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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. -
The Morphometric Study of Occurrence and Variations of Foramen Ovale S
Research Article The morphometric study of occurrence and variations of foramen ovale S. Ajrish George*, M. S. Thenmozhi ABSTRACT Background: Foramen vale is one of the important foramina present in the sphenoid bone. Anatomically it is located in the greater wing of the sphenoid bone. The foramen ovale is situated posterolateral to the foramen rotundum and anteromedial to the foramen spinosum. The foramen spinosum is present posterior to the foramen ovale. The carotid canal is present posterior and medial to the foramen spinosum and the foramen rotundum is present anterior to the foramen ovale. The structures which pass through the foramen ovale are the mandibular nerve, emissary vein, accessory middle meningeal artery, and lesser petrosal nerve. The sphenoid bone has a body, a pair of greater wing, pair of lesser wing, pair of lateral pterygoid plate, and a pair of medial pterygoid plate. Aim: The study involves the assessment of any additional features in foramen ovale in dry South Indian skulls. Materials and Methods: This study involves examination of dry adult skulls. First, the foramen ovale is located, and then it is carefully examined for presence of alterations and additional features, and is recorded following computing the data and analyzing it. Results: The maximum length of foramen ovale on the right and left was 10.1 mm, 4.3 mm, respectively. The minimum length of the foramen in right and left was 9.1 mm, 3.2 mm, respectively. The maximum width of foramen ovale on the right and left was 4.8 mm and 2.3 mm, respectively. The minimum width of the foramen in the right and the left side was 5.7 mm and 2.9 mm, respectively. -
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. -
Septation of the Sphenoid Sinus and Its Clinical Significance
1793 International Journal of Collaborative Research on Internal Medicine & Public Health Septation of the Sphenoid Sinus and its Clinical Significance Eldan Kapur 1* , Adnan Kapidžić 2, Amela Kulenović 1, Lana Sarajlić 2, Adis Šahinović 2, Maida Šahinović 3 1 Department of anatomy, Medical faculty, University of Sarajevo, Čekaluša 90, 71000 Sarajevo, Bosnia and Herzegovina 2 Clinic for otorhinolaryngology, Clinical centre University of Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina 3 Department of histology and embriology, Medical faculty, University of Sarajevo, Čekaluša 90, 71000 Sarajevo, Bosnia and Herzegovina * Corresponding Author: Eldan Kapur, MD, PhD Department of anatomy, Medical faculty, University of Sarajevo, Bosnia and Herzegovina Email: [email protected] Phone: 033 66 55 49; 033 22 64 78 (ext. 136) Abstract Introduction: Sphenoid sinus is located in the body of sphenoid, closed with a thin plate of bone tissue that separates it from the important structures such as the optic nerve, optic chiasm, cavernous sinus, pituitary gland, and internal carotid artery. It is divided by one or more vertical septa that are often asymmetric. Because of its location and the relationships with important neurovascular and glandular structures, sphenoid sinus represents a great diagnostic and therapeutic challenge. Aim: The aim of this study was to assess the septation of the sphenoid sinus and relationship between the number and position of septa and internal carotid artery in the adult BH population. Participants and Methods: A retrospective study of the CT analysis of the paranasal sinuses in 200 patients (104 male, 96 female) were performed using Siemens Somatom Art with the following parameters: 130 mAs: 120 kV, Slice: 3 mm. -
Entrapment Neuropathy of the Central Nervous System. Part II. Cranial
Entrapment neuropathy of the Cranial nerves central nervous system. Part II. Cranial nerves 1-IV, VI-VIII, XII HAROLD I. MAGOUN, D.O., F.A.A.O. Denver, Colorado This article, the second in a series, significance because of possible embarrassment considers specific examples of by adjacent structures in that area. The same entrapment neuropathy. It discusses entrapment can occur en route to their desti- nation. sources of malfunction of the olfactory nerves ranging from the The first cranial nerve relatively rare anosmia to the common The olfactory nerves (I) arise from the nasal chronic nasal drip. The frequency of mucosa and send about twenty central proces- ocular defects in the population today