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Sample records for growing skull fracture

  1. Skull fracture

    MedlinePlus

    Basilar skull fracture; Depressed skull fracture; Linear skull fracture ... Skull fractures may occur with head injuries . The skull provides good protection for the brain. However, a severe impact ...

  2. Remote intracranial hemorrhage following surgery for giant orbitofrontal growing skull fracture: A lesson learnt

    PubMed Central

    Baldawa, Sachin

    2016-01-01

    Growing skull fracture is an extremely rare complication of pediatric head injury, especially in infants. Repair of the dural tear early in the course of development of growing skull fracture has been suggested for a better outcome. Surgical repair of large, tense growing skull fractures, especially those in the communication of the ventricles can lead to potentially life-threatening complications. The author reports a rare case of remote intracranial hemorrhage following surgery for large, tense growing skull fracture in a 12-year-old girl and discusses the likely pathogenesis and possible ways to avoid this life-threatening complication. PMID:27606019

  3. Remote intracranial hemorrhage following surgery for giant orbitofrontal growing skull fracture: A lesson learnt.

    PubMed

    Baldawa, Sachin

    2016-01-01

    Growing skull fracture is an extremely rare complication of pediatric head injury, especially in infants. Repair of the dural tear early in the course of development of growing skull fracture has been suggested for a better outcome. Surgical repair of large, tense growing skull fractures, especially those in the communication of the ventricles can lead to potentially life-threatening complications. The author reports a rare case of remote intracranial hemorrhage following surgery for large, tense growing skull fracture in a 12-year-old girl and discusses the likely pathogenesis and possible ways to avoid this life-threatening complication. PMID:27606019

  4. Infant skull fracture (image)

    MedlinePlus

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent ... or blow can result in fracture of the skull and may be accompanied by injury to the ...

  5. Biomechanics of frontal skull fracture.

    PubMed

    Delye, Hans; Verschueren, Peter; Depreitere, Bart; Verpoest, Ignaas; Berckmans, Daniel; Vander Sloten, Jos; Van Der Perre, Georges; Goffin, Jan

    2007-10-01

    The purpose of the present study was to investigate whether an energy failure level applies to the skull fracture mechanics in unembalmed post-mortem human heads under dynamic frontal loading conditions. A double-pendulum model was used to conduct frontal impact tests on specimens from 18 unembalmed post-mortem human subjects. The specimens were isolated at the occipital condyle level, and pre-test computed tomography images were obtained. The specimens were rigidly attached to an aluminum pendulum in an upside down position and obtained a single degree of freedom, allowing motion in the plane of impact. A steel pendulum delivered the impact and was fitted with a flat-surfaced, cylindrical aluminum impactor, which distributed the load to a force sensor. The relative displacement between the two pendulums was used as a measure for the deformation of the specimen in the plane of impact. Three impact velocity conditions were created: low (3.60+/-0.23 m/sec), intermediate (5.21+/-0.04 m/sec), and high (6.95+/-0.04 m/sec) velocity. Computed tomography and dissection techniques were used to detect pathology. If no fracture was detected, repeated tests on the same specimen were performed with higher impact energy until fracture occurred. Peak force, displacement and energy variables were used to describe the biomechanics. Our data suggests the existence of an energy failure level in the range of 22-24 J for dynamic frontal loading of an intact unembalmed head, allowed to move with one degree of freedom. Further experiments, however, are necessary to confirm that this is a definitive energy criterion for skull fracture following impact. PMID:17970621

  6. An accessory skull suture mimicking a skull fracture.

    PubMed

    Wiedijk, J E F; Soerdjbalie-Maikoe, V; Maat, G J R; Maes, A; van Rijn, R R; de Boer, H H

    2016-03-01

    This paper describes an investigation of the sudden and unexpected death of a five-and-a-half-month-old boy. As in every Dutch case of sudden unexpected death in infancy (SUDI), a multidisciplinary diagnostic approach was used. This included post-mortem radiography, showing a linear discontinuity of the parietal bone. Originally this was interpreted as a skull fracture, but autopsy indicated no signs of mechanical trauma. Instead the defect was defined as a unilateral accessory suture of the parietal bone. The initial erroneous diagnosis had severe adverse consequences and thus every health care professional or forensic specialist dealing with paediatric mechanical traumas should be cautious of this rare anomaly. PMID:26860068

  7. A New Biomechanically-Based Criterion for Lateral Skull Fracture

    PubMed Central

    Vorst, Michael Vander; Chan, Philemon; Zhang, Jiangyue; Yoganandan, Narayan; Pintar, Frank

    2004-01-01

    This work develops a skull fracture criterion for lateral impact-induced head injury using postmortem human subject tests, anatomical test device measurements, statistical analyses, and finite element modeling. It is shown that skull fracture correlates with the tensile strain in the compact tables of the cranial bone as calculated by the finite element model and that the Skull Fracture Correlate (SFC), the average acceleration over the HIC time interval, is the best predictor of skull fracture. For 15% or less probability of skull fracture the lateral skull fracture criterion is SFC < 120 g, which is the same as the frontal criterion derived earlier. The biomechanical basis of SFC is established by its correlation with strain. PMID:15319125

  8. Harvey Cushing's Early Operative Treatment of Skull Base Fractures

    PubMed Central

    Pendleton, Courtney; Raza, Shaan M.; Gallia, Gary L.; Quinones-Hinojosa, Alfredo

    2013-01-01

    Objectives To review Dr. Harvey Cushing's early surgical cases at the Johns Hopkins Hospital, revealing details of his operative approaches to fractures of the skull base. Design Following institutional review board approval and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files. Setting The Johns Hopkins Hospital, 1896 to 1912. Participants A total of 24 patients underwent operative treatment for suspected fractures of the skull base. Main Outcome Measures The main outcome measure was operative approach, postoperative mortality, and condition recorded at the time of discharge. Results Overall, 23 patients underwent operative treatment for suspected skull base fractures. The mechanisms of injury were known for 22 patients and included work-related injuries (41%), falls (23%), vehicle injuries (32%), and other trauma (5%). One patient had no mechanism of injury specified in the file. The outcome at the time of discharge from the hospital was “well” or “improved” in 12 patients (52%). The remaining 11 patients died during their admission. Conclusions Although Cushing's experience with selected skull base pathology has been previously reported, the breadth of his contributions to operative approaches to the skull base has been neglected. PMID:24498586

  9. Biomechanical analysis of skull fractures after uncontrolled hanging release.

    PubMed

    Thollon, Lionel; Llari, Maxime; André, Lucile; Adalian, Pascal; Leonetti, Georges; Piercecchi-Marti, Marie-Dominique

    2013-12-10

    In forensic research, biomechanical analyses of falls are widely reported. However, no study on falls consecutive to uncontrolled hanging release, when a hanging body is cut down, has ever been published. In such cases, the presence of cranial trauma can raise interpretation issues, and there may be doubt as to whether the fall was an accident or a crime disguised as suicide. The problem remains as to whether or not a fall after a free hanging release can lead to a skull fracture. To address this question, numerical simulations, post-mortem human subject tests and parametric studies were performed. We first recreated the kinematics and velocity of this atypical fall with post-mortem human subject tests and multibody simulations. We then tested the influence of biological variability on fracture production using a finite element model of the head. Our results show that fall severity depends largely on the direction of the fall. The risk of fracture is highest in the occipital region and with a backward fall. Our study also highlights the frequent occurrence of lower limb trauma in a free hanging release. Most importantly, we show that a fracture is produced in only 3.4% of falls that occur in a 10-90 cm height range. The overall findings of this study provide tools for pathologists and magistrates to decide on the most likely scenario and to justify further forensic investigations if required. PMID:24314523

  10. [A Case of Depressed Skull Fracture Involving only the Inner Table].

    PubMed

    Miyake, Shigeta; Yamamura, Kouji; Abe, Hiroyuki

    2016-07-01

    Depressed skull fracture commonly results from trauma and usually occurs following high-speed impact with a small object. The outer and inner tables of the skull typically break concurrently. We present a case of depressed skull fracture involving only the inner table. The case resulted in a good outcome with only conservative treatment, although the mechanism remained unclear. Fracture models of cadavers have been the main tool for biomechanical investigation, but this classical method cannot accurately measure mechanical factors. We utilized a computer simulation model to assess the human head following skull fracture. This is the first report of an inner table fracture;the fracture mechanism was determined using a simulated computer model. PMID:27384121

  11. [Skull fracture or accessory suture in a child?].

    PubMed

    Burkhard, Katrin; Lange, Lena M; Plenzig, Stefanie; Verhoff, Marcel A; Kölzer, Sarah C

    2016-01-01

    Differentiation between accessory sutures and fractures in the skull of an infant can be difficult. Apart from the regular sutures there is a multitude of variations that may be mistaken for a fracture line. Such variations include for instance the intraparietal suture between the two ossification centers of the parietal bone or the mendosal suture between the supraoccipital and interparietal bone of the occipital squama. The presented case refers to an approximately 20-month-old female child. During autopsy, a discontinuity in the right paramedian posterior cranial fossa parallel to the internal occipital crest with connection to the foramen magnum was observed. The macroscopic findings suggested a fracture line because of its course. However, neither a hemorrhage in the soft tissue nor callus formation was discernible. The discontinuity was preserved with the adjacent parts of the occipital bone for further histological examination. In the report of a cranial CT, which was carried out five days before the child's death, an accessory suture paramedially in the right posterior cranial fossa was described. When the clinical CT records were re-evaluated, a similar discontinuity at the corresponding position on the other side was detected, though of noticeably shorter length. Additionally, the preserved occipital bone fragment including the discontinuity was histologically processed. In the radiological literature, precise (radiological) criteria for differential diagnosis are indicated. A zigzag pattern with sclerotic borders and a bilateral and fairly symmetric occurrence indicate a suture, whereas a sharp lucency with non-sclerotic edges and a unilateral occurrence indicate a fracture. Taking all the findings into account, the depicted discontinuity was regarded as an accessory suture. This case demonstrates that differentiation between a fracture and an accessory suture may be difficult in the autopsy of a child and underlines the importance of a postmortem CT

  12. The Comprehensive AOCMF Classification: Skull Base and Cranial Vault Fractures – Level 2 and 3 Tutorial

    PubMed Central

    Ieva, Antonio Di; Audigé, Laurent; Kellman, Robert M.; Shumrick, Kevin A.; Ringl, Helmut; Prein, Joachim; Matula, Christian

    2014-01-01

    The AOCMF Classification Group developed a hierarchical three-level craniomaxillofacial classification system with increasing level of complexity and details. The highest level 1 system distinguish four major anatomical units, including the mandible (code 91), midface (code 92), skull base (code 93), and cranial vault (code 94). This tutorial presents the level 2 and more detailed level 3 systems for the skull base and cranial vault units. The level 2 system describes fracture location outlining the topographic boundaries of the anatomic regions, considering in particular the endocranial and exocranial skull base surfaces. The endocranial skull base is divided into nine regions; a central skull base adjoining a left and right side are divided into the anterior, middle, and posterior skull base. The exocranial skull base surface and cranial vault are divided in regions defined by the names of the bones involved: frontal, parietal, temporal, sphenoid, and occipital bones. The level 3 system allows assessing fracture morphology described by the presence of fracture fragmentation, displacement, and bone loss. A documentation of associated intracranial diagnostic features is proposed. This tutorial is organized in a sequence of sections dealing with the description of the classification system with illustrations of the topographical skull base and cranial vault regions along with rules for fracture location and coding, a series of case examples with clinical imaging and a general discussion on the design of this classification. PMID:25489394

  13. [Skull base fractures in childhood. The role of CT in the accuracy of diagnosis].

    PubMed

    Sült, T P; Szever, Z; Mona, T; Kerényi, I; Harmat, G

    1999-03-28

    The authors treated 51 patients suffering from basilar skull fractures between January 1995 and June 1997 following a newly initiated protocol. The effectiveness of recognizing these fractures increased to twice and a half after applying a complex (neurologic, otolaryngologic, ophthalmologic, X-ray and cranial CT) diagnostic examination. CT scans were performed at the slightest suspicion of basilar skull fracture since they provide far more information than the native skull X-ray. A close coherence was observed concerning clinical symptoms, potential complications and the manifested fractures, which helped to draw an exact therapeutical strategy and to prevent potential complications. The authors found X-ray gave satisfactory information only about fractures starting on the vault. In the studied period CT proved the basilar skull fracture in 40 (78%) cases out of the total 51. X-ray did it in only 4 (8%) cases and raised the suspicion of the vault fracture spreading to the cranial floor in 20 (39%) cases. CT did not prove the clinically supposed basilar skull fractures in only 11 (22%) cases compared to 27 (53%) by X-ray. After having consultation with radiologists examination methods were always determined by the clinical picture and the available technical conditions (helical technique, multiplan or 3D-reconstruction). PMID:10349317

  14. Transfer of children with isolated linear skull fractures: is it worth the cost?

    PubMed

    White, Ian K; Pestereva, Ecaterina; Shaikh, Kashif A; Fulkerson, Daniel H

    2016-05-01

    OBJECTIVE Children with skull fractures are often transferred to hospitals with pediatric neurosurgical capabilities. Historical data suggest that a small percentage of patients with an isolated skull fracture will clinically decline. However, recent papers have suggested that the risk of decline in certain patients is low. There are few data regarding the financial costs associated with transporting patients at low risk for requiring specialty care. In this study, the clinical outcomes and financial costs of transferring of a population of children with isolated skull fractures to a Level 1 pediatric trauma center over a 9-year period were analyzed. METHODS A retrospective review of all children treated for head injury at Riley Hospital for Children (Indianapolis, Indiana) between 2005 and 2013 was performed. Patients with a skull fracture were identified based on ICD-9 codes. Patients with intracranial hematoma, brain parenchymal injury, or multisystem trauma were excluded. Children transferred to Riley Hospital from an outside facility were identified. The clinical and radiographic outcomes were recorded. A cost analysis was performed on patients who were transferred with an isolated, linear, nondisplaced skull fracture. RESULTS Between 2005 and 2013, a total of 619 pediatric patients with isolated skull fractures were transferred. Of these, 438 (70.8%) patients had a linear, nondisplaced skull fracture. Of these 438 patients, 399 (91.1%) were transferred by ambulance and 39 (8.9%) by helicopter. Based on the current ambulance and helicopter fees, a total of $1,834,727 (an average of $4188.90 per patient) was spent on transfer fees alone. No patient required neurosurgical intervention. All patients recovered with symptomatic treatment; no patient suffered late decline or epilepsy. CONCLUSIONS This study found that nearly $2 million was spent solely on transfer fees for 438 pediatric patients with isolated linear skull fractures over a 9-year period. All patients

  15. Development of skull fracture criterion based on real-world head trauma simulations using finite element head model.

    PubMed

    Sahoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2016-04-01

    The objective of this study was to enhance an existing finite element (FE) head model with composite modeling and a new constitutive law for the skull. The response of the state-of-the-art FE head model was validated in the time domain using data from 15 temporo-parietal impact experiments, conducted with postmortem human surrogates. The new model predicted skull fractures observed in these tests. Further, 70 well-documented head trauma cases were reconstructed. The 15 experiments and 70 real-world head trauma cases were combined to derive skull fracture injury risk curves. The skull internal energy was found to be the best candidate to predict skull failure based on an in depth statistical analysis of different mechanical parameters (force, skull internal energy), head kinematic-based parameter, the head injury criterion (HIC), and skull fracture correlate (SFC). The proposed tolerance limit for 50% risk of skull fracture was associated with 453mJ of internal energy. Statistical analyses were extended for individual impact locations (frontal, occipital and temporo-parietal) and separate injury risk curves were obtained. The 50% risk of skull fracture for each location: frontal: 481mJ, occipital: 457mJ, temporo-parietal: 456mJ of skull internal energy. PMID:26703363

  16. A 5-year study of the outcome of surgically treated depressed skull fractures.

    PubMed Central

    Al-Haddad, Syed A.; Kirollos, Ramez

    2002-01-01

    BACKGROUND: Many changes and improvement have taken place in the management of head injured patients in the last 20 years. There have been few recent studies analysing the overall outcomes including early complications of depressed skull fractures. The aim of our study was, therefore, to examine the factors influencing the surgical outcome of patients with depressed skull fractures. METHODS: We reviewed case notes of 73 consecutive surgically treated depressed skull fractures during the period from 1 January 1994 to 31 December 1998 admitted to the Walton Centre for Neurology and Neurosurgery, Liverpool. RESULTS: There was a male preponderance of 9:1. Alleged assault was the most common cause of depressed skull fractures followed by road traffic accidents. Postoperative infection rate was 8.2%. More than 80% of patients received prophylactic antibiotics. We failed to show any statistically significant association between the use of antibiotics and reduction of the rate of infection. However, prevalence of infection was significantly associated with brain contusion, low GCS score and dural tear (P < 0.05). Prevalence of early post-traumatic epilepsy was 12.3%. No patients received prophylactic anticonvulsants. There was no significant association between dural tear and prevalence of post-traumatic epilepsy. Mortality rate was 1.4%. CONCLUSIONS: Paediatric populations have better outcome; 7 out of 10 patients in this series progressed to full recovery. Use of prophylactic antibiotics did not reduce the infection rate. Presence of dural tear was not associated with an increase risk of post-traumatic epilepsy. PMID:12092875

  17. Depressed Skull Fractures: A Pattern of Abusive Head Injury in Three Older Children

    ERIC Educational Resources Information Center

    Lee, Anselm C. W.; Ou, Yvonne; Fong, Dawson

    2003-01-01

    Objective: To describe a pattern of abusive head injury in a series of children older than 4 years of age. Methods: A hospital chart review of abused children with skull fractures from 1999 to 2001 was carried out. The clinical features, social background, and subsequent outcome and management are described. Results: An 11-year-old girl and a pair…

  18. Skull Radiography

    MedlinePlus

    What you need to know about… Skull Radiography X-ray images of the skull are taken when it is necessary to see the cranium, facial bones or jaw bones. ... Among other things, x-ray exams of the skull can show fractures. Patient Preparation Before the examination, ...

  19. Secondary skull fractures in head wounds inflicted by captive bolt guns: autopsy findings and experimental simulation.

    PubMed

    Perdekamp, Markus Grosse; Kneubuehl, Beat P; Ishikawa, Takaki; Nadjem, Hadi; Kromeier, Jan; Pollak, Stefan; Thierauf, Annette

    2010-11-01

    Apart from one article published by Rabl and Sigrist in 1992 (Rechtsmedizin 2:156-158), there are no further reports on secondary skull fractures in shots from captive bolt guns. Up to now, the pertinent literature places particular emphasis on the absence of indirect lesions away from the impact point, when dealing with the wounding capacity of slaughterer's guns. The recent observation of two suicidal head injuries accompanied by skull fractures far away from the bolt's path gave occasion to experimental studies using simulants (glycerin soap, balls from gelatin) and skull–brain models. As far as ballistic soap was concerned, the dimensions of the bolt's channel were assessed by multi-slice computed tomography before cutting the blocks open. The test shots to gelatin balls and to skull-brain models were documented by means of a high-speed motion camera. As expected, the typical temporary cavity effect of bullets fired from conventional guns could not be observed when captive bolt stunners were discharged. Nevertheless, the visualized transfer of kinetic energy justifies the assumption that the secondary fractures seen in thin parts of the skull were caused by a hydraulic burst effect. PMID:20393855

  20. Radiolucent hair accessories causing depressed skull fracture following blunt cranial trauma.

    PubMed

    Syed, Omar N; Hankinson, Todd C; Mack, William J; Feldstein, Neil A; Anderson, Richard C E

    2008-12-01

    Pediatric neurosurgeons frequently care for children with traumatic scalp and skull injury. Foreign objects are often observed on imaging and may influence the clinician's decision-making process. The authors report on 2 cases of poorly visualized hair beads that had become embedded into the skull during blunt trauma. In both cases, skull radiography and CT scanning demonstrated depressed, comminuted fractures with poorly demonstrated spherical radiolucencies in the overlying scalp. The nature of these objects was initially unclear, and they could have represented air that entered the scalp during trauma. In one case, scalp inspection demonstrated no evidence of the bead. In the other case, a second bead was observed at the site of scalp laceration. In both cases, the beads were surgically removed, the fractures were elevated, and the patients recovered uneventfully. Radiolucent fashion accessories, such as hair beads, may be difficult to appreciate on clinical examination and may masquerade as clinically insignificant air following cranial trauma. If they are not removed, these foreign bodies may pose the risk of an infection. Pediatric neurosurgeons should consider hair accessories in the differential diagnosis of foreign bodies that may produce skull fracture following blunt trauma. PMID:19035690

  1. Penetrating skull fracture by a wooden object: Management dilemmas and literature review.

    PubMed

    Arifin, Muhammad Zafrullah; Gill, Arwinder Singh; Faried, Ahmad

    2012-07-01

    Most penetrating skull injuries are caused by gun shot wounds or missiles. The compound depressed skull fracture represents an acute neurosurgical emergency. Management and diagnosis of such cases have been described, but its occurence following a fall onto a piece of wood is quite unusual. A 75-year-old female fell onto a piece of wood that penetrated her skull on the left frontal region and was treated in our department. The patient had no neurological deficits during presentation. She was managed surgically and removal of the wooden object was performed to prevent early or late infection complications. Wooden foreign bodies often pose a different set of challenges as far as penetrating injuries to the brain are concerned. Radiological difficulties and increased rates of infection due to its porous nature make these types of injuries particularly interesting. Their early diagnosis and appropriate treatment can minimize the risk of complications. PMID:23293668

  2. Intersecting fractures of the skull and gunshot wounds. Case report and literature review.

    PubMed

    Viel, Guido; Gehl, Axel; Sperhake, Jan P

    2009-01-01

    When two fracture lines of a solid surface (ice, glass, eggshell, etc.) intersect, it is always possible to tell which one has been made first. Indeed pre-existing damage of the surface arrests all the fracture lines produced by subsequent impacts. This well-known principle (established by Puppe in 1903) has been largely used in glass fracture analysis, but can be applied also to the examination of skull fractures. It can help sequencing blunt force or gunshot injuries determining the direction of fire and differentiating entrance from exit wounds in the absence of specific distinguishing features (i.e., internal/external beveling of the skull or overlying skin indicators). In this context, we report the case of a 76-year-old man who shot himself in the mouth with a Walther PPK 7.65 handgun and highlight the utility of the application of both Puppe's Rule and Multislice Computed Tomography (MSCT) in the examination of gunshot wounds to the skull. PMID:19291431

  3. Posttraumatic Intracranial Tuberculous Subdural Empyema in a Patient with Skull Fracture.

    PubMed

    Kim, Jiha; Kim, Choonghyo; Ryu, Young-Joon; Lee, Seung Jin

    2016-05-01

    Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M. tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema. PMID:27226867

  4. Posttraumatic Intracranial Tuberculous Subdural Empyema in a Patient with Skull Fracture

    PubMed Central

    Kim, Jiha; Kim, Choonghyo; Ryu, Young-Joon

    2016-01-01

    Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M. tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema. PMID:27226867

  5. A simple depressed skull fracture in an old man with Paget disease: forensic implications in a rare case.

    PubMed

    Gitto, Lorenzo; Arunkumar, Ponni; Maiese, Aniello; Bolino, Giorgio

    2015-01-01

    Skull fractures occur when forces striking the head exceed the mechanical integrity of the calvarium. A depressed skull fracture is a break in a cranial bone with depression of the bone into the brain. A depressed fracture may be open (compound), with a skin laceration over the fracture, or closed (simple), when the overlying tissue is not disrupted. The association between simple depressed fracture of the skull and elderly is rare. Paget disease of the bone is a chronic disease characterized by the deposition of abnormal bone tissue, more fragile than normal bone. We report a case of a 92-year-old man who was found supine on the floor in his residence, showing multiple signs of trauma. X-rays and computed tomography scans were performed, showing a simple depressed skull fracture on the right occipital-temporal area and even the characteristics of Paget disease of the skull. The first hypothesis was death due to voluntary homicide. A detailed study of clinical reports, laboratory tests, radiograph scans, and post mortem examination data allowed us to reconstruct the event. Death was finally ruled due to a mild passive trauma, suggesting the unlawful killing of a human without criminal intent, meaning involuntary manslaughter. PMID:24644219

  6. [Skull fracture and cephalhematoma in a newborn--a case report].

    PubMed

    Zakanj, Zora

    2014-01-01

    Skull fractures and cephalhematoma in newborns belong to the group of birth injuries of the head and neck, accounting for 11.4 to 15% of the total number of birth injuries. We presented a fracture of the parietal bones in a newborn, associated with parietal cephalhematoma. The newborn had transient and mild neurological symptoms: vomiting and changes in muscle tone. Clinical examination confirmed a positive "ping-pong" phenomen, craniogram confirmed the fracture of parietal bones and shown cephalhematoma, as well as ultrasound (US) examinations of the brain showed peri-interventricular bleeding grade II. After the disappearance of all clinical symptoms in a newborn, we observed total bone healing at the end of the second week of life, and good perinatal outcome. Successful recovery from injury contributes to the ability of rapid bone modeling and remodeling, and brain plasticity. Further interdisciplinary monitoring is very important. PMID:25647994

  7. Skull fracture during infancy: a five-year follow-up.

    PubMed

    Marsh, Nigel V; Whitehead, Gabrielle

    2005-04-01

    A group of 19 children, who had received a skull fracture during infancy, were assessed at least 5 years following injury. The majority of the group (89%) had received a mild traumatic brain injury (TBI), with the remaining two (11%) having a moderate injury. The neuropsychological, academic, and psychosocial functioning of the TBI group was compared to that of 20 orthopedic subjects. The two groups were matched on the variables of gender, age, and socio-economic status. The TBI group was impaired on tests of visual attention and memory for faces. The two groups did not differ significantly on measures of language, sensorimotor functions, or visuospatial functioning. There were no statistically significant differences between the two groups on academic performance, or parent and teacher reports of psychosocial functioning. It is concluded that while there is an absence of deficits in the vast majority of functions, skull fracture in infancy can result in enduring impairment in specific cognitive skills related to the processing of complex nonverbal stimuli. PMID:15969357

  8. Multiple congenital skull fractures as a presentation of Ehlers-Danlos syndrome type VIIC.

    PubMed

    Bar-Yosef, Omer; Polak-Charcon, Sylvie; Hoffman, Chen; Feldman, Zeev P; Frydman, Moshe; Kuint, Jacob

    2008-12-01

    We describe a newborn infant with multiple congenital skull fractures and intracranial hemorrhage. He also had multiple skin folds suggesting a connective tissue abnormality. Electron microscopy of the skin biopsy showed collagen abnormalities with a "hieroglyphic appearance." The analysis of the synthesis of collagen in the cultured dermal fibroblasts demonstrated an accumulation of procollagen I. Molecular analysis found a nonsense mutation Q225X in ADAMTS2 gene, which encodes procollagen I N-terminal proteinase. All these findings confirmed the diagnosis of Ehlers-Danlos syndrome type VIIC (MIM 225410). Family studies suggested a founder effect in Ashkenazi Jews originating from Belarus. Prenatal diagnosis in the subsequent pregnancy reassured the parents that the fetus was an unaffected carrier. PMID:18973246

  9. Comparative analysis of clinical and computed tomography features of basal skull fractures in head injury in southwestern Nigeria

    PubMed Central

    Olabinri, Eunice O.; Ogbole, Godwin I.; Adeleye, Amos O.; Dairo, David M.; Malomo, Adefolarin O.; Ogunseyinde, Ayotunde O.

    2015-01-01

    Background: Basal skull fractures (BSF) in head injury may be missed clinically. Early detection ensures prompt treatment and prevention of complications We compared the clinical and Computed Tomography (CT) features of basal skull fractures in head injured patients in a southwestern Nigerian hospital. Materials and Methods: Head injury patients who had cranial CT at a Southwestern Nigerian hospital were selected. CT images were acquired with a 64-slice Toshiba Aquillion CT scanner using a standard head protocol. The images were evaluated for evidence of skull fractures, and associated complications. The clinical data and CT findings were analyzed. Results: One hundred and thirty patients were evaluated, including 103 (79.2%) males. Their ages ranged between 7 months and 81 years, mean 35 years (SD, 20.3). In 59 patients (45.4%, 59/130) BSF was detected on CT, while 71 (54.6%) had no evidence BSF. Forty-two (71.2%) of the 59 patients detected on CT had clinical suspicion of BSF (P < 0.001) while the remaining 17 (28.8%) were not clinically diagnosed. This equaled a sensitivity of 71.2% and, specificity of 90.1% for clinical determination of BSF in this study. There was no statistically significant difference between clinical and CT diagnosis (P > 0.05). The commonest observed clinical feature in patients with confirmed BSF was otorrhagia (45.8%) and the petrous temporal bone (45.8%) was the most commonly fractured bone. The BSF was caused most commonly by motor bike accidents in 53 (40.8%). The most common associated intracranial injuries were intracerebral haemorrhage (34.6%) and subdural (17.3%) Conclusion: It appears that neurosurgical evaluation is comparatively reliable in evaluating basal skull fractures in this study area even as they are consistently demonstrated by high resolution CT scanners. A clinical suspicion of BSF should warrant a closer detailed CT evaluation and reporting by radiologists. PMID:25883468

  10. Prediction of skull fracture risk for children 0-9 months old through validated parametric finite element model and cadaver test reconstruction.

