with fresh blood in the feces. Symptoms typically ...


Flightlessness affects cranial morphology in birds.  


Flightless birds belonging to phylogenetically distant clades share several morphological features in the pectoral and pelvic apparatus. There are indications that skull morphology is also influenced by flightlessness. In this study we used a large number of flightless species to test whether flightlessness in modern birds does indeed affect cranial morphology. Discriminant analyses and variation partitioning show evidence for a relationship between skull morphology and the flightless condition in birds. A possible explanation for the change in cranial morphology can be linked to the reduced selective force for light-weight skulls in flightless birds. This makes an increase in muscle mass, and therefore an enlargement of muscle insertion areas on the skull, possible. We also compared the ontogenetic trajectory of Gallus with the adult morphology of a sample of flightless species to see whether the apomorphic features characterizing the skull of flightless birds share the same developmental basis, which would indicate convergent evolution by parallelism. Skull morphology (expressed as principal component scores) of palaeognathous flightless birds (ratites) is dissimilar (higher scores) to juvenile stages of the chicken and therefore seem peramorphic (overdeveloped). Principal component scores of adult neognathous flightless birds fall within the range of chicken development, so no clear conclusions about the ontogenetic trajectories leading to their sturdier skull morphology could be drawn. PMID:23337125

Gussekloo, Sander W S; Cubo, Jorge



Cranial mechanics and feeding in Tyrannosaurus rex.  

PubMed Central

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.

Rayfield, Emily J.



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


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

Schmidt, Jennifer; Piekarski, Nadine; Olsson, Lennart



Facial Nerve Outcome after Vestibular Schwannoma Surgery: Our Experience*  

PubMed Central

In this study we evaluate the postoperative facial nerve function after vestibular schwannoma (VS) surgery and analyze the factors that cause it. We included 97 consecutive patients undergoing surgical excision of sporadic unilateral VS. Patient and tumor characteristics, surgical approaches, facial nerve function, extent of tumor removal, perioperative complications are all analyzed through standardized systems. Four different surgical approaches are used: translabyrinthine, retrolabyrinthine, retrosigmoid, and middle cranial fossa. Anatomic preservation of the facial nerve is achieved in 97% of patients. The incidence of postoperative facial palsy is found to be statistically correlated to tumor size, but not to the surgical approach used and to extent of tumor penetration in the internal auditory canal. A significant improvement of the short-term facial nerve outcome is detected in patients undergone simultaneous intraoperative electromyography (EMG) and pneumatic facial nerve monitoring. Complete tumor excision is achieved in 94% of cases. Complication rates are excellent and no deaths are reported. Short- and long-term facial nerve outcome is good and comparable with those of other series reported in literature. In VS surgery both EMG and pneumatic facial nerve monitors should be simultaneously used. Further investigations are desirable to improve the facial outcome respecting the oncological radicality.

Rinaldi, Vittorio; Casale, Manuele; Bressi, Federica; Potena, Massimiliano; Vesperini, Emanuela; De Franco, Antonio; Silvestri, Sergio; Zini, Carlo; Salvinelli, Fabrizio



Unilateral oculomotor nerve palsy: unusual sign of hydrocephalus.  


We report an unusual case of hydrocephalus in which unilateral oculomotor nerve paralysis was the predominant sign. Misinterpretation of such an atypical clinical sign may lead to inappropriate therapy. We outline the role of intracranial pressure monitoring as an adjunctive diagnostic tool and we suggest a presumptive mechanism to explain the correlation between enlarged ventricles and 3(rd) nerve dysfunction. A 16-year-old boy presented with a complete left oculomotor nerve palsy associated with imaging findings of dilated ventricles and Dandy-Walker variant cystic malformation. Monitoring of intracranial pressure through a ventricular catheter was undertaken. In the first phase (no cerebrospinal fluid drainage [CSF] drainage) mean intracranial pressure (ICP) values were >0 mmHg. A second phase (with progressively longer CSF draining) further defined the diagnosis. A ventriculo-peritoneal shunt was then placed and the nerve function returned to normal within few days. Third cranial nerve dysfunction as a predominant sign of hydrocephalus is very rare and may raise doubts as to the real significance of the imaging findings of enlarged ventricles. In this ground, ICP monitoring is a safe and helpful diagnostic tool that can afford a more accurate evaluation and proper treatment. The supposed mechanism of 3(rd) nerve dysfunction was bending/stretching of the nerve. PMID:19546847

Cultrera, F; D'Andrea, M; Battaglia, R; Chieregato, A



Conceptual adequacy of the neuropathic pain symptom inventory in six countries  

Microsoft Academic Search

BACKGROUND: Neuropathic pain results from a nerve lesion or nerve damage. Because it is a subjective experience, patient-reported outcomes may measure both the symptoms and impact on the patient's life. The purpose of this study was to determine whether the Neuropathic Pain Symptom Inventory (NPSI) adequately assesses neuropathic pain symptoms in patients with diabetic peripheral neuropathy, post-herpetic neuralgia, trigeminal neuralgia,

Bruce Crawford; Didier Bouhassira; Audrey Wong; Ellen Dukes



Cranial Fasciitis Presenting with Intracranial Mass: A Case Report  

Microsoft Academic Search

We describe a very rare case of cranial fasciitis presenting with intracranial mass in a 3-year-old girl. There was no palpable scalp mass. CT scan and MRI demonstrated an epidural mass adherent to the dura with destruction of the inner table of the skull. The tumor was extirpated completely and the resected specimens were diagnosed as cranial fasciitis. When neurosurgeons,

Naoya Takeda; Katsuzo Fujita; Shigenori Katayama; Nobuyuki Akutsu; Kimio Hashimoto; Eiji Kohmura



Posterior fontanelle cranial ultrasound: anatomic and sonographic correlation  

Microsoft Academic Search

Objective: The purpose of this study was to correlate normal brain anatomy as seen on posterior fontanelle cranial sonography with anatomical sections of the premature infant brain. Materials and methods: Images obtained from 93 cranial ultrasound examinations performed via both the anterior and posterior fontanelle in 53 infants, ranging in gestational age from 24 to 42 weeks, were reviewed to

Nigel G. Anderson; Robyn Hay; Margaret Hutchings; Martin Whitehead; Brian Darlow



Ontogeny of cranial epi-ossifications in Triceratops  

Microsoft Academic Search

Historically, the scarcity of non-adult Triceratops fossils collected from Upper Cretaceous sediments of North America limited our understanding and promoted controversy with regard to the morphology, and presence or absence of cranial epi-ossifications in this widely known horned dinosaur. The recent discovery of several exceptionally well preserved juvenile and subadult Triceratops skulls and numerous juvenile, subadult, and adult cranial elements,

John R. Horner; Mark B. Goodwin



Cranial melioidosis with extradural extension after a fall in the bathroom  

PubMed Central

A 32-year-old diabetic male, with a past history of head injury and seizures, presented with a painful swelling over his forehead present for the past three months. Cranial MRI demonstrated the presence of a scalp collection with extradural extension through a bony defect. Biopsy from the area showed caseating necrosis suggestive of tuberculosis. Although the patient failed to return for initiation of anti-tubercular therapy for the next 11 months, the swelling did not progress, and there were no constitutional symptoms. The indolent nature of the swelling prompted re-evaluation and delayed cultures of pus from the collection grew Burkholderia pseudomallei.

Naha, Kushal; Dasari, Sowjanya; Kusugodlu, Ramamoorthi; Prabhu, Mukhyaprana



Cranial melioidosis with extradural extension after a fall in the bathroom.  


A 32-year-old diabetic male, with a past history of head injury and seizures, presented with a painful swelling over his forehead present for the past three months. Cranial MRI demonstrated the presence of a scalp collection with extradural extension through a bony defect. Biopsy from the area showed caseating necrosis suggestive of tuberculosis. Although the patient failed to return for initiation of anti-tubercular therapy for the next 11 months, the swelling did not progress, and there were no constitutional symptoms. The indolent nature of the swelling prompted re-evaluation and delayed cultures of pus from the collection grew Burkholderia pseudomallei. PMID:23024720

Naha, Kushal; Dasari, Sowjanya; Kusugodlu, Ramamoorthi; Prabhu, Mukhyaprana



Side-to-end hypoglossal-facial anastomosis via transposition of the intratemporal facial nerve  

Microsoft Academic Search

Summary  The technique of facial nerve repair with side-to-end hypoglossal-facial anastomosis is presented and evaluated in five patients\\u000a who were operated on for facial nerve paralysis after acoustic schwannoma surgery, or had cranial base trauma.\\u000a \\u000a The end-to-end hypoglossal-facial anastomosis is accompanied by hemilingual paralysis, with difficulty in swallowing, chewing\\u000a and speaking. In this new technique, the facial nerve is mobilised in

J. Rebol; V. Milojkovi?; V. Didanovi?



Radial nerve entrapment by the lateral head of the triceps.  


A case of slowly progressive radial nerve entrapment of spontaneous onset is presented. Surgical exploration revealed compression of the radial nerve by a musculotendinous arch of the lateral head of the triceps. Relief of signs and symptoms did not ensue. PMID:1880378

Nakamichi, K; Tachibana, S



The Molecular Toxicology of Chemical Warfare Nerve Agents  

Microsoft Academic Search

Chemical warfare nerve agents continue to be a threat to both military personnel and civilian populations. Organophosphorus nerve agents irreversibly inhibit the enzyme acetylcholinesterase, resulting in accumulation of high levels of the neurotransmitter acetylcholine (ACh) at muscarinic and nicotinic receptors. This accumulation of ACh induces clinical symptoms including myosis, difficulty in breathing, convulsions, seizures, and can result in death. Current

Kimberly D. Spradling; James F. Dillman



Early symptoms and outcome of Listeria monocytogenes rhombencephalitis: 14 adult cases  

Microsoft Academic Search

Listeria monocytogenes rhombencephalitis has never been studied in a significant group of patients. We describe 14 adult cases who were seen over a 10-year period. A biphasic illness was characteristic: (1) prodromes (5–15 days) with malaise, fatigue, headache, nausea or vomiting, and fever; (2) cranial nerve palsy with facial palsy, diplopia, dysphagia, dysarthria, usually multiple. Meningism and hemi- or tetraparesis

Pierre-Antoine Uldry; Thierry Kuntzer; Julien Bogousslavsky; Franco Regli; Judith Miklossy; Jacques Bille; Patrick Francioli; Robert Janzer



Visual Loss, Homonymous Hemianopia, and Unilateral Optic Neuropathy as the Presenting Symptoms of Vertebrobasilar Dolichoectasia  

PubMed Central

Vertebrobasilar dolichoectasia (VBD) is a relatively rare disorder for which unfortunately there is no treatment. Here we describe a case of simultaneous pre- and postchiasmal visual pathway pathology secondary to a space occupying VBD. In addition our patient demonstrates one of the very few cases of VBD compression of the retrochiasmal pathway with no other cranial nerve involvement.

Mortzos, Panteleimon; S?rensen, Torben Lykke



Multiple Myeloma Manifesting as a Fluctuating Sixth Nerve Palsy  

PubMed Central

We report a case of multiple myeloma that presented as a fluctuating sixth cranial nerve palsy in the absence of widespread signs of systemic disease. A 63-year-old woman presented with horizontal diplopia of two weeks duration that subjectively changed over time. Ocular examination showed a fluctuating sixth nerve palsy. A computed tomography (CT) scan of the brain showed multiple, enhancing, soft tissue, mass-like lesions involving the left cavernous sinus and the apex of both petrous bones. Based on bone marrow biopsy and hematologic findings, she was diagnosed with multiple myeloma. Multiple myeloma may be included in the differential diagnosis of a fluctuating sixth nerve palsy, and although ophthalmic signs are rare and generally occur late in the course of multiple myeloma, they can still be its first signs.

Park, Shin Hae



Arthroscopic Trans-capsular Axillary Nerve Decompression: Indication and Surgical Technique  

Microsoft Academic Search

Symptomatic axillary nerve compression is rare yet results in debilitating pain, weakness, and decreased athletic performance in some patients. If nonoperative modalities fail, surgical intervention is necessary to reduce symptoms and avoid functional decline. Traditionally, open techniques have been described to decompress the axillary nerve and are reported to provide satisfactory results. Similar to suprascapular nerve decompression, recent advances have

Peter J. Millett; Trevor R. Gaskill



Diphtheria Symptoms  


... Basics Describes symptoms of infection as well as benefits and risks of vaccination. English [400 KB, 2 pages] | Spanish [170 KB, ... about recent diphtheria outbreaks. Describes symptoms of infection, benefits and risks of vaccination, details about the vaccine, and history of the ...


Postconcussion symptoms.  


Research pertaining to the self-report of symptoms after traumatic brain injury was reviewed. Cognitive, emotional, and motivational factors have more relevance than demographic (except for female sex) and personality factors. Specific neuropsychological deficits in attention and memory have been found in the early stages after head injury of even mild severity. This is unlikely to be the only factor affecting symptom persistence. Exaggeration of cognitive dysfunction occurs in some cases, but appears unrelated to symptom overreport. Increased emotional distress typically accompanies symptom persistence. The psychological reaction of preoccupation with symptoms and emotional distress is not unique to concussion, but also occurs after severe head injury and back injury and relates more to the personal interpretation of the effect of the trauma than to objective indicators of brain injury severity. PMID:9253770

Gasquoine, P G



Botulinum Toxin Physiology in Focal Hand and Cranial Dystonia  

PubMed Central

The safety and efficacy of botulinum toxin for the treatment of focal hand and cranial dystonias are well-established. Studies of these adult-onset focal dystonias reveal both shared features, such as the dystonic phenotype of muscle hyperactivity and overflow muscle contraction and divergent features, such as task specificity in focal hand dystonia which is not a common feature of cranial dystonia. The physiologic effects of botulinum toxin in these 2 disorders also show both similarities and differences. This paper compares and contrasts the physiology of focal hand and cranial dystonias and of botulinum toxin in the management of these disorders.

Karp, Barbara Illowsky



Dorsomedial cutaneous nerve syndrome: treatment with nerve transection and burial into bone.  


Damage to the dorsomedial cutaneous nerve of the foot, which innervates the medial hallux, may occur with crush injury or iatrogenically with bunion surgery. Severe neuritic pain after bunion surgery may alert the surgeon that this small nerve has been damaged. The term "dorsomedial cutaneous nerve syndrome" is suggested for this condition, and nine patients with such forefoot presentations, all of which were unresponsive to nonoperative interventions, are described. The nerve had been either transected or bound in scar tissue; in these nine cases, the nerve was then resected and buried in the proximal aspect of the first metatarsal or the medial cuneiform. Most patients underwent an additional procedure (other than the nerve procedure), such as revision bunionectomy or arthrodesis, but all felt they could clearly delineate nerve pain from bone or joint pain. All patients experienced marked relief of their symptoms, usually within days after the surgery, and were satisfied with the results. The verbal analog pain score, on a scale of 0 (no pain) to 10 (pain requiring amputation), improved from a preoperative level of 8.6 to a postoperative level of 2.0. Resection and burial of this nerve appears to be a useful treatment for neuritis unresponsive to nonoperative measures. PMID:11310860

Miller, S D



Central nervous system and peripheral nerve growth factor provide trophic support critical to mature sensory neuronal survival  

Microsoft Academic Search

Primary sensory neurones in cranial and dorsal root ganglia (DRG) of adult animals are generally thought to be maintained through connections with their peripheral (but not central) targets by trophic factor(s) other than nerve growth factor (NGF)1. Damage to the peripheral process of sensory neurones results in a dramatic response or even death of the neurones, whereas axotomy (cutting) of

Eugene M. Johnson; Henry K. Yip



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

Microsoft Academic Search

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

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



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

PubMed Central

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.




Ulnar nerve damage (image)  


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


Nerves and Tissue Repair.  

National Technical Information Service (NTIS)

Studies have been conducted with regenerating amphibian sciatic nerves in organ culture to characterize further transport and release of transferrin in growing axons of peripheral nerves. The hypothesis under investigation is that transferrin, the iron-tr...

A. L. Mescher



Tibial nerve dysfunction  


... nerve dysfunction is a loss of movement or sensation in the foot from damage to the tibial ... the leg. The tibial nerve supplies movement and sensation to the calf and foot muscles. A problem ...


Optic Nerve Disorders  


... each eye carries impulses to the brain, where visual information is interpreted. Damage to an optic nerve ... determine where the problem is in the pathway. Visual Pathways and the Consequences of Damage Nerve signals ...


Common peroneal nerve dysfunction  


... type of peripheral neuropathy (damage to nerves outside the brain or spinal cord). This condition can affect people ... people: Who are very thin (for example, from anorexia nervosa ) ... damage the common peroneal nerve Charcot-Marie-Tooth disease is ...


Nerve Injuries in Athletes.  

ERIC Educational Resources Information Center

|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)|

Collins, Kathryn; And Others



Skin and Nerve Biopsies  

Center for Drug Evaluation (CDER)

Text VersionPage 1. Skin and Nerve Biopsies RA Malik Page 2. ... Nerve Biopsy • Evidence from Clinical Trials • Skin Biopsy • Evidence from Clinical Trials ... More results from


Quantifying cognitive decrements caused by cranial radiotherapy.  


