A study of cranial variations based on craniometric indices in a South Indian population.

PubMed

Kanchan, Tanuj; Krishan, Kewal; Gupta, Anadi; Acharya, Jenash

2014-09-01

Human skull has been the most extensively studied bone for establishing the taxonomies at evolutionary levels. Crania are also the most commonly used skeletal elements in population studies because they are known to be more genetically driven and less affected by environmental factors. The craniofacial indices are considered as clinical anthropometric parameters used in the investigation of craniofacial skeletal deformities and brain development. The present research is an attempt to study the cranial indices in the South Indian population. The sample for the study included 118 dry adult crania. All the osteometric measurements were taken using standard anthropometric instruments, and 3 indices, namely, cranial index, orbital index (OI), and index of foreman magnum (FMI), were calculated. Cranial index is calculated as (maximum cranial breadth / maximum cranial length) × 100, OI as (orbital height / orbital breadth) × 100, and FMI as (transverse diameter / anteroposterior diameter) × 100. The crania were further classified based on these indices. The cranial index ranged between 66.67 and 85.71 (mean, 78.57 [SD, 4.11]), the OI ranged between 68.89 and 102.63 (mean, 84.23 [SD, 6.64]), and the FMI ranged between 68.57 and 96.88 (mean, 79.71 [SD, 6.98]). Cranial index did not show any significant correlation with the OI (r = -0.162, P = 0.081) or the FMI (r = -0.045, P = 0.626). A statistically significant correlation was, however, observed between OI and FMI (r = -0.232, P = 0.012). The current study developed population-specific classification of crania using cranial indices. This craniometric baseline data pertaining to the craniofacial indices may be useful in presurgical planning and the postsurgical evaluation. It may also assist the forensic anthropologists in the categorization of human skulls, which may be an important component in identification of highly decomposed dead bodies and skeletal remains. More such studies need to be conducted to understand the effect of environment and genetics on the cranial shapes in different population groups.

Morphological adaptation to climate in modern Homo sapiens crania: the importance of basicranial breadth.

PubMed

Nowaczewska, Wioletta; Dabrowski, Paweł; Kuźmiński, Łukasz

2011-09-01

The aim of this study is to investigate whether the variation in breadth of the cranial base among modern human populations that inhabit different regions of the world is linked with climatic adaptation. This work provides an examination of two hypotheses. The first hypothesis is that the correlation between basicranial breadth and ambient temperature is stronger than the correlation between temperature and other neurocranial variables, such as maximum cranial breadth, maximum neurocranial length, and the endocranial volume. The second hypothesis is that the correlation between the breadth of the cranial base and the ambient temperature is significant even when other neurocranial features used in this study (including the size of the neurocranium) are constant. For the sake of this research, the necessary neurocranial variables for fourteen human populations living in diverse environments were obtained from Howells' data (except for endocranial volume which was obtained by means of estimation). The ambient temperature (more precisely, the mean yearly temperature) of the environments inhabited by these populations was used as a major climatic factor. Data were analysed using Pearson correlation coefficients, linear regression and partial correlation analyses. The results supported the two hypotheses, thus suggesting that ambient temperature may contribute to the observed differences in the breadth of the cranial base in the studied modern humans.

Alternative pre-rigor foreshank positioning can improve beef shoulder muscle tenderness.

PubMed

Grayson, A L; Lawrence, T E

2013-09-01

Thirty beef carcasses were harvested and the foreshank of each side was independently positioned (cranial, natural, parallel, or caudal) 1h post-mortem to determine the effect of foreshank angle at rigor mortis on the sarcomere length and tenderness of six beef shoulder muscles. The infraspinatus (IS), pectoralis profundus (PP), serratus ventralis (SV), supraspinatus (SS), teres major (TM) and triceps brachii (TB) were excised 48 h post-mortem for Warner-Bratzler shear force (WBSF) and sarcomere length evaluations. All muscles except the SS had altered (P<0.05) sarcomere lengths between positions; the cranial position resulted in the longest sarcomeres for the SV and TB muscles whilst the natural position had longer sarcomeres for the PP and TM muscles. The SV from the cranial position had lower (P<0.05) shear than the caudal position and TB from the natural position had lower (P<0.05) shear than the parallel or caudal positions. Sarcomere length was moderately correlated (r=-0.63; P<0.01) to shear force. Copyright © 2013 Elsevier Ltd. All rights reserved.

Body size, body proportions, and encephalization in a Middle Pleistocene archaic human from northern China.

PubMed

Rosenberg, Karen R; Zuné, Lü; Ruff, Christopher B

2006-03-07

The unusual discovery of associated cranial and postcranial elements from a single Middle Pleistocene fossil human allows us to calculate body proportions and relative cranial capacity (encephalization quotient) for that individual rather than rely on estimates based on sample means from unassociated specimens. The individual analyzed here (Jinniushan) from northeastern China at 260,000 years ago is the largest female specimen yet known in the human fossil record and has body proportions (body height relative to body breadth and relative limb length) typical of cold-adapted populations elsewhere in the world. Her encephalization quotient of 4.15 is similar to estimates for late Middle Pleistocene humans that are based on mean body size and mean brain size from unassociated specimens.

Cephalometric features in isolated growth hormone deficiency.

PubMed

Oliveira-Neto, Luiz Alves; Melo, Mariade de Fátima B; Franco, Alexandre A; Oliveira, Alaíde H A; Souza, Anita H O; Valença, Eugênia H O; Britto, Isabela M P A; Salvatori, Roberto; Aguiar-Oliveira, Manuel H

2011-07-01

To analyze cephalometric features in adults with isolated growth hormone (GH) deficiency (IGHD). Nine adult IGHD individuals (7 males and 2 females; mean age, 37.8 ± 13.8 years) underwent a cross-sectional cephalometric study, including 9 linear and 5 angular measurements. Posterior facial height/anterior facial height and lower-anterior facial height/anterior facial height ratios were calculated. To pool cephalometric measurements in both genders, results were normalized by standard deviation scores (SDS), using the population means from an atlas of the normal Brazilian population. All linear measurements were reduced in IGHD subjects. Total maxillary length was the most reduced parameter (-6.5 ± 1.7), followed by a cluster of six measurements: posterior cranial base length (-4.9 ± 1.1), total mandibular length (-4.4 ± 0.7), total posterior facial height (-4.4 ± 1.1), total anterior facial height (-4.3 ± 0.9), mandibular corpus length (-4.2 ± 0.8), and anterior cranial base length (-4.1 ± 1.7). Less affected measurements were lower-anterior facial height (-2.7 ± 0.7) and mandibular ramus height (-2.5 ± 1.5). SDS angular measurements were in the normal range, except for increased gonial angle (+2.5 ± 1.1). Posterior facial height/anterior facial height and lower-anterior facial height/anterior facial height ratios were not different from those of the reference group. Congenital, untreated IGHD causes reduction of all linear measurements of craniofacial growth, particularly total maxillary length. Angular measurements and facial height ratios are less affected, suggesting that lGHD causes proportional blunting of craniofacial growth.

Head circumference - a useful single parameter for skull volume development in cranial growth analysis?

PubMed

Martini, Markus; Klausing, Anne; Lüchters, Guido; Heim, Nils; Messing-Jünger, Martina

2018-01-10

The measurement of maximal head circumference is a standard procedure in the examination of childrens' cranial growth and brain development. The objective of the study was to evaluate the validity of maximal head circumference to cranial volume in the first year of life using a new method which includes ear-to-ear over the head distance and maximal cranial length measurement. 3D surface scans for cranial volume assessment were conducted in this method comparison study of 44 healthy Caucasian children (29 male, 15 female) at the ages of 4 and 12 months. Cranial volume increased from measurements made at 4 months to 12 months of age by an average of 1174 ± 106 to 1579 ± 79 ml. Maximal cranial circumference increased from 43.4 ± 9 cm to 46.9 ± 7 cm and the ear-to ear measurement increased from 26.3 ± 21 cm to 31.6 ± 18 cm at the same time points. There was a monotone association between maximal head circumference (HC) and increase in volume, yet a backwards inference from maximal circumference to the volume had a predictive value of only 78% (adjusted R 2 ). Including the additional measurement of distance from ear to ear strengthened the ability of the model to predict the true value attained to 90%. The addition of the parameter skull length appeared to be negligible. The results demonstrate that for a distinct improvement in the evaluation of a physiological cranial volume development, the additional measurement of the ear-to ear distance using a measuring tape is expedient, and, especially for cases with pathological skull changes, such as craniosynostosis, ought to be conducted.

Discriminant functions for sex estimation of modern Japanese skulls.

PubMed

Ogawa, Yoshinori; Imaizumi, Kazuhiko; Miyasaka, Sachio; Yoshino, Mineo

2013-05-01

The purpose of this study is to generate a set of discriminant functions in order to estimate the sex of modern Japanese skulls. To conduct the analysis, the anthropological measurement data of 113 individuals (73 males and 40 females) were collected from recent forensic anthropological test records at the National Research Institute of Police Science, Japan. Birth years of the individuals ranged from 1926 to 1979, and age at death was over 19 years for all individuals. A total of 10 anthropological measurements were used in the discriminant function analysis: maximum cranial length, cranial base length, maximum cranial breadth, maximum frontal breadth, basion-bregmatic height, upper facial breadth, bizygomatic breadth, bicondylar breadth, bigonial breadth, and ramal height. As a result, nine discriminant functions were established. The classification accuracy ranged from 79.0 to 89.9% when the measurements of the 113 individuals were substituted into the established functions, from 77.8 to 88.1% when a leave-one-out cross-validation procedure was applied to the data, and from 86.7 to 93.0% when the measurements of 50 new individuals (25 males and 25 females), unrelated to the establishment of the discriminant functions, were used. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Decoupled diversification dynamics of feeding morphology following a major functional innovation in marine butterflyfishes.

PubMed

Konow, Nicolai; Price, Samantha; Abom, Richard; Bellwood, David; Wainwright, Peter

2017-08-16

The diversity of fishes on coral reefs is influenced by the evolution of feeding innovations. For instance, the evolution of an intramandibular jaw joint has aided shifts to corallivory in Chaetodon butterflyfishes following their Miocene colonization of coral reefs. Today, over half of all Chaetodon species consume coral, easily the largest concentration of corallivores in any reef fish family. In contrast with Chaetodon , other chaetodontids, including the long-jawed bannerfishes, remain less intimately associated with coral and mainly consume other invertebrate prey. Here, we test (i) if intramandibular joint (IMJ) evolution in Chaetodon has accelerated feeding morphological diversification, and (ii) if cranial and post-cranial traits were affected similarly. We measured 19 cranial functional morphological traits, gut length and body elongation for 33 Indo-Pacific species. Comparisons of Brownian motion rate parameters revealed that cranial diversification was about four times slower in Chaetodon butterflyfishes with the IMJ than in other chaetodontids. However, the rate of gut length evolution was significantly faster in Chaetodon , with no group-differences for body elongation. The contrasting patterns of cranial and post-cranial morphological evolution stress the importance of comprehensive datasets in ecomorphology. The IMJ appears to enhance coral feeding ability in Chaetodon and represents a design breakthrough that facilitates this trophic strategy. Meanwhile, variation in gut anatomy probably reflects diversity in how coral tissues are procured and assimilated. Bannerfishes, by contrast, retain a relatively unspecialized gut for processing invertebrate prey, but have evolved some of the most extreme cranial mechanical innovations among bony fishes for procuring elusive prey. © 2017 The Author(s).

Morphometric characteristics of caudal cranial nerves at petroclival region in fetuses.

PubMed

Ozdogmus, Omer; Saban, Enis; Ozkan, Mazhar; Yildiz, Sercan Dogukan; Verimli, Ural; Cakmak, Ozgur; Arifoglu, Yasin; Sehirli, Umit

2016-06-01

Morphometric measurements of cranial nerves in posterior cranial fossa of fetus cadavers were carried out in an attempt to identify any asymmetry in their openings into the cranium. Twenty-two fetus cadavers (8 females, 14 males) with gestational age ranging between 22 and 38 weeks (mean 30 weeks) were included in this study. The calvaria were removed, the brains were lifted, and the cranial nerves were identified. The distance of each cranial nerve opening to midline and the distances between different cranial nerve openings were measured on the left and right side and compared. The mean clivus length and width were 21.2 ± 4.4 and 13.2 ± 1.5 mm, respectively. The distance of the twelfth cranial nerve opening from midline was shorter on the right side when compared with the left side (6.6 ± 1.1 versus 7.1 ± 0.8 mm, p = 0.038). Openings of other cranial nerves did not show such asymmetry with regard to their distance from midline, and the distances between different cranial nerves were similar on the left and right side. Cranial nerves at petroclival region seem to show minimal asymmetry in fetuses.

The craniofacial complex in 47, XXX females.

PubMed

Krusinskiene, Viktorija; Krusinskie, Viktorija; Alvesalo, Lassi; Sidlauskas, Antanas

2005-08-01

A study of the craniofacial complex in four 47, XXX Finnish females, or females with an extra X chromosome, was carried out using cephalometric analysis comprising linear and angular measurements. The lengths of the anterior and posterior cranial bases, the calvarium, mandibular ramus and posterior and upper anterior face heights were found to be significantly shorter than in female controls, while the angles between the foraminal and clival planes, the mandibular plane and cranial base, the maxillary and occlusal planes, the maxillary and mandibular planes and the foraminal and mandibular planes, and also the gonial angle, were significantly enlarged. The present findings of reduced linear measurements, together with the results of studies on the craniofacial complex of 47, XXY and 47, XYY males, suggest dimensional variation between these groups from the promoting effect of an extra Y chromosome and the retarding effect of an extra X chromosome on craniofacial growth.

Deformed Skull Morphology Is Caused by the Combined Effects of the Maldevelopment of Calvarias, Cranial Base and Brain in FGFR2-P253R Mice Mimicking Human Apert Syndrome

PubMed Central

Luo, Fengtao; Xie, Yangli; Xu, Wei; Huang, Junlan; Zhou, Siru; Wang, Zuqiang; Luo, Xiaoqing; Liu, Mi; Chen, Lin; Du, Xiaolan

2017-01-01

Apert syndrome (AS) is a common genetic syndrome in humans characterized with craniosynostosis. Apert patients and mouse models showed abnormalities in sutures, cranial base and brain, that may all be involved in the pathogenesis of skull malformation of Apert syndrome. To distinguish the differential roles of these components of head in the pathogenesis of the abnormal skull morphology of AS, we generated mouse strains specifically expressing mutant FGFR2 in chondrocytes, osteoblasts, and progenitor cells of central nervous system (CNS) by crossing Fgfr2+/P253R-Neo mice with Col2a1-Cre, Osteocalcin-Cre (OC-Cre), and Nestin-Cre mice, respectively. We then quantitatively analyzed the skull and brain morphology of these mutant mice by micro-CT and micro-MRI using Euclidean distance matrix analysis (EDMA). Skulls of Col2a1-Fgfr2+/P253R mice showed Apert syndrome-like dysmorphology, such as shortened skull dimensions along the rostrocaudal axis, shortened nasal bone, and evidently advanced ossification of cranial base synchondroses. The OC-Fgfr2+/P253R mice showed malformation in face at 8-week stage. Nestin-Fgfr2+/P253R mice exhibited increased dorsoventral height and rostrocaudal length on the caudal skull and brain at 8 weeks. Our study indicates that the abnormal skull morphology of AS is caused by the combined effects of the maldevelopment in calvarias, cranial base, and brain tissue. These findings further deepen our knowledge about the pathogenesis of the abnormal skull morphology of AS, and provide new clues for the further analyses of skull phenotypes and clinical management of AS. PMID:28123344

Deformed Skull Morphology Is Caused by the Combined Effects of the Maldevelopment of Calvarias, Cranial Base and Brain in FGFR2-P253R Mice Mimicking Human Apert Syndrome.

PubMed

Luo, Fengtao; Xie, Yangli; Xu, Wei; Huang, Junlan; Zhou, Siru; Wang, Zuqiang; Luo, Xiaoqing; Liu, Mi; Chen, Lin; Du, Xiaolan

2017-01-01

Apert syndrome (AS) is a common genetic syndrome in humans characterized with craniosynostosis. Apert patients and mouse models showed abnormalities in sutures, cranial base and brain, that may all be involved in the pathogenesis of skull malformation of Apert syndrome. To distinguish the differential roles of these components of head in the pathogenesis of the abnormal skull morphology of AS, we generated mouse strains specifically expressing mutant FGFR2 in chondrocytes, osteoblasts, and progenitor cells of central nervous system (CNS) by crossing Fgfr2 +/P253R-Neo mice with Col2a1-Cre, Osteocalcin-Cre (OC-Cre), and Nestin-Cre mice, respectively. We then quantitatively analyzed the skull and brain morphology of these mutant mice by micro-CT and micro-MRI using Euclidean distance matrix analysis (EDMA). Skulls of Col2a1-Fgfr2 +/P253R mice showed Apert syndrome-like dysmorphology, such as shortened skull dimensions along the rostrocaudal axis, shortened nasal bone, and evidently advanced ossification of cranial base synchondroses. The OC-Fgfr2 +/P253R mice showed malformation in face at 8-week stage. Nestin-Fgfr2 +/P253R mice exhibited increased dorsoventral height and rostrocaudal length on the caudal skull and brain at 8 weeks. Our study indicates that the abnormal skull morphology of AS is caused by the combined effects of the maldevelopment in calvarias, cranial base, and brain tissue. These findings further deepen our knowledge about the pathogenesis of the abnormal skull morphology of AS, and provide new clues for the further analyses of skull phenotypes and clinical management of AS.

Epidural migration of new methylene blue in 0.9% sodium chloride solution or 2% mepivacaine solution following injection into the first intercoccygeal space in foal cadavers and anesthetized foals undergoing laparoscopy.

PubMed

Lansdowne, Jennifer L; Kerr, Carolyn L; Bouré, Ludovic P; Pearce, Simon G

2005-08-01

To determine the relationship between epidural cranial migration and injectate volume of an isotonic solution containing dye in laterally recumbent foal cadavers and evaluate the cranial migration and dermatome analgesia of an epidural dye solution during conditions of laparoscopy in foals. 19 foal cadavers and 8 pony foals. Foal cadavers received an epidural injection of dye solution (0.05, 0.1, 0.15, or 0.2 mL/kg) containing 1.2 mg of new methylene blue (NMB)/mL of saline (0.9% NaCl) solution. Length of the dye column and number of intervertebral spaces cranial and caudal to the injection site were measured. Anesthetized foals received an epidural injection of dye solution (0.2 mL/kg) containing saline solution or 2% mepivacaine. Foals were placed in a 100 head-down position, and pneumoperitoneum was induced. Dermatome analgesia was determined by use of a described electrical stimulus technique. Foals were euthanatized, and length of the dye column was measured. Epidural cranial migration of dye solution in foal cadavers increased with increasing volume injected. No significant difference was found in epidural cranial migration of a dye solution (0.2 mL/kg) between anesthetized foals undergoing conditions of laparoscopy and foal cadavers in lateral recumbency. Further craniad migration of the dye column occurred than indicated by dermatome analgesia. Epidural cranial migration increases with volume of injectate. On the basis of dermatome analgesia, an epidural injection of 2% mepivacaine (0.2 mL/kg) alone provides analgesia up to at least the caudal thoracic dermatome and could permit caudal laparoscopic surgical procedures in foals.

Cranial suture complexity in caviomorph rodents (Rodentia; Ctenohystrica).

PubMed

Buezas, Guido; Becerra, Federico; Vassallo, Aldo

2017-08-01

Due to their flexibility, sutures are regions that experience greater strains than the surrounding rigid cranial bones. Cranial sutures differ in their degree of interdigitation or complexity. There is evidence indicating that a more convoluted suture better enables the absorption of high stresses coming from dynamic masticatory forces, and other functions. The Order Rodentia is an interesting clade to study this because of its taxa with diverse chewing modes. Due to repeated loading resulting from gnawing and grinding, energy absorption by the sutures might be a crucial factor in these mammals. Species within the infraorder Caviomorpha were chosen as a case study because of their ecomorphological and dietary diversity. This study compared five sutures from the rostrum and cranial vault across seven caviomorph families, and assessed their complexity by means of the relative length and fractal dimension. Across these rodents, cranial sutures are morphologically quite diverse. We found that the sutures connecting the rostrum with the vault were relatively more interdigitated than those in the cranial vault itself, especially premaxillofrontal sutures. Suture interdigitation was higher in species that display chisel-tooth digging and burrowing behaviors, especially in the families Ctenomyidae and Octodontidae, than those in families Dasyproctidae and Cuniculidae, which have more gracile masticatory systems. The reconstruction of the ancestral character state, on family and species phylogeny, points toward low suture interdigitation (i.e., low length ratio) as a likely ancestral state for interfrontal, premaxillofrontal and maxillofrontal sutures. Interspecific differences in suture morphology shown here might represent adaptations to different mechanical demands (i.e., soft vs. tough foods) or behaviors (e.g., chisel-tooth digging), which evolved in close association with the diverse environments occupied by caviomorph rodents. © 2017 Wiley Periodicals, Inc.

Sonographic Analysis of Changes in Skull Shape After Cranial Molding Helmet Therapy in Infants With Deformational Plagiocephaly.

PubMed

Kwon, Dong Rak

2016-04-01

-The purpose of this study was to investigate the changes in skull shape on sonography after cranial molding helmet therapy in infants with deformational plagiocephaly. -Twenty-six infants who were treated with cranial molding helmet therapy were recruited. Caliper and sonographic measurements were performed. The lateral length of the affected and unaffected sides of the skull and cranial vault asymmetry index were measured with calipers. The occipital angle, defined as the angle between lines projected along the lambdoid sutures of the skull, was calculated by sonography. The occipital angle difference and occipital angle ratio were also measured. All caliper and sonographic measurements were performed in each infant twice before and twice after treatment. -The study group included 12 male and 14 female infants with a mean age ± SD of 6.2 ± 3.5 months. The mean treatment duration was 6.0 ± 2.5 months. The difference in lateral length before and after helmet therapy was significantly greater on the affected skull than the unaffected skull (16.7 ± 12.7 versus 9.0 ± 13.4 mm; P < .01). The difference in the occipital angle before and after helmet therapy was significantly greater on the affected skull than the unaffected skull (-5.7° ± 7.3° versus 4.2° ± 7.9°; P < .01). The cranial vault asymmetry index and occipital angle ratio were significantly reduced after helmet therapy (cranial vault asymmetry index, 9.3% ± 2.3% versus 3.5% ± 3.0%; occipital angle ratio, 1.07 ± 0.05 versus 1.01 ± 0.01; P < .05). -These results suggest that occipital angle measurements using sonography, combined with cephalometry, could provide a better understanding of the therapeutic effects of cranial molding helmet therapy in infants with deformational plagiocephaly. © 2016 by the American Institute of Ultrasound in Medicine.

Stereological and Morphometric Analysis of MRI Chiari Malformation Type-1

PubMed Central

Alkoç, Ozan Alper; Songur, Ahmet; Eser, Olcay; Toktas, Muhsin; Esi, Ertap; Haktanir, Alpay

2015-01-01

Objective In this study, we aimed to investigate the underlying ethiological factors in chiari malformation (CM) type-I (CMI) via performing volumetric and morphometric length-angle measurements. Methods A total of 66 individuals [33 patients (20-65 years) with CMI and 33 control subjects] were included in this study. In sagittal MR images, tonsillar herniation length and concurrent anomalies were evaluated. Supratentorial, infratentorial, and total intracranial volumes were measured using Cavalieri method. Various cranial distances and angles were used to evaluate the platybasia and posterior cranial fossa (PCF) development. Results Tonsillar herniation length was measured 9.09±3.39 mm below foramen magnum in CM group. Tonsillar herniation/concurrent syringomyelia, concavity/defect of clivus, herniation of bulbus and fourth ventricle, basilar invagination and craniovertebral junction abnormality rates were 30.3, 27, 18, 2, 3, and 3 percent, respectively. Absence of cisterna magna was encountered in 87.9% of the patients. Total, IT and ST volumes and distance between Chamberlain line and tip of dens axis, Klaus index, clivus length, distance between internal occipital protuberance and opisthion were significantly decreased in patient group. Also in patient group, it was found that Welcher basal angle/Boogard angle increased and tentorial slope angle decreased. Conclusion Mean cranial volume and length-angle measurement values significantly decreased and there was a congenital abnormality association in nearly 81.5 percent of the CM cases. As a result, it was concluded that CM ethiology can be attributed to multifactorial causes. Moreover, congenital defects can also give rise to this condition. PMID:26713146

Neurocranium versus Face: A Morphometric Approach with Classical Anthropometric Variables for Characterizing Patterns of Cranial Integration in Extant Hominoids and Extinct Hominins

PubMed Central

Pérez-Claros, Juan Antonio; Jiménez-Arenas, Juan Manuel; Palmqvist, Paul

2015-01-01

The relative importance of the two main cranial complexes, the neurocranium and the splanchnocranium, has been examined in the five species of extant hominoids and in a huge sample of extinct hominins using six standard craniometric variables that measure the length, width and height of each cranial module. Factor analysis and two-block partial least squares were used for establishing the major patterns of developmental and evolutionary integration between both cranial modules. The results obtained show that all extant hominoids (including the anatomically modern humans) share a conserved pattern of developmental integration, a result that agrees with previous studies. The pattern of evolutionary integration between both cranial modules in australopiths runs in parallel to developmental integration. In contrast, the pattern of evolutionary and developmental integration of the species of the genus Homo is the opposite, which is probably the consequence of distinctive selective regimes for both hominin groups. PMID:26177535

Neurocranium versus Face: A Morphometric Approach with Classical Anthropometric Variables for Characterizing Patterns of Cranial Integration in Extant Hominoids and Extinct Hominins.

PubMed

Pérez-Claros, Juan Antonio; Jiménez-Arenas, Juan Manuel; Palmqvist, Paul

2015-01-01

The relative importance of the two main cranial complexes, the neurocranium and the splanchnocranium, has been examined in the five species of extant hominoids and in a huge sample of extinct hominins using six standard craniometric variables that measure the length, width and height of each cranial module. Factor analysis and two-block partial least squares were used for establishing the major patterns of developmental and evolutionary integration between both cranial modules. The results obtained show that all extant hominoids (including the anatomically modern humans) share a conserved pattern of developmental integration, a result that agrees with previous studies. The pattern of evolutionary integration between both cranial modules in australopiths runs in parallel to developmental integration. In contrast, the pattern of evolutionary and developmental integration of the species of the genus Homo is the opposite, which is probably the consequence of distinctive selective regimes for both hominin groups.

Correlation of Subjective Hospital Compare Metrics With Objective Outcomes of Cranial Neurosurgical Procedures in New York State.

PubMed

Bekelis, Kimon; Missios, Symeon; Coy, Shannon; Rahmani, Redi; MacKenzie, Todd A; Asher, Anthony L

2017-03-01

Public reporting is at the forefront of health care reform. To investigate whether patient satisfaction as expressed in a public reporting platform correlates with objective outcomes for cranial neurosurgery patients. We performed a cohort study involving patients undergoing cranial neurosurgery from 2009 to 2013 who were registered in the Statewide Planning and Research Cooperative System database. This cohort was merged with the corresponding data from the Centers for Medicare and Medicaid Services Hospital Compare website. The association of patient satisfaction metrics with outcomes was examined with the use of a propensity-adjusted regression model. Overall, 19 591 patients underwent cranial neurosurgery during the study. Using a propensity-adjusted multivariable regression analysis, we demonstrated that hospitals with a greater percentage of patient-assigned "high" scores had decreased mortality (OR, 0.60; 95% CI, 0.53-0.67), rate of discharge to rehabilitation (OR, 0.93; 95% CI, 0.88-0.98), length of stay (adjusted difference, -1.29; 95% CI, -1.46 to -1.13), and hospitalization charges (adjusted difference, -23%; 95% CI, -36% to -9%) after cranial neurosurgery. Similar associations were identified for hospitals with a higher percentage of patients, who would recommend these institutions to others. In a Centers for Medicare and Medicaid Services Hospital Compare-Statewide Planning and Research Cooperative System merged dataset, we observed an association of higher performance in patient satisfaction measures with decreased mortality, rate of discharge to rehabilitation, hospitalization charges, and length of stay. Copyright © 2017 by the Congress of Neurological Surgeons

Fourth cranial nerve: surgical anatomy in the subtemporal transtentorial approach and in the pretemporal combined inter-intradural approach through the fronto-temporo-orbito-zygomatic craniotomy. A cadaveric study.

PubMed

Pescatori, L; Niutta, M; Tropeano, M P; Santoro, G; Santoro, A

2017-01-01

Despite the recent progress in surgical technology in the last decades, the surgical treatment of skull base lesions still remains a challenge. The purpose of this study was to assess the anatomy of the tentorial and cavernous segment of the fourth cranial nerve as it appears in two different surgical approaches to the skull base: subtemporal transtentorial approach and pretemporal fronto-orbito-zygomatic approach. Four human cadaveric fixed heads were used for the dissection. Using both sides of each cadaveric head, we made 16 dissections: 8 with subtemporal transtentorial technique and 8 with pretemporal fronto-orbito-zygomatic approach. The first segment that extends from the initial point of contact of the fourth cranial nerve with the tentorium (point Q) to its point of entry into its dural channel (point D) presents an average length of 13.5 mm with an extremely wide range and varying between 3.20 and 9.3 mm. The segment 2, which extends from point D to the point of entry into the lateral wall of the cavernous sinus, presents a lesser interindividual variability (mean 10.4 mm, range 15.1-5.9 mm). A precise knowledge of the surgical anatomy of the fourth cranial nerve and its neurovascular relationships is essential to safely approach. The recognition of some anatomical landmarks allows to treat pathologies located in regions of difficult surgical access even when there is an important subversion of the anatomy.

Cranial base evolution within the hominin clade

PubMed Central

Nevell, L; Wood, B

2008-01-01

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

Fetal growth in muskoxen determined by transabdominal ultrasonography.

PubMed Central

Pharr, J W; Rowell, J E; Flood, P F

1994-01-01

A 5 MHz commercial sector scanner was used to monitor 13 muskox pregnancies and establish normal fetal growth curves. Examinations were carried out between 40 and 197 days of gestation and pregnancy could be detected throughout the period. Early pregnancies were found by scanning lateral to the udder but as pregnancy progressed the fetus was found closer to the dam's umbilicus. Measurements of cranial and abdominal diameters taken at about two week intervals in seven uncomplicated pregnancies in four cows were used to construct fetal growth curves. These can be reliably used in the reproductive management of muskoxen. In addition a series of regressions based on measurements of the fetuses of muskoxen killed in the Arctic are provided. These allow cranial and abdominal diameters to be related to fetal weight and crown-rump length. Images Fig. 1. Fig. 2. PMID:7954117

Reconstruction of large cranial defect with alloplastic material (bone cement-cold cure polymethyl-methacrylate resin).

PubMed

Hallur, Neelakamal; Goudar, Gayatri; Sikkerimath, Basavaraj; Gudi, Santosh S; Patil, Ravi S

2010-06-01

A 40-years-old male patient reported to our department with a chief complaint of persistent palatal fluid discharge and large depressed forehead defect. He gave a history of trauma 20 months back due to head on collision to electric pole and underwent surgery twice for open reduction and fixation of facial skeletal fractures. After 9 months of surgery again a third surgery was performed for the removal of frontal bone due to infection and osteomyelitis at the same site. Extra-oral examination revealed a large fronto-cranial defect extending from superior border of frontal bone to supra-orbital margins bilaterally in length, and from frontal right lateral to frontal left lateral side in width, measuring 8.0 cm in length, 10.5 cm in width and 1.5 to 2.0 cm in depth. Intra-oral sinus fluid discharge was from left posterior palatal region. Preoperative CT was taken and reconstruction of fronto-cranial defect was successfully performed with bone cement. Alloplastic implant reconstruction achieved an excellent esthetic result without any complications.

Intracranial meningiomas related to external cranial irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spallone, A.; Gagliardi, F.M.; Vagnozzi, R.

1979-08-01

Three cases are presented of meningiomas following small-dose external cranial irradiation in which several features clearly indicate a causal relationship between radiotherapy and tumor development. The length of the latent period separates meningiomas following high-dose irradiation from those which followed small-dose irradiation. Therefore the oncogenic mechanism seems to act differently in the two groups. This demonstration that multiple meningiomas can occur in patients irradiated for Tinea capitis should enable other similar cases to be recognized.

Development of the stapes and associated structures in human embryos

PubMed Central

Rodríguez-Vázquez, JF

2005-01-01

The objective of this study was to clarify the development of the stapes in humans and its relationship with the cartilage of the second branchial arch. The study was carried out in 25 human embryos between 6 and 28 mm crown–rump length. The stapes develops at the cranial end of the second branchial arch through an independent anlage of the cartilage of this arch. Between the stapedial anlage and the cranial end of the Reichert's cartilage there is a formation called the interhyale, the internal segment of which gives rise to the tendon of the stapedial muscle. The stapedial anlage is a unique formation with two distinct parts: the superior part that will comprise the base and the inferior part that will be crossed by the stapedial artery during embryonic development and will constitute the limbs and the head of the stapes. According to the results, the otic capsule is not involved in formation of the base of the stapes. PMID:16050903

Experimental definition of latissimus dorsi, gracilis, and rectus abdominus musculocutaneous flaps in the dog.

PubMed

Gregory, C R; Gourley, I M; Koblik, P D; Patz, J D

1988-06-01

Dissection and injection studies in canine cadavers and in anesthetized dogs were conducted to determine the feasibility of using the latissimus dorsi, gracilis, and rectus abdominus muscles as musculocutaneous free flaps. Lengths of vascular pedicles for the latissimus dorsi (2 +/- 0.8 cm), gracilis (1.8 +/- 0.8 cm), and rectus abdominus (1.9 +/- 0.9-cm cranial deep epigastric, 1.7 +/- 0.5-cm caudal deep epigastric), as well as arterial diameters (1.28 +/- 0.31-mm thoracodorsal for the latissimus dorsi, 1.10 +/- 0.33-mm muscular branch for the gracilis, 1.25 +/- 0.25-mm cranial deep epigastric and 1.26 +/- 0.32-mm caudal deep epigastric for the rectus abdominus) were considered satisfactory for microvascular transfer. Fluorometry demonstrated overlying cutaneous perfusion in all flaps based on their muscle vascular pedicles, with the exception of the rectus abdominus flap based on the caudal deep epigastric artery. In this instance, up to 20% of the cutaneous element had questionable or no perfusion.

Ultrasound as a Noninvasive Method to Assess Changes of Intracranial Volume and Pressure During Simulated Microgravity

NASA Technical Reports Server (NTRS)

Murthy, G.; Yost, W. T.; Ballard, R. E.; Watenpaugh, D. E.; Kawai, Y.; Hargens, A. R.

1994-01-01

Headaches are commonly experienced by astronauts in microgravity and by subjects undergoing head-down tilt (simulated microgravity on Earth). Exposure to microgravity probably elevates blood pressure and flow in the head which may increase intracranial volume (ICV) and pressure (ICP) and in turn cause headache. Due to the slightly compliant nature of the cranial vault and the encasement of brain and its vasculature within this vault, any increase of ICV will increase ICP and slightly distend the cranium. Previous studies document perivascular edema and increased ICP in rhesus monkeys during head-down tilt. Elevated ICP has also been reported in humans during head-down tilt. ICP measurements in healthy humans are rare because of the invasiveness of currently-available measurement techniques. Therefore, we proposed a noninvasive ultrasound technique to assess changes of ICV and JCP. The ultrasound principle is based on compliance of the cranial vault. A 450 kHz ultrasound stimulus is transmitted through the cranium by a transducer every 7.5-10 msec. The ultrasound wave enters the brain tissue, reflects off the opposite side of the cranium and is received by the same transducer. The detected wave is compared for phase quadrature (90 deg.to transmitted wave). Because the electronic circuitry of the device maintains a 90 deg. phase (phi), any alterations in the detected wave caused by an increase of ICV and ICP will be reflected as a change in the wave frequency. Phase shift is directly proportional to path length of the wave, DELTA x, which is expressed as DELTA x = phi lambda/2 pi where lambda is wavelength. Elevated ICV and ICP expand the cranial vault and increase path length of the wave (a measure of intracranial distance). Increased path length equals reduced frequency of the detected wave. Reduced frequency is then related to elevated ICP. This technique has potential uses for ICP studies of astronauts in space and head trauma patients on Earth.

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

PubMed

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

2011-10-01

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

Neurophysiological Identification of Cranial Nerves During Endoscopic Endonasal Surgery of Skull Base Tumors: Pilot Study Technical Report.

PubMed

Shkarubo, Alexey Nikolaevich; Chernov, Ilia Valerievich; Ogurtsova, Anna Anatolievna; Moshchev, Dmitry Aleksandrovich; Lubnin, Andrew Jurievich; Andreev, Dmitry Nicolaevich; Koval, Konstantin Vladimirovich

2017-02-01

Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, only a small number of published papers describe the technique of trigger electromyography (t-EMG) in endoscopic endonasal removal of such tumors. To assess the effectiveness of t-EMG in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. Nine patients were operated on using the endoscopic endonasal approach within a 1-year period. The tumors included large skull base chordomas and trigeminal neurinomas localized in the cavernous sinus. During the surgical process, cranial nerve identification was carried out using monopolar and bipolar t-EMG methods. Assessment of cranial nerve functional activity was conducted both before and after tumor removal. We mapped 17 nerves in 9 patients. Third, fifth, and sixth cranial nerves were identified intraoperatively. There were no cases of postoperative functional impairment of the mapped cranial nerves. In one case we were unable to get an intraoperative response from the fourth cranial nerve and observed its postoperative transient plegia (the function was normal before surgery). t-EMG allows surgeons to control the safety of cranial nerves both during and after skull base tumor removal. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationship between the cranial base and the mandible in artificially deformed skulls.

PubMed

Ferros, I; Mora, M J; Obeso, I F; Jimenez, P; Martinez-Insua, A

2016-11-01

There is controversy regarding the relationship between mandibular position and alterations of the cranial base that provoke a more anterior location of the glenoid fossa. Artificially deformed skulls display marked alterations of the cranial base. This study evaluates mandibular changes as function of the morphology of the cranial base in these skulls. A geometric morphometric study was performed on lateral cephalometric X-rays of three groups of skulls: 32 with anteroposterior deformity, 17 with circumferential deformity and 39 with no apparent deformity. In artificially deformed skulls, the cranial base was deformed causing the mandibular condyle to be in a more anterior position. There was a complete remodelling of the mandible involving narrowing and elongation of the mandibular ramus, rotation of the corpus of the mandible and increased vertical height of the symphysis. Forward displacement did not occur. Integration between mandible and cranial base is not altered by deformation of the skull. Deformity of the cranial vault exerts an influence on the mandible, supporting the theory of modular units in complete integration. This also supports the theory that mandibular prognathism is a multifactorial result and not a direct effect of displacement of the cranial base. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Three-dimensional photography for the evaluation of facial profiles in obstructive sleep apnoea.

PubMed

Lin, Shih-Wei; Sutherland, Kate; Liao, Yu-Fang; Cistulli, Peter A; Chuang, Li-Pang; Chou, Yu-Ting; Chang, Chih-Hao; Lee, Chung-Shu; Li, Li-Fu; Chen, Ning-Hung

2018-06-01

Craniofacial structure is an important determinant of obstructive sleep apnoea (OSA) syndrome risk. Three-dimensional stereo-photogrammetry (3dMD) is a novel technique which allows quantification of the craniofacial profile. This study compares the facial images of OSA patients captured by 3dMD to three-dimensional computed tomography (3-D CT) and two-dimensional (2-D) digital photogrammetry. Measurements were correlated with indices of OSA severity. Thirty-eight patients diagnosed with OSA were included, and digital photogrammetry, 3dMD and 3-D CT were performed. Distances, areas, angles and volumes from the images captured by three methods were analysed. Almost all measurements captured by 3dMD showed strong agreement with 3-D CT measurements. Results from 2-D digital photogrammetry showed poor agreement with 3-D CT. Mandibular width, neck perimeter size and maxillary volume measurements correlated well with the severity of OSA using all three imaging methods. Mandibular length, facial width, binocular width, neck width, cranial base triangle area, cranial base area 1 and middle cranial fossa volume correlated well with OSA severity using 3dMD and 3-D CT, but not with 2-D digital photogrammetry. 3dMD provided accurate craniofacial measurements of OSA patients, which were highly concordant with those obtained by CT, while avoiding the radiation associated with CT. © 2018 Asian Pacific Society of Respirology.

Assessing bone volume for orthodontic miniplate fixation below the maxillary frontal process.

PubMed

Präger, T M; Brochhagen, H G; Mischkowski, R; Jost-Brinkmann, P-G; Müller-Hartwich, R

2014-09-01

The maxillary bone below the frontal process is used for orthodontic anchorage; indications have included skeletally anchored protraction of the maxilla for treating Class III malocclusions or the intrusion of teeth in patients with a deep bite. This study was conducted to assess the condition of bone before cortically implanting miniplates in that area of the maxilla. A total of 51 thin-sliced computed tomography scans of 51 fully-dentate adult patients (mean age 24.0 ± 8.1 years; 27 men and 24 women) obtained prior to third-molar osteotomy were evaluated. Study parameters included total bone thickness, thickness of the facial cortical plate, and width of the nasal maxillary buttress. All these parameters were measured at different vertical levels. The bone volume adjacent to the piriform aperture was most pronounced at the basal level and decreased progressively toward more cranial levels. The basal bone structure had a mean total thickness of 7.8 mm, facial cortical plate thickness of 1.9 mm, and nasal maxillary buttress width of 9.2 mm. At 16 mm cranial to the aperture base, these values fell to 5.6 mm, 1.3 mm, and 5.8 mm, respectively. These bone measurements suggest that screws 7 mm in length can be inserted at the base level of the piriform aperture and screws 5 mm long at the cranial end of the bone.

The bovine kidney as an experimental model in urology: external gross anatomy.

PubMed

Carvalho, Francismar S; Bagetti Filho, Hélio J S; Henry, Robert W; Pereira-Sampaio, Marco A

2009-01-01

The objective of this work was to obtain and record detailed and accurate measurements of the bovine kidney and to compare these new data with findings in humans. Thirty-eight bovine kidneys were used. The total number of lobes, along with the number of lobes located in the cranial polar, caudal polar and hilar regions, were recorded. Several measurements of the kidneys were made and evaluated. The hilar region presents the greatest length (mean of 76.87 mm) of the 3 renal regions of the kidney. The large area of the bovine renal hilus could make access to hilar structures easier than in the human kidney. The coefficient of variation for renal length was small (8.14%), while the coefficient of variation for the lobar number was high (26.82%). The number of renal lobes ranged from 13 to 35, with a mean of 20.62. The hilar region presents the highest number of lobes, while the cranial pole presents the lowest. The number of lobes in the cranial and caudal poles increases with the width of these regions. This is different from the hilar region, in which the lobar number increases with the length of the hilus. These data indicate that the adult bovine kidney can be used as a model for certain urologic procedures, but researchers must be aware that there are some major differences between the adult bovine kidney and the human kidney, as indicated by the data reported in this paper. (c) 2008 S. Karger AG, Basel.

Mapping genetic variants for cranial vault shape in humans.

PubMed

Roosenboom, Jasmien; Lee, Myoung Keun; Hecht, Jacqueline T; Heike, Carrie L; Wehby, George L; Christensen, Kaare; Feingold, Eleanor; Marazita, Mary L; Maga, A Murat; Shaffer, John R; Weinberg, Seth M

2018-01-01

The shape of the cranial vault, a region comprising interlocking flat bones surrounding the cerebral cortex, varies considerably in humans. Strongly influenced by brain size and shape, cranial vault morphology has both clinical and evolutionary relevance. However, little is known about the genetic basis of normal vault shape in humans. We performed a genome-wide association study (GWAS) on three vault measures (maximum cranial width [MCW], maximum cranial length [MCL], and cephalic index [CI]) in a sample of 4419 healthy individuals of European ancestry. All measures were adjusted by sex, age, and body size, then tested for association with genetic variants spanning the genome. GWAS results for the two cohorts were combined via meta-analysis. Significant associations were observed at two loci: 15p11.2 (lead SNP rs2924767, p = 2.107 × 10-8) for MCW and 17q11.2 (lead SNP rs72841279, p = 5.29 × 10-9) for MCL. Additionally, 32 suggestive loci (p < 5x10-6) were observed. Several candidate genes were located in these loci, such as NLK, MEF2A, SOX9 and SOX11. Genome-wide linkage analysis of cranial vault shape in mice (N = 433) was performed to follow-up the associated candidate loci identified in the human GWAS. Two loci, 17q11.2 (c11.loc44 in mice) and 17q25.1 (c11.loc74 in mice), associated with cranial vault size in humans, were also linked with cranial vault size in mice (LOD scores: 3.37 and 3.79 respectively). These results provide further insight into genetic pathways and mechanisms underlying normal variation in human craniofacial morphology.

Mapping genetic variants for cranial vault shape in humans

PubMed Central

Lee, Myoung Keun; Hecht, Jacqueline T.; Heike, Carrie L.; Wehby, George L.; Christensen, Kaare; Feingold, Eleanor; Marazita, Mary L.; Weinberg, Seth M.

2018-01-01

The shape of the cranial vault, a region comprising interlocking flat bones surrounding the cerebral cortex, varies considerably in humans. Strongly influenced by brain size and shape, cranial vault morphology has both clinical and evolutionary relevance. However, little is known about the genetic basis of normal vault shape in humans. We performed a genome-wide association study (GWAS) on three vault measures (maximum cranial width [MCW], maximum cranial length [MCL], and cephalic index [CI]) in a sample of 4419 healthy individuals of European ancestry. All measures were adjusted by sex, age, and body size, then tested for association with genetic variants spanning the genome. GWAS results for the two cohorts were combined via meta-analysis. Significant associations were observed at two loci: 15p11.2 (lead SNP rs2924767, p = 2.107 × 10−8) for MCW and 17q11.2 (lead SNP rs72841279, p = 5.29 × 10−9) for MCL. Additionally, 32 suggestive loci (p < 5x10-6) were observed. Several candidate genes were located in these loci, such as NLK, MEF2A, SOX9 and SOX11. Genome-wide linkage analysis of cranial vault shape in mice (N = 433) was performed to follow-up the associated candidate loci identified in the human GWAS. Two loci, 17q11.2 (c11.loc44 in mice) and 17q25.1 (c11.loc74 in mice), associated with cranial vault size in humans, were also linked with cranial vault size in mice (LOD scores: 3.37 and 3.79 respectively). These results provide further insight into genetic pathways and mechanisms underlying normal variation in human craniofacial morphology. PMID:29698431

Thin-plate spline analysis of the cranial base in subjects with Class III malocclusion.

PubMed

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

1997-08-01

The role of the cranial base in the emergence of Class III malocclusion is not fully understood. This study determines deformations that contribute to a Class III cranial base morphology, employing thin-plate spline analysis on lateral cephalographs. A total of 73 children of European-American descent aged between 5 and 11 years of age with Class III malocclusion were compared with an equivalent group of subjects with a normal, untreated, Class I molar occlusion. The cephalographs were traced, checked and subdivided into seven age- and sex-matched groups. Thirteen points on the cranial base were identified and digitized. The datasets were scaled to an equivalent size, and statistical analysis indicated significant differences between average Class I and Class III cranial base morphologies for each group. Thin-plate spline analysis indicated that both affine (uniform) and non-affine transformations contribute toward the total spline for each average cranial base morphology at each age group analysed. For non-affine transformations, Partial warps 10, 8 and 7 had high magnitudes, indicating large-scale deformations affecting Bolton point, basion, pterygo-maxillare, Ricketts' point and articulare. In contrast, high eigenvalues associated with Partial warps 1-3, indicating localized shape changes, were found at tuberculum sellae, sella, and the frontonasomaxillary suture. It is concluded that large spatial-scale deformations affect the occipital complex of the cranial base and sphenoidal region, in combination with localized distortions at the frontonasal suture. These deformations may contribute to reduced orthocephalization or deficient flattening of the cranial base antero-posteriorly that, in turn, leads to the formation of a Class III malocclusion.

Stereotactic radiotherapy using Novalis for skull base metastases developing with cranial nerve symptoms.

PubMed

Mori, Yoshimasa; Hashizume, Chisa; Kobayashi, Tatsuya; Shibamoto, Yuta; Kosaki, Katsura; Nagai, Aiko

2010-06-01

Skull base metastases are challenging situations because they often involve critical structures such as cranial nerves. We evaluated the role of stereotactic radiotherapy (SRT) which can give high doses to the tumors sparing normal structures. We treated 11 cases of skull base metastases from other visceral carcinomas. They had neurological symptoms due to cranial nerve involvement including optic nerve (3 patients), oculomotor (3), trigeminal (6), abducens (1), facial (4), acoustic (1), and lower cranial nerves (1). The interval between the onset of cranial nerve symptoms and Novalis SRT was 1 week to 7 months. Eleven tumors of 8-112 ml in volume were treated by Novalis SRT with 30-50 Gy in 10-14 fractions. The tumors were covered by 90-95% isodose. Imaging and clinical follow-up has been obtained in all 11 patients for 5-36 months after SRT. Seven patients among 11 died from primary carcinoma or other visceral metastases 9-36 months after Novalis SRT. All 11 metastatic tumors were locally controlled until the end of the follow-up time or patient death, though retreatment for re-growth was done in 1 patient. In 10 of 11 patients, cranial nerve deficits were improved completely or partially. In some patients, the cranial nerve symptoms were relieved even during the period of fractionated SRT. Novalis SRT is thought to be safe and effective treatment for skull base metastases with involvement of cranial nerves and it may improve cranial nerve symptoms quickly.

Unconstrained cranial evolution in Neandertals and modern humans compared to common chimpanzees

PubMed Central

Weaver, Timothy D.; Stringer, Chris B.

2015-01-01

A variety of lines of evidence support the idea that neutral evolutionary processes (genetic drift, mutation) have been important in generating cranial differences between Neandertals and modern humans. But how do Neandertals and modern humans compare with other species? And how do these comparisons illuminate the evolutionary processes underlying cranial diversification? To address these questions, we used 27 standard cranial measurements collected on 2524 recent modern humans, 20 Neandertals and 237 common chimpanzees to estimate split times between Neandertals and modern humans, and between Pan troglodytes verus and two other subspecies of common chimpanzee. Consistent with a neutral divergence, the Neandertal versus modern human split-time estimates based on cranial measurements are similar to those based on DNA sequences. By contrast, the common chimpanzee cranial estimates are much lower than DNA-sequence estimates. Apparently, cranial evolution has been unconstrained in Neandertals and modern humans compared with common chimpanzees. Based on these and additional analyses, it appears that cranial differentiation in common chimpanzees has been restricted by stabilizing natural selection. Alternatively, this restriction could be due to genetic and/or developmental constraints on the amount of within-group variance (relative to effective population size) available for genetic drift to act on. PMID:26468243

Changes in Cranial Base Morphology in Class I and Class II Division 1 Malocclusions

PubMed Central

Agarwal, Anirudh; Pandey, Harsh; Bajaj, Kamal; Pandey, Lavesh

2013-01-01

Introduction: The cranial base plays a key role in craniofacial growth; it helps to integrate spatially and functionally different patterns of growth in various adjoining regions of the skull such as components of the brain, the nasal and oral cavity and the pharynx. The aim of this study was to evaluate the difference in cranial base flexure between skeletal and dental Class I and Class II division 1. Materials & Methods: Lateral cephalometric radiograph, of Class I and Class II with an average growth pattern were analyzed and compared. A total of 103 patients having class I (n=52) and class II (n=51) malocclusion, were taken from Department of Orthodontics, Rajasthan Dental College & Hospital, Jaipur. Cranial base angle (N-S-Ar) and ANB were measured on pre treatment lateral cephalograms. Results: In this study cranial base angle did not show statistically significant difference between the two groups studied. Conclusion: In the assessment of orthodontic problems involving anteroposterior malrelationships of the jaws, the problem is usually the result of size, form and position of the jaw. The present study failed to find any differences in cranial base angle between sagittal malocclusions. How to cite this article: Agarwal A, Pandey H, Bajaj K, Pandey L. Changes in Cranial Base Morphology in Class I and Class II Division 1 Malocclusion. J Int Oral Health 2013; 5(1):39-42. PMID:24155576

MEMO1 drives cranial endochondral ossification and palatogenesis

PubMed Central

Otterloo, Eric Van; Feng, Weiguo; Jones, Kenneth L; Hynes, Nancy E; Clouthier, David E; Niswander, Lee; Williams, Trevor

2016-01-01

The cranial base is a component of the neurocranium and has a central role in the structural integration of the face, brain and vertebral column. Consequently, alteration in the shape of the human cranial base has been intimately linked with primate evolution and defective development is associated with numerous human facial abnormalities. Here we describe a novel recessive mutant mouse strain that presented with a domed head and fully penetrant cleft secondary palate coupled with defects in the formation of the underlying cranial base. Mapping and non-complementation studies revealed a specific mutation in Memo1 - a gene originally associated with cell migration. Expression analysis of Memo1 identified robust expression in the perichondrium and periosteum of the developing cranial base, but only modest expression in the palatal shelves. Fittingly, although the palatal shelves failed to elevate in Memo1 mutants, expression changes were modest within the shelves themselves. In contrast, the cranial base, which forms via endochondral ossification had major reductions in the expression of genes responsible for bone formation, notably matrix metalloproteinases and markers of the osteoblast lineage, mirrored by an increase in markers of cartilage and extracellular matrix development. Concomitant with these changes, mutant cranial bases showed an increased zone of hypertrophic chondrocytes accompanied by a reduction in both vascular invasion and mineralization. Finally, neural crest cell-specific deletion of Memo1 caused a failure of anterior cranial base ossification indicating a cell autonomous role for MEMO1 in the development of these neural crest cell derived structures. However, palate formation was largely normal in these conditional mutants, suggesting a non-autonomous role for MEMO1 in palatal closure. Overall, these findings assign a new function to MEMO1 in driving endochondral ossification in the cranium, and also link abnormal development of the cranial base with more widespread effects on craniofacial shape relevant to human craniofacial dysmorphology. PMID:26746790

The Role of Interface Shape on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model,.

PubMed

Vaughan, Patrick E; Vogelsberg, Caitlin C M; Vollner, Jennifer M; Fenton, Todd W; Haut, Roger C

2016-09-01

The forensic literature suggests that when adolescents fall onto edged and pointed surfaces, depressed fractures can occur at low energy levels. This study documents impact biomechanics and fracture characteristics of infant porcine skulls dropped onto flat, curved, edged, and focal surfaces. Results showed that the energy needed for fracture initiation was nearly four times higher against a flat surface than against the other surfaces. While characteristic measures of fracture such as number and length of fractures did not vary with impact surface shape, the fracture patterns did depend on impact surface shape. While experimental impacts against the flat surface produced linear fractures initiating at sutural boundaries peripheral to the point of impact (POI), more focal impacts produced depressed fractures initiating at the POI. The study supported case-based forensic literature suggesting cranial fracture patterns depend on impact surface shape and that fracture initiation energy is lower for more focal impacts. © 2016 American Academy of Forensic Sciences.

Estimating cranial musculoskeletal constraints in theropod dinosaurs.

PubMed

Lautenschlager, Stephan

2015-11-01

Many inferences on the biology, behaviour and ecology of extinct vertebrates are based on the reconstruction of the musculature and rely considerably on its accuracy. Although the advent of digital reconstruction techniques has facilitated the creation and testing of musculoskeletal hypotheses in recent years, muscle strain capabilities have rarely been considered. Here, a digital modelling approach using the freely available visualization and animation software Blender is applied to estimate cranial muscle length changes and optimal and maximal possible gape in different theropod dinosaurs. Models of living archosaur taxa (Alligator mississippiensis, Buteo buteo) were used in an extant phylogenetically bracketed framework to validate the method. Results of this study demonstrate that Tyrannosaurus rex, Allosaurus fragilis and Erlikosaurus andrewsi show distinct differences in the recruitment of the jaw adductor musculature and resulting gape, confirming previous dietary and ecological assumptions. While the carnivorous taxa T. rex and Allo. fragilis were capable of a wide gape and sustained muscle force, the herbivorous therizinosaurian E. andrewsi was constrained to small gape angles.

Estimating cranial musculoskeletal constraints in theropod dinosaurs

PubMed Central

Lautenschlager, Stephan

2015-01-01

Many inferences on the biology, behaviour and ecology of extinct vertebrates are based on the reconstruction of the musculature and rely considerably on its accuracy. Although the advent of digital reconstruction techniques has facilitated the creation and testing of musculoskeletal hypotheses in recent years, muscle strain capabilities have rarely been considered. Here, a digital modelling approach using the freely available visualization and animation software Blender is applied to estimate cranial muscle length changes and optimal and maximal possible gape in different theropod dinosaurs. Models of living archosaur taxa (Alligator mississippiensis, Buteo buteo) were used in an extant phylogenetically bracketed framework to validate the method. Results of this study demonstrate that Tyrannosaurus rex, Allosaurus fragilis and Erlikosaurus andrewsi show distinct differences in the recruitment of the jaw adductor musculature and resulting gape, confirming previous dietary and ecological assumptions. While the carnivorous taxa T. rex and Allo. fragilis were capable of a wide gape and sustained muscle force, the herbivorous therizinosaurian E. andrewsi was constrained to small gape angles. PMID:26716007

The Relationship between Brachycephalic Head Features in Modern Persian Cats and Dysmorphologies of the Skull and Internal Hydrocephalus.

PubMed

Schmidt, M J; Kampschulte, M; Enderlein, S; Gorgas, D; Lang, J; Ludewig, E; Fischer, A; Meyer-Lindenberg, A; Schaubmar, A R; Failing, K; Ondreka, N

2017-09-01

Cat breeders observed a frequent occurrence of internal hydrocephalus in Persian cats with extreme brachycephalic head morphology. To investigate a possible relationship among the grade of brachycephaly, ventricular dilatation, and skull dysmorphologies in Persian cats. 92 Persian-, 10 Domestic shorthair cats. The grade of brachycephaly was determined on skull models based on CT datasets. Cranial measurements were examined with regard to a possible correlation with relative ventricular volume, and cranial capacity. Persians with high (peke-face Persians) and lower grades of brachycephaly (doll-face Persians) were investigated for the presence of skull dysmorphologies. The mean cranial index of the peke-face Persians (0.97 ± 0.14) was significantly higher than the mean cranial index of doll-face Persians (0.66 ± 0.04; P < 0.001). Peke-face Persians had a lower relative nasal bone length (0.15 ± 0.04) compared to doll-face (0.29 ± 0.08; P < 0.001). The endocranial volume was significantly lower in doll-face than peke-face Persians (89.6 ± 1.27% versus 91.76 ± 2.07%; P < 0.001). The cranial index was significantly correlated with this variable (Spearman's r: 0.7; P < 0.0001). Mean ventricle: Brain ratio of the peke-face group (0.159 ± 0.14) was significantly higher compared to doll-face Persians (0.015 ± 0.01; P < 0.001). High grades of brachycephaly are also associated with malformations of the calvarial and facial bones as well as dental malformations. As these dysmorphologies can affect animal welfare, the selection for extreme forms of brachycephaly in Persian cats should be reconsidered. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Skull Base Meningiomas and Cranial Nerves Contrast Using Sodium Fluorescein: A New Application of an Old Tool

PubMed Central

da Silva, Carlos Eduardo; da Silva, Vinicius Duval; da Silva, Jefferson Luis Braga

2014-01-01

Objective The identification of cranial nerves is one of the most challenging goals in the dissection of skull base meningiomas. The authors present an application of sodium fluorescein (SF) in skull base meningiomas with the purpose of improving the identification of cranial nerves. Design A prospective study within-subjects design. Setting Hospital Ernesto Dornelles, Porto Alegre, Brazil. Participants Patients with skull base meningiomas. Main Outcomes Measures Cranial nerve identification. Results The group of nine meningiomas was composed of one cavernous sinus, three petroclival, one tuberculum sellae, two sphenoid wing, one olfactory groove, and one temporal floor meningioma. The SF enhancement in all tumors was strong, and the contrast with cranial nerves clearly evident. There were one definite olfactory nerve deficit, one transient abducens deficit, and one definite hemiparesis. All lesions were resected (Simpson grades 1 and 2). The analysis of the difference of the delta SF wavelength between the meningiomas and cranial nerve contrast was performed by the Wilcoxon signed rank test and showed p = 0.011. Conclusions The contrast between the enhanced meningiomas and cranial nerves was evident and assisted in the visualization and microsurgical dissection of these structures. The anatomical preservation of these structures was improved using the contrast. PMID:27054056

Skull Base Meningiomas and Cranial Nerves Contrast Using Sodium Fluorescein: A New Application of an Old Tool.

PubMed

da Silva, Carlos Eduardo; da Silva, Vinicius Duval; da Silva, Jefferson Luis Braga

2014-08-01

Objective The identification of cranial nerves is one of the most challenging goals in the dissection of skull base meningiomas. The authors present an application of sodium fluorescein (SF) in skull base meningiomas with the purpose of improving the identification of cranial nerves. Design A prospective study within-subjects design. Setting Hospital Ernesto Dornelles, Porto Alegre, Brazil. Participants Patients with skull base meningiomas. Main Outcomes Measures Cranial nerve identification. Results The group of nine meningiomas was composed of one cavernous sinus, three petroclival, one tuberculum sellae, two sphenoid wing, one olfactory groove, and one temporal floor meningioma. The SF enhancement in all tumors was strong, and the contrast with cranial nerves clearly evident. There were one definite olfactory nerve deficit, one transient abducens deficit, and one definite hemiparesis. All lesions were resected (Simpson grades 1 and 2). The analysis of the difference of the delta SF wavelength between the meningiomas and cranial nerve contrast was performed by the Wilcoxon signed rank test and showed p = 0.011. Conclusions The contrast between the enhanced meningiomas and cranial nerves was evident and assisted in the visualization and microsurgical dissection of these structures. The anatomical preservation of these structures was improved using the contrast.

Open reduction and cranial bone plate fixation of fractures involving the distal aspect of the radius and ulna in miniature- and toy-breed dogs: 102 cases (2008-2015).

PubMed

De Arburn Parent, Rebecca; Benamou, Jérôme; Gatineau, Matthieu; Clerfond, Pierre; Planté, Jérôme

2017-06-15

OBJECTIVE To determine outcomes and complication rates of open reduction and cranial bone plate fixation of fractures involving the distal aspect of the radius and ulna in miniature- and toy-breed dogs. DESIGN Retrospective case series. ANIMALS 102 miniature- and toy-breed dogs (105 fractures) weighing ≤ 7 kg (15.4 lb) that had undergone open reduction and cranial bone plate fixation of a fracture involving the distal aspect of the radius and ulna from 2008 through 2015. PROCEDURES Medical records were reviewed and information extracted regarding dog and fracture characteristics, surgical variables, and follow-up examination data (including postoperative complications). Postoperative radiographs were examined for distal fragment size, implant placement, apposition, alignment, and healing stage. A long-term follow-up questionnaire was completed by telephone interview with dog owners at least 6 months after surgery. RESULTS Mean length of the distal bone fragment in all fractures was 19.2 mm, with a mean distal-to-total radial length ratio of 0.21. At last follow-up examination (typically 6 weeks after surgery), 97 (95%) dogs had no signs of lameness; minor lameness was identified in 5 (5%) dogs. Complications developed in 26 (25%) fractures (23 [22%] minor and 3 [3%] major complications). Sixty-eight of 71 (96%) owners rated the overall and long-term outcome as excellent and 3 (4%) as good; 68 of 71 (96%) dogs reportedly had no signs of residual lameness. CONCLUSIONS AND CLINICAL RELEVANCE Open reduction and cranial bone plate fixation for the treatment of radius-ulna fractures in miniature- and toy-breed dogs provided an excellent outcome with a low complication rate.

Performance Measures in Neurosurgical Patient Care: Differing Applications of Patient Safety Indicators.

PubMed

Moghavem, Nuriel; McDonald, Kathryn; Ratliff, John K; Hernandez-Boussard, Tina

2016-04-01

Patient Safety Indicators (PSIs) are administratively coded identifiers of potentially preventable adverse events. These indicators are used for multiple purposes, including benchmarking and quality improvement efforts. Baseline PSI evaluation in high-risk surgeries is fundamental to both purposes. Determine PSI rates and their impact on other outcomes in patients undergoing cranial neurosurgery compared with other surgeries. The Agency for Healthcare Research and Quality (AHRQ) PSI software was used to flag adverse events and determine risk-adjusted rates (RAR). Regression models were built to assess the association between PSIs and important patient outcomes. We identified cranial neurosurgeries based on International Classification of Diseases, Ninth Revision, Clinical Modification codes in California, Florida, New York, Arkansas, and Mississippi State Inpatient Databases, AHRQ, 2010-2011. PSI development, 30-day all-cause readmission, length of stay, hospital costs, and inpatient mortality. A total of 48,424 neurosurgical patients were identified. Procedure indication was strongly associated with PSI development. The neurosurgical population had significantly higher RAR of most PSIs evaluated compared with other surgical patients. Development of a PSI was strongly associated with increased length of stay and hospital cost and, in certain PSIs, increased inpatient mortality and 30-day readmission. In this population-based study, certain accountability measures proposed for use as value-based payment modifiers show higher RAR in neurosurgery patients compared with other surgical patients and were subsequently associated with poor outcomes. Our results indicate that for quality improvement efforts, the current AHRQ risk-adjustment models should be viewed in clinically meaningful stratified subgroups: for profiling and pay-for-performance applications, additional factors should be included in the risk-adjustment models. Further evaluation of PSIs in additional high-risk surgeries is needed to better inform the use of these metrics.

The evolutionary history of polycotylid plesiosaurians

NASA Astrophysics Data System (ADS)

Fischer, V.; Benson, R. B. J.; Druckenmiller, P. S.; Ketchum, H. F.; Bardet, N.

2018-03-01

Polycotylidae is a clade of plesiosaurians that appeared during the Early Cretaceous and became speciose and abundant early in the Late Cretaceous. However, this radiation is poorly understood. Thililua longicollis from the Middle Turonian of Morocco is an enigmatic taxon possessing an atypically long neck and, as originally reported, a series of unusual cranial features that cause unstable phylogenetic relationships for polycotylids. We reinterpret the holotype specimen of Thililua longicollis and clarify its cranial anatomy. Thililua longicollis possesses an extensive, foramina-bearing jugal, a premaxilla-parietal contact and carinated teeth. Phylogenetic analyses of a new cladistic dataset based on first-hand observation of most polycotylids recover Thililua and Mauriciosaurus as successive lineages at the base of the earliest Late Cretaceous polycotyline radiation. A new dataset summarizing the Bauplan of polycotylids reveals that their radiation produced an early burst of disparity during the Cenomanian-Turonian interval, with marked plasticity in relative neck length, but this did not arise as an ecological release following the extinction of ichthyosaurs and pliosaurids. This disparity vanished during and after the Turonian, which is consistent with a model of `early experimentation/late constraint'. Two polycotylid clades, Occultonectia clade nov. and Polycotylinae, survived up to the Maastrichtian, but with low diversity.

Timing of ectocranial suture activity in Gorilla gorilla as related to cranial volume and dental eruption

PubMed Central

Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

2011-01-01

Research has shown that Pan and Homo have similar ectocranial suture synostosis patterns and a similar suture ontogeny (relative timing of suture fusion during the species ontogeny). This ontogeny includes patency during and after neurocranial expansion with a delayed bony response associated with adaptation to biomechanical forces generated by mastication. Here we investigate these relationships for Gorilla by examining the association among ectocranial suture morphology, cranial volume (as a proxy for neurocranial expansion) and dental development (as a proxy for the length of time that it has been masticating hard foods and exerting such strains on the cranial vault) in a large sample of Gorilla gorilla skulls. Two-hundred and fifty-five Gorilla gorilla skulls were examined for ectocranial suture closure status, cranial volume and dental eruption. Regression models were calculated for cranial volumes by suture activity, and Kendall's tau (a non-parametric measure of association) was calculated for dental eruption status by suture activity. Results suggest that, as reported for Pan and Homo, neurocranial expansion precedes suture synostosis activity. Here, Gorilla was shown to have a strong relationship between dental development and suture activity (synostosis). These data are suggestive of suture fusion extending further into ontogeny than brain expansion, similar to Homo and Pan. This finding allows for the possibility that masticatory forces influence ectocranial suture morphology. PMID:21385182

Analysis of the Volumes of the Posterior Cranial Fossa, Cerebellum, and Herniated Tonsils Using the Stereological Methods in Patients with Chiari Type I Malformation

PubMed Central

Vurdem, Ümit Erkan; Acer, Niyazi; Ertekin, Tolga; Savranlar, Ahmet; İnci, Mehmet Fatih

2012-01-01

Objective. The aim of this study was to determine the posterior cranial fossa volume, cerebellar volume, and herniated tonsillar volume in patients with chiari type I malformation and control subjects using stereological methods. Material and Methods. These volumes were estimated retrospectively using the Cavalieri principle as a point-counting technique. We used magnetic resonance images taken from 25 control subjects and 30 patients with chiari type I malformation. Results. The posterior cranial fossa volume in patients with chiari type I malformation was significantly smaller than the volume in the control subjects (P < 0.05). In the chiari type I malformation group, the cerebellar volume was smaller than the control group, but this difference was not statistically significant (P > 0.05). In the chiari type I malformation group, the ratio of cerebellar volume to posterior cranial fossa volume was higher than in the control group. We also found a positive correlation between the posterior cranial fossa volume and cerebellar volume for each of the groups (r = 0.865, P < 0.001). The mean (±SD) herniated tonsillar volume and length were 0.89 ± 0.50 cm3 and 9.63 ± 3.37 mm in the chiari type I malformation group, respectively. Conclusion. This study has shown that posterior cranial fossa and cerebellum volumes can be measured by stereological methods, and the ratio of these measurements can contribute to the evaluation of chiari type I malformation cases. PMID:22629166

Cranial sutures and craniometric points detected on MRI.

PubMed

Cotton, François; Rozzi, Fernando Ramirez; Vallee, Bernard; Pachai, Chahin; Hermier, Marc; Guihard-Costa, Anne-Marie; Froment, Jean-Claude

2005-03-01

The main goal of the study was to determine on MRI the cranial sutures, the craniometric points and craniometric measurements, and to correlate these results with classical anthropometric measurements. For this purpose, we reviewed 150 cerebral MRI examinations considered as normal (Caucasian population aged 20-49 years). For each examination we individualized 11 craniometric landmarks (Glabella, Bregma, Lambda, Opisthocranion, Opisthion, Basion, Inion, Porion, Infra-orbital, Eurion) and three measurements. Measurements were also calculated independently on 498 dry crania (Microscribe 3-DX digitizer). To validate the MRI procedure, we measured four dry crania by MRI and with compass or digital caliper gauges. Cranial sutures always appeared without signal (black), whatever the MRI sequence used, and they are better visualized with a 5 mm slice thickness (compact bone overlapping). Slice dynamic analysis and multiplanar reformatting allowed the detection of all craniometric points, some of these being more difficult to detect than others (Porion, Infra-orbital). The measurements determined by these points were as follows: Vertex-Basion height=135.66+/-6.56 mm; Eurion-Eurion width=141.17+/-5.19 mm; Glabella-Opisthocranion length=181.94+/-6.40 mm. On the midline T1-weighted sagittal image, all median craniometric landmarks can be individualized and the Glabella-Opisthocranion length, Vertex-Basion height and parenchyma indices can be calculated. Craniometric points and measurements between these points can be estimated with a standard cerebral MRI examination, with results that are similar to anthropometric data.

Ontogenetic shifts of heart position in snakes.

PubMed

Lillywhite, Harvey B; Lillywhite, Steven M

2017-08-01

Heart position relative to total body length (TL) varies among snakes, with anterior hearts in arboreal species and more centrally located hearts in aquatic or ground-dwelling species. Anterior hearts decrease the cardiac work associated with cranial blood flow and minimize drops in cranial pressure and flow during head-up climbing. Here, we investigate whether heart position shifts intraspecifically during ontogenetic increases in TL. Insular Florida cottonmouth snakes, Agkistrodon conanti, are entirely ground-dwelling and have a mean heart position that is 33.32% TL from the head. In contrast, arboreal rat snakes, Pantherophis obsoleta, of similar lengths have a mean heart position that is 17.35% TL from the head. In both species, relative heart position shifts craniad during ontogeny, with negative slopes = -.035 and -.021% TL/cm TL in Agkistrodon and Pantherophis, respectively. Using a large morphometric data set available for Agkistrodon (N = 192 individuals, 23-140 cm TL), we demonstrate there is an anterior ontogenetic shift of the heart position within the trunk (= 4.56% trunk length from base of head to cloacal vent), independent of head and tail allometry which are both negative. However, in longer snakes > 100 cm, the heart position reverses and shifts caudally in longer Agkistrodon but continues toward the head in longer individuals of Pantherophis. Examination of data sets for two independent lineages of fully marine snakes (Acrochordus granulatus and Hydrophis platurus), which do not naturally experience postural gravity stress, demonstrate both ontogenetic patterns for heart position that are seen in the terrestrial snakes. The anterior migration of the heart is greater in the terrestrial species, even if TL is standardized to that of the longer P. obsoleta, and compensates for about 5 mmHg gravitational pressure head if they are fully upright. © 2017 Wiley Periodicals, Inc.

