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Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations
ORIGINAL RESEARCH INTERVENTIONAL Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations Z.-S. Shi, J. Ziegler, L. Feng, N.R. Gonzalez, S. Tateshima, R. Jahan, N.A. Martin, F. Vin˜uela, and G.R. Duckwiler ABSTRACT BACKGROUND AND PURPOSE: DAVFs rarely involve the sphenoid wings and middle cranial fossa. We characterize the angiographic findings, treatment, and outcome of DAVFs within the sphenoid wings. MATERIALS AND METHODS: We reviewed the clinical and radiologic data of 11 patients with DAVFs within the sphenoid wing that were treated with an endovascular or with a combined endovascular and surgical approach. RESULTS: Nine patients presented with ocular symptoms and 1 patient had a temporal parenchymal hematoma. Angiograms showed that 5 DAVFs were located on the lesser wing of sphenoid bone, whereas the other 6 were on the greater wing of the sphenoid bone. Multiple branches of the ICA and ECA supplied the lesions in 7 patients. Four patients had cortical venous reflux and 7 patients had varices. Eight patients were treated with transarterial embolization using liquid embolic agents, while 3 patients were treated with transvenous embo- lization with coils or in combination with Onyx. Surgical disconnection of the cortical veins was performed in 2 patients with incompletely occluded DAVFs. Anatomic cure was achieved in all patients. Eight patients had angiographic and clinical follow-up and none had recurrence of their lesions. CONCLUSIONS: DAVFs may occur within the dura of the sphenoid wings and may often have a presentation similar to cavernous sinus DAVFs, but because of potential associations with the cerebral venous system, may pose a risk for intracranial hemorrhage. -
Direct Sagittal CT in the Evaluation of Temporal Bone Disease
371 Direct Sagittal CT in the Evaluation of Temporal Bone Disease 1 Mahmood F. Mafee The human temporal bone is an extremely complex structure. Direct axial and coronal Arvind Kumar2 CT sections are quite satisfactory for imaging the anatomy of the temporal bone; Christina N. Tahmoressi1 however, many relationships of the normal and pathologic anatomic detail of the Barry C. Levin2 temporal bone are better seen with direct sagittal CT sections. The sagittal projection Charles F. James1 is of interest to surgeons, as it has the advantage of following the plane of surgical approach. This article describes the advantages of using direct sagittal sections for Robert Kriz 1 1 studying various diseases of the temporal bone. The CT sections were obtained with Vlastimil Capek the aid of a new headholder added to our GE CT 9800 scanner. The direct sagittal projection was found to be extremely useful for evaluating diseases involving the vertical segment of the facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, external auditory canal, middle ear cavity, infra- and supra labyrinthine air cells, and temporo mandibular joint. CT has contributed greatly to an understanding of the complex anatomy and spatial relationship of the minute structures of the hearing and balance organs, which are packed into a small pyramid-shaped petrous temporal bone [1 , 2]. In the past 6 years, high-resolution CT scanning has been rapidly replacing standard tomography and has proved to be the diagnostic imaging method of choice for studying the normal and pathologic details of the temporal bone [3-14]. -
A Morphological Study of Jugular Foramen
Vikas. C. Desai et al /J. Pharm. Sci. & Res. Vol. 9(4), 2017, 456-458 A Morphological Study of Jugular Foramen Vikas. C. Desai1, Pavan P Havaldar2 1. Asst. Prof, Department of Dentistry, BLDE University’s,Shri. B. M. Patil Medical College Hospital and Research Centre,Bijapur – 586103, Karnataka State. 