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1

Lower cranial nerves.  

PubMed

Imaging evaluation of cranial neuropathies requires thorough knowledge of the anatomic, physiologic, and pathologic features of the cranial nerves, as well as detailed clinical information, which is necessary for tailoring the examinations, locating the abnormalities, and interpreting the imaging findings. This article provides clinical, anatomic, and radiological information on lower (7th to 12th) cranial nerves, along with high-resolution magnetic resonance images as a guide for optimal imaging technique, so as to improve the diagnosis of cranial neuropathy. PMID:24210311

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

2014-02-01

2

Tumors of the Cranial Nerves  

Microsoft Academic Search

\\u000a The most frequent tumors of the cranial nerves are referred to as schwannomas (formerly neuromas). They may develop in most\\u000a cranial nerves, except I and II, which do not have Schwann cells, except for very rare cases of ectopic pediatric olfactory\\u000a schwannomas. CNSs account for 8% of intracranial tumors. The incidence is rising since the distribution of MRI became widespread.

Berndt Wowra; Jörg-Christian Tonn

3

The neglected cranial nerve: nervus terminalis (cranial nerve N).  

PubMed

The nervus terminalis (NT; terminal nerve) was clearly identified as an additional cranial nerve in humans more than a century ago yet remains mostly undescribed in modern anatomy textbooks. The nerve is referred to as the nervus terminalis because in species initially examined its fibers were seen entering the brain in the region of the lamina terminalis. It has also been referred to as cranial nerve 0, but because there is no Roman symbol for zero, an N for the Latin word nulla is a better numerical designation. This nerve is very distinct in human fetuses and infants but also has been repeatedly identified in adult human brains. The NT fibers are unmyelinated and emanate from ganglia. The fibers pass through the cribriform plate medial to those of the olfactory nerve fila. The fibers end in the nasal mucosa and probably arise from autonomic/neuromodulatory as well as sensory neurons. The NT has been demonstrated to release luteinizing-releasing luteinizing hormone and is therefore thought to play a role in reproductive behavior. Based on the available evidence, the NT appears to be functional in adult humans and should be taught in medical schools and incorporated into anatomy/neuroanatomy textbooks. PMID:22836597

Vilensky, Joel A

2014-01-01

4

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. PMID:19855858

Gillig, Paulette Marie; Sanders, Richard D.

2009-01-01

5

Extracranial lower cranial nerve sheath tumors  

Microsoft Academic Search

Objective: The purpose of this article is to review the clinicoradiographic features of lower cranial nerve sheath tumors and to outline surgical approaches that allow the safe and complete resection of these lesions. Methods: Thirteen patients with lower cranial nerve sheath tumors of the infratemporal fossa were surgically treated between 7\\/88 and 10\\/99. A retrospective chart analysis provided details pertaining

John P. Leonetti; Bryan Wachter; Sam J. Marzo; Guy Petruzzelli

2001-01-01

6

Palsies of Cranial Nerves That Control Eye Movement  

MedlinePLUS

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

7

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

PubMed

Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways is difficult using two-dimensional (2D) illustrations alone. Three-dimensional (3D) models aid the teacher in describing intricate and complex anatomical structures and help students visualize them. The study of the cranial nerves can be supplemented with 3D, which permits the students to fully visualize their distribution within the craniofacial complex. This article describes the construction and usage of a virtual anatomy platform in Second Life™, which contains 3D models of the cranial nerves III, V, VII, and IX. The Cranial Nerve Skywalk features select cranial nerves and the associated autonomic pathways in an immersive online environment. This teaching supplement was introduced to groups of pre-healthcare professional students in gross anatomy courses at both institutions and student feedback is included. Anat Sci Educ 7: 469-478. © 2014 American Association of Anatomists. PMID:24678025

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

2014-11-12

8

Twelfth cranial nerve involvement in Guillian Barre syndrome  

PubMed Central

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

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

2013-01-01

9

Twelfth cranial nerve involvement in Guillian Barre syndrome.  

PubMed

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

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

2013-07-01

10

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

2007-01-01

11

The naming of the cranial nerves: a historical review.  

PubMed

The giants of medicine and anatomy have each left their mark on the history of the cranial nerves, and much of the history of anatomic study can be viewed through the lens of how the cranial nerves were identified and named. A comprehensive literature review on the classification of the cranial names was performed. The identification of the cranial nerves began with Galen in the 2nd century AD and evolved up through the mid-20th century. In 1778, Samuel Sömmerring, a German anatomist, classified the 12 cranial nerves as we recognize them today. This review expands on the excellent investigations of Flamm, Shaw, and Simon et al., with discussion of the historical identification as well as the process of naming the human cranial nerves. PMID:24323823

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

2014-01-01

12

Frontal Sinus Lymphoma Presenting As Progressive Multiple Cranial Nerve Palsy  

PubMed Central

Primary frontal sinus lymphoma is a very uncommon disease. In all the previously reported cases, the presenting symptoms have been due to the tumor mass effect. We present an unusual case report of an immunocompetent patient who presented with facial palsy, and then progressively developed other cranial nerve palsies over several months. He was later diagnosed with diffuse large B cell lymphoma originating from the frontal sinus. The patient underwent chemotherapy, but eventually had to receive autologous peripheral blood stem cell transplantation. He is currently disease-free. The clinical course, diagnostic workup, and therapeutic outcome are described. PMID:22028175

Kim, Kyubo; Kim, Min Ju; Ahn, Sanghyeon; Bae, So Young; Kim, Won Seog

2011-01-01

13

Morphological characteristics of the cranial root of the accessory nerve.  

PubMed

There has been the controversy surrounding the cranial root (CR) of the accessory nerve. This study was performed to clarify the morphological characteristics of the CR in the cranial cavity. Fifty sides of 25 adult cadaver heads were used. The accessory nerve was easily distinguished from the vagus nerve by the dura mater in the jugular foramen in 80% of 50 specimens. The trunk of the accessory nerve from the spinal cord penetrated the dura mater at various distances before entering the jugular foramen. In 20% of the specimens there was no dural boundary. In these cases, the uppermost cranial rootlet of the accessory nerve could be identified by removing the dura mater around the jugular foramen where it joined to the trunk of the accessory nerve at the superior vagal ganglion. The cranial rootlet was formed by union of two to four short filaments emerging from the medulla oblongata (66%) and emerged single, without filament (34%), and usually joined the trunk of the accessory nerve directly before the jugular foramen. The mean number of rootlets of the CR was 4.9 (range 2-9) above the cervicomedullary junction. The CR of the accessory nerve was composed of two to nine rootlets, which were formed by the union of two to four short filaments and joined the spinal root of the accessory nerve. The CR is morphologically distinct from the vagus nerve, confirming its existence. Clin. Anat. 27:1167-1173, 2014. © 2014 Wiley Periodicals, Inc. PMID:25131313

Liu, Hong-Fu; Won, Hyung-Sun; Chung, In-Hyuk; Kim, In-Beom; Han, Seung-Ho

2014-11-01

14

Intracisternal Cranial Root Accessory Nerve Schwannoma Associated with Recurrent Laryngeal Neuropathy  

PubMed Central

Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy. PMID:25328655

Jin, Sung-Won; Park, Dong-Hyuk; Kang, Shin-Hyuk

2014-01-01

15

Primary Neurolymphomatosis of the Lower Cranial Nerves Presenting as Dysphagia and Hoarseness: A Case Report  

PubMed Central

Primary neurolymphomatosis is an extremely rare tumor. We report the case of a 74-year-old patient presenting with dysphagia and hoarseness. Initial contrast-enhanced computed tomography of the head, neck, and chest did not reveal any lesions. His symptoms improved with short-term administration of prednisone but recurred and deteriorated. Magnetic resonance (MR) imaging revealed a tumor along the ninth and tenth cranial nerves across the jugular foramen. Fluorine-18 fluorodeoxyglucose positron emission tomography indicated this was a primary tumor. Repeated MR imaging after 2 months revealed considerable tumor enlargement. A left suboccipital craniotomy was performed to remove the tumor that infiltrated the ninth and tenth cranial nerves. The histopathologic diagnosis was diffuse large B-cell lymphoma. Although focal radiation therapy was administered to ensure complete eradication of the tumor, the patient died of aspiration pneumonia with systemic metastasis. To our knowledge, this is the first reported case of primary neurolymphomatosis in the lower cranial nerves. PMID:25083392

Sakai, Naoto; Ito-Yamashita, Tae; Takahashi, Goro; Baba, Satoshi; Koizumi, Shinichiro; Yamasaki, Tomohiro; Tokuyama, Tsutomu; Namba, Hiroki

2014-01-01

16

Fulminant Guillain-Barré syndrome with quadriplegia and total paresis of motor cranial nerves as a result of segmental demyelination  

Microsoft Academic Search

Guillain-Barré syndrome (GBS) is a subacute demyelinating polyneuropathy with a monophasic course. Rarely, demyelination may be so severe as to produce electrically unexcitable nerves. We present a patient with fulminant onset of symptoms who was quadriplegic and had bilateral involvement of all motor cranial nerves. Serial EMGs indicated that segmental demyelination was responsible for these clinical findings.

Adrian K. Y. Tan; Michael W. L. Chee

1995-01-01

17

An autopsy case of meningeal carcinomatosis with parenchymal invasion through the cranial and spinal nerve roots.  

PubMed

Meningeal carcinomatosis is a well-known complication of malignant neoplasms. We report a case of meningeal carcinomatosis of 2 months' duration in a 22-year-old man, in whom the initial symptom was gradually worsening headache. Postmortem examination revealed infiltrating adenocarcinoma of the stomach. Carcinoma cells showed diffuse spread to the subarachnoid space of the brain and spinal cord. In many places, subarachnoid tumor cells had infiltrated to the cranial and spinal nerves. Moreover, carcinoma cells in the nerve roots extended to the parenchyma of the brain and spinal cord beyond the CNS-peripheral nervous system junction. These findings suggest that cranial and spinal nerve roots can be a possible route of parenchymal invasion in meningeal carcinomatosis. PMID:24779918

Kon, Tomoya; Funamizu, Yukihisa; Miki, Yasuo; Tomiyama, Masahiko; Baba, Masayuki; Kurotaki, Hidekachi; Wakabayashi, Koichi

2014-10-01

18

Malignant epithelioid cranial nerve sheath tumor: case report of a radiation response  

Microsoft Academic Search

Summary  Malignant epithelioid nerve sheath tumors (MESs) especially those involving intracranial cranial nerves are rare and thought\\u000a to be radioresistant. We report a case of a MES involving the Vth and VIIth cranial nerves responsive to radiotherapy. A 41-year-old\\u000a man with progressive left facial weakness underwent an MRI that disclosed an enhancing lesion involving both V3 cranial nerve and the distal

Barbara J. Fisher; Kristopher E. B. Dennis

2006-01-01

19

Facial nerve outcome after acoustic neuroma surgery: a study from the era of cranial nerve monitoring.  

PubMed

The introduction of intraoperative cranial nerve monitoring in posterior fossa surgery has greatly aided the surgeon in identification and anatomic preservation of cranial nerves. As a result, the long-term function of the facial nerve continues to improve after removal of acoustic neuroma. Herein, we report our long-term (1 year or greater) facial nerve outcome in 129 patients who underwent surgical removal of their acoustic neuromas with the aid of intraoperative neurophysiologic monitoring between 1986 and 1990. The facial nerve was anatomically preserved in 99.2% of the patients, and 90% of all the patients had grade 1 or 2 facial nerve function 1 year after surgery. Long-term facial function was inversely correlated with the size of tumor (chi-squared, p < 0.02) and was not related to the side of tumor, the age and sex of the patient, or the surgical approach. In a comparison among tumor groups matched for size, no statistically significant difference in facial nerve outcome between the translabyrinthine and retrosigmoid approaches was detected. The proximal facial nerve stimulation threshold at the end of surgical removal was predictive of long-term facial nerve function (analysis of variance, p < 0.02). At 1 year, 98% (87 of 89) of the patients with electrical thresholds of 0.2 V or less had grade 1 or 2 facial nerve function compared with only 50% (8 of 16) of those with thresholds between 0.21 and 0.6 V. In the era of cranial nerve monitoring, patients can be better advised about long-term facial nerve outcome after surgical intervention. Preoperatively, the size of the tumor is the most critical factor in predicting long-term facial function. Postoperatively, the proximal seventh nerve stimulation threshold at the end of the surgical procedure can be used as one prognostic measure of long-term facial nerve function. PMID:7970793

Lalwani, A K; Butt, F Y; Jackler, R K; Pitts, L H; Yingling, C D

1994-11-01

20

Perineural tumor spread - Interconnection between spinal and cranial nerves.  

PubMed

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

2012-12-15

21

Neurophysiological activation by vestibular or cranial nerve stimulation  

US Patent & Trademark Office Database

A method of treating a disorder may include positioning a thermoelectric device in the ear canal of a subject and activating the thermoelectric device to deliver caloric vestibular stimulation and/or cranial nerve stimulation effective to treat the disorder. In some embodiments, the ear canal may be cooled sufficiently to treat the disorder. In alternative embodiments, the ear canal may be warmed sufficiently to treat the disorder.

2012-09-18

22

Disk Edema and Cranial MRI Optic Nerve Enhancement  

Microsoft Academic Search

A 43-year-old woman presented with painful visual loss and optic disk edema in the right eye (OD) diagnosed as optic neuritis. Initial non–gadolinium-enhanced fat suppressed cranial magnetic resonance imaging (MRI) was normal. Three months later, the disk edema persisted and a gadolinium-enhanced MRI scan of the brain and orbits with fat suppression showed enhancement of the optic nerve OD, most

Michael S Vaphiades

2001-01-01

23

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

NSDL National Science Digital Library

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

Pearson, John C.

2009-06-08

24

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.

2009-09-21

25

Cranial mononeuropathy III  

MedlinePLUS

Third cranial nerve palsy; Oculomotor palsy; Pupil-involving third cranial nerve palsy; Mononeuropathy - compression type ... nerve is affected. It affects the third cranial (oculomotor) nerve. This is one of the cranial nerves that ...

26

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

PubMed

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

Nowinski, W L; Chua, B C

2013-06-01

27

The Cranial Nerves of the Senegal Bichir, Polypterus senegalus [Osteichthyes: Actinopterygii: Cladistia]; pp. 55–66  

Microsoft Academic Search

The organization of the roots, ganglia and peripheral distribution of the rami of the cranial nerves of larval and juvenile Senegal bichirs was examined with a wide range of techniques, including gross dissection and histological preparations. The profundal nerve of bichirs is completely separate from the trigeminal nerve and innervates the skin overlying the orbit and snout, and there is

Tatjana Piotrowski; R. Glenn Northcutt

1996-01-01

28

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

PubMed

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

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

2014-01-01

29

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

Microsoft Academic Search

The fundamental goal of skull base surgery is tumor removal with preservation of neurological function. Injury to the lower\\u000a cranial nerves (LCN; CN 9–12) profoundly affects a patient’s quality of life. Although intraoperative cranial nerve monitoring\\u000a (IOM) is widely practiced for other cranial nerves, literature addressing the LCN is scant. We examined the utility of IOM\\u000a of the LCN in

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

2008-01-01

30

Motor palsies of cranial nerves (excluding VII) after vaccination: reports to the US Vaccine Adverse Event Reporting System.  

PubMed

We reviewed cranial nerve palsies, other than VII, that have been reported to the US Vaccine Adverse Event Reporting System (VAERS). We examined patterns for differences in vaccine types, seriousness, age, and clinical characteristics. We identified 68 reports of cranial nerve palsies, most commonly involving the oculomotor (III), trochlear (IV), and abducens (VI) nerves. Isolated cranial nerve palsies, as well as palsies occurring as part of a broader clinical entity, were reported. Forty reports (59%) were classified as serious, suggesting that a cranial nerve palsy may sometimes be the harbinger of a broader and more ominous clinical entity, such as a stroke or encephalomyelitis. There was no conspicuous clustering of live vs. inactivated vaccines. The patient age range spanned the spectrum from infants to the elderly. Independent data may help to clarify whether, when, and to what extent the rates of cranial nerve palsies following particular vaccines may exceed background levels. PMID:24231288

Woo, Emily Jane; Winiecki, Scott K; Ou, Alan C

2014-02-01

31

On the presence of ganglion cells in the intracranial portion of the accessory nerve (XI cranial nerve) in some mammals.  

PubMed

The intracranial tract of the accessory nerve (XI cranial nerve) was studied in some mammals (equines, domestic and wild ruminants, pig, carnivores, rabbit, nutria, guinea pig, hamster, hedgehog). The specimens were embedded in paraffin or paraplast, the sections were stained with cresyl violet, haematoxylin and eosin, or submitted to argentic impregnation. Pseudounipolar ganglion cells were found in all the mammals examined, with the exception of the cat. The number of cells and their variability in the different species and subjects were related. The topography and morphology of the cells were described. This comparative study has demonstrated that the accessory nerve is not a entirely motor nerve, but it is a mixed, motor and sensitive, nerve. Nevertheless, we think further studies are necessary in order to establish the peripheral distribution, the central pathway and the functional role of the pseudounipolar neurons found in the intracranial tract of the accessory nerve. PMID:10684182

Panu, R; Bo Minelli, L; Acone, F; Gazza, F; Cacchioli, A; Botti, M; Palmieri, G

1999-01-01

32

Investigation of cranial and other nerves in the mouse with muscular dystrophy.  

PubMed Central

In the muscular dystrophic mouse mutant there is an absence of Schwann cells over circumscribed lengths of all cranial nerves except for II (I was not examined) and the lesion involves the sympathetic system. Where present, Schwann cells do not produce myelin of normal thickness. The lesion is similar to that described for the spinal roots. Causation is discussed. Images PMID:1141926

Biscoe, T J; Caddy, K W; Pallot, D J; Pehrson, U M

1975-01-01

33

Transcranial magnetic stimulation of the human brain: responses in muscles supplied by cranial nerves  

Microsoft Academic Search

The present investigation demonstrates that time-varying magnetic fields induced over the skull elicit distinct types of responses in muscles supplied by the cranial nerves both on the ipsilateral and the contralateral side. When the center of the copper coil was positioned 4 cm lateral to the vertex on a line from the vertex to the external auditory meatus, bilateral responses

R. Benecke; B.-U. Meyer; P. Schönle; B. Conrad

1988-01-01

34

A case of multiple cranial nerve palsy due to sphenoid sinusitis complicated by cerebral aneurysm  

Microsoft Academic Search

A case of sphenoid sinusitis and internal carotid aneurysm presenting with multiple cranial nerve palsy is reported. A 46-year-old man with high fever and neck rigidity developed progressive visual loss and ophthalmoplegia on both sides, and ptosis, mydriasis and facial numbness on the right side. CT scan and MRI revealed abnormal shadow of the sphenoid sinus and the cavernous sinus.

Nobuhiro Suzuki; Mamoru Suzuki; Susumu Araki; Harushiro Sato

2005-01-01

35

Sneddon syndrome presenting with unilateral third cranial nerve palsy.  

PubMed

Sneddon syndrome is a rare systemic vasculopathy affecting the skin as livedo racemosa and the central nervous system as stroke. A 31-year-old man with a history of livedo racemosa presented with a partial left third nerve palsy. Skin biopsy showed signs of endotheliitis with obliteration of dermal blood vessels due to intimal proliferation and fibrin thrombi consistent with Sneddon syndrome. The patient was treated with platelet antiaggregant therapy with complete resolution of his third nerve palsy. Clinicians should be aware of Sneddon syndrome because prompt diagnosis and treatment may prevent potential morbidity and mortality. PMID:24051423

Jiménez-Gallo, David; Albarrán-Planelles, Cristina; Linares-Barrios, Mario; González-Fernández, Julio A; Espinosa-Rosso, Raúl; Báez-Perea, José M

2014-03-01

36

Isolated III cranial nerve palsy: a Hodgkin's lymphoma?  

PubMed

A 69-year-old woman developed ptosis and diplopia due to an isolated pupil-involving left oculomotor nerve palsy. General examination was unremarkable. Initial workup showed a mild increase in cerebrospinal fluid proteins. Imaging studies were remarkable for a left oculomotor nerve enhancement in brain MRI and hyperfixation along the nerve's pathway in full body single-photon emission CT. Assuming the possible diagnosis of neurosarcoidosis, the patient was started on high-dose methylprednisolone. Three months later she developed pancytopenia. A bone marrow biopsy was performed and histopathology revealed infiltration by Hodgkin's lymphoma. Adriamycin, bleomycin, vinblastine, dacarbazine protocol chemotherapy was started and full haematological remission obtained after four cycles, despite mild oculomotor nerve palsy persisted. Isolated oculomotor palsy as the first presenting manifestation of a lymphoma is rare and alternative differential diagnosis must be considered in the absence of other lymphoma manifestations. In this case as with many rare initial manifestations of common diseases watchful waiting was crucial to the correct diagnosis and treatment strategy. PMID:24759607

Meireles, Joana; Garrett, Maria Carolina; Abreu, Pedro

2014-01-01

37

Scientific neurology and the history of the clinical examination of selected motor cranial nerves.  

PubMed

The content of the neurological examination of the motor cranial nerves is a reflection of the current understanding of the neuroanatomy and clinical neurophysiology of the brain stem. The history of the neuroanatomy of the cranial nerves extends from Galen's investigations c. 200 CE to the determination of the innervations of the facial nerve by Charles Bell in the early 19th century. Scientific clinical neurophysiology first appears in the work of John Hughlings Jackson in the mid- to late 19th century. The modern model of the organization and function of the nervous system results in a clinical examination that can be called neurological. The codification of the technique of the neurological examination of the cranial nerves mirrors the institutional and social history of neurology and is reflected in the changing role of neurology textbooks in the 19th and 20th centuries. The texts develop through stages of classification, pedagogy, reference, and institutionalization and illustrate the development of a specialized medical discipline. PMID:12539055

Steinberg, David A

2002-12-01

38

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. PMID:24066214

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

2013-01-01

39

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

E-print Network

Vertebral arteries ­ foramen magnum of occipital bone Middle meningeal arteries ­ foramen spinosum related to the skull Arterial blood supply to the cranial cavity Internal carotid arteries ­ carotid canal bones Blood supply to nasal cavity Sphenopalatine artery (branch of Maxillary artery) ­ sphenopalatine

Houde, Peter

40

The involvement of the cochlear nerve in neurinomas of the eighth cranial nerve  

Microsoft Academic Search

In view of recent controversies concerning the preservation of hearing in acoustic neurinoma surgery, we examined the courses of the vestibular and cochlear nerve fibers in 12 intact acoustic neurinomas studied in our department. Due to its lack of specificity, the Luxol fast blue stain was found to be inadequate for our study of the nerve fibers. In contrast, Verhoeff's

G. Forton; L. Moeneclaey; F. Declau; J. Marquet

1989-01-01

41

Alternative sites for intraoperative monitoring of cranial nerves X and XII during intracranial surgeries.  

PubMed

During intracranial surgeries, cranial nerve (CN) X is most commonly monitored with electromyographic endotracheal tubes. Electrodes on these endotracheal tubes may be displaced from the vocal folds during positioning, and there is a learning curve for their correct placement. Cranial nerve XII is most commonly monitored with electrodes in the dorsum of the tongue, which are also prone to displacement because of their proximity to the endotracheal tube. A retrospective review was conducted of a consecutive series of 83 skull base surgeries using alternative sites for monitoring CN X and XII. On-going (spontaneous) and evoked electromyography (EMG) were obtained from the cricothyroid muscle for CN X and submental genioglossus for CN XII. Stimulation of CN X or XII evoked specific compound motor action potentials from these muscles, and well-defined on-going EMG was observed during tumor resection in the vicinity of CN X and XII. Volume-conducted responses from the adjacent platysma muscle during CN VII stimulation were identified by concomitant responses from the orbicularis oris and oculi. In conclusion, during skull base surgeries, CN X may be monitored with electrodes in the cricothyroid muscle and CN XII with electrodes in the submental genioglossus. These alternative sites are less prone to displacement of electrodes compared with the more commonly used EMG endotracheal tube and electrodes in the dorsum of the tongue. The cricothyroid muscle should not be used when the recurrent laryngeal nerve is at risk. PMID:23733092

Holdefer, Robert N; Kinney, Gregory A; Robinson, Larry R; Slimp, Jefferson C

2013-06-01

42

Invasion of cranial nerves by salivary cylindroma: four cases treated by radiotherapy  

PubMed Central

Four cases of adenoid cystic carcinoma (cylindroma) of accessory salivary tissue are described, and the diagnostic difficulties experienced are emphasized. The tumour infiltrates cranial and other nerves and may invade the central nervous system by this route. It is highly malignant and may metastasize widely both by haematogenous and lymphatic pathways. The tumour is radiosensitive and it is suggested that the treatment of choice is radiotherapy combined, when possible, with surgical excision of the primary lesion. Metastases should be treated with radiotherapy since useful remission may occur. Images PMID:4328886

Swash, Michael

1971-01-01

43

[Detection of aneurysm by 3 Tesla MRA in third cranial nerve palsy].  

PubMed

The diagnostic work-up of patients with third cranial nerve palsy includes neuroimaging because the lesion of the oculomotor nerve may result from compression due to an aneurysm. The advantages and disadvantages of different neuroimaging techniques, i. e. magnetic resonance angiography (MRA), computed tomography angiography (CTA) and intra-arterial digital subtraction angiography (DSA), are still under debate. In this context, the present case report demonstrates that the application of 3 Tesla-MRA may help to detect an aneurysm of the internal carotid artery which had remained undetected by non-invasive standard methods applied before. Therefore 3 Tesla-MRA may help to fill a gap in diagnostic approaches between non-invasive (MRA, CTA) and invasive (DSA) neuroimaging techniques. PMID:20213590

Burghaus, L; Lie, C H; Dohmen, C; Hackenbroch, M; Fink, G R

2010-04-01

44

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

PubMed

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

2011-01-01

45

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

NASA Astrophysics Data System (ADS)

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

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

2014-06-01

46

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.

2009-01-02

47

Cranial nerve deficit caused by skull metastasis of prostate cancer: three Japanese castration-resistant prostate cancer cases  

Microsoft Academic Search

We report 3 Japanese patients with cranial nerve deficit caused by skull metastasis of prostate cancer (PCa). Case 1 was a\\u000a 75-year-old patient with a chief complaint of diplopia. The cause of diplopia was right oculomotor nerve palsy from the skull\\u000a metastasis. External beam radiation therapy (EBRT) to the whole brain, 40 Gy in 20 fractions, was performed and the diplopia

Kouji Izumi; Atsushi Mizokami; Kazutaka Narimoto; Kazuhiro Sugimoto; Eitetsu Koh; Tomoyasu Kumano; Mikio Namiki

2010-01-01

48

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

PubMed

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

2010-01-01

49

Frequency variations of discrete cranial traits in major human populations. IV. Vessel and nerve related variations  

PubMed Central

This concludes a series of descriptive statistical reports on discrete cranial traits in 81 human populations from around the world. Four variants classified as vessel and nerve related characters were investigated: patent condylar canal; supraorbital foramen; accessory infraorbital foramen; and accessory mental foramen. A significant asymmetric occurrence without any side preference was detected for the accessory mental foramen. Significant intertrait associations were found between the accessory infraorbital and supraorbital foramina in the panPacific region and Subsaharan African samples. The intertrait associations between the accessory infraorbital foramen and some traits classified as hypostotic were found mainly in the samples from the western part of the Old World, and those as hyperostotic traits in the samples from eastern Asian and the related population samples. With a few exceptions, the occurrence of a patent condylar canal and a supraorbital foramen was predominant in females, but the accessory infraorbital and accessory mental foramina were predominant in males. The frequency distributions of the traits showed interregional clinality and intraregional discontinuity. A temporal trend was found in the Northeast Asian region in the frequencies of the accessory infraorbital and accessory mental foramina. The diversity of modern human discrete cranial traits may at least in part be attributable to differential retention or intensification from an ancestral pattern. PMID:11554505

HANIHARA, TSUNEHIKO; ISHIDA, HAJIME

2001-01-01

50

[Depiction of the cranial nerves around the cavernous sinus by 3D reversed FISP with diffusion weighted imaging (3D PSIF-DWI)].  

PubMed

To evaluate the anatomy of cranial nerves running in and around the cavernous sinus, we employed three-dimensional reversed fast imaging with steady-state precession (FISP) with diffusion weighted imaging (3D PSIF-DWI) on 3-T magnetic resonance (MR) system. After determining the proper parameters to obtain sufficient resolution of 3D PSIF-DWI, we collected imaging data of 20-side cavernous regions in 10 normal subjects. 3D PSIF-DWI provided high contrast between the cranial nerves and other soft tissues, fluid, and blood in all subjects. We also created volume-rendered images of 3D PSIF-DWI and anatomically evaluated the reliability of visualizing optic, oculomotor, trochlear, trigeminal, and abducens nerves on 3D PSIF-DWI. All 20 sets of cranial nerves were visualized and 12 trochlear nerves and 6 abducens nerves were partially identified. We also presented preliminary clinical experiences in two cases with pituitary adenomas. The anatomical relationship between the tumor and cranial nerves running in and around the cavernous sinus could be three-dimensionally comprehended by 3D PSIF-DWI and the volume-rendered images. In conclusion, 3D PSIF-DWI has great potential to provide high resolution "cranial nerve imaging", which visualizes the whole length of the cranial nerves including the parts in the blood flow as in the cavernous sinus region. PMID:21972184

Ishida, Go; Oishi, Makoto; Jinguji, Shinya; Yoneoka, Yuichiro; Sato, Mitsuya; Fujii, Yukihiko

2011-10-01

51

Decrease in cranial nerve complications after radiosurgery for acoustic neuromas: a prospective study of dose and volume  

Microsoft Academic Search

Purpose: To determine whether tumor control can be maintained, and cranial nerve complications decreased by reducing the radiosurgical dose to acoustic neuromas.Methods and Materials: Forty-two consecutive patients with acoustic neuromas were treated prospectively using an initial standard-dose protocol in which the tumor-margin dose (50% isodose) was 20, 18, and 16 Gy for tumor diameters ? 2 cm, 2.1–3 cm, and

Robert C Miller; Robert L Foote; Robert J Coffey; Daniel J Sargent; Deborah A Gorman; Paula J Schomberg; Robert W Kline

1999-01-01

52

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

PubMed

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

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

2013-12-01

53

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

2008-01-01

54

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

PubMed Central

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

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

2013-01-01

55

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

PubMed Central

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

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

2012-01-01

56

Development of cranial nerve palsy shortly after endosaccular embolization for asymptomatic cerebral aneurysm: report of two cases and literature review  

Microsoft Academic Search

Clinical description  We report two cases of asymptomatic cerebral aneurysm in which cranial nerve palsy (CNP) developed shortly after symbolization.\\u000a The CNP occurred immediately in case 1, but case 2 showed the CNP 30 h after symbolization. Although both aneurysms had increased\\u000a in size on follow-up angiography, case 2 who showed dome re canalization resulted in progressive CNP deterioration.\\u000a \\u000a \\u000a \\u000a Conclusion  These findings

Kazuhiko Nishino; Yasushi Ito; Hitoshi Hasegawa; Junsuke Shimbo; Bumpei Kikuchi; Yukihiko Fujii

2009-01-01

57

Does MRI-Detected Cranial Nerve Involvement Affect the Prognosis of Locally Advanced Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy?  

