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Sample records for posterior fossa arachnoid

  1. Transfrontal Transaqueductal, Transtrigonal, and Suboccipital Infratentorial Supracerebellar Endoscopic Fenestration of Posterior Fossa Arachnoid Cysts: Three Surgical Cases.

    PubMed

    Idris, Zamzuri; Tan, Yew Chin; Kandasamy, Regunath; Ghani, Rahman Izaini; Abdullah, Jafri Malin

    2017-03-01

    Symptomatic intracranial arachnoid cysts are commonly treated using neuroendoscopy. Cysts located within the posterior fossa may present a greater surgical challenge to the neurosurgeon due to the numerous vital neurovascular structures located within this confined space. Adding neuronavigation during endoscopy helps a neurosurgeon to visualize and utilize both anterior and posterior corridors safely to access and manage these lesions. We present three symptomatic posterior fossa arachnoid cysts that were treated successfully using minimally invasive neuronavigation-guided endoscopic neurosurgery utilizing the anterior transfrontal transaqueductal, anterior transfrontal transtrigonal, and posterior suboccipital infratentorial supracerebellar approaches.

  2. Posterior Fossa Tumors.

    PubMed

    Brandão, Lara A; Young Poussaint, Tina

    2017-02-01

    Pediatric brain tumors are the leading cause of death from solid tumors in childhood. The most common posterior fossa tumors in children are medulloblastoma, atypical teratoid/rhabdoid tumor, cerebellar pilocytic astrocytoma, ependymoma, and brainstem glioma. Location, and imaging findings on computed tomography (CT) and conventional MR (cMR) imaging may provide important clues to the most likely diagnosis. Moreover, information obtained from advanced MR imaging techniques increase diagnostic confidence and help distinguish between different histologic tumor types. Here we discuss the most common posterior fossa tumors in children, including typical imaging findings on CT, cMR imaging, and advanced MR imaging studies.

  3. 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

  4. Posterior Fossa Meningioma

    PubMed Central

    Saleh, Essam A.; Taibah, Abdel Kader; Achilli, Vittorio; Aristegui, Miguel; Mazzoni, Antonio; Sanna, Mario

    1994-01-01

    Posterior fossa meningioma is the second most common tumor in the cerebellopontine angle. It has a higher rate of postoperative morbidity and mortality compared to acoustic neuroma. Forty posterior fossa meningioma patients managed in our centers were reviewed. Thirty-nine patients were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the modified transcochlear in 11 cases (26%), the petro-occipital transsigmoid in 5 cases (12%), the suboccipital in 4 cases (10%), the petro-occipital trassigmoid transcervical in 2 cases (5%), the petro-occipital transsigmoid transtentorial in 1 case (2%), and a subtemporal transtentorial for another case (2%). Facial nerve anatomical integrity was preserved in 87% of procedures but was interrupted in 5 cases, with 4 of the latter subsequently repaired. Total tumor removal was accomplished in 38 cases. A second-stage total tumor removal is planned for the remaining case. There was only one case of perioperative death and no cases of radiological recurrence so far. ImagesFigure 1Figure 2Figure 3Figure 4p206-bFigure 5p207-bFigure 5 PMID:17171173

  5. Microsurgical anatomy of the posterior fossa cisterns.

    PubMed

    Matsuno, H; Rhoton, A L; Peace, D

    1988-07-01

    The microsurgical anatomy of the posterior fossa cisterns was examined in 15 cadavers using 3X to 40X magnification. Liliequist's membrane was found to split into two arachnoidal sheets as it spreads upward from the dorsum sellae: an upper sheet, called the diencephalic membrane, which attaches to the diencephalon at the posterior edge of the mamillary bodies, and a lower sheet, called the mesencephalic membrane, which attaches along the junction of the midbrain and pons. Several other arachnoidal membranes that separate the cisterns were identified. These include the anterior pontine membrane, which separates the prepontine and cerebellopontine cisterns; the lateral pontomesencephalic membrane, which separates the ambient and cerebellopontine cisterns; the medial pontomedullary membrane, which separates the premedullary and prepontine cisterns; and the lateral pontomedullary membrane, which separates the cerebellopontine and cerebellomedullary cisterns. The three cisterns in which the arachnoid trabeculae and membranes are the most dense and present the greatest obstacle at operation are the interpeduncular and quadrigeminal cisterns and the cisterna magna. Numerous arachnoid membranes were found to intersect the oculomotor nerves. The neural and vascular structures in each cistern are reviewed.

  6. Stereolithography for Posterior Fossa Cranioplasty

    PubMed Central

    Agner, Celso; Dujovny, Manuel; Evenhouse, Raymond; Charbel, Fady T.; Sadler, Lewis

    1998-01-01

    Posterior fossa cranioplasty has been suggested for improvement of neurological symptoms following craniectomy. However, there is no particular recommendation in the literature about techniques for prosthesis manufacture and implantation. We report our experience using rapid prototyping technology and stereolithography for pre-surgical implant design and production of cranioplasties. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17171056

  7. Treatment implications of posterior fossa ependymoma subgroups.

    PubMed

    Ramaswamy, Vijay; Taylor, Michael D

    2016-11-15

    Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology. Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy, whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone.

  8. Congenital basis of posterior fossa anomalies

    PubMed Central

    Cotes, Claudia; Bonfante, Eliana; Lazor, Jillian; Jadhav, Siddharth; Caldas, Maria; Swischuk, Leonard

    2015-01-01

    The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies. PMID:26246090

  9. Posterior fossa syndrome—a narrative review

    PubMed Central

    Wahab, Salima S.; Hettige, Samantha; Mankad, Kshtij

    2016-01-01

    Posterior fossa syndrome (PFS), or cerebellar mutism syndrome (CMS), is a collection of neurological symptoms that occur following surgical resection of a posterior fossa tumour, and is characterised by either a reduction or an absence of speech. Some authors suggest that CM is only one symptom of the CMS complex that also includes ataxia, hypotonia and irritability as well as cranial nerve deficits, neurobehavioral changes and urinary retention or incontinence. It is seen almost exclusively in children. In 1985 Rekate et al. published the first work describing CM as a clinical entity, occurring as a consequence of bilateral cerebellar injury. Other associated symptoms include visual impairment, altered mood, impaired swallowing and significant gross and fine motor deficits. The effects of this can have a devastating impact on both the patient and their carers, posing a significant clinical challenge to neurorehabilitation services. The reported incidence was between 8% and 31% of children undergoing surgery for posterior fossa tumour. The underlying pathologies include vasospasm, oedema, and axonal/neuronal injury. Neuroimaging has contributed to a better understanding of the anatomical location of postoperative injury. There have been a number of suggestions for treatment interventions for PFS. However, apart from some individual reports, there have been no clinical trials indicating possible benefit. Occupational therapy, speech and language therapy, as well as neurocognitive support, contribute to the recovery of these patients. PMID:27942479

  10. BAER suppression during posterior fossa dural opening

    PubMed Central

    Shields, Christopher B.; Shields, Lisa B. E.; Jiang, Yi Dan; Yao, Tom; Zhang, Yi Ping; Sun, David A.

    2015-01-01

    Background: Intraoperative monitoring with brainstem auditory evoked responses (BAER) provides an early warning signal of potential neurological injury and may avert tissue damage to the auditory pathway or brainstem. Unexplained loss of the BAER signal in the operating room may present a dilemma to the neurosurgeon. Methods: This paper documents two patients who displayed a unique mechanism of suppression of the BAER apparent within minutes following dural opening for resection of a posterior fossa meningioma. Results: In two patients with anterior cerebellopontine angle and clival meningiomas, there was a significant deterioration of the BAER soon after durotomy but prior to cerebellar retraction and tumor removal. Intracranial structures in the posterior fossa lying between the tumor and dural opening were shifted posteriorly after durotomy. Conclusion: We hypothesized that the cochlear nerve and vessels entering the acoustic meatus were compressed or stretched when subjected to tissue shift. This movement caused cochlear nerve dysfunction that resulted in BAER suppression. BAER was partially restored after the tumor was decompressed, dura repaired, and bone replaced. BAER was not suppressed following durotomy for removal of a meningioma lying posterior to the cochlear complex. Insight into the mechanisms of durotomy-induced BAER inhibition would allay the neurosurgeon's anxiety during the operation. PMID:25883849

  11. Surgical management of posterior fossa metastases.

    PubMed

    Sunderland, Geraint J; Jenkinson, Michael D; Zakaria, Rasheed

    2016-12-01

    The diagnosis of brain metastases is associated with a poor prognosis reflecting uncontrolled primary disease that has spread to the relative sanctuary of the central nervous system. 20 % of brain metastases occur in the posterior fossa and are associated with significant morbidity. The risk of acute hydrocephalus and potential for sudden death means these metastases are often dealt with as emergency cases. This approach means a full pre-operative assessment and staging of underlying disease may be neglected and a proportion of patients undergo comparatively high risk surgery with little or no survival benefit. This study aimed to assess outcomes in patients to identify factors that may assist in case selection. We report a retrospective case series of 92 consecutive patients operated for posterior fossa metastases between 2007 and 2012. Routine demographic data was collected plus data on performance status, primary cancer site, details of surgery, adjuvant treatment and survival. The only independent positive prognostic factors identified on multivariate analysis were good performance status (if Karnofsky performance score >70, hazard ratio (HR) for death 0.36, 95 % confidence interval (CI) 0.18-0.69), adjuvant whole brain radiotherapy (HR 0.37, 95 % CI 0.21-0.65) and adjuvant chemotherapy where there was extracranial disease and non-synchronous presentation (HR 0.51, 95 % CI 0.31-0.82). Patients presenting with posterior fossa metastases may not be investigated as thoroughly as those with supratentorial tumours. Staging and assessment is essential however, and in the meantime emergencies related to tumour mass effect should be managed with steroids and cerebrospinal fluid diversion as required.

  12. Arachnoid cyst producing recurrent neurological disturbances.

    PubMed

    Lehman, R A; Fieger, H G

    1978-08-01

    A patient with an arachnoid cyst of the posteriro fossa experienced repeated episodes of transient right upper extremity numbness and weakness. Review of the literature indicates that arachnoid cysts of the posterior fossa and spinal canal as well as extradural spinal cysts may present with symptoms of transient neurological deficit which often suggest the diagnosis of multiple sclerosis.

  13. Costello syndrome: Analysis of the posterior cranial fossa in children with posterior fossa crowding.

    PubMed

    Calandrelli, Rosalinda; D'Apolito, Gabriella; Marco, Panfili; Zampino, Giuseppe; Tartaglione, Tommaso; Colosimo, Cesare

    2015-06-01

    This study aimed to assess changes in the posterior cranial fossa (PCF) to shed light on the mechanism of cerebellar herniation in children with Costello syndrome (CS) and posterior fossa crowding. We performed a morphovolumetric PCF analysis on brain magnetic resonance imaging (MRI) in seven children with CS (mean age 31 ± 16 months) comparing the MRI scans with those of seven age-matched healthy subjects.PCF volume (PCFV), PCF brain volume (PCFBV) and cerebellar volume (CeV) were assessed on axial T2-weighted MRI. Morphometric parameters (diameters of the foramen magnum, tentorial angle, basiocciput, supraocciput, basisphenoid and exocciput lengths) were measured on sagittal T1-weighted MRI. The volume of the cerebrospinal fluid (CSF) spaces was calculated as PCFV minus PCFBV.Five out of seven CS children showed tonsillar herniation in the upper cervical canal; no child had hydrocephalus but three out of seven children showed ventriculomegaly. In addition, the PCFV/PCFBV ratio, PCFV, CSF spaces volume, basiocciput, basisphenoid and exocciput lengths and latero-lateral and antero-posterior diameters of the foramen magnum were significantly reduced, whereas no significant changes were found in supraocciput length, PCFBV, CeV or hindbrain volume. The volumetric reduction of the PCF due to bony posterior fossa hypoplasia is a predisposing factor for developing cerebellar tonsillar herniation through the foramen magnum in children with CS. The altered anatomy of the foramen magnum and upward expansion of the PCF secondary to an increased tentorial slope serves to explain the possible mechanism of cerebellar herniation in patients with CS.

  14. Costello syndrome: Analysis of the posterior cranial fossa in children with posterior fossa crowding

    PubMed Central

    D’Apolito, Gabriella; Panfili, Marco; Zampino, Giuseppe; Tartaglione, Tommaso; Colosimo, Cesare

    2015-01-01

    This study aimed to assess changes in the posterior cranial fossa (PCF) to shed light on the mechanism of cerebellar herniation in children with Costello syndrome (CS) and posterior fossa crowding. We performed a morphovolumetric PCF analysis on brain magnetic resonance imaging (MRI) in seven children with CS (mean age 31 ± 16 months) comparing the MRI scans with those of seven age-matched healthy subjects. PCF volume (PCFV), PCF brain volume (PCFBV) and cerebellar volume (CeV) were assessed on axial T2-weighted MRI. Morphometric parameters (diameters of the foramen magnum, tentorial angle, basiocciput, supraocciput, basisphenoid and exocciput lengths) were measured on sagittal T1-weighted MRI. The volume of the cerebrospinal fluid (CSF) spaces was calculated as PCFV minus PCFBV. Five out of seven CS children showed tonsillar herniation in the upper cervical canal; no child had hydrocephalus but three out of seven children showed ventriculomegaly. In addition, the PCFV/PCFBV ratio, PCFV, CSF spaces volume, basiocciput, basisphenoid and exocciput lengths and latero-lateral and antero-posterior diameters of the foramen magnum were significantly reduced, whereas no significant changes were found in supraocciput length, PCFBV, CeV or hindbrain volume The volumetric reduction of the PCF due to bony posterior fossa hypoplasia is a predisposing factor for developing cerebellar tonsillar herniation through the foramen magnum in children with CS. The altered anatomy of the foramen magnum and upward expansion of the PCF secondary to an increased tentorial slope serves to explain the possible mechanism of cerebellar herniation in patients with CS. PMID:26246091

  15. Asystole during posterior fossa surgery: Report of two cases

    PubMed Central

    Goyal, Keshav; Philip, Frenny Ann; Rath, Girija Prasad; Mahajan, Charu; Sujatha, M.; Bharti, Sachidanand Jee; Gupta, Nidhi

    2012-01-01

    Asystole during posterior fossa neurosurgical procedures is not uncommon. Various causes have been implicated, especially when surgical manipulation is carried out in the vicinity of the brain stem. The trigemino-cardiac reflex has been attributed as one of the causes. Here, we report two cases who suffered asystole during the resection of posterior fossa tumors. The vago-glossopharyngeal reflex and the direct stimulation of the brainstem were hypothesized as the causes of asytole. These episodes resolved spontaneously following withdrawal of the surgical stimulus emphasizing the importance of anticipation and vigilance during critical moments of tumor dissection during posterior fossa surgery. PMID:22870159

  16. Rhinocerebral mucormycosis with extension to the posterior fossa: case report.

    PubMed

    Soloniuk, D S; Moreland, D B

    1988-11-01

    A 25-year-old man with juvenile onset diabetes presented with rhinoorbital mucormycosis. He was treated aggressively with orbital extirpation and amphotericin B. Six months later, he presented with posterior fossa extension of the mucormycosis.

  17. Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns.

    PubMed

    Eguchi, T; Taoka, T; Nikaido, Y; Shiomi, K; Fujimoto, T; Otsuka, H; Takeuchi, H

    1996-06-01

    Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre- and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space.

  18. Spontaneous defects between the mastoid and posterior cranial fossa.

    PubMed

    Rereddy, Shruthi K; Mattox, Douglas E

    2016-01-01

    Conclusions Spontaneous defects between the mastoid and the posterior cranial fossa are exceedingly rare. Patients with these lesions may have a lower BMI compared to those with middle cranial fossa encephaloceles, but are otherwise demographically similar. This study recommends repair via a transtemporal approach to allow for examination of the entire posterior face of the temporal bone. Objective To describe cases of spontaneous posterior cranial fossa defects. Methods This study reviewed all cases of spontaneous posterior fossa defects presenting to a tertiary referral center over the last decade and described clinical presentation, imaging, operative findings, and outcomes. We also compared these lesions to those previously reported in the literature as well as the more common spontaneous encephaloceles of the middle cranial fossa. Results This study identified five cases with a mean age of 61.4 years, female-to-male ratio of 4:1, and a mean BMI of 31. Three cases presented with spontaneous pneumocephalus, one with CSF otorrhea, and one as an incidental imaging finding. Four defects were found medial to the sigmoid sinus and one was in the lateral retrosigmoid air cells.

  19. Interconnecting the posterior and middle cranial fossae for tumors that traverse Meckel's cave.

    PubMed

    Cheung, S W; Jackler, R K; Pitts, L H; Gutin, P H

    1995-03-01

    Meckel's cave is an avenue for tumor to spread between the posterior and middle cranial fossae. The most common neoplasms that traverse this channel are trigeminal schwannomas and meningiomas. The classic approach to address disease in both cranial fossae involves separate craniotomies. Recent innovations in skull base surgery have made it possible to perform a single opening with simultaneous exposure of the posterior and middle fossae, without undue brain retraction. Tumors with a large middle fossa component and a smaller posterior fossa portion are exposed via subtemporal craniotomy with petrosectomy and tentorium division. However, tumors with a large posterior fossa component and a smaller middle fossa portion in the setting of serviceable hearing are addressed with retrosigmoid craniotomy and petrosectomy. For bilobed tumors with substantial components in both fossae, subtemporal craniotomy combined with varying degrees of transtemporal petrosectomy and tentorium division is employed. The evolution of techniques to address tumors that traverse Meckel's cave is reviewed and a treatment algorithm is proposed.

  20. Management of Cerebrospinal Fluid Leak following Posterior Cranial Fossa Surgery

    PubMed Central

    Altaf, Imran; Vohra, Anjum Habib; Shams, Shahzad

    2016-01-01

    Objective: Cerebrospinal fluid leakage remains a significant cause of morbidity following posterior fossa surgery, and its treatment remains a difficult problem. The aim of the study was to propose a treatment algorithm for its management. Methods: A retrospective, single-center study was conducted on 147 patients who underwent elective posterior fossa surgery for a variety of diseases. Patients with post operative CSF leakage had either been treated initially with conservative measures including re-suturing of the wound, with CSF lumbar drainage to be employed in case the CSF leakage didn’t stop, or the initial intervention was the institution of CSF lumbar drainage simultaneously with conservative measures. VP (ventriculo-peritoneal) shunt was done in patients with gross hydrocephalus on postoperative CT brain. Results: There were 25 (17%) cases of CSF leakage, including 24 incisional CSF leaks and one case of CSF otorrhea. In eight patients with incisional CSF leakage treated initially with conservative measures including re-suturing of the wound, CSF leakage stopped in only two cases. CSF lumbar drainage instituted later on in six cases with persistent leakage stopped the CSF leakage. In fourteen patients managed initially with re-suturing of the wound and concomitant CSF lumbar drainage, CSF leakage settled in all the cases. Two patients with gross hydrocephalus on post operative CT were managed successfully with VP shunt. Re-suturing of the wound with concomitant CSF lumbar drainage was found to be significantly associated (p=0.003) with the stoppage of CSF leakage, and the settlement of meningitis (p= 0.014). Conclusion: Incisional CSF leaks after posterior fossa surgery should be managed with re-suturing of the wound and concomitant CSF lumbar drainage, instead of an initial trial of conservative therapy alone. PMID:28083041

  1. Posterior fossa ruptured dermoid cyst presenting with hydrocephalus

    PubMed Central

    A. Wani, Abrar; Raswan, Uday S.; Malik, Nayil K.; Ramzan, Altaf U.

    2016-01-01

    Dermoid cysts are rare, benign lesions of embryological origin that represent 0.1-0.7% of all intracranial tumors. They are mainly located in the supra tentorial space, especially in the parasellar region. Their location in the posterior fossa remains uncommon. Rupture of intracranial dermoid cysts is a rare phenomenon. We present a case of dermoid cyst, which had ruptured into ventricular system. Computed Tomography and MRI revealed fat in the fourth ventricle, prepontine cistern, and cerebellomedullary cistern. Hydrocephalus was noted. We performed right ventriculo-peritoneal shunt on which patient improved and he continues to remain asymptomatic one year after. PMID:27744466

  2. Magnetic resonance properties of hydrogen: imaging the posterior fossa

    SciTech Connect

    Young, I.R.; Burl, M.; Clarke, G.J.

    1981-11-01

    Posterior fossa scans were performed on five healthy volunteers using a nuclear magnetic resonance (NMR) machine constructed by Thorn-EMI Ltd. Three different NMR scanning sequences were used. In the first, a type of saturation-recovery technique was used to produce images strongly dependent on the density of hydrogen nuclei, but with some dependence on the spin-lattice relaxation time (T/sub 1/). In the second, an inversion-recovery technique was used to produce images with a stronger dependence on the spin-lattice relaxation time. In the third, a spin-echo technique was used to obtain images with a dependence on the spin-spin relaxation time (T/sub 2/). All three types of NMR image were unaffected by bone artifact. Visualization of brain adjacent to the skull base was obtained without loss of detail due to partial-volume effect from bone. The saturation-recovery images highlighted arteries and veins that were clearly visible without the use of contrast agents. The inversion-recovery images showed remarkable gray-white matter differentiation enabling internal structure to be seen within the brainstem and cerebellum. The trigeminal nerve and ganglion were also seen outside the brain. Experience with the spin-echo technique is limited, but the images at the base of the brain show considerable soft-tissue detail. The NMR images of the posterior fossa in this study were comparable in quality to those obtained from a new rotate-rotate x-ray computed tomography machine and were superior in several respects.

  3. Lumbar subdural cerebrospinal fluid collection with acute cauda equina syndrome after posterior fossa decompression for Chiari malformation Type I: case report.

    PubMed

    Darwish, Houssein A; Oldfield, Edward H

    2016-09-01

    This report describes the circumstances of a patient with a cauda equina syndrome due to the development of a lumbar subdural CSF collection with ventral displacement of the cauda equina shortly following posterior fossa decompression for Chiari malformation Type I (CM-I). This unusual, but clinically significant, complication was successfully treated with percutaneous drainage of the extraarachnoid CSF collection. Although there are a few cases of intracranial subdural hygroma developing after surgery for CM-I, often attributed to a pinhole opening in the arachnoid, as far as the authors can determine, a spinal subdural hygroma associated with surgery for CM-I has not been recognized.

  4. Syringomyelia Associated with a Huge Retrocerebellar Arachnoid Cyst: A Case Report

    PubMed Central

    Hue, Sung Baek; Kwon, Soon Chan; Lyo, In Uk; Sim, Hong Bo

    2015-01-01

    Occasionally, a posterior fossa arachnoid cyst can induce compression of the spinal cord and cause syringomyelia. Here, we report the case of a 29-year-old man with both progressive shoulder pain and gait disturbance, who was found to have a huge retrocerebellar arachnoid cyst associated with syringomyelia. Accordingly, posterior fossa decompression and arachnoid cyst excision were performed. Post-operative MRI showed a marked reduction in the size of the arachnoid cyst and syringomyelia. The patient's symptoms were clearly improved compared to before surgery. In our view, treatment in such patients should focus on decompressing the foramen magnum and include the removal of the coexistent arachnoid cyst walls, which appear to be the crucial factor in development of syringomyelia. In this report, we discuss the pathogenic mechanisms underlying syringomyelia-associated retrocerebellar arachnoid cyst and review the current literature on this topic. PMID:26512273

  5. Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors

    SciTech Connect

    Rueckriegel, Stefan M.; Driever, Pablo Hernaiz; Bruhn, Harald

    2012-03-01

    Purpose: Therapy and tumor-related effects such as hypoperfusion, internal hydrocephalus, chemotherapy, and irradiation lead to significant motor and cognitive sequelae in pediatric posterior fossa tumor survivors. A distinct proportion of those factors related to the resulting late effects is hitherto poorly understood. This study aimed at separating the effects of neurotoxic factors on central nervous system metabolism by using H-1 MR spectroscopy to quantify cerebral metabolite concentrations in these patients in comparison to those in age-matched healthy peers. Methods and Materials: Fifteen patients with World Health Organization (WHO) I pilocytic astrocytoma (PA) treated by resection only, 24 patients with WHO IV medulloblastoma (MB), who additionally received chemotherapy and craniospinal irradiation, and 43 healthy peers were investigated using single-volume H-1 MR spectroscopy of parietal white matter and gray matter. Results: Concentrations of N-acetylaspartate (NAA) were significantly decreased in white matter (p < 0.0001) and gray matter (p < 0.0001) of MB patients and in gray matter (p = 0.005) of PA patients, compared to healthy peers. Decreased creatine concentrations in parietal gray matter correlated significantly with older age at diagnosis in both patient groups (MB patients, p = 0.009, r = 0.52; PA patients, p = 0.006, r = 0.7). Longer time periods since diagnosis were associated with lower NAA levels in white matter of PA patients (p = 0.008, r = 0.66). Conclusions: Differently decreased NAA concentrations were observed in both PA and MB groups of posterior fossa tumor patients. We conclude that this reflects a disturbance of the neurometabolic steady state of normal-appearing brain tissue due to the tumor itself and to the impact of surgery in both patient groups. Further incremental decreases of metabolite concentrations in MB patients may point to additional harm caused by irradiation and chemotherapy. The stronger decrease of NAA in MB

  6. [Craniological basis of operative approaches to the structures of posterior cranial fossa using endovideo-monitoring].

    PubMed

    Gaĭvoronskiĭ, A I

    2007-01-01

    Cranioscopic and craniometric characteristics of posterior cranial fossa and correlations between them were studied using 127 skulls with different cranial shape (dolicho-, meso- and brachicraniums). It was found that most of the craniometric characteristics were independent on gender and shape of the skull, while each characteristic had some individual peculiarities. Endovideomonitoring was used to assess the optimality of suboccipital paramedial and retrosigmoid approaches to posterior cranial fossa using 20 heads of the corpses belonging to adult individuals. It was demonstrated that retrosigmoid approach was optimal for the accessibility of major anatomical structures of posterior cranial fossa.

  7. Pressure-supported ventilation for posterior fossa operation.

    PubMed

    Mori, N; Takahashi, H; Yanase, T; Suzuki, M

    1990-03-01

    To maintain enough gas exchange while using spontaneous respiration as a monitor of the normal brainstem function, we tried pressure-supported ventilation (PSV) with a Servo 900C ventilator (Siemens Elema AB, Sweden) on 12 otherwise healthy patients during posterior fossa operation. Ventilation mode was switched from controlled to PSV after the dura was open uneventfully in all cases but one. With a trigger level of -1 to -2 cm H2O, spontaneous respiration was triggered to start the inspiration. With supporting inspiratory pressure of 4-20 cm H2O, PaCO2 was kept at 31.7-45.9 mm Hg. The ventilatory level could be monitored breath by breath by ventilatory frequency, tidal volume, minute volume, and end-tidal CO2 concentration shown on the ventilator system. Apnea was observed in two cases during surgical manipulation around the brainstem. It was indicated immediately by the ventilator's alarm for decreased expiratory minute volume, and no sign of brainstem dysfunction was observed postoperatively. PSV was useful in maintaining adequate ventilation whereas spontaneous respiration was used as an indicator of normal brainstem function. The alarm system of the ventilator was sensitive enough to detect the surgical invasion of the brainstem at a very early stage.

  8. Compressive Cervicothoracic Adhesive Arachnoiditis following Aneurysmal Subarachnoid Hemorrhage: A Case Report and Literature Review

    PubMed Central

    Rahmathulla, Gazanfar; Kamian, Kambiz

    2014-01-01

    We present the case of a 55-year-old woman with diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine following posterior inferior cerebellar artery aneurysmal subarachnoid hemorrhage (SAH). She underwent aneurysm clipping with subsequent gradual neurologic decline associated with sensory disturbances, gait ataxia, and spastic paraparesis. Magnetic resonance imaging revealed diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine, syringobulbia, and multiple arachnoid cysts in the cervicothoracic spine along with syringohydromyelia. Early surgical intervention with microlysis of the adhesions and duraplasty at the clinically relevant levels resulted in clinical improvement. Although adhesive arachnoiditis, secondary arachnoid cysts, and cerebrospinal fluid flow abnormalities resulting in syrinx are rare following aneurysmal SAH, early recognition and appropriate intervention lead to good clinical outcomes. PMID:25083391

  9. Compressive Cervicothoracic Adhesive Arachnoiditis following Aneurysmal Subarachnoid Hemorrhage: A Case Report and Literature Review.

    PubMed

    Rahmathulla, Gazanfar; Kamian, Kambiz

    2014-08-01

    We present the case of a 55-year-old woman with diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine following posterior inferior cerebellar artery aneurysmal subarachnoid hemorrhage (SAH). She underwent aneurysm clipping with subsequent gradual neurologic decline associated with sensory disturbances, gait ataxia, and spastic paraparesis. Magnetic resonance imaging revealed diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine, syringobulbia, and multiple arachnoid cysts in the cervicothoracic spine along with syringohydromyelia. Early surgical intervention with microlysis of the adhesions and duraplasty at the clinically relevant levels resulted in clinical improvement. Although adhesive arachnoiditis, secondary arachnoid cysts, and cerebrospinal fluid flow abnormalities resulting in syrinx are rare following aneurysmal SAH, early recognition and appropriate intervention lead to good clinical outcomes.

  10. Posterior fossa decompression combined with resection of the cerebellomedullary fissure membrane and expansile duraplasty: a radical and rational surgical treatment for Arnold-Chiari type I malformation.

    PubMed

    Liang, Chen Jian; Dong, Qiu Jian; Xing, You Heng; Shan, Ma; Wen, Lian Xiao; Qiang, Zhong Yuan; Ping, Zhang Qing; Tao, Peng Zhi; Ping, Huang Xiao

    2014-12-01

    This study aims to introduce a new surgical procedure for the treatment of Arnold-Chiari type I malformation (ACM-1) and to compare its effectiveness with the techniques described in previous studies. We performed the following procedures: foramen magnum decompression combined with the removal of both the atlanto-occipital membrane, extended resection of the cerebellomedullary fissure arachnoid membrane, and artificial duraplasty to enlarge the membranic posterior fossa without resecting the cerebellar tonsils and syringosubarachnoid shunting. There were 21 ACM-1 patients: 12 cases had osteo-compression on the cerebellar hemisphere, 18 cases had thickened adhered fabric ring that stretched from arachnoid membrane to cerebellar hemisphere, and 15 cases with syringomyelia. The patients were followed up for 6 months to 3 years after the surgery. All patients showed a remarkable recovery of syringomyelia. There were no morbidity or death related to the surgery. Most of ACM-1 patients, the osteo- and membrane compression on cerebellar hemisphere and tonsil were observed during the operation. Therefore, decompression of foramen magnum and posterior craniocervical combined with the removal of cerebellomedullary fissure arachnoid membrane and placement of an artificial dural graft should be considered as a comprehensive option of minimally invasive surgery and rational and radical treatment of ACM-1. Our experience showed that, by using our procedure, shunting becomes no longer necessary in the treatment of ACM-1-associated syringomyelia.

  11. Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery

    PubMed Central

    Heymanns, Verena; Oseni, Abidemi W.; Alyeldien, Ameer; Maslehaty, Homajoun; Parvin, Richard; Scholz, Martin

    2016-01-01

    Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark), Gelfoam® (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature. PMID:27478578

  12. Acute posterior fossa epidural hematoma in a newborn infant with Menkes disease.

    PubMed

    Takeuchi, Satoru; Horikawa, Masahiro; Wakamatsu, Hajime; Hashimoto, Jyunya; Nawashiro, Hiroshi

    2014-02-01

    Epidural hematoma (EDH) in newborn infants is rare compared with other types of intracranial hemorrhages. Furthermore, posterior fossa EDH is extremely rare. We present a case of posterior fossa EDH in an infant with Menkes disease with accessory bones in the occiput. A male infant with a condition diagnosed with Menkes disease by prenatal testing was born at 39 weeks via vacuum extraction. The patient presented with a mild tremor at 2 days after delivery. A brain computed tomography (CT) scan showed an acute EDH in the posterior fossa, extending into the occipitoparietal area. Three-dimensional CT and bone window CT scan revealed several accessory bones, diastasis of 1 accessory suture, a communicated fracture, and a linear fracture in the occipital bone. Furthermore, a bone fragment from a communicated fracture displaced toward the inside. The patient was treated conservatively for EDH because of his good general condition. The hematoma gradually resolved, and his tremor did not recur. We suggest the following mechanism of posterior fossa EDH development in our patient: (1) external force was applied to the occiput inside the birth canal during delivery, resulting in diastasis; (2) a communicated fracture occurred, and a bone fragment displaced toward the inside (linear fracture was caused indirectly by the force); (3) a transverse sinus was injured by the fragment; and (4) EDH developed in both the posterior fossa and supratentorial region. Copper deficiency can also cause fragility of connective tissues, vessels, and bones.

  13. Unilateral abducens and bilateral facial nerve palsies associated with posterior fossa exploration surgery

    PubMed Central

    Khalil, Ayman; Clerkin, James; Mandiwanza, Tafadzwa; Green, Sandra; Javadpour, Mohsen

    2016-01-01

    Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are different theories to explain this presentation, but the exact mechanism remains unclear. We propose that this patient cranial nerve palsies developed following cerebrospinal fluid (CSF) leak, potentially as a consequence of rapid change in CSF dynamics. PMID:26951144

  14. Cranial nerve assessment in posterior fossa tumors with fast imaging employing steady-state acquisition (FIESTA).

    PubMed

    Mikami, Takeshi; Minamida, Yoshihiro; Yamaki, Toshiaki; Koyanagi, Izumi; Nonaka, Tadashi; Houkin, Kiyohiro

    2005-10-01

    Steady-state free precession is widely used for ultra-fast cardiac or abdominal imaging. The purpose of this work was to assess fast imaging employing steady-state acquisition (FIESTA) and to evaluate its efficacy for depiction of the cranial nerve affected by the tumor. Twenty-three consecutive patients with posterior fossa tumors underwent FIESTA sequence after contrast agent administration, and then displacement of the cranial nerve was evaluated. The 23 patients with posterior fossa tumor consisted of 12 schwannomas, eight meningiomas, and three cases of epidermoid. Except in the cases of epidermoid, intensity of all tumors increased on FIESTA imaging of the contrast enhancement. In the schwannoma cases, visualization of the nerve became poorer as the tumor increased in size. In cases of encapsulated meningioma, all the cranial nerves of the posterior fossa were depicted regardless of location. The ability to depict the nerves was also significantly higher in meningioma patients than in schwannoma patients (P<0.05). In cases of epidermoid, extension of the tumors was depicted clearly. Although the FIESTA sequence offers similar contrast to other heavily T2-weighted sequences, it facilitated a superior assessment of the effect of tumors on cranial nerve anatomy. FIESTA sequence was useful for preoperative simulations of posterior fossa tumors.

  15. A Cognitive and Affective Pattern in Posterior Fossa Strokes in Children: A Case Series

    ERIC Educational Resources Information Center

    Kossorotoff, Manoelle; Gonin-Flambois, Coralie; Gitiaux, Cyril; Quijano, Susana; Boddaert, Nathalie; Bahi-Buisson, Nadia; Barnerias, Christine; Dulac, Olivier; Brunelle, Francis; Desguerre, Isabelle

    2010-01-01

    Aim: Posterior fossa strokes account for about 10% of ischaemic strokes in children. Although motor and dysautonomic symptoms are common, to our knowledge cognitive and affective deficits have not been described in the paediatric literature. Our aim, therefore, was to describe these symptoms and deficits. Method: In a retrospective study, we…

  16. 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.

  17. Morphometric analysis of posterior fossa in Indian CP angle acoustic schwannoma patients

    PubMed Central

    Patibandla, Mohana Rao; Panigrahi, Manas K.; Gurram, Paniraj L.; Thotakura, Amit Kumar; Kulkarni, Dilip

    2016-01-01

    Aim: To study the morphometry of posterior fossa in Indian CP angle schwannoma patients in order to know its influence on the extent of excision of the CP angle acoustic schwannomas. Materials and Methods: One hundred cases of cerebellopontine angle schwannomas treated surgically by the senior author and 20 controls between January 2006 and June 2011 were consecutively investigated with computed tomography (CT) using the high-resolution CT bone windows before surgery. Evaluation of anatomic parameters of the petrous bone and posterior fossa cavity were done in all patients and controls. Data were entered in Excel software and were analyzed using NCSS software. All possible regression analysis was done to select the important variables to be included in the model to predict the excision of tumor with these variables. A prediction model was developed defining the binary outcome as total excision or subtotal excision as dependent variable and the morphometric data and grading of tumor as independent variables. Results: Interpetrous distance (IP) is the distance between the two petrous apices. Sigmoid distance (IS) distance is the distance between the two sigmoid points. Sigmoid point is the point at which the scalloped impression of the sigmoid sinus straightens to join the occipital bone posteriorly. SAG is the distance between the mid IP point and the mid-point on the inner wall of the occipital bone. The PM angle was 47.8±4.14 degrees (38-58), the PA angle was 42.68±4.47 degrees (34-53), the IP distance was 2.07±0.13 cm (1.5-2.8), the sagittal diameter of posterior fossa was 6.22±0.73 cm (5.1-9.8) and the intersigmoid distance was 9.45±0.73 cm (7.4-11). There was no significant gender difference in the posterior fossa morphometry between patients and controls. Inter-sigmoid distance and the petrous-apex angle were more in the Indians when compared to the European population mentioned in the Mathies and Samii study. Conclusions: The posterior fossa

  18. Cerebellar Mutism Syndrome After Posterior Fossa Surgery: A Report of Two Cases of Pilocytic Astrocytoma

    PubMed Central

    GÜNDÜZ, Hasan Burak; YASSA, Mustafa İlker Kuntay; OFLUOĞLU, Ali Ender; POSTALCI, Lütfü; EMEL, Erhan

    2013-01-01

    Cerebellar mutism is a type of syndrome including decreased speech, hypotonia, ataxia and emotional instability which occurs after posterior fossa surgery. It has been first reported by Rekate et al. and Yonemasu in 1985. It is well known that long tract signs and lower cranial nerve involvement are not seen with this syndrome and understanding is preserved. However, the pathophysiology of cerebellar mutism has not been well clarified yet. It is mainly seen in patients with medulloblastoma and brainstem involvement. In this report, we present two extraordinary cases of cerebellar mutism after posterior fossa surgery. They were considered extraordinary because their hystopathological analysis results yielded pilocytic astrocytoma which is out of the predefined risk factors.

  19. Intracranial Capillary Hemangioma in the Posterior Fossa of an Adult Male

    PubMed Central

    2016-01-01

    Intracranial capillary hemangioma (ICH) is a rare entity, with approximately 24 reported cases in the literature. There are only three reported cases of ICH in an adult male. In this case report, we describe the fourth documented case of ICH in an adult male and, to the best of our knowledge, the first ever documented case of ICH in the posterior fossa of an adult male. We also discuss its imaging appearance and differential diagnosis. PMID:27747124

  20. Posterior fossa dermoid with Klippel-Feil syndrome in a child.

    PubMed

    Ramzan, Altaf; Khursheed, Nayil; Rumana, Makhdoomi; Abrar, Wani; Ashish, Jain

    2011-09-01

    Intracranial dermoid tumors constitute a rare entity. Their association with Klippel-Feil anomaly is all the more rare. These lesions, if associated with dermal sinuses, receive attention when a patient presents with features of central nervous system infection. We describe a 5-year-old girl who presented with purulent discharge from an occipital dermal sinus with an infected posterior fossa dermoid associated with cerebellar abscesses and characteristic Klippel-Feil anomaly.

  1. [Congenital medulloblastoma associated with intracranial arachnoid cyst].

    PubMed

    Gelabert González, Miguel; Serramito-García, Ramón; Liñares Paz, Mercedes; Aran-Echabe, Eduardo; García-Allut, Alfredo

    2014-01-01

    Arachnoid cysts are very common lesions in paediatric patients, with treatment depending on their location and symptomatology. They are usually solitary cysts but may be associated with other central nervous system diseases such as tumours and congenital deformities. We describe the case of a neonate diagnosed with an arachnoid cyst of the quadrigeminal cistern treated by endoscopy. After the operation, the child's condition worsened; a CT scan revealed a midline posterior fossa tumour not visible in the preoperative neuroradiological tests. The tumour, a medulloblastoma, was partially removed. Given the child's age and the poor prognosis, oncological treatment was not undertaken. The association between medulloblastoma and arachnoid cyst is very rare, and we could find only one such case in the literature.

  2. The use of wavelet filters for reducing noise in posterior fossa Computed Tomography images

    SciTech Connect

    Pita-Machado, Reinado; Perez-Diaz, Marlen Lorenzo-Ginori, Juan V. Bravo-Pino, Rolando

    2014-11-07

    Wavelet transform based de-noising like wavelet shrinkage, gives the good results in CT. This procedure affects very little the spatial resolution. Some applications are reconstruction methods, while others are a posteriori de-noising methods. De-noising after reconstruction is very difficult because the noise is non-stationary and has unknown distribution. Therefore, methods which work on the sinogram-space don’t have this problem, because they always work over a known noise distribution at this point. On the other hand, the posterior fossa in a head CT is a very complex region for physicians, because it is commonly affected by artifacts and noise which are not eliminated during the reconstruction procedure. This can leads to some false positive evaluations. The purpose of our present work is to compare different wavelet shrinkage de-noising filters to reduce noise, particularly in images of the posterior fossa within CT scans in the sinogram-space. This work describes an experimental search for the best wavelets, to reduce Poisson noise in Computed Tomography (CT) scans. Results showed that de-noising with wavelet filters improved the quality of posterior fossa region in terms of an increased CNR, without noticeable structural distortions.

  3. Identifying quantitative imaging features of posterior fossa syndrome in longitudinal MRI

    PubMed Central

    Spiteri, Michaela; Windridge, David; Avula, Shivaram; Kumar, Ram; Lewis, Emma

    2015-01-01

    Abstract. Up to 25% of children who undergo brain tumor resection surgery in the posterior fossa develop posterior fossa syndrome (PFS). This syndrome is characterized by mutism and disturbance in speech. Our hypothesis is that there is a correlation between PFS and the occurrence of hypertrophic olivary degeneration (HOD) in structures within the posterior fossa, known as the inferior olivary nuclei (ION). HOD is exhibited as an increase in size and intensity of the ION on an MR image. Longitudinal MRI datasets of 28 patients were acquired consisting of pre-, intra-, and postoperative scans. A semiautomated segmentation process was used to segment the ION on each MR image. A full set of imaging features describing the first- and second-order statistics and size of the ION were extracted for each image. Feature selection techniques were used to identify the most relevant features among the MRI features, demographics, and data based on neuroradiological assessment. A support vector machine was used to analyze the discriminative features selected by a generative k-nearest neighbor algorithm. The results indicate the presence of hyperintensity in the left ION as the most diagnostically relevant feature, providing a statistically significant improvement in the classification of patients (p=0.01) when using this feature alone. PMID:26835496

  4. Reversible dyscognition in patients with a unilateral, middle fossa arachnoid cyst revealed by using a laptop based neuropsychological test battery (CANTAB).

    PubMed

    Torgersen, Johan; Helland, Christian; Flaatten, Hans; Wester, Knut

    2010-11-01

    The aim of this study was to evaluate and validate the Cambridge Neuropsychological Test Automated Battery (CANTAB) in a Norwegian group of patients undergoing surgery for middle fossa arachnoid cysts (AC). We also wanted to assess health related quality of life (HRQOL) in these patients to see if it could be improved by decompression of the AC. Adult patients (>18 years) with unilateral middle fossa AC and no previous history of neurological disease, head injury, or a psychiatric disorder were eligible for inclusion. We used four tests from CANTAB to assess the level of neuropsychological performance: paired associate learning (PAL) and delayed matching to sample (DMS) assessed temporal lobe functions, while Stockings of Cambridge (SOC) and intra-extra dimensional (IED) shift focused on frontal lobe functions. Patients with postoperative cerebral complications were reported, but excluded from neuropsychological follow-up. In addition to the CANTAB data, pre- and postoperative clinical and radiological data were collected. HRQOL was assessed using Short Form 36 (SF-36) pre- and postoperatively. We found significant improvement in the two temporal tests assessing memory, but no improvement in the two frontal tests assessing executive function. HRQOL was significantly reduced preoperatively in two of eight SF-36 domains and improved significantly in four domains postoperatively. CANTAB facilitates detection of cognitive improvements after decompression of the cyst in patients with AC in the middle fossa. The improvements were detected on the tests sensitive to temporal lobe problems only, not on the tests more sensitive to frontal lobe affection. This establishes construct validity for CANTAB for the first time in this population.

  5. Vascular endothelial growth factor expression and bone formation in posterior glenoid fossa during stepwise mandibular advancement.

    PubMed

    Shum, Lily; Rabie, A B M; Hägg, Urban

    2004-02-01

    This study assessed the amount of vascular endothelial growth factor (VEGF) expression and related the findings to new bone formation in the posterior glenoid fossa during stepwise mandibular advancement. A total of 250 female Sprague-Dawley rats, 35 days old, were randomly divided into 10 groups, each including 5 control and 20 experimental rats. Within each group, 10 experimental rats were fitted with functional appliances with a 1-step advancement of 3.5 mm. Another 10 were fitted with stepwise appliances with an initial advancement of 2 mm and a subsequent increase to 3.5 mm on day 30. The rats in the experimental groups were killed on days 3, 7, 14, 21, 30, 33, 37, 44, 51, and 60, respectively. The matched controls were killed on the same time points. Sections (7 microm) were cut through the glenoid fossa sagittally and stained with anti-VEGF antibody. VEGF expression in the posterior glenoid fossa was evaluated with a computer-assisted image-analyzing system. Both VEGF expression and new bone formation were greater in the experimental rats than in the controls. During stepwise advancement, initial VEGF expression was less than that of 1-step advancement, but the second advancement elicited another peak on day 44. New bone formation was also less than that of 1-step advancement during early stages of stepwise advancement but then began to increase from day 37 onward. The maximum increase was observed on day 60. Stepwise advancement of the mandible delivers mechanical stimuli that produce a series of tissue responses that lead to increased vascularization and bone formation.

  6. Functional and neuropsychological late outcomes in posterior fossa tumors in children.

    PubMed

    Lassaletta, Alvaro; Bouffet, Eric; Mabbott, Donald; Kulkarni, Abhaya V

    2015-10-01

    Tumors of the posterior fossa (PF) account for up to 60 % of all childhood intracranial tumors. Over the last decades, the mortality rate of children with posterior fossa tumors has gradually decreased. While survival has been the primary objective in most reports, quality of survival increasingly appears to be an important indicator of a successful outcome. Children with a PF tumor can sustain damage to the cerebellum and other brain structures from the tumor itself, concomitant hydrocephalus, the consequences of treatment (surgery, chemotherapy, radiotherapy), or a combination of these factors. Together, these contribute to long-term sequelae in physical functioning, neuropsychological late outcomes (including academic outcome, working memory, perception and estimation of time, and selective attention, long-term neuromotor speech deficits, and executive functioning). Long-term quality of life can also be affected by endocrinological complication or the occurrence of secondary tumors. A significant proportion of survivors of PF tumors require long-term special education services and have reduced rates of high school graduation and employment. Interventions to improve neuropsychological functioning in childhood PF tumor survivors include (1) pharmacological interventions (such as methylphenidate, modafinil, or donepezil), (2) cognitive remediation, and (3) home-based computerized cognitive training. In order to achieve the best possible outcome for survivors, and ultimately minimize long-term complications, new interventions must be developed to prevent and ameliorate the neuro-toxic effects experienced by these children.

  7. Late effects of treatment on the intelligence of children with posterior fossa tumors

    SciTech Connect

    Duffner, P.K.; Cohen, M.E.; Thomas, P.

    1983-01-15

    This retrospective pilot study was undertaken to evaluate the late effects of treatment on intelligence in a population of children with posterior fossa tumors. Ten children with posterior fossa tumors treated with radiation and chemotherapy received intellectual evaluations at least one year following diagnosis. Six children had medulloblastomas, one child had a fourth ventricular ependymoma, two children had brainstem gliomas, and one child had a recurrent cerebellar astrocytoma. Children with supratentorial tumors were specifically excluded from the study in order to eliminate the possible influence of the tumor on intellectual functioning. Four children had had intelligence testing in school prior to treatment of their tumor. In each case results following treatment revealed a deterioration of full scale IQ of at least 25 points. Six children did not have prior testing; of these, two had IQ's less than 20. Overall, 50% of the patients had IQ's of less than 80 and 20% had IQ's of greater than 100. Furthermore, four children with normal intelligence (IQ greater than 80) have learning problems requiring special classes. Thus, of the ten children evaluated, all have either dementia, learning disabilities, or evidence of intellectual retardation. This study suggests that aggressive treatment of children with brain tumors may improve survivals but may be associated with significant long-term disabilities.

  8. Pathology, treatment and management of posterior fossa brain tumors in childhood

    SciTech Connect

    Bonner, K.; Siegel, K.R.

    1988-04-01

    Brain tumors are the second most common childhood malignancy. Between 1975 and 1985, 462 newly diagnosed patients were treated at the Children's Hospital of Philadelphia; 207 (45%) tumors arose in the posterior fossa and 255 (55%) appeared supratentorially. A wide variety of histological subtypes were seen, each requiring tumor-specific treatment approaches. These included primitive neuroectodermal tumor (n = 86, 19%), astrocytoma (n = 135, 30%), brainstem glioma (n = 47, 10%), anaplastic astrocytoma (n = 32, 7%), and ependymoma (n = 30, 6%). Because of advances in diagnostic abilities, surgery, radiotherapy, and chemotherapy, between 60% and 70% of these patients are alive today. Diagnostic tools such as computed tomography and magnetic resonance imaging allow for better perioperative management and follow-up, while the operating microscope, CO/sub 2/ laser, cavitron ultrasonic aspirator and neurosurgical microinstrumentation allow for more extensive and safer surgery. Disease specific treatment protocols, utilizing radiotherapy and adjuvant chemotherapy, have made survival common in tumors such as medulloblastoma. As survival rates increase, cognitive, endocrinologic and psychologic sequelae become increasingly important. The optimal management of children with brain tumors demands a multidisciplinary approach, best facilitated by a neuro-oncology team composed of multiple subspecialists. This article addresses incidence, classification and histology, clinical presentation, diagnosis, pre-, intra- and postoperative management, long-term effects and the team approach in posterior fossa tumors in childhood. Management of specific tumor types is included as well. 57 references.

  9. Multifocal melanocytoma of the posterior fossa and subcutaneous scalp in the absence of neurocutaneous melanosis

    PubMed Central

    Pierson, Matt; Marwaha, Nitin; Guzman, Miguel; Mikulec, Anthony A.; Coppens, Jeroen R.

    2016-01-01

    Background: Primary leptomeningeal melanocytic neoplasms of the central nervous system are rare. Multifocal lesions typically occur in the setting of cutaneous melanosis. We present the first report of a posterior fossa melanocytoma and subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. Case Description: We present the case of a 22-year-old male with decreased hearing on the right side, ataxia, nausea, vomiting and a scalp mass. Magnetic resonance imaging (MRI) demonstrated occipital and cerebellopontine (CP) angle masses. The patient underwent gross total resection of the scalp mass and subtotal resection of the CP angle mass. Pathologic examination revealed melanocytoma with intermediate grade. The patient underwent stereotactic radiosurgery to the residual CP angle tumor. This case represents, to the author's knowledge, the first report associating a posterior fossa melanocytoma with a subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. Conclusion: This case introduces the first report of a new variant of multifocal melanocytoma which is not confined to the central nervous system. PMID:27656317

  10. Extramedullary plasmacytoma presenting as a solitary mass in the intracranial posterior fossa.

    PubMed

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Shimia, Mohammad; Mazaheri-Khamene, Ramin; Daghighi, Shadi

    2012-11-01

    A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran.

  11. Extramedullary Plasmacytoma Presenting as a Solitary Mass in the Intracranial Posterior Fossa

    PubMed Central

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Shimia, Mohammad; Mazaheri-Khamene, Ramin; Daghighi, Shadi

    2012-01-01

    A patient with a 3-month history of headache refractory to pain medication was admitted. The CT scan and MRI showed evidence of a posterior fossa mass. This was pathologically confirmed as an extra medullary plasmacytoma (EMP). He had a pathologic fracture of the left humerus 7 years ago while the radiologist was unaware at the time of diagnosis. A solitary bone plasmacytoma (SBP) was the cause of the pathologic fracture. This report includes the first description of MRI findings in a patient with a rare-incidence intracranial solitary extra medullary plasmacytoma (SEP) in Iran. There is a striking similarity between the features of intracranial SEP and meningiomas. Intracranial SEP, although rare, should be included in the differential diagnosis of brain tumors in areas where meningiomas commonly arise. The MRI findings and differential diagnosis of plasmacytoma are reviewed. Before this case report, only few cases have been reported in the literature. Nonetheless, this is the first report of posterior fossa EMP from Iran. PMID:23408237

  12. Anatomical Factors Influencing Selective Vestibular Neurectomy: A Comparison of Posterior Fossa Approaches

    PubMed Central

    Master, Adam N.; Flores, Jose M.; Gardner, L. Gale; Cosetti, Maura K.

    2015-01-01

    Objectives To identify measurable anatomical factors that may guide the surgical approach for posterior fossa selective vestibular neurectomy (SVN) and predict identification of the vestibulocochlear cleavage (VCC) plane. Study Design Dissection of fixed cadaveric heads through retrolabyrinthine and retrosigmoid-internal auditory canal (RSG-IAC) approaches with measurement of landmarks. Setting Cadaveric dissection model. Main Outcome Measures Area of the Trautmann triangle (TT) and the distance from the posterior semicircular canal to the anterior border of the sigmoid along the posterior Donaldson line (pDL). VCC planes from each approach were calculated and compared. Results Overall mean pDL was 8.53 mm (range: 5–11.5 mm); mean TT area was 124 mm2 (range: 95–237 mm2). The VCC was identified in 63% of ears through the retrolabyrinthine (RVN) approach alone, whereas 37% of ears required the RSG-IAC approach. In ears requiring IAC dissection, the VCC was found within 1 to 2 mm distal to the porus. The pDL (p < 0.05) and area of TT (p < 0.05) were significantly larger in the RVN group compared with the RSG-IAC group. Conclusion Ears amenable to the RVN approach had a greater pDL and TT area. These anatomical measurements may have a role in surgical planning and the choice of approach for SVN. PMID:26949584

  13. Incidence, Risks, and Sequelae of Posterior Fossa Syndrome in Pediatric Medulloblastoma

    SciTech Connect

    Korah, Mariam P.; Esiashvili, Natia; Mazewski, Claire M.; Hudgins, Roger J.; Tighiouart, Mourad; Janss, Anna J.; Schwaibold, Frederick P.; Crocker, Ian R.; Curran, Walter J.; Marcus, Robert B.

    2010-05-01

    Purpose: To investigate the incidence, risks, severity, and sequelae of posterior fossa syndrome (PFS) in children with medulloblastoma. Methods and Materials: Between 1990 and 2007, 63 children with medulloblastoma at Emory University and Children's Healthcare of Atlanta were treated with craniectomy followed by radiation. Fifty-one patients were assigned to a standard-risk group, and 12 patients were assigned to a high-risk group. Five patients had <1.5-cm{sup 2} residual tumor, 4 had >=1.5-cm{sup 2} residual tumor, and the remainder had no residual tumor. Eleven patients had disseminated disease. Patients received craniospinal irradiation at a typical dose of 23.4 Gy or 36 Gy for standard- or high-risk disease, respectively. The posterior fossa was given a total dose of 54 or 55.8 Gy. Nearly all patients received chemotherapy following cooperative group protocols. Results: Median follow-up was 7 years. PFS developed in 18 patients (29%). On univariate analysis, brainstem invasion, midline tumor location, younger age, and the absence of radiographic residual tumor were found to be predictors of PFS; the last two variables remained significant on multivariate analysis. From 1990 to 2000 and from 2001 to 2007, the proportions of patients with no radiographic residual tumor were 77% and 94%, respectively. During the same eras, the proportions of patients with PFS were 17% and 39%. Only 4 patients had complete recovery at last follow-up. Conclusions: The incidence of PFS increased in the latter study period and is proportional to more aggressive surgery. Children with midline tumors exhibiting brainstem invasion are at increased risk. With the increased incidence of PFS and the permanent morbidity in many patients, the risks and benefits of complete tumor removal in all patients need to be reexamined.

  14. Therapeutic strategy and long-term outcome of meningiomas located in the posterior cranial fossa.

    PubMed

    Matsui, Toru

    2012-01-01

    The clinical and surgical findings of 41 consecutive cases of posterior cranial fossa meningiomas operated on between January 1987 and December 2011 at Saitama Medical Center/Saitama Medical University were reviewed. The 31 female and 10 male patients were aged from 19 to 74 years (mean 54 years). The tumors were located in the petroclival (N=15), craniovertebral junction (N=6), lateral tentorial (N=12), and cerebellopontine angle (N=8) regions. Mean tumor equivalent diameter was 4.3 cm (range 2-9 cm). Head pain (46.3%) and gait disturbance (26.8%) were the most common presenting symptoms, and cranial neuropathies were the most common neurological signs on admission. Mean preoperative performance status (Karnofsky scale) was 83% (range 40-100%). Surgical approaches to these tumors included presigmoidal transpetrosal, retrosigmoidal, transcondylar, and combined approaches. In 4 cases, a staged procedure was performed. Gross total resection was achieved in 85.4% of patients, and subtotal/partial resection in 12.2%. Surgical mortality was 2.4% and complications were encountered in 11 patients (26.8%) including temporary neurological deficits in 4 patients. The mean follow-up period was 8.2 years, ranging from 1 to 24 years, and the mean performance status of patients at 12 months after the last surgery was 92% (range 0-100%). Recurrence or progression of disease was found in 9.8% of cases. Postoperative adjuvant therapy was performed in 6 cases. My experience suggests that although posterior cranial fossa meningiomas represent a continuing challenge for contemporary neurosurgeons, such tumors may be completely or subtotally removed with low rate of mortality and acceptable morbidity, allowing most of these patients to achieve good outcome in long-term follow up.

  15. The complex arrangement of an "aorto-jejunal paraduodenal" fossa, as revealed by dissection of human posterior parietal peritoneum.

    PubMed

    Barberini, Fabrizio; Zani, Augusto; Ripani, Maurizio; Di Nitto, Valentina; Brunone, Francesca

    2007-01-01

    Peritoneal fossae derive from normal or anomalous coalescence of the peritoneum during fetal development, or from the course of retroperitoneal vessels. Clinically, internal abdominal hernias may be housed inside these fossae. In this report from an autopsy, a singular peritoneal fossa was delimited superiorly by an arcuate serous fold, raised up by the inferior mesenteric vein, and infero-posteriorly by two (right and left) avascular folds, extending from the abdominal aorta to the jejunum. The right fold reached the duodeno-jejunal flexure, which was located on the right side of the aorta. The left fold subdivided into two, anterior and posterior, secondary folds. The anterior fold reached the superior edge of the first jejunal loop, and the posterior fold turned medially to connect with the inferior edge of the proximal limb of the same loop. This fossa consisted of three recesses: superior, Located behind the subserous vascular arch, antero-inferior and postero-inferior, separated by interposition of the left posterior secondary fold, between the jejunum and aorta. The complex arrangement of this fossa suggests that it might have originated from a coalescence arising beyond the duodeno-jejunal flexure and including the first jejunal loop, and from the subserous course of the inferior mesenteric vein. Because of displacement to the right of the flexure, processes of coalescence in a location normally occupied by the ascending duodenum might have occurred in a similar pattern for the jejunum, involving the mesoduodenum and the proximal part of the mesentery. Labyrinthine fossae like this might cause strangulation of internal abdominal hernias and hinder intraoperative maneuvers.

  16. Giant cyst of the cavum septi pellucidi and cavum Vergae with posterior cranial fossa extension: case report.

    PubMed

    Bayar, M A; Gökçek, C; Gökçek, A; Edebali, N; Buharali, Z

    1996-05-01

    The cavum septi pellucidi (CSP) and cavum Vergae (CV) are frequently seen in premature and term infants. These cavities rarely enlarge and become symptomatic we describe a giant CSP and CV cyst in an 18-month-old boy, extending to the posterior cranial fossa and causing hydrocephalus. The literature is reviewed, and the MRI and CT findings of the case are reported.

  17. I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery

    PubMed Central

    Tang, Chaoliang; Chai, Xiaoqing; Kang, Fang; Huang, Xiang; Hou, Tao; Tang, Fei; Li, Juan

    2015-01-01

    Background. The adverse events induced by intubation and extubation may cause intracranial hemorrhage and increase of intracranial pressure, especially in posterior fossa surgery patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients. Methods. Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT) or I-gel facilitated endotracheal tube intubation (Group TI). Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared. Results. Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P < 0.05 versus Group TT). Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasma β-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI. Conclusion. Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery. PMID:26273146

  18. Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour

    ERIC Educational Resources Information Center

    Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

    2011-01-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

  19. Communicating hydrocephalus accompanied by arachnoid cyst in aneurismal subarachnoid hemorrhage.

    PubMed

    Choi, Jae Young; Cha, Seung Heon; Cho, Won Ho; Ko, Jun Kyeung

    2013-12-01

    The authors describe a case of communicating hydrocephalus accompanied by an arachnoid cyst in an aneurismal subarachnoid hemorrhage. A 69-year-old female was referred to our clinic due to the sudden onset of a headache. A head computed tomography scan demonstrated an arachnoid cyst in the right middle fossa with a mass effect and diffuse subarachnoid hemorrhage. Digital subtraction angiography then revealed a left internal carotid-posterior communicating artery aneurysm. The neck of the aneurysm was clipped successfully and the post-operative period was uneventful. However, two months after discharge, the patient reported that her mental status had declined over previous weeks. A cranial computed tomography scan revealed an interval increase in the size of the ventricle and arachnoid cyst causing a midline shift. Simultaneous navigation guided ventriculoperitoneal shunt and cystoperitoneal shunt placement resulted in remarkable radiological and clinical improvements.

  20. Role of the cerebellum in the neurocognitive sequelae of treatment of tumours of the posterior fossa: an update.

    PubMed

    Cantelmi, David; Schweizer, Tom A; Cusimano, Michael D

    2008-06-01

    The lengthened survival of patients with tumours of the posterior fossa has brought awareness of the neurocognitive deficits present in this patient population. In the past, these deficits were thought to be caused by radiotherapy damaging supratentorial structures known to be responsible for cognitive processing. This notion led to the development of new treatment protocols to restrict damage to supratentorial regions by decreasing the radiation dose and the irradiated volume. However, these treatment protocols have only resulted in marginal improvements, sometimes at the expense of long-term survival. Moreover, the current published work reports that non-irradiated patients with tumours of the posterior fossa exhibit similar cognitive impairments to irradiated patients. The growth and treatment of tumours of the posterior fossa also damage infratentorial structures, including the cerebellum. Findings from anatomical, clinical, and neuroimaging studies support a role for the cerebellum in cognitive functions similar to those impaired in patients with a tumour of the posterior fossa. Despite these findings, research focused on the treatment of these patients and on decreasing their cognitive impairments either ignores that the cerebellum has been implicated in non-motor functions or argues against the possibility that damage to the cerebellum might result in cognitive sequelae. Future studies need to address the possibility that the cognitive impairments of patients with tumours of the posterior fossa might be determined by a combination of factors, including damage to the cerebellum. Recognition of the important cognitive contributions of the cerebellum might lead to improved cognitive outcome and quality of life for this patient population.

  1. [Arachnoid cysts of the middle cranial fossa in children. A review of 75 cases, 47 of which have been operated in a comparative study between membranectomy with opening of cisterns and cystoperitoneal shunt].

    PubMed

    Lena, G; Erdincler, P; Van Calenberg, F; Genitori, L; Choux, M

    1996-01-01

    The authors report their experience concerning 75 cases of middle fossa arachnoid cysts observed in children during the period 1975-1993, 47 of which (62.6%) were operated upon. The aim of this study was to study the clinical presentation of these cysts, to discuss the surgical indications and to compare the results of the various techniques used to treat these malformations. Head injury was revealing in 17 cases (22.6%) and among these, 12 patients presented intracranial complications (subdural effusions; 6 cases, subdural hematomas: 4 cases and intracystic hematomas: 2 cases). The most usual signs and symptoms were: intracranial hypertension (25.3%), epilepsy (16%) and temporal bulging (24%). Twenty-one patients (44.7%) underwent a cystoperitoneal shunt; 20 patients (42.5%) were treated by membranectomy with opening of the basal cisterns and removal of intracystic (2 cases) or subdural hematoma (4 cases); 2 patients (4.3%) were treated using membranectomy, opening of the cisterns and cystoperitoneal shunt and 4 patients (8.4%) underwent a subduroperitoneal shunt. The long-term results were good regardless of the surgical procedure; nevertheless, only one patient among 20 cases treated by membranectomy and opening of the cisterns developped complications (5%), while multiple shunt revisions were necessary in 11 children (40.7%) out of 27 where a shunt was inserted. The authors conclude that membranectomy and opening of the basal cisterns is the procedure of choice to treat middle fossa arachnoid cysts in children.

  2. Posterior fossa syndrome with a large inflammatory ponto-mesencephalic lesion.

    PubMed

    Breit, S; Keserü, B; Nyffeler, T; Sturzenegger, M; Krestel, H

    2017-02-01

    Demonstration of a posterior fossa syndrome (PFS) in a 32-year-old male patient with clinically isolated syndrome which subsequently developed into relapsing-remitting Multiple Sclerosis. The patient suffered from double vision, coordination problems including unsteady gait and atactic dysarthria, concentration difficulties, as well as adynamia and impaired decision making. The patient clinically presented a cerebellar and dysexecutive syndrome. Cerebral magnetic resonance imaging (MRI) revealed a contrast enhancing ponto-mesencephalic lesion with a volume of 4.8cm(3). Neuropsychological tests showed pronounced executive dysfunctions, reduced visuoconstructive skills, attentional deficits, echolalia, and non-fluent speech production. After cortisone and plasmapheresis, the cerebellar syndrome improved but manual fine motor skills and executive dysfunctions persisted. After three months, symptoms remitted except for a slight gait imbalance. After six months, neuropsychological tests were normal except for a moderate attention deficit. MRI revealed a clear regression of the ponto-mesencephalic lesion to a volume of 2.4cm(3) without contrast enhancement. This case report intends to provide an overview of the symptomatology and etiology of PFS and offers new insights into its pathomechanism demonstrating a pontine disconnection syndrome caused by a large demyelinating plaque.

  3. Declarative and procedural learning in children and adolescents with posterior fossa tumours

    PubMed Central

    Quintero-Gallego, Eliana A; Gómez, Carlos M; Casares, Encarnación Vaquero; Márquez, Javier; Pérez-Santamaría, Fco Javier

    2006-01-01

    Background This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma), given that memory has an important impact on the child's academic achievement and personal development. Methods We had three groups: two clinical (eighteen subjects) and one control (twelve subjects). The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version [1] of the California Verbal Learning Test-Children's Version- CVLT- [2] to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available Results The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups. Conclusion The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning. PMID:16539720

  4. Tension pneumocephalus after posterior fossa craniotomy: report of four additional cases and review of postoperative pneumocephalus.