2. Assistant Professor of Anatomy, Gadag Institute of Medical Sciences, Mallasamudra, Mulgund Road, Gadag, Karnataka, India. Abstract Jugular foramen is a large aperture in the base of the skull. It is located behind the carotid canal and is formed by the petrous part of the temporal bone and behind by the occipital bone. The jugular foramen is the main route of venous outflow from the skull and is characterised by laterality based on the predominance of one of the sides. Sigmoid sinus continues as internal jugular vein in posterior part of jugular foramen. Ligation of the internal jugular is sometimes performed during radical neck dissection with the risk of venous infarction, which some adduce to be due to ligation of the dominant internal jugular vein. It is generally said that although the Jugular foramen is larger on the right side compared to the left, its size as well as its height and volume vary in different racial groups and sexes. The foramen’s complex shape, its formation by two bones, and the numerous nerves and venous channels that pass through it further compound its anatomy. The present study was undertaken in 263(526 sides) different medical and dental institutions in Karnataka, India. Out of 263 skulls in 61.21% of cases the right foramina were larger than the left, in 13.68% of cases the left foramina were larger than the right and in 25.09% cases were equal on both sides. -
Gross Anatomy Assignment Name: Olorunfemi Peace Toluwalase Matric No: 17/Mhs01/257 Dept: Mbbs Course: Gross Anatomy of Head and Neck
GROSS ANATOMY ASSIGNMENT NAME: OLORUNFEMI PEACE TOLUWALASE MATRIC NO: 17/MHS01/257 DEPT: MBBS COURSE: GROSS ANATOMY OF HEAD AND NECK QUESTION 1 Write an essay on the carvernous sinus. The cavernous sinuses are one of several drainage pathways for the brain that sits in the middle. In addition to receiving venous drainage from the brain, it also receives tributaries from parts of the face. STRUCTURE ➢ The cavernous sinuses are 1 cm wide cavities that extend a distance of 2 cm from the most posterior aspect of the orbit to the petrous part of the temporal bone. ➢ They are bilaterally paired collections of venous plexuses that sit on either side of the sphenoid bone. ➢ Although they are not truly trabeculated cavities like the corpora cavernosa of the penis, the numerous plexuses, however, give the cavities their characteristic sponge-like appearance. ➢ The cavernous sinus is roofed by an inner layer of dura matter that continues with the diaphragma sellae that covers the superior part of the pituitary gland. The roof of the sinus also has several other attachments. ➢ Anteriorly, it attaches to the anterior and middle clinoid processes, posteriorly it attaches to the tentorium (at its attachment to the posterior clinoid process). Part of the periosteum of the greater wing of the sphenoid bone forms the floor of the sinus. ➢ The body of the sphenoid acts as the medial wall of the sinus while the lateral wall is formed from the visceral part of the dura mater. CONTENTS The cavernous sinus contains the internal carotid artery and several cranial nerves. Abducens nerve (CN VI) traverses the sinus lateral to the internal carotid artery. -
Craniotomy for Anterior Cranial Fossa Meningiomas: Historical Overview
Neurosurg Focus 36 (4):E14, 2014 ©AANS, 2014 Craniotomy for anterior cranial fossa meningiomas: historical overview SAUL F. MORALES-VALERO, M.D., JAMIE J. VAN GOMPEL, M.D., IOANNIS LOUMIOTIS, M.D., AND GIUSEPPE LANZINO, M.D. Department of Neurologic Surgery, Mayo Clinic, Mayo Medical School, Rochester, Minnesota The surgical treatment of meningiomas located at the base of the anterior cranial fossa is often challenging, and the evolution of the surgical strategy to resect these tumors parallels the development of craniotomy, and neurosur- gery in general, over the past century. Early successful operations to treat these tumors were pioneered by prominent figures such as Sir William Macewen and Francesco Durante. Following these early reports, Harvey Cushing made significant contributions, allowing a better understanding and treatment of meningiomas in general, but particularly those involving the anterior cranial base. Initially, large-sized unilateral or bilateral craniotomies were necessary to approach these deep-seated lesions. Technical advances such as the introduction of electrosurgery, the operating microscope, and refined microsurgical instruments allowed neurosurgeons to perform less invasive surgical proce- dures with better results. Today, a wide variety of surgical strategies, including endoscopic surgery and radiosurgery, are used to treat these tumors. In this review, the authors trace the evolution of craniotomy for anterior cranial fossa meningiomas. (http://thejns.org/doi/abs/10.3171/2014.1.FOCUS13569) KEY WORDS • intracranial meningiomas • craniotomy • history • anterior cranial fossa ENINGIOMAS of the anterior cranial fossa represent has a few distinct clinical features. However, in practice, 12%–20% of all intracranial meningiomas.5,30 this group of tumors often represents a continuum. -