PubMed Central

Nasopharyngeal carcinoma (NPC) is one of the common cancers in South China. It can easily invade into cranial nerves, especially in patients with local advanced disease. Despite the fact that the magnetic resonance imaging (MRI) findings are not always consistent with the symptoms of CN palsy, MRI is recommended for the detection of CN involvement (CNI). However, the prognostic impact of MRI-detected CNI in NPC patients is still controversial. To investigate the prognostic value of MRI detected CNI, we performed a retrospective analysis on the clinical data of 375 patients with NPC who were initially diagnosed by MRI. All patients had T3-4 disease and received radical intensity modulated radiation therapy (IMRT) as their primary treatment. The incidence of MRI-detected CNI was 60.8%. A higher incidence of MRI-detected CNI was observed in T4 disease compared with T3 disease (96.8% vs. 42.8%, P<0.001), and a higher incidence was also found in patients with Stage IV disease compared with those with Stage III disease (91.5% vs. 42.3%; P<0.001). The local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) of patients with T3 disease, with or without MRI-detected CNI, was superior to that of patients with T4 disease (P<0.05). No significant differences in LRFS, DMFS or OS were observed between T3 patients with or without MRI-detected CNI. The survival of Stage III patients with or without MRI-detected CNI was significantly superior to that of Stage IV patients (P<0.01), but there was no significant difference between Stage III patients with or without MRI-detected CNI for all endpoints. Therefore, when treated with IMRT, MRI-detected CNI in patients with NPC does not appear to affect the prognosis. In patients with clinical T3 disease, the presence of MRI-detected CNI is not sufficient evidence for defining T4 disease. PMID:24963626

Zong, Jingfeng; Lin, Shaojun; Chen, Yunbin; Wang, Bingyi; Xiao, Youping; Lin, Jin; Li, Rui; Pan, Jianji

2014-01-01

58

Enterovirus 71 Can Directly Infect the Brainstem via Cranial Nerves and Infection Can Be Ameliorated by Passive Immunization.  

PubMed

Enterovirus 71 (EV71)-associated hand, foot, and mouth disease may be complicated by encephalomyelitis. We investigated EV71 brainstem infection and whether this infection could be ameliorated by passive immunization in a mouse model. Enterovirus 71 was injected into unilateral jaw/facial muscles of 2-week-old mice, and hyperimmune sera were given before or after infection. Harvested tissues were studied by light microscopy, immunohistochemistry, in situ hybridization, and viral titration. In unimmunized mice, viral antigen and RNA were detected within 24 hours after infection only in ipsilateral cranial nerves, motor trigeminal nucleus, reticular formation, and facial nucleus; viral titers were significantly higher in the brainstem than in the spinal cord samples. Mice given preinfection hyperimmune serum showed a marked reduction of ipsilateral viral antigen/RNA and viral titers in the brainstem in a dose-dependent manner. With optimum hyperimmune serum given after infection, brainstem infection was significantly reduced in a time-dependent manner. A delay in disease onset and a reduction of disease severity and mortality were also observed. Thus, EV71 can directly infect the brainstem, including the medulla, via cranial nerves, most likely by retrograde axonal transport. This may explain the sudden cardiorespiratory collapse in human patients with fatal encephalomyelitis. Moreover, our results suggest that passive immunization may still benefit EV71-infected patients who have neurologic complications. PMID:25289894

Tan, Soon Hao; Ong, Kien Chai; Wong, Kum Thong

2014-11-01

59

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

SciTech Connect

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

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

2013-08-01

60

CONGENITAL ABNORMALITIES OF CRANIAL NERVE DEVELOPMENT: OVERVIEW, MOLECULAR MECHANISMS, AND FURTHER EVIDENCE OF HETEROGENEITY AND COMPLEXITY OF SYNDROMES WITH CONGENITAL LIMITATION OF EYE MOVEMENTS  

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. PMID:15747768

Traboulsi, Elias I

2004-01-01

61

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: cgmhnog@yahoo.com

2005-12-01

62

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

PubMed

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

2012-01-01

63

[Unilateral laryngeal nerve paralysis in the adult: Epidemiology, symptoms, physiopathology and treatment].  

PubMed

In France, the main causes for unilateral laryngeal nerve paralysis in the adult patient are surgery and malignant tumors. Most of unilateral laryngeal nerve paralysis following thyroid surgery will recover within the first six postoperative months. At the time of unilateral laryngeal nerve paralysis, swallowing impairment and dyspnea occur in around 30% and 5% of cases, respectively. In the face of a unilateral laryngeal nerve paralysis occurring without a history of trauma of surgery, the main paraclinical examination to perform is a computed laryngeal nerve examination analyzing the whole length of the nerve involved. Speech therapy efficiency is related to the degree of severity of the symptoms related to unilateral laryngeal nerve paralysis. In the vast majority of cases, laryngeal medialization approaches improve dysphonia and swallowing impairment related to unilateral laryngeal paralysis, but not dyspnea. PMID:24525308

Laccourreye, Ollivier; Malinvaud, David; Ménard, Madeleine; Bonfils, Pierre

2014-04-01

64

Myofibroma in the Palm Presenting with Median Nerve Compression Symptoms  

PubMed Central

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

Sarkozy, Heidi

2014-01-01

65

Integrating cranial nerve and release enhancing exercises assist several manipulative methods when treating a subset of head and neck pain patients  

Microsoft Academic Search

Summary  \\u000a We believe that some direct and indirect barriers to active and passive movement are related to and maintained by altered\\u000a cranial nerve, cerebellar, autonomic and an unknown number of other higher brain functions. Building on these concepts, an\\u000a integrated diagnostic, treatment, and exercise program has been designed for a subset of long term chronic pain patients [43].\\u000a The strategy

R. C. Ward; R. J. Hruby; W. M. Falls

1998-01-01

66

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

PubMed

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

2013-04-30

67

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. PMID:24151506

Marupudi, Neena I.

2013-01-01

68

Dysphagia and disrupted cranial nerve development in a mouse model of DiGeorge (22q11) deletion syndrome  

PubMed Central

ABSTRACT We assessed feeding-related developmental anomalies in the LgDel mouse model of chromosome 22q11 deletion syndrome (22q11DS), a common developmental disorder that frequently includes perinatal dysphagia – debilitating feeding, swallowing and nutrition difficulties from birth onward – within its phenotypic spectrum. LgDel pups gain significantly less weight during the first postnatal weeks, and have several signs of respiratory infections due to food aspiration. Most 22q11 genes are expressed in anlagen of craniofacial and brainstem regions critical for feeding and swallowing, and diminished expression in LgDel embryos apparently compromises development of these regions. Palate and jaw anomalies indicate divergent oro-facial morphogenesis. Altered expression and patterning of hindbrain transcriptional regulators, especially those related to retinoic acid (RA) signaling, prefigures these disruptions. Subsequently, gene expression, axon growth and sensory ganglion formation in the trigeminal (V), glossopharyngeal (IX) or vagus (X) cranial nerves (CNs) that innervate targets essential for feeding, swallowing and digestion are disrupted. Posterior CN IX and X ganglia anomalies primarily reflect diminished dosage of the 22q11DS candidate gene Tbx1. Genetic modification of RA signaling in LgDel embryos rescues the anterior CN V phenotype and returns expression levels or pattern of RA-sensitive genes to those in wild-type embryos. Thus, diminished 22q11 gene dosage, including but not limited to Tbx1, disrupts oro-facial and CN development by modifying RA-modulated anterior-posterior hindbrain differentiation. These disruptions likely contribute to dysphagia in infants and young children with 22q11DS. PMID:24357327

Karpinski, Beverly A.; Maynard, Thomas M.; Fralish, Matthew S.; Nuwayhid, Samer; Zohn, Irene E.; Moody, Sally A.; LaMantia, Anthony-S.

2014-01-01

69

Dysphagia and disrupted cranial nerve development in a mouse model of DiGeorge (22q11) deletion syndrome.  

PubMed

We assessed feeding-related developmental anomalies in the LgDel mouse model of chromosome 22q11 deletion syndrome (22q11DS), a common developmental disorder that frequently includes perinatal dysphagia--debilitating feeding, swallowing and nutrition difficulties from birth onward--within its phenotypic spectrum. LgDel pups gain significantly less weight during the first postnatal weeks, and have several signs of respiratory infections due to food aspiration. Most 22q11 genes are expressed in anlagen of craniofacial and brainstem regions critical for feeding and swallowing, and diminished expression in LgDel embryos apparently compromises development of these regions. Palate and jaw anomalies indicate divergent oro-facial morphogenesis. Altered expression and patterning of hindbrain transcriptional regulators, especially those related to retinoic acid (RA) signaling, prefigures these disruptions. Subsequently, gene expression, axon growth and sensory ganglion formation in the trigeminal (V), glossopharyngeal (IX) or vagus (X) cranial nerves (CNs) that innervate targets essential for feeding, swallowing and digestion are disrupted. Posterior CN IX and X ganglia anomalies primarily reflect diminished dosage of the 22q11DS candidate gene Tbx1. Genetic modification of RA signaling in LgDel embryos rescues the anterior CN V phenotype and returns expression levels or pattern of RA-sensitive genes to those in wild-type embryos. Thus, diminished 22q11 gene dosage, including but not limited to Tbx1, disrupts oro-facial and CN development by modifying RA-modulated anterior-posterior hindbrain differentiation. These disruptions likely contribute to dysphagia in infants and young children with 22q11DS. PMID:24357327

Karpinski, Beverly A; Maynard, Thomas M; Fralish, Matthew S; Nuwayhid, Samer; Zohn, Irene E; Moody, Sally A; LaMantia, Anthony-S

2014-02-01

70

Incidence, Impact, and Predictors of Cranial Nerve Palsy and Haematoma Following Carotid Endarterectomy in the International Carotid Stenting Study  

PubMed Central

Objective Cranial nerve palsy (CNP) and neck haematoma are complications of carotid endarterectomy (CEA). The effects of patient factors and surgical technique were analysed on the risk, and impact on disability, of CNP or haematoma in the surgical arm of the International Carotid Stenting Study (ICSS), a randomized controlled clinical trial of stenting versus CEA in patients with symptomatic carotid stenosis. Materials and methods A per-protocol analysis of early outcome in patients receiving CEA in ICSS is reported. Haematoma was defined by the surgeon. CNP was confirmed by an independent neurologist. Factors associated with the risk of CNP and haematoma were investigated in a binomial regression analysis. Results Of the patients undergoing CEA, 45/821 (5.5%) developed CNP, one of which was disabling (modified Rankin score = 3 at 1 month). Twenty-eight (3.4%) developed severe haematoma. Twelve patients with haematoma also had CNP, a significant association (p < .01). Independent risk factors modifying the risk of CNP were cardiac failure (risk ratio [RR] 2.66, 95% CI 1.11 to 6.40), female sex (RR 1.80, 95% CI 1.02 to 3.20), the degree of contralateral carotid stenosis, and time from randomization to treatment >14 days (RR 3.33, 95% CI 1.05 to 10.57). The risk of haematoma was increased in women, by the prescription of anticoagulant drugs pre-procedure and in patients with atrial fibrillation, and was decreased in patients in whom a shunt was used and in those with a higher baseline cholesterol level. Conclusions CNP remains relatively common after CEA, but is rarely disabling. Women should be warned about an increased risk. Attention to haemostasis might reduce the incidence of CNP. ICSS is a registered clinical trial: ISRCTN 25337470. PMID:25344019

Doig, D.; Turner, E.L.; Dobson, J.; Featherstone, R.L.; de Borst, G.J.; Brown, M.M.; Richards, T.

2014-01-01

71

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

PubMed Central

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

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

2013-01-01

72

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

PubMed

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

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

2013-01-01

73

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

PubMed

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

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

2014-01-01

74

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

PubMed Central

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

2013-01-01

75

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.  

PubMed

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

2013-01-01

76

Upper Limb Neurodynamic Test 2Median Nerve Bias: An Investigation of Examiner Reliability, End-Range Shoulder Abduction, and Symptom Response in Asymptomatic Subjects  

Microsoft Academic Search

Background and purpose: The Upper Limb Tension Test (ULTT) has been established as a physical therapy examination tool to assist in assessment of the cervical nerve roots and peripheral nerves as possible components contributing to upper limb symptoms in patients. Research has focused on the use of the ULTT in assessment of asymptomatic individuals, and on the ULTT2-Radial Nerve Bias,

Rebecca Reisch; Kimberly Williams

2001-01-01

77

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. PMID:18092334

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

2012-01-01

78

[Intrapituitary adenoma metastasis from lung cancer with progressive cranial nerve palsies: a case report and literature review].  

PubMed

We report a rare case of metastasis to a preexisting pituitary adenoma. An 80-year-old man with a history of pituitary adenoma and lung cancer presented with recent onset of bilateral visual impairment, oculomotor nerve palsies, and severe headache. A CT scan revealed a pituitary tumor expanding into the suprasellar region and infiltrating the bilateral cavernous sinuses. We performed transsphenoidal surgery and diagnosed the tumor as lung cancer metastasis to the pituitary adenoma. After the surgery, visual impairment and severe headache were resolved, and the patient underwent radiation therapy for the residual tumor. To the best of our knowledge, 20 cases of metastases to pituitary adenomas have been reported in the literature. Clinical features of metastasis to a pituitary adenoma are different from those of metastasis to normal pituitary gland. In the case of a pituitary lesion with acute aggravation, one should be aware of the possibility of metastasis to preexisting pituitary adenomas. PMID:25266586

Fujimori, Takeshi; Okauchi, Masanobu; Shindo, Atsushi; Kawanishi, Masahiko; Miyake, Keisuke; Kawai, Nobuyuki; Tamiya, Takashi

2014-10-01

79

Skull base osteomyelitis presenting with an isolated hypoglossal nerve palsy.  

PubMed

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

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

2013-01-01

80

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

PubMed Central

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

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

2014-01-01

81

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

PubMed

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

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

2007-05-01

82

Origin, course and distribution of the nerves to the posterosuperior wall of the external acoustic meatus.  

PubMed

Patients with Ramsay Hunt syndrome have various clinical symptoms including vesicular rash of the external acoustic meatus and auricle. In addition to facial nerve paresis, neurological disturbances of various cranial nerves such as the acoustic nerve, glossopharyngeal nerve and vagus nerve are reported in patients of Ramsay Hunt syndrome. To understand the reasons for the clinical symptoms, we observed the nerve branches of the auricle and external acoustic meatus. We used 18 halves of 11 Japanese cadavers. All cadavers were fixed in 8% formalin and preserved in 30% ethanol. Dissection was performed under a stereomicroscope and the communication among the nerve branches was analyzed. Posterosuperior wall of the acoustic meatus was innervated by nerve branches that emerged from the tympanomastoid fissure in 17 specimens (17/18). These branches always crossed the facial canal and had more than one communicating branch with the facial nerve inside the canal (17/17) or in the petrous bone (1/17). These branches originated from the superior ganglion of the vagus. In the origin from the vagus nerve, some of these branches communicated with the glossopharyngeal nerve (3/17). In addition to these branches, the facial nerve, after originating from the stylomastoid foramen, bifurcated into two nerve branches in some specimens (7/17). Nerve branches around the external acoustic meatus and the auricle have various communications before reaching the central nervous system. The variety of communications could explain the varied symptoms of Ramsay Hunt syndrome. PMID:24604237

Kiyokawa, Juri; Yamaguchi, Kumiko; Okada, Ryuhei; Maehara, Taketoshi; Akita, Keiichi

2014-09-01

83

Fractionated stereotactic radiation therapy improves cranial neuropathies in patients with skull base meningiomas: a retrospective cohort study  

PubMed Central

Background Skull base meningiomas commonly present with cranial neuropathies. Fractionated stereotactic radiation therapy (FSRT) has been used to treat these tumors with excellent local control, but rates of improvement in cranial neuropathies have not been well defined. We review the experience at Thomas Jefferson University using FSRT in the management of these patients with a focus on symptom outcomes. Methods We identified 225 cases of skull base meningiomas treated with FSRT at Thomas Jefferson University from 1994 through 2009. The target volume was the enhancing tumor, treated to a standard prescription dose of 54 Gy. Symptoms at the time of RT were classified based on the cranial nerve affected. Logistic regression was performed to determine predictors of symptom improvement after FSRT. Results The median follow-up time was 4.4 years. In 92% of cases, patients were symptomatic at the time of RT; the most common were impaired visual field/acuity (58%) or extraocular movements (34%). After FSRT, durable improvement of at least one symptom occurred in 57% of cases, including 40% of visual acuity/visual field deficits, and 40% of diplopia/ptosis deficits. Of all symptomatic patients, 27% experienced improvement of at least one symptom within 2 months of the end of RT. Conclusions FSRT is very effective in achieving improvement of cranial neuropathies from skull base meningiomas, particularly visual symptoms. Over half of treated patients experience a durable improvement of at least one symptom, frequently within 2 months from the end of RT. PMID:23270432

2012-01-01

84

[Multiple cranial neuropathies in a patient with IgG4-related hypertrophic pachymeningitis: a case report].  

PubMed

We describe the case of a 75-year-old woman who presented with acute loss of vision. She experienced subacute headache, hearing loss on the left side, hoarseness, and dysphagia during the previous 10 months. On admission, she had bilateral loss of vision, without any ophthalmological abnormalities, and multiple cranial nerve palsies, including left hearing loss and right IX, X, and XI nerve palsies. Head magnetic resonance imaging with contrast enhancement revealed hypertrophic pachymeningitis. Laboratory findings showed no abnormalities except for an increased sedimentation rate and increased C-reactive protein levels. A biopsy of the dura mater was performed, and histopathological analysis revealed inflammatory thickening of the dura mater with plasma cell infiltration; the infiltrating cells were immunoreactive to an anti-IgG4 antibody, thereby indicating an IgG4-related disorder. Furthermore, the histopathological analysis revealed evidence of vasculitis in both veins and arteries. After corticosteroid treatment, her visual acuity dramatically improved. Acute loss of vision with multiple cranial nerve palsies may be an uncommon presentation of IgG4-related hypertrophic pachymeningitis. However, it should be recognized that these conditions might be underdiagnosed. The possibility of central nervous system involvement in IgG4-related disorders should be considered in patients with multiple cranial nerve neuropathies associated with hypertrophic pachymeningitis, even in the absence of systemic sclerosis symptoms. In our case, early treatment with corticosteroids showed immediate effectiveness in correcting the visual symptoms. PMID:24998832

Tsugawa, Jun; Ouma, Shinji; Fukae, Jiro; Tsuboi, Yoshio; Sakata, Noriyuki; Inoue, Toru

2014-07-01

85

Glomus Jugulare Presenting with Isolated Facial Nerve Palsy  

PubMed Central

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

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

2014-01-01

86

Signs and Symptoms Predictive of Death in Patients with Foodborne Botulism—Republic of Georgia, 1980–2002  

Microsoft Academic Search

Foodborne botulism is a severe, potentially fatal disease characterized by cranial nerve palsies and descending paralysis. Little is known about signs and symptoms predictive of death from botulism. We studied patients with botulism in the Republic of Georgia, which has the highest reported rate of foodborne botulism in the world. After abstracting medical records of patients with botulism who were

Jay K. Varma; Guram Katsitadze; Maia Moiscrafishvili; Tamar Zardiashvili; Maia Chokheli; Natalia Tarkhashvili; Ekaterina Jhorjholiani; Maia Chubinidze; Teimuraz Kukhalashvili; Irakli Khmaladze; Nelli Chakvetadze; Paata Imnadze; Mike Hoekstra; Jeremy Sobel

2004-01-01

87

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

PubMed Central

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

Alqahtani, Saeed

2014-01-01

88

Temporary bilateral oculomotor nerve palsy as the sole presenting sign of a pituitary mass  

PubMed Central

A 65-year-old patient presented with isolated bilateral third nerve palsy. Neuroimaging demonstrated a 2 cm pituitary mass with extension into the cavernous sinus on the right. The patient went on to experience spontaneous complete resolution of symptoms with associated radiological shrinkage of the mass. Bilateral third nerve palsy is a very rare presenting sign, with only one previous case reported in the literature secondary to a pituitary adenoma. Spontaneous resolution of non-functioning pituitary tumours is reported to occur in approximately 10% of cases. However, there are only a small number of reports to date involving spontaneous regression of tumours with corresponding resolution of cranial nerve palsies. PMID:22110556

Liniker, Elizabeth; Hyatt, Penny

2009-01-01

89

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 PMID:17171083

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

1999-01-01

90

Ultrasonographic median nerve cross-section areas measured by 8-point "inching test" for idiopathic carpal tunnel syndrome: a correlation of nerve conduction study severity and duration of clinical symptoms  

PubMed Central

Background Incremental palmar stimulation of the median nerve sensory conduction at the wrist, the "inching test", provides an assessment with reference to segments proximal and distal to the entrapment. This study used high-resolution ultrasonography (US) to measure the median nerve's cross-section areas (CSAs) like the "inching test" and to correlate with the nerve conduction study (NCS) severity and duration of carpal tunnel syndrome (CTS). Methods Two hundred and twelve (212) "CTS-hands" from 135 CTS patients and 50 asymptomatic hands ("A-hands") from 25 control individuals were enrolled. The median nerve CSAs were measured at the 8-point marked as i4, i3, i2, i1, w, o1, o2, and 03 in inching test. The NCS severities were classified into six groups based on motor and sensory responses (i.e., negative, minimal, mild, moderate, severe, and extreme). Results of US studies were compared in terms of NCS severity and duration of clinical CTS symptoms. Results There was significantly larger CSA of the NCS negative group of "CTS-hands" than of "A-hands". The cut-off values of the CSAs of the NCS negative CTS group were 12.5 mm2, 11.5 mm2 and 10.1 mm2 at the inlet, wrist crease, and outlet, respectively. Of the 212 "CTS-hands", 32 were NCS negative while 40 had minimal, 43 mild, 85 moderate, 10 severe, and two extreme NCS severities. The CSAs of "CTS-hands" positively correlated with different NCS severities and with the duration of CTS symptoms. By duration of clinical symptoms, 12 of the 212 "CTS-hands" were in the 1 month group; 82 in >1 month and ?12 months group, and 118 in >12 months group. In "inching test", segments i4-i3 and i3-i2 were the most common "positive-site". The corresponding CSAs measured at i4 and i3, but not at i2, were significantly larger than those measured at points that were not "positive-site". Conclusions Using the 8-point measurement of the median nerve CSA from inlet to outlet similar to the "inching test" has positive correlations with NCS severity and duration of CTS clinical symptoms, and can provide more information on anatomic changes. Combined NCS and US studies using the 8-point measurement may have a higher positive rate than NCS alone for diagnosing CTS. PMID:22189264

2011-01-01

91

Radiation-induced malignant and atypical peripheral nerve sheath tumors  

Microsoft Academic Search

The reported peripheral nerve complications of therapeutic irradiation in humans include brachial and lumbar plexus fibrosis and cranial and peripheral nerve atrophy. We have encountered 9 patients with malignant (7) and atypical (2) peripheral nerve tumors occurring in an irradiated site suggesting that such tumors represent another delayed effect of radiation treatment on peripheral nerve. In all instances the radio-theray

Kathleen M. Foley; James M. Woodruff; Frank T. Ellis; Jerome B. Posner

1980-01-01

92

Resolution of cranial neuropathies following treatment of intracranial aneurysms with the Pipeline Embolization Device.  

PubMed

Object Intracranial aneurysms, especially those of the cavernous segment of the internal carotid artery (ICA), can present with cranial nerve (CN) palsies. The Pipeline Embolization Device (PED) has demonstrated safety and efficacy in the treatment of cerebral aneurysms by flow diversion, but little data exist reporting the outcomes of cranial neuropathies following treatment with the device. Methods The prospectively maintained Barrow Neurological Institute's endovascular database was reviewed for all patients treated with the PED after presenting with one or more CN palsies secondary to a cerebral aneurysm since May 2011. Patient charts and digital subtraction angiograms were reviewed to report clinical and angiographic outcomes. Only patients with clinical follow-up were included in the analysis. Results A total of 127 patients were treated with the PED at the authors' institution after FDA approval. Twentytwo patients presented with cranial neuropathies, for initial inclusion in this study. Of these, 20 had sufficient followup for analysis. Cranial neuropathies included those of CN II, III, V, and VI, with presenting symptoms of diplopia, decreased visual acuity, and facial numbness and/or pain. Thirteen lesions were cavernous segment ICA aneurysms, whereas the remainder included supraclinoid and petrous segment ICA, posterior communicating artery, and basilar trunk aneurysms. At an average clinical follow-up of 9.55 months, 15 patients (75%) had resolution or significant improvement of their cranial neuropathies, and the remaining 5 had stable symptoms. Of the 18 patients with angiographic follow-up, 12 (66.7%) demonstrated complete obliteration or small neck residual, whereas 6 (33.3%) had residual lesion. Patients with complete or near-complete obliteration of their lesion were significantly more likely to demonstrate symptomatic improvement at follow-up (p = 0.009). Two patients with persistent symptoms were eventually treated with microsurgical bypass. Transient complications in this series included 6 (30%) extracranial hemorrhagic complications related to dual-antiplatelet therapy, all of which were managed medically. There was 1 delayed right ICA occlusion following retreatment that led to microsurgical bypass. Conclusions Intracranial aneurysms presenting with one or more CN palsies show a high rate of clinical improvement after treatment with the PED. Clinical outcomes must be weighed against the risks and challenges faced with flow diverters. Further research is warranted for patients whose symptoms do not respond optimally to device placement. PMID:25192477

Moon, Karam; Albuquerque, Felipe C; Ducruet, Andrew F; Crowley, R Webster; McDougall, Cameron G

2014-11-01

93

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. PMID:19714636

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

2009-01-01

94

Pediatric neuroradiology: Cerebral and cranial diseases  

SciTech Connect

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

Diebler, C.; Dulac, O.

1987-01-01

95

Painful ophthalmoplegia with normal cranial imaging  

PubMed Central

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

2014-01-01

96

Isolated abducens nerve palsy in hemolytic uremic syndrome.  

PubMed

Isolated abducens nerve (VI cranial nerve) palsies are reported in a dialyzed child with Escherichia coli 0157:H7-associated hemolytic uremic syndrome (HUS). There were no other neurological manifestations and he made a complete recovery, suggesting that isolated abducens nerve palsy in HUS may represent a minor neurological complication. PMID:15185136

Durkan, Anne; Menascu, Shay; Langlois, Valerie

2004-08-01

97

Optical stimulation of the facial nerve: a surgical tool?  

Microsoft Academic Search

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

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

2008-01-01

98

Diphtheria Symptoms  

MedlinePLUS

... by the bacteria. The pseudomembrane sticks to the tissue below and may get in the way of breathing. The toxin may be absorbed into the blood stream and may cause damage to the heart, kidneys and nerves. Related Pages Diphtheria for Parents: The Basics Describes symptoms ...

99

Radiation associated tumors following therapeutic cranial radiation  

PubMed Central

Background: A serious, albeit rare, sequel of therapeutic ionizing radiotherapy is delayed development of a new, histologically distinct neoplasm within the radiation field. Methods: We identified 27 cases, from a 10-year period, of intracranial tumors arising after cranial irradiation. The original lesions for which cranial radiation was used for treatment included: tinea capitis (1), acute lymphoblastic leukemia (ALL; 5), sarcoma (1), scalp hemangioma (1), cranial nerve schwannoma (1) and primary (13) and metastatic (1) brain tumors, pituitary tumor (1), germinoma (1), pinealoma (1), and unknown histology (1). Dose of cranial irradiation ranged from 1800 to 6500 cGy, with a mean of 4596 cGy. Age at cranial irradiation ranged from 1 month to 43 years, with a mean of 13.4 years. Results: Latency between radiotherapy and diagnosis of a radiation-induced neoplasm ranged from 4 to 47 years (mean 18.8 years). Radiation-induced tumors included: meningiomas (14), sarcomas (7), malignant astrocytomas (4), and medulloblastomas (2). Data were analyzed to evaluate possible correlations between gender, age at irradiation, dose of irradiation, latency, use of chemotherapy, and radiation-induced neoplasm histology. Significant correlations existed between age at cranial irradiation and development of either a benign neoplasm (mean age 8.5 years) versus a malignant neoplasm (mean age 20.3; P = 0.012), and development of either a meningioma (mean age 7.0 years) or a sarcoma (mean age 27.4 years; P = 0.0001). There was also a significant positive correlation between latency and development of either a meningioma (mean latency 21.8 years) or a sarcoma (mean latency 7.7 years; P = 0.001). The correlation between dose of cranial irradiation and development of either a meningioma (mean dose 4128 cGy) or a sarcoma (mean dose 5631 cGy) approached significance (P = 0.059). Conclusions: Our study is the first to show that younger patients had a longer latency period and were more likely to have lower-grade lesions (e.g. meningiomas) as a secondary neoplasm, while older patients had a shorter latency period and were more likely to have higher-grade lesions (e.g. sarcomas). PMID:22629485

Chowdhary, Abhineet; Spence, Alex M.; Sales, Lindsay; Rostomily, Robert C.; Rockhill, Jason K.; Silbergeld, Daniel L.