Blood loss and transfusion requirements with epsilon-aminocaproic acid use during cranial vault reconstruction surgery.

PubMed

Thompson, Mark E; Saadeh, Charles; Watkins, Phillip; Nagy, Laszlo; Demke, Joshua

2017-02-01

To determine whether epsilon-aminocaproic acid (EACA) load of 50 mg∙kg -1 before skin incision, and infusion of 25 mg∙kg -1 ∙h -1 until skin closure during cranial vault reconstruction (CVR) were associated with decreased estimated blood loss and transfusion requirements. Antifibrinolytic medications decrease bleeding and transfusion requirements during cardiothoracic and orthopedic surgeries with high blood loss, but practical reductions in blood loss and transfusion requirements have not been consistently realized in children undergoing CVR. Current dosing recommendations are derived from adult extrapolations, and may or may not have clinical relevance. Retrospective case-controlled study of 45 consecutive infants and children undergoing primary craniosynostosis surgery at Covenant Children's Hospital during years 2010-2014. Exclusion criteria included revision surgery, and chromosomal abnormalities associated with bleeding disorders. Blood loss and blood transfusion volumes as a percent of estimated blood volume were compared in the presence of EACA while controlling for age, suture phenotype, use of bone grafting, and length of surgery. Secondary outcomes measures included volume of crystalloid infused, length of hospital stay, and any postoperative intubation requirement. When analyzed based on length of surgery, EACA did reduce blood loss and blood transfusion (R 2 =0.19, P=.005 and R 2 =0.18, P=.010, respectively) with shorter surgeries. Using a standardized dosing regimen of EACA during craniosynostosis surgery, we found statistical significance in blood loss and transfusion requirements in surgeries of the shortest duration. We suspect this may be due to our selected dosing regimen, which may be lower than recently recommended. This study contributes to the growing body of evidence supporting EACA in CVR for craniosynostosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Locomotion and basicranial anatomy in primates and marsupials.

PubMed

Villamil, Catalina I

2017-10-01

There is ongoing debate in paleoanthropology about whether and how the anatomy of the cranium, and especially the cranial base, is evolving in response to locomotor and postural changes. However, the majority of studies focus on two-dimensional data, which fails to capture the complexity of cranial anatomy. This study tests whether three-dimensional cranial base anatomy is linked to locomotion or to other factors in primates (n = 473) and marsupials (n = 231). Results indicate that although there is a small effect of locomotion on cranial base anatomy in primates, this is not the case in marsupials. Instead, facial anatomy likely drives variation in cranial base anatomy in both primates and marsupials, with additional roles for body size and brain size. Although some changes to foramen magnum position and orientation are phylogenetically useful among the hominoids, they do not necessarily reflect locomotion or positional behavior. The interplay between locomotion, posture, and facial anatomy in primates requires further investigation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parenting, corpus callosum, and executive function in preschool children.

PubMed

Kok, Rianne; Lucassen, Nicole; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H; Ghassabian, Akhgar; Roza, Sabine J; Govaert, Paul; Jaddoe, Vincent W; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2014-01-01

In this longitudinal population-based study (N = 544), we investigated whether early parenting and corpus callosum length predict child executive function abilities at 4 years of age. The length of the corpus callosum in infancy was measured using postnatal cranial ultrasounds at 6 weeks of age. At 3 years, two aspects of parenting were observed: maternal sensitivity during a teaching task and maternal discipline style during a discipline task. Parents rated executive function problems at 4 years of age in five domains of inhibition, shifting, emotional control, working memory, and planning/organizing, using the Behavior Rating Inventory of Executive Function-Preschool Version. Maternal sensitivity predicted less executive function problems at preschool age. A significant interaction was found between corpus callosum length in infancy and maternal use of positive discipline to determine child inhibition problems: The association between a relatively shorter corpus callosum in infancy and child inhibition problems was reduced in children who experienced more positive discipline. Our results point to the buffering potential of positive parenting for children with biological vulnerability.

Arterial supply of the upper cranial nerves: a comprehensive review.

PubMed

Hendrix, Philipp; Griessenauer, Christoph J; Foreman, Paul; Shoja, Mohammadali M; Loukas, Marios; Tubbs, R Shane

2014-11-01

The arterial supply to the upper cranial nerves is derived from a complex network of branches derived from the anterior and posterior cerebral circulations. We performed a comprehensive literature review of the arterial supply of the upper cranial nerves with an emphasis on clinical considerations. Arteries coursing in close proximity to the cranial nerves regularly give rise to small vessels that supply the nerve. Knowledge of the arteries supplying the cranial nerves is of particular importance during surgical approaches to the skull base. © 2014 Wiley Periodicals, Inc.

Virtual cranial endocast of the oldest giant panda (Ailuropoda microta) reveals great similarity to that of its extant relative.

PubMed

Dong, Wei

2008-11-01

Recent development of computed tomography and three-dimensional visualization techniques has enabled the non-destructive inspection of the endocast morphology of fossil neurocranium, the basic material for paleoneurological study. A virtual cranial endocast was reconstructed based on the first skull of the oldest giant panda, Ailuropoda microta, discovered recently and dated at more than 2 Myr (million years) ago. It was compared with that of the extant giant panda (A. melanoleuca) and that of the polar bear (Ursus maritimus), as well as CT slices of the late Pleistocene A. baconi. The overall endocast morphology of A. microta is more similar to that of A. baconi and A. melanoleuca than to that of U. maritimus. The absolute endocast size is the smallest in A. microta, largest in A. baconi, and intermediate in A. melanoleuca. However, the proportion of cerebral volume to total endocast size is very close to each other between the oldest and extant giant panda, as well as the sulcal length per unit area of cerebral endocast surface.

Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications.

PubMed

Dallan, Iacopo; Castelnuovo, Paolo; de Notaris, Matteo; Sellari-Franceschini, Stefano; Lenzi, Riccardo; Turri-Zanoni, Mario; Battaglia, Paolo; Prats-Galino, Alberto

2013-05-01

The superior orbital fissure is a critical three-dimensional space connecting the middle cranial fossa and the orbit. From an endoscopic viewpoint, only the medial aspect has a clinical significance. It presents a critical relationship with the lateral sellar compartment, the pterygopalatine fossa and the middle cranial fossa. The connective tissue layers and neural and vascular structures of this region are described. The role of Muller's muscle is confirmed, and the utility of the maxillary and optic strut is outlined. Muller's muscle extends for the whole length of the inferior orbital fissure, passes over the maxillary strut and enters the superior orbital fissure, representing a critical surgical landmark. Dividing the tendon between the medial and inferior rectus muscle allows the identification of the main trunk of the oculomotor nerve, and a little laterally, it is usually possible to visualize the first part of the ophthalmic artery. Based on a better knowledge of anatomy, we trust that this area could be readily addressed in clinical situations requiring an extended approach in proximity of the orbital apex.

Virtual cranial endocast of the oldest giant panda ( Ailuropoda microta) reveals great similarity to that of its extant relative

NASA Astrophysics Data System (ADS)

Dong, Wei

2008-11-01

Recent development of computed tomography and three-dimensional visualization techniques has enabled the non-destructive inspection of the endocast morphology of fossil neurocranium, the basic material for paleoneurological study. A virtual cranial endocast was reconstructed based on the first skull of the oldest giant panda, Ailuropoda microta, discovered recently and dated at more than 2 Myr (million years) ago. It was compared with that of the extant giant panda ( A. melanoleuca) and that of the polar bear ( Ursus maritimus), as well as CT slices of the late Pleistocene A. baconi. The overall endocast morphology of A. microta is more similar to that of A. baconi and A. melanoleuca than to that of U. maritimus. The absolute endocast size is the smallest in A. microta, largest in A. baconi, and intermediate in A. melanoleuca. However, the proportion of cerebral volume to total endocast size is very close to each other between the oldest and extant giant panda, as well as the sulcal length per unit area of cerebral endocast surface.

Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age.

PubMed

Cuzzilla, R; Spittle, A J; Lee, K J; Rogerson, S; Cowan, F M; Doyle, L W; Cheong, J L Y

2018-06-01

Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth. Participants comprised 144 infants born at <30 weeks' gestational age at a single center between January 2011 and December 2013. Infants with major brain injury seen on cranial ultrasonography or congenital or chromosomal abnormalities were excluded. Brain tissue and fluid spaces were measured from cranial ultrasonography performed as part of routine clinical care. Brain growth was assessed in 3 time intervals: <7, 7-27, and >27 days' postnatal age. Data were analyzed using intraclass correlation coefficients and mixed-effects regression. A total of 429 scans were assessed for 144 infants. Several linear measures showed excellent reproducibility. All measures of brain tissue increased with postnatal age, except for the biparietal diameter, which decreased within the first postnatal week and increased thereafter. Gestational age of ≥28 weeks at birth was associated with slower growth of the biparietal diameter and ventricular width compared with gestational age of <28 weeks. Postnatal corticosteroid administration was associated with slower growth of the corpus callosum length, transcerebellar diameter, and vermis height. Sepsis and necrotizing enterocolitis were associated with slower growth of the transcerebellar diameter. Postnatal brain growth in infants born at <30 weeks' gestational age can be evaluated using sequential linear measures made from routine cranial ultrasonography and is associated with perinatal predictors of long-term development. © 2018 by American Journal of Neuroradiology.

The evolution of cranial base and face in Cercopithecoidea and Hominoidea: Modularity and morphological integration.

PubMed

Profico, Antonio; Piras, Paolo; Buzi, Costantino; Di Vincenzo, Fabio; Lattarini, Flavio; Melchionna, Marina; Veneziano, Alessio; Raia, Pasquale; Manzi, Giorgio

2017-12-01

The evolutionary relationship between the base and face of the cranium is a major topic of interest in primatology. Such areas of the skull possibly respond to different selective pressures. Yet, they are often said to be tightly integrated. In this paper, we analyzed shape variability in the cranial base and the facial complex in Cercopithecoidea and Hominoidea. We used a landmark-based approach to single out the effects of size (evolutionary allometry), morphological integration, modularity, and phylogeny (under Brownian motion) on skull shape variability. Our results demonstrate that the cranial base and the facial complex exhibit different responses to different factors, which produces a little degree of morphological integration between them. Facial shape variation appears primarily influenced by body size and sexual dimorphism, whereas the cranial base is mostly influenced by functional factors. The different adaptations affecting the two modules suggest they are best studied as separate and independent units, and that-at least when dealing with Catarrhines-caution must be posed with the notion of strong cranial integration that is commonly invoked for the evolution of their skull shape. © 2017 Wiley Periodicals, Inc.

Benchmarking pediatric cranial CT protocols using a dose tracking software system: a multicenter study.

PubMed

De Bondt, Timo; Mulkens, Tom; Zanca, Federica; Pyfferoen, Lotte; Casselman, Jan W; Parizel, Paul M

2017-02-01

To benchmark regional standard practice for paediatric cranial CT-procedures in terms of radiation dose and acquisition parameters. Paediatric cranial CT-data were retrospectively collected during a 1-year period, in 3 different hospitals of the same country. A dose tracking system was used to automatically gather information. Dose (CTDI and DLP), scan length, amount of retakes and demographic data were stratified by age and clinical indication; appropriate use of child-specific protocols was assessed. In total, 296 paediatric cranial CT-procedures were collected. Although the median dose of each hospital was below national and international diagnostic reference level (DRL) for all age categories, statistically significant (p-value < 0.001) dose differences among hospitals were observed. The hospital with lowest dose levels showed smallest dose variability and used age-stratified protocols for standardizing paediatric head exams. Erroneous selection of adult protocols for children still occurred, mostly in the oldest age-group. Even though all hospitals complied with national and international DRLs, dose tracking and benchmarking showed that further dose optimization and standardization is possible by using age-stratified protocols for paediatric cranial CT. Moreover, having a dose tracking system revealed that adult protocols are still applied for paediatric CT, a practice that must be avoided. • Significant differences were observed in the delivered dose between age-groups and hospitals. • Using age-adapted scanning protocols gives a nearly linear dose increase. • Sharing dose-data can be a trigger for hospitals to reduce dose levels.

Timing of ectocranial suture activity in Gorilla gorilla as related to cranial volume and dental eruption.

PubMed

Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

2011-05-01

Research has shown that Pan and Homo have similar ectocranial suture synostosis patterns and a similar suture ontogeny (relative timing of suture fusion during the species ontogeny). This ontogeny includes patency during and after neurocranial expansion with a delayed bony response associated with adaptation to biomechanical forces generated by mastication. Here we investigate these relationships for Gorilla by examining the association among ectocranial suture morphology, cranial volume (as a proxy for neurocranial expansion) and dental development (as a proxy for the length of time that it has been masticating hard foods and exerting such strains on the cranial vault) in a large sample of Gorilla gorilla skulls. Two-hundred and fifty-five Gorilla gorilla skulls were examined for ectocranial suture closure status, cranial volume and dental eruption. Regression models were calculated for cranial volumes by suture activity, and Kendall's tau (a non-parametric measure of association) was calculated for dental eruption status by suture activity. Results suggest that, as reported for Pan and Homo, neurocranial expansion precedes suture synostosis activity. Here, Gorilla was shown to have a strong relationship between dental development and suture activity (synostosis). These data are suggestive of suture fusion extending further into ontogeny than brain expansion, similar to Homo and Pan. This finding allows for the possibility that masticatory forces influence ectocranial suture morphology. © 2011 The Authors. Journal of Anatomy © 2011 Anatomical Society of Great Britain and Ireland.

Maxillary and mandibular contribution to the establishment of class II malocclusion in an adult Lebanese population.

PubMed

El Hajj, Nadine; Bassil-Nassif, Nayla; Tauk, Alain; Mouhanna-Fattal, Carole; Bouserhal, Joseph P

2017-12-01

The main aim of this study was to describe the contribution of the maxilla and the mandible to the establishment of a Class II skeletal malocclusion in an adult Lebanese population. Secondary aims were to detect the presence of sex-based dimorphism and to study the influence of the vertical dimension on the Class II skeletal pattern. A sample of 90 adults in skeletal Class II was recruited and equally distributed according to sex and vertical typology. The study describes the skeletal and dentoalveolar cephalometric characteristics of the Class II sample, essentially according to Coben's cephalometric analysis. The total effective depth of the cranial base and the anterior cranial base angle (SN-BaH) were both greater in the Class II sample. In females, the effective depth of the maxilla (Ptm-A) was larger than normal while SNB was smaller. The parameters describing the size and shape of the body of the mandible were significantly different from those of normal subjects. The upper incisors were in a retrusive position, while the axis of the lower incisors was located normally. The mandibular molars had a more distal sagittal position. Hyperdivergent subjects had more significant posterior alveolar growth, a more retrusive mandibular position and smaller mandibular dimensions than the other two vertical sub-groups. The cranial base contributes to the establishment of a Class II malocclusion, and mandibular retrusion cannot be considered as a characteristic shared by all skeletal Class II subjects. Lessening of the absolute length of the mandibular body is the second most frequent etiological factor noted in the Class II sample studied. Most individuals in skeletal Class II have an associated dental Class II malocclusion, and the vertical dimension has an influence on the Class II skeletal pattern. Copyright © 2017 CEO. Published by Elsevier Masson SAS. All rights reserved.

Electrophysiology of Extraocular Cranial Nerves: Oculomotor, Trochlear, and Abducens Nerve.

PubMed

Hariharan, Praveen; Balzer, Jeffery R; Anetakis, Katherine; Crammond, Donald J; Thirumala, Parthasarathy D

2018-01-01

The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during skull base surgeries poses a risk of injury to multiple cranial nerves, including those innervating extraocular muscles. Because tumors distort normal anatomic relationships, it becomes particularly challenging to identify cranial nerve structures. Studies have reported the benefits of using intraoperative spontaneous electromyographic recordings and compound muscle action potentials evoked by electrical stimulation in preventing postoperative neurologic deficits. Apart from surgical applications, electromyography of extraocular muscles has also been used to guide botulinum toxin injections in patients with strabismus and as an adjuvant diagnostic test in myasthenia gravis. In this article, we briefly review the rationale, current available techniques to monitor extraocular cranial nerves, technical difficulties, clinical and surgical applications, as well as future directions for research.

Developmental Regulation of the Growth Plate and Cranial Synchondrosis

PubMed Central

Wei, X.; Hu, M.; Mishina, Y.; Liu, F.

2016-01-01

Long bones and the cranial base are both formed through endochondral ossification. Elongation of long bones is primarily through the growth plate, which is a cartilaginous structure at the end of long bones made up of chondrocytes. Growth plate chondrocytes are organized in columns along the longitudinal axis of bone growth. The cranial base is the growth center of the neurocranium. Synchondroses, consisting of mirror-image growth plates, are critical for cranial base elongation and development. Over the last decade, considerable progress has been made in determining the roles of the parathyroid hormone–related protein, Indian hedgehog, fibroblast growth factor, bone morphogenetic protein, and Wnt signaling pathways in various aspects of skeletal development. Furthermore, recent evidence indicates the important role of the primary cilia signaling pathway in bone elongation. Here, we review the development of the growth plate and cranial synchondrosis and the regulation by the above-mentioned signaling pathways, highlighting the similarities and differences between these 2 structures. PMID:27250655

Indian and sonic hedgehogs regulate synchondrosis growth plate and cranial base development and function.

PubMed

Young, Blanche; Minugh-Purvis, Nancy; Shimo, Tsuyoshi; St-Jacques, Benoit; Iwamoto, Masahiro; Enomoto-Iwamoto, Motomi; Koyama, Eiki; Pacifici, Maurizio

2006-11-01

The synchondroses consist of mirror-image growth plates and are critical for cranial base elongation, but relatively little is known about their formation and regulation. Here we show that synchondrosis development is abnormal in Indian hedgehog-null mice. The Ihh(-/-) cranial bases displayed reduced growth and chondrocyte proliferation, but chondrocyte hypertrophy was widespread. Rather than forming a typical narrow zone, Ihh(-/-) hypertrophic chondrocytes occupied an elongated central portion of each growth plate and were flanked by immature collagen II-expressing chondrocytes facing perichondrial tissues. Endochondral ossification was delayed in much of the Ihh(-/-) cranial bases but, surprisingly, was unaffected most posteriorly. Searching for an explanation, we found that notochord remnants near incipient spheno-occipital synchondroses at E13.5 expressed Sonic hedgehog and local chondrocytes expressed Patched, suggesting that Shh had sustained chondrocyte maturation and occipital ossification. Equally unexpected, Ihh(-/-) growth plates stained poorly with Alcian blue and contained low aggrecan transcript levels. A comparable difference was seen in cultured wild-type versus Ihh(-/-) synchondrosis chondrocytes. Treatment with exogenous Ihh did not fully restore normal proteoglycan levels in mutant cultures, but a combination of Ihh and BMP-2 did. In summary, Ihh is required for multiple processes during synchondrosis and cranial base development, including growth plate zone organization, chondrocyte orientation, and proteoglycan production. The cranial base appears to be a skeletal structure in which growth and ossification patterns along its antero-posterior axis are orchestrated by both Ihh and Shh.

Cranial base pathology in pediatric osteogenesis imperfecta patients treated with bisphosphonates.

PubMed

Arponen, Heidi; Vuorimies, Ilkka; Haukka, Jari; Valta, Helena; Waltimo-Sirén, Janna; Mäkitie, Outi

2015-03-01

Cranial base pathology is a serious complication of osteogenesis imperfecta (OI). Our aim was to analyze whether bisphosphonate treatment, used to improve bone strength, could also prevent the development of craniocervical junction pathology (basilar impression, basilar invagination, or platybasia) in children with OI. In this single-center retrospective study the authors analyzed the skull base morphology from lateral skull radiographs and midsagittal MR images (total of 94 images), obtained between the ages of 0 and 25 years in 39 bisphosphonate-treated OI patients. The results were compared with age-matched normative values and with findings in 70 OI patients who were not treated with bisphosphonates. In addition to cross-sectional data, longitudinal data were available from 22 patients with an average follow-up period of 7.6 years. The patients, who had OI types I, III, IV, VI, and VII, had been treated with zoledronic acid, pamidronate, or risedronate for 3.2 years on average. Altogether 33% of the 39 bisphosphonate-treated patients had at least 1 cranial base anomaly, platybasia being the most prevalent diagnosis (28%). Logistic regression analysis suggested a higher risk of basilar impression or invagination in patients with severe OI (OR 22.04) and/or older age at initiation of bisphosphonate treatment (OR 1.45), whereas a decreased risk was associated with longer duration of treatment (OR 0.28). No significant associations between age, height, or cumulative bisphosphonate dose and the risk for cranial base anomaly were detected. In longitudinal evaluation, Kaplan-Meier curves suggested delayed development of cranial base pathology in patients treated with bisphosphonates but the differences from the untreated group were not statistically significant. These findings indicate that cranial base pathology may develop despite bisphosphonate treatment. Early initiation of bisphosphonate treatment may delay development of craniocervical junction pathology. Careful followup of cranial base morphology is warranted, particularly in patients with severe OI.

Use of Pericranial Flaps in the Management of Cranial Base Trauma

PubMed Central

Polley, John W.; Penney, Don; Cohen, Mimis

1993-01-01

Pericranial flaps based on the musuloaponeurotic or myofacial layers of the scalp have great utility in the management of acquired and congenital craniofacial deformities. Their use in traumatic deformities is indicated in the presence of craniopharyngeal communications and significant anterior cranial fossa dead space created from frontal sinus obliteration. The indications and operative techniques and the results of the use of these flaps in 10 consecutive patient with extensive cranial base trauma are presented. ImagesFigure 4p49-bFigure 4Figure 5Figure 5p52-b PMID:17170889

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

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

PubMed

Bink, A; Berkefeld, J; Zanella, F

2009-07-01

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

Harvey Cushing's Approaches to Tumors in His Early Career: From the Skull Base to the Cranial Vault

PubMed Central

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

2011-01-01

In this report, we review Dr. Cushing's early surgical cases at the Johns Hopkins Hospital, revealing details of his early operative approaches to tumors of the skull base and cranial vault. Following Institutional Review Board approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the Johns Hopkins Hospital surgical files from 1896 to 1912. Participants included four adult patients and one child who underwent surgical resection of bony tumors of the skull base and the cranial vault. The main outcome measures were operative approach and condition recorded at the time of discharge. The indications for surgery included unspecified malignant tumor of the basal meninges and temporal bone, basal cell carcinoma, osteoma of the posterior skull base, and osteomas of the frontal and parietofrontal cranial vault. While 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:22470271

Sex determination by three-dimensional geometric morphometrics of the palate and cranial base.

PubMed

Chovalopoulou, Maria-Eleni; Valakos, Efstratios D; Manolis, Sotiris K

2013-01-01

The purpose of this study is to assess sexual dimorphism in the palate and base of adult crania using three-dimensional geometric morphometric methods. The study sample consisted of 176 crania of known sex (94 males, 82 females) belonging to individuals who lived during the 20th century in Greece. The three-dimensional co-ordinates of 30 ectocranial landmarks were digitized using a MicroScribe 3DX contact digitizer. Generalized Procrustes Analysis (GPA) was used to obtain size and shape variables for statistical analysis. Three discriminant function analyses were carried out: (1) using PC scores from Procrustes shape space, (2) centroid size alone, and (3) PC scores of GPA residuals which includes InCS for analysis in Procrustes form space. Results indicate that there are shape differences between sexes. In males, the palate is deepest and more elongated; the cranial base is shortened. Sex-specific shape differences for the cross-validated data give better classification results in the cranial base (77.2%) compared with the palate (68.9%). Size alone yielded better results for cranial base (82%) in opposition to palate (63.1%). As anticipated, the classification accuracy improves when both size and shape are combined (90.4% for cranial base, and 74.8% for palate).

Evaluation of the cranial base in amnion rupture sequence involving the anterior neural tube: implications regarding recurrence risk.

PubMed

Jones, Kenneth Lyons; Robinson, Luther K; Benirschke, Kurt

2006-09-01

Amniotic bands can cause disruption of the cranial end of the developing fetus, leading in some cases to a neural tube closure defect. Although recurrence for unaffected parents of an affected child with a defect in which the neural tube closed normally but was subsequently disrupted by amniotic bands is negligible; for a primary defect in closure of the neural tube to which amnion has subsequently adhered, recurrence risk is 1.7%. In that primary defects of neural tube closure are characterized by typical abnormalities of the base of the skull, evaluation of the cranial base in such fetuses provides an approach for making a distinction between these 2 mechanisms. This distinction has implications regarding recurrence risk. The skull base of 2 fetuses with amnion rupture sequence involving the cranial end of the neural tube were compared to that of 1 fetus with anencephaly as well as that of a structurally normal fetus. The skulls were cleaned, fixed in 10% formalin, recleaned, and then exposed to 10% KOH solution. After washing and recleaning, the skulls were exposed to hydrogen peroxide for bleaching and photography. Despite involvement of the anterior neural tube in both fetuses with amnion rupture sequence, in Case 3 the cranial base was normal while in Case 4 the cranial base was similar to that seen in anencephaly. This technique provides a method for determining the developmental pathogenesis of anterior neural tube defects in cases of amnion rupture sequence. As such, it provides information that can be used to counsel parents of affected children with respect to recurrence risk.

Anthropometric Analysis of Cephalofacial Dimensions in Kerman, Iran.

PubMed

Pouya, Fatemeh; Eftekhar-Vaghefi, Seyed Hassan; Salehinejad, Parvin

2017-04-01

The human body dimensions are affected by ecological, biological, geographical, racial, sex, and age factors. Craniofacial measurements can be considered to be one of the important tools for determination of the morphological characteristics of the head and face. In this study, which was conducted on Persian adolescents living in Kerman/Iran, different forms of head and face were determined for using in various aspects of medicine. The study was conducted on 732 participants including 366 males and 366 females in the age of 18-20-year-old. In addition to the height and weight of the participants, cephalofacial sizes of them were measured and then cephalic, facial, and brain indices were calculated. Among the cephalofacial sizes, cranial length and breadth, cranial circumference, prosopic length and prosopic breadth were significantly greater in males compared to females (P<0.005). Also, volume and weight of brain were significantly greater in male comparing to female participants (P<0.005). The predominant type of head was meso-cephal, and the predominant type of face was meso-prosopic in both sexes.

Cephalometric oropharynx and oral cavity analysis in Chiari malformation Type I: a retrospective case-control study.

PubMed

Urbizu, Aintzane; Ferré, Alex; Poca, Maria-Antonia; Rovira, Alex; Sahuquillo, Juan; Martin, Bryn A; Macaya, Alfons

2017-02-01

OBJECTIVE Traditionally, Chiari malformation Type I has been related to downward herniation of the cerebellar tonsils as a consequence of an underdeveloped posterior cranial fossa. Although the common symptoms of Chiari malformation Type I are occipital headaches, cervical pain, dizziness, paresthesia, and sensory loss, patients often report symptoms related to pharyngeal dysfunction such as choking, regurgitation, dysphagia, aspiration, chronic cough, and sleep disorders. In addition, tracheal intubation is often difficult in these patients. The purpose of this study was to analyze the morphological features of the oropharynx and oral cavity in patients with Chiari malformation Type I to help identify underlying anatomical anomalies leading to these debilitating symptoms. METHODS Seventy-six adult patients with symptomatic Chiari malformation Type I with cerebellar tonsillar descent greater than 5 mm below the foramen magnum and a small posterior cranial fossa and 49 sex-matched controls were selected to perform a retrospective case-control MRI-based morphometric study in a tertiary hospital. Eleven linear and areal parameters of the oropharyngeal cavity on midsagittal T1-weighted MRI were measured and the average values between patients and control cohorts were compared. Correlations between variables showing or approaching statistical significance in these structures and posterior cranial fossa measurements related with the occipital bone were sought. RESULTS Significant differences were detected for several oropharynx and oral cavity measures in the patient cohort, primarily involving the length and thickness of the soft palate (p = 9.5E-05 and p = 3.0E-03, respectively). A statistically significant (p < 0.01) moderate correlation between some of these variables and posterior cranial fossa parameters was observed. CONCLUSIONS The existence of structural oropharyngeal and oral cavity anomalies in patients with Chiari malformation Type I was confirmed, which may contribute to the frequent occurrence of respiratory and deglutitory complications and sleep disorders in this syndrome.

Arterial supply of the lower cranial nerves: a comprehensive review.

PubMed

Hendrix, Philipp; Griessenauer, Christoph J; Foreman, Paul; Loukas, Marios; Fisher, Winfield S; Rizk, Elias; Shoja, Mohammadali M; Tubbs, R Shane

2014-01-01

The lower cranial nerves receive their arterial supply from an intricate network of tributaries derived from the external carotid, internal carotid, and vertebrobasilar territories. A contemporary, comprehensive literature review of the vascular supply of the lower cranial nerves was performed. The vascular supply to the trigeminal, facial, vestibulocochlear, glossopharyngeal, vagus, spinal accessory, and hypoglossal nerves are illustrated with a special emphasis on clinical issues. Frequently the external carotid, internal carotid, and vertebrobasilar territories all contribute to the vascular supply of an individual cranial nerve along its course. Understanding of the vasculature of the lower cranial nerves is of great relevance for skull base surgery. Copyright © 2013 Wiley Periodicals, Inc.

[Imaging anatomy of cranial nerves].

PubMed

Hermier, M; Leal, P R L; Salaris, S F; Froment, J-C; Sindou, M

2009-04-01

Knowledge of the anatomy of the cranial nerves is mandatory for optimal radiological exploration and interpretation of the images in normal and pathological conditions. CT is the method of choice for the study of the skull base and its foramina. MRI explores the cranial nerves and their vascular relationships precisely. Because of their small size, it is essential to obtain images with high spatial resolution. The MRI sequences optimize contrast between nerves and surrounding structures (cerebrospinal fluid, fat, bone structures and vessels). This chapter discusses the radiological anatomy of the cranial nerves.

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

PubMed

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

2008-01-01

The fundamental goal of skull base surgery is tumor removal with preservation of neurological function. Injury to the lower cranial nerves (LCN; CN 9-12) profoundly affects a patient's quality of life. Although intraoperative cranial nerve monitoring (IOM) is widely practiced for other cranial nerves, literature addressing the LCN is scant. We examined the utility of IOM of the LCN in a large patient series. One hundred twelve patients underwent 123 skull base operations with IOM between January 1994 to December 1999. The vagus nerve (n=37), spinal accessory nerve (n=118), and the hypoglossal nerve (n=83) were monitored intraoperatively. Electromyography (EMG) and compound muscle action potentials (CMAP) were recorded from the relevant muscles after electrical stimulation. This data was evaluated retrospectively. Patients who underwent IOM tended to have larger tumors with more intricate involvement of the lower cranial nerves. Worsening of preoperative lower cranial nerve function was seen in the monitored and unmonitored groups. With the use of IOM in the high risk group, LCN injury was reduced to a rate equivalent to that of the lower risk group (p>0.05). The immediate feedback obtained with IOM may prevent injury to the LCN due to surgical manipulation. It can also help identify the course of a nerve in patients with severely distorted anatomy. These factors may facilitate gross total tumor resection with cranial nerve preservation. The incidence of high false positive and negative CMAP and the variability in CMAP amplitude and threshold can vary depending on individual and technical factors.

The Lumbar Lordosis in Males and Females, Revisited.

PubMed

Hay, Ori; Dar, Gali; Abbas, Janan; Stein, Dan; May, Hila; Masharawi, Youssef; Peled, Nathan; Hershkovitz, Israel

2015-01-01

Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females. Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height. Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined). Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis). The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing.

Derivation of new diagnostic reference levels for neuro-paediatric computed tomography examinations in Switzerland.

PubMed

Wagner, Franca; Bize, Julie; Racine, Damien; Le Coultre, Regis; Francis, Verdun; Trueb, Philipp; Treier, Reto

2018-05-22

Definition of new national diagnostic reference levels (DRLs) for volume computed tomography dose index (CTDIvol) and dose length product (DLP) for neuro-paediatric CT examinations depending on the medical indication. Methods: Paediatric cranial CT data sets acquired between January 2013 and December 2016 were retrospectively collected between July 2016 and March 2017 from the eight largest university and cantonal hospitals that perform most of the neuro-paediatric CTs in Switzerland. A consensus review of CTDIvol and DLP was undertaken for the three defined anatomical regions: brain, facial bone and petrous bone; each with and without contrast medium application. All indications for cranial CT imaging in paediatrics were assigned to one of these three regions. Descriptive statistical analysis of the distribution of the median values for CTDIvol and DLP yielded minimum, maximum, 25th percentile (1st quartile), median (2nd quartile) and 75th percentile (3rd quartile). New DRLs for neuro-paediatric CT examinations in Switzerland were based on the 75th percentiles of the distributions of the median values of all eight centres. Where appropriate, values were rounded such that the DRLs increase or at least remain constant as the age of the patient increases. Results: Our results revealed DRLs for CTDIvol and DLP up to 20% lower than the DRLs used so far in Switzerland and elsewhere in Europe. Conclusions: This study provides Swiss neuro-paediatric CT DRL values to establish optimum conditions for paediatric cranial CT examinations. Periodic national updates of DRLs, following international comparisons, are essential. . Creative Commons Attribution license.

A case of bilateral lower cranial nerve palsies after base of skull trauma with complex management issues: case report and review of the literature.

PubMed

Lehn, Alexander Christoph; Lettieri, Jennie; Grimley, Rohan

2012-05-01

Fractures of the skull base can cause lower cranial nerve palsies because of involvement of the nerves as they traverse the skull. A variety of syndromes have been described, often involving multiple nerves. These are most commonly unilateral, and only a handful of cases of bilateral cranial nerve involvement have been reported. We describe a 64-year-old man with occipital condylar fracture complicated by bilateral palsies of IX and X nerves associated with dramatic physiological derangement causing severe management challenges. Apart from debilitating postural hypotension, he developed dysphagia, severe gastrointestinal dysmotility, issues with airway protection as well as airway obstruction, increased oropharyngeal secretions and variable respiratory control. This is the first report of a patient with traumatic bilateral cranial nerve IX and X nerve palsies. This detailed report and the summary of all 6 previous case reports of traumatic bilateral lower cranial nerve palsies illustrate clinical features, treatment strategies, and outcomes of these rare events.

Model-based surgical planning and simulation of cranial base surgery.

PubMed

Abe, M; Tabuchi, K; Goto, M; Uchino, A

1998-11-01

Plastic skull models of seven individual patients were fabricated by stereolithography from three-dimensional data based on computed tomography bone images. Skull models were utilized for neurosurgical planning and simulation in the seven patients with cranial base lesions that were difficult to remove. Surgical approaches and areas of craniotomy were evaluated using the fabricated skull models. In preoperative simulations, hand-made models of the tumors, major vessels and nerves were placed in the skull models. Step-by-step simulation of surgical procedures was performed using actual surgical tools. The advantages of using skull models to plan and simulate cranial base surgery include a better understanding of anatomic relationships, preoperative evaluation of the proposed procedure, increased understanding by the patient and family, and improved educational experiences for residents and other medical staff. The disadvantages of using skull models include the time and cost of making the models. The skull models provide a more realistic tool that is easier to handle than computer-graphic images. Surgical simulation using models facilitates difficult cranial base surgery and may help reduce surgical complications.

The practice of cranial neurosurgery and the malpractice liability environment in the United States.

PubMed

Bekelis, Kimon; Missios, Symeon; Wong, Kendrew; MacKenzie, Todd A

2015-01-01

The potential imbalance between malpractice liability cost and quality of care has been an issue of debate. We investigated the association of malpractice liability with unfavorable outcomes and increased hospitalization charges in cranial neurosurgery. We performed a retrospective cohort study involving patients who underwent cranial neurosurgical procedures from 2005-2010, and were registered in the National Inpatient Sample (NIS) database. We used data from the National Practitioner Data Bank (NPDB) from 2005 to 2010 to create measures of volume and size of malpractice claim payments. The association of the latter with the state-level mortality, length of stay (LOS), unfavorable discharge, and hospitalization charges for cranial neurosurgery was investigated. During the study period, there were 189,103 patients (mean age 46.4 years, with 48.3% females) who underwent cranial neurosurgical procedures, and were registered in NIS. In a multivariable regression, higher number of claims per physician in a state was associated with increased ln-transformed hospitalization charges (beta 0.18; 95% CI, 0.17 to 0.19). On the contrary, there was no association with mortality (OR 1.00; 95% CI, 0.94 to 1.06). We observed a small association with unfavorable discharge (OR 1.09; 95% CI, 1.06 to 1.13), and LOS (beta 0.01; 95% CI, 0.002 to 0.03). The size of the awarded claims demonstrated similar relationships. The average claims payment size (ln-transformed) (Pearson's rho=0.435, P=0.01) demonstrated a positive correlation with the risk-adjusted hospitalization charges but did not demonstrate a correlation with mortality, unfavorable discharge, or LOS. In the present national study, aggressive malpractice environment was not correlated with mortality but was associated with higher hospitalization charges after cranial neurosurgery. In view of the association of malpractice with the economics of healthcare, further research on its impact is necessary.

The Practice of Cranial Neurosurgery and the Malpractice Liability Environment in the United States

PubMed Central

Wong, Kendrew; MacKenzie, Todd A.

2015-01-01

Object The potential imbalance between malpractice liability cost and quality of care has been an issue of debate. We investigated the association of malpractice liability with unfavorable outcomes and increased hospitalization charges in cranial neurosurgery. Methods We performed a retrospective cohort study involving patients who underwent cranial neurosurgical procedures from 2005-2010, and were registered in the National Inpatient Sample (NIS) database. We used data from the National Practitioner Data Bank (NPDB) from 2005 to 2010 to create measures of volume and size of malpractice claim payments. The association of the latter with the state-level mortality, length of stay (LOS), unfavorable discharge, and hospitalization charges for cranial neurosurgery was investigated. Results During the study period, there were 189,103 patients (mean age 46.4 years, with 48.3% females) who underwent cranial neurosurgical procedures, and were registered in NIS. In a multivariable regression, higher number of claims per physician in a state was associated with increased ln-transformed hospitalization charges (beta 0.18; 95% CI, 0.17 to 0.19). On the contrary, there was no association with mortality (OR 1.00; 95% CI, 0.94 to 1.06). We observed a small association with unfavorable discharge (OR 1.09; 95% CI, 1.06 to 1.13), and LOS (beta 0.01; 95% CI, 0.002 to 0.03). The size of the awarded claims demonstrated similar relationships. The average claims payment size (ln-transformed) (Pearson’s rho=0.435, P=0.01) demonstrated a positive correlation with the risk-adjusted hospitalization charges but did not demonstrate a correlation with mortality, unfavorable discharge, or LOS. Conclusions In the present national study, aggressive malpractice environment was not correlated with mortality but was associated with higher hospitalization charges after cranial neurosurgery. In view of the association of malpractice with the economics of healthcare, further research on its impact is necessary. PMID:25798994

Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note.

PubMed

Brand, Y; Lim, E; Waran, V; Prepageran, N

2015-12-01

Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa. A 37-year-old male patient presented with multiple areas of cranial defect with cerebrospinal fluid leak due to osteoradionecrosis following radiation for nasopharyngeal carcinoma 4 years earlier. Clinical examination showed involvement of all cranial nerves except the IInd and XIth nerves on the left side. A prior attempt to repair the cerebrospinal fluid leak with craniotomy was not successful. This case demonstrates the successful endoscopic repair of a large cranial defect with cerebrospinal fluid leak.

Computer-aided implant design for the restoration of cranial defects.

PubMed

Chen, Xiaojun; Xu, Lu; Li, Xing; Egger, Jan

2017-06-23

Patient-specific cranial implants are important and necessary in the surgery of cranial defect restoration. However, traditional methods of manual design of cranial implants are complicated and time-consuming. Our purpose is to develop a novel software named EasyCrania to design the cranial implants conveniently and efficiently. The process can be divided into five steps, which are mirroring model, clipping surface, surface fitting, the generation of the initial implant and the generation of the final implant. The main concept of our method is to use the geometry information of the mirrored model as the base to generate the final implant. The comparative studies demonstrated that the EasyCrania can improve the efficiency of cranial implant design significantly. And, the intra- and inter-rater reliability of the software were stable, which were 87.07 ± 1.6% and 87.73 ± 1.4% respectively.

Tumors Presenting as Multiple Cranial Nerve Palsies

PubMed Central

Kumar, Kishore; Ahmed, Rafeeq; Bajantri, Bharat; Singh, Amandeep; Abbas, Hafsa; Dejesus, Eddy; Khan, Rana Raheel; Niazi, Masooma; Chilimuri, Sridhar

2017-01-01

Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor. PMID:28553221

Severe localised granulomatosis with polyangiitis (Wegener's granulomatosis) manifesting with extensive cranial nerve palsies and cranial diabetes insipidus: a case report and literature review.

PubMed

Peters, James E; Gupta, Vivek; Saeed, Ibtisam T; Offiah, Curtis; Jawad, Ali S M

2018-05-01

Granulomatosis with polyangiitis (GPA, formerly Wegener's granulomatosis) is a multisystem vasculitis of small- to medium-sized blood vessels. Cranial involvement can result in cranial nerve palsies and, rarely, pituitary infiltration. We describe the case of a 32 year-old woman with limited but severe GPA manifesting as progressive cranial nerve palsies and pituitary dysfunction. Our patient initially presented with localised ENT involvement, but despite treatment with methotrexate, she deteriorated. Granulomatous inflammatory tissue around the skull base resulted in cavernous sinus syndrome, facial nerve palsy, palsies of cranial nerves IX-XII (Collet-Sicard syndrome), and the rare complication of cranial diabetes insipidus due to pituitary infiltration. The glossopharyngeal, vagus and accessory nerve palsies resulted in severe dysphagia and she required nasogastric tube feeding. Her neurological deficits substantially improved with treatment including high dose corticosteroid, cyclophosphamide and rituximab. This case emphasises that serious morbidity can arise from localised cranial Wegener's granulomatosis in the absence of systemic disease. In such cases intensive induction immunosuppression is required. Analysis of previously reported cases of pituitary involvement in GPA reveals that this rare complication predominantly affects female patients.

Moderate climate signature in cranial anatomy of late holocene human populations from Southern South America.

PubMed

Paula Menéndez, Lumila

2018-02-01

The aim of this study is to analyze the association between cranial variation and climate in order to discuss their role during the diversification of southern South American populations. Therefore, the specific objectives are: (1) to explore the spatial pattern of cranial variation with regard to the climatic diversity of the region, and (2) to evaluate the differential impact that the climatic factors may have had on the shape and size of the diverse cranial structures studied. The variation in shape and size of 361 crania was studied, registering 62 3D landmarks that capture shape and size variation in the face, cranial vault, and base. Mean, minimum, and maximum annual temperature, as well as mean annual precipitation, but also diet and altitude, were matched for each population sample. A PCA, as well as spatial statistical techniques, including kriging, regression, and multimodel inference were employed. The facial skeleton size presents a latitudinal pattern which is partially associated with temperature diversity. Both diet and altitude are the variables that mainly explain the skull shape variation, although mean annual temperature also plays a role. The association between climate factors and cranial variation is low to moderate, mean annual temperature explains almost 40% of the entire skull, facial skeleton and cranial vault shape variation, while annual precipitation and minimum annual temperature only contribute to the morphological variation when considered together with maximum annual temperature. The cranial base is the structure less associated with climate diversity. These results suggest that climate factors may have had a partial impact on the facial and vault shape, and therefore contributed moderately to the diversification of southern South American populations, while diet and altitude might have had a stronger impact. Therefore, cranial variation at the southern cone has been shaped both by random and nonrandom factors. Particularly, the influence of climate on skull shape has probably been the result of directional selection. This study supports that, although cranial vault is the cranial structure more associated to mean annual temperature, the impact of climate signature on morphology decreases when populations from extreme cold environments are excluded from the analysis. Additionally, it shows that the extent of the geographical scales analyzed, as well as differential sampling may lead to different results regarding the role of ecological factors and evolutionary processes on cranial morphology. © 2017 Wiley Periodicals, Inc.

Clinical anatomy of the orbitomeningeal foramina: variational anatomy of the canals connecting the orbit with the cranial cavity.

PubMed

Macchi, Veronica; Regoli, Marì; Bracco, Sandra; Nicoletti, Claudio; Morra, Aldo; Porzionato, Andrea; De Caro, Raffaele; Bertelli, Eugenio

2016-03-01

In addition to the optic canal and the superior orbital fissure, orbits are connected with the cranial cavity via inconstant canals including the orbitomeningeal foramen. This study has been carried out in order to define many anatomical and radiological details of the orbitomeningeal foramen that are relevant in the clinical practice. Almost 1000 skulls and 50 computerized tomographies were examined to determine incidence, number, length, and caliber of the orbitomeningeal foramen as well as the topography of their orbital and cranial openings. A retrospective study of angiographies carried out on more than 100 children was performed to look for arteries candidate to run through the orbitomeningeal foramen. Orbitomeningeal foramina were detected in 59.46% of skulls and in 54% of individuals by computerized tomography. Orbits with two to five foramina were found. Canals were classified as M-subtype or A-subtype depending on their cranial opening. Large foramina, with the caliber ranging between 1 and 3 mm, were found in 12.17% of orbitomeningeal foramen-bearing orbits. By computed tomography the average caliber measured 1.2 ± 0.3 and 1.5 ± 0.5 mm (p < 0.005) at the orbital and cranial openings, respectively (p < 0.005). Angiographies showed meningo-lacrimal and meningo-ophthalmic arteries, meningeal branches of the lacrimal and supraorbital arteries, and some unidentified arteries that could pass through the orbitomeningeal foramina. Orbitomeningeal foramina are a common occurrence. When large they may house important arteries that can be the source of severe bleedings during deep dissection of the lateral wall of the orbit. Orbital surgeons should be aware of their existence.

[Neurophysiological identification of the cranial nerves in endoscopic endonasal surgery of skull base tumors].

PubMed

Shkarubo, A N; Ogurtsova, A A; Moshchev, D A; Lubnin, A Yu; Andreev, D N; Koval', K V; Chernov, I V

2016-01-01

Intraoperative identification of the cranial nerves is a useful technique in removal of skull base tumors through the endoscopic endonasal approach. Searching through the scientific literature found one pilot study on the use of triggered electromyography (t-EMG) for identification of the VIth nerve in endonasal endoscopic surgery of skull base tumors (D. San-Juan, et al, 2014). The study objective was to prevent iatrogenic injuries to the cranial nerves without reducing the completeness of tumor tissue resection. In 2014, 5 patients were operated on using the endoscopic endonasal approach. Surgeries were performed for large skull base chordomas (2 cases) and trigeminal nerve neurinomas located in the cavernous sinus (3). Intraoperatively, identification of the cranial nerves was performed by triggered electromyography using a bipolar electrode (except 1 case of chordoma where a monopolar electrode was used). Evaluation of the functional activity of the cranial nerves was carried out both preoperatively and postoperatively. Tumor resection was total in 4 out of 5 cases and subtotal (chordoma) in 1 case. Intraoperatively, the IIIrd (2 patients), Vth (2), and VIth (4) cranial nerves were identified. No deterioration in the function of the intraoperatively identified nerves was observed in the postoperative period. In one case, no responses from the VIth nerve on the right (in the cavernous sinus region) were intraoperatively obtained, and deep paresis (up to plegia) of the nerve-innervated muscles developed in the postoperative period. The nerve function was not impaired before surgery. The t-EMG technique is promising and requires further research.

Comparative sacral morphology and the reconstructed tail lengths of five extinct primates: Proconsul heseloni, Epipliopithecus vindobonensis, Archaeolemur edwardsi, Megaladapis grandidieri, and Palaeopropithecus kelyus.

PubMed

Russo, Gabrielle A

2016-01-01

This study evaluated the relationship between the morphology of the sacrum-the sole bony link between the tail or coccyx and the rest of the body-and tail length (including presence/absence) and function using a comparative sample of extant mammals spanning six orders (Primates, Carnivora, Rodentia, Diprotodontia, Pilosa, Scandentia; N = 472). Phylogenetically-informed regression methods were used to assess how tail length varied with respect to 11 external and internal (i.e., trabecular) bony sacral variables with known or suspected biomechanical significance across all mammals, only primates, and only non-primates. Sacral variables were also evaluated for primates assigned to tail categories ('tailless,' 'nonprehensile short-tailed,' 'nonprehensile long-tailed,' and 'prehensile-tailed'). Compared to primates with reduced tail lengths, primates with longer tails generally exhibited sacra having larger caudal neural openings than cranial neural openings, and last sacral vertebrae with more mediolaterally-expanded caudal articular surfaces than cranial articular surfaces, more laterally-expanded transverse processes, more dorsally-projecting spinous processes, and larger caudal articular surface areas. Observations were corroborated by the comparative sample, which showed that shorter-tailed (e.g., Lynx rufus [bobcat]) and longer-tailed (e.g., Acinonyx jubatus [cheetah]) non-primate mammals morphologically converge with shorter-tailed (e.g., Macaca nemestrina) and longer-tailed (e.g., Macaca fascicularis) primates, respectively. 'Prehensile-tailed' primates exhibited last sacral vertebrae with more laterally-expanded transverse processes and greater caudal articular surface areas than 'nonprehensile long-tailed' primates. Internal sacral variables performed poorly compared to external sacral variables in analyses of extant primates, and were thus deemed less useful for making inferences concerning tail length and function in extinct primates. The tails lengths of five extinct primates were reconstructed from the external sacral variables: Archaeolemur edwardsi had a 'nonprehensile long tail,' Megaladapis grandidieri, Palaeopropithecus kelyus, and Epipliopithecus vindobonensis probably had 'nonprehensile short tails,' and Proconsul heseloni was 'tailless.' Copyright © 2015 Elsevier Ltd. All rights reserved.

Occipital foramina development involves localised regulation of mesenchyme proliferation and is independent of apoptosis

PubMed Central

Akbareian, Sophia E; Pitsillides, Andrew A; Macharia, Raymond G; McGonnell, Imelda M

2015-01-01

Cranial foramina are holes within the skull, formed during development, allowing entry and exit of blood vessels and nerves. Once formed they must remain open, due to the vital structures they contain, i.e. optic nerves, jugular vein, carotid artery, and other cranial nerves and blood vessels. Understanding cranial foramina development is essential as cranial malformations lead to the stenosis or complete closure of these structures, resulting in blindness, deafness, facial paralysis, raised intracranial pressure and lethality. Here we focus on describing early events in the formation of the jugular, carotid and hypoglossal cranial foramina that form in the mesoderm-derived, endochondral occipital bones at the base of the embryonic chick skull. Whole-mount skeletal staining of skulls indicates the appearance of these foramina from HH32/D7.5 onwards. Haematoxylin & eosin staining of sections shows that the intimately associated mesenchyme, neighbouring the contents of these cranial foramina, is initially very dense and gradually becomes sparser as development proceeds. Histological examination also revealed that these foramina initially contain relatively large-diameter nerves, which later become refined, and are closely associated with the blood vessel, which they also innervate within the confines of the foramina. Interestingly cranial foramina in the base of the skull contain blood vessels lacking smooth muscle actin, which suggests these blood vessels belong to glomus body structures within the foramina. The blood vessel shape also appears to dictate the overall shape of the resulting foramina. We initially hypothesised that cranial foramina development could involve targeted proliferation and local apoptosis to cause ‘mesenchymal clearing’ and the creation of cavities in a mechanism similar to joint cavitation. We find that this is not the case, and propose that a mechanism reliant upon local nerve/blood vessel-derived restriction of ossification may contribute to foramina formation during cranial development. PMID:25994127

Geographical variations of the skull in the red fox Vulpes vulpes on the Japanese Islands: an exception to Bergmann's rule.

PubMed

Oishi, Takuya; Uraguchi, Kohji; Abramov, Alexei V; Masuda, Ryuichi

2010-12-01

In order to clarify the morphological differences between two subspecies of the red fox (Vulpes vulpes) on the Japanese Islands and test the validity of Bergmann's rule, we examined geographical variations in 25 cranial and 24 dental characters in V. v. schrencki from Hokkaido and V. v. japonica from the other main islands of Japan (Honshu, Shikoku, and Kyushu). Many skull measurements, including the male greatest length, condylobasal length, and the length of upper and lower tooth rows, were significantly larger for V. v. japonica than for V. v. schrencki, whereas most tooth measurements, especially the length of molars and premolars, in V. v. schrencki were larger than those in V. v. japonica. Although the two subspecies were morphologically well-differentiated from each other, the results did not support that they have evolved following Bergmann's rule of adaptation to cold climates. Based on consideration of the relatively large differences of their tooth sizes, which are not easily influenced by food abundance, and previous genetic research on the different migration histories of the two subspecies, the morphological differences detected in the present study may have resulted not only from the present ecological differences between the two subspecies, but also from the difference of migration history and evolutionary constraints.

OH 83: A new early modern human fossil cranium from the Ndutu beds of Olduvai Gorge, Tanzania.

PubMed

Reiner, Whitney B; Masao, Fidelis; Sholts, Sabrina B; Songita, Agustino Venance; Stanistreet, Ian; Stollhofen, Harald; Taylor, R E; Hlusko, Leslea J

2017-11-01

Herein we introduce a newly recovered partial calvaria, OH 83, from the upper Ndutu Beds of Olduvai Gorge, Tanzania. We present the geological context of its discovery and a comparative analysis of its morphology, placing OH 83 within the context of our current understanding of the origins and evolution of Homo sapiens. We comparatively assessed the morphology of OH 83 using quantitative and qualitative data from penecontemporaneous fossils and the W.W. Howells modern human craniometric dataset. OH 83 is geologically dated to ca. 60-32 ka. Its morphology is indicative of an early modern human, falling at the low end of the range of variation for post-orbital cranial breadth, the high end of the range for bifrontal breadth, and near average in frontal length. There have been numerous attempts to use cranial anatomy to define the species Homo sapiens and identify it in the fossil record. These efforts have not met wide agreement by the scientific community due, in part, to the mosaic patterns of cranial variation represented by the fossils. The variable, mosaic pattern of trait expression in the crania of Middle and Late Pleistocene fossils implies that morphological modernity did not occur at once. However, OH 83 demonstrates that by ca. 60-32 ka modern humans in Africa included individuals that are at the fairly small and gracile range of modern human cranial variation. © 2017 Wiley Periodicals, Inc.

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

NASA Astrophysics Data System (ADS)

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

2015-03-01

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

Reconstruction of the cranial base in surgery for jugular foramen tumors.

PubMed

Ramina, Ricardo; Maniglia, Joao J; Paschoal, Jorge R; Fernandes, Yvens B; Neto, Mauricio Coelho; Honorato, Donizeti C

2005-04-01

The surgical removal of a jugular foramen (JF) tumor presents the neurosurgeon with a complex management problem that requires an understanding of the natural history, diagnosis, surgical approaches, and postoperative complications. Cerebrospinal fluid (CSF) leakage is one of the most common complications of this surgery. Different surgical approaches and management concepts to avoid this complication have been described, mainly in the ear, nose, and throat literature. The purpose of this study was to review the results of CSF leakage prevention in a series of 66 patients with JF tumors operated on by a multidisciplinary cranial base team using a new technique for cranial base reconstruction. We retrospectively studied 66 patients who had JF tumors with intracranial extension and who underwent surgical treatment in our institutions from January 1987 to December 2001. Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. All patients were operated on using the same multidisciplinary surgical approach (neurosurgeons and ear, nose, and throat surgeons). A surgical strategy for reconstruction of the cranial base using vascularized flaps was carried out. The closure of the surgical wound was performed in three layers. A specially developed myofascial flap (temporalis fascia, cervical fascia, and sternocleidomastoid muscle) associated to the inferior rotation of the posterior portion of the temporalis muscle was used to reconstruct the cranial base with vascularized flaps. In this series of 66 patients, postoperative CSF leakage developed in three cases. These patients presented with very large or recurrent tumors, and the postoperative CSF fistulae were surgically closed. The cosmetic result obtained with this reconstruction was classified as excellent or good in all patients. Our results compare favorably with those reported in the literature. The surgical strategy used for cranial base reconstruction presented in this article has several advantages over the current surgical techniques used in cases of JF tumors.

Comparison of cranial form and function in association with diet in natricine snakes.

PubMed

Hampton, Paul M

2011-12-01

The skull of squamates has many functions, with food acquisition and ingestion being paramount. Snakes vary interspecifically in the frequency, size, and types of prey that are consumed. Natural selection should favor phenotypes that minimize the costs of energy acquisition; therefore, trophic morphology should reflect a snake's primary prey type to enhance some aspect of feeding performance. I measured 19 cranial variables for six natricine species that vary in the frequency with which they consume frogs and fish. Both conventional and phylogenetically corrected analyses indicated that fish-eating snakes have relatively longer upper and lower jaw elements than frog-eating snakes, which tended to have broader skull components. I also compared the ratio of the in-lever to the out-lever lengths of the jaw-closing mechanism [jaw mechanical advantage (MA)] among species. Fish-eating snakes had significantly lower MAs in the jaws than did the frog-eating snakes. This result suggests that piscivores have faster closing jaws and that the jaws of frog-eating snakes have higher closing forces. Cranial morphology and the functional demands of prey capture and ingestion appear to be associated with primary prey type in natricine snakes. Copyright © 2011 Wiley-Liss, Inc.

The Lumbar Lordosis in Males and Females, Revisited

PubMed Central

Hay, Ori; Dar, Gali; Abbas, Janan; Stein, Dan; May, Hila; Masharawi, Youssef; Peled, Nathan; Hershkovitz, Israel

2015-01-01

Background Whether differences exist in male and female lumbar lordosis has been debated by researchers who are divided as to the nature of variations in the spinal curve, their origin, reasoning, and implications from a morphological, functional and evolutionary perspective. Evaluation of the spinal curvature is constructive in understanding the evolution of the spine, as well as its pathology, planning of surgical procedures, monitoring its progression and treatment of spinal deformities. The aim of the current study was to revisit the nature of lumbar curve in males and females. Methods Our new automated method uses CT imaging of the spine to measure lumbar curvature in males and females. The curves extracted from 158 individuals were based on the spinal canal, thus avoiding traditional pitfalls of using bone features for curve estimation. The model analysis was carried out on the entire curve, whereby both local and global descriptors were examined in a single framework. Six parameters were calculated: segment length, curve length, curvedness, lordosis peak location, lordosis cranial peak height, and lordosis caudal peak height. Principal Findings Compared to males, the female spine manifested a statistically significant greater curvature, a caudally located lordotic peak, and greater cranial peak height. As caudal peak height is similar for males and females, the illusion of deeper lordosis among females is due partially to the fact that the upper part of the female lumbar curve is positioned more dorsally (more backwardly inclined). Conclusions Males and females manifest different lumbar curve shape, yet similar amount of inward curving (lordosis). The morphological characteristics of the female spine were probably developed to reduce stress on the vertebral elements during pregnancy and nursing. PMID:26301782

A mixed model for the relationship between climate and human cranial form.

PubMed

Katz, David C; Grote, Mark N; Weaver, Timothy D

2016-08-01

We expand upon a multivariate mixed model from quantitative genetics in order to estimate the magnitude of climate effects in a global sample of recent human crania. In humans, genetic distances are correlated with distances based on cranial form, suggesting that population structure influences both genetic and quantitative trait variation. Studies controlling for this structure have demonstrated significant underlying associations of cranial distances with ecological distances derived from climate variables. However, to assess the biological importance of an ecological predictor, estimates of effect size and uncertainty in the original units of measurement are clearly preferable to significance claims based on units of distance. Unfortunately, the magnitudes of ecological effects are difficult to obtain with distance-based methods, while models that produce estimates of effect size generally do not scale to high-dimensional data like cranial shape and form. Using recent innovations that extend quantitative genetics mixed models to highly multivariate observations, we estimate morphological effects associated with a climate predictor for a subset of the Howells craniometric dataset. Several measurements, particularly those associated with cranial vault breadth, show a substantial linear association with climate, and the multivariate model incorporating a climate predictor is preferred in model comparison. Previous studies demonstrated the existence of a relationship between climate and cranial form. The mixed model quantifies this relationship concretely. Evolutionary questions that require population structure and phylogeny to be disentangled from potential drivers of selection may be particularly well addressed by mixed models. Am J Phys Anthropol 160:593-603, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Clinical anatomy and imaging of the cranial nerves and skull base.

PubMed

Jha, Ruchira M; Klein, Joshua P

2012-09-01

Evaluation of patients with cranial neuropathies requires an understanding of brainstem anatomy and nerve pathways. Advances in neuroimaging, particularly high spatial resolution magnetic resonance imaging (MRI), have enabled visualization of these tiny structures and their related pathology. This review provides an approach toward using imaging in the evaluation of cranial nerve (CN) and skull base anatomy and pathology. Because brainstem nuclei are inextricably linked to the information contained within CNs, they are briefly mentioned whenever relevant; however, a comprehensive discussion of brainstem syndromes is beyond the scope of this review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

NASA Astrophysics Data System (ADS)

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

2011-02-01

In this study, landmark-based methods of geometric morphometrics are used for investigating the main aspects of cranial shape transformation in the evolution of the giant panda, Ailuropoda melanoleuca. Specifically, we explore if the highly derived cranial adaptations for bamboo feeding of the living panda were developed early in the panda's lineage. Results obtained show that the overall cranial morphologies of the oldest known panda, the "pygmy" Ailuropoda microta, and the late Pleistocene Ailuropoda baconi are both very similar to that of their closest living relative, A. melanoleuca, which agrees with a previous proposal based on qualitative criteria. However, we also describe several differences between the crania of A. microta, A. baconi, and A. melanoleuca, including the development of the postorbital process, the orientation of the occipital region, and the expansion of the braincase. As a result, the cranial morphology of A. microta shows a less specialized morphology toward a fibrous and durophagous diet compared to the giant panda. These results are confirmed by a comparative analysis of the dimensions of the upper teeth in bears, which has revealed differences in relative tooth size between A. microta and A. melanoleuca, most probably as a result of mosaic evolution. Therefore, we conclude that cranial shape did not remain essentially uniform in the Ailuropoda lineage, as previously thought, but underwent a number of changes during more than 2 Myr.

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

PubMed

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

2011-02-01

In this study, landmark-based methods of geometric morphometrics are used for investigating the main aspects of cranial shape transformation in the evolution of the giant panda, Ailuropoda melanoleuca. Specifically, we explore if the highly derived cranial adaptations for bamboo feeding of the living panda were developed early in the panda's lineage. Results obtained show that the overall cranial morphologies of the oldest known panda, the "pygmy" Ailuropoda microta, and the late Pleistocene Ailuropoda baconi are both very similar to that of their closest living relative, A. melanoleuca, which agrees with a previous proposal based on qualitative criteria. However, we also describe several differences between the crania of A. microta, A. baconi, and A. melanoleuca, including the development of the postorbital process, the orientation of the occipital region, and the expansion of the braincase. As a result, the cranial morphology of A. microta shows a less specialized morphology toward a fibrous and durophagous diet compared to the giant panda. These results are confirmed by a comparative analysis of the dimensions of the upper teeth in bears, which has revealed differences in relative tooth size between A. microta and A. melanoleuca, most probably as a result of mosaic evolution. Therefore, we conclude that cranial shape did not remain essentially uniform in the Ailuropoda lineage, as previously thought, but underwent a number of changes during more than 2 Myr.

Arterial relationships to the nerves and some rigid structures in the posterior cranial fossa.

PubMed

Surchev, N

2008-09-01

The close relationships between the cranial nerves and the arterial vessels in the posterior cranial fossa are one of the predisposing factors for artery-nerve compression. The aim of this study was to examine the relationships of the vertebral and basilar arteries to some skull and dural structures and the nerves in the posterior cranial fossa. For this purpose, the skull bases and brains of 70 cadavers were studied. The topographic relationships of the vertebral and basilar arteries to the cranial nerves in the posterior cranial fossa were studied and the distances between the arteries and some osseous formations were measured. The most significant variations in arterial position were registered in the lower half of the basilar artery. Direct contact with an artery was established for the hypoglossal canal, jugular tubercle, and jugular foramen. The results reveal additional information about the relationships of the nerves and arteries to the skull and dural formations in the posterior cranial fossa. New quantitative information is given to illustrate them. The conditions for possible artery-nerve compression due to arterial dislocation are discussed and two groups (lines) of compression points are suggested. The medial line comprises of the brain stem points, usually the nerve root entry/exit zone. The lateral line includes the skull eminences, on which the nerves lie, or skull and dural foramina through which they exit the cranial cavity. (c) 2008 Wiley-Liss, Inc.

A test for paedomorphism in domestic pig cranial morphology

PubMed Central

Owen, Joseph; Vidarsdottir, Una Strand; Dobney, Keith

2017-01-01

Domestic animals are often described as paedomorphic, meaning that they retain juvenile characteristics into adulthood. Through a three-dimensional landmark-based geometric morphometric analysis of cranial morphology at three growth stages, we demonstrate that wild boar (n = 138) and domestic pigs (n = 106) (Sus scrofa) follow distinct ontogenetic trajectories. With the exception of the size ratio between facial and neurocranial regions, paedomorphism does not appear to be the primary pattern describing the observed differences between wild and domestic pig cranial morphologies. The cranial phenotype of domestic pigs instead involves developmental innovation during domestication. This result questions the long-standing assumption that domestic animal phenotypes are paedomorphic forms of their wild counterparts. PMID:28794276

Application of Thinned-Skull Cranial Window to Mouse Cerebral Blood Flow Imaging Using Optical Microangiography

PubMed Central

Wang, Ruikang K.

2014-01-01

In vivo imaging of mouse brain vasculature typically requires applying skull window opening techniques: open-skull cranial window or thinned-skull cranial window. We report non-invasive 3D in vivo cerebral blood flow imaging of C57/BL mouse by the use of ultra-high sensitive optical microangiography (UHS-OMAG) and Doppler optical microangiography (DOMAG) techniques to evaluate two cranial window types based on their procedures and ability to visualize surface pial vessel dynamics. Application of the thinned-skull technique is found to be effective in achieving high quality images for pial vessels for short-term imaging, and has advantages over the open-skull technique in available imaging area, surgical efficiency, and cerebral environment preservation. In summary, thinned-skull cranial window serves as a promising tool in studying hemodynamics in pial microvasculature using OMAG or other OCT blood flow imaging modalities. PMID:25426632

Cephalometric assessment of human fetal head specimens.

PubMed

Radlanski, R J; Heikinheimo, K; Gruda, A

2013-07-01

Past investigations of prenatal craniofacial growth have largely relied on histological sections. Few studies have taken measurements on three-dimensional representations (3D reconstruction, 3D CT, postmortem) or varying depth levels (ultrasound), and we know of no craniofacial growth studies done on cleared-and-stained specimens of whole fetal heads. This study comprised 14 human fetal head specimens cleared and stained with alizarin red and alcian blue. They had been stored in glycerol and represented weeks 8-12 of gestation, with crown-rump lengths ranging from 23-145 mm. These specimens were cephalometrically analyzed in norma frontalis and norma lateralis, which notably included the opportunity for side-to-side comparison. As the cranial membrane bones progressively approached each other, the orbits, maxilla, and mandible gradually grew wider. Likewise, the sagittal dimensions of the maxilla and mandible increased continuously and synchronically. We noted side-to-side differences ranging from 2-5 mm. Another notable finding concerned the inclination of the maxilla relative to the cranial base, which increased more on the right than on the left side. This is the first investigation presenting side-to-side comparative measurements of human fetal head specimens. Such measurements are essential in the quest toward validating the findings of other imaging techniques such as CT or MRI and-most importantly-intrauterine sonography.

Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventionalist needs to know.

PubMed

Geibprasert, S; Pongpech, S; Armstrong, D; Krings, T

2009-09-01

Transarterial embolization in the external carotid artery (ECA) territory has a major role in the endovascular management of epistaxis, skull base tumors, and dural arteriovenous fistulas. Knowledge of the potential anastomotic routes, identification of the cranial nerve supply from the ECA, and the proper choice of embolic material are crucial to help the interventionalist avoid neurologic complications during the procedure. Three regions along the skull base constitute potential anastomotic routes between the extracranial and intracranial arteries: the orbital, the petrocavernous, and the upper cervical regions. Branches of the internal maxillary artery have anastomoses with the ophthalmic artery and petrocavernous internal carotid artery (ICA), whereas the branches of the ascending pharyngeal artery are connected to the petrocavernous ICA. Branches of both the ascending pharyngeal artery and the occipital artery have anastomoses with the vertebral artery. To avoid cranial nerve palsy, one must have knowledge of the supply to the lower cranial nerves: The petrous branch of the middle meningeal artery and the stylomastoid branch of the posterior auricular artery form the facial arcade as the major supply to the facial nerve, and the neuromeningeal trunk of the ascending pharyngeal artery supplies the lower cranial nerves (CN IX-XII).

Surgery: Modified Pi with Triple-Bonnet Flap and Fronto-Orbital Advancement.

PubMed

Singh Raswan, Uday; Singh Chhiber, Sarbjit; Ramzan, Altaf Umar

2017-01-01

Craniosynostosis is the premature fusion of one or more of the cranial sutures and can occur as part of a syndrome or as an isolated defect. Pansynostosis is a rare form of craniosynostosis that involves premature fusion of all the cranial sutures (coronal, sagittal, metopic, and occipital). Particularly in cases of late presentation, there are heightened clinical concerns, both functional and aesthetic. In untreated cases of pansynostosis and increased intracranial pressure, optic nerve damage progresses to optic atrophy and then blindness. Cranial vault reconstruction is the standard surgical treatment. We attempt to highlight the importance of modifying the osteotomies and reshaping of the cranial vault based on individual requirements in order to achieve the best possible result and to prevent catastrophic blood loss. We present a case of modified pi with triple-bonnet flap and fronto-orbital advancement, an individual modification of the techniques of cranial vault reconstruction, in a patient with pansynostosis with optic atrophy. The technical variation can be applied to any case of pansynostosis requiring cranial vault reconstruction. © 2017 S. Karger AG, Basel.

Association between intracranial plasmacytoma and multiple myeloma: clinicopathological outcome study.

PubMed

Schwartz, T H; Rhiew, R; Isaacson, S R; Orazi, A; Bruce, J N

2001-11-01

Intracranial plasmacytomas are rare lesions that can arise from the calvarium, dura, or cranial base and exhibit a benign course unless associated with myeloma. Attention has recently been focused on the role of the cell adhesion molecules CD56 and CD31 in the pathogenesis of myeloma. No such information is available for intracranial plasmacytomas and myeloma-associated lesions. We investigated the relationship between CD56 and CD31 expression, intracranial location, and progression to myeloma for a series of nine intracranial plasmacytomas (three dural, one calvarial, and five cranial base lesions). These parameters were also correlated with proliferation indices, as assessed by MIB-1 immunostaining of the histological sections. A single pathologist (AO) performed immunohistochemical analyses and reviewed all slides. Intracranial plasmacytomas presented more commonly in female patients (89%). The three dural lesions were CD56- and CD31-negative and exhibited MIB-1 staining of less than 10%; no patient developed myeloma or recurrence. Of the five cranial base lesions, three were CD56-positive, none was CD31-positive, and two exhibited MIB-1 labeling of more than 45%, with plasmablastic morphological features. Compared with other intracranial plasmacytomas, five of five patients with cranial base lesions developed bone marrow biopsy-proven myeloma (P < 0.05) within 8 months. The calvarial lesion was CD56- and CD31-positive, and the patient developed myeloma soon after diagnosis. Both of the two highly proliferative plasmablastic lesions recurred, one after gross total resection without radiotherapy and the other after a biopsy and 2000-cGy radiotherapy. Among intracranial plasmacytomas, cranial base location was the strongest predictor of the development of multiple myeloma. Expression of the cell adhesion molecules CD31 and CD56 was not predictive of outcome. Extramedullary dural-based lesions were CD56-negative and were not associated with myeloma. A high proliferation index and plasmablastic morphological features were predictive of a short time to recurrence and aggressive behavior. We recommend 4050- to 5040-cGy fractionated radiotherapy for all intracranial plasma cell neoplasms and gross total resection for non-cranial base lesions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henzen, D; Schmidhalter, D; Volken, W

Purpose: Radiation protection regulatory differentiates between primary and scatter radiation. Whereas for conventional clinical linear accelerators the solid angle for primary radiation is planar, the Cyberknife (Accuray Inc., Sunnyvale, CA) may point its beam in all spatial directions. In order to be able to judge on radiation protection calculations for a Cyberknife-M6 vault, the direction distribution for delivered plans was evaluated based on clinical experiences. Methods: The log-files of 121 delivered patient treatment plans were exported, divided into cranial and extra-cranial treatments and the delivered monitor units (MU) together with the corresponding beam directions were analyzed. This MU-weighted spatial distributionmore » was then projected to a 9.5 × 5.9 × 3.9 m{sup 3} vault, generating an “intensity map” using a binning of 50 × 50 cm{sup 2}. The factor of direction (FOD) is reported as a fraction of the total applied MUs to the walls, ceiling and floor in the perspective of a patient lying in head-first-supine position on the couch. In this study, the term intFOD refers to the integral FOD and maxFOD refers to the maximal FOD for a single bin. Results: For all kind of treatments and collimators, intFOD and maxFOD for the wall behind the patient’s head is 0.0. The intFOD for the floor varies between 0.65 and 0.74. For the ceiling, maxFOD is 0.002 and 0.0 for cranial and extra-cranial cases, respectively. The intFOD for the wall at the patient’s feet, is 0.094 for cranial and 0.005 for extra-cranial cases. There is nearly no difference between the maxFOD of the right and left wall for cranial cases, whereas for extra-cranial cases these numbers differ by a factor of 1.75. Conclusion: The varying FODs for the Cyberknife were quantified based on delivered treatment plans. These findings are helpful regarding the design of Cyberknife vaults.« less

Evaluation of the cranial rectus abdominus muscle pedicle flap as a blood supply for the caudal superficial epigastric skin flap in dogs.