    PubMed

    Li, Zhigang; Liu, Weiguo; Zhang, Jinhuan; Hu, Jingwen

    2015-09-01

    Skull fracture is one of the most common pediatric traumas. However, injury assessment tools for predicting pediatric skull fracture risk is not well established mainly due to the lack of cadaver tests. Weber conducted 50 pediatric cadaver drop tests for forensic research on child abuse in the mid-1980s (Experimental studies of skull fractures in infants, Z Rechtsmed. 92: 87-94, 1984; Biomechanical fragility of the infant skull, Z Rechtsmed. 94: 93-101, 1985). To our knowledge, these studies contained the largest sample size among pediatric cadaver tests in the literature. However, the lack of injury measurements limited their direct application in investigating pediatric skull fracture risks. In this study, 50 pediatric cadaver tests from Weber's studies were reconstructed using a parametric pediatric head finite element (FE) model which were morphed into subjects with ages, head sizes/shapes, and skull thickness values that reported in the tests. The skull fracture risk curves for infants from 0 to 9 months old were developed based on the model-predicted head injury measures through logistic regression analysis. It was found that the model-predicted stress responses in the skull (maximal von Mises stress, maximal shear stress, and maximal first principal stress) were better predictors than global kinematic-based injury measures (peak head acceleration and head injury criterion (HIC)) in predicting pediatric skull fracture. This study demonstrated the feasibility of using age- and size/shape-appropriate head FE models to predict pediatric head injuries. Such models can account for the morphological variations among the subjects, which cannot be considered by a single FE human model. PMID:25900622

  11. The oldest anatomical handmade skull of the world c. 1508: 'the ugliness of growing old' attributed to Leonardo da Vinci.

    PubMed

    Missinne, Stefaan J

    2014-06-01

    The author discusses a previously unknown early sixteenth-century renaissance handmade anatomical miniature skull. The small, naturalistic skull made from an agate (calcedonia) stone mixture (mistioni) shows remarkable osteologic details. Dr. Saban was the first to link the skull to Leonardo. The three-dimensional perspective of and the search for the senso comune are discussed. Anatomical errors both in the drawings of Leonardo and this skull are presented. The article ends with the issue of physiognomy, his grotesque faces, the Perspective Communis and his experimenting c. 1508 with the stone mixture and the human skull. Evidence, including the Italian scale based on Crazie and Braccia, chemical analysis leading to a mine in Volterra and Leonardo's search for the soul in the skull are presented. Written references in the inventory of Salai (1524), the inventory of the Villa Riposo (Raffaello Borghini 1584) and Don Ambrogio Mazenta (1635) are reviewed. The author attributes the skull c. 1508 to Leonardo da Vinci. PMID:24853982

  12. A device mimicking the biomechanical characteristics of crocodile skull for lumbar fracture reduction.

    PubMed

    Li, Jingmin; Guo, Lihua; Li, Yuancheng; Lei, Zhenkun; Liu, Yuanchang; Shi, Weiping; Li, Tao; Li, Weikang; Liu, Chong

    2016-01-01

    Open surgery is currently the main treatment method for the lumbar burst fracture with neurological deficit but may irreversibly disrupt the lumbar anatomy. The minimally invasive surgery (MIS) techniques have recently gained increasing attention. However, their use is still limited to lumbar burst fractures mainly due to their difficulties in burst fracture reduction and decompression. Here we present a novel bio-inspired MIS device which can be used with an endoscope to reset the bone fragments retropulsed into the spinal canal within the wounded vertebral body. Its head jaw mimics the biomechanical characteristics of a crocodile rostrum to improve the performance in gripping and moving bone pieces in the confined space of a vertebral body. This study may be capable of converting the posterior open surgeries to the MIS procedures, and expands the use of the MIS techniques in the treatment of lumbar burst fractures. PMID:27529133

  13. Conservative treatment of isolated condylar fractures in growing patients.

    PubMed

    Chatzistavrou, Evangelia K; Basdra, Efthimia K

    2007-01-01

    Traumas to the mandible in children, due to falls or traffic accidents, can involve fractures in the condylar area. Without timely and proper diagnosis, such fractures may give rise to serious problems, such as growth disturbances of the face and disorders of the temporomandibular joint. Orthodontists are often involved in the diagnosis of condylar fractures but, more importantly, they should be involved in the successful conservative management of the fracture. The aim of this article is to present 5 cases of isolated condylar fractures in children (2 boys, 3 girls; age range 4.5 to 10 years) who were diagnosed and treated solely by a conservative orthopedic approach, involving the use of a functional appliance (activator). After a follow-up period of 1 year, clinical and radiologic examination indicated, due to the growth potential of the condyles during childhood, successful healing and remodeling had occurred in all 5 cases and no discomfort or complications were reported. A conservative treatment approach for an isolated condylar fracture, using a functional appliance during the growth period, can lead to complete restoration of the fractured area and re-establishment of physiologic function of the stomatognathic system with no signs of disturbance in dentofacial development. PMID:17902329

  14. An autopsy case of a decomposed body with keyhole gunshot wound and secondary skull fractures.

    PubMed

    Harada, Kazuki; Kuroda, Ryohei; Nakajima, Makoto; Takizawa, Ayako; Yoshida, Ken-ichi

    2012-09-01

    The decomposed body of a 53 or 57-year-old male was found with a gun in a locked car parked in a coin-operated parking lot. During autopsy, the entrance wound in the frontal bone showed a characteristic keyhole defect with internal and external beveling. There was no exit wound. The fragmented bullet traveled downward within the calvarium and struck the right orbital plate. Two independent linear fractures were observed away from the entrance. These were believed to be secondary fractures resulting neither from internal ricochet of the bullet nor from direct blunt force to the head. Although decomposition complicated the evaluation of the gunshot wound characteristics, microscopic examination confirmed large quantities of soot along the wound tract, supporting our conclusion that the range of fire was contact. PMID:22633563

  15. Early Surgery Does Not Seem to Be a Pivotal Criterion to Improve Prognosis in Patients with Frontal Depressed Skull Fractures

    PubMed Central

    2014-01-01

    Introduction. There has been much debate about the ideal timing of surgery of frontal depressed skull fractures (DSF). In this paper, we assess whether timing of surgery may have influenced outcome. Methods. Retrospective cohort of 40 consecutive patients with frontal DSF who underwent surgical treatment over a 36-month period. The patients were divided into early surgery group (ESG) which were operated within 24 h and delayed surgery group (DSG). Results. The population comprised 39 (97.50%) men and the mean age was 27.9 years (range, 2–81 yr). There was no difference of age (P = 0.53), gender male (P = 1.00), presence of focal lesion on head CT (P = 0.89), hypotension (P = 0.28), and hypoxia (P = 0.15). Mean Glasgow Coma Scale (GCS) was significantly lower in patients of ESG than DSG (8.75 and 11.7, resp., P = 0.02). There was no difference between the groups in relation to death (P = 0.13), unfavourable outcome (P = 0.41), late posttraumatic epilepsy (P = 0.64), and smell-and-taste disturbances (P = 1.00). Only one patient (3.5%) evolved meningitis during follow-up. Conclusion. We found no difference between the ESG and DSG in respect to death, unfavourable outcome, LPE, and STD. PMID:25197666

  16. Skull (image)

    MedlinePlus

    The skull is anterior to the spinal column and is the bony structure that encases the brain. Its purpose ... the facial muscles. The two regions of the skull are the cranial and facial region. The cranial ...

  17. Skull Practice.

    ERIC Educational Resources Information Center

    Slesnick, Irwin L.

    1988-01-01

    Disguises a lesson about skulls with some fun to cause less fear among students. Outlines strategies, questions, and answers for use. Includes a skull mask which can be photocopied and distributed to students as a learning tool and a fun Halloween treat. Also shown is a picture of skull parts. (RT)

  18. Modeling the Effect of Fluid Flow on a Growing Network of Fractures in a Porous Medium

    NASA Astrophysics Data System (ADS)

    Alhashim, Mohammed; Koch, Donald

    2015-11-01

    The injection of a viscous fluid at high pressure in a geological formation induces the fracturing of pre-existing joints. Assuming a constant solid-matrix stress field, a weak joint saturated with fluid is fractured when the fluid pressure exceeds a critical value that depends on the joint's orientation. In this work, the formation of a network of fractures in a porous medium is modeled. When the average length of the fractures is much smaller than the radius of a cluster of fractured joints, the fluid flow within the network can be described as Darcy flow in a permeable medium consisting of the fracture network. The permeability and porosity of the medium are functions of the number density of activated joints and consequently depend on the fluid pressure. We demonstrate conditions under which these relationships can be derived from percolation theory. Fluid may also be lost from the fracture network by flowing into the permeable rock matrix. The solution of the model shows that the cluster radius grows as a power law with time in two regimes: (1) an intermediate time regime when the network contains many fractures but fluid loss is negligible; and (2) a long time regime when fluid loss dominates. In both regimes, the power law exponent depends on the Euclidean dimension and the injection rate dependence on time.

  19. Hair Today; Scalped Tomorrow: Massive Subgaleal Haematoma Following Sudden Hair Pulling in an Adolescent in the Absence of Haematological Abnormality or Skull Fracture.

    PubMed

    Edmondson, Sarah-Jayne; Ramman, Saif; Hachach-Haram, Nadine; Bisarya, Kamal; Fu, Brian; Ong, Juling; Akhavani, Mo

    2016-07-01

    Subgaleal haematoma (SH) is a rare condition, most frequently observed in neonates as a complication of Ventouse-assisted delivery. There have been few patients reported beyond this period. Those that are present within the literature have typically resulted from significant blunt scalp trauma, with or without associated skull fracture. Those resulting secondary to relatively minor trauma, such as hair braiding or hair pulling, are rare but have been reported and are often associated with underlying haematological abnormalities or nonaccidental injury patients. Most patients resolve spontaneously and without complication. The authors report a rare patient of a delayed presentation of a massive SH in an adolescent following a seemingly innocuous episode of hair pulling whilst play-fighting, in the absence of any underlying haematological or anatomical abnormality. Due to the size of the SH and the appearance of large areas of calcification within the haematoma, early liaison with senior neuroradiologists and haematologists, to rule out underlying anatomical and haematological abnormalities, respectively, was essential to guide appropriate management. Our patient highlights the need for an awareness of the possible aetiologies of SH and the necessity of early active multidisciplinary team involvement in the management of such patients, which is critical to ensure optimum patient outcomes. PMID:27258718

  20. Skull anatomy (image)

    MedlinePlus

    The skull is anterior to the spinal column and is the bony structure that encases the brain. Its purpose ... the facial muscles. The two regions of the skull are the cranial and facial region. The cranial ...

  1. Strontium Ranelate Reduces the Fracture Incidence in a Growing Mouse Model of Osteogenesis Imperfecta.

    PubMed

    Shi, Changgui; Hu, Bo; Guo, Lei; Cao, Peng; Tian, Ye; Ma, Jun; Chen, Yuanyuan; Wu, Huiqiao; Hu, Jinquan; Deng, Lianfu; Zhang, Ying; Yuan, Wen

    2016-05-01

    Osteogenesis imperfecta (OI) is a genetic bone dysplasia characterized by brittle bones with increased fracture risk. Although current treatment options to improve bone strength in OI focus on antiresorptive bisphosphonates, controlled clinical trials suggest they have an equivocal effect on reducing fracture risk. Strontium ranelate (SrR) is a promising therapy with a dual mode of action that is capable of simultaneously maintaining bone formation and reducing bone resorption, and may be beneficial for the treatment of OI. In this study, SrR therapy was investigated to assess its effects on fracture frequency and bone mass and strength in an animal model of OI, the oim/oim mouse. Three-week-old oim/oim and wt/wt mice were treated with either SrR or vehicle (Veh) for 11 weeks. After treatment, the average number of fractures sustained by SrR-treated oim/oim mice was significantly reduced compared to Veh-treated oim/oim mice. Micro-computed tomographic (μCT) analyses of femurs showed that both trabecular and cortical bone mass were significantly improved with SrR treatment in both genotypes. SrR significantly inhibited bone resorption, whereas bone formation indices were maintained. Biomechanical testing revealed improved bone structural properties in both oim/oim and wild-type (wt/wt) mice under the treatment, whereas no significant effects on bone brittleness and material quality were observed. In conclusion, SrR was able to effectively reduce fractures in oim/oim mice by improving bone mass and strength and thus represents a potential therapy for the treatment of pediatric OI. © 2015 American Society for Bone and Mineral Research. PMID:26679066

  2. Identification and characterization of growing large-scale en-echelon fractures in a salt mine

    NASA Astrophysics Data System (ADS)

    Maghsoudi, Samira; Hainzl, Sebastian; Cesca, Simone; Dahm, Torsten; Kaiser, Diethelm

    2014-02-01

    The spatiotemporal seismicity of acoustic emission (AE) events recorded in the Morsleben salt mine is investigated. Almost a year after backfilling of the cavities from 2003, microevents are distributed with distinctive stripe shapes above cavities at different depth levels. The physical forces driving the creation of these stripes are still unknown. This study aims to find the active stripes and track fracture developments over time by combining two different temporal and spatial clustering techniques into a single methodological approach. Anomalous seismicity parameters values like sharp b-value changes for two active stripes are good indicators to explain possible stress accumulation at the stripe tips. We identify the formation of two new seismicity stripes and show that the AE activities in active clusters are migrated mostly unidirectional to eastward and upward. This indicates that the growth of underlying macrofractures is controlled by the gradient of extensional stress. Studying size distribution characteristic in terms of frequency-magnitude distribution and b-value in active phase and phase with constant seismicity rate show that deviations from the Gutenberg-Richter power law can be explained by the inclusion of different activity phases: (1) the inactive period before the formation of macrofractures, which is characterized by a deficit of larger events (higher b-values) and (2) the period of fracture growth characterized by the occurrence of larger events (smaller b-values).

  3. [Anatomy of the skull].

    PubMed

    Pásztor, Emil

    2010-01-01

    The anatomy of the human body based on a special teleological system is one of the greatest miracles of the world. The skull's primary function is the defence of the brain, so every alteration or disease of the brain results in some alteration of the skull. This analogy is to be identified even in the human embryo. Proportions of the 22 bones constituting the skull and of sizes of sutures are not only the result of the phylogeny, but those of the ontogeny as well. E.g. the age of the skeletons in archaeological findings could be identified according to these facts. Present paper outlines the ontogeny and development of the tissues of the skull, of the structure of the bone-tissue, of the changes of the size of the skull and of its parts during the different periods of human life, reflecting to the aesthetics of the skull as well. "Only the human scull can give me an impression of beauty. In spite of all genetical colseness, a skull of a chimpanzee cannot impress me aesthetically"--author confesses. In the second part of the treatise those authors are listed, who contributed to the perfection of our knowledge regarding the skull. First of all the great founder of modern anatomy, Andreas Vesalius, then Pierre Paul Broca, Jacob Benignus Winslow are mentioned here. The most important Hungarian contributors were as follow: Sámuel Rácz, Pál Bugát or--the former assistant of Broca--Aurél Török. A widely used tool for measurement of the size of the skull, the craniometer was invented by the latter. The members of the family Lenhossék have had also important results in this field of research, while descriptive anatomy of the skull was completed by microsopical anatomy thanks the activity of Géza Mihálkovits. PMID:21661257

  4. Skull Base Anatomy.

    PubMed

    Patel, Chirag R; Fernandez-Miranda, Juan C; Wang, Wei-Hsin; Wang, Eric W

    2016-02-01

    The anatomy of the skull base is complex with multiple neurovascular structures in a small space. Understanding all of the intricate relationships begins with understanding the anatomy of the sphenoid bone. The cavernous sinus contains the carotid artery and some of its branches; cranial nerves III, IV, VI, and V1; and transmits venous blood from multiple sources. The anterior skull base extends to the frontal sinus and is important to understand for sinus surgery and sinonasal malignancies. The clivus protects the brainstem and posterior cranial fossa. A thorough appreciation of the anatomy of these various areas allows for endoscopic endonasal approaches to the skull base. PMID:26614826

  5. The Royal Book by Haly Abbas from the 10th century: one of the earliest illustrations of the surgical approach to skull fractures.

    PubMed

    Aciduman, Ahmet; Arda, Berna; Kahya, Esin; Belen, Deniz

    2010-12-01

    Haly Abbas was one of the pioneering physicians and surgeons of the Eastern world in the 10th century who influenced the Western world by his monumental work, The Royal Book. The book was first partly translated into Latin by Constantinus Africanus in the 11th century without citing the author's name. Haly Abbas was recognized in Europe after full translation of The Royal Book by Stephen of Antioch in 1127. The Royal Book has been accepted as an early source of jerrah-names (surgical books) in the Eastern world. The chapters regarding cranial fractures in Haly Abbas' work include unique management strategies for his period with essential quotations from Paul of Aegina's work Epitome. Both authors preferred free bone flap craniotomy in cranial fractures. Although Paul of Aegina, a Byzantine physician and surgeon, was a connection between ancient traditions and Islamic interpretation, Haly Abbas seemed to play a bridging role between the Roman-Byzantine and the School of Salerno in Europe. PMID:21107177

  6. Fractures

    PubMed Central

    Hall, Michael C.

    1963-01-01

    Recent studies on the epidemiology and repair of fractures are reviewed. The type and severity of the fracture bears a relation to the age, sex and occupation of the patient. Bone tissue after fracture shows a process of inflammation and repair common to all members of the connective tissue family, but it repairs with specific tissue. Cartilage forms when the oxygen supply is outgrown. After a fracture, the vascular bed enlarges. The major blood supply to healing tissue is from medullary vessels and destruction of them will cause necrosis of the inner two-thirds of the cortex. Callus rapidly mineralizes, but full mineralization is achieved slowly; increased mineral metabolism lasts several years after fracture. PMID:13952119

  7. Skull Base Tumors

    NASA Astrophysics Data System (ADS)

    Schulz-Ertner, Daniela

    In skull base tumors associated with a low radiosensitivity for conventional radiotherapy (RT), irradiation with proton or carbon ion beams facilitates a safe and accurate application of high tumor doses due to the favorable beam localization properties of these particle beams. Cranial nerves, the brain stem and normal brain tissue can at the same time be optimally spared.

  8. Fractures

    MedlinePlus

    ... commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the ...

  9. Fractures

    MedlinePlus

    A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open ... falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the ...

  10. Ganglioneuroblastoma of Skull Base

    PubMed Central

    Ramaswamy, Balakrishnan; Menon, Shalini S.; Agarwal, Ashish Chandra; Nair, Suraj S.

    2015-01-01

    Neuroblastic tumours are common in childhood and adrenal glands are the most common site. Head and neck ganglioneuroblastomas are extremely rare and nose is a very uncommon site for a ganglioneuroblastoma. The management of this primitive sympathogonic tumour may vary depending on the age of the patient and stage of the tumour. We present a middle-aged man with a ganglioneuroblastoma of skull base, management of this tumour and a review of literature. PMID:26435974

  11. Blunt force trauma to skull with various instruments.

    PubMed

    Sulaiman, Nur Amirah; Osman, Khairul; Hamzah, Noor Hazfalinda; Amir, Sri Pawita Albakri

    2014-04-01

    Deaths due to blunt force trauma to the head as a result of assault are some of the most common cases encountered by the practicing forensic pathologist. Previous studies have shown inflicting injury to the head region is one of the most effective methods of murder. The important factors that determine severity of trauma include the type of weapon used, type and site of skull fracture, intracranial haemorrhage and severity of brain injury. The aim of this study was to determine the characteristics of blunt force trauma to the skull produced by different instruments. Nine adult monkeys (Macaca fascicularis) skulls were used as models. Commonly found blunt objects comprising of Warrington hammer, hockey stick and open face helmet were used in this study. A machine calibrated force generator was used to hold the blunt object in place and to hit the skulls at forces of 12.5N and 25N. Resultant traumatic effects and fractures (linear, depressed, basilar, comminuted, and distastic) were analyzed according to type of blunt object used; surface area of contact and absolute force (N/cm(2)) delivered. Results showed that all investigated instruments were capable of producing similar injuries. The severity of trauma was not related to the surface area of contact with the blunt objects. However, only high absolute forces produced comminuted fractures. These findings were observational, as the samples were too small for statistical conclusions. PMID:24763233

  12. Congenital depression of the skull in a neonate.

    PubMed

    Tayeh, Christelle; Bali, Bassel; Milad, Nadine; Najjar, Marwan

    2016-01-01

    Congenital depression of the fetal skull is a rare condition. We discuss the case of a 14-days-old male infant, born at term by elective non-complicated caesarean section presenting with a left temporoparietal skull depression. A CT scan was performed which showed no associated fracture. A conservative approach was followed since the infant showed no signs of neurological deficit. Similar cases have been managed successfully in other reports using a conservative approach, with the condition being often self-resolving over the course of a few months. PMID:27605196

  13. [The skull of Combe Capelle].

    PubMed

    Hoffmann, Almut; Wegner, Dietrich

    2002-12-01

    Since the end of World War II two of the most important anthropological artefacts of the Museum für Vor- und Frühgeschichte in Berlin, the skulls and skeletons of Le Moustier and Combe Capelle, were believed to be missing or destroyed, respectively. The postcrania were severely damaged during a fire after the museum was bombed in February 1945, while the skulls were brought to the Soviet Union in 1945. In 1965, the skull of the Neanderthal man from Le Moustier and the chain of the grave of Combe Capelle were found amongst the art objects returned by the Soviet Union into the German Democratic Republic in 1958. However, the Combe Capelle skull was still missing. In the end of 2001 this skull could be found and identified in a store-house of the museum. Now, one the oldest known representatives of Homo sapiens sapiens is again available for scientific research and public exhibitions. PMID:12529957

  14. Skull x-ray

    MedlinePlus

    ... results may be due to: Fracture Tumor Breakdown ( erosion ) or calcium loss of the bone Movement of ... Absence seizure Alzheimer disease Dementia Ear infection - chronic Erosion Friedreich ataxia Hydrocephalus Increased intracranial pressure Malocclusion of ...

  15. Endoscopic Skull Base Surgery

    PubMed Central

    Senior, Brent A

    2008-01-01

    Endoscopic skull base surgery has undergone rapid advancement in the past decade moving from pituitary surgery to suprasellar lesions and now to a myriad of lesions extending from the cribriform plate to C2 and laterally out to the infratemporal fossa and petrous apex. Evolution of several technological advances as well as advances in understanding of endoscopic anatomy and the development of surgical techniques both in resection and reconstruction have fostered this capability. Management of benign disease via endoscopic methods is largely accepted now but more data is needed before the controversy on the role of endoscopic management of malignant disease is decided. Continued advances in surgical technique, navigation systems, endoscopic imaging technology, and robotics assure continued brisk evolution in this expanding field. PMID:19434274

  16. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  17. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  18. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  19. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  20. 21 CFR 882.4750 - Skull punch.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull punch. 882.4750 Section 882.4750 Food and... NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4750 Skull punch. (a) Identification. A skull punch is a device used to punch holes through a patient's skull to allow fixation of cranioplasty plates...

  1. Imaging of skull base tumours.

    PubMed

    Thust, Stefanie Catherine; Yousry, Tarek

    2016-01-01

    The skull base is a highly complex and difficult to access anatomical region, which constitutes a relatively common site for neoplasms. Imaging plays a central role in establishing the differential diagnosis, to determine the anatomic tumour spread and for operative planning. All skull base imaging should be performed using thin-section multiplanar imaging, whereby CT and MRI can be considered complimentary. An interdisciplinary team approach is central to improve the outcome of these challenging tumours. PMID:27330416

  2. Effect of skull flexural properties on brain response during dynamic head loading - biomed 2013.

    PubMed

    Harrigan, T P; Roberts, J C; Ward, E E; Carneal, C M; Merkle, A C

    2013-01-01

    The skull-brain complex is typically modeled as an integrated structure, similar to a fluid-filled shell. Under dynamic loads, the interaction of the skull and the underlying brain, cerebrospinal fluid, and other tissue produces the pressure and strain histories that are the basis for many theories meant to describe the genesis of traumatic brain injury. In addition, local bone strains are of interest for predicting skull fracture in blunt trauma. However, the role of skull flexure in the intracranial pressure response to blunt trauma is complex. Since the relative time scales for pressure and flexural wave transmission across the skull are not easily separated, it is difficult to separate out the relative roles of the mechanical components in this system. This study uses a finite element model of the head, which is validated for pressure transmission to the brain, to assess the influence of skull table flexural stiffness on pressure in the brain and on strain within the skull. In a Human Head Finite Element Model, the skull component was modified by attaching shell elements to the inner and outer surfaces of the existing solid elements that modeled the skull. The shell elements were given the properties of bone, and the existing solid elements were decreased so that the overall stiffness along the surface of the skull was unchanged, but the skull table bending stiffness increased by a factor of 2.4. Blunt impact loads were applied to the frontal bone centrally, using LS-Dyna. The intracranial pressure predictions and the strain predictions in the skull were compared for models with and without surface shell elements, showing that the pressures in the mid-anterior and mid-posterior of the brain were very similar, but the strains in the skull under the loads and adjacent to the loads were decreased 15% with stiffer flexural properties. Pressure equilibration to nearly hydrostatic distributions occurred, indicating that the important frequency components for typical

  3. Mastoid emissary in Indian skulls.

    PubMed

    Piasecki, K; Wysocki, J

    1998-01-01

    Two hundred and eleven Indian skulls originating from medieval times, South of Peru, were studied in respect to variability of the mastoid emissary. Occurrence and localisation of the external orifice of the mastoid emissary were studied in three distinct and well-separated populations, living in the three different places: Villa el Salvador, Tablada de Lurin and Paracas. Most of the skulls presented considerable degree of artificial deformation. External orifice of the mastoid emissary was multiple in most of the skulls, especially in Villa el Salvador and Paracas populations. Mastoid emissaries in Indian were situated generally higher than in European, especially regarding the Paracas population. Significant sex differences were present in this material, regarded as a whole (summarized results for the three populations), what is in agreement with previous observations on European skulls. It indicates that even in cases of relatively deep deformation, some characteristic features of sex dimorphism of the human skull are noticeable. Additionally, the three studied populations, which were well separated from each other and lived alone, differed significantly regarding localization of the mastoid emissaries. PMID:9857576

  4. Imaging of skull base lesions.

    PubMed

    Kelly, Hillary R; Curtin, Hugh D

    2016-01-01

    Skull base imaging requires a thorough knowledge of the complex anatomy of this region, including the numerous fissures and foramina and the major neurovascular structures that traverse them. Computed tomography (CT) and magnetic resonance imaging (MRI) play complementary roles in imaging of the skull base. MR is the preferred modality for evaluation of the soft tissues, the cranial nerves, and the medullary spaces of bone, while CT is preferred for demonstrating thin cortical bone structure. The anatomic location and origin of a lesion as well as the specific CT and MR findings can often narrow the differential diagnosis to a short list of possibilities. However, the primary role of the imaging specialist in evaluating the skull base is usually to define the extent of the lesion and determine its relationship to vital neurovascular structures. Technologic advances in imaging and radiation therapy, as well as surgical technique, have allowed for more aggressive approaches and improved outcomes, further emphasizing the importance of precise preoperative mapping of skull base lesions via imaging. Tumors arising from and affecting the cranial nerves at the skull base are considered here. PMID:27432686

  5. A biomechanical evaluation of skull-brain surrogates to blunt high-rate impacts to postmortem human subjects.

    PubMed

    Raymond, David E; Bir, Cynthia A

    2015-03-01

    The field of forensic injury biomechanics is an emerging field. Biomechanically validated tools may assist interdisciplinary teams of investigators in assessing mechanisms of blunt head trauma resulting in skull fractures. The objective of this study is to assess the biofidelity of spherical, frangible skull-brain (SB) surrogates. Blunt impacts were conducted at 20 m/s, using an instrumented 103 g rigid impactor, to the temporo-parietal region of four defleshed cephalic postmortem human subjects (PMHS). Force-deformation response, fracture tolerance, and fracture patterns were recorded for comparison to spherical skull-brain surrogates. Three brain substitutes were assessed: 10% gelatin, lead shot with Styrofoam and water. Force-deformation response of the skull-brain surrogates was similar to defleshed PMHS up to the point of fracture; however, none of the surrogates fractured at tolerance levels comparable to the PMHS. Fracture patterns of the skull-brain surrogates were linear and radiating, while PMHS fractures were all depressed, comminuted. PMID:25572885

  6. The skull of Chios: trepanation in Hippocratic medicine.

    PubMed

    Tsermoulas, Georgios; Aidonis, Asterios; Flint, Graham

    2014-08-01

    Cranial trepanation is the oldest neurosurgical operation and its roots date back to prehistory. For many centuries, religion and mysticism were strongly linked to the cause of diseases, and trepanation was associated with superstitions such as releasing evil spirits from inside the skull. The Hippocratic treatise "On injuries of the head" was therefore a revolutionary work, as it presented a systematic approach to the management of cranial trauma, one that was devoid of spiritual elements. Unfortunately, there are only a limited number of skeletal findings that confirm that the practice of trepanation was performed as part of Hippocratic medicine. In this historical vignette, the authors present a trepanned skull that was found in Chios, Greece, as evidence of the procedure having been performed in accordance with the Hippocratic teaching. The skull bears a parietal bur hole in association with a linear fracture, and it is clear that the patient survived the procedure. In this analysis, the authors examine the application of the original Hippocratic teaching to the skull of Chios. The rationalization of trepanation was clearly a significant achievement in the evolution of neurosurgery. PMID:24857244

  7. Landmark measurement of human skull

    NASA Astrophysics Data System (ADS)

    Zhai, Yu Jia; Ouyang, Jianfei; Cao, Xiaochun

    2010-06-01

    The landmark measurement of human skull is fundamental to geometric morphometry of palaeoanthropology. The landmarks are geometry points which can describe anatomically the homology of species group. They play an important role in palaeoanthropology. A structured-light based method is used to measure and make the 3D digital model of skull. The distances between all pairs of landmarks and interior angles from triangulations of the landmarks can be measured fast and accurately by the digital model. Other important geometric parameters of the skull, such as curvature, surface area, volume can also be measured. In order to validate and certificate the proposed method, 9 standard balls, which are embed at the landmarks, are measured by using Coordinate Measuring Arm (CMA). The experiment shows that the measuring errors of the distances and angles are less than 0.08 mm and 5' respectively.