With the exception of survival, cognitive impairment stemming from the clinical management of cancer is a major factor dictating therapeutic outcome. For many patients afflicted with CNS and non-CNS malignancies, radiotherapy and chemotherapy offer the best options for disease control. These treatments however come at a cost, and nearly all cancer survivors (~11 million in the US alone as of 2006) incur some risk for developing cognitive dysfunction, with the most severe cases found in patients subjected to cranial radiotherapy (~200,000/yr) for the control of primary and metastatic brain tumors. Particularly problematic are pediatric cases, whose long-term survival plagued with marked cognitive decrements results in significant socioeconomic burdens. To date, there are still no satisfactory solutions to this significant clinical problem. We have addressed this serious health concern using transplanted stem cells to combat radiation-induced cognitive decline in athymic rats subjected to cranial irradiation. Details of the stereotaxic irradiation and the in vitro culturing and transplantation of human neural stem cells (hNSCs) can be found in our companion paper (Acharya et al., JoVE reference). Following irradiation and transplantation surgery, rats are then assessed for changes in cognition, grafted cell survival and expression of differentiation-specific markers 1 and 4-months after irradiation. To critically evaluate the success or failure of any potential intervention designed to ameliorate radiation-induced cognitive sequelae, a rigorous series of quantitative cognitive tasks must be performed. To accomplish this, we subject our animals to a suite of cognitive testing paradigms including novel place recognition, water maze, elevated plus maze and fear conditioning, in order to quantify hippocampal and non-hippocampal learning and memory. We have demonstrated the utility of these tests for quantifying specific types of cognitive decrements in irradiated animals, and used them to show that animals engrafted with hNSCs exhibit significant improvements in cognitive function. The cognitive benefits derived from engrafted human stem cells suggest that similar strategies may one day provide much needed clinical recourse to cancer survivors suffering from impaired cognition. Accordingly, we have provided written and visual documentation of the critical steps used in our cognitive testing paradigms to facilitate the translation of our promising results into the clinic. PMID:22042060

Christie, Lori-Ann; Acharya, Munjal M; Limoli, Charles L



Clinical and Radiological Findings of Nerve Root Herniation after Discectomy of Lumbar Disc Herniation  

PubMed Central

The authors report 2 cases of nerve root herniation after discectomy of a large lumbar disc herniation caused by an unrecognized dural tear. Patients complained of the abrupt onset of radiating pain after lumbar discectomy. Magnetic resonance imaging showed cerebrospinal fluid signal in the disc space and nerve root displacement into the disc space. Symptoms improved after the herniated nerve root was repositioned. Clinical symptoms and suggestive radiologic image findings are important for early diagnosis and treatment.

Bae, Jun Seok; Pee, Yong Hun; Lee, Sang-Ho



Engineering peripheral nerve repair.  


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

Marquardt, Laura M; Sakiyama-Elbert, Shelly E



21 CFR 882.5800 - Cranial electrotherapy stimulator.  

Code of Federal Regulations, 2010 CFR

...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...



Accounting for cranial vault growth in experimental design.  


OBJECTIVE: Earlier studies have not accounted for continued growth when using the rat calvarial defect model to evaluate bone healing in vivo. The purpose of this study was: 1) to calculate rat cranial vault growth over time; and 2) to determine the effects of accounting for growth on defect healing. STUDY DESIGN: Bilateral parietal defects were created in 10 adult Wistar rats. Serial microscopic computerized tomography scans were performed. Bone mineral content (BMC) measured according to standard technique and repeated accounting for cranial growth over time was compared with the use of parametric and nonparametric tests. RESULTS: Cranial vault growth continued through 22 weeks of age, increasing 7.5% in width and 9.1% in length, and calvarial defects expanded proportionately. BMC was greater within defects accounting for growth 2-12 weeks postoperatively (P < .003). CONCLUSIONS: BMC was underestimated through standard analysis, which demonstrates the importance of accounting for cranial growth given advances in serial imaging techniques. PMID:23312535

Power, Stephanie M; Matic, Damir B; Holdsworth, David W



Cranial base approaches to intracranial aneurysms in the subarachnoid space.  


The use of cranial base approaches to aneurysm surgery is illustrated by means of patient examples. Over a 9-year period, cranial base approaches were used to expose and treat 38 aneurysms involving the anterior communicating artery complex, proximal internal carotid artery, basilar artery, or vertebral artery. The approaches included orbital osteotomy, orbitozygomatic osteotomy, petrous apicectomy, presigmoid petrosectomy, and extreme lateral transcondylar methods. Complications related to the approaches included one partial ptosis and two cerebrospinal fluid leaks, which resolved with treatment. The technique of three-dimensional computed tomographic angiography was useful in delineating the vascular anatomy and its relation to the cranial base structures. This helped the surgeon plan the appropriate approach to the aneurysm. Cranial base approaches, used selectively, can provide improved exposure of deep-seated aneurysms and large or giant aneurysms, while minimizing brain retraction. PMID:7800139

Sekhar, L N; Kalia, K K; Yonas, H; Wright, D C; Ching, H



21 CFR 882.4360 - Electric cranial drill motor.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. ...electrically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull....



21 CFR 882.4370 - Pneumatic cranial drill motor.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4370 Pneumatic cranial drill motor. ...pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull....



Characteristics of Nerve Agents.  

National Technical Information Service (NTIS)

There are three types of nerve agents currently stored in chemical stockpiles in the United States: VX, GB and GA. All three nerve agents are members of the organophosphate family. Nerve agent VX, a clear, odorless and tasteless liquid, has an appearance ...



Fibromyalgia Symptoms  


Donate | Join | Shop | eAlert | Contact Us About Fibromyalgia Symptoms Diagnosis Treatment Prevalence Causes Prognosis Science of FM Newly Diagnosed Patients FM Fact Sheet Economic Burden Research Abstract Clinical Trials Home > Fibromyalgia > ...


Major cranial changes during Triceratops ontogeny  

PubMed Central

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

Horner, John R; Goodwin, Mark B



Idiopathic hypertrophic cranial pachymeningitis successfully treated with weekly subcutaneous methotrexate  

Microsoft Academic Search

Summary  Idiopathic hypertrophic cranial pachymeningitis is a very infrequent disorder. Adequate management is still a matter of debate.\\u000a We describe the use of low-dose pulse methotrexate in treating a 63-year-old woman with idiopathic hypertrophic cranial pachymeningitis.\\u000a A weekly scheme with subcutaneous methotrexate was tried. Clinical improvement occurred in one week. Total remission of the\\u000a clinical and neuro-imaging abnormalities was evident 6

J. L. Ruiz-Sandoval; G. Bernard-Medina; E. J. Ramos-Gómez; S. Romero-Vargas; S. Gutiérrez-Ureña; S. González-Cornejo; E. Chiquete



Neurulation in the cranial region - normal and abnormal  

PubMed Central

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

Copp, Andrew J



Facial nerve: From anatomy to pathology.  


The facial nerve (CN VII) emerges from the facial nerve nucleus in the pons. It is accompanied by CN VIII along its cisternal pathway, as well as at the internal auditory meatus. Its petrous pathway includes a labyrinthine segment, a horizontal tympanic segment and a vertical mastoid segment until the stylomastoid foramen. It then continues to the parotid gland. Pontine impairment is usually associated with other neurological symptoms. Lesions of the cerebellopontine angle (most often meningioma and schwannoma) initially result in impairment of CN VIII. The impairment of CN VII takes second place. Peripheral impairment (outside of a traumatic context) is most often due to Bell's palsy. PMID:23891166

Toulgoat, F; Sarrazin, J L; Benoudiba, F; Pereon, Y; Auffray-Calvier, E; Daumas-Duport, B; Lintia-Gaultier, A; Desal, H A



Entrapment of the lateral cutaneous nerve of the calf.  


Isolated lesion of lateral cutaneous nerve of the calf (LCNC), particularly due to entrapment, is rarely reported in the literature. Patients usually present with sensory symptoms in the lateral aspect of the calf. Treatment is usually by local applications or local steroid/anaesthetic injection. We report the first case of LCNC entrapment in a 35-year-old man which is documented by nerve conduction studies. The patient had a temporary improvement following a local anaesthetic/steroid injection. Owing to the recurrence of symptoms, the patient opted for surgery. About 1 year after surgery, the symptoms disappeared completely. PMID:23821626

Khalil, Nofal M; Nicotra, Alessia; Kaplan, Charles; O'Neill, Kevin S



Optic Nerve Elongation  

PubMed Central

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

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



Evolution of nerve development in frogs. II. Modified development of the peripheral nervous system in the direct-developing frog Eleutherodactylus coqui (Leptodactylidae).  


We use whole-mount immunohistochemistry to describe the pattern of development of cranial nerves and muscles in the direct-developing leptodactylid frog Eleutherodactylus coqui. Comparison with nerve development in the biphasically developing frogs Physalaemus pustulosus (Leptodactylidae) and Discoglossus pictus (Discoglossidae; described in a companion paper) allows us to infer the ancestral leptodactylid ontogenetic pattern and the extent to which it has been modified during the evolution of direct development in Eleutherodactylus. While early embryonic development of cranial nerves and muscles is remarkably conserved in E. coqui, most transitory embryonic and larval characters (e.g., occipital and spinal myotomes together with their innervation, the distorted course of trigeminal and facial nerves, ventral branchial arch muscles, a subset of branchial-nerve rami and the lateral-line system) never develop. However, a few larva-typical characters are recapitulated, including Rohon-Beard cells and an anastomosis between the vagal and hypoglossal nerve. In addition to the abbreviation of ontogeny by loss of larva-specific traits, dramatic dissociations and heterochronic shifts of characters can be observed in E. coqui. The onset of development of limb and trunk innervation has been pre-displaced to early embryonic stage. Moreover, the reorientation of cranial muscles and nerves corresponding to late metamorphic events in biphasically developing anurans occurs relatively much earlier and is less pronounced in E. coqui resulting in an extreme condensation of ontogeny. PMID:9261555

Schlosser, G; Roth, G



Optical stimulation of the facial nerve: a surgical tool?  

NASA Astrophysics Data System (ADS)

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.

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



Rodent model of direct cranial blast injury.  


Traumatic brain injury resulting from an explosive blast is one of the most serious wounds suffered by warfighters, yet the effects of explosive blast overpressure directly impacting the head are poorly understood. We developed a rodent model of direct cranial blast injury (dcBI), in which a blast overpressure could be delivered exclusively to the head, precluding indirect brain injury via thoracic transmission of the blast wave. We constructed and validated a Cranium Only Blast Injury Apparatus (COBIA) to deliver blast overpressures generated by detonating .22 caliber cartridges of smokeless powder. Blast waveforms generated by COBIA replicated those recorded within armored vehicles penetrated by munitions. Lethal dcBI (LD(50) ? 515?kPa) was associated with: (1) apparent brainstem failure, characterized by immediate opisthotonus and apnea leading to cardiac arrest that could not be overcome by cardiopulmonary resuscitation; (2) widespread subarachnoid hemorrhages without cortical contusions or intracerebral or intraventricular hemorrhages; and (3) no pulmonary abnormalities. Sub-lethal dcBI was associated with: (1) apnea lasting up to 15?sec, with transient abnormalities in oxygen saturation; (2) very few delayed deaths; (3) subarachnoid hemorrhages, especially in the path of the blast wave; (4) abnormal immunolabeling for IgG, cleaved caspase-3, and ?-amyloid precursor protein (?-APP), and staining for Fluoro-Jade C, all in deep brain regions away from the subarachnoid hemorrhages, but in the path of the blast wave; and (5) abnormalities on the accelerating Rotarod that persisted for the 1 week period of observation. We conclude that exposure of the head alone to severe explosive blast predisposes to significant neurological dysfunction. PMID:21639724

Kuehn, Reed; Simard, Philippe F; Driscoll, Ian; Keledjian, Kaspar; Ivanova, Svetlana; Tosun, Cigdem; Williams, Alicia; Bochicchio, Grant; Gerzanich, Volodymyr; Simard, J Marc



[Neuropsychiatric symptoms in primary hyperparathyroidism].  


Over a period of 3 months a 51-year-old woman developed a depressive syndrome with loss of memory, inability to find words, impaired fine movements and phases of spacial disorientation. Biochemical tests demonstrated occasional slight rises in serum calcium (2.8-2.9 mmol/l) and parathormone (4.6-5.2 pmol/l). She had a grade II nodular goitre with normal thyroid function. Ultrasonography of the thyroid suggested a right cranial parathyroid adenoma, confirmed at a right thyroidectomy with resection of the right upper parathyroid, while the other parathyroid glands were grossly normal. Calcium and parathormone levels returned to normal after the operation, as did the neuropsychiatric symptoms (within two months). This typical case illustrates that even in seemingly isolated neuropsychiatric changes an organic disease, like primary hyperparathyroidism, needs to be thought of. PMID:8055744

Schreiber, W; Kellner, M; Heuser-Link, M; Krieg, J C



A novel simple real-time electrooculographic monitoring system during transsphenoidal surgeries to prevent postoperative extraocular motor nerve dysfunction.  


In transsphenoidal surgery (TSS) for pituitary tumors, the use of endoscopes allows approach to the lateral sides in and around the cavernous sinus. However, this approach is often associated with a risk of cranial nerve dysfunction causing impaired extraocular movement. We employed a novel, simple, and real-time monitoring system using electrooculography during TSS to avoid postoperative extraocular motor nerve dysfunction. A conventional electroencephalograph, which is available in every hospital, was used to detect effects induced by intraoperative manipulation on the cranial nerves related to extraocular movement (EOM) during TSS for pituitary adenomas. One hundred patients with pituitary adenomas who underwent endonasal endoscope-assisted TSS with EOM monitoring were included in the present study. When the extraocular motor nerves were stimulated mechanically directly or even indirectly by surgical procedures, abnormal extraocular muscle responses [electrooculograms (EOGm)] appeared on the monitor screen. When repeated or continuous EOGm were recorded, surgical procedures were discontinued briefly for around 5 to 10 s. The EOGm disappeared promptly when surgical procedures were stopped. Permanent extraocular dysfunction did not occur in the present series of patients. One, who was the fifth patient in the present series, of 100 patients (1.0 %) had transient delayed diplopia after TSS. We have not experienced any more postoperative EOM dysfunction since the first case. EOM monitoring during TSS is a novel, efficient, and simple method to prevent postoperative cranial nerve palsy related to EOM. PMID:23196421

Kawamata, Takakazu; Ishii, Nobuaki; Amano, Kosaku; Namioka, Takahiro; Hori, Tomokatsu; Okada, Yoshikazu



Selective percutaneous thermolesions of the ninth cranial nerve by lateral cervical approach: report of eight cases.  


Percutaneous radiofrequency thermolesion of the petrous ganglion at the jugular foramen was employed for the treatment of glossopharyngeal neuralgia in eight cases, three with essential and five with symptomatic pain from oropharyngeal cancer. Because of its technical simplicity, the lateral cervical approach was preferred to the anterior lateral approach. Immediate and subsequent surgical results were satisfactory. No neurological complication was noted, except for transitory bradycardia and hypotension during the procedure. PMID:6623334

Salar, G; Ori, C; Baratto, V; Iob, I; Mingrino, S



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

NSDL National Science Digital Library

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.



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

PubMed Central

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

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



Noninvasive transcranial stimulation of rat abducens nerve by focused ultrasound.  


Nonpharmacologic and nonsurgical transcranial modulation of the nerve function may provide new opportunities in evaluation and treatment of cranial nerve diseases. This study investigates the possibility of using low-intensity transcranial focused ultrasound (FUS) to selectively stimulate the rat abducens nerve located above the base of the skull. FUS (frequencies of 350 kHz and 650 kHz) operating in a pulsed mode was applied to the abducens nerve of Sprague-Dawley rats under stereotactic guidance. The abductive eyeball movement ipsilateral to the side of sonication was observed at 350 kHz, using the 0.36-msec tone burst duration (TBD), 1.5-kHz pulse repetition frequency (PRF), and the overall sonication duration of 200 msec. Histologic and behavioral monitoring showed no signs of disruption in the blood brain barrier (BBB), as well as no damage to the nerves and adjacent brain tissue resulting from the sonication. As a novel functional neuro-modulatory modality, the pulsed application of FUS has potential for diagnostic and therapeutic applications in diseases of the peripheral nervous system. PMID:22763009

Kim, Hyungmin; Taghados, Seyed Javid; Fischer, Krisztina; Maeng, Lee-So; Park, Shinsuk; Yoo, Seung-Schik



Total Facial Nerve Decompression for Severe Traumatic Facial Nerve Paralysis: A Review of 10 Cases  

PubMed Central

Management of traumatic facial nerve disorders is challenging. Facial nerve decompression is indicated if 90–95% loss of function is seen at the very early period on ENoG or if there is axonal degeneration on EMG lately with no sign of recovery. Middle cranial or translabyrinthine approach is selected depending on hearing. The aim of this study is to present retrospective review of 10 patients with sudden onset complete facial paralysis after trauma who underwent total facial nerve decompression. Operation time after injury is ranging between 16 and105 days. Excitation threshold, supramaximal stimulation, and amplitude on the paralytic side were worse than at least %85 of the healthy side. Six of 11 patients had HBG-II, one patient had HBG-I, 3 patients had HBG-III, and one patient had HBG-IV recovery. Stretch, compression injuries with disruption of the endoneurial tubules undetectable at the time of surgery and lack of timely decompression may be associated with suboptimal results in our series.

Yetiser, Sertac



Calvarial reconstruction using high-density porous polyethylene cranial hemispheres  

PubMed Central

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.

Mokal, Nitin J.; Desai, Mahinoor F.



An osteological and histological investigation of cranial joints in geckos.  