PubMed

Degner, D A; Walshaw, R; Arnoczky, S P; Smith, R J; Patterson, J S; Degner, L A; Hamaide, A; Rosenstein, D

1996-01-01

This study evaluates the cranial rectus abdominus muscle pedicle flap as the sole blood supply for the caudal superficial epigastric skin flap. This flap was composed of a cranially based rectus abdominus muscle pedicle flap that was attached to the caudal superficial epigastric island skin flap (including mammary glands 2 to 5) via the pudendoepigastric trunk. Selective angiography of the cranial epigastric artery in eight cadaver dogs proved that the arterial vasculature in the cranial rectus abdominus was contiguous with that in the caudal superficial epigastric skin flap. In the live dog study, three of six of the flaps failed because of venous insufficiency. Necrosis of mammary gland 2 occurred in two of six flaps. One of six flaps survived with the exception of the cranial most aspect of mammary gland 2. Angiography of the cranial epigastric artery proved that arterial blood supply to these flaps was intact. Histological evaluation of the failed flaps showed full-thickness necrosis of the skin and subcutaneous tissues, the presence of severe congestion, and venous thrombosis. Retrograde venous blood flow through the flap was inconsistent, and hence resulted in failure of this myocutaneous flap. Use of this flap for clinical wound reconstruction cannot be recommended.

Carotid artery and lower cranial nerve exposure with increasing surgical complexity to the parapharyngeal space.

PubMed

Lemos-Rodriguez, Ana M; Sreenath, Satyan B; Rawal, Rounak B; Overton, Lewis J; Farzal, Zainab; Zanation, Adam M

2017-03-01

To investigate the extent of carotid artery exposure attained, including the identification of the external carotid branches and lower cranial nerves in five sequential external approaches to the parapharyngeal space, and to provide an anatomical algorithm. Anatomical study. Six latex-injected adult cadaver heads were dissected in five consecutive approaches: transcervical approach with submandibular gland removal, posterior extension of the transcervical approach, transcervical approach with parotidectomy, parotidectomy with lateral mandibulotomy, and parotidectomy with mandibulectomy. The degree of carotid artery exposure attained, external carotid branches, and lower cranial nerves visualized was documented. The transcervical approach exposed 1.5 cm (Standard Deviation (SD) 0.5) of internal carotid artery (ICA) and 1.25 cm (SD 0.25) of external carotid artery (ECA). The superior thyroid and facial arteries and cranial nerve XII and XI were identified. The posterior extension exposed 2.9 cm (SD 0.7) of ICA and 2.7 cm (SD 1.0) of ECA. Occipital and ascending pharyngeal arteries were visualized. The transparotid approach exposed 4.0 cm (SD 1.1) of ICA and 3.98 cm (SD 1.8) of ECA. Lateral mandibulotomy exposed the internal maxillary artery, cranial nerve X, the sympathetic trunk, and 4.6 cm (SD 2.4) of ICA. Mandibulectomy allowed for complete ECA exposure, cranial nerve IX, lingual nerve, and 6.9 cm (SD 1.3) of ICA. Approaches for the parapharyngeal space must be based on anatomic and biological patient factors. This study provides a guide for the skull base surgeon for an extended approach based on the desired anatomic exposure. N/A. Laryngoscope, 127:585-591, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Cranial and dental abnormalities of the endangered red wolf Canis rufus

USGS Publications Warehouse

Federoff, Nicholas E.; Nowak, Ronald M.

1998-01-01

Three skulls of captive-raised female endangered red wolves (Canis rufus) exhibited severe malocclusion of the jaws. Cranial and dental abnormalities (including crowding of upper toothrows, and an extra tooth behind the lower left M3 in one of the three mandibles) were also evident. Ratios of alveolar length of maxillary toothrow to maximum width across the outer sides of crowns of P4 were significantly different (p=0.008) compared to unaffected skulls. Significant differences were also evident when ratios of maximum width across inner edges of alveoli of P1 to alveolar length of maxillary toothrow and maximum width across outer sides of crowns of P4 were compared between the two groups. Although the three skulls all exhibited malocclusion, the abnormality expressed itself differently in relation to the effects to each skull. Captive inbreeding may increase the probability and frequency of expressing these anomalies, although inbreeding coefficients calculated for the wolves expressing malocclusion were not considered high (0.0313-0.0508). A wild female red wolf specimen captured in 1921 in Arkansas also exhibited the malocclusion, although not as severely as in the captive females. This demonstrates that this trait was present in wild populations prior to, and not a result of, the captive breeding program.

Literature review of cranial nerve injuries during carotid endarterectomy.

PubMed

Sajid, M S; Vijaynagar, B; Singh, P; Hamilton, G

2007-01-01

In the recent prospective randomised trials on carotid endarterectomy (CEA), the incidence of cranial nerve injuries (CNI) are reported to be higher than in previously published studies. The objective of this study is to review the incidence of post CEA cranial nerve injury and to discover whether it has changed in the last 25 years after many innovations in vascular surgery. Generic terms including carotid endarterectomy, cranial nerve injuries, post CEA complications and cranial nerve deficit after neck surgery were used to search a variety of electronic databases. Based on selection criteria, decisions regarding inclusion and exclusion of primary studies were made. The incidence of CNI before and after 1995 was compared. We found 31 eligible studies from the literature. Patients who underwent CEA through any approach were included in the study. All patients had cranial nerves examined both before and after surgery. The total number of patients who had CEA before 1995 was 3521 with 10.6% CNI (352 patients) and after 1995, 7324 patients underwent CEA with 8.3% CNI (614 patients). Cranial nerves XII, X and VII were most commonly involved (rarely IX and XI). Statistical analysis showed that the incidence of CNI has decreased (X(2) = 5.89 + 0.74 = 6.63 => p-value = 0.0100). CNI is still a significant postoperative complication of carotid endarterectomy. Despite increasing use of CEA, the incidence of CNI has decreased probably because of increased awareness of the possibility of cranial nerve damage.

Cephalometric findings among children with velopharyngeal dysfunction following adenoidectomy-A retrospective study.

PubMed

Kassem, F; Ebner, Y; Nageris, B; Watted, N; DeRowe, A; Nachmani, A

2017-12-01

To characterise the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). Retrospective study. Speech and swallowing clinic of a single academic hospital. Thirty-nine children with persistent VPD following adenoidectomy (mean age 8.0±3.6 years) and a control group of 80 healthy children. Cephalometric landmarks were chosen; craniofacial linear and angular dimensions were measured and analysed. The linear dimensions of the nasopharyngeal area were shorter in the VPD group, S-Ba (41.6±4.2 mm, P<.05) and S-Ptm (42.4±5.1 mm, P<.05). The anterior skull base, N-S, was similar (68.1 mm±6.8). The velum length, Ptm-P was significantly shorter in the VPD group (27.8±4.3 mm, P<.001). The Ba-S-Ptm angle was significantly larger in the VPD group (63.5±5.6°, P<.001). There was no significant difference in cranial base angle (CBA), Ba-S-N, between the two groups. Cephalometry may provide information regarding persistent postoperative VPD. The nasopharyngeal space angle and velar length appear to be risk factors for persistent VPD after adenoidectomy. © 2017 John Wiley & Sons Ltd.

Prenatal growth of the interorbital septum in Macaca mulatta.

PubMed

Lozanoff, Scott; Doll, Sara; Hallgrimsson, Benedikt; Neufeld, Eric

2004-12-01

The interorbital septum is the portion of the anterior cranial base directly contiguous with the eyes. It is considered to be a primitive trait that has evolved independently in various primate groups as a result of ocular and olfactory convergence with concomitant encephalization. This process is hypothesized to have reduced the size of the lateral nasal capsule exposing the anterior cranial base to the ocular apparatus and thus creating an interorbital septum. The purpose of this study was to determine whether differential growth trajectories occur among the chondrocranial elements corresponding to this hypothesis. Macaca mulatta embryos from the Zingeser Collection were selected for this analysis since this primate shows a well-developed interorbital septum throughout ontogeny. Embryos between 40 and 90 days of gestation were selected from the collection and coronal sections including the eye, anterior cranial base and lateral nasal capsule were subjected to video microscopy and computerized reconstruction using SURFdriver Software. Tissue volumes were computed for these tissues while chondrocytic growth attributes were measured utilizing stereological techniques. Results showed a strong correlation between the volume of the lateral nasal capsule and anterior cranial base and these two structures showed a consistent correlation with an increasing eye volume. Chondrocytic volume density and average diameter were larger in the lateral nasal capsule while shape, numerical density and average volume did not differ between the two tissues. These data suggest if differential growth does account for a reduction of the nasal capsule compared to the central cranial base stem, it does not appear to result from differential tissue size change. However, certain cellular growth activities leading to premature chondrocytic hypertrophy may be involved.

Growth of functional cranial components in rats submitted to intergenerational undernutrition

PubMed Central

Cesani, María F; Orden, Alicia B; Oyhenart, Evelia E; Zucchi, Mariel; Muñe, María C; Pucciarelli, Héctor M

2006-01-01

The aim of the present study was to discover how intergenerational undernutrition affects the growth of major and minor functional cranial components in two generations of rats. Control animals constituted the parental generation (P). The undernourished generations (F1 and F2) were fed 75% of the control diet. Animals were X-rayed every 10 days from 20 to 100 days of age. The length, width and height of the major (neurocranium and splanchnocranium) and minor (anterior-neural, middle-neural, posterior-neural, otic, respiratory, masticatory and alveolar) cranial components were measured on each radiograph. Volumetric indices were calculated to estimate size variations of these components. Data were processed using the Kruskal–Wallis and Kolmogorov–Smirnov tests for two samples. Impairment in splanchnocranial and neurocranial growth was found, the latter being more affected than the former in F1. Comparison between F2 and F1 animals showed cumulative effects of undernutrition in both major and minor components (anterior-neural, respiratory, masticatory and alveolar in males, and middle-neural and respiratory in females). Such differential effects on minor components may reflect a residual mechanical strain resulting from the linkage between components. This phenomenon was clearly observed in the neurocranium and could be understood as an adaptive response to the demands of the associated functional matrices. PMID:16879595

A retrospective study of skull base neoplasia in 42 dogs.

PubMed

Rissi, Daniel R

2015-11-01

This study describes the prevalence and distribution of 42 cases of skull base neoplasia in dogs between 2000 and 2014. The average age of affected individuals was 9.5 years, and there was no sex or breed predisposition. The most common skull base neoplasms were meningioma (25 cases) and pituitary adenoma (9 cases). Less common tumors included craniopharyngioma (2 cases), nerve sheath tumor (2 cases), and 1 case each of pituitary carcinoma, meningeal oligodendrogliomatosis, presumed nasal or sinonasal carcinoma, and multilobular tumor of bone. All neoplasms caused some degree of compression of adjacent structures. The distribution of the tumors was greatest in the sellar region (n = 18), followed by the paranasal region (n = 12), caudal cranial fossa (n = 10), central cranial fossa (n = 1), and rostral cranial fossa (n = 1). © 2015 The Author(s).

CT Guidance is Needed to Achieve Reproducible Positioning of the Mouse Head for Repeat Precision Cranial Irradiation

PubMed Central

Armour, M.; Ford, E.; Iordachita, I.; Wong, J.

2011-01-01

To study the effects of cranial irradiation, we have constructed an all-plastic mouse bed equipped with an immobilizing head holder. The bed integrates with our in-house Small Animal Radiation Research Platform (SARRP) for precision focal irradiation experiments and cone-beam CT. We assessed the reproducibility of our head holder to determine the need for CT based targeting in cranial irradiation studies. To measure the holder’s reproducibility, a C57BL/6 mouse was positioned and CT scanned nine times. Image sets were loaded into the Pinnacle3 radiation treatment planning system and were registered to one another by one investigator using rigid body alignment of the cranial regions. Rotational and translational offsets were measured. The average vector shift between scans was 0.80 ± 0.49 mm. Such a shift is too large to selectively treat subregions of the mouse brain. In response, we use onboard imaging to guide cranial irradiation applications that require sub-millimeter precision. PMID:20041766

CT guidance is needed to achieve reproducible positioning of the mouse head for repeat precision cranial irradiation.

PubMed

Armour, M; Ford, E; Iordachita, I; Wong, J

2010-01-01

To study the effects of cranial irradiation, we have constructed an all-plastic mouse bed equipped with an immobilizing head holder. The bed integrates with our in-house Small Animal Radiation Research Platform (SARRP) for precision focal irradiation experiments and cone-beam CT. We assessed the reproducibility of our head holder to determine the need for CT-based targeting in cranial irradiation studies. To measure the holder's reproducibility, a C57BL/6 mouse was positioned and CT-scanned nine times. Image sets were loaded into the Pinnacle(3) radiation treatment planning system and were registered to one another by one investigator using rigid body alignment of the cranial regions. Rotational and translational offsets were measured. The average vector shift between scans was 0.80 +/- 0.49 mm. Such a shift is too large to selectively treat subregions of the mouse brain. In response, we use onboard imaging to guide cranial irradiation applications that require sub-millimeter precision.

Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins.

PubMed

Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton

2015-04-01

We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern.

Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

PubMed

Borji, Hassan; Moosavi, Zahra; Ahmadi, Fatemeh

2014-09-01

Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

Morphometric features of posterior cranial fossa are different between Chiari I malformation with and without syringomyelia.

PubMed

Yan, Huang; Han, Xiao; Jin, Mengran; Liu, Zhen; Xie, Dingding; Sha, Shifu; Qiu, Yong; Zhu, Zezhang

2016-07-01

To investigate whether the posterior cranial fossa (PCF) morphology in Chiari I malformation without syringomyelia (also called syrinx) (CMI-only) is different from that in Chiari I malformation with syrinx (CMI-S). Nineteen CMI patients without syrinx constituted the CMI-only group, whereas 48 CMI patients with syrinx were assigned to the CMI-S group. Another cohort of 40 age-matched asymptomatic adolescents was enrolled to serve as the control group. Six measurements were evaluated and compared between these three groups from T1-weighted magnetic resonance (MR) imaging, including the length of the clivus (AB), the anteroposterior diameter of the foramen magnum (BC), the length of the supraocciput (CD), the anteroposterior diameter of the posterior fossa (DA), the posterior fossa height (BE) and the clivus gradient ([Formula: see text]). The posterior cranial fossa morphology in relation to syrinx severity was also investigated. Compared to the normal controls, the AB, CD, DA, BE and [Formula: see text] were significantly larger in the CMI-S group. Similar changes in AB, CD, DA and BE were also demonstrated in the CMI-only group, while the clivus gradient ([Formula: see text]) was found to be normal when compared with the control group. A significantly decreased clivus gradient was observed in the CMI-S group as compared to CMI-only group. In addition, the clivus was significantly flattened in patients with a distended-syrinx in comparison to those with a non-distended syrinx. Small size of the posterior fossa was detected both in CMI cases with and without syrinx. The clivus gradient served as the only morphologic difference in the PCF between CMI-S and CMI-only patients and was correlated with the severity of the syrinx, may support the theory that the restricted circulation of cerebrospinal fluid at the anterior paramedial subarachnoid space contributes to the formation of a syrinx.

Cephalometric norms for orthognathic surgery for North India (Eastern Uttar Pradesh).

PubMed

Gulati, Rajeev; Jain, Shikha

2011-01-01

The present study was aimed at development of the cephalometric norms for orthognathic surgery for the population of eastern Uttar Pradesh in North India. This study was conducted at a dental college. The study sample consisted of 50 males and 50 females. Each lateral cephalogram was taken in occlusion and subsequently traced. All reference points, landmarks, and measurements were made according to cephalometrics for orthognathic surgery (COGS) system. The statistical analysis involved calculation of mean and standard deviation for each of the 23 parameters assessed for each subject. The data was subsequently compared with COGS study by using Normal (Z) test. The norms were derived for the purvanchal population of North India and these were found to be quite distinct compared to those obtained from COGS study with respect to specific parameters. Male subjects indicated greater prominence of chin relative to the face, decreased posterior divergence, infraeruption of upper and lower molar as well as lower incisors, decreased total effective length of the maxilla, tendency towards Class III occlusion, and procumbent lower incisors. Female subjects, however, indicated increased anterior cranial base length, greater prominence of chin relative to the face, prognathic maxilla and mandible, increased middle third facial height, infraerupted lower incisors, increased mandibular body length, and procumbent lower incisors.

Development and Tissue Origins of the Mammalian Cranial Base

PubMed Central

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

2008-01-01

The vertebrate cranial base is a complex structure composed of bone, cartilage and other connective tissues underlying the brain; it is intimately connected with development of the face and cranial vault. Despite its central importance in craniofacial development, morphogenesis and tissue origins of the cranial base have not been studied in detail in the mouse, an important model organism. We describe here the location and time of appearance of the cartilages of the chondrocranium. We also examine the tissue origins of the mouse cranial base using a neural crest cell lineage cell marker, Wnt1-Cre/R26R, and a mesoderm lineage cell marker, Mesp1-Cre/R26R. The chondrocranium develops between E11 and E16 in the mouse, beginning with development of the caudal (occipital) chondrocranium, followed by chondrogenesis rostrally to form the nasal capsule, and finally fusion of these two parts via the midline central stem and the lateral struts of the vault cartilages. X-Gal staining of transgenic mice from E8.0 to 10 days post-natal showed that neural crest cells contribute to all of the cartilages that form the ethmoid, presphenoid, and basisphenoid bones with the exception of the hypochiasmatic cartilages. The basioccipital bone and non-squamous parts of the temporal bones are mesoderm derived. Therefore the prechordal head is mostly composed of neural crest-derived tissues, as predicted by the New Head Hypothesis. However, the anterior location of the mesoderm-derived hypochiasmatic cartilages, which are closely linked with the extra-ocular muscles, suggests that some tissues associated with the visual apparatus may have evolved independently of the rest of the “New Head”. PMID:18680740

Automatic analysis for neuron by confocal laser scanning microscope

NASA Astrophysics Data System (ADS)

Satou, Kouhei; Aoki, Yoshimitsu; Mataga, Nobuko; Hensh, Takao K.; Taki, Katuhiko

2005-12-01

The aim of this study is to develop a system that recognizes both the macro- and microscopic configurations of nerve cells and automatically performs the necessary 3-D measurements and functional classification of spines. The acquisition of 3-D images of cranial nerves has been enabled by the use of a confocal laser scanning microscope, although the highly accurate 3-D measurements of the microscopic structures of cranial nerves and their classification based on their configurations have not yet been accomplished. In this study, in order to obtain highly accurate measurements of the microscopic structures of cranial nerves, existing positions of spines were predicted by the 2-D image processing of tomographic images. Next, based on the positions that were predicted on the 2-D images, the positions and configurations of the spines were determined more accurately by 3-D image processing of the volume data. We report the successful construction of an automatic analysis system that uses a coarse-to-fine technique to analyze the microscopic structures of cranial nerves with high speed and accuracy by combining 2-D and 3-D image analyses.

Craniofacial and pharyngeal airway morphology in patients with acromegaly.

PubMed

Balos Tuncer, Burcu; Canigur Bavbek, Nehir; Ozkan, Cigdem; Tuncer, Cumhur; Eroglu Altinova, Alev; Gungor, Kahraman; Akturk, Mujde; Balos Toruner, Fusun

2015-08-01

The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. With respect to controls, anterior (p<0.05), middle (p<0.01) and posterior (p<0.05) cranial base lengths were increased, sella turcica was enlarged (p<0.001) and upper spine morphology demonstrated differences in the height of atlas (p<0.01) and axis (p<0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p<0.01) and the mandible (p<0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p<0.001), uvular (p<0.01), mandibular (p<0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p<0.001) compared to healthy controls. Soft palate width was significantly higher (p<0.001) and the hyoid bone was more vertically positioned (p<0.01) in patients with acromegaly. Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

Examining biological continuity across the late holocene occupation of the Aleutian Islands using cranial morphometrics and quantitative genetic permutation.

PubMed

Maley, Blaine

2016-05-01

The number of distinct human migrations into the Aleutian Islands during the Holocene has been a recurrent debate in the anthropological literature. Stemming from Hrdlička's sorting of the prehistoric remains into two distinct populations based on archaeological context and cranial measurements, the human occupation of the Aleutian Islands has long been thought to be the consequence of two distinct human migrations, a Paleo-Aleut migration that provided the initial settlement of the islands, and a Neo-Aleut migration that replaced the original settlers around 1000 BP. This study examines the relationship of the Aleut cranial assemblages in the context of greater Alaskan population variability to assess the evidence for a substantial migration into the Aleutian Islands during the late Holocene. A battery of 29 cranial measurements that quantify global cranial shape were analyzed using Euclidean morphometric methods and quantitative genetic permutation methods to examine the plausibility for two distinct Aleut occupations ("Paleo-Aleut" and "Neo-Aleut"), the latter of which is held to share closer phenetic affinities to mainland Alaskan populations than the former. The Aleut skeletal assemblages were arranged according to temporal association, geographic location, and cranial typology, and analyzed within a comparative framework of mainland Alaskan samples using principal coordinates, biological distance and random skewers permutation methods. Regardless of how the Aleut assemblages are divided, they show greater similarity to each other than to any of the mainland Alaskan assemblages. These findings are consistent across the methodological approaches. The results obtained in this study provide no support for a cranial morphology-based subdivision of the Aleuts into two distinct samples, Hence, there is no evidence for a substantial population migration of so-called Neo-Aleuts, nor for a population replacement event of an extant Paleo-Aleut population by a mainland-affiliated Neo-Aleuts population at or after 1000 BP. © 2016 Wiley Periodicals, Inc.

Microstructure and mechanical properties of porous titanium structures fabricated by electron beam melting for cranial implants.

PubMed

Moiduddin, Khaja

2018-02-01

The traditional methods of metallic bone implants are often dense and suffer from adverse reactions, biomechanical mismatch and lack of adequate space for new bone tissue to grow into the implant. The objective of this study is to evaluate the customized porous cranial implant with mechanical properties closer to that of bone and to improve the aesthetic outcome in cranial surgery with precision fitting for a better quality of life. Two custom cranial implants (bulk and porous) are digitally designed based on the Digital Imaging and Communications in Medicine files and fabricated using additive manufacturing. Initially, the defective skull model and the implant were fabricated using fused deposition modeling for the purpose of dimensional validation. Subsequently, the implant was fabricated using titanium alloy (Ti6Al4V extra low interstitial) by electron beam melting technology. The electron beam melting-produced body diagonal node structure incorporated in cranial implant was evaluated based on its mechanical strength and structural characterization. The results show that the electron beam melting-produced porous cranial implants provide the necessary framework for the bone cells to grow into the pores and mimic the architecture and mechanical properties closer to the region of implantation. Scanning electron microscope and micro-computed tomography scanning confirm that the produced porous implants have a highly regular pattern of porous structure with a fully interconnected network channel without any internal defect and voids. The physical properties of the titanium porous structure, containing the compressive strength of 61.5 MPa and modulus of elasticity being 1.20 GPa, represent a promising means of reducing stiffness and stress-shielding effect on the surrounding bone. This study reveals that the use of porous structure in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength and structural characteristics, thus restoring better functionality and aesthetic outcomes for the patients.

Cranial base topology and basic trends in the facial evolution of Homo.

PubMed

Bastir, Markus; Rosas, Antonio

2016-02-01

Facial prognathism and projection are important characteristics in human evolution but their three-dimensional (3D) architectonic relationships to basicranial morphology are not clear. We used geometric morphometrics and measured 51 3D-landmarks in a comparative sample of modern humans (N = 78) and fossil Pleistocene hominins (N = 10) to investigate the spatial features of covariation between basicranial and facial elements. The study reveals complex morphological integration patterns in craniofacial evolution of Middle and Late Pleistocene hominins. A downwards-orientated cranial base correlates with alveolar maxillary prognathism, relatively larger faces, and relatively larger distances between the anterior cranial base and the frontal bone (projection). This upper facial projection correlates with increased overall relative size of the maxillary alveolar process. Vertical facial height is associated with tall nasal cavities and is accommodated by an elevated anterior cranial base, possibly because of relations between the cribriform and the nasal cavity in relation to body size and energetics. Variation in upper- and mid-facial projection can further be produced by basicranial topology in which the midline base and nasal cavity are shifted anteriorly relative to retracted lateral parts of the base and the face. The zygomatics and the middle cranial fossae act together as bilateral vertical systems that are either projected or retracted relative to the midline facial elements, causing either midfacial flatness or midfacial projection correspondingly. We propose that facial flatness and facial projection reflect classical principles of craniofacial growth counterparts, while facial orientation relative to the basicranium as well as facial proportions reflect the complex interplay of head-body integration in the light of encephalization and body size decrease in Middle to Late Pleistocene hominin evolution. Developmental and evolutionary patterns of integration may only partially overlap morphologically, and traditional concepts taken from research on two-dimensional (2D) lateral X-rays and sections have led to oversimplified and overly mechanistic models of basicranial evolution. Copyright © 2015 Elsevier Ltd. All rights reserved.

ANGIOGRAPHIC ANATOMY OF THE MAJOR ABDOMINAL ARTERIAL BLOOD SUPPLY IN THE DOG.

PubMed

Culp, William T N; Mayhew, Philipp D; Pascoe, Peter J; Zwingenberger, Allison

2015-01-01

Vascular-based interventional radiology (IR) procedures are being more regularly performed in veterinary patients for both diagnostic and therapeutic purposes. A complete description of the fluoroscopic arterial anatomy of the canine abdominal cavity has not been published. This information is essential for performance of IR procedures to allow for improved preparation before and during a particular procedure. The primary purpose of this study was to provide a fluoroscopic description of the vascular branching from the abdominal aorta in a ventro-dorsal projection with a secondary goal of producing pictorial reference images of the major abdominal arterial blood vessels. Five healthy female hound type dogs were enrolled and underwent fluoroscopic arteriography. During fluoroscopy, both nonselective and selective arteriography were performed. The nonselective arteriograms were obtained in the aorta at four locations: cranial to the celiac artery, cranial to the renal arteries, cranial to the caudal mesenteric artery, and cranial to the branching of the external iliac arteries. Selective arteriography was conducted by performing injections into the following arteries: celiac, splenic, common hepatic, cranial mesenteric, left and right renal, and caudal mesenteric. Fluoroscopic arteriography allowed for excellent characterization of the aortic ostia and the location of the lower order vascular branches. Future evaluation of vascular-based treatment options will likely increase as the understanding of the normal and pathologic anatomy improves. © 2015 American College of Veterinary Radiology.

Morphological evolution through integration: a quantitative study of cranial integration in Homo, Pan, Gorilla and Pongo.

PubMed

Singh, Nandini; Harvati, Katerina; Hublin, Jean-Jacques; Klingenberg, Christian P

2012-01-01

Morphological integration refers to coordinated variation among traits that are closely related in development and/or function. Patterns of integration can offer important insight into the structural relationship between phenotypic units, providing a framework to address questions about phenotypic evolvability and constraints. Integrative features of the primate cranium have recently become a popular subject of study. However, an important question that still remains under-investigated is: what is the pattern of cranial shape integration among closely related hominoids? To address this question, we conducted a Procrustes-based geometric morphometrics study to quantify and analyze shape covariation patterns between different cranial regions in Homo, Pan, Gorilla and Pongo. A total of fifty-six 3D landmarks were collected on 407 adult individuals. We then sub-divided the landmarks corresponding to cranial units as outlined in the 'functional matrix hypothesis.' Sub-dividing the cranium in this manner allowed us to explore patterns of covariation between the face, basicranium and cranial vault, using the two-block partial least squares approach. Our results suggest that integrated shape changes in the hominoid cranium are complex, but that the overall pattern of integration is similar among human and non-human apes. Thus, despite having very distinct morphologies the way in which the face, basicranium and cranial vault covary is shared among these taxa. These results imply that the pattern of cranial integration among hominoids is conserved. Copyright © 2011 Elsevier Ltd. All rights reserved.

Homology of the cranial vault in birds: new insights based on embryonic fate-mapping and character analysis

NASA Astrophysics Data System (ADS)

Maddin, Hillary C.; Piekarski, Nadine; Sefton, Elizabeth M.; Hanken, James

2016-08-01

Bones of the cranial vault appear to be highly conserved among tetrapod vertebrates. Moreover, bones identified with the same name are assumed to be evolutionarily homologous. However, recent developmental studies reveal a key difference in the embryonic origin of cranial vault bones between representatives of two amniote lineages, mammals and birds, thereby challenging this view. In the mouse, the frontal is derived from cranial neural crest (CNC) but the parietal is derived from mesoderm, placing the CNC-mesoderm boundary at the suture between these bones. In the chicken, this boundary is located within the frontal. This difference and related data have led several recent authors to suggest that bones of the avian cranial vault are misidentified and should be renamed. To elucidate this apparent conflict, we fate-mapped CNC and mesoderm in axolotl to reveal the contributions of these two embryonic cell populations to the cranial vault in a urodele amphibian. The CNC-mesoderm boundary in axolotl is located between the frontal and parietal bones, as in the mouse but unlike the chicken. If, however, the avian frontal is regarded instead as a fused frontal and parietal (i.e. frontoparietal) and the parietal as a postparietal, then the cranial vault of birds becomes developmentally and topologically congruent with those of urodeles and mammals. This alternative hypothesis of cranial vault homology is also phylogenetically consistent with data from the tetrapod fossil record, where frontal, parietal and postparietal bones are present in stem lineages of all extant taxa, including birds. It further implies that a postparietal may be present in most non-avian archosaurs, but fused to the parietal or supraoccipital as in many extant mammals.

Mild closed head injury promotes a selective trigeminal hypernociception: implications for the acute emergence of post-traumatic headache.

PubMed

Benromano, T; Defrin, R; Ahn, A H; Zhao, J; Pick, C G; Levy, D

2015-05-01

Headache is one of the most common symptoms following traumatic head injury. The mechanisms underlying the emergence of such post-traumatic headache (PTH) remain unknown but may be related to injury of deep cranial tissues or damage to central pain processing pathways, as a result of brain injury. A mild closed head injury in mice combined with the administration of cranial or hindpaw formalin tests was used to examine post-traumatic changes in the nociceptive processing from deep cranial tissues or the hindpaw. Histological analysis was used to examine post-traumatic pro-inflammatory changes in the calvarial periosteum, a deep cranial tissue. At 48 h after head injury, mice demonstrated enhanced nociceptive responses following injection of formalin into the calvarial periosteum, a deep cranial tissue, but no facilitation of the nociceptive responses following injection of formalin into an extracranial tissue, the hindpaw. Mice also showed an increase in the number of activated periosteal mast cells 48 h following mild head trauma, suggesting an inflammatory response. Our study demonstrates that mild closed head injury is associated with enhanced processing of nociceptive information emanating from trigeminal-innervated deep cranial tissues, but not from non-cranial tissues. Based on these finding as well as the demonstration of head injury-evoked degranulation of calvarial periosteal mast cells, we propose that inflammatory-evoked enhancement of peripheral cranial nociception, rather than changes in supraspinal pain mechanisms play a role in the initial emergence of PTH. Peripheral targeting of nociceptors that innervate the calvaria may be used to ameliorate PTH pain. © 2014 European Pain Federation - EFIC®

Cranial tibial wedge osteotomy: a technique for eliminating cranial tibial thrust in cranial cruciate ligament repair.

PubMed

Slocum, B; Devine, T

1984-03-01

Cranial tibial wedge osteotomy, surgical technique for cranial cruciate ligament rupture, was performed on 19 stifles in dogs. This procedure leveled the tibial plateau, thus causing weight-bearing forces to be compressive and eliminating cranial tibial thrust. Without cranial tibial thrust, which was antagonistic to the cranial cruciate ligament and its surgical reconstruction, cruciate ligament repairs were allowed to heal without constant loads. This technique was meant to be used as an adjunct to other cranial cruciate ligament repair techniques.

Quantitative analyses of variability in normal vaginal shape and dimension on MR images

PubMed Central

Luo, Jiajia; Betschart, Cornelia; Ashton-Miller, James A.; DeLancey, John O. L.

2016-01-01

Introduction and hypothesis We present a technique for quantifying inter-individual variability in normal vaginal shape, axis, and dimension, and report findings in healthy women. Methods Eighty women (age: 28~70 years) with normal pelvic organ support underwent supine, multi-planar proton-density MRI. Vaginal width was assessed at five evenly-spaced locations, and vaginal axis, length, and surface area were quantified via ImageJ and MATLAB. Results The mid-sagittal plane angles, relative to the horizontal, of three vaginal axes were 90± 11, 72± 21, and 41± 22° (caudal to cranial, p < 0.001). The mean (± SD) vaginal widths were 17± 5, 24± 4, 30± 7, 41± 9, and 45± 12 mm at the five locations (caudal to cranial, p < 0.001). Mid-sagittal lengths for anterior and posterior vaginal walls were 63± 9 and 98 ± 18 mm respectively. The vaginal surface area was 72 ± 21 cm2 (range: 34 ~ 164 cm2). The coefficient of determination between any demographic variable and any vaginal dimension did not exceed 0.16. Conclusions Large variations in normal vaginal shape, axis, and dimensions were not explained by body size or other demographic variables. This variation has implications for reconstructive surgery, intravaginal and surgical product design, and vaginal drug delivery. PMID:26811115

Bioelectrical impedance vector distribution in the first year of life.

PubMed

Savino, Francesco; Grasso, Giulia; Cresi, Francesco; Oggero, Roberto; Silvestro, Leandra

2003-06-01

We assessed the bioelectrical impedance vector distribution in a sample of healthy infants in the first year of life, which is not available in literature. The study was conducted as a cross-sectional study in 153 healthy Caucasian infants (90 male and 63 female) younger than 1 y, born at full term, adequate for gestational age, free from chronic diseases or growth problems, and not feverish. Z scores for weight, length, cranial circumference, and body mass index for the study population were within the range of +/-1.5 standard deviations according to the Euro-Growth Study references. Concurrent anthropometrics (weight, length, and cranial circumference), body mass index, and bioelectrical impedance (resistance and reactance) measurements were made by the same operator. Whole-body (hand to foot) tetrapolar measurements were performed with a single-frequency (50 kHz), phase-sensitive impedance analyzer. The study population was subdivided into three classes of age for statistical analysis: 0 to 3.99 mo, 4 to 7.99 mo, and 8 to 11.99 mo. Using the bivariate normal distribution of resistance and reactance components standardized by the infant's length, the bivariate 95% confidence limits for the mean impedance vector separated by sex and age groups were calculated and plotted. Further, the bivariate 95%, 75%, and 50% tolerance intervals for individual vector measurements in the first year of life were plotted. Resistance and reactance values often fluctuated during the first year of life, particularly as raw measurements (without normalization by subject's length). However, 95% confidence ellipses of mean vectors from the three age groups overlapped each other, as did confidence ellipses by sex for each age class, indicating no significant vector migration during the first year of life. We obtained an estimate of mean impedance vector in a sample of healthy infants in the first year of life and calculated the bivariate values for an individual vector (95%, 75%, and 50% tolerance ellipses).

Curvularia fungi presenting as a large cranial base meningioma: case report.

PubMed

Singh, Harminder; Irwin, Sibyl; Falowski, Steven; Rosen, Mark; Kenyon, Lawrence; Jungkind, Donald; Evans, James

2008-07-01

Fungal infections are emerging as a growing threat to human health, especially in immunocompromised patients. Candida, Cryptococcus, and Aspergillus are a few of the commonly encountered organisms leading to brain abscesses. In this report, we describe Curvularia geniculata as the causative agent in central nervous system infection. Our review of the literature did not reveal a similar published case of central nervous system infection with this organism. A 35-year-old African-American man presented with obstructive hydrocephalus from a large cranial base lesion. Imaging characteristics on computed tomographic and magnetic resonance imaging scans were consistent with those of a cranial base meningioma. The patient underwent an endoscopic transnasal/transclival approach to the anterior middle cranial base for biopsy and decompression of this lesion. A spindle cell proliferation was observed on frozen section, which favored a diagnosis of meningioma. However, on permanent sections, we identified fungal hyphae with budding. Subsequent biopsies grew Curvularia in fungal cultures. Deoxyribonucleic acid sequencing was used to confirm the identification of the isolate as Curvularia geniculata. Limited data are available for in vitro susceptibility testing of Curvularia, and treatment modalities have not yet been standardized. The prognosis is usually poor. Despite being treated with voriconazole and intravenous amphotericin, this patient progressed to multiorgan failure and ultimately died. This is the first reported case of central nervous system infection by Curvularia geniculata.

Congruence between muscle activity and kinematics in a convergently derived prey-processing behavior.

PubMed

Konow, Nicolai; Camp, Ariel L; Sanford, Christopher P J

2008-08-01

Quantification of anatomical and physiological characteristics of the function of a musculoskeletal system may yield a detailed understanding of how the organizational levels of morphology, biomechanics, kinematics, and muscle activity patterns (MAPs) influence behavioral diversity. Using separate analyses of these organizational levels in representative study taxa, we sought patterns of congruence in how organizational levels drive behavioral modulation in a novel raking prey-processing behavior found in teleosts belonging to two evolutionarily distinct lineages. Biomechanically divergent prey (elusive, robust goldfish and sedentary, malleable earthworms) were fed to knifefish, Chitala ornata (Osteoglossomorpha) and brook trout, Salvelinus fontinalis (Salmoniformes). Electromyography recorded MAPs from the hyoid protractor, jaw adductor, sternohyoideus, epaxialis, and hypaxialis musculature, while sonomicrometry sampled deep basihyal kinesis and contractile length dynamics in the basihyal protractor and retractor muscles. Syntheses of our results with recent analyses of cranial morphology and raking kinematics showed that raking in Salvelinus relies on an elongated cranial out lever, extensive cranial elevation and a curved cleithrobranchial ligament (CBL), and that both raking MAPs and kinematics remain entirely unmodulated-a highly unusual trait, particularly among feeding generalists. Chitala had a shorter CBL and a raking power stroke involving increased retraction of the elongated pectoral girdle during raking on goldfish. The raking MAP was also modulated in Chitala, involving an extensive overlap between muscle activity of the preparatory and power stroke phases, driven by shifts in hypaxial timing and recruitment of the hyoid protractor muscle. Sonomicrometry revealed that the protractor hyoideus muscle stored energy from retraction of the pectoral girdle for ca. 5-20 ms after onset of the power stroke and then hyper-extended. This mechanism of elastic recoil in Chitala, which amplifies retraction of the basihyal during raking on goldfish without a significant increase in recruitment of the hypaxialis, suggests a unique mechanism of modulation based on performance-enhancing changes in the design and function of the musculoskeletal system.

Neuropilin-1 interacts with the second branchial arch microenvironment to mediate chick neural crest cell dynamics

PubMed Central

McLennan, Rebecca; Kulesa, Paul M.

2011-01-01

Cranial neural crest cells (NCCs) require neuropilin signaling to reach and invade the branchial arches. Here, we use an in vivo chick model to investigate whether the neuropilin-1 knockdown phenotype is specific to the second branchial arch (ba2), changes in NCC behaviors and phenotypic consequences, and whether neuropilins work together to facilitate entry into and invasion of ba2. We find that cranial NCCs with reduced neuropilin-1 expression displayed shorter protrusions and decreased cell body and nuclear length-to-width ratios characteristic of a loss in polarity and motility, after specific interaction with ba2. Directed NCC migration was rescued by transplantation of transfected cells into rhombomere 4 of younger hosts. Lastly, reduction of neuropilin-2 expression by shRNA either solely or with reduction of neuropilin-1 expression did not lead to a stronger head phenotype. Thus, NCCs, independent of rhombomere origin, require neuropilin-1, but not neuropilin-2 to maintain polarity and directed migration into ba2. PMID:20503363

[Exploration of transnasal endoscopic cranialbase approach].

PubMed

Xu, Geng; Li, Yuan; Xie, Minqiang; Wen, Weiping; Shi, Jianbo; Chen, Hexin; Lu, Jianting; Zhang, Gehua; Liu, Xian; Xu, Rui

2002-12-01

To study feasibility and indication of cranialbase surgery by transnasal endoscopic approach. Nine cases treated by transnasal were analysed. Those cases included foreign body, olfactory neuroblastoma, meningoma and inverted papilloma in anterior cranial fossa, sinuses sphenoidalis macrosis cyst invading middle cranial fossa, primary cholesteatoma and space occupying lesion in middle cranial fossa. The complications were not occurred in all cases. Follow-up survey 1-7 years, no-relapse was occurred. It is probability that surgery lesion be close skull base by transnasal endoscopic approach, but indication must be exactitude selected. The operator should be have firm anatomic, skilled operation and richness experience. The malignancy lesion should be compositive treatment after surgery.

Repair of bony lateral skull base defects equal to or larger than 10 mm by extracorporeally sewed unit-sandwich graft.

PubMed

Indorewala, Shabbir; Nemade, Gaurav; Indorewala, Abuzar; Mahajan, Gauri

2018-06-23

To see effectiveness of the senior author's repair technique for repair of large (equal to or larger than 10 mm) bony lateral skull base defects. Retrospective. Secondary/tertiary care center. We performed retrospective review of 9 surgeries done in our institution between January 2010 and December 2013 for repair of large lateral bony skull base defects. We defined skull base defects extra-cranially and repaired them intra-cranially. We made an extracorporeal sandwich of autologous fascia-bone-fascia (fascia lata and nasal septal bone) and sewed it together to make it into a unit-sandwich graft. This extracorporeally sewed unit-sandwich graft was then inserted to close the large skull base defects either via (1) a cranial slit-window, or (2) the skull base defect itself. Since skull base is bony, bony repair is preferred. Bone plates that are easily available for skull base repair are calvarial and nasal septal bone. Occasionally, harvest of split calvarial bone carries risk of major complications. We preferred nasal septal bone. Harvesting of septal bone even in children using a posterior incision should not disturb the cartilage growth centers. All nine patients were operated by this technique. We had four patients with cerebrospinal fluid leak, and five patients with brain herniation. All these patients had complete reversal of herniation of cranial contents and cessation of cerebrospinal fluid leak. On imaging, in 6 cases the bone graft remained in original intended position after 12 months of surgery. The bone graft was not identifiable in 3 cases. The senior author's technique using autologous multi-layered graft is simple to master, repeatable and very effective.

Hypertrophic Cranial Pachymeningitis and Skull Base Osteomyelitis by Pseudomonas Aeruginosa: Case Report and Review of the Literature

PubMed Central

Caldas, Ana Rita; Brandao, Mariana; Paula, Filipe Seguro; Castro, Elsa; Farinha, Fatima; Marinho, Antonio

2012-01-01

Hypertrophic cranial pachymeningitis (HCP) is an uncommon disorder characterized by localized or diffuse thickening of the dura mater, and it usually presents with multiple cranial neurophaties. It has been associated with a variety of inflammatory, infectious, traumatic, toxic and neoplasic diseases, when no specific cause is found the process is called idiopathic. The infectious cases occur in patients under systemic immunosuppression, which have an evident contiguous source or those who have undergone neurosurgical procedures. We describe a case of a 62-year-old immunosuppressed woman with diabetes and rheumatoid arthritis, which had HCP and osteomyelitis of the skull base caused by pseudomonas aeruginosa, presenting with headache and diplopia. We believe this is the second documented case of pachymeningitis secondary to this microorganism. As a multifactorial disease, it is essencial to determine the specific causative agent of HCP before making treatment decisions, and great care is needed with immunocompromised patients. Keywords Pseudomonas aeruginosa; Hypertrophic pachymeningitis; Ophtalmoplegia, optical neuropathy; Osteomyelitis; Skull base PMID:22505989

Awful face of the war-impacted smoke bomb capsule in the face and systemic toxicity: reports from the conflict in Syria.

PubMed

Yilmaz, Bahar; Yeşiloğlu, Nebil; Firincioğullari, Remzi; Gökkaya, Ali; Özbey, Rafet; Özgür, Mustafa

2015-01-01

In this study, a rare kind of injury due to smoke bomb capsule impaction to midface and under the cranial base is presented, and maneuvers to reduce mortality are discussed. Three male patients were presented with impacted smoke bomb capsules into the midface and under the cranial base structures. Midface structures, anterior cranial base, and, in 2 patients, unilateral eye were severely damaged. Two patients died after the initial emergency operations because their lung disease progressed to acute respiratory distress syndrome. One of the patients lived, and soft tissue reconstruction was achieved by using temporal transposition and cheek advancement skin flaps with split-thickness skin graft from donor site. However, craniofacial destruction is important in these patients; a multidisciplinary approach is needed for the treatment of direct smoke bomb injuries because the patients experienced chemical burn and acute trauma. The timing of maxillofacial reconstruction is also a question in these specific patients.

Forces necessary for the disruption of the cisternal segments of cranial nerves II through XII.

PubMed

Tubbs, R Shane; Wellons, John C; Blount, Jeffrey P; Salter, E George; Oakes, W Jerry

2007-04-01

Manipulation of the cisternal segment of cranial nerves is often performed by the neurosurgeon. To date, attempts at quantifying the forces necessary to disrupt these nerves in situ, to our knowledge, has not been performed. The present study seeks to further elucidate the forces necessary to disrupt the cranial nerves while within the subarachnoid space. The cisternal segments of cranial nerves II through XII were exposed in six unfixed cadavers, all less than 6 hr postmortem. Forces to failure were then measured. Mean forces necessary to disrupt nerves for left sides in increasing order were found for cranial nerves IX, VII, IV, X, XII, III, VIII, XI, VI, V, and II, respectively. Mean forces for right-sided cranial nerves in increasing order were found for cranial nerves IX, VII, IV, X, XII, VIII, V, VI, XI, III, and II, respectively. Overall, cranial nerves requiring the least amount of force prior to failure included cranial nerves IV, VII, and IX. Those requiring the highest amount of force included cranial nerves II, V, VI, and XI. There was an approximately ten-fold difference between the least and greatest forces required to failure. Cranial nerve III was found to require significantly (P < 0.05) greater forces to failure for right versus left sides. To date, the neurosurgeon has had no experimentally derived data from humans for the in situ forces necessary to disrupt the cisternal segment of cranial nerves II through XII. We found that cranial nerve IX consistently took the least amount of force until its failure and cranial nerve II took the greatest. Other cranial nerves that took relatively small amount of force prior to failure included cranial nerves IV and VII. Although in vivo damage can occur prior to failure of a cranial nerve, our data may serve to provide a rough estimation for the maximal amount of tension that can be applied to a cranial nerve that is manipulated while within its cistern.

Fibulin-1 is required for morphogenesis of neural crest-derived structures

PubMed Central

Cooley, Marion A.; Kern, Christine B.; Fresco, Victor M.; Wessels, Andy; Thompson, Robert P.; McQuinn, Tim C.; Twal, Waleed O.; Mjaatvedt, Corey H.; Drake, Christopher J.; Argraves, W. Scott

2008-01-01

Here we report that mouse embryos homozygous for a gene trap insertion in the fibulin-1 (Fbln1) gene are deficient in Fbln1 and exhibit cardiac ventricular wall thinning and ventricular septal defects with double outlet right ventricle or overriding aorta. Fbln1 nulls also display anomalies of aortic arch arteries, hypoplasia of the thymus and thyroid, underdeveloped skull bones, malformations of cranial nerves and hemorrhagic blood vessels in the head and neck. The spectrum of malformations is consistent with Fbln1 influencing neural crest cell (NCC)-dependent development of these tissues. This is supported by evidence that Fbln1 expression is associated with streams of cranial NCCs migrating adjacent to rhombomeres 2–7 and that Fbln1-deficient embryos display patterning anomalies of NCCs forming cranial nerves IX and X, which derive from rhombomeres 6 and 7. Additionally, Fbln1-deficient embryos show increased apoptosis in areas populated by NCCs derived from rhombomeres 4, 6 and 7. Based on these findings, it is concluded that Fbln1 is required for the directed migration and survival of cranial NCCs contributing to the development of pharyngeal glands, craniofacial skeleton, cranial nerves, aortic arch arteries, cardiac outflow tract and cephalic blood vessels. PMID:18538758

Virtual temporal bone: an interactive 3-dimensional learning aid for cranial base surgery.

PubMed

Kockro, Ralf A; Hwang, Peter Y K

2009-05-01

We have developed an interactive virtual model of the temporal bone for the training and teaching of cranial base surgery. The virtual model was based on the tomographic data of the Visible Human Project. The male Visible Human's computed tomographic data were volumetrically reconstructed as virtual bone tissue, and the individual photographic slices provided the basis for segmentation of the middle and inner ear structures, cranial nerves, vessels, and brainstem. These structures were created by using outlining and tube editing tools, allowing structural modeling either directly on the basis of the photographic data or according to information from textbooks and cadaver dissections. For training and teaching, the virtual model was accessed in the previously described 3-dimensional workspaces of the Dextroscope or Dextrobeam (Volume Interactions Pte, Ltd., Singapore), whose interfaces enable volumetric exploration from any perspective and provide virtual tools for drilling and measuring. We have simulated several cranial base procedures including approaches via the floor of the middle fossa and the lateral petrous bone. The virtual model suitably illustrated the core facts of anatomic spatial relationships while simulating different stages of bone drilling along a variety of surgical corridors. The system was used for teaching during training courses to plan and discuss operative anatomy and strategies. The Virtual Temporal Bone and its surrounding 3-dimensional workspace provide an effective way to study the essential surgical anatomy of this complex region and to teach and train operative strategies, especially when used as an adjunct to cadaver dissections.

Anatomically shaped cranial collimation (ACC) for lateral cephalometric radiography: a technical report.

PubMed

Hoogeveen, R C; van der Stelt, P F; Berkhout, W E R

2014-01-01

Lateral cephalograms in orthodontic practice display an area cranial of the base of the skull that is not required for diagnostic evaluation. Attempts have been made to reduce the radiation dose to the patient using collimators combining the shielding of the areas above the base of the skull and below the mandible. These so-called "wedge-shaped" collimators have not become standard equipment in orthodontic offices, possibly because these collimators were not designed for today's combination panoramic-cephalometric imaging systems. It also may be that the anatomical variability of the area below the mandible makes this area unsuitable for standardized collimation. In addition, a wedge-shaped collimator shields the cervical vertebrae; therefore, assessment of skeletal maturation, which is based on the stage of development of the cervical vertebrae, cannot be performed. In this report, we describe our investigations into constructing a collimator to be attached to the cephalostat and shield the cranial area of the skull, while allowing the visualization of diagnostically relevant structures and markedly reducing the size of the irradiated area. The shape of the area shielded by this "anatomically shaped cranial collimator" (ACC) was based on mean measurements of cephalometric landmarks of 100 orthodontic patients. It appeared that this collimator reduced the area of irradiation by almost one-third without interfering with the imaging system or affecting the quality of the image. Further research is needed to validate the clinical efficacy of the collimator.

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. Copyright © 2016 Elsevier Inc. All rights reserved.

Variability of the cranial and dental phenotype in Williams syndrome.

PubMed

Axelsson, Stefan

2005-01-01

Williams syndrome (WS) is a rare congenital disorder involving the cardiovascular system, connective tissue, and the central nervous system, resulting in mild to moderate mental retardation, a specific cognitive profile, unique personality characteristics, distinctive facial features, and cardiovascular disease. The majority of individuals with a clinical diagnosis of WS have a contiguous gene deletion at chromosome 7 (7q11.23). Physical features include characteristic facial features with full prominent cheeks, wide mouth, long philtrum, small nose with depressed nasal bridge, heavy orbital ridges, medial eyebrow flare, dental abnormalities, hoarse voice, growth retardation, and cardiovascular abnormalities (most commonly supravalvular aortic stenosis and/or peripheral pulmonary artery stenosis). The cognitive profile is distinctive, consisting of strengths in auditory memory, language, and face-processing, but extreme weakness in visuospatial, numerical and problem-solving abilities. Neurological studies have identified a significantly decreased brain volume in adult individuals with WS with relatively normal development of the limbic, frontal and cerebellar structures. The aims were to analyse the neurocranium, the craniofacial region, and the dentition in a well defined Norwegian group of individuals with WS. In order to accomplish this, normative cephalometric standards for the neurocranium, including the cranial base and the sella turcica, were established for Norwegian males and females from 6 to 21 years of age, using lateral radiographic cephalograms from the Oslo University Craniofacial Growth Archive. The study material comprised radiographic lateral cephalograms, orthopantomograms and dental casts from 62 individuals with WS ranging from 4 to 44 years. The lateral cephalograms, orthopantomograms and dental casts were analysed using standard methods reported in the literature. Neurocranium: The results from the cephalometric analyses showed that the size and shape of the neurocranium in WS differed from normal controls. A flattening of the superior aspect of the parietal bone was found and the posterior prominence of the occipital bone was larger. These findings were in concordance with published neuroanatomical/neuropathological studies on WS and fit well with the reported anatomical aberrations in the WS brain, e.g. a smaller brain volume where some parts are of relatively normal size while others are decreased. The anterior and posterior cranial base was shorter in WS, but with a normal cranial base angle. The thickness of the calvarian bones, especially the frontal and occipital bones, was greater in WS than in normal controls. Sella turcica: The size of the sella turcica was somewhat smaller in WS compared with normal controls, though not significant. Aberrant types of shape of the sella turcica in WS are demonstrated. The correlation between prenatal malformation in the pituitary gland/sella turcica and the postnatal morphology of the sella turcica is discussed. The craniofacial skeleton: Two areas, in addition to the cranial base, have been identified to contribute to the characteristic facial appearance in WS; the anterior inclination of the maxilla, and the shape of the mandible. The severely deficient bony chin in combination with the high mandibular plane angle can explain earlier clinical descriptions of a retrusive mandible in WS. Frequent mouth breathing during childhood and the smaller cranial base may be associated with the characteristic craniofacial pattern. Dentition: In individuals with WS over 10 years of age 40.5 per cent had agenesis of one or more permanent teeth and 11.9 percent had agenesis of 6 teeth or more. The missing permanent teeth in the maxilla most commonly included 2nd premolars, 1st premolars, and lateral incisors. In the mandible most commonly 2nd premolars, 1st premolars, and central incisors were absent. The tooth crowns of permanent teeth were smaller, both in the mesio-distal and labio-lingual dimension. The permanent tooth crowns have several characteristic deviations from normal shape; especially incisors in both jaws were tapered or screwdriver-shaped. An evaluation of taurodontism on permanent molars was performed. However, most of the molars rated as being taurodontic had short total tooth lengths and could thus be rated taurodontic without meeting the classical definition. These studies have shown aberrations in the neurocranium including the sella turcica in WS not previously reported. In the craniofacial skeleton specific traits have been identified to contribute to the characteristic facial appearance in WS. Dental aberrations in the permanent dentition including agenesis, smaller size, and aberrant shape of teeth, are common in WS.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kushner, Brian H., E-mail: kushnerb@mskcc.or; Cheung, Nai-Kong V.; Barker, Christopher A.

2009-11-15

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

Pre-reconstruction of cervical-to-petrous internal carotid artery: An improved technique for treatment of vascular lesions involving internal carotid artery at the lateral skull base.

PubMed

Li, Fang-Da; Gao, Zhi-Qiang; Ren, Hua-Liang; Liu, Chang-Wei; Song, Xiao-Jun; Li, Yan-Feng; Zheng, Yue-Hong

2016-04-01

Reconstruction of the internal carotid artery (ICA) is an operative challenge for lesions involving the lateral skull base because of excessive blood loss, intraoperative cranial nerve injury, and difficulties in cerebral protection. Between January 2010 and October 2014, 9 patients with vascular lesions at the lateral skull base were treated with a "pre-reconstruction" technique, which means reconstruction of the ICA in advance of excising the lesions. All operations were technically successful with no mortality or strokes. The mean blood loss was 921 ± 210 mL. The mean total clamping time was 18 ± 5 minutes. Among the 5 patients without invasion of specific cranial nerves, no long-term sequelae occurred during the follow-up period ranging from 11 to 54 months. With less blood loss, slighter cranial nerve injuries, and shorter clamping time, the "pre-reconstruction" technique was safe and effective for the treatment of vascular lesions at the lateral skull base. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1562-E1567, 2016. © 2016 Wiley Periodicals, Inc.

Alternative radiation-free registration technique for image-guided pedicle screw placement in deformed cervico-thoracic segments.

PubMed

Kantelhardt, Sven R; Neulen, Axel; Keric, Naureen; Gutenberg, Angelika; Conrad, Jens; Giese, Alf

2017-10-01

Image-guided pedicle screw placement in the cervico-thoracic region is a commonly applied technique. In some patients with deformed cervico-thoracic segments, conventional or 3D fluoroscopy based registration of image-guidance might be difficult or impossible because of the anatomic/pathological conditions. Landmark based registration has been used as an alternative, mostly using separate registration of each vertebra. We here investigated a routine for landmark based registration of rigid spinal segments as single objects, using cranial image-guidance software. Landmark based registration of image-guidance was performed using cranial navigation software. After surgical exposure of the spinous processes, lamina and facet joints and fixation of a reference marker array, up to 26 predefined landmarks were acquired using a pointer. All pedicle screws were implanted using image guidance alone. Following image-guided screw placement all patients underwent postoperative CT scanning. Screw positions as well as intraoperative and clinical parameters were retrospectively analyzed. Thirteen patients received 73 pedicle screws at levels C6 to Th8. Registration of spinal segments, using the cranial image-guidance succeeded in all cases. Pedicle perforations were observed in 11.0%, severe perforations of >2 mm occurred in 5.4%. One patient developed a transient C8 syndrome and had to be revised for deviation of the C7 pedicle screw. No other pedicle screw-related complications were observed. In selected patients suffering from pathologies of the cervico-thoracic region, which impair intraoperative fluoroscopy or 3D C-arm imaging, landmark based registration of image-guidance using cranial software is a feasible, radiation-saving and a safe alternative.

Unsuspected osteochondroma-like outgrowths in the cranial base of Hereditary Multiple Exostoses patients and modeling and treatment with a BMP antagonist in mice

PubMed Central

Sgariglia, Federica; Ibrahim, Mazen M.; Koyama, Eiki; Jones, Kevin B.

2017-01-01

Hereditary Multiple Exostoses (HME) is a rare pediatric disorder caused by loss-of-function mutations in the genes encoding the heparan sulfate (HS)-synthesizing enzymes EXT1 or EXT2. HME is characterized by formation of cartilaginous outgrowths—called osteochondromas- next to the growth plates of many axial and appendicular skeletal elements. Surprisingly, it is not known whether such tumors also form in endochondral elements of the craniofacial skeleton. Here, we carried out a retrospective analysis of cervical spine MRI and CT scans from 50 consecutive HME patients that included cranial skeletal images. Interestingly, nearly half of the patients displayed moderate defects or osteochondroma-like outgrowths in the cranial base and specifically in the clivus. In good correlation, osteochondromas developed in the cranial base of mutant Ext1f/f;Col2-CreER or Ext1f/f;Aggrecan-CreER mouse models of HME along the synchondrosis growth plates. Osteochondroma formation was preceded by phenotypic alteration of cells at the chondro-perichondrial boundary and was accompanied by ectopic expression of major cartilage matrix genes -collagen 2 and collagen X- within the growing ectopic masses. Because chondrogenesis requires bone morphogenetic protein (BMP) signaling, we asked whether osteochondroma formation could be blocked by a BMP signaling antagonist. Systemic administration with LDN-193189 effectively inhibited osteochondroma growth in conditional Ext1-mutant mice. In vitro studies with mouse embryo chondrogenic cells clarified the mechanisms of LDN-193189 action that turned out to include decreases in canonical BMP signaling pSMAD1/5/8 effectors but interestingly, concurrent increases in such anti-chondrogenic mechanisms as pERK1/2 and Chordin, Fgf9 and Fgf18 expression. Our study is the first to reveal that the cranial base can be affected in patients with HME and that osteochondroma formation is amenable to therapeutic drug intervention. PMID:28445472

Hypersomnia Following Traumatic Brain Injury

PubMed Central

Watson, Nathaniel F; Dikmen, Sureyya; Machamer, Joan; Doherty, Michael; Temkin, Nancy

2007-01-01

Study Objectives: To evaluate the prevalence and natural history of sleepiness following traumatic brain injury. Methods: This prospective cohort study used the Sickness Impact Profile to evaluate sleepiness in 514 consecutive subjects with traumatic brain injury (TBI), 132 non-cranial trauma controls, and 102 trauma-free controls 1 month and 1 year after injury. Results: Fifty-five percent of TBI subjects, 41% of non-cranial trauma controls, and 3% of trauma-free controls endorsed 1 or more sleepiness items 1 month following injury (p < .001). One year following injury, 27% of TBI subjects, 23% of non-cranial trauma controls, and 1% of trauma-free controls endorsed 1 or more sleepiness items (p < .001). Patients with TBI were sleepier than non-cranial trauma controls at 1 month (p < .02) but not 1 year after injury. Brain-injured subjects were divided into injury-severity groups based on time to follow commands (TFC). At 1 month, the non-cranial trauma controls were less sleepy than the 1- to 6-day (p < .05), 7- to 13-day (p < .01), and 14-day or longer (p < .01) TFC groups. In addition, the ≤ 24-hour group was less sleepy then the 7- to 13-day and 14-day or longer groups (each p < .05). At 1 year, the non-cranial trauma control group (p < .05) and the ≤ 24-hour TFC group (p < .01) were less sleepy than the 14-day or longer TFC group. Sleepiness improved in 84% to 100% of subjects in the TBI TFC groups, as compared with 78% of the non-cranial trauma control group (p < .01). Conclusions: Sleepiness is common following traumatic injury, particularly TBI, with more severe injuries resulting in greater sleepiness. Sleepiness improves in many patients, particularly those with TBI. However, about a quarter of TBI subjects and non-cranial trauma control subjects remained sleepy 1 year after injury. Citation: Watson NF; Dikmen S; Machamer J et al. Hypersomnia following traumatic brain injury. J Clin Sleep Med 2007;3(4):363-368. PMID:17694724

Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach.

PubMed

Borghei-Razavi, Hamid; Tomio, Ryosuke; Fereshtehnejad, Seyed-Mohammad; Shibao, Shunsuke; Schick, Uta; Toda, Masahiro; Yoshida, Kazunari; Kawase, Takeshi

2016-02-01

Objectives  Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Method  A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used. The anatomical variations of cranial nerves IV-VI related to the tumor were divided into several location categories: superior lateral (SL), inferior lateral (IL), superior medial (SM), inferior medial (IM), and encased (E). These data were then analyzed taking into consideration pathologic subgroups of meningioma, epidermoid, and schwannoma. Results  In 41% of meningiomas, the trigeminal nerve is encased by the tumor. In 38% of the meningiomas, the trigeminal nerve is in the SL part of the tumor, and it is in 20% of the IL portion of the tumor. In 38% of the meningiomas, the trochlear nerve is encased by the tumor. The abducens nerve is not always visible (35%). The pathologic nerve pattern differs from that of meningiomas for epidermoid and trigeminal schwannomas. Conclusion  The pattern of cranial nerves IV-VI is linked to the type of petroclival tumor. In a meningioma, tumor origin (cavernous, upper clival, tentorial, and petrous apex) is the most important predictor of the location of cranial nerves IV-VI. Classification of four subtypes of petroclival meningiomas using magnetic resonance imaging is very useful to predict the location of deviated cranial nerves IV-VI intraoperatively.

Comparative Postembryonic Skeletal Ontogeny in Two Sister Lineages of Old World Tree Frogs (Rhacophoridae: Taruga, Polypedates)

PubMed Central

Senevirathne, Gayani; Kerney, Ryan

2017-01-01

Rhacophoridae, a family of morphologically cryptic frogs, with many genetically distinct evolutionary lineages, is understudied with respect to skeletal morphology, life history traits and skeletal ontogeny. Here we analyze two species each from two sister lineages, Taruga and Polypedates, and compare their postembryonic skeletal ontogeny, larval chondrocrania and adult osteology in the context of a well-resolved phylogeny. We further compare these ontogenetic traits with the direct-developing Pseudophilautus silus. For each species, we differentially stained a nearly complete developmental series of tadpoles from early postembryonic stages through metamorphosis to determine the intraspecific and interspecific differences of cranial and postcranial bones. Chondrocrania of the four species differ in 1) size; 2) presence/absence of anterolateral and posterior process; and 3) shape of the suprarostral cartilages. Interspecific variation of ossification sequences is limited during early stages, but conspicuous during later development. Early cranial ossification is typical of other anuran larvae, where the frontoparietal, exoccipital and parasphenoid ossify first. The ossification sequences of the cranial bones vary considerably within the four species. Both species of Taruga show a faster cranial ossification rate than Polypedates. Seven cranial bones form when larvae near metamorphic climax. Ossification of all 18 cranial bones is initiated by larval Gosner stage 46 in T. eques. However, some cranial bone formation is not initiated until after metamorphosis in the other three species. Postcranial sequence does not vary significantly. The comparison of adult osteology highlights two characters, which have not been previously recorded: presence/absence of the parieto-squamosal plates and bifurcated base of the omosternum. This study will provide a starting point for comparative analyses of rhacophorid skeletal ontogeny and facilitate the study of the evolution of ontogenetic repatterning associated with the life history variation in the family. PMID:28060923

Reconstruction of long digital extensor tendon by cranial tibial muscle fascia graft in a dog.

PubMed

Sabiza, Soroush; Khajeh, Ahmad; Naddaf, Hadi

2016-01-01

Tendon rupture in dogs is generally the result of a direct trauma. This report described the use of adjacent muscle autogenic fascial graft for reconstruction of distal rupture of long digital extensor tendon in a dog. A two-year-old male mix breed dog, was presented with a non-weight bearing lameness of the right hind limb and a deep rupture of lateral side of right tarsus. History taking revealed that this rupture appeared without any apparent cause, when walking around the farm, three days before. Radiography was done and no fracture was observed. Hyperextension of right tarsal joint compared to left limb was observed. Under general anesthesia, after dissections of the ruptured area, complete rupture of long digital extensor tendon was revealed. Then, we attempted to locate the edge of the tendon, however, the tendon length was shortened approximately 1 cm. Hence, a strip of 1 cm length from fascia of cranial tibial muscle was harvested to fill the defect. The graft was sutured to the two ends of tendon using locking loop pattern. Subcutaneous layers and the skin were sutured routinely. Ehmer sling bandage was applied to prevent weight bearing on the surgical region. Re-examination and phone contact with the owner eight weeks and six months postoperatively revealed a poor lameness and excellent function of the dog, respectively. It could be concluded that the fascia of adjacent muscles can be used as an autogenic graft for reconstruction of some tendon ruptures.

Reconstruction of long digital extensor tendon by cranial tibial muscle fascia graft in a dog

PubMed Central

Sabiza, Soroush; Khajeh, Ahmad; Naddaf, Hadi

2016-01-01

Tendon rupture in dogs is generally the result of a direct trauma. This report described the use of adjacent muscle autogenic fascial graft for reconstruction of distal rupture of long digital extensor tendon in a dog. A two-year-old male mix breed dog, was presented with a non-weight bearing lameness of the right hind limb and a deep rupture of lateral side of right tarsus. History taking revealed that this rupture appeared without any apparent cause, when walking around the farm, three days before. Radiography was done and no fracture was observed. Hyperextension of right tarsal joint compared to left limb was observed. Under general anesthesia, after dissections of the ruptured area, complete rupture of long digital extensor tendon was revealed. Then, we attempted to locate the edge of the tendon, however, the tendon length was shortened approximately 1 cm. Hence, a strip of 1 cm length from fascia of cranial tibial muscle was harvested to fill the defect. The graft was sutured to the two ends of tendon using locking loop pattern. Subcutaneous layers and the skin were sutured routinely. Ehmer sling bandage was applied to prevent weight bearing on the surgical region. Re-examination and phone contact with the owner eight weeks and six months postoperatively revealed a poor lameness and excellent function of the dog, respectively. It could be concluded that the fascia of adjacent muscles can be used as an autogenic graft for reconstruction of some tendon ruptures. PMID:27872726

A revised cranial description of Massospondylus carinatus Owen (Dinosauria: Sauropodomorpha) based on computed tomographic scans and a review of cranial characters for basal Sauropodomorpha

PubMed Central

2018-01-01

Massospondylus carinatus is a basal sauropodomorph dinosaur from the early Jurassic Elliot Formation of South Africa. It is one of the best-represented fossil dinosaur taxa, known from hundreds of specimens including at least 13 complete or nearly complete skulls. Surprisingly, the internal cranial anatomy of M. carinatus has never been described using computed tomography (CT) methods. Using CT scans and 3D digital representations, we digitally reconstruct the bones of the facial skeleton, braincase, and palate of a complete, undistorted cranium of M. carinatus (BP/1/5241). We describe the anatomical features of the cranial bones, and compare them to other closely related sauropodomorph taxa such as Plateosaurus erlenbergiensis, Lufengosaurus huenei, Sarahsaurus aurifontanalis and Efraasia minor. We identify a suite of character states of the skull and braincase for M. carinatus that sets it apart from other taxa, but these remain tentative due to the lack of comparative sauropodomorph braincase descriptions in the literature. Furthermore, we hypothesize 27 new cranial characters useful for determining relationships in non-sauropodan Sauropodomorpha, delete five pre-existing characters and revise the scores of several existing cranial characters to make more explicit homology statements. All the characters that we hypothesized or revised are illustrated. Using parsimony as an optimality criterion, we then test the relationships of M. carinatus (using BP/1/5241 as a specimen-level exemplar) in our revised phylogenetic data matrix. PMID:29340238

A soft, transparent, freely accessible cranial window for chronic imaging and electrophysiology

PubMed Central

Heo, Chaejeong; Park, Hyejin; Kim, Yong-Tae; Baeg, Eunha; Kim, Yong Ho; Kim, Seong-Gi; Suh, Minah

2016-01-01

Chronic in vivo imaging and electrophysiology are important for better understanding of neural functions and circuits. We introduce the new cranial window using soft, penetrable, elastic, and transparent, silicone-based polydimethylsiloxane (PDMS) as a substitute for the skull and dura in both rats and mice. The PDMS can be readily tailored to any size and shape to cover large brain area. Clear and healthy cortical vasculatures were observed up to 15 weeks post-implantation. Real-time hemodynamic responses were successfully monitored during sensory stimulation. Furthermore, the PDMS window allowed for easy insertion of microelectrodes and micropipettes into the cortical tissue for electrophysiological recording and chemical injection at any location without causing any fluid leakage. Longitudinal two-photon microscopic imaging of Cx3Cr1+/− GFP transgenic mice was comparable with imaging via a conventional glass-type cranial window, even immediately following direct intracortical injection. This cranial window will facilitate direct probing and mapping for long-term brain studies. PMID:27283875

[Chondroma adjacent to Meckel's cave mimicking a fifth cranial nerve neurinoma. A case report].

PubMed

Narro-Donate, Jose María; Huete-Allut, Antonio; Velasco-Albendea, Francisco J; Escribano-Mesa, Jose A; Mendez-Román, Paddy; Masegosa-González, Jose

2016-01-01

Cranial chondromas are tumours arising from chondrocyte embryonic remnants cells that usually appear in the skull base synchondrosis. In contrast to the rest of the organism, where chondroid tumours are the most common primary bone tumour just behind the haematopoietic lineage ones, they are a rarity at cranial level, with an incidence of less than 1% of intracranial tumours. The case is reported on a 42 year-old male referred to our clinic due to the finding of an extra-axial lesion located close to the Meckel's cave region, with extension to the posterior fossa and brainstem compression after progressive paraparesis of 6 months onset. With the diagnosis of trigeminal schwannoma, a subtotal tumour resection was performed using a combined supra-infratentorial pre-sigmoidal approach. The postoperative histopathology report confirmed the diagnosis of cranial chondroma. Copyright © 2016 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

Surgical treatment of a proximal diaphyseal tibial deformity associated with partial caudal and cranial cruciate ligament deficiency and patella baja.