  8. Skull base approaches in neurosurgery

    PubMed Central

    2010-01-01

    The skull base surgery is one of the most demanding surgeries. There are different structures that can be injured easily, by operating in the skull base. It is very important for the neurosurgeon to choose the right approach in order to reach the lesion without harming the other intact structures. Due to the pioneering work of Cushing, Hirsch, Yasargil, Krause, Dandy and other dedicated neurosurgeons, it is possible to address the tumor and other lesions in the anterior, the mid-line and the posterior cranial base. With the transsphenoidal, the frontolateral, the pterional and the lateral suboccipital approach nearly every region of the skull base is exposable. In the current state many different skull base approaches are described for various neurosurgical diseases during the last 20 years. The selection of an approach may differ from country to country, e.g., in the United States orbitozygomaticotomy for special lesions of the anterior skull base or petrosectomy for clivus meningiomas, are found more frequently than in Europe. The reason for writing the review was the question: Are there keyhole approaches with which someone can deal with a vast variety of lesions in the neurosurgical field? In my opinion the different surgical approaches mentioned above cover almost 95% of all skull base tumors and lesions. In the following text these approaches will be described. These approaches are: 1) pterional approach 2) frontolateral approach 3) transsphenoidal approach 4) suboccipital lateral approach These approaches can be extended and combined with each other. In the following we want to enhance this philosophy. PMID:20602753

  9. Missile injuries of the anterior skull base.

    PubMed

    Bhatoe, Harjinder Singh

    2004-02-01

    Missile injuries of the anterior skull base usually occur during war or war-like situations. These injuries may be isolated or associated with multiple traumatic injuries. We report 23 such cases managed during military conflicts and peacekeeping operations. All were adult males. Four of these patients sustained bullet injuries; the rest were injured from shrapnel. Eighteen patients had injury to the visual apparatus with permanent blindness. Proptosis was seen in 16, cerebrospinal fluid (CSF) leak from the wound in seven, and CSF orbitorrhea in three patients. Sixteen had irreparable injury to the eye necessitating evisceration/enucleation, and two had retrobulbar optic nerve injury. Three patients were comatose [Glasgow Coma Scale (GCS) 3/15], and 14 had altered sensorium. Six patients were fully conscious. All were investigated by computed tomography (CT), which revealed injury to the eyeball and skull base, orbital fracture, frontal hematoma, contusion, and pneumocephalus. Seventeen patients underwent emergency surgery, and six patients were initially managed conservatively. Neurosurgical management consisted of making bifrontal flaps, craniotomy/craniectomy, debridement, and repair of the base with fascia lata. Reconstruction of the orbital rim was required in three cases. All were managed postoperatively with cerebral decongestants and antibiotics in anti-meningitic dosages. There was one death in the postoperative period; outcome was good in 16 and moderate in four patients. Twelve patients had retained intracranial splinters; three of these developed recurrent suppurative meningitis. Of the six patients initially managed conservatively, three were subsequently operated for CSF rhinorrhea. Gross communition, dural loss, and injury to the frontal scalp often preclude the use of pericranial repair of the skull base. Fascia lata is extremely useful for reconstruction and repair. Anterior cranial fossa injury probably carries a better prognosis; however, there

  10. [Early stage of a cloverleaf skull malformation].

    PubMed

    Fischer, G; Hori, A; Ulbrich, R; Rath, W

    1982-12-01

    Cloverleaf skull anomaly was diagnosed sonographically and in the fetogram, together with concomitant chondrodystrophy. This resulted in an indication for intentional abortion in the 29th week. Consequently, this rare form of skull monstrosity could be examined pathologico-anatomically for the first time in a very early stage of foetal development. Contrary to the widely held opinion that the reason for such hideous malformation is a hydrocephalus internus due to a deformation of the skull base, we found a practically negligible hydrocephalus, although the cloverleaf skull had already developed in a very marked manner. Hence, this case contradicts the generally adopted formal pathogenetic interpretation of cloverleaf skull monstrosity. PMID:7178767

  11. Derivation of the mammalian skull vault

    PubMed Central

    MORRISS-KAY, GILLIAN M.

    2001-01-01

    This review describes the evolutionary history of the mammalian skull vault as a basis for understanding its complex structure. Current information on the developmental tissue origins of the skull vault bones (mesoderm and neural crest) is assessed for mammals and other tetrapods. This information is discussed in the context of evolutionary changes in the proportions of the skull vault bones at the sarcopterygian-tetrapod transition. The dual tissue origin of the skull vault is considered in relation to the molecular mechanisms underlying osteogenic cell proliferation and differentiation in the sutural growth centres and in the proportionate contributions of different sutures to skull growth. PMID:11523816

  12. Submental intubation in maxillofacial fracture: a case report

    PubMed Central

    2016-01-01

    It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text. PMID:27429940

  13. Biomaterials in skull base surgery

    PubMed Central

    Maier, Wolfgang

    2011-01-01

    Reconstruction materials and techniques for the base of the skull have undergone rapid developments and differentiation in recent years. While mostly autotransplants, collagens or resorbable alloplastic materials are preferred for duraplasties, pronounced organ-specific differences can be observed in the reconstruction of hard tissues. The use of polymethylmethacryl bone cement, once wide-spread, has decreased greatly due to the release of toxic monomers. Bony autotransplants are still used primarily for smaller skull-base defects, intraoperatively formable titanium nets may be also used for larger fronto- or laterobasal reconstructions of bony defects. Defects in visible areas are increasingly closed with preformed titanium or ceramic implants, which are planned and fitted to the individual patient using preoperative CT imaging. At the skull base, this applies especially to reconstructions of the frontal sinus. For extensive reconstructions of the orbita, titanium nets and non-resorbable plastics have proven valuable; in closing smaller defects especially of the orbital floor, resorbable implants based on Polyglactin 901 are also used. PMID:22073100

  14. Chondrosarcoma of the Skull Base

    PubMed Central

    Morimoto, Tadashi; Sasaki, Tomio; Takakura, Kintomo; Ishida, Tsuyoshi

    1992-01-01

    Five patients with chondrosarcoma, grade I or II, and one with mesenchymal chondrosarcoma of the skull base were treated at our clinic between 1967 and 1991. The patients were three men and three women who ranged in age from 21 to 39 years. The presenting symptoms were diplopia, decreased visual acuity, or symptoms of involvement of VIIIth and lower cranial nerves. The duration of the symptoms ranged from 18 months to 14 years. A plain skull x-ray and tomography of the skull, computed tomographic (CT) scans, and magnetic resonance images (MRI) revealed a calcified mass. Angiograms showed an occlusion of the arteries or venous sinuses, or both, in four patients, and a distinct tumor stain in one. The tumors were subtotally removed in all six cases. Two patients received postoperative irradiation for the residual tumor. In one patient, extraocular movement was compromised postoperatively, although in the other five patients there was no aggravation of the neurologic signs. Follow-up CT scans and MRI demonstrated no recurrent tumors nor any enlargement of residual tumors. Based on these findings, we advocate aggressive surgical removal of these tumors, which should be augmented by radiation therapy if the postoperative CT scans or MRI reveal residual tumors. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10 PMID:17170863

  15. Synthesis of Refractory Materials by Skull Melting Technique

    NASA Astrophysics Data System (ADS)

    Osiko, Vyacheslav V.; Borik, Mikhail A.; Lomonova, Elena E.

    This chapter discusses methods of growing refractory oxide single crystals and synthesis of refractory glasses by skull melting technique in a cold crucible. It shows the advantages of radiofrequency (RF) heating of dielectric materials in a cold crucible and points out some specific problems regarding the process of growing crystals by directional crystallization from the melt and by pulling on a seed from the melt. The distinctive features of the method of directional crystallization from the melt are discussed in detail on the example of technology of materials based on zirconia, i.e., cubic single crystals and partly stabilized single crystals. It is shown that the size and quality of crystals are functions of the process conditions, such as thermal conditions under crystallization, growth rate, and chemical composition. We provide an overview of research on the structure, phase composition, and physicochemical properties of crystals based on zirconia. The optical, mechanical, and electric properties of these crystals make them suitable for a number of technical and industrial applications in optics, electronics, materials processing, and medicine. In this chapter, we also consider some problems regarding the synthesis of refractory glasses by skull melting technique. The physicochemical and optical properties of glasses are given and their practical applications in technology are discussed. We note that one of the better developed and most promising applications of skull melting technique is the immobilization of liquid and solid waste (also radioactive waste) into solid-state materials by vitrification.

  16. Imaging of skull base: Pictorial essay

    PubMed Central

    Raut, Abhijit A; Naphade, Prashant S; Chawla, Ashish

    2012-01-01

    The skull base anatomy is complex. Numerous vital neurovascular structures pass through multiple channels and foramina located in the base skull. With the advent of computerized tomography (CT) and magnetic resonance imaging (MRI), accurate preoperative lesion localization and evaluation of its relationship with adjacent neurovascular structures is possible. It is imperative that the radiologist and skull base surgeons are familiar with this complex anatomy for localizing the skull base lesion, reaching appropriate differential diagnosis, and deciding the optimal surgical approach. CT and MRI are complementary to each other and are often used together for the demonstration of the full disease extent. This article focuses on the radiological anatomy of the skull base and discusses few of the common pathologies affecting the skull base. PMID:23833423

  17. Analysis of six Vietnamese trophy skulls.

    PubMed

    Sledzik, P S; Ousley, S

    1991-03-01

    This report presents morphologic, metric, and contextual information on six documented trophy skull specimens confiscated from U.S. servicemen during the Vietnam War. Additional information on the history and occurrence of trophy skull collecting is provided. This sample, consisting mostly of young Vietnamese males, exhibits graffiti, painting, and other evidence of postmortem decorative modification. Identification of trophy skulls is important to medicolegal and anthropological researchers in distinguishing trophy remains from archaeological and forensic specimens. PMID:2066727

  18. Aspergillus Osteomyelitis of the Skull.

    PubMed

    Nicholson, Simon; King, Richard; Chumas, Paul; Russell, John; Liddington, Mark

    2016-07-01

    Osteomyelitis of the craniofacial skeleton is rare, with fungal pathogens least commonly implicated. The authors present 2 patients of osteomyelitis of the skull caused by Aspergillus spp. and discuss the diagnosis, clinicopathological course, and management strategies.Late recurrence seen in this type of infection warrants long-term follow-up and a high index of suspicion for the clinical signs associated with recurrence.Such patients would benefit from their surgical debridement being planned and managed via a specialist craniofacial unit, so as to utilize the most aesthetically sensitive approach and the experience of specialists from several surgical disciplines. PMID:27391523

  19. Diagnosis of Depression in Adolescents Following Traumatic Fracture: A Retrospective Analysis

    PubMed Central

    Irvine, James N.; Madaan, Vishal

    2012-01-01

    Objective: To assess how frequently adolescents are clinically diagnosed with depression following hospitalization for traumatic fracture, with the assumption that a retrospective approach would yield lower rates of depression compared to those reported previously in prospective studies. We hypothesized that depression would be less common among adolescents whose injuries were primarily limited to fractures of the appendicular skeleton, vertebral column, and/or thoracic cage compared to those sustaining concomitant spinal cord and/or brain injuries and those suffering from facial/skull fractures. Method: A patient population of 1,121 adolescents, aged 12 to 19 years, who were hospitalized overnight at the University of Virginia (UVA) Health System, Charlottesville, for fractures between 2000 and 2009, was generated using the health system’s Clinical Data Repository. The number of these adolescents who received a new diagnosis of depression (per ICD-9 codes) at the UVA Health System within the first year following their injury was determined. Results: By the end of the first year, 37 of 913 adolescents (4.1%) who had at least 1 follow-up visit after their fracture were diagnosed with depression. When patients with a concomitant spinal cord injury and those with a facial/skull fracture with or without an associated brain injury were excluded, this percentage dropped to 3.2% and 1.1%, respectively. Conclusions: The results support our initial hypothesis that the percentage of adolescents diagnosed with depression following a traumatic fracture determined retrospectively would be lower than the percentages previously reported in related prospective studies. This finding adds to the growing concern that depression in youth is underdiagnosed, even among youth who have contact with health care providers. When compared to our own retrospectively determined data, the much higher rates of depression reported in several prospective studies indicate that more proactive

  20. High-speed documented experimental gunshot to a skull-brain model and radiologic virtual autopsy.

    PubMed

    Thali, Michael J; Kneubuehl, Beat P; Vock, Peter; Allmen, Gabriel v; Dirnhofer, Richard

    2002-09-01

    The authors documented and evaluated experimental gunshots to a skull-brain model with high-speed photography and subsequent radiographic examination for comparison of the morphologic findings in the model. The artificial skull was a polyurethane ball constructed in layers, with a porous diploe sandwiched between a tabula externa and a tabula interna. The brain itself was simulated with gelatin 10% at 4 degrees C, a material well known in wound ballistics. Gunshots were fired at the model from a distance of 10 m and documented with high-speed photography (up to 50 million frames/sec). Subsequently, a complete examination of the artificial skull was performed, including spiral computed tomography (with two-dimensional and three-dimensional reconstructions) and classic skull autopsy. The high-speed photographs clearly showed the dynamic development of the skull fracture system from an external perspective. The subsequent radiographic examination of the entire head volume created two-dimensional reformations in any plane and three-dimensional reconstructions of the gunshot injury of the polyurethane skull-brain model, especially the wound channel and the fracture system. Thanks to the model and high-speed photographs, the dynamic development of the morphology of a gunshot wound could be documented and studied. The data from computed tomography, using two-dimensional and three-dimensional postprocessing with a perspective view, were very similar to those from classic head autopsy, but derived in a hands-off and nondestructive manner. This examination method leads the way to radiographic digital autopsy or virtual autopsy. PMID:12198345

  1. The growth of the brain and skull in children.

    PubMed

    Mann, M D

    1984-04-01

    Published data for brain weight and head circumference in children were examined to determine whether there was evidence for development of brain size in 'spurts' rather than continuously. Graphical methods and various statistical analyses were used to detect significant deviations from a smooth progression in growth of the brain or skull. No convincing evidence for other than normal statistical sampling variations was found for either brain size or head circumference. It is premature to begin reorganization of school curriculae on the grounds that the brains of children grow in spurts. PMID:6722584

  2. Broadband acoustic properties of a murine skull

    NASA Astrophysics Data System (ADS)

    Estrada, Héctor; Rebling, Johannes; Turner, Jake; Razansky, Daniel

    2016-03-01

    It has been well recognized that the presence of a skull imposes harsh restrictions on the use of ultrasound and optoacoustic techniques in the study, treatment and modulation of the brain function. We propose a rigorous modeling and experimental methodology for estimating the insertion loss and the elastic constants of the skull over a wide range of frequencies and incidence angles. A point-source-like excitation of ultrawideband acoustic radiation was induced via the absorption of nanosecond duration laser pulses by a 20 μm diameter microsphere. The acoustic waves transmitted through the skull are recorded by a broadband, spherically focused ultrasound transducer. A coregistered pulse-echo ultrasound scan is subsequently performed to provide accurate skull geometry to be fed into an acoustic transmission model represented in an angular spectrum domain. The modeling predictions were validated by measurements taken from a glass cover-slip and ex vivo adult mouse skulls. The flexible semi-analytical formulation of the model allows for seamless extension to other transducer geometries and diverse experimental scenarios involving broadband acoustic transmission through locally flat solid structures. It is anticipated that accurate quantification and modeling of the skull transmission effects would ultimately allow for skull aberration correction in a broad variety of applications employing transcranial detection or transmission of high frequency ultrasound.

  3. Early medical skull surgery for treatment of post-traumatic osteomyelitis 5,000 years ago.

    PubMed

    Petrone, Pierpaolo; Niola, Massimo; Di Lorenzo, Pierpaolo; Paternoster, Mariano; Graziano, Vincenzo; Quaremba, Giuseppe; Buccelli, Claudio

    2015-01-01

    Here we describe the findings of a unique example of the early techniques adopted in neurosurgery around 5000 years ago, consisting in a double well healed skull trephination associated with a post-cranial traumatic event occurring intra vitam to a young male from the Early Chalcolithic cemetery of Pontecagnano (South Italy, ca. 4,900 - 4,500 cal BP). Morphological, X-ray and 3D-CT scan skull-cap evaluation revealed that the main orifice was produced by scraping, obtained by clockwise rotary motion of a right-handed surgeon facing the patient, while the partial trephination was carried out by using a stone point as a drilling tool. In both cases, bone regrowth is indicative of the individual's prolonged postoperative survival and his near-complete recovery. The right femur shows a poorly healed mid-shaft fracture presumably induced by a high energy injury, and a resulting chronic osteomyelitis, affecting both femurs by hematogenous spread of the infection. Our observations on the visual and radiological features of skull and femur lesions, along with evidence on the timing of experimental bone regrowth vs. healing of lower limb fractures associated to long-term bone infections now suggest that this young man underwent a double skull trephination in order to alleviate his extremely painful condition induced by chronic osteomyelitis, which is thought to have been the cause of death. PMID:26018014

  4. Early Medical Skull Surgery for Treatment of Post-Traumatic Osteomyelitis 5,000 Years Ago

    PubMed Central

    Petrone, Pierpaolo; Niola, Massimo; Di Lorenzo, Pierpaolo; Paternoster, Mariano; Graziano, Vincenzo; Quaremba, Giuseppe; Buccelli, Claudio

    2015-01-01

    Here we describe the findings of a unique example of the early techniques adopted in neurosurgery around 5000 years ago, consisting in a double well healed skull trephination associated with a post-cranial traumatic event occurring intra vitam to a young male from the Early Chalcolithic cemetery of Pontecagnano (South Italy, ca. 4,900 - 4,500 cal BP). Morphological, X-ray and 3D-CT scan skull-cap evaluation revealed that the main orifice was produced by scraping, obtained by clockwise rotary motion of a right-handed surgeon facing the patient, while the partial trephination was carried out by using a stone point as a drilling tool. In both cases, bone regrowth is indicative of the individual's prolonged postoperative survival and his near-complete recovery. The right femur shows a poorly healed mid-shaft fracture presumably induced by a high energy injury, and a resulting chronic osteomyelitis, affecting both femurs by hematogenous spread of the infection. Our observations on the visual and radiological features of skull and femur lesions, along with evidence on the timing of experimental bone regrowth vs. healing of lower limb fractures associated to long-term bone infections now suggest that this young man underwent a double skull trephination in order to alleviate his extremely painful condition induced by chronic osteomyelitis, which is thought to have been the cause of death. PMID:26018014

  5. The Genetics of Canine Skull Shape Variation

    PubMed Central

    Schoenebeck, Jeffrey J.; Ostrander, Elaine A.

    2013-01-01

    A dog’s craniofacial diversity is the result of continual human intervention in natural selection, a process that began tens of thousands of years ago. To date, we know little of the genetic underpinnings and developmental mechanisms that make dog skulls so morphologically plastic. In this Perspectives, we discuss the origins of dog skull shapes in terms of history and biology and highlight recent advances in understanding the genetics of canine skull shapes. Of particular interest are those molecular genetic changes that are associated with the development of distinct breeds. PMID:23396475

  6. Management of osteomyelitis of the skull base

    SciTech Connect

    Benecke, J.E. Jr. )

    1989-12-01

    Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol.

  7. Primary Intraosseous Cavernous Hemangioma in the Skull.

    PubMed

    Yang, Yi; Guan, Jian; Ma, Wenbin; Li, Yongning; Xing, Bing; Ren, Zuyuan; Su, Changbao; Wang, Renzhi

    2016-03-01

    Primary intraosseous cavernous hemangiomas (PICHs) are benign vascular tumors that may involve any part of the body. PICH occurs more frequently in the spine and less commonly in skull. The earliest description in the English literature was in 1845 by Toynbee, who reported a vascular tumor arising in the confines of the parietal bone. Skull PICHs do not always have typical radiologic features and should always be considered in the differential diagnosis of malignant skull lesions. We now reviewed and analyzed related literatures in detail with reporting a rare case of PICH in the left front bone that was surgically resected. PMID:26986133

  8. Primary Intraosseous Cavernous Hemangioma in the Skull

    PubMed Central

    Yang, Yi; Guan, Jian; Ma, Wenbin; Li, Yongning; Xing, Bing; Ren, Zuyuan; Su, Changbao; Wang, Renzhi

    2016-01-01

    Abstract Primary intraosseous cavernous hemangiomas (PICHs) are benign vascular tumors that may involve any part of the body. PICH occurs more frequently in the spine and less commonly in skull. The earliest description in the English literature was in 1845 by Toynbee, who reported a vascular tumor arising in the confines of the parietal bone. Skull PICHs do not always have typical radiologic features and should always be considered in the differential diagnosis of malignant skull lesions. We now reviewed and analyzed related literatures in detail with reporting a rare case of PICH in the left front bone that was surgically resected. PMID:26986133

  9. Management of osteomyelitis of the skull base.

    PubMed

    Benecke, J E

    1989-12-01

    Osteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4-year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate antipseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol. PMID:2601534

  10. 21 CFR 882.4030 - Skull plate anvil.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Skull plate anvil. 882.4030 Section 882.4030 Food... DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4030 Skull plate anvil. (a) Identification. A skull plate anvil is a device used to form alterable skull plates in the proper shape to...

  11. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Neurosurgical head holder (skull clamp). 882.4460... holder (skull clamp). (a) Identification. A neurosurgical head holder (skull clamp) is a device used to clamp the patient's skull to hold head and neck in a particular position during surgical procedures....

  12. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Neurosurgical head holder (skull clamp). 882.4460... holder (skull clamp). (a) Identification. A neurosurgical head holder (skull clamp) is a device used to clamp the patient's skull to hold head and neck in a particular position during surgical procedures....

  13. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Neurosurgical head holder (skull clamp). 882.4460... holder (skull clamp). (a) Identification. A neurosurgical head holder (skull clamp) is a device used to clamp the patient's skull to hold head and neck in a particular position during surgical procedures....

  14. 21 CFR 882.4030 - Skull plate anvil.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Skull plate anvil. 882.4030 Section 882.4030 Food... DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4030 Skull plate anvil. (a) Identification. A skull plate anvil is a device used to form alterable skull plates in the proper shape to...

  15. 21 CFR 882.4030 - Skull plate anvil.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Skull plate anvil. 882.4030 Section 882.4030 Food... DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4030 Skull plate anvil. (a) Identification. A skull plate anvil is a device used to form alterable skull plates in the proper shape to...

  16. 21 CFR 882.4030 - Skull plate anvil.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Skull plate anvil. 882.4030 Section 882.4030 Food... DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4030 Skull plate anvil. (a) Identification. A skull plate anvil is a device used to form alterable skull plates in the proper shape to...

  17. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Neurosurgical head holder (skull clamp). 882.4460... holder (skull clamp). (a) Identification. A neurosurgical head holder (skull clamp) is a device used to clamp the patient's skull to hold head and neck in a particular position during surgical procedures....

  18. 21 CFR 882.4030 - Skull plate anvil.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull plate anvil. 882.4030 Section 882.4030 Food... DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4030 Skull plate anvil. (a) Identification. A skull plate anvil is a device used to form alterable skull plates in the proper shape to...

  19. 21 CFR 882.4460 - Neurosurgical head holder (skull clamp).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neurosurgical head holder (skull clamp). 882.4460... holder (skull clamp). (a) Identification. A neurosurgical head holder (skull clamp) is a device used to clamp the patient's skull to hold head and neck in a particular position during surgical procedures....

  20. The Skull of Phyllomedusa sauvagii (Anura, Hylidae).

    PubMed

    Ruiz-Monachesi, Mario R; Lavilla, Esteban O; Montero, Ricardo

    2016-05-01

    The hylid genus Phyllomedusa comprises charismatic frogs commonly known as monkey, leaf or green frogs, and is the most diverse genus of the subfamily Phyllomedusinae, including about 31 species. Although there is some information about the anatomy of these frogs, little is known about the osteology. Here the adult skull of Phyllomedusa sauvagii, both articulated and disarticulated, is described and the intraspecific variation is reported. Additionally, cartilage associated with the adult skull, such as the nasal capsules, auditory apparatus, and hyobranchial apparatus, are included in the analysis. Further examination of disarticulated bones reveals their remarkable complexity, specifically in the sphenethmoid and of the oocipital region. The description of disarticulated bones is useful for the identification of fossil remains as well as providing morphological characteristics that are phylogenetically informative. When comparing the skull morphology with the available information of other species of the genus, Phyllomesusa sauvagii skull resembles more that of P. vaillantii and P. venusta than P. atelopoides. PMID:26916578

  1. Skull melting of fluorophosphate glass results

    SciTech Connect

    Wenckus, J.F.

    1982-06-07

    The results are presented of the third fluorophosphate glass skull-melting experiment which was carried out on July 30th. Details of the experimental procedures used were described in the report dated March 10, 1981.

  2. Unilateral compressive optic neuropathy due to skull hyperostosis secondary to nutritional vitamin A deficiency

    PubMed Central

    Zayed, Mohammed G.; Hickman, Simon J.; Batty, Ruth; McCloskey, Eugene V.; Pepper, Irene M.

    2015-01-01

    Summary We report a 17-year-old boy who presented with a chronic left unilateral optic neuropathy. Computerized tomography and magnetic resonance imaging demonstrated compression of the left optic nerve due to skull hyperostosis. He was found to be profoundly vitamin A deficient secondary to an unusual diet consisting predominantly of potato chips and crisps. Skull hyperostosis with cranial neuropathies and other neurological abnormalities has been described in growing animals fed vitamin A deficient diets but has not been previously reported in humans. PMID:26136803

  3. Unilateral compressive optic neuropathy due to skull hyperostosis secondary to nutritional vitamin A deficiency.

    PubMed

    Zayed, Mohammed G; Hickman, Simon J; Batty, Ruth; McCloskey, Eugene V; Pepper, Irene M

    2015-01-01

    We report a 17-year-old boy who presented with a chronic left unilateral optic neuropathy. Computerized tomography and magnetic resonance imaging demonstrated compression of the left optic nerve due to skull hyperostosis. He was found to be profoundly vitamin A deficient secondary to an unusual diet consisting predominantly of potato chips and crisps. Skull hyperostosis with cranial neuropathies and other neurological abnormalities has been described in growing animals fed vitamin A deficient diets but has not been previously reported in humans. PMID:26136803

  4. Conductivities of three-layer human skull

    NASA Astrophysics Data System (ADS)

    Akhtari, Massoud

    Electrical conductivities of compact, spongiosum, and bulk layers of the cadaver, live, and dead (corpse) human skull were determined at a number of frequencies and electric fields at room temperature using the four-electrode method. Current was applied and withdrawn over the top and bottom surfaces of each sample and potential drop across different layers was measured. A model that considers variations in skull thicknesses is used to determine the conductivity of the tri-layer skull and its individual anatomical structures. The results indicate that the conductivities of the spongiform (cadaver ˜ 5.4--11.5, live skull ˜ 16.2--41.1, dead ˜ 39.7--99.3 milliS/m), the top compact (cadaver ˜ 0.8--1.8, live ˜ 5.4--7.2, dead ˜ 5.4--12.3 milliS/m) and lower compact (cadaver ˜ 2.8--5.1, live ˜ 2.8--10.2, dead ˜ 5.2--19.3 milliS/m) layers of the skull have significantly different and inhomogeneous conductivities. The conductivities of the skull layers are frequency dependent in the 10--90 Hz region and are non-ohmic in the 0.45--2.07 A/m2 region.

