A Peculiar Case of Dural Venous Sinuses with Resulting Atypical Bony Markings in Posterior Cranial Fossa
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Multiple Osteomas of the Falx Cerebri and Anterior Skull Base: Case Report
CASE REPORT J Neurosurg 124:1339–1342, 2016 Multiple osteomas of the falx cerebri and anterior skull base: case report Khaled M. Krisht, MD,1 Cheryl A. Palmer, MD,2 and William T. Couldwell, MD, PhD1 1Department of Neurosurgery, Clinical Neurosciences Center, and 2Department of Pathology, University of Utah, Salt Lake City, Utah The authors describe a rare case of intracranial extraaxial parafalcine and anterior skull base osteomas in a 22-year- old woman presenting with bifrontal headaches. This case highlights the possible occurrence of such lesions along the anterior skull base and parafalcine region that, as such, should be considered as part of the differential diagnosis for extraaxial calcific lesions involving the anterior skull base. To the authors’ knowledge, this is the first reported case of a patient who underwent complete successful resection of multiple extraaxial osteomas of the anterior skull base and parafalcine region. http://thejns.org/doi/abs/10.3171/2015.6.JNS15865 KEY WORDS osteoma; anterior skull base; parafalcine; falx cerebri; differential; CT; oncology STEOMAS are benign neoplasms consisting of ma- was first evaluated 6 years earlier, undergoing contrast- ture normal osseous tissue. They commonly arise enhancing MRI of the brain that disclosed a nonenhanc- from the long bones of the extremities. In the re- ing extraaxial T1-weighted isointense and T2-weighted Ogion of the head and neck, they are usually limited to the hypointense parafalcine lesion. At her latest presentation paranasal sinuses, facial bones, skull, and mandible.4,5,7 repeat brain MRI with and without contrast enhancement Their etiology is still a matter of debate. -
CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit
228 CHAPTER 8 Face, Scalp, Skull, Cranial Cavity, and Orbit MUSCLES OF FACIAL EXPRESSION Dural Venous Sinuses Not in the Subendocranial Occipitofrontalis Space More About the Epicranial Aponeurosis and the Cerebral Veins Subcutaneous Layer of the Scalp Emissary Veins Orbicularis Oculi CLINICAL SIGNIFICANCE OF EMISSARY VEINS Zygomaticus Major CAVERNOUS SINUS THROMBOSIS Orbicularis Oris Cranial Arachnoid and Pia Mentalis Vertebral Artery Within the Cranial Cavity Buccinator Internal Carotid Artery Within the Cranial Cavity Platysma Circle of Willis The Absence of Veins Accompanying the PAROTID GLAND Intracranial Parts of the Vertebral and Internal Carotid Arteries FACIAL ARTERY THE INTRACRANIAL PORTION OF THE TRANSVERSE FACIAL ARTERY TRIGEMINAL NERVE ( C.N. V) AND FACIAL VEIN MECKEL’S CAVE (CAVUM TRIGEMINALE) FACIAL NERVE ORBITAL CAVITY AND EYE EYELIDS Bony Orbit Conjunctival Sac Extraocular Fat and Fascia Eyelashes Anulus Tendineus and Compartmentalization of The Fibrous "Skeleton" of an Eyelid -- Composed the Superior Orbital Fissure of a Tarsus and an Orbital Septum Periorbita THE SKULL Muscles of the Oculomotor, Trochlear, and Development of the Neurocranium Abducens Somitomeres Cartilaginous Portion of the Neurocranium--the The Lateral, Superior, Inferior, and Medial Recti Cranial Base of the Eye Membranous Portion of the Neurocranium--Sides Superior Oblique and Top of the Braincase Levator Palpebrae Superioris SUTURAL FUSION, BOTH NORMAL AND OTHERWISE Inferior Oblique Development of the Face Actions and Functions of Extraocular Muscles Growth of Two Special Skull Structures--the Levator Palpebrae Superioris Mastoid Process and the Tympanic Bone Movements of the Eyeball Functions of the Recti and Obliques TEETH Ophthalmic Artery Ophthalmic Veins CRANIAL CAVITY Oculomotor Nerve – C.N. III Posterior Cranial Fossa CLINICAL CONSIDERATIONS Middle Cranial Fossa Trochlear Nerve – C.N. -
Torcular Herophili)Ÿ W