PubMed

Vincenti, S; Knell, S; Pozzi, A

2017-04-01

Caudal cruciate ligament injury can be a complication following tibial plateau leveling osteotomy (TPLO) (Slocum und Slocum, 1993) especially if the post-operative Tibial Plateau Angle (TPA) is less than 5 degree. We describe a case of negative TPA associated with partial cranial and caudal ligament rupture treated with a center of rotation of angulation (CORA) based cranial tibial opening wedge osteotomy and tibial tuberosity transposition. A 13 kg, mixed breed dog was presented for right pelvic limb lameness. Radiographically a bilateral patella baja and a malformed tibia tuberosity along with a bilateral TPA of -8 degree were detected. Arthroscopically a partial rupture of the cranial and caudal cruciate ligaments were found. A cranial tibial opening wedge osteotomy of 23 degree and a fibular ostectomy were performed. The osteotomy was fixed with a 8 holes ALPS 9 (KYON, Switzerland) and a 3-holes 2.0mm UniLock plate (Synthes, Switzerland). Then a proximal tibial tuberosity transposition of 10mm was performed and fixed with a pin and tension band construct. The postoperative TPA was 15 degree. The radiographic controls at 6, 10 weeks, 6 months and 1 year after surgery revealed an unchanged position of the implants and progressive healing of the osteotomies. At the 6 and 12 months recheck evaluation the dog had no evidence of lameness or stifle pain and radiographs revealed complete healing of the osteotomy site and no implant failure. The diaphyseal CORA based osteotomy allowed accurate correction of a proximal tibial deformity associated with negative TPA.

Decision tree analysis as a supplementary tool to enhance histomorphological differentiation when distinguishing human from non-human cranial bone in both burnt and unburnt states: A feasibility study.

PubMed

Simmons, T; Goodburn, B; Singhrao, S K

2016-01-01

This feasibility study was undertaken to describe and record the histological characteristics of burnt and unburnt cranial bone fragments from human and non-human bones. Reference series of fully mineralized, transverse sections of cranial bone, from all variables and specimen states, were prepared by manual cutting and semi-automated grinding and polishing methods. A photomicrograph catalogue reflecting differences in burnt and unburnt bone from human and non-humans was recorded and qualitative analysis was performed using an established classification system based on primary bone characteristics. The histomorphology associated with human and non-human samples was, for the main part, preserved following burning at high temperature. Clearly, fibro-lamellar complex tissue subtypes, such as plexiform or laminar primary bone, were only present in non-human bones. A decision tree analysis based on histological features provided a definitive identification key for distinguishing human from non-human bone, with an accuracy of 100%. The decision tree for samples where burning was unknown was 96% accurate, and multi-step classification to taxon was possible with 100% accuracy. The results of this feasibility study strongly suggest that histology remains a viable alternative technique if fragments of cranial bone require forensic examination in both burnt and unburnt states. The decision tree analysis may provide an additional but vital tool to enhance data interpretation. Further studies are needed to assess variation in histomorphology taking into account other cranial bones, ontogeny, species and burning conditions. © The Author(s) 2015.

Comparative study of cranial anthropometric measurement by traditional calipers to computed tomography and three-dimensional photogrammetry.

PubMed

Mendonca, Derick A; Naidoo, Sybill D; Skolnick, Gary; Skladman, Rachel; Woo, Albert S

2013-07-01

Craniofacial anthropometry by direct caliper measurements is a common method of quantifying the morphology of the cranial vault. New digital imaging modalities including computed tomography and three-dimensional photogrammetry are similarly being used to obtain craniofacial surface measurements. This study sought to compare the accuracy of anthropometric measurements obtained by calipers versus 2 methods of digital imaging.Standard anterior-posterior, biparietal, and cranial index measurements were directly obtained on 19 participants with an age range of 1 to 20 months. Computed tomographic scans and three-dimensional photographs were both obtained on each child within 2 weeks of the clinical examination. Two analysts measured the anterior-posterior and biparietal distances on the digital images. Measures of reliability and bias between the modalities were calculated and compared.Caliper measurements were found to underestimate the anterior-posterior and biparietal distances as compared with those of the computed tomography and the three-dimensional photogrammetry (P < 0.001). Cranial index measurements between the computed tomography and the calipers differed by up to 6%. The difference between the 2 modalities was statistically significant (P = 0.021). The biparietal and cranial index results were similar between the digital modalities, but the anterior-posterior measurement was greater with the three-dimensional photogrammetry (P = 0.002). The coefficients of variation for repeated measures based on the computed tomography and the three-dimensional photogrammetry were 0.008 and 0.007, respectively.In conclusion, measurements based on digital modalities are generally reliable and interchangeable. Caliper measurements lead to underestimation of anterior-posterior and biparietal values compared with digital imaging.

Gamma Knife Radiosurgery for Skull Base Meningiomas: Long-Term Radiologic and Clinical Outcome

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Jung Ho; Kim, Dong Gyu; Chung, Hyun-Tai

2008-12-01

Purpose: To analyze the long-term outcomes in patients with skull base meningiomas (SBMNGs) treated with Gamma Knife radiosurgery (GKRS). Methods and Materials: Of the 98 consecutive patients with SBMNGs treated with GKRS between 1998 and 2002, 63 were followed up for more than 48 months. The mean ({+-}SD) age of the patients was 50 {+-} 12 years, the mean tumor volume was 6.5 cm{sup 3} (range, 0.5-18.4 cm{sup 3}), the mean marginal dose was 12.6 Gy (range, 7.0-20.0 Gy), and the mean follow-up duration was 77 {+-} 18 months. The mean number of shots was 13.7 {+-} 3.8. The tumormore » volume was decreased at the last follow-up in 28 patients (44.4%) and increased in 6 (9.6%). The actuarial tumor control rate was 90.2% at 5 years. No notable prognostic factor related to tumor control was identified. Ten patients (15.9%) with a cranial neuropathy showed unfavorable outcomes. The rate of improvement in patients with a cranial neuropathy was 45.1%. Age >70 years was likely correlated with an unfavorable outcome in patients with cranial neuropathy (odds ratio = 0.027; p = 0.025; 95% confidence interval 0.001-0.632). Cavernous sinus location was significantly associated with improvement of a cranial neuropathy (odds ratio = 7.314; p = 0.007; 95% confidence interval 1.707-31.34). Conclusions: Gamma Knife radiosurgery is an effective modality for the treatment of SBMNGs and provides favorable outcomes in patients with cranial neuropathy, even in the long-term follow-up period. However, radiosurgery for patients with no or only mild symptoms should be performed cautiously because neither complication rate is low enough to be negligible, especially in elderly patients. A cranial neuropathy by MNGs involving the cavernous sinus seems to have a higher chance of improvement after radiosurgery than other SBMNGs.« less

Heterochrony and patterns of cranial suture closure in hystricognath rodents

PubMed Central

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

2009-01-01

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

Cranial pole nephrectomy in the pig model: anatomic analysis of arterial injuries in tridimensional endocasts.

PubMed

Pereira-Sampaio, Marco A; Henry, Robert W; Favorito, Luciano A; Sampaio, Francisco J B

2012-06-01

To assess the intrarenal arteries injuries after cranial pole nephrectomy in a pig model to compare these findings with those in humans. Polyester resin was injected through the ureter and the renal artery to make three-dimensional casts of 61 pig kidneys. The cranial pole of the kidneys was sectioned at four different sites before the solidification of the resin, and the casts were examined for arterial damage. Section performed through the hilus (15 kidneys): The cranial division of the renal artery was sectioned in two (13.33%) cases, the ventral branch of the cranial division of the renal artery was sectioned in 13 (86.7%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 11 (73.34%) cases. Section at 0.5 cm cranial to the hilus (16 kidneys): The cranial division of the renal artery was sectioned in 1 (6.25%) case, the ventral branch of the cranial division of the renal artery was sectioned in 14 (87.5%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 13 (81.25%) cases. Section at 1.0 cm cranial to the hilus (15 kidneys): The ventral branch of the cranial division of the renal artery was sectioned in five (33.33%) cases, and the dorsal branch of the cranial division of the renal artery was injured in five (33.33%) cases. Section at 1.5 cm cranial to the hilus (15 kidneys): No lesions were found in the main arteries, only in the interlobular branches. As previously demonstrated in humans, sections at 1.0 cm or more cranially to the hilus in pigs also showed a significant decrease in damage to the major intrarenal arteries. Therefore, as regards arterial damage, the pig kidney is a useful model for partial nephrectomy in the cranial (upper) pole.

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

PubMed

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

2014-01-01

Descriptions of the anatomy of the neural communications among the cranial nerves and their branches is lacking in the literature. Knowledge of the possible neural interconnections found among these nerves may prove useful to surgeons who operate in these regions to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections among the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized in two parts. Part I concerns the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches with any other nerve trunk or branch in the vicinity. Part II concerns the anastomoses among the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or among these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part I is presented in this article. An extensive anastomotic network exists among the lower cranial nerves. Knowledge of such neural intercommunications is important in diagnosing and treating patients with pathology of the skull base. Copyright © 2013 Wiley Periodicals, Inc.

Subcranial approach in the surgical treatment of anterior skull base trauma.

PubMed

Schaller, B

2005-04-01

Fractures of the anterior skull base, because of the region's anatomical relationships, are readily complicated by neurological damage to the brain or cranial nerves. This review highlights the use of a subcranial approach in the operative treatment of injuries of the anterior skull base and compares it to the more traditional neurosurgical transcranial approach. The extended anterior subcranial approach takes advantage of the specific features of injuries in this region and allows direct access to the central anterior cranial base in order to repair fractures, close CSF fistulae and relieve of optic nerve compression. It avoids extensive frontal lobe manipulation. The success of the approach in achieving the aims of surgery with low morbidity is reviewed.

[Risk factors of rupture of internal carotid artery during surgical resection of carotid body tumor].

PubMed

Li, Y H; Wang, J S; Yao, C; Chang, G Q; Yin, H H; Li, S Q; Lü, W M; Hu, Z J; Wang, S M

2017-06-13

Objective: To investigate risk factors of rupture of internal carotid artery resection during carotid body tumor resection and to summarize our treatment experience. Methods: During the period from 1991 to 2016, rupture of internal carotid artery occurred in 27 patients (28 tumors) during surgical resection of carotid body tumor in the First Affiliated Hospital of Sun Yat-sen University. Their clinical and follow-up data were retrospectively collected and analyzed. For all patients underwent surgical resection during this period, Logistic regression analysis was used to investigate the risk factors of intraoperative rupture of internal carotid artery. Results: Of these 28 tumors, there were 15 (53.6%) tumors with diameter≥5 cm and 20 (71.4%) Shamblin Ⅲ tumors. Intraoperatively, shunt was applied for 8 (28.6%) cases. Thirteen (46.4%) patients underwent ligation of external carotid artery, while 2 (7.1%) patients accepted resection of cranial nerves. Direct closure/patchplasty, autologous vessels or graft reconstruction was used in 16, 10 and 2 cases, respectively. Postoperatively, stroke occurred in 4(14.3%) cases and cranial nerve deficit in 15 (53.6%) cases. During a median length of 36 (14-125) months, cranial nerve deficit persisted in 5 cases. Follow-up radiologic examination indicated 3 (10.7%) cases of targeted vessel occlusion. However, no new-onset stroke was identified. Among all patients underwent surgical resection of carotid body tumor, female ( OR =3.650, P =0.012), age≤25 years old ( OR =3.710, P =0.013) and Shamblin Ⅲ tumor ( OR =4.631, P =0.008) increase the risks of intraoperative carotid artery rupture. Conclusions: Shamblin Ⅲ tumor is the predictor of rupture of internal carotid artery. Intraoperative, properly increased blood pressure, intraoperative heparinization and use of shunt for those cases without well-compensated cranial collateral arteries are likely to decreasing the incidence of stroke.

Inferiorly based buccinator myomucosal island flap in oral and pharyngeal reconstruction. Four techniques to increase its application

PubMed Central

Rahpeyma, Amin; khajehahmadi, Saeedeh

2015-01-01

Introduction Reconstruction of oral and pharyngeal defects after pathologic resections with the same tissue is an optimal and ideal target. Islanded variety of inferiorly pedicled facial artery musculomucosal flap, in which facial artery and vein are skeletonized (referred to as inferiorly based BUMIF), is suitable for reconstruction of medium-sized mucosal defects. Presentation of cases In this article, with four cases, modifications of this flap are demonstrated in reconstruction of large intraoral and oropharyngeal defects and coverage of alveolar ridge in the mandible. Discussion In some situations, there is a need for more mucosal paddle, longer vascular pedicle and more adaptation to the recipient bed. Conclusion Relocating Stensen’s duct increases the mucosal paddle with cranial extension of superior limit while differential incision of the mucosa and buccinator muscle in mandibular vestibule extend the lower limit of this flap. Bone suture is a good complementary technique when this flap is used for coverage of mandibular alveolar ridge. Inferiorly based BUMIF with added length is indicated for oropharyngeal and contralateral mouth floor reconstructions. PMID:26218177

Report of a new syndrome: focus on differential diagnosis and review of Ellis-van Creveld, Curry-Hall, acrofacial dysostosis, and orofacial digital syndromes.

PubMed

Ghosh, Sujoy; Setty, Suhas; Sivakumar, A; Pai, Keerthilatha M

2007-05-01

Ellis-van Creveld (EvC) and Curry-Hall (CH) syndromes are rare syndromes that occur due to mutations of genes mapped to the chromosome 4p16 region. Hence, they both have few features that are common. The dental literature describing the oral manifestations and etiology of both syndromes is scarce. We report a case of a 7-year-old girl who appeared with features that are common to both syndromes, as well as with other features such as reduced cranial base flexure and toes of equal length with skeletal changes that have not been mentioned or described in earlier reports. The patient possibly represents a new syndromic entity that has not been reported until now. Further, we present a review of various other similar syndromes, such as various types of orofacial digital (OFD) syndrome and acrofacial dysostosis.

Traumatic superior orbital fissure syndrome: assessment of cranial nerve recovery in 33 cases.

PubMed

Chen, Chien-Tzung; Wang, Theresa Y; Tsay, Pei-Kwei; Huang, Faye; Lai, Jui-Pin; Chen, Yu-Ray

2010-07-01

Superior orbital fissure syndrome is a rare complication that occurs in association with craniofacial trauma. The characteristics of superior orbital fissure syndrome are attributable to a constellation of cranial nerve III, IV, and VI palsies. This is the largest series describing traumatic superior orbital fissure syndrome that assesses the recovery of individual cranial nerve function after treatment. In a review from 1988 to 2002, 33 patients with superior orbital fissure syndrome were identified from 11,284 patients (0.3 percent) with skull and facial fractures. Severity of cranial nerve injury and functional recovery were evaluated by extraocular muscle movement. Patients were evaluated on average 6 days after initial injury, and average follow-up was 11.8 months. There were 23 male patients. The average age was 31 years. The major mechanism of injury was motorcycle accident (67 percent). Twenty-two received conservative treatment, five were treated with steroids, and six patients underwent surgical decompression of the superior orbital fissure. After initial injury, cranial nerve VI suffered the most damage, whereas cranial nerve IV sustained the least. In the first 3 months, recovery was greatest in cranial nerve VI. At 9 months, function was lowest in cranial nerve VI and highest in cranial nerve IV. Eight patients (24 percent) had complete recovery of all cranial nerves. Functional recovery of all cranial nerves reached a plateau at 6 months after trauma. Cranial nerve IV suffered the least injury, whereas cranial nerve VI experienced the most neurologic deficits. Cranial nerve palsies improved to their final recovery endpoints by 6 months. Surgical decompression is considered when there is evidence of bony compression of the superior orbital fissure.

Evolution of cranial telescoping in echolocating whales (Cetacea: Odontoceti).

PubMed

Churchill, Morgan; Geisler, Jonathan H; Beatty, Brian L; Goswami, Anjali

2018-05-01

Odontocete (echolocating whale) skulls exhibit extreme posterior displacement and overlapping of facial bones, here referred to as retrograde cranial telescoping. To examine retrograde cranial telescoping across 40 million years of whale evolution, we collected 3D scans of whale skulls spanning odontocete evolution. We used a sliding semilandmark morphometric approach with Procrustes superimposition and PCA to capture and describe the morphological variation present in the facial region, followed by Ancestral Character State Reconstruction (ACSR) and evolutionary model fitting on significant components to determine how retrograde cranial telescoping evolved. The first PC score explains the majority of variation associated with telescoping and reflects the posterior migration of the external nares and premaxilla alongside expansion of the maxilla and frontal. The earliest diverging fossil odontocetes were found to exhibit a lesser degree of cranial telescoping than later diverging but contemporary whale taxa. Major shifts in PC scores and centroid size are identified at the base of Odontoceti, and early burst and punctuated equilibrium models best fit the evolution of retrograde telescoping. This indicates that the Oligocene was a period of unusually high diversity and evolution in whale skull morphology, with little subsequent evolution in telescoping. © 2018 The Author(s). Evolution © 2018 The Society for the Study of Evolution.

Development of a Standardized Cranial Phantom for Training and Optimization of Functional Stereotactic Operations.

PubMed

Krüger, Marie T; Coenen, Volker A; Egger, Karl; Shah, Mukesch; Reinacher, Peter C

2018-06-13

In recent years, simulations based on phantom models have become increasingly popular in the medical field. In the field of functional and stereotactic neurosurgery, a cranial phantom would be useful to train operative techniques, such as stereo-electroencephalography (SEEG), to establish new methods as well as to develop and modify radiological techniques. In this study, we describe the construction of a cranial phantom and show examples for it in stereotactic and functional neurosurgery and its applicability with different radiological modalities. We prepared a plaster skull filled with agar. A complete operation for deep brain stimulation (DBS) was simulated using directional leads. Moreover, a complete SEEG operation including planning, implantation of the electrodes, and intraoperative and postoperative imaging was simulated. An optimally customized cranial phantom is filled with 10% agar. At 7°C, it can be stored for approximately 4 months. A DBS and an SEEG procedure could be realistically simulated. Lead artifacts can be studied in CT, X-ray, rotational fluoroscopy, and MRI. This cranial phantom is a simple and effective model to simulate functional and stereotactic neurosurgical operations. This might be useful for teaching and training of neurosurgeons, establishing operations in a new center and for optimization of radiological examinations. © 2018 S. Karger AG, Basel.

Cranial tibial thrust: a primary force in the canine stifle.

PubMed

Slocum, B; Devine, T

1983-08-15

A cranially directed force identified within the canine stifle joint was termed cranial tibial thrust. It was generated during weight bearing by tibial compression, of which the tarsal tendon of the biceps femoris is a major contributor, and by the slope of the tibial plateau, found to have a mean cranially directed inclination of 22.6 degrees. This force may be an important factor in cranial cruciate ligament rupture and in generation of cranial drawer sign.

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

PubMed Central

Schmidt, Jennifer; Piekarski, Nadine; Olsson, Lennart

2013-01-01

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

Aquatic treadmill water level influence on pelvic limb kinematics in cranial cruciate ligament-deficient dogs with surgically stabilised stifles.

PubMed

Bertocci, G; Smalley, C; Brown, N; Bialczak, K; Carroll, D

2018-02-01

To compare pelvic limb joint kinematics and temporal gait characteristics during land-based and aquatic-based treadmill walking in dogs that have undergone surgical stabilisation for cranial cruciate ligament deficiency. Client-owned dogs with surgically stabilised stifles following cranial cruciate ligament deficiency performed three walking trials consisting of three consecutive gait cycles on an aquatic treadmill under four water levels. Hip, stifle and hock range of motion; peak extension; and peak flexion were assessed for the affected limb at each water level. Gait cycle time and stance phase percentage were also determined. Ten client-owned dogs of varying breeds were evaluated at a mean of 55·2 days postoperatively. Aquatic treadmill water level influenced pelvic limb kinematics and temporal gait outcomes. Increased stifle joint flexion was observed as treadmill water level increased, peaking when the water level was at the hip. Similarly, hip flexion increased at the hip water level. Stifle range of motion was greatest at stifle and hip water levels. Stance phase percentage was significantly decreased when water level was at the hip. Aquatic treadmill walking has become a common rehabilitation modality following surgical stabilisation of cranial cruciate ligament deficiency. However, evidence-based best practice guidelines to enhance stifle kinematics do not exist. Our findings suggest that rehabilitation utilising a water level at or above the stifle will achieve the best stifle kinematics following surgical stifle stabilisation. © 2017 British Small Animal Veterinary Association.

[Skull base meningiomas: a predictive system to know the extent of their surgical resection and patient outcome].

PubMed

Morales, F; Maillo, A; Díaz-Alvarez, A; Merino, M; Muñoz-Herrera, A; Hernández, J; Santamarta, D

2005-12-01

The aim of this study was to build a preoperative predictive system which could provide reliable information about: 1 degrees which skull base meningiomas can be total or partially removed, and 2 degrees their surgical outcome. Patient histories and imaging data were reviewed retrospectively from 85 consecutive skull base meningiomas patients who underwent surgery from 1990 and 2002. From the preoperative data, nine variables were selected for conventional statistical analysis as regards their relationship with: 1 degrees total vs partial tumor resection and 2 degrees with patients outcome according to the degree of tumour removal. From the nine variables analysed only two had a statistical association with the type of tumour resection performed (total vs partial) and the patient outcome: 1) arteries encasement and 2) cranial nerves involvement. Upon correlating these two variables with the type of tumour resection performed (total vs partial) and with the Karnofsky'scale to evaluate patients surgical outcome, the following grading groups were identified: Grade I: skull base meningiomas which did not involve cranial nerves or artery or only encased one artery or one cranial nerve. In these cases the incidence of gross tumour resection was 98.3% (p< 0.0001) and the perspective to reach 70 points in the Karnofsky'scale was of 96.5% ( p=0.001). Grade II: skull base meningiomas which involved one cranial nerve and encased, at least, two main cerebral arteries. In these cases, the frequency of total resection, decreased to 83.3% (p<0.0001) and the probability to reach 70 points in the Karnofsky'scale was 70.6% (p=0.001). Grade III: skull base meningiomas which involved two or more cranial nerves and encased several arteries In this group, the frequency of a total resection was of 42.9% (p<0.0001) and the probability of reaching 70 points in the Karnofsky'scale was only 60% (p=0.001). We propose a preoperative grading system for skull base meningiomas that helps predicting both whether total or partial tumor removal will be achieved during surgery and the immediate postsurgical outcome of the patient. In applying this predictive system we will be able to reduce surgical morbidity, to advance the possibility of a radiosurgical treatment and give a more precise information to the patients and their families about our surgical decision-making process.

[Gonadal ontogenesis and sex differentiation in the sea bass, Dicentrarchus labrax, under fish-farming conditions].

PubMed

Roblin, C; Bruslé, J

1983-01-01

The histology of the different stages of gonadal development (appearance of PGC, edification of gonad primordium, organization of an undifferentiated gonad, testicular or ovarian development) has been studied in fingerlings and juveniles of sea-bass in fish-culture conditions. Sex differentiation with a caudo-cranial gradient was direct and more in accordance with length than with age. Ovarian and testicular differentiation occurred in fish 11 to 23 months old and from 90 to 187 mm SL. Testis ova were frequently observed.

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

ERIC Educational Resources Information Center

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

2014-01-01

Visualization of the complex courses of the cranial nerves by students in the health-related professions is challenging through either diagrams in books or plastic models in the gross laboratory. Furthermore, dissection of the cranial nerves in the gross laboratory is an extremely meticulous task. Teaching and learning the cranial nerve pathways…

Postnatal Development of the Spheno-occipital Synchondrosis: A Histological Analysis.

PubMed

Dai, Jiewen; Lin, Yuheng; Ningjuan, Ouyang; Shi, Jun; Yu, Dedong; Shen, Guofang

2017-09-01

The spheno-occipital synchondrosis (SOS) in cranial base is an important growth center for the craniofacial skeleton, and also is a guide rail for development of the maxilla, midface, and mandible. Previous studies showed that SOS may be a treatment target for youngsters with midfacial hypoplasia and small cranial vault secondary to craniosynostosis. However, most of studies about the SOS are based on imaging data. In this study, we try to explore the characteristics of postnatal development of the mouse SOS based on histological analysis. Our findings showed that the width of the SOS in mice were gradually decreased from newborn mice to adult mice, and the SOS cartilage was gradually became small, then almost completely ossificated in adult mice. The resting and proliferative layers in SOS cartilage were gradually decreased, and almost only hypertrophic chondrocytes while no resting and proliferative layer chondrocytes in adult mice. The proliferative ability of SOS chondrocytes also gradually decreased. These findings will be of benefit for the further clinical treatment for patients with midfacial hypoplasia or small cranial vault secondary to craniosynostosis. Further evidence-based research about the clinical implication is necessary in future.

The evolution of cranial form and function in theropod dinosaurs: insights from geometric morphometrics.

PubMed

Brusatte, S L; Sakamoto, M; Montanari, S; Harcourt Smith, W E H

2012-02-01

Theropod dinosaurs, an iconic clade of fossil species including Tyrannosaurus and Velociraptor, developed a great diversity of body size, skull form and feeding habits over their 160+ million year evolutionary history. Here, we utilize geometric morphometrics to study broad patterns in theropod skull shape variation and compare the distribution of taxa in cranial morphospace (form) to both phylogeny and quantitative metrics of biting behaviour (function). We find that theropod skulls primarily differ in relative anteroposterior length and snout depth and to a lesser extent in orbit size and depth of the cheek region, and oviraptorosaurs deviate most strongly from the "typical" and ancestral theropod morphologies. Noncarnivorous taxa generally fall out in distinct regions of morphospace and exhibit greater overall disparity than carnivorous taxa, whereas large-bodied carnivores independently converge on the same region of morphospace. The distribution of taxa in morphospace is strongly correlated with phylogeny but only weakly correlated with functional biting behaviour. These results imply that phylogeny, not biting function, was the major determinant of theropod skull shape. © 2011 The Authors. Journal of Evolutionary Biology © 2011 European Society For Evolutionary Biology.

Fossil evidence and stages of elongation of the Giraffa camelopardalis neck

PubMed Central

Danowitz, Melinda; Vasilyev, Aleksandr; Kortlandt, Victoria; Solounias, Nikos

2015-01-01

Several evolutionary theories have been proposed to explain the adaptation of the long giraffe neck; however, few studies examine the fossil cervical vertebrae. We incorporate extinct giraffids, and the okapi and giraffe cervical vertebral specimens in a comprehensive analysis of the anatomy and elongation of the neck. We establish and evaluate 20 character states that relate to general, cranial and caudal vertebral lengthening, and calculate a length-to-width ratio to measure the relative slenderness of the vertebrae. Our sample includes cervical vertebrae (n=71) of 11 taxa representing all seven subfamilies. We also perform a computational comparison of the C3 of Samotherium and Giraffa camelopardalis, which demonstrates that cervical elongation occurs disproportionately along the cranial–caudal vertebral axis. Using the morphological characters and calculated ratios, we propose stages in cervical lengthening, which are supported by the mathematical transformations using fossil and extant specimens. We find that cervical elongation is anisometric and unexpectedly precedes Giraffidae. Within the family, cranial vertebral elongation is the first lengthening stage observed followed by caudal vertebral elongation, which accounts for the extremely long neck of the giraffe. PMID:26587249

[Acute palsy of twelfth cranial nerve].

PubMed

Munoz del Castillo, F; Molina Nieto, T; De la Riva Aguilar, A; Triviño Tarradas, F; Bravo-Rodríguez, F; Ramos Jurado, A

2005-01-01

The hypoglossal nerve or Twelfth-nerve palsy is a rare damage with different causes: tumors or metastases in skull base, cervicals tumors, schwannoma, dissection or aneurysm carotid arteries, stroke, trauma, idiopathic cause, radiation, infections (mononucleosis) or multiple cranial neuropathy. Tumors were responsible for nearly half of the cases in different studies. We studied a female with hypoglossal nerve acute palsy. We made a differential diagnostic with others causes and a review of the literature.

Low-Cost Smartphone-Based Photogrammetry for the Analysis of Cranial Deformation in Infants.

PubMed

Barbero-García, Inés; Lerma, José Luis; Marqués-Mateu, Ángel; Miranda, Pablo

2017-06-01

Cranial deformation, including deformational plagiocephaly, brachycephaly, and craniosynostosis, is a condition that affects a large number of infants. Despite its prevalence, there are no standards for the systematic evaluation of the cranial deformation. Usually, the deformation is measured manually by the use of calipers. Experts, however, do not agree on the suitability of these measurements to correctly represent the deformation. Other methodologies for evaluation include 3-dimensional (3D) photography and radiologic scanners. These techniques require either patient's sedation and ionizing radiation or high investment. The aim of this study is to develop a novel, low-cost, and minimally invasive methodology to correctly evaluate the cranial deformation using 3D imagery. A smart phone was used to record a slow motion video sequence on 5 different patients. Then, the videos were processed to create accurate 3D models of the patients' head, and the results were compared with the measurements obtained by the manual caliper. The correspondence between the manual and the photogrammetric 3D model measurements was high as far as head marks are available, with differences of 2 mm ± 0.9 mm; without marks, measurement results differed up to 20 mm. Smartphone-based photogrammetry is a low-cost, highly useful methodology to evaluate cranial deformation. This technique provides a much larger quantity of information than linear measurements with a similar accuracy as far as head marks exist. In addition, a new approach for the evaluation is pointed out: the comparison between the head 3D model and an ideal head, represented by a 3-axis ellipsoid. Copyright © 2017 Elsevier Inc. All rights reserved.

The cranial base of Australopithecus afarensis: new insights from the female skull

PubMed Central

Kimbel, William H.; Rak, Yoel

2010-01-01

Cranial base morphology differs among hominoids in ways that are usually attributed to some combination of an enlarged brain, retracted face and upright locomotion in humans. The human foramen magnum is anteriorly inclined and, with the occipital condyles, is forwardly located on a broad, short and flexed basicranium; the petrous elements are coronally rotated; the glenoid region is topographically complex; the nuchal lines are low; and the nuchal plane is horizontal. Australopithecus afarensis (3.7–3.0 Ma) is the earliest known species of the australopith grade in which the adult cranial base can be assessed comprehensively. This region of the adult skull was known from fragments in the 1970s, but renewed fieldwork beginning in the 1990s at the Hadar site, Ethiopia (3.4–3.0 Ma), recovered two nearly complete crania and major portions of a third, each associated with a mandible. These new specimens confirm that in small-brained, bipedal Australopithecus the foramen magnum and occipital condyles were anteriorly sited, as in humans, but without the foramen's forward inclination. In the large male A.L. 444-2 this is associated with a short basal axis, a bilateral expansion of the base, and an inferiorly rotated, flexed occipital squama—all derived characters shared by later australopiths and humans. However, in A.L. 822-1 (a female) a more primitive morphology is present: although the foramen and condyles reside anteriorly on a short base, the nuchal lines are very high, the nuchal plane is very steep, and the base is as relatively narrow centrally. A.L. 822-1 illuminates fragmentary specimens in the 1970s Hadar collection that hint at aspects of this primitive suite, suggesting that it is a common pattern in the A. afarensis hypodigm. We explore the implications of these specimens for sexual dimorphism and evolutionary scenarios of functional integration in the hominin cranial base. PMID:20855310

The Kölliker-Fuse nucleus: a review of animal studies and the implications for cranial nerve function in humans.

PubMed

Browaldh, Nanna; Bautista, Tara G; Dutschmann, Mathias; Berkowitz, Robert G

2016-11-01

To review the scientific literature on the relationship between Kölliker-Fuse nucleus (KF) and cranial nerve function in animal models, with view to evaluating the potential role of KF maturation in explaining age-related normal physiologic parameters and developmental and acquired impairment of cranial nerve function in humans. Medical databases (Medline and PubMed). Studies investigating evidence of KF activity responsible for a specific cranial nerve function that were based on manipulation of KF activity or the use of neural markers were included. Twenty studies were identified that involved the trigeminal (6 studies), vagus (9), and hypoglossal nerves (5). These pertained specifically to a role of the KF in mediating the dive reflex, laryngeal adductor control, swallowing function and upper airway tone. The KF acts as a mediator of a number of important functions that relate primarily to laryngeal closure, upper airway tone and swallowing. These areas are characterized by a variety of disorders that may present to the otolaryngologist, and hence the importance of understanding the role played by the KF in maintaining normal function.

Specification of functional cranial placode derivatives from human pluripotent stem cells.

PubMed

Dincer, Zehra; Piao, Jinghua; Niu, Lei; Ganat, Yosif; Kriks, Sonja; Zimmer, Bastian; Shi, Song-Hai; Tabar, Viviane; Studer, Lorenz

2013-12-12

Cranial placodes are embryonic structures essential for sensory and endocrine organ development. Human placode development has remained largely inaccessible despite the serious medical conditions caused by the dysfunction of placode-derived tissues. Here, we demonstrate the efficient derivation of cranial placodes from human pluripotent stem cells. Timed removal of the BMP inhibitor Noggin, a component of the dual-SMAD inhibition strategy of neural induction, triggers placode induction at the expense of CNS fates. Concomitant inhibition of fibroblast growth factor signaling disrupts placode derivation and induces surface ectoderm. Further fate specification at the preplacode stage enables the selective generation of placode-derived trigeminal ganglia capable of in vivo engraftment, mature lens fibers, and anterior pituitary hormone-producing cells that upon transplantation produce human growth hormone and adrenocorticotropic hormone in vivo. Our results establish a powerful experimental platform to study human cranial placode development and set the stage for the development of human cell-based therapies in sensory and endocrine disease. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Biomechanical Studies on Patterns of Cranial Bone Fracture Using the Immature Porcine Model.

PubMed

Haut, Roger C; Wei, Feng

2017-02-01

This review was prepared for the American Society of Mechanical Engineers Lissner Medal. It specifically discusses research performed in the Orthopaedic Biomechanics Laboratories on pediatric cranial bone mechanics and patterns of fracture in collaboration with the Forensic Anthropology Laboratory at Michigan State University. Cranial fractures are often an important element seen by forensic anthropologists during the investigation of pediatric trauma cases litigated in courts. While forensic anthropologists and forensic biomechanists are often called on to testify in these cases, there is little basic science developed in support of their testimony. The following is a review of studies conducted in the above laboratories and supported by the National Institute of Justice to begin an understanding of the mechanics and patterns of pediatric cranial bone fracture. With the lack of human pediatric specimens, the studies utilize an immature porcine model. Because much case evidence involves cranial bone fracture, the studies described below focus on determining input loading based on the resultant bone fracture pattern. The studies involve impact to the parietal bone, the most often fractured cranial bone, and begin with experiments on entrapped heads, progressing to those involving free-falling heads. The studies involve head drops onto different types and shapes of interfaces with variations of impact energy. The studies show linear fractures initiating from sutural boundaries, away from the impact site, for flat surface impacts, in contrast to depressed fractures for more focal impacts. The results have been incorporated into a "Fracture Printing Interface (FPI)," using machine learning and pattern recognition algorithms. The interface has been used to help interpret mechanisms of injury in pediatric death cases collected from medical examiner offices. The ultimate aim of this program of study is to develop a "Human Fracture Printing Interface" that can be used by forensic investigators in determining mechanisms of pediatric cranial bone fracture.

Familial Idiopathic Cranial Neuropathy in a Chinese Family.

PubMed

Zhang, Li; Liang, Jianfeng; Yu, Yanbing

Cranial neuropathy is usually idiopathic and familial cases are uncommon. We describe a family with 5 members with cranial neuropathy over 3 generations. All affected patients were women, indicating an X-linked dominant or an autosomal dominant mode of inheritance. Our cases and a review of the literature suggest that familial idiopathic cranial neuropathy is a rare condition which may be related to autosomal dominant vascular disorders (e.g. vascular tortuosity, sclerosis, elongation or extension), small posterior cranial fossas, anatomical variations of the posterior circulation, hypersensitivity of cranial nerves and other abnormalities. Moreover, microvascular decompression is the treatment of choice because vascular compression is the main factor in the pathogenesis. To the best of our knowledge, this is the first report of familial cranial neuropathy in China.

Multiple cranial neuropathy: a common diagnostic problem.

PubMed

Garg, R K; Karak, B

1999-10-01

Syndrome of multiple cranial palsies is a common clinical problem routinely encountered in neurological practice. Anatomical patterns of cranial nerves involvement help in localizing the lesion. Various infections, malignant neoplasms and autoimmune vasculitis are common disorders leading to various syndromes of multiple cranial nerve palsies. A large number of diffuse neurological disorders (e.g. Gullian-Barre syndrome, myopathies) may also present with syndrome of multiple cranial nerve palsies. Despite extensive biochemical and radiological work-up the accurate diagnosis may not be established. Few such patients represent "idiopathic" variety of multiple cranial nerve involvement and show good response to corticosteroids. Widespread and sequential involvements of cranial nerves frequently suggest possibility of malignant infiltration of meninges, however, confirmation of diagnosis may not be possible before autopsy.

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

PubMed

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

2014-01-01

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

Trigeminal complications arising after surgery of cranial base meningiomas.

PubMed

Westerlund, Ulf; Linderoth, Bengt; Mathiesen, Tiit

2012-04-01

Chronic severe facial pain is a feared sequel of cranial base surgery. This study explores the symptomatology, incidence and impact on the individual of postoperative de novo trigeminal nerve affection as well as the recovery potential. Out of 231 patients operated for cranial base meningiomas at the Karolinska University Hospital during 7 years, 25 complained of de novo trigeminal symptoms at clinical follow-up 3 months after surgery. Six were later lost to follow-up leaving 19 participants in the study, which was conducted using a questionnaire and a structured telephone interview. All patients complained of facial numbness, affecting the V1 branch in 10/19 patients (53%), the V2 branch in 18/19 (95%) and the V3 branch in 9/19 (47%). Surprisingly, only three (16%) suffered from trigeminal pain, which could be adequately managed by pharmacotherapy. However, five patients (26%) demonstrated ocular dysaesthetic problems. Twelve (63%) described their handicap to be mild, while seven (37%) had daily or severe symptoms. Five patients (26%) reported no improvement over time, while nine (47%) showed improvement and four (21%) stated good recovery. Only one patient (5%) claimed complete symptom remission. In the present study, 11% of the patients presented with a de novo postoperative affection of the trigeminal nerve after removal of a cranial base meningioma; 37% of these reported daily/severe symptoms. Only 26% showed good recovery, observed in patients without tumour infiltration of the nerve or intraoperative nerve damage. In spite of frequent complaints of numbness, pain was uncommon (16%) and often manageable by pharmacotherapy, while ocular symptoms turned out to be more frequent and more disabling than expected.

A dosimetric evaluation of the Eclipse AAA algorithm and Millennium 120 MLC for cranial intensity-modulated radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Calvo Ortega, Juan Francisco, E-mail: jfcdrr@yahoo.es; Moragues, Sandra; Pozo, Miquel

2014-07-01

The aim of this study is to assess the accuracy of a convolution-based algorithm (anisotropic analytical algorithm [AAA]) implemented in the Eclipse planning system for intensity-modulated radiosurgery (IMRS) planning of small cranial targets by using a 5-mm leaf-width multileaf collimator (MLC). Overall, 24 patient-based IMRS plans for cranial lesions of variable size (0.3 to 15.1 cc) were planned (Eclipse, AAA, version 10.0.28) using fixed field-based IMRS produced by a Varian linear accelerator equipped with a 120 MLC (5-mm width on central leaves). Plan accuracy was evaluated according to phantom-based measurements performed with radiochromic film (EBT2, ISP, Wayne, NJ). Film 2Dmore » dose distributions were performed with the FilmQA Pro software (version 2011, Ashland, OH) by using the triple-channel dosimetry method. Comparison between computed and measured 2D dose distributions was performed using the gamma method (3%/1 mm). Performance of the MLC was checked by inspection of the DynaLog files created by the linear accelerator during the delivery of each dynamic field. The absolute difference between the calculated and measured isocenter doses for all the IMRS plans was 2.5% ± 2.1%. The gamma evaluation method resulted in high average passing rates of 98.9% ± 1.4% (red channel) and 98.9% ± 1.5% (blue and green channels). DynaLog file analysis revealed a maximum root mean square error of 0.46 mm. According to our results, we conclude that the Eclipse/AAA algorithm provides accurate cranial IMRS dose distributions that may be accurately delivered by a Varian linac equipped with a Millennium 120 MLC.« less

Comparative investigations on the upper respiratory tract in Norwich terriers, brachycephalic and mesaticephalic dogs.

PubMed

Koch, D A; Rosaspina, M; Wiestner, T; Arnold, S; Montavon, P M

2014-03-01

For some time Norwich terriers have been known to suffer from respiratory problems. In order to assign this weakness to a pathophysiology, 23 terriers were examined clinically, with laryngoscope and with rhinomanometry. In addition their skulls were dimensioned on radiographs. Widened nostrils, overlong soft palates and the everted laryngeal pouches were consistent with brachycephalic syndrome. Resistance values in the nasal passage corresponded to the appearance in brachycephalic dogs. Skull measurements gave inconsistent results, because length to width ratios and craniofacial angles denoted mesaticephaly, whereas the facial to cranial length ratios (S-index = 0.65) lay in the brachycephalic sector. It can be concluded, that the Norwich terrier breed is in transition towards brachycephaly with some individual dogs already suffering from the brachycephalic syndrome. Breeders are requested to introduce necessary counter measures.

Endoscopy in neuro-otologic surgery.

PubMed

Wackym, Phillip A; King, Wesley A; Meyer, Glenn A; Poe, Dennis S

2002-04-01

Endoscopy offers several distinct advantages over the operating microscope during neuro-otologic surgery that make it an excellent adjunctive tool to the microscope or independent modality during cranial base surgery. The high magnification gives excellent definition of perforating blood vessels, cranial nerves, and neural structures, which in many cases is superior to that achieved with the microscope. Furthermore, the use of angled or flexible endoscopes allows one to look around corners and behind anatomic structures blocking the view seen via a 0 degree microscope. Endoscopy also has the theoretical advantage that a less invasive operative procedure is required, which should reduce the operative morbidity. Several notable disadvantages of endoscopy include the problems associated with blood soiling the endoscope, making visualization difficult or impossible, the lack of readily available instrumentation designed specifically for endoscopic neuro-otology, and the poor overview of the operative field. This last point is an important one because the endoscope is placed adjacent to the lesion and does not allow one to look backward to prevent [figure: see text] injury to structures next to the shaft of the telescope. Furthermore, the surgeon must be cognizant of potential thermal injury to structures caused by the heat generated by the light source. The present endoscopic technology limits the image that the surgeon sees to two dimensions, which results in certain unique problems when operating in a three-dimensional milieu. Because of this, there is a steep learning curve to acquire endoscopic dexterity and three-dimensional orientation. Finally, bimanual operation requires the use of an articulated endoscope holder or the commitment of the co-surgeon to hold the endoscope. One of the limitations of the operative microscope is that the angle of view is determined by the distance of the lens to the skull, retractor, or obstructing tissue, which is a function of the lens focal length; the longer the focal length, the narrower the viewing angle. During most microsurgical procedures, the focal distance varies between 200 and 400 mm. Using a previous analogy, if one looks through a door's keyhole at close range, nearly the entire room on the opposite side of the door can be seen, although nothing can be seen when the hole is viewed from a long distance. This is similar to what happens when using the endoscope with focal lengths ranging from 5 to 20 mm: a wider angle of view can be achieved. Based on their, experience the authors believe that endoscopes can be used safely during neuro-otologic surgery. As an adjunct to or substitution for the operative microscope, this modality does improve visualization of bony, neural, and vascular structures while minimizing cerebellar retraction.

Cranial Arterial Patterning in Greyhounds: Another Case of Internal Intraspecific Variation.

PubMed

Pols, S; Henneberg, M; Norris, R

2016-06-01

The greyhound is a dog breed highly specialized to run fast (17 m/s) over short distances (Usherwood and Wilson, 2005). As a result, there are many anatomical structures correlated with this sprinting function. The branching patterns of vasculature supplying blood to the head, forelimbs and thorax (subclavian arteries and its branches) were described in 34 adult greyhound cadavers (22 male, 12 female) (donated with owner consent and used under a memorandum of understanding with the University of Adelaide Animal Ethics Committee) from silicone casts of the arch of the aorta and the cranial arteries. Chi-squared analysis was used to test for pattern frequency differences, and t-tests were used to analyse the differences between sex and symmetry. All measurements were scaled to a fixed measure, the Open Thorax Length (OTL), to correct for size variation between individuals. Significant differences were found between the left and right subclavian arteries in the greyhound. The length to the first branch as a percentage of the OTL was greater in the right subclavian artery than the left subclavian artery (P < 0.001). The interval between the first and last branches (branching interval) as a percentage of the OTL was larger in the left subclavian artery than the right subclavian artery (P < 0.001). The reason for these differences remains unclear. Nonetheless, intraspecific variations of the branching patterns of the subclavian arteries have been described in the greyhound, thus suggesting that breed-specific variations in the cardiovascular system are likely to occur throughout domestic dogs. © 2015 Blackwell Verlag GmbH.

Effects of snout dimensions on the hydrodynamics of suction feeding in juvenile and adult seahorses.

PubMed

Roos, Gert; Van Wassenbergh, Sam; Aerts, Peter; Herrel, Anthony; Adriaens, Dominique

2011-01-21

Seahorses give birth to juveniles having a fully functional feeding apparatus, and juvenile feeding behaviour shows striking similarities to that of adults. However, a significant allometric growth of the snout is observed during which the snout shape changes from relatively short and broad in juveniles to relatively long and slender in adults. Since the shape of the buccal cavity is a critical determinant of the suction performance, this snout allometry will inevitably affect the suction feeding ability. To test whether the snout is optimised for suction feeding throughout an ontogeny, we simulated the expansion of different snout shapes varying from extremely long and slender to short and broad for juvenile and adult snout sizes, using computational fluid dynamic models. Our results showed that the snout diameter at the start of the simulations is involved in a trade-off between the realizable suction volume and expansion time on the one hand (improving with larger initial diameters), and maximal flow velocity on the other hand (improving with smaller initial diameters). Moreover suction performance (suction volume as well as maximal attainable flow velocity) increased with decreasing snout length. However, an increase in snout length decreases the time to reach the prey by the cranial rotation, which may explain the prevalence of long snouts among syngnathid fishes despite the reduced suction performance. Thus, the design of the seahorse snout revolves around a trade-off between the ability to generate high-volume suction versus minimisation of the time needed to reach the prey by the cranial rotation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Infant brain structures, executive function, and attention deficit/hyperactivity problems at preschool age. A prospective study.

PubMed

Ghassabian, Akhgar; Herba, Catherine M; Roza, Sabine J; Govaert, Paul; Schenk, Jacqueline J; Jaddoe, Vincent W; Hofman, Albert; White, Tonya; Verhulst, Frank C; Tiemeier, Henning

2013-01-01

Neuroimaging findings have provided evidence for a relation between variations in brain structures and attention deficit/hyperactivity disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the prospective association between brain structures measured during infancy and executive function and attention deficit/hyperactivity problems assessed at preschool age. In the Generation R Study, the corpus callosum length, the gangliothalamic ovoid diameter (encompassing the basal ganglia and thalamus), and the ventricular volume were measured in 784 6-week-old children using cranial postnatal ultrasounds. Parents rated executive functioning at 4 years using the behavior rating inventory of executive function-preschool version in five dimensions: inhibition, shifting, emotional control, working memory, and planning/organizing. Attention deficit/hyperactivity problems were assessed at ages 3 and 5 years using the child behavior checklist. A smaller corpus callosum length during infancy was associated with greater deficits in executive functioning at 4 years. This was accounted for by higher problem scores on inhibition and emotional control. The corpus callosum length during infancy did not predict attention deficit/hyperactivity problem at 3 and 5 years, when controlling for the confounders. We did not find any relation between gangliothalamic ovoid diameter and executive function or Attention deficit/hyperactivity problem. Variations in brain structures detectible in infants predicted subtle impairments in inhibition and emotional control. However, in this population-based study, we could not demonstrate that early structural brain variations precede symptoms of ADHD. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Structural and functional anatomy of the neck musculature of the dog (Canis familiaris)

PubMed Central

Sharir, Amnon; Milgram, Joshua; Shahar, Ron

2006-01-01

The morphometric properties and the anatomical relationships of the entire musculature of the canine cervical spine are reported herein. These data were obtained from the dissection of cadavers of six dogs. Total muscle length, muscle weight, fascicle length and angles of pennation were recorded for each muscle comprising the canine cervical spine. Based upon these properties, physiological cross-section area (PCSA) and architectural index were estimated. When scaled by whole body mass, the values of each of these parameters were found to be similar between all dogs. Muscles that course from the cranial neck to the shoulder girdle or the rib cage (e.g. brachiocephalicus and rhomboideus capitis) were found to have relatively long fascicles and low PCSA values and thus appear to be designed for rapid excursions. By contrast, muscles that primarily support the neck and shoulder against gravitational forces (e.g. serratus ventralis and trapezius) were found to have relatively high PCSA values and short fascicle lengths, and thus have the capacity to generate large forces. Differences of morphometry as well as nomenclature were found between the canine and human neck musculature. Nevertheless, many similarities exist; in particular, both species have similar muscles adapted to force generation or large excursions. We thus conclude that the canine neck may be used as a modelling tool for biomechanical investigations of the human cervical region as long as the differences listed are borne in mind. PMID:16533316

The Association of Unfavorable Outcomes with the Intensity of Neurosurgical Care in the United States

PubMed Central

2014-01-01

Object There is wide regional variability in the volume of procedures performed for similar surgical patients throughout the United States. We investigated the association of the intensity of neurosurgical care (defined as the average annual number of neurosurgical procedures per capita) with mortality, length of stay (LOS), and rate of unfavorable discharge for inpatients after neurosurgical procedures. Methods We performed a retrospective cohort study involving the 202,518 patients who underwent cranial neurosurgical procedures from 2005–2010 and were registered in the National Inpatient Sample (NIS) database. Regression techniques were used to investigate the association of the average intensity of neurosurgical care with the average mortality, LOS, and rate of unfavorable discharge. Results The inpatient neurosurgical mortality, rate of unfavorable discharge, and average LOS varied significantly among several states. In a multivariate analysis male gender, coverage by Medicaid, and minority racial status were associated with increased mortality, rate of unfavorable discharge, and LOS. The opposite was true for coverage by private insurance, higher income, fewer comorbidities and small hospital size. There was no correlation of the intensity of neurosurgical care with the mortality (Pearson's ρ = −0.18, P = 0.29), rate of unfavorable discharge (Pearson's ρ = 0.08, P = 0.62), and LOS of cranial neurosurgical procedures (Pearson's ρ = −0.21, P = 0.22). Conclusions We observed significant disparities in mortality, LOS, and rate of unfavorable discharge for cranial neurosurgical procedures in the United States. Increased intensity of neurosurgical care was not associated with improved outcomes. PMID:24647225

Cranial irradiation compromises neuronal architecture in the hippocampus.

PubMed

Parihar, Vipan Kumar; Limoli, Charles L

2013-07-30

Cranial irradiation is used routinely for the treatment of nearly all brain tumors, but may lead to progressive and debilitating impairments of cognitive function. Changes in synaptic plasticity underlie many neurodegenerative conditions that correlate to specific structural alterations in neurons that are believed to be morphologic determinants of learning and memory. To determine whether changes in dendritic architecture might underlie the neurocognitive sequelae found after irradiation, we investigated the impact of cranial irradiation (1 and 10 Gy) on a range of micromorphometric parameters in mice 10 and 30 d following exposure. Our data revealed significant reductions in dendritic complexity, where dendritic branching, length, and area were routinely reduced (>50%) in a dose-dependent manner. At these same doses and times we found significant reductions in the number (20-35%) and density (40-70%) of dendritic spines on hippocampal neurons of the dentate gyrus. Interestingly, immature filopodia showed the greatest sensitivity to irradiation compared with more mature spine morphologies, with reductions of 43% and 73% found 30 d after 1 and 10 Gy, respectively. Analysis of granule-cell neurons spanning the subfields of the dentate gyrus revealed significant reductions in synaptophysin expression at presynaptic sites in the dentate hilus, and significant increases in postsynaptic density protein (PSD-95) were found along dendrites in the granule cell and molecular layers. These findings are unique in demonstrating dose-responsive changes in dendritic complexity, synaptic protein levels, spine density and morphology, alterations induced in hippocampal neurons by irradiation that persist for at least 1 mo, and that resemble similar types of changes found in many neurodegenerative conditions.

Ultrasound assessment of cranial spread during caudal blockade in children: the effect of different volumes of local anaesthetics.

PubMed

Brenner, L; Marhofer, P; Kettner, S C; Willschke, H; Machata, A-M; Al-Zoraigi, U; Lundblad, M; Lönnqvist, P A

2011-08-01

Despite the large amount of literature on caudal anaesthesia in children, the issue of volume of local anaesthetics and cranial spread is still not settled. Thus, the aim of the present prospective randomized study was to evaluate the cranial spread of caudally administered local anaesthetics in children by means of real-time ultrasound, with a special focus on the effects of using different volumes of local anaesthetics. Seventy-five children, 1 month to 6 yr, undergoing inguinal hernia repair or more distal surgery were randomized to receive a caudal block with 0.7, 1.0, or 1.3 ml kg(-1) ropivacaine. The cranial spread of the local anaesthetic within the spinal canal was assessed by real-time ultrasound scanning; the absolute cranial segmental level and the cranial level relative to the conus medullaris were determined. All the blocks were judged to be clinically successful. A significant correlation was found between the injected volume and the cranial level reached by the local anaesthetic both with regards to the absolute cranial segmental level and the cranial level relative to the conus medullaris. The main finding of the present study was positive, but numerically small correlation between injected volumes of local anaesthetic and the cranial spread of caudally administered local anaesthetics. Therefore, the prediction of the cranial spread of local anaesthetic, depending on the injected volume of the local anaesthetic, was not possible. EudraCT Number: 2008-007627-40.

Humans preserve non-human primate pattern of climatic adaptation

NASA Astrophysics Data System (ADS)

Buck, Laura T.; De Groote, Isabelle; Hamada, Yuzuru; Stock, Jay T.

2018-07-01

There is evidence for early Pleistocene Homo in northern Europe, a novel hominin habitat. Adaptations enabling this colonisation are intriguing given suggestions that Homo exhibits physiological and behavioural malleability associated with a 'colonising niche'. Differences in body size/shape between conspecifics from different climates are well-known in mammals, could relatively flexible size/shape have been important to Homo adapting to cold habitats? If so, at what point did this evolutionary stragegy arise? To address these questions a base-line for adaptation to climate must be established by comparison with outgroups. We compare skeletons of Japanese macaques from four latitudes and find inter-group differences in postcranial and cranial size and shape. Very small body mass and cranial size in the Southern-most (island) population are most likely affected by insularity as well as ecogeographic scaling. Limb lengths and body breadths show group differences that accord with the expectations of thermoregulation across the whole range of latitudes. Postcranial size appears to vary more than shape, yet there is also evidence that limb segments follow Allen's rule in the forelimb at least, suggesting differing climatic signals in different regions of the skeleton. In contrast to other intraspecific studies of catarrhine ecogeography, the results presented here demonstrate non-allometric latitudinal patterns in craniofacial shape in Japanese macaques, which align closely with what is seen in cold-adapted humans. These insights begin to provide a comparison for hominin adaptation to similar habitat diversity and the role of biological adaptation in shaping the evolution and dispersal of Homo species.

The postcranial skeletal maturation of Australopithecus sediba.

PubMed

Cameron, Noel; Bogin, Barry; Bolter, Debra; Berger, Lee R

2017-07-01

In 2008, an immature hominin defined as the holotype of the new species Australopithecus sediba was discovered at the 1.9 million year old Malapa site in South Africa. The specimen (MH1) includes substantial post-cranial skeletal material, and provides a unique opportunity to assess its skeletal maturation. Skeletal maturity indicators observed on the proximal and distal humerus, proximal ulna, distal radius, third metacarpal, ilium and ischium, proximal femur and calcaneus were used to assess the maturity of each bone in comparison to references for modern humans and for wild chimpanzees (Pan troglodytes). In comparison to humans the skeletal maturational ages for Au. sediba correspond to between 12.0 years and 15.0 years with a mean (SD) age of 13.1 (1.1) years. In comparison to the maturational pattern of chimpanzees the Au. sediba indicators suggest a skeletal maturational age of 9-11 years. Based on either of these skeletal maturity estimates and the body length at death of MH1, an adult height of 150-156 cm is predicted. We conclude that the skeletal remains of MH1 are consistent with an ape-like pattern of maturity when dental age estimates are also taken into consideration. This maturity schedule in australopiths is consistent with ape-like estimates of age at death for the Nariokotome Homo erectus remains (KMN-WT 15000), which are of similar postcranial immaturity to MH1. The findings suggest that humans may have distinctive and delayed post-cranial schedules from australopiths and H. erectus, implicating a recent evolution of somatic and possibly life history strategies in human evolution. © 2017 Wiley Periodicals, Inc.

In vitro regulation of proliferation and differentiation within a postnatal growth plate of the cranial base by parathyroid hormone-related peptide (PTHrP).

PubMed

Wealthall, Rosamund J

2009-06-01

Parathyroid hormone-related peptide (PTHrP) is known to be an important regulator of chondrocyte differentiation in embryonic growth plates, but little is known of its role in postnatal growth plates. The present study explores the role of PTHrP in regulating postnatal chondrocyte differentiation using a novel in vitro organ culture model based on the ethmoidal growth plate of the cranial base taken from the postnatal day 10 mouse. In vitro the ethmoidal growth plate continued to mineralize and the chondrocytes progressed to hypertrophy, as observed in vivo, but the proliferative zone was not maintained. Treatment with PTHrP inhibited mineralization and reduced alkaline phosphatase (ALP) activity in the hypertrophic zone in the ethmoidal growth plates grown ex vivo, and also increased the proliferation of non-hypertrophic chondrocytes. In addition, exogenous PTHrP reduced the expression of genes associated with terminal differentiation: type X collagen, Runx2, and ALP, as well as the PTH/PTHrP receptor (PPR). Activation of the protein kinase A pathway using 8-Br-cAMP mimicked some of these pro-proliferative/anti-differentiative effects of PTHrP. PTHrP and PPR were found to be expressed within the ethmoidal growth plate using semi-quantitative PCR, and in other cranial growth plates such as the spheno-occipital and pre-sphenoidal synchondroses. These results provide the first functional evidence that PTHrP regulates proliferation and differentiation within the postnatal, cranial growth plate. J. Cell. Physiol. 219: 688-697, 2009. (c) 2009 Wiley-Liss, Inc.

The naming of the cranial nerves: a historical review.

PubMed

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

2014-01-01

The giants of medicine and anatomy have each left their mark on the history of the cranial nerves, and much of the history of anatomic study can be viewed through the lens of how the cranial nerves were identified and named. A comprehensive literature review on the classification of the cranial names was performed. The identification of the cranial nerves began with Galen in the 2nd century AD and evolved up through the mid-20th century. In 1778, Samuel Sömmerring, a German anatomist, classified the 12 cranial nerves as we recognize them today. This review expands on the excellent investigations of Flamm, Shaw, and Simon et al., with discussion of the historical identification as well as the process of naming the human cranial nerves. Copyright © 2013 Wiley Periodicals, Inc.

The cranial nuchal bursa: anatomy, ultrasonography, magnetic resonance imaging and endoscopic approach.

PubMed

Abuja, G A; García-López, J M; Manso-Díaz, G; Spoormakers, T J P; Taeymans, O

2014-11-01

Although an uncommon condition, cranial nuchal bursitis can affect the performance of the equine athlete. The anatomy is not well described and there are no reports of diagnostic imaging for endoscopic approaches. To describe the anatomy, ultrasonographic and magnetic resonance features of and endoscopic approach to the cranial nuchal bursa in horses. Experimental cadaver study. Four cranial nuchal bursae were dissected, 4 specimens were frozen to prepare anatomical sections and 2 were injected with latex to document surface landmarks and topographical anatomy and to identify the possible sites for endoscopic access. Six cadaveric specimens were used to describe the ultrasonographic and magnetic resonance features of the cranial nuchal bursa before and after intrabursal injection. Sixteen cadaver specimens were evaluated with a rigid arthroscope and gross dissection to determine the endoscopic appearance of the bursa. The cranial nuchal bursa could be identified consistently in all cadavers, using ultrasonographic and magnetic resonance on both pre- and post injection specimens. Cranial and caudal endoscopic approaches and instrument portals were developed for the cranial nuchal bursa. Using either approach, the entire extent of the bursa could be evaluated, but separate approaches for left and right compartments of the bursa were needed owing to the lack of manoeuvrability when examining the contralateral compartment. The cranial nuchal bursa can be identified on ultrasonographic and magnetic resonance images. An endoscopic approach to the cranial nuchal bursa is clinically feasible and offered an easy, repeatable entry into the cranial nuchal bursa, which allowed adequate observation of the structures within the bursa. This may be of help for diagnosis and treatment of conditions affecting the cranial nuchal bursa in horses. © 2014 EVJ Ltd.

Risk of Deep vein thrombosis in neurosurgery: State of the art on prophylaxis protocols and best clinical practices.

PubMed

Ganau, Mario; Prisco, Lara; Cebula, Helene; Todeschi, Julien; Abid, Houssem; Ligarotti, Gianfranco; Pop, Raoul; Proust, Francois; Chibbaro, Salvatore

2017-11-01

To analytically discuss some protocols in Deep vein thrombosis (DVT)/pulmonary Embolism (PE) prophylaxis currently use in Neurosurgical Departments around the world. Analysis of the prophylaxis protocols in the English literature: An analytical and narrative review of literature concerning DVT prophylaxis protocols in Neurosurgery have been conducted by a PubMed search (back to 1978). 80 abstracts were reviewed, and 74 articles were extracted. The majority of DVT seems to develop within the first week after a neurosurgical procedure, and a linear correlation between the duration of surgery and DVT occurrence has been highlighted. The incidence of DVT seems greater for cranial (7.7%) than spinal procedures (1.5%). Although intermittent pneumatic compression (IPC) devices provided adequate reduction of DVT/PE in some cranial and combined cranial/spinal series, low-dose subcutaneous unfractionated heparin (UFH) or low molecular-weight heparin (LMWH) further reduced the incidence, not always of DVT, but of PE. Nevertheless, low-dose heparin-based prophylaxis in cranial and spinal series risks minor and major postoperative haemorrhages: 2-4% in cranial series, 3.4% minor and 3.4% major haemorrhages in combined cranial/spinal series, and a 0.7% incidence of major/minor haemorrhages in spinal series. This analysis showed that currently most of the articles are represented by case series and case reports. As long as clear guidelines will not be defined and universally applied to this diverse group of patients, any prophylaxis for DVT and PE should be tailored to the individual patient with cautious assessment of benefits versus risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of cranial and thoracic electromyography within diagnostic criteria for amyotrophic lateral sclerosis.

PubMed

Jenkins, Thomas M; Alix, James J P; Kandler, Rosalind H; Shaw, Pamela J; McDermott, Christopher J

2016-09-01

The contribution of cranial and thoracic region electromyography (EMG) to diagnostic criteria for amyotrophic lateral sclerosis (ALS) has not been evaluated. Clinical and EMG data from each craniospinal region were retrospectively assessed in 470 patients; 214 had ALS. Changes to diagnostic classification in Awaji-Shima and revised El Escorial criteria after withdrawal of cranial/thoracic EMG data were ascertained. Sensitivity for lower motor neuron involvement in ALS was highest in the cervical/lumbar regions; specificity was highest in cranial/thoracic regions. Cranial EMG contributed to definite/probable Awaji-Shima categorization in 1.4% of patients. Thoracic EMG made no contribution. For revised El Escorial criteria, cranial and thoracic data reclassified 1% and 5% of patients, respectively. Cranial EMG data make small contributions to both criteria, whereas thoracic data contribute only to the revised El Escorial criteria. However, cranial and thoracic region abnormalities are specific in ALS. Consideration should be given to allowing greater diagnostic contribution from thoracic EMG. Muscle Nerve 54: 378-385, 2016. © 2016 Wiley Periodicals, Inc.

Imaging of Cranial Nerves III, IV, VI in Congenital Cranial Dysinnervation Disorders

PubMed Central

Kim, Jae Hyoung

2017-01-01

Congenital cranial dysinnervation disorders are a group of diseases caused by abnormal development of cranial nerve nuclei or their axonal connections, resulting in aberrant innervation of the ocular and facial musculature. Its diagnosis could be facilitated by the development of high resolution thin-section magnetic resonance imaging. The purpose of this review is to describe the method to visualize cranial nerves III, IV, and VI and to present the imaging findings of congenital cranial dysinnervation disorders including congenital oculomotor nerve palsy, congenital trochlear nerve palsy, Duane retraction syndrome, Möbius syndrome, congenital fibrosis of the extraocular muscles, synergistic divergence, and synergistic convergence. PMID:28534340

38 CFR 4.123 - Neuritis, cranial or peripheral.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Neuritis, cranial or....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

38 CFR 4.123 - Neuritis, cranial or peripheral.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Neuritis, cranial or....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

38 CFR 4.123 - Neuritis, cranial or peripheral.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Neuritis, cranial or....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

38 CFR 4.123 - Neuritis, cranial or peripheral.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Neuritis, cranial or....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

38 CFR 4.123 - Neuritis, cranial or peripheral.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Neuritis, cranial or....123 Neuritis, cranial or peripheral. Neuritis, cranial or peripheral, characterized by loss of... the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete...

Effect of Tibial Plateau Levelling Osteotomy on Cranial Tibial Subluxation in the Feline Cranial Cruciate Deficient Stifle Joint: An Ex Vivo Experimental Study.

PubMed

Bilmont, A; Retournard, M; Asimus, E; Palierne, S; Autefage, A

2018-06-11

 This study evaluated the effects of tibial plateau levelling osteotomy on cranial tibial subluxation and tibial rotation angle in a model of feline cranial cruciate ligament deficient stifle joint.  Quadriceps and gastrocnemius muscles were simulated with cables, turnbuckles and a spring in an ex vivo limb model. Cranial tibial subluxation and tibial rotation angle were measured radiographically before and after cranial cruciate ligament section, and after tibial plateau levelling osteotomy, at postoperative tibial plateau angles of +5°, 0° and -5°.  Cranial tibial subluxation and tibial rotation angle were not significantly altered after tibial plateau levelling osteotomy with a tibial plateau angle of +5°. Additional rotation of the tibial plateau to a tibial plateau angle of 0° and -5° had no significant effect on cranial tibial subluxation and tibial rotation angle, although 2 out of 10 specimens were stabilized by a postoperative tibial plateau angle of -5°. No stabilization of the cranial cruciate ligament deficient stifle was observed in this model of the feline stifle, after tibial plateau levelling osteotomy.  Given that stabilization of the cranial cruciate ligament deficient stifle was not obtained in this model, simple transposition of the tibial plateau levelling osteotomy technique from the dog to the cat may not be appropriate. Schattauer GmbH Stuttgart.

Quantitative Analysis of Chiari-Like Malformation and Syringomyelia in the Griffon Bruxellois Dog

PubMed Central

Knowler, Susan P.; McFadyen, Angus K.; Freeman, Courtenay; Kent, Marc; Platt, Simon R.; Kibar, Zoha; Rusbridge, Clare

2014-01-01

This study aimed to develop a system of quantitative analysis of canine Chiari-like malformation and syringomyelia on variable quality MRI. We made a series of measurements from magnetic resonance DICOM images from Griffon Bruxellois dogs with and without Chiari-like malformation and syringomyelia and identified several significant variables. We found that in the Griffon Bruxellois dog, Chiari-like malformation is characterized by an apparent shortening of the entire cranial base and possibly by increased proximity of the atlas to the occiput. As a compensatory change, there appears to be an increased height of the rostral cranial cavity with lengthening of the dorsal cranial vault and considerable reorganization of the brain parenchyma including ventral deviation of the olfactory bulbs and rostral invagination of the cerebellum under the occipital lobes. PMID:24533070

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cranial drill handpiece (brace). 882.4325 Section... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is used...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cranial drill handpiece (brace). 882.4325 Section... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is used...

21 CFR 882.4360 - Electric cranial drill motor.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source used...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cranial drill handpiece (brace). 882.4325 Section... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill handpiece (brace). (a) Identification. A cranial drill handpiece (brace) is a hand holder, which is used...

21 CFR 882.4360 - Electric cranial drill motor.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source used...

21 CFR 882.4360 - Electric cranial drill motor.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source used...

21 CFR 882.4360 - Electric cranial drill motor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source used...

21 CFR 882.4360 - Electric cranial drill motor.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Electric cranial drill motor. 882.4360 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4360 Electric cranial drill motor. (a) Identification. An electric cranial drill motor is an electrically operated power source used...

38 CFR 4.124 - Neuralgia, cranial or peripheral.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Neuralgia, cranial or....124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the...

[From anatomy to image: the cranial nerves at MRI].

PubMed

Conforti, Renata; Marrone, Valeria; Sardaro, Angela; Faella, Pierluigi; Grassi, Roberta; Cappabianca, Salvatore

2013-01-01

In this article, we review the expected course of each of the 12 cranial nerves. Traditional magnetic resonance imaging depicts only the larger cranial nerves but SSFP sequences of magnetic resonance imaging are capable of depicting the cisternal segments of 12 cranial nerves and also provide submillimetric spatial resolution.

38 CFR 4.124 - Neuralgia, cranial or peripheral.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Neuralgia, cranial or....124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the...

38 CFR 4.124 - Neuralgia, cranial or peripheral.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Neuralgia, cranial or....124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the...

38 CFR 4.124 - Neuralgia, cranial or peripheral.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Neuralgia, cranial or....124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the...

38 CFR 4.124 - Neuralgia, cranial or peripheral.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Neuralgia, cranial or....124 Neuralgia, cranial or peripheral. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the...

Lower cranial nerves.

PubMed

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

2014-02-01

Imaging evaluation of cranial neuropathies requires thorough knowledge of the anatomic, physiologic, and pathologic features of the cranial nerves, as well as detailed clinical information, which is necessary for tailoring the examinations, locating the abnormalities, and interpreting the imaging findings. This article provides clinical, anatomic, and radiological information on lower (7th to 12th) cranial nerves, along with high-resolution magnetic resonance images as a guide for optimal imaging technique, so as to improve the diagnosis of cranial neuropathy. Copyright © 2014 Elsevier Inc. All rights reserved.

Twelfth cranial nerve involvement in Guillian Barre syndrome

PubMed Central

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

2013-01-01

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

Twelfth cranial nerve involvement in Guillian Barre syndrome.

PubMed

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

2013-07-01

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

Imaging of Cranial Nerves III, IV, VI in Congenital Cranial Dysinnervation Disorders.

PubMed

Kim, Jae Hyoung; Hwang, Jeong Min

2017-06-01

Congenital cranial dysinnervation disorders are a group of diseases caused by abnormal development of cranial nerve nuclei or their axonal connections, resulting in aberrant innervation of the ocular and facial musculature. Its diagnosis could be facilitated by the development of high resolution thin-section magnetic resonance imaging. The purpose of this review is to describe the method to visualize cranial nerves III, IV, and VI and to present the imaging findings of congenital cranial dysinnervation disorders including congenital oculomotor nerve palsy, congenital trochlear nerve palsy, Duane retraction syndrome, Möbius syndrome, congenital fibrosis of the extraocular muscles, synergistic divergence, and synergistic convergence. © 2017 The Korean Ophthalmological Society.

[Application of neuroendoscope in the treatment of skull base chordoma].

PubMed

Zhang, Ya-Zhuo; Wang, Zong-Cheng; Zong, Xu-Yi; Wang, Xin-Sheng; Gui, Song-Bai; Zhao, Peng; Li, Chu-Zhong; He, Yue; Wang, Hong-Yun

2011-07-05

To further explore the application, approach, indication and prognosis of neuroendoscope treatment for skull base chordoma. A total of 101 patients of skull base chordoma were admitted at our hospital from May 2000 to April 2010. There were 59 males and 42 females. Their major clinical manifestations included headache, cranial nerve damage and dyspnea. They were classified according to the patterns of tumor growth: Type I (n = 13): tumor location at a single component of skull base, i. e. clivus or sphenoid sinus with intact cranial dura; Type II (n = 56): tumor involving more than two components of skull e. g clivus, sphenoid and nasal/oral cavity, etc. But there was no intracranial invasion; Type III (n = 32) : tumor extending widely and intradurally forming compression of brain stems and multiple cranial nerves. Based on the types of chordoma, different endoscopic approaches were employed, viz. transnasal, transoral, trans-subtemporal fossa and plus microsurgical craniotomy for staging in some complex cases. Among all patients, total resection was achieved (n = 19), subtotal (n = 58) and partial (n = 24). In partial resection cases, 16 cases were considered to be subtotal due to a second-stage operation. Most cases had conspicuous clinical improvements. Self-care recovery within one week post-operation accounted for 58.4%, two weeks 30.7%, one month 6.9% and more than one month 1.9%. Postoperative complications occurred in 13 cases (12.8%) and included CSF leakage (n = 4) cranial nerve palsy (n = 5), hemorrhagic nasal wounds (n = 3) and delayed intracranial hemorrhage (n = 1). All of these were cured or improved after an appropriate treatment. A follow-up of 6 - 60 months was conducted in 56 cases. Early detection and early treatment are crucial for achieving a better outcome in chordoma. Neuroendoscopic treatment plays an important role in managing those complicated cases. Precise endoscopic techniques plus different surgical approaches and staging procedures are required to improve the post-operative quality of life for patients.

Skull base tumors: a comprehensive review of transfacial swing osteotomy approaches.