ses through the cribriform plate of the ethmoid bone to the inferior surface of the olfactory attests to the vulnerability of the optic bulb. They are concerned only with the sense nerves. Certain areas traversed by of smell. Many normal people have difficulty in each oculomotor nerve are pointed out identifying definite odors although they can as potential trouble spots. It is seen perceive them. This is not of real concern. The how the trochlear nerves are subject total loss of smell, or anosmia, is the significant to tension, pressure, or stress from abnormality. It may be due to a considerable variety of causes from arteriosclerosis to tu- trauma to various bony components morous growths but there is another cause of the skull. Finally, structural which is not usually considered. influences on the abducens, facial, The cribriform plate fits within the ethmoid acoustic, and hypoglossal nerves notch between the orbital plates of the frontal are explored. -
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. -
Clinical Importance of the Middle Meningeal Artery
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Jagiellonian Univeristy Repository FOLIA MEDICA CRACOVIENSIA 41 Vol. LIII, 1, 2013: 41–46 PL ISSN 0015-5616 Przemysław Chmielewski1, Janusz skrzat1, Jerzy waloCha1 CLINICAL IMPORTANCE OF THE MIDDLE MENINGEAL ARTERY Abstract: Middle meningeal artery (MMA)is an important branch which supplies among others cranial dura mater. It directly attaches to the cranial bones (is incorporated into periosteal layer of dura mater), favors common injuries in course of head trauma. This review describes available data on the MMA considering its varability, or treats specific diseases or injuries where the course of MMA may have clinical impact. Key words: Middle meningeal artery (MMA), aneurysm of the middle meningeal artery, epidural he- matoma, anatomical variation of MMA. TOPOGRAPHY OF THE MIDDLE MENINGEAL ARTERY AND ITS BRANCHES Middle meningeal artery (MMA) [1] is most commonly the strongest branch of maxillary artery (from external carotid artery) [2]. It supplies blood to cranial dura mater, and through the numerous perforating branches it nourishes also periosteum of the inner aspect of cranial bones. It enters the middle cranial fossa through the foramen spinosum, and courses between the dura mater and the inner aspect of the vault of the skull. Next it divides into two terminal branches — frontal (anterior) which supplies blood to bones forming anterior cranial fossa and the anterior part of the middle cranial fossa; parietal branch (posterior), which runs more horizontally toward the back and supplies posterior part of the middle cranial fossa and supratentorial part of the posterior cranial fossa. -
The Neurocranium Forms the Cranial Cavity That Surrounds and Protects the Brain and Brainstem. the Neurocranium Is Formed from T
Name: Wokoma Olobo Benebo Department: Medical Laboratory Science Course: ANA 208 Matric Number: 18/MHS06/055 Assignment 1. Discuss the differences between viscerocranium and neurocranium The neurocranium forms the cranial cavity that surrounds and protects the brain and brainstem. The neurocranium is formed from the occipital bone, two temporal bones, two parietal bones, the sphenoid, ethmoid and frontal bones; they are all joined together with sutures. The viscerocranium bones form the anterior and lower regions of the skull and include the mandible, which attaches through the only truly motile joint found in the skull. The facial skeleton contains the vomer, two nasal conchae, two nasal bones, two maxilla, the mandible, two palatine bones, two zygomatic bones, and two lacrimal bones. 2. Femoral triangle is a special area of the thigh, Discuss Answers: The femoral triangle is a wedge-shaped area formed by a depression between the muscles of the thigh. It is located on the medial aspect of the proximal thigh. It is the region of the passage of the main blood vessels between the pelvis and the lower limb, as well as a large nerve supplying the thigh. It has several Borders and Contents. BORDERS: a. Lateral Border b. Medial Border c. Superior Border CONTENTS: a. Femoral Artery b. Femoral Vein c. Femoral Nerve d. Femoral Canal e. Lymphatics 3. Describe all the muscles of the lower limb that participates during 1/metre social distancing at the period of Covid 19. Answers: a. Rectus Femoris b. Vastus Medialis c. Vastus Lateralis d. Sartorius e. Gracilis f. The Hamstrings g.The Iliopsoas in the hips h.