The anatomical variations of the circle of Willis were probably genetically determined, develop in early embryonic stage and persist in post natal life. The amplitude of neck movements, racial, environmental and hemodynamic factors may also modify these variations. These anomalies may alter the occurrence, severity of symptoms, treatment options and recovery from certain cerebrovascular disorders viz., stroke and aneurysms. A detailed knowledge of the vascular variants is useful to surgeons in planning their shunt operations, choice of the patients and also keeps away inadvertent vascular traumas during surgeries.

During routine anatomical dissection, we encountered a unilateral variation in the insertion of Palmaris longus tendon on the right upper limb of an 82-year-old formalin embalmed, male cadaver. The fusiform muscle belly of Palmaris longus with dimensions 17.5×1.5×0.95 cm, proximally originated from medial epicondyle of the humerus, along with the other superficial flexor muscles of forearm. The muscle belly prolonged downwards into two separate well-formed flattened tendons at the middle of the forearm, 9 cm proximal from wrist, ran towards the wrist covering flexor digitorum superficialis and median nerve, on the medial side of flexor carpi radialis tendon [Table/ Fig-1a]. The superficial tendon was thicker, size 10.5×0.75 cm, passed over the flexor retinaculum, and at the distal half of the retinaculum, it is divided into three slips. The central slip, thick, broad and shiny, appeared to be the main continuation, merged with apex of the flattened palmar aponeurosis. The lateral collateral slip, thicker and stronger, was fused with the deep fascia covering abductor and flexor pollicis brevis muscles and contained few muscle fibres of origin of these muscles. The medial collateral slip, relatively small and thin, merged with deep fascia covering abductor and flexor digiti minimi [Table /Fig-1b]. The deep tendon was relatively thin, size 9.5×0.5 cm, passed deep to flexor retinaculum and faned out to merge with transverse tendinous fibres of flexor retinaculum [Table /Fig-1c].The Palmaris longus tendon on the left side of forearm was normal as in textbook morphology. DisCussionPalmaris longus, a superficial flexor of the forearm, arises from medial epicondyle of humerus by the common flexor origin, from adjacent intermuscular septum, and also from antebrachial fascia. The slender, fusiform belly converges into a long flattened tendon in the middle of the forearm, runs on the medial side of flexor carpi radialis, crosses the wrist superficial to flexor retinaculum, and terminates into a flat palmar aponeurosis. A few fibres interweave with the transverse fibres of the flexor retinaculum. It is supplied by median nerve of brachial plexus through C7 and C8 segments of spinal cord.It is a week flexor of metacarpo-phalangeal and carpometacarpal joints, but mainly anchor the skin and fascia of the hand and in resisting the horizontal shearing forces in distal direction, as in holding a golf club [1]. The most frequent variations include complete absence in one or both sides; anomalies in the form and location of

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Bilateral hydroureteronephrosis involves the dilatation of the renal pelvis, calyces and ureter; it develops secondary to urinary tract obstruction and leads to a build-up of back pressure in the urinary tract, and it may lead to impairment of renal function and ultimately culminate in renal failure. Although clinically silent in most cases, it can be diagnosed as an incidental finding during evaluation of an unrelated cause. In a minority of patients, it presents with signs and symptoms. Renal calculus is the most common cause, but there are multiple non-calculus aetiologies, and they depend on age and sex. Pelviureteric junction obstruction, benign prostatic hypertrophy, urethral stricture, neurogenic bladder, retroperitoneal mass and bladder outlet obstruction are some of the frequent causes of hydroureteronephrosis in adults. The incidence of non-calculus hydronephrosis is more common in males than in females. Ultrasonography is the most important baseline investigation in the evaluation of patients with hydronephrosis. Here, we report a rarely seen case of bilateral hydroureteronephrosis associated with a hypertrophied, trabeculated bladder in an adult male cadaver, suspected to be due to a primary bladder neck obstruction, and analyse its various other causes, clinical presentations and outcomes.

Objective:The aim of this study is to measure the height and volume of the bony part of the posterior cranial fossa (PCF) and the surface area of the foramen magnum (FM) using computed tomography (CT) scans and to correlate our clinical findings with the available current literature.Materials and Methods:This cross-sectional study was conducted in a tertiary care referral hospital in the Southern part of India during the period from January 2015 to August 2015. A total of 100 CT scans of the suspected head injury patients were collected retrospectively form the basis for this study. The height, volume of PCF and the anteroposterior (AP), transverse diameter, and surface area of the FM were measured. The values of all parameters were subjected to statistical analysis using SPSS version 16.Results:The age of the patients were ranged between 18 and 70 years with the mean age of 41.22 ± 13.93 years. The dimensions of the posterior fossa and FM were larger in males compared to females. The mean height of the posterior fossa was 38.08 (±4.718) mm (P = 0.0001), and the mean volume of the posterior fossa was 157.23 (±6.700) mm3 (P = 0.0001). The mean AP, transverse diameter, and the surface area of the FM were 33.13 (± 3.286) mm, 29.01 (± 3.081) mm, and 763.803 (±138.276) mm2, respectively.Conclusion:The normal dimensions of the posterior fossa and FM were less in females than males and were useful to radiologists and neurosurgeons to better their diagnostic inferences, as well as to determine the proper treatment options in Chiari malformation type I (CMI) and other posterior fossa anomalies. The posterior fossa tissue volume can be reliably measured in patients with CMI using our method. More studies were required because there were variations in dimensions among individuals of different races in different regions of the world.