Morphometric study of the human brainstem and its neurovascular relations

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AIM: To present the particularities of the intraorbital foreign bodies from a neurosurgical perspective by summarizing the findings of a case series. MATERIAL and METHODS: A retrospective study was conducted including a consecutive series of 30 patients with intraorbital foreign bodies treated between 1999 and 2017. Statistical analysis was performed in order to characterize the factors that influence the location of the foreign bodies and the clinical signs. RESULTS: The orbital trauma occurred mostly in working accidents. Multiple intraorbital foreign bodies were found in 23.3% of the patients. Metallic foreign bodies were seen in 66.6%, and 30% had wooden foreign bodies. Nonmetallic foreign bodies were significantly associated with displacement of the eyeball, palpebral oedema and upper lid ptosis. Posterior orbit location was associated with displacement of the eyeball and conjunctival hemorrhage. Intraconal location was associated with mydriasis and conjunctival hemorrhage. The posterior orbit was occupied by foreign bodies in 63% of the patients. The foreign bodies were in the extraconal compartment in 55.55% of the cases. Small foreign bodies tend to be retained in the anterior orbit while large ones tend to be retained in the posterior orbit. CONCLUSION: The diagnosis and management of intraorbital foreign bodies must be tailored according to their type and location and to the clinical aspect of the patient.

Section: A E C B F D Location Of the Foreign Bodymentioning

confidence: 99%

Intraorbital penetrating and retained foreign bodies –a neurosurgical case series

Szabo

Paşcalău²,

Bartoè³

et al. 2019

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“…Although the anatomical variants do not directly impair brain perfusion, they may increase the risk of neurological diseases by two main mechanisms: they may influence collateral perfusion (5,8,37), leading to vascular and neurological surgery complications (1,12,19,27,30,38), cerebral infarcts (3,17), migraine (9,10), or even psychiatric diseases (14,23), or the imbalanced branching geometry present in some variants can predispose to wall shear stress (2,5,29), associated with the formation and rupture of intracranial aneurysms (6, 13,26,29), and with atherosclerosis (7, 29). How each particular variant influences these processes is not fully understood.…”

mentioning

confidence: 99%

The geometry of the circle of willis anatomical variants as a potential cerebrovascular risk factor

Paşcalău¹,

Padurean²,

Bartoş³

et al. 2018

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“…The morphology of the dorsal brainstem is also important in surgical approaches for the fourth ventricle tumors. The dorsal surface of the brainstem has an intraventricular portion, the rhomboid fossa, which is the floor of the fourth ventricle, and an extraventricular portion represented by the tectal plate and the cerebellar peduncles (14). The rhomboid fossa has the shape of a diamond and is delineated by the internal margins of the superior and inferior cerebellar peduncles.…”

Section: █ Discussionmentioning

confidence: 99%

“…The rhomboid fossa has the shape of a diamond and is delineated by the internal margins of the superior and inferior cerebellar peduncles. The lateral angles of the rhombus are closed by the middle cerebellar peduncles, the inferior angleis the obex, and the superior corner is marked by the frenulum of the superior medullary velum of the fourth ventricle (14).…”

Section: █ Discussionmentioning

confidence: 99%

“…Szabo et al performed a research on 10 formalin fixed brainstem specimens, which were harvested with respect to the topographic anatomy and their macroscopic measurements were performed with a Vernier caliper (14). They evaluated many anatomic structures but similarly to us they measured facial colliculi paramedially located at the base of the triangle prospective MRI study done by Raz et al, the age and sex differences in the cerebellum and the ventral pons were reported, and they concluded that the cerebellum and pons were larger in men.…”

Section: █ Discussionmentioning

confidence: 99%

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Morphometric assesment of the external anatomy of fourth ventricle and dorsal brainstem in fresh cadavers

Antar¹,

Türk²,

Katar³

et al. 2018

In the literature, various surgical techniques and approaches have been developed previously, and morphometric studies have been conducted using either imaging methods or cadavers (1,2,4,5,6,9,10,15). However, most of the cadaveric studies were conducted using formalin and alcohol-fixed cadavers, and they were comprised of small sample sizes (1,2,15). Unfortunately, formaldehyde can cause structural changes in the brainstem, which can affect the morphometric values. █ INTRODUCTION T he surgical management of fourth ventricle and brainstem pathologies, particularly with regard to tumors, remains a surgical challenge (8). Therefore, a detailed knowledge of the anatomy of the area involved, and a determination of the safe entry points are key factors involved in a successful surgical outcome (3). AIM: To investigate the external anatomy of the fourth ventricle and dorsal brainstem using morphometric data, which could be useful for preoperative surgical planning. MATERIAL and METHODS: Between January 2017 and December 2017, 42 fresh adult cadavers were investigated for the measurements of the cadaver brainstems and fourth ventricle, and they were recorded by photography. Measurements were evaluated according to body mass indexes (BMIs) of the patients. We also investigate the visualization of facial colliculus and stria medullaris on brainstem. RESULTS: A total of 42 fresh cadavers with a mean age of 45.38 ± 16.41 years old were included in this research. We found no statistically significant difference between measurements and BMIs. Facial colliculus was visualized in 92.9% (n=39), but it could not visualized in 7.1% (n=3) of the subjects. When the right side of the stria medullaris was examined, one bundle was seen in 59.5% (n=25) of the subjects, two bundles were seen in 31% (n=13) of the subjects, and 3 bundles were seen in 9.5% (n=4) of the subjects. When the left side of the stria medullaris was examined, one bundle was seen in 57.1% (n=24) of the subjects, two bundles were seen in 33.3% (n=14) of the subjects, and three bundles were seen in 9.5% (n=4) of the subjects. CONCLUSION: Knowledge of the normal morphometry of the dorsal brainstem as it has been reported in this study will help one to assess distortions in any preoperative imaging studies and surgical planning.