  5. Intracranial pressure and skull remodeling

    PubMed Central

    McCulley, Timothy J.; Jordan Piluek, W.; Chang, Jessica

    2014-01-01

    In this article we review bony changes resulting from alterations in intracranial pressure (ICP) and the implications for ophthalmologists and the patients for whom we care. Before addressing ophthalmic implications, we will begin with a brief overview of bone remodeling. Bony changes seen with chronic intracranial hypotension and hypertension will be discussed. The primary objective of this review was to bring attention to bony changes seen with chronic intracranial hypotension. Intracranial hypotension skull remodeling can result in enophthalmos. In advanced disease enophthalmos develops to a degree that is truly disfiguring. The most common finding for which subjects are referred is ocular surface disease, related to loss of contact between the eyelids and the cornea. Other abnormalities seen include abnormal ocular motility and optic atrophy. Recognition of such changes is important to allow for diagnosis and treatment prior to advanced clinical deterioration. Routine radiographic assessment of bony changes may allow for the identification of patient with abnormal ICP prior to the development of clinically significant disease. PMID:25859141

  6. First nimravid skull from Asia.

    PubMed

    Averianov, Alexander; Obraztsova, Ekaterina; Danilov, Igor; Skutschas, Pavel; Jin, Jianhua

    2016-01-01

    Maofelis cantonensis gen. and sp. nov. is described based on a complete cranium from the middle-upper Eocene Youganwo Formation of Maoming Basin, Guangdong Province, China. The new taxon has characters diagnostic for Nimravidae such as a short cat-like skull, short palate, ventral surface of petrosal dorsal to that of basioccipital, serrations on the distal carina of canine, reduced anterior premolars, and absence of posterior molars (M2-3). It is plesiomorphic nimravid taxon similar to Nimravidae indet. from Quercy (France) in having the glenoid pedicle and mastoid process without ventral projections, a planar basicranium in which the lateral rim is not ventrally buttressed, and P1 present. The upper canine is less flattened than in other Nimravidae. Maofelis cantonensis gen. and sp. nov. exemplifies the earliest stage of development of sabertooth specialization characteristic of Nimravidae. This taxon, together with other middle-late Eocene nimravid records in South Asia, suggests origin and initial diversification of Nimravidae in Asia. We propose that this group dispersed to North America in the late Eocene and to Europe in the early Oligocene. The subsequent Oligocene diversification of Nimravidae took place in North America and Europe, while in Asia this group declined in the Oligocene, likely because of the earlier development of open habitats on that continent. PMID:27161785

  7. First nimravid skull from Asia

    PubMed Central

    Averianov, Alexander; Obraztsova, Ekaterina; Danilov, Igor; Skutschas, Pavel; Jin, Jianhua

    2016-01-01

    Maofelis cantonensis gen. and sp. nov. is described based on a complete cranium from the middle-upper Eocene Youganwo Formation of Maoming Basin, Guangdong Province, China. The new taxon has characters diagnostic for Nimravidae such as a short cat-like skull, short palate, ventral surface of petrosal dorsal to that of basioccipital, serrations on the distal carina of canine, reduced anterior premolars, and absence of posterior molars (M2-3). It is plesiomorphic nimravid taxon similar to Nimravidae indet. from Quercy (France) in having the glenoid pedicle and mastoid process without ventral projections, a planar basicranium in which the lateral rim is not ventrally buttressed, and P1 present. The upper canine is less flattened than in other Nimravidae. Maofelis cantonensis gen. and sp. nov. exemplifies the earliest stage of development of sabertooth specialization characteristic of Nimravidae. This taxon, together with other middle-late Eocene nimravid records in South Asia, suggests origin and initial diversification of Nimravidae in Asia. We propose that this group dispersed to North America in the late Eocene and to Europe in the early Oligocene. The subsequent Oligocene diversification of Nimravidae took place in North America and Europe, while in Asia this group declined in the Oligocene, likely because of the earlier development of open habitats on that continent. PMID:27161785

  8. Nose fracture

    MedlinePlus

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It ... with other fractures of the face. Sometimes a blunt injury can ...

  9. Epidemiology of fragility fractures.

    PubMed

    Friedman, Susan M; Mendelson, Daniel Ari

    2014-05-01

    As the world population of older adults-in particular those over age 85-increases, the incidence of fragility fractures will also increase. It is predicted that the worldwide incidence of hip fractures will grow to 6.3 million yearly by 2050. Fractures result in significant financial and personal costs. Older adults who sustain fractures are at risk for functional decline and mortality, both as a function of fractures and their complications and of the frailty of the patients who sustain fractures. Identifying individuals at high risk provides an opportunity for both primary and secondary prevention. PMID:24721358

  10. Endoscopic skull base training using 3D printed models with pre-existing pathology.

    PubMed

    Narayanan, Vairavan; Narayanan, Prepageran; Rajagopalan, Raman; Karuppiah, Ravindran; Rahman, Zainal Ariff Abdul; Wormald, Peter-John; Van Hasselt, Charles Andrew; Waran, Vicknes

    2015-03-01

    Endoscopic base of skull surgery has been growing in acceptance in the recent past due to improvements in visualisation and micro instrumentation as well as the surgical maturing of early endoscopic skull base practitioners. Unfortunately, these demanding procedures have a steep learning curve. A physical simulation that is able to reproduce the complex anatomy of the anterior skull base provides very useful means of learning the necessary skills in a safe and effective environment. This paper aims to assess the ease of learning endoscopic skull base exposure and drilling techniques using an anatomically accurate physical model with a pre-existing pathology (i.e., basilar invagination) created from actual patient data. Five models of a patient with platy-basia and basilar invagination were created from the original MRI and CT imaging data of a patient. The models were used as part of a training workshop for ENT surgeons with varying degrees of experience in endoscopic base of skull surgery, from trainees to experienced consultants. The surgeons were given a list of key steps to achieve in exposing and drilling the skull base using the simulation model. They were then asked to list the level of difficulty of learning these steps using the model. The participants found the models suitable for learning registration, navigation and skull base drilling techniques. All participants also found the deep structures to be accurately represented spatially as confirmed by the navigation system. These models allow structured simulation to be conducted in a workshop environment where surgeons and trainees can practice to perform complex procedures in a controlled fashion under the supervision of experts. PMID:25294050

  11. Cavernomas of the skull: review of the literature 1975-2000.

    PubMed

    Heckl, Stefan; Aschoff, Alfred; Kunze, Stefan

    2002-03-01

    We describe four patients with intraosseous cavernous hemangiomas of the skull which were localized supraorbitally, parietally (two cases), and occipitally. The diameter ranged from 15 mm to 25 mm. They presented with slowly growing mass, tender to pressure, with spontaneous pain, and with freely mobile skin above the cavernoma sites. Magnetic resonance imaging (hyperintensity on T2 and isointensity with brain on T1) and CT (osteolytic lesion with erosion of the tabula externa) confirmed the plain skull films showing the honeycomb or sunburst appearance pattern. Resections and postoperative course were uneventful. In three of these cases there was coexistence with tumors (meningeoma, malignant lymphoma, and malignant melanoma); none of these constellations has been described before. Generally, cavernous hemangiomas of the skull are rare. There is one extensive review published by Barnes in 1984 regarding a period of 136 years with 123 intraosseous hemangiomas of the skull and 74 of the jaws. Unfortunately, the histological confirmation is not completely clear and some capillary hemangiomas are included. In a review of the literature since 1975, we found 103 histologically proven intraosseous cavernous hemangiomas of the skull (with our four cases included) and 22 of the jaws, which are shown in an overview with respect to their localization. The most frequent site was frontal, followed by temporal. PMID:11954766

  12. Emergency skull radiography: the effect of restrictive criteria on skull radiography and CT use

    SciTech Connect

    Baker, S.R.; Gaylord, G.M.; Lantos, G.; Tabaddor, K.; Gallagher, E.J.

    1985-08-01

    A prospective study was performed to determine the effect of restrictive criteria on the use of emergency skull radiography and computed tomography (CT) of the head. Emergency skull radiography required the completion of a special requisition form. Emergency CT of the head was done at the request of senior consultants and was available on a full-time basis. Over 1 year, 2758 skull studies were performed, a decrease of 39.1% when compared with the year before restrictive criteria were instituted, during which 4587 skull examinations were done. In the same period, the number of emergency CT scans of the head increased by 45.7%, from 471 in the control year to 686 in the experimental year. With the use of restrictive criteria, a net savings of $164,000 was achieved. Our results suggest that the use of restrictive criteria is a cost-effective means of limiting skull radiography when CT of the head is readily available.

  13. Functional Relationship between Skull Form and Feeding Mechanics in Sphenodon, and Implications for Diapsid Skull Development

    PubMed Central

    Curtis, Neil; Jones, Marc E. H.; Shi, Junfen; O'Higgins, Paul; Evans, Susan E.; Fagan, Michael J.

    2011-01-01

    The vertebrate skull evolved to protect the brain and sense organs, but with the appearance of jaws and associated forces there was a remarkable structural diversification. This suggests that the evolution of skull form may be linked to these forces, but an important area of debate is whether bone in the skull is minimised with respect to these forces, or whether skulls are mechanically “over-designed” and constrained by phylogeny and development. Mechanical analysis of diapsid reptile skulls could shed light on this longstanding debate. Compared to those of mammals, the skulls of many extant and extinct diapsids comprise an open framework of fenestrae (window-like openings) separated by bony struts (e.g., lizards, tuatara, dinosaurs and crocodiles), a cranial form thought to be strongly linked to feeding forces. We investigated this link by utilising the powerful engineering approach of multibody dynamics analysis to predict the physiological forces acting on the skull of the diapsid reptile Sphenodon. We then ran a series of structural finite element analyses to assess the correlation between bone strain and skull form. With comprehensive loading we found that the distribution of peak von Mises strains was particularly uniform throughout the skull, although specific regions were dominated by tensile strains while others were dominated by compressive strains. Our analyses suggest that the frame-like skulls of diapsid reptiles are probably optimally formed (mechanically ideal: sufficient strength with the minimal amount of bone) with respect to functional forces; they are efficient in terms of having minimal bone volume, minimal weight, and also minimal energy demands in maintenance. PMID:22216358

  14. Posttraumatic skull films: who needs them

    SciTech Connect

    Freed, H.A.

    1986-03-01

    An effort has been under way for years to make the ordering of skull films in trauma more medically rational. Because the vast majority of skull films have no significant impact on patient management, effort had centered on increasing the yield by limiting radiographs to those who have one or more ''high-yield criteria.'' The publically promulgated high-yield criteria, however, were insufficiently sensitive to pick up some rare occult injuries. Emphasis recently has shifted to low-yield findings (scalp laceration, scalp hematoma, dizziness, headache, and asymptomatic). Although by common practice the presence of one or more of these low-yield findings often results in a skull film, omitting them appears to be extremely safe provided that the patient has no other clinically suspicious findings. Additionally, skull films are no longer the procedure of choice in patients with a neurosurgical emergency. A patient management strategy reflecting recent research is soon to be released with the FDA Skull Panel's final report.

  15. Analysis of 429 fractures in 189 battered children.

    PubMed

    King, J; Diefendorf, D; Apthorp, J; Negrete, V F; Carlson, M

    1988-01-01

    To assess empirically the radiologic appearance of fractures among victims of child abuse, the charts and radiographs of 189 battered children exhibiting fractures (n = 429 total fractures) were studied. Approximately one-half of the patients had a single fracture. Bones most commonly fractured were the humerus, femur, and tibia; transverse fractures were the most common type. Of long bone fractures, the middle third (50%) and distal third (41%) locations were most prominent. Age, race, and gender were not associated with any particular long bone fracture type. Skull fractures were the only type more likely to be present in children aged less than 1 year than in older children (p less than 0.05, one-tailed). In the past, emphasis has been placed on corner fractures, fractures at different stages of healing, and injuries at several sites. Our results suggest that fresh single diaphyseal fractures are more common. PMID:3170740

  16. Nose fracture

    MedlinePlus

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It usually occurs after an injury and often occurs with ...

  17. [Injury by skull osteolytic secundary syphilis].

    PubMed

    Alessandro, Lucas; Camporro, Julieta Piar; Arakaki, Naomi; Orellana, Nora; Mora, Claudia Andrea

    2016-04-01

    Bone involvement of syphilis can be observed in tertiary and congenital syphilis. It is infrequent during the secondary stage. The skull is the most affected bone in secondary syphilis, and its most frequent form of presentation is proliferative osteitis. If the skull is affected, headache is usual and can be as intense as in meningitis. Osteolyitic lesions may be seen in complimentary imaging studies, with a moth eaten aspect. These lesions raise concern over a number of differential diagnoses, among which are infectious, inflammatory and neoplastic diseases. The definitive diagnosis is made by bone biopsy of the compromised bone. Molecular techniques in the affected tissues increases diagnostic performance. There is no standardized treatment protocol for syphilis since there are no guidelines available. We report a case of a 19 year old female, presenting with a unique osteolytic lesion in the skull due to secondary syphilis. PMID:27315003

  18. [Fibrous dysplasia of the skull. Radiologic diagnosis].

    PubMed

    Amato, C; Moschini, M; Colavita, N; Tagliaferri, G

    1993-09-01

    The authors examined 11 patients with fibrous dysplasia of the skull pointing out its radiologic features and preferential sites. Conventional radiology, CT and MR imaging were used. As for conventional radiology, tangential scans which of great value to depict the most typical morphologic patterns. Lesions of the skull base were most frequent in the sphenoid (7 of 11 cases), where 5 of 7 exhibited a sclerotic pattern. Bone changes in the skull vault were: mixed (3 cases), pagetoid (2 cases), "ground glass" (1 case) and lytic (1 case): none of these cases was of the sclerotic type. A typical feature of vault lesions was the widening of diploic space associated with expansion of the outer bone and integrity of the inner bone. Radiologic findings, often associated with suggestive clinical manifestations, always allowed a diagnostic hypothesis; histopathologic confirmation was needed only in a few cases (4 of 11 patients). PMID:8210526

  19. Waterflood-induced fractures

    SciTech Connect

    Dikken, B.J.; Niko, H.

    1987-01-01

    Fracturing occurs quite often in water injection wells, with sometimes unforeseen consequences on waterflood sweep efficiency. One of the causes of fracturing is often the cooling of hot formations by cold injection water. A special version of a thermal reservoir simulator for prototype applications has thus been constructed that is capable of dealing with propagating waterflood-induces hydraulic fractures. With this simulator, fracture propagation and the effect of growing fractures on the sweep efficiency are studied. Infinite fracture conductivity is assumed. The limitation to a very high leak-off fractures justifies disregarding the changes in fracture volume. Fracture growth is calculated using the concept of a critical stress intensity factor. Both poro- and thermo-elastic changes in the horizontal stresses are calculated numerically and their influence on the fracture initiation/propagation is continuously taken into account. In addition, a model of fracture wall impairment because of filter-cake build-up due to poor quality injection water is included. Results are presented for both thermal and isothermal situations. It is observed in isothermal cases that the voidage replacement ratio (volume balance during injection) determined to a great extent the length to which the fracture eventually may grow.

  20. Pathologic aspects of skull base tumors.

    PubMed

    Marszałek, Andrzej; Szylberg, Łukasz; Wiśniewski, Sławomir

    2016-01-01

    Skull base tumors form a highly heterogeneous group. As there are several structures in this anatomical site, a large number of different primary malignancies might develop, as well as a variety of secondary (metastatic) tumors. In this article, the most common malignancies are presented, along with a short histopathologic description. For some entities, an immunohistochemical profile is also given that should be helpful in proper diagnosis. As many pathologic diagnoses nowadays also include genetic studies, the most common genetic abnormalities in skull base tumors are presented. PMID:27330415

  1. Osteoporotic skull lesions in moose at Isle Royale National Park.

    PubMed

    Hindelang, M; Peterson, R O

    1996-01-01

    Osteoporotic lesions were evaluated in the skulls of moose (Alces alces) collected in Isle Royale National Park, Michigan (USA), from 1958 to 1994. Circular lesions which penetrated the outer table of the skull were distributed over the frontal and nasal bones asymmetrically in both sexes. About 32% of skulls recovered had some porotic lesions with slightly greater prevalence among males. PMID:8627919

  2. 21 CFR 882.5960 - Skull tongs for traction.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Skull tongs for traction. 882.5960 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5960 Skull tongs for traction. (a) Identification. Skull tongs for traction is an instrument used to immobilize a patient with...

  3. 21 CFR 882.5960 - Skull tongs for traction.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Skull tongs for traction. 882.5960 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5960 Skull tongs for traction. (a) Identification. Skull tongs for traction is an instrument used to immobilize a patient with...

  4. 21 CFR 882.5960 - Skull tongs for traction.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Skull tongs for traction. 882.5960 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5960 Skull tongs for traction. (a) Identification. Skull tongs for traction is an instrument used to immobilize a patient with...

  5. 21 CFR 882.5960 - Skull tongs for traction.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Skull tongs for traction. 882.5960 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5960 Skull tongs for traction. (a) Identification. Skull tongs for traction is an instrument used to immobilize a patient with...

  6. 21 CFR 882.5960 - Skull tongs for traction.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Skull tongs for traction. 882.5960 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5960 Skull tongs for traction. (a) Identification. Skull tongs for traction is an instrument used to immobilize a patient with...

  7. Biophotonics: Through-skull brain imaging

    NASA Astrophysics Data System (ADS)

    Madsen, Steen J.

    2014-09-01

    The use of carbon nanotubes makes it possible to perform fluorescent imaging of cerebral vasculature of mice through their intact skulls. The high spatial and temporal resolution of the non-invasive technique may prove useful for studies of stroke and other brain disorders.

  8. Skull Base Tumors: A Kaleidoscope of Challenge

    PubMed Central

    Khanna, J.N.; Natrajan, Srivalli; Galinde, Jyotsna

    2014-01-01

    Resection of skull base lesions has always been riddled with problems like inadequate access, proximity to major vessels, dural tears, cranial nerve damage, and infection. Understanding the modular concept of the facial skeleton has led to the development of transfacial swing osteotomies that facilitates resection in a difficult area with minimal morbidity and excellent cosmetic results. In spite of the current trend toward endonasal endoscopic management of skull base tumors, our series presents nine cases of diverse extensive skull base lesions, 33% of which were recurrent. These cases were approached through different transfacial swing osteotomies through the mandible, a midfacial swing, or a zygomaticotemporal osteotomy as dictated by the three-dimensional spatial location of the lesion, and its extent and proximity to vital structures. Access osteotomies ensured complete removal and good results through the most direct and safe route and good vascular control. This reiterated the fact that transfacial approaches still hold a special place in the management of extensive skull base lesions. PMID:25083368

  9. Surgical Resectability of Skull Base Meningiomas.

    PubMed

    Goto, Takeo; Ohata, Kenji

    2016-07-15

    With recent advances in surgical technology such as preoperative imaging, neuro-monitoring, and surgical instruments, the surgical resectability of intracranial meningiomas has increased over the last two decades. This study reviewed clinical articles regarding the surgical treatment of meningiomas to clarify the role of surgical excision, with a focus on skull base meningiomas. We sub-classified clinical articles about skull base meningiomas into two categories (anterior and middle fossa meningiomas; and posterior fossa meningiomas) and reviewed papers in each category. In cases with anterior and middle fossa meningiomas, surgical resectability has reached a sufficient level to maximize functional preservation. In cases of posterior fossa meningioma, however, surgical respectability remains insufficient even with full use of recent surgical modalities. Continuous refining of operative procedures is required to obtain more satisfactory outcomes, especially for posterior fossa meningioma. In addition, recent long-term outcomes of stereotactic radiosurgery (SRS) were acceptable for controlling the skull base meningiomas. Therefore, combination with surgical excision and SRS should be considered in complicated skull base meningiomas. PMID:27076382

  10. Forensic and anthropological analysis of human skulls

    NASA Astrophysics Data System (ADS)

    Kinzl, Hans-Peter; Schreiber, Holger

    1990-11-01

    In biology and medicine there are many problems concrninq in vestigations of the human skeleton Beside the long bones the skull is the most important part of the skeleton for m.surement and iden tifiction The fc:e part9 the brain part and the mandibular part of the skul I are qenetical ly determined sectors with high percritage of individual characteristics

  11. Orbital emphysema following remote skull trauma.

    PubMed

    Brown, S M; Lissner, G

    1995-06-01

    In an unusual case of orbital emphysema following nose blowing, a reliable patient history and examination demonstrated no direct trauma to the orbit. Blunt posterior skull trauma was sustained several hours before the development of the orbital emphysema. A "seismic" transmittal of force to the orbital walls is postulated. PMID:7654620

  12. Porotic hyperostosis and the Gelligaer skull

    PubMed Central

    Cule, John; Evans, I. Lynn

    1968-01-01

    The differential diagnosis of the bony lesions known as porotic hyperostosis found on a Bronze Age child's skull is discussed. Keith and Shattock gave an opinion in 1923 that the cause was rickets. A firm conclusion is not reached in this paper, but it is suggested that it was more likely to have been an iron-deficiency anaemia. Images PMID:5717547

  13. Surgical Resectability of Skull Base Meningiomas

    PubMed Central

    GOTO, Takeo; OHATA, Kenji

    2016-01-01

    With recent advances in surgical technology such as preoperative imaging, neuro-monitoring, and surgical instruments, the surgical resectability of intracranial meningiomas has increased over the last two decades. This study reviewed clinical articles regarding the surgical treatment of meningiomas to clarify the role of surgical excision, with a focus on skull base meningiomas. We sub-classified clinical articles about skull base meningiomas into two categories (anterior and middle fossa meningiomas; and posterior fossa meningiomas) and reviewed papers in each category. In cases with anterior and middle fossa meningiomas, surgical resectability has reached a sufficient level to maximize functional preservation. In cases of posterior fossa meningioma, however, surgical respectability remains insufficient even with full use of recent surgical modalities. Continuous refining of operative procedures is required to obtain more satisfactory outcomes, especially for posterior fossa meningioma. In addition, recent long-term outcomes of stereotactic radiosurgery (SRS) were acceptable for controlling the skull base meningiomas. Therefore, combination with surgical excision and SRS should be considered in complicated skull base meningiomas. PMID:27076382

  14. Functional structure of the skull in hominoidea.

    PubMed

    Preuschoft, H; Witzel, U

    2004-01-01

    Finite elements stress analysis (FESA) was used to investigate the flow of compressive forces which occur if a homogenous, three-dimensional body representing the skull is loaded by simulated bite forces against the tooth row. Model 1 represents the snout alone. Bite forces are applied simultaneously, but increase rearward. Stresses in the model concentrate along the anterior contour and the lower surface of the model, leaving unstressed a nasal opening and a wide naso-oral connection. Model 2 represents the facial region, as far as the temporomandibular joint. The orbits and the nasal cavity are assumed to be present a priori. Model 3 applies reactions to the bite forces in the temporal fossa, corresponding to the origins of the masticatory muscles. Regions of the model under compressive stress correspond closely to the arrangement of bony material in a hominoid skull. If only the stress-bearing finite elements on each section are combined, and the stress-free parts neglected, the resulting three-dimensional shape is surprisingly similar to a hominoid skull. If bite forces are applied to parts of the tooth row only, the stress patterns are lower, asymmetrical and do not spread into all regions that are stress-bearing in simultaneous biting on all teeth. In model 2, the highest stresses occur at the tooth roots and along the forehead on top of the nasal roof. There are no marked stress concentrations on top of the orbits. The resulting shape resembles that of an orang-utan. In model 3, the highest stresses also occur at the tooth roots, but the circles of force mostly close below the brain case, so that the stress concentration in the forehead region remains much less marked. In this model, however, the stress concentrations are very similar to hollow brow ridges. The entire resulting shape resembles that of gorilla or chimpanzee skulls. A typical gracile australopithecine skull (STS-5) also shows clear similarities to the patterns of stress flow in our models

  15. Biomechanical analysis of biphasic distribution of skull injury in falls from height.

    PubMed

    Park, Sungji; Cha, Jang Gyu; Lee, Youngseok; Seo, Insoo; Lee, Bongwoo; Choi, Youngshik; Choi, Woongchul; Yang, Kyungmoo

    2015-10-01

    Fall from height is one of the most common ways of suicide in Korea. Skull fractures are typically accompanied with these cases, but several autopsy cases show absence of skull fracture even with serious body injuries including sternal and vertebral fracture. The mechanism of this pattern of injury can be explained by impact of facial part on chest or abdomen when the back of the body touches the ground first. We tried to figure out the relevance of this pattern of injury to the height of fall using a computer simulation tool (MADYMO 7.5). For this experiment, a condition of initial pose was limited to leaning forward. The simulation showed that when the body rotated forward, the body parts which got injured by the ground depended on the height of fall. For relatively lower height, head got injured, but as the height was set higher, the point of first impact area changed to the back, hip and then legs. When the body struck first around hip area on supine position, the impact made forceful flexion of lumbar, thoracic and cervical vertebrae, leading to folding the body in two, which resulted in collision between the part of face and the anterior part of body. Through the current investigation, it was explained that the biphasic distribution of the number of head injury cases versus the height distribution was attributed to the forward rotation of the body during the fall. PMID:26159255

  16. Osteoradionecrosis of the maxilla and skull base

    SciTech Connect

    Komisar, A.; Silver, C.; Kalnicki, S.

    1985-01-01

    Osteoradionecrosis of the maxilla and base of skull are rare phenomena, usually seen after combined therapy for malignancies of the maxillary sinus. While the mandible is most commonly affected by osteoradionecrosis, the maxilla and skull base may also be affected when preoperative or postoperative radiotherapy is combined with surgery. Contributing factors may be: high radiation dosage delivered to the treatment volume (greater than 6000 rads), loss of tissue protective effects due to surgery, decreased vascularity caused by surgery and radiation, and proximity of a contaminated field. Onset of symptoms may vary. One patient presented 25 years after postoperative radiotherapy. Major symptoms were pain, trismus, and purulent discharge. The best diagnostic modality remains the history and physical exam, as the area is readily accessible. CT scans may be helpful in diagnosis and treatment planning. Therapy should follow time honored principles of local wound care. Home irrigations and hyperbaric therapy have been helpful in encouraging early sequestration and rapid healing.

  17. Skull metastasis from rectal gastrointestinal stromal tumours.

    PubMed

    Gil-Arnaiz, Irene; Martínez-Trufero, Javier; Pazo-Cid, Roberto Antonio; Felipo, Francesc; Lecumberri, María José; Calderero, Verónica

    2009-09-01

    Gastrointestinal stromal tumours (GIST) are the most common mesenchymal neoplasm of the gastrointestinal tract. Rectum localisation is infrequent for these neoplasms, accounting for about 5% of all cases. Distant metastases of GIST are also rare. We present a patient with special features: the tumour is localised in rectum and it has an uncommon metastatic site, the skull, implying a complex differential diagnosis approach. PMID:19776004

  18. [Orbitozygomatic approaches to the skull base].

    PubMed

    Cherekaev, V A; Gol'bin, D A; Belov, A I; Radchenkov, N S; Lasunin, N V; Vinokurov, A G

    2015-01-01

    The paper is written in the lecture format and dedicated to one of the main basal approaches, the orbitozygomatic approach, that has been widely used by neurosurgeons for several decades. The authors describe the historical background of the approach development and the surgical technique features and also analyze the published data about application of the orbitozygomatic approach in surgery for skull base tumors and cerebral aneurysms. PMID:26529627

  19. Neurological susceptibility to a skull defect

    PubMed Central

    Honeybul, Stephen

    2014-01-01

    Background: There continues to be considerable interest in the use of decompressive craniectomy in the management of neurological emergencies. The procedure is technically straightforward; however, it is becoming increasingly apparent that it is associated with significant complications. One complication that has received relatively little attention is the neurological dysfunction that can occur due to the absence of the bone flap and the subsequent distortion of the brain under the scalp as cerebral swelling subsides. The aim of this narrative review was to examine the literature available regarding the clinical features described, outline the proposed pathophysiology for these clinical manifestations and highlight the implications that this may have for rehabilitation of patients with a large skull defect. Methods: A literature search was performed in the MEDLINE database (1966 to June 2012). The following keywords were used: Hemicraniectomy, decompressive craniectomy, complications, syndrome of the trephined, syndrome of the sinking scalp flap, motor trephined syndrome. The bibliographies of retrieved reports were searched for additional references. Results: Various terms have been used to describe the different neurological signs and symptoms with which patients with a skull defect can present. These include; syndrome of the trephined, posttraumatic syndrome, syndrome of the sinking scalp flap, and motor trephined syndrome. There is, however, considerable overlap between the conditions described and a patient's individual clinical presentation. Conclusion: It is becoming increasingly apparent that certain patients are particularly susceptible to the presence of a large skull defect. The term “Neurological Susceptibility to a Skull Defect” (NSSD) is therefore suggested as a blanket term to describe any neurological change attributable to the absence of cranial coverage. PMID:25024883

  20. Influence of head mass on temporo-parietal skull impact using finite element modeling.

    PubMed

    Sahoo, Debasis; Deck, Caroline; Yoganandan, Narayan; Willinger, Rémy

    2015-09-01

    The effect of head mass on its biomechanical response during lateral impact to the head is investigated in this computational study. The mass of the head of a state-of-the-art validated finite element head model is altered by ± 10 % from the base value of 4.7 kg. Numerical simulations of lateral head impacts for 30 cases (representing 15 human cadaver experiments × 2 mass configurations) are performed using the LS-DYNA solver at different velocities ranging from 2.4 to 6.5 m/s and three impacting conditions representing different stiffness and shapes of the contact/impact surfaces. Results are compared with the original model using the baseline head mass, thus resulting in a total of 45 simulations. Present findings show that the head mass has greater influence for peak interaction forces and the force has a greater dependency on stiffness of contact surface than the shape. Mass variations have also influence on skull strain energy. Regardless of increase/decrease in skull strain energy influenced by head mass variations used in the computational study, the 50 % fracture tolerance limit was unaltered, which was 544 mJ. The present study gives a better understanding of the mechanism of temporo-parietal skull impact. PMID:25863692

  1. [Modern skull base surgery from the perspective of neurosurgeons].