Cranial kinesis is a widespread feature of gekkotan lizards. Previous studies of kinesis in lizards often described the relevant, mobile joints as synovial, thus characterized by the presence of a synovial cavity lined with articular cartilage. To date however, detailed investigations of cranial joint histology are lacking. We examined eight cranial joints (quadrate-articular, quadrate-pterygoid, quadrate-otooccipital, quadrate-squamosal, epipterygoid-prootic, epipterygoid-pterygoid, basisphenoid-pterygoid, and frontal-parietal) in five gekkotan species (Oedura lesueuerii, Eublepharis macularius, Hemitheconyx caudicinctus, Tarentola annularis, and Chondrodactylous bibronii) using microcomputed tomography and serial histology. Particular focus was given to the relationship between the bony and soft-tissue components of the joint. Our results demonstrate that only three of these joints are synovial: the quadrate-articular, epipterygoid-pterygoid, and basisphenoid-pterygoid joints. The frontal-parietal and quadrate-pterygoid joints are syndesmosis (fibrous), the epipterygoid-prootic and quadrate-otooccipital joints are synchondroses (cartilaginous without a synovial cavity) and the quadrate-squamosal joint was not present. Based on previous descriptions, we determine that the structure of some cranial joints is variable among lizard taxa. We caution that osteology does not necessarily predict cranial joint histology. Although the functional implications of these findings remain to be explored we note that the development of synovial joints appears to be associated with a neural crest origin for the elements involved. PMID:21254447

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



Attentional ability among survivors of leukaemia treated without cranial irradiation  

PubMed Central

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.

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



Nerve and Blood Vessels  

Microsoft Academic Search

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

Maura Valle; Maria Pia Zamorani


[Abducens nerve palsy in spontaneous intracranial hypotension].  


Described by Schaltenbrand (1940), spontaneous intracranial hypotension is an unusual syndrome, sometimes revealed by an abducens nerve palsy motivating the patient to consult emergency ophthalmology services. The Authors report the case of a 50-Year-old Turkish woman who presented with diplopia due to a left abducens nerve palsy. These symptoms were associated with headache and nausea. Brain magnetic resonance imaging demonstrated diffuse pachymeningeal enhancement with gadolinium. A lumbar puncture showed low spinal fluid pressure (6 cm H2O), leading to the diagnosis of palsy by spontaneous intracranial hypotension. First, a classic treatment was prescribed with no result: increased water intake, corticoid therapy, and rest. Then a blood patch consisting of an injection of autologous blood by lumbar puncture between the third and fourth lumbar vertebrae to plug the spontaneous leak of spinal fluid, with success. A review of the literature provides information on the physiopathological mechanism, the clinical and imaging symptoms, and the treatment. PMID:15173648

Guigon, B; Tailla, H; de la Marnière, E; Macarez, R; Bazin, S; Madzou, M



Osseous expansion of the cranial vault by craniotasis.  


A study of cranial vault lengthening using a custom expandable fixation-distraction (craniotatic) appliance was performed in the young-adult rabbit model. Ten 24-week-old rabbits underwent circumferential suturectomy plus expansion (expanded group), 10 underwent circumferential suturectomy without expansion (sham control group), and 10 served as normal controls. The appliance was lengthened at a rate of 2.5 mm per week for 5 weeks. Serial lateral cephalometry, comparative dry-skull anthropometric measurements, and histologic examinations were performed. The expanded group demonstrated a significantly longer skull, cranial vault, anterior cranial base, posterior face, and orbit as compared with the control groups (p less than 0.05). Callus bone filled the distracted suturectomy and united the frontofacial complex to the posterior cranium. In conclusion, skull lengthening by distraction osteogenesis is possible in the rabbit model and offers a new technique for future investigation in the treatment of coronal synostosis. PMID:1561249

Remmler, D; McCoy, F J; O'Neil, D; Willoughby, L; Patterson, B; Gerald, K; Morris, D C



Monkey Median Nerve Repaired by Nerve Graft or Collagen Nerve Guide Tube  

Microsoft Academic Search

Nerve regeneration was followed in 15 median and 1 ulnar nerve of eight Macaca fascicularis monkeys by serial elec- trophysiological assessments over a period of three and a half years. Nerve gaps of 5 mm at the wrist were bridged by collagen-based nerve guides, nerve autografts, or direct suture repairs. Thenar muscle reinnervation occurred be- tween 50 and 70 d

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



Cranial and spinal magnetic resonance imaging: A guide and atlas  

SciTech Connect

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.

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



Primary Diffuse Large B Cell Lymphoma of the Cranial Vault  

PubMed Central

Primary non-Hodgkin’s lymphoma of the cranial vault is extremely rare. This case report presents a 42-year-old man with a painless subcutaneous scalp mass which extended intracranially associated with recent mild headache. Initial computed tomography and magnetic resonance imaging revealed two lesions emanating from the skull. Biopsy revealed a diagnosis of diffuse large B cell lymphoma (DLBCL). A thorough work-up revealed no other point of involvement. This case is concerned about considering lymphoma in the differential diagnosis of calvarial lesions with both intra- and extra cranial extensions but without obvious intervening bony destruction.

Rezaei-Kalantari, Kiara; Samimi, Kaveh; Jafari, Maryam; Karimi, Mohammad Ali; Ansari, Keyvan; Davoodi, Mohammad; Nabi-Meybodi, Mahtab; Gorjian, Mehrnoush



A case of traumatic bilateral abducens and unilateral hypoglossal nerve palsy  

PubMed Central

Patient: Female, 47 Final Diagnosis: Traumatic bilateral abducens • unilateral hypoglossal nerve palsy Symptoms: Diplopia Medication: — Clinical Procedure: — Specialty: Neurology Objective: Rare disease Background: Incidence of unilateral abducens palsy from head trauma has been reported to be as high as 1% to 2.7%, but bilateral abducens nerve palsy is extremely rare. Case Report: We present a case in which bilateral abducens nerve and unilateral hypoglossal nerve palsy developed with a high Glasgow Coma Score (GCS) 3 hours after head trauma due to a motor vehicle crash. Conclusions: This case highlights the occurrence and management of posttraumatic bilateral sixth nerve palsy.

Selcuk, Ferda; Mut, Senem E.



Avian enteric nerve plexuses  

Microsoft Academic Search

The enteric nerve plexuses of the domestic fowl (Gallus domesticus) were investigated in sections and stretch preparations by means of the cholinesterase and glyoxylic acid fluorescence histochemical techniques. Cholinesterase-positive and varicose and non-varicose fluorescent nerve fibres were distributed at all levels of the gut in myenteric, submucosal, muscle and mucosal plexuses, and in a perivascular plexus. The density of the

H. A. Ali; J. McLelland



Nerves of Simplicial Complexes.  

National Technical Information Service (NTIS)

If a simplicial complex K is considered as covered by its maximal (closed) faces, its nerve N(K) may be defined in the usual manner. Generalizing known results on interchange graphs of graphs, simplicial complexes which are nerves of d-dimensional simplic...

B. Grunbaum



Peripheral nerve and muscle.  


This review of the past year's literature on neurophysiology of muscles and peripheral nerves emphasizes areas with direct clinical interest. The subject is diversified but will be discussed under the following major headings: nerve conduction studies, electromyography, magnetic motor evoked potentials, quantitative sensory testing, assessment of peripheral pain fibers, and autonomic function assessment. PMID:8293143

Jamal, G A; Mann, C



[Obturator nerve block].  


Obturator nerve block is commonly used for transurethral resections of the bladder in order to inhibit reflectory adductor muscle reaction during electrocoagulation and to reduce the risk of bladder wall perforation during transurethral surgery. Furthermore, obturator block is used to complete regional blocks for major knee surgery in addition to femoral and sciatic nerve blocks. Continuous techniques are sometimes used to treat chronic pain problems such as adductor spasm. During a so called "3 in 1" block (femoral nerve block) the obturator nerve will only be anaesthetized in 0-62% of the patients. Therefore, a specific approach to the obturator nerve is deemed appropriate. In addition, an accessory branch of the obturator nerve will accompany the femoral nerve in 10-30% of the patients. The classical approach uses the tuberculum pubicum as an anatomical landmark, inserting the needle approximately 1.5cm lateral and caudal until bone contact is established. After laterocaudal redirection the canalis obturatorius is reached and the local anaesthetic is injected. The alternative approach is more often used: At the proximal tendon insertion of the adductor longus muscle the needle is introduced and advanced towards the anterior superior iliac spine. For both approaches a nerve stimulator is used and 15-20ml of local anaesthetic solution are injected. PMID:20455186

Freisburger, Christian; Nachtigall, Bernd; Wulf, Hinnerk



Ulnar nerve tuberculoma.  


The authors report a very rare case of tuberculoma involving the ulnar nerve. The patient, a 7-year-old girl, presented with swelling over the medial aspect of her right forearm just below the elbow joint, with features of ulnar nerve palsy, including paresthesias along the little and ring fingers and claw hand deformity. There was a history of trauma and contact with a contagious case of tuberculosis. There were no other signs of tuberculosis. At surgical exploration the ulnar nerve was found to be thickened, and on opening the sheath there was evidence of caseous material enclosed in a fibrous capsule compressing and displacing the nerve fibers. The lesion, along with the capsule, was subtotally removed using curettage, and a part of the capsule that was densely adherent to the nerve fibers was left in the patient. Histopathological examination of the specimen was consistent with tuberculoma. The patient received adequate antitubercular treatment and showed significant improvement. PMID:23082843

Ramesh Chandra, V V; Prasad, Bodapati Chandramowliswara; Varaprasad, Gangumolu




Microsoft Academic Search

The second of these teacher-physicians is William Garner Sutherland (1873-1954), who founded Osteopathy in the Cra- nial Field (OCF). Dr. Sutherland was a student of Still and became imbued with Still's thinking, methods, and practice. Sutherland formulated his first cranial hypothesis as a student in 1899 while examining a temporal bone from a disarticulated skull. The thought struck him that

John M. McPartland; Evelyn Skinner



Secondary syphilis presenting with features of cranial arteritis  

PubMed Central

The case of an elderly man with secondary syphilis is described. The clinical features at the time of presentation were suggestive of cranial arteritis and there was a substantial but incomplete response to corticosteroids. Subsequent treatment with penicillin proved highly effective.

Drew, P. J. T.



Cranial helminths of Mustela vison Schreber, 1777 in Spain.  


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

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



Cranial morphology of Archaeopteryx: evidence from the seventh skeleton  

Microsoft Academic Search

Most of the cranial bones are preserved in the seventh skeleton of Archaeopteryx. Whereas most of the braincase bones and the quadrates are crushed against one another as a result of sediment compaction, the displaced bones lying apart are nearly intact. In contrast with the predominantly reptilian postcranial skeleton, the skull of Archaeopteryx shows a few specifically avian traits. The

Andrzej Elzanowski; Peter Wellnhofer



Cranial Radiation Therapy and Damage to Hippocampal Neurogenesis  

ERIC Educational Resources Information Center

|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…

Monje, Michelle



Cranial-base repair using endoscopic laser welding.  


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

Bleier, Benjamin S; Palmer, James N



The taxonomic implications of cranial shape variation in Homo erectus  

Microsoft Academic Search

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.

Karen L. Baab



Facial nerve paralysis secondary to chronic otitis media without cholesteatoma.  


Numerous papers have been written on facial nerve paralysis caused by chronic suppurative otitis media. However the authors found none documenting the results of therapy in a series of patients in whom facial nerve dysfunction was caused by chronic otitis media without cholesteatoma. Thus, there is little factual information available to help select a specific therapeutic plan for such cases. Over the past decade, the senior author has managed five cases (6 ears) of chronic suppurative otitis media without cholesteatoma in which facial paresis (4 ears) or paralysis (2 ears) developed 10 days or less before surgery. The chronic otitis media involved the mastoid and middle ear in five cases; and the mastoid, middle ear, and petrous apex in one case. Modified radical mastoidectomy was performed in four ears, tympanomastoidectomy with facial recess exposure in one ear, and complete mastoidectomy with middle cranial fossa petrous apicectomy in one ear. Five patients had complete recovery of facial nerve function (House grade I), and one patient had 90 percent recovery (House grade II). The results provide support for semi-emergent surgery in the management of chronic suppurative otitis media when facial nerve paralysis supervenes. PMID:1415504

Harker, L A; Pignatari, S S



Ventricular Pneumocephalus with Meningitis after Lumbar Nerve Root Block  

PubMed Central

Lumbar nerve root block is a common modality used in the management of radiculopathy. Its complications are rare and usually minor. Despite its low morbidity, significant acute events can occur. Pneumocephalus is an accumulation of air in the intracranial space. It indicates a violation of the dura or the presence of infection. The object of this report is to describe the case of a patient with intraventricular pneumocephalus and bacterial meningitis after lumbar nerve root block. A 70-year-old female was brought into emergency department with severe headache and vomiting which developed during her sleep. She had received lumbar nerve block for her radiculopathy one day before her presentation. Cranial computed tomography scan revealed a few hypodense lesions in her left lateral ventricle frontal horn and basal cistern indicating ventricular pneumocephalus. Five hours later, she developed sudden hearing loss. Cerebrospinal fluid analysis showed bacterial meningitis, and she was treated with high dose steroid and antibiotics. However, her impaired hearing as a sequela from meningitis was persistent, and she is still in follow-up. Intracranial complications of lumbar nerve root block including meningitis and pneumocephalus can occur and should be considered as high-risk conditions that require prompt intervention.

Ko, Young Sang; Lim, Kyung Soo



A Nerve Cuff Electrode for Controlled Reshaping of Nerve Geometry  

Microsoft Academic Search

The purpose of this study is the development of a nerve electrode that reorganizes nerve geometry slowly and controllably. The Flat Interface Nerve Electrode (FINE) can reshape the nerve into an elongated oval and provide selective stimulation. However, the rate of closure of this electrode is difficult to control. The Slowly Closing - FINE (SC-FINE) is designed with an opening

Anthony V. Caparso; Dominique M. Durand; Joseph M. Mansour



Whole sensory nerve recordings with spiral nerve cuff electrode  

Microsoft Academic Search

We have used a self-curling nerve cuff electrode to record sensory information from a cutaneous nerve. This type of cuffs has previously been used only for stimulation, but its mechanical properties could make it very suitable for recording also, since it can be fitted closer to the nerve than traditional cuffs without compromising the nerve. In this study we show

T. Sinjar; B. Hinge; A. Jorgensen; M. L. Jensen; M. Haugland



Percutaneous peripheral nerve stimulation.  


Since its inception in the 1970s, peripheral neuromodulation has become an increasingly common procedure to treat chronic neuropathic disorders. Historically, peripheral nerve stimulation (PNS) originated with the placement of large surface cuff electrodes, which was refined by the introduction of functional nerve mapping with circumferential electrical stimulation. This substantially improved the targeting of sensory fascicles. Surgical placement of spinal cord stimulation (SCS) 'button type' paddle electrodes was replaced when the introduction of percutaneous cylindrical SCS electrodes expanded the spectrum of PNS applications and improved the ability to target afferent sensory fibers as well as reducing the complication rate. To further refine functional mapping for the placement of these percutaneous electrodes, radiofrequency needle probes have more recently been employed to elicit paresthesias in awake patients to map the pain generators and guide treatment. In this chapter, we provide a description of the development and basic mechanisms of peripheral nerve stimulation, as well as a more detailed description of the two most commonly employed forms of peripheral nerve stimulation: occipital nerve stimulation for occipital neuralgia, and subcutaneous peripheral nerve field stimulation to stimulate free nerve endings within the subcutaneous tissue when the pain is limited to a small, well-localized area. The closely related ideas of internal and external targeted subcutaneous stimulation are also discussed. PMID:21422775

Aló, Kenneth M; Abramova, Marina V; Richter, Erich O



Familial amyloidosis with cranial neuropathy and corneal lattice dystrophy.  

PubMed Central

Five siblings of a Danish family with slowly progressive involvement of the trigeminal, facial, glossopharyngeal, accessory, and hypoglossal nerves beginning at the age of 55-65 years were examined. All had asymptomatic corneal lattice dystrophy. Clinical and electrophysiological investigations also showed evidence of slight neurogenic involvement of the limbs. Conduction velocity along sensory nerves was normal but amplitude of sensory potentials was severely reduced suggesting an axonal affection which was confirmed by sural nerve biopsy. The neuropathy was secondary to amyloidosis revealed by skin and sural nerve biopsies. Images

Boysen, G; Galassi, G; Kamieniecka, Z; Schlaeger, J; Trojaborg, W



An increase in infant cranial deformity with supine sleeping position.  


Abnormalities of the occipital cranial suture in infancy can cause significant posterior cranial asymmetry, malposition of the ears, distortion of the cranial base, deformation of the forehead, and facial asymmetry. Over the past 2 years, we have noted a dramatic increase in the incidence of deformation of the occipital skull in our tertiary referral center. Our patient referral base has not changed appreciably over the past 5 years and patients have been referred from the same primary practitioner base. The timing of this increase correlates closely with the acceptance in our area of recommended changes in sleeping position to supine or side positioning for infants because of the fear of sudden infant death syndrome (SIDS). A total of 51 infants with occipital cranial deformity, with a mean age of 5.5 months at presentation, have been evaluated and treated by a single craniofacial surgeon in the 16-month period from September 1993 to December 1994. Older infants were treated with continuous positioning by the parent keeping the infant off the involved side. Younger infants and those with poor head control were treated with a soft-shell helmet. Mean timing of initial diagnosis and start of treatment was 5.5 months. Mean duration of helmet for positional treatment was 3.8 months. To date, only 3 of 51 patients have required surgical intervention, and other patients demonstrated spontaneous improvement of all measured parameters. Follow up has ranged from 8 to 24 months. We believe that most occipital plagiocephaly deformities are deformations rather than true cranio-synostoses. Despite varying amounts of suture abnormality evidenced on computed tomographic scans, most deformities can be corrected without surgery. In cases where progression of the cranial deformity occurs, despite conservative therapy, surgical intervention should be undertaken at approximately 1 year of age. The almost universal acceptance in the State of North Carolina of positioning neonates on their backs to avoid SIDS, may well increase the incidence of these deformities in the future. PMID:9086895

Argenta, L C; David, L R; Wilson, J A; Bell, W O



Extreme Cranial Ontogeny in the Upper Cretaceous Dinosaur Pachycephalosaurus  

PubMed Central

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

Horner, John R.; Goodwin, Mark B.