    PubMed

    Toung, T; Donham, R T; Lehner, A; Alano, J; Campbell, J

    1983-02-01

    Four cases of tension pneumocephalus after either posterior fossa craniotomy or translabyrinthine resection of acoustic neuroma with or without nitrous oxide anesthesia are described. Three of the operations were performed with the patient in the sitting position, and one was done with the patient in the lateral position. Of the three cases operated in the sitting position, no nitrous oxide was used at any time during anesthesia in one. Two patients failed to regain consciousness after the termination of anesthesia, and the other two developed the sudden onset of neurological symptoms 1 to 1.5 hours after the operation. In all cases computed tomography disclosed a large subdural collection of air. Re-exploration of the surgical wound or twist drill aspiration of the subdural air resulted in prompt recovery of neurological status in three patients, whereas the other patient's neurological status improved gradually without any specific treatment. The role played by nitrous oxide, the mechanisms by which air enters the intracranial space, the contributory factors, and the predisposing surgical conditions of tension pneumocephalus are reviewed and discussed. Dependent drainage of the cerebrospinal fluid, especially in a patient with coexisting hydrocephalus, seems to be the most important factor for the development of this complication.

  5. Longitudinal MRI assessment: the identification of relevant features in the development of Posterior Fossa Syndrome in children

    NASA Astrophysics Data System (ADS)

    Spiteri, M.; Lewis, E.; Windridge, D.; Avula, S.

    2015-03-01

    Up to 25% of children who undergo brain tumour resection surgery in the posterior fossa develop posterior fossa syndrome (PFS). This syndrome is characterised by mutism and disturbance in speech. Our hypothesis is that there is a correlation between PFS and the occurrence of hypertrophic olivary degeneration (HOD) in lobes within the posterior fossa, known as the inferior olivary nuclei (ION). HOD is exhibited as an increase in size and intensity of the ION on an MR image. Intra-operative MRI (IoMRI) is used during surgical procedures at the Alder Hey Children's Hospital, Liver- pool, England, in the treatment of Posterior Fossa tumours and allows visualisation of the brain during surgery. The final MR scan on the IoMRI allows early assessment of the ION immediately after the surgical procedure. The longitudinal MRI data of 28 patients was analysed in a collaborative study with Alder Hey Children's Hospital, in order to identify the most relevant imaging features that relate to the development of PFS, specifically related to HOD. A semi-automated segmentation process was carried out to delineate the ION on each MRI. Feature selection techniques were used to identify the most relevant features amongst the MRI data, demographics and clinical data provided by the hospital. A support vector machine (SVM) was used to analyse the discriminative ability of the selected features. The results indicate the presence of HOD as the most efficient feature that correlates with the development of PFS, followed by the change in intensity and size of the ION and whether HOD occurred bilaterally or unilaterally.

  6. An unusual and spectacular case of spindle cell lipoma of the posterior neck invading the spinal cervical canal and posterior cranial fossa.

    PubMed

    Petit, Damien; Menei, Philippe; Fournier, Henri-Dominique

    2011-11-01

    The authors describe the first case of spindle cell lipoma of the posterior neck invading the upper cervical spinal canal and the posterior cranial fossa. Spindle cell lipoma is an extremely rare variant of benign lipoma. It usually occurs as a solitary subcutaneous well-circumscribed lesion in the posterior neck or shoulders of adult men. Local aggressiveness is unusual. This 61-year-old man presented with an increased left cerebellar syndrome and headaches. He also had a posterior neck tumefaction, which had been known about for a long time. Computed tomography and MR imaging studies revealed a voluminous mass extending to the upper cervical canal and posterior cranial fossa and eroding the neighboring bones. The lesion was well delimited, and contrast enhancement was intense and heterogeneous. The tumor, which had initially developed under the muscles of the posterior neck, was totally resected. Histological assessment revealed numerous fat cells with spindle cells secreting collagen. The large size of the tumor and the submuscular location, bone erosion, and compression of the CNS were unusual in this rare subtype of benign adipose tumor. Its presentation could simulate a sarcoma.

  7. Inauguration of pediatric neurosurgery by Harvey W. Cushing: his contributions to the surgery of posterior fossa tumors in children. Historical vignette.

    PubMed

    Cohen-Gadol, Aaron A; Spencer, Dennis D

    2004-02-01

    Development of posterior fossa surgery remains Harvey Cushing's hallmark contribution to pediatric neurosurgery. During the era before Cushing, posterior fossa lesions were considered inoperable, and only osseous decompressive surgery was offered. The evolution of Cushing's surgical expertise from subtemporal decompressions to total extirpation of vascular fourth ventricular tumors, combined with a dramatic decrease in his operative mortality rate, reflects the maturation of modern neurosurgical techniques. A comprehensive review of the medical records of Cushing's pediatric patients treated between 1912 and 1932 revealed that procedures such as lateral ventricular puncture (to decrease cerebellar herniation), transvermian approach to midline tumors, and electrocoagulation were the key factors punctuating the path to his pioneering achievements in posterior fossa surgery. The outcome of such operations was improved by his recognition of the importance of tumor mural nodule in cyst recurrence, as well as elucidation of the histogenesis of pediatric posterior fossa tumors to tailor treatment including radiotherapy.

  8. Factors associated with spinal fusion after posterior fossa decompression in pediatric patients with Chiari I malformation and scoliosis.

    PubMed

    Mackel, Charles E; Cahill, Patrick J; Roguski, Marie; Samdani, Amer F; Sugrue, Patrick A; Kawakami, Noriaki; Sturm, Peter F; Pahys, Joshua M; Betz, Randal R; El-Hawary, Ron; Hwang, Steven W

    2016-12-01

    OBJECTIVE The authors performed a study to identify clinical characteristics of pediatric patients diagnosed with Chiari I malformation and scoliosis associated with a need for spinal fusion after posterior fossa decompression when managing the scoliotic curve. METHODS The authors conducted a multicenter retrospective review of 44 patients, aged 18 years or younger, diagnosed with Chiari I malformation and scoliosis who underwent posterior fossa decompression from 2000 to 2010. The outcome of interest was the need for spinal fusion after decompression. RESULTS Overall, 18 patients (40%) underwent posterior fossa decompression alone, and 26 patients (60%) required a spinal fusion after the decompression. The mean Cobb angle at presentation and the proportion of patients with curves > 35° differed between the decompression-only and fusion cohorts (30.7° ± 11.8° vs 52.1° ± 26.3°, p = 0.002; 5 of 18 vs 17 of 26, p = 0.031). An odds ratio of 1.0625 favoring a need for fusion was established for each 1° of increase in Cobb angle (p = 0.012, OR 1.0625, 95% CI 1.0135-1.1138). Among the 14 patients older than 10 years of age with a primary Cobb angle exceeding 35°, 13 (93%) ultimately required fusion. Patients with at least 1 year of follow-up whose curves progressed more 10° after decompression were younger than those without curve progression (6.1 ± 3.0 years vs 13.7 ± 3.2 years, p = 0.001, Mann-Whitney U-test). Left apical thoracic curves constituted a higher proportion of curves in the decompression-only group (8 of 16 vs 1 of 21, p = 0.002). CONCLUSIONS The need for fusion after posterior fossa decompression reflected the curve severity at clinical presentation. Patients presenting with curves measuring > 35°, as well as those greater than 10 years of age, may be at greater risk for requiring fusion after posterior fossa decompression, while patients less than 10 years of age may require routine monitoring for curve progression. Left apical thoracic curves

  9. Changes in cerebrospinal fluid flow assessed using intraoperative MRI during posterior fossa decompression for Chiari malformation.

    PubMed

    Bond, Aaron E; Jane, John A; Liu, Kenneth C; Oldfield, Edward H

    2015-05-01

    OBJECT The authors completed a prospective, institutional review board-approved study using intraoperative MRI (iMRI) in patients undergoing posterior fossa decompression (PFD) for Chiari I malformation. The purpose of the study was to examine the utility of iMRI in determining when an adequate decompression had been performed. METHODS Patients with symptomatic Chiari I malformations with imaging findings of obstruction of the CSF space at the foramen magnum, with or without syringomyelia, were considered candidates for surgery. All patients underwent complete T1, T2, and cine MRI studies in the supine position preoperatively as a baseline. After the patient was placed prone with the neck flexed in position for surgery, iMRI was performed. The patient then underwent a bone decompression of the foramen magnum and arch of C-1, and the MRI was repeated. If obstruction was still present, then in a stepwise fashion the patient underwent dural splitting, duraplasty, and coagulation of the tonsils, with an iMRI study performed after each step guiding the decision to proceed further. RESULTS Eighteen patients underwent PFD for Chiari I malformations between November 2011 and February 2013; 15 prone preincision iMRIs were performed. Fourteen of these patients (93%) demonstrated significant improvement of CSF flow through the foramen magnum dorsal to the tonsils with positioning only. This improvement was so notable that changes in CSF flow as a result of the bone decompression were difficult to discern. CONCLUSIONS The authors observed significant CSF flow changes when simply positioning the patient for surgery. These results put into question intraoperative flow assessments that suggest adequate decompression by PFD, whether by iMRI or intraoperative ultrasound. The use of intraoperative imaging during PFD for Chiari I malformation, whether by ultrasound or iMRI, is limited by CSF flow dynamics across the foramen magnum that change significantly when the patient is

  10. Torticollis secondary to posterior fossa and cervical spinal cord tumors: report of five cases and literature review.

    PubMed

    Kumandaş, Sefer; Per, Hüseyin; Gümüş, Hakan; Tucer, Bülent; Yikilmaz, Ali; Kontaş, Olgun; Coşkun, Abdülhakim; Kurtsoy, Ali

    2006-10-01

    Torticollis is either congenital or acquired in childhood. Acquired torticollis is not a diagnosis but rather a sign of an underlying disorder. The causes of acquired torticollis include ligamentous, muscular, osseous, ocular, psychiatric, and neurologic disorders and may be a symptom of significant abnormalities of the spinal cord and brain, such as spinal syrinx or central nervous system neoplasia. Torticollis is rarely considered to be an initial clinical presentation of posterior fossa and cervical spinal cord tumors. We report five cases of pediatric tumors with torticollis at the onset: an astrocytoma originating from the medulla oblongata, another presumptive astrocytoma of the spinal cord located between C1 and C6 cervical vertebrae (not operated), an ependymoma located throughout the whole cervical spinal cord extending into the bulbomedullary junction, an astrocytoma originating from the bulbus and extending into the posterior fossa, and another case of a eosinophilic granuloma located extradurally through the anterior and posterior portions of the vertebral bodies from C3 to C7 producing the collapse of the sixth cervical vertebra. All five cases were seen in children, aged between 3 and 12 years. All these cases reflect the misinterpretation of this neurological sign and the lack of association with the possibility of spinal or posterior fossa tumor. This delay in the diagnosis of these diseases led to progressive neurological deterioration and to the increase in the tumor size, which made surgical intervention difficult and the prognosis unfavorable. Although torticollis secondary to tumors is rarely seen, it is necessary to be kept in mind in the differential diagnosis.

  11. Endoscopic approach-routes in the posterior fossa cisterns through the retrosigmoid keyhole craniotomy: an anatomical study.

    PubMed

    Kurucz, Peter; Baksa, Gabor; Patonay, Lajos; Thaher, Firas; Buchfelder, Michael; Ganslandt, Oliver

    2016-11-10

    Endoscopy in cerebellopontine angle surgery is an increasingly used technique. Despite of its advantages, the shortcomings arising from the complex anatomy of the posterior fossa are still preventing its widespread use. To overcome these drawbacks, the goal of this study was to define the anatomy of different endoscopic approaches through the retrosigmoid craniotomy and their limitations by surgical windows. Anatomical dissections were performed on 25 fresh human cadavers to describe the main approach-routes. Surgical windows are spaces surrounded by neurovascular structures acting as a natural frame and providing access to deeper structures. The approach-routes are trajectories starting at the craniotomy and pointing to the lesion, passing through certain windows. Twelve different windows could be identified along four endoscopic approach-routes. The superior route provides access to the structures of the upper pons, lower mesencephalon, and the upper neurovascular complex through the suprameatal, superior cerebellar, and infratrigeminal windows. The supratentorial route leads to the basilar tip and some of the suprasellar structures via the ipsi- and contralateral oculomotor and dorsum sellae windows. The central endoscopic route provides access to the middle pons and the middle neurovascular complex through the inframeatal, AICA, and basilar windows. The inferior endoscopic route is the pathway to the medulla oblongata and the lower neurovascular complex through the accessory, hypoglossal, and foramen magnum windows. The anatomy and limitations of each surgical windows were described in detail. These informations are essential for safe application of endoscopy in posterior fossa surgery through the retrosigmoid approach.

  12. The role of visually evoked potentials in the management of hemispheric arachnoid cyst compressing the posterior visual pathways.

    PubMed

    Raja, Vignesh; Kumar, Anupma; Durnian, Jon; Hagan, Richard; Buxton, Neil; Newman, William

    2010-02-01

    We report a case of an occipital arachnoid cyst in an infant, managed on the basis of changes in visually evoked potentials (VEPs). A significant asymmetry of VEP responses prompted neurosurgical intervention, which improved visual behavior and electrical response to both pattern and flash stimuli.

  13. Posterior fossa decompression with tonsillectomy in 104 cases of basilar impression, Chiari malformation and/or syringomyelia.

    PubMed

    da Silva, José Alberto Gonçalves; dos Santos, Adailton Arcanjo; Melo, Luiz Ricardo Santiago; de Araújo, Antônio Fernandes; Regueira, Giseuda Pessoa

    2011-10-01

    The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM) and/or syringomyelia (SM) is based on the restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction through the creation of a large artificial cisterna magna. A small suboccipital craniectomy has been emphasized to avoid caudal migration of the hindbrain structures into the vertebral canal. Nevertheless, the results showed downward migration of the hindbrain related to that type of craniectomy. The authors present, otherwise, the results of 104 cases of BI, CM and/or SM, whose surgical treatment was characterized by a large craniectomy with the patient in the sitting position, tonsillectomy, large opening of the fourth ventricle and duraplasty with creation of a large artificial cisterna magna. A significant upward migration of the posterior fossa structures was detected by postoperative magnetic resonance imaging.

  14. Intraoperative somatosensory evoked potential recovery following opening of the fourth ventricle during posterior fossa decompression in Chiari malformation: case report.

    PubMed

    Grossauer, Stefan; Koeck, Katharina; Vince, Giles H

    2015-03-01

    The most appropriate surgical technique for posterior fossa decompression in Chiari malformation (CM) remains a matter of debate. Intraoperative electrophysiological studies during posterior fossa decompression of Type I CM (CM-I) aim to shed light on the entity's pathomechanism as well as on the ideal extent of decompression. The existing reports on this issue state that significant improvement in conduction occurs after craniotomy in all cases, but additional durotomy contributes a further improvement in only a minority of cases. This implies that craniotomy alone might suffice for clinical improvement without the need of duraplasty or even subarachnoid manipulation at the level of the craniocervical junction. In contrast to published data, the authors describe the case of a 32-year-old woman who underwent surgery for CM associated with extensive cervicothoracic syringomyelia and whose intraoperative somatosensory evoked potentials (SSEPs) did not notably improve after craniotomy or following durotomy; rather, they only improved after opening of the fourth ventricle and restoration of CSF flow through the foramen of Magendie. Postoperatively, the patient recovered completely from her preoperative neurological deficits. To the authors' knowledge, this is the first report of significant SSEP recovery after opening the fourth ventricle in the decompression of a CM-I. The electrophysiological and operative techniques are described in detail and the findings are discussed in the light of available literature. The authors conclude that there might be a subset of CM-I patients who require subarachnoid dissection at the level of the craniocervical junction to benefit clinically. Prospective studies with detailed electrophysiological analyses seem warranted to answer the question regarding the best surgical approach in CM-I decompression.

  15. [A Case of Ruptured Internal Carotid-Posterior Communicating Artery Aneurysm Associated with Acute Subdural Hematoma, Extending from the Interhemispheric Space to the Posterior Fossa].

    PubMed

    Otsuka, Hiroaki; Fukuda, Yuhtaka; Yoshimura, Shouta; Somagawa, Chika; Hiu, Takeshi; Ono, Tomonori; Ushijima, Ryujirou; Toda, Keisuke; Tsutsumi, Keisuke

    2016-06-01

    A 69-year-old woman was admitted to our hospital because of a sudden severe headache without a history of head trauma. CT and MRI revealed an acute subdural hematoma (ASDH) extending from the right interhemispheric space to the posterior fossa bilaterally, with a small amount of subarachnoid hemorrhage that was predominantly localized to the left side of the basal cistern. CT angiogram demonstrated a long protruding ruptured aneurysm at the junction of the right internal carotid and posterior communicating arteries (IC/PC AN) with a posteroinferior projection, associated with a small bleb located near the tentorial edge close to the ipsilateral posterior clinoid process, for which she received clipping surgery. Though rare, IC/PC AN could cause pure or nearly pure ASDH in the above-mentioned distribution. Therefore, in patients with such ASDH, especially without a history of head injury or precise information regarding the situation at the time of onset, urgent imaging evaluation and early intervention are essential to prevent devastating re-rupture events.

  16. Role of cerebellum in fine speech control in childhood: persistent dysarthria after surgical treatment for posterior fossa tumour.

    PubMed

    Morgan, A T; Liégeois, F; Liederkerke, C; Vogel, A P; Hayward, R; Harkness, W; Chong, K; Vargha-Khadem, F

    2011-05-01

    Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen long-term after surgical treatment for childhood PFT, unselected for the presence of post-operative mutism (mean time post-surgery=6y10m, range 1;4-12;6 years, two had post-operative mutism), and examine factors affecting outcome. Twenty-six age- and sex- matched healthy controls were recruited for comparison. Participants in both groups had speech assessments using detailed perceptual and acoustic methods. Over two-thirds of the group (69%) with removal of PFT had a profile of typically mild dysarthria. Prominent speech deficits included consonant imprecision, reduced rate, monopitch and monoloudness. We conclude that speech deficits may persist even up to 10 years post-surgery in participants who have not shown mutism in the acute phase. Of cases with unilateral lesions, poorer outcomes were associated with right cerebellar tumours compared to left, consistent with the notion based on adult data that speech is controlled by reciprocal right cerebellar/left frontal interactions. These results confirm the important role of the cerebellum in the control of fine speech movements in children.

  17. Controlateral cavernous syndrome, brainstem congestion and posterior fossa venous thrombosis with cerebellar hematoma related to a ruptured intracavernous carotid artery aneurysm.

    PubMed

    Aldea, Sorin; Guedin, Pierre; Roccatagliata, Luca; Boulin, Anne; Auliac, Stéphanie; Dupuy, Michel; Cerf, Charles; Gaillard, Stéphan; Rodesch, Georges

    2011-06-01

    Intracavernous carotid artery aneurysms (ICCAs) are rarely associated with life-threatening complications. We describe a 55-year-old woman who, after the rupture of an intracavernous carotid artery aneurysm, presented with a contralateral cavernous sinus syndrome and severe posterior fossa and spinal cord symptoms. Following parent artery occlusion, thrombosis of the posterior fossa and spinal cord veins caused a progressive worsening of the neurological status to a "locked-in" state. The patient fully recovered with anticoagulation therapy. Comprehension of the pathophysiological mechanism associated with the rupture of ICCA and early diagnosis of the related symptoms are essential in order to plan a correct treatment that includes the management of the aneurysm rupture and of possible complications related to venous thrombosis.

  18. Two alternative dural sealing techniques in posterior fossa surgery: (Polylactide-co-glycolide) self-adhesive resorbable membrane versus polyethylene glycol hydrogel

    PubMed Central

    Schiariti, Marco; Acerbi, Francesco; Broggi, Morgan; Tringali, Giovanni; Raggi, Alberto; Broggi, Giovanni; Ferroli, Paolo

    2014-01-01

    Background: Post-operative cerebrospinal fluid (CSF) leak in posterior fossa surgery remains a significant source of morbidity. TissuePatchDural (TPD), a novel impermeable adhesive membrane, was used to reinforce dural closure. A comparison with one of the most commonly used dural sealing devices, DuraSeal, has been made. Methods: A retrospective, single-center study was conducted on 161 patients who underwent elective posterior fossa surgery. On surgeon's opinion, when a primary watertight closure was not possible, they received TPD or DuraSeal to reinforce dural closure. Results: Out of 161 patients analyzed, 115 were treated with TPD and 46 with DuraSeal. The post-operative leaks related purely to TPD or DuraSeal failure were recognized in 3 (2.6%) and 5 (10.86%) cases, respectively (P = 0.015). The presence of pre- and post-operative risk factors was associated with an increased incidence of CSF leak in both groups. TPD showed a better control in patients without these risk factors (P = 0.08). The incidence of CSF leak in patients who underwent posterior fossa surgery by craniectomy was statistically lower in TPD group compared to DuraSeal group (3.22% vs 17.8%, respectively; P = 0.008) Conclusions: TPD seems to be a safe tool for use as an adjunct to standard dural closure in posterior fossa surgery, particularly in patients without pre- or post-oper ative risk factors, in those who did not develop hydrocephalus, and who underwent craniectomy. The CSF leak rate in TPD group was found to be lower or within the range of the more advanced alternative dural closure strategies, including polyethylene glycol (PEG)-based sealant. PMID:25593755

  19. Arachnoid cyst slit valves: the mechanism for arachnoid cyst enlargement.

    PubMed

    Halani, Sameer H; Safain, Mina G; Heilman, Carl B

    2013-07-01

    Arachnoid cysts are common, accounting for approximately 1% of intracranial mass lesions. Most are congenital, clinically silent, and remain static in size. Occasionally, they increase in size and produce symptoms due to mass effect or obstruction. The mechanism of enlargement of arachnoid cysts is controversial. One-way slit valves are often hypothesized as the mechanism for enlargement. The authors present 4 cases of suprasellar prepontine arachnoid cysts in which a slit valve was identified. The patients presented with hydrocephalus due to enlargement of the cyst. The valve was located in the arachnoid wall of the cyst directly over the basilar artery. The authors believe this slit valve was responsible for the net influx of CSF into the cyst and for its enlargement. They also present 1 case of an arachnoid cyst in the middle cranial fossa that had a small circular opening but lacked a slit valve. This cyst did not enlarge but surgery was required because of rupture and the development of a subdural hygroma. One-way slit valves exist and are a possible mechanism of enlargement of suprasellar prepontine arachnoid cysts. The valve was located directly over the basilar artery in each of these cases. Caudad-to-cephalad CSF flow during the cardiac cycle increased the opening of the valve, whereas cephalad-to-caudad CSF flow during the remainder of the cardiac cycle pushed the slit opening against the basilar artery and decreased the size of the opening. Arachnoid cysts that communicate CSF via circular, nonslit valves are probably more likely to remain stable.

  20. Delayed cerebrospinal fluid leak after watertight dural closure with a polyethylene glycol hydrogel dural sealant in posterior fossa surgery: case report.

    PubMed

    Jito, Junya; Nitta, Naoki; Nozaki, Kazuhiko

    2014-01-01

    A polyethylene glycol (PEG) hydrogel sealant recently has been approved as an adjunct to sutured dural closure in Japan. We treated consecutive six patients with PEG hydrogel sealant in posterior fossa operation. Three of six cases suffered delayed cerebrospinal fluid (CSF) leak after watertight dural closure with the PEG hydrogel sealant, although there was no leak case which was treated with fibrin glue, before 2 years until the adoption of the new material. These patients underwent posterior fossa craniotomy and discharged without remarkable CSF leak. The pseudomeningocele under the occipital wound caused the CSF leak occurr from 5th to 7th week postoperatively. All CSF leak cases needed surgical repair. At the repair, the PEG hydrogel was liquefied and almost absorbed. A fistula on the closure line and a dead space after the absorption of the PEG hydrogel was observed. When the absorbable PEG hydrogel sealant plugs in small gaps of sutured dura, its properties to prevent adhesion might suppress healing process of dural closure, so that CSF could leak through the gaps and collect as a pseudomeningocele in the dead space after absorption of the PEG hydrogel. In posterior fossa surgery a PEG hydrogel sealant should be applied when dural edges are closed tightly without any gaps.

  1. DTI fiber tractography of cerebro-cerebellar pathways and clinical evaluation of ataxia in childhood posterior fossa tumor survivors.

    PubMed

    Oh, Myung Eun; Driever, Pablo Hernáiz; Khajuria, Rajiv K; Rueckriegel, Stefan Mark; Koustenis, Elisabeth; Bruhn, Harald; Thomale, Ulrich-Wilhelm

    2017-01-01

    Pediatric posterior fossa (PF) tumor survivors experience long-term motor deficits. Specific cerebrocerebellar connections may be involved in incidence and severity of motor dysfunction. We examined the relationship between long-term ataxia as well as fine motor function and alteration of differential cerebellar efferent and afferent pathways using diffusion tensor imaging (DTI) and tractography. DTI-based tractography was performed in 19 patients (10 pilocytic astrocytoma (PA) and 9 medulloblastoma patients (MB)) and 20 healthy peers. Efferent Cerebello-Thalamo-Cerebral (CTC) and afferent Cerebro-Ponto-Cerebellar (CPC) tracts were reconstructed and analyzed concerning fractional anisotropy (FA) and volumetric measurements. Clinical outcome was assessed with the International Cooperative Ataxia Rating Scale (ICARS). Kinematic parameters of fine motor function (speed, automation, variability, and pressure) were obtained by employing a digitizing graphic tablet. ICARS scores were significantly higher in MB patients than in PA patients. Poorer ICARS scores and impaired fine motor function correlated significantly with volume loss of CTC pathway in MB patients, but not in PA patients. Patients with pediatric post-operative cerebellar mutism syndrome showed higher loss of CTC pathway volume and were more atactic. CPC pathway volume was significantly reduced in PA patients, but not in MB patients. Neither relationship was observed between the CPC pathway and ICARS or fine motor function. There was no group difference of FA values between the patients and healthy peers. Reduced CTC pathway volumes in our cohorts were associated with severity of long-term ataxia and impaired fine motor function in survivors of MBs. We suggest that the CTC pathway seems to play a role in extent of ataxia and fine motor dysfunction after childhood cerebellar tumor treatment. DTI may be a useful tool to identify relevant structures of the CTC pathway and possibly avoid surgically induced long

  2. Clinical and methodological confounders in assessing the cerebellar cognitive affective syndrome in adult patients with posterior fossa tumours.

    PubMed

    Omar, Dashne; Ryan, Tracy; Carson, Alan; Bak, Thomas H; Torrens, Lorna; Whittle, Ian

    2014-12-01

    The cerebellar cognitive affective syndrome (CCAS) was first described by Schmahmann and Sherman as a constellation of symptoms including dysexecutive syndrome, spatial cognitive deficit, linguistic deficits and behavioural abnormalities in patients with a lesion in the cerebellum with otherwise normal brain. Neurosurgical patients with cerebellar tumours constitute one of the cohorts in which the CCAS has been described. In this paper, we present a critical review of the literature of this syndrome in neurosurgical patients. Thereafter, we present a prospective clinical study of 10 patients who underwent posterior fossa tumour resection and had a detailed post-operative neuropsychological, neuropsychiatric and neuroradiological assessment. Because our findings revealed a large number of perioperative neuroradiological confounding variables, we reviewed the neuroimaging of a further 20 patients to determine their prevalence. Our literature review revealed that study design, methodological quality and sometimes both diagnostic criteria and findings were inconsistent. The neuroimaging study (pre-operative, n = 10; post-operative, n = 10) showed very frequent neuroradiological confounding complications (e.g. hydrocephalus; brainstem compression; supratentorial lesions and post-operative subdural hygroma); the impact of such features had largely been ignored in the literature. Findings from our clinical study showed various degree of deficits in neuropsychological testing (n = 1, memory; n = 3, verbal fluency; n = 3, attention; n = 2, spatial cognition deficits; and n = 1, behavioural changes), but no patient had full-blown features of CCAS. Our study, although limited, finds no robust evidence of the CCAS following surgery. This and our literature review highlight a need for guidelines regarding study design and methodology when attempting to evaluate neurosurgical cases with regard to the potential CCAS.

  3. MR-Based Morphometry of the Posterior Fossa in Fetuses with Neural Tube Defects of the Spine

    PubMed Central

    Woitek, Ramona; Dvorak, Anton; Weber, Michael; Seidl, Rainer; Bettelheim, Dieter; Schöpf, Veronika; Amann, Gabriele; Brugger, Peter C.; Furtner, Julia; Asenbaum, Ulrika; Prayer, Daniela; Kasprian, Gregor

    2014-01-01

    Objectives In cases of “spina bifida,” a detailed prenatal imaging assessment of the exact morphology of neural tube defects (NTD) is often limited. Due to the diverse clinical prognosis and prenatal treatment options, imaging parameters that support the prenatal differentiation between open and closed neural tube defects (ONTDs and CNTDs) are required. This fetal MR study aims to evaluate the clivus-supraocciput angle (CSA) and the maximum transverse diameter of the posterior fossa (TDPF) as morphometric parameters to aid in the reliable diagnosis of either ONTDs or CNTDs. Methods The TDPF and the CSA of 238 fetuses (20–37 GW, mean: 28.36 GW) with a normal central nervous system, 44 with ONTDS, and 13 with CNTDs (18–37 GW, mean: 24.3 GW) were retrospectively measured using T2-weighted 1.5 Tesla MR -sequences. Results Normal fetuses showed a significant increase in the TDPF (r = .956; p<.001) and CSA (r = .714; p<.001) with gestational age. In ONTDs the CSA was significantly smaller (p<.001) than in normal controls and CNTDs, whereas in CNTDs the CSA was not significantly smaller than in controls (p = .160). In both ONTDs and in CNTDs the TDPF was significantly different from controls (p<.001). Conclusions The skull base morphology in fetuses with ONTDs differs significantly from cases with CNTDs and normal controls. This is the first study to show that the CSA changes during gestation and that it is a reliable imaging biomarker to distinguish between ONTDs and CNTDs, independent of the morphology of the spinal defect. PMID:25393279

  4. Posterior fossa tumor

    MedlinePlus

    ... and the tumor can easily press on delicate structures if it grows. Depending on the type and size of the tumor, radiation treatment may also be used after surgery. Support Groups You can ease the stress of illness ...

  5. Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation type I in adult patients

    PubMed Central

    Chen, Junchen; Li, Yongning; Wang, Tianyu; Gao, Jun; Xu, Jincheng; Lai, Runlong; Tan, Dianhui

    2017-01-01

    Abstract Chiari malformation type I (CM-I) is a congenital neurosurgical disease about the herniation of cerebellar tonsil through the foramen magnum. A variety of surgical techniques for CM-I have been used, and there is a controversy whether to use posterior fossa decompression with duraplasty (PFDD) or posterior fossa decompression without duraplasty (PFD) in CM-I patients. Here, we compared the clinical results and effectiveness of PFDD and PFD in adult patients with CM-I. The cases of 103 adult CM-I patients who underwent posterior fossa decompression with or without duraplasty from 2008 to 2014 were reviewed retrospectively. Patients were divided into 2 groups according to the surgical techniques: PFDD group (n = 70) and PFD group (n = 33). We compared the demographics, preoperative symptoms, radiographic characteristics, postoperative complications, and clinical outcomes between the PFD and PFDD patients. No statistically significant differences were found between the PFDD and PFD groups with regard to demographics, preoperative symptoms, radiographic characteristics, and clinical outcomes(P > 0.05); however, the postoperative complication aseptic meningitis occurred more frequently in the PFDD group than in the PFD group (P = 0.027). We also performed a literature review about the PFDD and PFD and made a summary of these preview studies. Our study suggests that both PFDD and PFD could achieve similar clinical outcomes for adult CM-I patients. The choice of surgical procedure should be based on the patient's condition. PFDD may lead to a higher complication rate and autologous grafts seemed to perform better than nonautologous grafts for duraplasty. PMID:28121938

  6. Computational Investigation of Cerebrospinal Fluid Dynamics in the Posterior Cranial Fossa and Cervical Subarachnoid Space in Patients with Chiari I Malformation

    PubMed Central

    Støverud, Karen-Helene; Langtangen, Hans Petter; Ringstad, Geir Andre; Eide, Per Kristian; Mardal, Kent-Andre

    2016-01-01

    Purpose Previous computational fluid dynamics (CFD) studies have demonstrated that the Chiari malformation is associated with abnormal cerebrospinal fluid (CSF) flow in the cervical part of the subarachnoid space (SAS), but the flow in the SAS of the posterior cranial fossa has received little attention. This study extends previous modelling efforts by including the cerebellomedullary cistern, pontine cistern, and 4th ventricle in addition to the cervical subarachnoid space. Methods The study included one healthy control, Con1, and two patients with Chiari I malformation, P1 and P2. Meshes were constructed by segmenting images obtained from T2-weighted turbo spin-echo sequences. CFD simulations were performed with a previously verified and validated code. Patient-specific flow conditions in the aqueduct and the cervical SAS were used. Two patients with the Chiari malformation and one control were modelled. Results The results demonstrated increased maximal flow velocities in the Chiari patients, ranging from factor 5 in P1 to 14.8 in P2, when compared to Con1 at the level of Foramen Magnum (FM). Maximal velocities in the cervical SAS varied by a factor 2.3, while the maximal flow in the aqueduct varied by a factor 3.5. The pressure drop from the pontine cistern to the cervical SAS was similar in Con1 and P1, but a factor two higher in P2. The pressure drop between the aqueduct and the cervical SAS varied by a factor 9.4 where P1 was the one with the lowest pressure jump and P2 and Con1 differed only by a factor 1.6. Conclusion This pilot study demonstrates that including the posterior cranial fossa is feasible and suggests that previously found flow differences between Chiari I patients and healthy individuals in the cervical SAS may be present also in the SAS of the posterior cranial fossa. PMID:27727298

  7. Texture analysis of T1- and T2-weighted MR images and use of probabilistic neural network to discriminate posterior fossa tumours in children

    PubMed Central

    Orphanidou-Vlachou, Eleni; Vlachos, Nikolaos; Davies, Nigel P; Arvanitis, Theodoros N; Grundy, Richard G; Peet, Andrew C

    2014-01-01

    Brain tumours are the most common solid tumours in children, representing 20% of all cancers. The most frequent posterior fossa tumours are medulloblastomas, pilocytic astrocytomas and ependymomas. Texture analysis (TA) of MR images can be used to support the diagnosis of these tumours by providing additional quantitative information. MaZda software was used to perform TA on T1- and T2-weighted images of children with pilocytic astrocytomas, medulloblastomas and ependymomas of the posterior fossa, who had MRI at Birmingham Children's Hospital prior to treatment. The region of interest was selected on three slices per patient in Image J, using thresholding and manual outlining. TA produced 279 features, which were reduced using principal component analysis (PCA). The principal components (PCs) explaining 95% of the variance were used in a linear discriminant analysis (LDA) and a probabilistic neural network (PNN) to classify the cases, using DTREG statistics software. PCA of texture features from both T1- and T2-weighted images yielded 13 PCs to explain >95% of the variance. The PNN classifier for T1-weighted images achieved 100% accuracy on training the data and 90% on leave-one-out cross-validation (LOOCV); for T2-weighted images, the accuracy was 100% on training the data and 93.3% on LOOCV. A PNN classifier with T1 and T2 PCs achieved 100% accuracy on training the data and 85.8% on LOOCV. LDA classification accuracies were noticeably poorer. The features found to hold the highest discriminating potential were all co-occurrence matrix derived, where adjacent pixels had highly correlated intensities. This study shows that TA can be performed on standard T1- and T2-weighted images of childhood posterior fossa tumours using readily available software to provide high diagnostic accuracy. Discriminatory features do not correspond to those used in the clinical interpretation of the images and therefore provide novel tumour information. Copyright © 2014 John Wiley

  8. Differences in Supratentorial Damage of White Matter in Pediatric Survivors of Posterior Fossa Tumors With and Without Adjuvant Treatment as Detected by Magnetic Resonance Diffusion Tensor Imaging

    SciTech Connect

    Rueckriegel, Stefan Mark; Driever, Pablo Hernaiz; Blankenburg, Friederike; Luedemann, Lutz; Henze, Guenter; Bruhn, Harald

    2010-03-01

    Purpose: To elucidate morphologic correlates of brain dysfunction in pediatric survivors of posterior fossa tumors by using magnetic resonance diffusion tensor imaging (DTI) to examine neuroaxonal integrity in white matter. Patients and Methods: Seventeen medulloblastoma (MB) patients who had received surgery and adjuvant treatment, 13 pilocytic astrocytoma (PA) patients who had been treated only with surgery, and age-matched healthy control subjects underwent magnetic resonance imaging on a 3-Tesla system. High-resolution conventional T1- and T2-weighted magnetic resonance imaging and DTI data sets were obtained. Fractional anisotropy (FA) maps were analyzed using tract-based spatial statistics, a part of the Functional MRI of the Brain Software Library. Results: Compared with control subjects, FA values of MB patients were significantly decreased in the cerebellar midline structures, in the frontal lobes, and in the callosal body. Fractional anisotropy values of the PA patients were not only decreased in cerebellar hemispheric structures as expected, but also in supratentorial parts of the brain, with a distribution similar to that in MB patients. However, the amount of significantly decreased FA was greater in MB than in PA patients, underscoring the aggravating neurotoxic effect of the adjuvant treatment. Conclusions: Neurotoxic mechanisms that are present in PA patients (e.g., internal hydrocephalus and damaged cerebellar structures affecting neuronal circuits) contribute significantly to the alteration of supratentorial white matter in pediatric posterior fossa tumor patients.

  9. Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note

    PubMed Central

    Felbaum, Daniel R; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

    2016-01-01

    Introduction: Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk. Methods: A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy. Patient data was reviewed for craniotomy or craniectomy, dural graft, and/or sealant use as well as CSF complications. A pseudomeningocele was defined as a subcutaneous collection of cerebrospinal fluid palpable clinically and confirmed on imaging. A CSF leak was defined as a CSF-cutaneous fistula manifested by CSF leaking through the wound. All patients underwent regular postoperative visits of two weeks, one month, and three months. Results: Our retrospective review identified 33 patients matching the inclusion criteria. Overall, our cohort had a 21% (7/33) rate of clinical and radiographic pseudomeningocele formation with 9% (3/33) requiring surgical revision or a separate procedure. The rate of clinical and radiographic pseudomeningocele formation in the myofascial cuff preservation technique was less than standard techniques (12% and 31%, respectively). Revision or further surgical procedures were also reduced in the myofascial cuff preservation technique vs. the standard technique (6% vs 13%). Conclusions: Preservation of the myofascial cuff during posterior fossa surgery is a simple and adoptable technique that reduces the rate of pseudomeningocele formation and CSF leak as compared with standard techniques.   PMID:28133584

  10. Clinical significance of changes in pB-C2 distance in Chiari I malformation patients following posterior fossa decompression: a single-institution experience

    PubMed Central

    Maurer, Adrian J.; Duong, Ngoc Quyen; Bonney, Phillip A.; Cheema, Ahmed A.; Glenn, Chad A.; Safavi-Abbasi, Sam; Stoner, Julie B.; Mapstone, Timothy B.

    2016-01-01

    Object The coexistence of Chiari I malformations and ventral brainstem compression (VBSC) has been well-documented, but the change in VBSC after posterior fossa decompression (PFD) has had little investigation. In this study we evaluate the incidence and degree of VBSC in patients with Chiari I malformations and determine the change in VBSC after PFD, correlating changes in VBSC with clinical status and the need for further intervention. Methods Patients who underwent PFD for Chiari I malformations by the senior author from November 2005 – January 2013 with complete radiographic records were included in the analysis. The following data were obtained: subjective and objective measures of ventral brainstem compression; relationship of odontoid to Chamberlain’s, McGregor’s, McRae’s, and Wackenheim’s lines; clival length; foramen magnum diameter; and basal angle. The objective evaluation of VBSC was performed with the senior author’s previously described method using pB-C2 distance. Statistical analyses were performed using paired t-tests and a mixed effects ANOVA model. Results Thirty-one patients were included in the analysis. The mean age of the cohort was 10.0 years. There was a small but statistically significant increase in pB-C2 postoperatively (0.5 mm, p < 0.0001 via mixed effects ANOVA). Eleven patients had postoperative pB-C2 values greater than 9 mm. The mean distance from the odontoid tip to Wackenheim’s line did not change after PFD, signifying postoperative occipitocervical stability. No patients underwent transoral odontoidectomy or occipitocervical fusion. No patients experienced clinical deterioration after PFD. Conclusions The increase in pB-C2 in patients undergoing posterior fossa decompression is likely a result of releasing the posterior vector on the ventral dura, allowing it to relax posteriorly. This increase is well-tolerated, and a postoperative pB-C2 measurement of greater than 9 mm in light of stable craniocervical metrics and

  11. Spinal Extradural Arachnoid Cyst

    PubMed Central

    Woo, Joon Bum; Kang, Kyung Taek; Lee, Jun Seok; Song, Geun Seong; Sung, Soon Ki; Lee, Sang Weon

    2016-01-01

    A spinal extradural arachnoid cyst (SEAC) results from a rare small defect of the dura matter that leads to cerebrospinal fluid accumulation and communication defects between the cyst and the subarachnoid space. There is consensus for the treatment of the dural defect, but not for the treatment of the cyst. Some advocate a total resection of the cysts and repair of the communication site to prevent the recurrence of a SEAC, while others recommended more conservative therapy. Here we report the outcomes of selective laminectomy and closure of the dural defect for a 72-year-old and a 33-year-old woman. Magnetic resonance imaging of these patients showed an extradural cyst from T12 to L4 and an arachnoid cyst at the posterior epidural space of T12 to L2. For both patients, we surgically fenestrated the cyst and repaired the dural defect using a partial hemi-laminectomy. The patient’s symptoms dramatically subsided, and follow-up radiological images show a complete disappearance of the cyst in both patients. Our results suggest that fenestration of the cyst can be a safe and effective approach in treating SEACs compared to a classical complete resection of the cyst wall with multilevel laminectomy. PMID:27857934

  12. Thoracic arachnoid cyst resection.

    PubMed

    Deutsch, Harel

    2014-09-01

    Arachnoid cysts in the spinal cord may be asymptomatic. In some cases arachnoid cysts may exert mass effect on the thoracic spinal cord and lead to pain and myelopathy symptoms. Arachnoid cysts may be difficult to visualize on an MRI scan because the thin walled arachnoid may not be visible. Focal displacement of the thoracic spinal cord and effacement of the spinal cord with apparent widening of the cerebrospinal fluid space is seen. This video demonstrates surgical techniques to remove a dorsal arachnoid cyst causing spinal cord compression. The surgery involves a thoracic laminectomy. The dura is opened sharply with care taken not to open the arachnoid so that the cyst can be well visualized. The thickened arachnoid walls of the cyst are removed to alleviate the compression caused by the arachnoid cyst. The video can be found here: http://youtu.be/pgUrl9xvsD0.

  13. Clinical significance of changes in pB-C2 distance in patients with Chiari Type I malformations following posterior fossa decompression: a single-institution experience.

    PubMed

    Bonney, Phillip A; Maurer, Adrian J; Cheema, Ahmed A; Duong, Quyen; Glenn, Chad A; Safavi-Abbasi, Sam; Stoner, Julie A; Mapstone, Timothy B

    2016-03-01

    OBJECT The coexistence of Chiari malformation Type I (CM-I) and ventral brainstem compression (VBSC) has been well documented, but the change in VBSC after posterior fossa decompression (PFD) has undergone little investigation. In this study the authors evaluated VBSC in patients with CM-I and determined the change in VBSC after PFD, correlating changes in VBSC with clinical status and the need for further intervention. METHODS Patients who underwent PFD for CM-I by the senior author from November 2005 to January 2013 with complete radiological records were included in the analysis. The following data were obtained: objective measure of VBSC (pB-C2 distance); relationship of odontoid to Chamberlain's, McGregor's, McRae's, and Wackenheim's lines; clival length; foramen magnum diameter; and basal angle. Statistical analyses were performed using paired t-tests and a mixed-effects ANOVA model. RESULTS Thirty-one patients were included in the analysis. The mean age of the cohort was 10.0 years. There was a small but statistically significant increase in pB-C2 postoperatively (0.5 mm, p < 0.0001, mixed-effects ANOVA). Eleven patients had postoperative pB-C2 values greater than 9 mm. The mean distance from the odontoid tip to Wackenheim's line did not change after PFD, signifying postoperative occipitocervical stability. No patients underwent transoral odontoidectomy or occipitocervical fusion. No patients experienced clinical deterioration after PFD. CONCLUSIONS The increase in pB-C2 in patients undergoing PFD may occur as a result of releasing the posterior vector on the ventral dura, allowing it to relax posteriorly. This increase appears to be well-tolerated, and a postoperative pB-C2 measurement of more than 9 mm in light of stable craniocervical metrics and a nonworsened clinical examination does not warrant further intervention.

  14. Post traumatic arachnoiditis ossificans

    PubMed Central

    Kumaran, Sunitha P; Gupta, Kanchan; Maddali, Aparna; Viswamitra, Sanjaya

    2012-01-01

    Arachnoiditis ossificans is a rare chronic disorder characterized by the presence of calcification/ ossification of the spinal arachnoid. We describe the computed tomography (CT) and magnetic resonance imaging (MRI) findings of arachnoiditis ossificans as sequelae to trauma in a 30-year-old patient. This imaging diagnosis becomes important to alert the clinician as most of them can be treated by conservative management. PMID:22988405

  15. Posterior fossa decompression with and without duraplasty for the treatment of Chiari malformation type I-a systematic review and meta-analysis.

    PubMed

    Xu, Hao; Chu, LinYang; He, Rui; Ge, Chang; Lei, Ting

    2017-04-01

    The treatment of Chiari malformation type 1 (CM-I) with posterior fossa decompression without (PFD) or with duraplasty (PFDD) is controversial. Our aim is to compare the clinical outcome between the two methods for the treatment of CM-I. In this paper, the authors report a systematic review and meta-analysis of operation time, clinical improvement, and complications of PFD compared with PFDD for the treatment of CM-I. Randomized or non-randomized controlled trials of PFD and PFDD were considered for inclusion. Twelve published reports of eligible studies involving 841participants meet the inclusion criteria. There is significant difference in the operative time [mean difference = -74.63, 95 % CI (-83.02, -66.25), p < 0.05] in favor of PFD compared with PFDD. There is significant difference in overall complication rates [mean difference = 0.34, 95 % CI (0.19, 0.60), p < 0.05] and rates of CSF leak [mean difference = 0.24, 95 % CI (0.07, 0.78), p < 0.05] in favor of PFD groups. However, there is significant difference in the clinical improvement rate in favor of the PFDD group [mean difference = 0.85, 95 % CI (0.73, 0.99), p < 0.05]. Although PFDD is related with longer operation time and higher CSF leak rate, it can still be considered as a preferable treatment option for most CM-I patients for its higher improvement rate. More evidence from advanced multi-center studies are needed to provide illumination for the surgical decision making of CM-I.

  16. [Adhesive lumbar arachnoiditis].

    PubMed

    Ribeiro, C; Reis, F C

    1998-01-01

    Spinal arachnoiditis, an inflammatory process involving all three meningeal layers as well as the nerve roots, is a cause of persistent symptoms in 6% to 16% of postoperative patients. Although spinal surgery is the most common antecedent associated with arachnoiditis, multiple causes have been reported, including infection, intrathecal steroids or anesthetic agents, trauma, subarachnoid hemorrhage and ionic myelographic contrast material--both oil soluble and water soluble. In the past, oil-based intrathecal contrast agents (Pantopaque) were associated with arachnoiditis especially when this material was introduced into the thecal sac and mixed with blood. Arachnoiditis is apparently rarely idiopathic. The pathogenesis of spinal arachnoiditis is similar to the repair process of serous membranes, such as the peritoneum, with a negligible inflammatory cellular exudate and a prominent fibrinous exudate. Chronic adhesive arachnoiditis of the lower spine is a myelographic diagnosis. The myelographic findings of arachnoiditis were divided into two types by Jorgensen et al. In type 1, "the empty thecal sac" appearance, there is homogeneous filling of the thecal sac with either absence of or defects involving nerve root sleeve filling. In type 2 arachnoiditis, there are localized or diffuse filling defects within the contrast column. MRI has demonstrated a sensitivity of 92% and a specificity of 100% in the diagnosis of arachnoiditis. The appearance of arachnoiditis on MRI can be assigned to three main groups. The MRI findings in group I are a conglomeration of adherent roots positioned centrally in the thecal sac. Patients in group II show roots peripherally adherent to the meninges--the so called empty sac. MRI findings in group III are a soft tissue mass within the subarachnoid space. It corresponds to the type 2 categorization defined by Jorgensen et al, where as the MRI imaging types I and II correspond to the myelographic type 1.

  17. Arachnoid cyst spontaneous rupture.

    PubMed

    Marques, Inês Brás; Vieira Barbosa, José

    2014-01-01

    Arachnoid cysts are benign congenital cerebrospinal fluid collections, usually asymptomatic and diagnosed incidentally in children or adolescents. They may become symptomatic after enlargement or complications, frequently presenting with symptoms of intracranial hypertension. We report an unusual case of progressive refractory headache in an adult patient due to an arachnoid cyst spontaneous rupture. Although clinical improvement occurred with conservative treatment, the subdural hygroma progressively enlarged and surgical treatment was ultimately needed. Spontaneous rupture is a very rare complication of arachnoid cysts. Accumulation of cerebrospinal fluid accumulation in the subdural space causes sustained intracranial hypertension that may be life-threatening and frequently requires surgical treatment. Patients with arachnoid cysts must be informed on their small vulnerability to cyst rupture and be aware that a sudden and severe headache, especially if starting after minor trauma or a Valsalva manoeuvre, always requires medical evaluation.

  18. [Intraventricular arachnoid cyst].

    PubMed

    Rico-Cotelo, María; Diaz-Cabanas, Lucía; Allut, Alfredo G; Gelabert-Gonzalez, Miguel

    2013-07-01

    INTRODUCTION. Intracranial arachnoids cysts are considered benign developmental anomalies that occur within the arachnoid membrane and generally contain clear and colourless fluid resembling cerebrospinal fluid. The prevalence of these cysts is higher in the first two decades of life, and the incidence is widely quoted as approximately 1% of all space-occupying intracranial lesions. Arachnoids cysts in the elderly person are a rare occurrence. We report the unusual presentation of a woman with an intraventricular arachnoid cyst treated with endoscopic technique. CASE REPORT. A 75-year-old woman presented with progressive hemiparesis of two years duration. Cranial MR imaging showed a right parieto-occipital intraventricular cyst with local mass effect and moderate dilatation of lateral ventricles. A right-sided burr hole was made and the arachnoids cyst was reached and cysto-ventricle shunting was realized. This was followed by a septum pellucidum fenestration. There were no complications during the surgery and the patient presented no symptoms at time of discharge. CONCLUSIONS. The neuroendoscopic approach to intraventricular arachnoid cysts was effective with few complications.

  19. Medusae Fossae

    NASA Technical Reports Server (NTRS)

    2002-01-01

    [figure removed for brevity, see original site] (Released 31 July 2002) This image crosses the equator at about 155 W longitude and shows a sample of the middle member of the Medusae Fossae formation. The layers exposed in the southeast-facing scarp suggest that there is a fairly competent unit underlying the mesa in the center of the image. Dust-avalanches are apparent in the crater depression near the middle of the image. The mesa of Medusae Fossae material has the geomorphic signatures that are typical of the formation elsewhere on Mars, but the surface is probably heavily mantled with fine dust, masking the small-scale character of the unit. The close proximity of the Medusae Fossae unit to the Tharsis region may suggest that it is an ignimbrite or volcanic airfall deposit, but it's eroded character hasn't preserved the primary depositional features that would give away the secrets of formation. One of the most interesting feature in the image is the high-standing knob at the base of the scarp in the lower portion of the image. This knob or butte is high standing because it is composed of material that is not as easily eroded as the rest of the unit. There are a number of possible explanations for this feature, including volcano, inverted crater, or some localized process that caused once friable material to become cemented. Another interesting set of features are the long troughs on the slope in the lower portion of the image. The fact that the features keep the same width for the entire length suggests that these are not simple landslides.

  20. Neurologic deficits and arachnoiditis following neuroaxial anesthesia.

    PubMed

    Aldrete, J A

    2003-01-01

    Of late, regional anesthesia has enjoyed unprecedented popularity; this increase in cases has brought a higher frequency of instances of neurological deficit and arachnoiditis that may appear as transient nerve root irritation, cauda equina, and conus medullaris syndromes, and later as radiculitis, clumped nerve roots, fibrosis, scarring dural sac deformities, pachymeningitis, pseudomeningocele, and syringomyelia, etc., all associated with arachnoiditis. Arachnoiditis may be caused by infections, myelograms (mostly from oil-based dyes), blood in the intrathecal space, neuroirritant, neurotoxic and/or neurolytic substances, surgical interventions in the spine, intrathecal corticosteroids, and trauma. Regarding regional anesthesia in the neuroaxis, arachnoiditis has resulted from epidural abscesses, traumatic punctures (blood), local anesthetics, detergents, antiseptics or other substances unintentionally injected into the spinal canal. Direct trauma to nerve roots or the spinal cord may be manifested as paraesthesia that has not been considered an injurious event; however, it usually implies dural penetration, as there are no nerve roots in the epidural space posteriorly. Sudden severe headache while or shortly after an epidural block using the loss of resistance to air approach usually suggests pneumocephalus from an intradural injection of air. Burning severe pain in the lower back and lower extremities, dysesthesia and numbness not following the usual dermatome distribution, along with bladder, bowel and/or sexual dysfunction, are the most common symptoms of direct trauma to the spinal cord. Such patients should be subjected to a neurological examination followed by an MRI of the effected area. Further spinal procedures are best avoided and the prompt administration of IV corticosteroids and NSAIDs need to be considered in the hope of preventing the inflammatory response from evolving into the proliferative phase of arachnoiditis.

  1. Spinal adhesive arachnoiditis.

    PubMed

    Dolan, R A

    1993-06-01

    Forty-one cases of spinal adhesive arachnoiditis are presented. The key points are, first, that lumbar disc lesions, their investigations and surgical treatment and the use of nonabsorbable contrast materials are the most common etiological factors and, secondly, that operation is the best treatment. It is our contention that the majority of patients so treated do experience some improvement in what otherwise can be an unbearable amount of pain and disability. The use of adsorbable, nonirritative contrast materials such as Iohexol Parenteral will result in a marked reduction in the frequency of occurrence of arachnoiditis.

  2. Claritas Fossae

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 20 June 2002) The Science The eastern rim of this unnamed crater in Claritas Fossae is very degraded. This indicates that this crater is very ancient and has been subjected to erosion and subsequent bombardment from other impactors such as asteroids and comets. One of these later (younger) craters is seen in the upper right of this image superimposed upon the older crater rim material. Note that this smaller younger crater rim is sharper and more intact than the older crater rim. This region is also mantled with a blanket of dust. This dust mantle causes the underlying topography to take on a more subdued appearance. The Story Not every crater on Mars has a name. The one in this image doesn't. What would you name it if you could? That's what planetary scientists ask themselves when they come across such features. If they think of a good name, they can submit it for approval to a group of world astronomers who are members of the International Astronomical Union. There are special rules, though, so not any name can be selected. The selection committee especially wants to make sure that all world cultures are represented. While this crater may not have a name, the region it lies in does. It is called Claritas Fossae. 'Claritas' is the Latin word for 'bright.' 'Fossae' are long, narrow, shallow depressions that mark the region. You can see these best in the context image to the right. You can tell just by looking at this crater that it is very ancient. Its rim is very degraded from erosion and bombardment from other impactors such as asteroids and comets. Compare its roughened rim to the smoother outline of the small crater on the rim's edge (upper right). The smoother rim of the small one means that it is considerably younger than its older, choppier neighbor. You know it was certainly created after the large crater because it lies on top of the rim. Other than the old and young generations of craters, the surface looks pretty uniform in hue and perhaps even

  3. Mangala Fossa

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 29 May 2002) The Science Today's THEMIS release captures Mangala Fossa. Mangala Fossa is a graben, which in geologic terminology translates into a long parallel to semi-parallel fracture or trough. Grabens are dropped or downthrown areas relative to the rocks on either side and these features are generally longer than they are wider. There are numerous dust devil trails seen in this image. In the lower portion of this image several dust devil tracks can be seen cutting across the upper surface then down the short stubby channel and finally back up and over to the adjacent upper surface. Some dust avalanche streaks on slopes are also visible. The rough material in the upper third of the image contains a portion of the rim of a 90 km diameter crater located in Daedalia Planum. The smooth crater floor has a graben (up to 7 km wide) and channel (2 km wide) incised into its surface. In the middle third and right of this image one can see ripples (possibly fossil dunes) on the crater floor material just above the graben. The floor of Mangala Fossa and the southern crater floor surface also have smaller linear ridges trending from the upper left to lower right. These linear ridges could be either erosional (yardangs) or depositional (dunes) landforms. The lower third of the scene contains a short stubby channel (near the right margin) and lava flow front (lower left). The floor of this channel is fairly smooth with some linear crevasses located along its course. One gets the impression that the channel floor is mantled with some type of indurated material that permits cracks to form in its surface. The Story In the Daedalia Plains on Mars, the rim of an old eroded crater rises up, a wreck of its former self (see context image at right). From the rough, choppy crater rim (top of the larger THEMIS image), the terrain descends to the almost smooth crater floor, gouged deeply by a trough, a channel, and the occasional dents of small, scattered craters. The deep

  4. Septooptic Dysplasia with an Associated Arachnoid Cyst

    PubMed Central

    McLaurin-Jiang, Skyler V.; Wood, Julie K.

    2016-01-01

    A 4-week-old male infant presented with hypothermia, hypoglycemia, and hyperbilirubinemia. His medical history was remarkable for hydrocephalus secondary to an arachnoid cyst, intermittent hypoglycemia, hypothermia, and poor feeding requiring nasogastric tube for nutrition. Physical exam revealed retrognathia, mild hypotonia, micropenis, and clinodactyly. Ophthalmologic exam demonstrated bilateral optic nerve hypoplasia (ONH). Laboratory data confirmed inadequate cortisol and growth hormone response to hypoglycemia, a low thyroxine level, and direct hyperbilirubinemia. Magnetic resonance imaging of the brain confirmed the known history of arachnoid cyst with hydrocephalus but also revealed anterior pituitary hypoplasia, absence of the posterior pituitary bright spot, a thin pituitary stalk, and bilateral optic nerve hypoplasia. A diagnosis of septooptic dysplasia (SOD) was made. Hormone replacement with hydrocortisone and levothyroxine was started with improvement in the infant's glycemic control, thermoregulation, feeding, and cholestasis. This case reinforces the importance of careful physical examination and laboratory review in a patient with known history of arachnoid cyst which has been previously described as an associated feature of optic nerve hypoplasia and hypopituitarism. PMID:27891281

  5. Syringomyelia and arachnoiditis.

    PubMed Central

    Caplan, L R; Norohna, A B; Amico, L L

    1990-01-01

    Five patients with chronic arachnoiditis and syringomyelia were studied. Three patients had early life meningitis and developed symptoms of syringomyelia eight, 21, and 23 years after the acute infection. One patient had a spinal dural thoracic AVM and developed a thoracic syrinx 11 years after spinal subarachnoid haemorrhage and five years after surgery on the AVM. A fifth patient had tuberculous meningitis with transient spinal cord dysfunction followed by development of a lumbar syrinx seven years later. Arachnoiditis can cause syrinx formation by obliterating the spinal vasculature causing ischaemia. Small cystic regions of myelomalacia coalesce to form cavities. In other patients, central cord ischaemia mimics syringomyelia but no cavitation is present. Scar formation with spinal block leads to altered dynamics of cerebrospinal fluid (CSF) flow and contributes to the formation of spinal cord cystic cavities. Images PMID:2313296

  6. [Fulminant adhesive arachnoiditis].

    PubMed

    Tomczykiewicz, Kazimierz; Stępień, Adam; Staszewski, Jacek; Sadowska, Marta; Bogusławska-Walecka, Romana

    2012-01-01

    Adhesive arachnoiditis is a rare disease with insidious course. It causes damage of the spinal cord and nerve roots. The causes of adhesive arachnoiditis include earlier traumatic injury of the spinal cord, surgery, intrathecal administration of therapeutic substances (e.g. anaesthetics, chemotherapy) or contrast media, bleeding, and inflammation. It can also be idiopathic or iatrogenic. We present the case of a 42-year-old patient with fulminant adhesive arachnoiditis which was provoked by spinal surgery and caused severe neurological disability with profound, progressive, flaccid paraparesis and bladder dysfunction. The electromyography (EMG) showed serious damage of nerves of both lower limbs at the level of motor roots L2-S2 and damage of the motor neuron at the level of Th11-Th12 on the right side. Magnetic resonance imaging of the lumbosacral and thoracic part of the spinal cord demonstrated cystic liquid spaces in the lumen of the dural sac in the bottom part of the cervical spine and at the Th2-Th10 level, modelling the lateral and anterior surface of the cord. Because of the vast lesions, surgery could not be performed. Conservative treatment and rehabilitation brought only a small clinical improvement.

  7. Pituitary fossa: a correlative anatomic and MR study

    SciTech Connect

    Mark, L.; Pech, P.; Daniels, D.; Charles, C.; Williams, A.; Haughton, V.

    1984-11-01

    This study characterizes the normal appearance of the pituitary fossa in partial saturation magnetic resonance (MR) images. In sagittal images, the pituitary fossa appears inhomogeneous. Correlation of sagittal MR images in normal subjects with sagittal cryomicrotomic images in cadavers suggests that the highest intensity signal from the posterior-inferior pituitary fossa is due to a fat pad. This conclusion was supported by MR images and postmortem cryotome sections obtained in normal subhuman primates.

  8. [Imaging diagnosis of arachnoid cysts].

    PubMed

    Gelabert-González, Miguel; Santín-Amo, José María; Aran-Echabe, Eduardo; García-Allut, Alfredo

    2015-01-01

    Arachnoid cysts are malformed lesions that contain a fluid similar to the cerebrospinal fluid, and are usually located within the arachnoidal membrane. They represent 1% of all intracranial lesions, and in recent years, with the development of radiological techniques, the clinical detectability of arachnoid cysts seems to have increased. Although the majority of diagnosed arachnoid cysts are located in the cranial cavity and especially in the Sylvian fissure, a small number are located at spinal level and they can occur extra- or intra-spinally. An analysis is carried out, detailing the various tests used for the diagnosis of both intracranial and spinal arachnoids cysts, analysing the indications of each one depending on the location of the cysts and patient age.

  9. [Arachnoid cysts: Embriology and pathology].

    PubMed

    García-Conde, Mario; Martín-Viota, Lucia

    2015-01-01

    There is still great controversy surrounding the origin of the arachnoid cyst. The most accepted theory in the case of congenital cysts explains how they are formed from an anomalous development of the arachnoid membrane, which is unfolded allowing the accumulation of cerebrospinal fluid inside and creating a cyst. This theory seems to explain the origin of convexity and sylvian cistern arachnoid cysts, whereas those in other locations might be due to other mechanisms. In the anatomopathological analysis, the arachnoid cyst wall can be seen as having few differences from normal, although thickened due to an increase quantity of collagenous material. A description of the embryological development of the arachnoid layer and cyst formation is presented, describing the main anatomopathological findings.

  10. Tantalus Fossae

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 25 June 2002) The Science Tantalus Fossae is a set of long valleys on the eastern side of Alba Patera. These valleys are referred to as grabens and are formed by extension of the crust and faulting. When large amounts of pressure or tension are applied to rocks on timescales that are fast enough that the rock cannot respond by deforming, the rock breaks along faults. In the case of a graben, two parallel faults are formed by extension of the crust and the rock in between the faults drops downward into the space created by the extension. Numerous sets of grabens are visible in this THEMIS image, trending from north-northeast to south-southwest. Because the faults defining the graben are formed parallel to the direction of the applied stress, we know that extensional forces were pulling the crust apart in the west-northwest/east-southeast direction. The large number of grabens around Alba Patera is generally believed to be the result of extensional forces associated with the uplift of Alba Patera. Also visible in this image are a series of linearly aligned pits, called a pit chain. The pits are not the result of impact cratering, but are similar to sinkholes on Earth. Sinkholes are typically formed by the removal of rock (commonly limestone) underground by groundwater -- when enough rock is removed, the overlying rock becomes too heavy to be supported, and it collapses, forming a pit. Unlike sinkholes, however, the pit chains near Alba Patera were likely formed when empty underground lava tubes collapsed, accounting for the presence and alignment of many pits. Numerous channel features are also observed in the image, and follow the local topographic slope, which is downhill to the east-southeast. One of these, a long channel in the center of the image, nicely demonstrates the complex relations possible between geologic features. The geologist's rule of superposition says that a feature on top of (superposing) another feature, or cutting across another

  11. Tantalus Fossae

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 25 June 2002) The Science Tantalus Fossae is a set of long valleys on the eastern side of Alba Patera. These valleys are referred to as grabens and are formed by extension of the crust and faulting. When large amounts of pressure or tension are applied to rocks on timescales that are fast enough that the rock cannot respond by deforming, the rock breaks along faults. In the case of a graben, two parallel faults are formed by extension of the crust and the rock in between the faults drops downward into the space created by the extension. Numerous sets of grabens are visible in this THEMIS image, trending from north-northeast to south-southwest. Because the faults defining the graben are formed parallel to the direction of the applied stress, we know that extensional forces were pulling the crust apart in the west-northwest/east-southeast direction. The large number of grabens around Alba Patera is generally believed to be the result of extensional forces associated with the uplift of Alba Patera. Also visible in this image are a series of linearly aligned pits, called a pit chain. The pits are not the result of impact cratering, but are similar to sinkholes on Earth. Sinkholes are typically formed by the removal of rock (commonly limestone) underground by groundwater -- when enough rock is removed, the overlying rock becomes too heavy to be supported, and it collapses, forming a pit. Unlike sinkholes, however, the pit chains near Alba Patera were likely formed when empty underground lava tubes collapsed, accounting for the presence and alignment of many pits. Numerous channel features are also observed in the image, and follow the local topographic slope, which is downhill to the east-southeast. One of these, a long channel in the center of the image, nicely demonstrates the complex relations possible between geologic features. The geologist's rule of superposition says that a feature on top of (superposing) another feature, or cutting across another

  12. [Supratentorial arachnoidal cysts].

    PubMed

    Vizioli, L; Cerillo, A; Falivene, R; Mottolese, C; Tedeschi, G

    1983-01-01

    The AA., after having examined the various hypothesis reported in literature about the etiopathogenesis and the contrasting anatomical and pathological data concerning the arachnoid supratentorial cysts, point out the remarkable frequency of they malformative and above-all post-traumatic genesis. On the formation mechanism of this last type, they agree upon the supposition expressed by Taveras and Ransohoff in 1953. The AA., therefore, after having analysed the principal morphological and topographical aspects, pay attention to the present diagnostic possibilities, above all in radiological range, where the TAC represents, by this time, the examination of election compared with traditional assurances with means of contrast. It follows the analysis of the personal casuistry, consisting in 6 arachnoid supratentorial cysts, two of which clearly post-traumatic and two, very probably, of malformative genesis (for the coexistence of data in favour of both suppositions). The AA. draw these conclusions: the CT Scan is the only diagnostic means which permits an exact pre-operating diagnosis on the nature of the lesion; the surgical and, above all, anatomo-pathological reports assume an essential rule for an exact etiopathogenetic interpretation of the lesion examined.