    PubMed

    Spetzger, U

    2011-04-01

    At present, modern skull base surgery is a highly sophisticated interdisciplinary collaboration of various diagnostic and therapeutic disciplines. The overall goal is the treatment of complex tumorous, traumatic, vascular and inflammatory processes or developmental disorders of the skull base with preservation of function. The paper presents modern concepts, procedures and minimally invasive strategies in skull base surgery and also critically discusses the current trend to endoscopic and robot-assisted surgical techniques. PMID:21647829

  2. Device and method for skull-melting depth measurement

    DOEpatents

    Lauf, Robert J.; Heestand, Richard L.

    1993-01-01

    A method of skull-melting comprises the steps of: a. providing a vessel adapted for a skull-melting process, the vessel having an interior, an underside, and an orifice in connecting the interior and the underside; b. disposing a waveguide in the orifice so that the waveguide protrudes sufficiently into the interior to interact with the skull-melting process; c. providing a signal energy transducer in signal communication with the waveguide; d. introducing into the vessel a molten working material; e. carrying out the skull-melting process so that a solidified skull of the working material is formed, the skull and the vessel having an interface therebetween, the skull becoming fused to the waveguide so the signal energy can be transmitted through the waveguide and the skull without interference from the interface; f. activating the signal energy transducer so that a signal is propagated through the waveguide; and, g. controlling at least one variable of the skull-melting process utilizing feedback information derived from the propagated signal energy.

  3. Device and method for skull-melting depth measurement

    SciTech Connect

    Lauf, R.J.; Heestand, R.L.

    1993-02-09

    A method of skull-melting comprises the steps of: (a) providing a vessel adapted for a skull-melting process, the vessel having an interior, an underside, and an orifice connecting the interior and the underside; (b) disposing a waveguide in the orifice so that the waveguide protrudes sufficiently into the interior to interact with the skull-melting process; (c) providing a signal energy transducer in signal communication with the waveguide; (d) introducing into the vessel a molten working material; (e) carrying out the skull-melting process so that a solidified skull of the working material is formed, the skull and the vessel having an interface therebetween, the skull becoming fused to the waveguide so the signal energy can be transmitted through the waveguide and the skull without interference from the interface; (f) activating the signal energy transducer so that a signal is propagated through the waveguide; and, (g) controlling at least one variable of the skull-melting process utilizing feedback information derived from the propagated signal energy.

  4. Skull Optical Clearing Solution for Enhancing Ultrasonic and Photoacoustic Imaging.

    PubMed

    Yang, Xiaoquan; Zhang, Yang; Zhao, Kai; Zhao, Yanjie; Liu, Yanyan; Gong, Hui; Luo, Qingming; Zhu, Dan

    2016-08-01

    The performance of photoacoustic microscopy (PAM) degrades due to the turbidity of the skull that introduces attenuation and distortion of both laser and stimulated ultrasound. In this manuscript, we demonstrated that a newly developed skull optical clearing solution (SOCS) could enhance not only the transmittance of light, but also that of ultrasound in the skull in vitro. Thus the photoacoustic signal was effectively elevated, and the relative strength of the artifacts induced by the skull could be suppressed. Furthermore in vivo studies demonstrated that SOCS could drastically enhance the performance of photoacoustic microscopy for cerebral microvasculature imaging. PMID:26886977

  5. Carbon ion radiotherapy of skull base chondrosarcomas

    SciTech Connect

    Schulz-Ertner, Daniela . E-mail: Daniela.Ertner@med.uni-heidelberg.de; Nikoghosyan, Anna; Hof, Holger; Didinger, Bernd; Combs, Stephanie E.; Jaekel, Oliver; Karger, Christian P.; Edler, Lutz; Debus, Juergen

    2007-01-01

    Purpose: To evaluate the effectiveness and toxicity of carbon ion radiotherapy in chondrosarcomas of the skull base. Patients and Methods: Between November 1998 and September 2005, 54 patients with low-grade and intermediate-grade chondrosarcomas of the skull base have been treated with carbon ion radiation therapy (RT) using the raster scan technique at the Gesellschaft fuer Schwerionenforschung in Darmstadt, Germany. All patients had gross residual tumors after surgery. Median total dose was 60 CGE (weekly fractionation 7 x 3.0 CGE). All patients were followed prospectively in regular intervals after treatment. Local control and overall survival rates were calculated using the Kaplan-Meier method. Toxicity was assessed according to the Common Terminology Criteria (CTCAE v.3.0) and Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) score. Results: Median follow-up was 33 months (range, 3-84 months). Only 2 patients developed local recurrences. The actuarial local control rates were 96.2% and 89.8% at 3 and 4 years; overall survival was 98.2%at 5 years. Only 1 patient developed a mucositis CTCAE Grade 3; the remaining patients did not develop any acute toxicities >CTCAE Grade 2. Five patients developed minor late toxicities (RTOG/EORTC Grades 1-2), including bilateral cataract (n = 1), sensory hearing loss (n = 1), a reduction of growth hormone (n = 1), and asymptomatic radiation-induced white matter changes of the adjacent temporal lobe (n = 2). Grade 3 late toxicity occurred in 1 patient (1.9%) only. Conclusions: Carbon ion RT is an effective treatment for low- and intermediate-grade chondrosarcomas of the skull base offering high local control rates with low toxicity.

  6. Evolutionary origin of the turtle skull.

    PubMed

    Bever, G S; Lyson, Tyler R; Field, Daniel J; Bhullar, Bhart-Anjan S

    2015-09-10

    Transitional fossils informing the origin of turtles are among the most sought-after discoveries in palaeontology. Despite strong genomic evidence indicating that turtles evolved from within the diapsid radiation (which includes all other living reptiles), evidence of the inferred transformation between an ancestral turtle with an open, diapsid skull to the closed, anapsid condition of modern turtles remains elusive. Here we use high-resolution computed tomography and a novel character/taxon matrix to study the skull of Eunotosaurus africanus, a 260-million-year-old fossil reptile from the Karoo Basin of South Africa, whose distinctive postcranial skeleton shares many unique features with the shelled body plan of turtles. Scepticism regarding the status of Eunotosaurus as the earliest stem turtle arises from the possibility that these shell-related features are the products of evolutionary convergence. Our phylogenetic analyses indicate strong cranial support for Eunotosaurus as a critical transitional form in turtle evolution, thus fortifying a 40-million-year extension to the turtle stem and moving the ecological context of its origin back onto land. Furthermore, we find unexpected evidence that Eunotosaurus is a diapsid reptile in the process of becoming secondarily anapsid. This is important because categorizing the skull based on the number of openings in the complex of dermal bone covering the adductor chamber has long held sway in amniote systematics, and still represents a common organizational scheme for teaching the evolutionary history of the group. These discoveries allow us to articulate a detailed and testable hypothesis of fenestral closure along the turtle stem. Our results suggest that Eunotosaurus represents a crucially important link in a chain that will eventually lead to consilience in reptile systematics, paving the way for synthetic studies of amniote evolution and development. PMID:26331544

  7. Unfavourable results in skull base surgery

    PubMed Central

    Jaju, Hemen

    2013-01-01

    Treatment of skull base tumors involves multiple specialities. The lesions are usually advanced and the treatment is often associated with unfavorable results, which may be functional and/or aesthetic. Here we have done an analysis for the complications and unfavorable results of 546 cases treated surgically by a single craniofacial surgeon over a period of 14 years. The major morbidity ranges from death to permanent impairment of vital organ functions (brain, eye, nose), infections, tissue losses, flap failures, treatment associated complications, psychosocial issues, and aesthesis besides others. This article is aimed at bringing forth these unfavorable results and how to avoid them. PMID:24501460

  8. Spontaneous acute epidural hematoma developed due to skull metastasis of hepatocelluar carcinoma: A case report and review of the literature

    PubMed Central

    KIM, YOU-SUB; MOON, KYUNG-SUB; LEE, KYUNG-HWA; JUNG, TAE-YOUNG; JANG, WOO-YOUL; KIM, IN-YOUNG; JUNG, SHIN

    2016-01-01

    Acute epidural hematoma (AEDH) is one of the most common pathological types of head trauma, and may develop without an accidental event, although this is uncommon. The present study reports the case of a 41-year-old male patient that developed spontaneous AEDH due to skull metastasis of hepatocellular carcinoma (HCC). The man was admitted to Chonnam National University Hwasun Hospital and Medical School due to drowsiness and right-sided hemiparesis. A computed tomography scan of the head revealed the presence of a large AEDH and a lytic bone lesion in the left posterior fossa and parieto-occipital region, which exhibited heterogeneous enhancement. The perioperative findings revealed a large amount of mixed-stage epidural hematoma and a soft hemorrhagic mass that exhibited lytic change on the occipital bone. No evidence of head trauma, such as skull fracture or scalp contusion, was detected. The pathological diagnosis was hematoma with metastatic HCC. The current study reports the rare case of a patient with a metastatic tumor located in the skull that resulted in the development of spontaneous AEDH. Once a sudden and unpredicted neurological deficit occurs in a patient with HCC that is also diagnosed with skull metastasis, the possibility of spontaneous AEDH developing from the metastasis should be considered. PMID:26870277

  9. Development of a skull/brain model for military wound ballistics studies.

    PubMed

    Carr, Debra; Lindstrom, Anne-Christine; Jareborg, Andreas; Champion, Stephen; Waddell, Neil; Miller, David; Teagle, Michael; Horsfall, Ian; Kieser, Jules

    2015-05-01

    Reports on penetrating ballistic head injuries in the literature are dominated by case studies of suicides; the penetrating ammunition usually being .22 rimfire or shotgun. The dominating cause of injuries in modern warfare is fragmentation and hence, this is the primary threat that military helmets protect the brain from. When helmets are perforated, this is usually by bullets. In combat, 20% of penetrating injuries occur to the head and its wounding accounts for 50% of combat deaths. A number of head simulants are described in the academic literature, in ballistic test methods for helmets (including measurement of behind helmet blunt trauma, BHBT) and in the 'open' and 'closed' government literature of several nations. The majority of these models are not anatomically correct and are not assessed with high-velocity rifle ammunition. In this article, an anatomically correct 'skull' (manufactured from polyurethane) and 'brain' (manufactured from 10%, by mass, gelatine) model for use in military wound ballistic studies is described. Filling the cranium completely with gelatine resulted in a similar 'skull' fracture pattern as an anatomically correct 'brain' combined with a representation of cerebrospinal fluid. In particular, posterior cranial fossa and occipital fractures and brain ejection were observed. This pattern of injury compared favourably to reported case studies of actual incidents in the literature. PMID:25194710

  10. Skull Base Inverted Papilloma: A Comprehensive Review

    PubMed Central

    Wassef, Shafik N.; Batra, Pete S.; Barnett, Samuel

    2012-01-01

    Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts. PMID:23346418

  11. Cranial fractures and direction of fire in low velocity gunshots.

    PubMed

    Betz, P; Stiefel, D; Eisenmenger, W

    1996-01-01

    A total of 59 penetrating contact shot wounds to the head caused by handguns was investigated and a comparison was made between the magnitude and the number of fracture lines at the entrance and exist site of the vault and at the base of the skull. It was noted that in approximately 50% of the cases the extent of fractures at the entrance site exceeded those at the exit wound while in the remaining individuals no relevant differences or even greater exit fractures were found. Furthermore, no close correlation between the fracture patterns of the vault and at the base of the skull occurred indicating that differences in the magnitude and the number of entrance or exit fracture lines cannot provide reliable information on direction of fire. Additionally, no further conclusions on the gun used can be drawn from differences in the entrance and exit fracture patterns. It can only be assumed that the absence of fractures in the cranial fossae points to the use of small calibre handguns (< or = 7.65 mm) while a fragmentation of the skull can as a rule be expected after shots from guns with larger calibres (> 7.65 mm). PMID:8912048

  12. Glottic and skull indices in canine brachycephalic airway obstructive syndrome

    PubMed Central

    2014-01-01

    Background Forty dogs presented for brachycephalic airway obstructive syndrome with laryngeal collapse not over 1st degree (saccule eversion) underwent glottis endoscopic and radiographic skull measurements before surgery. Fifteen Pugs, fifteen French and ten English Bulldogs were included. The goals were prospectively to compare three common brachycephalic breeds for anatomical differences regarding glottis and skull measurements, and to assess if any correlation between glottis and skull measurements was present. Linear measurements were used to obtain glottis and skull indices. Correlations between glottis and skull indices and glottic measurements were evaluated. Finally, glottis indices were compared among the three breeds. Results No correlation was found for glottis and skull indices. The glottic index differed among the three breeds (smaller in Pugs and higher in English Bulldogs), ultimately representing a morphologic indicator of the different larynx shape in the three breeds (more rounded in English Bulldogs, more elliptical in Pugs and in-between in French Bulldogs). Conclusions The lack of correlation between skull/glottic indices does not support skull morphology as predictor of glottic morphology. As Pugs had the lowest glottic index, it may be speculated that Pugs’ original narrow glottic width may predispose to further progressive respiratory deterioration more easily than in the other two breeds. PMID:24410902

  13. Molecularly proven hypochondroplasia with cloverleaf skull deformity: a novel association.

    PubMed

    Angle, B; Hersh, J H; Christensen, K M

    1998-11-01

    We report on a case of cloverleaf skull deformity in a patient with hypochondroplasia, a disorder which has not been previously associated with this anomaly. Hypochondroplasia is a bone dysplasia caused by mutations in the fibroblast growth factor receptor 3 (FGFR3) gene. Cloverleaf skull is a trilobar skull deformity which is etiologically and genetically heterogeneous and occurs in association with a number of disorders which result from mutations in the fibroblast growth factor receptor genes. Our patient demonstrated one of the common FGFR3 mutations identified in hypochondroplasia, a C-to-A change at nucleotide 1620 (C1620A) in the tyrosine kinase domain. The occurrence of a cloverleaf skull deformity appears to represent an example of variable expressivity in hypochondroplasia and suggests that additional factors other than a specific mutation can modify the phenotype in this disorder. In addition, identification of another FGFR mutation associated with cloverleaf skull further illustrates the genetic heterogeneity of this anomaly. PMID:9842995

  14. Copper Beaten Skull! Can It be a Usual Appearance?

    PubMed

    Desai, Vela; Priyadarshini, Smita R; Sharma, Rajeev

    2014-01-01

    'Copper beaten' skull refers to the prominent convolutional markings seen in multiple bones of the skull. Underlying cause is thought to be related to increased intracranial pressure resulting from such processes as craniosynostosis, obstructive hydrocephalus and/or intracranial masses. However, the copper beaten appearance of the skull has poor sensitivity in detecting increased intracranial pressure as such an appearance can also be seen in normal patients. In this article, we have reported a case of a 5 years old child with classical features of beaten silver skull. How to cite this article: Desai V, Priyadarshini SR, Sharma R. Copper Beaten Skull! Can It be a Usual Appearance? Int J Clin Pediatr Dent 2014;7(1):47-49. PMID:25206238

  15. Skulls and Human Evolution: The Use of Casts of Anthropoid Skulls in Teaching Concepts of Human Evolution.

    ERIC Educational Resources Information Center

    Gipps, John

    1991-01-01

    Proposes the use of a series of 11 casts of fossil skulls as a method of teaching about the theory of human evolution. Students explore the questions of which skulls are "human" and which came first in Homo Sapien development, large brain or upright stance. (MDH)

  16. Transnasal endoscopy-assisted skull base surgery.

    PubMed

    Stamm, Aldo M

    2006-09-01

    Skull base surgery (SBS), which originated in the 19th century, became refined in the 20th century in parallel with technological advancements and is now in the midst of further refinements largely driven by advances in endoscopic sinus surgery. With the development of modern SBS, lesions that were once inoperable and potentially fatal can now be eradicated successfully by means of endoscopy-assisted procedures that reduce or completely eliminate intracranial trauma, minimize postsurgical morbidity, and make full recovery possible. It is absolutely mandatory to have the appropriate instrumentation for endoscopy-assisted SBS. Among the new technologies available are advanced endoscopes, high-speed suction irrigation drills, digital video cameras, computed tomography and magnetic resonance imaging, and systems for 3-dimensional computer-assisted image-guided surgical navigation. An experienced endoscopic surgeon working with multidisciplinary teams, and using new instrumentation and techniques, can bring SBS to new levels of success in the 21st century. PMID:17040018

  17. Osteomyelitis of the base of the skull

    SciTech Connect

    Chandler, J.R.; Grobman, L.; Quencer, R.; Serafini, A.

    1986-03-01

    Infection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well-developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long-term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism.

  18. The transnasal approach to the skull base. From sinus surgery to skull base surgery

    PubMed Central

    Wagenmann, Martin; Schipper, Jörg

    2012-01-01

    The indications for endonasal endoscopic approaches to diseases of the skull base and its adjacent structures have expanded considerably during the last decades. This is not only due to improved technical possibilities such as intraoperative navigation, the development of specialized instruments, and the compilation of anatomical studies from the endoscopic perspective but also related to the accumulating experience with endoscopic procedures of the skull base by multidisciplinary centers. Endoscopic endonasal operations permit new approaches to deeply seated lesions and are characterized by a reduced manipulation of neurovascular structures and brain parenchyma while at the same time providing improved visualization. They reduce the trauma caused by the approach, avoid skin incisions and minimize the surgical morbidity. Transnasal endoscopic procedures for the closure of small and large skull base defects have proven to be reliable and more successful than operations with craniotomies. The development of new local and regional vascularized flaps like the Hadad-flap have contributed to this. These reconstructive techniques are furthermore effectively utilized in tumor surgery in this region. This review delineates the classification of expanded endonasal approaches in detail. They provide access to lesions of the anterior, middle and partly also to the posterior cranial fossa. Successful management of these complex procedures requires a close interdisciplinary collaboration as well as continuous education and training of all team members. PMID:22558058

  19. Characteristics of gunshot wounds in the skull.

    PubMed

    Quatrehomme, G; Işcan, M Y

    1999-05-01

    The analysis of trauma to the skeleton is an important aspect of forensic case work, but most pathology references devote limited attention to this topic. This paper describes various aspects of gunshot wounds, including entrance and exit patterns, angle and path, range of fire and velocity, and caliber of the bullet, based on observations of a series of known cases. Skeletal remains of 21 victims of gunshot wounds were studied. In most cases, there was documentation of the investigation, autopsy, and victim's identity. Each case was analyzed in terms of wound location, shape, size and exit/entry surface area ratio, beveling, and direction of shooting Skull entry wounds were most often round or oval. Unusual shapes were observed in bones like the mandible and mastoid process, but were also found to be triangular, nearly rectangular or irregular. Tunneling was observed in the mastoid process. The expected internal beveling was obvious in all but one skull. External beveling of an entry wound was only observed in one case (parietal bone). Exit wounds were roughly round, oval, square, and rectangular and were always more irregular than entry wounds. External beveling of exit wounds was observed in most vault bones, but there was none in the orbit, maxilla, greater wing of the sphenoid, temporal, or left occipital bone. Tangential gunshot wounds were seen in a mastoid process, zygomatic process, mandibular ramus and condyle, and occipital condyle. Most of the exit to entry surface area ratios (cm2) varied from 1.4 to 2.0. In four cases the ratio indicated that entrances were larger than exists. In conclusion, understanding of gunshot wound characteristics is an important matter to interpret distance, velocity, direction and sometimes caliber size. Assessment of this nature of gunshot wounds helps reconstruct events surrounding the death. PMID:10408112

  20. Applied anatomy of the anterior cranial fossa: what can fracture patterns tell us?

    PubMed

    Stephens, J R; Holmes, S; Evans, B T

    2016-03-01

    The skull base is uniquely placed to absorb anteriorly directed forces imparted either via the midfacial skeleton or cranial vault. A variety of skull base fracture classifications exist. Less well understood, however, is fracture extension beyond the anterior cranial fossa (ACF) into the middle and posterior cranial fossae. The cases of 81 patients from two UK major trauma centres were studied to examine the distribution of fractures across the skull base and any relationship between the vector of force and extent of skull base injury. It was found that predominantly lateral force to the craniofacial skeleton produced a fracture that propagated beyond the ACF into the middle cranial fossa in 77.4% of cases, significantly more (P<0.001) than for predominantly anterior force (12.0%). Fractures were significantly more likely to propagate into the posterior fossa with a lateral vector of impact compared to an anterior vector (P=0.049). This difference in energy transfer across the skull base may, in part, be explained by the local anatomy. The more delicate central ACF acts as a 'crumple zone' in order to absorb force. Conversely, no collapsible interface exists in the lateral aspect of the ACF, thus the lateral ACF behaves like a 'buttress', resulting in increased energy transfer. PMID:26589135

  1. Geologic map of the Skull Creek Quadrangle, Moffat County Colorado

    USGS Publications Warehouse

    Van Loenen, R. E.; Selner, Gary; Bryant, W.A.

    1999-01-01

    The Skull Creek quadrangle is in northwestern Colorado a few miles north of Rangely. The prominent structural feature of the Skull Creek quadrangle is the Skull Creek monocline. Pennsylvanian rocks are exposed along the axis of the monocline while hogbacks along its southern flank expose rocks that are from Permian to Upper Cretaceous in age. The Wolf Creek monocline and the Wolf Creek thrust fault, which dissects the monocline, are salient structural features in the northern part of the quadrangle. Little or no mineral potential exists within the quadrangle. A geologic map of the Lazy Y Point quadrangle, which is adjacent to the Skull Creek quadrangle on the west, is also available (Geologic Investigations Series I-2646). This companian map shows similar geologic features, including the western half of the Skull Creek monocline. The geology of this quadrangle was mapped because of its proximity to Dinosaur National Monument. It is adjacent to quadrangles previously mapped to display the geology of this very scenic and popular National Monument. The Skull Creek quadrangle includes parts of the Skull Creek Wilderness Study Area, which was assessed for its mineral resource potential.

  2. Advances in Magnetic Resonance Imaging of the Skull Base

    PubMed Central

    Kirsch, Claudia F.E.

    2014-01-01

    Introduction Over the past 20 years, magnetic resonance imaging (MRI) has advanced due to new techniques involving increased magnetic field strength and developments in coils and pulse sequences. These advances allow increased opportunity to delineate the complex skull base anatomy and may guide the diagnosis and treatment of the myriad of pathologies that can affect the skull base. Objectives The objective of this article is to provide a brief background of the development of MRI and illustrate advances in skull base imaging, including techniques that allow improved conspicuity, characterization, and correlative physiologic assessment of skull base pathologies. Data Synthesis Specific radiographic illustrations of increased skull base conspicuity including the lower cranial nerves, vessels, foramina, cerebrospinal fluid (CSF) leaks, and effacement of endolymph are provided. In addition, MRIs demonstrating characterization of skull base lesions, such as recurrent cholesteatoma versus granulation tissue or abscess versus tumor, are also provided as well as correlative clinical findings in CSF flow studies in a patient pre- and post-suboccipital decompression for a Chiari I malformation. Conclusions This article illustrates MRI radiographic advances over the past 20 years, which have improved clinicians' ability to diagnose, define, and hopefully improve the treatment and outcomes of patients with underlying skull base pathologies. PMID:25992137

  3. Development of a neonatal skull phantom for photoacoustic imaging

    NASA Astrophysics Data System (ADS)

    Tavakolian, Pantea; Todd, Rhiannon; Kosik, Ivan; Chamson-Reig, Astrid; Vasefi, Fartash; St. Lawrence, Keith; Carson, Jeffrey J. L.

    2013-03-01

    Photoacoustic imaging (PAI) has been proposed as a non-invasive technique for the diagnosis and monitoring of disorders in the neonatal brain. However, PAI of the brain through the intact skull is challenging due to reflection and attenuation of photoacoustic pressure waves by the skull bone. The objective of this work was to develop a phantom for testing the potential limits the skull bone places on PAI of the neonatal brain. Our approach was to make acoustic measurements on materials designed to mimic the neonatal skull bone and construct a semi-realistic phantom. A water tank and two ultrasound transducers were utilized to measure the ultrasound insertion loss (100 kHz to 5MHz) of several materials. Cured mixtures of epoxy and titanium dioxide powder provided the closest acoustic match to neonatal skull bone. Specifically, a 1.4-mm thick sample composed of 50% (by mass) titanium dioxide powder and 50% epoxy was closest to neonatal skull bone in terms of acoustic insertion loss. A hemispherical skull phantom (1.4 mm skull thickness) was made by curing the epoxy/titanium dioxide powder mixture inside a mold. The mold was constructed using 3D prototyping techniques and was based on the hairless head of a realistic infant doll. The head was scanned to generate a 3D model, which in turn was used to build a 3D CAD version of the mold. The mold was CNC machined from two solid blocks of Teflon®. The neonatal skull phantom will enable the study of the propagation of photoacoustic pressure waves under a variety of experimental conditions.

  4. The MDP skull uptake test: A new diagnostic tool

    SciTech Connect

    Ell, P.J.; Jarritt, P.H.; Cullum, I.; Lui, D.

    1984-01-01

    An original approach to the measurement of bone turnover is presented. With SPECT, the authors have measured in pgr/ml, the uptake of MDP by the skull in man. The Cleon 710 scanner, ring phantoms and bone biopsies were used for ultimate in vivo/in vitro count recovery correlation and calibration. A normal range for 24 patients was found: 8.5 to 19.5 pgr/ml with a mean of 14. For patients with bony metastases (12), the values were: 22.5 to 50, mean of 30. For 5 patients with osteomalacia, the values were 46 to 68, mean of 62: for 12 patients with hyperparathyroidism, the values were 37 to 48.5, mean of 43. In 3 patients with Pagets disease, the values were 58.5 to 75, with a mean of 65. In 76 patients with metastatic disease to bone, the conventional wholebody bone scan was investigated against the following: 24h wholebody retention of MDP (WBR), skull uptake as described and GFR by Cr-51-DTPA. There is a correlation between GFR and WBR - r=0.67. There is a lesser correlation between GFR and skull uptake - r=0.3. There is no correlation between skull uptake and WBR - r=0.1. The comparison of skull uptake data with normal whole body bone scans leads to a significant proportion of cancer patients with positive skull uptake data. Monostotic disease (especially if metabolic in nature) expresses itself by abnormal skull uptake even if the clinical site of abnormality lies outside the skull. This new technique is ideal as a tool to investigate phosphonate concentration in bone. With it, the authors have shown the effect of specific activity of label on skull uptake, which increases as the specific activity of labelled MDP decreases.

  5. New Insights into the Skull of Istiodactylus latidens (Ornithocheiroidea, Pterodactyloidea)

    PubMed Central

    Witton, Mark P.