Suprascapular nerve entrapment.  


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

Corò, L; Azuelos, A; Alexandre, A



[Nerve injuries in children].  


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

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



Inferior alveolar nerve injury with laryngeal mask airway: a case report  

PubMed Central

Introduction The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use. Case presentation A 35-year-old Caucasian man presented to our facility for elective anterior cruciate ligament repair. He had no background history of any significant medical problems. He opted for general anesthesia over a regional technique. He was induced with fentanyl and propofol and a size 4 laryngeal mask airway was inserted without any problems. His head was in a neutral position during the surgery. After surgery in the recovery room, he complained of numbness in his lower lip. He also developed extensive scabbing of the lower lip on the second day after surgery. The numbness and scabbing started improving after a week, with complete recovery after two weeks. Conclusion We report the first case of vascular occlusion and injury to the inferior alveolar nerve, causing scabbing and numbness of the lower lip, resulting from laryngeal mask airway use. This is an original case report mostly of interest for anesthetists who use the laryngeal mask airway in day-to-day practice. Excessive inflation of the laryngeal mask airway cuff could have led to this complication. Despite the low incidence of cranial nerve injury associated with the use of the laryngeal mask airway, vigilant adherence to evidence-based medicine techniques and recommendations from the manufacturer's instructions can prevent such complications.



Whole nerve recordings with the spiral nerve cuff electrode  

Microsoft Academic Search

The feasibility of whole nerve recordings from the hypoglossal (HG) nerve is demonstrated in acute cats using the spiral nerve cuff electrode. A good contact between the nerve and the electrodes, provided by the spiral nerve cuff due to its self-coiling property, should improve the signal-to-noise ratio. An instrumentation amplifier with very low input noise characteristics is also utilized. The

Mesut Sahin; Dominique M. Durand; Musa A. Haxhiu



Complications of peripheral nerve blocks.  


Complications of peripheral nerve blocks are fortunately rare, but can be devastating for both the patient and the anaesthesiologist. This review will concentrate on current knowledge about peripheral nerve injury secondary to nerve blocks, complications from continuous peripheral nerve catheter techniques, and local anaesthetic systemic toxicity. PMID:21148659

Jeng, C L; Torrillo, T M; Rosenblatt, M A



Side-to-end hypoglossal-facial anastomosis via transposition of the intratemporal facial nerve.  


The technique of facial nerve repair with side-to-end hypoglossal-facial anastomosis is presented and evaluated in five patients who were operated on for facial nerve paralysis after acoustic schwannoma surgery, or had cranial base trauma. The end-to-end hypoglossal-facial anastomosis is accompanied by hemilingual paralysis, with difficulty in swallowing, chewing and speaking. In this new technique, the facial nerve is mobilised in the temporal bone, transected at the second genu and transposed to the hypoglossal nerve where a tensionless side-to-end anastomosis is performed. The hypoglossal nerve is transected in oblique fashion to about one third of its circumference. We were able to achieve a tensionless anastomosis in all patients. The idea is to bring about re-innervation of the previously denervated tissue via a collateral sprouting of axons of the donor nerve through the site of coaptation without sacrificing the innervation of the donor nerve's original targets. With side-to-end hypoglossal-facial anastomosis, two patients attained a House- Brackmann grade of III (one of them with independent movement of eyelids and mouth); one achieved grade IV, another grade V and grade VI. No patient had hemilingual atrophy nor any problems associated with swallowing or chewing. PMID:16493524

Rebol, J; Milojkovi?, V; Didanovic, V



Ulnar nerve dysfunction  


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


Cervical Radiculopathy (Pinched Nerve)  


... Copyright 2010 American Academy of Orthopaedic Surgeons Cervical Radiculopathy (Pinched Nerve) Some people have neck pain that ... The medical term for this condition is cervical radiculopathy. Understanding your spine and how it works can ...


Diabetic Nerve Problems  


... 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 ...


Experimental interfascicular nerve grafting.  


Twenty-nine adult rhesus monkeys underwent complete laceration of both tibial nerves at mid-thigh level and repair by different methods to study the relative efficacy of autogenous interfascicular nerve grafts. Sixteen animals in Group I had an interfascicular graft repair using short sural nerve autografts on one limb and fascicular repair without grafts on the other limb. Thirteen animals in Group II, after having a 1-cm segment of tibial nerve resected, had an interfascicular graft repair without tension in one limb and an epineurial repair under moderate tension in the other limb. Evoked nerve and muscle action potentials and muscle strenght in response to repetitive and tetanic stimulation were recorded as baseline values prelaceration and then on re-exploration at 4, 6, 9, or 12 months. All nerves were examined by light and electron microscopy. Electrophysiological data, particularly muscle strength response, showed non-graft repairs to be superior at 4 and 6 months of regeneration. However, by 9 and 12 months the graft repairs had caught up and were equal to the non-graft repairs. Histologically, it was observed that many axons missed the graft segments and were present in extrafascicular connective tissues. Nonetheless, enough axons regenerated to the distal nerve to explain the success of these relatively short grafts. From the results of these experiments, it is concluded that use of autogenous interfascicular grafts offers no advantage over end-to-end non-graft repair. When and end-to-end repair cannot be achieved, use of short interfascicular nerve grafts is feasible and will work. PMID:224152

Bratton, B R; Kline, D G; Coleman, W; Hudson, A R



Traumatic facial nerve injury.  


Facial nerve trauma can be a devastating injury resulting in functional deficits and psychological distress. Deciding on the optimal course of treatment for patients with traumatic facial nerve injuries can be challenging, as there are many critical factors to be considered for each patient. Choosing from the great array of therapeutic options available can become overwhelming to both patients and physicians, and in this article, the authors present a systematic approach to help organize the physician's thought process. PMID:24138740

Lee, Linda N; Lyford-Pike, Sofia; Boahene, Kofi Derek O



Traumatic Nerve Lesions  

Microsoft Academic Search

Traumatic lesions of peripheral nerves are common. According to the literature a relevant lesion of a peripheral nerve exists\\u000a in roughly 2%–3% of patients admitted to Level I trauma centers. If plexus and root injuries are included the incidence rises\\u000a to about 5% (Noble et al. 1998; Robinson 2000). In general, these types of injuries are increasingly recognized in today’s

Siegfried Peer; Hannes Gruber


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

PubMed Central

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

Martinez-Abadias, Neus; Esparza, Mireia; Sj?vold, Torstein; Gonzalez-Jose, Rolando; Santos, Mauro; Hernandez, Miquel



Use of frozen cranial vault bone allografts in the repair of extensive cranial bone defects.  


In cranioplasty complexity is proportional to the size of the detect, particularly if greater than 50 cm2. If the patient's own bone flap is not available, allogenic frozen bone graft can be used instead. Between June 1990 and June 1995 twenty cranioplasties with allogenic frozen bone grafts were performed. Age of patients ranged between 23 and 63 years (average 38.4 years). Male/female ratio was 2:1.7. Size of craniectomy ranged between 65 and 150 cm2 (average 83.3 cm2). Follow-up ranged between 10 and 58 months (average 41 months). Donors were tested to rule out transmissible diseases, infections, sepsis and/or cancer. Bone grafts were removed under aseptic conditions, microbiological cultures were taken, wrapped in a gauze soaked with Gentamicin sulphate and Bacitracin, sealed in three sterilised vinyl plastic bags, and stored in a deep freezer for a minimum of 30 days (range 36-93 days, average 67 days), at a temperature of -80 degrees C. Grafts were placed in the defect after a step was carved on its borders to facilitate the contact between host and graft. Vancomycin 1 g. IV/12 hours and Ceftriaxone 1 g. IV/12 hours were administered for five days. Grafts were covered by means of scalp flaps. Only one required a musculocutaneous free flap. None was exposed, extruded or had to be removed. Plain skull X-ray studies showed progressive remodelling of the grafts. Partial resorption was observed in two (2/20, 10%) and loss of thickness in another 3/20 (15%), but with no changes in the contour. Biopsies were taken in 3/20 (15%) cases at a second surgical procedure. Areas of osteoclastic resorptive activity mixed with others of osteoblastic bone apposition, showed replacement with new bone. We conclude that cranial vault frozen allografts are a good alternative to autologous bone when the latter is absent or not present in sufficient amount. PMID:9265959

Vanaclocha, V; Bazan, A; Saiz-Sapena, N; Paloma, V; Idoate, M



Pediatric Asthma: Symptoms  


... MD Dept. of Pediatrics View full profile Pediatric Asthma: Symptoms Asthma symptoms can range from very mild ... for exercise Downward trend in peak flow numbers Asthma Symptoms Asthma symptoms indicate that an asthma episode ...


[Positron emission tomographic evaluation for frontal hypertrophic cranial pachymeningitis using 11C-methyl-L-methionine].  


A case of frontal hypertrophic cranial pachymeningitis was presented with positron emission tomography (PET) using (11C-methyl)-L-methionine (11C-Met). A 55-year-old male developed right hemiparesis after generalized tonic convulsion one month prior to admission. MR images revealed patchy enhancement extending from the dura mater to the cerebral parenchyma surrounding high T2-weighted signal in the left frontal region. Left carotid angiogram showed atresia of the rostral superior sagittal sinus and obliteration of the cortical veins associated with compensatory venous channels coursing in the frontal deep white matter. PET demonstrated high 11C-Met uptake in the area corresponding to the enhancing lesion on the MR images. The ratio of lesion/normal cortex was 1.58 as an indicator of selective uptake in the lesion. The contralateral temporal gray matter was representative of a normal cortex. In contrast, 11C-Met did not accumulate in the frontal white matter where T2-weighted MR images showed abnormal high intensity lesion. This suggested that the frontal white matter lesion was derived from vasogenic edema due to venous infarction. The patient underwent an uneventful exploratory biopsy. The dura mater had proliferated to a thickness of 3.5mm and was tightly adherent to the left middle frontal gyrus. Microscopically, the thickened dura mater where the tracers had accumulated was composed of abundant collagenous fibers together with diffuse infiltration of inflammatory cells, including predominantly lymphocytes, plasma cells, and neutrocytes. The lymphocytes, which proved positive in both UCHL-1 and L26 staining, had no atypism. Histological findings corresponded to hypertrophic pachymeningitis. Met-PET clearly represented viable and infiltrative zones of inflammatory cells. The patient's neurological symptoms and signs gradually improved. Follow-up MR images three months after the surgery showed the enhancing lesion to be diminished and a marked regression of the vasogenic edema. Spatial determination of viable lesions permitting differentiation from biological inactive or vasogenic edema is an important guideline in selecting an appropriate surgical procedure in the diagnosis and treatment of hypertrophic cranial pachymeningitis. Met-PET would appear useful in delineating inflammatory lesions such as hypertrophic cranial pachymeningitis. PMID:8851962

Takahashi, M; Sasajima, T; Mineura, K; Itoh, Y; Kowada, M; Iwaya, K; Hatazawa, J; Ogawa, T; Okudera, T; Murakami, M; Uemura, K



A case of cranial surgery in the Talmud.  


The history of Jewish discourse on law and philosophy was transformed from an oral teaching to a written teaching around the beginning of the Common Era. The result of these written laws and commentaries is known today as the Talmud. Many pages of the Talmud discuss illnesses and diseases and their potential treatments, however very few of these potential treatments involve invasive surgery. In one instance, involving a painful skin ailment called ra'aton, the authors of the Talmud suggest cranial surgery as the cure and describe the preparation of a potential anesthetic, the surgery environment, and the removal of a growth. Although this account raises several questions about the ailment itself, it provides us with a rare look at invasive cranial surgery dating back nearly 2,000 years. PMID:16608740

Weinberg, Adam



Is the term "fasciculus opticus cerebralis" more justifiable than the term "optic nerve"?  


The terminology of the optic nerve had already been changed three times, since 1895 until 1955 when the term "nervus opticus" was introduced in the "Terminologia Anatomica". Following our study we claim that, from the aspect of phylogenetic evolution of binocular vision development as well as optical embryogenesis where opticus is evidently presented as a product of diencephalic structures, the addition of the term "nervus" to opticus is not adequate and justified. From the clinical aspect the term "nervus opticus" is also inadequate, both as a "nerve" that has no functional regenerative properties, unlike other cranial nerves, as well as from a pedagogical and didactical aspect of educating future physicians. We suggest that the term "Fasciculus Opticus Cerebralis" should be used as it much better explains the origin as well as its affiliation to the central nervous system. PMID:23837214

Vojnikovi?, Bojo; Bajek, Snjezana; Bajek, Goran; Strenja-Lini?, Ines; Grubesi?, Aron



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


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

Levine, Robert Aaron



Meta-analysis of brain and cranial size in schizophrenia  

Microsoft Academic Search

Several meta-analyses are presented that address the issue of brain and\\/or cranial size reductions in schizophrenia. Separate meta-analyses were conducted for brain size (n = 27 studies), intracranial size (n = 18) or extracranial size (n = 8). For each meta-analysis, the weighted composite effect size (d) was tested for statistical significance (the direction of the effect size was negative

Kimberley Elaine Ward; Lee Friedman; Alexandria Wise; S. Charles Schulz



Development of cranial placodes: insights from studies in chick.  


This review focuses on how research, using chick as a model system, has contributed to our knowledge regarding the development of cranial placodes. This review highlights when and how molecular signaling events regulate early specification of placodal progenitor cells, as well as the development of individual placodes including morphological movements. In addition, we briefly describe various techniques used in chick that are important for studies in cell and developmental biology. PMID:23278869

Jidigam, Vijay K; Gunhaga, Lena



Microsurgical Treatment of Posterior Cranial Fossa Tumors Via Keyhole Approaches  

Microsoft Academic Search

The neurosurgical keyhole operation which is a new concept developed recently, especially characterized by the supraorbital\\u000a subfrontal eyebrow approach, has be widely applied for intracranial tumors and aneurysms [1–3]. However, big craniotomies with large incisions are still predominant in the surgical treatments of posterior cranial fossa\\u000a lesions. There are few reports about modern keyhole techniques used in this field, although

Qing Lan; Zhigang Gong; Zhiyuan Qian; Jian Chen; Shihai Liu; Zhaohui Lu; Qiang Huang


Experience with craniosynostosis treatment using posterior cranial vault distraction osteogenesis  

PubMed Central

Background: Craniosynostosis compromises the cranial vault volume, severely impede growth, and may lead to increased intracranial pressure (ICP). Posterior cranial vault (PCV) distraction osteogenesis (DO) offers an excellent treatment opportunity for this condition. This article intends to describe the outcomes of PCV DO. Materials and Methods: Nine males and seven female children indicated for PCV DO were included in the study. The single vector distraction devices with quick-disconnect distraction rods, a type of miniaturized hardware, was used in all cases. Result: Seven of the 16 patients had a history of one or more prior cranioplasty. All reoperations in this series were performed for the indication of raised ICP including five of the scaphocephaly patients and the syndromic patients. Clinical signs of raised ICP were present in all patients with either measured raised intracranial pressure or those with clinical signs of raised ICP preoperatively. There was substantial decrease in the ICP postoperatively. Discussion: The outcomes of this study were encouraging. Placing the distractor stems as flat as possible against the outer layer of the cranial bone seems to be a very important maneuver. This keeps the distractor stem less proud and less likely to sustain future trauma. Removal of the distractor stems keeps the devices further away from the risk of later traumatic dislodgement. Moreover, miniaturized distractors allow precise control of the rate and the amount of distraction.

Ylikontiola, Leena P.; Sandor, George K.; Salokorpi, Niina; Serlo, Willy S.



Heterochrony and developmental modularity of cranial osteogenesis in lipotyphlan mammals  

PubMed Central

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.



Decompression of the posterior interosseous nerve for tennis elbow  

Microsoft Academic Search

Decompression of the posterior interosseous nerve (PIN) was performed in 111 cases of tennis elbow. After a median follow-up time of 5 years, 85% showed improvement and 30% were almost completely relieved of their symptoms, the latter figure being considered to represent the real frequency of PIN entrapment. It thus seems that the PIN is one etiological factor in tennis

P. Jalovaara; R. V. Lindholm



Lipofibromatous hamartoma of the median nerve  

PubMed Central

Lipofibromatous hamartoma is a rare tumour of peripheral nerves which is characterised by an excessive infiltration of the epineurium and perineurium by fibroadipose tissue. To the best of our knowledge, only approximately 88 cases are reported in the literature. We report a rare case of lipofibromatous hamartoma of the median nerve causing secondary carpal tunnel syndrome in a 25 year old patient. This patient was treated conservatively with decompression and biopsy and experienced a complete resolution of symptoms post-operatively. Magnetic resonance imaging may be used to diagnose this lesion as it has very distinctive characteristics. Multiple conditions have been associated with this lesion and a greater understanding of these associations may clarify the pathogenesis. The architecture of the tumour makes excision very challenging and the surgical management remains controversial. A review of the literature regarding the etiology, pathogenesis and surgical management of lipofibromatous hamartoma is included.



Acellular Nerve Allografts in Peripheral Nerve Regeneration: A Comparative Study  

PubMed Central

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.

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



Huge middle ear adenoma with delayed facial nerve paralysis.  


