scholarly journals Occipital condyle syndrome as the first manifestation of a rectal tumour

2020 ◽  
Vol 35 (6) ◽  
pp. 417-419
Author(s):  
M. Martín Asenjo ◽  
J.M. Martín Guerra ◽  
J. Galvan Fernández ◽  
M. Martín-Luquero Ibañez ◽  
J.M. Prieto de Paula
Author(s):  
Aldo Eguiluz-Melendez ◽  
Sergio Torres-Bayona ◽  
María Belen Vega ◽  
Vanessa Hernández-Hernández ◽  
Erik W. Wang ◽  
...  

Abstract Objectives The aim of this study was to describe the anatomical nuances, feasibility, limitations, and surgical exposure of the parapharyngeal space (PPS) through a novel minimally invasive keyhole endoscopic-assisted transcervical approach (MIKET). Design Descriptive cadaveric study. Setting Microscopic and endoscopic high-quality images were taken comparing the MIKET approach with a conventional combined transmastoid infralabyrinthine transcervical approach. Participants Five colored latex-injected specimens (10 sides). Main Outcome Measures Qualitative anatomical descriptions in four surgical stages; quantitative and semiquantitative evaluation of relevant landmarks. Results A 5 cm long inverted hockey stick incision was designed to access a corridor posterior to the parotid gland after independent mobilization of nuchal and cervical muscles to expose the retrostyloid PPS. The digastric branch of the facial nerve, which runs 16.5 mm over the anteromedial part of the posterior belly of the digastric muscle before piercing the parotid fascia, was used as a landmark to identify the main trunk of the facial nerve. MIKET corridor was superior to the crossing of the accessory nerve over the internal jugular vein within 17.3 mm from the jugular process. Further exposure of the occipital condyle, vertebral artery, and the jugular bulb was achieved. Conclusion The novel MIKET approach provides in the cadaver straightforward access to the upper and middle retrostyloid PPS through a natural corridor without injuring important neurovascular structures. Our work sets the anatomical nuances and limitations that should guide future clinical studies to prove its efficacy and safety either as a stand-alone procedure or as an adjunct to other approaches, such as the endonasal endoscopic approach.


2021 ◽  
Author(s):  
Cristina Toledo-Gotor ◽  
Nerea Gorría ◽  
Miren Oscoz ◽  
Katia Llano ◽  
Pablo la Fuente Rodríguez-de ◽  
...  

Abstract Background Multiple lower cranial nerve palsies have been attributed to occipital condyle fractures in older children and adults, but no clinical details of other possible mechanisms have been described in infants. Case Report A 33-month-old boy suffered blunt head trauma. A bilateral skull base fracture was diagnosed, with favorable outcome during the first days after trauma. On the sixth day, the patient began to refuse drinking and developed hoarseness. Physical examination and additional investigations revealed paralysis of left VII, IX, X, and XI cranial nerves. A follow-up computed tomography (CT) scan disclosed a left petrous bone fracture involving the lateral margin of the jugular foramen, and a cranial magnetic resonance imaging (MRI) study showed a left cerebellar tonsil contusion. He improved after methylprednisolone was started. Three months later, he was asymptomatic, although mild weakness and atrophy of the left sternocleidomastoid and trapezius muscles remained 1 year later. Discussion A posttraumatic “jugular foramen syndrome” is rare in children, but it has been reported shortly after occipital condyle fracture, affecting mainly IX, X, and XI cranial nerves. In this toddler, delayed symptoms appeared with unilateral involvement. While an occipital fracture was ruled out, neuroimaging findings suggest the hypothesis of a focal contusion as a consequence of a coup-contrecoup injury. Conclusion This exceptional case highlights the importance of gathering physical examination, anatomical correlation, and neuroimaging to yield a diagnosis.


Author(s):  
Henri Lassila ◽  
Tero Puolakkainen ◽  
Tuomas Brinck ◽  
Michael Wilson ◽  
Johanna Snäll

2019 ◽  
Vol 80 (S 04) ◽  
pp. S355-S357
Author(s):  
Robert T. Wicks ◽  
Xiaochun Zhao ◽  
Celene B. Mulholland ◽  
Peter Nakaji

Abstract Objective Foramen magnum meningiomas present a formidable challenge to resection due to frequent involvement of the lower cranial nerves and vertebrobasilar circulation. The video shows the use of a far lateral craniotomy to resect a foramen magnum meningioma. Design, Setting, and Participant A 49-year-old woman presented with neck pain and was found to have a large foramen magnum meningioma (Fig. 1A, B). Drilling of the posterior occipital condyle was required to gain access to the lateral aspect of the brain stem. The amount of occipital condyle resection varies by patient and pathology. Outcome/Result Maximal total resection of the tumor was achieved (Fig. 1B, C), and the patient was discharged on postoperative day 4 with no neurologic deficits. The technique for tumor microdissection (Fig. 2) is shown in the video. Conclusion Given the close proximity of foramen magnum meningiomas to vital structures at the craniocervical junction, surgical resection with careful microdissection and preservation of the overlying dura to prevent postoperative pseudomeningocele is necessary to successfully manage this pathology in those patients who are surgical candidates.The link to the video can be found at: https://youtu.be/Mds9N1x2zE0.