    2012-01-01

    The skull of the Cretaceous pterosaur Istiodactylus latidens, a historically important species best known for its broad muzzle of interlocking, lancet-shaped teeth, is almost completely known from the broken remains of several individuals, but the length of its jaws remains elusive. Estimates of I. latidens jaw length have been exclusively based on the incomplete skull of NHMUK R3877 and, perhaps erroneously, reconstructed by assuming continuation of its broken skull pieces as preserved in situ. Here, an overlooked jaw fragment of NHMUK R3877 is redescribed and used to revise the skull reconstruction of I. latidens. The new reconstruction suggests a much shorter skull than previously supposed, along with a relatively tall orbital region and proportionally slender maxilla, a feature documented in the early 20th century but ignored by all skull reconstructions of this species. These features indicate that the skull of I. latidens is particularly distinctive amongst istiodactylids and suggests greater disparity between I. latidens and I. sinensis than previously appreciated. A cladistic analysis of istiodactylid pterosaurs incorporating new predicted I. latidens skull metrics suggests Istiodactylidae is constrained to five species (Liaoxipterus brachyognathus, Lonchengpterus zhoai, Nurhachius ignaciobritoi, Istiodactylus latidens and Istiodactylus sinensis) defined by their distinctive dentition, but excludes the putative istiodactylids Haopterus gracilis and Hongshanopterus lacustris. Istiodactylus latidens, I. sinensis and Li. brachyognathus form an unresolved clade of derived istiodactylids, and the similarity of comparable remains of I. sinensis and Li. brachyognathus suggest further work into their taxonomy and classification is required. The new skull model of I. latidens agrees with the scavenging habits proposed for these pterosaurs, with much of their cranial anatomy converging on that of habitually scavenging birds. PMID:22470442

  6. Hand in glove: brain and skull in development and dysmorphogenesis

    PubMed Central

    Flaherty, Kevin

    2013-01-01

    The brain originates relatively early in development from differentiated ectoderm that forms a hollow tube and takes on an exceedingly complex shape with development. The skull is made up of individual bony elements that form from neural crest- and mesoderm-derived mesenchyme that unite to provide support and protection for soft tissues and spaces of the head. The meninges provide a protective and permeable membrane between brain and skull. Across evolutionary and developmental time, dynamic changes in brain and skull shape track one another so that their integration is evidenced in two structures that fit soundly regardless of changes in biomechanical and physiologic functions. Evidence for this tight correspondence is also seen in diseases of the craniofacial complex that are often classified as diseases of the skull (e.g., craniosynostosis) or diseases of the brain (e.g., holoprosencephaly) even when both tissues are affected. Our review suggests a model that links brain and skull morphogenesis through coordinated integration of signaling pathways (e.g., FGF, TGFβ, Wnt) via processes that are not currently understood, perhaps involving the meninges. Differences in the earliest signaling of biological structure establish divergent designs that will be enhanced during morphogenesis. Signaling systems that pattern the developing brain are also active in patterning required for growth and assembly of the skull and some members of these signaling families have been indicated as causal for craniofacial diseases. Because cells of early brain and skull are sensitive to similar signaling families, variation in the strength or timing of signals or shifts in patterning boundaries that affect one system (neural or skull) could also affect the other system and appropriate co-adjustments in development would be made. Interactions of these signaling systems and of the tissues that they pattern are fundamental to the consistent but labile functional and structural association

  7. Transoral robotic surgery of the central skull base: preclinical investigations.

    PubMed

    Fernandez-Nogueras, F J J; Katati, M J; Arraez Sanchez, M A; Molina Martinez, M; Sanchez Carrion, M

    2014-06-01

    In this study we explored possible applications of the da Vinci system in approaching the skull base at optic chiasm level on two cryopreserved cadavers, using an entirely transoral robotic technique (TORS). We used a standard 12 mm endoscopy and 8 mm terminals. Bone drilling was performed manually. The da Vinci system is equipped with very good illumination and 3D viewing, thus providing excellent vision and great maneuverability even in the less accessible areas of the skull. Our experience demonstrates that an entirely transoral skull base robotic approach to this complex anatomical region has many advantages as compared to traditional techniques. PMID:24077869

  8. Cancers of the nose, sinus, and skull base.

    PubMed

    Banuchi, Victoria; Mallen, Jonathan; Kraus, Dennis

    2015-07-01

    Malignancies of the nose, sinus, and skull base are rare. The most common histologies are squamous cell carcinoma and adenocarcinoma. The most common primary sites are the nasal cavity and maxillary sinus. Management of these tumors is technically challenging because they often present in advanced stages with extensive disease invading important structures such as the orbit and the skull base. In the last few decades advances in surgical resection techniques, as well as improved strategies to deliver adjuvant radiation, have substantially improved the outcomes in patients with malignancies of the sinonasal tract and skull base. PMID:25979400

  9. Former and present aspects in neuro-skull architecture.

    PubMed

    Niculescu, M C; Niculescu, V; Jianu, Adelina; Zăvolan, M; Motoc, A

    2006-01-01

    The classical authors considered the functional resistance of the neuro-skull to consist of arcs at the arch level, rafters at the base and pillars at the joint of the arcs and rafters, those last also connecting the neuro-skull framework and that of the viscero-skull. The new outlooks replace the term pillar with that of resistance node and assemble the arcs and rafters within common structures, named resistance belts. The belts are: one in transversal, three sagittal, two in frontal plane and two oblique positions. At the intersection of the belts, the resistance nodes are placed. PMID:17308689

  10. [Trochanteric femoral fractures].

    PubMed

    Douša, P; Čech, O; Weissinger, M; Džupa, V

    2013-01-01

    At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (p<0.001) and represented 30% of the group. The fractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (p<0.001). The patients with pertrochanteric fractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (p<0.001). The mortality rate within a year of injury was about 30%. Trochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (p<0.001). A total of 1 394 fractures were treated with a proximal

  11. Skull base, orbits, temporal bone, and cranial nerves: anatomy on MR imaging.

    PubMed

    Morani, Ajaykumar C; Ramani, Nisha S; Wesolowski, Jeffrey R

    2011-08-01

    Accurate delineation, diagnosis, and treatment planning of skull base lesions require knowledge of the complex anatomy of the skull base. Because the skull base cannot be directly evaluated, imaging is critical for the diagnosis and management of skull base diseases. Although computed tomography (CT) is excellent for outlining the bony detail, magnetic resonance (MR) imaging provides better soft tissue detail and is helpful for evaluating the adjacent meninges, brain parenchyma, and bone marrow of the skull base. Thus, CT and MR imaging are often used together for evaluating skull base lesions. This article focuses on the radiologic anatomy of the skull base pertinent to MR imaging evaluation. PMID:21816324

  12. Nuclide angiography in Paget's disease of the skull: Case report.

    PubMed

    Fitzer, P M

    1975-07-01

    Early-appearing and persistent uptake on nuclear angiography in a patient with early Paget's disease of the skull is described. The diagnosis of subdural hematoma may be ruled out at the time of brain scanning. PMID:1167280

  13. Comparison of skull and femur lead levels in adult rats

    SciTech Connect

    Denton, J.E.; Potter, G.D.; Santolucito, J.A.

    1980-12-01

    The purpose of the study was to elucidate the relationship between skull and femur lead levels in laboratory rats. Forty-eight female rats were given one of four lead chloride drinking water solutions: 0.05, 0.58, 17, or 352 ppM lead. Two animals from each group were sacrificed after 3, 6, 9, 12, 15, and 24 weeks of treatment. Both femurs and the frontal and parietal bones of the skull were removed from each animal and analyzed for lead concentration by atomic absorption spectroscopy. A significant accumulation of lead was observed in femurs and skull bones only from animals in the 352 ppM lead treatment group. The lead concentrations of the femurs were significantly higher than skull lead concentrations for all groups and this relationship was described using a linear regression equation.

  14. Lung cancer metastasis presenting as a solitary skull mass.

    PubMed

    Turner, Ryan C; Lucke-Wold, Brandon P; Hwang, Roy; Underwood, Bill D

    2016-01-01

    Lung cancer has been well documented to spread to bone and the axial skeleton after metastasis to adjacent organs. Bony metastasis is not, however, the typical presenting manifestation. The differential diagnosis for a tissue mass on the skull should warrant a workup for metastatic disease. Bony metastasis plays an important role in treatment and disease management. We report an exceptionally rare case of stage IV lung adenocarcinoma that presented with a solitary skull metastasis and a significant soft-tissue component. The lesion was treated by excision via craniotomy and subsequent medical management of the adenocarcinoma. This case illustrates a very rare presentation of lung adenocarcinoma and also represents what the authors believe to be the first report of a solitary skull mass originating from a lung primary. We also present a review of the literature surrounding bony metastasis to the skull and implications for patient care. PMID:27340229

  15. Lung cancer metastasis presenting as a solitary skull mass

    PubMed Central

    Turner, Ryan C.; Lucke-Wold, Brandon P.; Hwang, Roy; Underwood, Bill D.

    2016-01-01

    Lung cancer has been well documented to spread to bone and the axial skeleton after metastasis to adjacent organs. Bony metastasis is not, however, the typical presenting manifestation. The differential diagnosis for a tissue mass on the skull should warrant a workup for metastatic disease. Bony metastasis plays an important role in treatment and disease management. We report an exceptionally rare case of stage IV lung adenocarcinoma that presented with a solitary skull metastasis and a significant soft-tissue component. The lesion was treated by excision via craniotomy and subsequent medical management of the adenocarcinoma. This case illustrates a very rare presentation of lung adenocarcinoma and also represents what the authors believe to be the first report of a solitary skull mass originating from a lung primary. We also present a review of the literature surrounding bony metastasis to the skull and implications for patient care. PMID:27340229

  16. A direct measurement of skull attenuation for quantitative SPECT

    SciTech Connect

    Turkington, T.G.; Gilland, D.R.; Jaszczak, R.J.; Greer, K.L.; Coleman, R.E. . Dept. of Radiology); Smith, M.F. . Dept. of Biomedical Engineering)

    1993-08-01

    The attenuation of 140 keV photons was measured in three empty skulls by placing a [sup 99m]Tc line source inside each one and acquiring projection data. These projections were compared to projections of the line source alone to determine the transmission through each point in the skull surrounding the line source. The effective skull thickness was calculated for each point using an assumed dense bone attenuation coefficient. The relative attenuation for this thickness of bone was compared to that of an equivalent amount of soft tissue to evaluate the increased attenuation of photons in brain SPECT relative to a uniform soft tissue approximation. For the skull regions surrounding most of the brain, the effective bone thickness varied considerably, but was generally less than 6 mm, resulting in a relative attenuation increases of less than 6%.

  17. Minimally invasive surgery of the anterior skull base: transorbital approaches

    PubMed Central

    Gassner, Holger G.; Schwan, Franziska; Schebesch, Karl-Michael

    2016-01-01

    Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach. PMID:27453759

  18. Sinonasal Non-Hodgkin's Lymphoma with Skull Base Involvement

    PubMed Central

    Dare, Amos O.; Datta, Rajiv V.; Loree, Thom R.; Hicks, Wesley L.; Grand, Walter

    2001-01-01

    Non-Hodgkin's lymphoma (NHL) is a rare tumor of the skull base. As the incidence of primary central nervous system (CNS) lymphoma has increased, atypical presentations involving the skull or cranial base exclusively have been reported. In immunocompetent patients with no previous history or predisposing factors, the diagnosis of primary NHL of the skull base may be delayed. We present four cases of nasal and paranasal sinus NHL with both skull base and intracranial involvement in immunocompetent patients. Clinicopathologic correlation suggests that cranial base and intracranial involvement with NHL represents advanced-stage primary sinonasal disease. Surgical biopsy before definitive treatment is recommended. Radiation therapy provides local control; adjuvant chemotherapy after primary radiation therapy may be required for recurrent disease. ImagesFigure 1Figure 2Figure 3 PMID:17167612

  19. Historical evidence of the 1936 Mojokerto skull discovery, East Java.

    PubMed

    Huffman, O Frank; Shipman, Pat; Hertler, Christine; de Vos, John; Aziz, Fachroel

    2005-04-01

    To resolve ambiguities in the literature, we detail the discovery history of the Mojokerto child's skull (Perning 1), employing letters, maps, photographs, reports, and newspaper accounts not previously used for this purpose. Andoyo, an experienced vertebrate-fossil collector with the Geological Survey of the Netherlands Indies, found the skull on February 13, 1936, while collecting for Johan Duyfjes, who had mapped the field area geologically. On February 18-19 Andoyo sent the fossil and a 1:25,000-topographic map showing the discovery point to Survey headquarters. The locality lies between Perning and Sumbertengu villages, approximately 10km northeast of Mojokerto city, East Java. G.H. Ralph von Koenigswald, Survey paleontologist, identified the specimen as Pithecanthropus and then named it Homo modjokertensis (it is now accepted as Homo erectus). Unfortunately he confused the discovery record in a March 28 newspaper article by characterizing the skull as a "surface find" [Dutch: oppervlaktevondst] while also attributing it to ancient beds. von Koenigswald probably had insufficient basis for either assertion, having not yet talked to Andoyo or Duyfjes. Eugene Dubois challenged von Koenigswald on the "surface-find" issue, Andoyo was consulted, and Duyfjes went to the site. Duyfjes and von Koenigswald then published scientific papers stating that the skull was unearthed 1m deep from a hill-slope outcrop of conglomeratic sandstone in Duyfjes' Pucangan formation. A cross section by Andoyo, which may show the Mojokerto site, also indicates a skull at 1m depth in conglomeratic sandstone. Photographs taken in 1936-1938 show a shallow pit at a single field location that fits Duyfjes' site description and is identified as the Mojokerto-skull site in 1940-1943 publications. By WWII the scientific community accepted the skull as an early hominid. Although von Koenigswald's "surface-find" comment remains a source of doubt in the record, we consider in situ discovery for the

  20. Meningiomas of the Pediatric Skull Base: A Review

    PubMed Central

    Gump, William C.

    2014-01-01

    Pediatric skull base meningiomas are rare and complex clinical entities. Meningioma is a relatively uncommon brain tumor in children, and only ∼ 27% involve the skull base. Some evidence suggests that these tumors are more likely to be atypical or malignant in children than adults. The absence of female preponderance in pediatric meningiomas is reflected in the skull base subpopulation. Skull base meningiomas in children are most likely to be found in the anterior or middle fossa base, or involving the orbit and optic nerve sheath. Petroclival, suprasellar/parasellar, cerebellopontine angle, cavernous sinus, and foramen magnum tumors are very rare. Meningiomas constitute a small proportion of reported cases of pediatric skull base pathology, and they are entirely absent from many case series. Initial gross total resection is consistently associated with superior outcomes. Surgical approaches to the pediatric skull base must take additional factors into consideration including relatively smaller anatomy, immature dentition, incompletely aerated sinuses and air cells, and altered configurations of structures such as the pterional bony complex. Multidisciplinary expertise is essential to optimizing treatment outcomes. PMID:25685652

  1. "Bochdalek's" skull: morphology report and reconstruction of face.

    PubMed

    Klepáček, Ivo; Malá, Pavla Zedníková

    2012-12-01

    The objective of this study was to create a real model of a face using the well preserved "Bochdalek's skull" (from an eighteenth Century female aged 18 years) kept in the museum of anatomy (Institute of Anatomy, 1st Medical Faculty, Charles University in Prague). The skull had previously been appraised as a deformed skull with an adhesion present on both sides of the jaw, most likely of post-traumatic origin (bilateral syngnathia). In an attempt to find the best description for it, and to identify the spatial relationships between the surface of the facial bones which had changed in shape, as well as the formation of soft tissue on the face, we decided to perform a 3D reconstruction of the face. Due to the necessity of preserving the unique original undamaged skull, we created an exact digital "casting" of the facial bone structure on a computer first, which we then converted into a three-dimensional model using a 3D RepRap printer. We needed to take into consideration the fact that we had no portrait of the girl, just the skull. For this reason, we opted for a selected combination of anthropologic steps (the modified Manchester technique), which in our view, allows for optimum creation of the topography of the face in keeping with the deformed skull. The resulting reconstructed face was old in appearance with an overhanging lower lip and flattened surfaces in the areas of the temporalis and masseter muscles. PMID:22918853

  2. [Cloverleaf skull and other malformations of the skull. Pathology and clinical aspect].

    PubMed

    Gathmann, H A

    1977-01-01

    Malformations of different parts of the cartilage results in achondrogenesis II, thanatophoric dwarfism and in metatropic dwarfism. Whether the base of the skull or the cranial-distal skeleton are affected, both together or separately, depends upon the localization of the defect within the cartilage. The different types of the cloverleaf syndrome are characterised by a defect of vessels and cartilage that affect the chondrocranium and the cranial-distal skeleton in different grades. The mal-development of the vessel-system is particularly marked in the upper back of the calotte. PMID:610339

  3. [Human skull development and voice disorders].

    PubMed

    Piron, A; Roch, J B

    2006-01-01

    The hominisation of the skull comes with the bipedic posture, due to a network of muscular and aponevrotic forces applied to the cranio-facial skeleton. A brief sight of the morphogenetic origine and issues of these forces help to understand more clearly the postural statement of the larynx, his functions, and his many extrinsic biomechanical bounds; then further his most frequently dysfunctions. The larynx is surrounded by several effective systems of protection: active, activo-passive, passive. The architectural features of the components of the laryngeal system allows us to consider the laryngeal function as an auto-balanced system. All the forces engaged are auto-balanced in a continuum of tension. This lead us to the concept of tensegrity system, neologism coming from tensional integrity described by Buckminster Fuller. The laryngeal employement by extrinsic system is pathological in case of chronicity. Any osteopathic treatment, which aims to restore the losses of laryngeal mobility, has to release first the peripherical structures involved in the laryngeal defense, before normalising the larynx itself Finally, the larynx recovers his functions in a tensegrity system. PMID:17425001

  4. Peramorphic traits in the tokay gecko skull.

    PubMed

    Daza, Juan D; Mapps, Aurelia A; Lewis, Patrick J; Thies, Monte L; Bauer, Aaron M

    2015-08-01

    Traditionally, geckos have been conceived to exhibit paedomorphic features relative to other lizards (e.g., large eyes, less extensively ossified skulls, and amphicoelous and notochordal vertebrae). In contrast, peramorphosis has not been considered an important process in shaping their morphology. Here, we studied different sized specimens of Gekko gecko to document ontogenetic changes in cranial anatomy, especially near maturity. Comparison of this species with available descriptions of other geckos resulted in the identification of 14 cranial characteristics that are expressed more strongly with size increase. These characteristics become move evident in later stages of post-hatching development, especially near maturation, and are, therefore, attributed to peramorphosis (hyperossification). ACCTRAN and DELTRAN character optimizations were applied to these characters using a tree of 11 genera derived from a gekkotan molecular phylogeny. This analysis revealed that G. gecko expresses the majority of these putative peramorphic features near maturity, and that some of these features are also expressed in species closely related to G. gecko. The characters studied have the potential to be applied in future phylogenetic and taxonomic studies of this group of lizards. PMID:26010648

  5. Hemostasis in Endoscopic Endonasal Skull Base Surgery.

    PubMed

    Vaz-Guimaraes, Francisco; Su, Shirley Y; Fernandez-Miranda, Juan C; Wang, Eric W; Snyderman, Carl H; Gardner, Paul A

    2015-08-01

    William Halsted established the basic principles of modern surgical technique highlighting the importance of meticulous hemostasis and careful tissue handling. These concepts hold true today and are even more critical for endoscopic visualization, making hemostasis one of the most relevant cornerstones for the safe practice of endoscopic endonasal surgery (EES) of the skull base. During preoperative assessment, patients at higher risk for serious hemorrhagic complications must be recognized. From an anatomical point of view, EES can be grossly divided in two major components: sinonasal surgery and sellar-cranial base surgery. This division affects the choice of appropriate technique for control of bleeding that relies mainly on the source of hemorrhage, the tissue involved, and the proximity of critical neurovascular structures. Pistol-grip or single-shaft instruments constitute the most important and appropriately designed instruments available for EES. Electrocoagulation and a variety of hemostatic materials are also important tools and should be applied wisely. This article describes the experience of our team in the management of hemorrhagic events during EES with an emphasis on technical nuances. PMID:26225320

  6. Spontaneous Resorption of a Penetrating Orbital Bone Fracture Fragment.

    PubMed

    Campbell, Ashley A; Cunnane, Mary Elizabeth; Dunn, Gavin P; Gray, Stacy Tutt; Lefebvre, Daniel R

    2015-01-01

    The authors describe a 20-year-old man who sustained multiple facial fractures in a high-speed motor vehicle crash, including a bone fragment from a skull base fracture that penetrated the orbital soft tissues superomedially. Serial CT scans documented spontaneous resorption over a 6-month period. While it is known that autologous bone grafts used in craniofacial reconstruction exhibit variable amounts of bone resorption, the complete resorption of an intraorbital fracture fragment has not been documented in the literature. His clinical care and the report of his case were undertaken in a fashion in accordance with the principles of the Health Insurance Portability and Accountability Act regulations. PMID:24833452

  7. Earliest Directly-Dated Human Skull-Cups

    PubMed Central

    Bello, Silvia M.; Parfitt, Simon A.; Stringer, Chris B.

    2011-01-01

    Background The use of human braincases as drinking cups and containers has extensive historic and ethnographic documentation, but archaeological examples are extremely rare. In the Upper Palaeolithic of western Europe, cut-marked and broken human bones are widespread in the Magdalenian (∼15 to 12,000 years BP) and skull-cup preparation is an element of this tradition. Principal Findings Here we describe the post-mortem processing of human heads at the Upper Palaeolithic site of Gough's Cave (Somerset, England) and identify a range of modifications associated with the production of skull-cups. New analyses of human remains from Gough's Cave demonstrate the skilled post-mortem manipulation of human bodies. Results of the research suggest the processing of cadavers for the consumption of body tissues (bone marrow), accompanied by meticulous shaping of cranial vaults. The distribution of cut-marks and percussion features indicates that the skulls were scrupulously 'cleaned' of any soft tissues, and subsequently modified by controlled removal of the facial region and breakage of the cranial base along a sub-horizontal plane. The vaults were also ‘retouched’, possibly to make the broken edges more regular. This manipulation suggests the shaping of skulls to produce skull-cups. Conclusions Three skull-cups have been identified amongst the human bones from Gough's Cave. New ultrafiltered radiocarbon determinations provide direct dates of about 14,700 cal BP, making these the oldest directly dated skull-cups and the only examples known from the British Isles. PMID:21359211

  8. Growing and Growing: Promoting Functional Thinking with Geometric Growing Patterns

    ERIC Educational Resources Information Center

    Markworth, Kimberly A.

    2010-01-01

    Design research methodology is used in this study to develop an empirically-substantiated instruction theory about students' development of functional thinking in the context of geometric growing patterns. The two research questions are: (1) How does students' functional thinking develop in the context of geometric growing patterns? (2) What are…

  9. Modeling the vertical confinement of injection-well thermal fractures

    SciTech Connect

    Clifford, P.J.; Berry, P.J.; Gu, H. )

    1991-11-01

    Cooling of rock by water injection frequently causes fracturing of wells. This paper describes a 3D simulation model of thermally induced fracturing. It is used to show that fractures often tend to grow vertically into permeable zones. Procedures are outlined for confining fracture growth in wells where it will assist waterflood sweep performance.

  10. Surgically resected skull base meningiomas demonstrate a divergent postoperative recurrence pattern compared with non-skull base meningiomas.

    PubMed

    Mansouri, Alireza; Klironomos, George; Taslimi, Shervin; Kilian, Alex; Gentili, Fred; Khan, Osaama H; Aldape, Kenneth; Zadeh, Gelareh

    2016-08-01

    OBJECTIVE The objective of this study was to identify the natural history and clinical predictors of postoperative recurrence of skull base and non-skull base meningiomas. METHODS The authors performed a retrospective hospital-based study of all patients with meningioma referred to their institution from September 1993 to January 2014. The cohort constituted both patients with a first-time presentation and those with evidence of recurrence. Kaplan-Meier curves were constructed for analysis of recurrence and differences were assessed using the log-rank test. Cox proportional hazard regression was used to identify potential predictors of recurrence. RESULTS Overall, 398 intracranial meningiomas were reviewed, including 269 (68%) non-skull base and 129 (32%) skull base meningiomas (median follow-up 30.2 months, interquartile range [IQR] 8.5-76 months). The 10-year recurrence-free survival rates for patients with gross-total resection (GTR) and subtotal resection (STR) were 90% and 43%, respectively. Skull base tumors were associated with a lower proliferation index (0.041 vs 0.062, p = 0.001), higher likelihood of WHO Grade I (85.3% vs 69.1%, p = 0.003), and younger patient age (55.2 vs 58.3 years, p = 0.01). Meningiomas in all locations demonstrated an average recurrence rate of 30% at 100 months of follow-up. Subsequently, the recurrence of skull base meningiomas plateaued whereas non-skull base lesions had an 80% recurrence rate at 230 months follow-up (p = 0.02). On univariate analysis, a prior history of recurrence (p < 0.001), initial WHO grade following resection (p < 0.001), and the inability to obtain GTR (p < 0.001) were predictors of future recurrence. On multivariate analysis a prior history of recurrence (p = 0.02) and an STR (p < 0.01) were independent predictors of a recurrence. Assessing only patients with primary presentations, STR and WHO Grades II and III were independent predictors of recurrence (p < 0.001 for both). CONCLUSIONS Patients with skull

  11. Elbow Fractures

    MedlinePlus

    ... and held together with pins and wires or plates and screws. Fractures of the distal humerus (see ... doctor. These fractures usually require surgical repair with plates and/or screw, unless they are stable. SIGNS ...

  12. Olecranon Fractures.

    PubMed

    Brolin, Tyler J; Throckmorton, Thomas

    2015-11-01

    Olecranon fractures are common upper extremity injuries, with all but nondisplaced fractures treated surgically. There has been a recent shift in the surgical management of these fractures from tension band wiring to locking plate fixation and intramedullary nailing; however, this comes with increased implant cost. Although most patients can expect good outcomes after these various techniques, there is little information to guide a surgeon's treatment plan. This article reviews the epidemiology, classification, treatment, and outcomes of olecranon fractures. PMID:26498547

  13. [Intraoperative navigation, with focus on the skull base].

    PubMed

    Wirtz, C R

    2016-09-01

    Intraoperative navigation systems are widely used in ENT, oral and maxillofacial, and neurosurgery. The benefits of such systems have been demonstrated in various applications, including intracranial and skull base surgery. Intraoperative shift, "brain shift" and changes in anatomy caused by the surgical procedure itself impair the accuracy of navigation and represent factors limiting its application, particularly in glioma and metastatic brain surgery. For this reason, intraoperative imaging was incorporated into neurosurgery. A specific application of navigation is thus skull base surgery, where shifts are often negligible due to the bony structures in which pathologies are embedded. Development of new systems with seamless integration into the operative workflow propagated routine use of navigation in neuro- and ENT surgery. Navigation proved especially helpful in interdisciplinary surgery with pathologies located in anatomic regions where competences of different surgical disciplines overlap, as in the skull base. While this increased radicality in tumour resection, there was a high risk of morbidity. The integration of electrophysiological function monitoring served to preserve function and reduce morbidity, and has led to less invasive and radical strategies in skull base surgery. New radiosurgical methods to adjuvantly treat possible tumour remnants have also supported this development. Systems allowing resection borders to be marked in the navigational coordinates would enable direct linking of these data to radiotherapy planning and better interpretation of follow-up imaging. Navigation is thus a valuable tool supporting interdisciplinary cooperation in skull base surgery for the benefit of patients. PMID:27566369

  14. The need for skull radiography in patients presenting for CT

    SciTech Connect

    Tress, B.M.

    1983-01-01

    One thousand patients had both CT of the head and a conventional skull series of radiographs. Radiographic findings were abnormal in 250 patients (25%), but only 64 patients (6.4%) had diagnostically significant abnormalities at radiography that were not detected by CT. If the 163 patients who presented after acute trauma were excluded from the series, only 39 (4.7%) of the remaining patients had radiographically significant abnormal findings that were not seen at CT, and only two (0.2%) of these abnormalities could not be diagnosed by a lateral skull radiograph alone. In only five patients (0.5%) was the management actively changed because an abnormaltiy that was detected at skull radiography was not detected at CT. Thus, in nontrauma patients who have stroke, epilepsy, dementia, or non-specific symptoms without focal signs, or have recently undergone craniotomy, and who have been referred for CT, skull radiographs are not justified. In the patient with a history and findings that are strongly suggestive of a pathological disorder anywhere other than in the sella turcica, cerebello-pontine angle, and paranasal sinuses, only the lateral skull radiograph should be obtained after CT, and only if CT is equivocal.