PubMed

Moreira-Gonzalez, Andrea; Pieper, Daniel R; Cambra, Jorge Balaguer; Simman, Richard; Jackson, Ian T

2005-03-01

Numerous techniques have been proposed for the resection of skull base tumors, each one unique with regard to the region exposed and degree of technical complexity. This study describes the use of transfacial swing osteotomies in accessing lesions located at various levels of the cranial base. Eight patients who underwent transfacial swings for exposure and resection of cranial base lesions between 1996 and 2002 were studied. The mandible was the choice when wide exposure of nasopharyngeal and midline skull base tumors was necessary, especially when they involved the infratemporal fossa. The midfacial swing osteotomy was an option when access to the entire clivus was necessary. An orbital swing approach was used to access large orbital tumors lying inferior to the optic nerve and posterior to the globe, a region that is often difficult to visualize. Gross total tumor excision was possible in all patients. Six patients achieved disease control and two had recurrences. The complications of cerebrospinal fluid leak, infection, hematoma, or cranial nerve damage did not occur. After surgery, some patients experienced temporary symptoms caused by local swelling. The aesthetic result was considered good. Transfacial swing osteotomies provide a wide exposure to tumors that occur in the central skull base area. Excellent knowledge of the detailed anatomy of this region is paramount to the success of this surgery. The team concept is essential; it is built around the craniofacial surgeon and an experienced skull base neurosurgeon.

Segmental distribution of high-volume caudal anesthesia in neonates, infants, and toddlers as assessed by ultrasonography.

PubMed

Lundblad, Märit; Lönnqvist, Per-Arne; Eksborg, Staffan; Marhofer, Peter

2011-02-01

The aim of this prospective, age-stratified, observational study was to determine the cranial extent of spread of a large volume (1.5 ml·kg(-1) , ropivacaine 0.2%), single-shot caudal epidural injection using real-time ultrasonography. Fifty ASA I-III children were included in the study, stratified in three age groups; neonates, infants (1-12 months), and toddlers (1-4 years). The caudal blocks were performed during ultrasonographic observation of the spread of local anesthetic (LA) in the epidural space. A significant inverse relationship was found between age, weight, and height, and the maximal cranial level reached by 1.5 ml·kg(-1) of LA. In neonates, 93% of the blocks reached a cranial level of ≥Th12 vs 73% and 25% in infants and toddlers, respectively. Based on our data, a predictive equation of segmental spread was generated: Dose (ml/spinal segment) = 0.1539·(BW in kg)-0.0937. This study found an inverse relationship between age, weight, and height and the number of segments covered by a caudal injection of 1.5 ml·kg(-1) of ropivacaine 0.2% in children 0-4 years of age. However, the cranial spread of local anesthetics within the spinal canal as assessed by immediate ultrasound visualization was found to be in poor agreement with previously published predictive equations that are based on actual cutaneous dermatomal testing. © 2010 Blackwell Publishing Ltd.

Virtual Reality-Based Simulators for Cranial Tumor Surgery: A Systematic Review.

PubMed

Mazur, Travis; Mansour, Tarek R; Mugge, Luke; Medhkour, Azedine

2018-02-01

Virtual reality (VR) simulators have become useful tools in various fields of medicine. Prominent uses of VR technologies include assessment of physician skills and presurgical planning. VR has shown effectiveness in multiple surgical specialties, yet its use in neurosurgery remains limited. To examine all current literature on VR-based simulation for presurgical planning and training in cranial tumor surgeries and to assess the quality of these studies. PubMed and Embase were systematically searched to identify studies that used VR for presurgical planning and/or studies that investigated the use of VR as a training tool from inception to May 25, 2017. The initial search identified 1662 articles. Thirty-seven full-text articles were assessed for inclusion. Nine studies were included. These studies were subdivided into presurgical planning and training using VR. Prospects for VR are bright when surgical planning and skills training are considered. In terms of surgical planning, VR has noted and documented usefulness in the planning of cranial surgeries. Further, VR has been central to establishing reproducible benchmarks of performance in relation to cranial tumor resection, which are helpful not only in showing face and construct validity but also in enhancing neurosurgical training in a way not previously examined. Although additional studies are needed to better delineate the precise role of VR in each of these capacities, these studies stand to show the usefulness of VR in the neurosurgery and highlight the need for further investigation. Published by Elsevier Inc.

Dispelling dog dogma: an investigation of heterochrony in dogs using 3D geometric morphometric analysis of skull shape.

PubMed

Drake, Abby Grace

2011-01-01

Heterochrony is an evolutionary mechanism that generates diversity via perturbations of the rate or timing of development that requires very little genetic innovation. As such, heterochrony is thought to be a common evolutionary mechanism in the generation of diversity. Previous research has suggested that dogs evolved via heterochrony and are paedomorphic wolves. This study uses three-dimensional landmark-based coordinate data to investigate heterochronic patterns within the skull morphology of the domestic dog. A total of 677 adult dogs representing 106 different breeds were measured and compared with an ontogenetic series of 401 wolves. Geometric morphometric analysis reveals that the cranial shape of none of the modern breeds of dogs resembles the cranial shapes of adult or juvenile wolves. In addition, investigations of regional heterochrony in the face and neurocranium also reject the hypothesis of heterochrony. Throughout wolf cranial development the position of the face and the neurocranium remain in the same plane. Dogs, however, have a de novo cranial flexion in which the palate is tilted dorsally in brachycephalic and mesaticephalic breeds or tilted ventrally in dolichocephalic and down-face breeds. Dogs have evolved very rapidly into an incredibly morphologically diverse species with very little genetic variation. However, the genetic alterations to dog cranial development that have produced this vast range of phylogenetically novel skull shapes do not coincide with the expectations of the heterochronic model. Dogs are not paedomorphic wolves. © 2011 Wiley Periodicals, Inc.

Traumatic brain injury with a machete penetrating the dura and brain: Case report from southeast Mexico.

PubMed

Del Castillo-Calcáneo, Juan D; Bravo-Angel, Ulises; Mendez-Olan, Raúl; Rodriguez-Valencia, Francisco; Valdés-García, Javier; García-González, Ulises; Broc-Haro, Guy G

2016-01-01

Traumatic Brain Injury (TBI) is a major cause of death and disability in our society, we present the first case report of non-missile penetrating (NMP) cranial trauma with a machete in Mexico, and our objective by presenting this case is to prove the usefulness of recently proposed algorithms in the treatment of NMP PRESENTATION OF CASE: We present the case of a 47 year old woman who received a machete hit to the right side of her head during an assault., she arrived fully conscious to the emergency department (ED), computed tomography was performed and based on the findings of this study and in accordance to recently proposed algorithms for managing NMP cranial trauma a craniotomy was performed, at follow-up the patient presented wtih minor neurological disability in the form of left hemiparesis. Non-missile penetrating (NMP) lesions are defined as having an impact velocity of less than 100m/s, causing injury by laceration and maceration, An algorithm for treating NMP cranial trauma has been recently published in the Journal World Neurosurgery by De Holanda et al., in this case we followed the algorithm in order to provide best care available for our patient with good results. The use of current algorithms for managing NMP cranial trauma has proved to be very useful when applied on this particular case. GCS on admission is an important prognostic factor in NMP cranial trauma. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

A metric analysis of Mumbai region (India) crania.

PubMed

Salve, Vishal M; Chandrashekhar, C H

2012-10-01

The human skull has been studied both metrically and non- metrically previously. These studies have thrown light on the functional and morphological aspect of the skull. Cranial index and other cranial indices are useful in differentiation of racial and gender difference. As studies on sexual dimorphism of cranium were very few we have taken this study to find out the differences in cranial index, vertical index and transverse vertical index of male and female crania at Mumbai region. This study was carried out on 210 (150 males and 60 females) dry human skulls available in department of anatomy of four Medical Colleges in Mumbai. The mean and SD of cranial index were 74.23 +/- 4.06; for males: 73.19 +/- 3.76, and for females: 76.84 +/- 3.63. The mean and SD of transverse vertical index were 100.84 +/- 6.31; for males: 102.19 +/- 6.15, and for females: 97.46 +/- 5.41. The difference between cranial index (p = 0.000000) and transverse vertical index (p = 0.000019) of male and female skulls were significant. The results of the present study show that majority of male skulls of Mumbai region belong to dolicocephalic group and majority of female skulls to mesocephalic.The result of present study shows that majority of male skulls of Mumbai region belong to acrocranial group (based on transverse vertical index). This data can be useful for forensic medicine experts, plastic surgeons, anatomist and oral surgeons for clinical and research purpose.

Anatomical Relationship Between the Kidney Collecting System and the Intrarenal Arteries in the Sheep: Contribution for a New Urological Model.

PubMed

Buys-Gonçalves, Gabriela Faria; De Souza, Diogo Benchimol; Sampaio, Francisco José Barcellos; Pereira-Sampaio, Marco Aurélio

2016-04-01

Previous studies have demonstrated that the pig collecting system heals after partial nephrectomy without closure. Recently, a study in sheep showed that partial nephrectomy without closure of the collecting system resulted in urinary leakage and urinoma. The aim of this study was to present detailed anatomical findings on the intrarenal anatomy of the sheep. Forty two kidneys were used to produce tridimensional endocasts of the collecting system together with the intrarenal arteries. A renal pelvis which displayed 11-19 (mean of 16) renal recesses was present. There were no calices present. The renal artery was singular in each kidney and gave two primary branches one to the dorsal surface and one to ventral surface. Dorsal and ventral branches of the renal artery were classified based on the relationship between their branching pattern and the collecting system as: type I (cranial and caudal segmental arteries), type II (cranial, middle and caudal segmental arteries) or type III (cranial, cranial middle, caudal middle, and caudal segmental arteries). Type I was the most common branching pattern for the dorsal and ventral branches of the renal artery. The arterial supply of the caudal pole of the sheep kidney supports its use as an experimental model due to the similarity to the human kidney. However, the lack of a retropelvic artery discourages the use of the cranial pole in experiments in which the arteries are an important aspect to be considered. © 2016 Wiley Periodicals, Inc.

Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination.

PubMed

Wessely, Marlis; Reese, Sven; Schnabl-Feichter, Eva

2017-06-01

Objectives The aim of this study was to examine histologically intact and ruptured cranial cruciate ligaments in cats, in order to evaluate whether degeneration is a prerequisite for rupture. Methods We performed a histological examination of 50 intact and 19 ruptured cranial cruciate ligaments in cadaver or client-owned cats, respectively, using light microscopy. Cats with stifle pathology were further divided into five age groups in order to investigate the relationship of changes in the ligament with lifespan. Cats with ruptured cranial cruciate ligaments were divided into two groups according to medical history (with presumed history of trauma or without any known history of trauma) in order to investigate the relationship of ligament rupture with a traumatic event. Data from 200 healthy cats were selected randomly and reviewed to make a statistical comparison of cats with and without cranial cruciate ligament rupture (reference group). Results On histological examination, the intact cranial cruciate ligaments showed basic parallel arrangement of the collagen fibres, with no relation to age. While cats of a more advanced age showed fibrocartilage in the middle of the cranial cruciate ligament - a likely physiological reaction to compression forces over the lifespan - degenerative changes within the fibrocartilage were absent in all cases, regardless of age or rupture status. Cats suffering from cranial cruciate ligament rupture without history of trauma were significantly older than cats in the reference group. Conclusions and relevance This study showed that differentiation of fibrocartilage in the middle of the cranial cruciate ligament is likely a physiological reaction to compressive forces and not a degenerative change associated with greater risk of rupture in advanced age. This finding in cats is distinct from the known decrease in differentiation of fibrocartilage in dogs with cranial cruciate ligament rupture. Furthermore, the histological examination of cats revealed no other signs of degeneration in the cranial cruciate ligaments. Thus, degeneration is likely not an aetiological factor for cranial cruciate ligament rupture in cats.

Improved identification of cranial nerves using paired-agent imaging: topical staining protocol optimization through experimentation and simulation

NASA Astrophysics Data System (ADS)

Torres, Veronica C.; Wilson, Todd; Staneviciute, Austeja; Byrne, Richard W.; Tichauer, Kenneth M.

2018-03-01

Skull base tumors are particularly difficult to visualize and access for surgeons because of the crowded environment and close proximity of vital structures, such as cranial nerves. As a result, accidental nerve damage is a significant concern and the likelihood of tumor recurrence is increased because of more conservative resections that attempt to avoid injuring these structures. In this study, a paired-agent imaging method with direct administration of fluorophores is applied to enhance cranial nerve identification. Here, a control imaging agent (ICG) accounts for non-specific uptake of the nerve-targeting agent (Oxazine 4), and ratiometric data analysis is employed to approximate binding potential (BP, a surrogate of targeted biomolecule concentration). For clinical relevance, animal experiments and simulations were conducted to identify parameters for an optimized stain and rinse protocol using the developed paired-agent method. Numerical methods were used to model the diffusive and kinetic behavior of the imaging agents in tissue, and simulation results revealed that there are various combinations of stain time and rinse number that provide improved contrast of cranial nerves, as suggested by optimal measures of BP and contrast-to-noise ratio.

Bioinspired Collagen Scaffolds in Cranial Bone Regeneration: From Bedside to Bench

PubMed Central

Volpicelli, Elizabeth J.

2018-01-01

Calvarial defects are common reconstructive dilemmas secondary to a variety of etiologies including traumatic brain injury, cerebrovascular disease, oncologic resection, and congenital anomalies. Reconstruction of the calvarium is generally undertaken for the purposes of cerebral protection, contour restoration for psychosocial well-being, and normalization of neurological dysfunction frequently found in patients with massive cranial defects. Current methods for reconstruction using autologous grafts, allogeneic grafts, or allo-plastic materials have significant drawbacks that are unique to each material. The combination of wide medical relevance and the need for a better clinical solution render defects of the cranial skeleton an ideal target for development of regenerative strategies focused on calvarial bone. With the improved understanding of the instructive properties of tissue-specific extracellular matrices and the advent of precise nanoscale modulation in materials science, strategies in regenerative medicine have shifted in paradigm. Previously considered to be simple carriers of stem cells and growth factors, increasing evidence exists for differential materials directing lineage specific differentiation of progenitor cells and tissue regeneration. In this work, we review the clinical challenges for calvarial reconstruction, the anatomy and physiology of bone, and extracellular matrix-inspired, collagen-based materials that have been tested for in vivo cranial defect healing. PMID:28585295

Development and validation of technique for in-vivo 3D analysis of cranial bone graft survival

NASA Astrophysics Data System (ADS)

Bernstein, Mark P.; Caldwell, Curtis B.; Antonyshyn, Oleh M.; Ma, Karen; Cooper, Perry W.; Ehrlich, Lisa E.

1997-05-01

Bone autografts are routinely employed in the reconstruction of facial deformities resulting from trauma, tumor ablation or congenital malformations. The combined use of post- operative 3D CT and SPECT imaging provides a means for quantitative in vivo evaluation of bone graft volume and osteoblastic activity. The specific objectives of this study were: (1) Determine the reliability and accuracy of interactive computer-assisted analysis of bone graft volumes based on 3D CT scans; (2) Determine the error in CT/SPECT multimodality image registration; (3) Determine the error in SPECT/SPECT image registration; and (4) Determine the reliability and accuracy of CT-guided SPECT uptake measurements in cranial bone grafts. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split skull bone grafts and reconstructed to skull and malar recipient sites. To acquire all images, each specimen was CT scanned and coated with Technetium doped paint. For purposes of validation, skulls were landmarked with 1/16-inch ball-bearings and Indium. This study provides a new technique relating anatomy and physiology for the analysis of cranial bone graft survival.

Feasibility study using a Ni-Ti stent and electronic portal imaging to localize the prostate during radiotherapy.

PubMed

Carl, Jesper; Lund, Bente; Larsen, Erik Hoejkjaer; Nielsen, Jane

2006-02-01

A new method for localization of the prostate during external beam radiotherapy is presented. The method is based on insertion of a thermo-expandable Ni-Ti stent. The stent is originally developed for treatment of bladder outlet obstruction caused by benign hyperplasia. The radiological properties of the stent are used for precise prostate localization during treatment using electronic portal images. Patients referred for intended curative radiotherapy and having a length of their prostatic urethra in the range from 25 to 65 mm were included. Pairs of isocentric orthogonal portal images were used to determine the 3D position at eight different treatment sessions for each patient. Fourteen patients were enrolled in the study. The data obtained demonstrated that the stent position was representative of the prostate location. The stent may also improve delineation of the prostate GTV, and prevent obstruction of bladder outlet during treatment. Precision in localization of the stent was less than 1 mm. Random errors in stent position were left-right 1.6 mm, cranial-caudal 2.2 mm and anterior-posterior 3.2 mm. In four of 14 patients a dislocation of the stent to the bladder occurred. Dislocation only occurred in patients with length of prostatic urethra less than 40 mm. A new method for radiological high precision localization of the prostate during radiotherapy is presented. The method is based on insertion of a standard Ni-Ti thermo-expandable stent, designed for treatment of benign prostate hyperplasia.

Tissue-nonspecific Alkaline Phosphatase Deficiency Causes Abnormal Craniofacial Bone Development in the Alpl−/− Mouse Model of Infantile Hypophosphatasia

PubMed Central

Liu, Jin; Nam, Hwa Kyung; Campbell, Cassie; Gasque, Kellen Cristina da Silva; Millán, José Luis; Hatch, Nan E.

2014-01-01

Tissue-nonspecific alkaline phosphatase (TNAP) is an enzyme present on the surface of mineralizing cells and their derived matrix vesicles that promotes hydroxyapatite crystal growth. Hypophosphatasia (HPP) is an inborn-error-of-metabolism that, dependent upon age of onset, features rickets or osteomalacia due to loss-of function mutations in the gene (Alpl) encoding TNAP. Craniosynostosis is prevalent in infants with HPP and other forms of rachitic disease but how craniosynostosis develops in these disorders is unknown. Objectives: Because craniosynostosis carries high morbidity, we are investigating craniofacial skeletal abnormalities in Alpl−/− mice to establish these mice as a model of HPP-associated craniosynostosis and determine mechanisms by which TNAP influences craniofacial skeletal development. Methods: Cranial bone, cranial suture and cranial base abnormalities were analyzed by micro-CT and histology. Craniofacial shape abnormalities were quantified using digital calipers. TNAP expression was suppressed in MC3T3E1(C4) calvarial cells by TNAP-specific shRNA. Cells were analyzed for changes in mineralization, gene expression, proliferation, apoptosis, matrix deposition and cell adhesion. Results: Alpl−/− mice feature craniofacial shape abnormalities suggestive of limited anterior-posterior growth. Craniosynostosis in the form of bony coronal suture fusion is present by three weeks after birth. Alpl−/− mice also exhibit marked histologic abnormalities of calvarial bones and the cranial base involving growth plates, cortical and trabecular bone within two weeks of birth. Analysis of calvarial cells in which TNAP expression was suppressed by shRNA indicates that TNAP deficiency promotes aberrant osteoblastic gene expression, diminished matrix deposition, diminished proliferation, increased apoptosis and increased cell adhesion. Conclusions: These findings demonstrate that Alpl−/− mice exhibit a craniofacial skeletal phenotype similar to that seen in infants with HPP, including true bony craniosynostosis in the context of severely diminished bone mineralization. Future studies will be required to determine if TNAP deficiency and other forms of rickets promote craniosynostosis directly through abnormal calvarial cell behavior, or indirectly due to deficient growth of the cranial base. PMID:25014884

Negative-pressure and low-pressure hydrocephalus: the role of cerebrospinal fluid leaks resulting from surgical approaches to the cranial base.

PubMed

Filippidis, Aristotelis S; Kalani, M Yashar S; Nakaji, Peter; Rekate, Harold L

2011-11-01

Negative-pressure and low-pressure hydrocephalus are rare clinical entities that are frequently misdiagnosed. They are characterized by recurrent episodes of shunt failure because the intracranial pressure is lower than the opening pressure of the valve. In this report the authors discuss iatrogenic CSF leaks as a cause of low- or negative-pressure hydrocephalus after approaches to the cranial base. The authors retrospectively reviewed cases of low-pressure or negative-pressure hydrocephalus presenting after cranial approaches complicated with a CSF leak at their institution. Three patients were identified. Symptoms of high intracranial pressure and ventriculomegaly were present, although the measured pressures were low or negative. A blocked communication between the ventricles and the subarachnoid space was documented in 2 of the cases and presumed in the third. Shunt revisions failed repeatedly. In all cases, temporary clinical and radiographic improvement resulted from external ventricular drainage at subatmospheric pressures. The CSF leaks were sealed and CSF communication was reestablished operatively. In 1 case, neck wrapping was used with temporary success. Negative-pressure or low-pressure hydrocephalus associated with CSF leaks, especially after cranial base approaches, is difficult to treat. The solution often requires the utilization of subatmospheric external ventricular drains to establish a lower ventricular drainage pressure than the drainage pressure created in the subarachnoid space, where the pressure is artificially lowered by the CSF leak. Treatment involves correction of the CSF leak, neck wrapping to increase brain turgor and allow the pressure in the ventricles to rise to the level of the opening pressure of the valve, and reestablishing the CSF route.

[Maxillary swing approach in the management of tumors in the central and lateral cranial base].

PubMed

Liao, Hua; Hua, Qing-quan; Wu, Zhan-yuan

2006-04-01

A retrospective review of seventeen patients who were operated through the maxillary swing approach was carried out to assess the efficacy of this approach in the management of tumors of the central and lateral cranial base. From May 2000 to January 2005, 17 patients with primary or recurrent neoplasms involving the central cranial or lateral base underwent surgical resection via maxillary swing approach. Ten patients were male, and other seven patients were female, and age range was 7 to 58 years, with a mean age of 42. 6 years. Eight patients had tumors originally involving lateral cranial base, and nine patients had tumors originated from central cranial base. The pathology spectrum was very wide. Among them, five suffered from chordoma, two had rhabdomyosarcoma, two had squamous cell carcinoma, one had malignant fibrous histiocytoma, one had malignant melanoma, one had esthesioneuroblastoma, one had invaded hypophysoma, two had schwannoma, one had pleomorphic adenoma, and one had angiofibroma. Three patients had received previous surgery, two patients had previous radiation therapy and nine patients received postoperative radiotherapy. Sixteen of all seventeen patients had oncologically complete resection, one had near-total resection. This group patients was followed up from 10 to 60 months, with a median follow-up time of 28 months. Two patients died 14 and 26 months after surgery respectively, as a result of local recurrence and metastasis. One patient defaulted follow-up at 12 months after operation, and the other 14 patients were alive at the time of analysis. Of the 12 malignant tumors, the 1-and 2-year survival rate were 91.67% and 72.92%, respectively. The facial wounds of all patients healed primarily, and there were no necrosis of the maxilla, damage of the temporal branch of the facial nerve, lower-lid ectropion, and facial deformity. Epiphora and facial hypoesthesia were detected in all patients. Four patients (23.5%) developed palatal fistula, ten patients developed serous otitis media (58.8%), and four patients developed a certain degree of trismus (23.5%). Cerebrospinal fluid leak occurred in two patients. They subsequently healed with conservative management. The maxillary swing approach is a proven method for access to the central and lateral skull base with good exposure and acceptable morbidity. Complications and sequelae associated with this approach include facial scarring, transaction of the infraorbital nerve, impaired lacrimal drainage, eustachian tube dysfunction and serous otitis, palatal fistula, trismus etc. Some procedures should be performed for reducing the incidence and severity of complications in the maxillary swing approach.

Potential Therapeutic Use of Relaxin in Healing Cranial Bone Defects

DTIC Science & Technology

2016-08-01

successful production of chimeric mice after irradiation and GFP+ bone marrow transplantation; reproducible implementation of uniform cranial lesions of ~1.5...cranial defect model in chimeric mice transplanted with GFP+ bone marrow. We follow defect closure by three dimensional microcomputed tomography (µCT...histolomorphometry and immunohistochemistry, respectively. 2. Keywords GFP+ chimeric mice, cranial defect closure, relaxin, angiogenesis

Morphological characteristics of renal artery and kidney in rats.

PubMed

Yoldas, Atilla; Dayan, Mustafa Orhun

2014-01-01

The gross anatomy and morphometry of the kidney and renal arteries were studied in the strains of laboratory rat: Sprague-Dawley (Sp) and Wistar (W) rats. Total of 106 three-dimensional endocasts of the intrarenal arteries of kidney that were prepared using standard injection-corrosion techniques were examined. A single renal artery was observed in 100% of the cases. The renal arteries were divided into a dorsal and a ventral branch. The dorsal and ventral branches were divided into two branches, the cranial and caudal branch. Renal arteries were classified into types I and II, depending on the cranial and caudal branches and their made of branching. The present study also showed that the right kidney was slightly heavier than the left one and that the kidney of the male was generally larger than that of the female. The mean live weights of the Sprague-Dawley and Wistar rats were found to be 258.26 ± 5.9 and 182.4 ± 19.05 g, respectively. The kidney weights were significantly correlated (P < 0.01) with body weights. The kidney weights were not found significantly correlated (P > 0.01) with the length of renal arteries.

Morphological Characteristics of Renal Artery and Kidney in Rats

PubMed Central

Yoldas, Atilla; Dayan, Mustafa Orhun

2014-01-01

The gross anatomy and morphometry of the kidney and renal arteries were studied in the strains of laboratory rat: Sprague-Dawley (Sp) and Wistar (W) rats. Total of 106 three-dimensional endocasts of the intrarenal arteries of kidney that were prepared using standard injection-corrosion techniques were examined. A single renal artery was observed in 100% of the cases. The renal arteries were divided into a dorsal and a ventral branch. The dorsal and ventral branches were divided into two branches, the cranial and caudal branch. Renal arteries were classified into types I and II, depending on the cranial and caudal branches and their made of branching. The present study also showed that the right kidney was slightly heavier than the left one and that the kidney of the male was generally larger than that of the female. The mean live weights of the Sprague-Dawley and Wistar rats were found to be 258.26 ± 5.9 and 182.4 ± 19.05 g, respectively. The kidney weights were significantly correlated (P < 0.01) with body weights. The kidney weights were not found significantly correlated (P > 0.01) with the length of renal arteries. PMID:24737971

Head MRI

MedlinePlus

... the head; MRI - cranial; NMR - cranial; Cranial MRI; Brain MRI; MRI - brain; MRI - head ... the test, tell your provider if you have: Brain aneurysm clips An artificial heart valves Heart defibrillator ...

Application of a novel prenatal vertical cranial biometric measurement can improve accuracy of microcephaly diagnosis in utero.

PubMed

Leibovitz, Z; Shiran, C; Haratz, K; Tamarkin, M; Gindes, L; Schreiber, L; Malinger, G; Ben-Sira, L; Lev, D; Shapiro, I; Bakry, H; Weizman, B; Zreik, A; Kidron, D; Egenburg, S; Arad, A; Lerman-Sagie, T

2016-05-01

To construct a reference range for a new vertical measurement of the fetal head and to assess whether its combination with fetal head circumference (HC) can prevent the misdiagnosis of microcephaly in fetuses with an acrocephalic-like head deformation. A new vertical cranial biometric measurement was defined: the foramen magnum-to-cranium distance (FCD), measured between the foramen magnum and the upper inner cranial border along the posterior wall of the brainstem. The measurement was performed in a precise mid-sagittal plane using a three-dimensional multiplanar display of a sagittally acquired sonographic volume of the fetal head. The normal reference range was developed by measuring 396 healthy fetuses of low-risk singleton pregnancies between 15 and 40 gestational weeks. This reference was applied to 25 fetuses with microcephaly diagnosed prenatally (Fmic) based on HC ≥ 3 SD below the mean for gestational age. We determined an optimal FCD cut-off for combination with HC to detect all cases found with microcephaly at birth (micB), while excluding the fetuses with normal head circumference at birth (NHCB), who were described postnatally as having an acrocephalic-like cranial deformation. In the healthy singleton fetuses, FCD increased with gestational age, with a quadratic equation providing an optimal fit to the data (adjusted R(2) = 0.934). The measurement could be assessed in 95.2% of cases. Of the 25 cases diagnosed with Fmic prenatally, on the basis of HC alone, 14 were micB and 11 were NHCB. We observed FCD below the mean - 2SD for gestational age in all 14 micB cases, but in only four of the 11 NHCB cases (P < 0.003). An acrocephalic-like cranial deformation was described at birth in five of the seven NHCB cases with normal FCD. The mean ± SD FCD Z-score of the micB cases was significantly lower (P < 0.001) than that of the false-positive ones: -3.85 ± 0.96 SD and -1.59 ± 1.45 SD, respectively. Based on HC measurement alone, the positive predictive value (PPV) was 56%. Combination of the HC and FCD criteria raised the PPV to 78%, decreasing the number of false positives from 11 to four, without missing any of the 14 micB cases. Fetal vertical cranial biometric assessment in the mid-sagittal plane is feasible and correlates well with gestational age. In our series, a vertical cranial deformation was a frequent cause of a false Fmic diagnosis made on the basis of HC alone. Combination of the new vertical cranial biometric measurement with HC measurement can exclude these cases and thus improve diagnostic accuracy for Fmic. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Human Foramen Magnum Area and Posterior Cranial Fossa Volume Growth in Relation to Cranial Base Synchondrosis Closure in the Course of Child Development.

PubMed

Coll, Guillaume; Lemaire, Jean-Jacques; Di Rocco, Federico; Barthélémy, Isabelle; Garcier, Jean-Marc; De Schlichting, Emmanuel; Sakka, Laurent

2016-11-01

To date, no study has compared the evolution of the foramen magnum area (FMA) and the posterior cranial fossa volume (PCFV) with the degree of cranial base synchondrosis ossification. To illustrate these features in healthy children. The FMA, the PCFV, and the ossification of 12 synchondroses according to the Madeline and Elster scale were retrospectively analyzed in 235 healthy children using millimeter slices on a computed tomography scan. The mean FMA of 6.49 cm in girls was significantly inferior to the FMA of 7.67 cm in boys (P < .001). In both sexes, the growth evolved in a 2-phase process, with a phase of rapid growth from birth to 3.75 years old (yo) followed by a phase of stabilization. In girls, the first phase was shorter (ending at 2.6 yo) than in boys (ending at 4.33 yo) and proceeded at a higher rate. PCFV was smaller in girls (P < .001) and displayed a biphasic pattern in the whole population, with a phase of rapid growth from birth to 3.58 yo followed by a phase of slow growth until 16 yo. In girls, the first phase was more active and shorter (ending at 2.67 yo) than in boys (ending at 4.5 yo). The posterior interoccipital synchondroses close first, followed by the anterior interoccipital and occipitomastoidal synchondroses, the lambdoid sutures simultaneously, then the petro-occipital and spheno-occipital synchondroses simultaneously. The data provide a chronology of synchondrosis closure. We showed that FMA and PCFV are constitutionally smaller in girls at birth (P ≤ .02) and suggest that a sex-related difference in the FMA is related to earlier closure of anterior interoccipital synchondroses in girls (P = .01). AIOS, anterior interoccipital synchondrosesFMA, foramen magnum areaLS, lambdoid suturesOMS, occipitomastoidal synchondrosesPCFV, posterior cranial fossa volumePIOS, posterior interoccipital synchondrosesPOS, petro-occipital synchondrosesSOS, spheno-occipital synchondrosisyo, years old.

[Extended endoscopic endonasal posterior (transclival) approach to tumors of the clival region and ventral posterior cranial fossa. Part 1. Topographic and anatomical features of the clivus and adjacent structures].

PubMed

Shkarubo, A N; Koval', K V; Dobrovol'skiy, G F; Shkarubo, M A; Karnaukhov, V V; Kadashev, B A; Andreev, D N; Chernov, I V; Gadzhieva, O A; Aleshkina, O Yu; Anisimova, E A; Kalinin, P L; Kutin, M A; Fomichev, D V; Sharipov, O I; Ismailov, D B; Selivanov, E S

to describe the main topographic and anatomical features of the clival region and its adjacent structures for improvement and optimization of the extended endoscopic endonasal posterior (transclival) approach for resection of tumors of the clival region and ventral posterior cranial fossa. We performed a craniometric study of 125 human skulls and a topographic anatomical study of heads of 25 cadavers, the arterial and venous bed of which was stained with colored silicone (the staining technique was developed by the authors) to visualize bed features and individual variability. Currently, we have clinical material from more than 120 surgical patients with various skull base tumors of the clival region and ventral posterior cranial fossa (chordomas, pituitary adenomas, meningiomas, cholesteatomas, etc.) who were operated on using the endoscopic transclival approach. We present the main anatomical landmarks and parameters of some anatomical structures that are required for performing the endoscopic endonasal posterior approach. The anatomical landmarks, such as the intradural openings of the abducens and glossopharyngeal nerves, may be used to arbitrarily divide the clival region into the superior, middle, and inferior thirds. The anatomical landmarks important for the surgeon, which are detected during a topographic anatomical study of the skull base, facilitate identification of the boundaries between the different clival portions and the C1 segments of the internal carotid arteries. The superior, middle, and inferior transclival approaches provide an access to the ventral surface of the upper, middle, and lower neurovascular complexes in the posterior cranial fossa. The endoscopic transclival approach may be used to access midline tumors of the posterior cranial fossa. The approach is an alternative to transcranial approaches in surgical treatment of clival region lesions. This approach provides results comparable (and sometimes better) to those of the transcranial and transfacial approaches.

Organ and effective dose coefficients for cranial and caudal irradiation geometries: Neutrons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.

Dose coefficients based on the recommendations of International Commission on Radiological Protection (ICRP) Publication 103 were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57 for the six reference irradiation geometries: anterior–posterior, posterior–anterior, right and left lateral, rotational and isotropic. In this work, dose coefficients for neutron irradiation of the body with parallel beams directed upward from below the feet (caudal) and downward from above the head (cranial) using the ICRP 103 methodology were computed using the MCNP 6.1 radiation transport code. The dose coefficients were determined for neutrons ranging in energy from 10more » –9 MeV to 10 GeV. Here, at energies below about 500 MeV, the cranial and caudal dose coefficients are less than those for the six reference geometries reported in ICRP Publication 116.« less

[Localized invasive intracranial aspergillosis with multiple cranial nerve failure -- case report and review of the literature].

PubMed

Winkler, F; Seelos, K; Hempel, J M; Pfister, H-W

2002-12-01

Contrary to the more frequent hematogenously spread cerebral aspergillosis, localized invasive intracranial aspergillosis is a fungal infection that can also occur in patients who are not severely immunosuppressed. This illness can be effectively treated in some of these patients by early and rigorous therapy. Localized invasion of the fungus, generally from one of the nasal sinuses, causes intracranial growth mainly along the base of the skull and larger vessels,where fibrous, granulomatous tissue develops. This generally leads to damage of the cranial nerves (primarily I-VI) as well as localized pain syndromes. We report on the clinical course documented by MRI of a patient with localized invasive intracranial aspergillosis who had multiple failure of cranial nerves following surgery for an aspergilloma of the maxillary sinus. Clinical course, imaging findings, and treatment of the illness are discussed with a review of the relevant literature.

Organ and effective dose coefficients for cranial and caudal irradiation geometries: Neutrons

DOE PAGES

Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.; ...

2016-08-29

Dose coefficients based on the recommendations of International Commission on Radiological Protection (ICRP) Publication 103 were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57 for the six reference irradiation geometries: anterior–posterior, posterior–anterior, right and left lateral, rotational and isotropic. In this work, dose coefficients for neutron irradiation of the body with parallel beams directed upward from below the feet (caudal) and downward from above the head (cranial) using the ICRP 103 methodology were computed using the MCNP 6.1 radiation transport code. The dose coefficients were determined for neutrons ranging in energy from 10more » –9 MeV to 10 GeV. Here, at energies below about 500 MeV, the cranial and caudal dose coefficients are less than those for the six reference geometries reported in ICRP Publication 116.« less

A Rare Presentation of Cranial Polyneuropathy Without Rash Caused by Varicella Zoster Virus

PubMed Central

Tecellioglu, Mehmet; Kamisli, Suat; Erbay, Mehmet Fatih; Kamisli, Ozden; Ozcan, Cemal

2017-01-01

Introduction: Varicella Zoster Virus (VZV) is associated with many disorders of the central and peripheral nervous systems including neuralgia, meningitis, meningoencephalitis, cerebellitis, vasculopathy, myelopathy, Ramsay-Hunt syndrome, and polyneuritis cranialis. Cranial nerves V, VI, VII, VIII, IX, X, XI, and/or XII may be affected. The neurological disorders caused by VZV usually present with rash, but may rarely present without rash. Case report: We herein present a case of polyneuritis cranialis without rash caused by VZV affecting cranial nerves VII, VIII, IX, and X. After excluding other causes of the condition, we diagnosed VZV infection based on VZV DNA in the CSF and an elevated anti-VZV IgG level in serum. The patient responded well to antiviral therapy. Conclusion: VZV infection should be kept in mind during the differential diagnosis of polyneuritis cranialis; it is important to note that VZV re-activation may occur without rash. PMID:28974853

Relationship of cranial robusticity to cranial form, geography and climate in Homo sapiens.

PubMed

Baab, Karen L; Freidline, Sarah E; Wang, Steven L; Hanson, Timothy

2010-01-01

Variation in cranial robusticity among modern human populations is widely acknowledged but not well-understood. While the use of "robust" cranial traits in hominin systematics and phylogeny suggests that these characters are strongly heritable, this hypothesis has not been tested. Alternatively, cranial robusticity may be a response to differences in diet/mastication or it may be an adaptation to cold, harsh environments. This study quantifies the distribution of cranial robusticity in 14 geographically widespread human populations, and correlates this variation with climatic variables, neutral genetic distances, cranial size, and cranial shape. With the exception of the occipital torus region, all traits were positively correlated with each other, suggesting that they should not be treated as individual characters. While males are more robust than females within each of the populations, among the independent variables (cranial shape, size, climate, and neutral genetic distances), only shape is significantly correlated with inter-population differences in robusticity. Two-block partial least-squares analysis was used to explore the relationship between cranial shape (captured by three-dimensional landmark data) and robusticity across individuals. Weak support was found for the hypothesis that robusticity was related to mastication as the shape associated with greater robusticity was similar to that described for groups that ate harder-to-process diets. Specifically, crania with more prognathic faces, expanded glabellar and occipital regions, and (slightly) longer skulls were more robust than those with rounder vaults and more orthognathic faces. However, groups with more mechanically demanding diets (hunter-gatherers) were not always more robust than groups practicing some form of agriculture.

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

PubMed

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

2012-05-01

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

Gradenigo's Syndrome in a Patient with Chronic Suppurative Otitis Media, Petrous Apicitis, and Meningitis.

PubMed

Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

2017-09-28

BACKGROUND Gradenigo's syndrome includes the triad of suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve. Gradenigo's syndrome is rare, and the diagnosis is easily overlooked. This case is the first to report Gradenigo's syndrome presenting with meningitis on a background of chronic suppurative otitis media (CSOM) and petrous apicitis (apical petrositis). CASE REPORT A 58-year-old male African American presented with headaches and confusion. Magnetic resonance imaging (MRI) of the head showed petrous apicitis with mastoiditis and abscess formation in the cerebellomedullary cistern (cisterna magna). The case was complicated by the development of palsy of the fourth (trochlear) cranial nerve, fifth (trigeminal) cranial nerve, and sixth (abducens) cranial nerve, with radiological changes indicating infection involving the seventh (facial) cranial nerve, and eighth (vestibulocochlear) cranial nerve. Cerebrospinal fluid (CSF) culture results were positive for Klebsiella pneumoniae, sensitive to ceftriaxone. The patient improved with surgery that included a left mastoidectomy and debridement of the petrous apex, followed by a ten-week course of antibiotics. Follow-up MRI showed resolution of the infection. CONCLUSIONS This report is of an atypical case of Gradenigo's syndrome. It is important to recognize that the classical triad of Gradenigo's syndrome, suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve, may also involve chronic suppurative otitis media (CSOM), which may lead to involvement of other cranial nerves, petrous apicitis (apical petrositis), and bacterial meningitis.

Multiple Cranial Nerve Palsies in Giant Cell Arteritis.

PubMed

Ross, Michael; Bursztyn, Lulu; Superstein, Rosanne; Gans, Mark

2017-12-01

Giant cell arteritis (GCA) is a systemic vasculitis of medium and large arteries often with ophthalmic involvement, including ischemic optic neuropathy, retinal artery occlusion, and ocular motor cranial nerve palsies. This last complication occurs in 2%-15% of patients, but typically involves only 1 cranial nerve. We present 2 patients with biopsy-proven GCA associated with multiple cranial nerve palsies.

Robo signaling regulates the production of cranial neural crest cells.

PubMed

Li, Yan; Zhang, Xiao-Tan; Wang, Xiao-Yu; Wang, Guang; Chuai, Manli; Münsterberg, Andrea; Yang, Xuesong

2017-12-01

Slit/Robo signaling plays an important role in the guidance of developing neurons in developing embryos. However, it remains obscure whether and how Slit/Robo signaling is involved in the production of cranial neural crest cells. In this study, we examined Robo1 deficient mice to reveal developmental defects of mouse cranial frontal and parietal bones, which are derivatives of cranial neural crest cells. Therefore, we determined the production of HNK1 + cranial neural crest cells in early chick embryo development after knock-down (KD) of Robo1 expression. Detection of markers for pre-migratory and migratory neural crest cells, PAX7 and AP-2α, showed that production of both was affected by Robo1 KD. In addition, we found that the transcription factor slug is responsible for the aberrant delamination/EMT of cranial neural crest cells induced by Robo1 KD, which also led to elevated expression of E- and N-Cadherin. N-Cadherin expression was enhanced when blocking FGF signaling with dominant-negative FGFR1 in half of the neural tube. Taken together, we show that Slit/Robo signaling influences the delamination/EMT of cranial neural crest cells, which is required for cranial bone development. Copyright © 2017. Published by Elsevier Inc.

Anthropometry of craniosynostosis.

PubMed

Štefánková, Eva; Horn, František; Neščáková, Eva; Kabát, Michal; Petrík, Michal; Trnka, Ján

2015-01-01

Anthropometry is becoming a popular method for diagnostics of various diseases in pediatric clinical practice. The aim of this study was to assess the growth changes in craniofacial parameters in patients with craniosynostosis and positional plagiocephaly. Inclusion criteria for the study were presence of craniostenosis or positional plagiocephaly in a patient with at least three anthropometric evaluations at our department. Studied patients were aged from 1.0 month to 2.5 years with median age at the first and last anthropometric evaluation as 1.83 and 25.27 months, respectively. Further anthropometric results in patients older than 2.5 years were excluded from the study. Statistical significance was tested by the Mann-Whitney test. The studied group consisted of 70.5% male patients. The type of craniosynostosis was represented by scaphocephaly in 44.1%, by trigonocephaly in 45.6% and by coronal craniosynostosis in 10.3% of the cases. Cranial index was proven as a suitable parameter for evaluating differences in the trend of growth in craniosynostosis (p<0.001) and also for evaluating post-operative results. Significance was found in width of the head (p=0.038) for scaphocephaly and in length of the head for trigonocephaly (p=0.001) in surgically treated patients. Trend of cranial growth in operated patients copied the curve of the norm but in higher or lower values which depends on the type of prematurely closed suture. Longitudinal anthropometric follow-up is an objective and measurable method that can accurately non-invasively and non-expensively assess skull growth in pediatric patients with cranial deformity. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Comparative Skull Morphology of Uropeltid Snakes (Alethinophidia: Uropeltidae) with Special Reference to Disarticulated Elements and Variation

PubMed Central

Olori, Jennifer C.; Bell, Christopher J.

2012-01-01

Uropeltids form a diverse clade of highly derived, fossorial snakes that, because of their phylogenetic position among other alethinophidian lineages, may play a key role in understanding the early evolution of cranial morphology in snakes. We include detailed osteological descriptions of crania and mandibles for eight uropeltid species from three nominal genera (Uropeltis, Rhinophis, and Brachyophidium) and emphasize disarticulated elements and the impact of intraspecific variation on previously proposed morphological characters used for phylogenetic analysis. Preliminary analysis of phylogenetic relationships strongly supports a clade composed exclusively of species of Plectrurus, Uropeltis, and Rhinophis. However, monophyly of each of those genera and Melanophidium is not upheld. There is moderate support that Sri Lankan species (e.g., Rhinophis and Uropeltis melanogaster) are monophyletic with respect to Indian uropeltids. Previously proposed characters that are phylogenetically informative include the shape of the nasals, length of the occipital condyle, level of development of the posteroventral process of the dentary, and participation of the parietal in the optic foramen. Additionally, thirty new features that may be systematically informative are identified and described, but were not verified for their utility. Such verification must await availability of additional disarticulated cranial material from a larger sample of taxa. All characters require further testing through increased focus on sources and patterns of intraspecific variation, inclusion of broader taxonomic samples in comparative studies, and exploration of skeletal development, sexual dimorphism, and biogeographic patterns. Additionally, trends in the relative enlargement of the sensory capsules, reduction in cranial ossification and dentition, fusion of elements, and the appearance of novel morphological conditions, such as the structure and location of the suspensorium, may be related to fossoriality and miniaturization in some uropeltid taxa, and may complicate analysis of relationships within Uropeltidae and among alethinophidian snakes. PMID:22412874

Nonshaved cranial surgery in black Africans: technical report and a medium-term prospective outcome study.

PubMed

Adeleye, Amos O

2016-07-01

Nonshaved neurosurgery, cranial or spinal, is well reported among Caucasians but hardly among native Africans. The ungroomed scalp hairs of black Africans have unique anthropological characteristics needing special attention for shaveless cranial surgery. A technical report of the execution of this surgical procedure among an indigenous patient population in a sub-Sahara African country is presented, as well as an outcome analysis in a prospective cohort over a 7-year period. A total of 303 patients (211 males, 70 %) fulfilled the criteria for this study. The surgical procedure was primary in 278 (92 %) and redo in 8 %. It was emergency surgery in 153 (51 %). They were trauma craniotomies or decompressive craniectomies in 95 cases (31 %), craniotomies for tumour resections in 86 (28 %), and the surgical dissections for other conditions in 122 (41 %). The duration of surgery ranged from 30 min to 8.5 h, mean 2.5 (SD, 1.6), median 2. In-hospital clinical outcome was good (normal status or moderate deficit on dichotomized Glasgow outcome scale (GOS)) in 273 (90.1 %) cases while surgical site infections occurred in only 10 cases (3.3 %). The type of surgery, redo or primary, did not have any significant association with the in-hospital outcome (p = 0.5), nor with the presence of surgical site infection (SSI) (p = 0.7). The length of follow-up ranged from 2 to 63 months (mean, 7) with no untoward complications reported so far. Medium-term outcome of nonshaved neurosurgery in this indigenous black Africans remains favourable with no attendant significant adverse after-effects.

Anatomy and Cranial Functional Morphology of the Small-Bodied Dinosaur Fruitadens haagarorum from the Upper Jurassic of the USA

PubMed Central

Butler, Richard J.; Porro, Laura B.; Galton, Peter M.; Chiappe, Luis M.

2012-01-01

Background Heterodontosaurids are an important but enigmatic and poorly understood early radiation of ornithischian dinosaurs. The late-surviving heterodontosaurid Fruitadens haagarorum from the Late Jurassic (early Tithonian) Morrison Formation of the western USA is represented by remains of several small (<1 metre total body length, <1 kg body mass) individuals that include well-preserved but incomplete cranial and postcranial material. Fruitadens is hypothesized to represent one of the smallest known ornithischian dinosaurs. Methodology/Principal Findings We describe the cranial and postcranial anatomy of Fruitadens in detail, providing comparisons to all other known heterodontosaurid taxa. High resolution micro-CT data provides new insights into tooth replacement and the internal anatomy of the tooth-bearing bones. Moreover, we provide a preliminary functional analysis of the skull of late-surviving heterodontosaurids, discuss the implications of Fruitadens for current understanding of heterodontosaurid monophyly, and briefly review the evolution and biogeography of heterodontosaurids. Conclusions/Significance The validity of Fruitadens is supported by multiple unique characters of the dentition and hindlimb as well as a distinct character combination. Fruitadens shares highly distinctive appendicular characters with other heterodontosaurids, strengthening monophyly of the clade on the basis of the postcranium. Mandibular morphology and muscle moment arms suggest that the jaws of late-surviving heterodontosaurids, including Fruitadens, were adapted for rapid biting at large gape angles, contrasting with the jaws of the stratigraphically older Heterodontosaurus, which were better suited for strong jaw adduction at small gapes. The lack of wear facets and plesiomorphic dentition suggest that Fruitadens used orthal jaw movements and employed simple puncture-crushing to process food. In combination with its small body size, these results suggest that Fruitadens was an ecological generalist, consuming select plant material and possibly insects or other invertebrates. PMID:22509242

A new long-necked ‘sauropod-mimic’ stegosaur and the evolution of the plated dinosaurs

PubMed Central

Mateus, Octávio; Maidment, Susannah C.R.; Christiansen, Nicolai A.

2009-01-01

Stegosaurian dinosaurs have a quadrupedal stance, short forelimbs, short necks, and are generally considered to be low browsers. A new stegosaur, Miragaia longicollum gen. et sp. nov., from the Late Jurassic of Portugal, has a neck comprising at least 17 cervical vertebrae. This is eight additional cervical vertebrae when compared with the ancestral condition seen in basal ornithischians such as Scutellosaurus. Miragaia has a higher cervical count than most of the iconically long-necked sauropod dinosaurs. Long neck length has been achieved by ‘cervicalization’ of anterior dorsal vertebrae and probable lengthening of centra. All these anatomical features are evolutionarily convergent with those exhibited in the necks of sauropod dinosaurs. Miragaia longicollum is based upon a partial articulated skeleton, and includes the only known cranial remains from any European stegosaur. A well-resolved phylogeny supports a new clade that unites Miragaia and Dacentrurus as the sister group to Stegosaurus; this new topology challenges the common view of Dacentrurus as a basal stegosaur. PMID:19324778

Assessing the accuracy of cranial and pelvic ageing methods on human skeletal remains from a modern Greek assemblage.

PubMed

Xanthopoulou, Panagiota; Valakos, Efstratios; Youlatos, Dionisios; Nikita, Efthymia

2018-05-01

The present study tests the accuracy of commonly adopted ageing methods based on the morphology of the pubic symphysis, auricular surface and cranial sutures. These methods are examined both in their traditional form as well as in the context of transition analysis using the ADBOU software in a modern Greek documented collection consisting of 140 individuals who lived mainly in the second half of the twentieth century and come from cemeteries in the area of Athens. The auricular surface overall produced the most accurate age estimates in our material, with different methods based on this anatomical area showing varying degrees of success for different age groups. The pubic symphysis produced accurate results primarily for young adults and the same applied to cranial sutures but the latter appeared completely inappropriate for older individuals. The use of transition analysis through the ADBOU software provided less accurate results than the corresponding traditional ageing methods in our sample. Our results are in agreement with those obtained from validation studies based on material from across the world, but certain differences identified with other studies on Greek material highlight the importance of taking into account intra- and inter-population variability in age estimation. Copyright © 2018 Elsevier B.V. All rights reserved.

[Anterior skull-base schwannoma].

PubMed

Esquivel-Miranda, Miguel; De la O Ríos, Elier; Vargas-Valenciano, Emmanuelle; Moreno-Medina, Eva

Schwannomas are nerve sheath tumours that originate in Schwann cells. They are usually solitary and sporadic and manifest on peripheral, spinal or cranial nerves. Intracranial schwannomas tend to manifest on the eighth cranial nerve, particularly in patients with neurofibromatosis type2. Anterior skull-base schwannomas represent less than 1% of all intracranial schwannomas. They are more frequent in young people and are typically benign. These tumours represent a diagnostic challenge due to their rarity and difficult differential diagnosis, and numerous theories have been postulated concerning their origin and development. In this article, we present the case of a 13-year-old male with a single anterior cranial-base tumour not associated with neurofibromatosis who presented with headache, papilloedema, eye pain and loss of visual acuity. Complete resection of the tumour was performed, which was histopathologically diagnosed as a schwannoma. The patient made a complete clinical recovery with abatement of all symptoms. We conducted a review of the literature and found 66 cases worldwide with this diagnosis. We describe the most relevant epidemiological and clinical characteristics of this kind of tumour and its relation with the recently discovered and similar olfactory schwannoma. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluation of an animation tool developed to supplement dental student study of the cranial nerves.

PubMed

Lone, M; McKenna, J P; Cryan, J F; Vagg, T; Toulouse, A; Downer, E J

2017-12-30

The structure/function of the cranial nerves is a core topic for dental students. However, due to the perceived complexity of the subject, it is often difficult for students to develop a comprehensive understanding of key concepts using textbooks and models. It is accepted that the acquisition of anatomical knowledge can be facilitated by visualisation of structures. This study aimed to develop and assess a novel cranial nerve animation as a supplemental learning aid for dental students. A multidisciplinary team of anatomists, neuroscientists and a computer scientist developed a novel animation depicting the cranial nerves. The animation was viewed by newly enrolled first-year dental students, graduate entry dental students (year 1) and dental hygiene students (year 1). A simple life scenario employing the use of the cranial nerves was developed using a cartoon-type animation with a viewing time of 3.58 minutes. The animation was developed with emphasis on a life scenario. The animation was placed online for 2 weeks with open access or viewed once in a controlled laboratory setting. Questionnaires were designed to assess the participants' attitude towards the animation and their knowledge of the cranial nerves before and after visualisation. This study was performed before the delivery of core lectures on the cranial nerves. Our findings indicate that the use of the animation can act as a supplemental tool to improve student knowledge of the cranial nerves. Indeed, data indicate that a single viewing of the animation, in addition to 2-week access to the animation, can act as a supplemental learning tool to assist student understanding of the structure and function of cranial nerves. The animation significantly enhanced the student's opinion that their cranial nerve knowledge had improved. From a qualitative point of view, the students described the animation as an enjoyable and useful supplement to reading material/lectures and indicated that the animation was a useful tool in understanding the cranial nerves. Overall, these findings indicate that an animation demonstrating the cranial nerves in a simple, everyday functional scenario may act as a learning aid in the study of cranial nerves. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Incidence, cost, and mortality associated with hospital-acquired conditions after resection of cranial neoplasms.

PubMed

Zacharia, Brad E; Deibert, Christopher; Gupta, Gaurav; Hershman, Dawn; Neugut, Alfred I; Bruce, Jeffrey N; Spencer, Benjamin A

2014-06-01

In 2007, the Centers for Medicare and Medicaid Services stopped reimbursing for treatment of specified hospital-acquired conditions (HACs), also known as "never events." To establish benchmarks for HACs after common neurosurgical oncologic procedures. We identified adults in the Nationwide Inpatient Sample between 2002 and 2009 who underwent resection of a benign or malignant brain tumor. Baseline demographics, medical comorbidities, and hospital-level variables were assessed. A generalized estimating equation, multivariable-logistic model was used to identify predictors of HACs, mortality, prolonged hospital length of stay, and increased hospital charges. We identified 310,133 patients undergoing surgical treatment of a cranial neoplasm; 5.4% experienced an HAC. More medical comorbidities and the presence of an immediate postoperative neurosurgical complication increased one's risk of having an HAC (odds ratios: 1.56 and 2.48, respectively; both P < .01). Patients who experienced an HAC faced increased in-hospital mortality (6.47% vs 1.53%; P < .01) and increased total hospital costs ($52,882.61 vs $25,569.45; P < .01). Patients at urban teaching hospitals and those with a high surgical volume were more likely to experience an HAC compared with those treated at rural nonteaching hospitals and those with a low surgical volume (odds ratios: 1.33 and 1.16, respectively; P < .01). We found a 5.4% incidence of HACs after neurosurgical oncologic procedures, which varied based on several patient and hospital-level factors. A thorough analysis of the relationship between patient, procedure, and HAC incidence will be important to developing fair compensation practices for physicians as well as payers. Additionally, further investigation may identify opportunities for future quality improvement initiatives.

Three-dimensional assessment of curvature, torsion, and canal flare index of the humerus of skeletally mature nonchondrodystrophic dogs.

PubMed

Smith, Emily J; Marcellin-Little, Denis J; Harrysson, Ola L A; Griffith, Emily H

2017-10-01

OBJECTIVE To assess 3-D geometry of the humerus of dogs and determine whether the craniocaudal canal flare index (CFI) is associated with specific geometric features. SAMPLE CT images (n = 40) and radiographs (38) for 2 groups of skeletally mature nonchondrodystrophic dogs. PROCEDURES General dimensions (length, CFI, cortical thickness, and humeral head offset), curvature (shaft, humeral head, and glenoid cavity), version (humeral head and greater tubercle), and torsion were evaluated on CT images. Dogs were allocated into 3 groups on the basis of the craniocaudal CFI, and results were compared among these 3 groups. The CT measurements were compared with radiographic measurements obtained for another group of dogs. RESULTS Mean ± SD humeral head version was -75.9 ± 9.6° (range, -100.7° to -59.4°). Mean mechanical lateral distal humeral angle, mechanical caudal proximal humeral angle, and mechanical cranial distal humeral angle were 89.5 ± 3.5°, 50.2 ± 4.5°, and 72.9 ± 7.8°, respectively, and did not differ from corresponding radiographic measurements. Mean humeral curvature was 20.4 ± 4.4° (range, 9.6° to 30.5°). Mean craniocaudal CFI was 1.74 ± 0.18 (range, 1.37 to 2.10). Dogs with a high craniocaudal CFI had thicker cranial and medial cortices than dogs with a low craniocaudal CFI. Increased body weight was associated with a lower craniocaudal CFI. Radiographic and CT measurements of craniocaudal CFI and curvature differed significantly. CONCLUSIONS AND CLINICAL RELEVANCE CT-based 3-D reconstructions allowed the assessment of shaft angulation, torsion, and CFI. Radiographic and CT measurements of shaft curvature and CFI may differ.

Gradenigo’s Syndrome in a Patient with Chronic Suppurative Otitis Media, Petrous Apicitis, and Meningitis

PubMed Central

Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

2017-01-01

Patient: Male, 58 Final Diagnosis: Bacterial meningitis Symptoms: Altered mental status • headache • neck stiffness • vomiting Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare disease Background: Gradenigo’s syndrome includes the triad of suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve. Gradenigo’s syndrome is rare, and the diagnosis is easily overlooked. This case is the first to report Gradenigo’s syndrome presenting with meningitis on a background of chronic suppurative otitis media (CSOM) and petrous apicitis (apical petrositis). Case Report: A 58-year-old male African American presented with headaches and confusion. Magnetic resonance imaging (MRI) of the head showed petrous apicitis with mastoiditis and abscess formation in the cerebellomedullary cistern (cisterna magna). The case was complicated by the development of palsy of the fourth (trochlear) cranial nerve, fifth (trigeminal) cranial nerve, and sixth (abducens) cranial nerve, with radiological changes indicating infection involving the seventh (facial) cranial nerve, and eighth (vestibulocochlear) cranial nerve. Cerebrospinal fluid (CSF) culture results were positive for Klebsiella pneumoniae, sensitive to ceftriaxone. The patient improved with surgery that included a left mastoidectomy and debridement of the petrous apex, followed by a ten-week course of antibiotics. Follow-up MRI showed resolution of the infection. Conclusions: This report is of an atypical case of Gradenigo’s syndrome. It is important to recognize that the classical triad of Gradenigo’s syndrome, suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve, may also involve chronic suppurative otitis media (CSOM), which may lead to involvement of other cranial nerves, petrous apicitis (apical petrositis), and bacterial meningitis. PMID:28955030

Cranial symmetry in baleen whales (Cetacea, Mysticeti) and the occurrence of cranial asymmetry throughout cetacean evolution

NASA Astrophysics Data System (ADS)

Fahlke, Julia M.; Hampe, Oliver

2015-10-01

Odontoceti and Mysticeti (toothed and baleen whales) originated from Eocene archaeocetes that had evolved from terrestrial artiodactyls. Cranial asymmetry is known in odontocetes that can hear ultrasound (>20,000 Hz) and has been linked to the split function of the nasal passage in breathing and vocalization. Recent results indicate that archaeocetes also had asymmetric crania. Their asymmetry has been linked to directional hearing in water, although hearing frequencies are still under debate. Mysticetes capable of low-frequency and infrasonic hearing (<20 Hz) are assumed to have symmetric crania. This study aims to resolve whether mysticete crania are indeed symmetric and whether mysticete cranial symmetry is plesiomorphic or secondary. Cranial shape was analyzed applying geometric morphometrics to three-dimensional (3D) cranial models of fossil and modern mysticetes, Eocene archaeocetes, modern artiodactyls, and modern odontocetes. Statistical tests include analysis of variance, principal components analysis, and discriminant function analysis. Results suggest that symmetric shape difference reflects general trends in cetacean evolution. Asymmetry includes significant fluctuating and directional asymmetry, the latter being very small. Mysticete crania are as symmetric as those of terrestrial artiodactyls and archaeocetes, without significant differences within Mysticeti. Odontocete crania are more asymmetric. These results indicate that (1) all mysticetes have symmetric crania, (2) archaeocete cranial asymmetry is not conspicuous in most of the skull but may yet be conspicuous in the rostrum, (3) directional cranial asymmetry is an odontocete specialization, and (4) directional cranial asymmetry is more likely related to echolocation than hearing.

Cranial symmetry in baleen whales (Cetacea, Mysticeti) and the occurrence of cranial asymmetry throughout cetacean evolution.

PubMed

Fahlke, Julia M; Hampe, Oliver

2015-10-01

Odontoceti and Mysticeti (toothed and baleen whales) originated from Eocene archaeocetes that had evolved from terrestrial artiodactyls. Cranial asymmetry is known in odontocetes that can hear ultrasound (>20,000 Hz) and has been linked to the split function of the nasal passage in breathing and vocalization. Recent results indicate that archaeocetes also had asymmetric crania. Their asymmetry has been linked to directional hearing in water, although hearing frequencies are still under debate. Mysticetes capable of low-frequency and infrasonic hearing (<20 Hz) are assumed to have symmetric crania. This study aims to resolve whether mysticete crania are indeed symmetric and whether mysticete cranial symmetry is plesiomorphic or secondary. Cranial shape was analyzed applying geometric morphometrics to three-dimensional (3D) cranial models of fossil and modern mysticetes, Eocene archaeocetes, modern artiodactyls, and modern odontocetes. Statistical tests include analysis of variance, principal components analysis, and discriminant function analysis. Results suggest that symmetric shape difference reflects general trends in cetacean evolution. Asymmetry includes significant fluctuating and directional asymmetry, the latter being very small. Mysticete crania are as symmetric as those of terrestrial artiodactyls and archaeocetes, without significant differences within Mysticeti. Odontocete crania are more asymmetric. These results indicate that (1) all mysticetes have symmetric crania, (2) archaeocete cranial asymmetry is not conspicuous in most of the skull but may yet be conspicuous in the rostrum, (3) directional cranial asymmetry is an odontocete specialization, and (4) directional cranial asymmetry is more likely related to echolocation than hearing.

Effect of Unshaven Hair with Absorbable Sutures and Early Postoperative Shampoo on Cranial Surgery Site Infection.

PubMed

Oh, Won-Oak; Yeom, Insun; Kim, Dong-Seok; Park, Eun-Kyung; Shim, Kyu-Won

2018-01-01

Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study. A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison. Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site. Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation. © 2017 S. Karger AG, Basel.

The Morphogenesis of Cranial Sutures in Zebrafish

PubMed Central

Topczewska, Jolanta M.; Shoela, Ramy A.; Tomaszewski, Joanna P.; Mirmira, Rupa B.; Gosain, Arun K.

2016-01-01

Using morphological, histological, and TEM analyses of the cranium, we provide a detailed description of bone and suture growth in zebrafish. Based on expression patterns and localization, we identified osteoblasts at different degrees of maturation. Our data confirm that, unlike in humans, zebrafish cranial sutures maintain lifelong patency to sustain skull growth. The cranial vault develops in a coordinated manner resulting in a structure that protects the brain. The zebrafish cranial roof parallels that of higher vertebrates and contains five major bones: one pair of frontal bones, one pair of parietal bones, and the supraoccipital bone. Parietal and frontal bones are formed by intramembranous ossification within a layer of mesenchyme positioned between the dermal mesenchyme and meninges surrounding the brain. The supraoccipital bone has an endochondral origin. Cranial bones are separated by connective tissue with a distinctive architecture of osteogenic cells and collagen fibrils. Here we show RNA in situ hybridization for col1a1a, col2a1a, col10a1, bglap/osteocalcin, fgfr1a, fgfr1b, fgfr2, fgfr3, foxq1, twist2, twist3, runx2a, runx2b, sp7/osterix, and spp1/ osteopontin, indicating that the expression of genes involved in suture development in mammals is preserved in zebrafish. We also present methods for examining the cranium and its sutures, which permit the study of the mechanisms involved in suture patency as well as their pathological obliteration. The model we develop has implications for the study of human disorders, including craniosynostosis, which affects 1 in 2,500 live births. PMID:27829009

Comparison between cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs.

PubMed

Gaitero, Luis; Nykamp, Stephanie; Daniel, Rob; Monteith, Gabrielle

2013-01-01

Cranial thoracic intervertebral disc herniations have been reported to be rare in dogs due to the presence of the intercapital ligament, however some studies have proposed they may not be uncommon in German Shepherd dogs. The purpose of this retrospective study was to compare cranial thoracic intervertebral disc herniations in German Shepherd dogs and other large breed dogs (control group). Medical records at the Ontario Veterinary College were searched for German Shepherd dogs and other large breed dogs that had magnetic resonance imaging studies including the T1-T9 region. For each dog and each disc space from T1-T9, three variables (compression, disc degeneration, and herniation) were recorded and graded based on review of sagittal T2-weighted images. Twenty-three German Shepherd dogs and 47 other large breed dogs met inclusion criteria. The German Shepherd dog group had higher scores than the control group for compression (P = 0.0099) and herniation (P < 0.001), but not disc degeneration (P = 0.97). In the German Shepherd dog group, intervertebral discs T2-T3 and T4-T5 had an increased risk for compression and T3-T4 had an increased risk for compression and herniation. Findings from this study indicated that German Shepherd dogs may be more likely than other large breed dogs to have spinal cord compression due to cranial thoracic disc herniations. Imaging of the cranial thoracic spine, including T2-T3, is recommended for German Shepherd dogs with T3-L3 neurological signs. © 2012 Veterinary Radiology & Ultrasound.

Criteria for Performing Cranial Computed Tomography for Chinese Patients With Mild Traumatic Brain Injury: Canadian Computed Tomography Head Rule or New Orleans Criteria?

PubMed

Yang, Xiao-Feng; Meng, Yuan-Yuan; Wen, Liang; Wang, Hao

2017-09-01

Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China. Patients with mild TBI who underwent cranial CT within 24 hours of the trauma were included in our institute. Two neurosurgeons reviewed the CT images independently to identify positive CT findings. The sensitivity and specificity of CCHR and NOC for positive CT findings related to TBI were analyzed. Finally, this study included 625 patients. Positive CT findings related to TBI were discovered in 13.12% (82/625) of these patients on cranial CT, and 6.88% (43/625) of them were admitted to the hospital for further management. Ultimately, 11 patients (1.76%, 11/625) underwent neurosurgery. In this study, the sensitivities of both the CCHR and NOC were 100%, but the specificity of CCHR was 43.36% and that of NOC was 33.12%. Based on our study, both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.

Management of Zone III Missile Injuries Involving the Carotid Artery and Cranial Nerves

PubMed Central

Levine, Zachary T.; Wright, Donald C.; O'Malley, Sean; Olan, Wayne J.; Sekhar, Laligam N.

2000-01-01

Carotid and cranial nerve injuries from zone III (high cervical/cranial base) missile injuries are rare and difficult to treat. We have treated five patients with such injuries. We present our management scheme, and compare it to the management of the same injuries in other reports. Five consecutive zone III missile injuries presented to our institution. Trauma assessment by the trauma team, followed by detailed neurological assessment and radiographs (angiogram and computed tomography) were obtained on admission. All patients presented with dysphagia and carotid artery injury with good collateral flow, documented by angiogram. Two patients had facial nerve injury, one had trigeminal nerve injury, one patient presented with tongue weakness, and one patient suffered conductive hearing loss. No patient had evidence of stroke clinically or radiographically. Carotid artery injury was managed with bypass (3 of 5) or ligation (2 of 5). Cranial nerve injuries were documented and treated aggressively with surgery if needed. All patients were discharged to home. Patients presenting with zone III missile injuries should receive an expeditious neurological exam and four-vessel angiogram after initial trauma survey and resuscitation. Bypass of the injured portion of carotid artery is a valid treatment in the hemodynamically stable patient. The unstable patient should undergo ligation to stop hemorrhage and protect against immediate risk for stroke, with the option to bypass later. Cranial nerve injuries should be pursued and aggressively treated to minimize morbidity and prevent mortality. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8 PMID:17171097

Central Nervous System Injury and Neurobiobehavioral Function in Children With Brain Tumors

PubMed Central

Nelson, Mary Baron; Compton, Peggy; Patel, Sunita K.; Jacob, Eufemia; Harper, Ronald

2018-01-01

Background Children with brain tumors present a complex set of factors when considering treatment decisions, including type and location of tumor and age of the child. Two-thirds of children will survive, but historically have had poorer neurocognitive and quality-of-life outcomes when compared with survivors of other childhood cancers. Delaying or forgoing cranial radiation completely is thought to lead to improved neurobiobehavioral outcomes, but there is still relatively little research in this area. Objectives The objectives of this study were to review and consolidate what is known about the effects of cranial radiation and chemotherapy on normal brain tissue and to synthesize that information relative to neurobiobehavioral findings in children with brain tumors. Methods A literature search using PubMed and PsycINFO from 2000 to 2011 was done using a variety of terms related to childhood brain tumor treatment and outcome. A total of 70 articles were reviewed, and 40 were chosen for inclusion in the review based on most relevance to this population. Results Both cranial radiation and certain chemotherapy agents cause damage to or loss of healthy neurons, as well as a decrease in the number of progenitor cells of the hippocampus. However, in general, children treated with chemotherapy alone appear to have less of a neurobiobehavioral impact than those treated with cranial radiation. Conclusions The trend toward delaying or postponing cranial radiation when possible may improve overall neurocognitive and quality-of-life outcomes. Implications for Practice Nurses require knowledge of these issues when discussing treatment with families and with caring for long-term survivors. PMID:22781957

Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement.

PubMed

Dröge, L H; Hinsche, T; Canis, M; Alt-Epping, B; Hess, C F; Wolff, H A

2014-02-01

Skull base metastases frequently appear in a late stage of various tumor entities and cause pain and neurological disorders which strongly impair patient quality of life. This study retrospectively analyzed fractionated external beam radiotherapy (EBRT) as a palliative treatment approach with special respect to neurological outcome, feasibility and acute toxicity. A total of 30 patients with skull base metastases and cranial nerve disorders underwent EBRT with a mean total dose of 31.6 Gy. Neurological status was assessed before radiotherapy, during radiotherapy and 2 weeks afterwards categorizing orbital, parasellar, middle fossa, jugular foramen and occipital condyle involvement and associated clinical syndromes. Neurological outcome was scored as persistence of symptoms, partial response, good response and complete remission. Treatment-related toxicity and overall survival were assessed. Before EBRT 37 skull base involvement syndromes were determined with 4 patients showing more than 1 syndrome. Of the patients 81.1 % responded to radiotherapy with 10.8 % in complete remission, 48.6 % with good response and 21.6 % with partial response. Grade 1 toxicity of the skin occurred in two patients and grade 1 hematological toxicity in 1 patient under concurrent chemoradiotherapy. Median overall survival was 3.9 months with a median follow-up of 45 months. The use of EBRT for skull base metastases with symptomatic involvement of cranial nerves is marked by good therapeutic success in terms of neurological outcome, high feasibility and low toxicity rates. These findings underline EBRT as the standard therapeutic approach in the palliative setting.

Computer-assisted shape descriptors for skull morphology in craniosynostosis.

PubMed

Shim, Kyu Won; Lee, Min Jin; Lee, Myung Chul; Park, Eun Kyung; Kim, Dong Seok; Hong, Helen; Kim, Yong Oock

2016-03-01

Our aim was to develop a novel method for characterizing common skull deformities with high sensitivity and specificity, based on two-dimensional (2D) shape descriptors in computed tomography (CT) images. Between 2003 and 2014, 44 normal subjects and 39 infants with craniosynostosis (sagittal, 29; bicoronal, 10) enrolled for analysis. Mean age overall was 16 months (range, 1-120 months), with a male:female ratio of 56:29. Two reference planes, sagittal (S-plane: through top of lateral ventricle) and coronal (C-plane: at maximum dimension of fourth ventricle), were utilized to formulate three 2D shape descriptors (cranial index [CI], cranial radius index [CR], and cranial extreme spot index [CES]), which were then applied to S- and C-plane target images of both groups. In infants with sagittal craniosynostosis, CI in S-plane (S-CI) usually was <1.0 (mean, 0.78; range, 0.67-0.95), with CR consistently at 3 and a characteristic CES pattern of two discrete hot spots oriented diagonally. In the bicoronal craniosynostosis subset, CI was >1.0 (mean 1.11; range, 1.04-1.25), with CR at -3 and a CES pattern of four discrete diagonally oriented hot spots. Scatter plots underscored the highly intuitive joint performance of CI and CES in distinguishing normal and deformed states. Altogether, these novel 2D shape descriptors enabled effective discrimination of sagittal and bicoronal skull deformities. Newly developed 2D shape descriptors for cranial CT imaging enabled recognition of common skull deformities with statistical significance, perhaps providing impetus for automated CT-based diagnosis of craniosynostosis.