Neuroanatomy, 2002, Volume1, Page 14. Letter to the Editor Published online November 7, 2002 © neuroanatomy.org R. Shane Tubbs We would like to clarify a commonly misunderstood term (torcular Herophili)Ÿ W. Jerry Oakes that has infiltrated all fields associated with neuroanatomy e.g. neurosurgery, neurology, neurosciences. The term torcular (wine press) is an incorrect version of the original Greek word (a canal or gutter) [1]. Herophili is after the celebrated Greek physician/anatomist Herophilus (335 B.C.-280 B.C.) born in Chalcedon which is now Kadikoy, Turkey. Herophilus is known as the father of anatomy because he was the first to base his conclusions on dissection of the human body. Herophilus studied the brain, recognizing it as the center Pediatric Neurosurgery, Children’s Hospital, Birmingham, Alabama 35233 USA of the nervous system. The original term was meant to describe the concavity on the internal aspect of the occipital bone that housed the confluence of sinuses. However, over time this term has been used incorrectly as an interchangable term with the confluence of sinuses. Almost every textbook of anatomy with few exceptions, that we reviewed, interchange these terms with no distinction [e.g. 2-4]. True these two entities are intimately related Correspondence Address but clearly represent different anatomical structures. Just as other venous sinuses erode the inner table of the skull producing same named sulci or R. Shane Tubbs, Pediatric Neurosurgery ACC 400, 1600 7th Ave grooves e.g. the transverse sinus sulcus, the confluence of sinuses (formed by South, Birmingham, Alabama 35233 USA the superior sagittal, straight, occipital, and transverse sinuses) erode the Phone: 205-939-9914 Fax: 205-939-9972 occipital bone where the major venous sinus tributaries congregate thus forming E-mail: [email protected] the torcular Herophili. -
Human and Nonhuman Primate Meninges Harbor Lymphatic Vessels
SHORT REPORT Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI Martina Absinta1†, Seung-Kwon Ha1†, Govind Nair1, Pascal Sati1, Nicholas J Luciano1, Maryknoll Palisoc2, Antoine Louveau3, Kareem A Zaghloul4, Stefania Pittaluga2, Jonathan Kipnis3, Daniel S Reich1* 1Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States; 2Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, United States; 3Center for Brain Immunology and Glia, Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, United States; 4Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States Abstract Here, we report the existence of meningeal lymphatic vessels in human and nonhuman primates (common marmoset monkeys) and the feasibility of noninvasively imaging and mapping them in vivo with high-resolution, clinical MRI. On T2-FLAIR and T1-weighted black-blood imaging, lymphatic vessels enhance with gadobutrol, a gadolinium-based contrast agent with high propensity to extravasate across a permeable capillary endothelial barrier, but not with gadofosveset, a blood-pool contrast agent. The topography of these vessels, running alongside dural venous sinuses, recapitulates the meningeal lymphatic system of rodents. In primates, *For correspondence: meningeal -
Muscle Insertion Line As a Simple Landmark to Identify The
Original Article Muscle Insertion Line as a Simple Landmark To Identify the Transverse Sinus When Neuronavigation Is Unavailable Juri Kivelev1, Riku Kivisaari2, Mika Niemela¨ 2, Juha Hernesniemi2 - OBJECTIVE: Skull opening in occipital and suboccipital venous outflow disturbances, and increased intracranial pressure. regions might be associated with risk of damage to the When operating in a sitting position, inadvertent sinus opening transverse venous sinus and the confluence of sinuses. We causes air embolism. Modern frameless neuronavigation systems analyze the value of magnetic resonance (MR) imaging in are useful in localizing venous sinuses before craniotomy, but they localizing the venous sinuses in relation to the superior are not yet widely available due to high price. Furthermore, when surgery is performed in a sitting or prone position, some diffi- muscle insertion line (MIL) on the occipital bone. culties with neuronavigation may occur. Many studies have been - METHODS: We retrospectively analyzed head MR im- conducted regarding the role of external skull bony landmarks in ages of 100 consecutive patients imaged for any reason localization of posterior venous sinuses. Our study is the first to from 1 January 2013. All MR images were interpreted by a analyze a simple and effective way to localize the venous sinuses in radiologist (R.K.). The superior MIL was identified at the relation to the superior muscle insertion line (MIL) on occipital bone. In this region, a surgical view after skin incision includes midline and on both midpupillar lines, which represent the (from cephalad to caudal) the occipital bone surface, MIL, and most frequent sites of skin incision and craniotomy (me- muscles covered by the superficial layer of cervical fascia. -