Middle ear adenoma is a rare disease that arises from the mucosa of the middle ear. Only a few cases of associated facial nerve paralysis have been reported. Facial nerve involvement is most likely related to nerve compression rather than tumor invasion of the nerve. We describe a case of a huge middle ear adenoma in a 63-year-old man. He presented with a 1-month history of right-sided otalgia, otorrhea, and facial palsy; he also had a 10-year history of right-sided hearing loss. A tympanomastoidectomy was performed. Intraoperatively, the tumor was found to fill the middle ear cavity as well as the entire diameter of the external auditory canal. The tumor had eroded the wall of the facial canal at the second genu, and it was tightly adherent to the epineurium. Focal inflammation around the tumor was observed at the exposed facial nerve. The tumor was removed and the facial nerve was decompressed. Immediately after surgery, the patient's aural symptoms resolved. The final pathology evaluation established the diagnosis of a middle ear adenoma. At the 3-year follow-up, the ear cavity was completely healed and facial nerve function was improved. PMID:22711394

Lee, Seung Ho; Choi, Hoseok; Chu, Young Chae; Kim, Young Hyo; Kim, Kyu-Sung



Nerve globins in invertebrates.  


The expression of nerve hemoglobins in invertebrates is a well-established fact, but this occurrence is uncommon. In the species where nerve globins occur, they probably function as an oxygen store for sustaining activity of the nerves during anoxic conditions. Although invertebrate nerve globins are functionally similar with respect to O2 affinity, they are by no means uniform in structure and can differ in size, cellular localization and heme-coordination. The best-studied nerve globin is the mini-globin of Cerebratulus lacteus, which belongs to a class of globins containing the polar TyrB10/GlnE7 pair in the distal pocket. The amide and phenol side chains normally cause low rates of O2 dissociation and ultra-high O2 affinity by forming strong hydrogen bonds with bound ligands. Cerebratulus hemoglobin, however, has a moderate O2 affinity, due to the presence of a third polar amino-acid in its active site, ThrE11, which inhibits hydrogen bonding to bound oxygen by the B10 tyrosine side chain. PMID:15804828

Geuens, E; Dewilde, S; Hoogewijs, D; Pesce, A; Nienhaus, K; Nienhaus, G U; Olson, J; Vanfleteren, J; Bolognesi, M; Moens, L


Distinct spatiotemporal roles of hedgehog signalling during chick and mouse cranial base and axial skeleton development.  


The cranial base exerts a supportive role for the brain and includes the occipital, sphenoid and ethmoid bones that arise from cartilaginous precursors in the early embryo. As the occipital bone and the posterior part of the sphenoid are mesoderm derivatives that arise in close proximity to the notochord and floor plate, it has been assumed that their development, like the axial skeleton, is dependent on Sonic hedgehog (Shh) and modulation of bone morphogenetic protein (Bmp) signalling. Here we examined the development of the cranial base in chick and mouse embryos to compare the molecular signals that are required for chondrogenic induction in the trunk and head. We found that Shh signalling is required but the molecular network controlling cranial base development is distinct from that in the trunk. In the absence of Shh, the presumptive cranial base did not undergo chondrogenic commitment as determined by the loss of Sox9 expression and there was a decrease in cell survival. In contrast, induction of the otic capsule occurred normally demonstrating that induction of the cranial base is uncoupled from formation of the sensory capsules. Lastly, we found that the early cranial mesoderm is refractory to Shh signalling, likely accounting for why development of the cranial base occurs after the axial skeleton. Our data reveal that cranial and axial skeletal induction is controlled by conserved, yet spatiotemporally distinct mechanisms that co-ordinate development of the cranial base with that of the cranial musculature and the pharyngeal arches. PMID:23009899

Balczerski, B; Zakaria, S; Tucker, A S; Borycki, A G; Koyama, E; Pacifici, M; Francis-West, P



A Spiral Nerve Cuff Electrode for Peripheral Nerve Stimulation  

Microsoft Academic Search

A new type of newe cuff electrode consisting of conduc- tive segments embedded within a self-curling sheath of biocompatihle insulation has been developed. This spiral nerve cuff is biased to self- wrap around peripheral nerves and possesses a \\




Median nerve injury after carpal tunnel injection serially followed by ultrasonographic, sonoelastographic, and electrodiagnostic studies.  


The authors report a case of median sensory neuropathy after a carpal tunnel steroid injection for the management of carpal tunnel syndrome. Symptoms developed immediately after the injection. Nonoperative management was offered, and the median nerve was serially evaluated by performing ultrasonographic, sonoelastographic, and nerve conduction studies. The patient's symptoms improved with time. We consider that serial ultrasonographic, sonoelastographic, and electrodiagnostic studies are useful diagnostic methods for the evaluation of median nerve injury because ultrasonography and sonoelastography delineate anatomic information and electrodiagnostic studies describe neurophysiologic information. PMID:21765250

Park, Gi-Young; Kim, Seong-Kyu; Park, Jung Hyun



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

PubMed Central

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

Piao, Yuanlin; Liang, Xiaochun



Specific induction of PAG608 in cranial and spinal motor neurons of L-DOPA-treated parkinsonian rats.  


We identified p53-activated gene 608 (PAG608) as a specifically induced gene in striatal tissue of L-DOPA (100mg/kg)-injected hemi-parkinsonian rats using differential display assay. In the present study, we further examined morphological distribution of PAG608 in the central nervous system of L-DOPA-treated hemi-parkinsonian rats. PAG608 expression was markedly induced in fibers and neuronal cells of the lateral globus pallidus and reticular thalamic nucleus adjacent to internal capsule, specifically in the parkinsonian side of L-DOPA-treated models. The protein was also constitutively expressed in motor neurons specifically in either side of the pontine nucleus and motor nuclei of trigeminal and facial nerves. Furthermore, L-DOPA-induced PAG608 expression on motor neurons in the contralateral side of the ventral horn of the spinal cord and the lateral corticospinal tract without cell loss. The specific induction of PAG608 6-48h after L-DOPA injection in the extrapyramidal tracts, pyramidal tracts and corresponding lower motor neurons of the spinal cords suggests its involvement in molecular events in stimulated motor neurons. Taken together with the constitutive expression of PAG608 in the motor nuclei of cranial nerves, PAG608 may be a useful marker of stressed or activated lower motor neurons. PMID:18242749

Shimizu, Masako; Miyazaki, Ikuko; Higashi, Youichirou; Eslava-Alva, Maria J; Diaz-Corrales, Francisco J; Asanuma, Masato; Ogawa, Norio



[Peripheral facial nerve palsy].  


Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function. PMID:23627995

Pons, Y; Ukkola-Pons, E; Ballivet de Régloix, S; Champagne, C; Raynal, M; Lepage, P; Kossowski, M



An artificial nerve fiber for evaluation of nerve cuff electrodes  

Microsoft Academic Search

The different applications of natural sensors for feedback in rehabilitation systems using functional electrical stimulation (FES) require specialised and optimised designs of nerve cuff electrodes for recording of the sensory information. This paper describes a simple artificial nerve fiber for evaluation of nerve cuff electrode designs, cuff recording configurations and noise reduction methods in a controlled environment. The idea is

Lotte N. S. Andreasen; Johannes J. Struijk; Morten Haugland



Repetitive nerve stimulation for the evaluation of peripheral nerve hyperexcitability  

Microsoft Academic Search

Objective: To examine the utility of repetitive nerve stimulation (RNS) in the evaluation of peripheral nerve hyperexcitability (PNH). Background: PNH describes a group of disorders characterized by muscle cramps, twitching and stiffness. When severe, PNH may be characterized by the presence of continuous muscle fiber activity on routine needle electromyography (EMG). In milder forms of the disease, nerve hyperexcitability may

Michael Benatar; Kristine M Chapman; Seward B Rutkove



Peripheral Neuropathy: Symptoms and Signs  


... At first, you may notice numbness, tingling, abnormal sensations, or pain in your feet. Some people feel ... these nerves and their location: Sensory Nerves: affect sensation Autonomic Nerves: affect internal organ functions; and, Motor ...


Interleukin6 and nerve growth factor levels in peripheral nerve and brainstem after trigeminal nerve injury in the rat  

Microsoft Academic Search

Earlier studies have demonstrated that inflammation plays a role in the development of evoked pain following partial nerve injury. In this report, we demonstrate bilateral changes in interleukin-6 (IL-6) and nerve growth factor (nerve growth factor) levels following unilateral infraorbital nerve (infraorbital nerve) constriction. infraorbital nerve constriction resulted in an initial period of decreased mechanical sensitivity (1 and 3 days),

Leigh C Anderson; Ramesh D Rao



Optic nerve hypoplasia in children.  

PubMed Central

Optic nerve hypoplasia (ONH) is characterised by a diminished number of optic nerve fibres in the optic nerve(s) and until recently was thought to be rare. It may be associated with a wide range of other congenital abnormalities. Its pathology, clinical features, and the conditions associated with it are reviewed. Neuroendocrine disorders should be actively sought in any infant or child with bilateral ONH. Early recognition of the disorder may in some cases be life saving. Images

Zeki, S. M.; Dutton, G. N.



Painful neuropathy with trigeminal nerve involvement in type 2 diabetes.  


After several years of treatment for type 2 diabetes mellitus, a 69-year-old Japanese man developed an acute painful neuropathy, characterized by bilateral causalgia and dysaesthesia in his cheeks and around his eyes, typically 30 min to 3 h after meals. As his glycaemic control deteriorated, his haemoglobin (Hb) A1c level gradually increased from 7 - 8% to 10.3% and his symptoms became more severe. The pain radiated out along the distribution of the ophthalmic and maxillary divisions of the trigeminal nerve. The patient was treated with insulin therapy and his HbA1c level decreased from 10.3% to 6.8% within 7 months. Five months after initiating insulin therapy, his symptoms showed a dramatic improvement. This was a very unusual case of bilateral acute painful neuropathy that involved the ophthalmic and maxillary divisions of the trigeminal nerve, and in which aggravation of the symptoms clearly related to poor glycaemic control. PMID:16604832

Takayama, S; Osawa, M; Takahashi, Y; Iwamoto, Y


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

Microsoft Academic Search

In this study, landmark-based methods of geometric morphometrics are used for investigating the main aspects of cranial shape\\u000a transformation in the evolution of the giant panda, Ailuropoda melanoleuca. Specifically, we explore if the highly derived cranial adaptations for bamboo feeding of the living panda were developed\\u000a early in the panda's lineage. Results obtained show that the overall cranial morphologies of

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



Primary Peripheral B Cell Lymphoma, Burkitt-Like, of the Cranial Vault  

Microsoft Academic Search

We report an autopsy case of malignant lymphoma of the cranial vault. The patient was an 85-year-old woman who exhibited a painless subcutaneous scalp lump associated with no neurological abnormalities. CT scan and magnetic resonance imaging of the head showed an extra-intra cranial isodensity lesion of the cranial vault. Autopsy revealed that the tumor was composed of medium-sized cells which

Akiko Tanimura; Yasushi Adachi; Mariko Tanda; Hiroo Yuasa; Yoshifumi Ishii; Yasuo Katou



Optic nerve head segmentation  

Microsoft Academic Search

Reliable and efficient optic disk localization and segmentation are important tasks in automated retinal screening. General-purpose edge detection algorithms often fail to segment the optic disk due to fuzzy boundaries, inconsistent image contrast or missing edge features. This paper presents an algorithm for the localization and segmentation of the optic nerve head boundary in low-resolution images (about 20 ?\\/pixel). Optic

James Lowell; Andrew Hunter; David Steel; Ansu Basu; Robert Ryder; Eric Fletcher; Lee Kennedy



Does the Cranial Mesenchyme Contribute to Neural Fold Elevation During Neurulation?  

PubMed Central

The central nervous system is derived from the neural plate that undergoes a series of complex morphogenetic events resulting in formation of the neural tube in a process known as neurulation. The cellular behaviors driving neurulation in the cranial region involve forces generated by the neural tissue itself as well as the surrounding epithelium and mesenchyme. Of interest, the cranial mesenchyme underlying the neural plate undergoes stereotypical rearrangements hypothesized to drive elevation of the neural folds. As the neural folds rise, the hyaluronate-rich extracellular matrix greatly expands resulting in increased space between individual cranial mesenchyme cells. Based on inhibitor studies, expansion of the extracellular matrix has been implicated in driving neural fold elevation; however, since the surrounding neural and epidermal ectoderm were also affected by inhibitor exposure, these studies are inconclusive. Similarly, treatment of neurulating embryos with teratogenic doses of retinoic acid results in altered organization of the cranial mesenchyme but alterations in surrounding tissues are also observed. The strongest evidence for a critical role for the cranial mesenchyme in neural fold elevation comes from studies of genes expressed exclusively in the cranial mesenchyme that when mutated result in exencephaly associated with abnormal organization of the cranial mesenchyme. Twist is the best studied of these and is expressed in both the paraxial mesoderm and neural crest derived cranial mesenchyme. Here we review the evidence implicating the cranial mesenchyme in providing a driving force for neural fold elevation to evaluate whether there is sufficient data to support this hypothesis.

Zohn, Irene E.; Sarkar, Anjali A.



Origin and segregation of cranial placodes in Xenopus laevis.  


Cranial placodes are local thickenings of the vertebrate head ectoderm that contribute to the paired sense organs (olfactory epithelium, lens, inner ear, lateral line), cranial ganglia and the adenohypophysis. Here we use tissue grafting and dye injections to generated fate maps of the dorsal cranial part of the non-neural ectoderm for Xenopus embryos between neural plate and early tailbud stages. We show that all placodes arise from a crescent-shaped area located around the anterior neural plate, the pre-placodal ectoderm. In agreement with proposed roles of Six1 and Pax genes in the specification of a panplacodal primordium and different placodal areas, respectively, we show that Six1 is expressed uniformly throughout most of the pre-placodal ectoderm, while Pax6, Pax3, Pax8 and Pax2 each are confined to specific subregions encompassing the precursors of different subsets of placodes. However, the precursors of the vagal epibranchial and posterior lateral line placodes, which arise from the posteriormost pre-placodal ectoderm, upregulate Six1 and Pax8/Pax2 only at tailbud stages. Whereas our fate map suggests that regions of origin for different placodes overlap extensively with each other and with other ectodermal fates at neural plate stages, analysis of co-labeled placodes reveals that the actual degree of overlap is much smaller. Time lapse imaging of the pre-placodal ectoderm at single cell resolution demonstrates that no directed, large-scale cell rearrangements occur, when the pre-placodal region segregates into distinct placodes at subsequent stages. Our results indicate that individuation of placodes from the pre-placodal ectoderm does not involve large-scale cell sorting in Xenopus. PMID:21989028

Pieper, Mareike; Eagleson, Gerald W; Wosniok, Werner; Schlosser, Gerhard



Treatment of Childhood Acute Lymphoblastic Leukemia Without Prophylactic Cranial Irradiation  

PubMed Central

Background We conducted a clinical trial to test whether prophylactic cranial irradiation could be omitted in all children with newly diagnosed acute lymphoblastic leukemia. Methods A total of 498 evaluable patients were enrolled. Treatment intensity was based on presenting features and the level of minimal residual disease after remission induction treatment. Continuous complete remission was compared between the 71 patients who previously would have received prophylactic cranial irradiation and the 56 historical controls who received it. Results The 5-year event-free and overall survival probabilities (95% confidence interval) for all 498 patients were 85.6% (79.9% to 91.3%) and 93.5% (89.8% to 97.2%), respectively. The 5-year cumulative risk of isolated central-nervous-system (CNS) relapse was 2.7% (1.1% to 4.2%), and that of any CNS relapse (isolated plus combined) was 3.9% (1.9% to 5.9%). The 71 patients had significantly better continuous complete remission than the 56 historical controls (P=0.04). All 11 patients with isolated CNS relapse remain in second remission for 0.4 to 5.5 years. CNS leukemia (CNS-3 status) or a traumatic lumbar puncture with blasts at diagnosis and a high level of minimal residual disease (? 1%) after 6 weeks of remission induction were significantly associated with poorer event-free survival. Risk factors for CNS relapse included the presence of the t(1;19)[TCF3-PBX1], any CNS involvement at diagnosis, and T-cell immunophenotype. Common adverse effects included allergic reactions to L-asparaginase, osteonecrosis, thrombosis, and disseminated fungal infection. Conclusions With effective risk-adjusted chemotherapy, prophylactic cranial irradiation can be safely omitted in the treatment of childhood acute lymphoblastic leukemia.

Pui, Ching-Hon; Campana, Dario; Pei, Deqing; Bowman, W. Paul; Sandlund, John T.; Kaste, Sue C.; Ribeiro, Raul C.; Rubnitz, Jeffrey E.; Raimondi, Susana C.; Onciu, Mihaela; Coustan-Smith, Elaine; Kun, Larry E.; Jeha, Sima; Cheng, Cheng; Howard, Scott C.; Simmons, Vickey; Bayles, Amy; Metzger, Monika L.; Boyett, James M.; Leung, Wing; Handgretinger, Rupert; Downing, James R.; Evans, William E.; Relling, Mary V.



Cranial radiation necessary for CNS prophylaxis in pediatric NHL  

SciTech Connect

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

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



Ultrasound of the sural nerve: Normal anatomy on cadaveric dissection and case series.  