Cranial epidural hematomas: A case series and literature review of this rare complication associated with sickle cell disease.

PubMed

Hamm, Jennifer; Rathore, Nisha; Lee, Pearlene; LeBlanc, Zachary; Lebensburger, Jeffrey; Meier, Emily Riehm; Kwiatkowski, Janet L

2017-03-01

Patients with sickle cell disease (SCD) may experience many complications of the central nervous system (CNS) including stroke, silent cerebral infarcts, and neuropsychological deficits. Cranial epidural hematoma is a rare but potentially serious complication. Case series of cranial epidural hematomas in children with SCD from three different institutions is considered, along with a literature review of cranial epidural hematomas in this population. Seven children with SCD with cranial epidural hematomas were identified from three different institutions. All patients were male and the age at presentation ranged from 10 to 18 years. Two patients presented with headache (28.6%), while the rest had no neurologic symptoms at presentation. Four patients required urgent neurosurgical intervention (57.1%) and one patient died (14.3%). A literature review identified 18 additional cases of cranial epidural hematomas in children with SCD. Of these, treatment ranged from supportive care to neurosurgical intervention. Twelve patients completely recovered (66.7%), one patient had long-term cognitive impairment (5.6%), and four patients died (22.2%). Combined with our data, cranial epidural hematomas have a mortality rate of 20.0%. Although rare, cranial epidural hematoma can be fatal and should be considered in patients with acute neurological symptoms. © 2016 Wiley Periodicals, Inc.

Pediatric Emergency Care Applied Research Network head injuryprediction rules: on the basis of cost and effectiveness

PubMed

Gökharman, Fatma Dilek; Aydın, Sonay; Fatihoğlu, Erdem; Koşar, Pınar Nercis

2017-12-19

Background/aim: Head injuries are commonly seen in the pediatric population. Noncontrast enhanced cranial CT is the method of choice to detect possible traumatic brain injury (TBI). Concerns about ionizing radiation exposure make the evaluation more challenging. The aim of this study was to evaluate the effectiveness of the Pediatric Emergency Care Applied Research Network (PECARN) rules in predicting clinically important TBI and to determine the amount of medical resource waste and unnecessary radiation exposure.Materials and methods: This retrospective study included 1041 pediatric patients presented to the emergency department. The patients were divided into subgroups of "appropriate for cranial CT", "not appropriate for cranial CT" and "cranial CT/observation of patient; both are appropriate". To determine the effectiveness of the PECARN rules, data were analyzed according to the presence of pathological findings Results: "Appropriate for cranial CT" results can predict pathology presence 118,056-fold compared to the "not appropriate for cranial CT" results. With "cranial CT/observation of patient; both are appropriate" results, pathology presence was predicted 11,457-fold compared to "not appropriate for cranial CT" results.Conclusion: PECARN rules can predict pathology presence successfully in pediatric TBI. Using PECARN can decrease resource waste and exposure to ionizing radiation.

The cranial anatomy of the neornithischian dinosaur Thescelosaurus neglectus

PubMed Central

2014-01-01

Though the dinosaur Thescelosaurus neglectus was first described in 1913 and is known from the relatively fossiliferous Lance and Hell Creek formations in the Western Interior Basin of North America, the cranial anatomy of this species remains poorly understood. The only cranial material confidently referred to this species are three fragmentary bones preserved with the paratype, hindering attempts to understand the systematic relationships of this taxon within Neornithischia. Here the cranial anatomy of T. neglectus is fully described for the first time based on two specimens that include well-preserved cranial material (NCSM 15728 and TLAM.BA.2014.027.0001). Visual inspection of exposed cranial elements of these specimens is supplemented by detailed CT data from NCSM 15728 that enabled the examination of otherwise unexposed surfaces, facilitating a complete description of the cranial anatomy of this species. The skull of T. neglectus displays a unique combination of plesiomorphic and apomorphic traits. The premaxillary and ‘cheek’ tooth morphologies are relatively derived, though less so than the condition seen in basal iguanodontians, suggesting that the high tooth count present in the premaxillae, maxillae, and dentaries may be related to the extreme elongation of the skull of this species rather than a retention of the plesiomorphic condition. The morphology of the braincase most closely resembles the iguanodontians Dryosaurus and Dysalotosaurus, especially with regard to the morphology of the prootic. One autapomorphic feature is recognized for the first time, along with several additional cranial features that differentiate this species from the closely related and contemporaneous Thescelosaurus assiniboiensis. Published phylogenetic hypotheses of neornithischian dinosaur relationships often differ in the placement of the North American taxon Parksosaurus, with some recovering a close relationship with Thescelosaurus and others with the South American taxon Gasparinisaura, but never both at the same time. The new morphological observations presented herein, combined with re-examination of the holotype of Parksosaurus, suggest that Parksosaurus shares a closer relationship with Thescelosaurus than with Gasparinisaura, and that many of the features previously cited to support a relationship with the latter taxon are either also present in Thescelosaurus, are artifacts of preservation, or are the result of incomplete preparation and inaccurate interpretation of specimens. Additionally, the overall morphology of the skull and lower jaws of both Thescelosaurus and Parksosaurus also closely resemble the Asian taxa Changchunsaurus and Haya, though the interrelationships of these taxa have yet to be tested in a phylogenetic analysis that includes these new morphological data for T. neglectus. PMID:25405076

Neuromuscular ultrasound of cranial nerves.

PubMed

Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

2015-04-01

Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

Fgf20b is required for the ectomesenchymal fate establishment of cranial neural crest cells in zebrafish

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yamauchi, Hajime; Goto, Mami; Katayama, Mika

2011-06-17

Highlights: {yields} The establishment of the ectomesenchymal lineage within the cranial neural crest is of great significance. {yields} Fgf20b knockdown zebrafish embryos showed dysplasticneurocranial and pharyngeal cartilages. {yields} Fgf20b is required for ectomesenchymal fate establishment via the activation of Fgfr1 in zebrafish. -- Abstract: In cranial skeletal development, the establishment of the ectomesenchymal lineage within the cranial neural crest is of great significance. Fgfs are polypeptide growth factors with diverse functions in development and metabolism. Fgf20b knockdown zebrafish embryos showed dysplastic neurocranial and pharyngeal cartilages. Ectomesenchymal cells from cranial neural crest cells were significantly decreased in Fgf20b knockdown embryos, butmore » cranial neural crest cells with a non-ectomesnchymal fate were increased. However, the proliferation and apoptosis of cranial neural crest cells were essentially unchanged. Fgfr1 knockdown embryos also showed dysplastic neurocranial and pharyngeal cartilages. The present findings indicate that Fgf20b is required for ectomesenchymal fate establishment via the activation of Fgfr1 in zebrafish.« less

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

PubMed

Vilensky, Joel A

2014-01-01

The nervus terminalis (NT; terminal nerve) was clearly identified as an additional cranial nerve in humans more than a century ago yet remains mostly undescribed in modern anatomy textbooks. The nerve is referred to as the nervus terminalis because in species initially examined its fibers were seen entering the brain in the region of the lamina terminalis. It has also been referred to as cranial nerve 0, but because there is no Roman symbol for zero, an N for the Latin word nulla is a better numerical designation. This nerve is very distinct in human fetuses and infants but also has been repeatedly identified in adult human brains. The NT fibers are unmyelinated and emanate from ganglia. The fibers pass through the cribriform plate medial to those of the olfactory nerve fila. The fibers end in the nasal mucosa and probably arise from autonomic/neuromodulatory as well as sensory neurons. The NT has been demonstrated to release luteinizing-releasing luteinizing hormone and is therefore thought to play a role in reproductive behavior. Based on the available evidence, the NT appears to be functional in adult humans and should be taught in medical schools and incorporated into anatomy/neuroanatomy textbooks. Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.

Macroscopic Innervation of the Dura Mater Covering the Middle Cranial Fossa in Humans Correlated to Neurovascular Headache

PubMed Central

Lee, Shin-Hyo; Hwang, Seung-Jun; Koh, Ki-Seok; Song, Wu-Chul; Han, Sang-Don

2017-01-01

The trigeminovascular system within the cranial dura mater is a possible cause of headaches. The aim of this study is to investigate macroscopically dural innervation around the middle meningeal artery (MMA) in the middle cranial fossa. Forty-four sides of the cranial dura overlying the skull base obtained from 24 human cadavers were stained using Sihler’s method. Overall, the nervus spinosus (NS) from either the maxillary or mandibular trigeminal divisions ran along the lateral wall of the middle meningeal vein rather than that of the MMA. Distinct bundles of the NS running along the course of the frontal branches of the MMA were present in 81.8% of cases (N = 36). Others did not form dominant nerve bundles, instead giving off free nerve endings along the course of the MMA or dural connective tissue. The distribution of these nerve endings was similar to that of the course of the frontal, parietal and petrosal branches of the MMA (11.4%). The others were not restricted to a perivascular plexus, crossing the dural connective tissues far from the MMA (6.8%). These findings indicate that the NS generally travels alongside the course of the frontal branches of the MMA and terminates in the vicinity of the pterion. PMID:29311855

Human cranial vault thickness in a contemporary sample of 1097 autopsy cases: relation to body weight, stature, age, sex and ancestry.

PubMed

De Boer, H H Hans; Van der Merwe, A E Lida; Soerdjbalie-Maikoe, V Vidija

2016-09-01

The relation between human cranial vault thickness (CVT) and various elements of the physical anthropological biological profile is subject of ongoing discussion. Some results seem to indicate no correlation between CVT and the biological profile of the individual, whereas other results suggest that CVT measurements might be useful for identification purposes. This study assesses the correlation between CVT and body weight, stature, age, sex, and ancestry by reviewing data of 1097 forensic autopsies performed at the Netherlands Forensic Institute (NFI). In subadults (younger than 19 years of age at the time of death), all frontal, temporal, and occipital CVT measurements correlated moderately to strongly with indicators of growth (body weight, stature, and age). Neither sex nor ancestry correlated significantly with cranial thickness. In adults, body weight correlated with all CVT measurements. No meaningful correlation was found between CVT and stature or age. Females showed to have thicker frontal bones, and the occipital region was thicker in the Negroid subsample. All correlation in the adult group was weak, with the distribution of cranial thickness overlapping for a great deal between the groups. Based on these results, it was concluded that CVT generally cannot be used as an indicator for any part of the biological profile.

Cranial shape evolution in adaptive radiations of birds: comparative morphometrics of Darwin's finches and Hawaiian honeycreepers

PubMed Central

Tokita, Masayoshi; Yano, Wataru; James, Helen F.

2017-01-01

Adaptive radiation is the rapid evolution of morphologically and ecologically diverse species from a single ancestor. The two classic examples of adaptive radiation are Darwin's finches and the Hawaiian honeycreepers, which evolved remarkable levels of adaptive cranial morphological variation. To gain new insights into the nature of their diversification, we performed comparative three-dimensional geometric morphometric analyses based on X-ray microcomputed tomography (µCT) scanning of dried cranial skeletons. We show that cranial shapes in both Hawaiian honeycreepers and Coerebinae (Darwin's finches and their close relatives) are much more diverse than in their respective outgroups, but Hawaiian honeycreepers as a group display the highest diversity and disparity of all other bird groups studied. We also report a significant contribution of allometry to skull shape variation, and distinct patterns of evolutionary change in skull morphology in the two lineages of songbirds that underwent adaptive radiation on oceanic islands. These findings help to better understand the nature of adaptive radiations in general and provide a foundation for future investigations on the developmental and molecular mechanisms underlying diversification of these morphologically distinguished groups of birds. This article is part of the themed issue ‘Evo-devo in the genomics era, and the origins of morphological diversity’. PMID:27994122

Macroscopic Innervation of the Dura Mater Covering the Middle Cranial Fossa in Humans Correlated to Neurovascular Headache.

PubMed

Lee, Shin-Hyo; Hwang, Seung-Jun; Koh, Ki-Seok; Song, Wu-Chul; Han, Sang-Don

2017-01-01

The trigeminovascular system within the cranial dura mater is a possible cause of headaches. The aim of this study is to investigate macroscopically dural innervation around the middle meningeal artery (MMA) in the middle cranial fossa. Forty-four sides of the cranial dura overlying the skull base obtained from 24 human cadavers were stained using Sihler's method. Overall, the nervus spinosus (NS) from either the maxillary or mandibular trigeminal divisions ran along the lateral wall of the middle meningeal vein rather than that of the MMA. Distinct bundles of the NS running along the course of the frontal branches of the MMA were present in 81.8% of cases ( N = 36). Others did not form dominant nerve bundles, instead giving off free nerve endings along the course of the MMA or dural connective tissue. The distribution of these nerve endings was similar to that of the course of the frontal, parietal and petrosal branches of the MMA (11.4%). The others were not restricted to a perivascular plexus, crossing the dural connective tissues far from the MMA (6.8%). These findings indicate that the NS generally travels alongside the course of the frontal branches of the MMA and terminates in the vicinity of the pterion.

Intraoperative biopsy of the major cranial nerves in the surgical strategy for adenoid cystic carcinoma close to the skull base.

PubMed

Tarsitano, Achille; Pizzigallo, Angelo; Gessaroli, Manlio; Sturiale, Carmelo; Marchetti, Claudio

2012-02-01

Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base. During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection. The percentage of actuarial local control at 5 years for patients with a positive named nerve and skull base infiltration was 12.5%, compared with 90.0% in patients who were named nerve-negative and without infiltration of the skull base (P = .001). Our study shows that local control of disease for patients who are named nerve-positive with skull base infiltration is significantly more complex compared with patients who are named nerve-negative without infiltration of the skull base. Copyright © 2012. Published by Mosby, Inc.

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification. III. Comparison of lateral craniofacial morphology.

PubMed

Heliövaara, A; Ranta, R

1993-10-01

The craniofacial morphology of 116 consecutive patients with isolated cleft palate was studied by means of lateral cephalograms at 17 to 20 years of age. One-stage hard- and soft-palate closure had been carried out at the mean age of 1.8 years by using the Veau-Wardill-Kilner or the Cronin mucoperiosteal palatal V-Y pushback technique. In the Veau-Wardill-Kilner group the cranial base was longer, the cranial base angle was larger, and the mandible longer and its ramus higher but less backward rotated. The patients with originally the most extensive clefts showed the most marked deviations in craniofacial morphology at adult age.

Magnetic resonance imaging mesencephalic tectum dimensions according to age and gender.

PubMed

Sabanciogullari, Vedat; Salk, Ismail; Balaban, Hatice; Oztoprak, Ibrahim; Kelkit, Seref; Cimen, Mehmet

2013-01-01

To analyze and classify normal MRI tectum length and colliculus dimensions according to age and gender. Tectum length and colliculus diameters were measured on the T1 midsagittal and axial cranial MR images in the radiology archive of 532 (344 women, 188 men) patients aged 37.36+/-21.49 (range: 4-91) years old on average, and with no disorders affecting the mesencephalic tectum. All 532 patients underwent clinical MR imaging of the cranium at the MRI Unit of Sivas Numune Hospital and Sivas Cumhuriyet University Hospital, Sivas, Turkey between February and December 2011. Although there was a positive linear correlation between tectum length and age, there was a negative correlation between the anteroposterior diameter of the colliculus superior and colliculus inferior and age (p<0.01). While tectum length (M3) increases with age, the anteroposterior diameter of the colliculus superior and inferior (M1 and M2) decreased (p<0.01). The colliculi were larger, and the tectum was longer in men. Although there was no difference in size between right and left superior colliculi, the left colliculus inferior was larger than the right one. In addition to the fact that normal mesencephalic tectum dimensions provide information on the brain development of individuals, they may also be beneficial for the detection and treatment of related pathologies.

Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study

PubMed Central

Dolati, Parviz; Gokoglu, Abdulkerim; Eichberg, Daniel; Zamani, Amir; Golby, Alexandra; Al-Mefty, Ossama

2015-01-01

Background: Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. Methods: To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured. Results: Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases. Conclusion: Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients. PMID:26674155

Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study.

PubMed

Dolati, Parviz; Gokoglu, Abdulkerim; Eichberg, Daniel; Zamani, Amir; Golby, Alexandra; Al-Mefty, Ossama

2015-01-01

Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge. To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured. Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases. Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients.

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

PubMed Central

Kraft, S P; Lang, A E

1988-01-01

Blepharospasm, the most frequent feature of cranial dystonia, and hemifacial spasm are two involuntary movement disorders that affect facial muscles. The cause of blepharospasm and other forms of cranial dystonia is not known. Hemifacial spasm is usually due to compression of the seventh cranial nerve at its exit from the brain stem. Cranial dystonia may result in severe disability. Hemifacial spasm tends to be much less disabling but may cause considerable distress and embarrassment. Patients affected with these disorders are often mistakenly considered to have psychiatric problems. Although the two disorders are quite distinct pathophysiologically, therapy with botulinum toxin has proven very effective in both. We review the clinical features, proposed pathophysiologic features, differential diagnosis and treatment, including the use of botulinum toxin, of cranial dystonia and hemifacial spasm. Images Fig. 2 Fig. 3 PMID:3052771

Neonatal cranial sonography: A concise review for clinicians

PubMed Central

Gupta, Pankaj; Sodhi, Kushaljit Singh; Saxena, Akshay Kumar; Khandelwal, Niranjan; Singhi, Pratibha

2016-01-01

Cranial sonography continues to hold an important place in neonatal care. Attributes favorable to sonography that make it almost indispensable for routine care of the newborn includes easy access, low cost, portability, lack of ionizing radiations and exemption from sedation or anaesthesia. Cranial sonography has highest impact in neonates suspected to have meningitis and its complications; perinatal ischemia particularly periventricular leukomalacia (PVL); hydrocephalus resulting from multitude of causes and hemorrhage. Not withstanding this, cranial sonography has yielded results for a repertoire of indications. Approach to cranial sonography involves knowledge of the normal developmental anatomy of brain parenchyma for correct interpretation. Correct technique, taking advantage of multiple sonographic windows and variable frequencies of the ultrasound probes allows a detailed and comprehensive examination of brain parenchyma. In this review, we discuss the technique, normal and variant anatomy as well as disease entities of neonatal cranial sonography. PMID:27195026

The Ardipithecus ramidus skull and its implications for hominid origins.

PubMed

Suwa, Gen; Asfaw, Berhane; Kono, Reiko T; Kubo, Daisuke; Lovejoy, C Owen; White, Tim D

2009-10-02

The highly fragmented and distorted skull of the adult skeleton ARA-VP-6/500 includes most of the dentition and preserves substantial parts of the face, vault, and base. Anatomical comparisons and micro-computed tomography-based analysis of this and other remains reveal pre-Australopithecus hominid craniofacial morphology and structure. The Ardipithecus ramidus skull exhibits a small endocranial capacity (300 to 350 cubic centimeters), small cranial size relative to body size, considerable midfacial projection, and a lack of modern African ape-like extreme lower facial prognathism. Its short posterior cranial base differs from that of both Pan troglodytes and P. paniscus. Ar. ramidus lacks the broad, anteriorly situated zygomaxillary facial skeleton developed in later Australopithecus. This combination of features is apparently shared by Sahelanthropus, showing that the Mio-Pliocene hominid cranium differed substantially from those of both extant apes and Australopithecus.

Role of cranial neural crest cells in visceral arch muscle positioning and morphogenesis in the Mexican axolotl, Ambystoma mexicanum.

PubMed

Ericsson, Rolf; Cerny, Robert; Falck, Pierre; Olsson, Lennart

2004-10-01

The role of cranial neural crest cells in the formation of visceral arch musculature was investigated in the Mexican axolotl, Ambystoma mexicanum. DiI (1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine, perchlorate) labeling and green fluorescent protein (GFP) mRNA injections combined with unilateral transplantations of neural folds showed that neural crest cells contribute to the connective tissues but not the myofibers of developing visceral arch muscles in the mandibular, hyoid, and branchial arches. Extirpations of individual cranial neural crest streams demonstrated that neural crest cells are necessary for correct morphogenesis of visceral arch muscles. These do, however, initially develop in their proper positions also in the absence of cranial neural crest. Visceral arch muscles forming in the absence of neural crest cells start to differentiate at their origins but fail to extend toward their insertions and may have a frayed appearance. Our data indicate that visceral arch muscle positioning is controlled by factors that do not have a neural crest origin. We suggest that the cranial neural crest-derived connective tissues provide directional guidance important for the proper extension of the cranial muscles and the subsequent attachment to the insertion on the correct cartilage. In a comparative context, our data from the Mexican axolotl support the view that the cranial neural crest plays a fundamental role in the development of not only the skeleton of the vertebrate head but also in the morphogenesis of the cranial muscles and that this might be a primitive feature of cranial development in vertebrates. 2004 Wiley-Liss, Inc.

A COMPUTATIONAL ANALYSIS OF BONE FORMATION IN THE CRANIAL VAULT USING A COUPLED REACTION-DIFFUSION-STRAIN MODEL

PubMed Central

LEE, CHANYOUNG; RICHTSMEIER, JOAN T.; KRAFT, REUBEN H.

2017-01-01

Bones of the murine cranial vault are formed by differentiation of mesenchymal cells into osteoblasts, a process that is primarily understood to be controlled by a cascade of reactions between extracellular molecules and cells. We assume that the process can be modeled using Turing’s reaction-diffusion equations, a mathematical model describing the pattern formation controlled by two interacting molecules (activator and inhibitor). In addition to the processes modeled by reaction-diffusion equations, we hypothesize that mechanical stimuli of the cells due to growth of the underlying brain contribute significantly to the process of cell differentiation in cranial vault development. Structural analysis of the surface of the brain was conducted to explore the effects of the mechanical strain on bone formation. We propose a mechanobiological model for the formation of cranial vault bones by coupling the reaction-diffusion model with structural mechanics. The mathematical formulation was solved using the finite volume method. The computational domain and model parameters are determined using a large collection of experimental data that provide precise three dimensional (3D) measures of murine cranial geometry and cranial vault bone formation for specific embryonic time points. The results of this study suggest that mechanical strain contributes information to specific aspects of bone formation. Our mechanobiological model predicts some key features of cranial vault bone formation that were verified by experimental observations including the relative location of ossification centers of individual vault bones, the pattern of cranial vault bone growth over time, and the position of cranial vault sutures. PMID:29225392

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

PubMed

Harvati, Katerina; Weaver, Timothy D

2006-12-01

Cranial morphology is widely used to reconstruct evolutionary relationships, but its reliability in reflecting phylogeny and population history has been questioned. Some cranial regions, particularly the face and neurocranium, are believed to be influenced by the environment and prone to convergence. Others, such as the temporal bone, are thought to reflect more accurately phylogenetic relationships. Direct testing of these hypotheses was not possible until the advent of large genetic data sets. The few relevant studies in human populations have had intriguing but possibly conflicting results, probably partly due to methodological differences and to the small numbers of populations used. Here we use three-dimensional (3D) geometric morphometrics methods to test explicitly the ability of cranial shape, size, and relative position/orientation of cranial regions to track population history and climate. Morphological distances among 13 recent human populations were calculated from four 3D landmark data sets, respectively reflecting facial, neurocranial, and temporal bone shape; shape and relative position; overall cranial shape; and centroid sizes. These distances were compared to neutral genetic and climatic distances among the same, or closely matched, populations. Results indicate that neurocranial and temporal bone shape track neutral genetic distances, while facial shape reflects climate; centroid size shows a weak association with climatic variables; and relative position/orientation of cranial regions does not appear correlated with any of these factors. Because different cranial regions preserve population history and climate signatures differentially, caution is suggested when using cranial anatomy for phylogenetic reconstruction. Copyright (c) 2006 Wiley-Liss, Inc.

Diplopia as the primary presentation of foodborne botulism.

PubMed

Khakshoor, Hamid; Moghaddam, Ali Akbar Saber; Vejdani, Amir Hossein; Armstrong, Blair K; Moshirfar, Majid

2012-05-01

Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist.

Diplopia as the primary presentation of foodborne botulism

PubMed Central

Khakshoor, Hamid; Moghaddam, Ali Akbar Saber; Vejdani, Amir Hossein; Armstrong, Blair K.; Moshirfar, Majid

2012-01-01

Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist. PMID:22993467

Cranial Bone Graft Donor Site Reconstruction.

PubMed

Çelik, Muzaffer

2017-01-01

My most important concern, in my entire experience with cranial bone grafting procedures, is managing the bone graft donor site such as donor site cavity from harvesting and weakness of the cranium. The most common patient complaint, following cranial bone grafting for aesthetic indications, is the presence of a cavity at the donor site. The authors have managed more than 200 patients since 2001, wherein the cranial bone graft-donor sites were reconstructed with tiny bone chip lamellae harvested from the area adjacent to the donor site. This procedure was associated with a low incidence of patient complaints, thereby suggesting higher patient satisfaction. This approach for cranial bone grafting appears to have a high patient acceptance.

Modified three-dimensional skull base model with artificial dura mater, cranial nerves, and venous sinuses for training in skull base surgery: technical note.

PubMed

Mori, Kentaro; Yamamoto, Takuji; Oyama, Kazutaka; Ueno, Hideaki; Nakao, Yasuaki; Honma, Keiichirou

2008-12-01

Experience with dissection of the cavernous sinus and the temporal bone is essential for training in skull base surgery, but the opportunities for cadaver dissection are very limited. A modification of a commercially available prototype three-dimensional (3D) skull base model, made by a selective laser sintering method and incorporating surface details and inner bony structures such as the inner ear structures and air cells, is proposed to include artificial dura mater, cranial nerves, venous sinuses, and the internal carotid artery for such surgical training. The transpetrosal approach and epidural cavernous sinus surgery (Dolenc's technique) were performed on this modified model using a high speed drill or ultrasonic bone curette under an operating microscope. The model could be dissected in almost the same way as a real cadaver. The modified 3D skull base model provides a good educational tool for training in skull base surgery.

Three-dimensional model of the skull and the cranial bones reconstructed from CT scans designed for rapid prototyping process.

PubMed

Skrzat, Janusz; Spulber, Alexandru; Walocha, Jerzy

This paper presents the effects of building mesh models of the human skull and the cranial bones from a series of CT-scans. With the aid of computer so ware, 3D reconstructions of the whole skull and segmented cranial bones were performed and visualized by surface rendering techniques. The article briefly discusses clinical and educational applications of 3D cranial models created using stereolitographic reproduction.

[Neurological paleopathology in the pre-Columbian cultures of the coast and the Andean plateau (I). Artificial cranial deformation].

PubMed

Carod Artal, F J; Vázquez Cabrera, C B

The aim of this work was to study the cranial trepanations and deformations carried out by the ancient Paraca, Huari, Tiahuanaco and Inca cultures. To do so, we conducted a field study involving visits to archaeological remains and anthropological museums on the Andean plateau and the Peruvian coast. Cranial deformation was more common in the Andean regions and was performed by putting little pieces of wood or compressive bandages on newborn infants' heads in order to modify the growth axis of the cranial cavity. Cranial deformations were performed for aesthetic and magic religious reasons, but were also used as a means of ethnic or social identification, as a symbol of nobility or to distinguish the ruling classes. The immediate consequence of such deformation was the modification of the normal process by which the cranial sutures close. There is a significant correlation between the presence of posterior and lateral wormian bones, according to the degree of artificial deformation. The persistence of metopic suture and exostosis of the outer ear canal have been found in 5% of the skulls belonging to pre Columbine mummies. Other paleopathological findings include cranial fractures (7%), porotic hyperostosis (25% of children's skulls), spina bifida occulta, signs of spinal disk arthrosis and Pott's disease. Artificial cranial deformation was a very widespread practice in the Andean regions in pre Columbine times.

Leg length, body proportion, and health: a review with a note on beauty.

PubMed

Bogin, Barry; Varela-Silva, Maria Inês

2010-03-01

Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (femur + tibia), sitting height (trunk length + head length) and their proportions, for example, (leg length/stature), or the sitting height ratio (sitting height/stature x 100), among others) are associated with epidemiological risk for overweight (fatness), coronary heart disease, diabetes, liver dysfunction and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e., a high sitting height ratio) is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The HOXd and the short stature homeobox-containing gene (SHOX) are genomic regions that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, research with non-pathological populations indicates that the environment is a more powerful force influencing leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility.

Leg Length, Body Proportion, and Health: A Review with a Note on Beauty

PubMed Central

Bogin, Barry; Varela-Silva, Maria Inês

2010-01-01

Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (femur + tibia), sitting height (trunk length + head length) and their proportions, for example, (leg length/stature), or the sitting height ratio (sitting height/stature × 100), among others) are associated with epidemiological risk for overweight (fatness), coronary heart disease, diabetes, liver dysfunction and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e., a high sitting height ratio) is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The HOXd and the short stature homeobox-containing gene (SHOX) are genomic regions that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, research with non-pathological populations indicates that the environment is a more powerful force influencing leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility. PMID:20617018

Neuroprotective effect of lurasidone via antagonist activities on histamine in a rat model of cranial nerve involvement.

PubMed

He, Baoming; Yu, Liang; Li, Suping; Xu, Fei; Yang, Lili; Ma, Shuai; Guo, Yi

2018-04-01

Cranial nerve involvement frequently involves neuron damage and often leads to psychiatric disorder caused by multiple inducements. Lurasidone is a novel antipsychotic agent approved for the treatment of cranial nerve involvement and a number of mental health conditions in several countries. In the present study, the neuroprotective effect of lurasidone by antagonist activities on histamine was investigated in a rat model of cranial nerve involvement. The antagonist activities of lurasidone on serotonin 5‑HT7, serotonin 5‑HT2A, serotonin 5‑HT1A and serotonin 5‑HT6 were analyzed, and the preclinical therapeutic effects of lurasidone were examined in a rat model of cranial nerve involvement. The safety, maximum tolerated dose (MTD) and preliminary antitumor activity of lurasidone were also assessed in the cranial nerve involvement model. The therapeutic dose of lurasidone was 0.32 mg once daily, administered continuously in 14‑day cycles. The results of the present study found that the preclinical prescriptions induced positive behavioral responses following treatment with lurasidone. The MTD was identified as a once daily administration of 0.32 mg lurasidone. Long‑term treatment with lurasidone for cranial nerve involvement was shown to improve the therapeutic effects and reduce anxiety in the experimental rats. In addition, treatment with lurasidone did not affect body weight. The expression of the language competence protein, Forkhead‑BOX P2, was increased, and the levels of neuroprotective SxIP motif and microtubule end‑binding protein were increased in the hippocampal cells of rats with cranial nerve involvement treated with lurasidone. Lurasidone therapy reinforced memory capability and decreased anxiety. Taken together, lurasidone treatment appeared to protect against language disturbances associated with negative and cognitive impairment in the rat model of cranial nerve involvement, providing a basis for its use in the clinical treatment of patients with cranial nerve involvement.

An Investigation into the Relationship between Human Cranial and Pelvic Sexual Dimorphism.

PubMed

Best, Kaleigh C; Garvin, Heather M; Cabo, Luis L

2017-10-16

When faced with commingled remains, it might be assumed that a more "masculine" pelvis is associated with a more "masculine" cranium, but this relationship has not been specifically tested. This study uses geometric morphometric analyses of pelvic and cranial landmarks to assess whether there is an intra-individual relationship between the degrees of sexual expression in these two skeletal regions. Principal component and discriminant function scores were used to assess sexual dimorphism in 113 U.S. Black individuals. Correlation values and partial least squares regression (PLS) were used to evaluate intra-individual relationships. Results indicate that the os coxae is more sexually dimorphic than the cranium, with element shape being more sexually dimorphic than size. PLS and correlation results suggest no significant intra-individual relationship between pelvic and cranial sexual size or shape expression. Thus, in commingled situations, associations between these skeletal elements cannot be inferred based on degree of "masculinity." © 2017 American Academy of Forensic Sciences.

Cranial magnetic resonance imaging (MRI) in elderly American Indians: Design, methods, and implementation of the Cerebrovascular Disease and its Consequences in American Indians Study

PubMed Central

Suchy-Dicey, Astrid M.; Shibata, Dean; Best, Lyle G.; Verney, Steven P.; Longstreth, W.T.; Lee, Elisa T.; Okin, Peter M.; Devereux, Richard; O’Leary, Marcia; Ali, Tauqeer; Jensen, Paul N.; Muller, Clemma; Nelson, Lonnie A.; Rhoades, Everett; Madhyastha, Tara; Grabowski, Thomas J.; Beauchamp, Norman; Umans, Jason G.; Buchwald, Dedra

2016-01-01

The Cerebrovascular Disease and Its Consequences in American Indians (CDCAI) Study recruited surviving members of a 20-year, longitudinal, population-based cohort of American Indians focused on cardiovascular disease, its risk factors, and its consequences. The goal of CDCAI Study is to characterize the burden, risk factors, and manifestations of vascular brain injury identified on cranial magnetic resonance imaging (MRI). CDCAI Study investigators enrolled 1,033 participants aged 60 years and older from 11 American Indian communities and tribes in the Northern Plains, Southern Plains, and Southwestern U.S. In addition to cranial MRI performed according to standardized protocols, participants underwent extensive medical interview, clinical examination, neurocognitive testing, physical function evaluation, electrocardiogram, and provided blood and urine specimens. Participants also self-administered questionnaires covering demographics, quality of life, and medical history. This report describes the design, implementation, and some of the unique challenges of this study and data collection. PMID:27603047

Posterior cranial base natural growth and development: A systematic review.

PubMed

Currie, Kris; Sawchuk, Dena; Saltaji, Humam; Oh, Heesoo; Flores-Mir, Carlos; Lagravere, Manuel

2017-11-01

To provide a synthesis of the published studies evaluating the natural growth and development of the human posterior cranial base (S-Ba). The search was performed on MEDLINE, Embase, PubMed, and all EBM Reviews electronic databases. In addition, reference lists of the included studies were hand-searched. Articles were included if they analyzed posterior cranial-base growth in humans specifically. Study selection, data extraction, and risk of bias assessment were completed in duplicate. A meta-analysis was not justified. Finally, 23 published studies were selected: 5 cross-sectional and 18 cohort studies. Articles were published between 1955 and 2015, and all were published in English. The sample sizes varied between 20 and 397 individuals and consisted of craniofacial measurements from either living or deceased human skulls. Validity of the measurements was not determined in any of the studies, while six papers reported some form of reliability assessment. All the articles included multiple time points within the same population or data from multiple age groups. Growth of S-Ba was generally agreed to be from spheno-occipital synchondrosis growth. Basion displaced downward and backward and sella turcica moved downward and backward during craniofacial growth. Timing of cessation of S-Ba growth was not conclusive due to limited identified evidence. Current evidence suggests that S-Ba is not totally stable, as its dimensions change throughout craniofacial growth and a minor dimensional change is observed even in late adulthood.

An unusual case of isolated sixth cranial nerve palsy in leprosy.

PubMed

Vaishampayan, Sanjeev; Borde, Priyanka

2012-08-15

Cranial nerve involvement is not common in leprosy. The fifth and seventh cranial nerves are the most commonly affected in leprosy. Herein we present a patient with Hansen disease (BL) with type I reaction who developed isolated involvement of the sixth cranial nerve leading to lateral rectus muscle palsy. He responded to timely anti-reactional therapy and it produced a good response. Careful observation of patients with lepra reaction is needed to avoid damage to important organs.

Organ and Effective Dose Coefficients for Cranial and Caudal Irradiation Geometries: Neutrons

NASA Astrophysics Data System (ADS)

Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.; Hiller, M. M.

2017-09-01

With the introduction of new recommendations by ICRP Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors, and the introduction of reference sex-specific computational phantoms (ICRP Publication 110). Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT), and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for neutron irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue absorbed doses for caudal and cranial exposures to neutrons ranging in energy from 10-9 MeV to 10 GeV have been performed using the MCNP6 radiation transport code and the adult reference voxel phantoms of ICRP Publication 110. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above about 30 MeV the cranial and caudal values are greater.

A new horned dinosaur reveals convergent evolution in cranial ornamentation in Ceratopsidae.

PubMed

Brown, Caleb M; Henderson, Donald M

2015-06-15

Ceratopsid (horned) dinosaurs are an iconic group of large-bodied, quadrupedal, herbivorous dinosaurs that evolved in the Late Cretaceous and were largely restricted to western North America [1-5]. Ceratopsids are easily recognized by their cranial ornamentation in the form of nasal and postorbital horns and frill (capped by epiossifications); these structures show high morphological disparity and also represent the largest cranial display structures known to have evolved [2, 4]. Despite their restricted occurrence in time and space, this group has one of the best fossil records within Dinosauria, showing a rapid diversification in horn and frill morphology [1]. Here a new genus and species of chasmosaurine ceratopsid is described based on a nearly complete and three-dimensionally preserved cranium recovered from the uppermost St. Mary River Formation (Maastrichtian) of southwestern Alberta. Regaliceratops peterhewsi gen. et sp. nov. exhibits many unique characters of the frill and is characterized by a large nasal horncore, small postorbital horncores, and massive parietal epiossifications. Cranial morphology, particularly the epiossifications, suggests close affinity with the late Campanian/early Maastrichian taxon Anchiceratops, as well as with the late Maastrichtian taxon Triceratops. A median epiparietal necessitates a reassessment of epiossification homology and results in a more resolved phylogeny. Most surprisingly, Regaliceratops exhibits a suite of cranial ornamentations that are superficially similar to Campanian centrosaurines, indicating both exploration of novel display morphospace in Chasmosaurinae, especially Maastrichtian forms, and convergent evolution in horn morphology with the recently extinct Centrosaurinae. This marks the first time that evolutionary convergence in horn-like display structures has been demonstrated between dinosaur clades, similar to those seen in fossil and extant mammals [6]. Copyright © 2015 Elsevier Ltd. All rights reserved.

Are Cranial Biomechanical Simulation Data Linked to Known Diets in Extant Taxa? A Method for Applying Diet-Biomechanics Linkage Models to Infer Feeding Capability of Extinct Species

PubMed Central

Tseng, Zhijie Jack; Flynn, John J.

2015-01-01

Performance of the masticatory system directly influences feeding and survival, so adaptive hypotheses often are proposed to explain craniodental evolution via functional morphology changes. However, the prevalence of “many-to-one” association of cranial forms and functions in vertebrates suggests a complex interplay of ecological and evolutionary histories, resulting in redundant morphology-diet linkages. Here we examine the link between cranial biomechanical properties for taxa with different dietary preferences in crown clade Carnivora, the most diverse clade of carnivorous mammals. We test whether hypercarnivores and generalists can be distinguished based on cranial mechanical simulation models, and how such diet-biomechanics linkages relate to morphology. Comparative finite element and geometric morphometrics analyses document that predicted bite force is positively allometric relative to skull strain energy; this is achieved in part by increased stiffness in larger skull models and shape changes that resist deformation and displacement. Size-standardized strain energy levels do not reflect feeding preferences; instead, caniform models have higher strain energy than feliform models. This caniform-feliform split is reinforced by a sensitivity analysis using published models for six additional taxa. Nevertheless, combined bite force-strain energy curves distinguish hypercarnivorous versus generalist feeders. These findings indicate that the link between cranial biomechanical properties and carnivoran feeding preference can be clearly defined and characterized, despite phylogenetic and allometric effects. Application of this diet-biomechanics linkage model to an analysis of an extinct stem carnivoramorphan and an outgroup creodont species provides biomechanical evidence for the evolution of taxa into distinct hypercarnivorous and generalist feeding styles prior to the appearance of crown carnivoran clades with similar feeding preferences. PMID:25923776

Testicular receptor 2, Nr2c1, is associated with stem cells in the developing olfactory epithelium and other cranial sensory and skeletal structures.

PubMed

Baker, Jennifer L; Wood, Bernard; Karpinski, Beverly A; LaMantia, Anthony-S; Maynard, Thomas M

2016-01-01

Comparative genomic analysis of the nuclear receptor family suggests that the testicular receptor 2, Nr2c1, undergoes positive selection in the human-chimpanzee clade based upon a significant increase in nonsynonymous compared to synonymous substitutions. Previous in situ analyses of Nr2c1 lacked the temporal range and spatial resolution necessary to characterize cellular expression of this gene from early to mid gestation, when many nuclear receptors are key regulators of tissue specific stem or progenitor cells. Thus, we asked whether Nr2c1 protein is associated with stem cell populations in the mid-gestation mouse embryo. Nr2c1 is robustly expressed in the developing olfactory epithelium. Its expression in the olfactory epithelium shifts from multiple progenitor classes at early stages to primarily transit amplifying cells later in olfactory epithelium development. In the early developing central nervous system, Nr2c1 is limited to the anterior telencephalon/olfactory bulb anlagen, coincident with Nestin-positive neuroepithelial stem cells. Nr2c1 is also seen in additional cranial sensory specializations including cells surrounding the mystacial vibrissae, the retinal pigment epithelium and Scarpa's ganglion. Nr2c1 was also detected in a subset of mesenchymal cells in developing teeth and cranial bones. The timing and distribution of embryonic expression suggests that Nr2c1 is primarily associated with the early genesis of mammalian cranial sensory neurons and craniofacial skeletal structures. Thus, Nr2c1 may be a candidate for mediating parallel adaptive changes in cranial neural sensory specializations such as the olfactory epithelium, retina and mystacial vibrissae and in non-neural craniofacial features including teeth. Copyright © 2015 Elsevier B.V. All rights reserved.

A Retrospective 2D Morphometric Analysis of Adult Female Chiari Type I Patients with Commonly Reported and Related Conditions

PubMed Central

Eppelheimer, Maggie S.; Houston, James R.; Bapuraj, Jayapalli R.; Labuda, Richard; Loth, Dorothy M.; Braun, Audrey M.; Allen, Natalie J.; Heidari Pahlavian, Soroush; Biswas, Dipankar; Urbizu, Aintzane; Martin, Bryn A.; Maher, Cormac O.; Allen, Philip A.; Loth, Francis

2018-01-01

Purpose: Researchers have sought to better understand Chiari type I malformation (CMI) through morphometric measurements beyond tonsillar position (TP). Soft tissue and bone structures within the brain and craniocervical junction have been shown to be different for CMI patients compared to healthy controls. Yet, several morphological characteristics have not been consistently associated with CMI. CMI is also associated with different prevalent conditions (PCs) such as syringomyelia, pseudotumor, Ehlers-Danlos syndrome (EDS), scoliosis, and craniocervical instability. The goal of this study was two-fold: (1) to identify unique morphological characteristics of PCs, and (2) to better explain inconsistent results from case-control comparisons of CMI. Methods: Image, demographic, and PC information was obtained through the Chiari1000, a self-report web-accessed database. Twenty-eight morphometric measurements (MMs) were performed on the cranial MR images of 236 pre-surgery adult female CMI participants and 140 female healthy control participants. Custom software was used to measure 28 structures within the posterior cranial fossa (PCF) compartment, craniocervical junction, oral cavity, and intracranial area on midsagittal MR images for each participant. Results: Morphometric analysis of adult females indicated a smaller McRae line length in CMI participants with syringomyelia compared to those without syringomyelia. TP was reduced in CMI participants with EDS than those without EDS. Basion to posterior axial line was significantly longer in CMI participants with scoliosis compared to those without scoliosis. No additional MMs were found to differ between CMI participants with and without a specific PC. Four morphometric differences were found to be consistently different between CMI participants and healthy controls regardless of PC: larger TP and a smaller clivus length, fastigium, and corpus callosum height in CMI participants. Conclusion: Syringomyelia, EDS, and scoliosis were the only PCs that showed significant morphometric differences between CMI participants. Additionally, four midsagittal MR-based MMs were found to be significantly different between healthy controls and CMI participants regardless of the presence of one or more PCs. This study suggests that the prevalence of comorbid conditions are not strongly related to CMI morphology, and that inconsistent findings in the radiographic literature cannot be explained by varying prevalence of comorbid conditions in CMI study samples. PMID:29403363

Random genetic drift, natural selection, and noise in human cranial evolution.

PubMed

Roseman, Charles C

2016-08-01

This study assesses the extent to which relationships among groups complicate comparative studies of adaptation in recent human cranial variation and the extent to which departures from neutral additive models of evolution hinder the reconstruction of population relationships among groups using cranial morphology. Using a maximum likelihood evolutionary model fitting approach and a mixed population genomic and cranial data set, I evaluate the relative fits of several widely used models of human cranial evolution. Moreover, I compare the goodness of fit of models of cranial evolution constrained by genomic variation to test hypotheses about population specific departures from neutrality. Models from population genomics are much better fits to cranial variation than are traditional models from comparative human biology. There is not enough evolutionary information in the cranium to reconstruct much of recent human evolution but the influence of population history on cranial variation is strong enough to cause comparative studies of adaptation serious difficulties. Deviations from a model of random genetic drift along a tree-like population history show the importance of environmental effects, gene flow, and/or natural selection on human cranial variation. Moreover, there is a strong signal of the effect of natural selection or an environmental factor on a group of humans from Siberia. The evolution of the human cranium is complex and no one evolutionary process has prevailed at the expense of all others. A holistic unification of phenome, genome, and environmental context, gives us a strong point of purchase on these problems, which is unavailable to any one traditional approach alone. Am J Phys Anthropol 160:582-592, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Neurologic, neuropsychologic, and computed cranial tomography scan abnormalities in 2- to 10-year survivors of small-cell lung cancer.

PubMed

Johnson, B E; Becker, B; Goff, W B; Petronas, N; Krehbiel, M A; Makuch, R W; McKenna, G; Glatstein, E; Ihde, D C

1985-12-01

In order to evaluate the relationship between neurologic function and cranial irradiation, 20 patients treated on National Cancer Institute (NCI) small-cell lung cancer (SCLC) trials who were alive and free of cancer 2.4 to 10.6 years (median, 6.2) from the start of therapy were studied. All were tested with a neurologic history and examination, mental status examination, neuropsychologic testing, and review of serial computed cranial tomography (CCT) scans. Fifteen patients had been treated with prophylactic cranial irradiation (PCI), two patients with therapeutic cranial irradiation, and three received no cranial irradiation. All patients but one were ambulatory and none were institutionalized. Fifteen patients (75%) had neurologic complaints, 13 (65%) had abnormal neurologic examinations, 12 (60%) had abnormal mental status examinations, 13 (65%) had abnormal neuropsychologic testing, and 15 (75%) had abnormal CCT scans. Compared with those given low-dose maintenance chemotherapy during PCI using 200 to 300 rad per fraction, patients who were given high-dose induction chemotherapy during the time of cranial irradiation or large radiotherapy fractions (400 rad) were more likely to have abnormal mental status examinations (6/6 v 4/9) and abnormal neuropsychologic tests (6/6 v 4/9), but no major difference in CCT findings was present. CCT scans in the majority of cases (11/18) showed progressive ventricular dilatation or cerebral atrophy up to 8 years after stopping therapy. We conclude neurologic abnormalities are common in long-term survivors of SCLC, and may be more prominent in patients given high-dose chemotherapy during cranial irradiation or treated with large radiotherapy fractions. The CCT scan abnormalities are common and progressive years after prophylactic cranial irradiation and chemotherapy are stopped.

Preventing lower cranial nerve injuries during fourth ventricle tumor resection by utilizing intraoperative neurophysiological monitoring.

PubMed

Jahangiri, Faisal R; Minhas, Mazhar; Jane, John

2012-12-01

We present two cases illustrating the benefit of utilizing intraoperative neurophysiological monitoring (IONM) for prevention of injuries to the lower cranial nerves during fourth ventricle tumor resection surgeries. Multiple cranial nerve nuclei are located on the floor of the fourth ventricle with a high risk of permanent damage. Two male patients (ages 8 and 10 years) presented to the emergency department and had brain magnetic resonance imaging (MRI) scans showing brainstem/fourth ventricle tumors. During surgery, bilateral posterior tibial and median nerve somatosensory evoked potentials (SSEPs); four-limb and cranial nerves transcranial electrical motor evoked potentials (TCeMEPs); brainstem auditory evoked responses (BAERs); and spontaneous electromyography (s-EMG) were recorded. Electromyography (EMG) was monitored bilaterally from cranial nerves V VII, IX, X, XI, and XII. Total intravenous anesthesia was used. Neuromuscular blockade was used only for initial intubation. Pre-incision baselines were obtained with good morphology of waveforms. After exposure the floor of the fourth ventricle was mapped by triggered-EMG (t-EMG) using 0.4 to 1.0 mA. In both patients the tumor was entangled with cranial nerves VII to XII on the floor of the fourth ventricle. The surgeon made the decision not to resect the tumor in one case and limited the resection to 70% of the tumor in the second case on the basis of neurophysiological monitoring. This decision was made to minimize any post-operative neurological deficits due to surgical manipulation of the tumor involving the lower cranial nerves. Intraoperative spontaneous and triggered EMG was effectively utilized in preventing injuries to cranial nerves during surgical procedures. All signals remained stable during the surgical procedure. Postoperatively both patients were well with no additional cranial nerve weakness. At three months follow-up, the patients continued to have no deficits.

Effect of staff training on radiation dose in pediatric CT.

PubMed

Hojreh, Azadeh; Weber, Michael; Homolka, Peter

2015-08-01

To evaluate the efficacy of staff training on radiation doses applied in pediatric CT scans. Pediatric patient doses from five CT scanners before (1426 scans) and after staff training (2566 scans) were compared statistically. Examinations included cranial CT (CCT), thoracic, abdomen-pelvis, and trunk scans. Dose length products (DLPs) per series were extracted from CT dose reports archived in the PACS. A pooled analysis of non-traumatic scans revealed a statistically significant reduction in the dose for cranial, thoracic, and abdomen/pelvis scans (p<0.01). This trend could be demonstrated also for trunk scans, however, significance could not be established due to low patient frequencies (p>0.05). The percentage of scans performed with DLPs exceeding the German DRLs was reduced from 41% to 7% (CCT), 19% to 5% (thorax-CT), from 9% to zero (abdominal-pelvis CT), and 26% to zero (trunk; DRL taken as summed DRLs for thorax plus abdomen-pelvis, reduced by 20% accounting for overlap). Comparison with Austrian DRLs - available only for CCT and thorax CT - showed a reduction from 21% to 3% (CCT), and 15 to 2% (thorax CT). Staff training together with application of DRLs provide an efficient approach for optimizing radiation dose in pediatric CT practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Relative position of the atrioventricular canal determines the electrical activation of developing reptile ventricles.

PubMed

Gregorovicova, Martina; Sedmera, David; Jensen, Bjarke

2018-04-19

Squamate reptiles appear to lack the specialized His/Purkinje system that enables the cardiac ventricle to be activated from apex to base as in mammals and birds. Instead, activation may simply spread from where the atrioventricular canal connects to the base. Gja5 , which encodes Cx40 that allows fast impulse propagation, was expressed throughout the ventricles of developing anole lizards. Activation was optically recorded in developing corn snake and central bearded dragon. Early embryonic ventricles were broad in shape, and activation propagated from the base to the right. Elongated ventricles of later stages were activated from base to apex. Before hatching, the snake ventricle developed a cranial extension on the left and activation now propagated from the base to the caudal apex and the cranial extension. In squamate reptiles, the pattern of electrical activation of the cardiac ventricle is dependent the position of the atrioventricular canal and the shape of the ventricle. © 2018. Published by The Company of Biologists Ltd.

Portlandemys gracilis n. sp., a New Coastal Marine Turtle from the Late Jurassic of Porrentruy (Switzerland) and a Reconsideration of Plesiochelyid Cranial Anatomy

PubMed Central

Anquetin, Jérémy; Püntener, Christian; Billon-Bruyat, Jean-Paul

2015-01-01

Background Several groups of stem cryptodires became adapted to coastal marine environments as early as the Late Jurassic, 40 million years before the Pan-Chelonioidea. The Plesiochelyidae are a major component of this first radiation of crown-group turtles into marine habitats. They are abundant in many European localities, but their systematics is still greatly confused. Only three species are represented by cranial material: Plesiochelys etalloni, Plesiochelys planiceps, and Portlandemys mcdowelli. Methodology/Principal Findings In the present study, we describe a cranium and a mandible from the Kimmeridgian of Porrentruy (Switzerland), which we refer to a new species, Portlandemys gracilis n. sp. This new taxon differs from Portlandemys mcdowelli in several aspects of the cranium and mandible, notably in being generally more gracile, but the two species share a narrow skull, a more acute angle between the labial ridges on the mandible, and a unique configuration of the anterodorsal part of the basicranium. The cranial anatomy of plesiochelyid turtles is discussed in details based primarily on these new specimens and new cranial material of Plesiochelys etalloni from Solothurn, Switzerland. Conclusions/Significance Several characters (e.g., the contribution of the parietal to the foramen nervi trigemini, the configuration of the dorsum sellae and sella turcica, the presence of an infolding ridge on the posterior surface of the quadrate) appear as potential candidates to help elucidate plesiochelyid relationships. Some of these characters are included in a previously published phylogenetic dataset and help to stabilize the relationships of plesiochelyid turtles and closely related taxa. For the first time, our results suggest that plesiochelyids, 'Thalassemys' moseri, and Solnhofia parsonsi (representing the Eurysternidae) form a clade at the base of Eucryptodira. PMID:26106888

21 CFR 882.5800 - Cranial electrotherapy stimulator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5800 Cranial...

21 CFR 882.5800 - Cranial electrotherapy stimulator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5800 Cranial...

21 CFR 882.5800 - Cranial electrotherapy stimulator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... electrotherapy stimulator. (a) Identification. A cranial electrotherapy stimulator is a device that applies...

21 CFR 882.5800 - Cranial electrotherapy stimulator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... electrotherapy stimulator. (a) Identification. A cranial electrotherapy stimulator is a device that applies...

21 CFR 882.5800 - Cranial electrotherapy stimulator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cranial electrotherapy stimulator. 882.5800 Section 882.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... electrotherapy stimulator. (a) Identification. A cranial electrotherapy stimulator is a device that applies...

Infant Positioning, Baby Gear Use, and Cranial Asymmetry.

PubMed

Zachry, Anne H; Nolan, Vikki G; Hand, Sarah B; Klemm, Susan A

2017-12-01

Objectives This study aimed to identify predictors of cranial asymmetry. We hypothesize that among infants diagnosed with cranial asymmetry in the sampled region, there is an association between exposure to more time in baby gear and less awake time in prone and side-lying than in infants who do not present with this condition. Methods The study employed a cross sectional survey of caregivers of typically developing infants and infants diagnosed with cranial asymmetry. Results A mutivariable model reveals that caregivers of children who are diagnosed with cranial asymmetry report their children spending significantly less time in prone play than those children without a diagnosis of cranial asymmetry. Side-lying and time spent in baby gear did not attain statistical significance. Conclusions for Practice Occupational therapists, physical therapists, pediatricians, nurses and other health care professionals must provide parents with early education about the importance of varying positions and prone play in infancy and address fears and concerns that may serve as barriers to providing prone playtime.

Distinct requirements for cranial ectoderm and mesenchyme-derived wnts in specification and differentiation of osteoblast and dermal progenitors.

PubMed

Goodnough, L Henry; Dinuoscio, Gregg J; Ferguson, James W; Williams, Trevor; Lang, Richard A; Atit, Radhika P

2014-02-01

The cranial bones and dermis differentiate from mesenchyme beneath the surface ectoderm. Fate selection in cranial mesenchyme requires the canonical Wnt effector molecule β-catenin, but the relative contribution of Wnt ligand sources in this process remains unknown. Here we show Wnt ligands are expressed in cranial surface ectoderm and underlying supraorbital mesenchyme during dermal and osteoblast fate selection. Using conditional genetics, we eliminate secretion of all Wnt ligands from cranial surface ectoderm or undifferentiated mesenchyme, to uncover distinct roles for ectoderm- and mesenchyme-derived Wnts. Ectoderm Wnt ligands induce osteoblast and dermal fibroblast progenitor specification while initiating expression of a subset of mesenchymal Wnts. Mesenchyme Wnt ligands are subsequently essential during differentiation of dermal and osteoblast progenitors. Finally, ectoderm-derived Wnt ligands provide an inductive cue to the cranial mesenchyme for the fate selection of dermal fibroblast and osteoblast lineages. Thus two sources of Wnt ligands perform distinct functions during osteoblast and dermal fibroblast formation.

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

PubMed

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

2014-01-01

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

The accuracy of an electromagnetic navigation system in lateral skull base approaches.

PubMed

Komune, Noritaka; Matsushima, Ken; Matsuo, Satoshi; Safavi-Abbasi, Sam; Matsumoto, Nozomu; Rhoton, Albert L

2017-02-01

Image-guided optical tracking systems are being used with increased frequency in lateral skull base surgery. Recently, electromagnetic tracking systems have become available for use in this region. However, the clinical accuracy of the electromagnetic tracking system has not been examined in lateral skull base surgery. This study evaluates the accuracy of electromagnetic navigation in lateral skull base surgery. Cadaveric and radiographic study. Twenty cadaveric temporal bones were dissected in a surgical setting under a commercially available, electromagnetic surgical navigation system. The target registration error (TRE) was measured at 28 surgical landmarks during and after performing the standard translabyrinthine and middle cranial fossa surgical approaches to the internal acoustic canal. In addition, three demonstrative procedures that necessitate navigation with high accuracy were performed; that is, canalostomy of the superior semicircular canal from the middle cranial fossa, 1 cochleostomy from the middle cranial fossa, 2 and infralabyrinthine approach to the petrous apex. 3 RESULTS: Eleven of 17 (65%) of the targets in the translabyrinthine approach and five of 11 (45%) of the targets in the middle fossa approach could be identified in the navigation system with TRE of less than 0.5 mm. Three accuracy-dependent procedures were completed without anatomical injury of important anatomical structures. The electromagnetic navigation system had sufficient accuracy to be used in the surgical setting. It was possible to perform complex procedures in the lateral skull base under the guidance of the electromagnetically tracked navigation system. N/A. Laryngoscope, 2016 127:450-459, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Cranial Bosses of Choerosaurus dejageri (Therapsida, Therocephalia): Earliest Evidence of Cranial Display Structures in Eutheriodonts

PubMed Central

Benoit, Julien; Manger, Paul R.; Fernandez, Vincent; Rubidge, Bruce S.

2016-01-01

Choerosaurus dejageri, a non-mammalian eutheriodont therapsid from the South African late Permian (~259 Ma), has conspicuous hemispheric cranial bosses on the maxilla and the mandible. These bosses, the earliest of this nature in a eutheriodont, potentially make C. dejageri a key species for understanding the evolutionary origins of sexually selective behaviours (intraspecific competition, ritualized sexual and intimidation displays) associated with cranial outgrowths at the root of the clade that eventually led to extant mammals. Comparison with the tapinocephalid dinocephalian Moschops capensis, a therapsid in which head butting is strongly supported, shows that the delicate structure of the cranial bosses and the gracile structure of the skull of Choerosaurus would be more suitable for display and low energy combat than vigorous head butting. Thus, despite the fact that Choerosaurus is represented by only one skull (which makes it impossible to address the question of sexual dimorphism), its cranial bosses are better interpreted as structures involved in intraspecific selection, i.e. low-energy fighting or display. Display structures, such as enlarged canines and cranial bosses, are widespread among basal therapsid clades and are also present in the putative basal therapsid Tetraceratops insignis. This suggests that sexual selection may have played a more important role in the distant origin and evolution of mammals earlier than previously thought. Sexual selection may explain the subsequent independent evolution of cranial outgrowths and pachyostosis in different therapsid lineages (Biarmosuchia, Dinocephalia, Gorgonopsia and Dicynodontia). PMID:27548428

Cranial Bosses of Choerosaurus dejageri (Therapsida, Therocephalia): Earliest Evidence of Cranial Display Structures in Eutheriodonts.

PubMed

Benoit, Julien; Manger, Paul R; Fernandez, Vincent; Rubidge, Bruce S

2016-01-01

Choerosaurus dejageri, a non-mammalian eutheriodont therapsid from the South African late Permian (~259 Ma), has conspicuous hemispheric cranial bosses on the maxilla and the mandible. These bosses, the earliest of this nature in a eutheriodont, potentially make C. dejageri a key species for understanding the evolutionary origins of sexually selective behaviours (intraspecific competition, ritualized sexual and intimidation displays) associated with cranial outgrowths at the root of the clade that eventually led to extant mammals. Comparison with the tapinocephalid dinocephalian Moschops capensis, a therapsid in which head butting is strongly supported, shows that the delicate structure of the cranial bosses and the gracile structure of the skull of Choerosaurus would be more suitable for display and low energy combat than vigorous head butting. Thus, despite the fact that Choerosaurus is represented by only one skull (which makes it impossible to address the question of sexual dimorphism), its cranial bosses are better interpreted as structures involved in intraspecific selection, i.e. low-energy fighting or display. Display structures, such as enlarged canines and cranial bosses, are widespread among basal therapsid clades and are also present in the putative basal therapsid Tetraceratops insignis. This suggests that sexual selection may have played a more important role in the distant origin and evolution of mammals earlier than previously thought. Sexual selection may explain the subsequent independent evolution of cranial outgrowths and pachyostosis in different therapsid lineages (Biarmosuchia, Dinocephalia, Gorgonopsia and Dicynodontia).

Radiation-free quantification of head malformations in craniosynostosis patients from 3D photography

NASA Astrophysics Data System (ADS)

Tu, Liyun; Porras, Antonio R.; Oh, Albert; Lepore, Natasha; Mastromanolis, Manuel; Tsering, Deki; Paniagua, Beatriz; Enquobahrie, Andinet; Keating, Robert; Rogers, Gary F.; Linguraru, Marius George

2018-02-01

The evaluation of cranial malformations plays an essential role both in the early diagnosis and in the decision to perform surgical treatment for craniosynostosis. In clinical practice, both cranial shape and suture fusion are evaluated using CT images, which involve the use of harmful radiation on children. Three-dimensional (3D) photography offers noninvasive, radiation-free, and anesthetic-free evaluation of craniofacial morphology. The aim of this study is to develop an automated framework to objectively quantify cranial malformations in patients with craniosynostosis from 3D photography. We propose a new method that automatically extracts the cranial shape by identifying a set of landmarks from a 3D photograph. Specifically, it registers the 3D photograph of a patient to a reference template in which the position of the landmarks is known. Then, the method finds the closest cranial shape to that of the patient from a normative statistical shape multi-atlas built from 3D photographs of healthy cases, and uses it to quantify objectively cranial malformations. We calculated the cranial malformations on 17 craniosynostosis patients and we compared them with the malformations of the normative population used to build the multi-atlas. The average malformations of the craniosynostosis cases were 2.68 +/- 0.75 mm, which is significantly higher (p<0.001) than the average malformations of 1.70 +/- 0.41 mm obtained from the normative cases. Our approach can support the quantitative assessment of surgical procedures for cranial vault reconstruction without exposing pediatric patients to harmful radiation.

Do Concomitant Cranium and Axis Injuries Predict Worse Outcome? A Trauma Database Quantitative Analysis

PubMed Central

Chittiboina, Prashant; Banerjee, Anirban Deep; Nanda, Anil

2011-01-01

We performed a trauma database analysis to identify the effect of concomitant cranial injuries on outcome in patients with fractures of the axis. We identified patients with axis fractures over a 14-year period. A binary outcome measure was used. Univariate and multiple logistic regression analysis were performed. There were 259 cases with axis fractures. Closed head injury was noted in 57% and skull base trauma in 14%. Death occurred in 17 cases (6%). Seventy-two percent had good outcome. Presence of abnormal computed tomography head findings, skull base fractures, and visceral injury was significantly associated with poor outcome. Skull base injury in association with fractures of the axis is a significant independent predictor of worse outcomes, irrespective of the severity of the head injury. We propose that presence of concomitant cranial and upper vertebral injuries require careful evaluation in view of the associated poor prognosis. PMID:22470268

Hepatocellular carcinoma metastasizing to the skull base involving multiple cranial nerves.

PubMed

Kim, Soo Ryang; Kanda, Fumio; Kobessho, Hiroshi; Sugimoto, Koji; Matsuoka, Toshiyuki; Kudo, Masatoshi; Hayashi, Yoshitake

2006-11-07

We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-year-old woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI) disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cranial drill handpiece (brace). 882.4325 Section 882.4325 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill...

21 CFR 882.4325 - Cranial drill handpiece (brace).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cranial drill handpiece (brace). 882.4325 Section 882.4325 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4325 Cranial drill...

21 CFR 882.4370 - Pneumatic cranial drill motor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Pneumatic cranial drill motor. 882.4370 Section 882.4370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4370 Pneumatic cranial...

21 CFR 882.4370 - Pneumatic cranial drill motor.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pneumatic cranial drill motor. 882.4370 Section 882.4370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4370 Pneumatic cranial...

Asymmetric type F botulism with cranial nerve demyelination.

PubMed

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

2012-01-01

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

The protective role of sex hormones in females and exercise prehabilitation in males on sternotomy-induced cranial hypoperfusion in aortic banded mini-swine.

PubMed

Olver, T Dylan; Hiemstra, Jessica A; Edwards, Jenna C; Ferguson, Brian S; Laughlin, M Harold; Emter, Craig A

2017-03-01

During cardiac surgery, specifically sternotomy, cranial hypoperfusion is linked to cerebral ischemia, increased risk of perioperative watershed stroke, and other neurocognitive complications. The purpose of this study was to retrospectively examine the effect of sex hormones in females and exercise prehabilitation in males on median sternotomy-induced changes in cranial perfusion in a large animal model of heart failure. Cranial blood flow (CBF) before and 10 and 60 min poststernotomy was analyzed in eight groups of Yucatan mini-swine: female control, aortic banded, ovariectomized, and ovariectomized + aortic banded; male control, aortic banded, aortic banded + continuous exercise trained, and aortic banded + interval exercise trained. A median sternotomy decreased cranial perfusion during surgery in all pigs (~24 ± 2% relative to baseline; P ≤ 0.05). CBF was 30 ± 7% lower across all time points in all females vs. all males ( P ≤ 0.05) and sternotomy decreased cranial perfusion ( P ≤ 0.05) independent of sex (females = 34 ± 3% and males = 14 ± 3%) and aortic banding (intact control = 31 ± 5% and intact aortic banded = 31 ± 4%). CBF recovery at 60 min tended to be better in females vs. males (relative to 10 min poststernotomy, females = 23 ± 13% vs. males = -1 ± 5%) and intact aortic banded vs. control pigs (relative to 10 min poststernotomy, aortic banded = 43 ± 20% vs. control = 6 ± 16%; P ≤ 0.05) at 60 min poststernotomy. Ovariectomy impaired CBF recovery during cranial reperfusion 60 min following sternotomy (relative to baseline, all intact females = -1 ± 9% vs. all ovariectomized females = -15 ± 4%; P ≤ 0.05). Chronic exercise training completely prevented significant sternotomy-induced cranial hypoperfusion independent of aortic banding (sternotomy-induced deficit, all sedentary males = -24 ± 6% vs. all exercise-trained males = -7 ± 3%; P ≤ 0.05). Female sex hormones protected against impaired CBF recovery during reperfusion, while chronic exercise training prevented sternotomy-induced cranial hypoperfusion despite cardiac pressure overload. NEW & NOTEWORTHY Our findings suggest a median sternotomy may predispose patients, possibly postmenopausal women and sedentary men, to perioperative cerebral ischemia, an increased risk of cardiac surgery-related stroke, and resulting neurocognitive impairments. Specifically, data from this common surgical procedure show: 1 ) median sternotomy independently decreases cranial perfusion; 2 ) female sex hormones improve cranial blood flow recovery following sternotomy; and 3 ) exercise prehabilitation prevents sternotomy-induced cranial hypoperfusion. Exercise prehabilitation before cardiac surgery may be advantageous for capable patients. Copyright © 2017 the American Physiological Society.

Poly(trimethylene carbonate)-based composite materials for reconstruction of critical-sized cranial bone defects in sheep.

PubMed

Zeng, Ni; van Leeuwen, Anne C; Grijpma, Dirk W; Bos, Ruud R M; Kuijer, Roel

2017-02-01

The use of ceramic materials in repair of bone defects is limited to non-load-bearing sites. We tested poly(trimethylene carbonate) (PTMC) combined with β-tricalcium phosphate or biphasic calcium phosphate particles for reconstruction of cranial defects. PTMC-calcium phosphate composite matrices were implanted in cranial defects in sheep for 3 and 9 months. Micro-computed tomography quantification and histological observation were performed for analysis. No differences were found in new bone formation among the defects left unfilled, filled with PTMC scaffolds, or filled with either kind of PTMC-calcium phosphate composite scaffolds. Porous β-TCP scaffolds as control led to a larger amount of newly formed bone in the defects than all other materials. Histology revealed abundant new bone formation in the defects filled with porous β-TCP scaffolds. New bone formation was limited in defects filled with PTMC scaffolds or different PTMC-calcium phosphate matrices. PTMC matrices were degraded uneventfully. New bone formation within the defects followed an orderly pattern. PTMC did not interfere with bone regeneration in sheep cranial defects and is suitable as a polymer matrix for incorporating calcium phosphate particles. Increasing the content of calcium phosphate particles in the composite matrices may enhance the beneficial effects of the particles on new bone formation. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Cranial ultrasound findings in preterm infants predict the development of cerebral palsy.

PubMed

Skovgaard, Ann Lawaetz; Zachariassen, Gitte

2017-02-01

Our aim was to evaluate any association between gestational age, birth weight and findings on cranial ultrasounds during hospitalisation in very preterm infants and mortality and neurological outcome in childhood. This study was a retrospective cohort study based on a patient record review. The cohort consisted of very preterm born children (gestational age ≤ 32 + 0) born from 2004 to 2008. For each infant, we obtained results from all cranial ultrasounds performed during hospitalisation. In 2014, patient records were evaluated for cerebral palsy, Gross Motor Function Classification System, blindness and deafness. A total of 249 infants were included. The mortality rate was 9.2%. In all, 217 children were evaluated at 5-9 years of age. Four children were diagnosed with germinal matrix haemorrhage - intraventricular haemorrhage grade 3 (GMH-IVH3) and periventricular haemorrhagic infarction (PVHI), of whom two developed cerebral palsy. Nine children were diagnosed with periventricular leukomalacia (PVL), of whom six developed cerebral palsy. Cerebral palsy was detected in 14 children (6.4%), and one (0.5%) child was in need of a hearing assistive device. Severe brain injury (GMH-IVH3, PVHI or PVL) (p = 0.000) and being of male gender (p = 0.03) were associated with cerebral palsy in childhood. Severe brain injuries detected by neonatal cranial ultrasound in very preterm infants is associated with development of cerebral palsy in childhood. none. TRAIL REGISTRATION: not relevant.

A new therapeutic proposal for inoperable osteosarcoma: Photodynamic therapy.

PubMed

de Miguel, Guilherme Chohfi; Abrantes, Ana Margarida; Laranjo, Mafalda; Grizotto, Ana Yoshie Kitagawa; Camporeze, Bruno; Pereira, José Aires; Brites, Gonçalo; Serra, Arménio; Pineiro, Marta; Rocha-Gonsalves, António; Botelho, Maria Filomena; Priolli, Denise Gonçalves

2018-03-01

Osteosarcoma, a malignant tumor characterized by bone or osteoid formation, is the second most common primary bone neoplasm. Clinical symptoms include local and surrounding pain, unrelieved by rest or anesthesia. Osteosarcoma has a poor chemotherapeutic response with prognosis dependent on complete tumor excision. Therefore, for inoperable osteosarcoma new therapeutic strategies are needed. The present study aimed to develop murine models of cranial and vertebral osteosarcoma that facilitate simple clinical monitoring and real-time imaging to evaluate the outcome of photodynamic therapy based on a previously developed photosensitizer. Balb/c nude mice were divided into two groups: the cranial and vertebral osteosarcoma groups. Each group was further subdivided into the photodynamic therapy-treated and untreated groups. Images were obtained by scintigraphy with 99m Tc-MIBI and radiography. Tumor growth, necrotic area, osteoid matrix area, and inflammatory infiltration were analyzed. Cranial and vertebral tumors could be macroscopically observed and measured. Radiographic and scintigraphic images showed tumor cells present at the inoculation sites. After photodynamic therapy, scintigraphy showed lower tumoral radiopharmaceutical uptake, which correlated histologically with increased necrosis. Osteoid matrix volume increased, and tumor size decreased in all photodynamic therapy-treated animals. Cranial and vertebral osteosarcoma models in athymic mice are feasible and facilitate in vivo monitoring for the development of new therapies. Photodynamic therapy is a potential antitumoral treatment for surgically inoperable osteosarcoma. Copyright © 2017 Elsevier B.V. All rights reserved.

A Basal Lithostrotian Titanosaur (Dinosauria: Sauropoda) with a Complete Skull: Implications for the Evolution and Paleobiology of Titanosauria.