Duplication of Falx Cerebelli, Occipital Sinus, and Internal Occipital Crest
Romanian Journal of Morphology and Embryology 2009, 50(1):107–110 ORIGINAL PAPER Duplication of falx cerebelli, occipital sinus, and internal occipital crest SUJATHA D’COSTA, A. KRISHNAMURTHY, S. R. NAYAK, SAMPATH MADHYASTA, LATHA V. PRABHU, JIJI P. J, ANU V. RANADE, MANGALA M. PAI, RAJANIGANDHA VADGAONKAR, C. GANESH KUMAR, RAJALAKSHMI RAI Department of Anatomy, Centre for Basic Sciences, Kasturba Medical College, Bejai, Mangalore, Karnataka, India Abstract The incidence of variations of falx cerebelli was studied in 52 adult cadavers of south Indian origin, at Kasturba Medical College Mangalore, after removal of calvaria. In eight (15.4%) cases, we observed duplicated falx cerebelli along with duplicated occipital sinus and internal occipital crest. The length and the distance between each of the falces were measured. The mean length of the right falces cerebelli was 38 mm and the left was 41 mm. The mean distance between these two falces was 20 mm. No marginal sinus was detected. Each of the falces cerebelli had distinct base and apex and possessed a distinct occipital venous sinus on each attached border. These sinuses were noted to drain into the left and right transverse sinus respectively. After detaching the dura mater from inner bony surface of the occipital bone, it was noted that there were two distinct internal occipital crests arising and diverging inferiorly near the posterolateral borders of foramen magnum. The brain from these cadavers appeared grossly normal with no defect of the vermis. Neurosurgeons and neuroradiologists should be aware of such variations, as these could be potential sources of hemorrhage during suboccipital approaches or may lead to erroneous interpretations of imaging of the posterior cranial fossa. -
417.Full.Pdf
Postgrad Med J: first published as 10.1136/pgmj.38.441.417 on 1 July 1962. Downloaded from POSTGRAD. MED. J. (I962), 38, 4I7 THE SO-CALLED GENERAL SYMPTOMS OF INCREASED INTRACRANIAL PRESSURE Clinico-pathological Report Based on a Study of 100 Cases FATHY W. TADROS, PH.D., M.R.C.P.(Edin.), D.P.M. 0. H. SEROUR, M.CH. S. A. ZAKI, M.D., B.Sc. RASHAD SAKR, M.D., D.CH. From the Faculty of Medicine, Cairo University THERE has been much controversy regarding the in the cerebellum, brain stem and around the pathogenesis of the so-called general symptoms of aqueduct and 22 in the cerebrum; I2 cases were brain tumours. They are often ascribed to one or meningiomas, nine parasagittal, one in the lateral more factors which produce an increase in the sphenoid ridge, one suprasellar and one infra- intracranial pressure. It is generally accepted that tentorial in the pineal region. The rest comprised these factors are: firstly, the increase in the IO tuberculomas, eight cerebellar and two hemi- contents of the intracranial cavity produced by spherical; four pinealomas; two neurinomas; the size of the tumour and the surrounding cedema; two choroid carcinomas; one cranio-pharyngioma; secondly, the effect on the vascular system, one cholesteatoma; four hamangioblastoma cere- producing rise in the venous pressure; and, belli and two chronic abscesses, one cerebellar and thirdly, the effect on the flow of the cerebrospinal one temporal. fluid. In each case serial coronal sections of the braincopyright. The present work is devoted to the study of were made and the extent of the lesion verified. -
Tumors of the Meninges and Related Tissues: Meningiomas and Sarcomas