2012-01-01

100

Cranial fasciitis of childhood  

Microsoft Academic Search

We present a child with a rapidly growing mass and lytic skull lesion that on pathologic evaluation was diagnosed as cranial fasciitis. This disease entity is not widely known by radiologists, and should be included in the differential diagnosis of lytic skull lesions.

N. S. Hunter; D. I. Bulas; W. M. Chadduck; R. Chandra

1993-01-01

101

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

Microsoft Academic Search

Schwannomas are usually benign, single, encapsulated, slow-growing tumours originating from cranial or spinal nerve sheaths.\\u000a The vagus nerve involvement at the mediastinal inlet is very uncommon. For anatomical reasons, the resection of cervical and\\u000a mediastinal schwannoma of the vagus nerve has a high risk of vocal fold paralysis. We describe the case of a 67-year-old female\\u000a with a cervico-mediastinal schwannoma

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

2011-01-01

102

Cranial fasciitis: a rare pediatric non-neoplastic lesion with 14-year follow up.  

PubMed

Cranial fasciitis is a fibroblastic lesion found in the cranium of children three weeks to six years of age. It most commonly manifests as a solitary, rapid growing mass on the scalp with frequent involvement of underlying bone and occasional intracranial expansion. Patients with cranial fasciitis may present with a wide range of associated symptoms. Otologic symptoms such as otalgia, otorrhea, hearing loss and middle ear effusion are not frequently encountered. We present a case of cranial fasciitis with intracranial involvement and associated otologic symptoms in a four year old boy with subsequent follow up 14 years later. PMID:25041933

Lecavalier, Melanie; Ogilvie, Lauren N; Magee, Fergall; Poskitt, Kenneth J; Kozak, Frederick K

2014-01-01

103

Petrositis With Bilateral Abducens Nerve Palsies complicated by Acute Otitis Media  

PubMed Central

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

Choi, Kyu Young

2014-01-01

104

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 PMID:3052771

Kraft, S P; Lang, A E

1988-01-01

105

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

PubMed Central

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

Sonmez, Erkin; Yilmaz, Cem; Altinors, Nur

2009-01-01

106

Nerve biopsy  

MedlinePLUS

Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site will be sore for a few days ...

107

Polychlorinated biphenyl poisoning: correlation of sensory and motor nerve conduction, neurologic symptoms, and blood levels of polychlorinated biphenyls, quaterphenyls, and dibenzofurans.  

PubMed

In 1979 in Taiwan, more than 2000 people were poisoned with rice cooking oil contaminated with polychlorinated biphenyls (PCB). One hundred ten patients were studied within one year of the exposure. The blood PCB levels were 39.3 +/- 16.6 ppb. The blood levels of the PCB derivatives, polychlorinated quaterphenyls (PCQ) and polychlorinated dibenzofurans (PCDF), were 8.6 +/- 4.8 and 0.076 +/- 0.038 ppb, respectively. Both the sensory and motor nerve conduction velocities (NCV) of the patients were significantly lower than the control. Abnormal slowing of sensory NCV was found in 43.6% and abnormal slowing of motor NCV was seen in 21.8%. Patients who had higher PCQ blood levels had significantly slower median nerve sensory NCV than those with lower PCQ levels. Patients with higher PCB blood levels had significantly slower peroneal nerve motor NCV than those with lower PCB levels. PMID:3926478

Chen, R C; Tang, S Y; Miyata, H; Kashimoto, T; Chang, Y C; Chang, K J; Tung, T C

1985-08-01

108

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

Microsoft Academic Search

Introduction  The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low;\\u000a there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best\\u000a of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway\\u000a use.

Deepak Hanumanthaiah; Sarmad Masud; Anil Ranganath

2011-01-01

109

Evolution of Nerve Development in Frogs; pp. 74–83  

Microsoft Academic Search

The gross anatomical development of the peripheral nervous system (PNS) during embryogenesis and metamorphosis in the frog Discoglossus pictus is described based on whole-mount immunostaining for nerves and muscles. In the head, neurite outgrowth starts with the mandibular ramus of the trigeminal nerve at the tailbud stage. Cranial muscles are innervated as soon as they differentiate, beginning at mid-embryonic stages.

Gerhard Schlosser; Gerhard Roth

1997-01-01

110

Evolution of Nerve Development in Frogs; pp. 84–93  

Microsoft Academic Search

The gross anatomical development of the peripheral nervous system (PNS) during embryogenesis and metamorphosis in the frog Discoglossus pictus is described based on whole-mount immunostaining for nerves and muscles. In the head, neurite outgrowth starts with the mandibular ramus of the trigeminal nerve at the tailbud stage. Cranial muscles are innervated as soon as they differentiate, beginning at mid-embryonic stages.

Gerhard Schlosser; Gerhard Roth

1997-01-01

111

Evolution of Nerve Development in Frogs; pp. 112–128  

Microsoft Academic Search

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

Gerhard Schlosser; Gerhard Roth

1997-01-01

112

Evolution of Nerve Development in Frogs; pp. 94–112  

Microsoft Academic Search

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

Gerhard Schlosser; Gerhard Roth

1997-01-01

113

Evolution of Nerve Development in Frogs; pp. 61–73  

Microsoft Academic Search

The gross anatomical development of the peripheral nervous system (PNS) during embryogenesis and metamorphosis in the frog Discoglossus pictus is described based on whole-mount immunostaining for nerves and muscles. In the head, neurite outgrowth starts with the mandibular ramus of the trigeminal nerve at the tailbud stage. Cranial muscles are innervated as soon as they differentiate, beginning at mid-embryonic stages.

Gerhard Schlosser; Gerhard Roth

1997-01-01

114

[Landmarks to the cranial approaches].  

PubMed

The knowledge of the craniotopography allows the delimitation of the cranial approaches. In this study the landmarks, defined in relation to the craniometric points and used in the different cranial approaches, were systematized. Twenty two landmarks are described: the first twelve are in relation to the skull base and the remainder are in relation to the skull vertex. PMID:12806519

Gusmăo, Sebastiăo; Silveira, Roberto Leal; Arantes, Aluízio

2003-06-01

115

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

PubMed

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

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

2014-02-01

116

Cranial bacterial infection.  

PubMed

Early diagnosis of cranial sepsis is mandatory if morbidity is to be avoided. In the case of structural integrity of the skull, haematogenous spread or extension from adjacent structures, especially the sinuses, are the most common sources of infection. Infections may be limited to compartments by the meninges or spread diffusely. Focal disease includes brain abscess as well as subdural and extradural empyaema. A history or signs of sinus disease should always be sought. Tuberculosis, lyme disease and listeriosis may present specific pathological findings. A series of cases is presented to illustrate the role of imaging in infective disease and to draw attention to diagnostic and management points of which radiologists should be aware. PMID:14749953

Anslow, Philip

2004-03-01

117

Spinal Cord Metastasis of a Non-neurofibromatosis Type1 Malignant Peripheral Nerve Sheath Tumor: An Unusual Manifestation of a Rare Tumor  

Microsoft Academic Search

Summary Malignant peripheral nerve sheath tumors are rare spindle-cell sarcomas derived from Schwann cells or pluripotent cells of the neural crest. They arise from the spinal roots, peripheral nerves, brachial and lumbosacral plexi, cranial nerves and terminal nerve fibers within soft tissue, intestine, lung and bone. These tumors recur either locally, or metastasize distally. Most of these tumors occur in

William S. Baek; Peter Pytel; Samir D. Undevia; Helene Rubeiz

2005-01-01

118

Cranial Variability in Amazonian Marmosets  

E-print Network

. Two additional species, C. chrysoleuca and C. saterei, formed a discrete group in the central Amazon, and the westernmost species - C. melanura, C. nigriceps and the Rondonia marmoset - formed a third distinct group. These results from cranial...

Aguiar, John Marshall

2011-02-22

119

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

120

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

2002-01-01

121

Isolated abducens nerve palsy with hyperhomocysteinemia: Association and outcomes  

PubMed Central

Ischemic abducens nerve palsy usually presents as isolated cranial nerve palsy in the middle aged and elderly patients with known risk factors such as diabetes mellitus, hypertension, dyslipidemia, carotid artery disease, etc., In this report, we describe four patients with isolated abducens nerve palsy who presented with an acute onset diplopia whose detailed history and examination were suggestive of an ischemic etiology. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge this is the first report of association of hyperhomocysteinemia and isolated abducens nerve palsy. PMID:24212315

Sachdeva, Virender; Mittal, Vaibhev; Pathengay, Avinash; Kekunnaya, Ramesh; Gupta, Amit; Rao, Bhoompally V

2013-01-01

122

Multiple Cranial Nerve Palsies as the First Presentation of Sarcoidosis  

PubMed Central

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

Ahmad, Zahoor; Snow, Barry

2014-01-01

123

Multiple cranial nerve palsies as the first presentation of sarcoidosis.  

PubMed

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

Rose, Oliver; Ahmad, Zahoor; Snow, Barry

2014-01-01

124

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

Microsoft Academic Search

Artificial modification of the cranial vault was practiced by a number of prehistoric and protohistoric populations, frequently during an infant's first year of life. We test the hypothesis that, in addition to its direct effects on the cranial vault, annular cranial vault modification has a signifi- cant indirect effect on cranial base and facial morphology. Two skeletal series from the

Luci Ann P. Kohn; Steven R. Leigh; Susan C. Jacobs; James M. Cheverud

1993-01-01

125

CT measurements of cranial growth: microcephaly  

SciTech Connect

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

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

1984-06-01

126

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

127

Invasive cranial mycosis our experiences  

PubMed Central

Fungi can cause serious cranial infections in immunocompromised and diabetic patients. Common pathogens mainly include Aspergillus and Mucor. These organisms cause tissue invasion and destruction of adjacent structures (e.g. orbit, ethmoid, sphenoid, maxillary & cavernous sinuses). Mortality and morbidity rate is high despite combined surgical, antifungal and antidiabetic treatment. We present our experience of six cases with such infection. PMID:24251186

Kumbhkar, Tapas; Bansal, Shaifali; Jindal, Sushil; Saxena, Vivek; Baghel, Vijay Singh; Kapoor, Anil

2013-01-01

128

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. PMID:21317732

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

2012-01-01

129

Stroke Awareness in Luxemburg: Deficit Concerning Symptoms and Risk Factors  

PubMed Central

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

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

2014-01-01

130

Cardiac autonomic nerve distribution and arrhythmia?  

PubMed Central

OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia. DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation as the key words. SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included. MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated. RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system. CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the occurrence, maintenance, and symptoms of arrhythmia.

Liu, Quan; Chen, Dongmei; Wang, Yonggang; Zhao, Xin; Zheng, Yang

2012-01-01

131

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

Microsoft Academic Search

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

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

132

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

1998-01-01

133

[Hearing loss as the leading symptom in anterior inferior cerebellar artery infarction].  

PubMed

Hearing impairment is a rare but characteristic symptom of vertebrobasilar occlusive disease. Two patients with anterior inferior cerebellar artery (AICA) infarction and hearing loss as presenting complaint, are described. In patient 1 progressive bilateral AICA infarction was caused by occlusion of the basilar artery, verified by transcranial Doppler sonography. Initial dizziness and bilateral hearing loss were followed by ataxia, dysarthria, dysphagia and right facial sensory impairment. Hearing loss improved during the second week, parallel to a temporary partial recanalisation of the basilar artery, but the patient subsequently developed further progressive brain stem symptoms and died. A right-sided AICA-infarction was diagnosed in patient 2. Initial symptoms were right-sided deafness and dizziness. Neurological examination revealed nystagmus, ataxia and involvement of th 5th and 6th cranial nerve. A progressive improvement of hearing loss and total recovery of the other brain stem symptoms was evident. In conclusion every patient with sudden hearing loss should be examined for additional brain stem symptoms since this can be the presenting sign of a life-threatening basilar artery thrombosis. PMID:9565760

Deschauer, M; Georgiadis, D; Lindner, A

1998-03-01

134

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. PMID:15744823

Jung, Sung-No; Yim, Youngmin

2005-01-01

135

Highly Accurate CAD Tools for Cranial Implants  

Microsoft Academic Search

\\u000a Prefabricated patient-specific cranial implants are especially useful for large cranial defects. We present CAD tools for\\u000a large cranial implants that include validation of fit prior to rapid prototype fabrication. Our CAD process first determines\\u000a whether the prototype implant surface intersects adjacent soft-tissue structures via collision detection. If so, we measure\\u000a the volume of both the intersected dura and unoccupied area

Kyoung-june Min; David Dean

2003-01-01

136

Cardiac musculature of the cranial vena cava in the common tree shrew (Tupaia glis).  

PubMed Central

Cardiac musculature of the cranial vena cava in the common tree shrew (Tupaia glis) was examined by light and transmission electron microscopy. The common tree shrew has well developed cardiac myocyte layers in the tunica media of the cranial vena cava, extending from the right atrium to the root of the subclavian vein. Because the common tree shrew belongs to a primitive group of mammals, the occurrence of cardiac musculature in the cranial vena cava may be a common feature in lower mammals. The development of this musculature indicates that active contraction of the cranial vena cava wall occurs in this species. Electron micrographs showed the typical ultrastructure of myocytes and nerve endings. These observations suggest that this musculature may serve as a regulatory pump for the return of venous blood to the right atrium and as a blood reservoir system under conditions of rapid heart rate. Additionally, the presence of atrial natriuretic polypeptide (ANP) was also demonstrated in the myocytes of the vena cava immunohistochemically. These findings show that the cardiac endocrine organ for ANP develops even in the principal veins including the cranial vena cava. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 PMID:7591997

Endo, H; Maeda, S; Kimura, J; Yamada, J; Rerkamnuaychoke, W; Chungsamarnyart, N; Tanigawa, M; Kurohmaru, M; Hayashi, Y; Nishida, T

1995-01-01

137

'Nerves': folk idiom for anxiety and depression?  

PubMed

This study suggests that 'nerves' as presented in a primary care clinic is a lay idiom for emotional distress and documents a relationship between the folk ailment 'nerves' and anxiety and depression. One hundred and forty-nine patients at a Virginia clinic were studied, 47 with 'nerves', and 102 controls. Testing with the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) showed 'nerves' patients to be more anxious and depressed than controls. 'Nerves' patients had a mean GHQ score of 13.0 compared to 5.8 for controls (P less than 0.0001) and a BDI score of 7.6 compared to 2.5 for controls (P less than 0.0001). Testing with the Holmes-Rahe Social Readjustment Rating Scale showed 'nerves' patients to suffer more recent life stresses than controls: 'nerves' patients had a mean score of 187.1 compared to 119.3 for controls (P less than 0.05). 'Nerves' patients had somatic symptoms including gastrointestinal disturbances, headaches and shaking. 'Nerves' is most common among women and housewives, and is often attributed to misfortune and tragedy. The ethnomedical illness 'nerves' encompasses a rich array of cultural meanings reflecting the lifestyle and worldview of its sufferers. Despite its chronic debilitating nature, it is rarely recognized by physicians; it is, however, treated by alternative healers. Clinical implications are discussed and recommendations advanced, among them that physicians work with such healers in the recognition and treatment of 'nerves'. PMID:3206246

Nations, M K; Camino, L A; Walker, F B

1988-01-01

138

Benign recurrent VI nerve palsy in childhood.  

PubMed

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

Bixenman, W W; von Noorden, G K

1981-01-01

139

21 CFR 882.4370 - Pneumatic cranial drill motor.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Pneumatic cranial drill motor. 882.4370 ...Neurological Surgical Devices § 882.4370 Pneumatic cranial drill motor. (a) Identification. A pneumatic cranial drill motor is a...

2011-04-01

140

21 CFR 882.4370 - Pneumatic cranial drill motor.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Pneumatic cranial drill motor. 882.4370 ...Neurological Surgical Devices § 882.4370 Pneumatic cranial drill motor. (a) Identification. A pneumatic cranial drill motor is a...

2013-04-01

141

21 CFR 882.4370 - Pneumatic cranial drill motor.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Pneumatic cranial drill motor. 882.4370 ...Neurological Surgical Devices § 882.4370 Pneumatic cranial drill motor. (a) Identification. A pneumatic cranial drill motor is a...

2012-04-01

142

21 CFR 882.4370 - Pneumatic cranial drill motor.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Pneumatic cranial drill motor. 882.4370 ...Neurological Surgical Devices § 882.4370 Pneumatic cranial drill motor. (a) Identification. A pneumatic cranial drill motor is a...

2010-04-01

143

21 CFR 882.4370 - Pneumatic cranial drill motor.  

...2014-04-01 false Pneumatic cranial drill motor. 882.4370 Section 882.4370 Food... § 882.4370 Pneumatic cranial drill motor. (a) Identification. A pneumatic cranial drill motor is a pneumatically operated power...

2014-04-01

144

21 CFR 882.4360 - Electric cranial drill motor.  

...2014-04-01 false Electric cranial drill motor. 882.4360 Section 882.4360 Food... § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power...

2014-04-01

145

MRI of sports-related peripheral nerve injuries.  

PubMed

OBJECTIVE. Sports-related peripheral nerve injuries are common among athletes and are often underrecognized because of symptom overlap with more usual sports-related bone, soft-tissue, and joint injuries. CONCLUSION. MRI plays an increasingly important role in the workup of peripheral nerve injuries and may reveal severe nerve abnormalities before they are diagnosed by electrodiagnostic testing or a clinical examination. Sport-specific peripheral nerve injuries and their MRI appearance will be discussed in this article. PMID:25341148

Mitchell, Charles H; Brushart, Thomas M; Ahlawat, Shivani; Belzberg, Allan J; Carrino, John A; Fayad, Laura M

2014-11-01

146

Peripheral Nerve Disorders  

MedlinePLUS

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

147

Cranial base evolution within the hominin clade  

Microsoft Academic Search

The base of the cranium (i.e. the basioccipital, the sphenoid and the temporal bones) is of particular interest because it undergoes significant morphological change within the hominin clade, and because basicranial mor- phology features in several hominin species diagnoses. We use a parsimony analysis of published cranial and dental data to predict the cranial base morphology expected in the hypothetical

L. Nevell; B. Wood

2008-01-01

148

Cranial base evolution within the hominin clade  

PubMed Central

The base of the cranium (i.e. the basioccipital, the sphenoid and the temporal bones) is of particular interest because it undergoes significant morphological change within the hominin clade, and because basicranial morphology features in several hominin species diagnoses. We use a parsimony analysis of published cranial and dental data to predict the cranial base morphology expected in the hypothetical last common ancestor of the Pan–Homo clade. We also predict the primitive condition of the cranial base for the hominin clade, and document the evolution of the cranial base within the major subclades within the hominin clade. This analysis suggests that cranial base morphology has continued to evolve in the hominin clade, both before and after the emergence of the genus Homo. PMID:18380865

Nevell, L; Wood, B

2008-01-01

149

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

150

Acute cranial neuropathies heralding neurosyphilis in human immunodeficiency virus-infected patient.  

PubMed

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

Alqahtani, Saeed

2014-01-01

151

Peripheral nerve disease in pregnancy.  

PubMed

Neuropathies during pregnancy and the postpartum period are common and are usually due to compression around pregnancy and childbirth. The most common peripheral neuropathies are Bell's palsy, carpal tunnel syndrome (CTS), and lower extremity neuropathies. Although most neuropathies are usually reversible, associated disabilities or morbidities can limit functioning and require therapy. Nerve conduction study tests and imaging should only be considered if symptoms are unusual or prolonged. Some neuropathies may be associated with preeclampsia or an inherent underlying neuropathy that increases the risk of nerve injury. All neuropathies in pregnancy should be followed as some may be persistent and require follow-up. PMID:23563878

Klein, Autumn

2013-06-01

152

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. PMID:23419067

2013-01-01

153

Proximal and distal Facial nerve exploration during superficial parotidectomy.  

PubMed

One of the most technique sensitive surgeries in the maxillofacial region is the parotid gland surgery owing to the close relation between the gland and the extra-cranial course of facial nerve. Facial nerve is generally located by means of a proximal surgical identification technique aimed at identifying the facial nerve at its point of exit from the stylomastoid foramen to its entry into the posteromedial surface of parotid gland. There are reports in the literature on distal nerve identification techniques, either as a choice or in cases where proximal nerve identification is difficult. The present report deals with personal clinical experience, describing both the techniques for detection of the facial nerve in 17 cases reported. The technique mainly chosen was conventional proximal nerve identification technique in 16 cases. Distal exploration of the buccal branch was undertaken only in one case, on account of difficulty in locating the main trunk intraoperatively, due to the presence of a post inflammatory fibrosis. The decision to resort to the identification of the buccal nerve is supported by the regular course and adequate size of this branch of facial nerve in its peripheral area co-located with stenson's duct, which enable it to be easily identified during surgery. PMID:22190775

Sharma, Rohit; Sirohi, D

2010-06-01

154

[Malignant peripheral nerve sheath tumour of the infra-orbital nerve].  

PubMed

A malignant peripheral nerve sheath tumour (MPNST) is an uncommon neoplasm that rarely involves the head and neck region. It is even more infrequent for these tumours to affect cranial nerves. We report the case of a 53-year-old man who presented a MPNST involving the infra-orbital nerve, which extended through the orbit and the base of the skull, progressing intracranially. Histological studies identified the tumour as an MPNST. Response to radiotherapy was not complete and radical surgical resection was impossible, so the patient died 10months later. This rare case of MPNST with intracranial involvement illustrates the dismal prognosis for patients with these lesions. Prognosis is poor because of the difficulty of performing radical surgery with free margins in these locations. PMID:24930860

González-Orús Álvarez-Morujo, Ricardo; García Leal, Roberto; Lasso Vázquez, José María; Scola Yurrita, Barolomé

2014-01-01

155

Optic Nerve Pathway Gliomas and Optic Nerve Meningiomas  

Microsoft Academic Search

\\u000a Optic pathway gliomas are intrinsic slow-growing brain tumors that are the most common primary neoplasms of the optic pathways.\\u000a Optic pathway gliomas are associated with neurofibromatosis type 1; the incidence of optic nerve glioma in patients with this\\u000a syndrome varies from 8% to 31%. Sporadic optic pathway gliomas present with visual symptoms, the most common of which is decreased\\u000a visual

Sonali Singh; Jade S. Schiffman

156

Symptom Management  

Cancer.gov

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

157

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.

1984-06-01

158

Artificial cranial deformation and fossil Australians revisited  

Microsoft Academic Search

Based on cranial characters shared byHomo erectusin Java andHomo sapiensin Australia, Australasia is widely considered the strongest case for a regional origin of modern humans. However, artificial vault deformation has been suggested to be the cause of “archaic” characters such as frontal recession in key fossil Australian crania. We use log–log plots of cranial arc versus chord measurements and we

Susan C. Antón; Karen J. Weinstein

1999-01-01

159

Polyarteritis Nodosa Presenting with Bilateral Testicular Swelling and Complicated by Unilateral Facial Nerve Palsy  

PubMed Central

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that is generally restricted to medium-sized vessels. Here we describe the first case of a patient in which a bilateral testicular mass was a presenting symptom and the diagnosis was made on the basis of testicular histopathology. A 53-year-old Asian man presented with a history of constitutional symptoms and testicular swelling. Scrotal ultrasound revealed two avascular, bilateral, intratesticular lesions. The bilateral testicular abscess was treated without improvement. The patient developed left seventh cranial nerve palsy during his admission. The clinical changes made vasculitis or a related disorder more likely and the patient underwent a right testicular biopsy. Histopathology demonstrated features of transmural inflammation and fibrinoid necrosis of medium-sized vessel walls, consistent with PAN. This case illustrates the difficulty in diagnosing polyarteritis nodosa with isolated bilateral testicular swelling and the delay in the diagnosis. After 9 months of follow-up, no relapse had occurred and the patient's testosterone level was on the lower side of normal. PMID:21687399

Richards, Bethan; Rasiah, Kris; Thanigasalam, Ruban; Atmore, Bryn B; Laurent, Roger

2011-01-01

160

Vertical lid split approach for optic nerve sheath decompression  

PubMed Central

We describe a vertical lid split orbitotomy approach to perform optic nerve sheath fenestration which was done in a patient with idiopathic intracranial hypertension. A vertical lid split incision was used to enter the superomedial orbit and approach the optic nerve sheath. This approach resulted in a successful nerve sheath fenestration, with improvement in the patient's symptoms. The vertical lid split incision provides access to the optic nerve sheath with minimal morbidity and may be an option for optic nerve sheath decompression. PMID:19574700

Prabhakaran, Venkatesh C; Selva, Dinesh

2009-01-01

161

[Computed tomography and cranial paleoanthropology].  

PubMed

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-Thérčse; Istoc, Adrian; de Lumley, Henry; de Lumley, Marie-Antoinette; Coppens, Yves

2007-06-01

162

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

PubMed Central

The mechanism of the cranial neuropathy associated with heavy exposure to trichloroethylene (or dichloroethylene) is unknown. In severe cases there is destructive spread of the neuropathic process from the Vth cranial nerve nuclei up and down the brain stem in a manner that is difficult to explain on accepted neurotoxicological principles. However, there is a close association reported of this form of trigeminal neuropathy with reactivation of orofacial herpes simplex that suggests the possibility that the chemical, which readily gains entrance into the nervous system, may be responsible for reactivating the latent virus. This novel hypothesis is discussed in the light of current understanding of latency in herpes simplex infection in nervous tissue. PMID:2538571

Cavanagh, J B; Buxton, P H

1989-01-01

163

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

PubMed

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

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

2014-05-01

164

Cavernous nerve regeneration using acellular nerve grafts  

Microsoft Academic Search

Introduction  The restoration of erectile function following complete transection of nerve tissue during surgery remains challenging. Recently,\\u000a graft procedures using sural nerve grafts during radical prostatectomy have had favorable outcomes, and this has rekindled\\u000a interest in the applications of neural repair in a urologic setting. Although nerve repair using autologous donor graft is\\u000a the gold standard of treatment currently, donor nerve

Stephen S. Connolly; James J. Yoo; Mohamed Abouheba; Shay Soker; W. Scott McDougal; Anthony Atala

2008-01-01

165

Middle cranial fossa cystic schwannoma  

PubMed Central

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

2012-01-01

166

Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder: A Pilot Study of Two Military Veterans  

Microsoft Academic Search

This case study investigated the effects of cranial electrotherapy stimulation (CES) on the prevalence and intensity of posttraumatic stress disorder (PTSD) symptoms and self- perceived improvement of performance and satisfaction in daily activities in war veterans. Two male Caucasian veterans (ages 54 and 38) diagnosed with PTSD participated in these case studies with a pretest–posttest design. The Canadian Occupational Performance

Alfred G. Bracciano; Wen-Pin Chang; Stephanie Kokesh; Abe Martinez; Melissa Meier; Kathleen Moore

2012-01-01

167

Cranial MRI in Wilson's disease  

Microsoft Academic Search

Thirty-eight patients with biochemically proven Wilson's disease underwent magnetic resonanceimaging (MRI) of the brain as well as neurological examinations. The patients were scanned using spin-echo (SE) sequences; the neurologist was looking for typical symptoms: dysarthria, tremor, ataxia, rigidity\\/bradykinesia and chorea\\/dystonia. Pathological MR findings believed secondary to this uncommon inherited disorder of copper metabolism were found in twenty-two subjects. Focal abnormalities

L. Prayer; D. Wimberger; J. Kramer; G. Grimm; W. Oder; H. Imhof

1990-01-01

168

Rotavirus Symptoms  

MedlinePLUS

... copyright holder. Print page View page in Espańol (Spanish) Contact Us: Centers for Disease Control and Prevention ... CDC-INFO Rotavirus Home About Rotavirus Symptoms Symptoms - Spanish Transmission Transmission - Spanish Prevention Prevention - Spanish Treatment Treatment - ...

169

Restoration of large cranial defect for cranioplasty with alloplastic cranial implant material: a case report.  

PubMed

Cranial defects result either from trauma or after intentional osteocraniotomies or external decompression craniectomies. These defects occur most frequently during wartime, but their incidence during peacetime, as a result of accident or disease, makes knowledge of cranioplasty useful to the interested practitioner. Most cranial defects will have some variable proportion of cosmetic and mechanical aspects, and the decision regarding cranioplasty must be influenced by the patient's age, prognosis, activity level and the specific conditions of the scalp and calvarium. This case report is oriented towards post-traumatic restoration of large cranial defect with alloplastic heat-cure poly methyl methacrylate resin material. PMID:24757358

Goyal, Shelly; Goyal, Mukesh Kumar

2014-06-01

170

38 CFR 4.123 - Neuritis, cranial or peripheral.  

Code of Federal Regulations, 2012 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...

2012-07-01

171

38 CFR 4.123 - Neuritis, cranial or peripheral.  

Code of Federal Regulations, 2010 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...

2010-07-01

172

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...

2013-07-01

173

38 CFR 4.123 - Neuritis, cranial or peripheral.  

Code of Federal Regulations, 2011 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...

2011-07-01

174

Cranial MRI scans are indicated in all girls with central precocious puberty  

PubMed Central

Aims: (1) To assess the value of cranial magnetic resonance imaging (MRI) scans in the investigation of girls with central precocious puberty (CPP); and (2) to determine the clinical predictors of abnormal cranial MRI scans in these patients. Methods: A retrospective study of 67 girls diagnosed with CPP who underwent cranial MRI scans at diagnosis. Patients with neurological signs or symptoms at presentation were excluded. Results: The mean age of onset of puberty was 6.2 years (range 2.0–7.9). Intracranial abnormalities were present in 10 (15%) patients (MR+), while 57 (85%) had no abnormalities (MR-). There was no statistical difference between MR+ patients and MR- patients at presentation with respect to age of onset of puberty, pubertal stage, bone age advance, pelvic ultrasound findings, or height or body mass index standard deviation scores (SDS). Conclusion: Girls with CPP should have a cranial MRI scan as part of their assessment since clinical features, including age, are not helpful in predicting those with underlying pathology. Implementation of such an approach may have a substantial effect on clinical practice and healthcare cost. PMID:12716713

Ng, S; Kumar, Y; Cody, D; Smith, C; Didi, M; Donaldson, M

2003-01-01

175

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. PMID:18552605

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

2009-01-01

176

Rare communication between the musculocutaneous and median nerves in the forearm: its clinical significance.  