PubMed

Martínez, Rubén D F; Lamanna, Matthew C; Novas, Fernando E; Ridgely, Ryan C; Casal, Gabriel A; Martínez, Javier E; Vita, Javier R; Witmer, Lawrence M

2016-01-01

We describe Sarmientosaurus musacchioi gen. et sp. nov., a titanosaurian sauropod dinosaur from the Upper Cretaceous (Cenomanian-Turonian) Lower Member of the Bajo Barreal Formation of southern Chubut Province in central Patagonia, Argentina. The holotypic and only known specimen consists of an articulated, virtually complete skull and part of the cranial and middle cervical series. Sarmientosaurus exhibits the following distinctive features that we interpret as autapomorphies: (1) maximum diameter of orbit nearly 40% rostrocaudal length of cranium; (2) complex maxilla-lacrimal articulation, in which the lacrimal clasps the ascending ramus of the maxilla; (3) medial edge of caudal sector of maxillary ascending ramus bordering bony nasal aperture with low but distinct ridge; (4) 'tongue-like' ventral process of quadratojugal that overlaps quadrate caudally; (5) separate foramina for all three branches of the trigeminal nerve; (6) absence of median venous canal connecting infundibular region to ventral part of brainstem; (7) subvertical premaxillary, procumbent maxillary, and recumbent dentary teeth; (8) cervical vertebrae with 'strut-like' centroprezygapophyseal laminae; (9) extremely elongate and slender ossified tendon positioned ventrolateral to cervical vertebrae and ribs. The cranial endocast of Sarmientosaurus preserves some of the most complete information obtained to date regarding the brain and sensory systems of sauropods. Phylogenetic analysis recovers the new taxon as a basal member of Lithostrotia, as the most plesiomorphic titanosaurian to be preserved with a complete skull. Sarmientosaurus provides a wealth of new cranial evidence that reaffirms the close relationship of titanosaurs to Brachiosauridae. Moreover, the presence of the relatively derived lithostrotian Tapuiasaurus in Aptian deposits indicates that the new Patagonian genus represents a 'ghost lineage' with a comparatively plesiomorphic craniodental form, the evolutionary history of which is missing for at least 13 million years of the Cretaceous. The skull anatomy of Sarmientosaurus suggests that multiple titanosaurian species with dissimilar cranial structures coexisted in the early Late Cretaceous of southern South America. Furthermore, the new taxon possesses a number of distinctive morphologies-such as the ossified cervical tendon, extremely pneumatized cervical vertebrae, and a habitually downward-facing snout-that have rarely, if ever, been documented in other titanosaurs, thus broadening our understanding of the anatomical diversity of this remarkable sauropod clade. The latter two features were convergently acquired by at least one penecontemporaneous diplodocoid, and may represent mutual specializations for consuming low-growing vegetation.

A Basal Lithostrotian Titanosaur (Dinosauria: Sauropoda) with a Complete Skull: Implications for the Evolution and Paleobiology of Titanosauria

PubMed Central

Martínez, Rubén D. F.; Lamanna, Matthew C.; Novas, Fernando E.; Ridgely, Ryan C.; Casal, Gabriel A.; Martínez, Javier E.; Vita, Javier R.; Witmer, Lawrence M.

2016-01-01

We describe Sarmientosaurus musacchioi gen. et sp. nov., a titanosaurian sauropod dinosaur from the Upper Cretaceous (Cenomanian—Turonian) Lower Member of the Bajo Barreal Formation of southern Chubut Province in central Patagonia, Argentina. The holotypic and only known specimen consists of an articulated, virtually complete skull and part of the cranial and middle cervical series. Sarmientosaurus exhibits the following distinctive features that we interpret as autapomorphies: (1) maximum diameter of orbit nearly 40% rostrocaudal length of cranium; (2) complex maxilla—lacrimal articulation, in which the lacrimal clasps the ascending ramus of the maxilla; (3) medial edge of caudal sector of maxillary ascending ramus bordering bony nasal aperture with low but distinct ridge; (4) ‘tongue-like’ ventral process of quadratojugal that overlaps quadrate caudally; (5) separate foramina for all three branches of the trigeminal nerve; (6) absence of median venous canal connecting infundibular region to ventral part of brainstem; (7) subvertical premaxillary, procumbent maxillary, and recumbent dentary teeth; (8) cervical vertebrae with ‘strut-like’ centroprezygapophyseal laminae; (9) extremely elongate and slender ossified tendon positioned ventrolateral to cervical vertebrae and ribs. The cranial endocast of Sarmientosaurus preserves some of the most complete information obtained to date regarding the brain and sensory systems of sauropods. Phylogenetic analysis recovers the new taxon as a basal member of Lithostrotia, as the most plesiomorphic titanosaurian to be preserved with a complete skull. Sarmientosaurus provides a wealth of new cranial evidence that reaffirms the close relationship of titanosaurs to Brachiosauridae. Moreover, the presence of the relatively derived lithostrotian Tapuiasaurus in Aptian deposits indicates that the new Patagonian genus represents a ‘ghost lineage’ with a comparatively plesiomorphic craniodental form, the evolutionary history of which is missing for at least 13 million years of the Cretaceous. The skull anatomy of Sarmientosaurus suggests that multiple titanosaurian species with dissimilar cranial structures coexisted in the early Late Cretaceous of southern South America. Furthermore, the new taxon possesses a number of distinctive morphologies—such as the ossified cervical tendon, extremely pneumatized cervical vertebrae, and a habitually downward-facing snout—that have rarely, if ever, been documented in other titanosaurs, thus broadening our understanding of the anatomical diversity of this remarkable sauropod clade. The latter two features were convergently acquired by at least one penecontemporaneous diplodocoid, and may represent mutual specializations for consuming low-growing vegetation. PMID:27115989

21 CFR 882.4370 - Pneumatic cranial drill motor.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Pneumatic cranial drill motor. 882.4370 Section... drill motor. (a) Identification. A pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b...

21 CFR 882.4370 - Pneumatic cranial drill motor.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Pneumatic cranial drill motor. 882.4370 Section... drill motor. (a) Identification. A pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b...

21 CFR 882.4370 - Pneumatic cranial drill motor.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Pneumatic cranial drill motor. 882.4370 Section... drill motor. (a) Identification. A pneumatic cranial drill motor is a pneumatically operated power source used with removable rotating surgical cutting tools or drill bits on a patient's skull. (b...

Asymmetric Type F Botulism with Cranial Nerve Demyelination

PubMed Central

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

2012-01-01

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

Intraoperative cranial nerve monitoring.

PubMed

Harper, C Michel

2004-03-01

The purpose of intraoperative monitoring is to preserve function and prevent injury to the nervous system at a time when clinical examination is not possible. Cranial nerves are delicate structures and are susceptible to damage by mechanical trauma or ischemia during intracranial and extracranial surgery. A number of reliable electrodiagnostic techniques, including nerve conduction studies, electromyography, and the recording of evoked potentials have been adapted to the study of cranial nerve function during surgery. A growing body of evidence supports the utility of intraoperative monitoring of cranial nerve nerves during selected surgical procedures.

Craniofacial Prosthetic Reconstruction Using Polymethyl Methacrylate Implant: A Case Report.

PubMed

Simon, Paul; Mohan, Jayashree; Selvaraj, Sunantha; Saravanan, B S; Pari, Parikodaiarasan

2014-12-01

Large cranial defects of complex geometric shapes are challenging to reconstruct. The cranial implants has to be fabricated prior to the cranioplastic surgery. The ideal material for cranial implant has to be inert, light weight, easy to fit and adaptable to the defect, offering the best aesthetic and functional results. Here is a clinical case report of a patient who was operated for osteomyelitis in the parieto-temporal region. The defect was reconstructed with heat cure polymethylmethacrylate (PMMA). Operative closure of the defect was facilitated with ligature titanium wires with minimal prosthesis contouring. The heat cure PMMA cranial implant is a safe, easy and economic alternative with great adaptability to cranial vault defects. The cosmetic results in this patient was excellent. No post-operative complications occurred.

Anosmin-1 is essential for neural crest and cranial placodes formation in Xenopus.

PubMed

Bae, Chang-Joon; Hong, Chang-Soo; Saint-Jeannet, Jean-Pierre

2018-01-15

During embryogenesis vertebrates develop a complex craniofacial skeleton associated with sensory organs. These structures are primarily derived from two embryonic cell populations the neural crest and cranial placodes, respectively. Neural crest cells and cranial placodes are specified through the integrated action of several families of signaling molecules, and the subsequent activation of a complex network of transcription factors. Here we describe the expression and function of Anosmin-1 (Anos1), an extracellular matrix protein, during neural crest and cranial placodes development in Xenopus laevis. Anos1 was identified as a target of Pax3 and Zic1, two transcription factors necessary and sufficient to generate neural crest and cranial placodes. Anos1 is expressed in cranial neural crest progenitors at early neurula stage and in cranial placode derivatives later in development. We show that Anos1 function is required for neural crest and sensory organs development in Xenopus, consistent with the defects observed in Kallmann syndrome patients carrying a mutation in ANOS1. These findings indicate that anos1 has a conserved function in the development of craniofacial structures, and indicate that anos1-depleted Xenopus embryos represent a useful model to analyze the pathogenesis of Kallmann syndrome. Copyright © 2017. Published by Elsevier Inc.

Three-dimensional reconstruction of the cranial and anterior spinal nerves in early tadpoles of Xenopus laevis (Pipidae, Anura).

PubMed

Naumann, Benjamin; Olsson, Lennart

2018-04-01

Xenopus laevis is one of the most widely used model organism in neurobiology. It is therefore surprising, that no detailed and complete description of the cranial nerves exists for this species. Using classical histological sectioning in combination with fluorescent whole mount antibody staining and micro-computed tomography we prepared a detailed innervation map and a freely-rotatable three-dimensional (3D) model of the cranial nerves and anterior-most spinal nerves of early X. laevis tadpoles. Our results confirm earlier descriptions of the pre-otic cranial nerves and present the first detailed description of the post-otic cranial nerves. Tracing the innervation, we found two previously undescribed head muscles (the processo-articularis and diaphragmatico-branchialis muscles) in X. laevis. Data on the cranial nerve morphology of tadpoles are scarce, and only one other species (Discoglossus pictus) has been described in great detail. A comparison of Xenopus and Discoglossus reveals a relatively conserved pattern of the post-otic and a more variable morphology of the pre-otic cranial nerves. Furthermore, the innervation map and the 3D models presented here can serve as an easily accessible basis to identify alterations of the innervation produced by experimental studies such as genetic gain- and loss of function experiments. © 2017 Wiley Periodicals, Inc.

Non-Invasive Measurement of Intracranial Pressure Pulsation using Ultrasound

NASA Technical Reports Server (NTRS)

Ueno, Toshiaki; Ballard, R. E.; Yost, W. T.; Hargens, A. R.

1997-01-01

Exposure to microgravity causes a cephalad fluid shift which may elevate intracranial pressure (ICP). Elevation in ICP may affect cerebral hemodynamics in astronauts during space flight. ICP is, however, a difficult parameter to measure due to the invasiveness of currently available techniques. We already reported our development of a non-invasive ultrasound device for measurement of ICP. We recently modified the device so that we might reproducibly estimate ICP changes in association with cardiac cycles. In the first experiment, we measured changes in cranial distance with the ultrasound device in cadavera while changing ICP by infusing saline into the lateral ventricle. In the second experiment, we measured changes in cranial distance in five healthy volunteers while placing them in 60 deg, 30 deg head-up tilt, supine, and 10 deg head-down tilt position. In the cadaver study, fast Fourier transformation revealed that cranial pulsation is clearly associated with ICP pulsation. The ratio of cranial distance and ICP pulsation is 1.3microns/mmHg. In the tilting study, the magnitudes of cranial pulsation are linearly correlated to tilt angles (r=0.87). The ultrasound device has sufficient sensitivity to detect cranial pulsation in association with cardiac cycles. By analyzing the magnitude of cranial pulsation, estimates of ICP during space flight are possible.

Giant-cell arteritis without cranial manifestations

PubMed Central

de Boysson, Hubert; Lambert, Marc; Liozon, Eric; Boutemy, Jonathan; Maigné, Gwénola; Ollivier, Yann; Ly, Kim; Manrique, Alain; Bienvenu, Boris; Aouba, Achille

2016-01-01

Abstract Diagnosis of giant-cell arteritis (GCA) is challenging in the absence of cardinal cranial symptoms/signs. We aimed to describe the clinical presentation, diagnostic process, and disease course of GCA patients without cranial symptoms, and to compare them to those of patients with typical cranial presentation. In this retrospective multicenter study, we enrolled patients with GCA who satisfied at least 3 of the 5 American College of Rheumatology criteria for GCA, or 2 criteria associated with contributory vascular biopsy other than temporal artery biopsy or with demonstration of large-vessel involvement; underwent iconographic evaluation of large arterial vessels (aortic CT scan or a positron emission tomography with 18F-fluorodeoxyglucose combined with computed tomography (FDG-PET/CT) scan or cardiac echography combined with a large-vessel Doppler) at diagnosis. We divided the cohort into 2 groups, distinguishing between patients without cranial symptoms/signs (i.e., headaches, clinical temporal artery anomaly, jaw claudication, ophthalmologic symptoms) and those with cranial symptoms/signs. In the entire cohort of 143 patients, all of whom underwent vascular biopsy and vascular imaging, we detected 31 (22%) patients with no cranial symptoms/signs. In the latter, diagnosis was biopsy proven in an arterial sample in 23 cases (74% of patients, on a temporal site in 20 cases and on an extratemporal site in 3). One-third of these 31 patients displayed extracranial symptoms/signs whereas the remaining two-thirds presented only with constitutional symptoms and/or inflammatory laboratory test results. Compared to the 112 patients with cardinal cranial clinical symptoms/signs, patients without cranial manifestations displayed lower levels of inflammatory laboratory parameters (C-reactive level: 68 [9–250] mg/L vs 120 [3–120] mg/L; P < 0.01), highest rate of aorta and aortic branch involvement identified (19/31 (61%) vs 42/112 (38%); P = 0.02) and also a lower rate of disease relapse (12/31 (39%) vs 67/112 (60%); P = 0.04). Our results suggest that patients without cranial symptoms/signs are prone to lower inflammatory laboratory parameters, fewer relapses, and more large-vessel involvement than those displaying cardinal cranial manifestations. Further studies are therefore required in order to determine whether these 2 subgroups of patients have a different prognosis, and therefore warrant different therapeutic and monitoring regimens. PMID:27367984

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

PubMed

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

2014-01-01

Knowledge of the possible neural interconnections found between the lower cranial and upper cervical nerves may prove useful to surgeons who operate on the skull base and upper neck regions in order to avoid inadvertent traction or transection. We review the literature regarding the anatomy, function, and clinical implications of the complex neural networks formed by interconnections between the lower cranial and upper cervical nerves. A review of germane anatomic and clinical literature was performed. The review is organized into two parts. Part I discusses the anastomoses between the trigeminal, facial, and vestibulocochlear nerves or their branches and other nerve trunks or branches in the vicinity. Part II deals with the anastomoses between the glossopharyngeal, vagus, accessory and hypoglossal nerves and their branches or between these nerves and the first four cervical spinal nerves; the contribution of the autonomic nervous system to these neural plexuses is also briefly reviewed. Part II is presented in this article. Extensive and variable neural anastomoses exist between the lower cranial nerves and between the upper cervical nerves in such a way that these nerves with their extra-axial communications can be collectively considered a plexus. Copyright © 2013 Wiley Periodicals, Inc.

The relationship between hippocampal volume and static postural sway: results from the GAIT study.

PubMed

Beauchet, Olivier; Barden, John; Liu-Ambrose, Teresa; Chester, Victoria L; Szturm, Tony; Allali, Gilles

2016-02-01

The role of the hippocampus in postural control, in particular in maintaining upright stance, has not been fully examined in normal aging. This study aims to examine the association of postural sway with hippocampal volume while maintaining upright stance in healthy older individuals. Seventy healthy individuals (mean age 69.7 ± 3.4 years; 41.4 % women) were recruited in this study based on cross-sectional design. Hippocampal volume (quantified from a three-dimensional T1-weighted MRI using semi-automated software), three center of pressure (COP) motion parameters (sway area, path length of anterior-posterior (AP) and medial-lateral (ML) displacement) while maintaining upright stance (eyes open and closed), and the relative difference between open and closed eye conditions were used as outcome measures. Age, sex, body mass index, lower limb proprioception, distance vision, 15-item geriatric depression scale score, total cranial volume, and white matter abnormalities were used as covariates. The sway area decreased from open to closed eye condition but this variation was non-significant (P = 0.244), whereas path length of AP and ML displacement increased significantly (P < 0.003). Increase in sway area from open to closed eyes was associated with greater hippocampal volume (β -18.21; P = 0.044), and a trend for an association of increase in path length of AP displacement (P = 0.075 for open eyes and P = 0.071 for closed eyes) with greater hippocampal volume was reported. The hippocampus is involved in upright postural control in normal aging, such that an increase in sway area of COP motion from open to closed eyes is associated with greater hippocampal volume in healthy older adults.

Cranial cruciate ligament injury in the dog: pathophysiology, diagnosis and treatment.

PubMed

Jerram, R M; Walker, A M

2003-08-01

Cranial cruciate ligament (CCL) disease in the dog is a multifactorial complex problem that requires a thorough understanding of the biomechanics of the stifle joint to be understood. Successful treatment of rupture of the CCL should be based on managing underlying anatomical and conformational abnormalities rather than attempting to eliminate the tibial cranial drawer sign. The cranial and caudal cruciate ligaments, the patella ligament and quadriceps mechanism, the medial and lateral collateral ligaments, the medial and lateral menisci and the joint capsule provide stability of the joint and load-sharing. The function of the stifle is also significantly influenced by the musculature of the pelvic limb. An active model of biomechanics of the stifle has been described that incorporates not only the ligamentous structures of the stifle but also the forces created by weight-bearing and the musculature of the pelvic limb. This model recognises a force called cranial tibial thrust, which occurs during weight-bearing, and causes compression of the femoral condyles against the tibial plateau. In middle-aged, large-breed dogs, forces acting on the CCL together with conformation-related mild hyperextension of the stifle and slightly increased tibial plateau slopes are suspected to cause progressive degeneration of the ligament. Palpation of craniolateral stifle laxity has become pathognomonic for CCL rupture; however, chronic periarticular fibrosis, a partial CCL rupture, and a tense patient, may make evaluation of instability of the stifle difficult. Surgical treatment is broadly separated into three groups: intracapsular, extracapsular, and tibial osteotomy techniques. Tibial osteotomy techniques do not serve to provide stability of the stifle but rather alter the geometry of the joint to eliminate cranial tibial thrust such that functional joint stability is achieved during weight-bearing. Visualisation of both menisci is a critical aspect of CCL surgery, irrespective of the technique being performed. Regardless of the surgical technique employed, approximately 85% of dogs show clinical improvement. However, many of these dogs will demonstrate intermittent pain or lameness. Post-operative management is an integral part of the treatment of CCL rupture, and significant benefits in limb function occur when formalised post-operative physiotherapy is performed.

Owner Evaluation of a CORA-Based Leveling Osteotomy for Treatment of Cranial Cruciate Ligament Injury in Dogs.

PubMed

Kishi, Erin N; Hulse, Don

2016-05-01

To evaluate a center of rotation of angulation (CORA)-based leveling osteotomy for cranial cruciate ligament injury in dogs. Retrospective case series. Dogs (n=70). Medical records (March 2011 to March 2012) of dogs diagnosed with a cranial cruciate ligament (CCL) injury treated with a CORA-based leveling osteotomy and stabilized using a bone plate and headless compression screw were reviewed. Radiographs were reviewed for tibial plateau angle and radiographic healing at final evaluation graded on a 5-point scale. Follow-up for a minimum of 6 months postoperatively was conducted by owner completion of a questionnaire regarding their dog's function after surgery. Based on owner responses, clinical outcomes were established. CORA-based leveling osteotomy was used for 70 stifles with CCL injury. The mean time to final radiographic recheck was 107 days (range, 32-424 days). Radiographic healing scores were 42 dogs (69%) with grade 4, 17 dogs (28%) with grade 3, and 2 dogs (3%) with grade 2. The mean time to follow-up was 11.9 months (range 6-18 months). Fifty-four of the 70 (77%) dogs had full function, 13 (19%) had acceptable function, and 3 (4%) had unacceptable function. Complications occurred in 11 stifles (16%), including 3 incisional, 6 late-onset meniscal tears, and 2 implant related. The described method of a CORA-based leveling osteotomy can be successfully performed for treatment of CCL injury in dogs. At the time of mid-term and long-term owner follow-up, most dogs in this case series had returned to full function. © Copyright 2016 by The American College of Veterinary Surgeons.

Cranial nerve vascular compression syndromes of the trigeminal, facial and vago-glossopharyngeal nerves: comparative anatomical study of the central myelin portion and transitional zone; correlations with incidences of corresponding hyperactive dysfunctional syndromes.

PubMed

Guclu, Bulent; Sindou, Marc; Meyronet, David; Streichenberger, Nathalie; Simon, Emile; Mertens, Patrick

2011-12-01

The aim of this study was to evaluate the anatomy of the central myelin portion and the central myelin-peripheral myelin transitional zone of the trigeminal, facial, glossopharyngeal and vagus nerves from fresh cadavers. The aim was also to investigate the relationship between the length and volume of the central myelin portion of these nerves with the incidences of the corresponding cranial dysfunctional syndromes caused by their compression to provide some more insights for a better understanding of mechanisms. The trigeminal, facial, glossopharyngeal and vagus nerves from six fresh cadavers were examined. The length of these nerves from the brainstem to the foramen that they exit were measured. Longitudinal sections were stained and photographed to make measurements. The diameters of the nerves where they exit/enter from/to brainstem, the diameters where the transitional zone begins, the distances to the most distal part of transitional zone from brainstem and depths of the transitional zones were measured. Most importantly, the volume of the central myelin portion of the nerves was calculated. Correlation between length and volume of the central myelin portion of these nerves and the incidences of the corresponding hyperactive dysfunctional syndromes as reported in the literature were studied. The distance of the most distal part of the transitional zone from the brainstem was 4.19  ±  0.81 mm for the trigeminal nerve, 2.86  ±  1.19 mm for the facial nerve, 1.51  ±  0.39 mm for the glossopharyngeal nerve, and 1.63  ±  1.15 mm for the vagus nerve. The volume of central myelin portion was 24.54  ±  9.82 mm(3) in trigeminal nerve; 4.43  ±  2.55 mm(3) in facial nerve; 1.55  ±  1.08 mm(3) in glossopharyngeal nerve; 2.56  ±  1.32 mm(3) in vagus nerve. Correlations (p  < 0.001) have been found between the length or volume of central myelin portions of the trigeminal, facial, glossopharyngeal and vagus nerves and incidences of the corresponding diseases. At present it is rather well-established that primary trigeminal neuralgia, hemifacial spasm and vago-glossopharyngeal neuralgia have as one of the main causes a vascular compression. The strong correlations found between the lengths and volumes of the central myelin portions of the nerves and the incidences of the corresponding diseases is a plea for the role played by this anatomical region in the mechanism of these diseases.

Post-traumatic Unilateral Avulsion of the Abducens Nerve with Damage to Cranial Nerves VII and VIII: Case Report.

PubMed

Yamasaki, Fumiyuki; Akiyama, Yuji; Tsumura, Ryu; Kolakshyapati, Manish; Adhikari, Rupendra Bahadur; Takayasu, Takeshi; Nosaka, Ryo; Kurisu, Kaoru

2016-07-01

Traumatic injuries of the abducens nerve as a consequence of facial and/or head trauma occur with or without associated cervical or skull base fracture. This is the first report on unilateral avulsion of the abducens nerve in a 29-year-old man with severe right facial trauma. In addition, he exhibited mild left facial palsy, and moderate left hearing disturbance. Magnetic resonance imaging (MRI) using fast imaging employing steady-state acquisition (FIESTA) revealed avulsion of left sixth cranial nerve. We recommend thin-slice MR examination in patients with abducens palsy after severe facial and/or head trauma.

Induced transducer orientation during ultrasound imaging: effects on abdominal muscle thickness and bladder position.

PubMed

Whittaker, Jackie L; Warner, Martin B; Stokes, Maria J

2009-11-01

The use of ultrasound imaging (USI) by physiotherapists to assess muscle behavior in clinical settings is increasing. However, there is relatively little evidence of whether the clinical environment is conducive to valid and reliable measurements. Accurate USI measurements depend on maintaining a relatively stationary transducer position, because motion may distort the image and lead to erroneous conclusions. This would seem particularly important during dynamic studies typical of a physiotherapy assessment. What is not known is how much transducer motion can occur before error is introduced. The aim of this study is to shed some light on this question. Eight healthy volunteers (19 to 52 y) participated. USI images were taken of the lateral abdominal wall (LAW) and bladder base (midline suprapubic) at various manually induced transducer orientations (approximately -10 to 10 degrees about 3 axes of rotation), which were quantified by a digital optical motion capture system. Measurements of transversus abdominis (TrA) thickness and bladder base position (cranial /caudal and anterior/posterior) were calculated. Repeated measures analysis of variance was performed to determine if the measurements obtained at the induced transducer orientations were statistically different (p<0.05) from an image corresponding to a reference or starting transducer orientation. Motion analysis data corresponding to measurements that did not differ from reference image measurements were summarized to provide a range of acceptable transducer motion (relative to the pelvis) for clockwise (CW)/counter-clockwise (CCW) rotation, cranial/caudal tilting, medial/lateral tilting and inward/outward displacement. There were no significant changes in TrA thickness measurements if CW/CCW transducer motion was <9 degrees and cranial/caudal or medial/lateral transducer tilting was <5 degrees . Further, there were no significant changes in measurements of bladder base position if CW/CCW transducer motion was <10 degrees , cranial/caudal or medial/lateral transducer tilting was <10 degrees and 8 degrees , respectively and inward/outward motion was <8 mm. These findings provide guidance on acceptable amounts of transducer motion relative to the pelvis when generating measurements of TrA thickness and bladder base position. Future sonographic studies and clinical assessment investigating these parameters could take these findings into account to improve imaging technique reliability.

Neurological Imaging in Acquired Cranial Nerve Palsy: Ophthalmologists vs. Neurologists.

PubMed

Klein Hesselink, Tessa; Gutter, Mari; Polling, Jan Roelof

2017-09-01

Cranial nerve palsies often require neurological imaging by MRI. Guidelines on whether or not to utilize MRI have been absent or lack clarity. In daily practice, both neurologists and ophthalmologists treat patients with cranial nerve palsy and determine whether neuro-imaging is required. There appear to be differences in policy with respect to neuro-imaging. The question, which will be answered in this study, is the following: to what extent do differences in policy exist between ophthalmologists and neurologists regarding imaging by MRI of patients with acquired ocular cranial nerve palsy? PubMed database was searched for literature on acquired cranial nerve palsy and MRI scanning performed by ophthalmologists and neurologists. Case series published between 2000 and 2015 were included. The first author screened the literature on eligibility, profession of the authors, and conducted data abstraction. Ten case series were found eligible for analysis. A total of 889 cranial nerve palsies were described, 770 by ophthalmologists and 119 by neurologists. The age range of patients in all case series was 2 to 96 years of age. The oculomotor nerve was investigated in 162 patients, the trochlear nerve in 131 patients, and the abducens nerve in 486 patients. All neurologists (n=3) and 2 out of 7 investigated ophthalmologists recommended performing MRI scanning in every patient who presented with an ocular cranial nerve palsy, while 5 ophthalmologists (5/7) opted to triage patients for risk factors associated with cranial nerve palsies prior to ordering MRI imaging. When different groups of patients were viewed separately, it became apparent that almost all specialists agreed that every patient with a third nerve palsy and patients under 50 years of age should undergo MRI scanning. In patients with fourth nerve palsy, MRI scanning was not indicated. The neurologists in this study were more likely to perform MRI scanning in every patient presenting with ocular cranial nerve palsy. Ophthalmologists were more likely to determine risk factors associated with cranial nerve palsy, which they took into account when deciding whether or not to perform neurological imaging in patients aged more than 50 years or presenting with abducens nerve palsy.

[Anatomy and malformations of the posterior cranial fossa].

PubMed

Struffert, T

2016-11-01

Many important structures are located in the confined space within the posterior cranial fossa. This article describes the main aspects of the anatomy. As a uniform classification of malformations of the posterior cranial fossa does not exist the main syndromes, such as Chiari malformations, zerebellar hypoplasia and dysplasia are discussed separately.

Temporalis myofascial flap for primary cranial base reconstruction after tumor resection.

PubMed

Eldaly, Ahmed; Magdy, Emad A; Nour, Yasser A; Gaafar, Alaa H

2008-07-01

To evaluate the use of the temporalis myofascial flap in primary cranial base reconstruction following surgical tumor ablation and to explain technical issues, potential complications, and donor site consequences along with their management. Retrospective case series. Tertiary referral center. Forty-one consecutive patients receiving primary temporalis myofascial flap reconstructions following cranial base tumor resections in a 4-year period. Flap survival, postoperative complications, and donor site morbidity. Patients included 37 males and 4 females ranging in age from 10 to 65 years. Two patients received preoperative and 18 postoperative radiation therapy. Patient follow-up ranged from 4 to 39 months. The whole temporalis muscle was used in 26 patients (63.4%) and only part of a coronally split muscle was used in 15 patients (36.6%). Nine patients had primary donor site reconstruction using a Medpor((R)) (Porex Surgical, Inc., Newnan, GA) temporal fossa implant; these had excellent aesthetic results. There were no cases of complete flap loss. Partial flap dehiscence was seen in six patients (14.6%); only two required surgical débridement. None of the patients developed cerebrospinal leaks or meningitis. One patient was left with complete paralysis of the temporal branch of the facial nerve. Three patients (all had received postoperative irradiation) developed permanent trismus. The temporalis myofascial flap was found to be an excellent reconstructive alternative for a wide variety of skull base defects following tumor ablation. It is a very reliable, versatile flap that is usually available in the operative field with relatively low donor site aesthetic and functional morbidity.

Aberrant regeneration of the third cranial nerve.

PubMed

Shrestha, U D; Adhikari, S

2012-01-01

Aberrant regeneration of the third cranial nerve is most commonly due to its damage by trauma. A ten-month old child presented with the history of a fall from a four-storey building. She developed traumatic third nerve palsy and eventually the clinical features of aberrant regeneration of the third cranial nerve. The adduction of the eye improved over time. She was advised for patching for the strabismic amblyopia as well. Traumatic third nerve palsy may result in aberrant regeneration of the third cranial nerve. In younger patients, motility of the eye in different gazes may improve over time. © NEPjOPH.

Enhancement of multiple cranial and spinal nerves in vanishing white matter: expanding the differential diagnosis.

PubMed

Eluvathingal Muttikkal, Thomas Jose; Montealegre, Denia Ramirez; Matsumoto, Julie Ann

2018-03-01

Abnormal cranial or spinal nerve contrast enhancement on MRI in cases of suspected pediatric leukodystrophy is recognized as an important clue to the diagnosis of either metachromatic leukodystrophy or globoid cell leukodystrophy (Krabbe disease). We report a case of genetically confirmed childhood vanishing white matter with enhancement of multiple cranial and spinal nerves in addition to the more typical intracranial findings. This case expands the limited differential diagnosis of cranial nerve or spinal nerve enhancement in cases of suspected leukodystrophy and may aid in more efficient work-up and earlier diagnosis of vanishing white matter.

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. © 2016 Elsevier B.V. All rights reserved.

Light up the "no-man's land" on the brain stem.

PubMed

Kawase, T

1995-12-01

The ventral surface of the brain stem is anatomically surrounded by the clivus anteriorly, brain stem posteriorly and by the petrous pyramid and cranial nerves from IIIrd to XIIth laterally in the deep posterior cranial fossa. Neurosurgical extra-axial pathologies arising from the area are aneurysms on the vertebro-basilar artery, benign tumors such as clival meningiomas, chordomas, chondromas, trigeminal neurinomas and prepontine epidermoid tumors. Surgical access to the area had been difficult for long years since the neurosurgery was established, because located deeply in such a surgical blindness, so-called "no-man's land". However, recent technical development of "skull base surgery" is opening new doors to light up the surgical darkness of the "no-man's land". This paper reviews the history, development, technique and future prospect of the skull base surgery to open the "no-man's land".

Neuroanatomy of the Marine Jurassic Turtle Plesiochelys etalloni (Testudinata, Plesiochelyidae)

PubMed Central

Carabajal, Ariana Paulina; Sterli, Juliana; Müller, Johannes; Hilger, André

2013-01-01

Turtles are one of the least explored clades regarding endocranial anatomy with few available descriptions of the brain and inner ear of extant representatives. In addition, the paleoneurology of extinct turtles is poorly known and based on only a few natural cranial endocasts. The main goal of this study is to provide for the first time a detailed description of the neuroanatomy of an extinct turtle, the Late Jurassic Plesiochelysetalloni , including internal carotid circulation, cranial endocast and inner ear, based on the first digital 3D reconstruction using micro CT scans. The general shape of the cranial endocast of P. etalloni is tubular, with poorly marked cephalic and pontine flexures. Anteriorly, the olfactory bulbs are clearly differentiated suggesting larger bulbs than in any other described extinct or extant turtle, and indicating a higher capacity of olfaction in this taxon. The morphology of the inner ear of P . etalloni is comparable to that of extant turtles and resembles those of slow-moving terrestrial vertebrates, with markedly low, short and robust semicircular canals, and a reduced lagena. In P . etalloni the arterial pattern is similar to that found in extant cryptodires, where all the internal carotid branches are protected by bone. As the knowledge of paleoneurology in turtles is scarce and the application of modern techniques such as 3D reconstructions based on CT scans is almost unexplored in this clade, we hope this paper will trigger similar investigations of this type in other turtle taxa. PMID:23844257

Neuroanatomy of the marine Jurassic turtle Plesiochelys etalloni (Testudinata, Plesiochelyidae).

PubMed

Carabajal, Ariana Paulina; Sterli, Juliana; Müller, Johannes; Hilger, André

2013-01-01

Turtles are one of the least explored clades regarding endocranial anatomy with few available descriptions of the brain and inner ear of extant representatives. In addition, the paleoneurology of extinct turtles is poorly known and based on only a few natural cranial endocasts. The main goal of this study is to provide for the first time a detailed description of the neuroanatomy of an extinct turtle, the Late Jurassic Plesiochelysetalloni, including internal carotid circulation, cranial endocast and inner ear, based on the first digital 3D reconstruction using micro CT scans. The general shape of the cranial endocast of P. etalloni is tubular, with poorly marked cephalic and pontine flexures. Anteriorly, the olfactory bulbs are clearly differentiated suggesting larger bulbs than in any other described extinct or extant turtle, and indicating a higher capacity of olfaction in this taxon. The morphology of the inner ear of P. etalloni is comparable to that of extant turtles and resembles those of slow-moving terrestrial vertebrates, with markedly low, short and robust semicircular canals, and a reduced lagena. In P. etalloni the arterial pattern is similar to that found in extant cryptodires, where all the internal carotid branches are protected by bone. As the knowledge of paleoneurology in turtles is scarce and the application of modern techniques such as 3D reconstructions based on CT scans is almost unexplored in this clade, we hope this paper will trigger similar investigations of this type in other turtle taxa.

Craniofacial structures' development in prenatal period: An MRI study.

PubMed

Begnoni, G; Serrao, G; Musto, F; Pellegrini, G; Triulzi, F M; Dellavia, C

2018-05-01

The development of skeletal structures (cranial base, upper and lower) and upper airways spaces (oropharyngeal and nasopharyngeal) of the skull has always been an issue of great interest in orthodontics. Foetal MRI images obtained as screening exam during pregnancy can help to understand the development of these structures using a sample cephalometric analysis. A total of 28 MRI images in sagittal section of foetuses from 20th to 32th weeks of gestation were obtained to dispel doubts about the presence of skeletal malformations. Cephalometric measurements were performed on MRI T2-dependent images acquired with a 1.5 T scanner. The Software Osirix 5 permits to study sagittal and vertical dimensions of the skull analysing linear measurements, angles and areas of the skeletal structures. Vertical and sagittal dimension of cranial base, maxilla and mandible grow significantly (P < .01) between the second and third trimester of gestational period as well as nasopharyngeal and oropharyngeal spaces (P < .05). High correlation between the development of anterior cranial base and functional areas devoted to speech and swallow is demonstrated (r: .97). The development of craniofacial structures during foetal period seems to show a close correlation between skeletal features and functional spaces with a peak between the second and third trimester of gestation. MRI images result helpful for the clinician to detect with a sample cephalometric analysis anomalies of skeletal and functional structures during prenatal period. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Probabilistic Tractography of the Cranial Nerves in Vestibular Schwannoma.

PubMed

Zolal, Amir; Juratli, Tareq A; Podlesek, Dino; Rieger, Bernhard; Kitzler, Hagen H; Linn, Jennifer; Schackert, Gabriele; Sobottka, Stephan B

2017-11-01

Multiple recent studies have reported on diffusion tensor-based fiber tracking of cranial nerves in vestibular schwannoma, with conflicting results as to the accuracy of the method and the occurrence of cochlear nerve depiction. Probabilistic nontensor-based tractography might offer advantages in terms of better extraction of directional information from the underlying data in cranial nerves, which are of subvoxel size. Twenty-one patients with large vestibular schwannomas were recruited. The probabilistic tracking was run preoperatively and the position of the potential depictions of the facial and cochlear nerves was estimated postoperatively by 3 independent observers in a blinded fashion. The true position of the nerve was determined intraoperatively by the surgeon. Thereafter, the imaging-based estimated position was compared with the intraoperatively determined position. Tumor size, cystic appearance, and postoperative House-Brackmann score were analyzed with regard to the accuracy of the depiction of the nerves. The probabilistic tracking showed a connection that correlated to the position of the facial nerve in 81% of the cases and to the position of the cochlear nerve in 33% of the cases. Altogether, the resulting depiction did not correspond to the intraoperative position of any of the nerves in 3 cases. In a majority of cases, the position of the facial nerve, but not of the cochlear nerve, could be estimated by evaluation of the probabilistic tracking results. However, false depictions not corresponding to any nerve do occur and cannot be discerned as such from the image only. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgical prediction of skeletal and soft tissue changes in treatment of Class II.

PubMed

de Lira, Ana de Lourdes Sá; de Moura, Walter Leal; Artese, Flávia; Bittencourt, Marcos Alan Vieira; Nojima, Lincoln Issamu

2013-04-01

The purpose of this study was to study the treatment outcomes and the accuracy of digital prediction and the actual postoperative outcome with Dolphin program on subjects presenting Class II malocclusions. Forty patients underwent surgical mandibular advancement (Group 1) and 40 underwent combined surgery of mandibular advancement and maxillary impaction (Group 2). The available pre surgical (t₁) and a minimum of 12 months post surgical (t₂) cephalometric radiographs were digitized. Predictive cephalograms (t₃) for both groups were traced. At all times evaluated, Group 1 displayed a shorter mandibular length and Group 2 had a longer lower face. In both groups the surgical interventions (t₂) were greater than initially predicted. There was no significant difference between groups with regards to overjet, overbite and soft tissue measurements. In both groups surgeries were more extensive than planned. Facial convexity and the distance of the lips to cranial base presented similar values between t₂ (post surgical) and t₃ (predicted). Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Prediction and near-field observation of skull-guided acoustic waves

NASA Astrophysics Data System (ADS)

Estrada, Héctor; Rebling, Johannes; Razansky, Daniel

2017-06-01

Ultrasound waves propagating in water or soft biological tissue are strongly reflected when encountering the skull, which limits the use of ultrasound-based techniques in transcranial imaging and therapeutic applications. Current knowledge on the acoustic properties of the cranial bone is restricted to far-field observations, leaving its near-field unexplored. We report on the existence of skull-guided acoustic waves, which was herein confirmed by near-field measurements of optoacoustically-induced responses in ex-vivo murine skulls immersed in water. Dispersion of the guided waves was found to reasonably agree with the prediction of a multilayered flat plate model. We observed a skull-guided wave propagation over a lateral distance of at least 3 mm, with a half-decay length in the direction perpendicular to the skull ranging from 35 to 300 μm at 6 and 0.5 MHz, respectively. Propagation losses are mostly attributed to the heterogenous acoustic properties of the skull. It is generally anticipated that our findings may facilitate and broaden the application of ultrasound-mediated techniques in brain diagnostics and therapy.

Prediction and near-field observation of skull-guided acoustic waves.

PubMed

Estrada, Héctor; Rebling, Johannes; Razansky, Daniel

2017-06-21

Ultrasound waves propagating in water or soft biological tissue are strongly reflected when encountering the skull, which limits the use of ultrasound-based techniques in transcranial imaging and therapeutic applications. Current knowledge on the acoustic properties of the cranial bone is restricted to far-field observations, leaving its near-field unexplored. We report on the existence of skull-guided acoustic waves, which was herein confirmed by near-field measurements of optoacoustically-induced responses in ex-vivo murine skulls immersed in water. Dispersion of the guided waves was found to reasonably agree with the prediction of a multilayered flat plate model. We observed a skull-guided wave propagation over a lateral distance of at least 3 mm, with a half-decay length in the direction perpendicular to the skull ranging from 35 to 300 μm at 6 and 0.5 MHz, respectively. Propagation losses are mostly attributed to the heterogenous acoustic properties of the skull. It is generally anticipated that our findings may facilitate and broaden the application of ultrasound-mediated techniques in brain diagnostics and therapy.

Incidence of cranial nerve palsy after preoperative embolization of glomus jugulare tumors using Onyx.

PubMed

Gaynor, Brandon G; Elhammady, Mohamed Samy; Jethanamest, Daniel; Angeli, Simon I; Aziz-Sultan, Mohammad A

2014-02-01

The resection of glomus jugulare tumors can be challenging because of their inherent vascularity. Preoperative embolization has been advocated as a means of reducing operative times, blood loss, and surgical complications. However, the incidence of cranial neuropathy associated with the embolization of these tumors has not been established. The authors of this study describe their experience with cranial neuropathy following transarterial embolization of glomus jugulare tumors using ethylene vinyl alcohol (Onyx, eV3 Inc.). The authors retrospectively reviewed all cases of glomus jugulare tumors that had been treated with preoperative embolization using Onyx at their institution in the period from 2006 to 2012. Patient demographics, clinical presentation, grade and amount of Onyx used, degree of angiographic devascularization, and procedural complications were recorded. Over a 6-year period, 11 patients with glomus jugulare tumors underwent preoperative embolization with Onyx. All embolization procedures were completed in one session. The overall mean percent of tumor devascularization was 90.7%. No evidence of nontarget embolization was seen on postembolization angiograms. There were 2 cases (18%) of permanent cranial neuropathy attributed to the embolization procedures (facial nerve paralysis and lower cranial nerve dysfunction). Embolizing glomus jugulare tumors with Onyx can produce a dramatic reduction in tumor vascularity. However, the intimate anatomical relationship and overlapping blood supply between these tumors and cranial nerves may contribute to a high incidence of cranial neuropathy following Onyx embolization.

Extra- and intra-cranial arterial calcifications in adults depicted as incidental findings on cone beam CT images.

PubMed

Damaskos, Spyros; Tsiklakis, Kostas; Syriopoulos, Kostas; van der Stelt, Paul

2015-04-01

The aim of this study was to evaluate, retrospectively, the gender- and age-related prevalence of incidentally found calcifications, depicted within the course of the extra- and intra-cranial portion of internal carotid artery (ICA), in cone beam computed tomography (CBCT) examinations in adults, and to assess their clinical significance. Out of a pull of 700 CBCT examinations a total of 484 CBCT scans of adult patients were finally selected according to a set of pre-defined criteria. These were evaluated for arterial calcifications presence within the ICAs course according to gender and age criteria. In total, 492 calcifications were detected: 211 (42.88%) extra-cranial and 281 (57.11%) intra-cranial. Those were recorded in 150 scans (30.99%) and 161 scans (33.26%), respectively. Calcifications, with either extra- or intra-cranial allocation, were found more frequent in males than in females (all p-values < 0.05); also patients who presented with positive findings were older than those without findings (all p-values < 0.05). Furthermore, calcification presence with either extra- or intra-cranial allocation increases with age (all p-values < 0.05). Significant calcification frequencies were found within the ICA's course, in CBCT scans. Moreover, an increased incidence of either extra- or intra-cranial presence of these depictions and its relation to age and gender was documented.

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors.

PubMed

Barrett, Thomas F; Dyvorne, Hadrien A; Padormo, Francesco; Pawha, Puneet S; Delman, Bradley N; Shrivastava, Raj K; Balchandani, Priti

2017-07-01

Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care. Images were acquired at 7 T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5-, 3-, and 7-T scans for detection of intracavernous cranial nerves and internal carotid artery (ICA) branches. Detection rates were compared. Images were used for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7 T. The 7-T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. Our study represents the first application of 7-T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7-T MRI compared with 3- and 1.5-T MRI, and found that integration of 7 T into surgical planning and guidance was feasible. These results suggest a potential for 7-T MRI to reduce surgical complications. Future studies comparing standardized 7-, 3-, and 1.5-T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7-T MRI for endonasal endoscopic surgical efficacy. Copyright © 2017 Elsevier Inc. All rights reserved.

First Application of 7T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

PubMed Central

Barrett, Thomas F; Dyvorne, Hadrien A; Padormo, Francesco; Pawha, Puneet S; Delman, Bradley N; Shrivastava, Raj K; Balchandani, Priti

2018-01-01

Background Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. Methods Images were acquired at 7T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5T, 3T, and 7T scans for detection of intracavernous cranial nerves and ICA branches. Detection rates were compared. Images were utilized for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. Results Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7T. 7T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. Conclusion Our study represents the first application of 7T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7T MRI compared to 3T and 1.5 T, and found that integration of 7T into surgical planning and guidance was feasible. These results suggest a potential for 7T MRI to reduce surgical complications. Future studies comparing standardized 7T, 3T, and 1.5 T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7T MRI for endonasal endoscopic surgical efficacy. PMID:28359922

Understanding the extraocular muscles and oculomotor, trochlear, and abducens nerves through a simulation in physical examination training: an innovative approach.

PubMed

Zhang, Niu; He, Xiaohua

2010-01-01

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

A computer-based simulation of obstetric forceps placement.

PubMed

Lapeer, Rudy; Audinis, Vilius; Gerikhanov, Zelimkhan; Dupuis, Olivier

2014-01-01

Obstetric forceps are commonly used when the expulsion of the baby during childbirth fails to progress. When the two forceps blades are applied correctly, i.e. symmetrically, the inner surface of each blade maximises the area in contact with the fetal head. On the contrary, when the blades are applied asymmetrically, the contact areas between the inner surface of the blades and the fetal head are minimal and at distinct locations at the left and right sides of the fetal head. It is therefore assumed in the field of obstetrics that asymmetric application is bound to cause intra-cranial damage due to significantly higher shear forces and significant deformation of the fetal cranial bones as compared to symmetric application. In this paper we present the first of a series of studies to analyse the mechanical contact between head and forceps under different conditions using finite element analysis. We used high fidelity mesh models of a fetal skull and obstetric forceps. The fetal cranial material properties are known from previous studies. We observed significantly higher deformations and stresses for the asymmetric application of the blades as compared to symmetric placement.

Piezosurgery for the repair of middle cranial fossa meningoencephaloceles.

PubMed

Acharya, Aanand N; Rajan, Gunesh P

2015-03-01

To describe the use of a piezosurgery medical device to perform a craniotomy and produce a split calvarial graft for the repair of middle cranial fossa meningoencephaloceles. Retrospective case review. Tertiary referral hospital. Ten consecutive patients undergoing middle cranial fossa approach for the repair of meningoencephaloceles. Therapeutic. Intraoperative and postoperative complications, success rate as defined by the ability to fashion a split calvarial graft that achieves complete closure of the tegmen defect. As a secondary outcome measure, evidence of integration of the split calvarial bone graft with the adjacent skull base was assessed. There were no intraoperative or postoperative complications. An appropriately sized calvarial bone graft was produced, and complete closure of the tegmen defect was achieved in all 10 cases. Computed tomography demonstrated evidence of integration of the bone graft in eight cases between 4 and 9 months after surgery. The piezosurgery medical device provides a safe and effective means by which the middle fossa craniotomy and split calvarial bone graft can be produced to repair defects of the middle fossa tegmen, with integration of the bone graft in the majority of cases.

A review of hedgehog signaling in cranial bone development

PubMed Central

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

2013-01-01

During craniofacial development, the Hedgehog (HH) signaling pathway is essential for mesodermal tissue patterning and differentiation. The HH family consists of three protein ligands: Sonic Hedgehog (SHH), Indian Hedgehog (IHH), and Desert Hedgehog (DHH), of which two are expressed in the craniofacial complex (IHH and SHH). Dysregulations in HH signaling are well documented to result in a wide range of craniofacial abnormalities, including holoprosencephaly (HPE), hypotelorism, and cleft lip/palate. Furthermore, mutations in HH effectors, co-receptors, and ciliary proteins result in skeletal and craniofacial deformities. Cranial suture morphogenesis is a delicate developmental process that requires control of cell commitment, proliferation and differentiation. This review focuses on both what is known and what remains unknown regarding HH signaling in cranial suture morphogenesis and intramembranous ossification. As demonstrated from murine studies, expression of both SHH and IHH is critical to the formation and fusion of the cranial sutures and calvarial ossification. SHH expression has been observed in the cranial suture mesenchyme and its precise function is not fully defined, although some postulate SHH to delay cranial suture fusion. IHH expression is mainly found on the osteogenic fronts of the calvarial bones, and functions to induce cell proliferation and differentiation. Unfortunately, neonatal lethality of IHH deficient mice precludes a detailed examination of their postnatal calvarial phenotype. In summary, a number of basic questions are yet to be answered regarding domains of expression, developmental role, and functional overlap of HH morphogens in the calvaria. Nevertheless, SHH and IHH ligands are integral to cranial suture development and regulation of calvarial ossification. When HH signaling goes awry, the resultant suite of morphologic abnormalities highlights the important roles of HH signaling in cranial development. PMID:23565096

BMP9 induces osteogenesis and adipogenesis in the immortalized human cranial suture progenitors from the patent sutures of craniosynostosis patients.

PubMed

Song, Dongzhe; Zhang, Fugui; Reid, Russell R; Ye, Jixing; Wei, Qiang; Liao, Junyi; Zou, Yulong; Fan, Jiaming; Ma, Chao; Hu, Xue; Qu, Xiangyang; Chen, Liqun; Li, Li; Yu, Yichun; Yu, Xinyi; Zhang, Zhicai; Zhao, Chen; Zeng, Zongyue; Zhang, Ruyi; Yan, Shujuan; Wu, Tingting; Wu, Xingye; Shu, Yi; Lei, Jiayan; Li, Yasha; Zhang, Wenwen; Wang, Jia; Lee, Michael J; Wolf, Jennifer Moriatis; Huang, Dingming; He, Tong-Chuan

2017-11-01

The cranial suture complex is a heterogeneous tissue consisting of osteogenic progenitor cells and mesenchymal stem cells (MSCs) from bone marrow and suture mesenchyme. The fusion of cranial sutures is a highly coordinated and tightly regulated process during development. Craniosynostosis is a congenital malformation caused by premature fusion of cranial sutures. While the progenitor cells derived from the cranial suture complex should prove valuable for studying the molecular mechanisms underlying suture development and pathogenic premature suture fusion, primary human cranial suture progenitors (SuPs) have limited life span and gradually lose osteoblastic ability over passages. To overcome technical challenges in maintaining sufficient and long-term culture of SuPs for suture biology studies, we establish and characterize the reversibly immortalized human cranial suture progenitors (iSuPs). Using a reversible immortalization system expressing SV40 T flanked with FRT sites, we demonstrate that primary human suture progenitor cells derived from the patent sutures of craniosynostosis patients can be efficiently immortalized. The iSuPs maintain long-term proliferative activity, express most of the consensus MSC markers and can differentiate into osteogenic and adipogenic lineages upon BMP9 stimulation in vitro and in vivo. The removal of SV40 T antigen by FLP recombinase results in a decrease in cell proliferation and an increase in the endogenous osteogenic and adipogenic capability in the iSuPs. Therefore, the iSuPs should be a valuable resource to study suture development, intramembranous ossification and the pathogenesis of craniosynostosis, as well as to explore cranial bone tissue engineering. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

The role of branchial and orobranchial O2 chemoreceptors in the control of aquatic surface respiration in the neotropical fish tambaqui (Colossoma macropomum): progressive responses to prolonged hypoxia.

PubMed

Florindo, Luiz H; Leite, Cléo A C; Kalinin, Ana L; Reid, Stephen G; Milsom, William K; Rantin, F Tadeu

2006-05-01

The present study examined the role of branchial and orobranchial O(2) chemoreceptors in the cardiorespiratory responses, aquatic surface respiration (ASR), and the development of inferior lip swelling in tambaqui during prolonged (6 h) exposure to hypoxia. Intact fish (control) and three groups of denervated fish (bilateral denervation of cranial nerves IX+X (to the gills), of cranial nerves V+VII (to the orobranchial cavity) or of cranial nerves V alone), were exposed to severe hypoxia (Pw(O)2=10 mmHg) for 360 min. Respiratory frequency (fr) and heart rate (fh) were recorded simultaneously with ASR. Intact (control) fish increased fr, ventilation amplitude (V(AMP)) and developed hypoxic bradycardia in the first 60 min of hypoxia. The bradycardia, however, abated progressively and had returned to normoxic levels by the last hour of exposure to hypoxia. The changes in respiratory frequency and the hypoxic bradycardia were eliminated by denervation of cranial nerves IX and X but were not affected by denervation of cranial nerves V or V+VII. The V(AMP) was not abolished by the various denervation protocols. The fh in fish with denervation of cranial nerves V or V+VII, however, did not recover to control values as in intact fish. After 360 min of exposure to hypoxia only the intact and IX+X denervated fish performed ASR. Denervation of cranial nerve V abolished the ASR behavior. However, all (control and denervated (IX+X, V and V+VII) fish developed inferior lip swelling. These results indicate that ASR is triggered by O(2) chemoreceptors innervated by cranial nerve V but that other mechanisms, such as a direct effect of hypoxia on the lip tissue, trigger lip swelling.

Comparison of the biomechanical properties of rottweiler and racing greyhound cranial cruciate ligaments.

PubMed

Wingfield, C; Amis, A A; Stead, A C; Law, H T

2000-07-01

An in vitro study of rottweiler and racing greyhound cranial cruciate ligaments revealed that the rottweiler ligaments had a significantly greater cross-sectional area at their distal attachments. Mechanical testing showed that the ultimate load related to body mass was significantly higher in the extended racing greyhound stifle during cranial tibial loading to failure, as were linear stiffness, tensile strength and tangent modulus. During ligament axis loading to failure, the only significant difference in structural and mechanical properties recorded between the two breeds was a greater ultimate strain for the greyhound ligament with the stifle joint flexed. Energy absorbed by the ligament complex at failure during cranial tibial loading was twice that for ligament axis loading for both breeds. The clinical significance is that the rottweiler cranial cruciate ligament is more vulnerable to damage as it requires half the load per unit body mass that the greyhound requires to cause a rupture.

Cranial cruciate stability in the rottweiler and racing greyhound: an in vitro study.

PubMed

Wingfield, C; Amis, A A; Stead, A C; Law, H T

2000-05-01

An in vitro biomechanical study of cadaver stifles from rottweilers and racing greyhounds was undertaken to evaluate the contribution of the cranial cruciate ligament to stifle joint stability. This was performed at differing stifle joint angles, first with the joint capsules and ligaments intact and then with all structures removed except for the cranial cruciate ligament. Craniocaudal laxity increased in both breeds as stifle flexion increased. The rottweiler stifle showed greater craniocaudal joint laxity than the racing greyhound at all joint angles between 150 degrees and 110 degrees, but the actual increases in joint laxity between these joint angles were similar for both breeds. Tibial rotation during craniocaudal loading of the stifle increased craniocaudal laxity in both breeds during joint flexion. The relative contribution of the cranial cruciate ligament to cranial stability of the stifle joint increased as the joint flexed and was similar in both breeds.

TOMOGRAPHIC MORPHOLOGICAL STUDY OF THE CRANIUM AND ITS CORRELATION WITH CRANIAL HALO USE IN ADULTS

PubMed Central

ALMEIDA, TIAGO FERREIRA DE; CHARAFEDDINE, HOMAR TOLEDO; ARAÚJO, FERNANDO FLORES DE; CRISTANTE, ALEXANDRE FOGAÇA; MARCON, RAPHAEL MARTUS; LETAIF, OLAVO BIRAGHI

2017-01-01

ABSTRACT Objective: To evaluate using tomographic study the thickness of the cranial board at the insertions points of the cranial halo pins in adults Methods: This is a retrospective, cross-sectional, descriptive analysis of Computed Tomography (CT) scans of adult patients' crania. The study included adults between 20 and 50 years without cranial abnormalities. We excluded any exam with cranial abnormalities Results: We analyzed 50 CT scans, including 27 men and 23 women, at the original insertion points and alternative points (1 and 2 cm above the frontal and parietal bones). The average values were 7.4333 mm in the frontal bone and 6.0290 mm in the parietal bone Conclusion: There was no statistically significant difference between the classical and alternative points, making room for alternative fixings and safer introduction of the pins, if necessary.Level of Evidence II, Retrospective Study. PMID:28642643

Comparison of linac-based fractionated stereotactic radiotherapy and tomotherapy treatment plans for intra-cranial tumors

NASA Astrophysics Data System (ADS)

Jang, Bo Shim; Suk, Lee; Sam, Ju Cho; Sang, Hoon Lee; Juree, Kim; Kwang, Hwan Cho; Chul, Kee Min; Hyun Do, Huh; Rena, Lee; Dae, Sik Yang; Young, Je Park; Won, Seob Yoon; Chul, Yong Kim; Soo, Il Kwon

2010-11-01

This study compares and analyzes stereotactic radiotherapy using tomotherapy and linac-based fractionated stereotactic radiotherapy in the treatment of intra-cranial tumors, according to some cases. In this study, linac-based fractionated stereotactic radiotherapy and tomotherapy treatment were administered to five patients diagnosed with intra-cranial cancer in which the dose of 18-20 Gy was applied on 3-5 separate occasions. The tumor dosing was decided by evaluating the inhomogeneous index (II) and conformity index (CI). Also, the radiation-sensitive tissue was evaluated using low dose factors V1, V2, V3, V4, V5, and V10, as well as the non-irradiation ratio volume (NIV). The values of the II for each prescription dose in the linac-based non-coplanar radiotherapy plan and tomotherapy treatment plan were (0.125±0.113) and (0.090±0.180), respectively, and the values of the CI were (0.899±0.149) and (0.917±0.114), respectively. The low dose areas, V1, V2, V3, V4, V5, and V10, in radiation-sensitive tissues in the linac-based non-coplanar radiotherapy plan fell into the ranges 0.3%-95.6%, 0.1%-87.6%, 0.1%-78.8%, 38.8%-69.9%, 26.6%-65.2%, and 4.2%-39.7%, respectively, and the tomotherapy treatment plan had ranges of 13.6%-100%, 3.5%-100%, 0.4%-94.9%, 0.2%-82.2%, 0.1%-78.5%, and 0.3%-46.3%, respectively. Regarding the NIV for each organ, it is possible to obtain similar values except for the irradiation area of the brain stem. The percentages of NIV 10%, NIV20%, and NIV30%for the brain stem in each patient were 15%-99.8%, 33.4%-100%, and 39.8%-100%, respectively, in the fractionated stereotactic treatment plan and 44.2%-96.5%, 77.7%-99.8%, and 87.8%-100%, respectively, in the tomotherapy treatment plan. In order to achieve higher-quality treatment of intra-cranial tumors, treatment plans should be tailored according to the isodose target volume, inhomogeneous index, conformity index, position of the tumor upon fractionated stereotactic radiosurgery, and radiation dosage for radiation-sensitive tissues.

Time to cranial computerised tomography for acute traumatic brain injury in paediatric patients: Effect of the shorter stays in emergency departments target in New Zealand.

PubMed

Jones, Peter G; Kool, Bridget; Dalziel, Stuart; Shepherd, Michael; Le Fevre, James; Harper, Alana; Wells, Susan; Stewart, Joanna; Curtis, Elana; Reid, Papaarangi; Ameratunga, Shanthi

2017-07-01

Timely access to computerised tomography (CT) for acute traumatic brain injuries (TBIs) facilitates rapid diagnosis and surgical intervention. In 2009, New Zealand introduced a mandatory target for emergency department (ED) stay such that 95% of patients should leave ED within 6 h of arrival. This study investigated whether this target influenced the timeliness of cranial CT scanning in children who presented to ED with acute TBI. We retrospectively reviewed a random sample of charts of children <15 years with acute TBI from 2006 to 2012. Cases were identified using International Classification of Disease 10 codes consistent with TBI. General linear models investigated changes in time to CT and other indicators before and after the shorter stays in ED target was introduced in 2009. Among the 190 cases eligible for study (n = 91 pre-target and n = 99 post-target), no significant difference was found in time to CT scan pre- and post-target: least squares mean (LSM) with 95% confidence interval = 68 (56-81) versus 65 (53-78) min, respectively, P = 0.66. Time to neurosurgery (LSM 8.7 (5-15) vs. 5.1 (2.6-9.9) h, P = 0.19, or hospital length of stay (LSM: 4.9 (3.9-6.3) vs. 5.2 (4.1-6.7) days, P = 0.69) did not change significantly. However, ED length of stay decreased by 45 min in the post-target period (LSM = 211 (187-238) vs. 166 (98-160) min, P = 0.006). Implementation of the shorter stays in ED target was not associated with a change in the time to CT for children presenting with acute TBI, but an overall reduction in the time spent in ED was apparent. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

A morphometric study of the atlas occipitalization and coexisted congenital anomalies of the vertebrae and posterior cranial fossa with neurological importance.

PubMed

Natsis, Konstantinos; Lyrtzis, Christos; Totlis, Trifon; Anastasopoulos, Nikolaos; Piagkou, Maria

2017-01-01

Our study highlights the morphometry of the partial and complete atlas occipitalization (AOZ), its coexistence with fusions of the 2nd and 3rd cervical vertebrae and morphological and morphometric abnormalities of the posterior cranial fossa that are of paramount neurological importance. One hundred and eighty adult dry skulls, the atlas and axis vertebrae were examined. Four skulls (2.2 %) showed AOZ. Two of them (1.1 %) presented a partial AOZ, one male skull (0.6 %) a complete AOZ and a female skull (0.6 %) had a fused left hemiatlas with the occipital bone and a fusion of the 2nd and 3rd cervical vertebrae. The inner anteroposterior and transverse diameters of the foramen magnum (FM) in the control group were 34.6 ± 3.46 and 29.3 ± 3.47 mm. Only the skull with the complete AOZ had a reduced outer anteroposterior diameter of the FM (29.8 mm), while no specimen was found with a reduced transverse diameter. A wide total decrease (range 13.1-50.9 %) in the surface area of the FM in skulls with AOZ was detected. Extracranial, the clivus length in two skulls with AOZ was smaller than the normal range. No skull was detected with a reduction in the intracranial length of the clivus. All skulls with the AOZ had a vermian fossa. The study adds important morphometric details about the partial and complete AOZ and correlates the phenomenon of synostosis with the narrowing of the FM, particularly in the case of complete AOZ. Awareness of the AOZ and other fusions of the upper cervical vertebrae and their topographical relations and attendant problems are of paramount importance to surgeons, when operate to the craniocervical junction, or interpret imaging studies to plan a safe surgery for nerve or spinal tissue decompression.

Epiduroscopy of the lumbosacral vertebral canal in the horse: Technique and endoscopic anatomy.

PubMed

Prange, T; Shrauner, B D; Blikslager, A T

2016-01-01

Back pain is a common cause of gait alterations and poor performance in horses, but the available imaging modalities are frequently insufficient to isolate the underlying pathology. In human patients, epidural endoscopy (epiduroscopy) is successfully used to diagnose and treat challenging cases of lower back pain. Endoscopy of the cervical epidural space has previously been reported in anaesthetised horses. To develop a technique for lumbosacral epiduroscopy in standing horses and to describe the endoscopic anatomy of the lumbosacral epidural space. Pilot study to assess the feasibility of lumbosacral epiduroscopy in 5 horse cadavers. The cadavers of 5 horses, weighing 457-694 kg (mean, 570 kg), were suspended in an upright position. Vascular dilators of increasing size were inserted between the first 2 moveable vertebrae caudal to the sacrum to create a minimally invasive approach into the epidural space. A flexible videoendoscope was introduced and advanced as far cranially as the length of the endoscope permitted. The lumbosacral epidural space underwent gross necropsy examination following the procedure. The endoscope was successfully inserted into the epidural space in all horses. Saline injection through the working channel of the endoscope allowed the following anatomical structures to be seen: dura mater, left and right lumbosacral spinal nerves, cauda equina, epidural fat, connective tissue and blood vessels. Using the 60 cm working length of the endoscope, the epidural space could be examined as far cranial as L3-T18, depending on the size of the horse. No gross damage to epidural neurovascular structures was observed on necropsy examination. Lumbosacral epiduroscopy is technically feasible in standing horses and may become a valuable diagnostic tool in horses with caudal back or limb pain of unknown origin. Studies in live horses will be necessary to evaluate the safety of the procedure. © 2015 EVJ Ltd.

Robotic Stereotaxy in Cranial Neurosurgery: A Qualitative Systematic Review.

PubMed

Fomenko, Anton; Serletis, Demitre

2017-12-14

Modern-day stereotactic techniques have evolved to tackle the neurosurgical challenge of accurately and reproducibly accessing specific brain targets. Neurosurgical advances have been made in synergy with sophisticated technological developments and engineering innovations such as automated robotic platforms. Robotic systems offer a unique combination of dexterity, durability, indefatigability, and precision. To perform a systematic review of robotic integration for cranial stereotactic guidance in neurosurgery. Specifically, we comprehensively analyze the strengths and weaknesses of a spectrum of robotic technologies, past and present, including details pertaining to each system's kinematic specifications and targeting accuracy profiles. Eligible articles on human clinical applications of cranial robotic-guided stereotactic systems between 1985 and 2017 were extracted from several electronic databases, with a focus on stereotactic biopsy procedures, stereoelectroencephalography, and deep brain stimulation electrode insertion. Cranial robotic stereotactic systems feature serial or parallel architectures with 4 to 7 degrees of freedom, and frame-based or frameless registration. Indications for robotic assistance are diversifying, and include stereotactic biopsy, deep brain stimulation and stereoelectroencephalography electrode placement, ventriculostomy, and ablation procedures. Complication rates are low, and mainly consist of hemorrhage. Newer systems benefit from increasing targeting accuracy, intraoperative imaging ability, improved safety profiles, and reduced operating times. We highlight emerging future directions pertaining to the integration of robotic technologies into future neurosurgical procedures. Notably, a trend toward miniaturization, cost-effectiveness, frameless registration, and increasing safety and accuracy characterize successful stereotactic robotic technologies. Copyright © 2017 by the Congress of Neurological Surgeons

Effectiveness of osteopathic manipulative treatment versus osteopathy in the cranial field in temporomandibular disorders - a pilot study.

PubMed

Gesslbauer, Christina; Vavti, Nadja; Keilani, Mohammad; Mickel, Michael; Crevenna, Richard

2018-03-01

Temporomandibular disorders are a common musculoskeletal condition causing severe pain, physical and psychological disability. The effect and evidence of osteopathic manipulative treatment and osteopathy in the cranial field is scarce and their use are controversial. The purpose of this pilot study was to evaluate the effectiveness of osteopathic manipulative treatment and osteopathy in the cranial field in temporomandibular disorders. A randomized clinical trial in patients with temporomandibular disorders was performed. Forty female subjects with long-term temporomandibular disorders (>3 months) were included. At enrollment, subjects were randomly assigned into two groups: (1) osteopathic manipulative treatment group (20 female patients) and (2) osteopathy in the cranial field group (20 female patients). Examination was performed at baseline (E0) and at the end of the last treatment (E1), consisting of subjective pain intensity with the Visual Analog Scale, Helkimo Index and SF-36 Health Survey. Subjects had five treatments, once a week. 36 subjects completed the study (33.7 ± 10.3 y). Patients in both groups showed significant reduction in Visual Analog Scale score (osteopathic manipulative treatment group: p = 0.001; osteopathy in the cranial field group: p< 0.001), Helkimo Index (osteopathic manipulative treatment group: p = 0.02; osteopathy in the cranial field group: p = 0.003) and a significant improvement in the SF-36 Health Survey - subscale "Bodily Pain" (osteopathic manipulative treatment group: p = 0.04; osteopathy in the cranial field group: p = 0.007) after five treatments (E1). All subjects (n = 36) also showed significant improvements in the above named parameters after five treatments (E1): Visual Analog Scale score (p< 0.001), Helkimo Index (p< 0.001), SF-36 Health Survey - subscale "Bodily Pain" (p = 0.001). The differences between the two groups were not statistically significant for any of the three target parameters. Both therapeutic modalities had similar clinical results. The findings of this pilot trial support the use of osteopathic manipulative treatment and osteopathy in the cranial field as an effective treatment modality in patients with temporomandibular disorders. The positive results in both treatment groups should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field and support the importance of an interdisciplinary collaboration in patients with temporomandibular disorders. Implications for rehabilitation Temporomandibular disorders are the second most prevalent musculoskeletal condition with a negative impact on physical and psychological factors. There are a variety of options to treat temporomandibular disorders. This pilot study demonstrates the reduction of pain, the improvement of temporomandibular joint dysfunction and the positive impact on quality of life after osteopathic manipulative treatment and osteopathy in the cranial field. Our findings support the use of osteopathic manipulative treatment and osteopathy in the cranial field and should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field in patients with temporomandibular disorders. Rehabilitation experts should consider osteopathic manipulative treatment and osteopathy in the cranial field as a beneficial treatment option for temporomandibular disorders.

Craniofacial morphology and dental maturity in children with reduced somatic growth of different aetiology and the effect of growth hormone treatment.

PubMed

Davidopoulou, Sotiria; Chatzigianni, Athina

2017-12-01

Children with reduced somatic growth may present various endocrinal diseases, especially growth hormone deficiency (GHD), idiopathic short stature (ISS), chromosomal aberrations, or genetic disorders. In an attempt to normalize the short stature, growth hormone (GH) is administered to these children. The aim of this literature review was to collect information about the craniofacial morphology and dental maturity in these children and to present the existing knowledge on the effect of GH treatment on the above structures.This review demonstrated that regardless of the origin of the somatic growth retardation, these children show similar craniofacial features, such as short length of the cranial base and the mandible, increased lower facial height, retropositioned mandible, and obtuse gonion angle. On the other hand, dental maturation does not demonstrate a specific pattern. Except for the above findings, muscle alterations seem to be present in individuals with short stature, who present low body muscle mass and strength, while studies on their craniofacial muscles seem to be lacking. After GH administration, the exact amount and pattern of craniofacial growth is unpredictable; however, the facial convexity decreases, mandibular length increases, and posterior facial height increases, while tooth eruption remains unaffected. Thus, it is of great importance to gain more insight into the craniofacial growth of treated and untreated children with reduced somatic growth so that the influence of GH therapy on the various craniofacial structures could be ascertained and proper orthodontic treatment could be selected.

Virtual Surgical Planning for Correction of Delayed Presentation Scaphocephaly Using a Modified Melbourne Technique.

PubMed

Macmillan, Alexandra; Lopez, Joseph; Mundinger, Gerhard S; Major, Melanie; Medina, Miguel A; Dorafshar, Amir H

2018-02-23

Late treatment of scaphocephaly presents challenges including need for more complex surgery to achieve desired head shape. Virtual surgical planning for total vault reconstruction may mitigate some of these challenges, but has not been studied in this unique and complex clinical setting. A retrospective chart review was conducted for patients with scaphocephaly who presented to our institution between 2000 and 2014. Patients presenting aged 12 months or older who underwent virtual surgical planning-assisted cranial vault reconstruction were included. Patient demographic, intraoperative data, and postoperative outcomes were recorded. Pre- and postoperative anthropometric measurements were obtained to document the fronto-occipital (FO) and biparietal (BP) distance and calculate cephalic index (CI). Virtual surgical planning predicted, and actual postoperative anthropometric measurements were compared. Five patients were identified who fulfilled inclusion criteria. The mean age was 50.6 months. One patient demonstrated signs of elevated intracranial pressure preoperatively. Postoperatively, all but one needed no revisional surgery (Whitaker score of 1). No patient demonstrated postoperative evidence of bony defects, bossing, or suture restenosis. The mean preoperative, simulated, and actual postoperative FO length was 190.3, 182, and 184.3 mm, respectively. The mean preoperative, simulated, and actual postoperative BP length was 129, 130.7, and 131 mm, respectively. The mean preoperative, simulated, and actual postoperative CI was 66, 72, and 71.3, respectively. Based on our early experience, virtual surgical planning using a modified Melbourne technique for total vault remodeling achieves good results in the management of late presenting scaphocephaly.