  15. Mechanical properties of the brain-skull interface.

    PubMed

    Mazumder, Mohammad Mynuddin Gani; Miller, Karol; Bunt, Stuart; Mostayed, Ahmed; Joldes, Grand; Day, Robert; Hart, Robin; Wittek, Adam

    2013-01-01

    Knowledge of the mechanical properties of the brain-skull interface is important for surgery simulation and injury biomechanics. These properties are known only to a limited extent. In this study we conducted in situ indentation of the sheep brain, and proposed to derive the macroscopic mechanical properties of the brain-skull interface from the results of these experiments. To the best of our knowledge, this is the first ever analysis of this kind. When conducting in situ indentation of the brain, the reaction force on the indentor was measured. After the indentation, a cylindrical sample of the brain tissue was extracted and subjected to uniaxial compression test. A model of the brain indentation experiment was built in the Finite Element (FE) solver ABAQUS™. In the model, the mechanical properties of the brain tissue were assigned as obtained from the uniaxial compression test and the brain-skull interface was modeled as linear springs. The interface stiffness (defined as sum of stiffnesses of the springs divided by the interface area) was varied to obtain good agreement between the calculated and experimentally measured indentor force-displacement relationship. Such agreement was found to occur for the brain-skull interface stiffness of 11.45 Nmm⁻¹/mm². This allowed identification of the overall mechanical properties of the brain-skull interface. PMID:23951996

  16. Geographical variation of the skull of the lesser mouse deer.

    PubMed

    Endo, Hideki; Fukuta, Katsuhiro; Kimura, Junpei; Sasaki, Motoki; Stafford, Brian J

    2004-10-01

    We examined the geographical variation of the skull size and shape of the lesser mouse deer (Tragulus javanicus) from Laos, Thailand, Peninsular Malaysia, Sumatra, Java, Borneo, Langkawi and some Islands of Tenasserim in Myanmar. Although the influence of the climatic condition on skull size was not confirmed in the mainland populations, the skull became rostro-caudally longer in the populations of Tenasserim and Sumatra because of island isolation effect. The skull size was classified into the following three clusters of localities from the matrix of Q-mode correlation coefficients: 1) Langkawi and Tenasserim, 2) Laos and Thailand, 3) Sumatra and Borneo. The skulls in the population of Java belong to the cluster of Langkawi and Tenasserim in male, however were morphologically similar to those in the cluster of Borneo and Sumatra. The canonical discriminant analysis pointed out that the Laos and Tenasserim populations were separated from the other ones and that the populations of Sumatra, Java and Borneo were intermingled each other. PMID:15528854

  17. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    SciTech Connect

    O'Malley, Bert W. Weinstein, Gregory S.

    2007-10-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development.

  18. Skull base defect in a patient with ozena undergoing dacryocystorhinostomy

    PubMed Central

    Earley, Marisa A.; Eloy, Jean Anderson

    2011-01-01

    Ozena, which is often used interchangeably with atrophic rhinitis or empty nose syndrome, is a progressive and chronically debilitating nasal disease that results in atrophy of the nasal mucosa, nasal crusting, fetor, and destruction of submucosal structures. Although the etiology is not completely understood, infection with Klebsiella ozaenae is widely believed to contribute to the destructive changes. We present a case of a patient with ozena secondary to K. ozaenae with extensive destruction of bony structures of the nasal cavity undergoing elective dacryocystorhinostomy. An extensively thinned skull base secondary to the disease process resulted in an unforeseen complication in which the skull base was entered leading to a cerebrospinal fluid leak. Patients with known history of ozena or atrophic rhinitis often have extensive destruction of the lateral nasal wall and skull base secondary to progression of disease. Submucosal destruction of these bony structures mandates the need for extreme caution when planning on performing endoscopic intervention at or near the skull base. If physical examination or nasal endoscopy is suspicious for atrophic rhinitis or a patient has a known history of infection with K. ozaenae, we recommend preoperative imaging for surgical planning with careful attention to skull base anatomy. PMID:22852113

  19. Fracture Networks in Sea Ice

    NASA Astrophysics Data System (ADS)

    Vevatne, Jonas; Rimstad, Eivind; Hansen, Alex; Korsnes, Reinert; Hope, Sigmund

    2014-04-01

    Fracturing and refreezing of sea ice in the Kara sea are investigated using complex networkanalysis. By going to the dual network, where the fractures are nodes and their intersectionslinks, we gain access to topological features which are easy to measure and hence comparewith modeled networks. Resulting network reveal statistical properties of the fracturing process.The dual networks have a broad degree distribution, with a scale-free tail, high clusteringand efficiency. The degree-degree correlation profile shows disassortative behavior, indicatingpreferential growth. This implies that long, dominating fractures appear earlier than shorterfractures, and that the short fractures which are created later tend to connect to the longfractures.The knowledge of the fracturing process is used to construct growing fracture network (GFN)model which provides insight into the generation of fracture networks. The GFN model isprimarily based on the observation that fractures in sea ice are likely to end when hitting existingfractures. Based on an investigation of which fractures survive over time, a simple model forrefreezing is also added to the GFN model, and the model is analyzed and compared to the realnetworks.

  20. Foam-Driven Fractures of an Elastic Matrix

    NASA Astrophysics Data System (ADS)

    Lai, Ching-Yao; Smiddy, Sam; Stone, Howard

    2015-11-01

    We report an experimental study of foam-driven fractures in an elastic matrix. When a pressurized foam is constantly injected into a gelatin matrix with a constant flow rate, the foam generates a disc-like fracture which is commonly observed in liquid-driven fractures. Compare to liquid-driven fractures, foam-driven fractures grow faster with time. We investigate how the rheological behaviour of foams affects the fracture characteristics by varying the air volume fraction of the foam, the types and concentration of surfactants in the foam. Foam-fracturing reduces the environmental costs of hydraulic fracturing, which inspires this laboratory study.

  1. Skull Defects in Finite Element Head Models for Source Reconstruction from Magnetoencephalography Signals

    PubMed Central

    Lau, Stephan; Güllmar, Daniel; Flemming, Lars; Grayden, David B.; Cook, Mark J.; Wolters, Carsten H.; Haueisen, Jens

    2016-01-01

    Magnetoencephalography (MEG) signals are influenced by skull defects. However, there is a lack of evidence of this influence during source reconstruction. Our objectives are to characterize errors in source reconstruction from MEG signals due to ignoring skull defects and to assess the ability of an exact finite element head model to eliminate such errors. A detailed finite element model of the head of a rabbit used in a physical experiment was constructed from magnetic resonance and co-registered computer tomography imaging that differentiated nine tissue types. Sources of the MEG measurements above intact skull and above skull defects respectively were reconstructed using a finite element model with the intact skull and one incorporating the skull defects. The forward simulation of the MEG signals reproduced the experimentally observed characteristic magnitude and topography changes due to skull defects. Sources reconstructed from measured MEG signals above intact skull matched the known physical locations and orientations. Ignoring skull defects in the head model during reconstruction displaced sources under a skull defect away from that defect. Sources next to a defect were reoriented. When skull defects, with their physical conductivity, were incorporated in the head model, the location and orientation errors were mostly eliminated. The conductivity of the skull defect material non-uniformly modulated the influence on MEG signals. We propose concrete guidelines for taking into account conducting skull defects during MEG coil placement and modeling. Exact finite element head models can improve localization of brain function, specifically after surgery. PMID:27092044

  2. Properties and architecture of the sperm whale skull amphitheatre.

    PubMed

    Alam, Parvez; Amini, Shahrouz; Tadayon, Maryam; Miserez, Ali; Chinsamy, Anusuya

    2016-02-01

    The sperm whale skull amphitheatre cradles an enormous two-tonne spermaceti organ. The amphitheatre separates this organ from the cranium and the cervical vertebrae that lie in close proximity to the base of the skull. Here, we elucidate that this skull amphitheatre is an elastic, flexible, triple-layered structure with mechanical properties that are conjointly guided by bone histology and the characteristics of pore space. We contend that the amphitheatre will flex elastically to equilibrate forces transmitted via the spermaceti organ that arise through diving. We find that collisions from sperm whale aggression do not cause the amphitheatre to bend, but rather localise stress to the base of the amphitheatre on its anterior face. We consider, therefore, that the uniquely thin and extended construction of the amphitheatre, has relevance as an energy absorptive structure in diving. PMID:26781232

  3. [Two cases of tuberculosis of the skull cap (author's transl)].

    PubMed

    Memin, Y; Zurbach, J; Mafart, Y; Lesobre, B; Piéron, R; Hercend, T

    The authors report two cases of tuberculosis of the skull cap. The first in a Black African with heterozygous sickle cell disease also presenting with: tuberculosis of the cervical lymph nodes, subcutaneous frontal tumefactions bacteriologically confirmed to be of tuberculous origin, multiple lacunae of the vault from the same origin; the second case is an Asian woman having a multifocal tuberculous osteitis involving the skull, spine, pelvis and probably the same affection in the spleen. These cases are a reminder that the principal features of tuberculosis of the skull vault are very often associated with other tuberculous lesions, and to the problems of diagnosis it entails; the existence of a subcutaneous tumefaction of the vault or of any accessible site one can aspirate and/or perform biopsy constitutes a diagnostic aid. PMID:6244640

  4. Reconstruction Using Locoregional Flaps for Large Skull Base Defects.

    PubMed

    Hatano, Takaharu; Motomura, Hisashi; Ayabe, Shinobu

    2015-06-01

    We present a modified locoregional flap for the reconstruction of large anterior skull base defects that should be reconstructed with a free flap according to Yano's algorithm. No classification of skull base defects had been proposed for a long time. Yano et al suggested a new classification in 2012. The lb defect of Yano's classification extends horizontally from the cribriform plate to the orbital roof. According to Yano's algorithm for subsequent skull base reconstructive procedures, a lb defect should be reconstructed with a free flap such as an anterolateral thigh free flap or rectus abdominis myocutaneous free flap. However, our modified locoregional flap has also enabled reconstruction of lb defects. In this case series, we used a locoregional flap for lb defects. No major postoperative complications occurred. We present our modified locoregional flap that enables reconstruction of lb defects. PMID:26225296

  5. Sports fractures.

    PubMed Central

    DeCoster, T. A.; Stevens, M. A.; Albright, J. P.

    1994-01-01

    Fractures occur in athletes and dramatically influence performance during competitive and recreational activities. Fractures occur in athletes as the result of repetitive stress, acute sports-related trauma and trauma outside of athletics. The literature provides general guidelines for treatment as well as a variety of statistics on the epidemiology of fractures by sport and level of participation. Athletes are healthy and motivated patients, and have high expectations regarding their level of function. These qualities make them good surgical candidates. Although closed treatment methods are appropriate for most sports fractures, an aggressive approach to more complicated fractures employing current techniques may optimize their subsequent performance. PMID:7719781

  6. Proton therapy for tumors of the base of the skull.

    PubMed

    Noel, Georges; Gondi, Vinai

    2016-08-01

    Relative to conventional photon irradiation, proton therapy has distinct advantages in its ability to more precisely target tumor while shielding adjacent normal tissues. In the setting of skull base tumors, proton therapy plays a critical role in the dose-escalation required for optimal tumor control of chordomas, chondrosarcomas, and malignancies of the paranasal sinuses and nasal cavity. For benign tumors such as craniopharyngiomas, pituitary adenomas and meningiomas, proton therapy can limit long-term adverse effects, such as secondary malignancies. This review summarizes published literature to date regarding the role of proton therapy in skull base tumors and introduces emerging proton therapy approaches such as pencil-beam scanning (PBS). PMID:27558252

  7. Cavernous Hemangioma of the Skull and Meningioma: Association or Coincidence?

    PubMed Central

    Kilani, M.; Darmoul, M.; Hammedi, F.; Ben Nsir, A.; Hattab, M. N.

    2015-01-01

    Intraosseous cavernous hemangiomas of the skull are rare. Meningiomas are quite frequently encountered in a neurosurgical practice. The association between these two entities is nevertheless very uncommon. The authors present a case of a 72-year-old woman suffering from headache. The MRI showed a parietal meningioma with adjacent thick bone. The meningioma and the bone were removed. The histological examination confirmed the diagnosis of meningioma and revealed a cavernoma of the skull. The relationship between the lesions suggests more than a coincidental association. Several hypotheses are proposed to explain common causal connections. PMID:25960899

  8. Nonpenetrating Clips Successfully Replacing Sutures in Base of Skull Surgery

    PubMed Central

    Kirsch, Wolff M.; Zhu, Yong Hua; Hardesty, Robert A.; Petti, George; Furnas, David

    1993-01-01

    Reconstructive challenges engendered by skull base surgery are critical determinants of outcome. A novel nonpenetrating, arcuate-legged clip has proven to be both technically and biologically effective for management of these difficult closures. Clips have facilitated reconstructions associated with the surgical management of eight skull base cases: leiomyosarcoma of the orbit, middle fossa, ptyergopalatine fossa, two meningiomas (petrotentorial, cavernous sinus), vagus nerve paraganglioma, complex traumatic orbital dural tear, and one basilar and two vertebral artery aneurysms. ImagesFigure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11Figure 12Figure 14Figure 16Figure 17Figure 18 PMID:17170909

  9. [A skull of Mesopithecus with bite marks (author's transl)].

    PubMed

    Zapfe, H

    1981-01-01

    A skull of Mesopithecus pentelicus (Roth and Wagner) from the Turolian (Upper Miocene) of Pikermi (Greece) shows hole-shaped bitemarks. Considering the behavior and the character of the dentition of the groups of carnivores represented in Pikermi, it is supposed that these bitemarks have been caused by a felid of the size of a leopard. In the fauna of Pikermi only Metailurus parvulus (Hensel) can be taken into consideration. By the defects on a skull of a juvenile Australopithecine, interpreted by Brain in 1970 as bitemarks of a leopard, the above explanation gets a very essential support. PMID:6792015

  10. Removing Part of Skull After Severe Head Injury Brings Mixed Results

    MedlinePlus

    ... gov/news/fullstory_160857.html Removing Part of Skull After Severe Head Injury Brings Mixed Results More ... 8, 2016 (HealthDay News) -- Removing part of the skull to relieve pressure in the brain following a ...

  11. Segmentation, surface rendering, and surface simplification of 3-D skull images for the repair of a large skull defect

    NASA Astrophysics Data System (ADS)

    Wan, Weibing; Shi, Pengfei; Li, Shuguang

    2009-10-01

    Given the potential demonstrated by research into bone-tissue engineering, the use of medical image data for the rapid prototyping (RP) of scaffolds is a subject worthy of research. Computer-aided design and manufacture and medical imaging have created new possibilities for RP. Accurate and efficient design and fabrication of anatomic models is critical to these applications. We explore the application of RP computational methods to the repair of a pediatric skull defect. The focus of this study is the segmentation of the defect region seen in computerized tomography (CT) slice images of this patient's skull and the three-dimensional (3-D) surface rendering of the patient's CT-scan data. We see if our segmentation and surface rendering software can improve the generation of an implant model to fill a skull defect.

  12. Long-term outcome of extensive skull reconstruction using demineralized perforated bone in Siamese twins joined at the skull vertex.

    PubMed

    Salyer, K E; Gendler, E; Squier, C A

    1997-05-01

    The successful use of cortical demineralized perforated bone in the treatment of extensive skeletal defects in children is exemplified by this case involving Siamese twins joined at the skull vertex. Four years following extensive skull reconstruction using demineralized perforated bone, an examination revealed successful calvarial reconstruction in one twin. The other twin required additional implants of demineralized perforated bone to fill in defects. However, a histologic examination taken following this additional procedure revealed that these implants neither caused tissue reaction over a 4-year period, nor showed signs of resorption. Bony remodeling and new bone formation were in progress. Compared with other bone substitutes, demineralized perforated bone has proven to be effective in the treatment of large skull defects in children. PMID:9145145

  13. If the skull fits: magnetic resonance imaging and microcomputed tomography for combined analysis of brain and skull phenotypes in the mouse

    PubMed Central

    Blank, Marissa C.; Roman, Brian B.; Henkelman, R. Mark; Millen, Kathleen J.

    2012-01-01

    The mammalian brain and skull develop concurrently in a coordinated manner, consistently producing a brain and skull that fit tightly together. It is common that abnormalities in one are associated with related abnormalities in the other. However, this is not always the case. A complete characterization of the relationship between brain and skull phenotypes is necessary to understand the mechanisms that cause them to be coordinated or divergent and to provide perspective on the potential diagnostic or prognostic significance of brain and skull phenotypes. We demonstrate the combined use of magnetic resonance imaging and microcomputed tomography for analysis of brain and skull phenotypes in the mouse. Co-registration of brain and skull images allows comparison of the relationship between phenotypes in the brain and those in the skull. We observe a close fit between the brain and skull of two genetic mouse models that both show abnormal brain and skull phenotypes. Application of these three-dimensional image analyses in a broader range of mouse mutants will provide a map of the relationships between brain and skull phenotypes generally and allow characterization of patterns of similarities and differences. PMID:22947655

  14. Hip fracture - discharge

    MedlinePlus

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  15. Skull counting in late stages after internal contamination by actinides.

    PubMed

    Tani, Kotaro; Shutt, Arron; Kurihara, Osamu; Kosako, Toshiso

    2015-02-01

    Monitoring preparation for internal contamination with actinides (e.g. Pu and Am) is required to assess internal doses at nuclear fuel cycle-related facilities. In this paper, the authors focus on skull counting in case of single-incident inhalation of (241)Am and propose an effective procedure for skull counting with an existing system, taking into account the biokinetic behaviour of (241)Am in the human body. The predicted response of the system to skull counting under a certain counting geometry was found to be only ∼1.0 × 10(-5) cps Bq(-1) 1y after intake. However, this disadvantage could be remedied by repeated measurements of the skull during the late stage of the intake due to the predicted response reaching a plateau at about the 1000th day after exposure and exceeding that in the lung counting. Further studies are needed for the development of a new detection system with higher sensitivity to perform reliable internal dose estimations based on direct measurements. PMID:24920571

  16. Advances in computed tomography evaluation of skull base diseases.

    PubMed

    Prevedello, Luciano M

    2014-10-01

    Introduction Computed tomography (CT) is a key component in the evaluation of skull base diseases. With its ability to clearly delineate the osseous anatomy, CT can provide not only important tips to diagnosis but also key information for surgical planning. Objectives The purpose of this article is to describe some of the main CT imaging features that contribute to the diagnosis of skull base tumors, review recent knowledge related to bony manifestations of these conditions, and summarize recent technological advances in CT that contribute to image quality and improved diagnosis. Data Synthesis Recent advances in CT technology allow fine-detailed evaluation of the bony anatomy using submillimetric sections. Dual-energy CT material decomposition capabilities allow clear separation between contrast material, bone, and soft tissues with many clinical applications in the skull base. Dual-energy technology has also the ability to decrease image degradation from metallic hardwares using some techniques that can result in similar or even decreased radiation to patients. Conclusions CT is very useful in the evaluation of skull base diseases, and recent technological advances can increase disease conspicuity resulting in improved diagnostic capabilities and enhanced surgical planning. PMID:25992136

  17. Human Temporal Bone Removal: The Skull Base Block Method.

    PubMed

    Dinh, Christine; Szczupak, Mikhaylo; Moon, Seo; Angeli, Simon; Eshraghi, Adrien; Telischi, Fred F

    2015-08-01

    Objectives To describe a technique for harvesting larger temporal bone specimens from human cadavers for the training of otolaryngology residents and fellows on the various approaches to the lateral and posterolateral skull base. Design Human cadaveric anatomical study. The calvarium was excised 6 cm above the superior aspect of the ear canal. The brain and cerebellum were carefully removed, and the cranial nerves were cut sharply. Two bony cuts were performed, one in the midsagittal plane and the other in the coronal plane at the level of the optic foramen. Setting Medical school anatomy laboratory. Participants Human cadavers. Main Outcome Measures Anatomical contents of specimens and technical effort required. Results Larger temporal bone specimens containing portions of the parietal, occipital, and sphenoidal bones were consistently obtained using this technique of two bone cuts. All specimens were inspected and contained pertinent surface and skull base landmarks. Conclusions The skull base block method allows for larger temporal bone specimens using a two bone cut technique that is efficient and reproducible. These specimens have the necessary anatomical bony landmarks for studying the complexity, utility, and limitations of lateral and posterolateral approaches to the skull base, important for the education of otolaryngology residents and fellows. PMID:26225316

  18. Intracranial hypertension secondary to a skull lesion without mass effect.

    PubMed

    Serlin, Yonatan; Benifla, Mony; Kesler, Anat; Cohen, Avi; Shelef, Ilan

    2016-09-01

    We report and discuss five patients with intracranial hypertension due to a skull lesion reducing cerebral sinus patency with a compressive, non-thrombotic mechanism. We illustrate the importance of a high level of suspicion for this condition in patients presenting with headache, papilledema and increased intracranial pressure in the absence of focal signs or radiological evidence of mass effect. PMID:27283387

  19. Skull Size and Intelligence, and King Robert Bruce's IQ

    ERIC Educational Resources Information Center

    Deary, Ian J.; Ferguson, Karen J.; Bastin, Mark E.; Barrow, Geoffrey W. S.; Reid, Louise M.; Seckl, Jonathan R.; Wardlaw, Joanna M.; MacLullich, Alasdair M. J.

    2007-01-01

    An estimate of someone's IQ is a potentially informative personal datum. This study examines the association between external skull measurements and IQ scores, and uses the resulting regression equation to provide an estimate of the IQ of King Robert I of Scotland (Robert Bruce, 1274-1329). Participants were 48 relatively healthy Caucasian men…

  20. Reliability of Craniofacial Superimposition Using Three-Dimension Skull Model.

    PubMed

    Gaudio, Daniel; Olivieri, Lara; De Angelis, Danilo; Poppa, Pasquale; Galassi, Andrea; Cattaneo, Cristina

    2016-01-01

    Craniofacial superimposition is a technique potentially useful for the identification of unidentified human remains if a photo of the missing person is available. We have tested the reliability of the 2D-3D computer-aided nonautomatic superimposition techniques. Three-dimension laser scans of five skulls and ten photographs were overlaid with an imaging software. The resulting superimpositions were evaluated using three methods: craniofacial landmarks, morphological features, and a combination of the two. A 3D model of each skull without its mandible was tested for superimposition; we also evaluated whether separating skulls by sex would increase correct identifications. Results show that the landmark method employing the entire skull is the more reliable one (5/5 correct identifications, 40% false positives [FP]), regardless of sex. However, the persistence of a high percentage of FP in all the methods evaluated indicates that these methods are unreliable for positive identification although the landmark-only method could be useful for exclusion. PMID:26335587

  1. Giant Cell Tumor of the Skull: Review of the Literature.

    PubMed

    Tamura, Ryota; Miwa, Tomoru; Shimizu, Kazuhiko; Mizutani, Katsuhiro; Tomita, Hideyuki; Yamane, Nobuo; Tominaga, Takehiro; Sasaki, Shunichi

    2016-05-01

    Background Giant cell tumors (GCTs) are rare in the skull. The present report describes a case with a primary GCT located in the temporal bone and reviews the relevant literature. We also propose a treatment strategy for GCT of the skull. Clinical Presentation A 41-year-old man presented with headache and auditory disturbance. Radiologic images showed a lytic expansive extradural lesion originating primarily from the right temporal bone and expanding into the middle cranial fossa and the infratemporal fossa. A biopsy specimen of the lesion was obtained from the external auditory meatus. Total removal was performed with temporal craniectomy, mandibular condylar process removal, tympanoplasty, and mastoidectomy. Discussion The rate of recurrence of GCTs is related to complete resection and location of the GCT rather than to the degree of invasiveness. Some of the mononuclear cells and stromal cells in GCT express receptor activator of nuclear factor κ-β ligand (RANKL). Because inhibition of RANKL and bisphosphonate therapy might eliminate giant cells, this approach might be useful for recurrent or unresectable GCTs of the skull. Conclusions Preoperative diagnosis by biopsy is important in determining the therapeutic strategy of GCTs. Complete resection is important to reduce the recurrence rate of GCTs in the skull. PMID:26091114

  2. Dynamic photophysical processes in laser irradiated human cortical skull bone

    NASA Astrophysics Data System (ADS)

    Mandelis, Andreas; Kwan, Chi-Hang; Matvienko, Anna

    2009-02-01

    Modulated luminescence (LUM) technique was applied to analyze photophysical processes in the cortical layer of human skull bones. The theoretical interpretation of the results was based on the optical excitation and decay rate equations of the fluorophore and on the molecular interaction parameter with the photon field density in the matrix of the bone. Using comparisons of the theory with the frequency response of dental LUM it was concluded that the optically active molecular species (fluorophore) in the bones is hydroxyapatite. An effective relaxation lifetime of skull cortical bone was derived theoretically and was found to depend on the intrinsic fluorophore decay lifetime, on the photon field density, and on the thickness of the bone. The experimentally measured dependencies were in excellent agreement with the theoretical model. The theory was able to yield measurements of the optical scattering coefficient, optical absorption coefficient, and mean coupling coefficient. These results show that the quantitative LUM can be used as a sensitive method to measure optical properties of the active fluorophore in cortical skull bones and the optical-field-induced molecular interaction parameter. When calibrated vs. laser intensity, the modulated luminescence can also be used to measure human skull thickness. These traits can be applied to monitor the bone mineral density (BMD) and, ultimately can be used as potential markers of bone health or disease, such as osteoporosis or bone cancer.

  3. Can we abolish skull x rays for head injury?

    PubMed Central

    Reed, M; Browning, J; Wilkinson, A; Beattie, T

    2005-01-01

    Objectives: To assess the effect of a change in skull x ray policy on the rate of admission, use of computed tomography (CT), radiation dose per head injury, and detection of intracranial injuries; and to compare the characteristics of patients with normal and abnormal head CT. Design: Retrospective cohort study. Setting: UK paediatric teaching hospital emergency department. Patients: 1535 patients aged between 1 and 14 years with a head injury presenting to the emergency department between 1 August 1998 and 31 July 1999 (control period), and 1867 presenting between 1 August 2002 and 31 July 2003 (first year of new skull x ray policy). Intervention: Hospital notes and computer systems were analysed and data were collected on all patients presenting with a head injury. Results: The abolition of skull x rays in children aged over 1 year prevented about 400 normal skull x rays being undertaken in period 2. The percentage of children undergoing CT rose from 1.0% to 2.1% with no change in the positive CT pick up rate (25.6% v 25.0%). There was no significant change in admission rate (10.9% v 10.1%), and a slight decrease in the radiation dose per head injury (0.042 mSv compared to 0.045 mSv). Conclusions: Skull x rays can be abandoned in children aged 1 to 14 without a significant increase in admission rate, radiation dose per head injury, or missed intracranial injury. The mechanism and history of the injury and a reduced Glasgow coma scale are probably the most important indicators of significant head injury in children. PMID:15851418

  4. Micrometeorite Impacts in Beringian Mammoth Tusks and a Bison Skull

    SciTech Connect

    Hagstrum, Jonathon T.; Firestone, Richard B; West, Allen; Stefanka, Zsolt; Revay, Zsolt

    2010-02-03

    We have discovered what appear to be micrometeorites imbedded in seven late Pleistocene Alaskan mammoth tusks and a Siberian bison skull. The micrometeorites apparently shattered on impact leaving 2 to 5 mm hemispherical debris patterns surrounded by carbonized rings. Multiple impacts are observed on only one side of the tusks and skull consistent with the micrometeorites having come from a single direction. The impact sites are strongly magnetic indicating significant iron content. We analyzed several imbedded micrometeorite fragments from both tusks and skull with laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and X-ray fluorescence (XRF). These analyses confirm the high iron content and indicate compositions highly enriched in nickel and depleted in titanium, unlike any natural terrestrial sources. In addition, electron microprobe (EMP) analyses of a Fe-Ni sulfide grain (tusk 2) show it contains between 3 and 20 weight percent Ni. Prompt gamma-ray activation analysis (PGAA) of a particle extracted from the bison skull indicates ~;;0.4 mg of iron, in agreement with a micrometeorite ~;;1 mm in diameter. In addition, scanning electron microscope (SEM) images and XRF analyses of the skull show possible entry channels containing Fe-rich material. The majority of tusks (5/7) have a calibrated weighted mean 14C age of 32.9 +- 1.8 ka BP, which coincides with the onset of significant declines<36 ka ago in Beringian bison, horse, brown bear, and mammoth populations, as well as in mammoth genetic diversity. It appears likely that the impacts and population declines are related events, although their precise nature remains to be determined.