Ardipithecus Ramidus and the Evolution of the Human Cranial Base
Ardipithecus ramidus and the evolution of the human cranial base William H. Kimbela,1, Gen Suwab, Berhane Asfawc, Yoel Raka,d, and Tim D. Whitee,1 aInstitute of Human Origins and School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85287; bThe University Museum, University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan; cRift Valley Research Service, Addis Ababa, Ethiopia; dDepartment of Anatomy and Anthropology, Sackler School of Medicine, Tel Aviv University, 69978 Ramat Aviv, Israel; and eDepartment of Integrative Biology, Human Evolution Research Center, University of California, Berkeley, CA 94720 Contributed by Tim D. White, December 5, 2013 (sent for review October 14, 2013) The early Pliocene African hominoid Ardipithecus ramidus was di- We report here results of a metrical and morphological study agnosed as a having a unique phylogenetic relationship with the of the Ar. ramidus basicranium as another test of its hypothesized Australopithecus + Homo clade based on nonhoning canine teeth, phylogenetic affinity with Australopithecus and Homo. We ana- a foreshortened cranial base, and postcranial characters related to lyzed the length and breadth of the external cranial base and the facultative bipedality. However, pedal and pelvic traits indicating structural relationship between the petrous and tympanic elements substantial arboreality have raised arguments that this taxon may of the temporal bone in Ar. ramidus, Australopithecus (including instead be an example of parallel evolution of human-like traits Paranthropus of some authors), and mixed-sex samples of extant among apes around the time of the chimpanzee–human split. Here African hominoid (Gorilla gorilla, Pan troglodytes, Pan paniscus) we investigated the basicranial morphology of Ar. -
Study of Wormian Bones on Dry Human Skull and Its Sexual Dimorphism in the Region of Andhra Pradesh
Original Research Article Study of Wormian Bones on Dry human skull and its sexual dimorphism in the region of Andhra Pradesh Shone Vasudeo Durge Assistant Professor, Dept. of Anatomy, Fathima Institute of Medical Sciences, Ramarajupalli, Andhra Pradesh Corresponding Author: E-mail: [email protected] Abstract This study was aimed at identifying the wormian bone and their overall incidence in respect to their number and location in the region of Andhra Pradesh. Overall incidence of wormian bones was more in female (47.72%) than in male skulls (41.66%). They occurred more frequently at lambdoid suture (38%). Wormian bones along the coronal suture, Bregma and Asterion were seen only in male skulls, while intra-orbital wormian bones and wormian bones at Pterion were seen only in female skulls. This study concludes by stating that, there exists a moderate degree of sexual dimorphism among the wormian bones with respect to overall incidence, number and location. Keywords- Skull, Sexual dimorphism, Wormian bones, Lambda, Asterion. Background knowledge of WBs is important in the diagnosis of Wormian bones, also known as intra-sutural bones, these disorders (Cremin, Goodman, Spranger et al., are extra bone pieces that occur within a suture in the 1982). It was reported that their incidence is well suited cranium. These are irregular isolated bones that appear for comparative studies as an anthropological marker or in addition to the usual centers of ossification of the an indicator of population distance (Gumusburun, cranium and, although unusual, are not rare. They occur Sevim, Katkici et al., 1997). Their knowledge is of most frequently in the course of the lambdoid suture, interest to the human anatomy, physical anthropology which is more tortuous than other sutures. -
Morphological and Topographical Study of Wormian Bones in Cadaver Dry Skulls