The sural nerve is a small sensory nerve innervating the lateral aspect of the ankle and foot. Clinical symptoms of pathology may present as atypical sensory changes in this region. We present the normal anatomy and ultrasound technique for examination of the sural nerve based on an anatomical dissection, as well as imaging in a normal volunteer. We also present a case series (n=10) of different conditions of the sural nerve that we encountered based on a review of interesting cases from 4 institutions. The pathological conditions included neuropathy related to stripping or venous laser surgery, compression by abscess, Lyme disease, nerve tumors, traumatic transsection, and encasement by fibrous plaque and edema. Ultrasound with its exquisite resolution is the preferred imaging method for examining the sural nerve in patients with unexplained sensory changes at the lateral aspect of the ankle and foot. PMID:23809918

Belsack, Dries; Jager, Tjeerd; Scafoglieri, Aldo; Vanderdood, Kurt; Van Hedent, Eddy; Vanhoenacker, Filip; Marcelis, Stefaan; De Maeseneer, Michel



On two equations about brain volume, cranial capacity and age  

Microsoft Academic Search

Aim  We decided to study the relationship between brain volume and cranial capacity and the relationship between brain volume and\\u000a age on a series of CT from healthy adults.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Fifty-eight healthy volunteers (27 women, 31 men, age range 18–95 years) were examined using our imaging protocols. The volunteers\\u000a had no present or past neuropsychiatric illness and no abuse of alcohol or illicit

Anne-Sophie Ricard; Pascal Desbarats; Mathieu Laurentjoye; Michel Montaudon; Philippe Caix; Vincent Dousset; Claire Majoufre-Lefebvre; Bruno Maureille



Endoscopic Removal of a Bullet Penetrating the Middle Cranial Fossa  

PubMed Central

Reports of intracranial retained foreign bodies are relatively rare in the literature. Such objects can cause numerous complications requiring removal, such as infection, persistent cerebrospinal fluid (CSF) leak, or new-onset seizures. The transnasal endoscopic approach provides an excellent alternative to craniotomy for repairing middle cranial fossa (MCF) defects. We describe a case of a 57-year-old woman with a self-inflicted bullet piercing the MCF, creating a persistent CSF leak. The details regarding the removal of this penetrating foreign body from the MCF, including the unique management in the setting of a contralateral spontaneous CSF leak, are discussed.

Hatch, Neal U.; Riley, Kristen O.; Woodworth, Bradford A.



Symptoms of Ankylosing Spondylitis  


Ankylosing Spondylitis (AS): Quick Links Overview >>> Symptoms >>> Diagnosis >>> Treatment >>> Medication >>> Doctor Q&A From Spondylitis Plus >>> ANKYLOSING SPONDYLITIS Most Common Symptoms It is important to note ...


Cranial acetabular retroversion is common in developmental dysplasia of the hip as assessed by the weight bearing position  

PubMed Central

Background and purpose The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous prevalence estimates of acetabular retroversion in dysplastic hips have been established in radiographs recorded with the patient supine and with inclusion only if pelvic tilt met standardized criteria. We assessed the prevalence and the extent of acetabular retroversion in dysplastic hip joints in weight bearing pelvic radiographs. Patients and methods We assessed 95 dysplastic hip joints (54 patients) in weight bearing anteroposterior pelvic radiographs, measuring the acetabular height and the distance from the acetabular roof to the point of crossing of the acetabular rims, if present. Results Acetabular retroversion was found in 31 of 95 dysplastic hip joints. In 28 of 31 hip joints with retroversion, crossover of the acetabular rims was positioned within the cranial 30% sector. The degree of pelvic tilt differed between retroverted and non-retroverted dysplastic hip joints, though only reaching a statistically significant level in male dysplastic hip joints. Interpretation We identified cranial acetabular retroversion in one-third of dysplastic hip joints when assessed on weight bearing pelvic radiographs. If assessed on pelvic radiographs obtained with the patient supine, and with inclusion only if the degree of pelvic tilt meets standardized criteria, the prevalence of acetabular retroversion may be underestimated.



Management of peripheral facial nerve palsy.  


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

Finsterer, Josef



Management of peripheral facial nerve palsy  

PubMed Central

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.



[Bilateral abducens nerve palsies in treated cases of subarachnoid hemorrhage].  


Isolated abducens nerve palsies associated with the rupture of intracranial aneurysms have rarely been reported. We report two cases of isolated bilateral abducens nerve palsies occurring after subarachnoid hemorrhage due to the rupture of an intracranial aneurysm. Case 1: A 49-year-old woman had bilateral abducens nerve palsies following subarachnoid hemorrhage due to the rupture of the left vertebral artery-posterior inferior cerebellar artery aneurysm. Case 2: A 55-year-old man had bilateral abducens nerve palsies following subarachnoid hemorrhage due to dissecting aneurysm of the right vertebral artery. Case 1 and 2 were treated with surgical clipping of the aneurysm and internal occlusion of the parent artery. In both cases, bilateral abducens nerve palsies achieved almost full recovery several months after treatment. It is speculated that the main causes of palsies are compression and stretching of the bilateral abducens nerves by a thick clot in the prepontine cistern. Although most of the abducens palsies may be reversible and have good prognosis, it is important that they are kept in mind as isolated symptoms of subarachnoid hemorrhage. PMID:22824578

Saito, Hisayasu; Nakayama, Naoki; Takikawa, Shugo; Ushikoshi, Satoshi; Shinbo, Daisuke; Kuroda, Satoshi; Houkin, Kiyohiro



Bilateral eventration of sciatic nerve.  


During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN), the common peroneal nerve (CPN), and the tibial nerve (TN), either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block. PMID:22049898

Sharma, T; Singla, R K; Lalit, M


Premenstrual symptoms: another look.  

PubMed Central

A collection of over 200 symptoms has been labeled premenstrual syndrome. Common belief is that most women experience a marked increase in symptoms premenses. Cyclic variations in the prevalence of commonly cited perimenstrual symptoms were estimated from daily symptom recording. A community-based, multiethnic sample of 345 women recorded symptom severity from "not present" to "extreme" for 90 days. Maximum total reported symptom score occurred during menses, not during premenses. When individual symptoms are considered, the prevalence of those rated as moderate to extreme during menses is less than 15 percent. A method for identifying symptom severity patterns throughout the menstrual cycle is described. Six symptom severity patterns were identified. Only 13 percent of the women exhibited a pattern of increased symptom severity in the premenses. Another 13 percent had a pattern of decreased symptom severity in the premenses.

Woods, N F



Bilateral Optic Nerve Sheath Meningioma with Intracanalicular and Intracranial Component in a 25-year-old Saudi Patient  

PubMed Central

Bilateral optic nerve sheath meningioma is rare. A meningioma is a benign neoplastic lesion from meningothelial cells of the meninges. They usually involve the intracanalicular portion of the optic nerve but may extend into the optic canal and through it to occupy the intracranial space. We present a case of 25-year-old Saudi female with bilateral optic nerve sheath meningioma. The diagnosis was delayed more than six years from initial symptoms.

Badr, Maha A.; Elkhamary, Sahar M.; Al Sabbagh, Samira; Al Turjoman, Abdulsalam



Quantitative in vivo studies of median nerve sliding in response to wrist, elbow, shoulder and neck movements  

Microsoft Academic Search

Objective. To examine median nerve sliding in response to upper limb movements in vivo. To determine whether the median nerve can be unloaded.Design. Exploratory study in healthy subjects.Background. Impaired sliding may lead to neuropathic symptoms. In vivo results for neural dynamics in normal subjects are essential to understand changes in upper limb disorders.Methods. Ultrasound imaging of the median nerve during

Andrew Dilley; Bruce Lynn; Jane Greening; Nicola DeLeon



Clinical anatomy of the human anterior cranial fossa during the prenatal period.  


We examined the prenatal development of the human anterior cranial fossa and considered its clinical aspects. Our purpose was an evaluation of anterior cranial fossa geometry, its measurements and connections with the nasal cavity and middle cranial fossa. The study was performed on 29 foetuses from the first and second trimester of pregnancy. New methods of computer image analysis, Scion for Windows 98 and ELFv 4.2, were applied to examine this anatomical region. Different options used were binarisation, equalisation, filters, linear and non-linear transformations and mathematical operations of images. This enabled the dynamics of prenatal development to be accurately evaluated for parts of the base of the human skull. Measurements were taken of angles of the cranial base. The anterior cranial base angle (the apex in the middle of the sella turcica and the arms running through the zygomatic ossification points) decreased gradually between C-R 6 to 23.5 cm from 170 to 120 degrees and afterwards became constant. The contrary-medial cranial base angle (adjacent to the anterior cranial base angle and with a second arm running through the auricular cartilage) increased from 50 to 70 degrees. The anterior cranial fossa was first located on the same level as the middle and posterior fossae. The process of descent of the middle and posterior cranial fossa begins in the 4th gestational month. The geometry of the anterior cranial fossa changes rapidly, especially in the first trimester of pregnancy. The first trimester of pregnancy is crucial for the development of its defects. Preconception prophylaxis of inborn defects of the anterior cranial fossa is therefore extremely important. PMID:14507064

Derkowski, Wojciech; Kedzia, Alicja; Glonek, Micha?



Unsteady 3D flow simulations in cranial arterial tree  

NASA Astrophysics Data System (ADS)

High resolution unsteady 3D flow simulations in major cranial arteries have been performed. Two cases were considered: 1) a healthy volunteer with a complete Circle of Willis (CoW); and 2) a patient with hydrocephalus and an incomplete CoW. Computation was performed on 3344 processors of the new half petaflop supercomputer in TACC. Two new numerical approaches were developed and implemented: 1) a new two-level domain decomposition method, which couples continuous and discontinuous Galerkin discretization of the computational domain; and 2) a new type of outflow boundary conditions, which imposes, in an accurate and computationally efficient manner, clinically measured flow rates. In the first simulation, a geometric model of 65 cranial arteries was reconstructed. Our simulation reveals a high degree of asymmetry in the flow at the left and right parts of the CoW and the presence of swirling flow in most of the CoW arteries. In the second simulation, one of the main findings was a high pressure drop at the right anterior communicating artery (PCA). Due to the incompleteness of the CoW and the pressure drop at the PCA, the right internal carotid artery supplies blood to most regions of the brain.

Grinberg, Leopold; Anor, Tomer; Madsen, Joseph; Karniadakis, George



Early effects of cranial irradiation on hypothalamic-pituitary function  

SciTech Connect

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.

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



Heterochrony and patterns of cranial suture closure in hystricognath rodents  

PubMed Central

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.

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



Legionnaires' Disease with Facial Nerve Palsy  

PubMed Central

Legionnaires' disease is primarily a pneumonic process caused by Legionella pneumophilia, a gram-negative aerobic bacillus but also has multiple system involvement. The most common manifestation is encephalopathy suggesting a generalized brain dysfunction but focal neurological manifestations have been reported. We report a patient with Legionella pneumonia associated with cerebellar dysfunction and unilateral facial nerve weakness. 51-year-old previously healthy male presented with shortness of breath, cough, slurred speech, and unsteadiness on feet associated with malaise, fevers and myalgias. Patient's family reported facial asymmetry for 2 days. Patient had no significant medical history and was not on any medication. He denied smoking, alcohol or illicit drug use. Chest X-ray showed bilateral lower lobe infiltrates. Urinary antigen assay for Legionella pneumophilia serogroup 1 was positive. Patient was started on intravenous moxifloxacin. On day 5 the patient was discharged home and continued oral moxifloxacin for two weeks. After the two weeks, his respiratory symptoms, gait ataxia and dysarthria resolved. We report the first case of Legionnaires' disease with cerebellar dysfunction and seventh nerve palsy. Legionnaires' disease should be considered in patients with any neurological symptoms in the setting of pneumonia. Failure to recognize and treat the infection may lead to poor outcomes.

Basani, Shailesh R.; Ahmed, Salwa Mohamed; Habte-Gabr, Eyassu



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

PubMed Central

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.

Al-Khaled, Mohamed; Matthis, Christine; Munte, Thomas F; Eggers, Jurgen



[Ethmoid sinus mucocele penetrating to the orbit and anterior cranial fossa - case report].  


Paranasal sinus mucocele is the cystic formation lined by inflammatory changed mucoperiosteum. This is slow-growing pathology with a tendency to bone erosion. The symptoms are dependent on the direction of the penetration, and are as follows: increasing headaches, deformations of frontal or orbital region, ophthalmic manifestations such as lacrimation, decreased visual acuity, exophthalmos, ocular movement limitation, diplopia. The most common location of the mucocele is fronto-ethmoid region. The most useful diagnostic tests are a magnetic resonance imaging (MRI) and a computed tomography (CT) which show the progress of the disease and bone destructions. Surgery is the only method of treatment (external approach or FESS). This paper reports the case of a 74-year-old woman with ethmoid mucocele penetrating into the orbit, frontal sinus and anterior cranial fossa with compression of frontal lobe of the brain. The patient underwent CT and MRI and was treated with endoscopic intranasal marsupialization of the cyst. There are no clinical signs of disease recurrence 7 months after surgery. The endoscopic surgical management in treatment of sinus mucocele is a good alternative to the operation from external approach because of its low invasiveness, low complication risk, rapid healing and good therapeutic effects. PMID:24021830

Paradowska-Opa?ka, Beata; Kawczy?ski, Maciej; Jaworowska, Ewa



18F-FDG PET/CT diagnosis of vagus nerve neurolymphomatosis.  


A 62-year-old woman was in remission from previously treated stage IV diffuse large B-cell lymphoma with cranial involvement. She presented with new-onset hoarseness of voice and choking; MRI of the brain showed disease recurrence in the left cavernous sinus. She was subsequently referred for F-FDG PET/CT with contrast for further evaluation of lymphomatous recurrence. F-FDG PET/CT not only revealed hypermetabolic activity in the left cavernous sinus correlating to the MRI findings but also showed an interesting manifestation explaining the patient's hoarseness of voice, being neurolymphomatosis along the left vagus nerve. PMID:22889783

Tsang, Hailey Hoi Ching; Lee, Elaine Yuen Phin; Anthony, Marina-Portia; Khong, Pek-Lan



Occurrence of trochlear nerve palsy after epiduroscopic laser discectomy and neural decompression.  


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

Yoon, Keon Jung; Lee, Eun Ha; Kim, Su Hwa; Noh, Mi Sun



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

Microsoft Academic Search

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

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



Opioids and Sensory Nerves  

Microsoft Academic Search

\\u000a This chapter reviews the expression and regulation of opioid receptors in sensory neurons and the interactions of these receptors\\u000a with endogenous and exogenous opioid ligands. Inflammation of peripheral tissues leads to increased synthesis and axonal transport\\u000a of opioid receptors in dorsal root ganglion neurons. This results in opioid receptor upregulation and enhanced G protein coupling\\u000a at peripheral sensory nerve terminals.

Christoph Stein; Christian Zöllner


Transfection of Nerve Cells  

Microsoft Academic Search

Transfection is a method of transforming cells based on the introduction into living cells of plasmids encoding a particular\\u000a protein or RNA. This review describes the main methods of transfection and considers their advantages and disadvantages. Most\\u000a attention is paid to lentivirus transduction as one of the most efficient methods for transforming nerve cells. The development\\u000a of current transfection systems

S. V. Salozhin; A. P. Bol’shakov



Optic nerve hypoplasia  

PubMed Central

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).

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



Nevra in a Greek village: Idiom, metaphor, symptom, or disorder?  

Microsoft Academic Search

The folk model for nevra (nerves) in Methana, Greece, is discussed in terms of the contradiction between the ideal of solidarity, central to the local family ideology, and the reality of interpersonal conflict in daily life. Contradictions in values resulting from rapid socioeco?nomic change are also considered. Nevra, a broad, ambiguous, negotiated concept, expresses a wide range of symptoms and

Mari H. Clark



Cranial Size and IQ in Asian Americans from Birth to Age Seven.  

ERIC Educational Resources Information Center

Data from the Collaborative Perinatal Project analyzed for a subsample of 100 Asian Americans showed a higher IQ for the Asian American sample at age 7, and larger cranial capacity at birth, 4 months, 1 year, and 7 years as compared to Whites and Blacks. Socioeconomic status related to cranial capacity and IQ scores, but not stature or weight.…

Rushton, J. Philippe



Genetic and environmental contributions to cranial capacity in black and white adolescents  

Microsoft Academic Search

Data from 236 pairs of twins (472 individuals) aged 13 to 17 years were used to examine genetic and environmental factors influencing cranial size, an indirect estimate of brain volume. Measures were taken of zygosity, head lenght, head breadth, age, sex, race, height, and weight for 187 males and 285 females, 222 Whites and 250 Blacks. Cranial size was estimated

R. Travis Osborne



Cranial osteology of Guizhouichthyosaurus tangae (Reptilia: Ichthyosauria) from the Upper Triassic of China  

Microsoft Academic Search

The cranial osteology of the large ichthyosaur Guizhouichthyosaurus tangae from the Wayao Member of the Falang Formation (Lower Carnian, Upper Triassic) of Guizhou, southwest China, is described, based on a well preserved skull and mandible and additional specimens. It can be diagnosed by a suite of cranial characters that include premaxilla without well-developed processus subnarialis, maxilla reaches far anteriorly and

Michael W. Maisch; Xin-Ru Pan; Zuo-Yu Sun; Tao Cai; Da-Peng Zhang; Jia-Lin Xie



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

PubMed Central

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



Advice on hair and scalp care during cranial radiotherapy: a prospective randomized trial  

Microsoft Academic Search

Background: The advice on hair washing during brain irradiation is aimed at minimizing radiation induced skin toxicity. We performed a prospective randomized trial to assess the effect of advice on scalp care on the local skin reaction in patients undergoing cranial radiotherapy.Methods: One hundred and nine patients undergoing cranial radiotherapy were randomized into two groups. Patients in group 1 were

Charlotte Westbury; Frances Hines; Elizabeth Hawkes; Susan Ashley; Michael Brada



Combined intrinsic and extrinsic influences pattern cranial neural crest migration and pharyngeal arch morphogenesis in axolotl  

Microsoft Academic Search

Cranial neural crest cells migrate in a precisely segmented manner to form cranial ganglia, facial skeleton and other derivatives. Here, we investigate the mechanisms underlying this patterning in the axolotl embryo using a combination of tissue culture, molecular markers, scanning electron microscopy and vital dye analysis. In vitro experiments reveal an intrinsic component to segmental migration; neural crest cells from

Robert Cerny; Daniel Meulemans; Jürgen Berger; Michaela Wilsch-Bräuninger; Thomas Kurth; Marianne Bronner-Fraser; Hans-Henning Epperleina



Thickness of the human cranial diploe in relation to age, sex and general body build  

Microsoft Academic Search

BACKGROUND: Earlier studies have addressed the human total cranial vault thickness and generally found no correlation with sex, age or body weight. However, the thickness of the diploe has not been investigated. Our study has determined the diploeic thickness of the human cranial vault using modern autopsy material. METHODS: The diploeic bone thickness was measured in 64 individuals (43 males,

Niels Lynnerup; Jacob G Astrup; Birgitte Sejrsen



Evolutionary Relationships between Cranial Shape and Diet in Bats (Mammalia: Chiroptera)  

Microsoft Academic Search

The trophic radiation of new world phyllostomid bats has often been cited as an example of an explosive adaptive radiation. However, among Old World bats a similar radiation into diverse feeding niches such as frugivory, carnivory, insectivory and nectarivory has occurred. Previous analyses of cranial shape in dietary specialists have indicated general trends in cranial shape that seemed to be

Victor Van Cakenberghe; Anthony Herrel; Luis F. Aguirre


Myelinated axon number in the optic nerve is unaffected by Alzheimer's disease.  