PubMed

Morphologic classifications of communication between musculocutaneous and median nerves are not based on the distribution and the function of the communicating branch. The authors report a rare case of such a communication with passage of the median nerve through the pronator teres muscle and discuss its clinical significance. The musculocutaneous nerve was divided into a lateral branch that continued to the lateral antebrachial cutaneous nerve and a medial branch that joined the median nerve in the forearm. The authors separated the nerve bundles and noted that the communicating branch derived from the sixth to seventh cervical nerves and supplied nerve fibers to the pronator teres muscle and the proper palmar digital nerve of the thumb. In addition, the median nerve penetrated the humeral head of the pronator teres muscle. Isolated musculocutaneous neuropathy with such a communication may cause unexpected symptoms such as sensory deficit in the palm and muscular weakness of the forearm and the thumb. PMID:25122101

Liu, Hong-Fu; Won, Hyung-Sun; Chung, In-Hyuk; Kim, Seung-Min; Kim, In-Beom

2014-10-01

177

The primate cranial base: Ontogeny, function, and integration  

Microsoft Academic Search

Understanding the complexities of cranial base develop- ment, function, and architecture is important for testing hypotheses about many aspects of craniofacial variation and evolution. We summarize key aspects of cranial base growth and development in primates that are useful for formulating and testing hypotheses about the roles of the chondrocranium and basicranium in cranial growth, integration, and function in primate

Daniel E. Lieberman; Callum F. Ross; Matthew J. Ravosa

2000-01-01

178

The Primate Cranial Base: Ontogeny, Function, and Integration  

E-print Network

, Chicago, Illinois 60605-2496 KEY WORDS cranial base; basicranium; chondrocranium; pri- mates; humans ABSTRACT Understanding the complexities of cranial base develop- ment, function, and architecture key aspects of cranial base growth and development in primates that are useful for formulating

179

Development and tissue origins of the mammalian cranial base  

Microsoft Academic Search

The vertebrate cranial base is a complex structure composed of bone, cartilage and other connective tissues underlying the brain; it is intimately connected with development of the face and cranial vault. Despite its central importance in craniofacial development, morphogenesis and tissue origins of the cranial base have not been studied in detail in the mouse, an important model organism. We

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

2008-01-01

180

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

2011-01-01

181

Multicentric malignant peripheral nerve sheath tumor  

Microsoft Academic Search

We present a case of malignant peripheral nerve sheath tumor of multicentric origin, an extremely rare condition. A 25-year-old man was admitted to hospital with presenting symptoms of cough, dyspnea and left lateral back pain. Computed tomography and magnetic resonance imaging revealed extrapleural masses in the left hemithorax in addition to synchronous left inguinal mass. After surgical resection of the

Ersin Ozturk; Iclal Erdem; Guner Sonmez; Aptullah Haholu; Huseyin Onur Sildiroglu; Hakan Mutlu; C. Cinar Basekim; Esref Kizilkaya

2007-01-01

182

Cranial Ultrasonography in Maple Syrup Urine Disease  

Microsoft Academic Search

Summary: We performed serial cranial ultrasonography in four newborns affected by maple syrup urine disease. Symmetric increase of echogenicity of periventricular white matter, basal ganglia (mainly pallidi), and thalami was detected in the acute stage. The degree of ultrasonography abnormalities paralleled the clinical course of the disease. Maple syrup urine disease is a rare inborn error of branched-chain amino acid

Giuseppe Fariello; Carlo Dionisi-Vici; Cinzia Orazi; Saverio Malena; Andrea Bartuli; Paolo Schingo; Enza Carnevale; Isora Saponara; Gaetano Sabetta

183

Cranial computed tomography and MRI. Second edition  

SciTech Connect

This book contains 17 chapters. Some of the chapter titles are: Physics and Instrumentation: CT and MRI; Normal Cranial CT and MRI Anatomy; The Orbit; The ventricles and Subarachnoid Spaces in Children; Primary Tumors in Children; Trauma: Craniocerebral and Craniofacial; Infectious Disease; and Stroke.

Lee, S.H.; Rao, K.C.V.G.

1987-01-01

184

The cranial endoskeleton of Tiktaalik roseae  

Microsoft Academic Search

Among the morphological changes that occurred during the ‘fish-to-tetrapod’ transition was a marked reorganization of the cranial endoskeleton. Details of this transition, including the sequence of character acquisition, have not been evident from the fossil record. Here we describe the braincase, palatoquadrate and branchial skeleton of Tiktaalik roseae, the Late Devonian sarcopterygian fish most closely related to tetrapods. Although retaining

Edward B. Daeschler; Farish A. Jenkins; Jason P. Downs; Neil H. Shubin

2008-01-01

185

The cranial endoskeleton of Tiktaalik roseae  

Microsoft Academic Search

Among the morphological changes that occurred during the `fish-to-tetrapod' transition was a marked reorganization of the cranial endoskeleton. Details of this transition, including the sequence of character acquisition, have not been evident from the fossil record. Here we describe the braincase, palatoquadrate and branchial skeleton of Tiktaalik roseae, the Late Devonian sarcopterygian fish most closely related to tetrapods. Although retaining

Jason P. Downs; Edward B. Daeschler; Farish A. Jenkins; Neil H. Shubin

2008-01-01

186

Delayed onset facial nerve dysfunction following acoustic neuroma surgery.  

PubMed

Delayed onset facial nerve dysfunction following acoustic neuroma surgery is an under-appreciated phenomenon. The authors have recently reviewed long-term (> 1 year) facial nerve outcome in 129 patients who underwent acoustic neuroma removal with the aid of cranial nerve monitoring between 1986 and 1990. The facial nerve was anatomically preserved in 99.2% of the patients, and at one year, 90% of all the patients had House-Brackmann (H-B) grade I or II facial nerve function. Delayed onset worsening of facial nerve function was noted in 38 of 129 (29%) patients, most of which occurred in the first few postoperative days. The incidence increases to 41% (38 of 93) when corrected for those with immediate H-B grade VI weakness, and who therefore could not manifest further deterioration. The facial nerve function either deteriorated from normal to abnormal or increased in severity of weakness. Delayed facial palsy was not related to the size of tumor or the surgical approach. The most common occurrence was that of a patient with H-B grade I or II facial nerve function worsening to H-B grade VI in the postoperative period. The prognosis for recovery of facial nerve function following delayed palsy was excellent. In the majority of cases, the recovery was complete within the first 6 months without specific treatment. Comparable to the patients without delayed palsies, 89% (34 of 38) of the cases had H-B grade I or II and 97% (37 of 38) had H-B grade III or better facial nerve function at 1 year. This review suggests a surprisingly high incidence of delayed facial palsy following acoustic neuroma surgery, which fortunately has an excellent prognosis for spontaneous recovery. PMID:8572138

Lalwani, A K; Butt, F Y; Jackler, R K; Pitts, L H; Yingling, C D

1995-11-01

187

Peripheral Nerve Regeneration by Artificial Nerve Guides  

Microsoft Academic Search

It is more than 20 years since artificial nerve guides (or conduits) were introduced into clinical practice as a reliable\\u000a alternative to autograft. They are basically cylindrical conduits inside which a regenerating nerve stump may find protection\\u000a and guidance. Early guides were made of silicone and were not biodegradable; they were shown to support nerve regeneration\\u000a but, subsequently, were considered

A. Merolli; L. Rocchi

188

Descriptive epidemiology of primary cancer of the brain, cranial nerves, and cranial meninges in New Zealand, 1948–88  

Microsoft Academic Search

We used New Zealand data on occurrence of different types of brain cancer to investigate: (i) a possible secular increase which has been seen worldwide and has generated considerable debate; (ii) possibly higher rates among Maori; and (iii) possibly higher risks related to social class and occupation. Data from the NZ Cancer Registry on the 5,684 brain cancers diagnosed among

Susan Preston-Martin; Simon Lewis; Regina Winkelmann; Barry Borman; Jackie Auld; Neil Pearce

1993-01-01

189

Symptomatic Arnold-Chiari Malformation and Cranial Nerve Dysfunction: a Case Study of Applied Kinesiology Cranial Evaluation and Treatment  

Microsoft Academic Search

ObjectiveTo present an overview of possible effects of Arnold-Chiari malformation (ACM) and to offer chiropractic approaches and theories for treatment of a patient with severe visual dysfunction complicated by ACM.

Scott Cuthbert; Charles Blum

2005-01-01

190

Central Topography of Cranial Motor Nuclei Controlled by Differential Cadherin Expression  

PubMed Central

Summary Neuronal nuclei are prominent, evolutionarily conserved features of vertebrate central nervous system (CNS) organization [1]. Nuclei are clusters of soma of functionally related neurons and are located in highly stereotyped positions. Establishment of this CNS topography is critical to neural circuit assembly. However, little is known of either the cellular or molecular mechanisms that drive nucleus formation during development, a process termed nucleogenesis [2–5]. Brainstem motor neurons, which contribute axons to distinct cranial nerves and whose functions are essential to vertebrate survival, are organized exclusively as nuclei. Cranial motor nuclei are composed of two main classes, termed branchiomotor/visceromotor and somatomotor [6]. Each of these classes innervates evolutionarily distinct structures, for example, the branchial arches and eyes, respectively. Additionally, each class is generated by distinct progenitor cell populations and is defined by differential transcription factor expression [7, 8]; for example, Hb9 distinguishes somatomotor from branchiomotor neurons. We characterized the time course of cranial motornucleogenesis, finding that despite differences in cellular origin, segregation of branchiomotor and somatomotor nuclei occurs actively, passing through a phase of each being intermingled. We also found that differential expression of cadherin cell adhesion family members uniquely defines each motor nucleus. We show that cadherin expression is critical to nucleogenesis as its perturbation degrades nucleus topography predictably. PMID:25308074

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

2014-01-01

191

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

PubMed Central

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

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

2014-01-01

192

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

PubMed Central

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

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

2013-01-01

193

Simultaneous discovery of cranial and spinal intradural chordomas: case report.  

PubMed

The present case illustrates the unexpected occurrence of intradural chordomas that were simultaneously discovered in cranial and spinal locations. A 63-year-old female presented with weakness in the left upper extremity. The patient visited a local doctor and underwent brain computerized tomography (CT). CT revealed a brain tumor, and she was referred to our hospital. Brain magnetic resonance imaging (MRI) demonstrated a midline intradural retroclival tumor in addition to an intradural extramedullary mass lesion at the level of C1-C2. The patient developed a spastic gait disturbance that forced her to use a cane. She underwent laminectomy at C1-C2 along with total removal of the tumor and showed no remarkable symptoms after surgery. Histopathological examination confirmed the diagnosis of chordoma. One month after the cervical surgery, the intracranial tumor was subtotally removed in intracranial surgery via the right subtemporal approach. Histopathological data were identical to that of the cervical tumor. The patient consulted another hospital and underwent gamma-knife surgery. Her neurological examination is relatively unchanged 20 months after the cervical surgery. This case suggests that neuroradiological evaluation should also be performed for an intradural spinal chordoma when an intracranial chordoma is detected. Careful determination of the tumor responsible for the symptoms is necessary if an intradural spinal chordoma is simultaneously detected with an intracranial chordoma. PMID:24477062

Kawanabe, Yoshifumi; Ueda, Shigeo; Sasaki, Nobuhiro; Hoshimaru, Minoru

2014-11-15

194

Electromechanical Nerve Stimulator  

NASA Technical Reports Server (NTRS)

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

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

1993-01-01

195

Optic Nerve Imaging  

MedlinePLUS

... Tomography (OCT) , which measures the reflection of laser light much like an ultrasound measures the reflection of sound, can directly measure the thickness of the nerve fiber layer and create a three dimensional representation of the optic nerve. ...

196

The effect of vestibular nerve section on the expression of the hyaluronan in the frog, Rana esculenta  

Microsoft Academic Search

Following postganglionic lesion of the eighth cranial nerve, the changes in the expression of hyaluronan (HA), one of the\\u000a extracellular matrix macromolecules, were examined in the medial (MVN) and lateral (LVN) vestibular nuclei and in the entry\\u000a or transitional zone (TZ) of the nerve in the frog. HA was detected in different survival times by using a specific biotinylated\\u000a hyaluronan-binding

Gábor Halasi; Ervin Wolf; Tímea Bácskai; György Székely; László Módis; Zsuzsa M. Szigeti; Zoltán Mészár; Szabolcs Felszeghy; Clara Matesz

2007-01-01

197

Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and restrosigmoid approaches  

Microsoft Academic Search

Purpose  Therapeutic options for vestibular schwannomas (VS) include microsurgery, stereotactic radiosurgery and conservative management.\\u000a Early treatment of intracanalicular vestibular schwannomas (IVS) may be advisable because their spontaneous course will show\\u000a hearing loss in most cases. Advanced microsurgical techniques and continuous intraoperative monitoring of cranial nerves may\\u000a allow hearing preservation (HP) without facial nerve damage. However, there are still controversies about the

R. Noudel; P. Gomis; J. Duntze; D. Marnet; A. Bazin; P. H. Roche

2009-01-01

198

Engineering Peripheral Nerve Repair  

PubMed Central

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; Sakiyama-Elbert, Shelly E.

2013-01-01

199

Cranial modularity shifts during mammalian evolution.  

PubMed

The mammalian skull has been studied as several separate functional components for decades, but the study of modularity is a more recent, integrative approach toward quantitative examination of independent subsets of highly correlated traits, or modules. Although most studies of modularity focus on developmental and genetic systems, phenotypic modules have been noted in many diverse morphological structures. However, few studies have provided empirical data for comparing modules across higher taxonomic levels, limiting the ability to assess the broader evolutionary significance of modularity. This study uses 18-32 three-dimensional cranial landmarks to analyze phenotypic modularity in 106 mammalian species and demonstrates that cranial modularity is generally conserved in the evolution of therian mammals (marsupials and placentals) but differs between therians and monotremes, the two extant subclasses of Mammalia. Within therians, cluster analyses identify six distinct modules, but only three modules display significant integration in all species. Monotremes display only two highly integrated modules. Specific hypotheses of functional and developmental influences on cranial bones were tested. Theoretical correlation matrices for bones were constructed on the basis of shared function, tissue origin, or mode of ossification, and all three of these models are significantly correlated with observed correlation matrices for the mammalian cranium. PMID:16874636

Goswami, Anjali

2006-08-01

200

Cranial Osteology of Meiglyptini (Aves: Piciformes: Picidae)  

PubMed Central

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

Donatelli, Reginaldo José

2012-01-01

201

Studing cranial vault modifications in ancient Mesoamerica.  

PubMed

The artificial modification of infant cranial vaults through massages or by means of constriction and compression devices constitutes a readily visible, permanent body modification that has been employed cross-culturally to express identity, ethnicity, beauty, status and gender. For those ancient societies that staged head shaping, these cultural correlates may be ascertained by examining cranial shapes together with other data sets from the archaeological record. Studies of skulls modified for cultural reasons also provide important clues for understanding principles in neural growth and physiopathological variation in cranial expansion. This paper focuses on head shaping techniques in Mesoamerica, where the practice was deeply rooted and widespread before the European conquest. It provides a comprehensive review of the Mesoamericanistic research on shaping techniques, implements and taxonomies. An up-dated, interdisciplinary examination of the physiological implications and the cultural meanings of artificially produced head shapes in different times and culture areas within Mesoamerica leads to a discussion of the scope, caveats, and future directions involved in this kind of research in the region and beyond. PMID:22781584

Tiesler, Vera

2012-01-01

202

Optic nerve trauma.  

PubMed

Trauma to the optic nerve may be direct, such as from a penetrating object, or indirect, which may result despite lack of direct contact of an object with the nerve. Although indirect injury initially causes no change in the appearance of the nerve head, within a matter of weeks optic atrophy will be manifest. The pathophysiology of nerve damage is incompletely understood. Management is controversial; steroid therapy has been advocated, as has surgical decompression of the nerve. Indirect injuries affecting the optic nerve may also result from torsional rotation of the globe (avulsion) and from subdural or subarachnoid hemorrhage (Terson's syndrome). There is no treatment for optic nerve avulsion; the unaffected eye should be protected with appropriate eyewear. Hemorrhaging in the retina and vitreous in Terson's syndrome should be monitored for resolution and risk of retinal detachment. Computed tomography may be necessary if subarachnoid or intracranial hemorrhages are suspected. PMID:8268699

Dul, M W

1993-01-01

203

Transient facial nerve palsy after occipital nerve block: a case report.  

PubMed

Occipital nerve blocks are commonly performed to treat a variety of headache syndromes and are generally believed to be safe and well tolerated. We report the case of an otherwise healthy 24-year-old woman with left side-locked occipital, parietal, and temporal pain who was diagnosed with probable occipital neuralgia. She developed complete left facial nerve palsy within minutes of blockade of the left greater and lesser occipital nerves with a solution of bupivicaine and triamcinolone. Magnetic resonance imaging of the brain with gadolinium contrast showed no abnormalities, and symptoms had completely resolved 4-5 hours later. Unintended spread of the anesthetic solution along tissue planes seems the most likely explanation for this adverse event. An aberrant course of the facial nerve or connections between the facial and occipital nerves also might have played a role, along with the patient's prone position and the use of a relatively large injection volume of a potent anesthetic. Clinicians should be aware that temporary facial nerve palsy is a possible complication of occipital nerve block. PMID:24913733

Strauss, Lauren; Loder, Elizabeth; Rizzoli, Paul

2014-11-01

204

Painless hypoglossal palsy as an isolated symptom of spontaneous carotid dissection.  

PubMed

Spontaneous internal carotid artery dissection (sICAD) occurs annually in 2.5 to 3 per 100,000 presenting with signs of ischemic events in the majority of cases. In contrast, lower cranial nerve palsy due to peripheral nerve affection is seldom the presenting clinical sign. In symptomatic cases (>90%), sICAD is most commonly accompanied by local pain. We report a case of a 49-year old woman with a left sICAD presenting with isolated ipsilateral hypoglossal palsy as the sole clinical sign. Compared to other cases, local pain was absent and other cranial nerves were not affected. Further, sICAD could not be detected in repeated Doppler-/Duplex-sonography, but magnetic resonance imaging and MR-angiography only. PMID:24794948

Hennings, J M; Hoehn, D; Schumann-Spaeth, E; Weber, F

2014-08-01

205

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.

2008-02-01

206

Humeral diaphyseal osteochondroma causing median nerve injury.  

PubMed

Osteochondromas are the most common benign tumours of the bone. They are solitary or multiple, pedunculated or sessile exophytic outgrowths from the bone surface that are composed of cortical and medullary component with an overlying hyaline cartilage cap. Marrow and cortical continuity with the underlying parent bone is the characteristic of the lesion; they mostly arise from the metaphysis of the bone. Osteochondromas arising from the diaphysis are rare; and nerve palsy arising in the setting of a diaphyseal osteochondroma is even rarer. This is a report of solitary osteochondroma arising from diaphysis of left humerus in a 10 years old boy, which resulted in median nerve palsy. Surgical excision relieved the symptoms completely. The aim of this case report was to draw attention to an unusual etiology of median nerve palsy caused by an osteochondroma arising from the diaphysis of humerus which is a rare site, and to emphasize its importance. PMID:24718003

Mohindra, Mukul; Tiwari, Anurag; Gogna, Paritosh; Thora, Ankit

2014-03-01

207

Reliability of cranial CT versus intracerebral pressure measurement for the evaluation of generalised cerebral oedema in children  

Microsoft Academic Search

Objective. To examine the extent to which intracranial pressure (ICP) in children after severe brain trauma can be determined by cranial\\u000a CT.¶Materials and methods. Two experienced paediatric radiologists, without any knowledge of the clinical symptoms, evaluated 124 CT scans from 65 children\\u000a (average age 5.4 years) who underwent intracranial measurement of their cerebral pressure.¶Results. CT had high sensitivity (99.1 %)

Wolfgang Hirsch; Rainer Beck; Curt Behrmann; Axel Schobess; R.-P. Spielmann

2000-01-01

208

Anomaly of the supraclavicular nerve: case report and review of the literature.  

PubMed

We report a male cadaver found to have his right intermediate branch of the supraclavicular nerve piercing the clavicle. No other anomalies were found in this specimen. Following a review of the literature, it appears that symptoms related to this finding are rare but do occur most commonly involving the intermediate branch of the supraclavicular nerve. Symptoms may be alleviated with surgical decompression of the entrapped nerve. Although rare, the clinician should include entrapment of the supraclavicular nerve within the clavicle in their differential diagnosis of shoulder pain. PMID:16059930

Tubbs, R Shane; Salter, E George; Oakes, W Jerry

2006-10-01

209

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

PubMed Central

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

L'Heureux-Lebeau, Benedicte; Saliba, Issam

2013-01-01

210

The Furcal Nerve Revisited  

PubMed Central

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

Dabke, Harshad V.

2014-01-01

211

Noninvasive transcranial stimulation of rat abducens nerve by focused ultrasound.  

PubMed

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

2012-09-01

212

Relationship of Cranial Robusticity to Cranial Form, Geography and Climate in Homo sapiens  

E-print Network

Sciences, Stony Brook University Medical Center, Stony Brook, NY 11794 2 Department of Human Evolution, Max ABSTRACT Variation in cranial robusticity among modern human populations is widely acknowledged in modern humans are also used as diagnostic characters to distin- guish among Homo taxa and to reconstruct

Baab, Karen L.

213

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

214

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

PubMed

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

Heckmann, R A

1992-06-01

215

Cranial fasciitis of the petrous temporal bone.  

PubMed

Cranial fasciitis (CF) is a rare benign neoplastic lesion affecting the pericranium and deep fascia of the scalp. We report a case confined to the temporal bone, resembling a malignant destructive lesion. The mass was identified during myringotomy for recurrent unilateral otitis media. Biopsy was consistent with CF, which was partially resected. The patient has remained disease free for 12 months. Due to its rarity, no defined treatment algorithm for CF exists. Despite aggressive features on radiology, they may respond very well to partial resection. PMID:25017798

Fissenden, Thomas M; Taheri, M Reza; Easley, Samantha; Monfared, Ashkan

2014-09-01

216

Social stigmatization in patients with cranial and cervical dystonia.  

PubMed

Patients with cranial and cervical dystonia (CCD) suffer from visible involuntary facial, head, and neck movements. Therefore, the social appearance of patients with CCD may be seriously affected and self-perceived stigma can be a major source of disability. The present study investigated enacted social stigmatization of patients with CCD. In a pilot study, a semantic differential scale for assessment of stigma was constructed and validated. The final scale contained eight items representing personality traits to be rated on a seven-point scale (-3 negative extreme to 3 positive extreme). Short video sequences (15 seconds) of patients with various types of CCD and age- and sex-matched healthy controls were presented to a sample of 80 biology students (mean age, 19.8 +/- 2.3 years). Immediately after presentation of each video sequence, the students were asked to perform stigma ratings. Significant differences between CCD patients and controls were found on all eight items (P < 0.001 for each). CCD patients were rated as less accountable for their actions, less likeable, less trustworthy, less attractive, less self-confident, more odd and different, more reserved, and more piteous than controls. CCD patients are subject to serious prejudice and enacted stigmatization. There is a need for informing the public about the nature and symptoms of this disorder and a need to support patients to cope with stigmatization. PMID:16856133

Rinnerthaler, Martina; Mueller, Joerg; Weichbold, Viktor; Wenning, Gregor K; Poewe, Werner

2006-10-01

217

Major peripheral nerve injuries.  

PubMed

Major peripheral nerve injuries in the upper extremities can result in significant morbidity. Understanding the pathophysiology of these injuries aids in the assessment and planning of appropriate treatment. With limited nerve mobilization, tension-free repairs can often be performed using sutures, fibrin glue, or nerve connectors. Acellular allograft and autograft reconstruction are better for bridging any gaps greater than a few millimeters. Adherence to proper principles of nerve repair improves the chances of achieving a favorable result, although in general these injuries portend a guarded prognosis. PMID:23895717

Isaacs, Jonathan

2013-08-01

218

Pulfrich’s phenomenon in optic nerve hypoplasia  

Microsoft Academic Search

Background  Optic nerve hypoplasia (ONH) is a congenital deficiency of retinal ganglion cells and their axons that form the optic nerve.\\u000a The condition is associated with visual deficits ranging from no light perception in severe cases, to vision within normal\\u000a range in mild cases of ONH. We report here a case of mild ONH with normal vision and with visual symptoms

Gordon Heron; Gordon N. Dutton; Daphne L. McCulloch; Stewart Stanger

2008-01-01

219

Management of peripheral facial nerve palsy  

Microsoft Academic Search

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

Josef Finsterer

2008-01-01

220

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. PMID:23847710

Selcuk, Ferda; Mut, Senem E.

2013-01-01

221

Menopausal symptoms  

PubMed Central

Introduction Menopause is a physiological event. In the UK, the median age for onset of menopausal symptoms is 45.5 to 47.5 years. Although endocrine changes are permanent, menopausal symptoms such as hot flushes, which are experienced by about 70% of women, usually resolve with time, although they can persist for decades in some women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments for menopausal symptoms? What are the effects of non-prescribed treatments for menopausal symptoms? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 79 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: agnus castus, antidepressants, black cohosh, clonidine, oestrogens, phyto-oestrogens, progestogens, testosterone, and tibolone. PMID:21696644

2011-01-01

222

Menopausal symptoms  

PubMed Central

Introduction Menopause is a physiological event. In the UK, the median age for onset of menopausal symptoms is 45.5 to 47.5 years. Although endocrine changes are permanent, menopausal symptoms such as hot flushes, which are experienced by about 70% of women, usually resolve with time, although they can persist for decades in some women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments for menopausal symptoms? What are the effects of non-prescribed treatments for menopausal symptoms? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 68 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: agnus castus, antidepressants, black cohosh, clonidine, oestrogens, phyto-oestrogens, progestogens, testosterone, and tibolone. PMID:21718582

2010-01-01

223

The evolution and development of cranial form in Homo sapiens  

E-print Network

the origin of modern human cranial form. In terms of pattern, AMHS crania are uniquely characterized by twoThe evolution and development of cranial form in Homo sapiens Daniel E. Lieberman* , Brandeis M. Mc of the ontogeny of these autapo- morphies indicates that the developmental changes that led to modern human

Lieberman, Daniel E.

224

Middle Cranial Fossa Anatomy and the Origin of Modern Humans  

E-print Network

#12;Middle Cranial Fossa Anatomy and the Origin of Modern Humans MARKUS BASTIR,1 * ANTONIO ROSAS,1 cranial fossa (MCF) interacts during growth and development with the temporal lobes, the midface, and the mandible. It has been proposed that evolution- ary transformations of the MCF (perhaps from modification

Lieberman, Daniel E.

225

Phylogeny, Neoteny and Growth of the Cranial Base in Hominoids  

Microsoft Academic Search

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

M. C. Dean; B. A. Wood

1984-01-01

226

The Cranial Base in Craniofacial Development: a Gene Therapy Study  

Microsoft Academic Search

The etiology of midface retrusion remains largely unclear. We hypothesized that the cranial base synchondroses play a key role in the development of the craniofacial skeleton in the Sandhoff mouse model. We observed that developmental abnormalities of the cranial base synchondroses involving proliferative chondrocytes are important in craniofacial growth and development. Neonatal restitution of ?-hexosaminidase in mutant mice by gene

S. Kyrkanides; P. Kambylafkas; J. H. Miller; R. H. Tallents; J. E. Puzas

2007-01-01

227

Spontaneous migration of a redundant nerve root accompanied by absorption of lumbar disk herniation. A case report.  

PubMed

A redundant nerve root is defined as a large, elongated and tortuous nerve root commonly associated with severe lumbar spinal canal stenosis. Elongation of nerve roots as a result of mechanical trapping at stenotic level is assumed to be a possible mechanism. Here we present a case in a patient who showed a redundant nerve root above the level of a lumbar canal stenosis caused by disk herniation and redundancy spontaneously migrating to a lower lumbar stenosis level accompanied by absorption of the herniated disk as shown by magnetic resonance imaging (MRI). A 67-year-old Japanese woman presented with bilateral thigh/leg pain and intermittent claudication. A midsagittal T2-weighted MR image of the lumbar spine revealed severe spinal canal stenosis at the L3-4 and L4-5 levels. At the L3-4 level, central disk herniation compressed the dural tube. An MR image revealed redundant nerve roots just cranial to the severely compressed L3-4 level. A follow-up MRI study revealed regression of disk herniation at the L3-4 level. In contrast, there was no significant change of the stenosis at the L4-5 level. Sagittal T2-weighted MR imaging at follow-up revealed redundant nerve roots just cranial to the L4-5 level, whereas the redundant nerve roots cranial to the L3-4 level had disappeared. The MRI findings of the present case support the "squeeze" hypothesis as causative of redundant nerve roots. PMID:24029099

Koda, M; Rokkaku, T; Mannoji, C; Okamoto, Y; Kon, T; Murakami, M; Furuya, T; Yamazaki, M

2012-11-01

228

[Isolated neuritis of the oculomotor nerve in infectious mononucleosis].  

PubMed

A 19-year-old immune-competent patient developed right-sided headache and, subsequently, subacute diplopia. On clinical examination he had incomplete right oculomotor palsy. Cranial MRI showed pathologic contrast enhancement of the right oculomotor nerve at its exit point from the mesencephalon, and the CSF displayed slight pleocytosis. The following relevant differential diagnoses were not supported by additional examinations: neurosarcoidosis, Lyme neuroborreliosis, neurosyphilis, tuberculous meningitis, viral meningitis (HIV, VZV, CMV), CNS lymphoma, vasculitis associated with rheumatic disease, Tolosa-Hunt syndrome, and diabetic neuropathy. However, on the basis of blood lymphocytosis, positive heterophile antibody test (Paul-Bunnell test), the presence of IgM antibodies against Epstein-Barr virus capsid antigen, and elevated transaminases, infectious mononucleosis was diagnosed. Isolated neuritis of the oculomotor nerve is a rare parainfectious manifestation of infectious mononucleosis. PMID:18058080

Erben, Y; Gonzalez Hofmann, C; Steinmetz, H; Ziemann, U

2008-04-01

229

Persistence of attacks of cluster headache after trigeminal nerve root section  

Microsoft Academic Search

Summary Cluster headache is a strictly unilateral headache that occurs in association with cranial autonomic features. We report a patient with a trigeminal nerve section who continued to have attacks. A 59-year-old man described a 14-year history of left-sided episodes of excruciating pain centred on the retro-orbital and orbi- tal regions. These episodes lasted 1-4 h, recurring 2-3 times daily.