CHAPTER 30 Tumors of the Meninges and Related Tissues: Meningiomas and Sarcomas Kimberly P. Cockerham, John S. Kennerdell, Joseph C. Maroon, and Ghassan K. Bejjani ANATOMY OFTHE MENINGES Associations Dura Mater Diagnosis Arachnoid Treatment Pia Mater Adjuvant Therapy MENINGIOMAS Clinical Characteristics by Location Histogenesis SARCOMAS OFTHE MENINGES AND BRAIN Incidence Chondrosarcoma Pathology Osteogenic Sarcoma Cytogenetics Primary Sarcoma of the Meninges and Brain Endocrinology Rhabdomyosarcoma ANATOMY OF THE MENINGES The meninges of the brain and spinal cord consist of three into several freely communicating compartments. They in- different layers: the dura mater, arachnoid (tela arach- clude the falx cerebri, the tentorium cerebelli, the falx cere- noidea), and pia mater. Considerable anatomic differences belli, and the diaphragma sellae. exist among these structures, and these differences influence The falx cerebri, so named because of its sickle-like form, the nature, location, and spread of tumors that arise from is a fixed, arched process that descends vertically in the them. longitudinal fissure between the cerebral hemispheres (Fig. 30.2). The tentorium cerebelli is an arched lamina that is DURA MATER elevated in its midportion and inclines downward toward its peripheral attachments on both sides. It covers the superior The dura mater, typically referred to as the dura, is a thick surface of the cerebellum and supports the occipital lobes membrane that is adjacent to the inner table of the skull and (Fig. 30.2). The falx cerebelli is a small triangular process acts both as the functional periosteum of the skull and the of dura mater that lies beneath the tentorium cerebelli in outermost membrane of the brain (Fig. -
Dural Venous Sinuses Dr Nawal AL-Shannan Dural Venous Sinuses ( DVS )
Dural venous sinuses Dr Nawal AL-Shannan Dural venous sinuses ( DVS ) - Spaces between the endosteal and meningeal layers of the dura Features: 1. Lined by endothelium 2. No musculare tissue in the walls of the sinuses 3. Valueless 4.Connected to diploic veins and scalp veins by emmissary veins .Function: receive blood from the brain via cerebral veins and CSF through arachnoid villi Classification: 15 venous sinuses Paried venous sinuses Unpaired venous sinuses ( lateral in position) • * superior sagittal sinus • * cavernous sinuses • * inferior sagittal sinus • * superior petrosal sinuses • * occipital sinus • * inferior petrosal sinuses • * anterior intercavernous • * transverse sinuses • sinus * sigmoid sinuses • * posterior intercavernous • * spheno-parietal sinuses • sinus • * middle meningeal veins • * basilar plexuses of vein SUPERIOR SAGITTAL SINUS • Begins in front at the frontal crest • ends behind at the internal occipital protuberance diliated to form confluence of sinuses and venous lacunae • • The superior sagittal sinus receives the following : • 1- Superior cerebral veins • 2- dipolic veins • 3- Emissary veins • 4- arachnoid granulation • 5- meningeal veins Clinical significance • Infection from scalp, nasal cavity & diploic tissue • septic thrombosis • CSF absorption intra cranial thrombosis (ICT) • Inferior sagittal sinus - small channel occupy • lower free magin of falx cerebri ( post 2/3) - runs backward and • joins great cerebral vein at free margin of tentorium cerebelli to form straight sinus. • - receives cerebral -
An Anatomico-Radiological Study of the Grooves for Occipital Sinus in the Posterior Cranial Fossa
Bratisl Lek Listy 2008; 109 (11) 520524 COMPARATIVE ANATOMY An anatomico-radiological study of the grooves for occipital sinus in the posterior cranial fossa Srijit Das1, Azian Abd Latiff1, Farihah Haji Suhaimi1, Faizah Bt Othman1, Mohd F Yahaya1, Fairus Ahmad1, Hamzaini Abdul Hamid2 Department of Anatomy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia. [email protected] Abstract: Background: The occipital sinus (OS) lies in the attached margin of the falx cerebelli in the internal occipital crest of the occipital bone. The OS extends from the foramen magnum to the confluence of sinuses. Standard textbooks and research reports do not describe in detail any variation in the groove for the occipital sinus. Methods: In the present study, we examined a total of 50 human dried