  13. Adhesive arachnoiditis following lumbar myelography.

    PubMed

    Skalpe, I O

    1978-03-01

    Late sequelae (adhesive arachnoiditis) have been reported following myelography with the oily contrast medium (Pantopaque) and with the ionic water-soluble contrast media methiodal sodium (Abrodil, Conturex, Kontrast U) meglumine iothalamate (Conray Meglumine) and meglumine iocarmate (Bis-Conray, Dimer-X). Adhesive arachnoiditis has not yet been reported after the use of the nonionic water-soluble contrast medium metrizamide (Amipaque). Thus, this is considered the contrast medium of choice for lumbar myelography. Using the recommended dose of 10 ml with an iodine concentration of 170 mg/ml for this examination, adhesive arachnoiditis is unlikely to occur. Increased osmolality of spinal fluid after injection of contrast medium is related to increased frequency of arachnoiditis.

  14. Analysis on clinical characteristics of intracranial Arachnoid Cysts in 488 pediatric cases

    PubMed Central

    Huang, Jian-Huang; Mei, Wen-Zhong; Chen, Yao; Chen, Jian-Wu; Lin, Zhi-Xiong

    2015-01-01

    To summarize the clinical characteristics of intracranial arachnoid cysts (IACs) in pediatric cases. A retrospective analysis was carried out on clinical characteristics of IACs in 488 pediatric cases who were treated at our hospital from January 2003 to September 2013. There were 342 males and 146 females (male-to-female ratio, 2.34:1), aged 5.61±3.25 years on average. 221 cases (45.29%) were diagnosed accidentally, 267 cases had clinical complaints (54.71%), among which relationships between clinical complaints and IACs were identified in 123 (46.07%). Simple IACs occurred in 364 cases (4.59%), and concurrent congenital abnormalities occurred in 124 cases (4.59%). In terms of location, 355 had IACs in middle cranial fossa (72.75%), 82 cases in posterior cranial fossa (16.80%), 20 cases in anterior cranial fossa (4.10%), 12 cases in dorsolateral surface (2.46%), 7 cases in suprasellar cistern (1.43%), 5 cases in cerebral ventricle (1.02%), 5 cases in quadrigeminal cistern (1.02%), and 2 cases in interhemispheric region (0.41%). There were 449 cases with single IAC (92.01%) and 39 cases with multiple IACs (7.99%). On MRI, the cysts produced tension in 127 cases (26.02%), but not in the remaining 361 cases (73.98%). Surgery was performed on 76 of 488 cases (15.57%), while conservative observation was accepted in 412 cases (84.43%). For the former, the symptoms and the cyst volume were improved to varying extent; for the latter, the follow-up lasting for 3-72 months (average 32.43±8.92 months) showed that the cyst volume remained stable in 407 cases (98.78%), enlarged with aggravated symptoms in 3 cases (0.73%), and shrank in 2 cases (0.49%). Clinical complaints of IACs varied in pediatric cases, and the relationships between clinical complaints and IACs were established only partially. Some pediatric cases were combined with other congenital abnormalities. The cyst volume largely remained stable during the disease course, and surgery was required for only a few

  15. Lumbar adhesive arachnoiditis. Etiologic and pathologic aspects.

    PubMed

    Quiles, M; Marchisello, P J; Tsairis, P

    1978-03-01

    The etiologic factors and pathologic findings in 38 patients with lumbar arachnoiditis are presented. Lumbar spine surgery and the injection of contrast materials prior to the diagnosis of this condition are considered the most important factors in its genesis. In this series, there was microscopic evidence of arachnoiditis ossificans in 3 patients and arachnoiditis calcificans in 1 patient.

  16. Spinal Extradural Arachnoid Cyst

    PubMed Central

    Choi, Seung Won; Seong, Han Yu

    2013-01-01

    Spinal extradural arachnoid cyst (SEAC) is a rare disease and uncommon cause of compressive myelopathy. The etiology remains still unclear. We experienced 2 cases of SEACs and reviewed the cases and previous literatures. A 59-year-old man complained of both leg radiating pain and paresthesia for 4 years. His MRI showed an extradural cyst from T12 to L3 and we performed cyst fenestration and repaired the dural defect with tailored laminectomy. Another 51-year-old female patient visited our clinical with left buttock pain and paresthesia for 3 years. A large extradural cyst was found at T1-L2 level on MRI and a communication between the cyst and subarachnoid space was illustrated by CT-myelography. We performed cyst fenestration with primary repair of dural defect. Both patients' symptoms gradually subsided and follow up images taken 1-2 months postoperatively showed nearly disappeared cysts. There has been no documented recurrence in these two cases so far. Tailored laminotomy with cyst fenestration can be a safe and effective alternative choice in treating SEACs compared to traditional complete resection of cyst wall with multi-level laminectomy. PMID:24294463

  17. [Paraplegia due to adhesive arachnoiditis. A case report].

    PubMed

    Rodríguez Luna, José Guadalupe; Sandoval Sánchez, Víctor; Benavides Rodríguez, David; Olivares Camacho, Jorge L; Taboada, Jesús B

    2009-01-01

    Various conditions of the spinal column occur at the lumbar level and new therapeutic surgical techniques have been applied to reduce the length of hospital stay, contribute to a quick return of patients to their activities of daily living, and reduce the postoperative limitations. However, a silent complication, adhesive arachnoiditis, has been reported with a frequency of 6-16% in cases undergoing lumbar surgery or with a history of revision surgery, and thus a second complication may occur, paraplegia, since the common symptom of arachnoiditis is persistent low back pain. The case of a 40-year-old patient is presented herein, who underwent lumbar spine surgery for herniated discs, and developed adhesive arachnoiditis involving the cauda equina, which was diagnosed with MRI. He had irreversible paraplegia with diffuse involvement of the cauda equina despite the mechanical lavage and surgical debridement performed due to the persistence of serous fluid discharge from the wound. The interbody implant placed during the first surgery was removed and the treatment was completed with posterior stabilization reinstrumentation; the patient had persistent neurologic impairment. There are few reports in the world literature of paraplegia due to non-infectious adhesive arachnoiditis. The remaining reports of paraplegia have been in patients with spinal infection, such as HIV-TB, mycosis, brucellosis or meningeal hemorrhage. It is not easy for patients to understand the very likely irreversible neurologic lesion of his complication. However, it is important for the spine surgeon to bear in mind the occurrence and frequency of adhesive arachnoiditis which could lead to irreversible neurologic deficit in patients undergoing lumbar spine surgery.

  18. Adhesive arachnoiditis after lumbar myelography.

    PubMed

    Suolanen, J

    1977-08-01

    Of 1500 myelographies, 99 patients had subsequent myelographies from which the prevalence of adhesive arachnoiditis caused by the initial investigation could be calculated. Three different water-soluble contrast agents had been used in the initial study: Kontrast U (800 patients), Dimer-X (400 patients), and Conray (300 patients) and the subsets of patients restudied represented 6%, 8% and 8% respectively of the whole series. After the first myelography 68 patients had no operation, 31 patients had hemilaminectomy. Conray produced arachnoid changes in 71% of the nonoperated patients. This differed significantly from the 43% caused by Kontrast U, and the 27% evoked by Dimer-X. The same trend was evident in the operated subset. The severity of the arachnoid changes was greater after Conray. Analysis of the iodine content of the different contrast media and comparison with similar series suggested that hyperosmolarity of the agent was responsible for the changes.

  19. Craniocervical arachnoid cyst in a patient with Klippel-Feil syndrome: a unique case: case report.

    PubMed

    Khan, Imad Saeed; Ahmed, Osama; Thakur, Jai Deep; Shorter, Cedric D; Guthikonda, Bharat

    2013-02-01

    Klippel-Feil syndrome, or brevicollis, is a complex congenital disorder caused by the improper segmentation of the cervical vertebrae. The authors present the very rare case of a patient with Klippel-Feil syndrome who presented with an intradural arachnoid cyst at the craniocervical junction. They also examine possible factors contributing to this association. A 46-year-old woman presented with complaints of progressively worsening headaches and dizziness of 18 months' duration. She also demonstrated mild bilateral upper-extremity weakness. Magnetic resonance imaging revealed fused cervical vertebrae and a dorsal intradural arachnoid cyst at the craniocervical junction, extending down to the fourth cervical level. Because of worsening myelopathy and the presence of brainstem compression, the patient underwent surgical excision of the arachnoid cyst, which was approached via a midline posterior suboccipital/upper cervical route. An endoscope was introduced through a gap between the occiput and fused upper cervical vertebrae, and the arachnoid cyst was widely fenestrated. Postoperatively, the patient has remained symptom free for more than 2 years with evidence of good radiological decompression. The authors report a unique association between craniocervical arachnoid cyst and Klippel-Feil syndrome. To their knowledge, no other cases of this association have been reported in the literature. Arachnoid cysts should be part of the differential diagnosis in the presence of worsening myelopathic symptoms or pain in patients with Klippel-Feil syndrome.

  20. Retroclival arachnoid cyst with hemifacial spasm.

    PubMed

    Bonde, V; Muzumdar, D; Goel, A

    2008-10-01

    Arachnoid cysts are rare lesions occurring anywhere in the cerebrospinal axis. The sylvian fissure remains the most favoured site for their occurrence, followed by cerebellopontine angle, suprasellar, and quadrigeminal cisterns. Retroclival arachnoid cysts are very rare. We report a retroclival arachnoid cyst with bilateral cerebellopontine angle extensions with hemifacial spasm in a 26-year-old woman. The patient underwent surgery and her hemifacial spasm improved.

  1. Familial adhesive arachnoiditis associated with syringomyelia.

    PubMed

    Pasoglou, V; Janin, N; Tebache, M; Tegos, T J; Born, J D; Collignon, L

    2014-06-01

    Adhesive arachnoiditis is a rare condition, often complicated by syringomyelia. This pathologic entity is usually associated with prior spinal surgery, spinal inflammation or infection, and hemorrhage. The usual symptoms of arachnoiditis are pain, paresthesia, and weakness of the low extremities due to the nerve entrapment. A few cases have had no obvious etiology. Previous studies have reported one family with multiple cases of adhesive arachnoiditis. We report a second family of Belgian origin with multiple cases of arachnoiditis and secondary syringomyelia in the affected individuals.

  2. Medusae Fossae #1

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Extensive wind-swept plains of the Medusae Fossae formation on Mars. This northern subframe image, frame 3104, is of a 3.0 x 4.7 km area centered near 2.4 degrees north, 163.8 degrees west.

    Figure caption from Science Magazine

  3. Medusae Fossae #2

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Extensive wind-swept plains of the Medusae Fossae formation on Mars. This southern subframe image, frame 3104, is of a 3.0 x 4.7 km area centered near 2.0 degrees north, 163.8 degrees west.

    Figure caption from Science Magazine

  4. Characteristics of arachnoids from Magellan data

    NASA Technical Reports Server (NTRS)

    Dawson, C. B.; Crumpler, L. S.

    1993-01-01

    Current high resolution Magellan data enables more detailed geological study of arachnoids, first identified by Barsukov et al. as features characterized by a combination of radar-bright, concentric rings and radiating lineations, named 'arachnoids' on the basis of their spider and web-like appearance. Identification of arachnoids in Magellan data has been based on SAR images, in keeping with the original definition. However, there is some overlap by other workers in identification of arachnoids, corona (predominantly bright rings), and novae (predominantly radiating lineations), as all of these features share some common characteristics. Features used in this survey were chosen based on their classification as arachnoids in Head et al.'s catalog and on SAR characteristics matching Barsukov et al.'s original definition. The 259 arachnoids have been currently identified on Venus, all of which were considered in this study. Fifteen arachnoids from different regions, chosen for their 'type' characteristics and lack of deformation by other regional processes, were studied in depth, using SAR and altimetric data to map and profile these arachnoids in an attempt to better determine their geologic and altimetric characteristics and possible formation sequences.

  5. Recurrent spinal adhesive arachnoiditis. A case report.

    PubMed

    de Mattos, J P; André, C; Couto, B A

    1988-03-01

    Spinal adhesive arachnoiditis is not an uncommon disease, usually having a monophasic course. We studied an atypical patient with recurrent spinal adhesive arachnoiditis nine years after intrathecal anesthesia and the first attack of the disease. Also noteworthy was the favorable evolution after surgery.

  6. Arachnoid cysts with intracystic and subdural haematoma.

    PubMed

    Romero, F J; Rovira, M; Ibarra, B; Piqueras, J; Rovira, M

    1989-05-01

    Two cases of arachnoid cysts with acute intracystic and subdural haematomas are described. CT examination was performed in both cases, and showed a hyperdense expansion with thinning of the inner table of the skull. The different ways in which subdural haematomas associated with arachnoid cysts may be seen on CT are discussed.

  7. Postlumbar puncture arachnoiditis mimicking epidural abscess

    PubMed Central

    Gürbüz, Mehmet Sabri; Erdoğan, Barıs; Yüksel, Mehmet Onur; Somay, Hakan

    2013-01-01

    Lumbar spinal arachnoiditis occurring after diagnostic lumbar puncture is a very rare condition. Arachnoiditis may also present with fever and elevated infection markers and may mimic epidural abscess, which is one of the well known infectious complications of lumbar puncture. We report the case of a 56-year-old man with lumbar spinal arachnoiditis occurring after diagnostic lumbar puncture who was operated on under a misdiagnosis of epidural abscess. In the intraoperative and postoperative microbiological and histopathological examination, no epidural abscess was detected. To our knowledge, this is the first case of a patient with postlumbar puncture arachnoiditis operated on under a misdiagnosis of epidural abscess reported in the literature. The authors suggest that arachnoiditis may mimic epidural abscess due to its clinical and radiological features and should be considered in the differential diagnosis of complications of lumbar puncture. PMID:24197809

  8. Cranial arachnoid membranes: some aspects of microsurgical anatomy.

    PubMed

    Lü, Jian; Zhu, Xian-Li

    2007-07-01

    Although the arachnoid membranes have been known for more than 300 years, the anatomy of the arachnoid membranes has not been studied in detail. This study was performed to explore the microanatomical features of the cranial arachnoid membranes. The arachnoid membranes and cisterns were observed in eight Han Chinese adult human cadaveric brains with an operating microscope, without staining of intracranial structures or injection of colored material into blood vessels. Twenty seven arachnoid membranes and 21 subarachnoid cisterns were identified. The topographical features of each arachnoid membrane were described. On the basis of the arachnoid membranes we identified, the arachnoidal limits of the cisterns were discussed. The microsurgical anatomical research on the arachnoid membranes is a supplement to the anatomical study of the subarachnoid cisterns. The understanding of the topographical features of the arachnoid membranes is valuable to the reasonable dissection of the cisterns and the minimally invasive manipulations during microsurgical procedures.

  9. Yardangs in Medusa Fossae

    NASA Technical Reports Server (NTRS)

    2002-01-01

    [figure removed for brevity, see original site] (Released 29 July 2002) This THEMIS visible image covers a portion of the Medusa Fossae formation, near the equator of Mars. The most characteristic feature of the Medusa Fossae formation is the abundance of 'yardangs', which are erosional landforms carved by the wind. These features usually form in a linear fashion, and can be indicators of prevailing paleowind directions. On Earth, yardangs are typically found in rocks that are easily eroded, such as those that form from consolidated volcanic ash, dust-fall deposits or lake sediments. In this particular area of Medusa Fossae, the size, spacing, and orientation of the yardangs varies throughout the image. The largest form a stripe across the center of the image, while the smallest are found in the top half of the image (look closely). The small yardangs at the very top of the image are oriented NW-SE; however, the orientation changes to NE-SW near the bright ridge in the center of the image. The variation in size and orientation appears to correspond with topographic layers, and may be due either to differences in consolidation or changes in wind strength or direction as the yardangs were formed. Finally, the terrain in the lower third of the image appears etched or pitted, and was probably also formed by wind erosion.

  10. Pterygopalatine Fossa: Not a Mystery!

    PubMed

    Derinkuyu, Betul Emine; Boyunaga, Oznur; Oztunali, Cigdem; Alimli, Ayse Gul; Ucar, Murat

    2016-12-06

    The pterygopalatine fossa is an important anatomic crossroads that is connected with numerous intra- and extracranial spaces via foramina and fissures. Although this fossa is small, its central location in the skull base and its communications provide clinical, radiological, and anatomical significance. In this pictorial review, we aimed to describe the radiologic anatomy of the pterygopalatine fossa, as well as to give some pathologic examples to better understand this major conduit.

  11. [Microsurgical treatment of intracraneal arachnoid cysts].

    PubMed

    Saura Rojas, J Enrique; Horcajadas Almansa, Ángel; Ros López, Bienvenido

    2016-01-01

    Craniotomy and fenestration of membranes is one of the main treatment options for symptomatic arachnoid cysts. Open surgery advantages include, direct inspection of the cyst, biopsy sampling, fenestration in multilocular cysts and, in certain locations, cyst communication to basal cisterns. The aim of this paper is to review the advantages and disadvantages of this treatment modality for arachnoid cysts taking into account the different anatomical locations.

  12. Suprasellar arachnoid cyst with delayed puberty.

    PubMed

    Kumar, Raj; Singhal, Namit

    2007-11-01

    A 15-year-old female presented with primary amenorrhea and delayed onset of secondary sexual characteristics. Earlier she was operated for endoscopic third ventriculostomy (ETV) for a tense suprasellar arachnoid cyst with obstructive hydrocephalus. MRI revealed recurrence of hydrocephalus. Hormonal levels were suggestive of hypogonadism and deficiency of growth hormone. She was operated for fenestration of cyst. In this case, suprasellar arachnoid cyst presented with delayed puberty, which is unusual.

  13. Arachnoiditis

    MedlinePlus

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  14. Medusae Fossae Formation

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 10 April 2002) The Science This THEMIS visible image was acquired near 7o S, 172o W (188o E) and shows a remarkable martian geologic deposit known as the Medusae Fossae Formation. This Formation, seen here as the raised plateau in the upper two-thirds of the image, is a soft, easily eroded deposit that extends for nearly 1,000 km along the equator of Mars. In this region the deposit has been heavily eroded by the wind to produce a series of linear ridges called yardangs. These parallel ridges point in direction of the prevailing winds that carved them, and demonstrate the power of martian winds to sculpt the dry landscape of Mars. The Medusae Fossae Formation has been completely stripped from the surface in the lower third of the image, revealing a harder layer below that is more resistant to wind erosion. The easily eroded nature of the Medusae Fossae Formation suggests that it is composed of weakly cemented particles, and was most likely formed by the deposition of wind-blown dust or volcanic ash. Several ancient craters that were once completely buried by this deposit are being exposed, or exhumed, as the overlying Medusae Formation is removed. Very few impact craters are visible on this Formation, indicating that the surface seen today is relatively young, and that the processes of erosion are likely to be actively occurring. The Story Medusa of Greek mythology fame, the name-giver to this region, had snaky locks of hair that could turn a person to stone. Wild and unruly, this monster of the underworld could certainly wreak havoc on the world of the human imagination. As scary as she was, Medusa would have no advantage over the fierce, masterful winds blowing across Mars, which once carved the streaky, terrain at the top of this image. Wild and whipping, these winds have slowly eroded away the 'topsoil,' revealing ancient craters and other surface features they once covered. The loosely cemented particles of this 'topsoil' are likely made up of dust

  15. Dissapearance of arachnoid cyst after rupturing into subdural space.

    PubMed

    Yilmaz, C; Cetinalp, E; Caner, H; Altinors, N

    2007-01-01

    Arachnoid cysts are developmental anomalies usually diagnosed in childhood. The most important complications of arachnoid cysts are subdural haematomas and hygromas and intracystic haemorrhage. In our case we present a 7-year-old boy whose arachnoid cyst ruptured into the subdural space following a mild head injury and disappeared after draining the subdural haematoma by burr-holes.

  16. Intracranial arachnoid cysts in a chimpanzee (Pan troglodytes).

    PubMed

    Miyabe-Nishiwaki, Takako; Kaneko, Takaaki; Sakai, Tomoko; Kaneko, Akihisa; Watanabe, Akino; Watanabe, Shohei; Maeda, Norihiko; Kumazaki, Kiyonori; Suzuki, Juri; Fujiwara, Reina; Makishima, Haruyuki; Nishimura, Takeshi; Hayashi, Misato; Tomonaga, Masaki; Matsuzawa, Tetsuro; Mikami, Akichika

    2014-01-01

    An intracranial arachnoid cyst was detected in a 32-year-old, 44.6-kg, female chimpanzee at the Primate Research Institute, Kyoto University. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed and the cognitive studies in which she participated were reviewed. MRI revealed that the cyst was present in the chimpanzee's right occipital convexity, and was located in close proximity to the posterior horn of the right lateral ventricle without ventriculomegaly. CT confirmed the presence of the cyst and no apparent signs indicating previous skull fractures were found. The thickness of the mandible was asymmetrical, whereas the temporomandibular joints and dentition were symmetrical. She showed no abnormalities in various cognitive studies since she was 3 years old, except a different behavioural pattern during a recent study, indicating a possible visual field defect. Detailed cognitive studies, long-term observation of her physical condition and follow-up MRI will be continued.

  17. Medusae Fossae Formation

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 16 April 2002) The Science This THEMIS visible image was acquired near 11o N, 159o W (201o E) and shows examples of the remarkable variations that can be seen in the erosion of the Medusae Fossae Formation. This Formation is a soft, easily eroded deposit that extends for nearly 1,000 km along the equator of Mars. In this region, like many others throughout the Medusae Fossae Formation, the surface has been eroded by the wind into a series of linear ridges called yardangs. These ridges generally point in direction of the prevailing winds that carved them, and demonstrate the power of martian winds to erode the landscape of Mars. The easily eroded nature of the Medusae Fossae Formation suggests that it is composed of weakly cemented particles, and was most likely formed by the deposition of wind-blown dust or volcanic ash. Within this single image it is possible to see differing amounts of erosion and stripping of layers in the Medusae Fossae Formation. Near the bottom (southern) edge of the image a rock layer with a relatively smooth upper surface covers much of the image. Moving upwards (north) in the image this layer becomes more and more eroded. At first there are isolated regions where the smooth unit has been eroded to produce sets of parallel ridges and knobs. Further north these linear knobs increase in number, and only small, isolated patches of the smooth upper surface remain. Finally, at the top of the image, even the ridges have been removed, exposing the remarkably smooth top of hard, resistant layer below. This sequence of layers with differing hardness and resistance to erosion is common on Earth and on Mars, and suggests significant variations in the physical properties, composition, particle size, and/or cementation of these martian layers. As is common throughout the Medusae Fossae Formation, very few impact craters are visible, indicating that the surface exposed is relatively young, and that the process of erosion may be active today

  18. Medusae Fossae Formation

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 16 April 2002) The Science This THEMIS visible image was acquired near 11o N, 159o W (201o E) and shows examples of the remarkable variations that can be seen in the erosion of the Medusae Fossae Formation. This Formation is a soft, easily eroded deposit that extends for nearly 1,000 km along the equator of Mars. In this region, like many others throughout the Medusae Fossae Formation, the surface has been eroded by the wind into a series of linear ridges called yardangs. These ridges generally point in direction of the prevailing winds that carved them, and demonstrate the power of martian winds to erode the landscape of Mars. The easily eroded nature of the Medusae Fossae Formation suggests that it is composed of weakly cemented particles, and was most likely formed by the deposition of wind-blown dust or volcanic ash. Within this single image it is possible to see differing amounts of erosion and stripping of layers in the Medusae Fossae Formation. Near the bottom (southern) edge of the image a rock layer with a relatively smooth upper surface covers much of the image. Moving upwards (north) in the image this layer becomes more and more eroded. At first there are isolated regions where the smooth unit has been eroded to produce sets of parallel ridges and knobs. Further north these linear knobs increase in number, and only small, isolated patches of the smooth upper surface remain. Finally, at the top of the image, even the ridges have been removed, exposing the remarkably smooth top of hard, resistant layer below. This sequence of layers with differing hardness and resistance to erosion is common on Earth and on Mars, and suggests significant variations in the physical properties, composition, particle size, and/or cementation of these martian layers. As is common throughout the Medusae Fossae Formation, very few impact craters are visible, indicating that the surface exposed is relatively young, and that the process of erosion may be active today

  19. Sports participation with arachnoid cysts.

    PubMed

    Strahle, Jennifer; Selzer, Béla J; Geh, Ndi; Srinivasan, Dushyanth; Strahle, MaryKathryn; Martinez-Sosa, Meleine; Muraszko, Karin M; Garton, Hugh J L; Maher, Cormac O

    2016-04-01

    OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 ± 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.

  20. Sirenum Fossae Trough

    NASA Technical Reports Server (NTRS)

    2000-01-01

    [figure removed for brevity, see original site]

    The Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) orbits the red planet twelve times each day. The number of pictures that MOC can take varies from orbit to orbit, depending upon whether the data are being stored in MGS's onboard tape recorder for playback at a later time, or whether the data are being sent directly back to Earth via a real-time radio link. More data can be acquired during orbits with real-time downlink.

    During real-time orbits, the MOC team often will take a few random or semi-random pictures in between the carefully-selected, hand-targeted images. On rare occasions, one of these random pictures will surprise the MOC team. The picture shown here is an excellent example, because the high resolution view (top) is centered so nicely on a trough and an adjacent, shallow crater that it is as if someone very carefully selected the target for MOC. The high-resolution view covers an area only 1.1 km (0.7 mi) wide by 2.3 km (1.4 mi) long. Hitting a target such as this with such a small image is very difficult to do, on purpose, because there are small uncertainties in the predicted orbit, the maps used to select targets, and the minor adjustments of spacecraft pointing at any given moment. Nevertheless, a very impressive image was received.

    The high resolution view crosses one of the troughs of the Sirenum Fossae near 31.2oS, 152.3oW. The context image (above) was acquired at the same time as the high resolution view on July 23, 2000. The small white box shows the location of the high resolution picture. The lines running diagonally across the context image from upper right toward lower left are the Sirenum Fossae troughs, formed by faults that are radial to the volcanic region of Tharsis. Both pictures are illuminated from the upper left. The scene shows part of the martian southern hemisphere nearly autumn.

  1. Microscopic lysis of lumbar adhesive arachnoiditis.

    PubMed

    Johnston, J D; Matheny, J B

    1978-03-01

    The results of a long-term study of 28 patients operated on for adhesive lumbar arachnoiditis are presented. The technique involved was microscopic lysis of adhesions. The first case of surgery was performed in 1966 and the last, in 1970, with followup through 1976. Numerous observations are made regarding the clinical picture and the appearance of arachnoiditis at the time of surgery. Some conclusions are drawn regarding the causes of this condition with some emphasis on the role of Pantopaque, multiple surgeries, and other trauma. The conclusion is that surgical attack on arachnoiditis is a straightforward surgical exercise that, when carried out with appropriate caution, produces no further neurologic deficits and some short-term improvement. However, the authors feel that this procedure should not be performed at the present time because there does not appear to be a method for preventing the reaccumulation of the scar tissue and subsequent recurrence of the symptoms.

  2. Symptomatic lumbar spinal arachnoiditis: fact or fallacy?

    PubMed

    Petty, P G; Hudgson, P; Hare, W S

    2000-09-01

    It is generally accepted that chronic adhesive lumbar arachnoiditis is a cause of symptoms, notably back pain and/or pain (of almost any type, not necessarily 'anatomical') in the lower limbs, although there is no clearly defined clinical pattern which is clearly associated with this syndrome. There is no doubt that arachnoiditis occurs as a pathological and radiological entity due to a number of causes. In the view of the present authors, the nexus between the pathology and radiology on the one hand, and the patients' symptoms on the other hand, has not been demonstrated with any degree of scientific rigor.

  3. Multiple cavernous malformations with supravermian arachnoid cyst.

    PubMed

    Unalp, Aycan; Uran, Nedret

    2007-11-01

    Cerebral cavernous malformation are congenital vascular abnormalities that have been reported in 0.4% of the population; they represent 5-13% of all cerebrovascular malformations. Onset of cerebral cavernous malformations may be associated with seizures, intracranial hemorrhages, focal neurological deficit or migraine-type headaches. Some patients may require surgical intervention due to hemorrhage. Multiple cavernomas in childhood have been reported in the literature, but they are rare. This manuscript presents a 12-year-old girl with multiple cavernomas accompanied by supravermian arachnoid cyst detected by neuroimaging techniques. This is the first report that demonstrates a case of pediatric multiple cavernous malformation coexisting with arachnoid cyst of the supravermian cistern.

  4. Novel surgical management of spinal adhesive arachnoiditis by arachnoid microdissection and ventriculo-subarachnoid shunting.

    PubMed

    Mitsuyama, Tetsuryu; Asamoto, Shunji; Kawamata, Takakazu

    2011-12-01

    Spinal cord tethering and cerebrospinal fluid (CSF) flow disturbance are two major features in the pathophysiology of spinal adhesive arachnoiditis. We hypothesized that insufficient CSF supply to the surgically untethered spinal cord may be one of the causes of the typical post-operative recurrent extensive lesion. We report a patient with extensive spinal adhesive arachnoiditis, who was successfully treated using a novel surgical technique consisting of two procedures. First, microdissection of the thickened adherent arachnoid was performed to resolve spinal cord tethering. Next, a ventriculo-subarachnoid shunt was placed to provide sufficient flow of CSF. Clinical improvement was sustained for at least 22 months after surgery. The present surgical procedure may improve clinical outcome in patients with longitudinally extensive spinal adhesive arachnoiditis.

  5. Medusae Fossae Yardangs

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    Released 15 April 2003

    The Medusae Fossae formation is an enigmatic pile of eroding sediments that spans over 5000 km in discontinuous masses along the martian equator. The yardang ridges, formed from the scouring action of windblown sand, are a characteristic feature of this formation. In this image, there is evidence for a period of erosion when winds scoured the surface at nearly right angles to the prominent yardang direction.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

    Image information: VIS instrument. Latitude -5.1, Longitude 184.4 East (175.6 West). 19 meter/pixel resolution.

  6. Medusae Fossae Formation

    NASA Technical Reports Server (NTRS)

    1998-01-01

    An exotic terrain of wind-eroded ridges and residual smooth surfaces are seen in one of the highest resolution images ever taken of Mars from orbit. The Medusae Fossae formation is believed to be formed of the fragmental ejecta of huge explosive volcanic eruptions. When subjected to intense wind-blasting over hundreds of millions of years, this material erodes easily once the uppermost tougher crust is breached. In the Mars Orbiter Camera (MOC) image shown on the right, the crust, or cap rock, can be seen in the upper right part of the picture. The finely-spaced ridges are similar to features on Earth called yardangs, which are formed by intense winds plucking individual grains from, and by wind-driven sand blasting particles off, sedimentary deposits.

    The MOC image was taken on October 30, 1997 at 11:05 AM PST, shortly after the Mars Global Surveyor spacecraft's 31st closest approach to Mars. The image covers an area 3.6 X 21.5 km (2.2 X 13.4 miles) at 3.6 m (12 feet) per picture element--craters only 11 m (36 feet, about the size of a swimming pool) across can be seen. The context image (left; the best Viking view of the area; VO 1 387S34) has a resolution of 240 m/pixel, or 67 times lower resolution than the MOC frame.

    Malin Space Science Systems (MSSS) and the California Institute of Technology built the MOC using spare hardware from the Mars Observer mission. MSSS operates the camera from its facilities in San Diego, CA. The Jet Propulsion Laboratory's Mars Surveyor Operations Project operates the Mars Global Surveyor spacecraft with its industrial partner, Lockheed Martin Astronautics, from facilities in Pasadena, CA and Denver, CO.

  7. Clay at Nili Fossae

    NASA Technical Reports Server (NTRS)

    2006-01-01

    This image of the Nili Fossae region of Mars was compiled from separate images taken by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) and the High-Resolution Imaging Science Experiment (HiRISE), two instruments on NASA's Mars Reconnaissance Orbiter. The images were taken at 0730 UTC (2:30 a.m. EDT) on Oct. 4, 2006, near 20.4 degrees north latitude, 78.5 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36 to 3.92 micrometers, and shows features as small as 18 meters (60 feet) across. HiRISE's image was taken in three colors, but its much higher resolution shows features as small as 30 centimeters (1 foot) across.

    CRISM's sister instrument on the Mars Express spacecraft, OMEGA, discovered that some of the most ancient regions of Mars are rich in clay minerals, formed when water altered the planet's volcanic rocks. From the OMEGA data it was unclear whether the clays formed at the surface during Mars' earliest history of if they formed at depth and were later exposed by impact craters or erosion of the overlying rocks. Clays are an indicator of wet, benign environments possibly suitable for biological processes, making Nili Fossae and comparable regions important targets for both CRISM and HiRISE.

    In this visualization of the combined data from the two instruments, the CRISM data were used to calculate the strengths of spectral absorption bands due to minerals present in the scene. The two major minerals detected by the instrument are olivine, a mineral characteristic of primitive igneous rocks, and clay. Areas rich in olivine are shown in red, and minerals rich in clay are shown in green. The derived colors were then overlayed on the HiRISE image.

    The area where the CRISM and HiRISE data overlap is shown at the upper left, and is about 5 kilometers (3 miles) across. The three boxes outlined in blue are enlarged to show how the different minerals in the scene match up with different landforms. In the image

  8. Arachnoiditis ossificans and syringomyelia: A unique presentation

    PubMed Central

    Opalak, Charles F.; Opalak, Michael E.

    2015-01-01

    Background: Arachnoiditis ossificans (AO) is a rare disorder that was differentiated from leptomeningeal calcification by Kaufman and Dunsmore in 1971. It generally presents with progressive lower extremity myelopathy. Though the underlying etiology has yet to be fully described, it has been associated with various predisposing factors including vascular malformations, previous intradural surgery, myelograms, and adhesive arachnoiditis. Associated conditions include syringomyelia and arachnoid cyst. The preferred diagnostic method is noncontrast computed tomography (CT). Surgical intervention is still controversial and can include decompression and duroplasty or durotomy. Case Description: The authors report the case of a 62-year-old male with a history of paraplegia who presented with a urinary tract infection and dysautonomia. His past surgical history was notable for a C4–C6 anterior fusion and an intrathecal phenol injection for spasticity. A magnetic resonance image (MR) also demonstrated a T6-conus syringx. At surgery, there was significant ossification of the arachnoid/dura, which was removed. After a drain was placed in the syrinx, there was a significant neurologic improvement. Conclusion: This case demonstrates a unique presentation of AO and highlights the need for CT imaging when a noncommunicating syringx is identified. In addition, surgical decompression can achieve good results when AO is associated with concurrent compressive lesions. PMID:26693389

  9. Multiple lumbar arachnoid cysts. Case report.

    PubMed

    Pappalardo, S; Cassarino, A; Braidotti, P

    1986-09-01

    Arachnoid cysts are a rare cause of compression of the contents of the lumbar spinal canal; in the literature only about 100 cases are reported. The various methods of diagnosis are discussed in the light of a recent case observed by the authors.

  10. Mandibular fossa morphology in the Ngandong and Sambungmacan fossil hominids.

    PubMed

    Durband, Arthur C

    2008-10-01

    There has been debate in recent years concerning the significance of the mandibular fossa morphology in the Ngandong and Sambungmacan hominids. These fossils lack a postglenoid process and their squamotympanic fissure runs along the apex of the fossa for its entire length. This configuration differs from that seen in other fossil and modern humans, which have a prominent postglenoid process and a squamotympanic fissure that takes a more posterior course that does not lie in the apex of the fossa. Some recent studies have suggested that the Ngandong and Sambungmacan hominids are not unique in their expression of these characteristics, and that they can also be found in other fossil crania from Africa and Indonesia. The present study reexamines these morphologies in an effort to better understand their distribution in the hominid fossil record. The results confirm that the lack of a prominent postglenoid process in combination with a squamotympanic fissure that lies wholly in the apex of the mandibular fossa along its entire length is indeed autapomorphic for the Ngandong and Sambungmacan fossils. This finding, in conjunction with work on other nonmetric features in these hominids, suggests that at least two hominid morphs, possibly representing separate species, were present on Java during the Pleistocene. In addition, if this apparent autapomorphy is confirmed, then it is also unlikely that the Ngandong hominids contributed to the gene pool of modern humans.

  11. Arachnoiditis Ossificans - A Rare Cause of Progressive Myelopathy.

    PubMed

    Steel, Christopher J; Abrames, Erik L; O'Brien, William T

    2015-01-01

    Arachnoiditis ossificans is a rare cause of chronic, progressive myelopathy. In contrast to the more common benign causes of meningeal calcification, arachnoiditis ossificans results in replacement of portions of the spinal arachnoid by bone as an end-stage complication of adhesive arachnoiditis. It is usually the sequela of prior trauma or interventional procedures. Prognosis and treatment options depend upon the location and degree of spinal stenosis with thoracic involvement being more common and more severe than lumbar spine involvement. The imaging findings on magnetic resonance imaging may be confusing; however, the findings of intraspinal ossification on computed tomography are characteristics and diagnostic. We present a classic case of arachnoiditis ossificans in an elderly man who presented with progressive myelopathy and a recent fall, along with a review of the literature. The imaging in this case not only identified the characteristic findings of arachnoiditis ossificans but also identified secondary findings of the underlying causative etiology.

  12. Arachnoiditis Ossificans – A Rare Cause of Progressive Myelopathy

    PubMed Central

    Steel, Christopher J; Abrames, Erik L; O’Brien, William T

    2015-01-01

    Arachnoiditis ossificans is a rare cause of chronic, progressive myelopathy. In contrast to the more common benign causes of meningeal calcification, arachnoiditis ossificans results in replacement of portions of the spinal arachnoid by bone as an end-stage complication of adhesive arachnoiditis. It is usually the sequela of prior trauma or interventional procedures. Prognosis and treatment options depend upon the location and degree of spinal stenosis with thoracic involvement being more common and more severe than lumbar spine involvement. The imaging findings on magnetic resonance imaging may be confusing; however, the findings of intraspinal ossification on computed tomography are characteristics and diagnostic. We present a classic case of arachnoiditis ossificans in an elderly man who presented with progressive myelopathy and a recent fall, along with a review of the literature. The imaging in this case not only identified the characteristic findings of arachnoiditis ossificans but also identified secondary findings of the underlying causative etiology. PMID:26401174

  13. Cerebellopontine angle arachnoid cyst associated with mirror movements

    PubMed Central

    Gurkas, Esra; Altan, Buket Yucel; Gücüyener, Kıvılcım; Kolsal, Ebru

    2015-01-01

    Arachnoid cysts are benign developmental collections of cerebrospinal fluid (CSF). They constitute approximately 1% of intracranial masses. The cerebellopontine angle (CPA) arachnoid cysts are rare and often asymptomatic. The onset of symptoms and signs is usually due to the compression of the brain, cranial nerves and obstruction of CSF circulation. The major clinical symptoms for CPA arachnoid cysts were reported as headache, ataxia and 8th cranial nerve palsy. We report a patient with a CPA arachnoid cyst. He presented with cranial nerve palsies and mirror movements found in upper extremities. We postulated that CPA arachnoid cyst compressing the brain stem and the pyramidal decussation may lead to mirror movements. We conclude that mirror movements can be associated with CPA arachnoid cyst. PMID:26962347

  14. Lumbosacral arachnoid cyst with tethered cord: A rare case report

    PubMed Central

    Jain, S. K.; Sundar, I. Vijay; Sharma, Vinod; Goel, Ravishankar S.

    2012-01-01

    Arachnoid cysts are cerebrospinal fluid collections in the spine that can present with neurological symptoms or be discovered accidentally. Intradural location of such cysts especially in the lumbosacral region is relatively rare. The association of such cysts with other congenital anomalies such as tethered cord lends evidence to the developmental origin of arachnoid cysts. We report a case of lumbosacral arachnoid cyst with tethered cord in a 6-year-old male child and discuss the etiopathogenesis and management options. PMID:24082689

  15. [A case of syringomyelia associated with postoperative extradural cyst and adhesive arachnoiditis].

    PubMed

    Horimoto, C; Ryu, N; Sibata, S; Mori, K

    1989-09-01

    We report a rare case of syringomyelia associated with postoperative adhesive arachnoiditis and an extradural cyst. A 61-year-old male was admitted to our hospital five years after surgical removal of a cervical neurinoma. He complained of progressive quadriparesis and sensory disturbance. A CT scan showed a large cyst posteriorly within the C2, 3, 4 laminectomy area. MRI revealed syringomyelia with an extradural cyst at the C2, 3, 4 level. The operative findings revealed adhesive arachnoiditis on the dorsal surface at the C2, 3, 4 level and an extradural cyst communicating with the subarachnoid space through a dural defect on the left side of the C2 level. By excision of the extradural cyst and placement of a syringo-cisternal shunt, the syringomyelia shrank and the extradural cyst disappeared. It can be speculated that the pathogenesis of syringomyelia in this case was associated with ischemic change of the spinal cord due to compression and constriction caused by the extradural cyst and adhesive arachnoiditis.

  16. Syringomyelia and arachnoid cysts associated with spinal arachnoiditis following subarachnoid hemorrhage.

    PubMed

    Ishizaka, Shunsuke; Hayashi, Kentaro; Otsuka, Munehiro; Fukuda, Shuji; Tsunoda, Keishi; Ushijima, Ryujiro; Kitagawa, Naoki; Suyama, Kazuhiko; Nagata, Izumi

    2012-01-01

    A 66-year-old woman with primary Sjogren syndrome developed syringomyelia following two episodes of subarachnoid hemorrhage (SAH) due to the rupture of basilar artery aneurysms. Gait disturbance and abnormal sensation with pain over the foot and abdomen appeared 3 years after the last SAH. Magnetic resonance (MR) imaging revealed a syringomyelia throughout the thoracic cord, from the T2 to T11 levels. In addition, the thoracic cord was compressed by multiple arachnoid cysts in the ventral side of spinal cord. Computed tomography myelography revealed complete block of cerebrospinal fluid (CSF) flow at the T7 level. Surgery for microlysis of the adhesions and restoration of the CSF flow pathway was performed. Postoperatively, leg motor function slowly improved and she could walk unaided. However, abdominal paresthesia was persisted. Postoperative MR imaging revealed diminished size of the syrinxes. We should recognize syringomyelia and arachnoid cysts due to adhesive arachnoiditis as a late complication of SAH. Microlysis of the adhesions focusing on the lesion thought to be the cause of the symptoms is one of the choices to treat massive syringomyelia and arachnoid cysts associated with arachnoiditis following SAH.

  17. Posterior peritoneal recesses: assessment using CT

    SciTech Connect

    Rubenstein, W.A.; Auh, Y.H.; Zirinsky, K.; Kneeland, J.B.; Whalen, J.P.; Kazam, E.

    1985-08-01

    Intraperitoneal compartments may extend posteriorly to the level of known retroperitoneal structures at several locations within the abdomen. These locations include the posterior subhepatic or hepatorenal space, the splenorenal space, the retropancreatic recess, the paracolic gutters, and the pararectal fossae. Because of their posterior location, fluid collections within these compartments may be mistaken radiologically for retroperitoneal masses. The sectional anatomy of these spaces and particularly their appearance on computed tomographic scans, are illustrated in this paper.

  18. Bilateral cerebellopontine arachnoid cyst: A rare entity.

    PubMed

    Sharma, Anand; Sharma, Achal; Mittal, Radhey S; Gandhi, Ashok

    2015-01-01

    Bilateral cerebellopontine angle (CPA) arachnoid cysts (ACs) are very rare: only one case is reported in literature. Pathogenesis of those cysts is unknown; they are thought to be congenital. The presenting symptoms of CPA AC are frequently nonspecific or otological. The management of ACs of the CPA is controversial. We are reporting two cases of bilateral CPA AC with their pathophysiology and review of literature.

  19. [Flexible endoscopy in surgical treatment of spinal adhesive arachnoiditis and arachnoid cysts].

    PubMed

    Kashcheev, A A; Arestov, S O; Gushcha, A O

    2013-01-01

    Thecaloscopy is less invasive exploration of spinal subarachnoid space with ultra-thin flexible endoscope and endoscopic fenestration of scars and adhesions. Thecalopscopy was used in Russian neurosurgery at the first time. Since 2009 we operated 32 patients with following diagnosis: 17--spinal adhesive arachnoiditis (8--local forms, 9--diffuse forms), 12--spinal arachnoid cysts (7--posstraumatic cysts, 5--idiopathic cysts), 3--extramedullary tumors (thecaloscopic videoassistance and biopsy). In all cases we realized exploration of subarachnoid space and pathologic lesion with endoscopic perforation of cyst or dissection of adhesions using special instrumentation. Mean follow-up in our group was 11.4 months. Neurological improvement (mean 1.4 by modified Frankel scale, 1.8 by Ashworth spasticity scale) was seen in 87% of patients operated for spinal arachnopathies. Temporary neurological deterioration (mild disturbances of deep sensitivity) was seen in 9% of patients and managed successfully with conservative treatment. 1 (3.1%) patient was operated 3 times because of relapse of adhesions. There were no serious intraoperative complications (e.g., serious bleeding, dura perforation etc). Postoperative complications included 1 CSF leakage and 1 postoperative neuralgic pain. Mean term of hospitalization was 7.6 days. According to our data, we suppose that thecaloscopy is efficient and safe method, and should be widely used for spinal arachnopaties, adhesive arachnoiditis and arachnoid cysts. Taking into account that adhesive spinal arachnoiditis is systemic process and spinal arachnoid cysts can be extended as well, thecaloscopy may be regarded as the most radical and less-invasive way of surgical treatment existing currently in neurosurgery.

  20. [Intrasellar arachnoid cysts. Two case reports and literature review].

    PubMed

    Lorente-Muñoz, Asís; Lisbona-Alquézar, María Pilar; Alberdi-Viñas, Juan; Orduna-Martinez, Javier; González-Martínez, Luis; Fernández-Liesa, Rafael

    2013-01-01

    Intrasellar arachnoid cysts are an uncommon pathology, with only a few cases reported in scientific literature. Their physiopathology is still unknown, with different hypothesis about their development. Differential diagnosis with other cystic sellar lesions is difficult. We report two cases of two intrasellar arachnoid cysts that were treated surgically using transsphenoidal approach and present a review of the literature.

  1. Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis.

    PubMed

    Tachibana, Toshiya; Moriyama, Tokuhide; Maruo, Keishi; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

    2014-11-01

    The authors report a case of adhesive arachnoiditis (AA) and arachnoid cyst successfully treated by subarachnoid to subarachnoid bypass (S-S bypass). Arachnoid cysts or syringes sometimes compress the spinal cord and cause compressive myelopathy that requires surgical treatment. However, surgical treatment for AA is challenging. A 57-year-old woman developed leg pain and gait disturbance. A dorsal arachnoid cyst compressed the spinal cord at T7-9, the spinal cord was swollen, and a small syrinx was present at T9-10. An S-S bypass was performed from T6-7 to T11-12. The patient's gait disturbance resolved immediately after surgery. Two years later, a small arachnoid cyst developed. However, there was no neurological deterioration. The myelopathy associated with thoracic spinal AA, subarachnoid cyst, and syrinx improved after S-S bypass.

  2. Acoustic Schwannoma Presenting as Acute Posterior Fossa Hematoma

    PubMed Central

    Ghobashy, Ashraf; Loveren, Harry van

    1993-01-01

    Acoustic schwannomas usually present with gradually progressive unilateral sensorineural hearing loss. As the tumor enlarges, symptoms and signs develop when the adjacent cranial nerves, cerebelhim, and/or brainstem become compressed. Rarely, acoustic tumors present with acute subarachnoid or intratumoral hemorrhage. Of the 12 cases of acoustic schwannoma with tumoral hemorrhage presented in the literature of which we are aware, this is the third such case of a patient presenting with spontaneous pure intratumoral hemorrhage and the first such case presenting with sudden multiple cranial nerve palsies, The purpose of this report is to increase the awareness of this rare form of presentation of acoustic schwannoma in the hope of achieving better preservation of cranial nerves. ImagesFigure 1Figure 2Figure 3 PMID:17170903

  3. A 15 year old boy with a posterior fossa tumor.

    PubMed

    Chapman, Erin M; Ranger, Adrianna; Lee, Donald H; Hammond, Robert R

    2009-04-01

    A 15 year old male presented with hydrocephalus from a tectal mass obstructing the cerebral aqueduct and upper fourth ventricle. The solid-cystic partly enhancing mass proved to be a pigmented pleomorphic xanthoastrocytoma, the third such example reported. The lesion revealed typical features of a PXA with the unusual addition of intracytoplasmic melanin in select lesional cells. Melanin pigment production is uncommon in glial tumors and of uncertain significance. The present case is recurrence-free one year post-operatively.

  4. Surgical Anatomy of the Extended Middle Cranial Fossa Approach

    PubMed Central

    Arìstegui, Miguel; Cokkeser, Yasar; Saleh, Essam; Naguib, Maged; Landolfi, Mauro; Taibah, Abdel; Sanna, Mario

    1994-01-01

    The extended middle cranial fossa approach includes removal of the petrous bone from its subtemporal surface in order to expose widely the internal auditory canal and the posterior fossa dura around its porus while preserving all the important and closely related anatomical structures. We have dissected 25 temporal bones and five fresh cadavers in order to define the limits of this approach. Measurements were obtained between the different structures to find reliable angles and distances that could guide working in this area. A new method of identification of the internal auditory canal is discussed based on the measurements taken. The results of the present work showed wide variations in the different structures. The arcuate eminence was coincident with the superior semicircular canal in only 48% of bones. Dehiscence of the geniculate ganglion and of the internal carotid artery was noted in 16% and 20% of specimens, respectively. The angles measured between the different structures showed great variations. However, the angle between the internal auditory canal and superior petrosal sinus was constant. Though the extended middle cranial fossa is a versatile approach, it affords a limited access to the cerebellopontine angle. A thorough understanding of the complex and variable anatomy of this area is necessary should this approach be utilized. ImagesFigure 1p183-bFigure 2Figure 3Figure 4Figure 5 PMID:17171170

  5. Obstetric epidurals and chronic adhesive arachnoiditis.

    PubMed

    Rice, I; Wee, M Y K; Thomson, K

    2004-01-01

    It has been suggested that obstetric epidurals lead to chronic adhesive arachnoiditis (CAA). CAA is a nebulous disease entity with much confusion over its symptomatology. This review outlines the pathological, clinical, and radiological features of the disease. The proposed diagnostic criteria for CAA are: back pain that increases on exertion, with or without leg pain; neurological abnormality on examination; and characteristic MRI findings. Using these criteria, there is evidence to show that epidural or subarachnoid placement of some contrast media, preservatives and possibly vasoconstrictors, may lead to CAA. No evidence was found that the preservative-free, low concentration bupivacaine with opioid mixtures or plain bupivacaine currently used in labour lead to CAA.

  6. The changing pattern of spinal arachnoiditis.

    PubMed Central

    Shaw, M D; Russell, J A; Grossart, K W

    1978-01-01

    Spinal arachnoiditis is a rare condition. Eighty cases, diagnosed during a period when 7600 spinal contrast investigations were undertaken, have been reviewed. The majority had suffered a previous spinal condition, the most common being lumbar disc disease. There has been a change in the distribution of arahnoiditis with the lumbar region now most frequently involved. This accounts for the persistence of radicular symptoms and the relatively low incidence of paraplegia when compared with earlier series. Surgery does not appear to have any role in the treatment. Images PMID:632824

  7. Syringomyelia associated with adhesive spinal arachnoiditis: MRI.

    PubMed

    Inoue, Y; Nemoto, Y; Ohata, K; Daikokuya, H; Hakuba, A; Tashiro, T; Shakudo, M; Nagai, K; Nakayama, K; Yamada, R

    2001-04-01

    We reviewed the MRI of seven patients with syringomyelia associated with surgically proven adhesive spinal arachnoiditis to describe clinical and MRI findings in this condition. Using 0.5, 1.0 or 1.5 tesla units, we obtained sagittal T1- and T2-weighted spin-echo and axial T1-weighted images. Additional sagittal T2-weighted images were obtained without using motion-artefact suppression. Contrast medium was given intravenously to five patients. The syrinx cavities were thoracic in five cases, cervicothoracic in one, and extended from C4 to L1 in one. No Chiari malformation or craniovertebral junction anomaly was demonstrated. Meningeal thickening was seen on T2-weighted sagittal images only in one case. Cord deformity due to adhesion or displacement due to an associated arachnoid cyst was seen in all cases best demonstrated on axial images. Focal blurring of the syrinx wall on axial images was seen in six patients. Flow voids were seen in the syrinx fluid in all cases on T2-weighted images obtained without motion-artefact suppression. No abnormal contrast enhancement was demonstrated.

  8. Post-lumbar puncture arachnoiditis. The need for directed questioning.

    PubMed

    Etchepare, Fabien; Roche, Bruno; Rozenberg, Sylvie; Dion, Elisabeth; Bourgeois, Pierre; Fautrel, Bruno

    2005-03-01

    The inflammation of the arachnoid mater may produce a fibrinous exudate around the roots that causes them to adhere to the dural sheath. We report the case of a man aged 23 years who suffered from acute inflammatory truncated sciatica. The diagnosis of adhesive arachnoiditis was made in front of clinical arguments associated to typical signs on Myelo CT Scan and MRI. The only explanation ever found was a traumatic lumbar puncture at the age of 6 years for suspected meningitis. Sequelae of arachnoiditis are difficult to diagnosis. When MRI or myelography suggests it as a possibility, precise directed questioning is necessary to seek a history, albeit distant, of spinal or meningeal events.

  9. Quadrigeminal arachnoid cysts in a kitten and a dog.

    PubMed

    Reed, Scott; Cho, Doo Youn; Paulsen, Dan

    2009-09-01

    Two quadrigeminal arachnoid cysts with different pathogenesis are described in 2 different species. A 10-week-old male Persian kitten with a progressively decreasing level of consciousness died spontaneously. At necropsy, mild internal hydrocephalus, caudal cerebellar coning, and cerebellar herniation through the foramen magnum were associated with a congenital quadrigeminal arachnoid cyst compressing the rostral cerebellum and shifting the entire cerebellum caudally. In contrast, a possibly acquired quadrigeminal cyst was observed in a 2-year-old male neutered Yorkshire Terrier in association with necrotizing encephalitis. Quadrigeminal arachnoid cysts have been rarely reported in dogs and humans.

  10. Giant nontraumatic intradiploic arachnoid cyst in a young male*

    PubMed Central

    Sharma, Rajesh; Gupta, Puneet; Mahajan, Manik; Sharma, Poonam; Gupta, Anchal; Khurana, Arti

    2016-01-01

    Intradiploic arachnoid cysts have scarcely been reported in the literature, most reported cases being secondary to trauma. Nontraumatic arachnoid cysts are quite rare and have been reported mostly in adults. Here, we report the case of a 16-year-old male presenting with a slowly growing mass in the occipital region and intermittent headaches. On the basis of the findings of X-rays, computed tomography scans, and magnetic resonance imaging scans of the head, the mass was diagnosed as a giant intradiploic arachnoid cyst. PMID:27818549

  11. Brain Herniation into Giant Arachnoid Granulation: An Unusual Case

    PubMed Central

    Santos, Gonçalo Roque

    2017-01-01

    Arachnoid granulations are structures filled with cerebrospinal fluid (CSF) that extend into the venous sinuses through openings in the dura mater and allow the drainage of CSF from subarachnoid space into venous system. Usually they are asymptomatic but can be symptomatic when large enough to cause sinus occlusion. We report a rare case of a brain herniation into a giant arachnoid granulation in an asymptomatic elderly male patient, which was discovered incidentally. PMID:28392955

  12. [Arachnoid cysts. Historical evolution of the concept and pathophysiological theories].

    PubMed

    Conde Sardón, Rebeca

    2015-01-01

    Arachnoid cysts of central nervous system are benign collections filled with a liquid that is equal o similar to cerebrospinal fluid, coated with a single layer or flattened arachnoid cells membrane, congenital or secondary to trauma, meningitis or hemorrhage. First described by Bright in 1931, its definition and possible pathophysiology has been debated to date. Our objective is to present a summary of this process.

  13. Spinal arachnoid pseudocysts in 10 rottweilers.

    PubMed

    Jurina, K; Grevel, V

    2004-01-01

    Ten rottweilers presenting with spinal arachnoid pseudocysts were investigated. In six dogs, the lesions were localised dorsally at C2-C3; in three dogs, dorsally and ventrally at C5-C6; and, in one dog, dorsally and ventrally at C6-C7. Clinical signs were consistent with focal compression of the affected spinal cord segments. The animals showed ataxia of all four limbs, with truncal ataxia and marked hypermetria in cases of C2-C3 involvement, or ambulatory tetraparesis in cases of C5-C6 or C6-C7 involvement. Other than signs indicative of spina bifida in one dog, no abnormalities could be detected on plain radiographs. Myelography was used to define the localisation and extent of the pseudocysts. Additional information was obtained using magnetic resonance imaging in five dogs. Five dogs underwent a dorsal laminectomy; in three cases, the pseudocyst was treated by marsupialisation and, in two, by durectomy.

  14. Acheron Fossae in Visible Light

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This visible-light image, taken by the thermal emission imaging system's camera on NASA's 2001 Mars Odyssey spacecraft, shows the highly fractured, faulted and deformed Acheron Fossae region of Mars. The scarps visible in this image are approximately one kilometer (3,300 feet) high, based on topography derived from the laser altimeter instrument on Mars Global Surveyor.

    Dark streaks only 50 meters (164 feet) across can be seen on some of the cliff faces. These streaks may be formed when the pervasive dust mantle covering this region gives way on steep slopes to create dust avalanches.

    The image also shows impact craters as small as 500 meters (1,640 feet) in diameter, as well as smooth and textured plains.

    Acheron Fossae is located 1,050 kilometers (650 miles) north of the large shield volcano Olympus Mons. This image covers an area about 18 by 9 kilometers (11 by 6 miles) centered at 37 degrees north, 131 degrees west. North is to the top of this image, which was acquired on February 19,2002, at about 3:15 p.m. local Martian time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The thermal emission imaging system was provided by Arizona State University, Tempe. Lockheed Martin Astronautics, Denver, is the prime contractor for the project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  15. Syringomyelia associated with spinal arachnoiditis treated by partial arachnoid dissection and syrinx-far distal subarachnoid shunt.

    PubMed

    Iwatsuki, Koichi; Yoshimine, Toshiki; Ohnishi, Yu-Ichiro; Ninomiya, Koshi; Moriwaki, Takashi; Ohkawa, Toshika

    2014-01-01

    The authors describe a new modified surgical approach to minimize the postoperative recurrence of a syrinx after surgery to treat syringomyelia associated with spinal adhesive arachnoiditis in two cases. Both patients presented with progressive gait disturbance without any remarkable history, and spinal magnetic resonance imaging revealed a syrinx and broad irregular disappearance of the subarachnoid space and/or deformity of the cord. We successfully performed a partial arachnoid dissection and syrinx-far distal subarachnoid shunt for both cases.

  16. Syringomyelia Associated with Spinal Arachnoiditis Treated by Partial Arachnoid Dissection and Syrinx-Far Distal Subarachnoid Shunt

    PubMed Central

    Iwatsuki, Koichi; Yoshimine, Toshiki; Ohnishi, Yu-Ichiro; Ninomiya, Koshi; Moriwaki, Takashi; Ohkawa, Toshika

    2014-01-01

    The authors describe a new modified surgical approach to minimize the postoperative recurrence of a syrinx after surgery to treat syringomyelia associated with spinal adhesive arachnoiditis in two cases. Both patients presented with progressive gait disturbance without any remarkable history, and spinal magnetic resonance imaging revealed a syrinx and broad irregular disappearance of the subarachnoid space and/or deformity of the cord. We successfully performed a partial arachnoid dissection and syrinx-far distal subarachnoid shunt for both cases. PMID:25232285

  17. Scalloping Sacral Arachnoid Cyst as a Cause of Perianal Pain- A Case Report

    PubMed Central

    Tyagi, Himanshu Ravindra; Kalra, Kashmiri Lal; Acharya, Shankar; Singh, Rupinder Pal

    2014-01-01

    Introduction: Scalloping sacral arachnoid cyst though a rare condition, should be suspected in cases of persistent perianal pain without any obvious urological or anorectal pathology. Such difficult cases justify ordering an M.R.I of spine as plain X-Rays and clinical examination may come out to be inconclusive. X-ray in later stages may show changes corresponding to scalloping of bone due pressure effect of cyst on surrounding tissue. Diagnosis may further be confirmed by doing contrast MRI which differentiates arachnoid cyst from other intradural and extradural pathologies. Though anatomically spinal arachnoid cysts are just an out pouching from the spinal meningeal sac or nerve root sheath they may be extradural or intradural in their location, communicating to main C.S.F column through their pedicle or an ostium leading to continuous enlargement in size. Case Report: A 32 year old female was admitted under our spine unit with 1.5 year history of chronic pain, swelling and reduced sensation in perianal region. On examination she had tenderness and hypoesthesia over lower sacral region. The pain was continuous, dull aching in nature, not related to activity, localized over lower sacrum and perianal area. The neurological examination of her both lower limbs were unremarkable. Anal tone and anal reflex were normal. No sign of inflammation or tenderness was found over coccyx. Since the X-rays were inconclusive an MRI scan was done which showed a cystic lesion in the sacral area extending from S2 to S4 region with mechanical scalloping effect on the surrounding bone. The lesion had same intensity as C.S.F in both T1 &T2 weighted images. The treatment was done by way of surgical decompression with complete excision of cyst and obliteration of space by a posterior midline approach. Presently the patient is 1 year post operative and no sign of recurrence is there. Conclusion: Sacral arachnoid cysts should be considered as a differential diagnosis of perianal pain. Large

  18. Nili Fossae Resource and Science ROIs

    NASA Astrophysics Data System (ADS)

    Markle, L. M.

    2015-10-01

    The Nili Fossae region presents multiple resource and science ROIs for establishing a permanent colony on Mars. Water ice appears to cover a large are and multiple geological formations provide opportunity for science missions.

  19. Tumors of the Infratemporal Fossa

    PubMed Central

    Tiwari, Rammohan; Quak, Jasper; Egeler, Saskia; Smeele, Ludi; Waal, Isaac v.d.; Valk, Paul v.d.; Leemans, Rene

    2000-01-01

    Neoplastic processes involving the infratemporal fossa may originate from the tissues in the region, but more often are the result of extension from neighboring structures. Metastatic lesions located in the region are rarely encountered. Because of its concealed localization, tumors may remain unnoticed for some time. Clinical signs and symptoms often arise late, are insidious, and may be mistakenly attributed to other structures. The close proximity of the area to the intracranial structures, the orbit, the paranasal sinuses, the nasopharynx, and the facial area demands careful planning of surgical excision and combined procedures may be called for. Modern imaging techniques have made three-dimensional visualization of the extent of the pathology possible. Treatment depends on the histopathology and staging of the tumor. Several surgical approaches have been developed over the years. Radical tumor excision with preservation of the quality of life remain the ultimate goal for those tumors where surgery is indicated. Experience over a decade with various pathologies is presented. ImagesFigure 1p6-bFigure 2Figure 3 PMID:17171095

  20. Delayed occurrence of spinal arachnoiditis following a caudal block

    PubMed Central

    Na, Eun Hye; Han, Soo Jeong; Kim, Myung Hyun

    2011-01-01

    Context Spinal arachnoiditis is a rare disease caused by fibrosis and adhesion of the arachnoid membrane due to chronic inflammation. The causes of arachnoiditis are infection, spinal surgery, intraspinal injection of steroid or myelography dye, and spinal anesthesia. Method Case report. Findings A 60-year-old woman presented with progressive weakness and sensory change of both legs and urinary symptoms. She had received a single caudal block 6 months before symptom onset. Magnetic resonance imaging of the thoraco-lumbar spine showed an intradural extramedullary tumor at the T5–T7 level. She underwent laminectomy and tumor resection. The pathological finding was arachnoiditis. After surgery, a rehabilitation program of strengthening exercises of both lower extremities and gait training was started. At 2-month follow-up, she was able to walk with orthoses and performed daily activities with minimal assistance. Conclusion Symptoms of spinal arachnoiditis occurred 6 months after a single caudal block in this woman. Clinicians should be aware of this possible delayed complication. PMID:22330119

  1. Fibromyalgia and arachnoiditis presented as an acute spinal disorder

    PubMed Central

    Idris, Zamzuri; Ghazali, Faizul H.; Abdullah, Jafri M.

    2014-01-01

    Background: Adhesive arachnoiditis is a chronic, insidious condition that causes debilitating intractable pain and a range of other neurological problems. Its pathophysiology is not well understood. This manuscript discusses its presentations, which can mimic an acute spinal disorder, its hypothetical pathophysiology, treatment, and its relationship with fibromyalgia. Case Description: The authors present a case of a 47-year-old female who presented with clinical features mimicking an acute spinal disorder but later found to have an adhesive arachnoiditis. She was admitted following a trauma with complaints of back pain and paraplegia. On examination, there was marked tenderness over thoracolumbar spine with lower limbs upper motor neuron weakness. An urgent magnetic resonance imaging (MRI) of the spine revealed multiple lesions at her thoracic and lumbar spinal canals, which did not compress the spinal cord. Therefore, conservative management was initiated. Despite on regular therapies, her back and body pain worsened and little improvement in her limbs power was noted. Laminectomy was pursued and found to have spinal cord arachnoiditis. Subsequently, she was operated by other team members for multiple pelvic masses, which later proved to be benign. After gathering all the clinical information obtained at surgery and after taking detailed history inclusive of cognitive functions, diagnosis of an adhesive arachnoiditis syndrome was made. Currently, she is managed by neuropsychologist and pain specialist. Conclusion: This case report highlights the importance of knowing an adhesive arachnoiditis syndrome – a rarely discussed pathology by the neurosurgeon, which discloses a significant relationship between immune and nervous systems. PMID:25396073

  2. Results of surgical lysis of lumbar adhesive arachnoiditis.

    PubMed

    Wilkinson, H A; Schuman, N

    1979-05-01

    From a series of 681 patients with lumbar disc disease treated between 1966 and 1978, 17 patients required surgical lysis of lumbar adhesive arachnoiditis, 8 having initially been operated upon by another surgeon. All patients had severe pain as a predominant feature, with pain being bilateral in 9 patients. Pain was the only major symptom in 3; the other 14 exhibited varying combinations of progressive neurological dysfunction. Three patients developed late symptoms after trauma, 8 to 21 years after back surgery. At operation, multisegmental arachnoiditis was found in 5 patients and anular or subtotal adhesions were found in 12. Complete lysis could not be obtained in 4 patients. Fourteen patients were treated with steroids at the time of operation. Follow-up after lysis was less than 1 year for 5 patients but averaged 4.8 years for the remaining 12. During the 1st year after operation, 76% experienced improvement in pain (35%, good to excellent), 71% experienced improvement in neurological status. Follow-up after at least 1 year revealed 50% still enjoying pain relief (25%, good to excellent) and 45% experiencing neurological improvement. Pain relief persisted in 4 of 5 patients followed 5 years or more. The etiological role of myelograpy and lumbar disc surgery in arachnoiditis has probably been over-rated. Arachnoiditis may be symptomatic or asymptomatic and may mask other, treatable lumbar lesions. More frequent intradural exploration for discrepancies between operative and myelographic findings might reveal, and benefit, more cases of spontaneous arachnoiditis mimicking lumbar disc disease.