  5. A Giant Pliosaurid Skull from the Late Jurassic of England

    PubMed Central

    Benson, Roger B. J.; Evans, Mark; Smith, Adam S.; Sassoon, Judyth; Moore-Faye, Scott; Ketchum, Hilary F.; Forrest, Richard

    2013-01-01

    Pliosaurids were a long-lived and cosmopolitan group of marine predators that spanned 110 million years and occupied the upper tiers of marine ecosystems from the Middle Jurassic until the early Late Cretaceous. A well-preserved giant pliosaurid skull from the Late Jurassic Kimmeridge Clay Formation of Dorset, United Kingdom, represents a new species, Pliosaurus kevani. This specimen is described in detail, and the taxonomy and systematics of Late Jurassic pliosaurids is revised. We name two additional new species, Pliosaurus carpenteri and Pliosaurus westburyensis, based on previously described relatively complete, well-preserved remains. Most or all Late Jurassic pliosaurids represent a globally distributed monophyletic group (the genus Pliosaurus, excluding ‘Pliosaurus’ andrewsi). Despite its high species diversity, and geographically widespread, temporally extensive occurrence, Pliosaurus shows relatively less morphological and ecological variation than is seen in earlier, multi-genus pliosaurid assemblages such as that of the Middle Jurassic Oxford Clay Formation. It also shows less ecological variation than the pliosaurid-like Cretaceous clade Polycotylidae. Species of Pliosaurus had robust skulls, large body sizes (with skull lengths of 1.7–2.1 metres), and trihedral or subtrihedral teeth suggesting macropredaceous habits. Our data support a trend of decreasing length of the mandibular symphysis through Late Jurassic time, as previously suggested. This may be correlated with increasing adaptation to feeding on large prey. Maximum body size of pliosaurids increased from their first appearance in the Early Jurassic until the Early Cretaceous (skull lengths up to 2360 mm). However, some reduction occurred before their final extinction in the early Late Cretaceous (skull lengths up to 1750 mm). PMID:23741520

  6. Temporal bone fracture following blunt trauma caused by a flying fish.

    PubMed

    Goldenberg, D; Karam, M; Danino, J; Flax-Goldenberg, R; Joachims, H Z

    1998-10-01

    Blunt trauma to the temporal region can cause fracture of the skull base, loss of hearing, vestibular symptoms and otorrhoea. The most common causes of blunt trauma to the ear and surrounding area are motor vehicle accidents, violent encounters, and sports-related accidents. We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus. PMID:10211221

  7. Predicting zygoma fractures from baseball impact.

    PubMed

    Cormier, Joseph M; Stitzel, Joel D; Hurst, William J; Porta, David J; Jones, Jeryl; Duma, Stefan M

    2006-01-01

    The purpose of this study is to develop injury risk functions that predict zygoma fracture based on baseball type and impact velocity. Zygoma fracture strength data from published experiments were mapped with the force exerted by a baseball on the orbit as a function of ball velocity. Using a normal distribution, zygoma fracture risk functions were developed. Experimental evaluation of these risk functions was performed using six human cadaver tests and two baseballs of different stiffness values. High speed video measured the baseball impact velocity. Post test analysis of the cadaver skulls was performed using CT imaging including three-dimensional reconstruction as well as autopsy. The developed injury risk functions accurately identify the risk of zygoma fracture as a result of baseball impact. The experimental results validated the zygoma risk functions at the lower and upper levels. The injuries observed in the post test analysis included fractures of the zygomatic arch, frontal process and the maxilla, zygoma suture, with combinations of these creating comminuted, tripod fractures of the zygoma. Tests with a softer baseball did result in injury but these had fewer resulting zygoma bone fragments and occurred at velocities 50% higher than the major league ball. PMID:16817599

  8. Predicting and Preventing Skull Overheating in Non Invasive Brain HIFU Treatment Protocols

    SciTech Connect

    Pernot, Mathieu; Aubry, Jean-Francois; Tanter, Mickael; Fink, Mathias

    2005-03-28

    Ultrasound brain therapy is currently limited by the strong phase and amplitude aberrations induced by the heterogeneities of the skull. However the development of aberration correction techniques has made it possible to correct the beam distortion induced by the skull and to produce a sharp focus in the brain. Moreover, using the density of the skull bone that can be obtained with high-resolution CT scans, the corrections needed to produce this sharp focus can be calculated using ultrasound propagation models. We propose here a model for computing the temperature elevation in the skull during High Intensity Focused Ultrasound (HIFU) transcranial therapy. Based on CT scans, the wave propagation through the skull is computed with 3D finite differences wave propagation software. The acoustic simulation is combined with a 3D thermal diffusion code and the temperature elevation inside the skull is computed. Finally, the simulation is validated experimentally by measuring the temperature elevation in several locations of the skull.

  9. Reconstruction of skull defects in the middle ages and renaissance.

    PubMed

    Missori, Paolo; Currà, Antonio; Paris, Harry S; Peschillo, Simone; Fattapposta, Francesco; Paolini, Sergio; Domenicucci, Maurizio

    2015-06-01

    In Egyptian, Greco-Roman, and Arabic medicine, the closure of a skull defect was not provided at the end of a therapeutic trepanation or in cases of bone removal. The literature from the Middle Ages and Renaissance disclosed some striking and forgotten practices. Gilbertus Anglicus (c. 1180 to c. 1250) cites the use of a piece of a cup made from wooden bowl (ciphum or mazer) or a gold sheet to cover the gap and protect the brain in these patients; this citation probably reflected a widely known folk practice. Pietro d'Argellata introduced the use of a fixed piece of dried gourd for brain protection to reconstruct a skull defect. In the late Renaissance, the negative folklore describing this outlandish practice likely led to the use of silver and lead sheets. Nevertheless, for centuries, large numbers of surgeons preferred to leave the dura mater uncovered after bone removal, and failed to apply any brain protection. PMID:25403799

  10. Variation of BMP3 Contributes to Dog Breed Skull Diversity

    PubMed Central

    Schoenebeck, Jeffrey J.; Hutchinson, Sarah A.; Byers, Alexandra; Beale, Holly C.; Carrington, Blake; Faden, Daniel L.; Rimbault, Maud; Decker, Brennan; Kidd, Jeffrey M.; Sood, Raman; Boyko, Adam R.; Fondon, John W.; Wayne, Robert K.; Bustamante, Carlos D.; Ciruna, Brian; Ostrander, Elaine A.

    2012-01-01

    Since the beginnings of domestication, the craniofacial architecture of the domestic dog has morphed and radiated to human whims. By beginning to define the genetic underpinnings of breed skull shapes, we can elucidate mechanisms of morphological diversification while presenting a framework for understanding human cephalic disorders. Using intrabreed association mapping with museum specimen measurements, we show that skull shape is regulated by at least five quantitative trait loci (QTLs). Our detailed analysis using whole-genome sequencing uncovers a missense mutation in BMP3. Validation studies in zebrafish show that Bmp3 function in cranial development is ancient. Our study reveals the causal variant for a canine QTL contributing to a major morphologic trait. PMID:22876193

  11. Dental development of the Taung skull from computerized tomography.

    PubMed

    Conroy, G C; Vannier, M W

    Just over 60 years ago, Dart's description and analysis of the Taung child's skull triggered an intellectual revolution about human origins. Recently, several authors have suggested that one of the most significant hominid-like traits of australopithecines, delayed maturation, may not after all be valid. This is a radical departure from Mann's classic study of australopithecine maturation and palaeodemography based on dental eruption patterns. The resolution of this debate has important implications for the history of the biological and social evolution of the human species. In view of the controversies generated by recent studies, and particularly because the Taung skull is the type specimen of Australopithecus africanus, we have investigated the relevant anatomy of the Taung 'child' using computerized tomography. We conclude that the Taung 'child' shows some important dental maturational affinities with great apes, although as Dart noted, other hominid-like features are clearly present. PMID:3116435

  12. A new skull of early Homo from Dmanisi, Georgia.

    PubMed

    Vekua, Abesalom; Lordkipanidze, David; Rightmire, G Philip; Agusti, Jordi; Ferring, Reid; Maisuradze, Givi; Mouskhelishvili, Alexander; Nioradze, Medea; De Leon, Marcia Ponce; Tappen, Martha; Tvalchrelidze, Merab; Zollikofer, Christoph

    2002-07-01

    Another hominid skull has been recovered at Dmanisi (Republic of Georgia) from the same strata in which hominid remains have been reported previously. The Dmanisi site dated to approximately 1.75 million years ago has now produced craniofacial portions of several hominid individuals, along with many well-preserved animal fossils and quantities of stone artifacts. Although there are certain anatomical differences among the Dmanisi specimens, the hominids do not clearly represent more than one taxon. We assign the new skull provisionally to Homo erectus (=ergaster). The Dmanisi specimens are the most primitive and small-brained fossils to be grouped with this species or any taxon linked unequivocally with genus Homo and also the ones most similar to the presumed habilis-like stem. We suggest that the ancestors of the Dmanisi population dispersed from Africa before the emergence of humans identified broadly with the H. erectus grade. PMID:12098694

  13. Streamlined, Inexpensive 3D Printing of the Brain and Skull.

    PubMed

    Naftulin, Jason S; Kimchi, Eyal Y; Cash, Sydney S

    2015-01-01

    Neuroimaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) collect three-dimensional data (3D) that is typically viewed on two-dimensional (2D) screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM) images to stereolithography (STL) files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3-4 in consumable plastic filament as described, and the total process takes 14-17 hours, almost all of which is unsupervised (preprocessing = 4-6 hr; printing = 9-11 hr, post-processing = <30 min). Printing a matching portion of a skull costs $1-5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes. PMID:26295459

  14. Recurrent Giant Cell Tumor of Skull Combined with Multiple Aneurysms

    PubMed Central

    Kim, Dae Hwan

    2016-01-01

    Giant cell tumors are benign but locally invasive and frequently recur. Giant cell tumors of the skull are extremely rare. A patient underwent a surgery to remove a tumor, but the tumor recurred. Additionally, the patient developed multiple aneurysms. The patient underwent total tumor resection and trapping for the aneurysms, followed by radiotherapy. We report this rare case and suggest some possibilities for treating tumor growth combined with aneurysm development. PMID:27195256

  15. Hypofractionated stereotactic radiation therapy in skull base meningiomas.

    PubMed

    Navarria, Pierina; Pessina, Federico; Cozzi, Luca; Clerici, Elena; Villa, Elisa; Ascolese, Anna Maria; De Rose, Fiorenza; Comito, Tiziana; Franzese, Ciro; D'Agostino, Giuseppe; Lobefalo, Francesca; Fogliata, Antonella; Reggiori, Giacomo; Fornari, Maurizio; Tomatis, Stefano; Bello, Lorenzo; Scorsetti, Marta

    2015-09-01

    To investigate the role of hypo-fractionated stereotactic radiation treatment (HSRT) in the management of skull base meningioma. Twenty-six patients were included in the study and treated with a dose of 30 Gy in 5 fractions with volumetric modulated arc therapy (RapidArc). Eighteen patients were symptomatic before treatment. Endpoints were local toxicity and relief from symptoms. Tumors were located in anterior skull base in 4/27 cases, in middle skull base in 12/27 and in posterior skull base in 11/27. HSRT was performed as first treatment in 17 (65 %) patients, in 9 (35 %) patients it followed a previous partial resection. Median follow up was 24.5 months (range 5-57 months). clinical remission of symptoms, complete or partial, was obtained in the vast majority of patients after treatment. Out of the 18 symptomatic patients, partial remission occurred in 9 (50 %) patients and complete remission in 9 (50 %). All asymptomatic patients retained their status after treatment. No severe neurologic toxicity grade III-IV was recorded. No increase of meningioma in the same site of treatment occurred; 16 (62 %) patients had stable disease and 9 (38 %) patients had tumor reduction. The mean tumor volume after treatment was 10.8 ± 17.8 cm(3) compared with 13.0 ± 19.1 cm(3) before treatment (p = 0.02). The mean actuarial OS was 54.4 ± 2.8 months. The 1- and 2-years OS was 92.9 ± 0.7 %. HSRT proved to be feasible for these patients not eligible to full surgery or to ablative radiation therapy. Local control and durability of results suggest for a routine application of this approach in properly selected cases. PMID:26040487

  16. Skull shapes of the Lissodelphininae: radiation, adaptation and asymmetry.

    PubMed

    Galatius, Anders; Goodall, R Natalie P

    2016-06-01

    Within Delphinidae, the sub-family Lissodelphininae consists of 8 Southern Ocean species and 2 North Pacific species. Lissodelphininae is a result of recent phylogenetic revisions based on molecular methods. Thus, morphological radiation within the taxon has not been investigated previously. The sub-family consists of ecologically diverse groups such as (1) the Cephalorhynchus genus of 4 small species inhabiting coastal and shelf waters, (2) the robust species in the Lagenorhynchus genus with the coastal La. australis, the offshore La. cruciger, the pelagic species La. obscurus and La. obliquidens, and (3) the morphologically aberrant genus Lissodelphis. Here, the shapes of 164 skulls from adults of all 10 species were compared using 3-dimensional geometric morphometrics. The Lissodelphininae skulls were supplemented by samples of Lagenorhynchus albirostris and Delphinus delphis to obtain a context for the variation found within the subfamily. Principal components analysis was used to map the most important components of shape variation on phylogeny. The first component of shape variation described an elongation of the rostrum, lateral and dorsoventral compression of the neurocranium and smaller temporal fossa. The two Lissodelphis species were on the high extreme of this spectrum, while Lagenorhynchus australis, La. cruciger and Cephalorhynchus heavisidii were at the low extreme. Along the second component, La. cruciger was isolated from the other species by its expanded neurocranium and concave facial profile. Shape variation supports the gross phylogenetic relationships proposed by recent molecular studies. However, despite the great diversity of ecology and external morphology within the subfamily, shape variation of the feeding apparatus was modest, indicating a similar mode of feeding across the subfamily. All 10 species were similar in their pattern of skull asymmetry, but interestingly, two species using narrowband high frequency clicks (La. cruciger and C

  17. Lytic Complications after Skull Reconstruction Using GeneX®

    PubMed Central

    Park, Jin-Hack; Lee, Yoon-Soo; Lee, Jeong-Ho; Ryu, Kee-Young; Kang, Dong-Gee

    2015-01-01

    Multiple methods and materials are available for bone defect reconstruction. Bone graft substitute is one of the materials used for reconstruction of bone defect and have been widely used recently. This report describes some cases about complications related to GeneX® which is introduced as mixture of calcium sulfate and β-tricalcium phosphate at manufacturer's official web site. It informed of 3 patients who suffered wound inflammation, serous cyst after using GeneX® for reconstructing skull defect. PMID:27169079

  18. Streamlined, Inexpensive 3D Printing of the Brain and Skull

    PubMed Central

    Cash, Sydney S.

    2015-01-01

    Neuroimaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) collect three-dimensional data (3D) that is typically viewed on two-dimensional (2D) screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM) images to stereolithography (STL) files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3–4 in consumable plastic filament as described, and the total process takes 14–17 hours, almost all of which is unsupervised (preprocessing = 4–6 hr; printing = 9–11 hr, post-processing = <30 min). Printing a matching portion of a skull costs $1–5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes. PMID:26295459

  19. Gravity-Driven Hydraulic Fractures

    NASA Astrophysics Data System (ADS)

    Germanovich, L. N.; Garagash, D.; Murdoch, L. C.; Robinowitz, M.

    2014-12-01

    This study is motived by a new method for disposing of nuclear waste by injecting it as a dense slurry into a hydraulic fracture that grows downward to great enough depth to permanently isolate the waste. Disposing of nuclear waste using gravity-driven hydraulic fractures is mechanically similar to the upward growth of dikes filled with low density magma. A fundamental question in both applications is how the injected fluid controls the propagation dynamics and fracture geometry (depth and breadth) in three dimensions. Analog experiments in gelatin [e.g., Heimpel and Olson, 1994; Taisne and Tait, 2009] show that fracture breadth (the short horizontal dimension) remains nearly stationary when the process in the fracture "head" (where breadth is controlled) is dominated by solid toughness, whereas viscous fluid dissipation is dominant in the fracture tail. We model propagation of the resulting gravity-driven (buoyant or sinking), finger-like fracture of stationary breadth with slowly varying opening along the crack length. The elastic response to fluid loading in a horizontal cross-section is local and can be treated similar to the classical Perkins-Kern-Nordgren (PKN) model of hydraulic fracturing. The propagation condition for a finger-like crack is based on balancing the global energy release rate due to a unit crack extension with the rock fracture toughness. It allows us to relate the net fluid pressure at the tip to the fracture breadth and rock toughness. Unlike the PKN fracture, where breadth is known a priori, the final breadth of a finger-like fracture is a result of processes in the fracture head. Because the head is much more open than the tail, viscous pressure drop in the head can be neglected leading to a 3D analog of Weertman's hydrostatic pulse. This requires relaxing the local elasticity assumption of the PKN model in the fracture head. As a result, we resolve the breadth, and then match the viscosity-dominated tail with the 3-D, toughness

  20. Nasal cavity epithelioid hemangioendothelioma invading the anterior skull base

    PubMed Central

    Ogita, Shogo; Endo, Toshiki; Nomura, Kazuhiro; Ogawa, Takenori; Watanabe, Mika; Higashi, Kenjiro; Katori, Yukio; Tominaga, Teiji

    2016-01-01

    Background: Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that frequently occurs in soft tissues. Patients suffer from local recurrence and remote metastasis because of its malignant potential. Here, we present a rare case of EHE that originated from nasal cavity and invaded intracranially through the anterior skull base. Case Description: This is a 27-year-old woman who presented a local physician with intermittent epistaxis and a facial pain around her nose. Preoperative studies demonstrated that the tumor invaded into anterior skull base and the dura matter. Therefore, we performed combined skull base and transnasal surgery, which achieved complete resection of the tumor. Postoperative course of the patient was uneventful. No recurrence or distant metastasis was observed in the patient for 2 years following the radical resection. Conclusions: To date, four cases of EHE in the nasal cavity were reported. This is the first case in which EHE demonstrated invasive potentials with intracranial extension. Radical surgical resection plays an important role for better management of invasive paranasal EHE. PMID:27213107

  1. Shape similarities and differences in the skulls of scavenging raptors.

    PubMed

    Guangdi, S I; Dong, Yiyi; Ma, Yujun; Zhang, Zihui

    2015-04-01

    Feeding adaptations are a conspicuous feature of avian evolution. Bill and cranial shape as well as the jaw muscles are closely related to diet choice and feeding behaviors. Diurnal raptors of Falconiformes exhibit a wide range of foraging behaviors and prey preferences, and are assigned to seven dietary groups in this study. Skulls of 156 species are compared from the dorsal, lateral and ventral views, by using geometric morphometric techniques with those landmarks capturing as much information as possible on the overall shape of cranium, bill, orbits, nostrils and attachment area for different jaw muscles. The morphometric data showed that the skull shape of scavengers differ significantly from other raptors, primarily because of different feeding adaptations. As a result of convergent evolution, different scavengers share generalized common morphology, possessing relatively slender and lower skulls, longer bills, smaller and more sideward orbits, and more caudally positioned quadrates. Significant phylogenetic signals suggested that phylogeny also played important role in shape variation within scavengers. New World vultures can be distinguished by their large nostrils, narrow crania and small orbits; Caracaras typically show large palatines, crania and orbits, as well as short, deep and sharp bill. PMID:25826066

  2. Atypical radiographic features of skull base cholesterol granuloma.

    PubMed

    Dinh, Christine T; Goncalves, Stefania; Bhatia, Rita; Truong, Kim; Telischi, Fred; Angeli, Simon; Morcos, Jacques; Eshraghi, Adrien A

    2016-06-01

    Cholesterol granulomas (CGs) are the most common benign lesions of the petrous apex (PA) and have distinct computed tomography (CT) and magnetic resonance imaging (MRI) characteristics. On CT, CGs of the PA (PACG) present as expansile lesions with erosion of bony trabeculae. MRI shows a hyperintense lesion on T1-and T2-weighted images and do not enhance with gadolinium. The objective is to describe the radiographic features of CGs of the skull base that do not arise from the PA. This study is a retrospective review. Three patients were operated on for suspected recurrent endolymphatic sac tumor, intracranial cholesteatoma, and recurrent sphenoid wing meningioma based on CT and MRI findings. Pathology results were consistent with CG in all three cases. All patients had bone erosion on CT. These skull base CGs did not demonstrate similar MRI features. These lesions were hyperintense, iso-to-hyperintense, and hypointense on T1-weighted MRI, respectively. These CGs were hyperintense in two cases and iso-to-hyperintense in one case on T2-weighted MRI. These lesions either demonstrated central or rim enhancement after gadolinium administration. Skull base CGs that do not arise from the PA demonstrate a broad spectrum of radiographic characteristics on MRI that are not typical of PACG. PMID:26164292

  3. Morphometric analysis of infraorbital foramen in Indian dry skulls

    PubMed Central

    2011-01-01

    We analyzed the variability in position, shape, size and incidence of the infraorbital foramen in Indian dry skulls as little literature is available on this foramen in Indians to prevent clinical complications during maxillofacial surgery and regional block anesthesia. Fifty-five Indian skulls from the Department of Anatomy CSM Medical University were examined. The 110 sides (left and right) of the skulls were analyzed by measuring the infraorbital foramina distances from infraorbital margin and the piriform aperture on both sides. The vertical and horizontal dimensions were also measured. All measurements were taken with a compass transferred to calipers and analyzed statistically. The mean distances between the infraorbital foramen and the infraorbital margin on the right and left side were 6.12 mm and 6.19 mm, respectively. The mean distances between the infraorbital foramen and the piriform aperture were 15.31 mm and 15.80 mm on the right and left sides, respectively. The mean vertical dimensions on the right and left side were 3.39 mm and 3.75 mm, respectively. The mean horizontal dimensions on the two sides were 3.19 mm and 3.52 mm. These results provide detailed knowledge of the anatomical characteristics and clinical importance of the infraorbital foramina which are of paramount importance for surgeons when performing maxillofacial surgery and regional block anesthesia. PMID:21519552

  4. The use of free flaps in skull base reconstruction.

    PubMed

    Macía, G; Picón, M; Nuñez, J; Almeida, F; Alvarez, I; Acero, J

    2016-02-01

    Skull base tumours are rare, comprising less than 1% of all tumours of the head and neck. Surgical treatment of these tumours involves the approach, the resection, and the reconstruction of the defect, which present a challenge due to the technical difficulty and anatomical complexity. A retrospective study of 17 patients with tumours involving the skull base, treated by resection and immediate reconstruction using microsurgical free flaps, is presented; 11 were men and six were women. The following types of flap were used: osteocutaneous fibula flaps, fasciocutaneous anterolateral thigh flaps, and myocutaneous latissimus dorsi flaps. The most common histology of the tumours was squamous cell carcinoma. The most frequent point of origin was the paranasal sinuses (58.8%). All of the free flaps used for reconstruction were viable. A cerebrospinal fluid fistula occurred in two patients, and in one of these cases, meningoencephalitis led to death. In conclusion, the reconstruction of large defects of the skull base after ablation requires a viable tissue that in many cases can be obtained only through the use of microvascular free flaps. The type of flap to be selected depends on the anatomical structures and size of the defect to be restored. PMID:26421478

  5. Metric analysis of basal sphenoid angle in adult human skulls

    PubMed Central

    Netto, Dante Simionato; Nascimento, Sergio Ricardo Rios; Ruiz, Cristiane Regina

    2014-01-01

    Objective To analyze the variations in the angle basal sphenoid skulls of adult humans and their relationship to sex, age, ethnicity and cranial index. Methods The angles were measured in 160 skulls belonging to the Museum of the Universidade Federal de São Paulo Department of Morphology. We use two flexible rules and a goniometer, having as reference points for the first rule the posterior end of the ethmoidal crest and dorsum of the sella turcica, and for the second rule the anterior margin of the foramen magnum and clivus, measuring the angle at the intersection of two. Results The average angle was 115.41°, with no statistical correlation between the value of the angle and sex or age. A statistical correlation was noted between the value of the angle and ethnicity, and between the angle and the horizontal cranial index. Conclusions The distribution of the angle basal sphenoid was the same in sex, and there was correlation between the angle and ethnicity, being the proportion of non-white individuals with an angle >125° significantly higher than that of whites with an angle >125°. There was correlation between the angle and the cranial index, because skulls with higher cranial index tend to have higher basiesfenoidal angle too. PMID:25295452

  6. The first skull of the earliest giant panda

    PubMed Central

    Jin, Changzhu; Ciochon, Russell L.; Dong, Wei; Hunt, Robert M.; Liu, Jinyi; Jaeger, Marc; Zhu, Qizhi

    2007-01-01

    Fossils of the giant panda Ailuropoda (Order Carnivora, Family Ursidae) are largely isolated teeth, mandibles, and a few rare skulls, known from the late Pliocene to late Pleistocene in China and Southeast Asia. Much of this material represents a Pleistocene chronospecies, Ailuropoda baconi, an animal larger than the living giant panda, Ailuropoda melanoleuca. The earliest certain record of Ailuropoda is the late Pliocene chronospecies, Ailuropoda microta, smaller than either A. baconi or A. melanoleuca, and previously known only from teeth and a few mandibles from karst caves in south China. Here, we report the discovery of the first skull of A. microta, establishing its cranial anatomy and demonstrating that the specialized cranial and dental adaptations of Ailuropoda for durophagous feeding behavior centered on bamboo were already evident in this late Pliocene species. The skull from Jinyin cave (Guangxi) and dental remains from other karst localities in southeastern China show that Ailuropoda microta occupied south China from ≈2 to 2.4 Myr ago after a marked global climatic deterioration. Dental and basicranial anatomy indicate a less specialized morphology early in the history of the lineage and support derivation of the giant panda from the Miocene Asian ursid Ailurarctos PMID:17578912

  7. Macroscopic and roentgenographic anatomy of the skull of the ferret (Mustela putorius furo).

    PubMed

    He, T; Friede, H; Kiliaridis, S

    2002-01-01

    Normal macroscopic and roentgenographic features of the skull of the ferret (Mustela putorius furo) were examined and described. Data were based on a sample of 100 (50 male and 50 female) adult ferrets of known body weight and age. The skull was described macroscopically according to six standard views, i.e. dorsal, lateral, ventral, caudal, cranial and midsagittal. The mandible was described separately. The roentgenographic characteristics of the ferret skull were demonstrated only in lateral and dorsoventral projections. Furthermore, the skull length and width as well as the minimum frontal width were measured, and skull indices were derived from relevant measurements. Sexual dimorphism was examined both morphologically and craniometrically. Besides the common features of a carnivore skull, the ferret skull is relatively elongated and flat with a short facial region. The skulls of adult male ferrets are about 17% longer and 22% wider than those of the females. Significant sexual dimorphism also exists regarding certain skull indices. The general features and some dimensional parameters of the adult ferret skull support the contention that the ferret would be an interesting and workable alternative animal model in craniofacial research. PMID:11831741

  8. Assessment of the role of sutures in a lizard skull: a computer modelling study

    PubMed Central

    Moazen, Mehran; Curtis, Neil; O'Higgins, Paul; Jones, Marc E.H; Evans, Susan E; Fagan, Michael J

    2008-01-01

    Sutures form an integral part of the functioning skull, but their role has long been debated among vertebrate morphologists and palaeontologists. Furthermore, the relationship between typical skull sutures, and those involved in cranial kinesis, is poorly understood. In a series of computational modelling studies, complex loading conditions obtained through multibody dynamics analysis were imposed on a finite element model of the skull of Uromastyx hardwickii, an akinetic herbivorous lizard. A finite element analysis (FEA) of a skull with no sutures revealed higher patterns of strain in regions where cranial sutures are located in the skull. From these findings, FEAs were performed on skulls with sutures (individual and groups of sutures) to investigate their role and function more thoroughly. Our results showed that individual sutures relieved strain locally, but only at the expense of elevated strain in other regions of the skull. These findings provide an insight into the behaviour of sutures and show how they are adapted to work together to distribute strain around the skull. Premature fusion of one suture could therefore lead to increased abnormal loading on other regions of the skull causing irregular bone growth and deformities. This detailed investigation also revealed that the frontal–parietal suture of the Uromastyx skull played a substantial role in relieving strain compared with the other sutures. This raises questions about the original role of mesokinesis in squamate evolution. PMID:18765341

  9. Is solid always best? Cranial performance in solid and fenestrated caecilian skulls.

    PubMed

    Kleinteich, Thomas; Maddin, Hillary C; Herzen, Julia; Beckmann, Felix; Summers, Adam P

    2012-03-01

    Caecilians (Lissamphibia: Gymnophiona) are characterized by a fossorial lifestyle that appears to play a role in the many anatomical specializations in the group. The skull, in particular, has been the focus of previous studies because it is driven into the substrate for burrowing. There are two different types of skulls in caecilians: (1) stegokrotaphic, where the squamosal completely covers the temporal region and the jaw closing muscles, and (2) zygokrotaphic, with incomplete coverage of the temporal region by the squamosal. We used 3-D imaging and modeling techniques to explore the functional consequences of these skull types in an evolutionary context. We digitally converted stegokrotaphic skulls into zygokrotaphic skulls and vice versa. We also generated a third, akinetic skull type that was presumably present in extinct caecilian ancestors. We explored the benefits and costs of the different skull types under frontal loading at different head angles with finite element analysis (FEA). Surprisingly, the differences in stress distributions and bending between the three tested skull types were minimal and not significant. This suggests that the open temporal region in zygokrotaphic skulls does not lead to poorer performance during burrowing. However, the results of the FEA suggest a strong relationship between the head angle and skull performance, implying there is an optimal head angle during burrowing. PMID:22323206

  10. Fracture toughness of polyimide films

    NASA Technical Reports Server (NTRS)

    Hinkley, J. A.; Mings, S. L.

    1989-01-01

    Two aromatic polyimides and an aromatic polyamide-imide were tested in single edge notched tension. Fracture toughnesses, normalized to 25 micron film thickness ranged from 1.65 to 5.4 MPa m sup 1/2. LARC-TPI, a thermoplastic polyimide, showed evidence of crazing ahead of a growing crack whereas the other materials formed a shear yielded zone.