PubMed Central

AIMS/BACKGROUND--Visual symptoms are a common but not invariable feature of Alzheimer's disease (AD) and such symptoms appear to become more pronounced as the severity of the dementia increases. Pathology in both the pregeniculate and cortical parts of the visual system has been suggested to underlie the visual deficits in AD. In order to investigate the former possibility, the effect of AD on the optic nerve was investigated. METHODS--Intraorbital segments of optic nerve were taken at autopsy from nine patients with AD and seven patients with no history of psychiatric or neurological disease and no abnormal neuropathology. All patients had functional vision before death and appeared free of retinal, optic nerve, or microvascular disease. The optic nerves were processed into resin, semi-thin sections cut perpendicular to the long axis of each optic nerve, and stained with paraphenylenediamine. The sections were then investigated using an image analysis system and standard morphometric techniques. RESULTS--There was no significant difference in the mean cross sectional neural area of AD compared with control optic nerves. Neither were there any significant differences between myelinated axon surface density, total axon number, or mean cross sectional axon area in AD compared with control optic nerves. CONCLUSION--These results indicate that optic nerve degeneration is not a feature of AD and suggest that the visual deficits in the disease result from cortical dysfunction. This view is supported by the fact that visuospatial dysfunction appears to be the most common visual problem in AD. Images

Davies, D C; McCoubrie, P; McDonald, B; Jobst, K A



Non-invasive transcranial stimulation of rat abducens nerve by focused ultrasound  

PubMed Central

Non-pharmacological and non-surgical transcranial modulation of the nerve function may provide new opportunities in evaluation and treatment of cranial nerve diseases. This study investigates the possibility of using low-intensity transcranial focused ultrasound (FUS) to selectively stimulate the rat abducens nerve located above the base of the skull. FUS (frequencies of 350 kHz and 650 kHz) operating in a pulsed mode was applied to the abducens nerve of Sprague-Dawley rats under stereotactic guidance. The abductive eyeball movement ipsilateral to the side of sonication was observed at 350 kHz, using the 0.36 msec tone burst duration (TBD), 1.5 kHz pulse repetition frequency (PRF), and the overall sonication duration of 200 msec. Histological and behavioral monitoring showed no signs of disruption in the blood brain barrier (BBB) as well as no damage to the nerves and adjacent brain tissue resulting from the sonication. As a novel functional neuro-modulatory modality, the pulsed application of FUS has potential in diagnostic and therapeutic applications in diseases of the peripheral nervous system.

Kim, Hyungmin; Taghados, Seyed Javid; Fischer, Krisztina; Maeng, Lee-So; Park, Shinsuk; Yoo, Seung-Schik



Cannabis use in HIV for pain and other medical symptoms.  


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

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



Eif3ba regulates cranial neural crest development by modulating p53 in zebrafish.  


Congenital diseases caused by abnormal development of the cranial neural crest usually present craniofacial malformations and heart defects while the precise mechanism is not fully understood. Here, we show that the zebrafish eif3ba mutant caused by pseudo-typed retrovirus insertion exhibited a similar phenotype due to the hypogenesis of cranial neural crest cells (NCCs). The derivatives of cranial NCCs, including the NCC-derived cell population of pharyngeal arches, craniofacial cartilage, pigment cells and the myocardium derived from cardiac NCCs, were affected in this mutant. The expression of several neural crest marker genes, including crestin, dlx2a and nrp2b, was specifically reduced in the cranial regions of the eif3ba mutant. Through fluorescence-tracing of the cranial NCC migration marker nrp2b, we observed reduced intensity of NCC-derived cells in the heart. In addition, p53 was markedly up-regulated in the eif3ba mutant embryos, which correlated with pronounced apoptosis in the cranial area as shown by TUNEL staining. These findings suggest a novel function of eif3ba during embryonic development and a novel level of regulation in the process of cranial NCC development, in addition to providing a potential animal model to mimic congenital diseases due to cranial NCC defects. Furthermore, we report the identification of a novel transgenic fish line Et(gata2a:EGFP)pku418 to trace the migration of cranial NCCs (including cardiac NCCs); this may serve as an invaluable tool for investigating the development and dynamics of cranial NCCs during zebrafish embryogenesis. PMID:23791820

Xia, Zhidan; Tong, Xiangjun; Liang, Fang; Zhang, Yihan; Kuok, Chikin; Zhang, Yingla; Liu, Xinxing; Zhu, Zuoyan; Lin, Shuo; Zhang, Bo



Sacral nerve stimulation: Interstim therapy.  


Sacral nerve stimulation is a young but promising technique in the treatment of chronic voiding dysfunctions. Electrical stimulation of the S3 nerve--using a pacemaker device--is able to treat a wide range of pelvic floor dysfunctions. This article gives a brief review on the indications, mechanisms of action and possible complications of this technique. Furthermore, new evolutions in the domain of sacral nerve modulation are discussed. PMID:16288588

Peeren, Frederick; Hoebeke, Piet; Everaert, Karel



Neurophysiology of Nerve Conduction Studies  

Microsoft Academic Search

The methodology for performing standard nerve conduction studies has been established by identifying the most helpful and\\u000a consistent physiological data obtainable while being constrained by a variety of technical and practical limitations. Nerve\\u000a stimulation occurs underneath the negatively charged anode of the applied stimulator and simultaneous hyperpolarization of\\u000a the nerve occurs beneath the positively charged cathode. Referential or bipolar recording

James B. Caress; Gregory J. Esper; Seward B. Rutkove


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

PubMed Central

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

Zhang, Niu; He, Xiaohua



Cranial malformations in related white lions (Panthera leo krugeri).  


White lions (Panthera leo krugeri) have never been common in the wild, and at present, the greatest population is kept in zoos where they are bred for biological and biodiversity conservation. During the years 2003 to 2008 in a zoological garden in northern Italy, 19 white lions were born to the same parents, who were in turn paternally consanguineous. Out of the 19 lions, 4 (21%) were stillborn, 13 (69%) died within 1 month, and 1 (5%) was euthanatized after 6 months because of difficulty with prehension of food. Six lions (32%) showed malformations involving the head (jaw, tongue, throat, teeth, and cranial bones). One lion (5%) still alive at 30 months revealed an Arnold-Chiari malformation upon submission for neurological evaluation of postural and gait abnormalities. Paternal consanguinity of the parents, along with inbreeding among white lions in general, could account for the high incidence of congenital malformations of the head in this pride of white lions. PMID:20826844

Scaglione, F E; Schröder, C; Degiorgi, G; Zeira, O; Bollo, E



Determining the sex of human remains through cranial morphology.  


Sex determination is the keystone of a biological profile, yet few qualitative methods of cranial sex determination have been tested. This analysis examines the accuracy and precision of 17 morphological features of the skull commonly used to determine the sex of unknown skeletal remains. The sample consists of 46 identified skulls from the 19th century St. Thomas' Anglican Church Cemetery in Belleville, Canada. Nasal aperature, zygomatic extension, malar size/rugosity, and supraorbital ridge proved the most useful; of secondary value are chin form and nuchal crest; mastoid size is of tertiary consideration; nasal size and mandibular symphysis/ramus size rank fourth; forehead shape ranks fifth; and palate size/shape are sixth. Skull size/architecture provides an internal standard to assess the relative sizes of other traits. This research is a necessary step in establishing the credibility of morphological sex determination with respect to the Daubert and Mohan criteria for admissibility in a court of law. PMID:15932077

Rogers, Tracy L



Spontaneous spinal subdural hematoma concurrent with cranial subdural hematoma.  


A 39-year old female presented with chronic spinal subdural hematoma manifesting as low back pain and radiating pain from both legs. Magnetic resonance imaging (MRI) showed spinal subdural hematoma (SDH) extending from L4 to S2 leading to severe central spinal canal stenosis. One day after admission, she complained of nausea and severe headache. Computed tomography of the brain revealed chronic SDH associated with midline shift. Intracranial chronic SDH was evacuated through two burr holes. Back pain and radiating leg pain derived from the spinal SDH diminished about 2 weeks after admission and spinal SDH was completely resolved on MRI obtained 3 months after onset. Physicians should be aware of such a condition and check the possibility of concurrent cranial SDH in patients with spinal SDH, especially with non-traumatic origin. PMID:24044087

Moon, Wonjun; Joo, Wonil; Chough, Jeongki; Park, Haekwan



Spontaneous Spinal Subdural Hematoma Concurrent with Cranial Subdural Hematoma  

PubMed Central

A 39-year old female presented with chronic spinal subdural hematoma manifesting as low back pain and radiating pain from both legs. Magnetic resonance imaging (MRI) showed spinal subdural hematoma (SDH) extending from L4 to S2 leading to severe central spinal canal stenosis. One day after admission, she complained of nausea and severe headache. Computed tomography of the brain revealed chronic SDH associated with midline shift. Intracranial chronic SDH was evacuated through two burr holes. Back pain and radiating leg pain derived from the spinal SDH diminished about 2 weeks after admission and spinal SDH was completely resolved on MRI obtained 3 months after onset. Physicians should be aware of such a condition and check the possibility of concurrent cranial SDH in patients with spinal SDH, especially with non-traumatic origin.

Moon, Wonjun; Chough, Jeongki; Park, Haekwan



Lymphatic Drainage of the Neuraxis in Chronic Fatigue Syndrome: A Hypothetical Model for the Cranial Rhythmic Impulse  

Microsoft Academic Search

The cranial rhythmic impulse is a palpable, rhythmic fluc- tuation believed to be synchronous with the primary respi- ratory mechanism. The precise physiologic mechanism of the cranial rhythmic impulse is not fully understood. Based on traditional and current views of the cranial rhythmic impulse, animal studies, and clinical findings in patients with chronic fatigue syndrome, the author argues that the

Raymond N. Perrin



Cranial facet joint violations by percutaneously placed pedicle screws adjacent to a minimally invasive lumbar spinal fusion  

Microsoft Academic Search

Background contextProtecting cranial facet joint is a modifiable risk factor that may decrease the incidence of adjacent segment disease after lumbar spinal fusion. Percutaneously instrumented screws may more frequently violate cranial facet joints because of the potential limitation of screw entry site selection. To our knowledge, however, there is no study that has evaluated the cranial facet joint violations adjacent

Yung Park; Joong Won Ha; Yun Tae Lee; Na Young Sung



Nerve conduction and electromyography studies.  


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

Kane, N M; Oware, A



Nerve Agents: A Comprehensive Review  

Microsoft Academic Search

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

Sage W. Wiener; Robert S. Hoffman



Different Cranial Ontogeny in Europeans and Southern Africans  

PubMed Central

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.

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



A case of malignant transformation of vagus nerve schwannoma to angiosarcoma.  


Background. It is known that benign tumors have the potential for malignant transformation. Malignant transformation of vagus nerve schwannoma to angiosarcoma is very rare. Methods. We report a case of malignant transformation, where initial diagnosis was subsequently altered to angiosarcoma originating from the vagus nerve. We compare the findings of magnetic resonance imaging (MRI) and fine needle aspiration (FNA) at initial diagnosis with those following malignant transformation. Results. MRI revealed the mass property had been changed from the initially tumor, also the FNA findings were significantly different from those in the previous ones. The patient had significant clinical progression, with multiple cranial neuropathies and died. Conclusion. Schwannomas sometimes undergo malignant transformation, surgery should be recommended. If follow-up observation is chosen, MRI and FNA should be regular and patients should sign a statement acknowledging awareness of the potential for malignant transformation. © 2013 Wiley Periodicals, Inc. Head Neck, 2013. PMID:23720355

Ogawa, Tetsuya; Kato, Takashige; Ikeda, Atsuhiko; Nishimura, Kunihiro; Tsuchiya, Yoshimasa; Okamoto, Hiroki; Takahashi, Emiko; Yokoi, Toyoharu; Ueda, Hiromi



[Optic nerve neuritis].  


Optic nerve neuritis is one of the most important differential diagnoses of visual loss in young and middle aged adults. The prognosis in terms of functional outcome is generally good. The diagnosis of optic neuritis is clinical. Steroids can reduce the recovery time but do not affect the long-term functional outcome. Magnetic resonance imaging (MRI) is the most important investigation for assessing an associated risk of multiple sclerosis. Optical coherence tomography (OCT) contributes additional details on the course and functional outcome of optic neuritis. In the future OCT may additionally contribute to the relationship between optic neuritis and possible associated multiple sclerosis. PMID:23933792

Steffen, H



Nerve-pulse interactions  

SciTech Connect

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.

Scott, A.C.



Apparent diffusion coefficient on rat brain and nerves intoxicated with methylmercury.  


The effects of methylmercury chloride (MMC) on the degenerative changes in rat brain and cranial nerves were studied. Twelve Wistar rats were divided into two equal groups. The rat model of methylmercury intoxication (MMC group) was made by subcutaneously administering 10 mg mercury/g body weight daily for 7 days. Control group rats were infused with the same amount of normal saline during this period. Magnetic resonance imaging (MRI) measurements were performed before and 14 days after the first MMC administration, using a 4.7-T MR system. No significant focal changes were observed on T1- and T2-weighted MR images regarding the internal structures of the brains of the MMC-intoxicated rats, atrophy of the cerebellum, and dilatation of the arachnoid space around the brain stem of MMC-treated rats, but were demonstrated without edematous change. The apparent diffusion coefficients (ADC) of the cortex, caudate-putamen, and trigeminal nerve were not significantly different between the MMC-treated and control rats. However, the ADC parallel to the optic nerves were significantly increased in the MMC group, in contrast to the unchanged ADC perpendicular to the optic nerves. An electron microscopy study revealed a marked decrease of microtubules and moderate decrease of neurofilaments in the axons of myelinated fibers of optic nerves of the MMC-treated rats. We have thus demonstrated a disturbance in the integrity of microtubules and neurofilaments as a toxic action of MMC in the rat nervous system in vivo, particularly in the optic nerves. The use of ADC values calculated by diffusion-weighted MRI is a promising approach for the evaluation of changes in brains and nerves in methylmercury intoxication research. PMID:10330308

Kinoshita, Y; Ohnishi, A; Kohshi, K; Yokota, A



In vivo nerve-macrophage interactions following peripheral nerve injury  

PubMed Central

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.

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



In vivo nerve-macrophage interactions following peripheral nerve injury.  


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 Wld(s) 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

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



Unusual complication of otitis media with effusion: facial nerve paralysis.  


Facial nerve paralysis (FNP) is a very rare complication of otitis media with effusion (OME). There are few patients with OME and FNP in the literature. A 5-year-old girl was admitted to our department with right facial weakness. Right FNP and right OME were diagnosed on the examination. After medical treatment and ventilation tube insertion, FNP completely resolved. The symptoms, signs, and management of this patient are presented. PMID:21778856

Vayisoglu, Yusuf; Gorur, Kemal; Ozcan, Cengiz; Korlu, Sava?



Symptoms of Lung Cancer  


... and Giving Support For Health Professionals Get Involved Lung HelpLine Questions about your lung health? Ask an ... Lung Cancer Symptoms What are the Symptoms of Lung Cancer? Many people with lung cancer don’t ...


Signs and Symptoms  


... have milder symptoms. Rapid, forceful or irregular heartbeats (palpitations and arrhythmias) are common complications associated with hypertrophic ... in life. Common symptoms include shortness of breath, palpitations, fainting, swollen neck veins, abdominal discomfort and irregular ...


Symptoms, Diagnosis & Treatment  


... Home Current Issue Past Issues Cover Story: Leukemia/Lymphoma Symptoms, Diagnosis & Treatment Past Issues / Summer 2008 Table ... into (and restore) the body's blood cells. Hodgkin's Lymphoma Symptoms Painless, swollen lymph nodes in the neck, ...


Cervical Cancer Symptoms  


... Foundation for Women’s Cancer Home Types of Gynecologic Cancers Cervical Cancer Diagnosis and Treatment Symptoms Symptoms Cervical cancer ... Stay Connected About Gynecologic Cancers Types of Gynecologic Cancers Cervical Cancer Screening and Prevention Primary Prevention with Cervical ...