2012 ◽  
Vol 3 ◽  
Author(s):  
Alejandro Hornik ◽  
Federico Rodriguez-Porcel ◽  
Cagatay H. Ersahin ◽  
Ruth Kadanoff ◽  
José Biller
Keyword(s):  

2006 ◽  
Vol 177 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Marie Pincemaille-Quillevere ◽  
Eric Buffetaut ◽  
Frédéric Quillevere

Abstract Since the 19th century, the Campanian and Maastrichtian continental deposits of southern France have yielded numerous dinosaur remains [Le Loeuff, 1991; 1998; Buffetaut et al., 1997; Laurent et al., 1991; Allain and Suberbiola, 2003]. The ornithopod remains that have not been referred to the hadrosaurids have been systematically attributed to Rhabdodon [Buffetaut and Le Loeuff, 1991; Buffetaut et al., 1996; Garcia et al., 1999; Pincemaille-Quillévéré, 2002]. This genus, initially named by Matheron [1869] after its discovery in the lower Maastrichtian of La Nerthe (Bouches-du-Rhône), belongs to the Euornithopoda [sensu Sereno, 1999]. Rhabdodon represents the most common element of the dinosaur assemblages from the late Cretaceous of southern France [e.g. Allain and Suberbiola, 2003]. Nevertheless, since the localities have only provided some fragmentary material [Pincemaille-Quillévéré, 2002], the global morphology of this dinosaur and its phylogenetic placement within the euornithopods are still debated. The cranial morphology of Rhabdodon is particularly poorly understood due to the rarity of cranial remains preserved in the localities of southern France [Matheron, 1869; Garcia et al., 1999; Buffetaut et al., 1999; Pincemaille-Quillévéré, 2002]. Buffetaut et al. [1999] first mentioned the discovery of a braincase (M4) referred to Rhabdodon, at Massecaps, a locality close to the village of Cruzy (Hérault, France). More recently, a new braincase (MN25) has been discovered at Montplô Nord, another locality close to Cruzy (specimens M4 and MN25 are conserved in the Museum of Cruzy). Both these localities have revealed a diverse and abundant vertebrate fauna suggesting a late Campanian to early Maastrichtian age [Buffetaut et al., 1999]. These braincases are described here in an attempt to detect potential autapomorphic characters in Rhabdodon, and compared to a more complete braincase of Tenontosaurus, an euornithopod from the Lower Cretaceous of North America, considered as the sister group of Rhabdodon [Weishampel et al., 1998; 2003; Garcia et al., 1999; Pincemaille-Quillévéré, 2002], in order to determine the potential differences and synapomorphies between the occiputs of the two genera. Finally, the braincases from Cruzy are compared to those of the other euornithopods described in the literature. Specimen M4 (figs. 1–4) is incomplete but exceptionally well preserved. This braincase belongs to a juvenile individual, as shown by the numerous visible suture lines between the different cranial elements. Specimen MN25 (fig. 5) is badly deformed and attributable to an adult individual. Until now, all the ornithopods from the Upper Cretaceous of southern France have been referred either to hadrosaurs or to Rhabdodon. The Hadrosauridae show a low nuchal crest and their exoccipitals meet and form a bar on the dorsal border of the foramen magnum, excluding the supraoccipital from this border. Specimens M4 and MN25 do not present any nuchal crest and the supraoccipital participates in the dorsal border of the foramen magnum. Both braincases M4 and MN25 are therefore attributable to Rhabdodon. Specimens M4 and MN25 have been compared to the occiput of a juvenile Tenontosaurus tilletti (fig. 6 : MCZ 4205, conserved in the Museum of Comparative Zoology, Harvard University). This reveals that Tenontosaurus and Rhabdodon share numerous characters : (1) the exoccipitals form the lateral borders of the foramen magnum, its ventral border being occupied by the basioccipital; (2) the occipital condyle is partly constituted by the exoccipitals, and in the same proportions; (3) the supraoccipital is rostrally oriented; (4) the suture line located between the prootic and the laterosphenoid shows the same outline; (5) the cresta prootica starts within the paroccipital process and extends onto the opisthotic; (6) the cresta prootica is transversal and non-horizontal; (7) the distribution of the cranial nerves is homologuous along the lateral surface of the braincase. Nevertheless, the braincase of Tenontosaurus differs from that of Rhabdodon in several significant respects : (1) the exoccipitals are dorsally connected, excluding the supraoccipital from the dorsal border of the foramen magnum; (2) two small dorsal humps are present at the level of the suture of the exoccipitals; (3) the supraoccipital is excluded from the dorsal border of the foramen magnum, which gives it a triangular shape; (4) the paroccipital processes are short, laterally flattened, and wing-shaped, and are more mediodorsally oriented than in Rhabdodon; (5) the cresta prootica follows a concave line and ends up on the prootic, at the level of the opening of the trigeminal nerve; (6) the external curve of the laterosphenoids is stronger; (7) the suture between the basioccipital and the opisthotic is very clear. The first of these unshared characters suggests that Rhabdodon belongs to Norman’s [1984] ‘hypsilophodontoid’ clade and Tenontosaurus to the more evolved ‘iguanodontoid’ clade. The fusion of the exoccipitals on the dorsal border of the foramen magnum, together with other cranial adaptations, may have reduced the stress caused by a more elaborate mastication. Rhabdodon appears to have had a more primitive type of mastication. The strip formed by the reunion of the exoccipitals is less expanded dorsoventrally in Tenontosaurus tilletti than in the ‘iguanodontoid’ and ‘hadrosauroid’ clades. Tenontosaurus may therefore represent an intermediate group between the ‘hypsilophodontoid’ and ‘iguanodontoid’ clades.


1934 ◽  
Vol 9 (2) ◽  
pp. 84-85
Author(s):  
H. S. Meade
Keyword(s):  

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