1,721,169 research outputs found
Extracranial extradural origin of the posterior inferior cerebellar artery. Microanatomical study
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The sphenopetroclival venous gulf: a microanatomical study.
No full textThe sphenopetroclival area is the border zone between the middle and posterior cranial fossa. Several authors have studied the microsurgical anatomy of this region and have furnished sometimes contradictory descriptions of this area, which still represents a great challenge for the neurosurgeon. On the basis of previous anatomical data reported in the literature, the authors undertook a new microanatomical analysis of the sphenopetroclival region and report their findings.Twenty human cadaveric heads were used to reproduce, in the laboratory, different skull base approaches to expose the petroclival area. Measurements were taken in 40 specimens. From this study has emerged the finding that the sphenopetroclival area is a venous space, which the authors have named the "sphenopetroclival venous gulf" (SPCVG). The SPCVG is filled anteriorly by blood from the cavernous sinus (lateral sellar compartment [LSC], medially by blood from the basilar plexus, and laterally by blood from the superior petrosal sinus; this venous gulf is drained by the inferior petrosal sinus. The SPCVG is comparable in shape to an irregular hedron figure. It contains the Dorello canal, the venous segment of the abducent nerve, and the superior sphenopetrosal (Gruber) ligament, the fibers of which are in anatomical continuity with those of the inferior sphenopetrosal (petrolingual) ligament, forming a "falciform ligament."The structures defining the posterior surface of the SPCVG may represent a helpful surgical corridor through which it is possible to approach the LSC via the posterior fossa. This conceptualization of the SPCVG is an attempt to define univocally the microanatomy of the sphenopetroclival region in its entirety
Retrosigmoid suprameatal approach to Meckel's cave, cavernous sinus and middle fossa: Surgical anatomy and technical note
No full textApproccio retrosigmoideo esteso nel cavo di Meckel, nel seno cavernoso ed in fossa cranica media: anatomia microchirurgica e note tecniche
No full textDuplicated abducent nerve and its course: microanatomical study and surgery-related considerations.
No full textThe anatomy of the abducent nerve is well known; its duplication (ranging from 5 to 28.6\%), however, has rarely been reported in the literature. The authors performed a microanatomical study in 100 cadaveric specimens (50 heads) to evaluate the prevalence of this phenomenon and to provide a clear anatomical description of the course and relationships of the nerve. The surgery-related implications of this rare anatomical variant will be highlighted.The 50 human cadaveric heads (100 specimens) were embalmed in a 10\% formalin solution for 3 weeks. Fifteen of them were injected with colored neoprene latex. A duplicated abducent nerve was found in eight specimens (8\%). In two (25\%) of these eight specimens the nerve originated at the pontomedullary sulcus as two independent trunks: in one case the superior trunk was thicker than the inferior and in the other it was thinner. In the other six cases (75\%) the nerve originated as a single trunk, splitting in two trunks into the cisternal segment: in two of them the trunks ran below the Gruber ligament, whereas in four specimens one trunk ran below and one above it. In all the specimens, the duplicated nerves fused again into the cavernous sinus, just after the posterior genu of the internal carotid artery.Although the presence of a duplicated abducent nerve is a rare finding, preoperative magnetic resonance imaging should be performed to rule out this possibility, thus tailoring the operation to avoid postoperative deficits
Spontaneous resolution of Chiari I malformation and syringomyelia: case report and review of the literature.
No full textIndications for surgery and the surgical technique of foramen magnum decompression for patients with Chiari I malformation and syringomyelia are controversial issues. This case report supports the view that observation may be adequate for patients without progressive symptoms or with mild clinical symptoms.A 37-year-old woman presented with a 3-month history of burning dysesthesias and hypesthesia in her right arm. A neurological examination revealed hypesthesia in the right trigeminal distribution. A magnetic resonance imaging scan revealed a Chiari I malformation with syringomyelia between C2 and T2. No hydrocephalus was observed.Because the patient's symptoms regressed spontaneously, surgery was not performed. Thirty-two months after her initial examination, the patient was asymptomatic. A second magnetic resonance imaging scan was obtained, which demonstrated complete spontaneous resolution of the Chiari I malformation and syringomyelia.We attribute the regression of the patient's symptoms to spontaneous recanalization of cerebrospinal fluid pathways at the foramen magnum, which most likely was due to rupture of the arachnoid membranes that had obstructed cerebrospinal fluid flow
Epidermoid cyst of the cavernous sinus: clinical features, pathogenesis and treatment.
No full textEpidermoid cyst may rarely arise within the lateral wall of the cavernous sinus (CS) and produce clinical symptoms mimicking the Tolosa-Hunt syndrome. Pathogenically, it is suggested that some of the subpopulation of cells arising from the neural crest which give rise to skin, may remain entrapped in the meninges around the nerves in the lateral wall in an uncompleted stage of maturation and may develop epidermoid cysts. A case is presented of a 68-year-old man with a 4-week history previously diagnosed as Tolosa-Hunt syndrome. MRI is the investigation of choice. Surgical resection can result in excellent recovery of preoperative deficits of cranial nerves (CN) III through VI
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