Manjit S. Matharu; Peter J. Goadsby

2002-01-01

230

Spring-mediated cranial reshaping for craniosynostosis.  

PubMed

The evolution of modern craniofacial surgery has come full circle from the early strip craniectomies to the complete calvarial remodeling and now back to attempts at minimally invasive surgical interventions. The goal of the craniofacial surgeon has always been the correction of form and function with minimization of associated morbidity and mortality. Particularly problematic has been the ability to maintain the anatomical correction beyond the result seen on the operating room table secondary to changes with growth. The ability to improve the clinical result in a growing and developing child has been the impetus for dynamic treatment modalities. Dr Claes Lauritzen's pioneering work in this area has been particularly successful using internal springs to correct craniofacial deformities. The purpose of this study is to assess this treatment modality clinically in terms of safety and efficacy and to develop a methodology for the spring formation that would be easily reproducible. This is an institutional review board-approved prospective study of 15 children (11 male, 4 female) with non-syndromic sagittal suture synostosis. All patients were treated with a sagittal strip craniectomy and placement of 2 omega-shaped stainless steel springs at a mean age of 3.9 months. Patients were followed clinically and with cephalograms; after reossification of the intervening bone, the springs were removed at a mean age of 8.2 months. The mean force applied at initial placement of the springs was 6.9 N, and the mean spring deflection at formation was 6.87 cm. All patients completed the study protocol without any significant morbidity or any mortality. Perioperative variables, including blood loss, transfusion rate, operative time, intensive care unit stay, hospital stay, and hospital charges, were all significantly less (P < 0.05) in this study group compared with children with the same diagnosis treated with cranial vault reshaping during the same period. Furthermore, the preoperative mean cephalic index of 64.3 corrected to 77.6 after surgery and was maintained over time. Spring-mediated cranial reshaping is efficacious and safe for the treatment of sagittal synostosis. Long-term study of cranial development and clinical morphology are ongoing to validate further the effectiveness of this treatment modality. PMID:15346023

David, Lisa R; Proffer, Patrick; Hurst, William J; Glazier, Stephen; Argenta, Louis C

2004-09-01

231

Premenstrual symptoms.  

PubMed

Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in many women may be precipitated by simple psychological events such as leaving home, while severely stressful events produce a higher incidence. Unless a physiological factor such as malnutrition is operating, menses usually recur spontaneously within a few months. Amenorrhea is a constant feature of anorexia nervosa and may precede related attitudes toward eating and body weight. This syndrome is best regarded as a chronic and often severe neurotic disorder requiring combined physiological and psychological treatment, although some evidence exists to indicate an endocrine disorder. Extensive basic research is needed on the complex relationship between the neuroendocrine system and emotion. PMID:4735136

1973-03-24

232

Partial third nerve palsy and ocular neuromyotonia from displacement of posterior communicating artery detected by high-resolution MRI.  

PubMed

Ocular neuromyotonia is an unusual condition in which sustained, undesired contraction of one or more extraocular muscles occurs after normal muscle activation. Although most commonly reported after paraseller cranial irradiation for tumor, chronic nonaneurysmal vascular compression of the third nerve can produce partial ocular motor nerve paresis and ocular neuromyotonia. A 75-year-old woman presented with intermittent left-gaze-evoked binocular diplopia. She had an incomplete right third nerve palsy but became symptomatically diplopic and esotropic upon sustained left gaze. High-resolution brain magnetic resonance imaging showed displacement of the right posterior communicating artery and contact with the right third nerve. Gaze-evoked diplopia resolved with carbamazepine, but a partial third nerve paresis remained. PMID:23912769

Cruz, Franz Marie; Blitz, Ari M; Subramanian, Prem S

2013-09-01

233

[Transplantation in peripheral nerve injuries].  

PubMed

Autologous nerve grafting is the most commocommnlynly used operative technique in delayed primary, or secondary nerve repair after the peripheral nerve injuries. The aim of this procedure is to overcome nerve gaps that results from the injury itself, fibrous and elastic retraction forces, resection of the damaged parts of the nerve, position of the articulations and mobilisation of the nerve. In this study we analyse the results of operated patients with transections and lacerations of the peripheral nerves from 1979 to 2000 year. Gunshot injuries have not been analyzed in this study. The majority of the injuries were in the upper extremity (more than 87% of cases). Donor for nerve transplantation had usually been sural nerve, and only occasionally medial cutaneous nerve of the forearm was used. In about 93% of cases we used interfascicular nerve grafting, and cable nerve grafting was performed in the rest of them. Most of the grafts were 1 do 5 cm long (70% of cases). Functional recovery was achieved in more than 86% of cases, which is similar to the results of the other authors. Follow up period was minimum 2 years. We analyzed the influence of different factors on nerve recovery after the operation: patient's age, location and the extent (total or partial) of nerve injury, the length of the nerve graft, type of the nerve, timing of surgery, presence of multiple nerve injuries and associated osseal and soft tissue injuries of the upper and lower extremities. PMID:14619715

Grujici?, D; Samardzi?, M; Rasuli?, L; Savi?, D; Cvrkota, I; Simi?, V

2003-01-01

234

Animal Models of Cranial Suture Biology  

PubMed Central

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

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

2012-01-01

235

Advances in nerve repair.  

PubMed

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

Khuong, Helene T; Midha, Rajiv

2013-01-01

236

Cranial modularity and sequence heterochrony in mammals.  

PubMed

Heterochrony, the temporal shifting of developmental events relative to each other, requires a degree of autonomy among those processes or structures. Modularity, the division of larger structures or processes into autonomous sets of internally integrated units, is often discussed in relation to the concept of heterochrony. However, the relationship between the developmental modules derived from studies of heterochrony and evolutionary modules, which should be of adaptive importance and relate to the genotype-phenotype map, has not been explicitly studied. I analyzed a series of sectioned and whole cleared-and-stained embryological and neonatal specimens, supplemented with published ontogenetic data, to test the hypothesis that bones within the same phenotypic modules, as determined by morphometric analysis, are developmentally integrated and will display coordinated heterochronic shifts across taxa. Modularity was analyzed in cranial bone ossification sequences of 12 therian mammals. A dataset of 12-18 developmental events was used to assess if modularity in developmental sequences corresponds to six phenotypic modules, derived from a recent morphometric analysis of cranial modularity in mammals. Kendall's tau was used to measure rank correlations, with randomization tests for significance. If modularity in developmental sequences corresponds to observed phenotypic modules, bones within a single phenotypic module should show integration of developmental timing, maintaining the same timing of ossification relative to each other, despite differences in overall ossification sequences across taxa. Analyses did not find any significant conservation of developmental timing within the six phenotypic modules, meaning that bones that are highly integrated in adult morphology are not significantly integrated in developmental timing. PMID:17501752

Goswami, Anjali

2007-01-01

237

Anterior interosseous nerve syndrome  

PubMed Central

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

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

2014-01-01

238

Occipital diploic cranial fasciitis after radiotherapy for a cerebellar medulloblastoma.  

PubMed

Radiation-induced cranial fasciitis is a rare complication of radiotherapy, especially in an intradiploic location. The authors report such a case of cranial fasciitis in a 13-year-old girl previously subjected to cranial radiotherapy for a recurrent cerebellar medulloblastoma. The patient had undergone a gross-total removal of a medulloblastoma followed by no radiation therapy at the age of 10 years. The tumor recurred at the original site 2 years later, warranting a repeat operation with a gross-total tumor removal and subsequent radiation therapy. The follow-up MRI sequence demonstrated no abnormal appearance for 1 year, until a new enhancing mass was found within the occipital bone adjacent to the prior bone window. Following its resection, the new lesion was histologically identified as cranial fasciitis. Differential diagnosis of a well-circumscribed bone lesion should include cranial fasciitis, especially in young children with radiotherapy for a previous intracranial malignancy. Radiotherapy should be considered among the inciting factors in the development of cranial fasciitis. The osteolytic lesions of cranial fasciitis, although nontumoral and self-limited in duration, should be eligible candidates for early, total resection to avoid potential intracranial expansion. PMID:24116980

Wu, Bo; Zhu, Hong; Liu, Weidong; Chen, Longyi

2013-12-01

239

Anthropogenic environments exert variable selection on cranial capacity in mammals  

PubMed Central

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

Snell-Rood, Emilie C.; Wick, Naomi

2013-01-01

240

Diabetic Nerve Problems  

MedlinePLUS

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

241

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.

2011-03-01

242

Nav2 is necessary for cranial nerve development and blood pressure regulation  

Microsoft Academic Search

BACKGROUND: All-trans retinoic acid (atRA) is required for nervous system development, including the developing hindbrain region. Neuron navigator 2 (Nav2) was first identified as an atRA-responsive gene in human neuroblastoma cells (retinoic acid-induced in neuroblastoma 1, Rainb1), and is required for atRA-mediated neurite outgrowth. In this paper, we explore the importance of Nav2 in nervous system development and function in

Elizabeth M McNeill; Kenneth P Roos; Dieder Moechars; Margaret Clagett-Dame

2010-01-01

243

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

E-print Network

ar t - i f i c i t x l l y . 1 • Gruber: a . Schenck: P f l ug e r s Archil/ 1906 - Bd. 106 h a f t 8 & 9, S 368. 3 * P f l ü c k e r : P f l u g e r s Archiv 1905 - Bd. 106 ha f t 8 & 9 S 372. 4 • F r ö h l i c h : P f l u g e r s Archiv 1906... c it. t» (ŁX/o. Oppos ft? foot ,3* 1 1 Sec JZ 'tre/fe & firorrr Fr...

Gruber, Charles M.

1912-06-01

244

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.

1974-01-01

245

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

EPA Science Inventory

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

246

Sensory nerves in lung and airways.  

PubMed

Sensory nerves innervating the lung and airways play an important role in regulating various cardiopulmonary functions and maintaining homeostasis under both healthy and disease conditions. Their activities conducted by both vagal and sympathetic afferents are also responsible for eliciting important defense reflexes that protect the lung and body from potential health-hazardous effects of airborne particulates and chemical irritants. This article reviews the morphology, transduction properties, reflex functions, and respiratory sensations of these receptors, focusing primarily on recent findings derived from using new technologies such as neural immunochemistry, isolated airway-nerve preparation, cultured airway neurons, patch-clamp electrophysiology, transgenic mice, and other cellular and molecular approaches. Studies of the signal transduction of mechanosensitive afferents have revealed a new concept of sensory unit and cellular mechanism of activation, and identified additional types of sensory receptors in the lung. Chemosensitive properties of these lung afferents are further characterized by the expression of specific ligand-gated ion channels on nerve terminals, ganglion origin, and responses to the action of various inflammatory cells, mediators, and cytokines during acute and chronic airway inflammation and injuries. Increasing interest and extensive investigations have been focused on uncovering the mechanisms underlying hypersensitivity of these airway afferents, and their role in the manifestation of various symptoms under pathophysiological conditions. Several important and challenging questions regarding these sensory nerves are discussed. Searching for these answers will be a critical step in developing the translational research and effective treatments of airway diseases. PMID:24692141

Lee, Lu-Yuan; Yu, Jerry

2014-01-01

247

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

PubMed

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

Tavakoli, Mitra; Marshall, Andrew; Pitceathly, Robert; Fadavi, Hassan; Gow, David; Roberts, Mark E; Efron, Nathan; Boulton, Andrew Jm; Malik, Rayaz A

2010-05-01

248

21 CFR 882.5800 - Cranial electrotherapy stimulator.  

Code of Federal Regulations, 2010 CFR

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

2010-04-01

249

21 CFR 882.5800 - Cranial electrotherapy stimulator.  

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

2014-04-01

250

21 CFR 882.5800 - Cranial electrotherapy stimulator.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

251

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

PubMed Central

Cognitive and educational sequelae are inconsistently reported in children treated with cranial irradiation for acute lymphoblastic leukaemia. This study investigated differences in these skills after cranial irradiation, controlling the effects of chemotherapy and psychosocial factors. Three groups were evaluated: 100 children diagnosed with acute lymphoblastic leukaemia and treated with cranial irradiation and chemotherapy; 50 children diagnosed with acute lymphoblastic leukaemia or other cancers and treated with chemotherapy alone; and a healthy control group of 100 children. Children in the clinical groups stopped treatment at least two years before evaluation and had no history of relapse. Children were aged between 7 and 16 at the time of assessment. Evaluation included cognitive, educational, and behavioural measures. Analyses found that children receiving cranial irradiation and chemotherapy performed more poorly than non-irradiated groups on intellectual and educational tests, with verbal and attentional deficits most pronounced. Children receiving chemotherapy alone performed similarly to controls, suggesting such treatment is not associated with adverse neurobehavioural sequelae. PMID:8048815

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

1994-01-01

252

Quantifying cognitive decrements caused by cranial radiotherapy.  

PubMed

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

2011-01-01

253

Serial anthropometry predicts peripheral nerve dysfunction in a community cohort  

PubMed Central

Background Obesity is a risk factor for glucose intolerance, but the independent role of obesity in the development of peripheral neuropathy is unclear. This study assessed the impact of body size trajectories on prevalent nerve dysfunction in community-dwelling women with and without glucose intolerance. Methods Annual (1996–2008) anthropometric measures of weight, height, waist circumference, and body mass index (BMI, weight[kg]/height[m2]) were assessed in the Study of Women's Health Across the Nation – Michigan site. Glucose intolerance was defined annually based on current use of diabetes medications, self-reported diabetes diagnosis, and, when available, fasting glucose. Peripheral nerve dysfunction in 2008 was defined as abnormal monofilament testing or ?4 symptoms or signs. Linear mixed models were used to determine trajectories of anthropometry by subsequently-identified nerve dysfunction status. Results Mean BMI was 32.4 kg/m2 at baseline and 27.8% of women had nerve dysfunction in 2008. BMI, weight, and waist circumference increased over time. Women who would have nerve dysfunction were significantly larger than women without dysfunction, independent of glucose intolerance. At mean baseline age of 46, BMI, weight, and waist circumference differed significantly (p-value<0.01) by subsequent nerve dysfunction status, independent of glucose intolerance and hypertension. These body size differences were maintained but not exacerbated over time. Conclusions Peripheral nerve dysfunction is prevalent among community-dwelling women. Twelve years before the nerve assessment, anthropometry differed between women who would and would not have nerve dysfunction, differences that were maintained over time. Obesity deserves attention as an important and potentially modifiable risk factor for peripheral nerve dysfunction. PMID:23161607

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

2012-01-01

254

Microsurgical repair of nerve lesions with nerve grafts: the effect of nerve growth factor 7S  

Microsoft Academic Search

This study investigated the effect of local administration of nerve growth factor 7S (NGF-7S) on the axonal regrowth of mixed peripheral nerves through nerve grafts. Sixty male Wistar rats were randomized into two groups (n=30). A defect 12 mm long in the right sciatic nerve was created and repaired with a nerve autograft. NGF-7S (group A) or normal saline (group

Andreas I. Gravvanis; Efstathios G. Lykoudis; George A. Tagaris; Charalampos G. Patralexis; Apostolos E. Papalois; Petros N. Panayotou; Constantinos N. Stamatopoulos; John D. Ioannovich

2002-01-01

255

Reliability of cranial morphology in reconstructing Neanderthal phylogeny  

Microsoft Academic Search

The usefulness of cranial morphology in reconstructing the phylogeny of closely related taxa is often questioned due to the\\u000a possibility of convergence or parallelism and epigenetic response to the environment. However, it has been suggested that\\u000a different cranial regions preserve phylogenetic information differentially. Some parts of the face and neurocranium are thought\\u000a to be relatively developmentally flexible, and therefore to

K. Harvati; T. D. WEAVER

256

Development of a Human Cranial Bone Surrogate for Impact Studies  

PubMed Central

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

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

2013-01-01

257

The Effect of Hair on Infection after Cranial Surgery  

Microsoft Academic Search

Summary  ?Objective. Reports of large series of patients who had undergone successful cranial neurosurgery without hair removal led part of our\\u000a team to abandon the practice of shaving patients' heads preoperatively. The aim of this study was to assess whether this change\\u000a in routine, which was implemented in 1992, has affected the rate of postoperative infection in our cranial surgery patients.

A. Bekar; E. Korfal?; ?. Do?an; S. Y?lmazlar; Z. Ba?kan; K. Aksoy

2001-01-01

258

Unilateral lumbar facet joint hypertrophy causing nerve root irritation.  

PubMed

We present four cases of massive unilateral lumbar facet joint hypertrophy in an otherwise morphologically normal spine. All presented with a combination of low back pain and symptoms of entrapment of a single lumbar nerve root. The abnormality is best visualised by CT scanning and the results of surgical decompression by partial undercutting facetectomy are favourable. PMID:3190129

Wilde, G P; Szypryt, E P; Mulholland, R C

1988-09-01

259

ISOLATED MALIGNANT PERIPHERAL NERVE SHEATH TUMOR OF KIDNEY CAPSULE  

Microsoft Academic Search

A b s t r a c t: The occurrence of an isolated malignant peripheral nerve sheath tumor (MPNST) of the kidney capsule is extremely rare and its presence may only be ex- pressed by an insidious onset of non-specific and misleading symptoms with a predomi- nance of lower back pain. A computer tomography (CT) scan (as the imaging procedure

260

Nerve excitability properties in early preclinical diabetic neuropathy.  

PubMed

Diabetic polyneuropathy can be easily diagnosed when the nerve conduction studies are affected. Strength Duration Time (SDTc) reflects nerve excitability properties and was previously used several times to demonstrate the excitability properties of the nerves in the existence of electrophysiologically developed diabetic polyneuropathy. But as we all know, diabetic patients may experience neuropathic symptoms even though their routine nerve conduction studies are normal. SDTc may be useful in this early stages of developing neuropathy. In this study we aimed to evaluate the SDTc properties of diabetic patients in this early preclinic stage. Recently SDTc was commonly studied in the upper extremities but most of the diabetic neuropathies are predominant in the lower extremities. So here we also studied both upper and lower extremities to demonstrate a possible difference. PMID:21741106

Erdo?an, Ca?da?; Yücel, Mehmet; De?irmenci, Eylem; Öz, O?uzhan; Akgün, Hakan; Odaba??, Zeki

2011-10-01

261

Histopathological effects of radiosurgery on a human trigeminal nerve  

PubMed Central

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

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

2013-01-01

262

Magnetic resonance imaging of cranial radiation lesions  

SciTech Connect

Fifty-six patients who previously received therapeutic cranial irradiation (CRT) were imaged by a 1.5 Magnetic Resonance (MR) System 0.1-11 years following CRT. Abnormal MR findings within the treatment volume unrelated to tumor, prior to surgery, or coexisting conditions were reviewed for an association with CRT. Twenty-four patients had MR abnormalities considered to be attributable to CRT. These were scored as mild (Grade I) in 6, moderate (Grade II) in 9, and severe (Grade III) in 9. Eight of these 24 patients with CRT findings on MR had CT abnormalities that correlated with the MR. Six lesions seen on computed tomography (CT) were Grade III abnormalities; all were judged as being visualized better by MR. Eight patients had significant neurologic dysfunction attributable to their CRT lesions, and 7 of these had Grade III lesions. Whereas the clinical significance of mild or moderate CRT effects seen on MR is uncertain, Grade III (severe) MR lesions correlate well with important clinical findings.

Curran, W.J.; Hecht-Leavitt, C.; Schut, L.; Zimmerman, R.A.; Nelson, D.F.

1987-07-01

263

Repair of sciatic nerve defects using tissue engineered nerves.  

PubMed

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

Zhang, Caishun; Lv, Gang

2013-07-25

264

Inflammatory pseudotumor of nerve.  

PubMed

Two cases of inflammatory pseudotumor are described. The first patient, a 35-year-old white man, developed a progressive sensorimotor deficit in the right leg associated with a fusiform sciatic nerve mass in the posterior thigh. The lesion, compressive in nature and situated entirely within the epineurium, was totally resected. Histology revealed lymphocytic and plasmacellular inflammation as well as extensive fibrosis and collagen deposition. The patchy infiltrate consisted equally of CD2, CD3, CD5, and CD7 positive T-lymphocytes as well as CD20-and CD22-positive B-lymphocytes expressing both kappa and lambda immunoglobulin light chains. A selective biopsy of the encompassed and compressed nerve fascicles demonstrated both myelin loss and axonal injury. The second case was that of an 18-year-old woman with focal enlargement of a radial nerve by an epineurial infiltrate of multinucleate histiocytes and T as well as occasional B lymphocytes. No etiology was apparent in either case. The differential diagnosis includes non-neoplastic processes (amyloidoma and tuberculoid leprosy) as well as tumors (benign and malignant peripheral nerve sheath tumors, lymphoma). Although rare, inflammatory pseudotumors must be included in the differential diagnosis of tumor-like lesions of peripheral nerve. PMID:8827027

Weiland, T L; Scheithauer, B W; Rock, M G; Sargent, J M

1996-10-01

265

Abducens nerve palsy in a patient with scrub typhus: a case report.  

PubMed

Abducens nerve palsy is a known but rare complication of a few bacterial and viral infections like Mycoplasma pneumonia, cytomegalovirus, Epstein-Barr virus, Hanta virus, herpes zoster, and measles. Abducens nerve palsy due to scrub typhus is extremely rare and so far only one case has been reported in the literature. Scrub typhus is a febrile illness caused by rickettsia, Orientia tsutsugamushi, a gram negative intracellular obligate parasite which is endemic in Asia. This disease can present with wide range of clinical manifestations with involvement of any organ system, alone or in combination. Central nervous system involvement is very common and includes meningism, altered sensorium to focal neurological deficits. We present a rare manifestation of Scrub typhus in the form of sixth cranial nerve involvement which responded to the treatment with doxycycline. PMID:24522141

Bhardwaj, B; Panda, P; Revannasiddaiah, S; Bhardwaj, H

2013-12-01

266

Clinical History, Prognostic Factors, and Management of Facial Nerve in Malignant Tumors of the Parotid Gland  

PubMed Central

Objectives We analyzed the outcomes following clinical management of parotid masses that were determined to be malignant tumors after parotidectomy. Methods We evaluated data from 70 patients with parotid malignancies between November 1994 and December 2005. Results Among salivary histotypes (n=49), the most significant prognostic parameter was cT4 stage at diagnosis (P=0.0055, log-rank) both for clinical involvement of the facial nerve and for invasion of other structures. The main cause of cancer-related death was a distant metastasis. Conclusion The present series confirms that the main prognostic parameter in salivary parotid malignancies was cT4 classification at diagnosis, often due to clinical involvement of the facial nerve. The oncological outcome of salivary malignancies was influenced by distant metastasis more than most other head and neck sites. We recommend dissecting and preserving the functioning VIIth cranial nerve during surgery for parotid malignancies. PMID:24917910

Rigante, Mario; Giglia, Veronica; Bastanza, Giovanni; De Corso, Eugenio; Almadori, Giovanni; Paludetti, Gaetano

2014-01-01

267

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

PubMed Central

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

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

2012-01-01

268

Laryngeal nerve monitoring.  

PubMed

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

Kartush, Jack M; Naumann, Ilka

2014-09-01

269

[Nerve compression syndromes of the upper extremity].  

PubMed

The nerve compression syndromes of the upper extremity, the common carpal and cubital tunnel syndromes are described, but also the less common entrapments such as thoracic outlet syndrome,suprascapular-, interosseus-posterior- and anterior entrapments and the Loge-de-Guyon and Wartenberg syndromes are mentioned. Besides history, symptoms and physical examination electrodiagnostic and imaging are necessary for establishing the correct diagnosis. The conservative treatment is less successful than the operative therapy. Surgical procedures and techniques are discussed as well as complications. The prognosis is in most cases good--provided that indication and technique were correct. PMID:20936778

Assmus, H; Martini, A-K

2010-09-01

270

[Present role of prophylactic cranial irradiation].  

PubMed

Prophylactic cranial irradiation (PCI) plays a role in the management of lung cancer patients, especially small cell lung cancer (SCLC) patients. As multimodality treatments are now able to ensure better local control and a lower rate of extracranial metastases, brain relapse has become a major concern in lung cancer. As survival is poor after development of brain metastases (BM) in spite of specific treatment, PCI has been introduced in the 1970's. PCI has been evaluated in randomized trials in both SCLC and non-small cell lung cancer (NSCLC) to reduce the incidence of BM and possibly increase survival. PCI reduces significantly the BM rate in both limited disease (LD) and extensive disease (ED) SCLC and in non-metastatic NSCLC. Considering SCLC, PCI significantly improves overall survival in LD (from 15 to 20% at 3 years) and ED (from 13 to 27% at 1 year) in patients who respond to first-line treatment; it should thus be part of the standard treatment in all responders in ED and in good responders in LD. No dose-effect relationship for PCI was demonstrated in LD SCLC patients so that the recommended dose is 25?Gy in 10 fractions. In NSCLC, even if the risk of brain dissemination is lower than in SCLC, it has become a challenging issue. Studies have identified subgroups at higher risk of brain failure. There are more local treatment possibilities for BM related to NSCLC, but most BM will eventually recur so that PCI should be reconsidered. Few randomized trials have been performed. Most of them could demonstrate a decreased incidence of BM in patients with PCI, but they were not able to show an effect on survival as they were underpowered. New trials are needed. Among long-term survivors, neuro-cognitive toxicity may be observed. Several approaches are being evaluated to reduce this possible toxicity. PCI has no place for other solid tumours at risk such as HER2+ breast cancer patients. PMID:23306141

Le Péchoux, Cécile; Al Mohkles, Hweej; Dhermain, Frédéric

2013-01-01

271

Unilateral Recurrent Laryngeal and Hypoglossal Nerve Paralysis Following Rhinoplasty: A Case Report and Review of the Literature  

PubMed Central

Introduction: Injury to cranial nerves IX, X, and XII is a known complication of laryngoscopy and intubation. Here we present a patient with concurrent hypoglossal and recurrent laryngeal nerve paralysis after rhinoplasty. Case Report: The patient was a 27-year-old woman who was candidate for rhinoplastic surgery. The next morning after the operation, the patient complained of dysphonia and a sore throat .7 days after the operation she was still complaining of dysphonia. She underwent a direct laryngoscopy, and right TVC paralysis was observed. Right hypoglossal nerve paralysis was also detected during physical cranial nerve function tests. Hypoglossal and recurrent laryngeal nerve function was completely recovered after 5 and 7 months, respectively, and no complication was remained. Conclusion: Accurate and atraumatic intubation and extubation, true positioning of the head and neck, delicate and gentle packing of the oropharynx, and maintenance of mean blood pressure at a safe level are appropriate methods to prevent this complication during anesthesia and surgical procedures. PMID:24505575

Bakhshaee, Mehdi; Bameshki, Ali Reza; Foroughipour, Mohsen; Zaringhalam, Mohammad Ali

2014-01-01

272

Osteosarcoma of the cranial vault and skull base in pediatric patients.  

PubMed

Cranial osteosarcoma is very rare in children, rendering the development of optimal treatment algorithms challenging. The authors present 3 cases of pediatric cranial osteosarcoma: a primary calvarial tumor, a cranial metastasis, and a primary osteosarcoma of the cranial base. A review of the literature demonstrates significant variation in the management of cranial osteosarcomas and the outcome for patients with these tumors. This series and literature review is presented to improve the understanding of pediatric cranial osteosarcoma and to reinforce the importance of maximal resection in optimizing outcome. PMID:24483254

Hadley, Caroline; Gressot, Loyola V; Patel, Akash J; Wang, Lisa L; Flores, Ricardo J; Whitehead, William E; Luerssen, Thomas G; Jea, Andrew; Bollo, Robert J

2014-04-01

273

Airway nerves: in vivo electrophysiology  

Microsoft Academic Search

Information about the activity of airway sensory afferent nerves in vivo can be obtained electrophysiologically by extracellular recording of action potentials. Apart from data capture, the basic techniques used for recording sensory nerve activity have not advanced greatly in 50 years. However, clearly they continue to contribute vastly to our understanding of the role of these nerves in the control

John J Adcock

2002-01-01

274

Fibrolipoma of the median nerve  

Microsoft Academic Search

Neural fibrolipoma or fibrolipomatous hamartoma is an uncommon benign tumor that usually arises in the median nerve. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We report a case of fibrolipomatous hamartoma of the left median nerve in an 18-year-old woman. Our objective was to describe the pathognomonic magnetic resonance imaging features, whose presence obviates the

Kais Nouira; Hend Belhiba; Sofične Baccar; Anissa Miaaoui; Monia Ben Messaoud; Imčne Turki; Ilhem Cheour; Emna Menif

2007-01-01

275

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

PubMed Central

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

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

2014-01-01

276

FGF9 can induce endochondral ossification in cranial mesenchyme  

PubMed Central

Background The flat bones of the skull (i.e., the frontal and parietal bones) normally form through intramembranous ossification. At these sites cranial mesenchymal cells directly differentiate into osteoblasts without the formation of a cartilage intermediate. This type of ossification is distinct from endochondral ossification, a process that involves initial formation of cartilage and later replacement by bone. Results We have analyzed a line of transgenic mice that expresses FGF9, a member of the fibroblast growth factor family (FGF), in cranial mesenchymal cells. The parietal bones in these mice show a switch from intramembranous to endochondral ossification. Cranial cartilage precursors are induced to proliferate, then hypertrophy and are later replaced by bone. These changes are accompanied by upregulation of Sox9, Ihh, Col2a1, Col10a1 and downregulation of CbfaI and Osteocalcin. Fate mapping studies show that the cranial mesenchymal cells in the parietal region that show a switch in cell fate are likely to be derived from the mesoderm. Conclusion These results demonstrate that FGF9 expression is sufficient to convert the differentiation program of (at least a subset of) mesoderm-derived cranial mesenchyme cells from intramembranous to endochondral ossification. PMID:16504022

Govindarajan, Venkatesh; Overbeek, Paul A

2006-01-01

277

Update on the aetiopathogenesis of canine cranial cruciate ligament disease.  