Original article Morphological and topographical study of Wormian bones in cadaver dry skulls Murlimanju, BV.*, Prabhu, LV., Ashraf, CM., Kumar, CG., Rai, R. and Maheshwari, C. Department of Anatomy, Manipal University, Centre for Basic Sciences, Kasturba Medical College, Mangalore, India *E-mail: [email protected] Abstract Introduction: The Wormian bones are formations associated with insufficient rate of suture closure and regarded as epigenetic and hypostotic traits. It was reported that there exists racial variability among the incidence of these bones. In the present study, the aims were to find the incidence of Wormian bones in Indian skulls and to analyze them topographically. Material and methods: The study included 78 human adult dry skulls of Indian population which were obtained from the neuroanatomy laboratory of our institution. They were macroscopically observed for the incidence and topographical distribution of the Wormian bones. Results: The Wormian bones were observed in 57 skulls (73.1%) of our series. Remaining 21 skulls (26.9%) didn’t show these variant bones. They were observed at the lambdoid suture in 56.4% cases (44 skulls; 14-bilateral; 18-right side; 12-left side), at the asterion in 17.9% (14 skulls; 3-bilateral; 2-right side; 9-left side), at the pterion in 11.5% (9 skulls; 4-right side; 5-left side), at the coronal suture in 1.3% (only one skull) and at the sagittal suture in 1.3% cases (only one skull). Conclusion: The current study observed Wormian bones in 73.1% of the cases from Indian population. This incidence rate is slightly higher compared to other reports and may be due to racial variations. -
Morfofunctional Structure of the Skull
N.L. Svintsytska V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 Ministry of Public Health of Ukraine Public Institution «Central Methodological Office for Higher Medical Education of MPH of Ukraine» Higher State Educational Establishment of Ukraine «Ukranian Medical Stomatological Academy» N.L. Svintsytska, V.H. Hryn Morfofunctional structure of the skull Study guide Poltava 2016 2 LBC 28.706 UDC 611.714/716 S 24 «Recommended by the Ministry of Health of Ukraine as textbook for English- speaking students of higher educational institutions of the MPH of Ukraine» (minutes of the meeting of the Commission for the organization of training and methodical literature for the persons enrolled in higher medical (pharmaceutical) educational establishments of postgraduate education MPH of Ukraine, from 02.06.2016 №2). Letter of the MPH of Ukraine of 11.07.2016 № 08.01-30/17321 Composed by: N.L. Svintsytska, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor V.H. Hryn, Associate Professor at the Department of Human Anatomy of Higher State Educational Establishment of Ukraine «Ukrainian Medical Stomatological Academy», PhD in Medicine, Associate Professor This textbook is intended for undergraduate, postgraduate students and continuing education of health care professionals in a variety of clinical disciplines (medicine, pediatrics, dentistry) as it includes the basic concepts of human anatomy of the skull in adults and newborns. Rewiewed by: O.M. Slobodian, Head of the Department of Anatomy, Topographic Anatomy and Operative Surgery of Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Doctor of Medical Sciences, Professor M.V. -
Morphology of the Pterion in Serbian Population
Int. J. Morphol., 38(4):820-824, 2020. Morphology of the Pterion in Serbian Population Morfología del Pterion en Población Serbia Knezi Nikola1; Stojsic Dzunja Ljubica1; Adjic Ivan2; Maric Dusica1 & Pupovac Nikolina4 KNEZI, N.; STOJSIC, D. L.; ADJIC, I.; MARIC, D. & PUPOVAC, N. Morphology of the pterion in Serbian population. Int. J. Morphol., 38(4):820-824, 2020. SUMMARY: The pterion is a topographic point on the lateral aspect of the skull where frontal, sphenoid, parietal and temporal bones form the H or K shaped suture. This is an important surgical point for the lesions in anterior and middle cranial fossa. This study was performed on 50 dry skulls from Serbian adult individuals from Department of Anatomy, Faculty of Medicine in Novi Sad. The type of the pterion on both sides of each skull was determined and they are calcified in four types (sphenoparietal, frontotemporal, stellate and epipteric). The distance between the center of the pterion and defined anthropological landmarks were measured using the ImageJ software. Sphenoparietal type is predominant with 86 % in right side and 88 % in left side. In male skulls, the distance from the right pterion to the frontozygomatic suture is 39.89±3.85 mm and 39.67±4.61 mm from the left pterion to the frontozygomatic suture. In female skulls the distance is 37.38±6.38 mm on the right and 35.94±6.46 mm on the left. The shape and the localization of the pterion are important because it is an anatomical landmark and should be used in neurosurgery, traumatology and ophthalmology. -