Disequilibrium after Traumatic Brain Injury: Vestibular Mechanisms

DTIC Science & Technology

2012-09-01

potentially modifiable factors. 0078 Chiropractic Sacro Occipital Technique (SOT) and Cranial Treatment Model for Traumatic Brain Injury Along with...model incorporating laboratory testing to evaluate neurotrans- mitter balance and chiropractic cranial care for the treatment of a patient with traumatic...Approach She has been under care for three years, which consisted of chiropractic sacro occipital technique (SOT) and cranial treat- ment. Within the

Recent refinements to cranial implants for rhesus macaques (Macaca mulatta)

PubMed Central

Johnston, Jessica M.; Cohen, Yale E.; Shirley, Harry; Tsunada, Joji; Bennur, Sharath; Christison-Lagay, Kate; Veeder, Christin L.

2017-01-01

The advent of cranial implants revolutionized primate neurophysiological research because they allow researchers to stably record neural activity from monkeys during active behavior. Cranial implants have improved over the years since their introduction, but chronic implants still increase the risk for medical complications including bacterial contamination and resultant infection, chronic inflammation, bone and tissue loss and complications related to the use of dental acrylic. These complications can lead to implant failure and early termination of study protocols. In an effort to reduce complications, we describe several refinements that have helped us improve cranial implants and the wellbeing of implanted primates. PMID:27096188

Electrophysiology of Cranial Nerve Testing: Cranial Nerves IX and X.

PubMed

Martinez, Alberto R M; Martins, Melina P; Moreira, Ana Lucila; Martins, Carlos R; Kimaid, Paulo A T; França, Marcondes C

2018-01-01

The cranial nerves IX and X emerge from medulla oblongata and have motor, sensory, and parasympathetic functions. Some of these are amenable to neurophysiological assessment. It is often hard to separate the individual contribution of each nerve; in fact, some of the techniques are indeed a composite functional measure of both nerves. The main methods are the evaluation of the swallowing function (combined IX and X), laryngeal electromyogram (predominant motor vagal function), and heart rate variability (predominant parasympathetic vagal function). This review describes, therefore, the techniques that best evaluate the major symptoms presented in IX and X cranial nerve disturbance: dysphagia, dysphonia, and autonomic parasympathetic dysfunction.

Arachnoid Cyst in the Middle Cranial Fossa Presenting with Pulsatile Exophthalmos: Case Report and Literature Review

PubMed Central

SAITO, Atsushi; KON, Hiroyuki; HARYU, Shinya; MINO, Masaki; SASAKI, Tatsuya; NISHIJIMA, Michiharu

2014-01-01

A 20-year-old woman suffered gradual progression of right pulsatile exophthalmos and slight headache. Computed tomography (CT) demonstrated outward and downward displacement of the right globe and an arachnoid cyst in the right middle cranial fossa associated with thinned and anterior protrusion of a bony orbit. Microscopic cystocisternotomy was performed and the cerebrospinal fluid (CSF) inside of the cyst communicated into the carotid cistern and cistern in the posterior cranial fossa. Pulsatile exophthalmos improved immediately after surgery. Arachnoid cyst in the middle cranial fossa presenting with exophthalmos is rare. Microscopic cystocisternotomy might successfully improve CSF flow and relieve exophthalmos. PMID:24305013

Comparison of collagen fibre architecture between slow-twitch cranial and fast-twitch caudal parts of broiler M. latissimus dorsi.

PubMed

Nakamura, Y N; Iwamoto, H; Tabata, S; Ono, Y

2003-07-01

1. Collagen fibre architectures of perimysium and endomysium in the slow-twitch cranial and fast-twitch caudal parts of broiler M. latissimus dorsi were compared. 2. Type I and III collagens were distributed in both perimysium and endomysium as indicated by their positive immunohistochemical reactions to polyclonal antibodies. 3. Cells invested by endomysium with no myofibres were larger in the cranial part because of the presence of larger slow-twitch myofibres. The honeycomb structure of endomysium was divided into several parts by thick perimysium. 4. The thick perimysial collagen fibres with parallel fibrils, which were interconnected by the loose reticular fibrils and thin fibres, were more numerous and thicker in the cranial part than the caudal. 5. Thick endomysial sidewall of cells in the cranial part was composed of a rougher reticulum of slightly thicker collagen fibrils compared with the thin sidewall in the caudal part. 6. These results indicated that both perimysial constitutions of collagen fibres and endomysial collagen fibrils had attained much larger growth in the slow-twitch cranial part than the fast-twitch caudal in broiler latissimus dorsi muscle.

Calvarial reconstruction using high-density porous polyethylene cranial hemispheres

PubMed Central

Mokal, Nitin J.; Desai, Mahinoor F.

2011-01-01

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

Precraniate origin of cranial motoneurons

PubMed Central

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

2006-01-01

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

Cranial osteology of the pampathere Holmesina floridanus (Xenarthra: Cingulata; Blancan NALMA), including a description of an isolated petrosal bone

PubMed Central

Lyon, Lauren M.

2017-01-01

The present study entails descriptions of several well-preserved skulls from the pampathere species Holmesina floridanus, recovered from Pliocene localities in central Florida and housed in the collections of the Florida Museum of Natural History. Bone by bone descriptions have allowed detailed reconstructions of cranial morphology. Cranial foramina are described and illustrated in detail, and their contents inferred. The first ever description of an isolated pampathere petrosal is also included. Cranial osteology of Holmesina floridanus is compared to that of Pleistocene species of Holmesina from both North and South America (Holmesina septentrionalis, Holmesina occidentalis), as well as to the other well-known pampathere genera, to closely related taxa among glyptodonts (Propalaehoplophorus), and to extinct and extant armadillos (Proeutatus, Euphractus). This study identifies a suite of apomorphic cranial features that serve to diagnose a putative, progressive series of more inclusive monophyletic groups, including the species Holmesina floridanus, the genus Holmesina, pampatheres, pampatheres plus glyptodonts, and a clade formed by pampatheres, glyptodonts, and Proeutatus. The study highlights the need for further anatomical investigations of pampathere cranial anatomy, especially those using modern scanning technology, and for analyses of pampathere phylogenetic relationships. PMID:29250462

Facial bone fragmentation in blind cavefish arises through two unusual ossification processes.

PubMed

Powers, Amanda K; Kaplan, Shane A; Boggs, Tyler E; Gross, Joshua B

2018-05-03

The precise mechanisms underlying cranial bone development, evolution and patterning remain incompletely characterised. This poses a challenge to understanding the etiologies of craniofacial malformations evolving in nature. Capitalising on natural variation, "evolutionary model systems" provide unique opportunities to identify underlying causes of aberrant phenotypes as a complement to studies in traditional systems. Mexican blind cavefish are a prime evolutionary model for cranial disorders since they frequently exhibit extreme alterations to the skull and lateral asymmetries. These aberrations occur in stark contrast to the normal cranial architectures of closely related surface-dwelling fish, providing a powerful comparative paradigm for understanding cranial bone formation. Using a longitudinal and in vivo analytical approach, we discovered two unusual ossification processes in cavefish that underlie the development of 'fragmented' and asymmetric cranial bones. The first mechanism involves the sporadic appearance of independent bony elements that fail to fuse together later in development. The second mechanism involves the "carving" of channels in the mature bone, a novel form of post-ossification remodeling. In the extreme cave environment, these novel mechanisms may have evolved to augment sensory input, and may indirectly result in a trade-off between sensory expansion and cranial bone development.

[Food-borne botulism].

PubMed

Nakamura, Yuko; Sawada, Mikio; Ikeguchi, Kunihiko; Nakano, Imaharu

2012-08-01

Botulism is a neuroparalytic disease caused by neurotoxins produced by Clostridium botulinum, and classically presents as palsies of cranial nerves and acute descending flaccid paralysis. Food-borne botulism is the most common form of botulism, and caused by preformed neurotoxins produced by Clostridium botulinum. Electrophysiological studies play an important role in the early diagnosis. Confirmation of the diagnosis is based on the detection of botulinum toxins in the patient's serum or stool. In Japan, decades ago, botulism type E occurred, though only sporadically, almost every year, but in recent years, has dramatically decreased in frequency. Botulism is a curable disease when treated early and adequately. Differential diagnosis of cranial nerves and limb muscle palsies with rapid exacerbation should include food-borne botulism.

[Endoscopic assistance in surgery of cerebellopontine angle tumors].

PubMed

Poshataev, V K; Shimansky, V N; Tanyashin, S V; Karnaukhov, V V

2014-01-01

During the period of 2010-2012, 33 patients with cerebellopontine angle tumors were operated on at the Burdenko Neurosurgical Institute (Moscow, Russia) using different types of endoscopic assistance. All patients were operated on via the retrosigmoid suboccipital approach in semi-sitting and prone positions. 30° and 70° endoscopes were used during the surgery. Endoscopic assistance allowed us to increase the completeness of tumor removal and to reduce the risk of postoperative complications by retaining the anatomic integrity of cranial nerves and vascular structures in the base of the posterior cranial fossa. These benefits made it possible to maintain and improve quality of life in patients with CPA tumors in the postoperative period.

Intraoperative validation of CT-based lymph nodal levels, sublevels IIa and IIb: Is it of clinical relevance in selective radiation therapy?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levendag, Peter; Gregoire, Vincent; Hamoir, Marc

2005-07-01

Purpose: The objectives of this study are to discuss the intraoperative validation of CT-based boundaries of lymph nodal levels in the neck, and in particular the clinical relevance of the delineation of sublevels IIa and IIb in case of selective radiation therapy (RT). Methods and Materials: To validate the radiologically defined level contours, clips were positioned intraoperatively at the level boundaries defined by surgical anatomy. In 10 consecutive patients, clips were placed, at the time of a neck dissection being performed, at the most cranial border of the neck. Anterior-posterior and lateral X-ray films were obtained intraoperatively. Next, in 3more » patients, neck levels were contoured on preoperative contrast-enhanced CT scans according to the international consensus guidelines. From each of these 3 patients, an intraoperative CT scan was also obtained, with clips placed at the surgical-anatomy-based level boundaries. The preoperative (CT-based) and intraoperative (surgery-defined) CT scans were matched. Results: Clips placed at the most cranial part of the neck lined up at the caudal part of the transverse process of the cervical vertebra C-I. The posterior border of surgical level IIa (spinal accessory nerve [SAN]) did not match with the posterior border of CT-based level IIa (internal jugular vein [IJV]). Other surgical boundaries and CT-based contours were in good agreement. Conclusions: The cranial border of the neck, i.e., the cranial border of level IIa/IIb, corresponds to the caudal edge of the lateral process of C-I. Except for the posterior border between level IIa and level IIb, a perfect match was observed between the other surgical-clip-identified levels II-V boundaries (surgical-anatomy) and the CT-based delineation contours. It is argued that (1) because of the parotid gland overlapping part of level II, and (2) the frequent infestation of occult metastatic cells in the lymph channels around the IJV, the division of level II into radiologic sublevels IIa and IIb may not be relevant. Sparing of, for example, the ipsilateral parotid gland in selective RT can even be a treacherous undertaking with respect to regional tumor control. In contrast, the surgeon's reasoning for preserving the surgical sublevel IIb is that the morbidity associated with dissection of the supraspinal accessory nerve compartment of level II is reduced, whereas there is evidence from the surgical literature that no extra risk for regional tumor control is observed. Therefore, in selective neck dissections, the division into surgical sublevels IIa/IIb makes sense.« less

Role of blink reflex in diagnosis of subclinical cranial neuropathy in diabetic mellitus type II.

PubMed

Kazem, Shakouri S; Behzad, Davoudi

2006-05-01

Peripheral neuropathy (PN) is one of the late complications of diabetes mellitus. Cranial nerves III, VII, and V are among the most commonly affected in diabetic patients. Traditional electrodiagnosis (Edx) studies are a useful method for diagnosis of PN and symptomatic cranial neuropathy, and may not be useful for detecting subclinical involvement of cranial nerves. The main objective of this study is to evaluate the role of blink reflex (BR) for early diagnosis of cranial neuropathy in diabetic patients with PN. A prospective study was performed on NIDDM patients with PN. One hundred eighty-eight subjects were included in our study in which 142 acted as healthy subjects and 46 as diabetic patients. Patients were excluded with prior history of cranial nerve lesions, stroke, or any other disease with polyneuropathy or drug-induced neuropathy. Routine nerve conduction studies were performed, and only patients with PN were included in this study. Abnormalities were found in 54.4% of patients. R1, IR2, and CR2 were prolonged relative to the healthy group. Statistically there was no significant difference in R/D ratio of patients (P=0.201). Also, there was a positive correlation between R1, IR2, and CR2 latencies with duration of diabetes and severity of polyneuropathy, but not for R/D. The greatest correlation was shown in R1 latency (69.9% abnormality). BR is a noninvasive and very useful method for the evaluation and diagnosis of subclinical cranial nerve involvement in diabetic patients.

Role of Blink Reflex in diagnosis of subclinical cranial neuropathy in Diabetic Mellitus type II.

PubMed

Kazem, S S; Behzad, D

2005-01-01

Peripheral Neuropathy (PN) is one of the late complications of Diabetes Mellitus. Cranial nerves III, VII and V are among the most commonly affected in diabetic patients. Traditional Electrodiagnosis (Edx) studies are useful method for diagnosis of PN and symptomatic cranial neuropathy, and may not be useful for detecting subclinical involvement of cranial nerves. The main objective of this study is to evaluate the role of Blink Reflex (BR) for early diagnosis of cranial neuropathy in diabetic patients with PN. A prospective study was performed on NIDDM patients with a PN. 188 subjects were included in our study in which 142 acted as healthy subjects and 46 as diabetic patients. Patients were excluded with prior history of cranial nerve lesions, stroke, and other disease with polyneuropathy or drug-induced neuropathy. Routine nerve conduction studies were performed and only patients with PN were included in this study. Abnormalities were found in 54.4% of patients. R1, IR2 and CR2 were prolonged relative to healthy group. Statistically there was no significant difference in R/D ratio of patients (P = 0.201). Also there was a positive correlation between R1, IR2 and CR2 latencies with duration of diabetes and severity of polyneuropathy, but not for R/D. The greatest correlation was shown in R1 latency (69.9% abnormality). BR is a non-invasive and very useful method for evaluation and diagnosis of subclinical cranial nerve involvement in diabetic patients.

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

PubMed Central

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

2012-01-01

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

Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery.

PubMed

Walmsley, J P

1995-01-01

Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cranially and abaxially and its torn edges were debrided. Radiographically, 6 cases had proliferative new bone on the cranial aspect of the intercondylar eminence of the tibia and 3 had calcified soft tissue densities in the cranial, medial or lateral femorotibial joint. Following surgery and a 6 month period of rest and controlled exercise, 3 horses returned to full competition work, one was usable for hacking, 2 are convalescing and one is lame after one year. It is postulated that this could be a characteristic meniscal injury in horses which can benefit from arthroscopic surgery. Better techniques for accessing the body and caudal pole of the menisci are needed if a more complete diagnosis and treatment of meniscal injuries are to be achieved.

Bone up: craniomandibular development and hard-tissue biomineralization in neonate mice.

PubMed

Thompson, Khari D; Weiss-Bilka, Holly E; McGough, Elizabeth B; Ravosa, Matthew J

2017-10-01

The presence of regional variation in the osteogenic abilities of cranial bones underscores the fact that the mechanobiology of the mammalian skull is more complex than previously recognized. However, the relationship between patterns of cranial bone formation and biomineralization remains incompletely understood. In four strains of mice, micro-computed tomography was used to measure tissue mineral density during perinatal development in three skull regions (calvarium, basicranium, mandible) noted for variation in loading environment, embryological origin, and ossification mode. Biomineralization levels increased during perinatal ontogeny in the mandible and calvarium, but did not increase in the basicranium. Tissue mineral density levels also varied intracranially, with density in the mandible being highest, in the basicranium intermediate, and in the calvarium lowest. Perinatal increases in, and elevated levels of, mandibular biomineralization appear related to the impending postweaning need to resist elevated masticatory stresses. Similarly, perinatal increases in calvarial biomineralization may be linked to ongoing brain expansion, which is known to stimulate sutural bone formation in this region. The lack of perinatal increase in basicranial biomineralization could be a result of earlier developmental maturity in the cranial base relative to other skull regions due to its role in supporting the brain's mass throughout ontogeny. These results suggest that biomineralization levels and age-related trajectories throughout the skull are influenced by the functional environment and ontogenetic processes affecting each region, e.g., onset of masticatory loads in the mandible, whereas variation in embryology and ossification mode may only have secondary effects on patterns of biomineralization. Knowledge of perinatal variation in tissue mineral density, and of normal cranial bone formation early in development, may benefit clinical therapies aiming to correct developmental defects and traumatic injuries in the skull, and more generally characterize loading environments and skeletal adaptations in mammals by highlighting the need for multi-level analyses for evaluating functional performance of cranial bone. Copyright © 2017 Elsevier GmbH. All rights reserved.

The internal cranial morphology of an armoured dinosaur Euoplocephalus corroborated by X-ray computed tomographic reconstruction

PubMed Central

Miyashita, Tetsuto; Arbour, Victoria M; Witmer, Lawrence M; Currie, Philip J

2011-01-01

Internal cranial anatomy is a challenging area to study in fossilized skulls because of small sample sizes and varied post-mortem preservational alterations. This difficulty has led to the lack of correspondence between results obtained from direct osteological observation and from more indirect reconstruction methods. This paper presents corroborating evidence from direct osteological observation and from reconstruction based on computed X-ray tomography (CT) on the internal cranial anatomy of the ankylosaurid dinosaur Euoplocephalus tutus. A remarkable specimen of Euoplocephalus preserves rarely observed internal cranial structures such as vascular impressions in the nasal cavity, olfactory turbinates and possible impressions of conchae. Comparison with fossils and CT models of other taxa and other Euoplocephalus specimens adds osteological evidence for the previously reconstructed nasal cavity in this dinosaur and revises the previously described braincase morphology. A new interpretation of the ethmoidal homology identifies a mesethmoid, sphenethmoid and ectethmoid. These ethmoidal ossifications are continuous with the mineralized walls of the nasal cavity. The location of the olfactory fenestra provides further evidence that the olfactory regions of the nasal cavity are pushed to the sides of the main airway. This implies that the function of the vascular impressions in the nasal cavity and the looping of the cavity are not related to olfaction. A byproduct of the elongate, looping airway is a dramatic increase in surface area of the nasal respiratory mucosa, which in extant species has been linked to heat and water balance. A role in vocalization as a resonating chamber is another possible function of the looping and elongation of the nasal cavity. Olfaction remains as a possible function for the enlarged olfactory region, suggesting that multiple functions account for different parts of the ankylosaurid nasal cavity that underwent substantial modification. Cranial endocasts show negligible variation within Euoplocephalus, which lends some confidence to interspecific comparisons of endocranial morphology. PMID:21954840

Organ and effective dose coefficients for cranial and caudal irradiation geometries: photons

DOE PAGES

Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.

2015-05-02

With the introduction of new recommendations of the International Commission on Radiological Protection (ICRP) in Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors and the introduction of reference sex-specific computational phantoms. Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision ofmore » ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT) and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for photon irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue kerma and absorbed doses for caudal and cranial exposures to photons ranging in energy from 10 keV to 10 GeV have been performed using the MCNP6.1 radiation transport code and the adult reference phantoms of ICRP Publication 110. As with calculations reported in ICRP 116, the effects of charged-particle transport are evident when compared with values obtained by using the kerma approximation. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above similar to 30 MeV the cranial and caudal values are greater.« less

Organ and effective dose coefficients for cranial and caudal irradiation geometries: photons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veinot, K. G.; Eckerman, K. F.; Hertel, N. E.

With the introduction of new recommendations of the International Commission on Radiological Protection (ICRP) in Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors and the introduction of reference sex-specific computational phantoms. Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision ofmore » ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT) and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for photon irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue kerma and absorbed doses for caudal and cranial exposures to photons ranging in energy from 10 keV to 10 GeV have been performed using the MCNP6.1 radiation transport code and the adult reference phantoms of ICRP Publication 110. As with calculations reported in ICRP 116, the effects of charged-particle transport are evident when compared with values obtained by using the kerma approximation. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above similar to 30 MeV the cranial and caudal values are greater.« less

Computed tomography assessment of peripubertal craniofacial morphology in a sheep model of binge alcohol drinking in the first trimester

PubMed Central

Birch, Sharla M.; Lenox, Mark W.; Kornegay, Joe N.; Shen, Li; Ai, Huisi; Ren, Xiaowei; Goodlett, Charles R.; Cudd, Tim A.; Washburn, Shannon E.

2015-01-01

Identification of facial dysmorphology is essential for the diagnosis of fetal alcohol syndrome (FAS); however, most children with fetal alcohol spectrum disorders (FASD) do not meet the dysmorphology criterion. Additional objective indicators are needed to help identify the broader spectrum of children affected by prenatal alcohol exposure. Computed tomography (CT) was used in a sheep model of prenatal binge alcohol exposure to test the hypothesis that quantitative measures of craniofacial bone volumes and linear distances could identify alcohol-exposed lambs. Pregnant sheep were randomly assigned to four groups: heavy binge alcohol, 2.5 g/kg/day (HBA); binge alcohol, 1.75 g/kg/day (BA); saline control (SC); and normal control (NC). Intravenous alcohol (BA; HBA) or saline (SC) infusions were given three consecutive days per week from gestation day 4–41, and a CT scan was performed on postnatal day 182. The volumes of eight skull bones, cranial circumference, and 19 linear measures of the face and skull were compared among treatment groups. Lambs from both alcohol groups showed significant reduction in seven of the eight skull bones and total skull bone volume, as well as cranial circumference. Alcohol exposure also decreased four of the 19 craniofacial measures. Discriminant analysis showed that alcohol-exposed and control lambs could be classified with high accuracy based on total skull bone volume, frontal, parietal, or mandibular bone volumes, cranial circumference, or interorbital distance. Total skull volume was significantly more sensitive than cranial circumference in identifying the alcohol-exposed lambs when alcohol-exposed lambs were classified using the typical FAS diagnostic cutoff of ≤10th percentile. This first demonstration of the usefulness of CT-derived craniofacial measures in a sheep model of FASD following binge-like alcohol exposure during the first trimester suggests that volumetric measurement of cranial bones may be a novel biomarker for binge alcohol exposure during the first trimester to help identify non-dysmorphic children with FASD. PMID:26496796

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

PubMed

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

2013-06-01

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

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

PubMed Central

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

2013-01-01

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

Automatic, accurate, and reproducible segmentation of the brain and cerebro-spinal fluid in T1-weighted volume MRI scans and its application to serial cerebral and intracranial volumetry

NASA Astrophysics Data System (ADS)

Lemieux, Louis

2001-07-01

A new fully automatic algorithm for the segmentation of the brain and cerebro-spinal fluid (CSF) from T1-weighted volume MRI scans of the head was specifically developed in the context of serial intra-cranial volumetry. The method is an extension of a previously published brain extraction algorithm. The brain mask is used as a basis for CSF segmentation based on morphological operations, automatic histogram analysis and thresholding. Brain segmentation is then obtained by iterative tracking of the brain-CSF interface. Grey matter (GM), white matter (WM) and CSF volumes are calculated based on a model of intensity probability distribution that includes partial volume effects. Accuracy was assessed using a digital phantom scan. Reproducibility was assessed by segmenting pairs of scans from 20 normal subjects scanned 8 months apart and 11 patients with epilepsy scanned 3.5 years apart. Segmentation accuracy as measured by overlap was 98% for the brain and 96% for the intra-cranial tissues. The volume errors were: total brain (TBV): -1.0%, intra-cranial (ICV):0.1%, CSF: +4.8%. For repeated scans, matching resulted in improved reproducibility. In the controls, the coefficient of reliability (CR) was 1.5% for the TVB and 1.0% for the ICV. In the patients, the Cr for the ICV was 1.2%.

New insight on the anatomy and architecture of the avian neurocranium.

PubMed

Marugán-Lobón, Jesús; Buscalioni, Angela D

2009-03-01

This study aims to disentangle the main features of the avian neurocranium at high taxonomic scales using geometric morphometric tools. When surveying the variation across 60% of avian orders (sampled among 72 individuals), our results verify that the central nervous system has an important influence upon the architecture of the avian neurocranium, as in other very encephalized vertebrates such as mammals. When the avian brain expands relative to the cranial base it causes more "reptilian-like" neurocranial configurations to shape into rounder ones. This rounder appearance is achieved because the cranial base becomes relatively shorter and turns its flexure from concave to convex, at the same time forcing the foramen magnum to reorient ventrally instead of caudally. However, our analyses have also revealed that an important morphological difference between birds resides between the occiput and the cranial roof. This variation was unexpected since it had not been reported thus far, and entertains two plausible interpretations. Although it could be due to a trade-off between the relative sizes of the supraoccipital and the parietal bones, the presence of an additional bone (the intra- or post-parietal) between the latter two bones could also explain the variation congruently. This descriptive insight stresses the need for further developmental studies focused in understanding the evolutionary disparity of the avian neurocranium. (c) 2009 Wiley-Liss, Inc.

Growth of the skull in young children in Baotou, China.

PubMed

Hou, Hai-dong; Liu, Ming; Gong, Ke-rui; Shao, Guo; Zhang, Chun-Yang

2014-09-01

There are some controversies about the optimal time to perform skull repair in very young Chinese children because of the rapid skull growth in this stage of life. The purpose of this current study is to describe the characteristics of skull growth and to discuss the optimal time for skull repair in young Chinese children with skull defects. A total of 112 children born in the First Affiliated Hospital of Baotou Medical College were measured for six consecutive years starting in 2006. Cranial length (CL, linear distance between the eyebrows to the pillow tuberosity), cranial width (CW, double-sided linear distance of connection of external auditory canal), ear over the top line (EOTL), the eyebrows-the posterior tuberosity line (EPTL), and head circumference (HC) were measured to describe the skull growth. The most rapid period of skull growth occurs during the first year of life. The second and third most rapid periods are the second and third years, respectively. Then, the skull growth slowed and the values of the skull growth index of 6-year-old children were close to those of adults. Children 0-1 years old should not receive skull repair due to their rapid skull growth. The indexes of children 3 years old or older were close to those of the adult; therefore, 3 years old or older may receive skull repair.

Postsacral vertebral morphology in relation to tail length among primates and other mammals.

PubMed

Russo, Gabrielle A

2015-02-01

Tail reduction/loss independently evolved in a number of mammalian lineages, including hominoid primates. One prerequisite to appropriately contextualizing its occurrence and understanding its significance is the ability to track evolutionary changes in tail length throughout the fossil record. However, to date, the bony correlates of tail length variation among living taxa have not been comprehensively examined. This study quantifies postsacral vertebral morphology among living primates and other mammals known to differ in relative tail length (RTL). Linear and angular measurements with known biomechanical significance were collected on the first, mid-, and transition proximal postsacral vertebrae, and their relationship with RTL was assessed using phylogenetic generalized least-squares regression methods. Compared to shorter-tailed primates, longer-tailed primates possess a greater number of postsacral vertebral features associated with increased proximal tail flexibility (e.g., craniocaudally longer vertebral bodies), increased intervertebral body joint range of motion (e.g., more circularly shaped cranial articular surfaces), and increased leverage of tail musculature (e.g., longer spinous processes). These observations are corroborated by the comparative mammalian sample, which shows that distantly related short-tailed (e.g., Phascolarctos, Lynx) and long-tailed (e.g., Dendrolagus, Acinonyx) nonprimate mammals morphologically converge with short-tailed (e.g., Macaca tonkeana) and long-tailed (e.g., Macaca fascicularis) primates, respectively. Multivariate models demonstrate that the variables examined account for 70% (all mammals) to 94% (only primates) of the variance in RTL. Results of this study may be used to infer the tail lengths of extinct primates and other mammals, thereby improving our understanding about the evolution of tail reduction/loss. © 2014 Wiley Periodicals, Inc.

76 FR 48177 - Notice of Inventory Completion: Washington State Department of Natural Resources, Olympia, WA...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... to be consistent with Native American morphology, based on cranial deformation and wormian bone evidence. No known individual was identified. The one associated funerary is a bird bone. This individual...

Genome-Wide Profiles of Extra-cranial Malignant Rhabdoid Tumors Reveal Heterogeneity and Dysregulated Developmental Pathways | Office of Cancer Genomics

Cancer.gov

Malignant rhabdoid tumors (MRTs) are rare lethal tumors of childhood that most commonly occur in the kidney and brain. MRTs are driven by SMARCB1 loss, but the molecular consequences of SMARCB1 loss in extra-cranial tumors have not been comprehensively described and genomic resources for analyses of extra-cranial MRT are limited.

Sparse EEG/MEG source estimation via a group lasso

PubMed Central

Lim, Michael; Ales, Justin M.; Cottereau, Benoit R.; Hastie, Trevor

2017-01-01

Non-invasive recordings of human brain activity through electroencephalography (EEG) or magnetoencelphalography (MEG) are of value for both basic science and clinical applications in sensory, cognitive, and affective neuroscience. Here we introduce a new approach to estimating the intra-cranial sources of EEG/MEG activity measured from extra-cranial sensors. The approach is based on the group lasso, a sparse-prior inverse that has been adapted to take advantage of functionally-defined regions of interest for the definition of physiologically meaningful groups within a functionally-based common space. Detailed simulations using realistic source-geometries and data from a human Visual Evoked Potential experiment demonstrate that the group-lasso method has improved performance over traditional ℓ2 minimum-norm methods. In addition, we show that pooling source estimates across subjects over functionally defined regions of interest results in improvements in the accuracy of source estimates for both the group-lasso and minimum-norm approaches. PMID:28604790

A Case of Atypical Skull Base Osteomyelitis with Septic Pulmonary Embolism

PubMed Central

Lee, Soon Jung; Weon, Young Cheol; Cha, Hee Jeong; Kim, Sun Young; Seo, Kwang Won; Jegal, Yangjin; Ahn, Jong-Joon

2011-01-01

Skull base osteomyelitis (SBO) is difficult to diagnose when a patient presents with multiple cranial nerve palsies but no obvious infectious focus. There is no report about SBO with septic pulmonary embolism. A 51-yr-old man presented to our hospital with headache, hoarseness, dysphagia, frequent choking, fever, cough, and sputum production. He was diagnosed of having masked mastoiditis complicated by SBO with multiple cranial nerve palsies, sigmoid sinus thrombosis, and septic pulmonary embolism. We successfully treated him with antibiotics and anticoagulants alone, with no surgical intervention. His neurologic deficits were completely recovered. Decrease of pulmonary nodules and thrombus in the sinus was evident on the follow-up imaging one month later. In selected cases of intracranial complications of SBO and septic pulmonary embolism, secondary to mastoiditis with early response to antibiotic therapy, conservative treatment may be considered and surgical intervention may be withheld. PMID:21738354

A giant cranial aneurysmal bone cyst associated with fibrous dysplasia.

PubMed

Składzieriń, J; Olés, K; Zagólski, O; Moskała, M; Sztuka, M; Strek, P; Wierzchowski, W; Tomik, J

2008-01-01

An aneurysmal bone cyst (ABC) is a rare, benign fibro-osseous lesion, considered a vascular phenomenon secondary to fibrous dysplasia or a giant-cell tumour, and occurs mainly in long bones and vertebrae. In this case report a 16-year-old male presented with massive epistaxis. He was admitted with a 3-year history of chronic rhinitis, headaches, right ocular pain and recurrent epistaxis. CT scans showed a predominantly cystic, expansive mass obstructing both nasal cavities, extending to all paranasal sinuses and both orbits, with evidence of anterior cranial fossa skull base destruction. The patient underwent a craniofacial resection of the tumour performed with an external approach and an immediate reconstruction of the dural defect. Histology confirmed the lesion was an ABC associated with fibrous dysplasia. The patient's recovery was complete. A large facial aneurysmal bone cyst can damage the facial skeleton and skull base, and requires excision by a combined external approach.

Computed tomography of the lung of healthy snakes of the species Python regius, Boa constrictor, Python reticulatus, Morelia viridis, Epicrates cenchria, and Morelia spilota.

PubMed

Pees, Michael; Kiefer, Ingmar; Thielebein, Jens; Oechtering, Gerhard; Krautwald-Junghanns, Maria-Elisabeth

2009-01-01

Thirty-nine healthy boid snakes representing six different species (Python regius, Boa constrictor, Python reticulatus, Morelia viridis, Epicrates cenchria, and Morelia spilota) were examined using computed tomography (CT) to characterize the normal appearance of the respiratory tissue. Assessment was done subjectively and densitometry was performed using a defined protocol. The length of the right lung was calculated to be 11.1% of the body length, without a significant difference between species. The length of the left lung in proportion to the right was dependent on the species examined. The most developed left lung was in P. regius (81.2%), whereas in B. constrictor, the left lung was vestigial or absent (24.7%). A median attenuation of -814.6 HU and a variability of 45.9 HU were calculated for all species with no significant difference between species. Within the species, a significantly higher attenuation was found for P. regius in the dorsal and cranial aspect of the lung compared with the ventral and caudal part. In B. constrictor, the reduced left lung was significantly hyperattenuating compared with the right lung. Results of this study emphasize the value of CT and provide basic reference data for assessment of the snake lung in these species. Veterinary Radiology &

Knowledge of skull base anatomy and surgical implications of human sacrifice among pre-Columbian Mesoamerican cultures.

PubMed

Lopez-Serna, Raul; Gomez-Amador, Juan Luis; Barges-Coll, Juan; Arriada-Mendicoa, Nicasio; Romero-Vargas, Samuel; Ramos-Peek, Miguel; Celis-Lopez, Miguel Angel; Revuelta-Gutierrez, Rogelio; Portocarrero-Ortiz, Lesly

2012-08-01

Human sacrifice became a common cultural trait during the advanced phases of Mesoamerican civilizations. This phenomenon, influenced by complex religious beliefs, included several practices such as decapitation, cranial deformation, and the use of human cranial bones for skull mask manufacturing. Archaeological evidence suggests that all of these practices required specialized knowledge of skull base and upper cervical anatomy. The authors conducted a systematic search for information on skull base anatomical and surgical knowledge among Mesoamerican civilizations. A detailed exposition of these results is presented, along with some interesting information extracted from historical documents and pictorial codices to provide a better understanding of skull base surgical practices among these cultures. Paleoforensic evidence from the Great Temple of Tenochtitlan indicates that Aztec priests used a specialized decapitation technique, based on a deep anatomical knowledge. Trophy skulls were submitted through a stepwise technique for skull mask fabrication, based on skull base anatomical landmarks. Understanding pre-Columbian Mesoamerican religions can only be realized by considering them in their own time and according to their own perspective. Several contributions to medical practice might have arisen from anatomical knowledge emerging from human sacrifice and decapitation techniques.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Role of Cranial Molding Orthosis (Helmet) Therapy for Patients With Positional Plagiocephaly.

PubMed

Tamber, Mandeep S; Nikas, Dimitrios; Beier, Alexandra; Baird, Lissa C; Bauer, David F; Durham, Susan; Klimo, Paul; Lin, Alexander Y; Mazzola, Catherine; McClung-Smith, Catherine; Mitchell, Laura; Tyagi, Rachana; Flannery, Ann Marie

2016-11-01

No evidence-based guidelines exist on the role of cranial-molding orthosis (helmet) therapy for patients with positional plagiocephaly. To address the clinical question: "Does helmet therapy provide effective treatment for positional plagiocephaly?" and to make treatment recommendations based on the available evidence. The US National Library of Medicine Medline database and the Cochrane Library were queried by using MeSH headings and key words relevant to the objective of this systematic review. Abstracts were reviewed, after which studies meeting the inclusion criteria were selected and graded according to their quality of evidence (Classes I-III). Evidentiary tables were constructed that summarized pertinent study results, and, based on the quality of the literature, recommendations were made (Levels I-III). Fifteen articles met criteria for inclusion into the evidence tables. There was 1 prospective randomized controlled trial (Class II), 5 prospective comparative studies (Class II), and 9 retrospective comparative studies (Class II). There is a fairly substantive body of nonrandomized evidence that demonstrates more significant and faster improvement of cranial shape in infants with positional plagiocephaly treated with a helmet in comparison with conservative therapy, especially if the deformity is severe, provided that helmet therapy is applied during the appropriate period of infancy. Specific criteria regarding the measurement and quantification of deformity and the most appropriate time window in infancy for treatment of positional plagiocephaly with a helmet remains elusive. In general, infants with a more severe presenting deformity and infants who are helmeted early in infancy tend to have more significant correction (and even normalization) of head shape. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_5.

Guidelines: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Role of Cranial Molding Orthosis (Helmet) Therapy for Patients With Positional Plagiocephaly.

PubMed

Tamber, Mandeep S; Nikas, Dimitrios; Beier, Alexandra; Baird, Lissa C; Bauer, David F; Durham, Susan; Klimo, Paul; Lin, Alexander Y; Mazzola, Catherine; McClung-Smith, Catherine; Mitchell, Laura; Tyagi, Rachana; Flannery, Ann Marie

2016-11-01

No evidence-based guidelines exist on the role of cranial-molding orthosis (helmet) therapy for patients with positional plagiocephaly. To address the clinical question: "Does helmet therapy provide effective treatment for positional plagiocephaly?" and to make treatment recommendations based on the available evidence. The US National Library of Medicine Medline database and the Cochrane Library were queried by using MeSH headings and key words relevant to the objective of this systematic review. Abstracts were reviewed, after which studies meeting the inclusion criteria were selected and graded according to their quality of evidence (Classes I-III). Evidentiary tables were constructed that summarized pertinent study results, and, based on the quality of the literature, recommendations were made (Levels I-III). Fifteen articles met criteria for inclusion into the evidence tables. There was 1 prospective randomized controlled trial (Class II), 5 prospective comparative studies (Class II), and 9 retrospective comparative studies (Class II). There is a fairly substantive body of nonrandomized evidence that demonstrates more significant and faster improvement of cranial shape in infants with positional plagiocephaly treated with a helmet in comparison with conservative therapy, especially if the deformity is severe, provided that helmet therapy is applied during the appropriate period of infancy. Specific criteria regarding the measurement and quantification of deformity and the most appropriate time window in infancy for treatment of positional plagiocephaly with a helmet remains elusive. In general, infants with a more severe presenting deformity and infants who are helmeted early in infancy tend to have more significant correction (and even normalization) of head shape. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_5.

Middle cranial fossa approach to repair tegmen defects assisted by three-dimensionally printed temporal bone models.

PubMed

Ahmed, Sameer; VanKoevering, Kyle K; Kline, Stephanie; Green, Glenn E; Arts, H Alexander

2017-10-01

To explore the perioperative utility of three-dimensionally (3D)-printed temporal bone models of patients undergoing repair of lateral skull base defects and spontaneous cerebrospinal fluid leaks with the middle cranial fossa approach. Case series. 3D-printed temporal bone models-based on patient-specific, high-resolution computed tomographic imaging-were constructed using inexpensive polymer materials. Preoperatively, the models demonstrated the extent of temporal lobe retraction necessary to visualize the proposed defects in the lateral skull base. Also preoperatively, Silastic sheeting was arranged across the modeled tegmen, marked, and cut to cover all of the proposed defect sites. The Silastic sheeting was then sterilized and subsequently served as a precise intraoperative template for a synthetic dural replacement graft. Of note, these grafts were customized without needing to retract the temporal lobe. Five patients underwent the middle cranial fossa approach assisted by 3D-printed temporal bone models to repair tegmen defects and spontaneous cerebrospinal fluid leaks. No complications were encountered. The prefabricated dural repair grafts were easily placed and fit precisely onto the middle fossa floor without any additional modifications. All defects were covered as predicted by the 3D temporal bone models. At their postoperative visits, all five patients maintained resolution of their spontaneous cerebrospinal fluid leaks. Inexpensive 3D-printed temporal bone models of tegmen defects can serve as beneficial adjuncts during lateral skull base repair. The models provide a panoramic preoperative view of all tegmen defects and allow for custom templating of dural grafts without temporal lobe retraction. 4 Laryngoscope, 127:2347-2351, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

First virtual endocasts of adapiform primates.

PubMed

Harrington, Arianna R; Silcox, Mary T; Yapuncich, Gabriel S; Boyer, Doug M; Bloch, Jonathan I

2016-10-01

Well-preserved crania of notharctine adapiforms from the Eocene of North America provide the best direct evidence available for inferring neuroanatomy and encephalization in early euprimates (crown primates). Virtual endocasts of the notharctines Notharctus tenebrosus (n = 3) and Smilodectes gracilis (n = 4) from the middle Eocene Bridger formation of Wyoming, and the late Eocene European adapid adapiform Adapis parisiensis (n = 1), were reconstructed from high-resolution X-ray computed tomography (CT) data. While the three species share many neuroanatomical similarities differentiating them from plesiadapiforms (stem primates) and extant euprimates, our sample of N. tenebrosus displays more variation than that of S. gracilis, possibly related to differences in the patterns of cranial sexual dimorphism or within-lineage evolution. Body masses predicted from associated teeth suggest that N. tenebrosus was larger and had a lower encephalization quotient (EQ) than S. gracilis, despite their close relationship and similar inferred ecologies. Meanwhile, body masses predicted from cranial length of the same specimens suggest that the two species were more similar, with overlapping body mass and EQ, although S. gracilis exhibits a range of EQs shifted upwards relative to that of N. tenebrosus. While associated data from other parts of the skeleton are mostly lacking for specimens included in this study, measurements for unassociated postcrania attributed to these species yield body mass and EQ estimates that are also more similar to each other than those based on teeth. Regardless of the body mass prediction method used, results suggest that the average EQ of adapiforms was similar to that of plesiadapiforms, only overlapped the lower quadrant for the range of extant strepsirrhines, and did not overlap with the range of extant haplorhines. However, structural changes evident in these endocasts suggest that early euprimates relied more on vision than olfaction relative to plesiadapiforms, despite having relatively small endocranial volumes compared to extant taxa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis.

PubMed

Iyer, Rajiv R; Wu, Adela; Macmillan, Alexandra; Musavi, Leila; Cho, Regina; Lopez, Joseph; Jallo, George I; Dorafshar, Amir H; Ahn, Edward S

2018-01-01

Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7-160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and enhances operative efficiency and surgeon confidence while minimizing the risk of patient morbidity.

Molecular genetics of craniosynostosis

NASA Astrophysics Data System (ADS)

Caterine; Auerkari, Elza Ibrahim

2018-03-01

Tight regulation process and complex interplay occur along the osteogenic interfaces of the cranial sutures in normal growth and development of the skull. Cranial sutures serve as sites of bone growth while maintaining a state of patency to accommodate the developing brain. Cranial sutures are fibro-cellular structures that separate the rigid plates of the skull bones. Premature fusion of one or more cranial sutures leads to a condition known as craniosynostosis. Craniosynostosis is one of the most common craniofacial anomalies with a prevalence of 1 in 2,500 newborns. Several genes have been identified in the pathogenesis of craniosynostosis. Molecular signaling events and the intracellular signal transduction pathways implicated in the suture pathobiology will provide a useful approach for therapeutic targeting.

Vertical facial height and its correlation with facial width and depth: Three dimensional cone beam computed tomography evaluation based on dry skulls.

PubMed

Wang, Ming Feng; Otsuka, Takero; Akimoto, Susumu; Sato, Sadao

2013-01-01

The aim of the present study was to evaluate how vertical facial height correlates with mandibular plane angle, facial width and depth from a three dimensional (3D) viewing angle. In this study 3D cephalometric landmarks were identified and measurements from 43 randomly selected cone beam computed tomography (CBCT) images of dry skulls from the Weisbach collection of Vienna Natural History Museum were analyzed. Pearson correlation coefficients of facial height measurements and mandibular plane angle and the correlation coefficients of height-width and height-depth were calculated, respectively. The mandibular plane angle (MP-SN) significantly correlated with ramus height (Co-Go) and posterior facial height (PFH) but not with anterior lower face height (ALFH) or anterior total face height (ATFH). The ALFH and ATFH showed significant correlation with anterior cranial base length (S-N), whereas PFH showed significant correlation with the mandible (S-B) and maxilla (S-A) anteroposterior position. High or low mandibular plane angle might not necessarily be accompanied by long or short anterior face height, respectively. The PFH rather than AFH is assumed to play a key role in the vertical facial type whereas AFH seems to undergo relatively intrinsic growth.

Bony cranial ornamentation linked to rapid evolution of gigantic theropod dinosaurs

NASA Astrophysics Data System (ADS)

Gates, Terry A.; Organ, Chris; Zanno, Lindsay E.

2016-09-01

Exaggerated cranial structures such as crests and horns, hereafter referred to collectively as ornaments, are pervasive across animal species. These structures perform vital roles in visual communication and physical interactions within and between species. Yet the origin and influence of ornamentation on speciation and ecology across macroevolutionary time scales remains poorly understood for virtually all animals. Here, we explore correlative evolution of osseous cranial ornaments with large body size in theropod dinosaurs using a phylogenetic comparative framework. We find that body size evolved directionally toward phyletic giantism an order of magnitude faster in theropod species possessing ornaments compared with unadorned lineages. In addition, we find a body mass threshold below which bony cranial ornaments do not originate. Maniraptoriform dinosaurs generally lack osseous cranial ornaments despite repeatedly crossing this body size threshold. Our study provides novel, quantitative support for a shift in selective pressures on socio-sexual display mechanisms in theropods coincident with the evolution of pennaceous feathers.

Custom made orthotic device for maintaining skull architecture during the postoperative period in infants undergoing craniosynostosis surgery

PubMed Central

Gopal, Venu; Ganesh, Praveen; Nagarjuna, Muralidhara; Kumar, Kiran; Shetty, Samarth; Salins, Paul C.

2015-01-01

Aim To fabricate a cost effective, indigenous and simple orthotics helmet for post-operative cranial molding in patients with craniosynostosis surgery. Methods We present a case of 15 month old infant with secondary cranial vault deformity. Cranial vault remodeling surgery involving the posterior skull was planned and executed to increase the posterior gap, so that brain growth would be facilitated towards this empty space. Materials such as thermoplastic sponge, thermoplastic ionomer resin sheet, soft sponge and Velcro straps are used to fabricate a cranial orthotics helmet. Results We have successfully used the above materials to fabricate the orthotics helmet for post-operative cranial molding. Conclusion The technique described in this article is simple and cost effective. It can be custom made according to the demands of the surgical technique and the type of synostosis. It favors an individualistic prognosis, and proves worthwhile as every synostosis requires a unique treatment plan. It is an excellent adjuvant to craniosynostosis remodeling surgery. PMID:26258018

Assessment of the mechanical performance of titanium cranial prostheses manufactured by super plastic forming and single point incremental forming

NASA Astrophysics Data System (ADS)

Sgambitterra, Emanuele; Piccininni, Antonio; Guglielmi, Pasquale; Ambrogio, Giuseppina; Fragomeni, Gionata; Villa, Tomaso; Palumbo, Gianfranco

2018-05-01

Cranial implants are custom prostheses characterized by quite high geometrical complexity and small thickness; at the same time aesthetic and mechanical requirements have to be met. Titanium alloys are largely adopted for such prostheses, as they can be processed via different manufacturing technologies. In the present work cranial prostheses have been manufactured by Super Plastic Forming (SPF) and Single Point Incremental Forming (SPIF). In order to assess the mechanical performance of the cranial prostheses, drop tests under different load conditions were conducted on flat samples to investigate the effect of the blank thickness. Numerical simulations were also run for comparison purposes. The mechanical performance of the cranial implants manufactured by SPF and SPIF could be predicted using drop test data and information about the thickness evolution of the formed parts: the SPIFed prosthesis revealed to have a lower maximum deflection and a higher maximum force, while the SPFed prostheses showed a lower absorbed energy.

Bony cranial ornamentation linked to rapid evolution of gigantic theropod dinosaurs

PubMed Central

Gates, Terry A.; Organ, Chris; Zanno, Lindsay E.

2016-01-01

Exaggerated cranial structures such as crests and horns, hereafter referred to collectively as ornaments, are pervasive across animal species. These structures perform vital roles in visual communication and physical interactions within and between species. Yet the origin and influence of ornamentation on speciation and ecology across macroevolutionary time scales remains poorly understood for virtually all animals. Here, we explore correlative evolution of osseous cranial ornaments with large body size in theropod dinosaurs using a phylogenetic comparative framework. We find that body size evolved directionally toward phyletic giantism an order of magnitude faster in theropod species possessing ornaments compared with unadorned lineages. In addition, we find a body mass threshold below which bony cranial ornaments do not originate. Maniraptoriform dinosaurs generally lack osseous cranial ornaments despite repeatedly crossing this body size threshold. Our study provides novel, quantitative support for a shift in selective pressures on socio-sexual display mechanisms in theropods coincident with the evolution of pennaceous feathers. PMID:27676310

The Role of Interface on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model.

PubMed

Deland, Trevor S; Niespodziewanski, Emily; Fenton, Todd W; Haut, Roger C

2016-01-01

The role of impact interface characteristics on the biomechanics and patterns of cranial fracture has not been investigated in detail, and especially for the pediatric head. In this study, infant porcine skulls aged 2-19 days were dropped with an energy to cause fracturing onto four surfaces varying in stiffness from a rigid plate to one covered with plush carpeting. Results showed that heads dropped onto the rigid surface produced more extensive cranial fracturing than onto carpeted surfaces. Contact forces generated at fracture initiation and the overall maximum contact forces were generally lower for the rigid than carpeted impacts. While the degree of cranial fracturing from impacts onto the heavy carpeted surface was comparable to that of lower-energy rigid surface impacts, there were fewer diastatic fractures. This suggests that characteristics of the cranial fracture patterns may be used to differentiate energy level from impact interface in pediatric forensic cases. © 2015 American Academy of Forensic Sciences.

Classification of Porcine Cranial Fracture Patterns Using a Fracture Printing Interface,^.

PubMed

Wei, Feng; Bucak, Serhat Selçuk; Vollner, Jennifer M; Fenton, Todd W; Jain, Anil K; Haut, Roger C

2017-01-01

Distinguishing between accidental and abusive head trauma in children can be difficult, as there is a lack of baseline data for pediatric cranial fracture patterns. A porcine head model has recently been developed and utilized in a series of studies to investigate the effects of impact energy level, surface type, and constraint condition on cranial fracture patterns. In the current study, an automated pattern recognition method, or a fracture printing interface (FPI), was developed to classify cranial fracture patterns that were associated with different impact scenarios documented in previous experiments. The FPI accurately predicted the energy level when the impact surface type was rigid. Additionally, the FPI was exceedingly successful in determining fractures caused by skulls being dropped with a high-level energy (97% accuracy). The FPI, currently developed on the porcine data, may in the future be transformed to the task of cranial fracture pattern classification for human infant skulls. © 2016 American Academy of Forensic Sciences.

Cranial arterial patterns of the alpaca (Camelidae: Vicugna pacos).

PubMed

O'Brien, Haley D

2017-03-01

Artiodactyl cranial arterial patterns deviate significantly from the standard mammalian pattern, most notably in the possession of a structure called the carotid rete (CR)-a subdural arterial meshwork that is housed within the cavernous venous sinus, replacing the internal carotid artery (ICA). This relationship between the CR and the cavernous sinus facilitates a suite of unique physiologies, including selective brain cooling. The CR has been studied in a number of artiodactyls; however, to my knowledge, only a single study to date documents a subset of the cranial arteries of New World camelids (llamas, alpacas, vicugñas and guanacoes). This study is the first complete description of the cranial arteries of a New World camelid species, the alpaca ( Vicugna pacos ), and the first description of near-parturition cranial arterial morphology within New World camelids. This study finds that the carotid arterial system is conserved between developmental stages in the alpaca, and differs significantly from the pattern emphasized in other long-necked ruminant artiodactyls in that a patent, homologous ICA persists through the animal's life.

Effect of two laser photobiomodulation application protocols on the viability of random skin flap in rats

NASA Astrophysics Data System (ADS)

Martignago, C. C. S. M.; Tim, C. R.; Assis, L.; Neve, L. M. G.; Bossini, P. S.; Renno, A. C.; Avó, L. R. S.; Liebano, R. E.; Parizotto, N. A.

2018-02-01

Objective: to identify the best low intensity laser photobiomodulation application site to increase the viability of the cutaneous flap in rats. Methods: 18 male rats (Rattus norvegicus: var. Albinus, Rodentia Mammalia) were randomly distributed into 3 groups (n = 6). Group I (GI) was submitted to simulated laser photobiomodulation, group II (GII) was submitted to the laser photobiomodulation at three points in the flap cranial base, and group III (GIII) was submitted to laser photobiomodulation at twelve points distributed along the flap. All groups were irradiated with an Indium, Galium, Aluminum and Phosphorus diode laser (InGaAlP), 660 nm, with power of 50 mW, total energy of 12 J in continuous emission mode. The treatment started immediately after performing the cranial base random skin flap (dimension of 10X4 cm2 ) and reapplied every 24 hours, with a total of 5 applications. The animals were euthanized after the evaluation of the percentage of necrosis area and the material was collected for histological analysis on the 7th postoperative day. Results: GII animals presented a statistically significant decrease for the necrosis area when compared to the other groups, and a statistically significant increase in the quantification of collagen when compared to the control. We did not observe a statistical difference between the TGFβ and FGF expression in the different groups evaluated. Conclusion: the application of laser photobiomodulation at three points of the flap cranial base was more effective than at twelve points regarding the reduction of necrosis area.

Image quality of iterative reconstruction in cranial CT imaging: comparison of model-based iterative reconstruction (MBIR) and adaptive statistical iterative reconstruction (ASiR).

PubMed

Notohamiprodjo, S; Deak, Z; Meurer, F; Maertz, F; Mueck, F G; Geyer, L L; Wirth, S

2015-01-01

The purpose of this study was to compare cranial CT (CCT) image quality (IQ) of the MBIR algorithm with standard iterative reconstruction (ASiR). In this institutional review board (IRB)-approved study, raw data sets of 100 unenhanced CCT examinations (120 kV, 50-260 mAs, 20 mm collimation, 0.984 pitch) were reconstructed with both ASiR and MBIR. Signal-to-noise (SNR) and contrast-to-noise (CNR) were calculated from attenuation values measured in caudate nucleus, frontal white matter, anterior ventricle horn, fourth ventricle, and pons. Two radiologists, who were blinded to the reconstruction algorithms, evaluated anonymized multiplanar reformations of 2.5 mm with respect to depiction of different parenchymal structures and impact of artefacts on IQ with a five-point scale (0: unacceptable, 1: less than average, 2: average, 3: above average, 4: excellent). MBIR decreased artefacts more effectively than ASiR (p < 0.01). The median depiction score for MBIR was 3, whereas the median value for ASiR was 2 (p < 0.01). SNR and CNR were significantly higher in MBIR than ASiR (p < 0.01). MBIR showed significant improvement of IQ parameters compared to ASiR. As CCT is an examination that is frequently required, the use of MBIR may allow for substantial reduction of radiation exposure caused by medical diagnostics. • Model-Based iterative reconstruction (MBIR) effectively decreased artefacts in cranial CT. • MBIR reconstructed images were rated with significantly higher scores for image quality. • Model-Based iterative reconstruction may allow reduced-dose diagnostic examination protocols.

Craniofacial changes in Icelandic children between 6 and 16 years of age - a longitudinal study.

PubMed

Thordarson, Arni; Johannsdottir, Berglind; Magnusson, Thordur Eydal

2006-04-01

The aim of the present study was to describe the craniofacial changes between 6 and 16 years of age in a sample of Icelandic children. Complete sets of lateral cephalometric radiographs were available from 95 males and 87 females. Twenty-two reference points were digitized and processed by standard methods, using the Dentofacial Planner computer software program. Thirty-three angular and linear variables were calculated, including: basal sagittal and vertical measurements, facial ratio, and dental, cranial base and mandibular measurements. For the angular measurements, gender differences were not statistically different for any of the measurements, in either age group, except for the variable s-n-na, which was larger in the 16-year-old boys (P < or = 0.001). Linear variables were consistently larger in the boys compared with the girls at both age levels. During the observation period mandibular prognathism increased but the basal sagittal jaw relationship, the jaw angle, the mandibular plane angle and cranial base flexure (n-s-ba) decreased in both genders (P < or = 0.001). Maxillary prognathism increased only in the boys from 6 to 16 years. Inclination of the lower incisors and all the cranial base dimensions increased in both genders during the observation period. When the Icelandic sample was compared with a similar Norwegian sample, small differences could be noted in the maxillary prognathism, mandibular plane angle and in the inclination of the maxilla. Larger differences were identified in the inclination of the lower incisors. These findings could be used as normative cephalometric standards for 6- and 16-year-old Icelandic children.

Intra cranial complications of tuberculous otitis media.

PubMed

Prakash, M; Johnny, J Carlton

2015-04-01

Tuberculosis is one of the most common infections in the world. It is seen that tuberculous otitis media (TOM) is almost secondary to pulmonary tuberculosis. In this review we have tried to deal with all the aspects of the intra cranial complications of TOM such as tuberculoma, otitic hydrocephalus, brain abscess and tuberculous meningitis. The aspects covered in this review are the pathology, clinical features, and investigations of the intra cranial manifestations.

Cranial Electrotherapy Stimulation (CES) in Soldiers with Insomnia: A Pilot Study

DTIC Science & Technology

2016-07-28

hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...DATES COVERED 1 August 2011 – 31 March 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER N/A Cranial Electrotherapy Stimulation (CES...Purpose: 1. Test feasibility and acceptability of Cranial Electrotherapy Stimulation (CES) for insomnia. 2. Evaluate extent of change in pre- and post

Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series

PubMed Central

Zhang, Wei; Wei, Lin; Li, Gang; Sun, Jinlong; Jin, Peng; Yang, Jun; Wang, Daokui; Bai, Yunan; Li, Xingang; Fei, Chang; Wang, Chengwei; Wang, Baoan; Pan, Shumao; Du, Jihai; Xie, Bo; Xu, Dongfang; Xin, Changming; Wang, Jihua; Zhang, Qinglin

2015-01-01

This study aimed to describe the technique details of rapid pore cranial drilling with external ventricular drainage and document its clinical outcomes by highlighting the advantages over the traditional and modified cranial drilling technique. Intraventricular hemorrhage is one of the most severe subtypes of hemorrhagic stroke with high mortality. The amount of blood in the ventricles is associated with severity of outcomes, and fast removal of the blood clot is the key to a good prognosis. Between 1977 and 2013, 3773 patients admitted for intraventricular hemorrhage underwent rapid pore cranial drilling drainage. The therapeutic effects and clinical outcomes were retrospectively analyzed. Of these patients, 1049 (27.8%) experienced complete remission, 1788 (47.4%) had improved condition, and 936 (24.8%) died. A total of 3229 (85.6%) patients gained immediate remission. One typical case was illustrated to demonstrate the efficacy of the rapid pore drilling technique. Rapid pore cranial drilling drainage in patients with intraventricular hemorrhage is fast, effective, and provides immediate relief in patients with severe conditions. It could be a better alternative to the conventional drilling approach for treatment of intraventricular hemorrhage. A randomized controlled trial for direct comparison between the rapid pore cranial drilling drainage and conventional drilling technique is in urgent need. PMID:25590642

Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series.

PubMed

Zhang, Wei; Wei, Lin; Li, Gang; Sun, Jinlong; Jin, Peng; Yang, Jun; Wang, Daokui; Bai, Yunan; Li, Xingang; Fei, Chang; Wang, Chengwei; Wang, Baoan; Pan, Shumao; Du, Jihai; Xie, Bo; Xu, Dongfang; Xin, Changming; Wang, Jihua; Zhang, Qinglin

2015-06-01

This study aimed to describe the technique details of rapid pore cranial drilling with external ventricular drainage and document its clinical outcomes by highlighting the advantages over the traditional and modified cranial drilling technique. Intraventricular hemorrhage is one of the most severe subtypes of hemorrhagic stroke with high mortality. The amount of blood in the ventricles is associated with severity of outcomes, and fast removal of the blood clot is the key to a good prognosis. Between 1977 and 2013, 3773 patients admitted for intraventricular hemorrhage underwent rapid pore cranial drilling drainage. The therapeutic effects and clinical outcomes were retrospectively analyzed. Of these patients, 1049 (27.8%) experienced complete remission, 1788 (47.4%) had improved condition, and 936 (24.8%) died. A total of 3229 (85.6%) patients gained immediate remission. One typical case was illustrated to demonstrate the efficacy of the rapid pore drilling technique. Rapid pore cranial drilling drainage in patients with intraventricular hemorrhage is fast, effective, and provides immediate relief in patients with severe conditions. It could be a better alternative to the conventional drilling approach for treatment of intraventricular hemorrhage. A randomized controlled trial for direct comparison between the rapid pore cranial drilling drainage and conventional drilling technique is in urgent need.

Cranial nerves in the Australian lungfish, Neoceratodus forsteri, and in fossil relatives (Osteichthyes: Dipnoi).

PubMed

Kemp, A

2017-02-01

Three systems, two sensory and one protective, are present in the skin of the living Australian lungfish, Neoceratodus forsteri, and in fossil lungfish, and the arrangement and innervation of the sense organs is peculiar to lungfish. Peripheral branches of nerves that innervate the sense organs are slender and unprotected, and form before any skeletal structures appear. When the olfactory capsule develops, it traps some of the anterior branches of cranial nerve V, which emerged from the chondrocranium from the lateral sphenotic foramen. Cranial nerve I innervates the olfactory organ enclosed within the olfactory capsule and cranial nerve II innervates the eye. Cranial nerve V innervates the sense organs of the snout and upper lip, and, in conjunction with nerve IX and X, the sense organs of the posterior and lateral head. Cranial nerve VII is primarily a motor nerve, and a single branch innervates sense organs in the mandible. There are no connections between nerves V and VII, although both emerge from the brain close to each other. The third associated system consists of lymphatic vessels covered by an extracellular matrix of collagen, mineralised as tubules in fossils. Innervation of the sensory organs is separate from the lymphatic system and from the tubule system of fossil lungfish. Copyright © 2016 Elsevier Ltd. All rights reserved.

Performance Status and Number of Metastatic Extra-cerebral Sites Predict Survival After Radiotherapy of Brain Metastases from Thyroid Cancer.

PubMed

Dziggel, Liesa; Gebauer, Niklas; Bartscht, Tobias; Schild, Steven E; Rades, Dirk

2018-04-01

Patients with brain metastases from thyroid cancer are extremely rare. This study evaluated clinical factors for survival following whole-brain radiotherapy (WBRT) alone. In six patients, the following factors were analyzed for survival: Regimen of WBRT (5×4 Gy vs. 10×3 Gy), gender, age (≤55 vs. ≥56 years), Karnofsky performance score (KPS) (60% vs. 70-80%), number of brain lesions (2-3 vs. ≥4) and number of extra-cranial metastatic sites (one vs. more than one). KPS 70-80% (p=0.036) and involvement of only one extra-cranial site (p=0.018) were associated with better survival on univariate analysis. On Cox regression analysis, KPS (p=0.14) and number of extra-cranial sites (p=0.14) showed trends for association with survival. In patients with KPS 70-80% and only one extra-cranial site, 6-month survival was 100%, no patient with KPS 60% and more than one extra-cranial site survived to 6 months. KPS and number of involved extra-cranial metastatic sites were associated with survival and may be helpful for individualizing therapy in patients with brain metastases from thyroid cancer. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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.

Growth trajectories in the cave bear and its extant relatives: an examination of ontogenetic patterns in phylogeny.

PubMed

Fuchs, Manuela; Geiger, Madeleine; Stange, Madlen; Sánchez-Villagra, Marcelo R

2015-11-02

The study of postnatal ontogeny can provide insights into evolution by offering an understanding of how growth trajectories have evolved resulting in adult morphological disparity. The Ursus lineage is a good subject for studying cranial and mandibular shape and size variation in relation to postnatal ontogeny and phylogeny because it is at the same time not diverse but the species exhibit different feeding ecologies. Cranial and mandibular shapes of Ursus arctos (brown bear), U. maritimus (polar bear), U. americanus (American black bear), and the extinct U. spelaeus (cave bear) were examined, using a three-dimensional geometric morphometric approach. Additionally, ontogenetic series of crania and mandibles of U. arctos and U. spelaeus ranging from newborns to senile age were sampled. The distribution of specimens in morphospace allowed to distinguish species and age classes and the ontogenetic trajectories U. arctos and U. spelaeus were found to be more similar than expected by chance. Cranial shape changes during ontogeny are largely size related whereas the evolution of cranial shape disparity in this clade appears to be more influenced by dietary adaptation than by size and phylogeny. The different feeding ecologies are reflected in different cranial and mandibular shapes among species. The cranial and mandibular shape disparity in the Ursus lineage appears to be more influenced by adaptation to diet than by size or phylogeny. In contrast, the cranial and mandibular shape changes during postnatal ontogeny in U. arctos and U. spelaeus are probably largely size related. The patterns of morphospace occupation of the cranium and the mandible in adults and through ontogeny are different.

Comparing primate crania: The importance of fossils.

PubMed

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

2016-10-01

Extant primate crania represent a small subset of primate crania that have existed. The main objective here is to examine how the inclusion of fossil crania changes our understanding of primate cranial diversity relative to analyses of extant primates. We hypothesize that fossil taxa will change the major axes of cranial shape, occupy new areas of morphospace, change the relative diversity of major primate clades, and fill in notable gaps separating major primate taxa/clades. Eighteen 3D landmarks were collected on 157 extant and fossil crania representing 90 genera. Data were subjected to a Generalized Procrustes Analysis then principal components analysis. Relative diversity between clades was assessed using an F-statistic. Fossil taxa do not significantly alter major axes of cranial shape, but they do occupy unique areas of morphospace, change the relative diversity between clades, and fill in notable gaps in primate cranial evolution. Strepsirrhines remain significantly less diverse than anthropoids. Fossil hominins fill the gap in cranial morphospace between extant great apes and modern humans. The morphospace outlined by living primates largely includes that occupied by fossil taxa, suggesting that the cranial diversity of living primates generally encompasses the total diversity that has evolved in this Order. The evolution of the anthropoid cranium was a significant event allowing anthropoids to achieve significantly greater cranial diversity compared to strepsirrhines. Fossil taxa fill in notable gaps within and between clades, highlighting their transitional nature and eliminating the appearance of large morphological distances between extant taxa, particularly in the case of extant hominids. © 2016 Wiley Periodicals, Inc.

Rostral cranial fossa as a site for cerebrospinal fluid drainage - volumetric studies in dog breeds of different size and morphotype.

PubMed

Sokołowski, Wojciech; Czubaj, Norbert; Skibniewski, Michał; Barszcz, Karolina; Kupczyńska, Marta; Kinda, Wojciech; Kiełbowicz, Zdzisław

2018-05-18

Hydrocephalus is a multifactorial condition, whose aetiology is not fully understood. Congenital hydrocephalus frequently occurs in small and brachycephalic dog breeds. Although it is widely accepted that the cribriform plate located in the rostral cranial fossa (RCF) is a site of cerebrospinal fluid (CSF) drainage, the RCF has not been studied extensively. Literature reports indicate that a decreased caudal cranial fossa (CCF) volume in the course of the Chiari-like malformation may obstruct CSF circulation. We hypothesised that morphological diversity among different breeds in the volume of the RCF may affect CSF circulation. The aim of the study was to carry out a volumetric analysis of the RCF and the cranial cavity and to determine the ratio between them in dog breeds of different size and morphotype. We performed computed tomography (CT) morphometric analysis of the RCF compartment by obtaining volume measurements from the transverse and reformatted sagittal and dorsal planes. The rostral cranial fossa percentage - volume of the rostral cranial fossa/volume of cranial cavity × 100 (volRCF/volCC × 100) was lower in small and brachycephalic dog breeds than in the other dogs. A reduced RCF volume was detected in small and brachycephalic dog breeds, some of which are predisposed to congenital hydrocephalus. This may lead to overcrowding of brain parenchyma in the RCF and may impede CSF circulation. Our observations may be useful for future studies focusing on the causes and new therapies to treat conditions such as hydrocephalus and syringomyelia.

ANATOMICAL STUDY OF CRANIAL NERVE EMERGENCE AND SKULL FORAMINA IN THE HORSE USING MAGNETIC RESONANCE IMAGING AND COMPUTED TOMOGRAPHY.

PubMed

Gonçalves, Rita; Malalana, Fernando; McConnell, James Fraser; Maddox, Thomas

2015-01-01

For accurate interpretation of magnetic resonance (MR) images of the equine brain, knowledge of the normal cross-sectional anatomy of the brain and associated structures (such as the cranial nerves) is essential. The purpose of this prospective cadaver study was to describe and compare MRI and computed tomography (CT) anatomy of cranial nerves' origins and associated skull foramina in a sample of five horses. All horses were presented for euthanasia for reasons unrelated to the head. Heads were collected posteuthanasia and T2-weighted MR images were obtained in the transverse, sagittal, and dorsal planes. Thin-slice MR sequences were also acquired using transverse 3D-CISS sequences that allowed mutliplanar reformatting. Transverse thin-slice CT images were acquired and multiplanar reformatting was used to create comparative images. Magnetic resonance imaging consistently allowed visualization of cranial nerves II, V, VII, VIII, and XII in all horses. The cranial nerves III, IV, and VI were identifiable as a group despite difficulties in identification of individual nerves. The group of cranial nerves IX, X, and XI were identified in 4/5 horses although the region where they exited the skull was identified in all cases. The course of nerves II and V could be followed on several slices and the main divisions of cranial nerve V could be distinguished in all cases. In conclusion, CT allowed clear visualization of the skull foramina and occasionally the nerves themselves, facilitating identification of the nerves for comparison with MRI images. © 2015 American College of Veterinary Radiology.

Control of sodium excretion in patients with cranial diabetes insipidus maintained on desamino-[8-D-arginine]vasopressin.

PubMed

Sutters, M; Brace, C; Hatfield, E; Whitehurst, A; Lightman, S L; Peart, W S

1993-11-01

1. We have studied the response of six patients with cranial diabetes insipidus and six age-matched control subjects to dietary sodium restriction during constant administration of the synthetic vasopressin analogue desamino-[8-D-arginine]vasopressin. 2. Urine flow increased on the first low salt day in the normal control subjects but not in the patients with cranial diabetes insipidus. Body weight fell 1.35 kg in the control subjects but was constant in the patients with cranial diabetes insipidus. 3. Urinary sodium excretion fell at the same rate in both groups. Diurnal variation of urinary sodium excretion and creatinine clearance was present in the control subjects but not in the patients with cranial diabetes insipidus. 4. Changes in plasma sodium concentration and osmolality were similar. Plasma protein concentration increased more in the control subjects (from 69.1 +/- 1.5 to 73 +/- 1.2 versus from 71.7 +/- 1 to 73.2 +/- 1.1 milligrams). The responses of plasma atrial natriuretic peptide, plasma renin activity and salivary aldosterone concentration were similar between the two groups. Salivary aldosterone concentration levels were consistently higher in the patients with cranial diabetes insipidus. 5. We confirm that the low salt diuresis is triggered by release from the antidiuretic activity of arginine vasopressin. In the patients with cranial diabetes insipidus extracellular fluid osmoregulation appeared to be achieved by the movement of water out of and sodium into the extracellular fluid. 6. Absent posterior pituitary function and hypothalamic disturbances did not alter renal sodium conservation.(ABSTRACT TRUNCATED AT 250 WORDS)

Integration of parts in the facial skeleton and cervical vertebrae.

PubMed

McCane, Brendan; Kean, Martin R

2011-01-01

The purpose of this study was to undertake an exploratory analysis of the relationship among parts in the facial skeleton and cervical vertebrae and their integration as 2-dimensional shapes by determining their individual variations and covariations. The study was motivated by considerations applicable to clinical orthodontics and maxillofacial surgery, in which such relationships bear directly on pretreatment analysis and assessment of posttreatment outcome. Lateral radiographs of 61 adolescents of both sexes without major malocclusions were digitized and marked up by using continuous outline spline curves for 8 defined parts in the facial skeleton, including the cervical vertebrae. Individual part variation was analyzed by using principal components analysis, and paired part covariation was analyzed by using 2-block partial least squares analysis in 2 modes: relative size, position, and shape; and shape only. For individual part variations, cranial base, soft-tissue profile, and mandible had the largest variations across the sample. For covariation of relative size, position, and shape, the cervical vertebrae were highly correlated with the cranial base (r = 0.80), nasomaxillary complex (r = 0.70), mandible (r = 0.74), maxillary dentition (r = 0.70), and mandibular dentition (r = 0.74); the maxillary dentition and mandibular dentition were highly correlated (r = 0.70); the mandible was highly correlated with the bony profile (r = 0.72), soft-tissue profile (r = 0.79), and, to a lesser extent, the cranial base (r = 0.67); the bony profile was highly correlated with the cranial base (r = 0.70) and soft-tissue profile (r = 0.80); the soft-tissue profile was highly correlated with the nasomaxillary dentition (r = 0.81). Covariation of shape only was much weaker with significant covariations found between bony profile and mandible (r = 0.53), bony profile and mandibular dentition (r = 0.65), mandibular dentition and soft-tissue profile (r = 0.54), mandibular dentition and maxillary dentition (r = 0.55), and bony profile and soft-tissue profile (r = 0.69). We found that integration of the shape of parts in the facial skeleton and cervical vertebrae is weak; it is the relative size, position, and orientation of parts that form the strongest correlations. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.