PubMed

Cranial cruciate ligament disease (CCLD) is the most common cause of hindlimb lameness in the dog, being associated with and eventually leading to stifle osteoarthritis. Canine cranial cruciate ligament disease is a gradual degeneration of the ligament extracellular matrix (ECM) leading to ligament rupture. The aetiopathogenesis of this condition is still poorly understood but several risk factors have been identified such as breed, bodyweight, gender and conformation. Recent developments in this area include the role of genetics, stifle joint conformation, ligament ECM metabolism, and inflammation associated with immune-mediated disease within the stifle joint. A genetic mode of inheritance has been demonstrated in the Newfoundland which is predisposed to CCLD. Increased cellular metabolism within the cranial cruciate ligament has been directly associated with increased craniocaudal stifle joint laxity in dog breeds at high risk of CCLD. Conformation abnormalities, such as a narrowed distal femoral intercondylar notch, in high risk breeds have been shown to be associated with alterations in cranial cruciate ligament ultrastructure. Increased production of inflammatory cytokines, such as cathepsins and interleukins, by the stifle synovial cells may occur secondary to or may be an inciting cause of ligament degeneration. Future research endeavours will focus on the association between immune-mediated response and fibrocartilaginous metaplasia and matrix degradation within the cranial cruciate ligament, and whether this can be altered in all susceptible dogs or only certain breeds. PMID:21243176

Comerford, E J; Smith, K; Hayashi, K

2011-01-01

278

High resolution 3-T MR imaging in the evaluation of the facial nerve course.  

PubMed

Objectives. To assess the value of 3-Tesla (3-T) MR imaging (MRI) in the evaluation of the course of the intracranial and extra-cranial tracts of the facial nerve. Patients and methods. 83 patients were studied by MRI in order to detect the course of facial nerve; a total of 166 facial nerves were examined. T2-weighted 3D Fast imaging employing steady-state acquisition (FIESTA) and T1-weighted Fast spoiled gradient recalled echo (fast SPRG) sequences were used. Two radiologists (reader A and B), independently, evaluated the course of the tracts of the facial nerve according to a qualitative scale (excellent, good, fair, poor). The Intraclass Correlation Coefficient (ICC) and Pearson correlation coefficient were used to assess the intra-observer and interobserver variability in the nerve course evaluation. Results. Reader A evaluated 35 facial nerves as excellent, 94 as good, 33 as fair and 4 as poor. Reader B rated 31 facial nerves excellent, 89 good, 43 fair and 3 poor. The intraobserver variability was ICC = 0.919 in reader A and ICC = 0.842 in reader B. The interobserver variability (Pearson correlation coefficient) was 0.713 (p ? 0.01). Conclusions. According to the preliminary results of our study the use of 3-T MRI with FIESTA and fast SPGR sequences may allow the study of the course of the facial nerve and its branches. The knowledge of the course and of the anatomic relationships of these nerve bundles with surrounding structures, as well as of the anatomical variants, provide useful informations for a prompt neurosurgery and maxillofacial surgical planning. PMID:24690336

Cassetta, M; Barchetti, F; Pranno, N; Barchetti, G; Fioravanti, C; Stagnitti, A; Rubini, A; Fioravanti, E; Saccoliti, E; Elia, D; Rossignuolo, M; Russo, Claudio; Cantisani, V; D'Andrea, V

2014-01-01

279

Ischemic Nerve Block.  

ERIC Educational Resources Information Center

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

Williams, Ian D.

280

Iatrogenic nerve injuries  

PubMed Central

Thirty-one examples of iatrogenic peripheral nerve injuries have been collected from a review of the case records of one neurological referral centre over a 7-year period. The clinical details are described to call attention to the special care needed with the management of patients subjected to certain invasive procedures. PMID:7100035

Winer, J. B.; Harrison, M. J. G.

1982-01-01

281

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

PubMed Central

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

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

2014-01-01

282

Brainstem abnormalities and vestibular nerve enhancement in acute Neuroborreliosis  

PubMed Central

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

2013-01-01

283

Segmental thoracic lipomatosis of nerve with nerve territory overgrowth.  

PubMed

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

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

2014-05-01

284

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. PMID:18368417

2008-01-01

285

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. PMID:21369471

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

2008-01-01

286

Dislocation of the mandibular condyle into the middle cranial fossa.  

PubMed

Dislocation of the mandibular condyle into the middle cranial fossa is an uncommon event. A case report is presented based on a patient (32-year-old female) who sustained a traumatic left condyle fracture with superior dislocation into the middle cranial fossa due to a high-speed car accident. The diagnosis was done four months after trauma. Via a preauricular approach, left condylectomy and transposition of temporal muscle flap was performed. Postoperatively, the patient stayed for two weeks with intermaxillary fixation and four months of physical therapy. PMID:16770205

Clauser, Luigi; Tieghi, Riccardo; Polito, Jessica; Galič, Manlio

2006-05-01

287

Cranial irradiation--an unusual cause for diabetes insipidus.  

PubMed

Central diabetes insipidus frequently occurs due to tumours in the region of pituitary or hypothalamus or following surgical trauma to these regions. Rarely it has been reported following cranial irradiation. We report the case of a middle aged woman who underwent surgical removal of a frontal capillary hemangioblastoma and received cranial irradiation. She presented ten months later with features of diabetes insipidus which was confirmed to be of central origin. She responded well to desmopressin nasal spray. Radiation induced damage to the hypothalmo-pituitary axis presents usually with anterior pituitary hormone deficiencies, most commonly that of growth hormone. Presentation as central diabetes insipidus is very uncommon. PMID:11310392

Jyotsna, V P; Singh, S K; Chaturvedi, R; Neogi, B; Bhadada, S K; Sahay, R K; Singh, S K; Agrawal, J K

2000-11-01

288

Local and remote immune-mediated inflammation after mild peripheral nerve compression in rats.  

PubMed

After experimental nerve injuries that extensively disrupt axons, such as chronic constriction injury, immune cells invade the nerve, related dorsal root ganglia (DRGs), and spinal cord, leading to hyperexcitability, raised sensitivity, and pain. Entrapment neuropathies, such as carpal tunnel syndrome, involve minimal axon damage, but patients often report widespread symptoms. To understand the underlying pathology, a tube was placed around the sciatic nerve in 8-week-old rats, leading to progressive mild compression as the animals grew. Immunofluorescence was used to examine myelin and axonal integrity, glia, macrophages, and T lymphocytes in the nerve, L5 DRGs, and spinal cord after 12 weeks. Tubes that did not constrict the nerve when applied caused extensive and ongoing loss of myelin, together with compromise of small-, but not large-, diameter axons. Macrophages and T lymphocytes infiltrated the nerve and DRGs. Activated glia proliferated in DRGs but not in spinal cord. Histologic findings were supported by clinical hyperalgesia to blunt pressure and cold allodynia. Tubes that did not compress the nerve induced only minor local inflammation. Thus, progressive mild nerve compression resulted in chronic local and remote immune-mediated inflammation depending on the degree of compression. Such neuroinflammation may explain the widespread symptoms in patients with entrapment neuropathies. PMID:23771220

Schmid, Annina B; Coppieters, Michel W; Ruitenberg, Marc J; McLachlan, Elspeth M

2013-07-01

289

Ultrasound of Peripheral Nerves  

PubMed Central

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

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

2013-01-01

290

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

PubMed Central

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

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

2011-01-01

291

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). PMID:24082663

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

2013-01-01

292

Evolution and advances of the lateral surgical approaches to cranial base neoplasms  

Microsoft Academic Search

Summary The evolution and advances of the lateral surgical approaches used for neoplasms of the cranial base involving the middle and posterior cranial fossa are reviewed. The lateral approaches available for access to the cranial base are diverse and are often used in combination. Approaches for tumors that are completely extradural, usually involving the temporal bone or infratemporal fossa, include

Stephen P. Cass; Barry E. Hirsch; Michael T. Stechison

1994-01-01

293

Near nerve potential of sural nerve in leprosy.  

PubMed

Leprosy neuropathy is characterized by initial involvement of the small nerve fibers, later followed by involvement of the large fibers, when routine nerve conduction studies become abnormal. To increase the diagnostic yield and precocity of these studies, we applied the near nerve technique to the sural nerve of 8 leprosy patients. Contrary to our expectations, the main component of the sural nerve sensory action potential was abnormal in all patients, but the minimum conduction velocity originating from small 3-6 mm fibers was normal or only mildly involved in three patients. Also, although Schwann cells are the first to be involved in leprosy, the results are suggestive of axonal degeneration instead of demyelination. To better understand the neurophysiology and physiology of leprosy and to increase the accuracy and precocity of the diagnosis, it will be necessary to investigate patients in the very early stages of the disease and to correlate these findings with the corresponding nerve pathology. PMID:15334210

Arruda, Ana Paula M; Marques, Wilson; Foss, Norma T; Garbino, José A; Virmond, Marcos; Barreira, Amilton A

2004-09-01

294

Bifid median nerve causing carpal tunnel syndrome: MRI and surgical correlation.  

PubMed

Carpal tunnel syndrome can be secondary in some patients, and vascular anomalies (usually a persistent median artery), median nerve variations, or both are among the etiologic factors. High division of the median nerve proximal to the carpal tunnel (known as a bifid median nerve) is a median nerve anomaly that has an incidence rate of 2.8%. This rare entity is often associated with various abnormalities that are clinically relevant, such as vascular malformations (persistent median artery), aberrant muscles, and carpal tunnel syndrome. The bifid median nerve is one cause of carpal tunnel syndrome because of its relatively higher cross-sectional area compared with a nonbifid median nerve. Obtaining magnetic resonance imaging and ultrasounds of bifid median nerves has helped surgeons avoid potential surgical hazards.This article describes 3 men with 4 bifid median nerves associated with a persistent median artery. Mean patient age was 38 years (range, 37-40 years). Mean follow-up was 7 years (range, 3-11 years). Patients were diagnosed with carpal tunnel syndrome and underwent open carpal tunnel release. To reveal a morphological etiology in patients in whom it the possibility of having idiopathic carpal tunnel syndrome is unlikely, preoperative imaging studies should be obtained. Bifid median nerves associated with a persistent median artery in the carpal tunnel are important to understand for their clinical and surgical significance. A secondary nature should be suspected in patients with unilateral symptoms, especially those with a history of symptoms and when the symptomatic hand shows severe neurophysiologic impairment but the contralateral hand is neurophysiologically intact. Inadvertent injury to the median nerve during carpal tunnel surgery can be minimized if the variations of the median nerve are recognized. PMID:23590784

Bagatur, A Erdem; Yalcinkaya, Merter; Atca, Ali Onder

2013-04-01

295

Open cranial vault remodeling: the evolving role of distraction osteogenesis.  

PubMed

In this article, we review some of the traditional techniques used to treat craniosynostosis. In addition to sharing our current approach to treating craniosynostosis with open techniques, we discuss our opinions on the evolving roles of newer modalities such as spring-assisted cranioplasty and cranial vault expansion using distraction osteogenesis. PMID:22337415

Derderian, Christopher A; Bartlett, Scott P

2012-01-01

296

Evolution of the Cranial Computed Tomography Scan in Child Abuse.  

ERIC Educational Resources Information Center

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

Feldman, Kenneth W.; And Others

1995-01-01

297

Glycoconjugate Expression and Cartilage Development of the Cranial Skeleton  

Microsoft Academic Search

Only few detailed investigations have focused on the glycobiology of cranial development. The functional elements in most inductive and morphogenetic processes are not individual cells, but rather collectives of interacting populations and extracellular matrix components that give rise to specific tissues and organs. Experimental evidence strongly suggests that sugar chains not only confer morphological characteristics. Complex carbohydrate molecules and their

A. Zschäbitz

1998-01-01

298

Cranial computed tomography in the diagnosis of multiple sclerosis  

Microsoft Academic Search

A group of 202 patients with suspected, probable or definite multiple sclerosis was studied, using cranial computed tomography (CT). Atrophy alone, or in combination with white-matter and periventricular lucencies, and areas of contrast enhancement, were the main abnormal findings in 52% of patients. Atrophy was detected in 44% of patients, and its frequency and severity correlated with disease duration up

L A Loizou; E B Rolfe; H Hewazy

1982-01-01

299

[Cranial nonmetric variation of Yayoi people in the Kyushu District].  

PubMed

The Yayoi people in Kyushu and Yamaguchi area are generally classified by metrical analyses mainly into the Yayoi people in the northern Kyushu and Yamaguchi area who are regarded as migrants from the Asian Continent and their posterity and the Yayoi people in the northwestern Kyushu who are regarded as having inherited the characteristics of the Jomon people. Such classification is verified by the analysis with the 22 traits in the cranial nonmetric variation. Of the 22 traits, supraorbital foramen, transverse zygomatic suture vestige, biasterionic suture vestige, jugular foramen bridging, hypoglossal foramen bridging, pterygospinous foramen, mylohyoid bridging and tympanic dehiscence are particularly important as the traits to classify two types of Yayoi peoples. The analysis by the C. A. B. Smith's Mean Measure of Divergence (MMD) suggests that out of the migrant Yayoi peoples, the very Yayoi people who are closely related to the formation of the modern Japanese are the ones in the northern Kyushu area, not the ones in the Doigahama site. Also, it is assumed that the appearance and disappearance of cranial nonmetric variations is affected by genetic elements, because the incidencies of cranial nonmetric variations is largely different between two types of Yayoi peoples in infants like in adults. Lastly the cranial nonmetric variation in the people of the period equivalent to Jomon and Yayoi in the Okinawa district, and in the Kofun people in southern Kyushu area, was briefly introduced. PMID:10824516

Saiki, K; Wakebe, T; Nagashima, S

2000-04-01

300

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

2008-01-01

301

Different Cranial Ontogeny in Europeans and Southern Africans  

Microsoft Academic Search

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

Marina L. Sardi; Fernando V. Ramírez Rozzi

2012-01-01

302

Cranial MR Findings in Chronic Toluene Abuse by Inhalation  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Chronic abuse of toluene by inhalation causes variable white matter changes and thalamic hypointensity on T2-weighted MR images. The purpose of our study was to assess cranial MR findings in a large series of patients who chronically abuse toluene-containing solvents to investigate the factors causing the qualitative variability of white matter changes and thalamic hypointensity. METHODS: We

Kubilay Aydin; Serra Sencer; Turkay Demir; Kultekin Ogel; Atadan Tunaci; Ozenc Minareci

2002-01-01

303

Cranial-base repair using endoscopic laser welding.  

PubMed

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

2009-10-01

304

Posterior Maxillary (PM) Plane and Anterior Cranial Architecture in  

E-print Network

the back of the midface at its junction with the sphenoid, we demonstrate how the PM plane can) the average point on the anterior-most extent of the greater wings of the sphenoid (Fig. 1). Although the PM plane was developed for, and has principally been used in, radiographic studies of cranial growth

Lieberman, Daniel E.

305

CRANIAL ANATOMY, TAXONOMIC IMPLICATIONS AND PALAEOPATHOLOGY OF AN UPPER JURASSIC  

E-print Network

CRANIAL ANATOMY, TAXONOMIC IMPLICATIONS AND PALAEOPATHOLOGY OF AN UPPER JURASSIC PLIOSAUR (REPTILIA marine reptiles of the Late Jurassic are rare, and so the discovery of the 1.8-m- long skull, Kimmeridge Clay, Upper Jurassic, palaeopathology. P liosaurus is an enigmatic, advanced sauroptery- gian

Benton, Michael

306

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

2008-01-01

307

Diabetes and nerve damage  

MedlinePLUS

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

308

Nerve allografts and conduits in peripheral nerve repair.  

PubMed

Since the last update on nerve conduits and allograft in 2000, investigations have established the efficacy of these alternatives to autograft in the repair of small sensory neural gaps. However, limited insights into the biology of the regenerating nerve continue to preclude intelligent conduit design. Ongoing discoveries in neuroscience and biomaterial engineering hold promise for the eventual development of allograft and conduits with potential of surpassing nerve autografts in clinical efficacy. In this review, we summarize the history, recent advances, and emerging developments in nerve conduits and allograft. PMID:23895714

Lin, Michael Y; Manzano, Givenchy; Gupta, Ranjan

2013-08-01

309

The cranial anatomy of the neornithischian dinosaur Thescelosaurus neglectus  

PubMed Central

Though the dinosaur Thescelosaurus neglectus was first described in 1913 and is known from the relatively fossiliferous Lance and Hell Creek formations in the Western Interior Basin of North America, the cranial anatomy of this species remains poorly understood. The only cranial material confidently referred to this species are three fragmentary bones preserved with the paratype, hindering attempts to understand the systematic relationships of this taxon within Neornithischia. Here the cranial anatomy of T. neglectus is fully described for the first time based on two specimens that include well-preserved cranial material (NCSM 15728 and TLAM.BA.2014.027.0001). Visual inspection of exposed cranial elements of these specimens is supplemented by detailed CT data from NCSM 15728 that enabled the examination of otherwise unexposed surfaces, facilitating a complete description of the cranial anatomy of this species. The skull of T. neglectus displays a unique combination of plesiomorphic and apomorphic traits. The premaxillary and ‘cheek’ tooth morphologies are relatively derived, though less so than the condition seen in basal iguanodontians, suggesting that the high tooth count present in the premaxillae, maxillae, and dentaries may be related to the extreme elongation of the skull of this species rather than a retention of the plesiomorphic condition. The morphology of the braincase most closely resembles the iguanodontians Dryosaurus and Dysalotosaurus, especially with regard to the morphology of the prootic. One autapomorphic feature is recognized for the first time, along with several additional cranial features that differentiate this species from the closely related and contemporaneous Thescelosaurus assiniboiensis. Published phylogenetic hypotheses of neornithischian dinosaur relationships often differ in the placement of the North American taxon Parksosaurus, with some recovering a close relationship with Thescelosaurus and others with the South American taxon Gasparinisaura, but never both at the same time. The new morphological observations presented herein, combined with re-examination of the holotype of Parksosaurus, suggest that Parksosaurus shares a closer relationship with Thescelosaurus than with Gasparinisaura, and that many of the features previously cited to support a relationship with the latter taxon are either also present in Thescelosaurus, are artifacts of preservation, or are the result of incomplete preparation and inaccurate interpretation of specimens. Additionally, the overall morphology of the skull and lower jaws of both Thescelosaurus and Parksosaurus also closely resemble the Asian taxa Changchunsaurus and Haya, though the interrelationships of these taxa have yet to be tested in a phylogenetic analysis that includes these new morphological data for T. neglectus.

2014-01-01

310

Cannabis use in HIV for pain and other medical symptoms.  

PubMed

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

2005-04-01

311

Cranial suture biology of the Aleutian Island inhabitants.  

PubMed

Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations. PMID:21328563

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

2011-04-01

312

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

PubMed

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

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

2014-07-01

313

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. PMID:22763009

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

2012-01-01

314

Fibrolipoma of the median nerve.  

PubMed

Neural fibrolipoma or fibrolipomatous hamartoma is an uncommon benign tumor that usually arises in the median nerve. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We report a case of fibrolipomatous hamartoma of the left median nerve in an 18-year-old woman. Our objective was to describe the pathognomonic magnetic resonance imaging features, whose presence obviates the need for a diagnostic biopsy. PMID:17178460

Nouira, Kais; Belhiba, Hend; Baccar, Sofične; Miaaoui, Anissa; Ben Messaoud, Monia; Turki, Imčne; Cheour, Ilhem; Menif, Emna

2007-01-01

315

Live-Donor Nerve Transplantation  

Microsoft Academic Search

We recently reported the first case of live-donor nerve transplantation, performed in November 2000 in an 8-month-old infant\\u000a with global obstetric brachial plexus palsy (OBPP) and four root avulsion who had undergone prior sural nerve autografting\\u000a at 3 months. Cross-chest C7 nerve transfer and temporary tacrolimus (TCL)\\/prednisone immunosuppression were utilized. The\\u000a purpose of this chapter is twofold. First, we provide

Scott A. Gruber; Pedro Mancias

316

Distal enlargement of the optic nerve sheath in the hyperacute stage of intracerebral haemorrhage  

Microsoft Academic Search

AimsOptic nerve sheath diameter (ONSD) enlargement is detectable in patients with increased intracranial pressure. The aim was to detect an enlargement of the ONSD using optic nerve sonography in patients with acute intracerebral haemorrhage (ICH) within 6 h of the onset of symptoms.MethodsThirty-one acute ICH patients, 15 age-matched acute ischaemic stroke patients and 16 age-matched healthy volunteers were enrolled consecutively

David Školoudík; Roman Herzig; Tá?a Fadrná; Michal Bar; Pavel Hradílek; Martin Roubec; Monika Jelínková; Daniel Ša?ák; Michal Král; Jana Chmelová; Miroslav He?man; Kate?ina Langová; Petr Ka?ovský

2010-01-01

317

Unilateral lumbar facet joint hypertrophy causing nerve root irritation.  

PubMed Central

We present four cases of massive unilateral lumbar facet joint hypertrophy in an otherwise morphologically normal spine. All presented with a combination of low back pain and symptoms of entrapment of a single lumbar nerve root. The abnormality is best visualised by CT scanning and the results of surgical decompression by partial undercutting facetectomy are favourable. Images fig. 1 fig. 2 fig. 3 fig. 4 PMID:3190129

Wilde, G. P.; Szypryt, E. P.; Mulholland, R. C.

1988-01-01

318

Symptom masquerade: understanding the meaning of symptoms  

Microsoft Academic Search

Goals Somatization refers to patients who transform distress and global suffering into pain and symptom expression. We have observed the opposite phenomenon in some outpatients seen for palliative care: patients who transform pain nociception into global suffering or other symptoms. The goal of this study is to describe the meaning of these patients’ experiences that are not expressed as pain

Marlene Z. Cohen; Lori Williams; Patti Knight; Julie Snider; Kavin Hanzik; Michael J. Fisch

2004-01-01

319

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. PMID:22423110

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

2012-01-01

320

Optic Nerve Injury in a Patient with Chronic Allergic Conjunctivitis  

PubMed Central

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

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

2014-01-01

321

A Novel CT-Guided Transpsoas Approach to Diagnostic Genitofemoral Nerve Block and Ablation  

PubMed Central

Background Inguinal hernia repair is associated with a high incidence of chronic postsurgical pain. This pain may be caused by injury to the iliohypogastric, ilioinguinal, or genitofemoral nerves. It is often difficult to identify the specific source of the pain, in part, because these nerves are derived from overlapping nerve roots and closely colocalize in the area of surgery. It is therefore technically difficult to selectively block these nerves individually proximal to the site of surgical injury. In particular, the genitofemoral nerve is retroperitoneal before entering the inguinal canal, a position that puts anterior approaches to the proximal nerve at risk of transgressing into the peritoneum. We report a computed tomography (CT)-guided transpsoas technique to selectively block the genitofemoral nerve for both diagnostic and therapeutic purposes while avoiding injury to the nearby ureter and intestines. Case A 39-year-old woman with chronic lancinating right groin pain after inguinal hernia repair underwent multiple pharmacologic interventions and invasive procedures without relief. Using CT and Stimuplex nerve stimulator guidance, the genitofemoral nerve was localized on the anterior surface of the psoas muscle and a diagnostic block with local anesthetic block was performed. The patient had immediate relief of her symptoms for 36 hours, confirming the diagnosis of genitofemoral neuralgia. She subsequently underwent CT-guided radiofrequency and phenol ablation of the genitofemoral nerve but has not achieved long-term analgesia. Conclusion CT-guided transpsoas genitofemoral nerve block is a viable option for safely and selectively blocking the genitofemoral nerve for diagnostic or therapeutic purposes proximal to injury caused by inguinal surgery. PMID:20546515

Parris, David; Fischbein, Nancy; Mackey, Sean; Carroll, Ian

2010-01-01

322

Diabetic Neuropathies: The Nerve Damage of Diabetes  

MedlinePLUS

... nerve damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. Problems ... Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles ...

323

Tardy sciatic nerve palsy following apophyseal avulsion fracture of the ischial tuberosity. Case report.  

PubMed

This 4 1-year-old man presented with a 2-year history of symptoms and signs of sciatic nerve compression. Imaging studies revealed a large ossified fragment within the biceps muscle of the thigh abutting the sciatic nerve at the level of the lesser trochanter. The bony fragment resulted from an unrecognized apophyseal avulsion fracture of the ischial tuberosity, which the patient had sustained while sprinting 27 years earlier. External neurolysis of the sciatic nerve and excision of the mass led to a successful outcome. PMID:9817420

Spinner, R J; Atkinson, J L; Wenger, D E; Stuart, M J

1998-11-01

324

Bilateral optic nerve hypoplasia.  

PubMed

In the past 10 years, 15 children with bilateral optic nerve hypoplasia have been studied at the Royal Alexandra Hospital for Children. There were 5 boys and 10 girls. Nine were first-born and they presented at a mean age of 5 months (range: 4 days to 25 months). Five presented with suspected blindness and 7 with abnormal eye movements (nystagmus or less commonly squint). The other 3 presented because of fits or developmental delay. Eight showed evidence of neural damage--microcephaly, seizures and/or abnormalities of tone. Four appeared to be of normal or near normal intelligence, 6 were mildly retarded and 5 severely so. Two patients had already died, one suddenly. Six of the 7 cases investigated in detail had evidence of hypothalamic pituitary dysfunction. Another one had a minimal hypothalamic abnormality. Four were severely growth retarded and 2 were receiving growth hormone replacement. Two males had micropenis and a girl had precocious puberty with partial diabetes insipidus. Neuroradiological investigations showed an absent septum pellucidum in only 5 cases. Five patients had other major CNS malformations. Five patients had normal CT scans; 3 of these 5 appeared of normal intelligence and all 5 had normal neurological examinations. Bilateral optic nerve hypoplasia is frequently associated with serious brain and endocrine abnormalities. PMID:6926392

Ouvrier, R A; Lewis, D; Procopis, P G; Billson, F A; Silink, M; de Silva, M

1981-01-01

325

Ulnar Nerve Dislocation at the Elbow: Review of the Literature and Report of Three Cases  

PubMed Central

Ulnar nerve instability without compression at the cubital tunnel is not common and even more rare is a dislocating nerve. We review the literature regarding the etiology of instability, its incidence and treatment. Snapping around the medial humeral epicondyle can also be caused by a subluxing medial head of the triceps. This pathology may be accompanied by symptoms from the ulnar nerve. Differential diagnosis even intraoperatively is therefore essential if effective treatment is to be given. We also present our own experience on the subject consisting of three cases, one of them with bilateral instability. In only one case there were clinical findings suggesting nerve compression. All laboratory and screening tests were normal, except for the nerve conduction studies in this one case. The main symptom was strong pain, especially during manual activities. Only two of the four subluxing nerves required surgical treatment which in our case was by anterior submuscular or subcutaneous transposition of the ulnar nerve. As diagnosis is not always easy and is usually made on clinical grounds, we also present a clinical test that we believe to be diagnostic for the situation. PMID:19461901

Xarchas, K.C; Psillakis, I; Koukou, O; Kazakos, K.J; Ververidis, A; Verettas, D.A

2007-01-01

326

Temporal Adaptation Silicon Auditory Nerve  

E-print Network

Temporal Adaptation in a Silicon Auditory Nerve John Lazzaro CS Division UC Berkeley 571 Evans Hall (bottom trace), we see the envelope of the temporal adaptation superimposed on the cycle-by-cycle phase-locking). In biological auditory nerve fibers, cycle-by-cycle phase locking ceases for auditory fibers tuned

Lazzaro, John

327

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.

1985-01-01

328

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

PubMed

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

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

2014-10-01

329

Isolated Oculomotor Nerve Palsy Following Minor Head Trauma : Case Illustration and Literature Review  

PubMed Central

Isolated oculomotor nerve palsy (ONP) attributable to mild closed head trauma is a distinct rarity. Its diagnosis places high demands on the radiologist and the clinician. The authors describe this condition in a 36-year-old woman who slipped while walking and struck her face. Initial computed tomography did not reveal any causative cerebral and vascular lesions or orbital and cranial fractures. Enhancement and swelling of the cisternal segment of the oculomotor nerve was seen during the subacute phase on thin-sectioned contrast-enhanced magnetic resonance images. The current case received corticosteroid therapy, and then recovered fully in 13 months after injury. Possible mechanism of ONP from minor head injury is proposed and previous reports in the literature are reviewed. PMID:24379954

Chang, Hyukwon

2013-01-01

330

Peripheral nerve lengthening as a regenerative strategy  

PubMed Central

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

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

2014-01-01

331

Peripheral nerve surgery: primer for the imagers.  

PubMed

Peripheral nerve surgery represents a broad field of pathologic conditions, medical specialties, and anatomic regions of the body. Anatomic understanding of hierarchical nerve structure and the peripheral nervous system aids diagnosis and management of nerve lesions. Many peripheral nerves coalesce into organized arrays, including the cervical, brachial, and lumbosacral plexuses, controlling motor and sensory functions of the trunk and extremities. Individual or groups of nerves may be affected by various pathologic conditions, including trauma, entrapment, tumor, or iatrogenic damage. Current research efforts focus on enhancing the peripheral nerve regenerative process by targeting Schwann cells, nerve growth factors, and nerve allografts. PMID:24210320

Pindrik, Jonathan; Belzberg, Allan J

2014-02-01

332

Cranial radiation in childhood acute lymphocytic leukemia. Neuropsychologic sequelae  

SciTech Connect

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

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

1984-08-01

333

Vitiligo: Signs and Symptoms  

MedlinePLUS

... 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 ...

334

Shingles: Signs and Symptoms  

MedlinePLUS

... Diseases and treatments Q - T Shingles Signs, symptoms Shingles: Signs and symptoms Shingles tends to cause more ... painful before the shingles appeared. Learn more about shingles: Shingles Shingles: Who gets, causes Shingles: Diagnosis, treatment, ...