skulls for the groove of OS and its possible variations. We also performed an osteological study supplemented with digital X ray and CT scan. Results: Out of 50 skull specimens, a single case with two grooves for OS was observed (2 %). The two grooves for OS traversed as two limbs from the foramen magnum to join the other at the internal occipital protuberance. An accessory faint groove was also found at the lateral aspect of the left limb. Interestingly, in the same specimen, the superior sagittal sinus instead of continuing as right transverse sinus, continued as left transverse sinus. The X ray and CT scan of the anomalous bone specimen were compared to those of the normal bone specimen. Discussion: To the best of our knowledge, this is the first anatomico-radiological study of multiple OS groove with associated anomalies. -
Concussion and OMT Sports Medicine: Screening and Treating
Concussion and OMT Sports Medicine: Screening and Treating Sheldon C. Yao, D.O. March 14, 2019 Objectives • Define and discuss concussion diagnosis and screening. • Discuss how osteopathic manipulative medicine can be applied help address concussion injuries. • Discuss the application of osteopathic manipulation through the autonomic nervous, lymphatic, and musculoskeletal systems. • Review Fulford’s shock release, dural release, and venous sinus drainage and how it can help concussion symptoms. Concussion • Form of mild traumatic brain injury following a biomechanical force • Results in the rapid onset of short-lived impairment of neurologic function • LOC not necessary and does not correlate with severity • Centers for Disease Control and Prevention estimate that as many as 3.8 million sport- related traumatic brain injuries occur annually Pathophysiology • Concussion results from a rapid rotational acceleration of the brain which causes a shear strain which then induces immediate changes in brain neurochemistry : – Neuronal depolarization – Local lactic acid accumulation – Decreased cerebral blood flow with mismatch of cerebral glucose supply and demand Evaluation - History • Mechanism • Symptoms • Prior concussion • LOC • Change in mental status • Seizures Common Symptoms Evaluation: Sideline Assessment • Sideline eval: – ABC’s, C-spine evaluation – Neurologic exam – SPORT CONCUSSION ASSESSMENT TOOL (SCAT-5) – Balance Errors Scoring System (BESS) – King-Devick test • Suspected concussion = remove from play • Serial exams on sideline -
The Cranial Dura Mater: a Review of Its History, Embryology, and Anatomy
Childs Nerv Syst (2012) 28:827–837 DOI 10.1007/s00381-012-1744-6 REVIEW PAPER The cranial dura mater: a review of its history, embryology, and anatomy Nimer Adeeb & Martin M. Mortazavi & R. Shane Tubbs & Aaron A. Cohen-Gadol Received: 14 February 2012 /Accepted: 23 March 2012 /Published online: 15 April 2012 # Springer-Verlag 2012 Abstract mother) and umm al-raqiqah (thin mother). These terms were Introduction The dura mater is important to the clinician as then literally translated into Latin by the twelfth century Italian a barrier to the internal environment of the brain, and surgi- monk Stephen of Antioch, as the dura (hard) mater (Fig. 1), and cally, its anatomy should be well known to the neurosurgeon the pia (pious) mater. The term pia was a misnomer and should and clinician who interpret imaging. have been replaced by tenue (from tennus meaning thin), but Methods The medical literature was reviewed in regard to the term pia has persisted. The first introduction of the word the morphology and embryology of specifically, the intra- arachnoid (spider-like) mater was by Herophilus in the third cranial dura mater. A historic review of this meningeal layer century B.C., who also described its relation to the ventricles. It is also provided. was later described by the Dutch anatomist Frederik Ruysch in Conclusions Knowledge of the cranial dura mater has a rich the seventeenth century. The term mater is derived from ma- history. The embryology is complex, and the surgical anat- (from matru meaning mother) and the suffix -ter indicating a omy of this layer and its specializations are important to the state of being [41, 53].