A New Radiological Classification for the Risk Assessment of Anterior Skull
www.nature.com/scientificreports OPEN A new radiological classifcation for the risk assessment of anterior skull base injury in endoscopic sinus surgery Baharudin Abdullah 1*, Shiun Chuen Chew1, Mohd Ezane Aziz2, Norasnieda Md Shukri1, Salina Husain3, Sng Weirong Joshua4, De Yun Wang4 & Kornkiat Snidvongs5 Keros and Gera classifcations are widely used to assess the risk of skull base injury during endoscopic sinus surgery. Although, both classifcations are useful preoperatively to stratify risk of patients going for surgery, it is not practical to measure the respective lengths during surgery. In this study, we aimed to propose a new radiological classifcation (Thailand-Malaysia-Singapore (TMS)) to assess the anatomical risk of anterior skull base injury using the orbital foor (OF) as a reference. A total of 150 computed tomography images of paranasal sinuses (300 sides) were reviewed. The TMS classifcation was categorized into 3 types by measuring OF to cribriform plate and OF to ethmoid roof. Most patients were classifed as TMS type 1, Keros type 2 and Gera class II, followed by patients classifed as TMS type 3, Keros type 1 and Gera class 1. TMS has signifcant correlation with Keros classifcation (p < 0.05). There was no signifcant correlation between Keros and Gera classifcations (p = 0.33) and between TMS and Gera classifcations (p = 0.80). The TMS classifcation has potential to be used for risk assessment of skull base injury among patients undergoing ESS. It serves as an additional assessment besides the Keros and Gera classifcations. Endoscopic sinus surgery (ESS) has an overall complication rate of 0.5% with the specifc complications of cere- brospinal fuid leak, orbital injury, haemorrhage requiring surgery, blood transfusion and toxic shock syndrome at 0.09%, 0.09%, 0.10%, 0.18%, and 0.02%, respectively1. -
CLOSURE of CRANIAL ARTICULATIONS in the SKULI1 of the AUSTRALIAN ABORIGINE by A
CLOSURE OF CRANIAL ARTICULATIONS IN THE SKULI1 OF THE AUSTRALIAN ABORIGINE By A. A. ABBIE, Department of Anatomy, University of Adelaide INTRODUCTION While it is well known that joint closure advances more or less progressively with age, there is still little certainty in matters of detail, mainly for lack of adequate series of documented skulls. In consequence, sundry beliefs have arisen which tend to confuse the issue. One view, now disposed of (see Martin, 1928), is that early suture closure indicates a lower or more primitive type of brain. A corollary, due to Broca (see Topinard, 1890), that the more the brain is exercised the more is suture closure postponed, is equally untenable. A very widespread belief is based on Gratiolet's statement (see Topinard, 1890; Frederic, 1906; Martin, 1928; Fenner, 1939; and others) that in 'lower' skulls the sutures are simple and commence to fuse from in front, while in 'higher' skulls the sutures are more complicated and tend to fuse from behind. This view was disproved by Ribbe (quoted from Frederic, 1906), who substituted the generalization that in dolicocephals synostosis begins in the coronal suture, and in brachycephals in the lambdoid suture. In addition to its purely anthropological interest the subject raises important biological considerations of brain-skull relationship, different foetalization in different ethnological groups (see Bolk, 1926; Weidenreich, 1941; Abbie, 1947), and so on. A survey of the literature reveals very little in the way of data on the age incidence of suture closure. The only substantial contribution accessible here comes from Todd & Lyon (1924) for Europeans, but their work is marred by arbitrary rejection of awkward material.