  3. [The presyrinx state due to adhesive arachnoiditis: a case report].

    PubMed

    Nakata, Yasuhiro; Yagishita, Akira; Taniguchi, Makoto

    2006-06-01

    We report a 66-year-old woman with a presyrinx state due to adhesive arachnoiditis. She had a history of subarachnoid hemorrhage one year ago. She became aware of gait disturbance and abnormal sensation at the chest 6 months ago. Neurological examination revealed weakness of the both lower extremities and sensory disturbance below the T6 level. MR images of the thoracic spine revealed swelling of the thoracic cord at the T3-4 level, with an intramedullary hyperintensity on T2 weighted images (WI) and hypointensity on T1-WI. The intramedullary hypointensity on T1-WI was less than the CSF intensity. In addition, the thoracic cord lower than T5 level was compressed by an arachnoid cyst in the spinal canal. The preoperative diagnosis was the presyrinx state due to adhesive arachnoiditis. An operation for detachment of arachnoidal adhesion and restoration of CSF flow pathway was performed. After one month from the operation, neurological findings were improved. Postoperative MR images revealed improvement of swelling of the thoracic cord and intramedullary abnormal intensity. The arachnoid cyst in the spinal canal was decreased in the size. The presyrinx state is recently recognized condition before the formation of syringomyelia and that is known to resolve with proper treatment. We wish to emphasize we could prevent a progression to syringomyelia by a proper treatment for the presyrinx state.

  4. Surgical management of syringomyelia associated with spinal adhesive arachnoiditis.

    PubMed

    Ohata, K; Gotoh, T; Matsusaka, Y; Morino, M; Tsuyuguchi, N; Sheikh, B; Inoue, Y; Hakuba, A

    2001-01-01

    The authors describe a new surgical technique to minimise the postoperative recurrence of adhesion after microlysis of adhesion to treat syringomyelia associated with spinal adhesive arachnoiditis. A 47 year old male presented with numbness of the lower extremities and urinary disturbance and was demonstrated to have a case of syringomyelia from C1 to T2 which was thought to be secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis. Following meticulous microlysis of the adhesions, maximal expansion of a blocked subarachnoid space was performed by expansive duraplasty with a Gore-Tex surgical membrane, expansive laminoplasty and multiple tenting sutures of the Gore-Tex graft. Postoperatively, the syringomyelia had be en completely obliterated and improvement of the symptoms had been also achieved. The technique described may contribute to improvement of the surgical outcome following arachnoid dissection by maintaining continuity of the reconstructed subarachnoid space.

  5. Chronic adhesive arachnoiditis after repeat epidural blood patch.

    PubMed

    Carlswärd, C; Darvish, B; Tunelli, J; Irestedt, L

    2015-08-01

    Epidural blood patching is an effective treatment for postdural puncture headache but has potential risks. Arachnoiditis is a very rare disabling condition and few cases have been described following an epidural blood patch. We present a case of chronic adhesive arachnoiditis in a parturient treated with a repeat epidural blood patch. A healthy 29-year-old woman had an accidental dural puncture following epidural insertion during labour. Initial treatment of postdural puncture headache with an epidural blood patch was ineffective and was therefore repeated. She gradually developed severe neurological symptoms consistent with arachnoiditis confirmed with magnetic resonance imaging. Despite intensive multimodal treatment with analgesics and physiotherapy, her neurological condition remains unresolved two years later. This serious but rare complication should encourage caution when treating parturients with postdural puncture headache with a repeat epidural blood patch.

  6. Lumbar adhesive arachnoiditis following attempted epidural anesthesia--case report.

    PubMed

    Haisa, T; Todo, T; Mitsui, I; Kondo, T

    1995-02-01

    A 30-year-old female experienced a sudden sharp pain radiating down to the left leg from the lower back at epidural intubation for anesthesia at childbirth. She continued to complain of pain in the left leg afterwards. Magnetic resonance images demonstrated a conglomeration of adherent nerve roots due to lumbar adhesive arachnoiditis. Microsurgical dissection of adherent nerve roots was performed. Her symptoms disappeared after surgery, but soon recurred, being less severe and responsive to anti-inflammatory agents. Lumbar adhesive arachnoiditis should be considered for differential diagnosis in patients presenting with back and leg pain syndrome.

  7. [A case of symptomatic interhemispheric arachnoid cyst in the elderly].

    PubMed

    Tomabechi, M; Takano, K; Suzuki, N; Daita, G

    1999-04-01

    The incidence of interhemispheric cyst is rare. There have been only 12 cases reported in adults since the advent of CT. We encountered a case of an interhemispheric arachnoid cyst in a 54-year-old patient who had developed paraparesis. Excision of the cystic wall produced a satisfactory result. The CT and MRI scans were not contributory to histological differentiation of the lesions. According to the literature, however, it is highly likely that these patients are suffering from an arachnoid cyst, when the interhemispheric cyst without agenesis of the corpus callosum occurs in adults.

  8. Case Report: Floating fat globule within an arachnoid cyst

    PubMed Central

    Sudhir, Jayanand; Gopalakrishnan, Chittur Viswanathan; Prabhu, Sathia; Chinchure, Swati

    2011-01-01

    Intralesional floating fat globules have been reported in cystic lesions such as teratoma of the ovary and dermoid of the head and neck but not within intracranial lesions. Fat globules dispersed within the subarachnoid space are a known imaging finding of ruptured intracranial dermoid. We report a unique case of an intralesional solitary floating fat globule within a multicompartmental arachnoid cyst, with varying locations on serial imaging. We also put forward a hypothesis for the pathogenesis of fat within an arachnoid cyst. To the best of our knowledge, this is the first such report in the literature. PMID:22013301

  9. Trochanteric fossa or piriform fossa of the femur: time for standardised terminology?

    PubMed

    Ansari Moein, C M S; Gerrits, P D; ten Duis, H J

    2013-06-01

    Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in this review study. The trochanteric fossa, a deep depression at the base of the femoral neck is indicated as 'piriform fossa' in the vast majority of the publications. Other publications indicate the insertion site of the tendon of the piriformis muscle on the greater trochanteric tip as 'piriform fossa'. As a result of recurrent terminology error and consistent reproductions of it, the recommended entry point in literature is confusing and seems to need standardisation. The piriform fossa does not appear to exist in the femoral region. The trochanteric fossa is the standard entry point which most surgeons recommend for facilitating a standard straight intramedullary nail, as is in line with the medullary canal. The greater trochanteric tip is the lateral entry point for intramedullary nails with a proximal lateral bend.

  10. Correlation of replicating cells and osteogenesis in the glenoid fossa during stepwise advancement.

    PubMed

    Rabie, A B M; Wong, Louise; Hägg, Urban

    2003-05-01

    The purposes of this study were to quantify the number of replicating mesenchymal cells and to correlate it with the amount of new bone formed in the glenoid fossa during stepwise advancement. We randomly divided 250 female Sprague-Dawley rats, 35 days old, into 10 control groups (n = 5) and 20 experimental groups (n = 10). Fifty rats from the stepwise experimental group received initial advancement of 2 mm and another 1.5 mm of advancement on day 30 by the addition of veeners. On days 3, 7, 14, 21, 30, 33, 37, 44, 51, and 60, the rats were killed. One hour before that, the rats were injected with bromodeoxyuridine (BrdU) intravenously. We cut 7-microm tissue sections through the glenoid fossa sagittally and stained them with anti-BrdU antibody to evaluate the number of replicating mesenchymal cells. During the first advancement, the number of replicating cells in the posterior region of the glenoid fossa showed a significant increase compared with natural growth, but a significant decrease compared with 1-step advancement. On the second advancement, however, an increase in the number of replicating cells was observed on day 37 with a subsequent and significant increase in bone formation on day 44. Mandibular advancement conducted in a stepwise fashion increases the number of replicating mesenchymal cells in the glenoid fossa. However, a minimum threshold of strain must first be exceeded before these mesenchymal cells can differentiate to ultimately form new bone.

  11. Infratemporal fossa abscess: a diagnostic dilemma.

    PubMed

    Kamath, M Panduranga; Bhojwani, Kiran M; Mahale, Ajit; Meyyappan, Hari; Abhijit, Kumar

    2009-05-01

    An abscess in the infratemporal fossa is a rare complication of dental extraction. Although it is a recognized entity, only a handful of cases have been reported in the literature. We describe a case of abscess in the infratemporal fossa of a 55-year-old woman with noninsulin-dependent (type 2) diabetes who presented with left-sided facial pain and marked trismus. The abscess was managed successfully with external drainage. We have made an attempt to comprehensively review the literature on this rare condition, with special emphasis on its anatomic complexity and varied clinical presentation, and we provide a detailed discussion of the diagnosis and management of this condition.

  12. Thorotrast induced adhesive arachnoiditis associated with meningioma and schwannoma.

    PubMed

    Meyer, M W; Powell, H C; Wagner, M; Niwayama, G

    1978-05-01

    Adhesive arachnoiditis, a meningioma and a schwannoma were found at autopsy in a 56 year old man who had undergone Thorotrast myelography 33 years previously. Thorotrast was demonstrated in tissue sections by transmission and scanning electron microscopy, radioautography, and x-ray spectrometry.

  13. Arachnoid granules: Dandy was Dandy, Cushing and Weed were not.

    PubMed

    Maurizi, Charles P

    2010-08-01

    Errors can be instructive. It seems that Harvey Cushing and Louis Weed provided the medical world with a faulty theory of cerebrospinal fluid absorption. Louis Weed, working in Harvey Cushing's laboratory, initially studied the movement of substances in the cerebrospinal fluid by using low-pressure studies. Results of the low-pressure studies were considered unsatisfactory and high pressure experiments were undertaken and these had results similar to earlier work done by others in human cadavers. High pressure results demonstrating movement of fluid through the arachnoid granules were deemed correct. Because of Cushing's position of authority, the theory became accepted as fact and in time proved to be entrenched dogma. Walter Dandy demonstrated in experiments on hydrocephalus and the surgical removal of the arachnoid granule system that the fluid was produced by the choroid plexuses and not absorbed by the arachnoid granules. His work was dismissed by Weed as unreliable. Examination of the pattern of deposition of corpora amylacea on the surface of the brain provides evidence that cerebrospinal fluid does not pass through arachnoid granules but passes through the choroid fissure and is recycled through choroid plexus portals. The choroid plexus portal theory can explain the findings in the low-pressure experiments of Weed. Bias and pride seem to be the source of the faulty theory. Entrenched dogma is resistant to challenge.

  14. Petrous apex arachnoid cyst extending into Meckel's cave.

    PubMed

    Batra, Arun; Tripathi, Rajendra Prasad; Singh, Anil Kumar; Tatke, Medha

    2002-09-01

    A rare case of arachnoid cyst involving the petrous apex with an unusual clinical presentation has been described with special emphasis in the imaging features and importance of accurate presurgical diagnosis. Differentiation from the other benign lesions involving the petrous apex and the role of newer MR techniques in the diagnosis of these lesions has been highlighted.

  15. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  16. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  17. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  18. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3950 Glenoid fossa prosthesis. (a) Identification. A glenoid fossa prosthesis is a device that is intended to be implanted in the...

  19. Striae in the popliteal fossa (image)

    MedlinePlus

    ... syndrome. Most pregnant women experience striae at some point during their pregnancy. This picture shows striae in the popliteal fossa (the area on the back side of the leg at the knee joint). When the striae first appear they have a ...

  20. [Experimental syringomyelia in rabbits and rats after localized spinal arachnoiditis].

    PubMed

    Tatara, N

    1992-12-01

    In order to produce syringomyelia, localized arachnoiditis was created in adult New Zealand albino rabbits and Wistar rats by the injection of kaolin into the thoracic spinal subarachnoid space and incision of the dura mater of the thoracic spinal cord. The rabbits and rats were divided into 3 groups; the control group, dural incision group (DG) and kaolin injection group (KG). Each rabbit was sacrificed at 4, 8, 12 and 16 weeks after the operation. Each rat was sacrificed at 8 and 16 weeks after the operation. Cavity formation in the cord of all rabbits was examined by ultrasound. All animals were perfused with 10% neutral beffered formalin at 150 cm H2O pressure, and histological examination was performed with Luxol fast blue (LFB) and hematoxylin and eosin (H&E) stains. Results obtained: (1) Cavity formation was noted in 6 of 16 DG of rabbit (37.5%), 5 of 16 KG of rabbit (31.2%) and 2 of 9 KG of rat (22.2%) with histological verification. With use of ultrasound, cavity was noted in 3 of 16 DG rabbits (12.5%) and 2 of 16 KG rabbits (18.8%). (2) Cavity formation was present in the cord adjacent to the marked adhesive arachnoiditis both in rabbits and in rats. (3) Cavity was noted in the ischemic area. (4) In 2 rabbits in which kaolin encircled whole surface of the spinal cord, hydromyelia was formed communicating with enlarged central canal caudad from the kaolin subarachnoid block. (5) Histological examination showed obliteration or narrowing of lumen of the small pial vessels involved in the adhesive arachnoiditis. In the cord parenchyma adjacent to the arachnoiditis, multiple spots of demyelination due secondary to ischemia demonstrated by LFB stain were noted. On the other hand, in the cord with the pia-arachnoid remained uninvolved, no demyelination was observed. (6) Localized adhesive arachnoiditis consisted of proliferation of fibrous tissue, lymphocytic infiltration and obliterating processes of small pial vessels involved in it. These data suggest that

  1. Hemorrhagic infarction following open fenestration of a large intracranial arachnoid cyst in a pediatric patient.

    PubMed

    Auschwitz, Tyler; DeCuypere, Michael; Khan, Nickalus; Einhaus, Stephanie

    2015-02-01

    Intracranial arachnoid cysts are a rare condition thought to be congenital in nature. Treatment of intracranial arachnoid cysts remains controversial based on their variable presentation. Treatment options include CSF shunting, endoscopic fenestration, or craniotomy and open fenestration for larger cysts. The complications of these procedures can include hydrocephalus, subdural hematomas, hygromas, and--more rarely--intraparenchymal hemorrhage. The authors found very few reports of hemorrhagic infarction as a complication of arachnoid cyst fenestration in the literature. The authors report a case of an 18-year-old female patient who suffered an ipsilateral hemorrhagic infarction after craniotomy for open fenestration of an arachnoid cyst.

  2. Cystic Meningioma Simulating Arachnoid Cyst: Report of an Unusual Case

    PubMed Central

    Jorge, Docampo; Nadia, Gonzalez; Claudio, Vazquez; Carlos, Morales; Eduardo, Gonzalez-Toledo

    2014-01-01

    The purpose of this paper is to show an unusual case of meningioma simulating arachnoid cyst on CT scan and MRI, diagnosed in a 63-year-old woman evaluated for headache and vision disorders. The meningioma shown is predominantly cystic with a small mural nodule enhancing after gadolinium and exhibiting diffusion restriction. Cystic portion of the tumor is hypodense on CT, and evidences fluid signal intensity on T1- and T2-weighted MR imaging. PMID:25057425

  3. [Cochlear implantation through the middle fossa approach].

    PubMed

    Szyfter, W; Colletti, V; Pruszewicz, A; Kopeć, T; Szymiec, E; Kawczyński, M; Karlik, M

    2001-01-01

    The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

  4. Visualization of regional cerebrospinal fluid flow with a dye injection technique in focal arachnoid pathologies.

    PubMed

    Yamaguchi, Satoshi; Hida, Kazutoshi; Takeda, Masaaki; Mitsuhara, Takafumi; Morishige, Mizuki; Yamada, Naoto; Kurisu, Kaoru

    2015-05-01

    Surgical lysis of the thickened arachnoid membrane is the first choice of treatment in spinal arachnoid pathologies that cause flow disturbances or blockage of CSF. However, it is important to consider that while extensive lysis of the arachnoid may temporarily provide a wide pathway for CSF, an extensive lytic procedure may later cause secondary adhesion. Thus, it is ideal for the proper extent of the arachnoid lysis to be determined after careful analysis of regional CSF flow. The authors report their limited experience with intraoperative visualization of CSF flow in spinal arachnoid pathologies. Two patients with a dorsal arachnoid web (DAW) with cervical syringomyelia and 1 patient with focal adhesive arachnoiditis causing edema of the spinal cord were surgically treated at the authors' institution between 2007 and 2013. In all cases, the presence of a DAW or focal adhesive arachnoiditis was suspected from the findings on MRI, namely 1) an indentation on the upper thoracic spinal cord and 2) syringomyelia and/or edema of the spinal cord above the indentation. Exploratory surgery disclosed a transversely thickened arachnoid septum on the dorsal side of the indented cord. To prove blockage of the CSF by the septum and to decide on the extent of arachnoid lysis, regional CSF flow around the arachnoid septum was visualized by subarachnoid injection of gentian violet solution close to the web. Injected dye stagnated just close to the arachnoid septum in all cases, and these findings documented CSF blockage by the septum. In 2 cases, a 2-minute observation showed that the injected dye stayed close to the web without diffusion. The authors performed not only resection of the web itself but also lysis of the thickened arachnoid on both sides of the spinal cord to make a CSF pathway on the ventral side. In the third case, the dye stagnated close to the web at first but then diffused through the nerve root to the ventral CSF space. The lysis procedure was completed

  5. Effect of Incremental Endoscopic Maxillectomy on Surgical Exposure of the Pterygopalatine and Infratemporal Fossae

    PubMed Central

    Upadhyay, Smita; Dolci, Ricardo L. L.; Buohliqah, Lamia; Fiore, Mariano E.; Filho, Leo F.S. Ditzel; Prevedello, Daniel M.; Otto, Bradley A.; Carrau, Ricardo L.

    2015-01-01

    Objective Access to the pterygopalatine and infratemporal fossae presents a significant surgical challenge, owing to their deep-seated location and complex neurovascular anatomy. This study elucidates the benefits of incremental medial maxillectomies to access this region. We compared access to the medial aspect of the infratemporal fossa provided by medial maxillectomy, anteriorly extended medial maxillectomy, endoscopic Denker approach (i.e., Sturmann-Canfield approach), contralateral transseptal approach, and the sublabial anterior maxillotomy (SAM). Methods We studied 10 cadaveric specimens (20 sides) dissecting the pterygopalatine and infratemporal fossae bilaterally. Radius of access was calculated using a navigation probe aligned with the endoscopic line of sight. Area of exposure was calculated as the area removed from the posterior wall of maxillary sinus. Surgical freedom was calculated by computing the working area at the proximal end of the instrument with the distal end fixed at a target. Results The endoscopic Denker approach offered a superior area of exposure (8.46 ± 1.56 cm2) and superior surgical freedom. Degree of lateral access with the SAM approach was similar to that of the Denker. Conclusion Our study suggests that an anterior extension of the medial maxillectomy or a cross-court approach increases both the area of exposure and surgical freedom. Further increases can be seen upon progression to a Denker approach. PMID:26949591

  6. The next extreme sport? Subdural haematoma in a patient with arachnoid cyst after head shaking competition.

    PubMed

    Hopkin, J; Mamourian, A; Lollis, S; Duhaime, T

    2006-04-01

    A young man, engaged in a head shaking competition presented with headache, nausea and vomiting. Imaging revealed a subdural haematoma and ipsilateral arachnoid cyst. This novel mechanism of trauma underscores the predisposition to haemorrhage in patients with arachnoid cysts, even with minor trauma. Aetiology, imaging and possible treatment options are discussed.

  7. Extradural Giant Multiloculated Arachnoid Cyst Causing Spinal Cord Compression in a Child

    PubMed Central

    Kahraman, Serdar; Anik, Ihsan; Gocmen, Selcuk; Sirin, Sait

    2008-01-01

    Background: Spinal extradural arachnoid cysts are rare expanding lesions in the spinal canal. Enlargement may cause progressive signs and symptoms caused by spinal cord compression. They are associated with trauma, surgery, arachnoiditis, and neural tube defects. Most nontraumatic spinal extradural arachnoid cysts are thought to be congenital. Design: Case report and literature review. Findings: A 9-year-old boy with mild paraparesis was found to have an extradural multiloculated arachnoid cyst with fibrous septa at T4-L3 levels and anterior compression and displacement of the spinal cord. Conclusions: Definitive treatment of arachnoid cyst entails radical cyst removal and dura cleft repair. Formation of a postoperative cerebrospinal fluid fistula may require external lumbar drainage. PMID:18795482

  8. Scintigraphic demonstration of intracranial communication between arachnoid cyst and associated subdural hematoma

    SciTech Connect

    Yokoyama, K.; Tonami, N.; Kimura, M.; Kinoshita, A.; Aburano, T.; Hisada, K.

    1989-05-01

    An arachnoid cyst found to have a communication to an associated subdural hematoma was demonstrated with the Tc-99m DTPA brain scintigraphy. Although arachnoid cysts are known to be silent, when a patient with an arachnoid cyst develops signs of increased intracranial pressure or neurological deficits, the presence of a complication, including subdural hematoma, intracystic hemorrhage or subdural hygroma, is highly suspected. In the present case, the patient with an arachnoid cyst had a subdural hematoma following minor head injury. Tc-99m DTPA brain scintigraphy showed abnormal accumulation of the tracer not only in the hematoma but in the arachnoid cyst. This observation suggested communication of the two lesions, which was confirmed at surgery.

  9. Bullet removal from the infratemporal fossa

    PubMed Central

    Merza, Ahmed Maki

    2016-01-01

    War injuries are the cornerstone of maxillofacial surgery, and it led to the initiation and development of this specialty, and each case represents a challenge to the surgeon who deals with it. In this article, we present a 30-year-old male patient who was referred to our emergency department complaining of gunshot wound, severe pain, and limitation in mouth opening. Preoperative imaging showed a bullet with a very long path lodged in the infratemporal fossa. Three different approaches with the aid of C-arm imaging system were used for the removal of this bullet; the last approach was the successful one. PMID:28299274

  10. [medullar adhesive arachnoiditis: a late complication after obstetrical epidural analgesia].

    PubMed

    Ploteau, S; de Kersaint-Gilly, A; Boog, G

    2004-11-01

    A 30-year-old woman, G3P3, was progressively affected by spastic paraparesis with loss of sensitivity and urinary incontinence due to medullar adhesive arachnoiditis occurring five months after an epidural analgesia for repeat cesarean section. Magnetic resonance imaging showed a voluminous subarachnoid cyst and a septated syringomyelic cavitation attributed to metabisulfite, the preservative of epinephrine and to multiple lidocaine injections through the catheter in the postoperative period. Despite two decompressive neurosurgical operations, the neurological state of the patient continues to worsen.

  11. Intracranial arachnoid cyst on dental radiography: a diagnostic challenge.

    PubMed

    Sun, Lisha; Sun, Zhipeng; Ma, Xuchen

    2013-03-01

    Intracranial arachnoid cysts (IACs) can present as congenital asymptomatic lesions that may predispose them to present as an incidental finding during radiographic examination. On the other hand, IACs may also give rise to a series of neurologic symptoms depending on their size and location, such as vomiting, seizures, headache, and ataxia. Skull deformities, including macrocephaly, may occur and become remarkable on dental radiology. We report 2 patients who were identified with IAC before orthodontic treatment. The dental radiologic appearance of IAC is discussed and may constitute a diagnostic challenge to both the dentist and radiologist.

  12. An unusual foreign body in the infratemporal fossa

    PubMed Central

    Ramdas, Sharad

    2016-01-01

    Infratemporal fossa injuries are uncommon and often go undetected presenting later with complications. We present a case of an infratemporal fossa penetrating injury with a ball point spring following a vehicular accident. Post-traumatic trismus even following supposedly trivial injury in the area should raise suspicion of possible injury in this location. PMID:27833297

  13. Evaluation of tenoxicam on prevention of arachnoiditis in rat laminectomy model.

    PubMed

    Cemil, Berker; Kurt, Gokhan; Aydın, Cansel; Akyurek, Nalan; Erdogan, Bulent; Ceviker, Necdet

    2011-08-01

    Post laminectomy arachnoiditis has been shown by experiments with rats and post operative radiological imaging in humans. The purpose of this experimental study was to determine the efficacy of tenoxicam in preventing arachnoiditis in rats. Twenty-four Wistar rats were divided into two groups, and L3 laminectomy was performed. In the tenoxicam group, 0.5 mg/kg tenoxicam was applied intraperitoneally. Normal saline was applied intraperitoneally in the control group. Later, the rats were killed at weeks 3 and 6, and the laminectomy sites were evaluated pathologically for arachnoiditis. The results showed that 6 weeks after surgery, the tenoxicam group showed lowest arachnoiditis grades. However, statistically significant difference was not found in arachnoiditis between the control group and the tenoxicam group. Based on these findings it is concluded that application of the tenoxicam after lumbar laminectomy did not effectively reduce arachnoiditis. Performing the most effective surgical technique without damage around tissue in a small surgical wound and having meticulous hemostasis in surgery seem to be the key for preventing arachnoiditis effectively.

  14. Arachnoiditis ossificans associated with syringomyelia: An unusual cause of myelopathy

    PubMed Central

    Ibrahim, George M.; Kamali-Nejad, Tara; Fehlings, Michael G.

    2010-01-01

    Objective: The pathophysiology of arachnoiditis ossificans (AO) and its association with syringomyelia remains a rare and poorly understood phenomenon. Here, we present a case of AO associated with syringomyelia, a review of literature, and a discussion of current understanding of disease pathophysiology. Methods: A literature review was performed using MEDLINE (January 1900–May 2010) and Embase (January 1900–May 2010) to identify all English-language studies that described AO with syringomyelia. The current report was added to published cases. Results: Over 50 cases of AO are reported in literature, of which only eight are associated with syringomyelia. The various presumptive etiologies of syrinx formation include abnormalities in blood circulation, ischemia, hydrodynamic alternations in cerebrospinal fluid (CSF) flow, tissue damage, or incidental coexistence. Changing CSF dynamics related to decreased compliance of the subarachnoid space and subsequent paracentral dissection of the spinal cord may be implicated in the disease process. magnetic resonance imaging (MRI) scanning may identify the syrinx but fail to diagnose the calcified arachnoid. Five patients, including the current case, improved clinically following laminectomy and decompression. Conclusions: Syringomyelia in association in AO is a rare phenomenon. A high index of suspicion is required and both MRI and computed tomography (CT) are recommended for diagnosis. The pathophysiology of syringomyelia in AO remains an area of ongoing research. PMID:23637667

  15. [Arachnoid cyst and tension headache: symptom or accidental finding?].

    PubMed

    Lorenz, M; Niedermaier, N; Lowitzsch, K

    2002-08-01

    We report a 34 year old male patient presenting with occipital headache and bilateral shoulder and neck pain. Cranial MRT discloses a large arachnoid cyst ventral to the medulla oblongata. The cyst displaces the caudal medulla oblongata dorsally to an angle of almost 90 degrees without causing myelopathy. Physical examination reveals normal neurological findings without any sign of brainstem lesions or lesions of the medulla oblongata. Orthopedic evaluation shows mild functional abnormalities as expected in tension headache. Multiple electrophysiologic investigations such as motor-, somatosensory-, and acoustic-evoked potentials, masseter and brain stem reflexes, and electromyography of the left M. trapezius were performed and reveal normal results. MR-angiography discloses displacement of the left vertebral artery to the right without stenosis.We discuss the possibility of a causal connection between the cystic lesion and the reported symptoms. Considering the findings based on a review of the available literature we conclude that the pain syndrome is very likely unrelated to the arachnoid cyst. The latter is herewith an accidental finding in a patient with tension headache, and underlines the importance of thoroughfull clinical examination to avoid unnecessary diagnostic or therapeutic procedures.

  16. Coexistence of Epileptic Nocturnal Wanderings and an Arachnoid Cyst

    PubMed Central

    Jiménez-Genchi, Alejandro; Díaz-Galviz, John L.; García-Reyna, Juan Carlos; Ávila-Ordoñez, Mario U.

    2007-01-01

    Episodic nocturnal wanderings (ENWs) have rarely been associated with gross abnormalities of brain structures. We describe the case of a patient with ENWs in coexistence with an arachnoid cyst (AC). The patient was a 15-year-old boy who presented with nocturnal attacks characterized by complex motor behaviors. An MRI revealed a left temporal cyst and a SPECT Tc99 scan showed left temporal hypoperfusion and bilateral frontal hyperperfusion, more evident on the right side. During an all-night polysomnographic recording with audiovisual monitoring, dystonic posture followed by sleepwalking-like behavior was documented. The sleepwalking-like behavior was preceded by a spike discharge over the left frontocentral region with contralateral projection and secondary generalization during stage 2 sleep. Treatment with levetiracetam produced a striking remission of seizures. This supports a conservative management of an AC, considering that it may be an incidental finding. In epileptic patients, an AC may not necessarily be related to the location of the seizure focus. Citation: Jiménez-Genchi A; Díaz-Galviz JL; García-Reyna JC et al. Coexistence of epileptic nocturnal wanderings and an arachnoid cyst. J Clin Sleep Med 2007;3(4):399-401. PMID:17694730

  17. Penetration of the mandibular condyle into the middle cranial fossa: report of a case in a 6-year-old girl.

    PubMed

    DeFabianis, P

    2001-01-01

    Reported cases of dislocation of the mandibular condyle into the middle cranial fossa are rare. Treatment of this injury should be individualized and should take in account the age of the patient, growth potential, the degree of glenoid fossa destruction, the risk of ankylosis and the risk of further cranial injury. In children, functional therapy is aimed at helping the restoration of posterior facial height, good occlusal relations and function. Long-term follow-up is mandatory. Surgery may be required later to correct asymmetrical growth or developing ankylosis. This article describes a case of condylar penetration into the middle cranial fossa in a six-year-old child and the treatment performed to minimize consequences on occlusion and facial development.

  18. Optochiasmatic syndrome from adhesive arachnoiditis with coexisting hypophyseal adenoma: case report.

    PubMed

    Iraci, G; Carteri, A; Marin, G

    1977-03-01

    Adhesive arachnoiditis is an occasional finding during neurosurgical operations for pituitary adenoma, previously treated by radiation therapy. A case where an arachnoidal process was found in combination with an eosinophilic pituitary adenoma, which had never been treated by irradiation, is reported. A 44-year-old woman at the time of surgery with scarce endocrinologic symptoms had suffered visual loss from 2 episodes, 18 years apart. Analysis of her symptoms, neuro-ophthalmologic findings and neurodadiologic features suggest that her visual damage was due to an optochiasmatic arachnoiditis, rather than to the tumor itself.

  19. Hemifacial spasm caused by a cerebellopontine angle arachnoid cyst. Case report and literature review.

    PubMed

    Ruiz-Juretschke, Fernando; Vargas, Antonio; González-Rodrigalvarez, Rosario; Garcia-Leal, Roberto

    2015-01-01

    Arachnoid cysts involving the cerebellopontine angle are an unusual cause of hemifacial spasm. The case is reported of a 71-year old woman presenting with a right hemifacial spasm and an ipsilateral arachnoid cyst. Preoperative magnetic resonance imaging findings suggested a neurovascular compression caused by displacement of the facial-acoustic complex and the anterior inferior cerebellar artery by the cyst. Cyst excision and microvascular decompression of the facial nerve achieved permanent relief. The existing cases of arachnoid cysts causing hemifacial spasm are reviewed and the importance of a secondary neurovascular conflict identification and decompression in these cases is highlighted.

  20. [Expansive duralplasty and subarachnoid reconstruction for spinal adhesive arachnoiditis using Gore-Tex surgical membrane].

    PubMed

    Seki, Toshitaka; Hida, Kazutoshi; Yano, Syunsuke; Iwasaki, Yoshinobu

    2004-12-01

    Effective surgical treatment of adhesive spinal arachnoiditis has not been established because of its complex clinical manifestation. The authors present a new surgical technique to minimize the postoperative recurrence of adhesion after microlysis of adhesion to treat spinal adhesive arachnoiditis. After complete release and reconstruction of the spinal cord, a 0.1 mm Gore-Tex surgical membrane was placed over the cord and fixed to the lateral dural surface with stay sutures. Furthermore, maximal expansion of a subarachnoid space was performed by expansive dural plasty with a 0.3 mm Gore-Tex surgical membrane. We performed this surgical method in tree cases of spinal adhesive arachnoiditis. During a postoperative follow-up period ranging from 2 to 3 years, postoperative neurological deterioration did not occur in all cases, and postoperative MR imaging studied showed no adhesion spinal cord and reconstructed subarachnoid space. The authors believe that this procedure is an effective surgical treatment for spinal adhesive arachnoiditis.

  1. Cri-du-chat syndrome associated with arachnoid cyst causing triventricular hydrocephalus.

    PubMed

    Balci, S; Oguz, K K

    2001-10-01

    A male child with cri-du-chat syndrome [46,XY, del (5p13)] together with an arachnoid cyst causing triventricular hydrocephalus by obstruction of the aqueduct of Sylvius is described. This association has not been reported previously.

  2. [«De novo» development of a suprasellar arachnoid cyst].

    PubMed

    Gelabert-González, Miguel; Pita-Buezas, Lara; Santín-Amo, José María; Román-Pena, Paula; Serramito-García, Ramón; García-Allut, Alfredo

    2015-01-01

    Intracranial arachnoid cysts are fluid-filled cavities that arise within the cranial arachnoid, representing approximately 1%-2% of all intracranial lesions among the paediatric population. We present the case of a 2-year-old boy who presented with instability and episodes of ocular deviation. A computed tomography scan (CT scan) and magnetic resonance imaging (MRI) of the brain revealed a suprasellar cyst and obstructive hydrocephalus. At birth a transfontanellar ultrasound was normal. The cyst underwent endoscopic fenestration with complete remission of symptoms. In the review of the literature, we found only 6 previous cases of an intracranial arachnoid cyst whose origin was not clearly congenital or traumatic, and ours is the second case of a suprasellar arachnoid cyst to arise de novo. The clinical features, imaging characteristics and treatment of the previously reported cases are discussed.

  3. Chronic subdural hematoma associated with arachnoid cyst. Two case histories with pathological observations.

    PubMed

    Takayasu, Takeshi; Harada, Kunyu; Nishimura, Shigeru; Onda, Jun; Nishi, Tohru; Takagaki, Hisashi

    2012-01-01

    Arachnoid cysts are well known to induce chronic subdural hematoma (CSDH) after head injury. However, histological observations of the arachnoid cyst and hematoma membrane have only been rarely described. An 8-year-old boy and a 3-year-old boy presented with CSDH associated with arachnoid cyst. Surgical removal of the hematoma and biopsy of the hematoma membrane and cyst wall were performed. Clinical courses were good and without recurrence more than 1.5 years after surgery. Histological examination suggested that the cysts did not contribute to hematoma development. Pediatric hematoma membranes, similar to adult hematoma membranes, are key in the growth of CSDH. Therefore, simple hematoma evacuation is adequate as a first operation for CSDH associated with arachnoid cyst.

  4. Postoperative spinal adhesive arachnoiditis presenting with hydrocephalus and cauda equina syndrome.

    PubMed

    Koerts, Guus; Rooijakkers, Herbert; Abu-Serieh, Basel; Cosnard, Guy; Raftopoulos, Christian

    2008-02-01

    To our knowledge, the association between hydrocephalus and postoperative spinal adhesive arachnoiditis (SAA) has never been reported. Herein we describe an unusual case of a 45-year-old man with spinal adhesive arachnoiditis (SAA) who developed delayed-onset hypertensive hydrocephalus and cauda equina syndrome (CES) after multiple low-back surgeries. The patient's clinical presentation, imaging findings, surgical management, and the possible mechanisms are discussed in the light of the present literature.

  5. Adhesive arachnoiditis after lumbar radiculography with Dimer-X and Depo-Medrol.

    PubMed

    Dullerud, R; Morland, T J

    1976-04-01

    Lumbar radiculographs were obtained in 252 patients with suspected disk herniation. Fifteen patients who underwent previous radiculography with Dimer-X plus Depo-Medrol exhibited adhesive arachnoiditis. This was not observed in 6 patients who received Dimer-X alone. No positive correlation between radiological diagnosis of adhesive arachnoiditis and clinical symptoms can be demonstrated. The authors suggest that steroids not be used intrathecally in combination with water-soluble contrast media.

  6. Acquired cervical spinal arachnoid diverticulum in a cat.

    PubMed

    Adams, R J; Garosi, L; Matiasek, K; Lowrie, M

    2015-04-01

    A one-year-old, female entire, domestic, shorthair cat presented with acute onset non-ambulatory tetraparesis. Magnetic resonance imaging was consistent with a C3-C4 acute non-compressive nucleus pulposus extrusion and the cat was treated conservatively. The cat was able to walk after 10 days and was normal 2 months after presentation. The cat was referred five and a half years later for investigation of an insidious onset 3-month history of ataxia and tetraparesis. Magnetic resonance imaging of the cervical spine was repeated, demonstrating a spinal arachnoid diverticulum at C3 causing marked focal compression of the spinal cord. This was treated surgically with hemilaminectomy and durectomy. The cat improved uneventfully and was discharged 12 days later.

  7. Mineral Spectra from Nili Fossae, Mars

    NASA Technical Reports Server (NTRS)

    2008-01-01

    Spectra collected by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) indicate the presence of three distinct minerals. The graphed information comes from an observation of terrain in the Nili Fossae area of northern Mars. CRISM is one of six science instruments on NASA's Mars Reconnaissance Orbiter.

    Iron-magnesium smectite clay is formed through alteration of rocks by liquid water and is characterized by distinctive absorptions at 1.4, 1.9, and 2.3 micrometers due to water (H2O) and OH in the atomic structure of the mineral. Olivine is an iron magnesium silicate and primary igneous mineral, and water is not in its structure. Its spectrum is characterized by a strong and broad absorption at 1.0 micrometer due to ferrous iron (Fe2+). Carbonate is an alteration mineral identified by the distinctive paired absorptions at 2.3 and 2.5 micrometers. The precise band positions at 2.31 and 2.51 micrometers identify the carbonate at this location as magnesium carbonate. The broad 1.0 micrometer band indicates some small amount of ferrous iron is also present and the feature at 1.9 micrometers indicates the presence of water. CRISM researchers believe the magnesium carbonate found in the Nili Fossae region formed from alteration of olivine by water.

    The data come from a CRISM image catalogued as FRT00003E12. The spectra shown here are five-pixel-by-five-pixel averages of CRISM L-detector spectra taken from three different areas within the image that have then been ratioed to a five-pixel-by-five-pixel common denominator spectrum taken from a spectrally unremarkable area with no distinctive mineralogic signatures. This technique highlights the spectral contrasts between regions due to their unique mineralogy. The spectral wavelengths near 2.0 micrometers are affected by atmospheric absorptions and have been removed for clarity.

    NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology, Pasadena, manages the Mars

  8. Functional morphology of the Neandertal scapular glenoid fossa.

    PubMed

    Macias, Marisa E; Churchill, Steven E

    2015-01-01

    Neandertals and Homo sapiens are known to differ in scapular glenoid fossa morphology. Functional explanations may be appropriate for certain aspects of glenoid fossa morphology; however, other factors--e.g., allometry, evolutionary development--must be addressed before functional morphology is considered. Using three-dimensional geometric morphometrics, shape of the scapular glenoid fossa was compared among Neandertals, early and recent modern humans, chimpanzees, orangutans, Australopithecus afarensis, and Au. sediba. Permutation analysis revealed that side, sex, and lifestyle did not correlate with shape. Of the features we found to differ between groups, anterior glenoid rim morphology and fossa curvature did not correlate with the aforementioned shape variables; thus, a functional explanation is appropriate for these components of glenoid fossa shape. Shared morphology among recent humans and chimpanzees (to the exclusion of Neandertals and orangutans) suggests independent forces contributing to these morphological configurations. Potential explanations include adaptations to habitual behavior and locomotor adaptations in the scapulae of recent humans and chimpanzees; these explanations are supported by clinical and experimental literature. The absence of these morphological features in Neandertals may support the lack of these selective forces on their scapular glenoid fossa morphology.

  9. Computed Tomographic Evaluation of Condylar Symmetry and Condyle-Fossa Relationship of the Temporomandibular Joint in Subjects with Normal Occlusion and Malocclusion: A Comparative Study

    PubMed Central

    Ponnada, Swaroopa Rani; Gaddam, Kranthi Praveen Raju; Perumalla, Kiran; Khan, Imran; Mohammed, Naqeed Abdul

    2017-01-01

    Introduction The relationship of the condyle and the mandibular fossa differs in shape with type of malocclusion and skeletal pattern. A review of literature shows till date there are no studies on Temporomandibular Joint (TMJ) condyle-fossa relation to the type of malocclusion based on growth pattern. Computed Tomography (CT) provides optimal imaging of the osseous components of the TMJ. Aim The purpose of this study was to investigate the condyle-fossa relationship and the dimensional and positional symmetries between the right and left condyles in subjects with normal occlusion and malocclusion in different growth patterns utilizing the CT scans of the TMJ. Materials and Methods Sixty subjects with age group of 18-30 years were selected for the study. The sample was divided into three groups based on overbite and growth pattern. The groups included 20 subjects with normal occlusion and average growth pattern, 20 patients with horizontal growth pattern and deep bite, 20 patients with vertical growth pattern and deep bite. The depth of the mandibular fossa, the condyle-fossa relationship, and the concentric position of the condyles were evaluated by the images obtained from the sagittal slices. ANOVA was performed to assess the significance. If it was found significant, post-hoc Tukey’s test was performed to see which two groups were statistically significant. Results No statistically significant difference was found in the anterior joint space and the superior joint space in horizontal and vertical growers with deep bite. Statistically significant (p <0.05) posterior positioning of the condyles was observed (nonconcentric positioning) in vertical growers with deep bite. Conclusion There is a significant change in the position of the condyle in vertical growers compared to average and horizontal growers. Left condyle is more anteriorly placed than the right condyle in all the three groups. There is no significant change in the vertical depth of the mandibular

  10. Medusae Fossae Formation - High Resolution Image

    NASA Technical Reports Server (NTRS)

    1998-01-01

    An exotic terrain of wind-eroded ridges and residual smooth surfaces are seen in one of the highest resolution images ever taken of Mars from orbit. The Medusae Fossae formation is believed to be formed of the fragmental ejecta of huge explosive volcanic eruptions. When subjected to intense wind-blasting over hundreds of millions of years, this material erodes easily once the uppermost tougher crust is breached. The crust, or cap rock, can be seen in the upper right part of the picture. The finely-spaced ridges are similar to features on Earth called yardangs, which are formed by intense winds plucking individual grains from, and by wind-driven sand blasting particles off, sedimentary deposits.

    The image was taken on October 30, 1997 at 11:05 AM PST, shortly after the Mars Global Surveyor spacecraft's 31st closest approach to Mars. The image covers an area 3.6 X 21.5 km (2.2 X 13.4 miles) at 3.6 m (12 feet) per picture element--craters only 11 m (36 feet, about the size of a swimming pool) across can be seen. The best Viking view of the area (VO 1 387S34) has a resolution of 240 m/pixel, or 67 times lower resolution than the MOC frame.

    Malin Space Science Systems (MSSS) and the California Institute of Technology built the MOC using spare hardware from the Mars Observer mission. MSSS operates the camera from its facilities in San Diego, CA. The Jet Propulsion Laboratory's Mars Surveyor Operations Project operates the Mars Global Surveyor spacecraft with its industrial partner, Lockheed Martin Astronautics, from facilities in Pasadena, CA and Denver, CO.

  11. The Age of the Medusae Fossae Formation

    NASA Astrophysics Data System (ADS)

    Kerber, L.; Head, J. W.

    2008-09-01

    Introduction The Medusae Fossae Formation (MFF) is a complicated and discontinuous formation located in the southern parts of Elysium Planitia and Amazonis Planitia (130°-230°E and 12°S-12°N), covering an area of approximately 2.1 x 106 km2 and having an estimated volume of 1.4 x 106 km3 [1]. It is thought to have been deposited during the Amazonian period [2,3]. However, much of the cratering record may have been erased as friable units were eroded and long-buried terrains exhumed [4-6]. The formation is characterized by large accumulations of fine-grained, friable deposits and evidence of large amounts of erosion. There are many theories regarding the emplacement of this formation; recently the literature has focused on three possibilities: ignimbrites, ash fall, and aeolian dust. Some modified and inverted fluvial channels have been found within the deposit [7,8], (Fig. 1), indicating that there was some fluvial activity during or after the emplacement of the MFF. If the MFF is among the youngest surficial deposits on Mars [9], it is implied that meandering, channelized flow must have extended into the Amazonian, a significant constraint when considering the atmospheric evolution of the planet through time. Because of the wide implications that these findings have for the evolution of Mars and the Martian atmosphere, it is instructive to re-examine the evidence for the Amazonian age of the MFF. The initial conclusion comes from two main arguments: the relatively few superposed craters on the unit, and the superposition of the MFF on young lowland lava deposits [1, 9]. Using new high resolution data, we reexamine the relationships both within the MFF and with respect to adjacent units. Cratering Record The cratering record of the MFF and other easily eroded units has often been deemed unreliable [4, 10, 12], but it continues to be cited as evidence for the formation's young age. Throughout the MFF, pedestal craters, inverted craters, and remnant knobs can be

  12. Postoperative arachnoiditis diagnosed by high resolution fast spin-echo MRI of the lumbar spine.

    PubMed

    Fitt, G J; Stevens, J M

    1995-02-01

    Chronic adhesive arachnoiditis is cited as an important cause of recurrent pain and disability after extradural lumbar disc surgery. Myelography using oil-based or ionic water-soluble contrast media was a major contributing factor, and it was not possible to distinguish the prevalence of arachnoiditis probably due to surgery alone. Today it should be possible to make this distinction, which was the purpose of this study. Using high-resolution MRI in 129 patients symptomatic at least 1 year after surgery, a prevalence of arachnoiditis of 20% was found, which dropped to 3% when patients who had undergone oil-based myelography were excluded. Arachnoiditis was diffuse in 88% and focal in 12%. When oil-based media were involved it was focal in 13%, and when not, in one of three cases. It was concluded that arachnoiditis does occur after extradural lumbar disc surgery independently of the use of some myelographic contrast media, and that it may be diffuse or confined only to the operated level. Its prevalence was estimated at 4.6%, four cases focal and two cases diffuse. The causes and clinical significance can only be the subject of speculation.

  13. Extra-axial ependymoma of posterior fossa extending to the Meckel's cave.

    PubMed

    Torun, Fuat; Tuna, Hakan; Bozkurt, Melih; Deda, Haluk

    2005-06-01

    An extra-axial ependymoma extending from the left cerebellopontine corner to the Meckel's cave is reported. This lesion's clinical, radiological, and histological characteristics are presented. This tumor's infrequent extra-axial location, extension to the Meckel's cave and possible origin are discussed.

  14. Symptomatic Large Spinal Extradural Arachnoid Cyst: A Case Report

    PubMed Central

    Cho, Ho-Yeon; Lee, Sun-Ho; Kim, Eun-Sang

    2015-01-01

    Spinal extradural arachnoid cysts (SEACs) are relatively rare cause of compressive myelopathy. SEACs can be either congenital or acquired, but the etiology and the mechanism for their development are still unclear. A number of cases have been reported in the literature, and the one-way valve mechanism is the most widely accepted theory which explains the expansion of cysts and spinal cord compression. We report two cases of SEAC in this article. Patients had intermittent, progressive cord compressing symptoms. MRI image showed large SEAC which caused compression of the spinal cord. Pre-operative cystography and CT myelography were performed to identify the communicating tract. Pre-operative epidural cystography showed a fistulous tract. The patients underwent primary closure of the dural defect which was a communicating tract. The operative finding (nerve root herniation through the tract) suggested that the SEAC developed through a checkvalve mechanism. Postoperatively, the patients had no surgical complications and symptoms were relieved. Based on our experience, preoperative identification of the communicating tract is important in surgical planning. Although surgical excision is the standard surgical treatment, primary closure of the dural defect which was a communicating tract can be an acceptable surgical strategy. PMID:26512289

  15. Fossa navicularis magna detection on cone-beam computed tomography

    PubMed Central

    Mupparapu, Mel

    2016-01-01

    Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed. PMID:27051639

  16. Ganglion cyst in the supraspinous fossa: arthroscopically undetectable cases.

    PubMed

    Shimokobe, Hisao; Gotoh, Masafumi; Mitsui, Yasuhiro; Yoshikawa, Eiichiro; Kume, Shinichiro; Okawa, Takahiro; Higuchi, Fujio; Nagata, Kensei; Shiba, Naoto

    2013-01-01

    Studies have demonstrated favorable outcomes of arthroscopic decompression for ganglion cyst in the supraspinous fossa; however, little attention has been paid to the difficulty in detecting these cysts during arthroscopy. In this report, we present 2 cases in which ganglion cysts in the supraspinous fossa were undetectable during arthroscopy. The ganglion cysts were not identified in these cases during surgery despite arthroscopic decompression being performed through the area in which the cyst was expected until the suprascapular nerve was entirely exposed. After surgery, magnetic resonance imaging (MRI) confirmed the disappearance of the ganglion cyst and external rotation strength was fully improved, without shoulder pain. We emphasize here that surgeons should be aware of this difficulty when performing arthroscopic decompression of ganglion cysts in the supraspinous fossa.

  17. Myeloscopic observation of adhesive arachnoiditis in patients with lumbar spinal canal stenosis.

    PubMed

    Kawauchi, Y; Yone, K; Sakou, T

    1996-07-01

    In this study a myeloscope was used to assess the influence of adhesive arachnoiditis on the surgical outcome of patients with lumbar spinal canal stenosis (LSS). The presence or absence and the degree of the complication of adhesive arachnoiditis were preoperatively determined by myeloscopy in 36 patients with LSS, and these findings were compared with the postoperative results. Various degrees of adhesive changes in the cauda equina were observed in all 36 patients. Patients with marked adhesions, which may indicate a blocked cauda equina, had distinctly worse operative results than did patients with slight or moderate adhesions. Adhesive arachnoiditis was considered to be one of the causes for the poor operative results for LSS. Myeloscopy is useful in diagnosing the morbid condition of the cauda equina in LSS, and for predicting the operative results.

  18. Tuberculous lumbar arachnoiditis mimicking conus cauda tumor: A case report and review of literature

    PubMed Central

    Konar, Subhas K; Rao, KVL Narasinga; Mahadevan, Anita; Devi, B Indira

    2011-01-01

    Tuberculous spinal arachnoiditis involving cauda equina is rare. A patient with lumbar tuberculous arachnoiditis in the absence of both vertebral and meningeal tuberculosis, which was mimicking spinal intradural extramedullary tumor is described here. Diagnosis was made based on intraoperative findings and was confirmed by histopathology. Surgical decompression along with a combination of steroid and antitubercular therapy resulted in a good outcome. At 3 months follow-up, the patient regained bladder control and was able to walk with support. Clinical features, magnetic resonance imaging, and intraoperative findings are described. Pathology and the relevant literature are discussed. Based on the patient's clinical and radiologic findings, it was believed that the patient had a conus cauda tumor and was operated on. Histologic examination of the mass revealed tuberculoma. Surgical decompression followed by antituberculosis medication resulted in good outcome. Hence tuberculous arachnoiditis should be considered in differential diagnosis of conus cauda tumors. PMID:21716842

  19. Adhesive arachnoiditis in mixed connective tissue disease: a rare neurological manifestation.

    PubMed

    Khan, Maria Usman; Devlin, James Anthony Joseph; Fraser, Alexander

    2016-12-16

    The overall incidence of neurological manifestations is relatively low among patients with mixed connective tissue disease (MCTD). We recently encountered a case of autoimmune adhesive arachnoiditis in a young woman with 7 years history of MCTD who presented with severe back pain and myeloradiculopathic symptoms of lower limbs. To the best of our knowledge, adhesive arachnoiditis in an MCTD patient has never been previously reported. We report here this rare case, with the clinical picture and supportive ancillary data, including serology, cerebral spinal fluid analysis, electrophysiological evaluation and spinal neuroimaging, that is, MRI and CT (CT scan) of thoracic and lumbar spine. Her neurological deficit improved after augmenting her immunosuppressant therapy. Our case suggests that adhesive arachnoiditis can contribute to significant neurological deficits in MCTD and therefore requires ongoing surveillance.

  20. Adhesive arachnoiditis in mixed connective tissue disease: a rare neurological manifestation

    PubMed Central

    Devlin, James Anthony Joseph; Fraser, Alexander

    2016-01-01

    The overall incidence of neurological manifestations is relatively low among patients with mixed connective tissue disease (MCTD). We recently encountered a case of autoimmune adhesive arachnoiditis in a young woman with 7 years history of MCTD who presented with severe back pain and myeloradiculopathic symptoms of lower limbs. To the best of our knowledge, adhesive arachnoiditis in an MCTD patient has never been previously reported. We report here this rare case, with the clinical picture and supportive ancillary data, including serology, cerebral spinal fluid analysis, electrophysiological evaluation and spinal neuroimaging, that is, MRI and CT (CT scan) of thoracic and lumbar spine. Her neurological deficit improved after augmenting her immunosuppressant therapy. Our case suggests that adhesive arachnoiditis can contribute to significant neurological deficits in MCTD and therefore requires ongoing surveillance. PMID:27986694

  1. Chronic subdural hematoma associated with an arachnoid cyst in a juvenile taekwondo athlete: a case report and review of the literature.

    PubMed

    Kertmen, Hayri; Gürer, Bora; Yilmaz, Erdal Resit; Sekerci, Zeki

    2012-01-01

    Both chronic subdural hematoma and arachnoid cysts are common lesions in neurosurgical practice. Arachnoid cysts are a well-known predisposing factor for chronic subdural hematoma. Here, we present a 12-year-old taekwondo athlete with chronic subdural hematoma associated with arachnoid cysts. The chronic subdural hematoma was evacuated through 2 burr holes and the patient was discharged in good condition. To our knowledge, this is the first case of chronic subdural hematoma with associated arachnoid cysts in a taekwondo athlete. We also review the literature on sports-related chronic subdural hematomas associated with arachnoid cysts in children.

  2. Discovery of Olivine in the Nili Fossae Region of Mars

    USGS Publications Warehouse

    Hoefen, T.M.; Clark, R.N.; Bandfield, J.L.; Smith, M.D.; Pearl, J.C.; Christensen, P.R.

    2003-01-01

    We have detected a 30,000-square-kilometer area rich in olivine in the Nili Fossae region of Mars. Nili Fossae has been interpreted as a complex of grabens and fractures related to the formation of the Isidis impact basin. We propose that post-impact faulting of this area has exposed subsurface layers rich in olivine. Linear mixture analysis of Thermal Emission Spectrometer spectra shows surface exposures of 30% olivine, where the composition of the olivine ranges from Fo30 to Fo70.

  3. Endoscopic Removal of a Bullet in Rosenmuller Fossa: Case Report

    PubMed Central

    Burks, Joshua D.; Glenn, Chad A.; Conner, Andrew K.; Bonney, Phillip A.; Sanclement, Jose A.; Sughrue, Michael E.

    2016-01-01

    Fractures of the anterior skull base may occur in gunshot victims and can result in traumatic cerebrospinal fluid (CSF) leak. Less commonly, CSF leaks occur days or even weeks after the trauma occurred. Here, we present the case of a 21-year-old man with a delayed-onset, traumatic CSF leak secondary to a missile injury that left a bullet fragment in the Rosenmuller fossa. The patient was treated successfully with endoscopic, endonasal extraction of the bullet, and repair with a nasal septal flap. Foreign bodies lodged in Rosenmuller fossa can be successfully treated with endoscopic skull base surgery. PMID:27330924

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

    PubMed Central

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

    1974-01-01

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

  5. Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy.

    PubMed Central

    Shaw, P J; Allcutt, D A; Bates, D; Crawford, P J

    1990-01-01

    A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cysts and when the patient is seen early before irreversible damage to the cauda equina has occurred. Images PMID:2292702

  6. Arachnoid membrane: the first and probably the last piece of the roadmap.

    PubMed

    Lü, Jian

    2015-03-01

    Most neurosurgical procedures could be performed noninvasively by working through the natural corridors provided by the subarachnoid cisterns. In consequence, the subarachnoid cisterns have been considered as the roadmaps for the microneurosurgeons. The concept and the contents of the cisterns have been well known and described, but the knowledge of the detailed anatomy of the arachnoid membranes, which are the real septa of the cisterns and provide the practical and important landmarks and planes for the dissections during the brain surgeries, is still lacking. The present article reviews the previous reports of the intracranial arachnoid membranes with a special emphasis on the microsurgical anatomy and the clinical significance.

  7. A Comparison between splenic fossa and subhepatic fossa auxiliary partial heterotopic liver transplantation in a porcine model

    PubMed Central

    Liang, Xiao; Wang, Zhifei; Shen, Jie; Yu, Feiyan; Xie, Limei; Pan, Yongming; Lin, Hui

    2016-01-01

    To test the alternative possible locations for the placement of a liver graft and the relevant surgical technique issues, we developed a porcine model of auxiliary partial heterotopic liver transplantation (APHLT) and evaluated the difference between 2 styles of liver transplantation, either subhepatic fossa or splenic fossa APHLT, by comparing survival and biochemical indexes. Thirty‐eight miniature pigs were randomly divided into 2 groups. A left hemihepatic graft without the middle hepatic vein (HV) was procured from the living donor. In group A (n = 9), an 8 mm diameter polytetrafluoroethylene (PTFE) graft approximately 2.5 cm long was connected to the left HV while another PTFE graft of the same size was connected to the left portal vein (PV). The liver graft was implanted in the right subhepatic fossa following splenectomy and right nephrectomy. In group B (n = 10), a PTFE graft of the same size was connected to the left HV while the liver graft was implanted in the splenic fossa following splenectomy and left nephrectomy. Survival rate and complications were observed at 2 weeks after transplantation. Data were collected from 5 animals in group A and 6 animals in group B that survived longer than 2 weeks. The liver function and renal function of the recipients returned to normal at 1 week after surgery in both groups. Eighty‐eight percent (14/16) of the PTFE grafts remained patent at 2 weeks after surgery, but 44% of the PTFE grafts (7/16) developed mural thrombus. No significant differences in the survival rate and biochemistry were found between the 2 groups. In conclusion, the splenic fossa APHLT can achieve beneficial outcomes similar to the subhepatic fossa APHLT in miniature pigs, although it also has a high morbidity rate due to hepatic artery thrombosis, PV thrombosis, and PTEF graft mural thrombus formation. Liver Transplantation 22 812–821 2016 AASLD. PMID:26785299

  8. Fretted Terrain Valley in Coloe Fossae Region

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Figure 1 Click on image for larger version

    The image in figure 1 shows lineated valley fill in one of a series of enclosed, intersecting troughs known as Coloe (Choloe) Fossae. Lineated valley fill consists of rows of material in valley centers that are parallel to the valley walls. It is probably made of ice-rich material and boulders that are left behind when the ice-rich material sublimates. Very distinct rows can be seen near the south (bottom) wall of the valley. Lineated valley fill is thought to result from mass wasting (downslope movement) of ice-rich material from valley walls towards their centers. It is commonly found in valleys near the crustal dichotomy that separates the two hemispheres of Mars. The valley shown here joins four other valleys with lineated fill near the top left corner of this image. Their juncture is a topographic low, suggesting that the lineated valley fill from the different valleys may be flowing or creeping towards the low area (movement towards the upper left of the image). The valley walls appear smooth at first glance but are seen to be speckled with small craters several meters in diameter at HiRISE resolution (see contrast-enhanced subimage). This indicates that at least some of the wall material has been stable to mass wasting for some period of time. Also seen on the valley wall are elongated features shaped like teardrops. These are most likely slightly older craters that have been degraded due to potentially recent downhill creep. It is unknown whether the valley walls are shedding material today. The subimage is approximately 140 x 400 m (450 x 1280 ft).

    Image PSP_001372_2160 was taken by the High Resolution Imaging Science Experiment (HiRISE) camera onboard the Mars Reconnaissance Orbiter spacecraft on November 11, 2006. The complete image is centered at 35.5 degrees latitude, 56.8 degrees East longitude. The range to the target site was 290.3 km (181

  9. Polymorphous low-grade adenocarcinoma of the nasal fossa.

    PubMed

    González-Lagunas, Javier; Alasà-Caparrós, Cristian; Vendrell-Escofet, Gerard; Huguet-Redecilla, Pere; Raspall-Martin, Guillermo

    2005-01-01

    An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient.

  10. 21 CFR 872.3950 - Glenoid fossa prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Glenoid fossa prosthesis. 872.3950 Section 872.3950 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... or a notice of completion of a PDP is required to be filed with the Food and Drug Administration...

  11. Efficacy of arachnoid plasty with collagen sheets and fibrin glue: An in vitro experiment and a case review

    PubMed Central

    Abe, Junya; Ichinose, Tsutomu; Terakawa, Yuzo; Tsuyuguchi, Naohiro; Tsuruno, Takashi; Ohata, Kenji

    2015-01-01

    Background: Postoperative subdural fluid collection sometimes occurs after clipping of cerebral aneurysms. Arachnoid plasty is used to prevent such postoperative complications; however, the optimal materials for arachnoid plasty remain unclear. In this study, we aimed to clarify the optimal materials for arachnoid plasty and report our experience of arachnoid plasty after clipping of unruptured aneurysms. Methods: In an in vitro experiment, adhesive strengths of three materials permitted for use in the intradural space, such as collagen sheets, gelatin sponge, and oxidized cellulose sheets, were measured by assessing their water pressure resistance. Then, 80 consecutive cases surgically treated unruptured cerebral aneurysms were retrospectively reviewed to examine the occurrence rate of postoperative subdural fluid collection. Results: The collagen sheet exhibited the greatest adhesive strength, so we used collagen sheets for the arachnoid plasty procedures. In all of these cases, arachnoid plasty was performed with fibrin glue-soaked collagen sheets. No postoperative subdural fluid collection, inflammation, or allergic reactions occurred in any case. Conclusions: The present study suggests that collagen sheet might be one of the optimal materials for arachnoid plasty. This technique is simple and may be effective to prevent subdural fluid collection after clipping. PMID:26060599

  12. Focal adhesive arachnoiditis of the spinal cord: Imaging diagnosis and surgical resolution

    PubMed Central

    Morisako, Hiroki; Takami, Toshihiro; Yamagata, Toru; Chokyu, Isao; Tsuyuguchi, Naohiro; Ohata, Kenji

    2010-01-01

    Background: Although adhesive arachnoiditis of the spinal cord can cause progressive symptoms associated with syringomyelia or myelomalacia, its surgical resolution based on the imaging diagnosis is not well characterized. This study aims to describe the use of imaging for the diagnosis of focal adhesive arachnoiditis of the spinal cord and its surgical resolution using microsurgical arachnoidolysis. Materials and Methods: Four consecutive patients with symptomatic syringomyelia or myelomalacia caused by focal adhesive arachnoiditis underwent microsurgical arachnoidolysis. Comprehensive imaging evaluation using constructive interference in steady-state (CISS) magnetic resonance imaging (MRI) or myelographic MR imaging using true fast imaging with steady-state precession (TrueFISP) sequences was included before surgery to determine the surgical indication. Results: In all four patients a focal adhesion was identified at the cervical or thoracic level of the spinal cord, a consequence of infection or trauma. Three patients showed modest or minor improvement in neurological function, and one patient was unchanged after surgery. The syringomyelia or myelomalacia resolved after surgery and no recurrence was noted within the follow-up period, which ranged from 5 months to 30 months. Conclusions: MRI diagnosis of focal adhesive arachnoiditis is critical to determine the surgical indication. Microsurgical arachnoidolysis appears to be a straightforward method for stabilizing the progressive symptoms, though the procedure is technically demanding. PMID:21572630

  13. Cervical arachnoidal cyst with basilar impression and Arnold-Chiari malformation: a case report.

    PubMed

    Fiaschi, A; Orrico, D; Polo, A; Gerosa, M; Bricolo, A

    1992-01-01

    A case of cervical spinal arachnoidal cyst is presented. The association with basilar impression and Arnold-Chiari malformation is a peculiarity seldom reported. The clinical aspects with remission and exacerbation are discussed. The importance of the neuroradiological findings and the usefulness of the neurophysiological examination (evoked potentials) are suggested.

  14. [Fracture of the glenoid fossa without mandibular condylar dislocation or fracture: two case reports].

    PubMed

    Şahan, Murat; Derin, Serhan; Beydilli, Halil; Çullu, Neşet

    2014-01-01

    The mandibular condyle region which protects the middle cranial fossa from facial and jaw traumas has an excellent osteomuscular structure. Condylar structures reduce or limit the force of trauma. Most importantly, the condylar neck is the weakest part of the mandible and is easily fractured without dislocation. Generally, this mechanism prevents condylar penetration into the middle cranial fossa; however, there are condylar penetration into the middle cranial fossa can be rarely. Glenoid fossa fractures without mandibular condylar fracture and dislocation can be made. In this article, we present two cases to assess the isolated glenoid fossa fractures of the temporal bone.

  15. Percutaneous Posterior Calcaneal Osteotomy.

    PubMed

    Lui, Tun Hing

    2015-01-01

    Different types of posterior calcaneal osteotomy are used for calcaneal realignment in the management of hindfoot deformity. We describe a percutaneous technique of posterior calcaneal osteotomy that can be either a Dwyer-type closing wedge osteotomy or displacement osteotomy.

  16. Three-dimensional assessment of mandibular and glenoid fossa changes after bone-anchored Class III intermaxillary traction

    PubMed Central

    De Clerck, Hugo; Nguyen, Tung; de Paula, Leonardo Koerich; Cevidanes, Lucia

    2013-01-01

    Introduction Conventional treatment for young Class III patients involves extraoral devices designed to either protract the maxilla or restrain mandibular growth. The use of skeletal anchorage offers a promising alternative to obtain orthopedic results with fewer dental compensations. Our aim was to evaluate 3-dimensional changes in the mandibles and the glenoid fossae of Class III patients treated with bone-anchored maxillary protraction. Methods Twenty-five consecutive skeletal Class III patients between the ages of 9 and 13 years (mean age, 11.10 ± 1.1 year) were treated with Class III intermaxillary elastics and bilateral miniplates (2 in the infrazygomatic crests of the maxilla and 2 in the anterior mandible). The patients had cone-beam computed tomography images taken before initial loading and at the end of active treatment. Three-dimensional models were generated from these images, registered on the anterior cranial base, and analyzed by using color maps. Results Posterior displacement of the mandible at the end of treatment was observed in all subjects (posterior ramus: mean, 2.74 ± 1.36 mm; condyles: mean, 2.07 ± 1.16 mm; chin: mean, −0.13 ± 2.89 mm). Remodeling of the glenoid fossa at the anterior eminence (mean, 1.38 ± 1.03 mm) and bone resorption at the posterior wall (mean, −1.34 ± 0.6 mm) were observed in most patients. Conclusions This new treatment approach offers a promising alternative to restrain mandibular growth for Class III patients with a component of mandibular prognathism or to compensate for maxillary deficiency in patients with hypoplasia of the midface. Future studies with long-term follow-up and comparisons with facemask and chincup therapies are needed to better understand the treatment effects. PMID:22748987

  17. Guidelines for the management of obstructive hydrocephalus from suprasellar-prepontine arachnoid cysts using endoscopic third ventriculocystocisternostomy.

