A previously unrecognized connection between occipital condyle fractures and internal carotid artery injuries (carotid and condyles)

2006 ◽  
Vol 12 (4) ◽  
pp. 192-195 ◽  
Author(s):  
James Y. Chen ◽  
Gregory Soares ◽  
Robert Lambiase ◽  
Timothy Murphy ◽  
Walter Biffl
PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5686 ◽  
Author(s):  
Yanina Herrera ◽  
Juan Martín Leardi ◽  
Marta S. Fernández

Thalattosuchians are a group of Mesozoic crocodylomorphs known from aquatic deposits of the Early Jurassic–Early Cretaceous that comprises two main lineages of almost exclusively marine forms, Teleosauridae and Metriorhynchoidea. Teleosaurids were found in shallow marine, brackish and freshwater deposits, and have been characterized as semiaquatic near-shore forms, whereas metriorhynchids are a lineage of fully pelagic forms, supported by a large set of morphological characters of the skull and postcranial anatomy. Recent contributions on Thalattosuchia have been focused on the study of the endocranial anatomy. This newly available information provides novel evidence to suggest adaptations on the neuroanatomy, senses organs, vasculature, and behavioral evolution of these crocodylomorphs. However, is still not clear if the major morphological differences between teleosaurids and metriorhynchids were also mirrored by changes in the braincase and endocranial anatomy. Based on X-ray CT scanning and digital endocast reconstructions we describe the braincase and endocranial anatomy of two well-preserved specimens of Thalattosuchia, the semiaquatic teleosaurid Steneosaurus bollensis and the pelagic metriorhynchid Cricosaurus araucanensis. We propose that some morphological traits, such as: an enlarged foramen for the internal carotid artery, a carotid foramen ventral to the occipital condyle, a single CN XII foramen, absence of brain flexures, well-developed cephalic vascular system, lack of subtympanic foramina and the reduction of the paratympanic sinus system, are distinctive features of Thalattosuchia. It has been previously suggested that the enlarged foramen for the internal carotid artery, the absence of brain flexures, and the hypertrophied cephalic vascular system were synapomorphies of Metriorhynchidae; however, new information revealed that all of these features were already established at the base of Thalattosuchia and might have been exapted later on their evolutionary history. Also, we recognized some differences within Thalattosuchia that previously have not been received attention or even were overlooked (e.g., circular/bilobate trigeminal foramen, single/double CN XII foramen, separation of the cranioquadrate canal from the external otic aperture, absence/presence of lateral pharyngeal foramen). The functional significances of these traits are still unclear. Extending the sampling to other Thalattosuchia will help to test the timing of acquisition and distribution of these morphological modifications among the whole lineage. Also comparison with extant marine tetrapods (including physiological information) will be crucial to understand if some (and/or which) of the morphological peculiarities of thalattosuchian braincases are products of directional natural selection resulting in a fully adaptation to a nektonic life style.


2013 ◽  
Vol 75 (5) ◽  
pp. 896-903 ◽  
Author(s):  
Gaurav Jindal ◽  
Manuel Fortes ◽  
Timothy Miller ◽  
Thomas Scalea ◽  
Dheeraj Gandhi

Neurosurgery ◽  
2004 ◽  
Vol 55 (1) ◽  
pp. 143-154 ◽  
Author(s):  
Marcelo D. Vilela ◽  
Robert C. Rostomily

Abstract OBJECTIVE: The preauricular subtemporal-infratemporal (PSI) approach is commonly used to resect clival tumors and other lesions anterior to the brainstem. One of the surgical steps in this approach is a condylar osteotomy or a condylectomy, which often leads to temporomandibular joint dysfunction. We describe a modification of the PSI approach that preserves the temporomandibular joint without sacrificing the ability to mobilize the petrous internal carotid artery or gain surgical access to the clivus and anterior brainstem. METHODS: Anatomic studies in cadaveric specimens were performed, and the extent of exposure of critical skull base and intradural structures was documented with postdissection fine-cut computed tomographic scans. This modification of the PSI approach was subsequently used in three consecutive patients with a clival chondrosarcoma, and the completeness of tumor resection was documented with postoperative magnetic resonance imaging and computed tomographic scans. RESULTS: This approach allowed complete mobilization of the petrous internal carotid artery and surgical access to the mid-lower clivus, jugular tubercle, hypoglossal canal, occipital condyle, anterior brainstem, and the origin of the trigeminal through hypoglossal nerves. It also proved to be safe and feasible in the three patients who underwent surgical resection of a clival chondrosarcoma, allowing a complete tumor removal. CONCLUSION: This variation of the PSI approach is practical, has no additional morbidity, and provides complete access to critical cranial base regions and tumor margins. It can certainly be used as an alternative to the standard PSI approach when dealing with clival tumors and other lesions anterior to the brainstem.


2020 ◽  
Vol 11 ◽  
pp. 357
Author(s):  
Mohammed Bafaquh ◽  
Sami Khairy ◽  
Mahmoud Alyamany ◽  
Abdullah Alobaid ◽  
Gmaan Alzhrani ◽  
...  

Background: Internal carotid artery (ICA) injuries are a major complication of endoscopic endonasal approaches (EEAs), which can be difficult to manage. Adding to the management difficulty is the lack of literature describing the surgical anatomical classification of these types of injuries. This article proposing a novel classification of ICA injuries during EEAs. Methods: The classification of ICA injuries during EEAs was generated from the review of the literature and analysis of the main author observation of ICA injuries in general. All published cases of ICA injuries during EEAs in the literature between January 1990 and January 2020 were carefully reviewed. We reviewed all patients’ demographic features, preoperative diagnoses, modes of injury, cerebral angiography results, surgical and medical management techniques, and reported functional outcomes. Results: There were 31 papers that reported ICA injuries during EEAs in the past three decades, most studies did not document the type of injury, and few described major laceration type of it. From that review of the literature, we classified ICA injuries into three main categories (Types I-III) and six sub-types. Type I is ICA branch injury, Type II is a penetrating injury to the ICA, and Type III is a laceration of the ICA wall. The functional neurological outcome was found to be worse with Type III and better with Type I. Conclusion: This is a novel classification system for ICA injuries during EEAs; it defines the patterns of injury. It could potentially lead to advancements in the management of ICA injuries in EEAs and facilitate communication to develop guidelines.


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