335

Heart attack symptoms (image)  

MedlinePLUS

... Some people (the elderly, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms ...

336

Symptoms of Acoustic Neuroma  

MedlinePLUS

... Neuroma Legacy Society Search ANAUSA.org Symptoms of Acoustic Neuroma Early symptoms are easily overlooked, thus making diagnosis ... Resources Patient Survey Links Additional Resources © 2014 Acoustic Neuroma Association Acoustic Neuroma Association • 600 Peachtree Parkway • Suite 108 • Cumming, ...

337

Posterior cranial vault distraction with resorbable distraction devices.  

PubMed

Posterior cranial vault distraction is recognized as a viable initial approach to patients with syndromic craniosynostosis. It offers advantages to initial anterior vault surgery and to traditional 1-stage advancements. Reports of posterior vault distraction have thus far focused on the use of standard titanium distractors. We present a case of posterior vault distraction with resorbable distraction devices, obviating the need for a second surgery and anesthetic for distractor removal. Distraction was performed successfully without complications or device-related issues. PMID:25006906

Maurice, Samuel M; Gachiani, John M

2014-07-01

338

Endoscopic approaches to the cranial base: perspectives and realities  

Microsoft Academic Search

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

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

2000-01-01

339

Twist1 dimer selection regulates cranial suture patterning and fusion  

Microsoft Academic Search

Saethre-Chotzen syndrome is associated with haploinsufficiency of the basic-helix-loop- helix (bHLH) transcription factor TWIST1 and is characterized by premature closure of the cranial sutures, termed craniosynostosis; however, the mechanisms underlying this defect are unclear. Twist1 has been shown to play both positive and negative roles in mesenchymal specification and differentiation, and here we show that the activity of Twist1 is

Jeannette Connerney; Viktoria Andreeva; Yael Leshem; Christian Muentener; Miguel A. Mercado; Douglas B. Spicer

2006-01-01

340

High Mega Jugular Bulb Presenting with Facial Nerve Palsy and Severe Headache  

PubMed Central

We present a rare case of a 50-year-old female patient with symptomatic high mega jugular bulb requiring surgery. We review her medical file, preoperative and postoperative imaging, audiograms, and surgical report. High jugular bulb was diagnosed with computed tomography and magnetic resonance imaging. Symptoms of facial nerve palsy and headache were abolished after surgical procedure. Headache and facial nerve palsy can be caused by high mega jugular bulb. Surgery is indicated in such symptomatic cases and leads to relief of signs and symptoms of disease. PMID:21772806

Filipovic, Boris; Gjuric, Mislav; Hat, Josip; Gluncic, Ivo

2010-01-01

341

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

PubMed Central

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

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

2014-01-01

342

Unruptured internal carotid-posterior communicating artery aneurysm splitting the oculomotor nerve: a case report and literature review.  

PubMed

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

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

2014-08-01

343

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

PubMed

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

2012-11-15

344

Oculomotor nerve schwannoma: a case report.  

PubMed

Schwannomas account for about 8% of intracranial tumors and 90% are vestibular schwannomas. Oculomotor schwannoma without neurofibromatosis is extremely rare. A 41-year-old female presented with complaints of blurred vision, and the neurologic examination revealed afferent pupillary defect and decreased visual acuity of the left side. Brain magnetic resonance image showed an extra axial mass in the left superior orbital fissure. The patient underwent major surgery via the fronto-temporal approach. The tumor originated from the oculomotor nerve and was subtotally removed under microscopic surgery. The pathological findings confirmed the tumor as a schwannoma. After surgery, ptosis and medial gaze limitation of the left eye was detected, but the symptoms improved gradually. PMID:24926472

Cho, Yong-Hwan; Sung, Kyung-Su; Song, Young-Jin; Kim, Dae-Cheol; Choi, Sunseob; Kim, Ki-Uk

2014-04-01

345

Photofabricated gelatin-based nerve conduits: nerve tissue regeneration potentials.  

PubMed

There is a strong demand for development of nerve guide conduit with prompt nerve regeneration potential for injury-induced nerve defect. Prior to study on nerve tissue engineering using Schwann cells or nerve stem cells, the effectiveness of photofabricated scaffolds based on photocurable gelatin was examined. This study describes the evaluation of in vivo nerve tissue regeneration potentials of three custom-designed and -fabricated prostheses (inner diameter, 1.2 mm; outer diameter, 2.4 mm; wall thickness, 0.60 mm; and length, 15 mm) made of photocured gelatin: a plain photocured gelatin tube (model I), a photocured gelatin tube packed with bioactive substances (laminin, fibronectin, and nerve growth factor) coimmobilized in a photocured gelatin rod (model II), and a photocured gelatin tube packed with bioactive substances coimmobilized in multifilament fibers (model III). These prostheses were implanted between the proximal and distal stumps 10 mm of the dissected right sciatic nerve of 70 adult male Lewis rats for up to 1 year. The highest regenerative potentials were found using the model III prosthesis, followed by the model II prosthesis. Markedly retarded neural regeneration was observed using the model I prosthesis. These were evaluated from the viewpoints of functional recovery, electrophysiological responses, and tissue morphological regeneration. The significance of the synergistic cooperative functions of multifilaments, which serve as a platform that provides contact guidance to direct longitudinal cell movement and tissue ingrowth and as a cell adhesive matrix with high surface area, and immobilized bioactive substances, which enhance nerve regeneration via biological stimulation, is discussed. PMID:15565867

Gámez, Eduardo; Goto, Yoshinobu; Nagata, Kengo; Iwaki, Toru; Sasaki, Tomio; Matsuda, Takehisa

2004-01-01

346

Acid-sensing by airway afferent nerves  

PubMed Central

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 associated with airway inflammatory diseases. PMID:23524016

Lee, Lu-Yuan; Gu, Qihai; Xu, Fadi; Hong, Ju-Lun

2013-01-01

347

Gastrointestinal autonomic nerve tumor of the stomach  

PubMed Central

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

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

2014-01-01

348

Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery  

PubMed Central

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

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

2014-01-01

349

Peripheral nerve regeneration with sustained release of poly(phosphoester) microencapsulated nerve growth factor within nerve guide conduits  

Microsoft Academic Search

Prolonged delivery of neurotrophic proteins to the target tissue is valuable in the treatment of various disorders of the nervous system. We have tested in this study whether sustained release of nerve growth factor (NGF) within nerve guide conduits (NGCs), a device used to repair injured nerves, would augment peripheral nerve regeneration. NGF-containing polymeric microspheres fabricated from a biodegradable poly(phosphoester)

Xiaoyun Xu; Woon-Chee Yee; Peter Y. K Hwang; Hanry Yu; Andrew C. A Wan; Shujun Gao; Kum-Loong Boon; Hai-Quan Mao; Kam W Leong; Shu Wang

2003-01-01

350

Nanofibrous nerve conduit-enhanced peripheral nerve regeneration.  

PubMed

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

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

2014-05-01

351

Slower nerve conduction velocity in individuals with functional ankle instability.  

PubMed

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

Simon, J; Docherty, C

2014-08-01

352

Histologic confirmation of neuronal cell bodies along the spinal accessory nerve.  

PubMed

Abstract Introduction. Most sources conclude that the spinal accessory nerve (SAN) is a purely motor nerve. There are some reports that suggest a sensory component, although the exact nature of such sensory fibers has yet to be elucidated. With such discrepancies in the literature and with well-established pain syndromes of unknown etiology following SAN injury, the authors performed the present study to better clarify this anatomy. Materials and methods. The entire accessory nerve was harvested from 10 adult cadavers. Samples were then submitted for immunohistochemical analyses. Results. Occasional microganglia cells were identified along the SAN in all specimens. These ganglia were most numerous along the intracranial segment of the SAN, but none was found along the cranial rootlets of the accessory nerve. Conclusions. Neuronal cell bodies were identified along the course of the SAN in human cadavers. Although the function is not certain, such cells have been found in other animals to be nocioceptive in nature. Pending further study, these cells may be found to be involved in enigmatic pain syndromes thought to arise in the sternocleidomastoid and trapezius muscles. PMID:24902994

Tubbs, R Shane; Sorenson, Edward P; Watanabe, Koichi; Loukas, Marios; Hattab, Eyas; Cohen-Gadol, Aaron A

2014-12-01

353

Malignant peripheral nerve sheath tumor arising from the colon in a newborn: report of a case and review of the literatures  

Microsoft Academic Search

A malignant peripheral nerve sheath tumor (MPNST) is a rare neoplasm arising from peripheral nerve sheath. Here, we report the first case of MPNST arising in the colon and also the youngest case of MPNST in the gastrointestinal tract. The patient was a 2-day-old neonate with symptoms and signs of intestinal obstruction. The patient had no family history or stigmata

Young-Joon Lee; HyeongGon Moon; Soon-Tae Park; Woo-Song Ha; Sang-Gyeong Choi; Soon-Chan Hong; Young-Tae Joo; Chi-Young Jeong; Eun-Jung Jung

2006-01-01

354

Endometriotic lesions of the lower troncular nerves.  

PubMed

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

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

2014-10-01

355

Mechanisms of Nerve Damage in Leprosy  

Microsoft Academic Search

Peripheral nerve involvement is inevitable once infection progresses to disease in man with leprosy. Some of the relevant questions pertaining to mechanisms of nerve damage in leprosy are: How does M. leprae gain entry into the nerve? What is the sequence of events that follow? How early and diffused is the nerve involvement? What is the relationship between infection, inflammation

V. P. Shetty

356

Functional neurological symptoms.  

PubMed

Functional neurological symptoms refer to neurological symptoms that are not explained by disease. They may also be called psychogenic, non-organic, somatoform, dissociative or conversion symptoms. The most common functional neurological symptoms are non-epileptic attacks and functional weakness. These are common in neurology and general medical practice, especially in emergency situations, where they can be mistaken for epilepsy or stroke. Many studies have shown that these symptoms often persist, are associated with distress and disability and, in the right hands, have a low rate of misdiagnosis. Physicians are often uncertain how to approach patients with these problems. Are patients making up the symptoms? How can the diagnosis be made confidently? What is the best way to explain the diagnosis to the patient? Does treatment ever help? This review takes readers through these questions with practical tips for avoiding common pitfalls, both in diagnosis and management. There is no good evidence that these symptoms are any more 'made up' than irritable bowel symptoms or chronic pain. The diagnosis should usually be made by a neurologist on the basis of positive signs of inconsistency such as Hoover's sign or the typical features of a non-epileptic attack. A 'functional' model of the symptoms is useful both in thinking about the problem and when explaining the symptoms to the patient. There are many useful steps in management that do not require a detailed understanding of aetiology in an individual patient. PMID:21365066

Stone, J

2011-03-01

357

Imaging of the facial nerve.  

PubMed

The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve. PMID:20456888

Veillona, F; Ramos-Taboada, L; Abu-Eid, M; Charpiot, A; Riehm, S

2010-05-01

358

The impact of cranial irradiation on the growth of children with acute lymphocytic leukemia  

SciTech Connect

Heights, height velocities, weights, and weight velocities were measured serially in 21 patients with acute lymphocytic leukemia (ALL) who had survived three to five years in continuous complete remission. These patients were assigned randomly to treatment regimens that varied according to whether cranial irradiation was used. Patients receiving cranial irradiation had lower height velocities during therapy than normal subjects and patients not receiving cranial irradiation. Twenty-two other children with ALL, who were irradiated but not randomized, exhibited similar alterations in growth. These results indicate that cranial irradiation, and not leukemia or antileukemia chemotherapy, causes reduced growth.

Wells, R.J.; Foster, M.B.; D'Ercole, A.J.; McMillan, C.W.

1983-01-01

359

Targeting peripheral afferent nerve terminals for cough and dyspnea.  

PubMed

Chronic unproductive coughing and dyspnea are symptoms that severely diminish the quality of life in a substantial proportion of the population. There are presently few if any drugs that effectively treat these symptoms. Rational drug targets for cough and dyspnea have emerged over the recent years based on developments in our understanding of the innervation of the respiratory tract. These drug targets can be subcategorized into those that target the vagal afferent nerve endings, and those that target neural activity within the CNS. This review focuses on targets presumed to be in the peripheral terminals of afferent nerves within the airways. Conceptually, the activity of peripheral afferent nerves involved with unwanted urge-to-cough or dyspnea sensations can be inhibited by limiting the intensity of the stimulus, inhibiting the amplitude of the stimulus-induced generator potential, or inhibiting the transduction between the generator potential and action potential discharge and conduction. These mechanisms reveal many therapeutic strategies for anti-tussive and anti-dyspnea drug development with peripheral sites of action. PMID:21705272

Muroi, Yukiko; Undem, Bradley J

2011-06-01

360

Diagnostic value of history and physical examination in patients suspected of lumbosacral nerve root compression  

PubMed Central

Objective: To evaluate patient characteristics, symptoms, and examination findings in the clinical diagnosis of lumbosacral nerve root compression causing sciatica. Methods: The study involved 274 patients with pain radiating into the leg. All had a standardised clinical assessment and magnetic resonance (MR) imaging. The associations between patient characteristics, clinical findings, and lumbosacral nerve root compression on MR imaging were analysed. Results: Nerve root compression was associated with three patient characteristics, three symptoms, and four physical examination findings (paresis, absence of tendon reflexes, a positive straight leg raising test, and increased finger-floor distance). Multivariate analysis, analysing the independent diagnostic value of the tests, showed that nerve root compression was predicted by two patient characteristics, four symptoms, and two signs (increased finger-floor distance and paresis). The straight leg raise test was not predictive. The area under the curve of the receiver-operating characteristic was 0.80 for the history items. It increased to 0.83 when the physical examination items were added. Conclusions: Various clinical findings were found to be associated with nerve root compression on MR imaging. While this set of findings agrees well with those commonly used in daily practice, the tests tended to have lower sensitivity and specificity than previously reported. Stepwise multivariate analysis showed that most of the diagnostic information revealed by physical examination findings had already been revealed by the history items. PMID:11971050

Vroomen, P; de Krom, M C T F M; Wilmink, J; Kester, A; Knottnerus, J

2002-01-01

361

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. PMID:19553647

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.

2009-01-01

362

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.

1987-03-01

363

A Case of Hypertrophic Cranial Pachymeningitis Presenting with Scleritis in a Patient with Undifferentiated Connective Tissue Disease  

PubMed Central

Hypertrophic cranial pachymeningitis (HCP) is an uncommon disorder that causes a localized or diffuse thickening of the dura mater and has been reported to be infrequently associated with systemic autoimmune disorders such as Wegener's granulomatosis, rheumatoid arthritis, sarcoidosis, Behçet's disease, Sjögren syndrome, and temporal arteritis. Here, we report a case of HCP initially presented with scleritis and headache in a patient with undifferenciated connective tissue disease (UCTD). HCP was initially suspected on brain magnetic resonance imaging and defined pathologically on meningial biopsy. Immunologic studies showed the presence of anti-RNP antibody. After high dose corticosteroid therapy, the patient's symptoms and radiologic abnormalities of brain were improved. Our case suggested that HCP should be considered in the differential diagnosis of headache in a patient with UCTD presenting with scleritis. PMID:20514324

Kim, Ji-Hyeon; Joo, Young-Bin; Kim, Jeana

2010-01-01

364

Computed tomography in schizophrenics and normal volunteers. II. Cranial asymmetry.  

PubMed

We studied cranial asymmetry in 31 schizophrenics and 32 normal volunteers, all of whom were male and right-handed. Automated measures of computed tomographic (CT) scans were used to estimate global hemicranial and hemispheric ventricular volume differences. A manual method was used to measure hemicranial asymmetries between the widths of the frontal and occipital areas on CT images. The observers making the measurements were unaware of the group membership of the subjects. High reliability was established for the manual method. In contrast to findings by other investigators, no group differences were observed. Methodologic flaws in earlier studies may account for this discrepancy. PMID:6984641

Jernigan, T L; Zatz, L M; Moses, J A; Cardellino, J P

1982-07-01

365

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. PMID:22950041

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

2012-01-01

366

Kinesio tape management for superficial radial nerve entrapment: a case report.  

PubMed

This case report describes a 41-year-old female who presented with complaints of pain in the lower lateral one-third of the right radius extending into the first web space. Tinel's sign reproducing the patient's symptoms was elicited 8.2 cm above the radial styloid process. Physical diagnosis for superficial radial nerve entrapment was made based on a positive upper limb neural tension test 2a along with symptom reproduction during resisted isometrics to brachioradialis and wrist extensors. A potential first time successful conservative Kinesio tape (KT) management for entrapment of the superficial radial nerve is described in this report. An immediate improvement in grip strength and functional activities along with a reduction in pain and swelling was noted in this patient after the first treatment session, which was maintained at a 6 month follow-up. A model is proposed describing the mechanism by which KT application could be used to intervene for nerve entrapment interfaces. PMID:22924428

Anandkumar, Sudarshan

2013-04-01

367

[Medically unexplained symptoms].  

PubMed

Patients with physical symptoms for which no medical explanation can be found are relatively common in general practice. Patients with medically unexplained symptoms are frequently frustrating to physicians both in primary and secondary care and utilize health sources disproportionately. They frequently attend both primary care units and hospitals and are usually not satisfied with the care they receive. Medically unexplained symptoms in patient populations are strongly associated with psychiatric pathology and with anxiety and depression in particular. They are also linked to personality pathology, childhood adversity, adult trauma or medically unexplained symptoms in childhood. The predictive value of alexithymia in determining these symptoms is controversial. Patients who have high negative affectivity or neuroticism tend to score high on measures of physical symptoms. These symptoms have a high degree of co-occurrence. The same person may meet the diagnostic criteria for several functional somatic syndromes simultaneously. The clinician should be aware of the cultural and social shaping of the bodily experience of these patients and hence acknowledge the somatic nature and reality of the symptoms. The clinician should make the person feel understood and establish a positive collaborative relationship. This would enable him/her to correct misconceptions about the disease and give a positive explanation of symptoms. Antidepressant therapy and cognitive-behavioural psychotherapy have been proved to be moderately effective in this group of patients. Because of the high disability that might be caused by these symptoms, psychiatrists and primary and secondary care physicians should pay careful attention to this clinical condition. These symptoms may also aid us in challenging the long-held idea of mind-body dualism which is inherent in Western biomedicine. PMID:12794657

Sayar, Kemal

2002-01-01

368

Carpal Tunnel Syndrome: Factors Influencing Permanent Nerve Damage The Brown Procedure: Safety and Efficacy  

Microsoft Academic Search

In this study 12,171 carpal tunnel patients were studied over a period of twelve years. The diagnosis of carpal tunnel syndrome (CTS) was established electrodiagnostically and quantified based on latencies. The duration of CTS symptoms prior to definitive surgical release was documented. This data shows the incidence of post-operative permanent nerve damage is directly related to both duration of CTS

MICHAELG. BROWN

369

Relationships of the palmar cutaneous branch of the median nerve: a morphometric study  

Microsoft Academic Search

Treatment of carpal tunnel syndrome consists in decompression of the median nerve by section of the flexor retinaculum. Usually, this surgery improves the disease with disappearance of the symptoms. However, some painful sequelae may remain such as painful discharges, paresthesiae or permanent anesthesia of the base of the thumb or of the scar related to an injury of the palmar

P. Chaynes; J. Bécue; P. Vaysse; M. Laude

2004-01-01

370

Activated Mast Cells in Proximity to Colonic Nerves Correlate With Abdominal Pain in Irritable Bowel Syndrome  

Microsoft Academic Search

Background & Aims: The mechanisms underlying ab- dominal pain perception in irritable bowel syndrome (IBS) are poorly understood. Intestinal mast cell infiltra- tion may perturb nerve function leading to symptom perception. We assessed colonic mast cell infiltration, mediator release, and spatial interactions with mucosal innervation and their correlation with abdominal pain in IBS patients. Methods: IBS patients were diagnosed ac-

GIOVANNI BARBARA; VINCENZO STANGHELLINI; ROBERTO DE GIORGIO; CESARE CREMON; GRAEME S. COTTRELL; DONATELLA SANTINI; GIANANDREA PASQUINELLI; ANTONIO M. MORSELLI-LABATE; EILEEN F. GRADY; NIGEL W. BUNNETT; STEPHEN M. COLLINS; ROBERTO CORINALDESI

2004-01-01

371

Preservation of facial, cochlear, and other nerve functions in acoustic neuroma treatment.  

PubMed

Between March 1966 and September 1992, 1400 acoustic neuromas were treated in Paris, France, by surgical excision. The findings over the last 7 years are presented. The translabyrinthine approach has been used in more than 85% of cases. Where hearing preservation is attempted, the middle fossa approach has been adapted for intracanilicular tumors and the retrosigmoid approach for small tumors extending into the cerebellopontine angle, in which the fundus of the internal meatus is free of tumor. The main goal is to achieve a grade I or II result in facial function within 1 month of surgery. Results improved during 1991 after the introduction of continuous facial nerve monitoring and the use of the Beaver mini-blade for dissection of tumor from nerve. With these techniques, facial function of grade I or II at 1 month improved from 20% to 52% for large tumors (larger than 3 cm), from 42% to 81% for medium tumors (2 to 3 cm). and from 70% to 92% for small tumors (up to and including 2 cm extracanalicular). The facial nerve was at greater risk using the retrosigmoid or middle fossa approaches than by the translabyrinthine route. Since 1985, success in hearing preservation has changed little, with useful hearing being preserved in 38.2% of cases operated on by means of the retrosigmoid route and a 36.4% of cases after the middle fossa approach. In older patients with good hearing and small tumors, observation with periodic MRI scanning is recommended. Despite earlier diagnosis, the number of patients suitable for hearing preservation surgery remains very limited and careful selection is required. Trigeminal nerve signs were present in 20% of cases preoperatively, in 10% postoperatively, and recovered spontaneously. Palsies of the other cranial nerves after surgery were much rarer and were as follows: sixth nerve (abducens), 0.5%; ninth nerve (glossopharyngeal), 1.4%; and tenth nerve (vagus), 0.7%. The importance of preservation of function of the nervus intermedius of Wrisberg is stressed. These results emphasize the advantages of the translabyrinthine approach, offering greater security to the facial nerve and lower morbidity. PMID:8108149

Sterkers, J M; Morrison, G A; Sterkers, O; El-Dine, M M

1994-02-01

372

Dermatological and immunological conditions due to nerve lesions.  

PubMed

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

Bove, D; Lupoli, A; Caccavale, S; Piccolo, V; Ruocco, E

2013-01-01

373

Evaluation of retinal nerve fiber layer thickness in migraine  

PubMed Central

Background Headache is one of the most disturbing symptoms with common neurological signs. Variations in optic nerve perfusion quality or retinal microcirculation may end up in ganglion cell damage in patients with migraine. Methods Sixty patients diagnosed with migraine and thirty normal individuals were evaluated in groups including migraine with aura, migraine without aura and controls. Retinal nerve fiber layer (RNFL) thickness was measured using stratus optical coherence tomography (OCT™) and then was compared in case and control groups. Results RNFL thickness was only significantly thinner in nasal quadrant in migraineurs compared to the control group. Other parameters showed no difference between the two groups and besides there was no statistically difference between the two migraine subgroups. Conclusion Given the significant difference in nasal quadrant RNFL thickness between the migraineurs and normal individuals, we might be able to defend the retinal blood flow decrease theory in migraine; however, multicentre studies with larger samples seem mandatory. PMID:24250902

Sorkhabi, Rana; Mostafaei, Somaiyeh; Ahoor, Mohammadhosein

2013-01-01

374

Dermatological and immunological conditions due to nerve lesions  

PubMed Central

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

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

2013-01-01

375

INSOMNIA: SYMPTOM OR DIAGNOSIS?  

Microsoft Academic Search

Is insomnia a clinical entity in its own right or is it simply a symptom of an underlying medical or psychological disorder? The widely held view among many clinicians and researchers is that insomnia is secondary to or an epiphenomenon of a ‘primary’ medical or psychological disorder. Consequently, insomnia ‘symptoms’ have tended to be trivialized or ignored. This paper aims

Allison G Harvey

2001-01-01

376

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

PubMed Central

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

Porr, Jason; Chrobak, Karen; Muir, Brad

2013-01-01

377

Dyspeptic Symptoms after Laparoscopic Large Hiatal Hernia Repair and Primary Antireflux Surgery for Gastroesophageal Reflux Disease: A Comparative Study  

Microsoft Academic Search

Background: Several patients with gastroesophageal reflux disease suffer from functional dyspepsia. After laparoscopic Nissen fundoplication, these symptoms persist in a substantial number of patients. We hypothesized that, due to a higher chance of vagal nerve impairment during extensive hernia sac resection and esophageal mobilization, dyspeptic symptoms are more frequent after laparoscopic large hiatal hernia (types II–IV) repair than after primary

Edgar J. B. Furnée; Werner A. Draaisma; Eric J. Hazebroek; Niels van Lelyveld; André J. P. M. Smout; Ivo A. M. J. Broeders

2010-01-01

378

Cranial Neural Crest Migration: New Rules for an Old Road  

PubMed Central

The neural crest serve as an excellent model to better understand mechanisms of embryonic cell migration. Cell tracing studies have shown that cranial neural crest cells (CNCCs) emerge from the dorsal neural tube in a rostrocaudal manner and are spatially distributed along stereotypical, long distance migratory routes to precise targets in the head and branchial arches. Although the CNCC migratory pattern is a beautifully choreographed and programmed invasion, the underlying orchestration of molecular events is not well known. For example, it is still unclear how single CNCCs react to signals that direct their choice of direction and how groups of CNCCs coordinate their interactions to arrive at a target in an ordered manner. In this review, we discuss recent cellular and molecular discoveries of the CNCC migratory pattern. We focus on events from the time when CNCCs encounter the tissue adjacent to the neural tube and their travel through different microenvironments and into the branchial arches. We describe the patterning of discrete cell migratory streams that emerge from the hindbrain, rhombomere (r) segments r1–r7, and the signals that coordinate directed migration. We propose a model that attempts to unify many complex events that establish the CNCC migratory pattern, and based on this model we integrate information between cranial and trunk neural crest development. PMID:20399765

Kulesa, Paul M.; Bailey, Caleb M.; Kasemeier-Kulesa, Jennifer C.; McLennan, Rebecca

2010-01-01

379

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. PMID:19245501

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

2009-01-01

380

Cranial neural crest cells form corridors prefiguring sensory neuroblast migration  

PubMed Central

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

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

2013-01-01

381

Cranial implant design using augmented reality immersive system.  

PubMed

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

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

2007-01-01

382

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

2008-11-01

383

Preclinical pathways to treatment in infants with positional cranial deformity.  

PubMed

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

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

2014-10-01

384

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

Microsoft Academic Search

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

Katerina Harvati; Timothy D. Weaver

2006-01-01

385

Preformed acrylic cranial implants using fused deposition modeling: A clinical report  

Microsoft Academic Search

Fabrication of acrylic cranial implants by conventional methods of moulage and mold formation may be difficult when the margin of the defect cannot be accurately detected. Three-dimensional anatomic models built by fused deposition modeling can serve as templates for the fabrication of custom acrylic implants for large or complicated cranial defects. Virtual mirror imaging of the contralateral nondefect side can

Peter M Gronet; Gregory A Waskewicz; Charles Richardson

2003-01-01

386

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

Microsoft Academic Search

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

Richard V. S. Wright

1996-01-01

387

The human cranial remains from Gran Dolina Lower Pleistocene site (Sierra de Atapuerca, Spain)  

Microsoft Academic Search

In this article we study the cranial remains of the late Lower Pleistocene human fossils from Gran Dolina (Sierra de Atapuerca, Spain), assigned to the new species Homo antecessor. The cranial remains belong to at least five individuals, both juveniles and adults. The most outstanding feature is the totally modern human morphology of the very complete face ATD6-69, representing the

Juan-Luis Arsuaga; Ignacio Mart??nez; Carlos Lorenzo; Ana Gracia; Alberto Muńoz; Oscar Alonso; Jesús Gallego

1999-01-01

388

A pre-operation planning system and biomechanical evaluation of the cranial flap  

Microsoft Academic Search

Neurosurgeons are required to perform craniotomies to remove brain tumors, hemangiomas, cerebral aneurysms, blood clots in the brain, or relieve internal pressure in the brain. After a craniotomy, the cranial flaps removed from the skull must be set back and fixed appropriately. However, due to the different sizes and shapes of cranial flaps and the various fixation methods, in certain

Shou-I Chen; Sheng-Chuan Wang; Hung-Ta Hsiao; Lung-Cheng Lee; Ming-Hsiao Lee; Chih-Min Yao

2012-01-01

389

AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 90:3548 (1993) Cranial Deformation and Nonmetric Trait Variation  

E-print Network

versus `hot-deformed"does not take into account the fact that there are different types of deformationAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 90:3548 (1993) Cranial Deformation and Nonmetric Trait, Native Ameri- ABSTRACT Cranial deformation is known to influence many traditional craniometricvariables

Cheverud, James M.

390

Disruption of acvrl1 increases endothelial cell number in zebrafish cranial vessels  

Microsoft Academic Search

The zebrafish mutant violet beauregarde (vbg) can be identified at two days post-fertilization by an abnormal circulation pattern in which most blood cells flow through a limited number of dilated cranial vessels and fail to perfuse the trunk and tail. This phenotype cannot be explained by caudal vessel abnormalities or by a defect in cranial vessel patterning, but instead stems

Beth L. Roman; Van N. Pham; Nathan D. Lawson; Magdalena Kulik; Sarah Childs; Arne C. Lekven; Deborah M. Garrity; Randall T. Moon; Mark C. Fishman; Robert J. Lechleider; Brant M. Weinstein

391

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

392

Ontogeny of australopithecines and early Homo: evidence from cranial capacity and dental eruption  

Microsoft Academic Search

The relationship between cranial capacity and age of eruption of the mandibular first permanent molar is examined in modern anthropoid primates and used to infer age of eruption in fossil hominids. In developing and evaluating the predictive model, emphasis is placed on (i) distinguishing among cranial capacity, brain weight and brain volume as measures of brain size; (ii) selection of

Richard J. Smith; Patrick J. Gannon; B. Holly Smith

1995-01-01

393

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

2004-01-01

394

Molecular evidence from ascidians for the evolutionary origin of vertebrate cranial sensory placodes  

Microsoft Academic Search

Cranial sensory placodes are specialised areas of the head ectoderm of vertebrate embryos that contribute to the formation of the cranial sense organs and associated ganglia. Placodes are often considered a vertebrate innovation, and their evolution has been hypothesised as one key adaptation underlying the evolution of active predation by primitive vertebrates. Here, we review recent molecular evidence pertinent to

Francoise Mazet; Sebastian M. Shimeld

2005-01-01

395

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. PMID:23433104

2013-01-01

396

Facial-hypoglossal nerve anastomosis using laser nerve welding.  