    PubMed

    Mattox, Austin; Choi, Jonathan D; Leith-Gray, Linda; Grant, Gerald A; Adamson, D Cory

    2010-09-01

    Intracranial endoscopy has emerged as an innovative surgical tool for various intracranial procedures, but its use remains limited to neurosurgeons trained in this minimally invasive technique. Complex, skull base arachnoid cysts represent one entity that is challenging to treat because of adjacent critical neurovascular structures; however, the advent of intracranial endoscopic techniques has revolutionized treatment. Arachnoid cysts located in the suprasellar-prepontine skull base region can cause obstructive hydrocephalus or symptomatic mass effect and require urgent decompression. These patients may present with nonfocal symptoms that can quickly lead to a life-threatening condition if not accurately diagnosed and treated. The authors present a summary of the world literature of suprasellar-prepontine arachnoid cysts (SPACs) to ascertain clinical presentations and provide class III evidentiary treatment guidelines for this uniquely challenging type of arachnoid cyst. Urgent endoscopic third ventriculostomy results in normalization of intracranial pressure, return of normal CSF flow, and relief of symptoms.

  18. Actinomyces infection causing acute right iliac fossa pain

    PubMed Central

    Govindarajah, Narendranath; Hameed, Waseem; Middleton, Simon; Booth, Michael

    2014-01-01

    This is a case of a 75-year-old man being admitted to the on-call surgical department with acute abdominal pain. On arrival he was clinically dehydrated and shocked with localised pain over McBurney's point and examination findings were suggestive of appendiceal or other colonic pathology. Full blood testing revealed a white cell count of 38×109/L and a C reactive protein (CRP) of 278 mg/L. A CT scan revealed a gallbladder empyema that extended into the right iliac fossa. This case highlights the potential for a hyperdistended gallbladder empyema to present as acute right iliac fossa pain with blood tests suggestive of complicated disease. Further analysis confirmed Actinomyces infection as the underlying aetiology prior to a laparoscopic subtotal cholecystectomy. This case serves to remind clinicians of this as a rare potential cause of atypical gallbladder pathology. PMID:24872493

  19. Temporal fossa bone grafts: a new technique in craniofacial surgery.

    PubMed

    Spear, S L; Wiegering, C E

    1987-04-01

    The calvarium has become an increasingly popular bone-graft donor site. Previously described harvesting techniques are often difficult to perform and may produce unsatisfactory bone fragments. However, full-thickness bone grafts taken from the region of the temporal fossa, beneath the temporaiis muscle, have proven to be of high quality and technically easy to obtain. In our experience with eight patients, temporal fossa bone grafts were used primarily around the orbit, including reconstruction of the orbital floor, frontal bone, and zygoma. The procedure begins with a hemicoronal or bicoronal incision; the temporalis muscle is reflected, and an underlying bone plate up to 4 X 6 cm is removed. The resulting bone graft is consistently 3 to 4 mm in thickness. The cranial defect is packed with bone debris, and the muscle is replaced. This technique has proven to be safe, technically simple, consistently productive of high-quality bone grafts, and within discernible donor-site deformity.

  20. Encephalomyelitis by Toxoplasma gondii in a captive fossa (Cryptoprocta ferox).

    PubMed

    Corpa, J M; García-Quirós, A; Casares, M; Gerique, A C; Carbonell, M D; Gómez-Muñoz, M T; Uzal, F A; Ortega, J

    2013-03-31

    Encephalomyelitis due to Toxoplasma gondii was diagnosed in a fossa (Cryptoprocta ferox). The animal had ataxia, atrophy of hind limb muscles and progressive wasting before dying 12 months after the onset of clinical signs. Toxoplasmosis was suspected antemortem based on clinical signs and the detection of T. gondii DNA by PCR on EDTA-blood from live animal. Necropsy revealed necrotizing gastritis and severe emaciation. The main histological lesions included non-suppurative encephalomyelitis, with dilation of myelin sheaths and swollen axons in the spinal cord, and multifocal gliosis in the brain with intralesional protozoan cysts that stained positive for T. gondii immunohistochemistry. To the authors' knowledge, this is the first report of toxoplasmosis in a fossa, and a new host record.

  1. Adhesive arachnoiditis following lumbar radiculography with water-soluble contrast agents. A clinical report with special reference to metrizamide.

    PubMed

    Skalpe, I O

    1976-12-01

    The frequency of adhesive arachnoiditis following lumbar radiculography with methiodal sodium (95 patients), methylglucamine iocarmate (20 examinations in 18 patients), and metrizamide (77 examinations in 73 patients) was found to be 29% in patients who were not operated on between methiodal studies and 48% in those who were operated on. With both methylglucamine iocarmate and metrizamide the frequency was very low. No changes indicating adhesive arachnoiditis were seen with these media in patients who were not operated on between radiographic examinations.

  2. Extradural Dermoid Cyst of the Anterior Infratemporal Fossa. Case Report

    PubMed Central

    Watanabe, Kentaro; Filomena, Carol A.; Nonaka, Yoichi; Matsuda, Masahide; Zomorodi, Ali R.; Friedman, Allan H.; Fukushima, Takanori

    2015-01-01

    Dermoid cysts are rare in the skull base. There have been 10 reported cases of dermoid cysts in the cavernous sinus, two in the petrous apex, and one in the extradural Meckel cave. This is the first case report of a dermoid cyst in the anterior infratemporal fossa attached to the anterior dura of the foramen ovale. The clinical presentation, radiologic findings, histologic features, tumor origin, and operative technique are described along with a review of the literature. PMID:26623226

  3. Morphology of the caudal fossa in Cavalier King Charles Spaniels.

    PubMed

    Cerda-Gonzalez, Sofia; Olby, Natasha J; McCullough, Susan; Pease, Anthony P; Broadstone, Richard; Osborne, Jason A

    2009-01-01

    Chiari malformations and syringohydromyelia are an important disease complex in Cavalier King Charles Spaniels. Although abnormalities in caudal fossa morphology are considered major contributors to the development of this disease, limited information exists on the range of morphologies in Cavalier King Charles Spaniels and on the relationship of these to clinically evident disease. Sixty-four Cavalier King Charles Spaniels were studied. Each underwent a neurologic examination and magnetic resonance imaging of the cervical spine and brain. T2-weighted sagittal images were used to determine both the morphologic characteristics and volume of the caudal fossa in each dog. This volume was also analyzed as a percentage of total cranial cavity volume. Each attribute was correlated with neurological grade and presence of syringohydromyelia. Fifteen dogs had neurologic signs, and 59 had morphologic abnormalities of the craniocervical junction. While 27 dogs had syringohydromyelia, 13 of these were clinically normal. Cerebellar herniation and occipital dysplasia were common findings but were not associated with syringohydromyelia. Dorsal compressive lesions were noted at the first and second cervical vertebral junction. Factors associated with the presence of neurologic signs included syringohydromyelia and the ratio of caudal fossa/total cranial cavity volume; dogs with signs had significantly larger syringohydromyelia than asymptomatic dogs. Caudal fossa size was not associated with syringohydromyelia. A positive association was identified between foramen magnum size and length of cerebellar herniation. The prevalence of craniocervical junction abnormalities is high in Cavalier King Charles Spaniels. While several factors are associated with neurologic signs, occipital hypoplasia appears to be the most important factor.

  4. Middle fossa approach: Applications in temporal bone lesions.

    PubMed

    Domenech Juan, Iván; Cruz Toro, Paula; Callejo Castillo, Ángela; Moya, Rafael; Merán Gil, Jorge L; Bartel, Ricardo

    2016-01-01

    The middle fossa approach is a surgical technique that is very useful for lateral skull base surgery. However, it is true that it has limited surgical indications and implementation due to its technical complexity. We present our experience in 10 patients in whom the middle fossa approach was the treatment of choice because of the extent of the injury and complexity of the lesion or process. Despite the complexity of the cases, there was no mortality associated with surgery. Postoperative complications were found in 2 patients who presented an epidural hematoma and a cortico-subcortical hematoma. Hearing function was preserved in 5 patients out of the 7 who had adequate hearing at the time of surgery. House/Brackmann I-II facial nerve function was achieved in 8 patients; the remaining 2 had no deterioration of the nerve function. In 9 out of 10 patients, the surgery achieved complete solution of the lesion. The middle fossa approach is a safe and reliable surgical technique. It gives us great control and exposure of different skull base processes. We consider its knowledge of great importance, because it may be the only viable surgical alternative in some specific patients. That is the reason why it is important to learn this approach and know about it in our specialty.

  5. Posterior foss avenous angiomas with drainage through the brain stem

    SciTech Connect

    Damiano, T.R.; Truwit, C.L. ); Dowd, C.F. ); Symonds, D.L. )

    1994-04-01

    To describe 11 cases of posterior fossa venous angiomas with drainage through the brain stem. Eleven cases of posterior fossa venous angioma with drainage through the brain stem were evaluated using MR. Correlation with known routes of venous drainage for the cerebellum and brain stem is made. Six of the 11 venous angiomas were found in the cerebellum, four in the brain stem; one involved both the cerebellum and brain stem. The cerebellar venous angiomas drained to subependymal veins about the fourth ventricle and dorsal pons. These then connected with an enlarged transmesencephalic or transpontine vein, to drain anteriorly to the anterior pontine veins. The brain stem angiomas had variable drainage depending on location. Evidence of hemorrhage was seen in five cases. Cerebellar and brain stem venous angiomas have several potential routes of drainage, including an enlarged vein traversing the pons, midbrain, or medulla. A knowledge of the normal venous anatomy of this region helps to understand the occurrence of these uncommon routes of venous drainage. 15 refs., 8 figs., 1 tab.

  6. Xanthomatous posterior pyramid meningioma in a 2-year-old girl.

    PubMed

    Germanò, A; Galatioto, S; La Rosa, G; Caffo, M; Cardia, E

    1997-07-01

    Meningiomas are common lesions in adults but unusual in infancy and meningiomas located in the posterior cranial fossa are even more rare. Metaplastic changes of meningothelial meningiomas can lead to the rarely observed xanthomatous form. We describe the case of a posterior pyramid xanthomatous meningioma in a 2-year-old girl. After detailed neuroradiological evaluation, the histological diagnosis was confirmed with the aid of immunohistochemical evaluation. A critical case evaluation in the light of the more recent literature, the surgical strategy and technique, and an immunohistological hypothesis are reported.

  7. Role of Merlin in the Growth and Transformation of Arachnoidal Cells

    DTIC Science & Technology

    2009-01-01

    III inter- mediate filament protein and desmoplakin, a component of desmosomal cell junctions, is a feature unique to arachnoidal cells and meningiomas...the conundrum of the intermediate filament gene family. Bioessays 20: 79–86, 1998 21. Burdett ID: Aspects of the structure and assembly of desmosomes ...Micron 29: 309–328, 1998 22. Akat K, Mennel HD, Kremer P, Gassler N, Bleck CK, Karten- beck J: Molecular characterization of desmosomes in meningiomas

  8. Dura-arachnoid lesions produced by 22 gauge Quincke spinal needles during a lumbar puncture

    PubMed Central

    Reina, M; Lopez, A; Badorrey, V; De Andres, J A; Martin, S

    2004-01-01

    Aims: The dural and arachnoid hole caused by lumbar puncture needles is a determining factor in triggering headaches. The aim of this study is to assess the dimensions and morphological features of the dura mater and arachnoids when they are punctured by a 22 gauge Quincke needle having its bevel either in the parallel or in the transverse position. Methods: Fifty punctures were made with 22 gauge Quincke needles in the dural sac of four fresh cadavers using an "in vitro" model especially designed for this purpose. The punctures were performed by needles with bevels parallel or perpendicular to the spinal axis and studied under scanning electron microscopy. Results: Thirty five of the 50 punctures done by Quincke needles (19 in the external surface and 16 in the internal) were used for evaluation. When the needle was inserted with its bevel parallel to the axis of the dural sac (17 of 35), the size of the dura-arachnoid lesion was 0.032 mm2 in the epidural surface and 0.037 mm2 in the subarachnoid surface of the dural sac. When the needle's bevel was perpendicular to the axis (18 of 35) the measurement of the lesion size was 0.042 mm2 for the external surface and 0.033 mm2 for the internal. There were no statistical significant differences between these results. Conclusions: It is believed that the reported lower frequency of postdural puncture headache when the needle is inserted parallel to the cord axis should be explained by some other factors besides the size of the dura-arachnoid injury. PMID:15146008

  9. Arachnoiditis Following Caudal Epidural Injections for the Lumbo-Sacral Radicular Pain

    PubMed Central

    Nanjayan, Shashi Kumar; Yallappa, Sachin; Bommireddy, Rajendra

    2013-01-01

    Caudal epidural steroid injection is a very common intervention in treatment of low back pain and sciatica symptoms. Although extensively used, it is not devoid of complications. A few reports of chemical and infective arachnoiditis exist following lumbar epidural anaesthesia, but none following a caudal epidural steroid injection.We report a case of arachnoiditis following caudal epidural steroid injections for lumbar radiculopathy. The patient presented with contralateral sciatica, worsening low back pain and urinary retention few days following the injection, followed by worsening motor functions in L4/L5/S1 myotomes with resultant dense foot drop. Gadolinium-enhanced magnetic resonance imaging suggested infective arachnoiditis with diffuse enhancement and clumping of the nerve roots within the lumbar and sacral thecal sac. As the number of injections in the management of back pain and lumbo-sacral radicular pain is increasing annually, it is imperative to have a thorough understanding of this potentially dangerous complication and educate the patients appropriately. PMID:24353855

  10. Spontaneous resolution of a Meckel's cave arachnoid cyst causing sixth cranial nerve palsy.

    PubMed

    Jacob, Maud; Gujar, Sachin; Trobe, Jonathan; Gandhi, Dheeraj

    2008-09-01

    A 32-year-old pregnant woman developed a progressive right sixth cranial nerve palsy as an isolated finding. Brain MRI disclosed a discrete lobulated lesion centered in the right Meckel's cave with intermediate signal on T1, high signal on T2, and diffusion characteristics similar to those of cerebrospinal fluid on apparent diffusion coefficient mapping. The initial radiologic diagnosis was schwannoma or meningioma. No intervention occurred. Shortly after cesarean delivery, the abduction deficit began to lessen spontaneously. One month later, the abduction deficit had further improved; 7 months later it had completely resolved. Repeat MRI after delivery failed to disclose the lesion, which was now interpreted as consistent with an arachnoid cyst arising within Meckel's cave. Twenty-one similar cases of Meckel's cave arachnoid cyst or meningocele have been reported, 7 found incidentally and 14 causing symptoms, 2 of which produced ipsilateral sixth cranial nerve palsies. All previously reported symptomatic patients were treated surgically. This is the first report of an arachnoid cyst arising from Meckel's cave in pregnancy and having spontaneous resolution.

  11. Hesperian age for western Medusae Fossae Formation, Mars.

    PubMed

    Zimbelman, James R; Scheidt, Stephen P

    2012-06-29

    The Medusae Fossae Formation (MFF) on Mars is an intensely eroded deposit north of the cratered highlands. It is widely thought that MFF materials were emplaced through ignimbrite eruptions. Recent geologic mapping of western MFF identified outliers of MFF materials well beyond the previously mapped western extent for the deposit, including outliers close to Gale crater. We report counts of impact craters on the MFF units that have implications for our understanding of the general history of MFF and the uppermost layered materials on the Gale crater mound.

  12. Chondroblastoma of the temporal bone: consistent middle fossa involvement.

    PubMed

    Selesnick, S H; Levine, J M

    1999-01-01

    The objective of this study is to describe the presentation and clinical course of two patients with temporal bone chondroblastoma, and to review the literature on temporal bone chondroblastoma to identify characteristic clinical and radiological presentations, and optimal treatment regimens. MEDLINE literature searches covering the period from 1966 to January 1998, in all languages, were performed as well as a review of the bibliographies of the identified studies. Strict inclusion criteria were upheld, In total 18 studies had patients whose data could be analyzed. From the 18 studies, 34 patients were identified, but only 21 cases met the inclusion criteria. Demographic, clinical presentation, radiological, operative and treatment parameters were analyzed in this cohort of patients. Ninety-five percent of patients were found to have invasion of the middle cranial fossa and 76% were found to have erosion into the superior aspect of the external auditory canal by temporal bone chondroblastoma. The characteristic growth pattern of temporal bone chondroblastoma may result from embryonal or cartilagenous rests entrapped in the tympanosquamous suture line in the middle fossa floor. Temporal bone chondroblastoma represents a pathology that does not arise from, or have a growth pattern resembling other pathologies in the temporal bone.

  13. Incidence of Clavicular Rhomboid Fossa in Northeastern Thais: An Anthropological Study

    PubMed Central

    Sampannang, Apichakan; Tuamsuk, Panya; Kanpittaya, Jaturat

    2016-01-01

    The rhomboid fossa of clavicle is used to determine the age and sex in anthropology and forensic sciences. The variant types of rhomboid fossa on inferior surface have been reported in many races except in Thais. This study therefore was aimed at classifying the types of the rhomboid fossa in Northeastern Thais. The identified 476 Northeastern Thais dried clavicles (270 males and 206 females) were observed and recorded for the types of rhomboid fossa. The results showed that Thai-rhomboid fossa could be classified into 4 types: Type 1: smooth; Type 2: flat; Type 3: elevated; and Type 4: depressed, respectively. The incidences of rhomboid fossa were as follows: Type 1: 0.21%; Type 2: 19.75%; Type 3: 76.26%; and Type 4: 3.78%, respectively. Additionally, it was found that the percentage of Type 4 (11.84%) was much greater than that of female (1.94%) compared to other types. This incidence of rhomboid fossa types especially Type 4 may be a basic knowledge to be used in sex identification. The high incidence of rhomboid fossa in both sexes of Northeastern Thai clavicles was Type 3 (elevated type). PMID:27648305

  14. Reconciling the convergence of supraspinous fossa shape among hominoids in light of locomotor differences.

    PubMed

    Green, David J; Sugiura, Yui; Seitelman, Brielle C; Gunz, Philipp

    2015-04-01

    Differences in scapular morphology between modern humans and the African and lesser apes are associated with the distinct locomotor habits of these groups. However, several traits, particularly aspects of the supraspinous fossa, are convergent between Homo and Pongo-an unexpected result given their divergent locomotor habits. Many morphological assessments of the scapula rely on the limited number of static landmarks available, and traditional approaches like these tend to oversimplify scapular shape. Here, we present the results of two geometric morphometric (GM) analyses of hominoid supraspinous fossa shape-one employing five homologous landmarks and another with 83 sliding semilandmarks-alongside those of traditional methods to evaluate if three-dimensional considerations of fossa shape afford more comprehensive insights into scapular shape and functional morphology. Traditional measures aligned Pongo and Homo with narrow and transversely oriented supraspinous fossae, whereas African ape and Hylobates fossae are broader and more obliquely situated. However, our GM results highlight that much of the convergence between Homo and Pongo is reflective of their more medially positioned superior angles. These approaches offered a more complete assessment of supraspinous shape and revealed that the Homo fossa, with an intermediate superior angle position and moderate superoinferior expansion, is actually reminiscent of the African ape shape. Additionally, both Pongo and Hylobates were shown to have more compressed fossae, something that has not previously been identified through traditional analyses. Thus, the total morphological pattern of the Pongo supraspinous fossa is unique among hominoids, and possibly indicative of its distinctive locomotor habits.

  15. Posterior Cruciate Ligament Injury

    MedlinePlus

    ... ACL connect your thighbone (femur) to your shinbone (tibia). If either ligament is torn, it might cause ... ligaments connect the thighbone (femur) to the shinbone (tibia). The anterior and posterior cruciate ligaments form an " ...

  16. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases.

  17. Piriform and trochanteric fossae. A drawing mismatch or a terminology error? A review.

    PubMed

    Papadakis, Stamatios A; Shepherd, Lane; Babourda, Eleni C; Papadakis, Stefanos

    2005-08-01

    The current literature indicates that the standard starting point for intramedullary nailing is the piriform fossa. The accuracy of the entry point for anterograde femoral intramedullary nailing between published texts and relevant illustrations was recorded. The piriform fossa is the site of insertion of the piriform tendon and represents a small, shallow depression located on the tip of the greater trochanter. The trochanteric fossa is a deep depression on the inner surface of the greater trochanter, and in the vast majority of the published data is indicated incorrectly as "piriform fossa". As a result of either a recurrent drawing mismatch or a terminology error, the correct entry point for anterograde femoral intramedullary nailing is confusing and should be indicated in the current literature. The trochanteric fossa appears to be the standard entry point that most surgeons recommend.

  18. Syringomyelia and spinal arachnoiditis resulting from aneurysmal subarachnoid hemorrhage: Report of two cases and review of the literature

    PubMed Central

    Abel, Taylor J.; Howard, Matthew A.; Menezes, Arnold

    2014-01-01

    Syringomyelia resulting from arachnoiditis secondary to aneurysmal subarachnoid hemorrhage (SAH) is an extremely rare clinical entity with few cases reported in the literature. The presentation, management, and pathogenesis of syringomyelia in this setting is poorly understood. We describe the presentation, radiology, management, and outcomes in two patients with syringomyelia resulting from arachnoiditis secondary to aneurysmal SAH and review the literature on this rare condition. Case number 1 was treated successfully with syrinx-subarachnoid shunt after extensive lysis of adhesions. Case number 2 was treated with syringoperitoneal shunt. Both patients had radiographic decreased syrinx size postoperatively. These patients add to the small literature on syringomyelia occurring secondary to SAH-associated arachnoiditis. The radiographic outcomes demonstrate that in the appropriately selected patient, syrinx-subarachnoid or syringoperitoneal shunting are viable options. PMID:25013348

  19. Experimental syringohydromyelia induced by adhesive arachnoiditis in the rabbit: changes in the blood-spinal cord barrier, neuroinflammatory foci, and syrinx formation.

    PubMed

    Kobayashi, Shigeru; Kato, Katsura; Rodríguez Guerrero, Alexander; Baba, Hisatoshi; Yoshizawa, Hidezo

    2012-06-10

    There are many histological examinations of syringohydromyelia in the literature. However, there has been very little experimental work on blood permeability in the spinal cord vessels and ultrastructural changes. We prepared an animal model of spinal adhesive arachnoiditis by injecting kaolin into the subarachnoid space at the eighth thoracic vertebra of rabbits. The animals were evaluated 4 months later. Of the 30 rabbits given kaolin injection into the cerebrospinal fluid, 23 showed complete circumferential obstruction. In the 7 animals with partial obstruction of the subarachnoid space, intramedullary changes were not observed. However, among the 23 animals showing complete obstruction of the subarachnoid space, dilatation of the central canal (hydromyelia) occurred in 21, and intramedullary syrinx (syringomyelia) was observed in 11. In animals with complete obstruction, fluorescence microscopy revealed intramedullary edema around the central canal, extending to the posterior columns. Electron microscopy of hydromyelia revealed a marked reduction of villi on the ependymal cells, separation of the ependymal cells, and cavitation of the subependymal layer. The dilated perivascular spaces indicate alterations of fluid exchange between the subarachnoid and extracellular spaces. Syringomyelia revealed that nerve fibers and nerve cells were exposed on the surface of the syrinx, and necrotic tissue was removed by macrophages to leave a syrinx. Both pathologies differ in their mechanism of development: hydromyelia is attributed to disturbed reflux of cerebrospinal fluid, while tissue necrosis due to disturbed intramedullary blood flow is considered to be involved in formation of the syrinx in syringomyelia.

  20. Does degenerative disease of the lumbar spine cause arachnoiditis? A magnetic resonance study and review of the literature.

    PubMed

    Jackson, A; Isherwood, I

    1994-09-01

    The magnetic resonance appearances in 165 patients with symptoms suggestive of degenerative lumbar spine disease were reviewed. The aim of the study was to evaluate the relationship between abnormalities of nerve root distribution and degenerative disease of the lumbar spine in the absence of other known risk factors for arachnoiditis. Central clumping of nerve roots was present in 16 patients (9.7%) and was associated with spinal stenosis at one of the affected levels in all (p < 0.001). Spinal stenosis was present in 44 patients giving an incidence of abnormal nerve root distribution of 36% in this group. Nerve root clumping occurred in association with pure spinal stenosis (10 cases), stenosis secondary to disc prolapse (four cases) and degenerative spondylolisthesis (two cases). Nerve root clumping was confined to one vertebral level in nine cases and extended over two to four levels in seven. In five of the latter spinal stenosis was present at multiple levels. The appearance of nerve root clumping described here may result entirely from mechanical apposition of nerve roots but is indistinguishable from the central pattern of nerve root adhesions which occurs in adhesive lumbar arachnoiditis. No abnormalities of nerve root distribution were seen in association with any indicator of degenerative disk disease in the absence of stenosis. We have been unable to demonstrate the previously reported relationship between lumbar disk degeneration and arachnoiditis and discuss this with a critical review of the literature. Abnormal central clumping of nerve roots as described in arachnoiditis may occur in association with spinal stenosis in the absence of other risk factors although the cause for this appearance remains unexplained. Arachnoiditis-like changes extending over more than one vertebral level are rare (7%) except in the presence of spinal stenosis at multiple levels (29%). Awareness of this appearance may avoid a possibly incorrect diagnosis of arachnoiditis

  1. A Schizophrenia-Like Psychotic Disorder Secondary to an Arachnoid Cyst Remitted with Neurosurgical Treatment of the Cyst

    PubMed Central

    Baquero, G.A.; Molero, P.; Pla, J.; Ortuño, F.

    2014-01-01

    We describe a case of delusional psychosis that was terminated by neurosurgical removal of a large arachnoid cyst. The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia. The case underscores the importance of considering that an arachnoid cyst can induce psychopathological symptoms, even those of schizophrenia. Indeed, such symptoms may be the cyst's only clinical manifestation. In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of psychosis, especially if the episode is relatively late in appearance. Such imaging may lead to a diagnosis that in turn can enable a definitive neurosurgical resolution of the psychosis. PMID:24653786

  2. [Syringomyelia secondary to adhesive arachnoiditis: clinical profiles and efficacy of shunt operations].

    PubMed

    Kamada, K; Iwasaki, Y; Hida, K; Abe, H; Isu, T

    1993-02-01

    The authors report nine cases of syringomyelia secondary to adhesive arachnoiditis treated in our institute from 1982 to 1991. Neurological signs, radiological features, and results of surgical treatment were reviewed. Common initial manifestations in association with syringomyelia were spastic paraparesis in 8 patients (88.9%), regional sensory loss in 4 (44.4%), neurogenic bladder in 4 (44.4%), and somatic pain in 2 (22.2%). All the neurological symptoms or signs progressed gradually for years. All the patients were treated with various modes of shunt operations, including syringo-peritoneal shunt in seven patients, syringo-subarachnoid shunt in one, and ventriculo-peritoneal shunt in one, respectively. Three patients who failed to resolve their major complaints after the first surgery further received syringo-peritoneal shunts. Postsurgical follow-up periods ranged from 18 months to 10 years. Serial MR imaging revealed a significant reduction of the size of syringomyelia in 8 of 9 patients. However only 6 patients showed certain improvement of neurological deficits. Three patients who failed to improve clearly had a long (beyond 15 years) history of syringomyelia before the first surgical treatment. A total of 11 syringo-peritoneal shunts were done in 8 patients of whom 5 patients improved neurologically. It was noticed that 4 of 5 successful syringo-peritoneal shunts were placed in the caudal level of the syrinx. In conclusion, syringo-peritoneal shunt may be at present an optimal mode of surgical management for syringomyelia secondary to adhesive arachnoiditis. In addition, we would like to recommend that follow-up serial MR imaging be done for patients having adhesive arachnoiditis in order to detect syringomyelia as early as possible.

  3. Large/giant meningiomas of posterior third ventricular region: falcotentorial or velum interpositum?

    PubMed

    Behari, Sanjay; Das, Kuntal Kanti; Kumar, Ashish; Mehrotra, Anant; Srivastava, Arun K; Sahu, Rabi N; Jaiswal, Awadhesh K

    2014-01-01

    Surgical excision of rare, large-to-giant posterior third ventricular (PTV) meningiomas [including velum-interpositum meningiomas (VIM; postero-superior venous complex displacement; without falco-tentorial attachment) and falco-tentorial meningiomas (FTM; falco-tentorial attachment; displacing major veins antero-inferiorly)] is extremely challenging. To study the management nuances in the excision of large-to-giant PTV meningiomas. Tertiary care referral center. Four patients with large (>3 cm; n = 2) and giant (>5 cm; n = 2) meningiomas (FTM = 2; VIM = 2, mean tumor size = 4.9 cm) underwent occipital transtentorial approach (OTT) for tumor excision. One also underwent a second-stage supracerebellar infratentorial (SCIT) approach. The side of approach was determined by lateral tumor extension and venous displacement (right = 3, left = 1). Near-total removal or subtotal excision (<10% remaining) with radiotherapy was performed in 2 patients each, respectively. At follow-up (mean: 14.75 months), clinical improvement without tumor recurrence/re-growth was achieved. Extent of excision was determined by position of great vein of Galen; tumor attachment to falco-tentorium or major veins; its consistency; its lateral and inferior extent; and, presence of a good tumor-neuraxial arachnoidal plane. OTT is the preferable approach for large-to-giant meningiomas as it provides a wider corridor and better delineation of tumor-neurovascular arachnoidal interface.

  4. Vocal sequential exchanges and intragroup spacing in the Northern Muriqui Brachyteles arachnoides hypoxanthus.

    PubMed

    Mendes, Francisco D C; Ades, César

    2004-06-01

    Sequential exchanges of vocalizations (staccatos and neighs) emitted by Northern Muriquis Brachyteles arachnoides hypoxanthus were recorded at the Biological Station of Caratinga, Minas Gerais State, Brazil. Staccatos and neighs containing larger proportion of short elements were preferentially produced during short-range exchanges; neighs, produced by a larger number of participants, were typical of long-range exchanges. Staccatos emitted by animals feeding in a dispersed manner contained a larger proportion of tonal elements than those emitted by muriquis feeding in a cohesive manner. Sequential exchanges seem thus to be constituted by two inter-related subsystems of calls that aid muriquis to coordinate intragroup spacing, despite the poor visibility of the habitat.

  5. Giant Arachnoid Granulation Associated with Anomalous Draining Vein: A Case Report

    PubMed Central

    Oskouian, Rod J; Loukas, Marios; Tubbs, R. Shane

    2017-01-01

    Giant arachnoid granulations (AG) can mimic intracranial lesions. Knowledge of these structures can help avoid misdiagnosis when interpreting imaging. Here, we report a child who presented with a mass within the superior sagittal sinus and an anomalous draining vein. Herein, the diagnosis of a giant AG was made. Clinicians who view or interpret imaging of the head should be aware of these anatomical variants and though when very large, apparently, do not necessarily result in pathology. Based on our case report, giant AG might also demonstrate anomalous draining veins.

  6. Intracranial Intra-arachnoid Diverticula and Cyst-like Abnormalities of the Brain.

    PubMed

    Platt, Simon; Hicks, Jill; Matiasek, Lara

    2016-03-01

    Primary intracranial cystic or cyst-like lesions include intra-arachnoid, epidermoid, dermoid, and choroid plexus cysts. Differentiation of these cystic lesions can usually be accomplished by imaging studies alone; however, some cysts are similar in appearance and require histopathology for definitive diagnosis. Clinical signs often reflect the location of the cysts within the intracranial cavity rather than the type of cyst. If clinical signs are significant and progressive, surgical removal is warranted and may be successful, although cystic contents could be harmful if allowed to contact surrounding brain parenchyma or meninges.

  7. Imaging diagnosis--Vertebral canal porcupine quill with presumptive secondary arachnoid diverticulum.

    PubMed

    Schneider, Adam R; Chen, Annie V; Tucker, Russell L

    2010-01-01

    A 3-year-old Gordon Setter developed cervical hyperesthesia and a stiff gait. Upon magnetic resonance (MR) imaging, an arachnoid diverticulum was detected at the C1 level. Upon surgical resection, a porcupine quill was identified within the vertebral canal in the area of the cyst. At a retrospective review of the MR images, the quill appeared as a circular well-demarcated T2-hypointense lesion. Porcupine quill migrations are common in the dog but migration into the central nervous system is rare.

  8. Arachnoid cyst of the cavum velum interpositum in a septuagenarian: radiological features and differential diagnosis.

    PubMed

    Rajesh, S; Bhatnagar, Shorav; Chauhan, Udit; Gupta, Shailesh; Agarwal, Nitesh; Kasana, Vivek

    2014-04-01

    The cavum velum interpositum (CVI) is a thin, triangular-shaped cerebrospinal fluid (CSF)-filled space between the lateral ventricles that lies below the fornices and above the third ventricle. It is a normal variant seen in premature and newborn infants and usually disappears with brain maturation. CVI is rarely seen in adults as a persistent primitive structure. Although moderate cystic dilatation of the CVI may sometimes be observed, a true large cyst is extremely rare with only a handful of reported cases, mostly in children and adolescents. We describe the case of CVI arachnoid cyst diagnosed on imaging in a septuagenarian with the complaint of occasional headaches.

  9. Dimensions of the temporal glenoid fossa and tooth wear in prehistoric human skeletons.

    PubMed

    Owen, C P; Wilding, R J; Adams, L P

    1992-01-01

    Both the mandibular condyle and the glenoid fossa remodel in response to changes in the dentition during life, although the precise relationship between teeth and joint is not clear. This study was undertaken to ascertain changes, if any, occurring in the glenoid fossae in skeletons with much tooth wear. In a collection of skulls from an excavation site on the South African coast, occlusal wear was measured using the scale devised by Molnar. The dimensions of the glenoid fossae were measured using a reflex microscope. Profiles of the glenoid fossa at right angles to a line through its medial and lateral poles provided estimates of the slope of the articular eminence in three places: centrally, and midway between this slope and each of the poles. The mediolateral profile gave an estimate of the height and gabling of the fossa. Central and lateral slope angles showed weak correlation with molar wear, and the medial but not the lateral angel was significantly different from the central. The fossa appears to remodel in response to patterns of forces generated during function, but compared to the condyle, is not as strongly influenced. This may be accounted for if the relative load-bearing areas of the condyle and fossa are considered.

  10. Amyloidoma Involving the Orbit, Meckel's Cave and Infratemporal Fossa: 3T MRI Findings.

    PubMed

    Menetti, F; Bartolomei, I; Ambrosini-Spaltro, A; Salvi, F; Agati, R; Leonardi, M

    2009-03-23

    Amyloidoma is a rare lesion characterized by tissue deposition of an abnormal fibrillary protein (amyloid). It is the focal and localized counterpart of systemic amyloidosis, where the deposition of amyloid diffusely involves several organs. The few literature reports of intracranial amyloidomas include lesions involving the pituitary gland, orbit, cerebral hemispheres, temporal bone, cerebellopontine angle and jugular foramen. We describe the case of a 27-year-old woman presenting with painless slowly progressive proptosis of the right eye. The patient underwent a contrast-enhanced CT study of the head, followed by 3T MRI which disclosed a homogeneous mass in the right Meckel's cave and cavernous sinus, extending through an enlarged foramen ovale to the infratemporal fossa. The right optic nerve and ocular muscles were enlarged and infiltrated along with the retrobulbar fat by contrast-enhancing tissue. Thin contrast-enhanced MRI scans through the area of interest showed the mass to extend posterior to the gasserian ganglion, involving the cerebellopontine angle cistern, where the intracisternal parts of the III, V, and VI nerves bilaterally appeared enlarged and showed perineural enhancement. The lesion closely mimicked a malignant tumor with perineural tumor infiltration, so we performed fine needle biopsy of the portion of the lesion near the right foramen ovale under fluoroscopic guidance. Histopathology revealed that the lesion was an amyloidoma. Further clinical and blood examinations, serum chemistry, followed by biopsy of the periumbilical fat showed no signs of systemic amyloidosis or an underlying inflammatory or neoplastic disorder. No further treatment was instituted, follow-up MRI six months later showed no enlargement of the mass.

  11. The tibialis posterior tendon.

    PubMed

    Lhoste-Trouilloud, A

    2012-02-01

    The tibialis posterior tendon is the largest and anteriormost tendon in the medial ankle. It produces plantar flexion and supination of the ankle and stabilizes the plantar vault. Sonographic assessment of this tendon is done with high-frequency, linear-array transducers; an optimal examination requires transverse retromalleolar, longitudinal retromalleolar, and distal longitudinal scans, as well as dynamic studies. Disorders of the posterior tibial tendon include chronic tendinopathy with progressive rupture, tenosynovitis, acute rupture, dislocation and instability, enthesopathies. The most common lesion is a progressive "chewing gum" lesion that develops in a setting of chronic tendinopathy; it is usually seen in overweight women over 50 years of age with valgus flat feet. Medial ankle pain must also be carefully investigated, and the presence of instability assessed with dynamic maneuvers (forced inversion, or dorsiflexion) of the foot. Sonography plays an important role in the investigation of disorders involving the posterior tibial tendon.

  12. Posterior crossbites in children.

    PubMed

    Zhu, J F; Crevoisier, R; King, D L; Henry, R; Mills, C M

    1996-11-01

    Posterior crossbite, the most common malocclusion in young children, can be caused by a variety of skeletal, muscular, or dental factors. This condition produces insufficient maxillary arch width and is frequently associated with various oral sucking and postural habits. If left untreated, this problem can result in adverse skeletal growth changes. Various mechanical treatment modalities designed to expand the posterior maxillary arch width are available to correct this problem. The appropriate treatment method depends on the patient's age and level of cooperation as well as the determined etiology of the constriction.

  13. Wound breakdown after middle cranial fossa craniotomy: an unusual complication after rhytidectomy.

    PubMed

    Moberly, Aaron C; Tweel, Benjamin C; Welling, D Bradley

    2014-02-01

    Wound complications after middle cranial fossa craniotomy are rare. We describe a patient who underwent a left middle fossa craniotomy for resection of a small internal auditory canal tumor with subsequent development of wound breakdown and infection 1 week postoperatively. Prompting of the patient elicited a history of bilateral rhytidectomies. Wound debridement, hyperbaric oxygen therapy, dermal regeneration template placement, and prolonged antibiotic treatment were performed. Complete secondary intention healing occurred with an acceptable cosmetic outcome. Prior rhytidectomy scars must be identified and incorporated into the surgical planning prior to performing middle fossa craniotomy incisions.

  14. Tibialis Posterior Tendon Entrapment Within Posterior Malleolar Fracture Fragment.

    PubMed

    Fantry, Amanda; Lareau, Craig; Vopat, Bryan; Blankenhorn, Brad

    2016-01-01

    Management of posterior malleolus fractures continues to be controversial, with respect to both need for fixation and fixation methods. Fixation methods include an open posterior approach to the ankle as well as percutaneous reduction and fixation with or without arthroscopy for visualization of the articular surface. Plain radiographs are unreliable in identifying fracture pattern and intraoperative reduction, making arthroscopy a valuable adjunct to posterior malleolus fracture management. In this article, we report a case of tibialis posterior tendon entrapment within a posterior malleolus fracture, as identified by arthroscopy and managed with open reduction. Tibialis posterior tendon entrapment within a posterior malleolus has not been previously reported. Ankle arthroscopy for posterior malleolus fractures provides an opportunity to identify soft-tissue or tendinous entrapment, articular surface reduction, and articular cartilage injuries unlikely to be identified with fluoroscopy alone and should be considered in reduction and fixation of posterior malleolus fractures.

  15. Quantitative Analysis of Change in Intracranial Volume After Posterior Cranial Vault Distraction.

    PubMed

    Shimizu, Azusa; Komuro, Yuzo; Shimoji, Kazuaki; Miyajima, Masakazu; Arai, Hajime

    2016-07-01

    Posterior cranial vault distraction is considered to be more effective for increasing intracranial volume than fronto-orbital advancement or anterior cranial vault expansion, but the changes in intracranial volumes after posterior cranial vault distraction remain unclear. The changes in intracranial volume were investigated in patients of premature craniosynostosis treated by this technique. Seven patients, 3 boys and 4 girls aged from 5 months to 3 years 3 months (mean 23 months) at operation, with craniosynostosis underwent posterior cranial vault distraction at Juntendo University Hospital from 2011 to 2014. Patient characteristics, length of distraction, and pre- and postoperative computed tomography findings were reviewed. Total intracranial volume, including the supratentorial space and posterior cranial fossa, was measured using the workstation functions on three-dimensional computed tomography scans. Posterior distraction was performed without severe complications except in 2 patients requiring additional surgeries. The distraction length was 22.3 to 39 mm (mean 31 mm), the intracranial volume change was 144 to 281 mL (mean 192 mL), and the enlargement ratio of intracranial volume was 113% to 134% (mean 121%). The present quantitative analysis of intracranial volume change after posterior distraction showed greater increases in intracranial volume compared with previous reports. Furthermore, intracranial volumes in our patients became nearly normal and were maintained for the follow-up period (maximum 13 months). Posterior cranial vault distraction is very effective to increase cranial volume, so may be the first choice of treatment in patients of craniosynostosis.

  16. Non-traumatic adhesive arachnoiditis as a cause of spinal cord syndromes. Investigation of 507 patients.

    PubMed

    Jenik, F; Tekle-Haimanot, R; Hamory, B H

    1981-01-01

    Spinal cord syndromes with a mainly syringomyelic pattern of sensory diorders, radiculopathies, mixed paresis of varying degree (without any history of trauma), have been found in 507 out of 1305 new patients referred to out Clinic from January 1976 till 31 October 1977. In 105 randomised and unselected cases with these syndromes, myelographies have disclosed findings compatible with an adhesive spinal and/or cisternal arachnoiditis. A prospective study of the syndromes for evidence of infectious aetiology has been performed, in which tuberculosis, syphilis and other infections appear to be causative agents. A randomised therapeutic trial on a limited number of cases has been evaluated, as well as the results of specific therapy in a larger number of cases. Results of treatment have not been satisfactory. Operations were performed on only five patients and in no case was an autopsy obtained. Spinal cord syndromes due to non-traumatic adhesive arachnoiditis are discussed. The possible pathogenetic mechanisms the predominantly syringomyelic sensory deficits in those syndromes are briefly mentioned.

  17. Severe adhesive arachnoiditis resulting in progressive paraplegia following obstetric spinal anaesthesia: a case report and review.

    PubMed

    Killeen, T; Kamat, A; Walsh, D; Parker, A; Aliashkevich, A

    2012-12-01

    A 27-year-old woman developed severe adhesive arachnoiditis after an obstetric spinal anaesthetic with bupivacaine and fentanyl, complicated by back pain and headache. No other precipitating cause could be identified. She presented one week postpartum with communicating hydrocephalus and syringomyelia and underwent ventriculoperitoneal shunting and foramen magnum decompression. Two months later, she developed rapid, progressive paraplegia and sphincter dysfunction. Attempted treatments included exploratory laminectomy, external drainage of the syrinx and intravenous steroids, but these were unsuccessful and the patient remains significantly disabled 21 months later. We discuss the pathophysiology of adhesive arachnoiditis following central neuraxial anaesthesia and possible causative factors, including contamination of the injectate, intrathecal blood and local anaesthetic neurotoxicity, with reference to other published cases. In the absence of more conclusive data, practitioners of central neuraxial anaesthesia can only continue to ensure meticulous, aseptic, atraumatic technique and avoid all potential sources of contamination. It seems appropriate to discuss with patients the possibility of delayed, permanent neurological deficit while taking informed consent.

  18. Homicide and subsequent catatonia associated with a large arachnoid cyst: case report.

    PubMed

    Margetić, Branimir; Palijan, Tija Zarković; Kovacević, Drazen

    2013-12-01

    The existence of a focal brain lesion that might be the crucial cause for the development of diverse psychiatric phenomena and certain characteristics of personality is often a controversial issue. The patient was a 29-year-old male when he killed his father with a single knock with the blunt side of an axe. Subsequently to the act, the patient developed a 10-month-long catatonic stupor during which he experienced intensive fear, delusions, and affective symptoms. He was an emotionally blunted person with no medical record and without prior history of aggressive behavior. Magnetic resonance image revealed a large, right-sided arachnoid cyst that was associated with right temporal and frontal lobe hypoplasia and bilateral changes of perfusion in peri-insular regions. The treatment with clozapine and diazepam showed to be therapeutic. This could be the second case of homicide committed by a person with arachnoid cyst and without past history of aggression, and the second description of an adult patient with cyst who developed catatonic stupor. This is the first description of long-lasting organic catatonic stupor treated with clozapine and diazepam. Relevant literature is reviewed and some controversial issues are discussed.

  19. Bilateral sensorineural deafness, partial agenesis of the corpus callosum, and arachnoid cysts in two sisters.

    PubMed

    Hendriks, Y M; Laan, L A; Vielvoye, G J; van Haeringen, A

    1999-09-10

    We describe two sisters (ages 10 and 3 years, respectively) with a normal development and a combination of congenital sensorineural hearing loss, partial agenesis of the corpus callosum, arachnoid cyst, and hydrocephalus. Neither girl has distinctive physical anomalies. In the oldest girl, there was a hearing loss of 80 dB bilaterally, and the most severe loss on audiogram was seen at 2,000-4,000 Hz. In the youngest girl, there was a hearing loss of 100 dB bilaterally. Above 2,000 Hz no neural reactions were seen. Cerebral magnetic resonance imaging in one girl and computed tomography in the other showed a partial agenesis of the corpus callosum and a cyst in the pineal region, causing an aqueduct stenosis by compression and consequent hydrocephalus. The parents have normal hearing, and brain magnetic resonance imaging showed no abnormalities. They are nonconsanguineous but from the same small village. This is the first report of a combination of congenital sensorineural hearing loss, partial agenesis of the corpus callosum, and an arachnoid cyst. The pattern of inheritance is probably autosomal recessive.

  20. Nili Fossae in Natural Color and Across the Spectrum

    NASA Technical Reports Server (NTRS)

    2007-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this image of the Nili Fossae region at 0643 UTC (2:43 a.m. EDT) on June 21, 2007, near 21.15 degrees north latitude, 74.24 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 20 meters (66 feet) across. The region covered is just over 10 kilometers (6.2 miles) wide at its narrowest point, and is one of several dozen that CRISM has taken to map the minerals at candidate landing sites for the Mars Science Laboratory (MSL) mission, which will launch in 2010.

    The Nili Fossae region is critical to understanding the history of water on Mars and whether water ever formed environments suitable for life, because the region is underlain by a layer of phyllosilicate (clay) minerals. This type of mineralogy formed where water was in contact with Mars' crustal rocks for very long periods, altering the silicates in volcanic rocks. In addition, phyllosilicates can encapsulate and preserve organic chemicals associated with life (if life was present). Its rocky record of an ancient wet environment makes Nili Fossae a top contender among the 30-plus landing sites being considered for MSL, whose objectives include measuring the chemistry preserved in an ancient wet environment.

    This series of four different versions of the same 544-color image illustrates the mineral-mapping capability that comes from moving beyond the wavelength range of the human eye, and into infrared wavelengths where minerals leave distinct 'fingerprints' in reflected sunlight. At upper left, more than three dozen of the distinct wavelengths measured by CRISM were combined to mimic how the human eye would see the image. The subtle shading comes from the Sun's position high in Mars' sky when the image was taken, creating few shadows. The bland, butterscotch color comes from the dust coating nearly all of the Martian surface to some degree. At upper right

  1. Phyllosilicate and Olivine around a Fracture in Nili Fossae

    NASA Technical Reports Server (NTRS)

    2007-01-01

    The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this observation of part of the Nili Fossae region at the western margin of the Isidis impact basin at 3:07 (UTC) on December 12, 2006, near 21.9 degrees north latitude, 78.2 degrees east longitude. The image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 18 meters (60 feet) across. The image is about 11 kilometers (7 miles) wide at its narrowest point.

    The Isidis basin resulted from a gigantic impact on the surface of Mars early in the planet's history. The image of the Isidis basin at the top left is the colored elevation data from the Mars Orbiter Laser Altimeter (MOLA) overlain on a digital image mosaic from the Viking mission. Reds represent higher elevations, and blue lower elevations. The western rim of the Isidis basin has numerous, concentric troughs (or 'fossae') which may have formed during faulting associated with the impact event. Since then, the Nili Fossae region has since been heavily eroded, and is one of the most mineralogically diverse spots on Mars.

    This CRISM image targets one of region's smaller fractures. The image is shown overlain on the Viking digital image mosaic at lower left. The lower right CRISM image was constructed from three visible wavelengths (0.71, 0.60 and 0.53 microns in the red, green and blue image planes, respectively) and is close to what the human eye would see. The blue on the right of the image is an artifact from light scattering in the atmosphere. The upper right image was constructed from three infrared channels (2.38, 1.80 and 1.15 microns in the red, green and blue image planes, respectively) to highlight the mineralogy of the area. The bright green areas are rich in 'phyllosilicates,' a category of minerals including clays. The purple material along the walls of the fracture likely contains small amounts of the iron- and magnesium-rich mineral pyroxene. The yellow-brown material contains the

  2. Hypopharynx and larynx defect repair after resection for pyriform fossa cancer with a platysma skin flap.

    PubMed

    Cai, Qian; Liang, Faya; Huang, Xiaoming; Han, Ping; Pan, Yong; Zheng, Yiqing

    2015-02-01

    We used a platysma skin flap to repair larynx and hypopharynx defects to improve postoperative laryngeal function in patients with pyriform fossa cancer. Larynx-sparing surgery and postoperative radiotherapy were used in 10 patients with pyriform fossa cancer. The surgical approaches of lymph node dissection of the neck, vertical partial laryngectomy, and pyriform fossa resection were adopted, and a platysma skin flap was used to repair the resulting defects. In this group, the overall 3-year survival rate was 75% according to the Kaplan-Meier analysis, and the local control rate was 90%. Additionally, all patients were able to speak fluently with mild-to-moderate hoarseness. The tracheal tube was removed in all cases. Laryngeal fistulas were observed in 1 patient during radiotherapy. In conclusion, a platysma skin flap can be used to rebuild the larynx and hypopharynx in larynx-sparing resection for pyriform fossa cancer. These patients can obtain good postoperative function in swallowing, breathing, and pronunciation.

  3. Polygonal Dike Networks in the Medusae Fossae Formation

    NASA Astrophysics Data System (ADS)

    Kerber, L.; Dickson, J. L.; Forget, F.; Head, J. W.; Grosfils, E. B.

    2013-09-01

    1. Introduction 1.1 The Medusae Fossae Formation The Medusae Fossae Formation (MFF) is a widespread and voluminous formation which covers 2.1 x 106 km2 between 130-230ºE and 12ºS-12ºN [1-3]. As a fine-grained, friable deposit, its surface is dominated by aeolian features such as yardangs [3-5] and a large number of both fresh and indurated transverse aeolian ridges [TARs] [5]. The deposition of the MFF began at the latest in the Hesperian [6], and over time it has been recognized that, by virtue of its fine-grained nature, the MFF may preserve an important record of Martian history, most directly as a result of the burial and exhumation of channels found in the Zephyria region of the formation [7]. In order to better document the occurrence of smallscale features of interest within the MFF, we examined 427 High Resolution Imaging Science Experiment (HiRISE) images spread across the formation, during which the occurrence of features of interest were mapped [8]. HiRISE images were supplemented by Mars Reconnaissance Orbiter Context Imager (CTX), Mars Express High Resolution Stereo Camera (HRSC) and Mars Global Surveyor Mars Orbiter Camera (MOC) images where needed. Here we describe the occurrence and characteristics of several polygonal networks of rectilinear ridges. 1.2 Rectilinear Ridges on Mars Rectilinear ridges have been recognized in several different areas on Mars. Long, linear to slightly curving or en echelon ridges hypothesized to be exhumed magmatic dikes have been found in a variety of environments on Mars [9-13], particularly in formerly glaciated terrains where magma may have been emplaced into an icy substrate. A network of rectilinear ridges was described in detail in an unnamed crater on the dichotomy boundary [14]. These chaotic, intersecting ridges, forming irregular polygons ~1 km across, are hypothesized to be brecciated dikes emplaced during the process of crater formation [14]. A group of intersecting rectilinear ridges, informally known as

  4. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    PubMed Central

    Smith, Keely; Gomez-Rubio, Ana M.; Harris, Tomika S.; Brooks, Lauren E.

    2016-01-01

    We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2) resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV) during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway. PMID:27418995

  5. Acoustic interaction between the right and left piriform fossae in generating spectral dips.

    PubMed

    Takemoto, Hironori; Adachi, Seiji; Mokhtari, Parham; Kitamura, Tatsuya

    2013-10-01

    It is known that the right and left piriform fossae generate two deep dips on speech spectra and that acoustic interaction exists in generating the dips: if only one piriform fossa is modified, both the dips change in frequency and amplitude. In the present study, using a simple geometrical model and measured vocal tract shapes, the acoustic interaction was examined by the finite-difference time-domain method. As a result, one of the two dips was lower in frequency than the two independent dips that appeared when either of the piriform fossae was occluded, and the other dip was higher in frequency than the two dips. At the lower dip frequency, the piriform fossae resonated almost in opposite phase, while at the higher dip frequency, they resonated almost in phase. These facts indicate that the piriform fossae and the lower part of the pharynx can be modeled as a coupled two-oscillator system whose two normal vibration modes generate the two spectral dips. When the piriform fossae were identical, only the higher dip appeared. This is because the lower mode is not acoustically coupled to the main vocal tract enough to generate an absorption dip.

  6. Pedestal Craters and Wind Streaks, South Medusae Fossae

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Mars is a desert planet in which wind has a considerable effect on the landscape. Bright and dark wind streaks in this image indicate past movement of fine sediment across the landscape from upper left toward lower right. Two impact craters that look like flowers or starfish are seen in the lower portion of the image. The ejecta deposits of these craters are raised above the surrounding terrain, and indicate that wind has deflated a layer of material (that is, blown it away, thus lowering the surface) that was present at the time that the craters formed. The craters were formed by impacts of meteorites into the earlier, higher surface, and the rocks and gravel thrown out when they formed protected some of this former layer from the wind's effects. This picture--showing part of the Medusae Fossae region near the martian equator--was taken in early April 1999 and covers an area only 1 kilometer (0.62 miles)wide. Illumination is from the lower right.

    Malin Space Science Systems and the California Institute of Technology built the MOC using spare hardware from the Mars Observer mission. MSSS operates the camera from its facilities in San Diego, CA. The Jet Propulsion Laboratory's Mars Surveyor Operations Project operates the Mars Global Surveyor spacecraft with its industrial partner, Lockheed Martin Astronautics, from facilities in Pasadena, CA and Denver, CO.

  7. Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum.

    PubMed

    Bilgen, I G; Yunten, N; Ustun, E E; Oksel, F; Gumusdis, G

    1999-07-01

    We present the radiological features of a 42-year-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sac to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hypothesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS.

  8. Posterior Circulation Ischemic Stroke.

    PubMed

    Go, Steven

    2015-01-01

    Approximately 20-25% of all acute strokes occur in the posterior circulation. These strokes can be rather difficult to diagnose because they present in such diverse ways, and can easily be mistaken for more benign entities. A fastidious history, physical exam, high clinical suspicion, and appropriate use of imaging are essential for the emergency physician to properly diagnose and treat these patients. Expert stroke neurologist consultation should be utilized liberally.

  9. Ossification of the Posterior Petroclinoid Dural Fold: A Cadaveric Study with Neurosurgical Significance

    PubMed Central

    Kimball, David; Kimball, Heather; Matusz, Petru; Tubbs, R. Shane; Loukas, Marios; Cohen-Gadol, A. Aaron

    2015-01-01

    Objectives The roof of the porus trigeminus, composed of the posterior petroclinoid dural fold, is an important landmark to the skull base surgeon. Ossification of the posterior petroclinoid dural fold is an anatomical variation rarely mentioned in the literature. Such ossification results in the trigeminal nerve traversing a bony foramen as it enters Meckel cave. The authors performed this study to better elucidate this anatomical variation. Design Fifteen adult cadaveric head halves were subjected to dissection of the middle cranial fossa. Microdissection techniques were used to examine the posterior petroclinoid dural folds. Skull base osteology was also studied in 71 dry human skulls with attention paid to the attachment point of the posterior petroclinoid dural folds at the trigeminal protuberances. Setting Cadaver laboratory Main Outcome Measures Measurements were made using a microcaliper. Digital images were made of the dissections. Results Completely ossified posterior petroclinoid folds were present in 20% of the specimens. Of the 142 dry skull sides examined, 9% had large trigeminal protuberances. Conclusions Based on this study, the posterior petroclinoid dural fold may completely ossify in adults that may lead to narrowing of the porus trigeminus and potential compression of the trigeminal nerve at the entrance to Meckel cave. PMID:26225315

  10. PDGF activation in PGDS-positive arachnoid cells induces meningioma formation in mice promoting tumor progression in combination with Nf2 and Cdkn2ab loss.

    PubMed

    Peyre, Matthieu; Salaud, Céline; Clermont-Taranchon, Estelle; Niwa-Kawakita, Michiko; Goutagny, Stephane; Mawrin, Christian; Giovannini, Marco; Kalamarides, Michel

    2015-10-20

    The role of PDGF-B and its receptor in meningeal tumorigenesis is not clear. We investigated the role of PDGF-B in mouse meningioma development by generating autocrine stimulation of the arachnoid through the platelet-derived growth factor receptor (PDGFR) using the RCAStv-a system. To specifically target arachnoid cells, the cells of origin of meningioma, we generated the PGDStv-a mouse (Prostaglandin D synthase). Forced expression of PDGF-B in arachnoid cells in vivo induced the formation of Grade I meningiomas in 27% of mice by 8 months of age. In vitro, PDGF-B overexpression in PGDS-positive arachnoid cells lead to increased proliferation.We found a correlation of PDGFR-B expression and NF2 inactivation in a cohort of human meningiomas, and we showed that, in mice, Nf2 loss and PDGF over-expression in arachnoid cells induced meningioma malignant transformation, with 40% of Grade II meningiomas. In these mice, additional loss of Cdkn2ab resulted in a higher incidence of malignant meningiomas with 60% of Grade II and 30% of Grade III meningiomas. These data suggest that chronic autocrine PDGF signaling can promote proliferation of arachnoid cells and is potentially sufficient to induce meningiomagenesis. Loss of Nf2 and Cdkn2ab have synergistic effects with PDGF-B overexpression promoting meningioma malignant transformation.

  11. Differentiation of idiopathic spinal cord herniation from dorsal arachnoid webs on MRI and CT myelography.

    PubMed

    Schultz, Randall; Steven, Andrew; Wessell, Aaron; Fischbein, Nancy; Sansur, Charles A; Gandhi, Dheeraj; Ibrahimi, David; Raghavan, Prashant

    2017-03-24

    OBJECTIVE Dorsal arachnoid webs (DAWs) and spinal cord herniation (SCH) are uncommon abnormalities affecting the thoracic spinal cord that can result in syringomyelia and significant neurological morbidity if left untreated. Differentiating these 2 entities on the basis of clinical presentation and radiological findings remains challenging but is of vital importance in planning a surgical approach. The authors examined the differences between DAWs and idiopathic SCH on MRI and CT myelography to improve diagnostic confidence prior to surgery. METHODS Review of the picture archiving and communication system (PACS) database between 2005 and 2015 identified 6 patients with DAW and 5 with SCH. Clinical data including demographic information, presenting symptoms and neurological signs, and surgical reports were collected from the electronic medical records. Ten of the 11 patients underwent MRI. CT myelography was performed in 3 patients with DAW and in 1 patient with SCH. Imaging studies were analyzed by 2 board-certified neuroradiologists for the following features: 1) location of the deformity; 2) presence or absence of cord signal abnormality or syringomyelia; 3) visible arachnoid web; 4) presence of a dural defect; 5) nature of dorsal cord indentation (abrupt "scalpel sign" vs "C"-shaped); 6) focal ventral cord kink; 7) presence of the nuclear trail sign (endplate irregularity, sclerosis, and/or disc-space calcification that could suggest a migratory path of a herniated disc); and 8) visualization of a complete plane of CSF ventral to the deformity. RESULTS The scalpel sign was positive in all patients with DAW. The dorsal indentation was C-shaped in 5 of 6 patients with SCH. The ventral subarachnoid space was preserved in all patients with DAW and interrupted in cases of SCH. In no patient was a web or a dural defect identified. CONCLUSIONS DAW and SCH can be reliably distinguished on imaging by scrutinizing the nature of the dorsal indentation and the integrity of

  12. Adhesive arachnoiditis after percutaneous fibrin glue treatment of a sacral meningeal cyst.

    PubMed

    Hayashi, Kazunori; Nagano, Junji; Hattori, Satoshi

    2014-06-01

    The authors present the case of a 64-year-old woman who was referred for severe sacral pain. She reported that her pain had been longstanding, and had greatly increased after percutaneous fibrin glue placement therapy for a sacral meningeal cyst 2 months earlier at a different hospital. An MRI scan obtained immediately after fibrin glue placement at that hospital suggested that fibrin glue had migrated superiorly into the subarachnoid space from the sacral cyst to the level of L-4. On admission to the authors' institution, physical examination demonstrated no abnormal findings except for perianal hypesthesia. An MRI study obtained at admission demonstrated a cystic lesion in the peridural space from the level of S-2 to S-4. Inhomogeneous intensity was identified in this region on T2-weighted images. Because the cauda equina and nerve roots appeared to be compressed by the lesion, total cyst excision was performed. The cyst cavity was filled with fluid that resembled CSF, plus gelatinous material. Histopathological examination revealed that the cyst wall was composed of hyaline connective tissue with some calcification. No nervous tissue or ganglion cells were found in the tissue. The gelatinous material was acellular, and appeared to be degenerated fibrin glue. Sacral pain persisted to some extent after surgery. The authors presumed that migrated fibrin glue caused the development of adhesive arachnoiditis. The risk of adhesive arachnoiditis should be considered when this therapy is planned. Communication between a cyst and the subarachnoid space should be confirmed to be sufficiently narrow to prevent the migration of injected fibrin glue.

  13. Relative placement of the mandibular fossa in great apes and humans.

    PubMed

    Sherwood, Richard J; Rowley, Rebecca B; Ward, Steven C

    2002-07-01

    Several researchers have investigated, or commented on, the relative placement of the hominin mandibular fossa with regard to brain expansion and masticatory function. Two confounding factors are identified in this previous work. First, a number of different measurement techniques have been applied, confusing comparisons between studies. Second, the effects of squamous thickening due to temporal bone pneumatization are shown to influence measurements based relative to the ectocranial margin of the skull. To investigate the influence of these factors, a sample of adult human (n=12), chimpanzee (n=12), gorilla (n=15), and orang-utan (n=8) skulls from the Cleveland Museum of Natural History, University of Wisconsin Zoology Museum, and University of Wisconsin Anthropology collections, were CT scanned. Coronal scans were horizontally aligned and measured on a personal computer using ImageJ (NIH). To identify fossa placement, fossa breadth was measured as the projected distance in the coronal plane between the tip of the entoglenoid to lateral margin of the articular surface. A second distance, from the tip of the entoglenoid to a sagittal plane, tangent to the lateralmost margin of the endocranial surface was taken to indicate the extent of medial placement of the fossa. By eliminating the influence of pneumatization, these data unambiguously confirmed the medial placement of the human fossa and show all great apes as having a laterally placed fossa. Similar measurements on three fossil hominins, KNM-BC 1 (Homo sp. indet.), OH 5 and KNM-ER 23000 (Paranthropus boisei) demonstrate that, while all specimens demonstrate a broad fossa, only KNM-BC 1 is characterized by a relatively medial placement while the latter two display lateral placement.

  14. Medusae Fossae Formation: New perspectives from Mars Global Surveyor

    NASA Astrophysics Data System (ADS)

    Bradley, Bethany A.; Sakimoto, Susan E. H.; Frey, Herbert; Zimbelman, James R.

    2002-08-01

    The nature and origin of the Medusae Fossae Formation (MFF) on Mars has been debated since the return of the first Viking images. The MFF's young age, distinctive surface texture, and lack of obvious source have prompted multiple hypotheses for its origin. This study uses data from the Mars Global Surveyor (MGS) mission to examine the MFF at all available scales. We discuss and quantify observations from Mars Orbiter Laser Altimeter (MOLA) topography and Mars Orbiter Camera (MOC) images to better constrain the origin of the MFF. Topographic grid estimates yield a present extent of 2.1 × 106 km2 and a volume of 1.4 × 106 km3; however, remnant yardang deposits observed far from the thicker lobes of MFF material suggest that it may have once covered up to 5 × 106 km2. We do not find compelling evidence for extensive fluvial reworking of the MFF; however, in several regions, buried channels are apparent in the MFF because the formation is draped over underlying topography. Layering is apparent at all scales, from submeter to hundreds of meters, with variable resistance to weathering. Continuity of layers appears to be local to regional, but not likely formation-wide. Yardangs form both parallel and bidirectional patterns, with resistant layers and jointing probably influencing their orientations. A comparative study of MFF regional topography and surface expression indicates that the MFF is quantitatively dissimilar to Martian polar layered deposits. The material is most likely a friable and irregularly consolidated air fall deposit of probable volcanic origin.

  15. Morphological study of fossa ovalis and its clinical relevance

    PubMed Central

    Joshi, S.D.; Chawre, H.K.; Joshi, S.S.

