No abstract

Echinococcus multilocularis (EM) is caused by the larval stage of the tapeworm. The main endemic regions for human alveolar echinococcosis are Central Europe, Russia, Turkey, Japan, China, Eastern France, North America. EM is an endemic disease in Turkey and especially common in the eastern Anatolia Region as seen in our case. The liver is the primary focus of the disease, cerebral localization is rare. Cerebral hydatid disease is approximately 5% of alveolar hydatid cases and generally considered to be fatal. Surgical treatment should be considerd whenever possible. We present a case of cerebral alveolar hydatid disease that was thought to be cerebral metastasis.

AIm: The connections of posterior commissure are defined. Its fibers mediate the consensual light reflex by interconnecting the pretectal nuclei. The fiber connections from the thalamic, pretectal, superior colliculus and the habenular nuclei are known, but they have not been shown anatomically. The present study is a fiber dissection study to define the anatomy of the posterior commissure. mAterIAl and methOds: Twenty formalin-fixed sheep heads were used in the study. The specimens were fixed in 10% formalin solution for 3 weeks. The arachnoidal and vascular structures were removed by using a surgical microscope magnification (x6-x40) and brains were again fixed for 4 weeks at -20°C. The fiber dissections were performed at Marmara University, Rhoton Laboratory. Also, a radiological tractographic study was carried on five healthy volunteers to see the posterior commissure cortical connections. results:In fifteen sheep brains, the dimensions of the posterior commissure were measured as 1.36 mm (range 0.5-2.5 mm) width, and as 4.6 mm (range 3-6 mm) length. In the dissection study, a frontotemporooccipital fascicle was observed to connect with the fibers of the posterior commissure. Diffusion tensor imaging scans showed the frontotemporooccipital tract to extend to posterior commissural region.COnClusIOn: To our knowledge, this is the first anatomical and tractographic study regarding the posterior commissure. However, further human cadaveric studies are necessary. BulGulAr: On beş koyun beyninde posterior komissür'ün ortalama kalınlığı 1,36 mm (0,5-2,5 mm), uzunluğu 4,6 mm (3-6 mm) olarak bulundu. Posterior komissür'ün her iki tarafta superior ve inferior kolikulusları bağladığı; habenula, pretektal, tektal ve periakuaduktal bölgeden kısa liflerle bağlantı kurduğu görüldü. Bazı spesimenlerde hipokampal komissür liflerinin splenial bölgede bu liflere eşlik ettiği izlendi. Talamik diseksiyondan sonra gözlenen frontotemporooksipital fasikülün posterior komissür'e uzandığı saptandı. sOnuÇ: Çalışmada diseksiyonla posterior komissür'ün frontotemporooksipitopontin bağlantısı gösterilmiştir. Araştırma posterior komissür'ün lif bağlantılarını ortaya koyacak insan kadavra çalışmalarıyla desteklenmelidir.

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.

We found a linear relationship between the axon density of the OMNs and pupillary diameters. High degenerated neuron density in the OMNs may be responsible for an unresponsive pupillary that has not been mentioned in the literature.