PubMed

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

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

2006-07-01

397

Nerve hyperplasia: a unique feature of ketamine cystitis  

PubMed Central

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

2013-01-01

398

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

PubMed Central

We report two immigrants with tuberculosis of the skull base and a review of the literature. A Somalian man presented with bilateral otitis media, hearing loss, and facial and abducens palsy. Imaging showed involvement of both mastoid and petrous bones, extending via the skull base to the nasopharynx, suggesting tuberculosis which was confirmed by characteristic histology and positive auramine staining, while Ziehl-Neelsen staining and PCR were negative. A Sudanese man presented with torticollis and deviation of the uvula due to paresis of N. IX and XI. Imaging showed a retropharyngeal abscess and lysis of the clivus. Histology, acid-fast staining, and PCR were negative. Both patients had a positive Quantiferon TB Gold in-tube result and improved rapidly after empiric treatment for tuberculosis. Cultures eventually yielded M. tuberculosis. These unusual cases exemplify the many faces of tuberculosis and the importance to include tuberculosis in the differential diagnosis of unexplained problems. PMID:21541186

Richardus, Renate A.; Jansen, Jeroen C.; Steens, Stefan C. A.; Arend, Sandra M.

2011-01-01

399

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

Microsoft Academic Search

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

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

2006-01-01

400

Detecting interregionally diversifying natural selection on modern human cranial form by using matched molecular and morphometric data  

Microsoft Academic Search

This comparison of morphological and neutral genetic variation in 10 human populations was designed to test a neutral hypothesis of cranial evolution in living and recent humans and to explain deviations from neutrality where detected. Overall, among-population differences in extant Homo sapiens cranial morphology are proportional to among-population differences in neutral molecular characteristics. For most of the populations studied, cranial

Charles C. Roseman

2004-01-01

401

Nerve lesioning with direct current  

NASA Astrophysics Data System (ADS)

Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

2011-02-01

402

Burkholderia pseudomallei Penetrates the Brain via Destruction of the Olfactory and Trigeminal Nerves: Implications for the Pathogenesis of Neurological Melioidosis  

PubMed Central

ABSTRACT Melioidosis is a potentially fatal disease that is endemic to tropical northern Australia and Southeast Asia, with a mortality rate of 14 to 50%. The bacterium Burkholderia pseudomallei is the causative agent which infects numerous parts of the human body, including the brain, which results in the neurological manifestation of melioidosis. The olfactory nerve constitutes a direct conduit from the nasal cavity into the brain, and we have previously reported that B. pseudomallei can colonize this nerve in mice. We have now investigated in detail the mechanism by which the bacteria penetrate the olfactory and trigeminal nerves within the nasal cavity and infect the brain. We found that the olfactory epithelium responded to intranasal B. pseudomallei infection by widespread crenellation followed by disintegration of the neuronal layer to expose the underlying basal layer, which the bacteria then colonized. With the loss of the neuronal cell bodies, olfactory axons also degenerated, and the bacteria then migrated through the now-open conduit of the olfactory nerves. Using immunohistochemistry, we demonstrated that B. pseudomallei migrated through the cribriform plate via the olfactory nerves to enter the outer layer of the olfactory bulb in the brain within 24 h. We also found that the bacteria colonized the thin respiratory epithelium in the nasal cavity and then rapidly migrated along the underlying trigeminal nerve to penetrate the cranial cavity. These results demonstrate that B. pseudomallei invasion of the nerves of the nasal cavity leads to direct infection of the brain and bypasses the blood-brain barrier. PMID:24736221

St. John, James A.; Ekberg, Jenny A. K.; Dando, Samantha J.; Meedeniya, Adrian C. B.; Horton, Rachel E.; Batzloff, Michael; Owen, Suzzanne J.; Holt, Stephanie; Peak, Ian R.; Ulett, Glen C.; Mackay-Sim, Alan; Beacham, Ifor R.

2014-01-01

403

Robust frameless stereotactic localization in extra-cranial radiotherapy  

SciTech Connect

In the field of extra-cranial radiotherapy, several inaccuracies can make the application of frameless stereotactic localization techniques error-prone. When optical tracking systems based on surface fiducials are used, inter- and intra-fractional uncertainties in marker three-dimensional (3D) detection may lead to inexact tumor position estimation, resulting in erroneous patient setup. This is due to the fact that external fiducials misdetection results in deformation effects that are poorly handled in a rigid-body approach. In this work, the performance of two frameless stereotactic localization algorithms for 3D tumor position reconstruction in extra-cranial radiotherapy has been specifically tested. Two strategies, unweighted versus weighted, for stereotactic tumor localization were examined by exploiting data coming from 46 patients treated for extra-cranial lesions. Measured isocenter displacements and rotations were combined to define isocentric procedures, featuring 6 degrees of freedom, for correcting patient alignment (isocentric positioning correction). The sensitivity of the algorithms to uncertainties in the 3D localization of fiducials was investigated by means of 184 numerical simulations. The performance of the implemented isocentric positioning correction was compared to conventional point-based registration. The isocentric positioning correction algorithm was tested on a clinical dataset of inter-fractional and intra-fractional setup errors, which was collected by means of an optical tracker on the same group of patients. The weighted strategy exhibited a lower sensitivity to fiducial localization errors in simulated misalignments than those of the unweighted strategy. Isocenter 3D displacements provided by the weighted strategy were consistently smaller than those featured by the unweighted strategy. The peak decrease in median and quartile values of isocenter 3D displacements were 1.4 and 2.7 mm, respectively. Concerning clinical data, the weighted strategy isocentric positioning correction provided the reduction of fiducial registration errors, featuring up to 61.7% decrease in median values (versus 46.8% for the unweighted strategy) of initial displacements. The weighted strategy proved high performance in minimizing the effects of fiducial localization errors, showing a great potential in improving patient setup. The clinical data analysis revealed that the application of a robust reconstruction algorithm may provide high-quality results in patient setup verification, by properly managing external fiducials localization errors.

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

2006-04-15

404

Weber's syndrome and sixth nerve palsy secondary to decompression illness: a case report.  

PubMed

We describe the first case of Weber's Syndrome to present as a manifestation of decompression illness in a recreational scuba diver. Weber's Syndrome is characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis. The patient was a 55 year-old male with a past medical history of a pulmonary cyst, in whom symptoms developed after a multilevel drift dive to a depth of 89 feet for 53 minutes, exceeding no-decompression limits. Symptom onset was within 30 minutes of surfacing and included the Weber's Syndrome, a sixth nerve palsy, dizziness, nausea, sensory loss, and ataxia. The patient received four U.S. Navy Treatment Tables with complete resolution of all neurological signs and symptoms. The mechanism of injury remains unclear, but may involve aspects of both air gas embolism and decompression sickness. Individuals with pre-existing pulmonary cysts may be at increased risk for dive-related complications. PMID:15926301

Padilla, W; Newton, H B; Barbosa, S

2005-01-01

405

Managing Chemotherapy Side Effects: Nerve Changes  

MedlinePLUS

... services national institutes of health Managing Chemotherapy Side Effects Nerve Changes “My fingers and toes felt numb ... or constipation l Stomach pain Managing Chemotherapy Side Effects: Nerve Changes Try these tips from others: “Prevent ...

406

Nerve Agents ATSDR ? General Information 1  

E-print Network

Nerve Agents ATSDR ? General Information 1 Nerve Agents Tabun (GA) CAS 77-81-6; Sarin (GB) CAS 107 are heavier thanair. Odor does not provide adequate warning of detection. The estimated LCt50 (the product

Baloh, Bob

407

Infraspinatus muscle atrophy from suprascapular nerve compression.  

PubMed

Muscle weakness without pain may signal a nerve compression injury. Because these injuries should be identified and treated early to prevent permanent muscle weakness and atrophy, providers should consider suprascapular nerve compression in patients with shoulder muscle weakness. PMID:24463748

Cordova, Christopher B; Owens, Brett D

2014-02-01

408

Listeriosis: Definition and Symptoms  

MedlinePLUS

... page: About CDC.gov . Listeria (Listeriosis) Share Compartir Definition Listeria : Food Poisoning's Rare but Deadly Germ February ... 888) 232-6348 Contact CDC–INFO Listeria (Listeriosis) Definition & Symptoms Outbreaks Oasis Brands Inc., Cheese Recall & Advice ...

409

About Kennedy's Disease: Symptoms  

MedlinePLUS

Kennedy's Disease Association A Public Benefit, Non-Profit Organization Register GTranslate GTranslate Javascript is required to use ... KDA Newsletters Memorials Symptoms Print Email Medical Term: Definition: Neurological: Bulbar Signs The Bulbar muscles are those ...

410

Medically unexplained physical symptoms  

Microsoft Academic Search

ObjectiveThe aim of this study was to estimate the number of patients with medically unexplained physical symptoms (MUPS) that could be eligible for group cognitive–behavioural treatment (CBT) and to assess the acceptability of this treatment.

I. A. Arnold; A. E. M. Speckens; A. M. van Hemert

2004-01-01

411

Tetanus: Symptoms and Complications  

MedlinePLUS

... of the muscles of the jaw, or "lockjaw". Tetanus symptoms include: Headache Jaw cramping Sudden, involuntary muscle ... sweating High blood pressure and fast heart rate Tetanus complications include: Uncontrolled/involuntary muscular contraction of the ...

412

Module 3 – Symptoms  

Cancer.gov

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

413

Dyslexia: Causes, Symptoms, Definition.  

ERIC Educational Resources Information Center

The article reviews proposed causes and observable symptoms that characterize dyslexia, concluding that individualized analysis and specialized treatments are required and that, until an operational definition can be agreed upon, use of the label "dyslexia" is counterproductive. (DB)

Shannon, Albert J.

1986-01-01

414

Neurosteroid 3?-androstanediol efficiently counteracts paclitaxel-induced peripheral neuropathy and painful symptoms.  

PubMed

Painful peripheral neuropathy belongs to major side-effects limiting cancer chemotherapy. Paclitaxel, widely used to treat several cancers, induces neurological symptoms including burning pain, allodynia, hyperalgesia and numbness. Therefore, identification of drugs that may effectively counteract paclitaxel-induced neuropathic symptoms is crucial. Here, we combined histopathological, neurochemical, behavioral and electrophysiological methods to investigate the natural neurosteroid 3?-androstanediol (3?-DIOL) ability to counteract paclitaxel-evoked peripheral nerve tissue damages and neurological symptoms. Prophylactic or corrective 3?-DIOL treatment (4 mg/kg/2 days) prevented or suppressed PAC-evoked heat-thermal hyperalgesia, cold-allodynia and mechanical allodynia/hyperalgesia, by reversing to normal, decreased thermal and mechanical pain thresholds of PAC-treated rats. Electrophysiological studies demonstrated that 3?-DIOL restored control values of nerve conduction velocity and action potential peak amplitude significantly altered by PAC-treatment. 3?-DIOL also repaired PAC-induced nerve damages by restoring normal neurofilament-200 level in peripheral axons and control amount of 2',3'-cyclic-nucleotide-3'-phosphodiesterase in myelin sheaths. Decreased density of intraepidermal nerve fibers evoked by PAC-therapy was also counteracted by 3?-DIOL treatment. More importantly, 3?-DIOL beneficial effects were not sedation-dependent but resulted from its neuroprotective ability, nerve tissue repairing capacity and long-term analgesic action. Altogether, our results showing that 3?-DIOL efficiently counteracted PAC-evoked painful symptoms, also offer interesting possibilities to develop neurosteroid-based strategies against chemotherapy-induced peripheral neuropathy. This article shows that the prophylactic or corrective treatment with 3?-androstanediol prevents or suppresses PAC-evoked painful symptoms and peripheral nerve dysfunctions in rats. The data suggest that 3?-androstanediol-based therapy may constitute an efficient strategy to explore in humans for the eradication of chemotherapy-induced peripheral neuropathy. PMID:24260511

Meyer, Laurence; Patte-Mensah, Christine; Taleb, Omar; Mensah-Nyagan, Ayikoe Guy

2013-01-01

415

Continuous Vagal Nerve Stimulation for Recurrent Laryngeal Nerve Protection in Thyroid Surgery  

Microsoft Academic Search

Introduction: Newly developed vagal stimulation probes permit continuous intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid resection. Complete signal loss indicates damage of the nerve. There is no other criterion so far to warn before imminent nerve function impairment. Methods: In 100 patients, thyroid resection (188 nerves at risk, 52 thyroidectomies, 21 Dunhill resections, 12 hemithyroidectomies, 5 two-sided subtotal

J. Jonas

2010-01-01

416

Video-Gait Analysis of Functional Recovery of Nerve Repaired with Chitosan Nerve Guides  

E-print Network

guides is commonly evaluated through histomorphometry and walking track analysis. We conducted a unique of nerve guide tubes is considered an alternative method to achieve nerve regeneration of transected nerves method of autografts.5­9 Currently a vast amount of research is being pursued to engineer the ideal nerve

VandeVord, Pamela

417

Supraclavicular nerve entrapment and clavicular fracture.  

PubMed

Because the supraclavicular nerve lies in close proximity to the clavicle, it is particularly vulnerable to injury in cases of clavicle fracture and in the surgical treatment of these fractures. The development of painful neuromas after iatrogenic transsection and symptomatic nerve entrapment in fracture callus after healing have previously been described. Reported here is a case of acute supraclavicular nerve entrapment and tension after fracture of the clavicle with significant pain relief after fracture fixation and nerve decompression. PMID:22430514

O?Neill, Kevin; Stutz, Christopher; Duvernay, Matthew; Schoenecker, Jonathan

2012-06-01

418

Proximal Sciatic Nerve Intraneural Ganglion Cyst  

PubMed Central

Intraneural ganglion cysts are nonneoplastic, mucinous cysts within the epineurium of peripheral nerves which usually involve the peroneal nerve at the knee. A 37-year-old female presented with progressive left buttock and posterior thigh pain. Magnetic resonance imaging revealed a sciatic nerve mass at the sacral notch which was subsequently revealed to be an intraneural ganglion cyst. An intraneural ganglion cyst confined to the proximal sciatic nerve has only been reported once prior to 2009. PMID:20069041

Swartz, Karin R.; Wilson, Dianne; Boland, Michael; Fee, Dominic B.

2009-01-01

419

Association of Low PON1 Type Q (Type A) Arylesterase Activity with Neurologic Symptom Complexes in Gulf War Veterans  

Microsoft Academic Search

Previously Haley et al. described six possible syndromes identified by factor analysis of symptoms in Gulf War veterans and demonstrated that veterans with these symptom complexes were more neurologically impaired than age–sex–education-matched well controls. They also uncovered strong associations (relative risks 4–8) suggesting that these symptom complexes were related to wartime exposure to combinations of organophosphate pesticides, chemical nerve agents,

Robert W. Haley; Scott Billecke; Bert N. La Du

1999-01-01

420

Determining the sex of human remains through cranial morphology.  

PubMed

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

2005-05-01

421

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

PubMed

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

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

2014-12-01

422

Spontaneous spinal subdural hematoma concurrent with cranial subdural hematoma.  

PubMed

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

2013-07-01

423

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

PubMed

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

2010-11-01

424

Ischemic oculomotor nerve palsy and skin necrosis caused by vascular embolization after hyaluronic acid filler injection: a case report.  

PubMed

Hyaluronic acid filler injection is widely used for soft tissue augmentation. However, there can be disastrous complications by direct vascular embolization. We present a case of ischemic oculomotor nerve palsy and skin necrosis after hyaluronic acid filler injection on glabellar.blepharoptosis, exotropia and diplopia developed suddenly after the injection, and skin necrosis gradually occurred. Symptoms and signs of oculomotor nerve palsy continuously improved with steroid therapy. Skin defects healed with minimal scars through intensive wound care.Percutaneous filler injection of periorbital areas should be performed carefully by experienced surgeons, and the possibility of embolization should be considered promptly if symptoms develop. PMID:23203244

Kwon, Seung Gee; Hong, Jong Won; Roh, Tai Suk; Kim, Young Seok; Rah, Dong Kyun; Kim, Sung Soo

2013-10-01

425

In vivo visualization of the cochlear nerve and nuclei with fluorescent axonal tracers.  

PubMed

In recent years multichannel neuroprostheses have been developed which directly stimulate the central auditory pathway. Substantially these have been used in cases of total hearing loss caused by neurofibromatosis type 2 where bilateral damage to the auditory nerve prevents more peripheral stimulation. The electrode carrier of the auditory brainstem implant (ABI) is designed to be placed on the cochlear nucleus complex residing at the lateral brainstem surface. Despite altered anatomy due to tumor growth or preceding surgery, correct electrode placement is essential to maximize the variety of pitch percept elicited during electrical stimulation with the ABI without producing side-effects. In order to assist intraoperative identification of the proximal auditory nerve and cochlear nuclei, the non-toxic fluorescent axonal tracers Fast Blue or Fluorogold were injected into the cochlea of rats and Java monkeys. Four to seven days after tracer application, labeling of the eighth cranial nerve, its entrance into the brainstem and the primary radiation of auditory fibers into the cochlear nucleus could be demonstrated as colored fluorescence on the living brain under appropriate ultraviolet illumination. Additional histological processing revealed groups of retrogradely labeled neuronal cell bodies in both species. Our results suggest that this method could also be used in humans in order to aid surgeons with the proper positioning of the electrode array. PMID:11707351

Marangos, N; Illing, R B; Krüger, J; Laszig, R

2001-12-01

426

Bifid median nerve: Report of two cases  

Microsoft Academic Search

Summary The median nerve divides into its terminal branches at or proximal to the distal edge of the flexor retinaculum. An anatomy of the median nerve within the carpal tunnel is reported in two separate cases. Emphasis has been given to the value of direct vision when incising the flexor retinaculum in order to avoid injure of the median nerve.

M. Artico; L. Cervoni; G. Stevanato; V. D. Andrea; F. Nucci

1995-01-01

427

Minimal access cranial suspension lift: a modified S-lift.  

PubMed

There is a strong trend at hand toward less dramatic facial rejuvenation surgery. Most of the authors' patients want a cosmetic improvement but not at the cost of prolonged disfigurement or a high risk of complications. In 1999, a very simple but effective rhytidectomy technique, termed an S-lift, was described in the literature and was adopted by the authors. Its basic principle is the suspension of sagging facial features by a strong, permanent purse-string suture. The procedure is performed with the patient under local anesthesia. Significant modifications were applied to the incision, to the purse-string suture anchoring site, and to the direction and shape of the skin excision. The authors named the modified procedure the minimal access cranial suspension lift to specifically describe the concept of the technique. Through an inverted L-shaped preauricular incision with extension below the sideburn, a limited skin undermining is performed. Two strong, permanent purse-string sutures are woven into the superficial musculoaponeurotic system tissues in a vertical U and an oblique O shape, initiating from a strong anchorage in the deep temporal fascia at the level of the helical crus. Tying these sutures produces a very powerful vertical correction of descended facial features that acts mainly on the jowls and the upper neck. The procedure can be extended by continuing the dissection over the malar fat pad, placing a third vertical purse-string suture with strong action on the nasolabial groove, and vertically repositioning the midfacial volumes. During 20 months, pleasing results and a very low complication rate were obtained in 88 consecutive patients with a mean age of 551/2 years. In this article, the authors provide a detailed description of the anesthetic and surgical technique, a demonstration of the results in different patient age categories, and a discussion comparing the minimal access cranial suspension lift with other types of facial rejuvenation procedures. PMID:11994618

Tonnard, Patrick; Verpaele, Alexis; Monstrey, Stan; Van Landuyt, Koen; Blondeel, Philippe; Hamdi, Moustapha; Matton, Guido

2002-05-01

428

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

PubMed

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

Bona, Paula; Desojo, Julia Brenda

2011-07-01

429

Nerve identification and prevention of intraneural injection in regional anesthesia  

Microsoft Academic Search

This thesis deals with techniques to more reliably identify nervous structures and subsequently prevent intraneural injection in the practice of regional anesthesia. To identify nerves of the brachial plexus and sciatic nerve, both conventional techniques such as nerve stimulation, as well as ultrasound are described. The first chapters deal with nerve identification techniques using nerve stimulation and ultrasound. Nerve stimulation

Nizar Moayeri

2010-01-01

430

SUNCT and optic nerve hypoplasia  

Microsoft Academic Search

SUNCT has been reported in association with abnormalities of the brainstem and pituitary region. We present a patient with\\u000a a history of left optic nerve hypoplasia, mild hypothalamic-pituitary dysfunction, and SUNCT starting in adolescence. SUNCT\\u000a with an early age of onset may be associated with congenital abnormality of the hypothalamic-pituitary axis.

Brett J. Theeler; Kevin R. Joseph

2009-01-01

431

The Optical Stretcher Nerve Regeneration  

E-print Network

to test their relevance and importance for biological function. Our ultimate goal is the transfer of our present after neurological trauma to see whether those pose mechanical barriers to nerve regeneration. We are also investigating the importance of mechanical cues for normal differentiation and axonal pathfinding

Steiner, Ullrich

432

Ultrasound of nerve and muscle  

Microsoft Academic Search

Over the last two decades, ultrasound has developed into a useful technology for the evaluation of diseases of nerve and muscle. Since it is currently not used at by the majority of clinicians involved in diagnosis or care of patients with neuromuscular disorders, this review briefly describes the technical aspects of ultrasound and its physical principles. It relates normal muscle

Francis O Walker; Michael S Cartwright; Ethan R Wiesler; James Caress

2004-01-01

433

Symptom Management Concept Design Webinar  

Cancer.gov

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

434

Contact Dermatitis: Signs and Symptoms  

MedlinePLUS

... treatments A - D Contact dermatitis Signs and symptoms Contact dermatitis: Signs and symptoms Allergic contact dermatitis : Testing ... these symptoms, you need immediate medical care. Allergic contact dermatitis This skin condition occurs when you have ...

435

Median Nerve Stimulation in a Patient with Complex Regional Pain Syndrome Type II.  

PubMed

A 54-year-old man experienced injury to the second finger of his left hand due to damage from a paintball gun shot 8 years prior, and the metacarpo-phalangeal joint was amputated. He gradually developed mechanical allodynia and burning pain, and there were trophic changes of the thenar muscle and he reported coldness on his left hand and forearm. A neuroma was found on the left second common digital nerve and was removed, but his symptoms continued despite various conservative treatments including a morphine infusion pump on his left arm. We therefore attempted median nerve stimulation to treat the chronic pain. The procedure was performed in two stages. The first procedure involved exposure of the median nerve on the mid-humerus level and placing of the electrode. The trial stimulation lasted for 7 days and the patient's symptoms improved. The second procedure involved implantation of a pulse generator on the left subclavian area. The mechanical allodynia and pain relief score, based on the visual analogue scale, decreased from 9 before surgery to 4 after surgery. The patient's activity improved markedly, but trophic changes and vasomotor symptom recovered only moderately. In conclusion, median nerve stimulation can improve chronic pain from complex regional pain syndrome type II. PMID:19844632

Jeon, Ik-Chan; Kim, Min-Su; Kim, Seong-Ho

2009-09-01

436

Median Nerve Stimulation in a Patient with Complex Regional Pain Syndrome Type II  

PubMed Central

A 54-year-old man experienced injury to the second finger of his left hand due to damage from a paintball gun shot 8 years prior, and the metacarpo-phalangeal joint was amputated. He gradually developed mechanical allodynia and burning pain, and there were trophic changes of the thenar muscle and he reported coldness on his left hand and forearm. A neuroma was found on the left second common digital nerve and was removed, but his symptoms continued despite various conservative treatments including a morphine infusion pump on his left arm. We therefore attempted median nerve stimulation to treat the chronic pain. The procedure was performed in two stages. The first procedure involved exposure of the median nerve on the mid-humerus level and placing of the electrode. The trial stimulation lasted for 7 days and the patient's symptoms improved. The second procedure involved implantation of a pulse generator on the left subclavian area. The mechanical allodynia and pain relief score, based on the visual analogue scale, decreased from 9 before surgery to 4 after surgery. The patient's activity improved markedly, but trophic changes and vasomotor symptom recovered only moderately. In conclusion, median nerve stimulation can improve chronic pain from complex regional pain syndrome type II. PMID:19844632

Jeon, Ik-Chan; Kim, Min-Su

2009-01-01

437

Optic nerve regeneration with return of vision through an autologous peripheral nerve graft.  

PubMed

The optic fiber termination layer in the contralateral optic tectum was reinnervated and useful vision was recovered in the adult frog, after successful optic nerve regeneration through an autologous peripheral nerve-bridge used to replace the optic nerve and optic chiasma. During their course through the nerve-bridge, the optic fibers were associated with Schwann cells in the usual relationship observed in peripheral nerve. PMID:1511315

Scalia, F; Roca, S

1992-07-10

438

Detection of peripheral nerve pathology  

PubMed Central

Objective: To compare accuracy of ultrasound and MRI for detecting focal peripheral nerve pathology, excluding idiopathic carpal or cubital tunnel syndromes. Methods: We performed a retrospective review of patients referred for neuromuscular ultrasound to identify patients who had ultrasound and MRI of the same limb for suspected brachial plexopathy or mononeuropathies, excluding carpal/cubital tunnel syndromes. Ultrasound and MRI results were compared to diagnoses determined by surgical or, if not performed, clinical/electrodiagnostic evaluation. Results: We identified 53 patients who had both ultrasound and MRI of whom 46 (87%) had nerve pathology diagnosed by surgical (n = 39) or clinical/electrodiagnostic (n = 14) evaluation. Ultrasound detected the diagnosed nerve pathology (true positive) more often than MRI (43/46 vs 31/46, p < 0.001). Nerve pathology was correctly excluded (true negative) with equal frequency by MRI and ultrasound (both 6/7). In 25% (13/53), ultrasound was accurate (true positive or true negative) when MRI was not. These pathologies were typically (10/13) long (>2 cm) and only occasionally (2/13) outside the MRI field of view. MRI missed multifocal pathology identified with ultrasound in 6 of 7 patients, often (5/7) because pathology was outside the MRI field of view. Conclusions: Imaging frequently detects peripheral nerve pathology and contributes to the differential diagnosis in patients with mononeuropathies and brachial plexopathies. Ultrasound is more sensitive than MRI (93% vs 67%), has equivalent specificity (86%), and better identifies multifocal lesions than MRI. In sonographically accessible regions ultrasound is the preferred initial imaging modality for anatomic evaluation of suspected peripheral nervous system lesions. PMID:23553474

Seelig, Michael J.; Baker, Jonathan C.; Mackinnon, Susan E.; Pestronk, Alan

2013-01-01

439

Radiological and Clinical Factors Predicting the Facial Nerve Outcome following Retrosigmoid Approach for Large Vestibular Schwannomas (VSs)  

PubMed Central

Objective The aim of our study was to identify the radiological and clinical factors that predict postoperative facial nerve outcome following retrosigmoid approach for large vestibular schwannomas (VSs). Methods A total of 72 patients with large (? 3 cm) vestibular schwannomas was included in this retrospective study. Various parameters evaluated were age, gender, clinical presentation, tumor diameter in three planes, intrameatal extension, and pattern of growth. Results Age of the patient and presenting symptoms such as headache, ataxia, or preoperative facial nerve dysfunction correlated with poorer facial nerve outcome (p < 0.05). Patients with larger tumor volumes and extrameatal growth experienced a worse outcome (p < 0.05). Anterior and caudal extension (p = 0.001) correlated with poorer outcome, as well. Intrameatal extension and bony changes of the internal acoustic meatus did not correlate with the outcome (p > 0.05). Of the various examined factors, preoperative facial nerve function independently predicted postoperative facial nerve outcome. Conclusion Our study suggests that young patients with small tumor volume and normal facial nerve function at presentation are more likely to experience a good postoperative facial nerve outcome. These clinical and radiological parameters can be used to predict facial nerve outcome prior to surgery. PMID:24436931

Sharma, Mayur; Sonig, Ashish; Ambekar, Sudheer; Nanda, Anil

2013-01-01

440

Benign recurrent sixth nerve palsies in childhood. Secondary to immunization or viral illness.  

PubMed

Four children had benign, isolated, and recurrent sixth nerve palsies. Two of the children had palsies that occurred following immunizations. This had not been previously reported, to our knowledge. The other two patients had palsies that followed mild, febrile illnesses that were assumed to be of viral origin. In all patients the palsy resolved without other associated neurologic signs or symptoms. When a child has an atraumatic sixth nerve palsy, a tumor, hydrocephalus, and meningitis must be considered. If the neurologic examination shows no associated abnormalities, invasive testing is not indicated. The patient should be followed up closely by the ophthalmologist and pediatrician for spontaneous recovery. PMID:6838420

Werner, D B; Savino, P J; Schatz, N J

1983-04-01

441

Indication of peripheral nerve hyperexcitability in adult-onset subacute sclerosing panencephalitis (SSPE).  

PubMed

Subacute sclerosing panencephalitis (SSPE) is a rare chronic, progressive encephalitis that affects primarily children and young adults, caused by a persistent infection of immune-resistant measles virus. Diagnostic hallmarks include widespread cortical dysfunction on EEG, myoclonus, white matter abnormalities on neuroradiological examination and the presence of IgG anti-measles antibodies in the cerebrospinal fluid. We present the first case of SSPE with signs of peripheral nerve hyperexcitability, observed as extra discharges following the compound motor action potential at motor nerve stimulation. In addition we demonstrate the importance of SSPE in the differential diagnosis of adult patients with psychiatric and neurological symptoms. PMID:18483711

Schreurs, Annabel; Stĺlberg, Erik V; Punga, Anna Rostedt