    2016-01-01

    Aims Patent foramen ovale (PFO) has been implicated in the etiology of a number of different pathologies, including cryptogenic stroke, decompression sickness in divers, etc. It can act as a channel for paradoxical embolism. PFO is not an uncommon condition, with a probe-patency in 15–35% population. The fossa ovalis (FOv) varies in size and shape from heart to heart; the prominence of annulus FOv also varies. The entire FOv may be redundant and aneurysmal. The anatomico-functional characterization of interatrial septum seems to be of paramount importance for both atrial septal defect (ASD) and PFO, not only for the device selection, but also for the evaluation of the outcome of this procedure. Method This study was conducted in 50 apparently normal hearts available in Department of Anatomy. After opening the right atrium, the shape of FOv was observed. The size was measured with the digital vernier caliper; the prominence and extent of limbus, and the redundancy or otherwise of FOv were noted; probe patency was confirmed. Results In the majority, FOv was oval (82%); average transverse diameter was 14.53 mm and vertical 12.60 mm. In 90%, the rim of the annulus was raised; in 20%, a recess was found deep to the margin of the annulus; and 18% showed probe patency. Conclusion As no study of this nature has been carried out in the Indian population, this provides pertinent information on the morphology of FOv, which may be useful for device selection in treating ASD and PFO. PMID:27133322

  16. Posterior interosseous neuropathy

    PubMed Central

    Kele, Henrich; Xia, Annie; Weiler, Markus; Schwarz, Daniel; Bendszus, Martin; Pham, Mirko

    2016-01-01

    Objective: To investigate the spatial pattern of lesion dispersion in posterior interosseous neuropathy syndrome (PINS) by high-resolution magnetic resonance neurography. Methods: This prospective study was approved by the local ethics committee and written informed consent was obtained from all patients. In 19 patients with PINS and 20 healthy controls, a standardized magnetic resonance neurography protocol at 3-tesla was performed with coverage of the upper arm and elbow (T2-weighted fat-saturated: echo time/repetition time 52/7,020 milliseconds, in-plane resolution 0.27 × 0.27 mm2). Lesion classification of the radial nerve trunk and its deep branch (which becomes the posterior interosseous nerve) was performed by visual rating and additional quantitative analysis of normalized T2 signal of radial nerve voxels. Results: Of 19 patients with PINS, only 3 (16%) had a focal neuropathy at the entry of the radial nerve deep branch into the supinator muscle at elbow/forearm level. The other 16 (84%) had proximal radial nerve lesions at the upper arm level with a predominant lesion focus 8.3 ± 4.6 cm proximal to the humeroradial joint. Most of these lesions (75%) followed a specific somatotopic pattern, involving only those fascicles that would form the posterior interosseous nerve more distally. Conclusions: PINS is not necessarily caused by focal compression at the supinator muscle but is instead frequently a consequence of partial fascicular lesions of the radial nerve trunk at the upper arm level. Neuroimaging should be considered as a complementary diagnostic method in PINS. PMID:27683851

  17. Posterior Urethral Strictures

    PubMed Central

    Gelman, Joel; Wisenbaugh, Eric S.

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  18. Symptomatic posterior mediastinal angioleiomyoma.

    PubMed

    I, Hoseok; Jeong, Yeon Joo; Choi, Kyung Un; Kim, Yeong-Dae

    2008-08-30

    We report a case of a symptomatic angioleiomyoma in the left posterior mediastinum. A 66-year-old woman presented with left back and flank pain for 6 months. Chest computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-circumscribed 4.3 cm round mass. The mass was initially diagnosed as nerve sheath tumor, because of her symptoms and its close location to the sympathetic trunk and intercostal nerve. It was uneventfully removed through video-assisted thoracoscopic surgery. The pathology revealed an angioleiomyoma.

  19. Arachnoid Cysts

    MedlinePlus

    ... may cause permanent severe neurological damage when progressive expansion of the cyst(s) or bleeding into the cyst ... may cause permanent severe neurological damage when progressive expansion of the cyst(s) or bleeding into the cyst ...

  20. Posterior Cortical Atrophy

    PubMed Central

    Crutch, Sebastian J; Lehmann, Manja; Schott, Jonathan M; Rabinovici, Gil D; Rossor, Martin N; Fox, Nick C

    2013-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterized by a progressive decline in visuospatial, visuoperceptual, literacy and praxic skills. The progressive neurodegeneration affecting parietal, occipital and occipito-temporal cortices which underlies PCA is attributable to Alzheimer's disease (AD) in the majority of patients. However, alternative underlying aetiologies including Dementia with Lewy Bodies (DLB), corticobasal degeneration (CBD) and prion disease have also been identified, and not all PCA patients have atrophy on clinical imaging. This heterogeneity has led to diagnostic and terminological inconsistencies, caused difficulty comparing studies from different centres, and limited the generalizability of clinical trials and investigations of factors driving phenotypic variability. Significant challenges remain in identifying the factors associated with both the selective vulnerability of posterior cortical regions and the young age of onset seen in PCA. Greater awareness of the syndrome and agreement over the correspondence between syndrome-and disease-level classifications are required in order to improve diagnostic accuracy, research study design and clinical management. PMID:22265212

  1. Is Mandibular Fossa Morphology and Articular Eminence Inclination Associated with Temporomandibular Dysfunction?

    PubMed Central

    Paknahad, Maryam; Shahidi, Shoaleh; Akhlaghian, Marzieh; Abolvardi, Masoud

    2016-01-01

    Statement of the Problem Finding a significant relationship between temporomandibular joint (TMJ) morphology and the incidence of temporomandibular dysfunction (TMD) may help early prediction and prevention of these problems. Purpose The purpose of the present study was to determine the morphology of mandibular fossa and the articular eminence inclination in patients with TMD and in control group using cone beam computed tomography (CBCT). Materials and Method The CBCT data of bilateral TMJs of 40 patients with TMD and 23 symptom-free cases were evaluated. The articular eminence inclination, as well as the glenoid fossa depth and width of the mandibular fossa were measured. The paired t-test was used to compare these values between two groups. Results The articular eminence inclination and glenoid fossa width and depth were significantly higher in patients with TMD than in the control group (p < 0.05). Conclusion The articular eminence inclination was steeper in patients with TMD than in the control group. Glenoid fossa width and depth were higher in patients with TMD than that in the control group. This information may shed light on the relationship between TMJ morphology and the incidence of TMD. PMID:27284559

  2. Novel posterior fixation keratoprosthesis

    NASA Astrophysics Data System (ADS)

    Lacombe, Emmanuel

    1992-08-01

    The keratoprosthesis is the last solution for corneally blind patients that cannot benefit from corneal transplants. Keratoprostheses that have been designed to be affixed anteriorly usually necessitate multi-step surgical procedures and are continuously subjected to the extrusion forces generated by the positive intraocular pressure; therefore, clinical results in patients prove inconsistent. We proposed a novel keratoprosthesis concept that utilizes posterior corneal fixation which `a priori' minimizes the risk of aqueous leakage and expulsion. This prosthesis is implanted in a single procedure thereby reducing the number of surgical complications normally associated with anterior fixation devices. In addition, its novel design makes this keratoprosthesis implantable in phakic eyes. With an average follow-up of 13 months (range 3 to 25 months), our results on 21 cases are encouraging. Half of the keratoprostheses were implanted in severe burn cases, with the remainder in cases of pseudo- pemphigus. Good visual results and cosmetic appearance were obtained in 14 of 21 eyes.

  3. Posterior pole tumor update.

    PubMed

    Ou, Judy I; Wheeler, Sharon M; O'Brien, Joan M

    2002-12-01

    This chapter focuses on the diagnosis and management of choroidal melanoma in light of recent findings from the COMS. Retinoblastoma is emphasized to describe recent trends in primary treatment away from EBRT and toward chemoreduction with local therapy. In addition, vascular and glial tumors of the retina and tumors of the retinal pigment epithelium are described because of the association between these lesions and systemic disease. Recent advances in treatment and genetic testing for these diseases are discussed. Finally, ocular metastasis, intraocular lymphoid tumors, and intraocular leukemia are included because of their importance in determining systemic treatment and prognosis. The chapter gives an overview of important posterior pole tumors and highlights recent developments in the management of each intraocular disease process.

  4. Endoscopic Endonasal Approach to the Middle Cranial Fossa through the Cavernous Sinus Triangles: Anatomical Considerations

    PubMed Central

    KOMATSU, Fuminari; ODA, Shinri; SHIMODA, Masami; IMAI, Masaaki; SHIGEMATSU, Hideaki; KOMATSU, Mika; TSCHABITSCHER, Manfred; MATSUMAE, Mitsunori

    2014-01-01

    The lateral limit of endoscopic endonasal surgery has yet to be defined. The aim of this study was to investigate the lateral limit of endoscopic endonasal surgery at the level of the sphenoid sinus. Access from the sphenoid sinus to the middle cranial fossa through the cavernous sinus triangles was evaluated by cadaver dissection. Anatomical analysis demonstrated that the medial temporal dura mater was exposed through the anterior area of the clinoidal triangle, anteromedial triangle, and superior area of the anterolateral triangle, indicating potential corridors to the middle cranial fossa. This study suggests that the cavernous sinus triangles are applicable in selected cases to manage middle cranial fossa lesions by endoscopic endonasal surgery. PMID:25446385

  5. Displacement of a maxillary third molar into the infratemporal fossa: case report.

    PubMed

    Dimitrakopoulos, Ioannis; Papadaki, Maria

    2007-01-01

    The case of a maxillary third molar displaced into the infratemporal fossa, with difficulty in localization due to the synchronous creation of oroantral communication, is described in this article. The patient was referred to the oral and maxillofacial department and underwent successful surgical treatment through an intraoral access. The causes of tooth displacement into the infratemporal fossa, the aid of a computerized tomography (CT) scan in tooth localization, and the difficulty in treating this complication, particularly when the tooth migrates toward the base of the skull, are emphasized. Prevention of maxillary third molar displacement into the infratemporal fossa predominates over removal and is achieved by adequate flap design, correct extraction technique, and a distal retractor during surgical extraction. In the case of displacement, no effort to retrieve the tooth is recommended because of the risk of hemorrhage, neurologic injury, and further displacement of the tooth. The patient should be treated with antibiotics and referred to an oral and maxillofacial department.

  6. Delayed removal of a maxillary third molar from the infratemporal fossa.

    PubMed

    Gómez-Oliveira, Guillermo; Arribas-García, Ignacio; Alvarez-Flores, Modesto; Gregoire-Ferriol, Johanna; Martínez-Gimeno, Carlos

    2010-05-01

    Removal of an impacted superior third molar is usually a simple and uncomplicated procedure for an Oral and Maxillofacial Surgeon. Nevertheless, complications are possible and include infection, facial swallowing, trismus, wound dehiscence, root fracture or even orosinusal fistula. Iatrogenic displacement into the infratemporal fossa is frequently mentioned but rarely reported. This anatomical fossa includes several important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopalatine nerve, the coronoid process of the mandible and the pterygoid muscles. Recommended treatment includes immediate surgical removal if possible or initial observation and secondary removal, as necessary, because of infection, limited mandibular movement, inability to extract the tooth, or the patient's psychological unease. Sometimes, the displaced tooth may spontaneously migrate inferiorly and becomes accessible intraorally. This report describes the location and secondary surgical removal of a left maxillary third molar displaced into the infratemporal fossa, two weeks after first attempt at extraction.

  7. Unusual anatomical detection of a third molar in the infratemporal fossa.

    PubMed

    Corega, C; Vaida, L; Festila, D; Bertossi, D

    2013-01-01

    Third molar presence in the infratemporal fossa is a rare event and it has been reported previously only two times in the literature, except for the cases which arise from complications occurring during the extraction of the impacted upper third molar. Due to the presence of important vessel bundles and nerves in this area, third molar removal requires a correct surgical management in order to avoid many possible serious side effects. We report an unusual case of upper third molar detected in the infratemporal fossa, which has been thoroughly investigated radiologically and removed through a safe surgical approach.

  8. Posterior Reversible Encephalopathy Syndrome

    PubMed Central

    Algahtani, Abdulhadi; Aldarmahi, Ahmad; Hmoud, Mohammed; Marzuk, Yousef; Shirah, Bader

    2016-01-01

    Objectives: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headache, altered mental status, seizures, or loss of vision. In this study, we report the largest series of PRES coming from Saudi Arabia and explore the etiology, clinical presentation, and outcome. We also report new imaging findings associated with this condition. Methods: We performed a retrospective study of all cases of PRES admitted to King Abdulaziz Medical City, Jeddah, Saudi Arabia, between the years 2005 and 2015. A neurologist reviewed all charts and analyzed the clinical presentations, etiological factors, and outcomes, and a neuroradiologist reviewed the imaging studies. Only patients with clinical and imaging features consistent with PRES were included in the study. Results: We collected 31 patients who had clinical and radiological features consistent with PRES. Females were more affected than males (18 females and 13 males), and patients’ age ranged from 6 to 95 years, with a mean of 38.3 years. Patients were treated by removing the precipitating causes and treating the underlying conditions. Resolution of neurologic signs occurred within 2 to 3 weeks in all patients. Conclusion: In our opinion, PRES itself is usually a benign condition with complete recovery if the condition is recognized early and managed appropriately. Although clinical signs are nonspecific, the constellation of symptoms including headache, visual problems, seizures, and altered level of consciousness should suggest the possibility of PRES, especially in high-risk group. Abnormalities on magnetic resonance imaging are often characteristic and may be the first clue to the diagnosis. PMID:28042366

  9. Transsacrococcygeal approach to ganglion impar block for treatment of chronic coccygodynia after spinal arachnoid cyst removal

    PubMed Central

    Cha, Young Deog; Yang, Chun Woo; Han, Jung Uk; Song, Jang Ho; Na, WonJu; Oh, Sora; Kim, Byung-Gun

    2016-01-01

    Abstract Background: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions. Although there are no standard guidelines for the treatment of coccygodynia, ganglion impar blockade is one of the effective options for treatment. Methods: Here, we report a 42-year-old female patient presenting with severe pain in the coccygeal area after spinal arachnoid cyst removal. Results: Treatment involved neurolysis with absolute alcohol on the ganglion impar through the transsacrococcygeal junction. Pain was relieved without any complications. Conclusion: Our case report offers the ganglion impar blockade using the transsacrococcygeal approach with absolute alcohol can improve intractable coccydynia. PMID:27684866

  10. [Persistent neurological deficit and adhesive arachnoiditis following spinal anesthesia with bupivacaine containing preservatives].

    PubMed

    Uefuji, T

    1999-02-01

    A 75 year-old female with osteoarthritis of bilateral knee joints was scheduled for right total knee replacement. Her medical history included coronary artery disease, bronchial asthma, and previous surgery of lumbar laminectomy, but she had no neurological deficit before the operation. A 22-gauge spinal needle was inserted at the L 4-5 level and 4 ml of 0.5% bupivacaine with preservatives (Marcain 0.5%) was administered. The sensory block level was noted to L 1 and motor blockade of bilateral feet was achieved within 10 minutes. Anesthesia and operative courses were uneventful for 1.5 hours, and she complained severe low back pain but she could not move her thigh. Eight hours after administration of the anesthetic, her low back pain improved but the anesthetic effects showed no improvement. MRI showed no abnormality of the spinal cord on the following day, but her sensory loss level to L 1 and flaccid paralysis of bilateral lower extremities continued. Myelogram showed inflammation of cauda equina on the fourth day after the operation. She suffered from hydrocephalus two months later and MRI utilizing gadolinium as a contrast medium was consistent with a diagnosis of adhesive arachnoiditis of thoracolumbar region. Her neurological deficit showed no improvement for two years.

  11. [Subdural, extra-arachnoid block as a complication of stellate ganglion block: documentation with ultrasound].

    PubMed

    Kapral, S; Krafft, P; Gosch, M; Fridrich, P; Weinstabl, C

    1997-10-01

    We present a patient who developed a high central neural block after stellate-ganglion-blockade. The underlying pathophysiology was assessed via sonographic imaging. Stellate ganglion block was performed in a 19-year old patient according to the standard technique. Multiple aspiration tests were negative and a test dose of 3 ml bupivacaine 0.25% was injected. After a 3 min interval another 5 ml were injected. Two minutes after the local anaesthetic administration the patient reported nausea and sensations in the upper extremity. Spontaneous respiration efforts stopped, and the patient became unconscious. Tracheal intubation was performed, and the patient was ventilated in a controlled mode for two hours. Heart rate as well as blood pressure remained within the normal range. Neurologic recovery occurred rapidly and extubation was performed about two and a half hours after the event. Our sonographic studies demonstrated a local anaesthetic depot directly at the root of C 6, with a mean diameter of 10 mm and a length of 5 to 6 cm (about a third smaller than expected). Sonographic studies and clinical symptoms of our patient are most likely to occur with a subdural extra-arachnoidal block. Ultrasonographic guided puncture enhances the patient's safety by the opportunity to directly visualise transverse process, nerval root as well as local anaesthetic depot. In case of depot formation directly at the nerval root, injection may be stopped and the needle repositioned. Furthermore, direct visualisation of the great vessels (A. vertebralis) prevents intravascular injection and haematoma formation.

  12. Intraoperative Arachnoid Plasty Has Possibility to Prevent Chronic Subdural Hematoma after Surgery for Unruptured Cerebral Aneurysms

    PubMed Central

    YAGI, Kenji; IRIE, Shinsuke; INAGAKI, Toru; ISHII, Yosuke; SAITO, Osamu; LEE, Tejin; NAKAGAWA, Hiroshi; SAITO, Koji; NAGAHIRO, Shinji

    Some patients develop chronic subdural hematomas (CSDHs) after the clipping/coating of unruptured aneurysms. The risk factors are not well understood and while no preventive methods are currently available, arachnoid plasty (ARP) may intercept the development of postoperative CSDH. We investigated the risk factors for CSDH and the usefulness of ARP to prevent postoperative CSDH. Between January 2009 and June 2013, 393 patients underwent 416 aneurysm surgeries via the pterional approach at Kushiro Kojinkai Memorial Hospital. Of these, 394 aneurysms (371 patients) were included in this study. Using multivariate analysis we evaluated the relationship between the patient demographics and clinical characteristics, and the development of postoperative symptomatic CSDH. We also studied the effect of ARP performed during aneurysm surgery. We found that symptomatic CSDH developed after 20 (5.1%) of the 394 operations; it was addressed by burr hole surgery and evacuation/irrigation. Male gender, advanced age, and oral anticoagulant therapy were significant risk factors for CSDH. Additive ARP, performed in the course of 132 surgeries (33.5%) was found to be a significant negative risk factor. The incidence of CSDH was significantly lower in patients who had undergone ARP than in patients who had not undergone it (0.8% vs. 7.3%, p < 0.01). We first report that ARP is useful for the prevention of CSDH in patients treated by aneurysm surgery. PMID:26041629

  13. FOXC2 Mutations in Familial and Sporadic Spinal Extradural Arachnoid Cyst

    PubMed Central

    Ogura, Yoji; Yabuki, Shoji; Iida, Aritoshi; Kou, Ikuyo; Nakajima, Masahiro; Kano, Hiroki; Shiina, Masaaki; Kikuchi, Shinichi; Toyama, Yoshiaki; Ogata, Kazuhiro; Nakamura, Masaya; Matsumoto, Morio; Ikegawa, Shiro

    2013-01-01

    Spinal extradural arachnoid cyst (SEDAC) is a cyst in the spinal canal that protrudes into the epidural space from a defect in the dura mater. Most cases are sporadic; however, three familial SEDAC cases have been reported, suggesting genetic etiological factors. All familial cases are associated with lymphedema-distichiasis syndrome (LDS), whose causal gene is FOXC2. However, FOXC2 mutation analysis has been performed in only 1 family, and no mutation analysis has been performed on sporadic (non-familial) SEDACs. We recruited 17 SEDAC subjects consisting of 2 familial and 7 sporadic cases and examined FOXC2 mutations by Sanger sequencing and structural abnormalities by TaqMan copy number assay. We identified 2 novel FOXC2 mutations in 2 familial cases. Incomplete LDS penetrance was noted in both families. Four subjects presented with SEDACs only. Thus, SEDAC caused by the heterozygous FOXC2 loss-of-function mutation should be considered a feature of LDS, although it often manifests as the sole symptom. Seven sporadic SEDAC subjects had no FOXC2 mutations, no symptoms of LDS, and showed differing clinical characteristics from those who had FOXC2 mutations, suggesting that other gene(s) besides FOXC2 are likely to be involved in SEDAC. PMID:24278289

  14. Spontaneous Cervical Intradural Disc Herniation Associated with Ossification of Posterior Longitudinal Ligament

    PubMed Central

    Wang, Dachuan; Wang, Haifeng; Shen, Wun-Jer

    2014-01-01

    Intradural herniation of a cervical disc is rare; less than 35 cases have been reported to date. A 52-year-old man with preexisting ossification of posterior longitudinal ligament developed severe neck pain with Lt hemiparesis while asleep. Neurological exam was consistent with Brown-Séquard syndrome. Magnetic resonance images showed a C5-6 herniated disc that was adjacent to the ossified ligament and indenting the cord. The mass was surrounded by cerebrospinal fluid signal intensity margin, and caudally the ventral dura line appears divided into two, consistent with the “Y-sign” described by Sasaji et al. Cord edema were noted. Because of preexisting canal stenosis and spinal cord at risk, a laminoplasty was performed, followed by an anterior C6 corpectomy. Spot-weld type adhesions of the posterior longitudinal ligament to the dura was noted, along with a longitudinal tear in the dura. An intradural extra-arachnoid fragment of herniated disc was removed. Clinical exam at 6 months after surgery revealed normal muscle strength but persistent mild paresthesias. It is difficult to make a definite diagnosis of intradural herniation preoperatively; however, the clinical findings and radiographic signs mentioned above are suggestive and should alert the surgeon to look for an intradural fragment. PMID:25295205

  15. Small-Scale Features of the Medusae Fossae Formation: Do They Support a Volcanic Origin?

    NASA Astrophysics Data System (ADS)

    Kerber, L.

    2013-12-01

    The Medusae Fossae Formation is a widespread and voluminous fine-grained deposit that lies just north of the Martian equator along the dichotomy boundary. It is thought to consist of pyroclastic deposits, either in the form of pyroclastic flows or ashfall, though numerous other possibilities have been suggested, including wind-blown loess and icy dust. For this work a survey was conducted of 427 High Resolution Imaging Science Experiment (HiRISE) images spread across the Medusae Fossae Formation. From these images maps were created of small-scale features which can aid in distinguishing between formation hypotheses for the deposit, including rootless cones, jointing, layering, and exposed dikes. Relationships between the Medusae Fossae Formation and adjacent lava plains and volcanoes were also carefully examined using HiRISE, Mars Reconnaissance Orbiter Context Imager (CTX), Mars Express High Resolution Stereo Camera (HRSC), and Mars Global Surveyor Mars Orbital Camera (MOC) images. The interactions between the Medusae Fossae Formation and nearby lava flows can inform us about the chronology of the deposit as well as how it has eroded over time. Certain diagnostic volcanic features were found, but mostly close to deposit boundaries where there are lava flows. The morphologies of the formation are compared with those of terrestrial pyroclastic deposits, terrestrial loess deposits, and other icy dust deposits on Mars. It is found that while the deposit is morphologically unlike icy layered deposits in most places, distinguishing between pyroclastic flow morphologies and reworked aeolian morphologies is more ambiguous.

  16. Geomorphic Mapping and Analysis of the Eastern Medusae Fossae Region of Mars

    NASA Technical Reports Server (NTRS)

    Takagi, M.; Zimbelman, J. R.

    2001-01-01

    A geomorphic map of the MC-8SE quadrangle on Mars is used to examine hypotheses of origin for the Medusae Fossae Formation, as well as to characterize the regional setting of these enigmatic materials. Additional information is contained in the original extended abstract.

  17. Increased depth-diameter ratios in the Medusae Fossae Formation deposits of Mars

    NASA Technical Reports Server (NTRS)

    Barlow, N. G.

    1993-01-01

    Depth to diameter ratios for fresh impact craters on Mars are commonly cited as approximately 0.2 for simple craters and 0.1 for complex craters. Recent computation of depth-diameter ratios in the Amazonis-Memnonia region of Mars indicates that craters within the Medusae Fossae Formation deposits found in this region display greater depth-diameter ratios than expected for both simple and complex craters. Photoclinometric and shadow length techniques have been used to obtain depths of craters within the Amazonis-Memnonia region. The 37 craters in the 2 to 29 km diameter range and displaying fresh impact morphologies were identified in the area of study. This region includes the Amazonian aged upper and middle members of the Medusae Fossae Formation and Noachian aged cratered and hilly units. The Medusae Fossae Formation is characterized by extensive, flat to gently undulating deposits of controversial origin. These deposits appear to vary from friable to indurated. Early analysis of crater degradation in the Medusae Fossae region suggested that simple craters excavated to greater depths than expected based on the general depth-diameter relationships derived for Mars. However, too few craters were available in the initial analysis to estimate the actual depth-diameter ratios within this region. Although the analysis is continuing, we are now beginning to see a convergence towards specific values for the depth-diameter ratio depending on geologic unit.

  18. Snapshot quiz - recurrent right iliac fossa pain in the patient with a previous history of appendicitis.

    PubMed

    Aris Chandran, Johan; Cobb, Will A; Keeler, Barrie D; Soin, Bob

    2015-06-01

    A low threshold for computed tomography (CT) scanning in patients with previous appendicectomy and right iliac fossa pain helps facilitate timely diagnosis and exclusion of other differential diagnoses. Here, we present a rare cause which has significant medicolegal ramifications and is accurately diagnosed with CT.

  19. MOLA Topography of Small Volcanoes in Tempe Terra and Ceraunius Fossae, Mars: Implications for Eruptive Styles

    NASA Technical Reports Server (NTRS)

    Wong, M. P.; Sakimoto, S. E. H.; Garvin, J. B.

    2001-01-01

    We use Mars Orbiter Laser Altimeter (MOLA) data to measure small volcanoes in the Tempe Terra and Ceraunius Fossae regions of Mars. We find that previous geometry estimates based on imagery alone are inaccurate, but MOLA data support image-based interpretations of eruptive style. Additional information is contained in the original extended abstract.

  20. Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma.

    PubMed

    Struewer, Johannes; Kiriazidis, Ilias; Figiel, Jens; Dukatz, Thomas; Frangen, Thomas; Ziring, Ewgeni

    2012-07-01

    Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Owing to the proximity of the temporal glenoid fossa to the middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 36-year-old male patient, who was beaten up in a family dispute and presented with complex mandibular and maxillofacial fractures, including mandibular condyle intrusion into the middle cranial fossa causing extensive meningeal bleeding. The patient underwent immediate surgery, with evacuation of the epidural haematoma via a temporal approach. In addition open reduction and reconstruction of the temporal glenoid fossa via anatomic reduction of the fragments was performed. A functional occlusion was re-established via miniplate reconstruction of the complex mandibular body and ramus fractures. Prompt diagnosis and a multidisciplinary approach are essential to minimize the complications. Advanced imaging modalities of computed tomography are indicated. Treatment options should be individualized in particular in case of suspected neurological injury.

  1. Age and sex related differences in normal pituitary gland and fossa volumes.

    PubMed

    Pecina, Hrvoje Ivan; Pecina, Tatjana Cicvara; Vyroubal, Vlasta; Kruljac, Ivan; Slaus, Mario

    2017-03-01

    This study investigates the influence of age and sex on the volumes of the pituitary fossa and gland in 91 males and 108 females from Croatia who underwent magnetic resonance imaging of the endocranium for complaints not related to the pituitary gland. Isometric 3DT1 MPRAGE and 3DT1 MPR sequences were obtained on 1.5. Tesla and analysed on ISSA software. The volumes were obtained from the sum of all the areas multiplied by the thickness of the section. The mean volume of the pituitary fossa for males was 1111.1.4 mm(3), for females 1354.4.2 mm(3). Correlation analysis showed a significant negative correlation (P=0.0.09) between age of the patient, and pituitary volume. Age of the patient and free volume demonstrate a significant positive correlation (P=0.0.01) indicating that the amount of unoccupied space in the pituitary fossa significantly increases with age. Determining general morphological values, as well as variations of pituitary depth and the occupation of the fossa with the pituitary gland is of great help in everyday diagnostic and therapeutic approach.

  2. Geomorphology and structural geology of Saturnalia Fossae and adjacent structures in the northern hemisphere of Vesta

    NASA Astrophysics Data System (ADS)

    Scully, Jennifer E. C.; Yin, A.; Russell, C. T.; Buczkowski, D. L.; Williams, D. A.; Blewett, D. T.; Ruesch, O.; Hiesinger, H.; Le Corre, L.; Mercer, C.; Yingst, R. A.; Garry, W. B.; Jaumann, R.; Roatsch, T.; Preusker, F.; Gaskell, R. W.; Schröder, S. E.; Ammannito, E.; Pieters, C. M.; Raymond, C. A.

    2014-12-01

    Vesta is a unique, intermediate class of rocky body in the Solar System, between terrestrial planets and small asteroids, because of its size (average radius of ∼263 km) and differentiation, with a crust, mantle and core. Vesta's low surface gravity (0.25 m/s2) has led to the continual absence of a protective atmosphere and consequently impact cratering and impact-related processes are prevalent. Previous work has shown that the formation of the Rheasilvia impact basin induced the equatorial Divalia Fossae, whereas the formation of the Veneneia impact basin induced the northern Saturnalia Fossae. Expanding upon this earlier work, we conducted photogeologic mapping of the Saturnalia Fossae, adjacent structures and geomorphic units in two of Vesta's northern quadrangles: Caparronia and Domitia. Our work indicates that impact processes created and/or modified all mapped structures and geomorphic units. The mapped units, ordered from oldest to youngest age based mainly on cross-cutting relationships, are: (1) Vestalia Terra unit, (2) cratered highlands unit, (3) Saturnalia Fossae trough unit, (4) Saturnalia Fossae cratered unit, (5) undifferentiated ejecta unit, (6) dark lobate unit, (7) dark crater ray unit and (8) lobate crater unit. The Saturnalia Fossae consist of five separate structures: Saturnalia Fossa A is the largest (maximum width of ∼43 km) and is interpreted as a graben, whereas Saturnalia Fossa B-E are smaller (maximum width of ∼15 km) and are interpreted as half grabens formed by synthetic faults. Smaller, second-order structures (maximum width of <1 km) are distinguished from the Saturnalia Fossae, a first-order structure, by the use of the general descriptive term 'adjacent structures', which encompasses minor ridges, grooves and crater chains. For classification purposes, the general descriptive term 'minor ridges' characterizes ridges that are not part of the Saturnalia Fossae and are an order of magnitude smaller (maximum width of <1 km vs

  3. Posterior sampling with improved efficiency

    SciTech Connect

    Hanson, K.M.; Cunningham, G.S.

    1998-12-01

    The Markov Chain Monte Carlo (MCMC) technique provides a means to generate a random sequence of model realizations that sample the posterior probability distribution of a Bayesian analysis. That sequence may be used to make inferences about the model uncertainties that derive from measurement uncertainties. This paper presents an approach to improving the efficiency of the Metropolis approach to MCMC by incorporating an approximation to the covariance matrix of the posterior distribution. The covariance matrix is approximated using the update formula from the BFGS quasi-Newton optimization algorithm. Examples are given for uncorrelated and correlated multidimensional Gaussian posterior distributions.

  4. TMJ in facial class III deformity. Condyle/fossa relations

    PubMed Central

    Muñoz, Gonzalo; Olate, Sergio; Cantín, Mario; Vásquez, Bélgica; del Sol, Mariano; Fariña, Rodrigo

    2014-01-01

    The aim of this study was to ascertain the joint space present in the TMJ of subjects diagnosed with Class III dentofacial deformity with an indication for orthognathic surgery. Fourteen subjects were recruited from the Division of Oral and Maxillofacial Surgery at the Universidad de La Frontera, Chile. All subjects were admitted to the study after signing an informed consent and undergoing cephalometric analyses to define the severity of the deformity. Then, the joint space was analyzed, studying a cone beam CT image of the TMJ, which was evaluated in the coronal and sagittal views, defining the most anterior, median and posterior joint space (sagittal view), as well as the lateral, median and medial joint space (coronal view). The data were recorded in millimeters by an observer and data were analyzed after measuring the same parameter at three different times. A student’s t-test was used for the analyses. Differences observed in both joints were not greater than 0.2 mm with spaces between 2 mm and 1.5 mm, thereby establishing the homogeneity of the sample, which presented no significant differences between the two joint spaces (right and left). It can be concluded that the joint space is symmetrical in both condyles and that no important changes are present compared to the results indicated in the international literature. PMID:25356133

  5. TMJ in facial class III deformity. Condyle/fossa relations.

    PubMed

    Muñoz, Gonzalo; Olate, Sergio; Cantín, Mario; Vásquez, Bélgica; Del Sol, Mariano; Fariña, Rodrigo

    2014-01-01

    The aim of this study was to ascertain the joint space present in the TMJ of subjects diagnosed with Class III dentofacial deformity with an indication for orthognathic surgery. Fourteen subjects were recruited from the Division of Oral and Maxillofacial Surgery at the Universidad de La Frontera, Chile. All subjects were admitted to the study after signing an informed consent and undergoing cephalometric analyses to define the severity of the deformity. Then, the joint space was analyzed, studying a cone beam CT image of the TMJ, which was evaluated in the coronal and sagittal views, defining the most anterior, median and posterior joint space (sagittal view), as well as the lateral, median and medial joint space (coronal view). The data were recorded in millimeters by an observer and data were analyzed after measuring the same parameter at three different times. A student's t-test was used for the analyses. Differences observed in both joints were not greater than 0.2 mm with spaces between 2 mm and 1.5 mm, thereby establishing the homogeneity of the sample, which presented no significant differences between the two joint spaces (right and left). It can be concluded that the joint space is symmetrical in both condyles and that no important changes are present compared to the results indicated in the international literature.

  6. Posterior Interosseous Nerve Syndrome Resulting from Parosteal Lipoma of the Proximal Radius: An Elusive Diagnosis Yet Excellent Outcome

    PubMed Central

    Saaiq, Muhammad; Siddiui, Saad

    2017-01-01

    A 53-year old man presented with seven months history of progressive weakness of extension of the digits and the thumb of the left hand. The wrist extension was normal and sensations were also intact. The patient had also been noticing a progressively enlarging lump on the lower anterolateral aspect of the left antecubital fossa for the last three months. Physical examination andelectro diagnostic studies revealed motor deficit along the posterior interosseous nerve (PIN) distribution with preservation of sensations. Also a soft tissue solitary lump (measuring 6×5 cm in its greatest dimensions) was palpable in the left antecubital fossa. The magnetic resonance imaging (MRI) of the forearm revealed a well-defined, non-enhancing, homogenous, fat intensity lesion in the left antecubital fossa, attached to the proximal radius. The patient underwent surgical excision of the lump with decompression of the PIN in the radial tunnel. Histopathology confirmed the diagnosis of parosteal lipoma. Although the diagnosis was elusive at the very outset, yet prudent clinical judgment, appropriate ancillary investigations and timely surgical intervention resulted in optimal functional recovery of the hand drop. There was complete motor recovery at 4-months follow up with no recurrence of the lipomaafter one year. PMID:28289621

  7. Periventricular nodular heterotopia, frontonasal encephalocele, corpus callosal dysgenesis and arachnoid cyst: A constellation of abnormalities in a child with epilepsy.

    PubMed

    Krishnan, Prasad; Chattopadhyay, Arijit; Saha, Manash

    2014-01-01

    A 7-year-old male child presented with poorly controlled generalized tonic-clonic seizures. On examination, he was mentally retarded, deaf and had a swelling at the root on the nose. Computed tomography scan done previously revealed a left temporal arachnoid cyst (AC) due to which he was referred for surgery. However, magnetic resonance imaging revealed a constellation of abnormalities - all of which could be responsible for his seizures. The combination of periventricular nodular heterotopias with encepaholcele is rarely described in the literature, and more infrequently so its combination with AC and callosal dysgenesis - the Chudley-Mccullough syndrome. We describe the case and review relevant literature on this subject.

  8. Architecture of arachnoid trabeculae, pillars, and septa in the subarachnoid space of the human optic nerve: anatomy and clinical considerations

    PubMed Central

    Killer, H E; Laeng, H R; Flammer, J; Groscurth, P

    2003-01-01

    Aims: To describe the anatomy and the arrangement of the arachnoid trabeculae, pillars, and septa in the subarachnoid space of the human optic nerve and to consider their possible clinical relevance for cerebrospinal fluid dynamics and fluid pressure in the subarachnoid space of the human optic nerve. Methods: Postmortem study with a total of 12 optic nerves harvested from nine subjects without ocular disease. All optic nerves used in this study were obtained no later than 7 hours after death, following qualified consent for necropsy. The study was performed with transmission (TEM) and scanning electron microscopy (SEM). Results: The subarachnoid space of the human optic nerve contains a variety of trabeculae, septa, and stout pillars that are arranged between the arachnoid and the pia layers of the meninges of the nerve. They display a considerable numeric and structural variability depending on their location within the different portions of the optic nerve. In the bulbar segment (ampulla), adjacent to the globe, a dense and highly ramified meshwork of delicate trabeculae is arranged in a reticular fashion. Between the arachnoid trabeculae, interconnecting velum-like processes are observed. In the mid-orbital segment of the orbital portion, the subarachnoid space is subdivided, and can appear even loosely chambered by broad trabeculae and velum-like septa at some locations. In the intracanalicular segment additionally, few stout pillars and single round trabeculae are observed. Conclusion: The subarachnoid space of the human optic nerve is not a homogeneous and anatomically empty chamber filled with cerebrospinal fluid, but it contains a complex system of arachnoid trabeculae and septa that divide the subarachnoid space. The trabeculae, septa, and pillars, as well as their arrangement described in this study, may have a role in the cerebrospinal fluid dynamics between the subarachnoid space of the optic nerve and the chiasmal cistern and may contribute to the

  9. Sport-related structural brain injury associated with arachnoid cysts: a systematic review and quantitative analysis.

    PubMed

    Zuckerman, Scott L; Prather, Colin T; Yengo-Kahn, Aaron M; Solomon, Gary S; Sills, Allen K; Bonfield, Christopher M

    2016-04-01

    OBJECTIVE Arachnoid cysts (ACs) are congenital lesions bordered by an arachnoid membrane. Researchers have postulated that individuals with an AC demonstrate a higher rate of structural brain injury after trauma. Given the potential neurological consequences of a structural brain injury requiring neurosurgical intervention, the authors sought to perform a systematic review of sport-related structural-brain injury associated with ACs with a corresponding quantitative analysis. METHODS Titles and abstracts were searched systematically across the following databases: PubMed, Embase, CINAHL, and PsycINFO. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed case reports, case series, or observational studies that reported a structural brain injury due to a sport or recreational activity (hereafter referred to as sport-related) with an associated AC were included. Patients were excluded if they did not have an AC, suffered a concussion without structural brain injury, or sustained the injury during a non-sport-related activity (e.g., fall, motor vehicle collision). Descriptive statistical analysis and time to presentation data were summarized. Univariate logistic regression models to assess predictors of neurological deficit, open craniotomy, and cystoperitoneal shunt were completed. RESULTS After an initial search of 994 original articles, 52 studies were found that reported 65 cases of sport-related structural brain injury associated with an AC. The median age at presentation was 16 years (range 4-75 years). Headache was the most common presenting symptom (98%), followed by nausea and vomiting in 49%. Thirteen patients (21%) presented with a neurological deficit, most commonly hemiparesis. Open craniotomy was the most common form of treatment (49%). Bur holes and cyst fenestration were performed in 29 (45%) and 31 (48%) patients, respectively. Seven patients (11%) received

  10. Decrypting the Formation Conditions of the Basement Carbonate-Bearing Rocks at Nili Fossae

    NASA Astrophysics Data System (ADS)

    Brown, A. J.

    2015-12-01

    The Nili Fossae region is the site of a number of proposed Landing Sites for the Mars 2020 Rover. A distinguishing feature of many of these sites is the access to large exposures of carbonate (Ehlmann et al. 2008). Serpentinization has been proposed as a formation mechanism of these carbonates, including carbonated (Brown et al. 2010, Viviano, et al. 2013) and low temperature, near surface serpentinization. The potential for carbonated serpentization at Nili Fossae links the region to Earth analogs in terrestrial greenstone belts such as the Pilbara in Western Australia, where talc-carbonate bearing komatiite cumulate units of the Dresser Formation overlie the siliceous, stromatolite-bearing Strelley Pool Chert unit (Van Kranendonk and Pirajno, 2004). If a similar relationship exists on Mars, investigations of rocks stratigraphically beneath the carbonate-bearing units at Nili Fossae ("the basement rocks") may provide the best chance to examine well preserved organic material from the Noachian. This hypothesis is testable by Mars 2020. In preparation for the the Mars 2020 landing site, we are examining the thermodynamic relationships that favor formation of serpentine and talc-carbonate and different pressures and temperatures in the crust (Barnes 2007). This will allow us to constrain the low grade metamorphism required to replicate the proposed models of serpentinisation and help us understand the regional metamophic gradient that is critical to furthering our knowledge of the ancient rocks of Nili Fossae. Refs:Barnes, S. J. "Komatiites: Petrology, Volcanology, Metamorphism, and Geochemistry." S.E.G. 13 (2007): 13. Brown, A. J., et al.. "Hydrothermal Formation of Clay-Carbonate Alteration Assemblages in the Nili Fossae Region of Mars." EPSL 297 (2010): 174-82. Ehlmann, B. L. et al. "Orbital Identification of Carbonate-Bearing Rocks on Mars." Science 322, no. 5909 1828-32. Van Kranendonk, M.J., and F. Pirajno. "Geochemistry of Metabasalts and Hydrothermal

  11. Properties of the Medussae Fossae Formation and its relation to the volcanic history of Mars

    NASA Astrophysics Data System (ADS)

    Ivanov, Anton B.; Cantini, Federico

    2016-10-01

    Medussae Fossae (MFF) is a well known formation, stretching west of Tharsis volanoes. It is characterized as a relatively young Amazonian units (Amm, Amu), due to widespread signs of erosion. Earth based imaging radar observations at 3.5 cm [1] and 12 cm [2] have discovered a dark radar feature (Stealth), which roughly correlates with the MFF outline.Recent investigations [3], suggested that the unit emplacement is in fact during Hesperian period, but it is composed of material that can be easily eroded. It is not clear when the erosion happened and if it is a continuing process. Hypotheses on MFF formation range from volcanic material emplacement (ash flow tuffs or pyroclastic materials) to an ice-rich dusty mantle, deposited during high obliquity.In this work, we will present the latest observations of the East Medussae Fossae formation by the long wavelength MARSIS radar, continuing the work reported in [4], as well as complementing data surveyed by SHARAD data in [5]. The MARSIS radar has detected strong subsurface interfaces in the areas of Gordi and Eumenides Dorsae at depths up to 1.5km. We will present our analysis of the data, inferring the dielectric properties of the material to constrain properties of the material constituting the Medusae Fossae formation. We will also demonstrate an efficient user interface to work with MARSIS data inside a Geographical Information System (GIS).The research leading to these results has received funding from the European Unions Seventh Framework Programme (FP7/2007-2013) under iMars grant agreement 607379.[1] D. Muhleman, et al., "Radar images of mars," Science, vol. 253, no. 5027, 1991.[2] J. K. Harmon, et al., "Arecibo radar imagery of Mars: The major volcanic provinces," Icarus, vol. 220, aug 2012.[3] L. Kerber, et al., "The dispersal of pyroclasts from Apollinaris Patera, Mars: Implications for the origin of the Medusae Fossae Formation," Icarus, vol. 216, nov 2011.[4] T. R. Watters, et al., "Radar Sounding of the

  12. An Exploration Zone in Cerberus Containing Young and Old Terrains, Including Fossae/Faults and Shergottite Distal Ejecta

    NASA Astrophysics Data System (ADS)

    Wright, S. P.; Niles, P. B.; Bell, M. S.; Milbury, C.; Rice, J. W.; Burton, A. S.; Archer, P. D.; Rampe, E. B.; Piqueux, S.

    2015-10-01

    Cerberus contains Amazonian lava flows embaying a range of photogeologic units: ridged plains, heavily cratered terrain, highland knobs, and perhaps the Medusa Fossae Fm. Zunil Crater distal ejecta produced secondary crater fields (of shergottites?).

  13. Extreme redundancy of the valve of the fossa ovalis with right heart hypoplasia in a neonate with trisomy 18.

    PubMed

    Vyas, Himeshkumar; Cabalka, Allison K

    2006-10-01

    Infants with trisomy 18 often have important cardiovascular malformations. We describe an infant with trisomy 18 who had extreme redundancy of the flap valve of the fossa ovalis along with right heart hypoplasia.

  14. [Thyroid adenoma in the piriform fossa: a case report and literature review].

    PubMed

    Huang, X T; Ma, B; Liu, M B; Zhang, Y; Huang, D L; Chen, L

    2017-02-07

    Objective: To explore the clinical characteristics of case of thyroid adenoma in the piriform fossa, and review the literatures of the congentital thyroid gland abnormality. Methods: A 44-year-old male had foreign body feeling in his pharynx for 3 years. A mass in his left piriform fossa was detected by the clinical and imaging examination. Biopsy report that the mass was thyroid papillary carcinoma. The resection of tumor with partial back thyroid cartilage through lateral neck and pharyngeal approach was performed. Results: The surgical wound healed in first-stage and no any surgical complication occurred. With postoperative pathological and immunohistochemical examination, the mass was finally diagnosed as thyroid gland adenoma. Staining for cytokerantin19 was negative. Conclusion: The symptomatic and neoplastic abnormal thyroid gland should be excised, but asymptomtic, non-neoplastic and functional abnormal thyroid gland should be retained with regular follow up.

  15. The small saphenous vein and other 'neglected' veins of the popliteal fossa: a review.

    PubMed

    O'Donnell, T F; Iafrati, M D

    2007-01-01

    The small saphenous vein (SSV) and other veins in the popliteal fossa merit little discussion in the literature or in didactic programmes regarding their role in chronic venous insufficiency (CVI) and, in this sense, they are neglected. The purpose of this review is to present both duplex ultrasound findings and the associated clinical characteristics of patients with SSV reflux, from several large series. Both the anatomic variations and the epidemiology of the SSV, as well as other veins of the popliteal fossa, the gastrocnemius veins, Gocamini vein, popliteal area veins and popliteal vein, will be discussed. Findings from our review of the current available literature will demonstrate the important role that these veins play in association with CVI. The implications for open and endovenous surgery will be underlined.

  16. Effects of friction massage of the popliteal fossa on blood flow velocity of the popliteal vein

    PubMed Central

    Iwamoto, Koji; Mizukami, Masafumi; Asakawa, Yasutsugu; Endo, Yusuke; Takata, Yuichi; Yoshikawa, Kenichi; Yoshio, Masaharu

    2017-01-01

    [Purpose] Friction massage (friction) of the popliteal fossa is provided for the purpose of relieving pain related to circulatory disorders by improving venous flow in the lower legs. The purpose of this study is to verify the effects of enhancing the venous flow based on measuring the blood flow velocity of the popliteal vein before and after providing friction to the patients. [Subjects and Methods] Fifteen healthy male university students participated in the study. The Doppler ultrasonography (DU) was used to measure the blood flow velocity of the popliteal vein, in order to verify the effects of enhancing the venous flow by comparing the measured values before and after a friction massage. [Results] The result of comparing the blood flow velocity before and after providing friction showed that there was a significant increase after friction. [Conclusion] This study proved that friction to the popliteal fossa is effectively enhances venous flow by increasing the blood flow velocity in the popliteal vein. PMID:28356643

  17. An Inflammatory Pseudotumor Arising from Pterygopalatine Fossa with Invasion to the Maxillary Sinus and Orbital Cavity

    PubMed Central

    Yokoi, Hidenori; Yazawa, Takuya; Matsumoto, Yuma; Ikeda, Tetsuya; Fujiwara, Masachika; Ohkura, Yasuo; Kohno, Naoyuki

    2015-01-01

    We report a patient who had an inflammatory pseudotumor (IPT) that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site; this is a very rare case. The patient was an 83-year-old woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects. To obtain a definitive diagnosis from histopathological analysis, the lesion was biopsied, and she was diagnosed as the inflammatory pseudotumor with the immunohistochemical study and multiplex polymerase chain reaction-based clonality assays. The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective. It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery. PMID:26167321

  18. Ectopic choroid plexus within a juvenile arachnoid cyst of the cerebellopontine angle: cause of cyst formation or reason of cyst growth.

    PubMed

    Schuhmann, M U; Tatagiba, M; Hader, C; Brandis, A; Samii, M

    2000-02-01

    The unusual and rare case of a 6-year-old boy is reported who presented with an arachnoid cyst located in the cerebellopontine angle incorporating an ectopic piece of choroid plexus tissue. A microneurosurgical cyst wall resection was performed and the plexus tissue identified and removed. The rare occurrence of ectopic choroid plexus tissue within cysts of the CNS is discussed.

  19. Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination

    NASA Astrophysics Data System (ADS)

    Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

    2003-06-01

    In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

  20. Unilateral renal agenesis and other causes of the solitary photopenic renal fossa

    SciTech Connect

    Howard, W.H.; Bunker, S.R.; Karl, R.D. Jr.; Ralston, T.; Hartshorne, M.F.; Cawthon, M.A.; Bauman, J.M.

    1985-04-01

    The differential diagnosis of a solitary photopenic defect in the renal fossa observed at renal scintigraphy is extensive. A case of one of the most unusual causes for this finding, renal agenesis, is presented. Additional cases that illustrate the similarity in the radionuclide appearance of other pathologic entities are also presented. Correlation with clinical findings and other imaging modalities is required to accurately distinguish these conditions.

  1. Geologic Mapping of the Medusae Fossae Formation, Mars, and the Northern Lowland Plains, Venus

    NASA Technical Reports Server (NTRS)

    Zimbelman, J. R.

    2010-01-01

    This report summarizes the status of mapping projects supported by NASA grant NNX07AP42G, through the Planetary Geology and Geophysics (PGG) program. The PGG grant is focused on 1:2M-scale mapping of portions of the Medusae Fossae Formation (MFF) on Mars. Also described below is the current status of two Venus geologic maps, generated under an earlier PGG mapping grant.

  2. Geologic Mapping of the Medusae Fossae Formation on Mars and the Northern Lowland Plains of Venus

    NASA Technical Reports Server (NTRS)

    Zimbelman, J. R.

    2009-01-01

    This report summarizes the status of mapping projects supported by NASA grant NNX07AP42G, through the Planetary Geology and Geophysics (PGG) program. The PGG grant is focused on 1:2M-scale mapping of portions of the Medusae Fossae Formation (MFF) on Mars. Also described below is the current status of two Venus geo-logic maps, generated under an earlier PGG mapping grant.

  3. The supraclavicular fossa ultrasound view for central venous catheter placement and catheter change over guidewire.

    PubMed

    Kim, Se-Chan; Klebach, Christian; Heinze, Ingo; Hoeft, Andreas; Baumgarten, Georg; Weber, Stefan

    2014-12-23

    The supraclavicular fossa ultrasound view can be useful for central venous catheter (CVC) placement. Venipuncture of the internal jugular veins (IJV) or subclavian veins is performed with a micro-convex ultrasound probe, using a neonatal abdominal preset with a probe frequency of 10 Mhz at a depth of 10-12 cm. Following insertion of the guidewire into the vein, the probe is shifted to the right supraclavicular fossa to obtain a view of the superior vena cava (SVC), right pulmonary artery and ascending aorta. Under real-time ultrasound view, the guidewire and its J-tip is visualized and pushed forward to the lower SVC. Insertion depth is read from guidewire marks using central venous catheter. CVC is then inserted following skin and venous dilation. The supraclavicular fossa view is most suitable for right IJV CVC insertion. If other insertion sites are chosen the right supraclavicular fossa should be within the sterile field. Scanning of the IJVs, brachiocephalic veins and SVC can reveal significant thrombosis before venipuncture. Misplaced CVCs can be corrected with a change over guidewire technique under real-time ultrasound guidance. In conjunction with a diagnostic lung ultrasound scan, this technique has a potential to replace chest radiograph for confirmation of CVC tip position and exclusion of pneumothorax. Moreover, this view is of advantage in patients with a non-p-wave cardiac rhythm were an intra-cardiac electrocardiography (ECG) is not feasible for CVC tip position confirmation. Limitations of the method are lack of availability of a micro-convex probe and the need for training.

  4. A Nomenclature for Vertebral Fossae in Sauropods and Other Saurischian Dinosaurs

    PubMed Central

    Wilson, Jeffrey A.; D'Emic, Michael D.; Ikejiri, Takehito; Moacdieh, Emile M.; Whitlock, John A.

    2011-01-01

    Background The axial skeleton of extinct saurischian dinosaurs (i.e., theropods, sauropodomorphs), like living birds, was pneumatized by epithelial outpocketings of the respiratory system. Pneumatic signatures in the vertebral column of fossil saurischians include complex branching chambers within the bone (internal pneumaticity) and large chambers visible externally that are bounded by neural arch laminae (external pneumaticity). Although general aspects of internal pneumaticity are synapomorphic for saurischian subgroups, the individual internal pneumatic spaces cannot be homologized across species or even along the vertebral column, due to their variability and absence of topographical landmarks. External pneumatic structures, in contrast, are defined by ready topological landmarks (vertebral laminae), but no consistent nomenclatural system exists. This deficiency has fostered confusion and limited their use as character data in phylogenetic analysis. Methodology/Principal Findings We present a simple system for naming external neural arch fossae that parallels the one developed for the vertebral laminae that bound them. The nomenclatural system identifies fossae by pointing to reference landmarks (e.g., neural spine, centrum, costal articulations, zygapophyses). We standardize the naming process by creating tripartite names from “primary landmarks,” which form the zygodiapophyseal table, “secondary landmarks,” which orient with respect to that table, and “tertiary landmarks,” which further delineate a given fossa. Conclusions/Significance The proposed nomenclatural system for lamina-bounded fossae adds clarity to descriptions of complex vertebrae and allows these structures to be sourced as character data for phylogenetic analyses. These anatomical terms denote potentially homologous pneumatic structures within Saurischia, but they could be applied to any vertebrate with vertebral laminae that enclose spaces, regardless of their developmental origin

  5. A (comparative study on the nasal fossae of Tupaia glis and four insectivores.

    PubMed

    Woehrmann-Repenning, A; Meinel, W

    1977-01-01

    The macro- and microscopic anatomy of the nasal fossa of Tupaia glis was compared with those of some insectivores. No significant group differences were found as far as the intranasal structures are concerned. Since the number of receptor cells in the olfactory epithelium of Tupaia glis and Talpa europaea is smaller than in the other species studied, a slight reduction of the sense of smell is suggested.

  6. Chiari Type I malformation presenting with bilateral hearing loss.

    PubMed

    Dolgun, Habibullah; Turkoglu, Erhan; Kertmen, Hayri; Yilmaz, Erdal R; Sekerci, Zeki

    2009-09-01

    Chiari Type I malformations can present with several clinical signs and symptoms. We describe a 44-year-old female patient presenting with bilateral hearing loss with hydrocephalus coexisting with Chiari Type I malformation and a unilateral arachnoid cyst. Thus, sensorineural hearing loss may be caused by hydrocephalus with Chiari Type I malformation. The placement of a ventriculoperitoneal shunt without a posterior fossa decompression is an effective treatment.

  7. Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases

    PubMed Central

    Lesser, Juan Carlos Cisneros; Brito Neto, Rubens Vuono de; Martins, Graziela de Souza Queiroz; Bento, Ricardo Ferreira

    2016-01-01

    Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated. PMID:28050216

  8. Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases.

    PubMed

    Lesser, Juan Carlos Cisneros; Brito Neto, Rubens Vuono de; Martins, Graziela de Souza Queiroz; Bento, Ricardo Ferreira

    2017-01-01

    Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.

  9. Temporal fossa defects: techniques for injecting hyaluronic acid filler and complications after hyaluronic acid filler injection.

    PubMed

    Juhász, Margit Lai Wun; Marmur, Ellen S

    2015-09-01

    Facial changes with aging include thinning of the epidermis, loss of skin elasticity, atrophy of muscle, and subcutaneous fat and bony changes, all which result in a loss of volume. As temporal bones become more concave, and the temporalis atrophies and the temporal fat pad decreases, volume loss leads to an undesirable, gaunt appearance. By altering the temporal fossa and upper face with hyaluronic acid filler, those whose specialty is injecting filler can achieve a balanced and more youthful facial structure. Many techniques have been described to inject filler into the fossa including a "fanned" pattern of injections, highly diluted filler injection, and the method we describe using a three-injection approach. Complications of filler in the temporal fossa include bruising, tenderness, swelling, Tyndall effect, overcorrection, and chewing discomfort. Although rare, more serious complications include infection, foreign body granuloma, intravascular necrosis, and blindness due to embolization into the ophthalmic artery. Using reversible hyaluronic acid fillers, hyaluronidase can be used to relieve any discomfort felt by the patient. Injectors must be aware of the complications that may occur and provide treatment readily to avoid morbidities associated with filler injection into this sensitive area.

  10. Infratemporal fossa cellulitis caused by a remnant iatrogenic foreign body after a bimaxillary operation.

    PubMed

    Park, Do Yang; Choo, Oak-Sung; Hong, Sang Young; Kim, Hyun Jun

    2015-05-01

    Infratemporal fossa cellulitis is rare and mostly occurs because of sinusitis and dental procedures. Furthermore, cellulitis caused by iatrogenic foreign bodies is very rare. A 28-year-old woman who had previously undergone cosmetic bimaxillary operation visited our hospital complaining of left facial swelling, oppressive pain, and nasal obstruction since 2 years. She had been attending another clinic, but despite having additional procedures and taking medications, her symptoms persisted. A subsequent operation was performed, during which we found a remnant surgical gauze from the previous operation, which was decomposed and trapped around the necrotic soft tissue and had eroded the bony structure around the pterygoid fossa. The material was successfully removed by endoscopic surgery, and the necrotic tissue was debrided. After the operation, all symptoms disappeared, and the patient was discharged without sequelae. During any procedure, surgeons must meticulously check for remnant material. Additionally, physicians must carefully note patient history and perform a physical examination, even in patients without serious symptoms. We report a case of advanced infratemporal fossa cellulitis due to remnant gauze material during a previous operation that was undetected.

  11. [Linear accelerator-based stereotactic radiation treatment of patients with medial middle fossa meningiomas].

    PubMed

    Golanov, A V; Cherekaev, V A; Serova, N K; Pronin, I N; Gorlachev, G E; Kotel'nikova, T M; Podoprigora, A E; Kudriavtseva, P A; Galkin, M V

    2010-01-01

    Medial middle fossa meningiomas are challenging for neurosurgical treatment. Invasion of cranial nerves and vessels leads to high risk of complications after removal of such meningiomas. Currently methods of conformal stereotactic radiation treatment are applied wider and wider for the discussed lesions. During a 3.5-year period 80 patients with medial middle fossa meningiomas were treated in Burdenko Moscow Neurosurgical Institute using linear accelerator "Novalis". In 31 case radiation treatment was preceded by surgical resection. In majority of patients symptoms included cranial nerve dysfunction: oculomotor disturbances in 62.5%, trigeminal impairment--in 37.5%, visual deficit--in 43.8%, facial nerve palsy--in 1.25%. 74 patients underwent radiotherapy with classical fractioning, 2--in hypofractionated mode and 4 received radiosurgery. In cases of classical fractioning mean marginal dose reached 46.3 Gy during 28-33 fractions, in hypofractioning (7 fractions)--31.5 Gy, in radiosurgery--16.25 Gy. Mean follow-up period was 18.4 months (6-42 months). Control of tumor growth was achieved in 97.5% of cases (78 patients): in 42 (52.5%) lesion shrinked, in 36 (45%) stabilization was observed. Clinical examination revealed improvement of visual function in 15 patients (18%) and deterioration in 2 (2.5%). No new neuropathies were found. Stereotactic radiation treatment is the method of choice for medial anterior and middle fossa meningiomas due to effective control of tumor progression and minimal rate of complications.

  12. Rethinking "posterior" tongue-tie.

    PubMed

    Douglas, Pamela Sylvia

    2013-12-01

    Currently, many clinicians who help with breastfeeding problems are diagnosing "posterior" tongue-tie in infants and performing or referring for frenotomy. In this "Speaking Out" article, I argue that the diagnosis of "posterior" tongue-tie has successfully raised awareness of the importance of impaired tongue function in breastfeeding difficulty. However, the diagnosis of "posterior" tongue-tie also applies a reductionist, medicalized theoretical frame to the complex problem of impaired tongue function, risking unintended outcomes. Impaired tongue function arises out of multiple interacting and co-evolving factors, including the interplay between social behaviors concerning breastfeeding and mother-infant biology. Consideration of theoretical frames is vital if we are to build an evidence base through efficient use of the scarce resources available for clinical breastfeeding research and minimize unintended outcomes.

  13. Experimental model of posttraumatic syringomyelia: the role of adhesive arachnoiditis in syrinx formation.

    PubMed

    Cho, K H; Iwasaki, Y; Imamura, H; Hida, K; Abe, H

    1994-01-01

    An experimental model was devised to elucidate the role of spinal blockade in posttraumatic syringomyelia. Thirty-eight Japanese White rabbits, each weighing about 3 kg, were used in this study. The animals were divided into four groups: in Group 1, eight animals received traumatic injury only; in Group 2, 12 animals received traumatic injury following injection of 100 mg kaolin suspended in 1 cc normal saline solution into the subarachnoid space at the site of trauma; in Group 3, nine animals received traumatic injury following injection of 200 mg kaolin in 1 cc normal saline solution into the subarachnoid space at the site of trauma; and in Group 4, nine animals without traumatic injury received an injection of 200 mg kaolin in 1 cc normal saline solution into the subarachnoid space. The subjective criteria for syrinx formation were the presence of a definite round cyst having a smooth margin and an upper or lower extension of more than 2 cm from the injured site. Syrinx formation was seen in 12.5% (one of eight rabbits) in Group 1, 41.7% (five of 12 animals) in Group 2, 55.5% (five of nine rabbits) in Group 3 and 0% (none of nine animals) in Group 4 (p < 0.05). There was a tendency for the combined trauma/kaolin injection groups to be more prone to develop a syrinx. In the kaolin injection only group (Group 4), no animal showed a definite cyst or an extending cavity during the experimental period. The results suggest that kaolin enhances the extension of multiple small cavities that have already formed at the time of initial injury. The difference between the frequency of syrinx formation and the time of survival was statistically significant well beyond the 0.05% level. The overall difference, relating to the frequency of syrinx development, group, and duration of survival, was also statistically significant. In summary, subarachnoid block secondary to adhesive arachnoiditis is important in initiating the extension of the syringomyelia cavity.

  14. Endoscopic ligation of the internal maxillary artery for treatment of intractable posterior epistaxis.

    PubMed

    Pritikin, J B; Caldarelli, D D; Panje, W R

    1998-02-01

    Lack of universal success with both transantral ligation of the internal maxillary artery and percutaneous embolization of the distal branches of the internal maxillary distribution has led to consideration of alternative techniques to control intractable posterior epistaxis. One such technique takes advantage of advances in endoscopic technology and instrumentation, as well as a nearly constant anatomic configuration. The internal maxillary artery divides into terminal branches within the pterygomaxillary fossa, sending branches through the bony maxilla to exit the posterolateral nasal wall in the posterior aspect of the middle meatus. Endoscopic identification and ligation of these terminal branches of the internal maxillary artery (the sphenopalatine and nasopalatine arteries) as they exit the maxilla has been performed on 10 patients with a 100% success rate and no morbidity or mortality associated with the procedure. These results compare favorably to the average reported success rates of 89% for transantral ligation and 94% for percutaneous embolization, and average complication rates of 28% and 27%, respectively. This endonasal procedure has been performed for spontaneous epistaxis as well as postsurgical nasal bleeding with equal success. The ascending scale of treatment previously outlined in the literature may be amended, as a potentially definitive procedure is available, and we believe that this technique is easier to perform, has less associated morbidity, and has equal efficacy in comparison to transantral ligation or percutaneous embolization in the treatment of intractable posterior epistaxis.

  15. Integrated Anterior, Central, and Posterior Skull Base Unit – A New Perspective

    PubMed Central

    Brand, Yves; Waran, Vicknes; Zulkiflee, Abu Bakar; Lim, Elizabeth; Prepageran, Narayanan

    2015-01-01

    The skull base is one of the most complex anatomical regions and forms the floor of the cranial cavity. Skull base surgery involves open, microscopic, and endoscopic approaches to the anterior, middle, or posterior cranial fossa. A multispecialty team approach is essential in treating patients with skull base lesions. Traditionally, rhinologists are involved in providing access to anterior skull base lesions while otologists are involved in the treatment of lesions of the posterior skull base. This is the case in most skull base centers today. In this article, we share a new perspective of an integrated skull base unit where a team of otolaryngologists and neurosurgeons treat anterior, middle, and posterior skull base pathologies. The rationale for this approach is that most technical skills required in skull base surgery are interchangeable and apply whether an endoscopic or microscopic approach is used. We show how the different skills apply to the different approaches and share our experience with an integrated skull base unit. PMID:26258128

  16. Children's Understanding of Posterior Probability

    ERIC Educational Resources Information Center

    Girotto, Vittorio; Gonzalez, Michael

    2008-01-01

    Do young children have a basic intuition of posterior probability? Do they update their decisions and judgments in the light of new evidence? We hypothesized that they can do so extensionally, by considering and counting the various ways in which an event may or may not occur. The results reported in this paper showed that from the age of five,…

  17. Case Series: Long segment extra-arachnoid fluid collections: Role of dynamic CT myelography in diagnosis and treatment planning.

    PubMed

    Ellika, Shehanaz; Marin, Horia; Pace, Mitchell; Newman, Daniel; Abdulhak, Muwaffak; Kole, Maximilian

    2012-04-01

    We report five patients in whom spinal MRI revealed extra-arachnoid fluid collections. These spinal fluid collections most likely resulted from accumulation of cerebrospinal fluid (CSF) from a dural leak. The patients presented with either compressive myelopathy due to the cyst or superficial siderosis (SS). All of these fluid collections were long segment, and MRI demonstrated the fluid collections but not the exact site of leak. Dynamic CT myelogram demonstrated the site of leak and helped in the management of these complicated cases. Moreover, we also found that the epicenter of the fluid collection on MRI was different from the location of the leak on a dynamic CT myelogram. Knowledge of these associations can be helpful when selecting the imaging studies to facilitate diagnosis and treatment.

  18. Anatomy of greater palatine foramen and canal and pterygopalatine fossa in Thais: considerations for maxillary nerve block.

    PubMed

    Methathrathip, D; Apinhasmit, W; Chompoopong, S; Lertsirithong, A; Ariyawatkul, T; Sangvichien, S

    2005-12-01

    This study aims to investigate the anatomy of the greater palatine foramen (GPF), greater palatine canal (GPC) and pterygopalatine fossa (PPF) with special reference to the blockage of the maxillary nerve. A correlation between the length of GPC and PPF and the heights of the orbit and the maxilla was also studied using simple linear regression analysis. The morphology of the GPF, GPC and PPF as well as heights of the orbit and the maxilla were assessed in 105 Thai skulls. The thickness of the mucosa over the GPF was also measured from the dissection of 55 cadavers. The results showed that most GPF appeared as an oval foramen located at the palatal aspect of the upper third molar. The GPF was 16.2+/-1.3 mm lateral to the median sagittal plane of the hard palate, 2.1+/-1.3 mm anterior to the posterior border of the hard palate and 5.1+/-1.3 mm from the greatest concavity of the distolateral margin of the hard palate. The mean length of GPC and PPF was 29.7+/-4.2 mm. The mean angles of the GPC in relation to the hard palate and the vertical plane were 57.9+/-5.8 degrees and 6.7+/-5.2 degrees , respectively. In attempting to insert a needle to reach the foramen rotundum through the GPF, 31.7% passed into the orbit while 8.7% passed into the brain. The mean thickness of the mucosa over GPF was 6.7+/-2.3 mm. Two models for estimating the depth of needle injection in maxillary nerve block have been developed as follows: Length of GPC and PPF=19.038+0.314 (orbital height) and length of GPC and PPF=21.204+0.187 (maxillary height). The calculated length combined with the mucosal thickness was the estimated depth of needle injection. In conclusion, our results concerning the GPF, GPC and PPF will provide the useful reference for clinicians to anesthetize the maxillary nerve with a greater degree of success.