Vitiligo: Signs and Symptoms  


... Diseases and treatments U - W Vitiligo Signs, symptoms Vitiligo: Signs and symptoms Vitiligo causes loss of color. ... amount of color loss or type of vitiligo. Vitiligo has types and subtypes If you are diagnosed ...


Warts: Signs and Symptoms  


... Diseases and treatments U - W Warts Signs, symptoms Warts: Signs and symptoms There are a few different ... some of the different types of warts. Common warts (also called vurruca vulgaris) Wart under a child's ...


Shingles: Signs and Symptoms  


... Diseases and treatments Q - T Shingles Signs, symptoms Shingles: Signs and symptoms Shingles tends to cause more pain and less itching ... get a fever or headache with the rash. Shingles . The rash can be very painful and widespread. ...


Determination of nerve conduction abnormalities in patients with impaired glucose tolerance  

Microsoft Academic Search

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

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



Pupil-sparing third nerve palsy with preoperative improvement from a posterior communicating artery aneurysm  

Microsoft Academic Search

BACKGROUNDDespite the plenitude of reports concerning partial or complete third nerve palsies, especially as presenting symptoms with posterior communicating artery (PCoA) aneurysms, we present a patient with an unusual variation.CASE DESCRIPTIONA 66-year-old woman presented with progressive right-sided headaches and diplopia and was found to have a partial, pupil-sparing third nerve palsy. A small right-sided PCoA aneurysm, nearly indistinguishable from an

Jeffrey E Arle; John M Abrahams; Eric L Zager; Carolyn Taylor; Steven L Galetta



Altered thermal sensitivity in injured and demyelinated nerve  

PubMed Central

Electrophysiological studies were performed on frog and guinea-pig peripheral nerves to determine the effect of temperature on conduction at the site of pressure and demyelinating lesions. An increased susceptibility to thermally-induced conduction blockade has been demonstrated. In pressure-injured frog and guinea-pig nerves, conduction blocks occur at temperatures approximately 6°C lower than in normal nerves. A similar phenomenon occurs in guinea-pig demyelinated nerve (experimental allergic neuritis) and in some cases at temperatures around 15°C lower than in controls. It is suggested that these effects are the result of a critical lowering by temperature of an already markedly depressed conduction safety factor. In support of this, it has been shown that calcium ion depletion, which would be expected to increase the conduction safety factor by lowering the threshold for excitation, counteracts the increased thermal sensitivity of frog pressure-injured nerve. These findings are discussed in relation to well-known temperature effects in multiple sclerosis. They add support to an earlier proposed hypothesis that the changes in signs and symptoms with a change of body temperature in multiple sclerosis may be caused by an effect of temperature on axonal conduction. Images

Davis, Floyd A.; Jacobson, Samuel



Prefabricated patient-matched cranial implants for reconstruction of large skull defects.  


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

Sundseth, Jarle; Berg-Johnsen, Jon



Managing Chemotherapy Side Effects: Nerve Changes  


... anD human services national institutes of health Managing Chemotherapy Side Effects Nerve Changes About nerve changes Some chemotherapy can ... from getting cuts, I always wore shoes.” Managing Chemotherapy Side Effects: Nerve Changes Try these tips from others: “Prevent ...


[A case of Churg-Strauss syndrome with subarachnoid hemorrhage and left phrenic nerve paralysis].  


A 60-year-old woman was given a diagnosis of Churg-Strauss syndrome (CSS) in 2000 because of peripheral blood eosinophilia, eosinophilic pneumonia, asthma, polyarticular pain, and limb numbness. She was treated with prednisolone (PSL), and the above symptoms improved but then relapsed on tapering of PSL. In September 2009, after 7 days of tapering of PSL to 5mg/day, the patient developed a subarachnoid hemorrhage and was admitted. MRA and cerebral angiography revealed no aneurysm; the source of bleeding could not be determined, but her symptoms indicated a benign course. A chest X-ray 27 days after admission showed left diaphragmatic elevation, and left phrenic nerve paralysis was diagnosed by a phrenic nerve stimulation test. Peripheral blood eosinophilia had progressed gradually during the admission period, and although it is rare for subarachnoid hemorrhage and phrenic nerve paralysis to be associated with CSS, we regarded these as vasculitis symptoms related to CSS. PMID:22073608

Shimizu, Kyoko; Ohoba, Hiromi; Shimada, Hiroyuki; Inoue, Yukihisa; Jinn, Yasuto; Yoshimura, Nobuyuki



Functions of the Renal Nerves.  

ERIC Educational Resources Information Center

|Discusses renal neuroanatomy, renal vasculature, renal tubules, renin secretion, renorenal reflexes, and hypertension as related to renal nerve functions. Indicates that high intensitites of renal nerve stimulation have produced alterations in several renal functions. (A chart with various stimulations and resultant renal functions and 10-item,…

Koepke, John P.; DiBona, Gerald F.



Nerve Agent Sensing Biopolymer Wipe.  

National Technical Information Service (NTIS)

This research and development project entitled 'Nerve Agent Sensing Biopolymer Wipe' is directed at developing a simple-to-use enzyme-containing sensor for detecting nerve agent contamination at surfaces, in air and in solution, and to provide a tool for ...

M. Erbeldinger K. LeJeune



Human diabetic endoneurial sorbitol, fructose, and myo-inositol related to sural nerve morphometry.  


Fascicles of the sural nerve from each of 20 diabetic patients, mostly with maturity-onset diabetes, were studied by biochemical and pathological techniques, and results were compared to values found in nerve specimens from 15 healthy persons. The sorbitol and fructose content was much more variable in diabetic than in healthy nerves. More than one-third of the diabetic nerves had sorbitol and fructose values above the highest levels for controls. myo-Inositol and scyllo-inositol content was not reduced in diabetic nerves. The sorbitol, fructose, and inositol concentrations could not be related to clinical, neurophysiological, or pathological severity of neuropathy. A comparison of scored symptoms and signs and clinical neurophysiological studies against morphometric and teased fiber studies of sural nerve demonstrated that the former three provide sensitive and reliable measures of severity of neuropathy that can be used for controlled clinical trials of diabetic neuropathy. The presence and type of teased fiber abnormalities could be related to the duration of diabetes and to symptoms of neuropathy. In untreated diabetics without symptoms of neuropathy, a higher than normal frequency of teased fibers showing segmental demyelination and remyelination was found. Untreated diabetics with symptomatic neuropathy showed two kinds of abnormalities: fibers with segmental demyelination and remyelination and fibers undergoing axonal degeneration. In treated diabetics, who often had longstanding neuropathy, the most common abnormalities were fibers undergoing axonal degeneration. PMID:7212646

Dyck, P J; Sherman, W R; Hallcher, L M; Service, F J; O'Brien, P C; Grina, L A; Palumbo, P J; Swanson, C J



Welander's distal myopathy: clinical, neurophysiological and muscle biopsy observations in young and middle aged adults with early symptoms  

Microsoft Academic Search

Nine young or middle aged patients with early symptoms of Welander's distal myopathy were subjected to a detailed neurological examination including quantitative sensory testing, determination of motor and sensory nerve conduction velocity (NCV), sensory nerve action potentials, electromyography (EMG) and muscle biopsy from the tibialis anterior muscle (TA). Slight weakness of the extensors of the fingers and hands was found

K Borg; G Ahlberg; J Borg; L Edström



Isolated radial nerve palsy in newborns-case report of a bilateral manifestation and literature review.  


Uni- or bilateral radial nerve palsy in newborn is a rare symptom. We report about a case of unusual bilateral radial nerve palsy in a term-born girl who recovered completely after 10 months and review the English-speaking literature about this condition. Review of the literature shows less than 60 reported cases of radial nerve palsy, most of them unilateral. Conclusion: Besides the clinical examination, in most cases, no further diagnostic investigation is necessary. An incomplete restitution is rare as recovery mostly occurs within 3-6 months. PMID:23686513

Böhringer, Elisabeth; Weber, Peter



Multiple Intraneural Glomus Tumors on a Digital Nerve: Case Report.  


Glomus tumors are soft-tissue tumors that are commonly found in the hand. Intraneural glomus tumors, however, are rare, and the few reported cases are mostly solitary tumors. We present a woman with a symptomatic swelling on her finger whose imaging findings suggested multiple tumors on the digital nerve, most compatible with a neuroma. Surgical excision and histology, however, confirmed the presence of multiple glomus tumors of the digital nerve. The patient's symptoms resolved after surgery. We describe the biology, typical presentation, and clinico-pathologic features of glomus tumors associated with a peripheral nerve and explore issues that the clinician should consider with multiple tumors. PMID:24079525

Wong, Gloria N L; Nandini, C L; Teoh, Lam Chuan



An aneurysmal bone cyst within the proximal fibula causing common peroneal nerve palsy.  


The case of a 15-year-old patient presenting with pain as well as paraesthesia over the lateral aspect of the leg is reported. Clinical and radiological investigations showed an aneurysmal bone cyst arising from the proximal fibula and pressing on the common peroneal nerve. Surgical decompression of the nerve and curettage of the cyst was performed resulting in complete resolution of his symptoms. Our aim is to alert surgeons that this problem may occur and that the entire nerve needs to be exposed when dealing with the cyst. PMID:21822623

Jesudason, Prash; Akhtar, Sabeen; Zenios, Michalis



Posterior cranial vault distraction osteogenesis in craniosynostosis: estimated increases in intracranial volume  

Microsoft Academic Search

Purpose  To study distraction osteogenesis of the posterior cranial vault in children requiring increased intracranial volume.\\u000a \\u000a \\u000a \\u000a Materials and methods  Ten patients were treated with cranial distractors. Five children had previously been operated for scaphocephaly and one child\\u000a for Saether-Chotzen syndrome. Two patients had bilateral coronal suture synostosis with Muenke syndrome and two patients had\\u000a Apert syndrome. At surgery, the cranial bones were

Willy S. Serlo; Leena P. Ylikontiola; Niina Lähdesluoma; Olli-Pekka Lappalainen; Jarkko Korpi; Jani Verkasalo; George K. B. Sàndor



Primary lymphoma of the cranial vault: case report and a systematic review of the literature  

Microsoft Academic Search

Background  Bone involvement is a common finding in many types of lymphoma. Cranial vault involvement is extremely rare, and the majority\\u000a of patients are found at staging to have concurrent disease in lymph nodes. Thirty-eight cases of primary lymphoma of the\\u000a cranial vault have been reported to date.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This article presents a rare case of primary cranial vault lymphoma and conducts

Abad Cherif El Asri; Ali Akhaddar; Hassan Baallal; Omar Boulahroud; Cherkaoui Mandour; Hafsa Chahdi; Mohammed Mikdame; Miloudi Gazzaz; Brahim El Mostarchid; Mohamed Boucetta


Cranial vault defects: the description of three cases that illustrate a spectrum of anomalies.  


Three cases of cranial vault defects in fetuses are described. All 3 cases underwent postmortem examination, and in 2 of them postmortem magnetic resonance imaging was also performed. The phenotypical differences between the cases illustrate a spectrum of cranial vault defects, associated anomalies, and pathogenic mechanisms involved in the etiology of this rare malformation. All 3 cases were male, and the cranial vault defects corresponded to exencephaly with acrania/acalvaria caused by amniotic band syndrome, acalvaria, and acrania presenting in a chorangiopagus parasiticus twin. PMID:18442303

Evans, Clair; Marton, Tamas; Rutter, Susan; Anumba, Dilly O; Whitby, Elspeth H; Cohen, Marta C



Vertigo and cranial nerve palsy caused by different forms of spontaneous dissections of internal and vertebral arteries  

Microsoft Academic Search

In this report we compare a subintimal hemorrhage of a dissected vertebral artery to a subadventitial hemorrhage of a dissected extracranial internal carotid artery. A subintimal hemorrhage compresses the lumen of the artery. Therefore, magnetic resonance imaging (MRI), angiography and ultrasound are screening methods. For the subadventitial hemorrhage, which does not really compress the lumen but forms an aneurysmal dilatation,

Victor Bonkowsky; Silke Steinbach; Wolfgang Arnold



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

Microsoft Academic Search

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

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



Nerve stimulation for chronic pelvic pain and bladder pain syndrome: a systematic review.  


Chronic pelvic pain (CPP) and bladder pain syndrome (BPS) can have a negative impact on quality of life. Neuromodulation has been suggested as a possible treatment for refractory pain. To assess the effectiveness of tibial and sacral nerve stimulation in the treatment of BPS and CPP. We searched until July 2012: the Cochrane Library, EMBASE (1980-2012), Medline (1950-2012), Web of knowledge (1900-2012), LILACS (1982-2012) and SIGLE (1990-2012) with no language restrictions. We manually searched through bibliographies and conference proceedings of the International Continence Society. Randomized and prospective quasi-randomized controlled studies vs. sham nerve stimulation treatment or usual care of patients with CPP and BPS who underwent sacral or tibial nerve stimulation were included. Any studies involving transcutaneous stimulation were excluded. The outcome was a cure or improvement in symptoms. Three studies with 169 patients treated with tibial nerve stimulation were included; two for CPP and one for BPS. There were improvements in pain, urinary and quality of life scores. There were no reported data for sacral nerve stimulation. There is scanty literature reporting variable success of posterior tibial nerve stimulation in improving pain, urinary symptoms and quality of life in CPP and BPS. In view of the dearth of quality literature, a large multi-centered clinical trial investigating the effectiveness of electrical nerve stimulation to treat BPS and CPP along with the cost-analysis of this treatment is recommended. PMID:23710833

Tirlapur, Seema A; Vlismas, Antonis; Ball, Elizabeth; Khan, Khalid S



Permanent Sacral Nerve Stimulation for Fecal Incontinence  

PubMed Central

Objective To characterize the longer-term therapeutic response of permanent sacral nerve stimulation for fecal incontinence and to delineate suitable indications and the mode of action. Summary Background Data A single report of permanent sacral nerve stimulation in three patients followed up for 6 months showed marked improvement in fecal continence. Acute evaluation has shown that the effect may be mediated by altered rectal and anal smooth muscle activity, and facilitation of external sphincter contraction. Methods Five women (age 41–68 years) with fecal incontinence for solid or liquid stool at least once per week were followed up for a median of 16 months after permanent implantation. All had passive incontinence, and three had urge incontinence. The cause was scleroderma in two, primary internal sphincter degeneration in one, diffuse weakness of both sphincters in one, and disruption of both sphincters in one. Results All patients had marked improvement. Urgency resolved in all three patients with this symptom. Passive soiling resolved completely in three and was reduced to minor episodes in two. Continence scores (scale 0–20) improved from a median of 16 before surgery to 2 after surgery. There were no early complications, and there have been no side effects. One patient required wound exploration at 6 months for local pain, and a lead replacement at 12 months for electrode displacement. The quality of life assessment improved in all patients. The resting pressure increased in four patients, but there was no consistent measured physiologic change that could account for the symptomatic improvement. Conclusions In patients with sphincter degeneration and weakness, and possibly in those with sphincter disruption, sacral nerve stimulation markedly improves fecal incontinence.

Malouf, Andrew J.; Vaizey, Carolynne J.; Nicholls, R. John; Kamm, Michael A.



A resorbable nerve conduit as an alternative to nerve autograft in nerve gap repair  

Microsoft Academic Search

Poly-3-hydroxybutyrate (PHB) occurs within bacterial cytoplasm as granules and is available as bioabsorbable sheets. Previously, the advantage of PHB in primary repair has been investigated while in this study the same material has been used to bridge an irreducible gap. The aim was to assess the level of regeneration in PHB conduits compared to nerve autografts.The rat sciatic nerve was

A. Hazari; M. Wiberg; G. Johansson-Rudén; C. Green; G. Terenghi



Cranial base abnormalities in osteogenesis imperfecta: phenotypic and genotypic determinants.  


Cranial base abnormalities are an important complication of osteogenesis imperfecta (OI), a hereditary bone fragility disorder that in most patients is caused by mutations affecting collagen type I. To elucidate which clinical characteristics are associated with the occurrence of cranial base abnormalities in OI, we compared cephalometric results of 187 OI patients (median age 12.0 years, range 3.4 to 47 years; 96 female) with those of 191 healthy subjects and related findings to clinical descriptors of the disease. Overall, 41 patients (22%) had at least one unambiguously abnormal skull base measure. Multivariate logistic regression analysis in patients with OI types I, III, and IV (n = 169) revealed that height Z-score [odds ratio (OR)?= 0.53, 95% confidence interval (CI) 0.43-0.66, p

Cheung, Moira S; Arponen, Heidi; Roughley, Peter; Azouz, Michel E; Glorieux, Francis H; Waltimo-Sirén, Janna; Rauch, Frank



Acid-sensing by airway afferent nerves.  


Inhalation of acid aerosol or aspiration of acid solution evokes a stimulatory effect on airway C-fiber and A? afferents, which in turn causes airway irritation and triggers an array of defense reflex responses (e.g., cough, reflex bronchoconstriction, etc.). Tissue acidosis can also occur locally in the respiratory tract as a result of ischemia or inflammation, such as in the airways of asthmatic patients during exacerbation. The action of proton on the airway sensory neurons is generated by activation of two different current species: a transient (rapidly activating and inactivating) current mediated through the acid-sensing ion channels, and a slowly activating and sustained current mediated through the transient receptor potential vanilloid type 1 (TRPV1) receptor. In view of the recent findings that the expression and/or sensitivity of TRPV1 are up-regulated in the airway sensory nerves during chronic inflammatory reaction, the proton-evoked irritant effects on these nerves may play an important part in the manifestation of various symptoms</