  19. Distortions of posterior visual space.

    PubMed

    Phillips, Flip; Voshell, Martin G

    2009-01-01

    The study of spatial vision is a long and well traveled road (which, of course, converges to a vanishing point at the horizon). Its various distortions have been widely investigated empirically, and most concentrate, pragmatically, on the space anterior to the observer. The visual world behind the observer has received relatively less attention and it is this perspective the current experiments address. Our results show systematic perceptual distortions in the posterior visual world when viewed statically. Under static viewing conditions, observer's perceptual representation was consistently 'spread' in a hyperbolic fashion. Directions to distant, peripheral locations were consistently overestimated by about 11 degrees from the ground truth and this variability increased as the target was moved toward the center of the observer's back. The perceptual representation of posterior visual space is, no doubt, secondary to the more immediate needs of the anterior visual world. Still, it is important in some domains including certain sports, such as rowing, and in vehicular navigation.

  20. Usefulness of laboratory data in the management of right iliac fossa pain in adults

    PubMed Central

    Ortega-Deballon, Pablo; Ruiz De Adana-Belbel, Juan C; Hernández-Matías, Alberto; García-Septiem, Javier; Moreno-Azcoita, Mariano

    2008-01-01

    Background Inflammatory markers could be helpful in the management of patients with right iliac fossa pain, but the heterogeneity of designs and results precludes a definitive conclusion. A retrospective analysis of prospectively collected data was performed to assess the usefulness of laboratory data in the management of these patients. Patients and methods Patients with right iliac fossa pain referred to the surgeon were included. Blood samples were obtained for C-reactive protein, leukocyte, and granulocyte analysis. Clinical, surgical, and histopathologic data were collected. Analysis of inflammatory parameters was performed with logistic regression and areas under the receiver operating characteristic curve were compared. Results One hundred thirty-four patients were included. C-reactive protein increased with the severity of appendicitis and predicted accurately perforation (r2 = 0.613; P < 0.0005), showing the highest accuracy among inflammatory markers (areas under the ROC curve were 0.846, 0.753 and 0.685 for C-reactive protein, leukocyte and granulocytes, respectively; P < 0.001). Accuracy improved when C-reactive protein and leukocytes were combined (positive and negative predictive values were 93.2 percent and 92.3 percent, respectively). Conclusions C-reactive protein is a helpful marker in the management of patients with right iliac fossa pain. It increases with the evolution of the inflammatory process. Its predictive values improve in combination with the leukocyte count. A patient with normal C-reactive protein and leukocytes has a very low probability of appendicitis and should not undergo surgery. PMID:18484138

  1. Condyle-fossa modifications and muscle interactions during herbst treatment, part 1. New technological methods.

    PubMed

    Voudouris, John C; Woodside, Donald G; Altuna, Gurkan; Kuftinec, Mladen M; Angelopoulos, Gerassimos; Bourque, Paul J

    2003-06-01

    Changes in the condyle, the glenoid fossa, and the muscles of mastication were investigated in subjects undergoing continuous orthopedic advancement of the mandible with a Herbst-block appliance. The total sample consisted of 56 subjects and included 15 nonhuman primates (in the middle mixed, early permanent, and permanent dentitions), 17 human Herbst patients in the early permanent dentition, and 24 human controls from the Burlington Growth Center. The 8 nonhuman primates in the middle mixed dentition were the focus of this study. Mandibular advancement was obtained progressively in 5 animals by adding stops to the telescopic arms of fixed functional Herbst appliances with occlusal coverage; activations of 5.0 mm, 7.0 mm, and 8.0 mm were achieved. Two primates served as controls, and the third was a sham control. Two experimental animals and the 2 controls also wore surgically implanted electromyographic electrodes in the superior and inferior heads of the lateral pterygoid muscles and in the superficial masseter and anterior digastric muscles. Changes in condylar growth direction and amount were assessed with the Björk method from measurements made on serial cephalometric tracings superimposed on metallic implants. Undecalcified sections, treated with intravenous tetracycline vital staining, were viewed with fluorescence microscopy to examine histologic changes in the condyle and the glenoid fossa. New bone formation in the fossa associated with continuous mandibular protrusion was quantified by using computerized histomorphometric analysis of decalcified histological sections and polarized light. The unique combination of permanently implanted electromyographic electrodes, tetracycline vital staining, and histomorphometry represents a significant technological advancement in methods and materials. Together, they demonstrated different muscle-bone interaction results for functional appliances than those reported in previous studies. In Part 1 of this study, we

  2. Evidence for an additional uppermost geological unit in the Medusae Fossae Formation, Equatorial Mars

    NASA Astrophysics Data System (ADS)

    Harrison, Samantha; Balme, Matt; Hagermann, Axel

    2013-04-01

    The Medusae Fossae Formation (MFF) is a geological formation comprising three geological units (members) spread across five principal outcrops. The MFF dominates roughly a quarter of the longitudinal extent of the equatorial region of Mars, extending east-west across a distance of ~ 5,500 km between the southern Elysium Planitia and the Tharsis region. The nature of these materials is often referred to as enigmatic, as their exact origin remains unknown. Harrison et al. (Icarus, 2010) presented new observations of outlying occurrences of MFF materials on the southern highlands, atop the dichotomy boundary. They presented two hypotheses to explain these observation: 1) the MFF had a much larger pre-erosional extent than previously thought or 2) these materials had initially been eroded from the main outcrops of the formation, then transported southward by wind and subsequently reworked. A subsequent extension of this work provided evidence for an even larger extent of outlying MFF materials, particularly around and south of the easternmost portions of the MFF. Here we present these new outlier data, together with new textural classification and facies mapping of this region of the MFF. These data show that MFF outlier textures, whilst external to the main MFF outcrops in many places, are also found superposing large areas of the "main" MFF formations. These data support the first of the two working hypotheses presented, but also suggest that these so-called outlying materials represent a previously unmapped, stratigraphically uppermost unit of the Medusae Fossae Formation. We also suggest that, based upon our own morphometric study of yardangs across members and analogue studies by de Silva et al. (Icarus, 2010), these represent a less indurated material than other units of the formation. In the overall context of the origins of the MFF, we find that our data are consistent with the Medusae Fossae materials being a large-scale ignimbrite complex, perhaps with

  3. Avian Cerebellar Floccular Fossa Size Is Not a Proxy for Flying Ability in Birds

    PubMed Central

    Walsh, Stig A.; Iwaniuk, Andrew N.; Knoll, Monja A.; Bourdon, Estelle; Barrett, Paul M.; Milner, Angela C.; Nudds, Robert L.; Abel, Richard L.; Sterpaio, Patricia Dello

    2013-01-01

    Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex (VOR). Because gaze stabilization is a critical aspect of flight, some authors have suggested that the flocculus is enlarged in flying species. Whether this can be further extended to a floccular expansion in highly maneuverable flying species or floccular reduction in flightless species is unknown. Here, we used micro computed-tomography to reconstruct “virtual” endocranial casts of 60 extant bird species, to extract the same level of anatomical information offered by fossils. Volumes of the floccular fossa and entire brain cavity were measured and these values correlated with four indices of flying behavior. Although a weak positive relationship was found between floccular fossa size and brachial index, no significant relationship was found between floccular fossa size and any other flight mode classification. These findings could be the result of the bony endocranium inaccurately reflecting the size of the neural flocculus, but might also reflect the importance of the flocculus for all modes of locomotion in birds. We therefore conclude that the relative size of the flocculus of endocranial casts is an unreliable predictor of locomotor behavior in extinct birds, and probably also pterosaurs and non-avian dinosaurs. PMID:23825638

  4. Avian cerebellar floccular fossa size is not a proxy for flying ability in birds.

    PubMed

    Walsh, Stig A; Iwaniuk, Andrew N; Knoll, Monja A; Bourdon, Estelle; Barrett, Paul M; Milner, Angela C; Nudds, Robert L; Abel, Richard L; Sterpaio, Patricia Dello

    2013-01-01

    Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex (VOR). Because gaze stabilization is a critical aspect of flight, some authors have suggested that the flocculus is enlarged in flying species. Whether this can be further extended to a floccular expansion in highly maneuverable flying species or floccular reduction in flightless species is unknown. Here, we used micro computed-tomography to reconstruct "virtual" endocranial casts of 60 extant bird species, to extract the same level of anatomical information offered by fossils. Volumes of the floccular fossa and entire brain cavity were measured and these values correlated with four indices of flying behavior. Although a weak positive relationship was found between floccular fossa size and brachial index, no significant relationship was found between floccular fossa size and any other flight mode classification. These findings could be the result of the bony endocranium inaccurately reflecting the size of the neural flocculus, but might also reflect the importance of the flocculus for all modes of locomotion in birds. We therefore conclude that the relative size of the flocculus of endocranial casts is an unreliable predictor of locomotor behavior in extinct birds, and probably also pterosaurs and non-avian dinosaurs.

  5. Solitary Fibrous Tumor in the Lacrimal Gland Fossa: A Case Report

    PubMed Central

    Mupas-Uy, Jacqueline; Kitaguchi, Yoshiyuki; Takahashi, Yasuhiro; Takahashi, Emiko; Kakizaki, Hirohiko

    2016-01-01

    Solitary fibrous tumors (SFTs) are benign, spindle-cell tumors of mesenchymal origin that are usually seen in the superior orbital area in adults. We report a rare case of SFT in the lacrimal gland fossa that developed in a young female. A 25-year-old woman had a 6-month history of a progressive painless mass in the left upper eyelid accompanied by proptosis. Computed tomography and magnetic resonance imaging showed an ovoid, demarcated mass with distinct margins in the lacrimal gland region without bone invasion. Excision biopsy with immunohistochemical study, specifically with positive signal transducer and activator of transcription 6, confirmed the diagnosis. PMID:27721790

  6. Unusual Presentation of Hepatocellular Carcinoma into Right iliac fossa: A Rare Entity

    PubMed Central

    Periyasamy, Karthikumaran

    2015-01-01

    Hepatocellular carcinoma (HCC) is the most common primary malignant hepatic tumour. Hepatocellular carcinoma presenting itself or extending into the right iliac fossa (RIF) is a very rare entity. We report on a rare case of hepatocellular carcinoma in a 60-year-old lady, presented with a mobile mass in the lower abdomen without cirrhosis, with normal α-feto protein levels (AFP) or any known risk factors for liver disease. HCC in this case was unusual in its presentation both in the patient as well as a disease. PMID:26672490

  7. ModFossa: A library for modeling ion channels using Python.

    PubMed

    Ferneyhough, Gareth B; Thibealut, Corey M; Dascalu, Sergiu M; Harris, Frederick C

    2016-06-01

    The creation and simulation of ion channel models using continuous-time Markov processes is a powerful and well-used tool in the field of electrophysiology and ion channel research. While several software packages exist for the purpose of ion channel modeling, most are GUI based, and none are available as a Python library. In an attempt to provide an easy-to-use, yet powerful Markov model-based ion channel simulator, we have developed ModFossa, a Python library supporting easy model creation and stimulus definition, complete with a fast numerical solver, and attractive vector graphics plotting.

  8. Motor Speech Apraxia in a 70-Year-Old Man with Left Dorsolateral Frontal Arachnoid Cyst: A [18F]FDG PET-CT Study

    PubMed Central

    Haugen, Jacob; Kluin, Karen; Kotagal, Vikas

    2016-01-01

    Motor speech apraxia is a speech disorder of impaired syllable sequencing which, when seen with advancing age, is suggestive of a neurodegenerative process affecting cortical structures in the left frontal lobe. Arachnoid cysts can be associated with neurologic symptoms due to compression of underlying brain structures though indications for surgical intervention are unclear. We present the case of a 70-year-old man who presented with a two-year history of speech changes along with decreased initiation and talkativeness, shorter utterances, and dysnomia. [18F]Fluorodeoxyglucose (FDG) Positron Emission and Computed Tomography (PET-CT) and magnetic resonance imaging (MRI) showed very focal left frontal cortical hypometabolism immediately adjacent to an arachnoid cyst but no specific evidence of a neurodegenerative process. PMID:28003922

  9. Geologic Mapping along the Arabia Terra Dichotomy Boundary: Mawrth Vallis and Nili Fossae, Mars

    NASA Technical Reports Server (NTRS)

    Bleamaster, Leslie F., III; Crown, David A.

    2009-01-01

    Geologic mapping studies at the 1:1M-scale are being used to assess geologic materials and processes that shape the highlands along the Arabia Terra dichotomy boundary. In particular, this mapping will evaluate the distribution, stratigraphic position, and lateral continuity of compositionally distinct outcrops in Mawrth Vallis and Nili Fossae as identified by spectral instruments currently in orbit. Placing these landscapes, their material units, structural features, and unique compositional outcrops into spatial and temporal context with the remainder of the Arabia Terra dichotomy boundary may provide constraints on: 1) origin of the dichotomy boundary, 2) paleo-environments and climate conditions, and 3) various fluvial-nival modification processes related to past and present volatile distribution and their putative reservoirs (aquifers, lakes and oceans, surface and ground ice) and the influences of nearby volcanic and tectonic features on hydrologic processes in these regions. The results of this work will include two 1:1M scale geologic maps of twelve MTM quadrangles (Mawrth Vallis - 20022, 20017, 20012, 25022, 25017, and 25012; and Nili Fossae - 20287, 20282, 25287, 25282, 30287, 30282).

  10. Geologic Mapping along the Arabia Terra Dichotomy Boundary: Mawrth Vallis and Nili Fossae, Mars: Introductory Report

    NASA Technical Reports Server (NTRS)

    Bleamaster, Leslie F., III; Crown, David A.

    2008-01-01

    Geologic mapping studies at the 1:1M-scale will be used to characterize geologic processes that have shaped the highlands along the Arabia Terra dichotomy boundary. In particular, this mapping will evaluate the distribution, stratigraphic position, and lateral continuity of compositionally distinct outcrops in Mawrth Vallis and Nili Fossae as identified by spectral instruments currently in orbit. Placing these landscapes, their material units, structural features, and unique compositional outcrops into spatial and temporal context with the remainder of the Arabia Terra dichotomy boundary will provide the ability to: 1) further test original dichotomy formation hypotheses, 2) constrain ancient paleoenvironments and climate conditions, and 3) evaluate various fluvial-nival modification processes related to past and present volatile distribution and their putative reservoirs (aquifers, lakes and oceans, surface and ground ice) and the influences of nearby volcanic and tectonic features on hydrologic processes in these regions. The result will be two 1:1M scale geologic maps of twelve MTM quadrangles (Mawrth Vallis - 20022, 20017, 20012, 25022, 25017, and 25012; and Nili Fossae - 20287, 20282, 25287, 25282, 30287, 30282).

  11. Unusual foramen in the middle cranial fossae of adult black South African skull specimens.

    PubMed

    Mazengenya, Pedzisai; Ekpo, Okobi

    2016-11-11

    Variations of the skull base foramina are quite common and often cause surgical confusion during surgical intervention of the region. The unusual foramen was observed in five (0.98%) adult skulls of black South Africans obtained from the Raymond A Dart collection of human specimens housed in the School of Anatomical Sciences at the University of the Witwatersrand. Three of the five specimens were females while the remaining two were males. In four of the five skulls, the unusual foramen was located anterolateral to the foramen rotundum both on the left and right sides. In the fifth specimen, the foramen was located posterolateral to the foramen rotundum on the left half of the middle cranial fossa. On radiographs, two specimens with unusual foramen on the right showed that the foramen opened into a canal directed inferomedially towards the pterygopalatine fossa. In the remaining three specimens, the canals were blind and shallow. This information is vital during interpretation of CT scans at the base of the skull, as any less well-known foramen may be mistaken for abnormalities leading to surgical complications.

  12. Assessment of Condyle and Glenoid Fossa Morphology Using CBCT in South-East Asians

    PubMed Central

    Al-koshab, May; Nambiar, Phrabhakaran; John, Jacob

    2015-01-01

    Introduction Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians. Methods CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years). i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF). Results No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese. Conclusion The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population. PMID:25803868

  13. Primary non-Hodgkin's lymphoma of the infratemporal fossa: a rare case report

    PubMed Central

    Thakur, Jagdeep S; Minhas, Ravinder S; Mohindroo, Narinder K; Sharma, Dev R; Mohindroo, Shobha; Thakur, Anamika

    2009-01-01

    Background The head and neck are two of the most common sites of extranodal non-Hodgkin's lymphoma (NHL). However, primary tumors of the infratemporal fossa are infrequent, and NHL in this region is extremely rare. Case presentation We present a case of a 41-year-old female that presented with swelling in the right preauricular region that had persisted for the past two years. The patient was diagnosed as having a small lymphocytic NHL. She initially underwent chemo-radiation but reported relapse. The tumor was excised and again the patient underwent chemotherapy. The patient remained symptomatic and developed a second primary squamous cell carcinoma in the right retromolar trigone. Discussion and conclusion We discussed NHL with an emphasis on extranodal manifestations. Extranodal NHL that is limited to a single site can be managed by surgery and regular follow up. To the best of our knowledge, this is only the second case of primary NHL of the infratemporal fossa to be reported in the literature. PMID:19545392

  14. Endoscopic versus Open Approach to the Infratemporal Fossa: A Cadaver Study

    PubMed Central

    Youssef, Ahmed; Carrau, Ricardo L.; Tantawy, Ahmed; Ibraheim, Ahmed; Solares, Arturo C.; Otto, Bradley A.; Prevedello, Daniel M.; Filho, Leo Ditzel

    2015-01-01

    Introduction Various lateral and anterior approaches to access the infratemporal fossa (ITF) have been described. We provide our observations regarding the endoscopic transpterygoid and preauricular subtemporal approaches, listing their respective advantages and limitations through cadaveric dissection. Methods A cadaver study was performed on five adult specimens. An endoscopic transpterygoid approach to the ITF was completed bilaterally in three specimens, and an open preauricular ITF approach was performed bilaterally in two specimens. Results After completing the cadaveric dissections, we studied differences between the endoscopic transpterygoid approach and open preauricular subtemporal approaches in regard to exposure and ease of dissection of different structures in the ITF. Conclusions In comparison with a lateral approach, the endonasal endoscopic transpterygoid approach provides better visualization and more direct exposure of median structures such as the nasopharynx, eustachian tube, sella, and clivus. We concluded that the endoscopic transpterygoid approach can be utilized to resect benign lesions and some select group of malignancies involving the infratemporal and middle cranial fossae. Open approaches continue to play an important role, especially in the resection of extensive malignant tumors extending to these regions. PMID:26401477

  15. Effects of friction massage of the popliteal fossa on dynamic changes in muscle oxygenation and ankle flexibility

    PubMed Central

    Iwamoto, Koji; Mizukami, Masafumi; Asakawa, Yasutsugu; Yoshio, Masaharu; Ogaki, Ryo; Takemura, Masahiro

    2016-01-01

    [Purpose] This study aimed to examine whether or not friction massage of the popliteal fossa would be effective for achieving dynamic changes in muscle oxygenation and ankle flexibility. [Subjects and Methods] Twelve healthy male university students participated. Before and after friction massage, dynamic changes in muscle oxygenation and ankle flexibility were measured by near-infrared spectroscopy to evaluate its efficacy. [Results] Oxygenated hemoglobin was significantly higher after as compared to before massage. The range of ankle dorsiflexion tended to increase after massage. [Conclusion] These results suggest that friction massage of the popliteal fossa stimulates venous return in the lower leg. PMID:27821920

  16. Posterior commissure of the human larynx revisited.

    PubMed

    Tucker, John A; Tucker, Sean T

    2010-05-01

    The existence of the posterior commissure (PC) of the human larynx has been disputed (Hirano M, Sato K, et al. The posterior glottis. Trans Am Laryngol Assoc. 1986;107:70-75). "The term posterior commissure has no relevance to anatomical structure. The term commissure means a joining together. The bilateral vocal folds never join at their posterior ends. The posterior aspect of the glottis is a wall. The posterior lateral aspect of the posterior glottis is also the lateral wall of the posterior glottis" (Hirano M, Sato K, et al. The posterior glottis. Trans Am Laryngol Assoc. 1986;107:70-75). This study is intended to clarify the development of anatomical and morphological aspects of the PC in conjunction with a clinical classification of the larynx in sagittal view. This study uses human embryo and fetal laryngeal sections from the Carnegie Collection of Human Embryos (the world standard) and whole organ laryngeal sections from the Tucker Laryngeal Fetal Collection. Correlation of histologic and gross anatomical structure is made with the Hirano et al atlas, the Vidić Photographic Atlas of the Human Body, and the O'Rahilly Embryonic Atlas. Embryologic data clearly describe and illustrate the posterior union of the cricoid cartilage with formation of the PC. The anatomical functional aspects of the posterior lateral cricoid lamina as the supporting buttress of the articulating arytenoid cartilages are illustrated.

  17. Isolated posterior cruciate ligament calcification

    PubMed Central

    Koukoulias, Nikolaos E; Papastergiou, Stergios G

    2011-01-01

    The authors present a case of calcified posterior cruciate ligament (PCL). A 61-year-old female presented in our department reporting 12 months history of knee pain that was getting worse during the night. The patient was under medication for epileptic seizure, osteoporosis and hyperthyroidism. X-rays demonstrated calcification of the PCL. CT and MRI excluded any other intra-articular and extra-articular pathology. Arthroscopic debridement of the calcium deposits was performed and the symptoms resolved immediately, while the postoperative x-rays were normal. Histological examination confirmed the calcium nature of the lesion. Two years postoperatively the patient remains asymptomatic. PMID:22669889

  18. Huge interparietal posterior fontanel meningohydroencephalocele

    PubMed Central

    Dos Santos, Manuel Filipe Dias; de Santa Barbara, Rita de Cassia

    2015-01-01

    Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion. PMID:26484324

  19. Longevity of Posterior Composite Restorations

    PubMed Central

    Opdam, N.J.M.; van de Sande, F.H.; Bronkhorst, E.; Cenci, M.S.; Bottenberg, P.; Pallesen, U.; Gaengler, P.; Lindberg, A.; Huysmans, M.C.D.N.J.M.; van Dijken, J.W.

    2014-01-01

    The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years’ follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces. PMID:25048250

  20. [Dissecting aneurysm of the posterior inferior cerebellar artery--studied by serial angiography].

    PubMed

    Yamashita, Y; Hayashi, S; Saitho, H; Teramoto, A

    2001-11-01

    We report the case of a 34-year-old male with cerebellar hemorrhagic infarction caused by a dissecting aneurysm of the left posterior inferior cerebellar artery (PICA). The patient suffered from a headache and vomiting for two days and was transferred to our hospital with sudden deterioration of consciousness. On admission, he was semicomatose. A CT scan revealed hemorrhagic infarction in the left cerebellum and upward herniation. The emergency operation for posterior fossa decompression was performed. Postoperatively, his consciousness level improved promptly and he had no neurological deficits except for slight gait disturbance. The first vertebral angiography was performed on Day 27. It showed a sausage-like dissecting aneurysm of the left distal PICA. We planned conservative therapy with careful observation because of there being no indication for an operation. Serial angiography was performed and demonstrated the regression of the dissecting aneurysm on Day 258. Dissecting aneurysms of the distal PICA are rare and their natural history is not well understood. Conservative therapy for vertebrobasilar dissecting aneurysms has often been reported. We suggest that conservative therapy with serial angiography is the treatment of choice especially for ischemic-type dissecting aneurysms. We review 17 cases of dissecting aneurysm of the distal PICA in this study.

  1. Topographic Constraints on the Mode of Formation of an Enigmatic Flow in Cerberus Fossae, Mars

    NASA Astrophysics Data System (ADS)

    Mouginis-Mark, P. J.; Wilson, L.

    2013-12-01

    We use a digital elevation model (DEM), derived from stereo Context Camera (CTX) images referenced to Mars Orbiter Laser Altimeter (MOLA) data, and shadow length measurements made from High Resolution Imaging Science Experiment (HiRISE) images, to investigate the geometry of a young enigmatic flow in S.W. Cerberus Fossae, Mars. The flow originates from an almost circular (1.2 x 1.5 km) pit within a remnant of a yardang at 0o 35'N, 155o 17'E, within the lower unit of the Medusae Fossae Formation. The flow is ~42 km long and 0.5 to 2.0 km wide, and MOLA data indicate that the flow falls ~50 m along its length. The flow has a broad distal fan of material ~8 x 14 km in size that has a platey surface texture. The source area of the flow displays several sets of semi-concentric ridges with different centers of curvature, and the CTX DEM shows this depression is ~20 m deep, implying a volume of ~0.03 km3 for the removed material. Measurements made from the DEM of the height of the bounding walls of several 160 - 200 m wide constrictions, where 'over-spill' from the flow forms a clear disrupted margin to the flow on the adjacent hills, indicate that the flow was never more than ~8 - 10 m thicker than it currently appears. The total surface area of the flow is ~153 km2 and 25 shadow length measurements made from HiRISE images of the flow margins at 16 different places along the flow give a typical thickness of ~4 m. These measurements imply a volume for the flow of ~0.6 km3, which is 20 times larger than the volume of the flow's source area, thereby demonstrating that a significant amount of new material was erupted to form the flow. The available morphologic and topographic data raise the intriguing probability that the flow is most likely not a lava flow, but is instead a mud flow produced by water reaching the surface within the yardang materials and the subsequent mobilization of the unconsolidated material that comprised the yardang. This proposed mud flow origin

  2. Carbon Sequestration on Mars: Constraints from the Nili Fossae Carbonate Plains

    NASA Astrophysics Data System (ADS)

    Edwards, C. S.; Ehlmann, B. L.

    2015-12-01

    Martian carbonates have been observed telescopically, from orbit, in situ and in Martian meteorites; however, a long-postulated geologic reservoir that accounts for proposed thinning of a multi-bar early Mars atmosphere by CO2 sequestration has not yet been identified. One striking aspect of the Martian geologic record is the presence of valley networks and open basin lakes last active around the Noachian/Hesperian boundary, at ca. 3.5 Ga. If surface waters were supported by a thicker atmosphere, hundreds of millibars to bars of CO2 would need to be lost to space during the Hesperian/Amazonian, inconsistent with current atmospheric models. Was this late CO2 sequestered in the Martian crust? We consider the role of diffuse and localized CO2 sequestration and constrain the timing and explore implications for late Noachian atmospheric conditions via examination of the age and composition of the largest contiguous exposure of carbonate-bearing rock on Mars, the Nili Fossae carbonate plains (21.5°N, 78.5°E). Morphological, spectral and thermophysical data sets from the Thermal Emission Spectrometer, Compact Reconnaissance Imaging Spectrometer for Mars, Thermal Emission Imaging System, and High Resolution Imaging Science Experiment are considered in the context of past atmospheric drawdown. We find the olivine-enriched (~20%-25%) basalts of the Nili Fossae plains have been altered, by low-temperature, in-situ carbonation processes, to at most ~20% Fe-Mg carbonate, thus limiting carbon sequestration in the Nili Fossae region to ~0.25-12 mbar of CO2 during the late Noachian/early Hesperian, before or concurrent with valley network formation. While large compared to modern-day CO2 reservoirs, the lack of additional, comparable-sized post-Late Noachian carbonate-bearing deposits on Mars indicates ineffective carbon sequestration in rock units over the past ~3.7 Ga. This implies a thin atmosphere (≲500 mbar) during valley network formation, extensive post

  3. Usefulness of high-resolution 3D multifusion medical imaging for preoperative planning in patients with posterior fossa hemangioblastoma: technical note.

    PubMed

    Yoshino, Masanori; Nakatomi, Hirofumi; Kin, Taichi; Saito, Toki; Shono, Naoyuki; Nomura, Seiji; Nakagawa, Daichi; Takayanagi, Shunsaku; Imai, Hideaki; Oyama, Hiroshi; Saito, Nobuhito

    2016-08-26

    Successful resection of hemangioblastoma depends on preoperative assessment of the precise locations of feeding arteries and draining veins. Simultaneous 3D visualization of feeding arteries, draining veins, and surrounding structures is needed. The present study evaluated the usefulness of high-resolution 3D multifusion medical imaging (hr-3DMMI) for preoperative planning of hemangioblastoma. The hr-3DMMI combined MRI, MR angiography, thin-slice CT, and 3D rotated angiography. Surface rendering was mainly used for the creation of hr-3DMMI using multiple thresholds to create 3D models, and processing took approximately 3-5 hours. This hr-3DMMI technique was used in 5 patients for preoperative planning and the imaging findings were compared with the operative findings. Hr-3DMMI could simulate the whole 3D tumor as a unique sphere and show the precise penetration points of both feeding arteries and draining veins with the same spatial relationships as the original tumor. All feeding arteries and draining veins were found intraoperatively at the same position as estimated preoperatively, and were occluded as planned preoperatively. This hr-3DMMI technique could demonstrate the precise locations of feeding arteries and draining veins preoperatively and estimate the appropriate route for resection of the tumor. Hr-3DMMI is expected to be a very useful support tool for surgery of hemangioblastoma.

  4. Relationships Between the Medusae Fossae Formation (MFF), Fluvial Channels, and the Dichotomy Boundary Southeast of Nicholson Crater, Mars

    NASA Technical Reports Server (NTRS)

    Bradley, B. A.; Sakimoto, S. E. H.

    2001-01-01

    We use Mars Global Surveyor's Mars Orbiter Laser Altimeter (MOLA) and Mars Orbiter Camera (MOC) data to investigate the Medusae Fossae Formation (MFF) and its relationship to fluvial channels southeast of Nicholson Crater. In this area the MFF shows small-scale layering and is draped over Labou Vallis. Additional information is contained in the original extended abstract.

  5. Mapping of Sand Types and Dune Morphologies in the Aeolis Dorsa Region, Western Medusae Fossae Formation, Mars

    NASA Astrophysics Data System (ADS)

    Boyd, A. S.; Burr, D. M.

    2016-06-01

    Preliminary mapping of low- and high-albedo sand deposits in the Aeolis Dorsa region, Medusae Fossae Formation (MFF), suggests sand transport from the north, consistent with sand source(s) in Elysium Mons, the Cerberus plains, or the MFF itself.

  6. Imaging of the Posterior Skull Base.

    PubMed

    Job, Joici; Branstetter, Barton F

    2017-01-01

    The posterior skull base can be involved by a variety of pathologic processes. They can be broadly classified as: traumatic, neoplastic, vascular, and inflammatory. Pathology in the posterior skull base usually involves the lower cranial nerves, either as a source of pathology or a secondary source of symptoms. This review will categorize pathology arising in the posterior skull base and describe how it affects the skull base itself and surrounding structures.

  7. Posterior ankle impingement in the dancer.

    PubMed

    Moser, Brad R

    2011-01-01

    Dancers spend a lot of time in the relevé position in demi-pointe and en pointe in their training and their careers. Pain from both osseous and soft tissue causes may start to occur in the posterior aspect of their ankle. This article reviews the potential causes of posterior ankle impingement in dancers. It will discuss the clinical evaluation of a dancer and the appropriate workup and radiographic studies needed to further evaluate a dancer with suspected posterior ankle impingement.

  8. Geologic Mapping Applications Using THEMIS Data for the Medusae Fossae Formation, Mars

    NASA Technical Reports Server (NTRS)

    Zimbelman, J. R.; Bender, K. C.; Harris, J. C.

    2003-01-01

    The Medusae Fossae Formation (MFF) is a regionally extensive deposit located along the equator of Mars between roughly 130 and 240 E longitude, the origin of which has stimulated a host of published hypotheses. A volcanic or aeolian origin appear most consistent with Viking and MGS data, but other hypotheses remain viable and new data, as from the Mars Odyssey spacecraft, is likely to stimulate additional hypotheses of origin. NASA is supporting geologic mapping of portions of the MFF deposits, but it is now quite clear that this on-going mapping will need considerable revision as data from the Thermal Emission Imaging System (THEMIS) on Mars Odyssey become available. The daytime IR THEMIS images hold particularly strong potential for providing a new base on which geologic mapping can be carried out, as illustrated by the examples discussed.

  9. Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation

    SciTech Connect

    Tewari, Sanjit O.; Petre, Elena N.; Osborne, Joseph; Sofocleous, Constantinos T.

    2013-12-15

    A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

  10. Patterns of chronic adhesive arachnoiditis following Myodil myelography: the significance of spinal canal stenosis and previous surgery.

    PubMed

    Laitt, R; Jackson, A; Isherwood, I

    1996-08-01

    109 patients who had undergone Myodil myelography on at least one occasion were identified. The patterns of lumbar nerve root distribution in this group were examined using magnetic resonance imaging. The relationship between these patterns and the presence of spinal stenosis or previous surgery was investigated. Chronic adhesive arachnoiditic nerve root patterns were seen in 68 patients and were classified into three groups according to Delemarter et al. Central clumping of nerve roots (type 1) and complete opacification of the thecal sac (type 3), extending over at least one vertebral level, were significantly related to spinal stenosis at an adjacent level (p < 0.0001). Peripheral adhesion of nerve roots to the theca (type 2) was significantly related to previous surgery at the level of abnormality (p < 0.00005). Only a single case of arachnoiditic nerve root patterns was seen in the absence of stenosis or previous surgery. We conclude that chronic adhesive arachnoiditis is significantly related to previous Myodil myelography in the presence of spinal stenosis or previous surgery but that Myodil alone rarely produces these changes.

  11. Subarachnoid pressure-dependent change in syrinx size in a patient with syringomyelia associated with adhesive arachnoiditis. Case report.

    PubMed

    Chang, Han Soo; Joko, Masahiro; Matsuo, Naoki; Kim, Sang Don; Nakagawa, Hiroshi

    2005-02-01

    The pathophysiology of syringomyelia is still not well understood. Current prevailing theories involve the assumption that cerebrospinal fluid (CSF) flows into the syrinx from the subarachnoid space through the perivascular space of Virchow-Robin. Reported here is the case of a patient with syringomyelia in which this course is clearly contradicted. This patient with a holocord syrinx associated with adhesive arachnoiditis was treated 3 years previously with insertion of a subarachnoid-peritoneal shunt and had recently experienced worsening myelopathy. On surgical exploration, the shunt system was functioning normally. The medium-pressure shunt valve was replaced with an adjustable valve with a higher closing pressure setting, thus increasing the CSF pressure in the subarachnoid space. Contrary to prevailing theories, this procedure markedly reduced the size of the syrinx. This case provides direct evidence that the syrinx size is inversely related to subarachnoid CSF pressure and supports the hypothesis that the pressure gradient across the spinal cord parenchyma is the force that generates syringes in syringomyelia.

  12. Biomechanical response of the bovine pia-arachnoid complex to normal traction loading at varying strain rates.

    PubMed

    Jin, Xin; Ma, Chunsheng; Zhang, Liying; Yang, King H; King, Albert I; Dong, Guang; Zhang, Jinhuan

    2007-10-01

    The pia-arachnoid complex (PAC) covering the brain plays an important role in the mechanical response of the brain due to impact or inertial loading. The mechanical properties of the bovine PAC under tensile loading have been characterized previously. However, the transverse properties of this structure, such as shear and normal traction which are equally important to understanding the skull/brain interaction under traumatic loading, have not been investigated. These material properties are essential information needed to adequately define the material model of the PAC in a finite element (FE) model of human brain. The purpose of this study was to determine, experimentally, the material properties of the PAC under normal traction loading. PAC Specimens were obtained from freshly slaughtered bovine subjects from various locations. Quasi-static and dynamic tests along the radial direction were performed at four different strain rates (0.36, 2.0, 20.5, and 116.3 s(-1)) to investigate the rate and regional effects. Results suggest that the PAC under traction loading is stiffer than brain tissue, rate dependent, and can be characterized as linearly elastic until failure. However, no regional difference was observed.

  13. Timing of births in sympatric brown howler monkeys (Alouatta fusca clamitans) and northern muriquis (Brachyteles arachnoides hypoxanthus).

    PubMed

    Strier, K B; Mendes, S L; Santos, R R

    2001-10-01

    We monitored the birth patterns of sympatric brown howler monkeys (Alouatta fusca clamitans) and northern muriquis (Brachyteles arachnoides hypoxanthus) during a 4-yr period from October 1996 to August 2000 at the Estação Biológica de Caratinga, Minas Gerais, Brazil. Brown howler monkey births (n = 34) occurred throughout the year, and birth frequencies did not differ between rainy and dry season months. The aseasonal birth patterns of the howler monkeys differed significantly from the dry season concentration and dry month peak in muriqui births (n = 23). We found no effects of infant sex or the number of females on interbirth intervals (IBIs) in our 10 howler monkey study troops. IBIs of brown howler monkeys averaged 21.2 +/- 2.5 mo (n = 8, median = 21.0 mo), and were significantly shorter following dry season births than rainy season births. Their IBIs and yearling survivorship (74%) were similar to those reported for other species of howler monkeys, but yearling survivorship was much lower than that of muriquis (94%), whose IBIs were more than 12 mo longer than those of the howler monkeys. Our study extends comparative knowledge of birth patterns in Alouatta to a poorly known species, and provides insights into the different ways in which diet and life history may affect the timing of births in large-bodied platyrrhines under the same seasonal ecological conditions.

  14. Posterior repair and sexual function

    PubMed Central

    Komesu, Yuko M.; Rogers, Rebecca G.; Kammerer-Doak, Dorothy N.; Barber, Matthew D.; Olsen, Ambre L.

    2011-01-01

    OBJECTIVE The purpose of this study was to determine the effect of posterior repair (PR) on sexual function in patients who have undergone incontinence and/or pelvic reconstructive surgery. STUDY DESIGN A cohort study of women who underwent incontinence and/or prolapse surgery was performed. Participants completed the pelvic organ prolapse urinary incontinence sexual questionnaire (PISQ) before and after the operation. PISQ scores were compared between women who underwent PR and women who did not. RESULTS Of 73 study participants, 30 women underwent PR; 43 women did not (no PR). Although there was no difference in dyspareunia between groups pre-op, dyspareunia prevalence post-op was significantly lower in the no PR group. Preoperative PISQ scores were similar between groups. After the operation, both groups significantly improved their PISQ scores, without a difference between groups. CONCLUSION Although the incidence of dyspareunia differed between PR and no PR groups, overall improvement in sexual function was reflected in improved total PISQ scores that occurred irrespective of PR performance. PMID:17618777

  15. Sinuous Ridges as Tools to Investigate Post-Flow Modification in the Aeolis-Zephyria Plana, Western Medusae Fossae Formation, Mars

    NASA Astrophysics Data System (ADS)

    Lefort, A.; Burr, D. M.; Beyer, R. A.; Howard, A. D.

    2012-03-01

    The longitudinal profiles of inverted fluvial features located in the Medusa Fossae Formation exhibit undulations that we interpret as evidence of post-fluvial deformation of the region. We propose and evaluate possible deformation processes.

  16. Recurrent posterior shoulder instability. Diagnosis and treatment.

    PubMed

    Pollock, R G; Bigliani, L U

    1993-06-01

    Recurrent posterior glenohumeral instability is regarded as a difficult problem to diagnose and treat. A careful history and physical examination are the most helpful tools in making this diagnosis. A positive posterior stress test, demonstrable posterior subluxation, and a sulcus sign are frequently present on examination. Special roentgenographic studies, such as the computerized arthrotomography (arthro-CT) scan, may be used in cases in which plain roentgenographs suggest bony glenoid abnormalities. When conservative therapy fails, there is no consensus on the operative treatment. Procedures that address the soft tissues, such as capsulorrhaphy and posterior labral repair, as well as those that alter the bony geometry of the joint, such as posterior bone blocks and glenoid or humeral osteotomies, have been described. Capsular laxity is the most common pathologic finding in the authors' experience, and they favor the use of a posterior-inferior capsular shift procedure to correct this problem. Augmentation of the repair with a posterior bone block is reserved for unusual cases, such as when glenoid hypoplasia is present or in certain revision situations.

  17. Posterior labral injury in contact athletes.

    PubMed

    Mair, S D; Zarzour, R H; Speer, K P

    1998-01-01

    Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.

  18. Signs of potential renewal of eruptive activity at La Fossa (Vulcano, Aeolian Islands)

    NASA Astrophysics Data System (ADS)

    Montalto, A.

    1996-04-01

    Since the end of the last magmatic eruption (1890), activity of La Fossa (southern Tyrrhenian Sea, Italy) has consisted of fumarolic emissions of fluctuating intensity. Fluids are discharged principally at two fumarolic fields located in the northern rim of the active crater and at the beach sited at its northern foot. Increased thermal, seismic and geochemical activity has been recorded since 1978, when an earthquake of M=5.5 occurred in the region. This paper combines available geophysical and geochemical information in order to develop a tentative interpretation of two episodes of apparent unrest which occurred in 1985 and 1987 1988, enhancing the risk of renewal of the eruptive activity. The 1985 unrest consisted essentially of a sharp build up of the internal pressure in the shallow hydrothermal system, which was induced by the injection of hot gases of magmatic origin. The crater fumaroles displayed significant increases in CO2 and other acid species, but their outlet temperature did not change. Conversely, the 1987 1988 episode was characterized by appreciable modifications at the crater fumaroles, with only secondary effects at the fumarole system of the beach. The sliding of part of the eastern flank of the La Fossa cone into the sea occurred on 20 April 1988, when the region was affected by crustal dilatation producing a seismic sequence of relatively high intensity. Both episodes of unrest were accompanied by increases of local microseismic activity, which affected the nothern sector of the island in 1985, and the southern one in 1988. Finally, a phase of appreciable areal contraction was detected in 1990, probably due to the effect of the cooling and crystallization of magma at relatively shallow depths, accompanying the increased thermal activity at the crater fumaroles. Regional tectonic stress seems to play an important role in the transition of the volcanic system from a phase of relative stability to a phase of apparent unrest, inducing the heating

  19. Peripheral primitive neuroectodermal tumour - a rare cause of a popliteal fossa mass: A case report and review of the literature.

    PubMed

    Davis, Colin M; Choong, Andrew Mtl; Sharp, David; Taheri, Touraj; Senewiratne, Shireen; Hinckley, Vedella

    2014-01-01

    A literature review of peripheral primitive neuroectodermal tumours, illustrated with an index case report describing an 80-year-old woman who presented with a mass in the left popliteal fossa, is reported. An excision biopsy was performed, revealing a possible peripheral primitive neuroectodermal tumour as the primary pathology. Normally confined to the chest wall and axial soft tissues of children and young adults, reports of this tumour existing in other areas and in the elderly population are scarce.

  20. Johann Christian Rosenmüller (1771-1820): A Historical Perspective on the Man behind the Fossa

    PubMed Central

    Amene, Chiazo; Cosetti, Maura; Ambekar, Sudheer; Guthikonda, Bharat; Nanda, Anil

    2013-01-01

    Introduction The fossa of Rosenmüller, also known as the lateral pharyngeal recess, is a well-established site of origin of nasopharyngeal carcinoma. It is located in the lateral pharyngeal wall behind the cartilaginous portion of the Eustachian tube, the torus tubarius, and is named after Johann Christian Rosenmüller (JCR). Objective We present a history on the life and extensive works of Johann Christian Rosenmüller, a German physician and anatomist. Results Johann Christian Rosenmüller was a dedicated anatomist. In addition to identifying the fossa of Rosenmüller, his influence extends to various other anatomic subjects, including the Rosenmüller gland, the palpebral portion of the lacrimal gland, and the organ of Rosenmüller (i.e., the caudal remnant of the mesonephric duct). He was also an avid speleologist, studying the composition of caves and their life forms. For his contributions to this field, he had a cave in Germany and an extinct species named after him—Rosenmüllerhöhle and Ursus spelaeus Rosenmüller, respectively. Conclusion The fossa of Rosenmüller plays an important role in the growth and surgical treatment of nasopharyngeal carcinoma. We present a brief glimpse into the life of Johann Christian Rosenmüller, for whom it was named. PMID:24436911

  1. Functional Outcomes of the Retromaxillary-Infratemporal Fossa Dissection for Advanced Head and Neck/Skull Base Lesions

    PubMed Central

    Shibuya, Terry Y.; Doerr, Timothy D.; Mathog, Robert H.; Burgio, Don L.; Meleca, Robert J.; Yoo, George H.; Guthikonda, Murali

    2000-01-01

    The retromaxillary-infratemporal fossa (RM-ITF) dissection, using a preauricular incision, was initially popularized for the treatment of temporomandibular joint disorders, facial fractures, and orbital tumors. This approach has been expanded for the treatment of advanced head and neck and skull base tumors extending into the infratemporal fossa. We studied prospectively eight consecutive patients requiring a RM-ITF dissection. Pre- and postoperative functional outcomes measured were mastication, speech, swallowing, cranial nerve function, pain, and cosmesis. A significant reduction in pain was noted postoperatively in all patients studied. Limited changes were identified in mastication, speech, swallowing, vision, hearing, or cosmesis postoperatively. The RM-ITF dissection should be considered when resecting advanced head and neck/skull base lesions that extend into this region. We have found minimal morbidity associated with this dissection. This procedure may have a useful place in palliation of patients with incurable pain caused by tumor invasion into the infratemporal fossa. ImagesFigure 2Figure 3Figure 4 PMID:17171134

  2. Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus.

    PubMed

    Verit, Ayhan; Savas, Murat; Ciftci, Halil; Unal, Dogan; Yeni, Ercan; Kaya, Mete

    2006-02-01

    Urethral calculus is a rare form of urolithiasis with an incidence lower than 0.3%. We determined the outcomes of 15 patients with urethral stone, of which 8 were pediatric, including an undiagnosed primary fossa navicularis calculus. Fifteen consecutive male patients, of whom eight were children, with urethral calculi were assessed between 2000 and 2005 with a mean of 19 months' follow-up. All stones were fusiform in shape and solitary. Acute urinary retention, interrupted or weak stream, pain (penile, urethral, perineal) and gross hematuria were the main presenting symptoms in 7 (46.7%), 4 (26.7%), 3 (20%) and 1 (6.6%) patient, respectively. Six of them had accompanying urethral pathologies such as stenosis (primary or with hypospadias) and diverticulum. Two patients were associated with upper urinary tract calculi but none of them secondary to bladder calculi. A 50-year-old patient with a primary urethral stone disease had urethral meatal stenosis accompanied by lifelong lower urinary tract symptoms. Unlike the past reports, urethral stones secondary to bladder calculi were decreasing, especially in the pediatric population. However, the pediatric patients in their first decade are still under risk secondary to the upper urinary tract calculi or the primary ones.

  3. Can serum interleukin-6 levels predict the outcome of patients with right iliac fossa pain?

    PubMed Central

    Goodwin, A. T.; Swift, R. I.; Bartlett, M. J.; Fernando, B. S.; Chadwick, S. J.

    1997-01-01

    In patients with right iliac fossa (RIF) pain it can be difficult to distinguish between appendicitis and nonspecific abdominal pain (NSAP). In this study we sought to determine whether serum interleukin-6 (IL-6) levels, an early marker of acute inflammation, taken at the time of admission could predict the outcome of patients admitted with RIF pain. Data were collected in a prospective manner on 53 consecutive patients (23 male, 30 female), mean age 22.1 years (range 10-79 years). Nineteen (36%) patients underwent surgery, of whom 16 had appendicitis (histologically proven). The mean (SEM) IL-6 levels (pg/ml) in patients undergoing operation vs those receiving non-operative management were 270.8 (106.3) vs 265.0 (80.4) (P = NS). The mean white blood cell (WBC) counts (x10(9)/l) in these patients were 14.28 (0.81) vs 9.66 (0.67), respectively (P = 0.0002). When patients with a confirmed diagnosis of appendicitis were compared with patients with a diagnosis of NSAP, the IL-6 levels were 149.4 (69.1) vs 363.6 (113.2), respectively (P = NS). In the same groups of patients, the WBC counts were 14.21 (0.81) vs 9.51 (0.68) (P = 0.004). We conclude that IL-6 levels taken at the time of admission are not useful in predicting the outcome of RIF pain. PMID:9135242

  4. Can serum interleukin-6 levels predict the outcome of patients with right iliac fossa pain?

    PubMed

    Goodwin, A T; Swift, R I; Bartlett, M J; Fernando, B S; Chadwick, S J

    1997-03-01

    In patients with right iliac fossa (RIF) pain it can be difficult to distinguish between appendicitis and nonspecific abdominal pain (NSAP). In this study we sought to determine whether serum interleukin-6 (IL-6) levels, an early marker of acute inflammation, taken at the time of admission could predict the outcome of patients admitted with RIF pain. Data were collected in a prospective manner on 53 consecutive patients (23 male, 30 female), mean age 22.1 years (range 10-79 years). Nineteen (36%) patients underwent surgery, of whom 16 had appendicitis (histologically proven). The mean (SEM) IL-6 levels (pg/ml) in patients undergoing operation vs those receiving non-operative management were 270.8 (106.3) vs 265.0 (80.4) (P = NS). The mean white blood cell (WBC) counts (x10(9)/l) in these patients were 14.28 (0.81) vs 9.66 (0.67), respectively (P = 0.0002). When patients with a confirmed diagnosis of appendicitis were compared with patients with a diagnosis of NSAP, the IL-6 levels were 149.4 (69.1) vs 363.6 (113.2), respectively (P = NS). In the same groups of patients, the WBC counts were 14.21 (0.81) vs 9.51 (0.68) (P = 0.004). We conclude that IL-6 levels taken at the time of admission are not useful in predicting the outcome of RIF pain.

  5. Radar sounding of the Medusae Fossae Formation Mars: equatorial ice or dry, low-density deposits?

    PubMed

    Watters, Thomas R; Campbell, Bruce; Carter, Lynn; Leuschen, Carl J; Plaut, Jeffrey J; Picardi, Giovanni; Orosei, Roberto; Safaeinili, Ali; Clifford, Stephen M; Farrell, William M; Ivanov, Anton B; Phillips, Roger J; Stofan, Ellen R

    2007-11-16

    The equatorial Medusae Fossae Formation (MFF) is enigmatic and perhaps among the youngest geologic deposits on Mars. They are thought to be composed of volcanic ash, eolian sediments, or an ice-rich material analogous to polar layered deposits. The Mars Advanced Radar for Subsurface and Ionospheric Sounding (MARSIS) instrument aboard the Mars Express Spacecraft has detected nadir echoes offset in time-delay from the surface return in orbits over MFF material. These echoes are interpreted to be from the subsurface interface between the MFF material and the underlying terrain. The delay time between the MFF surface and subsurface echoes is consistent with massive deposits emplaced on generally planar lowlands materials with a real dielectric constant of approximately 2.9 +/- 0.4. The real dielectric constant and the estimated dielectric losses are consistent with a substantial component of water ice. However, an anomalously low-density, ice-poor material cannot be ruled out. If ice-rich, the MFF must have a higher percentage of dust and sand than polar layered deposits. The volume of water in an ice-rich MFF deposit would be comparable to that of the south polar layered deposits.

  6. Origin of the Medusae Fossae Formation, Mars: Insights from a synoptic approach

    NASA Astrophysics Data System (ADS)

    Mandt, Kathleen E.; de Silva, Shanaka L.; Zimbelman, James R.; Crown, David A.

    2008-12-01

    The geologic origin of the Medusae Fossae Formation (MFF) has remained a mystery despite three decades of research. To better constrain its formation, an in-depth analysis of observations made in the literature was combined with a new survey of over 700 Mars Orbiter Camera narrow-angle images of the MFF to identify morphologic characteristics and material properties that define this formation as a whole. While previous work has identified clear agreement on some characteristics, our analysis identifies yardangs, collapse features, and layering as pervasive features of the MFF. Whereas collapse features and layering may implicate several different physical and chemical processes, yardangs provide vital information on material properties that inform about mechanical properties of the MFF lithology. Aspect ratios of megayardangs range from 3:1 to 50:1, and slope analyses reveal heights of up to 200 m with cliffs that are almost vertical. Other yardangs show lower aspect ratios and topographic profiles. These characteristics coupled to the presence of serrated margins, suggest that MFF lithology must be of weakly to heavily indurated material that lends itself to jointing. The characteristics and properties of the MFF are inconsistent with those of terrestrial pyroclastic fall deposits or loess, but are in common with large terrestrial ignimbrites, a hypothesis that explains all key observations with a single mechanism. Yardang fields developed in regionally extensive ignimbrite sheets in the central Andes display morphologic characteristics that correlate with degree of induration of the host lithology and suggest an origin by pyroclastic flow for the MFF.

  7. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo

    PubMed Central

    Ceylan, Emin Mehmet; Evrensel, Alper

    2016-01-01

    Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient's vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years) psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient. PMID:27651969

  8. Geology of Hebrus Valles and Hephaestus Fossae, Mars: evidence for basement control of fluvial patterns

    SciTech Connect

    Christiansen, E.H.

    1985-01-01

    Hebrus Valles (HV) and Hephaestus Fossae (HF) are valley systems located SW of Elysium Mons in the low northern plains of Mars. HV share many of their characteristics with other martian outflow channels--widely interpreted as having formed by catastrophic flooding. The NW-trending HV system is 250 km long and begins in an elongate depression. Individual channels are less than 1 km wide; a braided reach is about 10 km wide. Streamlined islands are abundant in the middle reach. HV terminate as a series of narrow distributaries. No sedimentary deposits are obviously related to the development of the channel. HV cut across a broad expanse of older plains dotted by irregular mesas and smaller knobs. HF are a connected series of linear valley segments which branch and cross downslope but have high junction angles. Locally, the channel pattern is polygonal. HF are parallel to HV but are considerably deeper and longer (600 km). HF also originate in a depression, but to the NW they terminate near the gradational boundary between the knobby plains and polygonally fractured terrain of Utopia Planitia. The valley pattern has led some to suggest that HF are tectonic features. It is suggested that like HV, HF are also of fluvial origin. Downcutting to, or subsurface flow at this pre-existing surface red to a channel pattern that was strongly controlled by the polygonal troughs buried beneath the younger knobby plains materials.

  9. Assessment of Consistency Between the Arm-Fossa Test and Gillet Test: A Pilot Study

    PubMed Central

    Cooperstein, Robert; Blum, Charles; Cooperstein, Elaine C.

    2015-01-01

    Objective The purpose of this pilot study was to test methods needed to conduct a study with adequate power to investigate consistency between the arm-fossa test (AFT) and the Gillet test. Methods A convenience sample of chiropractic college students enrolled in a weekend Sacro-Occipital Technique seminar participated. Each was tested with AFT and sacroiliac orthopedic tests, including the Gillet test. Statistical testing included calculation of κ for consistency of the AFT and Gillet test and their diagnostic efficiency. Results This study recruited 14 participants. Important issues arose in gathering and recording data, the standardization of examiner methods, and the flow of participants to examination stations. κ for AFT and Gillet test consistency = 0.55, corresponding to “moderate.” Conclusion This pilot suggests that the future study should include a mix of symptomatic and asymptomatic participants; record trichotomous data, where appropriate; use washout periods between diagnostic tests; and refine the selection of orthopedic tests deployed besides the AFT. The preliminary data are consistent with but do not establish due to the very small sample size and experimental design issues, that a positive AFT may be consistent with a negative Gillet test. PMID:26693214

  10. Cerberus Fossae and Elysium Planitia Lavas, Mars: Source Vents, Flow Rates, Edifice Styles and Water Interactions

    NASA Technical Reports Server (NTRS)

    Sakimoto, S. E. H.; Gregg, T. K. P.

    2004-01-01

    The Cerberus Fossae and Elysium Planitia regions have been suggested as some of the youngest martian surfaces since the Viking mission, although there was doubt whether the origins were predominantly volcanic or fluvial. The Mars Global Surveyor and Mars Odyssey Missions have shown that the region is certainly young in terms of the topographic preservation and the youthful crater counts (e.g. in the tens to a few hundred million yrs.). Numerous authors have shown that fluvial and volcanic features share common flow paths and vent systems, and that there is evidence for some interaction between the lava flows and underlying volatiles as well as the use by lavas and water of the same vent system. Given the youthful age and possible water-volcanism interaction environment, we'd like constraints on water and volcanic flux rates and interactions. Here, we model ranges of volcanic flow rates where we can well-constrain them, and consider the modest flow rate results results in context with local eruption styles, and track vent locations, edifice volumes, and flow sources and data.

  11. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    PubMed

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.

  12. Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

    PubMed

    Scheich, Matthias; Ginzkey, Christian; Ehrmann-Müller, Desiree; Shehata-Dieler, Wafaa; Hagen, Rudolf

    2016-10-01

    Microsurgery is one of the primary current standard options for the treatment of vestibular schwannoma (VS). Especially the middle cranial fossa (MCF) approach is a safe and efficacious technique for the preservation of hearing and facial nerve function in small VS. Postoperative complications are rare, although a leakage of cerebrospinal fluid (CSF) is common. The aim of this study was to analyze postoperative CSF leaks and to describe strategies for postoperative treatment. Between October 2005 and May 2012, 148 patients suffering from VS and selected for microsurgery via the MCF approach were treated in our department. Postoperative CSF leakage occurred in 19 patients. We found a leakage via the Eustachian tube into the nasopharynx in 18 patients and one case of incisional leakage. In 13 cases leaking stopped within 5 days by conservative management including bed rest and intravenous (i.v) antibiotics. Five patients needed lumbar drainage (LD) and only two patients had to undergo revision surgery to seal and pack the mastoid. Analyzed risk factors were age, gender, tumor size and pneumatization of the mastoid. Only the latter showed a significant influence on CSF leakage. We could demonstrate that a stepwise strategy is needed for successful treatment of CSF leaks.

  13. Volcanic emissions from soils at the base of La Fossa volcano, Vulcano island, Italy

    NASA Astrophysics Data System (ADS)

    Obenholzner, J. H.; Parks, J. L.

    2006-12-01

    A top-sealed plastic tube with a diameter of ca. 15 cm had been buried vertically at the base of La Fossa volcano, Volcano island, Italy, next to the front of the obsidian flow. The tube had been filled with quartz wool to condense vapors emanating from the soil. At ca. 75 cm below the surface the sample had been exposed to vapors from Sept. 2005 to April 2006. The leached sample had not been in touch with the ground. Another glass wool cushion (ca. 3 cm thick) had been underneath to minimize capillary effects. Leaching of the quartz wool and ICP-MS analysis documented positive values for: Mg, Al, Si, P, K, Ca, Cr, Mn, Ni, Cu, Zn, Cd, Sn, Pb. Leaching with nitric acid documented also V and Fe. Acid leaching produced higher values for all elements, except K and Sn, than leaching with deionized water. Negative values had been obtained for As, Se, Mo. Influence from soil breathing can be excluded as the active fumaroles contain As and Se. This experiment documents for the first time an unknown element transport by vapors/gases through a volcanic edifice interacting with hydrothermal and magmatic gases. It remains unknown if elements detected are entering the atmosphere or are getting adsorbed onto the volcanic ash soil particles derived from reworked surge beds. This question is very important as soils might be an unknown filter medium to filter volcanically polluted air in case of major volcanic crises. Data can be obtained from the authors.

  14. Posterior Hip Pain in an Athletic Population

    PubMed Central

    Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944

  15. Posterior cruciate ligament (PCL) injury - aftercare

    MedlinePlus

    Adib F, Curtis C, Bienkowski P Micheli LJ. Posterior cruciate ligament sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, ...

  16. Gibbs Sampling for Marginal Posterior Expectations

    DTIC Science & Technology

    1991-11-19

    Achcar and Smith (1989) shows that performance of the Laplace method is often very sensitive to parametrization. Morris (1988) offers expansions based on...Berkeley Symp. 1, 453-468. Lindley, D.V. (1980). "Approximate Bayesian Methods" in Bayesian Statistics, J.M. Bernardo, M.H. DeGroot , D.V. Lindley...A.F.M. Smith, University Press, Valencia, Spain. Morris , C. "Approximating Posterior Distributions and Posterior Moments" In: Bayesian Statistics 3, J.M

  17. [Posterior cortical atrophy (Benson-syndrome)].

    PubMed

    Rózsa, Anikó; Szilvássy, Ildikó; Kovács, Krisztina; Boór, Krisztina; Gács, Gyula

    2010-01-30

    We present the characteristics of posterior cortical atrophy--a very rare cortical dementia--in a 69 year old woman's case. Our patient's symptoms began with a visual problem which was initially explained by ophthalmological disorder. After neurological exam visual agnosia was diagnosed apart from other cognitive disorder (alexia without agraphia, acalculia, prosopagnosia, constructional disorder, clock-time recognition disorder, dressing apraxia, visuospatial disorientation). The brain MRI showed bilateral asymmetric parieto-occipital atrophy which is characteristic of posterior cortical atrophy.

  18. Posterior Wnts Have Distinct Roles in Specification and Patterning of the Planarian Posterior Region.

    PubMed

    Sureda-Gómez, Miquel; Pascual-Carreras, Eudald; Adell, Teresa

    2015-11-05

    The wnt signaling pathway is an intercellular communication mechanism essential in cell-fate specification, tissue patterning and regional-identity specification. A βcatenin-dependent signal specifies the AP (Anteroposterior) axis of planarians, both during regeneration of new tissues and during normal homeostasis. Accordingly, four wnts (posterior wnts) are expressed in a nested manner in central and posterior regions of planarians. We have analyzed the specific role of each posterior wnt and the possible cooperation between them in specifying and patterning planarian central and posterior regions. We show that each posterior wnt exerts a distinct role during re-specification and maintenance of the central and posterior planarian regions, and that the integration of the different wnt signals (βcatenin dependent and independent) underlies the patterning of the AP axis from the central region to the tip of the tail. Based on these findings and data from the literature, we propose a model for patterning the planarian AP axis.

  19. Vertigo due to posterior circulation stroke.

    PubMed

    Kim, Ji Soo; Lee, Hyung

    2013-07-01

    Stroke in the distribution of the posterior circulation may present as acute onset spontaneous vertigo and imbalance. Although vertigo due to posterior circulation stroke is usually associated with other neurologic symptoms or signs, small infarcts in the cerebellum or brainstem can present with vertigo without other localizing symptoms. Approximately 17% of patients with isolated posterior inferior cerebellar artery territory infarction presented with isolated vertigo, nystagmus, and postural unsteadiness. A head impulse test can differentiate acute isolated vertigo associated with cerebellar stroke from more benign disorders involving the inner ear. Sometimes acute isolated audiovestibular loss can be the initial symptom of impending posterior circulation ischemic stroke (particularly within the territory of the anterior inferior cerebellar artery). In this case, evaluation of isolated audiovestibular loss may prevent the progression of acute vertigo and hearing loss into more widespread areas of infarction in the posterior circulation. In this article, the clinical syndromes and signs of acute vestibular syndrome due to posterior circulation stroke involving the brainstem and cerebellum are summarized.

  20. Posterior urethral polyp with type I posterior urethral valves: a rare association in a neonate.

    PubMed

    Kesan, Krushnakumar V; Gupta, Rahul Kumar; Kothari, Paras; Gupta, Abhaya; Mudkhedkar, Kedar; Kamble, Ravikiran; Dikshit, K Vishesh

    2014-06-01

    Urethral polyp is a rare cause of bladder outlet obstruction, voiding dysfunction, and hematuria in the pediatric age group. Urethral polyps are rarely associated with other congenital urinary tract anomalies. In this study, we report a case of solitary posterior urethral polyp with type I posterior urethral valve in a 7-day-old neonate presented with urinary retention and deranged renal function. The polyp was diagnosed on cystoscopy. Transurethral resection of the polyp with posterior urethral valve fulguration was performed. Pathologic assessment revealed a fibroepithelial lesion, which was consistent with congenital posterior urethral polyp.

  1. Geological Structure of the Itoigawa - Shizuoka Tectonic Line, Northern Fossa Magna, Central Japan

    NASA Astrophysics Data System (ADS)

    Kim, H.; Iwasaki, T.

    2009-12-01

    Geological structure of two different natures is recognized in the Northern Fossa Magna (NFM). NFM is situated near the zone where the central Japan Island bent geographically and a graben zone formed between the North Alps and the Kanto highland. NFM is characterized by thick Neogene deposits and with active tilting of the crustal blocks and active folding bloc. At the present the sedimentary basin is the Saigawa hill due to the active faulting and folding in the Fossa Magna. Active fault system of Itoigawa-Shizuoka Tectonic Line (ISTL) is an eastward - dip of reverse fault which strikes N-S along the western margin of the NFM. The vertical displacement rate of ISTL is estimated to be maximum 9 mm/yr from the offset amount and the formation age of flexure scarp which appeared in the fluvial terrace [ex. Ikeda et al., (2002)]. Besides, the last event and the reccurrence interval are presumed to be about about 1,500 years aga and 2,000 years, respectively [Okumura (2001)]. In addition the western margin fault of the Nagano basin (NBF) strikes NNE-SSW along the east edge of NFM. The NBF is an eastward-dip of reverse fault, and the Zenkoji earthquake (M7.4) in 1847 was occurred. The purpose of present study is to discuss the geometry of ISTL and geological process of NFM based on the geomorphological and geological survey using the geological dip and strike already obtained at the more than 1,500 data points. Based on these geological data, the geological structure provinceis divided into two types those are a tilt block and a folding belt at west and east sides, respectively. The Western tilting block and an Eastern folding belt trend NS strike and NNE-SSW strike, respectively. As a result of the geomorphic decipherment in alignment with ISTL using the air photograph, flexure scarp of east side upheaval is formed in the fluvial terrace side and it is difficult for the terrace riser which crosses flexure scarp and a valley to observe lateral offset. The tilt block,

  2. Dosimetry and field matching for radiotherapy to the breast and superclavicular fossa

    NASA Astrophysics Data System (ADS)

    Winfield, Elizabeth

    Radiotherapy for early breast cancer aims to achieve local disease control and decrease loco-regional recurrence rates. Treatment may be directed to breast or chest wall alone or, include regional lymph nodes. When using tangential fields to treat the breast a separate anterior field directed to the axilla and supraclavicular fossa (SCF) is needed to treat nodal areas. The complex geometry of this region necessitates matching of adjacent radiation fields in three dimensions. The potential exists for zones of overdosage or underdosage along the match line. Cosmetic results may be compromised if treatment fields are not accurately aligned. Techniques for field matching vary between centres in the UK. A study of dosimetry across the match line region using different techniques, as reported in the multi-centre START Trial Quality Assurance (QA) programme, was undertaken. A custom-made anthropomorphic phantom was designed to assess dose distribution in three dimensions using film dosimetry. Methods with varying degrees of complexity were employed to match tangential and SCF beams. Various techniques combined half beam blocking and machine rotations to achieve geometric alignment. Matching of asymmetric beams allowed a single isocentre technique to be used. Where field matching was not undertaken a gap between tangential and SCF fields was employed. Results demonstrated differences between techniques in addition to variations within the same technique between different centres. Geometric alignment techniques produced more homogenous dose distributions in the match region than gap techniques or those techniques not correcting for field divergence. For this multi-centre assessment of match plane techniques film dosimetry used in conjunction with a breast shaped phantom provided relative dose information. This study has highlighted the difficulties of matching treatment fields to achieve homogenous dose distribution through the region of the match plane and the degree of

  3. The Vindija Neanderthal scapular glenoid fossa: comparative shape analysis suggests evo-devo changes among Neanderthals.

    PubMed

    Di Vincenzo, Fabio; Churchill, Steven E; Manzi, Giorgio

    2012-02-01

    Although the shape of the scapular glenoid fossa (SGF) may be influenced by epigenetic and developmental factors, there appears to be strong genetic control over its overall form, such that variation within and between hominin taxa in SGF shape may contain information about their evolutionary histories. Here we present the results of a geometric morphometric study of the SGF of the Neanderthal Vi-209 from Vindjia Cave (Croatia), relative to samples of Plio-Pleistocene, later Pleistocene, and recent hominins. Variation in overall SGF shape follows a chronological trend from the plesiomorphic condition seen in Australopithecus to modern humans, with pre-modern species of the genus Homo exhibiting intermediate morphologies. Change in body size across this temporal series is not linearly directional, which argues against static allometry as an explanation. However, life history and developmental rates change directionally across the series, suggesting an ontogenetic effect on the observed changes in shape (ontogenetic allometry). Within this framework, the morphospace occupied by the Neanderthals exhibits a discontinuous distribution. The Vindija SGF and those of the later Near Eastern Neanderthals (Kebara and Shanidar) approach the modern condition and are somewhat segregated from both northwestern European (Neandertal and La Ferrassie) and early Mediterranean Neanderthals (Krapina and Tabun). Although more than one scenario may account for the pattern seen in the Neanderthals, the data is consistent with palaeogenetic evidence suggesting low levels of gene flow between Neanderthals and modern humans in the Near East after ca. 120-100 ka (thousands of years ago) (with subsequent introgression of modern human alleles into eastern and central Europe). Thus, in keeping with previous analyses that document some modern human features in the Vindija Neanderthals, the Vindija G(3) sample should not be seen as representative of 'classic'--that is, unadmixed, pre

  4. Evidence for Recent Liquid Water on Mars: Gullies in Sirenum Fossae Trough

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This mosaic of two Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) images shows about 20 different gullies coming down the south-facing wall of a trough in the Sirenum Fossae/Gorgonum Chaos region of the martian southern hemisphere. Each channel and its associated fan--or apron--of debris appears to have started just below the same hard, resistant layer of bedrock located approximately 100 meters (about 325 feet) below the top of the trough wall. The layer beneath this hard, resistant bedrock is interpreted to be permeable, which allows ground water to percolate through it and--at the location of this trough--seep out onto the martian surface. The channels and aprons only occur on the south-facing slope of this valley created by faults on each side of the trough. The depression is approximately 1.4 km (0.9 mi) across.

    The mosaic was constructed from two pictures taken on September 16, 1999, and May 1, 2000. The black line is a gap between the two images that was not covered by MOC. The scene covers an area approximately 5.5 kilometers (3.4 miles) wide by 4.9 km (3.0 mi) high. Sunlight illuminates the area from the upper left. The image is located near 38.5oS, 171.3oW. MOC high resolution images are taken black-and-white (grayscale); the color seen here has been synthesized from the colors of Mars observed by the MOC wide angle cameras and by the Viking Orbiters in the late 1970s.

  5. Shallow radar (SHARAD) sounding observations of the Medusae Fossae Formation, Mars

    USGS Publications Warehouse

    Carter, L.M.; Campbell, B.A.; Watters, T.R.; Phillips, R.J.; Putzig, N.E.; Safaeinili, A.; Plaut, J.J.; Okubo, C.H.; Egan, A.F.; Seu, R.; Biccari, D.; Orosei, R.

    2009-01-01

    The SHARAD (shallow radar) sounding radar on the Mars Reconnaissance Orbiter detects subsurface reflections in the eastern and western parts of the Medusae Fossae Formation (MFF). The radar waves penetrate up to 580 m of the MFF and detect clear subsurface interfaces in two locations: west MFF between 150 and 155?? E and east MFF between 209 and 213?? E. Analysis of SHARAD radargrams suggests that the real part of the permittivity is ???3.0, which falls within the range of permittivity values inferred from MARSIS data for thicker parts of the MFF. The SHARAD data cannot uniquely determine the composition of the MFF material, but the low permittivity implies that the upper few hundred meters of the MFF material has a high porosity. One possibility is that the MFF is comprised of low-density welded or interlocked pyroclastic deposits that are capable of sustaining the steep-sided yardangs and ridges seen in imagery. The SHARAD surface echo power across the MFF is low relative to typical martian plains, and completely disappears in parts of the east MFF that correspond to the radar-dark Stealth region. These areas are extremely rough at centimeter to meter scales, and the lack of echo power is most likely due to a combination of surface roughness and a low near-surface permittivity that reduces the echo strength from any locally flat regions. There is also no radar evidence for internal layering in any of the SHARAD data for the MFF, despite the fact that tens-of-meters scale layering is apparent in infrared and visible wavelength images of nearby areas. These interfaces may not be detected in SHARAD data if their permittivity contrasts are low, or if the layers are discontinuous. The lack of closely spaced internal radar reflectors suggests that the MFF is not an equatorial analog to the current martian polar deposits, which show clear evidence of multiple internal layers in SHARAD data. ?? 2008 Elsevier Inc.

  6. Posterior cruciate ligament removal contributes to abnormal knee motion during posterior stabilized total knee arthroplasty.

    PubMed

    Cromie, Melinda J; Siston, Robert A; Giori, Nicholas J; Delp, Scott L

    2008-11-01

    Abnormal anterior translation of the femur on the tibia has been observed in mid flexion (20-60 degrees ) following posterior stabilized total knee arthroplasty. The underlying biomechanical causes of this abnormal motion remain unknown. The purpose of this study was to isolate the effects of posterior cruciate ligament removal on knee motion after total knee arthroplasty. We posed two questions: Does removing the posterior cruciate ligament introduce abnormal anterior femoral translation? Does implanting a posterior stabilized prosthesis change the kinematics from the cruciate deficient case? Using a navigation system, we measured passive knee kinematics of ten male osteoarthritic patients during surgery after initial exposure, after removing the anterior cruciate ligament, after removing the posterior cruciate ligament, and after implanting the prosthesis. Passively flexing and extending the knee, we calculated anterior femoral translation and the flexion angle at which femoral rollback began. Removing the posterior cruciate ligament doubled anterior translation (from 5.1 +/- 4.3 mm to 10.4 +/- 5.1 mm) and increased the flexion angle at which femoral rollback began (from 31.2 +/- 9.6 degrees to 49.3 +/- 7.3 degrees). Implanting the prosthesis increased the amount of anterior translation (to 16.1 +/- 4.4 mm), and did not change the flexion angle at which femoral rollback began. Abnormal anterior translation was observed in low and mid flexion (0-60 degrees) after removing the posterior cruciate ligament, and normal motion was not restored by the posterior stabilized prosthesis.

  7. Posterior odontoid process angulation in pediatric Chiari I malformation: an MRI morphometric external validation study.

    PubMed

    Ladner, Travis R; Dewan, Michael C; Day, Matthew A; Shannon, Chevis N; Tomycz, Luke; Tulipan, Noel; Wellons, John C

    2015-08-01

    OBJECT Osseous anomalies of the craniocervical junction are hypothesized to precipitate the hindbrain herniation observed in Chiari I malformation (CM-I). Previous work by Tubbs et al. showed that posterior angulation of the odontoid process is more prevalent in children with CM-I than in healthy controls. The present study is an external validation of that report. The goals of our study were 3-fold: 1) to externally validate the results of Tubbs et al. in a different patient population; 2) to compare how morphometric parameters vary with age, sex, and symptomatology; and 3) to develop a correlative model for tonsillar ectopia in CM-I based on these measurements. METHODS The authors performed a retrospective review of 119 patients who underwent posterior fossa decompression with duraplasty at the Monroe Carell Jr. Children's Hospital at Vanderbilt University; 78 of these patients had imaging available for review. Demographic and clinical variables were collected. A neuroradiologist retrospectively evaluated preoperative MRI examinations in these 78 patients and recorded the following measurements: McRae line length; obex displacement length; odontoid process parameters (height, angle of retroflexion, and angle of retroversion); perpendicular distance to the basion-C2 line (pB-C2 line); length of cerebellar tonsillar ectopia; caudal extent of the cerebellar tonsils; and presence, location, and size of syringomyelia. Odontoid retroflexion grade was classified as Grade 0, > 90°; Grade I,85°-89°; Grade II, 80°-84°; and Grade III, < 80°. Age groups were defined as 0-6 years, 7-12 years, and 13-17 years at the time of surgery. Univariate and multivariate linear regression analyses, Kruskal-Wallis 1-way ANOVA, and Fisher's exact test were performed to assess the relationship between age, sex, and symptomatology with these craniometric variables. RESULTS The prevalence of posterior odontoid angulation was 81%, which is almost identical to that in the previous report

  8. Fundus autofluorescence imaging in posterior uveitis.

    PubMed

    Durrani, Khayyam; Foster, C Stephen

    2012-01-01

    Although the phenomenon of fundus autofluorescence has been known for decades, it has only recently been recognized as a measure of retinal pigment epithelial function and health. Characteristic fundus autofluorescence patterns have been described in eyes affected by inflammation of the posterior segment, and these patterns have provided insights into the pathogenesis of posterior uveitis entities. In addition, preliminary data indicate that fundus autofluorescence characteristics may serve as markers of disease activity, allow prediction of visual prognosis, and may help determine the adequacy of therapy. We provide an overview of the current state of fundus autofluorescence imaging technology and review our current knowledge of fundus autoflourescence findings and their clinical use in the posterior uveitis entities.

  9. Reversible cortical blindness: posterior reversible encephalopathy syndrome.

    PubMed

    Bandyopadhyay, Sabyasachi; Mondal, Kanchan Kumar; Das, Somnath; Gupta, Anindya; Biswas, Jaya; Bhattacharyya, Subir Kumar; Biswas, Gautam

    2010-11-01

    Cortical blindness is defined as visual failure with preserved pupillary reflexes in structurally intact eyes due to bilateral lesions affecting occipital cortex. Bilateral oedema and infarction of the posterior and middle cerebral arterial territory, trauma, glioma and meningioma of the occipital cortex are the main causes of cortical blindness. Posterior reversible encephalopathy syndrome (PRES) refers to the reversible subtype of cortical blindness and is usually associated with hypertension, diabetes, immunosuppression, puerperium with or without eclampsia. Here, 3 cases of PRES with complete or partial visual recovery following treatment in 6-month follow-up are reported.

  10. Posterior cortical atrophy: a brief review.

    PubMed

    Kirshner, Howard S; Lavin, Patrick J M

    2006-11-01

    Posterior cortical atrophy is a striking clinical syndrome in which a dementing illness begins with visual symptoms. Initially, the problem may seem to be loss of elementary vision, but over time the patient develops features of visual agnosia, topographical difficulty, optic ataxia, simultanagnosia, ocular apraxia (Balint's syndrome), alexia, acalculia, right-left confusion, and agraphia (Gerstmann's syndrome), and later a more generalized dementia. Occasional patients have visual hallucinations and signs of Parkinson's disease or Lewy body dementia. A number of different neuropathologic disorders are associated with posterior cortical atrophy.

  11. Young Debris Flows of Elysium Fossae and Utopia Planitia, Mars: Implications for Eruptive Sequences, Styles, and Mechanisms

    NASA Astrophysics Data System (ADS)

    Skinner, J. A.; Tanaka, K. L.

    2001-05-01

    Late-stage volcanic activity along the northwest flank of the Elysium volcanic construct deposited a variably fluidized sequence of channelized debris flows, in some cases >1500 km long, into Utopia Planitia. Using integrated imagery and topographic datasets, we have re-examined the stratigraphic relationships of these channelized deposits to help elucidate their history and evolution. Source troughs and chaotic depressions developed from differential heating along distributed patterns of pre-existing structures. Concentrated heating and intrusion along these structures caused collapse and mobilization of debris into laharic flows. Volumetric comparisons suggest that depressions within source terrains (Elysium Fossae and Galaxias Chaos/Fossae) inadequately account for the deposit volume. Though the volumes removed from the flanks of Elysium Mons regionally exceed 104 km3, the channelized deposits comprise >6x104 km3 as determined by cut/fill relations. These comparisons suggest the incorporation of substantial amounts of juvenile volcanic material while the lengthy run-out, smooth floors, and lobate terminations within the channelized deposits point to emplacement of highly fluidized debris. We are currently investigating the supplying relationships between the relatively shallow ( ~300 meters) northern source fossae and chaos and the topographically unconnected and considerably deeper troughs ( ~3000 meters) of Elysium Fossae in the south. We recognize subtle variations in morphologic styles between the southern and northern channelized flow deposits. Both deposits display extensive smooth medial floors bound by higher standing rugged terrains, which apparently acted as constructional "levees" constricting distribution into Utopia Planitia. However, potential pseudocraters, "softened" terrain, and discontinuous elevated channels suggest that the northern flows incorporated more volatile material and/or were emplaced upon volatile rich terrains. Regionally, the

  12. Cerebrospinal fluid dynamics in the human cranial subarachnoid space: an overlooked mediator of cerebral disease. II. In vitro arachnoid outflow model

    PubMed Central

    Holman, David W.; Kurtcuoglu, Vartan; Grzybowski, Deborah M.

    2010-01-01

    The arachnoid membrane (AM) and granulations (AGs) are important in cerebrospinal fluid (CSF) homeostasis, regulating intracranial pressure in health and disease. We offer a functional perspective of the human AM's transport mechanism to clarify the role of AM in the movement of CSF and metabolites. Using cultures of human AG cells and a specialized perfusion system, we have shown that this in vitro model mimics the in vivo characteristics of unidirectional fluid transport and we present the first report of serum-free permeability values (92.5 µl min−1 mm Hg−1 cm−2), which in turn are in agreement with the CSF outflow rates derived from a dynamic, in vivo magnetic resonance imaging-based computational model of the subarachnoid cranial space (130.9 µl min−1 mm Hg−1 cm−2). Lucifer yellow permeability experiments have verified the maintenance of tight junctions by the arachnoidal cells with a peak occurring around 21 days post-seeding, which is when all perfusion experiments were conducted. Addition of ruthenium red to the perfusate, and subsequent analysis of its distribution post-perfusion, has verified the passage of perfusate via both paracellular and transcellular mechanisms with intracellular vacuoles of approximately 1 µm in diameter being the predominant transport mechanism. The comparison of the computational and in vitro models is the first report to measure human CSF dynamics functionally and structurally, enabling the development of innovative approaches to modify CSF outflow and will change concepts and management of neurodegenerative diseases resulting from CSF stagnation. PMID:20335192

  13. Treatment rationale of fractured posterior teeth.

    PubMed

    Silvestri, A R; Singh, I

    1978-11-01

    The four types of fractures most frequently encountered in posterior teeth--obliquely directed complete fractures, vertically directed complete fractures, obliquely directed incomplete fractures, and vertically directed incomplete fractures--have been described. A detailed treatment approach for each type has been presented.

  14. Posterior Predictive Model Checking in Bayesian Networks

    ERIC Educational Resources Information Center

    Crawford, Aaron

    2014-01-01

    This simulation study compared the utility of various discrepancy measures within a posterior predictive model checking (PPMC) framework for detecting different types of data-model misfit in multidimensional Bayesian network (BN) models. The investigated conditions were motivated by an applied research program utilizing an operational complex…

  15. Posterior Probabilities for a Consensus Ordering.

    ERIC Educational Resources Information Center

    Fligner, Michael A.; Verducci, Joseph S.

    1990-01-01

    The concept of consensus ordering is defined, and formulas for exact and approximate posterior probabilities for consensus ordering are developed under the assumption of a generalized Mallows' model with a diffuse conjugate prior. These methods are applied to a data set concerning 98 college students. (SLD)

  16. Complicated posterior capsulorhexis: aetiology, management, and outcome

    PubMed Central

    Van Cauwenberge, F.; Rakic, J.; Galand, A.

    1997-01-01

    BACKGROUND—A 1 year retrospective analysis of 650 patients, who underwent a posterior capsulorhexis on their intact capsules, was performed to examine the incidence of complications, their aetiologies, and the outcome.
METHODS—Data were analysed on 32 patients with complicated capsulorhexis for type of surgery, preoperative and postoperative factors, and relative risk factors for vitreous issue.
RESULTS—There were six patients with vitreous loss. The posterior capsulorhexis was uncontrolled in 14 cases and difficult to perform in 12 cases. Implantation into the capsular bag was possible in all cases. Systemic vascular hazard and old age (over 80 years) were found to be statistically significant risk factors for vitreous loss (p=0.002 and p=0.03 respectively). The mean follow up was 13.5 months (range 4-25 months). One patient developed a retinal detachment and two had a transient clinical cystoid macular oedema. Visual acuity of ≥ 20/40 was obtained in 93% of the patients.
CONCLUSION—Loss of control of the posterior capsulorhexis has a low incidence but can lead to serious problems during surgery. A good knowledge of the technique is necessary to complete the procedure with a posterior capsulorhexis of the optimum size without vitreous loss.

 PMID:9135382

  17. Subspecialization in the human posterior medial cortex

    PubMed Central

    Bzdok, Danilo; Heeger, Adrian; Langner, Robert; Laird, Angela R.; Fox, Peter T.; Palomero-Gallagher, Nicola; Vogt, Brent A.; Zilles, Karl; Eickhoff, Simon B.

    2014-01-01

    The posterior medial cortex (PMC) is particularly poorly understood. Its neural activity changes have been related to highly disparate mental processes. We therefore investigated PMC properties with a data-driven exploratory approach. First, we subdivided the PMC by whole-brain coactivation profiles. Second, functional connectivity of the ensuing PMC regions was compared by task-constrained meta-analytic coactivation mapping (MACM) and task-unconstrained resting-state correlations (RSFC). Third, PMC regions were functionally described by forward/reverse functional inference. A precuneal cluster was mostly connected to the intraparietal sulcus, frontal eye fields, and right temporo-parietal junction; associated with attention and motor tasks. A ventral posterior cingulate cortex (PCC) cluster was mostly connected to the ventromedial prefrontal cortex and middle left inferior parietal cortex (IPC); associated with facial appraisal and language tasks. A dorsal PCC cluster was mostly connected to the dorsomedial prefrontal cortex, anterior/posterior IPC, posterior midcingulate cortex, and left dorsolateral prefrontal cortex; associated with delay discounting. A cluster in the retrosplenial cortex was mostly connected to the anterior thalamus and hippocampus. Furthermore, all PMC clusters were congruently coupled with the default mode network according to task-constrained but not task-unconstrained connectivity. We thus identified distinct regions in the PMC and characterized their neural networks and functional implications. PMID:25462801

  18. Fuchs's heterochromic cyclitis and posterior capsulotomy.

    PubMed Central

    Roussel, T J; Coster, D J

    1985-01-01

    We report a case of intractable glaucoma following an uncomplicated secondary posterior capsulotomy in a 48-year-old male with Fuchs's heterochromic cyclitis. The patient had been free of inflammation and glaucoma since cataract extraction 27 years previously. We also report the results of phenotypic analysis of lymphocytes removed from the anterior chamber. Images PMID:3859323

  19. Posterior dislocation of the shoulder in athletes.

    PubMed

    Samilson, R L; Prieto, V

    1983-07-01

    Although posterior dislocation of the shoulder is a rare injury in athletes, failure to recognize and properly manage acute dislocation may have serious consequences. The article discusses the incidence, mechanism of injury, classification, pathologic findings, clinical and radiologic diagnosis, and management.

  20. A New Method to Explore the Spectral Impact of the Piriform Fossae on the Singing Voice: Benchmarking Using MRI-Based 3D-Printed Vocal Tracts

    PubMed Central

    Delvaux, Bertrand; Howard, David

    2014-01-01

    The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics) is introduced. The findings support results in the literature: the piriform fossae create a spectral trough in the region 4–5 kHz and act as formants repellents. Moreover, this study extends those results by demonstrating numerically and perceptually the impact of having large piriform fossae on the sung output. PMID:25048199

  1. A new method to explore the spectral impact of the piriform fossae on the singing voice: benchmarking using MRI-based 3D-printed vocal tracts.

    PubMed

    Delvaux, Bertrand; Howard, David

    2014-01-01

    The piriform fossae are the 2 pear-shaped cavities lateral to the laryngeal vestibule at the lower end of the vocal tract. They act acoustically as side-branches to the main tract, resulting in a spectral zero in the output of the human voice. This study investigates their spectral role by comparing numerical and experimental results of MRI-based 3D printed Vocal Tracts, for which a new experimental method (based on room acoustics) is introduced. The findings support results in the literature: the piriform fossae create a spectral trough in the region 4-5 kHz and act as formants repellents. Moreover, this study extends those results by demonstrating numerically and perceptually the impact of having large piriform fossae on the sung output.

  2. Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications

    PubMed Central

    Herranz-Aparicio, Judit; Marques, José; Almendros-Marqués, Nieves

    2016-01-01

    Background In order to choose the appropriate implant size and to prevent complications, an oral surgeon must know the size and shape of the mandible. In the posterior mandibular region, a lingual undercut is often found and could represent a difficulty hard to manage if a lingual or buccal perforation occur. A large series of computed tomography (CT) images of the mandibular first molar was evaluated and the bone morphology, the prevalence and the degree of the lingual concavity in the first molar region were studied. Material and Methods One hundred and fifty-one computed tomography (CT) examinations of patients were retrospectively evaluated to determine anatomical variations in bone morphology in the submandibular fossa region. Results A total of 151 subjects were included, consisting of 64 males (M) (42.4%) and 87 females (F) (57.6%). The under-cut type ridge was present in 64.2% of the cases. The concavity angle was 66.6 ± 8.9° (M) and 71.6 ± 8.4° (F) and the linear concavity depth 4.5 ± 2.3 mm (M) and 3.1 ± 1.7 mm (F) (p>0.05). Conclusions Mandibles with any lingual concavity present a potential increased risk of lingual cortical perforation during implant placement surgery. CT imaging allows characterizing the anatomy of the submandibular fossa and provides other important information for the preoperative assessment of the posterior mandible for dental implants placement. Key words:Anatomy, computed tomography, dental implants, intraoperative complications, mandible, panoramic radiography, radiographic examination. PMID:27694785

  3. Path to the Interpeduncular Fossa: Anatomical Comparison of Endoscopic-Assisted versus Standard Subtemporal Approach

    PubMed Central

    Lamki, Tariq; Salma, Asem; Baidya, Nishanta; Ammirati, Mario

    2012-01-01

    Objective The aim of this study was to assess the assumed advantage of endoscopic assistance to the standard subtemporal approach. The idea was to measure qualitatively and quantitatively visibility versus operability. Design We performed eight subtemporal dissections on four cadaver heads. Our dissections integrated an operating microscope, endoscope, and neuronavigation. Comparison was made between visibility and operability afforded by the microscope alone or by the microscope–endoscope combination. Visibility was recorded as complete or incomplete and was quantified for key structures using linear measurements taken by the navigation system. Operability was determined by whichever maneuvers could be safely and comfortably accomplished in the space afforded. Results From our survey, the structures whose visibility most benefitted from the addition of the endoscope include: contralateral third nerve, posterior perforated substance, mammillary bodies, and contralateral superior cerebellar artery. With regard to quantitative evaluation, we found increased visibility of both basilar artery and posterior cerebral artery. With regard to the operability, no objective advantage was afforded by the addition of the endoscope. Subjectively, the maneuvers were easier to perform while using the endoscope. Conclusion Using the endoscope as an assistance tool during conducting classical subtemporal approach can help in overcome a lot of the classical subtemporal approach limitations. PMID:23905002

  4. Displacement-length relationship of normal faults in Acheron Fossae, Mars: new observations with HRSC.

    NASA Astrophysics Data System (ADS)

    Charalambakis, E.; Hauber, E.; Knapmeyer, M.; Grott, M.; Gwinner, K.

    2007-08-01

    For Earth, data sets and models have shown that for a fault loaded by a constant remote stress, the maximum displacement on the fault is linearly related to its length by d = gamma · l [1]. The scaling and structure is self-similar through time [1]. The displacement-length relationship can provide useful information about the tectonic regime.We intend to use it to estimate the seismic moment released during the formation of Martian fault systems and to improve the seismicity model [2]. Only few data sets have been measured for extraterrestrial faults. One reason is the limited number of reliable topographic data sets. We used high-resolution Digital Elevation Models (DEM) [3] derived from HRSC image data taken from Mars Express orbit 1437. This orbit covers an area in the Acheron Fossae region, a rift-like graben system north of Olympus Mons with a "banana"-shaped topography [4]. It has a fault trend which runs approximately WNW-ESE. With an interactive IDL-based software tool [5] we measured the fault length and the vertical offset for 34 faults. We evaluated the height profile by plotting the fault lengths l vs. their observed maximum displacement (dmax-model). Additionally, we computed the maximum displacement of an elliptical fault scarp where the plane has the same area as in the observed case (elliptical model). The integration over the entire fault length necessary for the computation of the area supresses the "noise" introduced by local topographic effects like erosion or cratering. We should also mention that fault planes dipping 60 degree are usually assumed for Mars [e.g., 6] and even shallower dips have been found for normal fault planes [7]. This dip angle is used to compute displacement from vertical offset via d = h/(h*sinα), where h is the observed topographic step height, and ? is the fault dip angle. If fault dip angles of 30 degree are considered, the displacement differs by 40% from the one of dip angles of 60 degree. Depending on the data

  5. Right and left heart catheterization via an antecubital fossa vein and the radial artery--a prospective study.

    PubMed

    Williams, Paul D; Palmer, Sonny; Judkins, Chris; Gutman, Jack; Whitbourn, Rob; MacIsaac, Andrew; Xu, Bo; Burns, Andrew; Wilson, Andrew

    2014-12-01

    Right heart catheterization has been described via the arm but previous reports have been retrospective, performed for limited indications, and may not give an accurate assessment of the success rate or safety of this technique. We sought to prospectively examine the feasibility and safety of left and right heart catheterization entirely via the arm using the radial artery and an antecubital fossa vein for a broad range of indications. Fifty-eight consecutive procedures were included. Transradial arterial access was successful in 57 patients (98%), right heart catheterization via the antecubital fossa vein was successful in 54 patients (93%) and bilateral catheterization from the arm was achieved in 53 patients (91%). Standard diagnostic catheterization was the most frequent procedure (59%), although thermodilution (6.9%), percutaneous coronary intervention (33%), and coronary sinus sampling (16%) were also performed in selected cases. Compared to a historical cohort of patients undergoing right and left heart catheterization via femoral access, mean procedural time (38 vs 47 minutes; P=.03) and screening time (8.1 vs 11.2 minutes; P<.001) were significantly reduced. There was 1 venous forearm hematoma that was managed conservatively. Right and left heart catheterization can be performed routinely via the arm in a broad range of patients and is associated with reduced procedural and fluoroscopy time as compared to femoral access. This approach can be considered for all patients in whom right and left heart catheterization is planned.

  6. Towards an evidence-based management of right iliac fossa pain in the over 50-year-old patient

    PubMed Central

    Gammeri, E; Catton, A; van Duren, BH; Appleton, SG

    2016-01-01

    Introduction Right iliac fossa pain is a common presenting complaint to general surgery. The differential diagnosis is wide, particularly in the elderly. Computed tomography (CT) is often used in the ‘older’ population, as they have a higher prevalence of acute colonic diverticulitis and colonic neoplasia, both of which should be identified prior to surgery. There is, however, no published evidence to support this practice. Methods We retrospectively reviewed the records of all patients aged over 50 years who presented with right iliac fossa (RIF) pain to a district general hospital. We determined whether tenderness was predominantly right- or left-sided and whether systemic inflammatory response syndrome (SIRS) was present on admission. The use of imaging modalities, their results and, if performed, operative findings were recorded. Results Of 3160 patients identified, 89 met the inclusion criteria. Diagnoses included appendicitis (27%), neoplasia (15%), non-specific abdominal pain (15%) and acute colonic diverticulitis (10%). CT was performed in 82% of patients, with a sensitivity of 97% based on operative findings. Six patients underwent surgery without a scan, two of whom required a change in the planned procedure due to unexpected findings. Conclusions Unless contraindicated, CT scanning should be mandatory in patients aged over 50 years presenting with signs of peritonism in the RIF or lower abdomen. PMID:27269436

  7. A case of symptomatic mass in the right iliac fossa: a Bermuda Triangle which often lies the right diagnosis.

    PubMed

    Panarese, Alessandra; Pironi, Daniele; Pontone, Stefano; Vendettuoli, Maurizio; De Cristofaro, Flaminia; Antonelli, Manila; Romani, Annamaria; Filippini, Angelo

    2014-02-24

    Disease of the iliac fossa can often be accompanied by non-specific symptoms and some of these are exclusively caused by the compression of bulky masses of other neighboring structures. In young women a differential diagnosis is a non trivial task as several possible causes have to be taken into account. Thus, intraligamentary tumors, which are extremely rare finding, are frequently confused with uterus, ovary or intestinal tumors. Even if myomas are the most benign tumors of the female genital tract, broad ligament leiomyomas are an unusual finding in women of reproductive age. These tumors are often asymptomatic until they reach a volume likely to cause symptoms related to the mass pressure. An accurate patient's anamnesis and examination serve as a guide to further examinations. Ultrasound is the first line imaging as it can show ovarian or other pelvic mass and doesn't involve exposure to radiations in young patients, who can be pregnant. We describe the clinical presentation and imaging features of a broad ligament leiomyoma, which presented as an inguinal mass in a patient with a right iliac fossa pain. We also report our diagnostic process performing the differential diagnosis with other potential pathologies of RIF. In these cases, a preoperative disease classification discriminating the benign or malignant tumor nature is closely linked to the proper patient management.

  8. The efficacy of fibrin glue injection in the prostatic fossa on decreasing postoperative bleeding following transurethral resection of prostate

    PubMed Central

    Khorrami, Mohammad Hatef; Tadaion, Farhad; Ghanaat, Iman; Alizadeh, Farshid

    2016-01-01

    Background: To evaluate the efficacy of fibrin glue injection in the prostatic fossa at the end of transurethral resection of prostate (TURP), in decreasing postoperative bleeding in patient with benign prostatic hyperplasia (BPH). Materials and Methods: In this prospective randomized clinical trial, sixty patients with BPH, who were a candidate for TURP, were randomly divided into two equal groups. In the intervention group, 10cc of fibrin glue was injected in the prostatic fossa at the end of the surgery; through a 5 Fr feeding tube attached to Foley catheter and its tip was proximal to the balloon of catheter. The other thirty patients created the control group. Hemoglobin (Hb) level and lower urinary tract symptoms (LUTS) score were recorded before and 6, 24, 48 h, and 5 days after TURP. Results: The mean age of the patients and prostate volumes were comparable between the groups. The mean Hb level before and 6 h after TURP were not different between the two groups, however, 24 and 48 h and 5 days after TURP, there was a significant difference as well as a higher decrease in the mean Hb level of the control group (P = 0.023). The mean LUTS score was not statistically different between the two groups. Conclusion: Fibrin glue injection in the prostatic after TURP reduces postoperative bleeding without any effect on LUTS score in patients with BPH. PMID:27995100

  9. [Bilateral cerebellopontine arachnoid cyst].

    PubMed

    Gelabert-Gonzalez, M; Aran-Echabe, E; Pita-Buezas, L

    2016-06-16

    Introduccion. Los quistes aracnoideos bilaterales del angulo pontocerebeloso son excepcionales, y unicamente existen tres casos publicados en la bibliografia. Caso clinico. Niña de 14 años, previamente sana, que acude a consultas por presentar cefalea bifrontal de seis semanas de evolucion. La exploracion clinica era normal y la resonancia magnetica craneal mostraba dos lesiones extraaxiales localizadas en ambos angulos pontocerebelosos, siendo ligeramente mayor la izquierda. Las lesiones se comportaban como homogeneamente intensas en T1 e hiperintensas en T2, no captaban contraste y no existia restriccion en las secuencias de difusion. No se indico tratamiento quirurgico. Conclusiones. Los quistes aracnoideos bilaterales situados en el angulo pontocerebeloso son excepcionales. La principal indicacion para el tratamiento quirurgico es la presencia de sintomas o signos neurologicos coincidentes con la localizacion de los quistes.

  10. Posterior Wnts Have Distinct Roles in Specification and Patterning of the Planarian Posterior Region

    PubMed Central

    Sureda-Gómez, Miquel; Pascual-Carreras, Eudald; Adell, Teresa

    2015-01-01

    The wnt signaling pathway is an intercellular communication mechanism essential in cell-fate specification, tissue patterning and regional-identity specification. A βcatenin-dependent signal specifies the AP (Anteroposterior) axis of planarians, both during regeneration of new tissues and during normal homeostasis. Accordingly, four wnts (posterior wnts) are expressed in a nested manner in central and posterior regions of planarians. We have analyzed the specific role of each posterior wnt and the possible cooperation between them in specifying and patterning planarian central and posterior regions. We show that each posterior wnt exerts a distinct role during re-specification and maintenance of the central and posterior planarian regions, and that the integration of the different wnt signals (βcatenin dependent and independent) underlies the patterning of the AP axis from the central region to the tip of the tail. Based on these findings and data from the literature, we propose a model for patterning the planarian AP axis. PMID:26556349

  11. Mapping Medusae Fossae Formation materials in the southern highlands of Mars

    NASA Astrophysics Data System (ADS)

    Harrison, S. K.; Balme, M. R.; Hagermann, A.; Murray, J. B.; Muller, J.-P.

    2010-10-01

    The Medusae Fossae Formation (MFF) is an extensive deposit (2.2 × 10 6 km 2, Bradley, B.A., Sakimoto, S.E.H., Frey, H., Zimbelman, J.R. [2002]. J. Geophys. Res. 107, 5058) of wind-eroded material of widely debated origin, which unconformably overlies a considerable area of the crustal dichotomy boundary on Mars. The MFF shows a variety of layering patterns, erosional styles and channel-like forms and has been mapped into five main outcrops and three geological members according to exposure and stratigraphy (Scott, D.H., Tanaka, K.L., 1986. USGS Map I-1802-A; Greeley, R., Guest, J.E., 1987. Map I-1802-B; Zimbelman, J.R., Crown, D., Jenson, D., 1996. Lunar Planet. Sci. XXVII. Abstract #1748.). Away from the three main lobes are numerous outliers of MFF materials. These have mainly been reported in the northern lowlands regions (Keszthelyi, L., Jaeger, W.L., and HiRISE team, 2008. Lunar Planet. Sci. XXXIX. Abstract #2420.) but few studies have examined the possibility of MFF outliers on high ground south of the dichotomy boundary. We have searched Mars Orbiter Camera Narrow Angle (MOC NA) images for outliers in this region. Our observations show that there are many MFF outliers on the southern highlands. The characteristics of the outliers indicate materials which overlie the underlying terrain for they appear widely in dips, craters and topographic lows. The surfaces are typified by yardang fields and have a similar patchy and discontinuous nature to materials of the upper member of the MFF. Most have consistent lineation orientations across the wider area which match the dominant orientation of yardangs in the main MFF outcrops. Furthermore, elevation data shows that the maximum, minimum and mean elevations of these newly discovered outliers are closest to those of the upper member of the MFF. We therefore conclude that these deposits are MFF outliers and that they probably represent remnant upper member material. We suggest that there might be two possible

  12. [Manual rotation of occiput posterior presentation].

    PubMed

    Le Ray, C; Goffinet, F

    2011-10-01

    Delivery in occiput posterior position is associated with a higher risk of cesarean section, operative vaginal delivery and severe perineal tears. We report the technic of manual rotation described by Tarnier and Chantreuil and used daily in our maternity center. Only five studies were published on this topic; all of them demonstrate that manual rotation decreases the risk of cesarean section. Moreover, it could decrease the risk of prolonged second stage, chorioamnionitis and third and fourth degree tears in comparison with expectant management. However, manual rotation is associated with a two-fold higher risk of cervical and vaginal lacerations. Manual rotation performed with an adequate technic is an efficient and safe manœuvre to avoid complications associated with occiput posterior vaginal delivery.

  13. Acute traumatic posterior elbow dislocation in children.

    PubMed

    Lieber, Justus; Zundel, Sabine M; Luithle, Tobias; Fuchs, Jörg; Kirschner, Hans-Joachim

    2012-09-01

    Traumatic posterior dislocation of the elbow is often associated with significant morbidity and incomplete recovery. The aim of this study was to retrospectively analyse the outcome of 33 children (median age 10.8 years). Patients underwent reduction and assessment of stability under general anaesthesia. Pure dislocations (n=10) were immobilized, whereas unstable fractures (n=23) were stabilized. Refixation of ligaments was performed if stability was not achieved by fracture stabilization alone. Immobilization was continued for 26 (pure dislocations) or 35 days (associated injuries), respectively. Results were excellent (n=9) or good (n=1) after pure dislocation. Results were excellent (n=15), good (n=7) or poor (n=1) in children with associated injuries. Accurate diagnosis, concentric stable reduction of the elbow as well as stable osteosynthesis of displaced fractures are associated with good results in children with acute posterior elbow dislocations.

  14. Posterior tibial nerve lesions in ankle arthroscopy.

    PubMed

    Cugat, Ramon; Ares, Oscar; Cuscó, Xavier; Garcia, Montserrat; Samitier, Gonzalo; Seijas, Roberto

    2008-05-01

    Ankle arthroscopy provides a minimally invasive approach to the diagnosis and treatment of certain ankle disorders. Neurological complications resulting from ankle arthroscopy have been well documented in orthopaedic and podiatric literature. Owing to the superficial location of the ankle joint and the abundance of overlying periarticular neurovascular structures, complications reported in ankle arthroscopy are greater than those reported for other joints. In particular, all reported neurovascular injuries following ankle arthroscopy have been the direct result of distractor pin or portal placement. The standard posteromedial portal has recognized risks because of the proximity of the posterior neurovascular structures. There can be considerable variability in the course of these portals and their proximity to the neurovascular structures. We found one report of intra-articular damage to the posterior tibial nerve as a result of ankle arthroscopy in the English-language literature and we report this paper as a second case described in the literature.

  15. Progressive visual agnosia with posterior cortical atrophy.

    PubMed

    Mizuno, M; Sartori, G; Liccione, D; Battelli, L; Campo, R

    1996-05-01

    A patient of posterior cortical atrophy characterized by early signs of progressive visual agnosia documented by repeated neuropsychological tests, is reported. SPECT and MRI findings showed left unilateral parieto-occipital involvement in the earlier stage. A PET study executed eight months later showed bilateral parieto-occipital hypometabolism, but predominantly in the left hemisphere. This suggests that the degeneration may have developed asymmetrically, progressing from left unilateral to bilateral.

  16. Endoscopic posterior interhemispheric complete corpus callosotomy.

    PubMed

    Sood, Sandeep; Asano, Eishi; Altinok, Deniz; Luat, Aimee

    2016-12-01

    Traditionally corpus callosotomy is done through a craniotomy centered at the coronal suture, with the aid of a microscope. This involves dissecting through the interhemispheric fissure below the falx to reach the corpus callosum. The authors describe a posterior interhemispheric approach to complete corpus callosotomy with an endoscope, which bypasses the need to perform interhemispheric dissection because the falx is generally close to the corpus callosum in this region.

  17. Material Properties of the Posterior Human Sclera☆

    PubMed Central

    Grytz, Rafael; Fazio, Massimo A.; Girard, Michael J.A.; Libertiaux, Vincent; Bruno, Luigi; Gardiner, Stuart; Girkin, Christopher A.; Downs, J. Crawford

    2013-01-01

    To characterize the material properties of posterior and peripapillary sclera from human donors, and to investigate the macro- and micro-scale strains as potential control mechanisms governing mechanical homeostasis. Posterior scleral shells from 9 human donors aged 57–90 years were subjected to IOP elevations from 5 to 45 mmHg and the resulting full-field displacements were recorded using laser speckle interferometry. Eye-specific finite element models were generated based on experimentally measured scleral shell surface geometry and thickness. Inverse numerical analyses were performed to identify material parameters for each eye by matching experimental deformation measurements to model predictions using a microstructure-based constitutive formulation that incorporates the crimp response and anisotropic architecture of scleral collagen fibrils. The material property fitting produced models that fit both the overall and local deformation responses of posterior scleral shells very well. The nonlinear stiffening of the sclera with increasing IOP was well reproduced by the uncrimping of scleral collagen fibrils, and a circumferentially-aligned ring of collagen fibrils around the scleral canal was predicted in all eyes. Macroscopic in-plane strains were significantly higher in peripapillary region then in the mid-periphery. In contrast, the meso- and micro-scale strains at the collagen network and collagen fibril level were not significantly different between regions. The elastic response of the posterior human sclera can be characterized by the anisotropic architecture and crimp response of scleral collagen fibrils. The similar collagen fibril strains in the peripapillary and mid-peripheral regions support the notion that the scleral collagen architecture including the circumpapillary ring of collagen fibrils evolved to establish optimal load bearing conditions at the collagen fibril level. PMID:23684352

  18. Iris fixation of posterior chamber intraocular lenses.

    PubMed

    Yazdani-Abyaneh, Alireza; Djalilian, Ali R; Fard, Masoud Aghsaei

    2016-12-01

    We introduce a technique for iris fixation of a posterior chamber intraocular lens (IOL) in which most of the procedure is done outside the eye. This minimizes intraocular manipulation, maximizes corneal endothelial preservation, and avoids the risk for IOL drop into the vitreous cavity intraoperatively. The IOL is fixated to the most peripheral part of the iris, resulting in a rounder pupil. Sutures are placed at exact positions on the haptics, resulting in a well-centered IOL.

  19. Cervical disc hernia operations through posterior laminoforaminotomy

    PubMed Central

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis. PMID:27217655

  20. Electrocardiographic diagnosis of remote posterior wall myocardial infarction using unipolar posterior lead V9

    SciTech Connect

    Rich, M.W.; Imburgia, M.; King, T.R.; Fischer, K.C.; Kovach, K.L. )

    1989-09-01

    The accuracy of four electrocardiographic criteria for diagnosing remote posterior myocardial infarction was assessed prospectively in 369 patients undergoing exercise treadmill testing with thallium scintigraphy. Criteria included the following: (1) R-wave width greater than or equal to 0.04 s and R-wave greater than or equal to S-wave in V1; (2) R-wave greater than or equal to S-wave in V2; (3) T-wave voltage in V2 minus V6 greater than or equal to 0.38 mV (T-wave index); (4) Q-wave greater than or equal to 0.04 s in left paraspinal lead V9. Twenty-seven patients (7.3 percent) met thallium criteria for posterior myocardial infarction, defined as a persistent perfusion defect in the posterobase of the left ventricle. Sensitivities for the four criteria ranged from 4 to 56 percent, and specificities ranged from 64 to 99 percent. Posterior paraspinal lead V9 provided the best overall predictive accuracy (94 percent), positive predictive value (58 percent), and ability to differentiate patients with and without posterior myocardial infarction of any single criterion (p less than .0001). Combining the T-wave index with lead V9 further enhanced the diagnostic yield: the sensitivity for detecting posterior infarction by at least one of these criteria was 78 percent, and when both criteria were positive, specificity was 98.5 percent. It is concluded that a single, unipolar posterior lead in the V9 position is superior to standard 12-lead electrocardiographic criteria in diagnosing remote posterior myocardial infarction, and that combining V9 with the T-wave index maximizes the diagnostic yield.

  1. Polygonal ridge networks on Mars: Diversity of morphologies and the special case of the Eastern Medusae Fossae Formation

    NASA Astrophysics Data System (ADS)

    Kerber, Laura; Dickson, James L.; Head, James W.; Grosfils, Eric B.

    2017-01-01

    Polygonal ridge networks, also known as boxwork or reticulate ridges, are found in numerous locations and geological contexts across Mars. Distinguishing the morphologies and geological context of the ridge networks sheds light on their potential as astrobiological and mineral resource sites of interest. The most widespread type of ridge morphology is characteristic of the Nili Fossae and Nilosyrtis region and consists of thin, criss-crossing ridges with a variety of heights, widths, and intersection angles. They are found in ancient Noachian terrains at a variety of altitudes (between -2500 and 2200 m) and geographic locations and are likely to be chemically altered fracture planes or mineral veins. They occur in the same general areas as valley networks and ancient lake basins, but they are not more numerous where these water-related features are concentrated, and can appear in places where th morphologies are absent. Similarly, some of the ridge networks are located near hydrated mineral detections, but there is not a one-to-one correlation. Smaller, light-toned ridges of variable widths have been found in Gale Crater and other rover sites and are interpreted to be smaller versions of the Nili-like ridges, mostly formed by the mineralization of fractures. This type of ridge is likely to be found in many other places on Mars as more high-resolution data become available. Sinus Meridiani contains many flat-topped ridges arranged into quasi-circular patterns. The ridges are eroding from a clay-rich unit, and could be formed by a similar process as the Nili-type ridges, but at a much larger scale and controlled by fractures made through a different process. Hellas Basin is host to a fourth type of ridge morphology consisting of large, thick, light-toned ridges forming regular polygons at several superimposed scales. While still enigmatic, these are most likely to be the result of sediment-filled fractures. The Eastern Medusae Fossae Formation contains large swaths

  2. Geologic Mapping of the Medusae Fossae Formation on Mars (MC-8 SE and MC-23 NW) and the Northern Lowlands of Venus (V-16 and V-15)

    NASA Technical Reports Server (NTRS)

    Zimbelman, J. R.

    2008-01-01

    This report summarizes the status of a mapping project supported by NASA grant NNX07AP42G, funding for which became available on July 18, focusing on the mapping of the Medusae Fossae Formation (MFF) on Mars. The report also briefly discusses the status of maps of Venus and Ascraeus Mons, begun under previous NASA grants but which are still in progress.

  3. Evidence for the episodic erosion of the Medusae Fossae Formation preserved within the youngest volcanic province on Mars

    NASA Astrophysics Data System (ADS)

    Morgan, Gareth A.; Campbell, Bruce A.; Carter, Lynn M.; Plaut, Jeffrey J.

    2015-09-01

    We use orbital SHAllow RADar (SHARAD) sounder data to three-dimensionally visualize the subsurface structure of Elysium Planitia, the youngest volcanic province on Mars. Our results reveal an emplacement history consisting of multiple groups of overlapping lava flow units, originating from different sources. The uniquely complex "radar stratigraphy" of Elysium Planitia, relative to other volcanic regions, requires a distinct mechanism to generate the numerous reflectors observed in SHARAD data. Sedimentary deposits interbedded with successive batches of lava flows could account for the elaborate pattern of reflectors. We infer that widespread, rapidly emplaced material sourced from the enigmatic Medusae Fossae Formation (MFF) creates these sedimentary layers. This implies that episodes of atmospheric activity, perhaps linked with the obliquity of Mars, periodically erode and redeposit material from the MFF across a large region.

  4. Favorable patient reported outcomes following IMRT for early carcinomas of the tonsillar fossa: Results from a symptom assessment study

    PubMed Central

    Gunn, GB; Hansen, CC; Garden, AS; Fuller, CD; Mohamed, ASRM; Morrison, WH; Frank, SJ; Beadle, BM; Phan, J; Chronowski, GM; Sturgis, EM; Lewis, CM; Lu, C; Hutcheson, KA; Mendoza, TR; Cleeland, CS; Rosenthal, DI

    2016-01-01

    Background A questionnaire-based study was conducted to assess long-term patient reported outcomes (PROs) following definitive IMRT-based treatment for early stage carcinomas of the tonsillar fossa. Methods: Participants had received IMRT with or without systemic therapy for squamous carcinoma of the tonsillar fossa (T1-2 and N0-2b) with a minimum follow-up of 2 years. Patients completed a validated head and neck cancer-specific PRO instrument, the MD Anderson Symptom Inventory-Head and Neck module (MDASI-HN). Symptoms were compared between treatment groups of interest and overall symptom burden was evaluated. Results Of 139 participants analyzed, 51% had received ipsilateral neck IMRT, and 62% single modality IMRT alone (no systemic therapy). There were no differences in mean individual symptom and interference ratings for those treated with bilateral versus ipsilateral neck IMRT alone. However, 40% of those treated with bilateral versus 25% of those treated with ipsilateral neck RT alone reported moderate-to-severe levels of dry mouth (p=0.03). Fatigue, numbness/tingling, and constipation were rated more severe for those who had received systemic therapy (p<0.05 for each), but absolute differences were small. Overall, 51% had no more than mild symptom ratings across all 22 symptoms assessed. Conclusions The long-term patient reported symptom profile in this cohort of tonsil cancer survivors treated with definitive IMRT-based treatment showed a majority of patients with no more than mild symptoms, low symptom interference, and provides an opportunity for future comparison studies with other treatment approaches. PMID:26403258

  5. Shallow hydrothermal alteration and permeability changes in pyroclastic deposits: a case study at La Fossa cone (Vulcano island, Italy):

    NASA Astrophysics Data System (ADS)

    Cangemi, Marianna; Madonia, Paolo; Speziale, Sergio; Oliveri, Ygor

    2016-04-01

    La Fossa cone at Vulcano, the southernmost island of the Aeolian volcanic archipelago (Italy), has been characterized by an intense fumarolic activity since its last eruption dated 1888-90. Mineralogical alteration induced by shallow hydrothermal circulation has significantly reduced the permeability of the volcanic products, causing important feedbacks on the circulation of fluids in the shallowest portion of the volcanic edifice. The summit area of the cone is sealed by a quite continuous coating surface, fostering the condensation of hydrothermal fluids inside the volcanic edifice. The combination of fractures and volcano-stratigraphic discontinuities, conveying hydrothermal fluids, makes significant rock volumes prone to slide seaward, as occurred in 1988 during the main unrest experienced by Vulcano island since its last eruption. Similar instability conditions are found over the Forgia Vecchia crater rim area, formed by phreatic activity on the NE flank of the cone, where tensile fracturing and hydrothermal circulation interacts with mutual negative feedbacks. In the behalf of the DPC-INGV V3 Project 2012-15 we investigated the mineralogical composition and the hydraulic conductivity (under saturated conditions) of volcanic deposits potentially prone to hydrothermal fluid circulation, for evaluating their ability in retaining water, creating favourable conditions for gravitational instability. We also measured rainfall rate and volumetric soil moisture content in two automated stations located in different areas, with and without active hydrothermal circulation. We found that hydrothermal alteration transforms volcanic products into clay minerals, significantly reducing permeability of volcanic deposits. Argillified volcanic materials show background water contents, modulated by impulsive increments following rainfalls, higher than unaltered pyroclastic deposits, due to the combination of lower permeability and direct condensation of hydrothermal vapour. The

  6. Posterior ventricular anchoring neochordal repair of degenerative mitral regurgitation efficiently remodels and repositions posterior leaflet prolapse†

    PubMed Central

    Woo, Y. Joseph; MacArthur, John W.

    2013-01-01

    OBJECTIVES Mitral valve repair techniques for degenerative disease typically entail leaflet resection or neochordal construction, which may require extensive resection, leaflet detachment/reattachment, reliance on diseased native chords or precise neochordal measuring. Occasionally, impaired leaflet mobility, reduced coaptation surface and systolic anterior motion (SAM) may result. We describe a novel technique for addressing posterior leaflet prolapse/flail, which both simplifies repair and addresses these issues. METHODS Fifty-four patients (age 62 ± 11 years) with degenerative MR underwent this new repair, 36 of whom minimally-invasively. A CV5 Gore-Tex suture was placed into the posterior left ventricular myocardium underneath the prolapsing segment as an anchor. This suture was then used to imbricate a portion of the prolapsed segment into the ventricle, creating a smooth, broad, non-prolapsed coapting surface on a leaflet with preserved mobility, additional neochordal support and posteriorly positioned enough to preclude SAM. RESULTS Repair was successful in all patients. The mean MR grade was reduced from +3.8 to +0.1 with 50 of 54 patients having zero MR and 4 of the 54 having trace or mild MR. All patients had proper antero-posterior location of the coaptation line of a mean length of 10.2 mm, and preserved posterior leaflet mobility. No patients had SAM or mitral stenosis. All patients were discharged and are currently doing well. CONCLUSION This new technique facilitated efficient single-suture repair of the prolapsed posterior leaflet mitral regurgitation without the need for resection or sliding annuloplasty. It precluded the need for precise neochordal measurement and preserved the leaflet coaptation surface. PMID:23449863

  7. Talar Osteochondroma Fracture Presenting as Posterior Ankle Impingement.

    PubMed

    Ercin, Ersin; Bilgili, Mustafa Gokhan; Gamsizkan, Mehmet; Avsar, Serdar

    2016-05-01

    Osteochondromas are the most common benign bone tumors. They are usually asymptomatic and found incidentally. When symptomatic, the symptoms are usually due to its location and size. Fracture of an osteochondroma presenting as posterior ankle impingement is a rare condition. We describe a 22-year-old man with solitary exostosis who presented with a posterior ankle mass and posterior ankle impingement with 2 years of follow-up. Surgical intervention was the treatment of choice in this patient, and histologic examination revealed a benign osteochondroma. Osteochondromas found in the posterior aspect of the talus can be complicated by fracture due to persistent motion of the ankle. Talar osteochondroma should be included in the differential diagnosis of posterior ankle impingement causes. Posterior talar osteochondromas, especially when a stalk is present, should be treated surgically before it is more complicated by a fracture and posterior ankle impingement.

  8. [Posterior dislocation of the sternoclavicular joint].

    PubMed

    Mäkinen, Tatu; Madanat, Rami; Heinänen, Mikko; Brinck, Tuomas; Pajarinen, Jarkko

    2013-01-01

    Posterior dislocation of the sternoclavicular joint is a rare injury. It can be associated with life-threatening complications. Computed tomography is the imaging modality of choice with which possible associated injuries can be detected. Acute injuries are managed with closed reduction under general anaesthesia. A fracture-dislocation is inherently more unstable than an isolated dislocation. Surgical treatment is advocated in cases of delayed diagnosis or failed closed reduction. With early diagnosis and treatment, the long-term outcome of this injury is good.

  9. Decompression of Posterior Ankle Impingement With Concomitant Anterior Ankle Pathology by Posterior Ankle Arthroscopy in the Supine Position.

    PubMed

    Lui, Tun Hing

    2016-10-01

    Posterior ankle endoscopy is a safe and effective approach for treatment of posterior ankle impingement. This is usually performed with the patient in prone position. The purpose of this technical note is to describe an arthroscopic approach of decompression of posterior ankle impingement with the patient in supine position. This is indicated if there is posterior ankle impingement together with other ankle pathology requiring anterior ankle arthroscopy. This approach allows treatment of both anterior ankle and posterior ankle pathology with the patient in the supine position. Concomitant anterior ankle arthroscopy can be performed with the usual orientation without the need of change of patient's position.

  10. Traumatic posterior dislocation of hip in children.

    PubMed

    Kutty, S; Thornes, B; Curtin, W A; Gilmore, M F

    2001-02-01

    Traumatic posterior dislocation of the hip joint in children is an uncommon injury. It constitutes a true orthopedic emergency. It makes up over 80% of pediatric hip dislocations. In children, it can occur as a result of minimal trauma, which is attributed to a soft pliable acetabulum and ligamentous laxity. In skeletally mature adolescents, a greater force is required to dislocate the hip joint. Delay in reduction is associated with long-term complications such as avascular necrosis and degenerative arthritis. Avascular necrosis is related to the duration of dislocation. A poorer prognosis is associated with delay in reduction beyond 6 hours, advanced skeletal maturity, or multiple traumas. Prompt reduction minimizes complications. We report two cases of traumatic posterior dislocation of hip in children aged 3 and 14 years. Both were reduced within 6 hours of dislocation, and review at 6 months revealed normal examination and no evidence of any post-traumatic changes. Post-reduction treatment remains without a consensus. This review highlights the clinical presentation, management, and time-sensitive complications of the injury.

  11. Management of an Uncomplicated Posterior Elbow Dislocation

    PubMed Central

    Blackard, Douglas; Sampson, Jo-Ann

    1997-01-01

    Objective: To present a case of an uncomplicated posterior elbow dislocation in a US World Cup athlete and discuss her rehabilitation. Background: Traditional protocol for management of this injury has been splint immobilization for several weeks, but research suggests a shortened duration of immobilization and early active motion. Differential Diagnosis: Elbow dislocation with possible fracture. Treatment: The dislocation was reduced and a compression bandage and sling were applied. The sports medicine staff and athlete determined that rehabilitation would involve limited immobilization with a posterior splint. Also, active range-of- motion exercises were to be incorporated early in the range-of- motion program to decrease pain at the articulation. Uniqueness: The athlete was not immobilized and her aggressive five-phase rehabilitation program progressed according to decrease in inflammation and increase in range of motion and strength. Conclusions: Shortened immobilization and return to World Championship competition 6 weeks postinjury had no longterm adverse effects on the athlete. ImagesFig 1.Fig 2.Fig 3.Fig 4.Fig. 5. PMID:16558436

  12. Posterior malleolar fractures of the ankle.

    PubMed

    Bartoníček, J; Rammelt, S; Tuček, M; Naňka, O

    2015-12-01

    Despite an increasing awareness of injuries to PM in ankle fracture-dislocations, there are still many open questions. The mere presence of a posterior fragment leads to significantly poorer outcomes. Adequate diagnosis, classification and treatment require preoperative CT examination, preferably with 3D reconstructions. The indication for surgical treatment is made individually on the basis of comprehensive assessment of the three-dimensional outline of the PM fracture and all associated injuries to the ankle including syndesmotic instability. Anatomic fixation of the avulsed posterior tibiofibular ligament will contribute to syndesmotic stability and restore the integrity of the incisura tibiae thus facilitating anatomic reduction of the distal fibula. A necessary prerequisite is mastering of posterolateral and posteromedial approaches and the technique of direct reduction and internal fixation. Further clinical studies with higher numbers of patients treated by similar methods and evaluation of pre- and postoperative CT scans will be necessary to determine reliable prognostic factors associated with certain types of PM fractures and associated injuries to the ankle.

  13. Prehension Movements in a Patient (AC) with Posterior Parietal Cortex Damage and Posterior Callosal Section

    ERIC Educational Resources Information Center

    Frak, Victor; Paulignan, Yves; Jeannerod, Marc; Michel, Francois; Cohen, Henri

    2006-01-01

    Prehension movements of the right hand were recorded in a right-handed man (AC), with an injury to the left posterior parietal cortex (PPC) and with a section of the left half of the splenium. The kinematic analysis of AC's grasping movements in direct and perturbed conditions was compared to that of five control subjects. A novel effect in…

  14. GNSS integer ambiguity validation based on posterior probability

    NASA Astrophysics Data System (ADS)

    Wu, Zemin; Bian, Shaofeng

    2015-10-01

    GNSS integer ambiguity validation is considered to be a challenge task for decades. Several kinds of validation tests are developed and widely used in these years, but theoretical basis is their weakness. Ambiguity validation theoretically is an issue of hypothesis test. In the frame of Bayesian hypothesis testing, posterior probability is the canonical standard that statistical decision should be based on. In this contribution, (i) we derive the posterior probability of the fixed ambiguity based on the Bayesian principle and modify it for practice ambiguity validation. (ii) The optimal property of the posterior probability test is proved based on an extended Neyman-Pearson lemma. Since validation failure rate is the issue users most concerned about, (iii) we derive the failure rate upper bound of the posterior probability test, so the user can use the posterior probability test either in the fixed posterior probability or in the fixed failure rate way. Simulated as well as real observed data are used for experimental validations. The results show that (i) the posterior probability test is the most effective within the R-ratio test, difference test, ellipsoidal integer aperture test and posterior probability test, (ii) the posterior probability test is computational efficient and (iii) the failure rate estimation for posterior probability test is useful.

  15. Visual input to the mouse lateral posterior and posterior thalamic nuclei: photoreceptive origins and retinotopic order

    PubMed Central

    Allen, Annette E.; Procyk, Christopher A.; Howarth, Michael; Walmsley, Lauren

    2016-01-01

    Key points The lateral posterior and posterior thalamic nuclei have been implicated in aspects of visually guided behaviour and reflex responses to light, including those dependent on melanopsin photoreception.Here we investigated the extent and basic properties of visually evoked activity across the mouse lateral posterior and posterior thalamus.We show that a subset of retinal projections to these regions derive from melanopsin‐expressing retinal ganglion cells and find many cells that exhibit melanopsin‐dependent changes in firing.We also show that subsets of cells across these regions integrate signals from both eyes in various ways and that, within the lateral posterior thalamus, visual responses are retinotopically ordered. Abstract In addition to the primary thalamocortical visual relay in the lateral geniculate nuclei, a number of other thalamic regions contribute to aspects of visual processing. Thus, the lateral posterior thalamic nuclei (LP/pulvinar) appear important for various functions including determining visual saliency, visually guided behaviours and, alongside dorsal portions of the posterior thalamic nuclei (Po), multisensory processing of information related to aversive stimuli. However, despite the growing importance of mice as a model for understanding visual system organisation, at present we know very little about the basic visual response properties of cells in the mouse LP or Po. Prompted by earlier suggestions that melanopsin photoreception might be important for certain functions of these nuclei, we first employ specific viral tracing to show that a subset of retinal projections to the LP derive from melanopsin‐expressing retinal ganglion cells. We next use multielectrode electrophysiology to demonstrate that LP and dorsal Po cells exhibit a variety of responses to simple visual stimuli including two distinct classes that express melanopsin‐dependent changes in firing (together comprising ∼25% of neurons we recorded). We also

  16. Iodine-125 radiation of posterior uveal melanoma

    SciTech Connect

    Packer, S.

    1987-12-01

    Twenty-eight cases of posterior choroidal melanoma were treated with iodine-125 in gold eye plaques. Eleven cases were located within 3.0 mm of the optic nerve (group A), nine were within 3.0 mm of the fovea (group B), and eight were within 3.0 mm of the optic nerve and fovea (group C). The mean follow-up of group A was 46.3 months; group B, 25.5 months; and group C, 42.7 months. Complications included macular edema, cataract and tumor growth. Visual acuity remained within two lines of that tested preoperatively for 4 of 11 patients in group A, 4 of 9 in group B, and 5 of 8 in group C. These results with iodine-125 suggest it as an appropriate treatment for patients with choroidal melanoma located near optic nerve and/or macula.

  17. Polycythemia causing posterior segment vascular occlusions

    PubMed Central

    Ganesan, Suganeswari; Raman, Rajiv; Sharma, Tarun

    2017-01-01

    A 44-year-old male patient presented with features suggestive of transient central retinal artery occlusion (CRAO) followed by permanent CRAO and lateral posterior ciliary artery occlusion. He had diagnostic features of polycythemia vera (PV). When presented for the first time, the patient had features of ocular ischemia such as ocular pain, conjunctival congestion, and retinal opacification but with normal arm-to-retina time and normal arteriovenous transit time. During the second presentation, he had ocular pain, congested conjunctiva, retinal opacification, cherry red spot with box-carrying of retinal vessels, and choroidal infarct (Amalric's sign). He had lost light perception in that eye. Patients with polycythemia are prone to multifocal vascular occlusions and this can be the presenting feature in PV. A timely diagnosis and prompt management can prevent these repeated thromboembolic occlusive episodes. PMID:28298862

  18. Hemifacial spasm and posterior auricular muscle.

    PubMed

    Kiziltan, M; Sahin, R; Uzun, N; Kiziltan, G

    2006-09-01

    We aimed to investigate to which extent posterior auricular muscle (PAM) was affected and whether it contributed to the reflex activity in hemifacial spasm (HFS) patients. 19 HFS patients' spasm activities were recorded from facial muscles. Spasm activity of PAM was recorded synchronously on the symptomatic side in all patients. Lateral spread of blink reflex to orbicularis oris and PAMs were recorded in all but two patients. Botulinum toxin was applied to the PAM with the 14 patients presenting tinnitus, "clicking" or a "ticking" sound on the sane side and other positive auricular symptoms. After treatment, there was symptomatic improvement in 9 of 14 patients. The patients presenting with auricular symptoms and showing spasm activity in their PAMs can be thought as a candidate for botulinum toxin treatment scheme.

  19. Bladder neck incompetence at posterior urethroplasty

    PubMed Central

    Koraitim, Mamdouh M.

    2015-01-01

    The finding of an incompetent bladder neck (BN) at the time of posterior urethroplasty will necessarily exacerbate the already difficult situation. In such cases the aim of the treatment is not only to restore urethral continuity by end-to-end urethral anastomosis, but also to restore the function of the BN to maintain urinary continence. Fortunately, the incidence of incompetence of the BN at posterior urethroplasty is uncommon, usually ≈4.5%. It seems that pelvic fracture-related BN injuries, in contrast to urethral injuries which result from a shearing force, are due to direct injury by the sharp edge of the fractured and displaced pubic bone. The risk of injuries to the BN is greater in children, in patients with a fracture involving both superior and inferior pubic rami on the same side, and in those managed initially by primary realignment. An incompetent BN is suspected by finding an open rectangular BN on cystography, and a fixedly open BN on suprapubic cystoscopy. An incompetent BN can be treated either subsequent to or concomitant with the urethral repair, according to whether a perineal or a perineo-abdominal urethroplasty is used, respectively. Several options have been reported to treat pelvic fracture-related BN incompetence, including reconstructing the BN, forming a new sphincter by tubularisation of a rectangular flap of the anterior bladder wall, and mechanical occlusion by an artificial sphincter or collagen injection. Reconstruction of the BN by the Young-Dees-Leadbetter∗∗ procedure probably provides the most successful results. PMID:26019982

  20. A branching, positive relief network in the middle member of the Medusae Fossae Formation, equatorial Mars—Evidence for sapping?

    NASA Astrophysics Data System (ADS)

    Harrison, S. K.; Balme, M. R.; Hagermann, A.; Murray, J. B.; Muller, J.-P.; Wilson, A.

    2013-09-01

    The Medusae Fossae Formation (MFF) is a geological formation comprising three geological units (members) spread across five principal lobes. It dominates a quarter of the longitudinal extent of the equatorial region of Mars. Positive relief features referred to as ‘sinuous ridges’ (commonly interpreted as inverted paleoflow channel or valley fills) have been observed in the lowest member of the western MFF, but have not been identified within the central and eastern portions of the formation, in the middle and upper members. This paper presents the identification and analysis of a branching, positive relief system which occurs in the central lobe of the MFF in what appears to be an exposure of the middle member. A simple geomorphological map of the system is presented, from which we have adopted the working hypothesis that this is an inverted fill of a branching fluvial channel or valley system. A suite of morphological and topographic evidence supporting this hypothesis is presented, including analysis of the network using a ∼15 m/pixel digital terrain model derived from a Context Imager (CTX) stereo image pair. The evidence supporting this hypothesis includes: (1) the local slope and topography of the upper surface of the network are consistent with a contributory network; (2) the braided, fan-like form at the termination of the branching network is consistent in morphology with it being a depositional fan at the end of a fluvial system; (3) the terminal fan and surrounding deposits show layering and polygonization; and (4) there is strong association between the lower order branches and amphitheater shaped scarps in the depression walls. We evaluate the possible origins of this fluvial system and suggest that seepage sapping is the most probable. Two possible models for the evolution of the network and related features are presented; both require melt of ice within the MFF to form liquid water. We conclude that at least some portions of the Medusae Fossae